Diet and Weight Loss: Ask the Nutritionist

Diet and Weight Loss: Ask the Nutritionist

Registered dietitian Carolyn O'Neil answers your questions on dieting, weight loss, and eating right.

Question: I lost 50 pounds this year. But I've reached a plateau. How can I get past it? I only have 12 pounds more to go!

Answer:


Good for you! You've accomplished a lot! But don't despair, because weight loss plateaus are common. A plateau can occur when your metabolism -- the process in your body of burning calories for energy -- slows as you lose lean muscle tissue along with body fat. To lose more weight now, you need to increase your physical activity. Oftentimes, by using the same approaches that helped you lose the first 50 pounds, you'll only be able to maintain your weight loss. But at a certain point, those techniques won't lead to more weight loss. Add muscle-strengthening exercises to your routine in order to build more muscle. Although more calories are required to maintain muscle than fat, muscle building and maintenance helps boost your metabolic rate.

Question: I'm 27 years old. I'm 6'2" and I weigh 171 pounds. I plan to get pregnant within the next year with my second child and I think I should lose about 15 to 20 pounds before doing so. What do you think? If you agree, what kind of diet should I maintain to lose weight and prepare my body for another pregnancy?

Answer:
At your height and weight, your current BMI is 22, which is considered healthy.  So there's no need for you to go on a weight loss diet. Instead, focus on maintaining your weight by staying physically active and eating a well-balanced diet that includes a variety of healthy foods.

To plan ahead for your next baby, ask your health care provider how much weight you should gain during pregnancy. A woman of average weight before pregnancy should gain 25 to 35 pounds during pregnancy. In general, you should gain about 2 to 4 pounds during your first three months of pregnancy and 1 pound a week for the remainder of your pregnancy.

Question: I've heard that adding avocados to my diet could help me lose weight. Is this true?

Answer:
Unfortunately, there are no magic foods to add to your diet with any unique weight loss properties. But avocados do contain a nice combination of nutrients associated with maintaining a healthy weight. Since they are a source of healthy monounsaturated fats they can help to protect your heart. They're also pretty high in fiber and contain a moderate amount of protein. And both fiber and protein can help you feel fuller, longer. But keep in mind, avocados are pretty high in calories. And any successful weight loss diet must be calorie-controlled. (One avocado contains 322 calories, 13.5 g of fiber, 4 g of protein, and 29.5 g of fat, mainly monounsaturated.)  

Question: Lately, I've been weight training more, and my appetite has skyrocketed. I'm especially hungry after I work out, which is usually in the evenings. Why is this? How should I eat during the day to avoid the urge to binge after I work out?

Answer:
Working your body harder burns more calories, and therefore triggers your appetite. If you work out in the evenings, make sure you eat a mini-meal an hour or so before you exercise. A mini-meal should be a combination of carbohydrates, protein, and fat. Something as simple as half a turkey sandwich on whole-grain bread, with a glass of nonfat milk, or a few whole-grain crackers with cheese and a small apple can provide a healthy balance of nutrients for your workout. This will ensure that you have the energy needed for your workout and will blunt the urge to binge afterward. Also, always drink water after you work out. You may find that this helps curb your cravings, too.

Question: My family eats a lot of rice. Is eating brown rice really any healthier for us than eating white rice?

Answer:
While brown and white rice contain about the same amount of calories per serving, brown rice has double the amount of fiber and minerals such as magnesium, zinc, and potassium. On the other hand, enriched white rice contains more folic acid and other B vitamins, because it's fortified with these nutrients.

Question: Is counting calories really the trick to losing weight? I've heard that I don't have to count calories to lose weight, as long as I work out every day and "eat right."

Answer:
Healthy weight management is all about energy balance. That means burning more calories than you're consuming. So it is helpful to become familiar with the calorie counts of the foods you eat most often. Keep a food diary for a couple of days, and then look up the calorie counts of the foods you've eaten. You can get that information by referring to the nutrition facts panel on packaged foods, or by looking online at websites like the USDA National Nutrient Database. This will give you a sense of where your calories are coming from and help you identify some smart and easy ways to cut calories. For instance, if you normally drink whole milk, you can switch to fat-free milk and save 60 calories per cup. After a while, you'll become a good diet detective and be able to estimate the calorie counts of your most regularly eaten foods.  Also, remember that the higher the fat content, the higher the caloric level. And of course, the larger your portion, the more calories you're consuming.

