Nancy Clark, RD, Author at MedFitNetwork

The Debate: Is Sugar Evil or OK for Athletes?

Nancy Clark, RD/13 September 2018/ All MFN blog/

Sugar is a total waste of calories. I don’t touch the stuff.

I have such a sweet-tooth. My day is grim without some sugar in it.

Before I compete, I eat a spoonful of honey to boost my energy.

If you are like most of my clients, you are confused about the role of sugar in your daily sports diet. The anti-sugar media reports sugar is health-erosive, yet sports nutrition researchers claim sugar is performance enhancing. That might leave you wondering: Should I eat sugar or avoid it?

To address this conflict, I’ve summarized a sugar debate published in 2018 in the Journal of Progressive Cardiovascular Disease. The article, critique, and editorial do a good job of examining the question: Have the ill effects of those toxic white crystals in your diet been over-emphasized? Here is some information to help you better understand the two sides to the Sugar Wars debate.

Sugar is Evil⁽¹⁾

Sugar is not an essential nutrient. Our bodies can make sugar (glucose) from the dietary fat and protein that we eat, or by breaking down our body’s muscle and adipose tissue.

• The average American eats about 100 pounds of sugar per year; that’s 2 pounds a week and contributes abundant empty calories.

• Populations with a high intake of added sugars tend to have health issues. Reducing added sugar to less than 10% of total calories reduces risk of overweight, obesity, and tooth decay.

• Dietary sugar drives up blood sugar. Routinely consuming 150 sugar-calories each day (i.e., one can of soda) increases the risk of developing diabetes by 1%. Much of this sugar is hidden in packaged foods.

• Metabolizing added sugar (with no nutritional value) requires vitamins and minerals. With very high sugar consumption (and low intake of other nourishing foods), one could become nutrient depleted.

• Trading empty sugar calories for nutrient-rich calories is a no-brainer. Limiting sugar intake does not harm anyone.

Sugar is OK for People Who Are Fit⁽²⁾

• Sugar consumption increased from less than 10 lbs. per person per year in the late 1800’s to about 100 pounds per person per year by World War II. Consumption remained relatively flat until 1980. Our health also improved between 1880 and 1980—so is it fair to say that the increase in sugar hurt our health?

• Sugar (and starch—a string of sugar molecules linked together) is in breast milk, dairy foods, fruit, honey, potato, wheat, corn, quinoa, and all grains. People around the globe have consumed these “carbs” for years. So why now do sugar and starch suddenly become responsible for creating human obesity and diseases?

• The fear-mongering terms of unhealthy, toxic and poisonous are simply unscientific. People who lack knowledge about physiology accept this disease-mongering, anti-sugar rhetoric. But the fact is no one food is healthy or unhealthy.

• Our present state of poor health is not because our diets are unhealthy or that we consume sugar, but because we are physically inactive. Low levels of physical inactivity reduce our ability to metabolize sugar optimally, and that explains the true cause of obesity and metabolic diseases.

• In terms of diabetes, blood sugar, not dietary sugar, matters. The rise in blood sugar that occurs after eating is not pathological but rather the failure of the muscles and liver to take up the sugar. That is, it’s not what you eat, but what your body does with what you eat.

• Physical activity affects appetite and energy intake. If we are too inactive and live a sedentary lifestyle, energy intake gets dissociated from energy expenditure. We can easily eat more calories than we burn. Lack of physical activity negatively impacts metabolic health.

• A maternal effect impacts both pre- and post-natal development. Children of inactive mothers are born increasingly predisposed to inherited childhood obesity and Type II Diabetes. This increases with each passing generation.

Concluding comments⁽³⁾

Lack of physical activity, more so than sugar, is the greater threat to our health. Given that so many people are overfat and underfit, a diet low in sugars and starches is likely a good idea for them. But for sports-active, fit people—who are at lower risk for heart disease, diabetes, and obesity—sugar and carbs are not toxic but rather a helpful way to enhance athletic performance. The one size diet does not fit all.

No one is suggesting that athletes should eat more sugar, but rather understand that, as an athlete, you can embrace a sports diet that includes an appropriate balance of carbohydrate (sugars and starches) in each meal. Strive for a healthy eating pattern that includes 85% to 90% quality foods and 10% to 15% whatever. Some days, whatever might be an apple; other days, it might be a slice of apple pie.

Addendum: If you are fearful sugar will harm your health, note that fear-mongering relies on cherry-picked scientific information that can prove what the messenger wants to prove. Fear-mongering messengers have created a general distrust of Big Food, and have shaped opinions that support raw foods, super foods, whole foods, organic foods, and clean eating. While a plant-based diet based on unprocessed foods with no added sugar is ideal, I commonly see athletes who take the advice to the extreme and eat “too clean” (orthorexia). That is not healthy, either.

My suggestion: Enjoy a balanced variety of foods, in moderation. The US Dietary Guidelines recommend limiting added sugar to less than 10% of your total calories (about 250+ sugar-calories per day for an active woman who might require about 2,500+ calories a day) Enjoying a daily small sweet seems better than routinely “cheating” with sugar-binges. Does the age-old advice to enjoy a balanced variety of foods—with a sprinkling of sugar, if desired—seem a reasonable goal?

Nancy Clark, MS, RD, CSSD counsels both casual and competitive athletes at her office in Newton, MA (617-795-1875). Her best selling Sports Nutrition Guidebook and food guides for marathoners, cyclists and soccer players offer additional information. They are available at NancyClarkRD.com. For her popular online workshop, see NutritionSportsExerciseCEUs.com.

References

This article is based on information from the Journal of Progressive Cardiovascular Disease (August, 2018)

DiNioloantonio JJ, O’Keefe JH. In critique of “In Defense of Sugar: The Nuance of Whole Foods. https://doi.org/10.1016/j.pcad.2018.07.006
Archer E. In Defense of Sugar. https://doi.org/10.1016/j.pcad.2018.07.013
Lavie CJ. Sugar Wars -Commentary From the Editor https://doi.org/10.1016/j. pcad.2018.07.007

Sports Nutrition Questions

Nancy Clark, RD/16 August 2018/ All MFN blog/

Athletes have many questions about how to fuel for top performance. The Internet abounds with answers—but how do you what’s valid? Here are some trust-worthy answers, based on research presented at the American College of Sports Medicine’s Annual Meeting (May 2018; www.ACSM.org).

