I’ve lost about 30 pounds. Do I have to exercise to keep it off, or can I just continue my diet?

* No diet on the planet will maintain a healthy weight if you don’t exercise. The trick is how much? Most health experts recommend that Americans exercise at least a half hour most days of the week, but people who have lost weight – and more importantly maintained the weight loss – are moving much more than that. They get lots of exercise; the equivalent of an hour or more a day or 28 miles of walking a week, which means they probably have much less time to veg out in front of the TV.  The more weight you have lost and need to maintain, the more you have to move. Researchers don’t understand why a formally obese person must exercise more than an always-lean person to maintain the lower weight, although they speculate it probably relates to some kind of permanent metabolic slowdown that results from having been obese. It’s not fair that you need to move 12,000 steps a day, while your skinny neighbor might need only 8,000 steps, but that’s the reality. To spice up their active lives, weight-loss maintainers turn to variety, with six out of every ten masters incorporating two or more types of exercise into their weekly routines.  Photo credit: Chris JL via Compfight 

What is your opinion of the product, Juice Plus?

Summer color Juice Plus may be touted as the “next best thing to fruits and vegetables,” but don’t be fooled. Dehydrating produce shrinks it by about 90%, but it still would take 15 capsules to supply the equivalent of a half cup serving of broccoli, while Juice Plus recommends 4 capsules a day. Hmmm, that’s about as much broccoli as you’d get in a small sprig. And, remember…you need 8 to 10 servings of colorful fruits and vegetables every day. That’s 15 capsules times 10. YIKES! Yes, the company adds some extra vitamin C, beta carotene, and other nutrients to make up the difference, but you’ll still be missing out on the fiber and 100s of 1,000s of health-enhancing phytochemicals identified so far in produce., not to mention the cost to your pocketbook. There is no short cut when it comes to vegetables. Just bite the bullet and make a pack with yourself to include at least 2 servings of real fruits and vegetables at every meal and at least 1 at every snack. Period.   Photo credit: Silke Gerstenkorn via Compfight

Does soy increase or decrease my risk for breast cancer?

IMG_8541 The statistics are ominous when it comes to women’s risk for developing breast cancer in the United States. This risk is five-fold higher than Asian women’s risks in Japan and China. When these women migrate to the United States and adopt our eating and lifestyle habits, their risk increases to 60% higher than their counterparts who remained in Asia. Studies provide strong evidence that only 5% to 10% of breast cancer cases are attributable to inherited factors, which means up to 95% of breast cancer might be prevented with changes in lifestyle. Diet is associated with up to one in every two newly diagnosed breast cancer cases. This link between lifestyle and breast cancer has led  researchers to investigate the possible benefits of soy for the prevention of breast cancer. But the link is not a clear one.

Both epidemiological and clinical data show that exposure to estrogen increases breast cancer risk by inducing malignant breast cell growth. Asian women living in Asia have a 40% lower blood estrogen levels compared to Caucasian women living in the U.S., and they consume more phytoestrogens, such as genistein, in soy products. Some studies show that adding soy to the diet reduces blood estrogen levels in premenopausal women. Genistein inhibits the blood supply to cancer cells and curbs metastasis of breast cancer. It also has a structure similar to estrogen, but its binding affinity is several-fold weaker than that of a woman’s normal estrogen, so it could curb estrogen’s effects on initiating cancer. Finally, genistein has beneficial effects on bone, the cardiovascular system, and blood cholesterol levels, thus helping prevent osteoporosis and heart disease.

The confusion arises from the limited evidence that soy also might increase breast cancer risk. Whether soy increases or decreases breast cancer risk might be dose, tissue, and time dependent. Estrogen production varies dramatically throughout a woman’s life span. It is possible that genistein has varying effects on the breast in the presence of high estrogen (during pregnancy), moderate estrogen levels (during pre-menopause), and low estrogen (during childhood and post-menopause). One reason why Asian women living in Asia have low breast cancer risk is that a lifetime exposure to soy provides the protective effect. It also is possible that soy contains other factors other than the phytoestrogens that oppose the estrogenic effects of genistein and actually reduce breast cancer risk. Or, perhaps other environmental factors might be related more to low cancer rates in Asian women than increased soy consumption.

The bottom line? Moderate intake of minimally-processed soy products, such as tofu and soymilk, are safe and possibly beneficial in the prevention of numerous diseases, including breast cancer. But, until more is known, excessive intake of highly-processed soy constituents, such as soy powders or phytoestrogen pills, especially in women with a family or personal history of breast cancer, should be viewed with a cautionary eye.   Photo credit: Mr. Wang via Compfight

How much of what should my child be eating every day?

even their teeth is missing the same way Children of all ages need the same number of servings of foods from each of the four food groups as do adults. The size of the serving increases as we get older. So, for example, a 2 year-old needs the same 5 to 6 servings of whole grain, but the serving is a half slice instead of a whole slice of bread. Your child also needs lots of colorful vegetables and fruits, or at least 5 servings a day. I emphasize “colorful”, since I don’t count French fries or iceberg lettuce, or even apple juice as a serving. A typical recommendation when it comes to serving size is 1 tablespoon for each year of life; so, a 4 year-old would need 4 tablespoons of green peas, while an older child or adult would need ½ cup. Children also need 2 to 3 glasses of calcium-rich milk and two servings of low-fat protein, such as chicken, fish, or beans. Total calories, on average, should be about 1,500 calories for a “low active” kid aged four to eight. Kids today are getting too much of the foods from the top of the Food Guide Pyramid, such as fat and sugar, and like their parents are shunning the most healthy foods, like vegetables, fruits, and whole grains. Photo credit: Julie Kertesz via Compfight

I’ve heard mixed reports about soy and heart disease. Can you help?

udon noodles, with vegetables and tofu Most people are familiar with the heart-healthy benefits of soy. More than 100 studies show that soy protein lowers LDL-cholesterol by 10 to 15 percent and raises HDL-cholesterol (the “good” cholesterol), thus reducing heart-disease risk. Studies, such as one from the University of Kentucky, show that adding one to two ounces of soy protein to the daily diet lowers cholesterol by about 10 to 20 percent, reflecting a 20 to 40 percent decrease in heart-disease risk. Soy also lowers oxidized LDL-cholesterol, homocysteine levels, and blood pressure. The Portfolio Diet studied at the University of Toronto and published in JAMA found that diets that included several servings daily of soy, along with other real foods, managed cholesterol (29% decrease) as well as statin drugs, while conventional low-fat diets lowered it by only 8%. While you can’t depend on soy alone to lower heart disease risk, as part of a healthy diet, daily exercise, not smoking, and managing stress, a bit of whole soy foods added to the diet can be a help in preventing and managing heart disease for many people. Of course, always, always check with your physician before making any major changes in dietary intake.   Photo credit: sharyn morrow via Compfight