Have You Heard?


How is Your Microbiota?

Excuse me? When was the last time someone asked you about YOUR microbiota?  Most people don’t realize that our bodies are made up of more bacterial cells than human cells. “We are walking ecosystems, as our bodies are colonized from top to bottom by microbes that, not happy with behaving like guests, are actually integrated into our biology. “They help us digest food, shape our immune system, alter our metabolism and evidence is even starting to show that they affect the nervous system, influencing our mood and behaviour,” explains Justin Sonnenburg, a microbiologist at Stanford University (USA).”

Keeping the microbiome, or the environment that the bacteria live in, optimal is key. As you might have guessed, this brings us to the discussion of our diets. Our GI bacteria, although very adaptive, love plant materials and fiber.   Those who follow vegan and vegetarian diets have different combinations of colonies in their guts, than carnivores, the bacteria in our colon actually help break down the fiber that other enzymes cannot.

Stress negatively impacts the health of our bacteria, for many reasons, but often due to poor dietary choices. Bacteria, or our bodies in general, don’t like the highly processed, highly sugared foods – (although they may taste great in the moment) they’re actually inflammatory. However these are often the types of foods we reach for when we are stressed. If you want to keep your microbioata happy, be selective with your diet. These microbes produce 95% percent of the body’s serotonin. Yes, serotonin – that neurotransmitter that can make us “sleepy” or “relax” us. Eating a diet that is rich in plant materials and dietary fiber is a good way to nurture your microbiome.  Consider yogurt and Kefir and even sauerkraut, yes sauerkraut to help keep a healthy environment. Just don’t lose sight of balance in the diet. Plant materials may be important but protein and fats are equally as important. Just living on salads is also not the answer.

So the next time you’re stressing, like right now or in the upcoming weeks, remember to be kind to your microbiota by eating well; have some yogurt with “live culture” bacteria, along with some granola and fruit, consider some hummus and raw veggies for a snack, sandwich on a whole grain bun along with some minestrone or vegetable soup at lunch, cheese and whole grain crackers as a mid-afternoon treat and maybe some schnitzel and sauerkraut for dinner.
Want to learn more: Follow http://www.gutmicrobiotawatch.org/


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Where’s the Fire Now? Anti-inflammatory Eating Updates

Yes we have covered this topic before back in the fall of 2012 Inflammation-Where's the Fire?.

Back then we were presenting to you a proposed list of anti-inflammatory food to include in your diet.

These foods included healthy fats, spices, vegetables, fruits, whole grains, legumes and of course dark chocolate (70% cocoa or more).

Recent research published in the Journal of the American Medical Association has highlighted what we have known for quite some time, many of us eat more added sugar than is recommended for a healthy diet and this may be contributing to heart disease.

What does this mean for us?  Not only should we consume anti-inflammatory foods every day but there are also some foods that we should try to limit our intake of as well.  If you eat too much simple sugar cutting back on the amount in your diet is important in the effort to fight chronic disease, which can be attributed to inflammation on the cellular level. Most recent studies refer to heart disease in particular.

Not everyone needs to decrease their sugar intake but if you feel that you are eating too much of the sweet stuff and you are looking for areas to cut back, consider the following:

·         Don’t Drink Your Fruit- opt for whole fruit instead of fruit juices and you will significantly decrease your intake of simple sugars and increase your intake of healthy fibers.

·         Avoid Sugar Sweetened Beverages- replace sodas, fruit flavored drinks, and sweet teas with water. Can’t give them up? Go “halfsies” by mixing half sweetened with half sugar free, unsweetened or water.

·         Be a Wise Consumer of your Favorite Hot Beverage- many coffee and tea drinks are loaded with sugar, each pump of syrup has about 5 grams of sugar, so limit the number of pumps or better yet go for a simple latte sans syrup.

·         When Baking- you can easily reduce the amount of sugar called for by ¼- 1/3 without sacrificing taste.

·         Share Desserts- if you eat them regularly. Otherwise eat what you enjoy but do so less often.

·         Enjoy!

The take home message here is you don't need to totally avoid sugar, just eat it in moderation and make the real thing count.