Question: I'm a 30-year-old woman, and 4'11" with an athletic build. Is there a sure-fire way to figure out how many calories I should be taking in every day, and how many I should be trying to burn with exercise?

Answer:
It's hard for me to answer because you haven't shared your body weight. But if you go to the USDA's ChooseMyPlate.gov and search for "Daily Food Plan," you can fill in your age, weight, height, and activity level to determine your daily caloric needs. You can also get a calorie-specific meal plan that suggests the number of servings of dairy, fruits, vegetables, meat/protein, and grains you should be consuming daily.

Question: Is there anything you can really do to increase your metabolism? If so, what can be done?

Answer:
The best way to increase your metabolism is to increase two types of physical activity in your weekly regimen. Strength training with weights helps build muscle mass and increases your ratio of lean muscle tissue to fat tissue. And muscle burns more calories than fat. Also, cardiovascular exercises, such as walking, running, biking, and dancing, get the heart pumping and the body moving to burn calories while you work out.

Question: I've heard that having too much fat around your waist increases your risk of serious health issues. But how can I protect myself from these conditions if I'm just naturally inclined to gain weight around my waist?

Answer:
Fat deposits are nature's way of banking excess calories. Some people deposit more fat around their hips, while others tend to store more fat around the waistline. It's genetic. Unfortunately, you can't easily whittle your waistline through spot exercises. The most effective way to get rid of unwanted fat is to burn more calories than you consume. Add more calorie-burning aerobic exercises to your weekly regime, such as walking, dancing, or hitting the elliptical machine.

Question: What are types of exercise should I do every week to lose weight? What kinds should I do most often?

Answer:
The most effective exercises for weight loss are the ones you enjoy the most, whether it's dancing, walking with friends, or horseback riding. If it's an activity you enjoy, chances are you'll keep it up. The American College of Sports Medicine suggests a combination of aerobic exercises -- like swimming, running, and walking -- to maintain and improve heart and lung function. They also recommend resistance exercises (weight training) to help increase muscle mass. It's also important as we age to include exercises that improve our flexibility and balance, such as yoga and dancing.

Question: If I want to lose weight, are there any behaviors I should avoid that may cause my metabolism to slow down?

Answer:
If you starve yourself by skipping meals to cut calories, you will fool your body into thinking it's in a famine situation, and your metabolism will slow down to preserve energy resources. Although weight loss may occur by crash dieting, it's usually at the expense of lost muscle mass. And the lower your muscle mass, the slower your metabolism. So avoid crash diets of below 1,000 calories a day, and don't skip meals.  Fuel the fire of your metabolism with healthy foods to keep the furnace burning.

Question: I've seen a lot of "gluten-free" products in the grocery store lately. What are the benefits of a gluten-free diet?

Answer:
The health benefits of following a gluten-free diet are clear for individuals with celiac disease, because their intestinal tracts are damaged by gluten, which is a component in wheat, barley, rye, and some oat products. Many people report that they follow a gluten-free diet to lose weight. But the American Dietetic Association Nutrition Practice Guidelines on celiac disease report that there is no scientific evidence supporting the alleged benefit that a gluten-free diet will promote weight loss. Research has shown that adherence to the gluten-free dietary pattern may result in a diet that is low in carbohydrates, iron, folate, niacin, zinc, and fiber.

"Gluten-free" does not equate with fat-free or calorie-free. The bottom line is that evidence-based research is needed to confirm the benefits of a gluten-free diet beyond its use for celiac disease.

Question: I'm 26 and I want lose 15lbs. Are there any specific plans or diets that you would seriously recommend I try?

Answer:
Don't waste time and effort by following a fad diet. There are no foods or pills that magically burn fat. No super foods will alter your genetic code. No products will miraculously melt fat while you watch TV or sleep. And the so-called "expert" claims and testimonials could confuse even the most informed consumers.

If a diet or product sounds too good to be true, it probably is. And some ingredients in weight loss supplements and herbal products can be dangerous or even deadly for some people.

Be wary of rapid weight loss claims. Slow, steady weight loss is more likely to last than dramatic weight changes. Healthy weight loss plans aim for a loss of 1/2 pound to 1 pound per week. If you lose weight quickly, you'll lose muscle, bone, and water weight.  You'll also be more likely to regain the pounds quickly afterward.

Regular physical activity is essential for good health and healthy weight management. Find physical activities that you enjoy, and then aim for 30 to 60 minutes of activity on most days of the week. If you want to maintain a healthy weight, build muscle, and lose fat, the best path is a lifelong combination of eating smarter and moving more.  The best weight loss plan is personalized to your lifestyle and food preferences.

