Nutrition & Physical Activity

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Hungrier and hungrier

Dear Hungry,

When it comes to weight, the two factors to pay attention to are calories consumed and calories burned. If you consume more calories than you burn, you will gain weight and vice versa. The problem here is either that you are not consuming enough calories or your body is somehow not making the best use of them. Before we get into the biological possibilities, try a quick dietetic experiment.

With all the media surrounding diets and obesity, it may be easy to get the wrong idea about what constitutes "healthy." Eating a lot of vegetables as you do is great (and a vital component of a healthy diet) but vegetables are low in calories and many don't contain fat or protein, both nutrients your body needs. When you feel those hunger pains, consider grabbing a snack or a meal that combines all of these, such as a salad with chicken (lean protein), avocado (healthy fat and a fruit!), and low-fat ranch dressing. Including more healthy fats (limit trans and saturated fats) and lean proteins (also found in seafood, dairy, and nuts) in your diet may help you feel fuller longer and will also add more healthy calories into your diet.  

If this doesn't curb your appetite, there may be other factors affecting your hunger sensors, which a health care provider may help identify. Some questions to ask yourself are whether you've been feeling increased anxiety, if you've recently started or changed medications, or if you've experienced increased thirst, heart palpitations, or a need to urinate. These may be signs of hunger-causing conditions such as:

  • Anxiety and other mental conditions
  • The use of drugs such as corticosteroids and anti-depressants
  • An overactive thyroid gland (hyperthyroidism)
  • Diabetes
  • Grave's Disease

List adapted from The National Institutes of Health.

If you experience nausea or vomiting along with your insatiable hunger, that may be a sign that you have a parasite (such as tapeworm) in your digestive track. That possibility brings a whole new meaning to "eating for two." In the related Q&A's below, you may want to read more about parasites as well as other conditions that could explain your hunger. Regardless of the cause of your insatiability, though, if you lose more than ten pounds or five percent of your bodyweight unexpectedly or if weight loss persists, consider contacting a health care provider to get to the bottom of the issue…and your bottomless stomach. Columbia students may do this by contacting Medical Services or logging on to Open Communicator.

Whatever the cause of your endless appetite, hopefully this has sated your hunger for an answer. Eat up!

Alice

February 3, 2012

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This may sound weird but have you explored the possibility of a parasite? Maybe I am watching to much TV but I have seen several programs on parasites. If you have a tape worm for instance it could...
This may sound weird but have you explored the possibility of a parasite? Maybe I am watching to much TV but I have seen several programs on parasites. If you have a tape worm for instance it could make you hungry all the time while you are eating more than enough, coupled with weight loss. Just a thought...

ALWAYS hungry!

Dear Overactive eater,

Generally, a case of the munchies is your body's way of signaling that it's time to refuel. If snacks and even full meals don't fill you up, there may be another cause for your ongoing hunger. If diet changes don't do the trick, a visit to a health care provider may ease your mind and your appetite. 

Based on your description, it sounds like you can rule out the possibility of a digestive parasite. Rather than fueling your hunger, most stomach bugs cause digestive troubles like nausea, vomiting, and diarrhea that can kill your appetite. There is one infamous bug, the Taeniasis parasite (aka tapeworm), that is often blamed for insatiable appetites or unintended weight loss. However, Taeniasis is acquired by eating infected pork or beef so it's not likely that you have a tapeworm since you've been vegetarian for years.

As you suggested, people who follow a vegetarian diet sometimes don't get enough protein. These power nutrients give your body energy and also help you feel full, more so than carbs or fruits and vegetables. Vegetarians also need to consider the kind of proteins they eat. Unlike meats, individual plant foods don't supply all the amino acids that your body needs. To make sure you're getting a complete protein package, try combing two complementary foods that offer different amino acids from these four protein groups: grains, legumes or beans, seeds and nuts, and eggs and dairy. For example, a PBJ sandwich combines grains (go for whole wheat bread!) and legumes (peanuts) for a complete protein. Similarly, a yogurt parfait with fruit and almonds complements dairy with nuts. Newer research has indicated that protein pairings need not be consumed at the same time. That is, it should be sufficient to combine the complementary foods within the same day. For more tasty protein pairings, check out the related Q&As below about protein sources.

