Nutrition & Physical Activity

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The body mass index (BMI) and being overweight

Dear Scales,

You've encountered an issue with the body mass index (BMI) that many others have encountered, too! A tremendous amount of press has been given to the BMI charts and the "strict" standards many people feel the U.S. government has imposed upon the population. The truth is most of these articles and news reports don't tell the entire story. To set the record straight, keep reading.

BMI is a ratio of weight to height. BMI is frequently used as a measure of overweight and obesity because it's a quick, easy, and inexpensive measure that correlates pretty accurately with body fat percentage for most people. The key word here is "most." As you've discovered, it doesn't work for everyone. The major shortcoming and the primary point of contention among health care providers is that it cannot decipher between fat and muscle weight. It's a rather simplistic measure that does not take into account other factors such as age, build, and body composition.

The rationale behind these numbers is that, across large population groups, there is an increased prevalence of certain diseases in people with a BMI over 25, and a much greater risk of disease and death in those with a BMI over 30.  BMI is calculated as follows:

BMI=weight (kg) / [height (m)] 2

OR

BMI=weight (lb) / [height (in)] 2 x 703.

The standard weight calculations for overweight and obese adults are as follows: a person with a BMI of 25.0 to 29.9 is classified as overweight; those with a BMI greater than 30 are classified as obese.

When BMI measurements are taken into account with other factors such as family history, gender, race, age, and dietary and exercise habits, it may help health care providers determine a person's risk for developing the following conditions:

  • Hypertension (high blood pressure)
  • Coronary heart disease
  • Type 2 diabetes (adult diabetes)
  • Stroke
  • Gallbladder disease
  • Osteoarthritis
  • Sleep apnea and other respiratory problems
  • Endometrial, breast, and colon cancers

List adapted from the Centers for Disease Control and Prevention.

An important point here is the relationship between being overweight or, better yet, "overfat", and disease development. BMI often doesn't tell the entire story. A better tool is a person's waist-to-hip measurement ratio (measuring around the widest part of the hips then dividing this number by the measurement around the widest part of the abdomen). The recommended threshold ratio for these two measurements is equal to or less than 1.0 for men and 0.8 for women. Increased risk for the diseases listed above is associated with lower ratios and thus excess abdominal fat — the apple body shape (vs. pear where body fat is primarily carried on the hips and buttocks). When using either this ratio or BMI measurements, other risk factors for developing disease are important to assess. Considering these factors together, health care providers must use their clinical judgment to determine whether or not a person really does need to lose weight.

Many web sites, books, and articles that publish BMI charts tend to simplify this message. A trained athlete or physically fit individual is NOT the target of this message. These BMI charts are a tool to be used as one part of an overall health assessment. Over large population groups, many people with BMIs in the upper range, and high waist measurements or waist-to-hip ratios, are the folks with whom health care providers need to discuss various aspects of health. A fit, well-nourished person with developed muscles may have a higher BMI, but it's likely due to increased muscle mass.

Hopefully, this answer has clarified some of the misunderstanding about BMI. Overall, it is a very limited and highly criticized measure of overweight and obesity; therefore, focus on your overall health, fitness level, dietary variety, and self-satisfaction. Your well-being is certainly much more than just an absolute number.

Alice

Partner is bulimic — what can I do to help her and myself?

Dear Tim,

When a loved one shares such personal information, or you come to realize there is someone close to you that may need support, it's not unusual to feel shock, confusion, hurt, grief, guilt, mistrust, and/or other strong emotions. There are a host of feelings you may have experienced since discovering that your partner is, and has been, bulimic. Your reactions are understandable since you probably assumed that you knew almost everything about your partner. Remind yourself that your partner probably did not intend to hurt you by keeping her bulimia a secret. She may have wanted to let you know, but could not bring herself to tell you about it. People with bulimia almost always carefully hide their behaviors from others, especially loved ones.

So, what should you do? It's clear that you have a lot of questions that you want answered, but it also appears that your partner is not yet ready to answer them. She probably needs more time before sharing such personal, and likely painful, information with you. For now, just let her know that you are there for her when she needs you. Also, if possible, try to encourage her to seek the professional help that will help her on a path to overcoming bulimia, if she hasn't already. If she is not open to your suggestion, then it may be best to approach her about this at another time.

It is also important to know that people with eating disorders are not the only ones who seek help; their families and friends also seek and find assistance. If your partner is not ready to talk, you may want to learn more about bulimia from some other reputable sources. You can start by browsing the related questions below. Other options include speaking with someone who understands, and share your feelings with her/him.

