Nutrition 5

General Nutrition Information

Basics Nutritional Terms

Nutrients are chemical substances which nourish the body by providing energy, structural materials, and factors to regulate the essential chemical reactions in the body. They are also important in the growth, maintenance, and repair of body tissues. Because the body cannot generate some nutrients or produce them fast enough to meet its needs, nutrients must be supplied by outside sources, namely food. There are five types of nutrients: carbohydrates, fats, proteins, vitamins, and minerals.

Aside from general nutritional requirements, women of reproductive age must meet additional requirements to help their bodies prepare for the rapid changes that occur with menstruation, pregnancy, and lactation. Women's nutritional requirements also vary with age. This section explains the significance of each of these types of nutrients in a woman's diet. This section also lists sources for these nutrients, which can be easily incorporated into a balanced diet. Sections on vegetarian eating, eating disorders, and strategies for healthy eating away from home are also presented.

Nutrition Services at the University of Chicago

The University of Chicago Student Care Center offers Nutrition Services, which addresses a variety of issues including eating disorders, vegetarianism, weight reduction, and sports nutrition. They are also available for consultation if you have acute or chronic health problems which require a special diet. The staff of the nutrition services is comprised of Nutrition Specialists. The offices are located in R100 and are available by phone at 702-4156.

Energy-Yielding Nutrients

The chemical energy provided by carbohydrates, lipids, and proteins can be converted by the body into mechanical, electrical, or heat energy. Energy is measured in 1000-calorie units called kilo-calories (which are usually shortened to "calories"). When, for example, a cookie box states that each cookie provides 150 calories of energy, it actually means 150 kilo-calories.

· One gram of carbohydrates provides four kilo-calories of energy.

· One gram of protein provides four kilo-calories of energy.

· One gram of fat provides nine kilo-calories of energy.

General Dietary Guidelines

1. Eat a variety of foods, including fruits, vegetables, breads, cereals, milk products, meats, fish, poultry, eggs, etc.

2. Balance the foods you eat with physical activity, to maintain or improve your weight.

3. Choose a diet low in saturated fat and cholesterol. Select low fat protein sources such as lean meats, fish, poultry, beans, lentils, etc.

4. Choose a diet with plenty of vegetables, fruits, and grain products.

5. Consume sugar in moderation.

6_. Use salt and sodium in moderation.

7. If you drink alcoholic beverages, do so in moderation.

A balanced diet is composed of the following food groups:

1. The Fruit and Vegetable Group: Five servings from this group are needed daily. Citrus fruits, melons, berries, and tomatoes are good sources of Vitamin C. Deep-yellow and dark-green vegetables are good sources of Vitamin A. Unpeeled fruits and vegetables and those with edible seeds are good sources of fiber.

2. The Bread-Cereal Group: Six servings or more are needed daily. This group includes breads, cereals, pasta, baked goods, and rice, which provide B vitamins, iron, and fiber.

3. The Milk-Cheese Group: Two to three servings are needed daily by adult women. Teenagers, pregnant, and lactating women need more. This group includes milk, yogurt, ice cream, ice milk, and cheese, which provide calcium, riboflavin, protein, and vitamins.

4. The Meat-Poultry-Fish-Beans Group: Two servings are needed daily. This group includes eggs, nuts, and seeds which provide protein, phosphorus, magnesium, zinc, iron, other minerals, and certain vitamins.

5. The Fats and Sweets Group: Some fat is needed in the diet to provide essential nu-

trients. Servings in this group should be included according to calorie require-

ments. This group includes butter, margarine, mayonnaise, candies, jellies, and syrup.

Percentage of Fats in Common Foods:

>90% bacon, mayonnaise, butter, margarine, salad and cooking oil,

lard, cream, baking chocolate, vegetable shortening

80-90% sausages, most salad dressings, cream cheese, coconut, walnuts,

pecans, sesame seeds

65-85% potato chips, dry toasted peanuts, frankfurters, American, Swiss,

and cheddar cheeses, corned beef, sunflower seeds, cashews,

peanut butter

50-65% broiled beef-loin steaks, roasted leg of lamb

35-50% most cookies, cakes, and donuts, round steak, lean ground beef,

whole milk, roasted chicken (dark meat, without skin)

20-35% 2% milk, roasted chicken (white meat, no skin)

10-20% broiled fish

Negligible skim milk, dry cereal, dry cottage cheese (no added milk fat), dried

beans, baked or boiled potatoes, most breads, fruits and vegetables

(except avocados)

Recommended Daily Allowances

The recommended daily allowances (RDAs) are set by the Food and Nutrition Board and the National Research Council. RDAs are defined as the adequate levels of nutrient intake that, on the basis of scientific knowledge, are judged to be adequate to meet the known nutrient needs of practically all healthy persons. The chart on the following page lists the specific RDAs for women of various ages as well as for pregnant and lactating women.

