Nutrition & Physical Activity
Dear the Pounds Thief,
Kudos to both of you for trying to maintain healthy eating patterns during the major life transition of moving in together! Your question seems to indicate that you two have different nutritional needs, but not wildly different diets. The good news is that your nutritional needs may not be as different as you think; what will vary more are you daily caloric requirements. The other good news is that partners who have very different diets move in together all the time: vegans with carnivorous dairy lovers, gluten-free and gluten-loving people, diabetics with non-diabetics, pescatarians with vegetarians. You get the idea. So you’re in good company as you try to figure this all out.
Two primary factors determine one’s caloric needs: body size and activity level. Sedentary people (regardless of gender) need about 13 calories per pound of body weight per day. Moderately active people need about 16 calories for every pound per day, and very active people should boost that amount to about 18. People tend to over-estimate how much protein they need. As a general rule, people of any activity level and gender and size need only 15 percent of their daily calories to be from proteins. Excess protein can decrease calcium absorption and cause calcium to be lost in the urine. Excess protein is also stored as fat, so it can contribute to weight gain from fat, not only muscle. Excess protein can also cause kidney stones. Typically 6-8 ounces of meat will cover it, less if you are eating other protein rich foods like beans and some cheeses.
Approximately 45-65 percent of your daily calories should be from carbohydrates. The more fiber in those sources, the better. It’s also great if your carbohydrates are coming from dark leafy greens like kale and spinach, because these will also have lots of iron and B vitamins.
Fat consumption should be below 30-35 percent of your total caloric intake (or 20-25 percent if weight loss is a concern). Try to avoid trans fats (found in some types of margarine, fried foods at restaurants, and store-bought snacks). And try to have more mono-unsaturated fats (avocadoes, olive oil, flax, fish) then saturated fats (found in dairy, vegetable oil, and meats).
Couples with different caloric or dietary needs may need to do a bit more planning and be more intentional about their menus than others. There is no rule that says you have to eat exactly the same items at the same time and in the same amounts. Here are some tips to help with meal times:
- If you’re worried about portion control, try to be mindful of how much you put on your plate at a time. People often feel compelled to finish what’s on their plate, even if they are no longer hungry. Try loading your plate with less and then going back for more if you’re still hungry.
- Try to keep fewer unhealthy snacks in the house. If they aren’t there, you’re less likely to consume the “empty calories” from these snacks when you get hungry.
- Speaking of snacks, do you snack throughout the day? If not, consider trying it! People will eat less at meal times if they have been snacking some throughout the day. This also is easier on your metabolism and digestive system. Try keeping lots of healthy snacks around: whole grain breads, yogurt, granola, fruit, carrots, raisins, walnuts, and celery are all good, healthy, lean yet filling snack choices that will put a dent in your appetite by dinner.
- Along these same lines, don’t skip meals! This will make you hungrier by dinner and that’s when people are most likely to eat more than needed.
- Buy foods you both like and alternate nights cooking for each other. On the night your partner cooks for you, eat the foods you most prefer. If it is not quite enough for him, perhaps he can cook up a side dish to give him a little extra. On the night you cook for him, make him a meal he loves. If he doesn’t want veggies, cook up a side of veggies for yourself. This can be a great way to honor each other’s dietary preferences.
- Do you like cooking together? Consider taking a cooking class or checking out some recipes online that might incorporate food ingredients that you both would enjoy. Make it a fun project of discovery.
As you noted, having different activity levels and different dietary needs in the same household can be a source of stress. But, working through and honoring these differences can also strengthen a relationship. As the poet Rainer Maria Rilke said: “Once the realization is accepted that even between the closest human beings infinite distances continue, a wonderful living side by side can grow, if they succeed in loving the distance between them, which makes it possible for each to see the other whole against the sky.”
