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

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Q: I like to use old recipes. I made a lasagna from a 1970’s era recipe of mine. It was very (too) salty. I used Italian sausage (Johnson brand), ground beef, tomato paste, mozzarella cheese (Rouse’s brand), ricotta, an egg, and only added 2 teaspoons salt. I should have known better than to add salt, but I don’t recall the recipe being that salty. Is there more sodium in prepared foods (I’m thinking cheese and tomato paste) these days?

A: I think that it’s more likely that your taste buds have learned to be more sensitive to salt over the last few years. For many that can be the case. Where recipes used to contain this level of added salt that’s less true now. We know that over time when eating less salt your taste buds will adjust to the lower sodium levels (see: The Health of It All: Do Your Taste Buds Learn?)

Many of the ingredients in this recipe are higher in salt, including the sausage, tomato paste and mozzarella. Combining those with the two teaspoons of salt can make the recipe pretty salty tasting.Are foods saltier than they used to be?

Q: Recently I bought four peaches. When I cut into each one the pit had come apart and the nut inside was loose. I have always heard that the inside nut is poisonous so I threw the peaches away. Is my premise correct or could we have eaten the peaches?

A: Technically speaking, peach pits do contain cyanide.

According to the National Institute of Health Website:

“The edible portions of dietary plant species commonly used in the United States contain relatively low levels of cyanogen glycosides, although some pits and seeds of common fruits, apple, apricot, peach, contain significantly higher concentrations.”

One hundred grams of moist peach seed contains 88 mg of cyanide. That’s a fair amount and if you ate 100 grams of peach seed it could be dangerous. Peach Pits

Q: I have been wondering if substituting brown sugar for refined sugar is beneficial or is it the same. I would like to reduce my consumption of sugar in my baking, and I do know that you can reduce the amount used with little effect on the baked item.

A: There is no significant difference between granulated sugar and brown sugar. Traditionally brown sugar was the crystals that were the last step in the refining process before the final “white sugar” refinement. These days the brown sugar that you purchase in grocery stores today simply contains molasses (3.5% for light brown sugar or 6.5% for dark brown sugar). Sugar

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I’ve talked before about research that shows that those who gradually reduced the sodium level in their overall diet found that the same crackers tasted saltier after they’d become accustomed to a lower daily salt intake. Researchers in The Netherlands just published an interesting study in which they looked at people’s responses to reduced sodium levels in bread. You CAN get used to less salt!

Q: I know that high fructose corn syrup is bad for me. Now that I’m reading labels more carefully, I’m very surprised at how often it shows up in prepared foods, even as an additive in supposedly healthy whole-wheat bread. I love to bake, and occasionally a recipe calls for corn syrup. What’s the difference between the corn syrup in my pantry and the high fructose corn syrup found in so many commercial products? Is Karo syrup as bad for me as HFCS, and should I try to find a substitute?

A: Like you, I find high fructose corn syrup (HFCS) in so many products and am often amazed at the number of foods that contain this ingredient. You’ll find it in processed foods in very high amounts, like soda and sweet drinks, baked goods and other processed foods. There is a lot of controversy about whether this ingredient is worse for you than other sweeteners.

Q: How can a nutrition label say NO trans fats, NO saturated fats, and NO cholesterol, when it contains hydrogenated oils?

A: Trans-fats do occur in natural foods, but in very small amounts. Most of them are created when oils are saturated by the process of hydrogenation. Here’s a bit of science to help explain….

Q: I have a friend that is lactose intolerant and she says she has discovered that Indian Ghee has no lactose because the milk solids have been removed. Is this true?

A: This is for the most part true. Butter contains very little lactose to begin with and only those who are very sensitive would likely react to small amounts of butter. The milk solids that do remain in butter are removed when the butter is clarified (what the Indians call ghee). There might be minute amounts of lactose in ghee but it is unlikely to be enough to have an effect on those who are lactose intolerant.

Q: What can be used to counteract too much salt used in a recipe?

A: There are a lot of old wives’ tales about this, but truthfully not much can be done. The myth that I grew up with was that putting a raw potato in the soup would work. This is the most common remedy one finds when searching the web, although there are others, including adding sugar or vinegar. For the best answer to this question….

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This week’s death of Blair River, the 575 pound spokesperson for the Heart Attack Grill is disturbing to be sure. First and foremost because this young man was only 29 years old. This means that he lived a scant 11 years as an adult and this kind of story always makes my heart ache.