FUELING DURING

Do elite athletes, such as professional soccer players, consume the recommended 30 to 60 g carb (120 to 240 calories) per hour during moderate/high intensity training?

Likely not. A soccer study indicates the players barely consumed half that amount (17 g carb (~70 calories)/hour of moderate intensity training and only 14 g (~55 calories) per hour during high intensity training). Soccer players—and other athletes in stop-and-start sports—want to experiment with consuming the recommended amount of fuel. They’ll likely learn they can have greater stamina and endurance at the end of their games—and that can be their winning edge.

FUELING AFTER

Does enjoying a recovery snack after training actually impact on the next day’s exercise session?

Yes, according to 8 female collegiate tennis players who enjoyed 680 calories of recovery food (an apple, a banana, 2 tablespoons peanut butter, and a bagel) daily for 4 weeks after high intensity strength and power training. They reported being able to train hard the next day with 10% less perceived effort compared to sessions without the recovery snack. No one “got fat”; there were no differences in body composition. Knowing that the food was available contributed to better-quality training sessions. Whether psychological or physiological, eating within an hour post-exercise made a positive difference. Perhaps you want to make refueling a consistent habit?

HYDRATION

When training in summer heat, what’s best to drink?

In a simulated heat wave study, trained athletes exercised lightly for 3 hours in each of 4 trials. They drank either 1) room temp water (20 degrees C) as desired, 2) cold water (4 degrees c) as desired, 3) no fluid replacement, or 4) full replacement of sweat losses with programmed drinking. Obviously, those who drink nothing suffered the most heat strain. Those who drank ad libitum (as desired) consumed enough to prevent dangerous levels of dehydration. The athletes drank more of the room-temperature water. Preliminary findings suggest the cold 4°C water blunted thirst. Be careful about how much ice you put in your water bottle?

I’m afraid of becoming dehydrated when I train hard in the heat. I plan to push fluids. How much is too much to drink?

While drinking an extra-large volume of fluid before endurance exercise might seem advantageous, the question arises: would doing so actually trigger a diuretic effect and, thus, not provide the desired benefit (hyper-hydration). To test that theory, subjects drank 5, 10, 15 or 20 ml/kg of a sodium-containing beverageThat’s about 12 to 50 ounces (350 ml to 1,400 ml) for a 155-lb (70 kg) athlete. The data suggest that the athletes retained about half of what they drank, regardless of the volume consumed. Thus, if you will be exercising in the heat, tank up as tolerated.

ALTITUDE

How much harder do you need to work when exercising in the summer heat at altitude?

In order to meet the combined demands of increased blood flow to the skin (to dissipate body heat) plus transport of adequate oxygen to the exercising muscles, the heart has to work about 17% harder than at sea level during 30 min of moderate intensity exercise. If you are a fit, healthy person who is just exercising at altitude or just exercising in the heat, the heart works about 10% harder. No wonder exercising at altitude and/or in the heat is tiring! Programmed eating and drinking can help provide the extra energy and fluids needed to support the extra effort. Hikers and skiers, plan ahead…

CONCUSSIONS

As a soccer player, I am fearful of getting a concussion. Can I do anything with my diet to help protect my brain from damage?

An effective way to reduce the harmful response to traumatic brain injuries is to routinely consume oily fish (omega-3 fats) during training. Unfortunately, a study with 112 football players (none of whom took fish oil supplements) indicates only 1% of them consumed adequate dietary omega-3s. They would be wise to enjoy more tuna sandwiches, grilled salmon, and other oily fish, as well as take fish oil supplements.

INJURIES

What can I do to reduce my risk of getting injured?

You want to eat well on a daily basis and stay in peak physical condition. Fit individuals have a lower injury risk. A study with Navy SEALs suggests having good knee strength and flexible hamstrings, as well as strong leg muscles, are important factors to reduce the risk of lower-leg muscle & bone injuries.

You also want to maintain an appropriate body weight—not too thin! Among female collegiate athletes, those with components of the Female Athlete Triad (amenorrhea, stress fractures, and/or restrictive eating) experienced more injuries than those who ate enough calories to support normal menses and strong bones. Eat enough!

WEIGHT

I eat less than my teammates but I am not losing weight. How can that be???

The less you eat, the more the body down-regulates to conserve energy. A study with collegiate female athletes reported those eating ~1,600 calories a day, as compared to their peers who ate 2,100 calories, conserved energy via a lower resting metabolic rate and reduced thyroid (T3) level. Try getting out of “hibernation” by eating a bit more and enjoy better energy? Consulting with a sports dietitian can help guide this process. To find your local sports nutrition professional, use the referral network at www.SCANdpg.org.

NITRATES

I’ve heard that beets, arugula and nitric oxide supplements can enhance athletic performance by improving blood flow to muscles. Could they also help my grandpa who gets tired when walking?

Likely yes. A promising pilot study in older adults (average age, 78 years) showed that chronic nitric oxide supplementation (40 mg, 3 times/day) was well tolerated and associated with increased ability to walk more efficiently. We need more research to better understand the impact of dietary nitrates and nitric oxide supplements on physical activity and health among elderly people. Till then, we can all enjoy more beets, arugula, celery, and other foods rich in dietary nitrates. They help youthful athletes as well as their grandparents.

Nancy Clark, MS, RD counsels both casual and competitive athletes at her office in Newton, MA (617-795-1875). Her best selling Sports Nutrition Guidebook and food guides for marathoners, cyclists and soccer players offer additional information. They are available at www.NancyClarkRD.com. For her popular online workshop, visit www.NutritionSportsExerciseCEUs.com.

man with food rich in protein showing thumbs up

Sports Nutrition Update from the American College of Sports Medicine

Nancy Clark, RD/10 July 2018/ All MFN blog/

Staying on top of the latest sports nutrition information is a challenge. That’s why I attend the annual meeting of the American College of Sports Medicine (ACSM). ACSM is a professional organization for sports medicine doctors and health-care providers, sport dietitians, exercise physiologists and sport science researchers. More than 3,000 ACSM members gathered in Minneapolis (May 2018) to share their knowledge and latest research. The following summarizes a Sports Nutrition Update session presented by many leading exercise scientists from around the globe.

