Nutrition & Physical Activity

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Kickstart for getting healthy eating and exercise plan in gear?

Dear In dire need of a diet/workout routine,

While you may be low on motivation right now, don't fret; it's never too late to get back on track.

Instead of thinking about the negatives related to lack of exercise and poor diet (excess weight, feeling sluggish), thinking about the positive benefits of healthy exercise and eating patterns may help your motivation return. Exercise and a healthy eating plan can help promote long-term health, but they also have more immediate effects. Exercise helps relieve stress and causes the brain to release mood-improving compounds called endorphins. Time spent on exercise is time spent on you, time for you to consider the issues of the day or to simply clear your head. Working out improves sleep quality, so we have more energy to take on work, school, and the next workout. In the past, what positives have you experienced from exercising and eating well?

Having established some pros, you may want to consider the barriers that are keeping you from eating healthily and doing regular physical activity. One example might be that you don't see healthy lunch options at your workplace or school. Another could be that some fitness center memberships are too pricey. What are all the barriers you can think of? (Hint: start writing them down!) Once you know what you're up against, you can brainstorm solutions and take a step-by-step approach to implement your solutions. For example, with the lunch time conundrum, would it work to pack a healthy lunch two or three times per week? Or could you start to scour the menu and deli shelves for healthy options that may be hidden away? Some folks find that rewards are part of the solution. What are some non-calorie rewards that would give you the incentive you need to stay active and eat well?

Feeling sluggish can be related to giving your body more fat, sugar, and calories than it needs. An energy boosting, balanced diet includes plenty of fruit, veggies, low-fat dairy, lean proteins, and whole grains. Look at the Related Q&As listed below, or visit the Academy of Nutrition and Dietetics or Choosemyplate.gov web sites for tips and guidelines that will help you to put together a healthy and tasty eating plan. As you change your eating patterns, you may even chart your moods in a daily organizer, to see the foods that are making a difference.

Another great way to get back on track with exercise and healthy eating is to gain the support of an ally. Working out with a buddy will make it easier and more enjoyable, and will keep you accountable for those days when you want to skip your exercise. By varying the time of your workout and/or the activity you do, you can prevent getting bored with your same old routine. Sharing a home-cooked meal with a friend can be fun and healthy.

If you prefer, you could also get a professional perspective. Columbia students can schedule time with a trainer at Dodge Fitness Center. For healthy meal planning, Columbia students can set up an appointment with a registered dietitian by contacting Medical Services (Morningside) or the Student Health Service (CUMC). You can also participate in Columbia's physical activity initiative by joining CU Move. CU Move encourages members of the Columbia community to engage in active lives that include regular physical activity. The program provides participants with motivation, incentives to be active throughout the year, and event calendars with access to plenty of free and low-cost physical activity options on campus and around NYC. If you are not part of the Columbia community, you likely have personal trainers at your university fitness center, local gym, or YM/YWCA.

Be realistic, have fun, take small steps toward your goals, and you'll be on your way to getting big rewards!

Alice

I'm worried about my friend who may have bulimia

Dear Reader,

Your friend is lucky to have a friend like you, who observed a change that concerned you enough to ask for help and learn more about what could be going on. A twenty-five pound weight loss in one month is definitely cause for concern. Losing that much weight in such a short period of time could indicate a medical problem. Has your friend seen a health care provider recently? If not, you may consider urging her to schedule an appointment with a medical provider for a physical exam to make sure she is okay. This may or may not be an easy thing for you to do. Strategies to consider when encouraging a friend to see a health care provider include:

Validating your friendship
Convey that you care for her and that your concern is genuine. You can say, "I value our friendship, and I hope you know that I care about you."
 
Thinking about your approach
Plan what you will say. Be direct with your concern, and focus on your friend's health rather than on her weight. Sometimes it's easier to identify an aspect of someone's health or behavior. For example, "I've noticed that you seem tired all the time"; or, "I've noticed that you seem kind of blue lately." If she's an athlete, you might be able to comment on her decreased performance. Whatever you choose to say, keep the emphasis away from weight, appearance, and food, because sometimes the most seemingly innocent statement can be misinterpreted and unwittingly close a door you had planned to open.
 
