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.

How To Eat If You Are Training for a Marathon

July 22, 2024July 11, 2023 by amystephens

How To Eat If You Are Training for a Marathon

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

What to eat

CALORIES:

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

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

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

CARBOHYDRATES:

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

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

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

PROTEIN:

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

HEALTHY FATS:

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

VITAMINS:

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

How to eat around your workouts

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

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

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

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

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

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

How to hydrate

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

References

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

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

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

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

Oatmeal 101: How to Level Up Your Daily Oatmeal

June 30, 2023June 27, 2023 by amystephens

Oatmeal 101: How to Level Up Your Daily Oatmeal

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

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

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

Banana Bread Baked Oats

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

Ingredients:

● 1⁄2 cup oats

● 1⁄2 cup milk of choice

● 1 banana

● 1 tbsp any plain yogurt

● 1⁄2 tbsp maple syrup/honey

● 1⁄2 tsp baking powder

Directions:

● Preheat oven to 400°F

● Blend all ingredients

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

Toppings:

● Peanut butter, granola, banana slices::

Carrot Cake Overnight Oats

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

Ingredients:

● 1⁄2 cup oats

● 1⁄2 cup milk of choice

● 1⁄2 cup grated carrots

● 2 tbsp any plain yogurt

● Dash of cinnamon, nutmeg, cloves, ginger

Directions:

● Mix all ingredients, put in a closed container

● Store in the refrigerator overnight

● The next day: Add toppings and enjoy

Toppings:

● Almond butter, pecans, raisins

Lemon Coconut Microwave Oats

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

Ingredients:

● 1⁄2 cup oats

● 1⁄2 cup milk of choice

● 1 tbsp any plain yogurt

● 1 tbsp maple syrup/honey

● 1⁄2 tbsp chia seeds

● 1⁄2 a lemon, squeezed

● 1⁄2 cup shredded coconut

Directions:

● Blend all ingredients

● Microwave for 3 mins Toppings

● Cashew butter, lemon zest, granola

Savory Overnight Oats

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

Ingredients:

● 1⁄2 cup oats

● 1⁄2 cup water

● 1⁄2 Tbsp hemp seeds

● Dash of salt

Directions:

● Mix all ingredients, put in a closed container

● Store in the refrigerator overnight Toppings

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

Delicious Recovery Smoothie Ideas for Athletes

June 26, 2023May 10, 2023 by amystephens

Delicious Smoothie Ideas for Athletes

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

Berry Blast Smoothie

Blend together:

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

1 banana (use frozen banana for creamy texture)

1 scoop of vanilla protein powder (optional)

2 tablespoons of peanut butter

1 cup of milk

handful of ice

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

Green Monster Smoothie

Blend together:

1 cup of spinach

1 banana

1 scoop of vanilla protein powder (optional)

1 tablespoon of almond butter

1 cup of milk

handful of ice

Top with 1/2 teaspoon of chia seeds

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

Tropical Paradise Smoothie

Blend together:

1 cup of frozen pineapple chunks

1 banana

1 scoop of vanilla protein powder

1 cup of coconut water

handful of ice

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

Chocolate Peanut Butter Smoothie

Blend together:

1 cup of milk

2 tablespoons of cocoa nibs or cocoa powder

1 banana

1 tablespoon of natural peanut butter

2 tablespoons maple syrup, honey or agave

handful of ice

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

Mango Vanilla Smoothie

Blend together:

1 cup Vanilla yogurt

handful of ice

½ cup fresh or frozen mango

1 banana

1 cup milk

1 teaspoon chia seeds added on top

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

Cherry Almond Smoothie

Blend together:

1 cup of frozen cherries

1 scoop of vanilla protein powder (optional)

1 tablespoon of almond butter

1 cup of milk

handful of ice

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

Fuel Your Body: A Week of Nutritious Dinners for Athletes

June 22, 2023April 29, 2023 by amystephens

Fuel Your Body: A Week of Nutritious Dinners for Athletes

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

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

photo: Well-Plated

Monday:

Grilled chicken with sweet potato and broccoli

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

Recipe The Spruce Eats

Tuesday: Quinoa and black bean bowl

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

Recipe Eating Well

Wednesday:

Salmon with roasted vegetables and brown rice

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

Recipe Roasted Root

Thursday: Lentil soup and sourdough bread

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

Recipe Simply Recipes

Friday: Whole wheat pasta with turkey meatballs

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

Recipe Recipe Girl

Saturday: Stir-fry with tofu and vegetables

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

Recipe Well Plated

Sunday:

Grilled chicken with roasted potato and asparagus

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

Recipe Simply recipes

Easy LUNCH ideas for athletes

June 22, 2023April 21, 2023 by amystephens

quick LUNCH ideas for athletes

Why is eating LUNCH important to an athlete?

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

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

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

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

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

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

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

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

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

Granola parfait with yogurt and berries

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

Pita pizza with mushrooms and spinach

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

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

Salads

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

Grilled chicken salad

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

Kale chicken caesar salad

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

Salad Nicoise

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

Easy three bean salad

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

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

Sandwiches & Wraps – Serve with side of fruit

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

Chicken caesar wrap with lettuce and tomatoes.

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

Turkey and avocado sandwich on whole wheat.

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

Peanut butter and jelly sandwich, yogurt and fruit

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

Quesadilla

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

Burrito

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

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

Smoothies

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

Bowls

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

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

Salad Dressings

Basic balsamic vinaigrette

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

Lemon vinaigrette

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

Soy sesame dressing

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

Peanut dressing

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

Easy three bean salad with vinaigrette

For the salad:

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

For the dressing:

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

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

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

For the marinade:

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

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

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

Athlete’s Guide to Optimizing Bone Health

November 19, 2023March 5, 2023 by amystephens

Athlete’s guide to optimizing bone health

Why bone health matters

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

How bones are formed

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

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

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

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

Underfueling can lead to bone injuries

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

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

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

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

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

Risk factors for low bone mineral density (BMD)

Low testosterone (male athlete)

Amenorrhea (female athlete)

Inadequate calcium intake

Low Vitamin D levels

Eating disorder (past or present)

Dietary restrictions – vegan, gluten free, lactose free

Inadequate calorie intake

History of stress fracture

Sports at highest risk for bone stress injuries

Swimming

Diving

Crew

Cross country

Dance

Impact of the menstrual cycle on bone health

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

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

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

Birth control and bone density

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

How to improve bone health

Ensure adequate calories/energy balance.

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

Target the right amount of calcium and vitamin D

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

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

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

RDA

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

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

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

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

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

Sleep

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

Exercise loading to build bones

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

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

References

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

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

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

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

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

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

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

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

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

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

Amy Stephens