Dear Da Windex Guy,
The cheapest and safest way to get tickets to the gun show is to hit the gym! Whereas human growth hormone (HGH) products like Sytropin may help your friend beef up, it only does so in the short-term while also beefing up other hormones in the body that may lead to some unintended side effects (as you suspected). As a general rule, take caution when using any substance that isn’t approved by the Food and Drug Administration (FDA) as well as using prescription drugs without the okay from a health care provider.
Initial development and prescription of HGH products were for people with growth disorders and for people with diseases such as AIDS who had growth hormone deficiencies. Now HGH has gotten a reputation for being abused in the sports world and also used controversially to increase milk production in cows. Normally, the pituitary gland (located in the base of the brain) regulates the natural release of HGH. Products like Sytropin introduce synthetic HGH into the body promoting cell growth, reproduction, and regeneration. This, in turn, reduces fat in the body, and increases lean body mass (muscle mass and bone density) and exercise capacity. However, though HGH may increase bulk, there is no solid proof that it increases strength or improves athletic ability (at least not in the long-term).
Your hesitation in using Sytropin or other HGH products is warranted because there is no solid evidence to prove their safety. HGH is only legally available by prescription and scientists still aren’t certain whether HGH taken in pill or spray form (like Sytropin) are effective. Other side effects of HGH use may include:
- Swelling in the limbs.
- Pain in the joints and muscles.
- Gynecomastia (swelling of the breast tissue in men).
- Higher risk for heart disease and diabetes due to increases in insulin and cortisol.
- Potential insulin resistance.
List adapted from the Mayo Clinic
Those who reap the most benefits of using HGH are people who have problems naturally producing growth hormone. The average Jane or Joe looking to boost their muscle volume will likely have the same luck (sans potential HGH side effects) if they stick to a healthy diet and workout regime. Though it may seem tempting to buy scalped tickets to the gun show from Sytropin, investing the extra time and effort into physical exercise is the best and safest approach to securing front row seats. Check out the exercise and diet tips in the Related Q&As below for more information.
Dear Nancy Nutrition,
Props to you for your commitment to good health! And for your attempts to spread the wisdom to your boyfriend. You're right; trying to change another's habits will generally only frustrate both of you. So, you're trying to do your own thing, but find your attempts to avoid junk food foiled by temptation. What to do?
A good first step may be to clearly communicate your healthy eating goals to your boyfriend. From your question, it's not immediately clear if you've already done this. If you haven't, tell him why eating a healthy and balanced diet is so important to you. Let him know how it makes you feel, but also share with him how much you'd value his support. Have you told him how his eating habits are affecting you? He may not realize how much of an impact he is having on you.
There are a number of ways in which he could support you. Perhaps he could agree to bring home less tempting snacks, or stash them somewhere out of sight as a simple first step in being an ally to you around your health goals. Around a mouthful of pizza, could he perhaps offer verbal encouragement for your healthier eating? Does he "peer pressure" you into eating the way he does? If so, he could agree not to do this. And could he commit to eating one of your delicious home-cooked meals at least once a week?
Some other things you may be able to do while living with someone who doesn't share your same eating goals:
- Have plenty of healthy snack items on hand to substitute for cookies when you have the cravings.
- Set up at least one shelf in the pantry and one shelf in the fridge that is only for your healthy food choices.
- Make sure there are rooms in the house that do not contain unhealthy snacks.
- When you do decide to indulge, try not to snack directly from the bag or container. If you portion out how much you want to eat, you'll likely consume less.
While you certainly can make healthy choices without your boyfriend being on board, you are more likely to stick to your healthy goals if your boyfriend is making some similar healthy choices, as well. Consider getting his help in small ways at first, and if he's comfortable with it, he can make some larger changes to his lifestyle as well.
- Perhaps both of you can exercise together or go for a walk after meals.
- Try cooking meals together and cleaning up after together; make it a date
- Perhaps when you decide to indulge in take-out food with him, you could choose healthier options than pizza or Chinese take–out. Avoid fast food altogether if you can.
- Bring healthy snacks when you go out.
- If you are out together and you get hungry and you don't have snacks, if he insists on heading to the nearest fast food place, pick a healthier option for yourself and ask him to meet you there with his food.
In a world of tempting and unhealthy food choices, you have managed to establish a healthy diet for yourself. This is quite an achievement! Keep it up. See related Q&A's below for some healthy eating options.
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!
