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Eating for Endurance

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!


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.

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

running-beach

Proven and Tested Tips to Run Safely with Diabetes

According to statistics, in 2014, 8.5% of adults above 18 years old had diabetes. Sadly, the disease is also affecting the youths below the age of 20. Basically, what this means is the chances of getting the disease are becoming higher for everyone. Eating healthy and maintaining a good exercise routine are often thought of as preventive measures but the truth is they can work wonders even if you have been diagnosed.

In this article, we will discuss some simple tips on how you can run safely with diabetes.  There is no reason for you to quit running just because you have the condition. In fact, being able to lose weight with running can contribute to your general health.

You simply have to take a few more things into consideration before you hit the road. First off, you need to understand the needs of your body depending on the type of diabetes you have.

Running With Type 1 Diabetes

Type 1 diabetes is basically when the pancreas does not produce enough insulin and the sufferer requires daily insulin injections. The condition is not curable and symptoms include excessive urine, constant hunger, thirst, weight loss, and fatigue.

Those suffering from type 1 diabetes face the risk of getting fatigued after extended periods of running. You will need to constantly monitor your sugar levels during the run and make sure they stay normal. This is one of the most important steps you ought to take: understand how your body reacts to exercise and fueling.

Once you understand your body’s reaction, you may opt to use a GU energy gel after every 15 minutes to fuel their runs. However, before making any decisions, consult your physician and get their advice first. When it comes to fueling, runners generally require 30-60 grams of carbohydrates every hour but this depends on your insulin levels.

Preventing Low Insulin Levels

Type 1 diabetes sufferers need to always remember that the blood glucose response to exercise will vary depending on these factors:

  • The level of your blood sugar before the run
  • The intensity or duration of the run
  • The changes in your insulin intake

Basically, through trial and error, you will be able to come up with a system of insulin intake and fueling that works for you.

Running With Type 2 Diabetes

Type 2 diabetes is the most common type of diabetes and happens when your body does not properly use insulin-making your body “insulin resistant”.  Initially, your pancreas produces extra insulin but in time it isn’t enough to keep your sugar levels normal.

The symptoms are very similar to Type 1 diabetes and include weight loss, increased thirst, and frequent urination, fatigue, blurred vision and slow healing sores.

The benefit of running even with diabetes Type 2 is that, your muscles use glucose during exercise which means your glucose levels go down. There are also many long-term benefits of running with Type 2 diabetes such as lowered risk of heart problems.

Like Type 1 diabetes, you will need to constantly monitor your blood glucose levels during exercise and fuel accordingly. The same suggestions provided for Type 1 Diabetes can be applied to Type 2 diabetes.

General Tips for Running with Diabetes

Whichever Type of diabetes you are diagnosed with, there are some general rules you can follow to make sure you are safe during your runs. Of course, consulting your physician should always be on top of the list, after you do this, remember these five tips:

1.  Ease into running

This is true even if you have been running for a long time in the past. Remember that your body is different now and you need to understand it all over again. Instead of running a sprint immediately, gradually ease into it. Try walking for an hour, then upgrade to a brisk walk, then combine walking and jogging and finally try a short run.

2. Engage in Strength Training Exercises

According to one study, increased muscle mass attained as a result of strength training can contribute to blood glucose absorption thereby lowering the levels in the blood. This, in turn, can increase insulin sensitivity. You don’t have to go to the gym to lift weights but even workouts such as squats, push-ups, and lunges that use your own body weight can be done at home.

3. Have a Running Buddy

This is another great aid to running with diabetes safely. Find a running buddy who knows your condition and knows what to do if your blood sugar gets too low. Another option is to carry an identification tag with you that says that you have diabetes.

4. Wear the right footwear

Although this applies to everyone who runs, it is more serious if you have diabetes. Wearing the wrong kind of footwear could lead to getting foot ulcers. With diabetes, even the slightest blister could take a long time to heal and lead to many more complications such as gangrene.

When purchasing footwear, take into consideration the shape of your foot and whether you have foot deformities such as bunions. If you do have any kind of foot deformity, you might need special inserts or specially made therapeutic shoes.

5.  Keep yourself hydrated

A lack of water can greatly affect blood sugar levels so before you run, make sure you are fully hydrated and continue to hydrate during your run.

