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Nutrition and Digestion: Ask the Nutritionist

WebMD's Chief Medical Editor, Michael Smith, MD, answers your questions about nutrition and digestion issues.

Question:
I cannot eat butter because of acid reflux problems. What would be the healthiest substitute?
Answer:

High-fat foods like butter are a common trigger for acid reflux and heartburn. The trick is to slim down the fat content in your diet and see if that improves your symptoms. There are “lite” versions of butter that have less fat. But if you still have symptoms with that, light margarine is another option. Just be sure to choose one that has zero trans-fat and no hydrogenated oils listed in the ingredients. Some people with acid reflux tolerate vegetable and olive oil better than butter. So you can give those a try, as well.

Question:
I've been drinking a tea that is making me go to the bathroom a lot. But I don't seem to be losing weight. Is this something I should be doing or should I stop drinking the tea?
Answer:

Tea is rich in antioxidants. And while more research is needed, some studies have shown that tea, especially green tea, may help you maintain a healthy body weight and keep your cholesterol and blood pressure stable. However, it’s very unlikely that tea alone is going to help you lose weight if you’re not watching your fat and calorie intake and exercising regularly. If you’re drinking a lot of tea, just the extra liquid is going to make you have to go to the bathroom more often, which is normal. If the tea contains caffeine, that can also cause some people to go to the bathroom more often.

Question:
Can taking too many vitamins cause or contribute to ulcerative colitis?
Answer:

It’s always best to get your nutrients from your diet. But taking vitamins and minerals may be a good idea, given the increased risk of malnutrition for people with ulcerative colitis.

You never want to take more than the recommended amount of any vitamin or mineral. There are certain vitamins and minerals that people with ulcerative colitis are more likely to need in supplement form, including vitamin D, calcium, iron, and folic acid. A multi-vitamin may even help you get the added nutrients you’ll need. Talk to your doctor or a nutritionist to make sure you’re taking the right vitamins, at the right amounts.

Question:
I was told that tomato juice is good for regulating high blood sugar. Is this true?
Answer:

There is really nothing about tomato juice that would help you manage your blood sugar. Foods that are high in fiber can help your blood sugar. But tomato juice only has 1 gram of fiber per cup, which isn’t much. Also, most tomato juices will have a high salt content. One cup can hold about 25% of all the sodium you should be getting in a day.

A healthy way to regulate your blood sugar is to eat several small meals throughout the day and limit your intake of “bad” carbs -- such as white rice, potatoes, and pasta -- and foods that are high in sugar content. Opt for vegetables, fruit with the skin, and whole wheat carbs instead.

Question:
I'm lactose intolerant. Besides milk, what other foods should I avoid?
Answer:

First, it’s important to understand that you don’t have to avoid milk and dairy just because you’re lactose intolerant. Dairy products are the best sources of calcium and vitamin D. A healthier option is to choose lactose-free milk and dairy, preferably low-fat or fat-free options. There are also lactase enzyme supplements that can help prevent LI symptoms when eating or drinking regular dairy. Yogurt is also an excellent source of calcium and protein that most people with lactose intolerance can eat, with few to no symptoms, since the probiotics in yogurt help digest the lactose sugar that causes LI symptoms with other dairy products.

Question:
How much sodium should you eat with every meal?
Answer:

The simplest answer is as little as possible. Your body needs sodium, but most of us get plenty of sodium just from the foods that we eat, without adding any extra. Sodium is even found naturally in certain foods. You should get no more than 2,300 mg of sodium a day, or no more than 1,500 mg a day if you’re over 50, African-American, or have high blood pressure, diabetes, or kidney disease.

The reality is that most of us get around 3,400mg a day.

Question:
I recently found out that I have hypoglycemia. How can I eat to avoid dips in my blood sugar?
Answer:

Work with your doctor to make sure you’re addressing your low blood sugar in the right ways. Certain medical conditions can cause low blood sugar, or it may simply occur from not eating. For some, it can occur a few hours after eating, which is called reactive hypoglycemia.

If your doctor determines there is no medical condition causing your low blood sugar, there are several things you can do to help prevent it. Eat several small meals and snacks throughout the day, about every 2 to 3 hours. Include lean protein and high-fiber foods like whole grains, fruits, and vegetables. Limit high-sugar foods. Alcohol can also cause low blood sugar. So be sure to eat a little something if you’re having a drink.

Question:
I recently had a heart attack. Should I avoid eating red meat as a result?
Answer:

Anyone with heart disease needs to limit the amount of saturated fat in their diet. Saturated fats mostly come from meat and high-fat dairy products. Foods that are high in saturated fat also tend to be higher in cholesterol. You don’t need to eliminate red meat altogether, but you will need to limit it and choose leaner cuts of red meat, such as top sirloin or round roast. Also, be aware of other foods that are high in saturated fats, including cream, butter, high-fat cheeses, and many baked and fried foods.

