NYC MARATHON NUTRITION PANEL

August 17, 2023August 8, 2023 by amystephens

NYC marathon nutrition panel

If you’re a marathon runner, you’ll appreciate this presentation. On July 16th, 2023, I was invited to participate in the NYC Marathon nutrition panel hosted by NYRR. We covered a lot of important topics for runners such as: hydration, fueling, gear, and how to prevent hitting the wall. There were over 1,000 individuals on live stream and 50 attended at the NYRR Run Center. Below is the YouTube link for the full talk.

How Social Media Affects Athletes

August 7, 2023August 6, 2023 by amystephens

How social media affects athletes

Social media can be a great place for athletes to connect with other athletes, share content about their own journeys, and follow their favorite pros. However, social media can also become a toxic environment for those who are not cognizant of its impact.

Social media can be a catalyst for negative thoughts about body image, caused by comparison to others. It is impossible to know whether an account owner is editing their photos, posing in a certain way, or the relationship they have with their own bodies. With that said, comparison to others on social media often becomes an unavoidable truth.
Creators may use social media as an outlet to spread information or advice on topics like training, nutrition, and “tips for athletes” despite not always being licensed professionals. It is important to consume information written by professional, credible sources because the viral wellness tips or popular hashtags shared online can be polluted with misinformation. For an innocent scroller, differentiating the two can be challenging.
Social media may cause an athlete to think their own wins are not good enough. For example, a runner may feel proud of themselves for running 6 miles without stopping, and then they may open Instagram and see that another runner ran 7 miles at a faster pace, and their pride can turn into disappointment.
Social media promotes quick fixes. Too often athletes get caught up in looking for the easy and fast route, whether that be to heal an injury or improve their performance. If something online looks easy, it probably isn’t true.
Social media platforms provide medical advice for various symptoms often obtained from unreliable sources. This poses a significant risk to consumers and hinders an athlete from seeking a thorough evaluation by a qualified medical professional. Relying on untrustworthy information can impede and delay a timely delivery of care.

Where should athletes get their information?

Injury recovery/Diagnosis: Their own medical doctor (MD), physical therapist (PT) or coach
Fueling/Nutrition: Registered Sports Dietitian/Nutritionist who focus on fueling for performance
Training plan/lifting plan: Directly from their coach, physical therapist, or athletic trainer

*Make sure the person providing advice has training in the specified area.

How to use social media in a positive way?

Be a conscious consumer! Seek out accounts that promote a positive body image and convey positive messages. If certain posts spark feelings of dread, sadness, or uneasiness, it may be beneficial to unfollow those accounts.

Be skeptical when it comes to products and services endorsed by influencers lacking relevant education or expertise in the field. It’s important to remember that their primary goal is to sell a product or service. They may present the product in an appealing manner to achieve that objective.

There is no supplement, powder or pill that will help you perform better. The key is to follow a well-balanced diet, prioritize recovery, and follow a suitable training plan.

How To Eat If You Are Training for a Marathon

January 2, 2024July 11, 2023 by amystephens

How To Eat If You Are Training for a Marathon

By Amy Stephens RDN CSSD
Sara Fischer, Intern

The way you nourish your body is equally important as your training and strength exercises. As a sports nutritionist based in NYC, I frequently encounter questions regarding dietary recommendations for individuals preparing for a marathon. In collaboration with my intern, Sara Fischer, we have developed this guide specifically tailored to individuals participating in the NYC marathon or any fall marathon, providing valuable insights on how to fuel your body leading up to the 26.2-mile journey.

What to eat

CALORIES:

It is important for runners to eat a well rounded, nutrient rich, balanced diet. First and foremost, runners need to ensure they are eating enough calories. Because running requires a lot of energy, it is extremely important that runners are in an energy balance to prevent underfueling. Underfueling leads to serious health effects.

Energy requirements are not static throughout a marathon training block. As the training volume intensifies, higher levels of nutrients become essential. The energy demands may be less on recovery days, but it is equally important to continue fueling to restock glycogen and repair muscle tissue.

A common mistake is to underfuel on recovery days. Recovery days require an adequate amount of nutrients to help the body recover for the next workout. Energy is required for cross-training, daily activities such as attending work or class, errands, or commuting. It’s possible that you may not require as many snacks during these lower intense periods.

CARBS:

Runners need to focus on a carbohydrate rich diet. If you are training for a marathon, you are spending most of your time either recovering from a run, or preparing for another one. Since running requires glucose from the bloodstream, your body is in need of carbohydrates to replenish those glycogen stores after workouts. Runners should aim for 60-70% of their calories from carbohydrates.

Over time, with adequate carbohydrates, the body gradually increases the amount of glycogen that can be stored in muscles and liver. Proper fueling throughout training can increase your overall glycogen storage capacity. Glycogen is one way to help prevent “hitting the wall”. This occurs when runners have not properly trained, run too fast on race day or under fuel on race day.

In order to maximize glycogen stores, runners should aim to consume 7-10 grams of carbohydrates per kilogram of body weight, daily. The average runner should aim for 475-700 g/day. This can be met by eating carb-rich meals spread into three meals plus two-to-three snacks.

PROTEIN:

Protein is broken down into amino acids which are essential for building and repairing damaged tissue. Eating protein throughout the day is also helpful to maintain the immune system and prevent muscle breakdown. Eating too much protein can displace other important nutrients that are necessary to optimize sports performance. Aim for 1.5-1.7 grams protein/kilogram which is about 20-30 grams with meals and 10-15 grams for snacks.

HEALTHY FATS:

It is crucial that runners include healthy fats in their diet. Healthy fats are necessary to absorb fat soluble vitamins, they help to lower injury risk, and regulate energy levels. Healthy fats are a great source of omega-3’s which have been shown to reduce inflammation. In order to keep the diet balanced, aim for approximately 20-30% of calories from fats.

