Nutrition & Physical Activity

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All torn up over stretching

Dear All Torn Up,

Don't get all strung out! Contrary to popular belief, inadequate stretching is not the cause of all injuries. However, sticking with a stretching routine over an extended period of time can lead to increased flexibility and range of motion. The correct type of stretching depends on what physical activity you are involved in, as well as how much weightlifting you do. Getting muscle-specific will help target the muscles and joints that you exercise most.

There are three main types of stretching techniques: static stretching (holding a stretch for an extended period of time), dynamic or ballistic stretching (moving your muscles towards their maximum range of motion in a bouncing manner), and proprioceptive neuromuscular facilitation (alternating passive stretching and isometric contractions). Static stretching is the most commonly used form of stretching, and the other two are generally done under the supervision of athletic trainers or physical therapists due to the risk of injury.

For those wishing to stretch before exercise, it's best to stretch following a mild warm-up, such as aerobics, walking, light jogging, or any activity that slowly raises heart rate. A warm-up increases body temperature and warms the body's muscles and tendons, making them less likely to tear or pull easily. Stretching after exercise relaxes muscles and may prevent tightness. While it is not proven that stretching before and after exercise reduces soreness, some people feel better after stretching. Some people like to stretch during their cool-down routine.

Remember, it's recommended that you match the type of stretching that you do with the muscles that you use during your exercise routine. Here are some general guidelines for healthy stretching:

  • Stretch the muscle groups that you use most on your exercise routine.
  • Apply at least four to five 60-second stretches to the targeted muscle groups, making sure you're stretching both sides of the body equally.
  • Only stretch until you feel the stretch, not pain.

One thing to keep in mind is that studies are inconclusive as to whether or not stretching helps decrease sports injuries. In fact, research has identified other factors that could be more closely related to sports injuries. These include a history of chronic or recent injury, having a higher body mass index (BMI), and switching pre-participation stretching routines (that is, those who normally stretch before an activity suddenly stopping). Here are a few suggestions to help prevent sports injuries:

  • Maintain strength in the muscles surrounding the joint.
  • Cross train to mix up your workouts and to prevent repetitive motion injuries.
  • Include a warm up in your routine, such as dribbling for soccer, skating for hockey, and a few laps for swimming.
  • Never skip your warm-up or cool down.
  • Don't drastically change your warm-up routine. Sudden changes to your warm-up can also increase your risk for injury.
  • Use proper technique and form to minimize your risk of injury.
  • Keep your cardiovascular health up — a stronger heart allows you to keep up your strength and avoid risky errors that could lead to injury.
  • Use proper protective equipment, such as knee and shoulder pads.

All in all, there are many factors that go into injury prevention. Your coach, physical therapist, or health care provider may be able to give you a few pointers on keeping your body healthy during exercise.

Learning more about injury prevention is the ultimate home run. Batter up!

Alice

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

Medical Services (Morningside)

Student Health Services (CUMC)


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

508812
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!

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

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

520002
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.

Weight loss tricks for big and chunky teens?

Dear Big and Chunky brothers,

The big secret that a lot of people have been slowly learning is that most restrictive diets don't work in the long run. Being on a diet usually makes people hungry, tired, cranky, frustrated, depressed, deprived, annoyed, and anxious. Sounds like a recipe for failure, huh? The key to eating a balanced diet is to be mindful of what you are eating and how much you are eating. Aim to eat a generally healthy diet, but allow yourself to follow your cravings without guilt. Moderation is key.

So, what's a teen to do? First, take a look at your lifestyle. Are you sitting in front of a computer, TV, or video game system most of the time? You need to get up and get your body in motion! Having a friend with the same concerns is helpful, because being active is more fun with someone else. Make a list of things you could do together. Some ideas to get you started include:

  • Playing some sport — outside
  • Enthusiastic walking
  • Riding bikes
  • Walking up stairs
  • Getting off at an earlier bus or subway stop and walking the rest of the way

Second, identify your usual eating routine. For many people, it's almost automatic to snack while working and studying, reading, or watching television. Hunger doesn't even matter. This is a pattern of eating that can be hard to break. Trying to be more mindful of what, when, and how much you eat is a good way to start. Set out to eat only when you're hungry, rather than for entertainment. If you are hungry (and it is okay and even helpful to eat between meals), take a few moments to sit and have a snack. Instead of eating out of a bag, box, or container, put out a set amount on a plate or in a bowl. Healthy snack ideas include vegetables and hummus, an apple and an ounce of cheese, or a rice cake with nut butter. When you are done eating, move to the next activity.

Eating three regular meals a day can make a difference. If you're a breakfast or lunch skipper, it may set the stage for you to get too hungry and overeat at some point later in the day. You can build healthy meals by:

  • Including at least one fruit (e.g., apple, orange, pear) or non-starchy vegetable (e.g., leafy greens, broccoli, carrots) at every meal.
  • Incorporating one food that is a good source of protein: low- or non-fat dairy (e.g., milk, yogurt, cheese); soy (e.g., tofu, soy milk); lean meat, chicken, fish; legumes (e.g., beans, lentils, and split peas) or nuts.
  • Making half of all of your grains whole ones (that's a minimum of one meal or snack), and including items such as whole grain breads or cereals, brown rice, or whole grain pasta.
  • Cutting down on fat. Although some fat in your eating plan is healthy, it's a concentrated source of calories that can add up quickly. Making French fries out of a potato adds over 20 grams of fat and almost 200 calories, while a plain baked potato has less than one gram of fat and 220 calories. Choose fried foods infrequently and opt for baked, broiled, grilled, roasted, or steamed items instead.

