Nutrition & Physical Activity
Fortunately for people who wish to lose weight, there are universal rules that apply, regardless of your typical diet — whether you're a vegetarian or omnivore. First, to lose weight a person has to use more energy (calories) than s/he takes in. To achieve this deficit you can either make dietary changes (so you're taking in less calories), get more physical activity (so you're using more calories in a day), or you can make changes in both areas. Experts recommend making both dietary changes and getting more physical activity for the best results.
It takes a deficit of about 3500 calories to lose one pound of body weight. This means if you are able to cut 500 calories per day from your regular diet you should be able to lose a pound a week (a healthy weight loss rate). It may be beneficial to consider finding the right balance of increasing your physical activity and decreasing caloric intake. You can check out the ChooseMyPlate.gov SuperTracker as a resource that can help you calculate how many calories you need per day, what nutrients are in the foods you eat, and how many calories you burn doing different exercises.
Some suggestions for dietary changes to reduce calories:
- Steam, boil or bake foods instead of frying in butter or oil.
- Sauté foods in vegetable broth, wine, or water instead of oil.
- Limit of high-fat condiments (like mayonnaise, margarine, sour cream, cream cheese, salad dressing, etc.).
- Try low-fat dairy products and nut- or peanut butter. Vegetarians sometimes begin to rely heavily on these foods as sources of protein, but low-fat dairy and nut products provide the same amount of protein as their full-fat counterparts.
- Add beans and legumes to your diet as low-fat sources of protein.
- Eat actual fruit or vegetables rather than drinking them in juice or smoothie form. The fiber in fresh produce works well to satisfy hunger.
- Substitute water, tea, and diet beverages for regular soda, juices, and other high-sugar drinks.
- Limit the amount of alcoholic beverages consumed (empty calories for everyone).
- Begin lunch or dinner with a broth-based, vegetable filled soup or a large salad with a small amount of low-fat or fat-free dressing. These foods take longer to eat and can help curb your hunger so you don't overeat during the rest of the meal.
Be mindful of portion sizes — read nutrition fact labels to find out serving sizes. Some rules of thumb:
- A medium apple or orange is the size of a tennis ball.
- A medium potato is the size of a computer mouse.
- An average bagel is the size of a hockey puck.
- An ounce of cheese is size of four dice.
Some suggestions for incorporating more physical activity into your day:
- Take the stairs as often as possible.
- Park at the far end of the parking lot or get off the bus or subway a stop early.
- Schedule your cardiovascular exercise (walking, jogging, swimming, biking, frantically cleaning your apartment before visitors come over, etc.) so you know you will be able to fit it in. If you're at Columbia, you can participate with CU Move to help stay motivated with your physical activity efforts and earn incentives. Check out the site to learn more.
Hopefully, you'll find some of these suggestions new and helpful. Good luck!
Kudos for taking the first step and reaching out to ask about your feelings and behaviors. The symptoms you describe, including going long periods of time without eating, may be dangerous and could have long-term effects on your health. Feeling down once in a while is common but the depression you mention, and the fear of becoming more depressed if you begin eating more regularly, may be a serious clinical depression (and could be what is affecting your eating habits).
Skipping meals and intentionally not eating for periods of time (sometimes called fasting) can become addictive. Many people who fast experience euphoric feelings of well-being, feelings that are likely harmless when fasting in moderation. However, this "high" may mask feelings of being down or depressed and could explain why you feel better when you avoid eating (and why you continue to go long periods of time without food). Fasting too often can be detrimental to your health because your body is denied nutrients and energy it needs.
Avoiding food could also be a sign of a serious eating disorder: anorexia nervosa. See Eating disorders vs. normal eating for more information about the signs and symptoms of eating disorders. People with anorexia sometimes describe a feeling of control when they don't eat; a feeling that may be very powerful. You mention that you feel like you can't change anything in your life; controlling what you eat and skipping meals may be a way of feeling in control. Talking with a counselor or other mental health care provider about your feelings and eating habits may help you to understand your behaviors and feel more in control of your life.
Talking with a mental health care provider may be a good way to begin to think about other factors in your life that may be contributing to your desire to skip meals, especially when you are around your friends. If you aren't sure how to begin a conversation with a counselor, you could simply tell her or him what you have written here, or you could ask one of your concerned friends to go along and help explain what s/he has noticed about your eating habits. Gaining an understanding of why you are feeling this way is an important step to overcoming these feelings and being able to eat normally without fear of becoming depressed.
