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There’s An App for That-But Should I Use It?

Have you noticed that now-a-days there appears to be a mobile app for everything: one to monitor our sleep, our exercise, our diet, our breathing, our heart rate and so on and so on.  But the question begs, just because the app exists, is it really always in our best interest to use it? As dietitians we hear a lot about calorie and physical activity tracking apps, so we’d like to review a few of the more popular ones. Important point to remember is that both diet and exercise are behaviors, which are not typically tracked using numbers: mindfulness, hunger/satiety, feelings; whereas apps tend to be all about “the numbers”; calories, fat, protein, carbs, sugar, time spend exercising, intensity of exertion, number of days, minutes, hours etc.  Just because the numbers “hit” your target, doesn’t mean you’re engaging in healthy behaviors. It’s important to try to create healthy behaviors and habits that are long lasting, not just for immediate gratification.  

1.       My Fitness Pal-Tracks food intake and exercise and is focused on weight loss. Estimated calories burned during exercise are added to “daily allowed calories”.  Allows users to connect with a community for support, which is an important predictor of long term success (healthy support system).  Concerning is that exercise becomes a reward to eat more or leads one to believe that you’ll lose more weight the more you do, which is not necessarily true. Weight loss is complex and doing more and eating less, doesn’t always lead to more weight lost. Be careful not to set goals that are unattainable, especially long term.

2.       Lose It!-Very similar to MFP in that it is primarily for those who want to lose weight (just like the name!) but also tracks some other nutrients beside the regular carbohydrates, protein, and fat, such as cholesterol, sodium, sugars and fiber.  This app also includes a social aspect. This app might be appropriate for someone wishing to increase fiber or lower saturated fat intake to reduce cholesterol, but as with any weight loss app, be careful with weight loss goals.

3.       Recovery Record-Target audience are those struggling with disordered eating, but can be used by anyone.  This app uses no “numeric” values but rather focuses more on “mindfulness” of meal timing, balance as well feelings and emotions. Users can collaborate with their treatment team (dietitian, therapist, MD) if the practitioners also have the app. 

4.       Couch to 5K-This is a physical activity app that gives the user a specific fitness plan to work up to running a 5K.

5.       Health Watch 360-This app not only allows the user to track food and exercise, but over 500 conditions and symptoms (sleep, anxiety, etc.). Most comprehensive of all the apps which is a nice way of reminding us that there is more to “health” than just eating and exercise.

While some number tracking can be helpful for a short period of time to increase awareness of certain behaviors; i.e how much one eats based on “energy intake” or how much you are moving (steps), these apps are very detail-oriented and can cause someone to micromanage food and/or physical activity, which is not the goal.  If focusing on diet and exercise is preventing you from getting sleep or going out with friends (because you’ve already eaten your day’s quota), it’s time to move away from the app and reconnect with the bigger picture.

Unsure of what to eat? At Duke you can take advantage of meeting with one of the dietitians at Student Health-it’s covered by your health fee.  If you’re not inclined to do that, then just be wise to the fact that apps may be fine, temporarily, in conjunction with other behavioral changes, but using apps exclusively to make changes may not get you the results you wish.

 

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Are You a Moody Foodie?

I remember several years ago as a young adolescent my daughter and her friend dressing up in homemade Halloween costumes as “We’ve Been Dumped Girls”. The costumes consisted of PJs, bathrobes, fuzzy slippers, hair in sloppy ponytails, smeared mascara and of course empty containers of Ben and Jerry’s ice cream.  Creative-Yes! Accurate? Let’s see…

New research shows that people with temporary mood lows generally bounce back pretty well on their own regardless of what they may eat. Those with more prolonged mood lows may turn to food on a more regular basis for comfort but the resulting lift in spirits is generally short lived and may result in cyclical emotional eating patterns. For these folks consulting a qualified therapist for an evaluation is the best advice.

But for the majority of us who experience temporary emotional lows the “comfort” we receive from eating certain foods may have more to do with associations we have with that food than any magical mood lifting powers. For example did you and your mom (or dad) make cookies together for fun? Did you share an ice cream cone with a beloved grandparent?

