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Archive for the "Glad You Asked - Q&A" Category

Overweight But Otherwise Healthy – Still At Risk?

Dear Timi,
Although I’m probably thirty to forty pounds over my ideal weight, I’m healthy and feel fine about being a little chunky. I eat well and exercise regularly. Should I still be concerned about being overweight?

Dear Reader,
Yes, you should, and here’s why: Being thirty or more pounds overweight puts you clearly at risk for heart disease, stroke, hypertension, diabetes and also cancer. You may not suffer from any weight-related effects on your health right now, but the risks will increase over time. You say that you generally adhere to a health-conscious lifestyle. So, my guess is that your portion sizes are probably too generous, and you may want to start cutting back your servings and see what happens. Read more »

Q&A Sessions About Your Health Concerns

Glad You Asked Q&A sessions are listed in the order of their publication. You may also search for specific topics by key word(s) or by date. Please leave your questions and comments to be addressed in future issues.

 
Overweight But Otherwise Healthy – Still At Risk?
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I’m Trying to Lose Weight, But I’m Not Getting the Support I Need
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Crash Diets – Do They Work?
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What’s Wrong With Carbonated Sodas?
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Kids Can Gain Weight in Response to Stress
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Picky Eaters – How Concerned Should You Be if Your Child Refuses to Eat Right?
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Jet Lag, Not as Harmless as You May Think
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Food in a Pill, How Important Are Vitamins and Supplements?
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Fruit Drinks, A Cause for Concern?
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Is Fast Food Especially Bad For Young Kids and Teenagers?
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How Safe Are Water Bottles and Plastic Food Containers?
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“Organically Grown Produce” – Is It Worth the Extra Money?
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Strictly Vegetarian, Too Radical?
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Children With Food Allergies
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Is There a Right Way to Diet?
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Fasting for Weight Loss and What Else?
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Multivitamin Supplements for Children
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How Safe is Your Refrigerator?
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What’s Wrong With Carbonated Sodas?

Dear Timi,
The controversy over a new “soda tax” – an extra tax on soft drinks – has me thinking about my own kids’ soda consumption. I’ve never paid much attention to the issue before, but now I wonder if I do them a disfavor by letting them have as many soft drinks as they want. Am I worrying too much?

Dear Reader,
No, in fact you should be worried about giving your kids sodas. The whole tax issue aside, I believe that sodas, especially when consumed in large quantities, are indeed harmful for our kids’ health – and not just because they contain lots of empty calories from sugar. Unfortunately, it is only the issue of weight gain in connection with sodas that drives the current discussion. What bothers me as much, however, is the fact that almost all diet and regular sodas are carbonated.

Carbonated drinks have high levels of phosphoric acid (phosphate) and carbonic acid. Elevated acidic levels can cause an imbalance of calcium (an alkaline mineral) in our blood stream. Under normal circumstances, our body’s natural mechanism maintains a steady ratio of calcium to phosphate in the blood (also known as “acid base balance” or “blood pH”) with the help of a healthy diet.

However, if we overindulge in foods and beverages that throw off the delicate acid-alkaline balance, the body has to struggle hard get it back by adding calcium. The more phosphate from carbonated drinks is ingested, the more calcium is needed. If that calcium is not supplied in sufficient quantities from food products, such as milk, cheese, salmon and sardines (with bones), dark green leafy vegetables and the like, calcium that is already stored in the body will be “pulled” from bone mass and teeth, thereby damaging their density. Severe osteoporosis and premature loss of teeth may result in later years.

For growing kids, an acid-alkaline imbalance is especially harmful, because potentially serious damage to their bone structure is being done at a critical time when they build up their bone mass that has to last for a lifetime. The consumption of large amounts of carbonated drinks can jeopardize this process. And once the damage is done, it is very hard to reverse.

For me, as a dietitian and health counselor who has worked with children for many years, carbonated drinks rank almost as high as tobacco products and alcohol in their potential to cause great harm, especially at a young age.

In absence of any government regulations to speak of, we consumers have to educate ourselves about the facts of carbonated drinks, so we can make better informed choices for ourselves and on behalf of our children.

