Nutrition & Physical Activity

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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!


Best thing to drink before a workout? After?

Dear Thirsty,

Parched after a workout, a person might be tempted to grab the nearest sports drink to help rehydrate and reenergize. In fact, water is the best option for most people post-exercise. Your body depends on water to sustain chemical reactions and to maintain correct body temperature. It's possible to lose up to a quart of water during an hour of exercise through sweating, which can lead to dehydration if fluids aren't replaced. Drinking water before and during exercise also has benefits for performance.   

Here are some tips for healthy hydration:

  • Consume 20 ounces of water during the two- to three-hour period before you start exercising.
  • Consume 8 ounces of water during your warm-up.
  • For every 10 to 20 minutes of activity, drink 8 ounces of water.
  • Within 30 minutes of finishing your activity, drink 8 ounces of water.
  • For every pound of body water you lose during exercise, drink 16 to 24 ounces of water.
  • Drink cool water as it is more quickly absorbed by your body than warmer water, and it is less likely to cause cramps.
  • Avoid drinks that contain caffeine, a diuretic. They can also cause the jitters and shakes.
  • Steer clear of alcohol, also a diuretic. In addition, it is a poor energy source, and can depress the heart and nervous system. (Obviously, alcohol also hampers your coordination and impairs performance.)
  • Make hydration a part of your daily routine.

If you are an endurance athlete and workout for longer periods of time (more than 45 minutes), you may want to opt for a sports drink to fuel your muscles and replace electrolytes (such as salt) that are lost in sweat. There are many brands and flavors and several low-sugar energy drinks have recently been introduced to the marketplace. If the taste of these drinks is too strong for you, consider diluting them with cool water. 

As always, listening to your body is good advice when it comes to hydration. Unfortunately, thirst alone is not a good indicator of how much you need to drink, because thirst is quickly quenched by drinking very small amounts of water; additionally, once you notice thirst, you are already on your way to dehydration. An easy way to check your hydration level is to notice the color of your urine. If it's a dark yellow or orange color, you could probably use some plain old water. A hydrated body excretes nearly clear-colored pee (although taking certain vitamins or supplements may turn your pee darker in color).

Remember, these tips for hydration apply to any kind of activity and you don't have to be a marathon runner to benefit from quenching your thirst. Stay hydrated, have fun, and good job with those workouts!


Do you have any information on cholesterol?

Dear Seeking fat,

Cholesterol is a white, waxy lipid (fat) found naturally in the human body. Most cholesterol is produced by the liver, while a smaller amount is ingested directly from meat, poultry, seafood, dairy products, and other foods of animal origin (plant foods do not contain cholesterol). Cholesterol is involved in many vital life-processes, such as the production of hormones and the repair of cell membranes. To get where it's needed, cholesterol travels through the bloodstream as lipoproteins — fat packaged up in little protein spheres.

Studies have demonstrated that a blood test measuring cholesterol levels can help establish one's risk for heart disease. This test measures the amount of fat found in the bloodstream, including high-density lipoproteins (HDL), low-density lipoproteins (LDL), and triglycerides (another type of fat molecule). A total cholesterol score is then obtained by putting these three numbers into a mathematical formula. Research has shown that high levels of HDL decrease one's risk for heart disease (hence the term "good" cholesterol), while high LDL levels (a.k.a. "bad" cholesterol) increase one's risk. The medical community currently uses the following guidelines to put these numbers in perspective.


  Desirable Range
Total Cholesterol       < 200 milligrams (mg)/deciliter (dL)
LDL       < 130 mg/dL
HDL       > 60 mg/dL
Triglycerides       < 150 mg/dL


Because the total cholesterol score is a composite that includes both "good" and "bad" cholesterol, this number alone is less useful as an indicator of risk than the ratio of total cholesterol to HDL. For example, having a total cholesterol number above 200 mg/dL indicates a statistically greater risk of heart disease, but if this number is arrived at because the HDL number is especially high while the LDL and triglyceride numbers are normal or low, then the risk level may actually be below average. The ideal total cholesterol to HDL ratio is less than 3.5; a ratio of 4.5 is average, while a ratio of 5 or greater is a red flag.


Total Cholesterol/HDL Ratio Guidelines
Ideal: < 3.5
Average: 4.5
Potentially Harmful: = 5


Blood cholesterol levels vary according to genetics as well as lifestyle choices. For example, eating saturated fats is the largest contributor to high blood cholesterol levels. Other lifestyle factors include smoking, which is associated with lowering HDL levels (increasing risk), and regular exercise, which is associated with boosting them (lowering risk).

For more detailed information on cholesterol, read the Related Q&As listed below or visit the American Heart Association web site.


What to eat?

