Nutrition & Physical Activity
Eating gluten-free certainly warrants paying attention to what you are excluding and how that may impact your health. Good for you for thinking carefully about your diet and asking questions. As someone with celiac disease, it's even more important to learn about how your food choices may impact the amount of certain vitamins and nutrients in your meals.
Let’s start with some basic facts about gluten-free diets. While eating a gluten-free diet is advised for those with celiac disease, it is not a quick fix, and it is not a flawless nutritional regimen.
- The pros? Removing gluten will reduce inflammation and hopefully reduce damage to the intestines caused by celiac disease. Initiating and maintaining a gluten-free diet is universally recommended as a lifelong treatment for those with celiac disease.
- The cons? Gluten-free diets/foods may be low in certain nutrients (like B vitamins, calcium, vitamin D, iron, zinc, magnesium, and fiber). Many gluten-free packaged foods may also be higher in fat and cholesterol.
One way, and perhaps the preferred option, for increasing your intake of vitamins is through food. Some food sources of B-vitamins, calcium, fiber, folate, iron, magnesium, vitamin D, and zinc are:
- Fruits — apples, berries, figs, oranges, pears, plums, prunes
- Legumes — lentils, split peas, beans (black, garbanzo, kidney, lima, pinto)
- Meats, fish, and eggs — all kinds!
- Nuts and seeds — almonds, chia seeds, flax seeds, pecans, pistachios, sunflower seeds
- Vegetables — artichokes, broccoli, green leafy vegetables (chard, collards, kale, spinach, etc.), squash
- Whole grains — amaranth, quinoa, buckwheat, brown rice, teff, millet
Vitamin D is exceptionally hard to find in a wide variety of foods. The foods with the highest levels of vitamin D per serving are cod liver oil, swordfish, salmon, and tuna. Vitamin D is also produced in our bodies when we exposed to sun. For this reason, many people in northern climates have lower levels and may take supplements. You may want to talk with your health care provider to determine whether taking vitamin D supplements in addition to food sources is right for you.
Maintaining a healthy diet is important for everyone — and especially for those with celiac disease. Some good tips to get the most benefits from your food are:
- Opt for fresh produce, whenever possible. Fresh vegetables and fruits will have the highest levels of vitamins. Also try to eat foods that are grown local and in season. If you can’t always eat fresh, frozen is second best.
- Don’t overcook vegetables. Cooking vegetables too long will detract from their nutritional value. Using various cooking methods like sautéing, steaming, blanching, or even baking your veggies will reduce the amount of vitamins and minerals lost so your veggies will still pack a nutritious punch!
- Aim for “whole” foods. The fewer ingredients in your food, the better. One way of doing this is to avoid processed and packaged goods. Processed foods will have higher levels of unhealthy fats, sodium, and sugars.
- Eat the rainbow! A diet that includes a variety of colors (like those found in fruits and vegetables) is indicative of different vitamins. Keeping your plate or bowl colorful will ensure you’re eating a wide range of nutrients.
Before beginning a new nutritional program or diet, consider talking with your health care provider about the pros and cons and whether it is right for you. Additionally, a registered dietitian can give you in-depth information about the benefits and risks of excluding and including specific foods or supplements. If you are a Columbia student, you can make an appointment to speak with a registered dietitian or a health care provider by contacting Medical Services (Morningside) or the Student Health Service (CUMC). Checking out the Academy for Nutrition and Dietetics' celiac disease page may also help you get ideas on what to look for at the grocery, how to decipher what is gluten-free, and links to other helpful websites.
Here’s to noshing for nutrients!
Regular exercise is good for the body and mind — and can also boost your immune system! But what to do when germs already have you down? Here are a couple rules of thumb:
Are your symptoms above or below the neck?
- “Above the neck”— if you have symptoms like a runny nose, watery eyes, a mild sore throat, or other symptoms of a mild cold, it is generally ok to exercise. Listen to your body — if you feel up to a light work out, go for it.
- “Below the neck”— if you have symptoms like chest congestion or tightness, muscle aches, cough, or nausea, hold off. Exercise may do more harm than good, no matter how exercise-ready you feel. Monitor these symptoms closely, get plenty of rest, hydration, and if you’re not starting to feel better, set an appointment with you health care provider.
