Running for Two: Training through Pregnancy

Amber Miller was nearly 39 weeks pregnant when she ran the 2011 Chicago Marathon. She ran- walked her way to the finish line and grabbed a bite to eat before giving birth later that night. To some she is a hero, to others nuts. Either way, one begs the question, “Is running a marathon a reasonable goal when pregnant?”

Most women don’t dream of running a marathon while pregnant but what about running in general? For many running is much more than their cardio of choice. It is an identity, a social atmosphere, a stress relief and they cannot imagine giving it up for nine plus months!

Everyone has an opinion on prenatal exercise; however the science on exercise while pregnant has improved over the past few decades. It is safe to run while pregnant; yet every woman and pregnancy is different therefore all moms should consult with their obstetrician. If you ran before you became pregnant, are in good health and not caring multiples generally you can keep running while pregnant.

 Expect instant changes-

The first thing out the window is speed and intensity. You will notice that your speed declines and your shoes feel like bricks- this is normal. The heart beats harder to deliver oxygen to you and your baby. Running form and stride will also change as your center of gravity shifts with the growth. But do not get discouraged! Although you are running slower you are actually building aerobic fitness (heart, lungs and muscular strength). Many women who run the majority of their pregnancy experience increase in speed and endurance post pregnancy – promise.

Heart rate is no longer the ideal monitor now it is advised to go by how you feel.  Always be able to talk or hold a conversation while running and if you can't, slow down. If you use this as a guide, you'll naturally slow as you progress through the trimesters.

Think time not miles-

Anyone who exercises at a lower intensity for a long period of time starts to burn fat as fuel. This is the goal of exercise however; a pregnant body is working hard to increase fat stores to support pregnancy and growth of the baby. Going for long and slow distances competes with this process. It is recommended to go in a forward motion (run or walking) for one hour or less. The number of days varies depending on the individual but 3 to 5 days of one hour bouts of exercise a week is deemed safe.   

Nutrition is key-

Pregnant runners need to rethink the way they fuel and refuel their runs. It is imperative each run begins well hydrated and with a normal blood sugar and ends well hydrated with a proper recovery.  A carbohydrate rich snack should be consumed approximately 1 hour before exercise with water or diluted fruit juice. Drink water every 10-15 minutes during and after a run focus on a carbohydrate and protein rich snack within 30 minutes. Rehydrate until urine is clear.

To Race or Not to Race?

As for whether to race while pregnant or not is up to the mom and their OB. As a health professional I would not advise anyone to take the risk. I believe this is a time to reconnect to the joys of running and the changes within and around you. Take this time to tune in and reflect on the journey. And be sure to cut yourself some slack. You are not and should not be the same runner you were before you got pregnant. Pregnancy is only for a short season. Childbirth will be the greatest endurance race of your life, get to the finish line as healthy and vibrant as you started!  

Rebecca Turner, MS, RD, CSSD, LD is a registered dietitian and certified sports specialist in dietetics and founder of Runner’s FUEL. Find her on SCAN, follow her on Facebook and Twitter @RunnersFuel. For more information visit www.runner-fuel.com or email at a runnersfuel@gmail.com.

Why Do I Crave Sugar?

Sugar cravings are a real problem for many including runners. When we “cave” to temptation we self inflict frustration and feelings of low self-worth. One reason we crave sugar (or caffeine) is because of low adrenal function. The adrenals are hormone glands that sit above the kidneys.

Amongst other things, one of their jobs is to secrete epinephrine (better known to some as adrenaline) which provides us with energy. They also secrete cortisone when there is inflammation present in the body (heavy training). Thirdly, they replace the function of the ovaries in the production of the female hormones estrogen and progesterone when women get close to their menopausal years. When everything is functioning well and everything is being nourished properly, there is no problem.

What can interfere with this? Stress, first and foremost. When we’re stressed the adrenals secrete adrenaline as if we were preparing to fight tigers in the jungle. They don’t know the difference between the stress of facing a tiger and the stress of facing an irate boss, rush-hour traffic, or a two year old. They just jump into gear and adrenaline flows.

Inflammation can be caused by many well-known factors such as injury and diseases but also new training or exercise programs. Marathon training definitely increases inflammation over the whole body for weeks at a time. The adrenals are consistently under pressure to produce cortisone to keep the inflammation under control as much as possible.