Offering a plan with options
Sometimes it's not enough to express concern. Follow up your observation with action-oriented ideas. For instance, "Is there a health care provider you feel comfortable scheduling an appointment with? If not, I'd be happy to help you find one." Or, "I can go with you to your appointment with the health care provider, if you like, or perhaps there is someone closer to you whom you might like to go with instead."
 
Recognizing your own limitations
Perhaps going to a health care provider with your friend is outside of your comfort zone. That's okay. It's important to know what you feel comfortable with so you avoid overextending yourself. Maintain whatever boundaries you need to so as not to get stressed out. Choosing to stay within your limits doesn't mean you're not supporting your friend.

It is not clear whether or not your friend has bulimia; however, you have noticed that she is in a serious situation and needs to be seen medically, since her health may be at risk. If you think your friend has an eating disorder, consider the following:

  • Individuals with bulimia nervosa tend to be of normal to slightly overweight range. Bulimia typically involves regular and repeated, often secretive binge eating bouts followed by purging, or other compensatory behaviors, to prevent weight gain. In general, purging is accomplished by self-induced vomiting and/or misuse of laxatives, diuretics, or enemas (purging type). People with bulimia may resort to other extreme behaviors, such as excessive physical activity or self-induced starvation (non-purging type) to avoid weight gain. Bulimia is highly correlated with substance abuse. People with bulimia often have a history of misusing alcohol and/or other substances.
     
  • Anorexia nervosa is characterized by an unwillingness and inability to maintain a healthy body weight. Typically, someone with anorexia is at 85 percent or less of her/his healthy body weight. S/he has a severe fear of fat and weight gain, and has a distorted body image. The seriousness of the significant weight loss is often denied by someone with anorexia.
     
  • Binge eating disorder is similar to bulimia nervosa in that it is typically characterized by regular and repeated binge eating episodes. An episode of binge eating involves rapidly and uncontrollably eating a large amount of food in a single time period at one sitting until uncomfortably full. Unlike bulimia nervosa, binge eating disorder does not include purging or other compensatory behaviors. Affected individuals are usually obese and have had problems with fluctuations in their body weight. For a majority of these individuals, binge eating begins during a diet.
     
  • Eating Disorders Not Otherwise Specified (EDNOS) describes individuals who show signs of anorexia and/or bulimia, but do not fully exhibit the behaviors necessary to be clinically diagnosed with anorexia or bulimia. Someone with EDNOS may purge but not binge eat, or binge eat less than twice per week. So someone with disordered eating may not fit into the category of anorexia or bulimia, but still have an eating disorder that requires treatment.

A medical problem can trigger such significant weight loss in a short period of time, and so can depriving and/or ridding one's body of calories. Body weight remains stable when people eat just enough food to give their bodies the energy (calories) that they need for daily activity — calories taken in or ingested need to equal calories out or expended for weight maintenance. People gain weight if they consume more calories than their bodies need and use. If people eat fewer calories than they need and use, their bodies will take the energy from their storage, body fat, and will lose weight. Significant weight loss indicates that there may be multiple factors involved.

Based on your observations, the sooner you take action, the better. If you're comfortable, consider your approach if/when you talk with your friend. Timing is important, so choose when you two can sit in a relaxed environment that allows enough time to talk. Think about what you will say without coming across in a threatening or accusatory manner. Use "I" statements to express your feelings about what you've noticed that seems to be happening with her: "I'm worried that something is going on with your health." Try not to let the discussion turn into an argument or power struggle. If the conversation becomes hostile, back off and resume after you both have had time to calm down and think. Be prepared for rejection the first, fifth, or tenth time you express your concern with her. Persistence could pay off at some point, as the road to recovery is a process. If your friend denies she has a problem, a common reaction, don't take it personally; at least your friend now knows that she can come to you if/when she's ready to ask for or to get help.

