Crave: The Hidden Biology of Addiction and Cancer - By Dr. Raphael Cuomo

 Hello Bob Whelan,

My name is Raphael Cuomo, and I am a scientist and professor in the School of Medicine at the University of California, San Diego. I am reaching out to you because you have a unique online platform and capacity to raise awareness of important issues with your sizeable audience. Recently, I wrote a book, titled Crave: The Hidden Biology of Addiction and Cancer which sheds light on important and often-overlooked daily behaviors with scientific evidence pointing to increased risk for the development of cancer. However, as a scientist, I have limited avenues to raise awareness of this issue to a large audience. Therefore, if there is anything you could do through your website, even if only by sharing my link in your blog or on a social media post, I would deeply appreciate it. I have shared the link below. If you would like a PDF copy of the book, please don't hesitate to let me know by responding directly to this email.

https://raphaelcuomo.com/crave

Best Wishes,

Dr. Raphael Cuomo

Professor of Medicine

University of California

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Understanding and treating type 2 Diabetes - By Dr. Jason Fung

Dr. Jason Fung is a Canadian nephrologist. He's a world-leading expert on intermittent fasting and Keto, especially for treating people with type 2 diabetes.

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All You Want to Know About Peanut Butter - By Nancy Clark, MS, RD

This month's article addresses one of the all-time favorite sports foods: peanut butter. As you ramp-up your summer-time activities, peanut butter can be center-stage for your sports diet! Thanks for sharing it with your readers.

Best,
Nancy

In my humble opinion, peanut butter (PB) is one of the best sports foods around. Not only is it yummy, it is also health-promoting and performance enhancing. A review of the research on peanuts validates why I routinely choose to enjoy two (!) PB sandwiches a day: one for lunch and the other to curb late-afternoon hunger.

If you are among the many athletes who try to stay away from peanut butter because it is fattening or too fatty, think again and keep reading (as long as you are not allergic to peanuts, that is). The purpose of this article is to educate you about the value of PB in a diet for sports-active people of ages and athletic abilities—as well as their parents and grandparents.

• PB is not inherently fattening. While any food eaten in excess can be fattening, people who eat PB (and nuts, for that matter) five or more times a week are not fatter than nut avoiders. A Purdue University study (1) reports subjects who ate peanuts daily did not overeat total calories for the day. That’s because peanuts and PB are satiating; they help you feel pleasantly fed. Peanut eaters tend to intuitively eat less at other times of the day.

• PB offers many health benefits. The fat in PB is primarily health-promoting mono- and poly- unsaturated fat that knocks down inflammation. People who eat PB and nuts five or more times a week have lower markers of inflammation than nut avoiders. For athletes who get micro-injuries every time they train, an anti-inflammatory food such as PB is a wise choice.

• Compared to nut avoiders, unhealthy women (with type 2 diabetes) who ate 1.5 oz. (250 calories) of peanuts (and/or nuts) five or more times a week reduced their risk of heart disease by 44% and the risk of having a heart attack by 60% (2). Routinely swapping a burger for a simple-to-make PB sandwich is a heart-healthy choice.

• PB, like all sources of plant protein, reduces that risk of developing Type II diabetes. A breakfast with PB offers a positive “second meal effect.” This means, it helps control blood glucose through lunchtime and into the afternoon. Stable energy—and a reduced desire to eat. (3)

• The fat in PB helps absorb the fat-soluble vitamins A, D, E and K. You want to include some (healthful) fat in each meal; PB is a painless way to do so!

* If you are an endurance athlete, such as a marathoner or cyclist, you’ll optimize your sports diet by eating at least 0.5 grams fat per pound of body weight. The body stores some fat within muscle cells and uses it for fuel during extended exercise. PB in oatmeal before a long bike ride or a PB & J sandwich on a long bike ride are yummy and healthy ways to enjoy adequate dietary fat. Fat-phobic athletes (who avoid fat) can hinder their endurance.

• PB is a good source of arginine, an amino acid that helps keep blood vessels flexible so that blood flows more easily and reduces blood pressure. The more PB you eat, the bigger the effect on health protection.

• What’s good for the heart is also good for the brain. Research suggests PB eaters improve their brain-blood circulation and mental function. This contributes to enhanced processing speed and better short-term memory (4). Plus, a diet rich in healthy fats helps slow cognitive decline. Given the risk of developing Alzheimer’s disease increases exponentially with age, eating PB and nuts today is a wise investment in your future brain health.

•Peanuts offer slightly more protein than nuts. That’s because peanuts are a legume (like lentils and dried beans) and not a nut. One serving (2 tablespoons) of PB has 8 grams of protein, while 2 Tbsp. almond butter has 6 grams (at a much higher price!) Athletes want to target about 20 grams of protein per meal or snack. You can get that by swirling PB into oatmeal cooked in (soy) milk, enjoying a PB & honey sandwich with a yogurt, or making a PB-banana smoothie. Quick, easy, and inexpensive.

• PB contains numerous bioactive compounds (phenols) that bolster the immune system. Spanish peanuts and shell peanuts are particularly wise snack choices because the peanut skin is rich in anti-oxidants and fiber. Fiber feeds gut-bacteria (your microbiome); these bacteria strongly enhance your immune system, overall health and mood.

•All peanuts are non-GMO and have low risk of pesticide residue, in part because peanuts grow under the ground.

• Is all natural peanut butter far better than Skippy of Jif? All types of PB need to meet a “standard of identity” as defined by the USDA. Conventional brands might have 2% added saturated fat (palm oil, hydrogenated oils) to control the oil from separating. This small amount does not over-ride the positive health benefits of PB.

• What about all the sugar added to Skippy and Jiff PB? “All” that sugar is only 2 or 3 grams. That’s nothing compared to the 10 to 15 grams of sugar in the jelly or honey you might enjoy with the PB, or the 6 g sugar in the sandwich bread. Regardless, sugar fuels your muscles. Please fret less about added sugar and focus more on PB’s zinc, folate, vitamin E, niacin, and selenium. It is nutrient-rich.

• What about all that sodium in PB? The 150 mg. sodium in a serving of PB is less than the sodium you get in one slice of bread or 12-ounces of Gatorade. Regardless, as an athlete, you want to replace sodium you lose in sweat.

• But what if I can’t eat just one spoonful…? If you stay away from PB because you can’t eat just a reasonable serving, think again. Overindulging in PB means you like it; you should eat it more often! By enjoying PB at every meal, in a few days, you will stop craving it. No more binges!

Avoiding peanut butter just sets you up for “last chance eating.” You know, I just blew my diet by eating PB so I’d better keep eating it. Last chance before I go back on my diet. Denial and deprivation of PB lead to overeating. Do not deny yourself of this yummy sports food. You will deprive your body of valuable health benefits!

Sports nutritionist Nancy Clark MS RD CSSD has a private practice in the Boston-area (Newton; 617-795-1875), where she helps both fitness exercisers and competitive athletes create winning food plans. Her best-selling Sports Nutrition Guidebook, and food guides for marathoners, cyclists and soccer are available at www.nancyclarkrd.com. For workshops, see www.NutritionSportsExerciseCEUs.com .

(1) Alper, Int'l J Obesity 26:1129, 2002)
(2) Li, Nutr 138(7):1333-8
(3) Reis, Br J Nutr 109(11):2015-23, 2013
(4) Barbour Nutr Neurosci July 7:1-8, 2016

 "Helping active people win with good nutrition."

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Get Off Omeprazole! - By Bob Whelan

If you have frequent heartburn or acid reflux, its hard to quit omeprazole because IT FEELS LIKE IT WORKS. (And Larry the Cable Guy has those great Prilosec commercials.)

Prilosec (omeprazole) gets rid of the burning sensation, yes, but it only makes the root cause of the problem worse. Acid reflux is caused by too little acid in your stomach, ... not too much. The reflux is caused by your stomach trying to spread the "too little" acid around like a washing machine on spin dry.

Omeprazole is a "Proton pump inhibitor, ... a group of drugs whose main action is a pronounced and long-lasting reduction of gastric acid production." (Wikipedia) Besides making the problem worse, the long term side effects of omeprazole are huge, (from kidney damage to irregular heart beat), and not worth the risk. Google it and see for yourself.  Not to mention the growth of bad bacteria in your gut that needs stomach acid to keep it under control. The uncontrolled growth of the bad bacteria in your gut, (due to lack of stomach acid), can lead to all sorts of serious health problems.

A better alternative is Apple Cider Vinegar. I've been using it now every day for over a year. No more heartburn at all. It tastes like crap but you get used to it. I take 2 table spoons in a glass of water, once or twice a day. If I use it once, it is before bed. I usually mix a heaping big kitchen spoon of Metamucil in with it. The mix is good for you and makes the ACV taste a lot better. 

Many brands of ACV are worthless. They are processed, pasteurized and the main beneficial nutritional and pro-biotic elements, (The Mother), are destroyed. Make sure you buy ACV "With the Mother" ... In unfiltered organic apple cider vinegar, this beneficial group of bacteria and acids remains and creates the murky web-like Mother.  MAKE SURE it says "With the Mother" on any ACV you buy or you are just wasting your money. The best brand to get is BRAGG but WHITE HOUSE is also good. 

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Meal Timing: Does It Matter When You Eat? - Nancy Clark, MS, RD, CSSD

My clients commonly ask me questions about when to eat. A recent article on Meal Timing spurred me to write this article (below). Perhaps it will offer some food for thought, and help you plan your meals for health as well as for energy and performance. I hope you enjoy the information.

Best wishes from snowy Boston,

Nancy

Meal Timing: Does It Matter When You Eat?

