Nutrition & Physical Activity

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Is decaffeinated coffee safe to drink?

Dear Curious,

In order for coffee to qualify as decaffeinated, it must have at least 97 percent of its caffeine removed. What does that chock up to? An eight-ounce cup of decaf coffee would have no more than 5 or fewer milligrams of caffeine (compared to the range of 40 - 180 mg. typically found in one eight-ounce cup of brewed, dripped, or percolated java). Your concern over the safety of decaffeinated coffee probably stems from solvents used in the past.

Today, most processors use safe methods to remove caffeine. A few different techniques are available, and understanding them may help allay your concerns about coffee contaminants. Coffee beans are decaffeinated by softening the beans with water and using a substance to extract the caffeine. Water alone cannot be used because it strips away too much of the flavor. The goal is to extract the caffeine with minimal loss of flavor. Substances used to remove the caffeine may directly or indirectly come in contact with the beans, and so the processes are referred to as direct or indirect decaffeination.

In one process, coffee beans are soaked in water to soften them and dissolve the caffeine. The water containing the caffeine (and the flavor from the beans) is treated with a solvent, heated to remove the solvent and caffeine, and then returned to the beans. The flavors in the water are reabsorbed by the beans, which are then dried. This process is referred to as "indirect decaffeination," because the beans never touch the solvent themselves. The most widely used solvent today is ethyl acetate, a substance found in many fruits. When your coffee label states that the beans are "naturally decaffeinated," it is referring to this process, specifically using ethyl acetate. Although it doesn't sound like a natural process, it can be labeled as such because the solvent occurs in nature. Other solvents have been used, some of which have been shown to be harmful. One, methylene chloride, has been alleged to cause cancer in humans and therefore is not often used. Back in the 1970s, another solvent, trichloroethylene, was found to be carcinogenic and is no longer used.

Another indirect method soaks the beans in water to soften them and remove the caffeine, and then runs the liquid through activated charcoal or carbon filters to decaffeinate it. The flavor containing fluid is then returned to the beans to be dried. This charcoal or carbon process is often called "Swiss water process" (developed by a Swiss company). If your coffee is labeled naturally decaffeinated or Swiss water processed, you can be assured that no harmful chemicals are used. If you are uncertain, you can ask or call your coffee processor to learn about the method used.

A direct decaffeination process involves the use of carbon dioxide as a solvent. The coffee beans are soaked in compressed CO2, which removes 97 percent of the caffeine. The solvent containing the extracted caffeine evaporates when the beans return to room temperature.

So go ahead and enjoy that Cup of Joe — caffeine free!

Alice

Nutrition suggestions to promote recovery from surgery

Dear Columbia Alumnus,

Several nutrients are important in supporting a healthy central nervous system (CNS). Your best bet is to get these nutrients through food, as there is no evidence that taking large doses of nutritional supplements will speed your recovery. Key nutrients include:

Nutrient Action(s) Good Sources
Vitamin A Helps maintain nerve cell sheaths Fortified dairy products
Beta-carotene (which is converted to vitamin A) Helps maintain nerve cell sheaths Spinach, dark leafy green vegetables, broccoli, deep orange fruits and veggies (apricots, cantaloupe, squash, carrots, sweet potatoes, and pumpkin)
Thiamin Supports nervous system function Pork, ham, liver, whole grains, legumes (beans and peas), nuts
Niacin Also supports a healthy nervous system Milk, eggs, meat, poultry, fish, nuts, whole grain and enriched breads and cereals
Vitamin B12 Maintains the sheath that surrounds and protects nerve fibers and promotes their normal growth All animal based foods; for vegans, fortified soy milk or yeast grown in a vitamin B12 rich environment are recommended
Copper Helps form the protective covering of nerves Grains, nuts, meats, seeds, some drinking water

After surgery, eating properly can help with the recovery process. Obtaining adequate calories and protein is vital. Protein is extremely important for recuperation. Not only is it required for fighting infections, it is the backbone for repair and maintenance of many crucial tissues in the body. In addition, protein is vital for building collagen, which is necessary for scar formation.

In addition, plasma proteins, formed from dietary proteins, maintain fluid and electrolyte balance.

