Are NSAIDs Safe for Cartilage and Health?

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NSAIDsNSAIDs can help decrease inflammation and pain from musculoskeletal injuries, menstrual cramps, rheumatoid arthritis and more. However, they come with some major potential side effects.

NSAIDs can Destroy Cartilage

NSAIDs (non steroidal anti-inflammatory drugs) like ibuprofen (Advil) and indomethacin may speed up the breakdown of cartilage in osteoarthritic joints. They might also inhibit tissue repair. But, not all studies show NSAIDs damage cartilage. It may depend on the specific NSAID. The best study I’ve seen to date (and also published in a very reputable journal) found older adults (a group that commonly has osteoarthritis) who used NSAIDs including diclofenac, ibuprofen, naproxen, ketoprofen and piroxican for an extended period of time had higher risk of cartilage defects and nonsignificant loss of cartilage compared to nonusers.

Osteoarthritis is very common (athletes, older adults, those who are overweight, those who have been very active their whole life) and is “wear and tear” arthritis; symptoms include joint pain and stiffness.

If you have mild osteoarthritis look for other solutions including curcumin, glucosamine and chondroitin sulfate, and boswella serrata AKBA.

NSAIDs Can Lead to Major Side Effects:

In most cases the increase in risk is statistically significant but very small (see below in blue).

  • Increased risk of heart attack and stroke. Risk increases even with short term use (1 week) and increases more with higher doses of NSAIDs used for a longer period of time.

The increase in risk is about 20 – 50% higher if using NSAIDs vs. not using them. What does this mean? If you take NSAIDs the risk of heart attack is about 1% per year. 

Aspirin does not increase risk.

  • Heart attack and stroke risk is greatest in those who already have heart disease though people without heart disease are at risk.

“Patients treated w/ NSAIDs following a first heart attack were more likely to die in the first year after the heart attack compared to those not treated with NSAIDs” (FDA).

  • Increased risk of a bleeding ulcer in the stomach or intestines. Bleeding often comes without symptoms. Bleeding could lead to death. Risk increases in those who drink alcohol, smoke, take corticosteroids and anticoagulants, those who are older and people in poor health.
  • Kidney damage
  • Liver damage; very low risk
  • Anemia; when used for a prolonged time due to wearing of the stomach lining and therefore decreased absorption of iron and / or an increase in bleeding.
  • High blood pressure
  • Central nervous system issues headache, fatigue
  • Asthma attacks in those with asthma
  • Risk of bleeding
  • Hives

Safer Use of NSAIDs

Lower your risk of harmful side effects from NSAIDs by doing the following:

  • Take the lowest effective dose.
  • Take your NSAID for the shortest possible time.
  • Don’t take more than one NSAID at a time!
  • Find other solutions for pain (see my previous and upcoming posts, especially on Instagram).
  • If you notice any other symptoms including black tar like poop, skin rashes, stomach pain, yellow skin or eyes, nausea, feeling tired, swelling or vomiting, call your doctor ASAP.
  • Call 911 ASAP if you experience any heart attack, stroke or allergy symptoms including but not limited to shortness of breath, pain in chest, arm or neck; difficulty speaking, headache, blurred vision, droopy face, swelling in throat or face.

Tylenol may be a better option though it can cause liver damage if taken in doses > 4 g per day

NSAIDs (non-steroidal anti-inflammatory drugs) might be okay for very short-term use if you have:

  • No bleeding history
  • You are well hydrated, healthy and without renal issues.

Types of NSAIDs:

There are many different NSAIDs on the market and each one has a generic name and sometimes several trade names.

Types of NSAIDs

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Keep in mind, NSAIDs are not a long-term solution to pain. Also, most NSAID safety data is not from athletes.

References:
FDA
Br J Clin Pharmacol 2010;69(6):689-700.
Ther Clin Risk Manag 2015;11:1061-1075.
Eur J Rheumatol Inflamm 1993;13(1):7-16.
J Prolotherapy 2010;(2)1:305-322.
Arthritis Rheum 2005(52):3137-3142.
Inflammation 2002;26:139-142.
Am J Med 2009;122(9):836-842.
World J Gastroenterol 2010;16(45):5651–5661.