Dear Reader,

How's this for a treat — you should eat whatever you want to, just as long as it's in moderation. Eating can be for fuel, but can, and many would argue should, be for pleasure as well. Of course, sometimes you have to take the pleasure with some pain; in this case, better make it whole-wheat pain (French for bread). In addition to whole wheat and whole grain products, fresh fruits and vegetables, lean protein and low- or non-fat dairy products should also be eaten regularly in order to ensure that you're getting all the nutrients you need from a healthy and balanced diet.

How much of any food group you should eat depends on your age, sex, weight and activity level. According to the United States Department of Agriculture (USDA), a typical man aged 19-30 should try to eat eat about 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, 6.5 ounces of protein (lean meats and beans) and are allowed 7 teaspoons of foods from the oil group.

A typical woman aged 19-30 should try to eat 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, 5.5 ounces of protein (lean meats and beans) and can consume about 6 teaspoons from the oil group. With a balanced diet like those described above, men and women can eat still eat sweets and treats in moderation and maintain a healthy diet.

These are only guidelines, which can most certainly be tailored to your activity level, medical history, and/or food likes and dislikes. If you are looking for a specific nutritional plan, it's a great idea to discuss any concerns and thoughts with a health care provider. Students at Columbia can make an appointment with a registered dietitian or their health care provider by contacting Medical Services (Morningside) or the Student Health Service (CUMC).

If this has whetted your appetite to find out more on what and how much of a food constitutes a serving and what group it comes from, you can check out the site. You can also check out Food Guidelines — How much is a serving? in the Go Ask Alice! archives for more information on serving sizes, as well as where to go to learn more about dietary recommendations. Another great resource is the Get Balanced! Guide for Healthier Eating.

Bon appétit!


Weightlifting and still fat

Dear No desire to be lard-boy,

Good for you for taking care of yourself by exercising! It may be frustrating to work so hard and not see the results you want, but you're on the right track. You may need to make changes to your diet and/or workout to look like a lean, mean, workout machine, but it may be best (and helpful) to do so under the supervision of a health care provider and/or a registered dietitian.

When we consume more calories than we expend, we gain weight. When the amount of calories consumed is less than the amount expended, we lose weight. Pretty straightforward, right? Maybe not. Additional factors may influence the amount of calories we burn, including genetics and body mass composition. Generally, however, eating a low fat, well-balanced diet that does not exceed your ideal caloric intake may be helpful for weight loss. A dietitian may be able to help you create a healthy, well-balanced food plan based on your specific dietary needs and personal goals. For more information, you can also check out the Go Ask Alice! nutrition and physical activity archives.

Now let's talk workout. Have you considered asking a physical trainer for suggestions? In any case, you may want to consider incorporating more aerobic activity into your exercise regimen. Aerobic exercise, which gets your body to burn lots of calories, occurs when you move the big muscles of your body through space for 20 minutes or more (e.g., running, walking, biking). Increasing the amount of aerobic exercise you do in proportion to weight lifting may, therefore, help with taking off the extra fat. A tip: evidence suggests that you'll burn more calories during your aerobic workout if you hit the weight room first. Not a bad deal.

Whether you're sculpted of chiseled rock or, er… lard, positive body image is key. Although the media portrays a certain image of how we are supposed to look, we come in all different shapes and sizes, and that's a good thing. Weight loss and sculpting may help you make positive changes to your lifestyle, but just make sure that it's not at the expense of your physical health and emotional well-being. So, while you're lifting weights or running on that treadmill, you may want to mull over whether you enjoy doing these activities, and how they make you feel.

If you are a student at Columbia and would like to speak with a registered dietitian and/or health care provider, you can make an appointment by contacting Medical Services (Morningside) or the Student Health Service (CUMC). You can also visit the Dining Services' nutrition resources. For additional information, check out the Physical Activity Guidelines for Adults on the Centers for Disease Control and Prevention (CDC) website. Keep up the good work and good luck!


Measuring your basic metabolic rate

Dear Reader,

To figure out your basic metabolic rate, it must be measured under very strict conditions such as after a night’s sleep, on a fast, and without any physical activity, etc. What is more common and often more useful is a person’s resting metabolic rate (RMR). RMR is the number of calories you burn to maintain vital functions such as breathing, pumping blood, and maintaining your muscle and nervous system at resting conditions. This is measured under less strict conditions and often does not require the person to fast or to sleep right before the measurement. An accurate RMR measurement requires the use of an apparatus called indirect calorimetry. This can be expensive, so estimating RMR using parameters such as body weight, height, and age can be used as well.

There are three common equations to estimate RMR: (1) the Harris-Benedict equation, (2) the Mifflin equation, and (3) the Cunningham equation. These equations are population specific, so it is important to be aware of their limitations.

