Is your last stop before boarding a plane stopping to buy a meal to eat during your flight? You're not alone if you've rejected the meals and snacks available for purchase on planes nowadays, and opt to carry-on.  According to a new Wall Street Journal report, several airlines are now trying to compete for your meal dollars with a variety of new offerings.

While first class passengers often get free meals, coach travel is a food free-for-all, with most carriers only providing a complimentary soft drink. Even the small bags of pretzels are mostly gone (one big exception is Jet Blue, still providing a range of snacks).

Importantly, your new sky-high purchases are pretty closely matched to what you'd pay on the ground.

So what's new? Airlines have gone the celebrity chef route (Delta has foods designed by Todd English), while others have opted for the name-brand option (American has partnered with Boston Market), or choice meals (United's caprese sandwich and yogurt parfaits).

Hawaiian Airlines has a meal-upgrade program. A basic meal is free, and a surcharge ($10) for a "fancier" meal. You've got to love an airline whose best-seller is a sushi bento box with California rolls, edamame, and teriyaki chicken.

What's your experience with airline food? Thumbs up or down?

What could be bad about a restaurant meal? We're out of the kitchen, out with friends or family, and no clean up! I'd like you to read the "fine print" when it comes to restaurant eating. What you don't know can be harmful to your health. You can't assume the same rules apply in your home kitchen and the restaurant kitchen. From fast-food to high-end eateries, it's time to learn more about why your restaurant foods are so much tastier than your homemade version (yes, it's not your imagination!), how hidden calories, fat and salt add to this -  and how to make some smarter choices.

Multiple lawsuits aimed at restaurants now focus on the "uninformed consumer". It's time to stop being the "food victim" and gain some control over what you're eating, no matter where you're eating. Ask for what you want, downsize your portion sizes, or just go out less often. The choice is yours.

Before you go to a restaurant again, check out these 5 essentials:

1.  Many restaurant foods are scientifically studied and designed to optimize tastiness. It's not just the individual sugar, fat, and salt content of foods. Studies show that the proportions of these combined ingredients in foods can be optimized to maximize a preferred taste. Think sugar/fat combinations (ice cream)  or fat/salt combinations (French fries); their special blend boosts the flavor of either one alone. So, when you think that restaurant foods taste better than the same ones at home, you're right!

2. Calorie-controlled restaurant meals are not tested every day. While you might think that the 350 calorie entree you've ordered because the menu makes the claim, you might not get a calorie savings. Your meal can be off by hundreds of calories, as well as much more fat and salt than listed on the menu.. A dish is prepared once, or up to several times, to determine the specific calorie content, and content of fat, protein, and carbohydrates in that particular serving, to get the endorsement of particular group (like Weight Watchers and Applebees). It doesn't mean that every serving is like that. A finicky chef, an inattentive kitchen worker, or some other food handler might add extra fat, salt or sugar, or provide a bigger serving.

3. Restaurant food contains a lot of hidden salt. Salt is a major flavor enhancer. Restaurants want their foods to taste good. Many foods are loaded with salt - but don't have to taste "salty". The response is for food to taste "great". It works. Even healthy foods can be loaded with salt. Some entrees contain about half the salt recommended for healthy people in an entire day (about 1300 mg)! If you have high blood pressure, you've got to be even more careful of dietary salt.

4. Extra "hidden"  fat is often added to keep foods "moist". Just like salt, your food doesn't have to taste greasy or oily for there to be a lot of extra fat. This "hidden" fat is translated to a mouth feel of "moist". Ever wonder why your baked fish tastes is so soft and juicy in a restaurant, and a lot drier when you're at home, monitoring the added fat?

5. You can only change your own eating behavior While lawsuits bring attention to this area, it's not going to change anything. We're not a nation of food victims, and we have to snap out of this mentality. You DO have a choice. Stay out of many restaurants, and cook at home. When that "formula" of tasty foods is out of sight, and out of mind, it makes it easier to stay in control.

