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Solid versus liquid calories — Which is better?

Dear Reader #1 and Confused About Calories,

Good questions! While a liquid diet probably wouldn't affect the way your digestive system works, you would still need to ensure that you are receiving plenty of calories and nutrients. Discussing this issue with a health care provider, such as a gastroenterologist or nutritionist, may be good steps if a liquid diet is something you want or think you need to pursue. Also, Reader #1, check out the Related Q&As below for more information about food allergies.

As for the calorie query submitted by Confused About Calories, the fact of the matter is, regardless of the consumption method, a calorie is a calorie. The energy it takes to burn one liquid calorie equals exactly the same as that needed to burn one solid calorie. What throws some people off is the concept of caloric density. Foods that have high water content tend to have lower caloric density (think fruits and veggies), meaning a greater calorie to volume ratio. For example, to consume the same amount of calories you would get from one cup of raisins, you would need to eat nearly ten cups of grapes. What adds to this is that low caloric density foods tend to make you feel fuller faster because of their water content.

This does not mean that simply consuming more liquid will make you want to eat less. Liquid calories may in fact be deceiving because beverages like sodas often contain a lot of calories but do little to satiate hunger. When studies compared food intake between one group given water to drink and the other given soda, there was little difference in the amount of solid calories they ate. However, even though both groups ate roughly the same amount of food, the group who drank the soda consumed more calories overall because of the beverage that accompanied their meal.

Depending on the motivation for your question, you may want to consider meeting with a registered dietitian or other health care provider to discuss this matter further. Keep in mind that a health care provider can also make any referrals to a specialist, if appropriate. In addition, you may find it helpful to read some of the responses in the Go Ask Alice! Nutrition & Physical Activity archives or the related Q&As below.

Remember though, your body needs more than just calories; it also needs nutrients, which may be lacking in a liquid diet. Although liquid calories may seem less significant than calories consumed from solid foods, keep in mind that a raisin in the hand is worth ten grapes in the bush.

Alice

For more information or to make an appointment, check out these recommended resources:

Medical Services (Morningside)

Columbia Health Nutrition Services (Morningside)

Student Health Services (CUMC)


Hungrier and hungrier

Dear Hungry,

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)
  • Diabetes
  • 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!

Alice

February 3, 2012

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This may sound weird but have you explored the possibility of a parasite? Maybe I am watching to much TV but I have seen several programs on parasites. If you have a tape worm for instance it could...
This may sound weird but have you explored the possibility of a parasite? Maybe I am watching to much TV but I have seen several programs on parasites. If you have a tape worm for instance it could make you hungry all the time while you are eating more than enough, coupled with weight loss. Just a thought...

ALWAYS hungry!

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 (a.k.a., 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 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:

  • Anxiety
  • Certain medications (such as corticosteroids and some antidepressants)
  • Bulimia
  • Diabetes
  • Hyperthyroidism
  • Grave's disease
  • Hypoglycemia
  • Premenstrual syndrome (PMS)

List adapted from 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.

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,

Alice

For more information or to make an appointment, check out these recommended resources:

Medical Services (Morningside)

Student Health Service (CUMC)


Foods with negative calories?

Dear Reader #1 and Reader #2,

Negative-calorie or calorie-burning foods may sound magically delicious. Alas, there is no such thing as a calorie-free lunch (or breakfast, or dinner, or midnight snack). The negative-calorie theory hasn't been officially debunked, but all foods, with the exception of water, contain calories.

The idea of "negative-calorie" food stems from the notion that the body uses more energy to chew and digest certain foods than the food itself contains, thereby creating a net deficit in caloric intake. Some foods commonly thought to have this effect include celery, cucumbers, and cold water. However, that doesn't mean that eating these foods should be substituted for your daily workout. The amount of calories your body burns processing these low-calorie foods is so miniscule that it will not make a difference in your body weight. Additionally, these foods have little nutritional value, so if your diet is limited to these foods you may be missing out on the many vitamins, minerals, and other nutrients your body needs to maintain health.