Vitamins

This essential nutrient is one that the body cannot produce in adequate amounts. Of the thirteen essential vitamins, recommended daily allowances (RDA) have been established for eleven. Three of the vitamins (A, C, E) are antioxidants. Antioxidants are believed to help prevent disease by neutralizing free radicals (such as unstable oxygen) in the body.

The fat-soluble vitamins are: Vitamin A (retinol), Vitamin D (calciferol), Vitamin E (tocopherol), and Vitamin K. These vitamins are absorbed along with fats in the diet and cannot be eliminated from the body. As a result, these vitamins do not have to be ingested every day, and excess amounts of these vitamins can be toxic to a person.

Table of RDAs:

The water-soluble vitamins are: Vitamin B₁ (thiamin), Vitamin B₂ (riboflavin), Vitamin B₃ (niacin), Vitamin B₆ (pyroxidine), Vitamin B₁₂ (cobalamin), Vitamin C (ascorbic acid), pantothenate, biotin, and folate. Excess water-soluble vitamins can be excreted through sweat and urine. Because they are not stored by the body, they must be constantly replenished by external sources.

Eating balanced meals which contain the appropriate proportions of the various food groups should provide a person with the recommended daily allowances of vitamins. A person following these standards is receiving more than enough vitamins and minerals to maintain good health.

The following section gives a brief summary of what each vitamin is needed for and which foods contain it. Vegetarians, pregnant or nursing women, and women on oral contraceptives may need to pay special attention to meeting the recommended daily allowances for certain vitamins. Such special considerations, as well as nutritional points of interest for all women, are outlined in the following section.

Vitamin A: Beta carotene can be converted to Vitamin A on an as-needed basis. Vitamin A and beta carotene are involved in growth, vision, and cell differentiation. Deficiencies can cause night blindness and deficiencies in children can lead to growth problems. Beta carotene is found in fruits and vegetables. Pre-formed Vitamin A can be found in fish-liver oil, meat, and milk.

Vitamin B₆: Some studies have found that Vitamin B₆ may relieve premenstrual symptoms. Pregnant or nursing women, as well as women on oral contraceptives, may require additional Vitamin B₆. Vitamin B₆ is important for maintaining a strong immune system and is needed to help enzymes function. Deficiencies can cause anemia-like symptoms, irritability, fatigue, nervous disorders, and skin problems. However, excessive intake of Vitamin B₆ through supplements is not recommended. Vitamin B₆ can be found in fortified cereals, whole grains, fish, chicken, soybeans, oats, peanuts, fruits, and vegetables.

Vitamin B₁₂: Vitamin B₁₂ is needed to synthesize DNA and to help make blood. Women who do not eat meat, fish, milk, or eggs may need Vitamin B₁₂ supplements, since this vitamin is found exclusively in animal food products.

Biotin: Biotin is a B vitamin produced in the intestines and involved in the synthesis of fatty acids and glucose and the metabolism of several amino acids. Biotin is found in milk, vegetables, nuts, whole grains, organ meats, brewer's yeast, and tuna.

Vitamin C: Vitamin C helps form the dentin (under enamel) in teeth and collagen. It is also involved in amino acid metabolism and helps the body use iron, calcium, and folate. Broccoli, spinach, potatoes, citrus fruits, strawberries, and melons are all good sources of Vitamin C.

Vitamin D: Vitamin D, which is formed by the body when skin is exposed to ultraviolet rays, helps build and maintain strong bones and teeth. Vegetarians, heavy drinkers, and those who avoid the sun may need extra Vitamin D. Pregnant or nursing women need an additional 200 I.U. of Vitamin D daily. Fatty fish (mackerel, sardines, salmon), liver, egg yolks, and fortified milk are all good sources of Vitamin D.