Here’s to love and food,
Kudos to you for developing a healthy workout habit! No matter how fit and healthy you are, all runners require rest periods in order to allow the body to recover and grow stronger. How much rest one needs depends on a lot of factors, such as the type of training one is doing, ageing, injuries, illness, and increases in exercise intensity. Some runners take only one day off per week and find that this is sufficient. Others find that they are their healthiest when they take more. After an intense run, muscles need about 48 hours to recover. Do you find that you are quite sore after running for three days? If so, are you still sore or stiff after your day of rest? If so, this may be an indication that you could benefit from a bit more rest, but there are other causes of soreness besides not enough rest. In addition to soreness, significant weight loss, difficulty sleeping, or an elevated resting heart rate are other indicators you may need more rest.
Running is one the best endurance sports you can do — it gives your cardiovascular system a great workout. It also gives your body quite a beating and this is one reason why rest periods for runners are particularly important. But a day off doesn’t have to mean a day off from all physical activity. Many runners (and other athletes, as well) find that they benefit from what’s known as the “active rest.” This involves doing some other activity in place of running and toning down the intensity level somewhat. Your rest day activity could involve a brisk walk, racquetball, swimming, or riding a bike, for instance. All of these are more low-impact than endurance running and give your body a different type of work out, allowing you to use different muscle groups.
Rest allows your muscles, tendons, ligaments, and bones the opportunity to recover from the beating they take during your 50 minute runs, but there are other ways to ease the stress on your body:
- A good stretch both before and after your run.
- Frequently replacing your running shoes.
- A long warm up (run slowly and ideally on a flat surface for the first 10-15 minutes of your run).
- A cool down period (5-10 minutes of a brisk walk or very slow jog at the end of your run).
- Hydration! Drink plenty of water.
Another good argument for changing up the type of exercise you do on your rest days is that your body “adjusts” to your workouts, which means that over time, if you do the same activity, your body becomes so good at it that the workout produces fewer benefits, even as you increase the intensity. Changing the type of activity “shocks” your body, as it is doing something it is less accustomed to and thus working harder. This extra hard work allows you to reap more benefits. Plus, variety keeps life interesting.
But even if you stick with your 50 minute runs 3-4 times a week, you are doing a great thing for your body. Good for you and keep it up! If you are a Columbia student, check out CU Move for tons of resources, information, and ideas for staying active. Your body will thank you.
March 19, 2012508798
Dear Da Windex Guy,
The cheapest and safest way to get tickets to the gun show is to hit the gym! Whereas human growth hormone (HGH) products like Sytropin may help your friend beef up, it only does so in the short-term while also beefing up other hormones in the body that may lead to some unintended side effects (as you suspected). As a general rule, take caution when using any substance that isn’t approved by the Food and Drug Administration (FDA) as well as using prescription drugs without the okay from a health care provider.
Initial development and prescription of HGH products were for people with growth disorders and for people with diseases such as AIDS who had growth hormone deficiencies. Now HGH has gotten a reputation for being abused in the sports world and also used controversially to increase milk production in cows. Normally, the pituitary gland (located in the base of the brain) regulates the natural release of HGH. Products like Sytropin introduce synthetic HGH into the body promoting cell growth, reproduction, and regeneration. This, in turn, reduces fat in the body, and increases lean body mass (muscle mass and bone density) and exercise capacity. However, though HGH may increase bulk, there is no solid proof that it increases strength or improves athletic ability (at least not in the long-term).
Your hesitation in using Sytropin or other HGH products is warranted because there is no solid evidence to prove their safety. HGH is only legally available by prescription and scientists still aren’t certain whether HGH taken in pill or spray form (like Sytropin) are effective. Other side effects of HGH use may include:
- Swelling in the limbs.
- Pain in the joints and muscles.
- Gynecomastia (swelling of the breast tissue in men).
- Higher risk for heart disease and diabetes due to increases in insulin and cortisol.
- Potential insulin resistance.
