Should I take supplements?
How do I lose weight?
I want to lose weight. Should I avoid carbohydrates?
Are trans fats and hydrogenated fats the same thing?
Are artificial sweeteners okay to use?
How much fiber do I need and how can I be sure to get it?
I would like to become a vegetarian, but want to make sure I will be able to eat healthfully.

Q. Should I take supplements?
A. First, let’s define supplements. The Food and Drug Administration (FDA) defines a supplement as any pill, tablet, capsule, powder, or liquid taken by mouth that contains a dietary ingredient.

So what is a dietary ingredient? A dietary ingredient is any organ tissue (desiccated liver), vitamin, mineral, herb, amino acid, enzyme, hormone, metabolite (produced when nutrients are digested), or extract (Echinacea). By definition, your vitamin pill is a supplement. As is the calcium tablet, protein powder or herbal supplement you might be taking. Should you take it? Actually, experts are still not sure. In general, the nutrients in food are better absorbed those that are isolated in supplements, and food is less expensive than many supplements. Age, gender, illness, and dietary preferences can increase the need for certain nutrients.

For persons who eat less than 1600 calories per day, it might be difficult to eat enough nutrient dense foods to achieve the RDA for every nutrient. Those people who eat less than 1600 calories per day should consider taking a multivitamin that contains 100% of the RDA for all vitamins and minerals as a precaution. Some healthy people who typically eat a balanced, nutritious diet take supplements to be certain all their nutritional needs are met. So individuals’ needs for a particular nutrient may be more or less.

Generally, the minimum intake of a nutrient should be no less than 2/3's of the RDA and should not be maintained for prolonged periods of time. A recently released National Institutes for Health panel of thirteen experts concluded, “The presence evidence is insufficient to recommend either for or against the use of multivitamins/minerals by the American public to prevent chronic disease.”

They identified only three instances in which scientific evidence clearly supports supplementation: supplementation of vitamins A and C, zinc and beta-carotene to prevent age-related macular degeneration; supplementation with folic acid by any woman of child-bearing age to prevent neural tube defect; and supplementation with calcium and vitamin D to reduce the risk of bone fractures in post menopausal women.

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Q. How do I lose weight?
A. First, are you really ready? How important is it to you? Are you willing to make regular physical activity a part of your routine? It will be a lot easier to achieve the required calorie deficit if you can find a form of exercise that you will enjoy. It also helps to have an equally committed buddy to motivate you on the days you just don’t feel like it.

• Commit to making small gradual changes in your eating plan that you can sustain. Deprivation is almost certain to lead to a binge that often causes guilt and a feeling of failure that will undermine your efforts.
• Have a realistic weight-loss goal in mind. You may not be able to get to your high school weight. A ten-percent weight loss achieved in six months and then maintained is far more likely.
• Can you control your food choices and meal preparation methods? If your lifestyle usually means eating in the local quick stop with limited choices, you will have to devise a plan to prepare your food and take it with you, or find alternatives.
  Why do you want to lose weight?
• Are you losing weight to improve your health or because you are feeling pressured by another? As is the case in most challenges, success will be determined by your attitude.
• If you are less than enthused, perhaps you should work on becoming healthier at your size. There is a movement to assist people with size acceptance and can be found by researching Health at Every Size. If you can answer the above questions affirmatively, you are ready to make the necessary changes for successful weight loss.

The body has an amazing ability to store excess energy as fat, in preparation for famine, a rare event in our society. The availability of high calorie food makes it easy to overeat. Weight loss requires patience and a willingness to make long-term dietary changes. It is important to remember that a one-pound weight loss represents a loss of 3500 calories. You must create a demand for stored fat by decreasing your intake of energy (calories), increasing your body’s expenditure, or both.

If you want to lose one pound of fat each week, you must create a 500-calorie deficit each day. A two-pound loss will require an average calorie deficit of 1000 calories every day. When your body begins to run out of fuel, it uses stored fat for energy. It also draws on glycogen (stored glucose). Fat cells break down fat molecules and release their components into the blood. Then other cells break them into even smaller fragments that combine with a fragment from glucose. This reaction produces energy, carbon dioxide and water. Whenever body fat is broken down for energy, carbohydrate is needed too, or the body will produce ketones, products of incomplete fat breakdown, which can have adverse effects on health.

Before starting a weight loss plan ask yourself if you are in the right frame of mind. Losing weight and keeping it off means developing a plan that is easy to follow, enjoyable and adaptable to your lifestyle. Very few people can enjoy a diet with no carbohydrates. That’s why the no carbohydrate plan worked well for weight loss, but fell short when it came to maintenance.