Meals and snacking patterns have changed over the past 40 years. You have undoubtedly noticed that many of us are eating fewer calories from meals and more calories from snacks. As a result, I get questions from both athletes and non-athletes alike about how to best fuel their bodies: Should I stop eating after 8:00 pm? Which is better: to eat 3 or 6 meals a day? Does it really matter if I skip breakfast? Because meals can be a central part of our social life—and busy training schedules can contribute to chaotic eating patterns—many athletes disregard the fact that food is more than just fuel. When (and what) you eat impacts your future health (and today’s performance).

Food consumption affects the central clock in your brain. This clock controls circadian rhythms and impacts all aspects of metabolism, including how your organs function. Restricting daytime food and eating in chaotic patterns disrupts normal biological rhythms. The end result: erratic meal timing can impact the development of cardiovascular disease (CVD), type-2 diabetes and obesity.

This article offers food for thought from the American Heart Association’s Scientific Statement on Meal Timing and Frequency: Implications for Cardiovascular Disease Prevention. (Circulation, Jan 30, 2017). The information is particularly important for athletes, because training schedules can really upset standard meal times. Plus, most of us want to live a long and healthful life. Hence, we need to pay attention to meal timing—starting at an early age. Children and adolescents who skip meals have a higher risk of developing health issues (higher BMI, more belly fat, higher serum insulin and blood glucose). Not a good start for a long and healthy life. (Parents take note: Be responsible with family meals!)

Older athletes also want to stay healthy. In 2014, 14.5% of the US population was 65 years or older. Over the next 25 years, older Americans are expected to grow to 22% of the US population. We need to outlive the diseases of aging. That starts with fueling wisely on a regular schedule and enjoying regular exercise!

Breakfast: Is it really the most important meal of the day?

If you define breakfast as eating 20% to 35% of your daily calories within two-hours of waking, about one-fourth of US adults do not eat breakfast. This drop in breakfast consumption over the past 40 years parallels the increase in obesity. Breakfast skippers tend to snack impulsively (think donuts, pastries, chips and other fatty foods). They end up with poorer quality diets and increased risk of diabetes, heart disease, high blood pressure and overweight/obesity.

Eating a wholesome breakfast starts the day with performance enhancing fuel at the right time for your body’s engine. If you exercise in the morning, fuel-up by having part of your breakfast before you workout and then enjoy the rest of the breakfast afterwards. This will help you get more out of your workout, improve recovery—and click with natural circadian rhythms.

Meal Frequency: Is it better to eat 1, 3. 6, 9 or 12 times a day?

In terms of weight, eating 2,000 calories divided into 1, 3, 6, 9, or 12 meals doesn’t change your body fatness. In a study where breakfast provided 54% of the day’s calories and dinner only 11% of calories—or the reverse, the subjects (women) had no differences in fat loss. Yet, in terms of cardiovascular health, the big breakfast led to significant reductions in metabolic risk factors and better blood glucose control. The bigger breakfast matched food intake to circadian rhythms that regulated metabolism.

Athletes who skimp at breakfast commonly get too hungry and then devour way too may calories of ice cream and cookies. If they do this at night, when the body is poorly programmed to deal with an influx of sweets, they are paving their path to health issues. Hence, if you are eating a lot of calories at night, at least make them low in sugary foods, to match the reduced insulin response in the evening. This is particularly important for shift workers, who eat at odd hours during the night and tend to have a higher rate of heart disease.

Should you stop eating after 8:00 PM? There’s little question that late-night eating is associated with obesity. Research with 239 US adults who ate more than one-third of their calories in the evening had twice the risk of being obese. Among 60,000 Japanese adults, the combination of late-night eating plus skipping breakfast was associated with a greater risk of diabetes, heart disease and obesity. A study with 2,200 US middle-aged women reports each 10% increase in the number of calories eaten between 5:00 PM and midnight was associated with a 3% increase in C-reactive protein, a marker of inflammation. Inflammation is associated with diabetes, CVD and obesity. Wise athletes make a habit of eating the majority of their calories earlier in the day, to curb evening eating.

The best plan: Plan to eat intentionally.

Failing to plan for meals can easily end up in missed meals, chaotic fueling patterns and impaired health, to say nothing of reduced performance. If you struggle with getting your food-act together, consult with a sports dietitian who will help you develop a winning food plan. Use the referral network at www.SCANdpg.org to find a local sports RD.

Instead of holding off to have a big dinner, enjoy food when your body needs the fuel: when it is most active. If you worry you’ll eat just as much at night if you eat more during the day (and you’ll “get fat”), think again. Be mindful before you eat and ask yourself: Does my body actually need this fuel?

Most active women and men can and should enjoy about 500 to 700 calories four times a day: breakfast, early lunch, second lunch, and dinner. To overcome the fear that this much food will make you fat, reframe your thoughts. You are simply moving calories in your pre- and/or post-dinner snacks into a substantial and wholesome second lunch (such as a peanut butter-honey sandwich, or apple, cheese & crackers.). The purpose of this second lunch is to curb your evening appetite, refuel your muscles from your workout earlier in the day (or fuel them for an after-work session) and align your food intake to your circadian rhythms. Give it a try?

Sports nutritionist Nancy Clark MS RD CSSD has a private practice in the Boston-area (Newton; 617-795-1875), where she helps both fitness exercisers and competitive athletes create winning food plans. Her best-selling Sports Nutrition Guidebook, and food guides for marathoners, cyclists and soccer are available at nancyclarkrd.com. For workshops, see www.NutritionSportsExerciseCEUs.com .

Nancy Clark, MS RD CSSD Sports nutrition counselor www.nancyclarkrd.com (Books, presentations)

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Eat Fat, Get Fat or Eat Fat, Get Healthy? - By Nancy Clark MS, RD

Remember when the Eat fat, get fat mantra prevailed? Athletes avoided fat like the plague. They ate poached fish, dry salads, and steamed vegetables in efforts to reduce the risk of getting fat — to say nothing of having a heart attack. Unfortunately for many low-fat eaters, dieting went awry. Fat-free foods left them unsatisfied, with gnawing hunger and a relentless drive for fat-free frozen yogurt (fat-free = calorie free, right?) or (what the heck) a pint of Ben & Jerry’s Chunky Monkey Ice Cream.

Nutrition professionals learned a lesson: advising Americans to eat less fat led to the unintended consequences: of eating more sugar. A big mistake. Hence, the new 2015 Dietary Guidelines recommend we include health-promoting poly- and mono-unsaturated fats in our meals—but still limit the artery-clogging saturated fats from greasy meats and fatty “junk” foods.

Given that Time magazine reported butter is back and the Paleo diet embraces coconut oil (high in saturated fat), athletes are left wondering whom to believe. Can we really eat bacon, burgers and other foods rich in saturated fats without hurting our health? This article addresses issues related to dietary fat and your sports diet.

What about coconut oil … is it better than olive oil?

All fats contain a variety of mono-unsaturated, poly-unsaturated and saturated fats in varied proportions. The harder the fat —butter, beef lard—the more saturated it is. The softer/more liquid the fat (avocado, olive oil) the better it is for your health. Coconut “oil” (called an oil because it is from a plant, but it is solid at room temperature) has some “good” fats, but it also has some “bad” fats. To date, research on the health risks or benefits associated with long-term intake of coconut oil is sparse. Hence, you want to ask yourself, ”Why would I want to trade extra-virgin olive oil (known to be health-promoting) with coconut oil (with questionable health claims)?”

What percent of my calories should come from fat?

The percent of total calories that should come from fat is whatever is left after consuming a foundation of grains, fruits and vegetables to fuel your muscles, and adequate protein-rich foods (lean meat, fish, beans, low-fat dairy, soy) to build and repair muscles. The percent of total calories from fat is less critical than the type of fat.

The 2015 Dietary Guidelines recommend no more than 10% of calories come from saturated fat. That means, if you eat 2,000 calories a day (a reducing diet from most active people), you can choose 200 calories (22 grams) of saturated fat a day. Ideally, you will spend those fat-grams on foods rich in nutrients, such as 2% milk (3 g sat-fat per 8 ounces); reduced-fat cheese (3-6 g sat-fat per ounce), or hard-boiled eggs (1 g sat-fat per egg) — not on empty-calorie butter (7 g sat fat per tablespoon) or coconut oil (12 g sat-fat per tablespoon).

Unsaturated fats knock down inflammation. For athletes who damage muscles during hard exercise, reducing inflammation can enhance recovery. Hence, you want to eat health-promoting fats—extra virgin olive oil, avocado, all-natural peanut butter, nuts, and salmon. They are not only anti-inflammatory, but also needed to absorb vitamins A,D,E and K. Plus, they help food taste better. Enjoying some healthful fat in each meal makes the meal yummier and more satisfying—and easier for you to reduce hankerings for decadent desserts. NOTE: While unsaturated fats are health promoting, they are never-the-less calorie-dense. One tablespoon of oil (of any type) has about 120 calories. Eat fats in portions that fit within your calorie budget!

Are fat-free foods, like skim milk and fat-free salad dressing, wise additions to a sports diet?

The answer to that question depends on what other foods are in the entire meal. The goal is to not eat fat-free meals! That is, a fat-free breakfast of Cheerios and skim milk can leave you feeling “unfed” and hankering for a donut or two by 9:30 a.m. In comparison, choosing 2% milk for the cereal could help you feel satiated. Better yet, add whole grain toast with all-natural peanut butter to the breakfast and you will be truly content. Similarly, a salad with fat-free dressing can leave you hankering for cookies—unless you toss in some quality calories, such as avocado, chopped walnuts, tuna and extra-virgin olive oil. Including some health-promoting fat in each meal and snack can actually help save you calories in the long run if it calms the cookie monster.

Should I avoid peanut butter because it is so high in fat?

