Nutrition & Physical Activity
Dear No desire to be lard-boy,
Good for you for taking care of yourself by exercising! It may be frustrating to work so hard and not see the results you want, but you're on the right track. You may need to make changes to your diet and/or workout to look like a lean, mean, workout machine, but it may be best (and helpful) to do so under the supervision of a health care provider and/or a registered dietitian.
When we consume more calories than we expend, we gain weight. When the amount of calories consumed is less than the amount expended, we lose weight. Pretty straightforward, right? Maybe not. Additional factors may influence the amount of calories we burn, including genetics and body mass composition. Generally, however, eating a low fat, well-balanced diet that does not exceed your ideal caloric intake may be helpful for weight loss. A dietitian may be able to help you create a healthy, well-balanced food plan based on your specific dietary needs and personal goals. For more information, you can also check out the Go Ask Alice! nutrition and physical activity archives.
Now let's talk workout. Have you considered asking a physical trainer for suggestions? In any case, you may want to consider incorporating more aerobic activity into your exercise regimen. Aerobic exercise, which gets your body to burn lots of calories, occurs when you move the big muscles of your body through space for 20 minutes or more (e.g., running, walking, biking). Increasing the amount of aerobic exercise you do in proportion to weight lifting may, therefore, help with taking off the extra fat. A tip: evidence suggests that you'll burn more calories during your aerobic workout if you hit the weight room first. Not a bad deal.
Whether you're sculpted of chiseled rock or, er… lard, positive body image is key. Although the media portrays a certain image of how we are supposed to look, we come in all different shapes and sizes, and that's a good thing. Weight loss and sculpting may help you make positive changes to your lifestyle, but just make sure that it's not at the expense of your physical health and emotional well-being. So, while you're lifting weights or running on that treadmill, you may want to mull over whether you enjoy doing these activities, and how they make you feel.
If you are a student at Columbia and would like to speak with a registered dietitian and/or health care provider, you can make an appointment by contacting Medical Services (Morningside) or the Student Health Service (CUMC). You can also visit the Dining Services' nutrition resources. For additional information, check out the Physical Activity Guidelines for Adults on the Centers for Disease Control and Prevention (CDC) website. Keep up the good work and good luck!
Dear Diet Coke,
Aspartame — how sweet it is! A common artificial sweetener used in various foods and drinks, aspartame is about 200 times sweeter than sugar. However, it contains fewer calories than sugar, making it a substitute for individuals who wish to cut back on sugar. To date, the U.S. Food and Drug Administration (FDA) considers aspartame safe to use, though it recommends maximum levels of acceptable daily intake (ADI) for children and adults.
An adult weighing 150 pounds (70 kilograms) can have up to 3,500 milligrams per day of aspartame. In terms of diet soda, this translates into no more than 19 cans of diet soda per day (diet soda typically contains 180 milligrams of aspartame per can). A child who typically weighs 66 pounds (30 kilograms) could drink up to 8 cans of diet soda before going over the ADI for children. That's still quite a lot of soda! There may be other considerations, such as caffeine and the acid in soda that can damage teeth, to weigh before drinking a case a day.
There is no conclusive data demonstrating that aspartame poses a safety risk to humans. However, the FDA has noted some possible, but uncommon, side effects of aspartame consumption. These complaints have included headaches, dizziness, stomach problems, and changes in mood. One particular safety risk of aspartame involves individuals with phenylketonuria (PKU). PKU is a rare genetic disease characterized by the inability to break down the amino acid phenylalanine, which is found in aspartame. People with PKU should avoid all products that contain aspartame. These products are labeled for easier recognition.
You may want to keep in mind that aspartame and other artificial sweeteners are not exactly a green light to consume excessive amounts of foods and drinks that contain it, as the calories still add up. Research suggests artificial sweeteners may stimulate a person's appetite. Because they have no caloric content, they don't seem to activate the same food reward signals in the brain that induce feelings of satiety. As a result, craving a sweet flavor after eating artificially sweetened foods but not feeling full or satisfied by them may lead to overeating.
If you are concerned about the safety of aspartame, you can always check the labels of the foods and drinks before you buy them. You may also want to consider discussing any concerns with a health care provider, who may be able to suggest other sweetening alternatives. 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 this response didn't sugarcoat your concerns!
