THEME: NUTRITION

Clearing UpCommonNutritionMyths

by Janet Walberg Rankin, Ph.D., FACSM

Who hasn’t been confused by conflictingreports about what to eat? Let’s take a look atrecent scientific evidence to clear up five verycommon nutrition myths.

Myth 1: Calcium willguarantee strong bones.

Most adults should consume between 1000-1300 mg of calcium per day in order topromote good health, including bone health.However, even this level of calcium intakeshould not be considered an insurance policyagainst bone loss. Exercise, hormones andvitamin D are major contributors to bonehealth. Some believe that most people don’tneed to worry about vitamin D because ourskin naturally produces it after sun exposure.However, recent research broke this myth wideopen.

Growing evidence of the importance ofvitamin D led some scientists to propose thatwe triple the previously recommended 400 IU(international unit) daily amount of vitamin D.Experts at the Institute of Medicine (IOM)recently took on this volatile topic to develop aconsensus. In Dec. 2010, the IOM report onvitamin D and calcium bumped therecommended vitamin D intake to 600 IU perday for children and adults and up to 800 IUper day for those over 71 years. Over-supplementing, defined as an intake greaterthan 4000 IU, can damage kidneys andcontribute to kidney stones, so experts cautionagainst consuming too much calcium.

Myth 2: Low-carb diets arethe best for weight loss.

Several large-scale studies have comparedpopular weight loss diets head-to-head, andnone of the diets emerged as the clear winner.This may be partly due to the fact thatalthough people adhere carefully to therestrictions initially, they digress toward oldeating habits over time. The boring conclusionis that the people who adhere most closely tothe diet recommendations are most successfulin their weight loss, regardless of which dietthey follow.

When health factors other than weight loss aremeasured, most studies report the greatestreduction in blood triglycerides for low-carbdiets and the greatest reduction in bloodcholesterol levels for low-fat diets. Althoughmy professional opinion holds to a low-fat dietrich in fruits, vegetables and whole grains asthe best for weight loss, I would consideragreeing to a low-carb diet for someone whoprefers this, as long as they agree to carefulmonitoring of their micronutrient intake andblood cholesterol levels.

Myth 3: Water is just asgood as a sports drink forathletes.

This myth needs clarification. Although wateris a good hydrator for most people under most

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A m e r i c A n c o l l e g e o f S p o r t S m e d i c i n e

AcSm Fit Society® pAge

Letter from the Editorby Dixie L. Thompson, Ph.D., FACSM

Welcome to the spring 2011 edition of theACSM Fit Society® Page, sponsored byLiberty Mutual. Physical activity andnutrition are both critical components of theenergy balance equation, and this issue isdedicated entirely to nutrition. This issuewill help you clear up common nutritionmyths, find simple ways to eat healthy on abudget, derive essential nutrients from avegetarian or vegan diet, keep yourself fueledduring endurance exercise and select theappropriate dietary supplements for yourunique needs. We hope these articles equipyou with the knowledge you need to makesmart choices about what you eat.

Please look over this information that ACSMexperts have prepared for you, share it withfriends and family, and enjoy the fitnessopportunities afforded by good nutrition.

Dixie L. Thompson, Ph.D., FACSM

Editor, ACSM Fit Society® Page

Email: dixielee@utk.edu

To subscribe to the ACSM Fit Society® Page,please send an email to publicinfo@acsm.org.

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Spring 2011

I N S I D E T H I S I S S U E :1 | Letter from the Editor1 | Clearing Up Common Nutrition Myths2 | Q&A with ACSM3 | Top 10 Simple Ways to Eat Healthy on a Budget

4 | Deriving Essential Nutrients from Vegetarian andVegan Diets

5 | Preventing the “Low-Fuel Light” in Endurance Exercise5 | Dietary Supplements for Aging: A Fountain of Youth or

Deluge of Dollars?7 | The Athlete’s Kitchen

ACSM Fit Society® Page Editorial Board:Dixie L. Thompson, Ph.D., FACSM, Editor

University of TennesseeThomas S. Altena, Ed.D.

Southwest Missouri State UniversityKatherine A. Beals, Ph.D., R.D., FACSM

University of UtahDawn Coe, Ph.D.

University of TennesseeJessica Ellis, M.D.