NSAIDs Can Help Decrease Inflammation and Pain but Impact Muscle Gains

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NSAIDs (non-steroidal anti-inflammatory drugs) including ibuprofen, naproxen, diclofenac, celecoxib and indomethacin can decrease pain. Take them for the shortest possible time as they can be harmful.

Should you use NSAIDs? If you must get back to work ASAP then consider the risks vs. benefits. Talk to your pharmacist and physician (MD).

NSAIDs can help decrease inflammation and pain

NSAIDs can Help Decrease Pain from:

  • Acute ligament sprain – use for < 5 days. NSAIDs reduce pain and swelling so you can return to activity faster.
  • Osteoarthritis (cartilage wear and tear)
  • Delayed onset muscle soreness. When taken for several days before muscle damaging exercise, NSAIDs may reduce soreness. Take with caution as they can wreck your strength gains (see below).
  • Muscle bruise (contusion). Short term use can decrease inflammation with no adverse effects on healing.
  • Tendonitis – reduces inflammation and helps recovery. NSAIDs may do more harm than good for chronic tendon issues.

How NSAIDs Impact your Strength Gains

  • Short-term low dose (400 mg ibuprofen) use may have no real impact on muscle strength or size.
  • Longer term, higher doses (1,200 mg ibuprofen) may compromise muscle growth and, when training was preformed with all-out max reps, strength gains were also compromised.
  • The elderly may benefit due to a decrease in inflammation from taking NSAIDs. Chronic inflammation, which is not uncommon in the elderly, impairs strength gains. NSAIDs help tame inflammation.
  • After muscle injuries, NSAIDs can help reduce strength loss, soreness and muscle markers of inflammation, particularly when lower body muscles are injured.

Why do NSAIDs Impact Training (Strength) Gains?

NSAIDs work by blocking COX enzymes. COX enzymes alter prostaglandin synthesis, mediators of inflammation and pain. Prostaglandins have other actions in the body including regulation of muscle protein metabolism. Decreases in the prostaglandin PGFare associated with decreased protein synthesis and reduced muscle fiber size. In one study, 1200 mg ibuprofen blocked protein synthesis after resistance training. Other studies show signaling responses in muscle are decreased for hours or days after resistance training when NSAIDs are used.

References:
Arthritis Res Ther 2013;15(Suppl 3):S2.
Annals of Phys and Rehab Med 2010;278-288.
Am J Sports Med 2004;32(8):1856-9.
Am J Physiol Endocrinol Metab 2002;282(3):E551-6.
Acta Physiol (Oxf) 2018;222(2).
J Physiol 2009;587(Pt 24): 5799-5800.
Am J Sports Med 2018;46(1):224-233.

 

Is Saturated Fat Good for You?

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Though largely driven by misinterpretation of the science and cherry-picked population studies, the “Butter is Back” movement comes with very persuasive sound bites followed by arrogant punctuation marks. No wonder so many people hopped on board the bandwagon while looking back, pointing fingers and shouting “health professionals have been misleading us for decades!” Yet the flawed reasoning behind the pro-saturated fat movement comes with a hefty price tag – you could be making food choices that, over time, will increase your risk for cardiovascular disease and type 2 diabetes.

Here’s what I’ll cover in this article:

  • Why is there so much confusion about saturated fat?;
  • The science behind saturated fats, cardiovascular disease (diseases of the heart & blood vessels) and type 2 diabetes;
  • Best food choices for heart health.

Why is there so Much Confusion about Saturated Fat?

There are a few reasons for the confusion about saturated fat (fat that is solid at room temperature such as butter, shortening, coconut oil and the fat on meat) and misinterpretation of the science. First off, some people group all saturated fatty acids (saturated fatty acids make up saturated fat) together as a team. However, there are several types of saturated fatty acids. Some raise LDL cholesterol (the kind that contributes to clogged arteries and is a risk factor for cardiovascular disease) as well as HDL cholesterol (“good” cholesterol, the kind that removes bad cholesterol; SN: drugs that increase HDL do not lower risk of heart disease so there is some considerable debate regarding the role of HDL), others don’t raise LDL cholesterol and some we aren’t quite sure about. Secondly, using population-based studies alone to draw conclusions about saturated fat intake and heart disease is misguided.  These studies are not designed to determine cause and effect (that’s the job of well-designed clinical trials) plus, there are inherent issues with the methods used in many of these studies.  Nutrition research is not easy, especially in humans living their life (those not in a metabolic ward where all factors are controlled and measured including diet and physical activity).

