'Don't Go on a Diet'

By Jennifer Huget
Special to The Washington Post
Tuesday, January 8, 2008

When we invited readers to round off our recent list of nine health traps to avoid in the coming year, you weren't shy.

Some of you offered guidance on diet and exercise; others waxed philosophical about general approaches to healthy living. Some shared lessons learned the hard way, some promoted causes and some took issue with our advice. Some posted online; others weighed in by e-mail. Thanks, all!

Whether submissions were framed as traps to avoid or straight-up tips, they showed a breadth of concerns. We can't print them all, but here's a hearty sampling. (Some have been edited for length and clarity.)

And here's to a healthier 2008!

Beware Weight-Loss Wiles

"Don't go on a diet," counseled georgewbogus (whose political leanings I can only guess at). "You will probably end up fatter." He rightly notes that "regarding so-called whole wheat bread that's primarily white flour, 'white flour' won't be listed as the first ingredient. The euphemism for white flour is 'enriched wheat flour.' "

Robb Dunn warns, " Do not fall prey to the 'energy drink' craze! Only drink these drinks within 30 minutes before, during, or within 30 minutes after exercise. These drinks are high in simple sugars and are the first source of energy the body will draw from when it needs it. Instead, drink plenty of water, and if you do need a quick pick-me-up, have a cup of coffee, soda or chocolate bar, as they will perform the same function without as many calories or the quick crash that will follow."

"Don't give up! On exercise, that is," wrote herons-landing. "I know too many people who think a lapse in their exercise plan means failure, and then they quit. The best thing to do is just get back to it. It all counts! Keep going!"

The "keep going" theme took on a different meaning from bb211: "If you're trying to lose weight (or just to feel better), remember that eliminating is as important as ingesting. Eat fewer foods that clog the digestive tract and more things that help it run smoothly." That's why we keep telling you to eat more dietary fiber.

When it comes to exercise or other healthy habits, " Don't think you can do it alone," suggests pali2500. "Join a class, a group. If you can't find a group devoted to good health, do your friends and neighbors a favor and start one. Remember the Zen saying: 'Beginning is easy; continuing is hard.' Continuing is much easier when you have company -- and a regular, specific time."

Hmmm. Sound familiar? We've said the same many times. Maybe you'll listen to pali.

Gerry Silverstein of South Burlington, Vt., knows there's only one equation that matters in dieting. He writes: "I have been an academic health educator for 20 years. Here are the two most important realities I have learned for those concerned about weight: Calories in must equal calories out in order to maintain weight. For those wanting to lose weight, calories in must be less than calories out."

Mind Money -- and Privacy

When it comes to insurance, we're all skeptics. Most skeptical of all is dotellen, who wrote, "My advice (and my parents were both doctors) is to avoid health insurance, take vitamins, and accept the notion that someday you will die. I have known too many people whose deaths were expensively prolonged by useless procedures that just eroded their savings."

Not sure about that first bit, dotellen; losing that gamble could be ruinous.

JimC2 wrote, "Protect your medical history.. . . If you have ever applied for health insurance you probably learned very quickly that your medical history is gathered only to determine the care you are most likely to need and then to deny you coverage for it. To protect your interests, seek medical testing anonymously when at all possible. If you go for a physical or medical testing, when possible pay cash and keep the results to yourself. . . . It's a sad state we're in, but knowing how the system works is important."

David Ollman of Reston advises: " Set up a flexible spending account. It's tax-free and helps with those co-payments and unexpected costs not covered by health, vision and dental insurance. Two years ago I was diagnosed with colon cancer. Our health insurance required a significant co-pay before it would cover all expenses. While we quickly exceeded the amount that we had to pay, it still came out of our pocket. If we would have had a flexible spending account, we could have covered those co-payments and had a significant tax savings."

Question Everything . . .

Many readers emphasized the importance of being your own best health advocate.

"Challenge your doctor," wrote jenandtomh1, "when he/she gives you a diagnosis too quickly and without paying attention to your complaint. You hired the doctor, and even though he/she won't like it, a physician has a responsibility to answer your questions. If your doc gets indignant, asks about your medical degree, ignore the insults and ask him/her what about your question makes him/her nervous. Lots of doctors are out there and want your money."

