Q: I feel misled by “whole grain” breads. I'm trying to eat foods with a low glycemic index, but I've noticed that many whole-grain slices have less than 3 grams of fiber per serving — about the same as some white breads. Should I just eat the white stuff? — Bert, Tucson, Ariz.


A: Checking that bread has 3 grams of fiber per slice is smart shopping, since fiber-filled foods often are lower in calories and they help you feel full. But it's not just fiber that counts for your health. The key is to avoid simple carbs that aren't related to fiber, which just turn to sugar very fast. So continue to avoid buying bread or any food made from “refined” flour. Whole grains deliver important health protectors beyond fiber:

♦People who eat more whole grains gain protective nutrients, including magnesium, and that helps you to stay healthy and your arteries to stay younger.

♦Whole grains are also cancer-fighting heroes: In an important recent study, people who ate the most whole grains had a 20 percent lower risk of colorectal cancer than those who ate the least (and it wasn't due to the grains' fiber content).

So keep your grains whole, and aim to get 25-35 grams of fiber a day. (Among other reasons, to keep your GI tract humming along.)

That said, when it comes to the glycemic index of breads, you probably know two things: Scientists don't know how each gram of fiber affects a food's glycemic index, so don't obsess over that; and what's on your bread greatly influences its glycemic index. Jam sends it soaring, while vegetables and a little walnut or olive oil or even avocado oil bring it down.

Q: When you gain weight, does it go to every part of your body — even your ears and forehead? — Kathy, New Berlin, Wis.


A: All of your fat cells get bigger when you gain weight. But you have many more of those cells in your genetic fat-gathering spots, which is why you develop a “muffin top” over your jeans rather than a flabby forehead. The layer of fat cells beneath your forehead skin or on your ears is pretty thin, so they don't get the inflatable-mattress effect. Your genetics, of course, also determine whether excess calories preferentially end up on your hips or in your omentum (belly).

Scientists think that by the time you're a teenager, you have all your fat cells. When you eat too many calories, the fat globules in those cells increase and the cells expand; cut back on calories, and the cells shrink.

A bad exception has been discovered recently: When you gain weight in your omentum (the fat between your abdominal organs), you actually manufacture more omental fat cells, and then preferentially add fat in your belly. That fat becomes metabolically active in a bad way — it causes inflammation in your arteries, decreases the actions of insulin and causes you to be hungrier (fat elsewhere does not have those bad effects). So even if your forehead won't get fatter, it's still smart to eat healthful food, enjoy it and do enough physical activity to see your six pack.

Q: I developed eczema two years ago, and it's driving me crazy. It's difficult to do normal tasks — not to mention exercise — since it's on the palms of my hands and the soles of my feet. I've been to a dermatologist and an allergist, but nothing they've done helps. Who else can I see? I refuse to believe I have to live with this the rest of my life. — Marta, Medford, Ore.


A: Eczema is really a type of allergic reaction. Hand eczema is the most common type, with interesting names like “dishpan hands” being given to women with this condition. Your description of hand and foot eczema is typical of a disease called “pompholyx” (say that three times fast!). No one knows what causes this, but stress may be a factor. Some people think that it is caused by eating trace elements such as nickel, cobalt and chromium, even if an allergist's patch test is negative for these.

According to New Jersey plastic surgeon Dr. Arthur Perry, people with pompholyx sweat more than twice the normal amount, and creative docs have actually injected Botox into hands and feet (ouch!) to decrease sweating.

You can try steroid creams or pills, avoidance of nickel-containing foods (canned foods, foods cooked in nickel-plated pots or with nickel-plated utensils, and asparagus, beans, mushrooms, onions and others). If it becomes debilitating, you might consider using methotrexate, and if life becomes intolerable, radiation therapy can be used.