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Alcohol and Spring Break

“It is wise to bring some water, when one goes out to look for water.” This is not a recent Tweet or Facebook status update, but rather, wisdom from an Arab proverb.  What does this have to do with your life as a Duke student, you say? With spring break approaching, there are many choices on what to do, whether that be traveling to Peru with the Duke Alternative Spring Break Program; canoeing and kayaking with Duke Recreation; hanging out at home; or, jaunting to the coast to catch some rays.  For some, activities will include the use of alcohol.  While most students will be responsible with the amount they consume, 42% of college students get drunk at least once during spring break (Litt et al. 2013).

The combination of drinking alcohol and possibly being in warmer weather easily brings about dehydration. Warmer temperatures aside, when someone has a standard drink (12 ounces of beer, five ounces of wine, or 1.5 ounces of liquor in a mixed drink), he or she urinates a greater amount of water than is contained in the drink. This happens because alcohol inhibits the body’s anti-diuretic hormone (it also inhibits judgment but that is another article altogether. I would recommend making strategic decisions about how much and what to drink prior to consumption).  This leads to more water coming out than going in, even if water is included when having some drinks. In addition to the alcohol, remember that warmer temperatures promote sweating, and we need fluids to sweat. Being dehydrated and spending time in the sun, can lead to heat exhaustion and heat stroke.

National Institute of Alcohol Abuse and Alcoholism (NIAAA) recommends drinking one nonalcoholic drink for every alcoholic drink consumed: http://pubs.niaaa.nih.gov/publications/SummerSafety/SummerSafety.htm. The nonalcoholic drink should not contain caffeine for two reasons: 1) caffeine is a diuretic, and 2) drinking caffeine increases the urge to move more (it is a stimulant). Alcohol decreases physical motor coordination.  The combination of increased motor activity and decreased coordination will not end well. It would be wise to keep sugar out of it, too, as drinking alcohol influences the body’s sugar levels. You can learn more about this here.  You may also want to check out the environmental-dependent tolerance section in this article.

As you consider Spring Break during these dreary months of winter, keep in mind that the goal of a break is to have fun and enjoy life!  Feeling bad because of the negative effects of alcohol takes away from the joy of vacation.  So, when headed toward warmer climates, please drink some water, replenish your electrolytes, eat a full meal prior to drinking, and have fun.  I will leave you with this:

“To keep the body in good health is a duty, for otherwise we shall not be able to trim the lamp of wisdom, and keep our mind strong and clear. Water surrounds the lotus flower, but does not wet its petals.” (Hindu Prince Gautama Siddharta, founder of Buddhism, 563-483 B.C.)



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Accepting Our Bodies…Accepting Ourselves: A Focus on Developing an Awareness of Black Women and Eating Issues


I am aware that I am the only one responsible for what has and will happen in my life. It is empowering to know I am in full control of my destiny. –Carol Joy

Black Women at Duke! Are you managing your stress well…to avoid the risk of developing eating issues? I am a CAPS clinician and have been working with women of color struggling with eating issues for over 20 years. The issues of perfectionism and always feeling that you need to be in control are the same for all women and especially Duke women.  Duke women are leaders and strive for excellence and perfection in all endeavors, which can make some women at Duke vulnerable to eating problems.

National Eating Disorders Awareness week is February 23-March 1, 2014. The goal is to promote  public and media attention to the seriousness of eating problems and improve education about the biological underpinnings, environmental triggers, warning signs and how to help individuals struggling with eating issues.  It is important to include Black Women and other women of color in our outreach efforts as culturally competent, mental health providers, health educators, dietitians  and medical providers.

Most college age women struggle with identity development, issues of power and voice, affirmation, validation and self-confidence .Which leaves many women vulnerable to eating problems, including Black Women and other women of color.

The impact of eating issues among Black women has been around for a long time. Essence magazine conducted a survey in 1994 to bring awareness to the issue. The survey found that 53.5 percent of their Black female respondents were at risk for developing an eating disorder. Many Black Women experience multiple forms of oppression and other life stressors. Research has shown that Black Women are more vulnerable to mental health outcomes from the impact of traumatic experiences. Black Women are vulnerable to binge eating and may use food as a way to cope with emotional distress and regulate negative emotions.


