What's the Fuss about "Fat Burners" ?

You walk into a drugstore and you see rows upon rows of herbal remedies, fat burners, slimming teas, & other weight loss products. You open up a newspaper or magazine and advertisement are splashed across the page for the latest break-through pill which metabolises or binds fat! And you wonder if there is any truth in what these products are claiming and if you should try it. You are particularly tempted after the extra weight you gained over the festive season (which was a continuos celebration from Christmas to Hari Raya, New Year & Chinese New Year). At least one of our readers did and asked the question "how effective are fat burner products & are there any side effects?" Fat burner products contain a variety of ingredients ranging from fillers to fibre to what is claimed to be the key/active ingredient. I picked three of the most common ingredients found in these products to discuss.

Common Ingredients in "Fat Burners" L-carnitine Function: L-Carnitine (or just carnitine) is an amino acid. It has a key role in the metabolism of fat; it transports fat into the cell to be oxidized or "burnt" to provide energy. Fat cannot penetrate the inner mitochondial membrane of the cell to be utilized unless it is paired to carnitine, thus carnitine has an important role in fat transport into cells. Claim: Supplement companies marketing fat burners products that contain carnitine claim that since carnitine is necessary for fat metabolism, taking extra carnitine will help you burn more fat, leading to weight loss. The Truth: Research has shown that extra carnitine does not enable more fat than usual to be burnt for energy. Even in athletes training hard, carnitine deficiency is rare. The body is very efficient in conserving carnitine, so taking more carnitine will not help burn more fat. Double-blind studies reveals that carnitine supplementation failed to get rid of the pudge. Subjects on low calorie diets undertaking exercise programs and supplementing with carnitine show no difference in fat or weight loss to those that did not use carnitine1,2,3. Side-Effects: From the studies that I found, L-carnitine has not been linked with any toxicity. Our body makes carnitine from lysine & methionine, in conjunction with vitamin C, iron, niacin, and vitamin B6. Ephedra (Ma Huang) Function: Ephedra or Ma Huang has broncho-dilating and decongesting properties. The active ingredient, which is ephedrine, stimulate the central nervous system, dilate the bronchial tubes, elevate blood pressure, and increase heart rate. Pseudoephedrine (the synthetic form of ephedrine) is a popular over-the-counter remedy for relief of nasal congestion. Claim: Since ephedra is a central nervous system stimulant, it is believed that ephedra, particularly when combined with caffeine, promotes weight loss by increasing heart rate and possibly metabolism. The Truth: Many doctors discourage the use of ephedra as a weight-loss aid because of the many side effects that can occur with its use, especially since many of the side effects are intensified when ephedra is combined with caffeine. Side-Effects: Ephedra or Ma Huang has amphetamine-like side effects, including elevated blood pressure, rapid heart beat, nervousness, irritability, headache, urination disturbances, vomiting, muscle disturbances, insomnia, dry mouth, heart palpitations, and even death due to heart failure4. It interacts with drugs such as MAO-inhibiting antidepressants, digitoxin, or guanethidine, thus you should consult a physician before taking Ephedra or Ma Huang. See CNN article on the danger of taking herbs and drugs which interact with each other. FDA (Food and Drug Administration, USA) have determined that products contain the combination of Ma Huang and kola nut, a source of caffeine, can cause severe injury to people even under conditions of usual or recommended use. Reported reactions range from serious, life-threatening conditions such as irregular heartbeat, heart attack, stroke, seizures, hepatitis and psychosis, to relatively minor and temporary conditions such as dizziness, headache and gastrointestinal distress. Chitosan Chitosan technically is not a "fat burner". It is touted more as a "fat trapper" or "fat absorber", but I have included it in this discussion as it has been in the news recently & I've had many questions about it. Function: Chitosan is a derivative of chitin (pronounced KI-tin), a substance found in the shells of insects, crabs, lobsters, and other crustaceans. Claim: Sellers claim that chitosan causes weight loss by binding fats in the stomach and preventing them from being digested and absorbed. Some refer to it as a "fat magnet". It is added to diet pills because it is supposed to bind with fats in the digestive tract and filter them out before the body can absorb them. The Truth: A study involving thirty-four overweight volunteers in a randomized placebo- controlled double-blind trial where subjects were given four capsules of chitosan/placebo for 28 consecutive days. Results suggest that chitosan in the administered dosage, without dietary alterations, does not reduce body weight in overweight subjects5. Side-Effects: Since dietary fat is being excreted, you may have gastrointestinal side effects such as gas, bloating, diarrhea or fatty stools. More importantly, if chitosan really entraps a significant amount of fat, it would grab up all fats, including fat soluble vitamins and omega-3 fatty acids (a good fat), in trying to rid your body of the fats. Animal studies have show that chitin lowers vitamin E (a fat-soluble vitamin) levels in the body. It will also absorb medications that are encapsulated in fat-based compounds. These include some cholesterol-lowering drugs, as well as oral contraceptives and some forms of hormone-replacement therapy.

Buyer Beware

You can see from the above review that you have be vigilant regarding the supplements you may be considering. My best advice to you is not to take any supplement without first doing extensive research on it from scientific & reliable sources (not just reading literature from the manufacturers who have a vested interest in selling you their products) and speaking with your doctor. In addition, if you are taking any medication, you need to be extra sure that there are no interactions between the medication you are taking and the herbal supplement.

Product Labelling

A word of caution regarding what is labelled on the bottle and the actual content of herbal supplements. Herbal supplements is not a heavily regulated industry currently, although it is beginning to come under close scrutiny in the US and also in Singapore. Often what you would find is that there are discrepancies in what is on the bottle's label in terms of quantity & ingredients and the actual content. In one survey by the University of Arkansas for Medical Sciences, it was found that alkaloid content often differed considerably from label claims and was inconsistent between two lots of some products6. Sometimes, ingredients that are used as fillers are not labelled.

References

Grunewald KK, Bailey RS. Commercially marketed supplements for bodybuilding athletes. Sports Med. 1993;15:90-103. Williams MH. Ergogenic and ergolytic substances. Med Sci Sports Exerc 1992:24; Suppl.: S344-8. Villanti RG, et al. L-carnitine supplementation combined with aerobic training does not promote weight loss in moderately obese women. Int J Sport Nutr Exerc Metab 2000;2:199-207. Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, MA: Integrative Medicine Communications, 1998, 125–6. Pittler MH, Abbot NC, Harkness EF, Ernst E. Randomized, double-blind trial of chitosan for body weight reduction. Eur J Clin Nutr 1999 May;53(5):379-81. Gurley BJ, Gardner SF, Hubbard MA. Content versus label claims in ephedra-containing dietary supplements. Am J Health-Syst Pharm. 2000; 57:963-9.

