How Much Iron Should I Take for my Anemia?

Hi, Thank you for taking my question.
I have been diagnosed with anemia since I was a teenager. It seems once a year I have been told by a doctor to take iron pills, or eat liver. I am not going to eat liver. I was wondering if I eat beef, though, how much should I eat a day, should I eat it more than daily or just a number of days a week? 

Kristin K.

Hi Kristin,

First of all I want to clarify there are several different types of anemia. I'm assuming yours is from iron-deficiency since your doctor has suggested iron pills. (But an FYI to others with anemia, it may be related to a deficiency of vitamin B12, folic acid, or even vitamin E--so know that taking iron does nothing to help any condition other than iron-deficiency anemia).

The daily value for dietary iron is 18 milligrams. Supplement pills have 2 to 5 times as much iron as this, depending on the chemical form of the supplement. You could never get this amount in a reasonable diet--it's nearly impossible just to meet the RDA--so the pills would make a much bigger difference in your condition. A 3-ounce serving of ground beef has less than 2.5 milligrams; the same portion of liver has 6 milligrams. So they can't even come close to what an iron supplement can do for you.

It seems there is some reason you are reluctant to take the supplements that you are told to take every year. I'm not sure why that is. Perhaps if you don't feel bad you're not inclined to treat your condition. In fact, some people are used to their low hematocrit and hemoglobin (measures of the red blood cells) and don't have symptoms. If this is the case, you may just opt to walk around slightly anemic. 

On the other hand, you may like to try an experiment: take the iron pills as prescribed for 2 months and see if you notice an increase in your mood and energy level as your blood levels rise to normal--wouldn't that be nice!

For more on iron-deficiency anemia click here for a summary from a reputable site. 

How Many Calories Do I Need?

One question I hear all the time is "How many calories should I be eating a day?" This, of course, varies greatly from person to person. It depends not only on your weight but also your height; the taller you are the more you burn because you have more lean body tissue and this lean tissue (muscle) uses more energy than fat. It depends on whether you are male or female; men typically have more muscle mass, so they burn more calories (not fair!). It depends how old you are because after a certain age (around 35) we start burning fewer calories and that number continues to decrease gradually as we continue to age. Finally, it greatly depends on your activity level because if you get a lot of exercise you naturally burn a lot more calories.

Here's a quick and convenient way to estimate how many calories you need. Multiply your weight by 15 to get the number of calories you need per day to maintain your weight. If you weight 150 pounds and you are happy with this weight, you need (15 x 150) approximately 2250 calories a day to maintain it. This is a very general starting point, because from these numbers we don't know whether you are male or female, active or sedentary, young or older. It's just an estimate.

If you would like to lose weight, multiply your present weight by 10. If you weigh 180 pounds and you would like to weigh less, a good estimate is for you to eat (10 x 180) 1800 calories a day. Again, it depends on how active you are, how tall you are, and whether you are male or female (a man could lose weight faster on this calorie level than a woman), but it's a good place to start.

Play around with the range of 10 to 15 times your weight. If you weigh 160 pounds, look at the numbers from 1600 (160 x 10) to 2400 calories (160 x 15). You would probably lose at least a pound a week by limiting your calorie intake to 1600 calories, and you would probably not lose if you ate 2400 calories a day. Remember if you are middle-aged, female, less than 5'4", and/or not very active, you will need to keep your calories in the lower part of this range to lose, and maybe even to maintain your weight.

If you are very overweight (say, 250 pounds or more) you should multiply the weight you would like to be by 15 to find a good starting calorie level. People who are nearly 100 pounds overweight are carrying that extra weight as fat tissue, which does not burn nearly the calories of our muscles and lean tissue. A 250 pound woman might aim for (170 x 15) 2550 calories to start losing weight if her goal is to weigh 170 pounds. It sounds like a very high calorie level for weight loss to occur, but people who are this heavy are usually eating more than 2500 calories a day! Therefore, reducing your intake to less than you usually eat will result in weight loss. You do not have to start with a 1200 calorie diet and starve yourself to lose weight. It's okay to lose one or two pounds a week.  Eat a little less; take your time with weight loss. Make it permanent!

Check out my website for details on hiring your own personal weight-loss coach to work one-on-one with you, catering to your unique circumstances. Or try some of the products for do-it-yourself, or for a bit of assistance each week.

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Is Sea Salt Better Than Table Salt?

I keep hearing that sea salt is better than regular iodized salt. What is different in sea salt? And is table salt another kind different from iodized salt?  Ken R.

Hi Ken,
I hear this question frequently and it can be very confusing. First it's important to know that all salt is sodium-chloride. Period. And all salt contains the same content of sodium and chloride, no matter where it's from or how it's used.