“Choose to Be Well at Duke”

Duke Resources:

Culturally Competent Assessments by CAPS Clinicians
Mindfulness/Yoga Workshops
Groups for Women of Color
Being Well Room

Personal Trainer –Wilson Gym
Nutrition-SHS –Certified Eating Disorders Dietitians
Medical Physician-SHS-Specialized Assessment for eating issues
Duke Wellness Center -Holistic Integrative Health Coaches

National Eating Disorders. Org
National Eating Disorders Association(2005) Eating Disorders in Women of Color


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Dorm Cooking

Returning to Duke’s dining scene after a winter break of home-cooked meals and special holiday treats may be underwhelming for some, but there’s no need to feel limited by the regular offerings on campus.  To add variety to your everyday eating routine, try preparing some of your meals and snacks right in your dorm room or dorm kitchen.  Cooking need not be overwhelming – many satisfying options can be prepared quickly and easily just by following a few basic tips!

Start Simple: When looking for dorm-appropriate recipes, choose ones that keep the ingredient count low and don’t require many pots, pans, bowls or specialty ingredients or equipment.  Few ingredients doesn’t have to mean bland taste, however.  Consider keeping balsamic vinegar, salsa, salt and pepper, or a few of your favorite spices (cinnamon, cumin, paprika, nutmeg) or herbs on hand to add flavor. 

The Microwave is Magic: While at first it might only seem good for popcorn and frozen dinners, the microwave is one of the most versatile tools in the dorm kitchen.  Invest in a glass or ceramic dish or bowl and check out recipes for microwaved omelets, steamed meat and veggies, rice, oatmeal, “baked” apples, and mug cakes.

Find a Friend: Sometimes it’s hard to buy ingredients in quantities appropriate for only one person, so find a friend to cook with, share time in the kitchen, and split the grocery bill!     

Double Duty: Many basic ingredients can work double duty in different recipes.  Consider using peanut butter not just in sandwiches, but also in a simple sauce for noodles.  Use a jar of tomato sauce not just over pasta, but over veggies and meat as well.  Also, consider making a double batch of whatever you’re preparing and save some in the fridge for later in the week.   

Ease into the Equipment: Don’t think you need to go out and buy a kitchen full of pots and pans to start cooking in the dorm.  Check out the refrigerator, microwave, and stove in dorm common kitchens and ask your house council about any communal equipment that might already be available. If you think you’ll be cooking for yourself often, it might be worth investing in a set of measuring cups, a sharper paring knife, and a small selection of oven and microwave-safe dishes. 

To get started in the kitchen, try out this easy and healthy microwave recipe for a stuffed Mexican sweet potato.  Look for more recipes online at Duke Student Health Nutrition’s Cook’s Corner- Dorm Room Cooking.  Bon appetit!

Stuffed Mexican Sweet Potato

• 1 medium sweet potato
• 2 tablespoons low-fat sour cream
• 1/3 cup black beans
• ¼ cup salsa
• ¼ avocado, diced (optional)
• ¼ cup shredded cheddar cheese (optional)
1. Prick potato several times with a fork.
2. Place on a microwave-safe plate and microwave on high for 7 to 8 minutes (rotate potato half-way through) or until tender.
3. Split potato and fluff with fork.
4. Top potato with black beans, salsa, avocado and cheese.


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Multivitamins-a Waste of Money or a Form of Health Insurance?

In the past month, there has been much to-do about the benefits of multivitamins, or lack thereof.  While headlines can be catchy, they often take a small piece from a research study and ignore the rest of the details.  The article by NPR focuses on 3 studies and then gives an overarching recommendation, disregarding the unique samples that were studied.  The studies don’t address women of childbearing age or those with nutritional deficiencies.  One study reported poor compliance rate, so it’s unknown whether the effects were due to supplementation or not.  None of the studies reported harm from taking a multivitamin.

So what does this mean for you?  Before deciding if you should take a multivitamin or supplement, check with your doctor and read the National Institute of Health’s “What You Need to Know” article.  Rather than a “one size fits all” statement, it’s important to understand your needs in terms of micronutrients.

