Caffeine is found naturally in coffee, tea, chocolate, guarana, and yerba mate. It may also be added to other foods or beverages (like energy drinks) and sold in powdered or capsule forms. While a moderate consumption caffeine per day appears fine (around 4 cups of coffee per day), excessive consumption may cause unpleasant, and even dangerous, side effects. 

Possible Dangers of Excessive Caffeine

• Muscle Tremors
• Insomnia
• Dehydration
• Irritability
• Nervousness
• Frequent urination
• Fast hear beat
• Nausea
• Upset Stomach

 

Energy Drinks

Energy drinks are a concentrated source of multiple stimulant-containing ingredients that promise to give you that extra push to focus longer or perform better. What’s not advertised is the possible cost of drinking such concentrated sources of caffeine, additives, and sugar. In addition to possible tooth erosion, to exceeding the recommendations of added sugar per day, to all of the above listed side effects, energy drinks may be costing you more than they are promising. Studies suggest that college students who regularly consume energy drinks may engage in riskier drinking practices (think binge drinking) and are more likely to visit the emergency room, report poor sleep, and feel more irritable.

Another nutrition concern is when students drink energy drinks instead of eating food.  If done on a regular basis, nutrient gaps can turn into deficiencies. These nutrient gaps may not be obvious but can gradually take a toll on your health and academics.

 

A better option…

Often, students use energy drinks to increase their alertness and academic performance. Studies show that eating regularly, getting enough sleep, managing stress, and reaching for fiber rich, whole foods can keep mental alertness and physical performance optimized without any risky side effects. If you feel dependent on energy drinks, consider switching to a natural source of caffeine like coffee or tea.  There are possible health benefits associated with those beverages. If you are going to keep caffiene in your diet, try to keep your intake under 600 mg per day. Your mental health, heart, and academics will thank you.

Food allergies are an immune system response to specific foods. Responses can include itching, hives, and anaphylaxis. Allergies are IgE mediated which means the immune system is responding. This means that IgE is produced when your body identifies a threat (in this case, a protein in the food) and sends a response.

Food intolerances do not have an immune system response. A food intolerance is a digestive system response to a food. 

 

Symptoms and Trigger Foods 

The most common food allergy reactions are to eggs, peanuts, treenuts, milk protein (casein or whey), soy, wheat, fish and shellfish. When an allergic reaction occurs, symptoms may range from upset GI responses (diarrhea, vomiting, abdominal pain within 1 hour of ingestion) to skin reactions (hives, dermatitis).

When a food intolerance response occurs, the symptoms also involve the digestive system. These may include gassiness, cramping, nausea, diarrhea.  

Another type of reaction, called oral allergy syndrome, is associated with fresh fruit and raw vegetables. This type of hypersensitivity causes mild lip and throat swelling, irritation and itchiness.

 

Testing for Food Allergies

Skin testing is a standard procedure for food allergies (not food intolerances) but there is some question about the reliability of this test. A more reliable test is the IgE test. Used in conjunction with a clinical review of symptoms, history, and, a food challenge, a physician can determine a treatment plan. Please note that the variety or severity of symptoms is not correlated with the positivity of the tests.

 

Testing for Food Intolerances 

There are no tests for food intolerances. Tests which are NOT accurate (but heavily marketed) include hair follicle tests, ALCAT, IgG testing, Electrodermal/Iridology, MRT, and LEAP. However, procedural methods like elimination diets, or symptom and food diaries, can be useful to identify possible trigger foods.

 

Next Steps

If you'd like to discuss a possible intolerance or ways to avoid a known allergy, we suggest scheduling an appointment with Emory Student Health Nutrition as a first step. If you would like to have testing done, please seek out allergy IgE testing through an allergy or dermatology clinic. Gastroenterology (GI) exams may also complete some testing including for Celiac disease.

One of the most common challenges our Emory Eagle athletes face is nutrition. With an increase in activity comes an increased demand for more fuel but, with rigorous academics, clubs, or group work, students often struggle to eat appropriately. The symptoms of not eating enough may present as feeling unfocused, lethargic, irritable, and they may see their competition or practice performance suffers. Student athletes who are not fueling enough are also at an increased risk for injury and slow recovery time.

Learn more about how to optimize your athletic performance here.

Most people go through a period of low energy but many of the triggers are preventable! Check our list of common causes and try some easy solutions. If you can’t find success, please schedule a visit with us to dive deeper into less common causes and solutions for low energy.

Eating Enough

Our bodies require energy to do everything: think, move, feel, breathe, study – even sleep! The source of energy for us to do anything is food. Food gives us energy through carbohydrates (predominant source), protein and fat. If we don’t eat enough to meet our bodies energy demands, we can feel sluggish. Think about this: if you wanted to drive your car out of state, you’d have to put enough gas in to make it. If you don’t, you will run out of the ability to go (and be stuck on the side of the road). The same can be said for our bodies. Rigorous academics, sports, social gatherings and relaxing all take energy so make sure you are eating enough throughout the day (like filling up multiple times on a road trip). 

