Marathon Eating 101

Running a marathon, or training for any big sport’s event, is a huge commitment, and takes months of preparation. Training, however, does not simply consist of sprints, scrimmages, or other heart-pumping related activities. A major component is nutrition. Without proper fuel for your body, you will be unable to reach your maximum potential.

There are four nutrients on which to focus during training. These include water, carbohydrates, protein, and fat. When you drink enough water and eat a balanced diet, your body can work efficiently and provide energy to fuel performance.

Water
Water makes up 60 percent of your body and is involved in essentially every bodily process. Unlike with other nutrients, your body cannot store excess water - you must replace whatever you lose. There is a fine line, however, between drinking too little and drinking too much. If you drink too little, you run the risk of dehydration, which hampers performance and increases the risk of heat illnesses, such as heat exhaustion or heat stroke. Conversely, too much fluid puts you at risk for hyponatremia. Hyponatremia is a condition that occurs when the level of sodium in the blood drops too low. Although rare, hyponatremia can result in seizure, coma, or death. Those at risk are people who drink too much and do not adequately replace the sodium lost in sweat.

The best way to prevent hyponatremia and dehydration is to learn the correct way to hydrate.

* Drink to Hydrate: Your fluid-replacement goal is to drink the perfect amount of fluid, resulting in neither weight loss or weight gain. A helpful tool may be to estimate your sweat rate. Weigh yourself before and after a workout. Then account for fluid consumed during training and add this to the total weight loss.

For instance, if you lost 1 pound (16 oz) during 1 hour of training, and drank 16 oz, you should drink 32oz (16 + 16) each hour during similar intensity exercise training.
* Include More Salt: Salt is lost through sweat, so make certain to replace all of the salt lost during training. Consider including more salty snacks (i.e. pretzels or crackers) into your diet.

* Invest in Sports Drinks: Drinks, such as Gatorade®, help keep your body hydrated while replacing essential electrolytes, like salt, during exercise. Because of the added flavor, you are more likely to consume more. These drinks are preferred over water during long distance or intense training or competition.

Carbohydrates
Carbohydrates are the preferred source of fuel for the body. They are found in fruits, vegetables, starches, and other foods. The body converts carbohydrates into glucose for immediate energy or stores it in the liver and muscle tissues as glycogen. Muscle glycogen is used during endurance sports. As glycogen is depleted, an individual may become fatigued and unable to maintain training and racing intensity. With high intensity training, 60-70% of calories should come from carbohydrates. Remember: while we usually encourage high fiber and whole grains, opt for low fiber foods (i.e. white pasta, potatoes, etc.) when training to avoid gastric distress and cramping.

* Stock up before*: Eat carbohydrates for at least several days before competing so that you start with glycogen loaded muscles.

* Be consistent during: If training or competing for more than an hour, eat carbohydrates during the activity to replenish energy and delay fatigue. Consider energy gel supplementation. A typical gel has 90-100 calories composed mostly of carbohydrates. These are especially helpful during colder days when the sweat rate is lower, and you are not prone to drink as much. Gels, however, can upset your stomach, so try using them to gage your tolerance prior to the competition.

* Replenish: After a long run or an intense training session, your muscle glycogen stores will be depleted. Therefore, eat a carbohydrate snack of approximately 100-300 calories immediately after training. Snacks may include pretzels, baked chips, or frozen fruit pops.

*A note on carbohydrate (carbo) loading: Carbo-loading is a method some athletes use to maximize glycogen stores. The original method began 1 week prior to the event. For the first 3 days, athletes ate a very low carbohydrate diet (about 10% of total calories) and exercised intensely to deplete glycogen stores. The following 3 days the athlete ate a very high carbohydrate diet (about 90% of total calories) and reduced exercise intensity to maximize glycogen stores. Over the years this technique has been modified and the depletion phase has basically been eliminated. Now athletes usually just increase carbohydrate intake for the 3 days prior to the event (about 70% of calories) and decrease exercise intensity. Consult a physician before attempting a carbo-loading diet.

Protein
Protein is needed for muscle and tissue growth and repair. However, too much protein can cause dehydration and muscle heaviness. When muscle glycogen stores are high, protein contributes less than 5% of the energy needed by the body. When glycogen stores are low, protein must be used for energy and may contribute as much as 10% of the energy needed. This process of using protein for energy is expensive and inefficient, and should be avoided as much as possible.

* Increased Needs: Endurance athletes need up to 50% more protein than sedentary adults.

* Avoid Excess: Consume no more than 1 gram of protein per pound of body weight. A high protein diet, especially after heavy training will cause incomplete replenishment of muscle glycogen and impair performance.

