Diet and nutrition Archive

Ask the doctors

Q. I don't need to lose weight, so I don't exercise very often, but I maintain a healthy diet. Could my lack of exercise lead to health problems?

A. Exercise is essential for good health — even if you're not overweight. This point is illustrated by a recent study, published March 1 in The American Journal of Cardiology. It found that 30% of normal-weight people who were sedentary had the same risk of heart attack and stroke as people who were overweight. In short, just being at a healthy weight didn't necessarily ensure that someone was in good health. In addition to having a higher risk of serious cardiovascular events, some inactive but normal weight people were also more likely to have labored breathing during exercise and a larger-than-recommended waist circumference, compared with normal-weight adults who exercised regularly.

Managing emotionally driven weight gain requires planning ahead.

How much and when you eat isn't driven just by hunger, which you likely already know if you've ever found yourself hunched over a bowl of ice cream after having a particularly stressful day. Stress can set off a cascade of physical reactions in your body that may not only drive you to eat more and make you crave less nutritious, fattening comfort foods, but also help you pack on extra pounds much more easily.

"Stress drives up levels of a hormone called cortisol in the blood," says Dr. Fatima Cody Stanford, an instructor in medicine at Harvard Medical School. Cortisol is a hormone produced by the adrenal gland that helps to regulate your metabolism. It also plays a role in blood sugar management and memory. When levels of cortisol rise, it can promote inflammation and may spur the body to start stockpiling fat around the midsection. "Stress might also disrupt sleep and drive people to seek out food when they wouldn't normally — such as in the middle of the night," says Dr. Stanford.

Even though "nut" is in its name, a peanut is actually a legume. Like soybeans, lentils, and other legumes, peanuts are edible seeds that grow in pods. Still, most people think of them as nuts, along with tree nuts such as walnuts, almonds, and hazelnuts. (Unlike other legumes, which grow on vines or shrubs, peanuts grow underground.)

Nutritionally speaking, peanuts and tree nuts are fairly similar: they're all rich in healthy unsaturated fats and fiber, as well as several vitamins and minerals. Numerous studies suggest that people who eat peanuts or tree nuts frequently have lower rates of heart disease compared with people who rarely eat them. One added bonus for peanuts: they're not as pricey as tree nuts, making them a more affordable addition to your daily menu.

Q. My family has squabbled about oats for some time. Some members say that to get the biggest health benefit from oats you need to eat them raw, at room temperature, and moistened with water. Others say they should be cooked. Does cooking take something beneficial out of oats? Can you bring us some peace at breakfast time?

A. Eating a bowl of raw oats "moistened with water" doesn't sound all that appetizing. And I am not sure it makes sense from a nutrition perspective. Normal cooking takes little away from oats. In fact, cooking helps release some nutrients that your body can't extract from raw oats.

Concern about the amount of sugar in kids’ diets has led the American Academy of Pediatrics and the American Heart Association to encourage the consideration of steps to reduce the consumption of sugary drinks among children and teens.

Regularly eating whole grains can help you lower “bad” cholesterol, triglycerides, and blood pressure. A diet rich in whole grains also “is associated with a lower risk of developing cardiovascular disease, type 2 diabetes, metabolic syndrome, and certain types of cancer,” says Dr. Qi Sun, an associate professor at Harvard Medical School.

In a study published in JAMA Internal Medicine, Sun and colleagues reported that eating whole grains may even extend your life. Sun used the diet information of more than 100,000 men and women whose health was followed for more than 20 years. The study found that those who regularly ate whole grains had a 9% lower overall death rate and a 15% lower death rate from heart disease.

Try losing weight, changing your diet, and exercising.

Sometimes getting your blood pressure under control requires that you take several medications each day, such as a diuretic and a calcium-channel blocker. But some therapies don't involve medication. "People who have drug intolerances or are unwilling to take medications can try pill-free therapy, and it can also be used to make a medication regimen more effective," says Dr. Randall Zusman, a cardiologist and Harvard Medical School associate professor.

It may be helpful to eat a diet rich in omega-3 fatty acids.

 Image: Elena_Danileiko/Thinkstock

Maybe you're hoping to protect your thinking skills by eating oily fish like salmon or taking a daily fish oil supplement. After all, the media frequently talk about the benefits of omega-3 fatty acids in fish oil, and sales of fish oil supplements are more than $1 billion per year in the United States. But can fish oil keep us thinking clearly? "For people who are healthy, who don't have a decline in memory and thinking skills, the question of prevention has not yet been answered," Dr. Scott McGinnis, an assistant professor in neurology at Harvard Medical School, explains.

About omega-3s

Omega-3 fatty acids are polyunsaturated fats in food that are essential for health. There are three main types:

How to gain weight safely when you're down a few pounds.

You've spent your whole life trying to keep extra pounds off. Now your doctor says you actually need to gain a few pounds to stay healthy. But healthy weight gain isn't so simple. "Some people find it difficult to add enough calories to their usual diet. It takes a lot of effort," says registered dietitian Kathy McManus, director of the Department of Nutrition at Harvard-affiliated Brigham and Women's Hospital.

Where to begin

A dietitian can help you come up with an eating plan based on your specific calorie needs. It starts with understanding how quickly you've lost weight and why (see "Why are you underweight?"). Your age, size, activity, amount of weight lost, and overall health will be key to designing a diet that's right for you.

News briefs

Ever hear the saying that drinking beer before wine can reduce hangover symptoms? It's just a myth, according to a small randomized study published Feb. 1, 2019, in The American Journal of Clinical Nutrition. Researchers found out by dividing 90 men and women (ages 19 to 40) into four groups. One group drank beer first, and then wine; another group drank wine first, and then beer; and the last two groups drank only beer or only wine. All of the participants drank until they were intoxicated (measured by a breath test), and then rated their hangover symptoms (like headache and nausea) on the day after drinking. The process was repeated a week later, but this time the beer-first group drank wine first; the wine-first group drank beer first; the wine-only group drank only beer; and the beer-only group drank only wine. The results: everyone experienced hangovers, no matter what they drank or the order in which they drank it. The strongest predictors for hangover intensity were perceived drunkenness and vomiting. The bottom line: Drinking too much is unhealthy for anyone. If you drink at all, drink in moderation. That means no more than one drink per day for women, no more than two drinks per day for men.

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