Fat vs. Carb

Gareth Wallis PhD, Univ. Birmingham, UK

Which will better enhance athletic performance: A high carbohydrate or a high fat sports diet? Despite growing interest in a high fat sports diet, research does not support it for athletes who exercise at high intensity. Rather, research supports consuming 3 to 4.5 grams carbohydrate per pound (7-10 g carb/kg) body weight per day to be well fueled for hard training and competitive events.

Grains, fruits and veggies are obligatory if you want to exercise hard. Some athletes eat a high fat diet for training and then switch to carb-loading before a competitive event. Bad idea. The enzymes involved in metabolizing carbohydrate become less active, so the muscles are less able to access carbs for fuel when it is needed for winning sprints and surges.

Protein for Athletes

Nicholas Burd PhD, Univ Illinois and Trent Stellingwerff PhD. Canadian Sport Institute

If you want to build muscle, when is the best time to eat protein: before, during or after you lift weights? It might not actually matter because resistance exercise stimulates a muscle-building effect that is most robust within the first 4 hours but lasts for 1 to 2 days. You need not carry a protein shake around the gym! More important is to pace your protein intake evenly throughout the day.

Resistance exercise is far more potent than a high protein diet for increasing strength and muscle gains. That said, most athletes could expect to see only a gain of about 2 pounds (1 kg) of muscle in 13 weeks. That’s not very much compared to what they really want to see.

Maximal anabolic (muscle-building) effects are seen with about 25 to 30 g protein per meal. More precisely: 0.75 g protein per pound of body weight per day, or 0.1 to 0.2 g protein per pound per meal in young men. More than that has little or no further benefit. However, these recommendations do change with age. If you are >50 years old, you should target an additional 10 grams of high quality protein (milk, egg, fish, soy) per meal. That’s just a little bit more: a glass of milk or 1.5 ounces of meat-fish-chicken.

Despite rumors, protein does not damage the kidneys nor cause a decline in kidney function. Even people with chronic kidney disease should consume the RDA for protein (0.8 g/kg). A high protein diet also does not cause bone loss. Bone is 40% to 50% protein (collagen).

Over-consuming protein is not only a waste of money but it also stresses the environment. As athletes, we need to take a holistic and whole-foods approach to our diets. Natural protein-rich foods, as opposed to processed supplements, are best (if compatible with your training schedule) because they offer a complex and complete matrix that is more effective than processed proteins. One example of the benefits of whole foods can be seen with eggs. A whole egg promotes 40% greater muscle protein synthesis in the 5 hours post-exercise as compared to eating just the egg white (van Vliet AJCN 2017). Nutrient interactions seem to facilitate a more robust response when compared to eating isolated protein.

Sport Supplements

Eric Rawson PhD RD, Messiah College

There is no one single sport supplement that works for all athletes. To better understand why, we need a more specific scientific approach to studying supplements based on age, sex, body size, training status, and genetics. That would help us give better advice to target groups of athletes, rather than simply make population-wide recommendations. Many athletes take multiple supplements, so research with “stacked” supplements would also be helpful. Here’s some of what we do know:

Creatine enables an athlete to lift harder in the training room—and build more muscle. But not everyone is a responder. For example, 3 of 11 subjects in a research study had a strong positive response, 5 had a slight response—and 3 did not respond at all (Syrotuik, Bell 2004). Why not? Maybe their daily diets impacted their baseline creatine levels?

Creatine is found in meat and other animal proteins. When a meat-eating athlete goes on a meat-free lacto-ovo-vegetarian diet (milk, eggs, beans) for 26 days, his or her creatine levels will drop. (Lukaszuk, 2005). To normalize the level, athletes could take creatine monohydrate supplements (the most effective form of creatine).

Caffeine is a known energy-enhancing sport supplement. Your response to caffeine will depend on your genetics. Caffeine works best when you are starting to fatigue. Athletes can consume it in coffee, tea, soda, gels, gum, and pills, preferably consumed with carbs.

Sodium bicarbonate is used by some athletes to buffer the lactic acid that builds up during intense bursts of exercise. Research suggests peak response times can vary widely, from 40-165 minutes. (Jones 2016 ISSN). This variability makes it hard for exercise scientists to offer firm recommendations; hence, outcomes vary. Sub-elite athletes seem to respond better then elite athletes. Because sodium bicarbonate easily causes nausea and vomiting, a solution it to take it in gastro-resistant capsules.

Fluids and Hydration

Linsday Baker, R&D Principal Scientist, Gatorade Sports Science Institute, Pepsi Co.

When you sweat, you lose proportionately more water than sodium, hence sodium levels in the blood increase with dehydration. The amount of sodium you lose in sweat varies from a lot to a little, related to both sweating rate and how well you are acclimated to exercising in the heat, among other factors. A high concentration of sodium in your blood stimulates thirst.

Thirsty athletes have three ways they deal with replacing fluid losses: hit-or-miss ad lib drinking as desired; drinking to quench thirst; and drinking on a set schedule. The effectiveness of these strategies depends on the individual athletes, availability of fluids, the weather, and exercise intensity and duration. If you happen to have a lot of tattoos, take note: tattooed skin may sweat less and excrete saltier sweat.

Nancy Clark, MS, RD counsels both casual and competitive athletes at her office in Newton, MA (617-795-1875). Her best selling Sports Nutrition Guidebook and food guides for marathoners, cyclists and soccer players offer additional information. They are available at www.NancyClarkRD.com. For her popular online workshop, see www.NutritionSportsExerciseCEUs.com.

Alcohol in Sport: How Bad Is It for Athletes?

Nancy Clark, RD/12 June 2018/ All MFN blog/

Alcohol has a strong link with sport, be it with sponsorship, beer consumption after a hard workout, or teams enmeshed in a culture of heavy drinking. To address what is known—and not known—about the impact of alcohol on athletic performance, members of Professionals In Nutrition for Exercise and Sport (PINES) organized a session at the American College of Sports Medicine (ACSM) 2018 annual meeting in Minneapolis. Respected researchers answered some questions athletes commonly ask regarding alcohol and sport performance. Here’s what you might want to know.

What effect does a big night of drinking have on sports performance the next day?

