Some Scary Facts About BMI

BMI or body mass index has often been a source of debate and conversation – and yet because BMI is constantly referenced as a marker of health by providers in our healthcare system, it continues to be a thorn in the work I do with my clients of all body sizes. I’ve certainly been guilty of using this metric in my career. It is what we were taught in school, and frankly it is sadly often required by insurance companies to document a nutrition-related diagnosis for coverage in many cases. But, when you really dig in and understand the history of BMI and the reasons we continue to depend on this measure, it’s really disappointing that as a medical science and healthcare system, we haven’t figured out how to move beyond it.

So, what’s the big deal? Well, for one, too many people are victims of weight bias because of the BMI classifications and are unfairly dismissed, misdiagnosed or mistreated because of the belief that a certain BMI classification = health (which has been challenged and disproven in numerous research studies). Plus, consider the fact that in the 21st century, our healthcare providers, insurance companies, and researchers continue to rely on a 19th century mathematical equation based on a person’s height and weight as an indication of health and health status. We have the technology and the ability to do better for our patients!

Consider these facts about BMI:

1. BMI was introduced in the early 19th century by Adolphe Quetelet, a Belgian astronomer and mathematician (not a physician). Not only was this formula based on European white males from that era, but Quetelet never intended the formula for individual use.
2. There is no physiological reason to support the formula (weight in kilograms / height in meters squared). A high or low number does not tell us anything about whether the person is fit or healthy.
3. The formula ignores relative proportions of bone, muscle, fat, blood volume, hydration, etc.
4. The classifications of “underweight, normal, overweight, and obese” are each separated by a single decimal point and are not based on sound science (nor do the categories take into account genetics and ethnic variability).
5. Based on #4 – there is dangerous racial bias!
6. It promotes fat phobia or the fear of having an “unhealthy” BMI.
7. When doctors, healthcare providers, researchers, and insurance companies continue to rely on BMI, there’s less of a need to use more scientifically sound methods to assess one’s overall health.
8. Finally, it’s the 21st century. We can (and should) do better!

Can you imagine a world without BMI? This would mean no longer seeing a number (with a stigmatizing word like “normal” vs “overweight”) in “MyChart.”

It would mean that your doctor would have to work harder to consider your overall health status, or problem you are seeking help for, versus assumptions based on BMI. With today’s technology, a more comprehensive approach to patient’s concerns, including lifestyle or other social determinants of health is not only possible, but it’s vital – but this means providers need to take time to ask you about these kind of things. On the flipside, when “you need to lose weight” (or “your weight is ‘normal’ thus there’s nothing to worry about”) becomes the answer to a potentially serious health concern, be mindful that this is not comprehensive care.

And, in response to the persistent strong held belief that “you just need to lose weight” because weight = health, I wonder if the prescribing physician has considered the fact that a significant percent of the population have tried to lose weight – multiple times! It’s well-documented that 50% of adults in the U.S. have attempted to lose weight and 60% of women have dieted in the past year. Moreover, it would be meaningful for doctors to screen for eating disorders and trauma history, and understand the role these issues have on a person’s health (and weight). It’s merely wishful thinking on my part, but it would be even better if these same clinicians had training in eating disorders and trauma-informed care – even if just so that they can recognize and then refer to providers who can compassionately and appropriately treat these conditions.

If you are concerned about your weight (or your BMI), I encourage you to consider what you can control. Consider a self-assessment of your lifestyle. How is your overall dietary intake and eating pattern? Are you fairly active and moving your body regularly? How is your sleep quality/quantity? Do you need to address how you manage stress or begin to say no to certain activities or relationships? After assessing your lifestyle behaviors, begin to identify small steps that you can take to address any areas of concern. From a nutrition standpoint, here’s a few ideas:

• Eat more (and more variety) of fruits and vegetables
• Prioritize whole grains (oats, bran, quinoa, etc)
• Cook more with beans, legumes, soy, fish, nuts, seeds
• Add natural herbs and spices to home-cooked meals (cinnamon, ginger, garlic, turmeric, rosemary, cayenne pepper)
• Enjoy pleasurable foods in moderation
• Work on building strength and cardiovascular fitness
• Take time to relax Address your emotional and spiritual needs

Until the day that we abolish the use of BMI, remember to ask questions about your health that goes beyond weight, height and BMI. Remember: if you are unsatisfied with your care, advocate for yourself – or you may need to find a weight-neutral health provider. They do exist!

Bone Health for Female Athletes Across the Lifespan

Good bone health affects your ability to stay active and healthy throughout life. However, when female athletes, especially those training for recreational or elite athletic competition, knowingly or unknowingly exercise too much and eat too little, they may be at risk for low bone mass and fractures.

Athletes across the lifespan are at risk for low bone density and bone stress injuries

The incidence of low bone density and stress fractures, is increasing among competitive and recreational female athletes of all ages, and leads to pain and lost time from training and competition. Osteoporosis, a bone disease caused by weakened, porous bone, occurs silently and progressively over time, often with no symptoms until a fracture occurs. It’s currently estimated that one in three women over the age of 50 will suffer from an osteoporotic fracture www.iofbonehealth.org.