If you're a college student, you can get help and support for your friend and even for you in dealing with your friend, from your resident adviser (RA) or residence hall director (RD), dean, advisor, or from someone in the Counseling Department. If you are at Columbia, you can reach out to the Health Services' Eating Disorders Team, Counseling and Psychological Services (CPS) at x4-2878, or a nutritionist or medical provider at Medical Services at x4-2284. As you can see, there are many opportunities to begin to get the help you need to be able to help your friend. It is important to remember that she needs medical care, and that you alone cannot fix her. She's lucky to have someone like you who cares enough to reach out.

In an emergency situation, however, you need to involve your friend's RA, RD, and/or dean to make sure she gets appropriate help immediately. Signs that indicate an urgent situation include sleeping all day, blacking out, suicidal thoughts or attempts, or significant weight loss, such as in this case. You may feel reluctant to blow the whistle on your friend, but you will be a better friend by helping her get the assistance she needs than by respecting her privacy in this specific situation.

Alice

I need an effective, short-term weight loss and toning plan

Dear Annie,

Bravo for incorporating physical activity into your schedule! Regular exercise increases energy levels, improves quality of sleep, and boosts self-esteem. In terms of the effectiveness of your routine, it's difficult to say. Losing weight and toning up is influenced by multiple factors, including height, weight, bone density, genetics, and previous exercise regimen. By "a few pounds," do you mean two or ten or more? When setting out to change your body, it's important to ask yourself if the change you are striving for is realistic. In terms of your desired outcome, first ask yourself, "is this a realistic goal for me?" If you are unsure, it is wise to consult a personal trainer, exercise physiologist, registered dietitian, or your health care provider.

Part of effectively setting and reaching a goal means establishing one, or several, measurement criteria. Are you using a scale to measure body weight? Are you measuring body/fat composition? Strength? Clothes size? Body image? It's important to keep consistent with your indicators to know if you are making progress. If you are using a scale to measure body weight (in pounds), keep a few things in mind:

  • Muscle weighs more than fat.
  • Women especially can be prone to minor weight fluctuations due to menstruation and other types of hormonal activity.
  • Water, an essential nutrient for all sorts of body functions, can tip the scale one way or another.

You can also incorporate some basic guidelines into your plan that will help you maintain an active lifestyle:

  • Start slowly and build over time. It is smart to start off with a goal of running one mile as a workout, with the intention of increasing distance over time. Many people drop out of their exercise program because they go too hard, too fast, too soon. Pacing yourself, especially at the beginning, will help you establish confidence, self-awareness, and a strong fitness base.
  • Incorporate variety into your exercise and eating routine. Including different types of food and activity into your schedule will help to maintain enjoyment and motivation. You mention running and abdominal exercises — are there other types of activities you enjoy? Decreasing body fat and increasing toning or strengthening of muscle requires a balance of cardiovascular and strength training activities. Also, a wide variety of foods will help to ensure that your body is getting the nutrients it needs. Eat plenty of fruits and vegetables and think about decorating your plate as though it were a box of Crayola crayons; that is, aim for foods that are rich in color, such as blueberries, spinach, salmon, and tomatoes.
  • Find a friend. Studies have shown social support plays an important role in exercise motivation and sticking to an activity plan. Recruit friends and/or family to join you on a run, accompany you to lunch, or offer support.
  • Get plenty of rest. Sleep deprivation often makes everything more challenging, and it is especially easy to skip exercise when you feel tired. Sleeping well may help you avoid that trap. Plus, the more you exercise, the more rest your muscles will need to repair and recover.
  • Make it fun. Listening to music, running in the sunshine, or playing a rousing game with friends are all examples of ways to maximize fun and make physical activity something you look forward to and enjoy.

Maintaining a healthy and nutritious diet is an integral part of living a healthy lifestyle and achieving your weight loss goals. Here are a few great tips that may help you achieve your nutrition goals:

  • Keep a food diary.
  • Choose a diet low in fat, saturated fat and cholesterol and moderate in sugars.
  • Eat smaller meals more often — this can help ward off hunger so that you won't overeat at your next meal. Healthy snack options include low fat yogurt, fruit, nuts, vegetables, and whole-grain crackers.
  • Prepare smaller portion sizes.
  • Eat your favorite foods in moderation to help stifle cravings and help you to stick to your diet.
  • Avoid unhealthy fad diets.
  • Eat slowly — this can help you feel more full and avoid overeating.

