Tuesday, November 20, 2007

I cannot believe it is holiday time already!

The summer has come and gone. The fall is almost over. And I haven't posted a message since spring. The good news is that I have been very busy. I work two days a week at New York Downtown Hospital as the Renal Dietitian. It is a challenging yet rewarding job. The other days are devoted to my nutrition and exercise private practice. This is going well and I enjoy spending time with my clients.


I wanted to post something about healthy holiday eating, but I did that in November 2006. Take a look at that post. Have fun during the holidays!

Wednesday, April 11, 2007

My Favorite Recovery Drink

During my last bike ride, I was asked “Is it true that chocolate milk is a good recovery drink?” The answer is yes. A study published in the February 2006 issue of the International Journal of Sports Nutrition and Exercise Metabolism, and funded in part by the dairy industry, reported that cyclists who drank chocolate milk at a break were able to continue cycling about 50% longer than those who drank Endurox R4 and about equally as long as those who drank Gatorade.

In three trials administered at one-week intervals, nine male endurance trained cyclists performed an interval workout then drank one of three drinks after 2 hours of recovery. One group got standard 2% chocolate milk, another drank fluid- and electrolyte-replenishing Gatorade and a third group Endurox R4, a specially formulated beverage with a "patented 4 to 1 ratio of carbohydrates to protein" and other ingredients aimed at replenishing muscle glycogen stores and helping rebuild muscle. Four hours later they performed an endurance trial to exhaustion at 70% VO2max.

So what does that mean to us? If you are a male endurance trained cyclist, chances are that chocolate milk is a good recovery drink. Remember, this is only one study with a very small sample size. However, I do recommend chocolate milk to all my athletes as a recovery drink. Why? It contains carbohydrates that are needed to refuel the muscles. It also contains protein that provides amino acids for building and repairing of muscle tissues. Also, a little protein might give an athlete a performance edge by enhancing the insulin release, which aids in the transport of carbohydrates to the muscles. It contains calcium, a nutrient that most adults don’t get enough of. And it tastes good!

The period after a ride is important to the recovery of our muscle tissues and replenishment of energy stores. Some studies suggest a ratio of 4:1 carbohydrates to proteins. This is a good guideline. More specifically, after a long, fast ride follow these guidelines (Sports Nutrition: A Practice Manual for Professionals: 4th edition, American Dietetic Association, Marie Dunford, editor, copyright 2006):


* Drink 16-24 ounces sports drink for every pound of body weight lost. (Note: the fluid contributes to your carbohydrate and protein needs listed below.)
* Eat 1-1.2 grams carbohydrate per kilogram bodyweight within the 1st 30 minutes and at 2 hour intervals thereafter.
* Include 6-20 grams protein within the 1st 30 minutes then a mixed meal 2 hours later.
* Fat intake should be minimal for 2-4 hours.
(Divide your weight in pounds by 2.2 to calculate kilograms)

To estimate the amount of carbohydrates and protein in a food, you can use this guide:
* Starches including ½ bagel, 1 slice break, ¾ cup cereal, ¼ cup granola, ½ cup cooked pasta, ½ cup corn or peas, 1 small potato, ½ cup beans or lentils, or 1/3 cup cooked rice contain 15 grams carbohydrate and 3 grams protein.
* 1 cup of milk, ¾ cup plain yogurt or 1 cup sweetened yogurt contains 12 grams carbohydrate and 8 grams protein. 1 cup soy milk contains 5-8 grams carbohydrates and 7 grams protein.
* ½ cup cooked vegetables or vegetable juice, or 1 cup raw vegetables contains 5 grams carbohydrate and 2 grams protein.
* 1 small to medium fresh fruit, ½ cup fresh fruit or fruit juice, or ¼ cup dried fruit contains 15 grams carbohydrate and no protein.
* Meats and meat substitutes (1 oz meat, fish, poultry or cheese, or ½ cup beans, peas or lentils) contain 7 grams protein. ½ cup beans contains 6 grams carbohydrate. 2 tablespoons of nut butter contain 8 grams of protein and 6 grams carbohydrate. Meat, poultry, pork, and fish do not contain carbohydrates. The amount of carbohydrate in cheese is minimal.
(To find out more nutritional facts for a particularly food, see www.nutritiondata.com)

If you are a small person (like me), you may only need 50 grams of carbohydrates after a ride. I usually eat a low-fat plain yogurt, a small piece of fruit and a cup of chocolate (non-fat) milk. Most average sized people will need almost double this amount. But consuming that much after a ride is sometimes difficult. Often our appetite is suppressed. So I recommend blending a drink of low-fat milk, plain yogurt and fruit. Or you can try a specially developed recovery drink. Other options are Ensure and energy bars with a 4:1 ratio carbs to protein. Or a glass of chocolate milk. (Note: Soy milk does not contain the 4:1 ratio since it only contains 5-8 grams of carbs vs cow’s milk of 12 grams. But if do not drink cow’s milk, soy milk is an adequate substitute – make sure you purchase soy milk with added calcium and vitamin D.)