Lastly, some research studies (and the media) take the results way out of context. So, here’s the lowdown based on sound science:

The Science Behind Saturated Fat, Cardiovascular Disease and Type 2 Diabetes

  • There is no dietary requirement for saturated fat. Your body can make all of the saturated fatty acids it needs.
  • Foods high in saturated fat typically increase total, HDL and LDL cholesterol. However, the impact dietary saturated fat has on increasing LDL-cholesterol (the kind that contributes to clogged arteries and an inflammatory cascade in arteries) may depend on the amount of polyunsaturated fat (PUFAs) in your diet (as well as the type of saturated fatty acids consumed).
  • In general, replacing saturated fat with polyunsaturated fat (and monounsaturated fat though there is less evidence for monounsaturated fat) reduces LDL and total cholesterol, both risk factors for cardiovascular disease.
  • saturated fat and cholesterolOverweight, obesity and insulin resistance may reduce the beneficial effects (lowered LDL cholesterol) generally noticed from a reduction in saturated fat intake. *If obese or overweight, losing excess body fat (regardless of the type of diet used to lose the weight) has powerful effects on lowering risk for cardiovascular disease, some cancers, and type II diabetes.
  • Food contains a complex mixture of compounds that may affect cholesterol and cardiovascular disease risk (it is not just the fat). The food “matrix” matters.
  • Many factors impact how a food affects cholesterol and blood lipids (fats) including fats eaten at the same time, overall diet, and carbohydrate intake (and type of carbohydrates consumed – high fiber vs. foods high in added sugar with few other nutrients).
  • There are individual, genetic differences in response to saturated fat intake – your cholesterol might shoot up after eating a diet containing a diet high in the type of saturated fatty acids that raise LDL cholesterol and I might be able to get away with this diet without a problem (blame your genetics or consider it an opportunity to open your taste buds to foods containing less saturated fat; particularly the kind that is artery clogging).
  • Certain saturated fatty acids, or a diet high in saturated fat, may increase risk for type 2 diabetes.

Best Choices for Heart Health

If you are overweight, focus on losing excess body fat. Even small amounts of fat loss will improve health and risk factors for cardiovascular disease. If you have high total and LDL cholesterol, swap foods high in saturated fat for foods high in polyunsaturated fat (liquid oils, nuts, seeds, olives, avocados). Minimize your intake of foods high in added sugars and refined, white flour, carbohydrates. Instead, choose higher fiber carbohydrates as often as possible.

Don’t get sucked into the media headlines written by journalists who could sell ice to an eskimo. Butter isn’t back (for good health anyway). The bulk of your fat intake should still come from foods that are higher in polyunsaturated and monounsaturated fats. However, food is a complex matrix of compounds and therefore, some foods higher in saturated fat may have little to no impact on cholesterol and therefore fit into your diet while contributing to your vitamin and mineral needs and providing plant-based compounds important for good health.

References

Tholstrup T, Hoy CE, Andersen LN, Christensen RD, Sandstrom B. Does fat in milk, butter and cheese affect blood lipids and cholesterol differently? J Am Coll Nutr 2004;23:169–76.

Nestel P. Effects of Dairy Fats within Different Foods on Plasma Lipids. J Am Coll Clin Nutr 2008, 27(6): 735S–740S.

Hodson L, Skeaff CM, Chisholm WA. The effect of replacing dietary saturated fat with polyunsaturated or monounsaturated fat on plasma lipids in free-living young adults. Eur J Clin Nutr 2001; 55(10):908-15

Soerensen KV et al. Effect of dairy calcium from cheese and milk on fecal fat excretion, blood lipids, and appetite in young men. Am J Clin Nutr 2014;99(5):984-91.

 

The Truth about Detox Diets

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Detox Diets and Cleanses

Detox diets promise to clean up the mess left behind from daily life so you feel better, more energetic and lose excess body fat. Consider them the Merry Maids for your body. They come with an army of equipment and compounds to attack years of buildup from environmental toxins, pesticides, allergens, waste, and inflammatory substances. This “sewage sludge” is stuck to your gut, interfering with digestion, leaving you bloated, tired, fat and with joints and muscles that feel like they are on fire.

