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Sugar and Sodium

It's Friday and I love my new credentials behind my name. I will never forget the hard work that was put forth in order to become Marni Sumbal, MS, RD and I am enjoying every day and the emails, questions and comments that come my way.
I recently accepted a PRN position at Baptist Beaches Hospital and I am really looking forward to learning more in the acute care setting, specifically dealing with the clinical side of dietetics. While the position doesn't provide me with a lot of weekly hours, I am very blessed that I was given the opportunity to interview (prior to becoming a RD) and get accepted for the job (after I passed my exam) as there are very few open job positions in the Jacksonville, FL area.
I found this quote today and thought it was very appropriate:
“We tend to forget that happiness doesn't come as a result of getting something we don't have, but rather of recognizing and appreciating what we do have.”

I had two triathletes contact me for questions regarding to sodium and sugar. My good friend Ange (angesdrivetotri.blogspot.com) was my very first athlete by which I helped her with her nutrition, back in 2006. She has excelled in so many ways, both in her personal life and with training/racing and she is an amazing mother of 3 boys as well as a dedicated wife. She posts great blogs about her training and daily life and how she balances it all with a great attitude. What I also enjoy is that she is a planner and really thinks through things, even if she makes a mistake here and there with training. There is nothing better than an athlete that learns from his/her mistakes rather than feeling like a failure. As we are all athletes/fitness enthusiasts, reaching for a goal, it is important that we find ways in our life (nutrition, exercise and personal life) to move forward, becoming stronger, healthier and smarter for the future.

Ange asked me to review her hydration concerns with her last big block prior to IM Lake Placid and I wanted to share my response as it may help out other athletes who are confused with sodium surrounding training.

Hey Ange!
Thanks for reaching out to me. First off, you are doing so many great things with your training. Preparing is the biggest thing you can do to improve performance. Don't count yourself out for the next 2 weeks as this was a learning opportunity. Race day is about putting all the training sessions to the test..not just one workout.
Here are my thoughts. I think that you overhydrated on water before the run. I think it was great that your coach had you bike before the run as I am a big fan of warming up the legs before a long run. With good daily hydration status, it is likely that you will go into the run well hydrated with 1 bottle of your sport drink (1 scoop) and to sip on that every 10-15 min.I also encourage being consistent with gels as well (taking a little bit every 10-15 minutes rather than 1 gel every 30-40 min). For athletes training in the summer, over an hour (or running off the bike), I suggest just sticking with sport drinks. It can be really easy to guzzle water which can lead to overhydration/hyponatremia in excess. Because we need both calories and liquids during workouts, liquid calories will meet both requirements. As for having too much sodium during workouts, our diet contains plenty of sodium for hot workouts (unless you consume a raw diet), thanks to processed food. Table salt is only 40% sodium and 60% chloride but 1 tsp. of table salt contains 1,500 mg of sodium. It's super easy to meet daily recommendations (i don't count training calories into daily calories). I wouldn't be too concerned about salt in the diet but rather getting in a wide spectrum of electrolyts. Although sodium is essential in small quantities, in order to maintain fluid balance and control the contraction and relaxation of muscles, during and post workout we want to focus on sodium, potassium, chloride, calcium and magnesium. As far as exercising in the heat, you are depleting both sodium and electrolyte stores when sweating. The concern with a high sodium diet (or high sodium intake during or after exercise) is that sodium will accumulate in the blood if the kidneys cannot regulate the amount of sodium in the body. When sodium levels are high, the kidneys excrete sodium in the urine and then sodium levels are low, the kidneys conserve sodium. In the case of sodium-loading before and during exercise, blood volume increases to sodium’s attraction to water. As blood volume increases, the heart pumps harder to circulate blood throughout the body thus increasing the pressure in the arteries. ALl of this combined can make you feel weezy and lightheaded. Although the body can regulate itself to get into a balanced state (in your case, you likely depleted your sodium levels from drinking too much water and then trying to take in gels and sport drinks to maintain energy which made you feel extremely lethargic and likely confused), focus on fruits post workout (in your protein post workout smoothie) in addition to consuming sport drinks during exercise. You can get all of your vitamins and minerals from a plant-based, balanced diet but a daily Multi Vitamin is good health insurance as well. Also, listen to your body so if it wants pretzels after a workout, eat them. You will be just fine :)


Another friend and triathlete in the Jacksonville area asked me about yogurt after I shared a link for an article on yogurt on facebook:
http://www.floridatoday.com/article/20110707/LIFE/107070305/Tips-how-pick-healthiest-kind-yogurt
I also shared an article on milk that was a great read:
http://www.msnbc.msn.com/id/43672735/ns/health-diet_and_nutrition/

Here question was as followed:
What yogurts do you recommend Marni? I like Stoneyfield Farms lowfat Vanilla and Strawberry because they don't taste as sweet as some of others and have the active cultures and plain non-fat greek yogurt with fresh fruit or a little honey and walnuts. Article did not give any guidance on grams of sugar.

My response:
Since I believe in emphasizing foods with little to no ingredients, I recommend a yogurt that has 1 main ingredient - cultured milk. They may add pectin (gelling agent made from plant cells) or vitamin D. As for many yogurts, added sugars ...will be added so it's best to check the label. Greek yogurt 0% and Dannon Natural Plain are my two top choices in our house and we sweeten them just like you - with nuts, fruit, honey or whole grain cereals.
Food labels are not required to list how much is "added sugar" so when you check labels for all foods, you can simply tell if a food has added sugar by reading the ingredients. Recommendations are 25 grams a day (around 100 calories or 6 tsp) for women and around 35 grams a day for men (around 150 calories or 9 tsp) of ADDED sugar. Because dairy contains Lactose, which is a natural sugar (disaccharide), you will notice 11-13grams of sugar on most food labels for milk but no "sugar" has been added. In contrast you may find added sugar in chocolate milk (like yoohoo) may have 20-30+grams sugar (and a long list of ingredients).
manufactures will try to trick you and put things like organic sugar, raw sugar, cane sugar/juice, brown sugar, dextrose, fructose (or High fructose corn syrup), but all sugar is similar to white sugar in terms of calories and sugar-content. I am not an encourager of sweeteners in the diet so if you need to add sweetness to something, just add a tsp of sugar (15 calories).
Does this all make sense? Hope I helped.


Please let me know if you have any questions and feel free to share your thoughts/experiences with any of the above information.