Another source of satisfaction comes from eating enough fat. Depending on your level of physical activity and other factors your fat needs will vary. However recent research shows that eating moderate amounts of healthy fats can really help satisfy. In addition to nuts, think avocado and healthy oils (canola, olive, safflower, trans-fat free spreads). Check out ChoseMyPlate.gov to calculate your calorie, protein, fat, and carb needs and determine whether what you're eating should be filling you up.

To make sure you're eating enough of the right proteins and fats as part of a balanced diet, it may also be helpful for you to keep a food journal. You can use the journal to plan out meals, make grocery lists that include healthy and filling snacks, and record when and what you eat throughout the day (and night). The food journal may help you answer some key questions to explain the uptick in your appetite. For example, are you eating enough calories throughout the day to make you feel full? Do your tummy rumblings coincide with any particular emotions like stress, sadness, or happiness? If you do end up seeing a health care provider, the journal will help them understand your diet and what might be causing your excess hunger.

If diet changes don't seem to satisfy your hunger, there may be an underlying health condition that's giving you the munchies. According to the National Institute of Health, causes of increased appetite may include:

  • Anxiety
  • Certain medications (such as corticosteroids and some antidepressants)
  • Bulimia
  • Diabetes
  • Hyperthyroidism
  • Grave's disease
  • Hypoglycemia
  • Premenstrual syndrome (PMS)
    List adapted from the article Appetite - increased at MedlinePlus

Since there are a variety of explanations for your hunger pangs, if adding a healthy balance of proteins and fats to your plate won't satiate your appetite, your best bet is to see a health care provider. Getting medical attention is a good idea especially if you have any other unexplained symptoms like frequent urination, increased heart rate, or feeling very thirsty. Students at Columbia on the Morningside campus can call 212-854-7426 or log on to Open Communicator to make an appointment with a health care provider or nutritionist at Medical Services. If you are a student on the CUMC campus, give the Student Health Center a call at 212-305-3400 to make an appointment with a health care provider or nutritionist.

Fueling up with more complete proteins and healthy fats may help you feel full and keep your body running strong. If your hunger still hangs around, visit a health care provider to find out what your body needs to fill up and feel good. Take care,

Alice

Cart Pushing: How to prevent muscle aches

Dear Cart Pushing Professional,

Work life may get tough, but when push comes to shove, don't put your back into it! Your attention to your body is an excellent first step in pain prevention. While there are some things you may do to reduce your pain, it's important to know that your employer is also expected to provide a safe working environment for you, free of conditions that cause injury.

Remember when pushing the cart(s) or other heavier items, try to bend from your hips rather than your waist. You'll know you're doing this right if your back is straight and you feel yourself using your legs. If you have a "hump" when you bend or if you find yourself hunching as you bend and twist, it means you're probably putting more stress on your back. Try to move from your lower core, putting your weight on your glutes (butt muscles). Flexing your stomach muscles while cart-pushing may add more support from your core, as well, hopefully helping to take pressure off your knees. Another option may be to see if your employer may provide you with some type of support belt that may help distribute the pressure more evenly and support your lower back. Staying well hydrated throughout your shift may also help prevent soreness, and healthy snacks and meals may help you sustain your energy level.

Stretching is certainly a good way to help with soreness, as is the occasional massage. Unless you know someone, professional massages may be costly. If funds for an occasional massage aren't in your budget, consider trading massages with a friend or locating a massage school where you may be able to get discounts with massage therapists in training.

You also mentioned that the snow makes pushing carts more difficult. One thing that may help is a device consisting of rubber straps that you may stretch over the soles of your shoes. Lining these rubber straps are small, metal rings that dig into ice and snow, creating friction and reducing or eliminating slippage. Runners and hikers often use them to stay active in the winter months and they may be found at many outdoor and sporting goods stores at a low price. Make sure to use the kind that has studs on the entire sole, rather than ones only of the ball or heel. You may consider asking your employer to cover the cost or give you a discount if they're sold in your store.

Speaking of which, you employer has the responsibility to provide a safe working environment for you — they are required by Occupational Safety and Health Act (OSHA). Any employee of a private company may make an anonymous complaint and request an investigation. Even if your employer were to somehow find out it were you, they're legally prohibited from firing you, refusing to promote or give you a raise, or otherwise punish you from making the complaint. For more information, check out the OSHA website or call 1-800-321 OSHA.