Other important nutrients specific to wound healing include:

Nutrient Good Sources
Vitamin C Citrus fruits, cabbage, broccoli, Brussels sprouts, dark green vegetables, cantaloupe, strawberries, peppers, lettuce, tomatoes, potatoes, papayas, mangoes
Zinc Meat, fish, poultry, beans

A person with post-surgery complications or depleted nutrition stores needs more calories and protein than s/he did before the procedure, regardless of his or her weight. A higher caloric intake also increases the need for B-vitamins. Supplements usually are not necessary since these nutrients are found in a wide array of foods.

As there are no supplements that are recommended for enhanced recovery, get your nutrients from a well-balanced eating plan, rich in a variety of fruits, veggies, legumes, whole grains, and lean proteins, such as lean meats and low-fat dairy products. Happy healing!

Alice

Fruitarian teens: Are they stunting their growth?

Dear Reader,

Feeling fruity? Devoted fruitarians say they feel better eating in this style, that it makes their life easy, and they feel it is beneficial for the environment. Fruitarian diets include all sweet fruits and vegetable fruits — including (but not limited to) tomato, cucumber, peppers, olives, avocadoes, and squash. Some fruitarians add grains, beans, nuts, and seeds to their eating plans. If these foods are included, the proportions are generally about 70 - 80 percent sweet and vegetable fruits, with some beans, smaller amounts of grains and tofu, and a sprinkling of nuts and seeds. Many fruitarians prefer to eat their food raw. Depending on which items are included, some may have to be cooked.

The human body needs a variety of nutrients. Because fruitarian diets provide fewer calories and protein than vegetarian diets, they are not suitable for teens. For a teen, the implications of missing many nutrients can have long lasting effects. Following this eating plan can cause your body to fall short on calcium, protein, iron, zinc, vitamin D, most B vitamins (especially B-12), and essential fatty acids. Not only could your height be affected, your bones may not reach their peak density, and vital nutrients for nervous system development may be missing in your diet. It's important to understand that one food cannot provide the multitude of nutrients found in a mixed eating plan.

Such a restrictive eating plan for a teen also presents other concerns. Have you thought about why you feel this eating style might be right for you, and what the ramifications also could be? If you're considering fruitarianism as a means to lose weight, or deflect attention from food issues, you are better off addressing these concerns directly. Restrictive eating can lead to hunger, cravings, and food obsessions. Also, keep in mind that a diet of one food (or of one food group) is not an effective way to cleanse the body.

As you move into adulthood, you may become interested in trying out different diets to improve your health and nutrition. For your future reference, it is recommended that adults only adhere to a fruitarian diet for a limited period of time. This is because fruitarian adults (just like their teen counterparts) can experience deficiencies in calcium, protein, iron, zinc, vitamin D, most B vitamins (especially B12), and essential fatty acids.

Lastly, keep in mind that a limited diet may cause certain social disruptions. Meals with family and friends may become more difficult. Some people with less flexible food options report social isolation.

Just planting a few seeds to think about. Now let your knowledge grow!

Alice

Food's travels through the body

Dear Union of Uranus,

From the way you signed your letter, your question is most likely related to the discharge of food from the colon and "your anus." In order to cover the ins and outs of the process (no puns intended) it’s best to start from the very beginning:

  1. The eater spots a delicious-looking bite to eat (amount of time depends how picky of an eater we’re dealing with).
  2. Food is chewed, lubricated, and partially digested by saliva in the mouth, and then the tongue moves it to the back of the throat. This process takes about one minute to complete.
  3. Chewed and partially digested food is travels through the pharynx and into the esophagus, where it takes about ten seconds to be propeled into the stomach.
  4. The stomach is a hollow, elastic sac where food is churned and mixed thoroughly with digestive juices secreted by the stomach lining. This process takes about two to four hours to complete, depending on the type of food and the amount of food eaten.
  5. Processed food is then released gradually into the small intestine. In the small intestine, digestive juices produced in the liver and pancreas convert carbohydrates, proteins, and fats into chemical mixtures used by the body. The broken down mixtures then pass through the wall of the small intestine into the bloodstream or lymph system if it is fat. This process takes around three to ten hours to complete.
  6. Water and undigested food are then passed into the large intestine, where the water can be absorbed. It takes between seven to sixteen hours for this process to be completed.
  7. The solid waste from the large intestine is then stored in the rectum for a variable period of time (between twelve and fourteen hours). The muscles then push the solid waste out of the anus as feces.

