Online Health Chat with Kylene Bogden, MS, RD, CSSD, LD

Tuesday, July 7, 2015 | Noon


Weight loss and exercise – you cannot have one without the other according to everything that you hear lately. But are there tips and tricks for weight loss while participating in regular exercise? How do you know what to eat before and after a workout, as well as throughout the day? What are "fueling strategies" as they relate to weight management? How should you increase calories while working out or as preparation for small events such as a 5k?

Cleveland Clinic registered dietician and sports nutrition expert, Kylene Bogden, answers questions and discusses these concerns including myths vs. facts regarding post workout protein shakes, chocolate milk and carb loading before intensive workouts or events.

About the Speaker:

Kylene Bogden, MS, RD, CSSD, LD, is a registered clinical dietitian who works in the Department of Nutrition Therapy at Cleveland Clinic. Her specialty areas include weight management, sport and fitness nutrition, weight loss/weight gain, fueling for performance, diabetes management and wellness/prevention. She is also a certified specialist in sports dietetics, education/counseling at Cleveland Clinic Main Campus and a member of the College and Professional Sports Dietitians Association, Sports, Cardiovascular and Wellness Nutrition Practice Group, Academy of Nutrition and Dietetics, and Ohio Dietetic Association.

Let’s Chat About Weight Loss & Exercise

Moderator: Welcome to our chat about Weight Loss & Exercise with Cleveland Clinic registered dietician and sports nutrition expert, Kylene Bogden, MS, RD. Thank you, Kylene, for taking the time to be with us to share your expertise and answer our questions.

Let’s get started with our questions.

Menopause Metabolism

Meg_N_Ohio: This is concerning weight loss – or lack thereof – after menopause. I am cutting calories to 1200 to 1400 a day and walking/jogging three to five miles a day, as well as doing daily chores (cutting grass/shoveling snow etc.) and gaining weight. My doctor said to do two hours of exercise (minimum) a day on the treadmill. I don't have the time or the energy for that. I upped the calories to 1600 thinking maybe I'm not eating enough, and I gained even faster. The next thing I will try is more relaxation (yoga/meditation) to help with stress and a sleep aid (ZzzQuil™) to help get more sleep. Any other ideas will be greatly appreciated. Thank you.

Kylene_Bogden,_MS,_RD,_CSSD,_LD: Great question. You definitely do not have to spend two hours on the treadmill each day. Here are my top two suggestions: 1) STRENGTH TRAIN! This is one of the most important (yet often missed) ways to increase metabolism, especially as we age. This is more beneficial than strapping yourself to a machine for two hours. 2) Take a look at your diet. Where is the hidden sugar? Late night? Weekends? Afternoon snack? Also, keep in mind that consuming sugar-sweetened beverages is one of the fastest ways to pack on stomach fat because of the spike in insulin that it causes. Beverages should be calorie free.

DebNsatx: Thank You for having this web chat. I want to know if there is any way to jumpstart a weight loss program or to get your metabolism going while you are in menopause? Also, I just heard recently that a person can lose weight if they start with eating either a protein or vegetable before eating a carbohydrate, and I want to know if you had heard anything about this research and if it is true. One last question, can a person lose weight by walking 10,000 steps daily for exercise? Thank you in advance for answering these questions.

Kylene_Bogden,_MS,_RD,_CSSD,_LD: Thanks for joining. Some tips for weight loss after menopause:

  1. Remove all added sugar, especially in liquid form.
  2. Begin a consistent, full body strength training routine if you do not have one already.
  3. Be sure to include adequate protein at all meals, even breakfast.

The more important fact is that meals should last at least 20 minutes. By eating slowly and consuming the lean protein and veggies off your plate first, you will likely consume less of the starch. In terms of research, there is a study showing that saving the starch for last results in less of a spike in blood sugar. It is possible to lose weight by walking 10,000 steps per day if you lead a sedentary lifestyle. However, if you walk 10,000 steps per day for work or you are used to being on your feet, you will not automatically lose weight just because you walk 10,000 steps per day. Of course, proper nutrition must be incorporated for true body fat loss, no matter how active you are.

michigan: I would like to rebound off that last question. What exactly do you mean by added sugar?

