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Lean Plate Club
Talk About Nutrition and Health

Sally Squires
Washington Post Health and Nutrition Writer
Tuesday, March 18, 2008 1:00 PM

Confused about nutrition? Wondering how to fit in more physical activity? Welcome to the Lean Plate Club. Ask Sally Squires, nationally syndicated Lean Plate Club columnist for the Washington Post, about eating smart and moving more every Tuesday at 1 p.m. ET. Sally draws upon her master's degree in nutrition from Columbia University to preside over the lively Lean Plate Club web chat. Whether you're trying to reach a healthier weight or simply maintain it, you'll find plenty of tips and strategies.

Share your own food finds, creative workouts and secrets for healthy, great tasting meals. We'll cheer your successes and help with your setbacks. (None of this, of course, is a substitute for medical advice.) E-mail Sally, author of the newly published Secrets of the Lean Plate Club (St. Martin's Press) at leanplateclub@washpost.com.

Or just sign up for the free Lean Plate Club e-mail newsletter. The Lean Plate Club column appears Tuesdays in the Washington Post Health section and is nationally syndicated by the Washington Post Writers Group. Find other Lean Plate Club members at www.frappr.com/leanplateclub.

The Archives:

Sally Squires's Recent Columns

Discussion Transcripts

A transcript follows.

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Sally Squires: Welcome to the Lean Plate Club! We've got eggs up for discussion today along with plenty of other topics.

Today's e-mail newsletter should already have arrived in your electronic in-box. In today's issue, find links to:

Asian Corn Soup--just 97 calories per serving. Also:

Eating Well Fish Sticks, Halibut with Braised Fennel and Fried Green Tomato Sandwiches with Remoulade. (My mouth is watering, I hope yours is too.)Other possibilities: a vegetarian cassoulet, a Middle Eastern dip with red peppers, walnuts and pomegranates from Gourmet magazine and healthy recipes for Easter.

Last but not least, there is a free Lean Plate Club widget that will make access to current and past columns--dare I say it?--a piece of cake!

Now on to the chat.

Also, on the calorie-buring side, you'll find links to a new effort that Eli Manning plans to kick off this week with the President's Council on Physical Fitness and Sports. Check out the details at www.fitness.gov and look for more on our Website later this week and in the upcoming Lean Plate Club column.

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New York, N.Y.: Eggs Portobello

I saw this recipe on the food network but I changed it significantly

Grilled Portobello "Benedict"

2007 Ellie Krieger, All rights reserved

Show: Healthy Appetite with Ellie Krieger

Episode: Myth Busting

I use two portobello mushrooms with the stems on - I remove the stems and chop, add chopped onions, celery, garlic and carrots. I saute the mixture until tender and add whatever spices appeal to me that day. We like cajun spices so we mix that in. Some days we use a mix of Italian spices (rosemary, thyme, etc.) and salt and pepper.

We pan sear the caps until tender and able to be flattened.

Scoop the sauteed mixture on top and put the eggs on top or next to that.

We love it. Sometimes we do this as a side dish with fish or chicken (an leave out the eggs of course).

I am on a restricted diet and don't have bread except for one slice at breakfast. It was cold one day and I wanted a hot open turkey sandwich. I made the mushrooms and took sliced deli turkey over it and heated the whole thing. It was delicious!!!

Sally Squires: This sounds really good. And thanks very much for giving credit to the original recipe designer along with your tweaks. I have become a huge fan of Portobello mushrooms. They give a rich kind of smoky, meaty flavor with very few calories, don't you think? Thanks again New York.

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Hard-Boiled Truth about Eggs: Even though doctors may go back and forth about categorizing eggs as cholesterol bombs or "strokes in a shell," the sad reality is that behind nearly every "incredible, edible" egg sold in grocery stores today is a hen confined inside a barren wire "battery" cage so restrictive, she can barely even move. She'll never nest, dust bathe, or even set foot outside.

See for yourself at www.EggIndustry.com -- and be sure to also check out the delicious egg-free recipes!