Above all, the most important thing to remember is that every individual is different. If you feel good about what you are doing and are making progress, keep going until you reach your realistic, healthy goal. You can do it!

Alice

Allergic to peanuts = allergic to pecans?

Dear Reader,

Being allergic to peanuts doesn't necessarily mean being allergic to tree nuts (and vice- versa). Being allergic to peanuts also doesn't automatically mean being allergic to other members of the legume family, such as lentils and soybeans. Similarly, being allergic to one kind of tree nut doesn't automatically result in being allergic to other tree nuts. However, most health experts recommend that people with peanut and/or tree nut allergies avoid all peanuts and tree nuts, just in case. A little introduction to peanuts and tree nuts might clarify this.

Peanuts are not actually nuts, but legumes, which are beans and peas. Peanuts, peanut products, and peanut by-products are found in many foods and in many variations, such as peanut flour, peanut oil, and peanut butter. The presence of peanuts in foods is tricky to identify; they can even be a hidden, unlabelled ingredient, such as hydrolyzed plant or vegetable protein. Also, cross contamination during manufacture of food products is another source of exposure to peanuts that can elicit allergic reactions, so some non-nut items are labeled as "may contain nuts."

Unlike peanuts, pecans are part of the tree nut family, which also includes almonds, walnuts, cashews, hazelnuts, pistachios, macadamia, chestnuts, and brazil nuts. Tree nuts are also present in a variety of foods and even in some bath and beauty products.

Allergy to peanuts and tree nuts, usually life-long, are two of the most common food allergies. Fortunately, many people with these allergies experience mild responses to the proteins found in peanuts and tree nuts, such as sneezing and/or itching. However, what is worrisome about these allergies is that some people experience severe enough reactions from miniscule amounts that can be life-threatening (e.g., difficulty breathing, loss of consciousness). In fact, about 100 people in the United States die each year from their peanut allergy. The most intense responses tend to be from ingesting food containing peanuts, tree nuts, or their derivatives, but inhaling air contaminated with peanut or tree nut dust, having skin or eye contact with something containing these items, and even kissing someone who recently consumed peanuts or tree nuts also can produce allergic responses. In particular, the sensitivity of peanut allergies and the prevalence of peanuts in our food supply and elsewhere have made peanuts a source of heated controversy for schools, camps, airlines, and restaurants concerning whether or not to ban them in these places.

What is in your control to prevent peanut and tree nut allergies is avoiding all peanuts and tree nuts (though accidental exposure could still happen no matter how vigilantly you avoid nuts). Educating oneself about the allergy (i.e., always asking about ingredients and reading food labels carefully) and preparing oneself for accidental exposure (i.e., always keeping epinephrine nearby) are other keys to managing a peanut or tree nut allergy. If you are uncertain about whether or not you can eat pecans safely, your health care provider may be able to refer you to an allergist. S/he can administer a skin prick, blood, and/or medically supervised food challenge test.

For more information about peanut, tree nut, and other food allergies, check out the Food Allergy and Anaphylaxis Network web site.

Alice

Is canola oil dangerous or is this another urban legend?

Dear Confused,

Canola oil comes from a hybrid plant developed in Canada during the late 1960s to early 1970s using traditional pedigree hybrid propagation techniques (not genetically modified) involving black mustard, leaf mustard, and turnip rapeseed. The original rapeseed plant was high in erucic acid, which is an unpalatable fatty acid having negative health effects in high concentrations. Canola oil contains less than 1 percent erucic acid. In fact, another name for canola oil is LEAR (Low Erucic Acid Rapeseed) oil.

Your confusion about canola oil's safety is understandable. While the Internet can be a great source of information, many rumors and urban legends have circulated on web sites and been passed along in e-mails. Urban legends usually warn of dire consequences from something perfectly innocent; they often relate a story about someone who had such a terrible experience with something, yet that person almost always remains anonymous. These often frightening stories or accusations usually lack enough detail to make scientific, logical evaluation of the claim. The scare tactics of canola oil fit into this scenario.