If you are trying to lose weight, it may be helpful to consider substituting so-called "negative calorie" foods for higher-calorie ones, such as celery sticks instead of potato chips. In fact, substituting any kind of low-calorie foods (including celery and other veggies) for high-fat snacks may contribute to weight loss. However, adding "negative calorie foods" to an already healthy diet will have a miniscule (if any) effect. Some foods will cause a calorie deficit, but this deficit is tiny (think single calories) compared to the number of calories the average person eats per day.

For more tips on healthy eating, check out the Go Ask Alice! Nutrition & Physical Activity archive. Additionally, you may find it helpful to talk to your health care provider about developing a nutrition plan. To really jump-start your weight loss plan, you can also check out your local gym, fitness center, or join an exercise club to get a move on adding physical fitness to your routine! Fads aside, a realistic, long-term weight management plan includes plenty of fruits, veggies, whole grains, and lean proteins as well as a decent serving of physical activity. Take care,

Alice

For more information or to make an appointment, check out these recommended resources:

Medical Services (Morningside)

Student Health Service (CUMC)


Food allergies and getting enough fiber

Dear Reader,

Getting the recommended amount of fiber can be a challenge, especially if you are limited in your food choices. Eating healthy foods other than whole grains is certainly one option, but with a bit of planning ahead, there are some other ways to make sure you are fulfilling your fiber and carbohydrate requirements.

If fiber is your main concern, then getting a lot of fruits and vegetables and taking a fiber supplement can help to "bridge the gap" on days where you must avoid grains. However, whole grains have a lot more to offer than just fiber. They may contain many other healthy components such as complex carbohydrates, antioxidants, vitamins, and minerals. Whole grain consumption has been linked to a reduced risk of heart disease, diabetes, and obesity.

Eating out is a challenge for anyone who has dietary restrictions, but thankfully some restaurants are adapting their menus to cater to clients that cannot eat certain foods, including wheat, dairy, gluten (a compound found in wheat and some other grains) and other common allergens. Consider talking with your server about your food allergies so they can notify the chef. They may also have some recommendations for you from the menu. If this is embarrassing for you to do in front of a client, consider calling or emailing ahead to ask about what items on the menu are free of wheat, corn, and sugar or how other dishes can be adapted to fit your needs. You might also consider ordering foods you can eat, such as salads, potato- or rice-based dishes, lean meats and seafood, and soups while out with clients, and snacking on complex carbohydrate- and fiber-rich foods before or after your business meals.

Checking out menus and calling ahead is useful because common food allergens can "hide" in places you may not expect to find them, such as salad dressings and some sauces. One resource to consider for finding a friendly restaurant is the Gluten-Free Restaurant Awareness Program website, which lists restaurants with gluten-free options throughout the US.

Since there are many benefits to eating a variety of whole grains, perhaps you can start taking some food with you when you travel, or shopping for food once you reach your destination. Since food packages must list all ingredients you can be sure you're getting what you need, avoiding what you can't eat, and you might save yourself some money in the process. Who doesn't like saving money?!

Finally, it might be useful for you to spend a little time with a dietician. A consultation could trigger many new ideas for getting the right amount of fiber. S/he is likely to present some creative and tasty options you may not have expected. If you are a Columbia Student, you can contact Medical Services (Morninside) or the Student Health Service (CUMC) to schedule an appointment with a registered dietitian on campus.

With creative planning and a visit with a professional you can be sure you're getting what your body needs to stay healthy. It might take some extra time and effort, but your health is worth it!

Alice

Weightloss diets for vegetarians, and everybody

Dear Reader,

Fortunately for people who wish to lose weight, there are universal rules that apply, regardless of your typical diet — whether you're a vegetarian or omnivore. First, to lose weight a person has to use more energy (calories) than s/he takes in. To achieve this deficit you can either make dietary changes (so you're taking in less calories), get more physical activity (so you're using more calories in a day), or you can make changes in both areas. Experts recommend making both dietary changes and getting more physical activity for the best results.