It may take some work to find the right counselor and confront your fear of becoming depressed, but you already took an important (and difficult!) first step to seeking help. It also sounds like you have good friends who want to support you. Best of luck as you take the next steps to living a healthier, happier life.
Kudos for thinking about how your behavior might affect your long-term health and writing in to ask about it. What you describe is called pica, an eating disorder where people frequently eat non-nutritive (non-food) substances. Depending on what a person eats, pica can be very dangerous. Ingesting dangerous substances or large amounts of some substances can lead to medical problems, including poisoning. There is also a risk of infection resulting from some substances, such as soil, and stomach problems including constipation, and other issues.
Fortunately, in your case soap is not a very dangerous substance, though in large amounts over time it could disrupt your health. Soap is generally non-toxic and should not lead to poisoning. However, it can cause diarrhea, vomiting or skin irritation.
The causes of pica are not known but some suggest that the following may contribute to the desire to eat non-food items:
- Nutritional deficiencies. Some speculate that pica is your body's way of telling you that you are missing some important nutrient. Iron, calcium, zinc, and vitamins C & D deficiencies have been found in people with pica.
- Culture and family influences. There is some suggestion that certain cultures and social groups accept eating non-food substances. Also, if your parents encouraged this as a child, you may still have the urge to eat these substances.
- Stress. The desire to eat non-food substances may be a coping strategy for stress.
- Underlying biochemical disorder. In some cases, pica may result from chemical imbalances in your brain.
You mentioned that eating soap makes you feel good when you're stressed. This could be a sign that your stress level is too high and your body is reacting by craving soap. You could consider finding alternative ways to deal with your stress. See Stress, anxiety and learning to cope and Number one cause of stress for some tips on other ways to combat stress.
Pica is rare in adolescents and adults, and can be the sign of other medical issues including nutrition deficiencies so you should consider contacting a health care professional to help figure out what might be causing this behavior. Columbia students on the Morningside campus can call 212-854-2284 to make an appointment or log on to Open Communicator. Students on the Medical Center campus can contact Student Health at 212-304-3400. You may also want to consider talking with a counselor about healthier strategies for coping. Columbia students can make an appointment with Counseling and Psychological Services (Morningside) or the Mental Health Service (Medical Center).
You took an important first step in asking about your behavior, but it's also important that you take the next step and talk to a health care professional who can help you figure out if there is some underlying cause. Taking care of your health is not silly — it's smart.
All the best,
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Thank you, I thought that I was the only one and I searched high and low. I feel better knowing that there is a name for it. I opened up and told two relatives and I got scared when...
Thank you, I thought that I was the only one and I searched high and low. I feel better knowing that there is a name for it. I opened up and told two relatives and I got scared when they hinted that it may cause sterility. I also only eat bar soap and it relaxes me. I will take a chunk out of it and it's kinda like woosaa.
Thank you for this post and thank you for opening up soap eater.
It's wise to keep a healthy skepticism about the marketing efforts of some of these huge food corporations. Dannon's probiotic-fortified yogurt, Activia, is certainly an example of a highly promoted product. In recent years, the global market for "functional foods," has grown to billions of dollars annually, and since these supplement-food hybrids are appearing on the shelves ever more rapidly, the FDA doesn't have a chance to evaluate all of their claims. While there is evidence that probiotics do help to improve digestion and gastronomic health, it is hard to say that one brand over another is more effective at doing so.
Probiotics, beneficial bacteria that live in the small intestine, are believed to improve digestion. These gut-friendly bacteria actually help you to digest and eliminate your food, while crowding out the unhealthy gut-dwelling bacteria that cause gas, constipation, and bloating. Studies have shown that certain probiotics can help relieve irritable bowel syndrome, diarrhea, constipation, atopic eczema, and may also help protect against various infections and colon cancer. Researchers have found that stressed-out rats have benefited from a serving of water containing certain probiotics. Not a flattering comparison for us people, who might feel like stressed-out rats from time to time, but the findings of the study may be helpful. Probiotics are found in many types of fermented foods, like yogurt, sauerkraut, tempeh, and miso.
