4/1/11

Race Nutrition

I hope you enjoy my latest article from the free Iron Girl Newsletter. Nothing makes me happier than writing and sharing my thoughts with my readers. Enjoy!


Race Day Nutrition
By Marni Sumbal



Nutrition can either make or break your race. Fortunately, nutritional fueling is one of the few things in a race day plan that is in your control. As for what's out of your control? You cannot control the terrain of the course, the weather, the number of registered athletes, what time the race will start and the port-o-john lines.



In addition to training, there are three important variables that can help you feel confident on race day.


1) You can control your racing plan. For example, how fast or slow you will race in order to preserve muscle glycogen. Based on the duration of the event, your goal is to race as efficiently as possible in order to conserve energy while controlling heart rate. Within your racing plan, you can also control what you wear. Dependent on the weather, it is important that you dress appropriately in an effort to control core body temperature throughout the day.



2) You can control your nutrition. What you consume on the days before, the morning of and throughout the race will affect how you perform on race day. When it comes to putting your training to the test, nothing is more important than the quality and quantity of training fuel. Experimentation and awareness of your body will allow you to feel confident when it comes to race day nutrition.



3) You can control your attitude. How well do you respond to stress and anxiety? How determined are you in meeting your race day goals. Are you the type of athlete that gives energy to others or takes it away?

Because there are no guarantees in racing, keep in mind that your goal is to not only prevent nutrition-related problems but to learn how to deal with them when they arise. Lastly, be realistic with your race day goals. Sadly, no amount of nutrition is going to allow you to run six-minute miles if you haven't trained your body to do so.

Happy racing!



Marni holds a Master of Science in Exercise Physiology, is a Certified Sports Nutritionist (CISSN) and holds a certification by the American Dietetic Association in Adult Weight Management. Marni is a Level-1 USAT Coach and is currently pursuing a registered dietitian degree. She is a 4x Ironman finisher and has qualified for the 2011 Ironman World Championship. Marni enjoys public speaking and writing, and she has several published articles in Lava Magazine, Hammer Endurance News, CosmoGirl magazine and Triathlete Magazine, and contributes monthly to IronGirl.com and Beginnertriathlete.com.
Any questions, Email trimarnicoaching@gmail.com

3/31/11

Leucine

There has been a lot of talk lately regarding leucine as a supplement. It seems like every journal I read has an article on the benefit of leucine in the diet.
Leucine is one of the three Branch Chain Amino Acids (BCAA's) - isoleucine and valine are the other two. There are 9 essential amino acids (can not be made in the body) and 11 non essential amino acids (made in the body). The beauty about the three BCAA's (essential AA's) is that they can be metabolized in the muscle, rather than in the liver (where most dietary protein is metabolized such as deamination and transamination of amino acids). Once protein is broken down into individual amino acids, the aminos are either used to build new proteins or to be burned as fuel for energy. After exercise (ex. recovery), it's most important that you properly refuel with protein and carbs, so that carbs and fats (primarily fats) can be used for resting energy expenditure, and BCAA's can be used for tissue repair. BCAA's are the most abundant amino acids in muscle tissue and make up 1/3 of the muscle. Therefore, because BCAA's are essential amino acids, it's important that we receive adequate amounts of these wonderful nutrients. However, more than anything, it's important that you don't deprive yourself of any macronutrient (carbs, protein and fat) so that you can create a balanced diet which encourages the use of food for fuel. Keep in mind that you will only sabotage your weight goals and exercise routine if you keep your body in a calorie deficit and neglect vital nutrients which aid in tissue repair, glycogen synthesis, immune system functioning and brain health. Additionally, overloading the body with too many calories at one time will also lessen the chance of performance gains and/or meeting weight and body composition goals.