Subway

MENU ITEM	Calories (kcal)	Fat (g)	Protein (g)	Carbs (g)	Fibre (g)	Chol (mg)	Sodium (mg)
Subs
6" BMT®	453	24	21	40	3	56	1740
6" Cold Cut Trio?	415	20	19	40	3	57	1670
6" Meatball	501	25	23	46	4	56	1350
6" Seafood & Crab	378	16	14	46	3	24	1270
6" Steak & Cheese	362	13	23	41	4	37	1200
6" Subway Melt	384	15	22	40	3	44	1720
6" Tuna	419	21	18	39	3	42	1180
6" Ham	261	4.5	17	39	3	25	1260
6" Roast Beef	264	4.5	18	39	3	20	840
6" Roasted Chicken Breast	311	6	25	40	3	48	880
6" SUBWAY Club	294	5	22	40	3	33	1250
6" Turkey Breast	254	3.5	16	39	3	20	1000
6" Turkey Breast & Ham	267	4.5	18	40	3	26	1210
6" Veggie Delite	200	2.5	7	37	3	0	500
Wraps
Steak and Cheese	353	9	22	46	3	37	1400
Turkey Breast & Bacon	321	7	18	45	2	28	1510
Deli Sandwiches
Ham	194	3.5	10	30	2	12	750
Roast Beef	206	4	12	31	2	13	600
Tuna	309	15	12	31	2	26	810
Turkey Breast	200	3.5	12	31	2	13	700
Salads
BMT	272	19	16	11	3	56	1440
Cold Cut Trio	234	15	14	11	3	57	1370
Meatball	320	20	17	17	4	56	1050
Seafood & Crab	197	11	9	17	4	24	970
Steak & Cheese	181	8	17	12	4	37	890
SUBWAY Melt	203	10	17	11	3	44	1410
Tuna	238	16	13	10	3	42	880
Ham	112	3	11	11	3	25	1070
Roast Beef	114	3	12	11	3	20	660
Roasted Chicken Breast	137	3	16	12	3	36	730
SUBWAY Club	145	3.5	17	12	3	33	1070
Turkey Breast	105	2	11	11	3	20	820
Turkey Breast & Ham	117	3	13	11	3	26	1030
Veggie Delite	50	1	2	9	3	0	310
Breakfast Sandwich
Bacon & Egg	305	15	13	29	1	184	500
Cheese & Egg	302	15	13	29	1	187	520
Ham & Egg	291	12	15	30	1	189	700
Western Egg	285	12	13	31	2	182	510
Cookies
Chocolate Chip	209	10	3	29	1	12	135
Chocolate Chunk	210	10	2	30	1	12	150
M & M	210	10	2	29	1	13	135
Oatmeal Raisin	197	8	3	29	1	14	180
Peanut Butter	220	12	3	26	1	0	200
Sugar	222	12	2	28	1	18	170
White Macadamia Nut	221	12	2	27	1	13	140
Breads
6" Country Wheat Bread	206	2.5	8	39	3	0	360
6" Hearty Italian Bread	191	2	7	36	2	0	350
6" Italian (White) Bread	178	2	7	33	2	0	350
6" Parmesan Oregano Bread	195	3	8	34	2	4	400
6" Sesame Italian Bread	210	4.5	8	34	2	0	360
6" Sourdough Bread	265	3	10	49	2	0	460
6" Wheat Bread	186	1.5	7	36	3	0	360
Deli Style Roll	150	2.5	5	27	1	0	260
Wrap	200	2	6	39	1	0	670
Fruizle Express (small)
Berry Lishus	113	0	1	28	1	0	30
Peach Pizazz	103	0	0	26	0	0	25
Pineapple Delight	133	0	1	33	1	0	25
Sunrise Refresher	119	0	1	29	1	0	20
Condiments & Extras
Bacon (2 strips)	45	4	2	0	0	8	180
Cheddar Cheese (2 slices)	60	5	4	0	0	15	95
Light Mayonnaise (1 T)	46	5	0	1	0	6	100
Mayonnaise (1T)	111	12	0	0	0	9	80
Mustard (2 tsp)	8	0	0	0	0	0	115
Olive Oil Blend (1 tsp)	45	5	0	0	0	0	0
Pepperjack Cheese (2 slices)	40	3.5	2	0	0	11	210
Processed American Cheese (2 slices)	41	3.5	2	0	0	10	200
Provolone Cheese (2 slices)	51	4	4	0	0	11	125
Swiss Cheese (2 slices)	53	4	4	0	0	13	30
Vinegar (1 tsp)	1	0	0	0	0	0	0
Salad Dressings (2 oz)
Fat Free French	70	0	0	17	0	0	390
Fat Free Italian	20	0	0	4	0	0	610
Fat Free Ranch	60	0	0	14	0	0	530
Vegetables
Green Peppers (3 strips)	2	0	0	0	0	0	0
Lettuce	3	0	0	0	0	0	0
Olives (3 rings)	3	0.3	0	0	0	0	25
Onions	5	0	0	1	0	0	0
Pickles (3 chips)	1	0	0	0	0	0	125
Tomato (3 wheels)	7	0.1	0	2	0	0	0
BEVERAGES
COCA COLA ® Classic Small	160	0	0	41	0	0	N/A
COCA COLA ® Classic Medium	230	0	0	56	0	0	N/A
COCA COLA ® Classic Large	330	0	0	82	0	0	N/A