Some of the information circulating on the Internet states that canola oil causes endless maladies: joint pain, swelling, gum disease, constipation, hearing loss, heart disease, hair loss... the list goes on and on. Canola oil has undergone years of extensive testing to assure its safety. In truth, canola oil contains essential fatty acids that our bodies need and cannot make on their own. Over 90 percent of the fatty acids present is the long chain unsaturated variety that has been proven beneficial to health.

It has also been claimed that canola oil is used in making mustard gas, a poison. This is totally untrue. Actually, mustard gas doesn't even come from the mustard plant; it was so named because it smells similar to mustard. Canola oil has allegedly been used as an industrial lubricant and ingredient in fuels, soaps, paints, etc. The truth is that many vegetable oils, such as corn, soybean, and flax, are also used in these applications. That doesn't make those oils unhealthy or dangerous. Canola oil has also been accused of killing insects, such as aphids. Again, all other oils can do the same, not by poisoning insects, but by suffocating them.

In China, rapeseed oil cooked at very high temperatures was found to give off toxic emissions. In the U.S., the combination of refined oils, added antioxidants, and lower cooking temperatures prevents this from occurring. In China, the oil contains contaminants, is not refined, and has no antioxidants. Some people have blamed the Canadians for paying the United States government to have canola oil added to its GRAS (Generally Recognized As Safe) list. There is absolutely no evidence of this.

As you can see, misinformation can be used to scare people. Good thing you knew where to turn! For more information on canola oil, you can check out the Canola Council of Canada web site.

Alice

December 17, 2012

520285
Why ingest erucic acid when you don't have to? I'll stick with my organic macadamia/olive oil.
Why ingest erucic acid when you don't have to? I'll stick with my organic macadamia/olive oil.

December 11, 2012

519994
I wouldn't eat it.
I wouldn't eat it.

Track versus treadmill

Dear Reader,

First off, it's not clear if you are running on an indoor or outdoor track. For the sake of this answer, let's assume you run outdoors when you do your track runs. There may be some slight physical differences between how your body expends energy running on a track versus a treadmill.

  • The treadmill belt offers some help by pulling your feet back underneath your body, so you are potentially exerting less energy to move your feet and legs than if you were not on a treadmill. However, running stride may change depending on jogging geography. Studies have shown that many runners shift their stride when running on a treadmill. There is a chance that these changes may contribute to your slumping stamina. Subconscious attempts to correct balance on the revolving surface of the treadmill may also cause a runner to increase the amount of time his or her support leg is in contact with the belt, which, in turn, may decrease his or her forward lean. This may result in a runner spending more energy on moving up and down rather than forward, potentially leading to a quicker sap on energy.
  • When you run indoors on a treadmill, you do not have to overcome wind resistance. The lack of wind means you'll spend less energy running four miles on a treadmill than you will when you run four miles outdoors. However, it may depend on how fast you are running. For the average person, running five to nine miles per hour (mph) will result in little difference. Some studies say outdoor running expends up to five percent more calories; if you run faster than nine mph, running outdoors could utilize up to ten percent more calories because you are working harder against wind resistance. Other studies say there's no difference. One study demonstrated the way to balance energy use between indoor and outdoor running is to set the treadmill at an incline (or grade) of one percent.
  • Running indoors maintains or offers stable elements. Runners not only avoid wind, but also other potential natural elements, such as cold air, rain, or sand (if you run on a beach), which demand extra energy. The stability offered by a treadmill, however, does not necessarily mimic reality. On a treadmill you consistently run at the same pace. When outside, you may subconsciously slow down as your body tires, allowing you to run farther since you're exerting less energy. If you haven't already done so, use a stopwatch to measure your outdoor running speed to see if this is the case.
  • Running on a treadmill versus pavement (the composition of the track surface you run on is unclear) provides a softer surface, making it a little easier for your joints. People with knee pain or soreness might opt for a treadmill versus the road outside for this reason.
  • Though running on a treadmill may offer these benefits plus others, the psychological benefits of running au naturel may be contributing to your feelings of fatigue. Psychological cues from running outdoors, such as feeling wind against your face or gaining motivation from running with or around other people may make runners feel like they're making progress. On a treadmill, there is also the option to track the distance, speed, and other characteristics of your workout which may subconsciously cause you to feel tired ("wow, I'm running really fast/far!").