Conclusion

Running with diabetes is possible. You just have a checklist that is a little longer and a body that has different needs. Don’t let diabetes be the end of your running career! Remember that there are thousands of runners who continue to run marathons with the condition and you can do the same.


Amber Irwin is a running and sports writer; she loves to share her passion with fellow outdoor lovers. Amber believes running is an amazing sport for everyone and hopes to inspire others. Visit her website, everyfirststep.com

References

http://www.who.int/mediacentre/factsheets/fs312/en/

http://www.diabetes.org/diabetes-basics/statistics/

https://www.mayoclinic.org/diseases-conditions/type-1-diabetes/symptoms-causes/syc-20353011

http://www.diabetes.org/diabetes-basics/type-2/

https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc-20351193

https://www.endocrineweb.com/conditions/type-2-diabetes/type-2-diabetes-exercise

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2992225/

Health

Full Transparency in the Health and Wellness Industry

Ari Gronich, MFN Industry Expert and owner of Achieve Health USA, was recently interviewed by the In the Clear Podcast, with host Justin Recla, to discuss full transparency in the health and wellness industry. Ari is The Performance Therapist and brings experience working with Olympic, Paralympic, professional, and amateur athletes for almost 20 years. He has over 25,000 hours of hands on work and 5000 plus hours of training and internship. Listen in to hear him talk about what transparency in health and wellness looks like.

 

You can find the full transcript on Ari’s website, achievehealthusa.com 

Posted with permission from Ari Gronich.


Ari Gronich is highly trained and certified in many disciplines within the fields of bodywork, emotional release, energy work, nutrition, sports hypnotherapy, health, and kinesiology and sports therapy. For the last 17 years, he has helped transform his clients’ bodies and lives through increased performance, thus enhancing physical, mental, and emotional health. To work with Ari, or for a Consultation Appointment you can email PerformanceTherapist@gmail.com or call 310-363-0FIT (0348). Visit his website, PerformanceTherapist.com

senior man having a massage in a spa center

What is an Allied Healthcare Professional?

Whether it’s exercise, nutrition, or massage therapy you are seeking, finding the right person to do the job can be incredibly challenging. The area known as allied healthcare professionals can be a challenging one to navigate.

The professions that require a state or national licensures, such as physicians, nurses, or physical therapists, help to provide checks and balances on who should and should not be providing a service to any individual. However, there are many professions within our healthcare community that are poorly understood and many times misrepresented by individuals with minimal certifications or credentials.

Allied healthcare professionals are thought to make up roughly 60% of the healthcare workforce by providing a range of diagnstic, technical, therapeutic and direct patient care and support services that are critical to the other health professionals they work with and the patients they serve. All categories of allied healthcare require either registration by law to practice or post secondary degree or higher education. Click here for more information about allied healthcare professions.

Is it time to re-assess who you trust with your healthcare needs?

It is essential to know the credentials and education of anyone you are trusting for information or advice whether it be an accountant, lawyer, dentist or teacher. Healthcare is no different, but there are many misunderstood healthcare professions.

Distinct from nursing, dentistry or medicine, allied healthcare professionals make up approximately 60% of the health workforce. Examples include athletic trainer, exercise physiologist, paramedic, and massage therapist. Many times, these professionals are those you are referred to by your physicians to help manage your healthcare needs daily, weekly, and monthly. National and state licensures ensure that certain healthcare professionals uphold the standards and scope of pratice that is pertinent to their level of education.

senior man having a massage in a spa centerMultiple allied professions remain to establish this key aspect of standardized care which simply means that certain professions are more susceptible to individuals claiming a level of expertise or knowledge that can be misleading or confusing to the general population. For example, as a Clinical Exercise Physiologist, I clearly understand the difference between my skillset and that of a personal trainer; however, to the general public, both professions provide guidance with exercise. Due to lack of established licensure exams, it is unclear to many people that some Exercise Physiologists (like myself) have a Master’s Degree, while others may have earned a weekend certification. It is incredibly important for you to understand the roll of any healthcare professional from which you seek treatment and advice as well as their experience and background in relation to your particular healthcare needs. Accessing information about these resources from a knowledgeable professional can help to ensure proper connection to an individual that is appropriately educated to effectively meet your needs.


