How to Restore Your Period as an Endurance Athlete

November 11, 2023August 25, 2023 by amystephens

How to Restore Your Period as an Endurance Athlete

Athletes burn tons of extra calories each day because of the high demands of their training. If their nutritional needs are not being met, they may be underfueling. For female athletes, underfueling poses a high risk for secondary amenorrhea, which is defined as the absence of three or more periods in a row by someone who has had periods in the past. It can lead to a variety of other health issues, specifically impacting bone health and lowering immunity. Unfortunately, secondary amenorrhea is extremely common in female runners. The good news is, it is possible for an athlete to regain their menstrual cycle and potentially reverse the effects caused by secondary amenorrhea. But how?

The short answer is simple: exercise less, and eat more.

The long answer is that it isn’t so simple for athletes. Many athletes may feel that they have no chance at regaining their menstrual cycle, because their lifestyle directly goes against the baseline rule of exercising less and eating more to restore their period. Additionally, some athletes may fear weight gain despite the fact that it may be necessary for them to restore their cycle. However, secondary amenorrhea is reversible, and here are 5 ways in which an athlete can make small changes in order to restore their period:

Increasing Calories – Secondary amenorrhea is caused by a prolonged caloric deficit. The most important thing an athlete must do to restore their menstrual cycle, is to increase their caloric intake. It does not need to be a major lifestyle change or a completely new diet, adding in 1-2 nutritionally dense snacks every day might even do the trick. Adding between 350-450 calories per day above energy requirements, may be enough to restore an athlete’s menstrual cycle (Ciadella-Kam et al., 2014). However, if you are substantially under nourished, your body may require a higher level of calories to meet nutritional needs.
Timing of Fueling – No matter what time of day it is, refueling as soon as possible after a run or a hard workout is essential for your body to properly recover. It is best to eat a snack or a meal within 30 minutes of finishing a run, to kickstart replenishing your glycogen stores. Additionally, eating as soon as possible after a workout is a great way to replenish the calories expended during the training session. By refueling, you are preventing your body from falling into a prolonged calorie deficit, thus supporting the goal of avoiding a caloric deficit for restoring the menstrual cycle.
Dialing Back Training – Studies show that reducing exercise intensity restores estrogen production and hormonal balance. It may be beneficial for an athlete to dial back on their training, if they are struggling to regain their menstrual cycle after a period of time. However, there are some athletes that can restore their period by making nutritional changes, and continuing their normal training pattern. Focusing more on food timing around workouts may be supportive to athletes who need to be training year round.

4. Increasing Healthy Fats – Healthy fats supply the building blocks for female hormone production in the body. Increasing healthy fats when in secondary amenorrhea recovery supports the production of estrogen, progesterone, and healthy brain tissue. Healthy fats also support overall nutrient absorption, so consuming healthy fats allows your body to make the most out of all the other food you eat, ensuring that you are absorbing all the nutrients you need. Some easy ways to increase healthy fats can be from foods like full fat dairy products, avocados, fish, nuts and nut butters, seeds, and cooking with olive oil.

5. Necessary Weight Gain and Increasing Body Fat – It is a common misconception among runners and other athletes that being thinner will improve performance. This is not true, and in fact having a body fat percentage that is too low can be dangerous. For menstrual health, body fat is crucial. Women that have a low BMI (body mass index) are producing less estrogen, which can lead to secondary amenorrhea. While everybody is different, and using BMI may not be an accurate representation of what is healthy versus what is not, if an athlete has a low BMI as a result of extremely demanding training as well as a calorie deficit, it is not healthy. This is especially the case if they suffer from secondary amenorrhea. If you have lost your menstrual cycle, even if you are not necessarily “underweight” as understood by the BMI scale, you may be at an unhealthy bodyweight for YOU. Gaining some essential body fat will support hormone health by aiding the production of estrogen, allowing your body to regain its menstrual cycle.

6. Shift away from the diet mindset – Deliberately limiting your food or food intake with the aim of losing weight can lead to changes in your metabolism and hormone balance. Ensure that you eating enough to sustain your physical activity and promote recovery. Seek guidance from a sports dietitian expert to accurately assess your nutrition requirements and create a well-balanced meal plan.

