When it comes to dietary fat, what's the real "take-home" message? Here's a quick summary: Fat is divided into "good" and "bad" types. Stick with the "good" fats - unsaturated fats from plant sources, and avoid the "bad" fats - saturated fats from animal sources. A newer addition, "trans" fats (that started out as plant fats and were chemically converted to act like animal fats) also goes in the "bad" fats list.

Why are they bad? Because abundant scientific evidence shows a link between a high intake of saturated fat, and high levels of LDL (think "lousy") cholesterol - which in turn is linked to higher rates of heart disease. The key word here is "linked". That means connected, but it's not always an absolute fact.

In fact, over the past decade, some studies have questioned whether this link is as strong as has been previously thought (based on a scientific view, called the "lipid hypothesis" supporting the connection between saturated fat intake, cholesterol, and and heart disease.) These studies suggest that small amounts of saturated fat actually support good health and that a balance of fats is important in the diet.

Before you run out and gobble down a giant steak and bowl of premium ice cream to support "good health" I'd like to suggest that you look at your dietary fat intake in a new and different way: Moderation of all sources of dietary fat. If we downsize our overall intake of all sources of fats, we'll have a lot easier time maintaining (or losing) our weight and having sufficient "caloric room" for an abundance of fruits and vegetables that should be the foundation of a healthy diet, as well as moderate amounts of protein and some fat.

Many of us make the mistake of choosing plant fats to replace animal fats, which can often lead to over-consumption of calories. Saturated and unsaturated fats have the same number of calories - 120 per tablespoon. I often hear from people who feel they're doing a health promoting activity by frying their chicken in olive oil (plant fat) instead of lard (animal fat). To me, the health promoting activity is to bake the chicken (and remove the skin before eating).

When it comes to dietary fat, I think we need to think this through a little more. The food police won't come and arrest you because you enjoyed a steak or a slice of cheesecake now and then. There's no reason to feel guilty about these choices; you're not a bad person because you chose a "bad" fat! It's all about the portion size: Think 6 ounce steak and small slice of cheescake, not the 16 ounce porterhouse and giant slab of cheesecake.

Limiting saturated fat is a good idea. Eliminating all saturated fats is going to be hard, and lead to deprivation.

While diet is a significant factor contributing to a healthy cholesterol level and healthy heart for most people, there are other factors that are also important, including family history and genetics. You probably know someone who doesn't eat a drop of saturated fat and has high blood levels of cholesterol. Or, the person who eats butter, meat, cheese and other saturated fats and has a cholesterol level in the healthy range and a healthy cardiovascular system.

Many people respond amazingly well to lowering their saturated fat intake, reflected in a lowering of their LDL (bad) cholesterol. Some people do not. If you've made this effort, and it hasn't lowered your LDL, it's not your fault. Talk to you doctor about other ways to improve your heart health.

If you've lost weight, do you still "feel fat"? This is sometimes one of the surprising findings of sustained weight loss. Whether you call it phantom fat, mental fat or body image issues, it's a factor that must be dealt with head-on, as part of everyone's weight loss journey. No matter what size package you're in, nor how much weight you've lost, we all have a struggle with this complex issue.

It's not an easy transition to thinking like a "thin person" (whatever that means!). The psychological adjustment to losing weight often takes a lot more time than the physical. Even specific documentation - smaller clothing size and a lower number on the scale - often don't resolve the issue.

You've got to retrain your brain to the "new you". It's important to match up your weight loss successes to support your mental retraining. The first step is acceptance that you've lost the weight, and will keep it off. If you think it's temporary, it's going to be hard to change your mindset about your body. Be proud of the changes you've made, and be positive about the new physical you.

For some women, particularly those who have lost 80-100 pounds or more, body contouring to trim excess skin has been a tremendous mental boost (and sometimes a support to physical health as well). It's never necessary, but an available option.

This is not an easy question to answer, and there are many ways to manage this. How have you dealt with phantom fatness? In this area, we can use all the advice we can get!

The answer to this question is not as simple as it might appear. To me, it's not a "yes" or "no", but a resounding "sometimes". Before you think that is a wishy-washy answer, of no particular benefit, I'd like to tell you why I believe this, and how you can best translate the answer to this question to your own personal health.