Vitamin E: All vegetable oils, mayonnaise, margarine, nuts, whole grains, wheat germ, and spinach are good sources of Vitamin E.

Folate: Folate is a B vitamin also known as folic acid. Folate is involved in metabo-lism and all biological reactions in the body. People with sickle cell anemia (a disorder particularly common in African-American women), heavy drinkers, women on oral contraceptives, and pregnant or nursing women may need additional folate in their

diets. Folate can be found in fresh leafy green vegetables, wheat germ, mushrooms, oranges, rice, beans, brewer's yeast, and liver.

Vitamin K: This vitamin plays a crucial role in blood clotting, maintaining healthy bones, and helping fractures heal. Vitamin K is found in green leafy vegetables, fruits, root vegetables, seeds, eggs, dairy products, meat, and alfalfa sprouts.

Niacin: Niacin, which is involved in the synthesis of protein and fat and the formation of DNA, also helps to maintain the skin, nerves, and digestive system. Niacin is found in brewer's yeast, meats, poultry, halibut, salmon, swordfish, tuna, peanut butter, sunflower seeds, and legumes.

Pantothenate: Also known as pantothenic acid, pantothenate is found in all food groups. Pantothenate can be found in organ meats, fish, whole grains, blue cheese, yeast, corn, eggs, lentils, wheat germ, sunflower seeds, peanuts, and peas.

Riboflavin: Also called Vitamin B₂, riboflavin is essential for growth and tissue repair. If you take a riboflavin supplement, be sure to take it with meals to increase the amount absorbed. Heavy drinkers may need additional riboflavin. Riboflavin is found in milk, yogurt, cheese, wheat germ, whole grains, chicken, leafy green vegetables, almonds, and fruit.

Thiamin: Also known as Vitamin B₁, thiamin is involved in the conversion of blood sugar to energy. Thiamin also helps form red blood cells and maintain skeletal muscle. Pregnant or nursing women may require additional thiamin. Thiamin is found in pork, whole grains, wheat germ, brewer's yeast, legumes, and seafood.

Minerals

Minerals are pure inorganic elements that do not provide energy and cannot be metabolized by the body. However, some minerals are essential to certain structures in the body.

Calcium: Calcium is important at all stages of a woman's life. From adolescence to the age of 24 or 25 years, women need 1200 milligrams (mg) of calcium daily because they have not yet achieved their peak bone mass. This level should also be maintained during pregnancy and lactation. Many post-menopausal women are at risk for osteoporosis and need between 1200 and 1500 mg of calcium daily.

Iron: Women are also at greater risk for iron deficiency. Eighty percent of iron stored in the body is stored in the blood. As a result, women lose iron during menstruation, making their need for iron higher than that of men. Men and older (post-menopausal) women require 10 mg of iron daily while women of childbearing age require 15 mg of iron daily. In addition, iron absorption is facilitated by the intake of foods rich in Vitamin C and animal products. Iron absorption is inhibited by tea, coffee, and calcium supplements.

Fiber

Fiber is a complex carbohydrate that is not broken down in the gastrointestinal tract

and is not absorbed by the body. Fiber supplies no calories, vitamins, or minerals. It passes through the GI tract and traps water. This process makes the stool softer and makes the bowel generate less pressure to move the bowel contents through the excretory system. Some studies have shown that people who have high-fiber diets have lower incidences of colon cancer.

Special Dietary Concerns

Vegetarian Eating

There are five types of vegetarians:

Semi-vegetarians eat no red meat (beef, pork or lamb) but eat poultry and fish.

Pisci-vegetarians eat no red meat or poultry but eat fish.

Lacto-ovo-vegetarians eat no meat, poultry, or fish but do eat eggs and milk products.

Lacto-vegetarians eat no meat, poultry, fish or eggs but do eat milk products.

Vegans/Strict vegetarians eat no animal products, including milk products.

All vegetarians should pay close attention to their nutritional intake. Some nutrients are especially important for vegetarians to consider, because they can be difficult to find in foods that are not meat.

The following is a list of some of these nutrients and non-meat foods in which they are found:

· Iron can be found in dried beans and peas; whole grain breads, enriched breads,

and cereals; dried fruits; dark green leafy vegetables; potatoes, including sweet

potatoes.