Kylene_Bogden,_MS,_RD,_CSSD,_LD: Take a look at the label of the food you are going to eat. Let’s use granola as an example. Do you see sugar listed in the nutrition facts panel? Yes? Ok, now check out the ingredient list. Is sugar listed there as well? Yes? That means sugar has been added to the product. Now let’s take cow’s milk for example. Sugar is on the label, but NOT on the ingredient list. This means milk does not contain added sugar. Fresh fruit is another great example of a food that is sweet, but does not contain added sugar.

Calorie Counter

tperk100: Do calories from hard liquor add just as much caloric energy/fat as calories from other sources? What are "empty calories" so many people refer to?

Kylene_Bogden,_MS,_RD,_CSSD,_LD: Excellent question. To make a long story short: A serving of alcohol is typically not very high in calories, BUT it is metabolized very differently than our food (90 percent in the liver), which can make weight loss tricky. For example, a light beer is roughly 100 calories and so is a handful of nuts. In terms of calories, this is not much at all, but in terms of metabolism, they vary significantly, partly because you have fiber, protein and fat in the nut and virtually none of these in beer. This is why we can't say a calorie equals a calorie. Think of it this way, an empty calorie food or drink is something you can remove from the diet but still maintain optimal physiological function. Do our bodies need alcohol to survive? No. Candy? No. Soda? No. These are empty calories because they don't have a purpose. Do we need lean protein to survive? Yes. Fresh produce? Yes. You get the idea...

tperk100: Thanks for answering my question above, but I am still unclear on one thing. Do excessive calories from alcohol (not just beer) result is weight gain just like calories from other sources?

Kylene_Bogden,_MS,_RD,_CSSD,_LD: Yes, all can result in excess weight gain.

leiter1230: I am 60 years old and have a third-degree heart block. These are the medicines I take: pantoprazole, Premarin, spironolactone, lisinopril, carvedilol, famotidine, Multaq, Pradaxa and simvastatin. I am 30 pounds overweight. I have a hard time exercising and not getting lightheaded. I walk one mile or more four to five days a week and watch my calorie intake. I try to keep it at 1,200 to 1,300 daily. Is there anything else I can do to help take this weight off?

Kylene_Bogden,_MS,_RD,_CSSD,_LD: It is not possible to make a full assessment without having a full consultation, however, here are a few thoughts:

  1. Make sure you are well hydrated throughout the ENTIRE day. This means water as your fluid of choice, not tea, coffee or soda.
  2. It is possible that you have set your calories too low, so be sure to keep that in mind.
  3. If you have seen a professional and that was the determined caloric amount, what are those calories consisting of?
  4. As long as your doctor has deemed it appropriate, do not neglect strength training.

Stan: I count my calories to the tee, and I am exercising regularly, but I still can’t seem to lose weight. Any suggestions?

Kylene_Bogden,_MS,_RD,_CSSD,_LD: Let’s start with this: a calorie does not equal a calorie. You may have heard this in school (I did too), but the science of metabolism tells us this is not exactly true. While your calorie intake may be on target, your macronutrient intake may be off. Are you eating a lot of added sugars? Sure, you may not be indulging in sweets, but added sugar can be found in yogurt and granola bars, even if the label says “Weight Loss.” Does your diet contain a large amount of starch, particularly in the evening? These are big offenders in the world of weight loss, even if you are exercising consistently. Here is a general rule of thumb that is appropriate for most active individuals: try to keep your added sugar intake to less than 25g/day.

Ann77: In counting carbs, some recommend subtracting the fiber from the total carbs. What is the basis for this? Does the fiber not contribute as much as other carbs to total calories? Why not?

Kylene_Bogden,_MS,_RD,_CSSD,_LD: Excellent question. This is because fiber does not cause a rise in blood sugar the same way that refined carbohydrate does. Fiber is slower to digest. This is because your body works a little harder to break down fiber. Just remember, a big key to weight loss is to try and prevent constant spikes in blood sugar throughout the day.

Training Tips

wellman: I have seen numerous articles/discussions on the optimum number of times to strength train per week. What is the correct answer, if there is one?

Kylene_Bogden,_MS,_RD,_CSSD,_LD: This, of course, depends on training goals, but typically two to three sessions per week of full body strength is ideal.

Ann77: What is the best way to prepare for an early morning workout in terms of eating beforehand or working out on an empty stomach and eating afterward?