A report (American Journal of Clinical Nutrition, July 2005)) on long-term weight loss reported the following six tips for weight loss maintenance:

• Engage in physical activity
• Eat a low-calorie, low-fat diet
• Eat breakfast regularly
• Maintain a consistent eating pattern across weekdays and weekends
• Self-monitor your weight
• Catch “slips” before they turn into larger weight regains. Set a maximum weight to be reached before automatically resuming the previous eating plan.

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Q. I want to lose weight. Should I avoid carbohydrates?
A. Carbohydrates are often thought of as being fattening. Glucose from carbohydrates is the preferred fuel for most body functions and is especially important as the chief fuel of nerve cells, including the brain, which depend almost exclusively on glucose for energy. Starchy foods, or complex carbohydrates, are the preferred sources of glucose. You should get most of your carbohydrates (sugars) from starchy foods such as pasta, rice, bread, other grain products, potatoes and other starchy vegetables. These foods are high quality sources of complex carbohydrates, vitamins, minerals and fiber. Gram for gram, they have fewer calories than fats (four versus nine), so a balanced diet based on high carbohydrate foods is likely lower in calories than a diet with lots of high fat foods. In addition, changing glucose to fat costs many of the glucose’s original calories, making glucose even less fattening.

However, pure sugars, like those found in candy and soft drinks, displace nutrient dense foods from the diet and contain none of the protein, vitamins, minerals, or fiber of milk, whole grains, fruits, or vegetables. That is why they are called empty calorie foods. This type of carbohydrate is the type we often turn to when we need comfort.

Brain Wansink of Cornell found women prefer snacking on comfort foods and offers these tips to resist overindulgence in comfort carbs:

• Keep comfort foods out of sight.
• Skip the money saving, super-sized packages that encourage overeating. 100-calorie packs are a perfectly sized treat.
• Resist the descriptive adjectives that are created to tempt. Moist, Double Fudge Chocolate Sin is likely just chocolate cake.

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Q. Are trans fats and hydrogenated fats the same thing?
A. Some trans-fats occur naturally in limited amounts, mostly in dairy foods and beef. Others are created through the manufacturing process. When manufacturers process foods, they change the fatty acid chains by adding hydrogen molecules. This changes the shape of the fatty acid and creates unusual products that are not often made in nature. These changes make them stay fresher longer. Hydrogenated oils are easily handled, spread well, and store well. They also have a higher smoking point, making them more suitable for frying foods.

Unfortunately, these trans-fatty acids behave like saturated fats in the body. Research has found that trans-fatty acids increase the bad cholesterol (LDL) and decreases the good cholesterol (HDL) even though it started out as healthful polyunsaturated fat before hydrogenation.

In 2006, the FDA began requiring trans-fatty acid levels to be listed on food labels, but the labeling is tricky. A manufacturer can label its food trans-fat free if there are fewer than 0.5 grams of trans fat in a serving. To get around this, some manufacturers have decreased the serving size. If you have a large portion, you will be getting trans-fats. When reading a label that states there are no trans-fats, be sure to check the ingredients for the words “partially hydrogenated.”

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Q. Are artificial sweeteners okay to use?
A. The preference for sweet is inborn, and the average person consumes about 32 teaspoons of sugar daily. This represents 480 calories, which can contribute to weight gain. This is close to 25% of the recommended calories for most people, and far exceeds the 10% limit recommended by the World Health Organization (WHO).

To combat this tendency, many people consume artificial sweeteners. There are two types of alternatives to sugar. One is sugar alcohols, which have calories. Sugar alcohols, sorbitol, manitol, xylitol, and isomalt are metabolized by human beings and do provide close to equal calories as sugar. One cautionary note with sugar alcohols is their tendency to cause diarrhea in some people. This problem is because it stays too long in the intestine and is consumed by normal bacteria, which attracts water and causes diarrhea. A new product, erythritol, has 0.2 calories per gram. Due to its small molecular size and structure, erythritol is rapidly absorbed in the small intestine and is unlikely to cause gas and diarrhea.

The other group is artificial sweeteners, which have virtually no calories. The major sweeteners used currently are saccharin (Sweet n Low) with zero calories; acesulfame-K, Sunette or Sweet One, not recognized by the body and excreted by the kidneys; sucralose (Splenda), made from chemically altered sugar; and aspartame (Nutrasweet), not appropriate for those individuals with PKU. Still another sweetener is stevia, Stevia (STEE-vee-uh) is a South American shrub whose leaves have been used for centuries by native peoples in Paraguay and Brazil to sweeten their yerba mate and other stimulant beverages.

Stevia leaf is a plant used to sweeten herbal tea since "ancient times" and by multinational food companies to sweeten foods for sale in Japan, Brazil, and other countries where it is approved. In the U.S. this sweetener does not have FDA approval for use as food, but it can be sold as a supplement.

Numerous studies have demonstrated the safety of these sweeteners when used in moderation. If there is heavy use of these products, it is recommended that you choose all forms to prevent any toxicity. For the American Dietetic Association’s position on this subject, go to eatright.org and click on position papers.