VITAMINS:

Runners need to make sure they are giving their bodies adequate vitamins. Vitamin D and Calcium are particularly important for bone health, specifically reducing the risk of stress fractures. Iron is important to keep you energized. Iron deficiency can lead to decreases in performance. B vitamins are essential to energy production.

How to eat around your workouts

Before a run, especially if the run is 60 minutes or longer, your body will need fuel beforehand. Your pre-run snack should be rich in carbohydrates, and eaten at least 30 mins to an hour before you head out. Avoid high fiber foods as they are difficult to digest and may lead to discomfort during the workout.

Pre-run snack examples include a banana, toast with peanut butter, homemade energy balls, dates, dried fruit, granola bar or Clif bar.

For runs lasting less than 60 minutes, fueling is optional. If you experience hunger, consuming snacks and fluids can be beneficial for sustaining energy levels.

For a run lasting longer than 90 minutes, your body might need additional carbohydrates. Your body processes approximately 60g carbs per hour of exercise, so during these longer sessions you will need to start fueling within 45 minutes, and continue to consume 30-60g carbs/hour for the duration of the run.

You can accomplish this by eating things like energy gels, easy-to-eat dried fruit, go-go squeeze applesauce, or even gummy bears. You can also put a spoonful of honey mixed with something like coconut water into your water bottle to make a carb and electrolyte rich sports drink.

After a run, your body needs to replenish its glycogen stores. Refuel after runs by eating a balanced meal or snack high in protein and carbs. It is best to eat this within 30 minutes to an hour of finishing a run, so that you can kick start the recovery process and be ready to go for your next session. Prioritize recovery food especially on tough workout days or if you are planning a double workout session.

How to hydrate

Hydration requirements are individualized. Sweat rates depend on many factors such as: genetics, gender, heat acclimation, exercise intensity, humidity, etc. A sweat test is a great way to determine individual sweat rates.
Easy runs: 1-2 hours before your run, drink 10-20oz of water. During your run, it is your choice whether you want to sip on water throughout. After your run, replenish the lost fluids with 35-70 oz of water with electrolyte. Take note of your hydration level prior to running. If you begin your workout in a dehydrated state, you will need to consume fluids regardless of the duration. Additional fluids will aid in replenishing lost fluids from previous workouts and prevent further dehydration.
Long runs/tempos: 1-2 hours before your workout, drink 10-20oz of water. During your run, drink 4-8oz of water every 20 minutes, with electrolytes. After your workout, replenish the fluids with 35-70 oz of water with electrolytes.

References

Burke L, Hawley J, Wong S & Jeukendrup A. Carbohydrates for training and competition, J Sp Sc, 2011. 29:sup1, S17-S27.

Coyle, E. F. Fluid and fuel intake during exercise. J Sp Sc 2004. 22: 39–55.

Jeukendrup, A. E. and Chambers. Oral carbohydrate sensing and exercise performance. Current Opinion in Clinical Nutrition and Metabolic Care, 2010. 13: 447–451.

Sawka MN, et al. American College of Sports Medicine position stand. Exercise and fluid replacement. Med Sci Sports Exerc. 2007. 39(2):377-90.

Oatmeal 101: How to Level Up Your Daily Oatmeal

June 30, 2023June 27, 2023 by amystephens

Oatmeal 101: How to Level Up Your Daily Oatmeal

Oatmeal is a fantastic breakfast option for runners. Oats are a very nutritionally rich food, as they contain carbohydrates, proteins, vitamins and minerals and antioxidants. Additionally, oats are generally easy on the stomach and are filling without causing discomfort. Oats are a great pre-run option for sustained energy.

A side note from Sara (the intern): As a runner, I eat oatmeal pretty much every day. It sounds like a bland meal, but if there’s anybody who you should trust to help you jazz up your oatmeal it’s me! (I’ve posted over 37 oatmeal recipes on @eatzbysara). Here are 3 recipes you can try at home to add some more creativity to your daily oatmeal!

Optional : you can add protein powder to any of these recipes if you choose

Banana Bread Baked Oats

Have some extra time in the morning? Try baked oats. This cozy breakfast takes 30-40 mins to bake, and it comes out with a cake texture! This recipe tastes just like you are eating banana bread for breakfast.

Ingredients:

● 1⁄2 cup oats

● 1⁄2 cup milk of choice

● 1 banana

● 1 tbsp any plain yogurt

● 1⁄2 tbsp maple syrup/honey

● 1⁄2 tsp baking powder

Directions:

● Preheat oven to 400°F

● Blend all ingredients

● Bake for 22-30 mins (depending on oven)

Toppings:

● Peanut butter, granola, banana slices::

Carrot Cake Overnight Oats

For those on-the-go people – have NO time in the morning? Overnight oats are your best friend. You make them the night before, so all you have to do in the morning is grab them from the fridge and you’re all set. This recipe is a mix of the refreshing chilled oats plus the cozy irresistible carrot cake flavor.

Ingredients:

● 1⁄2 cup oats

● 1⁄2 cup milk of choice

● 1⁄2 cup grated carrots

● 2 tbsp any plain yogurt

● Dash of cinnamon, nutmeg, cloves, ginger

Directions:

● Mix all ingredients, put in a closed container

● Store in the refrigerator overnight

● The next day: Add toppings and enjoy

Toppings:

● Almond butter, pecans, raisins

Lemon Coconut Microwave Oats

Microwave oats are great for busy people who still love a warm bowl of oatmeal in the morning. This recipe combines tangy and sweet in the most delicious way.

Ingredients:

● 1⁄2 cup oats

● 1⁄2 cup milk of choice

● 1 tbsp any plain yogurt

● 1 tbsp maple syrup/honey

● 1⁄2 tbsp chia seeds

● 1⁄2 a lemon, squeezed

● 1⁄2 cup shredded coconut

Directions:

● Blend all ingredients

● Microwave for 3 mins Toppings

● Cashew butter, lemon zest, granola

Savory Overnight Oats

If savory is more your speed, don’t worry. You can still enjoy the versatility of a bowl of oats just like the rest of us. For this recipe, the toppings are the main event. Lots of room for creativity!

