Sunday, March 6, 2016

12 Things I Gained in My First Year of BodyBuilding

It's the first weekend of March.

While that may not mean much to most people, to anyone interested in strength and physique sports, it only means one thing: The Arnold Sports Festival is upon us.

My social media feeds have been inundated with snapshots of lean, sinewy fitness models posing at protein bar booths, spray-tanned bikini competitors strutting their stuff on the national stage, and strong-as-Hell women setting 601-pound world raw squat records (you SLAY, Bonica Lough!)

Just over a year ago, I would have had no idea (nor could I have cared) about the incredible, inspiring feats of strength, discipline, and tenacity going on in Columbus, Ohio right now. But then again, a whole lot has changed since I dove head-first into the world of bodybuilding in January 2015. Over the course of nine months, I lost 23 pounds and around 9% body fat - but it's what I gained that tells the real story.

1. I found what I'd been looking for for years: a calling that I could call my own. 

I spent my high school, college, and post-secondary years as a self-described dilettante. It's not that I mind being interested in a great number of activities and ideas - I believe unbridled curiosity and openness to the world's possibilities is one of the most valuable human traits. But I also always felt like I was missing something.

I was never a kid who could be identified by a bracelet charm of a soccer ball or a musical note or an ice skate. I loved playing the oboe in small chamber groups and pit orchestras, but I not-so-secretly loathed the innumerable hours of solitary "woodshedding"-style practice necessary to take my playing from good to great. Politics was always an interest of mine, but in college, that transformed from my Weberian avocation into something I actually thought I'd pursue as a career - then those dreams dissolved after a particularly grueling summer where I learned the reality of political organizing.

Though it felt nonsensical at the time - I loved working out, sure. But me, diet? 
...And wear a microscopic, rhinestoned suit on stage in front of an audience? 
...In 5" plastic clear heels and three coats of copper paint?

But somehow, like all of the greatest love stories, it also made all the sense in the world. It was the push I needed to take my currently uninspired exercise routines from "chore" to "passion." It made me wake up for 6am gym sessions genuinely excited. It made hours and hours of self-guided learning fun - no, irresistible. It made me understand what true obsession felt like.

2. I gained impeccable mental-math skills.

Quick! You're making a protein banana bread recipe. The recipe calls for 4 egg whites, but you don't buy whole eggs; you use the whites from a carton. How much liquid is that supposed to be? Well, each egg white is about two tablespoons of the pasteurized stuff. There's three tablespoons in a 46-gram serving. 4x2=8, and 8/3 = 2 and 1/3, and that times 46 = just under 123g of whites needed for your baking adventure.

Before I got into bodybuilding, it was an accomplishment just to calculate the tip correctly.

3. I found ingenious ways to sneak vegetable matter into everything

You want some oatmeal? Shred a zucchini in there and you've got twice as much volume for breakfast. Daily carbs getting too low to enjoy those oats? Easy: grind up a head of cauliflower in your food processor and boil it on the stove with some protein powder and you've got yourself a piping-hot bowl of "fauxts." Craving pasta? Buy this mung bean fettuccine and you'll be giving yourself a whopping amount of protein and fiber and a delightfully full stomach.

4. I started seeing food as fuel, and I stopped seeing exercise as punishment.

As loath as I am to admit it, in the first seven years I spent as a gym-rat, I didn't do miles and miles of cardio on the treadmill because I found it fun. I did it because I wanted desperately for my body to change. I needed to believe that eventually, after just one more intense HIIT class or after slogging through one additional mile every day, I'd wake up one morning with the "toned," cellulite-free legs I've always dreamed of. If I didn't believe this, I may have stopped those workouts altogether. Because a good portion of the time, I wasn't actually having fun.

Shifting my focus from trying to burn my body away to building my body up changed the way I saw food, training, and my own body. I needed food to fuel my workouts - which I was actually excited to do (almost) every day - and I needed to give myself ample recovery time not to get smaller and thinner, but to come back stronger and bigger. For the first time in my dieting life since pre-adolescence, I wanted to be more, not less. 

