Hide

Error message here!

Lost your password? Please enter your email address. You will receive a link to create a new password.

Error message here!

Back to log-in

Close
Healthy-Lifestyle-Nutrition-Exercise-Medicine

Yes, Even Athletes Get Heart Disease…

As he indulged in a jumbo sugar-covered fried pastry, the athlete unabashedly remarked, “I’m skinny; I can eat this.” Well, the truth is even skinny athletes die suddenly of heart attacks and strokes. Heart disease is the number-one killer, ahead of cancer, and accounts for one in four deaths. No one can out-exercise a bad diet.

While we’ve all heard let food be thy medicine, the latest dietary advice from the American Heart Association (AHA) focusses less on individual foods (such as eggs, meat) and nutrients (fat, sodium) and more on lifestyle and dietary patterns. Given cardiovascular disease (CVD) starts in the womb, adopting heart-healthy eating patterns early and maintaining them throughout one’s life is important. Thankfully, the same food plan that invests in heart health invests in sports performance—as well as reduced risk of type II diabetes, mental decline, and environmental issues.

Below are the 2021 AHA dietary guidelines. Because these guidelines are targeted to the “general public,” athletes can appropriately make a few tweaks to support optimal sports performance.

1. Adjust energy intake and expenditure to achieve and maintain a healthy body weight.

Most athletes do a good job with weight control. Just remember, large portions of even “heart healthy” foods can contribute to weight gain.

2. Eat plenty of fruits and vegetables; choose a wide variety.

Fruits and veggies (F&V)—in particular, those with deep colors (such as peaches, berries, spinach, carrots)— offer natural vitamins as well as phytochemicals that improve heart-health. Many F&V are rich in potassium, which has been associated with lower blood pressure. Some F&V (such as arugula, Romaine lettuce, beets, rhubarb) are nitrate-rich and improve blood flow and aerobic performance.

If you have trouble including plenty of fresh F&V in your daily meals, make food prep easier by using frozen F&V. They offer more nutrients than the wilted produce that has been sitting in your refrigerator for several days. Frozen produce is ready to use, reduces food waste, and costs less than fresh. Stock up!

3. Choose foods made mostly with whole grains rather than refined grains.

The fiber in whole grains helps feed gut microbes that enhance the immune system and over-all health. While most of your breads, cereals, and pastas should be whole grain, eating refined grains at one meal a day will not undermine your health. That is, if you eat oatmeal for breakfast, whole wheat bread at lunch, and popcorn for a snack, eating white pasta for dinner fits within the guidelines that more than half your grains should be whole grains.

4. Choose healthy sources of protein: mostly protein from plants (legumes and nuts); fish and seafood; low-fat or fat-free dairy products instead of full-fat. If meat or poultry are desired, choose lean cuts, avoid processed forms

Plant protein is excellent for heart health: lentils, hummus, edamame, tofu, all beans and nuts. The more nuts and nut butters, the lower the risk of CVD and stroke!

The benefits of low-fat and fat-free vs full-fat dairy is controversial and continues to be debated. To date, the AHA reports full-fat yogurt and kefir are positive additions to your diet. Note: nut milk is actually nut juice—low in protein, lacking in nutrients. The better plant-based alternatives to dairy are soy milk or pea milk.

Processed meats (ham, hot dogs, bacon, sausage, pepperoni, salami) have a stronger link to CVD than lean red meats. The potential adverse effects of red meat on heart health have been attributed to a combination of factors, including saturated fat, heme iron, the gut microbiota, and metabolism of l-carnitine and phosphatidylcholine.

The AHA has historically limited eggs because of their high cholesterol content; currently there is no specific limit on dietary cholesterol. The question arises: Are eggs a contributor to CVD? Or is the bacon or sausage that accompanies the eggs the culprit? The intake of dietary cholesterol and saturated fat tend to increase in parallel (i.e., eating eggs with bacon and sausage). Dietary cholesterol itself is currently less of a nutrient of concern.

5. Use liquid plant oils rather than tropical oils (coconut, palm, and palm kernel), animal fats (butter and lard), and partially hydrogenated fats.

Replacing hard-at-room-temperature saturated fats (butter, coconut oil) with soft-or-liquid polyunsaturated fat (corn oil, walnuts) and monounsaturated fat (olive, canola oil, peanut butter) has robust scientific evidence of protecting against heart disease by lowering bad LDL cholesterol. This reduces the risk of developing heart disease. In comparison, coconut oil has a high saturated fat content; it raises LDL cholesterol, with little evidence of positive health benefits.

6. Choose minimally processed foods instead of ultra-processed foods.

Ultra-processed foods (ramen noodles, cheese curls, commercially baked cookies) are easy to over-consume! Choose more minimally processed, if not unprocessed foods, such as homemade granola bars and trail mix made with nuts & dried fruit.

7. Minimize intake of beverages and foods with added sugars.

Sugar comes in many forms: glucose, dextrose, sucrose, corn syrup, concentrated fruit juice, honey, and maple syrup. The same athletes who scrutinize food labels for added sugar often consume lots of sport drinks, gels, and chomps. Simple-to-digest sugar is actually what your body needs during extended exercise, when the theme is survival and not good nutrition. Sugar becomes a problem when athletes skip wholesome meals, get too hungry, start to crave sugary foods, and then eat the whole plate of cookies. Preventing hunger is the key to preventing cravings for sugary foods. Eating a hearty protein-rich breakfast can set the stage for reduced sugar cravings towards the end of the day.

