Did You Know?! We Do Many Things At SSSI

The Sanford Sports Science Institute offers many services besides just research and nutrition consults. We have state of the art facilities that allow us to work as a multi-disciplinary team to help athletes of all levels and ages as well as active individuals reach their goals. Whether its achieving a new PR or getting back to exercise post injury, we can assist.
Here are the services we provide, with a full description:

COMPREHENSIVE GAIT ANALYSIS

This is a comprehensive functional and biomechanical evaluation, as well as a rehabilitation and consultation service, for anyone who is looking to improve his/her running performance or with lower body musculoskeletal injuries. The analysis is performed on a Zebris® Force and Pressure Distribution platform that is integrated on a high-end h/p/cosmos® treadmill to analyze foot pressure, impact forces, roll-off and other gait parameters during walking and running. High-speed video cameras (100 fps) are used in conjunction with the Simi Aktisys automated motion-capture system to provide precise, quantitative biomechanical assessments for real-time biofeedback and off-line evaluation. Each athlete receives a personalized performance plan, including specific stretching and strengthening exercises, shoe/orthotic recommendations and corrective exercise techniques. Our expert professionals work one-on-one with the athlete to develop an individualized program to help achieve his/her specific performance goals.

CYCLING SPIN-SCAN ANALYSIS

Cyclists and triathletes can optimize their pedal stroke via a comprehensive computerized analysis on their bikes using the RacerMate® CompuTrainer™. The spin-scan evaluation calculates bi-lateral cycling efficiency of the leg musculature, as well as left vs. right power split and average torque angle. The individualized analysis also includes instantaneous, average and peak power output, revolutions per minute and speed.

SPORT NUTRITION ASSESSMENT AND CONSULT

Sport-specific nutrition interventions can help an athlete maximize power and endurance, as well as overall health and performance. The intervention begins with a 3-day dietary analysis, including an assessment of daily eating patterns, training dietary habits and nutrition tactics used during training and competition, including preparation and recovery. Through a one-on-one consultation with our sports dietitian, individualized strategies to maximize training and performance are developed. The dietitian also helps the athlete accommodate any specific allergies or chronic health conditions he/she may have. The goal is to help each athlete effectively fuel his/her body for optimal performance and health.

RESTING ENERGY EXPENDITURE (REE) AND BODY COMPOSITION EVALUATIONS

Determining an athlete’s REE, or roughly the minimum number of calories the body needs each day to function properly at rest, is extremely important when trying to personalize one’s nutrition and fitness strategies. Body composition (relative percentage of body fat and lean body mass) and REE are closely linked to one another and provide a foundation for establishing an athlete’s nutrition and fitness goals. Body fat percentage is estimated from multiple skin fold measurements and REE is determined from measuring oxygen and carbon dioxide exchange while at rest.

SWEAT FLUID AND ELECTROLYTE LOSSES AND PHYSIOLOGICAL STRAIN IN THE HEAT

This is an individual evaluation of an athlete in a specific environment using a temperature, humidity, and exercise intensity that elicited performance or health problems (for example, premature fatigue, heat exhaustion or muscle cramps) or to simulate upcoming training or competition conditions. Sweat fluid and electrolyte (sodium, potassium and chloride) losses are determined and cardiovascular and thermal strain (heart rate, core body temperature and physiological strain index) are evaluated. Individual-specific hydration and dietary strategies are provided, so that each athlete can more optimally prepare for, manage and recover from sweat fluid and electrolyte losses incurred during training or competition.

HEAT TOLERANCE TESTING
This is an evaluation of an athlete’s current tolerance to exercising in the heat. Athletes should consider having this test performed if he/she has had a heat-related illness, especially exertional heat stroke, or a long period of no exposure to the heat. This test can also be used to evaluate an athlete’s thermal and cardiovascular responses while wearing a particular clothing or uniform configuration during physical activity.

ATHLETE FIELD EVALUATIONS

One or more athletes are evaluated during training, practice or competition for hydration status (pre- and post-session), fluid intake and sweat fluid and electrolyte (sodium, potassium and chloride) losses.

Individual-specific hydration and dietary strategies are provided to help each athlete more optimally prepare for, manage and recover from fluid and electrolyte losses incurred during training and competition. Thermal strain (core body temperature, heart rate and physiological strain index) can be monitored in selected individuals.