Eat well to ride strong!

Saturday, March 24, 2007

Water, Sport Drinks and Exercise

Last week, I was asked “what should I drink while I exercise”. This is an important question that I get frequently. The answer is it depends on how long you exercise. If it is less than 1 hour, water will suffice. There is little evidence that consuming a carbohydrate-electrolyte drink (such as Gatorade, PowerAde, Cytomax, etc.) versus plain water during exercise that lasts less then 1 hour improves performance or fatigue. Consuming a carb-electrolyte drink if you are exercising less than 1 hour is only suggested if you are trying to gain weight or if it’s a morning work-out and you did not eat breakfast. If you are exercising for more than 1 hour, studies have shown that a drink containing carbohydrates and electrolytes will delay fatigue and may enhance performance. The sodium added to the drink may improve palatability, promote fluid retention, and possibly prevent hyponatremia in individuals who drink excessive quantities of fluid. Studies recommend that the percentage of carbohydrate in the drink is 4%-8%. Although recently disputed, some studies have shown that a combination of carbohydrate and protein in a 4:1 ratio improves the muscle's fuel efficiency and spares muscle glycogen contributing to an improvement in endurance.

With so many options of fluid replacement drinks, what should you drink? I have tried Gatorade, Cytomax, Amino Vital, Accelerade and many more. You may want to try Accelerade which contains a 4:1 ratio of carbs to protein. I know athletes who love it and others who cannot stomach it. If you have problems digesting or drinking any fluid replacement drink, do not force it on yourself. You’ll just feel sick and uncomfortable which will hinder your work-out. Try something else and you’ll eventually find the drink that is right for you. (Note: Never try a new food or drink on a long ride, event or race day – it will ruin the day if you have problems digesting it.)

How much should you drink? The best answer is to determine your hourly sweat rate. Your size, gender and fitness level influence sweat rate. So don’t expect your friend’s fluid needs to be the same as yours. Weigh yourself before and after a one hour work-out. For each pound of weight you lose, your fluid shortfall is about 16 ounces (2 cups). For example, if you lose one pound, you have sweated away 16 ounces (1 lb x 16 oz) more of fluid than you have consumed. Add in the amount of fluid consumed during the work-out. If you drank 16 ounces, then your hourly sweat-rate is 32 ounces (16 ounces of fluid + 16 ounces of sweat). This means you should consume 8 ounces of fluid every 15 minutes.

On long bike rides, unless you drink Gatorade which you can purchase on the road, don’t forget to bring a supply of your fluid replacement powder to mix at the lunch spot. I do not recommend buying Snapple or other juices because they do not contain the recommended amount of carbohydrates and electrolytes.

Eat well to feel strong!

Tuesday, March 13, 2007

Weight loss for Athletes

March in New York is the beginning of spring training for outdoor recreation athletes, particularly cyclists, runners and triathletes.

The number one rule for weight loss if training for an event or race is lose the weight during the winter when you are not in serious training mode. But now it is too late and you want to lose 5-10 pounds. What do you do so that you can train without bonking, properly recover from the ride and lose weight?

Weight Loss Facts
Here are a few weight loss facts to consider. To lose one pound, you must have a deficit of 3500 calories. Sounds like a lot, but if you stretch the calories across one week, that is a reduction of 500 calories a day. Do not try to lose more than 1 pound a week, otherwise you will be sacrificing the nutrients necessary for training.

Weight Loss Tips
How do you reduce your caloric consumption of 250-500 calories a day when you are trying to maintain your glycogen stores?
1. Cut down on liquids and foods that is high in processed sugar and fat. Some examples are soda, sweetened drinks, potato chips, candy, regular salad dressing, mayonnaise, pastries (cookies, cake and cinnamon rolls) and ice cream. For that sweet tooth, consume fruits which have natural sugars.
2. Do not consume anything fried or sautéed in large quantities of oil. Preferred cooking methods are baked, broiled, steamed or sautéed lightly oil.
3. Eat low-fat dairy and protein foods. Drink one-percent or non-fat (skim) milk. Eat low-fat cottage cheese, yogurt and cheese. Eat fish, chicken or turkey without skin, and lean cuts of meat. Trim all fat off of meat before cooking meat.
4. Eat foods that are high in fiber. Eat five or more servings of fruits and vegetables. Eat whole grain foods (such as whole wheat bread), beans and legumes. These high fiber foods are healthy and may give you a feeling of fullness. This may help you to avoid overeating at or between meals. Add high fiber foods to your diet slowly if you have not been eating high fiber foods. Adding many high fiber foods to your diet too quickly may cause bloating, gas and stomach discomfort. Avoid eating high fiber foods before a long ride if you are worried about bloating, gas or other stomach discomfort.
5. Cut out alcoholic drinks. Alcohol contains empty calories and increases the appetite. 12 ounces of beer is 150 calories, 4 ounces of wine is 77 calories, an ounce of hard liquor (gin, vodka, rum, whiskey, or scotch) contains 64 calories for 80 proof varieties, and 80 calories for those that are100 proof. If you add a mixer, the calories may soar. One cup (8 ounces) of orange juice contains 111 calories, regular cola or lemon-lime soda has about 100 calories, and regular ginger ale, tonic, or quinine water has around 80 calories. And you don’t usually drink just 4 oz of wine – that’s a small pour. Nor are you getting just 1 oz of hard liquor. Think of all the calories that you can save by not drinking those beers, in addition to the nuts and pretzels that go along with the drinks.