No! Research suggests people who eat nuts and peanut butter are not fatter than people who avoid those foods. While the majority of calories in peanut butter do come from fat, the good news is the fat is primarily poly- and mono-unsaturated (only 1 g sat-fat per tablespoon of all-natural peanut butter). Peanut and other nut-butters protect against heart disease and diabetes, two diseases related to inflammation. Like all fats, enjoy nut butters in portions that fit within your calorie budget.

I consider peanut butter to be one of the best sports foods (and diet foods) around, not just because it knocks down inflammation, but because it is yummy and satiating. That is, a lunchtime low-fat turkey sandwich leaves me hankering for dessert, but a peanut butter and honey sandwich leaves me feeling satiated for several hours; no snacks needed!

The bottom line: Enjoying health-promoting unsaturated fats in your sports diet reduces inflammation, enhances absorption of certain vitamins, helps curb the appetite — and adds yumminess. Just don’t overeat calories from fat—or from any type of food, for that matter. The mantra Eat excess calories, get fat is more accurate than Eat fat, get fat.

Sports nutritionist Nancy Clark MS RD CSSD has a private practice in the Boston-area (Newton; 617-795-1875), where she helps both fitness exercisers and competitive athletes create winning food plans. Her best-selling Sports Nutrition Guidebook, and food guides for marathoners, cyclists and soccer players, as well as teaching materials, are available atwww.nancyclarkrd.com. For online workshops, visit www.NutritionSportsExerciseCEUs.com.

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Active Women without Monthly Menses: A Cause for Concern - By Nancy Clark MS, RD, CSSD

The Athlete’s Kitchen - Copyright: Nancy Clark February 2013

Hey ladies, has your monthly “visitor” stopped coming? Some active women feel relieved when they no longer get a monthly menstrual period. (Yes! More freedom, less discomfort, no more cramps.) They may believe having no period is a sign they are training hard, like a real athlete. Others believe they have stopped menstruating because they are exercising too much or have too little body fat. No. Many very thin athletes who exercise hard have regular menses.

Absence of periods (called amenorrhea) can be linked to serious health problems, including loss of calcium from the bones, almost a three times higher incidence of stress fractures today and long-term problems with osteoporosis in the not-too-distant future. If you should want to start a family, amenorrhea interferes with the ability to conceive easily, and can also contribute to future problems with infertility (even though normal menses may have returned).

Amenorrhea is not sport-specific. Sports that emphasize lightness (ballet, running) have the highest prevalence. Up to 44% of these athletes may experience amenorrhea (as compared to 2% to 5% of women in the general population).The question arises: among a team of female athletes, why do some of the women experience menstrual problems and others don't? The answer may relate to nutrition. Woman with amenorrhea commonly under-eat. Their bodies have inadequate fuel to support the menstrual process, to say nothing of nurture a baby. Under famine-like conditions, menstruation can stop to conserve energy.

If you among the estimated 20% of active women who have missed three or more consecutive menstrual periods and are experiencing amenorrhea, please stop rejoicing and go see your gynecologist. Amenorrhea is abnormal. It can be a red flag for body image problems (i.e., claiming to feel fat even when emaciated), an intense fear of gaining weight or becoming fat, and restrictive eating. Amenorrhea is part of The Female Athlete Triad, along with low bone mineral density/stress fractures, and restrictive eating patterns/eating disorders. Amenorrhea can create undesired health issues.

Resolving the problem

If you no longer get regular menstrual periods and feel as though you are struggling to balance food and exercise, please get a nutrition check-up with a sports dietitian as well as a medical check-up with your doctor or gynecologist. To find a sports dietitian in your area, use the Academy of Nutrition and Dietetics referral networks at www.SCANdpg.org or www.eatright.org.

The most important change required to resume menses includes matching your energy intake with your energy output, so you eat enough to support both exercise and normal body functions. Historically, doctors gave the birth control pill to women with amenorrhea; this forced menstrual bleeding. But taking the birth control pill is a “Band-Aid approach” and does not resolve the underlying problem. You are likely eating too few calories if you are hungry all the time and think about food too much. You can achieve energy balance by exercising a little less (add a rest day) and by eating a little more (add a healthy snack or two). Your goal is to consume about 15 calories per pound of body weight that you do not burn off with exercise. That means, if you weigh 100 pounds, you my need to eat ~1,500 calories to maintain your weight PLUS another 500 to 800 calories to replace the fuel you burned while training. That totals 2,000-2,300 calories for the entire day, a scary amount of food for some women.

Tips for resolving the issue

If eating this much sounds overwhelming to you, the following tips may help you get “back on the healthy track.”

1. Take a vacation from dieting. If you cannot let go of your compulsion to lose weight, at least be less restrictive. Cut back on your eating by only 100 to 200 calories at the end of the day, not by 500 to 1,000 calories during the active part of your day. Small deficits can result in losing excess body fat and are far more sustainable than the food chaos that accompanies starving-stuffing patterns. 2. Throw away the bathroom scale.

Rather than striving for a certain number on the scale, let your body achieve a natural weight that is in keeping with your genetics.

3. Eat adequate protein.

When you under-eat, your body burns protein for energy. Some of the protein comes from your diet; for example, the protein in your omelet gets used for fuel instead of building and repairing muscle. Some of the protein comes from your muscles, hence, you experience muscle wasting and that can lead to weaker bones and stress fractures. A 120-pound athlete should target 60 to 90 g protein per day. If you think your diet might be low in protein, track your food intake at www.supertracker.usda.gov.

4. Eat a calcium-rich food at each meal to help maintain bone density.

Exercise alone is not enough to keep bones strong. Enjoy milk on cereal, low fat cheese on a lunchtime sandwich, a decaf latte in the afternoon, and a yogurt after dinner.

5. Get adequate vitamin D to help with calcium absorption and bone health. Sunlight on the skin helps make vitamin D. If you are an “indoor runner” (a “treadmill rat”) who gets little sunshine, be sure to choose foods fortified with D (milk, some breakfast cereals), fatty fish like salmon, eggs, and mushrooms. In the winter months, you may need to take a vitamin supplement.

6. Eat at least 20% of your calories from (healthful) fat. While excess calories from fat are easily fattening, a little fat at each meal (15 to 20 g fat per meal, or 45 to 60 g fat per day) is an important part of a sports diet. You won’t “get fat” by eating fat. Your body uses fat to absorb vitamins A, D, E, and K; these vitamins are important for good health. To boost your intake of healthy fats, sprinkle slivered almonds on cereal, snack on a banana spread with peanut butter, enjoy salmon for dinner, drizzle olive oil on steamed veggies, and add avocado to your turkey sandwich.

Is there long-term damage? Loss of bone density can be irreversible and lead to early osteoporosis. The younger you are, the better your chances of recovery. My advice: nip this problem in the bud now!

Nancy Clark, MS, RD CSSD (Board Certified Specialist in Sports Dietetics) counsels active people at her private practice in Newton, MA (617-795-1875). For more information, read her Sports Nutrition Guidebook and food guides for marathoners and new runners. The books are available at www.nancyclarkrd.com. Also see www.sportsnutritionworkshop.com for online education and CEUs.

-- Nancy Nancy Clark MS RD CSSD Sports Nutrition Services LLC

www.sportsnutritionworkshop.com (Indianapolis Feb 5, online) www.nancyclarkrd.com (books, handouts, CEUs) Twitter.com/nclarkrd iPhone app: Recipes for Athletes

Nancy Clark's Sports Nutrition Guidebook Food guides for soccer, new runners, marathoners, cyclists 1155 Walnut St, Newton Highlands, MA 02461 Phone: 617.795.1875 Fax: 617.963.7408

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Injured Athletes - Nutrition Tips to Hasten Healing - By Nancy Clark, MS, RD, CSSD

The Athlete’s Kitchen, Copyright: Nancy Clark Jan 2013

Being injured is one of the hardest parts of being an athlete. If you are unable to exercise due to broken bones, knee surgery, stress fracture, or concussion, you may wonder: What can I eat to heal quickly? How can I avoid getting fat while I'm unable to exercise? Should I be taking supplements? This article will address those concerns, plus more.

Don’t treat good nutrition like a fire engine

To start, I offer this motherly reminder: Rather than shaping up your diet when you get injured, strive to maintain a high quality food intake every day. That way, you'll have a hefty bank account of vitamins and minerals stored in your liver, ready and waiting to be put into action. For example, a well-nourished athlete has enough vitamin C (important for healing) stored in the liver to last for about six weeks. The junk food junkie who gets a serious sports injury (think bike crash, skiing tumble, hockey blow) and ends up in the hospital in a coma has a big disadvantage. Eat smart every day!

Don’t diet

A big barrier to optimal fueling for injured athletes is fear of getting fat. Please remember: even injured athletes need to eat! I've had a runner hobble into my office on crutches saying, “I haven't eaten in three days because I can't run.” He seemed to think he only deserved to eat if he could burn off calories with purposeful exercise. Wrong! Another athlete lost her appetite post-surgery. While part of her brain thought “what a great way to lose weight”, her healthier self realized that good nutrition would enhance recovery.

Despite popular belief, your organs (brain, liver, lungs, kidneys, heart, etc.)—not exercising muscles—burn the majority of the calories you eat. Organs are metabolically active and require a lot of fuel. About two-thirds of the calories consumed by the average (lightly active) person support the resting metabolic rate (the energy needed to simply exist). On top of that, your body can require 10% to 20% more calories with trauma or minor surgery; major surgery requires much more. Yes, you may need fewer total calories because you are not training hard, but you definitely need more than your sedentary baseline. Your body is your best calorie counter, so respond appropriately to your hunger cues. Eat when hungry and stop when your stomach feels content.

Here are two other weight myths, debunked:

Muscle turns into fat. Wrong. If you are unable to exercise, your muscles will shrink, but they will not turn into fat. Wayne, a skier who broke his leg, was shocked to see how scrawny his leg muscles looked when the doctor removed the cast six weeks later. Once he started exercising, he rebuilt the muscles to their original size.

