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Living Well : Nutrition

All About Fruit

It's delicious, it's nutritious, and it can play a role in every meal

FRUIT: ESSENTIAL TO ANY DIET

Fruit is an important part of a healthy and balanced diet. Fruit comes in many forms—it can be fresh, canned, frozen, or dried, whole, sliced, or puréed. Fruit is naturally low in calories, sodium, and fat. Fruit is also a good source of fiber, carbohydrates, potassium, and vitamins A and C.

Most people do not eat enough fruit. If you do not eat enough fruit, your body may not get the vitamins and fiber it needs. Adults are recommended to eat 1½ to 2 cups of fruit each day. A ½ cup of dried fruit is equal to a full cup of fresh fruit.

Fruit can also help fill you up. Whole fruit, such as an apple, will leave you feeling fuller than puréed fruit, like applesauce, or fruit juice. Eating fruit at the start of a meal has been shown to help people eat fewer calories.

FRUIT FOR EVERY MEAL

  • Breakfast. Breakfast can be your first chance to have some fruit in your day. If you have cereal for breakfast, add some fresh fruit instead of sugar. Strawberries, blueberries, bananas, and grapes are smart choices that do not take a lot of time to prepare. You can buy frozen berries when fresh ones are out of season. If you are in a rush, you can take the fruit with you. Try to keep fresh oranges, bananas, apples, peaches, or pears available to "grab and go"—it’s an easy way to have fruit for breakfast or for a snack
  • Lunch. Try to include fresh or canned fruit in your lunch. If you pack your lunch, it’s easy to include a piece of fruit or a fruit salad as a dessert. If you eat out, it is still possible to have some fruit. Many restaurants now offer fresh fruit as an appetizer or for dessert
  • Snacks. Fruit can make a terrific snack. Fruit like apples and oranges can be tossed into a purse, briefcase, or backpack in the morning for when you’re hungry. If you don't have fresh fruit available for a snack, canned fruit is fine, but watch out for heavy syrup and added sugars in canned fruit. Dried fruit is tasty and can be a great option if fresh fruit is not available. Dried fruit is also easy to store in your office or home because it does not need to be kept in a refrigerator
  • Dinner. Dinner is a good time to review how much fruit you have eaten during the day. If you missed a serving, try fitting some into your evening meal. A chopped apple, pear, berries, or raisins can be nice toppings for a salad. Try adding dried fruit (like raisins or dried cranberries) to cooked greens (like spinach) or rice and grain dishes, or serve fruit or a fruit salad for dessert. Poaching or baking fruit can make a dessert special, with very few added calories!

CHOOSING FRUIT

In most parts of the country, some fruits are seasonal so you may have to choose from different varieties. Variety can be important because different fruits provide different amounts of important vitamins and nutrients. The following tips may be helpful when choosing fruit:

  • Choose a variety of fruits each day
  • Eat citrus fruits, melons, and berries regularly—these are rich in vitamin C
  • Eat fresh fruits as often as you can. Try to avoid fruits that are canned or frozen in heavy syrups and sweetened fruit juices
  • Choose fresh fruit instead of juice whenever possible. Fresh fruit has fewer calories and more fiber than juice
  • Drink juices that are 100% fruit juice and do not have a lot of added water and sugars

FRUIT JUICES VS FRUIT DRINKS AND SMOOTHIES

It is important to know the difference between fruit juice and a fruit drink. Many fruit drinks are mostly water, sugar, artificial colors, and artificial flavors. Some fruit drinks have added vitamin C and may include some real fruit juice, but usually in small amounts. It is important to read the label.

How can you ensure you are choosing juice and not a juice drink? Look at the label first: anything called "drink," "beverage," or "cocktail," is not 100% fruit juice. Punches may contain no fruit at all!

Smoothies can be a delicious way to get fruit in your diet, but many have added sugars. Look for smoothies made with whole fruit. You can make healthful smoothies at home. Search the internet for some low-calorie smoothie ideas or experiment and create your own by mixing different fruits with low-fat yogurt.

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INDICATION

Qsymia® should be used together with a reduced-calorie diet and increased physical activity for chronic weight management in adults with an initial body mass index (BMI) of:

  • 30 kg/m2 or greater (obese) or
  • 27 kg/m2 or greater (overweight) in the presence of at least one weight-related medical condition such as high blood pressure, type 2 diabetes, or high cholesterol

Limitations of Use:

  • It is not known if Qsymia changes your risk of heart problems or stroke or of death due to heart problems or stroke
  • It is not known if Qsymia is safe and effective when taken with other prescription, over-the-counter, or herbal weight loss products

It is not known if Qsymia is safe and effective in children under 18 years old

IMPORTANT SAFETY INFORMATION

Do not take Qsymia if you are pregnant, planning to become pregnant, or become pregnant during Qsymia treatment; have glaucoma; have thyroid problems (hyperthyroidism); are taking certain medicines called monoamine oxidase inhibitors (MAOIs) or have taken MAOIs in the past 14 days; are allergic to topiramate, sympathomimetic amines such as phentermine, or any of the ingredients in Qsymia. See the end of the Medication Guide for a complete list of ingredients in Qsymia.

