Tuesday, August 23, 2011

Choose My Plate

From Food Guide Pyramid to USDA's My Plate helps Americans graphically represent the 2010 Dietary Guidelines.

Because more than one-third of Americans are overweight or obese, the Dietary Guidelines focuses on reduced calorie consumption and increased physical activity. It is important to balance your activity with your calories. However, not all calories are created equally so the plate method graphically explains the importance of all foods and how they fit in a healthy diet.

According to the plate to the left, vegetables and grains make up the largest portions of the plate, then fruits and protein, and then dairy. So half of your plate should contain vegetables and fruits. According to the 2003 National Health and Nutrition Examination Survey, less than 1 out 10 Americans eat the recommended amount of vegetables and fruits per day. This is a shockingly low number. Americans tend to be very much focused on eating protein, however, high protein intakes can cause low intake of other critical nutrients. High protein intakes can also lead to loss of lean muscle mass, contrary to popular belief.

To know exactly what you should be eating, make an appointment with a Registered Dietitian to received unbiased information. Go to www.eatright.org to find a list of dietitians in your area. In the mean time, make healthy choices by using www.choosemyplate.gov

Saturday, January 22, 2011

Iron deficiency anemia - some stats

ACSM Conference Highlights new research:

Iron-deficiency anemia in the general population of men is 2%. However, in cross country and distance runners 18-22 years of age, 21% were deficient.

For women, the percentage of iron deficiency anemia in the general population is 14%. However, 50% of female athletes are iron deficient.

For more information about iron deficiency anemia see my previous post on "Iron for Performance" dated October 14, 2010.

Friday, January 21, 2011

Weight Gain During Marathon Training

A question came up recently about weight gain during marathon training. Many new runners training for a marathon are confused about why they would gain weight while running all those extra miles. I have a few theories about why this is happening.

1) Most people overestimate the calories they burn on a run. The amount of calories you burn depends on your weight, gender, lean muscle mass, and intensity and duration of your run. The Garmin 405 cx watch will calculate how many calories you burn based on your hear rate during a workout. This is slightly more accurate than just using your gender and weight. It is known that the faster you run the more calories you burn. So someone running for an hour at a 6 min mile pace will burn more calories than someone running for 2 hours at a 10 min mile pace.

2) Newer runners will experience increasing muscle fiber recruitment, strengthening of tendons, and increasing bone density all of which contribute to extra weight. Newer runners or runners increasing their mileage also experience increases in muscle glycogen storage. For every gram of glycogen that is stored, 2-3 g of water is stored along with it.

3) There is an increase in plasma volume. This translates to extra weight as well.

4) Many runners have very detailed training regimens, but have absolutely no nutrition plan. This can lead to over consumption of calories and/or not combining macronutrients (carbohydrates, protein and fats) appropriately.

5). Many new marathoners believe that they can eat whatever they want because of all the mileage. Not only can this lead to weight gain, but it also can lead to poor recovery in between workouts and minimized training effects.

6) The other phenomenon I have seen is that a runner, in an effort to lose weight, will under consume calories. This runner's metabolism slows down and the runner gains weight or struggles to lose weight.

7) There are lots of myths associated with eating for marathoning. One that comes to mind is the big pasta bowl eaten the night before a marathon. Although pasta can be part of a healthy diet, it is usually covered in high fat sauces. There are many other healthier carbohydrate options that you can consume on a daily basis leading up to a marathon - not just for one pre-race meal.

Tuesday, January 18, 2011

What is the deal with the cupcake craze?

