University Health Services

EXERCISE

Why is exercise important?

Although Princeton students usually have very busy schedules, it is essential that you make time for exercise in order to lead a healthy life. In fact, fitting exercise into your daily routine will likely help you accomplish other goals for the day, such as studying and getting a good night’s sleep. Because physical fitness can increase your concentration, stamina, energy, and mental well-being, you are more likely to be productive while studying. Exercise is also a great stress reducer, and can enhance self-confidence. Long-term benefits include lowered risk for cardiovascular disease, diabetes, and obesity.

How much time should I spend exercising?

Aerobic activity, such as walking, jogging, biking, or swimming should be done 3-5 times a week for 20-60 minutes at a time. Weight training should be done less frequently − 2-3 times a week − because your muscles need greater time to recover after resistance workouts. If you don’t have time to schedule such workouts, think about ways you can fit physical activity into your daily routine. Perhaps you can take the stairs instead of the elevator, or take a short walk when you have a few free minutes. Long hours of studying can be made more productive if you take occasional breaks to walk around and get your blood flowing. You will feel more energized and ready to work when you return to your desk.

How do I follow an exercise regimen?

The best advice is to choose an activity that you enjoy. If you look forward to exercising you will be far more likely to stick to your physical fitness plan. Sign up for an intramural sport through your residential college or eating club, or make up your own team. You will not only have fun playing athletic games with peers, but you will also meet new people. Joining a team can lend support to faltering self-discipline because the team’s performance depends on your physical fitness and your commitment to showing up at practices and games. If you miss practices or games, you will not only be letting yourself down, but also your teammates.

If you’d rather exercise on your own, make sure you set goals for yourself. You may want to lose a little weight or get in shape for a sport during the off-season. Avoid overexertion by beginning slowly and eventually working up to longer and more intense workouts as you get in better shape. Starting an exercise routine with high intensity workouts may deter you from exercising at all as you experience pain and fatigue. Each training session is an important, yet small step on the way to reaching your fitness goals. Don’t focus on the effects of working out on a daily or weekly basis, but notice your progress over months and years. Reaching your fitness goals is a long-term process. Keeping track of your progress will give you confidence to see how far you’ve advanced since you started, and make you more responsible for completing a planned routine. [top]

OVERTRAINING SYNDROME

It is no secret among athletes that in order to improve performance you've got to work hard. However, hard training breaks you down and makes you weaker. It is rest that makes you stronger. Physiologic improvement in sports only occurs during the rest period following hard training. This adaptation is in response to maximal loading of the cardiovascular and muscular systems and is accomplished by improving efficiency of the heart, increasing capillaries in the muscles, and increasing glycogen stores and mitochondrial enzyme systems within the muscle cells. During recovery periods these systems build to greater levels to compensate for the stress that you have applied. The result is that you are now at a higher level of performance.

If sufficient rest is not included in a training program then regeneration cannot occur and performance plateaus. If this imbalance between excess training and inadequate rest persists then performance will decline. Overtraining can best be defined as the state where the athlete has been repeatedly stressed by training to the point where rest is no longer adequate to allow for recovery. The “overtraining syndrome" is the name given to the collection of emotional, behavioral, and physical symptoms due to overtraining that has persisted for weeks to months. Athletes and coaches also know it as "burnout" or "staleness." This is different from the day-to-day variation in performance and post exercise tiredness that is common in conditioned athletes. Overtraining is marked by cumulative exhaustion that persists even after recovery periods.

The most common symptom is fatigue. This may limit workouts and may be present at rest. The athlete may also become moody, easily irritated, have altered sleep patterns, become depressed, or lose the competitive desire and enthusiasm for the sport. Some will report decreased appetite and weight loss. Physical symptoms include persistent muscular soreness, increased frequency of viral illnesses, and increased incidence of injuries.

There have been several clinical studies done on athletes with the overtraining syndrome. Findings in these studies have shown decreased performance in exercise testing, decreased mood state, and, in some, increased cortisol levels -- the body's "stress" hormone. A decrease in testosterone, altered immune status, and an increase in muscular break down products have also been identified. Medically, the overtraining syndrome is classified as a neuro-endocrine disorder. The normal fine balance in the interaction between the autonomic nervous system and the hormonal system is disturbed and athletic "jet lag" results. The body now has a decreased ability to repair itself during rest. Heaping more workouts onto this unbalanced system only worsens the situation. Additional stress in the form of difficulties at work or personal life also contributes.

It appears that there are two forms of the syndrome. The sympathetic form is more common in sprint type sports and the parasympathetic form is more common in endurance sports. In the sympathetic form, the resting heart rate is elevated. In the parasympathetic form, however, the resting heart rate is decreased. If this sounds confusing, then you are not alone. There is very little agreement in the literature about abnormal laboratory findings. Additionally, it is possible to have the overtraining syndrome, but have completely normal physical findings and biochemical tests. At this point, there is no single test that will confirm the presence of overtraining. The overtraining syndrome should be considered in any athlete who manifests symptoms of prolonged fatigue and performance that has leveled off or decreased.

