Healthy Eating

Do adults need milk?

DEAR DOCTOR K: My parents made us drink milk every day, and I've continued that as an adult. A friend just told me that adults don't need milk, and that it can even be bad for you. What's the truth?

DEAR READER: Like you, we always had milk when I was a kid. In fact, the coming of the milkman to deliver the milk at home (remember him?) was an important event each day. These days, I have milk on cereal, but I don't drink it by the glass. As with most things, there are both benefits and risks.

What is the Mediterranean diet and is it actually healthy for you?

DEAR DOCTOR K: In some of your columns you've said that the "Mediterranean diet" is healthy. First, what is a Mediterranean diet? Second, what proof is there that it really is healthy? Call me "Skeptical."

DEAR READER: Well, "Skeptical," prepare yourself for a fairly emphatic reply. Because when I think skepticism about something important is misguided, I tend to unload. The Mediterranean diet is the traditional diet of people in countries near the Mediterranean Sea. The diet is rich in plant foods. These include fruits, vegetables, grains, beans, nuts and seeds. Animal protein is consumed chiefly in the forms of fish and poultry. Olive oil is the principal fat. And wine is taken with meals.

What are good fats and bad fats?

DEAR DOCTOR K: I've read in your column about "good fats" and "bad fats." I've also heard that recent studies challenge which fats are "bad." Can you shed a little light on this issue?

DEAR READER: I don't blame you for being confused. One problem with medical studies is that they don't always agree. That's why we often need a lot of them to determine the "truth." Let's start at the beginning. For years, you probably heard that all fats were bad for you and carbohydrates ("carbs") were good. That was nonsense. We need both fats and carbs in our diet.

I’m 80 and I eat a lot less now, am I getting enough nutrients?

DEAR DOCTOR K: I'm in my 80s. These days, I'm not very hungry and I eat a lot less than I used to. My daughter is worried I'm not getting enough nutrients. Is she right?

DEAR READER: Of course, I don't know if you are getting enough nutrients, but your daughter is right to be worried about it. For one thing, you say you're not eating much. People normally start to have a reduced appetite as they get into their 70s and 80s, but it's not a dramatic change.

Is a vegetarian diet really better for your health?

DEAR DOCTOR K: I'm thinking of becoming a vegetarian. But I need to be certain -- is a vegetarian diet really better for your health?

DEAR READER: The answer is: it depends. Just avoiding meats and eating only vegetables can be accomplished in both healthy and unhealthy ways. After all, a vegetarian who subsists on meat-free pizza and grilled cheese sandwiches isn't doing himself any favors. And, believe it or not, I've had more than one "vegetarian" patient whose diet was like that. However, for a while now, it's been clear that healthy, plant-based diets may improve long-term health. Such healthy vegetarian diets include proteins from vegetables (peas, spinach, broccoli, Brussels sprouts and many others) and carbs from whole grains.

What are considered bad carbs?

DEAR DOCTOR K: You talk about "good carbs" and "bad carbs" in your column. Since I know new studies sometimes change thinking, I'm wondering if "bad carbs" are still bad -- because I like eating them.

DEAR READER: I've got some bad news for you. If anything, the case against bad carbs is growing stronger. To refresh everyone's memory, let's distinguish good carbs from bad carbs. Carbohydrates are found in a broad range of foods; some are healthy and some aren't. Table sugar, fruits and vegetables, and grains such as rice and wheat are all carbs. But they aren't equal in how they affect your body.

Should you still eat fish even if there’s a chance you could get mercury poisoning?

DEAR DOCTOR K: I've been hearing for years that eating fish is healthy. But I also hear that mercury and other poisons can be in fish. I like the taste of fish, but should I seek it or avoid it?

DEAR READER: Questions from readers so often ask about the benefits versus the risks of lifestyle practices, or medical tests and treatments. That's because most things have both benefits and risks -- and eating fish is no exception. Fish ranks way up there on the list of healthful foods we should be eating.

Does a healthy diet include red meat?

DEAR DOCTOR K: I love red meat and I'm not going to stop eating it. Is it still possible for me to eat a healthy diet?

DEAR READER: I can't think of any food that a person should never eat; it's always a matter of degree. As you've read many times in this column, there is solid scientific evidence that a healthy diet is rich in vegetables, fruits, whole grains, and lean proteins such as fish, poultry, nuts and legumes. But you don't have to give up red meat entirely.

Can you explain what a low glycemic index diet is?

DEAR DOCTOR K: Diabetes runs in my family, and my mother says I should eat a "low glycemic index" diet. Can you explain what this is?

DEAR READER: Carbohydrates ("carbs," for short) are one of the main types of nutrients in food. Common sources of carbs include bread, pasta, cereals, fruit, milk, vegetables and beans. The carbs we eat are mostly too big for us to digest. Carbs are long strings of a certain type of molecule. Think of them as a string of pearls. When they hit the gut, digestive enzymes start to chop them up. It is the one-pearl and two-pearl strings that are the sugars that get digested and travel from the gut into the blood.

Are there health benefits to spices?

DEAR DOCTOR K: I've read about the health benefits of spices that most of us have in our kitchen cabinets. Is there anything to this?

DEAR READER: I'll bet you've been seasoning your food for years, using herbs and spices to add freshness and depth to your dishes. Researchers have begun to investigate the effects of these flavor enhancers on health. It turns out that herbs and spices may do much more than make your food more inviting.