FITNESS TESTING (VO₂MAX)

VO2max (maximal oxygen uptake) is the best measure of an athlete’s cardiorespiratory fitness. Also referred to as aerobic capacity, VO2max reflects the body’s ability to deliver and use oxygen to meet the energy demands of exercise. A high aerobic capacity is especially important in endurance-type activities (for example, distance running, cycling and swimming); however, it is also important to enhance recovery between brief intermittent bouts of high-intensity activity in other sports (such as soccer, tennis, basketball and football) during practice and competition. This is a progressive incremental exercise test using a treadmill or exercise bike, depending on the athlete’s primary sport or preference.

FITNESS TESTING (LACTATE THRESHOLD)

Lactate threshold (LT) reflects the exercise intensity at which the concentration of lactate in the blood increases sharply. LT is a very good predictor of sustained endurance capacity and performance and is also helpful in determining an athlete’s appropriate training intensity zones. A high LT is especially important in endurance-type activities (e.g. distance running, cycling and swimming). Tracking changes in LT can assist an athlete in assessing the effectiveness of his/her training over several months. This is a progressive, incremental workload exercise test using a treadmill or exercise bike, depending on the athlete’s primary sport or preference.

PRESENTATIONS AND WORKSHOPS

The Sanford Sports Science Institute can meet with coaches, support staff (e.g., athletic trainers and administrators) and teams to discuss sport-specific training and competition challenges and nutrition/hydration needs that can help athletes optimize training, performance and recovery. A particular emphasis is placed on the challenges and solutions to training and competing optimally in the heat, while reducing the risk for heat- and fluid/electrolyte-related problems (e.g., muscle cramps, pre-mature fatigue, exhaustion and hyponatremia).

On our website you can find all this information as well as videos explaining some of the tests more thoroughly. Moreover, we have great education materials you are welcome to print and/or share with your coaches, teams, children and friends. For more information and/or to book our services, feel free to call us at (605)-328-4750. 

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Fighting Inflammation, The Healthy Way

In sports nutrition we talk about inflammation a lot. In fact, even in the clinical setting, we talk about inflammation. We talk about it because it promotes negative outcomes. It's associated with cancer, diabetes, heart disease and other conditions as well as sports injury, becoming ill (e.g. flu) and lack of ability to recover optimally. Therefore, we put emphasis in our practice to educate athletes on how to fight inflammation. Its important to understand though, that inflammation is an important process for an athlete as it is naturally created due to activity. However, we want to fight it in a healthy manner. Research shows that fighting sports related inflammation with drugs such as Aleve, Ibuprofen or other anti-inflammatories, may prevent the natural healing process muscle and even increase inflammation.

Here are some things you can do to help fight inflammation the healthy way:

• Sleep well! For a college athlete recommendations are about 8-10 hours per day. If you did not meet this quota at night, consider taking a nap in the middle of the day. Lack of sleep prevents healing and promotes inflammation. 
• Avoid or limit alcohol. Alcohol promotes inflammation and also decreases deep sleep (as mentioned above, sleep is important).
• Avoid or limit fried fatty foods (pizza, fried chicken, fries, etc.) and concentrated sweets (Pop Tarts, soda, cookies, cake, milkshake, candy, etc.) as they promote inflammation.
• Hydrate. Mainly with water. Fluids are important to help deliver nutrients to different parts of the body, including nutrients to fight inflammation. Moreover, dehydration decreases your immune function, which could cause you to get ill (=inflammation).
• Eating plenty of fruits and vegetables. Fruits and vegetables are rich with antioxidants and phytochemicals that help fight inflammation. When you get injured, the first thing most people do is put ice. Think of fruits and vegetables as your ice inside the body. Very powerful anti-inflammatory.
• Omega 3's, the fat located mainly in fish (salmon, tuna, mackerel, etc.) as well as some nuts and seeds (flaxseeds, chia seeds, walnuts, etc.) are a great source of anti-inflammatories. It is recommended to have at least 8 oz of fish per week. In certain cases, a supplement could be considered (please consult with a medical professional before taking any supplement).
• Vitamin D aka the sun vitamin has been shown to be quite the immune booster. Vitamin D can be found in fortified products such as orange juice, dairy, soy foods as well as fish. Supplements can also be considered (please consult with a medical professional before taking any supplement).
• Vitamin C, Vitamin A and Zinc. These micro-nutrients have been shown to boost our immune system and help with healing. 
• Eating enough calories. Calories are a measurement of energy. If we do not eat enough calories, we will not have enough energy to fight inflammation or recover optimally from exercise.
• Keeping your stomach healthy. Positive bacteria is important to keep a healthy gut. A healthy gut can help maintain healthy immune function. By eating a balanced diet, containing pre and probiotics with a good variety of whole grains, dairy (yogurt), fruits, vegetables, legumes and lean meats, you can help sustain a healthy gut. 
• Rest. We all know the importance of recovery for performance. Overtraining and overreaching have a lot to do with chronic inflammation. Make sure you take rest seriously, as you would your training. 