McDonald's

McDonald's   MENU ITEM Calories (kcal) Fat (g) Protein (g) Carbs (g) Fibre (g) Chol (mg) Sodium (mg) SANDWICHES Hamburger 270 9 13 35 2 30 600 Cheeseburger 320 13 16 35 2 40 830 Quarter Pounder 430 21 23 37 2 70 820 Quarter Pounder w. Cheese 530 30 28 38 2 95 1310 Big Mac 570 32 26 45 3 85 1100 Arch Deluxe 550 31 28 39 4 90 1010 Arch Deluxe w. Bacon 590 34 32 39 4 100 1150 Big Xtra 710 46 24 51 4 95 1400 Big Xtra with Cheese 810 55 29 52 4 120 1870 Crispy Chicken Deluxe 550 24 23 54 3 55 1100 Filet-O-Fish 470 26 15 45 5 50 890 Chicken McGrill 450 18 26 46 2 60 970 Chicken McGrill, no mayo 340 7 26 45 2 50 890 FRIES Small 210 10 3 26 3 0 135 Medium 450 22 6 57 5 0 290 Large 540 26 8 68 6 0 350 Super Size 610 29 9 77 7 0 390 CHICKEN NUGGETS, SAUCES Chicken Nuggets, 4 pc. 190 11 12 10 1 40 340 Chicken Nuggets, 6 pc. 290 17 18 15 2 60 510 Chicken Nuggets, 9 pc. 430 26 27 23 2 90 770 Hot Mustard Sauce (1 pkg) 60 3.5 1 7 0 5 240 Barbeque Sauce (1 pkg) 45 0 0 10 0 0 250 Sweet 'N Sour Sauce (1 pkg) 50 0 0 11 0 0 140 Honey (1 pkg) 45 0 0 12 0 0 0 Honey Mustard (1 pkg) 50 4.5 0 3 0 10 85 Light Mayonnaise 40 4 0 1 0 5 85 SALAD SHAKERS AND DRESSINGS Chef 150 8 17 5 2 95 740 Garden 100 6 7 4 2 75 120 Grilled Chicken Caesar 100 2.5 17 3 2 40 240 Croutons 50 1 1 9 0 0 105 Caesar Dressing 150 13 2 5 0 15 390 Fat Free Herb Vinegrette 30 0 0 7 0 0 220 Honey Mustard 150 11 1 13 0 15 290 Ranch 170 18 0 2 0 10 480 Red French 130 6 0 18 0 0 370 1000 Island 130 9 0 11 0 15 360 DESSERTS AND SHAKES Fruit and Yogurt Parfait with Granola 370 5 10 73 4 10 260 Fruit and Yogurt Parfait, no Granola 260 4 7 51 3 10 120 Vanilla Reduced Fat Ice Cream Cone 150 4.5 4 23 0 20 75 Strawberry Sundae 290 7 7 50 0 30 95 Hot Caramel Sundae 360 10 7 61 0 35 180 Hot Fudge Sundae 340 12 8 52 1 30 170 Nuts (Sundaes) 40 3.5 2 2 0 0 0 Butterfinger® McFlurry 620 22 16 90 0 70 260 M&M® McFlurry 630 23 16 90 1 75 210 Nestle Crunch® McFlurry 630 24 16 89 0 75 230 Oreo® McFlurry 570 20 15 82 0 70 280 Baked Apple Pie 260 13 3 34 0 0 200 Chocolate Chip Cookie 170 10 2 22 1 20 120 McDonaldland Cookies (1 pkg) 180 5 3 32 1 0 190 Vanilla Shake - small 360 9 11 59 0 40 250 Chocolate Shake - small 360 9 11 60 0 40 250 Strawberry Shake - small 360 9 11 60 0 40 180 BREAKFASTS Egg McMuffin 290 12 17 27 1 235 790 Sausage McMuffin 360 23 13 26 1 45 740 Sausage McMuffin with Egg 440 28 19 27 1 255 890 English Muffin 140 2 4 25 1 0 210 Sausage Biscuit 470 31 11 35 1 35 1080 Sausage Biscuit with Egg 550 37 18 35 1 245 1160 Bacon, Egg & Cheese Biscuit 470 28 18 36 1 235 1250 Biscuit 290 15 5 34 1 0 780 Sausage 170 16 6 0 0 35 290 Scrambled Eggs (2) 160 11 13 1 0 435 170 Hash Browns 130 8 1 14 1 0 330 Hotcakes (Plain) 340 9 9 58 2 25 540 Hotcakes (Margarine 2 pats & Syrup) 610 18 9 104 2 25 680 Breakfast Burrito* 320 20 13 23 1 195 600 Lowfat Apple Bran Muffin 300 3 6 61 3 0 380 Apple Danish 340 15 5 51 1 40 290 Cheese Danish 410 22 7 47 0 70 340 Cinnamon Roll 390 18 6 50 2 65 310 BEVERAGES 1% Lowfat Milk, 8 fl oz/1 carton 100 2.5 8 13 N/A 10 115 Orange Juice 6 fl oz/177 ml 80 0 0 20 N/A 0 20 COCA COLA ® Classic Small 160 0 0 41 0 0 N/A COCA COLA ® Classic Medium 230 0 0 56 0 0 N/A COCA COLA ® Classic Large 330 0 0 82 0 0 N/A diet Coke,® small 0 0 0 0 N/A 0 30 Sprite,® small 150 0 0 39 N/A 0 55 Hi-C®, Orange Drink, small 160 0 0 44 N/A 0 30

Nutrition.com.sg copyright 2000-2007 © all rights reserved

Reproducing content on this site, in any form, is prohibited without written permission.

KFC

MENU ITEM	Calories (kcal)	Fat (g)	Protein (g)	Carbs (g)	Fibre (g)	Chol (mg)	Sodium (mg)
ORIGINAL RECIPE CHICKEN PIECES
Whole Wing	140	10	9	5	0	55	414
Breast	400	24	29	16	1	135	1116
Drumstick	140	9	13	4	0	75	422
Thigh	250	18	16	6	1	95	747
EXTRA TASTY CRISPY CHICKEN PIECES
Whole Wing	200	13	10	10	0	45	290
Breast	470	28	31	25	1	80	930
Drumstick	190	11	13	8	0	60	260
Thigh	370	25	19	18	2	70	540
HOT AND SPICY CHICKEN PIECES
Hot and Spicy Wing	210	15	10	9	0	50	340
Breast	530	35	32	23	2	110	1110
Drumstick	190	11	13	10	0	50	300
Thigh	370	27	18	13	1	90	570
CHICKEN STRIPS
Crispy Strips,3	261	16	20	10	3	40	658
Spicy Buffalo Strips, 3	350	19	22	22	2	35	1110
TENDER ROAST CHICKEN WITH SKIN
Whole Wing	121	8	12	1	0	74	331
Breast	251	11	37	2	0	151	830
Thigh	207	12	18	2	0	120	504
Drumstick	97	4	15	1	0	85	271
TENDER ROAST CHICKEN WITHOUT SKIN
Skin Breast	169	4.3	31	1	0	112	797
Thigh	106	5.5	13	1	0	84	312
Drumstick	67	2.4	11	0	0	63	259
OTHER CHICKEN ITEMS
Hot Wings, 6 pc	471	33	27	18	2	150	1230
Original Recipe Chicken Sandwich	497	22.3	28.6	45.5	3	52	1213
Value BBQ Chicken Sandwich	256	8	17	28	2	57	782
Chunky Chicken Pot Pie	770	42	29	69	5	70	2160
SIDE ORDERS
Mashed Potatoes with Gravy	120	6	1	17	2	1	440
Potato Wedges	180	13	5	28	5	5	750
Macaroni Cheese	180	8	7	21	2	10	860
Corn on the Cob	150	1.5	5	35	2	0	20
Green Beans	45	1.5	1	7	3	5	730
BBQ Baked Beans	190	3	6	33	6	5	730
Mean Greens	70	3	4	11	5	10	650
Potato Salad	230	14	4	23	3	15	540
Cole Slaw	180	9	2	21	3	5	280
Biscuit, 1	180	10	4	20	1	0	560
Cornbread, 1	228	13	3	25	1	42	194
BEVERAGES
COCA COLA ® Classic Small	160	0	0	41	0	0	N/A
COCA COLA ® Classic Medium	230	0	0	56	0	0	N/A
COCA COLA ® Classic Large	330	0	0	82	0	0	N/A