In the last few years, cupcake shops have opened up everywhere. My first experience with a cupcake shop was the "Teacake Bake Shop" in Emeryville, CA. I was out with my three daughters and they noticed the cute shop with pink and brown colors. There was something about the color scheme that drew me in. I ended up buying 4 cupcakes, 1 for each child and one for myself. I believe I spent about $12.00 that day.
I still can't believe I spent that much money for 4 tiny cakes with frosting. They put the cupcakes in a cute little brown box with pink accents. And as far as taste goes, they were very delicious. As some one who bakes all of her cakes from scratch, I can truly appreciate a cake made from real ingredients. However, as a dietitian I have some concerns.
1) These cupcakes can pack a punch in terms of calories. Depending on the bakery, the type of frosting, and the size of the cupcakes, they can contain anywhere from 200 to 500 calories. For example, the "Sprinkles" Red Velvet Cupcake with cream cheese frosting contains a whopping
497 calories and 27 g of fat and 16 g of saturated fat and 45 g of sugar.
2) Since they are so small, can you just eat one?
3) These cupcakes do not have any nutritional value at all. At least ice cream contains calcium, a nutrient important for bone health.
4) Cupcakes really appeal to children. And at 45 g of sugar for one cupcake, it's like feeding your children 9 teaspoons of sugar at one time. At least soda, only contains 6 teaspoons of sugar. Well, I don't recommend soda. That was a joke.
5) Eating a food item with sugar causes your blood sugar levels to rise sharply. Your pancreas responds by producing insulin which later causes an increased uptake of blood sugar leaving you feeling fatigued or lethargic. Not a fun feeling. And not ok for a diabetic.
6) Let's say a person needs about 2,000 calories per day to maintain weight and be healthy. Of course calorie needs are multifactorial. The recommended fat intake for this person would be about 67 g of fat per day. The Red Velvet Cupcake mentioned above provides 39% (26g) of fthat person's fat needs for the day. This is significant.
7) Let's say this person has elevated blood cholesterol levels (>200mg/dl), she should not eat more than 22 g of saturated fat a day, if any. This cupcake provides 16g of saturated fat - 73% of the upper limit. JUST IN ONE TINY CAKE.
My suggestion: Don't eat them. LOL. Ok, if you are going to eat them, have them after running a marathon or competing in a really long distance event. However, the empty calories won't help with your recovery. Seriously, have one. Don't make it a habit, but at least know what is in them.

Tuesday, December 14, 2010

My 16th marathon race report

My last marathon PR was CIM 2007 where I ran a 3:22:01. I really just thought I was going to get faster and faster. Well, I did in 2008 when I ran a PR half marathon at San Jose in October 1:32:36. This was my tune up to the 2008 New York City Marathon. I was very confident going in to NYC. I travelled with friends and we were going to have a blast. Well, at mile 4 I psyched myself out when I spend an entire minute on the porta potty. And then my hamstring started hurting so I decided to walk it in at mile 16 and try again at the California International Marathon 5 weeks later. This was probably not a very smart move for me. I had trained and tapered for NYC and then continued the training cycle for the next 5 weeks. Well, at CIM I ran really well until mile 18 when I started having sharp pain in my right hamstring. I thought I was done, but when I resumed running, the pain subsided somewhat and I was able to shuffle to the finish in 3:28. I won the Athena division, but cried so hard at the finish line because I did not even come close to my personal record.

As the great Haile Gebrselassie said, " There are good days and there are bad days, today was a good day". This was after he ran a world record in the Marathon. So I learned from my bad day at CIM 2008. Racing a marathon 5 weeks after another does not work for me. I extended my training period and probably got burned out in the process. I also learned to have more fun with running, then the minute long porta potty stop at New York would not have been a big deal. I also learned that some pain comes and goes. In my case, the hamstring pain was fleeting.
I then struggled to pull myself together in 2009 and 2010. I gained 20 pounds in 2009, lost the weight in 2010. Add to that some personal problems, 2010 was less than ideal. I was so stressed, I had a series of not so great races. My hamstring would flare up during races. I had diarrhea in Philadelphia. I bonked during San Diego.