 The memory of the good feelings may be what is actually helping.

Although we do know that foods high in carbohydrate temporarily make you feel better, a piece of fruit or a granola bar will do the job just as nicely as ice cream or brownies or chips—although these foods will probably not be the thing that comes to mind first.

Here is a list of some “comfort” with a healthier twist”

·         Oatmeal

·         Fresh fruit and a little nut butter

·         Nuts and dark chocolate

·         Bean soups

·         Grilled cheese sandwich on whole wheat bread

·         Whole grain granola bar

Let’s face it though; sometimes you do just want a little ice cream because it tastes good. Enjoy it for that reason alone.

 

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Why Are We Celebrating Our Bodies?

Beginning next Monday, February 16th, Nutrition Services is partnering with many offices across campus to host a positive body image week.  In the past, we’ve celebrated National Eating Disorder Awareness Week, but found that students are already aware of eating disorders.  Renaming the week and focusing on learning to embrace our bodies can help students to move away from some of the behaviors that might increase risk of developing disordered eating and exercise patterns.

Here’s a breakdown of the events we have going on next week, all of which are free and do not require tickets.

Monday, February 16th:

From 11am to 1pm, The Center for Multicultural Affairs is offering lunch at their Monday Motivation titled “Being Fine with Who You Are”.  At a roundtable discussion, students can discuss culture and body image with Mazella Fuller, PhD, MSW, LCSW from CAPS, J’nai Adams from the CMA and Kate Sayre, MPH, RDN from Student Health.  Courtney E. Martin will join the discussion.

Our keynote speaker’s talk and launch of our “Identity Over Image” campaign will take place at 7pm in the Nelson Music Room.  Courtney E. Martin, author of Perfect Girls, Starving Daughters and TED talk presenter, will discuss how effortless perfection is harming young women.  One of her quotes that we find most powerful is “We’re a generation of young {people} who were told they could be anything and heard they had to be everything”.

Tuesday, February 17th:

Have you heard of the “fitspo” movement?  These “inspirations” to exercise can be much more damaging than helpful.  We’re hosting a “true fitspiration” event in Brodie Gym from 5-7:30pm.  Here students can focus on positive reasons why they work out.  It may be to build strength, relieve stress or be able to sleep better.  It’s important we think of these benefits rather than superficial ones.

Those of us who treat eating disorders are often asked by students how they can approach a friend who they think is struggling with disordered behaviors.  Partnering with Duke students, we’ve created a recurring event called “Is This Normal?: How to Help a Friend with Disordered Eating”.  Embody Carolina is joining us to empower our community members to help each other.  This session will start at 6:30pm in McClendon 2.

Wednesday, February 18th:

WHOspeaks images remain powerful reminders of how we view our bodies.  The Women’s Center is hosting a showcase of these pictures as well as a discussion from 2-4pm.

Thursday, February 19th:

Me Too Monologues just wrapped up another very successful year.  We’re grateful to those who shared their stories, the actors and all in attendance.  We’re hosting a screening of past monologues that discuss body image.  Join us in the Keohane Atrium at 6:30pm.

Friday, February 20th:

To wrap up our week, we’re kicking it back at the Center for Sexual and Gender Diversity from 3-5pm.  Karen Kuebler, the art therapist from Veritas Collaborative, is leading an activity titled "Using Visual Language to Promote Self-Compassion and Positive Body Image". We’ll be creating individual and collective positive art and would love you to join us.  Food will be provided.

With this week of events, we’re hoping to start and continue conversation on campus of how we can better treat ourselves and our bodies.  If you aren’t able to attend the events, we ask that you do your part.  Use positive language, disallow “fat talk” in your social circles, and celebrate your body for all it is capable of.  If you’re concerned about your own behaviors, please take our anonymous screen to assess.

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Time to Rethink the Midnight Snack?

As a Duke student, I am no stranger to the late-night cram session the night before an exam, or the essay-writing marathon that stretches into the early morning hours.  For many of us in college, day and night have become flexible terms that more often than not misalign with being awake and being asleep.  When burning the midnight oil, we often crave a snack to keep us going through the night.  However, a recent study by the Salk Institute for Biological Studies (reviewed here in the NY Times) suggests that these late-night nibbles may be messing with our bodies’ internal clocks.