Jet Lag – Not as Harmless as You May Think

Dear Timi,
I travel a lot on business, mostly to the Far East. In the beginning, I have had some symptoms of jet lag, mostly being fatigued for a few days. I was hoping that I would get used to long distance travel and changing time zones. Over time, however, my symptoms have worsened and I now seem unable to get back into my regular sleep pattern for weeks. What should I do? I have to travel, but I fear that suffering from constant jet lag is going to affect my health.

Dear Reader,
Jet lag, also called desynchronosis, affects many air travelers who travel across different time zones. The cause is the inability of the body to adjust fast enough to a new schedule. This can lead to fatigue, insomnia, irritability as well as digestive discomforts, such as constipation or diarrhea. Most people can adjust their circadian rhythm to a new situation within a few days, depending on the geographical distances they travel.

Direction also matters. Travelers flying north or south stay close to the same time zone and therefore experience fewer problems. Those going east, on the other hand, “lose time” by flying against the clock, if you will. Respectively, those flying west “gain” time. By traveling to the Far East, depending on the route you’re taking, you may unfortunately experience the severest symptoms of jet lag.

You are right to be apprehensive about your reaction to jet lag. Frequent flyers like you are at risk of developing chronic symptoms of jet lag, which then indeed may become cause for concern. Here is a reason: A small part in our brain, called the hypothalamus, is in charge of activating a number of diverse body functions, such as hunger, thirst and sleep. It also helps to regulate body temperature, blood pressure, blood sugar and certain hormones. If the hypothalamus acts out of sync with the environment, it causes the kind of problems we experience when we’re jet lagged. If this inner “confusion” continues for a long time and without reprieve, it may lead to a series of potential health problems, such as elevation of blood pressure, blood glucose and hormonal imbalances.

Assuming that you cannot simply change your work schedule or find another line of work, I can only advise you to apply any means necessary to minimize the effects of your jet lag before things get worse. I suggest you start with the most obvious remedies at your disposal. First and foremost, stay in shape. A physically fit body can handle a lot more abuse than a frail one. So, exercise, eat nutritious food and rest as much as you can whenever you find some downtime. Second, don’t add toxins to your system, such as alcohol, nicotine and caffeine. Drink plenty of water instead. Third, spoil yourself as often and as much as possible. If you can afford it, travel first class or business class where the seats are wider and give you enough leg room to bed down. Be discriminating about your hotel accommodations. Your sleep is interrupted enough without additional disturbances from noisy streets and the likes.

There are also a number of “anti jet lag diets” you may want to look into. I personally find most of them rather cumbersome and hard to follow, though.

The effectiveness of hormonal treatments of jet lag, e.g. with Melatonin, is still disputed among the experts. Melatonin is the hormone released by the hypothalamus to promote sleep. You have to start taking it days before your departure, but it may make your symptoms worse if you don’t get the timing right.

I also advise strongly against taking sleeping pills to fight jet lag – especially before or during your flight. Sleeping pills put you in a comatose state during which you will remain more or less immobilized for long periods of time. Such prolonged immobility in an uncomfortable position may lead to the forming of blood clots with potentially fatal results.

If your jet lag symptoms keep getting worse, you should definitely consult with your physician and see what else can be done in terms of medication. The worst you can do is to ignore the messages your body is sending you. Safe trip!

Picky eaters – How concerned should you be if your child refuses to eat right?

Dear Timi,
My three year old must be the pickiest eater in the world. I’m having the hardest time to make him eat at least one full meal a day. It is beginning to concern me that he may not get even his most basic nutritional needs met. I have tried many things to trick him into eating without much success and I’m reaching the end of my wits. Any ideas how to convince this little “hard head” that he must eat his food?

Dear Reader,
Most kids go through phases where they test your strength and resolve as well as their own. The dinner table is just one of the battlefields. And it is not always about food, even when food is the issue of contention. If you don’t take the bait and don’t make a big deal out of it, it will eventually subside. Keep offering your son a variety of healthy foods, and don’t ever try to bribe him with treats of lesser nutritious quality, such as candy or ice cream. It’s a myth to think that kids have naturally a sweet tooth.