Ingredients:

● 1⁄2 cup oats

● 1⁄2 cup water

● 1⁄2 Tbsp hemp seeds

● Dash of salt

Directions:

● Mix all ingredients, put in a closed container

● Store in the refrigerator overnight Toppings

● Options include hard boiled or scrambled eggs, sauteed spinach, avocado, tofu, smoked salmon, hot sauce

Caffeine to improve athletic performance

June 27, 2023June 22, 2023 by amystephens

Caffeine to improve athletic performance

Studies have shown an improvement in sports performance when caffeine is consumed before exercise (Clarke, 2018). Here are details about how caffeine works and the safe and effective dose that yields the best results.

How it works:

Caffeine blocks adenosine receptors that, in turn, prevent you from feeling tired. By blocking adenosine receptors, you can feel less pain, increase neuro-excitability, and improve your ability to focus which can lead to ergogenic effects on exercise performance.

Benefits:

Reduces perception of pain and fatigue
Mobilizes fat to use for energy, sparing glycogen
Increasing alertness (reaction time and mood)

Risks:

Effects of too much caffeine can cause jitteriness, shakiness, upset stomach, or reflux. None of these symptoms are ideal before or during a race. Be sure to test out caffeine dose and response before race day.

Dose:

The effective dose of caffeine is 3-6 mg/kg about one hour before competition which is approximately 200-400 mg for a person weighing 150 pounds (70kg) which is equivalent to a tall coffee from Starbucks.

There is a bigger performance benefit when caffeine is reduced prior to competition (Beaumont).

Form:

The amount of caffeine in energy bars, gels and medications tends to be standardized, while the amount in coffee and tea can vary considerably. Be sure to read labels and know how much you are consuming.

Some energy drinks or pre-workout beverages might have caffeine listed as one of these ingredients:

Green tea extract

Guarana

Guayaki yerba mate

Guayusa

Cola nut

Cacao

College athletes:

Caffeine is a banned substance by the NCAA. A urinary caffeine concentration exceeding 15 micrograms per milliliter (corresponding to ingesting about 500 milligrams, the equivalent of six to eight cups of brewed coffee, two to three hours before competition) results in a positive drug test.

* Caffeine content varies among brewing methods. See chart below.

Olympic level athletes:

Caffeine is permitted in sports governed by the World Anti-Doping Agency (WADA).

Food-first approach:

The perception of having increased energy from caffeine will not replace the actual energy provided from food. Successful athletic performance is dependent on a nutrition plan that meets your energy and nutrient needs through food first. Caffeine can be used to improve performance and will be most effective if energy needs are met with food-first.

References

Beaumont R, Cordery P, Funnell M, Mears S, James L, Watson P. Chronic ingestion of a low dose of caffeine induces tolerance to the performance benefits of caffeine. J Sports Sci. 2017 Oct;35(19):1920-1927. doi: 10.1080/02640414.2016.1241421. Epub 2016 Oct 20.

Clarke ND, Richardson DL, Thie J, Taylor R. Coffee Ingestion Enhances 1-Mile Running Race Performance. International Journal Sports Physiology and Performance. 2018;13(6):789-794.

Davis JK, Green JM. Caffeine and anaerobic performance: ergogenic value and mechanisms of action. Sports Med. 2009;39:813–832.

Laurent D, Schneider KE, Prusaczyk WK, et al. Effects of caffeine on muscle glycogen utilization and the neuroendocrine axis during exercise. J Clin Endocrinol Metab. 2000;85:2170–2175.

McLellan TM, Bell DG. The impact of prior coffee consumption on the subsequent ergogenic effect of anhydrous caffeine. Int J Sports Nutr Exerc Metab. 2004;14:698–708.

Spriet LL. Exercise and sport performance with low doses of caffeine. Sports Med. 2014;44:175–184.

Talanian JL, Spriet LL. Low and moderate doses of caffeine late in exercise improve performance in trained cyclists. Appl Physiol Nutr Metab. 2016 Aug;41(8):850-5.

Wiles JD, Bird SR, Hopkins J, Riley M. Effect of caffeinated coffee on running speed, respiratory factors, blood lactate and perceived exertion during 1500-m treadmill running. Br J Sports Med. 1992; 26:116–120.

Delicious Recovery Smoothie Ideas for Athletes

June 26, 2023May 10, 2023 by amystephens

Delicious Smoothie Ideas for Athletes

Smoothies are great for after a workout because they contain the perfect balance of protein and carbohydrates. They also have plenty of antioxidants to help with tissue repair. Smoothies are a delicious and easy way to refuel and recover after a tough workout. Packed with protein, carbs, and antioxidants, these recovery smoothie ideas are perfect for athletes looking to optimize performance and recovery.

Berry Blast Smoothie

Blend together:

1 cup of mixed berries (strawberries, blueberries, and raspberries)

1 banana (use frozen banana for creamy texture)

1 scoop of vanilla protein powder (optional)

2 tablespoons of peanut butter

1 cup of milk

handful of ice

Berries are rich in antioxidants that help reduce inflammation, while the protein powder provides essential amino acids for muscle repair and growth.

Green Monster Smoothie

Blend together:

1 cup of spinach

1 banana

1 scoop of vanilla protein powder (optional)

1 tablespoon of almond butter

1 cup of milk

handful of ice

Top with 1/2 teaspoon of chia seeds

Spinach is rich in vitamins and minerals, while the almond butter provides healthy fats that help reduce inflammation and support brain function.

Tropical Paradise Smoothie

Blend together:

1 cup of frozen pineapple chunks

1 banana

1 scoop of vanilla protein powder

1 cup of coconut water

handful of ice

Pineapple is rich in bromelain, an enzyme that helps reduce muscle soreness, while the coconut water provides essential electrolytes to support hydration and recovery.

