Nutrition & Physical Activity

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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

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

ALWAYS hungry!

Dear Overactive eater,

Generally, a case of the munchies is your body's way of signaling that it's time to refuel. If snacks and even full meals don't fill you up, there may be another cause for your ongoing hunger. If diet changes don't do the trick, a visit to a health care provider may ease your mind and your appetite. Based on your description, it sounds like you can rule out the possibility of a digestive parasite. Rather than fueling your hunger, most stomach bugs cause digestive troubles like nausea, vomiting, and diarrhea that can kill your appetite. There is one infamous bug, the Taeniasis parasite (a.k.a., 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 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 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.

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

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

Medical Services (Morningside)

Student Health Service (CUMC)


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

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

Blue corn chips — Are they healthier?

Dear Reader,

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

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

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

Alice

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