8. Choose and prepare foods with little or no salt.

In general, reduced salt intake is linked with reduced blood pressure. That said, most athletes have low blood pressure. They also lose salt (more correctly, sodium) in sweat. Athletes who sweat heavily can appropriately replace sodium losses by eating salty foods. The leading sources of dietary sodium are processed, restaurant, and packaged foods. If your sports diet is mostly unprocessed foods, it can be low in sodium. If you find yourself craving salt, eat salt!

9. If you do not drink alcohol, do not start; if you choose to drink alcohol, limit intake.

The link between alcohol intake and heart disease is complex, depending on how and how much you drink. Athletes are known to drink more alcohol than non-athletes. Alcohol has negative effects not only on heart-health, but also athletic performance and is linked to injuries, violence, digestive diseases, poor pregnancy outcomes, and cancer.

10. Adhere to this guidance regardless of where food is prepared or consumed.

Because so many athletes buy takeout foods, healthy eating patterns need to apply to both meals prepared in and outside of home. Occasional treats are fine; just be sure they are not the norm.

By following the above guidelines, you will be taking steps towards a lifetime of better health, which means better quality of life and happiness. Be wise, choose your foods wisely, and enjoy your active lifestyle.


Nancy Clark MS RD CSSD counsels both fitness exercisers and competitive athletes in the Boston-area (Newton; 617-795-1875). Her best-selling Sports Nutrition Guidebook is a popular resource, as is her online workshop. Visit NancyClarkRD.com for more info.

Reference: Dietary guidance to improve cardiovascular health: a scientific statement from the American Heart Assoc. Circulation, 2021; 144

intermittent-fasting

Intermittent Fasting for Health

Intermittent fasting is a type of diet that has been growing in popularity in recent years due to its potential health benefits and effectiveness for weight loss. This dietary approach involves alternating periods of eating with periods of fasting usually for a set number of hours each day the idea behind intermittent fasting is to limit caloric intake and trigger the body’s natural fat-burning mechanisms.

One of the most well-known benefits of intermittent fasting is weight loss. When we fast, our body switch from using glucose as fuel to using stored fat this metabolic state, known as ketosis helps the body burn fat more efficiently, leading to weight loss. In addition, intermittent fasting has been shown to increase insulin sensitivity, which is a key factor in controlling body weight and preventing type 2 diabetes. 

Intermittent fasting has also been linked to improved heart health. studies have shown that this type of diet can lower blood pressure reduce bad cholesterol levels and improve cardiovascular function. Furthermore, it has been shown to reduce inflammation and oxidative stress which are both associated with an increased risk of heart disease.

Intermittent fasting has also been shown to have a positive impact on brain health. Research has found this type of diet can increase the production of brain-derived neurotrophic factor (BDNF) which is a protein that plays a critical role in growth of in survival of brain cells. This increase in BDNF may help improve cognitive function, reduce the risks of neurodegenerative diseases, and potentially even extend lifespan. 

In addition, intermittent fasting has been found to have a positive impact on gut health.  This type of diet has shown to promote the growth of beneficial bacteria and reduce the growth of harmful bacteria in the gut leading to improved digestion immune function and mental health.

Is important to note that not everyone is a good candidate for intermittent fasting. People with a history of eating disorders low blood sugar, or other health conditions should consult with a health care professional before starting this type of diet. Additionally, it is important to listen to your body and adjust the fasting period based upon your own needs and tolerance.

In conclusion, intermittent fasting is a dietary approach that has a range of health benefits including weight loss, improved insulin sensitivity, improved heart health, improved brain health, and improve gut health while. While it may not be suitable for everyone, for those who can adapt it, intermittent fasting can be an effective tool for improving overall health and reducing the risk of certain diseases. It is important to speak with a healthcare professional and listen to your body and starting an intermittent fasting diet to ensure that it is safe and effective for you.


Reprinted with permission from author.

Mike Rickett MS, CSCS*D, CSPS*D, RCPT*E is a nationally recognized health and fitness trainer of the trainers, fitness motivator, author, certifier, educator, and the 2017 NSCA Personal Trainer of the Year.  He has been a fitness trainer for more than 35 years.  He directs the personal training site, ApplicationInMotion.com. In addition, he also directs BetterHealthBreathing.com, a conscious breathing educational program focusing on the diaphragmatic technique to enhance overall wellness.  

egg faces

Eggs: Unscrambling the Confusion

When it comes to eating eggs, nutrition advice has changed. In 1968, the American Heart Association (AHA) recommended Americans consume no more than three whole eggs per week. The belief was eating cholesterol-rich egg yolks would elevate cholesterol in the blood, increasing one’s risk of developing cardiovascular disease and having a heart attack or stroke. By 2015, that belief had changed. Today’s 2020-2025 US Dietary Guidelines no longer limit eggs. (Nutrition is an evolving science. New research led to new understandings about eggs. Though confusing, the “system is working” when new knowledge leads to new recommendations about what’s best to eat to protect good health.)