Fast Food Facts

Had you given it much thought on what is in that humongous hamburger you are eating, plus the extra large fries and medium soft drink to boot? If you are like many people, you probably have not. Did you know that a Whopper with Cheese, medium fries, and medium soft drink totals up to a whopping 1440 calories, 69 grams of fat, and 2269 milligrams of sodium? Considering that we need about only 2000 calories per day for women and 2500 calories for men, that meal alone will provide 57% to 72% of our daily requirement. That is not all - it also provides 43% of the calories from fat and exceeds the daily requirement. The Guidelines for a Healthy Diet for Singapore recommends calories from fat be less than 30% of total calories consumed in one day. The combination meal also exceeds the recommended intake of 2000 milligram of sodium per day. So next time you are wondering whether you should order the Extra Value Meal, think again. Let's take a look at a meal at another favourite restaurant -- a 3-piece dinner Kentucky Fried Chicken. Three pieces of chicken (I have used a wing, a thigh and a drumstick in this case) with mashed potatoes & gravy, plus coleslaw adds up to 780 calories, 42.5 grams of fat and 1830 milligrams of sodium. This meal serves up 49% of its calories from fat! Eating out at fast food restaurants requires some planning.

Don't "super-size" it unless you are sharing. You can save some calories by cutting out the cheese, having smaller fries, or adding a salad instead of dessert to fill you up. It is also a matter of letting the restaurants know that you like to see better choices on their menu. Many of the fasts food chains have started to serve lower fat choices at their overseas outlets such as grilled chicken sandwich, garden salads with reduced fat dressings, and holding the mayonnaise/sauce at customers' request. Tell them you want to see it here in Singapore too!

Keep a copy of your favourite fast food restaurant nutritional profile handy so that you can make informed decisions the next time you are there.

Dining Out Tips

The Food Consumption Study conducted in 1993 by the Ministry of Health reported that as much as 43% of Singaporeans eat out more than 7 times per week at hawker centres. In addition, 90% of you eat out at fast food outlets at least once a week.

So with so many of you eating out daily, what should you be looking out for the next time you go out to your favourite hawker centre or coffee shop? By following the tips given here, you can dine on hawker foods and still be health conscious.

Ask for less oil to be used in cooking items like roti prata, fried noodles, fried rice Ask for skin to be removed on chicken dishes such as chicken rice, chicken briyani or remove the skin before eating Leave behind the gravy, especially coconut based ones, in laksa and other curry gravies. This helps to reduce the saturated fat by as much as 50%. Ask for less or no gravy on rice. This could reduce the sodium on a plate of char siew rice by about 25%. Ask for less syrup on dessert items like ice kachang, this could cut down sugar significantly. Ask for less sugar or sweetened condensed milk in coffee and tea. Have a smaller portion or share with a friend high fat food such as char kway teow or oyster omelette. Fill up on lower fat item such a soup, plain rice and vegetables. Look for items that are roasted, grilled, steamed, boiled, stewed or poached. These items are prepared without excess fat Order a side dish of vegetables or select a serving of vegetables at rice stalls. This will help fill you up and add 35% more dietary fibre to the meal. Have smaller amounts of organ meats and have more lean meats and beancurd. This could help cut the cholesterol in a normal serving of kway chap by 30%. If you have a high fat or high calorie item, balance it off with lower fat/calorie items the rest of the day.

Check out the Local Food Guide to help you make informed choices about the calorie and nutrient levels of various hawker foods. Also take a look at Fast Food Facts for items served some of the fast food outlets. It is more difficult to control the amount of fat, sodium and sugar in the foods when eating out. Try to alternate eating out with home-cooked meals regularly.

Snack Attacks

Did You Know That...

Munching on just one carrot will meet your vitamin A needs for the entire day? Preschoolers get nearly one third of their energy from snacks? Snacking is on the rise: 75 percent of us eat at least one snack a day? A planned snack can help prevent overeating? Television watching tends to increase snacking--particularly on high-fat, high-calorie "goodies"? Snacking can help or hurt a healthful diet. The difference depends on what you choose and how much you eat. Whether you like to munch, nibble, or simply quench the mid-afternoon "hungries," you can make snacking work for you. It just takes a little planning.

Benefits Of Snacking

Snacks can give you an energy boost to help fuel your body between meals. Your body uses up the carbohydrate stores in your liver (which help maintain a normal level of blood sugar) in 4 to 6 hours. You need food to replace them. Many people can benefit from eating snacks. Growing children with tiny appetites may not be able to fulfill their energy needs with only three meals a day. Snacks can provide what may be missing from their meals. Athletes of all ages have increased energy demands. They especially need energy in the form of carbohydrates, which help power exercising muscles. Snacks such as sandwiches, bread buns, pau, and fruit can help give athletes the additional energy they need. Teenagers are well known for their snack attacks and for good reason. They also have high energy and nutrient needs to support their growing bodies. Carefully chosen snacks can help fuel their growth. Carrying a baby places additional nutrient and energy demands on the mother. Selective snacking can help pregnant women meet their extra nutrition needs. Small, frequent snacks can be especially helpful for women who have morning sickness or who always feel full. Older adults who can eat only small portions of food at a time may find it easier to maintain their health by eating snacks to supplement their meals. Snacks can offer nutritional advantages, but they also can become liabilities, depending on the types and quantities of food they contain. Mindless nibbling can lead to trouble in the form of unwanted calories. Some snacks--such as potato chips, prawn crackers, chocolate, and sweets--can add a fat burden to the diet. And high-fat diets are clearly linked with such chronic diseases such as heart disease and cancer.