In theory this sounds great. But there’s one glaring issue. The human body doesn’t need to “detox” because it comes equipped with organs designed to remove waste products. Plus, many detox diets are simply very low calorie plans with added laxatives and diuretics (because instant, yet temporary, weight loss might fool you into believing the outrageous claims on detox and cleansing products). Instead of wasting your money, take the top 3 good points about many of these diets and incorporate them into your overall nutrition plan:

Drink More Water

There are a few studies showing that individuals who are obese can lose weight by drinking 2 glasses of water before each meal. Plus, many people don’t get enough water or total fluids each day anyway and dehydration can make you feel sluggish and grouchy. So, grab it from the tap or if it’s more convenient, fill up your stainless steal water bottles and carry them with you at all times.

Eat More Fruits and Vegetables

The average American is falling short on fruit and vegetable intake. According to the National Cancer Institute, people with diets rich in plant foods, such as fruits and vegetables, have a lower risk of getting some types of cancer as well as diabetes, heart disease and high blood pressure. Produce generally has fewer calories than many other foods making it a great addition to a weight loss diet.

Get Friendly with Bacteria

Many detox plans include unfiltered apple cider vinegar – the kind that has a cloudy appearance – is full of probiotics. Probiotics are friendly (beneficial) bacteria – the kind that live in your gut and have a number of important functions in your body. Improving your gut bacteria may support immune functioning, improve the health of your intestinal tract, increase your body’s absorption of certain nutrients and alleviate constipation. Apple cider vinegar is acidic so I don’t recommend drinking it straight. Instead, dilute it in a big glass of water or another beverage. Other great sources of probiotics include kefir, yogurt (check the container for “live and active cultures”), miso soup, tempeh, sauerkraut, kimchi.

Add 2 glasses of water before each meal, load up on vegetables and fruits and make an effort to consume probiotic-rich food daily and you will reap the rewards of better nutrition without wasting money on detox diets and cleanses.

References:
Parvez J et al. J Appl Microbio 2006;100(6):1171-1185.
Parretti HM et al. Obesity 2015, 23(8):1785-1791.
Dennis EA et al. Obesity 2010;18(2):300-307.

 

Which Fat is Best for Heart Health?

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Butter

If you are more confused than ever about dietary fats, you’re not alone. Can a high fat diet help you lose body fat? Which fat is best for heart health – butter, coconut oil or vegetable oil?

What is Cholesterol & Why is it Essential?
Cholesterol is an essential component of all cell membranes and a precursor to hormones, vitamin D and bile acids (needed for the digestion of fat). It is so important that your body regulates cholesterol balance to ensure your cells receive a continuous supply of cholesterol.

How does High LDL Contribute to Cardiovascular Disease?

Though cholesterol is critical for life, low density lipoprotein cholesterol, LDL cholesterol, is considered a risk factor for heart disease because excess LDL can lead to an increase in plaque buildup in your arteries. Think of this process like a garden hose with gunk stuck in it. The gunk interferes with water flowing through the hose. If too much debris gets in there, no water will flow through.  Likewise, plaque in your arteries will decrease the amount of blood that moves through your arteries at one time and a complete blockage could lead to a heart attack or stroke.  Now, this is a simplistic view, especially considering LDL isn’t just one particle but instead, several that contain different amounts of cholesterol. Some research suggests that smaller, more dense LDL particles are more artery clogging. However, in addition to particle size, total number of LDL particles and oxidation of LDL contribute to the disease process.

As LDL particles travel through the bloodstream, excess LDL particles can stick to artery walls (particularly walls that are damaged due to smoking, high blood pressure and other insults). Trapped LDL becomes oxidized and sets off an inflammatory cascade resulting in the development of plaque (gunk) stuck to arteries – atherosclerosis.

Coronary Artery Disease

How Can I Lower my LDL Cholesterol?

Cholesterol in food has little effect on your blood cholesterol.