Chocolate Peanut Butter Smoothie

Blend together:

1 cup of milk

2 tablespoons of cocoa nibs or cocoa powder

1 banana

1 tablespoon of natural peanut butter

2 tablespoons maple syrup, honey or agave

handful of ice

This smoothie is packed with protein and healthy fats, which help repair and rebuild muscles and support recovery.

Mango Vanilla Smoothie

Blend together:

1 cup Vanilla yogurt

handful of ice

½ cup fresh or frozen mango

1 banana

1 cup milk

1 teaspoon chia seeds added on top

Mango is a great source of antioxidants and potassium that is an electrolyte that helps to maintain proper hydration levels in the body.

Cherry Almond Smoothie

Blend together:

1 cup of frozen cherries

1 scoop of vanilla protein powder (optional)

1 tablespoon of almond butter

1 cup of milk

handful of ice

Cherries are rich in antioxidants that help reduce inflammation and promote recovery, while the almond butter provides healthy fats and protein for sustained energy.

Fuel Your Body: A Week of Nutritious Dinners for Athletes

June 22, 2023April 29, 2023 by amystephens

Fuel Your Body: A Week of Nutritious Dinners for Athletes

As an athlete, what you eat is crucial to fueling your body and providing the necessary nutrients to support your training and competition. However, it can be challenging to come up with new and healthy meal ideas each week. That’s why I’ve put together a list of weekly dinners that are perfect for athletes!

It’s important to prioritize your nutrition to fuel your training and competition. These weekly dinner ideas are just a starting point, but they provide a variety of nutrients and flavors to keep your meals interesting and healthy. Don’t be afraid to experiment with different ingredients and recipes to find what works best for you!

photo: Well-Plated

Monday:

Grilled chicken with sweet potato and broccoli

Grilled chicken is a great source of protein, which is essential for muscle repair and growth. Sweet potatoes are an excellent source of complex carbohydrates, which provide energy for workouts and help to keep you feeling full. Broccoli is packed with vitamins and minerals, including Vitamin C, which is essential for the immune system.

Recipe The Spruce Eats

Tuesday: Quinoa and black bean bowl

Quinoa is a complete protein, which means it contains all of the essential amino acids that your body needs to build and repair muscle. Black beans are a great source of fiber, which can help regulate digestion and keep you feeling full. Add in some vegetables like peppers, onions, and tomatoes for added nutrients and flavor.

Recipe Eating Well

Wednesday:

Salmon with roasted vegetables and brown rice

Salmon is an excellent source of omega-3 fatty acids, which can help reduce inflammation and improve cardiovascular health. Roasted vegetables such as Broccoli and carrots are loaded with vitamins and minerals, making this a well-rounded and nutritious meal.

Recipe Roasted Root

Thursday: Lentil soup and sourdough bread

Lentils are an excellent source of protein, fiber, and complex carbohydrates. This hearty soup is perfect for athletes as it is packed with nutrients, and it is easy to make in bulk and store for meals throughout the week. Add in some vegetables like carrots, celery, and spinach for added flavor and nutrition.

Recipe Simply Recipes

Friday: Whole wheat pasta with turkey meatballs

Whole wheat pasta is a great source of complex carbohydrates, which can provide sustained energy for workouts and competition. Turkey meatballs are a lean source of protein, and adding vegetables like spinach and tomatoes can help increase the overall nutrient content of the meal.

Recipe Recipe Girl

Saturday: Stir-fry with tofu and vegetables

Tofu is an excellent source of plant-based protein, and stir-frying with vegetables like broccoli, bok choy, and bell peppers makes for a colorful and nutrient-dense meal. Add in some brown rice for added fiber and carbohydrates.

Recipe Well Plated

Sunday:

Grilled chicken with roasted potato and asparagus

Chicken is a great source of protein and iron, which is essential for carrying oxygen throughout the body. Roasted potatoes provides complex carbohydrates, while asparagus is a great source of fiber and vitamins.

Recipe Simply recipes

Easy LUNCH ideas for athletes

June 22, 2023April 21, 2023 by amystephens

quick LUNCH ideas for athletes

Why is eating LUNCH important to an athlete?

Lunchtime is an opportunity to replenish nutrients from your morning workout or prepare your body for an evening workout. Plan out lunches to ensure you have a variety of foods in your home to prepare meals.

Strive for a balanced lunch to help with feeling full, feeling energized and reduce cravings.

Essential components of a balanced meal >> carbs, protein, fats

A balanced meal consists of three macronutrients: carbohydrates, fat and protein. If you have too much of one nutrient, you might miss out on important nutrients that your body needs to perform at its bes Carbohydrates provide the primary source of fuel for exercise. As you exercise, your body breaks down glycogen into glucose for energy. Foods that increase your glycogen are carbohydrates. Ideally, these carbohydrates are broken down more slowly which help keep energy levels stable after a workout. Some examples are oatmeal, rice (white or brown), sweet or white potatoes, pasta, whole grain breads and quinoa.

Before a workout, look for simple carbohydrates that are low in fat and fiber. Simple carbohydrates are digested quickly into usable energy. However, after a workout you should reach for complex carbohydrates that contain fiber and other nutrients for optimal recovery.

Protein-rich foods are essential to help with recovery and replenish amino acids used by muscles. By eating high-quality protein after a workout, the body can recover faster and gain more strength. Muscle strength is essential to running faster speeds. Best sources of protein are eggs, dairy, tofu, chicken, turkey, fish (salmon, mackerel, anchovies, herring) and lean beef.

Aim for 20-30 grams high-quality protein at each meal. That’s about 3-4 oz protein from an animal source and 1-2 cups from vegetable sources like beans, lentils, or tofu.

Fat provides calories to support hormone production and foods with fat also have important fat soluble vitamins such as A, D, E, and K. All of these vitamins help with menstruation, bone formation, or iron regulation. It’s important to get in enough healthy fat calories to keep you full and provide fat soluble vitamins.