Dear A Sip of Calm,
Can we actually find relaxation in a can? Seems like it could be a great idea, unfortunately, at this point in time, it's just too good to be true. Just like herbal supplements, the FDA does not require companies manufacturing the "relaxation beverages" to prove their claims or standardize their ingredients. As such, there is no conclusive scientific evidence that any of these products are safe and effective. What little research has been done has shown that many compounds in these drinks, such as 5-HTP and melatonin, degrade in water. Other ingredients such as GABA, cannot cross the blood-brain barrier so are completely ineffective. One study even tested five popular brands and found that many of the ingredients listed were barely even present in the drinks themselves!
Two popular ingredients in relaxation beverages that have been studied are valerian and kava and the news is not good. Valerian can cause dependency if taken regularly while kava has been shown to cause liver damage. These types of ingredients can also interact with medications such as Allegra or benzodiazepines (Xanax, Valium, Atvian, etc.) or even with Tylenol and cause serious health problems.
What's your best bet for relaxation? For starters, maintaining a proper diet, exercising, and trying to keep a regular sleep schedule can contribute to feelings of relaxation. You may also want to try meditation and/or yoga.
In the end, it seems as if nothing beats a glass of warm milk or hot (decaf) tea to unwind in the evening.
Trying to make sense of all the vitamin and mineral supplements on the pharmacy shelves may make you feel stuck between a rock and a hard place! Before you swallow any information, it is important to know that both ionic minerals and colloidal minerals have a lot of dubious marketing and advertising surrounding them. Manufacturers of colloidal and ionic supplements may make a variety of claims about their products — many of which are not confirmed by scientific research. Moreover, the body doesn’t need a whole lot of minerals; fewer than 20 have been judged to be essential to your health.
A colloid is a mixture in which particles are suspended in a liquid or a gas. Colloidal minerals come from humic shale deposits, primarily from Emery County, Utah. After collection, the shale is crushed and placed in water so that the minerals can enter the solution. Colloidal mineral distributors stress the “naturalness” of their product and have made claims about improving conditions associated with certain diseases, a practice judged to be illegal by the FDA. In addition, some advertisements state that colloidal supplements contain 75 minerals, many of which have not been proven to be beneficial to health (such as platinum, gold, and silver).
Ionic mineral distributors state that colloidal minerals have too large of a particle size to be absorbed by the body. Therefore, ionic minerals (named after their supposed positively and negatively charged molecules) were created to have the “correct electrical charge” and therefore lead to higher levels of absorption by the body. Although these supplements may actually lead to greater absorption, it is important to remember that there are various other conditions that must be present in the body in order for this to happen.
In reality, the body only needs minerals in trace amounts. Excessive dosages of minerals can actually be toxic. Therefore, before you experiment with any vitamin or mineral supplements, you may want to speak with your health care provider. A provider can help you sort out fact from fiction, so you can make an informed decision and avoid products that may be harmful or simply ineffective. In certain cases, you may be better off wearing these minerals than ingesting them!
December 11, 2012520002
There is so much nutrition information available from a host of different sources and it’s not hard to see why confusion can arise. You may have access to information published in scientific journals, which are studies that have been critiqued by nutrition experts. At the other end of the spectrum, some sources such as websites and corporate advertisements are created with the intention of boosting sales of the latest diet book or food product. In order to increase the chances of finding valid nutrition information, it's important to identify, use, and refer back to sources you trust. Additionally, when comparing information from multiple sources it is very important to make sure you are comparing exactly the same thing (same serving size, same source, etc).
When gathering information online, it is important to determine who sponsors the site, how often it is updated, the sources for information, and if advertising is involved (or influences content). As an example; Go Ask Alice! is sponsored by Columbia University, content is updated daily (all pages have an update date listed), the sources are described (see below), and the site is advertising free (learn about our no ad policy).
The U.S. Department of Agriculture (USDA) is generally the most reliable source of nutrition and food-related information for the general public in the United States. The dietary guidelines can be found at their MyPlate website where you can also find sample menus and recipes, a food tracker, BMI calculator, as well as several other useful health and food-related tools.
The USDA also has a National Nutrient Database, which is a reliable source for nutrient values for foods. Frequently, this site is accessed by nutrition researchers and developers of nutrient analysis programs. The National Nutrient Database site is user friendly enough that even regular people will be able to do a food search during her/his first visit to the site. Even the National Nutrient Database site, however, can be confusing. For example, it will generate conflicting numbers for nutrients in products such as milk, which comes in a number of varieties. For example, cow's milk provides 8 grams of protein per 8 ounces, evaporated skim milk provides 19 grams, and soy milk, 3 grams. The lesson learned here is to check the details of the food you searched for if the results seem different. For example, a search for milk could yield information on both coconut milk and cow's milk.
The MyPlate SuperTracker and the Nutrient Analysis Tool (NAT) are comprehensive online programs that can be used to analyze not just one food, but an entire day of food intake. They show a comparison of the analysis to your daily nutrient needs. The food lists in these programs come from the USDA National Nutrient Database, and nutrient needs are based on the Recommended Dietary Allowance (RDA).