Bone is a living tissue that is constantly changing. Nutrition, physical activity, and certain hormones all play a role in the development and maintenance of healthy bones. With adequate nutrients, in particular calcium, Vitamin D, and protein, as well as weight-bearing exercise, most people achieve a peak bone mineral density by their late 20’s. During the normal aging process, both bone mass and bone strength decrease, with increased declines related to the lack of estrogen, such as with menopause or in female athletes with amenorrhea. Therefore, bone disease prevention begins during childhood and adolescence, as well as lessening the extent of bone loss that occurs during the aging process.

Photo courtesy: Shutterstock.com

To optimize bone health, female athletes need to:

1. Consume foods that provide adequate calcium and vitamin D
2. Eat enough calories to support their training
3. Include high quality protein at meals and snacks
4. Participate in strength or resistance exercises that provide an mechanical force on the bone
5. Recognize that menstrual irregularity is a warning sign for low bone mass – and for postmenopausal women, consider having a DEXA bone density scan done to measure your bone density.

The Role of Calcium and Vitamin D

Calcium is an important mineral in the body for maintaining bone strength, regulating muscle contractions, maintaining blood pressure, and transmitting nerve impulses. Most of the body’s calcium is stored in our bones (and teeth); and, without enough calcium each day from the diet, the body will use what it needs from the bone to keep blood calcium levels normal. If more calcium is removed from the bones than is consumed in the diet, the bones may become fragile or weak.

The calcium recommendation for women ages 25 to 50 is 1,000 to 1,200 milligrams per day and 1,200 mg/day for women after age 50. Good sources of calcium include dairy products (milk, yogurt, kefir, and cheese), calcium-fortified juices or plant milks, some types of tofu, certain vegetables (collard greens, kale, broccoli, bok choy), oranges and almonds.

Vitamin D is also vital to bone health as it is needed for the absorption of calcium from the intestines and plays a key role in bone mineralization. The recommended daily allowance is 600 international units (IU) for those women under 70 years of age and 800 IU for those over 71 years of age. Vitamin D is present in only a few foods including fatty fish, egg yolks and fortified foods, like milk and cereal. It is also made in the skin when exposed to sunlight. For those unable to get sunlight or consume sufficient Vitamin D from foods, 2,000 units of Vitamin D daily may be recommended, but you should consult with your doctor before taking any supplement.

Photo courtesy: Adobestock.com

Other Key Nutrients for Bone Health

Consuming enough calories to fuel activity and other body functions is critical. Eating a variety of foods at three meals and two to three snacks throughout the day according to your hunger and fullness will generally meet the energy demands of your sport.

Including a source of protein (lean meat, fish, dairy products, soy foods, beans, legumes and nuts) at each of your meals and snacks will provide the building blocks necessary for building a strong matrix of protein fibers in bone. Achieving peak bone mass during childhood and adolescence, as well as preserving bone mass with aging, is dependent on the body having enough protein available for bone development.

Many other nutrients are needed for healthy bones. Although research is still evolving on their role and benefits, Vitamin K, magnesium, phosphorus, and zinc also have a role in bone health. 

I’m often asked if there is a way to reverse bone loss or if a supplement, like collagen, will help prevent bone loss. There are medications that can help slow bone loss, however these come with side effects. Osteoporosis is not reversable. At this time, there is no evidence to support taking a collagen powder to prevent bone loss. Collagen powders only provide three amino acids that are components of collagen in the body, but there is no way to direct those amino acids to specific tissues in your body (in this case bone) to aid in collagen synthesis. A better strategy would be to consume adequate amounts of high quality protein (such as those foods highlighted above) or include a protein powder that provides the body all of the amino acids (i.e. whey or soy protein).

Bottom line: A food first approach is a superior way to ensure your body is getting all the key nutrients needed for bone metabolism. For advice on customizing a fueling plan, consult a Registered Dietitian who specializes in sports, particularly a Board Certified Specialist in Sports Dietetics (CSSD).

Nutrition and Skin Health: Can You Eat Your Way to Healthier Skin?

The effect of diet on human health has become a source of debate, and perhaps even an obsession in the US. Many beg to know “what foods or diet is best” … to improve overall health, prevent disease, achieve a certain aesthetic look, or optimize athletic performance? But, how does your diet affect the body’s largest organ – your skin?

Numerous factors affect skin health, including genetics, hormones, aging, stress, sleep, and exposure to alcohol, smoking or the sun. Some of these you cannot influence, however, what you eat (or don’t eat) may be one of the most important factors you can influence in modulating the health of your skin.

Most well-known is the impact of malnutrition and nutrient deficiencies on disorders of the skin. For example, malnutrition due to an eating disorder, such as anorexia nervosa, is often observed by significant changes to the skin, i.e. dry, red, itchy and/or inflamed skin, lanugo-like body hair, acne, petechiae (tiny purple, red, or brown spots on the skin), and in some cases, a yellowish discoloration of palms and soles of feet referred to as carotenoderma. It’s well documented that certain vitamin and mineral deficiencies, due to under-eating or malabsorption, are also associated with various dermatological changes, such as the clinical manifestation of pellagra with niacin deficiency, or hyperpigmentation of the skin due to vitamin B₁₂ deficiency.