The quantity of food you are eating is also a component in managing your weight. This doesn't mean that you have to go hungry. Rather, tune in to the portion sizes you are eating. Do you feel overly stuffed after eating? Are you truly hungry when you start eating? Perhaps you could be satisfied with smaller sized meals and snacks. Soft drinks are another source of excess calories for many teens. One can of soda or pop has 150 calories, all from sugar. Drinking a liter a day could add over 3,000 calories to a person's weekly intake, or nearly one extra pound of weight. If this sounds like you, try cutting down, or switching to flavored seltzer or water. Look to whole foods, rather than processed ones, to supply your meals and snacks as often as possible.

Hopefully this answer has given you some "food for thought." Although there aren't any shortcuts to good health, increasing your awareness of your eating patterns is a good start.

Alice

Apple cider vinegar

Dear Reader,

"Apple cider vinegar a day keeps the doctor away" doesn't exactly roll off the tongue, does it? Even still, many people claim that this product of fermented crushed apples yields a variety of health benefits including those that you mentioned. Usually taken in liquid, powder, or pill form before meals, it's most often used to aid digestion since the high acetic acid content helps break down food. In addition to this, it has also been used for centuries to treat fungal infections and sunburn. Although this may spark a domino effect on other aspects of health, there is no scientific proof that it has any effect on weight, blood pressure, or acne.

A common misconception about apple cider vinegar is that it curbs appetite and promotes fat burning, but physiologically, even though acetic acid intake may temporarily facilitate loss of water weight, it doesn't appear to affect fat. In fact, the high acidity of the vinegar may cause erosion of tooth enamel, throat irritation, and drug/supplement interactions (particularly with insulin and diuretics). It also acts as a blood thinner, so people who are on blood-thinning medications may want to reconsider its use.

Because the confirmed health benefits of apple cider vinegar are often a result of its high nutrient content (including iron, calcium, copper, and potassium), the choice between organic and non-organic is one to consider carefully. Non-organic apple cider vinegar has undergone pasteurization, the process of heating the liquid to a very high temperature to kill bacteria. As a result, the vinegar is much clearer and more attractive to consumers but in the process has lost the bulk of its nutrient content. Depending on what the consumer is aiming to gain from apple cider vinegar, this could affect the health benefits they experience. Then again, the potential bacteria content in organic (unpasteurized) apple cider vinegar could be problematic. Regardless of the nutritional supplement, a health care provider could be consulted before starting any alternative treatment.

Overall, if the reason for using apple cider vinegar is to lose weight, reduce blood pressure, or prevent acne, there are other treatments whose effects have been scientifically confirmed. In terms of weight loss, the key is to consume fewer calories than you burn on a daily basis. Routine physical exercise and a diet of fruits, vegetables, whole grains, and lean protein are your best bet. For more guidance on addressing these health concerns, see the Q&As below. You may also want to consider speaking with a health care provider or registered dietitian. Columbia students can make an appointment with Medical Services (Morningside campus) or the Student Health Service (CUMC).

In the end, an apple a day is more likely to keep the doctor away!

Alice

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

506179
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

Solid versus liquid calories — Which is better?

Dear Reader #1 and Confused About Calories,

Good questions! While a liquid diet probably wouldn't affect the way your digestive system works, you would still need to ensure that you are receiving plenty of calories and nutrients. Discussing this issue with a health care provider, such as a gastroenterologist or nutritionist, may be good steps if a liquid diet is something you want or think you need to pursue. Also, Reader #1, check out the Related Q&As below for more information about food allergies.

As for the calorie query submitted by Confused About Calories, the fact of the matter is, regardless of the consumption method, a calorie is a calorie. The energy it takes to burn one liquid calorie equals exactly the same as that needed to burn one solid calorie. What throws some people off is the concept of caloric density. Foods that have high water content tend to have lower caloric density (think fruits and veggies), meaning a greater calorie to volume ratio. For example, to consume the same amount of calories you would get from one cup of raisins, you would need to eat nearly ten cups of grapes. What adds to this is that low caloric density foods tend to make you feel fuller faster because of their water content.

This does not mean that simply consuming more liquid will make you want to eat less. Liquid calories may in fact be deceiving because beverages like sodas often contain a lot of calories but do little to satiate hunger. When studies compared food intake between one group given water to drink and the other given soda, there was little difference in the amount of solid calories they ate. However, even though both groups ate roughly the same amount of food, the group who drank the soda consumed more calories overall because of the beverage that accompanied their meal.

Depending on the motivation for your question, you may want to consider meeting with a registered dietitian or other health care provider to discuss this matter further. Keep in mind that a health care provider can also make any referrals to a specialist, if appropriate. In addition, you may find it helpful to read some of the responses in the Go Ask Alice! Nutrition & Physical Activity archives or the related Q&As below.

Remember though, your body needs more than just calories; it also needs nutrients, which may be lacking in a liquid diet. Although liquid calories may seem less significant than calories consumed from solid foods, keep in mind that a raisin in the hand is worth ten grapes in the bush.

Alice

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

Medical Services (Morningside)

Columbia Health Nutrition Services (Morningside)

Student Health Services (CUMC)


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