Nutrition & Physical Activity
Dear Breathe easy,
Some evidence suggests that eating foods rich in nutrients and anti-oxidants may help some individuals to control asthma, but conclusive research on the matter is still up in the (hopefully breathable) air. Additionally, since certain foods or dietary behaviors have been known to trigger asthma attacks in sensitive individuals, eliminating the foods or behaviors may be a sensible choice.
Scientists do not know the exact cause of asthma, only that it involves a basic defect in the lungs that leaves them highly irritable. However, there are well known aggravating factors that can bring on an asthma attack. Allergies are a common trigger of asthma, including allergies to pollen, mold, house dust, animal dander, and occasionally medicine or foods. Allergies alone will not cause asthma however — not all allergic people have asthma and many asthmatics are not allergic. Respiratory infections are likely to aggravate asthma, as are changes in the weather (seasonal, temperature, or humidity level). Exercise is another common asthma trigger, as well as environmental irritants such as cigarette smoke, gasoline fumes, hair sprays, perfumes, and cleaning solutions. Emotional stress can lead to an asthma attack. Hormones, aspirin, cold dry air, very cold or spicy foods or beverages, and "intrinsic factors" can all stimulate an asthma attack. No two people with asthma are exactly alike; each has his/her own pattern of sensitivity.
Food-trigged asthma occurs in only six to eight percent of children with asthma and less than two percent of asthmatic adults. However, as asthma can be triggered by very cold food or drink, and on occasion, by overeating, it would be wise to avoid these situations. In addition, reactions to food preservatives known as sulfites and bisulfites (found in dried fruits, prepared potatoes, wine, bottled lemon and lime juice, and shrimp) have triggered asthmatic reactions in sensitive individuals.
On the other hand, some foods may actually help to control asthma. Although the findings are not conclusive, there have been a variety of studies that indicate certain nutrients may guard against asthma attacks. Antioxidants, a group of nutrients that protect the body from free radicals and reduce inflammation in the body, show the most promise for asthma relief. Helpful antioxidants may include vitamins C and E which are found in many fruits and vegetables. Those with severe allergies may suffer from low levels of vitamin D. Vitamin D can be found in milk, eggs and some fish, but your body can also produce vitamin D by exposure to sunshine! Adding omega-3 non-saturated fatty acids (found in fish oil and other seafood) to your diet may also be helpful. Before rushing to the pharmacy to stock up on vitamin supplements, it's worth knowing that the protective effect of these nutrients on asthma control is far from proven. Groups of nutrients found naturally in foods seem to have the most impact. The take-home message is one you've no doubt heard before: eat a balanced diet that includes a variety of fresh fruits and veggies and occasional servings of fish for those omega-3s and some vitamin D.
If you decide to modify your diet, a food journal may help you identify links to any changes in your asthma — for better or worse. For example, anytime you have something to eat or drink, jot it down, and also make a note of times when your asthma flares up. After you've collected a few weeks’ worth of observations, you can look for patterns in your asthma and diet.
There are holistic approaches to health and healing that promote dietary changes to control asthma. Other recommended methods of care include acupuncture treatments and meditation.
Medication, especially steroid inhalers, remains one of the most common treatments for asthma. Unfortunately there's no miracle diet to control asthma, but you may find that eating more fruits and veggies helps you breathe a bit easier.
Dear The Bee,
Great question. There are a number of tasty choices for foods rich in folic acid. First, let's look at why it may be important to pay attention to folic acid intake.
Folic acid, also known as folate or folacin, is an important B vitamin that significantly lowers the risk of serious birth defects of the brain and spinal cord. Folic acid is important in the synthesis of DNA, which controls cell function and heredity as well as tissue growth. In addition, folate acts with vitamin B-12 to produce red blood cells. Preliminary studies also suggest that folacin may be helpful in preventing cervical cancer.
Most people get an adequate amount of folic acid from the foods they eat. Pregnant women, people taking certain medications, and alcoholic individuals may be at higher risk for folate deficiency. Women of childbearing age (approximately fifteen to forty-five years) are recommended to include 400 micrograms of folic acid in their diets, particularly important before and during pregnancy to prevent birth defects.