RDAs are amounts of nutrients that, if consumed on a daily basis, would meet the needs of approximately 97 percent of the population, and are amounts that have been established after years of intensive research studies. The RDA of protein for adult males is 56 grams per day, and for women it is 46 grams per day. This general recommendation is based on 0.8 grams of protein per kilogram of body weight, for individuals in good general health. Protein needs can vary depending on a person's health status and exercise regimen.
For a personalized assessment of your nutrient needs Columbia studnets can make an appointment with a Registered Dietitian. Columbia University students can call x4-2284 or log into Open Communicator to schedule an appointment. Non-students may have access to a nutritionist through her/his primary health care provider or search for a dietitian in your area through the Academy of Nutrition and Dietetics web site. You might also want to check out the resources listed on the Columbia Health Get Balanced nutrition page.
For additional information regarding finding quality health information online, check out Health information on-line: Whom can you trust? Hopefully these new resources will help to clear up your nutrient value confusion, making it easier for you to make healthier eating choices.
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.
While it appears that androstenedione has helped some people (a few prominent athletes included) increase their muscle mass and recover more quickly from injury, there is no scientific research supporting these results. In order to help you decide whether such nutritional supplements are right for you, let’s first take a look at androstenedione.
Androstenedione is a direct precursor hormone to testosterone and other hormones including one type of estrogen. It is converted from cholesterol, as are all other steroid hormones. Specific enzymes and hormones, among other things, must be present and ready to work for these conversions to take place. For instance, luteinizing hormone, produced and released by the pituitary gland, plays a pivotal role in converting androstenedione to testosterone. Simply introducing extra androstenedione to your system does not automatically indicate that all of the necessary players will be there to produce testosterone or improve the productivity of your workout.
About sixty years ago, when androstenedione was first synthesized, it was shown to have both androgenic (male hormone-like) and anabolic steroid-like properties. The anabolic effects were considerably less than those of testosterone. Subsequent research found that testosterone levels rose after inhalation of androstenedione, but remained elevated for only a couple of hours, with peak levels lasting a few short minutes.
Beyond these cursory early studies, rigorous studies have come to two broad conclusions about androstenedione. First, despite increasing testosterone levels for those with low baseline testosterone levels such as women and older men, androstenedione has not been shown to increase the testosterone levels of young men or to improve the effectiveness of their exercise regiments aimed at building muscle.
What side effects can you expect from androstenedione? No one knows for sure. Androstenedione falls under the category of steroid hormones, which are known to have androgenic and anabolic properties. Therefore, androstenedione may produce side effects similar to those of testosterone-based anabolic steroids. The most dangerous of these side effects is the increased risk for cardiovascular disease, certain cancers, depression, psychoses, and even extreme aggression. There are also gender-specific effects. For men, these include shrinking testes, increased hair loss, enlarged breasts, and possible sterility. Women may experience side effects such as shrinking breasts and uterus, enlarged clitoris, irregular menstruation, increased facial and body hair growth, and a deepening voice. In fact, due to many potential negative health hazards, the Food and Drug Administration (FDA) has prohibited the sale of over-the-counter androstenedione and similar steroid-like dietary substances.
Is it safe? Safety can be difficult to determine when you don't really know what you're dealing with. Is it worth the risk? That's for you to decide. Before you begin taking any dietary supplements you may want to speak with your healthcare provider. S/he can answer your questions and give you more detailed information. Columbia students might want to consider making an appointment at Medical Services by calling x4-2284 or online using Open Communicator. Students on the Medical Center campus can contact the Student Health Service.
When it comes to weight, the two factors to pay attention to are calories consumed and calories burned. If you consume more calories than you burn, you will gain weight and vice versa. The problem here is either that you are not consuming enough calories or your body is somehow not making the best use of them. Before we get into the biological possibilities, try a quick dietetic experiment.
With all the media surrounding diets and obesity, it may be easy to get the wrong idea about what constitutes "healthy." Eating a lot of vegetables as you do is great (and a vital component of a healthy diet) but vegetables are low in calories and many don't contain fat or protein, both nutrients your body needs. When you feel those hunger pains, consider grabbing a snack or a meal that combines all of these, such as a salad with chicken (lean protein), avocado (healthy fat and a fruit!), and low-fat ranch dressing. Including more healthy fats (limit trans and saturated fats) and lean proteins (also found in seafood, dairy, and nuts) in your diet may help you feel fuller longer and will also add more healthy calories into your diet.
