Nutrition & Physical Activity

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Dancer thinks she may have an eating disorder

Dear Confused!,

It sounds as though your school did a good job in raising awareness of eating disorders, but you're fuzzy on whether or not this actually applies to you.

Lots of sports — including dance — focus on attaining a certain "body type." Some people are naturally born to look a certain way, while others are not. Striving for an ideal that is not always attainable (or even realistically possible) can lead some people to develop obsessions and unhealthy behaviors.

Eating disorders are not always "black and white." As a result, health care professionals use a designated set of criteria to medically diagnose an eating disorder. According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), these include:

Anorexia Nervosa

  • Refusal to maintain minimal body weight for age and height
  • Intense fear of becoming fat or weight gain despite being underweight
  • Misperception of body size and shape
  • Missed three or more periods in a row

Bulimia Nervosa

  • Regular and repeated binge eating bouts, followed by self-induced vomiting; misuse of laxatives, diuretics, enemas, or other drugs; starvation; or, excessive physical activity, to prevent weight gain
  • Both bingeing and compensatory behaviors take place about two or more times a week for at least three months
  • Self-evaluation is overly based on body size and shape

Sometimes people exhibit certain conditions of these eating disorders, but not all. What does this mean? They could have disordered eating and/or body image distortions, but not a fully developed eating disorder. Even so, it is preferable for a health care professional to diagnose the situation, because s/he can then refer a patient to the right people. Obtaining the appropriate resources can help a person identify the issues behind the eating and/or body image concerns.

You may want to speak with a parent(s), trusted friend, teacher, or mentor about your thoughts. Perhaps you can also make an appointment with your health care provider and/or with one of the professionals who spoke at your school. S/he could assess your situation and help you develop a healthy relationship with food, your body, and dance.

For further information, eating disorder resources are available on the web, including:

Here's to dancing to the beat of healthy living,


Are yams an adequate alternative to hormone replacement therapy?

Dear Ana,

Wild yam (Dioscorea villosa) and Mexican yam have been marketed as alternatives to synthetic progesterone (not estrogen), which is a hormone taken by some women during menopause. These yams contain diosgenin, a plant substance that has a chemical structure similar to progesterone. In the laboratory, diosgenin can be converted to progesterone by using specific reagents and enzymes to carry out a series of chemical reactions. This transformation can only be performed in a lab — the same process does not occur in the human body. As a result, it's actually misleading for a manufacturer to term a wild yam supplement as "natural progesterone" because it is not progesterone, nor does it have any impact on a woman's hormone levels. Since diosgenin doesn't have hormonal activity itself, creams containing this substance are not effective.

In the United States, what is commonly referred to as a "yam" is actually a variety of sweet potato (ipomoea batatas). Yams are similar in shape to sweet potatoes, but are drier and starchier in taste, and are rougher and scalier in texture. Sweet potatoes are a good source of beta-carotene, vitamin C, folic acid, and some B vitamins. Predominantly grown in the Caribbean and Africa, yams are a good source of potassium, but contain no beta-carotene, and have lower levels of B vitamins, vitamin C, and folic acid than sweet potatoes. Eating sweet potatoes or yams will provide nutrients, but, as they contain neither progesterone nor estrogen, they won't affect a woman's hormonal balance.


Breakfast ideas for thirteen-year-olds, and everyone else

Dear Student & Parent,

Bravo to eating breakfast! It's fairly well known as this point that a healthy breakfast is a great way to start each day — especially when it's made from scratch. Taking into consideration that, just sometimes, younger people are a little picky about what they'll eat, not to mention the energy it can take a groggy chef to whip up something in the A.M., here are a few easy, interesting, and nutritious breakfast recipes:

Creamy Apple-Cinnamon Oatmeal (makes two servings):

2 c. skim milk
1 c. rolled oats
1 T. Brown sugar
1 T. Maple syrup
1 apple — peeled, cored, and chopped into cubes


  1. In a medium pot, heat the milk over medium heat, almost to a boil.
  2. Add the oatmeal, reduce the heat to low, and cook for about 5 minutes, or until all of the milk is soaked up by the oatmeal.
  3. Add the brown sugar, maple syrup, and apple pieces. Stir well and serve.

