Healthy Eating

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Food aversions and nutrition

Dear Reader,

Being a picky eater is one thing, but having such strong aversions to certain foods that you gag violently is quite another. You’re right to associate symptoms such as ongoing lethargy with an unbalanced diet, and it sounds as though the difficulties you experience when trying to eat certain foods may be preventing you from meeting your most essential nutritional needs, including calories for energy. Good news — studies show that treatment for individuals who experience similar aversions to a wide variety of foods is highly effective, so keep at it!

Parents and babysitters will attest to the fact that picky eating is very common among children and adolescents. However, highly selective eating behaviors that begin in or last through adulthood are much less prevalent. Fortunately, treatment works; in a study with individuals whose diets were composed of six foods or less, phasing new foods into the diet with an emphasis on trying new foods, not eating large quantities of them, was effective. All study participants who accepted treatment were able to incrementally diversify their diet.

One of the principal consequences of eating an unbalanced diet low in nutrients is becoming underweight. Being underweight may cause a variety of short- and long-term health consequences, including fatigue (as you mention), weakened immune system, fragile bones and osteoporosis, anemia, and for women, interrupted periods and fertility issues. One of the best ways to prevent becoming underweight is to maintain a healthy diet. For a thorough summary of what a balanced diet looks like, check out the Get Balanced Guide to Healthier Eating. Looking over the Guide will help you set goals and give you ideas about new foods you may be willing to try, such as delicious and nutritious fruits and vegetables. While maximized for students at Columbia, the key ideas in the guide can work for anyone and there are additional resources listed.

Seems like your current diet is high in carbohydrates, which may give you a short blast of energy but fade away rather quickly. Have you considered trying other foods of various textures that can help sustain your energy, such as fruit smoothies, nuts, yogurt, and berries? Alternatively, consider recombining ingredients in your existing diet — for example, you might try putting some cheese with tomato sauce on your pasta (almost the same as pizza). Experimentation within the range of your “safe foods” list may help you become more open to trying new foods. Once you’re ready to try new foods, take small tastes and evaluate what you like and don’t like about the food. You won’t necessarily like every new food you try, and that’s okay — it’s all about being open to experimentation.

In addition to simply disliking the texture of certain foods, there may be emotional factors that are preventing you from eating a well-balanced diet. In fact, clinical trials show that gagging, vomiting, and retching when exposed to a new food is often stress-related. Meditating, using breathing exercises, and experimenting with other relaxation techniques is highly effective. Seeking treatment from a professional may also be helpful. Columbia students are encouraged to contact Counseling and Psychological Services (Morningside Campus) or Mental Health Services (CUMC Campus) for support.

By slowly incorporating different foods into your diet, you will be on the right path to achieving a healthy weight. For additional input, consider reaching out to a dietician. Columbia students may schedule an appointment with a nutritionist through Medical Services (Morningside) or Student Health (CUMC) and should also check out Alice! Health Promotion Nutrition Initiatives. If you are not a student at Columbia, check with your campus health service or primary care provider for a referral.

The long term health benefits of working to overcome food aversions are well worth it; those who undergo treatment often report enjoying eating more, being less anxious about social situations involving eating, and increased self-confidence both at and beyond the table. Bon appétit!

Alice

I don't get hungry. When should I eat?

Dear Reader,

Although you describe your appetite as being low, the fact that you love food makes your problem much easier to manage. It sounds like you’re losing track of your eating schedule now that you’re on your own, but there are lots of ways to work around this, especially because you like to cook and eat! Establishing healthy habits takes time and effort, but practice makes perfect, and soon enough you’ll get into the swing of a healthy routine. Planning your meals in advance, incorporating food into your daily activities, and sticking to a schedule will all help you get there.

A widely accepted general rule is to not eat if you’re not hungry. However, not eating all day isn’t a particularly healthy pattern— consuming too little food throughout the course of the day may result in shakiness, tiredness, and general mental cloudiness as well as nutritional deficiencies and immune system weakness. The first step: Incorporating a healthy breakfast into your morning routine can help get your metabolism going early in the day, which can help boost appetite later on, helping you remember to eat. Although you may not feel hungry first thing in the morning, consider energizing your body with complex carbohydrates — try whole-grain cereals with milk, whole-wheat toast with peanut butter, or yogurt with nuts and fruit. For more information on other specific meal and snack options, check out the get balanced! Guide for Healthier Eating.