You and your partner are lucky to have a variety of good resources to aid you in your processes, individual and joint, to get help. By getting help, you and your partner may be able to better cope with, and understand, the varied emotions you have been feeling. You should be able to get a referral to a therapist and/or registered dietician by talking with your health care provider.

You and your partner may also want to contact the The National Eating Disorders Association. Don't forget to search through the Go Ask Alice! Nutrition and Physical Activity archive for more information about bulimia. In particular, read Eating disorders vs. normal eating for more general information. And, an excellent book for you to read that is written specifically for families and friends of people with eating disorders is, Surviving an Eating Disorder: Strategies for Family and Friends, by Michelle Siegel, Judith Brisman, and Margot Weinshel.

It's important to keep in mind that if your partner is not ready for professional assistance at this time, you can still seek the help you need. Take care of yourself first; in that way, you can be a stronger support person for your partner.

Alice

Managing high blood pressure through diet

Dear Reader,

Hypertension is known as the "silent killer" and is one of the most common diseases of the cardiovascular system. It is defined as a condition of sustained elevated pressure in the arteries of 140/90 or higher. In this case, 140 is the systolic pressure. Simply put, systolic pressure represents the blood pressure against the arteries while the heart is contracting or beating. The number 90 is the diastolic pressure, meaning the blood pressure while the heart is relaxing or between beats. People who are genetically sensitive to sodium experience high blood pressure from excesses in salt intake. People who are most likely to be salt sensitive include children of parents with hypertension, African Americans, and people over 50 years of age. It is important to keep in mind that not everyone is salt sensitive. As hypertension in the body becomes prolonged, the risk for heart failure, vascular disease, kidney (renal) failure, and stroke increases.

Although there has been no cause identified for hypertension in 90 percent of people, dietary factors have been shown to influence blood pressure. People with hypertension can use the following food guidelines:

Avoid foods high in sodium.
Sodium causes vasoconstriction, the narrowing of blood vessels. Therefore, the amount of space blood has to travel through decreases. This decrease creates an increase in the resistance the blood has to overcome. This increased resistance makes it more difficult for the arteries to expand with each beat of the heart, causing the internal pressure to rise. High sodium foods include processed meats, salted snack foods, cheeses, and canned foods.

Eat foods high in potassium.
Good dietary sources of potassium include bananas, potatoes, avocados, tomato juice, grapefruit juice, and acorn squash. Potassium helps maintain intracellular osmotic pressure, which is the force required to stop the flow of water across a membrane.

Limit adding salt to foods, particularly in restaurants.
Most foods, especially at restaurants, are already high in sodium.

Use salt substitutes.

Eat calcium and magnesium rich foods to help reduce blood pressure.
Food sources rich in calcium include low-fat milk, green beans, sardines with bones, broccoli, spinach, and tofu. Good sources of magnesium-rich foods include any legumes and seeds, such as navy beans and sunflower seeds.

Lower saturated fat intake.
Saturated fat increases the level of low density lipoproteins (LDL), which tend to stick to the sides of the arterial wall. This deposit of fat is known as atherosclerosis. Atherosclerosis begins with the accumulation of fatty streaks on the inner arterial walls. When this fatty buildup enlarges and becomes hardened with minerals, such as calcium, it forms plaque. Plaque stiffens the arteries and narrows the passages through them. Thus, blood pressure rises. This rise in blood pressure is due to the arteries' lack of elasticity.

Hypertension can also be treated with drugs, including diuretics, beta blockers, calcium channel blockers, and ACE inhibitors. Talk with your health care provider to see what treatment is best for you, if you need it.

According to a Harvard research study, the DASH! Diet could be another possible way to decrease blood pressure. DASH! stands for Dietary Approaches to Stop Hypertension. The Dash trials began with 459 adults with systolic pressure of less than 160 and diastolic pressure between 80 and 95. The Dash study randomly assigned people to one of three diets for eight weeks. The first diet was the Control Diet. This diet had levels of fat and cholesterol that matched the average American's diet. It had lower than average levels of potassium, magnesium, and calcium. The other two groups were divided into a "Fruit and Vegetable Diet" and a "Combination Diet." The Fruit and Vegetable group matched the control group in fat, saturated fat, cholesterol, and protein. However, the difference was that this diet had more potassium and magnesium. The fruit and vegetable diet reduced systolic blood pressure 2.8 mm Hg more than the control diet. It also reduced diastolic blood pressure 1.1 mm Hg more than the control. The Combination Diet had less total fat, saturated fat, and cholesterol than the fruit and vegetable and control diets. The combination diet, rich in fruits, vegetables, and low-fat dairy products, also had more potassium, magnesium, calcium, fiber, and protein. This combination diet reduced systolic blood pressure 5.5 mm Hg more than the control diet. It also reduced diastolic blood pressure 3.0 mm Hg more than the control diet.