5. I found freedom from my fear of "bad foods."

Deep in the recesses of my Pinterest, one will find a treasure trove of "grain-free" treats waiting to be made. During my highly impressionable adolescent years, I was surrounded by a culture of misinterpreted dietary studies that called some carbs "bad" and some carbs "good." Low-glycemic carbs wouldn't "spike" my blood sugar, and we all knew that insulin was the reason people got fat...right? Wrong.

Since my first foray into the world of bodybuilding, I've been a dedicated follower of flexible dieting, also known as "If It Fits Your Macros (IIFYM)." This approach to nutrition is based on the evidence that overall calorie balance (energy intake versus energy output) and to a slightly lesser extent, your breakdown of fats, carbohydrates, and protein (the three macronutrients or "macros") is responsible for the overwhelming majority of changes in body composition. 

Flexible dieting allows the individual to choose foods that fit best with his or her own taste and preferences, schedule and lifestyle - you love low-GI brown rice and sweet potatoes? Enjoy! PopTarts, ice cream, or cereal more your style? Be my guest. Provided you are hitting a baseline amount of fiber and eating a variety of foods every day, you will be able to effectively meet your fitness goals, fuel for performance both in and out of the gym, and eat the foods that will be part of a long-term fitness lifestyle, not a six-week crash diet. 

No food is "bad" and no food is "good." Any and all foods, eaten in the appropriate amounts to fit your needs, can help you reach your goals.

Intrigued by the idea that you can eat what you want, when you want (yes, carbs after seven are kosher!) and still meet your goals for now and for life? Read on here. 

6. I started grasping the idea of moderation.

Lifetime card-carrying member of the Clean Plate Club: that's me. I'll always remember the early fall of 2014, when I was just starting graduate school, as the point my approach to nutrition and balance reached its nadir. I decided that, after finishing off yet another jar of full-fat peanut butter in less than a week, I simply couldn't be trusted with the stuff. I made the shift to PB2, powdered peanut flour that could be reconstituted into something vaguely resembling the real thing, and never looked back.

But several months into flexible dieting, I had a realization. I was now able to put just one cinnamon brown sugar PopTart in my nightly bowl of yogurt, and save the other half for as many days as I wanted until it fit my macros again. Me. Leaving half an opened treat in my pantry without a second thought. 

It was revolutionary.

Could I do the same thing, I wondered, with my old flame, peanut butter? The answer was yes! ...Sort of.

Moderating my intake of my most-loved foods is still a skill I'm mastering. I have days when the thought of an unmeasured spoonful of the good stuff doesn't even cross my mind, and I enjoy a truly satiating two tablespoons like some form of a normal person. I have other days when I go HAM on a freshly opened jar and wake up a few minutes later, disoriented, with a sticky mouth and a spoon in my hand. But I now feel the freedom to keep peanut butter - the real stuff - as a household staple, and when I do have my moments of indulgence, I savor them, eventually seal up the jar, and move on - (relatively) guilt-free. Hey, I'm still learning.

7. I fed my thirst for new knowledge and expanded my vocabulary.

One of the more unexpected avenues that opened for me when I began bodybuilding was the amount of new information I learned along the way. Coming from a family that values curiosity and lifelong learning, I've always been a bit of an autodidact. This is a trait I like about myself and one that I seek and value in others. In this way, it makes perfect sense that I'd fall deep into the world of bodybuilding, which combines all the best aspects of continual learning, self-guided education, and the application of theory in the eternal n-of-1 experiment of the human body. 

Suddenly, I was spending hours listening to podcasts and filling every unoccupied moment reading articles about the science of muscle growth, body composition, human nutrition and athletic performance. Some of my favorite muscle-nerd podcasts that entertain as they educate: Ice Cream 4 PRs and Physique Science Radio. If reading is more your style, check out the undisputed king of the evidence-based fitness and nutrition movement: Alan Aragon.

8. I made new friends, and for the first time in my life, learned what it felt like to be part of a team.

Bodybuilding, most presume, is a solitary sport. It's true that it can often feel that way: many hours spent on your own pounding out cardio during competition prep and foregoing a round of drinks shared with friends at the bar because it doesn't fit your weight-cutting macros can make you feel all alone in your endeavors. And after all, at the end of the day when you're up on that stage, you're competing on your own. 