Athletes training with a heart rate monitor may notice that they cannot sustain the workout at their usual "set point." Fatigue takes over and prematurely terminates the workout. Regulation of glucose can become altered and the athlete may experience symptoms of hypoglycemia during exercise.

When diagnosing overtraining syndrome, it is important to exclude any underlying illness that may be responsible for the fatigue. The only treatment for the overtraining syndrome is rest. The longer the overtraining has occurred, the more rest required. Therefore, early detection is very important. If the overtraining has only occurred for a short period of time (e.g., 3 - 4 weeks) then interrupting training for 3 - 5 days is usually sufficient rest. After this, workouts can be resumed on an alternate day basis. The intensity of the training can be maintained but the total volume must be lower. It is important that the factors that lead to overtraining be identified and corrected. Otherwise, the overtraining syndrome is likely to recur. The alternate day recovery period is continued for a few weeks and then an increase in volume is permitted. In more severe cases, the training program may have to be interrupted for weeks, and it may take months to recover. An alternate form of exercise can be substituted to help prevent the exercise withdrawal syndrome.

All of the medical studies and advice on overtraining have involved single sport athletes. For tri-athletes and other multi-sport athletes the recovery process may be different depending on the circumstances. If it can be identified that the overtraining has occurred in only one discipline, then resting that discipline along with significant decreases in the other sports can bring about full recovery. It is vitally important not to suddenly substitute more workouts in one sport in an attempt to compensate for rest in another. The athlete that does this will not heal the overtraining, but will drive him or herself deeper into a hole. Overtraining affects both peripheral and central mechanisms in the body. Resting from overtraining on the bicycle by swimming more will help a pair of fatigued quadriceps, but to the heart, pituitary, and adrenals, stress is stress.

As with almost everything else health related, prevention is the key. Well-balanced gradual increases in training are recommended. A training schedule design called periodization varies the training load in cycles with built-in mandatory rest phases. During the high workload phase, the athlete alternates between high intensity interval work and low intensity endurance work. This approach is used by a number of elite athletes in many sports.

A training log is the best method to monitor progress. In addition to keeping track of distance and intensity, the athlete can record the resting morning heart rate, weight, general health, how the workout felt, and levels of muscular soreness and fatigue. The latter two can be scored on a 10-point scale. Significant, progressive changes in any of these parameters may signal overtraining. Avoiding monotonous training and maintaining adequate nutrition are other recommendations for prevention. Vigorous exercise during the incubation period of a viral illness may increase the duration and severity of that illness. Athletes who feel as if they are developing a cold should rest or reduce the training schedule for a few days.

In conclusion, the prevailing wisdom is that it is better to be under trained than over trained. Rest is a vital part of any athlete's training. There is considerable evidence that reduced training (same intensity, lower volume) for up to 21 days will not decrease performance. A well-planned training program involves as much art as science and should allow for flexibility. Early warning signs of overtraining should be heeded and schedule adjustments made accordingly. Smart training is the path to faster times and good health. [top]

EATING HEALTHY

When should I eat?

The answer to this question varies for each individual so you should learn the eating style that works best for you. Some people like eating many small meals throughout the day, while others feel better eating just three large meals. No matter what style you feel comfortable with, you should eat for the right reasons. Do not eat out of boredom, custom, or emotion, but when you are hungry. This does not mean waiting until you are starving and are already suffering from a headache, fatigue, and dizziness, but finding food when you are mildly hungry.

You should always start the day with breakfast to give your body energy to start the day. Even if you are trying to lose weight, it is important not to skip meals because your metabolism will slow to preserve fat stores if your body believes it is being starved. In fact, studies have shown that eating breakfast can contribute to successful weight loss because as soon as food hits your stomach in the morning your metabolism increases and you burn calories through digestion. Additionally, people who eat breakfast are less likely to overeat later in the day.

Sit down to eat meals. The life of a Princeton student is often very hectic, but setting time aside for meals is important for your health. If you eat “on the go” you are less likely to keep track of what and how much you eat. It is easier to dismiss a slice of pizza as a snack when you eat it while walking to class. Sitting down to meals also helps digestion and provides a relaxing study break.

Should I avoid snacking?

No, snacking is part of healthy eating because your body needs energy to fuel your daily activities. Especially at school where the dining hall is only open at certain times, which do not necessarily fit into your schedule, it is important not to go more than six hours without eating. In fact, depending on your metabolism, you may find it necessary to eat every two hours. The best way to measure when you should be eating is being aware of your body’s hunger signals. Don’t just eat because you’re bored or food is being offered for free − know when your body needs energy. Symptoms of hunger often include stomach contractions, low blood sugar (dizziness when standing up), and headaches.