List adapted from the Mayo Clinic
Those who reap the most benefits of using HGH are people who have problems naturally producing growth hormone. The average Jane or Joe looking to boost their muscle volume will likely have the same luck (sans potential HGH side effects) if they stick to a healthy diet and workout regime. Though it may seem tempting to buy scalped tickets to the gun show from Sytropin, investing the extra time and effort into physical exercise is the best and safest approach to securing front row seats. Check out the exercise and diet tips in the Related Q&As below for more information.
Creating an at-home exercise program is a great way to get more physically fit, especially if you have limited time and resources. The good news is you can have a well-rounded workout without ever stepping in a gym or using machines! Current CDC and USDA recommendations for physical activity are at least 150 minutes of moderate intensity each week, spread out over at least three days. Moderate intensity simply means that you will raise your heart rate and break a sweat. Strengthening activities are also recommended at least twice a week.
One way to incorporate aerobic and strengthening activities in a home-based workout is by alternating between cardio exercises and strength training exercises. For example, do jumping jacks for two minutes then do push-ups for one minute. Follow this up by repeating jumping jacks for two minutes and doing lunges for one minute, etc. In this type of circuit, you integrate aerobic activities with various strengthening activities in an efficient routine. Other examples of at-home aerobic activities include walking/marching/jogging in place and jumping rope. Sit-ups, squats, and leg lifts can be done at home to strengthen muscles.
In addition to working out in your home, it can be easy to get extra exercise while going about your everyday activities. For example, get off the bus or subway a few stops early and walk the rest of the way. Taking the stairs instead of the elevator is always a good option, as well. And, if you have that extra hour, a brisk 30-minute walk or jog outdoors is great aerobic exercise and you will still have 30 minutes to take a shower and get ready for your next activity!
In addition to the information listed above, the USDA MyPlate initiative is a great resource for physical activity information. Also, many Columbia-affiliated students find Alice!’s physical activity initiative, CU Move, to be helpful. The program provides participants with physical activity tips and tools, motivational messages, and event calendars with access to plenty of free and low-cost physical activity options on campus and around NYC.
Break a sweat!
It can be tricky to check in with a loved one about the concern that they may have an eating disorder. You may be afraid that you'll say something that might shut them down or hurt their feelings. You may be afraid that you're mistaken. This worry may be especially great for you since eating disorders are more prevalent in women (though eating disorders are more common among men than many people realize). Don't let these worries stop you from having an honest conversation about what you have observed and what your concerns are.
First, how might you recognize if a loved one has an eating disorder? There are a few different types of eating disorders, but you need not worry about making an "exact diagnosis." The following may be warning signs of bulimia, but a loved one need not exhibit all these signs in order to have it.
- Frequent complaining or worrying about being overweight.
- Use of "purging" tactics for weight loss, including excessive exercise, herbal weight loss supplements, weight loss medications, laxatives, or forced vomiting after eating.
- Not wanting to eat in front of other people.
- Eating large quantities of food in one sitting.
Warning signs of Anorexia can include:
- Significant weight loss.
- Enjoyment of cooking and preparing meals for others without eating much.
- Significantly distorted body image — sees self as overweight, when he or she is likely significantly underweight.
Some people with eating disorders recognize that they have one, but are afraid to reach out for help. They may be afraid of being judged and/or losing loved ones if they open up about their eating disorder. Others may be in denial about having an eating disorder, while others may have such a low self-esteem that they feel, either consciously or unconsciously, that they do not deserve help. If you are afraid to check in with him about the possibility that he has an eating disorder, it may be helpful to know that eating disorders do not go away on their own and they can have severe health consequences. So the sooner he seeks help, the better his chances of recovery and the less damage that will be done.
But how to bring this up? There are a few good guidelines to cover that will help you convey a nonjudgmental attitude and also help ensure you are respecting your boyfriend's privacy:
- Make the basis of the conversation about your worry. Try to remain positive while also explaining that you care about him and because of this, you are worried about his health and his emotional state.
- Avoid comments about his appearance. Some people with eating disorders will not be affected, while others will be extremely affected by hearing your assessment of their weight (e.g. they may be flattered or they may be horrified. Either way, you may inadvertently reinforce their restricted eating or purging).
