Friday, April 11, 2014

Marathon Taper Nutrition

You’ve been working hard for months, getting up early to train in the dark, in the cold and wind and snow.  The big day is almost here! Make sure that you keep your focus as you finish up your season of training with the week leading up to it: the taper.

The foundation of any runner’s diet, at any time of training, should be healthy and balanced: lean proteins, whole grains, unsaturated fats, and plenty of fruits and vegetables. A base of carbohydrates (from grains, vegetables, fruit, and dairy) should be complemented with protein and fat.

Decrease intensity and duration of activity. Increase proportion of carbohydrates 3 days prior; increase even more for the last 4 days. Keep mealtimes consistent and don’t try new foods. Hydrate!

Don’t overeat samples at the Expo; ask to take one to try later. Stick with familiar foods that you have been successful at eating the day before a long run. These should be foods that are easy on your stomach. Attempt regular meal and snack times, and remember to hydrate. Try to get some sleep.

Keep in mind timing of waiting for the start. You may have several hours of waiting and may or may not be provided with snacks and drinks while you wait. Does that work with your race-day nutrition plan? If not, bring your own.

Tuesday, April 8, 2014

Upcoming Event: Taper Nutrition at True Runner

Wondering what to eat in the week leading up to a marathon? Come to True Runner in Chestnut Hill, MA on Friday, April 11th at 6pm to hear Katrina speak about taper nutrition. Have questions prior to the event? Leave them in the comments and they'll be answered that night!

Thursday, March 13, 2014

Happy Nutrition Month!

Yesterday was "Registered Dietitian Day" and while I didn't get breakfast in bed or a bouquet of flowers delivered to my door, I did have the pleasure of listening to a patient tell me how much he loves the meal plan that we came up with together at his initial visit and have his mom tell me "we've been waiting for you forever." It feels so good to help others, and patients like this one balance out others who might not be quite as ready to make necessary changes to the way that they eat.

This month is National Nutrition Month and this year's theme, declared by the Academy of Nutrition and Dietetics, is Enjoy the Taste of Eating Right. Many people think of healthy food as being flavorless. Perhaps this is due to the way that vegetables were prepared for them as children, or maybe it's because unhealthy foods tend to be filled with delicious flavors like sugar, oil, and salt. Whether you've known it forever or are just starting to realize that healthy food can taste amazing, take a moment this month to really enjoy the taste and flavor of your favorite healthy dish.

Monday, February 24, 2014

Eating Disorders: I Had No Idea

This week is National Eating Disorders Awareness Week and the theme this year, announced by the National Eating Disorder Association (NEDA) is: I Had No Idea. I've had friends in the past who were dealing with an eating disorder and have had the pleasure over the past six months to get to know a lot of new people with eating disorders as they seek treatment at the clinic where I work as a dietitian. Sticking with the theme of "I Had No Idea", here is some information about eating disorders you might find surprising.

Definitions. There are several different ways to define an eating disorder. There are official definitions in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM 5).  Then there are more fluid definitions that indicate a broken relationship with food, regardless of current or past weight.

Food on the Brain. Jessica Setnick is an RD who has a training curriculum called Eating Disorder Boot Camp. In it, she states that people with anorexia nervosa spend 90-110% of their day thinking about food. I use this as a quiz question when teaching medical residents about eating disorders: who spends the most amount of time thinking about food, people who are on a diet, people with bulimia nervosa, or people with anorexia nervosa? Last week I had the first group get it right - most guess that it is people on a diet. Sadly, it is those who are eating the least who are thinking about food the most.

No One Image. When you think of a person with an eating disorder, does an image of a skinny female model with her ribs poking out pop into your head? Frail women are often portrayed as the image of a severe eating disorder. But in reality, this disease spares no one and affects people of all genders, race, shapes, and sizes. We're seeing an increase in our clinic of patients who had been told they were overweight or obese and began to lose weight, which everyone around them applauded, not knowing that they were doing so in an unhealthy and potentially dangerous way.

Mental and Physical. There is almost no part of the body or mind that an eating disorder will spare.

Whether you know someone who has been officially diagnosed or just someone who struggles with self-esteem and has a disordered attitude towards food, take a moment this week to think about them and what they might be going through.

Monday, February 17, 2014

Why You Should Meet with an RD

A Registered Dietitian (RD) is a healthcare provider who specializes in nutrition; how food affects your body and how your body reacts to food. Like some other medical specialties, it can be confusing to know whether or not you need an RD or could benefit from meeting with one. To help figure this out, the Academy of Nutrition and Dietetics put out an article, What a Registered Dietitian Can Do For You. Here is an excerpt to help you better understand whether or not an RD can help you:

The highest level of nutrition counseling. Anyone can call themself a nutritionist, but only a registered dietitian (RD) has completed multiple layers of education and training established by the Academy of Nutrition and Dietetics. In addition to holding a bachelor's degree, an RD must fulfill a specially designed, accredited nutrition curriculum, pass a rigorous registration exam, and complete an extensive supervised program of practice at a health care facility, foodservice organization or community agency.

Personally tailored advice. When you see an RD, the last thing you'll get is one-size-fits-all diet advice.  After learning about your health history, favorite foods, eating and exercise habits, an RD will help you set goals and prioritize. Follow-up visits will focus on maintenance and monitoring your progress.

Guidance navigating food allergies, sensitivities and intolerances. When you suffer from conditions such as celiac disease, food allergies or lactose intolerance, it's easy to be overwhelmed by what you think you can't eat. That can translate into a boring diet and may even lead to nutrient deficiencies. An RD can teach you how to read food labels so you’ll know which ingredients to avoid and a help you find substitutions to keep your diet balanced and tasty, too.

A weight loss program that really works. Fad diets may sound like the quick ticket to weight loss, but they rarely work for very long. A registered dietitian will partner with you to develop a safe, effective weight loss plan that you can stick with for the long haul. 

If you're convinced that now is the time for you to see an RD, contact me for an appointment today by e-mailing or calling 617-431-8006.

Tuesday, January 28, 2014

What's Getting in Your Way?

As I was rinsing off the salt-crusted soles of my running shoes tonight, I realized how warn down they are. A quick calculation and I realized that I've probably been wearing the shoes longer than the recommended 300 miles. I also remembered that every time I've put them on recently I've been a little bit grumpy about the way that they feel. Have they ever explicitly stopped me from going out on a run? No. But "old, warn shoes" are one thing that I could write in my list of the barriers that I feel get in my way of being as active as I could be.

What do your barriers look like?
In nutrition counseling we often talk about barriers. Part of being a successful dietitian is helping people to overcome or at least recognize whatever barriers they might have getting in the way of healthy eating. This could be a practical barrier such as lack of grocery stores with fresh produce or it could be something more internal such as feeling sad lately and feeling the need to find comfort in food.

Is there something that you're having a hard time accomplishing? Try making a list of barriers and potential solutions. Here's are a few examples - the first is one of my personal barriers and others I've drawn from patients.

Goal: run more often during the week
Barriers: cold weather, uncomfortable old shoes, darkness
Ideas to break barriers: put together a chart of outside temperatures with appropriate clothes that will keep me warm, buy new running shoes, find friend to run with consistently after work

Goal: eat more vegetables each day
Barriers: fresh produce just goes bad whenever I buy it, vegetables are hard to cook and expensive
Ideas to break barriers: stock freezer with selection of frozen vegetables that I know I like, find Pinterest boards featuring easy vegetable recipes to bookmark for trying each week, buy produce with recipe in hand on the day I know I have time to prepare it to avoid spoilage

Goal: lose weight in order to better fit into clothes
Barriers: gym membership is expensive, family doesn't like 'health' food, low motivation
Ideas to break barriers: find a friend to go for walks with outside on a consistent schedule, try making current favorite family meals using healthier ingredients, put sticky notes with inspirational quotes on car dashboard to remind myself of goal

These are just a few ideas of ways to get into the mindset of breaking through barriers. If you can think up some ideas for overcoming your own barriers, try writing them down. Even if you're not ready to take action yet, looking at your list of solutions can motivate you to take small steps in the direction of your goal! Now I'm off to buy some new running shoes...

Monday, January 6, 2014

94 Years Old and Still Running... on Carbohydrates

If you're a runner or endurance athlete or have ever read up on sports nutrition, you are likely aware of how important carbohydrates are. They give you energy to "go the distance" and are the main source of fuel for an active lifestyle. People have even made a science of carbohydrate "loading," finding ways to pack as much carbohydrate into their body's stores before a big endurance event. I've been reading a lot about sports nutrition lately, in part because I've started a small private practice counseling athletes and also because it's a fascinating topic.

In reading the newly published 5th edition of Nancy Clark's Sports Nutrition Guidebook, she really drives home the focus on carbohydrates for athletes and how your body (and possibly performance) will suffer if you focus too much on protein or go gluten-free for no medical reason without replacing it with enough non-gluten carbohydrates.

It's no secret that carbohydrates get a bad rap in general, but if you're an athlete the cold hard truth is that you need them and they will help you if you use them right. As Nancy emphasizes, carbs don't cause you to gain weight; extra calories, especially from fat, and not enough physical activity cause you to gain weight.

I was reading an inspirational story in Parade magazine recently about Olga Kotelko, a 94 year-old track star. She's broken all sorts of records and is still going strong. Obviously they asked her about her diet, and this is part of how they reported on it:
"She is no stranger to carbs, often having toast in the morning (perhaps topped with cheese and honey) and bread again in her lunchtime sandwich."
I could be adding emphasize in the wrong places here, but when I read that I could just picture some readers across the country thinking to themselves "BREAD?! TWICE a day?!" The way that it is phrased, that she is not a stranger to carbs, seems to imply that eating bread twice a day is excessive. In reality, active people need a whole bunch of carbohydrates in order to fuel themselves properly (the amount depends on the athlete's weight and the intensity of the activity) and no one should ever be a stranger to carbs. Has your relationship with carbohydrates taken a turn for the worse? Consider making 2014 the year you mend that bond - you'll be amazed by what carbohydrates can do for you!