Nutrition Q & A

From 2013 to 2016 I wrote the Nutrition Q&A for The Washington Post. In each column I provided research-based answers blended with practical pointers. Below you'll find the topics I covered and links to the complete articles on The Post's website. Enjoy the reliable reads!

Q: I love cheese. How can I continue to enjoy it as I strive to eat better? Are there cheeses that are healthier than others?

A: I’m a cheese lover, too. I eat a small amount nearly every day: feta or blue cheese to top a salad, Swiss cheese in an omelet, or a chunk of cheddar with an apple as an on-the-run snack. I must admit that my allotment crept higher recently when I had the irresistible opportunity to choose from an array of cheeses served at room temperature at a breakfast buffet in Munich. 

Where does the advice on cheese stand now that the nutrition guidance on fat is focused more on quality vs. quantity? Has cheese eased its way off the verboten list? Here’s the current science and nutrition advice.

Q: I’m hearing so much these days about the need to eat more protein and distribute it evenly throughout the day. How much protein do I really need to eat and when?

A: You may be increasingly spotting the words “high in protein” or boasts of protein counts on the fronts of packaged foods. Or you may see articles or advertisements encouraging you to eat more of the “high-quality protein foods” — seafood, meats, poultry, eggs, legumes, nuts, seeds, dairy foods and soy products, which contain most or all of the 20 amino acids that are the building blocks of protein.

With the current push on protein, you’d think we were sorely lacking in this important nutrient. Hardly!

Q: I’ve recently lost weight and kept it off for a while. Now a few of those pounds have crept back on. What are the best ways to keep lost pounds off?

A: If you are disheartened by the recent headlines about the weight regained by a handful of “Biggest Loser” participants due to metabolic slowdown, you shouldn’t be. Their experience is not applicable to you if you want to lose, and keep off, 10, 20 or even 40 pounds.

“Obesity experts estimate that the metabolic adaptation, or handicap, from weight loss is roughly about 15 calories for every percent of weight loss,” says Donna Ryan, a physician and obesity researcher at the Pennington Biomedical Research Center in Baton Rouge.

The heated debate surrounding the 2015-2020 Dietary Guidelines is over, and we’ve had time to explore them (and maybe even shift our food choices based on them). So how are they looking, nearly three months in? We asked some leading experts what they think: what’s missing, what they like and a pointer they think we should take to heart. Here’s what they said by email about portion control, eating meat, sustainability and much more.

 

Q: Which matters more when it comes to weight loss: food and calorie intake or exercise?

A: Oh, yes, it’s that time of year again: time to kick those New Year’s resolutions into high gear, dust off the weight and food scales, hit the gym, and ask critical questions about losing weight. (However, I wish more people asked, “What does it take to keep lost pounds off?” Just sayin’!)

For starters, let’s define what is meant by exercise.

Q: Can we eat carbohydrates at every meal?

A: In brief, absolutely yes, but questioning this notion is understandable in our current era of fearmongering about foods — processed meats one week, potatoes and corn the next. 
Let’s get straight to the facts. Think of foods as packages of nutrients with varying amounts of the three calorie-containing nutrients: carbohydrates, protein and fat. 

Q: I’m trying to eat more salads because I’ve been told they’re filling and nutritious. Which salad greens are most nutritious?

A: Good job! Eating more salads is an easy way to achieve one nutrition goal that doesn’t stir the nutrition cauldron: eating more vegetables. Although dark green leafy lettuces are your best bet for a base, any greens tossed with raw vegetables and topped with a low-calorie dressing can be healthful. But it’s these toppings — rather than the right shade of greens — that matter most.

Q: I’ve heard I should eat more nuts, but I’m confused about which nuts are most healthful. And how often I should eat them?

A: Yes, the noise about nuts’ nutritional attributes is louder than ever, and they’re available in a growing array of flavors, portions and locations. Spot them in single on-the-go servings in convenience stores or occupying an ever-growing berth of supermarket shelf space. Find them in flavors we’re used to seeing on bags of snack foods – salt and vinegar, chili lime and today’s “in” flavor, sriracha. So do nuts’ nutritional assets live up to the industry hype?