To adapt the Dash Diet into your lifestyle, follow these guidelines:

  • Make gradual changes in your eating patterns.
  • Center your meal around carbohydrates, such as pastas, rice, beans, or vegetables.
  • Increase consumption of fruits and vegetables.
  • Treat meat as one part of the whole meal.
  • Decrease use of fat.

For example, total number of servings in a 2,000 calorie per day menu would look like this:

Food Group Servings
Grains 8
Vegetables 4
Fruits 5
Dairy Foods 3
Meats, Poultry, & Fish 2
Nuts, Legumes, & Seeds 1
Fats & Oils 2.5

For more info on the Dash Diet, you can go to the Harvard Medical School Family Health Guide website.

Finally, weight loss is recommended if you are overweight. Obesity can worsen hypertension. Extra adipose tissue means miles of extra capillaries through which the blood must be pumped. Weight loss can be accomplished through aerobic activity. Aerobic exercise will utilize fat stored in the body. This, along with weight training, will increase your muscle mass, which, in turn, will raise your metabolic rate. Therefore, you will expend more calories throughout the day.

Alice
[Material adapted from:

Marieb, Elaine N. Human Anatomy and Physiology. CA: The Benjamin/Cummings Publishing Co., 1997: p. 710.

Whitney, Eleanor and Sharon Rolfes, eds. Understanding Nutrition. Minneapolis/St. Paul: West Publishing Co., 1996.]


What's more important: Calories or fat grams?

Dear Reader,

A calorie is the standard unit for measuring energy released from energy-yielding nutrients, such as fat, protein, and carbohydrate. Fat is an essential nutrient that helps the body transport and absorb fat-soluble vitamins (e.g., A, D, E, and K), among other functions. Whereas proteins and carbohydrates have only four calories of energy per gram, fat has nine. Food labels are federally standardized to help make it easier for the consumer to know what's in a particular food. You can calculate the percentage of calories from fat by looking at the column marked "Percent Daily Value" for total fat and simply add up these percentages. It's recommended that fat make up no more than 30 percent of your daily diet (meaning less than or equal to 30 percent of total calories a day from fat).

Although it is important to watch both calories and fat grams, it's best to focus on  the total number of calories consumed, which often seems to be forgotten. With the introduction of low-fat and fat-free versions of many common foods, you'd expect people to lose weight. Instead, many are either staying at the same weight or even gaining weight. Sometimes you can eat more of these foods than their full-fat versions for the same number of calories. However, sometimes low-fat foods contain more sugar than their full-fat cousins, and hence as many calories per serving. Ultimately, if you eat more calories than your body expends, regardless of whether these calories come from fat, protein, or carbohydrates, you will gain weight. Unused energy is converted and stored as excess body fat.

The amount of calories a person needs is based on body weight, age, gender and physical activity level. Generally, 1200 to 1400 calories per day is considered low, and anything above 2400 is considered too much. To find out how many calories you should be getting a day, check out the MyPlate website. This USDA-sponsored site will ask you to input your age, gender, weight, height and physical activity level in order to determine what caloric intake will be right for you. You can also check out Ideal Caloric Intake? in the Go Ask Alice! archives for more information on calorie counting.

Alice

Are plastic wrap and containers safe for microwaving food?

Dear Reader,

You are quite right that some questions have been raised about whether microwaving food using plastic wrap and plastic containers is harmful to our health. Much of the focus has been on plasticizers (chemicals used to make plastic more flexible), polyvinyl chloride, and polycarbonate. More recently, bisphenol-A (BPA), primarily used in hard plastics like polycarbonate, has also been called into question.