Lastly, seeing a health care provider may help rule out serious injuries as the cause of your soreness and may be able to provide you with more information for pain relief and injury prevention. If you're a student, you may be covered by your school's health care plan. Columbia students can make an appointment by contacting Medical Services (Morningside) or the Student Health Service (CUMC).

Working hard is important, and ensuring that you stay healthy to continue working in the long run may be even more important. Try some of the precautions, exercise self care, and flex your employee rights — work doesn't have to be back breaking!

Alice

March 20, 2012

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I've been a cart pusher for about 2 years and I can definitly say that it is a tough job. As far as muscle aches and pains go, try to use your legs when pushing around a corner and or turning the...
I've been a cart pusher for about 2 years and I can definitly say that it is a tough job. As far as muscle aches and pains go, try to use your legs when pushing around a corner and or turning the carts. For example, when turning use your legs and move forward toward the opposite direction you want the carts to go, thus pushing them in the direction you want to go. This should help knee pain also. When pushing be sure not to stress one part of your body all the time especially if pain persists, switch up the technique in which you push the carts. A good way to warm up is by walking around or even getting a light jog to get your blood pumping, it reduces soreness. Protein drinks can be used to further cut down on soreness. Be careful always of injury, take it easy if you feel persistent pain. Hope this helps, good luck in your future

Adult sports education in NYC?

Dear Reader,

It's great that you want to stay active and try new sports or activities, both at Columbia and beyond. There are lots of resources for adult sports education in New York City, and with so much online information it's sometimes hard know where to look.

If you like exercising in the great outdoors, check out Central Park's list of activities and resources. This site has information on a wide range of activities, from road running to wall climbing, and much more. Some of the activities do have fees, so be sure to read the fine print. Also, many of these are not instructional, so if you're looking to try something new and want to take a class, you might look a little further downtown at Chelsea Piers.

Although you will have to spend a bit more money, Chelsea Piers just might be worth the extra cash. This place has just about everything you're looking for, including a wide range of sports, and all levels of instruction from beginner to advanced. The field house has basketball, gymnastics, soccer and rock climbing, or check out golf lessons and ice hockey. If Chelsea is a bit too far from Columbia for you, the 92nd Street YMCA (on the East side) also has classes in basketball, racquetball and volleyball.

If hitting the roads is more your thing (and you have a bike or are thinking of getting one) you can take advantage of the organized bike rides from the New York Cycle Club that are inclusive of all types of riders. If you prefer running over cycling, check out the classes offered through New York Road Runners. You can also check out Zog Sports and MeetUp.com for groups, often organized by neighborhood, that meet up to play a range of informal and formal team sports, from soccer to softball to ultimate Frisbee. Again, some groups have fees, so check out the details.

It's great that you're revved up to try something new. If you want a great way to stay motivated and connected, you can participate with Columbia's CU Move initiative. CU Move encourages members of the Columbia community to engage in active lives that include regular physical activity. The program provides participants with motivation, incentives to be active throughout the year, and event calendars with access to plenty of free and low-cost physical activity options on campus and around NYC.

There's plenty out there to choose from, so what will it be? Ice hockey? Wall climbing? Golf? Something else entirely? The choice is yours; whatever you choose, be sure to have fun!

Alice

Microwave ovens decrease nutritional content of food?

Dear Needing Antioxidants,

Microwave ovens may be a common and convenient fixture in many kitchens, but they have long been accused of causing cancer, radiation poisoning, and, as you mentioned, being weapons of mass destruction (of nutrients in foods, that is). No matter how you slice it, the act of cooking fruits and vegetables will destroy some of their nutrients because certain minerals, vitamins, and antioxidants cannot withstand the heat. The good news is that there are many ways to reduce the amount of nutrients lost. Additionally, microwave cooking generally does not cause any more damage to food than other cooking methods such as baking, boiling, or sautéing.

