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Nutrition Tips for Women: Ask the Nutritionist

Question:
I have a problem with my weight -- namely I lose a few pounds, but then it comes right back. What can I do?
Answer:

Losing weight is tough. But maintaining weight loss can be even tougher. Obviously, whatever you did to lose the weight, you have to keep doing, and then some.

As part of the National Weight Control Registry, doctors have done research on people who have maintained long-term weight loss to see what they do differently than people who tend to gain weight back. In addition to continuing a low-calorie, low-fat diet, those who have maintained their weight loss tend to eat breakfast every day, weigh themselves at least once a week, watch less than 10 hours of TV per week, and exercise, about an hour a day on average.

Question:
What foods are rich in folic acid and good for me to eat during the first trimester -- and throughout -- my pregnancy?
Answer:

Foods that are rich in folic acid include leafy green vegetables like spinach, cereals fortified with folic acid, lentils, and avocados. While it’s great that you want to eat more foods that are rich in folic acid, I and most pregnancy experts recommend that you take a folic acid supplement to help prevent birth defects. You want to be absolutely sure you’re getting enough folic acid, which is why many women start taking prenatal vitamins before they get pregnant. You don’t want to wait until you get pregnant to start loading up on folic acid, because it is particularly important during the very early stages of pregnancy.

Question:
I am a 25-year-old woman. I'm 5'5" and 168lbs. I have been working out intensely, six times a week for 4 weeks. I've also been eating only about 1500 calories a day. Although I have lost inches, I have yet to lose even a single pound. I'm becoming discouraged about my lack of weight loss. Do I need to further reduce my caloric intake?
Answer:

The fact that you’ve lost inches, even if you haven’t lost any weight, shows that what you’re doing is working, and there’s no reason to get discouraged. It sounds like you’re building muscle and losing fat, which is the perfect way to go. By building muscle, you’re helping boost your metabolism throughout the day, so you continue to burn calories. A 1500-calorie diet for a young woman like yourself -- who is working out six times a week -- is very reasonable. In fact, when you’re that active, you actually need to make sure you’re eating enough. If you don’t, your body will go into starvation mode and hold onto fat instead of burning it off. Make sure you eat three meals with two or three small snacks in between. Eating every 2 to 3 hours helps keep your metabolism going.

Question:
Can a person consume too much folic acid?
Answer:

The risk of too much folic acid is low. But, as with any vitamin, it is possible to consume too much folic acid if you combine supplements with food. Adults should not get more than 1000 micrograms of folic acid per day. To put it into perspective, a folic acid supplement or multivitamin usually has about 400 micrograms. Other than breakfast cereals that are fortified with 100% of your folic acid needs (400 micrograms per day), most foods have relatively little folic acid content. For example, we often recommend leafy green vegetables as a good source of folic acid. But frozen spinach, which has the most folic acid, has only 115 micrograms in a 1/2 cup. My point is that, even if you take a folic acid supplement, you still have plenty of room to enjoy foods rich in folic acid without the risk of over-consumption.

Question:
I have a hard time fighting my urge to snack at night. What is a good late-night snack to help kill my hunger?
Answer:

Actually, you probably should eat a snack at night. The key is what you eat. A healthy carb is great, but you want to be sure to combine it with a protein or healt

  1. How much protein and how much fat is a woman supposed to consume every day?
Question:
How much protein and how much fat is a woman supposed to consume every day?
Answer:

The exact amount of protein and fat you need depends on the number of calories you need each day, which in turn, is based on factors such as your height and activity level.

Protein should make up about 10% to 35% of your total calories a day. So, in general, women need about 50 grams of protein each day. That’s honestly not hard to get, especially if you eat meat. Protein is good for satisfying hunger so it’s safe to include a little more if that helps. A 3-ounce piece of meat has 21 grams of protein. Even a cup of beans has 16 grams. And a cup of yogurt has 11 grams.

Fat should make up 20% to 35% of your total calories. So, if you’re eating 1500 calories per day you want to eat less than about 60 grams of fat. And of course make sure it's the good fat sources that you're eating, like nuts, avocados, and olive oil.

Food labels are a good way to see how many grams of protein and fat are in your food. But keep in mind, the 2000-calorie diet that’s often referred to on food labels is too much for most women unless you’re very physically active.

Question:
I've been dealing with kidney stones for 4 years now. What should I add or remove from my diet to avoid them?
Answer:

The most important thing you can do is drink plenty of fluids. If you’re drinking enough, your urine should be clear or light yellow.

If you have calcium kidney stones -- the most common type -- eating less salt or salty foods may help. Watch out for salt content in processed foods and in restaurants. You do not need to avoid calcium-rich foods and they may even help prevent another type of kidney stone, being oxalate kidney stones.