Published this past December in the journal Cell Metabolism, the study used mice to look at the relationships between meal times, weight gain, and overall health.  Mice were allowed to eat on two different schedules – one group had access to food all day long, while the other group of mice had access to food for only 9 or 12 hours per day.  The results showed that even though all of the mice consumed the same number of daily calories, those mice that only ate during the 9 to 12 hour window were healthier, gained less weight (some obese mice even lost weight), and had more lean muscle mass than the mice that ate all day long.

Scientists believe that the results seen in the mice may have significant implications for humans too.  Although the exact mechanism is still being researched further, this study hypothesizes that meal times affect the body’s circadian rhythms, even more so than dark and light cycles.   Circadian rhythms are our bodily processes that run on an approximately 24-hour cycle, and they affect how our genes work.  This study suggests that eating only within a 12-hour time window allows for our genes and metabolic pathways to synchronize and work together more effectively, keeping our bodies leaner and stronger.  While the old adage goes, “we are what we eat,” it may be more likely that “we are when we eat. “

This being said, it can be nearly impossible to avoid those midnight cravings all the time, so it’s important to be smart when choosing a late-night snack.  To give yourself a boost of fuel at any hour, pair a carbohydrate (fresh or dried fruit, whole grain crackers, veggies) with a protein source (yogurt, cheese, nuts, hummus) – check out this Smart Snacking resource for more ideas!  Also, be sure to feed yourself well and regularly during the day to meet your daily energy needs, so when nighttime rolls around, you’re still feeling satisfied and productive.  Your body and its clock will thank you!

      

 

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Count calories? Maybe it’s better if we don’t.

It’s ironic that at a time when new legislation will demand that restaurants (having more than 20 locations), and vending machines (anyone owning more than 20) will have to disclose calorie and nutrition information, we are also learning that counting calories might be counterproductive to addressing the obesity epidemic in this country.

It’s not rocket science to figure out that calorie counting might not be working – it’s been done for years and look where it got us. Believe me, I realize that our obesity epidemic is not just about calorie counting: obesity is actually very complex, we always just want to over simplify it by bringing it back to calories in and calories out.  We now know that the source of calories consumed have different effects metabolically in our bodies.    

There are times where calorie counting may be beneficial; such as to offer perspective on energy intake, when someone has no idea of how much they are eating. Our food label information, for instance, is currently based on a 2000 calorie diet and for many this means very little. Perhaps counting calories for a day might assist in increasing awareness of how our intake compares.  However, that is more or less where it ends. Counting calories, or counting nutrient values for that matter, diminishes the food we eat to a numeric value.  Inherently that removes the pleasure, joy and satisfaction we derive from eating only to have it replaced with worry, guilt and an overall unsatisfying dining experience.  If you look at countries that are not struggling with weight issues, or hadn’t until recently, it’s not because they’ve been counting calories all these years.  Perhaps it is because they eat food and not nutrients, they appreciate the flavor, color, texture and origins of the food that they are eating and enjoy the company of the people they are eating with. It’s really not about calories, it’s about balance, and it’s just taking us a little longer to realize that.

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The Flu Forecast

The forecast isn’t great for the flu season this year.  It started a little earlier than usual; one of the strains that is going around – H3N2 – is a little more aggressive than usual; and even though this year’s vaccine targets H3N2, it isn’t a great match for the strain that’s actually going around.

The flu can cause mild to severe illness, and people who have it usually experience the sudden onset of fever, cough, sore throat, runny or stuffy nose, muscle aches, headaches, fatigue and occasionally nausea and vomiting.

People with flu can spread it to others up to about 6 feet away through droplets made when they cough, sneeze or talk. Less often, a person might also get flu by touching a surface or object that has flu virus on it and then touching their own mouth or nose. You can avoid spreading the flu to yourself and others by staying away from sick people and avoiding others if you are sick. Covering your cough and washing your hands often with soap and water or alcohol-based hand sanitizer is also a good idea.

