The rallying cry is, “Let’s change healthcare!” From all corners of the medical universe, there is agreement that change is necessary. The biggest questions are, “What is the change?” and, “Who will make it happen?”
It is well recognized that the population of individuals over the age of 65 in the United States is expanding. With age, comes natural and expected physiologic deficits in the musculoskeletal system that affect the pursuit of exercise and fitness.
Over the past 18 months, I have seen my primary M.D. three times, enjoyed the services of my favorite massage therapist six times, visited my chiropractor nine times, chatted with a local R.D. twice and seen my personal trainer regularly. And not one of them even asked if I was seeing any of the others, much less inquiring what their treatments or approaches to treatments might be. To me, that is like trying to achieve success with a baseball team where the 1st base coach, 2nd base coach, 3rd base coach and pitching coach never communicate with each other.
Success cannot occur in a vacuum, neither can true individual health & wellness, yet for decades these medical, fitness & wellness providers have proffered their services in distinct and distinctly separate spaces.
Even as the internet has made access to information easier and facilitated the sharing of knowledge, including private, HIPAA compliant information, these providers continue to operate in “informational silos.”
It is true that in the past some of these providers may have held less than favorable opinions of some of the other providers, but that is, and certainly should be, a thing of the past. No longer will M.D.’s consider Chiropractors “quacks”, R.D.’s claim nutritionists “just don’t know enough”, and Physical Therapists think of Personal Trainers as ”wanna-be P.T.’s who couldn’t hack the education.” Science, knowledge and time have evolved all these disciplines into valuable, useful and incredibly beneficial specialties, each offering specific training and specific methods to apply to their patients/clients. And all those patients/clients typically can benefit from their combined expertise and knowledge.
No longer is it sufficient to simply treat the symptoms. Real wellness needs to encompass the patient/client holistically… address the symptoms, understand the cause, strengthen the mind, examine the diet, resolve the issue and prevent future occurrences. And isn’t that best accomplished by viewing patient/client wellness as a Team Sport?
Over the years I have had the pleasure of knowing and speaking at length with many of these medical, fitness & wellness providers, and not one of them indicated there is anything in their training that says “Thou Shalt Not Collaborate.”
We are not talking about “asking for help.” Rather we are simply saying to include those other practitioners in the conversation. Instead of the M.D. telling the patient to “walk more to improve cardio health”, why not conference call with the Personal Trainer and discuss the walking program that is most appropriate. Let the Physical Therapist inform the Personal Trainer of any specific issues to address or avoid. Allow the Massage Therapist to work with the Chiropractor to ensure optimum results from both. In other words, (and the simplicity of all this may surprise you), just TALK TO EACH OTHER.
So, let’s start to make that happen. For more than 20 years my company has helped health clubs and fitness centers create mutually beneficial relationships with Physical Therapy practices, Chiropractic offices, Registered Dietitians, Nutritionists and Massage Therapists. Now is the time to extend the conversation, and, to return to my baseball metaphor, get ALL the coaches working together to create truly Championship results.
Join Cosmo for his upcoming MedFit webinar on this topic:
Cosmo Wollan is the Senior Executive at Synergy Cubed, a premiere consulting firm providing customized solutions to the health & fitness, parks & recreation, medical fitness and corporate wellness industries since 1994. His Fitness Industry clients have engaged him as an expert problem-solver in profit center development, retention strategies, customer engagement, sales training, programming design, operational streamlining and health club management.
Have you ever wondered why a particular diet, workout routine or cleanse offers remarkable results for some people, but not others?
It’s because of bio-individuality and Metabolic Chaos®.
When it comes to health, there is no one size fits all! Each person is unique on a cellular and metabolic level. They have their own health strengths and weaknesses, or vital voids as Reed Davis, the founder of Functional Diagnostic Nutrition® calls them. So, instead of treating symptoms, tests and/or assessment results, the key is to assess the specific needs of each person.
Functional lab testing is the best way to analyze a person’s specific needs on a deeper level. The comprehensive data obtained through lab testing can be used to inform and guide a health-building program, to get real results that last a lifetime.
Reed Davis, the founder of Functional Diagnostic Nutrition®, worked for over a decade as a certified nutritional therapist and case manager perfecting lab testing and resources. And now for over 10 years, he has been sharing his knowledge through the FDN course with a mission to empower as many people as possible to help as many people as possible to get well and stay well naturally.
After helping hundreds of clients, Reed discovered that while each was unique in their health challenges, they also had much in common – H.I.D.D.E.N. stressors.
Through clinical work, Reed identified 5 foundational lab tests essential for in-depth insights in order to uncover a client’s H.I.D.D.E.N. stressors and reveal their true healing opportunities to build their health.
Having access to lab testing, knowing how to properly interpret the results and use the data to guide a health building protocol is what makes certified Functional Diagnostic Nutrition® Practitioners so successful in getting their clients real results.