So when I was finally able to deal with my stress and personal problems (October 2010) and lose the weight, I felt a huge relief and started focusing on training again. My confidence was slowly starting to come back and having my husband as a training partner really helped me get to the starting line of CIM 2010. This would be my husband's second attempt at racing the marathon. His first attempt at San Diego 2003, caused him to get injured at mile 18 and not finish the race.

I started the 2010 CIM race, right at the line because the Athena times are based on gun time, not chip time. I felt really stupid doing this though because I got passed like crazy at the start for at least 5 miles. It was like a stampede. LOL. I ran my first mile in 7:59.
Mile 2 7:45 - ok I thought this feels easy
Mile 3 7:45
Mile 4 7:32 - oops too fast
Mile 5 7:41 - ok better
Mile 6 7:41 - I am now behind the 3:20 pace group
Mile 7 7:39 - still feeling good
Mile 8 7:55 - Uh oh what happened here?
Mile 9 7:51 - Uh again, I better try to pick it up but I am not even half way yet
Mile 10 7:38 - ok that's better
Mile 11 7:52 - yikes - I am feeling pretty tight
Mile 12 7:51 - can I at least keep my splits under 8 - God I hope so. The 3:20 group is fading in the distance
Mile 13 7:43 - ok maybe I was just having a bad patch earlier or maybe it's the hills
Half 1:41:xx - that's kinda what i was shooting for so I am good, yet I don't feel so good or very confident about going another 13 miles
Mile 14 7:59 - ouch
Mile 15 8:04 - Oh suck! My first mile in the 8s and it's only mile 15. C'mon Reyana this is when the hills end right? I have been telling everybody and their mother that the hills end at mile 15. I need something to motivate me.
Mile 16 8:04 - Another 8 min mile. Yikes. Ok well keep it in the low 8s at least
Mile 17 8:01 - Nice I am ok with this now. I see people that blew by me at the earlier miles slowly coming back to me. Yes I am passing people left and right.
Mile 18 7:59 Yay a mile under 8 min. I can do this. I know I can do this. I am an athlete. I am strong. I can do this.
Mile 19 8:05 Oh goodness. Ok so if I can run 7 miles at 9 min pace I should be able to run sub 3:30. 9 x 7 is what? @#$% Damn I can't do the math. Ok I know 9 x 5 is 45 so 9 x 7 is more than 45 mins. Ok how about 10 x 7. So at 10 min miles I have another hour and 10 mins. That will put me at over 3:30.
Mile 20 8:55 The beginning of the end. Damn Damn Damn c mon Reyana
Mile 21 8:30 Ok so if I run 8:30s from here can I run sub 3:30. I try to do math again. 5 x 9 is 45 mins. Yes, this I can do. If I run 9 min miles to the finish I can run 3:29. Yes Yes Yes.
Mile 22 8:54 Oh no, what about the 0.2. How do I calculate the time for the 0.2. How fast have I run 0.2? What is 0.2? Is that a quarter mile? Oh geez no that's less than a quarter mile.
Mile 23 8:35 Oh nice not bad. Please God let me finish. My dad did not raise a quitter. I am a winner.

Mile 24 8:53 Oh who cares about winning. I just want to stop. I don't care about this stupid race. I hate this part. I still have 2 miles to go. What is the street number? Are we still in the 50s, 40s? I know we have to turn on 8th street. HELLO that is a freaking long way to go.
Mile 25 8:32 WOW I had no idea I could even pick it up a bit at this late stage of the race. Oh yeah a runner in pink tried to pass me. No, you don't pass me.
Mile 26 8:27 Yes the mile 26 flag how beautiful you are. I love you flag. What? I am at 3:30 already. Oh no, that's right the 0.2. I did not know how to calculate the 0.2 into my time. So much for sub 3:30. Dang it!
The last 0.2 1:35 - yeah I actually sprinted to the finish line (well, sub 8 pace). I obviously did not give it my all out there.
I ended up taking third in my division. The first place Athena ran 2:54. I am sooo motivated now.

Today I feel good.

