Nutrition Action Newsletter Articles & Resources

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Herndon, Va.: I have lost 18 pounds....reduced calories, increased exercise and I feel great. Only problem: I have hit a plateau....haven't lost in a week...any suggestions?

Sally Squires: Congratulations on those 18 pounds, Herndon! That's quite an accomplishment. And I bet you feel a whole lot better as a result. So right there you have accomplished a lot.

It's quite common to hit plateaus. They happen for a whole bunch of reasons. So check your food intake of course. Take stock of your activity levels. And relax. Because this plateau could last a week or two and you will in all likelihood go back to losing weight once your body adjusts to whatever it is that has put it on this plateau--provided of course that you do keep up your healthy habits.

You might try adding even 5 minutes of activity every hour just to boost your metabolism a little.

Finally, one last question: have you perhaps reached what is a healthy weight--even if it's not your goal weight? That's something else to consider.

Let us know how you do and continued success with your efforts. Thanks!

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EMS in Reston, Va.: Hi Sally-

Can you give LPCers a heads up as to when "Secrets of the Lean Plate Club" will be released?

Thanks!

Sally Squires: You're very kind to ask. It's scheduled for release in 2006 by St. Martin's Press. We're in the final editing phases and I just got notice today that galleys are being ordered, which is kind of exciting. So bottom line is sometime next year, likely the early part of the year, I believe, but these things are sometimes fluid. Thanks.

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Chicago, Ill.: I just found out my "bad" cholesterol is higher than it should be -- not horrendous, but about 20 percent higher than the target, my doctor said. I'm 26, female, I exercise 3-4 times a week (cardio for half an hour, plus pilates), I can't remember the last time I ate fast food, and I really do try to choose healthy options. High cholesterol runs in my family. How concerned should I be?

Sally Squires: Concerned? No, don't think you need to be concerned based on what you're doing. Vigilant? Yes. This is something that you want to pay attention to. If it continues to rise you may need to take other action, including considering cholesterol lowering medication, and especially since you have a family history of this condition.

Saturated fat and trans fatty acids are two leading culprits for raising the "bad blood cholesterol" also known as low density lipoprotein (LDL.) And you also want to know from your doctor what your level of "good" cholesterol, high density lipoprotein (HDL) is. That can help redcue risk somewhat.

Saturated fat is found in fatty meats, bacon, poultry with the skin, butter, coconut oil, etc. Trans fatty acids are found in a lot of commercial baked goods and snacks as well as frosting plus some frozen food, such as breaded fish sicks. You're going to be able to ferret out trans fat a lot more easily thanks to new food labels.

./~dms/

will give you some information.

Also think about adding Benecol, Take Control as your margarine like spread. Both have been shown to reduce cholesterol by abou 6 percent--as good as some drugs.

You can get lots more info at

.org/cholesterol

Good luck and let us know what happens. Thanks.

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Arlington, Va.: Quick recipe:

I like to take fish (any fish will do, but I tend to like firm fish like salmon, tilapia, or mahi) and bake it in the oven. I take 1-2 small garlic cloves and dice them up (or, use a garlic press to save time) and cook them in the microwave with about 3 tablespoons of butter. I then put the fish in a baking pan and pour the butter over the fish, straining out the garlic with a fork. Then, sqeeze lemon and lime (about 1/2 a lemon or lime per 1/2 pound of fish) into the baking pan. Pour orange juice into the pan to submerge the fish in juice. Then, bake it at 375 for about 12-15 minutes. The oven sort of poaches and bakes the fish, and the result is easy to make, easy to clean up, and really delicious and healthy!

Sally Squires: This sounds really good Arlington. I'd only make one change: Use olive oil or half olive oil and a little of that butter if you really love the flavor of butter. Thanks.

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Boston, Mass.: While we're on the food pyramid issue:

Is it OK to split things up? For example -- if I have my protein and grains mostly at lunch, but veggies at dinner and fruits for snacks - is that OK? Or does each meal have to be balanced?

Thanks !

