How To Boost Your Immune System (All Year Long!)

We've all had those days where you can just feel a cold coming on. Eyes watering, nose running, coughing, sneezing, and feeling headache, you head over to the nearest grocery store to pick up some orange juice, soup and medicine. If you're an athlete, you might even think, "I wonder if I can still go to practice...?" or "I'll just wait for this cold medicine to kick in before I go running..."

Being sick can not only force you to take days off from school or work, but can also put a kink in your training schedule if your cold or flu lingers for days...or even weeks. If you push too hard while you're sick, you can risk even worse illness or injury.

Sometimes, you can't control getting sick, and popping vitamin C capsules probably won't help you kick a cold once you have it, but you can promote a healthier immune system throughout the year by consistently fueling your body with the foods it needs - use these 5 guidelines for more info:

1. Avoid under-eating or over-exercising

It is easy for athletes to get caught up in a training schedule, neglecting those rest days and proper nutrition. If you're not meeting your calorie needs and every single one of your workouts get your heart working at its max, your stress hormones will increase and you're going to be at risk for over-training, injury, and a weakened immune system. 

Any good training program will have rest days built in - they're there for a reason. Make your hard days hard, your easy days easy, and make sure your weight is consistent. If you start to lose more than 1 lb. per week or you're feeling weak or easily fatigued, you may not be eating enough calories to support your training. Weight loss goals are met during the off-season, so if you're trying to meet your weight loss goals during training, you may not be getting enough calories in to push your body on those hard training days. 

Not sure how many calories you need to eat to support your training or weight loss/gain goals? Call the Sanford Sports Science Institute at 605-312-7870 to schedule an appointment to get your Resting Energy Expenditure tested. 

2. Get enough sleep

A recent study showed that people with shorter sleep duration (under 6 hours per night) had an increased susceptibility to the common cold. Sleep should be an integral part of any athlete's training schedule. While you sleep, you give your muscles a chance to rest and rebuild. 

If your sleeping pattern is erratic or you're not getting at least 7-8 hours of sleep each night, you're not giving your body the rest it needs to recover. Your stress hormone cortisol increases, which can delay recovery after exercise. There is also an increase in ghrelin and decrease in leptin, two hormones that affect your hunger - in this case, by making you feel hungrier than normal. In addition, when you're sleep deprived, your immune system doesn't work as hard to fight off illness. 

The combination of delayed recovery, increased hunger (which can lead to overeating and weight gain) and decreased immune system functioning can be bad news for athletes during training. Make sure you're making sleep a priority - your sleep schedule should be considered just as important as your training schedule and your nutrition. 

3. Eat 5 or more servings of vegetables and fruits per day

...and we're not talking about potatoes, corn, or peas. You should be eating a serving of vegetables and/or fruits at each meal and snack, and the more color you have on your plate, the more immune-boosting vitamins and minerals you're getting in your diet. 

Some colorful foods you should be eating include: carrots, green leafy vegetables like spinach and kale, berries like strawberries and blueberries, citrus fruits such as oranges and grapefruit, bell peppers, sweet potatoes, winter squash and apples. Eating more fruits and vegetables increases your supply of inflammation-fighting, immune-boosting vitamins and minerals, so the more you eat, the better your body can recover after exercise or hard training. 

4. Jump-start recovery after exercise

After high intensity or long duration (>90 minute) workouts, athletes should eat a post-workout snack with 2:1 to 3:1 ratio of carbs to protein to refuel muscle glycogen (energy) and help promote muscle healing and growth. By doing this, your body can start to recover right away so you can start your next workout refueled and feeling energized. 

Good examples of this snack are chocolate milk, Greek yogurt with berries and granola, a banana with peanut butter, a peanut butter and jelly, rice with chicken and vegetables, a smoothie, etc. Make sure to eat periodically throughout the day (don't skip meals) to make sure your body has the building blocks it needs to build muscle and store carbohydrates away as glycogen to use in your next workout.