Monday, December 13, 2010

Nutrition Misinformation

Nutrition misinformation can have harmful effects on the health, well-being and economic status of individuals. About 22% of consumers claim to be confused by reports on health and nutrition. Sadly it is not always easy to decipher all the information out there. The good news is that accurate food and nutrition information is a result of scientific agreement from peer-reviewed studies that can be replicated.

Erroneous information is abundant and consists of incomplete, misleading science or anecdotal evidence. It can be disseminated recklessly, to gain attention, to promote a product, or to promote a philosophy of a special interest group. Food and nutrition misinformation includes food faddism, health fraud and misdirected claims.

Food fads are exaggerated unreasonable claims that eating or not eating certain foods, nutrients, supplements, combinations of certain foods may cure disease, provide significant health benefits, offer quick weight loss or provide some magical solution. More often these claims are made in an attempt to sell a product. Be wary of magic bullet statements. For example, "Eating 100% organic is the only way to be healthy".

Health fraud is a deliberate use of food faddism to make money. For example, marketing and selling a pill claiming that it will make your burn fat. According to the American Dietetic Association's (ADA's) Complete Food and Nutrition Guide, "health fraud means a promotion for financial gain, a health remedy that doesn't work - or hasn't yet been proved to work" and that is "promoted to improve health, well-being, or appearance".

Misdirected claims include those that lead consumers to make incorrect inferences and generalizations about food. A label on a food item may read, "low in cholesterol" in a plant product that does not contain cholesterol to begin with. It is perfectly legal to provide misdirected claims on food products, yet the Federal Trade Commission is working on providing adequate disclosures to correct advertising misinterpretations.

So, we have to be savvy consumers and take charge of our self-care. In 2004 consumers spent $43 billion on weight-loss solutions. Food faddism, health fraud and misdirected claims can be very expensive for individuals. it is thus important to get information from credible sources such as nationally credentialed dietetics professionals working in health care, academia, public health, the media, government, and the food industry because they are uniquely qualified to promote science-based nutrition information.

"It is the position of the American Dietetic Association (1) that Registered Dietitians (RD) and ADA members provide consumers with sound, science-based nutrition information and help them to recognize misinformation; (2) RDs and ADA members need to be the primary source of sound, science-based nutrition information for the media and to inform them when misinformation is presented; and (3) ADA members should continue to diligently work with other health care practitioners, educators, policy makers, and food and dietary supplement industry representatives to responsibly address the health and psychological, physiological, and economic effects of nutrition-related misinformation". Journal of the American Dietetic Association. 2006; 106:601-607

Thursday, October 14, 2010

Iron For Performance

Fatigue during training is inevitable, but fatigue caused by iron deficiency anemia can be avoided and prevented. Iron, a trace mineral, is a major component of hemoglobin in red blood cells and is responsible for transporting oxygen to the lungs and various muscles during endurance exercise. When we are iron-deficient we may experience early-onset fatigue during a run, muscle burning, shortness of breath, nausea, frequent infections, pale appearance, light-headedness, or feelings of having heavy legs. Over 50% of female endurance athletes suffer from iron-deficiency anemia. However, male endurance athletes are not immune to anemia. Alan Culpepper, a top US marathoner, battled anemia in the summer of 2006. He struggled to train and compete until he was able to start supplementing with iron to improve his iron stores.

The iron needs of endurance athletes are greater than for non-athletes due to the iron losses that occur with each footstrike, and the loss in sweat. These needs are even greater for female runners because of menses. In addition, dietary intake of iron can be a limiting factor as well. Seventy-five percent of women aged 18 to 44 don’t eat enough iron-rich foods to meet their daily needs, so iron depletion is inevitable. And it doesn’t help that we absorb about 15% of the iron we ingest. The recommended daily allowance (RDA) for iron for women (11-50 years of age) is 15mg day and 10mg per day for men. During pregnancy iron needs increase to 30mg per day. Even though we know that endurance runners need more iron, there aren’t special iron recommendations for endurance athletes.