Sally Squires: Absolutely that's okay, Boston. And I'm so glad that you've brought up this topic. Nothing wrong with this at all. This came up a bit when we discussed Jorge Cruise's Three Hour diet. People asked me if they ate at 2 hours and 45 minutes if they'd blown it. (Absolutely not!) One of the tenets of the Lean Plate Club is to eat smart, know more about nutrition and of course, move more so that you can really incorporate the best healthy foods and activities for your daily life based on your preferences. Do also check out a site that we talked about last week called:

.com

which gives a lot of healthful options to commonly eaten foods.

Hope that helps.

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Ellenton, Fla.: For the LPC'er who hit the plateau, have you been eating the same types of foods day after day? You may want to introduce some new foods into your diet. It could be that your metabolism has become accustomed to a certain menu, and you are not burning the additional calories necessary to lose the rest of the pounds.

Sally Squires: Could be Ellenton. (And by the way, from my recent visit to Florida, I understand that there's a great discount mall in your hometown.) But you should also know that research shows when we eat the same old things day after day that we do get a little bored with them and actually eat a little less. Of course, on the other hand variety not only the spice of life, but really important for healthful nutrition. So as always, it's a balancing act. Thanks for your input.

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10,000 steps: There was a story on NPR yesterday that said there was no scientific evidence for the 10,000 steps. They said it all originated in an advertising campaign in Japan. They went on to say that the idea of additional movement - whether it is 4, 6, or 10,000 steps is definitely a good idea, but cautioned that simply adding some steps might not get you the cardiac benefits of raising your heart rate.

I was wondering whether you had heard the story and what your thoughts were?

(I still plan to add a pedometer to my current exercise regimen...)

Sally Squires: Sounds like an interesting piece on NPR. I'll try to listen to it later. But no one has ever suggested that 10,000 steps is a good cardiovascular regimen (unless you happen to be counting speed walking or jogging as part of your steps. And by the way, if you do wear your pedometer while jogging, you need to recalibrate your stride length to reflect that since it's different for running and walking. I know that Digiwalker pedometers will allow you to do that.)

Pedometers have also sometimes been misunderstood. They are meant to help you add more movement to your day, mostly through so called lifestyle exercises, like taking the stairs, walking around the office, or yes, talking an afterdinner walk. Remember also, that they are one measure--not THE measure--for all activity. Use them as a reminder to see how much activity you're getting, not as an end all and be all.

You can find a lot more about pedometers and how to use them well at:

.org

Hope that helps.

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Springfield, Va.: I really wonder about the changes to the estimates of the cost of obesity. First a huge number of deaths are linked to obesity, then a whole lot fewer. How much of the change can be attributed to pressure from the big business interests within the food industry? A lot of them wouldn't be in business if people didn't overeat. I loved the parody site you mentioned -- .org -- but there is also a lot of food for thought on there. When they call it the US Dept. of AgriBUSINESS, they aren't kidding.

Sally Squires: Good food for thought, Springfield. And by the way, I'd heard that the parody website has been taken down, but haven't been able to check it. Thanks.

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Boston, Mass.: After incorporating healthy eating and exercise into my daily routine I initially lost 25 pounds over a six month period. My weight has plateaued for close to a year now. Unless I eat less than 1000 calories per day and exercise an hour a day my weight will not budge. There is so much conflicting advice from exercising daily to over training, to cutting calories, to not cutting too many. At 52 and female what advice can you give me about getting back on the losing track?

Sally Squires: Boston: First congratulations on what you've accomplished. That's really wonderful. Based on research, you likely will need to keep up that 60 minutes of activity daily--and maybe even up it to 90 to maintain your weight loss. At less tan 1,000 calories daily, however, you are going to have trouble meeting all your nutrient needs. (And I'm working a little in the dark here since I don't know your weight.) I also wonder if you're eating too little, and your body is moving a bit into starvation mode--one reason why the scale won't budge. Have you also achieved what is a healthy weight?

And if you're not already doing it, consider adding some weight training to your daily regimen. You won't build muscle overnight, but it will come on gradually--and don't worry most of us mere mortals build at best about 4 pounds of muscle--but it may help give you the boost you need since muscle burns more calories than fat.