Fats
Fats are required in small amounts by the body for certain critical functions and as an alternative energy source to glucose. Eating too much fat, however, is associated with heart disease, some cancers, and other major problems. A high fat intake probably means you aren’t getting enough carbohydrates. Moreover, a high fat diet is difficult to digest and may cause sluggishness.

* Aim for Moderation: All individuals, including athletes, should consume less than 30% of total calories from fat and less than 10% of calories from saturated fat.

While these basic guidelines will help, we do recommend seeking personalized advice when it comes to intense training. Every body is different, and it is important to make sure you are adequately nourished and hydrated during training and during the event.

Homemade Snack Bar

Though there are definitely snack bars out there that taste good and are fairly balanced, sometimes you like to know exactly what’s going in your bar. This recipe is easy and fits all of our requirements for being a balanced snack bar. Best of all, it tastes good!

Serves 10

3 ½ cups quick oats
1 ½ cups powdered non-fat milk
4 scoops chocolate or vanilla protein powder
¼ cup mini chocolate chips
1 cup sugar-free maple syrup
2 egg whites
¼ cup orange juice
1 tsp Vanilla
¼ cup natural applesauce

1. Preheat oven to 325°F.
2. Mix all dry ingredients in a bowl and blend well.
3. In a separate bowl, combine maple syrup, egg whites, orange juice, vanilla, and applesauce.
4. Stir wet mixture (step 3) into dry mixture (step 2).
5. Spread mixture evenly onto a sprayed baking sheet.
6. Bake until edges are crisp and brown.
7. Cut into 10 bars.

Calories: ~185
Fat: 2g
Saturated Fat: 1g
Protein: 15g
Total Carbohydrates: 27g
Fiber: 4g
Sugar: 18g

Night Snacking and Weight

Night-snacking tends to be a problem for many. After dinner, we finally have a chance to relax. Oftentimes that relaxation comes with snacking. In a study published in 2004 by the Journal of the American College of Nutrition, researchers examined whether eating a calorie-controlled snack at night would help with weight management in night snackers. Sixty-two men and women were divided into two groups: calorie-controlled night snackers vs. ad libitum night snackers. The participants followed their assigned night-snacking routine for four weeks. After four weeks, those in the calorie-controlled night snacking group lost about 2 pounds while those in the group who ate ad libitum lost less than half a pound. Though in this case the calorie controlled snack was a measured out bowl of cereal, any calorie controlled item (i.e. a snack bar) may help to keep you from overeating and thus gaining weight.

Snack Bar Break

Though in an ideal world we would all eat balanced meals and snacks with whole grains, lean protein, and lots of fruits and vegetables, realistically it is often too time consuming and impractical. However, we can’t just starve until we have time to grab a decent meal. That’s where bars come in. Bars are quick, and if you choose the “right” ones, they can be balanced and filling. They are great to keep in your purse or briefcase if a meeting runs late and lunch seems far away, in the glove compartment of your car if you get stuck in traffic, or by the front door if there’s no time for breakfast so you can grab one and go.

The tricky part when it comes to bars is figuring out which ones are best or the most balanced. To help you, we’ve outlined a few nutrients/ingredients to watch for when choosing a bar. The major question to ask yourself, however, is will this bar help me eat less later or will it simply set off a sugar craving and leave me wanting more.

Calories
As a snack, ideally it should have less than 200 calories. If you’re replacing a meal, it can be higher than this, but beware that the very high calorie bars usually contain loads of sugar and/or saturated fat.

Fiber
Fiber helps by slowing digestion and allowing you to feel fuller longer. Finding high fiber bars can be tough, but aim for at least 3 grams of fiber per bar.

Protein
There are loads of high protein bars out there, but the main idea of protein is to balance out the carbohydrates and satiate us longer. There is no need to go overboard with protein (keep in mind, this is just a snack), but aim to get at least 7 grams in your bar.

Fat
You do want to have some fat in your bar to keep your snack balanced, to allow for a more satisfying snack, and to improve the taste and texture of the bar. However, try to keep the fat below 5 grams, with as little as possible coming from saturated fat. Also, avoid any bars with trans fats.

Sugar
This is definitely the hardest ingredient to assess. Most of the bars contain lots of sugar to improve taste. We decided to judge sugar based on its relation to fiber in the bar. Aim for bars that have at most a 6 to 1 ratio of sugars to fiber. For instance, if a bar has 3 grams of fiber, it should have no more than 18 grams of sugar.

To be honest, it was almost impossible to find a bar that fit all of our requirements. The bottom line is that you have to choose which ingredients are most important to you, and which bars help you most in staving off hunger (and which you like the taste of!). We’ve chosen some of our favorites to give you some ideas. The bars in bold fit every requirement.