If you have “above the neck” symptoms, and want to get in a light workout, some of your best options are walking, jogging, qi gong, yoga, or other low-intensity activities. In general, try to exercise at a lower intensity than your normal routine — less weight and more reps, jog or cycle at a slower pace, etc.
Try to avoid gyms or group settings, where you may be exposed to more germs and spread the germs you are carrying to others. As an alternative, try to workout at home with body weight exercises or personal equipment.
Here are some additional ways to keep yourself healthy when you work out:
- Drink up! Hydration is key when you are sweating. If you become dehydrated your mucous membranes also dry up and are more susceptible to infection.
- Re-Fuel! Exercise will burn up calories faster than normal — and calories are your primary source of energy. Eat a healthy post-workout snack with both carbohydrates and protein to make sure your body can continue to work efficiently, even after your sweat session is over.
- Get your R&R! Rest and recovery is just as important as your regular workout. Balance training days with regular rest days so your body can recover from tough workouts and perform at its peak.
- Get out of those sweaty gym clothes! Sweating helps your body regulate temperature — as you heat up from exercise, sweat cools you down. But staying in cool, damp clothing post-workout is not ideal. Ditch the sweaty spandex and opt for drier, warmer options.
- Wash your hands! The signs in the bathroom are not just for employees — everyone benefits from hand washing. Even at the gym. Sharing weights, mats, and even using the water fountain are all ways you can spread germs and pick up germs. Do yourself and your gym-mates a favor and wash your hands thoroughly and frequently.
If you are feeling under the weather, keep track of your symptoms and exercise in moderation. If you notice increased congestion, coughing or wheezing, it’s a good idea to make an appointment with a health care provider. If you’re a Columbia student on the Morningside campus, you can use Open Communicator to schedule a visit with Columbia Health Medical Services. If you are on the Medical Center campus, contact the Student Health Service for an appointment. More serious symptoms include chest tightness or pressure, trouble breathing, dizziness, or difficulty with balance. If you experience any of these symptoms, stop exercise and seek emergency medical attention right away.
Hope this helps!
Although wine snobs may claim they can taste the difference between cheap and expensive wines, the truth is that delicious wines can be purchased at a wide range of prices. Many different factors, such as land price, farming practices, the fermentation and aging processes, and even the brand name can affect how much wine costs — but none of these are directly related to adding sugar.
Sugar serves several purposes in the complex process of winemaking. First, sugar is what yeast metabolizes into alcohol to make wine alcoholic. The riper grapes are, the higher sugar content they have, and the more alcohol the wine will eventually contain. If grapes are less ripe, sugar may be added before fermentation so the final product will be more alcoholic. In dry wines, all the sugar is allowed to ferment into alcohol, whereas sweet wines have more residual sugar. Sugar can also be added after the fermentation process to change the sweetness level of the wine. In some cases, risking losing the grape crop by letting the fruit ripen for longer on the vine or complicating the process by using sugar for flavor or a secondary fermentation may increase the price of wine.
However, what determines the calorie level of your wine is not how much it costs, but a combination of its sugar content and, most importantly, the amount of alcohol in it. A six ounce-serving of wine can contain anywhere from around 107 to 275 calories depending on whether it is red or white, dry or sweet, and light or heavy alcohol. As alcohol contains close to twice as many carbs as sugar, heavier wines tend to be more caloric. If you’re looking for the wine with the smallest effect on your waistline, you’re best off choosing a light, dry white wine. Since you said you prefer red, however, try looking for a light, dry wine such as a Pinot Noir, Cabernet Sauvignon, or Syrah — not only do these wines tend to have fewer calories, but they also contain different minerals and antioxidants which, when consumed in moderation, may be beneficial for heart health.
Congratulations on finding an exercise program that you truly enjoy and want to stick with. Good news — your yoga practice doesn’t have to suffer now that your months’ worth of yoga classes has run out! Taking yoga classes can be expensive and time consuming, but there are numerous ways to work around the cost.
