Dietitians needed as guides through diets


DEAR DR. DONOHUE: My 37-year-old daughter had a massive coronary. She has quit smoking and is trying to lose 100 pounds through diet and exercise. She is a diabetic and has high blood pressure and high cholesterol. Please tell us how much sugar, sodium, cholesterol and carbs she can have a day. – C.C.

Your daughter has serious illnesses at a young age. The diets for her conditions are confusing.

She needs the guidance of a dietitian, who can instruct her on the ins and outs of a low-salt, low-cholesterol, diabetic diet. It will take her more than a few sessions to master this. You can go with her. A rough estimate of daily calories for one wanting to lose weight is 10 calories for each pound of desired weight. If your daughter should weigh 130, then she should be on a 1,300-calories-a-day diet.

Of those calories, 50 percent to 55 percent is carbohydrates – sugars, starches, things like pasta, bread, fruits, vegetables, grains and low-fat milk. Ten percent to 20 percent is protein – meat, poultry, dairy products and eggs. Thirty percent or less comes from fats – oils, shortenings and dairy products, like butter. You see dairy products under all three groups. Most foods are a mixture of all three.

Salt presents a problem because it’s spoken of as “sodium” or “sodium chloride.” We’re told to keep our total daily intake of sodium to 2,300 mg (5,700 mg of sodium chloride – salt). Some set the limit at 1,500 (3,750). Your daughter should not add salt to her food at the table or during cooking. Most of our salt comes from salt added to food during its processing, so she must look on labels. She should stay away from luncheon meats, most canned and dried soups, many frozen dinners and things like sauerkraut, pickles, potato chips and pretzels. The daily limit of cholesterol has been set at 300 mg.

READERS: For those who have asked so many questions about diverticulosis, the booklet on that common malady explains how it comes about, how to avoid it and how it’s treated. Readers can order a copy by writing: Dr. Donohue – No. 502, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I cannot keep my blood potassium under 7 without taking medicine. I understand my heart can stop because of this. I can no longer take the medicine. The doctor says there is no answer to this. I am healthy in all other respects. What will happen to me? – G.M.

Potassium keeps nerves firing, muscles contracting and the heart beating. Normal blood potassium lies between 3.5 and 5.

A level of 7 is on the threshold of big trouble. A reading of 7.5 constitutes grave danger.

Someone has to find out why your potassium is so high. Usually it’s a problem with the kidneys or the adrenal glands. If your current doctor has surrendered in trying to find an answer, see a nephrologist — a kidney specialist and a specialist in the control of potassium.

High potassium levels can impair the heart’s ability to generate a heartbeat. See the specialist soon in order to stay healthy.

DEAR DR. DONOHUE: I wonder if there is a connection between glaucoma and uric acid. I am faced with cataracts and glaucoma. My family doctor has me on uric acid medicine because my level is high. Could it be causing my eye problems?

More should be done about glaucoma. I have always said that the worst thing for me would be to go blind. – D.S.

An increase in blood uric acid leads to gout. Neither uric acid nor gout has anything to do with glaucoma or cataracts.

Glaucoma comes from a deterioration of the optic nerve, usually because fluid pressure in the eyeball has risen. Sight can be preserved by lowering the pressure, often only with eyedrops.

Cataracts are clouded eye lenses, something that comes with age. The clouded lens can be removed and replaced with a clear, artificial lens, which restores vision.

You shouldn’t go blind from either condition if they’re both treated.

DEAR DR. DONOHUE: Three years ago I had a hip replacement, and have lived in daily pain since the operation.

I have to use a cane even in my home. I have had six shots, chiropractic adjustments and pain patches, but none has given me relief from constant pain. My surgeon finds nothing wrong on X-rays. Any thoughts? – K.S.

The X-rays might be fine, but the hip isn’t. If your surgeon can’t give you an explanation, seek another orthopedic surgeon.

The pain has to be coming from something that’s not right. You shouldn’t have to live with it.

DEAR DR. DONOHUE: I have been taking the expensive drug Lipitor for nine years. When can I expect to see a generic Lipitor on the market? – G.L.

: The patent on Lipitor (atorvastatin) expires in 2010. Lipitor is one of the statin drugs, the widely prescribed medicines for the lowering of cholesterol.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from