Check your measurements from time to time. With age, weght loss is sometimes a bit harder, but you will see improvements in measurements or in percent body fat. The bathroom scale isn't the only sign of progress. Good luck and let us know how it goes. Thanks.

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Fullerton, Md.: Today is my birthday and I'm having a good day. I am now 45 pounds lighter than I was 6 months ago. I do walk aerobics for 2 miles every morning. I pay attention to what I eat and actually enjoy eating the healthier things. I try to keep it simple so that I can achieve the healthier eating and exercise goals I set. I feel better and can fit in clothes that I haven't been able to for years. I never would have thought that I could do it but with each small goal I reached, I realized I could go further.

Sally Squires: Happy Birthday, Fullerton! What a fantastic gift you have given yourself. You are quite an inspiration. Congratulations! Well done. Thanks very much.

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Struggling with motivation, Va.: Help! I keep eating cookies and watching TV!! I'm 25 and 210 lbs. at 5'6". During the months of January and February I walked 2 miles 4x/week and did strength training 2x/week, but when midterms came around (I'm in grad school), I stopped. I don't expect to be a size 4, but I would like to look better in my clothes. Please tell me what I need to hear--that exercise is great for my health, that I can deal with stress in other ways besides eating sweets, and that I need to take it one week at a time!!

Sally Squires: You can, you can, you can! And you already know that because you've said it yourself. You hit a stressful stretch of time. Put it behind you. Set a new goal for this week and start again. And yes, recognize that like many of us--me included--you can be an emotional eater. We have to take extra steps to outwit ourselves. But you can do this. One of my favorites is to reach into the cookie jar. Yes, you read that right. Only your cookie jar is going to have slips of paper in it that have a healthy activity on it for when you feel like nibbling.

Also, do a little housecleaning. And I don't mean with dusting or vacuuming (although those will burn a few calories.) For the next couple of weeks, rid your house of trigger foods that you're likely to reach for when you are very stressed.

Another strategy: have healthy food around ready to eat that you can reach for first when the jittery munchie surface. And you know they will. So when you're not hungry, cut up veggies and prepare a healthful dip. (Crunchy stuff can often really help.) Have some healthy sweets around (start with fruit). THere's lots more, but I'm getting a bit long winded here. Finally, try using physical activity to help with your over-eating. And if that means getting an exercise partner to help, do it.

Good luck. You can do this! And let us know how it goes. Thanks.

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Arlington, Va.: I just wanted to share an easy, yummy (and of course healthy!) way to cook asparagus -- a springtime favorite. Heat the asparagus in a pan with some salt pepper, and a bit of olive oil. Make sure you do this long enough to "seal" in the water of the asparagus to ensure that it stays crispy. If you like, add a bit of fresh thyme. After about 5 minutes, pour about 1 cup of OJ into the pan and simmer the asparagus for another few minutes. The asparagus comes out crispy and delicious with a bit of citrus flavor. Love the chats and glad that I could share one of my easy favorites!!

Sally Squires: That sounds great, Arlington. And it reminds me that when I did the column on French Women Don't Get Fat, that one of the experts I interviewed mentioned that in France, dinner can be steamed asparagus with a little bread and a little grated parmesan cheese. Yum! Thanks agan.

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Alexandria, Va.: A tip for dealing with the cravings for sweets ... I buy the break-apart Toll House cookies from the refrigerated section of the grocery store. Every night before bed I bake on and have it with a glass of skim milk. One warm cookie, gooey and fresh from the oven, makes me happy and it keeps me out of the junk food all day long because I don't get the cookie if I don't follow my eating plan.

Sally Squires: Great idea Alexandria. And a wonderful example of moderation. Thanks much.

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Philadelphia, Pa.: I have lost 15 lbs since December, and am now holding steady, just within the "normal" BMI range. I now plan to continue to get in better shape through exercise and portion control. My wife wishes to join in my efforts. She has a tough time getting motivated to exercise, though, due to chronic pain and being chronically tired. She gets upset with herself when I am exercising and she is not motivated. So ... the net result is, I get demotivated and lackadaisical, and she laments her lack-a-motivation and lack-a-fitness! Wondering if you or others have some ideas on how we might best to combat the MOTIVATION issue. Thanks!

