Nutrition & Physical Activity
What a better way to show your support than to become educated! Celiac disease leads to malabsorption of nutrients and abnormal immune reactions to gluten (a protein in wheat, rye, and barley). Celiac disease works by damaging or destroying villi when gluten is consumed or used in a product. Celiac disease is genetic, meaning it runs in families. Therefore, people who have Celiac disease in their family may want to get tested. The disease affects approximately 1 out of every 133 people.
The only treatment for celiac disease is a gluten-free diet. In other words, a person with celiac disease should not eat most grains, pasta, cereal, and many processed foods. Gluten is also used in some medications, vitamins, and even lip balm. Therefore, it is important that people with Celiac speak with a pharmacist to see if prescribed medications contain wheat. Even if a person doesn’t have symptoms, s/he should still completely avoid gluten in order to prevent damage to the intestines and long-term problems.
It is highly important to diagnose this disease because without treatment, people with Celiac can develop complications such as osteoporosis, anemia, and cancer. Although Celiac disease may affect people in different ways, common symptoms of Celiac disease in adults include:
- Unexplained iron-deficiency anemia
- Bone or joint pain
- Bone loss or osteoporosis
- Depression or anxiety
- Tingling numbness in the hands and feet
- In women, missed menstrual periods, infertility, or recurrent miscarriage
- Canker sores inside the mouth
- An itchy skin rash called dermatitis herpetiformis
So what’s for dinner? A gluten-free diet could include potato, rice, soy, amaranth, quinoa, buckwheat, or bean flour instead of wheat flour. There are also gluten-free breads, pastas, and other products that are labeled "gluten-free." Corn tortillas, rice cake, popcorn, crackers made of rice or corn, rice, pasta made from rice, flax, quinoa, buckwheat are also fine. While oats may not be harmful for most Celiacs, it is best to avoid oat products as they are frequently contaminated with wheat. Also, most gluten-free grain products aren't supplemented with vitamins, so it is important for Celiacs to take a vitamin supplement. Speaking with a registered dietitian can help you and your lady friend come up with delicious and suitable meals. There are also a variety of cookbooks and blogs that cater to a gluten-free lifestyle.
Creating a supportive environment can definitely make life easier for a person with Celiac disease. Here are some tips for you to help your girlfriend manage her health:
- Provide emotional support.Being diagnosed as a Celiac may be a difficult, life-changing experience. Eating, grocery shopping, going to restaurants, and traveling may become much more challenging — even overwhelming. Therefore, it is extremely important to be gentle, patient, and understanding.
- Do your research.Asking Go Ask Alice! was a great first step! Continue to stay up-to-date with the ins and outs of Celiac disease. You can also educate yourself on how to make delicious, gluten-free dinners.
- Remember, wheat-free doesn’t mean gluten-free.There are a whole bunch of products available that are wheat-free but not gluten-free. While someone with a wheat allergy could potentially eat these products, those with Celiac cannot.
- Be aware of hidden gluten. You may want to call or email food companies for clarification on a product’s ingredients.
- Understand that even cross-contamination can be dangerous.For a person with Celiac disease, even the tiniest crumb can cause symptoms. Ideally, a person with Celiac will live in a gluten-free household. This eliminates any chance of accidental contamination. If this isn’t possible, the next best option is to keep foods containing gluten in a separate area of the kitchen, and using different pots, pans, cutting boards and utensils to prepare.
For more information, you may want to check out Celiac Disease Foundation and the related questions below. Here’s to health and happiness — for both of you!
Dear For future reference,
Living with someone who has an eating disorder can be incredibly stressful. It is certain that others, similar to yourself, notice unusual eating patterns among friends, loved ones, roommates, partners, etc. that they later learned were signs of an eating disorder. Eating disorders affect people of all ages, ethnic backgrounds, and sexual orientations.
Your helping strategies depend on whether or not this is an emergency situation. If this were an emergency situation, for instance, the person is blacking out, losing significant amounts of weight, sleeping all day, and/or expressing suicidal thoughts or attempts, then do not try to deal with the situation politely or gently. Tell your resident advisor (RA), residence hall director (GA), or someone else who can help to get the assistance and support you need to intervene. If you are at Columbia on the Morningside campus, you can call Counseling and Psychological Services (CPS) at 212-854-2878 or Medical Services at 212-854-2284 for an appointment. CUMC students can contact the Mental Health Service or Medical Services at 212-305-3400. Morningside students can also use Open Communicator to make a primary care appointment. If this were an extreme emergency, you would need to call your campus's volunteer ambulance service, if there is one at your school, which should come with security. If you are at Columbia, you can call CU-EMS, Columbia University's Emergency Medical Service, at 212-854-5555.