Removing The Guilt: Snacking Myths

Despite the benefits that snacking can offer, many people think of snacks as something extra they should not eat. Here are five myths worth challenging: Myth - Snacks are fattening. Fact - Eating a snack during a long stretch between meals can take the edge off hunger, which might lead to overeating otherwise. Of course, specific snack food choices will make a difference. Myth - Snacks spoil your appetite for meals. Fact - Eating a small amount of food--maybe an apple or half of a turkey sandwich--2 to 3 hours before a meal will not spoil an appetite. But it may keep you from becoming ravenously hungry. By eating a snack, you can be more in control of your food choices and less inclined to overeat at your next meal. Myth - Snacking causes cavities. Fact - While snacks expose the teeth to food (and decay-producing bacteria) more often, choosing foods that are not sticky and brushing your teeth afterward help prevent cavities. Some foods such as cheese have been found to have properties that prevent cavity formation. Myth - Snacking is the same as eating junk food. Fact – Snacking does not have to equate junk food, choosing better alternatives can help fill in the gaps in meals to complete a healthful diet. Myth - Healthful snacking means I can never eat potato chips again. Fact - It's possible to eat fun foods and still follow a diet that is low in fat, but it requires a little planning. If you have a high fat snack, you need to balance that out with lower-fat choices at other meals. One snack, one meal, or one day of eating cannot make or break your health. It is what you eat consistently over time that counts.

Healthy Bites: Nutritious Notables

By choosing your snacks wisely, you can take a sizable step toward meeting your nutrition needs. Here are some snacks that are particularly nutrient-rich: Food...Percentage Of Daily Nutrient Requirement* 1/2 cup of 100% orange juice...more than 100 percent of vitamin C 1 bowl of tofu dessert...a whopping 80 percent of calcium 1 bowl of tau suan (yellow split pea soup) ...63 percent of dietary fibre ½ mango...53 percent of vitamin 1 serving of chinese rojak...36 percent of iron for women, more than 100 percent for men 1 medium banana...25 percent of potassium

* Based on the Recommended Dietary Allowance for Singapore.

Making The Most Of A Snack Attack

Follow these guidelines to help make snacking work for your health: Plan ahead so that you have the desired food at hand when you need it. You don't want to be forced to choose from the limited selections in a corner store, or a randomly stocked refrigerator. Instead of munching absent-mindedly, make snacking a conscious activity. Ideally, this means eating without doing anything else at the same time (for example, watching TV). Otherwise, you can easily overeat without realizing it. Choose lower-fat snacks:

Instead of Try... Chendol Cheng Tng Bubor cha cha Mango pudding Meat curry puff Sardine puff Potato crisps Pretzels Ice cream Low fat frozen yogurt Milkshake Fruit smoothie Ice cream bar Frozen juice bar Butter cookie Marie biscuits Pound cake Chiffon cake

Keep the above tips in mind that next time you reach for a snack. Happy Snacking!

Fats - Where It's At

How much fat can I have?

It depends on your calorie needs. The Dietary Guidelines recommend that Singaporeans limit fat in their diets to 20-30 percent of calories. This works out to no more than 53 grams of fat in a 1,600-calorie diet, 73 grams of fat in a 2,200-calorie diet, and 93 grams of fat in a 2,800-calorie diet. You will get up to half this fat even if you pick the lowest fat choice from each good group and add no fat to your foods in preparation or at the table. You decide how to use the additional fat in your daily diet. You may want to have foods from the four major food groups that are higher in fat--such as whole milk instead of skim milk. Or you may want to use it in cooking or at the table in the form of oils, spreads, or toppings.

How to check your diet for fat

If you want to be sure you have a low-fat diet, you can count the grams of fat in your day's food choices using the Pyramid Food Choices Chart, and compare them to the number of grams of fat suggested for your calorie level. You do not need to count fat grams every day, but doing a fat checkup once in a while will help keep you on the right track. If you find you are eating too much fat, choose lower fat foods more often. You can figure the number of grams of fat that provide 30% of calories in your daily diet as follows: A. Multiply your total day's calories by 0.30 to get your calories from fat per day.Example: 2,200 calories x 0.30 = 600 calories from fat. B. Divide calories from fat per day by 9 (each gram of fat has 9 calories) to get grams of fat per day.Example: 660 calories from fat ÷ 9 = 73 grams of fat.

Are some types of fat worse than others?

Yes. Eating too much saturated fat raises blood cholesterol levels in many people, increasing their risk for heart disease. The Dietary Guidelines recommend limiting saturated fat to less than 10 percent of calories, or about one-third of total fat intake. All fats in foods are mixtures of three types of fatty acids - saturated, monounsaturated, and polyunsaturated. Saturated fats are found in largest amounts in fats from meat and dairy product and in some vegetables fats such as coconut, palm, and palm kernel oils. Monounsaturated fats are found mainly in olive, peanut, sesame and canola oils. Polyunsaturated fats are found mainly in safflower, sunflower, corn, soybean, and cottonseed oils and some fish. How do I avoid too much saturated fat? Follow the Healthy Diet Pyramid, keeping your total fat within recommended (See the table for the number of grams suggested at various calorie levels). Choose fat from a variety of food sources, but mostly from those foods that are higher in polyunsaturated or monounsaturated fat.

Here are some selection tips:

»Use lean meats and lowfat dairy products. »Use unsaturated vegetable oils and margarines that list a liquid vegetable oil as first ingredient on the label. »Read nutrition and ingredient labels on food packages to check the kinds and amounts of fat they contain. »Limit use of products that contain a large amount of saturated fats. Examples are coconut milk and rich baked products such as pie crusts and other pastries, cakes, and cookies.

Cholesterol

What about cholesterol? Cholesterol and fat are not the same thing. Cholesterol is a fat-like substance present in all animal foods - meat, poultry, fish, milk and milk products, and egg yolks. Both the lean and fat of meat and skin of poultry contain cholesterol. In milk products, cholesterol is mostly in the fat, so lower fat products contain less cholesterol. Egg yolks and organ meats, like liver, are high in cholesterol. Plant foods do not contain cholesterol. Dietary cholesterol, as well as saturated fat, raises blood cholesterol levels in many people, increasing their risk for heart disease. The Dietary Guidelines recommend that dietary cholesterol be limited to 300 mg or less per day. To keep dietary cholesterol to this level, follow the Healthy Diet Pyramid, keeping your total fat to the amount that is right for you. It's not necessary to eliminate all foods that are high in cholesterol. You can have three to four egg yolks a week, counting those used as in custards, baked goods and omelettes. Use lower fat dairy products often and occasionally include dry beans and peas in place of meat.

Where's the Cholesterol?

Healthy Eating For Men

Finding time to eat right is often a challenge for Singaporean men. No time for breakfast; Business lunches, Entertaining clients in the evening or working late; all make it difficut to eat right. The 1993 Food Consumption Study showed that 84% of men are eat out at lunch daily and the majority (76%) eat at hawkers' centers or workplace canteens, 53% eat out at breakfast and 28% eat out at dinner. What are some of the issues with eating on the run and what can you do to make sure that you are eating right? Read on.

USE THE RIGHT FUEL

Your body is just like your car -- you have to give it the right fuel for it to perform well. Just as your car performs better with premium gas, your body performs best with certain foods. Your body needs carbohydrates, protein, fat, vitamins, minerals -- but all in the right balance.