Here are our recommendations for supplement use:

  • Check with your doctor before starting any supplements to be sure you’re taking the correct dose and that it isn’t interacting with any other medications you’re taking. 
  • Taking  ½ of a multivitamin twice a day is best.   A multivitamin can supplement what may be lacking in your diet.  If you eat the same thing all the time or a less than healthy diet, it’s a good idea to take a multivitamin
  • No mega vitamins, which are defined by an amount 10x the recommended dose.  Just because the recommended amount of a vitamin or mineral is good, it doesn’t mean that more is better.  Some vitamins taken at high doses, such as vitamin A, which is not the same as beta-carotene, are harmful.  Only take the recommended amount advised by your doctor.
  • Women and men have different needs for folic acid, iron, calcium and other micronutrients.  Choose a vitamin that meets those needs but doesn’t exceed them.  Here are some guidelines in choosing multivitamin.

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“Nutrition Analysis = Dietary Paralysis”

I can’t take credit for the quote but boy did this resonate with me. It would appear that we have moved in a direction where we use numbers to validate everything about us:  BMI and weight speaks to our appearance,  grams of protein, fat, and carbohydrate tell us how “healthy” we are, body fat analysis speaks to our leanness, grades speak to our intelligence, and bank statements touch on our wealth.   I can’t help but wonder if this “numeric trend” isn’t having a negative impact on life satisfaction, but particularly on how we feel about our food and dining experiences – it has certainly lead to a lot of confusion about what to eat. Daily, I meet with people that tell me they eat “healthy” but then go on to say they’re not satisfied, or worse yet, don’t like what they’re eating—how healthy is that? Eating was never intended to be a numbers game, food is not a number. Food is nourishment, enjoyment, satisfaction, love, comfort and I could go on and on, but it’s not a number! As long as we use numbers to tell us how well we’re doing or how healthy we are, we’ve lost sight of what’s important; the enjoyment of eating and the company of the people that share our gastronomic experience.  Food is a party for our senses, (mindfulness) but we lose sight of that when the numbers are driving the show. Although, clearly there are times when food  analysis is appropriate,  it is however, not something that should be done daily (APPs) or even weekly but rather only as need dictates. As we approach the holiday season and we think about our good fortune to have access to ample food, let’s not waste the opportunity calculating our caloric and nutrient needs, but rather focus on the smells, tastes and textures of the food that we are fortunate enough to share with good company.


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Thirsty? You May Already Be Dehydrated.

In a recent blog on training preparation, we asked if you’ve checked on your fluid needs.  What exactly does that mean?  Your body needs fluid to keep cool, so it doesn’t overheat – if you overheat your body shuts down and this is very dangerous.  Each person’s hydration needs are different, but there are some basic signs that can tell you how you’re doing. Unfortunately, you can’t rely on thirst sensations alone as all that tells you is that you’ve already begun the dehydration process, and ideally you’d like to prevent that from happening. 

One of the more commonly used indicators is the color of your urine.  Is your urine dark and low in volume?  You probably need fluids.  Aim for urine that is light yellow in color.  No bathroom around?  Know the signs of dehydration-dry mouth, headache, increased thirst, decreased sweat, weakness, and in severe cases- dizziness, confusion and fainting.

How much you need to drink has a lot to do with how much you lose.  If you sweat a lot, then you need to drink more than someone who doesn’t. General recommendations are about 60-80 ounces or more per day; 3-4 (20 oz) water bottles to start. Use your best judgment. Don’t force fluids, but keep up with how much you’ve had to drink.  All fluids count (with the exception of alcohol): 100% juice, milk, chocolate milk, sports drinks, water and even soda or diet soda count as fluid—just limit them to no more than 1-2 per day. Remember to use a sports drink only after 45 minutes to an hour of working out, there really isn’t a need prior to that time. Water will do just fine.

Ideally, you don’t want to lose more than 2% of your body weight during exercise.  Calculate this number by weighing yourself before and after working out.  For each pound lost during exercise, you should drink 24 fluid ounces afterward over a few hours.  Your goal is to be back at your pre-exercise weight within 24 hours.