· Calcium can be found in milk; cheeses; yogurt; dark green vegetables; almonds,

soybeans, tofu, and fortified soybean milk products.

· Riboflavin can be found in milk; cheeses; yogurt; mushrooms; enriched grains.

· Vitamin D can be found in fortified milk products; sunlight; egg yolk.

· Protein can be found in milk; cheeses; yogurt; eggs; dried beans and peas; nuts

and seeds; soy products.

· Zinc can be found in wheat germ; black-eyed peas.

Strict vegetarians must pay attention to receive adequate amounts of calcium, Vitamin B12, phosphorus, riboflavin, Vitamin D, iron, and zinc. Therefore, they may need to take supplements of these nutrients in order to meet their nutritional needs. Vitamin B12, which is found only in foods of animal origin, is needed by all cells, particularly by the cells of the nervous system, the digestive tract, and bone marrow. A vegan should consult with his/her health practitioner about nutrient supplements.

Pregnant Women

A good diet during pregnancy can reduce the risk of complications, improve the chances of delivering a healthy baby, and promote better post-pregnancy health. Over the nine months of pregnancy a woman requires approximately 300 extra calories a day. These calories should not be wasted on nutrient-deficient foods, but instead should be spent on nutrient-rich foods such as milk, cottage cheese, lean meats, eggs, dried beans, whole grains, fruit, and leafy greens. One of the most important nutrients in short supply for pregnant women is iron. Calcium is also required for proper development of the fetal

skeleton. Folic acid and zinc are needed for the rapid cell division that accompanies fetal growth and the formation of new red blood cells. In addition, Vitamin B6 is needed for proper development of the brain.

As soon as a woman finds out she is pregnant, she should ask her doctor about proper nutrition. Her doctor may want to recommend vitamin supplements.

If the woman is lactating, she will require approximately 500 extra calories a day. Breast milk is high in calcium, which should be supplied by the mother's diet. Also, Vitamin B12 is necessary for proper cell division and growth in the infant. Deficiency of this vitamin can occur in women who are strict vegetarians.

Dining Out

Tips for Healthy Dining

Dining out and eating in a healthy manner do not have to be mutually exclusive. If you are concerned with your fat or salt intake, the following suggestions can help you choose foods that will allow you to enjoy dining out while staying on a balanced diet.

1. Be careful of free appetizers: they are often loaded with fat and salt.

2. Try to avoid deep-fried foods for appetizers. Instead, choose simple appetizers

like fresh vegetables or clear soups.

3. If you order a salad, beware of high-fat dressings and cheese. Ask for them on the

side, or use an alternative dressing, like oil and vinegar or lemon juice and pepper.

4. Drink just water instead of soda or fruit juice, which are loaded with sugar.

Some Basic Guidelines to Healthy Ethnic Eating

Chinese: Choose steamed rice and vegetables, skinless poultry and tofu. Avoid

fried rice and sweet and sour meats.

Middle Eastern: Choose pita, lentils, hummus, couscous, and bulgar. Avoid excess

sive olives, feta cheese, fatty lamb, and baklava.

Mexican: Choose whole beans with rice, salsa, and grilled chicken. Avoid guaca-

mole, refried beans, and heavy cheese.

Indian: Choose yogurt-based curry, tandoori chicken, fish, and bread. Avoid ghee

and deep-fried meats.

Italian: Choose pasta with vegetables, salad and antipasto without oily dressing.

Avoid cream and butter sauces, sausage, and heavy cheese.

Japanese: Choose steamed rice, fish, and vegetables. Avoid heavy peanut sauce,

tempura, and teriyaki dishes.

Soul Food: Choose greens cooked with turkey, beans/peas with rice. Avoid deep

fried food and excessive gravies.

Weight Loss and Dieting

Facts About Weight Gain and Loss

A person gains weight when he/she consumes more calories than he/she burns. Conversely, weight is lost when he/she consumes less calories then he/she burns. A woman who is five feet, four inches tall and weighs 120 pounds needs 2000 kilo-calories a day to maintain her weight. A pound of body fat represents the storage of approximately 3500 kilo-calories, and to lose this pound she must create a 3500 kilo-calorie deficit by consuming less and/or expending more. To shed this pound over a week, she must consume 500 fewer kilo-calories per day or burn them off by exercising. A combination of both is ideal.

