Dear Dr. Roach: I have a friend who lost weight on a diet designed to speed up metabolism. It seems very complicated and restrictive, and counters a lot of things I always thought to be true about weight loss, including the importance of 鈥渃alories in/calories out.鈥� Is there any research to support this diet, and do you think it is a realistic lifestyle to maintain?
L.B.
I looked through the information on these types of diets, and I found a mixture of advice. Some of it is very good, and some contradicts the best knowledge on weight loss.
Starvation diets are problematic. The body can adapt to starvation by increasing its efficiency, holding on to every calorie. People who have had a lot of weight loss have been found to have this kind of slower metabolism, and that makes regaining the weight very easy. On the other hand, a few people do well losing weight with intermittent fasting. This underscores that what works poorly for some people is absolutely helpful for others.
A recent large study showed that both lower-fat diets and lower-carbohydrate diets are effective in helping people lose weight, when people avoid some of the most dangerous foods: simple sugars and refined grains. By choosing healthier foods and avoiding unhealthy ones, most people lost weight without counting calories.
There is no good evidence that certain foods 鈥渟peed up鈥� the metabolism to make losing weight easier, at least none that are both safe and effective.
Dear Dr. Roach: I am finally getting the courage to write to you. I am 73 years old and just found out that I have herpes. How can I have herpes when it has been at least 10 years since I last had sex? I am one of those 鈥渇ine community leaders.鈥�
Anon.
Genital herpes infections may be caused by two viruses: herpes simplex viruses 1 and 2. In recent years, HSV-1 increasingly has been the cause of genital herpes in younger people. However, most cases of recurrent genital herpes are caused by HSV-2.
Once someone has acquired genital herpes, the virus is with the person for life. Not everyone with genital herpes has symptoms. It is possible that the person you acquired the infection from 10 or more years ago was unaware of being infected. People can shed the virus without any symptoms, but are more likely to be infectious when they have symptoms. Recurrences can be treated with antiviral drugs, and people with frequent outbreaks benefit from taking preventive medication.
Sometimes people can jump to the wrong conc lusion. For example, if you happened to have had a sexual partner a month before you noticed symptoms of herpes, you would be likely to suspect that partner of being the source. In fact, it may have been from an exposure in the distant past. This situation has led to difficulties in many relationships, including marriages.
Having genital herpes does not make you any less of a fine person and does not disqualify you from being a community leader. Many people needlessly feel embarrassment or shame about a diagnosis of herpes. You can find support group information, as well as much more information about herpes, at www.ashastd.org.
A person who knows he or she has genital herpes should tell any future partners about the diagnosis, use a condom for sex every time and avoid sex during times of symptoms.
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].