My bottom line: Save restaurant eating for a special indulgence. If you're a restaurant regular, order simple foods, with sauces and salad dressing on the side; ask for "no butter" on grilled foods and vegetables..  Downsize your portions by sharing a main dish, or choosing two appetizers or small plates. You CAN take control of your restaurant eating!

Weight discrimination comes in many forms. It's unfair, and extremely hurtful, among other things. But it can also be a major problem for many people when it comes to visiting their doctor. We've been hearing from many readers that "doctor discrimination" comes in different forms.

Some people feel they are "blamed" for their excess weight, as the cause of their other physical problems, or not being taken seriously when discussing their interest in losing weight (it's hard!). While the vast majority of physicians and specialists treat all patients respectfully and with dignity, providing optimal care no matter what size package the patient is in - there are enough self-reports of bad experiences and even some research studies documenting that this might be a problem to address. In fact, some studies show that not only physicians, but nurses and dietitians have some negative views about obese patients, ranging from a "lack of willpower and self-control" to "overindulgent and lazy".

So, what to do if you find yourself in a situation where you feel your doctor is judging you negatively because of your weight? Here is a game plan that helps to empower you, and ensure you are receiving the kind of medical care you feel you might be lacking.

1. Talk to your doctor. Yes, I mean have an honest conversation with your doctor about your feelings. You might have been a bit oversensitive (of course - weight is a very sensitive issue!) in a particular situation, and you should point that out. This is especially important if you are happy with your medical care, but uncomfortable from a particular comment. It's good to clear the air - and you might be very surprised to hear that your doctor wants to support you any way possible. Sometimes it's just miscommunication. Sometimes its not - give your doctor the benefit of the doubt, for starters.

2. Switch to another physician in the group. If you are happy with the care from the practice, but not the specific physician in the group, ask your present doctor for a within-group referral to someone who might be a better fit for your needs. This is not "bad form" and is a plus for your doctor, who knows you need to feel more comfortable, and doesn't want you to be unhappy.

3. Ask a friend or family member. You already have a built in network in trusted friends and family. Seek out the advice and physician referral from someone who understands your needs. Make sure this doctor is part of your insurance network before scheduling a visit (a simple call to your insurance company can answer that) to avoid out of pocket expenses.

4. Call your health plan (insurance company) and ask for a specific referral. Call the member services line (on your insurance card), and ask for a referral to a bariatric physician in your network. This is a internist or family medicine physician, with particular interest and training in treating patients with both weight issues, and medical consequences of excess weight. A bariatrician is also a good resource for specialist referrals. (Note: this is NOT the same person as a bariatric surgeon, who specializes in obesity surgery).

Share your experiences with us. Have you experienced doctor discrimination? Do you have a beloved physician who has stuck by you through "thick and thin"? We can all learn more about how to manage this very sensitive area. Sadly, many obese people avoid visiting the doctor for just this reason.

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.

We all know what to do to lose weight, right? So, why, as a nation, do we continue to put on extra pounds year after year? A new report from the Center for Disease Control revealed that nearly two-thirds of states now have adult obesity rates of about 25%. That's 1 in 4 people. Plus weight is creeping up in all age groups - particularly troubling when it comes to children and adolescents.

Maybe an important area to revisit is just how we determine "obesity". For many years, it was the eyeballing approach - do I "look" fat, or "feel" fat, or have health problems which seem to accompany extra weight? Multiple large scale studies have strongly linked increasing weight with increasing health risk. This has been based on body mass index or BMI (What's your BMI?), a term linking height and weight for a single number used as the marker comparing weight and likelihood of diseases (like high blood pressure, diabetes, and high cholesterol). Your BMI translates in number that classifies you as healthy, overweight, and obese. You don't have to look particularly "heavy" to be classified as medically obese. In fact, many "overweight" folks agree they want to "lose a few pounds", but don't feel this is a health issue, since they have no medical illness related to their weight.

