Nutrition & Physical Activity

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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)


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

Barefoot running

Dear Toe-tally Barefoot,

Aside from "getting back to nature," many runners who choose to go shoeless do so to prevent injury, though if you haven't experienced injury in traditional running shoes, there's little added benefit to switching. Running shoes aim to reduce pressure on the heel, but in doing so, affect the natural tendency for some people to run on the front part of their foot which acts as a natural shock absorber. Though studies aren't conclusive, some evidence suggested that the sturdy, built-up heels developed to cushion feet in running shoes may actually contribute to injuries, such as plantar fasciitis. Also, without the added weight at the end of your legs, your body may use up to five percent less energy during your run, which some people claim helps them run faster. The natural spring that comes from landing on the front of the foot may also add to this, but it's unlikely to increase your pace substantially.

By relying more on the muscles of your feet, toes, and ankles to propel you forward, running barefoot may contribute to stronger muscles in the arch of the foot and the calf as well as less pressure on your knees. However, for people who naturally land hard on their heels, they may need to take extra precautions. Shortening their stride and focusing on landing on the mid to front part of the foot may help prevent injury when running sans shoes. The extra workout also requires increased attention to stretching and massaging the muscles in the legs and feet before and after running to prevent strain, muscle tears, and scar tissue build-up.

At first, some runners who switch from traditional running shoes to being barefoot may feel discomfort in their feet, legs, and hips. Aside from the fact that your shoe-accustomed feet may require some sensorial adjustment, other parts of your body will likely need time to acclimate as well. One way to minimize discomfort is to transition gradually. Slowly build up distance (starting at a quarter mile to one mile every other day) sans shoes. If you're already a skilled runner, run with shoes for most of your run, then progressively increase the amount of time without shoes. A good rule of thumb is to increase distance without shoes by ten percent every week. Muscle soreness will likely occur as your body adjusts, but pain in your joints or bones may be a sign of injury. You may want to discuss your potential injuries with a health care provider.

For those with less skepticism about shoes, some manufacturers are producing minimal footwear, or lighter running shoes with flatter, more flexible soles that mimic the benefits of being barefoot. Less cushioning and elevation in the heel may offer many of the same benefits as barefoot running while still protecting your tootsies from the elements. To learn more about barefoot running or running in minimal footwear, check out the great videos and tips from Harvard's Skeletal Biology Lab.

No shoes? No problem! Just watch out for debris!

Alice

January 3, 2013

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Try the Vibram FiveFingers shoes (the ones with individual toes, and no cushioning. They encourage (require) you to run exactly as you would in bare feet, but they protect against glass, thorns, and...
Try the Vibram FiveFingers shoes (the ones with individual toes, and no cushioning. They encourage (require) you to run exactly as you would in bare feet, but they protect against glass, thorns, and other debris. The Bikilia model is excellent for late-spring, summer, early-autumn running and general kicking around, but it's not water-proof at all. The new Lontra model is touted to be the equivalent for nasty-weather running. I've got Bikilias and a couple pair of earlier models (that I don't like as much), and my Lontra's have just been ordered. I prefer the separate-toes design to the other so-called minimalist runners that I've tried, because it lets the toes and forefoot move much more naturally in response to terrain. I can do a few miles at a time in my FiveFingers, but after more than a year, I consider myself still in transition from my moderate-support New Balance and Sauconys. I'd love to just run barefoot, but humans have made that unsafe. You get the sole of your foot slashed, and your running is set back for weeks or months. Vibram FiveFingers and other minimalist shoes seem to be the happy medium between dangerously unprotected and dangerously over-coddled.

Foods with negative calories?

Dear Reader #1 and Reader #2,

Negative-calorie or calorie-burning foods may sound magically delicious. Alas, there is no such thing as a calorie-free lunch (or breakfast, or dinner, or midnight snack). The negative-calorie theory hasn't been officially debunked, but all foods, with the exception of water, contain calories.

The idea of "negative-calorie" food stems from the notion that the body uses more energy to chew and digest certain foods than the food itself contains, thereby creating a net deficit in caloric intake. Some foods commonly thought to have this effect include celery, cucumbers, and cold water. However, that doesn't mean that eating these foods should be substituted for your daily workout. The amount of calories your body burns processing these low-calorie foods is so miniscule that it will not make a difference in your body weight. Additionally, these foods have little nutritional value, so if your diet is limited to these foods you may be missing out on the many vitamins, minerals, and other nutrients your body needs to maintain health.

If you are trying to lose weight, it may be helpful to consider substituting so-called "negative calorie" foods for higher-calorie ones, such as celery sticks instead of potato chips. In fact, substituting any kind of low-calorie foods (including celery and other veggies) for high-fat snacks may contribute to weight loss. However, adding "negative calorie foods" to an already healthy diet will have a miniscule (if any) effect. Some foods will cause a calorie deficit, but this deficit is tiny (think single calories) compared to the number of calories the average person eats per day.