Snacking is healthy, but you should choose snacks that contain vitamins and minerals without too much fat and sugar. While it is often hard to figure out what nutrients are in various foods, the best advice for snacking is to eat a variety of foods that are not deep-fried or processed and packaged. Healthy snacks include apples, peanuts, carrot sticks, cheese and crackers, milk, yogurt, whole wheat bread, applesauce, dried fruit, etc. Foods high in protein, like dairy, meat, and nuts, will ward off hunger longer, and even use more calories for digestion. Three terms to remember when snacking (and when eating in general) are balance, variety, and moderation.

What should I eat in the dining hall and eating clubs?

Dining Services now offers online nutrition labels for meals in the dining hall, eating clubs and Frist. Make sure your diet has variety so you receive a vast range of nutrients. The biggest problem for most college students is a diet with too much fat and salt, and too little fiber. To avoid excess fat, you should eat low fat dairy products, trim fat and skin from meat, use tomato sauce instead of cream or pesto sauce on pasta, and select fewer fried foods, like French fries, chicken tenders, mozzarella sticks, and doughnuts.

Still have questions? Dining Services offers online nutrition advice. Click here to Ask the Dietician!

Limit your consumption of white flour. Even though foods containing white flour, like white bread and pasta, are considered complex carbohydrates, they will not satiate your hunger for long and do not provide much nutrition. Whole grain and whole-wheat foods are high in fiber, which helps maintain balanced blood sugar levels. This means you’ll feel full longer because your blood sugar will not soar and plummet the way it tends to do after eating simple carbohydrates.

There are two kinds of fiber: soluble and insoluble. Insoluble fiber, found in vegetables and whole grain products, adds bulk to your stools and prevents constipation. It also lowers your risk of colon and rectal cancers. Soluble fiber improves cholesterol and blood sugar levels, and is found in oats, dried beans and some fruit, such as apples, strawberries, and oranges. Although most Americans only get about 10-15 grams of fiber per day, men under 50 should have 38 grams and women should have 25. To give you some frame of reference, a slice of whole wheat bread (assuming it’s real wheat and not food coloring) has about 3 grams of fiber, a cup of Kellogg’s Raisin Bran has 8, and a medium apple with skin has 3.7.

Creative ideas for the dining hall:
 

• grilled chicken and vegetables from the salad bar in a whole-wheat pita, with a little salad dressing or mustard
• celery sticks with peanut butter and raisins
• peanut butter and banana sandwich on whole-wheat bread
• grilled cheese sandwich with wheat bread (you’ll have to give the grill workers wheat bread)
• salad dressing made with oil, vinegar, and mustard
• canned or fresh fruit with cottage cheese

How much calcium do I need and where should I get it from?

After puberty, young adults need 1,000 milligrams of calcium (over 3 cups of milk) per day to maintain healthy bone mass. Strong bones are important to prevent fractures now, but especially during old age when osteoporosis becomes a major health concern. Not only does calcium provide strong bones, but it also helps muscle and nerve function and has been linked to reduced symptoms of PMS.

It’s best to get calcium from food, rather than from supplements. However, people who are lactose-intolerant may need to take calcium supplements. Worrying about the fat content in many dairy products should not hinder calcium intake because skim milk actually contains more calcium per cup than 2% or whole milk. Calcium is better absorbed in the presence of vitamins C and D and lactose. Salt, phosphorous, and caffeine lead to a loss of calcium in bones. Phosphorous and caffeine are found in soda, so if you drink soda instead of milk your problem may not simply involve not getting enough calcium, but losing what you have.

What’s the best kind of diet?

The healthiest way to lose weight and keep it off is to reduce calories and to exercise regularly. To be successful keeping lost weight off, it’s best to think of your eating and exercise habits as a “lifestyle,” rather than a “diet.” When people go on “yo-yo” diets, drastically reducing caloric intake, they end up rebounding by giving in to food cravings, and perhaps bingeing. Thus, the vast majority of people who diet regain all the weight they lost plus 10 extra pounds within five years. Your new lifestyle should result in slow weight loss so that you’re not starving and craving certain foods.

Avoiding fat will not necessarily lead to weight loss. Even low-fat diets can lead to weight gain if excess calories are taken in from other sources. Often products advertised as non-fat or low fat still have many calories, so watch your portion sizes. Unfortunately, small portions of fat-free food are not likely to satisfy hunger because they lack fat’s ability to provide a feeling of satiety. Believe it or not, fat is an important nutrient that your body needs to maintain health, and if you don’t take in adequate amounts, your brain can trigger cravings for fat, which is necessary for the absorption of certain essential vitamins, such as vitamins A, D, E, and K. However, keep in mind that some fats are better than others. Saturated (animal fat) and trans fats (hydrogenated oils) have been shown to cause heart disease. Monounsaturated fat is generally considered the best because it reduces blood cholesterol. It’s found in nuts, avocados, olives, and canola, peanut, and olive oils.

