Q: I have felt for some time now that I am addicted to food. I know that sounds stupid since we need food to live, but I feel like I can't say no to food and my life revolves around it. I feel like an addict.

I started dieting and exercising about a week ago, and every day is a struggle not to just grab something and eat it until I'm stuffed.

I realize I need to make a lifestyle change and I need some support. When I talk to my friends about struggling with dieting and saying no to sweets, they seem to sympathize but I don't think they get it.  

I think I need professional help, but as a single mom, I simply don't have the time. I really do want to be healthy-for me and my baby. I don't want her to grow up like me. Any advice would be great.

--marie1st

A:  I'm glad you are reaching out for help. You really do need it - and you're not alone. We all struggle with saying no to food, in different degrees. Yes, we are all "food addicts" because we have to eat, you need some strategies to get some structure in your eating, and become what's called a "mindful eater". You always want to think before you eat. Eating is both about the food and the behavior related to it. While I am sure you know an apple is a better choice than a slice of apple pie, it's a real struggle for you to resist. So, I'd suggest you join a structured program on-line, like Weight Watchers, with a lot of 24/7 support (there is a fee). Or, at no charge, is Overeaters Anonymous, that works for some people. One thing for sure - you can't do this by yourself, to get started.

In 1998 my daughter was diagnosed with celiac disease at the age of 2. She had been sick for about 6 months - losing weight, vomiting, and so tired she wanted to be carried everywhere. We were stunned by the news - particularly because we knew no one else in the family with the illness.

Celiac disease is a genetic condition characterized by the inability to digest gluten - a protein found in wheat, rye and barley. Because gluten is found in so many foods, the first weeks after our daughter's diagnosis were terrifying, as food after favorite food was struck of her "safe" list.

Cereals, pasta, bread, cakes, cookies - even some soups and medicines - all of these are out of bounds for people with celiac, who must follow a lifelong gluten-free diet.

Thankfully, we mastered the gluten-free diet, and our daughter is now a healthy and happy 13-year-old.

But, since it's a genetic disease, what about the rest of the family?

Q: I am 42 years old. My workouts consist of 5 days of cardio (45-60 min), 2 days of strength plus cardio/strength combo. I also follow Weight Watchers points.

It seems that my scale is either staying the same 122 lbs (5'4") or less but my pants are getting more snug. How can this be? Is my body changing? Is my weight being distributed differently as I get older? I am so baffled and very frustrated.

Hopefully someone can shed some light on this.

A: Hi! You'd be amazed how common your problem really is - doing everything right, but your pants are snug! First, congrats on your mental focus, and ability to stay on track with both eating and exercise. Even staying the same weight takes a lot of effort - just "not gaining" is success, as you're avoiding "weight creep" so often seen in anyone over the age of 35.

You don't say what kind of cardio or weights you're doing, but some people gain more muscle mass in the lower body - particularly the thighs (where there are several large muscle groups). As a general rule, if you're doing a lot of lunges, and squats for leg strength with weights , you might want to rethink that set of exercises.

Also, for the cardio - the step machine sometimes "bulks" up the lower body for many women - and you might want to consider the elliptical or bike, or the treadmill in the mix.

For the most personalized opinion, I'd suggest having one or two sessions with a trainer or exercise physiologist to review your current plan, and learn how to tweak what you're doing to tone without too much muscle buildup. Your aim, it sounds like, is to be proportioned.

Keep up the good work - you're doing great. Let me know how you are doing!

Q: We just found out we were expecting -- it's a surprise after 10 years. In that time I have gained about 70 lbs; I know this is because I haven't paid attention to my diet.  Ask Madelyn a question and look for her answers every week on HealthBeat  

It's a delicious but vicious cycle: Food, particularly high-sugar and high-fat foods, can bring acute relief both from physical and emotional pain, studies show. But in the long run, overeating may make your pain worse.

"My patients say when they hurt they have to eat," says Dr. Francis Keefe, Ph.D., professor in the department of psychology and neuroscience at Duke University, Durham. Unfortunately, pain relief from food is usually short-lived, and the long-term consequence is weight gain. And that can make your joints hurt, not to mention your self-esteem.

Q: My cholesterol is extremely high, but I don't want to take the medicine used in lowering it. I am trying a vegetarian diet, and walking four to eight miles a day. I was told that taking extra Niacin would also help bring down my cholesterol. Do you know if there is any scientific proof of this?

A:While Niacin can lower triglyceride levels, and may raise HDL (good cholesterol), it's important to talk with your doctor about prescription niacin, which is sometimes combined with other medications. Steer clear of over the counter niacin supplements to self-medicate without professional advice. While Niacin is in the B vitamin family, when used in high doses, it acts like a medicine. 