Best sources of fats are from avocado, nuts, seeds, olive oil, and fish.

Granola parfait with yogurt and berries

Scrambled eggs with sauteed vegetables such as onions and peppers. Serve with a side of mixed berries and whole grain toast. Use either the whole egg or egg whites to make a nutritious meal any time of day. Make a tofu scramble as a vegetarian option.

Pita pizza with mushrooms and spinach

Toast pita, add tomato sauce and handful of spinach and mushrooms then bake in the oven, toaster or air fryer at 350 x 15 min.

Stir fry (chicken, vegetable or tofu). Serve with white or brown rice. Recipe below.

Salads

Quinoa salad made with peppers, avocado, mango, chickpeas, nuts, cheese and chicken. Top with lime and olive oil dressing, see below for more dressing ideas.

Grilled chicken salad

Use fresh spinach as a base and top with rotisserie, leftover chicken or tofu. Add roasted chickpeas, hard-boiled egg and lemon-vinaigrette dressing (recipe below).

Kale chicken caesar salad

Buy the kale cleaned and washed to save time, then add chickpeas, parmesan and avocado. Mix in caesar dressing.

Salad Nicoise

Romaine lettuce, hard boiled eggs, steamed string beans, olives and top with lemon vinaigrette dressing (recipe below). Serve with a side of sourdough bread.

Easy three bean salad

Made with chickpeas, kidney beans and green beans (recipe below).

Pasta salad with vegetables, topped with balsamic vinaigrette dressing. Ingredients: cooked pasta, chopped cucumbers, carrots, feta (sub tofu for vegan version), and chickpeas.

Sandwiches & Wraps – Serve with side of fruit

Hummus and avocado wrap with lettuce, tomato and shredded carrots.

Chicken caesar wrap with lettuce and tomatoes.

Egg salad sandwich – combine 4-6 hard boiled eggs with 2-3 Tbsp mayo.

Turkey and avocado sandwich on whole wheat.

Grilled chicken wrap – can use rotisserie chicken. Serve with chopped red peppers and fruit salad.

Peanut butter and jelly sandwich, yogurt and fruit

Open-faced toast and avocado – add shredded carrots, sprouts (and any veggie you can fit).

Quesadilla

Whole wheat wrap with cheese, black beans, salsa, and avocado.

Burrito

Southwest burrito with grilled chicken, beans, rice, salsa, avocado.

Veggie burrito made with roasted sweet potato, black beans, salsa, and avocado. Click here for recipe from the Spruce Eats.

Smoothies

Green smoothie combine a handful of Kale, 1 banana, 2 handfuls of ice, 1 cup milk, 3 dates or honey, and 2 Tbsp peanut butter, optional: top with ½ tsp chia seeds or ground flax seeds

Bowls

Quinoa bowl with sauteed spinach, egg, onion and sriracha. Click here for recipe from Dinner A Love Story.

Buddha bowl with quinoa, diced carrots, diced cucumber, diced tomato, crunchy chickpeas and sunflower seeds with avocado on top; meat protein optional; eat hot or cold. Click here for full recipe.

Salad Dressings

Basic balsamic vinaigrette

¼ cup balsamic vinegar
1 teaspoon honey or maple syrup
1 garlic clove, minced
2 teaspoons Dijon mustard
½ teaspoon sea salt
Freshly ground black pepper
¼ cup plus 2 tablespoons extra-virgin olive oil

Lemon vinaigrette

Juice of 1 fresh lemon (about ¼ cup)
1 small garlic clove, grated
1 teaspoon Dijon mustard
1/4 teaspoon sea salt, more to taste
Freshly ground black pepper
1/2 teaspoon honey or maple syrup, optional
1/4 to 1/3 cup olive oil
1/2 teaspoon fresh or dried thyme, optional

Soy sesame dressing

¼ cup extra virgin olive oil
¼ cup seasoned rice vinegar (can also use regular rice vinegar + ½ tsp sugar, ¼ tsp salt, or white vinegar)
1 ½ T honey or maple syrup
3 tablespoons sesame oil
1 ½ teaspoons soy sauce (I use reduced sodium)
pinch salt
1 -2 cloves garlic minced (optional)

Peanut dressing

1 small clove garlic, minced
2 T creamy peanut butter
1/4 cup Juice of 1 lime
1 T low-sodium soy sauce
1 T honey or maple syrup
1 T toasted sesame oil

Easy three bean salad with vinaigrette

For the salad:

1 (15-ounce) can cannellini beans, rinsed and drained
1 (15-ounce) can kidney beans, rinsed and drained
1 (15-ounce) can garbanzo beans, rinsed and drained
1/2 red onion, finely chopped (about 3/4 cup), soaked in water to take the edge off the onion
2 celery stalks, finely chopped (about 1 cup)
1 cup loosely packed, fresh, finely chopped flat-leaf parsley
1 teaspoon fresh finely chopped rosemary

For the dressing:

1/3 cup apple cider vinegar
1/4 cup granulated sugar (more or less to taste)
3 T extra virgin olive oil
1 1/2 teaspoons salt
1/4 teaspoon black pepper

Stir Fry recipe
Can also buy carrots and onions chopped to save time

3/4 cup brown rice (cooked based on package instructions)
3 garlic cloves (finely chopped)
1 chunk ginger (small, peeled and finely chopped)
1 yellow onion (chopped to your preference)
1 head broccoli (stems removed)
3 carrots (sliced)
1 baby bok choy (ends cut off and leaves separated)
1/4 cup toasted sesame oil
1/4 cup tamari (or soy sauce)
scallions (sliced)
chili flakes
Sriracha
2 # chicken or package of tofu, cut into 1 inch pieces

For the marinade:

1 cup water
¼ cup soy sauce
5 teaspoons packed brown sugar or 2 Tbsp honey
½ teaspoon ground ginger
¼ teaspoon garlic powder

Combine and add protein (chicken or tofu). Let marinade for at least half an hour.

