What do you have about low carbohydrate diet or anything that discusses foods and carbohydrates?   I have been advised by a physician to limit my carbohydrates.

This is the kind of letter that annoys me, not because of the writer's legitimate question, because of what was apparently missing in the doctor's advice.

First one would have to know why the doctor told you this.  To lose weight?  Because of borderline high blood sugar?  Because of low blood sugar episodes?  Or something else altogether?

Bet it was an overworked doctor at a crowded clinic or HMO.  If not, shame on him or her.  To advise a patient this way and not give specifics, or if it is treatment for a serious condition, to fail to give a referral to a dietitian, is outrageous behavior.   

Carbohydrates are mostly starches and sugars.  This would mean limiting your intake of sugared drinks, added sugar in other foods, candies, most desserts, bread and other baked goods, potatoes, corn products, rice, pasta, etc.  A lot of this is empty calories anyway.  But even real fruit juice and whole grain cereals and breads contain carbohydrates.  To what extent does the doctor want you to limit your carb intake?

Does the doctor just want you to eat less?  Or eat other things, like more protein, for example.  That can be hard on the kidneys for some people.  If you cut carbohydrates too much, you may find you are eating more fats to compensate-- possibly a very bad idea.  More salads and non-starchy veggies are good for almost everyone, so that is an excellent place to start if you have no other way to get advice.   Whole grain products (brown rice, real whole wheat bread, wheat and oat bran, etc.) contain slightly less carbohydrates than refined ones, since they contain healthy fiber, plus they are slower to digest, therefore slowing the release of sugars into the bloodstream.

But basically, you need to get more specific information from your doctor or a referral to a dietitian.  Otherwise, any radical changes you make in your diet may be jumping out of the frying pan and into the fire, so as to speak.    I don't know of any reliable sources of information, although there are plenty of fad diets out there, including low-carb ones, that often do more harm than good long term.  Don't fall for them, please.

I'm going to refer this letter to Dietitian Jessica Setnick for her comments, so please get back to us in a few days.   

My name is Z. *** and I eat too much.   I love to eat because I am unhappy.  Please send me free diagrams. 

First, I don't have any diagrams.  Second, I'm afraid you're about to put the cart before the horse here.

Restricting one's diet and caloric intake when one is overeating because of unhappiness is like trying to scrub a dirt floor.  You're unlikely to get anywhere with it.

Furthermore, suppose I had a "diagram" for losing weight and you had the will power to follow it.  That's like putting a band-aid on a broken arm.  The problem will still be there, and the big danger is that, deprived of acting out its problem by the symptom of over-eating, your body will act out in another and perhaps more dangerous way.   Sometimes it's a case of "better the devil you know than the one you don't"!   Your mind and body are trying to tell you something.  

At least you realize the basic cause of your overeating; dissatisfaction with your life.  Here's some ideas for you to toss around:

Are you unhappy because you are fat?   What would you do or have if you were thin that you can't do or have as a fat person?  Are you secretly afraid those good things wouldn't happen after all if you were thin?  Or that you wouldn't deserve them?  Maybe being fat keeps you from facing up to something.

Do you have situations in your life that are making you very unhappy?  Deal with them!   That doesn't mean you can necessarily solve these problems, but you can either change them or learn to live with them in a better frame of mind.

Is it easier just to eat and enjoy eating rather than make painful changes in your life and in your outlook?

My own recommendations are:

1. Try to improve your diet rather than restrict it.   Stock up on healthier foods including lower-calorie snacks.   Eat lots and lots of veggies, fruits, low-fat calcium rich foods and whole grains.   Cut most added sugar out of your diet.   Read from articles listed in the link at the bottom of this page for more guidance.
   
   
2. Analyze just why you are unhappy and what you could do about it.  Write down the pros and cons.  See if you can change the problem and not the symptom (overeating).   Be good to yourself in other ways.
   
   
3.  If you can't do these things yourself, think about seeing a counselor-- perhaps a psychologist, dietitian or other professional.  To find a dietitian in your area you could check out http://www.eatright.org  where you can search for one by zip code.   
   
   
4. Please don't fall into the trap of taking drugs of any kind-- prescription or otherwise-- on a long-term basis to control your weight and/or depression.  That, too, is a band-aid that may keep you from dealing with the real problem.   

Write again.  I would like to hear from you, and keep in mind that there's people who care.

Related:   All About Healthy Choices  

Keith.....Protein Bars

Hi.   I recently realized that because of the large amount of in-between-meal protein bars (40-30-30) I'm consuming every day, I'm also getting a lot of sugars with that.  So I started to read up on other convenient sources of carbs, and most books recommend stuff like fruit.  No surprise there.

My confusion stems from this: the reason I want to cut my sugar intake is that I've been putting on a little bit of excess weight, and I attribute it to the sugars in the protein bars, since my diet and exercise regime is otherwise topnotch.  But if I look at the sugar content of most fruits (e.g. apples), there is not much less sugar in them than in the protein bars.  So if I switch from 40-30-30 protein bars to, say, a mix of low-carb protein bars and fruit, I'll be taking in almost as much sugar as before.  Why is that any better, strictly from the point of view of fat development?  (I realize, of course, that from an overall nutritional point of view, it's better to eat apples than protein bars!)

If I'm right on that, then can anybody suggest in-between  snacks that are  40-30-30, and not loaded with sugars? Since I need to eat them at work, it has to be something convenient and portable. 