So, as you can see, there is a range of time, usually between 24 and 44 hours. Exactly how long it takes is up to the individual’s digestive system, not to mention what s/he eats. For example, eating fiber-rich foods helps speed up digestion, while eating animal proteins, like meat, poultry and seafood can slow it down.

Bon apetit!

Alice

Anorexia, Dexatrim, and Prozac?

Dear Worried friend,

Your question brings up a couple of different, complicated issues. Let's start with your inquiry, about the dangers of mixing Dexatrim and Prozac. Prozac is not, as you stated, in the antidepressant class of MAOI inhibitors. Rather, it is an SSRI, a selective serotonin reuptake inhibitor. These two different groups of drugs are both prescribed to address biological causes of depression, as well as some other psychological conditions. Their use is only one part of such treatment, which should also include counseling in the form of individual, group, or family therapy with a trained social worker, psychologist, or psychiatrist.

The main ingredient in Dexatrim is phenylpropanolamine (PPA), which decreases appetite and has been, until recently, a common ingredient in decongestants, as it also relaxes the bronchial tubes. A study by the Yale University School of Medicine revealed that PPA is associated with an increased risk of stroke. Therefore, in November 2000, the U.S. Food and Drug Administration (FDA) released a statement asking that manufacturers of products containing PPA replace it with alternative active ingredients. For further important information about this, read the response to Too much Dexatrim?.

If your friend is indeed taking Prozac while also taking Dexatrim, the best bet would be for her to discuss this with her health care providers. Although using these two drugs together is not specifically contraindicated from a medical standpoint, it's possible that there could be adverse reactions, such as an increased or decreased effect of one or both of the drugs, unhealthy changes in heart and blood pressure, or intensified side effects. For example, both Dexatrim and Prozac can cause nausea, headache, trouble sleeping, and nervousness.

There are some other things for your friend to think about, too. One is that PPA is an amphetamine-like drug and can cause people to feel unusually good about themselves and the world while they're taking it. If your friend is taking Prozac to treat symptoms of depression at the same time, it will be difficult to tell which of the drugs is having an effect on her emotions. Discussing this with the health care provider who has prescribed the Prozac will help in figuring out if the anti-depressant is helpful, and, if so, an appropriate dose.

Another complicated aspect of your question has to do with the treatment of eating disorders. One concern is the simple fact that your friend is taking Dexatrim. You state that your friend has anorexia. The hallmarks of anorexia are severely restricted eating and a significant drop in body weight. In fact, Prozac is contraindicated for the treatment of this disorder, as it may actually cause a loss of weight and disinterest in food. It's possible that your friend has been prescribed Prozac because she's depressed (common in eating disorders), yet hasn't revealed the fact that she's struggling with issues around food. On the other hand, Prozac has been found to be helpful in the treatment of bulimia, an eating disorder involving cyclical periods of intense eating or binges, followed by purging of the food by vomiting or other compensatory behaviors. It is very important that your friend be honest with her health care providers and counselors about her patterns of eating and the feelings that prompt her behavior. Only then can she be appropriately diagnosed and helped to find healthier ways of managing food and the emotional stresses in her life.

If you would like to speak to a counselor about your friend, Columbia students can meet with a counselor at Counseling and Psychology Services (CPS) (Morningside) or Mental Health Services (Medical Center). If your friend is a Columbia student (Morningside), she can make an appointment with a healthcare provider by logging on to Open Communicator.  If she is a student at the Medical Center campus, she can contact Student Health.

Alice

Ginkgo — what d'ya thinko?

Dear What D'Ya Thinko About Ginkgo,

Gingko (Latin name, Ginkgo biloba) has been part of Chinese traditional medicine for thousands of years. It is extracted from the leaves of the hardy ginkgo biloba tree and is available in a variety of forms, including teas and tablets. Proponents of ginkgo believe that consuming the leaves increases cerebral blood flow and prevents the lumping of platelets in brain tissue. They also believe that ginkgo has other health benefits, such as slowing memory loss, improving cognitive ability, and curing conditions such as asthma, PMS, multiple sclerosis, and sexual dysfunction. For one herb, that's quite a resume!