Years ago we were told to stay away from shrimp, eggs and other high cholesterol foods. Yet this advice wasn’t based on sound science – cholesterol in food has little effect on your blood cholesterol levels. So there is no need to take these nutrient-rich foods out of your diet. Shrimp is loaded with protein, and is a good source of iron plus it contains just 80 calories per serving. Eggs are also packed with nutrition – the whites are an excellent source of protein and the yellow color you see in the yolk is from antioxidants – plant compounds that protect plants from disease and protect your body from the damaging effects of free radicals, compounds that are essential but can cause damage as well.

Coconut Oil, Butter and Other Solid Fats are Not the Best Options

Man-made trans fats (partially hydrogenated oils) are the worst kind of fat you can eat. However, they should, finally, be making their way out of our food supply over the next few years. High levels of *saturated fat, the kind that is solid at room temperature like butter, increases HDL (the “good” cholesterol but not a target of therapy – doctors don’t focus on HDL levels because increasing HDL does not lower heart disease risk) and LDL cholesterol in the blood. In controlled diet experiments where saturated fat is replaced with polyunsaturated fat rich vegetable oils, risk of heart disease is reduced. Replacing saturated fat with monounsaturated fat, the kind found in olive oil, also lowers LDL but not to the extent that polyunsaturated fat does.

Coconut oil is popular and calorie for calorie it might be better for weight management than other fats. However, coconut oil raises our total, good and bad cholesterol levels. And therefore, it is not the best option for heart health.

Excess Carbohydrate Intake can Increase LDL

Overconsumption of carbohydrate-rich foods can also increase VLDL cholesterol (very low density lipoprotein). Foods with added sugars, in particular, are potent stimulators of VLDL production when the energy (calories) aren’t needed right away for energy or increasing glycogen stores (stored carbohydrate in your liver and muscle).

Best Fats for Your Heart

Nuts, seeds, avocados, olives and liquid oils are your bets for heart health. Oils with more polyunsaturated fat have a greater impact on LDL cholesterol than those rich in monounsaturated fat. Make sure you are choosing the right oil for the right cooking application. Many oils can’t stand high heat and they break down, damaging the structure (and function) of the oil.

Fatty Acids in Oils

Conclusion

Many factors contribute to high blood cholesterol levels, including genetics, overweight/obesity, inactivity, smoking, diabetes and age, making cholesterol management a multifactorial issue. Saturated fat increases LDL cholesterol but, as I’ll say over and over, we are all different and, people vary in their response to dietary saturated fat due to intrinsic differences in fat metabolism as well as other factors including obesity, insulin resistance and high triglycerides.

Replace fats that raise cholesterol with liquid oils, nuts, seeds, avocados, and olives. Consider your overall diet as well. Eat a plant-based diet including vegetables (non-starchy veggies as well as beans, lentils and peas), fruits, nuts, seeds and whole grains (oats, barley etc.). Consume fatty fish ( salmon, mackerel, herring, halibut, sardines etc.) at least two times per week. Limit your intake of foods with added sugars and refined starches as well as your alcohol consumption. 

* There are differences in specific saturated fatty acids and their effects on blood cholesterol. Therefore, some foods high in saturated fat do not raise LDL cholesterol. Also, oils have a different array of vitamins (primarily vitamin E) and plant-based compounds that may be beneficial for heart health.

Fatty acids composition of oils taken from the USDA Nutrient Database.

Are Your Muscles Sore and Joints Hurting? Here’s What You Should be Eating

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When I first started cross country in high school I would go to sleep in a homemade pajama of Ben Gay slathered all over my sore legs. And then each morning at 5 am my sister would have to pry me out of bed for our newspaper route. As I threw one sore leg after the other off the bed I absolutely dreaded the thought of running, a necessary task since she made me go to the houses with the dogs that chased us and the sketchy places by the woods (I’m the youngest). If you too have tried Ben Gay, massage, ice packs or any other modality for trying to decrease muscle soreness and keep your joints moving, it’s time to fight exercise-induced inflammation through your diet.