Sally Squires: And that's why I prefer "cage-free" eggs--although I have also read that some of these hens aren't always so free living as one might expect.

The best eggs I ever ate came from a roomate's farm in Connecticut. Second best are the ones that I buy from our neighborhood farmer's market, which I believe live much freer lives too.

How about you? Can you tell the difference between organic, cage free and other eggs?

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Egg yolks: Hi Sally, if you are healthy with normal cholesterol levels, is it safe to eat 1 large hardboiled egg per day (with yolk)? Or should I still limit yolk consumption to just a few times a week? Thanks!

Sally Squires: The short answer: yes.

The longer answer: also take into account the other sources of dietary cholesterol, which include liver, other organ meats and some seafood, such shrimp.

I pushed Lawrence Appel, chair of the American Heart Association's committee, pretty hard on this question. He says that the AHA really feels based on the scientific evidence that we should not routinely exceed 300 milligrams per day of dietary cholesterol.(That includes eggs and other foods of course.) National Institutes of Health agrees.

But studies also show that trans fat and saturated fat are huge contributors of raising the bad kind of dietary cholesterol. So limiting those is important too. Bottom line: it comes down to--drum roll please--everything in moderation.

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Columbia, Md.: I have been trying to eat healthier breakfasts that will help keep me feeling full longer into the day - switching from toast to cereal with skim milk and now I'm experimenting with smoothies made from low-fat yogurt, berries, and homemade applesauce. I've been reading a bit about the glycemic index, but I worry that my current breakfast is pretty high-glycemic. Can you give me any guidance or suggestions? I love my smoothies!! I do occasionally eat eggs - but I try to limit myself to three eggs a week.

Sally Squires: That toast could be okay if it's whole grain. You might also top it with a nut butter--now available in peanut, cashew, almond, sesame. The list goes on and on.

Smoothies are wonderful. And depending on how you make them, could certainly have a low glycemic index. Start with a non fat or low fat plain yogurt. Don't worry about the sugar you may see on the side of the package. That's from lactose. It's a milk sugar and it is not sweet tasting nor does it raise blood sugar the way that glucose does. Plus the protein in the yogurt helps lower the glycemic index.

Berries are a high fiber fruit and fairly low on the glycemic index. If you use vanilla flavoring or a dash of almond, you may not even need added sugar of any kind.

Also, you could add half a banana, the less ripe, the lower the glycemic index. We'll try to post a column on the GI in a minute. And by the way, don't overlook whole grain hot cereals either. Oatmeal is one smart choice.

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Rockville, Md.: I'd like to say a great, big THANK YOU to the chatter who (several weeks ago) mentioned that those low-cal noodles from Whole Foods are found in the dairy section. I heard about them months ago, but I was looking in the dry pasta section. No wonder I couldn't find them! I just bought them and haven't had a chance to try them out yet, but right now I'm just happy to have that chance. Thanks again.

Sally Squires: You're very welcome. And this is one of the things that I love about the Lean Plate Club: the chance to share our tips, our slips and yes, our successes. Thanks for the feedback.

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Temple Hills, Md.: Hi, thank you for taking my question. About today's column on egg consumption: for a middle-aged person with a history of 'low' cholesterol levels (140s; good HDL/LCL ratios) and low blood pressure, is it safe to eat, say, 5-7 eggs (with yolk) a week, as long as one's cholesterol level stays low? Is a person with low blood cholesterol level still at some risk for arterial plaque and stroke and hence can benefit from getting the cholesterol level even lower? Thanks!

Sally Squires: If you keep your total dietary cholesterol intake at 300 milligrams or less per day, you're good to go. Depending on the size of the egg, you could probably eat up to 7 a week. (Small eggs--and sometimes you have to hunt for those in the grocery store--have the least cholesterol.) But also remember what Dr. Appel said in today's column: it's not just the eggs that matter. It's what you eat them with. So if your eggs come with toast slathered with butter and a stack of bacon or sausage, you probably need to proceed carefully. Ditto for that omelet that may come with three eggs at a restaurant, trans fat oil and cheese.