Orthopaedic and Rheumatology AssociatesKate A. Heelan, Ph.D., FACSM

University of Nebraska-KearneyCherilyn Hultquist, Ph.D.

Kennesaw State UniversityGerald Jerome, Ph.D.

Towson UniversityAnthony C. Luke, M.D., M.P.H., FACSM

University of California, San FranciscoLynn Millar, Ph.D., FACSM

Andrews University

ACSM is the world’s largest association devoted tosports medicine and exercise science. ACSM advances andintegrates scientific research to provide educational andpractical applications of exercise science and sportsmedicine.

Permission to reprint material from this publication isgranted by ACSM contingent upon manuscripts beingreprinted in total without alteration and on proper creditgiven to ACSM by citing ACSM Fit Society® Page, issue andpage number; e.g., “Reprinted with permission of theAmerican College of Sports Medicine, ACSM Fit Society®

Page, Spring 2011, p. 3.”

conditions, athletes are anything but typical.Highly competitive athletes may experiencesignificant reduction of glycogen stores anddehydration during an intense, prolongedcompetition or workout. Sports drinksprovide carbohydrate as well as theelectrolytes and fluid that replenish criticalenergy reserves and delay fatigue. I believe ifexercise is less than an hour, or of onlymoderate intensity, water is sufficient. High-intensity, longer performance may beimproved by regular consumption of a sportsdrink.

Myth 4: I eat only 1,200calories per day, but I can’tlose weight.

Few people are good at estimating portionsizes of their food. This can cause them tounderestimate their true calorie intake. Forexample, a USDA study found that theaverage baked potato is 2.5 times the defined

serving size. So, using the food table caloriesfor one potato may substantiallyunderestimate actual intake. Alternatively,maybe you only ate 1,200 calories one day,but you splurged the next with 2,500 calories.It is difficult to accurately determine howmany calories you should consume each dayto lose weight (it’s best to consult a dietitian),but you can get a rough estimate of your dailygoal by multiplying your weight in kilogramsby 35 and subtracting 500-600 calories.

Myth 5: Avoid coffee.This is my personal favorite myth, as I amrarely seen first thing in the morning withoutmy coffee. Recent research does not vilifycoffee; rather, it finds health benefits inconsuming this brew. Coffee consumption hasbeen associated in some research studies withlower risk of diabetes, stroke and Parkinson’sdisease. In fact, one recent study of more than86,000 nurses reported that the risk of dying

was 26 percent lower among those who drankfour to five cups of coffee per day comparedto those who abstained. People with heart orsleep problems, or women who are pregnant,should consult their doctor first, but most ofus can drink our morning coffee withoutworry.

So, why do we get conflicting messages aboutnutrition? Scientists are a naturally skepticalbunch who continually question “truths” to besure they are correct. One must look for theconsensus out of the many research studies.Since most of us can’t put the time intoreading all that research, one of the best waysis to use good online sources likeNutrition.gov or the USDA NationalAgriculture Library. You can also talk to adietitian. Either way, rely on the experts to siftthrough the latest claims and scientificdiscoveries to steer you down the right path.

Q&Aby Anthony Luke, M.D., FACSM

Q: I’ve heard of athletes drinking chocolate milk for recovery. Is this for real?

A: Chocolate milk has been shown to be effective as a recovery beverage following a period ofincreased training. During long bouts of exercise, an athlete’s energy stores (known as glycogen) canget depleted. Chocolate milk is rich in high-quality protein and carbohydrates. Drinking a beveragelike chocolate milk, which has more carbohydrates and proteins than water or some sports drinks,may improve recovery because it increases muscle glycogen storage as well as replenishes fluids.

In a recent study of cyclists riding twice with a recovery period of two hours between rides, athleteswho drank chocolate milk performed better than those who did not. Similarly, a recent study ofsoccer players showed lower markers of muscle damage (creatine kinase) in athletes who drankchocolate milk as opposed to a recovery beverage with similar calories. Milk also has the benefits ofcalcium, potassium and magnesium, which can be helpful for athletes. Low-fat chocolate milk canbe a good recovery drink for athletes.

Q: I’m a female runner in my 30s, and I run regularly. What do I need to consider forvitamin and mineral supplements? Do I really need them?