Studying the role of eggs in our diet has been done, in part, by surveying thousands of egg-eaters from a cross-section of the general population. This led to the conclusion that eating eggs can increase one’s risk for elevated blood cholesterol and heart disease. But that conclusion applied best to the average American (overfat, underfit) who ate fried eggs + bacon + buttery white toast, i.e., a lot of saturated fat. Today’s heart-healthy dietary guidelines focus on saturated fat as the culprit. Of the 5 grams of fat in an egg, only 1.5 g are saturated. (The recommended daily limit for saturated fat is about 15 grams per 2,000 calories.) Athletes who eat poached eggs + avocado + whole-grain toast can more likely enjoy that breakfast worry-free.

Overall, epidemiological evidence suggests enjoying 6 to 7 eggs/week does not increase heart disease risk. For most healthy athletes, cholesterol in eggs does not convert into artery-clogging cholesterol in the blood. That said, some people are hyper-responders to dietary cholesterol, meaning when they eat cholesterol-rich foods, their blood cholesterol level increases. If you have a family history of heart disease and/or diabetes, a worry-free choice is to enjoy more oatmeal breakfasts, made really yummy by stirring in a spoonful of peanut butter. (Both oatmeal and peanut butter are known to be heart-healthy choices.)

Heart health is enhanced by far more than eliminating eggs from your menu. Rather than targeting eggs as a contributor to heart disease, I suggest you take a good look at your overall lifestyle as well as dietary intake. As an athlete, you get regular exercise, but do you get enough sleep? Drink alcohol only in moderation, if at all? Eat an overall well-balanced diet? You might want to focus less on whether or not an omelet for breakfast will ruin your health (doubtful!) and instead make other long-term dietary enhancements. That is, could you add more spinach and arugula to your salads? Munch on more nuts instead of chips? Enjoy more salmon and fewer burgers? There’s no question that whole grains, nuts, beans, fish, and colorful fruits and veggies promote heart health.

Egg truths

• Eggs are nutrient dense. They contain all the nutrients needed to sustain life. The 150 calories in two eggs offer far more vitamins, minerals, protein, and other nutrients than you’d get from 150 calories of other breakfast foods (i.e., English muffin, energy bar, banana).

• Brown eggs are nutritionally similar to white eggs. The breed of hen determines the color of the eggs.

• Yolks contain nutrients that athletes can easily miss out on, including vitamin D, riboflavin, folate, and for vegans, B-12.

• One large egg has about 6 to 7 grams of high-quality protein that contains all the essential amino acids (such as BCAAs) that are needed to build muscles. Half of an egg’s protein is in the yolk (along with most of the vitamins, minerals, fat, and flavor). The white is primarily protein and water.

• Egg yolks contain the (once feared) cholesterol. One egg yolk has about 185 to 200 milligrams of dietary cholesterol. That’s more than half of the 300-milligram limit previously recommended by the American Heart Association (and has been dropped).

• Eggs are rich in a well-absorbed source of lutein and zeaxanthin, two types of antioxidants that reduce risk of cataracts and age-related macular degeneration.

• For dieters, eggs are pre-portioned, which can be helpful. Eggs are also satiating. Research suggests people who eat eggs for breakfast tend to eat fewer calories later in the day.

• What about omega-3 eggs? Are they all they are cracked up to be? Yes and no. Omega-3 fats are thought to be protective against heart disease. Egg yolks from hens fed flaxseed, algae, and fish oils have a higher omega-3 fat content, increasing it from about 50 mg omega-3s in an ordinary egg to 125 mg in an Eggland’s Best egg. This small amount is tiny compared to the 3,000 mg. omega-3s in a standard portion of Atlantic salmon ( 4-5-oz.).

Omega-3 eggs are more expensive than standard eggs: $6 vs $4/dozen. You’ll get a lot more omega-3s by consuming more salmon. That said, for non-fish eaters, any omega-3 fats are better than no omega-3s.

Stay tuned

Someday, we will have a 100%-clear answer to which foods contribute to high levels of blood cholesterol and if that even impacts heart disease risk. That will put an end to the egg-cholesterol-heart health confusion. In addition, we’ll likely be able to benefit from genetic testing that offers personalized nutrition advice. Targeted research that looks at the genes of specific populations, will enable us to know, for example, which athletes can routinely enjoy three-egg omelets (with or without buttered toast) day after day without any fear of impairing their heart-health.

Until then, if your family is predisposed to heart disease, you certainly want to talk with your doctor and ask about not just eggs but also the possibility of getting tested for biomarkers for heart disease, such as Coronary Artery Calcium score, C-Reactive Protein, and a type of blood lipid called Lp(a). You could also get personalized guidance about a heart-healthy diet from a registered dietitian who specializes in cardiovascular disease. The referral list at eatright.org can help you find that expert!


Reprinted with permission from Nancy Clark.

Nancy Clark MS RD CSSD counsels both fitness exercisers and competitive athletes in the Boston-area (Newton; 617-795-1875). Her best-selling Sports Nutrition Guidebook is a popular resource, as is her online workshop. Visit NancyClarkRD.com for info.

energy bar nutrition

Surviving a Toxic Society: Nutrition 101

Understanding how to read a food label, determining appropriate portion sizes, making healthy food choices, calorie consumption vs. burning, fats, carbohydrates, protein, micro and macro nutrients, calorie dense vs. nutritionally dense foods, water and staying hydrated, hidden calories and so much more. These are just SOME of the challenges being faced by people of all ages today – and it’s getting WORSE with each passing day! With these topics I have just scratched the surface of what it means to survive in our toxic world – and ultimately thrive. These and many other issues have contributed to our society’s obesity crisis and as a result, the onset of multiple chronic diseases as a consequence of our inattention to the basic nutritional requirements for healthy living. 