It takes a deficit of about 3500 calories to lose one pound of body weight. This means if you are able to cut 500 calories per day from your regular diet you should be able to lose a pound a week (a healthy weight loss rate). It may be beneficial to consider finding the right balance of increasing your physical activity and decreasing caloric intake. You can check out the ChooseMyPlate.gov SuperTracker as a resource that can help you calculate how many calories you need per day, what nutrients are in the foods you eat, and how many calories you burn doing different exercises.

Some suggestions for dietary changes to reduce calories:

  • Steam, boil or bake foods instead of frying in butter or oil.
  • Sauté foods in vegetable broth, wine, or water instead of oil.
  • Limit of high-fat condiments (like mayonnaise, margarine, sour cream, cream cheese, salad dressing, etc.).
  • Try low-fat dairy products and nut- or peanut butter. Vegetarians sometimes begin to rely heavily on these foods as sources of protein, but low-fat dairy and nut products provide the same amount of protein as their full-fat counterparts.
  • Add beans and legumes to your diet as low-fat sources of protein.
  • Eat actual fruit or vegetables rather than drinking them in juice or smoothie form. The fiber in fresh produce works well to satisfy hunger.
  • Substitute water, tea, and diet beverages for regular soda, juices, and other high-sugar drinks.
  • Limit the amount of alcoholic beverages consumed (empty calories for everyone).
  • Begin lunch or dinner with a broth-based, vegetable filled soup or a large salad with a small amount of low-fat or fat-free dressing. These foods take longer to eat and can help curb your hunger so you don't overeat during the rest of the meal.
  • Be mindful of portion sizes — read nutrition fact labels to find out serving sizes. Some rules of thumb:
    • A medium apple or orange is the size of a tennis ball.
    • A medium potato is the size of a computer mouse.
    • An average bagel is the size of a hockey puck.
    • An ounce of cheese is size of four dice.

Some suggestions for incorporating more physical activity into your day:

  • Take the stairs as often as possible.
  • Park at the far end of the parking lot or get off the bus or subway a stop early.
  • Schedule your cardiovascular exercise (walking, jogging, swimming, biking, frantically cleaning your apartment before visitors come over, etc.) so you know you will be able to fit it in. If you're at Columbia, you can participate with CU Move to help stay motivated with your physical activity efforts and earn incentives.  Check out the site to learn more. 

Hopefully, you'll find some of these suggestions new and helpful. Good luck!

Alice

Is wheatgrass as groovy as they say it is?

Dear Reader,

Wheatgrass, a relative of wheat, is grown mostly for hay or is planted for sheep, cattle, or horses to graze. The leaves are harvested within seven to ten days after sprouting. Freshly sprouted leaves can be crushed to make wheatgrass juice or dried and made into tablets or capsules, often in combination with other herbs. Though wheatgrass used as a dietary supplement is generally considered safe for consumption, headaches (as you mentioned), nausea, hives, and even swelling of the throat are all recognized as possible side effects. And, as far as the health claims, there are many associated with this green grass (more on that in a bit). However, while a few studies show promise, the majority of the claims are not backed by scientific evidence.

It is noted that wheatgrass is a concentrated source of many nutrients, including several vitamins, iron, calcium, magnesium, amino acids, and chlorophyll. Proponents of the green stuff claim that it can support immunity, kill harmful gut bacteria, and rid the body of toxins. Along those same lines, wheatgrass is also touted as a treatment for a wide range of conditions, such as anemia, diabetes, infections, constipation, ulcerative colitis, AIDS, and even cancer. But, Reader beware: many of these supposed claims are lacking scientific evidence.

What has research found? There is a small amount of evidence that supports the use of wheatgrass in the treatment of ulcerative colitis. Another study found that wheatgrass may reduce myelotoxicity (damage to bone marrow) due to chemotherapy in breast cancer patients. Though some studies show promise, more research is needed.