A: Athletes are commonly low in vitamins and minerals such as calcium, vitamin D, the B vitamins,iron, zinc, magnesium and some antioxidants, such as vitamins C, E, A-carotene and selenium.Calcium, vitamin D and iron are particularly important for women. ACSM’s updated Position Standon Nutrition and Athletic Performance recommends that, “Vitamin and mineral supplements are notfelt to be needed if an athlete has adequate dietary intake from a variety of foods to supply energyand maintain body weight. However, athletes who are at risk for nutritional issues, including thosewho restrict energy intake, use severe weight-loss practices, eliminate one or more food groups fromtheir diet, or consume unbalanced diets with low micronutrient density, may require supplements.”In the end, a healthy diet is still the best solution for making sure your body gets the nutrients itneeds.

Q: Is kale a new superfood?

A: Kale is a leafy green vegetable in the cabbage, broccoli and cauliflower family. There are nutrientsin kale that have powerful antioxidant and possible anti-inflammatory properties. Kale hassulforaphane, which is thought to have potent anti-cancer effects. Kale is also rich in beta-carotene,vitamin K, vitamin C, lutein and zeaxanthin, and it contains some calcium. More than 45 flavonoids

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THEME: NUTRITION

Top 10Simple Waysto Eat Healthyon a Budget

by Stacy Mitchell, R.D., L.D.

Healthy and inexpensive? Many people don’tthink these words belong in the samesentence. Simple, smart planning with yourfood can make it happen every week.Prioritize the foods in your diet, and go fornutrient-dense foods first, such as fruits,vegetables, whole grains, lean protein andlow-fat dairy. Cut the junk out of the grocerycart, as you get the biggest bang for your buckwith healthier foods.

Eating healthy won’t cost a fortune if youfollow these ten simple tips:

1. Shop the weekly ad.Shopping the sale advertisement from yourlocal grocery store is the first step to stretchingthe food dollar the healthy way. Take sometime to plan weekly meals using healthier aditems.

2. Embrace seasonal freshproduce.Fresh fruits and vegetables in season are notonly a great buy in the weekly ad but they arealso at their peak flavor. Pick a new fruit orvegetable each week to add some variety.

3. Plan a meatless Monday.The largest food dollar in the meal comes fromthe protein source. Substituting a lower-costprotein can save $10 to $20 per week. Trybeans, eggs, nut butters or even cheese in yourMonday meal.

4. Stretch your meat withbeans.Another way to save some money in theprotein department is to substitute a can ofbeans, or two cups of dried beans, for everyhalf pound of ground meat. For example, addone can of mashed black beans to a halfpound of ground beef. Add taco seasoningand sauce to the dish, and your family willnever know your little secret!

5. Go for store brands.Private labels can save you an average of 15-25 percent over the national name brand.Find some especially great savings in the graingroup with private labels—go for 100 percentwhole wheat or whole grain for best nutrition.

6. Find fruits and veggies atthe salad bar.The goal is always adding more fruits andvegetables to daily meals, but it can be difficultto keep produce fresh if you are buying forjust one or two people. To avoid wasting food,take a look at the salad bar and buy perpound. Pick up your favorite veggies, andpurchase only what you will actually eat.Some stores even have some pre-packagedveggies in snack-size bags for less than onedollar! These are perfect for a lunch bag orsnack.

7. Don’t forget frozenveggies.Frozen vegetables are a staple to any meal.From broccoli to spinach, frozen veggies areloaded with antioxidants and essentialnutrients, and they can be added to yourfavorite pasta dish or soup in a snap. Look forprivate labels for only a few dollars per largebag.

8. Get back to basics.Skip the packaged meal kits, and make yourmeal from scratch! Don’t worry—it can still besimple to put a meal together. Instead ofbuying a box of Hamburger Helper, purchasewhole grain noodles, sauce and a can of fire-roasted, low-sodium diced tomatoes. You’llsave up to a dollar per serving and up to 500milligrams of sodium. Packaged items areloaded with sodium—watch out!

9. Reduce fat in groundbeef.Eighty-five percent lean ground beef can stillbe a part of the grocery list, but make sureyou drain excess fat from the beef crumblesfor a healthier option. One study by theAmerican Dietetic Association found thatsimply rinsing cooked beef crumbles with hotwater and patting excess fat with a papertowel can reduce the fat content of cookedground beef by as much as 50 percent! (If youhave to follow a low-fat diet, 90 percent leanbeef is still recommended.)