Vitamin or Nutrient Deficiencies

If you avoid foods or food groups, you may be missing some key nutrients. The most common causes are lack of adequate carbohydrates (think fruits, whole grains, beans, tubers etc.), low B12, or low vitamin D.

Often, students avoid carbohydrates worrying that they cause weight gain. This is an incorrect assumption about carbohydrates. Carbohydrates do not inherently cause weight gain but eating too much processed, sugary or fatty foods may contribute. Rather than avoiding carbs, why not focus on increasing quality carbohydrate sources at each meal and see how you feel?

Vitamin B12 originates in soil; since we don’t eat a lot of dirt these days, we are only exposed to it through animals that do eat dirt or through a supplement. If you do not eat animal-based foods, a supplement is likely recommended. B12 is very important for energy metabolism. 

Our best source for Vitamin D is through the sun; however, with much of our lives happening inside buildings and with the increase in sunscreen and protective clothing, we do not usually get enough sun exposure to get adequate vitamin D. Some easy options to increase vitamin D is to spend 15 minutes outside with arms, legs, and/or torso exposed, eat more vitamin D containing foods (fatty fish, eggs, fortified foods like yogurt), or consider a supplement (not too much, though! Vitamin D gets stored in our bodies if we don't need it and we can over do it). Vitamin D is important for immunity, energy, and many other reactions. 

There are many other causes to low energy including lack of sleep, high stress, or medical conditions like anemia, hypoglycemia, diabetes, thyroid disorders, etc. so we encourage a visit to Student Health to learn more and ensure another condition is not the cause.

Irritable Bowel Syndrome, also known as IBS, is a gastrointestinal issue that can present as bloating, abdominal pain, diarrhea, constipation, heartburn, reflux, altered taste, cramping, incomplete bowel movements, and/or gas.  There is no official cause of IBS but there are many factors that are known to serve as triggers; further complicating it, though, is that each person’s symptoms and triggers vary.

Diagnosing IBS

• At least 12 weeks of reoccurring pain in the abdominal area that occurs in relation to a bowel movement (and may be relieved by the movement). Consistency, formation and frequency of bowel movements is usually changed.
• Issues with having a bowel movement including straining, feeling as if the movement is incomplete, and/or urgency.
• Mucus in stool
• Bloating or cramping
• Having a colonoscopy to rule out Inflammatory Bowel Disease (IBD) should be completed as this set of conditions can cause long-lasting damage to the GI tract.

Treatment

Once you have been cleared of other conditions known to cause similar issues, the efforts are focused on reducing symptoms. The Student Health Nutrition team can help you identify possible triggers and develop a tailored management plan to reduce or eliminate symptoms. 

Sugar has become a hot topic as of late and for good reason: the number one source of excess calories in our diet is from sugary beverages! But sugar is not evil. As a matter of fact, sugar is an easy-to-metabolize, quick-acting carbohydrate source that has a long history of helping all mammals survive and thrive. It also tastes delicious and is a big part of why we seek things out with sugar in them.

According to Nutrition in Clinical Practice (2015), “the problem ensues when we consume sugar in excess. Our Stone Age ancestors lived in a world scarce of food – while we live in an energy-rich environment. For us, sugar is addictive because the more there is (and there is a lot in our world), the more we habituate to it, and the more we desire. One of the reasons we eat too much sugar is because high-fructose corn syrup (HFCS) can be derived inexpensively from subsidized corn.” HFCS and table sugar are nearly identical molecules, but we can consume so much more of HFCS simply because of the cheap economics of it.

Another misunderstood source of sugar is fructose. Fructose is the sugar source found within natural foods like fruits but also in many highly processed, junk foods. Overall, a diet can have fructose or sugar in it and still be optimal, or a diet can be devoid of any sugar and be poor. The quality of foods and quantity of foods is what matters much more so than avoiding any one nutrient.

That being said, there are issues with eating high amounts of simple sugars. Often times, sugar rich foods take the place of nutrient-rich foods (like fruit, whole grains, vegetables, etc.) which leaves the body missing out on key nutrients. Also, eating excessive amounts of sugar can cause wild blood sugar swings which is tough for your body to manage. There are many health issues related to excessive sugar intake including fatty liver, type 2 diabetes, mood swings, difficulty sleeping, weight gain, obesity, poor bone health, and headaches. More so, if the sources of sugar are combined with high amounts of fat (think snack foods, desserts, etc.) then the risks increase to include cardiovascular disease, gout, stroke, etc.

