Nutrition Planning with GERD and an Unhappy Thyroid | QA

Nutrition Planning with GERD and an Unhappy Thyroid | QA

Question:

Hi, I was wondering if you would be able to help my girlfriend with her diet.  We’re both LA Fitness members.  She’s an avid swimmer and eats pretty healthy (usually eating far less than what I normally intake). She has a thyroid issue and suffers from GERD, acid reflux. She was swimming several times a week and doing weights, yet not really losing any weight. And, if she can keep food down it’s a good day for her. She takes stuff for GERD but stopped taking her thyroid medication as she wasn’t getting any change. She was going to try one of the app diets, but her mom passed away this year and canceled on that. So, I was wondering if there’s a diet you would recommend for her, to first get her stomach back on track and possibly help her to lose the weight she wants to drop. Thank you for your help. 

– John B 

Answer:

It’s imperative that your girlfriend follow up with her physician on an appropriate course of action regarding her thyroid condition since she stopped taking her medication. Thyroid function determines cellular metabolism and doctors test hormone levels, not body weight, to indicate medication effectiveness. 

I’ll assume she requested your assistance, otherwise advice offered by you regarding her diet and weight may not be accepted! (Always a good idea to be clear on a significant other’s intent in sensitive matters.) If she already eats healthy and has had a recent stress, then simply reducing portions may be reasonable versus following a structured diet plan.  

For gastroesophageal reflux disease (GERD), the International Foundation for Intestinal Disorders* recommends a diet that includes non-citrus fruits, lean proteins, complex carbohydrates, and vegetables except tomatoes and onions. Low-fat dairy foods, non-mint chewing gum, and small amounts of oils, avocado and nut butters are generally well tolerated. Avoid alcohol, caffeine, carbonated beverages and chocolate.  

There is no specific menu plan to follow for losing weight with acid reflux. If your girlfriend is absolutely ready to begin new eating habits, then she may resume her intention of using an app and make adjustments for GERD accordingly. Consumer Affairs recently posted their top 10 weight loss apps of 2019 based on user ratings. And last year Kaiser Permanente shared their reviews of 10 nutrition and diet apps of 2018. That’s twenty apps for her to choose from though not all offer meal plans. 

Best of luck to both of you for 2020 from Living Healthy! 

* https://www.aboutgerd.org/diet-lifestyle-changes/diet-changes-for-gerd.html Accessed 11/22/2019 

– Debbie J., MS, RD

This article should not replace any exercise program or restrictions, any dietary supplements or restrictions, or any other medical recommendations from your primary care physician. Before starting any exercise program or diet, make sure it is approved by your doctor.

Some questions have been edited for length and/or clarity.

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Juggling Protein and Fat-Burner Supplements | QA

Juggling Protein and Fat-Burner Supplements | QA

Question:

I am a pretty fit, over 50-year-old female. I eat anywhere from 1,200-1,400 calories per day. However, I’ve since learned my real issue is compulsive eating. I keep getting hungry and will crave sugary carbs (something I never really did when younger).   

I take Carnitine about twice to three times per day and one to two scoops of Lean 1 fat burning meal replacement per day. I take 1 scoop in the morning at times with 2 wheat bread slices, a banana at times.  I take another scoop again after a workout.  The Lean 1 is about 95 calories for one scoop (11g carb cal/ 2.2g fat cal /10g prot cal).  I started to use a post-workout scoop as a meal replacement generally. I must say the urge to overeat dramatically decreased doing all of this and my sugar levels and carb levels are more balanced in the day (protein and fat also)!  

Dinner is the heaviest meal and, by the time I eat, I’m hungry for it. I recently added a microcellular casein protein scoop at night after working or as a snack hoping it will help achieve a more muscular / defined. I tend to crave candies around 11pm and one reason I chose the Casein option as well as for other benefits. I wanted recommendations on how to incorporate these three items into my daily regimen if I’m not doing so appropriately.  

– Kina C.

Answer:

Kina, it sounds like your supplements have had the desired impact on your compulsive eating and carbohydrate cravings. Let me say that, although I normally promote whole food solutions to hunger and other dietary issues, I’m glad these are working for you. Still, I’m curious if you tried a solid option (like half an apple with peanut butter) after workouts to forestall the candy craving?  

Your intake of the meal replacement and protein powder total around 300 calories, which is a considerable portion of your day. Not knowing which foods these replaced and if they subsequently added or reduced intake from your previous eating habits, it’s difficult to comment on their use. Plus, “fat burning” supplements have other non-caloric components such as caffeine or other stimulants.  