7. Pay attention to your body’s hunger cues – Feeling hungry is a sign that your body needs food. By ignoring hunger cues, your body’s natural rythms can become imbalanced. When you feel hungry, opt for a nutritious meal or snack to address your body’s needs.

In addition to misinformation regarding the effects and severity of amenorrhea in athletes, it is also common for people to believe that going on birth control will fix these issues. While the birth control pill can produce a “period” it’s actually a withdrawal bleed. It’s not a natural period where your body has enough nutrients to produce hormones. A withdrawal bleed is not a real period and it doesn’t indicate you are in calorie balance.

Your physician may suggest that, as an athlete, it’s ok to miss your period. As mentioned, losing a period is not healthy and indicates an imbalance with nutrition and exercise that requires attention. Prolonged amenorrhea can have long-term effects on bone health.

Ultimately, there is no formula for restoring your period. Everybody is different, and some methods may work better than others. Additionally, some people may regain their periods faster than others, but this does not mean that you should stop trying. Small changes over time build up, and eventually by using these tips you can restore your period and continue becoming the strongest and healthiest athlete you can be.

Reach out to an informed physician or sports dietitian who can provide additional guidance about restoring your cycle.

References

Cialdella-Kam, L.; Guebels, C.P.; Maddalozzo, G.F.; Manore, M.M. Dietary Intervention Restored Menses in Female Athletes with Exercise-Associated Menstrual Dysfunction with Limited Impact on Bone and Muscle Health. Nutrients 2014, 6, 3018-3039.

De Souza MJ, Mallinson RJ, Strock NCA, Koltun KJ, Olmsted MP, Ricker EA, Scheid JL, Allaway HC, Mallinson DJ, Kuruppumullage Don P, Williams NI. Randomised controlled trial of the effects of increased energy intake on menstrual recovery in exercising women with menstrual disturbances: the ‘REFUEL’ study. Hum Reprod. 2021 Jul 19;36(8):2285-2297.

Hackney AC. Menstrual Cycle Hormonal Changes and Energy Substrate Metabolism in Exercising Women: A Perspective. Int J Environ Res Public Health. 2021 Sep 24;18(19):10024.

Ihalainen JK, Kettunen O, McGawley K, Solli GS, Hackney AC, Mero AA, Kyröläinen H. Body Composition, Energy Availability, Training, and Menstrual Status in Female Runners. Int J Sports Physiol Perform. 2021 Jul 1;16(7):1043-1048.

ENERGY BARS AND BITES

August 17, 2023August 11, 2023 by amystephens

ENERGY BARS and BITES

Athletes have high energy demands, and it can be difficult to meet these needs with meals alone. Energy bars and bites are a great way to offset hunger and fill in gaps between meals. Together with my intern, Sara, we created a list of energy bars and bites that we personally enjoy. These recipes can be easily prepared as a convenient way to meet nutritional needs.

Chocolate Peanut Butter Bites

Ingredients:

1 cup old-fashioned oats (use instant oats if you don’t have a blender)
2/3 cup shredded coconut (sweetened or unsweetened)
1/2 cup creamy peanut butter
1/2 cup ground flaxseed
1/2 cup mini chocolate chips
¼ cup maple syrup
1 tablespoon chia seeds (optional)
1 teaspoon vanilla extract
2-3 Tbsp water

Directions:

Combine all ingredients (except chocolate chips) in a food processor and pulse until well-mixed. If you don’t have a food processor, use instant oats.
Add 2-3 Tbsp water to hold the mixture together.
Remove from the food processor and stir in mini chocolate chips.
Scoop mixture and roll into balls. Freeze until solid and store in the freezer or refrigerator.