Fuel your body with carbohydrates

Our best source of fuel is carbohydrates. Carbohydrate is what the body uses for energy. It is stored in two forms: as glycogen in our muscles and liver for a quick energy source, and the excess carbohydrate are stored as fat in the rest of the body. Aim for 60 to 65 percent of your diet from carbohydrates, that is 6 to 10 servings of items like steamed rice, noodles, bread, pasta, buns, pau, biscuits, chapati, cereals, etc. Have mostly complex carbohydrate such as those listed above instead of simple carbohydrate like sugar, honey, syrup, soft drinks, cakes, and desserts, etc.

Pump up with protein

Protein is the building block of muscle and blood. You do not need a lot of it -- only about 6 - 9 ounces per day--but make what you take count. The best sources of protein are lean meat, fish, poultry, dried beans & lentils, tofu, low-fat dairy products (milk, yoghurt, cheese), and eggs. If you are body building, you only need an extra 3-5 ounces per day which is another glass of milk! The main source for body building is carbohydrate, not protein. So do not feel like you have to eat large amounts of meat nor take protein supplements. Whatever protein that is not utilized by the body is stored as fat. Also excess protein is broken down and passed out in the urine; this places an additional load on your kidneys.

Fat make you fat

Fat packs more than twice as many calories as protein or carbohydrate gram for gram (9 for fat versus 4 calories per gram of protein or carbohydrate). Some fat is essential for good health--but most people eat three to four times more than they need. If you are eat out or cook with oil or eat meat and coconut-based products, you are probably getting more than enough fat. In fact you have to be careful about cutting back on the high-fat items in your diet, for example crispy fried foods, curry gravies, fat & skin on meat, potato crisps, etc.

Tips for better nutrition

Follow the Healthy Diet Pyramid guidelines. Choose steamed rice over fried rice. Go for noodles in soup over fried noodles more often. Include a serving of vegetable at every meal. Have a piece of fruit after each meal or as a snack. Avoid the peanut & other snacks served as appetizers in restaurants. If you are having a big meal later, have a lighter lunch. Have all-you-can-eat buffets only occasionally. Drink in moderation if you entertain often (alcohol pack a whopping 150 calories per can of beer, 100-120 calories per shot of whiskey, another 150 calories for a can of soft drink) Drink six to eight glasses of water each day.

Did You Know That... A man in his 50s who exercises regularly has more energy and a better sex life, and can work longer hours than someone who doesn't? Five of the ten leading causes of death and disease are directly associated with diet? Two-thirds of all American CEOs exercise at least three times a week? Source: American Dietetic Association (ADA) brochure "Food Strategies for Men," 1991

Make time for exercise

You cannot afford not to. Your health depends on it. Set aside time 2 - 3 times per week either in the morning before work, during lunch or after work to do an activity for at least 30 minutes. You can jog, swim, play badminton, join a health club, or whatever works for you. In addition, increase your daily activity such as walking more (park your car further away, take the stairs, leave 5 minutes earlier so that you can get off a stop earlier & walk). Little things do add up. Increasing physical activity stokes the metabolic fire so calories burn faster and helps keep your weight down!

Looking for answers

Here are some questions men often ask registered dietitians (RD).

1. How do I know if my weight is healthy?

Start by using the BMI (Body Mass Index) calculator to find out if you are within a healthy weight range. Being over or underweight is associated with health problems. Excess weight increases your risk of developing heart disease, stroke, diabetes, cancer, and high blood pressure. Being underweight has been linked to heart problems, lowered resistance to infection, chronic fatigue, depression, and other illnesses. A "spare tire" or excess accumulations of body fat, particularly in the stomach area, have been linked to increased risks of heart disease, stroke, and diabetes. Make changes to gradually decrease or increase your weight.

2. What can I do to lower my blood cholesterol?

Cholesterol is essential for life to make strong cell membranes and hormones. The body manufactures about 1,000 mg of cholesterol daily. Too much cholesterol can cause fatty plaques on arterial walls which narrows the artery. This condition is known as atherosclerosis. The build-up of fat on the vessel walls can occlude and in some case totally block the flow of blood to important organs like the heart and brain. Cholesterol is a fat-like substance found only in animal products. The highest sources of cholesterol come from organ meats (example: liver, kidney, brain, heart, tripe) and eggs, but other common sources are any type of meat, poultry, cheese, and butterfat. Singaporean men generally consume 300 to 420 milligrams of cholesterol a day; the highest level is in Malay men at 424 mg per day *. The recommended amount is no more than 300 mg per day for the average person. To lower your blood cholesterol levels, firstly follow your physician's advice for prescribed treatment. Other interventions include not just cutting back on high cholesterol foods, but also the total amount of fat you eat AND increasing your level of physical activity.

* Source: The Diet of Singaporeans, Ministry of Health 1997

3. Can you give me some tips for eating out?

Check out the Dining Out section for Tips on dining out as well as look up the Local Foods and Fast Food tables to learn how much fat, calories & sodium is in your favourite meals.

4. Do I really need to be physically active?

Did you know that a physically active man has more energy and can work longer hours than one who is sedentary? Think of physical activity as doing preventive body maintenance to keep you from becoming overweight and to provide protection from heart disease, stroke, and cancer. Before you get started, get a physical exam from a physician, especially if you are over 40, overweight or have heart, circulation, joint, or bone problems. Find a variety of activities you like, then start slowly. Begin with moderate physical activity, such as walking --every bit helps. If you lack motivation, find a partner or a group program that meets regularly. Take time to see how far you've come. Do you feel more energized? Are you less stressed?

REMEMBER YOU ARE WHAT YOU EAT and WHAT YOU DO

Healthy Eating For Women

Breast cancer. Osteoporosis. Iron deficiency. Weight reduction. What do these things have in common? They are either unique to women, or are more prevalent in women. And they affect current recommendations on what women should eat for optimum health. While new information on what's good and what's bad seems to surface almost daily, some basic guidelines have taken root over the past several years. The bottom line is: Eat a variety of foods Maintain healthy weight Choose a diet low in fat, saturated fat, and cholesterol Choose a diet with plenty of vegetables, fruits, and grain products Use sugar and salt/sodium only in moderation If you drink alcoholic beverages, do so in moderation. That sounds simple enough. Except, what exactly is variety? Cake one day, cookies the next? What is a diet low in fat, saturated fat, and cholesterol? And, finally, what parts of a healthy diet have special importance for women?

Vitamins and Minerals

There are several vitamins and minerals essential to a healthy diet. A well-balanced diet will usually meet women's allowances for them (see Recommended Dietary Allowances for Adults). However, for good health, women need to pay special attention to two minerals, calcium and iron.

