Nutrition & Physical Activity

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Eating healthy at the campus dining hall?

Dear Hungry,

Going off to college opens many opportunities for learning — in this case, how to make healthy food choices on your own. Relatively balanced meals, possibly planned by parents who were watching out for their childrens' health, are replaced by a smorgasbord of dining hall offerings. And while the "First-Year 15" are largely a myth (most college students don't gain 15 pounds, or any weight, during their first year), having unlimited access to a variety of foods the first year of college is a new challenge for many students.

The foods that you mention — pizza, Chinese food, and tacos — are not inherently unhealthy. Each contains foods from important food groups and provides energy that will fuel your brain during long study sessions. Sometimes these foods are prepared in such a way that they are high in fat, which is a nutrient that helps us to feel full, but also provides extra calories. These foods can be part of a filling and balanced meal, but only if they share the plate with side dishes that are low in fat, high in fiber, and nutrient dense.

One easy tip for healthy "all you care to eat" dining: When you place food on your lunch or dinner plate, make sure half the plate is filled with different colored steamed, grilled, broiled, or raw vegetables. One fourth of the plate should contain lean proteins, such as beans, grilled skinless chicken, or baked skinless fish. The remaining fourth of the plate can hold whole grains, such as 100 percent whole wheat bread or brown rice. For example, in order to balance a plate that includes pizza, choose one slice with chicken and veggies on whole wheat crust (if available) and fill the rest of your plate with a salad. Or on taco night, grab one taco with the meaty, cheesy, or beany filling of your choice and fill up the rest of your plate with steamed or grilled veggies and brown rice. For flavor fiends, look around for condiments like hot sauce, mustard, fresh salsa, and other seasonings. More information on dividing up your plate can be found on the United States Department of Agriculture's (USDA) MyPlate website.

If you find yourself stuffed after a dining hall meal, here's another tip: Fill only one plate and don't go back for seconds. You could even skip using a tray, to avoid filling too many plates and grabbing too many calorie-rich beverages. If you're still hungry after letting your food settle, grab some fruit; high in fiber and deliciously sweet, fruit can be a filling and satisfying second course. Making regular meals of a plate full of fruit, veggies, lean protein, and whole grains can fill and satisfy, and leave plenty of wiggle room for the occasional treat, such as french fries or ice cream.

Depending on the layout of your dining hall, you may need to poke around to find the healthiest options, but it's likely there are plenty of grilled, steamed, baked, or broiled veggies and proteins and whole grain carbs to fill your plate. Healthy dining options to look out for include:

  • A salad bar
  • Whole grain bread and/or bagels near the toaster
  • Entree options without any breading
  • Cooked veggies without any batter or heavy sauces
  • Broth-based soups (rather than cream-based)
  • Low-fat milk or yogurt for cereal or granola
  • Whole pieces of fruit or fresh fruit salad
  • Seltzer water or diet soda from the soda machines
  • A choice in plate, bowl, and cup size

For recommendations tailored to individual dietary needs, food experiences, and taste preferences, you can meet with a registered dietitian. Columbia students can make an appointment at Medical Services by calling x4-2284 or logging on to Open Communicator. The staff at the dining hall are also a great resource, as they are familiar with the menus. They may be able to answer your questions regarding foods that are  prepared in a healthier manner, and the concerns of other students trying to eat a balanced diet.

Bon appétit!

Alice

Cooking veggies and vitamin loss?

Dear Reader,

Vegetables can be a wonderful source of vitamins, minerals, and other nutrients that people need to stay healthy. The problem is that preparation can put a damper on the benefits that vegetables provide. In fact, according to the American Dietetic Association (ADA), improper preparation can cut the nutrient content of certain fruits and vegetables in half.

When cooking vegetables in water, some of the nutrient content, especially water-soluble vitamins including vitamins B and C, may leach into the surrounding water. But, as you suggest, using that water (or broth) in a soup or a gravy can, in fact, be a way of saving those nutrients and putting them to good use.