It is appalling to me that in only the span of half of my life, we are seeing the manifestation of this inattention to healthy eating taking many forms such as the onset of type II diabetes in children starting at under the age of 13! This trend – if not corrected or addressed NOW – WILL destroy scores of families if we don’t find solutions for these BASIC pressing issues now. This article is designed for all of us – me as a review – and for those of you who don’t know – an opportunity to “catch up” and maybe make different choices in not only your own lives – but those you love as well!

We associate healthy eating with weight loss and diet programs – everything else is eating for fun. We take care of our emotional and spiritual wounds through food. Families gather to eat at Thanksgiving but in the interim we “eat out”, rarely seeing that special time with family again as our days spiral on one to another. Our lifestyle has become toxic through overeating, unhealthy choices, and massive quantities – all in the desire to “forget” or calm ourselves from the stresses of the day. We are immersed in technology and tied to an unforgiving master who demands more from us than many of us can afford to give. The idea of reading a label, or noticing calorie counts before we eat something seems impossible – so we go for the easy “fix” and just say “I’ll get back to making an effort tomorrow”. It is always going to be tomorrow until tomorrow finally doesn’t come.

I see this problem as a “three pronged” issue or challenge:

1. People are woefully unprepared to deal with the enormous impact of marketing and media and the power they hold over our lives

2. The complexity of foods and their confusing claims about their value is taking our ability to choose rationally away from us

3. The food industry has basically “kidnapped” healthy eating by making it easy to select every possible harmful form of nutrition (packaged, processed foods, fast food, massive portions and so much more).

The basics of healthy eating have become such a “mystery” to most Americans so that every talk show imaginable schedules healthy eating segments and how to lose weight for good regularly! When I was a boy on Maui I ate peanut butter and jelly sandwiches and bananas and we NEVER went out to eat. All our meals were at home with the family sharing in the effort.

Calories count and there is no difference between them – they just “are”. Burning calories is what we do to stay alive so eating pretty much is a given. Learning about portion control and balanced intake of nutrient dense/calorie deficient foods is not rocket science. It requires a desire to improve your choices by providing our bodies with the fuel they need to survive and thrive – nothing more, nothing less. We need to get back to “eating to live, NOT living to eat”. The calories now proclaimed on menus throughout America should be a wakeup call to Americans of all ages. Should our food be fried or baked? Should it have sauce or no sauce? Should we eat everything we are served or save some for later? What is the source of the primary calories – saturated fat or carbohydrate? Are we getting enough protein in our diet and is it from healthy sources? These and other questions need to be addressed and I will do my part to help answer them. I am not allowed by my professional code of conduct to provide specific advice on what and how much someone should consume – that is for a licensed professional to determine, but I am allowed to talk about nutrition and the role it plays in leading a healthy and happy life. That is part of my job and I take it very seriously!

Today I saw a lady at McDonald’s who was eating their terrific side salad but had also ordered the large order of fries – a common staple at McDonalds (what was she thinking – that the one would “cancel” out the other? or was she NOT thinking but going for the joy the fries bought? I don’t know but it happens all the time!). People don’t go to this place for the salads – they go for the fries! McDonald’s is REALLY good at selling those fries and one cannot blame them for wanting to make a profit after all, can they? The idea that one could order a meal that includes the burger and fries and NOT notice it contains over 1200 calories is “mind blowing” to me. I would have to run 8 miles to burn those off at just under 55 minutes of hard running! We need to “connect the dots” as I do every day when I choose and IF I choose the pizza I am absolutely sure I can run that pizza off tomorrow. Every choice has consequences and every day we will live with those consequences until our bodies say “NO MORE”. That day of reckoning is not far off and if today’s children don’t get to live longer than their parents then we will all be to blame to some degree, won’t we?

When you look at food think of it as fuel to keep you alive and ask yourself: Does it have water as a primary part of its makeup?  Is it fried, boiled or baked? Is it good for me? Will it promote my general health and preserve my immune system? Will I enjoy it and possibly eat it again? Can I find a way to eat more or less of this food? If it has lots of chemicals associated with its manufacture will that eventually harm me? Am I being proactive in my food choices and not reactive to the inevitable emotional swings in my mood that occur throughout my day? Do I eat for reasons other than because I am hungry? Am I compulsive when it comes to eating alone and do I overeat for reasons beyond my knowledge and control? These and other questions are a part of the dialogue on healthy eating and MUST be addressed if we are to slow the death spiral being brought on by the obesity crisis – and its cousin the “sitting of America”. 

I see the massive need for ongoing education and communication at ALL levels of society and from all aspects of life that touch the American family. These include the schools, government, the weight loss community, the food manufacturer’s, the restaurant community (including McDonald’s of course who IS actually “trying” to make healthy choices available to its customers although not fully succeeding because of those “damn” fries), supermarkets, the community at large, non profits, spiritual centers and so many more. It will take “that village” referred to earlier to solve the problems we are facing but they MUST be addressed if we are to save lives in the future. I will discuss basic food issues in future articles and identify some of the ways in which we can all participate as part of the solution. If we each just help one person improve something in their nutritional lives TODAY we end up helping “the many” too – and I think that is well worth the effort! Don’t you?