My feedback would also be to follow each products’ limits for use. Know that protein utilization at one time is rather limited (about 30 grams per meal), thus you may not be getting the most out the fat-burning meal replacement shake and micellar casein protein scoop if taken together after your workout. Perhaps moving one to an afternoon snack before dinner is in order. Sounds like your day is relatively low-fat and low-calorie leading up to dinner, therefore it’s no surprise you’re hungry enough to eat a ‘heavy’ meal. 

Also, I’d advise sticking to your vegetables and protein dinner, and consider adding a half-cup of brown rice on your workout evenings. Don’t forget to search the Living Healthy blog for related inquiries! Read our previous answers regarding cravings and hunger for more advice.  

– Debbie J., MS, RD

This article should not replace any exercise program or restrictions, any dietary supplements or restrictions, or any other medical recommendations from your primary care physician. Before starting any exercise program or diet, make sure it is approved by your doctor.

Some questions have been edited for length and/or clarity.

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Vegan Foods to Increase Bone Density | QA

Vegan Foods to Increase Bone Density | QA

Question:

I would like to increase my bone density. Do you have any suggestions for me regarding the best vegan foods to eat?

Very respectfully,

– Brenda H.

Answer:

Congratulations on providing the first bone density inquiry to Living Healthy! Your answer follows. First, here’s a brief primer on bone mineralization for the rest of our audience: Bone is actually a living tissue with blood supply to the marrow and cells that are adding tissue (osteoblasts) while others remove it (osteoclasts). The main structural compound is hydroxyapatite, made from the minerals calcium and phosphorus. Bone also contains small amounts of magnesium, sodium and bicarbonate. Density refers to the mass of the bone mineral material in a certain volume. Peak bone mass occurs around age thirty years. Keeping bones strong and avoiding loss of the matrix helps to prevent a porous condition later in life called osteoporosis.  

How to Increase Bone Density 

Diet and physical activity are controllable lifestyle factors that account for 10–50% of bone mass and structure. Physical activity stresses the bone to adapt and strengthen. Maintaining an adequate weight allows optimal pressure from gravity against the ground. Not smoking and avoiding heavy alcohol use prevents mineral loss due to tobacco products and drinking. 

A well-balanced diet is important for bone health throughout the lifespan though notably significant are calcium and vitamin D. As mentioned previously, calcium is a major mineral component of bone structure while vitamin D assists in calcium absorption and utilization. The majority of the body’s phosphorus and magnesium are found in the skeleton. Other micronutrients that appear to play a positive role in bone health include vitamins B12, C and K, and minerals copper, manganese, zinc, potassium and iron. 

Vegan diets abundant in whole grains, legumes, fruits, vegetables, nuts and seeds that are not excessive in sodium or caffeine can promote optimal bone density, but may need to be supplemented in certain areas. The strongest plant sources of the aforementioned nutrients are dark green leafy vegetables, cabbage, broccoli, beans, mushrooms exposed to light, almonds, blackstrap molasses, okra, calcium-set tofu, fortified nut milks, nut butters, brown rice, dried figs, chia seeds, potatoes, citrus fruit, strawberries, tomatoes, dried coconut and cocoa. Supplements of vitamin B12 are advised for vegans since it is not found in plant foods. 

Sources: 

  1. Office of the Surgeon General (US). Bone Health and Osteoporosis: A Report of the Surgeon General. Rockville (MD): Office of the Surgeon General (US); 2004. 6, Determinants of Bone Health. Available from: https://www.ncbi.nlm.nih.gov/books/NBK45503/ 
  2. Sharon Palmer. Protecting Bone Health Among Vegans. Today’s Dietitian, February 2016; 18 (2): 24. https://www.todaysdietitian.com/newarchives/0216p24.shtml Accessed 11/22/2019 

– Debbie J., MS, RD

This article should not replace any exercise program or restrictions, any dietary supplements or restrictions, or any other medical recommendations from your primary care physician. Before starting any exercise program or diet, make sure it is approved by your doctor.

Some questions have been edited for length and/or clarity.

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Achieving a Calorie Deficit with Hypoglycemia | QA

Achieving a Calorie Deficit with Hypoglycemia | QA

Question:

Hi, I’d like to know some good ways to cut calories for people with low blood sugar issues (hypoglycemia). It can be hard to cut caloric intake with approaches like intermittent fasting and meal replacement shakes because that causes blood sugar levels to drop. So, I’d like to know the best way to obtain a calorie deficit when there are limitations like hypoglycemia in play. Thank you for your help!