In the section of this blog titled “Kids Love Healthy Foods,” I express my belief that kids learn to love healthy foods as much as they learn to love anything. All preferences in a child’s life are learned, including eating preferences. It’s up to you as the parent to channel that learning process in the right direction. The best way to go is by example. If you  practice what you preach, e.g. eat a healthy diet yourself, buy wholesome foods, keep to regular meal times, sit down for dinner with the entire family, etc. – your kids will naturally adopt. Once they reach the age where they make lifestyle decisions for themselves, your influence will be gone. So, you better lay the tracks now.

Kids can gain weight in response to stress

Dear Timi,
My 12-year old grand-daughter is getting chunky. I’m alarmed by this since she was always a healthy and athletic girl who never had any weight concerns until now. Her parents are getting divorced and I suspect that her newly acquired eating disorder has something to do with the stress she’s experiencing from this unfortunate event in her life. What can I do to prevent her from becoming overweight or worse?

Dear Reader,
Kids respond to stressful situations in similar fashion as we adults do, except that they have a more pronounced sense of helplessness added. When dramatic changes occur in a child’s life, such as their parents getting a divorce, their whole world gets turned upside down. So they reach for the few tools they have at their disposal to cope with the situation as well as they can. Dysfunctional and destructive behavior can result in response to the traumatic impact events like these have. Reaching for food may give them comfort and help them to calm down their anxieties. It may also be a cry for help. Some children blame themselves for their parents’ actions and seek ways to punish themselves out of misguided feelings of guilt. And there is also the turmoil that comes with the dissolving of a household. Sit-down family dinners give way to irregular eating habits. Unsupervised kids are not likely to maintain a healthy diet regimen on their own. If pizza delivery and fast food joints are the most convenient options, parents will be tempted to go for the easy road when they already have a hard time holding things together.

As a grandparent, provided you live nearby and you’re in a position to offer any help, you can prepare a few “extra healthy” dishes for your grand-daughter or invite her to share a sit-down meal with you every so often. Perhaps you can take her to a nearby farmers market or health food store and initiate a conversation about the benefits and pleasures of eating fresh, tasty and nutritious foods. At twelve, she can be treated like an adult in these matters and as a grandparent, you may be in a better position than her parents to bring a little stability into her life when she needs it the most. If nothing else, you let her feel that she is still being loved and cared for.

Of course, it would be naive to think that insisting on good nutrition could take anything away from the pain a child goes through in a situation like this. However, weight issues and other potential health problems only add to the damage that is being done to this young life. Therefore, I wish to encourage you to take appropriate action along the lines I mentioned, based on your observations and hopefully in agreement with the parents, if that is at all possible.

Natural Sugar or High-Fructose Corn Syrup – An Issue for Your Health?

Dear Timi,
I’m confused. For the longest time, I have been trying to avoid high-fructose corn syrup by not using items that are notoriously loaded with them, such as sodas and fruit juices that are not made from 100% fruit. I do the same for my kids. Lately, however, I read that there is no real scientific evidence that natural sugar is healthier than fructose made from corn, although some manufacturers explicitly advertise the exclusive use of natural sugar in their products as a better, albeit pricier choice.

Dear Reader,
You are not the only one who is getting mixed signals on this subject. There are indeed conflicting messages from the food manufacturing industry as well as the medical science community.

High-fructose corn syrup was developed in the 1970s as a sweetener, not just for sodas but also for countless other food products. In fact, high-fructose corn syrup serves not only as a sweetener, but more predominantly as a preservative. It is made by changing sugar, which is glucose, in cornstarch to fructose, which is another form of sugar. The end product consists of a mixture of both, fructose and glucose. Because it helps to extend the shelf life of processed foods and drinks, and because it is much cheaper than natural sugar, high-fructose corn syrup has become extremely popular among food and drink manufacturers. You will find it not only in sweet tasting products, but also in bread, cereal, pasta, soups, canned vegetables, salad dressings, ketchup and even in supposedly “healthful” items such as flavored yogurt.