A more frequent, and perhaps controversial, question is whether there is a relationship between diet and relatively common skin conditions, such as acne. The link between frequent dairy or milk consumption and acne is often referenced, but to date there is insufficient evidence with no high-quality randomized controlled studies to recommend milk restriction as a treatment for patients with acne (Burris, et al. 2013). The evidence seems to be more convincing for a possible connection between the quality and quantity of carbohydrate consumption and acne. Still, by today’s standards, nutritional studies that isolate a food-triggered influence on acne are reportedly costly and difficult to control, thus making it challenging to develop well-defined, evidence based nutritional recommendations (Fiedler et al, 2017). 

Best Foods for Healthy Skin

Foods rich in antioxidants. Antioxidants are chemicals found in foods that fight unstable molecules, called free radicals, that can cause damage to cells in the body. A diet rich in antioxidants is important for the whole body, but antioxidants have an important role in skin health by protecting cells against UV-induced damage which may prevent or reduce dry, wrinkled skin. Beta-carotene, lycopene and vitamins A, C and E are specific nutrients that have antioxidant properties, while vitamin C also helps to make a protein, called collagen that keeps skin strong.

Good food sources include: A variety of colorful fruits and vegetables are rich in antioxidants. Specific foods sources of beta-carotene and vitamin A include carrots, sweet potatoes, red and yellow bell peppers. Foods rich in vitamin C include bell peppers, oranges, strawberries, and tomatoes (also a good source of lycopene); and, foods providing vitamin E include avocados, nuts, seeds, and spinach.

Foods high in Omega-3 Fatty Acids. Omega-3’s provide important building blocks for each cell membrane in the body. Our body is not able to make these essential fatty acids, so they need to be supplied to the body from the foods we eat. Flexible, healthy cells rich in omega-3 fatty acids enable nutrients to move easily into, and waste easily out of cells while helping to reduce inflammation in the body, reducing redness, maintaining skin moisture, and may also help improve the clinical symptoms of psoriasis.

Good food sources include: Fatty fish, such as salmon, mackerel, tuna, herring and sardines; nuts and seeds, such as flaxseed, chia seeds and walnuts; and, plant oils, such as flaxseed oil, soybean oil and canola oil.

Fluids and Hydration. Staying well-hydrated by drinking plenty of unsweetened beverages throughout the day is good for the entire body. So, will excessive water intake have an even better effect on hydration and skin health? The “more is better” philosophy, as it relates to skin and hydration, was explored by Wolf, at al. who concluded that in otherwise healthy individuals, there doesn’t appear to be an improved benefit. However, as often recommended, further research is needed to provide definitive evidence (Wolf et al, 2010).  

Final Thoughts. Although nutrition may be one of the most important factors involved in promoting healthy skin, the link between diet and disease is not always as simple as a single food or nutrient triggering a particular sign that disease is present. For example, dietary restriction or the stress/anxiety induced by worrying that a certain food is “causing” a skin problem may actually be more problematic than any single food item. An individual’s overall dietary pattern (i.e. adequate calories with plenty of fruits and vegetables, whole grains, lean protein and healthy fats) together with lifestyle (i.e., regular physical activity, stress management, not smoking, quality sleep, and low alcohol consumption) take advantage of the additive and synergistic nature of these behaviors to promote healthy outcomes, including healthier skin.

Foods & beverages to prioritize in your meals and snacks:

Vegetables: broccoli, spinach, kale, peppers, zucchini, cauliflower, carrots, beets, etc.

Fruit: berries, grapefruit, oranges, apples, cherries, bananas, pears, grapes, peaches, etc.

Whole grains and starchy vegetables: Sweet potato, quinoa, butternut squash, brown rice, oats, buckwheat, etc.

Healthy fats: whole eggs, olive oil, avocados, nuts, seeds, nut butters, coconut oil, etc.

Plant-based dairy alternatives: cashew milk, almond milk, coconut milk, coconut yogurt, etc.

High-quality protein: salmon, tofu, chicken, turkey, eggs, shellfish, etc.

Legumes: chickpeas, black beans, lentils, kidney beans, etc.

Anti-inflammatory herbs and spices: turmeric, cinnamon, black pepper, parsley, garlic, ginger, cayenne, etc.

Unsweetened beverages: water, sparkling water, green tea, hibiscus tea, lemon water, etc.

Menopause and Gut Health: The Role of Hormones, Stress and Diet

Fluctuating hormones and the presence or absence of estrogen, that occurs before or during the menstrual cycle – remember puberty – and during the transition to menopause influences the gut-brain connection. The gut-brain connection refers to a bidirectional communication between the “gut” (your digestive system) and the brain. Complex and intricate neurological and physiological factors influence this connection, and in the past decade this has become a hot area of nutritional and psychological research. Scientists continue to reveal information about this two-way highway and the consequential impact of emotions, stress, and hormones on gut function, as well as the influence of the food we eat (and the resulting trillions of microorganisms that exist in the gut) on mood, anxiety, stress, and brain function. Although we know that this complex connection impacts women at all stages of life, the research is still evolving as it relates to the shift in hormones during menopause.

