Optimal Nutrition

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Does warm milk really lull us to dreamland?

Dear Reader,

A cup of warm milk is no magic sleep potion, yet it is probably the most common food associated with bedtime. Milk contains two substances that are known to be related to sleep and relaxation, the hormone melatonin and the amino acid tryptophan. The amount of melatonin in a glass of milk is minute, much less than what would be taken in a supplement. The amount of tryptophan in milk is also small. In addition, our digestive process is complex. Considering these factors, it is unlikely that a glass of warm — or cold — milk would shorten the length of time that it takes to fall asleep.

Though milk components and serving temperature are not likely to influence the onset of sleep through physiological means, warm milk might have psychological significance. The routine of consuming a glass of warm milk may elicit memories of mom, home, and comforts of childhood that help us to relax. This is part of the natural transition from wakefulness to sleep. Recommendations include practicing stress reduction techniques, sticking to a regular sleep schedule, creating a relaxing bedroom environment, and avoiding caffeine or heavy meals close to bedtime.

For some individuals, particularly those with lactose intolerance or milk allergies, a glass of milk can be followed by uncomfortable digestive consequences. Lactose reduced, soy, almond, and rice milk are options that are more likely to be tolerated. If you have no allergy or intolerance, and warm milk simply grosses you out, you could try flavoring it with a bit of honey, vanilla, or cinnamon, but there is no reason that you need to continue attempting to use it as a sleep aid. Keep drinking your cold milk, to meet your daily calcium needs, and try other sleep improvement techniques.

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

I'm bored, so I eat

Dear Fat Frat Guy,

You write that you're sitting around the frat house bored. It sounds as though you may have more time to fit in activity than you realize. Exercise doesn't always need to be a long, intensive workout. Short, frequent bouts can be just as effective as longer ones. Why not go out for a walk? Does your frat house have weights in the basement or other area? Taking advantage of exercise equipment is a great idea, but if there isn't any available, jumping rope between sets of push-ups and sit-ups, in your room or a living room or den, can help alleviate boredom.

If these ideas aren't possible, or you still need some suggestions to resist snacking, a few questions to ask yourself may help. First of all, are you actually hungry? When was the last time you ate? Could you put off eating for 15 minutes? If you can wait 15 minutes and then see how you feel, you may decide that you really weren't hungry after all, or you may even forget all about that snack. If you don't and still want to eat — try to quantify your hunger.

Consider the Hunger and Fullness scale. On a scale from 0 - 10, with 0 being BEYOND HUNGRY as though you haven't eaten in an entire day (not recommended) and 10 representing BEYOND FULL as if you ate three Thanksgiving dinners — again not recommended, see where your hunger or fullness falls:

0 Beyond hungry
1 Extremely hungry, irritable, and cranky
2 Very hungry
3 You have a strong urge to eat, but aren't ready to fall over.
4 Just a little hungry
5 Totally neutral... neither hungry nor full
6 You are a notch past neutral — you could eat more but aren't hungry
7 You are feeling satisfied. If you stopped eating at this point, you would need to eat again in about 4 - 4½ hrs.
8 You are getting pretty full. If you stopped eating at this level, you would probably get hungry again in 5 - 6 hours.
9 You are getting really full, and uncomfortable.
10 Beyond full

One way to use this scale is to try to rate your feelings of hunger and fullness. You have to work on paying attention to your body's signals. Make an agreement with yourself that you will eat when your hunger is at 3, and stop eating when you reach 7. If you can ask yourself how you are feeling before taking a snack, you may be able to alleviate or at least cut down on boredom eating. Remember, food's for nutrition and nourishment. If another part of yourself needs nourishment, it's important to figure out what that is and create other ways of meeting that need. Excessive snacking often catches up with us in the form of excess pounds, as you have found. If you repeatedly find yourself eating when you aren't hungry, or when you are no longer hungry, you probably don't need those excess calories.