There was a tremendous amount of press surrounding Mr. River’s death because of his role as a morbidly obese man pitching a restaurant that profiteers from today’s tremendous problem with weight gain in America. Founded by Jon Basso, who uses the moniker “Dr. Jon,” the restaurant serves burgers and fries with no limit on the calories, fat or salt. In Memoriam

Featured Recipe

Creamy Crab and Asparagus Fettuccine

This is a light pasta dish with the flavor of the crab enhanced by both the slight creaminess and the flavors of the lemon and oregano.

I am fortunate enough to live on the Gulf Coast and there’s great quality crab here. I purchase mine at the farmer’s market here in New Orleans. You can find great quality crabmeat even if you don’t live on the coast – ask at the fish counter of your local store.

Q: I like to use old recipes. I made a lasagna from a 1970’s era recipe of mine. It was very (too) salty. I used Italian sausage (Johnson brand), ground beef, tomato paste, mozzarella cheese (Rouse’s brand), ricotta, an egg, and only added 2 teaspoons salt. I should have known better than to add salt, but I don’t recall the recipe being that salty. Is there more sodium in prepared foods (I’m thinking cheese and tomato paste) these days?

A: I think that it’s more likely that your taste buds have learned to be more sensitive to salt over the last few years. For many that can be the case. Where recipes used to contain this level of added salt that’s less true now. We know that over time when eating less salt your taste buds will adjust to the lower sodium levels. Are Foods Saltier?

Q: I am an fairly active 27 year old vegetarian who doesn’t eat any meat or dairy. I only include very limited amounts of egg and shellfish in my diet. I do everything that I am supposed to be doing to lower cholesterol (minimal processed foods, no trans fat or hydrogenated oils, a lot of whole grains and veggies, regular exercise). My HDL is way above optimal, but my LDL and triglycerides are slightly above where they should be. The only thing I can think of that is keeping these numbers up is coconut milk. I don’t eat dairy and I limit soy, so I have been using coconut milk products to replace things like milk, coffee creamer, yogurt, and ice cream. I know that coconut is high in saturated fat, but I thought that it was a good type of fat. Is it possible that the coconut milk in my diet is keeping some of my cholesterol numbers high? My diet is about 90% vegan, so I don’t know what else I could be doing wrong.

A: Cholesterol profiles can be a challenging thing to evaluate and I would urge you to speak with your physician regarding yours.

Having an HDL (good cholesterol) way above optimal is fantastic and may help to balance your slightly higher LDL (bad cholesterol) and triglycerides. At the same time such cholesterol profiles need to be taken in the context of overall health including high blood pressure and diabetes as well as family history and social history such as tobacco use and exercise. Coconut and Cholesterol

Q: I have purchased a HealthMaster advertized by Montel Williams. I love it and am eating so much healthier. My question is: every morning I have been making a drink. I drink one right away, about a 16oz drink, and have one for later. Someone told me that if I didn’t drink it all as soon as I made it the nutrients would be lost. Is this true, and if the 2nd one was not used that day but the next day would it still be healthy?

A: To some extent this is true. From the moment vegetables and fruits are picked they begin losing vitamins. While the loss of nutrients after such juicing is difficult to quantify, it is best to make your juices and drink them fresh.

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Q: I am on the MAOI Parnate and I cannot have anything with tyramine in it. Could you tell me exactly what is in the Acai Berry fruit? I ordered the freeze dried berry in a capsule. I’m just not sure if I can have it.

A: It is possible that acai berries may contain tyramine. Many fruits do, including grapes, figs, plums and pineapple. As fruits age, the levels of tyramine they contain increase, so fresh fruit may not be as much of a problem.

All of that said, the freeze dried acai that you ordered is likely to be a scam. Acai Berry Supplements

Q: Which salt substitute would you recommend?

A: Generally speaking I don’t recommend salt substitutes. I believe that it’s more important to learn to use salt carefully. Here’s some information on how to get started and understand sodium better: Salt

Q: Since I have high blood pressure one of my major concerns is salt content. Some recipes (like eggplant parmesan) call for salting items like eggplant, zucchini, and cucumber to either cut down on bitterness or excess water.

I have usually skipped the salting because I am concerned that it significantly increases the sodium content of the recipe, even if the salt is rinsed off the vegetable after the soaking. Does covering the vegetables in salt result in significant absorption of sodium? If it does, are there alternative methods that will achieve the same goals?