Still, high temperatures and long cooking times can degrade vitamins that are more sensitive to heat. While this is hard to avoid with soups, it is much less of a concern than leached and wasted vitamins. 

If you're planning on preparing vegetables to eat alone, you may want to try steaming them briefly until they are crisp and tender.  It's almost always best to keep cooking times low: microwaving, steaming, blanching, and stir-frying take the cake when it comes to speed.  Also, you may want to eat your veggies raw; salads and crudité are a great way to enjoy fresh vegetables and their full range of nutrients. Generally, the less cooked the better — overcooked vegetables don't only lose nutritional content, they also lose much of their flavor and color. This doesn't mean you should stop adding vegetables to your soup. The ADA recommends that you consume at least 3 to 5 servings of vegetables every day, so it may be a good idea to vary your preparation on a daily basis. Bon apetite!

Alice

Is soreness a good indicator of a good workout?

Dear Pushed too far,

The old axiom, "no pain, no gain," is just that... old and outdated. Pain and soreness aren't valid measures of the benefits of exercise. Muscle soreness can occur with anyone who exercises, from a beginning exerciser embarking on a new program to a conditioned veteran who is working at a greater intensity, frequency, and/or duration than s/he is used to. It frequently happens to well-trained people as they begin a new activity. Muscle soreness may also be a result of overuse, which may eventually lead to injury. It's important to listen to your body and seek treatment for injuries.

Meeting goals in terms of developing strength or endurance needs to be the focus of any exercise program. Well-defined goals guide results that you are able to attain through gradual behavior change. Examples: I want to be able to do 20 push-ups; I want to be able to run a 10K by the end of the year, etc. Goals are specific and measurable and can be useful in guiding any training program. Soreness can be a consequence of working toward a training goal, but should not be a goal in and of itself.

You write: "I think it's kind of odd that he bases his progress on how sore his clients are." It's important to consider who is looking for the progress here: you the client or the trainer? Your development and achievement should be the trainer's first concern. Some trainers feel the way a client looks or how much s/he can lift is a direct reflection of her or his ability. Does it make sense for you to have a conversation with your trainer about your concerns? You may want to reference Selecting and Effectively Using a Personal Trainer, developed by The American College of Sports Medicine. If you are a Columbia student, you can contact the Dodge Fitness Center to set up an appointment with personal trainer. 

Since soreness is not a reliable indicator of a "good" workout, it sounds your trainer may need a little training. Best of luck toning up!

Alice

No time for working out

Dear Aziz,

The job, school, family, dog, and/or bills — the responsibilities of life seem to multiply with each year that we age. As a result, responsibilities to ourselves — health maintenance activities, such as exercise and balanced eating — get pushed off the schedule. From what you've said, it sounds as though unhealthy changes in lifestyle are taking a toll on your self-esteem, body image, and energy level. Your mind and body are calling out for a change in the program! So the question is, how can healthy eating and exercise be incorporated into your day without interfering with your busy schedule?

Fortunately, adopting a healthier eating style — one that emphasizes veggies, fruit, low-fat dairy, lean proteins, and whole grains — does not require hours of preparation in the kitchen. A fast fix for your eating plan can be found in the freezer section of your local grocery store. You can pick up a variety of healthy foods and meals that require little to no preparation. Microwave meals of today are much tastier and healthier than the stereotypical T.V. dinners of the past, and they offer the added benefit of portion control. Paying more attention to what is on your plate and ultimately cutting back on portion sizes is one specific doable step that may help you to get back to your runner's physique.

Take a quick look at food labels to single out healthier choices. Choose convenience meals that contain approximately one fourth to one third of your daily caloric needs and 30 percent of calories from fat, with less than 10 percent of calories from saturated fat. Look for meals that contain less than 800 mg of sodium and at least 4 grams of fiber. Add frozen or pre-cut/washed veggies to these meals and a piece of fruit for dessert. The high fiber content of fruits and vegetables will leave you feeling fuller after you have eaten, without adding many calories.