- Do not demand that he eat or change his behavior.
- Avoid placing blame or giving advice.
- Watch out for accidental "fat phobic" remarks that you might make inadvertently (in other words, avoid making disparaging remarks about weight or overweight people). Avoid making remarks even about your own body weight.
Aside from offering you nonjudgmental support, the most important thing you can do for a person with an eating disorder is to encourage him or her to get treatment. The longer an eating disorder remains undiagnosed and untreated, the harder it is on the body and the more difficult to overcome, so urge your boyfriend to see a therapist or his health care provider right away. If your boyfriend is a Columbia student, he can make an appointment with Counseling and Psychotherapy Services (CPS) or with his primary care provider through Open Communicator.
It may also be worth checking out the following resources:
- The National Eating Disorders Association's 24-hour information and referral helpline at 1-800-931-2237
- Eating Disorder Referral and Information Center
- Something Fishy Website on Eating Disorders
Recovering from an eating disorder usually takes time. Kudos to you for your patience and your willingness to support someone struggling with an eating disorder. This may at times be difficult for you, too, so make sure you are getting support, as well, whether it be through friends, family, and/or therapy.
Props to you for wanting to donate blood! Alas, isn't it iron(ic) that one of the foods with higher iron content also may contain an iron absorption inhibitor? It's one thing to worry about getting enough iron through your food sources, but a whole other thing to worry about whether that iron is actually being absorbed. Boosting your hemoglobin by upping your iron intake shouldn't be too tricky, but know that there are a number of possible causes for low hemoglobin — being low on iron is only one cause (more on that later).
Let's discuss the raisin bran question first. Phytic acid is often found in foods that contain whole grains, including some types of raisin bran. In large enough quantities, phytic acid can inhibit your body's iron absorption. This is annoying since these foods may also be high in iron. In addition to iron absorption inhibitors, there are also substances that aid in iron absorption. The primary is vitamin C, which is often also found in raisin bran. Your best bet is to check food labels so you know when you are consuming foods that contain phytic acid (and also whether it contains a substance such as vitamin C, which will help you absorb iron). If food products contain iron and phytic acid, chances are you'll still likely get at least some iron benefit from them (especially if that food contains vitamin C, too); however, it's wise to have additional sources or iron other than raisin bran. Another iron absorption inhibitor is tannic acid, which is often found in red wine, coffee, some teas, chocolate, and some sodas.
So what does all this mean? Diversified food sources of iron will be your best bet in ensuring that you meet your recommended daily allowance, but there's no harm in making raisin bran one of those sources. Check out the Q&A's below for more information on iron, how much you need, and getting enough of it through your diet.
Now, are you sure low iron is the cause of your low hemoglobin? There are several other possible causes. Cirrhosis (scarring) of the liver is one cause. Some common causes of cirrhosis include alcohol abuse, hepatitis B or C, cystic fibrosis, and some parasites caused by chronic liver damage. These conditions, as well as the cirrhosis itself, would likely be accompanied by additional symptoms, such as fatigue, nausea, weight loss, and/or easy bruising.
Other causes can include certain cancers of the blood (e.g. leukemia, multiple Myeloma) or of the lymphatic system (e.g. Hodgkin's and non-Hodgkin's lymphoma), enlarged spleen (splenomeglamy), or vasculitis (inflammation of blood vessels caused by an autoimmune response of various origins). Though anemia and iron deficiency are common causes of low hemoglobin, it may be worth a trip to your health care provider to rule out these other causes.
Happy hemoglobin boosting!
Dear A Sip of Calm,
Can we actually find relaxation in a can? Seems like it could be a great idea, unfortunately, at this point in time, it's just too good to be true. Just like herbal supplements, the FDA does not require companies manufacturing the "relaxation beverages" to prove their claims or standardize their ingredients. As such, there is no conclusive scientific evidence that any of these products are safe and effective. What little research has been done has shown that many compounds in these drinks, such as 5-HTP and melatonin, degrade in water. Other ingredients such as GABA, cannot cross the blood-brain barrier so are completely ineffective. One study even tested five popular brands and found that many of the ingredients listed were barely even present in the drinks themselves!