For more tips on healthy eating, check out the Go Ask Alice! Nutrition & Physical Activity archive. Additionally, you may find it helpful to talk to your health care provider about developing a nutrition plan. To really jump-start your weight loss plan, you can also check out your local gym, fitness center, or join an exercise club to get a move on adding physical fitness to your routine! Fads aside, a realistic, long-term weight management plan includes plenty of fruits, veggies, whole grains, and lean proteins as well as a decent serving of physical activity. Take care,

Alice

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

Medical Services (Morningside)

Student Health Service (CUMC)


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

Long cardio workouts bad for losing fat?

Dear Wanna Lose Fat,

The Internet can be a good resource for health and fitness information, but it's great that you are double-checking your findings. Especially because there is not much support for the claim that long cardio workouts cause your body to store more fat. However, there is good evidence that high-intensity interval training (HIIT) is an effective fat-buster.

HIIT, or interval training, is characterized by alternating between periods of high- and low-intensity activity during a workout. For example, instead of running at a steady pace for 30 minutes, you could alternate between sprinting for one minute and then walking or jogging for two minutes. This fast/slow technique seems to maximize fat-burning.  HIIT may work by training mitochondria (the cell's energy centers) to burn fat calories before carbohydrate calories.

In general, high-intensity or aerobic exercise burns more fat than low-intensity exercise. For example, you will burn more fat calories by running for 30 minutes compared to power walking for the same amount of time. What counts as "high" or "low" intensity exercise varies from person to person, and also depends on your heart rate. Check out Minimum and maximum heart rate for aerobic exercise to learn more about how to calculate your target heart rate during a high intensity workout.

Many fitness experts also recommend mixing up your workouts to include weight training along with aerobic exercise in order to build muscle and burn fat more efficiently. Finding a variety of ways to exercise that you truly enjoy (whether it's cycling, dancing, running, or yoga) will also help you burn more fat in the long run — if you're having fun, you may be more likely to exercise longer and more often, and avoid burnout.

Before you begin interval training or start a new exercise regimen, you may want to talk with your health care provider. You can discuss your fitness goals with a personal trainer at your local gym or fitness center. 

Good luck finding a fitness plan that works best for you!

Alice

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

Medical Services (Morningside)

Student Health Services (CUMC)


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

"Diabulimia" — risky weight management for people with type 1 diabetes?

Dear The Wondering Diabetic,

As you've experienced, weight gain can be a common side effect of insulin therapy. Some diabetics do resort to skipping their insulin shots in order to lose weight, a disorder known as "diabulimia." Doing this can be dangerous to your health, but the good news is that diabetics and non-diabetics alike can safely control their weight through regular exercise and a healthy diet.

Normally, insulin allows body cells to absorb sugar from the food we eat. Cells burn the sugar as energy and any leftovers are stored as fat. Before being diagnosed, type 1 diabetics are often under-weight since their bodies are unable to use sugar properly. Insulin therapy enables type 1 diabetics to process sugar, and to convert excess sugar into fat, which then causes weight gain. Skipping insulin shots may seem like an easy way to lose weight, but denying the body insulin has harmful effects.

Without insulin to metabolize sugar, body cells are deprived of necessary fuel. To survive, the body breaks down fat and protein (instead of sugar) for energy, which releases toxic acids called ketones. This leads to a potentially deadly condition called ketoacidosis. According to the Mayo Clinic, signs of diabulimia and/or ketoacidosis include weight loss, excessive thirst, frequent urination, low energy, nausea, fruity-scented breath, neglecting blood sugar monitoring or insulin dosage, and uncontrolled blood sugar. Diabulimia and lack of insulin also cause sugar to build up in the bloodstream. Over time, high blood sugar can cause heart and blood vessel disease, nerve damage, and kidney damage.

Safe weight management strategies for diabetics (and people recovering from diabulimia) include a healthy diet, frequent exercise, and proper insulin therapy. Nutrition recommendations are similar for diabetics and folks without insulin disorders, and include eating mainly fresh fruits and veggies, whole grains, and a daily breakfast to keep your metabolism steady. The American Diabetes Association has several good resources for diabetics who are looking for healthy ways to keep off excess pounds and stay in shape. Take a look at their exercise plan and meal plan for diabetics. You might also want to check out Meal planning for people with diabetes on Go Ask Alice!

Before making diet or exercise changes, diabetics should talk with a health care provider.

Although it may be tempting to skimp on your insulin shots to lose a few pounds, diabulimia has serious health consequences so you're right to be wary of this weight loss strategy. Healthy diet and exercise are safe ways to manage your weight that will keep you healthy in the long run.

Alice

Food coma

Dear Reader,

The symptoms you describe sound like what many people call the "food coma." Sometimes, 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

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