Also important, to limit unhealthy saturated and trans fats in all foods. And to enjoy healthy olive oil or canola oil in moderation.

Hope that helps.

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Eggs and Type 2 Diabetes: I can understand the cholesterol issue with eggs and heart disease, but why is there an issue with eggs and Type 2 Diabetes?

Sally Squires: Because diabetes significantly raises the risk of heart disease. In fact, some experts have told me that we should consider diabetes "early heart disease." It has just that much effect on blood vessels and the heart. So the National Cholesterol Education Program--part of the National Heart, Lung and Blood Institute, advises that people with type 2 diabetes need to take many of the same steps in prevention as those who already have high blood cholesterol or other signs of heart disease.

The good news: We know from the Diabetes Prevention Program that weight loss, exercise and eating right can significantly reduce risk of developing diabetes. And we know from other research that people who already have type 2 diabetes can takes steps to control it and sometimes even reverse it.

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calcium: How much calcium (milk, yogurt, cheese) should a woman have in one day? I was thinking 2-3 glasses of milk. But I was told only one is neccessary.

Sally Squires: Better check your source again. Recommendations vary a bit by age, but are as follows from the National Academy of Sciences Dietary Reference Intakes (yes, I know that's a mouthful, but that's the title.)

It's 1,000 milligrams daily for men and women 19 to 50 years; 1,200 for those 51 and older.

How does that work out to food? Eight ounces of skim milk contains about 300 milligrams of calcium. So that works out to about three servings per day for those 50 and younger, four for those 51 and older. And of course, this calcium doesn't just have to come from milk or dairy products. It can come from calcium fortified juice, cereal, etc. as well as supplements.

Hope that helps.

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Centreville, Md.: I worked on a farm last summer over college break and one of my jobs was to gather the eggs from the chickens who pretty much had the run of the place. I'd say there sure is a difference and anyone who hasn't had the opportunity to try fresh eggs like this really should put it on their to-do list.

Sally Squires: Thanks for that feedback. And it's good to know that your chickens really were cage free.

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Breakfast: I have recently been put on a restricted diet. For breakfast I had 1/3 cup dry oatmeal cooked with water. One cup of skim milk and a piece of fruit (banana). I can't tell you how hungry I was all morning. Maybe because I am nearly 300 pounds this doesn't seem like much food to me. But I was just wondering if this is the amount of food that a person of a healthy weight would eat.

Sally Squires: That's not an unreasonable breakfast, but I need to know about why you were put on a restricted diet. Is it because of weight? Blood sugar levels? High blood pressure? Something else?

And what did you do when you felt so hungry? Also, what do you have for lunch and dinner?

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washingtonpost.com: After 30 Years, Glycemic Index Still Fights for Acceptance (Post, Jan. 15)

Sally Squires: As promised...the link will get you to a recent column on the glycemic index for those who want to know more.

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Falls Church, Va.: I was diagnosed with hypothyroidism about a year ago and thought it would become easier to lose weight once I started taking replacement thyroid hormone and my levels went back into the normal range. But this hasn't been the case. I still find it very difficult to lose weight despite tracking what I eat, portion control and exercise. I know it was definitely easier to lose weight before I had this thyroid condition. Have any other LPC members had similar experiences?

Sally Squires: Sorry to hear about your thyroid condition, Falls Church. But it's good you got diagnosed. I'll post your question in a minute to the membership so they can weigh in too. But first, I was once on a panel with a leading thyroid expert at NIH who told the audience that correcting an underactive thyroid helps a little with weight, but not alot. He said that the average he sees is a loss of about four pounds.

So it still comes down to the same old thing: more activity and fewer calories.

How about others? How has a thyroid condition affected your weight?