What happens?
-Lack of energy
-Fatigue
-Need naps
-Cravings for sugar or caffeine to compensate for the energy that is lacking
-Menopausal symptoms can also kick in if the adrenals are not up to par

So what to do? First, develop a stress relief plan of action. Exercise is great; however, if you have repeated (daily) stressful situations stimulated by the same source then you need to develop a stress relief plan. You know it is coming, you know what triggers it, you know the feelings that lead up to it and you know the downward spiral. In a way, knowing the step by step play will help you develop a plan that can be intersect at any step to divert you from choosing something sweet to eat.

Second, keep a food dairy and noting what you eat and how you feel an hour or two later. Note the types of carbohydrate mostly eaten and their portion size. Eliminating excess sugar from the diet (even if it fits into your calorie range) will decrease the cravings and weight. Be very mindful that you are not getting a large dose of carbohydrates at one time in one meal but spread them evenly throughout the day. This helps balance blood sugar and decrease cravings and improve insulin sensitivity.

Third, rest and recover!! Without proper rest (sleep and off days) and recovery (nutrition and stretching) our body can not keep up with the endless miles and exercise induced stress.  Train smart… run healthy.

 Rebecca Turner, MS, RD, CSSD, LD is a registered dietitian and certified sports specialist in dietetics and founder of Runner’s FUEL. Follow her on Facebook and Twitter @RunnersFuel. For more information visit www.runner-fuel.com or email at a runnersfuel@gmail.com You can also find Rebecca here on SCAN: http://www.scandpg.org/dietitians/15186/

Update On White House Petition For RDs, Act Now!

From the Academy of Nutrition and Dietetics:

We did it! White House petition reaches 25,000 signatures
Members of the Academy responded across the US to reach the required number of signatures for the White House petition asking the President to urge the Center for Medicare and Medicaid Services (CMS) to reconsider its decision to excluded dietitians as billable providers for intensive behavioral therapy for obesity. Thank you for promoting this effort within your membership. We could not have achieved our goal without your support.
What happens now?
The Academy has already begun to prepare for the next step which could include communication or a meeting with the Obama Administration. Now that the petition has reached the signatures threshold, the Administration will contact the Government Relations team in the Academy’s Washington, D.C. office. In addition, the Academy is working with members of Congress to also urge CMS to reconsider its decision.
What can you do?
We need you to lead by example and encourage our constituents to keep the momentum moving!
First: If you haven’t sent a letter to your members of Congress, please take action today! Overall less than 2% of Academy members have done so (see attached document with state-by-state breakdown). Visit the Academy’s Grassroots Manager at: http://www.eatright.org/members/actioncenter.aspx to send your letters and share this link again with your members. It only takes a few minutes and will ensure our voices are heard in Congress.
Next: Every member should be considering their next steps as outlined by Academy President Sylvia Escott-Stump in her message on December 8, 2011. On a continuous basis, strive to:

•  Participate in activities that document the RDs worth.

•  Start in your own backyard - does your personal health insurance include coverage for RD services?

•  Become a Medicare provider for Part B MNT services. We need to demonstrate that we have the providers to meet demand. http://www.cms.gov/cmsforms/downloads/cms855i.pdf

•  Form relationships with Primary Care Practitioners to provide nutrition counseling services in medical practices.

•  Market your services to the healthcare community and other community groups.

• Work with your DPGs and Affiliate Public Policy Panels - provide your expert input when issues arise.

• Attend the Public Policy Workshop. PPW 2012 is scheduled for April 5-17 in Washington, D.C. http://www.eatright.org/ppw/

• Donate to the Academy Political Action Committee. The PAC is our way as a profession to support federal elected officials who are supportive of our causes. https://eweb.eatright.org/eweb/DynamicPage.aspx?webcode=pacdonationslist&site=pac

• Vote in national and local elections.

• Be a preceptor for dietetic students - we need to build the RD and DTR workforce.

• Keep our voice strong and united-get involved in legislative and regulatory issues affecting food, nutrition and dietetics.

Watch for further updates on the Academy’s efforts to address this situation.

Freekeh Friday: Whole Grains for Fueling the Whole Family

  "Take also unto thee Wheat, and Barley, and beans, and lentils, and millet, and Spelt, and put them in one vessel, and make bread of it..."—Ezekiel 4:9

Ancient grains have been making a comeback to replace the typical American staples: oats, barley, wheat, corn, and soy.  More people are being diagnosed with food allergies and Celiac disease while others are looking for affordable sources of plant protein.

Not all ‘ancient grains’ are actually grains or grasses.  Spelt, Kamut, and wheat are grains while quinoa and amaranth ended up thrown in the pot.