Regular yogurt is made using these live cultures, and serves up a healthy serving of them with each spoonful. But your question, is Dannon's Activia more effective in providing these results than regular good old-fashioned yogurt, is one that begs a good answer. Dannon (of course) says yes. Their Activia yogurt contains Bifidus regularis, a probiotic strain trademarked by Dannon that is not in other yogurts, and they claim that this particular strain speeds wastes through the digestive system and improves immunity in the intestines more effectively than other strains.
Dannon says that their Bifidus regularis, "survives passage through the digestive tract, arriving in the colon as a living culture," whereas other cultures can be destroyed by stomach acids and the natural process of digestion. The consumer reports lab has confirmed Dannon's claim, reporting that about three million of the original three billion probiotic organisms in a four-ounce serving of Activia made it through the stomach to the colon.
There is one other difference you mentioned between this yogurt and the others: the price. Activia typically costs more per ounce than regular Dannon yogurt. There are also other brands on the market that offer yogurts containing probiotics that are similar to those in Activia. If you're willing to spoon out the extra cash for yogurts with these particular probiotics and have noticed a decrease in stomach grumblings as a result, it seems like it working for you and might be worth it. However, now that you know that all yogurts contain healthy amounts of probiotics, it might be interesting to see if those regular yogurts feel just as good as the one with all the advertising. Eat up!
Congratulations on getting a handle on a difficult situation. Anorexia can be life-threatening, so you've essentially saved your own life — something that hopefully makes you proud. As you point out, a side effect of anorexia can be secondary amenorrhea (loss of period for six months of longer). Typically, women in recovery find their periods come back once they get their weight up to what it was before they stopped getting their period. Some women, who aren't underweight, but who stop getting their periods during times of extreme exercise and erratic eating, regain their period once they get back into a routine of healthy eating and exercise habits. So, your concern is warranted. And, yes, it would be a great idea to seek a medical work-up at this point. Before you head to your health care provider, it might help you to get more information.
There are several possible explanations for secondary amenorrhea. Given your history of living with anorexia you may be experiencing functional hypothalamic amenorrhea (FHA). While FHA seems to occur most frequently in women with low amounts of body fat, it can happen in women of various body shapes. The common denominator seems to be erratic eating patterns and/or excessive exercise. These behaviors disturb the thyroid gland and hypothalamus-pituitary-adrenal gland in ways that lead to increased production and release of steroid hormones, called glucocorticoids (including cortisol, a major stress hormone). Also, low body weight is associated with lower levels of leptin, a necessary chemical that helps to regulate ovulation. In combination, these chemical changes in the body can affect periods and stop them altogether until the chemical balance is restored through changes in behavior and/or hormone therapy.
While your amenorrhea might be related to your history of anorexia, there are other health-related factors to secondary amenorrhea that you might want to consider:
- Hormonal contraceptives (e.g., some birth control pills, implanted or injected methods, intrauterine devices)
- Pregnancy or breast-feeding
- Extreme mental stress
- Certain medications (e.g., some antidepressants, chemotherapy drugs for cancer, oral corticosteroids)
- Chronic illness
- Thyroid problems
- Hormonal imbalance
- Benign pituitary tumor
- Uterine scarring
- Premature menopause
You can see there are many possible reasons for secondary amenorrhea. It's also important to know that women with secondary amenorrhea can be at increased risk for some pretty serious health conditions like: osteoporosis, bone fractures, cardiovascular disease, and metabolic problems.
You can contact your primary care provider or women's health specialist. If you don't have a trusted women's health care provider, you might consider finding one soon. If money's a problem, you can check out Planned Parenthood's website to find a local health center. Some Planned Parenthood centers offer sliding-fee services and other programs to cover the cost of care for people who qualify financially.
There's no doubt that secondary amenorrhea is a complex issue with many possible causes and consequences. And, everyone woman's situation is different. If investigating the absence of your period is the next step for you, working with a women's health specialist could help you get the answers you need.
To your continuing good health,
January 22, 2013522172
The symptoms you describe sound like what many people call the "food coma." Sometimes, after eating a holiday meal, a big dinner or lunch, or even sometimes after meals that didn't seem that big, you may feel a bit drowsy. Some medical conditions can cause this feeling, including anemia, kidney dysfunction, sleep disorders, infections, or an electrolyte imbalance just to name a few. But even people who don't have any of these medical conditions may still feel tired after eating, because this symptom is also a consequence of normal digestion!
