Nutrition & Physical Activity
SAMe, also known as SAM-e, stands for S-adenosylmethionine and occurs naturally in the body. It is formed from the amino acid methionine and the nucleotide adenosine triphosphate, more commonly known as ATP. SAMe works by donating the needed methyl groups for many of the essential reactions that occur in the body. SAMe is also available as a supplement, and is thought to be effective in treating a wide range of diseases ranging from depression and other psychiatric illnesses to infertility, liver problems, osteoarthritis, and premenstrual symptoms and disorders. SAMe can be taken either by mouth or through injections in the muscle given by qualified and trained medical professionals. Since limited research exists on the effectiveness of SAMe in treating the many listed health concerns, it is important for individuals to consult with her/his health care provider before making the decision to take SAMe.
Side-effects of taking SAMe may include nausea, vomiting, diarrhea, stomachaches, increased thirst, increased salivation, and decreased appetite, among others. As noted above, your health care provider can help you to decide if SAMe is the appropriate method of treatment for your specific condition, and recommend the proper dosage and method of administration. S/he should also be consulted if you experience any of the side effects described above, or any other side effects, while you are taking the supplement.
Because SAMe is sold as a supplement rather than a drug, it is available over the counter without a prescription. However, keep in mind that supplements and herbs are very loosely regulated by the US Food and Drug Administration (FDA). This means that there are no checks or guarantees that why you buy actually contains what is labeled on the bottle. Unlike prescription or over-the-counter medications, there are also no guarantees as to the purity, strength, efficacy, or safety of the product. So, even though products like SAMe may sound like a good idea, take the time to talk with your health care provider and to make an informed decision about your health!
Rejoining the ranks of the omnivorous need not mean you make major shifts in your current vegetarian diet, assuming that your current diet is reasonably well-balanced and contains plenty of fruits, vegetables, and whole grains. Most recommendations about transitioning from a vegetarian diet to one that includes meat suggest slowly adding in easy-to-digest, lean meats, while continuing to eat vegetarian staples.
Fish is an excellent first step. Fish, especially salmon, trout, herring, and sardines (in general, cold-water fish with small bones) is a great source of protein as well as omega-3 fatty acids, and fish isn't as hard for the body to break down and digest as more dense, fattier meats. Choosing the right fish has become trickier as concerns about mercury levels (a toxin), overfishing of wild stocks, and aqua-farming practices increase. Check out the Monterrey Bay Aquarium's Seafood Watch program to learn more about sustainable and healthy choices for getting your fish fix.
Lean meats, such as poultry (white meat and skinless are the leanest poultry choices), lean cuts of beef and pork, and ground meats with the least percentage of fat, are also good sources of protein and iron. These should be at least 90 percent lean. Again, when adding poultry and meats back into your diet, you may want to consider issues of sustainability when buying. Some issues to consider include whether the animals were free-range, raised without hormones or antibiotics, or grass-fed.
Like any meat-eater, you may want to use caution when considering processed meats like ham, sausage, hot dogs, and packaged lunch meats, as they're often loaded with preservatives and sodium. However, if you find a trustworthy brand or deli, these are a convenient and easy way to incorporate meat into your diet once your body has had a while to get used to the leaner meats. Turkey, roast beef, and low-fat varieties of luncheon meats tend to have less fat than bologna or salami. With the addition of meat to your diet comes increased cholesterol and saturated fat. Fatty or red meats, egg yolks, and full-fat dairy are high in both cholesterol and saturated fat. Everyone, not just those transitioning from vegetarianism, should be mindful of how much cholesterol and saturated fat they're consuming.
Finally, just because you are adding meat to your diet, remember that your vegetarian favorites like grains, beans, nuts, seeds, fruits, and vegetables are still an important part of your eating plan. These are all important sources of vitamins, minerals, fibers, proteins, and enzymes. You mentioned that you were a lacto-ovo vegetarian, which means you have been eating eggs and dairy. These animal products are great sources of protein and other nutrients and can be included in your diet along with everything else.
