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,

Alice

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!

Alice

I have an eating disorder and need to gain weight, but how?

Dear Slim,

It sounds as though you are interested in recovering from your eating disorder, but aren't receiving the guidance and help that would benefit you. Does your physician know that you have an eating disorder? What about your family? If you are dealing with recovery on your own, it would greatly benefit you to seek out support from experienced professionals that your family or others might help you find. Other resources are listed at the end of this answer.

Gaining weight without resolving the underlying issues is not a cure. Weight gain can help alleviate some of the medical complications that are caused by malnutrition and being severely underweight. However, one of the difficult parts about weight gain during eating disorder treatment is that as a person increases his or her food intake, his or her metabolism increases, requiring even more calories. This is further complicated by the fact that eating disordered persons need more calories to gain weight than non-eating disordered, underweight individuals. This could be due to the fact that a person's metabolic rate is depressed in anorexia, and so is the thermic effect of food (the amount of calories being burned during the digestive process). As anorexic persons get well, and eat more, both their metabolism and thermic effect of food increase, raising their caloric needs. Levels of growth hormone, leptin, and other hormones are also lower in eating disordered people and become more normalized during recovery, which may also contribute to changes in calorie needs. The same disproportionate rise in metabolic rate to body weight is not seen in non-eating disordered individuals.

In order to gain weight, you need to follow a schedule of steadily increasing your calorie intake until you reach a level that is appropriate for you. Since you are fifteen and possibly still growing, you may need to account for this factor as well. Weight gain (termed "re-feeding") is a process that often requires help and guidance. Your calorie needs for weight gain need to be assessed by a registered dietitian specializing in eating disorders. S/he can help you gain weight at an appropriate rate for you. Many factors are considered when developing re-feeding plans. Some of these include your current medical status, body frame, weight history, current food intake, and eating patterns, just to name a few. In addition, on-going nutrition counseling can help you to understand and cope with the changes that happen to your body as you succeed in gaining weight.

You mentioned that you are not really in treatment. Are you seeing only your medical doctor, or are you seeing other health care professionals, too? It is well documented that the most effective treatment for eating disorders is to work with a multidisciplinary team consisting of a medical provider, psychologist, and nutritionist. Gaining weight is not the only answer. Dealing with the problems that are central to the eating disorder is vital for recovery. A therapist experienced with eating disorders can help you with this. Learning how to eat properly and handling issues around food can be addressed with a qualified nutritionist. If your current treatment doesn't include all three areas of care, you may want to consider it.

At the Columbia Morningside Heights campus, the multidisciplinary Eating Disorders Team has nutritionists and psychotherapists on board who are able to work with students with eating disorders, and, when appropriate, can offer referrals to in- and outpatient treatment centers in the area. At the Columbia Health Sciences campus, The Eating Disorders Clinic of the New York State Psychiatric Institute and Columbia Presbyterian Medical Center is a nationally recognized treatment/research program that offers free treatment to eligible women who have anorexia nervosa and bulimia nervosa, and to men and women who have binge eating disorder. The Clinic also has inpatient and outpatient facilities staffed by a multidisciplinary team of health care providers.

Outside of Columbia, a health care provider or local hospital may be able to refer someone to a nutritionist and therapist or a treatment center that can assist him or her. If they are unable, here are some resources to help a person find ones in his or her area:

Academy of Nutrition and Dietetics: 1.800.877.1600

National Association of Anorexia Nervosa and Associated Disorders: 847.831.3438

Eating Disorder Referral and Information Center

Alice

Nuts about nuts: Are some better for health than others?

Dear Nuts for nuts,

What did one squirrel say to the other squirrel? "I'm nuts about you!" One variety of nut isn't necessarily healthier or better than another. All nuts are healthy, unless you have an allergy or sensitivity to one or more kinds. While individual types vary in nutrients, most nuts contain an array of vitamins and minerals, such as iron, magnesium, zinc, vitamin E, and small amounts of folate, copper, phosphorous, and calcium. Nuts may also contribute to one's daily protein and fiber needs.

The following chart provides nutritional information for some popular nuts. All numbers are for dry roasted, unsalted nuts. Some nuts are roasted in oil, which adds fat and calories without adding additional vitamins or minerals. In addition, some nuts are salted, which may greatly contribute to one's daily sodium intake. Based on that information alone, it seems that dry roasted, unsalted nuts are the way to get the best bang for your buck.