If this were not an emergency situation, a good roommate or friend may be the best person to express concern and get her to help. You can choose to speak with your roommate directly, or you can do things that are less direct — such as place pamphlets about eating disorders around the common living areas; you can attend a seminar or workshop on eating disorders, body image, or healthy eating and invite your roommate to come with you; or, set up an appointment with a mental health provider to discuss ways to help your roommate.
If you choose to speak with your roommate directly, pick a time to talk when you are feeling calm and both of you have plenty of time. Choose a time and place where you will not be interrupted. Start off by keeping your observations away from food or her body, and on her non-appearance oriented traits — such as what a good roommate or person she is and/or how much you care about her. Focus on expressing your concern by conveying your observations about her health or behaviors. Tell her that you are worried. Make sure she knows you value her and highlight for her the qualities in her you appreciate.
If your roommate seems receptive to your thoughts, you can mention the following things in your conversation:
- What you see that makes you think there is a problem: Be specific about what you see regarding her eating, purging, exercising, or starving behaviors. Your observations, rather than evidence of wrongdoing, can be discussed gently if you focus on your concern. Stick to the issue — if she changes the subject, ask her when would be a better time to talk.
- How you feel: Use "I" statements to express your feelings about what's happening to your roommate: "I'm upset because I've noticed that you don't eat meals with us anymore," or "I'm concerned because you complain about how fat you are all the time. I think there's something wrong."
What you would like to see happen: Make sure that your goals for the conversation are attainable. Your goal is NOT to stop her from bingeing, purging, or starving. You would most likely end up in an ineffective control battle. A realistic goal is simply to open the door to talk, either now or in the future, and to encourage her to take steps to get the help she needs and deserves.
This may be a difficult conversation, and you can try to keep it from becoming an argument. For example, if you become upset, ask if you can continue the conversation at another time. Also realize that your roommate may need to hear your worry several times before she's willing to have a conversation with you about it.
Remember, regardless of her reaction, you can know that you've tried to help her. She's lucky to have you as a roomie.
Dear Weight conscious,
Feeling like life is passing you by or “putting off” your life can be a discouraging feeling for anyone. Here’s something to consider: If you lose all the weight you want to lose, what would your life look like? What would you be doing that you aren’t currently doing? Can you begin to do some of these things now? Following your heart and doing things you truly love today may help you feel better about tomorrow. And, that just might provide you with more motivation to accomplish your weight loss goals.
Now, let’s talk more about your specific question. Unfortunately, free weight loss camps are hard to come by, and may not even exist. However, if you're willing to think outside the box a little, you may be able to find a short-term physically active job that can help get you moving. For example, you could look into a program such as WWOOF, which places people who want to volunteer on organic farms with small organic farmers around the world. In addition to requiring volunteers to contribute physical labor, many of these opportunities provide one or more meals per day of healthy, farm-fresh foods for their working volunteers. And besides being a great work out, these programs offer a great opportunity for adventure!
Now back to the more traditional residential weight loss programs. Some are helpful, whereas others are simply moneymaking ventures. A sound weight loss program addresses three key issues: controlling calorie intake, changing problematic food habits, and increasing physical activity. Specifically, look for the following characteristics in a weight loss program:
- The program's diet plan should meet nutritional needs, even though you are eating fewer calories. This means following guidelines like those at MyPlate.gov, which emphasize healthy and balanced eating.
- The program should stress gradual, rather than rapid, weight loss. Look for a loss of 1 to 2 pounds per week.
- The program's plan should be adaptable to habits and tastes. No rigid rituals should be required.
- The program's plan should minimize hunger and fatigue while ideally supplying at least 1500 kilocalories a day for men and 1200 for women. Any lower calorie regimens should provide either fortified foods or a vitamin and mineral supplement.
- The program doesn't have to be expensive to be helpful to you.
- The program should help reshape lifestyle and problem eating habits to make weight loss and, later, maintenance possible.
- The program should improve overall health. It should emphasize regular physical activity, proper rest, stress reduction, and other healthy lifestyle changes.
You can also make changes on your own to incorporate physical activity and healthier eating into your everyday life. Some tips are:
- Plan out your meals in advance. Be sure to include a variety of foods (like whole grains, vegetables, fruits, and lean protein) in each meal. Planning in advance will help you to avoid any impulsive, less healthy choices.