Dr. Louise Burke, Head of Sports Nutrition for the Australian Institute of Sport, reported heavy drinking is common after many athletic events. For example, research with rugby players suggests they consumed an average of 13 units* of alcohol post-game, with a range of 1 to 30 units (*One unit equates to 10 grams of alcohol; 5 ounces (150-ml) wine equates to 1.5 units; a 30-ml nip of hard (40%) alcohol is 1 unit; a 375 ml (13 oz.) bottle of 4.8% alcohol beer is 1.4 units.)

What does heavy post-exercise alcohol intake do to rehydration and refueling goals?

Dr. Ron Maughan, visiting professor at St. Andrew’s University, acknowledged a modest amount of alcohol, consumed along with a balanced meal, is unlikely to have a negative impact. Alcohol impairs glycogen resynthesis only a little bit. But in the real world of sports drinking, athletes who drink a lot tend to make high fat food choices—and that can hinder optimal muscle glycogen replenishment a lot! Consuming a balanced meal before embarking on heavy drinking is probably a good idea.

Alcohol is a diuretic. One unit (10 g) of alcohol stimulates the formation of 100 ml of excess urine. The alcohol content of beer is low—and beer has a lot of water—so dehydrated athletes can effectively rehydrate with beer. Whiskey and other spirits, however, cause more water loss than they contribute.

What impact does pre-exercise alcohol have on heat tolerance/dehydration during exercise?

According to research presented by Dr. Doug Casa, professor at the University of Connecticut, pre-exercise alcohol contributes to slower running across a wide range of distances. Anecdotes, more so than much-needed research, link pre-event alcohol with poor sleep, under-hydration, reduced heat tolerance, and decreased mental function. Dr. Casa reported that one major summer road race had 20 to 25 heat injuries one year. The common denominator among those heat-stricken runners was pre-event alcohol consumption. Don’t drink excessive alcohol before an event—especially in the summer heat!

What does heavy alcohol after exercise do to weight and body-fat goals?

Dr. Barry Braun, professor at Colorado State University, said for most athletes, alcohol is a source of unwanted calories. For example, just five Heineken Light Beers add 500 calories—and that’s not counting the pepperoni pizza or nachos that you can easily overeat when alcohol lowers your inhibitions.

What effect does heavy post-exercise alcohol intake have on muscle recovery?

Dr. Stuart Phillips, professor at McMaster University, noted bad things happen during exercise and good things happens during recovery when athletes rehydrate, refuel, and repair (by consuming protein) their muscles. Adding alcohol to the recovery diet slows down muscle repair, protein synthesis, and adaptation processes. Heavy alcohol intake is not on Phillips’ list of best recovery practices for athletes to follow! Yet, he doesn’t begrudge anyone a glass or two of wine. Moderation is the key word.

What does heavy alcohol intake do to sleep?

Dr. Shona Halson, Senior Physiologist at the Australia Institute of Sport, reports that alcohol might help you fall asleep faster, but it disrupts your sleep cycles so you get less restorative sleep. Alcohol alters body temperature, which can affect how well you sleep. It also aggravates snoring (due to relaxed muscles and a lower breathing rate), so your bed partner also gets sleep deprived. Plus, you have to get up to go to the bathroom more often in the middle of the night. None of this enhances athletic performance.

What does heavy alcohol intake after exercise do to muscle soreness, injury, and inflammation? Matthew Barnes of Massey University in New Zealand noted when athletes perform exercise to which they are accustomed, alcohol’s negative effects are less pronounced compared to doing a new form of exercise. That is, after getting battered up in a game, a 200-lb rugby player who is experienced with both sport and drinking could have perhaps 20 standard drinks and still effectively perform a vertical jump! As for inflammation, players who are conditioned to both their sport and to drinking alcohol do not have a significant inflammatory response. But if you are a weekend warrior, watch out…

Why isn’t alcohol & performance better researched?

Indeed, more research would be very helpful, but few research institutions approve studies that involve alcohol + heat. The alternative is to study athletes who have already been drinking. For example, they can track the number of runners in the medical tent who consumed alcohol the night before.

Any words of wisdom?

When asked, Is beer good for runners?, running legend Jim Fixx’s answer was “Sure, if it’s the other guy drinking it.” If you stay sober, you can take advantage of other athletes’ poor judgment!

Nancy Clark, MS, RD counsels both casual and competitive athletes at her office in Newton, MA (617-795-1875). Her best selling Sports Nutrition Guidebook and food guides for marathoners, cyclists and soccer players offer additional information. They are available at NancyClarkRD.com. For her popular online workshop, see NutritionSportsExerciseCEUs.com.

Sports Nutrition: #ScienceNotOpinion

Nancy Clark, RD/15 May 2018/ All MFN blog/

Performance starts with fueling, not training! The best way to fuel for top performance seems to be a debatable topic these days. To keep on top of the science regarding food, exercise & performance, I look to SCAN, the Sports & Cardiovascular Nutrition practice group of the Academy of Nutrition and Dietetics (AND). Here are some tidbits of information from this year’s 35th annual meeting in Keystone CO, May 2018.

In your search for sports nutrition information, Leslie Bonci RD CSSD wants you to find #ScienceNotOpinionand #FactsOverFallacy. Here’s some of what science supports:

—Exercising in a fasted stated leads to muscle breakdown. Think twice before eating nothing before morning exercise.

—The keto diet does not enhance performance, but rather leads to a down-regulation of the enzymes needed by carbohydrates to fuel a surge or a winning sprint at an event.

—Whole30 and Intermittent Fasting are just two more fads to add to the list of unsuccessful diets. You never want to embark upon a diet you won’t maintain for the reset of your life. Otherwise, diet backlash (binge eating, weight gain) takes it toll. Learn how to eat smarter, not diet harder!

—Carb-phobia refuses to go away, despite the plethora of research supporting the performance benefits of a carb-based sports diet. #Don’tDreadTheBread.

Omega-3 fats (DHA, EPA) found in oily fish (salmon, tuna, mackerel) are related to brain health. Animal research (rats, mice) suggests giving intravenous DHA within an hour after brain or spinal cord injury contributes to better outcomes regarding recovery. Would the same help athletes? Could DHA help with reducing the damage done by brain injuries? According to Michael Lewis MD, athletes, war fighters and others at high risk for getting concussed should consider taking 3,000 mg. EPA + DHA per day as a protective strategy.Omega-3s can also help treat depression, and that might help reduce suicides. Among soldiers with adequate levels of omega-3, the suicide-rate was 62% lower than soldiers with low blood levels of DHA.