Additionally, because wheatgrass is consumed raw, it can be contaminated with mold, bacteria, or other not-so-groovy substances. This means it’s crucial to wash it thoroughly. People who show signs of an allergic reaction (e.g., hives or a swollen throat) should seek medical attention and avoid consuming wheatgrass again. It’s also recommended that women who are pregnant or breastfeeding, folks with celiac disease, gluten intolerance, or a wheat or grass allergy steer clear of wheatgrass. Lastly, it’s good to note that the U.S. Food and Drug Administration (FDA) does not regulate dietary supplements, and thus, potency and safety may be difficult to determine.

If you enjoy the taste of wheatgrass, and you're headache-free, then feel free to drink up. Wheatgrass isn't, however, a substitute for eating a variety of fruits and vegetables. There are other ways to get the nutrition you need. For more information, check out the Go Ask Alice! Nutrition & Physical Activity archive.

Alice

Airborne — does it cure/prevent colds?

Dear To sneeze or not to sneeze,

People in the United States spend billions of dollars a year trying to escape the misery of the common cold. Though some swear by remedies ranging from vitamin C to garlic to exercise, scientists have not conclusively found anything that will prevent, cure, or shorten the course of the common cold. The manufacturers of Airborne claim that the unique combination of herbs, amino acids, antioxidants, and electrolytes "offers vitamin and mineral support for hours," and imply that it helps the body fight bacteria and viruses by boosting the immune system. They have withdrawn their original claims that their product cures or prevents colds.

In addition to vitamins, Airborne contains Echinacea, an herbal supplement some people take on its own for colds or the flu. Similar to research on vitamin C, studies draw a mix of conclusions about whether Echinacea works in preventing or treating colds. There are many products on the market, as well as natural remedies, that successfully treat the symptoms of the cold: body aches, sore throat, stuffy nose. However, as of yet, there is no proven cure.

Some people may feel that Airborne works for them, but it's tough to say conclusively. Colds can last anywhere from one to ten days and a person's immune system will eventually fight it off, even without vitamins or supplements. There has been one study on the effectiveness of Airborne. The clinical trial was a double-blind, placebo study, meaning that neither the researchers nor the participants knew who took the real supplement and who took the placebo until after the trial ended. The study found that Airborne out-performed the placebo, however many people question the potential bias of this study because the research was conducted by the manufacturer.

Additionally, some people have expressed concern about the amount of vitamins A and C contained in Airborne. According to the Food and Drug Administration, the average adult should have 5000 units of vitamin A each day, and 60mg of vitamin C. One dose of Airborne contains 5000 units of A and 1000mg of C, and the package recommends taking a dose every three hours. That means taking significantly more than the recommended daily allowance of both. Overdosing on vitamin A may cause nausea, vomiting, headache and dizziness. Too much C can cause diarrhea and excess gas.

Subways and other enclosed spaces with many people can be germy, especially in cold season. Medical professionals say your best defense against the common cold is maintaining a healthy lifestyle. That includes: eating a balanced diet, being physically active, and getting plenty of sleep. On top of that, thorough hand washing with soap and water, especially before you eat, can keep the subway germs at bay. So, before you go out and buy the new very berry flavor of Airborne or a similar supplement, it might be wise to take its claims with a grain of salt (mix with 8 ounces of water and gargle!).

Alice

Lactobacillus acidophilus for diarrhea?

Dear Reader,

Lactobacillus acidophilus is bacteria, not the pathogenic type that causes illness, but actually one of several kinds of beneficial bacteria called probiotics. These helpful bacteria are normally found in the intestine and the vagina. They are also naturally available in cultured or fermented dairy products, such as yogurt that contain live active cultures and acidophilus milk. Probiotics are also sold as nutritional supplements. Since the U.S. Food and Drug Administration (FDA) does not regulate dietary supplements, the presence and/or amount of live active cultures in supplements is not guaranteed.

Probiotics appear to offer various health benefits. They create a more acidic environment in the intestine and vagina, which helps keep harmful bacterial growth in check. This natural balance can be disrupted, however, by antibiotic use and illness. In these cases, the bad bacteria proliferate, usually causing conditions such as diarrhea or vaginal infections. Taking probiotics may help reduce the symptoms of diarrhea and treat vaginal infections.