Lack of exercise means you'll get fat. Wrong. If you overeat while you are injured (as can easily happen if you are bored or depressed), you can indeed easily get fat. Joseph, a frustrated football player with a bad concussion, quickly gained 15 pounds post-injury because he continued to eat lumberjack portions. But if you eat mindfully, your body can regulate a proper intake. Before diving into meals and snacks, ask yourself, “How much of this fuel does my body actually need?”

When injured, some underweight athletes gain to their genetic weight. For example, Shana, a 13-year-old gymnast, perceived her body was “getting fat” while she recuperated from a knee injury. She was simply catching up and attaining the physique appropriate for her age and genetics.

Do eat “clean”

To enhance healing, you want to choose a variety of quality foods that supply the plethora of nutrients your body needs to function and heal. Don't eliminate food groups; they all work together synergistically! Offer your body:

Carbohydrates from grains, fruits, vegetables. By having carbs for fuel, the protein you eat can be used to heal and repair muscles. If you eat too few carbs—and too few calories, your body will burn protein for fuel. That hinders healing.

Protein from lean meats, legumes, nuts and lowfat dairy. Protein digests into the amino acids needed to repair damaged muscles; your body needs a steady stream of amino acids to promote healing (especially after physical therapy). You need extra protein post-injury or surgery, so be sure to include 20 to 30 grams of protein at each meal and snack. A portion with 20 to 30 grams of protein equates to one of these: 3 eggs, 1 cup cottage cheese, 3 to 4 ounces of meat, poultry, or fish, two-thirds of a 14-ounce cake of firm tofu, or 1.25 cups of hummus. While you might see ads for amino acid supplements including arginine, ornithine, and glutamine, you can get those amino acids via food.

Plant and fish oils. The fats in olive and canola oils, peanut butter, nuts and other nut butters, ground flaxseeds, flax oil, and avocado have an anti-inflammatory effect. So do omega-3 fish oils. Eat at least two or three fish meals per week, preferably the oilier fish such as Pacific salmon, barramundi, and albacore tuna. Reduce your intake of the omega-6 fats in packaged foods with “partially hydrogenated oils” listed among the ingredients, and in processed foods containing corn, sunflower, safflower, cottonseed, and soy oils. Too much of these might contribute to inflammation.

Vitamins. By consuming a strong intake of colorful fruits and vegetables, you'll get more nutrition than in a vitamin pill. Fruits and veggies have powerful anti-oxidants that knock down inflammation. Don’t underestimate the healing powers of blueberries, strawberries, carrots, broccoli, and pineapple. Make smoothies using tart cherry juice, PomWonderful pomegranate juice, and grape juice.

Minerals. Many athletes, particularly those who eat little or no red meat, might need a boost of iron. Blood tests for serum ferritin can determine if your iron stores are low. If they are, your doctor will prescribe an iron supplement. You might also want a little extra zinc (10 to 15 mg) to enhance healing.

Herbs, spices and botanicals. Anti-inflammatory compounds are in turmeric (a spice used in curry), garlic, cocoa, green tea, and most plant foods, including fruits, vegetables, and whole grains. For therapeutic doses of herbs and spices, you likely want to take them in pill-form. Yet, consuming these herbs and spices on a daily basis, in sickness and in health, lays a strong foundation for a quick recovery.

Nancy Clark, MS, RD, CSSD (Board Certified Specialist in Sports Dietetics) counsels both casual and competitive athletes at her office in Newton, MA (617-795-1875). Her Sports Nutrition Guidebook and food guides for new runners, marathoners, and soccer players offer additional information. They are available at www.nancyclarkrd.com. See also sportsnutritionworkshop.com.


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Sports Nutrition News from The Academy of Nutrition & Dietetics - By Nancy Clark MS RD CSSD

The Athlete’s Kitchen Copyright: Nancy Clark 2012

The Academy of Nutrition and Dietetics (formerly the American Dietetic Association; the nation's largest group of food and nutrition professionals) recently convened in Philadelphia (Oct., 2012). The following highlights from that conference may shed new light on ways for you to optimize your sports diet and manage your weight

Protein: How much is enough?

Many athletes believe more protein is better. Not necessarily true, according to exercise physiologist Doug Paddon-Jones from the University of Texas Medical Branch. Research subjects who ate a 30-gram dose of protein (about 4 ounces of meat) had similar rates of protein synthesis as those who ate a 90-gram dose (~12 ounces of meat, i.e., a big steak). Because the body does not temporarily store extra protein as muscle, about 60 grams of the protein got “wasted” (or rather, burned for energy or stored as fat). Yet, if you eat only a 10-gram dose of protein at breakfast (1 egg + 1 white), you may not have eaten enough to maximally stimulate muscle synthesis. Paddon-Jones recommends athletes target about 30 grams of protein at three meals per day. That means, cut your hefty dinner steak into thirds and enjoy two-thirds of it the next day at breakfast and lunch!

Although 30 grams is the number often mentioned by researchers, Paddon-Jones reminds us this is not an exact science. Protein research is incredibly expensive; few researchers are able to do dose-response studies to precisely determine the number of grams of protein needed per pound of body weight. Hence, Paddon-Jones suggests athletes simply enjoy a moderate portion of protein-rich foods at each meal.

He also recommends eating protein after you exercise (back your exercise into a meal-time), so your muscles will have the tools they need to do the building and repairing that peaks in the next 3 to 5 hours. “Mind you, following this strategy will not make a massive difference in your musculature, but it may optimize muscle maintenance. This could make a meaningful difference over the course of a year, particularly for athletes over 30 years old who slowly lose muscle as a normal part of the aging process.”

Enjoying an even distribution of protein throughout the day has another benefit: you'll feel less hungry all day. For yet-unknown reasons, eating protein-rich foods for breakfast contributes to greater satiety than protein eaten at other times of the day. Research suggests a higher protein breakfast can result in consuming 200 fewer calories at dinner. Theoretically, that's enough to lose 20 pounds of fat in a year! How about boosting your breakfast with more Greek yogurt, cottage cheese, and omelets?

Weight Management: How much exercise is enough?

If you want to lose weight temporarily, you don't have to exercise; you “simply” need to create an energy deficit by eating less food. (Think about people in the hospital who lose weight without exercise.) But if you have already lost a lot of weight and want to maintain that fat-loss (and help minimize fat-regain), you need to be active for about one hour a day. According to obesity researcher Dr. Jim Hill, “Unfortunately, that's the price a person who has lost 70 pounds needs to pay for having been obese.”

Dr. Hill suggests there is a yet undefined “sweet spot” where just the right amount of exercise (not too much, not too little) enhances fat loss. As many frustrated dieters have learned, too much exercise forces the body into starvation mode and then the traditional weight loss rule—to knock off 500 calories per day to lose one pound of fat per week—becomes a myth. The less you eat (or the more you exercise), the more your body down-regulates to conserve energy and your metabolic system adapts. The body has a very complex system that makes weight reduction difficult.

While any type of exercise is good for weight management, lifting weight and doing other forms of strength training help maintain muscle mass. Dr. Brenden Gurd of Ontario suggests high intensity interval training as an effective strategy for fat loss, particularly abdominal fat. But it can also be a good strategy for getting injured; be careful!

Weight and Taste Buds

Weight gain is related to not only under-exercising, but also to over-eating. Why do some people routinely overeat? According to Dr. Beverly Tepper of Rutgers University, the answer might be related to their taste buds! About 30% of the population has a genetic variation in bitter taste that results in a preference for the taste and texture of high fat foods, such as creamy salad dressings, cheese, and ice cream—as well as spicy hot foods. Combine this with our enticing food environment—voila, overeating! When compared by body mass index (BMI, a ratio of weight and height), fat-preferring women have a higher BMI (30 vs. 24; obese vs. average physique) as compared to women with a different version of this gene.

When presented with a buffet lunch (that encourages overeating), genetic “fat lovers” need to muster more dietary restraint to consciously choose foods that are lower in fat. Otherwise, they may eat 88% more calories than usual, while those without the gene will consume “only” about 38% more calories. (Buffets can be dangerous!)

In a three-day food experiment during which women ate a standard breakfast (OJ, yogurt, toast) and then selected their lunch and dinner, the genetically predisposed “fat lovers” chose more added fats (butter, salad dressing), cakes, and pies, while the others preferred more fruits and vegetables. Perhaps obesity prevention programs could include genetic screening so these people can be taught to better manage our food environment?

Cooking tip: Mushrooms have an “umami” (meaty, savory) flavor that allow them to easily substitute for meat. Taste-testers equally enjoyed tacos made with 100% beef, 50% beef with 50% mushrooms, or 20% beef with 80% mushrooms. How about adding more mushrooms to your next beef stew, spaghetti sauce, or meatballs to save calories and saturated fat—as well as helping save the environment? According to the Center for Science in the Public Interest, for every two pounds (1 kg) less beef we eat, we spare the environment about 60 pounds (27 kg) of greenhouse gasses. This adds up; we don’t need more super-storms like Hurricane Sandy.

Nancy Clark, MS, RD, CSSD (Board Certified Specialist in Sports Dietetics) counsels both casual and competitive athletes at her office in Newton, MA (617-795-1875). Her Sports Nutrition Guidebook and food guides for new runners, marathoners, and soccer players offer additional information. They are available at www.nancyclarkrd.com. Also see www.sportsnutritionworkshop.com.

Nancy Clark's Sports Nutrition Guidebook Food guides for soccer, new runners, marathoners, cyclists 1155 Walnut St, Newton Highlands, MA 02461 Phone: 617.795.1875 Fax: 617.963.7408 "Helping active people win with good nutrition."