Before we had the term BMI (body mass index - that ratio of height to weight), it was hard to "size yourself up", to figure out how your weight was related to health risk. We only had those insurance charts - and surely we were all "big boned"! Decades of study have shown a relationship between increasing BMI and health risks like high blood pressure, diabetes, and sleep apnea, depending on which category you were in. Sounds like an easy connection - right? Not so easy, though, in real life. Population statistics don't always connect to the individual. While BMI is a useful guideline, it doesn't take body fat into account (only height and weight). And that's where this debate comes in.

A small portion of the population (think some professional athletes, trainers, and celebrities) have a high muscle mass, and low body fat (and we all know that muscle weighs more than fat). The lower body fat is not a genetic advantage - it comes from intense and regular physical activity. So, it is possible to be overweight, but not over-fat. That's why a measure of body fat is also essential, when it comes to sizing yourself up, if you believe your increased muscle mass is contributing to your weight. For a woman, you'll want a body fat of less than 23%, and for a man less than 18% to be in the "healthy" range. So, if your body fat is lower, and you are in the overweight category, this is one example where being "fit" and "fat" are compatible.

Most people don't fall into that category, and are those who both struggle with weight loss (and work just to not gain!) and are overweight or obese. Here is where I'd like to clarify that this is not an "either/or" situation. Abundant scientific data show that those who are in this category, and exercise regularly have health advantages related to improved cardiovascular performance, and other health pluses. If you struggle with your weight, for any variety of reasons, it's important to sustain physical activity (with your doctor's approval), even if it's not associated with weight loss. Improved health is not only related to the number on the scale. Physical activity, even without weight loss, is a plus.

Like most things in nature, there are no absolutes. Healthy eating and regular exercise are habits that support good health, no matter what your size.

Care to "weigh in" with your views?

I was interviewed earlier this morning for my thoughts on a new report from the New England Journal of Medicine talking about brown fat and weight loss (there were 3 reports published from different researchers). If you've never heard of brown fat, you're not alone. It's not something that's often talked about, since adult humans have little (or none) of it. We're all familiar with "white" fat - that's the storage facility for our bodies' extra calories. In caveman times, we could utilize this fat for energy. Now, with obesity exploding, white fat is a problem--particularly around the belly, where it's associated with a lot of negative health problems.

A mini-biology lesson on "good" and "bad" body fat.
The brownish color (hence, the name) comes from the presence of "mitochondria"--little energy burners usually found in muscle. There are no mitochondria in white fat, and that's a big difference. Brown fat actively burns calories, while white fat just stores them. I'm sure you're starting to see the connection to weight loss.

But there's more to the story. There's been a scientific debate for several decades about whether adults even have any functional brown fat. Infants do, and most studies looking at brown fat have been in animals, especially mice. Mice and infants have brown fat? What they have in common in that neither can shiver--which is the adult response to generating body heat when exposed to cold. So, in a cold environment, the brown fat generates heat (burns calories) to maintain a normal body temperature if shivering is not an option.

What is the new finding all about?
The finding is interesting because it demonstrates that at least some adults (7.5% of women and 3% of men) have measurable brown fat. This was done using a PET scanner, which is highly sensitive. The thought is that perhaps earlier methods were just not sensitive enough to detect it. Plus, the brown fat was also found in body places different from infants and mice (like in the neck, and near the spine), so the authors thought perhaps people were looking in the wrong place for it. In a second study, some healthy adults had a measurement of the brown fat, before and after exposure to cold. Before the cold exposure, there was no detectable brown fat, but when exposed to cold, there was measurable brown fat. The interpretation is that perhaps brown fat CAN be stimulated when needed, and adults DO have the capacity to produce it.