Should athletes take anti-oxidant supplements? Likely not, according to exercise physiologist Scott Powers PhD of the University of Florida in Gainesville. The body has a natural balance of pro-oxidants and anti-oxidants. An imbalance can lead to muscular fatigue and molecular damage. Anti-oxidant supplements can down-regulate the body’s natural production of anti-oxidants, and that can blunt the training response. Athletes can ingest a performance enhancing balance of anti-oxidants (including vitamins C & E, zinc, carotenoids, and polyphenols) via all sorts of colorful fruits and vegetable: blueberries, strawberries, tart cherry juice, grape juice, broccoli, spinach, carrots….

The Academy of Nutrition and Dietetics, along with the American College of Sports Medicine and Dietitians of Canada, have created guidelines on nutrition for athletes. But what about nutrition for fitness exercisers and weekend warriors? If that’s you, exercise physiologist Asker Jeukendrup, PhD, of www.mysportscience.com suggests you match your nutritional guidelines to your athletic goals. That is, are you exercising to lose weight? build muscle? finish an Ironman Triathlon? or just to invest in better health?

When it comes to fueling during extended exercise, Jeukendrup stated the recommendations are similar for both athletes and less fit people: For exercise that lasts from 60 to 90 minutes, you want to maintain high energy by consuming from 30 to 60 grams of carbohydrate (120 to 240 calories) per hour of exercise. If you are a weekend warrior who exercises hard for more than two hours, you want to target 60 to 90 grams carh (240 to 360 calories) per hour. You might have to start at the low end of the calorie range while you train your gut to tolerate that much fuel. (The gut is trainable!). You’ll discover that exercise is much more fun when you have high energy!

An estimated 35 million Americans are older than 65. By 2030, 70 million Americans will exceed the age of 85. Unfortunately, as we age, we lose muscle strength. That loss is associated with frailty and falls. Because the daily diet of an estimated 25% to 40% of older people lacks adequate protein, muscle loss gets exacerbated.

Research suggests that older people, including athletes, should increase their protein intake to 1.4 g to 1.6 g/kg per day, and up to 40 grams after hard exercise. Exercise physiologist Robert Murray, PhD,(www.sportsscienceinsights.com) reports this could help boost the muscle-building response to exercise. If you are an older athlete who weighs 150 pounds (68 kg), this means. 95 to 110 gram protein per day. That’s about 25 grams, four times a day—much more than in a bowl of oatmeal or a handful of nuts!

The health risks of yoyo dieting are more harmful than the (short-lived) benefits of weight loss. Julie Duffy Dillon RD (host of the Love Food podcast) reminds us that weight cycling (yoyo dieting) contributes to malnutrition, muscle loss, reduced metabolic rate, and feelings of deprivation. The binge-eating that occurs upon “blowing the diet” is linked to fat gain, inflammation, elevated blood pressure, and insulin resistance—to say nothing about disordered eating. Dieting is the #1 predictor of who will develop an eating disorder.

According to sports dietitian Nanna Meyer PhD RD of the University of Colorado in Colorado Springs, climate change is here. It’s time for athletes to think more about how we can be good Food Citizens and take better care of the earth that we enjoy. This could be by eating locally grown foods, choosing more plant foods, buying sustainably farmed fish, using fewer plastic water bottles, eating less food in wrappers, and buying from local farmers. Eat with integrity and with respect for the planet!

Sports Supplements: Buyer Beware?

Nancy Clark, RD/23 April 2018/ All MFN blog/

Definition of Sports supplement: A food, food component, nutrient, or non-food compound that is purposefully ingested in addition to the habitually consumed diet with the aim of achieving a specific health and/or performance benefit.

The global sports nutrition supplement market (including sports foods, drinks and supplements) accounted for $28+ billion in 2016 and, with the help of rigorous advertising, is expected to almost double by 2022. How many of the products are moneymaking ploys marketed to uninformed athletes? Unfortunately, too many.

Due to the plethora of products that have infiltrated gyms, fitness centers and professional sports teams alike, I get questioned by fitness exercisers and aspiring Olympians: Which of these supplements are actually effective?? Hands down, the most effective way to enhance sports performance is via your day-to-day sports diet, coordinated with a consistent training program. Eating the right foods at the right times creates the essential foundation to your success as an athlete.

That said, specific sports supplements could make a minor contribution to small performance improvements for certain elite athletes. If you wonder if the grass is greener on the other side of your sports diet’s fence, here are some facts from the 2018 IOC Consensus Statement: Dietary Supplements and the High-Performance Athlete (1).

Supplement use varies across sports. It increases with the athletes’ training level and age, is higher in men than women and is strongly influenced by perceived cultural norms. (For example, “Everyone” on my team takes creatine, so I do, too.)
Before making any decisions regarding sports supplements, you want to get a nutritional assessment to be sure your diet supports your performance goals. No amount of supplements will compensate for a lousy diet. To find a local sports dietitian who is a Certified Specialist in Sports Dietetics (CSSD), use the referral network at www.SCANdpg.org.
Despite the ads you see for a zillion sports supplements, very few have strong proof of directly enhancing performance. These include caffeine, creatine, specific buffering agents, and nitrate. Period.
Very little research with supplements offers definitive evidence, in part because the research is rarely done with elite athletes under real life conditions. Real life includes 1) multi-day tournaments, competitions or events, 2) “stacking” supplements (such as mixing caffeine and nitrates) and 3) determining if an elite athlete responds the same way to a supplement as does a Division-3 collegiate athlete. Real life also includes your unique microbiome (the bacteria in your gut that influence your overall health and well-being). We do not yet know how much a microbiome, which varies 80% to 90% between individuals, influences the effectiveness of a sports supplement and contributes to different responses.

Supplements are used for many different reasons. Here’s a breakdown of supplements by categories.