While some claims on the Ginkgo plant may have some merit, not all are backed by research. Some studies have found that ginkgo biloba has positive effects on cognitive ability, though others have found that this may not be true. Ginkgo has been found to have possible antioxidant properties, which means that it may help the body fight free radicals. Free radicals in the brain attack healthy cells, stealing the cells' electrons. As an antioxidant, ingested ginkgo provides a target for these hungry cells, allowing them to steal ginkgo's electrons rather than from the healthy cells. Ginkgo has been found to be helpful in some patients with claudication (painful legs due to clogged arteries) and dementia. Despite these findings, more research is needed to establish ginkgo as the panacea that it's believed to be.

So, let's say you decide to ginkgo. You may be wondering about the recommended dose. For adults 18 and older, common dosage is typically around 80 to 240 mg, and may be taken two to three times a day (depending on the reason for use). It’s recommended that if you’re just starting to take ginkgo, it’s best to not take any more than 120 mg per day to avoid some gastrointestinal upset. Ginkgo might be safe for children, but it's probably a good idea not to give it to them unless it's under the strict supervision of a health care provider.

Ginkgo, though it is natural, may cause side effects, such as bleeding, headache, nausea, dizziness, diarrhea, and allergic reactions (some of which may be severe). Moreover, the U.S. Food and Drug Administration does not regulate ginkgo or other supplements. As such, it's recommended you ask your health care provider, if you are considering taking ginkgo, especially if you have a bleeding disorder or if you are taking any other medications/supplements. For more information about ginkgo, you may want to check out the section on supplements and ergonenic aids in the Go Ask Alice! Nutrition & Physical Activity archives.

Doing your homework on complementary and alternative medicine is a wise step to take — be proud of yourself for learning more info before you gink-go or gink-no.

Alice

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

Liposuction — Permanent fat removal?

Dear Reader,

You and your husband are probably not the only ones having this debate. Various health professionals have also been in disagreement regarding the long-term outcomes of liposuction. The problem is that much of our evidence about the long-term outcomes of liposuction is based on anecdotes, which indicate that some people maintain the weight/fat loss, others re-gain the weight, and some people even gain more weight/fat than their pre-liposuction amounts. This debate will likely continue for some time.

Truth be told, multiple factors including gender, age, lifestyle, and genetic factors all impact weight. A one-time removal of 4-6 pounds of fat (even in very obese individuals no more than 20 pounds of fat is typically removed in one surgical procedure) must be accompanied by dietary changes and physical activity to maintain the weight loss. In the absence of these lifestyle changes, the individual can regain weight (and fat) that was lost during the liposuction procedure. While liposuction does remove entire fat cells, the fat cells remaining in the body can increase in size and can signal that more fat cells be created if there is an excess of fat in the body that must be stored. In other words, if the individual eats more calories than the body can store with its current supply of fat cells, the body will create more storage space to accommodate the excess fat.

Regarding your husband's argument, people are not born with all of the fat cells they will ever develop. Instead, cell number continues to increase throughout adolescence. After this point fat cell number may become fixed unless the individual gains a significant amount of weight. In this case, existing fat cells will be filled to their limit of about 1.0 microgram of fat per cell (normal is approximately 0.5 - 0.6 of a microgram), and more fat cells may be produced if needed. Pregnancy also seems to permit formation of new fat cells.

Cosmetic motivations aside, some people may opt for surgeries like liposuction to reverse medical complications from extreme obesity. However, research suggests that losing weight by achieving a negative energy balance (by reducing food intake and increasing energy expended through exercise) is important for achieving the metabolic benefits that go along with weight loss (like decreased risk for chronic diseases, increased endurance, and so on) (1). Also, liposuction procedures tend to target the abdominal area and sometimes the back of the upper arms and legs, but fat can be deposited in muscle, on organs, and in several other places throughout the body. These other locations where fat may be stored would be reduced in size when the person loses weight the traditional way. Although some good research has been done, more research with large sample sizes studying the long-term effects of liposuction is needed.

Alice
(1) Klein, S., Fontana, L., Young, V.L., Coggan, A.R., Kilo, C., Patterson, B.W., & Mohammed, B.S. (2004). Absence of an effect of liposuction on insulin action and risk factors for coronary heart diseases. The New England Journal of Medicine; 350(25), 2549-2557.

