Nutrition & Physical Activity

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Getting off colas, sodas, pop, fizz...oh, whatever!

Dear Cokehead,

Drinking too much of the bubbly? Regular soda (not diet) is a source of sugar, caffeine, sometimes caramel coloring, and little else. A 12-ounce can of regular soda typically contains approximately 150 calories and 40 grams of sugar. The American Heart Association recommends that men limit their added sugar intake to nine teaspoons (or 36 grams) per day and women get no more than six teaspoons (or 24 grams) of added sugar per day. One can of pop…er, soda, can throw that recommendation to the curb! In addition, when consuming a soda, you are getting empty calories. That is, the soda is providing no other nutritious, good-for-you stuff — just good old calories and carbohydrates. True, these carbs can be used by the body for energy; however, if consumed in excess, sugar/carbs can contribute to weight gain.

Besides that, the sugar and acid in soda can increase your chances for cavities. Acid can wear down tooth enamel and cause tooth decay. Enamel is the thin, outer layer of hard tissue that helps maintain the tooth's shape and structure. Certain sodas also contain caffeine. If you're bothered by headaches, restlessness or anxiety, you may want to take a closer look at just how much caffeine you get in a typical day. One (12 oz) can of a cola product has about half the caffeine as a cup of coffee. On the upside, caffeine can improve mental alertness and provide a quick pick-me-up. Much research on the long-term effects of caffeine has found that two cups of coffee per day has little or no negative health consequences. However, too much caffeine can cause anxiety and/or sleep loss. Also, caffeine increases stomach acid levels, which can cause stomach irritation.

In terms of "quitting" soda, going cold turkey can be difficult. The good news is that you can feel physically and mentally better after an initial period of adjustment. Start the quitting process by cutting down on the amount of soda you drink each day. Do this for a few weeks and gradually reduce your intake until you aren't drinking any soda. Headaches, lethargy, and/or simply feel the "blues" are all normal parts of the cutting back process. In the meantime, here are some alternatives to soda that you can try:

  • Seltzer with a little unsweetened cranberry or grape juice
  • Unsweetened, non-caloric flavored seltzers
  • Plain tap water with lemon juice and an optional one to two teaspoons of sugar

Keeping a journal of your soda consumption can be helpful in making you aware of how much soda you are actually drinking. How much soda you consume may surprise you. You might also try quitting with a friend. Having a buddy around can help make the quitting process easier, and even a fun challenge. Lastly, if you're thirsty and there's nothing else around, it can become easy to pop some coins in the closest soda machine. Keeping alternative beverages around, like water or seltzer, can help quench your cravings. Cheers to that!

Alice

May 5, 2014

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Quitting soda has been extremely difficult for me and even though I have cut back considerably, I still struggle with cravings. One thing I noticed is that I would often crave soda when I was truly...
Quitting soda has been extremely difficult for me and even though I have cut back considerably, I still struggle with cravings. One thing I noticed is that I would often crave soda when I was truly just thirsty and dehydrated. Next time you want a soda, tell yourself that first you will drink a full glass of water. If you still want a soda afterwards, then enjoy! (Spoiler alert: most of the time you don't)

Vegetarian — Hair loss?

Dear Where's my hair?

You can expect to normally lose between 100-200 strands of hair each day. If your hair is coming out by the handfuls however, you do have cause to worry and should see a physician for a complete medical workup. A large loss of hair can indicate more serious bodily malfunctions. Stress can also be implicated as a cause of hair loss, and if things have been extra stressful for you lately, you might want to see a counselor to help you reduce your stress levels.

If your hair loss is more moderate, you are right that your nutrition and diet have a lot to do with it. Zinc is an important mineral for your hair, and a deficiency would probably show up as excessive hair loss, lack of sheen, and difficulty with control. The Recommended Dietary Allowance (RDA) for zinc in adult men is 11 mg, and for adult women the RDA is 8 mg. A  zinc supplement might help you here, but consult your health provider before starting one. Zinc is found naturally in beans, seeds and nuts, legumes, milk, and wheat bran and germ. Also, in terms of your vegetarianism, you might very well be taking in insufficient levels of vitamin B-12. This is somewhat common among vegetarians, and the results of a deficiency include dandruff, scaling, and hair loss. Most of the naturally occurring B-12 is in animal products, but can also be found in nutritional yeast and sometimes in fermented soy products (i.e. tempeh). For adult women, the RDA for B-12 is 2.4 mcg. For adult men, the RDA is 2.4 mcg. Read Vegetarian — B-12 deficient for more information on vegetarians and B-12 deficiencies.