You may become aware of this connection when you experience symptoms such as bloating, gas, constipation and/or diarrhea, along with feeling anxious, moody, fatigue, or suffering with headaches or “brain fog.” More extreme symptoms such as persistent migraines, “urgent diarrhea” or “functional constipation,” could be related to signs of other health concerns and should be discussed with a qualified physician, such as a gastroenterologist or your gynecologist. Additionally, it is recommended if you are suffering from disabling feelings of depression or unmanaged anxiety to visit with a licensed psychologist.

Like hormones, stress and diet also impact the health of the gut-brain connection. Consequently, as women approach their mid-40’s, additional stress such as career changes, kids leaving for college, divorce, aging parents, downsizing, etc. may increase. At the same time, women may unintentionally or intentionally be skipping meals, cooking less at home, and eating out more or more frequently and diet quality may suffer.

A diet rich in plant foods is important for promoting a healthy gut in midlife and beyond.

Nutrition research in this area is relatively new and emerging. We are learning that a diet rich in plant foods and fiber (whole grains, vegetables, fruit, nuts, beans, and legumes), supports a more healthy, diverse microbiome (the name for those trillions of microorganisms) and is associated with improvements in digestion as well as overall physical and mental health. The habitual intake of fermented foods, such as yogurt (with live and active cultures), sauerkraut, and kefir may also help maintain a healthy gut. Negative influences on the gut microbiome that may affect health and disease risk include chronic over consumption of ultra-processed foods (sodas, packaged snacks, energy drinks, energy bars, etc.), diets high in fat and animal protein, as well as yo-yo dieting or going on and off diets, and certain medications.

How to Spot Fake Nutrition News and Find Credible Sources You Can Trust

People love to share nutrition information, and everyone seems to be a nutrition expert these days! Unfortunately, a lot of what we see in the media or hear people talking about is inaccurate and/or misleading. Some of this is relatively harmless. However, for some people, this contributes to confusion and unnecessary anxiety about food choices and sets consumers up to believe that there is a “perfect, correct and right” food, beverage or supplement for them to achieve their nutrition, performance, weight, or health goals.

Misinformation about food and eating often leads to people eliminating perfectly nutritious (and enjoyable) foods from their diet and many of my clients – casual exercisers and elite, competitive athletes, midlife women and those with a history of dieting or disordered eating – are easy prey for marketers who want to sell products or services to enhance sports performance, gain or lose weight, and/or “get healthy” – often with unsubstantiated claims.

Image Source: Shutterstock.com

To help you sort through the chatter and find credible, evidence-based nutrition information, here are 6 tips to help you spot misinformation.

1. Recommendations that promise a quick fix. When a person or product makes claims that sound too good to be true, it probably is. For example, per the following magazine cover suggesting that you can “lose 10 pounds in 7 days” – not only is this unlikely, but one should be concerned if you are losing that amount of weight in just a week (no matter what your starting weight is).

Also, recognize that break-throughs in science do not happen overnight or by just one individual or a single research lab.

2. Learn to distinguish hype from evidence-based science. Does the advertisement or nutrition information include fear-based words or dramatic statements (i.e.  “break-through”, “miracle”, “toxic”, “bad”, “cure-all”) to influence you one way or another about a food or product? Claims about juice cleanses and detox supplements, for example sway consumers into believing that a single nutrient (versus your overall dietary pattern) will cure or solve your health or weight concerns. Abby Langer, Registered Dietitian Nutritionist, writes quite frequently about fad diets and nutrition trends and provides a great resource to learn more. Check out this ONE on the celery juice diet.

3. Are claims supporting the product based on personal stories rather than on facts? Be critical of anecdotal information from friends, coaches, and celebrities who have no formal training in nutrition. Ask questions about recommendations to understand if the reported benefits are backed by rigorous scientific research. 

4. When a claim is based on research, consider the following questions. Did the headline or article capture the actual results of the study or do we have a case of a journalist who didn’t read past the abstract and/or wrote a sexy headline as “clickbait?” Has the study been replicated with same or similar results among different researchers? How many humans were used in the study (or were animals used)? Is there a direct cause and effect for the population the claim is targeting? For example, a study that demonstrates prunes has a positive effect on bone health in postmenopausal women does not necessarily mean that a 20-year old male or premenopausal female athlete would experience the same benefit. Nothing wrong with eating prunes, but we can’t assume prunes are going to have the same effect with these other populations. And…per this particular study outcome, another important question to ask is whether study results were due to “association” or “causation.” Consider the data supporting the facts that: a) more people eat ice cream in the summer months, and b) more people drown in the summer months. It appears that there is an association between summer, eating ice cream and people drowning, but can we conclude that eating ice cream increases your risk of drowning? Probably not!

Photo credit: phdcomics.com

5. When considering products, such as special foods or supplements, are you aware of the products’ safety, purity or effectiveness? Manufacturers of dietary supplements must list all ingredients on the product label; however, a dietary supplement may contain a banned substance not listed due to poor manufacturing practices or intentional adulteration. Furthermore, some supplement ingredients may interact with prescription and over-the-counter medications resulting in adverse effects that can be life threatening. Consumers also need to be cautious of supplements that contain very high amounts of performing-enhancing ingredients, i.e. caffeine, citrulline or beta-alanine, that are not illegal, but in high doses may cause unwanted side effects such as increased blood pressure, jitteriness, or itchy tingling skin (in the case of beta-alanine). Many consumers believe that “even if a supplement or herbal remedy may not help me, it, it at least won’t hurt me.” However some ingredients, including vitamins and minerals, consumed in high doses for a long enough period of time, can be a concern.