Another challenge with depending on quick sugars for energy is that they don’t last very long in the body. Simple sugar processes in and then right back out again which leaves you reaching for more. And more. And more. It’s tough to have just one cookie, right? If we choose a slow digesting energy source like fiber rich whole grains, the energy release is slow and steady. This helps us focus, stay calm and alert, and perform better academically for longer periods of time.

So How Much? The daily limit for added sugar is 25 grams or 5 teaspoons. Guess how much added sugar a regular 20 oz soda has in it? 65 grams! That’s 16 teaspoons. How many Oreo cookies do you think it would take to meet the 25 grams/ 5 teaspoon recommendations? Just 4 Oreo cookies. You can see how easy it is to go over the recommendations when sugary beverages and processed foods are included. This is why we recommend drinking unsweetened beverages and focusing on whole foods rather than processed. When a food as been processed, the likelihood that too much sugar, fat or salt has been added is high. Rather than avoiding foods, simply focus on increasing the foods known to be protectors of health and reducing the sugary stuff slowly, over time. There’s still room for sugar in our lives but we should enjoy them in small amounts as they can quickly.

The average adult should aim to get about 64 oz of unsweetened fluids in per day. The needs for 64 oz isn’t exact and we get water from fruits and vegetables, soups or smoothies, etc. so always hitting it exactly doesn’t need to happen. However, if you chronically avoid drinking fluids, and don’t eat a lot of vegetables or fruits, you may be at risk. Hydration is important (besides better skin and hair) because it promotes easier and regular bowel movements, flushes bacteria and helps carry nutrients to cells. Almost every reaction in our body happens in a watery medium so maintaining that can be important to making sure all those reactions happen correctly.

How to Check for Dehydration

If you aren’t sure if you’re getting enough fluids, here are a few signs:

• Frequent Headaches
• Persistent Hunger
• Low Energy
• Dark or Bright Urine Color
• Constipation
• Irritability

 

Ways to Increase Fluids

Find a Favorite Water Bottle: this really matters - really! If you love your water bottle, you are more likely to use it. With a straw, wide mouthed style, metal, glass, there’s so many options and whatever works for you is worth it.

There's an App for That: there are tons of mobile phone apps to send you reminders to drink throughout the hour (there’s even a light up water bottle that will flash when it’s time to drink).

Set Reminders: on your phone or calendar, consider using an alarm on your smart watch or phone.

Add to Meals: aim to have a glass with meals, especially right beforehand if you are working on natural weight loss.

Hydrate through Food: by adding a few servings of fresh fruit and water-heavy veggies to the day (cucumbers, tomatoes, lettuces, etc.).

Stomach issues is often code for constipation, diarrhea, bloating or gas. These are very common and are usually easily treated with a few minor nutrition adjustments including one-time medications, supplements, increasing water, changing or avoiding foods, and eating more mindfully.

There is another common cause that is often overlooked and seems unrelated because it isn't nutrition at all: it's stress. Most of our patients experiencing issues report a decrease or elimination of symptoms when they find effective stress management techniques. If you have chronic GI issues, we strongly recommend paying attention to the stress factors in your life and taking note of your current coping mechanisms. If you suspect this is a factor for you, we recommend scheduling an appointment with CAPs or a third party therapist in addition to working with nutrition to increase the effectiveness of treatment. 

Weight management refers to any state where a person is trying to gain, lose or maintain their weight. Each state has a different set of requirements so we recommend scheduling a nutrition consult to help develop a tailored plan for you and your goals. 

Weight Gain

Common for people trying to put on muscle or for those who are chronically underweight, weight gain is achieved by increasing energy intake and reducing energy output. More simply: we want to take in more energy than we burn off. We still want to focus on quality nutrition and avoid common side effects like bloating, fullness and GI distress by eating in a purposeful, measured way throughout the day. We may also adjust to accommodate activity by eating before and after the exercise or competition. 

Weight Maintenance

It is important to maintain a healthy weight and we can do so by eating enough to fuel our activity but not so little that we lose weight or so much that we gain. Often, we can focus on high quality nutrition, regular meals, and acknowledging hunger/fullness cues to maintain healthy weight. 

Weight Loss

Weight loss is a very common goal for many people. If your current body weight is exceeding the healthy ranges as recommended by your physician (and this weight is not mostly muscle), weight loss can be helpful for long-term health, disease risk reduction and better energy. Very simply, we want to reduce how much we are eating calorie-wise and increase our activity. Doing so creates a deficit for energy that our body must then find energy for, typically turning inwards and breaking down fat or muscle. There are unhealthy and healthy forms of weight loss. The healthy methods are usually slow and steady and they also last longer. Healthy methods also avoid leaving you hungry and irritable which is common in faster methods. Fast methods (crash diets, fad diets, restricting, over exercising) are very unhealthy and cause more damage in the long run (and most people will regain any lost weight).