It's important that you know that cholesterol comes from two sources: what you eat and how much your liver produces. You only have control over what you eat - and you can't control, with diet, how much your liver is producing.

A vegetarian diet is a healthful one for a lot of reasons, and if you are controlling your saturated fat intake (limiting animal products, including full fat dairy and whole eggs) you are on the right track, from the dietary point of view. Many people cut way back on their dietary saturated fat and cholesterol, and still have elevated blood cholesterol.

Depending on your own numbers, I'd suggest talking to your doctor about non-prescription and prescription options. Some people respond to phytosterol treatment (plant compounds that can help lower cholesterol) found in pills, or "supershots" (a fortified yogurt drink), while others need a small dose of a prescription medication. Good luck - and let me know how you are doing!

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Madelyn H. Fernstrom, PhD, CNS, is the iVillage Health Editor-at-Large, Diet & Nutrition Editor for the Today Show and the Founder and Director of the University of Pittsburgh Medical Center's Weight Management Center.

A: I was wondering what kind of chocolate is good to eat while in a diet? I read that Dove dark chocolate was okay to take in -- is that true? I lost 11 lbs in just 4 months, but I don't think that's good enough, so I add a 15-minute ab workout plus what I've been doing for the past months.
-- mmm_crystal5

Q: You are right on track with your efforts - and you raise some VERY important questions that most women need help with.

When it comes to chocolate, the best kind when you are watching your weight is anything in a small portion! Seriously, it's calories in and calories out when it comes to losing weight. Chocolate CAN be a smart indulgence, IF you choose a monitored portion. First, only eat chocolate if that's a treat food that you like - the health benefits to dark chocolate come with eating nearly a quarter of a pound every day, so don't think you're choosing a "health food" in your small portion!

Dark chocolate does contain more antioxidants than milk chocolate, but when we're talking about a chocolate "treat", you need to pick what tastes best to you. Dove dark, in individual pieces is a good choice, but there are a number of other varieties that you can select. You might look for pre-packaged serving size of 100 calories, or even less (some are 80 cal). You might also try low calorie hot chocolate (25-50 calories per packet), or a frozen low-calorie item like a Fudgscicle, or similar products made by Weight Watchers, Skinny Cow, and other companies.

Your rate of weight loss is FABULOUS. At about 3 pounds a month, you're more likely to keep it off, than more rapid weight loss. Most people don't realize that a weight loss of about 1/2 a pound a week - 2 pounds a month is considered true success!! Yes, it's more than good enough! Adding some abs work is a plus - and I'm glad you're finding it enjoyable. When it comes to exercise, it you enjoy it, you're more likely to stick with it!

Continued success - you're doing great! Let me know how you are doing!

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Madelyn H. Fernstrom, PhD, CNS, is the iVillage Health Editor-at-Large, Diet & Nutrition Editor for the Today Show and the Founder and Director of the University of Pittsburgh Medical Center's Weight Management Center.

Q: Because of my living situation (no stove or microwave), I eat broccoli most days of the week, if not every day. I mainly eat it raw-- broccoli tacos, broccoli florets. I also put it just about everything I eat. TMI Alert : Since I have GI issues, including ulcerative colitis, I usually try to notice what's going on with my stools, the color especially. I ate broccoli daily for months this year without any green color. However, about a week ago it just started to change color.

I started eating broccoli about 10 years ago. High blood pressure and heart disease made me decide to try it. Am I overdoing it? I actually really like it now, and don't want to give it up. Any suggestions?

A: Hello! You raise a VERY important question.....that stool color is one marker of good health. Since you have a variety of digestive issues, it's most important to follow up with your doctor regularly to make sure your nutrient needs are met, regardless of stool color. I would suggest taking a daily multiple vitamin/mineral supplement (100% of the recommended daily intake, RDI) as good "insurance".
 

A "green" stool often is a sign of faster transit time through the digestive tract, but can be caused by a variety of factors. If this is occurring frequently, you should telephone your doctor.

While it's great that you like broccoli - it's nutrient dense, fiber rich, and has anti-cancer properties - and you can't over do it, you might want a little more variety, and get a greater variety of nutrients. Any colorful vegetable is a good option - and try some fresh fruit, if it agrees with your digestive tract. The other vegetables in the broccoli "family", called cruciferous vegetables, are cauliflower, brussel sprouts, and cabbage.

So, enjoy your broccoli, and try to be a more adventurous vegetable and fruit eater. You can also rotate raw and cooked varieties of any fruits and veggies....

Good luck, and let me know how you are doing!

