Dr. Gourmet Newsletter: June 29, 2009

Dr. Tim Says....

Timothy S. Harlan, M.D.[This is another in our series on the How and Why of Eating Healthy.]

Almost every day I have patients ask me what they should weigh and how much they need to lose. I will admit that sometimes I am a bit evasive, saying such things as, "Start working on your weight, and I'll tell you when to stop."

Why am I not always more direct? Because folks can often be pretty unrealistic about their health and their weight. Usually people are shocked when I tell them what an ideal weight would be for them. While shock is their first reaction, folks usually say something like "Oh, I'll do that, it's easy for me to lose 50 pounds and you'll see when I come back in three months." What Are Really Realistic Goals? (Really.)

4th of July Menu

Here in the United States the Fourth of July is a traditional time for grilling outdoors with friends and family. Here are some ideas for that summer outdoor meal. Enjoy!

Southwest Venison (or Ground Beef) Cheeseburgers or
Portobello Burger or Barbecue Chicken with
Zucchini Salad or Spaghetti Squash Salad and
Sweet Potato Salad or Corn on the Cob

Faith Bontrager, RN, BSNA Healthy Pregnancy
with Faith Bontrager, RN, BSN

A Question from a Reader:

I am currently 36 years old and 7 months pregnant with my first child; I've gained 20 pounds so far. I started the pregnancy being overweight, but I do moderate exercise and I eat rather healthfully; unfortunately, a side effect of pregnancy is that I've been craving more refined carbohydrates than normal! I try to keep things under control, but I admittedly have been indulging in more sweets than what I had before becoming pregnant (my biggest downfall has been a bowl of ice cream or frozen yogurt once or twice a week).

I had high cholesterol before pregnancy (since my early 20s, my total cholesterol has been in the 240-250 range), but my HDL levels have always been quite good, over 60 mg/dL. My primary care doctor wanted me to get my cholesterol checked, so when I went for the glucose tolerance test, I asked for a fasting lipid panel, as well. This time, the total cholesterol came back at 355, with HDL being 90. I acknowledge that this is very high, but I thought that being pregnant is supposed to raise cholesterol levels--I'm writing because my primary care doctor wants to put me on a drug as soon as I deliver. I don't want to do that, though, and am wondering if you might have any insight into this topic?

Faith Says....

I can not make a specific recommendation as to exactly what you should or shouldn't do regarding medications to reduce your cholesterol after delivery. Your decision needs to be based on many things, including your family history, your health history, a look at your complete health picture including all lab tests, your weight, your BMI, your blood pressure and other physical findings, your response (currently or in the past) to specific diet and exercise regimes, etc. not just one cholesterol test during pregnancy. Discuss all of these findings with your doctor. If your primary care doctor is not your obstetrician, you may want to discuss these findings with both doctors.

Here is some general information about cholesterol, pregnancy, and breastfeeding that can assist you in making an informed decision. I have included detailed citations for those who are interested in the supporting research. Pregnancy and Cholesterol

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