Research suggests that plasticizers, BPA, and other chemicals may leach into food while being heated in a microwave. Plastics tend to break down and release chemicals when exposed to high temperatures, and the fear is that some plasticizers could mimic or compete with our hormones, producing a hormonal imbalance. This imbalance has been associated with the development of cancer, birth defects, and fertility difficulties. The United States Food and Drug Administration (FDA) does consider BPA to be an endocrine disruptor, meaning it can alter hormonal levels if present in high enough quantities. What is in dispute, however, is whether BPA and other chemicals leach into food in amounts high enough to cause serious health issues. Recently the FDA updated its stance on BPA to indicate moderate concern about its harmful effects during fetal development and for infants and young children. However, the FDA has not taken the same position regarding adults, who are generally less susceptible to chemicals.

While time and more testing will show whether or not heated plastics pose a health threat, limiting exposure to plastic containers with BPA, and all plastics when heated in a microwave, is a precaution some people have decided to take recently. Infants and developing embryos are especially vulnerable to potential chemical leaching, so pregnant and breastfeeding women and parents with young children might want to be particularly careful not to heat plastics in the microwave.

Here are some hints for safe microwaving:

  • Choose microwave-safe plastic wrap and never let it directly contact food.
  • Try using waxed or parchment paper instead of plastic wrap.
  • Only use containers that have been designated as microwave-safe. Best to use microwaveable glass and ceramic cookware. Otherwise, choose those made of polyethylene plastic which is plasticizer-free.
  • Never use microwave convenience food trays and containers more than once.
  • Do not microwave plastic containers used for cold food storage. They often melt and warp because they are not designed to withstand the high heat of microwaving.
  • Avoid microwaving food in freezer cartons and on Styrofoam trays.

Since microwaves are so common this is information everyone can use. Thanks again for the heads up!

Alice

St. John's wort

Dear M,

What’s the word on St. John’s wort? Also known by its botanical name, Hypericum perforatum, this supplement is derived from a yellow flowering plant. It has been used — with mixed results — as an herbal remedy for a wide range of ailments, including mild to moderate depression, menopausal symptoms, somatization disorder (when mental experiences are converted into physical symptoms in the body), and wound healing. Research suggests that St. John's wort raises levels of serotonin, norepinephrine, and dopamine (different neurotransmitters that help boost morale and mood), but the active ingredient that produces this effect is still unknown. More research is needed to better understand how St. John’s wort works and what beneficial effects it may have on health. You also asked about the recommended dosage for this supplement. How much of the supplement to take and the number of times you'll need to take it daily will vary depending upon the condition you wish to treat.

Although the evidence is mixed, there are a number of studies that suggest St. John’s wort can be effective in treating depression without the side effects common to traditional anti-depressant medications (It’s good to note that it’s not recommended for the treatment of severe depression). Unlike prescription anti-depressants, which can cause side effects such as lowered sex drive and delayed ejaculation and/or orgasm, the same sexual side effects have not been associated with the use of St. John's wort. However, this does not mean that the supplement is free from potential adverse side effects, some of which include:

  • Fatigue
  • Dry mouth
  • Dizziness
  • Vivid dreams
  • Headache
  • Skin rash
  • Gastrointestinal discomfort, such as diarrhea
  • Allergic reactions
  • Irritability
  • Restlessness
  • Increased sensitivity to sunlight
  • Confusion
  • Anxiety

Due to the lack of scientific evidence, it’s hard to know how taking St. John’s wort may affect different individuals. You may want to be especially wary of taking this supplement if you’re:

  • Taking prescription medications. Anti-depressant medications, monoamine oxidase inhibitors (MAOIs), and HIV/AIDS medications combined with St. John’s wort can lead to possibly dangerous interactions. Additionally, St. John’s wort can affect how the body metabolizes medicine, which may make certain medications less effective. If you’re using any other medications, prescription or otherwise, it’s best to let your health care provider know before taking this herbal supplement.
  • Pregnant or breastfeeding. Limited research has been done on women who are pregnant or breastfeeding. Until more is known, women who are pregnant or breastfeeding are advised not to take St. John's wort.
  • Have certain health conditions. Components of St. John's wort may raise blood pressure, possibly resulting in a stroke. Those who are already at risk of high blood pressure should be especially cautious.

As a rule, it’s helpful to remember that "natural" does not necessarily mean safe. Since St. John's wort is an herbal supplement and not regulated by the U.S. Food and Drug Administration (FDA), the quality of the supplement may vary. For more even more detailed information, check out the National Center for Complementary and Alternative Medicine website. Before trying St. John's wort, or any other natural supplement, it’s recommended that you talk with your health care provider. Doing so may help you gather all of the necessary information to decide wort the best course of action is for you.

Alice

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

Medical Services (Morningside)

Student Health Service (CUMC)


Better to drink warm rather than cold water?