Your boredom theory may certainly be contributing to feeling like you're running on empty. Without the need to worry about navigating different paths, terrains, or natural elements, treadmill runners may have more of an opportunity to think about how tired they are. Some people find that being distracted may help them fight this and run for a longer duration. Sports and exercise psychologists often refer to the "distraction hypothesis" as an explanation for the stress/anxiety reducing effects of exercise. Running, in this case, gives someone a time-out from daily stressors or worries by diverting attention. Some people enjoy running on a treadmill because they can watch television, listen to music, or just zone out and run. Others prefer running outdoors because they are distracted by the scenery, other people, the weather, varying terrain, and/or avoiding traffic.

The next time you run on a treadmill, if possible, position yourself in front of a television or listen to your favorite music to test this "distraction hypothesis." See if you can run for a longer period of time. Other factors that contribute to how a person feels when s/he runs include the food(s) s/he has eaten, how well s/he has slept, and/or whether or not s/he is properly hydrated. Every day is a different day for our bodies, but if someone is a consistent runner and has fairly consistent lifestyle behaviors, it may be that their enjoyment of the outdoors is what fuels their running. Though track and treadmill running both offer many of the same benefits, finding out what works best in your workout routine will lead to a more satisfying experience.

Alice

Nutrition facts label

Dear Mom trying to offer healthy choices, but having some technical difficulties,

To think, while some children beg for the latest neon-colored sugar cereal to hit the shelves, your two children are tallying fiber grams. They have fostered their interest in nutrition. Educating about and encouraging healthy behaviors are keys to lowering risks of chronic diseases, such as heart disease and cancer, later in life.

As you are aware, the "Nutrition Facts" label is a helpful tool for understanding what each food contributes to daily nutrient intake. These labels provide the amount of carbohydrates, fat, protein, as well as percent daily values for a number of nutrients. Percent Daily Values (DV) are based on a 2000-calorie eating plan, which can be confusing, because that's more calories than most of us need. For an in-depth explanation about this or other food label content issues, check the U.S. Food and Drug Administration (FDA), or the Kidshealth.org Figuring Out Food Labels page for kid friendly explanations.

Unfortunately, curious consumers will not find "Nutrition Fact" labels on all foods, even if foods have packaging. Some specific exceptions to food labeling requirements include:

  • Ready-to-eat food that is not for immediate consumption but is prepared primarily on site — for example, bakery, deli, and candy store items
  • Food shipped in bulk, as long as it is not for sale in that form to consumers
  • Medical foods, such as those used to address the nutritional needs of people with certain diseases
  • Plain coffee and tea, some spices, and other foods that contain insignificant amounts of nutrients

Though you might not see nutrient labels on fresh foods, the information needs to be nearby. The FDA created a voluntary program to promote retailer labeling of the top 20 most commonly sold fruits, vegetables, and fish, as well as the 45 best-selling cuts of raw meat and poultry. The nutrient information needs to be available as a brochure, leaflet, notebook, or stickers in the appropriate grocery department. Labels for fruits, veggies, and raw fish include the following:

  • Name of the fruit, vegetable, or fish
  • Serving size
  • Calories per serving
  • Amount of protein, carbohydrates, fat, and sodium per serving
  • Percent of the Recommended Daily Allowances (RDA) for iron, calcium, and vitamins A and C per serving

For nutrient information for 5,900 foods from alfalfa sprouts to zucchini at the click of a button, look to the U.S. Department of Agriculture's (USDA) Nutrient Database. A simple keyword search and portion size specification will yield the complete nutrient profile of your food.

