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Frequently Asked Questions
on Nutrition
Questions from visitors to our Ask-an-Expert
site might provide the answers you're looking for!
| Q | | What is wrong with eating dinner late at night? | | A | | While we hear often that it is best not to eat dinner late at night, there is no research to suggest that it is a problem. Latin and European cultures often eat their evening meal at 10PM. However, it is typically a small meal and they usually have "tea" with food at about 4-5PM.
Eating dinner late at night is often cited as associated with weight gain; however, there is no research to support this. What is associated with weight gain is the U.S. tradition of eating dinner between 5-7PM and then snacking throughout the evening, unconsciously, while watching TV into the late hours.
To keep a healthy metabolism it is best to eat every 4-5 hours. Eating lunch at noon and waiting to eat dinner at 11PM at night could increase the risk that you might overeat because you are extremely hungry after no food for 11 hours. People tend to eat more and faster when they are very hungry.
| | | Answered at 4/20/2005 | | |
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| Q | | My mother has high potassium levels and the doctor told her to eat less of the types of food with high potassium content. What foods would this be? | | A | | Primarily, fruits, vegetables and juices. The highest sources of potassium include: potato, tomato, melons, beans (lima, kidney, pinto), pumpkin, spinach, banana, kiwifruit, pomegranate, dried fruit, orange juice, and tomato juice. Milk also has a significant amount of potassium. Also be careful to avoid salt substitutes made with potassium.
| | | Answered at 1/3/2005 | | |
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| Q | | I am 32, in pretty good shape and I have started to take on weight. I am now overweight (BMI 26). Although I exercise 3 times per week, I always feel very hungry and find it extremely difficult to avoid eating during the day. I have also tried to improve what I am eating. On the advice of my doctor, I am now considering taking Meridia for a short period of time, to help loose some of the weight and help me fight my food cravings.
However, we are considering having a baby. I am wondering if they are any side effects (especially on conception) that I should be aware of. As said, I am in good shape, no medical problems, no other medication and normal blood pressure.
| | A | | First of all, Meridia would not be indicated for you. A BMI of 26 is just not that bad. Secondly, I generally frown on using a drug for this purpose unless there is a major current health problem (or risk) due to obesity. I'm doubtful any study has shown whether or not Merida can affect male fertility, but it seems unlikely. I recommend considering a low carbohydrate diet such as The South Beach Diet. People generally have fewer cravings on a low carb diet and weight loss can progress pretty rapidly in many cases, making it especially attractive.
| | | Answered by Frank Littell, MD, Hospitalist, Springfield, PeaceHealth Hospital Medicine (12/1/2004) | | |
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| Q | | I have a question about vitamins. I take Equate Multivitamins. I also take calcium. I take these in the morning with Zelnorm and Prilosec. Is it beneficial to take two multivitamins, or is that a bad idea? I have always taken two. Someone mentioned that if too many are taken, they can become toxic in the system. I would like to know what guidelines are appropriate. | | A | | Taking a multivitamin to supplement a healthy diet is probably not necessary, but neither is it harmful. Taking two multivitamins could potentially lead to toxicity from the fat soluable vitamins A and D. These vitamins accumulate in the liver and, over time, can reach toxic levels if too much is taken. Taking extra calcium is probably good as long as not more than 2500 mg calcium per day is not exceeded (twice the recommended intake). Because the Prilosec you take decreases stomach acid, calcium citrate might be the preferred calcium salt, as calcium carbonate is poorly absorbed without stomach acid.
| | | Answered at 10/28/2004 | | |
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| Q | | My sister is a non-stop dieter although at 5' 4" and 130 lbs, I feel she is at a healthy weight. She also walks, runs and lifts free weights regularly. There is a strong history of heart disease in my family and I worry about her and her "diet-pills". Before ephedra was taken out of Zenedrine (sp?) she was taking it and did have spells of increased heart rate and dizziness. She even tried the non-ephedra version and still had these similar reactions, just not as extreme. She's tried several forms of diet pills since and her new diet excursion is CortiSlim. This morning she had really bad tightness in her chest and felt like she couldn't breathe. She was reluctlant to tell me that she started taking CortiSlim a day or two ago. I know they are being hit hard by the FTC but would any of the ingredients in this cause heart problems or bring on a heart attack? She won't listen to me and says that there was nothing in the information that came with the pills saying anything about causing heart complications. CortiSlim is relatively new and I was just concerned for my sister's health. I can't seem to find anything else on the web about this "supplement" causing any physical health problems. Please provide your opinion on whether CortiSlim can cause health problems or heart problems. | | A | | I think your concern about your sister is justified. Your sister is smaller than the "average" person, so an "average" dose would be a large dose for her. A person with a family history of heart disease should be very careful about taking supplements containing stimulants. So called "dietary supplements" are not obligated to carry warnings of their side effects and often make unsubstantiated claims of their effectiveness. CortiSlim contains green tea and bitter orange, which can inhibit liver enzymes. Green tea contains caffeine, and bitter orange can also inhibit the metabolism of caffeine. This product also contains the ingredient synephrine. Synephrine is a stimulant similar to ephedrine, which is contained in the herb ephedra (ma huang). Ephedra products were removed from the U.S. market due to safety concerns. Ephedra is linked to stroke, heart attack, seizures, and other serious side effects.