Here is a great segment of the Staying Strong article from Nutrition Action April 2011
It's not just the amount, but the kind of protein that may matter for muscle building. Our bodies can make 11 of the 20 amino acids that are the building blocks of protein and therefore of muscle tissue. Since we have to rely on our food for the other nine, they're called "essential".
"Only the essential amino acids in food stimulate protein synthesis," says Katsanos. One of the nine-leucine - appears to be the most powerful for making protein.
Leucine is more than a building block of new protein.
"It is the key amino acid that drives the majority of the protein synthesis response," explains Drummon.
In a one-day study, older men who were given extra leucine synthesized more protein than those who didn't get extra leucine. In younger men, leucine didn't matter.
While researchers don't know exactly how much leucine is optimal, early research suggests that it may be around three grams per meal, says Drummond.
"The proteins riches in essential amino acids and leucine are the animal proteins, such as eggs, dairy, meat, poultry and fish," explains Paddon-Jones.
Whey protein, which makes up about 20% of the protein in milk (the rest is casein) , has the highest concentration of leucine compared to other proteins says Katsanos. That's one reason why whey, which is the byproduct of cheese-making, is the source of protein in many bodybuilding powders.
"plan proteins are okay, too," notes Elena Volpi. "But they have lesser amounts of leucine, so individually they may not be as efficient as animal proteins." The best of the vegetable proteins seems to be soy, she adds.
Just don't expect extra leucine to make you look like a bodybuilder.
When Dutch researchers gave 30 healthy older men either 7.5 grams of leucine or a placebo every day for three months, they saw no difference in muscle strength or mass. But the extra leucine may not have mattered because the men were getting enough protein -they averaged 83 grams per day from their food.

3/30/11

Hello world

Hi there...I'm still alive and doing well.
I'm about to finish my 1st of 4 weeks of staff relief and things are going better than expected. As I sit here writing this blog, I feel my heavy eyes attempting to close. My days are slammed-packed and I have a lot of responsibilities from 8am until 5 or 6pm.
I start my day looking at my unit and I print out my task list to see what patients I need to see for the day. I see patients based on Length of Stay (5 days in the hospital), database referrals (for wounds, eating problems >1 week, wt loss), RD nutrition consults (ex. failure to thrive, decubitis/ulcers, diet education, etc.) and clear liquid diets >5 days. I then make my list of patients to see which is typically around 8-10 patients. Because I am covering a unit for another dietitian, she would typically see my unit, in addition to two other units, so my 8-10 person task list (which takes 8-10 hours) is nothing compared to 15 or 20+ patients that the other dietitians see per day.
I then make my way upstairs and start my day by reviewing charts (physician orders and MD notes/progress notes, flow sheets) and the clipboards (which contain medications from the MAR, current flow sheets, the database and the skin sheet). It can often be a struggle to find and keep a chart when there are a dozen other people wanting your chart. The docs get the final say-so so I often have to turn over my charts when a doctor asks for my pt's chart. So when that happens, I stop what I am doing and try to find another chart for another patient.
Once I obtain the necessary info for the patient, I talk to the nurse to see how she/he has been eating and any other info that is necessary for my note. I then visit the patient to discuss specifics that will help my assessment/follow-up and to plan my interventions.
I will always ask about vomiting, diarrhea, constipation, diarrhea, any food allergies, current appetite (poor, fair or good), and difficulty chewing or swallowing and in the case of a follow-up, he the patient is tolerating tube feeding (typically the nurse tells me that) or supplements. I also ask about usual body weight, any recent weight loss/gain and anything else related to food, appetite and weight. Talking to the patients is my favorite part.
Often I have to gown up (with gloves) if the patient has MRSA or sepsis or another infection.

Once I gather my data I sit at the computer, look of the H&P to gather past medical history and the reason why the patient arrived at the hospital (I like that part as well, always an interesting story). I then look up labs (ex. hemoglobin, hematocrit, albumin/prealbumin, sodium, potassium, BUN, creatinine, A1C, glucose) and I am finally read to star my note.

I have a paper where I keep track of all the info so that I can properly type my note and address all issues.

I type my note on a program on the computer but I do my calculations (ex. figuring out estimated protein, calorie and fluid needs based on ht and wt as well as disease process, labs or tube feeding formulas) by hand on my paper. I have finally learned the proper lingo for an acute care dietitian (although I still get corrected here and there for better ways to saying things) and I feel much more confident with my interventions.