Errands, such as trips to the grocery, are multitasking opportunities for exercise. You can jog or even ride your bike to work, the grocery, and/or the cleaners, and avoid wasting time in traffic or finding a parking spot. Physical activity will not only help you to get closer to your ideal body shape, but has the potential to relieve stress, increase work productivity, boost after work energy level, and improve sleep quality. The following tips may be useful:

  • Set the alarm 10 minutes earlier and wake up with stretching.
  • Climb at least some of the stairs instead of waiting for the elevator.
  • Take a walk around the office whenever you leave your desk for a bathroom or beverage break.
  • Take a walk to a co-worker's desk instead of calling or sending an e-mail.
  • Multitask by reading or doing research while walking on a treadmill or riding a stationary bike.
  • Use a little extra effort and motion in the chores you do around the house in order to use more calories.
  • Get off the train or bus one stop early or park your car a little further away from home/stores, to get in some walking.
  • Work activity into your social life by meeting friends to go dancing or playing Frisbee in the park.

In addition to the tips listed above, a great source for nutrition and physical activity information is the USDA's MyPlate initiative. This site allows users to tailor much of their information to meet individual nutrition and activity needs. Columbia-affilaited students, faculty, staff, and alumni can participate in the University's physical activity initiative, CU Move. 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

After you start making even small changes in your eating plan and include informal exercise in your day, you are likely to begin feeling better. At this point, you may get the urge to do more. In addition, cut back on sedentary activities so that additional time and attention can be given to optimizing your health. With a slow and steady approach you should be able to find the minutes you desire for being more active. Go for it!

Alice

Airborne — does it cure/prevent colds?

Dear To sneeze or not to sneeze,

People in the United States spend billions of dollars a year trying to escape the misery of the common cold. Though some swear by remedies ranging from vitamin C to garlic to exercise, scientists have not conclusively found anything that will prevent, cure, or shorten the course of the common cold. The manufacturers of Airborne claim that the unique combination of herbs, amino acids, antioxidants, and electrolytes "offers vitamin and mineral support for hours," and imply that it helps the body fight bacteria and viruses by boosting the immune system. They have withdrawn their original claims that their product cures or prevents colds.

In addition to vitamins, Airborne contains Echinacea, an herbal supplement some people take on its own for colds or the flu. Similar to research on vitamin C, studies draw a mix of conclusions about whether Echinacea works in preventing or treating colds. There are many products on the market, as well as natural remedies, that successfully treat the symptoms of the cold: body aches, sore throat, stuffy nose. However, as of yet, there is no proven cure.

Some people may feel that Airborne works for them, but it's tough to say conclusively. Colds can last anywhere from one to ten days and a person's immune system will eventually fight it off, even without vitamins or supplements. There has been one study on the effectiveness of Airborne. The clinical trial was a double-blind, placebo study, meaning that neither the researchers nor the participants knew who took the real supplement and who took the placebo until after the trial ended. The study found that Airborne out-performed the placebo, however many people question the potential bias of this study because the research was conducted by the manufacturer.

Additionally, some people have expressed concern about the amount of vitamins A and C contained in Airborne. According to the Food and Drug Administration, the average adult should have 5000 units of vitamin A each day, and 60mg of vitamin C. One dose of Airborne contains 5000 units of A and 1000mg of C, and the package recommends taking a dose every three hours. That means taking significantly more than the recommended daily allowance of both. Overdosing on vitamin A may cause nausea, vomiting, headache and dizziness. Too much C can cause diarrhea and excess gas.

Subways and other enclosed spaces with many people can be germy, especially in cold season. Medical professionals say your best defense against the common cold is maintaining a healthy lifestyle. That includes: eating a balanced diet, being physically active, and getting plenty of sleep. On top of that, thorough hand washing with soap and water, especially before you eat, can keep the subway germs at bay. So, before you go out and buy the new very berry flavor of Airborne or a similar supplement, it might be wise to take its claims with a grain of salt (mix with 8 ounces of water and gargle!).