Nicholas Prukop is an ACE Certified Personal Trainer & a Health Coach, a fitness professional with over 25 years of experience whose passion for health and fitness comes from his boyhood in Hawaii where he grew up a swimmer on Maui. He found his calling in writing his first book “Healthy Aging & You: Your Journey to Becoming Happy, Healthy & Fit” and since then he has dedicated himself to empowering, inspiring and enabling people of all ages to reach for the best that is within them and become who they are meant to be – happy, healthy and fit – and be a part of a world where each person can contribute their own unique gifts to life.

The Word NO In Cereal Letters

The Stress Factor

What lights a fire under you?? What grinds your gears, makes you angry, sad, worried, or STRESSED?? We each deal with the components of life differently, and our reactions to circumstances dictate our emotional well-being. Time, relationships, work, school, kids, family…. all these responsibilities can require a balancing act that seems impossible. But that’s life. And unfortunately, stress can have adverse effects on our health… especially weight.

Your body and mind are one and the same. When put under pressure, your brain kicks into a flight or fight mode. And guess what? Your body wants to use calories in its defense. As such, “Most of us become overeaters when we’re feeling a lot of pressure. This happens thanks to your fight-or-flight response, a.k.a. survival mode — once your body reaches a certain stress level, it does what it feels it needs to. In most cases, that means overeat.” (1)

Initially, adrenaline spikes in the body, making one feel less hungry. However, soon after cortisol takes over. Cortisol is the stress hormone. When activated, inhibition can go out the window. Here’s run down: “Because increased levels of the hormone also help cause higher insulin levels, your blood sugar drops and you crave sugary, fatty foods.”(1) Cheap, convenient, processed foods, are right there to answer the calling.

Here’s the catch: “Today’s human, who sits on the couch worrying about how to pay the bill or works long hours at the computer to make the deadline, does not work off much energy at all dealing with the stressor! Unfortunately, we are stuck with a neuroendocrine system that didn’t get the update, so your brain is still going to tell you to reach for that plate of cookies anyway.” (2)

We have to learn to relax, sleep, and breathe. Many clients ask me what foods to turn to. Here’s what I found:·

Dark chocolate: Two studies of 95 adults showed that consuming dark chocolate reduced their cortisol response to a stress challenge.

Many fruits: A study of 20 cycling athletes showed eating bananas or pears during a 75-km ride reduced levels compared to drinking water only.

Black and green tea: A study of 75 men found 6 weeks of drinking black tea decreased cortisol in response to a stressful task, compared to a different caffeinated drink.

Probiotics and prebiotics: Probiotics are friendly, symbiotic bacteria in foods such as yogurt, sauerkraut and kimchi. Prebiotics, such as soluble fiber, provide food for these bacteria. Both probiotics and prebiotics help reduce cortisol.·

Water: Dehydration increases cortisol. Water is great for hydrating while avoiding empty calories. A study in nine male runners showed that maintaining hydration during athletic training reduced cortisol levels.(3)

Life’s demands throw us for a loop from time to time. Reassure yourself that patience is the key and that this too shall pass. Don’t let your negative thoughts take the wheel. Healthy choices outlast split second mistakes. Be kind to your BODY, even in it’s weak moments.


Originally printed on Every BODY’s Fit blog. Reprinted with permission.

Dr. Megan Johnson McCullough, owner of Every BODY’s Fit in Oceanside CA, is a NASM Master Trainer, AFAA group exercise instructor, and specializes in Fitness Nutrition, Weight Management, Senior Fitness, Corrective Exercise, and Drug and Alcohol Recovery. She’s also a Wellness Coach, holds an M.A. Physical Education & Health and a Ph.D in Health and Human Performance. She is a professional natural bodybuilder, fitness model, and published author.

  1. https://www.webmd.com/diet/features/stress-weight-gain#1
  2. https://www.psychologytoday.com/us/blog/the-mindful-self-express/201308/why-we-gain-weight-when-we-re-stressed-and-how-not
  3. https://www.healthline.com/nutrition/ways-to-lower-cortisol#section11
CRC-healthy-meals-snacks-food

Colorectal Cancer Development and Nutritional Deficits Management

On an annual basis, a number of Americans are diagnosed with some form of cancer. One of the most commonly occurring cancers that is recognized as the third deadliest cancer in America and the world is colon cancer, or colorectal cancer (CRC).1 CRC is first known to present as cancer of the colon and rectum which generally affects older adults. The incidence and mortality rate of CRC can increase with age with the median age of diagnosis at 70 years within developed countries.2 However, there is the potential for the cancer to impact individuals of all ages.

There are also potential risk factors for development which can include male sex, excessive alcohol intake, smoking, and lack of physical activity to name a few.2 Given the current and increasing rate of CRC diagnosis, there has been ongoing promotion of preventative measures and treatment interventions once formal diagnosis has been made.3

There are a number of recommendations for dietary measures to prevent colorectal but once diagnosed, nutritional support is also needed. For any person who is suspected of having CRC, there are both signs and symptoms to be aware of. Many patients can be symptomatic for several months before presentation. Some of the more common findings include rectal bleeding, changes in bowel habit, or loss of appetite and fatigue.4 The loss of appetite that can be associated with CRC can present with nutritional deficits. Given that the primary function of the colon is to aid with the absorption of electrolytes and fluids, the diagnosis of CRC and the treatment interventions that can be applied can impact nutritional absorption. The treatment of colorectal cancer can increase the demand for nutrients so during treatment it is important for patients to adhere to a healthy diet to nourish their bodies.