Despite the FDA demanding companies stop selling these products…

HCG products remain marketed and sold to consumers!

The best way to protect yourself against questionable health and nutrition products is to be an informed consumer. Third party companies, such as NSF, Informed Choice or Consumer Lab, conduct testing to verify product ingredients. You may also contact the manufacturer directly to ask questions about how it tests for safety or if there are ingredients that aren’t listed on the label.

6. What are the person’s qualifications? Just because someone “went through something” does not make them an expert. Dig a little deeper and ask for credentials. Many states explicitly define that the practice of nutrition and dietetics must be done by a licensed professional. Look for the initials “RDN or LDN” to identify a Registered Dietitian Nutritionist and Licensed Dietitian Nutritionist. For athletes, look for the initials “CSSD” that designates a Registered Dietitian who has specialized training in sports nutrition. To find a sports dietitian in your area, access “Find a SCAN RD” at http://www.scandpg.org.

In addition, to an individual’s credentials, following are tips to help you navigate information found on various media sources. While the internet can be a minefield for misinformation, it can also be a valuable source of accurate and reliable information. Websites ending in .edu (an educational institution), .gov (government agency), or .org (non-profit) are considered good sources for credible information or to verify nutrition information read elsewhere.  

When reading nutrition material in books, magazines or other publications, look at who wrote the article you are reading. The author should be educated in the field of nutrition/dietetics and preferably hold a degree in nutrition from an accredited university. With any nutrition recommendations, beware of personal bias and when reading an article or blog, look for current and up-to-date citations with research that meets the criteria for point #4.

Be a critical thinker!

Finally, be a critical thinker when it comes to information about nutrition or your health. Frankly, the words “health” and “wellness” have been hijacked by the multi-billion dollar diet industry making it essential for all of us to be smart and responsible consumers. If you find yourself fixated or obsessed with reading articles (or watching health/food documentaries), consider the following:

Why do you think you are so interested in this information – rather than just dismissing the sensationalized content and reading/watching something with entertainment value?

What are you hoping to learn more about or are you feeling anxious about food/weight in general (and may need to address the anxiety and ruminating on these thoughts)?

Do you have difficulty anytime you hear or read nutrition information from a qualified health provider? For example, learning that “all foods fit” or “consuming sugar will not cause cancer or diabetes” but perhaps this challenges or disagrees with something you read or believe that says the contrary – why might this be happening for you? If someone told you that the earth was flat (with all kinds of their own research and reasons for their claims), would you  believe it? Why or why not?

Bottom line is that it may be a good idea to talk this out with a qualified nutrition professional and talk through all of these messages…and ultimately, maybe it would be helpful to avoid “googling” and binge-watching food documentaries and enjoy something more pleasure-oriented. For the health of it!

Grilled Salmon with Garlic Vermouth Butter Sauce

• Servings: 4
• Prep Time: 20 mins
• Cook Time: 10 mins
• Difficulty: easy to moderate
• Rating: ★★★★★
• Print

A delicious butter sauce for grilled salmon that pairs nicely with mashed potatoes and sautéed veggies

Ingredients

• (4) 6-ounce Salmon filets, skin removed and cut no more than 3/4 of an inch thick

• 1 cup clarified butter

• 1 cup margarine

• 1 TBL garlic salt

• 1/3 cup dry vermouth

• 1 TBL Worcester

• 1 TBL Lawry’s seasoning

• 1 1/2 tsp lemon pepper

• 2 TBL sugar

• 2 tsp paprika

• 1 tsp pepper

• 1 TBL salt

• 1/2 cup fresh lemon juice

Directions

Combine the melted butter, margarine and all ingredients. Cool, stirring occasionally to combine ingredients. Butter should have a slathering consistency.

Heat barbecue so that the grates are around 650 degrees. Liberally brush one side of salmon and place on grill. Cook for two minutes, basting the top with garlic butter. Turn over and cook an additional 3 minutes or until desired doneness. Baste with more butter and serve immediately. Internal temperature should be a minimum of 145 degrees in the thickest part.

Enjoy!

Spring Cleaning: A Healthy Pantry for Preseason Nutrition

The days are getting longer, the snow is beginning to melt (for you northerners), things are beginning to open up around the country, and a new racing season is “hopefully” about to begin! Spring is a great time to get to work on dusting off those forgotten places in your home – including your pantry, refrigerator, and freezer. Cleaning out the cupboards and stocking up on wholesome food will go a long way in getting you prepared for summer events – or an upcoming race season.

Editorial credit: Joni Hanebutt / Shutterstock.com

What’s in your pantry?