The U.S. Recommended Dietary Allowance (RDA) for folate is 180 to 200 micrograms (mcg). Rich dietary sources of folate are recommended over supplements. They include:
- Dark green, leafy vegetables
- Whole wheat bread
- Lightly cooked beans and peas
- Nuts and seeds
- Oranges and grapefruits
- Liver and other organ meats
- Fortified breakfast cereals and enriched grain products
One cup (8oz) of orange juice provides half the RDA for folate, underscoring how easy a nutrient it is to consume. Keep in mind that processing food destroys 50 percent to 90 percent of the folate, as it is very susceptible to heat. It is really important to eat raw foods and lightly cooked vegetables as they retain their nutrient value the best when cooked minimally in water — through steaming, stir-frying, or microwaving. Because folic acid is so important during pregnancy, some pregnant women take a multivitamin or supplement with folic acid. However, taking too much folic acid could mask a vitamin B-12 deficiency, which could be dangerous, meaning that pregnant women should discuss their diet, whether they need folic acid supplementation, and the best potential sources of folic acid for their situation with a health care provider.
Hope this helps you fill your plate with folate!
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!
You can definitely find iron in foods other than spinach, that's for sure! Animal sources of iron include liver, kidneys, red meat, poultry, fish (especially oysters and clams), and eggs. Good plant sources of iron include peas, beans, nuts, dried fruits, leafy green vegetables (especially spinach), enriched pastas and breads, and fortified cereals. Our ability to absorb iron from foods varies from about three percent to 40 percent, depending on its form in the food, the body's need for it, and a variety of other factors. Iron from animal proteins (heme iron) is better absorbed by the body than iron from plant foods (non-heme iron).
Iron is an essential mineral our body needs to function well. Iron is necessary for the formation of hemoglobin, which carries oxygen in the blood, and myoglobin, which carries oxygen in muscle. It is part of several enzymes and proteins in the body, is needed for immune function, and contributes to drug detoxification pathways in the liver.
Certain foods and nutrients can impact how much iron you get from your food: zinc, high-dose calcium supplements, and tannins in tea can all reduce iron absorption. Compounds known as phylates and oxalates, found in grains and vegetables, respectively, can all bind iron and therefore reduce its absorption as well. To optimize the amount of iron you get from plant foods, eat them with a food high in vitamin C at the same meal. Foods high in vitamin C include broccoli, tomatoes, greens, sweet potatoes, white potatoes, cantaloupe and citrus fruits. You can also eat meat or other food with heme iron along with plant foods to enhance the absorption of all nonheme iron present.
The recommended daily allowance (RDA) for iron is 8 mg for adult men (ages 19-50+) and 18 mg for adult women (ages 19-50). The higher dosage for women in this age range is primarily because of menstrual blood loss. After the age of 50, a woman's RDA is 8 mg. If you don't take in enough iron, you can become iron-deficient. Iron deficiency is one of the most common nutrient deficiencies internationally, and is most common when iron needs are greatest in your life cycle — during infancy, preschool years, and puberty, and during child-bearing years for women. Pregnancy and disease also increase iron needs. For more information, see Iron deficiency in the General Health archive. If you are at
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.
|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|
|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.
Dear Trying to Eat Healthy,
Knowing what and how much to eat can feel overwhelming. In recognition of the fact that more Americans are overweight and obese than ever before, the U.S. Department of Agriculture (USDA)/U.S. Department of Health and Human Services regularly reviews and updates the food guide recommendations. The newest update by "Choose My Plate" and makes suggestions based on age, gender, and activity level. It no longer recommends amounts of food in terms of serving size, but rather suggests portions according to actual weights and amounts of specific foods. You can learn more about how to apply the new food guide recommendations to your lifestyle at ChooseMyPlate.gov.
Even though there is no single chart that details how much of a particular food constitutes a serving, you can click on each food group's heading (see below) for more information on common portion sizes. Also, here's a basic breakdown of the guidelines:
One serving equals 1 slice of bread; 1/2 cup of cooked rice, pasta, or cereal; or 1 cup of ready-to-eat cereal. All of these serving sizes are known as "ounce equivalents" in Choose My Plate-speak.