| | | Answered at 10/25/2004 | | |
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| Q | | What are some of the side effects of using Cortislim? | | A | | Cortislim and similar products are more accurately classified as appetite suppressants. They are advertised as ephedra free but contain synephrine, an ephedra like drug. Tremor, anxiety, and insomnia may occur with this product. A better alternative would be a 2000 kcal/day diet and 20 minutes of daily exercise.
| | | Answered by John Holroyd, MD, Internal Medicine, Bellingham, PHMGW/IM 2A-Cordata (9/30/2004) | | |
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| Q | | Is fiber contraindicated while taking Coumadin/Tinzaparin inections? I come in to your TCU every day for the above medication, trying to reach an INR goal of 2.5 & after 6 injections, I'm not there yet. I consume 2 to 4 slices of 8 grain, high fiber bread daily, in addition to a large bowl of oatmeal. Is this keeping me from absorbing the meds? | | A | | It is more likely your vitamin K intake. The fiber should not make a difference, but warfarin is in direct competition with vitamin K for vitamin K dependent clotting factors (II, VII, IX, and X). Vitamin K is found in green leafy vegetables, milk, dairy products, meats, eggs, cereals, and fruits. You should talk with the pharmacist about your diet. It is important to keep vitamin K intake consistent.
| | | Answered at 9/27/2004 | | |
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| Q | | Is there an internet site that I can log on to find out the foods that will be better for my diet --(that won't cause gas)? I am really in need of help, any suggestions is appreciated. I was thinking about changing my diet to consist of more herbs and/or organic foods? Will these types of foods make a difference? | | A | | There are many cause for gas. Are you taking any new medications? Have you changed your diet significantly - are you eating a food consistently that you had not been eating before -- milk, chocolate, beans, fruits and vegetables, low carb breads or cereals? A normal person passes gas about 28 times a day - granted it is not usually noticable to the person or those they are with - but it is interesting to realize it is a natural process. Generally the food mentioned above produce gas. If you have increased the fiber content of you diet gas is a likely result initally, but if you are consistent your body begins to adjust. A web site I can think of off hand is michiganbean.org - they promote eating more beans and often address the gas issue. I don't know of any reason why organic foods or herbs would make a difference.
There are some good general nutrition sites in the Health Links in the Nutrition category.
| | | Answered at 9/2/2004 | | |
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| Q | | I would like to know about a certain supplement called chromium. It is offered by health and fittness companies as a digestive aid for weight loss. It is supposed to keep your metabolism working properly so that food is digested better, thus keeping weight down. I wonder if you know what the pros and cons are for taking this supplement? Do you know of any weight loss supplements that are best? Do you have a recommended source for information about them? | | A | | There is a lot of anecdotal information available on chromium and its benefit in losing weight and in improving blood sugar control. Generally it is considered safe for short term use. Studies at Yale and U.of Alabama have noted some folks who have problems with irregular heart beat. It is also uncertain if some possible genetic damage may occur that would increase risk of cancer.
Because weight control is usually a long term problem it might be better to focus on what is safe and healthy and has been documented to work. The advice I am going to give you is not flashy and probably isn't in the latest book on weight loss, but it works.
Start with 30-60 minutes of exercise everyday. If you have not been exercising you will want to start slowly. Walking is good enough. If you have any orthopedic problems you might consider water exercise. This can be as simple as walking in the pool.
The food part of almost as simple. You want to have a minimum of three meals a day. These meals should be spread out over the day and should consist of at least 5 servings of vegetables and fruit per day. A serving is about 1/2 cup. Try to eat just a bit less than you want. Avoid all regular soda and juice (4oz of juice once a day is ok). Expect this plan to be a life time plan rather than 2-3 weeks or even months. Weight loss of 2-3 pounds per month is great, imadgine how that works over 2-3 years.