The study you mentioned noted that the broccoli was immersed in a large amount of water when it was cooked, which may have been responsible for such a high proportion of the antioxidants being destroyed; the nutrients likely leaked out into the water during cooking. Other studies have shown that when broccoli was cooked in the microwave with no water, the degree of antioxidant loss was much lower. The key ingredients to preserving antioxidants and other nutrients seem to be a shorter exposure time to heat while using as little water as possible. In that case, microwave cooking can actually be better than other methods of cooking, because it cooks food quickly and therefore reduces the time the food is heated. Other tips to keep the nutrients intact during cooking include:

  • Leaving vegetables in big pieces so less surface area, and therefore less nutrients, are exposed.
  • Cover your container to hold in heat and steam, which will reduce the cooking time.
  • Avoid peeling the vegetable if possible; many nutrients are actually in the peel itself or just below its surface.
  • Make sure you don't overcook your vegetables; take them out when they are crisp and tender.

If you are really concerned about getting enough antioxidants, you can also stick to choosing fruits and vegetables that you can eat raw, such as carrots, tomatoes, or cucumbers, or simply eating more of them. If an apple a day keeps the doctor away, think of what doubling or tripling that can do! Just keep in mind that not only is variety the spice of life, but it's also the best way to make sure you get all the antioxidants you need.

Alice

Food allergies and getting enough fiber

Dear Reader,

Getting the recommended amount of fiber can be a challenge, especially if you are limited in your food choices. Eating healthy foods other than whole grains is certainly one option, but with a bit of planning ahead, there are some other ways to make sure you are fulfilling your fiber and carbohydrate requirements.

If fiber is your main concern, then getting a lot of fruits and vegetables and taking a fiber supplement can help to "bridge the gap" on days where you must avoid grains. However, whole grains have a lot more to offer than just fiber. They may contain many other healthy components such as complex carbohydrates, antioxidants, vitamins, and minerals. Whole grain consumption has been linked to a reduced risk of heart disease, diabetes, and obesity.

Eating out is a challenge for anyone who has dietary restrictions, but thankfully some restaurants are adapting their menus to cater to clients that cannot eat certain foods, including wheat, dairy, gluten (a compound found in wheat and some other grains) and other common allergens. Consider talking with your server about your food allergies so they can notify the chef. They may also have some recommendations for you from the menu. If this is embarrassing for you to do in front of a client, consider calling or emailing ahead to ask about what items on the menu are free of wheat, corn, and sugar or how other dishes can be adapted to fit your needs. You might also consider ordering foods you can eat, such as salads, potato- or rice-based dishes, lean meats and seafood, and soups while out with clients, and snacking on complex carbohydrate- and fiber-rich foods before or after your business meals.

Checking out menus and calling ahead is useful because common food allergens can "hide" in places you may not expect to find them, such as salad dressings and some sauces. One resource to consider for finding a friendly restaurant is the Gluten-Free Restaurant Awareness Program website, which lists restaurants with gluten-free options throughout the US.

Since there are many benefits to eating a variety of whole grains, perhaps you can start taking some food with you when you travel, or shopping for food once you reach your destination. Since food packages must list all ingredients you can be sure you're getting what you need, avoiding what you can't eat, and you might save yourself some money in the process. Who doesn't like saving money?!

Finally, it might be useful for you to spend a little time with a dietician. A consultation could trigger many new ideas for getting the right amount of fiber. S/he is likely to present some creative and tasty options you may not have expected. If you are a Columbia Student, you can contact Medical Services (Morninside) or the Student Health Service (CUMC) to schedule an appointment with a registered dietitian on campus.

With creative planning and a visit with a professional you can be sure you're getting what your body needs to stay healthy. It might take some extra time and effort, but your health is worth it!

Alice

Will probiotic-enriched yogurt aid digestion?

Dear Reader,

It's wise to keep a healthy skepticism about the marketing efforts of some of these huge food corporations. Dannon's probiotic-fortified yogurt, Activia, is certainly an example of a highly promoted product. In recent years, the global market for "functional foods," has grown to billions of dollars annually, and since these supplement-food hybrids are appearing on the shelves ever more rapidly, the FDA doesn't have a chance to evaluate all of their claims. While there is evidence that probiotics do help to improve digestion and gastronomic health, it is hard to say that one brand over another is more effective at doing so.