Sally Squires: Yes, indeeed. Motivation seems to be a common theme today. We all suffer from it. And having nearly recovered from a strained back, I understand your wife's reluctance to workout when she's already in pain.

But...for nearly every condition, physical activity helps. (So obviously, she'll want to check with her doctor.) What else helps with motivation is setting a very small goal--maybe it's simply a five minute walk today--and a reward for doing it. You could also do this together (and you can still do your more vigorous activity at another time.)

So maybe your wife says that today, she'll walk five minutes with you and afterward you'll give each other back rubs as a reward. Or maybe soak in a lovely long bath with candles and lavendar. Or fill in the blank. Or maybe you want to up the ante, and give her a manicure (or a certificate for a professional manicure for a week's worth of daily walks.) What you and she choose are up to you. But you get the idea. Set a goal. Even write it down. Be sure to set a reward and give it when you achieve that goal. Go step by step from there and let us know how it goes. Good luck and thanks.

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Washington, .: I have a great healthy food find! They are called Vitamuffins. Yummy chocolate muffins with only 100 calories and a bunch of vitamins and minerals. I picked mine up at Whole Foods.

Sally Squires: Thanks, DC. And you remind me that I've got another one to add: some whole grain, blueberry muffins from Trader Joe's. I didn't like the small versions, but the larger ones were delicious. They're about 240 calories--but half does fine and they are great. Thanks!

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Washington, .: Thanks for your quick response to my pyramid results question ... the other glitch (I think) is this: I entered a bunch of fruit, mixed veggie salads, latte, 1 piece of cheese, veggie soup - home made, and 4oz baked salmon and it said my saturated fats and oils were way too high??? I can't imagine eating much healthier than that? What do they assume is in these things in the list? My veggie soup has no oil whatsoever. Also when you get results that something is too high or low - it would be GREAT if we knew which ITEM led to those high results! I don't know where it came from!

Thanks,

Frustrated user.

Sally Squires: We'll try to get the answers for you. Watch this space or next week's e-mail newsletter. Thanks!

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Goshen, Md.: . for an earlier post-Thanks for recommending Prochaska's "Changing for Good" in this chat. I'm about halfway through, and am very favorably impressed.

Sally Squires: Thanks Goshen. I, too, think it's classic, the reason I put it in the e-mail newsletter. And the co-authors include John Norcross, Phd, from the University of Scranton and Carlo DiClemente, PhD, from the University of Maryland. It's good no matter what habits you're trying to change.

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St Jo, Mo.: The beauty of the pedometer is that on the days I come home most tired I find I've walked the fewest steps--Just the nagging for a numbers obsessed accountant to get her walking shoes on.

Sally Squires: There you go, St. Jo. And that's exactly how the pedometers are meant to be used--as a good reminder to keep moving. It is shocking, isn't it, how few steps some of us can take if we don't make this a priority. Those numbers can be pretty sobering. Thanks much.

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Fort Worth, Tex.: I appreciate Springfield, Va.'s skepticism about the newer estimates on the cost of obesity. I've wondered myself, but I am an example of someone that's been tottering between obesity and morbid obesity for the last several years with none of the usual risk factors for diabetes or heart disease.

My blood lipids put me at lower that average risk for heart disease, my blood pressure was 100/60 at the last doctor's visit and my fasting blood sugar is well within normal range. I even asked my doctor to check the newer risk factor of C-reactive protein. It was also normal. In most cases these risk factors accompany obesity, but I have trouble beleiving that obesity in and of itself is a risk factor. I think there are probably other as yet unidentified factors that we just don't know to measure yet.

I did see one report that excees weight whether fat or lean puts a stress on organs that are only designed to support a "normal" amount of weight.

