Nutrition & Physical Activity
Dear Breathe easy,
Some evidence suggests that eating foods rich in nutrients and anti-oxidants may help some individuals to control asthma, but conclusive research on the matter is still up in the (hopefully breathable) air. Additionally, since certain foods or dietary behaviors have been known to trigger asthma attacks in sensitive individuals, eliminating the foods or behaviors may be a sensible choice.
Scientists do not know the exact cause of asthma, only that it involves a basic defect in the lungs that leaves them highly irritable. However, there are well known aggravating factors that can bring on an asthma attack. Allergies are a common trigger of asthma, including allergies to pollen, mold, house dust, animal dander, and occasionally medicine or foods. Allergies alone will not cause asthma however — not all allergic people have asthma and many asthmatics are not allergic. Respiratory infections are likely to aggravate asthma, as are changes in the weather (seasonal, temperature, or humidity level). Exercise is another common asthma trigger, as well as environmental irritants such as cigarette smoke, gasoline fumes, hair sprays, perfumes, and cleaning solutions. Emotional stress can lead to an asthma attack. Hormones, aspirin, cold dry air, very cold or spicy foods or beverages, and "intrinsic factors" can all stimulate an asthma attack. No two people with asthma are exactly alike; each has his/her own pattern of sensitivity.
Food-trigged asthma occurs in only six to eight percent of children with asthma and less than two percent of asthmatic adults. However, as asthma can be triggered by very cold food or drink, and on occasion, by overeating, it would be wise to avoid these situations. In addition, reactions to food preservatives known as sulfites and bisulfites (found in dried fruits, prepared potatoes, wine, bottled lemon and lime juice, and shrimp) have triggered asthmatic reactions in sensitive individuals.
On the other hand, some foods may actually help to control asthma. Although the findings are not conclusive, there have been a variety of studies that indicate certain nutrients may guard against asthma attacks. Antioxidants, a group of nutrients that protect the body from free radicals and reduce inflammation in the body, show the most promise for asthma relief. Helpful antioxidants may include vitamins C and E which are found in many fruits and vegetables. Those with severe allergies may suffer from low levels of vitamin D. Vitamin D can be found in milk, eggs and some fish, but your body can also produce vitamin D by exposure to sunshine! Adding omega-3 non-saturated fatty acids (found in fish oil and other seafood) to your diet may also be helpful. Before rushing to the pharmacy to stock up on vitamin supplements, it's worth knowing that the protective effect of these nutrients on asthma control is far from proven. Groups of nutrients found naturally in foods seem to have the most impact. The take-home message is one you've no doubt heard before: eat a balanced diet that includes a variety of fresh fruits and veggies and occasional servings of fish for those omega-3s and some vitamin D.
If you decide to modify your diet, a food journal may help you identify links to any changes in your asthma — for better or worse. For example, anytime you have something to eat or drink, jot it down, and also make a note of times when your asthma flares up. After you've collected a few weeks’ worth of observations, you can look for patterns in your asthma and diet.
There are holistic approaches to health and healing that promote dietary changes to control asthma. Other recommended methods of care include acupuncture treatments and meditation.
Medication, especially steroid inhalers, remains one of the most common treatments for asthma. Unfortunately there's no miracle diet to control asthma, but you may find that eating more fruits and veggies helps you breathe a bit easier.
Dear Animal Lover,
Vitamin B12 is important in the formation of nerve cells and red blood cells. Natural food sources of the vitamin are found primarily in meat and other animal products, which mean those who stick with a plant-based diet have to find their source elsewhere. Though there are some foods that your friend may want to add to her/his diet, vitamin supplements may also be something to consider. However, because of the serious symptoms and long-term risks involved with B12 deficiency, consulting with a health care provider and/or a registered dietitian may help as well.
Contrary to popular belief that B12 deficiency takes many years to develop, it actually may only take a matter of two to four years to become symptomatic. A recent meta-analysis found that the prevalence rate of B12 deficiency among non-pregnant young adults who followed a vegetarian diet (lacto- or lacto-ovo) was at about 32 percent and among vegans, ( those who eschew all animal products: meat, eggs, dairy, honey, leather, silk, etc.) prevalence was at 43 percent. Symptoms of B12 deficiency include anemia, fatigue, weakness, constipation, loss of appetite, and weight loss. Long-term effects may be neurological changes such as numbness and tingling in the hands and feet. Additional signs of B12 deficiency include difficulty in maintaining balance, depression, confusion, dementia, poor memory, and soreness of the mouth or tongue. But be advised that these can also be symptoms of many different ailments, so having a blood test from a doctor like your friend did can help with diagnosis.
