Nutrition & Physical Activity
Dear Toe-tally Barefoot,
Thinking about sayin’ see-ya to your sneakers? The question of whether to go au naturel has been discussed among runners for years. Everyone has a different running “footprint” (literally!): your stride length, how you land, and your speed can all play a part in your risk for injuries, whether you’ve got footwear on or not. But, research has started to confirm that barefoot running can be a good choice for runners who are injured, and it can lead to some improvements in running technique (though not speed). However, the consensus is that that unless you’re already experiencing injuries in traditional running shoes, there’s little added benefit to going shoeless.
Humans flitted around this Earth for many, many years without any sort of special footwear. Then, along came the modern, cushioned running shoe. The aim was to reduce pressure on the heel and protect the foot from sharp or dangerous objects on the ground. This is all well and good, but, for some people, the design of modern shoes affects the natural tendency to land on the front part of their foot — an area that’s designed to be a natural shock absorber. Some evidence suggests that the sturdy, built-up heels in running shoes may actually contribute to injuries, such as plantar fasciitis. How could this be? The design of modern shoes causes most runners to land on their heel (called a “rearfoot strike” or RFS). But, it’s believed that it’s actually better for the body to land with a forefoot strike (FFS), on the ball of the foot, because it:
- Requires you to take short strides, which keeps your weight centered.
- Reduces the force on the knee and hip joints.
- Gives you a more natural spring to your step, which may help you expend less energy.
Here’s where barefoot running comes in: When people run barefoot, they tend to naturally use to a FFS, as opposed to a RFS. For runners with injuries like plantar fasciitis or who find shoes uncomfortable, running barefoot may “force” them into a technique that is easier on their body. Barefoot runners may also land more softly, and because they must rely on the muscles of their ankles and toes, they may end up with stronger feet and lower legs. However, this extra workout also requires increased attention to stretching and massaging the muscles in the legs and feet before and after running to prevent strain and muscle tears.
So, why don’t researchers recommend barefoot running for everyone? There are a couple of potential risks:
- While it has been shown to help runners who are injured, it’s unclear whether barefoot running actually results in fewer injuries overall.
- People who naturally land very hard on their heels could hurt themselves trying to run barefoot. It takes time, effort, and patience to un-train yourself from running a certain way.
- People with bunions, neuromas, or severe diabetes may want to stick with their sneaks for necessary added foot protection and support.
- The added force on your toe bones and Achilles tendons could result in injuries to those areas.
One way to minimize discomfort and injury with barefoot running is to transition to shoeless-ness gradually. Slowly build up distance without shoes. Muscle soreness may occur, but pain in your joints or bones could be a sign of injury. You may want to discuss potential injuries with a health care provider. Also, the pads of your feet are pretty tough, but keeping an eye on the ground is essential so as to avoid stepping on something dangerous.
If you’re not ready to let your feet go naked, some manufacturers produce minimal footwear, or shoes with flatter, more flexible soles that mimic being barefoot. Keep in mind, though, simply switching shoes won’t necessarily mean a change to technique. Some runners are able to transition to a FFS while still wearing traditional shoes. Working with a running expert or physical therapist might be a smart move if you’re interested in improving your technique, whether you’re laced up or shoeless. 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? (Probably) no problem! Just take it easy, pow-wow with a pro, and watch out for debris!
"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!
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)
- 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.
Whatever the cause of your endless appetite, hopefully this has sated your hunger for an answer. Eat up!
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:
- Certain medications (such as corticosteroids and some antidepressants)
- Grave's disease
- 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,
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 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.
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.
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!
March 20, 2012508875
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.
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!