Why? Because our bodies spend a lot of energy digesting food. The stomach mechanically churns the food, produces acid to break the food into tiny pieces, and then controls the rate this broken down food can enter the intestines. In the intestines, enzymes use energy to further break down and absorb food particles into the body. For humans, it is normal for the rate of energy use to increase by 25 to 50 percent after a meal. This increased bodily activity could contribute to your feeling flushed after eating.
One explanation for your drowsiness lies in one of the hormones released during digestion — cholecystokinin. Commonly referred to as CCK, this hormone helps make you feel full, but also activates the areas in the brain associated with sleep. So after eating, when CCK levels rise to tell you you're full, you may also start to feel sleepy. Additionally, meals high in carbohydrates can increase the levels of tryptophan (an amino acid) in the blood. In the brain, tryptophan is converted into serotonin (a neurotransmitter that makes people feel both happy and sleepy). This boost in serotonin could also cause someone to feel tired.
Since you don't feel tired after every meal, you may want to keep a food journal to see what types of food have you craving a post-lunch nap. If carbohydrate-rich or heavy foods like pizza, pasta, or panini slow you down, you could opt for a salad, soup, or sushi on days when you have a lot of work to do in the afternoon. You could also try eating several smaller meals throughout the day, rather than a big lunch, to avoid overwhelming your digestive system.
Feeling tired after eating is a common experience, and not necessarily linked to a medical condition. However, if you feel your symptoms may be related to a medical problem, it's always a good idea to visit your health care provider, especially if your fatigue begins to seriously impair your ability to get your work done. Students at Columbia can contact Medical Services (Morningside campus) or the Student Health Services (CUMC).
Best of luck in staying alert during your post-meal endeavors,
You’re not alone — almost everyone struggles with self or body image at some point, and occasionally worrying about how you look is completely normal. However, if you find yourself constantly thinking about food, your body shape and size, or your appearance, and these thoughts get in the way of work or school, your emotional well-being, or your social life, you may have a more complex body image and/or eating issue.
It may be tricky to distinguish between a healthy diet and exercise routine and habits and behaviors that could be detrimental to your health. For example, restricting calorie intake and engaging in exercise are common elements of a weight loss diet, which is healthy and normal for individuals who have too much body fat. However, if you’re exercising or restricting calories so much so that your emotional and/or physical health suffers, you might be experiencing a more serious issue that requires more attention. If any of this rings true, a good place to start would be to meet with your healthcare provider or a counselor for proper assessment.
A common misconception is that body image issues and disordered eating only affects women. That’s simply not true. Men also experience varying degrees of body image disturbances, eating disorders, and other related issues just as women do. Many men keep these concerns secret, but estimates from the National Association of Anorexia Nervosa and Associated Disorders suggest that as many as 10 percent of those with eating disorders identify as male. Because men are less likely than women to disclose their disordered eating or exercise routines to their friends, loved ones, and doctors, diagnosis and treatment are often delayed. All this to say, reaching out was a brave thing to do!
Eating a healthy, well-balanced diet is essential in making sure you’re getting all of the nutrients you need, including an appropriate number of calories. A balanced diet includes foods from all of the different food groups, and eating at least three meals a day. A balanced diet should not include too much sugar or fat, although some fat is necessary in any diet. For more information about the food groups and to help figure out how much you should be eating, check out the United States Department of Agriculture’s guidelines as well as the get balanced! Guide for Healthier Eating.
Since you’re already wondering if your eating and exercise habits may be an issue, it's a good idea to talk to someone about food and body image to be sure you're on track for a healthy relationship with food and exercise. If you are a Columbia student, you can make an appointment with a member of the Eating Disorders Team, a multidisciplinary team of health care providers specializing in eating and body image concerns, by contacting Medical Services (Morningside) or the Student Health Service (CUMC) for an appointment. If you're not at Columbia, you can start by discussing your concerns with a healthcare provider or a counselor.
You took a big step in inquiring about these issues, and that isn't easy. You deserve to start feeling better about your weight and body image — hopefully some of this information will get you moving in that direction!