I still think I should seek to attain a normal weight, but some of the reports on the cost of obesity just lead to discrimination against the obese. That doesn't solve anything. In fact the guidelines at suggest that overweight people without risk factors should be counseled to lose weight to avoid the negative social pressures. Those negative social pressures create stress. The stress response may be the main damage caused by simple obesity. That's pretty sad.

Sally Squires: You raise some excellent point, Ft. Worth. And I'm glad that you're not suffering any ill effects of your weight. Two things to add: one instead of "normal" weight, most experts talk about "healthy" weight. It's small word change, but an important one. And also, even the authors of the study that offered the revised numbers on obesity deaths, underscore that they did not examine health effects of obesity. But plenty of other studies have and the heavier one is, the more the odds go against you.

Having said that, losing even 10 percent of body weight ca make a big health difference. Thanks.

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Newsletter?: Hi Sally, did the newsletter go out this week? It's understandable if it didn't since you were traveling. I didn't get it and I wanted to make sure there wasn't a problem with my e-mail.

Thanks!;

Sally Squires: Yes, it did go out this week, so if you--or others--didn't receive theirs, please e-mail me at and we'll track down the problem. We definitely want to know if you don't receive it and you have subscribed. Thanks.

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McLean, Va.: Sally and fellow LPCers - I need help. I'm blue. I've lost pounds, but not size. My clothes still aren't loose on me, I still haven't gotten down to that next size, where I wanted to be before the summer got here. I don't know why. I do the right things - I've cut out high-fructose corn syrup, I eat whole grains/whole wheat, lots of fruit and veggies, I drink water, milk and juice - no soda, no alcohol. I don't smoke, I try to exercise (but I'm limited cause of my knees - and I'm only 25!). I'm worried - if I can't fight it off now, how can I do it later?

Sorry this is so long, but are there any words of advice or encouragement for me? Thanks!

Sally Squires: You'll find lots of encouragement here, McLean. And we do understand. Know that you didn't gain this weight overnight and the pounds won't come off that way either--despite the many promises of various diet books, weight loss programs and exercise regimens.

Do you keep food records? I know it can be tedious, but the only want to be sure that you're staying within a reasonable calorie range is to measure and record what you eat. If you're not doing that, I urge you to consider it.

Look closely at your portion sizes. It's so easy to consume more than you might think. .gov offers some pretty neat pictures and measurements of portion sizes. Believe me, they are smaller than most of us consume. Also the National Heart, LUng and Blood Institutes has a portion distortion quiz that you might find helpful. I'll try to link to it in the next e-mail newsletter.

Physical activity may help with both your blues and weight loss efforts. If your knees are a probelm, think low impact activities, including swimming. Water aerobics are a popular activity for a number of LPCers and this won't put a lot of pressure on your joints.

You may also want to find some additional group support. TOPS (Take Off Pounds Sensibly) .org; Foodaddicts and Overeaters Anonymous are three that come to mind. You may want to consider one or two sessions with a registered dietitian to get a little personal help. Or join a group such as Weight Watchers, which is also available on-line.

You can do this. You just haven't found the approach yet that works best for you. It may take a little time, so hang in there. Check back with us. We're here for support too.

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Waldorf, Md.: I have a wonderful recipe for low-carb dieters and for those who cannot have wheat

Magical Peanut Butter Cookies

1 Cup any kind of peanut butter (creamy/chunky), 1 Cup Splenda Mix well and then add 1 beaten eggm 1 tsp vanilla

Bake at 375 for half hour on parchment paper. Let cool completely before handling.

These are delicious and it's hard to believe they're actually GOOD for you.

Sally Squires: Yum! Thanks.

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Bethesda, Md.: Re: motivation for exercise: My husband and I try to take weekly walks or hikes in parks or other places where we have not been before. Some places are more interesting than others, and some are a lot more stenuous. But it gives us incentive to work out more during the week, so we'll have that weekend stamina. And we get some positive reinforcement of having some together time that's pretty much just us.

Sally Squires: Sounds like a great strategy, Bethesda. And there are so many wonderful places to walk around here (and in other locations too.) I love the fact that you do this with your husband. It's great reinforcement for both of you. Thanks.