The USDA considers fish, meat, legumes, and beans to be in the same food group. The recommended daily amount one should eat from this group depends on age, sex, and level of physical activity; however, typically a serving from the protein group is 3 to 4 ounces. As you can see, meat doesn't need to be eaten in huge portions to meet your protein requirements and, you don't need to eat it every day. Making the change to an omnivorous diet slowly, with continued use of the vegetarian foods you were accustomed to eating, can help avoid shocking your system with a sudden onslaught of new foods.
Columbia students who would like more nutrition guidance can make an appointment with a Registered Dietician by calling Medical Services (Morningside campus) or the Student Health Center (CUMC campus). Enjoy the vast array of new options you have in meal planning and restaurant choices, and don't forget to eat your vegetables, even in the midst of meat-eating bliss!
Part of the difficulty with managing diverticulitis (a condition where small sacs form in the intestine and become inflamed) is that the recommended dietary regimen can be quite complicated. What to eat with diverticulitis? gives an overview of recommended foods and what to avoid. But in a nutshell (er… if those aren't off limits!) you can probably eat a more varied diet than the one you describe in your question.
To figure out how many calories you should be eating each day, go to MyPyramid to get a personalized plan to help you maintain a healthy weight. If you are trying to gain weight, you will need to eat approximately 500 extra calories per day than you are now; the easiest way to do this may be to add one or two substantial snacks throughout your day. You may also consider adding healthy fats such as fats from nuts, avocados, and/or olive oil during meals or snacks.
Nuts and seeds may be a good option for you, though there is some confusion regarding whether they help prevent or trigger diverticulitis attacks. Including them in your diet is a personal choice. If you have had any trouble with them in the past, you should avoid eating them. However, if you body is able to handle these foods, they offer a healthy fat source and protein.
Although fruits and vegetables are a healthy addition to your diet, too many may make it difficult for you to maintain a healthy weight if you aren't also getting calories from the other food groups. There are other ways to add fiber to your diet that can help increase your overall calorie intake. Many whole grains, which are high in fiber, are also calorie-dense. For example, consider dipping whole grain bread in olive oil or adding sliced avocado to brown rice dishes for a fiber and calorie boost. You may also consider adding dried fruits to your diet. Since their water content has been removed, you may be able to eat more.
Low-fiber foods are sometimes recommended during mild attacks of diverticulitis. These may include smooth peanut butter, eggs, milk, yogurt and cheese, all of which provide some fat and protein. If your diet can include low-fiber foods, these may aid in maintaining (or even gaining) some weight. You may also consider a meal supplement such as Ensure, which can replace much-need calories in your diet.
Check out previous questions on this topic including the one mentioned above and Diverticular disease and diet. There are many people that struggle to get the right balance in their diet, especially with a condition like diverticulitis. Considering the complicated recommendations for people with diverticulitis, it may be worth your while to visit a nutritionist, who can give you specific recipes to use and foods to add to your shopping list. If you're a Columbia student you may take advantage of Columbia's nutritional services by calling x4-2284.
Take care of yourself!
Ouch — sorry to hear that your sports bra is rubbing you the wrong way! This seems to be a common problem for runners and exercisers, as indicated by the number of products on the market meant to prevent chafing. Chafing is caused by sweating and rubbing on the sweaty skin, and prevention can begin even before your lace up your running shoes. The four key steps in doing so include:
Staying hydrated: drinking enough water before, during, and after your run will ensure that your sweat is flowing freely, rather than drying into gritty salt crystals that will make the chafing worse.
Staying dry: Try a little sprinkle of talcum powder, cornstarch, or potato starch on your easily-chafed body parts in order to soak up the sweat. You could also look for an anti-chafing powder in your local sports store. You may have to experiment a little here — each person's skin is different. Talcum powder, for example, may work for you, but for some, it can make chafing worse. Go easy on the anti-perspirant, too, because that can make things even sticker.
Staying slick: Using a lubricant, such as hand cream or body butter to keep body parts gliding easily past each other. Because you mentioned that Vaseline hasn't been working for you, you could also try some of the new gel-based products formulated especially for walkers, joggers, and runners. Look for a formula that is non-greasy, non-staining, and dries quickly.