The Mechanism of Fat Conversion in the Body

1. Carbohydrates are broken down into sugars. In the body tissues they may be built

up to form glycogen or converted to fat and stored.

2. Fat is broken down into glycerol and fatty acids for absorption. In the body tis-

sues it may be recombined to make new fat for storage.

3. Protein is broken down into amino acids for absorption. They may be used to re-

place lost body protein and to build new muscles and other lean tissue. Extra am-

ino acids are converted to fat.

Trendy Dieting Programs

1. Low-Carbohydrate Diets (a.k.a., Atkins Diet, Air Force Diet, Scarsdale Diet)

These diets were first introduced in the early 1960's as a revolutionary diet program. They are attractive to dieters because they allow them to eat whatever they want, except for carbohydrates. These diets use the principle that the body stores carbohydrates (glucose) as fat, because carbohydrates trigger the release of insulin. Theses diets state that if you restrict carbohydrates, and thus the insulin released, you will not store fat. Instead, you will lose weight. Since your body does not burn fat and muscle tissue simultaneously, and you are ingesting protein, you will not lose muscle tissue.

These diets do not work for several reasons. The foundation of this diet is not valid. Carbohydrates do not trigger the secretion of insulin, and there have been no widely received study which has shown otherwise. Glucose is only stored as fat when there is an excess. Furthermore, high protein often means high fat, which is the nutrient dieters really should be restricting.

This diet only works because it causes dieters to restrict calorie intake. However, there are very serious side-effects of these diets. Neither the AHA nor the NIH recommends these diets. These diets causes an excess of nitrogen in the blood, a by-product of protein when it is converted to glucose. This nitrogen burdens the kidneys. More seriously, however, is the fact that these diets may cause ketones to build-up because of incomplete breakdowns of fat. This may cause high blood cholesterol, hypoglycemia, mineral imbalances, and other metabolic abnormalities.

2. Sugar-free Diets

This new trend recommends a diet of whole breads, whole grains, no white sugar, and no white flour. It is very strict, but generally has sound advice. This diet is fairly new

but has already become a fad. The reason this diet works is because it cuts out what contributes to most people's weight-problems: sugary foods and potato chips. This diet is recommended for diabetics. Additionally, it is recommended more as a guide than as a diet. The diet does note that exercise is recommended for healthy living.

The down-fall of this diet is that it is very strict. You need a lot of willpower to give up sweets and potato chips. You may find this diet too hard to follow for very long and give up all together. Instead, most nutritionists and the USDA recommend you use sugar and fats sparingly.

3. 30-Day Miracle Diets

You may see signs, see television ads, or read magazine blurbs about how to lose 30 pounds in just 30 days. Too good to be true? Absolutely. Do not believe the hype. Most of these diets preform their "miracles" by causing you to lose water weight or lean muscle tissue. This weight is easily lost and easily regained. These diet programs are not recommended by the USDA.

There are great dangers of these diets. Dehydration is serious, as it causes dizziness, irritability, and fatigue. Furthermore, you will not get the nutrients your body needs, even if you are taking supplementary pills. Remaining on this diet for more than a month is highly dangerous.

4. Diet Centers (Jenny Craig, Weight Watchers)

Diet centers can be a successful, although expensive, way to lose weight. Most centers put you on an individualized program based on how much weight you wish to lose. They may assign "food points" or other devices to keep you on a balanced diet. Additionally, they recommend plenty of water and moderate exercise. They also may have group meetings, in which you discuss with others your weight issues. These meetings, meant for moral support, are optional in most programs.

5. Diet Shakes, Bars, Powders

These are simply tools to help you lose weight. Most are balanced and have many nutrients in them. Although they work for some people, there are drawbacks. First, they may be expensive for the long-term. Also, you may find yourself unable to maintain your weight-loss without them. Additionally, you may or may not find them tasty and/or satisfying.

6. Diet Pills

Over-the-counter pills are usually just appetite suppressants. Most contain caffeine, and if you take too many you may experience nervousness, dizziness, sleeplessness, headaches, or in severe cases, stroke, seizure, heart attack, arrythmia, or even death.

If you have ever taken fenfluramine and phentermine (Fen/Phen and Redux) you should be aware that these pills have been recalled by the USDA. They have been linked to heart-valve disease. Recent studies have shown that the heart-valves may not be able to close completely, forcing blood back into the heart. This is extremely dangerous, and it is recommended you have an echocardiography if you have ever taken these pills.

