When I go to the gym after work, I don't get home until 6 or 7. I begin work at 8:15am and have my lunch break at 11:15. Needless to say, I can't go without eating until that late. I have been eating an apple and two rice cakes on my way to the gym at 4, but my blood sugar gets really low after my aerobics class. A nutritionist has told me to stay away from dairy products and wheat, so choices are limited. Do you have any good low-fat suggestions? I am a 47-year-old teacher who needs to lose 20 pounds, as I am 5'4" and 149 lbs.

Uh ... no, I don't have any good low-fat suggestions. If your blood sugar gets low then you need snacks that don't stimulate insulin (which is of course the cause of low-blood-sugar swings). The foods that accomplish that are fats (hard to get as a low-fat food) and protein (which usually has a fair amount of fat attached). You could, I guess, chug down some pure protein powder available as health food/bodybuilding products. Otherwise you're stuck with some fat in the process. (Low fat usually means high carbohydrate, which is the source of the problem in the first place.)

It's a shame that so many dedicated, diet-conscious people have been affected by the low-fat campaign. I'm always surprised at how long it's survived, now that the overweight population in the eight years of the low-fat campaign has grown from 1 in 3 to an amazing 1 in 2. Fat intake has dropped in each of those years.

Before everyone goes nuts (pardon the pun), I'm not for all fats. Hydrogenated (and partially so), heated, rancid and artificially formed fats should be strictly avoided.

Great snacks to kill appetite and avoid blood-sugar swings are nuts and seeds (fresh). Since dairy is out for you (though yogurt and kefir are often tolerated by milk-sensitive people), you're left with eggs, meats (any type) and the snack bars that are now everywhere that have no more than 40 percent carbohydrates.

Consider such a snack (not a meal) before your workout, and right after, then see how your body responds.

Good health,
A.N. Spreen, M.D.