Question: I exercise hard every day for at least an hour. Could "raw foods" give me the nutrients I need to stay active?

Answer:
Raw-food diets are often vegan diets, which do not include meats or dairy products. They can be rich in plant-based nutrients, full of fiber, and low in fat and sugar. But because many food groups are avoided, raw foodists need to make sure they're getting enough vitamin B12, calcium, iron, and omega-3 fatty acids, which are found most naturally in animal products.

Raw foodists typically get the same amount of protein as non-vegetarians through plant foods eaten throughout the day. But because plant protein is less digestible, the American Dietetic Association (ADA) recommends eating plenty of soy and bean products. The ADA suggests that raw foodists and vegans increase their calcium intake, because their diets are high in sulfur-containing amino acids -- nuts and grains, for example -- which can increase calcium loss in the bones.

The ADA also recommends soaking and sprouting beans, grains, and seeds. Doing this may help the body better absorb the nutrients from these foods.

Finally, people who do not eat meat or dairy products should be vigilant about their vitamin D intake -- especially those who live in cooler, less-sunny climates. Low levels of vitamin D can lead to weaker bones. So the American Dietetic Association recommends vitamin D-fortified foods, including certain brands of soy milk, rice milk, breakfast cereals, and margarines. You also may want to take a vitamin D supplement.

Question: Some cereal brands recommend replacing two meals a day with a bowl of cereal in order to lose weight. Should a busy and active adult really try to lose weight this way?

Answer:
While this approach can help you easily keep count of the daily calories you've consumed, it lacks variety. So you may tire of this plan quickly.  It also limits your fruit and vegetable servings. And the USDA suggests that half our meals be filled with fruits and vegetables. The other quarters are filled with lean protein and whole grains, respectively.

Question: I'm trying to lose weight for a cruise I'm going on in three months. How should I eat if I want to lose about 30 pounds?

Answer:
Slow, steady weight loss is more likely to last than dramatic weight changes. Healthy plans aim for a loss of no more than 1/2 pound to 1 pound per week. If you lose weight quickly, you'll lose muscle, bone, and water. You'll also become more likely to regain the weight quickly afterward.

If you lose 1 pound a week before your cruise, that would total 12 pounds of weight loss, which is about two sizes smaller than your current size. Most cruise ships today offer menus for low-calorie and healthy choices, including wonderful salads, beautiful fresh fruit, lean entrée items, and lots of fresh fish.

Question: I want to get leaner and toned. I work out every day. What should my diet include or exclude for muscle definition?

Answer:
Carbohydrates, such as whole-grain breads, cereals, pastas, and brown rice, provide the energy needed to fuel a workout that is designed to tone your body.  Proper nutrition is important for resistance training, and weight and strength training. Maintaining good eating habits can improve your overall performance and increase muscle strength. This is true whether you lift weights once a week or multiple times a day. People who perform a great deal of resistance training need a diet that includes carbohydrates for energy and moderate amounts of fat and protein. You can easily meet these needs with a nutrient-dense, well-balanced diet.

Question: I run 6 miles a day. My goal is to get to 10. Are there any nutrients or foods I should be sure to eat as a runner?

Answer:
The more exercise you add to your day, the more calories your body will require. Focus on food quality, regardless of total caloric intake. Consume half of your foods as fruits and vegetables, and the remaining quarters as lean protein and whole grains.  Carbohydrates, including fruits, vegetables, and whole grain foods, provide the body with easy-to-use energy and the necessary nutrients for cell maintenance and repair. When eating for endurance sports, such as long-distance running, it's important to set a pace for refueling and dehydrating.  Multiple small meals and snacks throughout the day are often better than three large meals.

Question: If I use oil when I cook, does it really matter what kinds I use? If so, what are the best oils to use and why?

Answer:
Cooking oils are included in the fat sources in our diets. The recommendation is to keep fats at no more than 20% to 35% of your total calories from fat per day. The majority of this fat should be monounsaturated and polyunsaturated fats. Foods that are high in monounsaturated fats include vegetable oils (olive oil, canola oil, peanut oil, sunflower oil, and sesame oil), avocados, peanut butter, and many nuts and seeds.

Question: I do all the cooking for my family and I really focus on serving healthy meals and portions. I also pack my kids' lunches every day for school, snacks included. My youngest daughter of 13 has gained excess weight over the past year, but the rest of my kids are growing normally. She says she's not eating more food than I give her and all my kids are pretty active and involved. What could be going on? How can I help her avoid getting any heavier?