You can find additional information on Chromium in Healthwise Alternative Medicine.
| | | Answered at 8/4/2004 | | |
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| Q | | I am extremely allergic to Sulfa-drugs. I would like to begin taking a supplement, but it contains MSM. Would it be safe? I know sulfur (like in food) is ok and not the same as sulfa, but I don't know much about MSM & where it fits in. Any thoughts would be greatly apperciated. | | A | | MSM has a sulfonyl chemical group in its structure. While it is impossible to know if you would have an allergy to MSM, it would be wise to avoid it.
| | | Answered by John Holroyd, MD, Internal Medicine, Bellingham, PHMGW/IM 2A-Cordata (1/6/2004) | | |
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| Q | | I have some questions about steroids: How do they build muscle? Is the muscle they enable one to build "real" muscle? Are they addictive? Would it be safe to use steroids only long enough to achieve the desired physique, then discontinue use?
| | A | | Anabolic steroids have been abused by athletes to enhance strength, performance, and endurance. They do increase lean body mass (muscle) if used in conjuction with an adequate diet and maximal excercise. Despite evidence of benefit in some athletes, the use of anabolic steroids to enhance performance is condemned by the medical community. These agents have also been associated with severe toxicity in athletes, including hepatotoxicity, liver cancer, hypertension, decreased testicular size/spermatogenesis, and lipid abnormalities. Other effects include fluid retention, weight gain, psychiatric symptoms, lipid abnormalities, elevation of liver function tests, hypercalcemia, hypoglycemia, and pain on injection. Even short term steroid use has caused harm. They are not addictive in the same fashion as heroin, but the effects they produce will wane with time after the steroid (or exercise or diet) is stopped.
| | | Answered at 12/23/2003 | | |
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| Q | | I'm a 35 year old female, 5'4", 112lbs and I'm concerned that I'm not consuming enough protein to keep up with my exercise routine. I take 4 Power Step classes (with hand weights) per week and weight train with free weights/machines for an hour 4x per week. I also have a Nordic Track ski machine that I use 2 days per week. I generally get home so late 3 nights per week that I eat a small bowl of multi grain cereal. I eat a can of tuna for lunch and plenty of fruits and veggies and water. I'm trying to build more muscle, so I know I need more protein. How can I get more into my diet? I'm concerned about the extra fat/calories/sugar/sodium in the protein bars on the market. What about the protein drinks? Any suggestions?
I have to add that I do eat a regular dinner (chicken or fish plus veggies and pasta or rice or potato) three nights per week. I'm not trying to drop any weight but to gain muscle. | | A | | The recommendation for protein is .8gms per kg. For you that would be 41 gms of protein per day. If you are training, to go up to l.0 would certainly be reasonable. The max would be 1.5gms/kg.-- the kind of training one might do for the Olympics or professional sports.
Protein is found in most foods except fruit. The richest sources are milk( 8gms per 8 oz.), meat (7gms/oz), and egg (7gm each). Most portions of starch and vegetable are between 3-5gms per serving. I personally see real food as a better source of nutients than bars. You didn't mention milk but if you had two glasses of milk, 4-5 oz of meal/poultry and 6-8 servings of starch per day that would equal about 65 grams of protein per day. That is about 1.1gms of protein per kg.
| | | Answered at 5/20/2003 | | |
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| Q | | What can you tell me about the dangers of the Atkin's diet- namely the drawbacks of long-term ketosis on body tissues and systems?
| | A | | Greetings. This information comes from a Physician's Advisory put out by the Physicians Committee for Responsible Medicine. . I will give you the exact paragraph in their paper, Adkins Diet Alert.
"High protein, very-low-carbohydrate weight-loss diets are designed to induce ketosis, a state that also occurs in uncontrolled diabetes mellitus and starvation. When carbohydrate intake or utilization is insufficient to provide glucose to the cells that rely on it as an energy source, ketone bodies are formed from fatty acids. An increase in circulating ketones can disturb the body's acid-base balance, causing metabolic acidosis. Even mild acidosis can have potentially deleterious consequences over the long run, including hypophosphatemia, resorption of calcium from the bone, increased risk of osteoporosis, and an increased propensity to form kidney stones."