In a large omelet pan or dutch oven, saute garlic, onion, ginger, broccoli, and carrots. Cook for 5-10 minutes or until browned. Then add baby bok choy and cook for 3 minutes longer. Place vegetables on a large dish or pan. Add 2 Tbsp olive oil and 1 Tbsp sesame oil and cook protein (chicken or tofu) until golden brown. Pour in the rest of the marinade and cook over medium heat for 3 minutes. Add rice and vegetables and stir. Serve and add scallions, chili flakes or sriracha.

Athlete’s Guide to Optimizing Bone Health

November 19, 2023March 5, 2023 by amystephens

Athlete’s guide to optimizing bone health

Why bone health matters

Bone stress injuries (BSI) such as stress fractures and stress reactions are common among athletes with a lifetime prevalence of 40%. They can happen suddenly, just as an athlete might be peaking with training. Most injuries can take about two months to recover. Newer research has identified certain risk factors to help prevent bone stress injuries. Female athletes that miss a period and male athletes that have low testosterone levels are at an increased risk. It’s NOT normal for a female athlete to miss a period. While a missed period is a key indicator that females are at risk of declining bone health, male athletes can also suffer bone stress injuries due to inadequate fueling. Bone injuries are not fully preventable, however there are dietary and lifestyle modifications that can reduce the risk. This blog is intended to educate athletes, parents and coaches about how to optimize bone health. I will explain the relationship of running to bone health and best strategies to optimize bone strength.

How bones are formed

Bones are dynamic tissues. They are breaking down and building up daily.

After a workout, bones are broken down and if adequate nutrients are available, bones will rebuild and remain strong. Rebuilding is dependent on energy availability. This requires eating enough not only to support exercise, but to backfill nutrition requirements for daily living. If there is a lack of nutrition or the energy balance is off, in addition to failing to repair the stress to the bone tissue itself, the muscles will not have enough energy to fire and protect bones, leading to additional damage. This process worsens over time.

Specific cells responsible for breaking down bones (osteoblasts) and building up bones (osteoclast). It’s important for there to be a balance between the two so that bone can maintain its strength. Bones need to be built up at the same rate they are broken down. If muscles are unable to produce adequate force due to under-fueling, the balance is upended. Typically, underfueling prevents bone from being reformed thereby disrupting the breakdown and growth cycle of bones. Disruption to bone formation can occur in as few as five days of underfueling.

Lack of nutrition doesn’t support homeostasis with bones. It doesn’t mean that all exercises cause bone injury; it’s the opposite. Exercise is helpful to strengthen bones because the muscles pull on ligaments and tendons which break bone down. If the body is fueled properly and adequately rested, bones will rebuild stronger. For both male and female athletes, 90% of bone mass peaks by age 20 and will continue, to a lesser extent until 30 years old (Specker).

Underfueling can lead to bone injuries

It’s important for an athlete to consume adequate calories to meet daily nutritional requirements. If the athlete is uable to meet nutritional needs, the energy balance is disrupted.

In a situation of chronic underfueling or inadequate energy balance, the muscles weaken and overuse injuries can develop. In order for the body to work properly, there needs to be a balance with food and activity. Running, in particular, puts excessive strain on bones which has both short-and long-term consequences.

Underfueling for a short time, as little as five days, will increase the risk of a bone stress injury. Bone injuries can come on suddenly, even if you think you’re doing all the right things.

Chronic underfueling has long-term consequences because training suppresses hormones that protect bones (estrogen/testosterone). Over time, gradual bone loss will occur and bones begin to lose density. During adolescent years, achieving maximum bone mass is critical to protect an athlete later in their sports career.

Bone stress injuries can occur at any age. When an athlete is training at an intense level and an inadquate amount of nutrients are consumed, bone stress injuries can develop.

Risk factors for low bone mineral density (BMD)

Low testosterone (male athlete)

Amenorrhea (female athlete)

Inadequate calcium intake

Low Vitamin D levels

Eating disorder (past or present)

Dietary restrictions – vegan, gluten free, lactose free

Inadequate calorie intake

History of stress fracture

Sports at highest risk for bone stress injuries

Swimming

Diving

Crew

Cross country

Dance

Impact of the menstrual cycle on bone health

A normal menstrual cycle lasts approximately 25-35 days, during which estrogen levels increase and decrease, causing menstruation. An abnormal menstrual cycle, either shortened or lengthened between periods, provides a warning sign that requires further evaluation, as it may indicate a hormonal imbalance. Hormonal imbalances such as suppression of estrogen occur if energy balance is not adequate.

Because estrogen plays a significant role in bone formation, fueling adequately to maintain healthy estrogen levels is essential. Low food intake disrupts estrogen production, preventing bones from reaching maximum strength. Changes in bone have been seen in as little as 5 days of underfueling. During phases of amenorrhea (absence of menstruation), bone growth does not occur. Over time, stress from exercise outpaces bone mass maintenance. This imbalance can lead to bone injuries in the short term and bone density issues (osteopenia/osteoporosis) in the future. This is particularly damaging if the athlete wants to continue a post-collegiate athletic career.

If an athlete has irregular periods, speak with a local sports dietitian for further evaluation. If irregular cycles persist, other medical conditions may be the cause. Reach out to your doctor or healthcare center to rule out medical causes of amenorrhea.

Birth control and bone density

Birth control pills have minimal effect on improving bone density. They work by controlling hormones to produce a period. However, the underlying issue of chronic underfueling is not addressed and the hormones are not working naturally to increase bone density. The effect of underfueling prevents the body from making enough hormones.

How to improve bone health

Ensure adequate calories/energy balance.

Eat on a schedule. Be proactive. One week of underfueling can drop bone density. Studies have shown that one missed meal can increase bone injury by 40%. Eating on a schedule can help ensure you are eating enough food to support exercise. Plan out meals and snacks to eat before and after workouts. If you know it’s going to be a busy week with travel, bring snacks to fill in gaps between meals. For student athletes, this might require snacking during class or for adult runners to eat during a meeting. The goal is to eat food on a regular basis so the body will function at an optimal level. When exercise exceeds food consumed, the energy available to support bones and other important functions is diminished. The body will prioritize movement and sacrifice bone health.

