It is March now in the mountain region and as you have it....we should be prepared for 70 degree days and three feet of snow. We need cozy plastic seedling containers installed to stop toddlers from dumping their contents unto cement just for the cruel pleasure of destruction after weeks of careful cultivation and indoor quarters to all hide from the snow mounds developing outside. This is they time of year where we are blessed to get our water supply and to hopefully decrease chances of another horrible fire season where the sky turns orange and rains ash.
      Sometimes I feel like the seedlings get more attention and walks than the dog. So, what is the plan and we will see if said toddlers and Colorado can rally together to destroy it?
     Enter, our new temporary green house and seed starting area. We have talked for years about building a green house on the south side of our house and use the thermal brick and landscaping stone as additional capturers of heat in this southwest facing location seemly perfect for capturing the solar heat. The one issue, an egress window popping out in the middle of this spot that seems to ruin any plans for permanent placement of a greenhouse at this time. Time will tell if we can bypass this obstacle but for now we are relying on this amazon greenhouse and our three cold frames as well as our seeding starting station in the furnace room.
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Gone are the days where I could wake up with my odd green smoothie and walk around all morning unaware that it had left a green unibrow as it's mark. Usually this is because I am staggering out of my bedroom circa 5am with a one year old on my hip and 3 year old in tow or have been up for at least an hour by that point with no way to drink the smoothie via the respirator. As every health care provider knows....what happens behind the n95...stays behind the n95 all day long. This has made me come to terms with a new set of bylaws for nutrition planning for myself and my family: one meal.....may the odds ever be in your favor.
Now, I have to make sure my meals are palatable to every family member, the right stage for every family member (hello stage one for several months), and somewhat nutritionally sound. We are Costco members as well as urban famers so this means using some of our bulk foods combined with some form of seasonable produce. This usually means my kids eat things you would have never have expected ie pickled beets and mom eats more pasta and oatmeal then ever before. Not the best solution for my post baby and covid body but we are making the best of it. If I have learned one thing in the past several months; it was to roll with it. 
To give you an idea of a meal plan circa February 2021 for our family here it goes: breakfast is sheet pan pumpkin chocolate chip pancakes with oats and whole wheat, lunch is left over dinner Costco pasta with pumpkin, canned tomatoes, garbanzo beans with meat balls with a side of garbanzo bean, raisin, nut, beet, spinach salad, and dinner is homemade hummus and veggies with veggie burgers a la tapas style. Snacks are usually a combo of fruit, cheese, cheerios, or peanut butter. Dessert can be homemade chocolate hummus with fruit, fruit with yogurt, or for valentines...homemade whole wheat sugar cookies heart shaped (I am quite liberal here with my definition of heart....could be more akin to the avian three chamber version). 
So, welcome back and thanks for reading and I hope you got a laugh out of this one, 

Two lectures this month explains why I have been in hiding for most of the month. That and a crazy er schedule.  Here goes....how do we fuel as an athlete and specifically as a runner? This obviously differs as the event goes from very short track events to ultra marathons,. This talk was designed for the middle to longer distance athlete from the 10k runner to the marathon runner in mind. 

When I say this: I mean your diet should be planned around your workout. As you will see later, you can calculate roughly how many calories you need each day based upon your activity and ideal weight. There are more accurate ways to determine this from resting metabolic rate measurements to heart rate monitors and so on. But we will stick with the rough idea here. If you can determine these two things, you can plan you caloric intake and macro nutrient proportions around you activity for the day. For many of those this is in the morning but this can also be lunch time, dinner time, or even several times a day for those in multi sport. The plan is to consume most of your carbohydrates around that activity period as determined by your activity level and add in a little protein when needed for muscle recovery. This is then split into the before, during, and after periods. 

The during period occurs during the activity and event and usually just included simple carbohydrates and electrolytes. During longer events, a little protein has been shown to reduce muscle breakdown ie at least 90 minutes or longer and likely in 2+ to 3+ hour events. For those competing in ultra endurance events, consumption of complex carbohydrates and starches is often necessary but not covered in this post. The after period is the start of the recovery of the event and is key in building muscle glycogen stores as well as starting the process of hydration. This is usually split into two periods: immediately after or within 30 minutes and the post activity meal up to two hours after the event. Again, simple carbohydrates are often easier to consume immediately after a high intensity workout and are likely digested better. 

For example: let's take a 130 lb woman on a moderate activity day exercising for two hours with some interval training such as mile track repeats. Her goal would likely be to consume at least 70-96g of protein per day, 47 g of fat per day, and anywhere from 236 to 360 g of carbohydrate that day. Again, this is a rough estimate and might vary with athlete and individual goals and workouts. 
I did have some questions about weight loss in the athlete but will actually focus on that in an upcoming lecture so please either listen to the podcast or try to attend that lecture when it is approved by Natural Grocers.