The big problem here is automatically translating population statistics to our own personal situation. While the BMI has been a major plus in helping to assess overweight and obesity in this country, we've gotten too caught up in the numbers, and not enough in the constellation of factors that also contribute to good health.

New research studies update national health recommendations. But what does that mean for excess weight? It's often forgotten that a number of years ago, a BMI of 27 or less was considered a "heathy" weight. Now, recent large-scale population studies showed that a BMI of less than 25 was now the healthy range. So overnight an entire segment of the population became overweight, without gaining a pound.

While weight is a major barometer of good health, I think it's time we took a broader look at what "counts". I think it's unrealistic for many people to get below a BMI of 25. When the bar is set too high, most of us give up and do nothing. It's just too defeating. We've got to get away from the "all of nothing approach", to the "something is better than nothing approach".

We need to return to a more realistic way of looking at the weight issue. It's the big picture that counts - including blood pressure, blood sugar, blood fats, and the lifestyle activities that support them (eating, activity, no smoking, stress control), with weight being one of the factors, but not the only focus.

Choosing a realistic weight as a healthy one should be the major focus, rather than an idealized weight. For many people, a BMI of less than 25 is not going to be a reality. We need to think more about a goal weight that we are able to maintain (not just achieve!) to support good health and avoid the endless round of self-defeating weight loss and regain episodes.

That's an important step in the right direction, to combating this very real epidemic. Let's use the BMI as a guideline, but not the sole replacement to evaluation of good health.

There are many ways to work at good health. Do you agree?  Leave a comment below.

What if you heard that you could eat less, and live longer? Sound too good to be true? There's been a lot of buzz for the past few decades (in fact since the 1930s) about what's called "caloric restriction", and how it promotes longevity. Both Wired (July 9) and the New York Times (Friday, July 10) recently revisited this topic.

Early studies in mice, and newer studies in monkeys seem to suggest that when caloric intake is cut by about one third of what would be considered "normal" to maintain a healthy weight, that these animals live longer. Cutting calories by 30% is a big decrease, and significant weight loss occurs; the big debate is whether it's a healthy way to live.

In humans, there's a caloric restriction society, whose members adhere to this way of eating. To me, the folks look excessively thin (a BMI in the "unhealthy" range), but claim to be energized, feel great, and report excellent physical health.

This isn't about weight loss, and reducing calories to remain in a stable weight range (the kind of caloric restriction most of us deal with on a daily basis). This is cutting significant calories from your maintenance calories. For example, if you eat 1800 calories daily, to remain at a certain weight, within a healthy range, you'd voluntarily consume about 1200 calories daily, as a "calorie restrictor". This is not anorexia - although weight loss occurs in all people doing this (not a surprise!). People DO eat, and work hard at maintaining a healthy diet.

While there's no guarantee that calorie restriction promotes longevity in humans (the society members DO believe this), the newest 20-year study in monkeys suggests that this appears to be true in primates (monkeys and humans are in this class together), and not just mice. While the mechanism(s) by which this might be occurring are currently unknown, multiple studies are ongoing to continue to explore this phenomenon.

Would you cut your maintenance calories by a third, to live longer? I'd love to know your thoughts.

Surely you've heard of it. The "sport" of competitive eating. Whoever eats the most _______ (fill in the blank with any kind of food from ice cream to cake to hot dogs) wins money and a "title."

The annual 4th of July hot-dog eating contest, sponsored by Nathan's (of hot-dog fame), was held at Coney Island, New York. All of the "athletes' were lined up, with mounds of hot dogs in buns, waiting to be chugged down. My daughter, Lauren, called to me, to come watch the "contest" with her, live on ESPN. "ESPN?" I said. "I can't believe this is considered a sport."