Calcium

Both women and men need enough calcium to build peak (maximum) bone mass during their early years of life. Low calcium intake appears to be one important factor in the development of osteoporosis. Women have a greater risk than men of developing osteoporosis. A condition in which progressive loss of bone mass occurs with aging, osteoporosis causes the bones to be more susceptible to fracture. If a woman has a high level of bone mass when her skeleton matures, this may modify her risk of developing osteoporosis. Therefore, particularly during adolescence and early adulthood, women should increase their food sources of calcium. "The most important time to get a sufficient amount of calcium is while bone growth and consolidation are occurring, a period that continues until approximately age 30 to 35," says Marilyn Stephenson, a registered dietitian with FDA's Center for Food Safety and Applied Nutrition. "The idea is, if you can build a maximum peak of calcium deposits early on, this may delay fractures that occur later in life." In Singapore, the recommended dietary allowance (RDA) for calcium for woman 19 to 64 is 500 milligrams per day. The American RDA breaks it down for women 19 to 24 to have 1,200 mg of calcium; the allowance drops to 800 milligrams for women 25 and older. "That is still a significant amount." says Stephenson. "The need for good dietary sources of calcium continues throughout life," she says. How do you get enough calcium without too many calories and fat? After all, the foods that top the calcium charts--milk, cheese, ice cream--are also high in calorie and fat. There are lower fat choices such as HiLo or skim milk instead of homogenized (whole) milk, and lower fat cheeses, yoghurts, and ice milk. In addition to dairy foods, other good sources of calcium include fish with bones (ikan bilis or sardines), tofu (soybean curd), certain vegetables, dried peas and beans, seeds, and nuts.

Iron

For women, the RDA for iron is 11 milligrams per day, 5 milligrams more than the RDA for men. Women need more of this mineral because they lose an average of 15 to 20 milligrams of iron each month during menstruation. Without enough iron, iron deficiency anemia can develop and cause symptoms that include pallor, fatigue and headaches. After menopause, body iron stores generally begin to increase. Therefore, iron deficiency in women over 50 may indicate blood loss from another source, and should be checked by a physician. Animal products--meat, fish and poultry--are good and important sources of iron. In addition, the type of iron, known as heme iron, in these foods is well absorbed in the human intestine. Dietary iron from plant sources, called non-heme, are found in peas and beans, spinach and other green leafy vegetables, potatoes, and whole-grain and iron-fortified cereal products. Although non-heme iron is not as well absorbed as heme iron, the amount of non-heme iron absorbed from a meal is influenced by other constituents in the diet. The addition of even relatively small amounts of meat or foods containing vitamin C substantially increases the total amount of iron absorbed from the entire meal.

Calories and Weight Control

Weight control is often a concern for women. There is a lot of pressure in our society to be a certain body size; we see tall, underweight models splashed across the front page of glamour magazines suggesting that they should be the norm. Weight alone is not the only determinant of health, body shape, amount of fat to lean body mass, familial history, and other factors all contribute to your overall health. See section on Health Assessment to see how you rate. On the other hand, a woman's metabolism slows down from 2 to 8 percent every decade, which means women need 100 fewer calories a day than she did 10 years ago. It is no surprise then to find ourselves putting on weight even if we are eating the same or maybe less than before. Cutting back on calories is not always the answer to losing weight. It is important that you are meeting all your daily requirements for a healthy diet by having the minimum number of servings per day from the Healthy Diet Pyramid. If you find you are gaining weight, do not only focus on cutting calories, but also about increasing activity and exercise. Calories are only half of the equation for weight control. Physical activity burns calories, increases the proportion of lean to fat body mass, and raises your metabolism. Include strength-training and weight-bearing exercise in your routine to preserve bone density and combat the loss of muscle. So, a combination of both calorie control and increased physical activity is important for attaining healthy weight. If, however, you are been pigging out--well, you know what you have to do.

Folic Acid

Folate is important for women who are considering getting pregnant. Folic acid, the synthetic form of folate, a B vitamin protects fetuses from birth defects such as neural tube defects. Folate-deficient diets have also been linked to heart disease, colon cancer and dementia in the elderly. Good sources of folate include green, leafy vegetables, citrus fruits, folic acid-fortified cereal, and supplements. It is important to have enough folate even before you find out that you are pregnant because most of us do not find out that we are pregnant until a month into the pregnancy. It is in the first few weeks of fetal development that the folate is most important as the foundation for nerve generation is laid down.

Cholesterol & Fats

Women tend to have higher levels than men of a desirable type of cholesterol called HDLs (high-density lipoproteins) until menopause, leading some researchers to believe there is a link between HDLs and estrogen levels. But this does not let women off the hook--a diet high in saturated fat and cholesterol can still mean trouble. For both women and men, blood cholesterol levels of below 5.2 mmol/l (200 mg/dl) are desirable. Levels between 5.2-6.2 mmol/l (200-240 mg/dl) are considered borderline, and anything over 6.2 mmol/l (240 mg/dl) is high. High levels of blood cholesterol increase the risk of coronary heart disease. To keep levels in the good range, the Dietary Guidelines recommends eating no more than 300 milligrams of cholesterol a day. Cholesterol is found only in food from animal sources, such as egg yolks, dairy products, meat, poultry, shellfish, and--in smaller amounts--fish and some processed products containing animal foods. Even more important than limiting dietary cholesterol to under 300 milligrams is keeping saturated fat to under 10 percent of total calories. Saturated fat is found in fat on meats, full-fat dairy products, coconut milk & oil, lard, ghee and palm oil. Also follow general guidelines to keep total fat in the diet to less than 30% of total calories.

During Pregnancy

Your health and nutritional state before you become pregnant not only affect your ability to conceive but also the health of your baby and your own health down the road. To help ensure conception and delivery of a healthy baby and to protect your own health, you should get your weight into a healthy range even before trying to conceive. If you're undernourished and underweight, you may stop menstruating and become unable to conceive. If you do become pregnant while malnourished, you're starting off with inadequate stores of nutrients for both you and your baby. To lessen your chances of giving birth to a premature, underweight baby with a higher than normal risk of birth defects, it's important for you to start eating well before you decide to become pregnant. Overweight women also run the risk of developing more complications during pregnancy and tend to gain more weight than normal-weight women during pregnancy. If you're obese, you have a higher risk of developing high blood pressure or gestational diabetes, a form of diabetes that develops during pregnancy, usually disappears afterward and poses risks for both mother and baby. You may also deliver an overweight baby. If, however, you are overweight and do become pregnant, now is not the time to try losing weight. Instead, you'll have to work a little harder to gain no more than the appropriate amount of weight throughout your pregnancy.

