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The Athlete’s Kitchen
Copyright: Nancy Clark MS RD CSSD October 2009
Reforming Your Healthcare Policy: Food for Thought
Healthcare reform is a hot topic these days, not only in the news but also (hopefully) in your personal life. You likely already know that by eating well, exercising at least 150 minutes a week, and not smoking, you can reduce the risk of an early death by 80%. (That’s a lot, eh?!) But your friends and family may not fully appreciate how much slacking off, underexercising, and gaining undesired body fat too easily leads to negative health consequences that cost us millions of dollars.
Losing excess body fat is important because fat is an active tissue, not just a bank account of extra calories. Fat cells create an inflammatory response that contributes to heart disease, cancer, amd diabetes. Fat also produces a hormone, leptin, that affects appetite. Leptin sends signals to the brain to stop eating. Hence, the brain and the intestinal tract are highly connected. Unfortunately, the brain developed in ancient times when food was scarce and unpredictable. This might explain why the body stores fat easily, yet sheds fat with greater difficulty.
To address nutrition, obesity, and health concerns, experts discussed the latest research at the 4th Annual Symposium of Tuft’s University’s Friedman School of Nutrition Science and Policy (Boston, Sept.’09). Perhaps this information will inspire you and your loved ones to take an active role in preserving your good health for a robust and lengthy lifespan.
Food shopping reform
Good nutrition starts in the supermarket. Unfortunately, you almost have to have a PhD in nutrition to know which groceries to buy. But this is changing. For example, the Smart Choices food ranking system (www.SmartChoicesProgram.com) is now is on the front of many food packages. This program gives a check mark to foods that meet certain criteria (rich in vitamins, fiber; low in sodium, added sugar, trans fat, etc.). Participation in Smart Choices is voluntary, yet many of the major food companies are participating.
Hannaford Supermarket has created a Guiding Star system that ranks foods according to the nutrients we want to eat more of (calcium, iron, fiber) and those we should eat less of (saturated fat, trans fat, sodium). Signs in the marketplace indicate if a food has one, two or three stars. Would you believe 77% of the foods in grocery stores do not qualify for even one Hannaford Guiding Star? This indicates how health-eroding our food supply is! Let’s hope that companies whose products fail to earn even one star might quietly start tweaking their recipes to create healthier 
products…
As a result of the Guiding Stars food ranking system, Hannaford customers are actually shifting their shopping patterns. They are now buying more of the best foods (nutrient-dense and locally grown) and less of the rest. The hope is better food labeling, along with consumer education, will help Hannaford shoppers shave off 100 to 200 calories a day. This small change can lead to losing 10 to 20 pounds fat in a year. This is a sure way to chip away at the obesity epidemic.
Obesity: a huge problem
A simple look around the mall confirms this fact: Obesity is rising to epidemic proportions. Despite years of advice from health professionals to add on exercise and eat fewer calories, obesity rates continue to increase. Reducing the prevalence of obesity will take years, because we need to change many systems. That is, restaurants need to serve smaller portions; kids need to be able to walk safely to school; food manufactures need to make products with less fat and calories; housing developments need to be designed so people can walk to stores, as opposed to drive to the mall. All of this takes time, coordination, planning, and policy.
In the meantime, what can you do? You can implement small but sustainable changes that you can happily maintain for the rest of your life. The changes might have more to do with lifestyle than food—and what you choose to do with your feet, not just your fork. Here’s a little of what we know:
• We need to live in neighborhoods that encourage walking, biking, and public transportation. As you have undoubtedly noticed, walkability has been engineered out of your life. Busy streets and highways now divide neighborhoods that used to be vibrant communities. We have created lifestyles that focus on the automobile. No longer can most of us walk to stores, the post office, and to work; instead, we need to drive cars. To shop, we drive to malls; this takes people out of cities and dissolves the communities that get created when neighbors interact while walking outside.
Even schools are being built away from the center of town because there is more land (the required 40 acres). This ties kids to school busses. Some schools have started parking the busses farther away from the classrooms, so the kids at least get a little more exercise before and after school.
Preventing health problems
Preventing obesity and the diseases of aging (which are really diseases of inactivity and overeating) is far easier than fixing health problems. The standard recommendations to exercise more and eat less are seemingly ineffective. To our detriment, (over)eating is pleasing. In comparison, food deprivation is less attractive. We need to find ways to lose undesired body fat without feeling deprived or punished.
