DEAR DR. BLONZ: I would like an explanation of the connection between Type 2 diabetes and obesity. After annual tests, I was told that I was a borderline diabetic. I am only slightly overweight, nothing serious at this point, but I certainly have no interest in going any further down this road. -- F.S., San Francisco

DEAR F.S.: A basic understanding of the relationship between what we eat, our blood sugar level, insulin, diabetes and body weight will serve us well. Digestion involves enzymes acting on foods to break them down into absorbable pieces. In the case of carbohydrates, it means breaking the complex carbohydrate down into its building blocks, which are primarily glucose, as a prelude to absorption. (There is no delay for carbs already in the form of glucose, sucrose or fructose.)

Once absorbed, glucose is often referred to as "blood glucose" or "blood sugar." It serves as a source of energy, but needs to get inside the cells to do its work. To gain entry, glucose requires insulin, a hormone produced and released by the pancreas in response to a rising blood glucose level. Any excess glucose will be changed into fat, the body's most concentrated form of energy, and be put away in storage in the body's fat cells.

Diabetes is present when there's insufficient insulin to get the glucose out of the bloodstream and into the cells. Type 1 diabetes is when the pancreas is unable to produce the insulin. In such cases, replacement insulin needs to be provided, usually by injection.

More common is Type 2 diabetes, which occurs when the pancreas is still able to produce and release insulin, but is unable to keep up with the demand and the blood glucose levels remain elevated. Treatments in such cases can include diet and lifestyle adjustments, or medications to stimulate the pancreas to release more insulin. Type 2 diabetes used to be known as "adult onset" diabetes because it was only seen in adults. With the increasing prevalence of childhood obesity, we now see cases of Type 2 diabetes in children.

The connection with obesity relates to the fact that, as a person gains weight, his or her fat cells increase in size. Scientists have learned that enlarged fat cells are associated with a decreased sensitivity to insulin. This "insulin resistance" means that the body needs more insulin to clear the same amount of glucose out of the bloodstream. The obesity, in essence, overworks the pancreas and eventually it is unable to keep up. Between 80 and 90 percent of those with Type 2 diabetes are obese. This also helps explain why those with Type 2 diabetes often experience dramatic improvements when they lose a few of their excess pounds.

As there can be short- and long-term complications when one's blood glucose remains elevated, the goal with any diabetic condition is to keep the glucose level within normal limits. This can be done with diet, exercise and medication, including insulin. The diet aspect involves the avoidance of eating in a way that brings about a rapid rise in your blood glucose level. Along with this goes regular blood glucose monitoring.

You appear to be at a point where monitoring and lifestyle changes can have a positive impact on your future wellbeing. I encourage you to speak with your family physician and a registered dietitian, who can help you map out strategies for weight control and food selection. It may also help to contact your local chapter of the American Diabetes Association. To find a chapter in your area, check diabetes.org.

Send questions to: "On Nutrition," Ed Blonz, c/o Universal Uclick, 1130 Walnut St., Kansas City, MO, 64106. Send email inquiries to questions@blonz.com. Due to the volume of mail, personal replies cannot be provided.

DEAR DR. BLONZ: I am interested in adding more fiber to my cereal and thought bran flakes would be a good choice -- a key reason being the economy of them when purchased in large quantities. We now add the bran to cereal and baked goods, and even to gravies. Do you see any problems here? Also, how many grams of fiber are in one tablespoon of bran? -- F.S., via email

DEAR F.S.: Fiber comes as part of the package with whole plant foods, but bran is an excellent way of adding fiber to any diet. There are other options, as well. I have been adding hemp hearts to my morning cereal, enjoying the nutty taste it adds to the meal. One issue with purchasing bran in large quantities is that it contains vitamins and essential oils. This means it should be stored in airtight containers and kept in a cool place.