Like you, most of our FDN practitioners started off as health coaches, personal trainers, nutritionists, nurses, homemakers or were in non-health related fields and changed their career because they were inspired by their personal health journey.
No matter what their prior profession was, all of them have these 3 things in common:
- A strong desire to help others on a deeper level
- Willingness to walk the talk and empower others to do the same
- A feeling as if they were missing some very important pieces to the health puzzle.
FDN’s complete methodology has empowered over 3,000 trainees in over 50 different countries to help people get well and stay well naturally.
Join Reed Davis in our upcoming webinar and learn how to get real results for you and your clients, and create a successful business doing what you love while positively impacting others.
Reed Davis is a Nutritional Therapist and has been the Health Director and Case Manager at a wellness clinic San Diego for over 15 years; he is the Founder of the Functional Diagnostic Nutrition® Certification Course.
Health can be defined in a variety of ways.
- The absence of disease.
- The absence of symptoms of a disease.
- The ability to achieve a specific health goal. (Weight loss or reduced medication)
- The ability to achieve a specific life goal. (Travel or dance at your granddaughter’s wedding)
There’s no right or wrong definition of health. It’s all what’s of most importance to you. However, unless you take a moment to reflect on and define it for yourself, you may by default be guided by your physician’s goal for your health.
Their goal is well-intended and certainly well researched, however, without the understanding what’s most meaningful to you in terms of your health, you’re likely following a standard protocol. They may get you 90% of the way to your health, not realizing it’s the last 10% beyond the standard protocol that enables you to achieve what is most meaningful to you.
As we’ve entered into a New Year when health goals are more at the forefront of our minds, it can be an inspirational time to determine what health means for us.
A vision helps you determine what you’re aiming towards.
You can then communicate a clearly defined vision with your health care providers, so they can support you in achieving your goal.
So, what does this look like?
As a nutrition coach, I always take new clients through this process.
What goal comes to mind first?
Generally speaking, the most popular answer is weight loss. But nobody wants to lose weight just to have a lower number on the scale. It’s about what they can do when they’re at that lower weight. (Walk up the stairs without being winded, not need a seatbelt extender during a plane ride or feeling comfortable in a bathing suit on your anniversary vacation.)
Because I work primarily with individuals that have autoimmune disease, the motivations are much deeper. The obvious would be less pain, more energy and increased mobility. But when truly getting to understand each person, they share that they want to regain the ability to walk down the driveway to get the mail, have enough energy to do their own grocery shopping, or reduce pain so they can sleep better at night.
The latter goals have such great detail that your care team will want to get onboard in setting you up for success.
From here, you can best determine what providers and services you need most to achieve health in your terms.
This may also prompt them to offer more options for you in achieving your goal. It could be as simple as suggesting a session with a physical therapist to a mediation app that’s been helpful to other patients in managing pain.
Bottom line, you need to first define your vision for health and then clearly communicate that vision with your healthcare team – ideally starting with your primary care physician – so you can be supported with the best path to your health success.
Join Alene for her upcoming webinar with MedFit Classroom:
Alene Brennan has been featured in USA Today, Philadelphia Inquirer, Huffington Post and Mind Body Green. Alene overcame debilitating migraine headaches through diet and lifestyle and is now once again using a “Less Pharm, More Table” approach is managing her diagnosis of Multiple Sclerosis. Alene holds four certifications: Nutrition Coach, Yoga Instructor, Personal Trainer and Natural Food Chef. She also completed specialized training in nutrition for autoimmune disease specifically the Wahls Protocol and the Autoimmune Protocol. Since receiving her MS diagnosis and seeing first-hand the power of using diet and lifestyle to create a healing environment in the body, she dedicated her virtual nutrition coaching practice to helping people with MS and autoimmune dieseases take back control of their health. Visit her website, alenebrennan.com.
The winter holidays are often a barrage of non-stop feasting that spans from Thanksgiving to the Super Bowl. Week after week, you indulge yourself with goodies, justifying your poor food choices in the name of holiday cheer. You promise yourself to mend your ways as soon as the excitement dies down, but meanwhile the pounds creep on and bad nutrition becomes the new normal. Cleaning up your act is a process, but you can speed it up by taking some proactive steps.
Let It Go
Gifts of food abound during the holidays, and if you are like me, you still have plenty of sweets, snacks and junk food in your fridge and cupboards. To get your diet back on track, begin by banishing the bad stuff. If you cannot bear to throw perfectly good food in the trash, donate to your local food bank or homeless shelter. Or throw one final bash, featuring your holiday stash of goodies as the main course. Clean and organize your refrigerator to make room for fresh produce, filtered water and whole foods. Rearrange your cupboards so that healthy food options are at eye level.