Preventing weight gain needs to start early. Given that 25% of today’s’ kids ages two to five years old are overfat or obese (as are 33% of school-age kids), waiting until kids enter the school system is too late to deal with the problem. Prevention offers an opportunity to improve the child’s health, reduce disease, save money. An obese child with at least one obese parent is very likely to become an obese adult…
Prevention of undesired fat gain can start as early as infancy. For example, sleep deprivation is a known contributor to weight gain—even in infants. Research indicates infants who routinely sleep less than 11 hours a night are more likely to be overweight than those who sleep more than 13 hours. This means, if you are a working parent, don’t keep your kids up too late, just so you can enjoy a little bit more family time!
The bottom line
Health care reform needs to start on the personal level. While you may live an active lifestyle, others need encouragement to take responsibility and be more active, eat wisely, sleep well, and stay well!
Nancy Clark, MS, RD, CSSD (Board Certified Specialist in Sports Dietetics) counsels casual and serious exercisers in her private practice at Healthworks, the premier fitness center in Chestnut Hill MA (617-383-6100). Her Sports Nutrition Guidebook, and food guides for new runners, marathoners, or cyclists are available via www.nancyclarkrd.com. See also sportsnutritionworkshop.com.
(image: flikr, happyshooter)
The Athlete’s Kitchen
Copyright: Nancy Clark MS RD CSSD, August 2009
“I’m 44. Should I start taking calcium pills?”
“A bone density test indicated I have the bones of a 70 year old—and I’m only 34. I guess I should have had more milk and less soda as a kid…?”
“Will drinking more milk help my stress fracture heal faster?”
Questions and confusion abound about the role of calcium in athletes’ diets. If you are like most active people, you may think, “Milk is for kids” and quench your thirst at lunch and dinner with (diet) soda or water. As a result, you can easily end up consuming a calcium-deficient diet (that is, unless you consume yogurt and cheese instead of milk).
Weight-conscious women, in particular, are known to have calcium-deficient diets out of (the unjustified) fear that milk’s calories will add to undesired weight gain (1). Many men also have calcium-poor diets. If they are not milk drinkers, means’ main sources of calcium are from the cheese on cheeseburgers and pizza. Not very health enhancing…
Given the average American lives for 77.7 years, maintaining bone health throughout the lifespan should be a priority for all athletes, starting as youngsters and continuing as master’s athletes. A calcium-rich diet, weight-bearing exercise (such as running, as opposed to biking and swimming) and strength-training to have strong muscles tugging on bones are all important factors for optimizing the bone density of both growing children and active adults.
Bones are alive and require a life-long calcium intake. If your family has a history of osteoporosis, your risk for “shrinking” (losing height) as you get older is high and you should pay special attention to maintaining your bone density. Female athletes with a history of amenorrhea also have a high risk for weak bones and should get their bone density tested so they know where they stand and if they need to take extra steps to try to enhance bone density. Here’s some information about calcium and bone health to help you enjoy lifelong health, no bones about it.
Q. Can I take a calcium supplement instead of drink milk?
A. While any calcium is better than none, taking a calcium pill does not compensate for a calcium-poor diet. A supplement offers calcium, but it does not offer the high-quality protein found in milk or soymilk, nor the myriad of other health-enhancing nutrients. Little babies thrive on milk, not calcium pills. Do you really think a pill can replace a whole food?
Q. I like to save calories by taking a calcium pill instead of drinking milk. Is that OK?
A. Not really. Although a calcium pill offers a low calorie alternative to consuming the recommended three (8-ounce) glasses of milk or yogurt each day, research indicates milk drinkers tend to be leaner than milk avoiders (1). I encourage my clients to embrace milk as a “liquid food” that is satiating and curbs one appetite. That is, milk can be more filling than the same number of calories from soda or juice.
Most of my active female clients reduce weight on 1,800 calories; men on 2,100+ calories. That breaks down to 500 to 600 calories per meal (breakfast, lunch, dinner) and 300 calories for a snack. Enjoying low-fat (soy) milk on cereal, a mid-morning latte and a yogurt for a snack seems a powerful way to spend 300 of those calories and approach the recommended intake of 1,000 milligrams of calcium per for adults 19-50 years; 1,200 mg for adults older than 50 years, and 1,300 mg for kids 9-18 years. If you are a parent, be a role model and drink milk at dinner to encourage a calcium-rich intake for your kids. Building strong bones during the ages of 10 to 18 is a wise investment for the future.
