Q: I’ve been following a Weight Watchers type diet for 2 1/2 months now. I’m 44 yrs old, 5′4″ and weigh just over 150 lbs. In the past, as recently as last year, I have been able to go a month or two with a WW type diet and lose 5 lbs minimum. This time I have not been able to lose even 1/2 lb.

I have really been careful about sticking to eating well, but I feel at a real loss right now and don’t know what to do next. Any advice you can offer to help me lose weight would be appreciated. What would you advise as the next steps?

A: This is a great question. There’s some evidence that as we get older – into our 40s and 50s – that it can be more difficult to lose weight. Everyone is different, of course, and there’s been some research focusing on this but nothing conclusive as to the actual cause.

What we do know is that this requires more attention to calorie balance. The first thing to look at is your amount of exercise. Folks tend to be less and less active as they move toward their 50s. A lot of factors contribute to this – job, home, stress – quite simply, the time constraints of modern life. In a woman your height, burning an extra 200 calories per day is the difference between weight loss and maintaining stable weight. Losing Weight After 40

Q: I am a 46 year old woman and was diagnosed with DCIS breast cancer in Dec. of 2007. I had a lumpectomy and a sentinal lymphectomy followed by 30 treatments of radiation. In May of 2008 I had an oovarectomy because of many complicated cysts on both ovaries. I had started taking Tamoxifen in March 2008 and was taken off of it by my oncologist in June 2008. She thought it wasn’t necessary because I am without estrogen producing ovaries now.

I have recently discovered edamame and love it! It has helped immensely with the hot flashes and night sweats I’ve been dealing with.

I was hoping you could elaborate on the effects of edamame on women in my situation. I understand it is good for young girls but what about a woman of 46 who was suddenly thrown into menopause?

A: What we know about soy and breast cancer has been a little difficult to interpret because most of the research offers us only indirect evidence. Ideally, research would be performed that would have women eat more soy products after being diagnosed with breast cancer and compare them with those without disease to see if there are higher or lower rates of recurrence. It’s unlikely that we’ll have that sort of information anytime soon.

It is the phytoestrogens in soy that appear to have anti-estrogenic properties. As such the belief that a diet high in soy might prevent breast cancer has some merit. It is those properties that appear to help some women with menopausal symptoms. Edamame and Menopause

Q: Do you recommend against adding table salt while cooking and before eating?

Can we get all the required sodium from the vegetables that we eat? I have heard that the amount of sodium the body needs/uses is around 300mg per day. Is that correct?

A: I don’t recommend using added salt at the table. I am a big fan of measuring salt carefully when cooking recipes.

Here’s the minimum Recommended Daily Allowance of sodium for different age groups. Daily Sodium Requirements

Have a question? Send it to askdrgourmet@drgourmet.com and your question may be answered in this column. Read more Ask Dr. Gourmet questions.

Q: My almost 16yr old daughter has announced that she is a vegetarian. She will eat fish and dairy products. We’re concerned about her obtaining the required amount of daily protein and iron. She has always been reluctant to consume meat products, but in the last month she has completely abstained from meat products. She does take multi teen vitamins, calcium, and one iron tab daily, as recommended by our pediatrician. Thank you for your assistance. We enjoy your web site tremendously!

A: Because your daughter is eating fish and dairy she is not likely to miss the essential amino acids that she needs. This is, in fact, a very healthy way to eat. We know from research that vegetarians are healthier than the general population. In addition there is clear evidence about the benefits of eating less red meats and more fish.Vegetarian Teens

Q: I’ve been searching for an appropriate diet for my husband and one of my children….both are battling extra pounds…..several friends have gone on a diet that they eat no (or very little) potatoes, rice, bread and pasta…..they have all lost significant amounts of weight but I remain skeptical. My son is 14 and I am nervous to restrict his diet too drastically. Do you recommend a diet like this. Thank you for your help and I love your site.

A: The diet that you refer to is the same diet as The Atkins Diet. While many people feel that this diet may be dangerous to one’s health, the main problem seems to be that while it is pretty easy to lose weight on it, in the end the pounds come back. One can lose weight by cutting down on carbohydrates because this essentially means cutting down on calories. The problem with this is that the body uses carbohydrates as a more immediate source of fuel. Atkins for Families

Q: My 11 year old daughter loves edamame (Japanese name for fresh green soy beans) However, I’ve heard that too much edamame is not good for you since it has estrogen. Is this true?

A: The most recent research indicates that the type of phytoestrogens (isoflavones) found in soy products are probably not harmful. One study showed that those Asian women eating the highest amounts of isoflavones (about 50 times the amount that Westerners typically eat) actually had a reduced incidence of breast cancer. Edamame for Girls

Q: I love tuna and it’s cheap. I have been eating it most days taking a sandwich to work. Is this a problem?