So far, researchers have not been able to come up with irrefutable evidence that high-fructose corn syrup is harmful to our health. There is suspicion that our body processes the fructose from corn syrup differently than it does cane or beet sugar, and that this may alter the metabolism. It may be that this process also makes the liver release more fat into the bloodstream.

Most experts on the subject agree, however, that it is mostly the omnipresence of high-fructose corn syrup in processed foods that may promote weight gain which, in turn, can have many other negative health implications. In other words, it is perhaps not so much the quality but the quantity of the fructose we consume that is unhealthy.

For example, a single 12-ounce can of soda contains as much as a dozen teaspoons of sugar in the form of high-fructose corn syrup. According to the U.S. Department of Agriculture (USDA), the average American consumes more than 62 pounds of sugar every year. Especially children and teenagers may be at risk. A few years ago, The American Journal of Clinical Nutrition reported that since 1965 milk consumption among teenagers has continuously declined – although milk is an important source of calcium which a growing body needs – while the consumption of sodas and fruit drinks has more than doubled. Our kids are overloaded with sugar from early on by a diet that is dominated by sodas and processed foods. Today, we lament an epidemic growth of childhood obesity, type-2 diabetes and hypertension. And the adults are not better off. Most of us eat too much sugar, whether we intend to or not, and the results are plain to see.

So, if you want to escape the sugar trap, limit your intake of processed foods as much as possible, stick to fresh produce, stay away from sugary drinks and, most importantly, cut down on your portion sizes no matter what you put on the table. Good luck!

Food in a Pill, How Important Are Vitamins and Supplements?

Dear Timi,
We are a middle-aged couple and in great shape. We eat healthy and exercise every day. I pride myself in having a healthy lifestyle and do everything I can to maintain a balanced diet, and I also take a daily dose of vitamin supplements. My husband thinks it’s overkill to add vitamin pills to our diet and calls it a waste of money. Do you think he’s right?

Dear Reader,
Vitamins and minerals are essential nutrients in charge of regulating bodily functions, such as energy generation, muscle contraction, and fluid balance, to mention a few. They don’t supply any calories and are only needed in small quantities. Supplements cannot and should not be taken in lieu of a well balanced diet. However, having said that, a daily multivitamin with 100% of vitamins and minerals  is a good way to cover your bases, whether your diet is balanced or not.

Overdosing on water-soluble vitamins (vitamin C and B-complex) is possible but unlikely. Excessive amounts pass through the system and get eliminated in the urine. Fat-soluble vitamins (A, D, E, and K), on the other hand, are stored in fat cells and can build up to toxic levels if consumed in large doses.

Minerals (calcium, chloride, chromium, copper, fluoride, iodine, iron, magnesium, manganese, molybdenum, phosphorus, potassium, selenium, sodium, and zinc), are absorbed in the body as well. Excess amounts can be harmful to the liver and the kidneys. This is especially important if you are on medication that may interfere with the metabolism of nutrients, or if you follow a restricted diet for medical reasons.

Here is a short list of some important vitamin and mineral functins:

• Vitamins A, C, E, the mineral selenium (all antioxidants), B-complex vitamins, iron, and zinc strengthen the immune system.

• Vitamins B-6, B-12, and folic acid lower high homocysteine levels – one of the risk factors for heart disease.

• Thiamin, riboflavin, niacin, B-6, B-12, folic acid, biotin, and pantothenic acid (all B-complex vitamins) play an important role in energy metabolism.

• Calcium, phosphorus, magnesium, and vitamin D help to build and maintain strong bones and teeth.

• B-12, folic acid, and iron are key in preventing anemia. Folic acid can also protect against neural tube birth defects like spina bifida. 400 mcg/day are recommended during childbearing age.

• Vitamins A, C, E, and the mineral selenium (antioxidants) decrease the risk of heart disease and certain types of cancer.

• Iron, a trace mineral, is essential in the formation of hemoglobin (carries oxygen in the blood) and myoglobin (carries oxygen in muscle). Deficiency symptoms include microcytic anemia, fatigue, and decreased immune function.