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Silver Spring, Md.: Hi Sally! I have recently started reading your blog and chats as recently my boyfriend and I have started a regimen of calorie counting, portion control and regular work outs. It has been hard, but I already feel a difference in my energy level and just overall I feel healthier. My biggest problem area though is sweets. I love 'em. Specifically ice cream. With hot fudge sauce. I love sundaes, I can't help it. I know there are healthier dessert alternatives, such as fruit and frozen yogurt, but I have found nothing quite does it for me as ice cream with hot fudge. Any suggestions on ways that I can still enjoy this treat semi-regularly, but not be blown out by both the fat and sugar calories? Thanks so much!

Sally Squires: Welcome! We're delighted to have you with us. And for those who have not yet discovered the Lean Plate Club Discussion Group, it's the latest addition to the growing Lean Plate Club. (And we hope to continue to offer more in the future. So if you have ideas of what you'd like us to do, please drop me an e-mail at leanplatecub@washpost.com.)

And you can even call me--believe me, I'll let you know if I'm on deadline--at 202-334-5018. (No posting in bathrooms, please! :-)]

If you really don't feel satisfied without eating ice cream, you might either adjust calories during the day to fit in a scoop with a tablespoon or two (note portions carefully by measuring) of chocolate sauce. (Chocolate sauce versus hot fudge is much lower in calories.)

You'll need to measure the ice cream carefully. A lower fat variety--Breyer's is one choice--with about 7-8 grams of fat would be okay. Or you can go the low fat or non fat route (which will likely have more added sugar for flavor.)

If one scoop isn't enough, better think about limiting this treat to once or twice a week unless you plan to burn off the calories with a lot of exercise. You could also add some fresh or frozen fruit to this mix and slowly decrease the ice cream to see if you can be satisfied with less. (Increase fruit as you decrease ice cream.)

Then there are many other cold options including frozen fruit. Or some great possibilities from Skinny Cow that can be as little as 80 calories per serving.

Hope that helps. Other suggestions out there? Dish them our way.

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washingtonpost.com: The Lean Plate Club Group

Sally Squires: Here's a link to the new LPC Discussion Group where I post news and nutrition/exercise information about four to five times weekly. Hope to see some of you there in addition to here.

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Raleigh, N.C.: I've been eating canned tuna lately. It's good and filling, but it is really dry. Almost to the point where I can't get it down. I cannot stand mayo, though. Just the thought of eating it puts my stomach in knots. Is there something else I can add to the tuna to help moisten it?

Sally Squires: I often make a mediterranean tuna salad with sun dried tomatoes, beans (white beans, kidney beans, garbanzo beans are all good options), celery, endive, capers, olives, fresh tomatoes (adds to the flavor) basil, fennel, diced carrots, slices of sweet pepper. By the time you're finished, the tuna is almost a garnish. You can add some balsamic vinegar and a little olive oil. It's quite good.

Another option is to buy tuna packed in olive oil. Pat with paper towels to remove some of the oil, then add the other ingredients. But I find that packing the tuna in oil gives it a lot of flavor. You might also want to try some of the tuna in seal packs rather than cans. You may find that also less dry.

And you could also branch out to canned salmon or mackerel for other flavors....

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Rockville, Md,: A point that frequently gets lost in discussions over GI (it is alluded to by Walter Willett in the article you link; maybe the full quote got cut) is that it is determined empirically. The GI of a piece of white bread is different from the GI of a piece of white bread with a teaspoon of butter. If you were only going to eat a fixed amount of a single, tested food the GI per se would be meaningful. But as soon as you have a meal the number per se means nothing (you can still have a sense as to whether one meal is overall "less glycemic" than another but not necessarily by how much). GI is only one measure of the "healthiness" of foods.

Sally Squires: Absolutely right. And very few of us eat single meal foods. So this is a matter of continued debate in the scientific community. But having said that, it also doesn't seem to hurt to eat a diet that is lower on the glycemic index. Thanks for weighing in.

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Tulsa, Okla.: Green eggs and Ham!! This is my favorite egg recipe!