Sugary foods and carbohydrate-laden snacks and meals are holiday mainstays that can wreak havoc with your insulin balance. Going cold turkey on the simple carbs can cause discomfort and cravings that last for two or three days, but it is one of the quickest ways to normalize your blood sugar and reset your metabolism. Adding high intensity exercise can speed up the process. Create a menu plan for your week that includes fresh fruits and vegetables and healthy proteins, and stock your fridge with ingredients. Planning and preparing healthy snacks and meals ahead of time will keep you from being tempted to grab fast food.
The end of the Holiday Season does not necessarily mark the end of the eating season. Valentine’s Day and Girl Scout Cookies loom on the horizon. Prepare for the onslaught by making committed decisions in advance. Instead of preparing special foods for Valentine’s Day, plan a romantic getaway or a movie date night. Ask your sweetie for flowers or jewelry instead of candy. Decide ahead of time to purchase only one box of Girl Scout cookies, and ration them out at the rate of one cookie per day. If you want to help out the Scouts, they accept donations in lieu of a cookie purchase.
Jay Del Vecchio is the Founder and CEO of the World Instructor Training Schools (W.I.T.S.). Jay is an advocate for establishing national standards for the health and fitness training industry.
Telomeres are sections of genetic material that form a protective cap at the end of each chromosome in every cell of the body. When a cell divides, the telomere gets a tiny bit shorter, until there is no more telomere left to protect DNA from “unraveling,” and the cell dies. Cellular death causes the body to age, whether the cell is from cardiac muscle, skin, or brain tissue, thus making telomeres a novel biomarker for biological age. The longer one’s telomeres, the younger one’s biological age. Several things affect telomere attrition rate – both positive (good nutrient status, healthy blood sugar and lipid metabolism, normal weight, exercise, etc.) and negative (micronutrient deficiencies, inflammation, cellular stress, a sedentary lifestyle, etc.).
How is micronutrient status linked to the aging process?
Micronutrient status has direct implications for telomere length. This makes it especially important to correct specific deficiencies and maintain micronutrient balance. Measuring total antioxidant capacity via SPECTROX® is equally important as the body’s ability to handle oxidative stress contributes significantly to telomere health/length.
Why measure fatty acids?
OmegaCheck® measures the amount of three very important fatty acids (EPA, DHA, and DPA) in one’s blood. Fatty acids can either contribute to or alleviate inflammation, and the OmegaCheck determines the amount of these pro- and anti-inflammatory fatty acids. Although the protective omega-3 fatty acids influence enzyme and hormone systems throughout the body, they have gained attention primarily for their superb cardiovascular benefits. Since fatty acid status is a surrogate marker for inflammation and oxidative stress, it is not surprising that omega-3 fatty acids can slow cellular aging by preserving telomeres. When it comes to OmegaCheck, higher is better.
Omega-3 fatty acids can slow the aging process. There are many reasons for this: they reduce inflammation, help maintain the cardiovascular system healthy, and protect the brain. However, the existing research points to an entirely different mechanism of action against aging: protection of telomeres.
A recent study on people with active heart disease demonstrated that individuals with high blood levels of omega-3 fatty acids also had the lowest rate of telomere attrition, suggesting that omega-3 fatty acids protect against cellular aging.1 In another study, the adoption of comprehensive lifestyle changes (including daily supplementation with 3 grams of fish oil, which is high in omega-3 fatty acids) was associated with an increase in telomere length in human leukocytes.2 In animal studies, dietary enrichment of omega-3 fatty acids prolongs life span by approximately one-third.3
Yet another way that omega-3 fatty acids have a protective effect on telomeres is through their action on cortisol. Following six weeks of fish oil supplementation, a group of men and women in a study demonstrated significantly reduced4 cortisol, a stress hormone known to reduce the activity of telomerase,5an enzyme that protects and even lengthens telomeres. Even stress-related cellular aging may be thwarted by omega-3 fatty acids!
SpectraCell’s Telomere Analysis
SpectraCell’s telomere test measures a person’s telomere length. A control gene is also measured and compared to the telomere length, and then results are stated as a ratio. A higher ratio means a longer telomere, and younger biological age. The Telomere Score is also compared to other individuals in the same chronological age group.
The price of the Telomere Test is affordable and is also covered by insurance. Testing once each year or every other year is suggested to monitor the rate of telomere loss.
The great news is that with the telomere analysis and appropriate lifestyle, habits, you can protect your telomeres and reduce the rate at which they shorten! Discover your estimated cellular age today with a comprehensive, and individualized approach to managing the aging process.
Click here to learn more about SpectraCell testing services.
Reprinted with permission from the SpectraCell blog.
SpectraCell Laboratories, Inc. is a leading clinical laboratory specializing in personalized disease prevention and management solutions. Our pioneering intracellular micronutrient and cardiometabolic testing, driven by state-of-the-art technology, assesses a spectrum of risk factors and biomarkers for optimum wellness. Through our dedication to research and development, SpectraCell also provides innovative solutions for hormone health and genetics.
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).
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.
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?
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.
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…
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.
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!
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.
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.
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.
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.