If you have oxalate kidney stones, limiting foods high in oxalate may help, such as dark green vegetables, nuts, and chocolate. Other diet changes that may help include not eating too much protein, increasing your fiber intake, avoiding grapefruit juice, and drinking real lemonade since the citrate from real lemons may help prevent kidney stones.

If you take supplements, ask your doctor about how much calcium and C and D vitamins you should be taking, since these may increase your risk of kidney stones.

Question:
What is the recommended daily dosage of vitamin D3 for women?
Answer:

Vitamin D3 is often the form of vitamin D that you’ll see in vitamins and supplements.

The answer to this question depends on your age. Women 70 and under need 600 IU of vitamin D a day. Women 71 and over need 800 IU to help support strong bones. Older people need more vitamin D because their skin doesn’t create vitamin D as efficiently when exposed to the sun. Their kidneys are also not as effective at producing the active form of vitamin D. Vitamin D is critical for strong bones, as it helps your body absorb calcium. You’ll often see calcium and vitamin D combined in the same supplement. So it’s important to get enough of both of those nutrients.

Question:
Why would my cholesterol level suddenly be elevated if I have not changed my diet in any way?
Answer:

I’m not sure what you mean by “suddenly”. But it’s unfortunately common for cholesterol levels to rise as we age, particularly if you have a family history of high cholesterol. In addition, certain medications and medical conditions, such as thyroid problems, are associated with a rise in cholesterol. So make sure to check in with your doctor about rising cholesterol levels. If everything checks out fine, then be sure to take a very close look at what you’re eating. Cut back on saturated fat and cholesterol intake. Losing weight, if needed, will also typically drop cholesterol levels. Exercise also helps. If all else fails, talk to your doctor about medication for lowering cholesterol.

Question:
Is drinking vegetable supplements as beneficial as eating actual vegetables?
Answer:

Given the choice, eating the actual vegetable is a healthier approach. Both the vegetable supplements (juice) and the actual vegetables have the vitamins and minerals and the healthy phytonutrients found in abundance in vegetables. However, vegetables juices do not contain the fiber found in the actual vegetable. Whole vegetables are one of the best sources of fiber, which most of us get far too little of.

I recommend that you try to find at least some actual vegetables that you like to eat. But if you’re not a big fan of veggies, a vegetable drink is a good alternative. Make sure it’s 100% juice, with no added sugar. Keep in mind that vegetable drinks are often very high in sodium, and most of us don’t need any more sodium than we already get. So look for lower-sodium options.

Question:
Everyone says that eating fish is so good for you. But I'm allergic to them. What else could I eat that would provide the same nutrients?
Answer:

It must be frustrating to hear study after study about fish being good for you when you can’t eat it. Many of the potential benefits are linked to omega-3 fats from fish. However, there are other good sources of these healthy fats, including flax seeds, walnuts (and other nuts), soybeans, and tofu. Fish is also a good source of lean protein. But there are plenty of other good sources of protein, such as skinless chicken, lean ground turkey or beef, and even rice and beans.

Question:
If I eat 1,200 calories a day, should I lose weight regardless of what kind of foods I’m eating?
Answer:

When it comes down to it, most nutrition experts do believe in the calories in-calories out approach when it comes to weight loss or gain, meaning that as long as you don’t eat any more calories than your body burns in a day, your weight will remain stable. However, there’s more to your health than just your weight. Your body obviously needs the right nutrients to function optimally. This means your calories should primarily come from lean protein, whole grains, healthy fats, and fruits and vegetables. Plus, if you opt for more calorie-dense foods -- those that are packed with calories, typically due to high fat or sugar content -- you’re most likely going to be quite hungry toward the end of a no-more-than-1,200-calories day.

Question:
I am losing more weight now that I am eating more calories and exercising less! How is this possible?
Answer:

I know it sounds backward. But the problem is that you may not have been eating enough before. It’s a common mistake that people make when they’re trying to lose weight. If you cut back too much on your calorie intake, while at the same time increasing your exercise, your body may go into starvation mode. This causes your metabolism to plummet and your body holds onto fat instead of burning it.

So, keep eating the amount of calories you’re eating now and pump up your exercise again. That may help you strike the right balance. Also, be sure to eat every 2 to 3 hours, obviously small meals or snacks. If you go too many hours between meals, your metabolism will start to shut down as your body tries to conserve energy.

Question:
Could the numbness in my hands and feet indicate some type of vitamin deficiency?
Answer:

A vitamin deficiency is a possibility. But, given that there are so many other possible causes of numbness, some of which can be serious, you should see your doctor before assuming it’s a vitamin deficiency.

