Q & A: Ask a Dietitian

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Carrie Grobe, Registered Dietitian, is back with answers to the questions and comments you posted here.

Total Carbs vs. Net Carbs
If you take the total carbohydrate of an item and subtract the fiber (if 5 grams or more) and the sugar alcohol amount, then you will get the net carbohydrate. The net carb amount is the amount to count towards your daily carb intake. In other words, the net carbohydrates will affect your blood sugar. An example would be if a product serving contains 25 grams of carbohydrate, 11 grams fiber, and has 3 grams of sugar alcohol.

25 grams total carbohydrate – 11 grams fiber – 3 grams sugar alcohol = 11 net carbohydrate

Sugar vs. Sugar Alcohol
Sugar alcohols, such as mannitol, sorbitol and xylitol, are neither sugar nor alcohol. They get their name from their chemical structure which resembles both sugar and alcohol. Sugar alcohols are a type of carbohydrate that sweetens foods, but with half the calories of regular sugar. They are safe, do not promote tooth decay, and add sweetness to the food products. If you have diabetes, I would recommend that you still count ½ the amount of sugar alcohol grams toward your carbohydrate allowance. For example, if an item has 4 grams of sugar alcohol, then count it as 2 grams of carbohydrate.

Pumpkin Bars
Anne: I agree, the pumpkin bars are one of my favorites! I would love to co-teach a cooking class. I am not a cook by nature, but definitely know how to modify recipes and make dishes healthier. Maybe Linda Setchell and I could work together on this one! Thank you Anne!

Nutrition Books
Michael: In regards to your question about the best book out there on nutrition for consumers. There really is no ONE book that sums it all up. There are many books out there; unfortunately not all are good ones. I would suggest looking at the American Dietetic Association website which is www.eatright.org and go to the public section, then type in nutrition books. It will give you a Good Nutrition Reading List. Personally, I utilize the internet often and one of my favorite websites that is very reliable is www.rd411. It is tailored toward the dietitian, but anyone can utilize the information. To address your other question, carbohydrate fillers are commonly in products such as deli meats, hot dogs, sausage, ham, etc. They are not necessarily a bad thing and usually the gram amount is low. It really depends what your goals are as to the products you choose. For someone with heart disease and elevated cholesterol, I definitely recommend choosing the low fat items. There is not a significant reduction in fat in regular vs. reduced fat peanut butter, so personally I choose the regular. The bigger issue would be finding the peanut butter that does not contain partially hydrogenated oil. Great questions Michael and I am glad you have a vested interest in nutrition.

Lunch n’ Learn
Nick – I also enjoyed Dr. Rifaquat Khan’s lunch n learn and feel he presented the information wonderfully. I believe any way that we as health professionals can share our knowledge with each other is a very positive thing for everyone.

Recipes
Rosie – I will work on getting more healthy recipes out there for everyone. Maybe I can put a new recipe every month on the OC or a couple in the connection. It is great to try new recipes and get more variety in our diets. Turkey as a replacement for beef can be tricky. If the turkey is ground white meat only, it will be very lean and work well. It is high in protein, and extremely low in fat. Some ground turkey is a combination of white and dark meat (and maybe some other stuff!), which would not be a healthier choice. There is extra lean ground beef available that is suitable for a low fat diet. I believe both are acceptable.

Choices
Mary – Thank you for your comments and you are correct in that we can offer and present a lot of useful information, but what is done with that information is up to each individual.

Nutrition Tips
Chris – Thank you for reading the nutrition tips I have provided on The OC during the month of March! I like your idea of using body fat % as more of an indicator of progress than body weight. Time is often an issue in that case.

Some of the new “diets” suggest 5-6 small meals and deal with calorie counts. One doesn’t even give an idication of what to eat, just the number of calories. Can you give your opinion of these diets and the good, bad and ugly of them?
There are both positives and negatives with the type of “diet” you are talking about. I often recommend eating small, frequent meals every 3-4 hours. This helps keep our metabolism high and also helps prevent us from being “too” hungry at our next meal; thus resulting in overeating. I do believe in listening to our own body, however, and even though it may be “time to eat” according to the diet, if you are not hungry, then you shouldn’t eat. On the other hand, you must eat when you are hungry, regardless of the time in between meals/snacks. Counting calories can be very effective, because in order to lose weight, we must burn more calories than what we eat. Most people do not know how many calories they are eating and will often underestimate the amount. Therefore, keeping a food record for a month or so, can be a effective tool. However, what these types of diets are lacking is DIET QUALITY. It is essential that we focus on “what” we are eating to ensure good nutrient intake and promote health. If a person eats within their calorie allowance, but is choosing high sugar foods with no nutritional value, she or he will lack energy, and will not function up to their ability. Following a low quality/low nutrition diet long term could also lead to many medical complications. There is no ONE diet for everyone, but a healthy one low in fat and sugar, high in fiber, fulll of fruits, vegetables, whole grains, lean/low fat proteins and dairy products, is important for overall health.

There is so much talk about using “Sea Salt”, Natural Salt or good old Morton Salt. Why is one better than the other?
Great question, especially with the rise in high blood pressure in our society! First off, the majority of our sodium intake is already in the food when we purchase it, so there is no need to add any more. Sea Salt has been heavy in the news and is being used in some restaurants now as well as products such as Campbell’s soups. Sea Salt is a larger grain and has a stronger flavor than regular salt, so not much needs to be added for a stronger taste. It still contains sodium, however, so is not to be used excessively. I would not even recommend using it on a daily basis. As for natural salt or Morton salt, leave it at the store. We really need to avoid adding salt to our foods. Salt is a learned taste and can be unlearned. As i mentioned earlier, we get too much sodium already in the foods we purchase. If you desire to add flavor, stick to the Mrs. Dash varieties or try using fresh herbs which add great taste and are sodium free!

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