The winner, for the third consecutive year was Joey Chestnut, who amazingly broke his own record by eating 68 hot dogs and buns in 10 minutes (Congrats?). This was nearly 10 more than his last year's winning number. I guess he's been training harder!

Now, I've had many Nathan's and other hot dogs, as occasional treats, all over the country, and have nothing against hot dogs. Or any other kind of food, in moderation.

Eating as a competitive sport - complete with prize money, trophies and records to beat? Say it ain't so... what do you think?

Kudos to our President for his fab eating habits. While he is a model of healthy eating and daily physical activity, he can also enjoy a burger and fries on occasion, without guilt (and with obvious enjoyment!). As you've heard me say before, it's all about the portions.

While the world recently watched President Obama going out for burgers and fries with Vice President Joe Biden, I was more impressed with what was ordered: Regular size hamburgers - or a splurge of a regular cheeseburger! No super-sizing, or bacon double cheeseburgers. No orders of mega-fries, just a regular (which if I recall correctly might have been a "shared" item.)  No giant-sized regular sodas or milkshakes.

I'd like to see this portion "downsizing" stick around. Perhaps President Obama is setting the next new food trend, and fighting back against portion distortion. I sure hope so!

What do you think? Leave a comment below.

More from Madelyn:

• Managing Your Food Cravings

New federal guidelines from the Institute of Medicine are in place for weight gain during pregnancy. About half of women of childbearing age are overweight, with nearly 1 in 4 being medically obese (a BMI of 30 or more). This new "starting weight" at the beginning of a pregnancy has a big impact on the new recommendations for a healthy weight gain - for both mother and baby. And forget about the old "eating for two"; that old wives' tale is an absolute myth.

This is an important set of guidelines, since overweight and obese women who gain extra weight during pregnancy are at risk for complications including pregnancy related high blood pressure and diabetes. Babies born to women who gain extra weight are at greater risk for premature birth, and more likely to be overweight or obese themselves.

Here's where the body mass index (BMI, or height/weight ratio) really matters. For those women already at a healthy BMI (18.5 - 24.9), the recommendations remain the same - a weight gain of between 25 to 35 pounds. What's your BMI?



An overweight woman (BMI 25 - 29.9) should aim for a pregnancy weight gain of 15 to 25 pounds,while an obese woman (BMI 30 or higher) should aim for 11 to 20 pounds.

Underweight women must also make adjustments. For those with a BMI less than 18.5, a weight gain of 28 to 40 pounds is recommended.

Have an honest talk with your doctor about pregnancy and your weight, before you think about pregnancy. Depending upon your own health profile, weight loss prior to pregnancy is often recommended. Being proactive can support a healthy pregnancy and baby, as well as limiting those extra post-pregnancy pounds.

What do you think of these new guidelines? Leave a comment below.

I was in Washington DC last week, at the National Academy of Sciences, to discuss the unique needs of women when it comes to weight loss research. This was an important meeting, since the committee's directive was to provide a report to Congress on the state of women's health research, and what directions should be addressed in the future. Multiple topics on women's health were addressed, and I talked about obesity and eating disorders.

When it comes to weight control, it's clear that "one size does not fit all" for both men and women. But there are gender specific issues, many of which we are all familiar. Besides the biological differences (testosterone and muscle mass), women have many separate issues related to weight control, which have nothing to do with biology, and are connected to eating behavior, stress management, and other environmental (portion size) and behavioral (social) factors.

So, how can clinical research address these topics? It's important to have controlled research studies, to document recommendations made to the public, that are true, and based on evidence gathered in hundreds or thousands of women. This is an important distinction from personal stories and anecdotes, that cannot be the basis of widespread advice that works for most people. A personal story works for one person, and that's a great thing, but cannot usually be translated to others.

Like it or not, as women we are experienced multi-taskers and need a lifestyle plan that can support this is a realistic manner. While the perfect world option of eating 7-9 servings of produce a day and exercising for an hour daily sounds appealing, most of us struggle with that concept on a daily basis. Science and research reap great benefits for improving our health, but sometimes the bar can be set too high, based on "perfect world" research. While we all strive for a more healthful lifestyle, when the bar is set too high, for "optimum health", we all tend to give up and do nothing.