- Start a food journal. Do you frequently crave a fatty or sugary snack around the same time each day? Do you tend to skip meals, and then overeat later on? Keeping track of what you eat and how much may help you identify where you could make healthier choices.
- Slowly initiate physical activity. Try starting with a 10-15 minute walk a few times a week and gradually work your way up to 30 minutes of moderate aerobic exercise on most days.
- Work in physical activity throughout the day. Using a slightly farther away parking space, bus stop, or subway station; taking the stairs when possible; and stretching or walking around the office as a short break from work are all possibilities.
- Enlist the help of friends and family. Have a regular weeknight tennis match with a friend. Practice cooking healthy with your family.
For more tips on exercise and healthier eating, check out the Nutrition and Physical Activity section in the Go Ask Alice! archives. You may want to speak with a nutritionist (if you're at Columbia, login to Open Communicator or call x4-2284 to make an appointment); or, contact a registered dietitian in your area for a weight loss camp or program recommendation that will work for you. These providers can help you find affordable, convenient suggestions for successful weight loss.
May 17, 2012511312
November 9, 200420793
Another option that you might check into would be hiking/backpacking/bicycling trips in national parks, or other such trips sponsored by outdoorsy groups (Sierra Club, National...
Another option that you might check into would be hiking/backpacking/bicycling trips in national parks, or other such trips sponsored by outdoorsy groups (Sierra Club, National Wildlife Federation, American Wheelmen, etc., if I remember correctly). Try an on-line search for some of these websites. I'm sure some of their trips last for a couple weeks, and maybe you could do them back-to-back, or figure out something creative. I don`t know if they are cheap or not, but it's worth checking out, or contact them stating your needs and they might have further suggestions.
May 18, 200120362
Yes, both boys and men can and do suffer from eating disorders. In fact, disordered eating and eating disorders can affect anyone, regardless of gender, race, ethnicity, sexual orientation, or socioeconomic status. You raise a great question, though; all too often eating disorders in boys and men are much less talked about than in girls and women. Doctors are also less likely to diagnose males with an eating disorder compared to females and there are also fewer resources for boys and men who wish to get help with their condition.
In recent years, there has been increased attention (and research) given to this topic. Some older studies reported that around 10 percent of patients with eating disorders were men. More recent studies, however, indicate that as many as 30 percent of patients with anorexia or bulima were male, and that men accounted for 40 percent of binge eating cases.
While men and women can both experience eating disorders, men are often trying to change their physical appearance for different reasons than women, including:
- A desire to improve athletic performance.
- A history of being teased, criticized, or picked on for being overweight.
- Wanting to change a specific body part (to reduce "flab" and promote muscle definition).
- To make required weight for a specific sport (i.e., wrestling or crew).
- To be more attractive to a potential partner.
- To look less like one's father.
In addition, it’s important to note that while women with eating disorders are often preoccupied with weight, men tend to focus more on achieving a particular body type, such as being muscular or lean. One example of this is a disorder known as megarexia, a term used to describe an individual who is obsessed with increasing his or her muscle size. Men are more likely than women to have megarexia, which also goes by the names muscle dysmorphia or bigorexia. These individuals exhibit many of the same symptoms of other more well-known eating disorders, such as a very restricted diet, preoccupation with food and body weight, and a history of low-self esteem. For more information on this disorder, check out Obsessed with building muscle in the Go Ask Alice! archives.
For further reading on how men are affected by eating disorders, try Arnold E. Anderson's book, Making Weight: Healing men’s conflicts with food, weight, shape, and appearance. If you are a Columbia student (of any gender) and feel you are suffering from disordered eating, make an appointment with the Columbia Health Eating Disorders Team.
February 27, 2012507779
Dear Hopelessly hungry,
It's true that some students put on weight when they first come to college, however this is not a universal event, nor a foregone conclusion. For many first year students, it's their first time away from home, making choices about what to eat, how much, and how often. On top of this, many college students eat in cafeterias, where meal options are abundant and portion control can be a daunting task. Students may also be facing new challenges and situations that lead them to eat for reasons other than hunger — such as coping with stress, loneliness, or even hanging out and having fun late at night with friends.