Once you’ve had your breakfast, you have a solid nutritional base to build off of for the rest of the day. Try sticking to a schedule by eating at approximately the same times every day, whether you choose to eat three large or six small meals per day. Spread your meals apart, and set alarms if needed. When mealtime arrives, make sure to focus on your food, and avoid eating on the go or while watching a movie. Mindfulness will help you get into a routine.

In addition to eating at regular times, try keeping a food journal to analyze your habits. Write down what and when you eat, and after a few days, check your journal for patterns. You might find, for example, that you tend to reach for sweet snacks around 3:00 p.m. for an afternoon pick-me-up. Adjust your food choices and eating schedule according to your observations.

More ideas: Choose a library or workspace that has vending machines with healthy options so you’re reminded to eat, or make a commitment to have lunch with a colleague, classmate, or friend, which will help to incorporate healthy eating into your professional, academic, and social engagements. Always make sure to have healthy snacks on hand so you aren’t forced to make poor nutritional choices under pressure. Nutritious and yummy snack options include string cheese and dried fruit, almonds and low-fat cottage cheese or yogurt, or multigrain crackers with sliced turkey, hummus, or a hard-boiled egg. Prepare your healthy snacks and meals at night so you don’t forget to bring food along with you in the morning.

More generally, have you ever investigated the possible reasons for your lifelong low appetite? Lack or loss of appetite is sometimes indicative of various medical and psychological conditions, so it would be helpful to make an appointment with your healthcare provider to discuss your concerns. Individuals experiencing sudden loss of appetite should meet with a healthcare provider as soon as possible. Columbia students can use Open Communicator or call 212-854-7426 to make an appointment with a healthcare provider on the Morningside Campus or dial 212-305-3400 to book over the phone with Student Health on the Medical Center Campus. Columbia community members are also encouraged to take a look at the Alice! Health Promotion Nutrition Initiatives.

Most importantly, be patient with yourself. Don’t try to make too many changes at once; slowly incorporating these ideas into your day will help you get on track without getting burned out or frustrated. If you slip up every now and then, don’t beat yourself up. Instead, ask yourself what caused you to forget to under- or overeat, and consider ways to adapt and prevent this from happening again. Bon appétit!

Alice

Am I too nuts for nuts?

Dear Reader,

A few things to consider: First, do the nuts and nut butters you’re eating have added salt or sugars? If so, you may want to look at your overall sodium and sugar intake. You can have “toChoose my plate recommendations.o much of a good thing” when it comes to salt and sugar. Second, how’s the rest of your diet? Are you eating lots of vegetables (don’t forget your greens)? What about whole grains and fruits? While the calories in nuts can meet your body’s energy needs and provide protein, fiber, and some vitamins, there are additional nutrients, vitamins, carbohydrates, and sugars that can only be found in vegetables, fruits, starches, and other protein sources. So, dear reader, depending on your answers to the questions above, the amount of nuts you consume may or may not help you achieve a balanced diet. If you're not sure what a balanced diet looks like, head on over to ChooseMyPlate.gov for more information.

Nuts provide a lot of nutritional benefits, not to mention convenience in the form of a quick and tasty snack. As you might already know, nuts are mostly made up of vegetable protein and unsaturated fat, as well as dietary fiber, vitamins, and minerals. Studies have shown that eating nuts lowers the risks of coronary disease and cardiac death, and reduces serum cholesterol levels and risk of type-2 diabetes in women.

Some may worry that too many nuts will contribute to weight gain, but that doesn’t sound like an issue for you.  Weight gain is a result of calories in versus calories out. While nuts are a calorie-dense food, if the remainder of your diet is mostly low-calorie fruits and vegetables, whole grains, and some lean protein source, you probably aren’t eating more calories than you burn. The amount of calories you need is dependent on a number of factors, physical activity levels included. Eating nuts is even potentially protective against weight gain, as nuts can increase feelings of fullness and replace calories that would be consumed in other foods, leading to smaller and less frequent meals. Further, the number on the scale doesn’t necessarily indicate the health of a person. If you feel good, are living an active lifestyle, and consuming a balanced diet, your nutty obsession should be just fine.