5. Give your gut some attention

You may have heard that 50-70% of your immunity comes from your stomach, so making sure your gut is healthy is vital to boosting your immune function. Check out a previous blog post on promoting good gut health for some more ideas, and include more of these foods in your diet:

Probiotics (good gut bacteria)

Yogurt or kefir with live and active cultures, probiotic supplements, kimchi, sauerkraut

Prebiotics (promote the health of good gut bacteria)

Asparagus, garlic, leeks, onions, beans, whole grains, potatoes

If you want to know more about boosting your immune system through food, call the Sanford Sports Science Institute to make a one-on-one appointment with the sports nutritionist: 605-312-7878.

You may also like:

NCAA/SCAN || Foods to Promote Immune Function

Food & Nutrition Magazine || Spices for Winter Wellness

Harvard Health || How to Boost Your Immune System 

Bazaar || 10 Foods to Eat to Avoid a Winter Cold

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Tips for a Happier, Healthier Thanksgiving

Right around Thanksgiving, a million articles pop up on the news about what you should do to avoid the dreaded weight gain associated with the holidays, how you need to detox the day before and after Thanksgiving, or how to burn off all those calories from the food you ate.

There's a lot of dieting advice going around the internet these days, which can often times cloud the real reason to celebrate this time of year, to be thankful for what we have, not to burn off all those calories you're about to go eat. This doesn't mean these articles get it all wrong - Thanksgiving shouldn't be an excuse to eat ALL THE FOOD. When people overeat, they don't feel good, which is no fun when you want to enjoy your time with family and friends.

To put things into perspective, most Americans only gain about one pound during the holidays. One pound - this might make a difference in your overall health or sports performance if you're eating heavy, high fat meals plus desserts every day from November to January, resulting in greater than one pound weight gain...or if you gain one pound every year without losing that one pound during the rest of the year.

But, if you're an active individual or a competitive athlete, Thanksgiving can act as a rest day from your normal regimen, sit back, relax, enjoy being around family and friends, and enjoy some of your seasonal favorites. If that means you get a piece of pie, so be it! In fact, if you choose your foods correctly, you can enjoy some of your favorite dishes and be fueled up for a workout the next day. No detox, no diet, no restrictions.

1. Don't skip your other meals on Thanksgiving day.

By skipping meals because you assume you're going to want to eat massive quantities of food later in the day, you're setting yourself up to overeat. Instead, try to eat balanced meals (breakfast, lunch). If your Thanksgiving meal is scheduled for lunch time, a light, high-protein breakfast will help hold you over until lunch. If your meal is around dinner time, two lighter, balanced meals will prevent you from going into your meal feeling ravenous and ready to eat one of each food item.

Good options for a lighter breakfast and lunch:

Breakfast: Vegetable and egg scramble with a side of a banana with peanut butter
or 1/2 cup oatmeal with berries, cinnamon, milk and a sprinkle of walnuts
or a couple slices of nut butter toast with a banana

Lunch: Big salad made with mixed greens salad with 2 hard-boiled eggs, 1/2 cup garbanzo beans, 1 cup raw broccoli, 1 Tbsp sunflower seeds and 1 Tbsp balsamic vinaigrette
or 1/2 cup plain Greek yogurt with 1/4 cup raw oatmeal, 1 Tbsp honey, 1 banana and                          sprinkle of nuts
or your favorite bowl of warm soup

2. Be aware of portions.

• The recommendation for what your plate should look like for each meal is: ~1/2 the plate is vegetables and fruit, 1/4 lean protein and 1/4 starches (grains, bread, corn, potatoes, etc.) Your plate should look like this on Thanksgiving, too. Even if the foods are "more unhealthy," at least you have the right idea on how your plate is divided. 



