# Nutrition in Med School

Discussion in 'Pre-Medical - MD' started by ZekeMD, Apr 28, 2004.

1. ### ZekeMD 10+ Year Member

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I usually try to eat right but am worried that this will not continue into medical school. We'll all be very busy and probably have little time to worry about eating right. I found this article and think it may help to use this as well as using the tool found at http://www.fitday.com .

Clean Eating
A primer for the 52 Day Challenge: Nutrition Event

]b]Caloric Requirements
Before we talk about ?clean eating?, let?s discuss caloric requirement.
One way to calculate your caloric requirement is with the Harris-Benedict Formula:
I use the following formula(for males):

66 + (6.3 x body weight in lbs.) + (12.9 x height in inches) - (6.8 x age in years)

This gives you your Basal Metabolic Rate (BMR)
Now that you know your BMR, multiply your BMR by your activity multiplier from below:

Activity Multiplier
Sedentary = BMR X 1.2 (little or no exercise, desk job)
Lightly active = BMR X 1.375 (light exercise/sports 1-3 days/wk)
Mod. active = BMR X 1.55 (moderate exercise/sports 3-5 days/wk)
Very active = BMR X 1.725 (hard exercise/sports 6-7 days/wk)
Extr. active = BMR X 1.9 (hard daily exercise/sports & physical job

Your BMR X Activity Level = Calories Needed for maintenance : what you need to sustain your body at status quo. If you want to lose weight, subtract 500 calories a day to lose 1 pound per week. Subtract 1000 to lose 2 pounds per week. It is not recommended to go below a 1000 calorie deficit. It is also not recommended to go below 2000 calories a day if you are trying to maintain / build muscle mass. I recommend you start out a fat loss program at a 500 calorie deficit, try that for a couple of weeks, then, if you aren?t getting the results you want, cut 250 off, try that for a couple of weeks, and repeat until you find the level that works for your body. After a few months, change it; your body will become accustomed to a caloric level and needs it to be altered once in a while.

To set up your macronutrient ratios:
Protein is 4 calories per gram.
Carbohydrates are 4 calories per gram.
Fat is 9 calories per gram.
Alcohol is 7 calories per gram.

First, set your protein requirement. A good protein requirement for most people is 0.9 grams per pound of body weight. After getting your protein intake in grams by this formula, multiply it by 4 to get your daily protein requirement in calories.
Subtract that number from the daily calorie target you?ve calculated.
The remaining number divide by two to get your carb calories and fat calories. Divide that by 4 and 9 respectively to get grams per day.
You can play with the ratios if you want. Many people losing weight go for 40% protein, 30% carbs, and 30% fat. Some go for 33 / 33 / 33. You can experiment to find what works for you.

Eating clean

? Eating clean? means, basically, eating the right kinds of proteins, carbohydrates, and fats.

Carbohydrates: Carbohydrates are an important energy source for your body and your brain. Some are better than others. The Glycemic Index describes how quickly your body metabolizes foods into sugars. High G.I. foods turn into sugars quickly, causing an insulin spike. Low GI foods metabolize slowly. Try to keep your carbs lower than 75 GI. You can find the GI ratings here: http://diabetes.about.com/library/mendosagi/nmendosagi.htm, or www.glycemicindex.com, or various other sources.
Examples of Low GI Carbs:
Vegetables, Mixed Beans, Oatmeal, Bran, Whole Grain Breads, Whole Grains, Barley, Brown Rice, Low GI Fruits
Lowfat Milk, Lowfat Yogurt (note: while these dairy products have a low GI, they have a high Insulin Index (the reaction your body produces to the metabolizing of these products), so use in moderation)
White Rice (note: while having a higher GI, these have a low Insulin Index, so again, use in moderation)
High GI Carbs to Avoid:
White Bread (includes ?wheat bread? ? must say ?whole wheat? or ?whole grain?) this means bagels, tortillas, pitas, and all other forms of bread
Potatoes (the worst ? very high GI) (sweet potatoes are OK)
High GI fruits (watermelon, dates, raisins, ) and fruit juice ? eat raw fruits instead (one glass of orange juice has over three oranges in it, without the benefits of the fiber in the raw orange)
Sugar and processed food with sugar or its many forms (high fructose corn syrup, cane sugar, molasses, etc)
Pastas (use in moderation, and never with saturated fats, e.g. fettucine alfredo)
Most breakfast cereals (stick to whole grain / bran cereals if you must eat cereals)

Note: There is a whole other subject, called ?glycemic loads?, describing the value of the entire item you are eating, that can be taken into consideration, but it is simply too extensive and undeveloped to go into at this time. Look into it yourself at www.mendosa.com (now http://diabetes.about.com/library/mendosagi/nmendosagi.htm) if you?re interested.