Two popular ingredients in relaxation beverages that have been studied are valerian and kava and the news is not good. Valerian can cause dependency if taken regularly while kava has been shown to cause liver damage. These types of ingredients can also interact with medications such as Allegra or benzodiazepines (Xanax, Valium, Atvian, etc.) or even with Tylenol and cause serious health problems.
What's your best bet for relaxation? For starters, maintaining a proper diet, exercising, and trying to keep a regular sleep schedule can contribute to feelings of relaxation. You may also want to try meditation and/or yoga.
In the end, it seems as if nothing beats a glass of warm milk or hot (decaf) tea to unwind in the evening.
First of all, the fact that you are reaching out for help takes lots of strength and is incredibly brave. It is also a very good sign for recovery. Your willingness to attend the eating disorders group at Columbia, visit Barnard Health Services, talk openly with your therapist and your parents, and write here, shows a lot of determination and courage, qualities which have probably gotten you through other challenges previously in your life.
Your questions about various forms of treatment are good ones. Most studies put the recovery rate for outpatient treatment (what you are currently receiving) at about 60 to 70%. Studies indicate that the vast majority of hospitalized patients respond favorably to treatment. However, (and this is what your therapist may be referring to), there are high relapse rates following hospitalization (30 to 50%) so what happens after hospitalization is crucial to maintaining the benefits. Relapse rates for outpatient treatment aren’t available because it’s often so unsuccessful in the first place, that it’s too tricky to accurately measure relapse rates. The fact that the data is skewed in this way may make hospitalization look less effective than it is. If your gut is telling you that it’s time for hospitalization, keep fighting for it. Tell your parents and therapist that you think it is best for you right now. They need to understand that you have a potentially life threatening condition. It is not your fault. It’s not a character flaw. You deserve treatment.
Hospitals that treat eating disorders do so holistically. Anorexia needs to be addressed from a nutritional, bio-chemical, psychological, and social perspective. They have you work with psychiatrists, psychologists, dieticians, gastro-enterologists, endocrinologists, and other health care providers. Any co-occurring issues such as substance use, depression, body distortions, etc. need to also be addressed, and hospitals that treat eating disorders understand this. When people are released from the hospital, it can feel like a significant loss of structure and support. Therefore, it is important that you, the hospital, your parents, and therapist plan for this and have such structures in place.
Research indicates that a combination of individual therapy, group therapy, and family therapy (if you’re living with your family), plus visits with a dietician and medication (often antidepressants) can prevent relapse. Individual therapy should specifically be cognitive behavioral therapy, preferably with a clinician that has had specific training in treatment of eating disorders. And it’s important to know that even in cases of relapse, you can bounce back. When people learn new behaviors and new ways of thinking about themselves, mistakes are almost inevitable and should be expected, because you are changing patterns that are firmly etched into your way of being. As a Barnard student, you have many rich resources around you. For instance, Barnard students can make an appointment to see a professional counselor at the Rosemary Furman Counseling Center.
As far as insurance goes, it may be a good time to have a heart-to-heart with your parents. Let them know how you feel and share any information or research that you have found. The National Eating Disorders Association has specific information on insurance coverage and how you and your parents can discuss what is and is not covered with your insurance company. Your willingness to seek out help is a real strength and will likely inspire other readers. So thank you. For more resources on eating disorders, see these resources and the related Q&As below.
Dear Long Cooker,
Whether you’re an avid chef or a microwave maven, it is important to know that overcooking can deplete the amount of vitamins and minerals in foods. If you are cooking your pasta and beans for as long as you say, you are most likely losing some of their nutritional value. Overcooking destroys bonds between molecules, significantly depleting the nutritional value. For example, overcooking can destroy amino acids and many of the B vitamins, such as Vitamins B-1 and B-5. These vitamins are important for metabolism and energy production.