Hydration is another key topic. As we all know, it can be really tricky to arrive at an activity just hydrated enough. Too much as you might miss your start waiting in line at the porta potties or have that dreaded sloshing occur in your stomach. Too little and you might not even finish the race or event due to cramping or other symptoms of dehydration. Guidelines to live by are do what is working on the workout that most resembles your race. Weigh yourself before and after to see how much fluid you are losing. If you are gaining fluid you may be over hydrating or taking in the wrong concentration of fluid. Also watch your urine output for color and amount. No urine after a workout is a bad sign as well as very dark urine since you may be dehydration.  Pay attention to how much you sweat and how much residual salt you find on your clothing after workouts. This might indicate you need to increase your salt intake.

What works for one person will likely not work for another. Use your workouts as your prep for your races. Remember nothing is steady state and training and nutrition has to vacillate around your goals for the season with proper training periods as well as recovery periods. I hope you enjoyed this blog post and please listen to the podcast for additional information. 

      It is going to be hard to cover everything but here goes...Increased food intake can be caused by a multitude of factors. One way to look at those factors is to separate them into interval and external factors. The internal factors can be physiologic or based upon a response from the body or hedonistic which might also come from the body but is more more cerebral in nature. One of the recommendations from AND or the Academy of Nutrition and Dietetics is the goal for a 3-10% baseline weight reduction in those needing to lose weight. The lower recommendation of 3% has been shown to improve blood pressure, lipid profiles, and diabetic factors in some populations still make this an important number even if smaller. The 5-10% is the more effective and harder to achieve guideline but does show significant health benefits as shown by the paper. This is translated to a 500-1000 calorie deficit per day resulting in a loss of 1-2 lbs per week. 
        The most surprising part of this paper is that the evidence does not support one macronutrient ie low carb versus high protein versus DASH versus Mediterranean over another. The most significant factor of the diet is if there is caloric restriction ie a 500-1000 calorie deficit built in to the diet. Not that these diets are all equal since some are associated with better blood pressure profiles ie DASH or lipid ie Mediterranean but for weight loss; caloric deficit is most important. 
        Other factors that have been shown to be be effective in weight loss include reducing or eliminating sugar sweetened beverages, portion control/ premade meals/ meal replacements, and consuming more calories earlier in the day. Now don't shoot the messenger with this one. Increased fruit and vegetable intake have not been show to result in significant weight loss in obese patients based on the paper as well as meal frequency/timing or breakfast consumption. To play devil's advocate; I would honestly need to review the papers discussed in this statement to really believe the fruit and vegetable statement.

       The paper then focuses on recommendations for physical activity. Besides the guidelines for 30 min of moderate activity on most days of the week or 150 min/week, the focus on physical activity has been shown to improve weight loss when combined with caloric restriction and improve weight maintenance. The other important side of this story. If we up the activity level to >250 min per week; it was more likely that weight maintenance would be achieved. These are some pretty high recommendations meaning that there would need to be some pretty big life changes occurring to produce these results. There wasn't a real explanation of level of physical activity and it's comparison ie high vs low vs moderate such as aerobic activity versus high intensity training. 

      The best part of this paper is the additional discussion of behavioral interventions. This is a team effort and having a multidisciplinary approach is more effective. Particular behavioral interventions studied included: cognitive behavioral therapy, motivational interviewing, and acceptance and commitment therapy. I will not go into these individually but you can review my podcast for examples of the first two. Additional behavioral interventions include: self monitoring such as self weighing, problem solving help, contingency management, relapse prevention, slowed eating, social support, stimulus reduction, and stress management.
   An additional interesting aspect is how technology comes into play with therapy...not just behavioral. Apparently face to face interventions are more effective than computer based interventions. The paper notes that with the smart phone and new and upcoming apps; many possibly successful options are out there that have not been researched. The paper also discussed how community based programs such as weight watchers, gym based, and church based programs have been shown to be effective at weight loss. Additional discussion is covered in the podcast so please see that for more information. 

     The last couple of things I will note include supplements, medications, and surgical interventions just for completeness sake. To be brief,  supplements are just no effective and are harmful at times. Medications have a role with some patients and the studied medications included: orlistat, lorcaserin, and pheneramine/topiramate. The surgical options include: laparoscopic gastric banding, gastric bypass, and sleeve gastrectomy. Again, please see my podcast for a deeper review of these topics. This podcast/lecture was not intended to focus on these topics since they are only briefly reviewed in the paper and require a discussion in of themselves. Other things I would have liked to see the paper discuss include water consumption as well as sleep activity however they were not discussed and do seem to have significant effects on weight loss. Thanks for following!

If you are at all like me, you are usually running around with your hair on fire torn between tending to small animals or children after work, trying to figure out what paperwork you still need to do before the weekend, and picking up whatever has mysteriously deposited itself in your living room between when you left in the morning and arrived home. In the middle of all of this, somehow you can still throw a healthy dinner together while you get other things done. Surprise the amazing roasted vegetable dish! 