Probiotics, beneficial bacteria that live in the small intestine, are believed to improve digestion. These gut-friendly bacteria actually help you to digest and eliminate your food, while crowding out the unhealthy gut-dwelling bacteria that cause gas, constipation, and bloating. Studies have shown that certain probiotics can help relieve irritable bowel syndrome, diarrhea, constipation, atopic eczema, and may also help protect against various infections and colon cancer. Researchers have found that stressed-out rats have benefited from a serving of water containing certain probiotics. Not a flattering comparison for us people, who might feel like stressed-out rats from time to time, but the findings of the study may be helpful. Probiotics are found in many types of fermented foods, like yogurt, sauerkraut, tempeh, and miso.

Regular yogurt is made using these live cultures, and serves up a healthy serving of them with each spoonful. But your question, is Dannon's Activia more effective in providing these results than regular good old-fashioned yogurt, is one that begs a good answer. Dannon (of course) says yes. Their Activia yogurt contains Bifidus regularis, a probiotic strain trademarked by Dannon that is not in other yogurts, and they claim that this particular strain speeds wastes through the digestive system and improves immunity in the intestines more effectively than other strains.

Dannon says that their Bifidus regularis, "survives passage through the digestive tract, arriving in the colon as a living culture," whereas other cultures can be destroyed by stomach acids and the natural process of digestion. The consumer reports lab has confirmed Dannon's claim, reporting that about three million of the original three billion probiotic organisms in a four-ounce serving of Activia made it through the stomach to the colon.

There is one other difference you mentioned between this yogurt and the others: the price. Activia typically costs more per ounce than regular Dannon yogurt. There are also other brands on the market that offer yogurts containing probiotics that are similar to those in Activia. If you're willing to spoon out the extra cash for yogurts with these particular probiotics and have noticed a decrease in stomach grumblings as a result, it seems like it working for you and might be worth it. However, now that you know that all yogurts contain healthy amounts of probiotics, it might be interesting to see if those regular yogurts feel just as good as the one with all the advertising. Eat up!

Alice

Food coma

Dear Reader,

The symptoms you describe sound like what many people call the "food coma." Often times, after eating a holiday meal, a big dinner or lunch, or even sometimes after meals that didn't seem that big, you may feel a bit drowsy. Some medical conditions can cause this feeling, including anemia, kidney dysfunction, sleep disorders, infections, or an electrolyte imbalance just to name a few. But even people who don't have any of these medical conditions may still feel tired after eating, because this symptom is also a consequence of normal digestion!

Why? Because our bodies spend a lot of energy digesting food. The stomach mechanically churns the food, produces acid to break the food into tiny pieces, and then controls the rate this broken down food can enter the intestines. In the intestines, enzymes use energy to further break down and absorb food particles into the body. For humans, it is normal for the rate of energy use to increase by 25 to 50 percent after a meal. This increased bodily activity could contribute to your feeling flushed after eating.

One explanation for your drowsiness lies in one of the hormones released during digestion — cholecystokinin. Commonly referred to as CCK, this hormone helps make you feel full, but also activates the areas in the brain associated with sleep. So after eating, when CCK levels rise to tell you you're full, you may also start to feel sleepy. Additionally, meals high in carbohydrates can increase the levels of tryptophan (an amino acid) in the blood. In the brain, tryptophan is converted into serotonin (a neurotransmitter that makes people feel both happy and sleepy). This boost in serotonin could also cause someone to feel tired.  

Since you don't feel tired after every meal, you may want to keep a food journal to see what types of food have you craving a post-lunch nap. If carbohydrate-rich or heavy foods like pizza, pasta, or panini slow you down, you could opt for a salad, soup, or sushi on days when you have a lot of work to do in the afternoon. You could also try eating several smaller meals throughout the day, rather than a big lunch, to avoid overwhelming your digestive system.  

Feeling tired after eating is a common experience, and not necessarily linked to a medical condition. However, if you feel your symptoms may be related to a medical problem, it's always a good idea to visit your health care provider, especially if your fatigue begins to seriously impair your ability to get your work done. Students at Columbia can contact Medical Services (Morningside campus) or the Student Health Services (CUMC).

Best of luck in staying alert during your post-meal endeavors,

Alice

Blue corn chips — Are they healthier?