If updates to your eating plan don't seem to help, perhaps a visit with your health care provider is the next step.  S/he can run some tests to check for a number of other possible options. If you are a Columbia student, you may consider a visit with a Registered Dietitian. Never fear, hope is not lost.  Happy eating and a speedy solution to your concerns.

Alice

Am I anorexic?

Dear Anyone who goes to the gym knows me,

Anorexia can be a scary word, and it takes a lot of courage to consider the fact that you may have an eating disorder. Based on your description, it sounds like your friends and family are concerned about you. Perhaps they have picked on the fact that you may be struggling with healthy versus unhealthy eating and exercise habits. Talking with a health care provider, nutritionist, or even a therapist may help you identify ways to stay strong, both physically and emotionally.  

Balance is the key to healthy eating and exercise. A nutritious diet includes a variety of foods from all the major food groups, including a small amount of fat each day. Since your daily meals consist mostly of carbs, fruits, and veggies you may be missing out on important nutrients found in other food groups. Also, losing weight and skipping meals are important signs that you may not be getting enough calories for your activity level.

Sometimes, unhealthy eating and/or exercise habits can develop into a more serious problem. Anorexia is a form of disordered eating characterized by an obsession with food, weight, and body shape. According to the Mayo Clinic, some physical signs of anorexia include:

  • Extreme weight loss
  • Thin appearance
  • Abnormal blood counts
  • Fatigue, dizziness or fainting
  • Dry skin, hair, or nails
  • Soft, downy hair covering the body
  • Absence of menstruation
  • Constipation
  • Intolerance of cold
  • Irregular heart rhythms
  • Low blood pressure
  • Dehydration
  • Osteoporosis

Despite the outward emphasis on food, the root causes of anorexia often have more to do with self-esteem and/or control over emotional issues completely unrelated to diet or exercise. For this reason, it may be helpful to talk with a therapist if you are worried about your recent weight loss and eating habits. At Columbia, there are several resources for students with concerns about healthy versus disordered eating. Medical Services has put together an Eating Disorders Team. This group is comprised of physical and mental health professionals who focus on nutrition and eating concerns. To make an appointment with a health care provider on the team, call x4-2284 or log on to Open Communicator. You can also call Counseling and Psychological Services (CPS) at x4-2878 to talk with a therapist who specializes in eating disorders. After your initial visit at CPS, you may want to consider the Eating Concerns Group. If you are off-campus, this related question, Eating disorder support resources on the Web, offers a variety of online supports.

You've already taken a brave first step just by considering the fact that your eating and exercise habits might not be healthy. By talking with a health professional about your concerns, you can gather the support you need to keep running strong.

Alice

Dodge Gym schedule

Dear Work-out,

How about giving your mouse a virtual workout and surfing on over to the Dodge Physical Fitness Center web site and click under "Schedules" to find the most specific, up-to-date schedules for the gym. Heck, you could even get started on some cardio by running or walking over to Dodge and checking out the schedule posted there.

In general, during the fall and spring semesters, the building is open

  • Monday through Thursday 6 AM to midnight 
  • Friday 6 AM to 10 PM 
  • Saturday 10 AM to 10 PM 
  • Sunday 10 AM to midnight

During the summer, it's open Monday through Thursday 7 AM to 11 PM, Friday 7 AM to 9 PM, Saturday noon to 5 PM, and Sunday noon to 7 PM. There are some exceptions though, so check out the suggestions above to ensure you aren't left out in the cold or wasting your time.  Have a great workout!

Alice

Body fat — genetic?

Dear Gland Problem?,

First off, great job with your daily exercise routine! Moving on to your question, genetics do influence body size and body fat composition, but family tendencies are only part of the picture.

Based on your description, your eating and exercise habits seem fairly healthy. Avoiding fatty foods is one weight loss strategy, but ultimately a person needs to cut overall calories, not necessarily fat, to lose pounds. In fact, eating a moderate amount of healthy fats can help make meals satisfying, so that filling up on "empty" calories from sugary, salty, or processed foods becomes a habit of the past. For veggie- and vegan-friendly weight loss tips, check out Weightloss diets for vegetarians, and everybody in the Go Ask Alice! archive. As a new vegan, take care to eat a variety of whole grains, legumes (beans and peas), seeds, and nuts to for adequate protein. You may be interested in Vegan Eating (also in the Go Ask Alice! archive) for more vegan nutrition info.