The single best way to prevent the flu is to get your flu vaccine, even during seasons like this one when there is a less than ideal match for one virus. (Flu clinic: Wednesday, 1/21, from 5-8pm in Wilson Rec.) The vaccine may protect against the other viruses floating around, and antibodies made in response to vaccination with one flu virus can sometimes provide protection against different but related viruses.

All Duke Students can get a flu shot at the Student Health Center or one of the flu shot clinics we offer around campus.

Luckily for most Duke Students, the flu will resolve on its own after a few days of feeling crummy with the help of rest, fluids and over the counter pain and fever reducers.  However, there are prescription medications that can shorten the duration of the illness in severe cases if started early enough. If you are worried that you might have the flu, call the Student Health Center to speak to one of our nurses or make an appointment to see one of our health care providers.  We are here to keep you healthy!

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Eat to Remember and Remember to Eat

The semester is rapidly coming to an end, and we all know what that means……. yup, time to study for finals. Wouldn’t it be amazing if we could offer you some secret eating tips to help boost your memory? Well we don’t have any magic formulas but we do have some good advice.

Think Healthy Fats

There is strong evidence that the same anti-inflammatory properties that help protect your heart can improve memory. These fats include fatty fish like salmon and tuna, nuts/seeds, avocado, olive oil and flax.

Where to find them on campus*:

·         Try the guacamole on your burrito bowl at Penn

·         Look for salmon and tuna or other fish on café menus  (Div café offers a salmon wrap, Café DeNovo offers a Tuna Nicoise salad, Penn serves salmon at dinner frequently, Perk has a salmon salad)

·         Add avocado or hummus to sandwiches and salads (ABP and other cafés)

·         Snack on nuts (available in the Lobby Shop, Quenchers and The East Campus Store), sprinkle sunflower seeds on your salad at salad bars

·         Pick up some individual containers of peanut butter and some fruit  for a healthy energizing snack

·         Try a grab and go hummus snack plate which is found at many cafés on campus

Devour Dark Fruits and Veggies

Fruits like blueberries, strawberries and dark green veggies like spinach, broccoli and collards are full of phytonutrients (dark greens include vitamin E and folate) with memory boosting properties.

Where to Find On Campus*:                            

·         Fruit cups are widely available at grab and go locations , also check out the fruit bar at Quenchers

·         Look for spinach and other dark greens at salad bars and as side dishes in many cafés

·         Add broccoli to your stir fry

Enjoy Whole Grain Goodness

Whole grains like oatmeal, quinoa, brown rice, etc. are an integral part of an anti-inflammatory diet like the Mediterranean diet. This type of diet plan promotes increased blood flow to the brain and has been linked to improved memory.

Where to Find on Campus*:

·         Look for whole grain salads at salad bars around campus

·         Many cafés have whole grain side dishes

·         Choose whole grain breads for sandwiches and create a satisfying breakfast with some oatmeal (Marketplace, Penn, Café Edens, Div  Café, ABP just to name a few)

 

Remember we don’t eat nutrients in isolation so for best results include these foods as part of a healthy eating pattern and remember to eat regularly throughout the day and stay hydrated.

Good luck and Happy Holiday eating.

*The cafes listed are only a sample of where you may find these foods on campus.  For a more thorough list refer to The Devil’s Advocate.

 

 

 

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On the greatness of counseling

Let me be entirely honest and open in what I’m about to say. Honesty after all, is so little found in conversations about mental health and yet so powerful when it is. I have, like 1 in 4 other young people my age, struggled with my mental health on and off. There have been times when I’ve been sick with hopelessness and misery, consumed with self-loathing and hatred. Likewise, there have times when I’ve been ecstatically happy and grateful. My emotional health is a mental rollercoaster and contains the best and worst memories for me. But it is not all of me.