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Bulking Up A-Z - By Sean Toohey

Most folks turn to the RT after having paid a king's ransom to the nutritional supplement stores, and failing on mainstream training programs. Well, the RT is clearly a home for hardgainers, and for some of us, a method of marrying the old with the new. I fall into that second category. I'm an old school trainer, and that is where I choose to stay. I do find quite a bit of value however, in some of the newer dietary practices… particularly those used to shed fat.

Old methods actually worked quite well, and I was always a fan of John McCallum's method of choice: drop all carbs, eat all protein (as much as you want) and don't sweat the fat. Look under "The Definition Diet" for details. Anyway, I sat down and figured out a diet based on the plan McCallum outlines, and then for kicks I figured out the nutritional content. As it turns out, the fat grams were nearly three times the protein grams. Hello Ketogenic Diet.

So I looked into CKDing and realized that McCallum's logic could be refined a bit. As it turns out, the high calorie CKD sheds fat like crazy and leaves plenty o'muscle behind. So the question then becomes, "What is the fastest way to gain muscle, regardless of bodyfat?"

The answer is, emphatically, bulking. Why? Because it is a near sure-fire way to ensure that all (and I mean ALL) the nutritional requirements are met (read: exceeded). So let's roll up our shirtsleeves and talk about bulking. What it is, what it ain't, and how you do it.

For starters, bulking is NOT binge eating. You do not "wing" it on a bulking program. There are very clear rules that must be followed and if you don't follow them, you are going to wind up very fat, and lose a tremendous amount of muscle when you diet down. You can't just say, "eat everything there is in your house, then repeat" day in and day out. There are limits! The warning has been issued, so I'm not going to worry about you any more if you don't listen! Now, on to what bulking is.

Bulking is, essentially, a method of super-saturating your body with all the available nutrients for building mass. Combined with a proper workout to "trigger" those gains, and plenty of rest, the results are that your body will gain muscle at an incredible rate. How incredible? Once you tweak your routine and diet so that it fits YOU, gains of 30 pounds in a month or six weeks are quite possible, with a solid 20 pounds of that being pure lean tissue. I know that is a fact. I have bulked myself, I have taught bulking to others, and I have witnessed the results of bulking many, many times. I have well over 10 years experience bulking up and training down, so I'm not new to it.

You cannot bulk non-stop. Everything needs to be right before you do it. The best time to bulk is usually about a month or two after maintaining a new body weight… usually after dieting down to lean tissue. You have to be mentally ready to gain like this, which means you need to be prepared for an all-out onslaught with the weights, you must be primed for new pr's (meaning that you have to be training at a peak) and you must be in good condition.

Coming back after a layoff is NEVER a good time to bulk. Why? Because you aren't training at peak levels yet. Peak level training is when you are stimulating the most growth. If you aren't stimulating the most growth, you will be short-changing yourself and some of the nutrients that you consume will be unnecessary, thus leading to an excessive fat gain. If you aren't 100% mentally ready to gain, you aren't going to get the most out of your program.

For this reason alone, I suggest a maximum of 3 bulking sessions a year, and probably 2 is best. Done properly you can easily pack on 30-40 pounds of lean tissue in a year or a year and a half… compare that to the 5-10 pounds of lean tissue promised by the "gain lean mass" crowd and you will see why people love bulking!

Training for bulk is really just a method of advantages. What I mean is that you take advantage of some of the little nuances that you notice as "training phenomenon." None of these little techniques are necessary, but they do help. Let's say that you have been training on a standard 20 rep squat routine for the last 2 months after having dieted down your fat levels, and you are now at an all-time high. Great! Time for some subtle changes in your routine to help stimulate the growth!

First, I would recommend switching to two sets of 15 reps. Perform a set of 20 rep's (very light) as a warm up, concentrate on the breathing aspects during the first set (taking advantage of the breathing as outlined by Roger Eells) and hammer the first set of 15 reps HARD. Then drop a full 100 pounds, and perform a second set, while concentrating on the breathing again. This is, of course, just an example, but it should give you an idea of what I'm referring to when I say "slight modifications" and how to seize the advantages offered by a new routine. In this case, you isolate a major growth factor (breathing) and drop the reps a bit to throw some extra iron on the bar. Incidentally, McCallum himself was a staunch advocate of 2 x 15 as a squatting protocol. Basically, concentrate on a slight change in what you are doing - preferably one that allows you to "add iron."

Be prepared for some very hard work, albeit for a short duration. Bulking should never really last longer than 2 months, and 6 weeks is probably best. After this period of time, your body will have a tendency to adjust to the protocol and diet, and you will tend to get fatter rather than continuing to add new muscle. If you have been hitting a series of PRs throughout the entire bulking period (as you should) you will also be primed for injury and over-training, so backing off is a good idea.

Subtle alterations in training protocol are one thing, but all the training in the world isn't worth a plugged nickel without a diet strategy. And make no mistake - bulking has a special diet strategy. Two words need to be in your diet vocabulary 24 hours a day: Protein and Calories. Fats would run a close third on the list, and carbohydrates bring up the rear.

I don't care how many nutrition experts tell you that any excess of any nutrient above a certain calorie level will be stored as fat. I don't care how many of these experts also say that carbohydrates are "protein sparing." The fact is that carbohydrates make you fat, and protein builds muscle. If you don't agree with that, then don't bother bulking… ignore me and go back to the method that you find works best for you. NOBODY is going to twist your arm to bulk, and nobody is making a claim that bulking is the "only" way to build muscle. It is my opinion that bulking is the best way to build muscle fast, but it can backfire if you screw up. So make sure you have all your ducks in a row. Anyway, the dietary rules are the following:

1. 20 x bodyweight in calories is the minimum. Adjust upward as needed. Below this number is a "high calorie diet." If you don't break 20x, you ain't bulkin'.

2. 2 x TARGET bodyweight in protein. The disclaimer here is that you shouldn't be aiming for a 50 pound gain on one bulking cycle, so 2.25 x CURRENT bodyweight is a solid guide. That equates to a 25 pound gain for a 200 pound man.

3. Arrange the remainder of calories after protein in an equal portion of fats and carbs. For purely unadulterated bulk, start eating all the carbs you want AFTER you get all the other elements (protein/fats/micronutrients). You will get fatter that way, but face it -- you will also get bloody strong as well. The disclaimer to carbs is below. Pay attention to it. Carbs without protein is a recipe for disaster.

As you can see, the rules strictly adhere to protein and calories as the key to the whole thing. Make no mistake… if you try to bulk using calories and carbohydrates, you will turn into a fat-ass overnight, with little to show for your efforts. Carbs cost less than protein. Think of a carbohydrate based bulking plan as "cheap" and you will soon figure out that you get what you pay for.

You cannot eat this way forever. But you can do it for a couple of months without a problem. If you are due for a big weight increase, this is your ticket… no question. I would be remiss if I didn't point out things that people do to fail on a bulking program, so here you go.

1. Eating too many carbohydrates compared to other nutrients. This is the number one mistake. If your carbs are too high, you will get fat. I feel like tatooing that on everyone who bulks. Preferably in reverse, and right on their forehead so they can't miss it when they look in a mirror. Carbs will add to bodyweight. IF you want to gain lots of everything (fat and muscle) then add more carbs. IF you want leaner bulk cycles, keep the carbs equal to the fats you ingest. Either way, protein is king.

2. Winging it. If you think you can just "eat heavy" you will fail. You actually have to sit down and plan out your attack on the food. 20x bodyweight in calories and 2.25 x bodyweight in protein just don't happen "by accident." It also doesn't do the job as fast as 25-30 x bodyweight.

3. "Easing into it." When you bulk, you are trying to take advantage of the body's natural reactions to sudden stimulus. Part of this is nutritionally… so eat heavy right from day one. Your body will react by flooding you with hormones and building some impressive muscle. Ease into it and you allow your body to "get used" to what you do. Great idea when eating normally. Not a good idea when bulking. In this case, the shock works in your favor.

4. Thinking that they can get away with a "glossy mag" routine. Weider workouts don't work, so don't think that merely eating heavy will change that. When bulking you need to stimulate a muscular increase. Overtraining will occur even if you have all the optimum nutritional levels. Design a program that would work on any diet.

5. Leaving nutritional gaps. Don't neglect vitamins and minerals. Supplement them if you must.

6. Forgetting to sleep. You need 8 hours a night. If you are working particularly difficult hours, don't waste it by trying to bulk too. Wait until you are ready in all aspects of your life.

7. Bulking too long. You really need to pay attention to this. Guys think they will gain like this forever… no way buddy. Just bulk for 6 weeks or so, and never more than 2 months.

8. Training down too quickly. Keep your new mass for a month after you bulk. Let your body have a chance at "holding" weight. Then diet it off, and take your time doing so. Hold the lighter, more muscular you for a while too before bulking again.

9. Not treating fat loss as important. If you really don't care how big your gut gets, fine. If you do care, get a good checkup from the doctor, and diet off that belly. Once you are lean, start preparing to bulk again.

10. Not fine-tuning the bulk cycle. Take careful notes, and modify as you see fit. The bulking I have listed here is a great place to start, but you may react differently… experiment as you need until you find the formula that works perfectly for you. Mind you, the alterations from what I have outlined here will be slight…. Don't go thinking you will react "differently" to high carbs….

That pretty much sums it up. It ain't the only way, but it is a great old-time method of adding some substantial mass and strength. Give it a shot if the time is right.

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For Athletes with Food Cravings and “Sugar Addictions” - By Nancy Clark, MS RD CSSD

The Athlete’s Kitchen Copyright: Nancy Clark MS RD CSSD May 2011 For Athletes with Food Cravings and “Sugar Addictions”

“If I crave a candy bar, should I eat a candy bar?”

That’s the title of one of my most popular blog posts! Clearly, food cravings and sugar addictions are a source of concern and frustration for many athletes who believe that eating one chocolate bar (or whatever food they crave) will lead to eating ten of them, expand their waistlines, and ruin their health. They avoid chocolate like the plague. Instead, they righteously snack on only "healthy foods" like apples and oranges.