Mint Chocolate Bites

Ingredients:

1 cup rolled oats
1 1/4 cups Medjool dates — softened and pitted (about 10 dates)
1/2 cup peanut butter
3 tablespoons mini chocolate chips
1 tablespoon chia seeds (optional)
1 tablespoon ground flaxseed
1/8 teaspoon salt
3 tablespoons cocoa powder
2-3 Tbsp water

Directions:

To soften dates, leave in water for 10 min or add to boiling water for 5 min.
Place the dates in the bowl of a food processor and pulse several times until the dates break into small bits and form a ball that sticks to the side of the bowl.
Add the oats, peanut butter, and salt. Pulse until the mixture is broken down and in small pieces but not completely smooth. Add the cocoa powder and pulse to combine. At this point, the dough will look like crumbs. Add 2-3 tablespoons of water until the mixture forms a paste.
Scoop some into your hand and press to roll it into a ball, it should hold together easily. If it seems too dry and isn’t holding together, add a little peanut butter; if it’s too sticky, add a few more oats. (The amount you need may vary based upon the brand of peanut butter you use and the moisture of the dates.)
Roll the dough into balls of your desired size (I did slightly over 1 inch and ended up with 14 energy balls).
Place in the freezer or refrigerator to harden.

Energy bar

Inspired by wellplated

Ingredients:

3/4 cup creamy peanut butter
1/3 cup honey
2 tablespoons coconut oil
2 cups old fashioned rolled oats
Optional – 1/2 cup vanilla protein powder about 2 scoops, depending upon your brand
3 tablespoons flaxseed meal
1/4 teaspoon ground cinnamon
1/4 teaspoon kosher salt
1/3 cup mini chocolate chips or dried cranberries

Directions:

1. Line an 8×8- or 9×9-inch baking pan with parchment paper, leaving an overhang on two sides like handles.
2. Place the peanut butter, honey, and coconut oil in a medium heatproof bowl. Set the bowl over a saucepan of water and bring the water to a simmer over medium to medium-high heat. (Do not let the water boil, and make sure the water does not touch the bottom of the mixing bowl.) Stir and heat until the mixture is smoothly combined. Remove the bowl from the saucepan and turn off the heat
3. Add the oats, protein powder, flaxseed, cinnamon, and salt to the bowl with the peanut butter mixture. Stir to combine. The mixture will seem very dry at first but will come together as you stir. It won’t be sticky but should hold together when pressed.
4. Fold in the chocolate chips or cranberries. (If the mixture is still fairly warm, pop the bowl into the refrigerator for a few minutes to let it cool. Cooling the mixture will prevent the chocolate from melting. Don’t worry if they do melt a little—the bars will still be delicious!)
5. Press evenly into the prepared pan and refrigerate for 1 hour or until firm.
6. Lift the bars from the pan using the parchment handles and transfer them to a cutting board. Slice into bars as desired and enjoy.

Pumpkin energy bites

Inspired by pinchofyum

Ingredients:

2 cups oats
1/2 cup canned pumpkin puree
1/4 cup almond butter or peanut butter
1/4 cup chia seeds
1/4 cup pumpkin seeds
1 teaspoon vanilla extract
1/2 teaspoon cinnamon (optional, see notes)
1/2 cup maple syrup or honey
generous pinch of salt
1/2 cup dark chocolate chips

Directions:

Pulse all ingredients (except chocolate chips) in a food processor until well-mixed.
Add chocolate chips and pulse a few more times until they are in small pieces.
Scoop mixture and roll into balls. Freeze until solid and store in the freezer or refrigerator.

Energy Bites By Sara Two Ways

IG @eatzbysara

Coconut Cashew Energy Bites

Ingredients:

1 cup oats
½ cup cashew butter
¼ cup honey
1 cup shredded coconut
Optional: 2 tbsp vanilla protein powder

Maple Cinnamon Energy Bites

Ingredients:

1 cup oats
½ cup almond butter
¼ cup maple syrup
2 tbsp chia seeds
*(for this recipe I recommend Justin’s Maple Almond Butter for flavor)*

Directions for both recipes:

Mix all ingredients together in a large bowl
With your hands, roll the mixture into balls (you can make them any size you like, I usually make them about 1-2 inches in diameter. This way, the recipe yields about 12-15 bites.

NYC MARATHON NUTRITION PANEL

August 17, 2023August 8, 2023 by amystephens

NYC marathon nutrition panel

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

How Social Media Affects Athletes

August 7, 2023August 6, 2023 by amystephens

How social media affects athletes

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

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

Where should athletes get their information?

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

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

How to use social media in a positive way?