Here’s what I’ll cover in this post (and as shared on Talk of Alabama this morning – see their website for more information):

  • The top two foods you need to decrease muscle soreness
  • Foods that keep your joints healthy

Talk of Alabama

Decreasing Muscle Soreness

When it comes to exercise, some inflammation is good and actually essential for muscle growth and repair. But, excess inflammation can lead to muscle cell damage and that feeling like you couldn’t possibly get off the couch for days. So, I recommend athletes include tart cherry juice into their regular nutrition regimen as a preventative measure. Research shows **tart cherry juice can help decrease exercise-induced muscle soreness and inflammation. Try it in a shake or check out my gelatin chews below.

Research from the University of Georgia found 2 grams of ginger, either fresh ginger or in spice form (they tested McCormick ginger), helps reduce muscle pain when consumed daily for 11 days prior to exercise testing. I have a few recipes below you might want to try. Also, check out Reed’s Ginger Brew (it is like ginger ale but made from real ginger with 17 grams per bottle!).

Keeping Your Joints Moving

Fatty fish including salmon, mackerel, herring, anchovies etc. contain long chain omega-3 fatty acids that have modest anti-inflammatory effects and have been shown to decrease cartilage breakdown (cartilage is like a sponge that cushions your joints so they can easily glide on top of one another) and inflammation in cell culture studies. In addition, research studies show these fatty acids can improve several symptoms associated with *rheumatoid arthritis and possibly even decrease the need for anti-inflammatory drugs. *Always talk to your physician if you have a disease such as rheumatoid arthritis.

Plus, there are two types of plant-based foods you should focus on. Foods rich in vitamin C including citrus, bell peppers, broccoli, strawberries, cauliflower, pineapple, kiwi. Vitamin C is necessary for repairing and maintaining cartilage and higher intakes are associated with less severe cartilage breakdown. In addition to vitamin C, yellow and orange fruits and vegetables contain an antioxidant that may improve bone formation and decrease bone breakdown. And finally, ginger is also effective for reducing joint pain though you have to consume it regularly over several weeks (500 mg ginger extract was used). 

Cherry Ginger Smoothie

Ingredients
8 oz. vanilla soymilk
1 scoop unflavored or vanilla whey protein (if using unflavored you may need to add a sweetener)
½ cup frozen tart cherries
2 tsp. (or more if desired) fresh cut ginger
Ice as desired

Directions
Add vanilla soymilk to blender followed by the rest of the ingredients in order. Blend until smooth.

Honey Ginger Salmon

Ingredients
4 salmon fillets (4-6 oz. each)
2 tsp. finely grated fresh ginger or 1 tsp. ginger spice
3 Tbsp. honey
2 tsp. olive oil
¼ cup soy sauce

Directions
Mix all ingredients except salmon in a bowl. Place marinade and salmon in large resealable plastic bag so that marinade coats salmon fillets. Refrigerate for 30 minutes or longer. Remove salmon fillets and grill 6 to 8 minutes per side or bake at 350°F for 15-20 minutes.

Fig Cherry Ginger Chews

Ingredients
13 dried figs
1/2 cup dried tart cherries
3 tsp finely grated fresh ginger

Directions:
Place all ingredients in a food processor and mix throughly. Take small portions out and make small balls. If you want them even sweeter, roll finished balls in cane sugar or powdered coconut sugar.

Tart Cherry Gelatin

Ingredients
2 packets gelatin mix
2 cups tart cherry juice
3 tsp fresh ginger

Directions
Boil 1.5 cups tart cherry juice. While juice is boiling place remaining 1/2 tart cherry juice in a bowl and mix in gelatin packets. Let sit for at least one minute. When juice is finished boiling mix it into juice & gelatin mixture until throughly blended. Add 3 tsp. fresh grated ginger and 1 – 2 Tbsp. sugar if desired. Place mixture in an 8×8 pan and refrigerate for at least one hour. Remove from refrigerator and enjoy!

** TV segment, but not post, sponsored by the Cherry Marketing Institute

Help Dry Eyes with Better Nutrition

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Tears protect your eyes from dust, infections and pollution. And therefore, those with chronic dry eye, caused by either a decrease in tear production (the prescription drug Restasis helps this) or tears that evaporate too quickly, may notice their eyes are frequently so dry they hurt, sting or feel gritty. In addition, chronic dry eye can lead to blurred vision, heightened sensitivity to light or smoke/pollution, excessive tearing, or like someone took sandpaper and rubbed it on them. There are a number of causes of chronic dry eye including Lasik surgery, thyroid disorders, and certain autoimmune diseases (including Sjogren’s syndrome, which causes drying of the mucus membranes including the eyes, mouth and sinuses). If left untreated chronic dry eye can lead to irritation, inflammation, blurred vision, increased risk of developing an eye infection, and scarring of the cornea.