After a workout, is there a grainy, white substance on your skin?  You’re a salty sweater.  It’s a good idea to replace electrolytes through sports drinks during exercise and then with foods containing salt at your next meal.

Hyponatremia, an over-dilution of salt, can occur when people drink too much in anticipation of losing a lot of water. Pace yourself on the fluids and make sure to take into account not only your sweat losses, but weather conditions as well. Cooler temperatures and lower humidity won’t require as much.  Proper hydration, including replacement of electrolytes, can prevent this. 


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True Blue: Meet Robert Ansel

What is college life? What is it really that defines the ground floor of the quintessential American college experience? After two years at Duke University, I’m only just beginning to understand the answer to that question. Here’s a head start: The answer is you. You are the one and only factor that will define what college life is to each and every person you tell about ‘the good old days’ when you attended one of the most prestigious institutions in the United States.
My name is Robert Ansel, and I am a representative of the Duke University Wellness Center, and a member of the cast of True Blue. I am also an Electrical and Computer Engineering major, you know, one of those nerdy guys that can’t introduce themselves without a stutter, much less write a coherent essay. Then again maybe I like to defy expectations. I’m an active member in an on campus fraternity and participate in a variety of athletic and artistic extracurricular activities as well. I believe I’ve spent the last two years of my life in meaningful ways and with decidedly good intentions. That’s the cliff note summary of who I have become, but if you ever get the chance to know me you’d see much more.

The types of activities I’ve chosen only represent a small portion of what defines my college experience. I’ve had the time to sift through the many opportunities laid out before me to help shape myself into the individual writing this blog post. This process boils down to choices and expectations. In college, you will become the person who will live the rest of your life; and if you think you already are that person, you’ll soon find that you’re looking back and already seeing the changes that have taken place.  You will have to choose how to conduct yourself in a wide variety of circumstances and how to influence those around you. You will be faced with an eclectic variety of personal decisions ranging from how you will be influenced by your peers to how to deal with personal disappointment, loss and misfortune.

Issues like the consumption (or not) of alcohol, interactions with the opposite sex, washing your dirty socks, and dealing with the mounting pressure leading up to your exams will be some of the foundational experiences you will face. The Duke Wellness center can be a powerful resource for all of these issues (okay not all, but 3 out of 4 isn’t bad). To me, being a member of the cast of True Blue allows me to represent a possible route to one of many good college experiences, and striving to share my less pleasant mistakes so that others may not need to make them for themselves.

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True Blue: Meet Nancy Su

Greetings, ladies and gentlemen, and welcome to the Duke Class of 2017! How are you feeling—nervous, hopeful, invigorated? Breathe it all in! Let me introduce myself:

My name is Nancy Su, and I will be a junior this coming fall. I am pursuing a major in psychology, minor in biology, with an interest in health care.

I wanted to participate in True Blue because it offers something I don’t think any freshman can get enough of—knowledge. Specifically, knowledge about the push and pull of college life. Nervous? Yeah, I was nervous when I stepped onto East Campus for the first time that move-in day. Hopeful? I felt hopeful that I wouldn’t totally bomb the first Chemistry exam of my freshman year. Invigorated? I was rather invigorated about experiencing for myself the social scene everyone talks about.Apart from those, there are topics not everyone may properly enlighten you on, such as keeling over from pulling three all-nighters in a row, whereby you are found by your roommate and delivered to the hospital. Or, maybe getting wrapped up in happy partying for a weekend, whereby you are too incapacitated to head to class on Monday. Exaggerations aside, situations like these may arise from your time at Duke; academic, social, and personal stresses are pretty common for the average student.

You may wonder if two years of college under my belt makes me a pro at making the “right decisions,” right? Ha! Surely you jest. Life is a learning curve, my friend, and no one can make perfect decisions all day every day, but what you and I can do to mollify this is to listen and to learn. And, what’s a better way to begin listening and learning than to use True Blue as a platform for your new start at Duke? I believe that the knowledge you gain from True Blue can be helpful for whatever situations you chance upon in college.

I personally welcome the wonderful Class of 2017! For now, this is Nancy signing off.

~Nancy Su

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