Other possible benefits include enhancement of the immune system, helping the digestion process, production of antimicrobial substances, and protection against certain chronic illnesses, such as cancer, among other possibilities. However, more research is needed to definitively demonstrate that probiotics have these favorable actions.

To answer your question: There has been some research to suggest that L. acidophilus (commonly combined with another probiotic) may reduce the risk and/or duration of of some cases of diarrhea if used as a preventative measure. More specifically, a few studies have shown that the use of this probiotic has reduced the risk and incidence of diarrhea associated with antibiotic use and chemotherapy. In another study, a combination of probiotics that included L. acidophilus resulted in a shorter duration of acute diarrhea in children. While these findings are promising, there is currently no consensus on whether L. acidophilus alone or in combination with other probiotics would be effective for the prevention or treatment of traveler’s diarrhea.

Despite this research, if you are considering using L. acidophilus or other probiotics, consult your health care provider before doing so. Those who are pregnant or immune-compromised will need to determine whether or not it's medically safe to take probiotics. Adverse effects include gas and/or bloating, irritation, sensitivities or allergies, and interactions with over-the-counter or prescription drugs and/or other dietary supplements.

There are other remedies for diarrhea, including antidiarrheal and antimicrobial medicines, but these are not recommended in all cases. When the cause is food poisoning, it’s best to let the illness run its course. Antidiarrheals can delay the time it takes for food-borne microorganisms to leave the body.

Hope this helps!

Alice

Hunting for whole grains

Dear David,

Even the savviest of shoppers can be fooled by some of the products on the market today. Food labels can be confusing. Did you know that when a claim appears on a food item stating, for example, that whole grains reduce the risk of heart disease and certain cancers, only 51 percent of its grain contents needs to be whole grain? A little background information will be helpful to you as you navigate your way through the grocery store looking for easy and convenient whole grain foods.

So, what exactly is a whole grain? A grain contains three parts, the bran, endosperm, and germ. The bran is the outer layer, which is high in fiber and B vitamins. The endosperm is primarily starch, or carbohydrates, which turn into sugar in our bodies when we it. The germ is the seed for a new plant and it contains B vitamins, protein, minerals, and healthy oils. When grain is processed, the bran and germ are removed, leaving only the endosperm or starch. This is essentially why whole grains are more nutritious.

And how do we figure out if a food is made from whole grains? It's easy to be tricked into thinking a food is a whole grain when it's not. For example, if an ingredient is listed as unbleached wheat flour, it is still refined flour and not a whole grain. One way to determine if a product is whole grain is if it has a Whole Grain Stamp from the Whole Grains Council. This identifies it at as containing whole grains. However, if there is no stamp, the key way to determine if a product is whole grain can be found in the nutrition label list of ingredients. If the phrase "whole" appears as part of the FIRST ingredient in the ingredient section of the food label, such as "whole wheat flour" or "whole oats," it is likely that it is a whole grain product. Words that are often indicators of a whole grain product also include "stoneground whole," "brown rice," and "wheatberries." Be wary of items listed without the word "whole" before, such as durum wheat or multigrain, because they may not be actual whole grains. You can also visit the Whole Grains Council, which is a good resource for additional information regarding whole grains and packaging, particularly words you may see on packages and how to identify which are whole grain and which are not.

As far as whole grains coming in a convenient package that can be grabbed off the shelf, let's start in the bread and cereal aisle since these items are the main types of food that offer immediate edibility of whole grains. Next we take a walk to the pasta aisle followed by the aisle containing rice and other whole grains, such as barley and quinoa, which typically involve some cooking time. However, many grocery stores now offer areas where you can find all of these whole grains prepared for you, so the final stop is the hot and cold prepared foods area.

For more tips about healthy eating and whole grain choices, check out the these whole grain eating tips from Myplate.Gov! 

Hope this clears up some of the confusion,

Alice

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