Dear J,

Staying well-hydrated is extremely important for an active athlete. It's great that you want to make staying hydrated as easy and healthy for your body as possible. In this case though, you're in luck — health and preference coincide!

In a happy coincidence of what feels good and what's good for you, it's actually cold water that's recommended when exercising vigorously. During intense physical activity, the body's core temperature rises above the normal 98.6°F (37°C). Drinking cool water lowers the body's temperature and helps it settle back to its normal range. Studies have also shown that cold water 41°F (5°C) is absorbed more quickly from the stomach than warm, abating dehydration and allowing you to play harder and enjoy your game of soccer even more. Sweating also helps to lower the body's temperature, but through sweating we lose a lot of water, so it's important to keep drinking.

The body is smart and often craves what it needs. That doesn't mean you should have an ice cream sundae every time you get a hankering, but in this case, cold water is what you want and cold water is what your body uses best. That said, if the only water around is warm, or if some prefer it warm, that's ok too. The main point is — listen to your body, stay hydrated, and have fun!

Alice

Iron, calcium, and constipation, oh my!

Dear Calcium and Iron Maiden,

It seems like you're approaching a supplement regimen with a healthy consideration of various factors like absorption and affects on your system — a great idea! You're right that there are certain foods that can inhibit iron absorption, like the oxalic acid in spinach, phosphates primarily in milk, other dairy products, and egg whites, phytates in beans, and tannins in tea and coffee. While it would take a lot of these foods to seriously impair your ability to absorb iron, you might want to consider going easy on them while trying to boost iron levels.

On the opposite side of the spectrum, there are many foods that are rich in iron, and it's usually preferable to get your essential nutrients from food rather than supplements. The body has an easier time digesting and absorbing nutrients like iron and calcium in the amounts and forms in which they occur naturally. You can check out Sources of Iron in Alice's Fitness & Nutrition archives for a list of these iron-boosting foods (sneak preview: meat, fish, dark leafy greens, dried beans, and nuts are all healthy iron-rich foods). Another dietary tactic to boost iron absorption is to eat a vitamin C rich food with your iron-rich food or supplement, as vitamin C aids in iron absorption. For example, eating citrus (oranges, grapefruits, lemons) along with your spinach salad will help unlock the iron in spinach. You can also cook your food in cast iron pots and pans to enrich your food with iron.

In terms of your sensitive GI system, the least constipating iron formula is hydrolyzed protein chelate, but again, diet can come into play here. In addition to looking for gentle and non-constipating types of iron supplements, you can also alleviate constipation by drinking plenty of water and by eating fibrous foods like whole grains, fresh fruits, fresh vegetables, and other foods as unprocessed as you can find them (whole grain bread instead of white, whole grain pasta instead of white, brown rice instead of white). It's a good idea to increase fiber intake slowly — too much too soon can cause gas and bloating. And to underscore again, when increasing fiber it's important to drink even more water than you think you need to make sure all that bulk moves through your system smoothly.

As for calcium, the two most common forms in supplements are calcium citrate and calcium carbonate. Studies show that calcium citrate is the most absorbable supplement form, and may be taken between or with meals. Vitamin D helps to assimilate calcium into bones. When exposed to sufficient sunlight, the human body synthesizes its own vitamin D. Fatty fish like salmon, tuna, and sardines are great food sources of vitamin D. If you want a D supplement, which might be a good idea for folks who live in northern climates and don't get adequate sun exposure during the winter, or for people who don't eat a lot of fish, look for supplements that contain vitamin D3 (cholecalciferol), rather than vitamin D2 (ergocalciferol) — vitamin D3 is more potent. You might also want to consider taking a magnesium supplement with your calcium at a ration of two-parts calcium to one part magnesium, as magnesium is needed to fully absorb and utilize calcium.

Finally, see if you can avoid taking your calcium and iron supplements together, as they compete for absorption. It may seem like a lot of juggling of different foods, supplements, and timing of the two, but hopefully this kind of careful consideration and knowledge will boost your iron and calcium levels to new heights.

Farewell, fair Iron (and calcium) Maiden,

Alice

I want a flat stomach!

Dear help,

This may seem like bad news, but it simply is not possible for every human being to have a stomach as flat as some of the models we see in magazine and newspaper ads, on the sides of buses, and, well, just about everywhere. The fact of the matter is that a really flat stomach may not be in your genes! Among many other physical traits, a person's genetic makeup determines the shape of internal organs (e.g., stomach, intestines, liver, kidneys). Depending on these organs' shapes and sizes, they may or may not contribute to a slight roundedness of our stomachs. Another aspect of body shape under genetic control is body fat distribution. Your body may naturally store more fat around your waist than in other areas of your body.