Supplements used to prevent/treat nutrient deficiency. Nutrients of concern for athletes include iron (to prevent anemia), calcium and vitamin D (for bone health), as well as iodine, folate and B-12 for specific sub-groups of athletes, including vegans and women who might become pregnant. The basic supplement question is: If you are deficient, what led to that deficiency and what dietary changes will you make to resolve the issue so that it doesn’t happen again?
Supplements used to provide energy. Sports drinks, energy drinks, gels, electrolyte replacements, protein supplements, energy bars, and liquid meals are commonly used to help meet energy needs before, during and after exercise. They are a convenient, albeit more expensive alternative to common foods. They aren’t magical or superior to natural food. They are just easy to carry, standardized and eliminate decisions about which foods would offer, let’s say, the “recommended ratio” of carbs, protein and fat.
Supplements that directly improve performance. Caffeine, creatine monohydrate, nitrate, sodium bicarbonate, and possibly beta-alanine are the very few performance enhancing supplements that have adequate support to suggest they may offer a marginal performance gain. If you choose to use them, be sure to test them thoroughly during hard training that mimics the competitive event. Choose a brand that is NSF Certified for Sport to minimize the risk of inadvertent doping due to contamination. Every year, athletes get suspended for failing a drug test after they unknowingly took a supplement with an illegal ingredient…
Supplements that indirectly improve performance. Some supplements claim to enhance performance indirectly by supporting the athlete’s health and limiting illness. “Immune support” supplements that have moderate research to support their health claims include probiotics, vitamin D, and vitamin C. Supplements that lack strong support for their immune-enhancing claims include zinc, glutamine, Echinacea, vitamin E, and fish oil. Tart cherry juice and curcumin show promise

A supplement with strong evidence to indirectly improve performance by helping build muscle is creatine monohydrate. Questionable supplements without strong evidence for athletes include gelatin and HMB.

Adverse Effects

If some supplements are good, would more be better? No, supplements can cause harm. Too much iron can lead to iron overload. Too much caffeine increases anxiety. Supplements are linked to liver toxicity, heart problems and seizures. In the USA in 2015, dietary supplements contributed to about 23,000 emergency department visits. Manufacturers are not required to show safety or assure quality of a supplement. Athletes beware— and try eating better to perform better?

Nancy Clark, MS, RD, CSSD counsels both casual and competitive athletes at her office in Newton, MA (617-795-1875). Her best selling Sports Nutrition Guidebook and food guides for marathon-ers, cyclists and soccer players offer additional information. They are available at www.NancyClarkRD.com. For her popular online workshop, see www.NutritionSportsExerciseCEUs.com.

References

Maughan R, Burke L, Dvorak J et al. IOC Consensus Statement: Dietary Supplements and the High-Performance Athlete Intl J Sports Nutr Exerc Metab 2018, 28: 104-125.

https://globenewswire.com/news-release/2017/01/10/904591/0/en/Global-Sports-Nutrition-Market-will-reach-45-27-Billion-by-2022-Zion-Market-Research.html

Breakfast is for Champions

Nancy Clark, RD/3 April 2018/ All MFN blog/

I don’t have time, I’m not hungry in the morning and I’m on a diet are three common excuses for missing breakfast. Unfortunately, athletes who skip breakfast generally suffer needless fatigue. They tend to have trouble concentrating later in the morning, and they work or study less efficiently. They can easily overeat at night and gain undesired body fat. Clearly, breakfast is a very important meal of the day!

If you are a breakfast skipper and routinely miss this energizing meal, try this experiment: Eat breakfast for three consecutive days and observe the benefits: more energy, less hunger, better nutrition. You’ll quickly discover breakfast is a key meal for champions!

Here are solutions to some breakfast barriers:

I don’t have time

You really do have time to do what you want to do. If you can make time to exercise, you can also make time to enhance your exercise program by appropriately fueling your muscles. You’ll discover:

you can think, work, and recover better if you eat breakfast within an hour of your morning workout.
you’ll have much more energy during an afternoon workout if you have eaten a substantial breakfast.

If you won’t eat breakfast at home, then simply eat breakfast on the run: a bagful of raisins and granola at the bus stop, a bagel with peanut butter on the way to school, or a yogurt and almonds at work. You don’t have to eat breakfast immediately upon getting out of bed. Your morning break can be more than just coffee!

I’m not hungry in the morning

Most often, athletes who lack a morning appetite ate their breakfast at bedtime, the night before. Too many evening snacks can easily ruin your morning appetite and also contribute to weight gain (if you overeat), dietary deficiencies (if you displace healthful breakfasts with “junk food” for snacks) and muscle fatigue (if you eat high-fat evening snacks—such as chips, chicken wings, ice cream—that inadequately refuel your muscles). Plan to rearrange your meal pattern so you eat a heartier breakfast, fewer evening snacks—and wake up hungry.

I’m on a diet

The most successful diets start with a substantial breakfast and end with a lighter dinner. A wholesome, carb-protein breakfast both fuels and builds your muscles and also prevents you from getting too hungry. When too hungry, you are less likely to care about what you eat and more likely to indulge in sweets and treats. Research suggests athletes who under-eat during the day have more body fat than those who eat adequately during their waking hours. Remember: You are going to eat the calories eventually; you might as well enjoy them in the morning in the form of quality food that keeps you feeling well-fed.

What’s best to eat?

Any breakfast is better than no breakfast, but some choices are better than others for your sports diet. You can easily boost your energy with some of these breakfast foods that fuel your muscles and your brain: oatmeal, whole grain cereal, whole-grain waffles, French toast, bagel, English muffin, banana bread, grits, fruit, juice, or whatever carbohydrate-based foods that might be readily available. Add some protein to build and repair muscles: eggs, cottage cheese, yogurt, cheese, nuts, and peanut butter.

One quick and easy “breakfast of champions” is iron-enriched cereal with lowfat milk, banana, and orange juice. This simple meal provides important nutrients that support your athletic program:

Carbohydrates: the best source of muscle fuel. Carbs should be the foundation of every sports-meal. A breakfast with whole-grain cereal, milk, fruit, and juice is an easy way to help meet that goal!
Iron: a mineral important for carrying oxygen from the lungs to your working muscles. An iron-rich diet reduces your risk of becoming anemic and experiencing needless fatigue during exercise. By enjoying orange juice along with iron-enriched cereals, you can absorb more iron. Note: the “all natural” cereals such as granola or Kashi, have no additives, hence no iron added. Combine them with enriched brands.
Calcium: from milk or yogurt eaten with the cereal. Calcium is important for strong bones, as well as for helping muscles contract properly.
Potassium: a mineral (electrolyte) lost in sweat. Bananas, OJ, whole grain cereals are potassium-rich.
Fiber: to promote regular bowel movements and reduce the risk of unwanted pit stops during exercise. If plagued by constipation, select raisin bran, bran flakes, All-Bran, or any type of bran cereal. If diarrhea is a problem, reduce fiber intake!