How is this connected to weight loss?
The real contest here is among pharmaceutical companies trying to tap into a pill that can help with weight loss. The strategy here is that rather than try too suppress hunger (the usual method), it's worth a try to stimulate metabolism, and calorie burning, perhaps by stimulating the production of brown fat. There's been a number of drugs tested in this area, but it's too soon to say if and when early drug trials will turn into an approved drug. A major barrier is that stimulating this pathway can also stimulate a lot of negative nervous system activities, with health damaging effects. It's also possible that even if this pathway for brown fat stimulation were activated, without any other side effects, we can't assume the people wouldn't eat more to make up for the calories burned. Remember, our bodies are hard wired for survival.

What should we do in the meantime?
Don't expect a medication to be at your corner drugstore anytime soon. And even if a medication is available in the future, oftentimes behavior trumps biology when it comes to weight loss. Lifestyle change will always be the foundation of weight loss. Eating less and moving more are always the starting lineup, which remains a challenge for all of us. Medications, whether they help reduce hunger or boost calorie usage, can only support, but never replace our own lifestyle efforts.

Fast food gets a bad rap from us nutritionists—and with good reason. Many (but not all!) choices are loaded with fat, calories, and salt, usually in giant portions. But, "fast food" doesn't have to mean "fat food". With some healthier add ins, smart deletions, and portion control, you can enjoy the convenience and fun of fast foods without expanding your waistline, raising your blood pressure, or clogging your arteries.

That's the topic of a fun Today Show segment with Hoda and Kathie Lee. You'll find some eye-popping information about fast foods of all kinds. From burgers to chicken, salads to tacos, sandwiches to pizza, we'll be comparing the most popular foods from fast food eateries. You'll get some good tips on how to eat when in a fast food restaurant, and not derail healthy eating.

Watch the segment from TODAY
Here's the truth about fast food quiz:

Which is worse? French fries or onion rings?

• French fries: 360 cals, 20g fat
• Onion rings: 300 cals, 15g fat

What is the best drink to get at a fast food restaurant?

• Small milkshake: 420 cals
• Large regular soda: 310 cals

When it comes to fat grams, here’s the ranking from the healthier option to the most fattening:

1. Large chili and crackers: 9g fat
2. Kids meal hamburger/fries: 22g fat
3. Small meatball sub: 24g fat
4. Extra crispy chicken breast: 28g fat

Here’s the ranking of 4 items with calories in mind, from the best to the worst:

1. Grilled steak taco: 260 cals
2. Asian chicken salad: 380 cals
3. Turkey sub: 560 cals
4. Mini cheese pizza: 620 cals

So what is the best option out there when it comes to fast food? Here are some tips:

• When in doubt, avoid anything fried
• Go for thin crust pizza light on cheese and toppings
• Grilled chicken is a better choice, skip sauces
• Skip desserts
• Drinks: go for diet soda or water

What's your view of fast food? I'd love to hear your opinions - pro and con!

More from Madelyn Fernstrom:

• Test your caffeine smarts
• Are liquid calories packing on the pounds?
• Calorie counts on fast food menus

Childhood obesity is on the rise, and we're all concerned about what we're feeding our children. We want to make sure that our children are well fed, for normal growth and development, but how do we know what's too much?

Should we set limits on our children's eating? What if they're eating too much? Should we say something? When is too young to put a child on a diet?

Watch the segment from TODAY First, you should never tell your child they're overweight and you're putting them on a diet to lose weight. That's the kind of comment, even delivered in a caring way, that plagues a child for life, and affects their self-esteem and body image for life.

What you DO want to focus on is healthy eating for the whole family, so it is a "team" effort. Everyone needs to focus on healthier eating, more physical activity, and management of boredom and stress eating (yes, this happens to kids, too).

Here are my top tips for healthy eating and healthy living for families. Plus, if there is a weight issue in a child you can see a much more rapid improvement, since they're in active growth for many years.

1. Give repeated exposure to healthy foods. You need to try foods more than once, and vary the form (cooked versus raw).

2. Modify high-fat favorites. Choose a thin crust pizza, light on the cheese (or make you own with a low-fat version). Skip the fatty meats and top with onions, peppers, and mushrooms.

3. Provide appropriate portions. Use smaller plates, and down-size serving size. Your child will ask for more, if he or she wants something more. Include fruits or veggies as a side dish for every meal.

4. Keep healthy snacks in plain sight. With a bowl of fruit on the kitchen table, or small bags of dried fruit on the counter, your kids will eat what is available.