Berry Parfaits (makes two servings):

2 containers of yogurt (vanilla, lemon, or peach)
2 c. mixed berries: strawberries, raspberries, blueberries, and/or blackberries
1 c. low fat granola


  1. In 2 glasses or plastic cups, add a layer of yogurt to the bottom. Cover with a layer of berries, and then sprinkle on a layer of granola.
  2. Repeat the layers until the glasses or cups are full, ending with a sprinkle of granola.

Egg Scramblers (one serving):

1 or 2 eggs
1 toasted whole wheat pita or toasted English muffin
Optional item(s): mushrooms, peppers, grated cheese, chopped tomatoes, onions, salsa, or whatever else you like!

Microwave Directions:

  1. Crack eggs into a glass measuring cup and beat well. Mix in any other ingredients you like.
  2. Cover tightly with a microwave safe plastic wrap.
  3. Microwave at 70 percent: 1 minute for 1 egg; 1-½ minutes for 2 eggs — slightly longer if you add other ingredients, or if you like your eggs more well done.
  4. Spoon into a pita, or onto a toasted English muffin.

Stovetop Directions:

  1. Crack eggs into a bowl and beat well. Mix in any other ingredients you like.
  2. Pour egg mixture into a non-stick pan. Cook over low heat, stirring occasionally, until eggs are cooked through, not runny.
  3. Spoon into a pita or onto a toasted English muffin.

Banana Smoothie (makes one serving):

1 banana cut into 1-inch chunks (works great if already frozen)
½ c. yogurt
½ c. milk or soy milk
2 T. honey or jam
¼ t. vanilla extract


  1. Put all of the ingredients into a blender. Mix until all of the fruit is pureed.
  2. Pour into a glass, and drink immediately.

You can freeze this beverage overnight, then toss it into a blender, and pour it back in the plastic cup you froze it in. If you run out of time in the morning, you can bring your smoothie with you on the way to school.

Regardless of what you make, consider involving your breakfast companion in both the decision process and making the breakfast. This way you can both enjoy some time together and a nutrient-filled morning. Eat up!


Weight training: Do I need to change my workout to see results?

Dear Reader,

The body does adapt to weight lifting, so you won't see results if you continue with the same routine. After weeks or months of training, the same exercises that once exhausted you may seem almost effortless. To experience continued improvement in fitness, you need to challenge your body by making your workouts progressively harder in one way or another.

Although people change at different rates, it's generally recommended that people make a few alterations in their program every 4 to 8 weeks for continued results. You don't need to transform your entire workout, but modifying your routine slightly will help keep your muscles challenged. Here are some basic training variables to take into consideration when you're changing your workout, but only change one variable at a time:

This refers to the number of times you work a muscle per week; 2 - 3 times per week is optimal. Muscles need rest between workouts, so leave at least 24 - 48 hours between training the same muscle.

This refers to the weight used to perform the exercise, which may be in pounds or kilograms. The weight will affect the number of repetitions and the number of sets you're able to do. Beginners should use weights that allow them to do 12 - 15 repetitions and 1 to 2 sets of each activity. Use trial and error to find the appropriate resistance level: decrease the weight if you can only lift it a few times; increase the weight if you can easily lift it sixteen times or more. If/When you're upping the amount of resistance you use, do not increase it by more than 5 percent per week.

Also called "reps," this term refers to one complete action of an exercise. The heavier the weight, the fewer the number of repetitions you need to perform. Beginners should start with 1 to 2 sets of 12 to 15 repetitions. The last repetition should be somewhat difficult to finish — again, change the weight you use if this number of reps is too easy or hard.

Training Sets
These are a pre-determined number of repetitions of a specific activity. Beginners start with 1 to 2 sets of each exercise and increase the number of sets as they become stronger.

Rest and Recovery
This refers to the amount of time between sets and between training sessions. As you increase resistance, you'll need longer periods of rest, so your muscles can recover. Rest for at least 30 seconds between sets and for 24 to 48 hours between training sessions for the same muscle group.

Training Method
As you become stronger, you may progress to more advanced variations of activities for each muscle group. Performing such exercises stresses the muscle(s) in slightly different ways.

For even more variety, try throwing some of the following suggestions into the mix:

  • Work a different combination of muscle groups each day — i.e., back and biceps one day; chest, shoulders, and triceps one day; and legs and abdominals one day.
  • Do a total body workout 2 or 3 times a week.
  • Change the order in which you perform exercises (although larger muscles should be trained first).
  • Increase (or decrease) the number of activities for each muscle group.
  • Vary the type of exercises you do — i.e., progress to more advanced activities; use free weights; and/or vary the machines you use.

Keep in mind that if you increase resistance, you need to decrease repetitions and increase recovery time between exercises. If you add more sets, you'll need to decrease the number of repetitions. It may help to work with a Certified Personal Trainer to create a schedule you can work with over a period of months, tailored to your needs, abilities, and fitness goals.


Morning workout increases metabolism throughout the day?

Dear Reader,

When it comes to exercise, both early birds and night owls experience a metabolism boost from getting their heart rates up. And, though there is a difference in what is burned when you're gettin' your sweat on before downing a bowl of cereal in the A.M., overall, morning workouts don’t offer any extra metabolic benefits when compared to afternoon or evening exercise sessions. Additionally, skipping breakfast prior to a morning sweat session may not adequately get your engine running and enable you to sustain longer, more efficient workouts (if that's your jam). You might be happy to know though, there isn't just one way to rev up your metabolism (more on that later).

The key to burning calories (or increasing energy expenditure) is more complex than simply excising before or after breakfast. During exercise, muscles burn a combination of carbohydrates and fat. As an individual becomes more fit, her/his muscles utilize a greater percentage of fat for energy. Research indicates that while folks burn more fat when they exercise before a meal, the total energy expenditure is equal regardless of the order (i.e., no matter if you eat breakfast before exercise or exercise before breakfast). What it really comes down to personal preference to eat or not to eat prior to getting active. That is a question only you can answer.

Before you forgo breakfast, you may also want to consider that many people have low blood sugar levels in the morning, which means they’re low on energy. So, exercising before breakfast could leave you feeling lightheaded and tired more quickly. In turn, this could translate to shorter, less intense workouts. Eating a small mix of carbohydrates and protein(e.g., one medium banana and a four ounce non-fat plain yogurt) will give you the energy for a more strenuous, fat burning, calorie-torching session.

Lastly, if a metabolism boost is what you’re after, the American Council on Exercise has a few additional tips:

  • Drink green tea. The antioxidants and caffeine in green tea can cause a metabolism boost and green tea drinkers may burn up to an extra 70 to 100 calories per day.
  • Add spicy peppers to meals. Capsaicin, the chemical in peppers that gives them their heat, is also responsible for boosting metabolism. It’s theorized that metabolism increases because hot peppers literally heat you up — for every half degree that body temperature rises in Fahrenheit, metabolism is estimated to increase roughly seven percent.
  • Eat lean proteins. While all foods create a thermic effect and will slightly raise your metabolism, eating protein provides a larger boost compared to eating carbohydrates or fats.
  • Incorporate strength training. Muscle requires more calories to exist than body fat, so the more lean muscle tissue you have, the more calories you burn.
  • Add high intensity interval training (HIIT) to your workouts. When you’re doing cardiovascular exercise, HIIT keeps the body guessing by constantly alternating faster, more intense exercise periods with slower, shorter recovery paces. The body is forced to continually pump up the intensity and it helps exercisers to burn more calories and get in shape faster than if you exercise at a stable pace.

There are many strategies you can incorporate into and add onto your exercise routine to help you get your metabolism goin’. You’ve just got to figure out what works best for you!


Is rest the best relief for muscle soreness from intensive training?

Dear Concerned wife,

Unfamiliar or newly strenuous activity, among other factors, can contribute to delayed aches and pains after exercise. Some intensive regimens, such as your husband's, do not accommodate for a sufficient break to help the muscles to recover. You're 100 percent right — rest is most helpful in overcoming muscle soreness.

Firefighting is a physically demanding occupation and it's certain the training is intense and exhausting. It's likely that your husband is performing exercises that incorporate a full range of motion involving two types of muscle contractions. Concentric contractions occur when muscles shorten as they overcome resistance. Think of a bicep curl — raising the weight up produces a concentric contraction. Eccentric contractions happen as muscles act to oppose gravity. In this phase, the muscle is actually lengthening. During a bicep curl, think of lowering the weight — this is the eccentric contraction. It is well documented that the eccentric contractions during exercise contribute to the soreness felt after a workout. The tendons and some connective tissue of stiffer muscles are unable to absorb the stresses of the lengthening part of exercise.

People prone to stiffer muscles may be more susceptible to muscle damage after physical activity than others. They may benefit from warming up first, as this has been shown to reduce symptoms of additional damage, and may possibly protect against further soreness. It's a good idea to start by elevating the pulse rate slowly with some light aerobic activity, such as a brisk walk or easy jog. It's best to stretch once the body has had a chance to warm up a little. Static stretching (i.e. holding a stretch in place for several moments, without bouncing back and forth) can help get muscles ready for any type of training. There is some controversy regarding the usefulness and safety of certain stretches, so it would be a good idea for your husband to get tips from a health care provider or personal trainer on how to stretch. The related Q&A's below provide some tips as well.  

Hydration and nutrition can also play a role in helping the body heal from activity of any intensity. Dehydration is a frequent contributor to soreness and your husband should be hydrating before, during, and after training. Water is the best bet for quenching thirst and a low sugar sports drink can help replace electrolytes for prolonged periods of training. A well-balanced diet with fruits, vegetables, plenty of protein, and complex carbohydrates can help the body perform under intense conditions. Potassium can also help reduce soreness, so your husband may want to consider adding a banana or two to help with recovery. Avoiding excessive alcohol or caffeine use can also prove beneficial.

In the mean time, massage can feel really good to fatigued muscles. So if you're inclined, a relaxing rubdown may be greatly appreciated by your tired, aching husband. To be fair, the two of you could trade massages so you can each relax and recover from the day!


Eating tips when heartburn hits (acid reflux)

Dear Reader,

Gastroesophageal reflux disease (commonly referred to as GERD) occurs when the contents of the stomach back up into the esophagus. Since the esophagus doesn't have the same protective lining as the stomach, these acidic substances cause irritation and discomfort. Although this has nothing to do with the heart, it is frequently called heartburn because a burning sensation is felt just behind the breastbone.

The reflux, or burning, is a symptom of a malfunction of the digestive tract — specifically, the muscle connecting the esophagus to the stomach isn't working properly. In normal digestion, this muscle, called the lower esophageal sphincter, opens to allow food into the stomach, then closes. In GERD, this muscle is weak and relaxes, allowing backflow of the stomach's contents since it is not shutting properly.

In the digestive process, the stomach secretes strong acids that are needed for enzymes to do their job. Some people produce more acid than is needed, which contributes to the problems of GERD. It is often believed that spicy or citric foods cause GERD, which is not exactly true. More accurately, they often cause the acidic contents of the stomach to be more irritating to the esophagus. In any event, people who have GERD are usually recommended to stay away from these irritating foods:

  • Citrus juices
  • Tomato products
  • Coffee
  • Spicy foods
  • Carbonated beverages
  • Any other food that regularly causes heartburn for them (this varies from person to person)

Other strategies for people with GERD center on increasing the pressure of the lower esophageal sphincter to prevent backflow of the stomach's contents, including:

  • Increasing consumption of lean proteins (these help the sphincter to close)
  • Decreasing dietary fat intake (fat remains in the stomach for a long time, keeping the sphincter open longer)
  • Not smoking
  • Avoiding peppermint and spearmint
  • Staying away from both regular and decaffeinated coffee, strong tea, and chocolate

Keep the contents of the stomach small to help close the sphincter. People can eat small, frequent meals, and drink fluids between meals, rather than with meals. It's also a good idea to avoid lying down for two to three hours after eating. When people do lie down, some find relief in elevating the head of their bed by six inches, or by sleeping on a specially designed wedge to help clear the stomach's contents from the esophagus.

Excessive use of antacids is not a good idea because they can interfere with the absorption of some vitamins and minerals. Chronic acidic irritation to the esophagus can cause permanent swallowing difficulties, so it is important to seek treatment. In rare cases, esophageal cancer can result. If none of these strategies help, prescription medications may be needed to help reduce acid production, hasten stomach emptying, or increase the strength of the lower esophageal sphincter. Your health care provider will be a valuable resource.


For more information or to make an appointment, check out these recommended resources:

Medical Services (Morningside)

Student Health Service (CUMC)

Exercising with mini-trampolines and other “toys”

Dear Reader,

Whether you're jumping on a trampoline or a basketball court or gyrating with a hula-hoop or on the dance floor, you're burning calories! Might as well have fun with physical activity! Some people dread heading into a cramped gym with lines of manufactured machines. Creative and fun alternatives like yours help break the routine. Tapping into motivations like fun, positive childhood memories, and being social (what's more fun than having friends over to jump around?) is likely to develop healthy physical activity routines you look forward to!

You don't have to be a circus performer or an Olympic gymnast to get low impact cardiovascular benefits from mini-trampolines. In fact, a movement called "rebounding" promotes this form of exercise. Whenever you're taking up a new activity, remember to focus on developing the proper form and fundamental skills first, especially before you attempt any advanced moves. Some moves really aren't meant to be tried at home.

In using a mini-trampoline, it's important that you learn how to control your bounce. You may want to visit a fitness center to try it out before investing in your own equipment. A lesson or two from a fitness professional would provide the guidance you need to proceed on your own.

As with any new exercise equipment, it's vital to investigate the product. You may want to try one out before investing in your own equipment. If you decide to get your own, make sure that the trampoline frame is sturdy, has good suspension, and that the padding is adequate. If the model opens and closes, take a good look at these mechanisms; check to see that the trampoline won't collapse while you're jumping. Also, find a good place to jump, with adequate space so that you won't smash into walls, ceilings, other furniture, or small pets. Similar to when you were younger, keep in mind some safety precautions:

  • "Bounce with me!": it's more fun and safer with other people watching!
  • Take turns: have only one person jump at a time to avoid colliding your forehead into someone's neck.
  • Start slow: warm up your ankles and joints to avoid twists and sprains.
  • Leave it to the pro's: it's tempting, but try to avoid doing somersaults and shoulder, stomach, or back landings.
  • Bounce on an empty stomach: time to take a break if you feel nauseous.
  • Know when it's time: tune into your body, remembering that a little soreness may be a good indicator that you're working your muscles and that pain means stop.

Hopping into your second question, hula-hoops may be a lot of fun and a good source of coordination development. Using hula-hoops may not build lots of muscle, but you may get some light cardio benefits if you hula long enough. The effort you put forth is sure to make for an amusing performance or two. Consider using a jump rope if you want to kick your cardio up a notch. This exercise may really rev up your heart rate. Toys and games with cardiovascular benefits may help keep everyone young at heart!

Mixing it up a little is good for your fitness and happiness. Anything that gets and keeps you moving and puts a smile on your face is probably worth the effort!


August 4, 2006



Hula Hooping is loads of fun. It's easier with a bigger hoop at first because it spins slower and the rhythm is easier to pick up. Hula Hooping will give your middle an intense workout...