Alice

I'm bored, so I eat

Dear Fat Frat Guy,

You write that you're sitting around the frat house bored. It sounds as though you may have more time to fit in activity than you realize. Exercise doesn't always need to be a long, intensive workout. Short, frequent bouts can be just as effective as longer ones. Why not go out for a walk? Does your frat house have weights in the basement or other area? Taking advantage of exercise equipment is a great idea, but if there isn't any available, jumping rope between sets of push-ups and sit-ups, in your room or a living room or den, can help alleviate boredom.

If these ideas aren't possible, or you still need some suggestions to resist snacking, a few questions to ask yourself may help. First of all, are you actually hungry? When was the last time you ate? Could you put off eating for 15 minutes? If you can wait 15 minutes and then see how you feel, you may decide that you really weren't hungry after all, or you may even forget all about that snack. If you don't and still want to eat — try to quantify your hunger.

Consider the Hunger and Fullness scale. On a scale from 0 - 10, with 0 being BEYOND HUNGRY as though you haven't eaten in an entire day (not recommended) and 10 representing BEYOND FULL as if you ate three Thanksgiving dinners — again not recommended, see where your hunger or fullness falls:

0 Beyond hungry
1 Extremely hungry, irritable, and cranky
2 Very hungry
3 You have a strong urge to eat, but aren't ready to fall over.
4 Just a little hungry
5 Totally neutral... neither hungry nor full
6 You are a notch past neutral — you could eat more but aren't hungry
7 You are feeling satisfied. If you stopped eating at this point, you would need to eat again in about 4 - 4½ hrs.
8 You are getting pretty full. If you stopped eating at this level, you would probably get hungry again in 5 - 6 hours.
9 You are getting really full, and uncomfortable.
10 Beyond full

One way to use this scale is to try to rate your feelings of hunger and fullness. You have to work on paying attention to your body's signals. Make an agreement with yourself that you will eat when your hunger is at 3, and stop eating when you reach 7. If you can ask yourself how you are feeling before taking a snack, you may be able to alleviate or at least cut down on boredom eating. Remember, food's for nutrition and nourishment. If another part of yourself needs nourishment, it's important to figure out what that is and create other ways of meeting that need. Excessive snacking often catches up with us in the form of excess pounds, as you have found. If you repeatedly find yourself eating when you aren't hungry, or when you are no longer hungry, you probably don't need those excess calories.

So, once you realize that you aren't hungry, there are probably a ton of things you can do to pass the time. Getting off your duff and moving your body — somewhere further away from the kitchen — would be a good start!

Alice

Dizzy after exercise

Dear Reader,

And thanks to you and everyone else for asking the questions.

Feeling lightheaded and/or dizzy, as if you are about to pass out, are not normal reactions to exercise. After an aerobic exercise session, you should feel invigorated, not totally wiped out. Your description sounds as though you are working extraordinarily hard. Do you eat anything before your physical activity? Are you drinking during your run or bike ride? How is your overall fluid intake? Although an exact diagnosis based on your description can't be given here, these few suggestions may help avoid these feelings:

  • Eat a snack prior to exercise. If you have less than one hour before your session, fewer than 200 calories is recommended. A piece of fruit and a couple of crackers work well for many people. Your snack can be a bit larger if you have two hours or so until your workout begins: one small plain bagel with jam, a piece of fruit and a yogurt, or handful of nuts and some crackers are a few suggestions.
  • Drink 16 oz. of fluid two hours before an event. This promotes hydration and allows enough time to excrete any excess liquid.
  • Drink fluids during exercise. Weighing yourself before and after exercise can help determine your sweat rate, and how much you'll need to drink.
    • If you lose 1 lb. per hour: drink 4 oz. every 15 min
    • If you lose 2 lbs. per hour: drink 8 oz. every 15 min
    • If you lose 3 lbs. per hour: drink 8 oz. every 10 min.
    • If you lose 4 lbs. per hour: drink 10 oz. every 10 min.
  • If you are exercising for longer than 60 minutes, add some fuel to your water with a sports drink. These fluid replacement drinks include glucose and electrolytes (sodium and potassium) to help with fluid intake and absorption.