Thanks! And if you could copy me directly via email, that would be great!

Sorry for the delay in getting back to you, but your letter threw me for a loop.  I cannot imagine eating that amount of protein bars.  I'm inclined to think your real problem is working at a job where you can't take a healthy sit-down lunch break and a walk in the park, but who am I to say so.  For several years I was working under such pressure that there often was no way I could leave to eat, but I'd get someone to bring me, for instance, a tuna sandwich with tomatoes and lettuce, or an apple and piece of cheese, a small can of baked beans, a carton of yogurt, or that old standby, a banana, marmalade and peanut butter sandwich which was risky as it can really mess up a keyboard!  And 40-30-30, etc. is pure Greek to me.  

So I'm asking Dietitian Jessica Setnick to field this one for me.

The main point to reinforce is that he is not gaining weight because of the sugars in his bars, he is gaining weight for the same reason most people gain weight.  He is eating more kcalories than he is  spending. 

There is nothing in protein or sports bars that he couldn't find in food.  The sugars in his bar are likely not that different from the sugars in fruit, or crackers, or other sources of simple carbohydrates.  The only advantage of bars is convenience.  There are several pitfalls, though, and Keith has found one of them.  When eating bars instead of food, it is often difficult to gauge satiety (feeling full), which can easily lead to overeating.  If Keith is gaining weight eating mostly bars, especially between meals, when he might need a smaller snack, but ends up eating a whole bar instead, it means that he is eating more kcalories than he is spending.  This would occur regardless of how much sugar is in the bars, and from his point of view of "fat development," there is no difference when eating sugars from fruits or sugars from protein bars.  Once they are chewed up and into his stomach, they are indistinguishable.  The only difference is the other nutrients they come in with - the bars provide fats, proteins, possibly some complex carbohydrates (starch), vitamins, and minerals in addition to the sugars.  The fruits provide starch, vitamins, and water, but essentially no proteins or fats. 

That leads to Keith's question of how to convert a fruit (100% of kcalories from carbohydrates) into a 40-30-30 snack (40% of kcalories from carbohydrates, 30% from fats and 30% from proteins).  Of course I am tempted to say, Why?   Why do his snacks need to be 40-30-30.  Why not just stick with the good nutrition principle of including proteins, carbohydrates, and fats at every meal without having to actually calculate the percentages?  For example, cheese and crackers.  That comes close to 40-30-30 without even trying.  Peanut butter on an apple - same thing.  But Keith didn't ask for reasons to follow or not follow 40-30-30.  He asked for menu ideas.  I would suggest checking out a copy of The Zone Diet (not good for weight loss, but contains recipes for meals and snacks that meet 40-30-30) or searching on the web.  I am sure that there are websites devoted to this question, it is just a matter of finding them. 

Just to be clear, I am not willing to advocate a 40-30-30 eating style to anyone I have not met, and I do not think it would be healthy for many people.  But many people like to experiment with different ways of eating, and I encourage anything that helps people take a healthy (meaning not obsessive) interest in their nutrition.  My one caveat to Keith is that no matter what kind of eating plan he follows, if he continues to eat more than his body needs, either because he is eating when not hungry, eating after he is full, eating foods that do not satisfy him because he doesn't really like them, or eating till the end of the bar, just because it's there, he will  continue to gain weight. 

There you are, Keith.  This will give you some basis on which to make some decisions you will be happy with.  There's no magic bullet.

PS:  How about a Tupperware® container with fresh veggie sticks, salt and ice cubes?  I used to carry this to the office to avoid too many higher calorie snacks and give me something to crunch on when the pressure was high and I got stress-induced munchies, and this filled me up too.  Sunflower seeds (in their hulls) are good on both points, but really messy, as my assistant during those years, whose job including tidying up after me, could attest to.  Also sugar-free chewing gum helped.  And frequent cups of tea and bottled water, which give an illusion of fullness to some degree.  

For those interested in the Zone Diet:

• The Zone : A Dietary Road Map to Lose Weight Permanently : Reset Your Genetic Code : Prevent Disease : Achieve Maximum Physical Performance by Barry Sears, Bill Lawren 
  
  
• The Balanced Diet Cookbook : Easy Menus and Recipes for Combining Carbohydrates, Proteins, and Fats by Bill Taylor
  
  
• A Week in the Zone by Barry Sears
  
  
• The Top 100 Zone Foods : Supercharge Your Health by Barry Sears
  
  
• The 40 30 30 Phenomenon : The Easy-To-Follow, 'Zone'-Based Diet Plan Tailored for Individual Needs (Keats Good Health Guide) by Ann L. Gittleman
  
  
• Mastering the Zone : The Next Step in Achieving Superhealth and Permanent Fat Loss by Barry Sears, Mary Goodbody
  
  
• Zone Food Blocks: The Quick & Easy, Mix & Match Counter for Staying in the Zone by Barry Sears

Can one buy a book that contains the same USDA information on nutritional values?

Frankly, I can't find it listed.  I poked around in the USDA site and didn't see one that lists all the nutritional values, although I remember those books years ago and they were a pain to use.  The nice thing about the online version is that one can specify quantities, types and so on and their computer gives you the calculations, saving a lot of math on your part. 

Here's a list of some publications on food at The Federal Consumer Information Center.  Since they are available online, you frequently have to pay a small fee to receive printed versions.  You can also order a catalog of their publications.

If you are trying to lose weight, control diabetes or some other disorder, there's guides available for that, printed or online.

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