Healthy Eating

Could artificial sweeteners actually cause weight gain?

DEAR DOCTOR K: For 20 years, I've substituted artificial sweeteners for sugar in my coffee, and switched to diet soft drinks to avoid obesity and the diseases that overweight people are prone to, like Type 2 diabetes. Now I hear that new research says that's a bad idea. What is going on?

DEAR READER: Here's what's not confusing: More than a modest amount of sugar each day is not good for you. Nothing's changed there. The sweet tooth that many of us have (I plead guilty) leads us to eat too much sugar.

What are phytonutrients?

DEAR DOCTOR K: You've mentioned phytonutrients in a few recent columns. What are they? And what can they do for our health?

DEAR READER: Let's begin by breaking "phytonutrients" into its two parts. First, "nutrients." These are chemicals in our environment that we need to get inside our body, usually through eating foods that contain them. Nutrients are a necessary part of our body chemistry. Indeed, many are necessary for the life of most living things.

How can I fight inflammation without medications?

DEAR DOCTOR K: You've written that chronic inflammation has been linked to diseases such as diabetes and heart disease. Is there anything I can do to fight inflammation without using medications?

DEAR READER: Inflammation in the body is a double-edged sword. Short-lived inflammation, directed by your immune system at invaders like bacteria or viruses, protects your health. But sometimes inflammation persists, even when there is no health threat. That's when it can become your enemy. Many major diseases have been linked to chronic (ongoing) inflammation, including cancer, heart disease, diabetes, arthritis, depression and Alzheimer's.

Is there a nutritional difference between frozen and fresh produce?

DEAR DOCTOR K: I'm trying to eat more fruits and vegetables, but I don't have time to go to the grocery store every week. So I stock up on frozen produce. Am I missing out on any nutritional benefits by eating frozen instead of fresh?

DEAR READER: For taste, variety and quality of nutrients, recently picked local produce is the way to go. But if fresh produce is inconvenient or beyond your budget, frozen fruits and vegetables provide plenty of nutrition. Fresh fruits and vegetables are indeed more nutritious, but the difference between fresh and frozen produce may not be as stark as you think. Researchers at the University of California-Davis found that:

How much weight should a woman gain during pregnancy?

DEAR DOCTOR K: I am pregnant, and my doctor says that I'm gaining too much weight. I trust the doctor, but I've heard that it's normal to gain weight during pregnancy. How much weight should a woman gain?

DEAR READER: It's natural for a woman's appetite to increase during pregnancy. This is nature's way of making sure that she eats enough for herself and her growing baby. All women should gain weight during pregnancy, while eating healthfully and sensibly. But too much weight gain isn't good for a woman or her baby.

Does eating several smaller meals help with weight loss?

DEAR DOCTOR K: Does eating several smaller meals throughout the day rather than three larger meals help with weight loss?

DEAR READER:We know that eating fewer calories is important to losing weight, but there is less agreement on the specifics. Are three meals a day best for weight loss? Or is it better to eat more -- or less -- frequently? We can rule out eating fewer than three times a day. You'll feel hungry, making it more likely that you will overeat and choose less healthy foods when you do eat.

Is watching TV the worst sedentary activity for our health?

DEAR DOCTOR K: Is watching TV worse for your health than any other activities that keep you from being active?

DEAR READER: We know that exercise is good for our health, and that too much inactivity is bad for our health. But does it make sense that watching TV is worse than other sedentary activities? Actually, it may. My colleague Dr. Robert Shmerling is an associate professor of medicine at Harvard Medical School. He noted that a recent study shows watching a lot of TV is worse for your health than other activities that involve long periods of sitting. The study Dr. Shmerling referred to enrolled more than 13,000 young and middle-aged adults. Researchers asked the study subjects how much time they spent watching TV, using a computer and driving.

What’s the difference between a good and bad carbs?

DEAR DOCTOR K: In your column you often distinguish between "good" and "bad" carbohydrates. What makes a carb good or bad?

DEAR READER: Carbohydrates -- carbs -- occur naturally in a variety of foods, from fruits, vegetables and milk, to breads, cereals and legumes. Carbs are also added to many foods, often in the form of sugar. Your digestive system transforms carbs into glucose (blood sugar). They are your body's main source of energy. Whether a carb is "good" or "bad" depends on several factors. Some of the most important are:

How does sugar increase the risk of heart disease?

DEAR DOCTOR K: I've read that sugar increases the risk of heart disease. How does it do that? Also, any advice for those of us with a sweet tooth?

DEAR READER: So far as we know, sugar doesn't directly harm the heart. But it sure indirectly harms the heart, by promoting the following cardiac risk factors -- problems that lead to heart disease: OBESITY: Excess calories contribute to obesity. Added sugar is a major source of excess (and empty) calories. Overweight and obese people are at greater risk for heart problems. Today, we're discovering that the cells containing fat make hormones that travel in the blood and have many harmful effects on the heart.

Is it possible to go off blood pressure medication through diet and exercise?

DEAR DOCTOR K: Is it possible to get off blood pressure-lowering medication through diet and exercise?

DEAR READER: Yes, it is. I've seen many patients commit to lifestyle changes and get off blood-pressure medicines entirely. More often, I've seen that a commitment to a healthier lifestyle allows people to greatly reduce how much medication they take, even though they still need some medicines to control their blood pressure. While many people, myself included, would like to not have to take medicines at all, being able to reduce the dose is a big deal. Many of the side effects of medicines are reduced or eliminated by reducing the dose.