But if you're lucky enough to find a group of people who love the sport as much as you do, you will find an overwhelming sense of community, shared values, and mutual support. I found this with a local group made up of both male and female competitors across the sport's different divisions. We share 5am fasted-cardio selfies to motivate others to get out of bed and start their day. We show our triumphs when we lift a weight we've never lifted before, or reach new levels of leanness before an upcoming competition. We revel in one another's successes and we commiserate when calories are low and anxiety and hangriness run high. At local competitions, we are in the front rows screaming the loudest to cheer on our teammates. And even when we are sharing the stage in competition, we are also hoping for our teammates to succeed along with us. 

Before bodybuilding, I had never experienced the camaraderie and the kind of drive that comes with  sharing a passion with others who share your goals. And in a sport that can be as mentally and physically challenging as this one, I can't imagine going without it. 

9. I learned the importance of smart goal-setting - and the virtue of patience.

My first "prep" for a bodybuilding competition technically lasted nine months. During the first three, I didn't lose a pound. My body was adjusting to the changes in diet and training and building new lean tissue. I could feel that changes were happening in my body, but they weren't fast enough to my liking. If I couldn't see it on a scale, it was hard to find it worth the work.

Through my first competition prep, I learned the value of taking goals day by day. I believe much of the reason we as a society struggle with adopting and keeping healthful habits is not an issue of determination; it's an issue of expectation. Pills, creams, "waist trainers," and "30-day squat challenges" offer nothing but empty promises of drastic changes in minimal time, often with minimal work. But as anyone who's successfully transformed any part of their life can tell you, it's the small, daily habits that add up over time and make the difference. 

Somewhere along the way, I realized that I couldn't depend on dreaming of the final end-point goal to motivate me day in and day out. I needed to focus on every small step along the way that would eventually get me to the destination - every meal, every workout (sometimes, every rep!), and every day that I'd put in my best effort was a success to be celebrated. With this mentality, I lost the angst of pining after the far-away prize, and saw every day as a reason to feel accomplished.

10. I learned to love my body at every stage - not just stage-lean.

One of the first things I did when I began competition prep was that I started following countless competitors on Instagram and other forms of social media. While I was on my first "cut" and trying to get lean for a show, others were in the midst of their "building period," putting on quality muscle by lifting heavy and eating a caloric surplus. I quickly learned that, in order to put on muscle and to progress from year to year, you must provide your body with enough energy to build new lean tissue. This means - yes - eating slightly more than your caloric maintenance level. And though a smart training regimen can minimize fat gain, it's important to remember that along with new muscle tissue comes new fat. 

I thank my lucky stars that I stumbled upon a community of young women who made it their mission to show the reality behind the sport: that no one who wants to truly improve their physique from year to year can spend their whole life looking cover-model lean. In fact, it's quite the opposite: the most serious competitors take the longest time between competitions in order to improve their weak points, which means taking time away from dieting and returning to normal levels of body fat. They spend the majority of their life looking relatively "fit," but the terms "diced," "cut," "ripped" need not apply. When running errands and attending family events, they do not look like the version of themselves on the cover of Muscle and Fitness.

Annika, AKA The Swole Barbie, isn't a stage competitor, but she's one of my balanced-lifestyle idols all the same. She made Hella gains over the course of two years and rehabilitated her metabolism and strength to sky-high levels. 

 Lisa Mahoney, Registered Nurse by day and powerlifter/national Canadian bikini athlete/online coach by night. She's one of my biggest inspirations when it comes to embracing the off-season. Over the course of her last cut in summer 2015, she lost 15 pounds and added upwards of 20 pounds to her deadlift. Yes, queen.

Erin Dimond, a competitor who built enough muscle to transition from bikini to figure division, documents the changes in her physique from the end of a building season to the end of a bikini competition prep. 

They are real people with real bodies. Seeing these young women proudly bare their physiques at all phases - not just when their abs were most visible and their arms at peak vascularity - made me feel comfortable with my current body for the first time in a long time. I realized that this sport was about so much more than the five minutes spent on stage in a spray tan. It is about the years of sweat and dedication poured into every day, and the body will (and needs to) look different on the days when the hardest work is done.