Scramble a dozen eggs, and stir in one chopped up tomato, diced ham, pepper to taste, and I always add some romano cheese. Then once the eggs are done, stir in some pesto. You don't want to cook the pesto, so I turn off the heat, but still leave it on burner.

Trust me, this will be the BEST EGGS YOU HAVE EVER EATEN!!

Sally Squires: They sound delicious, Tulsa. My only question: how many people does this green eggs and ham serve? As Dr. Appel noted, it's not so much the eggs, as what is served with the eggs that matters. (And by the way, that pesto is usually the source of some healthy fat.)

Thanks!

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NC: I recently had my RMR tested and the results were very concerning to me. 720. That seems impossibly low. What is considered to be a normal resting metabolism rate for middle aged, active women at a normal weight and body fat percentage? What would cause your RMR to be that low (thyroid is normal)?

Sally Squires: That does seem quite low. How as it measured? And by whom? Was there only one reading? All questions to be followed up. And for those who are not familiar with RMR, it stands for resting metabolic rate and is basically the number of calories that you burn when you are sitting doing nothing.

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re: breakfast: I was put on restricted diet because of weight loss only.

This is my meal plan:

BREAKFAST

1/3 cup oatmeal

1 Protein

1 Fruit

Coffee

LUNCH

1 Protein

1 Vegetable

Finger Salad

(no dressing)

DINNER

1 Protein

1 Vegetable

Salad

2 tb salad dressing (no sugar)

Sally Squires: This is a quick guess, but it looks like this would provide about 1,200 calories depending on what constitutes one protein. Where did you get the plan?

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New York, NY: For my birthday, my husband found this great egg white recipe on www.BellyBytes.com. He used EggBeaters. We sprinkled some non fat mozzerella on it and it was delicious:

Egg White Frittata from BellyBytes.com

Vegetable Egg White Frittata

Dished up in pancake form, this is a refreshing alternative to the everyday omelet.

Ingredients:

Twenty egg whites

1/2 cup broccoli florets, bite-size

1/2 cup diced red bell peppers

One Portobello mushroom, sliced

Nonstick cooking spray

Salt and pepper

One small red onion, optional

3/4 cup roasted tomato salsa

Directions:

Advance Preparation: Separate 20 eggs, discarding yolks and placing whites in an airtight plastic container. In a steam basket set in a small saucepan, steam broccoli and bell peppers until just tender, about 6 minutes. Plunge into ice water, drain and cool completely. Place in a resealable plastic bag.

Mushroom: In small skillet, saute mushroom. Cool and transfer to small airtight container. Refrigerate everything until needed.

Preparation: Spray an omelet pan or skillet with nonstick cooking spray and place over low heat. Lightly beat egg whites and add them to the pan with sauteed vegetables and seasonings. Continue cooking until eggs are set.

Options: Brown the top under a broiler. Thinly slice onion and saute in another pan coated with nonstick cooking spray until onion begins to caramelize.

Serve: cover a large plate with salsa, place frittata on top, and garnish with onion. Serves 4

Sally Squires: Happy Birthday! And an egg white frittata or omelet is a wonderful food to eat. I also love the flavors of salsa with eggs. Gives them a nice kick. Thanks.

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Kalamazoo, Mich.: Grow Roses! That's how I work off those winter pounds. I'm 75 years "old" and care for 60 rose bushes. This time of year it's uncovering and spring pruning. Then adding mulch and all the other things one does to make roses grow into beautiful flowers. I think working in a garden is one healthy way to keep "young".

Sally Squires: What a wonderful activity to do with great payoff both from burning calories and from looking at those future roses. Bet your yard is beautiful. Thanks Kalamazoo.

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re: hot grains/whole grains: Aside from oatmeal, what other whole grains are filling and high in fiber with a low gi? Is cracked wheat one of them?

Sally Squires: Barley, amaranth and quinoa (both ancient grains) as well as brown rice and wild rice. We'll try to post some links in a minute to more info. As for cracked wheat, it could be a whole grain. Look for the words, whole wheat flour in the ingredient list. Hope this helps.