Staying stylish: Wearing proper attire can keep chafing at bay. Stick to snug-fitting clothes that will not move and rub against the skin. Look for tops and bottoms made from materials like polypropylene, polyester, Lycra, and Spandex. Not only will these materials allow the clothes to fit well and stay in place, they are also good at absorbing excess moisture while allowing the skin to breathe. In addition these materials are non-abrasive. If it's the sports bra that seems to be giving you the rub, you can concentrate on protecting the skin in this area by making sure you are wearing one with covered hooks and seams, wide elastic bands, and widely cut armholes that will stay in place as you move.
To help get the chafed skin off your chest properly, you can wash the wound with antiseptic to prevent infection. Place a sterile gauze pad or other covering over it that will allow it to breathe until it heals.
Hope this helps! After all, with the numerous physical and mental challenges of long distance running, the most difficult part should not be getting dressed!
Although no one ever said a pomegranate a day keeps the doctor away, this fruit, also known as a Chinese apple, is filled with vitamin C and other nutrients that are good for your body. Much of the current research focuses on antioxidants in the pomegranate called polyphenols, which may play an important role in protecting your heart and arteries. Studies in mice (not men…or women) have shown that pomegranate juice slows down the rate at which arteries harden and may also reduce the amount of LDL, or "bad" cholesterol, in the bloodstream. The polyphenols may even help reverse damage that having high blood pressure causes to the walls of the arteries and blood vessels.
The hardest part about eating a pomegranate is the skin (literally!). Pomegranates are surrounded by a thick skin that, unlike apples, should not be eaten. Rather, it's the fleshy pink pulp and seeds inside that contain the good stuff. In order to dig in, one should:
- Remove the flowery part of the pomegranate, usually by cutting it off with a knife.
- Cut through the rind lengthwise, making sure not to cut so deeply that your knife's blade goes to the middle of the fruit.
- Soak the fruit in a bowl of water for five minutes or so.
- Carefully break apart sections of the pomegranate along the cuts in the rind while the fruit is still under water. This should allow for the seeds to fall out and sink to the bottom while the inedible parts (the membrane and rind) float at the top.
- Throw away the membrane and rind, drain the seeds, and enjoy!
If that sounds too much work for you, you can break or cut the fruit in half, and then pick away at the seeds with your fingers or fork. Be careful though, because the red juice from the seeds is likely to stain. You can also make your own pomegranate juice by blending the seeds in a blender or food processor, or rolling the whole fruit along a hard surface like a floor or counter, and then breaking open the skin and squeezing out the juice. If that still sounds like too much work, or if you want to keep your hands clean, you can also buy the juice from the store — just be aware of whether you are getting 100 percent juice, or if there are added sweeteners. Although it's not clear how much someone who is healthy should drink daily, some researchers feel that 16 ounces of pomegranate juice (which is 2 cups, 1 pint, or about 500 milligrams) might be beneficial to those who are already showing the early signs of heart damage.
As far as pomegranate pills go, over-the-counter supplements and herbs are not currently regulated by the FDA, nor are their claims. With that in mind, you might be better off sticking to the real stuff. If it's the extra cost of buying pomegranates or juice that's getting you down, you could think of it as a long investment in your health. Additionally, pomegranates are supposed to be eaten (or drunk) as part of a healthy diet. That is, you should feel free to substitute pomegranates for oranges, bananas, apples or whatever fruit you would normally eat, which may help keep your overall grocery costs down. Students at Columbia (Morningside campus) can also schedule an appointment with a nutritionist at Medical Services by dialing 212-854-2284 or online through Open Communicator. Students on the Medical Center campus can contact the Center for Student Wellness for information on achieving a health diet.
While dentists may not necessarily endorse drinking large amounts of either coffee or pop, there is some evidence that coffee is not as bad for your teeth, at least in terms of structural damage. Both coffee and pop may cause teeth staining and discoloration over time, and both may make you jittery if you drink the caffeinated versions.