A: There’s no doubt that tuna contains mercury and you do need to be cautious. When it comes to canned tuna for a long time it is has been felt that eating “light” tuna is safer as reported by the FDA. It has been thought that albacore contains more mercury and that this is the higher risk of canned tuna.Canned Tuna

Q: My husband is diabetic, and I am a cancer survivor. With the guidelines given to me to minimize recurring of the cancer, as well as my health in general after chemo, it seems easier for me to follow a diabetic diet than it would be to try and fix 2 different meals twice a day. Would I be starving my cells and ultimately doing more harm than good if I were to follow his diet?

A: You would be doing yourself a great service to follow a diabetic diet.

We now know that the most effective diet for diabetics is a Mediterranean style diet. There’s information about this in ourDiabetes Diet section.

At the same time the Mediterranean diet has been shown to help lower the risk of cancer. Cancer Survivor Diet

Q: Does drinking milk contribute to developing diabetes? This is a shocker to me as I drink three glasses a day to get calcium.

I have read that people who have taken selenium for a number of years are prone to an increase in their blood sugar, possibly leading to diabetes. Is this true?

A: Milk itself is not linked to diabetes. We do know that Mediterranean style diet doesn’t really include drinking milk. Those in Mediterranean countries consume the majority of their dairy as processed dairy such as cheese and yogurt.

There has been some recent research that links an excess of selenium in people’s bloodstream with diabetes. Milk, Selenium and Diabetes

Q: I was just reading your article and someone wrote in and said they were on warfarin and told not to take vitamin C. I also am on warfarin and I’ve been taking vitamin C because after my surgery a few months ago they gave it to me in the hospital. I asked about taking it at home and was told I could. I was not told for how long. But, since it is cold season I have continued to take it daily along with echinacea and zinc to help ward off any colds. What effect does vitamin C have with warfarin if any? And does taking these other vitamins really help in warding off colds?

A: There have been isolated reports of interaction between Vitamin C and Coumadin (warfarin). These have not been well supported and it appears that up to 1,000 mg of Vitamin C is safe. Check with your physician about whether he or she feels this would be OK for you.Vitamin C, Coumadin and Cold Prevention

We know that following a Mediterranean style diet is linked with lower incidence of heart disease, high blood pressure, and cancers. Until recently, few studies have looked specifically at the Mediterranean Diet and the risk of breast cancer. Those studies that have been published have looked at only olive oil and breast cancer, or have taken place in the United States, where most people do not adhere to a Mediterranean Diet. What has been lacking has been a study focused on the Mediterranean Diet in a country where the Mediterranean Diet is the dominant style of eating. Fortunately, a study just published in the American Journal of Clinical Nutrition does just that. Mediterranean Diet and Breast Cancer Risk

Many women with fibrocystic breast disease are told to avoid caffeine because this seems to help minimize the symptoms of the disease, which include lumps in the breast and sometimes pain and swelling. Accordingly, one theory is that avoiding caffeine may help women avoid breast cancer.

The problem, however, is that the results from the many different studies that have been done are mixed. Most studies seem to show no connection, but some smaller studies show a weak positive link, while others….

Researchers from the Centers for Disease Control worked with scientists at the German Institute of Human Nutrition on a study that included over 23,000 men and women between the ages of 35 and 65. At the start of the study, each person received a score of 1 or 0 (yes or no) on four positive health factors. Sometimes It’s Just That Simple

A: The good news is that we have research from large studies to show that there’s no increase in risk of breast cancer for women who drink coffee. Breast Cancer and Caffeine

The key is moderation.

The earliest meaningful research was done by a cardiologist named Arthur Klatsky. He noticed that many of his patients with heart disease were not drinkers. This led him to do a retrospective study of over 80,000 patients and he discovered those who drank more had a much lower risk of dying from a heart attack. The Mediterranean Diet: Alcohol

Soy foods, in particular, are naturally high in these isoflavones, and there has been some controversy over whether breast cancer survivors should avoid soy foods and whether their estrogen-receptor status, whether positive or negative, should make a difference. Good Food News for Breast Cancer Survivors

Researchers at the University of Southern California and the University of Minnesota recently looked at 28 studies of soy intake and its effects on breast cancer risk (Brit J Cancer 2008; 98: 9-14). Six of those studies had focused on people in Asia, while the other 22 took place in Western countries. Those women in the studies who ate a traditional Asian diet averaged eating 25 to 50 milligrams of isoflavones per day, because soy is such a major source of protein in their diet.

People who follow a more traditional Western-style diet—like those in the United States and the United Kingdom—get most of their protein from animal sources. A Westerner’s typical daily intake of isoflavones….