Jaclyn Chadbourne, MA, CES has worked within the allied health profession as a Clinical Exercise Physiologist for 15 years.  She is currently the Director of Research and Development at Universal Medical Technology, and serves as Adjunct Faculty at University of New England DPT Program

senior-and-trainer

Tips for Exercising With Multiple Sclerosis

Exercise and stretching are very important for someone who has Multiple Sclerosis. Each individual, however, is different and exercises need to be tailored specifically to that person. The exercises that are chosen depend on the progression of the disease, what the individual is capable of doing, and even the day. Exercises may have to be changed if the client is too tired or is feeling stronger and has more energy.

What exactly causes Multiple Sclerosis is not known but there are symptoms to look out for. The symptoms are fatigue, walking difficulties, vision problems, spasticity or stiffness, weakness, bladder problems, depression, dizziness or vertigo, emotional changes, cognitive changes, pain, headaches, tremors and breathing problems. Exercise prescriptions need to be planned according to the symptoms that are being presented. Each time you work with your trainer talk to them about how you feel that day. This will help to ensure that you don’t overdo a workout.

Many times, we hear the saying no pain, no gain. Please keep in mind that this is not true for individuals with Multiple Sclerosis. You want the workout to feel challenging but it is important not to overheat. If you feel warm, simply take a break and continue when you feel that you have cooled down. Individuals in wheelchairs benefit from exercise as well. I would like to share an example of a client of mine.

My client, Sally, (the name has been changed) was a client of mine for 4 years. She is in a wheelchair and had no leg movement and minimal arm movement. Through exercise she is almost able to feed herself and I have her doing simple leg movements. I cannot see any leg movement but she can feel it. She reports that her muscles are sore when we are finished. The important thing is to just move.

It is important to start an exercise program slowly and to set goals. If you would like to get to 20 minutes of activity maybe start with 10. Do not assess how well you are doing by comparing yourself to others. Look for progress in yourself through reaching personal goals as in the example of my client.

As an individual with Multiple Sclerosis starts exercising they may have less depression, improved strength, better bladder and bowel function, a positive attitude and be better able to participate in social activities. Please remember that it is important to share any symptom changes with your trainer. The exercises may have to be adjusted frequently for a safe and effective workout.


Robyn Caruso is the Founder of The Stress Management Institute for Health and Fitness Professionals. She has 15 years of experience in medical based fitness.

Sources
http://www.nationalmssociety.org/Living-Well-With-MS/Health-Wellness/Exercise
http://www.webmd.com/multiple-sclerosis/guide/multiple-sclerosis-symptoms-types

young attractive doctor and patient

Nutrition for Cancer

Prepare for Treatment

Did you know that by adjusting your nutrition you can feel better and stay stronger during cancer treatment? Both the cancer and the cancer treatment can affect your appetite, your ability to tolerate foods, and your body’s ability to utilize nutrients. By having a dietitian or nutritionist on your treatment team, you’ll be better prepared to cope with side effects and meet your nutrition needs during this difficult time.

Weight Management

young attractive doctor and patientSome cancer treatments can lead to weight loss while others can lead to weight gain. Weight loss may be due to a loss of appetite and/or an inability to tolerate food, while weight gain may be related to fluid retention, increased appetite and/or decreased physical activity. If cancer treatment is making it difficult for you to manage your weight, ask an dietitian or nutritionist to join your treatment team. You won’t regret it!

Complementary and Alternative Treatments

Many herbs and other supplements are marketed to people who are going through cancer treatment. Always talk to your oncologist before adding any herbs or supplements to your treatment regimen. Some herbs and supplements can cause harmful side effects and interfere with proven cancer treatments such as chemo and radiation.

For a detailed description of herbs and supplements and any evidence supporting their effectiveness and safety, visit nccam.nih.gov/health/atoz.htm. Your oncologist and a dietitian/nutritionist can help you sort through this information and make an informed decision about whether or not take any herbs or other supplements.


Kristy Richardson is a dietitian and exercise physiologist, specializing in sports nutrition and weight management, She is the founder of OC Nutrition and also works as a nutrition professor at Fullerton College.

References

American Cancer Society (2012). Nutrition for the Person with Cancer During Treatment: A Guide for Patients and Families. Retrieved November 4, 2013, http://www.cancer.org/acs/groups/cid/documents/webcontent/002903-pdf.pdf.