Kylene_Bogden,_MS,_RD,_CSSD,_LD: If you are getting ready to embark on a tough workout early in the morning but you do not want to have a full stomach, try a half piece of fruit or a few swigs of your favorite sports drink. This will provide simple carbohydrate without the protein and fat to upset your stomach. Then, shortly after the workout, try to consume breakfast within one hour. It should contain protein and carbohydrate with a small amount of fat. Try an egg or 1 tbsp. peanut butter on a whole-grain English muffin with a 4-6 oz. cup of low- or non-fat Greek yogurt for optimal recovery.

Ann77: Is it okay to use powdered milk instead of a protein powder product in a protein shake?

Kylene_Bogden,_MS,_RD,_CSSD,_LD: It is fine, however, powdered milk typically has nowhere near the amount of protein that a powder such as whey contains. It really depends on your fitness goals and how hard you are training. It also depends on what you are combining the milk powder with.

B-Bop: Should I be “carb loading” for regular physical activity? I am actually running a 5k this weekend and that is why I am asking.

Kylene_Bogden,_MS,_RD,_CSSD,_LD: No! Contrary to popular belief, you do not need to consume excess carbohydrate the night before an athletic event lasting less than three hours. Our bodies are very efficient at storing glycogen (in muscles, liver and blood actually). Enjoy regular meals the day before your race and make sure dinner includes carbohydrate, protein and fat. Think grilled chicken breast, quinoa, a tennis ball size of fruit and fresh veggies sautéed in olive oil.

dave: I am an ultra endurance athlete (50- to 100-mile races) but believe it or not, I am still struggling to lose weight. How do I handle the whole idea of carb loading?

Kylene_Bogden,_MS,_RD,_CSSD,_LD: You will still want 75 percent of your calories to come from carbohydrate that week, BUT choose carbohydrate from the earth such as fruit, sweet potatoes and legumes, NOT white bread, crackers upon crackers and fruit snacks.

Meg: I know that timing and choice of meals is critical to success when it comes to weight loss and athletic performance. Can you speak more to this?

Kylene_Bogden,_MS,_RD,_CSSD,_LD: Yes. This is so true:

  1. Avoid going longer than four hours between meals and snacks. This prevents you from becoming ravenous and overeating later in the day. Small, frequent meals also help keep your metabolism in check.
  2. Your meal before the event/run/practice should be consumed three to four hours beforehand for the best digestion. This would be a balanced meal.
  3. Consume a carbohydrate-rich snack one hour before the event (minimal protein/minimal fat). Think cup of fruit or low-fat yogurt, or a piece of toast with 1-2 tsp jelly.
  4. Your recovery nutrition is SO important. It’s great to repair the muscles, but this is also a key to weight loss. Intense exercise lasting greater than 60 minutes, typically requires recovery nutrition within 30 to 60 minutes post exercise. Aim for a liquid such as a shake. For weight management, focus on a ratio of 1:1 protein to carbohydrate. You will likely find yourself experiencing early satiety at your next meal, which can aid in weight loss.

Diet Dimensions

Raniashehab2001: Hello. I weigh 65 kg and I want a good diet that will help me lose about 10 kg before summer.

Kylene_Bogden,_MS,_RD,_CSSD,_LD: Thanks so much for your question. Nutrition, especially for weight loss, is never a one-size-fits-all answer, and fad diets are not the best option because we want something sustainable. Consider scheduling an appointment with a registered dietitian for a plan and suggestions tailored to your size, current eating regimen and exercise habits.

lumahai: Is there an ideal time to eat meals? Also, how many meals should one eat? Thank you.

Kylene_Bogden,_MS,_RD,_CSSD,_LD: Try to focus on eating breakfast within an hour of waking. That is the start of your "food clock." Roughly every four hours after this, you will continually incorporate meals/snacks depending on how many hours you are awake. For optimal digestion, try to stop eating two hours before your bed time.

bhl93019: What is a healthy protein bar to eat in between meals?

Kylene_Bogden,_MS,_RD,_CSSD,_LD: Try Good Greens protein bars.

Moderator: I agree. These are actually pretty tasty!

Meg_N_Ohio: I think my sugar intake is too high. I have a fruit smoothie for breakfast, with added protein powder and Greek yogurt. I'm sure this has too much sugar. I'll stop those. There have been some great questions!