Source: American Heart Association Blog

• Turkey, especially the white meat, is a great source of lean protein. If you're going to have a piece of meat, keep the portion to the size of a deck of cards and move on to the other options.
• Each portion of your favorite foods can have between 150-200+ calories each: 1/2 cup mashed potatoes, 1/2 cup stuffing, 1 cup green bean casserole, 1 biscuit, 1 cup of gravy, several ounces of turkey with skin, a SMALL piece of pie...etc.
• A reasonable serving of pie is as big as the area between your fingers when you make a "peace sign" - Did you make a peace sign? How does your usual slice of pie compare? 
• Don't forget liquid calories - all those holiday drinks (punch, egg nog, hot cocoa, beer, wine, champagne, etc.) add up! Be mindful of how many drinks you're having that aren't water and try to replace some of those beverages with regular water. 

Calories shouldn't be your biggest focus, but it is always good to be aware of how much you're really eating before loading up your plate, and splitting your plate into the different sections can help you keep portions in check.  See tip 3 for tips on choosing foods. 

3. Survey all the options before loading up your plate, and only make one trip. 

This tip is included in Saint Louis University's Whitney Linsenmeyer's list of tips for enjoying the holiday without having to wear your sweatpants - Clean Eaters Can Beat Thanksgiving Food Hangover. You don't have to give up those indulgent foods you love, but by taking a smaller portion and savoring each bite, you'll really appreciate the food more.

This tip is good for anyone confronted with a buffet eating situation - it can be especially tempting to get heaping piles of a bit of everything the first time around...only to go back for seconds (or thirds) of your favorite dishes.

Instead, survey the food options - choose one serving of protein (turkey, ham, legumes, fish), grains/starches (stuffing, corn, roll, mashed potatoes), and fill the rest of your plate with vegetables (green bean casserole doesn't count as a vegetable) and some cranberry sauce.

4. Prepare healthy side dishes with a focus on vegetables.

The Harvard School of Public Health recommends that people prioritize plants, instead of focusing on meats (turkey, ham) and starches (mashed potatoes, stuffing/dressing). Even if you're a meat-lover, there are TONS of seasonal recipes for healthier, plant-based side dishes that help you break away from the traditional green bean goop and creamy mashed potatoes. Load up on the vegetables - they're high in nutrients and lower in calories.

Deep-orange foods (sweet potatoes, squash, pumpkin) are full of antioxidants and fiber, so try to incorporate those seasonal orange foods into your menu for a nutrient boost.

Ideas for plant-based dishes:

Cookie and Kate || 16 Healthy Thanksgiving Sides

Plant Eaters' Manifesto || Plant-Based Thanksgiving Recipe Ideas

5. Sweat a little!

It's a great idea to exercise for 30-60 minutes on Thanksgiving (and really, every day!) Some families make it a habit to go on a walk, throw around the football, run a Turkey Trot, the list goes on. If you can find a way to move your body and get the blood flowing, you're going to feel a lot better than if you sat around watching football and eating all day (not that there isn't room in your day for exercise, sitting, AND football!)

Do you have any favorite healthier Thanksgiving dishes? 

Want to read more about this topic?

Peeled Wellness || Tips for Healthy Thanksgiving Feasting

Real Simple || How to Build a Healthier Thanksgiving Plate

American Heart Association || Healthy Holiday Eating Guide

This time of year is a great time to get in contact with the Sanford Sports Science Institute to set up an appointment with the sports nutritionist, or check out our sports testing offerings for athletes of all ages and abilities. Call today to find out more! 606-312-7870

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How Much Protein You REALLY Need

How much protein should I be eating every day?

This is a common question from athletes and really, protein is a huge topic in magazines, websites and newspapers. Protein has been attributed to promoting muscle growth and recovery, maintaining lean muscle mass during weight loss, reducing body fat gain in teens, and helping with blood sugar control.

With all these benefits, wouldn't it seem that more protein is better? 

Not necessarily...eating more protein won't magically make your muscles grow and you don't store the extra protein as amino acids to use later and you don't just "pee out" the extra protein you eat. Although many athletes like to focus on protein-rich foods and protein shakes/supplements, it's important to focus on building a balanced performance plate, where carbohydrates (think complex carbohydrates like whole grains, vegetables, fruit, starches) are making up the majority of your calories to fuel your muscles and protein is only ~25% of your plate. Because everyone's calorie needs are DIFFERENT, this "perfect amount" of protein is going to be different for everyone. A large male is going to need a lot more calories and a proportional increase in his protein needs compared with a lighter female.

