Exercise is key in keeping insulin levels normal

Q. Can certain foods help with hyperinsulinemia?

A. Your overall diet and lifestyle can have strong effects in reducing hyperinsulinemia, the term for elevated blood levels of insulin. This condition is known to precede the development of type 2 diabetes and seems to promote development of some types of cancer.

If you are overweight, losing as little as 7 percent to 10 percent of your initial weight can have a major impact on insulin levels.

Regular exercise also plays an important role. Some studies suggest that overweight people who are physically active may have more normal insulin levels than lean, inactive people.

Diet appears to be a contributing factor as well. A Western diet pattern -- typified by higher consumption of red and processed meat, refined grains, French fries and sweets -- has been linked with higher insulin levels, so you are wise to limit these foods.

Emerging research also suggests that a balanced plant-based diet that focuses on vegetables, fruits, whole grains, beans, fish and poultry may also help.

Q. I think that my food portions have gotten too large, but I'm having trouble getting back to "normal" portions. What do you suggest?

A. Good for you for addressing this! It's easy to lose perspective on what a "normal" portion is when excess is all around us. To start, you might try serving yourself a portion that is 25 percent smaller than usual; after you finish, use your internal hunger cues to decide if you truly need more.

Also, studies have shown that using smaller plates and bowls may help to readjust our perceptions. In addition, cooking smaller portions, leaving serving bowls off the table and packing up excess restaurant portions before you even start eating are all tips that work for some people.

Although the evidence is inconclusive that people actually eat less when they eat more slowly and away from distractions like television, these tactics may help you to savor your food more and make smaller amounts feel more satisfying.

Finally, don't let yourself get overly hungry. This can lead to overeating when you finally sit down to eat. In short, focus on how it feels to eat a portion that leaves you satisfied but not stuffed.

Q. Is it true that people who take blood thinner medicines aren't supposed to eat lettuce?

A. No, although there is a relationship between foods that contain vitamin K (like lettuce) and these medications.

To work, blood thinner medications decrease the effects of vitamin K, which is used in the production of substances that enhance blood clotting. If the medication is to work effectively, it is important that vitamin K in the diet stays fairly consistent. Although your doctor can adjust your level of medication to match your intake of vitamin K, it is imperative that patients keep their daily intake even.

If for example, a patient's medication is matched to a higher intake level and that patient eats vitamin K rich foods only sporadically, the medication level will be unsafe (too high) on days when these foods are not eaten. The major sources of vitamin K are the very dark leafy greens: kale; collard, mustard, beet and turnip greens; Swiss chard and spinach. Raw parsley, when eaten in larger amounts as a salad green (rather than sparingly as an herb), is also high in vitamin K. Lettuce is unlikely to cause problems as long as huge servings (more than three cups per day) aren't consumed.

People who like to eat these greens daily should discuss it with their doctors so that medication can be adjusted accordingly.