How can you soothe chronic dry eyes? Follow these steps:

  • First and foremost – see an ophthalmologist.
  • Drink plenty of fluid every day.
  • Eat fatty fish at least twice per week or consider a fish oil supplement (always tell your physician about any dietary supplements you are taking). I typically recommend at least 1 gram of EPA + DHA combined (check the label to see how much EPA and DHA the product contains per serving; EPA and DHA are the omega 3 fatty acids found in fish). Two grams decreases inflammation throughout the body.
  • Consider caffeine in moderation. One study found that caffeine may help increase tear production.
  • Cut down on antihistamine use if possible. Allegra, Zyrtec and other antihistamines can increase dryness. Decongestants also increase dry eye so weigh the benefits versus side effects before using them.
  • Use eye drops for dry eyes (not those for redness).
  • Put warm compresses on your eyes for 10-15 minutes at a time.
  • Cut down on diuretics unless they are prescribed by your physician.
  • Talk to your physician about all of your medications. Certain blood pressure drugs, birth control pills and other prescription medications can increase dryness.
  • Take breaks from the computer, TV, iPad and other electronics. Starring at these for hours may further decrease tear production.

Pre-Workout and Post-Workout Meal Ideas

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You’ve seen them. The people who faithfully go to the gym day after day and spend quality time on the cardio equipment and in the weight room. Yet their bodies never seem to make any visible changes. They are training. But they aren’t training smart with a plan that is specifically designed to meet their goals, lifestyle and current state of conditioning. A plan that helps them progress and not just maintain. But, even with the best training program, a person’s progress will be limited if they don’t eat a diet that provides the energy they need while also facilitating training adaptations and helping improve recovery. And though eating well means choosing nutrient-dense foods 90 – 95% of the time, the most important meals for an athlete are pre- and post-workout:

Pre-workout:

In order to sustain your energy levels through your workouts, your body needs food. If you have just 2 hours before you hit the gym, track or field, opt for a lighter snack. Four hours beforehand, opt for meal that is higher in carbohydrate, contains some protein for staying power and is low in fiber and fat (both slow digestion and who wants their stomach busy digesting food when they are about to run sprints?). Lastly, don’t try something new before workouts that may make you a little queasy. For example, spicy food can give you heartburn and greasy food may make you sick to your stomach. Think familiar and easy-to-digest.

Half a cantaloupe with cottage cheese

Snack examples:

  • Cottage cheese and fruit
  • Banana spread lightly with almond butter or peanut butter
  • Yogurt
  • Granola bar
  • Pancakes or waffles

Post-workout:

The main purpose of eating after you workout is to turn a catabolic environment into an anabolic one. In other words – your post-workout meal will facilitate the processes underlying muscle growth, re-hydrate, help curb excess inflammation and restore muscle glycogen. In addition to improving recovery, your post workout meal will help you make training gains.

Post-workout meal ideas:

  • Protein pancakes (Simply pancake mix with added protein powder.)
  • Protein shake
  • Low fat chocolate milk (you’ll need more protein than this if you are lifting weights)
  • Bagel, bread or pita with melted cheese
  • Tunafish or turkey sandwich

Eat so you can train well, don’t hit the gym or run a few extra miles as an excuse to eat more food that doesn’t fit in your training program.

Written by: Rachel Rosenthal & Marie Spano

Post Workout Nutrition – what do you really need?

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Are you confused about what to consume post workout? RD-to-be Sara Shipley breaks down the basics and provides excellent suggestions for post workout nutrition:

We’ve heard it all before: “You need protein after a workout!”

But why? And how much? Will two scoops of any protein powder in your morning smoothie cover all of your bases? Maybe, but here’s what else you need to know about properly refueling and repairing your muscles so you can get back to your life and get ready for tomorrow’s workout.