The short answer is that the Adkins diet is usually a short term solution to a long term problem. Most folks have a hard time following it for more than 6 weeks. Dr Atkins does aim at the problem when he advises carbohydrate restriction. Many folks can certainly benefit by reducing carbs, but a reduction to 50% of the calories provides adequate nutrition and can be part of a long term nutrition and fitness plan.
| | | Answered at 5/1/2003 | | |
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| Q | | How does Vitamin C affect absorption of Iron? | | A | | That is a very interesting question with a clear cut answer! Vitamin C increases absorption of iron by changing iron from the ferric state to the ferrous state (from a 3+ charge per atom to a 2+ charge per iron atom in a process called reduction by adding an electon). So taking a multivitamin or taking a Vitamin C tablet with an iron tablet (if iron therapy is recommended by your physician) will heighten iron uptake by the intestine.
| | | Answered at 3/12/2003 | | |
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| Q | | I am considering taking Liptoprin for weight loss. Is it safe? I do have high blood pressure and Type 2 diabetes. I am desperate for help. | | A | | Leptoprin, or Anorex, has many weight loss claims listed on their web site. It is not clear, however, what exactly this non-prescription supplement is, or how safe it is. A literature search of all recognized medical journals found no information on this supplement. This means that there exists no research on this supplement regarding not only its safety, but if it actually works. I believe the marketing of this supplement is another scam targeted at the desperate overweight community. Weight loss is a challenge for sure. The only weight loss plan that seems to work long term includes regular exercise and a lower fat balanced diet.
| | | Answered at 2/5/2003 | | |
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| Q | | What foods cause constipation? What foods are good to eat when constipated? | | A | | The foods that cause constipation are difficult to list because of individual digestion. It is easier to list for you foods that help with digestion and constipation: fresh fruits, fresh vegetables (especially the cabbage family--broccoli, brussel sprouts, etc), high-fiber foods such as nuts, whole grain breads. Another easy way to get fiber is a bulking agent like Metamucil, Citrocel, Fiberall, Fibercon, etc. Also make sure you drink plenty of fluids, 6 to 8 glasses of fluids a day. This can be juices, soups, water, teas, lemonade etc.
| | | Answered by Glen Hoversten, MD, Surgery: General, , (12/13/2002) | | |
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| Q | | I am experiencing problems with my gall bladder and am nutritionally ingorant. I know I eat too many carbohydrates but I need to know what a 40 year old female who is overweight should be eating. Do you have a publication available that outlines what a healthy balance of fat, saturated fat, carbohydrates, etc. is? | | A | | I'm not sure what to do about your gall bladder, that is in the realm of medicine and I am a dietician. I do know about a healthy balance of nutrients. Most folks can manage quite nicely with about 50% carbohydrate and 25-30% fat. The saturated fat level should be less than 10% but but probably not less than 7%. The Mediterranean diet seems to be a healthy approach to eating. It encourages fish, vegetables, fruit and starches but limits fatty meats and high fat dairy. The fat of choice is olive oil. Most of us do best if we exercise daily and cut calories by 200-300 per day if we wish to lose weight. Increasing, exercise is seen as better than cutting calories. Most overweight women of average height should probably have more than 1200 calories, but no more than 1600 calories. Good educational materials are available in libraries or on Internet sites like the American Medical Association's Delicious Decisions
| | | Answered at 2/8/2002 | | |
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| Q | | I am wondering if Sacred Heart offers a weight loss program that would be regulated by and through a program located within the Hopital. I have heard of such a program in the past but have been unable to locate any information. I would be very interested in this avenue to lose weight in the safest way possiblle. | | A | | Yes, there is such a program. It is called Healthworks and was designed by the two dietitians who do the program. The program is a series of group classes offered several times a year, and lasting about 10 weeks. Please call 686-7074 with questions.
| | | Answered at 1/29/2002 | | |
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| Q | | How does the body use food? What are the different kinds of nutrients needed to stay healthy? Why is nutrition so important? | | A | | I did not answer this question initially because it seemed so complicated. Your questions are great but probably require a nutrition text to answer completely. You might start with Jane Brody's Nutrition Book/Cookbook which you should find at the public library. In Eugene you could find information at the Health Information Library. An interesting web site you might try is NUTRITION.GOV
Our body is a complicated machine that requires many nutrients to complete its' many functions. Appropriate amounts of vitamins, minerals and fuel allow it to do its best work. Excesses and deficits keep it from working efficiently. One example is that extra fuel(food) combined with too little activity and genes for diabetes allow the body to begin the 5-10 year journey towards diabetes. During the process the body ceases to work as effectively and risks for coronary artery disease and stroke increase. Taking good care of the machine (body) helps it to do its best work and avoid some health problems.