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Madelyn H. Fernstrom, PhD, CNS, is the iVillage Health Editor-at-Large, Diet & Nutrition Editor for the Today Show and the Founder and Director of the University of Pittsburgh Medical Center's Weight Management Center.

Q: Do you believe that eating late at night causes weight gain?

A: GREAT question - and a lot of confusion about this topic. Eating at night does not cause weight gain - eating too many calories at night (or any other time during your waking hours) is what packs on the pounds. Many people do well with 3 meals, and 2 snacks each day - calorie controlled to keep you around a total of 1400-1600 calories (for weight loss - it varies for each individual). While some people eat dinner, and are "done" for their eating day, many people like an evening snack.

I always advise people to allow for around 200 calories in the evening, if this is a time that you'd like to eat - but pay attention to the calories! Where "night eating" gets a bad rap is that many people skip meals, get overly hungry in the evening, and eat all night. That's not what we're talking about.

If you like to eat in the evening, pre-plan your snack for that time of day. Good luck! Let me know how you're doing!

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Madelyn H. Fernstrom, PhD, CNS, is the iVillage Health Editor-at-Large, Diet & Nutrition Editor for the Today Show and the Founder and Director of the University of Pittsburgh Medical Center's Weight Management Center.

Q: My daughter is 13-years-old and has decided to be a vegetarian. My friend said she was too young to eat much tofu - because it has too much estrogen in it! Is this true?

Do you have any other tips for her to follow? She doesn't like many veggies, and thus ends up eating a lot of carbs/fats.

A: Many teenagers - just like your daughter - experiment with their food choices, and opt for a "vegetarian" diet. This means different things to each person. Soy products are an excellent source of heart-healthy protein, and tofu, edamame, and other soy products should be encouraged. Soy does act as a very weak estrogen, but this is not a health minus for a young, healthy teenager (for those with a history of breast cancer, and estrogen sensitive tumors, a chat with the doctor is a must-do). As with any kind of diet, moderation is key.

You'll want to encourage your daughter to include dairy products - as she needs calcium-rich foods to support active bone growth. Skim or low-fat milk, low-fat cheese and yogurt are all important. While you can get calcium from dark green veggies, she'll need multiple cups of foods like broccoli to meet her calcium need without dairy products. Plus, eggs are a great source of protein as well. It's also a good idea for your daughter to take a daily, multiple vitamin (100% of the daily recommended intake - no super vitamins!) to round out her needs. Plenty of fruits, veggies, and some whole grains should round out her eating plan.

Let me know how your daughter is doing with her new eating strategy!

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Madelyn H. Fernstrom, PhD, CNS, is the iVillage Health Editor-at-Large, Diet & Nutrition Editor for the Today Show and the Founder and Director of the University of Pittsburgh Medical Center's Weight Management Center.

Low-carb diets can lead to weight loss, but are they healthy for the heart? Cardiologist Anthony Rosenzweig, MD, Director of Cardiovascular Research in Beth Israel Deaconess Medical Center and Professor of Medicine at Harvard Medical School, was so convinced that they were heart-healthy that he used them himself to lose weight. But then his lab did some research that convinced him to find a healthier way. Here's his story:

    A few years ago, like many middle-aged Americans, I was experimenting with a low-carbohydrate diet. As a cardiologist, I knew that the few randomized controlled trials of this diet suggested that are effective ways to lose weight and, somewhat surprisingly - given how high in fat and cholesterol they sometimes are - had relatively little adverse effect on the usual markers of cardiovascular risk, such as serum cholesterol or CRP [a measurement of inflammation].  

Dr. Shi Yin Foo, a talented physician-scientist and cardiologist working in my laboratory, was taken aback by what I was eating at lunch. She'd ask how I could eat that way and would tell me about the last low-carb patient she'd admitted to the hospital with a heart attack. I'd point out that there were no controls for her observations, and that - as with the clinical studies - my own cholesterol and other markers remained unchanged.  

Of course, what we really wanted to know was what was happening to the blood vessels, and the risk of future heart attack or stroke on these diets. These questions are very difficult to address in clinical trials, and thus remains unanswered. Finally, I asked Shi Yin to do the mouse experiment - so that we could know what happens in the blood vessels and so I could eat in peace.

Q: I'm a vegan so nutritional yeast is a normal part of my diet. However I have a friend who is always researching food (mostly Crohn's Disease) and she thinks that nutritional yeast could be dangerous for women. I don't use more than a tablespoon or two in a day. Is there any medical reason to think she's right and I should be cautious about how much nutritional yeast I use?