That said, different textures of salt can have different uses. Because sea salt has larger grains than table salt, the perceived taste may be preferable on certain dishes. On the other hand, the smaller grains of table salt are spread across your tongue easier, and using less can bring more of the flavor.
There is also an anti-caking agent added to most brands of regular table salt, and some people believe that interferes with the pure salt taste.


Iodized salt has iodine added to it as a vehicle to provide this essential mineral to diets across the states. It dates back to the first part of the 20th century when goiter (the iodide-deficiency disease) was found rampant in the northern part of the midwest where soil was iodine-poor. Nowadays we have access to food from all over the world and we don't see nearly as many people with mineral deficiencies.


Bottom line: Choose whichever texture you prefer and experiment with different types on different foods. Be sure to limit your use, especially if you are prone to high blood pressure or kidney disease. And remember that a large portion of sodium in the diet of many Americans comes from processed, smoked, and canned foods as opposed to using too much salt at the table.

How Can I Stop Eating Junk Food?

Hi,
I've recently noticed that I have been eating a lot of snacks and junk food. It might just be summer boredom. But when I get bored, I find myself eating again. I can never seem to get full. I'll find myself standing over the snacks and looking for which ones I want first. It's gotten a bit worse lately. I just can't seem to stop eating so much junk.

My diet in general is kind of poor. I want to change my diet, but It's hard. I try to, but always end up eating the same old things until I get sick of them. All I eat is basically junk food.
How do I stop eating so much junk food, and change my diet to something more healthy?

Ginger R.

Hi Ginger,
That's tough. Because junk food tastes so good and makes us feel so good when we eat it. You may have to just keeping doing it until the suffering (do you really feel awful about it?) outweighs the pleasure you get from eating it. Until you are suffering in some obvious way ("my clothes don't fit!") the scales will always tip towards the pleasure of eating sweet and salty snacks.

If you want to make a change, you're going to have to come up with some motivation. Here's the task: Write down the top 5 reasons you want to stop eating junk food and improve the healthfulness of your diet. Usually these will be non-descript one-word answers like "health". Well, that doesn't sound very motivating. Take each of these words another step and ask "Why is health important to me?" Keep asking that question of each answer until you come up with a darn good reason to stop eating junk food! For some people it's, 'My parents both have diabetes and I know that's what's in store for me if I don't get down to a reasonable weight' and for others it's more like, 'I feel terrible about myself and look horrible in my clothes--most of which don't even fit anymore--so I never go out with my friends anymore and I miss them'.

Then establish a reward system. Give yourself credit (in the form of a star sticker on a calendar or a dollar in a jar) every time you make the right move, and choose a glass of water instead of a handful of cookies, or a piece of fruit instead of a candy bar. Have an established reward, like a pedicure after 20 stars, or a new pair of shoes when the jar has enough $$ in it. This way you'll be working towards something you want in addition to feeling better about making the right choice. Chances are, you'll feel much better physically as well. And, in time, the junk food won't have the same hold on you, and avoiding it will become easier.

I would just like to lose 10 pounds

Hi, I feel a little funny writing because I only want to lose 10 pounds. It's not even a matter of health. I just know I would feel better if I were 10 pounds lighter. I'm a 41 year old female, 5'4" weighing 140 pounds. I just want to get back to where I was a few years ago. I don't know what changed--I can't think of anything--and I am so frustrated I don't know where to start. Can you just point me in the right direction. It's so confusing hearing about all the diets I'm not sure what would work. I don't really think a diet is the right answer. Cynthia F.

Hi Cynthia,
It's quite common to put on a few pounds over several years and not even realize it. Keep in mind that by changing just 20 calories a day--that's right, just 20!--you can gain two pounds a year. So it's not even noticeable...until a few years later when you're up 8 or 10 pounds. Now the clothes are getting tight--now it's serious!
So how do you lose it? The same way you gained it. Only, hopefully a bit quicker!

Take a look at some small things that may have changed in your lifestyle: Did you pick up a habit like having a creamy latte at your Monday meetings or an ice cream or alcoholic beverage after work on Fridays? Did you stop taking 2 flights of stairs because you changed jobs or moved from where you used to live? Have you slacked on your exercise routine because you're dating someone new? Or started eating out more than you used to (it's terribly difficult to watch calories when you don't know what's in that dish you ordered).

Even if you can't figure it out, it's easy to find a way to cut 100 calories from your diet and lose that 10 pounds over a year. Want to lose it quicker? Lose another 100 or so from sweets and added fats, and add a 100-calorie burning exercise, like just a 20-minute walk in the evening.