10. Eat more meals fromhome.

Something as simple as eating at home canreally add up to big savings. Plus, you cancook once and serve twice by using leftoveringredients for lunch the next day.

Don’t let your budget be a barrier to eatinghealthy. These ten simple steps are just a fewways that you can eat healthy on a budget.

ACSM Fit Society® Page • A Quarterly Publication of the American College of Sports Medicine • www.acsm.org • Spring 2011 Page 3

THEME: NUTRITION

DerivingEssentialNutrientsfromVegetarianand VeganDiets

by Pamela S. Hinton, Ph.D.

A vegetarian is someone who does not eatmeat, poultry or fish, although self-describedvegetarians come in many forms. Some eatfish, but not meat or poultry (semi-vegetarians). Some eat dairy products and eggs(lacto-ovo vegetarians). Some eat only plant-based foods (vegans).

There are many reasons people adopt a plant-based diet, such as economic reasons, religiousbeliefs or concerns for personal health, theenvironment or animal welfare. Regardless ofthe motivation for choosing this diet,vegetarians can be healthier than theiromnivorous counterparts. However, by noteating animal foods, vegetarians eliminateprime sources of protein, n-3 fats DHA andEPA, iron, zinc, calcium and vitamins D andB12 from their diets. These potential deficitscan be overcome with some careful planningand wise food choices.

Dietary protein is broken down into itsessential elements, amino acids, which thebody uses as building blocks to make newproteins. Animal-based proteins contain theessential amino acids needed for proteinsynthesis, and they are considered “complete”or “high-quality” proteins. Although legumes,grains, nuts and seeds contain protein, they donot provide the ideal mix of amino acids thatthe body needs, so they are said to be“incomplete.” In addition, plant sources ofprotein tend to be harder for the body todigest, so less of what we eat is available foruse. However, eating the right combination ofplant proteins can give a vegetarian theneeded mix of amino acids. Plant proteins thatprovide the required amino acids whencombined complement each other to make acomplete protein source. For example, wholewheat bread and peanut butter or beans andcorn are complementary proteins.Complementary proteins should be consumedwithin the same day, but they do not have tobe eaten simultaneously.

Vegetarians who do not regularly eat fattyfish—such as salmon, tuna or cod—may beshort on the essential n-3 (also called “omega-3”) fats DHA and EPA, which are importantfor cardiovascular, emotional and cognitivehealth. The n-3 fat found in plant sources—such as flax seed, walnuts, canola oil andsoy—is α-linolenic acid (ALA). Unfortunately,the body converts only a small percentage ofALA into DHA and EPA, so vegans shouldincrease their intake of ALA-containing foods.While the most common DHA/EPAsupplements are derived from fish oil, thereare microalgae-produced supplementsavailable for vegetarians who want extraassurance they are meeting their DHA/EPArequirements.

The minerals iron and zinc—which areneeded for oxygen transport, energyproduction, immunity, brain and nervoussystem health and muscle function—are likelyto be lacking in a plant-based diet. There arecompounds in plants that tie up iron and zincso only a small fraction can be absorbed. Thereduced bioavailability of iron is so significantthat vegetarians need nearly twice as muchiron each day as omnivores. Food-preparationtechniques, such as soaking and sproutingbeans and grains and leavening bread, allowsmore of the zinc and iron in these foods to beabsorbed. Other strategies to increase theamount of iron and zinc absorbed are toconsume them with a source of vitamin C andto avoid drinking coffee or tea, whichnaturally contain compounds that reducemineral absorption, at meals. It is preferable touse wise food selection to meet zinc and iron

requirements, rather than take dietarysupplements, because ingestion of large dosesof a nutrient at one time can interfere with theabsorption of other nutrients.