Target the right amount of calcium and vitamin D

Obtain nutrients mainly from foods, and supplement only when necessary to fill in gaps. The RDA for adolescent athletes is 1,300 mg calcium and 600 IU vitamin D. Many foods with calcium also contain adequate amounts of vitamin D. An adolescent athlete can meet calcium requirements with 3 servings of dairy per day. Try eating oatmeal made with milk, yogurt for a snack and adding cheese to sandwiches or as a snack.

Non-dairy athletes can meet calcium requirements by including soymilk, fortified orange juice, dark green leafy vegetables, chickpeas, and fish such as sardines and salmon.

Vitamin D is found in most foods that also have calcium as well as sunlight. Most athletes spend a lot of time outdoors training so supplementation is not always necessary. Sports that are mostly held indoors are at a higher risk of vitamin D deficiency such as swimming, gymnastics, track and field, and dance.

RDA

9-18 yrs old require 1,300 mg calcium and 600 IU Vitamin D

<70 yrs, 1,000 mg of calcium and 600 IU vitamin D

>70 yrs, 1,200 mg of calcium and 800 IU vitamin D

Please note that excessive calcium intake can be harmful and lead to medical issues. Speak with your doctor or healthcare provider about supplementation.

One study by Dr. Nieves showed that one cup of skim milk reduced stress fracture risk by 62%.
“If skim milk were a medicine, it would be a blockbuster.” -Adam Tenforde, MD

Sleep

In addition to high energy demands of athletes, lack of sleep has an even greater risk for bone injury. Impaired sleep has been shown to cause up to 5 percent bone loss within one week (BenSasson 1994).

Exercise loading to build bones

Work with a trained physical therapist to help create a fitness plan that includes a variety of movements. Younger athletes will benefit from a variety of exercises rather than specializing in a single sport. For example, runners will utilize different muscle systems in soccer or basketball. Using multi-directional sports recruits more muscles that strengthen bones from different locations.

If you are worried about your bone density, reach out to a pediatrician, primary care doctor or sports dietitian that works with athletes.

References

Ben-Sasson SA, et al. Extended duration of vertical position might impair bone metabolism. Euro J Clin Investigation. 1994 Jun. Vol 24-6: 421-425. https://doi.org/10.1111/j.1365-2362.1994.tb02186.x

Chan JL, Mantzoros CS. Role of leptin in energy-deprivation states: normal human physiology and clinical implications for hypothalamic amenorrhoea and anorexia nervosa. Lancet. 2005 Jul 2-8;366(9479):74-85. doi: 10.1016/S0140-6736(05)66830-4. PMID: 15993236.

Nieves J, et al. Nutritional Factors That Influence Change in Bone Density and Stress Fracture Risk Among Young Female Cross-Country Runners. PMR Journal. 2010. Aug Vol 2, Issue 8. 740-750. https://doi.org/10.1016/j.pmrj.2010.04.020

Nieves JW. Bone. Maximizing bone health–magnesium, BMD and fractures. Nat Rev Endocrinol. 2014 May;10(5):255-6. doi: 10.1038/nrendo.2014.39. Epub 2014 Apr 1. PMID: 24686202.

Schoenau E, Frost HM. The “muscle-bone unit” in children and adolescents. Calcif Tissue Int. 2002 May;70(5):405-7. doi: 10.1007/s00223-001-0048-8. Epub 2002 Apr 19. PMID: 11960207.

Specker BL, Wey HE, Smith EP. Rates of bone loss in young adult males. Int J Clin Rheumtol. 2010 Apr 1;5(2):215-228. doi: 10.2217/ijr.10.7. PMID: 20625439; PMCID: PMC2897064.

Swanson CM, Shea SA, Wolfe P, Cain SW, Munch M, Vujovic N, Czeisler CA, Buxton OM, Orwoll ES. Bone Turnover Markers After Sleep Restriction and Circadian Disruption: A Mechanism for Sleep-Related Bone Loss in Humans. J Clin Endocrinol Metab. 2017 Oct 1;102(10):3722-3730. doi: 10.1210/jc.2017-01147. PMID: 28973223; PMCID: PMC5630251.

Tenforde AS, Fredericson M, Sayres LC, Cutti P, Sainani KL. Identifying sex-specific risk factors for low bone mineral density in adolescent runners. Am J Sports Med. 2015 Jun;43(6):1494-504. doi: 10.1177/0363546515572142. Epub 2015 Mar 6. PMID: 25748470.

Tenforde AS, Carlson JL, Sainani KL, Chang AO, Kim JH, Golden NH, Fredericson M. Sport and Triad Risk Factors Influence Bone Mineral Density in Collegiate Athletes. Med Sci Sports Exerc. 2018 Dec;50(12):2536-2543. doi: 10.1249/MSS.0000000000001711. PMID: 29975299.

Tenforde AS, Barrack MT, Nattiv A, Fredericson M. Parallels with the Female Athlete Triad in Male Athletes. Sports Med. 2016 Feb;46(2):171-82. doi: 10.1007/s40279-015-0411-y. PMID: 26497148.

Best Nutrition Bars for Athletes

June 22, 2023January 26, 2023 by amystephens

Athlete’s Guide to Choosing a Nutrition Bar

I always recommend a food first approach but sometimes fresh food isn’t always available. Athletes have high energy demands, and in order to maintain a positive energy balance, athletes need to eat throughout the day. This might be challenging for athletes that have long, busy schedules or a second practice. There are many nutrition bar options available, but I’ve narrowed it down to a few that have enough protein and carbohydrates for athletes.

Nutrition bars are a great way to offset hunger, prevent injury and help with recovery.