Kylene_Bogden,_MS,_RD,_CSSD,_LD: All great points. Thanks for being a part of the chat.

chickbull: I am 81 years old, male, 154 pounds, 5 feet 7 inches. I get very limited activity, just walking almost daily. I had a heart bypass 15 years ago. I am eating only healthy, real food and a smoothie every morning. I am on 25 mg Toprol-ER, 20 mg atorvastatin, and 1/2-5 mg lisinopril. Is a protein a good idea to add to morning smoothie? I do add 2 tbsp. flax or chia seed to greens, fruit, almond milk, coconut oil and take a turmeric capsule for my arthritis (inflammation).

Kylene_Bogden,_MS,_RD,_CSSD,_LD: Great job eating fresh, whole foods! Protein and fat are great macronutrients to include at breakfast. From what you listed, you are already consuming both in your smoothie. If you are looking for other options, consider incorporating natural nut butter such as almond or peanut butter in your smoothie. Otherwise, keep up the great work.

Naomie: I have recently gone Paleo because it seems to be the new craze at my gym. I have definitely lost weight, but I have heard mixed reviews regarding this type of eating. What are your thoughts?

Kylene_Bogden,_MS,_RD,_CSSD,_LD: I LOVE that you are eating whole, unprocessed foods. That should be step one for anyone, whether you are interested in weight loss or not. My #1 rule for weight loss: if you do not recognize the ingredients on the back of your food label, don’t eat it! The idea of Paleo encompasses many great principles; however, it is not only not supported by research, but many well-known researchers have also proven the theory behind Paleo to be somewhat of a fallacy. It’s important to be mindful of what food groups you are cutting out and be sure to supplement if necessary. For example, calcium deficiency is common in this population. If you are interested in more information, check out the presentations and articles from senior research scientist Steve Hertzler, PhD, RD.

Raniashehab2001: What should I eat to increase leptin?

Kylene_Bogden,_MS,_RD,_CSSD,_LD: Leptin is actually a hormone that is produced in your adipose (fat) tissue. There aren't any leptin-rich foods that will cause your leptin levels to rise. However, there are certain foods to eat/avoid that can help to increase or decrease your leptin sensitivity. Foods that INCREASE leptin sensitivity (this is good) include:

  1. Lean protein (especially at breakfast)
  2. Fiber rich food sources (think legumes!)
  3. Dark leafy greens

Foods that DECREASE your sensitivity (this is not good) include:

  1. Simple starches like white flour and crackers
  2. Highly processed foods containing sugar and high-fructose corn syrup

And don’t forget, regular sleep helps regulate leptin!

DebNsatx: Is there a site or a book where we can find quick, easy low-calorie recipes to make that have ingredients that you can buy at most grocery stores without going to a specialty store for the ingredients? What is your opinion on the diets out there as to which one is the best and healthiest to lose weight on: Weight Watchers, Atkins or others? Thank you for your responses!

Kylene_Bogden,_MS,_RD,_CSSD,_LD: Try I think you will enjoy it. Avoid Atkins. Weight Watchers can be done well if you choose whole, unprocessed foods WHILE focusing on counting points versus counting points alone and not caring exactly what you put in your mouth.

tperk100: I am looking at Good Green Bars. Are they ALL protein bars or is it only the Apple? Amazon's site and Good Green's site are both confusing.

Kylene_Bogden,_MS,_RD,_CSSD,_LD: They have a large variety. Only a select few have the 10g of protein.

lumahai: It is said that processed food should be avoided. What is the definition of "processed"?

Kylene_Bogden,_MS,_RD,_CSSD,_LD: Besides looking at the ingredients, think of it this way, did someone have to jumble something together in a factory to make your food or was it picked right from the tree? Or harvested from the ground? In its natural state can be another term for unprocessed. Hopefully that makes more sense.

lumahai: How about packaged turkey bought at a supermarket?

Kylene_Bogden,_MS,_RD,_CSSD,_LD: Consider going to the deli and asking for it "off the bone." Besides cooking a turkey yourself, this is one of the more natural ways to eat lunchmeat.

Foodie: What is your take on sweeteners?