Bar	Calories	Total Fat(g)	Saturated Fat(g)	Protein(g)	Carbs(g)	Fiber(g)	Sugar(g)
Bellybar™ (for pregnant women)	170-180	4-6	1-2.5	8	22-26	2	11-13
Clif® Mojo™	180-210	8-11	1-2	9-10	19-23	2-3	8-12
Gnu® Foods	130-140	3	0-1	3-4	30-32	12	8-9
Kashi™ GOLEAN® Roll!	190-200	5	1.5-2	12	27-29	6	13-14
Kashi™ TLC™*	120-180	2-6	0.5	5-7	19-26	4	5-8
Larabar®	180	4	2	8	29	5	11
Luna® Sunrise™	180	4	2	8	29	5	11
Luna®*	180-190	3.5-6	0.5-3	9-10	23-28	3-5	9-11
Pria® Complete Nutrition	170	6	4	11	22	5	7
Slim Fast® Optima™ Meal On-The-Go Bar	180-220	4-9	2.5-4	8	28-35	2-3	12-16
thinkGreen™	180-190	5-7	1-3	6-7	27-29	2-4	15-22

*Not every bar in this brand fits all of the requirements.

Take this guide with you as you navigate the supermarket aisles. By keeping balanced, healthy bars on hand, you will never have an excuse for going hungry!

Gazpacho with Chickpeas

Low calorie soups and salads are invaluable as natural appetite suppressants. Since soups and salads are full of water (or watery ingredients), they help to fill you up before you indulge in a big lunch or dinner. Moreover, if you add extra fiber to your meal, you will also feel fuller sooner. This recipe combines all of these aspects in one easy, refreshing, and tasty dish. No need for diet pills when you can fill up on veggies!

Serves 6

2 – 14.5 oz cans diced tomatoes, with juice
½ cup tomato juice
2 Tbsps extra-virgin olive oil
1 seedless cucumber, cut into a ¼-inch dice
1 small onion, cut into a ¼-inch dice
2 medium garlic cloves, minced
1 small jalapeno pepper, seeded and minced (can leave in seeds for spicier soup)
1-15 oz can chickpeas, drained and rinsed
2 Tbsps lime juice
¼ - ½ teaspoon cumin (to taste)
2 Tbsps chopped fresh cilantro (can substitute flat-leaf parsley if prefer)
Salt and freshly ground pepper, to taste

1. In a food processor or blender, blend a ½ cup of the diced tomatoes with the tomato juice and olive oil. Transfer to a medium bowl.
2. Add the remaining ingredients to the bowl. Season with salt and pepper to taste.
3. Refrigerate for at least 4 hours before serving.

Calories: ~140
Fiber: 6

Natural Herbs or Foods and Weight Loss…or not?

Considering the main topic of this newsletter is diet pills and weight loss drugs, we wanted to report on a single natural food or herb that is touted for weight loss and present the current research. Amazingly, after searching through the peer-reviewed journals, we found almost no actual research regarding the most common weight-loss ingredients. We searched apple cider vinegar, cayenne pepper, cinnamon, ginger, ginseng, green tea, and even some of the less common ingredients like turmeric and rhubarb. Though there were a few animal studies regarding one or two of these ingredients, and a few actual studies on green tea, a couple of the searches brought up absolutely nothing (i.e. apple cider vinegar). Yes, we could have chosen one of those rare random studies to report on, but we think a stronger take-home message this month is to beware of what you hear or read. As our fruitless search has shown, the ingredients in most weight loss supplements have barely been researched, and though they may seem harmless because they are common household ingredients, taking large doses of them has not been satisfactorily tested (or even tested at all). When there are actual studies regarding natural ingredients and weight loss, we’ll get back to you.

The Skinny on Diet Pills

With the release of Alli this past June, diet pills are once again in the spotlight. The claims are appealing: “Lose 30 lbs in 30 days” or “Melt your fat away”. But, do these pills really work? And more importantly, are they even safe? We’ve broken down for you some of the more popular over the counter and prescription diet pills on the market to let you decide for yourself. As a disclaimer, we believe that there are no magic pills to get you to your goal – changing your lifestyle is the only truly tested and effective method.

Prescription Drugs
Research regarding prescription drugs is more thorough and credible since they have to be approved by the Food and Drug Administration. Prescription weight loss drugs are intended for individuals with medically significant weight problems, and are intended to be used in conjunction with dietary, behavioral, and exercise programs. If used correctly by the intended group of users, oftentimes they can be a lifesaver. For those who do not fit the description of the intended user, or for those who simply take the pills without changing their lifestyle, expect disappointment.

Orlistat (Brand name prescription drug: Xenical; OTC drug: Alli)
How it Works: Orlistat blocks the absorption of fat by working on the digestive system. It is claimed to inhibit the action of an enzyme called lipase, which breaks down dietary fat so the body can absorb it. Orlistat blocks the absorption of up to 30% of dietary fat, and the unabsorbed fat is eliminated through the stool.