Summary

A carbohydrate-based breakfast that also includes some protein is a critical energy booster that helps athletes fuel and repair their muscles. Without this morning meal, you are likely to run on fumes, perform less effectively, and reduce your intake of nutrients that contribute to health and top performance. Try these meals for a high energy day:

Bran cereal, banana, chopped almonds, and lowfat milk.
Whole wheat bagel with peanut butter, and a latte.
French toast, ham, orange juice, and Greek yogurt.
Greek yogurt with granola, almonds, and berries.

Reprinted with permission from Nancy Clark.

Nancy Clark, MS, RD, CSSD (Board Certified Specialist in Sports Dietetics) counsels both casual and competitive athletes at her office in Newton, MA (617-795-1875). Her best selling Sports Nutrition Guidebook and food guides for marathoners, cyclists and soccer players offer additional information. They are available at www.NancyClarkRD.com. For her popular online workshop, see www.NutritionSportsExerciseCEUs.com.

Eating for Endurance

Nancy Clark, RD/26 March 2018/ All MFN blog/

What’s the best way to fuel for the Boston Marathon?

Should I eat a high fat diet to train my body to burn more fat and less glucose?

What percent of calories should come from carbohydrate? protein? fat?

When it comes to eating for endurance, today’s athletes are confronted with two opposing views:

Eat a traditional carbohydrate-based sports diet, or
Eat a fat-based diet that severely limits carbohydrate intake.

What should an eager marathoner, Ironman triathlete, or other endurance athlete eat to perform better? Here’s what you want to know about eating for endurance, based on the Joint Position Statement on Nutrition for Athletic Performance from the American College of Sports Medicine, the Academy of Nutrition and Dietietics, and Dietitians of Canada.

1. Eat enough calories.

Most athletes need ~21 calories per pound (45 cal/kg) of lean body mass (LBM). That means, if you weigh 150 pounds and have 10% body fat, your LBM is 135 pounds and you require about 2,800 calories a day. That said, energy needs vary from person to person, depending on how fidgety you are, how much you sit in front of a computer, how much muscle you have, etc.. Hence, your body is actually your best calorie counter—more accurate than any formula or app!

If you are eat intuitively—that is, you eat when you feel hunger and stop when feel content, you are likely eating enough. If you find yourself stopping eating just because you think you should, if you are feeling hungry all the time and are losing weight, you want to eat larger portions. Underfueling is a needless way to hurt your performance.

If you can’t tell when enough food is enough, wait 10 to 20 minutes after eating and then, mindfully ask yourself “Does my body need more fuel?” Athletes who routinely stop eating just because they have finished their packet of oatmeal (or other pre-portioned allotment) can easily be under-fueled. Even dieting athletes want to surround their workouts with fuel. Their plan should be to eat enough during the day to fuel-up and refule from workouts, and then eat just a little bit less at the end of the day, to lose weight when they are sleeping.

2. Eat enough carbohydrates.

According to the Position Statement on Nutrition for Athletic Performance, the optimal amount of carbohydrate on a day with one hour of training is 5 to 7 grams carb/kg. On high volume days, you need about 6 to 12 g carb/kg body weight. For a 150-pound (68 kg) athlete, this comes to about 350 to 800 grams carb a day—the equivalent of about one to two (1-lb) boxes of uncooked pasta (1,400 to 3,200 calories). That’s more than many of today’s (carb-phobic) athletes consume. You want to make grains the foundation of each meal : choose more oatmeal for breakfast; more sandwiches at lunch; and more rice at dinner to get three times more calories from carbs than from protein. Otherwise, you set the stage for needless fatigue.

3. Eat adequate—but not excess—protein.

Protein needs for athletes range from 1.4 g/kg (for mature athletes) to 2.0 g protein/kg (for athletes building muscle or dieting to lose fat). For a 150-pound (68 kg) athlete, protein needs come to about 95 to 135 grams protein per day, or 25 to 35 grams protein four times a day. That means 3 eggs at breakfast (with the bowl of oatmeal), a hearty sandwich at lunch, portion of lean meat/fish/chicken at dinner, and cottage cheese (with fruit) for an afternoon or bedtime snack.

For vegetarians, generous servings of beans, hummus, nuts and tofu at every meal can do the job; a light sprinkling of beans on a lunchtime salad will not. By consuming protein every 3 to 5 hours, you will optimize muscle building and deter muscle breakdown.

4. Fill in the calorie-gap with fat.

Include in each meal and snack some health-promoting, anti-inflammatory fat: nuts, salmon, peanut butter, avocado, olive oil, etc.. Fat adds flavor, offers satiety, and is a source of fuel for endurance exercise. Training your muscles to burn more fat for fuel happens when you do long, steady “fat burning” exercise. By burning more fat, you burn less of the limited carbohydrate (muscle glycogen, blood glucose) stores. You will have greater endurance and avoid or delay hitting the wall.

A (tougher) way to train your body to burn more fat is to severely limit your carbohydrate intake and push your fat intake to 70% of your calories. That could be 1,800 calories (185 g) of fat per day. This very high fat diet produces ketones and forces the body to burn ketones for fuel. Keto-athletes endure a tough, 3 to 4 week adaptation period as their bodies transition to burning fat, not glucose, for fuel. While some keto-athletes rave about how great they feel when in ketosis, the sports nutrition literature, to date, reports little or no performance benefits from a ketogenic sports diet. It might nix sugar binges, but it’s unlikely to make you a better athlete.

5. Drink enough fluids.

A simple way to determine if you are drinking enough fluid is to monitor your urine. You should be voiding dilute, light colored urine every 2 to 4 hours. (Exception: athletes who take vitamin supplements tend to have dark colored urine.) You want to learn your sweat rate, so you can strategize how to prevent dehydration. Weigh yourself nude before and after one hour of race-pace exercise, during which you drink nothing. A one-pound drop pre- to post-exercise equates to 16 ounces of sweat loss. Losing two pounds of sweat in an hour equates to 32 ounces (1 quart). To prevent that loss, you should target drinking 8 ounces of water or sports drink every 15 minutes. Athletes who pre-plan their fluid intake tend to hydrate better than those who “wing it.”