Free yoga classes are often available through community centers, the YMCA, public parks (New Yorkers should see Shape Up NYC), and university clubs and student organizations. Some private yoga studios offer free classes during off-peak hours with teachers-in-training. Other studios, such as New York City’s Yoga to the People, are donation-based and operate under the principle that yoga should be accessible to everyone, regardless of socioeconomic status. Most studios also offer class punch cards, purchased in bulk (usually between 10 to 20 classes), that are offered at a discounted rate. Finally, don’t hesitate to ask your local yoga studio if you may participate in karma yoga, a practice in which yogis trade assistance around the studio (such as front desk work, cleaning, or publicity) for free yoga classes.
The benefits of practicing at home are numerous — the fact that it’s free is just one of them! Doing yoga at home may help release you from self-consciousness, mitigate the stress of daily life, permit you extra time to focus on the poses you prefer or want to work on, allow you to focus your attention inward, and help you establish awareness of the relationship between the mind, body, and breath.
Indeed, there are guidelines for practicing yoga at home:
- Block out time for your at-home yoga practice in your schedule just as you would an in-person yoga class. You might try 30 minute sessions three to four days a week, for example.
- Set a timer at the beginning of your practice — some yogis prefer long sessions, but research shows that consistency, not the duration of the practice, helps build routine.
- Consider purchasing a yoga mat, block, and strap for home use. This equipment does involve an initial investment, but it will pay off the more you practice at home.
- If you’re not sure where to start, consider following a CD or video (available online and at most public libraries). As you grow more accustomed to at-home practice, you’ll naturally become your own teacher.
Other types of exercise, such as Pilates, dance, barre, and Tai Chi, function similarly to yoga in that they focus on stretching, strengthening, and mindfulness. Like yoga, you may that they require some guidance, especially when first starting, but that you can eventually move to an at-home practice.
Engaging in a combination of full cost, low-cost, free, and at-home yoga practice methods may be the best way to address your various needs. If you’re a Columbia student, check out the various low-cost exercise classes offered at the Dodge Fitness Center for more ideas and inspiration. While you’re at it, take a look at the CU Move program to discover other ways to stay physically active on campus, and if you’re interested in addressing stress outside of your yoga practice, look into the Stressbusters program or, if you’re on the Medical Center campus, the Center for Student Wellness.
Dear Pondering Protein,
Everyone knows that the best part about hitting the salad bar is having free reign over all the toppings! As you know, when it comes to protein toppings for your salads, there’s a long list of options; but with so many options to choose from, it can be difficult to decide which ones are the healthiest. Ultimately, the “best” protein to add to your salad is the one that will satisfy your appetite and contribute to a balanced diet. So, while there’s no definitive answer as to which protein is the smartest choice, let’s discuss some things to consider before you dig into that salad.
You are certainly correct that turkey is leaner than chicken. In fact, turkey has about two-thirds fewer calories per ounce! Turkey also contains less saturated fat, which is good for keeping your cholesterol down. While both chicken and turkey are excellent sources of protein, chicken contains almost double the amount of protein per ounce. Chicken also contains less sodium, which means it can help stabilize your blood pressure. So it really depends on what you’re looking for, especially when you take into account the other foods you’re eating throughout the day. It’s all about balance.
There are also trade-offs to consider with the other sources of proteins you mentioned. Tuna has less calories and fat than chicken, but it also has less protein. And, as you mentioned, tuna, depending on where it's from and whether it's fresh or from a can, can also contain mercury, so you will need to keep that in mind. Eggs contain less saturated fat, but are high in cholesterol. With a family history of high cholesterol, you might want to try egg whites instead or do the whole egg, just not every single day. Don’t forget that popular salad toppings like beans, nuts, and some grains are also great sources of protein, in addition to offering plenty of fiber, vitamins, and minerals. Just think about all the options: bulgur, quinoa, black beans, chickpeas, kidney beans, walnuts, almonds, lentils, tofu, tempeh — the list goes on and on. You can also add some protein to your salads in the way of a dressing. What about using hummus, cottage cheese, or a yogurt-based dressing?
Each option offers different pros and cons, so try switching it up to add variety to your diet. This will also keep you excited and looking forward to your meals. If you want to investigate further, check out the USDA National Nutrient Database, which will give you information about the nutritional content of all your favorite foods. If you’re a Columbia student, you may also want to check out the Get Balanced Guide for Healthier Eating.
