Nutrition & Physical Activity

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Muscle building product (HGH)?

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.

Alice

Working out at home

Dear Reader,

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! The Centers for Disease Control and Prevention (CDC) 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!

Alice

I'm worried my boyfriend has bulimia

Dear Reader,

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:

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.

Take care,

Alice

Relaxation drinks

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.

Alice
Assigned researcher

Raisin bran confusion — is it a good source of iron?

Dear Reader,

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!

Alice

Anorexia and successful hospitalization?

Dear Future-In-Question,

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.

Helpguide.org

National Association of Anorexia Nervosa and Associated Disorders

Eating Disorder HOPE

Take care,

Alice

Overcooked pasta and beans — Still nutritious?

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.

Bon appétit!

Alice

Androstenedione — is it safe?

Dear Reader,

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.

Alice

Desires to feel more confident and sexy about self

Dear Reader,

Sporting sexy things for one's paramour is one of the many perks (no pun intended) of relationship life. And it is a great testament to your relationship that your boyfriend compliments you. Some wise person once said, however, that "reassurance never reassures." So it is possible that his compliments may not be fully sinking in. In order to accept kind words from others, some part of you must also believe the statement. Have you noticed how you react when he compliments you? Are you able to hear and believe positive comments about your appearance?

It is possible that your low self-esteem, or at least your negative evaluation of your appearance, may affect you beyond intimate situations. Do you think this is true? In the western world, the skinny image of feminine beauty is everywhere. Any young child can tell you what an "ideal woman" should look like and very, very few women fit that standard (which is not culturally universal). Many people have internalized negative beliefs about themselves. These messages did not originate with you: They are the voices of young peers, family members, TV, magazine and billboard ads, and other mass-produced images of a standardized and very specific idea of beauty. Once a person has internalized a negative belief about the self, it can be very difficult to unlearn it, especially if you have held the belief for a long time.

So what to do about it? Here are some strategies to address your self-consciousness:

Gaining more insight. Many psychologists believe that suffering can be alleviated through insight. There are many different kinds of insight: You can gain insight about the source of your pain, insight about how and when it operates currently, and insight about how tour low self–esteem may affect other people. Source insight can be helpful because it can help you understand how and when the view was established. Many believe that people experience a type of liberation when they are able to make connections between early experiences and current thinking. You are able to see that your view of self originated outside of you and may very well be distorted. Gaining more insight into how others view you, you may begin to wonder if your own negative view of self is distorted.

Changing thoughts. Even without gaining insight, people can change their belief systems. Cognitive behavioral therapy is one way in which a therapist can help address distorted thinking or false beliefs that you may have about yourself and about your appearance.

Changing emotions. What are the feelings that come up for you when you undress? Do you experience anxiety? Shame? Fear? What emotions come up when you imagine yourself wearing something sexy for your boyfriend? What emotions do you notice yourself feeling when he compliments you? Do you feel happy? Embarrassed? Doubtful? Another benefit of therapy is that it may help you uncover some these emotions and which may allow you to work on changing them. Sometimes, negative self–esteem can be as much about someone's emotional state as one's thought process.

Fake it 'til you make it. Some psychologists believe that changing behavior is what leads feeling better. If you do the things that you'd like to do, even if they cause anxiety, you may eventually become "de-sensitized," meaning that the negative feelings may become less powerful over time and may be replaced by more positive ones, especially if you have good experiences when you take such risks.