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

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

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

Oatmeal 101: How to Level Up Your Daily Oatmeal

June 30, 2023June 27, 2023 by amystephens

Oatmeal 101: How to Level Up Your Daily Oatmeal

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

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

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

Banana Bread Baked Oats

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

Ingredients:

● 1⁄2 cup oats

● 1⁄2 cup milk of choice

● 1 banana

● 1 tbsp any plain yogurt

● 1⁄2 tbsp maple syrup/honey

● 1⁄2 tsp baking powder

Directions:

● Preheat oven to 400°F

● Blend all ingredients

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

Toppings:

● Peanut butter, granola, banana slices::

Carrot Cake Overnight Oats

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

Ingredients:

● 1⁄2 cup oats

● 1⁄2 cup milk of choice

● 1⁄2 cup grated carrots

● 2 tbsp any plain yogurt

● Dash of cinnamon, nutmeg, cloves, ginger

Directions:

● Mix all ingredients, put in a closed container

● Store in the refrigerator overnight

● The next day: Add toppings and enjoy

Toppings:

● Almond butter, pecans, raisins

Lemon Coconut Microwave Oats

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

Ingredients:

● 1⁄2 cup oats

● 1⁄2 cup milk of choice

● 1 tbsp any plain yogurt

● 1 tbsp maple syrup/honey

● 1⁄2 tbsp chia seeds

● 1⁄2 a lemon, squeezed

● 1⁄2 cup shredded coconut

Directions:

● Blend all ingredients

● Microwave for 3 mins Toppings

● Cashew butter, lemon zest, granola

Savory Overnight Oats

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

Ingredients:

● 1⁄2 cup oats

● 1⁄2 cup water

● 1⁄2 Tbsp hemp seeds

● Dash of salt

Directions:

● Mix all ingredients, put in a closed container

● Store in the refrigerator overnight Toppings

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

Delicious Recovery Smoothie Ideas for Athletes

June 26, 2023May 10, 2023 by amystephens

Delicious Smoothie Ideas for Athletes

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

Berry Blast Smoothie

Blend together:

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

1 banana (use frozen banana for creamy texture)

1 scoop of vanilla protein powder (optional)

2 tablespoons of peanut butter

1 cup of milk

handful of ice

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

Green Monster Smoothie

Blend together:

1 cup of spinach

1 banana

1 scoop of vanilla protein powder (optional)

1 tablespoon of almond butter

1 cup of milk

handful of ice

Top with 1/2 teaspoon of chia seeds

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

Tropical Paradise Smoothie

Blend together:

1 cup of frozen pineapple chunks

1 banana

1 scoop of vanilla protein powder

1 cup of coconut water

handful of ice

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

Chocolate Peanut Butter Smoothie

Blend together:

1 cup of milk

2 tablespoons of cocoa nibs or cocoa powder

1 banana

1 tablespoon of natural peanut butter

2 tablespoons maple syrup, honey or agave

handful of ice

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

Mango Vanilla Smoothie

Blend together:

1 cup Vanilla yogurt

handful of ice

½ cup fresh or frozen mango

1 banana

1 cup milk

1 teaspoon chia seeds added on top

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

Cherry Almond Smoothie

Blend together:

1 cup of frozen cherries

1 scoop of vanilla protein powder (optional)

1 tablespoon of almond butter

1 cup of milk

handful of ice

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

Fuel Your Body: A Week of Nutritious Dinners for Athletes

June 22, 2023April 29, 2023 by amystephens

Fuel Your Body: A Week of Nutritious Dinners for Athletes

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

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

photo: Well-Plated

Monday:

Grilled chicken with sweet potato and broccoli

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

Recipe The Spruce Eats

Tuesday: Quinoa and black bean bowl

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

Recipe Eating Well

Wednesday:

Salmon with roasted vegetables and brown rice

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

Recipe Roasted Root

Thursday: Lentil soup and sourdough bread

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

Recipe Simply Recipes

Friday: Whole wheat pasta with turkey meatballs

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

Recipe Recipe Girl

Saturday: Stir-fry with tofu and vegetables

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

Recipe Well Plated

Sunday:

Grilled chicken with roasted potato and asparagus

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

Recipe Simply recipes

Easy LUNCH ideas for athletes

June 22, 2023April 21, 2023 by amystephens

quick LUNCH ideas for athletes

Why is eating LUNCH important to an athlete?