Weight

Pregnant women who start off at a healthy weight are advised to gain 25 to 35 pounds. Underweight women may need to gain up to 40 pounds and overweight women only 15. Your doctor will tell you which end of the range you should aim for, depending on your age, height and weight when you become pregnant. You can determine if you are at a healthy weight pre-pregnancy by using the Body Mass Index calculator.

Energy (Calorie) Requirements

To get the all nutrients you need without overeating during pregnancy, choose your foods carefully. Stick to the Healthy Diet Pyramid but add 2 daily serving of milk and milk products (Meat & Alternatives Food group) in the first trimester. During the second and third trimesters, you need 300 extra calories a day, so add an extra serving from each of the four food group. Adequate energy intake is important for growth and development of the fetus and for the mother's ability to adapt to stresses such as infections or episodes of bleeding. Additional energy during pregnancy is required for the development of the baby and growth of maternal tissues, the additional metabolism the new tissues require, and the increased energy needed to move the added body tissue. Since a woman body increases about 20% during pregnancy, work involving a lot of movement will cost as much as 20% more in energy. Given these considerations, the total caloric cost of pregnancy has been calculated to be about 80,000 kcal or 300 calories per day. A further adjustment of energy requirement should be based on physical activity. Since energy expenditure varies so widely, the best index of adequate intake is a satisfactory weight gain. Since you also need extra protein, B-vitamins, vitamin D and minerals, such as calcium, phosphorus, iron and zinc, these 300 calories should come from nonfat milk and dairy products, lean meats, beans, whole grain breads and cereals, citrus fruits, dark green, leafy vegetables and other nutrient-rich foods. If you are a vegetarian, you should be especially careful about getting enough protein, iron and vitamin B-12 during pregnancy. Your doctor may prescribe or recommend a multivitamin-mineral supplement with iron to ensure that you meet your extra nutritional needs.

Protein Requirements

Complex new tissues are produced in pregnancy at a rate greater than at any other time during a woman's life. Protein is essential for this purpose, but during pregnancy protein requirements cannot be separated from needs for calories and other nutrients. As energy needs take first priority in metabolism during pregnancy, protein will be used for energy if carbohydrates and fat are not consumed in sufficient amounts. Conversely, increasing energy intake will improve utilization of protein. It is recommended that pregnant women consume an additional 10 grams of protein a day that is an extra 1½ ounce of meat, fish, poultry or in 2 cups of low-fat milk.

Vitamins and Minerals

Three vitamin in particular is of utmost importance during pregnancy: folate, iron & calcium. The role of folate has been discussed above. Talk to your doctor about supplementing the diet with folate if there is a question about adequate folate in the diet. Iron is needed during pregnancy for increased blood supply in the mother, as well as for the baby. For iron, small amounts of lean red meat are the best source, or combine beans, green leafy vegetables and iron-fortified or whole-grain cereals with vitamin C to improve absorption. Limit tea and coffee at mealtimes, as it can interfere with iron absorption. Calcium helps build bones for mother and child, so don't forget to include rich sources of calcium in your diet. Further, when unusual dietary practices or restrictions exist, other supplements may be needed. For women consuming a poor diet and for those in high risk categories--carrying more than one fetus, smoking heavily or using alcohol and drugs--a multivitamin-mineral preparation (containing iron, zinc, copper, calcium, vitamin B6, folate and vitamins C and D) is recommended.

Other Considerations

Artificial sweeteners are best avoided. There has been some debate about the safety of diet sodas and other foods that contain the artificial sweetener aspartame. While there is no evidence that aspartame is hazardous to pregnant women or their unborn babies, a mother-to-be is better off drinking milk, water and fruit juices than diet soda. Low-fat foods are always recommended, but pregnancy generally is not a time to use artificially sweetened diet foods. Caffeine may cause heartburn and nausea, but there is no convincing evidence that coffee or caffeine causes birth defects in humans. Still, many doctors recommend that pregnant women consume only moderate amounts of caffeine-containing beverages, such as coffee, tea, cola drinks, cocoa, etc. during their pregnancy because there is a suggestion that heavy and even moderate intake can lower infant birth weight. Alcohol can act as a potent agent on the young fetus. Fetal Alcohol Syndrome (FAS) was first described in 1973. Since then we have learned that there is a direct dose-response effect. While heavy drinking by alcohol abusers can result in FAS, lower levels of alcohol consumption can lead to fetal growth retardation. The data, although inconsistent, suggest that even one or two drinks per day can interfere with fetal growth. Smoking may affect maternal and fetal nutrition as well as produce harmful chemicals that result in a decrease in birth weight. The adverse effects are proportional to the frequency of smoking. Exercise during pregnancy is safe in the absence of medical or health conditions or problems that would preclude exercising. An exercise program can include large muscle exercises. You can exercise regularly -- 3 to 5 days a week. If in doubt or you experience any undesirable affects, stop and check with your doctor before continuing. Food cravings may be caused by hormonal changes in pregnancy, which can make some women more or less sensitive to tastes and smells. There is no evidence, however, that a craving indicates a need for any particular nutrient. If you crave pickles, for instance, it does not mean you need salt, and if you crave ice cream, you are not short on calcium. You may simply want the comfort associated with certain types of foods. If your cravings for junk food get out of hand, try to substitute foods that are more nutritious but similar in some way. If you're looking for something cool and creamy, have ice milk or low-fat frozen yogurt instead of ice cream. If you're looking for crunch, have baby carrots or unsalted pretzels instead of prawn crackers or potato chips. If you're looking for a sweet taste, have fresh, frozen, canned or dried fruit instead of candy, cake or cookies. Pica is an unusual, rare but serious condition that leads to cravings for foods that are not normally eaten, such as raw flour and cornstarch, and nonfoods including clay and paste. It may be related to an iron deficiency, and it also occurs in some pregnant women. Some people have even been known to crave toxic substances such as lead. If you find yourself craving unusual substances, call your doctor right away. Morning (noon and night) sickness is something of a misnomer for the nausea or vomiting that may occur in the early months of pregnancy at any time of day. It is probably caused by hormonal changes that upset the gastrointestinal tract. If you find yourself vomiting more than twice a day, call your doctor. To help you through this uncomfortable rite of passage: Eat smaller, more frequent meals, and do not let your stomach get empty. Avoid spicy and fried foods and eat plain, easy-to-digest foods, such as crackers, pasta, potatoes and rice. Drink fluids between meals, not with them--and not before breakfast. Eat a snack such as cereal with milk, cheese or fruit before going to bed at night. Eat a snack of crackers, dry toast or plain bisuit before you get out of bed. Get up slowly from bed; rushing is tough on your digestive system.