One of the most concerning vitamin deficiencies that can cause numbness is a vitamin B12 deficiency. If you eat meat or other animal products, you’re probably getting plenty of this in your diet. However, vegans (those who eat no animal products) do have to take extra care to be sure they’re getting vitamin B12, either through fortified foods like cereal or through supplementation. Some people also have a medical condition called pernicious anemia that decreases their ability to absorb vitamin B12. Your doctor can run tests to see if you may have this condition.

Question:
I just started taking flaxseed today. Now my stomach is rumbling. Could it be the flaxseed?
Answer:

Yes, it could definitely be the flaxseed. Flaxseed is relatively high in fiber. A tablespoon has about 3 grams of fiber. When you start eating more fiber than your body is used to, it can lead to stomach upset and gas. Most of us only get half the amount of fiber we need in a day, so it’s great that you’re taking steps to fill that gap. Women need about 25 grams of fiber a day. However, if your body needs more time to get used to the extra fiber, back off on the amount of fiber and then build it up slowly. Your body will get used to it and be all the healthier for it. Also, remember to drink plenty of water as you begin to eat more fiber. Fiber is great for the digestive system, but not drinking enough water can lead to constipation.

Question:
I have type 2 diabetes. Is it safe for me to start a low-carb diet?
Answer:

Studies have shown that a low-carb diet can be safe for people with diabetes. However, I really don’t like the idea of any diet that severely restricts or eliminates any particular food or food group. It’s just not sustainable and ultimately will most likely leave you discouraged or disappointed. Keep in mind that carbohydrates are the primary source of energy for our bodies. So they are critical for maintaining good health. The key is choosing the right kinds of carbohydrates, being good carbs with low glycemic index that are less likely to cause quick rises and falls in blood sugar. Opt for whole grains, brown rice, whole-wheat pasta, and beans. Combine that with lean proteins, and fruits and vegetables, and you’ll do wonders for your body and your diabetes.

Question:
Is there a way to increase my calcium intake without drinking milk?
Answer:

Although milk and dairy are the best sources of calcium, you can certainly get enough even if you don’t drink milk.

If dairy milk, or cow's milk, makes your stomach upset, or if you are lactose intolerant, there are plenty of lactose-free milks on the market. Also, yogurt is the best source of calcium, with 415 mg in 8 ounces. Even people with lactose intolerance can typically eat yogurt with no problem because the probiotics in yogurt help digest the lactose.

If dairy is not an option, other good food sources for calcium are calcium-fortified soy milk or other forms of non-dairy milk, calcium-fortified cereals, turnip greens, and kale. If you find it tough to get the recommended 1000-1200 mg/day, calcium supplements (which are often combined with vitamin D) can help fill the gap, as well.

Question:
What type of fish should I not eat while I'm pregnant?
Answer:

As you are probably aware, the issue with eating certain types of fish when you’re pregnant is mercury. Mercury is found in higher levels in certain fish. If a pregnant woman eats too much mercury, it could damage the brain and nerves in her developing fetus. But fish itself can be very good for both you and your baby. So the key is to eat the right kind of fish in the right amount. Do not eat shark, swordfish, king mackerel, or tilefish, as these all have high levels of mercury. Plus, they're probably not at the top of your list anyway. Instead, choose fish and seafood that are low in mercury, such as shrimp, canned light tuna, salmon, pollock, and catfish. You can safely eat up to 12 ounces of this type of fish per week while pregnant.

Question:
Do foods that have been pickled -- like canned beets -- still maintain their original nutritional value?
Answer:

Since there is generally no heat involved in the pickling process, it doesn’t significantly change the nutritional value of foods. This is particularly true if you start with raw veggies and keep the skin on, since the skin often carries much of the nutritional value including the fiber. The fermentation process involved in pickling may even produce some health benefits since the healthy bacteria (probiotics) involved in the process can help keep your digestive system healthy.

One possible nutritional downfall of pickling is the addition of salt, which is key to the process. For that reason, pickled beets and other vegetables are a good option to enjoy from time to time. But you don’t want to make them your go-to sources of veggies.

Question:
Is there some way to naturally detox or cleanse your body? How often can it be done, if so?
Answer:

There is a lot of hype around "detoxing" and "cleansing" these days. Most of what you'll hear is untrue, and can be just a waste of your time and money. There’s no evidence that detoxing and cleansing has any health benefit. Nonetheless, there are lifestyle changes you can make to “detox” your body. Cutting back on saturated fats, daily calories, refined grains, sugar, and sodium can help you reap all kinds of health benefits. Instead, choose fruits and vegetables, whole grains, fat-free or low-fat dairy, lean protein, seafood, and healthy fats.

Thank you for joining us for WebMD Ask the Nutritionist. Be sure to check in on Wednesday, July 11, at 1 p.m. ET, when we will discuss “Nutrition for Men.” Sign up if you'd like an email reminder the day before the event.

WebMD Ask the Specialist Transcript

Reviewed by Louise Chang, MD on June 07, 2012