Saturday, October 25, 2008

Picky, picky

Last week my husband, my daughter and I had lunch with some friends. I forget why now, but my husband mentioned how we do not force our daughter to eat anything. We simply present food to her and allow her to choose whether and how much to eat. Our friends asked us how we get her to eat things like vegetables, if she doesn't eat them. Well, we've made a commitment to live by the division of responsibility in child feeding (developed by child feeding specialist and RD, Ellyn Satter). These are: 1) Parents are responsible for what, when, and where children eat and 2) Children are responsible for whether and how much. Therefore, it is up to us to purchase, prepare, and serve a variety of healthful foods to our daughter and to trust HER to eat the right amount that she needs.

There are certain food items that our daughter doesn't eat (i.e., broccoli as of late); however, we do not force, push, or coax her to eat them. We offer a food to her, and she makes the decision as to whether or not she'll eat it and how much of it she'll eat. Even though she has turned down broccoli on several occasions, she's also eaten it on others. Sometimes it takes a child (or really anyone) up to 15-20 exposures before he/she will even try a food or try it AND like it. Heck, I used to HATE cottage cheese, but somehow one day I tried it as an adult and actually now like it. Go figure! It's our job to continue giving her the opportunity to try the broccoli. If after the first time she turned down broccoli we did not offer it to her ever again, she'd never really have the opportunity to try it and/or like it. There may be some foods that a child never eats/likes, and that's fine. There are some meals in which our daughter doesn't eat much at all, and that's okay. The beauty of the division of responsibility in feeding is that we do not worry that she's not getting enough nutrients since we know that we offer her a variety of healthful foods and she does eat many of them (just not always broccoli). This allows her to rely on HER internal cues (rather than external cues from us) to determine exactly how much she needs to eat while also being exposed to a variety of healthful foods.

These are difficult concepts for some parents and caregivers to grasp. I think it can be especially difficult depending on how their parents nurtured their feeding relationships or because as parents we often worry about the health and well-being of our children. Personally, practicing these principles has been helpful in relieving some of the pressure during feeding time for us and actually makes our meals much more relaxing and enjoyable, and that's really what I want to encourage in our daughter...a healthful AND enjoyable relationship with food and eating.

Happy Feeding!

Tuesday, October 21, 2008

Nutrition for the run of it

Some of you may know that I recently completed my second marathon two weekends ago. As I trained for the last six months, I was constantly reminded of the importance of sound nutrition to my physical performance. When I nourished my body well, I noticed a major difference not only in my physical state but mental as well. Throughout my training and up to my competition, it was interesting to hear the different thoughts and advice on nutrition that people would give me along the way. While the support and good intentions were always appreciated, it was often interesting to note the great amount of misinformation there must be about nutrition for sports out there. So, I thought I'd address a few of the sports nutrition in my blog.

1) "You can eat whatever you want since you just burned all of those calories!"

While it does seem tempting, it's not as easy as it sounds on several levels. Adequate nutrition is still important, especially for an athlete, so consuming nutritious foods, including vegetables, fruits, whole grains, and lean proteins, is essential even for an athlete. In fact, the need for certain nutrients are much greater for athletes than for non-athletes. Secondly, in order to ensure peak performance, having the right combination of nutrients is vital. Because carbohydrates provide a primary fuel source during physical activity, especially endurance activity, it's important to include foods rich in carbohydrates, like whole grains. Plus, with the need for more carbohydrates (at least for an endurance athlete) being so much greater, it can leave little room for foods high in fat and calories. Finally, I've found that in order to maintain a healthful diet, it's best to be consistent with the food intake, especially when coming off the training/competitive season.

2) "Be sure to load up on those carbs the night before!" or "Are you having a big pasta dinner the night before?"

Obviously, people are aware of the importance of carbohydrate for optimal performance. However, it's not just about loading up on carbohydrates the evening before a race. For optimal training and competition performance, it's best to consume an adequate amount of carbohydrates daily. In addition, true glycogen or carb loading involves increasing carbohydrate consumption ~6 days before the event to max out glycogen stores rather than simply doing so the night before. It's also important not to try out something new just before or during an event. So if one truly wants to load up on carbohydrates, it's best to practice during training along the way in case adjustments are needed.

3) "Don't you need some Gatorade?" (after a standard training run of 40-60 minutes)

Fluid replacement sport drinks have their place in training and competition, particularly for high intensity stop-and-go and endurance sports. However, they're most beneficial for activity lasting >90 minutes. So, for a short 40-60 minute run, water will do just fine.

4) "Make sure you drink enough water during the run!"

