YOU ASKED WE ANSWERED: Dr. Shai Answers Your Diet Questions

July 17, 2008— -- Laura from Grays River, Wash., asked: I have a strong family history of diabetes and I believe that I am a beginning-stages diabetic myself. What diet should I think about following? I have tried the Atkins diet in the past and remained on it for about one year, but could not remain on it because it was too strict. I did lose around 25 lbs on it, but gained it all back with interest. I really need to lose around 50 lbs now. I have changed my diet considerably and have been trying to eat more veggies and fruit and less sugar and breads, pasta etc. I love meat and eat a fair amount of it.

Dr. Shai answered: It would be better for you to set moderate goals to reduce 5 percent of your body weight, where you can still achieve significant improvements in some of your health indicators. You may want to try the Mediterranean diet, which is between the extreme low-fat and low-carb diets, but rich with olive oil. Combine this with physical activity.

Jo from Miami asked: What is an "average" complex carbohydrate daily range? To completely knock carbs out of my diet will defeat me. Considering that I'm at 40 lbs overweight and 65 years old, I'd like to know about how many carbs I can eat daily so that I don't get frustrated. I'm a post-gastric bypass patient by 3 years and still have a lot of problems eating protein, so carbs are important to me. Thanks.

Dr. Shai answered: If you are post-gastric bypass patient and carbs are important for you, don't adopt the low-carb diet, but restrict your beverages/milkshakes/ice cream that are probably well digested and keep a moderate low-calorie diet. You may need to take nutritional supplements. People can consume 400 grams of carbs per day, which equals 1,600 calories. It is impossible and undesirable to completely "knock out" carbs for your body, as it is one of the ingredients of vegetables and milk products, for example. Individuals can live with 40-100 grams of carbs.

Michele from Elizabethtown, Pa., asked: It appears from the study, if you have blood sugar problems (diabetes or hypoglycemia), you should follow the Mediterranean diet rather than low-carb. Is this true?

Dr. Shai answered: Yes, although the low-carb diet was favorable to diabetics as well, the results weren't that significant.

Jim from Denver asked: What online or print sources can you recommend for low-carb diet plans, and Mediterranean diet plans? Any books or authors to recommend?

Dr. Shai answered: Dr. Walter Willett, professor of epidemiology and nutrition at Harvard School of Public Health and professor of medicine at Harvard Medical School, wrote books and provides good diet information on the Mediterranean diet. Dr. Atkins also has a number of books with good information online on low-carb diets.

Ashlee from Austin, Tex., asked: Which is the best Low Carb diet to follow and which one should be avoided?

Dr. Shai answered: If you choose to adopt the low-carb regime, you need to consult with your doctor or nutritionist. Avoid trans fats (margarine, etc.) and keep consuming olive oil, fish and almonds within your high protein diet. I'd also recommend you get your blood tested regularly and be physically active.

JB from Oxnard, Calif., asked: My one concern is the lack of information on how a low carb diet can impact someone with depression. Why is that? Research shows that the amino acid typtophan, which is the precursor of 5htp which affects serotin levels, needs carbs to get across the blood-brain barrier. I lost 70 pound on a low carb diet but fell into the deepest depression I had experienced in my 45 years. I ended up taking 300 mg of Effexor a day to counter the depression. I went off the low-carb diet and unfortunately gained all my weight and more back. But I was able to drop down to only 75 mg of Effexor a day. Prior to going on the diet I had not been on medication for depression for 8 years. Without having to take high dosages of anti-depression meds how can I stay on a low-carb diet? It was the most effective diet for me.

Dr. Shai answered: Our study suggests that there are some alternative diet strategies that each individual can tailor according to his individual diet history, specific preferences and metabolic goals. You already experienced the feeling of successes in dieting. But if you feel that the low-carb diet was the reason for your mood change, you may switch to Mediterannean diet and keep eating more than two two fish portions a week or consume omega 3 supplements along with physical activity to improve your mood.