People naturally have varying percentages of body fat — and that's OK. How do you feel in your body? Strong? Healthy? Sluggish? Some people choose to focus on maintaining a feeling of good health, rather than a specific body weight. Experimenting with foods and your exercise routine can help you figure out what makes your body feel best.

If you are set on losing weight, depending on your body type, it may take a while to notice significant weight loss. Research shows that genetics explain 25 to 70 percent of the variation in body mass index (BMI). If many of your family members are on the heavy side, you may be predisposed to carry a bit more weight. Also, your body may be happy and healthy at its current weight, since you are already eating well and exercising regularly. These factors don't mean that your weight cannot be changed, but your weight loss may occur gradually. The good news is that people who lose weight slowly are more likely to keep off the pounds in the long run.

If you'd like to learn more, you might be interested in speaking with a registered dietitian. A dietitian can help you determine a realistic weight for your body and family history, and together you can craft a personalized eating and physical activity plan to reach your goal. If you're a Columbia student, you can make an appointment with a dietitian by contacting Medical Services (Morningside) or the Student Health Service (CUMC).

Regardless of where the scale points, you can feel proud of your healthy eating, physical activity habits, and your strong body. Here's to good nutrition and fitness!

Alice

Jogging injury: Stress fracture

Dear Out of Synch,

Injuries can happen even to the most careful physically active person. Though annoying, most injuries are neither serious nor permanent. However, an injury that isn't cared for properly (such as a stress fracture) can escalate into a chronic problem, occasionally serious enough to curtail the activity permanently.

Stress fractures are small cracks (fractures) in a bone that are usually caused by repetitive forces, such as those that result from running. Weakened bone unable to withstand the force arising from everyday activities can also lead to stress fractures (a problem for people with low bone mineral density or who have osteoporosis).

Have you consulted a health care provider about your stress fracture? If not, it is a good idea to seek medical attention to prevent further complications, including a full on broken bone. Your provider will probably ask you some questions, check out the area in pain, and order an X-ray, MRI, and/or CT scan. Depending on your particular case, stress fractures may require between two to twelve (or more) weeks to heal, and you’ll probably have to avoid non-weight bearing activities for some time. Your provider will be able to give you a better idea of how long you’ll have to stay on the sidelines. S/he may also suggest physical therapy.

In addition to seeing a health care provider, here is a four-stage process to keep in mind that can help you rehabilitate your body after a minor athletic injury:

Reduce the initial inflammation using the RICE principle. - Rest, Ice, Compression, Elevation

Restore normal joint motion. - Normal joint motion means being able to move a healed body part with full range of motion.

Restore normal strength and endurance. - During the rehabilitation process, your body will feel weaker and more fatigued because it's working hard to heal. Rest is imperative for successful healing, because as you slowly reintroduce movement and exercise, your body is working to rebuild strength and endurance.

Restore functional capacity. - Restoring functional capacity involves gradually reintroducing the stress of your regular physical activity (in this case, jogging), until you are capable of returning to your full intensity. Before jogging full speed ahead, however, you need to have complete range of motion in your joints; normal strength and balance among your muscles; normal coordinated patterns of movement; no injury compensation movements, such as limping; and little or no pain.

Initially, you’ll likely need to find ways to move your body with minimal impact. Athletic trainers and other sports medicine professionals often prescribe pool work, such as swimming or pool running. Other suggestions might include yoga, Pilates, or a stretch class, depending on your health care provider’s advice.

During recovery it is key that you pay attention to your pain. Pain is your body telling you to stop. Once you're pain-free, you can consider stepping up your activity to biking or using an elliptical trainer.

As you mentioned, stress plays a large role in healing. Tending to your mind as well as to your body is important, so increase your level of mental self-care. Check out the Stressbust Yourself Tips for strategies to help reduce and prevent stress (from this injury and in general).

To prevent injuries in the future, follow a few basic guidelines when physically active:

  • Stay in condition; haphazard exercise programs invite injuries.
  • Warm up thoroughly before exercise.
  • Stay hydrated.
  • Use proper body mechanics when lifting objects or executing sports skills. An exercise physiologist or trainer can demonstrate proper body alignment and position for these activities that's appropriate for you.
  • Don't exercise when you're ill or over trained.
  • Use proper equipment and safety gear.