Other ancient grains include mullet, teff, rye, farro, and freekeh

Spelt

This cousin of wheat is not gluten-free but contains less gluten than wheat.  It contains

manganese, copper, zinc and is a good source of protein.

Kamut

These kernels require an overnight soak but are good for the novice in the kitchen as they are difficult to overcook.  Additional nutrients are: Omega-3 fatty acids  and vitamins A, B-1, B-2, B-6, B-9, C and E.

Quinoa

Quinoa is gluten-free and also a source of protein making it perfect for fueling the vegetarian or vegan athlete.  It contains magnesium, phosphorus, iron, and manganese.

Amaranth

Once an ancient grain of the Aztecs now is a staple in gluten-free diets.  It has the highest amount of protein of the ancient grains and also contains calcium.

Millet

The Chinese have been using millet before rice.  It looks like bird seed and can be eaten raw or cooked, best of all, it’s gluten-free.

Teff

This gluten-free grain is one of the smallest on earth.  Ethiopians ground it into a flour for bread and it can be cooked and used as a thickening agent.

Rye

Another gluten-free grain, this cousin of the wheat berry has a nutty taste.

Farro

This grain comes right from Italy and was originally used in the American South to cycle in rice crop rotations during the Civil War.  Its been marketed towards diabetics for making less impact on blood sugar when compared to other whole grains.

Freekeh

Freekeh can be wheat or durum that is toasted and has a smoky flavor.  It has not been declared as gluten-free but because of the heating process it undergoes some research states that the gluten in freekeh is denatured.  Freekeh has more fiber, protein, and B vitamins than regular whole wheat.

Gina Lesako RD, LDN, registered dietitian, writer/blogger.  Follow Gina on Twitter @glesako; 

blog: Dietitians Eat Chocolate Too, or on the web: ginalesako.com.

Carbs to Add to Your Runner’s Diet

Being an endurance athlete comes with a number of perks: You spend hours outdoors, enjoy being in shape and don’t have to skimp on a generous portion of nutritious foods (when training). The endurance athlete’s diet is not full of restrictions and self-sacrifice. The training hours requires consuming enough macronutrients to allow them to replace fuel stores, recover and compete at their best.

Needless to say, runners should not and cannot afford to consume low carbohydrate diets. Their bodies require, crave and demand carbs to work and recover effectively. Carbohydrates are the primary high-energy fuel source that replenishes body stores of glycogen (energy) and provides vital nutrients and fiber for optimal health. Fruits, dairy and vegetables are all sources of carbohydrates.

On the flip side not all carbohydrates are created equal and there is a proper time and portion for endurance athletes to consume them. Avoid highly process, sugar laden or refined carbohydrates (white bread, pasta, rice and pastries). Focus on whole grain breads, rice, pasta and consuming mostly fruits, low fat dairy and vegetables to meet carbohydrates needs.

What’s whole grain? Whole grains contain all three parts of the kernel (bran, germ and endosperm). Refining removes the bran and the germ, leaving only the endosperm. Without the bran and germ, about 25% of a grain’s protein is lost, along with at least seventeen key nutrients. Whole grains are healthier, providing more protein, more fiber and many important vitamins and minerals endurance athletes depend on.

Who do you know if it’s whole grain? Flip the grocery item over. Find the ingredient list- if the words whole grains is the very (I mean very) first word after the colon then bingo its whole grain. If not, put it back and try again. Once you find your favorite trustworthy brands shopping is much easier.

FUEL Fact- the Journal of Nutrition found that eating three servings of whole grains a day helped people reduce their total body fat and abdominal fat. Even a runner can appreciate that! 

Here are 3 whole grains to FUEL your run and life.

Whole-Wheat Pasta Pasta is usually a staple of a long-distance runner's diet and let’s face it none runners as well. We Americans love pasta. Whole-wheat pasta offers 3 times more fiber and is just as delicious. Look for varieties with less than 200 calories and 5 grams of fiber per serving (the suggested serving not your idea or a serving).

Quinoa An answer to the vegetarian runner’s protein prayers. It provides some fiber and a good amount of protein (4 grams). Note: Rinsing quinoa removes any residue and bitter taste. Use it in the place of rice.

Popcorn When you’re craving pretzels or potato chips... an apple just isn’t going to do it. Popcorn satisfies a munchies craving and its whole grain. Look for the individual 100 calorie light versions. Put the butter lover’s movie style back on the shelf! Or try air popping your own- 6 cups popped is a serving. Yes! Six whole cups!