Q: When eating out, how can we gently nudge our children away from “kids’ meals” so they will eat healthier and expand their food horizons?

A: This is a question that, while pertinent year-round, is particularly relevant in the summer because of more restaurant meals eaten over long weekends or vacations...

Q: I’m trying to cut down on sugar (including low-calorie sweeteners), but I’m getting bored with plain water, which leads to me to not drinking enough. Any suggestions?

A: Cutting down on sugar. Drinking more water. Two wise and commendable health goals! 

The commonly cited mantra promoting eight ounces of fluids eight times a day no longer (sorry) holds water. In 2004, the Institute of Medicine, a government health advisory organization, offered an update in its Dietary Reference Intakes report, saying that fluid needs (not just water) vary widely from person to person and should be based on the climate one lives in and one’s food choices.

Q: Can you help me sort through the range of butters and spreads in the supermarket today? It’s so confusing, especially related to the latest guidance around saturated fat and cholesterol.

A: It’s confusing, for sure! “The hype about healthiness strewn across the packaging makes sorting out which butter, margarine or spreads to buy particularly confusing,” said registered dietitian nutritionist Janet Brill, a cardiovascular disease prevention expert and author of “Blood Pressure Down.”

So let’s get some perspective.

Q: If you have to eat fast food, what are the healthiest options?

A: One key premise I promote is that you can choose to eat healthfully in most restaurants, from fast food to upscale. Especially today, most restaurants, including fast-food chains, offer a cadre of healthier options. Let’s dig in.

Q: I’ve avoided taking fish-oil pills because they made me feel weird and I didn’t like the taste in my mouth hours later. Now I’ve been reading that research is showing that fish-oil pills don’t actually live up to their promise of preventing heart disease. Can I skip them?

A: Thanks for this timely question. The answer, as for many nutrition topics, has evolved as research has revealed fresh findings. “Nothing in nutrition is set in stone.

Q: Can you help resolve an ongoing discussion among my friends and family about non-organic apples? Is it healthier to eat the peel for its health benefits or discard the peel to get rid of any toxins? At home I buy organic apples, but when I travel I can’t always find them.

A: Your question focuses squarely on the debate about buying conventional or organic fruits and vegetables. Before digging in, let’s cover a couple basic points:

• Conflict remains about whether organically grown produce is nutritionally superior to conventional. 

Q: I’ve been hearing about Soylent, a complete nutrition product that promises to take all the bother out of food preparation. It’s strangely appealing. I like the idea of food efficiency and having an easy-to-carry food for traveling. Do you recommend it?

A: Soylent had not been on my radar screen until you asked. Here’s the lowdown on the product with its upsides and downsides.

Origins and premise
The name, says Rob Rhinehart, Soylent’s chief executive, is derived from Harry Harrison’s 1966 science fiction novel “Make Room! Make Room!”

Q: I have Type 2 diabetes. I like to have low-sugar nutrition bars handy for snacks or missed meals, so I’ve begun buying bars that contain sugar alcohols. What do you think about these bars and sugar alcohol in general?

A: I’m glad you asked. You’re not alone. “Lots of my clients are confused by foods labeled ‘sugar-free’ and containing one or more of these foreign-sounding ingredients with an ‘ol’ ending,” says Lise Gloede, a registered dietitian, certified diabetes educator and owner of Nutrition Coaching, a private practice in Arlington.

Q: My husband, an octogenarian, is overweight and a sugar lover. He’s having significant back pain. His physician recently encouraged him to lose weight by following the South Beach Diet and to quit drinking sugar-sweetened sodas. It’s hard for my husband to change his food choices and eating behaviors. What are some guidelines for him?

A: Your husband is hardly alone finding it a challenge to change his food habits. After all, he’s been fine-tuning these now for 80-plus years!

In my experience, when physicians give advice...

Q: I try to eat breakfast, usually yogurt and granola, right before I leave for work, but it seems like I’m hungrier by midmorning if I eat breakfast than if I skip it. Then if I eat my lunch by midmorning, I’m hungry again by midafternoon. What’s your advice to control between-meal hunger?