Perhaps you’ve perused the internet looking to stock up on the “perfect”, food, supplement, or nutrition product. Although many of these products may have a place in the recreational or competitive athlete’s kitchen, it’s important to remember that “you can’t out-supplement a bad diet” and there isn’t just “one food” or nutrition product that will improve your performance. A winning food plan is based on the fundamentals of eating: 1) meals and snacks evenly spaced throughout the day, and 2) a variety of nutrient dense foods from each food group – that provide adequate carbohydrates, protein, anti-inflammatory foods, and plenty of fluids.

Carbohydrates are the primary energy source for the endurance athlete, and they are necessary for performing intense, high quality exercise. Stocking your pantry with wholesome, carbohydrate-containing foods, (such as oatmeal, 100% whole-wheat bread, quinoa, potatoes, beans, brown rice, fruit, vegetables, milk, and yogurt) will provide important fuel for your workouts, along with providing essential vitamins, minerals and other important nutrients vital to your overall health.

Protein is essential to insure muscle growth and repair for faster recovery. Stock your pantry, freezer or refrigerator with a variety of lean protein-containing foods (chicken, fish, pork, turkey, lean beef, beans, legumes eggs, cheese, milk, yogurt, nuts, and, tofu). Plan for a serving of protein at each of your meals throughout the day (such as a palm-sized portion of fish, beef or poultry or a two-egg omelet with ¼ cup shredded cheese). Have convenient protein foods on hand so you can include about 20 grams of protein (along with carbohydrate) within 30 to 60 minutes following a workout. Simple snack ideas include Greek yogurt with nuts, granola and berries; peanut butter and banana sandwich; or tuna or chicken salad and whole grain crackers and grapes.

Anti-inflammatory foods to keep on hand include colorful fruits and vegetables, and healthy fats, such as nuts, seeds, avocado, olive oil, salmon and tuna. These foods and food groups provide the athlete rich sources of vitamins, minerals and antioxidants that have anti-inflammatory properties making them an indispensable part of the athlete’s diet. Consider stocking up on frozen fruit and vegetables, as well as canned tuna and salmon, for individuals looking for shelf-stable, nutritious and cost-effective solutions.

Fluids or hydration-promoting beverages include water, herbal tea, low-fat milk and 100% fruit juice. Try to limit fluids containing added ingredients, like caffeine, artificial sugars and sugar alcohols, as these may contribute to unwanted GI distress and are not effective forms of fuel or hydration.

Put your pantry into practice

Once you have your pantry well-stocked and your nutrition and hydration plan set, test that plan to make sure it will work for you. Plan to cook and eat more meals at home. Pack your lunch and bring it to work with you. Experiment with home-made nutrition bars or snacks, like “energy balls”. In addition to exploring different foods and fluids with the intent of expanding your food selection, practice the timing of prep work and consumption of meals and snacks before or after activity.

Often overlooked, don’t forget to test out your nutrition and hydration plan in various conditions, such as environment, distance or intensity. Is your tolerance for your favorite foods affected by heat and humidity? Do you need more fluids and electrolytes in these conditions? Or, if training volume or intensity changes, do you need to adjust your carbohydrate intake up or down, or experiment with the amount or type of carbohydrate or sports drink consumed during training. 

To help you know what adjustments you may need to make, consider keeping a food journal to track your workouts and food intake. Make note of how you feel before, during and after your workouts and if there are any habits or foods that are helpful or not so helpful for you to achieve your peak performance.

Finally, when it’s time for that first race of the season, or maybe even your goal race, be confident, keep your pantry organized and well-stocked, and stick to your plan! Just as you have practiced and prepared yourself with the best pace, recovery schedule and proper gear that works for you, the same is true with trusting your nutrition and hydration plan before, during and after the big event.

Hey Ladies: Protect Your Heart with Heart-Healthy Eating

February is American Heart Month! A time for many groups around the country to educate and raise awareness about heart disease. Despite these efforts, many women are unaware that heart disease is not just a “man’s disease” but is the leading cause of death for women in the United States.

In fact, 1 in 4 women in the United States dies of heart disease, while 1 in 30 dies of breast cancer.

Fortunately, heart disease is largely preventable with many things women can do, including physical activity. Even a modest 150 minutes each week of physical activity has been shown to be cardio-protective, which may be encouraging for the active female. However, factors like cholesterol, eating habits, smoking, and aging (menopause) can increase a woman’s risk of strokes, heart attacks and peripheral vascular disease – what together are called cardiovascular disease (CVD).

To reduce your risk of heart disease, The American Heart Association recommends the following:

• Know your blood pressure.
• Quit smoking.
• Talk to your doctor about whether you should be tested for diabetes.
• Have your cholesterol and triglycerides checked regularly.
• Lower your stress level and find healthy ways to cope with stress.
• Make healthy food choices and maintain a healthy weight for your body.

What is a heart healthy diet?

A heart-healthy diet stresses a dietary pattern that consists of vegetables, fruits, whole grains and healthy fats, rather than the negative consequences of a single food or food group. For many years the emphasis has been on eliminating single nutrients (such as cholesterol, saturated fat, and sugar) that promote the development of atherosclerosis, which is the hardening and narrowing of the arteries that is often the underlying cause of heart attacks, strokes and CVD.