Not only is it important to be well-hydrated during the event, but it is also important to maintain proper hydration on a daily basis. Staying adequately hydrated even during training is important as even a loss of 2% of body weight can result in impaired performance, and I speak from experience when I say that even mild dehydration can reduce mental stamina during any run. And it's important not to forget to replenish fluid losses after the training or event. (See #3 re: the need for sport beverages during activity lasting >90 minutes.)

5) "You don't really need that stuff do you?" (regarding carbohydrate gels)

Consuming carbohydrate during high-intensity events like basketball or endurance events like marathons helps replenish muscle glycogen (stored energy) and improve performance. It is important to try out these gels or other supplements during training as adjustments may be needed depending on individual tolerance and preference. It's best not to try something new on event day!

That's about all for now. Keep moving and happy training!

Sunday, October 5, 2008

The truth about trans fat

This topic may seem a bit un-hip at the moment as various items in nutrition news become hot and then not in no time. However, trans fat still interests me. I teach my students about it, and I still get asked about it a lot in practice. I thought I'd write about it this week because it still seems to be an area of interest for many. In fact, in July 2008 California lawmakers approved legislation for a ban on trans fat in foods from restaurants and bakeries, and the law will take effect in 2010. This follows the somewhat controversial ban on trans fat in restaurants in New York City and others.

First of all, what is trans fat? Well, it's a type of fatty acid in which the chemical structure has been changed. This can be done industrially in order to enhance the shelf life and texture of foods. There are two types of trans fats: industrially produced (usually found in margarines, shortening, baked and fried foods) and naturally occurring (found in beef fat and milk). It appears that it's the industrially-produced type that poses the most health risk.

Why all the hype? Well, let me count the ways.

First and foremost, intake of trans fat is linked with increased risk of coronary artery disease, risk of fatal and nonfatal heart attacks, and sudden cardiac death. It is associated with increasing total and LDL (bad) cholesterol, lowering HDL (good) cholesterol, and increasing total to HDL and LDL to HDL cholesterol ratios. Plus, the effect on LDL cholesterol appears to be dose-dependent meaning that trans fat has an affect at varying doses rather than starting at say an intake of X grams/day.

It doesn't stop there. There are several other avenues through which it possibly contributes to heart disease including causing the arterial walls to be less flexible and activating inflammatory responses, which is increasingly associated with heart disease.

The shocker for me was the effect on the unborn fetus and breastfed infant. Of course, this is a potential risk, but it may adversely affect growth and development by interfering with the metabolism of essential fatty acids needed for growth and brain development (DHA and ARA). However, it may also just be that women who consume a diet high in trans fat may also not eat sources of healthy fat (omega-3 fatty acids like fish, fish oil). In one study, newborns with high levels of trans fat in their blood system tended to have smaller head circumferences, which can be an indicator of brain growth/development. This was a small study with several limitations, but the data are intriguing. What I don't believe a lot of pregnant and/or breastfeeding women realize is that what they eat really can affect their babies negatively. The ONLY way a fetus or solely breastfed infant can have trans fat in their bodies is through the mother's dietary consumption.

Other studies show either no or some positive association between trans fat and cancer and diabetes. There are also studies linking trans fat with impaired insulin sensitivity or insulin resistance. This appears to be mostly in obese subjects and/or those who already have diabetes and/or insulin resistance.

The good news is that the FDA started requiring placement of trans fat content in foods on the Nutrition Facts Panel as of Jan. '06. So even before then, companies were scurrying to remove or reduce trans fat from their foods. This was done in other countries well before us, and the average trans fat intake in those countries declined with this change. That's good news for us! At the same time, in order to make up for this reduction in trans fat, many food manufacturers utilized fat sources that are high in almost equally unhealthy -- saturated fat. Be careful! Read the label. In addition, something can say it has 0 grams trans fat or 'trans fat free' and still contain trans fat. In order to state these things, it has to contain <0.5g trans fat per serving. Check the ingredients list, and if you see the words "partially hydrogenated" and whatever type of vegetable oil listed, it contains some trans fat. Be aware that the trans fat content includes both industrially produced ("partially hydrogenated") and naturally-occurring. Also, supplements may contain trans fat as well. They are also required to list this info on their Supplement Facts Panel. In fact, one woman I know saw that her child's Flintstone gummy vitamins contained "partially hydrogenated vegetable oil".

As for the ban on trans fats, I have no problem seeing industrially-produced trans fat disappear from the food supply. There is no real human need for it other than to offer a dense source of energy (calories), and there are other nutrients and types of fat that can serve that purpose. It is simply not an essential nutrient meaning our body does not need trans fat for survival or to function properly AND it is actually potentially harmful. Yet another reason to get a little closer to mother nature when it comes to the food we eat:)

Here's to a healthy week!
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