As a general rule of thumb,
1 serving size/ounce equivalent of bread = plastic CD case
2 servings/ounce equivalents of cooked brown rice = a tennis ball
Unlike the Grains group described above, cup size matters when it comes to vegetables. That is, vegetables servings are measured in cups rather than ounces. One serving equals 1/2 cup of raw or cooked vegetables or vegetable juice or 1 cup of leafy raw vegetables.
1 serving size = 1/2 cup of broccoli = a light bulb
1 serving size = 1/2 cup of potato = a computer mouse
Like the vegetable group, cup size matters here, too. One serving equals 1 cup of fruit or 100 percent fruit juice, or 1/2 cup of dried fruit. Because fruits come in so many different shapes and sizes, it's hard to say how many pieces of fruit count as a serving.
Generally, 1 serving size of whole fruit = 1 tennis ball
1 serving size of cut fruit = 7 cotton balls
One serving equals 1 cup of milk or yogurt, 1.5 to 2 ounces of cheese, and even 1.5 cups of ice cream. Choose low-fat options from this group whenever possible.
1 serving size of cheese = 2 9-volt batteries
Like the Grains group, serving sizes are also measured in ounce equivalents. One serving or ounce equivalent equals 1 ounce of cooked lean meat, poultry, or fish; 1/4 cup cooked beans; 1 egg; 1 tablespoon of peanut butter; or 1/2 ounce of nuts or seeds.
3 servings/ounce equivalents of fish = 1 checkbook
3 servings/ounce equivalents of meat or poultry = 1 deck of cards
2 servings/ounce equivalents of peanut butter = 1 roll of 35 mm film or 1 ping-pong ball
Choosemyplate.gov measures serving sizes in teaspoons.
1 serving/teaspoon of margarine and spreads = 1 dice
2 serving/teaspoons of salad dressing = 1 thumb tip
Because these oils are found in many of the foods we eat, there may not be a need to add this group to your diet. For example, half of a medium avocado or 2 tablespoons of peanut butter provide 3 and 4 teaspoons or servings of oil respectively, while also counting towards your vegetable or nuts allowance.
Remember, also, that most portions in the U.S. are oversized and contain several servings of the recommended categories. Ideally you want most of your food to be whole grains, plenty of fruits and vegetables, low-fat calcium fortified foods (such as milk and cottage cheese), and lean sources of protein (such as fish, turkey, and chicken).
If you're hungry for more information on dietary recommendations, check out the Dietary Guidelines for Americans 2010 and the American Academy of Nutrition and Dietetics’ Food and Nutrition Information web site. At Columbia, you can make an appointment with a registered dietitian to discuss your concerns and get more individualized information by contacting Medical Services (Morningside) or the Student Health Service (CUMC).
Ulcers can really eat at you. They typically occur in the lining of the top of the small intestine, the duodenum (aka duodenal ulcers), or the stomach (aka peptic ulcers). Various options exist for treating and/or possibly preventing them.
Common culprits of stomach ulcers include the Helicobacter pylori (H. pylori) bacteria and prolonged use of non-steroidal anti-inflammatory medications (NSAIDs like aspirin, ibuprofen, and naproxen). For more information on ulcer symptoms and causes, check out Ulcers and Stress and the stomach — how do I avoid getting an ulcer? in the Go Ask Alice! general health archives.
Although prescription medications are used to treat ulcers, some individuals may choose to treat ulcers without medication, typically by eating (or avoiding) certain foods, taking nutritional supplements, and herbs. Of course, herbs and nutritional supplements are not without risk, especially since they are not regulated by the U.S. Food and Drug Administration, so be sure to discuss any natural treatment options with a healthcare provider first.
The University of Maryland Medical Center recommends herbs such as DGL-licorice, mastic, and cranberry for relieving ulcer symptoms. Additional remedies that may also be helpful include homeopathy, acupuncture, and/or chiropractic treatment. If you prefer food (or nutritional supplements) as a strategy, you may want to consider :
- Eating foods that are high in antioxidants (i.e.blueberries, tomatoes, and bell pepper), flavonoids (i.e.apples, onions, garlic, and tea), and B-vitamins (i.e. almonds, beans, and dark leafy greens)
- Reducing red meat consumption
- Avoiding foods containing refined white flour, sugar, and trans-fats (usually found in commercially baked goods)
- Avoiding drinks that may irritate the stomach (i.e. coffee, alcohol, and carbonated drinks)
- Cooking with healthy oils, such as olive oil or vegetable oil
- Reducing stress by doing relaxing activities, such as meditation and yoga, or any other activity that you enjoy (Check out Meditation, yoga, tai-chi — how do I begin? in the Go Ask Alice! general health archives for some tips)
Supplementing your diet with a probiotic and a daily multivitamin containing vitamins A, C, E, the B-vitamins, and trace minerals (i.e., magnesium, calcium, zinc, and selenium)
List adapted from Peptic Ulcer from the University of Maryland Medical Center.