A great deal has been written on the subject of body image and self-confidence. If you're looking for some good reads, here's a list:

  • Joan J. Brumberg's, The Body Project: An Intimate History of American Girls
  • Rita Freedman's, Bodylove: Learning to Like Our Looks — and Ourselves and That Special You: FeelingGood about Yourself
  • Marcia Hutchinson's, Transforming Body Image: Learning to Love the Body You Have
  • Ophira Edut and Rebecca Walker’s Body Outlaws: Young Women Write About Body Image and Identity
  • Susie Orbach's, Fat Is a Feminist Issue
  • Kaz Cooke's, Real Gorgeous: The Truth about Body and Beauty
  • Judith Rodin's, Body Traps: Breaking the Binds that Keep You from Feeling Good about Your Body
  • Linda Sanford and Mary Donovan's, Women & Self-Esteem
  • Charles R. Schroeder's, Fat Is Not a Four-Letter Word
  • Eve Ensler's The Good Body
  • Naomi Wolf's, The Beauty Myth: How Images of Beauty are Used Against Women

Whatever you decide to read, seeking support may be another good option. If you are a Columbia student, you can make an appointment to speak with a therapist at Counseling and Psychological Services (Morningside) or the Mental Health Service (CUMC). Best of luck on your journey to feeling more positively and confident about yourself.

Take care,

Alice

March 19, 2012

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Dear reader, What you see as fat, others might see as delicious curves that offer opportunities for holding, stroking, grabbing, and caressing. I think many women, on average, underestimate how...
Dear reader, What you see as fat, others might see as delicious curves that offer opportunities for holding, stroking, grabbing, and caressing. I think many women, on average, underestimate how many men are attracted to a wide range of body types and sizes of body parts. Nothing's sexier than someone who feels sexy in their own skin. That can take time for some people. Good luck!

What's the difference between ionic and colloidal minerals?

Dear D2,

Trying to make sense of all the vitamin and mineral supplements on the pharmacy shelves may make you feel stuck between a rock and a hard place! Before you swallow any information, it is important to know that both ionic minerals and colloidal minerals have a lot of dubious marketing and advertising surrounding them. Manufacturers of colloidal and ionic supplements may make a variety of claims about their products — many of which are not confirmed by scientific research. Moreover, the body doesn’t need a whole lot of minerals; fewer than 20 have been judged to be essential to your health.

A colloid is a mixture in which particles are suspended in a liquid or a gas. Colloidal minerals come from humic shale deposits, primarily from Emery County, Utah. After collection, the shale is crushed and placed in water so that the minerals can enter the solution. Colloidal mineral distributors stress the “naturalness” of their product and have made claims about improving conditions associated with certain diseases, a practice judged to be illegal by the FDA. In addition, some advertisements state that colloidal supplements contain 75 minerals, many of which have not been proven to be beneficial to health (such as platinum, gold, and silver).

Ionic mineral distributors state that colloidal minerals have too large of a particle size to be absorbed by the body. Therefore, ionic minerals (named after their supposed positively and negatively charged molecules) were created to have the “correct electrical charge” and therefore lead to higher levels of absorption by the body. Although these supplements may actually lead to greater absorption, it is important to remember that there are various other conditions that must be present in the body in order for this to happen.

In reality, the body only needs minerals in trace amounts. Excessive dosages of minerals can actually be toxic. Therefore, before you experiment with any vitamin or mineral supplements, you may want to speak with your health care provider. A provider can help you sort out fact from fiction, so you can make an informed decision and avoid products that may be harmful or simply ineffective. In certain cases, you may be better off wearing these minerals than ingesting them!

Alice

December 11, 2012

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Dear Alice. I think people who are in tune to their body are able to judge very quickly if something helps, whereas health care providers know next to nothing about nutrition. It is amazing to me...
Dear Alice. I think people who are in tune to their body are able to judge very quickly if something helps, whereas health care providers know next to nothing about nutrition. It is amazing to me that those same health care providers are so quick to say you may harm yourself by using supplements, but in a heart beat will prescribe a drug they Know is toxic, habit forming, and with such a list of side effects it boggles the mind. I felt like a different person in just one week after starting Ionic Minerals. I had strange small muscle tics, anxiety and poor sleep and from reading and knowing my body, I decided to try a liquid and happened onto the Ionics. It's a miracle. I hate that the medical, pharmaceutical industry are so quick to label something dangerous.
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