You can, however, make good food choices. Here are some general tips for finding healthier options:
- Choose baked or grilled foods over fried foods
- Choose water, milk, or fortified soy milk over sodas
- Buy groceries if possible: you can better plan your meals, or at least have healthy snacks on hand when you get hungry during late-night chats or study sessions
- Try to control portion size: ask for a smaller amount, or remember you can come back for seconds if your dining hall is self-serve
- Have fruit for dessert (and grab an extra piece to snack on later)
- Vary your entrée selections: try to have chicken, fish, other meat, vegetarian, and pasta once or twice a week each
- Avoid cream-based soups and sauces
- Moderation is key: pizza, burgers, or ice cream once in a while are fine; just don't make them your key food groups
All in all, you want to aim for a varied diet with enough whole grains, lean protein, and fruits and vegetables and minimal fatty and sugary foods. For more tips about working in healthier foods, check out the Optimal Nutrition section of the Go Ask Alice! archive, learn more about the tools from Columbia's get balanced! initiative, or visit Choosemyplate.gov. You can also call your school's health service and make an appointment with, or get a referral for, a registered dietitian to create an appropriate food plan for your individual needs. At Columbia, students can contact Medical Services (Morningside) or the Student Health Service (CUMC) to make an appointment.
There are often different culprits outside of the dining hall. During the first year at college, some students consume much more alcohol than in the past. Although there is no fat in alcohol, calories from alcohol are unusual in that they can't be stored or converted to energy for later use. Meaning that calories from alcohol are used first by the body, while calories from food that would otherwise be burned are stored, potentially contributing to weight gain.
Additionally, many first-year students might not think about exercising or may have trouble finding the time. Eating balanced meals and participating in regular physical activity are both major factors in losing or maintaining weight. If your concern is avoiding weight gain, keep physical activity in mind as a key ingredient. It may help to work out with a friend or schedule your exercise — Columbia students, faculty, and alumni can connect with CU Move to access tools and support for choosing strategies that support being physically active.
Gaining a few pounds may feel like the worst thing that can happen to you; however, it's important to learn how to take care of yourself, stay healthy, listen to your body, and eat because you're hungry — not because you don't want to study, you just got in a fight with your roommate, or you think you might have flunked a test. Check out the related questions and tips below to think about what you can do to maintain a healthy eating routine, and have a great first year.
Eat varied and well-balanced meals at your school's eateries. Besides what you choose to eat, watch how much you eat as well, because calories count and can add up quickly.
- Low- or nonfat yogurt with fresh fruit or cold cereal
- Cold cereal (especially whole grain varieties) with skim milk
- Hot cereal (such as oatmeal)
- Waffles with fruit
- Whole grain toast
- A sandwich — choose lean meats (such as fresh roasted turkey, roast beef, or ham), grilled or fresh veggies, and low- or nonfat cheeses; top with whole wheat, rye, or whole grain breads; spread on some mustard rather than mayo or other dressing (unless low- or nonfat is available)
- A salad — include beans, peas, grains, and sweet potatoes (if offered), as well as a variety of fresh veggies (including different types of lettuce, if available) and fruits; choose low-fat dressings and get them on the side
- Soup — choose broth-based rather than cream-based
- Pasta — stick with tomato-based rather than cream-based sauces, and try to get them on the side
- A meat entree — choose baked, broiled, steamed, stewed, or roasted skinless and de-fatted meats
- Vary your entree selection — meat once a week, fish once or twice a week, pasta once or twice a week, chicken once or twice a week, and vegetarian once a week
- Steamed veggies
- Salad or soup (see above for hints)
Dear Needing Help,
Thank you for writing. Reaching out can be intimidating, even online. You've taken the first step towards regaining your health by admitting that you have a problem and asking for help. First of all, it is important to get support from others throughout this process. The reality is that anorexia nervosa (whose symptoms you describe perfectly) is a very complex disorder, and it will take time, energy, and the help of multiple health care professionals to untangle the components that got you into this state. Whereas last year you may have been teetering on the brink, it is now safe to say that this year you've crossed the line.
At this point, it is imperative that you see a health care provider. Some of the long term physiological effects of anorexia are irreversible, so the faster you get help, the better. Your health care provider may recommend that you start a comprehensive treatment program for eating disorders. If you are a Columbia Student, you can make an appointment at Medical Services by calling x4-2284 or by logging into Open Communicator. Let them know that this is urgent. You may choose to make an appointment with a member of the Eating Disorders Team, a multidisciplinary group of clinicians specializing in disordered eating issues among students.
If talking out loud about your problems seems daunting, you can start by simply making a list of your symptoms (as you've done here) and telling them to a counselor or doctor. Your health care provider will be able help you move forward from there. Together you will be able to work out a plan of action — whether this leads you to an in-patient treatment program, an out-patient program, or group and/or individual counseling. You can make the decision based on both your personal needs and your insurance plan. If you are not a Columbia student, you can find resources and information from the National Eating Disorders Association website and their helpline at 1.800.931.2237.