The recommended daily allowance (RDA) of B12 for adults is 2.4 micrograms (µg) and there are actually two forms of B12, active (which the body can actually use) and inactive (a.k.a.,pseudovitamin B12). Now, for the good news: Both vegetarians and vegans have various options for obtaining sufficient amounts of vitamin B12. Some varieties of mushrooms, green and purple nori (seaweed), and some fermented foods like sauerkraut and tempeh (fermented soy beans) are recognized as plant-based sources active B12. Fortified foods like some cereals, soy products, or meat substitutes are options for both vegans and vegetarians. Milk, yogurt, and eggs are rich in vitamin B12 and may also be added to a vegetarian diet. And while it is possible to get sufficient amounts of the vitamin from these sources, many vegans and vegetarians don’t seem to eat enough of these products. As such, it might be a good idea to look into vitamin supplements that contain B12. Due to the low absorption rate of the vitamin through supplements, taking a 250 microgram (µg) dose is recommended. Seeking out the guidance of a registered dietitian may prove helpful for your friend to identify where B12–rich sources can be added in her/his diet.
Happy healthy eating!
To figure out your basic metabolic rate, it must be measured under very strict conditions such as after a night’s sleep, on a fast, and without any physical activity, etc. What is more common and often more useful is a person’s resting metabolic rate (RMR). RMR is the number of calories you burn to maintain vital functions such as breathing, pumping blood, and maintaining your muscle and nervous system at resting conditions. This is measured under less strict conditions and often does not require the person to fast or to sleep right before the measurement. An accurate RMR measurement requires the use of an apparatus called indirect calorimetry. This can be expensive, so estimating RMR using parameters such as body weight, height, and age can be used as well.
There are three common equations to estimate RMR: (1) the Harris-Benedict equation, (2) the Mifflin equation, and (3) the Cunningham equation. These equations are population specific, so it is important to be aware of their limitations.
Harris-Benedict Equation (widely used and relatively accurate for average body type):
Men: RMR (in calories per day) = 66.47 + 6.23 x Weight (lbs) + 12.67 x Height (in) - 6.76 x Age (yrs)
Women: RMR (cal/day) = 655.1 + 4.34 x Weight (lbs) + 4.69 x Height (in) - 4.68 x Age (yrs)
Men: RMR (cal/day) = 10 x Weight (kg) + 6.25 x Height (cm) - 5 x Age (yrs) + 5
Women: RMR (cal/day) = 10 x Weight (kg) + 6.25 x Height (cm) - 5 x Age (yrs) - 161
Cunningham Equation (uses fat-free mass, suggested for athletes):
For men and women: RMR (cal/day) = 500 + 22 x FFM (kg)
If you would still like to know more about measuring your metabolic rate, such as through an indirect calorimetry, it is recommended to see a health care provider. Columbia students can make an appointment at Medical Services (Morningside) or at the Student Health Service (CUMC). You can also visit the Columbia Health site to learn more about services and programs available on campus to help you stay in tip-top shape.
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 Not worried...just curious,
If your diet is leaving you drowsy, it may be related to not eating enough calories — especially since many vegetarian foods tend to be relatively low-calorie. Eating too few calories would leave your body without enough energy to "get up and go" in the morning. To increase your calorie intake, try buying a variety of nuts, seeds (sunflower, pumpkin, etc.), and dried fruits to make your own trail mix: each day, put about one cup into a bag and carry it with you to snack on. Besides added calories, you will also be getting a good source of vitamins, minerals, and some protein into your diet.
At meal times, include healthy size portions of grains (whole wheat, brown rice, oats, barley, buckwheat, etc.), vegetables, fruit, and legumes (dried beans and peas), and use a moderate amount of vegetable oil (canola and olive are good choices) for cooking. If you eat eggs and dairy, they can also serve as a great source of protein, calcium, and added calories.
In terms of exercise, aim for about 30 minutes of aerobic activity five or more times a week to get cardiovascular and energy-boosting benefits. Exercise in excess of about one hour of aerobic activity, five or more times a week, should be reserved for those training for a competitive sport (and who are eating higher-calorie diets!). High levels of exercise increase the risk of sports-related injury and may make it harder to take in a sufficient amount of calories.