Hula Hooping is loads of fun. It's easier with a bigger hoop at first because it spins slower and the rhythm is easier to pick up. Hula Hooping will give your middle an intense workout. It tones the abdominals, hips, and waist. Pelvic muscles are also strengthened. Experiment with the hoop around the upper body, legs, etc. for more muscle tone. Body posture and alignment are positively improved with hula hooping. Many people make Hula Hoops, which are good to use, but you will still get an effective workout with a simple, plastic one. Some people even combine yoga or aerobics with hula hooping.

There are lots of fun tricks you can learn as well, look up "Hula Hoop Tricks" on google, and you'll find a bunch. Also your friends will want a turn if you show them. It is easy — no one is born without the skill, you just have to practice and have fun!

What's a healthy weightlifting schedule?

Dear Reader,

Weight training is an important component of fitness. But just like any other training regimen, rest is an essential factor to muscle health. It is important to leave a day in between exercising a specific body part or muscle in order to reap the benefits of your hard work.

Weightlifting can cause micro-tears in the muscle fiber(s).These tears can temporarily reduce muscle strength and cause some of the soreness you feel after a new exercise or tough workout. Rest time is extremely important, as it allows your muscles to build up the protein necessary to heal and become stronger. All in all, it takes about two days to heal any muscle fibers torn by weightlifting.

If you want to lift weights every day (remember to reserve at least one day a week for rest), try to focus on different muscle groups in three-day cycles, leaving two days in between the same group. For example:

  • Day one: back and biceps
  • Day two: chest and triceps
  • Day three: legs and abs
  • Day four: repeat day one

Other tips to consider for safer weightlifting are as follows:

  • To help prevent injury, start with some light cardiovascular activity to warm up your muscles.
  • Avoid rushing through your weightlifting workout — slow and steady is the way to go.
  • Limit your weightlifting motions while making sure you are keeping correct form. If you are not certain that you are weightlifting properly, you can ask a trainer for some assistance.
  • Remember to breathe! Inhale and exhale normally while you lift.
  • Rest muscle groups adequately between workout sessions (as mentioned above).

Following these tips should leave you in tip top shape — and your muscles happy!


Forgot to refrigerate leftovers — still okay to eat?

Dear Sleepy cook,

Sounds like a very tasty meal — one that would be tragic to discard. Unfortunately, it is likely that while you were sleeping, bacteria were partying on your stove and reproducing at alarming rates. Bacteria thrive at 40 to 140 degrees F and reproduce quickly. Thus, you should probably toss the sauce. Perishable foods should not be away from the fridge for more than two hours; seven hours would really be pushing it. Here are a few basic guidelines to follow in re-heating and refrigerating leftovers:

  • Tempting as it may be, do not taste food to determine if it is spoiled. You may get sick even from a small taste and your taste buds may not always detect good sauce gone bad.
  • Invest in a meat thermometer.
  • When initially cooking beef, chicken, or pork, make sure the meat reaches a minimum internal temperature of 160 degrees.
  • Make sure fish reaches a minimum temperature of 145 degrees.
  • Reheat all leftovers to 165 degrees.
  • Bring leftover sauces, soups, and gravy to a boil.
  • When wrapping up freshly cooked leftovers, store in multiple smaller containers so they cool more quickly.
  • Know that eating perishable foods that have been away from the fridge longer than two hours can be risky.

While it's ultimately up to you whether you eat or toss, wise eaters are wary of food that has been out a couple hours or more. Best of luck with future leftovers,


August 6, 2013

Thank you! That was very helpful. I made a large batch if stew and had it in a large container. It would have taken a long time to cool down. I used 4 different containers after reading this post so...
Thank you! That was very helpful. I made a large batch if stew and had it in a large container. It would have taken a long time to cool down. I used 4 different containers after reading this post so it would cool down faster instead of one so bacteria would less likely grow ! Thank you!
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