Proteins: Eat lean proteins, low in saturated fats.
Examples of Good Protein Sources:
Lean Beef (90% lean ground beef, lean steak)
Chicken (particularly white meat)
Turkey (particularly white meat)
Lean pork (tenderloin, lean ham)
Lowfat dairy products, in moderation
Cottage cheese (highly recommended form of casein protein)
Whey protein
Fish, particularly tuna, salmon, and cod
Eggs, particularly egg whites (yolks in moderation)
Soy and soy products, while very good sources of protein, have also been shown in some studies to have potential for causing high estrogen levels and sexual dysfunction. I suggest using these in moderation until testing is completed and a conclusion has been reached. Caveat Emptor.

Proteins to avoid:
Fatty meats (non-extra lean ground beef, fatty pork (bacon, ribs, etc)
Fatty dairy (whole milk, most cheese, ice cream)

Fats: Fats, which have been vilified, are an essential ingredient in our diet. Poly and monounsaturated fats must be included in your daily plan. A small amount of saturated fats are also needed. Minimize saturated fats, maximize monounsaturated fats and polyunsaturated fats. Try to get good Essential Fatty Acids ? Omega 3 and Omega 6?s. No more than 1/3 of your fat calories should be saturated fats (if you are on a 40/30/30 plan, 10% of your calories may come from sat fats)
Examples of good fats:
Fish and fish oils ? polyunsaturated, best source of Omega 3?s ? cold water fish ? tuna, salmon, cod
Flaxseed oil ? some Omega 3, good Omega 6
Olive Oil - monounsaturated fat
Avocados ? monounsaturated fat
Nuts ? mono, poly, and omega 6s ? best are walnuts and almonds

Saturated fats ? from animal products (fatty beef, pork, milk, etc)
Hydrogenated and partially hydrogenated fats (trans fatty acids) ? Wicked Bad Stuff. (margarine and Crisco are trans fatty acids)
Most vegetable oil and corn oil ? use Canola oil if you must use oil, and use in moderation ? try not to cook in oil if you can avoid it. If you cook with oil, use an oil with the appropriate smoke point.

Water:
Water is a compound we can?t do without for more than only a few days. The human body is about 60 to 75 percent water, and the brain is said to be about 85 percent water. Even bones are about 20 percent water. The body needs water. Nothing substitutes for water; coffee, tea, alcohol, are not the same as water. Drink at least 10 glasses of water a day. Note: The more caffeine you drink, the more water you must drink. Caffeine is a diuretic and flushes water out of your system.

Vitamins and Minerals:
Vitamins and Minerals play a vital role in maintaining the proper biological functioning of everything from muscles to memory. Nutritionists will tell you that they are unnecessary if we consume a properly balanced diet, but few of us consume a ?properly balanced diet?. It is highly recommended to consume a good quality multivitamin/mineral supplement daily. It is very difficult to obtain protective levels of some nutrients solely from diet.

Special notes:
1) Avoid mixing high GI carbs with fats
2) Avoid all processed / prepackaged foods
3) Read labels! Be on the lookout for bad stuff!
4) Eat your veggies!
5) Do not eat too little. Your metabolism will slow to a crawl and you will stop burning fat.
6) Do not eat too much. You will store excess as fat.
7) Alcohol, if required, must be kept to a minimum. When you drink alcohol, your body uses the alcohol as an energy source instead of burning your fat stores.

?Clean Eating? for the 52 Day Challenge:
1) Keep your caloric intake around your computed requirement ? not too low, not too high
2) Keep your macronutrient ratios per your computed requirement, say within 10% - track them on www.fitday.com if possible
3) Eat low GI carbs, lean proteins, mono & polyunsaturated fats
4) Eat your veggies! Eat your veggies! Eat your veggies!

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3. ### curlycity Guest

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Also, instant oatmeal kicks top ramen's butt, nutritionally speaking.

4. ### lessismoe Momma to Ronan 7+ Year Member

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Wow, that's a lot of info. Thanks for sharing, Zeke. I feel guilty for eating that fettuccine alfredo last night now

As I was reading through this, I was thinking about how I often crave a lot of the "good" foods on the lists. My mother does this too-- I kind of feel like sometimes I can crave what my body needs. Does anyone else do this? I mean, for instance, I never crave ice cream, per se. When I have low blood sugar, I crave something sugary, yes, but most of the time, when I have a craving, it's something like low-fat milk or cashews or broccoli.

Anyone else get "good" cravings?

5. ### Fumoffu Senior Member 10+ Year Member

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Good info man!

Although I think more than anything, it helps to eat a small meal every 3 hours (5 meals a day) instead of 3 big ones. Don't know if that's feasible in med school though.