With any addition of fiber, start out slowly. Don't add too much too soon, or you risk irritating your system -- a development that will reveal itself with cramps, bloating and increased gas. You are also advised to have sufficient intake of fluids at any meal where bran has been added.

Regarding your measurement question, a tablespoon is a unit of volume, and grams are units of weight. Different types of brans have different weights per unit volume, so the grams in a tablespoon will depend on the type of bran you have. One tablespoon of wheat bran weighs 3.6 grams; one tablespoon of corn bran weighs 4.8 grams; one tablespoon of oat bran weighs 5.9 grams; and one tablespoon of rice bran will weigh 7.4 grams.

DEAR DR. BLONZ: What are the main differences between regular table salt and salt substitutes? -- M.Q., St. Louis

DEAR M.Q.: Table salt, whether plain or iodized, is made from sodium chloride. There also may be very small amounts of compounds to help prevent the salt from caking. There are a variety of salt substitutes made up of combinations of a number of compounds; the only thing they share is that they're designed to serve as a culinary substitute for table salt. Some salt substitutes contain lesser amounts of sodium chloride mixed with powdery fillers, such as maltodextrin. Others rely exclusively on herbs and spices.

One of the first salt substitutes was based on potassium chloride, a compound that has a "salty" flavor, but unlike sodium chloride, it has a slightly bitter and metallic taste. Newer brands have been formulated to eliminate that bad taste. Potassium chloride, however, should be used with caution, especially by those having kidney problems, or by those taking diuretic medications that prevent potassium from being eliminated through the urine.

Send questions to: "On Nutrition," Ed Blonz, c/o Universal Uclick, 1130 Walnut St., Kansas City, MO, 64106. Send email inquiries to questions@blonz.com. Due to the volume of mail, personal replies cannot be provided.

Dear Dr. Blonz, I have a couple of questions about cheese. You have said positive things about cheese in the past, but could you please explain why cheese is good for you? The reason I'm asking is because my husband has a tendency to have high cholesterol, and I try to watch his diet. We have started eating tofu cheese, because it has calcium, but it has no fat or cholesterol. Do you think this is OK? Or are we missing out on some important nutrients by not eating regular cheese? Thanks. F.J., Amarillo, Texas

Dear F.J., There is an amazing variety of cheese available today that can lend flavors, textures and tastes to compliment meals. Couple this with an assortment of nutrients: A one-ounce serving (approximately a one-inch cube) of most types of cheese provides about 25 percent of the daily value for calcium, and also contains phosphorous, vitamin A, B12 and riboflavin. There can be variance among the different types of cheese, so be sure to check the label to verify the nutritional contents of the variety you are considering. Those with lactose intolerance might think they need to stay away from cheese because it is a milk product, but most lactose gets removed along with the liquid whey as the cheese is being made.

As with any calorie-dense food, there is no question that cheese can contribute to high cholesterol or other aspect of poor health if you overdo it or if the background diet to which the cheese is being added is already poor. It is the balance and variety that we eat that gives the body what it needs to remain in good health. Add cheese to a pastry-for-breakfast, fast-food-for-lunch, limited fruit, vegetable and fiber diet, and you are asking for trouble. (You should definitely keep your husband off that road!) But if a variety of wholesome foods with plentiful greens, grains, fruits and fiber make a regular appearance on your plate, cheese becomes a food you can definitely enjoy.

As for tofu cheese, it is true that tofu does not contain cholesterol, but you cannot assume that a cheese made from tofu will be fat free unless it is specially made that way. Anywhere from 30 percent to 55 percent of the calories in traditional tofu will come from fat. Also, soy is not a good source of calcium, but tofu is often made using a calcium salt. You will need to check the label to determine the level of fat and calcium in any particular tofu cheese you would choose.

Send questions to: "On Nutrition," Ed Blonz, c/o Universal Uclick, 1130 Walnut St., Kansas City, MO, 64106. Send email inquiries to questions@blonz.com. Due to the volume of mail, personal replies cannot be provided.