11. For the first time in as long as I can remember, I did something that scared the living sh*t out of me.

In the final analysis, the biggest impact that bodybuilding had on me had nothing to do with my body and everything to do with my approach to life. For too many years, I chose only to do things with which I had a reasonable shot of success. Going to college, going to grad school, getting my first job: I was checking off the marks of the Pathway To A Successful Life, and although I felt challenged plenty of times along the way, I never truly feared I would fail. I was living the easy way.

Bodybuilding was different. Not only was I, like any sane person, afraid of baring my body for the purpose of being judged against others'. I was afraid of the psychological wound of outright failure. Coming in last place. Getting the red lantern. Being - gulp - the worst at something.

But in a strange way, the idea of setting a goal at which I could possibly face a tremendous, unmitigated failure actually excited me. Just thinking about the possibility of failing made my stomach drop and my heart race. It energized me and pushed me toward working harder for something than I ever had in my life. And it made me realize that the only way to find out just what I was capable of, would be to let go of the reigns I had placed on my list of what's possible, and accept the possibility of failure. 

Of everything this sport has taught me, it's this lesson I value the most.

12. I developed an addiction to chewing gum.

Let's be real here. It's not all glamour and neatly-wrapped life lessons. Every competitor will feel hunger at a certain point of prep - that's the reality of living in a prolonged calorie deficit to obtain necessary levels of leanness for the stage.

Different people deal with hunger in different ways. My relatively tame poison of choice came in the form of finishing off more than a pack a day of Orbit Cinnamint.

What can I say? You win some, you chew some.

Sunday, February 21, 2016

My Biggest "Beef" with the New Dietary Guidelines

This is the long-delayed Part II of my discussion on the new American dietary guidelines, the first part of which can be read here. 

Back in early 2015, when the rough draft of the new 2015-2020 guidelines were released, media outlets widely reported about one of the biggest changes in these guidelines as compared to years past. In the draft, the guidelines included information about the environmental impact of different dietary patterns. These patterns included vegan, vegetarian, pescatarian, and several different meat-eating diets ranging from low-red meat, high-fish diets - such as the Mediterranean diet - to diets high in all meat types, such as the conventional American diet. The report concluded that replacing at least some of the meat in one's daily diet with plant-based foods would have a positive effect on the environment and that, on the whole, "dietary patterns that promote health also promote [environmental] sustainability."

The evidence upon which these conclusions were based was a rigorous systematic review of a decade and a half worth of scientific studies ranging from the year 2000-2014.  Only fifteen of the most rigorous, well-designed studies made the cut, and all of these studies came from industrialized nations where dietary guidelines are used, making them ideal to be compared to the U.S. population. Many of the studies analyzed the effect of food production on the environment using Life Cycle Assessment (LCA), or "cradle to grave" analysis. LCA takes into account the resources and energy needed to extract, produce, transport, use, and dispose of products.

Life Cycle Assessment, or LCA, takes every step of goods production into account. 

Even though the 15 studies used a variety of methods to define dietary patterns and measure the impact of food on the environment, there was little disagreement between them. After comparing the relative impact of these dietary patterns on the environment - including greenhouse gas emissions as well as land, energy, and water use - the report found that diets lower in meat consistently had a reduced impact on the environment.

Most of the reduction in energy consumption can be chalked down to the fact that animals (like cattle, pigs, chickens, and yes - humans) require a whole lot of energy and resources. Think about all the steps in the process that must happen to get food to your table (and Fido's bowl and Bessie's trough, too):

  1. Animals like us need energy in the form of digestible food (calories), and this food must be grown using water, fertilizer, and fossil fuels (such as the gas that runs the tractors that harvest the food). 
  2. The food must then be transported to us for eating, requiring more fuel and producing greenhouse gas emissions. 
  3. Some of the food will result in biological waste products, such as methane gas farts (tee tee!) and feces. 
The average non-lactating cow requires 25,000 calories per day. Stop giving us the side-eye, Bessie. It's the truth.