It is also very possible to have normal hemoglobin levels and have low iron stores (serum ferritin). Hemoglobin is the protein molecule attached to the red blood cell and is responsible for transporting oxygen to the various muscles and the lungs whereas serum ferritin is the storage form of iron in the body. Normal hemoglobin levels are between 11.5 -15.5g/dl and less than 11.5g/dl is considered anemia. Normal serum ferritin levels can range from 20ug/dl to 150ug/dl, yet some studies suggest that serum ferritin levels less than 30ug/dl to be iron depletion and 12ug/dl suggests exhaustion of iron stores. Athletes may feel tired and weak with low iron stores even though they are not anemic. The cut off levels for serum ferritin are very individual and may differ in athletes, so interpretation of low SF levels needs to be cautious. Anecdotal evidence suggests that serum ferritin levels around 50ug/dl or greater are preferred.

It has become standard practice in recent years to monitor an athlete's iron status by testing serum ferritin levels. However, there is no standardized ferritin level at which supplementation is recommended, nor is there a consensus as to the appropriate maintenance of ferritin. For example, an athlete experiencing symptoms of fatigue and has a serum ferritin level of 25ug/dl may be a candidate for iron supplementation and/or education regarding the importance of a balanced diet to maximize performance. Supplementation for the iron-depleted nonanemic athlete does not appear to be justified to solely improve performance. In fact, several studies show that supplementation with iron does not improve performance of iron-depleted nonanemic athletes. However, it is well-known that performance is diminished with anemia and is improved when the anemia is reversed.

The most prudent first step is to evaluate the athlete’s diet. It is possible that making a few dietary changes can improve iron stores. A diet rich in meats, beans and cereals combined with vitamin c rich foods can improve iron stores. Vitamin c increases the bioavailability of iron in the body. It is well established that the iron in animal sources, otherwise known as heme iron is better absorbed than iron from plant sources or non-heme iron. So meats are excellent sources of iron. A 3 oz portion of beef (visualize deck of cards) contains about 3 mg of iron. A cup of cereal can contain as much as 8 mg of iron, however, is not as well absorbed by the body. So eating iron-rich foods with vitamin c rich foods such as tomatoes, citrus fruits, strawberries, and broccoli can increase the amount of iron that is absorbed into the bloodstream. Cooking in a cast-iron skillet leaches iron into food.

Also note that the absorption of iron is inhibited by tannins found in tea and coffee, food additives such as phosphates found in soft drinks and certain preservatives. It is also decreased with excessive intake of certain minerals such as zinc and calcium

When a concerted effort has been made to increase dietary intake of iron and fatigue and low levels of serum ferritin and /or hemoglobin still persist, iron supplementation may be necessary until normal levels are achieved. Ferrous sulfate is the preferred form of iron since it has a high absorption rate. A typical dose of 50 to 100mg of elemental iron, 2 or 3 times a day taken with 500mg of vitamin c or with some orange juice will help absorption. Since high levels of iron can cause constipation or diarrhea, a liquid iron supplement may be preferable. Usually iron levels are restored within 60 days of therapeutic doses of supplemental iron.

Examples of food sources of iron:

· Lean cuts of beef, pork, lamb

· Liver

· Skinless turkey, and chicken

· Fish

· Iron-enriched cereals, breads, and pastas

· Green leafy vegetables

· Beans and dried peas

· Eggs (the yolk)

These foods eaten with vitamin c rich foods will aid in absorption. Listed below are examples with food rich in vitamin c:

  • Citrus fruits (oranges, grapefruits)
  • Strawberries
  • Broccoli
  • Juices fortified with vitamin c
  • Bell peppers
  • Tomatoes

It is important to continually monitor iron status as well as biochemical markers and nutritional status to ensure that iron deficiency anemia is prevented to assure optimal health and athletic performance.