Losing weight

You might have heard that a high protein diet helps you lose weight, but this may be because protein foods can help you feel less hungry if you're cutting calories in order to lose weight and because when you cut calories, you risk losing muscle in addition to body fat. Eating a slightly higher protein diet (~30% protein) can help you spare protein during weight loss.

Building muscle

When it comes to building muscle, you need to focus on several different components, not just protein intake.

Your strength training routine is important for muscle growth. A progressively difficult strength training routine allows your muscles to adapt to the new stressors you're putting them under by growing bigger and stronger.

You need to make sure you're meeting your weight maintenance calorie needs, plus extra calories to build muscle. 

You can estimate your maintenance calorie needs using different equations OR if you're serious about your training goals, you can get your resting energy expenditure tested. Knowing your  individual restring energy expenditure can help you individualize your performance diet by knowing exactly how many calories you SHOULD be eating during the day to support your performance.

Getting your resting energy expenditure tested is a quick and easy tool you can use to help you meet your goals.
Call the Sanford Sports Science Institute at (605) 312-7870 to make an appointment today!

 Many athletes aren't meeting their basic calorie needs to support performance or maintain weight, but may be drinking protein shakes, hoping they'll gain muscle, but that's just not how it works. You have to combine exercise and a balanced diet for muscle growth to occur. 

Protein needs based on your goals

Protein needs are slightly higher for people involved in exercise, for repairing the muscle damage from training and to build to muscle, and because in general, people who exercise have higher overall calorie needs. The recommended amount of protein for most adults (sedentary/currently not in training) is 0.8 g/kg (0.4 g/lb) body weight per day. 

This being said, most people can meet their protein needs through a real food diet and don't need extra protein or amino acid supplements. There hasn't been much research to support the claims made by supplement companies that they help you build muscle or "get lean" any better than real foods with protein.

Individual/Type of Athlete	Grams of protein per kg or lb. per day
Recreational exerciser, adult	1.1 - 1.6 g/kg (0.5-0.7 g/lb)
Endurance	1.3-1.6 g/kg (0.6-0.7 g/lb)
Strength (build muscle mass)	1.6-1.8 g/kg (0.7-0.8 g/lb)
Athlete restricting calories (weight loss)	1.8-2.0 g/kg (0.8-0.9 g/lb) *When you're cutting calories, you will lose fat, but you can also lose muscle, so protein intake is important to spare muscle protein. **The Profile weight loss plan is a personalized high protein plan that has helped many people lose weight and keep it off!

*Source: Nancy Clark's Sports Nutrition Guidebook 

A 130 lb. marathon running female would need between 78 and 91 grams of protein every day:

130 x 0.6 = 78 grams of protein/day

130 x 0.7 = 91 grams of protein/day

This breaks down to only about 26 grams of protein per meal, if she eats 3 meals a day (really, most people are eating pre- and/or post-workout snacks). Think about eating some protein at each meal and snack (beans, nuts, seeds, eggs, Greek yogurt, cottage cheese, cheese, fish, meat, hummus, and milk).

Example of protein in meals:

Meal	Food	Grams of protein per meal
Breakfast	2 whole eggs, scrambled 1 handful of spinach ¼ cup part-skim mozzarella 1 banana	23 g
Snack	¼ cup almonds 1 apple	7 g
Lunch	4 cups of mixed greens Chopped bell peppers 1/2 cup black beans ¼ cup pumpkin seeds (pepitas) 2 Tbsp balsamic vinaigrette	17 g
Snack	1 cup Greek yogurt 1 Tbsp honey ½ cup blueberries	22 g
Dinner	1 cup brown rice, cooked 4 oz. grilled chicken breast 1 cup steamed broccoli	40 g

Focus on balance

You can prevent muscle breakdown and maximize strength gains by optimizing your nutrition plan throughout the entire day. Instead of focusing on "protein, protein, protein," you should be providing your body with the "building blocks" it needs for muscle growth by eating a balanced meal or snack with protein and carbohydrates every 3-4 hours.You may have heard of the "window of opportunity" - eating a protein/carbohydrate-rich snack 30-60 minutes after your workout can aid in recovery and promote muscle repair.