Talking with your health care provider is a good idea if these strategies don't help. Being properly fed and hydrated, as well as getting enough rest and watching your breathing as your exercise, should help make your workouts more productive.

Alice

Milk allergy or lactose intolerance?

Dear Kathy,

Your question does not seem dumb. Many people confuse allergies with intolerances, or mistakenly use the terms interchangeably. So, what's the difference?

 

Intolerance is a physical reaction to a substance that usually does not involve the immune system. For example, lactose intolerance occurs when a person has a deficiency in lactase — the enzyme that breaks down lactose, the carbohydrate found in cow's milk. So, this milk sugar is not digested adequately, producing abdominal discomfort, gas, and diarrhea. Lactase enzyme supplements and reduced lactose dairy products can help people tolerate foods containing lactose.

 

An allergy is an immune response — when the body senses that a harmful substance has entered it, and releases specific chemicals to combat the perceived threat. For example, when you are having an allergic reaction, your body releases chemicals called histamines. These cause allergic symptoms that may affect your gastrointestinal tract, skin, respiratory system, and/or cardiovascular system. The effects on one's respiratory system could include a runny nose, cough, swelling of the larynx, and asthma. In the case of foods, studies show that food allergies rarely cause nasal symptoms or wheezing without also causing skin or gastrointestinal symptoms.

 

Since you are experiencing this set of symptoms, it seems possible that you have a milk allergy. It's important to get the diagnosis from an allergist, so that the appropriate treatment can be identified. If you are a Columbia Student, you can call x4-2284 or log into Open Communicator to schedule an appointment with Medical Services.

 

Other substances found in milk also can trigger allergic reactions in some people, including antibiotics given to cows, or the proteins of ragweed, linseed, peanut, or wheat that make their way into milk. People with a milk allergy may need to cut milk out of their diet entirely.

 

Diagnosing food allergies is complex. And having symptoms that seem like a milk allergy doesn’t necessarily rule out the possibility of also having an intolerance to lactose. You have found that cutting milk products out of your diet works well for you, which is a great step. It may make sense to see an allergist to learn more about your own specific situation.

 

Good luck!

Alice

Men and body image issues

Dear M,

You’re not alone — almost everyone struggles with self or body image at some point, and occasionally worrying about how you look is completely normal. However, if you find yourself constantly thinking about food, your body shape and size, or your appearance, and these thoughts get in the way of work or school, your emotional well-being, or your social life, you may have a more complex body image and/or eating issue.

It may be tricky to distinguish between a healthy diet and exercise routine and habits and behaviors that could be detrimental to your health. For example, restricting calorie intake and engaging in exercise are common elements of a weight loss diet, which is healthy and normal for individuals who have too much body fat. However, if you’re exercising or restricting calories so much so that your emotional and/or physical health suffers, you might be experiencing a more serious issue that requires more attention. If any of this rings true, a good place to start would be to meet with your healthcare provider or a counselor for proper assessment.

A common misconception is that body image issues and disordered eating only affects women. That’s simply not true. Men also experience varying degrees of body image disturbances, eating disorders, and other related issues just as women do. Many men keep these concerns secret, but estimates from the National Association of Anorexia Nervosa and Associated Disorders suggest that as many as 10 percent of those with eating disorders identify as male. Because men are less likely than women to disclose their disordered eating or exercise routines to their friends, loved ones, and doctors, diagnosis and treatment are often delayed. All this to say, reaching out was a brave thing to do!