When done correctly, crunches can be a good way to strengthen abdominal muscles and the lower back. However, ab work alone will not burn fat of the stomach region specifically. It's a myth that a rigorous sit-up routine will guarantee a flat tummy. Instead of concentrating so much on your stomach, why not try an exercise program that works out a greater range of muscle groups and involves some cardiovascular fitness? If there really is fat to be lost around your stomach, running, swimming, or biking regularly will be more effective at burning it than only doing sit-ups.

You might also want to examine your eating plan; a healthy diet is a good idea for anybody (see the Related Q&As listed below for some nutrition tips). And finally, keep in mind that a flat stomach is not necessarily the essence of beauty or an indicator of good health. You may find that eating nutritiously, exercising regularly, and accepting your body's natural shape and size will help you feel good about yourself and your stomach.

Alice

March 20, 2012

508886
I wish "Alice" had pointed out that a lot of the sexy, flat stomachs we see in ads are photoshopped. It may look like everybody who's anybody has a flat, even muscular stomach, but that's only...
I wish "Alice" had pointed out that a lot of the sexy, flat stomachs we see in ads are photoshopped. It may look like everybody who's anybody has a flat, even muscular stomach, but that's only because of the magic of technology, not to mention the unhealthy standards of beauty that models are forced to aspire to if they want to continue working.

Pros and cons of vegetarianism

Dear Reader,

It's a great idea to plan consciously when switching over to a vegetarian diet. Not eating meat can offer many health benefits, as well as addressing environmental and ethical concerns you may have regarding eating animals. However, before making the switch to a meat-free lifestyle, it is important to get a sense of the pros and cons.

Here’s the best news of all: with a well-planned diet, vegetarians can live a totally healthy lifestyle and help contribute to a better planet. The following list describes various benefits of vegetarianism:

  • Plant foods are abundant in nutrients, including vitamins, minerals, and protein. They also contain phytochemicals — plant chemicals that are not essential to life, but may help protect against disease — such as beta-carotene. Eating a variety of colors of fruits and vegetables can help ensure that the benefits nature provides are reaped.
  • Reduce your risk of type 2 diabetes. Vegetarians benefit from eating less saturated fat and cholesterol, and higher amounts of complex carbohydrates, dietary fiber, certain minerals, and phytochemicals. Cholesterol is only found in animal foods, so vegan diets are completely cholesterol-free.
  • Contribute to the vegetarian cause! Whether you have aim to respect animals, lessen your carbon footprint on the environment, or just want to make a lifestyle change, as a vegetarian you are making your own positive impact on the world. You can be proud that you are living according to the beliefs that you stand for.

Whenever you cut a food group out of your diet, it is important to understand how to replace the vital nutrients that go along with it. While the positives are all fine and dandy, it is important to be aware of the challenges of being a vegetarian:

  • It can be harder to get the protein you need. Protein is important formaintaining and repairing muscle tissue, and manufacturing blood cells, antibodies, hormones, and enzymes. Fortunately, there are plenty of non-meat proteins to supplement your diet.
  • Possible vitamin and mineral deficiencies can develop without a balanced eating plan. Cutting out dairy, meat, fish, and poultry reduces your intake of vitamin B12 (important for nerve transmission and necessary for life), calcium (for strong bones, among other functions), iron (for blood), and zinc (for immunity and healing), just to name a few.
  • Depending on where you live, it may be challenging to adhere to a meat-free lifestyle. For example, living in a big city may provide you with endless veggie options, while a small-town lifestyle may make it more difficult to find healthy substitutions for meat.
  • You may have difficulty explaining your eating habits to family and friends.While it may seem that being a vegetarian is relatively mainstream, certain cultures leave little room for herbivores. You may encounter some sticky situations where people have prepared for you a meaty meal, or perhaps, your friends and family may challenge your decision to remain meat-free.

Remember, what is included in your diet (rather than what is excluded) is what counts. It is extremely important to incorporate a balanced eating plan full of nutrient-rich foods. For help in selecting a healthy eating plan appropriate for your state of health, age, size, activity level, preferences, and moral and ethical values, consult with a registered dietitian. Informed choices are the best choices!

Alice

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

Medical Services (Morningside)

Medical Services (CUMC)


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