While the natural goodness of fruit is indeed the more nutritious and health-promoting choice, some nice chocolate, enjoyed in response to a hankering, can also fit into your sports diet. By regularly enjoying chocolates, you can avoid the strong cravings that lead to eating a sickening amount—not because you are “addicted to sugar” but because you are doing “last chance eating” before you go back into your self-defined food jail (1).

Keep in mind, your brain has a memory for the food you crave. If you try to ignore your craving for, let’s say, chocolate, you'll end up eating it sooner or later. This may happen after you've tried to curb your craving with an apple, crackers, pretzels, sugar-free fudgsicle—anything but the chocolate—and then, 500 calories later, you succumb to what you truly wanted. You could have more wisely enjoyed the chocolate in the first place; you would have saved yourself a bunch of calories!

Food cravings are a popular topic not only on my blog but also among LinkedIn's Intuitive Eating Professionals group. A discussion “If you crave a food, should you eat it?” spurred a lot of responses, with the answer being YES! History says that denial and deprivation of a desired food does not work permanently but rather results in binge eating. After all, if restrictive eating “worked,” then everyone who has ever been on a diet would be thin. The majority of dieters are overweight and obese, suggesting that “dieting fall-out” maybe be contributing to obesity. (2)

To our detriment, we live in a world where enjoying bagels, ice cream, candy, and chips gets “questioned.” Athletes talk about needing “will power” to curb their intake of the foods they crave. But most of us really want to be able to enjoy these foods. We just want to be able to eat them sanely, not in what feels like an out of control pig-out. We need nutrition skill power (not will power) to learn how to manage today’s food supply. That's where a sports dietitian can help you control hunger-based binges and find peace with food. (For a referral to a local sports dietitian, see www.SCANdpg.org.)

The question arises: What’s so bad about cravings in the first place? Is there really something wrong with eating what you truly want to eat? Cravings are not addictions. That is, if you crave a bagel because it tastes good, why should you not enjoy the bagel? When you eat a food you crave, your brain experiences a biochemical change that signals happiness. Can eating an appropriate portion (as opposed to overeating “the whole thing”) be a bad thing to do?

The answer commonly depends on if you are eating the food for fuel vs. mindlessly devouring it for its drug-like effect. If you find yourself on the verge of polishing off the whole bag of bagels, stop and ask yourself, “Does my body need this fuel?” If the answer is yes, you need to learn how to prevent the extreme hunger or derprivation that triggered the overeating. If the answer is no, then ask yourself, “What am I doing with my feelings?” Over-eating a craved food can distract you from sadness, smother your emotions, and protect your from feeling alone and lonely. But you are using food for the wrong reason. No amount of bagels, chocolate, or chips will resolve the real problem: you are likely hungry for a hug.

Do certain foods over-excite the pleasure centers in the brain? If so, do those foods become “addictive”? The recent science (3) says there is no such thing as a “sugar (or food) addiction.” Yes, it may have addictive-like qualities, particularly following a restriction/binge pattern of eating (1). In my practice, most people who binge have an unbalanced relationship with food; it has become too enticing, a primary focus for pleasure. The more they try to stay away from palatable foods, the more they want them.

While there is much we do not know about food and this controversial topic of food addictions, I encourage my clients to first rule-out hunger as the cause for cravings for sugar and carbohydrates. The physiology of hunger explains why we crave sugar; it’s a survival signal for quick energy. When your blood sugar is low, your brain signals an urgent need for sugar. When your muscles are glycogen depleted, you experience a niggling carb cravings until the muscles are adequately replenished.

What can you do to overcome cravings and perceived “addictions”? First and foremost, experiment with eating heftier breakfasts and lunches to abate hunger. (No, you will not “get fat” by eating more during the day. If you listen to your body, you will observe you are less hungry at night and will simply be able to consume fewer calories.) Also try changing your attitude. The mind is very influential. If you believe you are addicted to a food, you will have a hard time convincing yourself otherwise despite research that refutes the concept of food addiction and puts the focus on deprivation as a trigger to (over)eat.

The next time you have a craving for a specific food, relax, enjoy eating it slowly, taste it, savor the flavor, and linger over the treat. Do this several times throughout the week. Learn to enjoy the treat slowly, in moderation, without feeling guilty. Enjoy the foods you crave at every meal. For example, have a few Hershey's Kisses day after day, at breakfast, lunch, afternoon snack, and dinner. Eat them so often that you get sick of them. This may sound unhealthy in the short term but a week or two of excess chocolate will not ruin your health (nor your waistline) forever.

By learning your body's responses to different foods, you can at least become educated: food is not addictive and cravings are not bad. What’s bad is trying to live hungry as well as denied and deprived of foods you enjoy. There is a possibilty you can find peace with food. Nancy Clark, MS, RD, CSSD (Board Certified Specialist in Sports Dietetics) helps both casual and competitive athletes find peace with food. Her practice is at Healthworks, the premier fitness center in Chestnut Hill MA (617-383-6100). Her Sports Nutrition Guidebook and food guides for new runners, marathoners, and soccer players offer additional information. They are available at www.nancyclarkrd.com. See also www.sportsnutritionworkshop.com. Reference: 1. Pelchat M. Food addiction in humans. J Nutr. 2009; 139(3)620-622 2. Corwin RL, and P Grigson. Symposium Overview—Food Addiction: fact or fiction? J Nutr. 2009; 139(3):617-619. 3. Benton, D. The plausibility of sugar addiction and its role in obesity and eating disorders. Clinical Nutrition 29(3):288-303, 2010. -- Nancy

Nancy Clark MS RD CSSD Sports Nutrition Services

www.sportsnutritionworkshop.com (home study; online workshop) www.nancyclarkrd.com (books, handouts, CEUs)

Nancy Clark's Sports Nutrition Guidebook, 4th Edition Food guides for soccer, new runners, marathoners, cyclists

Healthworks, 1300 Boylston St., Chestnut Hill MA 02467 Phone: 617.795.1875 Fax: 617.795.1876 Twitter.com/nclarkrd

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Body Image and Athletes - By Nancy Clark, MS RD CSSD

The Athlete’s Kitchen
Copyright: Nancy Clark MS RD CSSD, January 2009




Question: What are two things dogs and athletes have in common?

Answer: One, both dogs and athletes love to exercise. Two, they both
come in different sizes and shapes.

Question: What is one thing dogs and athletes do NOT have in common?


Answer: Dogs are content with their natural physiques, while too many athletes try very hard to change the way they look. These athletes might be better off being like dogs. That is, does that bulky St. Bernard yearn to look like a lanky Greyhound? Heavens, no! Does the barrel-chested Labrador want to look like a sleek Setter? Doubtful. Each dog is very proud to represent his breed. Wouldn’t life be easier if each active person could be just as proud of his or her “breed”?As a sports dietitian, I spend too many hours helping my clients find peace with their bodies. Most of these active people take the outside-in
approach. They think if they change their body from the outside by losing undesired body fat or by adding some muscular bulk, they will be happier on the inside. Unfortunately, not true! No weight will ever be good enough to do the enormous job of creating happiness. This story, told to me by a cyclist, proves that point: “I once weighed 124 pounds and was unhappy with that weight. I started exercising and dieting rigidly. I lost to 99 pounds but I still wasn't happy. I ended up binge-eating; I gained to 160 pounds, where I was miserable. I sought help from a counselor, stopped eating emotionally, and with time, got my weight back to 124—and I felt happy there! Why couldn't I have been happy at 124 pounds in the first place? Because
happiness has nothing to do with weight...”Granted, some people do have excess body fat they can appropriately lose to be healthier as a person and lighter as an athlete. They can rightfully feel pleased when they accomplish the goal of attaining inappropriate weight. But other athletes just think they have excess fat to lose; they have distorted body images. A survey of 425 collegiate female athletes reports the women wanted to lose 5 pounds, on average.


(1) Another survey of the top women runners in the country found the same results.


(2) Even elite athletes wistfully believe they will perform better if they are leaner. Unfortunately, the struggle to attain that “perfect weight” can cost them their health and happiness. Restrictive diets with inadequate protein, iron, zinc, calcium and a
myriad of other health-protective nutrients—to say nothing of carbs for fuel—often contribute to injuries and poorer performance. So what can you do if you are discontent with your body? First of all, you should get your body fat measured to determine if you actually have excess fat to lose. Data can be helpful. (Find a local sports dietitian to measure your body fat via the referral network at SCANdpg.org.) You may discover you have less body fat than expected!

Feeling fat


It’s easy to understand why so many athletes have distorted body images. When you put on skimpy running shorts that expose your “flabby things”, or a bathing suit that shows every bump and bulge, you can very easily “feel fat.” Sound familiar?

One solution to the “I feel fat syndrome” is to remember “fat” is not a feeling. That is, you don't feel “blond hair” or “freckled.” You also do not feel “fat.” Yes, you may be feeling uncomfortable with your body. But you are really feeling imperfect, inadequate, insecure, anxious—and any number of other feelings that get described as “feeling fat. ”I encourage your to explore those real feelings, and figure out where you got the message that something is wrong with your body. The media is
a good start, but it could also be a parent who lovingly said at a tender age “That outfit looks nice, honey, but if only you'd lose a few pounds...” What you hear is “I'm not good enough” and this can create a downward spiral of self-esteem. Weight issues are rarely about weight. They tend to be about feeling inadequate and imperfect.