Do you really need to lose weight?
But what if you don’t drink alcohol, eat a high fiber, low-fat diet, and need to lose those 5-10 pounds? First of all, congratulations because eating healthfully may be more important than losing those stubborn pounds. I would like you to determine if your goal weight is realistic – have you ever been at that weight as an adult. If not, I recommend that you continue eating healthfully and focus on training. You may want to get your body fat measured to determine your body composition. You don’t want to risk losing muscle.

Reducing calories during spring training
To lose those stubborn pounds gained during the winter, on the non-training or light training days, reduce your caloric intake by 250-500 kcal. This will be accomplished by reducing portion size and following the suggestions listed. I do not recommend caloric restriction on a day of a race or a long training ride. Since your body requires adequate carbohydrates and protein, now it is time to determine your minimum needs. Carbohydrates intake should range from 7-13 grams per kilogram bodyweight. Protein intake should range from 1.4 to 2.0 grams per kilogram bodyweight. (To calculate kilogram bodyweight, divide your weight by 2.2.) Calculate your minimum needs using the lower end of the range. To determine carbohydrate and protein calories, multiple the number of grams by 4 (there are 4 calories in a gram of carbohydrate and protein, and 9 calories in a gram of fat.) The remaining calories should come from fat which should range from 0.8 to 1.0 grams per kilogram bodyweight. Avoid foods high in trans-fats and saturated fats. “Good” fats are in foods such as fish, nuts, olive oil, and avocados.

Body Composition
You may notice at some point you stop losing weight, or you may have possibly gained weight. Get your body fat measured now so that you can see changes in your body composition. If you belong to a health club, ask a trainer for a body composition measurement. If your body fat has decreased, the extra weight is muscle weight. Remember, you are exercising more and your muscles are getting larger while you are losing fat as you improve your diet. Do your pants fit you better? If so, you may want to reconsider your goal weight. The number is not as important as how you look and feel.

It is not recommended to go below 5% body fat for men and 12% for women. Elite male cyclists’ body fat range from 5-12%, and elite women from 8-15%. If you are too thin, you will be at a disadvantage. Excessive leanness (below essential body fat levels), and the processes of maintaining an unrealistically low body fat level through calorie restriction and excessive training can predispose an athlete to eating disorders and increase the risk for muscular injury, stress fractures and menstrual irregularities. The ranges of body fat for optimal health and fitness are 16-25% for women and 12-18% for men.

Friday, March 02, 2007

Not for kids only - Healthy, fun snacks and desserts

I am frequently asked “What should I give my child for a snack?” That is a great question because snacks are important, particularly for our busy children who participate in after-school activities and weekend sports. Snacks are essential because they re-fuel our bodies and add nutrients that are needed for growth and health. With that in mind, we should feed our body with foods that prepare us for the next activity. For example, if your child is going from school to sports class, you will want to give them a snack that contains whole grains and a little protein. Whole grains are carbohydrates that provide sustained energy for our body. Protein is necessary for growth and development. Examples are peanut butter and all-fruit jelly sandwich on whole wheat bread or hummus on whole wheat pita bread. However, if your child is going to a less strenuous activity, you may want to give them something that is nutrient dense. A nutrient dense food is one that is loaded with nutrients but not calories. Examples include raw vegetables with hummus, salsa or bean dip, fresh fruit or low-fat or non-fat yogurt. Potato chips and corn chips are not nutrient dense. They are “empty calories” loaded with fat and no nutritional value. Your child deserves the best so that they can be successful in their daily activities.

But what if you are not around to give your child a freshly made snack? I created two sections of snacks and desserts. One section is fresh or refrigerated (if your child can carry a freezer bag with an ice pack) and the other is “backpack ready”. Backpack ready are prepared items that will stay fresh all day without refrigeration.