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Bethesda, Md.: As someone with a long family history of cancer, I wanted to thank you for recommending some of the recipes from the American Institute for Cancer Research's New American Plate. We tried the chicken and sweet potato stirfry and loved it. We've also had the Greek-Style sea scallops. After 2 successful recipes, I bought the book. However, you can also get a lot of the recipes for free online in brochure or downloadable pdf format under the New American Plate series at this address: .org/publications/brochures/#2

Sally Squires: Thanks Bethesda. This is a beautiful cookbook. I haven't had time to try the recipes yet, but from what I've read, they look really good. Glad you've liked them. And thanks for the link.

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Arlington, Va.: A brag and a question this might be a marty gallagher question but I'll throw it your way: My not quite 5-year-old son told me that he wanted to run all the way to his favorite playground rather than ride on the back of my bike. I decided to humor him and let him run until he got tired. i figured that he would poop out in a block. he ran the entire 2 miles (yes, you read that right 2 miles) to the playground stopping at the street crossings to look both ways. now my questions is it OK to let a not quite 5 year old run distances like that? I want to encourage him to exercise but I don't want him to hurt himself. what sort of damage can running do? obviously, the $10 sneakers from payless aren't going to cut it. This is not a bogus post. I am totally for real on this.

Sally Squires: I don't take it as bogus at all. Kids have a huge amount of energy. Yes, it would be a good idea to invest in a great pair of shoes for your 5-year-old. But if he's enjoying it--and you're really not pushing him--there's nothing wrong with this. Kids--and adults--are meant to move. Current recommendations are for 60 minutes of daily physical activity for kids. You can also check with your pediatrician at your son's next visit, but from what I've read and the latest guidelines, there's nothing wrong with what your son is doing--as long as you are not pushing him to do this even in a subconscious way. Another clue: is he smiling and enjoying himself during the run? Thanks!

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Bowie, Md.: Recent find at BJ's - Skinny Cow cheese wheels in a three-pack (both regular and light). I bought them and found out that my kids (5 and 2) love the novelty of pulling the foil wrappers off.

Sally Squires: What a great treat for your kids, Bowie! And they're a good way to get more calcium into their daily fare. Question: Are they Skinny Cow or Laughing Cow? I love the Laughing Cow cheese. Also good on wedges of apple or pear for an extra treat. Thanks!

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Maryland: Not sure what the poster was concerned about rE: the food pyramid issue. As it read, it wasn't recommending the calorie intake be lowered, it was explaining that if the intake is less than the expenditure, you lose weight.

Sally Squires: Yes, good thought, that one occurred to me too, Maryland. But I'll still check with USDA after the chat. Thanks.

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Washington, .: How do I figure out what my appropriate food/calorie intake is? I'm 5'9", 115 lbs, 30 years old. (Yes, I need to eat more!)

Sally Squires: It's become really easy with . You can sign on and give you age, gender and activity level and they will give you your estimated calories...Your tax dollars at work, as we like to say.

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San Antonio, Tex.: For Struggling in Va., sometimes one change can make a difference -- a host of rules is hard to follow and NO fun, but just one is manageable. Suggested rule? The kitchen closes at 7:30.

Also, the only "exercise" I can maintain is something that is just plain fun. I have much more WantPower, than WillPower. I love to walk in my neighborhood in the spring, summer, and fall. But in winter--yes, there is winter in San Antonio--I switch to the mall--lights, people, colors, and warmth. But the main thing for me is that it is fun. Something I want to do, not should do.

Sally Squires: Well said, San Antonio. Thanks very much.