Generally, shorter cooking time retains more nutrition in a food. Here are a few basic cooking guidelines for your pasta and beans:
Beans, peas, and lentils (members of the legume family) are low in fat and high in fiber, making them a healthy part of your diet. Cooking your beans properly can make them a nutritious and delicious addition to a meal. Dried beans should be soaked overnight in fresh water. They are then cooked for 1-3 hours, depending on the variety of bean. This is standard preparation, and beans cooked in this manner are full of nutrients.
Pasta is a complex carbohydrate, with more fiber and a lower glycemic index than simple sugars. Overcooking pasta can strip it of its fiber content. Most pasta only needs to be boiled between 5 and 15 minutes, depending on the cut of the noodle. Overcooking pasta will only add to the loss of vitamins (especially water-soluble B vitamins) and minerals that occurs when you cook it. Another tip: try not to rinse cooked grains and pasta, as this causes further loss of nutrients.
The style of cooking plays an important role in the overall nutrition of food as well. Whether fresh, steamed, baked, grilled, boiled, or fried, how food is prepared can modify the nutritional content. For instance, boiling leeches more nutrients out of vegetables and beans than baking, as many of the vitamins in vegetables are water-soluble. Steaming and microwaving your food can help maintain the most nutrients.
While it appears that androstenedione has helped some people (a few prominent athletes included) increase their muscle mass and recover more quickly from injury, there is no scientific research supporting these results. In order to help you decide whether such nutritional supplements are right for you, let’s first take a look at androstenedione.
Androstenedione is a direct precursor hormone to testosterone and other hormones including one type of estrogen. It is converted from cholesterol, as are all other steroid hormones. Specific enzymes and hormones, among other things, must be present and ready to work for these conversions to take place. For instance, luteinizing hormone, produced and released by the pituitary gland, plays a pivotal role in converting androstenedione to testosterone. Simply introducing extra androstenedione to your system does not automatically indicate that all of the necessary players will be there to produce testosterone or improve the productivity of your workout.
About sixty years ago, when androstenedione was first synthesized, it was shown to have both androgenic (male hormone-like) and anabolic steroid-like properties. The anabolic effects were considerably less than those of testosterone. Subsequent research found that testosterone levels rose after inhalation of androstenedione, but remained elevated for only a couple of hours, with peak levels lasting a few short minutes.
Beyond these cursory early studies, rigorous studies have come to two broad conclusions about androstenedione. First, despite increasing testosterone levels for those with low baseline testosterone levels such as women and older men, androstenedione has not been shown to increase the testosterone levels of young men or to improve the effectiveness of their exercise regiments aimed at building muscle.
What side effects can you expect from androstenedione? No one knows for sure. Androstenedione falls under the category of steroid hormones, which are known to have androgenic and anabolic properties. Therefore, androstenedione may produce side effects similar to those of testosterone-based anabolic steroids. The most dangerous of these side effects is the increased risk for cardiovascular disease, certain cancers, depression, psychoses, and even extreme aggression. There are also gender-specific effects. For men, these include shrinking testes, increased hair loss, enlarged breasts, and possible sterility. Women may experience side effects such as shrinking breasts and uterus, enlarged clitoris, irregular menstruation, increased facial and body hair growth, and a deepening voice. In fact, due to many potential negative health hazards, the Food and Drug Administration (FDA) has prohibited the sale of over-the-counter androstenedione and similar steroid-like dietary substances.
Is it safe? Safety can be difficult to determine when you don't really know what you're dealing with. Is it worth the risk? That's for you to decide. Before you begin taking any dietary supplements you may want to speak with your healthcare provider. S/he can answer your questions and give you more detailed information. Columbia students might want to consider making an appointment at Medical Services by calling x4-2284 or online using Open Communicator. Students on the Medical Center campus can contact the Student Health Service.