Vegans, who do not consume milk and dairyproducts, are missing important sources ofdietary calcium and vitamin D. Although theseare especially important during childhood andadolescence when the skeleton is growing,calcium and vitamin D are also essential forskeletal health in adults, and low intakes ofthese nutrients might explain why vegans havea higher risk of bone fracture. Although thereare plant-based foods that provide calcium,some of these (e.g., spinach) also containcompounds that tightly bind calcium,preventing it from being absorbed. Goodsources of usable calcium include broccoli,kale, tofu and calcium-fortified products, suchas soy and rice milk or fruit juice. Productsthat are fortified with calcium also are typicallyfortified with vitamin D, but check the labeljust to be sure. Foods are supplemented witheither vitamin D3 or D2. Although vitamin D3is animal-derived, vegans can opt for productsor supplements containing vitamin D2, whichis made from yeast.

Vegans need to either regularly consume foodsfortified with vitamin B12 or take asupplement, as active vitamin B12 is presentonly in animal-based foods, such as dairy andeggs. The typical vegetarian diet containsenough folate to hide the early signs of avitamin B12 deficiency, so the condition mightgo undetected until symptoms of nerveproblems emerge.

By following the suggestions above,vegetarians and vegans can derive the healthbenefits of a plant-based diet and meetrequirements for these key nutrients, whichare needed not only for optimal health but tomaximize the positive effects of exercise.Vegetarians can get enough of the right aminoacids in the right combinations to buildmuscle mass and strength with weighttraining. Likewise, a well-planned, plant-baseddiet can provide the iron needed to improvefitness with regular aerobic exercise and thecalcium and vitamin D needed to increasebone mass following weight-bearing activity.Regardless of a person’s dietary preferences, itis critical to consume a diet with essentialnutrients in order to maximize health.

ACSM Fit Society® Page • A Quarterly Publication of the American College of Sports Medicine • www.acsm.org • Spring 2011 Page 4

THEME: NUTRITION

Preventingthe “Low-FuelLight” inEnduranceExercise

Andrea Hacker Thompson M.S., R.D.

Endurance athletes spend months training fora marathon or triathlon with a performancegoal in mind. Often, nutrition is mistakenlyleft out of their plan. Nutrition should be afundamental tool in every endurance athlete’stoolbox. During the training season, athletesshould practice and sharpen their nutritionplan so they feel confident in it on race day.

ACSM defines an endurance athlete as onewho trains and competes for 90 minutes orlonger. A nutritional plan is especiallyimportant for endurance athletes because theyare at high risk of bonking, or as I call it,having the “low-fuel light” come on.

The body of an endurance athlete is like a racecar with two fuel tanks. The duration andintensity of the activity determines which tankis the primary fuel source. Tank A is the body’sfat stores, which contain about 70,000 caloriesof fat that are available during lower-intensityaerobic exercise. Tank B is the body’scarbohydrate stores, which are glycogen storedin the muscle and liver. As the intensity of aworkout increases, the ability to use the fat intank A as fuel decreases, and the body

becomes more dependent on carbohydrates intank B for fuel. The body can only storearound 2,000 calories of glycogen at a time,which fuels both the working muscles andbrain. When our glycogen stores get low, thelow-fuel light comes on. Both the brain andmuscles send signals of fatigue.

When we exercise for less than 90 minutes,tank B has sufficient stores to power usthrough the activity. However, when weexercise for more than 90 minutes, we need tohave a nutritional plan to prevent the low fuellight from turning on.

There are four key areas to focus on if youwant to prevent a low-fuel light—fuelingbefore exercise, fueling during exercise, fuelingafter exercise and daily fueling.

Fueling Before ExerciseA race car never starts a race without new tiresand a full tank of gas, so an endurance athleteshould not start a workout without fueling.Eating before a workout guarantees that thebody starts with a full tank of glycogen.

If you have three or four hours, eat 300-600calories, primarily of carbohydrate (2-3g/kgbody weight), moderate in protein and low infat. Minimize the amount of fiber in this mealto prevent stomach discomfort duringexercise. Even if you are not hungry, youshould have something to eat before a longworkout. Think of it as fueling your body so itcan perform optimally.

Pre-exercise meals can include: • Oatmeal with milk, fruit and nuts• Turkey sandwich with fruit• Cottage cheese with crackers and fruit• Toast and peanut butter

Three to four hours before you work out,drink 2-4 cups of fluids. One hour before youwork out, drink 1-2 cups of fluids.

Fueling During ExerciseThis fueling opportunity is the well-planned“pit stop.” The fuel should be simple, easilydigestible carbohydrates that the body needsto maintain energy and prevent fatigue.