Dinner's in a few hours. Lunch seems like it was ages ago. You still have to work on a paper, drive your little brother to soccer, and do the dishes. The deliciousness of chocolate and the sweet sugar/caffeine fix it offers may seem to be the only thing to get you through, so you reach for a bar… is that so bad? New research says no, and yes, depending largely on which type of chocolate you choose and how much of it you eat. Cacao, the bean from which chocolate is made, is not itself unhealthy. In fact, it offers many potential health benefits like lowering blood pressure, increasing sensitivity to insulin, improving coronary vasodilatation (widening of blood vessels) as well as other cardiovascular benefits, and acting as an anti-oxidizing agent. But not all chocolates are created equal.
The good guys in chocolate are flavonoids, health-promoting compounds found in plant-based foods (fruits, veggies, nuts, legumes) that belong to a larger class of compounds called polyphenols. In plants, flavonoids work to repair damage and protect from environmental toxins. When we consume plant-based foods rich in flavonoids, it appears that they can act the same ways in our bodies, offering antioxidant protection from free radicals, and protection from plaque formation on our arterial walls.
Dark chocolate is the most flavonoid-rich variety of chocolate, and therefore the most likely to offer health benefits. However, as chocolate is processed flavonoids are lost, and most commercial chocolates are highly processed. Flavonoids also tend to have a bitter flavor, so many commercial chocolates intentionally process them out. In addition, many chocolate products are made with milk, which can interfere with the antioxidant functioning of flavinols, negating most of the potential health benefits. Finally, many chocolate products are laden with caramel, nuts, marshmallow, and other high-fat, high-calorie add-ins that decrease the amount of flavinols in every bite and make a small chocolate snack a hefty caloric load. Even the best, most flavonoid-rich dark chocolate is replete with fat, sugar, and calories (one ounce of any kind of chocolate has about 140 to 150 calories and 9 to 10 grams of fat), so if you're upping the amount of chocolate you eat to gain health benefits, keep in mind that you may want to trim calories in other areas.
One final consideration: there is currently no research that definitively suggests the amount of chocolate that should be eaten to achieve health benefits. You could also get the polyphenol-related health benefits by eating other flavonoid-rich foods like apples, red wine, tea, cranberries, and onions. That said, for most people, enjoying a small piece of dark chocolate once in a while is probably not going to be harmful, and is more favorable than reaching for the common trick-or-treat variety candy bar.
Over time chocolate has gotten a mixed reputation. It used to be seen as a fattening, pimple-producing crutch for the premenstrual. But chocolate does not cause acne, raise blood cholesterol, cause addiction, nor is it fattening if eaten in moderation. More recently, the pendulum has swung in favor of chocolate, which has come to be regarded as a kind of superfood. While it can offer some wonderful benefits, it may not be the antioxidant source of choice for everyone. Chocolate, as well as red wines and certain cheeses, contains phenylethylamine (PEA), a substance that can dilate blood vessels in the brain. People sensitive to PEA might find that eating chocolate can trigger headaches, even migraines. And for those prone to heartburn, chocolate can cause an episode, as would any other high-fat food.
So is chocolate bad for you? Each person should answer this question for themselves taking into consideration which kind of chocolate is within reach and their own health needs. For most healthy and fit individuals, chocolate is a pleasurable and reasonably healthy way to get some flavonoids into the system. For those prone to migraines or who have to watch their fat intake, they might want to stick with the cranberries and onions.
What you are referring to may actually be found ‘across the pond’. The British Heart Foundation Diet, (a.k.a: the Birmingham Cardiac Diet or the Greenland Diet), is a short-term diet plan that drastically restricts calories (as well as essential nutrients). The meal plan consists of three small meals and totals about 1200 calories per day. In online forums that discuss the diet, some claim to have lost up to 40 pounds in a month. However, searching for this diet to achieve weight loss, by any name, may be worthy of some skepticism and a critical eye.
In fact, the British Heart Foundation has taken measures to bust the health claims of the diet that has usurped its name. The foundation describes diets like this as “fad” diets and warns that most health care professionals and dietitians discourage such restrictive, “crash” or short-term eating plans.
