Q: I have been reading about the advantages of a ketogenic diet to lose weight and control blood sugar. I tried this in the past. I lost fat and felt healthy, but I had horrible acetone-smelling breath. This was even mentioned in my student evaluations — not a good thing for a professor. Is there any way to avoid this?
A: A ketogenic diet gets very little of its energy from carbohydrates and most of it from fat. In this low-carb, high-fat plan, protein intake is moderate. Under these conditions, the body burns fat for energy and produces chemicals called ketones as a byproduct.
Such a diet helps with body-fat loss and improves metabolic markers such as HDL cholesterol and triglycerides. Acetone is one of the ketones your body makes, and it shows up in the breath when following a strict no-sugar, no-starch approach.
According to Dr. Eric Westman, a proponent of this diet, the acetone breath should eventually fade. Until it does, he suggests drinking plenty of water, brushing teeth (and tongue) regularly and chewing sugarless gum, mint leaves or cinnamon bark.
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Q: After my husband had a heart attack, he was prescribed simvastatin. It wasn’t long before I noticed a change in his cognitive function.
He loves to cook, but suddenly he had trouble following recipes and buying items he needed for meals. My husband was always the main cook for large family dinners, such as Thanksgiving and Christmas, but he forgot how to properly time the main course and side dishes.
Eventually, the dose was lowered, but he still suffered memory lapses and also developed diabetes. His doctor finally agreed to a hiatus from the statin. After three weeks off simvastatin, he is much, much better cognitively. How else can he keep his heart healthy?
A: Some people cannot tolerate statins because of muscle damage, serious blood-sugar elevations or other complications. Although the question of drug-induced forgetfulness remains controversial, the Food and Drug Administration warns that memory loss and cognitive impairment may be possible statin-related side effects (FDA, January 2014).
In such instances, people come up with other strategies to control cholesterol and reduce inflammation. Your husband should ask his doctor about other cholesterol-lowering drugs. He also could discuss nondrug approaches such as nuts, cinnamon, psyllium and magnesium.
Q: I have had terrible trouble with vaginal dryness. The Vagifem estrogen tablets my doctor prescribed cause yeast infections that I have been fighting off for nearly a year.
He then suggested I try coconut oil instead for the dryness. That works, but he did not mention that coconut oil is not compatible with latex condoms. I read that on your site. So what’s a girl to do? Does that mean no sex ever? I have herpes, so my partner must use a condom for protection.
A: Coconut or olive oil can be helpful as personal lubricants, but they should not be used with latex because they can make it deteriorate quickly. A polyurethane or natural-skin condom would be a safer choice than latex when using oil for vaginal dryness.
In their column, Joe and Teresa Graedon answer letters from readers. Write to them c/o King Features Syndicate, 300 W. 57th St., 15th floor, New York, NY 10019, or via their website: www.peoplespharmacy.org