Can I give in to my cravings for chocolate?

When you crave a certain kind of food, it is best to give in, for both physical and mental health. Eating a small amount of chocolate can help satisfy your craving, relieving you of the mental energy necessary to hold off temptation, without contributing to weight gain. Forcing yourself to go without chocolate for a long period will increase your desire, and when you finally give in to temptation you will be more likely to binge.

If you’re worried about your weight, or about the effects of eating junk food, avoid chocolate products with hydrogenated oils, which have trans fats, a fatty acid linked to heart disease. Try dark chocolate, instead of milk chocolate. This concentrated dose of cocoa is more likely to satisfy a craving, and has nutritious value as well because it’s rich in antioxidants and stearic acid. Fat free chocolate syrup and chocolate frozen yogurt are good low calorie options.

Is vegetarianism a healthy option on campus?

Yes, vegetarians have many options for good nutrition on campus. The dining hall always provides a vegetarian main dish, veggie burgers, grilled cheese sandwiches, and many options at the salad bar. There are also vegetarian options at Frist and eating clubs. The key to good nutrition, no matter what kind of diet you follow, is variety.

There are several types of vegetarianism, but all exclude meat, poultry, and fish. Lacto-ovo vegetarians supplement their diet with dairy and egg products, while lacto vegetarians eat dairy, but not eggs. Vegans do not eat any animal derived products and may need to supplement their diet with calcium, iron, zinc, and vitamins B12 and D. Vegetarians should drink more water to help digest higher levels of fiber associated with plant-based foods.

A common myth about vegetarianism is that the diet makes it difficult to eat enough protein. However, there are many good sources of protein from foods other than meat, such as soy, lentils, tofu, dairy products, nuts, peas, and tempeh. Make sure you eat a wide variety of protein-rich foods in order to supply your body with the amino acids necessary to build and maintain tissue.

Iron deficiency is another concern, not just for vegetarians, but for everyone. Men need 10 mg of iron daily, while women of childbearing age should get 15 mg to make up for blood lost during menstruation. The reason anemia (lack of iron) is associated with vegetarianism is that red meat is known to contain high levels of iron. Without this source of iron in their diet, some vegetarians become anemic. Good sources of iron for vegetarians include spinach, prune juice, dried fruit, and dried beans. It’s important to know that vitamin C will increase absorption, but drinking coffee or tea with meals will inhibit absorption. Good sources of vitamin C include orange juice, broccoli, brussels sprouts, cauliflower, cantaloupe, cranberry juice, grapefruit, and strawberries.

If you are a vegetarian or vegan who plans to join an eating club, you may want to consider which clubs provide the best vegetarian options. Otherwise, you may want to cook for yourself or join the vegetarian coop at 2 Dickinson Street (2-D). [top]

FRESHMAN 15: MYTH OR REALITY?

Gaining the “freshman 15” is often a reality, but it doesn’t have to be. Many students find they gain weight during their first year of college due to changed living habits. The dining hall is only open certain hours, there are no set portions, and food is served at most social events. Transition to college life can be very emotional, which also contributes to changed eating habits. In order to prevent unwanted weight gain, only eat when you’re hungry, and avoid eating late at night. As your body prepares for sleep, your metabolism slows and does not require much energy from food. Have a light snack (a piece of fruit, whole-grain toast, yogurt, etc.) if hunger will prevent sleep, but otherwise skip eating before you sleep because when you wake up the next morning you’ll most likely ingest the same number of calories whether you gave in to late night cravings or not. That said, don’t chow down at study breaks just because the food is free, and don’t eat for emotional reasons, such as boredom or stress. Study break food is not usually the healthiest, so ask your RA if he/she can serve something along the lines of tropical fruit, raw vegetables and dip, sandwiches, or cheese cubes.

Increased alcohol consumption contributes to weight gain because people don’t generally focus on the calories they’re taking in during the course of a night spent drinking. However, skipping meals to counter the caloric wealth of your drinking habits is unhealthy because drinking on an empty stomach is dangerous and skipping meals confuses your body’s metabolism. Additionally, alcohol has more calories per gram than carbohydrates and protein, but does not have nutritional benefits. The best thing to do is limit alcohol consumption.

The healthiest and most effective way to maintain a healthy body weight is to exercise regularly. If you’ve decided not to join a sports team at Princeton, you should make an effort to exercise a few times a week. At college your time is less structured and you are more independent. An intense workload may lead you to spend more hours sitting at a desk than you did in high school. This is fine as long as you balance these hours of study with activity that works your muscles. [top]