This winter, "let food be thy medicine and medicine be thy food" to help you fight inflammation and keep a healthy immune system. Here is a great handout by NCAA Sport Science Institute of how to promote immune function.

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How to Build The Perfect Athlete's Plate

One of the most basic questions we get asked as dietitians all the time is "what should I eat?". Its a fairly simple question with a complex answer. However, there are ways to simplify this question, especially when it comes to athletes. The best way to simplify it is by showing you how an athletes plate should look like based on their training regimen.

           

On easy training days, rest days or if I am trying to focus on weight management (probably during off season) my plate should look like the one noted above. Working less, requires less carbohydrates for energy but more produce to assist with recovery and sustaining health. It should contain:

• 1/4 grains, ideally whole grains such as whole wheat pasta, brown rice, quinoa, sweet potato, whole wheat bread, etc. 
• 1/4 protein. Focus on lean protein such as chicken, turkey, fish, lean parts of the beef or pork, tofu, eggs, etc. Prefer grilled, roasted, broiled or baked over fried or pan fried. 
• 1/2 vegetables and fruits. Example: green beans, roasted beets, salad, sauteed cauliflower, broccoli and carrots, etc.
• Make sure you always have healthy fats in there such as: olive oil, olives, nuts, seeds, avocado.
• Hydration is always important. Continue hydrating adequately with mainly water.
• Example of a whole plate: chicken breast, brown rice with almonds and broccoli or large salad with egg, cheese, pumpkin seeds, lettuce, tomato, onion, cucumber, carrots and cabbage. 

As training increases our plate changes to accommodate more carbohydrates to assist with energy demands of the sport. Moderate training is typically when you have 1-2 training sessions a day that may include one easy workout and a second hard/moderate workout or just one hard workout.

          

This plate should contain:

• 1/3 grains. As noted before, prefer whole grains. A day before a game or a competition, you might want to consider limiting whole grains so they do not cause a stomach upset.
• 1/4 protein. As intensity increases we still need enough protein to help rebuild and recover.
• 1/3+ vegetables and fruits. Variety is important to help fight inflammation, assist with recovery and support a healthy immune system.
• Continue to incorporate healthy fats.
• Hydration - keep hydrating appropriately. Weigh before and after practice. For every pound lost, drink 16-20 oz liquid. Sports drinks could be incorporated. See previous post for more specific info on hydration.

Last but not least, when training intensity and duration have increased even more, we focus more on carbohydrates as that is our major source of energy. Hard training or competition day (depending on the sport) is when we have at least 2 workouts a day that are fairly high intensity or if duration is long

            

This plate should contain:

• 1/2 grains. The higher the intensity the more we rely on carbohydrates. This plate may need to contain more easily digestible carbohydrates such as regular rice and white pasta vs whole grain to prevent stomach issues.
• 1/4 protein. As intensity increases we still need enough protein to help rebuild and recover.
• 1/4 vegetables and fruits. Variety is important to help fight inflammation, assist with recovery and support a healthy immune system.
• Healthy fats are increased slightly to accommodate inflammation as well as being able to meet calorie goals. 
• Hydration continues to be very important. See above for recommendations 

As you can see, its quite simple. Whether you cook at home, eat at the dinning hall/training table or eat out, you should be able to build a healthy plate. Hopefully, these visuals have helped. You can also print out this cool education sheet the NCAA Sports Science Institute has created to building a performance plate.  

** Thanks to USOC and UCCS for the great athlete's plate ed material

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The Importance of Iron for Performance

Iron is one of the most essential trace minerals for athletic performance and the general population. As a college athlete, your body demands extra nutrients, including iron. According to the Academy of Nutrition and Dietetics (AND) endurance athletes, especially long distance runners, have iron needs that are 70% higher than the general population. Iron is also one of the most common nutrient deficiencies seen in athletes, especially women.

Why is iron important?
Iron is essential for energy production, metabolism and to help carry oxygen to the cells. It is also essential for growth, development and the immune system to function normally.

Common causes of iron deficiency:

• Individuals on vegetarian or vegan diets. Iron is less available in plant-based products.
• Inadequate energy intake. 
• Iron loss in sweat, feces, urine, menstrual bleeding, GI bleed, foot-strike hemolysis (with every foot strike we break red blood cells), injury, and blood donation. 
• Medical disorder that prevents absorption of iron
• Pregnancy. More demands due to a growing fetus
• Growth spurt

Symptoms of iron deficiency:

• Fatigue, irritability, shortness of breath, dizziness, headache, coldness in your hands and feet, pale skin, chest pain and weakness. 