Kylene_Bogden,_MS,_RD,_CSSD,_LD: Proceed with caution, as these are significantly more sweet than table sugar, often leading individuals to crave more sugar-laden foods throughout the day.

lumahai: Is there such a thing as a healthy sandwich? If so, please give some examples. How about peanut butter on whole wheat sprinkled with dehydrated cranberries?

Kylene_Bogden,_MS,_RD,_CSSD,_LD: Just be sure that your bread is not refined. Keep in mind that a sandwich can be anything, not just bread. Try a lettuce wrap or two slices of toasted eggplant, baked plantains etc. Of course it depends on what you are making, but don't forget to add a little creativity into the mix.

lumahai: Is decaffeinated tea an acceptable form of hydration?

Kylene_Bogden,_MS,_RD,_CSSD,_LD: Yes, just make sure that water makes its way in there somehow.

All About Exercise

terryd: My husband, who is 56, had a problem last year with atrial fibrillation. Fortunately it has now been corrected successfully with an ablation. He has made some lifestyle changes by eating healthier and losing some weight; however, I feel he could benefit greatly by increasing his exercise. I am always trying to encourage him to walk and cycle, but it is very difficult to get him to exercise independently. He could still stand to lose another 20 pounds. Do you have any advice on how we can speed this up by motivating him to exercise? Many thanks.

Kylene_Bogden,_MS,_RD,_CSSD,_LD: Help him find something that he enjoys. Was he a former athlete? What sport? Try to pick something that might mimic that. Or try something new with him that neither of you have done before. For example, if he hates walking, try not to push the issue. There are so many other options such as swimming, Zumba, kickboxing, etc. Lastly, consider enrolling in a group fitness class. He may not love riding a stationary bike alone, but a group class that involves spinning could be his new favorite time of the week.

jlp152: I am purchasing a NordicTrack elliptical and would like suggestions for how to burn the most calories and get in better shape while using it, and what length of time do you recommend for using it?

Kylene_Bogden,_MS,_RD,_CSSD,_LD: Try to ensure that each session lasts 30 to 60 minutes. Place your focus on interval training.

mfgold: Interval fitness training has been touted as a more efficient way to "burn" calories. Do you agree, and if so, what kind of exercise and which fitness intervals would you suggest to get the maximum weight loss benefit from same? Thank you for your response.

Kylene_Bogden,_MS,_RD,_CSSD,_LD: Yes. The beauty of this is that interval training can be incorporated into any activity, walking, swimming, running, biking, etc. Consider consulting an exercise physiologist if you are looking for an individualized plan.

Summertime: Should a person increase their calorie intake when they start an exercise program? What are the best foods to eat before and after working out?

Kylene_Bogden,_MS,_RD,_CSSD,_LD: Great question. This is very hard to answer without a full assessment. The answer depends on how active you are now versus what type of training program you are beginning and how much time you are devoting. In general, eat carbohydrate before exercise: fruit/starch/low fat dairy; and eat a balanced meal (must contain protein) after the workout. Think salmon, quinoa and asparagus or a small banana, low-fat vanilla Greek yogurt and a handful of nuts.

Medication Makes a Difference

lfreem02: I am 43 years old, and I have dysautonomia. I currently take Zoloft and Klonopin. I gained 35 pounds while on Lexapro three years ago, but stopped gaining weight when I switched to Zoloft. I was able to lose 15 pounds when I took a break from Zoloft in the fall, but I had to go back on it and haven't been able to lose more weight. I eat a plant-based, whole foods diet. (I make a lot of recipes from 22-day Revolution.) I haven't eaten desserts, sugar or chocolate (I can't have caffeine) in two years. I also drink 2.5 to 3 liters of water a day. I do a thirty minute group HIIT class six days a week and walk/jog. I average 10,000 steps a day. I have lost inches, but the scale is not budging. I am trying to figure out what else I can do. I didn't have weight issues before taking Lexapro. I am also concerned because most of the fat is around my waist.

Kylene_Bogden,_MS,_RD,_CSSD,_LD: Awesome job with diet and exercise! I know this isn't easy but you seem to have made amazing lifestyle adjustments. However, this sounds like an issue that needs to be discussed with the physician who is prescribing your medication. My only suggestion from a nutrition standpoint would be to make sure you are eating enough calories (under-fueling can almost be as bad as over-fueling sometimes) and make sure that you are consuming enough protein and fat and not eating excess carbohydrate, particularly late at night.