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washingtonpost.com: Sprouted Grains Recognized as Whole Grains wholegraincouncil.org

Sally Squires: As promised...

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Diabetic Friend: My friend recently lost a foot to diabetes. He lives alone and works long hours, and doesn't cook for himself. Delivered diabetic food is too expensive. He does need to lose weight, so restaurant food is usually too caloric. Question: Are frozen dinners like Lean Cuisine or Weight Watchers appropriate for this situation?

Sally Squires: I'm so very sorry to hear of your friends medical condition. Diabetes remains the number one cause of lost limbs. One aside: limb-sparing treatments that were developed to help treat leprosy have proven quite successful for type 2 diabetes as well. Former U.S. Surgeon C. Everett Koop first invited me to the public health service hospital in 1989 to write that story which I did for the Post. And that's how I happened to end up doing a PBS documentary, called "Triumph at Carville: A Tale of Leprosy in America," that is slated to air on Friday, March 28 at 10 p.m. ET on a station near you. (Check local listings for times.)

If your friend doesn't have access to a diabetes nutrition educator, he or she should ask his or her physician for a referral to one. (This is usually covered by Medicare, and many health insurance companies.) In theory, that Lean Cuisine or Weight Watchers dinners may be fine. But it would be worthwhile to check and to get a planned menu that will help your friend keep blood sugar in control and hopefully avoid any more amputations.

Please let us know how it goes.

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washingtonpost.com: Whole Grains Made Easy (PDF, wheatfoods.org)

Sally Squires: As promised...

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Rockville, Md.: You're not telling me how (or where) to sign up for the Physical Fitness Challenge...please do.

SEE BELOW:

Eli Manning--yes, the quarterback for the latest Super Bowl winner, the New York Giants--is scheduled to kick off the latest physical activity challenge from the President's Council for Physical Fitness and Sports on Thursday at the National Press Club. You can sign up for the challenge starting now through April 3.

Sally Squires: You're right! Sorry. The site: www.fitness.gov, should have a place to sign up. Look for more on our Web site later this week.

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Long Beach, N.Y.: My daily breakfast smoothie consists of peach yogurt (usually from Trader Joe's), 1/2 banana, a handful of frozen fruit, e.g. cherries, mangoes, peaches, or strawberries (also from Trader Joe's), and a raw egg. How dangerous is the egg?

Sally Squires: Quite dangerous unless it's pasteurized in the egg as in the Davidson's Safe Choice mentioned in today's chat. My hunch is that you don't want to risk a case of salmonella. So either cook that egg, or switch to one that is pasteurized in the shell.

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Rockville, Md.: Hi Sally, I had a baby...9 months ago. Starting weight was 125, finishing weight was 178, current weight is 146. I walk w/baby, we go to "baby gym" twice a week, I eat well as baby needs to eat well. There arent cookies or bunches of junk in my house. I cook our dinners which are all typically organic and/or low fat. The kicker is I am rarely hungry. I don't like to eat. It's like my taste buds have died. By the time it is my turn to eat I just want more coffee. I can add to this that I haven't slept through the night in over a year. Why cant I lose weight? Do I need to be MORE active? Eat more? I doubt I can get any more sleep. I drink water, lowfat milk, water and once a week two glasses of wine. What do I need to fix to drop 15 pounds? Mind you my 9 month old weighs 31 pounds...

Sally Squires: Congratulations on your baby! How exciting! Lack of sleep could definitely be affecting your efforts. Can you trade off with your husband or partner? Can you nap? Are you still nursing? That can sometimes make weight loss easier at first and then a little more difficult until you stop breastfeeding.

Do you ever measure how much you eat? It could be that you're either eating more than you think--very easy for all of us to do--or eating so little that your body thinks it's in starvation mode.

Check that for a few days and see what you find. Then since we are out of time, hope you will check back with us and tell us next week.

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