If you're struggling in your workouts, check your carbohydrate intake - if you're cutting too many calories and carbohydrates out of your diet, your performance could suffer because you're not fueling your muscles with the carbohydrates needed to work hard.

The Forgotten R - REST

Don't forget how important REST can be in your performance plan. Without rest days, you aren't giving your body enough time to repair from your last workout. By fueling your body correctly and taking time to rest, your body will be able to recover properly and you will ultimately be able to meet your goals.

As with everything in life, meeting your goals takes time. Stray away from programs that promise quick results - you have to put in the work and the time to meet your performance goals.

You can make an appointment to get your resting energy expenditure tested or to speak with the sports nutritionist at the Sanford Sports Science Institute by calling (605) 312-7870. 

Related links:

Today's Dietitian || Athletes and Protein Intake

MyFitnessPal || Nutrition 101 - Protein

Science Daily || Protein-packed breakfast prevents body fat gain in overweight teens

Eat Right || Protein and the Athlete: How Much Do You Need?

Greatist || 31 Healthy and Portable High-Protein Snacks

Stack || The High Protein Food You're Not Eating Enough Of

Profile by Sanford || Grocery Store Picks

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5 Tips to Making Hydration a Habit

Have you ever heard the rule, "You should be drinking eight 8-oz glasses of water a day?" 

I certainly have...and while this is a good rule of thumb, hydration guidelines are highly individual. This makes it difficult to give people, especially people of different body sizes and activity levels, a set amount of water to drink every day. 

Probably not drinking enough water for her sweaty run in the desert!

Most people know they need to drink more water - a CDC survey discovered that many people were falling short of their hydration needs, some people not drinking ANY water at all.

 You've probably heard that your body is made mostly of water, right? Water is essential for our cells to function! It helps our body get rid of waste, regulate temperature, helps our joints move smoothly and keeps your brain working correctly. 

DID YOU KNOW...

...most people don't FEEL THIRSTY until they are slightly dehydrated. 

...being even slightly dehydrated can have an effect on your brain, heart, muscles and mood? Some people may experience headache symptoms, feel like they're in a bad mood, or feel like they can't focus.

Athletes are especially susceptible to dehydration because they lose sweat during their workouts and often aren't drinking enough to replenish this fluid loss. When we lose sweat, our blood volume goes down, reducing the amount of blood pumped with each heart beat, which can impair performance by reducing the amount of oxygen delivered to our muscles. The bottom line is that even 2-3% decrease in body weight can impair performance. This brings us back to the question - 

How do we know if we're getting enough water?

Athletes often don't know that their performance is affected by hydration because they're always performing in a slightly dehydrated state. Because hydration is different for everyone, many health professions will refer to this "urine color chart" from the U.S. Anti-Doping Agency - if your urine is light yellow, you're probably drinking enough water. 

U.S. Anti-Doping Agency

What about coffee, tea and soda? Alcohol?

Unless you're drinking 7+ cups of coffee, caffeinated tea or caffeinated soda per day, your daily cup of caffeine isn't going to cause you to be dehydrated. Alcohol, on the other hand, has strong diuretic properties, making you urinate more often, which can lead to rapid dehydration. This can be detrimental to active people and athletes, so making sure to limit alcohol to 1-2 drinks and at least 1 to 2 cups of water between each drink can help you stay hydrated.

These 5 tips can help athletes and active people get and stay hydrated, feel better, and achieve optimal performance. 

Grab your water bottle and fill it up. 

The Sanford Power website has a Nutrition and Hydration for Team Sport Athletes page dedicated to this very topic! 

Remember, everybody is different and you can be over hydrated. If you're running to the bathroom frequently or your urine is clear, you are likely drinking too much water, which can be just as harmful, if not more harmful to athletes than being dehydrated. 