If you are a Columbia student, there are lots of ways to find out more about achieving a balanced diet. Check out Columbia’s get balanced! Guide for Healthier Eating which features information especially for CU students. You can also make an appointment with a Registered Dietician on both the Morningside or CUMC campuses.

Enjoy and happy snacking!

Alice

What can I do with egg yolks?

Dear Reader,

What an egg-cellent question! Not only can egg yolks be used for recipes and DIY-beauty products, but also eggs are a healthy component of a balanced diet, as both the yolks and whites are rich sources of nutrients. Egg whites contain 4 grams of protein, only 17 calories, and almost no fat. While egg yolks actually contain more than 90 percent of the calcium, iron, zinc, folate, and Vitamins B6, B12, A, E, D, and K found in eggs, you’re correct that they can also be an unhealthy source of cholesterol

In fact, the American Heart Association recommends that Americans eat less than 300 milligrams (mg) of cholesterol per day, but just one egg yolk has about 185 mg of cholesterol. One recent study even suggests that for people already at risk for heat disease, eating three or more egg yolks per week could be as damaging to arteries as smoking. Other research finds that eating eggs in moderation does not negatively affect cholesterol levels in healthy individuals. Check out the Alice! Health Promotion Nutrition Initiatives for more information about integrating eggs into a healthy diet.

If you do find yourself with extra yolks, you can use them to make custard, crème brûlée, aioli, Hollandaise Sauce, and more. For recipes, just do a quick Internet search for “egg yolk recipes.” Yolks can be saved for later by refrigerating them for three to four days or, for longer-term storage, freezing them in ice cube trays mixed with a pinch of salt or sugar. And for those who should avoid eating egg yolks altogether, there’s a sunny side — you can use egg yolks to create DIY hair treatments. Some people swear by egg yolks as treatments for split ends, dull or dry locks, and for strengthening weak strands. Again, a quick Internet search for “egg yolk hair treatments” will provide more than enough recipes to get you started.

Hope this was egg-ducational,

Alice

It's Greek (yogurt) to me!

Dear It’s Greek to me,

Greek, or strained, yogurt seems to be making all the top healthy food lists and taking up ever more space on the grocery store shelves lately. It’s great that you’re skeptical of what could feel like a healthy food fad. While yogurt is generally considered to be a healthy food and can be part of a healthful diet, Greek yogurt does have an edge over the regular stuff.

Greek yogurt differs from normal yogurt in that liquid whey is strained out of the yogurt to give it a tangier taste and richer, creamier texture. But how different is Greek yogurt from regular yogurt? Not so different, it turns out. In fact, Greek yogurt can actually be made from regular yogurt — all that is involved is placing regular yogurt on a cheese cloth and letting some of the liquid whey drain out into a container below it. Greek yogurt has a similar nutritional profile as regular yogurt in terms of being a good source of protein, calcium, phosphorus, riboflavin (vitamin B2), thiamin (vitamin B1), and vitamin B12, as well as of folate, niacin, magnesium and zinc. Any type of yogurt that contains probiotics (live bacterial cultures) is associated with a number of possible health benefits, such as aiding digestion, having antidiarrheal properties, combatting carcinogens, regulating gut environment, alleviating irritable bowel syndrome, and boosting immune response. 

So from where does Greek yogurt’s slight edge over regular yogurt originate? Greek yogurt has a higher protein and lower complex carbohydrate content than normal yogurt, as the process of making Greek yogurt allows some of the sugars in the yogurt to be strained out in the whey-containing liquid. However, check the label on what you bought — some varieties have added sweeteners, resulting in higher sugar levels. Also, keep the fat content in mind. Though many non-fat varieties of Greek yogurt are now available, fuller fat varieties can pack in the saturated fat.  

