Archive for the ‘Sports Nutrition’ Category
Finding Partners in Health
Selling the bakery has really been an impetus for me to address some underlying health issues that I have been let sliding for some time. Yesterday I had an appointment with a naturopathic doctor here in Portland to talk about solutions to my low iron levels, digestive troubles, and fatigue. I also have an appointment with a new endocrinologist next week!
I know it might seem like anyone who is able to run 70 mpw should have plenty of energy, but it’s all relative. I used to have energy coming out of every pore of my body… I never sat still!
Any athlete who is trying to push their body in any capacity, even if it is just recreationally, knows when something is off. As athletes we demand more from our bodies and frankly require a higher level of health. Having a doctor or health care provider that understands this is IMPERATIVE. I always try to get referrals or interview a doctor before I see him/her to make sure that they work with athletes, or in the very least understand the increased demands that training places on the body. This goes for Primary Care Providers, ND’s, Acupuncturists, Masseuses, OB’s, Endocrinologists, Allergists, etc. They have to be willing to treat your symptoms and not treat to a broad desired range that might work for the general public.
For instance, some doctors consider a “normal” serum ferritin (shows how much iron is stored in the body) range to start as low as 18 mcg/L and I’ve even seen ranges starting as low as 3 mcg/L! A common recommendation is for runners to be over 30, however, many top athletes and coaches strive for ferritin levels over 100 mcg/L. It’s one of those things that is very dependent on the athlete. We have a girl on our team who has naturally high iron, and she starts to feel terrible when her ferritin gets down to the 60’s. This is why regular blood tests are a good idea, so you have a health history and can see changes over time. We test our team 2 x per year to establish baseline levels and make sure that everyone is staying on top of things.
The increased demands that endurance sports place on the body just mean that we have to pay extra attention and make it important to find great partners in your health. If you aren’t receiving the treatment that you need, don’t be afraid to show your doctor research and get second or third opinions. Be your own advocate!
Lärabars & My Sanity
It’s Monday and I have a headache. OK, maybe it’s not really a headache… maybe it’s just that I have an endorphine hangover from the excitement and stress of last week’s events and I need a vacation.
Well, after going downstairs for a hit of Americano (bad!) and snack, I realized that I really take the Lärabar for granted.
Lärabars are always there when you need them. They are my food in a pinch. These bars are vegan and have no gluten, no soy, no gmo’s, and are only sweetened with fruit. Except for the newer Peanut Butter Cookie flavor, they are completely raw. (I don’t eat peanuts for other reasons though). All the flavors even have fewer than 6 ingredients. How many other foods can say that?
They also make a great bar to take on the road for a recovery food. Every ingredient is a food in a recognizable state to your body! That means less waist to build up and process and the more nutrients the body can absorb from the food. Reading the ingredients for most “energy bars” is a frightening and (hopefully) sobering moment. I wish people would stop to realize that if they can’t pronounce something, they probably shouldn’t be eating it.
My Favorites: Cherry Pie (cherries have been proven to have anti-inflammatory properties, so great after exercise!), Pistachio, Cinnamon Roll and Jocolat Chocolate Hazelnut.
One upside about the company being bought out by General Mills is that you can find them everywhere from cafeterias to gas stations. And as anyone with food allergies or restrictions can relate to: they mean not having to go hungry. So, thank you Lärabars. I owe you more than one.
Vegan Athlete Tips: Brendan Brazier
After suffering an intense bought of stomach pains, cramps, and intestinal distress due to a “non-constipating gentle” iron supplement on Monday night… I’ve been re-reading everything I can about vegan iron sources and blood building.
I found the article bellow on a website called In a Vegetarian Kitchen. It’s an interview with Brendan Brazier, the vegan triathlete and author of one of my favorite books: The Thrive Diet.
The book is filled with great recipes and advice that I use often as a resource. He has some great recipes and really advocates gluten-free eating.
I agree with the underlying principles that Brazier presents, especially his explanation of stress.
I talk about the cummulation of stress often with my athletes. It’s not just stress from training that takes a toll on the body, but all types: nutritional (from eating the wrong foods or not enough), emotional (from work or relationships), and environmental (from toxins and polluntants in both our homes and the outdoors). Basically, the idea is that the system is overwhelmed by the sum of all these types of stress… and you can’t handle enough good stress if you are up to your neck in bad stress. This is why it’s nearly impossible to have a great workout or race after a devasting breakup, or at the end of finals week.