Research: According to the FDA, before orlistat was approved in 1999, it was tested in seven clinical trials, in which more than 4,000 obese individuals participated. Each of these trials used orlistat in conjunction with a low-calorie, low-fat diet, and an exercise routine. Overall, 57% of people taking orlistat lost at least 5% of their body weight as compared to 31% who took a placebo.

Side Effects: Due to the fact that unabsorbed fat will exit through the stools, many gastrointestinal side effects may exist. Perhaps most embarrassing is that users may experience oily rectal seepage and in extreme cases, may need adult diapers. Fecal urgency, gas with discharge, and frequent, oily bowel movements are also possible. In addition, orlistat interferes with the absorption of fat-soluble vitamins (A,D,E, and K) and may also limit the absorption of healthy fats like fish oil or flaxseed oil. As a result, nutritional deficiencies may occur.

Sibutramine (brand name: Meridia)
How it Works: Sibutramine is a monoamine reuptake inhibitor, which means that is blocks the reabsorption of certain neurotransmitters, or messengers to the brain. This allows the levels of these neurotransmitters to increase, which then helps to control appetite. Thus, sibutramine is mostly an appetite suppressant.

Research: Manufacturers report several double-blind, placebo controlled trials. There was evidence that various levels of sibutramine led to significantly more weight loss in obese individuals, than for those who used the placebo. As with orlistat, these studies were done in conjunction with a healthy eating and exercise plan.

Side Effects: The most common side effects are dry mouth, anorexia, headache, insomnia, and constipation. Some users also experience an increase in blood pressure and heart rate.

OTC Drugs
Over the counter weight loss drugs are not subject to approval or regulation by the FDA. As a result, we have limited research on the hundreds of OTC diet pills out there, and almost no long-term research. In addition, because these pills aren’t regulated, they may not even have the amount of an effective ingredient that is stated on the bottle. There are hundreds of diet pills out there. This is only a small sample.

Alli
The only FDA approved OTC drug. See orlistat (above).

TrimSpa X32
How it Works: Trimspa, endorsed by the late Anna Nicole Smith, has many different ingredients in it. Unfortunately, TrimSpa no longer lists each of the ingredients separately, but rather states that it has a “x32 proprietary blend”. We were able to uncover some of the ingredients. Ingredients like caffeine, bitter orange, and green tea extract are thought to work as stimulants. Hoodia, chromium, and glucomannan (fiber) are proposed to work as appetite suppressants.

Research: Clinical trials have not shown that the ingredients in TrimSpa can reduce body fat. There is some evidence that green tea extract may aid in weight loss, and there is clear evidence that fiber (i.e. glucomannan) will lead to satiety, thus decreasing one’s appetite. However, none of the ingredients have been significantly proven to lead to weight loss.

Side Effects: Due to the fact that many of the ingredients have been insufficiently tested, there is concern that in large doses, some of these ingredients may be harmful. Bitter orange (naringin) may interfere with many common prescription drugs such as antiarrhythmics, anticoagulants, statins, immunosuppressants, calcium channel blockers, and protease inhibitors. Ingredients in TrimSpa may lead to insomnia, anxiety, palpitations, and restlessness. TrimSpa may also cause migraines in susceptible people since it contains cocoa extract which contains tyramine. Hoodia, a popular ingredient on its own, and thought to suppress appetite, is also still in the beginning research stages. There is a possibility that it can lead to liver toxicity. Moreover, Hoodia is a protected plant, and because OTC diet pills are not regulated, most of the pills don’t have as much Hoodia as is stated on the packaging.

Xenadrine EFX
How it Works: As with the TrimSpa, Xenadrine has a long list of ingredients. These include green tea leaf extract, bitter orange, caffeine, cocoa extract, grapeseed extract, ginger root, and guarana. These ingredients are purported to speed up the metabolism.

Research: Though proponents of Xenadrine claim numerous clinical trials have been completed, it was hard for us to find any. The two we did find were extremely small studies of six and ten subjects. In addition, we found it dodgy that the Xenadrine website listed “returning shortly…” under the tab for clinical studies. When we called the company, they could not elaborate.

Side Effects: The same side effects noted for specific ingredients in TrimSpa are noted here. In addition, people taking Xenadrine have noticed nausea and upset stomachs, anxiety, shaking, cramps, increased heart rate, and increased sweating.

There are hundreds of other diet pills out on the market. Most of the OTC diet pills rely on the fine print that states it must be combined with a low-calorie diet and exercise. In reality, if you followed the healthy diet and exercise portion, you would lose weight. However, in certain cases, prescription drugs may be helpful and/or necessary, but that must be determined by your physician. With all diet pills remember - if it sounds too good to be true, chances are it is.