Low-carb? Cut back pro­cessed foods and keep fruits, veg­gies

The Detroit News - - ARTS & STYLE -

Dear Dr. Roach: Would you be so kind as to send me a copy of your rec­om­mended low-car­bo­hy­drate diet? I have been try­ing to fol­low what I think it should be, but would like an ex­pert diet on which to base my food se­lec­tion.

– K.H. Dear K.H.: There is no spe­cific diet I feel com­fort­able rec­om­mend­ing for ev­ery­one. For peo­ple who want a lower-carb diet, I rec­om­mend elim­i­nat­ing pro­cessed starches, like white bread, pasta and rice, while con­tin­u­ing to eat veg­eta­bles and fruits. There is very good ev­i­dence that a plant­based diet, with no more than moder­ate amounts of an­i­mal pro­tein, is a healthy over­all diet for most peo­ple. In­creas­ing fats from olive, nut and veg­etable oils is rea­son­able, and there is some data to show this may help with weight con­trol and to pre­vent and treat di­a­betes.

A di­eti­cian nu­tri­tion­ist is an ex­pert in help­ing cre­ate a per­son­al­ized diet.

Dear Dr. Roach: As I’ve aged, I find sleep­ing to be more and more dif­fi­cult. When I take a prod­uct whose chief in­gre­di­ent is diphen­hy­dramine, I sleep well with no side ef­fects, but I worry about long-term con­se­quences. Is this safe to take daily?

– T.C. Dear T. C. : Most peo­ple take diphen­hy­dramine and have no prob­lems; how­ever, I still don’t rec­om­mend it, es­pe­cially for older peo­ple. These drugs in­crease the risk of fall­ing, lead to a higher risk of mo­tor ve­hi­cle col­li­sions, and may cause symp­toms of con­fu­sion and dry mouth. Men who take this can have de­creased abil­ity to uri­nate, some­times pro­foundly. Al­though there are some stud­ies that sug­gest an in­creased risk of de­men­tia with use of this prod­uct, I don’t think it is likely to be a big risk.

When­ever pos­si­ble, I rec­om­mend avoid­ing med­i­ca­tion and fo­cus­ing on be­hav­ioral tech­niques that have been proven ef­fec­tive: have a reg­u­lar sleep sched­ule; don’t try to force sleep; avoid al­co­hol and caf­feine near bed­time; and don’t use bright lights or com­puter screens be­fore bed.

Fi­nally, many older adults need less sleep. If you are sleep­ing fewer hours than you think you should be but aren’t sleepy dur­ing the day, even when do­ing some­thing less in­ter­est­ing, then you are prob­a­bly get­ting enough sleep.

Dear Dr. Roach: I am a 65-year-old dis­abled veteran. I have lost 40 pounds and 4 inches off my waist in the past year so I can have knee surgery. But the Vet­er­ans Af­fairs uses the BMI as the only met­ric to de­ter­mine body fat, so I am still cat­e­go­rized as “obese.”

I stand 5 feet, 10 inches with a 58-inch chest and 42-inch waist. In school I was de­fen­sive nose guard and catcher. My ques­tion: Is the BMI valid as a stand-alone met­ric to de­ter­mine body fat?

– D.W. Dear D.W.: The BMI (weight in kilo­grams di­vided by height in me­ters squared) is a rea­son­able met­ric for obe­sity, and at a pop­u­la­tion level, it is a rea­son­ably good pre­dic­tor of de­vel­op­ing di­a­betes and even over­all mor­tal­ity. How­ever, it is cer­tainly not per­fect, and one of the most com­mon fail­ures is when it is ap­plied to very mus­cu­lar peo­ple. There are some peo­ple who re­ally are “big boned,” but it’s the mus­cu­la­ture that makes the weight go up.

Among pro­fes­sional Amer­i­can foot­ball play­ers, even those with very high BMI lev­els may have very low amounts of body fat, as mea­sured by an ac­cu­rate method. In your case, the waist of 42 inches sug­gests that you may still have an ex­cess of body fat, de­spite your ex­cel­lent job of los­ing weight and inches off your waist.

KEITH ROACH

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