My best advice is always to keep a food and exercise diary. There are a lot of websites that make this easy, or you can do it the old-fashioned way (I do) with just a pencil and paper. Writing down what you eat makes you think about it and acknowledge it. Knowing that cinnamon roll could stand between you and that pound you want to lose this month may just be all the motivation you need to say no!

Think about having a buddy to partner with, or even a coach to get you started and staying on track (www.mycoachlaurie.com has a list of products and services). A lot of the websites keep you motivated by letting you link to other buddies, and award you token 'prizes' for staying the course.

Whatever you choose be sure it's the right way for you--it shouldn't be too complicated or rigid, and should eventually become a healthy habit, so you'll never find yourself in this situation again :)

What Does a 1200-Calorie Diet Look Like?

Hi,
I'm trying to lose weight, and being that I'm a woman in my 60's I find it harder than ever to get a few pounds off. I am trying to find a 1200-calorie diet to follow as I understand that's what it would take for me to lose this weight. I'm not sure how to go about planning my meals. Can you help?
Doris E.

Hi Doris,
It's likely you may find a 1200 calorie diet challenging, depending on how you normally eat. It's true we need fewer calories as we age, and especially women of shorter stature require precious few calories to prevent weight gain. Here's what a basic 1200-calorie diet would look like, with a few alternatives suggested.

Breakfast: 1 egg or 1/2 cup low-fat cottage cheese with 2 slices of "light" bread (40 calories per slice) and 1 cup of berries or melon. [an alternative is a bowl of high-fiber cereal with skim milk and fruit--this saves a protein serving for a morning snack, which could be a hard-boiled egg or string cheese sticks].

Lunch: Salad tossed with lots of fresh vegetables and 2 oz chicken, tuna or turkey (go very easy on the dressing--even lo-cal--as it can add up to over a hundred calories for every couple of tablespoons) and yogurt, saving starch for an afternoon snack, like a granola bar [alternative meal would be (1) lite lunchmeat on light bread with a small salad and fruit, or (2) a baked potato with plain yogurt and veggies--saving some calories for an afternoon snack such as cheese and crackers].

Dinner: 2-3 ounces of meat (preferably fish, chicken, or very lean beef or pork) with a side of about 1 cup of rice or pasta, cous cous, etc and about 1/2 your plate full of fresh vegetables like broccoli, carrots, zucchini, green beans or brussels sprouts. [If you choose to make dinner basically protein and veggies, you can save starches and a few grams of fat for an evening snack of peanut butter and graham crackers or a skinny cow ice cream treat].

Basically it's restricting portions of virtually everything you eat, and very limited in fat and sweets. You could add diet soda and diet jello, in moderation, as well as tea and coffee which have no calories.

Unfortunately most people stay on a diet like this for a few weeks, then go back to the way they were eating before and gain whatever they lost.
My advice is always to first try limiting and cutting back on some of the things you eat, allowing a slow and steady weight loss without suffering.

Does Milk Have Too Much Acid?

Hi,
I keep hearing that we shouldn't drink milk because it can make your body too acid. I like milk and I've always thought I was doing my body good, getting a concentrated source of calcium for my bones. And I drink skim milk so it's a good protein source without fat. Am I wrong? Is it really not good for me?
Staci R.

Hi Staci,


I've heard these rumors as well, and let me put your mind at ease--there is absolutely NO truth to this at all. 
In fact, the pH balance in your body (usually this refers to your blood pH) is controlled by your lungs and your kidneys. These organs tightly regulate the blood pH to between 7.35 and 7.45 at all times. They can adjust by retaining or excreting certain compounds in the body, such as CO2.

Stomach acid is more acidic than anything you can ever eat, even the much maligned coca-cola. (Coca-cola has a pH of about 2.8 and stomach acid between 1.0 and 2.0). 
After leaving the stomach, contents are neutralized on their way into the first section of the small intestine by release of bicarbonate (a strong basic compound contained in pancreatic juices). 

There is no way you can eat so much acidic food or so much basic food (the opposite of acid, these foods have a high pH) that it throws your body pH out of whack. The only times we see people have acid-base imbalance is (1) severe advanced lung illness, (2) severe advanced kidney disease (or acute kidney injury), or (3) diabetic ketoacidosis (a life-threatening condition caused by extremely high ketone levels in untreated diabetes). Even the ketosis-promoting carb-free diets cannot affect the pH of your system because the healthy kidneys and lungs correct for this.


Some people have to limit their intake of highly acidic foods because of indigestion called GERD, and others have to limit foods that make their stomach cells secrete more acid, like chocolate, caffeine and peppermint. These conditions are limited to the stomach and esophagus.


Bottom line: There really isn't any way acid foods make their way into the blood to affect the pH of your system.