Harris-Benedict Equation (widely used and relatively accurate for average body type):

Men: RMR (in calories per day) = 66.47 + 6.23 x Weight (lbs) + 12.67 x Height (in) - 6.76 x Age (yrs)

Women: RMR (cal/day) = 655.1 + 4.34 x Weight (lbs) + 4.69 x Height (in) - 4.68 x Age (yrs)

Mifflin Equation:

Men: RMR (cal/day) = 10 x Weight (kg) + 6.25 x Height (cm) - 5 x Age (yrs) + 5

Women: RMR (cal/day) = 10 x Weight (kg) + 6.25 x Height (cm) - 5 x Age (yrs) - 161

Cunningham Equation (uses fat-free mass, suggested for athletes):

For men and women: RMR (cal/day) = 500 + 22 x FFM (kg)

If you would still like to know more about measuring your metabolic rate, such as through an indirect calorimetry, it is recommended to see a health care provider. Columbia students can make an appointment at Medical Services (Morningside) or at the Student Health Service (CUMC). You can also visit the Columbia Health site to learn more about services and programs available on campus to help you stay in tip-top shape.


Ideal caloric intake?

Dear Confused by the news,

While this sounds like such a simple question, it's really not. First, what is ideal? The amount of calories needed to maintain each individual's weight appropriate for optimal health? The amount a person needs to maintain an unnaturally thin weight that meets false societal ideals? The amount an athlete needs to perform at her/his best? Reality tells us that the ideal caloric intake is different for everyone.

Caloric needs depend on age, gender, height, present weight, body frame, physical activities, hormones, and weight plans (maintain, gain, lose, etc). An intake between 1200 and 1400 calories per day is considered a low intake. This calorie level is just able to meet what are called basal metabolic needs, or the calorie needs to keep the heart beating and all the internal organs working. Calorie levels below 1200 should be avoided, because they may decrease metabolism and are usually hard to follow for any length of time. Very low caloric intake may promote binge eating due to the feeling of deprivation, and may be deficient in one or more nutrients. Some liquid diets call for fewer than 1200 calories, however, their long-term effectiveness is controversial, and they should only be followed under the supervision of a physician.

The Daily Values (DVs) used on food labels base their nutrient intake on a 2000 calorie per day diet. This was a result of many long meetings with nutrition experts who concluded that 2000 calories was the average amount needed by American adults. Therefore, short, thin females who are not active, will have caloric needs below 2000. For those who are "average" size and get moderate activity, caloric needs to maintain weight should be about 1600-2400 per day.

Instead of just worrying about a number of calories, have you tried listening to your own internal needs? Have you set goals related to healthy eating? Consider a focus on maintaining a balanced eating plan that includes a strong base in whole plant foods (fruit, vegetables and grains) and eat a moderate amount of healthy fats. Also don't go overboard on eating food just because it is fat-free (i.e. a whole box of "fat-free" cookies). Although fat calories are most easily converted to fat in the body, all calories from fat, carbohydrate and protein count! Finally, don't forget food should bring some pleasure to life and serves many needs other than energy functions.

If you would like to explore your individual caloric needs, or have other nutrition questions, Columbia students can make an appointment with the nutritionist at Medical Services (Morningside) or at the Student Health Service (CUMC). Columbia students may also want to check out Get Balanced! for tons of nutrition resources and information, including th Guide to Healthier Eating. You can also review many options and create your own plan using the online resources at MyPlate. Have fun determining the right balance for you and your goals.  Remember to try new foods and new food cominbations — there are lots of healthy and tasty options.  Eat and be well!


Minimum and maximum heart rate for aerobic exercise

Dear Reader,

Yes, it is true that there are recommendations for minimum and maximum heart rate during exercise. Two slightly different formulas are currently used to guide exercisers. Both formulas take your age into account, but one also factors in your resting heart rate and is particularly useful for individuals training with a specific performance goal in mind. Heart rate is measured in beats per minute (bpm). Before demonstrating each formula, it's useful to define a few terms:

  • Maximum heart rate — an estimate of the heart rate that one potentially could (not should) achieve during maximum physical exertion.
  • Resting heart rate — as simple as it sounds — your heart rate at rest with no physical exertion (best when measured in the morning before any stress, caffeine, or much movement).
  • Target heart rate — a percentage of your maximum heart rate. Experts recommend keeping your heart rate in a certain range to achieve benefits during exercise, depending on your level of conditioning and exercise goals.

To demonstrate how each formula works, let's say that Devon is 24 years old, has a resting heart rate of 65 bpm, and wants to work out between 60 and 80 percent of maximum heart rate. Time for a little arithmetic!