Sophie Korczyk of Alexandria recommends that when it comes to proposed medical treatment, "ask why, then if you don't like or understand the answer, just say no, whether to a drug, a diagnostic test or surgery. If they can't explain it, you don't need it."

Madperl wrote: "My wife had her first surgery, which was critical but inadequate, in February 2003 and died in February 2006. If faced with surgery, you must ask good questions and get a second opinion. Afterward, get copies of the operative and pathology reports. Read them and have them reviewed by at least one good doctor."

Madperl continued: "Good doctors often disagree. When you get a second opinion, you are not offending the first doctor; you are doing him a favor. The most important point is that you are responsible for the success of your treatment, not your doctor, the insurance company, the government or your mother. You are the one who is going to experience the consequences."

. . . Including Me

Vet those health Web sites, suggests Carolyn Barton, health librarian for Arlington Public Library, who took me to task for quoting a source as saying "there's no Good Housekeeping seal of approval" for Web sites. "There IS a substitute for a Good Housekeeping seal of approval for health Web sites," she writes. "It is the HONcode, a seal of approval from the Health on the Net Foundation." Check it out at http://www.hon.ch/index.html.

Well, yes, but. . . . Web sites bearing the HONcode logo are indeed supposed to adhere to a set of principles that ensure that the information they present is reliable. But as the Health section has reported, the voluntary program isn't foolproof; its administrators admit that sometimes Web sites display the logo even after they've fallen out of compliance. The advice stands: Check any Web site's sponsors, funders, sources and experts before making any big decisions based on what you read there.

"Be wary of journalists warning about supplements based on a small number of studies," wrote tumblemark. "There are charlatans on both sides, but the vast body of research shows that conventional supplements are beneficial in the long run or harmless. For example, nearly everyone should be taking vitamin D3 supplements, especially in winter, but where's the reporting?"

Alexander Fraser reached a different conclusion: Think twice about supplements, he counseled. "You say, 'There's nothing wrong with taking a daily supplement," he writes. "I say that's flat wrong. I got vitamin A poisoning while taking One A Day. Over a period of several months, I thought I was losing my mind. I'd be in the shower and, blip, have to stop and ask myself if I were dreaming. I'd look at a map and wonder if I were in the map. A CAT scan, visits to neurologists; nothing helped. I finally read about a woman who had gotten vitamin A poisoning from taking 25,000 IU a day. Hmm, said I. Wonder what I've been ingesting? You've guessed: 25,000 IU. It took several weeks, once I stopped, before the 'blips' stopped. A year later, I tried 10,000 IU a day. Still too much."

Well, that's disturbing. But a quick scan of the One A Day Web site shows a single pill contains between 2,500 and 3,500 international units (50 percent to 70 percent of the federally recommended Daily Value) of vitamin A, depending on whether it's a men's, women's or over-50 formula. Mr. Fraser's reported daily intake was nearly 10 times that amount. Be careful!

We warned you off "free" drug samples that can end up costing you. Stephen T. Owen of Alexandria begs to differ: Try that drug sample; you might like it, he suggests. "Those samples can be beneficial in at least two ways," he writes. "First, both my wife and I within the last year experienced delays in getting prescription refills filled, and our doctors were able to close the gap through samples on hand, in my case my medication to control glaucoma. Second, I don't see any valid reason why a patient should ignore the opportunity to try a new medication through a doctor's sample. It might actually be better than the cheaper, older medication, or have fewer side effects. Last spring, when I had severe allergy symptoms, my internist gave me some samples of a newer medication that worked faster and better, with no discernible side effects."

And Finally

The prize for most radical suggestion goes to mwelles, who advises: "Emigrate. Even if you, yourself, are healthy and can afford any health insurance or medical care necessary, your chances of staying healthy are better if all the people around you are also healthy and can afford to go to doctors when necessary! Come to Canada -- not only are most people healthy because they have access to medical care, but the economy is booming and there are lots of jobs in every field."

Jennifer Huget is a frequent contributor to Health. Comments:health@washpost.com.

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