Rebecca Turner, MS, RD, CSSD, LD is a registered dietitian and certified sports specialist in dietetics and founder of Runner’s FUEL. Follow her on Facebook and Twitter @RunnersFuel. For more information visit www.runner-fuel.com or email at a runnersfuel@gmail.com.  You can also find Rebecca here on SCAN: http://www.scandpg.org/dietitians/15186/

Encourage CMS to Include RDs

White House petition reaches 25,000 signatures

Members of the Academy responded across the US to reach the required number of signatures for the White House petition asking the President to urge the Center for Medicare and Medicaid Services (CMS) to reconsider its decision to excluded dietitians as billable providers for intensive behavioral therapy for obesity.  Thank you for promoting this effort within your membership. We could not have achieved our goal without your support.

What happens now?

The Academy has already begun to prepare for the next step which could include communication or a meeting with the Obama Administration.  Now that the petition has reached the signatures threshold, the Administration will contact the Government Relations team in the Academy’s Washington, D.C. office.  In addition, the Academy is working with members of Congress to also urge CMS to reconsider its decision. 

What can you do?

We need you to lead by example and encourage our constituents to keep the momentum moving!

First:  If you haven’t sent a letter to your members of Congress, please take action today!  Overall less than 2% of Academy members have done so (see attached document with state-by-state breakdown). Visit the Academy’s Grassroots Manager at:  http://www.eatright.org/members/actioncenter.aspx to send your letters and share this link again with your members through electronic newsletters, blogs and listserves.  It only takes a few minutes and will ensure our voices are heard in Congress.

Please review the attached information regarding participation by each state.  Despite at least three public policy panel leaders and an affiliate board of directors, some states have less than 3 responses to this advocacy campaign.  It is difficult to expect members to respond to our advocacy alerts if volunteer leaders do not make this a priority – please send your letters today!

Next: Every member should be considering their next steps as outlined by Academy President Sylvia Escott-Stump in her message on December 8, 2011.  On a continuous basis, strive to:   

·         Participate in activities that document the RDs worth. 

·         Start in your own backyard - does your personal health insurance include coverage for RD services?

·         Become a Medicare provider for Part B MNT services.  We need to demonstrate that we have the providers to meet demand. http://www.cms.gov/cmsforms/downloads/cms855i.pdf

·         Form relationships with Primary Care Practitioners to provide nutrition counseling services in medical practices.

·         Market your services to the healthcare community and other community groups.

·         Work with your DPGs and Affiliate Public Policy Panels - provide your expert input when issues arise.

·         Attend the Public Policy Workshop.  PPW 2012 is scheduled for April 5-17 in Washington, D.C.http://www.eatright.org/ppw/

·         Donate to the Academy Political Action Committee. The PAC is our way as a profession to support federal elected officials who are supportive of our causes. https://eweb.eatright.org/eweb/DynamicPage.aspx?webcode=pacdonationslist&site=pac

·         Vote in national and local elections.

·         Be a preceptor for dietetic students - we need to build the RD and DTR workforce.

·         Keep our voice strong and united-get involved in legislative and regulatory issues affecting food, nutrition and dietetics.  

Watch for further updates on the Academy’s efforts to address this situation.  Please feel free to contact me if you have additional questions.
Best Regards,
Jeanne

Jeanne D. Blankenship, MS RD

Vice President, Policy Initiatives and Advocacy

Academy of Nutrition and Dietetics

1120 Connecticut Avenue NW

Washington, DC 20036

The Quick & Dirty on Detox Dieting

With 2012 upon us many of our clients (or ourselves) are looking for a quick fix to rid our insides of the indulgences of the past holiday season.

Traditional ‘detox’ diets base their programs on little food intake.  Staples include foods with high water contents: cucumbers, fruit, juices, and teas.

By increasing the volume of fluid in the body, detox diets claim that this cleanses the body of toxins to enhance the body’s metabolic/calorie burning rate.

Its important to explain to your clients that any initial weight loss is water and the body’s protein/muscle stores.  In addition to the increase of body fat when weight gain resumes, protein breakdown also creates toxins which need to be filtered by the kidneys.  Any rebound weight gain comes back as fat and the body ends up with a slower metabolism. 

Some programs such as The Crazy, Sexy, Diet combine a traditional detoxing juice cleanse with laxative and enema use which disrupts the body’s natural bacteria that are located in the colon while other programs are gluten-free.

Its imperative to utilize a client’s New Year’s Resolution energy to set their goals for the upcoming months.