Please talk to someone soon. You're worth it!
July 27, 200721292
Dear New to the City,
Welcome to New York City, one of the greatest cities for walking, running, and many other indoor and outdoor physical activities. Yes, the Alice! Health Promotion, part of Columbia Health, manages CU Move, a physical activity initiative open to all Columbia students, faculty, alumni, and staff. CU Move encourages members of the Columbia community to engage in active lives that include regular physical activity. The program provides participants with motivation and incentives to be active throughout the year. Actually, CU Move encourages all types of exercise, not just running. You can participate whether you like to work out alone or in a group. One of the goals of the program is to encourage members to exercise at least 100 minutes per week.
To join register for the e-mail list online at CU Move. You'll also program features, inspirational reasons to participate, and links to other physical activity resources.
CU Move has some outstanding features, including:
- Motivational messages — receive inspirational emails that will help you stick to your regular exercise program through messages tailored to your specific level of activity
- Incentives and prizes — stay active and receive rewards, including limited-edition fitness gear, music gift cards, and other fun and inspirational incentives.
- Campus events — interact with campus fitness experts, learn how to improve your fitness level, and get free giveaways
Participating in CU Move is a great way for both runners and other exercise enthusiasts to set goals and track fitness progress over time. The program will also provide opportunities for you to connect with other fitness-related programs on campus, such as Dodge Fitness Center and other special campus and community events.
So, whether you are an avid exerciser or just beginning to think about starting a regular exercise program, we'd love to CU Move!
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!
May 5, 2014560280
Although the way you feel about your body is valid, sometimes it is helpful to remember that we are harder on ourselves than we need to be. You are smart for not wanting to "diet." Restricting food intake usually backfires because you end up eating more in the long run. This is especially true for college students with late night study schedules. Take a more holistic approach to your health, eating habits, and lifestyle, and make realistic changes considering your current situation at school.
Even if it's true that you feel better when you're exercising and now you're not, you can still benefit from eating healthfully. Many school dining services now offer more healthy and low-fat choices and can alter portion sizes to meet your needs.
For a healthy vegetarian diet, choose a variety of grains: brown rice, breads (whole grain when possible), pasta, cereals, and bulgur. Beans and peas — kidney, pinto, lentils, chickpeas — are a great way to balance grains and get a complete protein source. This category also includes tofu and tempeh, available at health food stores, and probably in some meal choices at your school's dining service. Fruits and veggies are also an important source of vitamins and minerals. If you eat dairy products, eat them in moderation or try low-fat or nonfat varieties.
With whatever food choices you make, eat enough throughout the day so you are hungry, not starving, at night. Do you eat breakfast? If not, a bowl of cereal with fruit can help jump-start your day. If you are living in a residence hall, keep some food in your room, such as fresh fruit, yogurt, cereal, and milk. You can also bring food with you to classes. Throw a piece of fruit in your bag for later, or carry some trail mix and dried fruit, graham crackers, rice cakes, or breadsticks, which won't spoil in your backpack. And you may want to eat several smaller meals throughout the day rather than three larger ones, if that's the case.
Additionally, plan for and allow yourself a late-night study snack, roughly two hours before going to bed. With this plan, you'll know you are supposed to have a snack, so you'll be more likely to make a wise choice no matter where you are. Try a piece of fresh fruit, air-popped popcorn, nuts and raisins, or cut-up veggies. Avoid a highly sugared item, like a candy bar, because it can leave you feelig more hungry, and even tired. And watch how much you eat because calories can add up quickly.
As you know, eating healthy at a cafeteria is only part of the challenge. Making time for physical activity is important, too. If you don't have time to formally integrate exercise into your schedule, walking and climbing stairs are a great way to get some exercise without taking up extra time. Get off a few stops early if you are taking mass transit and walk the rest of the way to your destination. You can also try climbing the stairs instead of taking the elevator all the time. You can also check out the exercise classes offered at your school's fitness center. They are usually free for students, and can complement your yoga class. Maybe you and a friend can sign up together and motivate each other to go; or, the two of you can agree to work out together twice a week. It sounds like you know what to do. The next step is to make a plan and follow through with it. Take it slowly, and don't get down on yourself if you miss a workout. For more information on nutrition and overall health at Columbia, students may conatct Medical Services (Morningside) or the Student Health Service (CUMC) to make an appointment with a registered dietitian. Outside of Columbia, you may want to speak to your health care provider for a referral.