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Reston, Va., Working Mom: Hi, Sally. I used to think that I didn't have time to exercise because I am married, work full time, do volunteer work and have a son who is very active in sports and other activities. Then one day I decided that was an excuse. Basically, you make time for what you want to make time for. I get up early and do exercise videos for cardio, walk outside at lunch a couple of days a week and go to my Y for weight training and/ or cardio three for four days a week. I've lost 18 pounds on Weight Watchers since January and feel so much better. I have more to lose and I know I will reach my goal weight. I've also added in stair climbing at work and parking farther away in parking lots to get in a little extra exercise. My workout tip is this. I love working out because I love listening to music. I have a pretty extensive CD collection, everything from Broadway show tunes and movie musicals to R and B to bluegrass to Hip Hop to jazz. I mix it up a lot so I never get tired of the music. When you work out, take your music along on a CD player or MP3 player. You will enjoy your workout a lot more. And my husband and son just gave me an Ipod Shuffle for my birthday, so once I program my songs, I will really have a great mix of songs. Thanks for all of the encouragement, everyone. I am a new LPC convert and I am learning a lot.

Sally Squires: Great going, Reston. And you are so right about making the time for workouts rather than finding the time. It's very easy to get caught up in the daily grind and forget that. Sounds like you're doing really well. Congratulations on those 18 pounds by the way!

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DC: Re new Exercize requirements.

To lose or MAINTAIN weight it says 30-60 (but more like 60) a day...

If I run 45min 3-4 times a week, shouldnt that be enough? Every day seems a bit excessive - I could eat a ton that way... (i think) but don't want to...

Ideas?

Sally Squires: Remember DC that when they say maintain--they're talking about people who have lost weight and are trying to maintain that weight loss. That's a bit different from people who have never been overweight and want to maintain their weight.

So the breakdown is this:

30 minutes of daily activity on most days for all adults

60 to up to 90 minutes daily for those who want to either lose weight or maintain their weight loss.

Kids: 60 minutes on most days.

And yes, if you can't work out one day, you do more on another. Weight training is also recommended two to three times weekly and it is suggested to make some of your daily activity cardiovascular about three times weekly to keep heart in shape.

Hope that helps.

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New Orleans: Can you help--I don't know if I should be concerned about my waist size or not, and here's why. Thru WW, I have from 241 to 164 (I am 5 8). My waist is still about 35 inches ... but pretty flabby. Could it be excess skin that will never go away, even if I make it the few more pounds to within my BMI range? My father had type II diabetes. Would you be concerned if you were me?

Sally Squires: Way to go New Orleans! What you've done is awesome. Remember waist size is one risk factor. It's important as is your family history of diabetes. But having lost so much weight, it's not unusual for you to need to firm up a little with continued exercse to tone and shape. Yes, pay attention to your waist size, but don't obsess about it. And get checked at your physical exam for blood sugar. Remember vigilance, not obsession.

And congratulations!

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Washington, .: McLean, Va, who mentioned that she's having trouble dropping a dress size, might want to stop drinking juice (which she listed as a beverage she currently drinks). Juice contains a lot of sugar and is basically "dead calories." Most people can drop it from their diet without really missing it.

Sally Squires: Good point, DC. Or she might want to dilute it with seltzer or other sparkling water. I've also become a big fan of unsweetened cranberry and unsweetened blueberry juice. One to two ounces mixed with a splash of lime and sparkling water is a great refreshing summer drink. A bit tart, however, so it may not be to everyone's taste. Thanks!

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Silver Spring, Md.: Hi Sally,

Thanks for all the great tips! I emailed you a pic to show that it works! My sister and I have been eating healthy and working out since January and have each lost about 40 lbs. And believe me, if I can do it, ANYONE can. We started out with waterwalking, moved up to deep water jogging and are now starting to add weight training. I'd like to lose at least another 60 lbs or so.

Question, in trying to avoid losing lean body mass while exercising and dieting, is there any benefit to upping the percentage of protein in my daily diet? I don't mean an Atkins like regime, but upping protein and just cutting back a bit on everything else.

Sally Squires: Wow Silver Spring. I think this is a first. I look forward to seeing you and your sister. Thanks very much. Weight training is really a prime way to help maintain lean muscle mass as you are losing weight. Odds are that you get plenty of protein in your diet. Thanks again.

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Washington, .: I'm on day 5 of the South Beach Diet and am shocked that my clothes fit very differently -- loosely. I'm a size 8 but felt sluggish and wanted to up my energy, so I'm working on what I eat. I didn't feel like I have that much to lose, so I'm surprised to lose about 3-5 pounds in the first few days. How much of this is water weight? How can I maintain this after this first induction phase?