If you like the taste and texture, then consider buying it again next week. The consumption of high protein snacks (Greek yogurt is considered to be an excellent choice) has been linked to reduced appetite, increased feelings of fullness and less frequent and heavy meals, compared to not snacking and to consuming regular varieties of yogurt. There are many uses for Greek yogurt besides as a snack. You could try Greek yogurt as a low-fat replacement for sour cream, in cooking, or as a salad dressing. Try swapping it for mayonnaise on a sandwich or in a dish like egg salad. Mixed with seasonings like garlic or dill, it can be made into a unique dip for veggies. Throw some fruit and granola on it for breakfast.

Hope you understand Greek (yogurt) a bit better now!

Alice

One fish, too much fish, how much fish?

Dear Reader,

This is a simple question for which there is no simple answer! How often you should eat fish depends on a variety of factors, including your specific health concerns, the type of fish you like to eat, how much you weigh, whether you’re pregnant or breastfeeding, and how much fish you eat per sitting. In addition to being quite tasty, fish can have many nutritional benefits, including being low in cholesterol, a good source of protein, and chock full of Omega-3 fatty acids. The American Heart Association even recommends eating a variety of fish, preferably oily fish (e.g., salmon, tuna, herring, etc.), at least twice a week.

Most people can eat fish without being concerned, but pregnant and breastfeeding women and young children should be more careful. Nearly all fish and shellfish contain traces of methylmercury, a type of mercury that can be harmful for pregnant women and young children. Mercury is present in both freshwater and oceans throughout the world as a result of industrial pollution. Generally speaking, older fish, larger fish, and fish that eat other fish will have accumulated the most mercury, thus there is lots of variation in mercury levels. There are three primary factors to monitor if you are trying to lower your consumption of mercury. These include the type of fish, the frequency you eat it, and the amount you eat per meal.

Some good general guidelines for fish consumption:

  • Eat fish that are lower in mercury. These include anchovies, clams, oysters, herring, tilapia, whiting, shrimp, sardines, salmon (in some cases), and a few others.
  • Eat less fish that are higher in mercury. These include tuna (especially steaks and sushi), Chilean Sea Bass, sharks, swordfish, eel, halibut, and orange roughy.
  • Eat a variety of fish. As an alternative to completely cutting high mercury fish out of your diet, simply eating a variety will make it more likely that some of the fish you consume is of the lower mercury variety.
  • Eat smaller (or fewer) servings of fish. Eating fish less frequently and eating smaller amounts will help keep mercury levels in check.

To get a more precise calculation of how often you should eat fish, check out the National Resources Defense Council's Mercury Contamination in Fish - Consumer Guide to Mercury in Fish. Other helpful resources include the New York City Department of Health – Mercury and Fish, the Environmental Protection Agency, and New Yorkers can check out New York State Fish Advisories.

If you are still concerned about the amount of fish you should include in your diet and if there are any restrictions based upon your individual health needs, you should make an appointment with your primary care provider or a registered dietitian to discuss. Columbia students on the Morningside campus can make an appointment at Medical Services using Open Communicator or by calling 212-854-2284. Columbia students at the Medical Center can make an appointment with Student Health or by calling 212-305-3400. 

Bon appétit!

Alice

Fruits and veggies on a budget. How do I avoid waste?

Dear Berry Healthy,

Eating healthily on a budget, when you can only get to the grocery store once a week, can be tricky. But fruits and veggies don’t have to break the bank or spoil on the shelf before you can take advantage of their nutrients! There’s a combination of strategies that can help. Buying fruits and vegetables that are low cost and nutritious combined with smart shopping habits, strategic meal planning, and effective storage can prevent waste. Here are some tips on how to more easily incorporate the good stuff into your diet and budget…

Before you go to the store:

  • Consider your options for shopping since a larger grocery store may have more options and lower costs than a nearby convenience store
  • Use coupons and monitor ads for what’s on sale
  • Know what’s in season to ensure freshness
  • Have a snack since it’s easier to stick to a budget at the grocery store on a full stomach

At the store:

  • Look for things that are on sale and buy in bulk to cut prices
  • Don’t buy single servings or pre-cut product, as this can cost much more than whole fruits and vegetables
  • Try hardy fruits like apples, bananas, pears, nectarines, and watermelon
  • Look for lasting vegetables like carrots, spinach, broccoli, collards, mustard greens, kale, potatoes, cabbage, and onions
  • Try frozen, especially for berries
  • Canned fruits and vegetables will last a long time, but choose those with no added salt or sugar

At home: 

  • Plan your meals to use up your purchases in a given week
  • Cook enough for multiple meals and freeze the leftovers
  • Fruit that is about to turn or purchased in bulk can be cut and frozen for smoothies or baking
  • Veggies on the way out can be frozen or made into soup
  • Store produce appropriately

List adapted from 30 Ways in 30 Days to Stretch Your Fruit & Vegetable Budget from the CDC.

This last point on prolonging the shelf life of produce varies wildly from item to item. Some veggies like to be damp (such as broccoli, dark leafy greens, and carrots), while others don’t like to get wet (onions). Some prefer the fridge (spinach), while others just need a cool, dry place (potatoes, winter squash). Remove or loosen any bands or twist ties from greens to let them breathe, and remove greens from items like turnips, radishes, and beets, as they draw moisture from the roots. Most fruits do well in a cool place on the counter, and shouldn’t be washed until you’re going to eat them, as added moisture encourages mold. You can ask your local grocer or take a look at how produce are presented in the store to get an idea of how produce like their environment. You can also check out get balanced! resources for additional information.

Hope these tips gave you some berry good ideas!

Alice

March 13, 2014

554640
I will also cut up and freeze and fruit that is going bad, so I can use it in smoothies or baking later. Same would work for vegetables. I also have a dehydrator which I much prefer to freezing goods...
I will also cut up and freeze and fruit that is going bad, so I can use it in smoothies or baking later. Same would work for vegetables. I also have a dehydrator which I much prefer to freezing goods - could be an investment. :)

April 16, 2013

527375
Try making a smoothie with the ripe fruits!
Try making a smoothie with the ripe fruits!

Forgetting to eat

Dear Really, I’m Not Hungry,

On the one hand, your body knows best. That is, taking cues and signals from your body about when to eat (and when to stop eating) is a surefire way to provide your body with what it needs — both in terms of quality and quantity.  On the other hand, each body needs a minimum amount of fuel to run efficiently and at its highest potential. Based on your question, it sounds as though you may not be getting the minimum amount of fuel for your body. For most people, hunger is the number one reminder that they need to eat. To boost your hunger and appetite, you might want to consider trying the following tips:

  • Exercise daily. At least 30 minutes of moderate physical activity each day has been shown to relieve stress, increase energy, and promote a healthy appetite.
  • Add variety to your regular diet. Sometimes even the foods you enjoy can start to seem boring. Experimenting with new herbs and spices in addition to new foods might be a great way to get excited about eating.

Sometimes, however, poor appetite may be indicative of an underlying health issue.  Research has shown that a loss of appetite can be associated with old age, as well as illness and even pregnancy. Illnesses as serious as cancer and as simple as the common cold are all known to decrease appetite. But it’s not always physical: Mental health issues such as depression or anxiety can affect your appetite as well. A few questions to consider: Have you always had a low appetite? Is under-eating something new for you? If so, does this change in appetite or eating habits correlate with any other events or issues going on in your life? If this is a fairly new phenomenon or sudden change, you may want to speak to a health care provider to rule out any underlying issues. Columbia students can log on to Open Communicator to make an appointment with either a medical provider or Registered Dietician at Medical Services.

In the meantime, you can check out What to eat? for an overview of…well, what to eat. Generally, nutrition experts believe that the basis for a good diet is exercise, combined with eating lots colorful fruits and vegetables, whole grains and lean proteins such as poultry, fish, beans and eggs.  It is advised that sugary drinks, red meats (beef, pork, lamb), processed meats (bacon, deli meats), and refined grains (white potatoes, white bread, white rice) as well as alcohol be consumed in moderation. Hope this advice whets your apetite!

Alice

Raisin bran confusion — is it a good source of iron?