It's important not to return to your normal exercise program until after athletic injuries have healed completely. As soon as you can move freely with no pain, and when advised by your health care provider, you can give yourself the green light to go.

Alice

Do I have bulimia and will it interfere with my birth control pills?

Dear Curious,

The world of eating disorders is complex; many individuals may have unhealthy behaviors or tendencies related to eating that do not fit neatly into diagnostic categories. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), published by the American Psychiatric Association and universally used in diagnosing eating disorders, bulimia includes both binging and purging, which is mostly likely what your professor was referencing. By contrast, sufferers of anorexia nervosa attempt to lose weight by inducing starvation, often coupled with rigorous exercise, and may also attempt to accelerate weight loss by vomiting, taking laxatives, and/or using diuretics.

It seems that your behavior may be a conglomerate of a few different eating disorder tendencies. Even though not everyone fits neatly into a specific diagnosis, this does not mean that health consequences associated with bulimia or anorexia will be absent. Repeated, self-induced vomiting packs a serious punch in terms of health risks.

In terms of your birth control pills, typically five to six hours is long enough for the pill to absorb into a woman's system. But keep in mind that frequent purging is highly stressful for your body, and is likely to disrupt normal bodily response to birth control pills or other medications, possibly including digestion and metabolism of birth control pills. Your contraceptive method will be most effective if you are successfully managing other medical conditions, such as eating disorder tendencies, with your health care provider's knowledge and support.

Some risks that may occur regularly and/or immediately following episodic vomiting include:

  • Fatigue, which may become chronic or persistent.
  • Sore throat.
  • Tooth decay and/or tooth pain.
  • Puffiness in cheeks and strained or broken blood vessels underneath eyes.

More serious health consequences of frequent purging include:

  • Constant electrolyte imbalance as a result of frequent vomiting can overly stress the heart, leading to irregular heartbeats and possible heart failure.
  • Inflammation and possible rupture of the esophagus.
  • Chronic constipation and/or irregular bowel movements.
  • Developing ulcers or pancreatic disease.

While there is a clear physiological component to purging, there is undeniably also a psychological component that is driving your actions. It may be useful for you to explore this issue more. If you are a Columbia student on the Morningside campus, you can make an appointment with a professional on the eating disorders team in either Counseling and Psychological Services or Medical Services. For counseling, you can make an appointment by calling 212-854-2878; for a medical appointment, you can call 212-854-2284 or log on to Open Communicator. For students on the CUMC campus, you can make an appointment with the Mental Health Service or Medical Services by calling 212-305-3400. Outside Columbia, some starting points are the National Institute of Mental Health's page on Eating Disorders, the National Association of Anorexia Nervosa and Associated Disorders (ANAD), and the National Eating Disorders Association, all with loads of information on how to approach this issue on a personal and medical level.

Eating disorders are complex and confusing; asking questions about the impact that purging can have on your health can be a great first step on the path toward managing and recovering from any type of disordered eating. Good luck along the way,

Alice

Ice cream for breakfast?

Dear icecreamlover,

Regardless of the time of day you eat it, ice cream wouldn't make it on any top ten healthy foods list. However, if your body is able to deal with the high doses of sugar and fat first thing in the morning, which many adults cannot, there might not be reason to toss out the ice cream scoop just yet.

The most important thing is to eat something within the first few hours after waking up in order to get your metabolism going and refuel your body after not eating for several hours. The fat in ice cream may help you stay full longer, and it contains a lot of calcium, which your body needs for healthy bones and other important functions.

Sound too good to be true? It might be… if you did it every day. Like many other things in life, too much of a good thing may not always be the best for you. Ice cream is high in calories and saturated fats, which is why it's a supplement to, rather than a basic staple, of a healthy diet.

If you're choosing ice cream first thing in the morning because you love that it's sweet, creamy, and cold, you may want to try some low-fat yogurt instead. It's like ice cream but not as high in fat, calories, or sugar. All the while, it still provides you with ample amounts of calcium. If you don't mind warming up, you could also try oatmeal sweetened with a touch of brown sugar, cinnamon, or honey and stir in some chopped up fruit for more flavor. Making the oatmeal with milk instead of water can help you feel full longer and provide essential vitamins and minerals, including calcium. If it's just your sweet tooth you're looking to satisfy, you could try switching to granola with fruit and yogurt, toast with jam or fruit spreads, or lightly sweetened cereal with milk.