Check out the link bellow for Brazier’s tips on vegan eating as an athlete:
Birth Control Pill Not Good for Lean Muscle Mass
Birth control pills have always been a subject of much debate for female athletes. It seems like it is the modern-day doctor’s answer to any irregularity in the menstrual cycle. They want you to go on the pill for everything, you bleed too much, your cycle is too short, too long, non-existent… or hey, you have acne? No problem… take this pill. It only gives you a constant supply of synthetic hormones. (!)
Popping a pill is a much easier solution than trying to look into the root cause of the hormonal problem in the first place. What really upsets me is the lack of studies that have been done on the long term side effects of being on the pill and the real lack of studies actually done on athletes.
This latest study finds that women on the pill are “less likely to build muscle” than those not taking it. “You can still gain muscle on the pill, you just have to work harder.” The reason for this is because the pill drops levels of circulating testosterone. For the collegiate athlete, or the competitive athlete this is a serious issue.
My favorite part is at the end of the video:
Q: Should you reconsider taking the pill in light of this study?
A: Probably not unless you are a competitive athlete or body builder.
Fast Recovery… Berry Smoothie
In my brief stint at Oregon, before quitting law school, the athletic department’s nutritionist required us to either down a “Balance Shake” in a can or a bar immediately following a hard workout. She wasn’t entirely fond of me since I refused to ingest these products. Not only did they contain dairy products, but they were loaded with the dreaded HFC (high fructose corn syrup) and coated with hydrogenated oils (trans-fats). GROSS. This wasn’t the stone age either- it was the fall of 2002. And, she was supposed to be a nutritionist! (Never mind that she was overweight herself, probably from snacking on too many of these free bars and shakes that were given to the school as some kind of promotional deal….)
Instead, my compromise was that I would bring along a Clif bar or almond butter and jam sandwich. These wholesome snacks, however, were very hard for me to consume after really exerting myself… especially if it was hot. I have a terribly sensitive stomach! And hard efforts make me nauseous. To be honest, for most of my running life, I have avoided eating anything for quite some time after a strenuous workout. I have also always been known by my coaches for slow recoveries.
And that is something I would like to change.
There is frankly too much evidence available now about muscle breakdown and recovery for me to neglect this aspect of training any longer. I have forced myself to get over my food aversion mostly through liquid forms of energy replacement. Bellow is a recipe for the smoothie that I consumed today after a moderately-paced 16 miler. It was sunny and hot toward the end, and I felt really zapped of fluid.
In a blender:
24 oz filtered water
1/4 C unsweetened cranberry juice
1.5 C of organic frozen mixed berries
2 tsp stevia powder
1 Tbs agave nectar
3 Tbs rice protein powder*
1/4 tsp sea salt
If you like a thicker smoothie, you can add ice.
- Fruit- bananas, melons, pineapple, mango, peaches, nectarines, plums.
- Dried fruit that has been soaked the night before in a little water to plump it up like: apricots, raisins, currants, dates, figs, prunes, etc. Provides fiber, flavor, nutrients.
- Juices (especially high antioxidant juices like unsweetened pomegranate, blueberry, acai, gojiberry- trader joes has some excellent varieties) Make sure they are free of HFC and other added sweeteners.
- Greens: powdered greens, spirulina, chlorophyll, blue-green algae, kelp. If you have a vitamix or K-tec, then add some whole greens like kale or sea-vegetables to the smoothie!
- Bee pollen
- Almond butter, handful of nuts (like walnuts or almonds)
- Flax oil, or flax seeds (preground if you do not have a very powerful blender) for Omega-3’s and fiber from the flax seeds.
- Dash of cinnamon- tastes great and helps regulate blood sugar.
- Powdered vitamin C, Emergen-C packet, liquid trace minerals.
You can be creative and add whatever you like. Sometimes I make “desert” smoothies too… with rice milk, agave, brewed chai tea, cinnamon, and ice. Great ending to a hot summer’s night.
I’d love to hear more ideas for creative smoothie making!
Happy sipping.
Signs of Iron Deficiency
Common Signs of Iron Deficiency:
- tiredness when running (hills are really hard!)
- sleeping a lot and still feeling tired
- muscle burning (especially quads)
- elevated heart rate
- reduced tolerance to cold weather
- apathy (lack of enthusiasm for running or anything else)
- shortness of breath
- frequent infections and colds
- irritability
- headaches
- poor concentration
- clumsiness
- bruising easily
- craving of non-food items (like ice)
Sound familiar? Consider getting tested. If your training has increased, ask about upping your dosage if you already take iron.
Running Into the Ground: Iron Basics
Reasons Why Runners are Often Low in Iron:
1. Foot Strike Hemolysis—red blood cells are destroyed by runners’ feet pounding on the ground. You literally squish them as you strike the ground. This loss can be even more intense at altitude.
2. Sweat & Urine—small amounts of iron are lost in sweat and urine and these amounts can add up over time and worsen in hot weather.
3. GI & Menstrual Bleeding—small amounts of iron are lost due to bleeding in the gastrointestinal tract that is common with intense training/racing, while larger amounts can be lost through a regular menstrual cycle. If your cycle is causing you to lose more significant amounts of blood due to an extended length, heavier flow or increased frequency, you should report this to your doctor so that she can try to find the cause.
4. Low Iron Intake—runners who follow the traditional high-carb/low-fat endurance diet often do not consume much red meat, which is the best absorbed source of dietary iron. Many runners also tend to under eat in an effort to maintain an artificially lower weight. There is evidence that this type of calorie restriction lowers metabolic functioning and over the long term may lead to a sluggish thyroid or hypothyroidism.
Key terms:
Hematocrit— the percentage of red blood cells in the blood
Ferritin— the body’s stored iron (primarily in bone marrow, liver, and spleen)
Iron-Deficiency Anemia—clinically low hemoglobin or hematocrit levels
(B12 deficiency can cause another type of anemia, more common in vegetarians than meat eaters because B12 is difficult to get from a vegan diet)
Iron Depletion—low ferritin levels (for running purposes 30)
What exactly is ferritin again?
For one thing, different people seem to require different levels to feel good. One athlete may perform best as long as her ferritin is over 40, while another may require double. When fine-tuning for performance enhancement, it is best to track ferritin levels over time, that way you can get a baseline level of what might be normal for you. Unfortunately, few people think to go in for blood tests when they are feeling fine. Some sports medicine docs and coaches like an athlete’s ferritin to be above 100. It is commonly accepted in the running community that a score under 30 means you should be pumping some iron into your system, in whatever form necessary.
Serious female runners should have their iron levels checked a minimum of twice (preferably four times) per year. Competitive male runners should be tested annually, and those with a history of iron depletion (or vegetarians) should be tested at least twice per year. To ensure consistent results, always have your blood tested before running (i.e., when you are well-hydrated), because dehydration will make your iron levels appear higher than they are. Again, the major iron status tests of interest to runners are: hemoglobin, hematocrit, red blood cells and ferritin. And, depending on how savvy your doc is, you may have to specifically request the ferritin to be checked. Unfortunately, it is still not a commonly performed test by many family practitioners.
More on iron supps and common signs of deficiency in another post.
Stoking the Fire…. Iron Scores
Today I got the results from the team blood test we had on Wednesday.
Drum roll please…..Ferritin is 16!*
Because low iron is so prevalent in distance runners, (why? see my post entitled Running Into the Ground) we screen our athletes twice a year with blood work from the health center. The woman who stuck me with the needle asked me what year I was when I got on the table. She was embarrassed when I told her my age and that I’m a coach. At least she complemented my veins.
Unfortunately, I couldn’t wait that long to get tested. At the end of June I began a pretty steep decline. I went from feeling somewhat decent on runs, to starting to get tired, to having an allergy induced asthma attack while running on Wildwood. That hasn’t happened to me in a few years- and it has only happened 4 or 5 times in my life. I do know from experience (and the allergist) that it is brought on by exposure to the allergen AND severe fatigue. Since the allergy tests revealed that I am basically allergic to Oregon, or at least all of its trees and grasses, I knew that fatigue was the main culprit.
The heat over the fourth of July in Ashland only made me feel worse, so I emailed my Endo in Houston to ask for some blood work. I was overdue in checking my thyroid’s status anyways. The only red flag from the results was, of course, my iron. Ferritin was 6. Again. Again! I thought the gluten-free diet was supposed to be helping, but apparently my intestines are still not in shape.
So it has been 5 or 6 weeks of stomachaches now. 5 or 6 weeks of reading gluten-free forums and message boards in search of some kind of help from the celiac community about how to overcome the chronic anemia. I have known about my iron issues since college. I was even sidelined my sophomore track season with chronic anemia. At least now the malabsorption problems have been somewhat explained. (i.e. in people with celiac, gluten destroys the microvilli which line the intestine to aid in capturing nutrients).
I’m trying to figure out how to go about getting a drip or even injections, but I am without insurance…. so who knows. I am just anxious to get rid of the stomach pain and GI problems again. I can only liken it to eating a steaming bowel of hot buckwheat**….EVERYDAY!!!
* The level of ferritin in your blood is a measure of your body’s iron stores. Ferritin is a protein containing iron stored in your bone marrow and liver. My highest recorded ferritin has been 18, the lowest was 5. Under 30 is a red flag. Ideally, much higher is better for performance.
**I actually did this by accident 3 weeks into my gf life- thought it was the cream o’rice cereal. Paid for dearly for it for three days afterwards.
Summer’s End & Thyroid
On the bright side, the rain does make it much more pleasant to bake. It is hard to believe that we’ve had such a dreary August. It is usually the only consistently nice month in the Northwest. Classes start on Monday and most of the team is back already. They had their camp over the weekend and we have our first practice on Friday. And just like that *** my weekends are booked until Christmas break.
Yesterday we went out to Sauvie Island to run the loop, to celebrate the end of our Sunday running freedom. It was beautiful, but it actually sprinkled on us for a little while. To be honest, I love the sun- but I don’t live in Oregon to put up with 90 or 100 degree weather like we had last summer. Ian often laughs and says that I “have the narrowest temperature range he’s ever seen.” It’s true. I HATE being hot- I absolutely wilt- and I get cold easily.
My tolerance, however, has been so much better since starting the thyroid medication. The difference was dramatic and the first thing I noticed. I used to get COLD. REALLY COLD. It would seep in and settle deep inside and I would feel like I was going to die. I know that sounds terribly over dramatic, but I did actually feel like I would die. The only way to warm up was to submerge myself in a boiling hot bath.
I’m not saying that the thyroid meds turned me into a Polar Bear. I’m still not like one of those middle aged men who wear t-shirts when it’s 40 degrees and refuses to don close-toed shoes. The pills just took the edge off. I still get cold (more easily than most), but I don’t feel like it will kill me. 
Actually, I’ve been lucky with the thyroid medication- I haven’t had to tinker with the dosage at all since starting it last November. I know that is pretty rare and my good friend has had a much harder time. I’m still holding out hope that the Celiac caused the elevated thyroid antibodies and if I remain gluten free for long enough, maybe my thyroid will self correct. I know it is a long shot and I’m not into the idea of going off the thyroid medication in the mean time, so I’m not sure if it would know to correct if I’m medicating it? Maybe that is faulty logic?
There seems to be a growing number of people who think that athletes may, in part, cause the thyroid disorder from overtraining and undereating. It is an interesting theory.
I’m also holding out hope that my long time battles with anemia will go away with my gluten free lifestyle. So far, it’s a no go…. but iron is another story altogether…
Veggies & Chocolate Milk
Last night, basking in the light of our beautiful fridge, I drank my second dessert straight from the carton… (The first having been a nice glass of ruby port from a serene Northern Italian restaurant where we ended up with Ian’s mom and stepdad.) I had gone a mini chocolate “milk” binge over the last week and a half after attending an endurance sports supplement lecture by a physiologist and doctor of sports nutrition up at OHSU – but more on that in a second.
So there I was slurping down my chocolate rice milk staring into the fridge and thinking: well at least being gluten free, I can still have this. The stuff is incredible. The amazing thing is that I don’t even consider myself a chocolate fan. When pondering flavor choices, be it energy bars or dessert menus, I will always choose the other option.
Anyways, standing in front of the open fridge I just happened to be reading the ingredients on the carton of chocolate soy milk that I bought Ian (he’s not a big fan of rice milk, and I didn’t want him drinking mine). And BEHOLD- Organic Barley Extract. What? Why? I love when companies just seem to indiscriminately throw gluten into the mix for no apparent reason. Why limit your customers? Who would miss the barley extract? uggh.
OK- how about some background…
The sports supplement lecture was given as part of an endurance athlete educational series at a well respected physical therapy office in town. The speaker was very qualified: a physiologist, an MD, a PhD in sports nutrition, blah blah. He basically had my attention. That is, until he mentioned that he thought the ideal recovery drink was CHOCOLATE MILK- which of course should be consumed 15 minutes after finishing your workout for maximum refueling. I mentally let it slide when he referred to the two types of protein as casein and whey, I just figured he meant two of the types of animal protein…. but when he said it a second and third time, I was done.
I can buy the reasoning behind his argument for chocolate milk, being that it has protein and carbohydrates for recovery. He just lost credibility by telling me to have dairy right after a hard effort…. It just seemed so establishment and so ignorant. And so likely to cause people to puke. So many people are sensitive to dairy, not to mention the fact that there is such an enormous and growing body of knowledge out there about the health risks.
I wanted to throw a copy of The China Study at him.
In the end, though, I guess he did get me thinking about chocolate “milk.”