One of the most comprehensive print versions of nutrient composition tables is Bowes & Church's Food Values of Portions Commonly Used, by Jean A. T. Pennington, Ph.D. Some 8,500 foods are listed according to food group with analysis results for 30 nutrients, but they are not in "Nutrition Facts" label format.

Hopefully these resources will help make your technical difficulties with nutrition labels a thing of the past!

Alice

What's a healthy weight?

Dear Confused,

It is courageous of you to write in about your situation, an important first step in getting to a healthy weight (and body image, for that matter). For most women, a healthy weight is one that allows regular menstruation and is sustainable when following a healthy, balanced eating plan. If the only way to attain a certain weight is by severely restricting your eating, that weight is not the healthiest, most natural weight for your body.

As far as a healthy weight for you is concerned, pinpointing a number, or even a range, without having a thorough medical assessment would be difficult, because different people can be healthy even if they have vastly different body weights. Unfortunately, media images and celebrities often aren't great role models when it comes to having a healthy weight. Some celebrities may be thinner than you, as you note, however they may achieve their weight through unhealthy means, such as over exercising, using drugs or diet supplements, or severely restricting their diets. In reality, they may owe their good looks more to teams of stylists and make-up artists than to good health.

It sounds as though you still have concerns about your health, even though the purging has stopped. You're right to realize that not getting your period is a huge red flag indicating something is not right with your body. Amenorrhea (loss of your period) can happen if your weight is very low, especially if your body fat is too low, or if your diet is too low in fat. Other factors, such as excessive exercise, may also play a role in amenorrhea. Your reluctance to see a health care provider is natural and understandable, many people who have disordered eating feel the same way, however amenorrhea is a condition that needs medical attention. If you are a student at Columbia, you can meet with a member of the Eating Disorders Team (Morningside) or with any provider at Medical Services (Morningside) or the Student Health Service (CUMC).

As for your diet, based on the plan you describe, your body is probably lacking many nutrients, including calcium, vitamins D, K, B-6, and B-12. In addition, you may be getting too little zinc, magnesium, iron, essential fatty acids, and protein. Some vitamin and mineral deficiencies take time to develop, but you are starting to see the effects of inadequate nutrition by not getting your period. Many people make the mistake of severely limit their dietary fat; however, our bodies must have some fat to absorb vitamins A, D, E and K, assimilate calcium into our bones, and manufacture sex hormones such as estrogen. Women need estrogen to keep their bones strong and get their period. The amenorrhea is a clue that your body isn't making sufficient estrogen, which, if continued, can put you at risk for developing osteoporosis — even as a young person.

When you're thinking about improving your diet, remember that your body needs healthy forms of carbohydrates, fats, and protein to function well and stay healthy. Balancing these "macronutrients" may sound like a daunting process, but if you break it down to small, manageable goals, even small bites, you could have a better chance for success. You can check out ChooseMyPlate.gov to find more information about balanced eating. Here are some tips to get started:

  • Try adding one new food at a time to your daily regimen.
  • You might start with a good source of protein: tofu, fish, poultry, meat, or eggs.
  • Next, you can add milk (soy or dairy) or yogurt to your cereal. It will help to satisfy your hunger, and provide much needed calcium in your eating plan.
  • Add in some vegetables, one at a time.
  • Finally, try switching to some whole grains; for example, whole wheat bread or brown rice (instead of the white varieties of each).
  • If you feel more comfortable snacking or having several small meals during the day instead of having full meals, that's fine, as long as you have well-balanced food choices.

Although you don't want to tell anyone about your situation, it might just help you feel better about your situation. Perhaps there is a parent, religious leader, guidance counselor, teacher, doctor, nurse, friend, or relative with whom you could speak to help put your body image in perspective. Maybe starting the conversation seems like the most difficult part. If you are nervous about how to start, you can simply write down your symptoms and show someone, like you have here. You may find that talking to someone is less difficult than you expect, and also worthwhile.

Alice

Eating healthy at the campus dining hall?

Dear Hungry,

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

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

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

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

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

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

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

Bon appétit!

Alice

Is soreness a good indicator of a good workout?

Dear Pushed too far,

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

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

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

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

Alice

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