What to look for in a nutrition bar

Calories are a guide to know how much you need to eat. Most bars listed below are between 200-400 calories, which is an appropriate amount of calories for a snack. Athletes’ calorie levels can vary depending on time spent exercising and intensity. Therefore, calorie requirements can be as much as 2500-5000 calories for very active individuals, which can be hard to obtain in meals. If you need further guidance on calories, it’s best to work with a sports dietitian to help you determine the best calorie intake for you.

Fat is an important nutrient that has key functions in the body such as helping to keep you fuller for longer, carry fat soluble vitamins and help with energy balance. Keep in mind, bars with high amounts of fat can take longer to digest, so it might be best to consume them well before you begin a workout or use them as a post workout recovery food. Athletes can target about 70-80 grams of fat per day, which is about 10 grams fat per snack and 25 grams fat per meal.

Protein is important to help grow muscle and prevent muscle breakdown. To maximize muscle growth and repair, studies show that protein spread throughout the day will have the biggest impact on muscle growth. Protein slows down digestion and helps keep blood sugars steady. Aim for 10-20 grams protein per bar.

Carbohydrates are essential for fueling working muscles before a workout and for recovery afterward. In between workouts, an athlete’s body is constantly restocking glycogen and recovering, even at rest. Bars are a great way to keep the supply of carbohydrates continuous. Look for nutrition bars that have 30-60 grams of carbs in the form of oats, fructose, glucose or maltose.

Fiber is essential to helps grow good gut bacteria, stabilize blood sugars and promotes regular bowel movements. Dietary guidelines suggest 25-30 grams fiber per day. Look for bars with about 3-5 grams fiber. Keep in mind, some bars contain very high levels of fiber which can be challenging to have the day before an endurance event. Fiber expands in the colon creating an urgency to use the bathroom multiple times. This can be a problem for endurance athletes in a competition without a bathroom nearby.

Sugar is okay for athletes. Diet culture has taught us that sugar is bad, but athletes have much higher energy demands and sugar can be part of a healthy diet in small quantities. Aim for bars with natural sugars such as honey or maple syrup on the label. Fructose and maltose have been shown to increase glycogen stores quickly, which helps performance and recovery.

Best pre-workout bars

Here are a few suggestions for pre-workout bars. I selected these options below because they contained higher carbohydrates, low-fat and low -fiber. These nutriets tend to cause GI issues in some people. Studies support a greater amount of carbohydrates and less protein/fat/fiber before a workout.

Nature’s Bakery Fig

Nutrition facts:

200 calories

5 g fat

38 g carb

3 g fiber

3 g protein

What I love: These bars are easy to find in local grocery stores, they’re inexpensive and contain high-quality ingredients.

✓ GF, vegan

$6.44/12 bars ($.54 each)

Order

Kind Oat Bar

Nutrition facts:

150 calories

5 g fat

23 g carb

2 g fiber

3 g protein

What I love: Kind bars are available in most grocery stores and they contain five super grains such as oats, millet, buckwheat, amaranth, and quinoa.

✓ GF

$35.92/40 bars ($.90 each)

Order

Larabar

Nutrition facts:

210 calories

12 g fat

23 g carb

4 g fiber

5 g protein

What I love: Larabar has only six ingredients (almonds, dats, semisweet chocolate chips, apples, cocoa powder and sea salt) and they taste great. Good option if you’re on a budget.

✓ GF

$16.14/86 bars ($.90 each)

Order

Skratch energy bar

Nutrition facts:

220 Calories

9 g fat

30 g carb

3 g fiber

5 g protein

What I love: great for pre-workout quick fuel. Interesting flavors such as cherry pistachio or peanut butter and strawberry.

✓ GF, Vegan, Kosher

$29.94/12 bars ($2.50 each)

Order

Bobo’s (Oat bar)

Maurten Solid

Nutrition facts:

340 calories

12 g fat

62 g carb

4 g fiber

6 g protein

What I love: Bobo’s are sold in local grocery stores and available in a bunch of interesting flavors such as chocolate almond and maple pecan. They can be broken in half for two snacks.

✓ GF, vegan

$29.88/12 bars ($2.49 each)

Order

Nutrition facts:

225 calories

3.6 g fat

41.5 g carb

2.4 g fiber

2.9 g protein

What I love: The fructose-glucose syrup is an ideal ratio for energy production plus the low fiber content make this a great choice for pre-workout fuel.

✓ GF

Cost $36.00/12 bars ($3.00 each)

Order

Best post-workout bars

These are my suggestions based on the nutrient composition. I generally look for a 4:1 ratio of carbohydrates to protein. This ratio has been shown to maximize glycogen stores, stimulate muscle protein synthesis and promote recovery.

Macrobar

Nutrition facts:

290 calories

11 g fat

39 g carb

2 g fiber

11 g protein

What I love: GoMacro is a great tasting vegan bar with protein from almond butter. Also has a snack size version.

✓ GF, Vegan

Cost $38.95/12 ($3.25 each)

Order

Clif

Nutrition facts:

235 calories

5 g fat

43 g carb

5 g fiber

11 g protein

What I love: Clif bars are available in many local grocery stores. I also like the 4:1 carbohydrate: protein ratio which is great for recovery after a workout.

✓ GF

$18.77/18 bars ($1.04 each)

Order

Rxbar

Nutrition facts:

210 calories

9 g fat

23 g carb

5 g fiber

12 g protein

What I love: RXBars have tons of flavors and they are easy to purchase, plus they are small enough to easily fit in your pocket.

✓ GF

$23.37/12 bars ($1.95 each)

Order

Over Easy

Nutrition facts:

230 calories

11 fat

24 g carb

6 g fiber

10 g protein

What I love: Over Easy bars are a great breakfast option as recovery food. They have a ratio of 2:1 carbs to protein which can help build glycogen and stimulate muscle protein synthesis (MSP).

✓ GF, dairy free

$29.69/12 bars ($2.47 each)

Order

Amy Stephens