If this doesn't curb your appetite, there may be other factors affecting your hunger sensors, which a health care provider may help identify. Some questions to ask yourself are whether you've been feeling increased anxiety, if you've recently started or changed medications, or if you've experienced increased thirst, heart palpitations, or a need to urinate. These may be signs of hunger-causing conditions such as:
- Anxiety and other mental conditions
- The use of drugs such as corticosteroids and anti-depressants
- An overactive thyroid gland (hyperthyroidism)
- Grave's Disease
List adapted from The National Institutes of Health.
If you experience nausea or vomiting along with your insatiable hunger, that may be a sign that you have a parasite (such as tapeworm) in your digestive track. That possibility brings a whole new meaning to "eating for two." In the related Q&A's below, you may want to read more about parasites as well as other conditions that could explain your hunger. Regardless of the cause of your insatiability, though, if you lose more than ten pounds or five percent of your bodyweight unexpectedly or if weight loss persists, consider contacting a health care provider to get to the bottom of the issue…and your bottomless stomach. Columbia students may do this by contacting Medical Services or logging on to Open Communicator.
Whatever the cause of your endless appetite, hopefully this has sated your hunger for an answer. Eat up!
February 3, 2012506179
Dear Overactive eater,
Generally, a case of the munchies is your body's way of signaling that it's time to refuel. If snacks and even full meals don't fill you up, there may be another cause for your ongoing hunger. If diet changes don't do the trick, a visit to a health care provider may ease your mind and your appetite.
Based on your description, it sounds like you can rule out the possibility of a digestive parasite. Rather than fueling your hunger, most stomach bugs cause digestive troubles like nausea, vomiting, and diarrhea that can kill your appetite. There is one infamous bug, the Taeniasis parasite (aka tapeworm), that is often blamed for insatiable appetites or unintended weight loss. However, Taeniasis is acquired by eating infected pork or beef so it's not likely that you have a tapeworm since you've been vegetarian for years.
As you suggested, people who follow a vegetarian diet sometimes don't get enough protein. These power nutrients give your body energy and also help you feel full, more so than carbs or fruits and vegetables. Vegetarians also need to consider the kind of proteins they eat. Unlike meats, individual plant foods don't supply all the amino acids that your body needs. To make sure you're getting a complete protein package, try combing two complementary foods that offer different amino acids from these four protein groups: grains, legumes or beans, seeds and nuts, and eggs and dairy. For example, a PBJ sandwich combines grains (go for whole wheat bread!) and legumes (peanuts) for a complete protein. Similarly, a yogurt parfait with fruit and almonds complements dairy with nuts. Newer research has indicated that protein pairings need not be consumed at the same time. That is, it should be sufficient to combine the complementary foods within the same day. For more tasty protein pairings, check out the related Q&As below about protein sources.
Another source of satisfaction comes from eating enough fat. Depending on your level of physical activity and other factors your fat needs will vary. However recent research shows that eating moderate amounts of healthy fats can really help satisfy. In addition to nuts, think avocado and healthy oils (canola, olive, safflower, trans-fat free spreads). Check out ChoseMyPlate.gov to calculate your calorie, protein, fat, and carb needs and determine whether what you're eating should be filling you up.
To make sure you're eating enough of the right proteins and fats as part of a balanced diet, it may also be helpful for you to keep a food journal. You can use the journal to plan out meals, make grocery lists that include healthy and filling snacks, and record when and what you eat throughout the day (and night). The food journal may help you answer some key questions to explain the uptick in your appetite. For example, are you eating enough calories throughout the day to make you feel full? Do your tummy rumblings coincide with any particular emotions like stress, sadness, or happiness? If you do end up seeing a health care provider, the journal will help them understand your diet and what might be causing your excess hunger.
If diet changes don't seem to satisfy your hunger, there may be an underlying health condition that's giving you the munchies. According to the National Institute of Health, causes of increased appetite may include:
- Certain medications (such as corticosteroids and some antidepressants)
- Grave's disease
Premenstrual syndrome (PMS)
List adapted from the article Appetite - increased at MedlinePlus
Since there are a variety of explanations for your hunger pangs, if adding a healthy balance of proteins and fats to your plate won't satiate your appetite, your best bet is to see a health care provider. Getting medical attention is a good idea especially if you have any other unexplained symptoms like frequent urination, increased heart rate, or feeling very thirsty. Students at Columbia on the Morningside campus can call 212-854-7426 or log on to Open Communicator to make an appointment with a health care provider or nutritionist at Medical Services. If you are a student on the CUMC campus, give the Student Health Center a call at 212-305-3400 to make an appointment with a health care provider or nutritionist.
Fueling up with more complete proteins and healthy fats may help you feel full and keep your body running strong. If your hunger still hangs around, visit a health care provider to find out what your body needs to fill up and feel good. Take care,