Consequences of iron deficiency: 

• Reduced endurance
• Muscle function weakens and ability to work is limited. 
• Can lead to iron deficiency anemia, which can take 3-6 months to reverse.

Possible benefits of improving iron deficiency: 

• Improved work volume and endurance. 
• Improved oxygen uptake. 
• Decreased lactate concentrations. 
• Decreased muscle fatigue. 

How to figure out of you are deficient:

A simple blood test allows to figure if you are deficient or not. The most common test is hemoglobin. However, low hemoglobin of < 12 g/dL for women and < 13.5 g/dL for men indicates iron deficiency anemia, which will require supplementation. You can be iron deficient with no anemia. In this case, it is highly recommended to test ferritin levels. Ferritin helps store iron in the body. If it is low, we have low iron stores as well. Although the normal lab values are 12-300 ng/dL in men and 12-150 ng/dL in women, it is found that ferritin below 35 ng/dL in athletes can affect performance and supplementation may be recommended. 

How to improve iron status:

Eat a balanced diet that meets your dietary needs. Women (19-50 years) need a minimum of 18 mg of iron each day and men 8 mg. Consult your doctor or health professional about taking an iron supplement if you do not feel that you can meet your iron needs by diet alone. 

Rich dietary sources of iron: 

• The most bio-available (best absorbed) sources of iron (also called heme iron): meat, poultry, and fish. 
• Other sources (plant derived sources are not absorbed as well. Called non-heme Iron): Ready-to-eat cereal, beans, tofu, nuts and dark leafy greens. 

Tips: 

• Choose breakfast cereals that are fortified with iron 
• Choose lean meat sources (e.g. Ground beef with less than 10% fat) 
• Consume iron rich foods with foods high in vitamin C to help your body absorb the iron better (e.g. Oranges, tomatoes, red peppers). 
• Avoid drinking tea with your iron containing meals. Substances in tea reduce the absorption of iron. 
• Avoid drinking milk with your iron containing meal.
• Oxalates and polyphenols are compounds found in certain fruits, herbs, nuts, chocolate and vegetables such as: spinach, kale, tea, beets, strawberries and rhubarb to name a few, that limit absorption of iron from non-heme sources. Cooking the vegetables may assist in preventing this from occuring.  

Guest Contributor: Emily Seidl, MS, RD

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Nutrition for the Injured Athlete

We talk all the time about nutrition for performance and nutrition for recovery but there is not much talk about nutrition for injury. Is there even a specific regimen for the injured athlete?!
Unfortunately, there is not much research out there on the injured athlete so we don't have a specific regimen, however, we do have some knowledge and recommendations to help heal faster and get back in the game sooner.

Injury has 3 healing phases:

1. Inflammation - occurs immediately up to 2-5 days post injury
2. Proliferation -  occurs 5 days - 3 weeks post. During this phase there is rebuilding and repairing 
3. Maturation - occurs 3 weeks - 2 years (depending on severity of injury). During this phase there is remodeling to a stronger structure

If the injury is serious we may not be able to immobilize which in turn will cause less muscle building, muscle loss, decrease in strength and of course decrease in performance.  

Nutritionally, we divide recommendations to 2 phases: 

1. Injury and immobilization - during this phase most of the muscle loss occurs
2. Rehabilitation - during this phase exercise is re-introduced in the form of therapy and advanced to full practice when able

Nutrition recommendations during Injury and immobilization (= inflammation and proliferation phase of healing):

• Energy (kcal) - demands of energy are slightly higher in order to assist with the healing processes. If injury is severe, energy expenditure can go up by 20%. If on crutches, energy expenditure can be 2-3 times higher than walking. Sometimes, a small weight gain is beneficial because with out enough calories we can prevent muscle protein synthesis (building muscle)
• Protein - During the immobilization phase we lose muscle which then causes us to lose strength. Protein helps us build and repair, therefore, are needs for protein are higher. Although we do not have an exact number of grams/lb we need per day, we assume its more than the DRI (dietary reference intake) which is 0.8 grams/kg (0.35 grams/lb). Some research suggests we need close to 1-1.2 grams/kg/day (0.45-0.55 grams/lb/day). Since the majority of us eat more protein than we need this should not be an issue
• Carbohydrates - When we exercise, carbohydrates are our main source of energy. However, when injured, we don't need as much, therefore, we may decrease carbohydrates slightly to prevent excessive weight gain. Sports beverages, gels, sodas and concentrated sweets are highly discouraged during this time
• Fats - very essential for healing. What type of fats is most important. Omega 3s (found in fatty fish as well as certain seeds/nuts) have been found to possibly help increase muscle protein synthesis (building muscle) as well as help with recovery and decreasing inflammation
• Vitamins and minerals:
             * Vitamin C - Helps with wound healing, tissue repair and increased immune function. Foods rich in vitamin C include: citrus fruit, strawberries, red bell peppers, watermelon, etc.
             * Vitamin A - Helps with cell growth and development as well as immune function. Foods high in vitamin A include: sweet potatoes, tomatoes, carrots, papaya (orange/red fruits and vegetables)
             * Zinc - Helps with wound healing, protein synthesis and immune function. Foods rich with zinc include: beef, almonds, seeds (sunflower, flax, pumpkin, etc.) and seafood
             * Vitamin D - Important for bone health and immune function. The sun vitamin - get 5-30 minutes of sun between 10 AM - 3 PM (time is based on skin color, the darker the skin the more time you need) or it can be found in dairy products, fatty fish or fortified foods