What to do


So how can a discontent athlete feel better about his or her body? One tactic is to stop comparing yourself to your peers. To compare is to despair. Rather, pretend you live on an island where your body is “good enough” the way it is. (You are unlikely to ever have a “perfect” body, so the second best option is to enjoy a body that is “good enough.”) If you step off your island and start comparing yourself to your peers, please notice: Do you end up being too fat, too slow, too ugly, too dumb? Do you ever let yourself rise to the top and be better than others? Doubtful. You are better off staying on your island, and calling
yourself a Gorgeous Goddess or Handsome Hulk. With time and practice, you can change the way you see yourself and come to believe perhaps you are, indeed, good enough the way you are! Granted, changing the way you feel about your body is a complex process. The following resources can help you in this journey to find peace with your body:


www.nourishingconnections.com (free e-newsletter)


www.findingbalance.com (has videos about resolving weight issues)

www.adiosBarbie.com (offers resources, and insights into the media)

For a plethora of books, visit the online bookshelf at www.gurze.com.

Some of my favorites include The Body Image Workbook and The Don’t Diet, Live-It Workbook.

Life is more enjoyable when you can love your body and appreciate it for all it does and stop hating it for what it is not. When the drive for thinness comes with a high price, that price may not be worth the cost.

Nancy Clark, MS, RD, CSSD (Board Certified Specialist in Sports

Dietetics) counsels both casual and competitive athletes in her practice

at Healthworks, the premier fitness center in Chestnut Hill MA

(617-383-6100). Her NEW 2008 Sports Nutrition Guidebook, Food Guide for

Marathoners, and Cyclist’s Food Guide are available via

www.nancyclarkrd.com. See also sportsnutritionworkshop.com.

References:

1. Beals K and M Manore. Disorders of the female athlete triad among
collegiate athletes. Int'l J Sport Nutrition and Exercise Metabolism.
2002. 12:281-293

2. Clark N, M Nelson, W Evans. Nutrition educational for elite female
runners. Physician and Sports Medicine. 1988. 16:124-135

Nancy Clark MS RD CSSD
Sports Nutrition Services

www.nancyclarkrd.com (books, powerpoint, handouts)
www.sportsnutritionworkshop.com (Dallas, St. Louis, Houston, online)

NEW 2008 Edition-Nancy Clark's Sports Nutrition Guidebook
Food Guide for Marathoners: Tips for Everyday Champions
Cyclist's Food Guide: Fueling for the Distance

Healthworks, 1300 Boylston St., Chestnut Hill MA 02467
Phone: 617.795.1875 Fax: 617.795.1876

"Helping active people win with good nutrition."

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2009 Sports Nutrition Guidelines - By Nancy Clark, MS, RD,

The Athlete’s Kitchen, Copyright March 2009: Nancy Clark MS RD CSSD


Hot off the press from three prominent nutrition and exercise associations—the American Dietetic Association, AmericanCollege of Sports Medicine, and Dietitians of Canada—is the 2009 Joint Position Stand on Nutrition for Athletic Performance. While there is little earth-shattering news in this comprehensive document (available on www.eatright.org; on the left side of the screen, click on Position stands), the authors comprehensively reviewed the research to determine
which sports nutrition practices effectively enhance performance. Here are a few key points, and the reminder that what and when you eat powerfully impacts how well you can perform. I hope this information entices you to “think again” if nutrition is your missing link.

• Don't weigh yourself daily! What you weigh and how much body fat you have should not be the sole criterion for judging how well you are able to perform in sports. That is, don't think that if you get to XX% body fat, you will run faster. For one, all techniques to measure body fat have inherent errors. (Even BodPod can underestimate percent fat by 2 to 3%.) Two, optimal body fat levels depend on genetics and what is optimal for your unique body. Pay more attention to how you feel and perform than to a number on the scale.

• Protein recommendations for both endurance and strength-trained athletes range from 0.5 to 0.8 grams per pound (1.2-1.7 g/kg) body weight. For a 150 lb. athlete, this comes to about 75 to 120 g protein per day, an amount most athletes easily consume through their standard diet without the use of protein supplements or amino acid supplements. Vegetarian athletes should target 10% more, because some plant proteins (not soy but legumes) are less well digested than animal proteins.If you are just starting a weight-lifting program, you’ll want to target the higher protein amount. Once you have built-up your muscles, the lower end of the range is fine.

• Athletes in power sports need to pay attention to carbohydrates, and not just protein. That's because strength training depletes muscle glycogen stores. You can deplete about 25% to 35% of total muscle glycogen stores during a single 30-second bout of resistance exercise.

• Athletes who eat enough calories to support their athletic performance
are unlikely to need vitamin supplements. But athletes who severely limit their food intake to lose weight (such as wrestlers, lightweight rowers, gymnasts), eliminate a food group (such as dairy, if they are lactose intolerant), or train indoors and get very little sunlight (skaters, gymnasts, swimmers) may require supplements.

• If you are vegetarian, a blood donor, and or a woman with heavy menstrual periods, you should pay special attention to your iron intake. If you consume too little iron, you can easily become deficient and be unable to exercise energetically due to anemia. Because reversing iron deficiency can take 3 to 6 months, your best bet is to prevent anemia by regularly eating iron-rich foods (lean beef, chicken thighs, enriched breakfast cereals such as Wheaties and Total) and including in each meal a source of vitamin C (fruits, vegetables).

.• Eating before hard exercise, as opposed to exercising in a fasted
state, has been shown to improve performance. If you choose to not eat before a hard workout, at least consume a sports drink (or some source of energy) during exercise.

• When you exercise hard for more than one hour, target 30 to 60 grams (120 to 240 calories) of carbohydrate per hour to maintain normal blood glucose levels and enhance your stamina and enjoyment of exercise. Fueling during exercise is especially important if you have not eaten a pre-exercise snack. Popular choices include gummi candy, jelly beans, dried fruits, as well as gels and sports drinks. More research is needed to determine if choosing a sports drink with protein will enhance endurance performance.

• For optimal recovery, an athlete who weighs about 150 pounds should target 300 to 400 calories of carbs within a half-hour after finishing a hard workout. More precisely, target 0.5-0.7 g carb/lb (1.0-1.5 g carb/kg). You then want to repeat that dose every 2 hours for the next four to six hours. For example, if you have done a rigorous, exhaustive morning workout and need to do another session thatafternoon, you could enjoy a large banana and a vanilla yogurt as soon as tolerable post-exercise; then, two hours later, a pasta-based meal; and then, another two hours later, another snack, such as pretzels and orange juice.

• Whether or not you urgently need to refuel depends on when you will next be exercising. While a triathlete who runs for 90 minutes in the
morning needs to rapidly refuel for a 3-hour cycling workout in the afternoon, the fitness exerciser who works out every other day has little need to obsess about refueling.

•Including a little protein in the recovery meals and snacks enhances
muscle repair and growth. Popular carb+protein combinations include chocolate milk, yogurt, cereal+milk, pita+hummus, beans+rice, pasta+meat sauce.

•Muscle cramps are associated with dehydration, electrolyte deficits, and fatigue. Cramps are most common in athletes who sweat profusely and are “salty sweaters.” They need more sodium than the standard recommendation of 2,400 mg/day. Losing about 2 pounds of sweat during a workout equates to losing about 1,000 mgsodium. (Note: 8 ounces of sport drink may offer only 110 mg sodium.) Salty sweaters (as observed by a salty crust on the skin of some athletes) lose even more sodium. If that’s your case, don’t hesitate to consume salt before, during and after extended exercise. For example, enjoy broth, pretzels, cheese & crackers, pickles and other sodium-rich foods. The majority of active people can easily replace sweat losses via a normal intake of food and fluids.

Final words of advice: If you can make time to train, you can also make time to eat well and get the most out of your training. Optimal sports performance starts with good nutrition!





Nancy Clark, MS, RD, CSSD (Board Certified Specialist in Sports Dietetics) counsels both casual and competitive athletes in her private practice at Healthworks, the premier fitness center in Chestnut Hill MA (617-383-6100). Her SportsNutritionGuidebook, and food guides for new runners, marathoners, or cyclists are available via www.nancyclarkrd.com. See also sportsnutritionworkshop.com.

Nancy Clark MS RD CSSD
Sports Nutrition Services
www.nancyclarkrd.com (books,teaching tools)
www.sportsnutritionworkshop.com (home study)


Nancy Clark's Sports Nutrition Guidebook, 2008 Edition
Food Guide for Marathoners: Tips for Everyday Champions
Food Guide for New Runners: Getting It Right The First Time
Cyclist's Food Guide: Fueling for the Distance

Healthworks, 1300 Boylston St., Chestnut Hill MA 02467
Phone: 617.795.1875 Fax: 617.795.1876

"Helping active people win with good nutrition."

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Missing Links - Part 2 - by Nancy Clark, MS, RD

In Part I of this article, I discussed 5 common missing nutrition links that hurt athletic performance: 1) Respect for the power of food. 2) Sufficient calories during the active part of the day. 3) Equal sized, evenly scheduled meals. 4) A beneficial intake of dietary fat. 5) Pre-exercise fuel. Here are six more missing links, with solutions so you can eat to win.

MISSING LINK #6: Beneficial protein intake Some athletes eat too little protein; others eat too much. For example, a 150 lb (68 kg)athlete may need 0.5 to 0.75 g protein/lb; this translates into ~75-105 g pro/day. If this athlete eats 6 egg whites (18 g pro)for breakfast, one can tuna (35 g) with lunch, a protein bar (20 g)for a snack, and two chicken breasts (90 g) with dinner along with 16 oz milk (16 g) the protein intake will be ~180 grams—excessive, to the point some of the protein could be traded for more carbs to better fuel the muscles. In contrast, a vegetarian athlete on a reducing diet could easily consume too little protein: 2 egg whites at breakfast (7 g), a salad with 1/4 cup chickpeas at lunch (3 g) and a gardenburger (11 g)for dinner. Too little! Solution: Meet with a sports dietitian, so you can learn your protein requirement and how to translate that into meals.