Answer:
In today’s culture, weight is an extraordinarily sensitive subject, especially for children and teens. Deciding how to approach weight issues with young people deserves careful attention. How you handle the topic can have serious and lifelong implications. Here are some tips for discussing weight with kids and what to do if a child brings up the topic on his or her own:

• Don’t talk. Do something. If your child is elementary age or younger and you’re concerned about his/her weight, just start making lifestyle changes as a family. Make it easy for kids to eat smart and move often. Serve regular, balanced family meals and snacks. Turn off televisions, video games, and computers. Look for ways to spend fun, active time together.
• Don’t play the blame game. Never yell, scream, bribe, threaten, or punish children about weight, food, or physical activity. If you turn these issues into parent-child battlegrounds, the results can be disastrous. Shame, blame, and anger are setups for failure. The worse children feel about their weight, the more likely they are to overeat or develop an eating disorder.
• As with any other important issue, make sure both parents and other important relatives are on the same page. Mixed messages about weight can have unhealthy consequences.
• If a health professional mentions a concern about your child’s weight, speak with him or her privately. Discuss specific concerns about your child’s growth pattern. Ask for ideas on making positive changes in your family eating habits and activity levels.
• For kids and teens, check out local programs and professionals who specialize in youth. Look for a registered dietitian with a specialty in pediatric weight management. Many hospitals and clinics have comprehensive programs with education and activities for both kids and adult family members. Some of these options may be covered by your health insurance plan.
• Focus on the big picture. The key is health, not weight. If your family starts eating better and moving more, your children may "grow into" their weight as their height increases. Compliment your children on lifestyle behaviors, rather than on the loss of a pound or two.

Question: I was advised to eat sweet fruits to curb my sweet tooth. But it's not working. What do you recommend?

Answer:
Maybe you're craving sweets because you're hungry. Be sure to eat breakfast, lunch, and dinner. If the time between meals is long -- more than four hours, for instance -- add a snack between those meals.

If fresh fruit just isn't taming your craving, then give into your sweet tooth's desires without consuming too many calories. Enjoy a small cookie or a small piece of good-quality chocolate. Try not to go over 150 calories per serving.

Question: I'm planning the Christmas menu for my family. Are vegan and vegetarian desserts any healthier than regular ones?

Answer:
The base of most desserts is a combination of sugar and fat, both of which are vegan/vegetarian if plant-based fats are used. While the plant-based fat may be a healthier fat, it's still a fat. Dessert recipes that contain primarily fruits with maybe a little bit of pastry -- such as a baked fruit crisp -- would be the healthiest choices.

Question: I hate carrots, raw or cooked. But I know they're good for me. What else can I eat to get those same benefits?

Answer:
Beta-carotene is found in carrots. It is used by the body to make vitamin A and is important for healthy eyes and skin. A cup of cooked sweet potatoes is equivalent to a cup of carrots.  Although it has three times the calories (150 vs. 52), the sweet potatoes also contain double the fiber (6 g vs. 3 g).  One cup of cooked butternut squash contains around 80 calories and is equivalent to carrots in beta-carotene, but double the fiber. Other good sources of beta-carotene include red bell peppers and mangos.

Question: What are some of the best high-protein, low-calorie foods to choose from?

Answer:
If you like to eat scrambled eggs, sliced roast beef, and black bean soup, you're already eating high protein foods that are lower in calories. In fact, there are 29 different types/cuts of lean beef -- most include the word "loin" in their name. Other good sources of lean protein include pork tenderloin, chicken, turkey, fish, fat-free or 1% milk, yogurt, and cheeses made with reduced-fat milk. 

Eggs contain the highest-quality protein. Don't skip the yoke because it contains a nutrient called choline, important for brain cell growth and repair. Vegetable sources of protein include legumes and beans such as lentils, black beans, pinto beans, peas, soy, tree nuts, and peanuts.

Thank you for joining us for WebMD Ask the Nutritionist. Be sure to check in on Wednesday, Dec. 14, at 1 p.m. ET when we discuss Nutrition and Pregnancy. Sign up if you'd like an email reminder the day before the event.

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Nov. 30, 2011, Diet and Weight Loss: Ask the Nutritionist, Carolyn O'Neil, MS, RD

Reviewed by Carolyn O'Neil, MS, RD on November 22, 2011

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