Sports pregnant young woman. Fitness.

Exercise & Pregnancy

Beautiful pregnant woman gym fitness exerciseThe understandable fear (due to things like decreased oxygen supply to the baby) that existed with pregnancy & exercise years ago is no longer warranted.  Because of substantial research, it is now safe for women to continue or start exercising while pregnant.  As long as she gets approval from her doctor & seeks out a qualified and certified fitness professional, she should be confident in knowing that the recommendations below will help her.

Considerations & Exercise Suggestions

1. Posture Change from the Growth of the Baby: As a result of the baby growing in the wound, the mother to be’s posture will change. This causes certain muscles to become weak, particularly her core. In the 1st and 2nd trimester, a mother to be should focus on strengthening her core through exercises such as planks, bridges, and birddogs. Once the 3rd trimester hits, it would be wise for the mother to be to avoid supine or prone core exercises. She can still work her core by doing standing exercises such as medicine ball chops, reverse chops & rotations. All of these exercises can be performed 2-3 days/week, 1-2 sets of 12-15 reps with appropriate rest time (45-90 seconds) between sets.

2. Cardiovascular Exercise: With the growth of the fetus, also comes more stress to the mother to be’s heart and lungs. As a result, her ability to work harder and longer is decreased. However, a mother to be can still perform low impact or step aerobics that do not involve jarring motions. Walking on the treadmill, stationary cycling and water aerobics done 3-5 days/week for 15-30 minutes is suggested.

3. Flexibility Exercise: Because the mother to be’s body posture has changed, this may cause certain muscles to overwork or become tight. As a result, she may feel the need to stretch certain muscles. This is ok to do so. Static and active stretches are advised along with foam rolling that can be tolerated. However, foam rolling on varicose veins or swollen muscles should not be done. I would advise stretching muscles that appear to be overworking such as her calves and lower back. This can be done everyday for 1-2 sets, holding each stretch for 30-60 seconds.

Pregnant woman holding dumbbells4. Weight Training Exercise: Circuiting training has shown to be very effective for mother’s to be throughout their entire pregnancy. These include exercises that work the entire body and can be performed back to back with little rest in between.  I recommend exercises that work the following muscles: legs, chest, back, shoulders and arms. They can be done 2-3 days/week, 1-2 sets of 12-15 reps. The rest period can be in between 45-75 seconds.

5. Cautions: Mothers to be should stop or avoid exercises that cause nausea, dizziness, stomach pain, prolonged shortness of breath, bleeding and fainting.

Conclusion

By taking the appropriate precautions, mothers to be can safely exercise during pregnancy. As a result, the pregnancy can be smoother and the recovery can be quicker.

Helpful links for exercises

http://blog.nasm.org/fitness/exercise-pregnancy-physiological-changes-exercise-programming/
http://www.fitpregnancy.com/exercise/prenatal-workouts/weight-training-pregnancy


Maurice D. Williams is a personal trainer and owner of Move Well Fitness in Bethesda, MD.

Source
Clark, Sutton, Lucett. NASM Essentials of Personal Fitness Training, 4th Ed. Revised. 2014

 

 

happy-feet

Footnotes: Your Amazing Feet and How to Keep Them Healthy

It’s pretty amazing that we all don’t suffer with achy feet. Leonardo Da Vinci, artist and engineer, said that “the human foot is a masterpiece of engineering and a work of art”. According to The American Academy of Orthopedic Surgeons, each foot has approximately 100 working parts including 26 bones and 33 joints. Twenty-five percent of all the bones in your skeleton reside in your feet, and they work hard. One mile of walking places over 60 tons of stress on each foot. The average person walks approximately 1000 miles per year. Serious runners often log 30 miles per week pounding their feet with forces 3 to 5 times body weight, absorbing 110 tons per foot, for each mile they run. It’s no wonder that 20% of all musculoskeletal related office visits involve the foot and ankle area. Foot problems cost the U.S. approximately 3.5 billion dollars a year. Perhaps Leonardo should have also warned us that artistic and durable do not often go together.