If you have been diagnosed with ulcers or if you think you may have them, you may want to consider discussing your symptoms with a healthcare provider. By working together, you and your provider can develop a treatment plan that meets your needs. If you are a student at Columbia, you can make an appointment to see a health care provider by contacting Medical Services (Morningside) or the Student Health Service (CUMC).
Here's hoping that, in time, the ulcers are the sore losers!
Dear Future Veggie,
Yes, absolutely! Columbia Health has lots of resources for you as you prepare to make the switch. When planning out a healthy vegetarian diet, it is certainly helpful to have some guidance. Get Balanced! Columbia University's Guide for Healthier Eating provides a ton of great information on making healthy food choices as a vegetarian or vegan. Columbia students can also meet with a registered dietitian through Columbia Health. Before meeting with a professional, it may be helpful to do some background research. Check out the related questions below for a plethora of useful information!
It's a great idea to plan consciously when switching over to a vegetarian diet. Not eating meat can offer many health benefits, as well as addressing environmental and ethical concerns. However, people who make the change without learning about proper nutrition can very easily become deficient in certain nutrients, experience undesired weight gain or loss, and fall into the famous trap of becoming a "pasta" vegetarian who lives on carbs and sweets and not much else.
Have you thought about to what degree of vegetarianism you will pledge? There are many variations on the vegetarian diet, including: lacto-ovo, vegetarians who avoid all meat but eat milk and eggs; pescatarians, who eat fish, and do not eat other types of meat; vegans, who avoid all animal products including milk, eggs, and even honey (produced by bees); raw foodists, who eat only raw fruits, veggies, sprouted nuts and grains; and even fruititarians, who only eat fruits, nuts, and seeds. Wherever you fall on the vegetarian spectrum, here are some general tips on converting to a vegetarian diet:
- Plan to incorporate into your diet a wide variety of whole grains, fruits, vegetables, legumes, nuts, seeds, vegetable oils, and of course leave room for some decadent delights (think: vegan triple chocolate cake).
- Ensure that you are eating adequate amounts of non-meat proteins, necessary for long-term sustained energy, and to repair and replace worn-out body cells. High protein veggie foods include beans, nuts (including peanuts and almonds), and milk.
- Vitamins B-12 and D, calcium, iron, and zinc are other nutrients important to pay attention to, as they are abundantly found in meat, but not as easy to find in plant foods. Some strategizing with a nutritionist or educating yourself about vegetarian sources for these nutrients will help you make sure you're getting enough of these important nutrients.
- Because vegetarian diets are often high in fiber, remember to drink lots of water to ensure all that roughage is moving through and out of your system efficiently. Six to eight glasses per day is the general recommendation.
When planning a vegetarian diet, it is important to take into consideration a number of variables, such as body size, activity level, health status, and food preferences. But standing behind your ethical beliefs with the food you take in and the industries you support is an admirable and worthwhile undertaking. With the right guidance, education, and support, you could enjoy great health, a happy and clean conscience, and the joy of being an inspiration and teacher for others who wish to join you!
Dear A Real Pain in the Butt,
Cramping can be so frustrating, and as you said, uncomfortable. Unfortunately, no one fully understands what causes muscle cramps. Factors that contribute to cramping include dehydration, electrolyte imbalance, overexertion, and/or inadequate fitness/conditioning.
Is it possible that the sort of exercise you are doing is a cause? Think about your exercise routine and examine your patterns. Are you doing specific exercises that stretch the muscles in your buttocks? If so, how often and for how long do you participate in these exercises? Could you change your regimens to see if it's the type or amount of exercise that could be causing your muscle distress? You may also try adding stretching routines before and after you exercise.