| | | Answered at 1/9/2002 | | |
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| Q | | Years ago I obtained a copy of a diet for quick weight loss prior to heart surgery from Sacred Heart Hospital. Has this diet been updated? Could you please E-mail me a copy? (the diet contained a recipe for cabbage soup). | | A | | The Sacred Heart Diet is a great urban myth. The diet comes neither from this Sacred Heart or the one in Spokane. I don't know if it comes from another Sacred Heart.The diet is a vegetable soup that uses instant onion soup mix as the base. It is not a healthy approach to weight loss and is not recommended or prescribed at this clinic. I'm sorry it is so boring but the best way to lose weight is slowly over an extended period of time and by increasing exercise to 30-60 minutes per day and eating less food from a healthy diet.
| | | Answered at 8/17/2001 | | |
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| Q | | I'm only 21 and I have gained so much weight in the last year. Is there any way that I can get rid of it?... I tried using coconut butter cream but it doesn't work at all! | | A | | A person at any age will gain excess weight if more calories are eaten (or drunk), than used up over time. Try to figure out how that balance changed over the past year. Have you had less exercise or physical activity? Have you been eating more in response to stress? Did you start drinking alcohol, or regular soda pop?
The ONLY way to reverse the weight you have gained is to eat less and exercise more. Fad diets and items that don't have anything to do with eating less and exercising more are a waste of money. Be sure and eat three meals each day, and try to eat ~5 servings every day from fruits and vegetables! If you need more help, ask your doctor to send you to a registered dietitian. You might want to read Choosing a Safe and Successful Weight-Loss Program. published by the NIDDK Weight-control Information Network.
| | | Answered at 6/18/2001 | | |
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| Q | | Can you recommend a diet to control cholesterol and LDL/HDL? | | A | | U.S. dietary guidelines to lower LDL cholesterol levels call for a low saturated fat, low cholesterol diet (depending on gender, height, weight, age and activity level, probably under about 12-17gm of saturated fat per day, and under 200mg cholesterol per day). Selecting foods high in fiber content, and including fresh or frozen fruits/vegetables (5-7 servings a day), and eating fish or poultry more often than small portions of red meat can help, too.
Fats that come from nuts or olive/canola oil are healthier than animal fats or margarine (unless the margarine indicates "trans-fat free"), but the calories from fat in these foods can add up quickly.
About the best LDL-lowering results you can get from dietary measures is a 20-25 point drop over about three months. Raising HDL cholesterol generally takes exercise and weight loss. Improvements of only a few points can make a difference in risk.
| | | Answered at 1/30/2001 | | |
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| Q | | Which vitamin supplements are truly essential to one's health? Is one multivitamin supplement sufficient, or should that be augmented with a supplement of vitamins E and C as well? If so, how many mg. of each daily? | | A | | Tough question. Many vitamins are promoted as being beneficial for both health maintenance and the treatment of disease. To what extent these claims are true remains unknown. For people with a healthy diet that includes lots of fruits and vegetables, scientific evidence for a benefit from supplementation is lacking for most vitamins.
Notable exceptions include viamin D in people over 50 and folic acid in pregnant women. Calcium is also important for all women and men over 50.
There is great interest in "antioxidants" such as vitamins A and C. Unfortunately, well done studies have not been able to demonstrate a true benefit for cancer, heart disease or stroke.
Many people are starting to take B12 and folate to prevent stroke and heart disease. There are ongoing studies of this, but the results are not yet in.
In the absence of good scientific evidence, I recommend focusing on a diet with many diverse fruits and vegetables. It also seems reasonable to take a good quality multivitamin once a day, which contains adequate vitamin D for mosy folks. All postmenopausal women should also take 1200-1500 mg of calcium a day. Men over 50 should take 800-1000 mg/day. I would save your money and not buy separate C and E supplements.
| | | Answered by John Holroyd, MD, Internal Medicine, Bellingham, PHMGW/IM 2A-Cordata (9/27/2000) | | |
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| Q | | I am 25 years old, and over the last 3 years I have gained 30-35 pounds. My only child is 6 years old. My activity level has decreased a lot in the past few years, but this is the only factor I can think of that may have contributed to weight gain. I am not an excessive eater, and I don't drink pop or caffeine or eat red meat or too many sweets. Is this normal for my age, or something to worry about? It has also caused me to become quite depressed, and I do not have enough money to go see a specialist. I have been wondering about diets and am doing my best to get more exercise. Can you give me any more advice? | | A | | Your food intake maybe right for your age to maintain weight, but not to lose it. You need to burn up 3500 calories more than you eat to loose 1 pound of fat. The best way to do that is to increase your exercise and to eat a low fat/calorie diet. It will come off slowly, but it will come off. This is normal for your age, but now's the time to get the weight off and keep it off. The older you get the harder it becomes.
| | | Answered by Kathleen Hirtz, MD, Family Practice, , (9/6/2000) | | |
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