I can't believe how far I have come in the past 9 weeks at St. Vincent's Hospital and I have learned more than I have ever thought I would learn. This 3-year journey has been filled with lots of busy and exciting times but I have never felt so overwhelmed as I do right now. As stressful, time consuming and exhausting as it is to be in staff relief, taking the necessary steps to become a Registered Dietitian has been one of the best decisions in my life. I am so happy that I didn't postpone this decision for later in life and most of all, I am glad that I did the right thing to pursue the dietetic route in order to be qualified to give and prescribe nutrition advice.

3 more weeks to go...OMG, this is a super exciting time in my life and I can't believe it is finally coming to an end!!

Thanks for believing in me and for supporting me!

3/27/11

Staying Strong

I think we all have something in common. We love to exercise. If you don't love to exercise, perhaps you are working your way to a consistent and enjoyable fitness routine, valuable for your heart and health. It's understandable if you are slowly making changes with your diet, to include more heart-healthy and wholesome foods. Take it from me, it took me about 8 years of being an unhealthy vegetarian, followed by 4-5 more years of not understanding my needs as an endurance vegetarian athlete, to finally (5 years later) understand my individual needs and how I can properly fuel for workouts. Yep, that's right, I've been a vegetarian for almost 18 years now!!

I remember around the age of 14, being in World's Gym with my swim team, lifting weights and doing plyometrics/dry land. After 30-40 min of strength, we would run over to the YMCA (Lexington, KY where I grew up) and swim for 2 hours. We did this two days a week and swam a total of 9 times a week. When I was in college, strength training didn't end. It was another 3 days a week in the gym, running, outside on the soccer fields for circuits and dry land, in addition to the same number of swim practices. Looking back, I think my ability to some-what manage my triathlon lifestyle as a dietetic student/intern comes from not knowing any other way to live my life without some type of exercise on most days of the week. The only difference between now and grad school, college and high school is that I have a husband, dog and bills to pay AND I'm not sleep deprived (well, maybe a little).

There was a fabulous article in the April 2011 issue of Nutrition Action titled Staying Strong: How exercise and diet can help preserve your muscles.

I find strength training a vital component of any fitness program, especially for a triathlete trying to train for swim-bike-run. I find that when athletes begin to obsess about cardio (perhaps for the association of cardio = calories burned), injuries begin to occur when volume and intensity increases and certain muscle groups are weak and tight.
And when I speak of strength training, I believe there are different types of strength training that are vital in a year-round training plan. I have my athletes focus on strength and power in the off-season and gradually build into plyometrics, once the body is strong, flexible and functionally balanced. Once my athlete enters the peak phase of his/her training plan (strength being done in the off and beginning of build phase and plyo's in the middle and end of build), I incorporate more stability and functional strength exercises which focus on glute, hip, core and lower back strength. A pilates routine or jazzercise routine (think laying side leg lifts and glute press on all-fours) would be a great example of the "strength training" that is needed 2-3 days a week during the peak phase of a training routine. For without this type of strength training (and stretching) the key muscles that encourage hip flexor movements, may be neglected and other body parts begin to compensate, bringing on quad, groin, knee, itb pain. Not to mention an athlete being super tight (sitting too much or/and not stretching) and having weak muscles, but a strong heart that forces the body to do more work than it can handle.

I wish I could re-type the entire article from my magazine but I must spend the rest of my day studying and preparing for my first week of playing "RD" at the hospital as a clinical acute care dietitian. I will try to post pieces of the article in the next few days so you can enjoy the article as much as I did.

Here are a few great links to help you build strong muscles in the peak phase of your training:


http://stronglifts.com/how-to-optimize-posterior-chain-power-glute-activation/

http://sportsmedicine.about.com/od/strengthtraining/ss/Glute-Activation-.htm

http://exercise.about.com/od/lowerbodyworkouts/ss/onelegpressball.htm