I think the message for weight control is a lifelong acceptance of moderation. The goal is to avoid having to lose weight at all, rather the effort goes into just "not gaining". That's a hard task, and takes a much work as losing weight. Plus, working on an earlier point of intervention where there's just 10 or 20 pounds to lose makes the lifestyle effort more sustainable. When it comes to weight loss, it's never too late. A jump-start on early intervention and prevention is the key.

What thoughts do you have on combating obesity? Leave a comment below.

Billions of dollars are spent yearly by Americans seeking quick and easy weight loss with unregulated dietary supplements. Why regulate, you might ask? These are "natural compounds" and are not "drugs", so what could be bad? The problem is that these products, while they do originate from a plant source, can do more harm than good. Natural doesn't mean safe - arsenic is natural! Many of these products DO have active ingredients - particularly stimulants - and there is no monitoring of safety, purity, or dosage. It's a major health gamble you don't want to risk. The odds are not in your favor.

The latest in this "discovery" of the health damaging effects of unregulated weight loss dietary supplements is for a family of products called Hydroxycut, associated with liver function problems. Hydroxycut products have been promoted for weight loss as fat burners and energy enhancers, The FDA's statement was quite clear: discontinue use of Hydroxycut products in order to avoid any undue risk. The company has recalled 14 different types of dietary supplements from store shelves (although 2 products still remain).

Unregulated dietary supplements for weight loss sound too good to be true, and they are. At the very least, they're a waste of money. At the worst, they can cause illness, and even death. And, this is not a new problem. You may also recall the FDA-mandated removal of "ephedra" (ma huang), from weight loss supplements because of illness and deaths.

But there is some good news. The FDA has approved the fat-blocking prescription medication, Orlistat, for over-the-counter use in a lower (but effective) dose, called Alli. In fact, all weight loss products need to be reviewed for safety, as well as efficacy. 

National efforts are ongoing to bring continued attention to this area. The Reality Coalition, a national group of health experts and organizations, has been working for the past few years on both education and improved health legislation to monitor and regulate the weight loss supplement industry.

Should you risk your health for the promise of quick and easy weight loss? I believe the answer is a resounding no. When it comes to losing weight, there is no quick fix, and slow and steady wins the race.

What do you think? Leave a comment.

"Can eating pork give you swine flu?"  I've been hearing this question a lot over the past few days. The answer is NO.

Pork is safe to eat, without any additional precautions for safety. The same food safety rules apply for meat consumption of any kind. For pork, cooking to an internal temperature of 160 degrees is the key part of food safety.

While there are several ways we can protect ourselves - like thorough hand washing - you won't avoid the H1 N1 virus (the official name) by minimizing your consumption of pork.

You will, though, minimize your intake of saturated, artery-clogging fat if you choose the leanest cuts of pork!

Other thoughts on pork consumption and swine flu?  Leave a comment.

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.

The sweetener battles are continuing with a vengeance. Cane sugar a.k.a regular table sugar is again a marketing tool for a more "natural" sweetener. Compared to what? High fructose corn syrup is the new dartboard of sweeteners.

Much of this debate had to do with cost and not health. High fructose corn syrup is much cheaper than cane sugar as a product ingredient. An interesting article in the New York Times took a closer look.

To set the record straight, all full calorie sweeteners--white sugar, brown sugar, molasses, honey--have the same number of calories (about 16 calories per teaspoon) and none of them can be considered a health food or a preferred product from the nutritional point of view. In fact, high fructose corn syrup and sugar are made from the same two building blocks: Glucose and fructose. Instead of an equal 50/50 mix in sugar, high fructose corn syrup is 45% glucose and 55% fructose, a difference of 5%.