Whichever protein you choose, keep eating those leafy greens!
The situation you describe is, unfortunately, all too common. That is to say, you are most definitely not alone in your feelings of not being in control and having the sense that food controls your life. Disordered eating, including binge eating disorder, is an issue that affects approximately 20 million women and 10 million men at some point during their lives. While there are a number of helpful online resources that can help, it’s highly recommended that you consult with a mental health professional about treatment. Fortunately, there are several reduced-cost treatment options you can take advantage of to help you on your road to recovery.
Let’s start with the online resources. The National Eating Disorder Association (NEDA) has a wealth of resources for people who struggle with eating disorders. Beyond the information on their website, the NEDA runs an Information and Referral Helpline through which you can connect with staff members who can help you find treatment programs, support groups, and other information specific to your situation. NEDA also allows you to search for treatment services with sliding scale payment options and runs an interactive website just for teens.
Other affordable options for treatment are training institutes accredited by the American Psychoanalytic Association. These institutes allow people to receive psychotherapy from therapists in training. This treatment comes with a low price tag, sometimes only $10 to $15 per session, or is priced on a sliding scale basis. If you are a student at Columbia, contact Counseling and Psychological Services (Morningside) or Mental Health Services (CUMC) to make an appointment with a therapist.
As far as the issue of weight gain goes, working with a professional, in addition to figuring out the underlying reasons behind your overeating, will help you become more comfortable with your body. Restrictive dieting is usually not the best approach, as it can be an unhealthy and ineffective method of losing weight. Finally, eating healthfully, exercising regularly, and getting enough sleep are great first steps and will positively complement other treatments such as therapy.
Hope this is helpful,
March 11, 2014554417
Being a picky eater is one thing, but having such strong aversions to certain foods that you gag violently is quite another. You’re right to associate symptoms such as ongoing lethargy with an unbalanced diet, and it sounds as though the difficulties you experience when trying to eat certain foods may be preventing you from meeting your most essential nutritional needs, including calories for energy. Good news — studies show that treatment for individuals who experience similar aversions to a wide variety of foods is highly effective, so keep at it!
Parents and babysitters will attest to the fact that picky eating is very common among children and adolescents. However, highly selective eating behaviors that begin in or last through adulthood are much less prevalent. Fortunately, treatment works; in a study with individuals whose diets were composed of six foods or less, phasing new foods into the diet with an emphasis on trying new foods, not eating large quantities of them, was effective. All study participants who accepted treatment were able to incrementally diversify their diet.
One of the principal consequences of eating an unbalanced diet low in nutrients is becoming underweight. Being underweight may cause a variety of short- and long-term health consequences, including fatigue (as you mention), weakened immune system, fragile bones and osteoporosis, anemia, and for women, interrupted periods and fertility issues. One of the best ways to prevent becoming underweight is to maintain a healthy diet. For a thorough summary of what a balanced diet looks like, check out the get balanced! Guide for Healthier Eating. Looking over the Guide will help you set goals and give you ideas about new foods you may be willing to try, such as delicious and nutritious fruits and vegetables. While maximized for students at Columbia, the key ideas in the guide can work for anyone and there are additional resources listed.
Seems like your current diet is high in carbohydrates, which may give you a short blast of energy but fade away rather quickly. Have you considered trying other foods of various textures that can help sustain your energy, such as fruit smoothies, nuts, yogurt, and berries? Alternatively, consider recombining ingredients in your existing diet — for example, you might try putting some cheese with tomato sauce on your pasta (almost the same as pizza). Experimentation within the range of your “safe foods” list may help you become more open to trying new foods. Once you’re ready to try new foods, take small tastes and evaluate what you like and don’t like about the food. You won’t necessarily like every new food you try, and that’s okay — it’s all about being open to experimentation.
In addition to simply disliking the texture of certain foods, there may be emotional factors that are preventing you from eating a well-balanced diet. In fact, clinical trials show that gagging, vomiting, and retching when exposed to a new food is often stress-related. Meditating, using breathing exercises, and experimenting with other relaxation techniques is highly effective. Seeking treatment from a professional may also be helpful. Columbia students are encouraged to contact Counseling and Psychological Services (Morningside Campus) or Mental Health Services (CUMC Campus) for support.