Thanks!

Sally Squires: Weight loss during the first few days of any diet are mostly due to water loss, DC. Sorry, but that's the way it works. It takes a deficit of 3,500 calories to lose a pound. But if you're feeling better and enjoying yourself, that is a reward of its own, don't you think? Continued success with your efforts.

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Washington, .: I have to take some issue with the person who posted the peanut butter cookie recipes. Sure it's great to have alternatives to traditional baked products. But to say that the recipe is good for you is quite an overstatement. It maybe save some calories over the full-sugar recipe, but it's hardly good for you. And by saying so, I would fear that those less knowledgeable about nutrition might be inclined to plow through an entire batch of those cookies in one sitting. They are good for you, after all. One or two tablespoons of peanut butter is a sensible snack and great source of protein. Inhaling a batch of cookies amde with one cup of the stuff is not.

Sally Squires: Absolutely right. Moderation--not batches of cookies or boxes of crackers or anything in big amounts--is the motto of the Lean Plate Club. Thanks for weighing in.

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Maryland: How do I keep apples from browning once cut up?

Sally Squires: Put a little lemon or lime juice on them, Maryland.

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Silver Spring, Md.: Hi Sally,

Your column today raises a question I keep meaning to ask my doctor: When you say that a woman's waist measurement of less than 35 inches is better health-wise, does that mean one's natural waist line or the widest part? To give you an example of what I mean, I have a BMI of . My natural waist measurement is 32", but in the past few years as menopause has kicked in, I've developed a bit of a "tummy," and if I measure THAT (which is 4-5" below my natural waist), it's nearly 40". My hips are 44". (I used to be a pear, but it looks like I'm becoming an apple as I near age 50.)

: Middle Ground On BMI (Post, May 17)

Sally Squires: It's very common for women (and men) to add weight around the middle with age. And yes, it is that weight that seems to be associated with an increased risk of type 2 diabetes and other health problems. So yes, apples have more to be concerned about healthwise than pears. Hope that helps. Thanks.

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Ottawa, Ontario, Canada: I reached my weight goal with Weight Watchers last year after losing 64 pounds then slipped off the program and gained 10 of it back. I'm back on program now and have been using MyPyramidTracker in tandem with WW for several weeks to keep track of both food intake and activity. The activity tracker is a great motivational tool to keep me focussed on my exercise regime. While I think the food tracker is pretty cumbersome (too much changing between screens), but I use it because I like to be able to compare the calories eaten each day to the WW points eaten. It would be nice if the food tracker would allow you to enter the nutritional information from food labels of those foods you commonly eat so that you could have a precise accounting of the nutrients rather than the "ballpark" numbers you get when you select from their database. I'd also like to be able to lump food items together as "frequently eaten meals" so that I could use them over again (. I eat the same breakfast nearly every day and would like to enter "oatmeal breakfast" rather than entering oatmeal, blueberries,&milk separately.) Overall, I think its a great tool and look forward to any improvements they make over time.

Sally Squires: Thanks for the very thoughtful feedback, Ottawa. And congratulations on those 64 pounds! Bet you trim that other 10 very soon. Let us know. Thanks.

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Green Bay, Wis.: All of the information that is given doesn't motivate or depress me. It is like reading lots of stats but what does it really mean to me. I believe most people just want to be given the bottom line, not lots of stats that gets confusing.

Sally Squires: Well said, Green Bay. Thanks.

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Sally Squires: Thanks to all. I'm giving myself the hook, because we're way over time, but I love chatting so much that sometimes it's hard to quit. Winners this week are:

Struggling with Wt in No. Va.; Fullerton; New Orleans; Philly; Bethesda (for the AICR link), Ottawa; Herndon and St. Jo, Mo.

Please send me you snail mail address to and please put winner in the subject line for faster mailing.

Thanks go all for a great chat. Until next week, eat smart and move more with the Lean Plate Club. Cheers.

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