Losing and Maintaining

Sandy123: I have been losing weight very slowly for years (five years, 65 pounds), and I wish I could speed up the last 30 pounds or so. But I overdid it with the walking and now am back to mostly water aerobics. The frustration gets to me sometimes. I've had overall success so far, but issues abound and always threaten. We went over to a plant-based diet (Esselstyn), but I have added some fish, chicken and egg whites and now a tiny bit of olive oil sometimes. The diet has helped tremendously with recognition of problem foods and enabled a huge reduction in junk eating, but will the urges ever go away? And what rate of loss really can be expected for long-term weight loss that STAYS off?

Kylene_Bogden,_MS,_RD,_CSSD,_LD: Great job! It's time to sit back and ask yourself when and why these cravings are occurring. Are you not hydrating properly? Does it happen more so when you accidentally skip a meal? Are you not eating enough of a certain food group? Could any of your medications be linked to the cravings? The rate of loss isn't the issue. It's how the weight was lost and if this is something you have truly incorporated into your life. Long-term weight loss will absolutely stay off if you are able to maintain a consistent exercise routine of strength and cardio, if you are achieving an adequate amount of sleep on a consistent basis, and if you have made those diet changes for good. Avoiding processed foods is critical to help keep weight loss off long term. Lastly, you will be able to maintain the weight loss if you have achieved a weight that is healthy for you.

DebNsatx : I just have a question about weight loss, exercise and food. A doctor once told me that you can run a marathon but if you keep on eating the same diet it won't really matter, as food makes a bigger difference in weight loss versus exercise. Is this a true statement in your opinion? Also, is there an age that both men and women experience a problem with a low metabolism such as in there forties and fifties? And what can they do about it to be able to lose weight? Thanks for your responses.

Kylene_Bogden,_MS,_RD,_CSSD,_LD: This is 100 percent true! What you put in your mouth is more important than how you exercise. For the record, I have worked with plenty of marathoners who gained weight throughout training because they assumed they could ingest whatever they wanted because they were training so often. Beginning around age 30, we begin to lose muscle mass every decade. As you know, muscle drives metabolism. The more lean mass you have, the more calories you will burn around the clock. Staying active your entire life will help tremendously. How do we prevent major plateaus? Strength training. I know I have said this over and over, but it is so true and it's something most of us neglect. Also, the less processed food you eat, the less you will struggle with your weight as you age.

gordita06: I am about 60 pounds overweight. I suffer from hypothyroidism and IBS. I walk about 12,000 to 15,000 steps a day. I exercise at least three to four times a week. I find it very difficult to lose weight, especially around my tummy and hip area. Please advise.

Kylene_Bogden,_MS,_RD,_CSSD,_LD: Start to keep a food journal and document what you eat and how it relates to your stomach weight and the way you feel each day. You might come to find that there are certain foods you would be better off eliminating.

Meg_N_Ohio: I have started free weights, but probably not enough, and I drink water with lemon in it 90 percent of the time. My downfall is a beer now and again.

Kylene_Bogden,_MS,_RD,_CSSD,_LD: Nice work! Try to make sure that it is light beer, and keep in mind, one serving is 12 oz, not 24 to 36 like many restaurants and bars often pour!

DebNsatx: What are your top three to five mistakes that people make when they are trying to lose weight. We have all heard to watch your calories, exercise 30 minutes a day, don't eat past 7 or 8 at night – two hours before you go to bed, don't drink sugary drinks. In a positive light, what are your top five things we can all do to get the weight off? Do we need to go on a liquid diet? Tell us please! Thanks for having this web chat.

Kylene_Bogden,_MS,_RD,_CSSD,_LD: I like this. And no, you do not have to go on a liquid diet. Here are some tips to counteract the common pitfalls:

  1. Eat the lean protein off your plate first, whether it be animal form or not.
  2. Don't neglect strength training!
  3. Check out the list of ingredients on a label BEFORE the nutrition facts panel. Are there strange words like high fructose corn syrup and partially hydrogenated oil? Put it back on the shelf and find something else.
  4. Hydrate like a champion. A really quick rule of thumb is to drink in ounces half of your body weight in pounds. So for 120 pounds, you would drink 60 oz/day. Water should be your best friend if you are serious about weight loss.