If you are an endurance athlete or exercising/practicing for several hours a day, you may want to consider adding an electrolyte replacement or sports drink to your routine to help you replenish the electrolytes you're losing in sweat. Some people might even try making their own sports drinks to help them stay hydrated.

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What are your best tips for staying hydrated? Ask the dietitian your hydration questions!

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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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Paleo Diet for Athletes (Article Summary)

Not long ago I heard this great presentation from a fellow RD (Steve Hertzler PhD, RD) about the Paleo diet (caveman diet) for athletes. Since the Paleo diet has been such a popular topic in the past several years, I decided why not share the wealth of information with you. Here is a summary of his talk and article from SCAN's Pulse. He reviews and references The Paleo Diet for Athletes by Loren Cordain and Joe Freel as they paved the way for this diet in the past decade.

First lets try and define the paleo diet: It's typically defined as the diet that was available in the paleolithic era which was in the pre-agricultural period between 2.5 million to 10,000 years ago. However, different regions had different diets during those times which means there was no one paleolithic diet. Books on Paleo state that humans should not have dairy products nor grains/legumes, since they did not exist in that era, but have a diet rich with meat/fish, vegetables and fruits, low in starches and only natural sources of sugar. The theory is that our "human genome was developed based on this diet" and by sticking to it we decrease risk of multiple chronic diseases and improve human performance. However, some of the science shows otherwise; anthropologists have evidence that during that era there was more reliance on starches and tubers. Moreover, research shows that our guts have evolved and continue to evolve since 10,000 years ago allowing us to digest many foods not present during that era. Lastly, to replicate that exact diet is quite impossible since most of the foods we currently have (meats, produce, fats) are very different than what they had back then. 

Pros about the diet and book:  

• The diet promotes eating less refined carbohydrates and more fruits and vegetables
• Lean meats (including game) are recommended
• Adequate fish (containing omega 3) is highly encouraged
• Healthy fats are important
• Timing is important when it comes to performance
• For recovery, combination of carbs and protein is important post exercise

Cons about the diet and book:

• Elimination of several food groups (e.g. grain, dairy) leads to limited variety which in turn could cause defeciencies
• Interestingly, alcohol in moderation is permitted (I wonder what caveman drank alcohol?!)
• The book itself only addresses endurance athletes, not power nor strength athletes
• To date, there are not many studies on the Paleo diet in athletes. The studies that have been done were done on mainly obese and sick individuals (heart disease, diabetes) which have seen improvements in body composition and health markers (blood lipids, blood sugar). Athletes are very different than obese individuals
• In the book there are multiple exceptions to meet the high carbohydrate demands of the endurance athlete. If there are so many exceptions are they really eating Paleo?!
• "The diet is nutritionally inadequate, expensive and impractical". Studies show that the diet would lack calcium, Iron and fiber recommendations as well as cost 9.3% more annualy
• "Acid ash theory states that by eating a diet high in grains and dairy we produce a high acid load on the body and the body must remove calcium from the bone to buffer the load." The more the food is acidic the more we are supposed to see calcium in the urine. However, urine pH does not represent blood pH as it stays more or less the same. Moreover, there is no evidence indicating that high calcium levels in the urine mean that there is less calcium in the bone or a decrease in calcium balance
• Some of the research quoted by the authors for "avoiding certain foods such as potatoes, peanuts and canola oil are misinterpreted and taken out of context"
• The authors mention that the Paleo diet is the best. However, currently, the people that live the longest (to about 100 years of age) eat meat infrequently and their diet is based on grains or starch

In summary, the Paleo diet promotes certain healthy habits that are worth keeping such as limiting processed foods, eating fruits and vegetables, healthy fats and lean meats. However, by adding dairy, legumes and grains in your diet you can have a more complete varied and healthy nutrition plan to promote your activity.   

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Carbohydrate Intake During Exercise

A recent review was published in Sports Medicine journal about carbohydrate intake during exercise. This review was meant to help bring what we know scientifically to practical implications. Here is a summary of the review article:

Recommendations of carbohydrates are always based on type of sport, duration and intensity as well as the ability consume them.