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

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

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

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

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

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

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

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

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

Granola parfait with yogurt and berries

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

Pita pizza with mushrooms and spinach

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

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

Salads

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

Grilled chicken salad

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

Kale chicken caesar salad

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

Salad Nicoise

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

Easy three bean salad

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

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

Sandwiches & Wraps – Serve with side of fruit

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

Chicken caesar wrap with lettuce and tomatoes.

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

Turkey and avocado sandwich on whole wheat.

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

Peanut butter and jelly sandwich, yogurt and fruit

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

Quesadilla

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

Burrito

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

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

Smoothies

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

Bowls

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

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

Salad Dressings

Basic balsamic vinaigrette

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

Lemon vinaigrette

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

Soy sesame dressing

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

Peanut dressing

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

Easy three bean salad with vinaigrette

For the salad:

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

For the dressing:

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

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

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

For the marinade:

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

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

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

Best Nutrition Bars for Athletes

June 22, 2023January 26, 2023 by amystephens

Athlete’s Guide to Choosing a Nutrition Bar

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

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

What to look for in a nutrition bar

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

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

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

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

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

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

Best pre-workout bars

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

Nature’s Bakery Fig

Nutrition facts:

200 calories

5 g fat

38 g carb

3 g fiber

3 g protein

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

✓ GF, vegan

$6.44/12 bars ($.54 each)

Order

Kind Oat Bar

Nutrition facts:

150 calories

5 g fat

23 g carb

2 g fiber

3 g protein

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

✓ GF

$35.92/40 bars ($.90 each)

Order

Larabar

Nutrition facts:

210 calories

12 g fat

23 g carb

4 g fiber

5 g protein

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

✓ GF

$16.14/86 bars ($.90 each)

Order

Skratch energy bar

Nutrition facts:

220 Calories

9 g fat

30 g carb

3 g fiber

5 g protein

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

✓ GF, Vegan, Kosher

$29.94/12 bars ($2.50 each)

Order

Bobo’s (Oat bar)

Maurten Solid

Nutrition facts:

340 calories

12 g fat

62 g carb

4 g fiber

6 g protein

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

✓ GF, vegan

$29.88/12 bars ($2.49 each)

Order

Nutrition facts:

225 calories

3.6 g fat

41.5 g carb

2.4 g fiber

2.9 g protein

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

✓ GF

Cost $36.00/12 bars ($3.00 each)

Order

Best post-workout bars

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

Macrobar

Nutrition facts:

290 calories

11 g fat

39 g carb

2 g fiber

11 g protein

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

✓ GF, Vegan

Cost $38.95/12 ($3.25 each)

Order

Clif

Nutrition facts:

235 calories

5 g fat

43 g carb

5 g fiber

11 g protein

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

✓ GF

$18.77/18 bars ($1.04 each)

Order

Rxbar

Nutrition facts:

210 calories

9 g fat

23 g carb

5 g fiber

12 g protein

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

✓ GF

$23.37/12 bars ($1.95 each)

Order

Over Easy

Nutrition facts:

230 calories

11 fat

24 g carb

6 g fiber

10 g protein

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

✓ GF, dairy free

$29.69/12 bars ($2.47 each)

Order

Eating Disorders in Athletes: Impact on Performance

June 22, 2023October 25, 2022 by amystephens

Eating Disorders in Athletes: Impact on Performance

Eating disorders affect an athlete both mentally and physically and have significant impacts on performance. This blog will discuss the prevalence of eating disorders, identify warning signs in athletes, distinguish the differences and similarities to relative energy deficiency syndrome (REDS), and provide resources for those struggling to seek help. Eating Disorders are a serious issue for everyone, but especially for athletes. Nutrition requirements are high and the inability to fuel an athlete’s body will lead to worsening of disordered eating, injuries, and overall decline in performance.