A healthy model is a model of health

Dear N,

Rather than prescribing you a "model's diet," as there are probably as many of them as there are models (both healthy and unhealthy), a better suggestion would be to follow the guidelines for a model diet — that is, start by resisting the urge to compare yourself to other models. Focusing on what's healthy for you is the healthiest runway to strut on.

You have already taken a step in the right direction by taking good care of yourself and your health:

Exercising regularly is fantastic for health and wellness. For a well-rounded exercise plan, be sure to include both cardio and weight training workouts. Current recommendations for a healthy dose of exercise for adults include 2 hours and 30 minutes (150 minutes) of moderate-intensity aerobic activity (i.e., brisk walking) every week, plus muscle-strengthening activities on 2 or more days per week that work all major muscle groups (legs, hips, back, abdomen, chest,  shoulders, and arms).

Meeting with a nutritionist or dietician can help you figure out a specific eating plan tailored for your energy and nutritional needs. According to the USDA’s 2011 MyPlate Plan, a healthy diet for a typical woman aged 19-30 includes 6 ounces of grains (with 3 ounces coming from whole grains), 2.5 cups of vegetables, 2 cups of fruit, 3 cups of dairy products, 5 1/2 ounces of protein (lean meats and beans) and up to 6 teaspoons from the oil group. Recommendations for a typical man aged 19-30 includes 8 ounces of grains, with at least 4 ounces coming from whole grains, 3 cups of vegetables, 2 cups of fruit, 3 cups of dairy products, 6 1/2 ounces of protein (lean meats and beans) and up to 7 teaspoons of foods from the oil group. With a balanced diet, men and women can eat still eat sweets and treats in moderation and maintain a healthy diet.

Getting your beauty sleep is important — both on and off the runway! While six solid hours can be enough for some people, others, especially people in their late teens and early 20s, need as many as nine or ten to be completely rested and alert. For sleep tips, you can check out the A!Sleep Site.  

Only your dietician can tell you how often you should meet with her/him in a given period of time. In addition, you might also meet with a health care provider at your university's health service for a physical or check-ups to make sure that your body stays healthy while you continue with your eating, exercise, and would-be modeling plans. Columbia students can make an appointment to discuss their nutritional concerns online through Open Communicator, or by calling x4-2284.

Good luck with your modeling debut. Following the above tips can help you make a lasting impression along your path to becoming a model of good health!

Alice

Dancing for health

Dear Reader,

According to researchers at the Mayo Clinic, social dancing provides the body with many health benefits. It may help reduce stress, increase energy, and improve strength, muscle tone, and coordination. Dancing can also burn as many calories as walking or riding a bike. One factor that determines how many calories you will use is the distance you travel while grooving to the beat. In one study, researchers found that square dancers covered five miles in a single evening. That's a lot of do-si-doing!

Other aspects of dance that contribute to your cardiovascular conditioning depend on how long, how often, and how intensely or vigorously you boogie and get down. The National Heart, Lung, and Blood Institute (NHLBI) recognizes the benefits of dance in lowering coronary heart disease risk, decreasing blood pressure, and managing weight. Another plus of dancing is that the weight bearing movements of your steps can strengthen the bones of your legs and hips, important for maintaining bone health as you age. As a result, dancing may be used as part of a rehabilitation program, of course with appropriate supervision.

While we may not all be hip-hopping into our nineties, dancing is one activity we can (hopefully) do for the rest of our lives... and the sociability it provides is part of its allure. It's a great way to make new friends, be creative and expressive, and just plain old enjoy life. And, the best part of dancing is the fun you can have while you're doing something great for your body.

Whatever your preference, there's sure to be a style to get your toes tappin'! Whether it's belly dancing, funk, swing, ballet, jazz, tap, square, hip-hop, the hustle, the tango, or modern dance, classes are popping up all over. Columbia students can join one of numerous student dance clubs (ballroom, latin, swing, oh my!). Visit the Clubs & Organizations page for more information. In addition, you can contact your local gym, YW/YMCA, recreation/community center, or dance studio to see what they offer.

Well, now that you know that dancing is good for you, put on your dancin' shoes and cut a rug!

Alice

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