MISSING LINK #7: Iron to prevent fatigue from anemia Iron-deficiency anemia is common, particularly in females. A survey of collegiate athletes indicates 20% of the female volleyball and basketball players were anemic, as were 50% of the soccer team. (Eichner ‘01)Anemia is particularly common among women who have heavy menstrual blood losses, but eat neither red meat nor iron-enriched cereals. Solution: If you don’t eat red meat and feel needlessly tired, get a blood test (including serum ferritin). Your MD might suggest iron pills. Boost the iron content of your diet with:

• iron-rich foods (if not red meat, enjoy dark meat chicken
or turkey, salmon, tuna fish)
• iron-fortified cereals (such as Wheaties, Raisin Bran,Total)
Include with each meal a source of vitamin C (from fruits
and veggies, such as orange juice, berries, broccoli, tomato).

MISSING LINK #8: Post-exercise recovery food. If you are doing hard workouts, you haven’t finished training until you have refueled! “No time” to refuel is no excuse. Solution: Plan ahead; have recovery foods readily available. Even in a time-crunch, you should be able to properly refuel.

MISSING LINK #9: Recovering with both carbs & protein Recovery foods should offer a foundation of carbs, with pro- tein as the accompaniment. Areasonable target is about 240 calories of carbs (60 g carb) and 80 calories (20 g) of protein Some popular choices include Greek yogurt with honey, cereal with milk, a turkey sandwich or pasta with meat sauce. You need not buy engineered sports foods; standard fare works fine and tends to taste a lot better! Athletes who do two workouts a day reallyneed to rapidly refuel with a proper recovery diet. In a six-week study with swimmers, those who did two workouts (morning and afternoon) sprinted slower than those who swam only in the
afternoon (Costill,1991). If nutrition is your missing link, don’t even think about double workouts! Solution: Post-exercise, you may not yet feel hungry for solid foods but you will likely be thirsty. Afruit smoothie (made with yogurt) is excellent for recovery, as is chocolate milk. Both contain carbs to refuel, protein to build and repair muscles and reduce muscle soreness.
Recovery foods can even be eaten pre-exercise. That is, a pre-exercise yogurt gets digested into amino acids and glucose that will be ready and waiting to be used when the exercise stops. In a 10-week studywith recreational body builders, those who consumed a protein-carb supplement both immediately before and right after the mid-afternoon strength training session gained 2.3 pounds more muscle and 7 pounds more in strength (bench press),compared to the group without pre- and post-exercise fuel. (Cribb, 06) Another study compared Marines who drank a carbohydrate recovery beverage with or without protein during 54 days of basic training. Those who received the 100-calorie recovery drink (with 10 g protein)immediately post-exercise reported 17% less muscle soreness after a 6 mile hard hike, 28% fewer medical visits for bacterial/viral infections, 37% fewer visits for muscle/joint problems, and 83% fewer visits due to heat exhaustion (Flakoll 2003). That's impressive!

MISSING LINK #10: Rest days for muscles to refuel Rest is an important part of a training program. Depleted muscles may need more than 24 hours to not only replace glycogen stores but also to heal. Hence, rest days with little or no exercise enhancea training program. Athletes who want to lose weight commonly hesitate to take a rest day because they fear they will “get fat.” These athletes need to understand: 1) On a rest day, they will feel just as hungry because the muscles need food to refuel. 2) They will gain (water) weight. For each 1 ounce of glycogen, the muscles store about 3 ounces water. This water gets released during exercise and is beneficial. Solution:Plan one to two rest days a week. Notice how much better you are able to perform the day after the rest day.

MISSING LINK #11: Adequate Fluids Athletes who maintain optimal hydration can train harder and perform better. For each one percent of body weight lost via sweat, the heart has to beat 3 to 5 more times per minute (Casa, 2000); this creates needless fatigue. Solution: Monitor your urine. If are well hydrated you will need to urinate every 2 to 4 hours; the urine will be a light color. If you sweat heavily, you should make the effort to determine how much sweat you lose (and need to replace) during a workout. Do this by weighing yourself naked before and after exercise. For each pound (16 oz) of sweat lost, you should drink at least 16 to 24 ounces of fluid.

MISSING LINK #12: Sodium before exercise in the heat Research with trained cyclists reports they rode 20 minutes longer to exhaustion (99 vs 79 minutes) in 90°heat when they drank a pre-ride beverage with 1,000 vs ~150 mg sodium. They drank no fluids while riding. (Sims) Solution: If you train and compete in the heat, you should consume some salty foods (salted oatmeal, soup, pretzels) beforehand. The salt holds water in your body and reduces your risk of becoming dehydrated.

MISSING LINK #13: The sports dietitian (RD, CSSD) Serious athletes generally have a support crew that includes a coach, sports psychologist, medical doctor, physical therapist and massage therapist. But to their detriment, some fail to have a sports dietitian on their team. Solution: To get the most from your workouts, use the referral network at www.SCANdpg.orgto find a local registered dietitian who is a Board Certified Specialist in Sports Dietetics (RD CSSD). This professional can help you resolve:

• struggles with “no time” to eat properly,
• issues with intestinal distress related to pre-exercise food
• weight issues and undesired body fat.
• disordered eating practices that hinder performance.

The bottom line: Don’t let nutrition be your missing link! You will always win with good nutrition!

Nancy Clark, MS, RD, CSSD (Board Certified Specialist in Sports Dietetics) offers private consultations to casual and competitive athletes in her practice at Healthworks, the premier fitness center in Chestnut Hill MA(617-383-6100). Her Sports Nutrition Guidebook (2008), Food Guide for Marathoners, and Cyclist’s Food Guideare available via www.nancyclarkrd.com. See also sportsnutritionworkshop.com.

The Athlete’s Kitchen Nutrition for the Underperforming Athlete, Part IISelected references Casa D, Armstrong L, Hillman S, Montain S, Reiff R, Rich B, Roberts W, Stone J (2000). National Athletic Trainers' Association position statement: Fluid replacement for athletes. J Athletic Training35(2):212-224. Costill D, Thomas R, Robergs R, Pascoe D, Lambert C, Barr S, Fink W (1991). Adaptations to swimming training: Influence of training volume. Med Sci Sports Exerc23(3):371-377.
Cribb P, Hayes A(2006). Effects of supplement timing and resistance exercise on skeletal muscle hypertrophy. Med Sci Sports
Exerc38(1):1918-1925. Eichner R (2001). Anemia and Blood Boosting. Sports Science Exchange #81, Vol 14(2).
Flakoll, P., T. Judy, K. Flinn, C. Carr, and S. Flinn. 2004. Postexercise protein supplementation improves health and muscle soreness during basic military training in marine recruits. J Appl Physiol96(3):951-956. Sims S, van Vliet L, Cotter J, Rehrer N (2007). Sodium loading aids fluid balance and reduces physiological strain of trained
men exercising in the heat. Med Sci Sports Exerc39(1):123-130.

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Nancy Clark, MS, RD, CSSD - Bio

Nancy Clark, MS, RD, CSSD is an internationally known sports nutritionist and nutrition author. She is a registered dietitian (RD) who specializes in nutrition for exercise, health and the nutritional management of eating disorders. She is board certified as a specialist in sports dietietics (CSSD).

Nancy has a successful private practice located at Healthworks Fitness Center (www.healthworksfitness.com ), the premier fitness facility in Chestnut Hill, MA (617-383-6100) . She offers one-on-one nutrition consultations to both casual exercisers and competitive athletes, teaching them how to enhance energy, optimize performance and manage weight.

Her more renowned clients have included members of the Boston Red Sox, the Boston Celtics, and many collegiate, elite and Olympic athletes from a variety of sports. Previously, she was Director of Nutrition Services at Sports Medicine Associates in Brookline, MA.

Nancy completed her undergraduate degree in nutrition from Simmons College in Boston, her dietetic internship at Massachusetts General Hospital, and her graduate degree in nutrition with a focus on exercise physiology from Boston University.

She is a Fellow of the American Dietetic Association (ADA), the recipient of their Media Excellence Award, an active member of ADA's practice group of sports nutritionists (SCAN), and recipient of SCAN's Honor Award for excellence in practice. Nancy is also a Fellow in the American College of Sports Medicine (ACSM) and recipient of the Honor Award from ACSM's New England Chapter.

Her contributions to runners in the Boston area culminated in her receiving the 1994 Will Cloney Award. Nancy also holds the honor of having her photo and advice on the back of the Wheaties box for their 2004 Olympic series. She is a member of the Mizuno Advisory Staff.

Clark is the nutrition columnist for New England Runner, Adventure Cycling and American Fitness . She is a frequent contributor to Runner's World and is on the advisory board for SHAPE magazine. Clark also writes a monthly nutrition column called The Athlete's Kitchen, which appears regularly in over 100 sports and health publications, including Active.com and the Running Network.

Nancy is the author of the best selling sports nutrition reference Nancy Clark's Sports Nutrition Guidebook, with a new Fourth Edition available in April 2008. Over 500,000 copies of this classic book have been enjoyed by health professionals and exercise enthusiasts alike. Her Food Guide for Marathoners: Tips for Everyday Champions helps novice runners and walkers go the distance with energy to spare. And her Cyclist's Food Guide: Fueling for the Distance (co-authored with Jenny Hegmann, MS, RD) helps both beginning and experienced cyclists optimize their performance.

Sports and nutrition are personal as well as professional interests. A member of The Greater Boston Track Club, Clark has competed at the 10 Kilometer, half marathon and marathon distances. Clark routinely bike commutes and enjoys bike touring. She has led many extended bike tours, including a Transamerica Trip and other tours through the Canadian and Colorado Rockies. She has trekked into the Himalayas and planned the high altitude menu for a successful expedition. Her newest sport is rowing (crew). She and her husband, son, and daughter live in the Boston area.

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