Scientists have recognized that this single-nutrient-based strategy is not enough and are now emphasizing a different approach based on whole foods and dietary patterns, such as the Dietary Approaches to Stop Hypertension (DASH) eating plan and Mediterranean diet. These dietary patterns take advantage of the beneficial effects of the additive and synergistic nature of nutrients and foods in the body.

What foods are in a heart healthy diet?

• Fruits and vegetables. Aim for 5 or more servings a day. One serving is equivalent to one cup fresh or raw fruits or vegetables (about the size of your fist), and ½ cup cooked (about ¼ of your plate).
• Whole grains. Aim for half of your intake to be whole grains, such as whole wheat breads and cereals, oatmeal, corn, brown and wild rice, rye, barley, buckwheat, and quinoa.
• Low-fat dairy products. These include milk, soy milk, cheese, yogurt, kefir and other milk products.
• Fish, poultry, beans, soy foods and eggs. Moderate portions (3 to 4 ounces or the size of the palm of your hand) of lean animal protein, seafood and plant-based proteins, such as soy.
• Nuts, seeds, olive oil, avocado. The type of fat you eat is important, including more unsaturated fats, such as those listed here, as well as omega-3 fatty acids found in foods like walnuts, flax seed and salmon.

Are there any foods I should limit?

Despite popular belief driven by our diet-focused culture, calories in food are not equal. There is no doubt that excessive caloric consumption combined with inadequate physical activity is the primary driver of excess weight gain and health problems. However, generalizations that certain nutrients (i.e. saturated fat and carbohydrates) increase one’s risk of CVD have been challenged and disputed in recent scientific literature. For example, consumption of saturated fat from dairy foods is associated with decreased risk of CVD, while the consumption of the same amount of saturated fat from other foods (such as red meat) does not have the same positive result.

As the scientific literature continues to unfold regarding heart-healthy eating, a few general principles about foods to limit or consume mindfully in moderation include the following:

• Saturated fats found in red meat, processed meats, bacon, fried foods and baked goods.
• Trans fats (partially hydrogenated oil) found in commercially prepared baked goods, snack foods, and fried foods.
• Sodium, found in salt and added to many baked and convenience foods, can increase blood pressure. The American Heart Association recommends no more than 2,300 milligrams (mg) a day and ideally no more than 1,500 mg for those with high blood pressure.
• Added sugars, such as those found in sodas, cake, candy, etc.
• Some research shows a link between moderate alcohol intake and a lower risk of heart disease and stroke. For women, moderate intake is up to 1 drink per day. For men, it is up to 2 drinks a day. One drink is defined as a 5-ounce glass of wine, 12-ounce beer, or 1.5 ounce shot of hard liquor.

Easy-Peasy Rhubarb & Strawberry Crunch

A little piece of trivia – rhubarb is actually a vegetable. However, in the kitchen it is usually prepared as a fruit, and because of it’s tart flavor, rhubarb is often cooked with sugar and used in pies or other desserts.

Growing up in the Midwest, rhubarb (being a perennial), seemed to grow everywhere. We’d snap off a piece and enjoy the raw, tart, crisp stalks alone or dipped in a little sugar! Of course, there’s countless versions of recipes for rhubarb crisp, rhubarb and apple crumble, and my mom’s absolutely delicious recipe for rhubarb crunch (pictured below) that we enjoyed during those summer months!

I just love these handwritten recipes – especially the ones from my mom!!

Recently, I was trying to find a “lower sugar” version of a rhubarb recipe, and everything I found just seemed a bit disappointing (in my opinion) – not something I’d feel proud serving for company, which is kind of a litmus test for me.

So I decided to do a little experimenting and came up with the following recipe. Since I typically don’t enjoy food substitutions or versions of dessert recipes that are tweaked to be “healthy” (they leave me a bit dissatisfied which is not the point of dessert), I was pleasantly surprised with how this turned out.

In some recipes, ingredients like sugar (or even salt) actually overpower the flavor of the food it’s added to. In fact, we’ve become a bit “used to” this level of sweetness or seasoning – and have come to expect it. As I’ve said before, we don’t need to “cut sugar out” of the diet, but we do need to recognize when we are missing out on the natural flavor of food because it’s masked or covered up by these highly palatable ingredients.

Therefore, preparing this recipe with less sugar seemingly highlights the deliciousness of the unique, tart flavor of the rhubarb and it doesn’t seem like a compromise on flavor. And…the crunch and light sweetness of the topping was accented with the addition of the walnuts. Absolutely delicious!

So, it passed my litmus test and I would definitely serve this for my guests!

Rhubarb & Strawberry Crunch

• Servings: 9
• Time: 50 mins
• Difficulty: easy
• Print

Rhubarb is a nutritious addition to many recipes. Typically baked with a lot of sugar to balance its tartness, this rhubarb recipe has just the right amount of sweetness from the strawberries and honey, so it’s a delicious treat, but not too much so you can still enjoy the tang of the rhubarb!