By slowly incorporating different foods into your diet, you will be on the right path to achieving a healthy weight. For additional input, consider reaching out to a dietician. Columbia students may schedule an appointment with a nutritionist through Medical Services (Morningside) or Student Health (CUMC) and should also check out Alice! Health Promotion Nutrition Initiatives. If you are not a student at Columbia, check with your campus health service or primary care provider for a referral.
The long term health benefits of working to overcome food aversions are well worth it; those who undergo treatment often report enjoying eating more, being less anxious about social situations involving eating, and increased self-confidence both at and beyond the table. Bon appétit!
Now that your coworker has planted the idea of chlorophyll’s health benefits in your mind, it’s time to dig up some facts. Chlorophyll has been used as a supplement since the 1960s, although chlorophyllin, a solution of sodium copper salts made from chlorophyll, is more commonly and inexpensively available (this is likely what your coworker’s “chlorophyll water” contained). Although it does have some approved uses and suspected health benefits, no long-term or large-scale studies with humans have been done to conclusively prove its supposed health-boosting properties. Furthermore, while most supplements are made with chlorophyllin, studies suggest that chlorophyll — naturally available in vegetables such as spinach, parsley, and garden cress — may be a more potent health agent.
Chlorophyllin-containing papain/urea ointments and sprays are sometimes prescribed to treat inflammation, speed healing, and reduce odor in wounds. Patients with colostomies and ileostomies can also take over-the-counter supplements containing chlorophyllin to reduce fecal odor, although some studies dispute the efficiency in this. While these are the only two approved uses for chlorophyllin, other potential positive health effects may include:
- Reducing damage from carcinogens. Chlorophyll has been shown to bind to carcinogens, such as those in tobacco smoke and cooked meats, thus reducing their ability to enter the bloodstream and reach tissues.
- Protecting against liver cancer. A study in China showed that a biomarker for aflatoxin, a carcinogen found in improperly stored grains which causes liver cancer, was present at lower levels in participants who simultaneously consumed the toxin and chlorophyll. Because the development of cancer takes many years, however, the long-term effectiveness of chlorophyll is unclear.
- Treating trimethylaminuria (or fishy body odor). Chlorophyll reduces the amount of trimethylamines, and the associated fishy odor, excreted by people with this hereditary condition.
- Combating colon cancer. Chlorophyllin has been shown to inhibit DNA synthesis and repair processes in colon cancer cells, giving it potential for use in cancer therapy.
- Antioxidant properties.
It’s important to note that chlorophyllin also has potential side effects. Taken by mouth, it can cause urine or feces to appear greenish, black or yellow discoloration of the tongue, or occasional diarrhea. Used as an ointment or spray, it can cause a slight burning or itching sensation. Despite these mild side effects, no major toxicity in chlorophyll or chlorophyllin has been discovered in more than 50 years of popular use. Because of the lack of substantial research into chlorophyllins, however, those who are pregnant or breastfeeding may want to avoid this supplement or check in with a health provider before using it.
In summary, while the grass may be greener on the chlorophyll-watered side, science has yet to demonstrate its health benefits outside of a few very specific uses.
Hope this helps!
Although you describe your appetite as being low, the fact that you love food makes your problem much easier to manage. It sounds like you’re losing track of your eating schedule now that you’re on your own, but there are lots of ways to work around this, especially because you like to cook and eat! Establishing healthy habits takes time and effort, but practice makes perfect, and soon enough you’ll get into the swing of a healthy routine. Planning your meals in advance, incorporating food into your daily activities, and sticking to a schedule will all help you get there.
A widely accepted general rule is to not eat if you’re not hungry. However, not eating all day isn’t a particularly healthy pattern— consuming too little food throughout the course of the day may result in shakiness, tiredness, and general mental cloudiness as well as nutritional deficiencies and immune system weakness. The first step: Incorporating a healthy breakfast into your morning routine can help get your metabolism going early in the day, which can help boost appetite later on, helping you remember to eat. Although you may not feel hungry first thing in the morning, consider energizing your body with complex carbohydrates — try whole-grain cereals with milk, whole-wheat toast with peanut butter, or yogurt with nuts and fruit. For more information on other specific meal and snack options, check out the get balanced! Guide for Healthier Eating.