So, once you realize that you aren't hungry, there are probably a ton of things you can do to pass the time. Getting off your duff and moving your body — somewhere further away from the kitchen — would be a good start!

Alice

Does cooking with cast iron pots and pans add iron to our food?

Dear Martha,

Yes, cooking in a cast iron skillet can add significant amounts of iron to your food and into your body. In addition to eating more iron-rich foods like meats, beans, and spinach, cooking in a cast iron pot is an easy way to boost your iron intake.

Iron is an essential nutrient for all the cells in our body. Iron's main job is to help transport oxygen through hemoglobin in the blood and myoglobin in muscles. In order to function well, your body needs just the right amount of iron, which depends on your age and sex. A lack of iron in red blood cells leads to a condition known as iron deficiency or anemia. On the other hand, too much iron can lead to a dangerous condition called iron toxicity. Children under age three are particularly susceptible to iron toxicity, and symptoms include nausea, diarrhea, and hemorrhaging. To be on the safe side, avoid cooking foods for young children in iron pots. For more information about iron intake and nutrition, check out the related Q&As below.

Researchers have found that cooking in an iron skillet greatly increases the iron content of many foods. Acidic foods that have a higher moisture content, such as applesauce and spaghetti sauce, absorb the most iron. For example, one study published in the Journal of the American Dietetic Association found that the iron content in 100 grams of spaghetti sauce jumped from 0.6 mg to 5.7 mg after being cooked in a cast iron pot. Other factors that boost the iron content of foods include longer cooking time, frequent stirring, and using a newer iron skillet.

However, not all foods benefit from cooking in an iron skillet. For example, hamburger, corn tortillas, cornbread, and liver with onions didn't absorb as much iron. This was probably due to the shorter cooking times, and the fact that they were either turned once or not at all, resulting in less contact with the iron. Cooks should also be aware that that iron pots and deep-frying don't mix. Iron can oxidize fats, causing the cooking oil to become rancid. If you want to deep-fry foods, stick with an aluminum or stainless steel pot, or better yet, try a healthier cooking method that still packs a lot of flavor like roasting, grilling, or using a marinade.

Foods cooked at home may vary in iron absorption based on the age of the skillet used and the amount of time the foods are heated. So, if you're looking to increase your dietary iron, use a new cast iron skillet. After all, the iron in cookware is no different from the iron in our bodies — except we have much smaller amounts!

Alice

How do I know when I'm no longer hungry?

Dear Not Fully Aware,

Your question is one many people deal with. Some people were taught from an early age to finish everything on their plate, no matter how they felt. This was often rationalized by well-intentioned parents referencing the millions of starving children around the world. Unfortunately, this type of encouragement does little to teach children about listening to their bodies or learning to identify or conceptualize the feelings that come when one is satisfied with the amount or type of food they are eating. This conditioning experienced by many growing up, can carry on into adulthood.

Others are out of touch with their body signals for other reasons. How often have you felt ravenously hungry and then couldn't believe how much you'd eaten? How much food does it seem to take to satisfy your hunger? Letting yourself get really, really hungry distorts awareness of body signals. If you're out of touch or ignore subtle hunger cues, it's extremely difficult to detect subtle fullness. As a result, you're only able to feel extremes. It's difficult to describe what comfortable fullness feels like inside your body, but some people express it as being satisfied and content after eating. Others say it's a subtle feeling of fullness, of not being hungry anymore (even if there's still food on their plate).

You can begin by thinking about how you are feeling while you are eating — a kind of checking in with yourself. This takes a conscious effort. Once you've eaten some of your food, consider asking yourself some of these questions: does the food (still) taste good? Is my hunger beginning to subside? After a few more bites, am I beginning to feel satisfied? Try stopping about halfway through to determine if you've had enough. Try rating your fullness from 1 - 10:

  1. Ready to collapse from hunger
  2. Ravenous
  3. Hungry
  4. I could eat something, but not very hungry
  5. Neutral
  6. Not hungry at all
  7. Comfortably satisfied
  8. Full to very full
  9. Stuffed
  10. Disgustingly sick

If you go from a 2 to a 9 easily, perhaps you are going for too long without food, or your last meal was too small (a problem for dieters). Maybe your last meal was lacking important satiety nutrients, such as protein, fat or fiber, which usually help to keep you satisfied over a few hours. Sometimes when we eat very quickly, a large quantity of food is consumed and before we realize it, we're stuffed. If this is your problem, try slowing down, taking your time chewing, swallowing, and resting between bites.

The most important part about eating to a pleasant fullness is to eat consciously — to increase your awareness. This takes practice for many people. Too often, we distract ourselves with other activities — such as studying, watching TV, or surfing the Internet, without realizing that we're full, until the entire bowl of popcorn, liter of soda, or pizza is gone. Give yourself time to enjoy and appreciate your food, and you can notice and identify its effects on your body.

For more information and insight, check out Evelyn Tribole and Elyse Resch's book, Intuitive Eating. If you are a Columbia student, you may want to make an appointment to speak with a nutritionist. Morningside campus students can contact Medical Services; CUMC students can reach out to the Student Health Service.

Best of luck!

Alice

Confused about carbs: What's a good carbohydrate choice?

Dear Jenny,

We need a variety of foods for good health and hunger satisfaction. This includes dietary sources of carbohydrates. Carbohydrates tend to get a bad rap, but in and of themselves, they are not bad for us. They are the preferred source of energy for the body, fueling the muscles as well as the brain.

You mentioned muffins, which generally are similar to a piece of cake. They usually contain flour, sugar, eggs, oil, and other ingredients, depending on the flavor. Don't be fooled by bran muffins — most typically don't contain significant amounts of bran, the fibrous part of a whole grain. In terms of other grain foods, it’s best to choose whole grains.

To get a better sense of carbs' role as a nutrient and its effects on the body, here's a brief overview: carbohydrates are either "simple" or "complex."

Simple carbohydrates are made up of one or two sugar molecules. The three single sugar molecules, referred to as monosaccharides, are glucose, fructose, and galactose. These single sugars combine with each other to form disaccharides, which are:

sucrose= glucose + fructose
found in fruits, vegetables, and table sugar
 
lactose= glucose + galactose
found in milk and milk products
 
maltose= glucose + glucose
formed when starches are broken down

Complex carbohydrates, also known as starches and fiber, are polysaccharides and oligosaccharides, which are long chains of sugar molecules. Starches are found in plant-based foods, such as rice, potatoes, beans, and grains. Fiber is found in a variety of fruits, vegetables, and whole grains.

Not all carbohydrates convert immediately to "sugar," or more accurately, to blood glucose. The digestive tract breaks down the long chains of sugars in complex carbohydrates into single sugars. Fructose and galactose do not immediately raise blood glucose levels, since they are first sent to the liver to be converted into glucose. Also, fiber is not digested by our gastrointestinal system, so it passes through, aiding digestion and contributing to feelings of fullness. Foods containing fiber often raise blood sugar more slowly than those without it.

However, there's more to a food than the amount it will increase blood glucose levels. Fruit contains many vitamins, minerals, and phytochemicals (plant chemicals) that are beneficial to good health. They are generally low in calories, and certainly are a good choice for a snack. As a matter of fact, many fruits contain a good amount of fiber, and more fructose than glucose. Examples of fruits that don't raise blood sugar quickly are fresh cherries, apples, pears, and plums. If you're hungry, some days, a couple of whole grain crackers may do the trick; other days, a piece of fruit will do. If you're really hungry, the piece of fruit may not suffice — you may want to add a handful of nuts, or a few whole grain snacks to satisfy you. When different foods are eaten together, the rate at which blood sugar increases is an average of the various items, and is also dependent on the quantity of food eaten. In addition to providing a wide array of nutrients, different foods provide various textures, flavors, and feelings in our mouths (known as mouth feel). These aspects of food provide much satisfaction — think about how we'd feel if we didn't have anything crunchy, chewy, fruity, creamy, etc. in our diet. These are more than enough reasons to see why it's important to include an assortment of foods each day.

Hope this helps you make healthier choices.

Alice

Complete and incomplete proteins in grains and vegetables?

Dear Perplexed by protein,

You're not alone — this can be a confusing subject. First some clarification — a complete protein is a protein that contains all nine essential amino acids (the building blocks of protein, which can only be obtained through eating food). Complete proteins come from animal-based products (meat, poultry, dairy, eggs, fish, etc), soy, and quinoa (a grain). An incomplete protein contains fewer than all nine essential amino acids, however incomplete proteins can be combined in meals to make a complete protein (for example by combining rice and beans or peanut butter and toast). These foods don't need to be eaten at the same time in order to be used by the body to build protein, as once was thought. We just need to eat these complementary proteins within 24 hours. Incomplete proteins come from plant-based foods, such as beans, rice, grains, legumes (other than soy), and vegetables.

Our bodies use amino acids from foods to make proteins. As a matter of fact, the amazing human body manufactures all types of substances — from hormones to muscle tissue, blood cells, enzymes, hair, nails, and many others — given the right proportions of amino acids.

All of the foods you mention contain amino acids, and therefore varying amounts of protein. Just because they don't contain all of the amino acids we need doesn't negate the fact that they contain some protein.

Although protein is a vital nutrient, our bodies don't require quite as much as you may think. The U.S. Recommended Dietary Allowance (RDA) of protein is 0.8 grams/kg per day for adults. This recommendation has been shown to meet the needs of 97.5 percent of the population. For a woman weighing 125 lbs (57 kg), her needs would be met with an intake of 46 grams of protein per day. For a man weighing 154 lbs. (70 kg), his needs would be met with 56 grams of protein a day. A person must be taking in sufficient calories to maintain their weight for these values. Dieters need larger amounts of protein, because some is burned for energy. Athletes require slightly more protein as well.

It's believed that people usually eat a variety of foods, thereby getting the amino acids needed to manufacture complete proteins. Granted, if a person only ate bread, s/he would be missing an essential amino acid. The same would be true if a person only ate vegetables. However, if these vegetarians added legumes to their diet, they would be able to obtain all of the essential amino acids needed to remain healthy. The Food and Nutrition Board of the National Academy of Sciences (which sets the RDAs) spell out the amount of each essential amino acid needed to form complete proteins. However, it isn't necessary to go that far, as long as you are covering your protein needs with a varied eating plan.

To determine your protein needs according to the RDA, divide your body weight in pounds by 2.2, which gives you your weight in kilograms, and then multiply that number by 0.8. Consult the following charts for protein content in various foods. Adjust for the serving size and the number of servings you actually eat.

Animal Sources of Protein Serving Size Protein (in grams)
Meat/Poultry/Fish 3 oz. 21
Cottage cheese ½ cup 14
Milk 1 cup 8
Yogurt 1 cup 8
Cheese 1 oz. 7
Egg 1 whole 6
Egg white only 1 3

 

Plant sources of Protein Serving Size Protein (in grams)
Tofu, raw, firm 3 oz. 13
Legumes: (Black beans, Kidney beans, Chickpeas, etc.) ½ cup 7 – 8
Peanut butter 2 T. 8
Nuts 1 oz. 5
Bread 1 oz. (1 slice) 3
Cereal 1 oz. 3
Vegetables ½ cup cooked or 1 cup raw 3
Pasta or rice ½ cup 3

So, as you can see, it's not difficult to reach your daily protein needs, as long as you include a variety of foods in your daily intake. Incomplete proteins needn't be too much of a concern. Vegetarians who consume complementary proteins are usually able to easily meet their protein requirements. If you'd like to get more information, it may be helpful to make an appointment with a registered dietitian to help you understand and meet your specific nutrition needs.

Alice

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

Columbia Health Nutrition Services (Morningside)

Student Health Service Nutrition Services (CUMC)


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