Even if you think you sleep the right number of hours, keep in mind that some people, particularly college-aged people, require up to ten hours of sleep a night. Other sleep habits might also give you problems; for example, it's important to try to go to bed and wake up at close to the same time each day. Although this may seem nearly impossible on a student schedule, try to get on an even keel to start off the semester. If you wake up at 11:00 AM most days and get up for an 8:00 AM class two days a week, you most likely will feel like you never quite wake up on the two early days, even if your total amount of sleep is adequate. You may want to adjust your routine so that you go to bed early enough to wake up at the same time each day (weekends included), and see if your tiredness improves. If you feel overly exhausted or your drowsiness is interfering with school and life activities, you may want to consider seeing your health care provider.
Good luck getting up and at 'em!
Yes, it is true that there are recommendations for minimum and maximum heart rate during exercise. Two slightly different formulas are currently used to guide exercisers. Both formulas take your age into account, but one also factors in your resting heart rate and is particularly useful for individuals training with a specific performance goal in mind. Heart rate is measured in beats per minute (bpm). Before demonstrating each formula, it's useful to define a few terms:
- Maximum heart rate — an estimate of the heart rate that one potentially could (not should) achieve during maximum physical exertion.
- Resting heart rate — as simple as it sounds — your heart rate at rest with no physical exertion (best when measured in the morning before any stress, caffeine, or much movement).
- Target heart rate — a percentage of your maximum heart rate. Experts recommend keeping your heart rate in a certain range to achieve benefits during exercise, depending on your level of conditioning and exercise goals.
To demonstrate how each formula works, let's say that Devon is 24 years old, has a resting heart rate of 65 bpm, and wants to work out between 60 and 80 percent of maximum heart rate. Time for a little arithmetic!
Maximum workout heart rate =
(220 - age) X percent of maximum heart rate
(220 - 24) X .60 = 117
(220 - 24) X .80 = 157
According to this formula, Devon should maintain a target heart rate between 117 and 157 bpm to reach 60 to 80 percent of maximum heart rate while working out.
Maximum workout heart rate, adjusted for resting heart rate =
(220 - age - resting heart rate) X percent of maximum heart rate + resting heart rate
(220 - 24 - 65) X .60 + 65 = 144
(220 - 24 - 65) X .80 + 65 = 170
According to this formula, Devon should maintain a target heart rate between about 140 and 170 bpm to reach 60 to 80 percent of maximum heart rate while working out.
As you can see, these formulas give Devon different recommendations for target workout heart rates. This is because the second formula adjusts for resting heart rate, a number that normally gets lower for most people as they exercise and become more conditioned. Using the second formula can increase the accuracy of target heart rate recommendations for regular, consistent exercisers.
The easiest place to check your heart rate may be on your carotid artery in the neck (avoid pressing too hard or the reading may be less accurate). Check your heart rate before, during, and after exercise by taking your pulse for 10 seconds and multiplying by 6, or for 15 seconds and multiplying by 4. You can then adjust your workout accordingly. Remember, you are estimating your heart rate with these formulas, so always let safety come first. Stop exercising if you feel dizzy, faint, or shortness of breath.
Hope this heart to heart was helpful!
Regardless of your age, one cup (8 ounces) of milk a day, which provides about 300 mg of calcium, is not enough to keep your bones strong and healthy. It is recommended that people in their 20s get at least 1,000 mg of calcium each day which would be about 3-1/3 cups of milk.
Why do we need so much calcium? The short and sweet answer is: to maintain strong, healthy bones and good general nutrition, as well as to prevent osteoporosis (See Women, calcium, and osteoporosis? in Alice's Fitness & Nutrition archive). Calcium is an essential component in the life-long process of laying down new bone. Before you reach thirty, more bone is made than lost; after thirty, this trend reverses, and calcium can help our bodies maintain bone mass.
Women especially need to be vigilant about this important mineral. On average, women make less bone and lose it at a greater rate than men. A woman's calcium stores are drawn on during pregnancy and lactation. Adding to this, women generally live longer than men, giving their bones more time to become brittle, less dense, and prone to fracture (i.e., to develop osteoporosis). The two best things you can do now to prevent future osteoporosis are: (1) include enough calcium in your diet; and, (2) exercise often, and include weight-bearing activities in your exercise routine.