                      

• Fluids - fluids are needed in order to deliver the different nutrients to the different organs and tissues. Moreover, its needed to support joints and soft tissues. Roughly, you should be drinking half your weight in ounces, preferably water. 

Nutrition during rehabilitation phase

We treat this phase as we were to treat someone who does strength and conditioning. We put emphasis on enough energy and protein as well as healthy fats and plenty of vegetables and fruits. More on strength and conditioning nutrition in a future blog.

There are also foods/beverages that can prevent us from healing optimally, which we should avoid:

• Fried fatty foods (example: pizza, fried chicken, french fries, etc.)
• Added sugars and concentrated sweets (soda, candy, ice-cream, etc.)
• Being malnourished (more common in elderly but applies to people that restrict eating a lot)
• Less than optimal sleep (athletes should sleep 8-10 hours/day)
• Alcohol - it inhibits muscle protein synthesis and increases muscle loss 

So, if you or any of your friends get injured, remember to also focus on nutrition to help speed your healing and recovery! Food always comes first and if need be, consult a sports RD or a sports MD for supplement recommendations.

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Soccer Nutrition

As you might have noticed, the world cup just started and it seems as though everyone is watching.
It took enormous amounts of training to get there and now it will take a lot to stay at the top. One of the more important ways to stay at the top, besides good players of course, is nutrition and rest. For those who don't know, only 2 teams brought their dietitian with them to Brazil. Team USA and the team from Italy (you can read more about what they are doing here). Therefore, I thought it would be appropriate to talk about sports nutrition strategies in soccer.

Soccer has a combination of endurance exercise and intense short burst sprints. Professional players that play most of the game, may cover up to 10-13 km (6-8 miles) with multiple sprints in between. Therefore, the main source of energy they utilize is carbohydrate. Athletes who do not consume enough carbohydrates and are insufficiently hydrated will not be able to train and/or compete at high intensities and will likely experience premature fatigue. 
Our nutrition strategy will focus on pre-during-post- activity:

Pre-activity/game nutrition depends on how soon my activity is:

Pre-activity meal (3-4 hours before):

-          High in carbohydrate

-          High in lean protein

-          Low in fiber and fat

-          12-20 fl. oz (e.g., milk, juice, sports drink)

Example:  Grilled chicken, brown rice, corn, green beans, salad and vanilla pudding.

Pre-activity snack (30-60 minutes before)

-          30-60 grams of easily digestible carbohydrate

-          Moderate in protein

-          Low in fiber and fat

-          5-16 fl. oz (e.g., water, sports drink)

Example: Banana & peanut butter, yogurt & small amount of granola, cereal & milk, granola bar, etc.

During activity depends on length of activity and whether you have one session or more per day:

 If activity is less than 60-90 minutes and that is the only session of the day:

-   hydrate with 5-10 oz of water every 15-20 minutes.

 If activity is more than 60-90 minutes and/or you have multiple sessions a day:

-          Drink 5-10 oz of fluid every 15-20 minutes (preferably a sports drink)

-          Consume 30-60 grams of carbohydrate every hour (by drinking or eating)

-          During half-time (or similar break), eat a simple carbohydrate snack with limited amount of protein, low in fiber and fat

-          Consume snacks that contain sodium (salt)  

Example: Banana, pretzels, crackers, beef jerky and/or a sports drink.

Post activity/Recovery

Recovery starts fairly close to when you finish your activity; therefore, within about 30-45 minute,
- focus on protein and carbohydrate foods and/or drinks. 