**6. Consume enough calories during extended exercise.**

If you will be exercising for longer than 60 to 90 minutes, you want to target 40 to 80 calories (10 to 20 g) of carbohydrate every 20 minutes (120 to 240 calories per hour), starting after the first hour (which gets fueled by your pre-exercise food). If you are an Ironman triathlete, long distance cyclist or ultra-athlete who exercises for more than three hours, you want to target up to 360 calories per hour. The key is to practice event-day fueling during the months that lead up to the event. By training your gut to tolerate the fuel, you’ll be able to enjoy the event without fretting about running out of energy.

The bottom line:

If you are going to train, you might as well get the most out of your workouts. Performance improves with a good fueling plan. Eat wisely and enjoy your high energy!

Reference:

Thomas, T at el. Position of the Academy of Nutrition and Dietetics, Dietitians of Canada and the American College of Sports Medicine: Nutrition and Athletic Performance. J Academy of Nutri and Dietetics. 2016; 116 (3):501-28

How To Gain Weight Healthfully

Nancy Clark, RD/1 March 2018/ All MFN blog/

“No matter what I eat, I can’t seem to gain weight…”

“What about those weight gain powders … do they work?”

“How much more protein should I eat to help me bulk up?”

Although two-thirds of Americans are overweight or obese, a handful of skinny people—including many athletes—feel very frustrated by their seeming inability to gain weight. Their struggle to bulk up is on par with that of over-fat folks who work hard to lose weight. Add in rigorous training for a marathon, soccer team, or other sport, and scrawny athletes can feel at a disadvantage, fearing that no matter how much they eat, they’ll get even skinnier.

Clearly, genetics plays a powerful role in why some athletes have so much trouble not only gaining weight, but also maintaining any weight they manage to add. “Hard gainers” tend to be fidgety. They rarely sit, to say nothing of sit still. They are constantly puttering around, or when sitting, they are tapping their fingers, swinging their legs, twirling their hair, and shifting around in the chair. All of these activities burn calories that commonly end up in the midriff of calmer people who can sit motionless for hours.

If you are a hard gainer, you might have been told that consuming an extra 500 to 1,000 calories per day will lead to gaining 1 to 2 pounds per week. Unfortunately, Nature often confounds this mathematical approach. For example, in a weight gain study where the subjects were overfed by 1,000 calories per day for 100 days, some subjects gained only 9 pounds, whereas others gained 29 pounds (1).

How could that be? The answer likely relates to Non-Exercise Activity Thermogenesis (N.E.A.T.), the technical term for spontaneous movements that naturally occur in fidgety people. When you overfeed a fidgety person, they can become even more active, as if Nature wants them to burn off those calories.

Seven Tips to Gain Weight Healthfully

Fret not; even very lean people can gain some weight when they systematically enhance their diet. Although they cannot change their genetics and their tendency to fidget, they can boost their calorie intake. If you are a scrawny athlete, have a teenage eating-machine who wants to weigh more, or are trying to bulk up for football, here are some tips to help you gain weight healthfully.

1. Eat consistently. Do NOT skip meals; doing so means you’ll miss out on important calories needed to reach your goal. Every day, enjoy a breakfast, an early lunch, a later lunch, dinner, and a bedtime meal. This might mean breakfast at 7:00, lunch at 11:00, second lunch at 3:00, dinner at 7:00, and a protein-rich bedtime snack at 10:00.

2. Eat larger than normal portions. Instead of having one sandwich for lunch, have two. Enjoy a taller glass of milk, bigger bowl of cereal, and larger piece of fruit.

3. Select higher calorie foods. Read food labels to discover which wholesome foods offer more calories. For example, cranapple juice has more calories than orange juice (170 vs. 110 calories per 8 ounces); granola has more calories than Cheerios (500 vs. 100 calories per cup); corn more calories than green beans (140 vs. 40 calories per cup).

4. Drink lots of 100% fruit juice and low-fat (chocolate) milk. Instead of quenching your thirst with water, choose calorie-containing fluids. By having milk with each meal, you can easily add 300 to 600 wholesome calories a day. One high school soccer player gained 13 pounds over the summer by simply quenching his thirst with six glasses of cranapple juice instead of water (1,000 vs. 0 calories). He consumed the fluid he needed (juice is 98% water) and bonus of more carbohydrates to refuel his depleted muscles, plus a good dose of vitamin C to enhance healing.

5. Enjoy peanut butter, nuts, avocado, and olive oil. These foods are high in (health-promoting) fats. They’re a positive addition to your sports diet; they help knock down inflammation. Their high fat content means they’re calorie-dense. To boost good fats, add almonds to cereal & salads, spread extra peanut butter on the PB&J sandwich, dive into the guacamole with baked chips, and add extra olive oil dressing to your salads. That’s an easy extra 500+ calories/day.

6. Do strengthening exercise as well as some cardio. Weight lifting and push-ups stimulate muscle growth so that you bulk-up instead of fatten up. Plus, exercise stimulates your appetite and, sooner or later, you’ll want to eat more. Exercise also increases thirst, so you will want to drink extra juices and caloric fluids.

Take note: You will not build bigger muscles by eating extra protein. While you want to target a protein-rich food with 20-30 grams protein at each meal (and 10-15/snack), having more will not build bigger muscles. Resistance exercise builds muscles. To have the energy to do the muscle-building training, you need extra carbs. That’s where drinking more 100% fruit juice and chocolate milk offer benefits; you’ll be better-fueled & better able to lift heavier weights.

7. Don’t bother to buy expensive weight gain drinks. A hefty PB&J with a tall glass of chocolate milk adds about 1,000 calories for about $2.00. You would spend at least $10 get-ting those calories from Muscle Milk.

Conclusion: By following these tips, you should see progress, but honor your genetics. Most people do gain weight with age as they become less active, more mellow, and have more time to eat. Granted, that information doesn’t help you today, but it offers optimism (or a warning) for your future physique!

References:

1) Bouchard, C. 1990. Heredity and the path to overweight and obesity. Med Sci Sports Exerc 23(3):285-291.

Sugar is Evil(1)

Sugar is OK for People Who Are Fit(2)

Concluding comments(3)