Nutrition & Physical Activity
Great question! Diet is one of the most important ingredients for treating kidney, or renal, insufficiency. When a person has renal insufficiency, it means that some of the nephron function in the kidneys has been lost, and the fluid, protein, and electrolytes are not filtered as efficiently through the kidneys. In order to delay renal insufficiency and prevent it from worsening, it is important to limit the amount of electrolytes (i.e., sodium, potassium, phosphorus, and calcium), fluids, and protein that one ingests.
Diabetes is the main cause of kidney insufficiency, which can eventually result in kidney failure. The reason for this is that increased blood sugar damages the capillaries and nerves that support kidney function. In addition to your low protein diabetic diet, you should also be sure that you are testing your blood sugar daily, exercising, and following your health care provider’s instructions.
Depending on the degree of your renal insufficiency, various protein restrictions would be necessary. At this point, you could plan a diet that balances your intake of phosphorus, potassium, and calcium. If you have fluid retention, decreased urinary output, and/or hypertension, it could be necessary for you to have a sodium and fluid restriction as well. In this case, you should speak with to your health care provider about how to restrict these nutrients.
When you eat large amounts of protein, extra stress is placed upon the kidneys. This is because they excrete waste products derived from protein. Since someone in your situation needs to eat a reduced amount of protein, the protein you eat should come from sources that are easily assimilated into body tissue. This type of protein is termed High Biological Value (HBV for short). The highest HBV protein is from an egg — other sources with slightly lower HBV protein include fish, beef, and poultry. In renal insufficiency, about 70 to 80% of your protein should come from these sources.
Various health care providers, such as a registered dietitian, can formulate an eating plan designed to meet your specific needs. If you are a Columbia student, this service is free for you at the Health Service. You can make an appointment with Medical Services through Open Communicator, or by calling x4-2284. You can also check out the American Dietetic Association to locate a Registered Dietitian in your area.
For more information on diabetes, you can try the following resources:
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!
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!
The Achilles tendon attaches to the calf muscle and to the heel bone. The calf muscles and the muscles along the shin are needed to protect against shock in high-impact exercises. This muscle group is very strong and is used constantly. Because of this, your Achilles tendon is put under a lot of pressure. The Achilles tendon handles forces that range from two to three times the body weight in walking, to four to six times the body weight in running and jumping. When it is overused, or if you continue to use it when it is injured, inflammation of the Achilles tendon could lead to local degeneration and recurrent injury, which may result in a partial, or even a complete, rupture. It was very wise of you to take a break before gradually resuming exercise.
As you get back into an exercise routine, make sure that you follow up with your health care provider and/or a physical therapist to be certain that you are not doing any more damage to your Achilles tendon. If you are a Columbia Student on the Morningside campus, you can call 212-854-2284 or log into Open Communicator to schedule an appointment. For students on the Medical Center campus, contact the Student Health Service by calling 212-305-3400.
Stretching and strengthening exercises can certainly play a role in taking care of your body. Remember that all stretching should be slow and static and that you should listen to your body — feel your muscles stretching, but stop if you feel pain. Specific to the Achilles tendon and surrounding muscles, consider the following:
Stretch #1 — Calf Stretch
- Stand about a foot from a wall, extend one leg behind you, keeping both feet flat on the floor, toes pointed straight ahead, and your rear knee straight and your front knee bent.
- Move your hips forward, keeping your lower back flat.
- Lean into the wall until you feel tension in the calf muscle of the extended leg.
- Hold for 10 seconds, then stretch the other leg.
- Repeat at least two more times.
Stretch #2 — Calf Stretch
- Stand arm's-length distance from a wall (or tree, or lamppost — whatever is handy and gives you support).
- Put your hands on the wall, keep your back and your legs straight, and make sure your heels are flat on the floor.
- Bend your arms and lean forward, trying to touch your chest to the wall.
- Feel the stretch in your calf muscles.
- Hold it for a few seconds.