Fuel every 45-60 minutes during a longworkout. ACSM guidelines recommend 30-60grams of carbohydrate (120-240 calories) perhour. Remember that for optimalperformance, we also need to provide thebody with fluids and electrolytes. If theworkout is less than 90 minutes, but at a highintensity, you may want to drink an energydrink instead of water or bring an energy gelwith you.

Mid-exercise foods can include:• Gels• Energy beans• Energy beverages• Honey• Bananas• Oranges

During endurance exercise, drink 6-12 oz. ofsports drink or water every hour.

Eating After ExerciseThe goal for post-workout fueling is recovery.Fueling will help you replenish glycogenstores used during the workout, optimizeprotein synthesis to repair damaged muscletissue and stimulate the development of newtissue, and replace fluids and electrolytes thatwere lost in sweat.

Within 30 minutes of exercise, an enduranceathlete should have a snack of 300-400calories containing carbohydrate (75-100grams) and protein (6 grams). Thecarbohydrate-to-protein ratio should be 2:1 inshort, low- to medium-intensity workouts or3:1 in long, high-intensity workouts.

Post-exercise foods can include• Chocolate milk• A high-density nutrition bar (e.g., Clif bar)• Smoothie with yogurt and fruit

After exercise, drink two cups of fluid forevery pound of body weight lost.

Daily FuelingThe fourth way to prevent your low-fuel lightfrom turning on is to eat a diet consistentlyhigh in carbohydrates. A diet full of wholegrains, fruits, vegetables and lean protein (notin cookies and chips) will ensure that yourmuscles have fuel when you hit the road.

A good pit crew at the Indianapolis 500 is akey part of a winning performance. A goodfueling plan is equally as important for anendurance athlete, making the differencebetween running out of fuel and taking avictory lap.

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THEME: NUTRITION

DietarySupplementsfor Aging: AFountain ofYouth orDeluge ofDollars?

by Jessica Maillet, M.S., R.D., L.D.N, CPT-ACSM

For centuries, humans have sought out elixirsand potions to extend one’s youthfulness andlongevity. In the last 100 years, medicaladvancements and access to health care havemade living longer a reality.

In the 2005 U.S. Census, about 12 percent ofthe population was over age 65. Thispercentage is expected to double in the next25 years as a result of the aging baby boomerpopulation and longer life spans. As ourpopulation’s average age rises, the healthconcerns most prevalent in this age group willneed to be addressed.

In addition to seeking medical treatment,eating a healthful diet and participating inregular physical activity, individuals look todietary supplements as an addition,enhancement and even cure for a variety of

age-related issues. A 2009 market reportprojected that by 2015, $291 billion dollarswill be spent annually on anti-aging goodsthat range from skin care products, anti-agingtechnologies and dietary supplements.

Older adults require fewer total calories eachday. This, in addition to dietary behaviors thattend to change with advancing age, makes itdifficult for older adults to get the nutrientsthey need. Can dietary supplements enhancetheir diets?

First, it is best to get nutrients through foodfirst and supplements second. Only about 3-4percent of Americans meet the recommendednutrient goals for maintaining good health.Dietary supplements may have the potential tofill in some of those gaps, but there are alsodownfalls to this solution. One must proceedwith care and caution to avoid toxicity ofcertain nutrients, false claims and unreliableproducts.

So how do popular dietary supplements stackup for conditions in which the olderpopulation is contending?

Bone Health andOsteoarthritis

The requirement for bone-strengtheningvitamins and minerals increases when adultsreach 50 years of age. Women over the age of50 and men over the age of 70 need 1,200 mgof calcium per day. For vitamin D, therecommendation also increases in men andwomen when they reach 70 years of age. Inaddition to nutrient-rich foods, a multivitaminwith calcium and vitamin D may help reachthese increased daily requirements.

Glucosamine and condroitin may have someeffect on pain relief in moderate-to-severeosteoarthritis sufferers, but gentle exercise hasalso been shown to relieve pain caused byosteoarthritis.