Ingredients

• 4 cups chopped fresh or frozen rhubarb**
• 1-pint strawberries hulled and sliced
• 3 tablespoons honey
• ¾ cup rolled oats
• ½ cup flour (can substitute with whole wheat or almond flour)
• ½ cup packed brown sugar
• ¾ tsp cinnamon
• ½ tsp nutmeg
• 1/3 cup walnuts or pecans, chopped (optional)
• ¼ cup butter, softened

Directions

1. Preheat oven to 350 degrees.
2. In a medium bowl, stir together the rhubarb, strawberries and honey. Transfer to a shallow baking dish, i.e. 8 x 8
3. In another bowl, combine the dry ingredients. Mix in butter with fork until crumbly and spread over top of the fruit.
4. Bake for 40 minutes, until rhubarb is tender and the topping is toasted.

 Note: if using frozen rhubarb, thaw according to package directions. Consider adding about 1 ½ tablespoons cornstarch to the rhubarb, honey and strawberry mixture.

A Nutrition Nerd’s Secret Ingredient for a Great Workout

A personal trainer (and good friend) always used to call me “the nutrition nerd.” He knew I had a passion for physical activity, but food and eating was obviously my hot button. As nutrition enthusiasts and professionals, we can debate all day about “what food or diet is best” for healthy living and healthy aging, but it’s indisputable that physical activity is key for lifelong health and well-being!

Except in the case of excessive, compulsive exercise (or recovery from an illness, injury or eating disorder), I can’t think of a single study, health provider or researcher who has suggested that it’s better to just sit around or that we should avoid physical activity. But, just because we know that to be true, doesn’t necessarily make it easy for most people.

I love to move my body, and have always been quite active. For one, as a child growing up in a small town in Nebraska, that’s just how we got around – walking, jogging or riding our bike. I also enjoyed participating and competing in activities like dance, gymnastics, and cheerleading all the way through college, and continue to be an avid cyclist and fitness advocate  – so it may be surprising to hear that exercise can be a struggle at times – and certainly not something I always look forward to.

Some of you may be able to relate to this scenario. After high school and college, everything seems to change. Busy work schedules, friend and family obligations, lack of access to (or choosing to avoid) fitness facilities, climate and lack of motivation seem to make exercise more of a chore than the fun, energizing activity it used to be (or that we hope it would be).

Fast forward about 30 years and I can certainly share many ideas, strategies, or “ingredients” for overcoming these obstacles and sustaining regular physical activity (none of which have anything to do with a “perfect, correct or right” food or supplement).  A few notable tips include: 1) do activities you enjoy; 2) participate in group fitness, if possible; 3) exercise at a time of day that’s best for you; 4) hire a personal trainer; 5) find a workout buddy; and, 6) mix it up / challenge yourself to try something new.

But, the ONE thing that has remained constant and still to this day motivates me and energizes my workouts more than anything else is MUSIC!

Whether it’s an instructor who creates a heart-pumping workout with a carefully choreographed selection of tunes, or making my own playlist; the rhythm, beat and even lyrics seem to be the “energizer bunny” that kicks everything into high gear.

 

We all have a unique “taste” for music. Therefore, there’s not a “right” or “perfect” music/genre/song list. Music that energizes one person doesn’t necessarily stir up the same effect for another – that’s okay. Have some fun experimenting with different genres and tunes to figure out what works for you. Streaming music with apps, such as Apple Music, Spotify, Pandora, YouTube, etc. make it convenient to mix it up and listen to your favorite music.

DIY or making your own playlist is a great strategy for personalizing your music selection, especially for those times when motivation is waning. I’ve been making playlists long before iTunes, Spotify, and Pandora (first recording onto tape, then CD to CD, etc). In fact, it’s a bit of a hobby and a fun way to distract when feeling uptight or run down.

For me, the process of creating a playlist and having it to look forward to at my next workout makes all the difference in not only getting to the gym, on the bike, or out for a walk/jog, but makes my workout feel like a “new guest” has shown up at the party and the fun just began!

And…since the secret to long term success with your health goals is about sustaining behavior change (and that includes all types of activity), then doing something you look forward to – because it’s fun and makes you feel great – will certainly be a difference maker.

To give you some ideas, following is my one of my new playlists (always a collection of new and old) – great for cardio! I love to follow-up a playlist like this with a little “Island Music” (a station I found on Pandora) for a fun vibe during a strength workout and stretch. As mentioned before, we all have unique music preferences – especially as it relates to exercise. So, take or leave whatever sounds good to you.

Reggaeton Lento (Remix) by CNCO & Little Mix 

One Kiss by Calvin Harris and Dua Lipa 

Spaceship by Comet Blue 

Bring it Back (feat Aleon Craft)  by Shy Carter 

Chained to the Rhythm by Katy Perry

Mr. Put it Down (feat Pitbull) by Ricky Martin A different 

Waiting for Tonight by Jennifer Lopez

Want You Back by 5 Seconds of Summer (explicit warning)

Ed Sheeran Shape of You (Tropical Club Remix) by DJ Nate Ro

Hold on Tight by R3HAB & Conor Maynard

September by Earth, Wind & Fire

Adventure of a Lifetime Workout Mix by Power Music Workout

Came Here for Love (Calvo Remix) by Signala & Ella Eyre

One (feat U2) by Mary J Blige

Do you have a favorite song(s) to workout to – or genre, playlist? Please do share 🙂

So…that’s an idea of what works for me. I’d love to hear your ideas! What helps to motivate you – to not only stay physically active – but look forward to and enjoy moving your body?

Peace!