Qsymia can cause serious side effects, including:

Birth defects (cleft lip/cleft palate). If you take Qsymia during pregnancy, your baby has a higher risk for birth defects called cleft lip and cleft palate. These defects can begin early in pregnancy, even before you know you are pregnant. Women who are pregnant must not take Qsymia. Women who can become pregnant should have a negative pregnancy test before taking Qsymia and every month while taking Qsymia and use effective birth control (contraception) consistently while taking Qsymia. Talk to your healthcare provider about how to prevent pregnancy. If you become pregnant while taking Qsymia, stop taking Qsymia immediately, and tell your healthcare provider right away. Healthcare providers and patients should report all cases of pregnancy to FDA MedWatch at 1-800-FDA-1088, and the Qsymia Pregnancy Surveillance Program at 1-888-998-4887.

Increases in heart rate. Qsymia can increase your heart rate at rest. Your healthcare provider should check your heart rate while you take Qsymia. Tell your healthcare provider if you experience, while at rest, a racing or pounding feeling in your chest lasting several minutes when taking Qsymia.

Suicidal thoughts or actions. Topiramate, an ingredient in Qsymia, may cause you to have suicidal thoughts or actions. Call your healthcare provider right away if you have any of these symptoms, especially if they are new, worse, or worry you: thoughts about suicide or dying; attempts to commit suicide; new or worse depression; new or worse anxiety; feeling agitated or restless; panic attacks; trouble sleeping (insomnia); new or worse irritability; acting aggressive, being angry, or violent; acting on dangerous impulses; an extreme increase in activity or talking (mania); other unusual changes in behavior or mood.

Serious eye problems, which include any sudden decrease in vision, with or without eye pain and redness or a blockage of fluid in the eye causing increased pressure in the eye (secondary angle closure glaucoma). These problems can lead to permanent vision loss if not treated. Tell your healthcare provider right away if you have any new eye symptoms.

Possible side effects of Qsymia include:

Mood changes and trouble sleeping. Qsymia may cause depression or mood problems, and trouble sleeping. Tell your healthcare provider if symptoms occur.

Concentration, memory, and speech difficulties. Qsymia may affect how you think and cause confusion, problems with concentration, attention, memory or speech. Tell your healthcare provider if symptoms occur.

Increases of acid in bloodstream (metabolic acidosis). If left untreated, metabolic acidosis can cause brittle or soft bones (osteoporosis, osteomalacia, osteopenia), kidney stones, can slow the rate of growth in children, and may possibly harm your baby if you are pregnant. Metabolic acidosis can happen with or without symptoms. Sometimes people with metabolic acidosis will: feel tired, not feel hungry (loss of appetite), feel changes in heartbeat, or have trouble thinking clearly. Your healthcare provider should do a blood test to measure the level of acid in your blood before and during your treatment with Qsymia.

Low blood sugar (hypoglycemia) in people with type 2 diabetes mellitus who also take medicines used to treat type 2 diabetes mellitus. Weight loss can cause low blood sugar in people with type 2 diabetes mellitus who also take medicines used to treat type 2 diabetes mellitus (such as insulin or sulfonylureas). You should check your blood sugar before you start taking Qsymia and while you take Qsymia.

High blood pressure medicines. If you are taking medicines for your blood pressure, your doctor may need to adjust these medicines while taking Qsymia.

Central Nervous System (CNS) side effects. The use of prescription sleep aids, anxiety medicines, or drinking alcohol with Qsymia may cause an increase in CNS symptoms such as dizziness and light-headedness. Do not drink alcohol with Qsymia.

Possible seizures if you stop taking Qsymia too fast. Seizures may happen in people who may or may not have had seizures in the past if you stop Qsymia too fast. Your healthcare provider will tell you how to stop taking Qsymia slowly.

Kidney stones. Drink plenty of fluids when taking Qsymia to help decrease your chances of getting kidney stones. If you get severe side or back pain, and/or blood in your urine, call your healthcare provider.

Decreased sweating and increased body temperature (fever). People should be watched for signs of decreased sweating and fever, especially in hot temperatures. Some people may need to be hospitalized for this condition.

Common side effects of Qsymia include:

Numbness or tingling in the hands, arms, feet, or face (paraesthesia); dizziness; changes in the way foods taste or loss of taste (dysgeusia); trouble sleeping (insomnia); constipation; and dry mouth.

Tell your healthcare provider if you have any side effect that bothers you or does not go away. These are not all of the possible side effects of Qsymia. For more information, ask your healthcare provider or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to VIVUS, Inc. at 1-888-998-4887 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Please read the Qsymia Medication Guide and Full Prescribing Information.

The Q and Me Patient Resources and Education site is based on the LEARN® Program provided under copyright license (September 15, 2010). All rights reserved.

IMPORTANT SAFETY INFORMATION

Do not take Qsymia if you are pregnant, planning to become pregnant, or become pregnant during Qsymia treatment; have glaucoma; have thyroid problems (hyperthyroidism); are taking certain medicines called monoamine oxidase inhibitors (MAOIs) or have taken MAOIs in the past 14 days; are allergic to topiramate, sympathomimetic amines such as phentermine, or any of the ingredients in Qsymia. See the end of the Medication Guide for a complete list of ingredients in Qsymia.

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