Web Chat on Nutrition with Linda Thompson, UTMG Family Nurse Practioner. (The following is an edited transcript of questions and answers from a web chat held on Wednesday, May 14, 2003 on WREG, News Channel 3)

Welcome to our chat. I'm Linda Thompson at UT Medical Group, Inc. I am a nurse practitioner working with pediatric endocrinology, and a dietitian, though not presently registered.

Q: I have a question about children's nutrition. My 14 month old hates milk. Any suggestions on how to get the calcium she needs?

Ms. Thompson: Calcium is essential for healthy growth. You can sneak some in by adding milk to cereals, soups; including puddings in the diet, finding a kind of yogurt your child might like, and offering cheese.

Q: Hello, I have an overweight son who is 11 and he has a problem in wetting the bed we have had him tested for diabetes and kidney problems and they have all been negative. Could his bed wetting be related to his diet?

Ms. Thompson: The only dietary connection likely to influence bedwetting are liquid and caffeine intake prior to bedtime.

Q: I have not been able to stay motivated to loose weight. I have joined LA weightloss and not been able to keep it up. How can I stay motivated to eat healthy foods?

Ms. Thompson: I am not familiar with LA weightloss, but most efforts benefit from group or companion support. It's hard to lose weight, alone!

Response: I work from home so I am here all of the time…no one to tell me to stay out of the kitchen.

Q: What do you do to get more energy? Well I need to know because I have a little boy to keep up I need more energy.

Ms. Thompson: Energy is complex. It depends on adequate rest, relaxation as well as good nutrition. It's actually a lifestyle issue.

Response: I have to take my medicines and I can't have much sugar or caffeine.

Ms. Thompson: Exercise is a great way to increase the metabolism and improve energy. Even relaxed exercise, like yoga, is helpful.

Q: What all do you do with yoga?

Ms. Thompson: I recommend good yoga tapes, such as AM Yoga, or private lessons. This increases flexibility and improves breathing which helps relax and energize.

Response: Yeah but would it hurt the depakote or the tegatol. I am going on 35 in june my weight is usually 105.

Ms. Thompson: What's important about you're weight is that you're comfortable with it, and that it's appropriate for your height.

Q: I don't know when I drink milk at night it hurts the medicines.

Ms. Thompson: It would be good to discuss this with your clinician. Milk does not interact with every medicine.

Q: Do you suggest a low or no carb diet? I have tried it and I seemed to have more energy but I heard it is not healthy to go too long without carbs. What is your opinion?

Ms. Thompson: Reducing carbohydrates has shown to be helpful in reducing appetite, believe it or not. When we reduce carbs in children we have to be careful. A severe reduction can be unhealthy.

Q: Thanks for you advice. Do you think a low or no carb diet would be okay for a 13 year old child?

Ms. Thompson: It's a matter of degree.

Q: What is your input on using exercising tapes for home rather than walking outside. I have bought the Walk a Way the pound set but I have yet to use it do you think they are any good.

Ms. Thompson: I have heard ringing endorsements of the Walk Away the Pound series. Exercise works whether you're indoors or out.

Q: What about lowfat chocolate milk? My child likes to get that at school -- is it better than nothing?

Ms. Thompson: lowfat chocolate milk is definitely better than no milk. It does have extra sugar.

Q: My husband has HIGH metabolism or something and never looses weight. He encourages me to eat because he says he loves me no matter what. I think he likes to keep me chubby so I wont get dressed to impress...like he thinks I will "find a new love!"

News Channel 3: Have you tried to get out an walk or run? Maybe you could find another girl in the neighborhood to walk with. Get an exercise buddy/

Response: I don’t have any one to walk or run with I will never get out and do it by myself. You have to want it for yourself in order to be able to start moving.

Q: What are some healthy snacks I can offer my kids? They're tired of fruit, yogurt, and celery. I think they want something crunchy.

Ms. Thompson: Crunchy: carrots, cereals, a vegetable called "jicama", lowfat crackers, pretzels.

Q: On weekends I give my children 1-2 caffeine-free diet colas, is that ok? Given the choice between that and sugar cola? The rest of the time they drink milk.

Ms. Thompson: Caffeine free drinks are not unhealthy...but I love to promote water, good old water, and lowfat milk is so good for growing kids.

Ms. Thompson: To all interested: the NIH (National Institutes of Health) has excellent nutrition info on their website. Also the American Dietetic Association has a website with up-to-date nutrition information. I believe their keyword is "Eat Well".

Q: What’s the best breakfast cereal? Is raising bran OK or does it have too much sugar.I dont like oatmeal or kids cereals. Is it OK to top my cereal with nuts?

Ms. Thompson: When choosing breakfast cereal, read the label. Be sure that sugar is at least the 4th ingredient on the list

Response: I don’t think there are any cereals out there like that.

Ms. Thompson: So many cereals are "like that"... Try Kashi Lean, Fruit and Fiber, for example. Check also for fiber....at least 6 grams per serving. And measure your portion size...don't just fill the bowl.

Q: I am 33 and have been dieting since December. I have been taking phentermine 37.5 mg once a day. Do you know of long term side effects?

Ms. Thompson: Is the phentermine helping reduce your appetite? There are long term side effects when other drugs are combined with phentermine. Check with your clinician.

Q: I've been trying to lose weight with Body for Life program but haven't been successful. I've been sticking to it strictly for almost 2 months. I've been weight lifting 3 days a week, cardio 3 days a week, and eating smaller portions 6x day. Cuts out all sugar and simple carbs. What gives?

Ms. Thompson: You have started a complex process. You are building muscle while trying to reduce pounds....not easy. Because you are eating 6 times a day, your body is metabolizing food more effectively. But...you could be taking in too many calories. Are you keeping a food diary?

And, most importantly, have you checked your measurements since you started this program? Not all success shows up on the scales, first. Don't get discouraged. This takes time. And more time as we age, unfortunately.

Response: Yes, I am keeping a diary and no I haven't kept my measurements... but I've noticed my clothes fit better

Q: I’m a 47 year old male. I weigh approximately 272. I have lost 10 pounds in the last month. I have throat cancer and went through a total larenjectomy 3 years ago now I’m doing radiation and my doc's are upset that I’m losing weight. I want to loose about 100 lbs. Why don't they want me to lose?

Ms. Thompson: Your body is healing. You need calories to become healthy again. Rapid weight loss could interfere with your recovery.

Q: I just do not have an appetite. What can I do to get one?

Ms. Thompson: Do you have the energy to walk for exercise?

Response: No, when I get home I’m just too tired to do any thing but sleep.

Ms. Thompson: Exercise can serve many purposes, psychologically as well as physically. I recommend that you start with just five minutes of walking per day. Have you discussed the lack of energy with your physicians?

Q: Does coffee hurt or help your weight loss? It seems to help fill me up when I drink it with breakfast. Sometimes I have decaf, sometimes regular.

Ms. Thompson: There's no real evidence that coffee itself helps or hurts weight loss. Decaf coffee can function just as water to fill you up...

A point I'd like to make regarding carbohydrates is that simple carbohydrates, such as crackers, sugar-sweetened beverages, white bread, tend to increase one's appetite for more of the same. We are just beginning to learn about obesity. Because of its prevalence, more research is under way to understand the complex relationships between heredity (genetics), metabolism and food intake. Stay tuned!

News Channel 3: We want to thank Ms. Linda Thompson for joining us today! And thank you for logging in and participating!

You can also visit the UT Medical Group web site at www.utmedicalgroup.com.

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