The mainstays for nourishment can be obtained from proteins, consumption of healthier fats, consumption of whole grain goods, fruits and vegetables, and intake of adequate amount of water given the potential for dehydration to occur.5 Additionally, according to the American Cancer Society, the following foods are recommended for those who are undergoing colon cancer treatments: plant based foods, fruits and vegetables that contain essential vitamins and antioxidants, and healthy snacks (like Greek yogurt or lean chicken).6 If there are instances in which tolerability issues arise with the consumption of these types of foods, it is important for a patient to immediately discuss this matter with their provider. 

A diagnosis of CRC can impact a person’s health and life in a significant way. During the course of the condition and the timeframe for therapeutic interventions, it is important to monitor the nutritional needs of the person. The potential for nutritional deficits to occur can be significant with CRC, so a clear, focused plan should be developed with the best course of action in mind to minimize any negative impact. While the goal is always for primary, secondary, and tertiary preventive strategies, it is also important to know how to appropriately address issues such as nutrimental deficits that can arise with the given diagnosis.7 The recognition of nutrition as a key element to improved treatment outcomes should also be addressed with its comes to comprehensive CRC management.


Abimbola Farinde, PhD is a healthcare professional and professor who has gained experience in the field and practice of mental health, geriatrics, and pharmacy. She has worked with active duty soldiers with dual diagnoses of a traumatic brain injury and a psychiatric disorder providing medication therapy management and disease state management. Dr. Farinde has also worked with mentally impaired and developmentally disabled individuals at a state supported living center. Her different practice experiences have allowed her to develop and enhance her clinical and medical writing skills over the years. Dr. Farinde always strives to maintain a commitment towards achieving professional growth as she transitions from one phase of her career to the next.

References

  1. Marley AR, Nan H. Epidemiology of colorectal cancer. Int J MolEpidemiol Genet. 2016;7(3):105-114. Published 2016 Sep 30.
  2. Brenner H, Chen C. The colorectal cancer epidemic: challenges and opportunities for primary, secondary and tertiary prevention. Br J Cancer 119, 785–792 (2018). https://doi.org/10.1038/s41416-018-0264-x
  3.  Holowaty EJ, Marrett LD, Parkes R, Fehringer G, editors. Colorectal Cancer in Ontario 1971-1996 [Internet] Cancer Care Ontario; 1998 [14 June 2016] Available from: https://www.cancercare.on.ca/common/pages/UserFile.aspx?fileId=13718.
  4. Thanikachalam K, Khan G. Colorectal Cancer and Nutrition. Nutrients. 2019;11(1):164. Published 2019 Jan 14. doi:10.3390/nu11010164
  5. Claghorn K. Colon,rectal, and anal cancer: Frequently asked nutrition questions. OncoLink.February 9, 2021. Accessed January 20, 2022.
  6. Kubala J. A diet plan for before and after colon cancer treatment. Healthline.June 7, 2021. Accessed January 20, 2022.
  7. Brenner, H., Altenhofen, L., Stock, C. &Hoffmeister, M. Prevention, early detection, and overdiagnosis of colorectal cancer within 10 years of screening colonoscopy in Germany. Clin. Gastroenterol. Hepatol.13, 717–723 (2015).
scale

Power to Weight Ratio: Cost and Benefits

Lugging around excess body fat can certainly hinder athletic performance. Just notice how much harder you work when carrying a heavy bag of groceries up a flight of stairs! That said, if you are an already-lean athlete and contemplating weight loss to supposedly improve your athletic performance, should you think again?

egg-avo-breakfast

Breakfast and Lunch: Food for Thought

Enjoyment of food should be one of life’s pleasures. Unfortunately, I counsel too many athletes who scrutinize food and talk about eating nutrients (protein, carbs, and fat). They put a lot of energy into counting macros, calories and grams of sugar. Some find meals and snacks to be sources of anxiety, not enjoyment.

Way too many athletes and fitness exercisers consider breakfast and lunch to be somewhat optional. The goal of this article is to share food for thought about these two important meals of the day—and help you fuel your body adequately, enjoyably, and effectively for your sports-active lifestyle.

Breakfast thoughts

• Weight-conscious athletes: please don’t even try to restrict calories at breakfast (or lunch). You need energy during the active part of your day to refuel from your morning workout or fuel up for your afternoon session. Your best bet is to fuel well by day, eat a lighter dinner, and lose weight at night when you are sleeping! As one dieter reported,“I lost weight easily when I ate dinner for breakfast and breakfast for dinner.” Give that a try?

• Remember when orange juice was a standard part of breakfast? Today, many athletes have stopped drinking orange juice because “it has too much sugar.” That might be true for unfit people with bodies that metabolize sugar far differently than the bodies of athletes. But for athletes, OJ is OK—a quick, easy, and thirst-quenching form of fruit. The natural sugars in orange juice offer helpful fuel before or after a morning workout— while simultaneously providing a day’s supply of Vitamin C, plus potassium, folate, and other health-promoting nutrients.

Ironically, the same athletes who shun orange juice often fail to take the time to eat a whole orange (or other fruit) instead. All 100%-juices are an easy way to boost the intake of this important food group. Any form of fruit—juice, canned, dried, frozen—is better than no fruit!