Question:
It seems that some foods pass very quickly through my digestive system. For certain foods, there's very little time between when I eat and when I have to use the bathroom. Is this normal?
Answer:

No. That is not normal and you should be sure to check with your health care provider. It sounds like a type of food intolerance where your body is not properly digesting certain foods and they’re just passing through your system. In addition to the unpleasant symptoms this may cause, such as diarrhea, you may be missing out on important nutrients. Certain medical conditions can cause this problem. One of the most common causes is lactose intolerance, when your body can’t digest lactose, the sugar found in milk and other dairy products. Good news is that lactose-free dairy can solve the problem. But it’s important to find out what’s causing your particular problem first. Until you can get in to see your doctor, start keeping a food diary, noting which foods you eat that tend to cause more symptoms. Then share this information with your doctor.

Question:
I am a 30-year-old woman, and I don't like milk. Will taking a vitamin D and calcium supplement each day be sufficient?
Answer:

Calcium and vitamin D supplements are a good way to help you reach the daily recommended intake of 1,000 mg of calcium and 600 IU of vitamin D for a 30-year-old woman. But it’s best to get the vitamins and minerals you need from what you eat. If you don’t like milk, yogurt is a source of calcium that’s actually even better than milk. However, unlike milk, yogurt is not typically fortified with vitamin D. Vitamin D is a tough nutrient to get in your diet. But other food sources include fortified cereals, salmon, and canned tuna.

Question:
Can ingesting calcium cause constipation?
Answer:

While calcium supplements can cause constipation, it’s quite uncommon when they’re taken appropriately and at the right dose. If you take too much, constipation is a more common side effect. Your body can’t absorb more than about 500 mg of calcium at a time. So there is no reason to take more than that at once.

Question:
Can eating too much processed sugar have a negative effect on your digestion?
Answer:

While processed sugar isn’t particularly bad for your digestion, it’s definitely something you want to have only occasionally if your goal is to be healthy. Increased sugar intake is associated with abnormal cholesterol and fat levels in the body. And overloading on sugary foods will usually add a significant number of calories to your diet, which can lead to weight gain.

Question:
I'm a 30-year-old woman and I have IBS. Is there a specific diet that is recommended for people with IBS?
Answer:

Dietary habits definitely play a role in managing irritable bowel syndrome (IBS). But there is no one diet plan that fits everyone with IBS. Nonetheless, many people with IBS do better maintaining a high-fiber diet, particularly if constipation is a problem. Most of us get far too little fiber. So it’s a good idea to increase your fiber intake with fruits, vegetables, whole grains, and even fiber supplements. Increase your fiber intake slowly, so that your digestive system has time to get used to it. Otherwise, it might cause increased gas or bloating. Also, be sure to drink a lot of water to make sure the fiber does its job, which is to keep your bowels moving.

Other diet strategies that work for some people are eating smaller, more frequent meals to decrease bloating. Some people may find that certain carbohydrates can be problematic. For those people, an elimination diet called FODMAPS may help. You should work with your health care provider or a nutritionist if you want to go that route.

Question:
It seems like the women in my family start gaining a lot of weight in their abdomens once they turn 60. Is there a certain diet I can maintain to avoid this? I’m 58 and in pretty good shape.
Answer:

One of the challenges with menopause is weight gain; the decrease in estrogen that a woman experiences may play a role. In addition, people tend to lose muscle as they age and will often become less active. But your age shouldn’t stop you from exercising. Exercise, and especially strength training, will help keep your muscles strong. And muscles burn more calories throughout the day, which provides the body with an increase in metabolism. Even 10 minutes of exercise a day can help. But it’s better to reach for at least 30 minutes, 5 days a week.

It’s a natural part of aging that our metabolism decreases some, despite our best efforts to speed it up. So we do need to decrease how much we eat as we get older. Focus on keeping whole grains, fruits, vegetables, and lean protein sources in your diet. And eat smaller meals, more often.

Question:
I have type 2 diabetes. Is it better for me to use agave or honey as a sweetener?
Answer:

Both agave and honey are sources of sugar, and could present a problem in controlling your blood sugar. Refined agave sweeteners are not inherently healthier than sugar or honey. It’s fine to use small amounts of agave or honey. However, if your blood sugar is not well controlled, you may be better off using an artificial sweetener from time to time. The American Diabetes Association recommends artificial sweeteners to help people with diabetes keep their blood sugar under control.

Question:
Are there any foods I can eat to naturally expel gall stones? Are there any foods I should avoid or cut back on to avoid gallbladder problems?
Answer:

Diets that are high in fat and cholesterol and low in fiber may increase the risk of gallstones. Cutting out fat and cholesterol may help calm symptoms from gallstones. This doesn’t mean they’ll actually dissolve and be expelled. But it may help improve your symptoms. As always, a healthy diet is best, whether you have gallstones or not. This includes fresh fruits and vegetables, whole grains, lean meat and protein sources, and low-fat dairy products.

Thank you for joining us for WebMD Ask the Nutritionist. Be sure to check in on Wednesday, Sept. 12, at 1 p.m. ET, when we will discuss "Nutrition for Beauty." Sign up if you'd like an email reminder the day before the event.

WebMD Ask the Specialist Transcript

Reviewed by Michael W. Smith, MD on August 08, 2012

The opinions expressed in this section are of the Specialist and the Specialist alone. They do not reflect the opinions of WebMD and they have not been reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance or objectivity. WebMD is not a substitute for professional medical advice, diagnosis, or treatment. Never delay or disregard seeking professional medical advice from your doctor or other qualified health provider because of something you have read on WebMD. 

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