A: Everyone is different, but it sounds like you're doing fine with nutritional yeast, and I'd keep taking it. For those with digestive and bowel problems (and even sometimes without), nutritional yeast can be a problem, as it is often associated with excessive bloating and gas. You don't seem to have any issues with it, so in your case, it's a fine nutritional supplement.

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Madelyn H. Fernstrom, PhD, CNS, is the iVillage Health Editor-at-Large, Diet & Nutrition Editor for the Today Show and the Founder and Director of the University of Pittsburgh Medical Center's Weight Management Center.

Q: I started menopause about 6 months ago, it's affected my weight. What sort of diet should I follow to get my weight down?
--nats8

A: Hi there! Most women find weight gain an even bigger struggle at menopause. This whole "change of life" - which by the way is a normal part of a woman's lifecycle - means that there's a lot of hormonal changes, as well as lifestyle changes (like the "empty nest", aging parents) that all can influence weight. From the biology side, hormonal changes can stimulate appetite, and also cause interrupted sleep (fatigue can make you overeat). From the behavior/lifestyle side, we often overeat from boredom, stress, mental fatigue, as well as cut down on activity, both which promote weight gain.

The good news is that studies show weight gain is NOT something that needs to occur with menopause. You can take control - and here's how.

First, keep a food record to look at your eating patterns. Aim for regular and consistent, structured eating - 3 meals a day and one or two snacks. You want to be in the 1400-1600 calorie range for starters. A realistic goal for a mid-life woman is about a 1/2 to 1 pound a week of weight loss. To lose a 1/2 pound a week (2 pounds a month) you need to trim about 250 calories a day (from both eating and exercise).

I admit it--I'm one of those people who steals envious glances at other women, specifically women with slim waistlines. I've been fighting a decade-long crusade against my belly fat and thick waist. I'm not overweight...it just seems as though all my fat cells have plotted together and picked a rendezvous point. Location: my belly.

I know I'm not alone, so that helps a little. What helps even more is learning there is logic behind the belly-fat madness.

Studies have recently found that two common lifestyle factors -- stress and financial debt -- can significantly add to your waistline.

In a study out of Germany, researchers found that obesity tends to rise along with the rising burden of your finances.

The study followed 9000 people and found that a full quarter of those in debt were considered medically obese, compared to only 11 percent of those not in debt.

The study adds that there might be certain lifestyle choices linked to the debt, such as "comfort eating" and food choices determined by financial restrictions -- as we've all experienced at the grocery store, the "healthy" choice often seems to be the most expensive.

Financial debt and stress usually go together, and stress is the subject of another study.

When monkeys were fed an American diet to get fat, researchers found that those under chronic stress put on more belly fat.

During the study, high-stress monkeys had high levels of the stress hormone cortisol. Over time, the hormone caused fat to gather in the belly.

If you're like me, these two studies are a great incentive to get the finances in order and learn to calm down.

Vitamin D can help prevent diseases like osteoporosis and even cancer, but up to 75 percent of Americans aren't getting enough. NBC's Dr. Nancy Snyderman discusses sunshine vitamin deficiencies with Dr. Michael Holick. What do you think? Leave a comment below or on the Ask dr. Nancy board. You can watch "dr. Nancy" on MSNBC weekdays at noon ET.

Is a Little Sun Healthy? Decoding Vitamin D
Are You Sunning Yourself Into Skin Cancer?

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Q: My doctor looked through my file and told me that the lab work I have had over the last few years has put me one point away from a diagnosis of diabetes. For more than 30 years, I have been thinking I had hypoglycemia. I haven't been able to go more than a few hours without eating for most of my adult life.

I don't know how to eat. Now that I know my blood sugar is high, I think I probably need to makeover my overall diet. I don't need recipes, just ideas of what foods are good, especially for grabbing in between meals. --noelani2

A: You are very attentive to your health changes, and a good first step is a complete review of your symptoms with your doctor, to try to piece together what specific illnesses are connected to your symptoms.

The best diet for prediabetes (and also for weight control) is one that is rich is fruits and vegetables, whole grains (fiber rich starches), lean protein, and plenty of water. You'll want to limit sugar/fat treat foods, that add extra calories, and cause your blood sugar to yo-yo. It's also important to schedule regular meals and snacks in moderate portions.

After you visit your doctor, who can establish whether you have prediabetes or diabetes, you can ask for a referral to a registered dietician or nutritionist for help with an eating plan that meets your needs. Plus, visit your local bookstore for a volume published by the American Diabetes Association for some specific information on eating with diabetes.

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Madelyn H. Fernstrom, PhD, CNS, is the iVillage Health Editor-at-Large, Diet & Nutrition Editor for the Today Show and the Founder and Director of the University of Pittsburgh Medical Center's Weight Management Center.