Dear Reader,

Props to you for wanting to donate blood! Alas, isn't it iron(ic) that one of the foods with higher iron content also may contain an iron absorption inhibitor? It's one thing to worry about getting enough iron through your food sources, but a whole other thing to worry about whether that iron is actually being absorbed. Boosting your hemoglobin by upping your iron intake shouldn't be too tricky, but know that there are a number of possible causes for low hemoglobin — being low on iron is only one cause (more on that later).  

Let's discuss the raisin bran question first. Phytic acid is often found in foods that contain whole grains, including some types of raisin bran. In large enough quantities, phytic acid can inhibit your body's iron absorption. This is annoying since these foods may also be high in iron. In addition to iron absorption inhibitors, there are also substances that aid in iron absorption. The primary is vitamin C, which is often also found in raisin bran. Your best bet is to check food labels so you know when you are consuming foods that contain phytic acid (and also whether it contains a substance such as vitamin C, which will help you absorb iron). If food products contain iron and phytic acid, chances are you'll still likely get at least some iron benefit from them (especially if that food contains vitamin C, too); however, it's wise to have additional sources or iron other than raisin bran. Another iron absorption inhibitor is tannic acid, which is often found in red wine, coffee, some teas, chocolate, and some sodas.

So what does all this mean? Diversified food sources of iron will be your best bet in ensuring that you meet your recommended daily allowance, but there's no harm in making raisin bran one of those sources. Check out the Q&A's below for more information on iron, how much you need, and getting enough of it through your diet.

Now, are you sure low iron is the cause of your low hemoglobin? There are several other possible causes. Cirrhosis (scarring) of the liver is one cause. Some common causes of cirrhosis include alcohol abuse, hepatitis B or C, cystic fibrosis, and some parasites caused by chronic liver damage. These conditions, as well as the cirrhosis itself, would likely be accompanied by additional symptoms, such as fatigue, nausea, weight loss, and/or easy bruising.

Other causes can include certain cancers of the blood (e.g. leukemia, multiple Myeloma) or of the lymphatic system (e.g. Hodgkin's and non-Hodgkin's lymphoma), enlarged spleen (splenomeglamy), or vasculitis (inflammation of blood vessels caused by an autoimmune response of various origins). Though anemia and iron deficiency are common causes of low hemoglobin, it may be worth a trip to your health care provider to rule out these other causes.

Happy hemoglobin boosting!

Alice

Overcooked pasta and beans — Still nutritious?

Dear Long Cooker,

Whether you’re an avid chef or a microwave maven, it is important to know that overcooking can deplete the amount of vitamins and minerals in foods. If you are cooking your pasta and beans for as long as you say, you are most likely losing some of their nutritional value. Overcooking destroys bonds between molecules, significantly depleting the nutritional value. For example, overcooking can destroy amino acids and many of the B vitamins, such as Vitamins B-1 and B-5. These vitamins are important for metabolism and energy production.

Generally, shorter cooking time retains more nutrition in a food. Here are a few basic cooking guidelines for your pasta and beans:

Beans, peas, and lentils (members of the legume family) are low in fat and high in fiber, making them a healthy part of your diet. Cooking your beans properly can make them a nutritious and delicious addition to a meal. Dried beans should be soaked overnight in fresh water. They are then cooked for 1-3 hours, depending on the variety of bean. This is standard preparation, and beans cooked in this manner are full of nutrients.

Pasta is a complex carbohydrate, with more fiber and a lower glycemic index than simple sugars. Overcooking pasta can strip it of its fiber content. Most pasta only needs to be boiled between 5 and 15 minutes, depending on the cut of the noodle. Overcooking pasta will only add to the loss of vitamins (especially water-soluble B vitamins) and minerals that occurs when you cook it. Another tip: try not to rinse cooked grains and pasta, as this causes further loss of nutrients.

The style of cooking plays an important role in the overall nutrition of food as well. Whether fresh, steamed, baked, grilled, boiled, or fried, how food is prepared can modify the nutritional content. For instance, boiling leeches more nutrients out of vegetables and beans than baking, as many of the vitamins in vegetables are water-soluble. Steaming and microwaving your food can help maintain the most nutrients.

Bon appétit!

Alice

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