- Relax and repeat at least two more times.
Stretch #3 — Achilles Tendon Stretch
- Stand with one leg in front of you, slightly bent, and the other leg extended back.
- Lower your hips downward as you slightly bend the knee of the extended leg.
- Keep both heels flat on the floor and toes straight ahead.
- Hold the stretch for 10 seconds, and then stretch the other leg.
Repeat at least two more times.
Note: This Achilles tendon stretch requires only a slight feeling of tension at the back of your ankle. Also, be sure that you do not bounce, and that you stretch gently and completely.
Besides jogging and running, the Achilles tendon can be injured from any activity that has an impact component. To help prevent injury to the Achilles tendon, consider exercises that put less stress on the Achilles tendon, such as bike riding and swimming. Also, abnormal pronation and muscle imbalances can be a problem for a recurring inflammation of the Achilles tendon. If you decide to get back into running, you need to have a physical therapist check out your running shoes to make sure they are not causing extra stress on your Achilles tendon and calf muscles. Be sure that you always wear running shoes that are not worn out, and try to avoid uneven or hard running surfaces. You may want to run on soft surfaces, such as running tracks, or soft trails without holes or ditches.
A reference to mythology seems unavoidable — stretch and allow your body to heal so your tendon doesn't become your Achilles heel.
Dear Goldilocks looking for something "just right,"
In your question, you bring up two issues — how to fit exercise into a hectic schedule and how to achieve quick weight loss. Let's deal with the quick weight loss issue first.
First of all, despite what the infomercials say, there is no particular piece of equipment that will help you lost fat better than another. Losing fat is a result of expending more energy than you consume, not what type of equipment you use. Second, no matter what you read, hear, or imagine (again, forget what the infomercials say!), quick weight loss usually is not permanent, because our bodies just DON'T burn fat very fast. When you see a dramatic drop on the scale, it's usually from water loss.
Theoretically, to lose one pound of fat, a person must have an energy deficit of about 3500 calories, meaning one has to eat 3500 fewer calories than one needs, burn 3500 more calories than one eats, or find a combination somewhere in-between. To lose ten pounds, a person has to generate a deficit of 35,000 calories (yes, that's thirty-five THOUSAND). Since most women of about your weight need approximately 1800 to 2200 calories a day to meet their total energy needs, this could take some time to accomplish. Women who are trying to lose weight still need to consume at least 1200 calories a day (any less can have unhealthy effects on your body).
Instead of focusing on quick weight loss, it is a good idea to focus on ways to keep healthy and active in order to reach your long-term fitness and weight management goals. You may also want to look at why you want to lose ten pounds. Consider asking questions like, do I have the energy to do what I need and want to do? Is my weight keeping me from other participating in other activities? Based on the information in your question, you appear to already be at a healthy weight for a person your height and gender.
Now, onto your scheduling issue. If getting to the gym proves difficult, consider other ways to keep fit. Without investing large amounts of money on fitness equipment that ends up becoming a high-tech clothes hanger, try:
- Investing in a jump rope — put on some lively music and skip to the beat. With a jump rope you can alternate between jump rope sets with strength builders, such as sit-ups, push-ups, and other free weight exercises.
- Incorporating more activity, that really won't take up any extra time, into your regular routine; for example, climb the stairs instead of using an elevator or escalator at every opportunity.
- Going for an early morning walk, jog, or run first thing if you typically get too bogged down later in the day.
- Checking out websites or mobile apps that feature workout videos on-demand.
Remember that exercise doesn't have to be an "all or nothing" endeavor. Do your best during the busy times, and try not to let the exercising itself become a source of stress.
Sticking to a balanced eating plan will also help you to manage your weight. Starving oneself or restricting your calorie intake by too much can lead to overeating later on. Instead, concentrate on nutrient dense foods rather than calorie dense ones; they will be more satisfying in the long run. And during busy times, having a light snack before a party or event can help to keep hunger in check and may help prevent you from overindulging later.
Here's to enjoying your food and your workouts!
Dear Confused and College Bound,
You are not alone with your concerns. Going to college is a big step in a person's life involving major changes. You and those around you may be living on your own for the first time, making decisions on a buffet of issues, including what to eat.
Eating healthy at college is possible. Many college dining services are offering more healthy choices and are often quite receptive to students' concerns and dietary preferences. But, this is only part of the challenge. In an environment where time, friends, and finances may combine in new ways, having options available only solves some of the puzzle. It's important to experiment with what works best for you. For example, that traditional idea of three square meals a day has been updated with a more contemporary concept of eating five smaller meals spread throughout the day. Steer clear of diets or fads, especially those that drastically limit a particular nutrient. Remember, balance, moderation, and variety win out over trendy and extreme. For some practical tips, navigate through the many options on Choosemyplate.gov. Columbia students can also take advantage of the resources from the get balanced! initiative. Plan ahead when possible so you don't have to rely on vending machines when you're hungry; think of ways to incorporate fruits, vegetables, and whole grains on a daily basis. Eating more of these will fill you up and possibly even enhance your already stellar brain power.
Making time for physical activity is important, too. Most college fitness centers have a variety of movement classes and options. When the weather is right, grab a friend and walk, run, bike, or blade outdoors. If you are Columbia affiliated, you can connect with 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, incentives to be active throughout the year, and event calendars with access to plenty of free and low-cost physical activity options on campus and around NYC.
Now, to address the second part of your question: an eating disorder, such as anorexia nervosa, is less about food, eating, and body weight. It has more to do with mental health, emotional, physical, socio-cultural, and family issues. If this is a particular concern of yours, you might want to take a look at Eating disorders vs. normal eating. Additionally, if you are a Columbia student, you can make an appointment with a health care provider or a registered dietitian to discuss your concerns by contacting Medical Services (Morningside) or the Student Health Service (CUMC).
Give yourself some time to adjust to a new environment and ask for help when you need it. Everything in moderation, even moderation.
Enjoy your time at college,
Dear Not So Sweet,
Oh, you're probably sweeter than you think…. Hypoglycemia is the medical name for low blood sugar. Excess insulin, along with glucose deficiency, usually causes hypoglycemia. We need glucose because it provides energy for our brain, central nervous system, and all of our body's cells. If someone is unable to maintain adequate blood glucose levels, major organs such as the brain are deprived of the fuel they need. When someone has low blood sugar, s/he may experience sweating, weakness, hunger, dizziness, trembling, headache, palpations (thumping in the chest), confusion and altered mental status, blurred vision, irrational behavior and aggressiveness, moodiness, and uncoordinated movements. S/he can appear to be intoxicated and have an increased heart rate. S/he may also have cool, moist skin and may even have a seizure. Over time, a hypoglycemic individual can experience allergies, sleeplessness, anxiety, depression, and is more predisposed to weight gain. S/he can also have recurrent headaches, poor memory, lack of confidence, and reduced libido.
Hypoglycemia may be caused by several factors. One cause is type I diabetes, also known as juvenile or insulin-dependent diabetes mellitus (IDDM). Type I diabetes is a chronic disease that impairs a person's ability to produce an adequate amount of insulin to control glucose levels (check out the diabetes-related questions below). Insulin must be injected and hypoglycemic drugs can be taken in order to lower the glucose level in the body. Other causes include too much medication, not eating enough carbohydrates, skipping meals, not eating soon enough, and too much exercise. Excessive alcohol consumption and insomnia have also been found to be causes of a low glucose level in the body.
A person with hypoglycemia can benefit from changing some of her/his behaviors:
- Instead of three large meals a day, have six small meals, which can help stabilize blood glucose levels throughout the day.
- Eat fewer simple sugars (i.e., candy, sweets, sugar, honey) and more complex carbohydrates. Complex carbohydrates are found in foods such as bread, cereals, pasta, rice, vegetables, and legumes (beans and peas). The body's primary source of glucose comes from the breakdown of carbohydrates.
- Eat more fiber.
- Choose fresh fruits as opposed to canned fruits and juices.
- At each meal, consume foods high in protein, such as fish, poultry, meats, and dairy products, such as low- or non-fat milk and cheese.
- Avoid alcohol, and limit coffee, tea, colas, chocolate, and cocoa.
- Maintain a healthy body weight by consuming a healthy diet and engaging in adequate exercise.
In case carbohydrate supplies run low, protein can be broken down to supply glucose for the body to use. This process, known as gluconeogenesis, is more likely to be a last resort for a person since proteins are needed for other body processes, such as tissue repair. Gluconeogenesis is also more frequently associated with fasting or starving.
If you have been experiencing signs and symptoms of hypoglycemia, and you believe you may have hypoglycemia, it's advisable to visit a health care provider so that you can be correctly diagnosed and receive any needed treatment. Students on the Morningside campus can contact Medical Services for an appointment; students on the CUMC campus should contact the Student Health Service.
For more information about hypoglycemia or low blood sugar, check out the related questions below. Enjoy the sweet life!
November 18, 2014591560
Diverticular disease occurs when diverticula, small pouches or sacs, develop in weak spots found in the walls of the colon. Depending on the state of these sacs, two conditions may result: diverticulosis or diverticulitis. The condition is referred to as diverticulosis if the small sacs do not become inflamed or bleed. Many cases are asymptomatic, but some people may experience cramping, bloating, constipation and/or diarrhea. If these sacs become infected or inflamed, this will, in turn, lead to diverticulitis. Symptoms can include fever, chills, nausea or vomiting, constipation or diarrhea, constant pain the lower abdomen, and bleeding. In the case of both conditions, diet can be a means of prevention and symptom management.
The long-held belief was that developing diverticulosis was associated with a low-fiber diet. More recent studies have challenged this notion, revealing that neurotransmitter levels in the body, smoking, obesity, lack of exercise, and even use of some pain relievers (NSAIDS) may be linked to diverticular disease. In light of this, research suggests that for those who’ve been diagnosed with diverticulosis, a high-fiber diet (in addition to fiber supplements, certain medications, and probiotics) may help relieve symptoms by reducing pressure on the colon and prevent further complications. Foods high in fiber include:
- Dried beans and peas
- 100 percent whole grain breads and cereals
- Fruits — particularly those with skin or edible seeds (e.g., apples, pears, raspberries)
- Vegetables (e.g., leafy greens, squash, potatoes, broccoli)
There are a few things to remember when increasing fiber intake: Take it slow! Increasing your fiber intake slowly will ensure enough time for your gastrointestinal (GI) tract to adapt. Also, keep your water bottle handy; drinking lots of water keeps stools soft and easier to pass.
Though the cause for diverticular disease is currently under investigation, experts agree that the inflammation associated with diverticulitis is caused by bacteria or feces caught in diverticula. Dietary changes recommended for diverticulitis depend on whether the focus is on preventing attacks or managing the severity of pain experienced during an attack. Prevention includes incorporating a high-fiber diet to reduce the risk of attacks. Some health care professionals used to think that particles from nuts, seeds, and hulls (like popcorn) could get trapped in the diverticula and cause diverticulitis attacks. However, there is no scientific evidence to indicate that these foods actually cause inflammation, and they can even be part of a high-fiber diet. People with diverticular disease should avoid foods that seem to aggravate them individually — keeping a food journal may help to pinpoint any culprits.
However, if someone experiences an attack, dietary changes are utilized to give the bowels a break. If the pain is mild, antibiotics and a liquid diet for a period of time may suffice as treatment. After that time, low-fiber foods are then added back to the diet. If there is significant pain, a hospital visit may be in order, which may include avoiding consumption of regular food and drink for several days. During this time, nutrition and antibiotics are administered intravenously (through an IV).
To learn more about diverticular disease, check out the related Q&As below and the National Digestive Diseases Information Clearinghouse website.
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!
May 18, 2012511344
You are already on the right track. Exercising has countless benefits for health, happiness, and if it matters to you, appearance. It sounds as though you know what you need to do, but want some suggestions on where to do it.
It's true, some fitness centers can feel intimidating. However, most everyone at the gym has had that same feeling at one time or another; it's common to feel nervous about joining a new gym, regardless of body size. In reality, fitness center users come in all shapes, sizes, and ages. If you have already found a facility, know that many fitness centers offer a complimentary training session or two to show you how to use the machines and help you devise a workout plan. A quality facility hires employees with a full understanding of "gymphobia." Investing some time to get oriented can help relieve some of the anxiety you experience during future visits as you'll be able to strut right in and jump into your workout.
If you're still searching for a fitness home, consider that YMCAs, YWCAs, local community centers, and independent gyms often feel more down to earth and less intimidating than many larger, chain gyms. As you are considering which facility to join, it's certainly fair to ask for a tour and a trial membership. Visit the location at different times of the day as early morning exercisers may seem very different than a mid-afternoon or late evening crowd. Look around for members who you feel are similar to you and ask them about their experience. Another option may be a college in your neighborhood. Some colleges offer community members use of their facilities for a nominal fee. Columbia students can check out all the great options at Dodge Fitness Center. New York City residents can also join the city's rec centers, which offer weights, cardio machines and classes, and pools for a low membership fee. Don't forget about exercising outside: running, biking, hiking, and walking immediately come to mind. Fresh air does the soul good.
If you've ever played a sport or wanted to learn a new one, consider joining a team or a league. There are a wide range of options, from dodge ball or softball to tennis and bowling. Leagues often offer options for beginners and seasoned athletes alike with the added bonus of meeting some new friends.
Just like with your first day of a new job or school, you start out not knowing many people and not being sure of what to do, but, within a short time, all that changes. Going to a gym, a team practice, or to the park to run won't be too much different. Think of your "gymtimidation" reduction efforts as a part of your entire workout — the more you stick with it, the easier it will get. And remember, health clubs are places to get and stay healthy — not beauty pageants or Olympic competitions. Gym'ers who disagree might consider shaving a few pounds off their egos.
Finally, remind yourself that working out is something you've committed to do. Schedule it on your calendar and grab a partner — you can encourage and motivate each other.
October 15, 200921598
I am skinny and a YOGA TEACHER... but I still felt intimidated going into my gym the first time two years ago, just cuz I'd never done it. Trust me, even if it's all in your head, just...
I am skinny and a YOGA TEACHER... but I still felt intimidated going into my gym the first time two years ago, just cuz I'd never done it. Trust me, even if it's all in your head, just keep on keepin' on. Everyone kinda feels self conscious at the gym. :)
May 19, 200420562
Another thing to try: do your workout at the gym's slowest hours at first, until you feel comfortable there and get into your routine. Go early and avoid lunchtime and any time...
Another thing to try: do your workout at the gym's slowest hours at first, until you feel comfortable there and get into your routine. Go early and avoid lunchtime and any time after 5, when most people get off work. The less people that are there, the less intimidated you will feel. Good Luck!
August 10, 200120374
Do what I did: Get yourself an MP3 player or portable CD player (preferably a newer one with less inclination to skip) — pop in your favorite tunes (something that really...
Do what I did: Get yourself an MP3 player or portable CD player (preferably a newer one with less inclination to skip) — pop in your favorite tunes (something that really pumps you up and gets you going!), PUT ON THOSE EARPHONES FOR YOUR ENTIRE WORKOUT and TUNE OUT the rest of the world, including those you perceive to be criticizing you. Tune into yourself and your workout, and before you know it, you will see results. Remember, it's your workout; it's YOUR life! Good luck! :)