After strenuous activity our muscle tissue is damaged (this is normal) and our glycogen (carbohydrate stored in our muscle) is depleted. And, depending on how much fluid you consumed while exercising, you may also need to replace a good amount of fluid lost through sweat (and possibly electrolytes too). The right combination of protein, carbohydrate and fluids consumed post-workout will help your muscles recover faster with less soreness and fatigue. Here’s a breakdown on how much you should take:

Protein will help your muscles repair and build new muscle tissue (especially after a bout of resistance training). You can consume protein rich foods or sports supplements for convenience. However, you should aim for a minimum of 25 grams after resistance training (lifting weights for instance) and at least 10 grams after endurance training. If you are choosing food-based sources of protein opt for lean, high quality protein such as egg whites, skinless chicken, turkey breast, 1% cottage cheese, low-fat yogurt.

Carbohydrate is the fuel that powers your workouts. Your body’s stores of carbohydrate, in the form of glycogen, last about 2 hours (less if you are exercising very intensely). And, we now that athletic performance suffers when our carbohydrate stores become depleted. Therefore, carbs post-workout are vital to replacing glycogen stores. Aim for at least 60-75 grams or more. Bagels, pretzels and pasta are all good bets. If you aren’t hungry, try liquid carbs in the form of a sports drink or flavored milk.

Hydration and electrolytes are lost through sweat. And, drinking during your workout may seem like a no brainer, but sometimes you can’t quite makeup for your fluid losses through sweat. If your workout was intense, you need to replace electrolytes (primarily sodium) lost through sweat as well (especially if you are a salty sweater as evidenced by white salt crystals on your face, ears or neck). Sports drinks are a great way to re-hydrate or you can opt for other hydrating beverages (water, juice, milk) consumed in combination with salty foods.

Another thought to consider: post-workout inflammation. Some inflammation is good but too much inflammation may slow the recovery process. So, choose foods that may help combat inflammation including tart cherry juice (or eat cherries), mango, fresh pineapple whey protein and deeply colored fruits and vegetables.

Some of my favorite post-workout foods:

  • chocolate milk
  • eggs on a toasted whole wheat English muffin, with a sprinkle of cheese
  • cottage cheese with sliced cherry tomatoes and whole grain pretzels
  • Greek yogurt with blueberries and whole grain granola
  • soup with grilled cheese (bonus – great for replacing sodium!)
  • skinless grilled chicken and wholegrain brown rice
  • whole grain pita filled with hummus, grilled veggies and a dollop of plain yogurt, paired with a large glass of milk
  • Clif or Luna bar
  • Sports drink
  • Smoothie made with whey protein, any mix of berries, skim milk and ice (you can also add mango or pineapple)

 

 

 

Post-Workout Power Smoothie

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Many people eat the same 25-30 foods each week. And, one of my favorites is this super easy post-workout smoothie. I typically don’t feel like eating right away after training but know that I have a 30 minute window of opportunity to replace the carbohydrate stores in my muscle tissue (glycogen) and boost muscle growth and repair.

So, I created this shake with tasty, functional ingredients that refuel my body, build and repair muscle and provide antioxidants to help tame muscle tissue inflammation. Here are the ingredients and the benefits each one provides below the recipe:

Power Smoothie

Ingredients

  • 8 oz milk (whole if you need to gain weight, otherwise choose skim, 1 or 2%)
  • 1 scoop protein powder (containing at least 20 grams whey protein)
  • 3-4 chunks of frozen mango
  • 1/3 cup frozen mixed berries
  • ginger root, shaved (if you don’t shave it you may break a cheap blender 😉

Directions

Mix, add ice if desired.

Rationale for each ingredient:

  • milk – calcium, vitamin D & magnesium all play roles in muscle functioning and bone health; plus milk is a great source of quality protein
  • protein powder – whey contains the optimal amount of specific amino acids you need for muscle tissue growth and repair
  • mango – in addition to making your shake thick like a milkshake, mango may help combat inflammation
  • red, blue and purple berries contain antioxidant flavonoids that may attenuate inflammation, limit tissue breakdown and improve circulation while promoting a nice strong collagen matrix
  • ginger –  research out of the University of Georgia found that 2 grams of ginger per day can help reduce exercise-induced muscle pain.
Looking for more great Summertime beverages? Check these recipes out from my colleagues: