Optimal Nutrition

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Could drinking too much soda lead to osteoporosis or kidney failure?

Dear Curious,

You may want to screw the cap back on that cola! It appears that there is an association between soda consumption and osteoporosis, as well as an association between soda consumption and markers for kidney disease in women who have a low to normal Body Mass Index (BMI). As with most foods and drinks, moderation is key to good health. A little information can go a long way, so keep on reading to learn more about these links.

Studies have shown an association between regular intake of colas that contain phosphoric acid and negative effects on the bone. Researchers hypothesize that a high level of phosphoric acid may lead the body to tap the bones for calcium to neutralize acids. Alternatively, researchers believe that osteoporosis could be a result of diet displacement — that is, heavy soda drinkers may not be drinking enough milk or fortified juices that are good sources of vitamin D and calcium. Just to note, the link between soda and osteoporosis was previously thought to be due to the carbonation in the soda — research has shown this association to be false.

As for kidney function, studies have found that women with low to normal BMIs who drink more than two cans of soda daily have about double the risk of developing albuminuria (the presence of the protein albumin in the urine) relative to those who don't drink that much soda. Albuminuria is a marker for developing early kidney disease. Researchers believe that this effect is more pronounced in low to normal weight women, because obesity already damages the kidneys and the extra damage from soda is likely to be less observable. It is unknown why the same effect is not seen in men. Additionally, studies have shown mixed results on the relationship between soda consumption and the development and recurrence of kidney stones.

In any case, reducing soda consumption can't be a bad thing. Not only are you playing it safe with regards to osteoporosis and kidney function, you're also avoiding a lot of extra calories and damage to your teeth. For tips on cutting down, check out Getting off colas, sodas, pop, fiz...oh, whatever!. Now raise your glass to better health! 

Alice

May 18, 2012

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Hmm...interesting. I also heard that cow's milk contains some protein which prompts the bones in your body to release calcium. There's supposodly support for high cow milk consumption and...
Hmm...interesting. I also heard that cow's milk contains some protein which prompts the bones in your body to release calcium. There's supposodly support for high cow milk consumption and osteoporosis.

Is juice as good as whole fruit?

Dear Joyful Juicer,

Juicers can be a great low calorie, high nutrient, tasty treat. However, they don’t generally carry all the benefits of eating the original fruit or veggie from whence it came.

If you've made juice, you know that it takes a lot of fruit to make a container of juice. Usually, juicers extract the juice and some pulp from fruits and/or vegetables. You’ll get all of the vitamins, minerals, beneficial plant chemicals (phytochemicals), and carbohydrates in juice that's extracted from a whole fruit. However, you won’t get much of the fiber, and depending on the fruit, you may not get any of it.

Fiber aids in the digestive process. It acts sort of like a scrub brush for your intestines and speeds up the movement of waste through your system. It also can fill you up, and may help protect against certain cancers. Fiber in fruit is found in the membranes between sections, the white part around the outside (as in oranges and grapefruits), the seeds, the skin, and the peels. For example, orange juice contains no fiber (even if it has pulp) because the fiber is found in the membrane, which is lost during the process of juicing.

It is also important to remember that juice is not a low calorie drink. An eight ounce glass of orange juice contains 110 calories — the equivalent of two oranges (each contains about 60 calories). But you won't feel as filled up from juice since it doesn't contain any fiber. For many people, drinking a caloric beverage, such as juice, isn't as satisfying as eating the same amount of calories in food. For those who need to increase caloric intake — such as athletes, children, or teens — juice is a great choice.

Fresh juice is certainly tasty and an excellent source of many nutrients. Less stable vitamins, such as vitamin C, are not compromised in fresh juice as they may be in some processed varieties. Also, watch for added sugar in many processed juices that can increase caloric content.

In general, juice is just fine. But if fiber’s what you’re after, go for the whole fruit or veggie over the liquefied form. Happy juicing!

Alice

Importance of eating breakfast

Dear Breakfast Boycotter,

Your brain (and central nervous system) run on glucose — that's the fuel you need to think, walk, talk, and carry on any and all activities. Let's say that the last time you eat something at night is at 10 or 11 PM (not optimal, just an example). The following day, you don't eat breakfast but wait until about noon or so to eat — you've gone thirteen or fourteen hours with nothing in your system. Your poor brain is surely deprived — and your body has to work extra hard to break down any stored carbohydrate or turn fat or protein into a usable form for your brain to function. That's a lot to ask for when you're sitting in a classroom, trying to concentrate on reading, or doing any other work. Eating breakfast has been proven (many times) to improve concentration, problem solving ability, mental performance, memory, and mood. You will certainly be at a disadvantage if your classmates have eaten breakfast and you've gone without. On average, they will think faster and clearer, and will have better recall than you. School or work can be tough enough without this extra added pressure.

Breakfast skippers also have a harder time fitting important nutrients into their diet. Many foods eaten at breakfast contain significant amounts of vitamins C and D, calcium, iron, and fiber.

Some people believe that skipping breakfast may help them lose weight. Not so! Skipping meals often leads to overeating later in the day. Becoming overhungry often leads to a lack of control and distorted satiety signals (meaning it's hard to determine when you're full). This can result in taking in more calories than if one had an appropriate breakfast. As a matter of fact, it's easier to control one's weight by eating smaller meals and snacks more frequently.

What if there's just no time in the morning to eat breakfast? There are plenty of items you can bring along with you to school or work. Carry a resealable bag of easy-to-eat whole grain cereal, or bring a yogurt or small box of skim milk, juice, or fruit. If you just can't stomach food in the morning, try to have a little something — such as some juice — and bring along a mid-morning snack. Other good portable items include: whole grain crackers, a hard boiled egg, cottage cheese, low-fat granola bars, or even a peanut butter sandwich. Single serving hot cereals, such as oatmeal, are handy — all you have to do is add hot water, available at most cafeterias or delis.

Whatever your choice, eat something. If you think you're doing fine with no breakfast, just try changing your tune for a week —you're likely to notice a difference. You will undoubtedly perform better with some fuel in your system, and, hopefully, become a breakfast believer.

Alice

Pros and cons of vegetarianism

Dear Reader,

It's a great idea to plan consciously when switching over to a vegetarian diet. Not eating meat can offer many health benefits, as well as addressing environmental and ethical concerns you may have regarding eating animals. However, before making the switch to a meat-free lifestyle, it is important to get a sense of the pros and cons.

Here’s the best news of all: with a well-planned diet, vegetarians can live a totally healthy lifestyle and help contribute to a better planet. The following list describes various benefits of vegetarianism:

  • Plant foods are abundant in nutrients, including vitamins, minerals, and protein. They also contain phytochemicals — plant chemicals that are not essential to life, but may help protect against disease — such as beta-carotene. Eating a variety of colors of fruits and vegetables can help ensure that the benefits nature provides are reaped.
  • Reduce your risk of type 2 diabetes. Vegetarians benefit from eating less saturated fat and cholesterol, and higher amounts of complex carbohydrates, dietary fiber, certain minerals, and phytochemicals. Cholesterol is only found in animal foods, so vegan diets are completely cholesterol-free.
  • Contribute to the vegetarian cause! Whether you have aim to respect animals, lessen your carbon footprint on the environment, or just want to make a lifestyle change, as a vegetarian you are making your own positive impact on the world. You can be proud that you are living according to the beliefs that you stand for.

Whenever you cut a food group out of your diet, it is important to understand how to replace the vital nutrients that go along with it. While the positives are all fine and dandy, it is important to be aware of the challenges of being a vegetarian:

  • It can be harder to get the protein you need. Protein is important formaintaining and repairing muscle tissue, and manufacturing blood cells, antibodies, hormones, and enzymes. Fortunately, there are plenty of non-meat proteins to supplement your diet.
  • Possible vitamin and mineral deficiencies can develop without a balanced eating plan. Cutting out dairy, meat, fish, and poultry reduces your intake of vitamin B12 (important for nerve transmission and necessary for life), calcium (for strong bones, among other functions), iron (for blood), and zinc (for immunity and healing), just to name a few.
  • Depending on where you live, it may be challenging to adhere to a meat-free lifestyle. For example, living in a big city may provide you with endless veggie options, while a small-town lifestyle may make it more difficult to find healthy substitutions for meat.
  • You may have difficulty explaining your eating habits to family and friends.While it may seem that being a vegetarian is relatively mainstream, certain cultures leave little room for herbivores. You may encounter some sticky situations where people have prepared for you a meaty meal, or perhaps, your friends and family may challenge your decision to remain meat-free.

Remember, what is included in your diet (rather than what is excluded) is what counts. It is extremely important to incorporate a balanced eating plan full of nutrient-rich foods. For help in selecting a healthy eating plan appropriate for your state of health, age, size, activity level, preferences, and moral and ethical values, consult with a registered dietitian. Columbia students can make an appointment with a registered dietician at Medical Services through Open Communicator or by calling (212) 854-7426. Informed choices are the best choices!

Alice

February 23, 2012

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I've been vegetarian for over two decades, vegan for the past 6. Most days I get more than the daily recommended allowance of protein and calcium. For B12, there are really good veg supplements. I...
I've been vegetarian for over two decades, vegan for the past 6. Most days I get more than the daily recommended allowance of protein and calcium. For B12, there are really good veg supplements. I also use vegan nutritional yeast (sprinkle over pasta or rice or another savory dish). I'd recommend checking out some vegetarian resources online so you can try going veg in a way that's going to make you feel satisfied and healthy. Veg meet-up groups are a great way to meet some like-minded folks and help give some social support. Personally, going vegan was the best decision I've ever made. I'm now naturally thin (something I definitely wasn't before then), I eat a lot of yummy food each day and always feel satisfied, my health is great, and I feel good about how my choices affect animals and the environment. There's a new film called Vegucated that documents three New Yorkers' experiences going from meat lovers to trying out a veg diet. You might find it interesting. Good luck and enjoy!

Recommended dietary allowances (RDAs) of nutrients?

Dear Reader,

RDAs (Recommended Dietary Allowances), prepared by the Food and Nutrition Board of the National Academy of Sciences, have been around for over 50 years, with periodic updates. The RDA is the average daily dietary intake level that would adequately meet the nutritional needs of nearly all (98 percent) healthy persons. RDAs include nutrients for which there is sufficient scientific evidence that they are required for good health. Their intention has always been to establish "standards to serve as a goal for good nutrition." RDAs provide the basis for evaluating the adequacy of diets of population groups. They are set at a level that includes a safety factor appropriate to each nutrient; so, this level actually exceeds the requirement for most individuals.

The Food and Nutrition Board has established Dietary Reference Intakes (DRIs). In addition to RDAs, DRIs include recommendations for food components for which RDAs cannot be established. Some of these include fat, carbohydrate, fiber, and plant estrogens, among others. DRIs also include maximum intake levels. Three dietary intake reference values for DRIs are:

  • Adequate Intake — the dietary intake level that would adequately sustain health when an RDA cannot be determined because of insufficient scientific evidence.
  • Estimated Average Requirement — the estimated dietary intake level that would maintain the health of half of a specified age and sex group.
  • Tolerable Upper Intake Level — the maximum level of daily nutrient intake that's apparently safe and unlikely to cause negative health effects in most healthy individuals.

DRIs and RDAs are not developed for specific individuals, but are for the making of policies for feeding programs, food labeling, and food fortification. The numbers signify levels of each compound that are appropriate for most healthy people in each category. To access information on RDAs and DRIs, check out the United States Department of Agriculture's (USDA) Food and Nutrition Information Center website.

Vitamin supplements may contain an amount equivalent to the RDA for DRI, but you'll probably not find a supplement with every imaginable nutrient, vitamin, and mineral. There are innumerable substances that keep us healthy, many of which cannot be packaged in a pill. In addition, many nutrients are difficult for the body to absorb when they come in pill form. Obtaining nutrients directly from a balanced diet of fruits, vegetables, whole grains, and lean proteins is still the recommended manner of giving your body all it needs to be healthy.

To assess whether your current diet is filled with nutrients, check out ChooseMyPlate.gov. You can also speak with your health care provider about whether you need a multivitamin or if the food you eat is sufficient. Students at Columbia can also make an appointment to speak with a registered dietician or a health care provider either through Medical Services (Morningside) or the Student Health Service (CUMC). Take care,

Alice

Chocolate — good or bad?

Dear Reader,

Dinner's in a few hours. Lunch seems like it was ages ago. You still have to work on a paper, drive your little brother to soccer, and do the dishes. The deliciousness of chocolate and the sweet sugar/caffeine fix it offers may seem to be the only thing to get you through, so you reach for a bar… is that so bad? New research says no, and yes, depending largely on which type of chocolate you choose and how much of it you eat. Cacao, the bean from which chocolate is made, is not itself unhealthy. In fact, it offers many potential health benefits like lowering blood pressure, increasing sensitivity to insulin, improving coronary vasodilatation (widening of blood vessels) as well as other cardiovascular benefits, and acting as an anti-oxidizing agent. But not all chocolates are created equal.

The good guys in chocolate are flavonoids, health-promoting compounds found in plant-based foods (fruits, veggies, nuts, legumes) that belong to a larger class of compounds called polyphenols. In plants, flavonoids work to repair damage and protect from environmental toxins. When we consume plant-based foods rich in flavonoids, it appears that they can act the same ways in our bodies, offering antioxidant protection from free radicals, and protection from plaque formation on our arterial walls.

Dark chocolate is the most flavonoid-rich variety of chocolate, and therefore the most likely to offer health benefits. However, as chocolate is processed flavonoids are lost, and most commercial chocolates are highly processed. Flavonoids also tend to have a bitter flavor, so many commercial chocolates intentionally process them out. In addition, many chocolate products are made with milk, which can interfere with the antioxidant functioning of flavinols, negating most of the potential health benefits. Finally, many chocolate products are laden with caramel, nuts, marshmallow, and other high-fat, high-calorie add-ins that decrease the amount of flavinols in every bite and make a small chocolate snack a hefty caloric load. Even the best, most flavonoid-rich dark chocolate is replete with fat, sugar, and calories (one ounce of any kind of chocolate has about 140 to 150 calories and 9 to 10 grams of fat), so if you're upping the amount of chocolate you eat to gain health benefits, keep in mind that you may want to trim calories in other areas.

One final consideration: there is currently no research that definitively suggests the amount of chocolate that should be eaten to achieve health benefits. You could also get the polyphenol-related health benefits by eating other flavonoid-rich foods like apples, red wine, tea, cranberries, and onions. That said, for most people, enjoying a small piece of dark chocolate once in a while is probably not going to be harmful, and is more favorable than reaching for the common trick-or-treat variety candy bar.

Over time chocolate has gotten a mixed reputation. It used to be seen as a fattening, pimple-producing crutch for the premenstrual. But chocolate does not cause acne, raise blood cholesterol, cause addiction, nor is it fattening if eaten in moderation. More recently, the pendulum has swung in favor of chocolate, which has come to be regarded as a kind of superfood. While it can offer some wonderful benefits, it may not be the antioxidant source of choice for everyone. Chocolate, as well as red wines and certain cheeses, contains phenylethylamine (PEA), a substance that can dilate blood vessels in the brain. People sensitive to PEA might find that eating chocolate can trigger headaches, even migraines. And for those prone to heartburn, chocolate can cause an episode, as would any other high-fat food.

So is chocolate bad for you? Each person should answer this question for themselves taking into consideration which kind of chocolate is within reach and their own health needs. For most healthy and fit individuals, chocolate is a pleasurable and reasonably healthy way to get some flavonoids into the system. For those prone to migraines or who have to watch their fat intake, they might want to stick with the cranberries and onions.

Alice

Creatine monohydrate supplement for strength?

Dear Reader,

Creatine is a substance manufactured in the human body by the liver and kidneys or obtained from meat in the diet. It is present in muscle, nerve, and sperm cells. In muscles, creatine is used to form phosphocreatine, which can be used to supply energy needed for muscle contractions. It has been suggested that by increasing creatine in the diet, one may increase the amount of phosphocreatine in the muscle, which would then provide a greater availability of high energy phosphate for energy production during muscle contraction. It also may cause the muscles to retain water, a proposed mechanism for the "bulking" effect of the supplement.

No one really knows how much creatine is too much. Some people experience muscle cramps, electrolyte imbalances, fever, or gastrointestinal symptoms like nausea and diarrhea when they take creatine. Long-term effects are much less well-studied. While there is little conclusive evidence for adverse affects, people who have liver or kidney problems or who take diuretics should avoid taking creatine because of the theoretical complications. People with diabetes or who take either medications or supplements that affect blood sugar should also use caution. If you start to notice any side effects, you should stop taking creatine and see your health care provider.

As for benefits, creatine can enhance performance for short bursts of anaerobic activity, like weightlifting. However, people doing aerobic activities, like running or cycling, probably won't see any improvement.  

The amount taken in through commercially marketed supplements is far greater than one would be able to ingest via food. Some regimes call for a loading period — perhaps 20 to 25 grams for five days, followed by daily doses of about 5 grams. Non-meat eaters (vegans) may respond better since their natural creatine stores are probably lower than meat-eaters. Since any long-term effects from these high levels are uncertain, your best bet is to let your health care provider know that you take creatine. That way, if you ever do experience side effects, he/she will be better able to help you decide whether to keep pumping up.

Alice

Vegetarian — Can't wake up in the morning

Dear Not worried...just curious,

If your diet is leaving you drowsy, it may be related to not eating enough calories — especially since many vegetarian foods tend to be relatively low-calorie. Eating too few calories would leave your body without enough energy to "get up and go" in the morning. To increase your calorie intake, try buying a variety of nuts, seeds (sunflower, pumpkin, etc.), and dried fruits to make your own trail mix: each day, put about one cup into a bag and carry it with you to snack on. Besides added calories, you will also be getting a good source of vitamins, minerals, and some protein into your diet.

At meal times, include healthy size portions of grains (whole wheat, brown rice, oats, barley, buckwheat, etc.), vegetables, fruit, and legumes (dried beans and peas), and use a moderate amount of vegetable oil (canola and olive are good choices) for cooking. If you eat eggs and dairy, they can also serve as a great source of protein, calcium, and added calories.

In terms of exercise, aim for about 30 minutes of aerobic activity five or more times a week to get cardiovascular and energy-boosting benefits. Exercise in excess of about one hour of aerobic activity, five or more times a week, should be reserved for those training for a competitive sport (and who are eating higher-calorie diets!). High levels of exercise increase the risk of sports-related injury and may make it harder to take in a sufficient amount of calories.

Even if you think you sleep the right number of hours, keep in mind that some people, particularly college-aged people, require up to ten hours of sleep a night. Other sleep habits might also give you problems; for example, it's important to try to go to bed and wake up at close to the same time each day. Although this may seem nearly impossible on a student schedule, try to get on an even keel to start off the semester. If you wake up at 11:00 AM most days and get up for an 8:00 AM class two days a week, you most likely will feel like you never quite wake up on the two early days, even if your total amount of sleep is adequate. You may want to adjust your routine so that you go to bed early enough to wake up at the same time each day (weekends included), and see if your tiredness improves.

If you feel overly exhausted or your drowsiness is interfering with school and life activities, you may want to consider seeing your health care provider. Students at Columbia can make an appointment through Open Communicator (Morningside) or by contacting the Student Health Service (CUMC).

Good luck getting up and at 'em!

Alice

Milk — Bad or good?

Dear Cow lover,

Why does a milking stool have only three legs? Because the cow has the udder! Get it? Unfortunately, there’s not such a definitive answer to YOUR question. Research on the health effects of drinking milk has produced mixed results. As with any other food group, it is important to consider the pros and cons of dairy consumption.

Before a discussion of pros and cons, here is a run-down on recent milk research as it relates to osteoporosis. Although it is thought that drinking milk every day helps ward off osteoporosis, a small group of renowned researchers recently found that drinking too much milk can actually contribute to calcium loss. This is because the high amount of protein in milk thins blood and tissue, causing it to become acidic. In order to neutralize the acidity, the body draws out calcium from bones. As a result, the more milk you consume, the more calcium you need to process the protein intake. With that being said, drinking moderate amounts of milk each day (500 to 700 milligrams daily) is still thought to be good for your bones. More information on osteoporosis can be found in Calcium, milk, and osteoporosis?.

Moooving on, here is a list of the various pros and cons of drinking milk:

Pros:

  • Milk is high in calcium, which is important for healthy bones. Additionally, the calcium in milk is well absorbed by the digestive tract because the vitamin D and lactose found in milk facilitate calcium absorption. Still, it's possible to get ample calcium without drinking dairy milk — by eating foods such as tofu, soy milk, or greens such as kale. See Calcium — how much is enough? for more information.
  • Whole milk is brimming with protein, which is beneficial for muscle growth.
  • Studies have shown that drinking milk can help regulate weight gain.
  • Skim milk is very low in fat and cholesterol, and is a complete source of protein.
  • Milk is also a good source of phosphorous, magnesium, vitamin A, vitamin D, and riboflavin (a B vitamin).

Cons:                          

  • Whole milk is high in saturated fat, which can increase cholesterol level.
  • Milk is a common cause of food allergy (allergy to milk protein).
  • Many people lack the enzyme to digest lactose (milk sugar). This is called lactose intolerance, which causes bloating, gas, and diarrhea.
  • Milk may contain the antibiotics given to the cow while it is lactating. It has been argued that humans subsequently absorb these antibiotics upon drinking milk, potentially leading harmful bacteria to become more resistant to these antibiotics. As a result, when antibiotics are prescribed, they may not be as effective at killing the bacteria.
  • Some research has found a correlation between drinking milk that is produced by cows injected with the bovine growth hormone (rBST) and cancer. However, research shows highly mixed results.

As a side note, if you are concerned about the possible effects of antibiotics and rBST on your body, it is possible to buy antibiotic-free (and typically hormone-free, as well) milk from specialty grocers that carry natural foods. Alternatively, you can purchase USDA-certified organic milk, which is available at most supermarkets.

Overall, when researching the pros and cons of milk, it is important to take into account that there are two opposing sides — one that believes that milk is great for the body, and another that believes that milk does not aid against osteoporosis and is even harmful for the body. Whatever camp you choose to join, it is important to be informed. Seize every opportunity (to obtain information), and milk it for all its worth!

Alice

Avocados are fatty — are they healthy?

Dear Guacamole,

No need to pause that chip in midair, or order sushi sans avocado! Avocados are indeed high in fat, but they're high in monounsaturated fat, the good fat, the kind of fat that may actually help lower blood cholesterol levels. And as you rightly said, avocados contain no cholesterol — no plant foods do.

You may have heard the term low-density lipoproteins (LDL) in the discussion of different types of cholesterol. LDL cholesterol is often referred to as bad cholesterol because when the body has too much it can form plaque on the walls of arteries and veins which can cause heart attack or stroke. In contrast, high-density lipoproteins (HDL) clear the blood stream and artery walls of LDL and transport it to the liver where it can be broken down and eliminated. Lowering LDL and increasing HDL is considered desirable in terms of preventing heart disease and stroke. The good news in terms of those tasty avocados is that eating monounsaturated fats, especially while decreasing intake of carbohydrates and saturated fats, may decrease levels of LDL and raise HDL cholesterol.

The American Heart Association recommends that total fat intake be kept to 25 to 35 percent of your daily calories and that saturated fat comprise less than seven percent of total daily calories. That means the remaining fat should come from monounsaturated and polyunsaturated fat sources like nuts, seeds, fish and vegetable oils. Translated into layman's terms this would mean that a typical 2,000 calorie a day diet would include 50 to 70 grams of fat, with about 34 to 50 grams of that fat from poly- or monounsaturated sources and about 16 grams or less from saturated sources. Because it's hard to keep track of exactly how many grams of fat are coming from which sources, it's a good rule of thumb to choose unsaturated over saturated fats whenever presented the option. Saturated fats come from animal products like meat, seafood, milk, butter, cheese, and ice cream. Monounsaturated fats come from vegetarian sources like nuts, seeds, vegetable oils, olives, and, drum roll please… avocados.

In addition to containing healthful fat, avocados are also high in beta carotene, fiber, folate (a B vitamin), and potassium (ounce for ounce, avocados have 60 percent more potassium than bananas). To put the fat in perspective, avocados have less fat than lean beef per ounce, and a whole Haas avocado has less fat than 3 tablespoons of Italian salad dressing. While it's a good idea to take all fats in moderation, rather than shun the guacamole bowl at the party, help yourself to some of the green gooeyness, along with plenty of veggies, fruits, and whole grains. Enjoy!

Alice

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