Example: Chocolate milk, Greek yogurt and a banana, recovery shake

Post-activity meal (1-2 hours after)

-          High in whole grain carbohydrates

-          High in lean protein

-          Good amount of fiber and fats

-          16-24 fl. oz (e.g. chocolate milk, smoothie, sports drink, water)

Example: 6”-12” sandwich with turkey, cheese & vegetables, trail mix, and oatmeal cookie.

Note - if you will have a meal within an hour post activity/game a recovery drink is not needed. However, if you are not hungry right after and there may be some time before your next meal, a recovery drink is important.

For hydration recommendations please refer to our previous post on that topic.

Remember, the right hydration and nutrition plan can really be a game changer, so make sure you fuel appropriately for your sport pre, during and after activity.

GO TEAM USA!

ole, ole, ole, ole, ole, ole .................... 

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Gastrointestinal Issues in Runners and Strategies to Overcome Them

Bill Rogers, a famous American runner that won four times the Boston and NYC marathon's between 1975-1980 and a 2000 USA Track & Field Hall of Famer stated, "more marathons are won or lost in the portable toilets than at the dinner table". Obviously, he was well aware of the gastrointestinal (GI) issues runners face.
GI issues have a variety of symptoms including: diarrhea, nausea, vomiting, bloating, belching, cramps heartburn and bloody stools. Symptoms are more common in women, younger athletes, elite athletes and people with a history of GI issues. It is estimated to occur in 30-90% of distance runners during and/or after exercise. Complaints of GI issues differ in severity and they may cause a decline in performance and recovery.

                           

There are three main reasons for GI problems:

• Physiological - When we exercise, depending on the intensity, blood supply to the gut may decrease by up to 80% in order to transfer more blood to the working muscles, skin and heart. This in turn may cause diarrhea, nausea, vomiting and stomach pain.
• Mechanical -   Running is a high impact sport with continuous pounding. This pounding also influences the GI tract which in turn can cause GI symptoms. Therefore, runners have a tendency to have more problems than bikers. 
• Nutritional - The meal timing before exercise as well as beverage and food choices may cause GI symptoms. A meal shortly before running, rich with fiber, fat and protein will cause GI symptoms because these nutrients have a slow emptying rate in the stomach. Drinking a concentrated carbohydrate beverage during or slightly before a race will cause GI symptoms. Moreover, dehydration intensifies GI symptoms. As discussed in the previous blog on alcohol and performance, drinking the night before a run several drinks can cause GI symptoms probably due to its diuretic effect. 
• Note; Certain people may have a medical condition such as: celiac disease, lactose/fructose mal-absorption and irritable bowel syndrome to name a few, that makes them more susceptible to GI symptoms

Since this blog is a nutrition blog, lets talk about some nutrition strategies to prevent GI symptoms:

• Hydration, hydration, hydration - before a run, make sure you are hydrated. Focus on hydrating well throughout the day. 
• Avoid beverages during or slightly before a run rich with fructose such as juice. Prefer water or if running long distance, a sports beverage with 6-8% carbohydrates such as Gatorade or Powerade.
• Avoid high fiber foods 1-2 hours pre-exercise as well as the day before a big race. 
• Avoid high fat and high protein foods 1-2 hours pre-exercise
• "Train the gut" - the gut is very adaptable, therefore, train your gut by eating during your training as well as before (if activity is lower than 60-90 minutes there is no need to eat anything during and water should suffice). Experiment with foods before a training session to check what works and what doesn't.
• Avoid using non-selective, non steroidal anti-inflammatory drugs (NSAIDs) such as Aspirin and Ibuprofen as they tend to increase GI symptoms.
• Avoid lactose containing milk products if you think or know that you are lactose intolerant. 
• Avoid or limit alcohol drinking before a morning run or a big race

It is very important that if you have severe GI symptoms such as bloody stools, you consult with a medical professional.

For specific guidance and assistance if you suffer from the symptoms noted above, consider consulting with a sports dietitian to help you with strategies to prevent any GI symptoms.

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Hydration, Hydration, Hydration

Summer is just around the corner and with it comes warm weather and training more outdoors. More time outdoors and training in the heat may cause dehydration and/or heat related issues.  Therefore, this summer, lets focus on hydrating for performance and preventing injuries related to dehydration.

To stay well hydrated we should rely mainly on fluids but we can also rely on foods.  Eating things like fruit, vegetables, soups, smoothies and yogurt can help replenish some of those fluids. Especially summer fruits and vegetables like: watermelon, peaches, nectarines, melons, grapes, cucumbers, sweet bell peppers, tomatoes, summer squash and berries. These fruits and vegetables not only have a good amount of fluids but they contain plenty of antioxidants to help us recover from our activity, stay healthy and maintain a strong immune system.