There was however, a point this semester when it got a little too much. I was exhausted with faking positivity to myself every day and pep-talking myself out of bed, throwing on smiles when all I wanted to do was cry. My sense of self-worth was at an all time low and life at Duke seemed unbearably overwhelming. I made an appointment at CAPS. It was not the first time. I had talked to woman once my freshmen year, when things had gotten particularly stressful. There seemed however, a difference to me between a one-time chat and regularly seeing a counselor with the intention of understanding yourself. And I decided that I was tired of having the emotional lows but no real answers. I was tired of believing in untruths about myself that led me to think in despairing ways.

So I decided to sign myself into regular counseling sessions. It was both frightening and liberating. A part of me was angry and afraid that I needed help in the first place – what was wrong with me? Another part of me was relieved because, for the first time, there was another option, one that validated my emotions instead of dismissing them.

I’m about five sessions in now, and I think going into counseling has been one of the best decisions I’ve ever made. It has surprised me and taught me how little I really knew about myself. If anything, it’s been an independent study in my own persona, to work out how I react to situations and why I react that way. This is information I feel that anyone young and uncertain can use because it has yielded insights richer than I could have hoped. How much do we really think about our ways of coping? Or whether the way we see ourselves is accurate? Or whether we need, sometimes, to catch ourselves when we self-hate and reassess the situation?

Counseling is not simply lying on a couch and talking about how you feel, like every film Hollywood makes. It’s an intimate leap into your own mind and it’s uncomfortable sometimes and it’s confronting. It’s shown me how little I truly know about myself, and helped me determine my values and priorities. It’s showing me slowly how to be happier. And it’s great.

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Burger Blog?

You’ve come to the right place, yes, this is the nutrition blog.  It may seem like a juxtaposition that a dietitian is writing about burgers, but a good burger is one of my favorite things to eat.  A local burger joint recently posted that they were having a Thanksgiving contest.  One and all were welcomed to enter the contest for the best themed burger.  The plan was for judges to choose the top 3 recipes and then taste test to pick the winner.  Rules of the competition were that it had to be a turkey burger and include cranberries, sweet potatoes, stuffing or all 3.  As I enjoy cooking and a challenge, I decided to enter.

I have to admit that I generally do not choose a turkey burger over a beef burger.  If a turkey burger is not made correctly, it can be a dry hockey puck.  So I knew that I had to give some love to the patty itself for my entry.  I didn’t want to include stuffing, as I already had carbohydrates in the bun and the sweet potato fries that came on the side.  To capture the flavor of stuffing (I do realize some of y’all may call it “dressing” but it’s stuffing in my house), I took the prominent spices, sage and thyme, and mixed it into the meat.  Thanksgiving turkey must have cranberry sauce, so I also incorporated dried cranberries into the meat mixture.  Using light and dark ground turkey instead of ground turkey breast without the skin helped with the moisture factor.  To further invoke tastes of the annual meal, I topped my burger with gravy.  In a nod to green bean casseroles around the country, I also added fried onions to it along with Brie.

I enjoyed being creative with the recipe and didn’t think much of my entry after the fact so you can imagine my surprise when I saw that not only did my burger make it into the taste testing round, but that I was the winner!  There were over 30 entries so I was pretty shocked.  The recipe was featured as the special for the day so my husband and close friends stopped by to grab one.  Luckily, we got there just in time as they ran out after we ordered.  Even my boss texted me to say that she was able to get one and really liked it.

Now for the nutrition part!  I didn’t have many non-starchy vegetables on my plate at this meal.  For me, this evokes the 80/20 rule.  If 80% of my meals are balanced, my body will be just fine when 20% are less balanced.  As for turkey versus beef?  If you choose ground turkey breast without the skin, it has less saturated fat.  Both options are high in other nutrients, too.  Turkey is a source of niacin, selenium, vitamin B6, phosphorus and zinc while beef is a source these as well as vitamin B12 and iron.

Whatever you choose, know that eating should be not only about meeting your nutrient needs, but also include items you enjoy.  For this nutritionist, that includes an occasional burger.

 

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Student Health Closed for Thanksgiving

The Student Health Center will be closed for Thanksgiving beginning at 12:30pm on Wednesday, 11/26, and will re-open at 8:30am on Monday, December 1st.

For after-hours care, please call us at 919-681-9355.

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