Q. I’m lactose intolerant. Can I get enough calcium from non-dairy foods like soymilk, spinach, broccoli and almonds?
A. For certain, you can get calcium from non-dairy sources. Soy milk is calcium-fortified and offers ~300 mg calcium in 8 ounces—similar to cows’ milk. Other convenient non-dairy calcium sources include fortified orange juice (350 mg/8 oz.) and fortified breakfast cereal, such as Total Cereal (1,000 mg/3/4 cup).
If you are do not consume dairy products or fortified soy products, you will have to work hard to consume adequate calcium. For example, to get the recommended intake from plant sources, you’d need to eat 10 cups of spinach salad, 3.5 cups of broccoli, and 4 ounces almonds (about 88 almonds @ 675 calories). That’s a lot of eating…
What you do NOT get from those plant sources of calcium is Vitamin D. Vitamin D enhances the absorption of calcium and is needed to not only protect bone health but also to reduce the risk of high blood pressure, diabetes, and heart disease; enhance immune function and reduce inflammation. Vitamin D is added to milk and some brands of yogurt, but is hard to find naturally in foods other than oily fish. Hence, non-milk drinkers have a high risk for not only calcium but also vitamin D deficiency.
Q. I live in Boston and spend lots of time outdoors in the sun. Should I take additional D even though I drink milk?
A. Yes, especially between Thanksgiving and Easter. Vitamin D deficiency is surprisingly common in people who live in northern latitudes (north of Atlanta GA), where the sun’s ultraviolet rays do not effectively convert the body’s inactive form of D (just under the skin) into an active form. And even Southerners need to be mindful. A study of southern distance runners indicates 40% of them were D-deficient (2). Indoor athletes (dancers, swimmers, hockey players, figure skaters, basketball players, gym rats, etc.) should ask their doctors about getting their blood tested to determine their level of vitamin D, and if it is low, take steps to correct the problem.
Q. Does the fat in milk contribute to heart disease?
A. Controversial. A study that tracked the health and dairy intake of 4,374 children for 56 years (between 1948 and 2006) reports there was no increased risk of heart disease or stroke among the 34% who died during that time—even though, as kids, the subjects in the study drank whole milk. In fact, the children who consumed the most milk and cheese lived longer. (3)
This study conflicts with the prevalent message to reduce the risk of heart disease by limiting the intake of milk’s saturated fat. Until more research clarifies this confusion, I recommend you enjoy low fat dairy/calcium-rich foods to help reduce excessive fat and calorie intake while maintaining a strong calcium intake.
Q. Will drinking extra milk help a broken bone heal faster?
A. Doubtful. Bones need time to heal … about 6 to 8 weeks. But perhaps you can reduce the risk of breaking a bone by building it stronger in the first place?
Do you get enough Calcium? What are some of your favorite Calcium Rich Foods?
Nancy Clark, MS, RD, CSSD (Board Certified Specialist in Sports Dietetics) counsels both casual and competitive athletes in her private practice at Healthworks, the premier fitness center in Chestnut Hill MA (617-383-6100). Her Sports Nutrition Guidebook, and food guides for new runners, marathoners, or cyclists are available via www.nancyclarkrd.com. See also sportsnutritionworkshop.com for information about upcoming workshops in Providence, Boston and Toronto.
References
1. Heaney R, Davies K, Barger-Lux M. Calcium and weight: clinical studies. J Amer College Nutrition 2002. 21(2):152S-155S.
2. Willis KS, Peterson NJ, Larson-Meyer DE. Should we be concerned about the vitamin D status of athletes? Int’l J Sports Nutr & Exerc Metab 2008 18:204-235.
3. van der Pols JC, Gunnell D, Williams G, Holly J, Bain C, Martin R. Childhood dairy and calcium intake and cardiovascular mortality in adulthood: 65-year follow-up of the Boyd Orr cohort. Heart. 2009; July 29. (Epub ahead of print)
Boston Women's Wellness 