• Many athletes take pride in cooking their steel-cut oats, believing they are far more nutrient-dense than good ol’ fashioned rolled oats. Both rolled and steel-cut oats have similar nutritional value. The difference is steel-cut oats are cut, instead of softened and then rolled, and take far more time to cook.

• Please don’t try to “stay away from” peanut butter, believing it to be “fattening.” Rather, enjoy peanut butter on toast and bagels, or blended into smoothies, or swirled into oatmeal. PB’s fat is health-protective, anti-inflammatory, and satiating. It’s slow to digest, which helps keep you feeling fed until lunch.

• Whole grain breakfast cereals that are enriched or fortified (as noted on the label) can be good sources of iron, needed to reduce your risk of developing iron-deficiency anemia. Athletes’ diets can easily be low in iron if they do not eat red meat or cook in a cast iron skillet. Hence, iron-fortified cereals topped with fruit (for vitamin C, to help absorb the iron), milk (dairy or soy, for calcium and protein), and almonds (for a bit more protein) offer an effective sports breakfast—as well as sports-snack.

• Almond milk on cereal or in your coffee is a nutritionally poor swap for dairy milk. Almond milk offers only 2 grams of low-quality protein, as compared to 8 grams of high-quality dairy protein. The protein in dairy milk is 80% casein and 20% whey—the stuff you get in protein powder! If you prefer plant-based milk, soy and pea milks are the best options for protein. Environmentalists, please note: Cars, not cows, will “ruin the planet.”

Lunch thoughts

• If you feel hungry an hour or two after lunch, you did not eat enough lunch. How much lunch is enough? By listening to your body’s signals, you can intuitively eat the right amount. The key is to pay attention to why you stop eating at lunchtime. Do you stop eating because 1) The food is gone? 2) You think you should? 3) You feel content and nicely satiated?

The correct answer is 3) You feel content. An adequate lunch will leave you feeling fed for three to four hours. You’ll no longer crave afternoon sweets within an hour or two post-lunch. A hearty lunch helps curb 3:00 pm snack attacks and helps you arrive home at the end of the day with the energy to cook a decent meal. You will eventually eat the calories, so why hold off until you can no longer white-knuckle the hunger?

• Despite popular belief, sandwich bread is NOT fattening; excess calories of any kind are fattening. You can even enjoy a bagel for breakfast and a sandwich for lunch without “getting fat”! Carb-rich bread will fuel your muscles far better than a carb-lite lunchtime salad.

• If you are among the many athletes who eat a salad for lunch—and then complain you are craving sweets and eating cookies an hour or two later, think again. While salads are a helpful way to boost your intake of veggies, you might be better off satiating your appetite with PB & J or a turkey/cheese/pesto sandwich made on Dave’s Killer Bread or other hearty bread. For veggies, simply, munch on cherry tomatoes, baby carrots, and pepper strips; far easier than making a salad!

• If you insist on eating a salad for lunch, make sure it is an “athlete’s meal” that offers a hefty dose of starchy veggies (sweet potato, beets, corn) and grains (farro, quinoa, pasta, a whole grain roll on the side). A bowlful of greens (50 calories) smothered with 350 calories of dressing will leave you with poorly fueled (i.e., tired) muscles.

To put the need for carbohydrates into perspective, a 150-pound athlete who trains hard for 1.5 to 2 hours a day should target at least 3 grams of carb per pound of body weight per day = 450 g carb = 1,800 calories from carbs/day = 500-600 calories carbs/ meal. A big spinach salad comes nowhere near that!

• Even if you want to build muscle, don’t over-eat protein to the extent it displaces carbohydrates. Poorly fueled muscles won’t be able to lift weights as well as when carb-loaded. Think again before filling up on a high protein, low carb green salad + big chicken breast + dressing for lunch. A sports diet should contain three times more calories from carbs than protein.

Bottom line

Please enjoy satisfying breakfasts and lunches that keep you feeling fed for three to four hours. You will feel happier, more energetic, have better workouts, be less ravenous at the end of the day—and be less likely to overeat the “wrong” food at night. Experiment?


Nancy Clark MS RD CSSD counsels both fitness exercisers and competitive athletes in the Boston-area (Newton; 617-795-1875). Her best-selling Sports Nutrition Guidebook is a popular resource, as is her online workshop. Visit NancyClarkRD.com for info.

gymnast-rings

Making Weight: Helpful or Harmful?

Many athletes fantasize about losing weight (“Wouldn’t it be nice to lose a few pounds…”). But some athletes have to lose weight in order to meet a specific division for their sport. Athletes such as boxers might have to make weight for a day only once or twice a year, but others such as wrestlers are wisest to keep their weight low for a season. And then there are figure skaters, dancers, and gymnasts who live in long-term “food jail” to maintain a sleek physique for months on end because they get judged on aesthetics. This article will not focus on the problems with long-term under-eating, but rather offer help for athletes who have to/want to lose weight for the short-term.

Weight classes exist to supposedly even the playing field so, for example, a wrestler or a rower competes against someone who is about the same physical size. A problem with weight-class sports is too many athletes target a minimal weight that is unlikely their best performance weight and focus on a number on a scale instead of ability to compete well.  They often resort to last-minute restrictive dieting and dehydrating to make weight. Inadequate recovery between weigh-ins and the event can contribute to early bonking, poor performance, and disappointments. One champion collegiate wrestler shared his winning advice, “I ate well, competed at my natural weight, and clobbered my starving opponents. Easy!” The same goes for athletes in running sports, who believe lighter equates to faster. Not always the case. There’s a lot to be said for running well-fueled at your natural weight.