Eating a healthy, well-balanced diet is essential in making sure you’re getting all of the nutrients you need, including an appropriate number of calories. A balanced diet includes foods from all of the different food groups, and eating at least three meals a day. A balanced diet should not include too much sugar or fat, although some fat is necessary in any diet. For more information about the food groups and to help figure out how much you should be eating, check out the United States Department of Agriculture’s guidelines as well as the Get Balanced Guide for Healthier Eating.

Since you’re already wondering if your eating and exercise habits may be an issue, it's a good idea to talk to someone about food and body image to be sure you're on track for a healthy relationship with food and exercise. If you are a Columbia student, you can make an appointment with a member of the Eating Disorders Team, a multidisciplinary team of health care providers specializing in eating and body image concerns, by logging on to Open Communicator or calling 212-854-7426 (Morningside campus students) Students on the Medical Center campus should call 212-305-3400 for an appointment. If you're not at Columbia, you can start by discussing your concerns with a healthcare provider or a counselor.

You took a big step in inquiring about these issues, and that isn't easy. You deserve to start feeling better about your weight and body image — hopefully some of this information will get you moving in that direction!

Alice

How do I know when I'm no longer hungry?

Dear Not Fully Aware,

Your question is one many people deal with. Some people were taught from an early age to finish everything on their plate, no matter how they felt. This was often rationalized by well-intentioned parents referencing the millions of starving children around the world. Unfortunately, this type of encouragement does little to teach children about listening to their bodies or learning to identify or conceptualize the feelings that come when one is satisfied with the amount or type of food they are eating. This conditioning experienced by many growing up, can carry on into adulthood.

Others are out of touch with their body signals for other reasons. How often have you felt ravenously hungry and then couldn't believe how much you'd eaten? How much food does it seem to take to satisfy your hunger? Letting yourself get really, really hungry distorts awareness of body signals. If you're out of touch or ignore subtle hunger cues, it's extremely difficult to detect subtle fullness. As a result, you're only able to feel extremes. It's difficult to describe what comfortable fullness feels like inside your body, but some people express it as being satisfied and content after eating. Others say it's a subtle feeling of fullness, of not being hungry anymore (even if there's still food on their plate).

You can begin by thinking about how you are feeling while you are eating — a kind of checking in with yourself. This takes a conscious effort. Once you've eaten some of your food, consider asking yourself some of these questions: does the food (still) taste good? Is my hunger beginning to subside? After a few more bites, am I beginning to feel satisfied? Try stopping about halfway through to determine if you've had enough. Try rating your fullness from 1 - 10:

  1. Ready to collapse from hunger
  2. Ravenous
  3. Hungry
  4. I could eat something, but not very hungry
  5. Neutral
  6. Not hungry at all
  7. Comfortably satisfied
  8. Full to very full
  9. Stuffed
  10. Disgustingly sick

If you go from a 2 to a 9 easily, perhaps you are going for too long without food, or your last meal was too small (a problem for dieters). Maybe your last meal was lacking important satiety nutrients, such as protein, fat or fiber, which usually help to keep you satisfied over a few hours. Sometimes when we eat very quickly, a large quantity of food is consumed and before we realize it, we're stuffed. If this is your problem, try slowing down, taking your time chewing, swallowing, and resting between bites.

The most important part about eating to a pleasant fullness is to eat consciously — to increase your awareness. This takes practice for many people. Too often, we distract ourselves with other activities — such as studying, watching TV, or surfing the Internet, without realizing that we're full, until the entire bowl of popcorn, liter of soda, or pizza is gone. Give yourself time to enjoy and appreciate your food, and you can notice and identify its effects on your body.

For more information and insight, check out Evelyn Tribole and Elyse Resch's book, Intuitive Eating. If you are a Columbia student, you may want to make an appointment to speak with a nutritionist. Morningside campus students can contact Medical Services; CUMC students can reach out to the Student Health Service.

Best of luck!

Alice

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