The danger I see in all of this is a misleading message that foods and beverages sweetened with sugar are better choices that those with added high fructose corn syrup. This is simply not true, from a nutritional point of view.

Plus, studies show that use of either sweetener is not the fundamental cause of increasing rates of obesity. If you drink two liters of soda a day, it's the same calories whether or not it's sweetened with sugar or high fructose corn syrup.

All sugar-containing products (outside of fruit, both fresh and dried, that I call nature's candy) need to be consumed in moderation as occasional treats. Many people can tell the difference between products sweetened with cane sugar and those with high fructose corn syrup. If you're interested in taking your own taste test, pay a visit to Mexico where Coke is still made with cane sugar, or try some Kosher for Passover Coke, which is made with sugar instead of high fructose corn syrup. (The corn is an off-limits food for many people during Passover).

Related Content:

• Myth and Fact of Low Calorie Sweetners
• Are Liquid Calories Packing on the Pounds?

Say the word "Barbie" and you'll have responses ranging from total bliss to complete disgust. I'd like to share some of my own thoughts on Barbie, and get yours as well. Love her or hate her, she's here to stay.

Whenever I think of Barbie dolls, I always have a smile on my face, thinking back to my childhood and the wonderful hours I spent in Barbie play. This was a doll you could enjoy dressing up while by yourself, or inviting a friend or two along for a group Barbie play session. In fact, I still have my first Barbie and some special outfits in my Barbie patent leather case on a shelf in my daughter's closet (who also had her own Barbies as a little girl).

I'd like to speak out in support of Barbie and why I think she was an inspiration to millions of girls. I do not think Barbie is the reason many young women have body image issues. I don't think a Barbie doll creates a sense of insecurity in those who enjoy imaginary play with her, or create a false sense of what beauty should be.

To me, she was a just a really fun doll. Barbie could do anything! And with such great clothes and accessories! She could be a flight attendant, or a surgeon... a lawyer or a nurse. Barbie surely was her own person. Her boyfriend, Ken, was not really her focus at all. In fact, for my friends and me, we really didn't know what to do with Ken. Other then coming to come hang out with Barbie, we had them chat briefly, then we tossed him in the corner, and went back to creating fabulous scenarios for Barbie as a solo act.

Of course we knew that Barbie was anatomically impossible, in so many ways (including those permanently high-heeled feet!) and that we didn't look anything like her. And we didn't care. We didn't want to be Barbie- we just liked to dress her up and take her out.

I recall a professional friend of mine who sneered at the thought that my daughter had received a "Doctor Barbie" as a birthday gift. And the gift was from a lawyer (another Barbie lover). Double sneer. By the way, despite this pressure from my friend, I didn't think I was a bad mother for allowing my daughter to enjoy playing with her Barbie doll!


Related Content:

• Happy 50th Birthday, Barbie

The barometer for an "acceptable" weight in our country continues to shift. What is a healthy weight? Dozens of magazine layouts are devoted to the fluctuating weights of celebrities from Oprah to Jessica Simpson, along with commentary of alleged happiness and sadness associated with weight change.

The current target is Jessica Simpson, who in recent pictures is certainly at a healthy weight. Since when are the "weight police" authorized to judge her as having a "weight problem"? It's great that she is comfortable in her own skin, and appears to be relying on her own sense of what is the "right" weight for her.

Sure, many of us have been thinner at different parts of our lives (think about the endless comparison photos of Jessica in her "Daisy Dukes"), but there is no contest. The "thinnest" we've ever been is not the gold standard of comparison, nor usually the best weight for long term success.

We must look inside ourselves to set a goal for a realistic weight, that we can maintain with reasonable effort every day. Do you agree?

How do you set your own weight loss goals? I'd love to know.