Although known for its ability to wake you up in the morning, coffee, including the caffeinated and decaffeinated versions, also contains substances that may prevent tooth decay. These components (chlorogenic acid, nicotinic acid, and trigonelline) have been shown to prevent bacteria from attaching to the tooth surface, and this may be the first step to preventing tooth decay. However, just drinking coffee isn't enough to prevent tooth decay. The amount of sugar a person adds to coffee (or consumes in pop) plays an important role. A diet high in sugar may lead to dental cavities; regular visits to a dentist, brushing, and flossing at home will help you avoid dental problems. If you are a Columbia student, check out Dental care in NYC for more information about dental options.
Pop, also known as soda, soda-pop, tonic and soft drinks, doesn't have the same components that protect from bacteria and there is some evidence that exposing teeth to pop over time may contribute to tooth erosion. Tooth erosion happens when the protective enamel wears away, and can be caused by many factors other than drink consumption including:
- Low levels of saliva.
- Acid reflux disease.
- Other gastrointestinal problems.
Pop may cause erosion because it is an acidic drink and, unlike coffee, studies suggest that the acids in pop are not protective. However, you would have to drink large amounts of pop to see these effects.
Coffee, and dark-colored pop such as cola, may both contribute to tooth staining. These drinks, along with tea and red wine, contain dark compounds that can build up over time and cause discoloration (because tooth enamel absorbs these compounds). To prevent this build up you can avoid drinking dark beverages and be sure to brush regularly. Teeth whiting treatments can also have a dramatic effect and may help remove stains.
Coffee and pop act differently on your teeth and it's a good idea to drink them in moderation since over time they may have negative effects. Brushing regularly will also help to protect your teeth from some of the damage and discoloration. Finally, regular visits to your dentist will help keep your mouth in tip top shape.
Unfortunately, whoever said the good things in life are free was not referring to diet soft drinks and beverages. Although these refreshments are sugar- and calorie-free, they can still do some serious damage to your teeth and possibly your waistline.
The acid in colas, even diet varieties, can help form plaque and soften the teeth's enamel (the hard outer covering). This in turn makes the teeth more susceptible to tooth decay and cavities, which can interfere with eating and cause oral sensitivity, pain, and infections. Drinking sodas from a straw or when eating a full meal will help combat the corrosion caused by the acid, as will brushing your teeth afterwards or chewing sugar-free gum.
Even though these drinks aren't adding any calories to your diet, recent studies on both human and animal subjects have shown that they may actually contribute to weight gain. Some researchers speculate that the sweet taste of soda may trick the body into thinking that it is going to get the calories associated with sugars. When the calories aren't delivered, the body stimulates the appetite, making you hungrier than if you had not had the soda. This may cause you to indulge in extra calories in other foods.
Other scientists have a different theory: the sweetness of the soft drink, coupled with the lack of calories, tricks the body into believing that all sweet foods have little or no calories. This mixed message interferes with your body's ability to interpret internal cues that regulate how much of a certain food or food group should be consumed. This bodily confusion, they believe, may then lead to over-eating.
The weight gain linked to diet sodas may also be attributed to certain behavioral patterns. Some people may mistakenly regard diet sodas as a diet and only switch from drinking regular sodas to diet sodas in order to lose weight. But, because they don't change any other aspect of their eating or exercising habits, they continue to gain weight and eventually become overweight or obese.
Does this mean you should swear off diet sodas forever? Certainly not, but moderation is a good idea. If you're currently drinking several cans or bottles of soda a day, it may be best to gradually replace your sodas with a healthier choice, such as water or milk. Although quitting cold turkey is better for you than large volumes of diet soda, you may find it easier to adjust to and keep your new habit if the switch is gradual. You can also check out Getting off colas, sodas, pop, fizz,... oh, whatever in the
Dear Readers (1) and (2),
With a variety of aerobic and weight training programs designed with different and varying goals it's no wonder that you are second guessing your workout regimen. There are varying opinions regarding whether or not to begin your workout with cardio or with weight training. There are also many experts who suggest alternating your routine by doing your cardio on completely separate days than your strength training. Ultimately, a well-balanced work out plan, regardless of the cardio versus strength training order, can help a person achieve her/his goals.
The suggested order for completing a workout that includes both strength training and cardio is: a short warm-up, some strength training, a cardio aspect, and a brief cool-down. The warm-up and cool-down can include stretching, cardio, or both. The order in which you partake in your cardio portion of your workout simply depends upon if you want to focus more on cardio or strength training. For example, you can do a bit of cardio to warm-up the muscles, do your strength training, and then complete a more strenuous cardio portion, cooling down at the end with some stretching. On the other hand, you can do all of your cardio at the beginning of your exercise session to pre-fatigue your muscles, do your strength training, and then cool-down with stretching. Likewise, you could do some stretching to warm up, strength training, more intensive cardio, and then more stretching to cool down. As you can see, there are many different ways to structure a workout depending on your individual goals.
There is a difference in the percentage of calories utilized from fat vs. carbohydrates, depending upon the level of exercise intensity. People expend around 60 percent of their calories from fat based caloric reserves while performing low-intensity exercise. This number decreases to 35 percent when performing high-intensity exercise. However, people will still utilize more overall calories and total calories from fat when exercising at a high intensity level than at a low intensity level if the amount of time spent exercising is the same. That said, your body does not burn all of the available calories from carbohydrates and then move on to burning calories from fat. Your body utilizes both at the same time.
For a more personalized consultation focused on your goals, consider talking with a certified personal trainer at a fitness center concerning the latest in fitness research and on the best program for you. Also keep in mind that physical activity goals may change over time so periodic consultations may be a good idea. Bottom line — as long as you are maintaining physical activity and including a warm up at the beginning and cool down with some stretching, the order of your cardio and strength training in between is really a personal choice.
Also referred to as pyridoxine, pyridoxamine, and pyridoxal, vitamin B-6 is involved in the metabolism of amino acids, glucose, and lipids in the liver. Vitamin B-6 is also crucial in the synthesis of neurotransmitters, hemoglobin, and histamine, as well as proper gene expression. Because vitamin B-6 plays a significant role in more than 100 metabolic reactions, consuming enough of it on a daily basis is important. However, research regarding vitamin B-6 supplements is generally inconclusive, so those deficient in the vitamin should consider making dietary adjustments rather than taking supplements.
The amount of vitamin B-6 to be consumed on a daily basis depends upon an individual’s age and gender. The Food and Drug Administration has established the following Recommended Dietary Intake (RDI) of vitamin B-6:
- 0.5 milligrams per day for children 1-3 years
- 0.6 mg/day for children 4-8 years
- 1 mg/day for children 9-13 years
- 1.2 mg/day for females 14-18 years; 1.3 mg/day for males 14-18 years
- 1.3 milligrams/day for adults 19-50 years
- 1.5 mg/day for females over 50 years; 1.7 mg/day for men over 50 years
Although it is relatively rare, vitamin B-6 deficiency can have harmful effects. Dialysis, arthritis, liver disease, ulcerative colitis, Crohn’s Disease, and HIV patients are at higher risk for vitamin B-6 deficiency, as well as individuals coping with alcoholism and those who take certain medications like penicillamine and hydrocortisone. It has also been found that oral contraceptives and other estrogens can interfere with vitamin B-6 metabolism, resulting in deficiency. Those deficient in the vitamin might consider changing their diets in order to ensure that they are consuming enough of the nutrient from food.
There are lots of great sources of vitamin B-6 in a wide range of delicious foods. Vitamin B-6 is found in meat, poultry, fish, eggs, whole grains, legumes (bean and peas), potatoes, yeast, bananas, corn, cabbage, yams, prunes, watermelon, and avocado. One’s daily quota of vitamin B-6 can be easily consumed through food, including these vitamin B-6 rich food sources:
Banana, medium size
Chicken breast, 3 oz., roasted
Pork loin, 3 oz., roasted
Baked potato with skin, 3 oz.
Watermelon, 1 cup
Black beans, boiled, 1 cup
For more information about nutrition, check out the Optimal Nutrition section of the Go Ask Alice! archives. If you’re a Columbia student on the Morningside campus, you can make an appointment with a Registered Dietitian to discuss your intake of vitamin B-6. If you are on the Medical Center campus, contact Medical Services to make an appointment with a Registered Dietitian. While you’re at it, take a look at Columbia’s Get Balanced Guide for Healthier Eating for more information and ideas.
Stomach stapling is a major surgical procedure for severely and/or morbidly obese individuals who have made numerous, unsuccessful attempts with traditional methods of losing weight (such as changing eating patterns, working with nutritionists on eating plans, dieting, regular physical activity), all with the knowledge and supervision of their health care provider. To qualify for gastrointestinal surgery (stomach stapling is one kind), the person needs to have a body mass index (BMI) of over 40. For a man, this means being at least 100 pounds overweight for his height; a woman must be over 80 pounds the healthy weight range for her height. This surgery gained popularity when multiple celebrities had the procedure done as a last resort treatment for morbid obesity.
For the procedure itself, a trained and experienced surgeon creates a small pouch at the top of the stomach, where it meets the esophagus, using staples and most often a band that is filled with saline that can enlarge and contract. The pouch will generally be large enough to hold only 1 to 3 ounces of food at a time. At the lower end of the "new" stomach, an opening of about 3/4 inches is made. This slows the movement of food, allowing the person to feel full more quickly. As a result, the person will be able to eat only a small amount of food — generally about one cup or less — at one time.
Sometimes the procedure is coupled with another one, called a malabsorptive operation, which diverts food from the stomach past much of the small intestine. This severely limits the body's ability to absorb nutrients and calories from the food, thus resulting in rapid weight loss.
Following the operation, the patient will have to consciously learn to change her or his eating patterns — to eat smaller amounts of food and to chew slowly and thoroughly. S/he won't be able to eat foods high in sugar or fat content, because they empty from the stomach more quickly than foods high in protein or complex carbs such as fiber, and can cause uncomfortable side effects. The patient will begin a lifelong dependency on nutritional supplements, since s/he will not be able to get enough vitamins and minerals from the food s/he eats. The individual will need to engage in regular physical activity as well, even if it's never been part of her or his routine.
Usually, maximum weight loss takes anywhere from 10 to 24 months after the surgery. Some people will not be successful. More than just the physical differences in the stomach, success also depends on the person's motivation to change her or his eating and exercise routines, continuing to use the traditional means of weight loss and maintenance that are most often successful and had been tried before having the surgery. These factors remain key to successful weight loss and maintenance, whether or not one has the procedure done.
While stomach stapling is a fairly simple procedure, it is not without risk. Nausea and vomiting are more prevalent, since eating larger amounts of food or not properly chewing will result in throwing up. Sugar and fat can cause "dumping syndrome," in which food moves through the stomach opening too quickly, causing nausea, vomiting, weakness, and even fainting. About 10 to 20 percent of people who undergo the surgery will need to have at least one follow-up operation due to complications. The band can slip, or even break, releasing saline into the abdomen; the staples can deteriorate and will need to be replaced. In a small number of cases, juices from the stomach can leak out into the abdomen, necessitating immediate emergency surgery. And in less than 1 percent of cases, infection can lead to death.
In addition, about 1/3 of the people who undergo the procedure will have gallstone problems and another 1/3 will have nutritional deficiencies. Some may also experience pulmonary embolisms (blockages of an artery) or respiratory failure. A final caution: the operation is quite expensive, and coverage varies depending on a person’s health insurance plan.
If you think you are a candidate for this type of surgery, you can speak with your health care provider. You have hopefully been working with her or him to lose weight already. If not, you might together come up with some simple, workable strategies for losing weight before having this type of procedure, if at all. If you are indeed a candidate, your provider will refer you to a bariatric surgeon, a doctor who specializes in the field of obesity and gastrointestinal surgery.
For further information, visit the National Institutes of Health (NIH) web page on Gastrointestinal Surgery for Severe Obesity, or the American Society for Bariatric Surgery web site.