Formula 1:
Maximum workout heart rate =
(220  - age) X percent of maximum heart rate

(220 - 24) X .60 = 117
(220 - 24) X .80 = 157

According to this formula, Devon should maintain a target heart rate between 117 and 157 bpm to reach 60 to 80 percent of maximum heart rate while working out.

Formula 2:
Maximum workout heart rate, adjusted for resting heart rate =
(220 - age - resting heart rate) X percent of maximum heart rate + resting heart rate

(220 - 24 - 65) X .60 + 65 = 144
(220 - 24 - 65) X .80 + 65 = 170

According to this formula, Devon should maintain a target heart rate between about 140 and 170 bpm to reach 60 to 80 percent of maximum heart rate while working out.

As you can see, these formulas give Devon different recommendations for target workout heart rates. This is because the second formula adjusts for resting heart rate, a number that normally gets lower for most people as they exercise and become more conditioned. Using the second formula can increase the accuracy of target heart rate recommendations for regular, consistent exercisers.

The easiest place to check your heart rate may be on your carotid artery in the neck (avoid pressing too hard or the reading may be less accurate). Check your heart rate before, during, and after exercise by taking your pulse for 10 seconds and multiplying by 6, or for 15 seconds and multiplying by 4. You can then adjust your workout accordingly. Remember, you are estimating your heart rate with these formulas, so always let safety come first. Stop exercising if you feel dizzy, faint, or shortness of breath.  

Hope this heart to heart was helpful!


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:


  • 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).


  • 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!


Exercise motivation... for stress reduction

Dear Reader,

A high-impact yes to your question! In fact, there aren't many better pursuits than exercise for stress reduction. Before we delve deeper into why exercise is so great, however, let's first make sure we're on the same treadmill about our definition of "exercise." According to the Physical Activity Guidelines for Americans, it is recommended that adults (ages 18 to 64) get 150 minutes of moderate physical activity or 75 minutes of vigorous activity each week. Physical activity is considered moderately intense if you are working hard enough to break a sweat, but you are still able to hold a conversation. If you're breathing hard and fast, your heart rate is up and you're not able to get many words in, that type of activity can be described as vigorous. Additionally, two or more days of muscle stregthening activity per week is also recommended.

Before you run in the other direction, consider some of the health-promoting and stress-controlling benefits of aerobic activity. Most notably, aerobic exercise strengthens your heart and lungs. These two vital organs — especially the heart — bear the brunt of the body's physiological stress response, as they are constantly being called upon to "fight or flee" from job, school, family, financial, relationship, and every other kind of stressor we confront daily.

You brought up another exercise plus: weight loss and maintenance. For many of us, looking good also means feeling good and vice versa. Exercise improves physical appearance, enhances self-esteem and self-confidence, and offers other mental health goodies. Regular exercisers report more energy and better ability to concentrate. Oh, and don't forget about improved quality of sleep, reduced stress reactivity (not getting as stressed out about things as you usually do), and, yes, maybe even a slowed aging process!

Exercise as stress-management strategy is easier said than done, so here are some tips that have helped many health-seekers to start and stick with exercise programs:

  • Begin slowly. If you are not accustomed to exercising, start out with ten to fifteen minutes twice a week and build up from there.
  • Snag a workout partner — there's nothing like the motivation of another sweaty, panting humanoid to keep you going.
  • If the gym will be "workout central" for you, take a quick lesson from a trainer on proper equipment use. Simple direction from experienced health club personnel can reduce gymphobia (and possibly injuries) while improving the quality of your workout. Your gym should offer this one-time service free of charge to newcomers, but this doesn't mean that you can't ask for guidance down the line, too.
  • Let friends and family know that you are exercising for your health — let them cheer you on.
  • Finally, make your workout sessions regular and real. Schedule them in your calendar, just as you would record business appointments, classes, and social engagements.

If you are thirty-five or older or have any heart trouble, blood pressure problems, or other medical conditions, you will want to get a medical clearance from your health care provider before you choose your exercise plan.

By the way, you have a variety of exercise options, and you don't have to join a gym to partake. Walking briskly, running, biking (mountain if it sustains your heart rate), swimming, calisthenics, playing tennis or basketball, and cross-country skiing are just a few possibilities. Check out some of the archived questions in the category Fitness & Nutrition to learn more about your options for making physical fitness a priority in your life. Columbia University students, faculty, staff, and alumni can also participate in the CU Move initiative.  CU Move encourages members of the Columbia community to engage in active lives that include regular physical activity. The program provides participants with motivation and incentives to be active throughout the year.

In addition to exercise, try to take breaks from your high-stress job. Walk around outside, take lunch, or sit in the bathroom for a few minutes if that's the only time you can get away. Just a few breathers during a hectic day can go a long way toward stress relief.

Good luck getting moving!


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