Interestingly, it’s not just the pounding that gets your feet into trouble — it’s often the shoes. Hard to believe but a significant number of individuals are wearing the wrong size shoes. This is in part because most of us do not realize that your shoe size actually changes as an adult. Even though the bones in your feet stop growing in your teens, your feet still expand with age. Your arch drops, leading to a lengthening of your foot and the ligaments weaken resulting in widening or “splaying” especially in the forefoot area. The overall result is a longer, wider foot and the need for shoes or sneakers one or two sizes bigger and with a wider toe box area. Women are particularly susceptible, and I’m not just talking about Sex and the City’s Carrie and her infamous Manolo’s. Most of their lives, they have jammed their poor feet into tight narrow high heeled shoes, almost the modern versions of foot “binding” popularized in China where women’s’ feet were tightly wrapped to keep their feet small and aesthetically pleasing. It’s no wonder that over 70% of women complain of foot pain. One study found that women stopped on the street were much more likely to be in a shoe too tight, than their correct size. This leads to many painful foot conditions like bunions, corns, calluses, neuromas (pinched nerve) and more. I recall a sweet older patient who came into my office and when asked how I could help her, she took off her shoes, pointed to her feet and said “these dogs are barkin”. Of course her shoes were two sizes too small.

Fashion is part of the problem, especially with kids who will often sacrifice proper fit to get a pair that is cool. Also, with the rapid growth spurts, even a shoe that fits well one month may not the next. Parents need to check often. Also, for both kids and especially adult shoewear, cost does not always equate with comfort.

Marketing drives much of what kids and adults want in terms of shoewear. Nike still wants you to be like Mike (Air Jordans started in 1985 and still going srtong!). And in a 1993 basketball sneaker commercial, Charles Barkley was perhaps the most honest when he said “These are my new shoes. They’re good shoes. They won’t make you rich like me, they definitely won’t make you handsome like me. They’ll only make you have shoes like me. That’s it.”

The influence starts quite early. I remember when my daughter’s Barbie Doll had such high fashion (i.e. high heeled, too tight) shoes that I hoped for her sake that Ken was studying to be a podiatrist.

So how do you keep your feet happy and healthy?

Learn to listen to them. If they are “barkin”, first be sure you are in the right footwear. Also, follow these tips:

  • Get both feet measured every time you buy shoes.
  • Shop at the end of the day when your feet tend to be their largest (swelling etc).
  • Be sure there’s plenty of room in the toe box area. Toes should wiggle freely not feel pressured or cramped. There should also be a thumb’s width space between the tip of the toes (especially the longest one) and the end of the shoe.
  • Ladies, try tracing your foot on a piece of paper. Next, place one of your “high fashion” shoes over the tracing. It should be pretty clear why your feet hurt.
  • Never think that you can “break-in” a shoe. The shoe always wins that battle.
  • Always wear the correct footwear designed for your specific sport or activity. All sneaks are not created equal!
  • A good shoemaker can help with minor pressure or hot spots, or a heel area that’s too loose. Remember, I said minor not major adjustments.
  • For more tips, check www.orthoinfo.org and click on the foot icon on the skeleton.

If symptoms persist, see an orthopedic surgeon or podiatrist who can help you better understand and resolve your foot problem and also assure that there is not other medical issues going on since systemic conditions (like diabetes and rheumatoid arthritis) can begin with foot related issues. Also, foot pain can be referred from other areas like a pinched nerve in your lower back. Get things checked!

Over the years many have philosophized about the foot. I suspect that it started with their own achy feet. A classic orthopedic surgery textbook about the foot (by Melvin Jahss) notes that “the foot is often neglected unless it is your own; it then becomes the pedestal on which the rest of you stands”. My mother even had a view – “You can’t cheat your feet.” Abraham Lincoln suggested that “a man only needs to be so tall that his feet reach the ground”. Along that line, Oprah Winfrey remarked, “I still have my feet on the ground, I just wear better shoes”. Hopefully they’re the right size.

So, be kind to your feet-use them, but don’t abuse them. It’s hard to keep a smile when your feet are frowning.

Originally published on the Huffington Post. Reprinted with permission from Dr. DiNubile.


Nicholas DiNubile, MD is an Orthopedic Surgeon, Sports Medicine Doc, Team Physician & Best Selling Author. He is dedicated to keeping you healthy in body, mind & spirit. Follow him MD on Twitter: twitter.com/drnickUSA

balanced-diet

How To Gain Weight Healthfully

“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!


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

References:

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