Thanks for being here.

Foodie: I skip breakfast daily and drink two cups of coffee as a substitute. I usually eat a healthy lunch and dinner, and I have been losing a pound or two a week. I always hear that I should never skip breakfast but it seems to work for me. What are your thoughts on skipping breakfast, and is it true that the more frequently I'd eat it, the more weight I'd lose?

Kylene_Bogden,_MS,_RD,_CSSD,_LD: Eating more frequently has been proven to help with weight loss. You will find divided research on the breakfast issue, but just remember that breakfast is used to break the fast. It's always best to jump start that metabolism as soon as possible.

For Total Health

chickbull: I have been working to lower my A1c from above 6.0, where it has been for many years. It is currently at 6.2. In the past two years, I have lost about 20 lbs from 174 to 154. I am 5 feet 7 inches and 81 years old. My cholesterol is 110, HDL stuck around 36 for many years, LDL is 51, Triglyceride 114. I am careful of what I eat. I no longer exercise due to discomfort from arthritis and Paget's disease so I only walk as far as exercise. Do you have any suggestions for how to get my glucose down? Could my medications be the problem? Toprol XL, Lipitor, Flowmax, Proscar.

Kylene_Bogden,_MS,_RD,_CSSD,_LD: Exercise is critical to lowering A1c. Consider pool therapy or floor-based exercise such as Pilates to help keep blood sugar at bay. Other important factors would be the consistency of meal timing and avoiding processed foods. Remember, sugar can disguise itself in many forms on a label. The core of your diet should be foods that do not necessarily need a food label such as nuts, eggs, olive oil, fruit and veggies.

WaveWolf: I eat a low-carb, high-fiber, "anti-inflammatory" diet, very limited wheat and nightshades and virtually no "white" starches, sweets, processed foods, etc. I exercise as much as a T9 incomplete paraplegic can. Still, I am gaining weight in the middle, notoriously not a good thing! Overall my BMI is just under 25. Do you have any recommendations?

Kylene_Bogden,_MS,_RD,_CSSD,_LD: Pay attention to meal timing and consistency of meals. Avoid getting to the point where you experience a drop in blood sugar because you have not eating in six hours. In terms of consistency, try to keep meals somewhat similar in size and composition. For example, don't skip breakfast only to overload at lunch.


Moderator: That is all the time we have for questions today. Thank you Kylene for taking time educate us about weight loss and exercise.

On behalf of Cleveland Clinic, we want to thank you for attending our online health chat. We hope you found it to be helpful and informative. If you would like to learn more about the benefits of choosing Cleveland Clinic for your health concerns, please visit us online at

Kylene_Bogden,_MS,_RD,_CSSD,_LD: Thanks so much for your question. Nutrition, especially for weight loss, is never a one-size-fits-all answer, and fad diets are not the best option because we want something sustainable. Consider scheduling an appointment with a registered dietitian for a plan and suggestions tailored to your size, current eating regimen and exercise habits. It is not possible to make a full assessment without having a full consultation, however:

  1. Make sure you are well hydrated throughout the ENTIRE day. This means water as your fluid of choice, not tea, coffee or soda.
  2. It is possible that you have set your calories too low, so be sure to keep that in mind.
  3. If you have seen a professional and that was the determined caloric amount, what are those calories consisting of?
  4. As long as your doctor has deemed it appropriate, do not neglect strength training!

For Appointments

To make an appointment with Kylene Bogden, MS, RD, CSSD, LD, or any of the other specialists in our Digestive Disease and Surgery Institute, Department of Nutrition at Cleveland Clinic, please call 216.444.3046 or toll-free at 800.223.2273, ext. 43046, or visit us online at

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Cleveland Clinic Health Information – Weight Loss & Exercise

Learn more about the benefits of combining weight loss and exercise.

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This information is provided by Cleveland Clinic as a convenience service only and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. Please remember that this information, in the absence of a visit with a health care professional, must be considered as an educational service only and is not designed to replace a physician’s independent judgment about the appropriateness or risks of a procedure for a given patient. The views and opinions expressed by an individual in this forum are not necessarily the views of the Cleveland Clinic institution or other Cleveland Clinic physicians. ©Copyright 1995-2015. The Cleveland Clinic Foundation. All rights reserved.