5. Allow sweet treats, but include sparingly. Moderate consumption of treats is a good way to avoid deprivation.

6. Encourage physical activity. This is item #6, but equally as important as all of the above tips. Both you and your kids have to move more. Increasing activity of daily living is key. Take a walk, play outside, hide the remote. Finding ways to increase your (and your chidren's) physical activity is key to a healthy lifestyle. New recommendations for children are about 60 minutes of activity a day.

I'd love to know your thoughts on this important and sensitive area!

I just read a scary—but not surprising—article in the scientific journal Obesity about the continuing rise in body weight in the United States. By the year 2030, it's estimated that roughly 86% of Americans will be overweight or obese. These predictions come from large-scale studies extending the pattern of the current trend towards the future. In two words: weight creep.

You don't have to be a geneticist to see that this is not a "genetic problem"—a doubling of the obesity rate in a generation is an immediate response to life in the U.S.: Cheap, plentiful food and lack of exercise. While biology and genetics DO play a role in weight regulation, weight control truly is a mixture of behavior and biology.

For whatever the reason (and there are many), people in our country continue to eat more and move less. It's a matter of calories in and calories out. The direct result of this is weight gain.

My approach to weight control is slow and steady change. It's much harder to make small changes and keep them up over time. In the U.S., we like to take the "all or nothing" approach to weight loss. This "on-off" approach continues to fail, and we need to identify better ways in our communities to sustain small lifestyle change over time.

We can fight back. While lifestyle change is a challenge, we can reverse this disturbing trend. What ideas do you have to halt the rise in obesity in the next 20 years?

A recent study in mice showed that the ability and/or preference to exercise might be related to a particular genetic marker. Could it be that our genes contribute to our motivation to exercise?

Watch the segment from TODAY

This study looked at a number of different strains of mice, and found that there was a lot of variation in how much the mice ran in their running-wheels. Some mice ran a lot (as much as 40 miles a day in human terms) and some mice ran a little (around 3-4 miles a day). The scientist running the study also measured a biological genetic marker, that was notably different among the various groups of mice.

While the idea of a "laziness gene" sounds appealing, it's not time to lay on the couch and blame your genes for your inactivity! Here's why:

• most biological activities, including eating, mood, and sexual activity, have both a biological and a behavioral component (in this study, the author's attributed about half of the running to genetic tendencies) - it's a matter of moderating these factors in a healthy lifestyle.


• this is a preliminary study in mice - which might not even pan out in humans.


• even if there is a genetic connection, it is only a predisposition, and can be overcome.

So, what do you think about the idea of an "exercise gene"?

How do you fight back when you don't feel lilke moving? Post a note and share your thoughts!

Let me get this straight, if I read all the amazing reports.....remove trans fat from the food supply, and obesity, diabetes, high cholesterol, and a host of other ailments will all magically disappear. The real story is a little more complicated - but not by much!. While getting rid of trans fat is a health plus, it's only part of the story.

Unless you cut down ALL sources of fat, you won't be saving calories, losing weight, or improving your health much at all. In our country, we make the mistake of selecting the information we want to use, and ignoring the rest. In fact, if we cut down on our daily total fat intake, the kinds of fat we consume would be less of an issue.

For trans fat, what is the substitute? Butter in baked goods? Or, olive oil to fry your chicken instead of shortening?
Until we decide to cut down ALL sources of fat in our diets to promote better health, we're still fooling ourselves.

It's easy to cut out trans fat from the diet, but really hard to cut fat out of the diet (we can always substitute a heart healthy fat!). Yes, it's a plus to limit trans fat in the food supply - to help support better food choices - but that is only one health factor that doesn't replace other healthful habits.

I remember doing a Today Show segment a couple of years ago, when this first became a priority in the world of nutrition. While there are some trans fats present in foods naturally (like beef), most of it is found in processed cakes, cookies, and pastries, as well as restaurant fried foods (from fish, to potatoes to onion rings). In this short time, many restaurants and food producers have voluntarily replaced trans fat in their food products. A great thing for consumers - especially those consuming fast foods!