Nutrition & Physical Activity
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!
January 3, 2013521062
"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!
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,
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!
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.
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!
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!
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.
Kudos for thinking about how your behavior might affect your long-term health and writing in to ask about it. What you describe is called pica, an eating disorder where people frequently eat non-nutritive (non-food) substances. Depending on what a person eats, pica can be very dangerous. Ingesting dangerous substances or large amounts of some substances can lead to medical problems, including poisoning. There is also a risk of infection resulting from some substances, such as soil, and stomach problems including constipation, and other issues.
Fortunately, in your case soap is not a very dangerous substance, though in large amounts over time it could disrupt your health. Soap is generally non-toxic and should not lead to poisoning. However, it can cause diarrhea, vomiting or skin irritation.
The causes of pica are not known but some suggest that the following may contribute to the desire to eat non-food items:
- Nutritional deficiencies. Some speculate that pica is your body's way of telling you that you are missing some important nutrient. Iron, calcium, zinc, and vitamins C & D deficiencies have been found in people with pica.
- Culture and family influences. There is some suggestion that certain cultures and social groups accept eating non-food substances. Also, if your parents encouraged this as a child, you may still have the urge to eat these substances.
- Stress. The desire to eat non-food substances may be a coping strategy for stress.
- Underlying biochemical disorder. In some cases, pica may result from chemical imbalances in your brain.
You mentioned that eating soap makes you feel good when you're stressed. This could be a sign that your stress level is too high and your body is reacting by craving soap. You could consider finding alternative ways to deal with your stress. See Stress, anxiety and learning to cope and Number one cause of stress for some tips on other ways to combat stress.
Pica is rare in adolescents and adults, and can be the sign of other medical issues including nutrition deficiencies so you should consider contacting a health care professional to help figure out what might be causing this behavior. Columbia students on the Morningside campus can call 212-854-2284 to make an appointment or log on to Open Communicator. Students on the Medical Center campus can contact Student Health at 212-304-3400. You may also want to consider talking with a counselor about healthier strategies for coping. Columbia students can make an appointment with Counseling and Psychological Services (Morningside) or the Mental Health Service (Medical Center).
You took an important first step in asking about your behavior, but it's also important that you take the next step and talk to a health care professional who can help you figure out if there is some underlying cause. Taking care of your health is not silly — it's smart.
All the best,
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Thank you, I thought that I was the only one and I searched high and low. I feel better knowing that there is a name for it. I opened up and told two relatives and I got scared when...
Thank you, I thought that I was the only one and I searched high and low. I feel better knowing that there is a name for it. I opened up and told two relatives and I got scared when they hinted that it may cause sterility. I also only eat bar soap and it relaxes me. I will take a chunk out of it and it's kinda like woosaa.
Thank you for this post and thank you for opening up soap eater.
Congratulations on getting a handle on a difficult situation. Anorexia can be life-threatening, so you've essentially saved your own life — something that hopefully makes you proud. As you point out, a side effect of anorexia can be secondary amenorrhea (loss of period for six months of longer). Typically, women in recovery find their periods come back once they get their weight up to what it was before they stopped getting their period. Some women, who aren't underweight, but who stop getting their periods during times of extreme exercise and erratic eating, regain their period once they get back into a routine of healthy eating and exercise habits. So, your concern is warranted. And, yes, it would be a great idea to seek a medical work-up at this point. Before you head to your health care provider, it might help you to get more information.
There are several possible explanations for secondary amenorrhea. Given your history of living with anorexia you may be experiencing functional hypothalamic amenorrhea (FHA). While FHA seems to occur most frequently in women with low amounts of body fat, it can happen in women of various body shapes. The common denominator seems to be erratic eating patterns and/or excessive exercise. These behaviors disturb the thyroid gland and hypothalamus-pituitary-adrenal gland in ways that lead to increased production and release of steroid hormones, called glucocorticoids (including cortisol, a major stress hormone). Also, low body weight is associated with lower levels of leptin, a necessary chemical that helps to regulate ovulation. In combination, these chemical changes in the body can affect periods and stop them altogether until the chemical balance is restored through changes in behavior and/or hormone therapy.
While your amenorrhea might be related to your history of anorexia, there are other health-related factors to secondary amenorrhea that you might want to consider:
- Hormonal contraceptives (e.g., some birth control pills, implanted or injected methods, intrauterine devices)
- Pregnancy or breast-feeding
- Extreme mental stress
- Certain medications (e.g., some antidepressants, chemotherapy drugs for cancer, oral corticosteroids)
- Chronic illness
- Thyroid problems
- Hormonal imbalance
- Benign pituitary tumor
- Uterine scarring
- Premature menopause
You can see there are many possible reasons for secondary amenorrhea. It's also important to know that women with secondary amenorrhea can be at increased risk for some pretty serious health conditions like: osteoporosis, bone fractures, cardiovascular disease, and metabolic problems.
You can contact your primary care provider or women's health specialist. If you don't have a trusted women's health care provider, you might consider finding one soon. If money's a problem, you can check out Planned Parenthood's website to find a local health center. Some Planned Parenthood centers offer sliding-fee services and other programs to cover the cost of care for people who qualify financially.
There's no doubt that secondary amenorrhea is a complex issue with many possible causes and consequences. And, everyone woman's situation is different. If investigating the absence of your period is the next step for you, working with a women's health specialist could help you get the answers you need.
To your continuing good health,