More from Dr. Madelyn Fernstrom:

• How Do You Find Your Ideal Weight?
• Hidden Reasons Why You're Not Losing Weight

It's 2009, and that means new food trends are appearing. When it comes to healthy eating, I always find that "everything old is new again". Here are some of my favorite food and healthy eating trends for '09.

Brussels Sprouts and Cauliflower
These are two of the lesser known "cruciferous" vegetables, known best for their cancer-fighting properties. While broccoli is the best known (and loved or hated), and cabbage has been on the radar for awhile, these two round out the category. In fact, brussels sprouts look like little cabbages, and have an amazing taste, whether they're steamed or roasted. They're popping up in restaurants across the country. Cauliflower is eaten raw, steamed, and even mashed like a potato. It's often part of a vegetable mix, including broccoli and carrots. While the fresh form can be pricey, frozen sprouts and cauliflower are an economical and healthful choice.

Flavanols
This group of antioxidants are found in a variety of foods, and have the property to improve blood circulation, keeping blood vessels elastic. Great for overall heart health and blood pressure control. Best sources are found in foods ranging from apples, to red wine, to dark chocolate. The old saying of an apple a day keeping the doctor away is good advice!

Apples
Apples are nearly one of nature's perfect foods, and for this challenging economy, a perfect choice any time of day. Apples are nutrient and fiber rich, thirst quenching (contains lots of water), acts like a toothbrush to clean your teeth. There are lots of varieties to choose from and economical when purchased by the bag.

It's been a big year for diet and nutrition, with a lot of new information as well as updates of "conventional wisdom". New studies and approaches are always a good thing. While sometimes information might seem contradictory or confusing, it's the only way we have to try out new ideas and shed light of the best ways to stay healthy. Check out some of these highlights. I'd love to hear some 2008 news that YOU use!

Beyond Apple and Pear Body Shapes : Most of us are familiar with the idea that "apple" shaped people (belly fat) are at higher risk for diabetes and heart disease, compared with "pears" who have most of their fat deposits in the hips, thighs, and buttocks. There's a lot more to the story. One of the best predictors of disease risk from excess fat is not only your body shape, but extra fat accumulating in your liver. Known as a "fatty liver", this condition is often associated with diabetes and heart disease risk, regardless of your shape. You'll need some blood work to determine this, so ask your doctor for liver function tests (liver enzyme blood levels) to see if you fall in this category.

NYC and Calorie Counts on Foods : Trying to cut calories to lose weight? New York City has a new policy that I hope will sweep across the country. Chain restaurants are now required to post calories next to the foods on the menu board - right next to the price. This is a great step in the right direction to be mindful of the calories in food. None of us are very good at "guesstimating" the calories in foods. Seeing those calories when checking out the food is a real eye-opener - and a big help.

Vitamin D Requirements Double for Children and Adults: Based on new scientific information, the requirement for daily vitamin D intake has recently doubled. While we all make Vitamin D in our skin, we're often not outside for long enough, and are wearing plenty of sunscreen, that blocks the process. For children and teens, aim for 400 IU a day - up from 200 IU. For adults, 800 IU per day is now the recommendation, up from 400 IU. Some fish are rich in vitamin D, but most foods are not, and fortification in dairy products is the most popular dietary source for many people, along with some supplementation when needed.

Gingko Biloba Supplementation Does Not Help Memory: The supplement industry is a multibillion dollar one in the USA. Whle some supplementation is health promoting - like a daily multiple vitamin containing 100% of the RDA - too much and too many can be a bad thing (at the very worst) or simply a waste of money (at the very best). Gingko has had many claims of memory boosting, but a longterm study showed this not to be the case. It is disappointing, but the "hear-say" of ginkgo had to be tested in a scientific setting in a controlled manner, to determine if there was a clear benefit. I think the take home message is to be careful with all supplements, and make sure you thoroughly information gather about any compound you hear is "health promoting" and is of interest to you. It's also a good idea to check with your doctor.