Combining these foods with the occasional bowl of ice cream in the morning will help to ensure that you're eating a healthy and balanced diet overall. Of course, it's also important to eat well throughout the day, which means including plenty of fruits and vegetables, lean meats, and low-fat dairy products in other meals. For more tips on healthy eating, check out the related Q&As below.

Bon appétit!

Alice

The right weight for my height?

Dear Curious at Columbia,

If you're trying to find your "ideal" weight, you may not want to bet your bottom dollar on a height-weight chart, or any one indicator of fitness for that matter. Body size is actually a pretty hefty topic that deserves a closer look. However, no matter where the scale points, maintaining a healthy diet and regular exercise are two signs that you're on the right track to fitness and overall good health.

One popular way to compare height and weight is the body mass index or BMI. For a full description, read About BMI for Adults on the Centers for Disease Control and Prevention (CDC) website. Basically, the BMI uses a math equation to create a ratio of your weight to height, similar to the older height-weight charts. Lower scores indicate you're on the lean side, while higher scores mean you may be too heavy for your stature. If you're looking for a clear-cut boundary between a "healthy" and "unhealthy" weight, your BMI can provide a helpful guide. However, BMI calculations can hide important differences in body composition. For example, BMI scores don't account for the fact a given volume of muscle weighs more than the same volume of fat. Likewise, the BMI says nothing about the distribution of fat throughout your body.

For another useful way to assess body size, break out a measuring tape. No matter what you weigh, waist size is  another indicator of health. As it turns out, all fat is not created equal. Packing extra pounds around the belly carries more health risks than flabby arms. According to experts at the National Institutes of Health (NIH), the chances of developing heart disease and type 2 diabetes shoot up when your waist exceeds 35 inches for women or 40 inches for men.

Measurements aside, there's also a lot to be said for good eating and exercise habits. Another way to define "healthy" weight is by whatever size your body settles at naturally when you follow a healthy diet and exercise moderately. People come in many shapes and sizes so your ideal weight may not conform to the sleek physique pictured in magazines even if you're eating well and getting plenty of physical activity.

Since you're at Columbia, you might want to take advantage of nutrition counseling at Medical Services (Morningside) or the Student Health Services (CUMC). A registered dietitian can assess your eating patterns, activity levels, and body size to help you determine a weight that works for you. Here are some other helpful resources:

How to Get to Your Healthy Weight — Research and tips from the Harvard School of Public Health

MyPlate — Personalized eating plans, calorie assessments, and other nutrition tools provided by the US Department of Agriculture

Weight and body size are important health indicators, but banking on numbers alone may not give you a good picture of your overall fitness. Hopefully this information helps to settle the score!

Alice

Gluten allergy — Celiac disease or something else?

Dear Sis living without wheat,

First off, kudos to you for seeking out more information on your sister’s behalf. She is lucky to have someone like you looking out for her! To shed some light on your food allergy inquiry, a “gluten allergy” is often used as an umbrella term for four different gluten-related conditions: celiac disease, non-celiac gluten sensitivity, dermatitis herpetiformis, or gluten ataxia. While the treatment for all four conditions is generally the same — avoiding gluten — each has different symptoms and different levels of severity. The most serious of these conditions is celiac disease. If a person has celiac disease, eating gluten can lead to inflammation and damage in the small intestine. Such damage makes it difficult for the body to absorb nutrients and can lead to severe malnutrition, diarrhea, and weight loss.

Based on the low bone density you have described, it seems that celiac disease may very likely be the cause of your sister’s condition. There are a few medical tests that can determine if a person has celiac disease. If your sister were to test positive, it would be a good idea for you and your family to get tested, as there is a genetic component to the disease. There is no cure for celiac disease, so early diagnosis is key!

It might also be a good idea for your sister to speak with a registered dietitian to discuss her new diet and where to find gluten-free foods. If your sister is a Columbia student, she can make an appointment at Medical Services (Morningside) or the Student Health Service (CUMC)

In the meantime, there is an abundance of reliable information available online. You and your sister might want to check out these resources:

Your sister may have a lot on her plate right now, so to speak, as she adjusts to a new diet. You can be supportive by learning about gluten-free eating and cooking, encouraging her to discuss questions with a health care provider or dietitian, and helping family and friends understand her dietary needs. Many people who have gone gluten-free find they enjoy cooking and eating more, knowing that the food they eat is not harming their bodies. Your sister might find that cutting out gluten will actually expand her cooking and eating repertoire!

Wishing you and your sister many enjoyable meals in the future!

Alice

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