• Activities that are at relative high intensities for a duration of 30-75 minutes have shown improved exercise performance when drinking or even rinsing mouth with a sports drink. It does not matter whether it is a single carbohydrate (glucose or fructose) or several combined. Some may be able to tolerate rinsing the mouth better than drinking the fluids.
• ACSM (American College of Sports Medicine) guidelines recommend consuming 30-60 grams of carbohydrates per hour during endurance activity that lasts more than an hour. 
• The ability to use carbohydrates as fuel is dependent on how well the intestine can absorb the carbohydrates
• Multiple carbohydrates combined (fructose+glucose, maltodextrin+fructose, etc.) can help better utilize more carbohydrates as fuel. 
• Research shows that being able to utilize more carbohydrates as fuel delays fatigue and increases performance.
• Sport drinks can be combined with gels and/or bars (low fiber, low fat, low protein bars) to help absorb and tolerate the higher carbohydrate levels
• Never try something new on race day. Training nutrition is important
• People that train/race at lower intensities (example: a marathon time of 5 hours) will use less carbohydrates and therefore, will need to be supplemented slightly less.
• Although not noted in figure below, a good hydration plan needs to accompany the nutrition plan.

Here is the figure that illustrates the recommended guidelines:

   

• The gut can also be trained. A high carbohydrate diet may assist tolerating and utilizing the higher carbohydrate load during exercise (90 gr/hour).
• In real-life ironman and long cycling races, greater carbohydrate consumption correlated with better finish times.
• Carbohydrate intake, even during sports that require skills such as jumping, sprinting, agility etc. may improve the skills as well as delay time to fatigue. However, the game structure and given breaks may make it difficult to implement (example: soccer game). 

Next time you are training for an endurance event, a high intensity aerobic or anaerobic activity, use this figure as a guide of how to utilize carbohydrates. For more personal recommendations, talk to me or a sports registered dietitian.

Jeunkendrup A. A step towards personalized sports nutrition: Carbohydrate intake during exercise. Sports Med (2014) 44 (Suppl 1):S25-S33. 

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To Take or Not to Take? That is The Question

In this abundant world of supplements we ask ourselves all the time; to take or not to take? However, not the question nor the answer are that simple. The supplement industry is a billion dollar making industry. Every week there are new supplements on the shelf that give big promises. Do they work? Do they contain what they're supposed to? Are they safe? These are all questions we need to ask ourselves before we go and spend our salary on them. Let me help by pointing some pros and cons:

                
Pros

• It's convenient, especially for the busy student athlete
• It could potentially help gain muscle
• It could potentially help recover or decrease muscle soreness
• It could potentially help perform better
• Help provide nutrients lacking in the diet
• Help fight inflammation

Cons

• Supplements are unregulated. Due to that, some shady supplements out there contain stimulants, steroids and other illegal substances. Moreover, some contain dangerous components that could cause liver failure, stroke and even death. Here is a great piece by USA Today talking about the risks. There are many more articles like that
• Illegal substances without you knowing, can show positive on a drug test and prevent athletes from finishing school, competing in the college setting (NCAA rules) or even becoming a pro
• Many supplements don't really work (if it sounds too good to be true, it probably is)
• Food is cheaper and can be convenient 
• You can't out supplement a bad diet
• Most foods can provide the pros that supplements do

How to decide if yes or no?!

• Make sure your diet is balanced and healthy first and foremost! If the diet is lacking, fix that. For example: if you skip breakfast, don't take a supplement to compensate, just eat breakfast. If you feel you eat enough vegetables and fruits, whole grains, healthy fats and lean protein then you can consider a supplement, depending on your goals and sport. 
• There are a little more than a handful of supplements that work (based on research) for performance (however, not in all people): whey and protein, creatine, beta-alanine, omega 3, tart cherry juice, beet juice, caffeine, sports drinks, iron (if deficient) and calcium/vitamin D (in certain cases).  
• No matter what, consult with a sport dietitian or a medical professional that understands supplements for performance. Always make sure your doctor knows as well. 
• Use NSF certified safe for sport website or app to make sure its safe and free of contaminants. Use also Supplement411.org to make sure they are not on this list (contains what banned substances were found). 
• Read and research if a supplement works from reliable sources (no, Bodybuilding.com is not a reliable source). If you do not know where to find reliable sources, ask me or any sports dietitian as well as coach, physician or athletic trainer. 