It’s good to be skeptical about these types of diets. Here’s a few reasons why:
- Fad diets don’t change your overall eating habits. While you might lose initial weight quickly on a fad diet, they don’t typically address or alter long-term eating patterns. That means you’re likely to regain the weight you lost once you end the diet and return to your established ways of eating.
- Rapid weight loss (more than a half to one pound per week) is usually not fat loss. In extreme calorie restriction your body will shed water, and even begin to break down muscle (which is called wasting). Muscle loss puts you at a metabolic disadvantage — it actually will make it harder to burn calories and fat in the future. Dehydration (from water loss) will also make it harder for your body to operate at peak performance. These conditions can contribute to irritability, mood swings, food cravings, and general malaise that many people feel under conditions of not eating enough.
- It doesn't just restrict calories. Because the diet has so few recommended foods, you may be depriving your body of the nutrients it needs to function well and prevent disease in the long-term. Although fad diets are meant to be short-term, cumulative effects of under-nutrition (especially if you crash diet frequently in the case of so-called “yo-yo” dieting) can have a negative impact on your immune system as well as your ability to remain at a stable and healthy weight in the future.
Now that you know a bit about the risks associated with the fad diet, there are some red flags to look out for that may indicate a diet is more than likely too good to be true. You may want to avoid diets that make claims to work with or guarantee any of the following:
- Losing more than one pound per week
- Unlimited quantities of one food or a restricted food list
- Designated meal times or specific food combinations
- Inflexible menus
- No need to exercise
While in some cases having a restrictive menu is needed, for a majority of individuals it’s not necessary to be healthy. Also, a severe or too strict dieting lifestyle can get in the way of the simple pleasures of life — after all, there are a lot of healthy and delicious foods out there! Consider checking out Columbia’s Guide for Healthier Eating for more information on how to eat for taste and overall nutrition. It might also be worth chatting with a registered dietician to figure out an eating plan that can help you achieve your weight goals while providing the pleasures of healthy cuisine. Columbia students can contact Medical Services (Morningside) or the Student Health Service (CUMC) to make an appointment with a registered dietitian. Outside of Columbia, you might speak to your health care provider for a referral.
Remember, the only proven method for weight loss and weight maintenance while supporting your health in the long-term is to eat a balanced diet and to get plenty of physical activity. This tried-and-true method doesn’t have the same speedy weight loss claims that fad diets do, but it has the added benefit of being better for your body and possibly being more pleasurable.
Dear Yolking it Up,
Egg powder is usually simply dehydrated eggs, a substitute that people may use when they're camping, or in other situations where there is a lack of refrigeration. Egg powder may also be added to some cake mixes, pancake mixes, and the like, so that the home baker doesn't have to add whole eggs to the mix. A large egg contains about 6 grams of high quality protein, making both eggs and egg powder good sources of protein. Eggs are also an important source of vitamins B12 and E, riboflavin, folacin, iron, and phosphorus. These make it one of nature's near perfect foods, except for the cholesterol — its yolk contains a significant portion of the total daily maximum intake of cholesterol.
Many people experiment with egg whites in order to lower the cholesterol content of their favorite recipes. There are numerous egg substitutes on the market, which come in frozen, refrigerated, and powdered form (this may be what you are referring to in your question). Most of the substitutes have egg whites as their main ingredient. The white of the egg is almost pure protein, containing a near complete balance of complementary amino acids. So, these substitutes are definitely a good source of protein, but not of fat or cholesterol, or B vitamins and minerals.
With the variety of egg substitutes on the market, it's important to read the label carefully. Some have vegetable oil, flavoring, or color added to give the effect of yolk. Other products contain no eggs at all, and are intended to be used in baked products to produce the leavening effect, but would taste terrible as scrambled eggs. The products range in caloric content from 15 to 60 calories per serving, as compared with about 80 calories for a whole egg. Most have little or no cholesterol, but some contain as much as 4 gms of fat per serving.
The American Heart Association recommends limiting average daily cholesterol intake to less than 300 milligrams. If you have heart disease, the recommendation drops to less than 200 milligrams daily. It may make sense to consult with a nutritionist or your health care provider if you already have elevated levels of cholesterol.
As with many foods, moderation is the key to getting "eggs-actly" what is best for your health.