Nut type Calories(per oz.) Fat (g) Sat. Fat (g) Unsat. Fat (g) Protein (g) Fiber (g) Calcium
(% DRI)
Zinc (% DRI) Vit. E (% DRI) Magnesium (% DRI)
Peanuts 166 14 2 12 7 7 1.5 9 19 12
Walnuts 182 18 2 16 4 4 3 7 7 11
Pecans 189 19 2 17 2 2 1 15 8 9
Almonds 167 15 1 14 6 6 7 9 11 20
Cashews 163 13 3 10 4 4 7 15 1 18
Macadamia 200 21 3 18 2 2 2 4 1 7

Nuts are calorie dense foods, meaning they pack a lot of calories into a small amount of food. This can be helpful for people trying to gain weight, but also need not make them off limits to those watching their waistlines. For example, one ounce of most nuts equals about 18 to 24 nuts (a small handful for many, and a tiny handful for larger-handed folks), and contains between 165 and 200 calories. The majority of the calories in nuts is derived from their unsaturated fats — specifically, monounsaturated fat — which is more healthful than saturated fat.

Nuts offer so many valuable nutrients, and can be enjoyed in small servings as well. Why not try to:

  • Mix sliced nuts into plain rice, rice pilaf, or couscous.
  • Sprinkle slivered nuts onto vegetables or into salads.
  • Use slivered or chopped nuts as a yogurt topping.
  • Substitute diced nuts for croutons in salads.
  • Add chopped nuts to vegetable dips or soups.

In conclusion, it's great that you're nuts about nuts. No ifs, ands, or nuts about it!

Alice

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,

Alice

August 6, 2013

534185
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!

Fiber supplements — Safe to use every day?

Dear Regular,

Some of the fiber supplements (available in powder and pill forms) you are referring to are designed to help alleviate constipation, and are to be used for a limited time only. That's because if a person has chronic constipation, the cause needs to be determined. Other products can be used as supplements, as long as there are no underlying medical issues, such as chronic constipation. Two steps to determine how you use supplements are 1) read the labels carefully to find a fiber product that can be used daily, and 2) speak with your health care provider to determine if you should be taking a daily supplement.

For people who experience constipation or other irregularity with their bowel movements, some causes may be: 

  • Inadequate fiber consumption
  • Lack of exercise
  • Insufficient fluid intake
  • Change in one's daily routine
  • Ignoring the urge to move one's bowels
  • Certain diseases
  • Some medications

Luckily for you and anyone who needs more fiber, fruits and vegetables aren't the only good sources for getting more fiber into your diet. Here are some fiber boosting tips:

  • Have a higher fiber cereal for breakfast — try to select one that contains at least 5 grams per serving.
  • Add beans to salad, or dine on a cup of chili for lunch. Each ½ cup of beans contains 3 to 4 grams of fiber.
  • Choose whole wheat bread, which has 2 grams of fiber per slice.
  • Munch on berries (one serving = ½ cup), pears (1 medium with skin), and oranges (1 medium). If you eat just two servings of these a day, you'll add 7 to 8 grams of fiber.
  • Snack on popcorn (go for air-popped). You get 1 gram of fiber per cup (equal to about 2 to 3 handfuls).
  • Have a baked potato, which has almost 4 grams of fiber.
  • Chomp on a medium carrot, which can add 2 grams of fiber.

Part of the benefit of getting fiber through food is that you will also take in the abundant vitamins, minerals, and plant chemicals (phytochemicals) that are present — you'll get lots of important nutrients, such as vitamin A, thiamin, riboflavin, niacin, folate, vitamin C, vitamin E, chromium, copper, iron, magnesium, potassium, and zinc; also in these foods are disease fighting plant chemicals, such as anthocyanins, alpha and beta-carotene, isoflavonoids, and phytosterols, among others.

If you do take a fiber supplement, you'll want to be careful because too much fiber can bind important minerals, such as calcium, iron, and magnesium, decreasing their absorption by the body. If you have more questions about your use of supplements, it would be a great idea to ask your health care provider, who knows your medical history and can recommend the best source of fiber for you. If you're a Columbia student, you can make an appointment with Medical Services (Morningside) or the Student Health Service (CUMC).

Wishing you continued regularity,

Alice

Do those electronic muscle toners do squat?

Dear Reader,

The ads for electric muscle toners make them sound like the best invention since the vibrator — strap on the device and zap yourself to rock-hard abs — no effort, no sweat, and no dreaded crunches. However, according to the U.S. Food and Drug Administration (FDA), the buzz over electronic muscle toners provides more hype than real hope for those who want to strengthen and tone muscles. The FDA has approved the use of electronic muscle stimulators to prevent and/or treat some medical conditions, including:

  • Muscle spasms
  • Muscle atrophy
  • Decreased range of motion

Typically, electronic muscle toners are used as a temporary fix to help people who have had a serious injury or some underlying medical problem or condition (such as those who have had a stroke or had major surgery) rebuild or retain muscle strength and function. When used as directed by physical therapists and rehabilitation specialists, electronic muscle stimulators can help those with muscle injury recover. However, there is no evidence that these devices can sculpt and strengthen flabby, but otherwise healthy, muscles, help people lose weight or burn fat, or develop "muscles of steel."