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.
Filtered water seems to be all the rage these days — your friend is not alone in her enthusiasm for filters of all types. Filter manufacturers claim that alkaline water, which has a higher pH than regular tap water, can neutralize acid in the blood, offer more energy, speed metabolism, and slow the aging process. While studies have shown that alkaline water can lead to a decrease of bone loss in pre-menopausal women, not enough research has been done on alkalizing water filters to know how effective they are in improving a range of health concerns.
A normal blood pH, the measure of acidity vs. alkalinity, is carefully maintained by various systems of the body to stay between 7.35 and 7.45. This is slightly on the alkaline side of neutral (7 on a scale of 1 to 14). Bones store calcium for the body, and also help to regulate the acidity or alkalinity of the blood. When the blood becomes too acidic from a diet high in refined sugar, flour, or lots of dairy or meat, calcium is drawn from the bones to bring the blood's pH back into the normal range. If the blood stays alkaline from a diet rich in fruits and vegetables (or from alkaline water, as the filter manufactures claim), the bones don't need to cede their calcium to the blood, the theory being that this calcium retention makes bones stronger and more dense. In addition to drinking alkaline water, researchers have found that eating a low-acid diet, that is, a diet full of fruits and vegetables and lower in animal protein and grains than the typical American diet, may lead to stronger bones.
Whether your friend would like to raise her blood alkalinity by shelling out for a filter is up to her. If you don't have extra money to drop on a filter that may or may not be effective, but would like to keep the pH of your blood in check, you could try to increase your consumption of fruits and green veggies and shave down your intake of refined sugars, flours, dairy, and meat. And fill up your water bottle at her house!
Dear Not Fully Aware,
Your question is one many people deal with. Some people were taught from an early age to finish everything on their plate, no matter how they felt. This was often rationalized by well-intentioned parents referencing the millions of starving children around the world. Unfortunately, this type of encouragement does little to teach children about listening to their bodies or learning to identify or conceptualize the feelings that come when one is satisfied with the amount or type of food they are eating. This conditioning experienced by many growing up, can carry on into adulthood.
Others are out of touch with their body signals for other reasons. How often have you felt ravenously hungry and then couldn't believe how much you'd eaten? How much food does it seem to take to satisfy your hunger? Letting yourself get really, really hungry distorts awareness of body signals. If you're out of touch or ignore subtle hunger cues, it's extremely difficult to detect subtle fullness. As a result, you're only able to feel extremes. It's difficult to describe what comfortable fullness feels like inside your body, but some people express it as being satisfied and content after eating. Others say it's a subtle feeling of fullness, of not being hungry anymore (even if there's still food on their plate).
You can begin by thinking about how you are feeling while you are eating — a kind of checking in with yourself. This takes a conscious effort. Once you've eaten some of your food, consider asking yourself some of these questions: does the food (still) taste good? Is my hunger beginning to subside? After a few more bites, am I beginning to feel satisfied? Try stopping about halfway through to determine if you've had enough. Try rating your fullness from 1 - 10:
- Ready to collapse from hunger
- I could eat something, but not very hungry
- Not hungry at all
- Comfortably satisfied
- Full to very full
- Disgustingly sick
If you go from a 2 to a 9 easily, perhaps you are going for too long without food, or your last meal was too small (a problem for dieters). Maybe your last meal was lacking important satiety nutrients, such as protein, fat or fiber, which usually help to keep you satisfied over a few hours. Sometimes when we eat very quickly, a large quantity of food is consumed and before we realize it, we're stuffed. If this is your problem, try slowing down, taking your time chewing, swallowing, and resting between bites.
The most important part about eating to a pleasant fullness is to eat consciously — to increase your awareness. This takes practice for many people. Too often, we distract ourselves with other activities — such as studying, watching TV, or surfing the Internet, without realizing that we're full, until the entire bowl of popcorn, liter of soda, or pizza is gone. Give yourself time to enjoy and appreciate your food, and you can notice and identify its effects on your body.
For more information and insight, check out Evelyn Tribole and Elyse Resch's book, Intuitive Eating. If you are a Columbia student, you may want to make an appointment to speak with a nutritionist. Morningside campus students can contact Medical Services; CUMC students can reach out to the Student Health Service.
Best of luck!