Lose More Weight With A Financial Incentive: A big question for dieters is always one of keeping up with a plan and not losing interest. An interesting study showed that money can be a good motivator, at least for the short term. When people were given a financial incentive to lose weight, they lost twice as much weight in 16 weeks, compared with those who had no financial gain. You might try to "reward" yourself with an item, based on your ability to stick with your plan. Pay yourself a small amount of money every time you make a health promoting daily change, and see if this helps you sustain your motivation. Small changes add up, as do small financial perks - at the end of a month, you'll likely have saved enough for a spa service, DVD, cosmetic item, or some other non-food bonus for yourself.

With 2008 winding down, I'm looking forward to sharing more diet and nutrition news for '09.

Happy Holidays to All!!

Losing weight is not easy. The simple phrase of "eat less and move more" is not so simple in the real world where food is readily available 24/7, inexpensive, and in such large portions! Our multitasking lives lead us to eat on the run, skip meals, and leave physical activity at the bottom of the "to-do" list. A recipe for the dreaded "weight creep". We know what to do to lose weight (many of us are walking calorie counters), but can't seem to keep it together for the long term.

A new study from the Journal of the American Medical Association has shed some light on a motivator supporting a weight loss effort, at least for the short term: money.

Three groups were given the task of losing 16 pounds in 16 weeks (that's a pound a week, which is realistic and manageable with moderate effort). One group had no financial motivation and lost an average of 4 pounds in 16 weeks. The other two groups had financial motivation, and lost three times more weight: An average of about 13-14 pounds.

The big question: Could they keep the weight off? Even the financially motivated groups regained some weight in follow up, after the active study was completed (the money phase was done), but weighed less than when they started.

While many diet studies don't easily translate to our real world lives, this one can. Create your own financial incentive to help stay on track. Here are my suggestions:

Set some reasonable goals, and "reward" yourself with a quarter, or a dollar, or whatever amount you choose when meeting your daily goals. These might include a 30 minute walk, 5 daily fruits and vegetables, or sticking to non/low-calories beverages.

Establishing your "weight loss account" for a purchase of a special indulgence—like a manicure, massage, cosmetic, running shoes, DVD, or whatever is a treat to you—can both jump start your initial effort, and help keep you on track for the long term.

How do you stick to your weight loss plan? Would a little extra cash help you drop a little weight? Leave a comment!

We are bombarded with information 24/7 on eating. How can you figure out what to eat? How much to eat? When to eat without a lot of confusion? Couple this with the challenge of figuring out how much to weigh, what is "extra" weight, and how thin is too thin, and you can often wind up with what I call "problem eating."

While the incidence of true eating disorders like anorexia and bulimia is very low, numerous milder symptoms of these disorders are making their way into the lives of many people, often with health-damaging consequences. That's the topic of my Today show segment with my fellow iVillage expert, Leslie Goldman.

Click to watch the segment We all have friends (and maybe ourselves) who we think are "going overboard" when it comes to healthy eating and weight control. I'd like to share some warning signs that you might find helpful in deciding if you're maintaining a healthy focus on eating and weight, or when a red flag should come up that health-promoting behaviors cross the line into health-damaging ones that require professional mental health care.

6 Warning Signs of Problem Eating:

1. Pre-occupation with food


2. Self-imposed rules on food and eating


3. Excessive meal planning


4. Rigidity of food choice


5. Eliminating whole food groups in the name of health


6. Extreme guilt when straying from the "diet plan"

When eating behaviors become intense and excessive—known as obsessive behaviors—it's not about the food. The psychological underpinnings of these behaviors (like control issues, depressive symptoms and anxiety) have to be addressed for long-term success in changing food intake behavior. Often "food issues" are really unresolved "mind issues." It's a win-win when they're tackled together!

Has problem eating affected you or a friend? How did you manage this? Leave a comment.

Related Content:

• Madelyn and Leslie on "dieting in secret"
• The Weighting Game with Leslie Goldman
• TODAY on iVillage