As the current inhabitants of the top of the food chain, humans have a choice. We can choose to eat the cows (sorry, Bessie) who eat 25,000 kilocalories of their own food per day, and spend the energy raising, processing, packing, and transporting them across the country. Or we can cut out the middleman and focus on eating the foods that are closer to the bottom of the food chain, skipping the middle step and all the energy that goes into it. All things considered, it's pretty apparent that the less meat and dairy (and, to some extent, packaged snack food and beverages) an individual consumes per day, the lower their impact.

Baby, you've changed.

Like your childhood best friend who went away to summer camp and returned with a newfound interest in boys (eww!) and training bras, summer was a time of change for the 2015-2020 U.S. dietary guidelines. Some time between February and October, the decision was made to exclude any discussion of sustainability within the guidelines. However the final dietary guidelines report issued in the fall of 2015 make no mention of the impact diet on the environment.  As you may be able to tell, I am not in favor of this decision.

Not only do I pity the poor saps who did a tremendous job on the systematic review described in detail here that will never see the (official) light of day. I feel that it is short-sighted and unwise to argue that issues of environmental sustainability are not directly "health-related" and therefore do not belong in the scope of the U.S. dietary guidelines. The stated purpose of the guidelines is to "promote health, prevent chronic disease, and help people reach and maintain a healthy weight." So, yes - the primary goals of the guidelines are all related to helping us live the best, healthiest lives possible. Offering recommendations to reduce the consumption of meat due to its effects on health and on the environment is perfectly in line with these goals.

According to the World Health Organization (WHO), global climate change (caused primarily from the release of greenhouse gases into the Earth's atmosphere) affects several critical "determinants of health" including factors such as air pollution, the safety of drinking water, the availability of food, and access to safe shelter around the world. In fact, the WHO estimates that between the years 2030 and 2050, climate change will cause as many as 5 million extra deaths, most of them caused by starvation, disease, and heat stress. If the lives of 5 million people hanging in the balance isn't just cause to include a page or two about the effect of what's on our plate on the health of the earth, then I really don't know what is.

What Difference Does It Make?
Depending on whom you ask, food production and consumption contributes to anywhere from ten to 57 percent of global greenhouse gas emissions. The higher estimates tend to include secondary sources of emissions such as food processing, packaging, and transportation, whereas the lower estimates strictly look at the food's production.

While transportation is one important part of the overall picture of energy use in the agricultural sector, it is not the biggest factor. Imagine, for a moment, the energy and effort it would require to eat a 100% totally local food diet for a whole year. What's the definition of a 100% local food diet? In this instance, it means that every morsel of food you eat cannot have traveled via air, truck, train, or boat at all - zero fuel emissions released.
  • There's no such thing as a "quick grocery trip." Your days would be consumed with walking, running, or biking (not driving) to the closest farm in your area to procure all foods you will eat, all year long, through snow, sleet, and rain.
  • Quick trips to Starbucks or through the Wendy's drive-through when you're low on time are certainly out the window.
  • Your all-time favorite cereal brand or soda that's shipped from across the country? Forget about it. 
  • Out to bars or dinner with friends? Hope you like water.

Imagine, for another moment, that for one year, you decide to replace every fourth piece of red meat with poultry or grains. Every fourth beef burger at your favorite joint becomes a turkey burger, you swap lentils in for beef in every fourth plate of spaghetti bolognese, and every fourth time you go out for Thai food, you grab the chicken panang curry instead of the beef. It might take a bit more planning, but after a couple of weeks, you'd get used to making these occasional changes. You might even find it fun to try new recipes and dishes when you're out. Due to the reduced fat content in some of your meals, you may even find yourself shedding a few pounds before the year is out. It's doable, isn't it?

Swapping chicken panang curry in for beef - I know, that's asking a lot, right?

Surprise: you just reduced your overall climate impact more effectively than if you had completely localized every bite of food for an entire year.

The point of this illustration is to show that when it comes to reducing the impact of your plate on the global climate, heroic measures need not be taken. You do not need to swear off all meat, or even your favorite cut of steak, forever. You don't even have to eat meat-free most days of the week. But by finding small, tasty, and manageable ways to reduce the resource-intensive foods eaten on a regular basis, you are already making a change that will make your diet more sustainable.