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Q. How much fiber do I need and how can I be sure to get it?
A. The latest recommendation on daily intake of dietary comes from the National Academies' Institute of Medicine (IOM).

Daily Recommended Fiber Intake:

• Women: 25 grams per day, for women younger than 50
  21 grams per day, for women older than 50
• Men: 38 grams per day, for men younger than 50
  30 grams per day, for men older than 50
• Children: Dietitians use a general formula of the child’s age plus 5 grams of fiber daily. Too much fiber in the diets of growing children can decrease appetite and increase nutrient losses.

Dietary fiber is classified as either soluble or insoluble, with each type contributing to your health. Insoluble fiber combines with water, increasing the bulk and softening the stool, enabling it to pass more quickly and easily through the intestines. A diet high in insoluble fiber can help prevent or reduce the risk of a number of health problems, including constipation and hemorrhoids and possibly colon and rectal cancer. Foods rich in insoluble fiber are cereals, grains, vegetables, and bran, especially wheat bran.

Soluble fiber is very absorbent and can decrease your blood-cholesterol by binding with cholesterol containing compounds in the intestines. It is found in fruits, barley, oats, and legumes (beans, peas, lentils, and peanuts).

Although most experts believe that the average person can benefit from an increase in dietary fiber, there is some disagreement about exactly how much and which types should be consumed. Most nutritionists and diet experts suggest that approximately 20-30 percent of our daily fiber intake should come from soluble fiber.

How can you increase your fiber intake? Mix a high fiber cereal (more than 5 grams a serving) (Fiber One or All Bran) with your regular brand and top with fruit. Look for 100% whole wheat or whole grain bread and check fiber grams on food labels to find those with three grams per serving. Try beans instead of meat as a source of protein. Eat a piece of fruit instead of drinking fruit juice or eat dried fruit as a snack. Wash well, then eat the skins of fruits and vegetables and potatoes. Eat whole grain crackers or vegetables, instead of chips and serve them with hummus or bean dips made with sour cream. You’ll save on fat calories, too.

One cautionary note: because dietary fiber soaks up water, increasing your fiber intake may divert water from cells. So when increasing your fiber consumption, do it gradually to avoid GI distress and be sure to increase your intake of fluids accordingly.

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Q. I would like to become a vegetarian, but want to make sure I will be able to eat healthfully.
A. There are different levels of vegetarianism. Lacto-ovo vegetarians will eat eggs and milk. Vegetarians do not eat meat, fish, and poultry. Vegans abstain from eating or using all animal products, including milk, cheese, other dairy items, eggs, gelatin, wool, silk, and leather. The key to a healthy vegetarian diet, as with any other diet, is to eat a wide variety of foods, including fruits, vegetables, plenty of leafy greens, whole grain products, nuts, seeds, and legumes. The American Dietetic Association has affirmed that a vegetarian diet can meet all known nutrient needs for adults and children. (See "Position of the American Dietetic Association: Vegetarian Diets," JADA, June 2003) As with all diets, sweets and fatty foods should be limited.

It is no longer necessary to plan combinations of foods with complementary proteins. A mixture of proteins throughout the day will provide enough essential amino acids. Good protein sources are beans, lentils, tofu, nuts, seeds, tempeh, chickpeas, and peas. Whole grain bread, greens, potatoes, needs by eating a varied diet. Iron requirements can be met with dried fruits, baked potatoes, mushrooms, cashews, dried beans, spinach, chard, tofu, tempeh, bulgur, and iron-fortified foods (such as cereals, instant oatmeal, and vegetarian meat substitutes. This iron is non-heme iron so is not as well absorbed as iron from animals. Its absorption will be increased if it is served with a good source of vitamin C, such as citrus fruit or juices, tomatoes, or broccoli. Because iron is leached out of cookware, using iron cookware will add to iron intake. An iron supplement can also be taken.

Calcium needs can be met with dark green leafy vegetables like collard greens, broccoli, kale, and turnip greens. Tofu prepared with calcium, low-fat dairy products if not vegan, fortified soymilk, and fortified orange juice also contain high quantities of calcium. Vitamin B12 comes from animal sources.

For lacto-ovo vegetarians, dairy products or eggs provide adequate vitamin B12.

If you are vegan, you should take a supplement or eat fortified foods, such as some brands of cereal, nutritional yeast, soymilk, or soy analogs, which can be good sources.

Visit the websites for the Vegetarian Resource Group and Seventh-day Adventist Dietetic Association for more information and recipes. For tips on meal planning you can go to http://www.dietitians.ca/news/downloads/Vegetarian_Food_Guide_for_NA.pdf. For a shopping list visit http://www.llu.edu/llu/nutrition/shopping.html.

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