Gastrointestinal (GI) HealthMaintaining a healthy gut is key in preventinggastrointestinal diseases like colon cancer anddiverticular disease. High-fiber foods act like abroom, cleaning out your intestines andkeeping them healthy. It is unclear whetherfiber supplements have the same effect on GIhealth as the fiber found naturally in wholegrains, fruits and vegetables. High-fiber dietsrequire adequate amounts of fluid, so be sureto consume lots of fluid throughout the day.Probiotics may also help improve the health ofthe intestines, so supplement your diet withyogurt that includes active cultures.

Heart HealthConsumption of omega-3 fatty acids throughfish or fish oils reduces risk of adverseoutcomes from cardiovascular disease, likeheart attack and cardiac death, and appears tohave a dose-dependent effect on triglyceridelevels.

Urinary Tract HealthCranberry juice has been shown in somestudies to prevent recurrent urinary tractinfections. In a study published in Jan. 2011,however, researchers showed that cranberryjuice might not actually be beneficial inpreventing recurrent UTIs.

Skin HealthAntioxidants help protect cells from freeradicals, the compounds that cause damage tocells. Alpha-tocopherol, a form of vitamin E,may protect the skin from the damagingeffects of free radicals like sun exposure. But,vitamin E can interfere with medications, andyou should consult with your doctor beforetaking a supplement.

Memory and Memory-Related Diseases

Early studies showed that gingko leaf extractmay improve symptoms of Alzheimer’s diseaseand dementia, but more recent studies areconflicting. At this time, it is unclear whetherpeople can benefit from taking it.

Eye HealthA large study called the Age-Related EyeDisease Study (AREDS) showed that certainantioxidants and zinc slow the progression ofvision loss in people diagnosed with age-related macular degeneration. A follow-upstudy (AREDS2) is currently being conductedto research the effects of other dietarycomponents.

Eating a diet rich in whole grains, fruits,vegetables, lean protein, low-fat dairy andhealthy fats, in conjunction with regularphysical activity, will keep your body healthyand functioning well. A multivitamin andomega-3 supplement that meets no more than100 percent of the age-appropriaterecommended dietary allowance appears to fillthe gaps if proper nutrition is not met, but it isstill unclear how effective supplementation isin delivering nutrients when not consumed asfood. Plus, some supplements may interferewith medications, so talk to your doctorbefore beginning any supplements.

ACSM Fit Society® Page • A Quarterly Publication of the American College of Sports Medicine • www.acsm.org • Spring 2011 Page 7

THE ATHlETE’s KITcHEN:

SportsNutritionGuidelines

by Nancy Clark, M.S., R.D., C.S.S.D., FACSM

In 2009, three prominent nutrition andexercise associations—the American DieteticAssociation, American College of SportsMedicine and Dietitians of Canada—releasedthe “2009 Joint Position Stand on Nutritionfor Athletic Performance.”

While there is little earth-shattering news inthis document, the authors comprehensivelyreviewed the research to determine whichsports nutrition practices effectively enhanceperformance. Here are a few key points andthe reminder that what and when you eatpowerfully impacts how well you canperform. I hope this information entices youto think again if nutrition is your missing link.

• Avoid obsession on body fat percentage orweight. What you weigh and how muchbody fat you have should not be the solecriterion for judging how well you are ableto perform in sports. That is, don't thinkthat if you get to a pre-determined body fat,you will run faster. First, all techniques tomeasure body fat have inherent errors, soprecisely determining body fat is difficult.Second, optimal body fat levels depend ongenetics and what is optimal for yourunique body. Pay more attention to how youfeel and perform than to a number on thescale.

• Protein recommendations for bothendurance and strength-trained athletes

range from 0.5 to 0.8 grams per pound (1.2-1.7 g/kg) body weight. For a 150 lb. athlete,this comes to about 75 to 120 g protein perday, an amount most athletes easily consumethrough their standard diet without the useof protein supplements or amino acidsupplements. Vegetarian athletes shouldtarget 10 percent more, because some plantproteins (not soy, but legumes) are lessdigestible than animal proteins. If you arejust starting a weight-lifting program, you’llwant to target the higher protein amount.Once you have built up your muscles, thelower end of the range is fine.

• Athletes in power sports need to payattention to carbohydrates, not just protein.That's because high-intensity strengthtraining depletes muscle glycogen stores.Carbohydrates are critical to not only theexercise bout itself but also the recoveryperiod.