A:I never salt eggplant (or other vegetables, for that matter) in the way you describe. There are two suggested reasons for doing this. One is to remove moisture and the other bitterness. My experience is that moisture is fine for eggplant and helps keep it tender. Salting Eggplant

The problem (once again) is the added salt. Daily Grill

We know that calories and saturated fat are an issue at such places, but Chevys is really over the top. Chevys Fresh Mex

Most of the salt in our diets comes from the processed food we eat. Several countries, including Finland, the United Kingdom and Australia, have instituted government and food-industry-led strategies to reduce the amount of sodium in processed foods, with some success: the UK has managed to reduce their overall average salt intake by about 10% (from 9.5 to 8.6 grams per day). Recently a team in Australia assessed the amount of salt in over 7,000 processed foods sold in Australia as part of their effort to gather information on the current status of their food industry. Assessing the Salt Content of Processed Foods

That’s a tablespoon and a half (4.5 teaspoons), for men, and about 1 tablespoon of salt (3 teaspoons) for women.

We know that reducing the amount of salt we eat can help reduce blood pressure and your risk of heart disease – from stroke to heart attack. If everyone in the United States over 35 years old reduced their salt intake by only 3 grams per day, what kind of impact would that have on our country’s overall health? Quantifying the Effects of Less Salt

Dear Dr. Gourmet,

Q: I am a 30-year veteran of the Army and in pretty good condition. I am active, no weight problems and (other than fried chicken) eat pretty reasonable meals. My big drawback is cholesterol. Mine has been as high as 285. My family has a history of high cholesterol.

I have tried every statin on the planet and have terrible reactions to them all. I have unbelievable muscle pains and had to be hospitalized after taking Pravachol. The doctors say this is rare. Right now I am not on any meds for the cholesterol. I am taking a few natural herbs like fish oil. What can I do that will help?

A: The most important consideration is your cholesterol profile. Occasionally I will have a patient who has been put on medication for a high cholesterol score, but their low density lipoprotein (LDL) cholesterol isn’t putting them at high risk when other risk factors are taken into consideration. Family history, smoking, diabetes and hypertension play a role in evaluating such risk. We also consider weight (Body Mass Index), waist circumference, race, activity level as well as stress. When you can’t take cholesterol-lowering medications….

Q: Could you please tell me how I can calculate the Body Mass Index of my husband? He is an athletic person with a muscular body and you have said that the regular Body Mass Index would not apply to people like him.

A: We know that obesity is a major problem and one way that we track this is the Body Mass Index (BMI). It is not a perfect measure, however. It’s used because of how simple and inexpensive it is to collect the data for research purposes. We use it as an indirect measure of body fat.

What we most care about is central adiposity (belly fat to most of us). There is now tons of research to show that obesity with a large waist circumference is as important (or maybe more important) than BMI. Assessing BMI for Athletes

Q: I purchase large jars of pickled onions imported from Italy and they are the best I have ever tasted. On the main (front) label it states “in balsamic vinegar” but on the ingredients list it states “wine vinegar”.

When finished with the onions there is, of course, lots of vinegar left. Can I safely reuse this vinegar to pickle beets? Other ingredients listed are water, sugar, salt, citric acid and trace of sulphuric anhydride, whatever that is. These sometimes come in cans and then olive oil is also listed.

A: The onions you purchase sound delicious. You could use the leftover liquid, but it likely is not your best choice, because pickled foods such as onions, peppers and artichokes are packed in vinegar as well as all of those other ingredients you listed. The issue that would most likely have an effect on your recipes would be the added salt. Reusing Pickling Vinegar

Q: I have been using your web site information since going on Coumadin (warfarin) about a year ago. It’s been very helpful to me and my wife for adjusting my diet to this medication that I will be on for the rest of my life (artificial heart valve).

I read on one of your replies about parsley being in certain dishes and not combining too many in one day. That made me wonder: how much parsley is in pizza sauce? Is it bad to have 3 slices of pizza for dinner? Should I be more wary about my weekend treat of pizza?

A: This is a really tough question. If there’s parsley listed in the ingredients in your tomato or pizza sauce, it could contain a fair amount of Vitamin K.

Your best choice is to make your own tomato sauce and not use any parsley. For convenience you can look for a tomato sauce that doesn’t have herbs in the ingredient list.

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http://www.bmj.com/cgi/content/abstract/339/nov24_1/b4567?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=midlife+obesity&searchid=1&FIRSTINDEX=0&sortspec=date&resourcetype=HWCIT

Most all of the baked goods were made with white and not whole wheat flour (although oatmeal was available).  Similar bread offerings at lunch.  The lightest item at lunch was a crab vinaigrette in lettuce cups.

For an afternoon snack — Snickers!  Snickers!  Amazing!

It’s just amazing how folks put together conferences like this and don’t even think about the food.

Its aroma while cooking was mostly of the veggies, especially the green beans and the peppers. The instructions call for cooking 3 minutes after piercing the plastic and then removing the plastic to stir. I was very careful stirring because rice pasta can fracture and break up. After another 3 minutes the dish looked really good. Two From the New Gluten Free Cafe