The most common forms of eating disorders are anorexia, bulimia and binge eating disorder. Anorexia refers to restriction of food and refusal to meet nutritional needs, typically resulting in extreme weight loss. Bulimia is defined by consuming a large quantity of food in a short period of time, followed by a desire to “get rid” of the food through vomiting, exercise, or medications. Often, athletes can have a combination of both. Binge eating disorder is another type of eating disorder characterized by consuming a large quantity of calories in a short period of time. In one study, up to 84% of athletes were found to have subclinical disordered eating, and engaging in maladaptive eating and weight control behaviors, such as binge eating, excessive exercise, strict dieting, fasting, self-induced vomiting, and the use of weight loss supplements (Chatterton, Clifford). Evaluation by a physician or therapist can determine the severity and best form of treatment.

Eating disorders do not discriminate as they affect all races, genders, and socioeconomic classes. Some populations have higher rates of eating disorders. Eating disorders are most commonly screened and diagnosed between the ages 12-19, but can occur at any age. The earlier an athlete is diagnosed, the more likely they are to recover and reverse any damage to their bodies. The longer an eating disorder behavior is untreated, the more difficult the treatment and full recovery become.

Prevalence

13.5% of athletes struggle with an eating disorder (Ghoch).
Up to 45% of female athletes and 19% of male athletes struggle with an eating disorder (Bratland-Sanda)
In a study by Petrie, 19.2% of athletes surveyed had maladaptive eating behaviors such as restricting food intake, limiting food choices, excluding large groups of foods, and purging behavior.

Risk factors for developing eating disorders in athletes

Certain sports that are weight dependent and focus on leanness pose a bigger risk for eating disorders. Both male and female athletes are at risk.

In addition, athletes who have recently undergone stressful events such as an injury are at a greater risk for developing an eating disorder. Athletes who have been struggling with poor performance might want to restrict food and blame the body.

There are additional societal contributions that can lead to eating disorders. It’s important to be aware of these factors so proper education for athletes and coaching staff can help prevent disordered eating among athletes.

Societal contributions include:

A fixation on thinness and the need to have a certain appearance in order to be happy or successful
Social media’s tendency to reinforce negative body image by giving attention to overly thin athletes
Restrictive diet plans promoted by ill-trained professionals
Society’s fixation on toxic positivity and the need to seek perfectionism to achieve one’s goals

All of these practices promote unhealthy relationships with the body and eating patterns. Athletes are no exception. Weight dependent sports not only encourage unhealthy dietary practices, but reward them. The thinner athletes promote themselves as having reached their performance levels due to their thin body type. Misinformation from friends, coaches, and media can cause an athlete to try and achieve an inappropriate level of thinness that causes physical and mental harm to their body. Eating disorders are often overlooked if the athlete is performing well.

Difference between eating disorders and Relative Energy Deficiency Syndrome (RED-S)

Relative Energy Deficiency Syndrome (REDS) is a new classification of symptoms identified in 2014 by International Olympic Committee Mountjoy. REDS is characterized by low calorie intake in relation to energy exerted during exercise. REDS was formerly named “The Female Athlete Triad Syndrome because it affected three key systems in the female body:low calorie intake, menstrual irregularities, and lowered bone density. The term REDS is new but the condition has been in existence for a long time. Simply put, exercising too much and not eating enough causes an imbalance in which the body cannot function at optimal levels. What’s most interesting to me is that someone with REDS can be any body weight. The difference between REDS and an ED is that REDS is an unintentional mismatch of calories. Once an athlete with REDS is evaluated and educated about an appropriate amount of calories to sustain daily exercise and body functions, the deficit is corrected and the body can function properly. ED is further explored if the athlete is unable to willingly consume calories to support energy expenditure.

Sometimes it may not be obvious or easy to diagnose REDS or eating disorders. Someone can be a normal weight but is exercising too much and refueling inadequately. In this instance, athletes may feel that they are eating well, but in truth, are not eating enough calories to support exercise.

