Is counting calories 'old-school' dieting?

DEAR DR. ROACH: I am a 68-year-old man, 5-feet-10-inches tall and weighing 223 pounds. Last January, my weight was up to 247, so I decided to diet and exercise in order to lose the excess. My goal is to get below 200.

In a recent visit to my physician, I told him that I was losing weight by restricting my total calories to 1,700 per day on a seven-day running average (so I can go out to eat once in a while). I am trying to keep my fats below 30 percent on a seven-day calorie basis, and I am trying to keep total carbs to 50 percent or so.

My physician told me that my diet plan was "old-school." He said that I should eliminate all sugars and all grains. I should eat a couple of ounces of meat and/or eggs. And I should eat as many fruits and vegetables as I want without worrying about calories.

In your opinion, should I follow his advice, or should I continue with what has been working for me? – J.B.

ANSWER: Your physician is right that counting calories is "old-school." However, if you can stay with it, it will work. If you expend more calories than you take in, you will lose weight. That is the energy balance equation, and there are no exceptions.

However, the issue isn't so straightforward as you might think from that statement. Fat and protein make almost everybody feel more full and satisfied, comparing meals of the same calories, than a high-carbohydrate meal. Plain, fresh fruits and vegetables, absent of dips or sauces that load on the calories, are low in calories, in most cases, and can be eaten in relatively large amounts without slowing weight loss much.

I also agree with your physician that simple sugars and processed grains add calories without a lot of real nutrition and don't fill you up much (and may even make you hungrier later). I don't think all grains need to be avoided: The fiber present in whole grains also improves satiety, and I recommend that all grains be whole grains. However, some people find that eliminating grain entirely helps them.

By all means, you can stick with what works for you. That being said, most people find that by adding a little healthy protein and fat, you can stick with your eating plan with less hunger or discomfort. Losing weight can make people feel a little uncomfortable. But I think you will find that the eating plan he outlined, while still keeping an eye on calories, will allow you to reach your weight goals and keep you on track while still feeling well.

DEAR DR. ROACH: Can you place plastics in the dishwasher? I have read that dangerous chemicals can be released from the plastic. – R.E.

ANSWER: Most plastics are safe, but you should put only plastics labeled "dishwasher safe" in the dishwasher, and placing on the top rack reduces the heat the plastic is subjected to. Never reuse any plastic that has been partially melted by dishwasher or microwave.

DEAR DR. ROACH: All of us look forward to eating. However, in my case (age 79) it has become a chore. Whether it is breakfast, lunch, dinner or a few snacks, after the first few bites I have to blow my nose. This goes on throughout the eating period, and at the end, my handkerchief is soaked. At breakfast time, after eating, I proceed to sneeze five to 10 times, most of the time. I have become a recluse. I turn down invitations to dinners at homes and restaurants, as it has become an embarrassment.

I have taken Toprol and Timoptic in the past 20 years, but this condition has occurred only in the past four or five years, so I don't think it's the drugs. During the day, I am fine with no sneezing and blowing my nose, except maybe once or twice. But when mealtime comes, out comes the handkerchief for another onslaught. Have you heard of this condition? Should I consult a specialist about it? – D.Z.

ANSWER: I have heard about it, many times, as it is much more common than you might think. It goes by the name of "gustatory rhinitis" (which simply means that your nose gets inflamed when eating). It is classified as a non-allergic rhinitis. It is more common in the elderly, though it can happen at any age.

Your regular doctor should be able to help you. If non-medication treatments like nasal saline irrigation haven't helped, then I usually prescribe ipratropium bromide nasal spray before eating.

DEAR DR. ROACH: I recently read your Q&A "Blood donation can affect athletic output." Your answer is correct, but you missed a key opportunity to educate your readers.

There is an alternative for this man: Instead of donating whole blood, he can ask his local Red Cross about donating via apheresis (as I do). The apheresis process requires more time (up to two hours) and attaches the donor to a centrifuge machine, which separates the donor's whole blood into red cells, plasma and platelets. Each of those blood products is then either bagged for collection (if needed at that time by the Red Cross) or returned to the donor's bloodstream (if not). The donor always retains the right to specify which blood products may or may not be drawn, so your reader can always say, "I prefer not to donate reds today, but feel free to draw plasma and platelets," if he knows he has a challenging athletic event coming up.

In my case, I usually donate platelets and plasma about every six weeks via apheresis, but normally not red cells. One advantage of not donating reds is that a donor can return to donate plasma and platelets more frequently. During my most recent donation, my nurse mentioned that there was a serious shortage of platelets but that the supply of red blood cells was fine, so she had been instructed to NOT draw reds from any donor if that donor was able to schedule another donation of platelets in the next few weeks. – M.M.

ANSWER: Thank you for the important information.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected]. To view and order health pamphlets, visit rbmamall.com, or write to Good Health, 628 Virginia Drive, Orlando, FL 32803. (c) 2016 North America Synd., Inc. All Rights Reserved