Reading Labels

Common Labelling Lingo

97% Fat-Free: means that the product has 3% fat, not 97% less fat

No/Low Cholesterol: only indicates cholesterol information, does not imply anything about the fat content of the product, and should not be a major concern unless you have a history of high cholesterol or have been warned by a physician to limit cholesterol.

Lite/Light: does not always mean low in calories. For example, lite beer has a lower alcohol content than regular beer, not less calories.

Reduced Fat: has 25-33% less fat than its counterpart. Still may have much fat, though.

All-Natural: may be misleading. Does not necessarily mean anything, as some products are just all-natural, like granola. This is sometimes put on labels to trick the consumer into thinking he/she is eating more healthily.

Organically Grown: defined as "to use materials and practices that enhance the ecological balance of natural systems that integrate the parts of the farming system into an ecological whole." Methods minimize pollution from air, soil and water. However, this does not mean that pesticides cannot be used, just that if they are used, they are the ones that are least harmful to the environment. This is tricky, as there are different classes of organically grown products, and not all are as strict. Furthermore, the store may not always tell you what class the product is in.

Sell-By-Date: date to sell by, not same as use-by-date. Always check use-by-date, especially when buying dairy (if not listed, it is usually one week after sell-by-date).

Serving Size: if a product advertises low-calorie/low-fat properties, you should check the serving size. Serving size may be incredibly small, and may attribute to the reason a delectable dessert is low-fat/low-calorie.

Sugar-free: if a product is sugar-free, it may still contain aspartame/nutrasweet.

Artificial Fats/Sugar

Aspartame/NutrasweetTM

This product, developed by Searle in the early 80's, is a sugar-alternative found in soda, yogurt, cookies, and other such products. While endorsed by the FDA and even given permission to expand usage, opponents argue that aspartame leads to serious neurological damage by over-exciting neurons because it allows too much calcium into the cells. Also, aspartame has been shown to cause brain tumors in laboratory rats. Some claim that aspartame causes Alzheimer's and cancer in humans. Other complaints are more mild, such as headaches, dizziness, and irritability.

Olestra/OleanTM

Developed by Proctor & Gamble in the mid-1990's, this product has been the cause of

much debate. This is an artificial fat, which passes through the body undigested because the body's digestive enzymes cannot find a way to break-down this complicated fat. It may cause cramping, diarrhea, and anal leakage. Opponents also say that it robs the body of valuable nutrients such as Vitamins A, D, E, and K. Proponents of Olestra point out that plenty of natural foods, such as cabbage, may cause the same results. They also advocate that this product may help people lose weight, and that the effects of obesity (such as heart disease and diabetes) are also very dangerous.

With both products, it is a judgement call. Moderation is always the best method of ingesting anything, and it is recommended that if you experience any of the unpleasant side-effects, you should immediately stop eating the product.

Eating Disorders

Anorexia Nervosa

Anorexia nervosa is defined as a self-starvation leading to extreme emaciation. Females are fifteen times more likely to become anorexic than males. Symptoms of starvation include: sensitivity to heat and cold, brittle hair, hair growth in unexpected parts of the body (such as the face, back, and arms), slowed heart beat, diminishing blood pressure, constipation, edema, cessation of the menstrual flow, and dental problems. The diagnostic criteria for anorexia nervosa according to the American Psychiatric Association are:

1. intense fear of becoming obese, a feeling which does not diminish as weight loss

progresses

2. disturbance of body image (i.e., claiming to feel "fat" when emaciated)

3. weight loss greater than 25% of original weight

4. refusal to maintain body weight above the minimal normal weight for height and age

5. no known physical illness that could account for the weight loss

Bulimia Nervosa

Bulimia nervosa is an eating disorder characterized by bingeing (episodes of compulsive overeating) followed by purging which may include self-vomiting or excessive use of laxatives or diuretics. This purging is an attempt to prevent weight gain from overeating. Though some bulimics develop anorexia and some anorexics have bulimic binges, bulimia is considered a separate eating disorder. Some symptoms of bulimia include: swelling in the hands and the feet as a result of the vomiting, nausea, abdominal pain, rashes, headaches, and exhaustion. According to the American Psychiatric Association, the diagnostic criteria for bulimia nervosa are:

1. recurrent episodes of binge-eating

2. at least three of the following

* consumption of high-calorie, easily ingested food during a binge

* inconspicuous eating during a binge

* termination of eating binge by abdominal pain, sleep, social interruption or self-

induced vomiting

* repeated attempts to lose weight by severely restrictive diets, self-induced

vomiting, or use of laxatives or diuretics

* frequent weight fluctuations greater than 10 pounds due to alternating binges

and fasts

3. awareness that the eating pattern is abnormal and a fear of not being able to stop

voluntarily

4. depressed mood and self-deprecating thoughts following eating binges

5. the bulimic episodes are not due to anorexia nervosa or any known physical disor-

der.

NOTE: If you suspect that you or someone you know has an eating disorder, you should get help immediately. You can do this by consulting your physician, by calling SCRS, or telling a resident head or resident assistant. It is important to get help immediately. Unfortunately, eating disorders are complex conditions which affect the person both physically and psychologically. It may take years to recover completely. The longer a victim suffers from an eating disorder, the more damage the disease will do to the body. The person will become sick more easily, feel tired, and may suffer long-term effects, such as a weakened heart.

Eating Disorders and Athletes

Female athletes, especially those competing in such weight-conscious sports as gymnastics, swimming, running, and crew, are at an increased risk of developing eating disorders as a result of the high priority these sports place on low-body fat percentages and overall thinness. For example, although the US Olympic Committee states that the normal body fat percentage is 20-22% for female athletes, the athletes and coaches often strive for a range of 10-14%. Women are more likely than men to have problems because they have a lower metabolic rate and a higher overall body fat percentage, and as a result they may turn to anorexic or bulimic behavior. Athletics are also sometimes used to disguise eating disorders because sports place an emphasis on leanness. Therefore, one might argue they are losing weight for the sport, not for themselves, and this is a necessary behavior. Sports are also a means for anorexics to purge calories. The athlete might argue excessive workouts are necessary for her sport, and thus legitimatize over-exercising to lose weight. Female athletes with eating disorders are often extremely difficult to treat because the sport legitimatizes the disorder in her mind. Female athletes are also very driven and demanding, and may believe that thinness is a matter of discipline. Therefore she may see weight-gain as a personal failure.

Diabetes

What is Diabetes

Diabetes is a disease in which the body is unable to use and store glucose properly. Glucose backs up in the bloodstream, causing the blood glucose to rise too high. There are two major types of diabetes. In Type I (also called juvenile or insulin-dependent) diabetes, the body stops producing any insulin. Insulin is a hormone which allows the body to use glucose found in foods for energy. People with this type of diabetes must take insulin daily to survive. In Type II (also called adult-onset or non-insulin dependent) diabetes, the body produces insulin but cannot properly convert food into energy. This form of diabetes usually occurs if only if you are over forty, overweight, and have

a history of diabetes in your family. However, you can never be too careful, and should always follow a healthy diet.

Symptoms of diabetes include:

· extreme thirst

· urge to urinate frequently

· weight-loss

· increased hunger

· blurry vision

· skin infections

· wounds that don't heal

· unexplained fatigue

See your health-care professional if you experience any of these symptoms. Diabetes (usually Type II) can lay dormant in the body without symptoms for years. The risk of developing diabetes increases as you grow older. You are also at higher risk if you are of African-American, Hispanic, or Asian heritage.

A condition called gestational diabetes occurs in 1%of all pregnant women. This condition is treatable, but also increases a woman's chance of developing diabetes later in life.

Student Care Center Nutrition Services

To make an appointment:

702-0240

For information:

702-9771

National Association of Anorexia Nervosa and Associated Disorders

Box 7

Highland Park, Il, 60035

(847) 831-3438

American Anorexia/Bulemia Association

293 Central Park West

New York, NY 10024

(212) 278-0697

Anorexia Nervosa and Related Eating Disorders (ANRED)

P.O. Box 5102

Eugene, OR 97405

http://www.anred.com

Suggested Readings

Anorexia Nervosa: A Guide to Recovery by Lindsay Hall and Monika Ostroff

Biting the Hand That Feeds Me: Days of Bingeing and Purging by Lisa Messinger

For more information about diabetes:

www.diabetes.org/ada