What about desserts? Yes, desserts can be fun and healthy. Instead of cookies or cake, try our family favorite, a fresh fruit parfait with yogurt. Sometimes we add chocolate sauce and other times granola. Pudding made with low-fat or non-fat milk is always fun and provides much needed calcium. Fruit flavored milk shakes made with your child’s favorite fruit and low-fat or non-fat milk are also calcium boosters. (Note: If you use soy milk, be certain that it is calcium fortified.)

Some of these snack items are packaged items that you will find in the supermarket. Read the label and avoid items that contain high fructose corn syrup, partially hydrogenated oils/trans fat, sugar listed as the first ingredient, or fat, cholesterol or sodium daily value greater than 10%.

Fresh snacks (to be made at home and/or place in a freezer bag with an ice pack)
· Raw vegetables, such as celery, carrots, cauliflower, broccoli, green pepper, green beans,
cucumbers, mushrooms or zucchini with hummus, salsa or bean dip.
· Whole wheat bread/pita with nut butter or hummus.
· Whole wheat crackers with low fat cheese
· Whole wheat wrap with chicken breast, turkey, vegetables, nut butter or hummus.
· Low fat or nonfat yogurt with fruit (total 1 cup)
· Low fat (1%) or non-fat (Cabot brand tastes good) cottage cheese with fruit (total 1 cup)
· Shakes with low fat or nonfat milk or yogurt and fruit (1 cup)
· Pre-portioned low-fat or non-fat pudding (1 individual serving)
· Pre-portioned oatmeal made with non-fat or low-fat milk and ¼ cup raisins
· Mozzarella “string-cheese”
· Hard boiled egg

Backpack Ready (will stay fresh all day without refrigeration)
· Raw vegetables
· Fresh fruit such as apples, oranges, bananas, peaches, grapefruit, grapes, melons, pears,
plums or strawberries.
· Pre-packaged all natural applesauce
· Pre-packaged unsweetened fruit juice (1/2 cup)
· Dried fruit (1/4 cup) or dried vegetables (1/2 cup)
· Nuts (1 oz)
· Pretzels (1 oz)
· Rice cakes (2)
· Whole grain fig cookies (example, Fig Newmans) (2)
· Graham crackers (2)
· Whole grain cereal (3/4 cup)
· Whole grain granola bars (example, Kashi brand)

Wednesday, January 10, 2007

Get Moving for you and your children

I am greatly impressed by the number of parents who are athletes in my son’s class. We have several accomplished marathoners, triathletes, cyclists, swimmers and runners. This school is home to many parents who exercise regularly. What great role models!

While training for a triathlon or marathon is not for everyone, moving your body on a daily basis is necessary to remain healthy. But why is exercise important? Here are reasons why you will want to take a brisk (pump up your heart) walk in the park based on recent scientific studies:
· Exercise reduces the risk of coronary heart disease and some cancers in women
· Men who exercise have a reduced risk of dying from both cardiovascular disease and cancer.
· Aerobic exercise helps overweight hypertensive adults lower their blood pressure, as well as improving their overall cardiovascular response to mental stress, another risk factor for heart disease.
· Being out of shape increases the risk of premature death including risk factors such as diabetes, high blood pressure, and obesity.
· Exercise may be protective against the development of Alzheimer's disease.
· Those who took brisk walks 45 minutes three times week for 6 months performed substantially better on several cognitive tasks than those who did stretching or strengthening exercises.
· Regular exercise is one of the best ways to combat daily stress.
· Exercise may be effective in reducing the perception of pain, even among those with chronic pain in the lower back.
· Being active may reduce the number of colds people get each year.
· Exercisers were perceived to be healthy, muscular and sexually attractive, while non-exercisers were perceived to be sickly, scrawny, and sexually unattractive.

Many of these studies found that the improvements were attributed to cardio exercise (exercise that increases your heart rate) rather than stretching and strength training. However, stretching and strength training should also be a part of your exercise routine. Keeping your body flexible will reduce the risk of injuries while strength training is important for maintaining muscle mass, reducing the risk of bone disease and improving your metabolism.

But my favorite reason why parents should exercise is because we are role models for our children. Those children who see their parents leave the apartment early to go to the gym or park before work understand that exercise is something that should be incorporated into your life. It is an ordinary part of their life to move their body daily.

Why should children exercise? A child who is active will have stronger muscles and bones, be less likely to become overweight, decrease the risk of developing type 2 diabetes, possibly lower blood pressure and cholesterol levels and have a better outlook on life. Kids who are physically fit sleep better and are better able to handle the physical and emotional challenges that a typical day presents - be that running to get to school on time, bending down to tie a shoe, or concentrating in class. For kids, exercise can be as easy as running around the playground, playing ball or tag with their friends, riding their bike with their mom or dad.

So let’s get moving for our health and the health of our children.