Just What the Doctor Ordered: Moderation

(The Washington Post) -

Dietitian and healthful-eating columnist Ellie Krieger answers questions about health and nutrition.

Q: What is your take on sugar substitutes? My husband had a scare with pre-diabetes numbers about a year ago, and we cut out as much sugar as we could. He is doing great, and we have also lost almost 100 pound, between the two of us. We use sugar substitutes in our tea, lemonade, etc., as well as in recipes that use sugar. The doctor says “everything in moderation,” but I would love your take on this subject.

A: I have been getting many questions about artificial sweeteners. It can be a confusing area. I agree with your doctor that moderation is fine when it comes to sugar and sugar substitutes. However, I personally try to avoid artificial ingredients in my food, so I am biased toward going for a little of the real thing and skipping the fake stuff. Also some artificial sweeteners are safer than others. From what I have read, Splenda has the cleanest safety record of all of the artificial sweeteners. Other have been linked with cancer and/or are not as well studied as they could be. The Center for Science in the Public Interest put out an excellent comprehensive report on sweeteners recently.

Q: Have you read the Cornucopia’s Yogurt Report? Most of the yogurts on the report that got the highest ratings are low in protein and high in fat, whereas some of the yogurt with lower ratings have high protein and low fat. What is your opinion on that and the report in general?

A: Thank you for bringing this report to my attention. I had not heard of it, but I was able to glance through it briefly since you posted. I agree with many points in the report. My takeaway is that it is best to buy plain yogurt and add your own fruit and flavorings, which is something I have always advocated. I think avoiding the flavor additives in many of the brands is more important and helpful than worrying about grams of fat or protein.

Q: I always have eaten low-fat yogurt high in protein. Are the higher-rated yogurts in the Cornucopia report based more on the benefits of the good bacteria counts rather than the protein and low fat? I have been eating Fage or Chobani Low Fat and never with added flavors or sugars. I always added just a bit of honey or pure maple syrup and my own fruit. Is this a bad way to go?

A: I think the low-fat Fage or Chobani plain yogurts are excellent choices.

Q: Any thoughts on a healthful but somewhat special breakfast I can make for two?

A: A  number of recipes come to mind. One is eggs in a basket with asparagus, and another, which you can make ahead and will last in the refrigerator for a few days, is the mushroom quiche with oat crust, and third, whole-wheat apple pancakes with nutty topping. You can make the whole batch of batter, cook the amount you’d like that morning and keep the rest in the refrigerator for a day or two.

Q: I have a little one who will soon be ready to start drinking cow’s milk. I’ve read that skim milk has slightly more sugar, but also more protein, than 2 percent or whole milk, but everything I’ve read says “whole milk only” for children. Is this still the case? If so, why? Also, can you explain hormone-free/organic/regular plain milk differences?

A: Yes, that is still the case: Children two and under need the fat and calories that whole milk provides. After the age of two they can start to have reduced-fat or low-fat milk. Organic milk is produced without giving cows hormones or antibiotics; the cows receive organic feed and have a certain amount of access to pasture. I opt for organic milk because I believe it is better for the cows and better for the environment. But I think milk, in general, is a nutrient-rich, healthful food, whether it is produced organically or conventionally.

Q: Please help settle a family dispute. I know neither choice is the best option, but if a child is to have a soda, would it be better to allow the diet soda or the regular?

A: Real sugar or artificial sweeteners once in a while are fine, but my philosophy is to avoid artificial ingredients in favor of the real thing. So I vote for the occasional regular soda instead of the artificial one. When my daughter was little, we set a specific daily candy maximum for her. (She was allowed to have three small candies/sweets a day that added up to no more than 150 calories’ worth of sugar.) It really empowered her to make decisions about how she used that allotment. We counted a can of soda as three candies, and she’d often want one but skip it, understanding it used up her sugar limit for the day.

Q: For those who believe dairy milk is only nutritious if you are a calf, what do you consider to be the best non-dairy milk options?

A: I love nut milk and enjoy making my own almond milk. It is so simple, really. Just soak almonds in water for a few hours in the fridge, then drain. Then place in a blender with fresh water and purée, then strain. When purchasing nut, soy, rice, etc., milk, my main suggestion is to get the unsweetened varieties. Many products contain quite a bit of added sugar.

Happy healthy cooking!