Dear Reader,

It's often said that the more (naturally) colorful your plate is, the healthier that meal is for you. This saying holds true in the corn arena: Blue corn does contain more of the amino acid lysine and the antioxidant anthocyanin than "regular" yellow corn; however, it loses much of these nutrients when it's processed into a chip. Blue corn chips may be slightly more nutritious in this sense, but if you're trying to increase the amounts of lysine or antioxidants in your diet, fresh and whole fruits, vegetables, and lean proteins are much better sources.

Research has also found that blue corn tortillas (fresh, not fried into chips) contain more protein than their yellow or white corn counterparts. In addition, blue corn tortillas have a lower starch content and lower glycemic index (GI) than regular corn tortillas. Both of these factors may be helpful to people on low GI diets, such as diabetics, because food with a lower starch and low GI breaks down more slowly into sugars absorbed by the blood stream and can help people avoid spikes in blood sugar levels.

Keep in mind that chips of any color are often fried and can be high in fat and calories, so it's probably best to not make them a regular snack. Baked chips or crackers may be a healthier alternative, especially if they're made with whole grains. Look for the words "whole grain" or "whole" before the grain's name on the ingredients label to make sure it falls into this category. Fiber is another important consideration in a healthy snack, and not all whole grain products are high in fiber, so be sure to look at fiber content on the nutrition label. For more information on whole grains and fiber, check out some of the Related Q&As below.

Alice

Weightloss diets for vegetarians, and everybody

Dear Reader,

Fortunately for people who wish to lose weight, there are universal rules that apply, regardless of your typical diet — whether you're a vegetarian or omnivore. First, to lose weight a person has to use more energy (calories) than s/he takes in. To achieve this deficit you can either make dietary changes (so you're taking in less calories), get more physical activity (so you're using more calories in a day), or you can make changes in both areas. Experts recommend making both dietary changes and getting more physical activity for the best results.

It takes a deficit of about 3500 calories to lose one pound of body weight. This means if you are able to cut 500 calories per day from your regular diet you should be able to lose a pound a week (a healthy weight loss rate). It may be beneficial to consider finding the right balance of increasing your physical activity and decreasing caloric intake. You can check out the ChooseMyPlate.gov SuperTracker as a resource that can help you calculate how many calories you need per day, what nutrients are in the foods you eat, and how many calories you burn doing different exercises.

Some suggestions for dietary changes to reduce calories:

  • Steam, boil or bake foods instead of frying in butter or oil.
  • Sauté foods in vegetable broth, wine, or water instead of oil.
  • Limit of high-fat condiments (like mayonnaise, margarine, sour cream, cream cheese, salad dressing, etc.).
  • Try low-fat dairy products and nut- or peanut butter. Vegetarians sometimes begin to rely heavily on these foods as sources of protein, but low-fat dairy and nut products provide the same amount of protein as their full-fat counterparts.
  • Add beans and legumes to your diet as low-fat sources of protein.
  • Eat actual fruit or vegetables rather than drinking them in juice or smoothie form. The fiber in fresh produce works well to satisfy hunger.
  • Substitute water, tea, and diet beverages for regular soda, juices, and other high-sugar drinks.
  • Limit the amount of alcoholic beverages consumed (empty calories for everyone).
  • Begin lunch or dinner with a broth-based, vegetable filled soup or a large salad with a small amount of low-fat or fat-free dressing. These foods take longer to eat and can help curb your hunger so you don't overeat during the rest of the meal.
  • Be mindful of portion sizes — read nutrition fact labels to find out serving sizes. Some rules of thumb:
    • A medium apple or orange is the size of a tennis ball.
    • A medium potato is the size of a computer mouse.
    • An average bagel is the size of a hockey puck.
    • An ounce of cheese is size of four dice.

Some suggestions for incorporating more physical activity into your day:

  • Take the stairs as often as possible.
  • Park at the far end of the parking lot or get off the bus or subway a stop early.
  • Schedule your cardiovascular exercise (walking, jogging, swimming, biking, frantically cleaning your apartment before visitors come over, etc.) so you know you will be able to fit it in. If you're at Columbia, you can participate with CU Move to help stay motivated with your physical activity efforts and earn incentives.  Check out the site to learn more. 

Hopefully, you'll find some of these suggestions new and helpful. Good luck!

Alice

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