The Recommended Daily Allowances (RDAs) for calcium intake is
- 9 to 18 years old — 1,300 mg/day
- 19 to 50 years old — 1,000 mg/day
- Over 50 — 1,200 mg/day
If this amount of lactose seems daunting, don't worry, there are many high calcium foods besides milk that you can consume to bulk up your calcium intake. The Linus Pauling Institute at Oregon State University provides the following table of common foods (some dairy, some not) and their relatively high calcium content:
Servings needed to equal the absorbable calcium in 8 oz of milk
1/2 cup, cooked
1/2 cup, cooked
1/2 cup, cooked
1/2 cup, cooked
1/2 cup, cooked
1/2 cup, cooked
1/2 cup, cooked
1/2 cup, cooked
1/2 cup, cooked
A few other pointers on how to maximize the calcium in your diet: calcium is absorbed better in the presence of vitamins C and D and lactose (a sugar found in milk and dairy products), so squirting some lemon or orange juice on your greens, in addition to tasting great, can help make the calcium in them more bio-available. Dairy products are also an excellent choice for calcium because of the lactose they contain.
While there are many calcium supplements available to help you meet your intake goals, getting calcium through foods is preferable to supplementation because of a better absorption rate. However, if you simply cannot eat enough to get adequate calcium, which is the case for many, especially busy students in their twenties, turning to a food-based, calcium supplement could be useful to you. Calcium citrate, which is in the newer calcium supplements, tends to be more easily absorbed than calcium carbonate, which is used in the older supplements like chewable antacids.
It's great that you're keeping tabs on your calcium consumption as a young person. With an awareness of what you need and how you can get it, you are sure to keep your bones healthy and strong.
Dear Seeking fat,
Cholesterol is a white, waxy lipid (fat) found naturally in the human body. Most cholesterol is produced by the liver, while a smaller amount is ingested directly from meat, poultry, seafood, dairy products, and other foods of animal origin (plant foods do not contain cholesterol). Cholesterol is involved in many vital life-processes, such as the production of hormones and the repair of cell membranes. To get where it's needed, cholesterol travels through the bloodstream as lipoproteins — fat packaged up in little protein spheres.
Studies have demonstrated that a blood test measuring cholesterol levels can help establish one's risk for heart disease. This test measures the amount of fat found in the bloodstream, including high-density lipoproteins (HDL), low-density lipoproteins (LDL), and triglycerides (another type of fat molecule). A total cholesterol score is then obtained by putting these three numbers into a mathematical formula. Research has shown that high levels of HDL decrease one's risk for heart disease (hence the term "good" cholesterol), while high LDL levels (a.k.a. "bad" cholesterol) increase one's risk. The medical community currently uses the following guidelines to put these numbers in perspective.
|Total Cholesterol||< 200 milligrams (mg)/deciliter (dL)|
|LDL||< 130 mg/dL|
|HDL||> 60 mg/dL|
|Triglycerides||< 150 mg/dL|
Because the total cholesterol score is a composite that includes both "good" and "bad" cholesterol, this number alone is less useful as an indicator of risk than the ratio of total cholesterol to HDL. For example, having a total cholesterol number above 200 mg/dL indicates a statistically greater risk of heart disease, but if this number is arrived at because the HDL number is especially high while the LDL and triglyceride numbers are normal or low, then the risk level may actually be below average. The ideal total cholesterol to HDL ratio is less than 3.5; a ratio of 4.5 is average, while a ratio of 5 or greater is a red flag.
|Total Cholesterol/HDL Ratio Guidelines|
|Ideal: < 3.5|
|Potentially Harmful: = 5|
Blood cholesterol levels vary according to genetics as well as lifestyle choices. For example, eating saturated fats is the largest contributor to high blood cholesterol levels. Other lifestyle factors include smoking, which is associated with lowering HDL levels (increasing risk), and regular exercise, which is associated with boosting them (lowering risk).
For more detailed information on cholesterol, read the Related Q&As listed below or visit the American Heart Association web site.
Dear Carrot top,
The concentrated nutritional value of vegetable and fruit juices has made them a popular addition to many people's diets. One pint of fresh vegetable juice provides approximately the same vitamins, minerals, and enzymes as two large salads. And while synthetic vitamins and/or minerals may be chemically identical to those found in fruits and vegetables, the body does not absorb them as well as those in natural foods.
In the United States, carrots are the leading source of beta carotene. Beta carotene is the most active form of carotenoids, which are pigment substances in plants that can often form vitamin A. The major contributions vitamin A makes to the human body are to promote growth, for visual light and color, to prevent drying of the skin and eyes, for maintenance of the digestive and urinary tracts, and to enhance resistance to bacterial infection. Vitamin A has also been linked to cancer prevention. A deficiency in vitamin A can cause symptoms such as night blindness; poor growth; dry skin; and xerophthalmia or "dry eye," which can promote blindness due to a lack of mucus production by the eye. Carrots also contain the vitamins B, C, D, E, and K; the minerals calcium, phosphorous, potassium, sodium, and traces of other minerals; and a trace amount of protein. Calcium helps to strengthen bones, teeth, and the intestinal walls. The high mineral levels in carrots contribute to healthy skin, hair, and nails. Carrots also work as a sort of cleanser for the liver, and when consumed regularly, can help the liver excrete fats and bile.