6. ### sinnah83 Member 7+ Year Member

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excellent, motivating info. I want to try the 52 day challenge after graduation. My only work this summer is preparibg my mind and body for med school and this should help. thanks

7. ### Newquagmire 15+ Year Member

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Wait, this is med school we're talking about, right?

8. ### Disgruntled One Member 7+ Year Member

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ive been following a clean/detox/whatever diet for a couple of years now. though i do eat dairy. thats my only bad thing; i love cheese and milk. ive had a tough time sticking to it with crappy cafateria food in college. the lack of protein in cafaterias is the worst, ive had a hard time dealing with that here. plus i dont have time to work out, ive lost a ton of muscle weight this past year. hopefully i'll gain it all back this summer.

and about craving good food... i crave tamatoes quite often. sometimes i'll just get a plate piled with sliced tomatoes. i always get funny looks.

9. ### GeddyLee Bad-ass Guitarist 7+ Year Member

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Med school curriculums are smarter than you think. It's designed to make you gain fat during the first two years that you will be able to burn off during you clinical years and residency. I'm back to my pre-med weight...just as I'm finishing 4th year.

10. ### bearpaw celebrated member 7+ Year Member

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haha! i am so cold these days, i graduated early and i haven't been getting my daily dose of greasy pizza and i keep forgetting to eat since i came home. i hope there are free drug company lunches or something to sustain me in school.

11. ### Fumoffu Senior Member 10+ Year Member

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You mean no breakfast, a medium lunch and then a friggin' huge dinner...of course with frequent in-between snacking?

How is that differnet from the typical American eating schedule?

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13. ### bearpaw celebrated member 7+ Year Member

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honestly, being healthy is not that complicated. Like this whole atkins thing...people in europe and asia aren't fat and they eat everything, not just meat. white bread or rice doesn't make you fat if you eat it normally. neither does anything else. It's not genetic, just eat less food, alot less junk, and stay active.

i thought this thread was about not eating when i first posted!!!! (i thought the first post was about how to eat more efficiently!). man, if you start calculating all that stuff before you eat, you might never actually get a bite in!

14. ### ForensicPath

What about peanut butter? As long as I can still eat peanut butter I am happy. Extra crunchy of course.

15. ### MrTee Senior Member 10+ Year Member

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Peanut butter has been shown to be incredibly atherogenic, which is counterintuitive because it's unsaturated. I avoid it. Almonds are a better choice.

16. ### MrTee Senior Member 10+ Year Member

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Bearpaw, you got it right. A lot of alleged diet and exercise gurus would like you to believe that you have to do x, y, and z at precise times with the appropriate planetary alignment in order to achieve good health and an awesome physique. This is simply not true. A low fat diet high in fruits, vegetables, and other unrefined carbs, plus some lean protein sources (including protein powders w/ minimal carbs) will go a long way to improve most peoples' diets. Adding some fish oil and flax oil can be done if there are concerns of insufficient fat. The sugar in the fruit thing is way overrated as being detrimental to your physique and well being. Unless you're eating in excess of 10 fruits in a day, you're not getting too much fructose. I've yet to see anybody become obese on a diet high in fruit, but devoid of all other sugar sources. It's the sweets, breads, fries, fatty meats and all the other junk that makes people fat and bloodwork look terrible.

17. ### Super Rob Senior Member 7+ Year Member

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The problem is that as we get older, the diseases manifest, and many of us want to imagine that diet and behavior have NOTHING to do with poor health. We are complacent exploring genetics, unraveling the human genome in an attempt to determine how we might be biologically predisposed to certain illness. But we have oversimplified solutions when it comes to diet (eat in moderation, avoid refined carbs, avoid saturated fat, etc.) and behavior (avoid stress). We also seem to ignore any aspect of health that doesn't make a penny for some pill company (omega 3 fatty acid deficiencies, vitamin deficiencies, quality of commercial grade meat and produce). But these areas deserve as much exploration as genetics, so think a small minority of us. Why? Cuz these are the areas we have and always will have the most control over.

Some foods are crap. They're bad for us, but drive an industry that has more money than we can imagine. Instead of doctors and scientists telling us what to eat, we have lobbyists and marketing directors planning our menus... and they don't really care whether or not diabetes and heart disease are preventable. They don't care how many people who THOUGHT they could eat everything while they were young turned out FAT and SICK and DEPRESSED as they got older. And they sure as hell don't care what people are paying for their health insurance premiums, because people are so FAT and SICK and DEPRESSED. Somebody had to step in, or doctors would still say that a pack of cigarettes a day is good for you!

Still, there is no money in investigating any of this. If healthy foods and behaviors came in patentable pill-form, things would be a lot easier.

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