• Athletes who eat enough calories to supporttheir athletic performance are unlikely toneed vitamin supplements. But athletes whoseverely limit their food intake to loseweight (such as wrestlers, lightweightrowers, gymnasts), eliminate a food group(such as dairy, if they are lactose intolerant)or train indoors and get very little sunlight(skaters, gymnasts, swimmers) may requiresupplements.

• If you are vegetarian, a blood donor and/or awoman with heavy menstrual periods, youshould pay special attention to your ironintake. If you consume too little iron, youcan easily become deficient and susceptibleto fatigue due to anemia. Because reversingiron deficiency can take three to six months,your best bet is to prevent anemia byregularly eating iron-rich foods (lean beef,chicken thighs or enriched breakfast cereals)and including in each meal a source ofvitamin C (fruits or vegetables).

• Eating before hard exercise, as opposed toexercising in a fasted state, has been shownto improve performance. If you choose tonot eat before a hard workout, at leastconsume a sports drink (or some source ofenergy) during exercise.

• When you exercise hard for more than onehour, target 30 to 60 grams (120 to 240calories) of carbohydrate per hour tomaintain normal blood glucose levels andenhance your stamina and enjoyment ofexercise. Fueling during exercise is especiallyimportant if you have not eaten a pre-exercise snack. Popular choices includegummi candy, jelly beans and dried fruits, as

well as gels and sports drinks. More researchis needed to determine if choosing a sportsdrink with protein will enhance enduranceperformance.

• For optimal recovery, an athlete who weighsabout 150 pounds should target 300 to 400calories of carbohydrates within 30 minutesof finishing a hard workout. More precisely,target 0.5-0.7 g of carbohydrates per lb (1.0-1.5 g carb/kg). You then want to repeat thatdose every two hours for the next four to sixhours. For example, if you have done arigorous, exhaustive morning workout andneed to do another session that afternoon,you could enjoy a large banana and a vanillayogurt as soon as tolerable post-exercise;then, two hours later, a pasta-based meal;and then, another two hours later, anothersnack, such as pretzels and orange juice.

• Whether or not you urgently need to refueldepends on when you will next beexercising. While a triathlete who runs for90 minutes in the morning needs to rapidlyrefuel for a 3-hour cycling workout in theafternoon, the fitness exerciser who worksout every other day has little need to obsessabout refueling.

• Including a little protein in the recoverymeals and snacks enhances muscle repairand growth. Popular carb+proteincombinations include chocolate milk,yogurt, cereal+milk, pita+hummus,beans+rice and pasta+meat sauce.

• Muscle cramps are associated withdehydration, electrolyte deficits and fatigue.Cramps are most common in athletes whosweat profusely and are “salty sweaters.”They need more sodium than the standardrecommendation of 2,400 mg/day. Losingabout two pounds of sweat during aworkout equates to losing about 1,000 mgsodium. (Note: eight ounces of sport drinkmay offer only 110 mg sodium.) Saltysweaters (as observed by a salty crust on theskin of some athletes) lose even moresodium. If that’s your case, don’t hesitate toconsume salt before, during and afterextended exercise. For example, enjoy broth,pretzels, cheese & crackers, pickles andother sodium-rich foods. The majority ofactive people can easily replace sweat lossesvia a normal intake of food and fluids.

Final words of advice: If you can make time totrain, you can also make time to eat well andget the most out of your training. Optimalsports performance starts with good nutrition!

ACSM Fit Society® Page • A Quarterly Publication of the American College of Sports Medicine • www.acsm.org • Spring 2011 Page 8

Q&A (continued from page 2)

have been identified in kale, along withomega-3 fatty acids, which are all desirableantioxidants. To maximize its nutritionalvalue, kale can be served steamed,microwaved, chopped, minced or sautéed, asopposed to boiling, which removes some ofthe desired nutrients. Kale isn’t really new—asit has been popular in Europe for centuries—but it can be a great new addition to your diet.

Get Answers to YourYouth Sports andHealth QuestionsThe new ACSMREACH website is arobust, searchabledatabase for parents,coaches, health careproviders, educators andothers seeking credibleinformation about youthsports and health.Experts review andapprove all materialincluded in the database,ensuring that all content on the site is medicallyaccurate and provides sound advice.