For more resources on dietary supplements, including which vitamins and minerals are essential to your wellbeing, check out the following resource from the United States Department of Agriculture (USDA). The USDA's Nutritional Data Laboratory also provides a nutrient database— a useful tool to help you determine the nutritional value of certain foods. To help establish your unique nutritional recommendations based on your lifestyle, take a look at the Choose My Plate.
Juicing carrots will provide one with the same nutrients as eating them whole, but some feel that the roughage contained in whole carrots is an important aspect of their value. Your body needs bulk (fiber-rich) foods for proper digestion. Should you decide to incorporate a fresh juice program into your diet, be sure to also include at least two fiber-rich foods each day, such as raw vegetables, fresh fruits, and whole grains.
One pound of carrots will make approximately six to eight ounces of carrot juice. Basically, if you already eat nutritionally balanced meals, juicing is a matter of time and preference. A balanced diet with a variety of foods and beverages will serve you well for a lifetime of health and fitness!
A high-impact yes to your question! In fact, there aren't many better pursuits than exercise for stress reduction. Before we delve deeper into why exercise is so great, however, let's first make sure we're on the same treadmill about our definition of "exercise." According to the Physical Activity Guidelines for Americans, it’s recommended that adults (ages 18 to 64) get 150 minutes of moderate physical activity or 75 minutes of vigorous activity each week. Physical activity is considered moderately intense if you are working hard enough to break a sweat, but you are still able to hold a conversation. If you're breathing hard and fast, your heart rate is up and you're not able to get many words in, that type of activity can be described as vigorous. Additionally, two or more days of muscle strengthening activity per week is also recommended.
Before you run in the other direction, consider some of the health-promoting and stress-controlling benefits of aerobic activity. Most notably, aerobic exercise strengthens your heart and lungs. These two vital organs — especially the heart — bear the brunt of the body's physiological stress response, as they are constantly being called upon to "fight or flee" from job, school, family, financial, relationship, and every other kind of stressor we confront daily.
You brought up another exercise plus: weight loss and maintenance. For many of us, looking good also means feeling good and vice versa. Exercise improves physical appearance, enhances self-esteem and self-confidence, and offers other mental health goodies. Regular exercisers report more energy and better ability to concentrate. Oh, and don't forget about improved quality of sleep, reduced stress reactivity (not getting as stressed out about things as you usually do), and, yes, maybe even a slowed aging process!
Exercise as stress-management strategy is easier said than done, so here are some tips that have helped many health-seekers to start and stick with exercise programs:
- Begin slowly. If you are not accustomed to exercising, start out with ten to fifteen minutes twice a week and build up from there.
- Snag a workout partner — there's nothing like the motivation of another sweaty, panting humanoid to keep you going.
- If the gym will be "workout central" for you, take a quick lesson from a trainer on proper equipment use. Simple direction from experienced health club personnel can reduce gymphobia (and possibly injuries) while improving the quality of your workout. Your gym should offer this one-time service free of charge to newcomers, but this doesn't mean that you can't ask for guidance down the line, too.
- Let friends and family know that you are exercising for your health — let them cheer you on.
- Finally, make your workout sessions regular and real. Schedule them in your calendar, just as you would record business appointments, classes, and social engagements.
If you are thirty-five or older or have any heart trouble, blood pressure problems, or other medical conditions, you will want to get a medical clearance from your health care provider before you choose your exercise plan.
By the way, you have a variety of exercise options, and you don't have to join a gym to partake. Walking briskly, running, biking (mountain if it sustains your heart rate), swimming, calisthenics, playing tennis or basketball, and cross-country skiing are just a few possibilities. Check out some of the archived questions in the Nutrition & Physical Activity category to learn more about your options for making physical fitness a priority in your life. Columbia University students, faculty, staff, and alumni can also participate in the CU Move initiative. 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.
In addition to exercise, try to take breaks from your high-stress job. Walk around outside, take lunch, or sit in the bathroom for a few minutes if that's the only time you can get away. Just a few breathers during a hectic day can go a long way toward stress relief.
Good luck getting moving!