It's interesting that your nighttime calf cramps disappeared when you introduced a sports drink as a post workout strategy. That could lend a possible explanation: perhaps you are dehydrated and/or have an electrolyte imbalance, particularly of sodium, potassium, and calcium. A low sodium eating plan, coupled with high perspiration losses or with persistent vomiting/diarrhea, can deplete your body of sodium. Potassium deficiency is not likely to be the result of sweat loss; however, the result of both a sodium and potassium deficiency can be muscle cramping. A lack of calcium has also been identified as a contributor to cramping.
Another approach might be to experiment with your eating plan — perhaps increase your salt (pretzels, olives, nuts, salami), potassium (bananas, oatmeal, potatoes), and calcium (milk, yogurt, fortified orange juice) intake to see if you notice any changes. Also try to stay hydrated. Drink plenty of water, especially in the hours leading up to a workout. An easy way to check hydration is to notice the color of your urine. Clear, light urine reveals a more hydrated body than dark, orange urine.
If these suggestions don't work, your condition gets worse, or it's severe enough to interfere with your daily life, it's probably time to consult your health care provider. Columbia students can make an appointment with a health care provider by contacting Medical Services (Morningside) or the Student Health Service (CUMC). Here's to putting your booty pains "behind" you!
January 6, 2014547791
There may be some downsides to guzzling milk, like lactose intolerance or a hefty grocery bill, but calcium loss is not one of them! To build strong bones and ward off osteoporosis, milk (and calcium supplements to some extent) does a body good. However, if you dislike so-called "cow's juice," there are other tasty (and inexpensive) foods that are high in calcium. For more pros and cons about drinking milk, see Milk — Bad or good? in the Go Ask Alice! archive for Fitness and Nutrition.
According to the Food and Nutrition Board of the Institute of Medicine, the amount of calcium your body needs varies by age:
Recommended Daily Allowance (RDA) for calcium
Life Stage Group
Calcium (in milligrams)
Children 1 to 3 years
Children 4 to 10 years
Adolescents and adults
1,000 to 1,300 mg
Pregnant and breastfeeding women
1,000 to 1,300 mg
Here are some tips to maximize calcium absorption and pave the way for healthy bones:
- Seek out vitamin D. Spend 15 to 30 minutes in the sun each day (sunlight fuels vitamin D production), eat foods containing vitamin D (try fortified breakfast cereals, tuna fish, or salmon), or take a supplement.
- Get enough vitamin K by munching green leafy veggies like broccoli, Brussels sprouts, and kale.
- Pair calcium-rich foods with acidic ones. Try adding orange segments to your spinach salad or squirting lemon juice on steamed broccoli to facilitate calcium absorption.
- Don't go overboard with dietary fiber, magnesium, tannins in tea, or high protein diets, all of which limit calcium availability.
- Cut back on salt, caffeine, cola, nicotine, and antacids containing aluminum since these ingredients can rob the body of calcium.
Once calcium is absorbed into the body, more than 99 percent of it is used for building bones and teeth. Due to daily strain on the skeletal system, our bones are constantly broken down and reconstructed. After age 35 this rebuilding process naturally slows. In some cases, bone tissue deteriorates dramatically, leading to osteoporosis (literally meaning "little bone"), a disease characterized by bones that become more and more fragile. Even under slight pressure, bones can break and crush, causing broken wrists or hip fractures. Women are at a higher risk than men partly because the decrease in estrogen in their bodies after menopause increases bone loss. Those most at risk are non-black women. Men and black women tend to have a greater amount of initial bone mass, so are less likely to have problems with osteoporosis.
Many factors influence the rate at which bone density decreases, including heredity, hormones, diet, physical activity, smoking, and kidney performance. You can't change your genes, but you can strengthen your bones by getting plenty of calcium as part of balanced diet, exercising regularly, and quitting smoking. If you believe that you're prone to osteoporosis, you may want to see a health care provider to talk about ways to reduce your risk. Students at Columbia can contact Medical Services (Morningside) or the Student Health Service (CUMC) for an appointment. For more general information on osteoporosis, check out the International Osteoporosis Foundation.
If you dislike dairy, you don't need to sport a milk mustache to ward off osteoporosis. By getting lots of calcium and exercise, you can stay strong at 23 or 83!