There have also been reports of people receiving electronic shocks, burns, and skin irritation from improperly made or unregulated electronic muscle stimulators. For more information about the potential risks and benefits, you can check out the FDA's web page of Consumer Information on Electronic Muscle Stimulators.

In the meantime, if you're looking for "six-pack abs" above your belt, you'll have better results going for the slow, arduous exercise burn rather than a quick electronic zap.

Alice

What's that growing in the refrigerator?!? A guide for storing and eating leftovers

Dear Leftover lover,

Enjoying holiday leftovers is a favorite tradition. However, food-borne illness resulting from eating leftovers long past their prime can dampen holiday cheer. Typical symptoms of food-borne illness, caused by bacteria, include abdominal pain, diarrhea, and vomiting.

Two different families of bacteria are found in food: pathogenic bacteria and spoilage bacteria.

Pathogenic bacteria cause food-borne illness. Leaving food out at room temperature (about 72° F or 22° C) for extended periods of time encourages growth of these types of pathogens. These bacteria grow rapidly when in the "danger zone," which is between 40° to 140° F (4 to 60° C). They are difficult to detect, because they don't affect the taste, smell, or appearance of food. Safe food handling and proper food storage are the best defenses against pathogenic bacteria. For detailed instructions on how to keep food safe for consumption, check out the Partnership for Food Safety Education web site.

Spoilage bacteria can grow at lower temperatures, such as ones found in refrigerators. These bacteria cause food to taste, look, and/or smell badly. Most of the time, spoilage bacteria won't cause illness, but they do make food much less appealing to eat.

Leftovers need to be kept in airtight containers recommended for reuse and food storage in the refrigerator and/or freezer. Leftovers can also be wrapped in two layers of plastic wrap and/or foil or in a plastic storage bag (with the food inside wrapped in a layer of plastic wrap or foil) to maintain moisture and prevent absorption of odors from other foods. When freezing leftovers, adding freezer tape also helps keep air and moisture out, and protects from freezer burn. Here are some safe time limits for keeping some common meat and poultry leftovers:

Food Item

Refrigerator Storage Temp.
(40° F / 4° C)

Freezer Storage Temp.
(0° F / -18° C)

Cooked turkey or chicken, plain

3 to 4 days

4 months

Cooked turkey or chicken dishes

3 to 4 days

4 to 6 months

Turkey or meat broth, gravy

1 to 2 days

2 to 3 months

Lunch meat

Unopened, 2 weeks
After opened, 3 to 5 days

1 to 2 months

Cooked fried chicken

3 to 4 days

4 months

Cooked chicken nuggets or patties

1 to 2 days

1 to 3 months

Cooked meat and meat casseroles

3 to 4 days

2 to 3 months

For more information on the safe keeping of most foods, visit the U.S. Department of Agriculture (USDA) Food Safety and Inspection Service web site. Enjoy your holiday meal today, tomorrow, and the next day,

Alice

Is it true that eating too many carbohydrates can cause diabetes?

Dear Concerned,

Carbohydrates don't cause diabetes, however eating too many calories overall (from carbohydrates or other types of food) can lead to diabetes in some people. Here's what's going on: Usually when a person eats, her or his blood glucose rises and in response insulin, a hormone secreted by the pancreas, is released. Insulin helps cells in the body to absorb glucose from the blood to use for energy or store as fat. People with diabetes either don't produce enough insulin, or their bodies don't respond to the insulin, or both. As a result, glucose remains in the blood, depriving the body's cells of energy they need, and causing damage to blood vessels, heart, kidneys, eyes, and feet. The Q&A Diabetes mellitus has more detailed information on the disease, as does the American Diabetes Association website.

Diabetes can be brought on by a number of factors, including old age, obesity, lack of exercise, or a genetic predisposition. Eating more calories than you expend, whether they're complex carbohydrates, sugars, fats, or proteins, paired with a lack of exercise and being overweight can increase some people's chances of developing diabetes. This is especially true if there is history of the disease in the family. The good news is that many people with or at-risk for developing diabetes are able to manage their condition through regular exercise and a healthy diet.