• Potassium, a major mineral, helps maintain the body’s acid-base balance, muscle contractions, and nerve impulses. It also aids the regulation of blood pressure and water balance in cells.

• Zinc, a trace mineral, is necessary for cell division, growth, wound healing, and proper functioning of the immune system. It also plays an important role in carbohydrate metabolism, DNA replication, taste and smell acuity.

Some known risks and side effects with prolonged overdose are:

Vitamin A  – Liver damage, headache, fatigue, nausea, vomiting.
Vitamin B-6  – Nerve damage, weak and numb muscles.
Vitamin C  – Diarrhea, kidney stones, urinary tract abnormalities.
Vitamin D – Kidney, heart, and blood vessel damage.
Folic acid – High doses may mask B-12 deficiency symptoms.
Calcium – Constipation and an increased risk of kidney stones.
Iron – Tissue damage in the liver with prolonged overdose.
Niacin - Liver damage and abnormal gastrointestinal function.
Potassium – Cardiac arrest.
Selenium – Tissue damage in selenium-concentrating organs.
Zinc – Intestinal irritation, impaired copper status, impaired
immune function.

Source: USDA Food and Nutrition Information Center

Fruit Drinks, A Cause For Concern?

Dear Timi,
My kids have discovered they like fruit drinks made at home from scratch. It’s all fresh fruit they are getting, so it’s supposed to be healthy, right? Should I be happy or worried?

Dear Reader,
Daily servings of fresh fruit are a good idea at any age and certainly beneficial for kids. Fruit is high in fiber and carbohydrate and has practically no fat, except for coconut and avocado (yes, that is a fruit too). The greatest benefits come from vitamin C and beta carotene and also from plant chemicals found in citrus fruits, berries, watermelons, grapes and apples.

Potentially negative side-effects of blenderized fruit drinks may be caused by the high sugar and calorie content. High quantities of fruit sugar can increase blood sugar levels to a degree that insulin secretion becomes elevated. This, in turn, may cause a “rebound drop” of blood sugar to a new low. The result is more intense craving for sugar. Overindulgence in high sugar drinks is one of the leading causes of obesity today. My advice to you: Everything in moderation – even the healthy stuff.

What about those Juice Smoothies?

Same thing. Made with fresh ingredients, smoothies are nutrient-dense and high in vitamins, minerals, phytochemicals and fiber. The downside is that when you blenderize fruit this much, you do essentially the stomach’s digestive work in advance by breaking down the fiber and the chemical structure of the fruit. Therefore, the nutrients become more readily available for absorption. If the digestive process is cut short, a higher concentration of sugar from the fruit reaches the blood stream and elevates the blood sugar level quickly. The same effects occur that I described above.

Also, most smoothies contain additional ingredients other than fruit, such as milk or soy. Typically, they are 20 to 32 ounces in size and can contain as many calories as a full meal. Some have a high fat level from added milk or yogurt. Read the ingredients list carefully before you buy commercially produced fruit drinks and smoothies and watch the serving sizes.

Is Fast Food Especially Bad For Young Kids and Teenagers?

Dear Timi,
I have always been an advocate for healthy eating and have tried to educate my children well in this regard. My thirteen year-old, however, likes to spend time with his friends hanging out at fast food places. I noticed that he’s getting a bit chunky lately. I don’t want to take away the fun he’s having, since we live in a small town where there’s not much to do for kids, but his weight gain concerns me. What should I do?

Dear Reader,
You are not alone. Most parents struggle at one time or another with their children’s eating habits. Teenagers especially, who are in the process of separating themselves from home and trying to find their own identity, will sometimes use food as a tool to assert their independence, simply because that may be an area where they have more control. This doesn’t have to give cause for alarm, unless someone develops serious eating disorders in the process.

I don’t think that’s the case with your son, though. Food may not even be the main issue. From the way you describe it, he just likes spending time with his friends and, unfortunately, that includes regular visits at fast food places – which is not a good idea at any age and certainly not for kids who are growing and are particularly in need of sound nutrition. If negative effects are already showing in terms of weight gain, it may be time to have a serious talk. You say that healthy eating habits are well established in your household. That should make it easier for you to remind your son of the importance of a balanced diet. It would be much harder if bad eating habits were common in your family and lifestyle changes had to be imposed on everyone.

Unfortunately, there is a certain urgency in all this. The damage your son is doing to his body right now may have serious consequences for his health later in life. In a few years, you will have less influence and control over your children’s lifestyle choices, and once they have money in their pockets and are old enough to drive, they are out of your reach.

Another obstacle that works against you is the omnipresence of fast food joints. Even in small towns like yours, they can be found on almost every corner. Health care professionals and policy makers have long urged legislation that keeps fast food outlets away from school grounds – obviously without much success. Worse yet, many schools depend on the funds they receive from snack food- and soft drink manufacturers for allowing them to sell their products on or near campus. Don’t expect for these policies to change any time soon.

So, what can parents in your situation do? As always, good communication is key. Your son is old enough to have a mature conversation about your concerns. At first, he may refuse to listen, but in my experience as a mother, nothing is really lost on teenagers, even if they pretend otherwise.

How Safe Are Water Bottles and Plastic Food Containers?

Dear Timi,
I’m concerned about using plastic water bottles and food containers since I read that there is increasing evidence that they are not safe and perhaps hazardous to our health. Do you have any more specific information on this subject?

Dear Reader,
There have been several studies on this subject. The one that was published recently by the Journal of the American Medical Association (JAMA) got a lot of attention. According to this study, higher levels of urinary Biphenol A (BPA), a chemical compound used in many plastic containers made for packaging of food and beverages (including plastic water bottles), have been found in individuals who have been diagnosed with cardiovascular disease, diabetes and liver problems. The Food and Drug Administration (FDA) has not yet released an official statement about BPA but has scheduled a hearing. BPA is widely used in the industry and various levels of the chemical have been detected, according to researchers, in more than 90 percent of the U.S. population.

Since no government action has been taken yet to eliminate BPA from the production process of plastic containers, you may have to take matters in your own hand. There are plastic containers available that are BPA free and they are advertised as such. Or you may switch to products made of stainless steel or other materials.

“Organically Grown Produce” – Is It Worth the Extra Money?

Dear Timi,
For many years, I have been careful to buy only organically grown produce. Unfortunately, organic fruits and vegetables are becoming more and more expensive than the non-organic version. I’m convinced that organic foods taste better and are overall healthier. I‘m also concerned about health risks posed by pesticides, fertilizers and other agricultural pollutants. However, I begin to wonder whether the difference in quality is worth the ever increasing costs.

Dear Reader,
Yes, there is a significant price difference between organically and non-organically grown produce – as much as 50 percent and more, depending where you do your shopping. Whether it’s worth it to spend that much more money is a matter of personal choice.

Originally, organic farming started out as a grassroots movement. The initial intent may have been to return to pre-industrial farming methods, whatever people thought they were. In that sense, organic farming was first and foremost a countercultural phenomenon. But then the whole thing evolved into a profitable industry and the federal government became involved by putting out strict regulations and giving it its own seal of approval. Consequently, many common agricultural practices were restricted – such as the use of certain pesticides and fertilizers as well as certain animal farming methods – in return for the government’s endorsement. Unfortunately, many of these policies, as well-intended as they may have been, have also caused widespread confusion among consumers. As a result, a lot of myths have been created about the meaning of organic farming.

Since I cannot address here all the pros and cons of organic versus regular farm products, let me just make a few sketchy remarks: Limiting your exposure to toxic chemicals, whether they stem from pesticides, fertilizers or unsound animal farming methods, is always a good idea and, if necessary, worth the extra investment. However, “organic” does not automatically mean “safe,” it does not even have to mean “healthy.” You can buy “organic” crackers or cookies – that does not make them more nutritionally beneficial than others. I personally prefer to buy foods that are “locally grown,” or use “sustainable farming methods.” Why? Because it gives me a chance to meet my food suppliers directly. By developing personal relationships with local farmers at the farmers market or by visiting their farms, I’m in a much better position to judge the quality of the food I’m buying. Last but not least, buying directly from the source also eliminates the middleman, making the prices more affordable.