The most efficient way to stay hydrated is drinking water or a sports beverage. How much and what you need to drink depends on genetics, the length and intensity of the activity as well as if you are a heavy and/or salty sweater. Make sure you arrive to your training session/game well hydrated or else you may not even last half of it. Activities that are 60-90 minutes ideally should be replenished with water. If your activity is more than 60-90 minutes you should hydrate with a sports beverage. Try to reach for your beverage every 15-20 minutes and drink about 5-12 oz. The ideal sports beverage should have 110-170 mg of sodium, 20-50 mg of potassium and 12-24 grams (6-8%) of carbohydrates per 8 oz.

How much fluid should I drink after activity? Weigh yourself before and after activity (ideally with minimal amount of cloths), for each pound you lose hydrate with 16-24 oz. If you are a salty sweater (characterized by the following: your sweat stings in your eyes or burns when reaches an open cut, you tend to leave white lines on things like hats and shirts, your skin feels gritty after a run and it actually tastes salty) make sure you also add simple salty foods to the equation not just a sports beverage (pretzels, crackers, etc.). You can also have a sweat test done (a test that can tell you how much sodium and fluids you lose in an hour of exercise) in order to provide you with an exact regimen of how much you need to drink as well as how much sodium you need.

    

To make sure you are hydrated, it’s important to know what the signs and symptoms of dehydration are. Signs and symptoms of dehydration include:  elevated heart rate, headache, reduced sweating, muscle cramps, dark urine, small urine volume, chills, clammy skin, nausea, vomiting, may cause heat related illness – e.g heat exhaustion, heat stroke (For more info on heat exhaustion and heat stroke visit http://www.cdc.gov/nceh/extremeheat/warning.html).
A urine scale is commonly used to check level of hydration. The rule we try to stick to is that it needs to be more like lemonade versus apple juice   

Whether its for fun or practice, make sure you hydrate well this summer!
Here are some ways to help you stay hydrated:

1. Drink throughout the day
2. Carry a full water bottle with you at all times
3. Drink 1-2 cups of water before each meal
4. Drink 2-3 cups of fluids before each practice/activity
5. Drink 1-2 cups of water before you go to bed
6. Drink every 15-20 minutes during practice/exercise
7. Avoid hydrating with energy drinks or caffeinated beverages
8. Depending on activity level, consider eating salty snacks as they will cause you to drink

 Drink up!

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Sleep, an Essential Component

There are 4 main components that are essential for any athlete: training, recovery, nutrition and sleep.
We tend to talk a lot about the first 3 components but not much on the last one.
The recommendations for sleep duration are as follows:
Children - 10-11 hours/day
Teens - 8.5-9.5 hours/day
Adults - 7-9 hours/day

Lack of sleep has been shown to: impair cognitive performance and mood, disturb glucose metabolism and appetite regulation which in turn can cause higher weight, decrease immune function and decrease production of hormones such as testosterone and growth hormone (these hormones assist with building and repairing muscle). 

When it comes to physical activity, sleep deprivation has been noted to cause: slower reaction times, slower sprint times, decreased aerobic performance, decreased cognitive processes (visual tracking, focus, mood, determination) and higher odds for injury.

Although there are not many studies out there, the University of Stanford has done several studies on swimmers, tennis players and basketball players. They tried to see what happens if you extend sleep time to 10 hours/day. College students had their baseline (performance and psychological tests) measured while sleeping regularly for several weeks (typical sleep day ranged 6-9 hours) and then got them to sleep at least 10 hours a day for several weeks. If they could not sleep the whole time at night, they were encouraged to take naps throughout the day. Interestingly enough the results showed they all had faster sprint times and they all had increased mood and decreased day time fatigue. 

Each sport also had specific improvements:

1. Tennis - Had about 24% better accuracy in hitting as well as 42% better hitting depth.
2. Basketball - Had improved shooting accuracy by 9% in both free throw as well as 3 point field goals. They also had a better reaction time
3. Swimming - Had faster reaction times, total faster times and 25% more kicks 

Are you ready to go to sleep yet? If you are, here are some things you can do to get a better sleep:

1. Sleep on a comfortable mattress with comfortable pillows
2. Finish eating about 2 hours before you go to sleep
3. Schedule time for sleep. If need be, set an alarm
4. Avoid caffeine or energy drinks close to bed-time
5. Dim the lights in your room and when its time to go to bed make sure your room is dark as possible
6. Turn off all screens at least an hour before bed: TV, laptop, computer, Ipad, cell phone, X-box, etc. If you feel you must text or email before bed make sure you use the light dimming apps 

Athletes should make sure they are not only training, eating and recovering right but also sleeping enough!