Once you’ve had your breakfast, you have a solid nutritional base to build off of for the rest of the day. Try sticking to a schedule by eating at approximately the same times every day, whether you choose to eat three large or six small meals per day. Spread your meals apart, and set alarms if needed. When mealtime arrives, make sure to focus on your food, and avoid eating on the go or while watching a movie. Mindfulness will help you get into a routine.
In addition to eating at regular times, try keeping a food journal to analyze your habits. Write down what and when you eat, and after a few days, check your journal for patterns. You might find, for example, that you tend to reach for sweet snacks around 3:00 p.m. for an afternoon pick-me-up. Adjust your food choices and eating schedule according to your observations.
More ideas: Choose a library or workspace that has vending machines with healthy options so you’re reminded to eat, or make a commitment to have lunch with a colleague, classmate, or friend, which will help to incorporate healthy eating into your professional, academic, and social engagements. Always make sure to have healthy snacks on hand so you aren’t forced to make poor nutritional choices under pressure. Nutritious and yummy snack options include string cheese and dried fruit, almonds and low-fat cottage cheese or yogurt, or multigrain crackers with sliced turkey, hummus, or a hard-boiled egg. Prepare your healthy snacks and meals at night so you don’t forget to bring food along with you in the morning.
More generally, have you ever investigated the possible reasons for your lifelong low appetite? Lack or loss of appetite is sometimes indicative of various medical and psychological conditions, so it would be helpful to make an appointment with your healthcare provider to discuss your concerns. Individuals experiencing sudden loss of appetite should meet with a healthcare provider as soon as possible. Columbia students can use Open Communicator or call 212-854-7426 to make an appointment with a healthcare provider on the Morningside Campus or dial 212-305-3400 to book over the phone with Student Health on the Medical Center Campus. Columbia community members are also encouraged to take a look at the Alice! Health Promotion Nutrition Initiatives.
Most importantly, be patient with yourself. Don’t try to make too many changes at once; slowly incorporating these ideas into your day will help you get on track without getting burned out or frustrated. If you slip up every now and then, don’t beat yourself up. Instead, ask yourself what caused you to forget to under- or overeat, and consider ways to adapt and prevent this from happening again. Bon appétit!
A few things to consider: First, do the nuts and nut butters you’re eating have added salt or sugars? If so, you may want to look at your overall sodium and sugar intake. You can have “too much of a good thing” when it comes to salt and sugar. Second, how’s the rest of your diet? Are you eating lots of vegetables (don’t forget your greens)? What about whole grains and fruits? While the calories in nuts can meet your body’s energy needs and provide protein, fiber, and some vitamins, there are additional nutrients, vitamins, carbohydrates, and sugars that can only be found in vegetables, fruits, starches, and other protein sources. So, dear reader, depending on your answers to the questions above, the amount of nuts you consume may or may not help you achieve a balanced diet. If you're not sure what a balanced diet looks like, head on over to ChooseMyPlate.gov for more information.
Nuts provide a lot of nutritional benefits, not to mention convenience in the form of a quick and tasty snack. As you might already know, nuts are mostly made up of vegetable protein and unsaturated fat, as well as dietary fiber, vitamins, and minerals. Studies have shown that eating nuts lowers the risks of coronary disease and cardiac death, and reduces serum cholesterol levels and risk of type 2 diabetes in women.
Some may worry that too many nuts will contribute to weight gain, but that doesn’t sound like an issue for you. Weight gain is a result of calories in versus calories out. While nuts are a calorie-dense food, if the remainder of your diet is mostly low-calorie fruits and vegetables, whole grains, and some lean protein source, you probably aren’t eating more calories than you burn. The amount of calories you need is dependent on a number of factors, physical activity levels included. Eating nuts is even potentially protective against weight gain, as nuts can increase feelings of fullness and replace calories that would be consumed in other foods, leading to smaller and less frequent meals. Further, the number on the scale doesn’t necessarily indicate the health of a person. If you feel good, are living an active lifestyle, and consuming a balanced diet, your nutty obsession should be just fine. If you'd like to ask even more questions about your diet, you might consider making an appointment with a registered dietitian.
Enjoy and happy snacking!