There is a lot of conflicting information about the pros and cons of supplements, so thanks for asking an important question. A healthy and nutritious diet involves six classes of nutrients:
Carbohydrate, fat, and protein are considered macronutrients [because our bodies require them in large quantities (grams/day)] and they yield energy. Vitamins and minerals are considered micronutrients [because our bodies need them in smaller amounts (milligrams or micrograms/day)] and instead of yielding energy, they help our bodies carry out necessary and important physiological processes. About 40 of these nutrients are essential for life because our bodies cannot synthesize enough to meet physiological needs (so our diet provides us with the bulk of these essential nutrients).
Vitamins are either water-soluble (water is required for absorption and are excreted in urine) or fat-soluble (requires fat for absorption and are stored in fat tissue). There are 9 different water-soluble vitamins: vitamin C and the eight B vitamins (thiamin, riboflavin, niacin, vitamins B6 and B12, folate, biotin, and pantothenic acid); and, 4 different fat-soluble vitamins: vitamins A, D, E, and K. Each of these vitamins have unique roles and functions in our bodies. For example, vitamin A promotes eyesight and helps us see in the dark, and vitamin K helps blood to clot.
Minerals are categorized as major or macro- (calcium, phosphorus, potassium, sodium, chloride, magnesium, and sulfur), and trace or micro- (iron, iodine, zinc, chromium, selenium, fluoride, molybdenum, copper, and manganese) minerals, the former needed in quantities of 100mg/day or more, and the latter required in much smaller, or "trace," amounts. These 16 essential minerals also play vital roles in the body, such as calcium in osteoporosis prevention and iron in (iron-deficiency) anemia prevention; and, they can be found in the body dissolved in body fluids as ions and/or are part of important compounds, such as calcium and phosphorus in hydroxyapatite found in bones and teeth. Other minerals, such as lead, are contaminant minerals and not nutrients because they can cause harm by disrupting normal bodily functions and processes, i.e. lead poisoning.
Vitamins ("vita" = life and "amine" = containing nitrogen) are organic (containing carbon, which is an element found in all living things) compounds (containing atoms of one or more different elements). Minerals are pure inorganic elements (containing atoms of the same element), meaning they are much simpler in chemical form than vitamins. All vitamins are essential or required by our bodies, whereas only some minerals are essential nutrients. Vitamins are vulnerable to heat, light, and chemical agents, so cooking, food preparation, processing, and storage must be appropriate to preserve vitamins in food. Minerals, on the other hand, are more stable to food preparation, but mineral loss can occur when they are bound to other substances in foods (such as oxalates found in spinach and tea, and phytates found in legumes and grains), making them unavailable for the body to utilize.
There is not a lot of research to state unequivocally if taking extra vitamins or minerals is harmful or helpful for the body. Our bodies do have a natural maximum capacity for different types of vitamins and minerals, so taking a lot of supplements may result in nausea or other side effects as your system works to get rid of the excess. While some vitamins and minerals are water soluble and can be excreted through urine if they are in excess, others are absorbed in fat and can accumulate over time. Some supplements can also interact with prescribed medications, so you may want to include them when asked about any medications during medical exams. You may also want to speak to your health care provider before adding any new supplements to your diet.
Health care professionals do agree that the best source of both macro and micro nutrients is from a well-balanced diet. Try visiting ChooseMyPlate.gov for information on the health benefits, nutrients, and vitamins available in different foods. Depending on the person, current levels of vitamins and minerals may be higher or lower than necessary and may warrant a supplement or dietary changes. To understand what vitamins and minerals are most appropriate for you, you may want to consult with your health care provider or a registered dietician. If you’re a Columbia student, you can make an appointment by contacting Medical Services (Morningside) or the Student Health Service (CUMC) to speak with either a health care provider or dietitian. You might also want to check out the get balanced! Guide for Healthier Eating. The National Institutes of Health (NIH) or the U.S. Food and Drug Administration (FDA) websites have additional information about dietary supplements in general.
Here’s to finding the balance that’s right for you!
Dear Confused by the news,
While this sounds like such a simple question, it's really not. First, what is ideal? The amount of calories needed to maintain each individual's weight appropriate for optimal health? The amount a person needs to maintain an unnaturally thin weight that meets false societal ideals? The amount an athlete needs to perform at her/his best? Reality tells us that the ideal caloric intake is different for everyone.
Caloric needs depend on age, gender, height, present weight, body frame, physical activities, hormones, and weight plans (maintain, gain, lose, etc). An intake between 1200 and 1400 calories per day is considered a low intake. This calorie level is just able to meet what are called basal metabolic needs, or the calorie needs to keep the heart beating and all the internal organs working. Calorie levels below 1200 should be avoided, because they may decrease metabolism and are usually hard to follow for any length of time. Very low caloric intake may promote binge eating due to the feeling of deprivation, and may be deficient in one or more nutrients. Some liquid diets call for fewer than 1200 calories, however, their long-term effectiveness is controversial, and they should only be followed under the supervision of a physician.
The Daily Values (DVs) used on food labels base their nutrient intake on a 2000 calorie per day diet. This was a result of many long meetings with nutrition experts who concluded that 2000 calories was the average amount needed by American adults. Therefore, short, thin females who are not active, will have caloric needs below 2000. For those who are "average" size and get moderate activity, caloric needs to maintain weight should be about 1600-2400 per day.
Instead of just worrying about a number of calories, have you tried listening to your own internal needs? Have you set goals related to healthy eating? Consider a focus on maintaining a balanced eating plan that includes a strong base in whole plant foods (fruit, vegetables and grains) and eat a moderate amount of healthy fats. Also don't go overboard on eating food just because it is fat-free (i.e. a whole box of "fat-free" cookies). Although fat calories are most easily converted to fat in the body, all calories from fat, carbohydrate and protein count! Finally, don't forget food should bring some pleasure to life and serves many needs other than energy functions.
If you would like to explore your individual caloric needs, or have other nutrition questions, Columbia students can make an appointment with the nutritionist at Medical Services (Morningside) or at the Student Health Service (CUMC). Columbia students may also want to check out Get Balanced! for tons of nutrition resources and information, including th Guide to Healthier Eating. You can also review many options and create your own plan using the online resources at MyPlate. Have fun determining the right balance for you and your goals. Remember to try new foods and new food cominbations — there are lots of healthy and tasty options. Eat and be well!
Dear Fat swimmer,
Swimming can be a wonderful form of exercise. It uses almost all the major muscle groups, and places a vigorous demand on your heart and lungs. It develops muscle strength and endurance, and improves posture and flexibility. The buoyancy factor makes it especially useful for people who are pregnant, have injuries such as leg or lower back problems, or who find high-impact exercise uncomfortable. It is a great sport for people of all ages and all proficiency levels. In order to lose weight, you might want to keep your swimming regime (speeding up your pace a little bit and increasing the length of your swimming sessions, if necessary), and supplement it with some good-paced, arm-swinging walks.
Research on swimming and weight loss, however, has produced inconsistent and contradictory results. Studies have found that swimmers lost weight (and body fat), gained a few pounds, and had no weight changes at all. In most of the cases where swimmers gained weight, it was lean body mass (muscle) and not fat.
One study found that people who swim in cold water may consume more calories post-workout than people who swim in warmer water. So if you're swimming primarily to lose weight, make sure that you aren't inadvertently consuming unneeded calories during post-workout snacks and meals. In addition, the number of calories you burn while swimming depends on how fast you go and for how long. At a slow pace, twenty laps may burn only fifty calories — little more than simply staying afloat. On the other hand, a swimmer doing a brisk forward crawl will often burn as much as eleven calories per minute.
Swimming in a pool may be more conducive to the type of workout you're looking for than swimming at a beach or lake; pools often have lap swim hours, and you won't have to contend with rolling waves or boats. If you're in New York City, check out one of the free lap-swim pools maintained by the city. For a guaranteed workout, you can also join up with a United States Masters Swimming group near you.
In the end, weight loss is dependent on a simple formula; more calories are burned than are consumed. No one exercise is necessarily better than another for weight loss; what matters is that you eat a healthy, well balanced diet and remain regularly physically active. Swimming can be a fun activity to add to your workout routine, whether you're a novice or a master. Enjoy!
Creatine is a substance manufactured in the human body by the liver and kidneys or obtained from meat in the diet. It is present in muscle, nerve, and sperm cells. In muscles, creatine is used to form phosphocreatine, which can be used to supply energy needed for muscle contractions. It has been suggested that by increasing creatine in the diet, one may increase the amount of phosphocreatine in the muscle, which would then provide a greater availability of high energy phosphate for energy production during muscle contraction. It also may cause the muscles to retain water, a proposed mechanism for the "bulking" effect of the supplement.
No one really knows how much creatine is too much. Some people experience muscle cramps, electrolyte imbalances, fever, or gastrointestinal symptoms like nausea and diarrhea when they take creatine. Long-term effects are much less well-studied. While there is little conclusive evidence for adverse affects, people who have liver or kidney problems or who take diuretics should avoid taking creatine because of the theoretical complications. People with diabetes or who take either medications or supplements that affect blood sugar should also use caution. If you start to notice any side effects, you should stop taking creatine and see your health care provider.
As for benefits, creatine can enhance performance for short bursts of anaerobic activity, like weightlifting. However, people doing aerobic activities, like running or cycling, probably won't see any improvement.
The amount taken in through commercially marketed supplements is far greater than one would be able to ingest via food. Some regimes call for a loading period — perhaps 20 to 25 grams for five days, followed by daily doses of about 5 grams. Non-meat eaters (vegans) may respond better since their natural creatine stores are probably lower than meat-eaters. Since any long-term effects from these high levels are uncertain, your best bet is to let your health care provider know that you take creatine. That way, if you ever do experience side effects, he/she will be better able to help you decide whether to keep pumping up.
Dear Cow lover,
Why does a milking stool have only three legs? Because the cow has the udder! Get it? Unfortunately, there’s not such a definitive answer to YOUR question. Research on the health effects of drinking milk has produced mixed results. As with any other food group, it is important to consider the pros and cons of dairy consumption.
Before a discussion of pros and cons, here is a run-down on recent milk research as it relates to osteoporosis. Although it is thought that drinking milk every day helps ward off osteoporosis, a small group of renowned researchers recently found that drinking too much milk can actually contribute to calcium loss. This is because the high amount of protein in milk thins blood and tissue, causing it to become acidic. In order to neutralize the acidity, the body draws out calcium from bones. As a result, the more milk you consume, the more calcium you need to process the protein intake. With that being said, drinking moderate amounts of milk each day (500 to 700 milligrams daily) is still thought to be good for your bones. More information on osteoporosis can be found in Calcium, milk, and osteoporosis?.
Moooving on, here is a list of the various pros and cons of drinking milk:
- Milk is high in calcium, which is important for healthy bones. Additionally, the calcium in milk is well absorbed by the digestive tract because the vitamin D and lactose found in milk facilitate calcium absorption. Still, it's possible to get ample calcium without drinking dairy milk — by eating foods such as tofu, soy milk, or greens such as kale. See Calcium — how much is enough? for more information.
- Whole milk is brimming with protein, which is beneficial for muscle growth.
- Studies have shown that drinking milk can help regulate weight gain.
- Skim milk is very low in fat and cholesterol, and is a complete source of protein.
- Milk is also a good source of phosphorous, magnesium, vitamin A, vitamin D, and riboflavin (a B vitamin).
- Whole milk is high in saturated fat, which can increase cholesterol level.
- Milk is a common cause of food allergy (allergy to milk protein).
- Many people lack the enzyme to digest lactose (milk sugar). This is called lactose intolerance, which causes bloating, gas, and diarrhea.
- Milk may contain the antibiotics given to the cow while it is lactating. It has been argued that humans subsequently absorb these antibiotics upon drinking milk, potentially leading harmful bacteria to become more resistant to these antibiotics. As a result, when antibiotics are prescribed, they may not be as effective at killing the bacteria.
- Some research has found a correlation between drinking milk that is produced by cows injected with the bovine growth hormone (rBST) and cancer. However, research shows highly mixed results.
As a side note, if you are concerned about the possible effects of antibiotics and rBST on your body, it is possible to buy antibiotic-free (and typically hormone-free, as well) milk from specialty grocers that carry natural foods. Alternatively, you can purchase USDA-certified organic milk, which is available at most supermarkets.
Overall, when researching the pros and cons of milk, it is important to take into account that there are two opposing sides — one that believes that milk is great for the body, and another that believes that milk does not aid against osteoporosis and is even harmful for the body. Whatever camp you choose to join, it is important to be informed. Seize every opportunity (to obtain information), and milk it for all its worth!