Signs of chronic underfueling that warrant further screening to determine if disordered eating is present

Females – change in menstrual cycle, can be longer or lighter periods, it is NOT normal for a female athlete to miss a period
Males – low testosterone and growth hormone. Both are natural performance enhancing hormones made by the body. Low levels can negatively affect sport performances, muscle growth, and energy production. Also important for serotonin uptake for the brain, it can lift mood. (Skolnick)
Hormonal changes can lead to stress fractures and ultimately osteoporosis
Frequent injuries to bones and soft tissues
Isolated, eats alone
Withdrawn behavior
Sudden changes with diet or food choices
Noticeable fluctuations in weight, both up and down
Irritability
Lethargy, difficulty finishing a workout
Digestive issues such as bloating (often mistaken for IBS), gas, diarrhea (this is often worsened by further restricting suspected nutrients)
Decrease in sports performance
Difficulty sleeping
Not seeing improvements in performance despite increasing workouts
Depressed immune system
Decreased cognitive functioning (lower blood sugar supplied to brain)

Treatment

Treatment often begins with an evaluation by a physician, eating disorder dietitian, and therapist. Once the patient is evaluated, they are recommended to the best form of treatment depending on their situation. The dietitian will create a plan that provides adequate calories to support daily expenditure. It can be challenging to find the right physician to help especially since there are differing opinions among professionals. In my experience, missing a period leads to complications related to menstrual cycle and bone growth. It is important to let your doctor know if you’ve lost your period for more than three months as this can be related to underfueling or the result of underlying medical conditions. Your doctor can help guide you to the best treatment approach.

Resources for help

There are many resources to help. If you or someone you are close to might have an eating disorder, here are some important resources that can help:

- Visit your doctor and explain why you are concerned. Be sure to ask if your doctor works with eating disorders.
- For college athletes, visit your health center and explain why you are concerned. The health professionals can conduct proper screenings and assessments.
- Seek out a sports dietitian (ask if they have experience with eating disorders)
- See a school psychologist
- If you think you have an eating disorder, speak to a trusted family member or friend and share your concerns. Eating disorders are isolating so speaking out is a step in the right direction.
- Seek out supportive teammates and coaches and share your eating concerns. They can help you locate the best resources for an evaluation and assessment.
- National Eating Disorders Hotline (NEDA) 1-800-931-2237

References

Bratland-Sanda S, Sundgot-Borgen J. (2013). Eating disorders in athletes: overview of prevalence, risk factors and recommendations for prevention and treatment. Eur J Sport Sci, 13(5):499-508.

Chatterton, J. M., & Petrie, T. A. (2013). Prevalence of disordered eating and pathogenic weight control behaviors among male collegiate athletes. Eating Disorders, 21(4), 328-341.

Clifford, T., & Blyth, C. (2018). A pilot study comparing the prevalence of orthorexia nervosa in regular students and those in university sports teams. Eating and Weight Disorders – Studies on Anorexia, Bulimia and Obesity, 24(3), 473-480.

Conviser, J. H., Schlitzer Tierney, A., Nickols, R. (2018). Essential for best practice: treatment approaches for athletes with eating disorders. J of Clin Sports Psych, 12.

Ghoch, M. E., et al. (2013). Eating disorders, physical fitness, and sport performance: a systematic review. Nutrients, 5:12.

Mehler, P.S., Sabel, A.L., Watson, T. and Andersen, A.E. (2018). High risk of osteoporosis in male patients with eating disorders. Int. J. Eat. Disord, 41: 666-672.

Mountjoy M, Sundgot-Borgen JK, Burke LM, et al. (2018). OC consensus statement on relative energy deficiency in sport (RED-S): 2018 update. Brit J of Sports Med, 52:687-697.

Petrie, Trent, Greenleaf, Christy, Reel, Justine, Carter, Jennifer. (2018). Prevalence of Eating Disorders and Disordered Eating Behaviors Among Male Collegiate Athletes. Psych of Men & Masculinity, 9: 267-277.

Scott CL, Plateau CR, Haycraft E. (2020). Teammate influences, psychological well-being, and athletes’ eating and exercise psychopathology: A moderated mediation analysis. Int J Eat Disord, 53(4):564-573.

Shufelt CL, Torbati T, Dutra E. (2017). Hypothalamic Amenorrhea and the Long-Term Health Consequences. Semin Reprod Med, 35(3):256-262.

Skolnick A, Schulman RC, Galindo RJ, Mechanick JI. (2016). The endocrinopathies of male anorexia nervosa: case series. AACE Clin Case Rep, 2(4):e351-e357.

Amy Stephens