So what are weight-class athletes supposed to do?

Obviously, they are not supposed to wait until the last few days before an event to lose weight by abstaining from food and water, over-exercising, and abusing their bodies. The better path is to start chipping away at weight loss weeks in advance. If you have to lose 10 pounds, give yourself at least 5 to 10 weeks to do so, if not more.

Ideally, athletes should first have their body fat accurately measured to determine if they even have fat to lose. Females should not drop below 12% body fat, males no less than 5%. Some athletes will need to lose muscle to be able to reach their weight goal.

What’s the best way to lose weight? Push yourself away from the dinner table before you eat your fill! Plain and simple, you have to eat less than your body requires.  Easier said than done. Hence, these tips might be helpful.

• Knock off only 300-500 calories/day from your typical daily intake. Do NOT chop your food intake in half or eat as little as possible! As an athlete, you need fuel to train.

• Fuel by day; diet by night. Plan to lose weight when you are sleeping—not when you are trying to train hard.

• Surround your workout with food, so that you fuel-up and refuel.

• Do NOT cut out all carbohydrates. Athletes need grains, veggies, and fruits to optimize their muscle glycogen stores. A very low-carb diet results in depleted glycogen,  “dead legs,” and inability to train hard.

• Enjoy carb-protein combinations: carbs to fuel muscles; protein to build and repair muscles. Protein is also satiating and can help curb hunger.

• When it’s crunch-time, to lose the last few pounds, some athletes target about 1.5 g carb, 1 g protein, and 0.5 g fat per pound of body weight (3 g carb, 2 g pro,  1 g fat/kg). This means a 150-lb (68 kg) athlete would target about 200 g carb, 135 g pro, and 70 g fat (~1,950-2,000 calories/day).

• Athletes who have to lose muscle mass to hit their weight target should cut back on their protein intake.

• Divide the calories into 4 food buckets and eat a meal at least every 4 hours. (The clock starts ticking when you get up in the morning). An athlete who trains from 6:30 to 7:30 a.m. could divide breakfast into 100-200 calories pre-workout at 6:00ish, then 400 calories post-workout at 8:00; eat early lunch (500 cal.) at 11:00ish; later lunch (400-500 cal.) at 3:00ish, and dinner at 6:00-7:00ish (500 cal.). The rest of the night, chew gum, drink herbal tea, go to bed early? (If you are ravenous, please eat a bit more.)

• If you don’t have fat to lose, plan in last-minute water-weight loss of 2% to 3% body weight. For a 150-lb athlete, that’s 3 to 4.5 pounds. Ways to reduce water-weight include depleting muscle glycogen with a low-carb diet (3 grams of water are stored with one gram of muscle glycogen), restricting fiber (to reduce gut contents),  sweating, and restricting fluids.

Rapid refueling pre-event

After weighing in, some weight-class athletes have only 1 to 2 hours to refuel and rehydrate before they compete; others have 12+ hours if they weigh-in the night before. To rapidly refuel, they should consume carbs they know they can tolerate well—and be sensible so they don’t vomit during the event. Enjoy (well-tolerated) salty foods like soup, pretzels, and crackers.

• A large bolus of fluid gets absorbed faster than smaller amounts, so dehydrated athletes want to drink 20 to 30 ounces of fluid followed by repeated sips. Salty broth and lowfat chocolate milk retain water in the body better than sports drinks and plain water. Co-ingestion of some protein can help with glycogen restoration (Turkey sandwich? Chocolate milk?)

Post-event weight regain

While the standard advice for weight-class athletes to just lose the weight and keep it off makes sense intellectually, it is the opposite of what the body wants to do physiologically. After having been underfed, hungry athletes experience a very strong drive to eat, if not over-eat, and regain all the lost weight. This happens with most dieters, athletic or not.

The urge to devour food after having made weight is physiological, and not simply due to lack of will-power. Here’s the analogy: If you hold your breath for too long, you will uncontrollably gasp for air. If you rigorously restrict calories for too long, you will uncontrollably grab for food and easily binge-eat. No wonder eating disorders blossom in weight-focused sports!

The bottom line

Any way you look at it, losing weight when you really are not over-fat in the first place is not much fun. Yes, it creates a bond with other athletes doing the same thing—misery loves company—and is embedded into the culture of weight-focused sports. Ideally, it’s time to change that culture to focus more on health (both short and long term) and injury reduction. How about establishing height classes instead of weight classes?  Or at least offer better access to sports dietitians to help with the weight-reduction process? 


Nancy Clark MS RD CSSD  counsels both fitness exercisers and competitive athletes in the Boston-area (Newton; 617-795-1875). Her best-selling Nancy Clark’s Sports Nutrition Guidebook is a popular resource, as is her online workshop. Visit www.NancyClarkRD.com for info.

References

Langan-Evans C. at al. 2021. Nutritional considerations for female athletes in weight category sports. European Journal of Sports Science

Burke, L, et al. 2021. ACSM Consensus Statement on Weight Loss in Weight-Category Sports. Current Sports Medicine Reports