Good Night

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Alcohol and Performance

Alcohol is the most abused recreational drug in society and is the one most used by athletes. It is well known to cause poor judgement, decreased reaction time and decreased fine motor skills which is why we don't drink and drive. In addition, it effects our heart function, our ability to regulate body temperature and it can cause hypoglycemia (low blood sugar).

Research states that 88% of intercollegiate American athletes use alcohol. Moreover, collegiate athletes are much more likely to binge drink compared with non-athlete students. It's speculated that maybe the competitive behavior of athletes is not just on the court or field but also in social activities, such as drinking.

So, what can alcohol do to performance? Lets go over some facts:

• Athletes that drink alcohol once per week have been shown to have twice the risk for injury. 
• Moderate alcohol consumption has been shown to lower force production.
• Chronic alcohol use can cause substantial weight gain. Which in turn can slow you down.
• Alcohol use can decrease aerobic ability as well as decrease sustained power output. In fact, one study showed that drinking 24 hours before an event caused 11% decrease in performance which could be the difference between being first and last.
• Alcohol hurts recovery by interfering with muscle protein synthesis (building and repairing muscle) as well as glycogen re-synthesis (restoring our glycogen stores so that we have stored fuel for exercise). One study showed that even if you consumed alcohol with protein after exercise you would still have lower rate of muscle protein synthesis.
• Alcohol can interfere with our ability to regulate core temperature, therefore, lowering our ability to tolerate training no matter what the temperature is (even in an air-conditioned facility).
• Alcohol influences our psycho-motor skills which means it can decrease balance, reaction time, visual search and recognition, memory as well as accuracy of fine motor skills. Now imagine a quarterback that has all these problems.
• Alcohol shortens our time in deep sleep (REM). Lack of deep sleep causes a decrease in performance as well as a decrease in human growth hormone (HGH) secretion. HGH helps us build and repair muscle. (Stay tuned for a blog on how sleep effects performance in the near future).
• Alcohol is a diuretic (promotes production of urine) which means it can cause dehydration. Dehydration in turn can cause a decrease in performance.
• Alcohol may continue to effect your performance 2-5 days after you drink, depending on how much you drank.

If you're an athlete that wants to improve PR, excel and/or win, you must think about what you are willing or not willing to do. Make sure you fuel right for performance and limit or avoid alcohol. Since social interaction with friends many times includes alcohol, be smart about it and consider following the American College of Sports Medicine (ACSM) guidelines:
"Pre-event - Avoid alcohol beyond low-amount social drinking for 48 hours.   

Post exercise - Re-hydrate first and consume food to retard any alcohol absorption"

Cheers! 

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Hitting the Wall

As athletes, I am sure you have all heard the expression "hitting the wall." That feeling when you have nothing left to give during your workout or competition. Do you really know what is happening inside your body? 

Photo Credit: Active.com

When an athlete "hits the wall" it means that he or she has exhausted all of their stored carbohydrate (glycogen) in their body, which leaves the body running on empty. The body uses both fat and carbohydrate as fuel sources when exercising, but during high-intensity activities such as running or cycling, your body relies on carbohydrate for the main source of energy. Your body will not exhaust all of your fat stores during activity, but it can deplete your stores of carbohydrate.

This condition can by avoided by beginning your activity well-nourished with your carbohydrate stores full. During long longs or rides, be sure to take in carbohydrate through whole foods or sports drinks. The recommended amount is about 30-60 grams of carbohydrate per hour of activity. 

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Athlete's Guide for Eating on the Road

Eating well on the road is hard for everyone because of the limited access to fresh, healthy foods. Fast food options are endless, but there are ways to still get the nutrients your body needs without the extra fat and empty calories. Choose foods that will help your performance, but not leave you feeling sluggish. 

• When possible, substitute vegetables and fruit in place of higher fat options that provide little nutrition quality to your meal (aka French fries)
• Get things on the side when possible (salad dressings, etc). Put the meal in your control!
• Look for words: bake, broil, steamed, and roasted. Avoid the words: fried, sauteed, and au gratin. The way that it is prepared can totally change the nutrient content. Don't get weighed down by adding extra fat. 
• Plan ahead and pack snacks. May need to avoid packing anything liquid if you are flying. Ideas include:
• Trail mix
• Bagels w/peanut butter
• Pretzels
• Fresh fruit
• Yogurt (if you have a cooler)
• Don't forget the water! Stay hydrated! 

Look at this handout provided by SCAN (group of sport RDs). It spells out ways to order at various types of restaurants, including Mexican, fast food, sub style, and bakeries. It also provides many other helpful hints. 

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