A: Your dilemma with breakfast is common. If I were counseling you individually, I’d gather additional details about how much and what you eat. I’d determine your nutrition, weight and health status concerns and goals. Without these details in hand, I can offer general guidance.

Q: Is a Paleo Vegetarian Diet Possible?

A: The short answer is that it’s possible. But in entertaining this eating plan, you’ve got to examine your health goals, the plan’s nutritional soundness and whether you can follow it long-term. Let’s unpack each part of the plan and look at the research and the nutritional pluses and minuses.

It’s March, National Nutrition Month, when the Academy of Nutrition and Dietetics spotlights the important role of healthful eating and physical activity to control weight and prevent chronic disease. But these aren’t snap-your-fingers, easy-to-achieve goals to execute in fast-paced, convenience-driven Washington.

In honor of National Nutrition Month, I exchanged e-mails with eight area registered dietitian nutritionists, asking them to divulge their secret weapons.

Q: When you read a nutrition facts label for raw meat, is the fat content listed for raw or cooked weight? If it’s the cooked weight, is the manufacturer assuming the meat is rare or well done?

A: Good questions! Let’s unravel this starting with a few bites of background on meat and poultry nutrition labels. First, definitions. Meats, sometimes called red meats, includes beef, lamb, pork and veal and the less commonly eaten bison, emu, venison, etc. Poultry includes chicken, turkey and the less commonly eaten duck, hen, goose, etc.

In 1994, when the federal Nutrition Labeling and Education Act of 1990 went into effect, our packaged foods got a facelift with the now familiar nutrition facts label.

Q: I’ve made up my mind: I’m going to lose 20 pounds this year by eating fewer calories and exercising more. Cutting down my breakfast calories is one challenge. My typical breakfast is 400 calories: three tablespoons of almond butter, two slices of low-calorie bread and one cup of fresh fruit. I could cut my calories to 200 by opting for a frozen low-calorie breakfast sandwich. Is this nutritional compromise worth the 200-calorie savings?

A: It’s January and the height of New Year’s resolutions season, so let me applaud you for tackling shedding those unwanted 20 pounds for good. It sounds like you realize your effort will take time, persistence and close examination of your current food choices. So true!

Breakfast is an important meal.

Q: I hear that incorporating flax into my eating plan is healthful. I see flaxseed oil, ground flaxseeds and whole flaxseeds available. Do they provide the same nutrients? What are ways to use them?

A: Let’s sort through the facts on flax. Flaxseeds are the seed of the flax plant, which grows in cooler climates, such as in Canada and the northern United States...

Q: What should I eat if I’ve been told by my health-care provider that I have prediabetes? I’m confused by the conflicting messages I hear and read.

A: November is an apt month to answer this increasingly common question. It’s American Diabetes Month.

You didn’t detail the conflicting messages you’ve gotten, but as a dietitian and diabetes educator, I hear and read many....Read more...

Q: It seems like all my friends are trying one of the trendy diets — one’s on a juice cleanse, another’s going gluten-free (but doesn’t need to be); is all of this safe and healthy?

A: We constantly hear about the latest, greatest diet sure to, once and for all, help you shed unwanted pounds forever...

Q: Do all whole grains contain dietary fiber? What are other sources of fiber?

A: Your questions seem simple, but they’re not. Answering them, however, is important because they focus on two healthful eating goals: 1) Eat more whole grains and 2) Eat more dietary fiber...

Q: I think I eat pretty healthful, balanced meals. Do I still need a multivitamin and mineral supplement?

A: Here’s the bottom line. Most people who are healthy and eat healthfully don’t need a daily multivitamin and mineral supplement.

Q: My boyfriend and I recently decided to start eating healthy together. After about six months of eating healthy meals (prepared by me!), he’s lost 15 pounds, and I’m up 5 pounds. What am I doing wrong?

A: Great question! First, kudos to you and your boyfriend for choosing to eat more healthfully and prepare more home-cooked meals...

Q: What’s the difference between sugar (white granulated sugar) and high-fructose corn syrup? Should I limit one more than the other for health reasons?

A: High-fructose corn syrup is a corn-based sweetener...