Exercising regularly actually helps the body's cells to properly use insulin. Eating a healthy, balanced diet of fresh whole foods (grains, veggies, fruits, nuts, legumes) also helps to ensure the proper functioning of glucose and insulin in the body. For ideas about healthy ways to diet and get in shape check out some of the archived Nutrition and Physical Activity questions.

If you are concerned you may be at risk for developing diabetes, it may be a good idea to make an appointment with your primary health care provider. If you need help learning how to eat right and get in shape, s/he may refer you to a registered dietician.

Alice

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

Medical Services (Morningside)

Student Health Services (CUMC)


Fruits and vegetables that can protect against cancer

Dear Jill,

You're right in thinking that some foods could help improve health or protect against disease. Some of these disease-fighting substances in food are vitamins and minerals, but another diverse group of plant chemicals are called phytochemicals. Phytochemicals, many of which are antioxidants, impart distinct flavors, aromas, and pigments to foods. For example, one enormous class of antioxidants, flavonoids, includes a group called allyl sulfides, which are found in garlic, onions, and shallots. It's believed that allyl sulfides may help produce a detoxification enzyme that protects against carcinogens. Other antioxidants are detectable by their colors — vividly colored fruits and veggies are rich sources of beneficial plant chemicals. For example, anthocyanins are antioxidants that lend the deep red, blue, and purple hues to raspberries, blueberries, eggplant, and red cabbage.

So how do antioxidants work? They are believed to protect cells from "free radicals," which are harmful oxygen molecules. Free radicals may cause damage to cells, possibly resulting in cancer. Smoking, air pollution, infection, and excessive sunlight can all increase production of free radicals, although they are also formed from normal bodily functions. Antioxidants may help prevent the formation of carcinogens (cancer causing substances), block the actions of carcinogens, and/or suppress cancer development. Most of these actions have yet to be proven in humans; however, foods containing antioxidants (mostly plants) contain many other healthy components.

The following table lists various classes of antioxidants and other phytochemicals, some of their rich food sources, and how they are believed to work:

Substance

Food Sources

Possible Action(s)

Vitamin C

citrus fruits, tomatoes, peppers, broccoli, leafy vegetables, strawberries, potatoes

Inhibits nitrosamine formation, a potentially dangerous carcinogen

Carotenoids

apricots, papaya, sweet potatoes, tomatoes, mangoes, carrots, pumpkin, red peppers, spinach, corn, cantaloupe

Numerous anti-cancer functions

D-limonene

citrus fruits

May detoxify cancer promoters

Lycopene

cooked tomato products, watermelon, pink grapefruit

A class of carotenoids that's protective against prostate and possibly other cancers

Anthocyanins

blueberries, strawberries, raspberries, blackberries, grapes, cherries, red peppers, eggplant, red cabbage

Antioxidant cell protection; may help prevent binding of carcinogens to DNA

Allyl sulfides

garlic, onions, shallots, leeks, chives, scallions

Various anti-carcinogen functions

Monoterpenes

parsley, carrots, broccoli, cabbage, cucumbers, squash, eggplant, peppers, mint, basil, citrus fruits

Aid protective enzyme activity

Flavonoids

parsley, carrots, citrus fruits, broccoli, cabbage, cucumbers, squash, tomatoes, eggplant, peppers, soybeans, berries

Block receptor sites for hormones that promote cancer

Indoles

cabbage, Brussels sprouts, kale

Stimulate production of enzymes that break down cancer causing agents

Phenolic acids

parsley, carrots, broccoli, cabbage, tomatoes, eggplant, peppers, citrus fruits, whole grains, berries

Antioxidant properties; inhibit nitrosamine formation and help form protective enzymes

Catechins

green tea, berries

Antioxidants linked to lower rates of gastrointestinal cancer

As you can see, a wide variety of fruits and veggies fall into one or more of the categories named above. Of note, the benefit from phytochemicals comes from eating the food, not in taking pills or supplements. Fruits and veggies contain a variety of phytochemicals, vitamins, and minerals, as well as fiber — these cannot be replicated in a pill form. In addition, excessive amounts of certain vitamins or other compounds found in some supplements have the potential to cause harm.

To optimize your antioxidant intake, you can include at least five servings of fruits and veggies a day. If you're already doing this, why not aim for even more? Researchers have found that five to nine servings per day are most beneficial. Set your sights on variety, too. To obtain the benefits of these plant compounds, try to vary your selections from day to day, and from week to week. Include red, yellow, green, orange, blue, purple, brown, and white fruits and veggies, and enjoy a colorful (and healthful) eating plan!

Alice

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