Ingredients:
1 butternut squash or other winter squash
1 bunch of beets scrubbed but not peeled
1 white onion
1 head of cabbage or kale
1/2 cup of chopped fresh sage
1 tablespoon olive oil
salt to taste

Directions:
1. Turn on oven to 350. Chop all vegetables into small pieces. Place on baking sheet or in baking dish, Toss with olive oil and salt and roast for about 20 minutes. You can even turn off the oven and do other chores and the vegetables will be even sweeter when you come back. 

Above the vegetables are served alongside homemade pizza from scratch with roasted veggies as a topping and a side salad. 

Ingredients:
1 green pepper
1 white onion
3 garlic cloves
4 cups of raw pumpkin or butternut squash
1 28 ounce canned tomatoes
3 cans of smoked clams or 2 cans of boiled clams
2 bay leaves
4 cups of vegetable bouillon *** see my make at home recipe here
3-4 strips of nori (optional adds flavor)
1 teaspoon salt
1 tablespoon olive oil (optional can skip if using clams packed in olive oil)

1. Chop all of the vegetable ingredients from the pepper to the pumpkin or squash and add to the crock pot. Add of the rest of the ingredients. Cook on low for 5-6 hours or high for 3 hours and enjoy.

Probiotics seemed to be the most promising new research that I reviewed for my lecture. The gut is often the location where bacteria, viruses, and other pathogens or disease causing microorganisms first encounter our immune system. That is why our gut health might equate to a healthier immune system. The research on probiotics and the microbiota or current bacteria living in our gut and it's correlation with various disease is promising. I only covered it's correlation with immunity in this lecture.
Obesity, anorexia, or malnutrition also correlate with our immunity. Obesity, or a  BMI >30 is determined to be a chronic state of inflammation and has been proven to cause more infections that tend to be worse as well. In fact, a BMI >30 in comparison to a BMI<17 is actually worse for your chance of getting an infection in some cases. Please see my references in the end slide for these papers. 

Vitamins have long been used to fight immunity with supplementation. However, the literature usually only supports increased supplementation with Vitamin D when sunlight exposure is low. This would include our region of Denver from the fall to the spring based upon our latitude. It is really hard to get enough Vitamin D from the diet in regions that don't receive enough sunlight based upon the way it is absorbed. Most of the other vitamins are consumed in enough amounts in a diet that incorporates lots of fruits and vegetables and occasional meat. In vegans or vegetarians that don't consume many processed foods, B vitamins may not be consumed in enough quantities and should be supplemented. Vitamin B12 is another vitamin that has poor oral absorption but it does appear like repeated oral absorption in large quantities may be better then a one time injection of large quantities. Another way to look at the above vitamins if the separation between fat soluble vitamins ie A,D,E,and K and water soluble vitamins. Fat soluble vitamins can become toxic in ingested in large supplement forms while water soluble vitamins such as Vitamin C are normally secreted out.  

Minerals have also been shown to improve immunity. Many people already take zinc supplementation. However, what they don't know is that sometimes supplementation can change that way the body absorbs other minerals. The charge on the zinc element is similar to copper, magnesium, calcium, and some forms of iron. The absorption of these elements can affect each other. Again, this could warrant a seminar in of itself but is important to keep in mind for those supplementing with large amounts of minerals; the supplement may be inhibiting absorption of other important minerals.

Some of the things I have already discussed are antioxidants. Quercetin is tumeric. Polyphenols naturally occur in many fruits and vegetables and are considered an antioxidant which are known to fight inflammation by combating free radicals in the body. In addition, I discussed polyunsaturated fatty acids and the three principle types of fatty acids: ALA, EPA, and DHA. I additionally emphasized that when taking in these fatty acids it is important to consume them in a ratio of your omega 6 fatty acids ie 2:1 or 1:1 or you may not gain the full benefit of your omega 3 fatty acids. 

Sleep is very important to immunity. Studies have shown that decreased sleep can even reduce your immune response to vaccines. The goal is to get between 7 to 9 hours per day of sleep. Anything less then 7 hours and sometimes more then 9 hours is often associated with obesity. Think of sleep as your time to repair the body. My slide above noted how sometimes athletes can require more sleep than someone who is less active. However, that time spent in bed can often be inefficient. Practice good sleep hygiene such as going to bed at the same time and waking up at the same time, avoiding screen time before bed, don't read stressful emails before bed, and avoid eating right before bedtime.

Stress is a hard factor to quantify but there are studies out there that do this. There is a old New England Journal of Medicine article that supports a direct correlation between rates of upper respiratory infections and stress with attempts to control outside factors. The theory behind this mechanism is that the fight or flight response produced by stress limits the bodies ability to fight infection during this stressful period. Ways to deal with this stress include avoiding caffeine, simple sugars, and trying to find ways to self soothe through biofeedback and relaxation techniques such as reading a book or exercising.