Remember, you can't out supplement a bad diet! Focus on fueling for performance instead.

Let food be thy medicine

          

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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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Nutrition for Recovery

Athletes invest time, effort and money in their sport. They buy cloths, shoes and gear that is necessary for them to excel. But, how much do they invest in their recovery plan?! Yes, recovery is also stretching, foam rolling and ice baths but what about nutrition for recovery?

The main purpose of nutrition for recovery is replenishing glycogen stores, repairing and rebuilding muscle as well as re-hydrating in order to get to the next practice like new (the 3 Rs).
Fueling for recovery does change based on the intensity and duration of your workout as well as when your next workout will occur. For example: Someone that has football practice in the morning for 1.5 hours and then a 1.5 hour lifting session in the afternoon will need to put a little more effort in fueling for recovery versus someone that ran for 60 minutes and will play tennis in 2 days. Athletes that rest 24 hours or more between sessions, do not have to put emphasis on nutrient timing when it comes to glycogen, withstanding they consume enough carbohydrates throughout the day.

                

• Refuel (=replenish) - The main source of fuel utilized during exercise is carbohydrate. Carbohydrates are stored in the form of glycogen in the muscle and liver and these stores are drained the longer the activity is or the higher the intensity. Therefore, we need to replenish those glycogen stores, especially if there are multiple practices or tournaments in the same day. Refueling should start within 30-45 minutes after exercise. It is recommended to consume 1-1.5 gr/kg of carbohydrate every 2 hours up to 4-6 hours post activity (1 kg = 2.2 lbs. Example: 154 lbs=70 kg - Will need to consume 70-105 grams carbohydrates every 2 hours for up to 4-6 hours post exercise or until eating a meal).
• Rebuild - Exercise causes damage to the working muscle. Protein is the main nutrient that helps repair the damage and rebuild the muscle (muscle protein synthesis). Protein should be consumed within 2 hours of activity to promote a greater muscle growth. Combining protein with carbohydrate post workout has shown to enhance recovery. Recommendations for protein are 6-20 grams within 2 hours of activity.
• Rehydrate - During exercise we can lose quite a lot of fluids in the form of sweat. Sweat is not just contrived of water but also multiple electrolytes, mainly sodium, potassium and chloride. Therefore, to recover optimally we need to rehydrate with fluids and electrolytes. The best way to rehydrate properly is weighing yourself before and after practice. For each pound lost, drinking 16-24 oz is recommended. Hydrating throughout the day well, makes rehydrating for recovery much easier. Eating salty snacks and drinking a sports beverage could be a good way to help replenish some of the electrolytes lost.

Simple, right?! However, some people may have a hard time eating something post exercise. In that case, drinking could be an option. In fact, one of the best recovery drinks out there is chocolate milk. It has a combination of whey and casein (fast absorbed and slow absorbed high quality protein respectively), good amount of carbohydrates and its a liquid containing electrolytes. Win win! 

Research also suggests the best ratio of carbohydrate to protein for recovery should be 2:1-4:1, chocolate milk is 3:1. 

Other recovery options can be: 

• Yogurt with strawberries
• Milk and a banana
• Protein bar, water and a fruit
• Fruit smoothie
• Turkey and cheese sandwich with a sports beverage
• Cereal with milk and blueberries

It is also important to mention that part of a good recovery plan includes sleep. For more info on sleep refer to previous Sleep  blog.

Investing in recovery is as important as the time you invest in training so remember to refuel, rebuild and rehydrate to achieve optimal recovery 

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