– Michael B.

Answer:

When people experience hypoglycemia it’s usually as a drop after elevated blood sugar following a meal (called reactive hypoglycemia), rather than waking up with low blood sugar (fasting hypoglycemia). The best approach to restricting intake while avoiding a hypoglycemic event would be to modestly reduce intake throughout the day, particularly of refined carbohydrate. 

Retaining protein, fiber and fat at an eating session will help slow carbohydrate absorption and blunt the initial spike in blood sugar. The analogy I like to provide is to consider a roller coaster – the greater the incline/peak, the greater the fall. Fun for a ride, but disaster for blood sugar stability. Keeping blood sugar steady is the goal, so consuming foods that minimize a spike to begin with is part of the approach. Stick to complex carbohydrates from starches along with your protein foods, vegetables, fruit, dairy and nuts/seeds. 

Consider cutting down portions slightly at each meal and snack. You’ll hardly notice a difference in satiety from eating three-quarters of your normal volume. And leave the side of bread/rolls/tortillas, only eating those that are the main part of the entrée. For example, no garlic bread necessary if you’re eating pasta and skip the side of toast with your omelet and home fries.  

– Debbie J., MS, RD

This article should not replace any exercise program or restrictions, any dietary supplements or restrictions, or any other medical recommendations from your primary care physician. Before starting any exercise program or diet, make sure it is approved by your doctor.

Some questions have been edited for length and/or clarity.

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Have a nutrition question? Our registered dietitian is ready to help!

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Mycotoxins in Food – How to Avoid Exposure | QA

Mycotoxins in Food – How to Avoid Exposure | QA

Question:

I’m hearing a lot about the dangers lurking in certain foods and keep seeing mycotoxins on the list. What are these, where are they, and what’s the risk? I’m going crazy trying to avoid contaminants! It seems nothing is safe.

– Karen H.

Answer:

No foods are truly 100% safe or non-perishable. Although we typically think of spoilage and rotting from visible bacterial growth and pest infestation, contamination of food can also be hiding from the naked eye. It’s said that mycotoxins are present practically everywhere in trace amounts and are unavoidable. 

According to the World Health Organization, “mycotoxins are toxic compounds that are naturally produced by certain types of molds (fungi).” Health effects from these toxins range from acute poisoning to immune deficiency and death. Mycotoxin-producing molds can grow on numerous foods such as cereals, dried fruits, corn, peanuts, coffee beans, nuts and spices. Fox News reported in 2015 that “in the United States aflatoxin contamination is most common is the Southeast in peanuts and corn products.” Aflatoxins are a type of mycotoxin known to cause liver cancer. Other major mycotoxins include citrinin, deoxylnivalenol, fumonisins, ochratoxin, patulin, trichothecenes and zearatenones. 

The good news: Contaminated foodstuffs (either visibly or tested) are not permitted in developed countries’ marketplace. The FDA has set very strict tolerance levels for certain mycotoxins present in crops. 

The bad news: In the U.S., agricultural products kept within state lines and animal feeds are not subject to FDA limits. Additionally, through the food chain, the consumption of even tiny amounts of mycotoxins can have a cumulative effect. This is evident in livestock, eggs and dairy products. 

How to avoid mycotoxins, then? You can reduce mycotoxin exposure by obtaining your raw food (whether conventional or organic) from trusted sources that adhere to federal and state safety testing and from local farmers’ markets (short storage periods). Of course, it could also be that reducing consumption of animal products, corn and peanuts may reduce your chance of exposure. 

Additional sources: 

  1. Alshannaq A, Yu JH. Occurrence, Toxicity, and Analysis of Major Mycotoxins in Food. Int J Environ Res Public Health. 2017;14(6):632. Published 2017 Jun 13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5486318/ doi:10.3390/ijerph14060632 
  2. Bennett JW, Klich M. Mycotoxins. Clin Microbiol Rev. 2003;16(3):497–516. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC164220/  doi:10.1128/cmr.16.3.497-516.2003 

– Debbie J., MS, RD

This article should not replace any exercise program or restrictions, any dietary supplements or restrictions, or any other medical recommendations from your primary care physician. Before starting any exercise program or diet, make sure it is approved by your doctor.

Some questions have been edited for length and/or clarity.

Ask our Dietitian

Have a nutrition question? Our registered dietitian is ready to help!

Email nutrition@lafitness.com or submit your question below and it may be featured in an upcoming article!

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