Regardless of whether you are more inclined to believe the lower or higher end, the fact remains that the impact of food production and consumption on the average American's climate footprint is not insignificant. There are many effective ways to use less energy and to reduce your impact on the environment as a consumer of goods and services, and scaling down meat consumption should be one part of the larger picture toward a more climate-friendly way of life.

What do you think? Should the 2015-2020 U.S. dietary guidelines have included a section on the sustainability of different diets? Have you made an effort to reduce your consumption of climate-friendly meats and meat alternatives? Let me know in the comments below.

Tuesday, January 19, 2016

Eating By the Book, Pt. 1: Introducing Your New Dietary Guidelines

As a person who spends the vast majority of her time making food, eating food, reading about food, talking about food, and thinking about food, (and at least 37.5 hours per week thinking about guidelines) you could say that the official unveiling of the new 2015-2020 Dietary Guidelines is kind of a big deal to me. 

The final versions were released to the public in early January, and were lauded by most trustworthy sources for nutrition information as a balanced, evidence-based, and actionable approach to steering Americans to better eating habits (with a few small caveats). But what exactly are these guidelines? How are they made, what do they say, and who are they to tell you how to eat, anyway?

What are the Dietary Guidelines?

The federal government has been doling out dietary advice since at least the 1960s - but it wasn't until 1990 (#90sbabies, holler) it was mandated by law that every five years, the U.S. Department of Agriculture (USDA) and Health and Human Services (DHHS) put their collective bureaucratic heads together and, after a long hard look at the most recent scientific data, make some recommendations about how to eat. The Dietary Guidelines for Americans (or DGAs for short) is a compilation of everything we currently know about nutrition - what to eat (and how much of it) in order to promote optimal health and well-being and prevent disease.

What are the main takeaways?

One of the biggest changes you'll see this year and in future iterations of the DGAs is that, in light of the fact that everyone has different needs and follows different patterns of eating, the new guidelines have officially done away with recommended servings of artificially categorized food groups. Rather, the guidelines focus on promoting certain foods to be eaten more or less, according to one's individual calorie needs. (If you're wondering how to get a good estimate of your own calorie needs, I recommend this online calculator).

Here's what the guidelines say we should be getting more of, and some personal commentary from yours truly:

Unlike stock photography lighting practices, it turns out not much has changed since the '90s in terms of what the U.S. government says we should be eating more of. 
  • All types of fruits and vegetables with all different colors of the rainbow. If it grows from the ground (and you can buy it in the produce section of a supermarket), eat more of it.
  • Fat-free or low-fat dairy, such as skim or 1% milk, yogurt (the less added sugar, the better), low-fat cheese, or vegan options such as almond milk that have been fortified with vitamins and minerals. 
    • Though I am not a vegan, I personally love unsweetened vanilla almond milk. It's only 30 calories per cup, has a light, clean taste, and is great for baking - or shamelessly chugging straight from the carton.
    • Plain, 0% Greek yogurt is also a staple in my daily diet. Most brands are around 130 calories per cup with upwards of 24g of high-quality protein. I dress mine up with sugar-free maple syrup, fresh fruit, and lots and lots of cinnamon.
  • High-protein foods, including seafood, lean meats and poultry, eggs, beans, peas, nuts, and soy products.
    • Tempeh, beans, nuts, and egg whites form the basis of my protein-rich foods as a vegetarian. Contrary to popular belief, you can easily meet your protein needs without the consumption of meat. Just this summer, as I was preparing for my first bodybuilding competition, I met my daily goal of 150+ grams of protein per day with these foods, Greek yogurt, and no more than 1.5 scoops of protein powder or protein bars per day.
  • Fiber-rich whole grain products, such as whole-grain pasta and breads.
    • Whole-grain products retain more of the grain's naturally occurring nutrients, including fiber, which most Americans needs to get more of. The guidelines recommend that at least half of your carb-rich foods, such as breads, rice, cereal, and pasta, come from sources with a whole grain label. 

Here are the foods the guidelines recommend limiting:

Salted caramel vodka cupcakes: for when you feel like throwing caution to the wind.
  • Added sugars - limit to 10% of your daily calories, or around 50 grams total per day.
    • Sugar, by itself, isn't evil - or toxic. It's naturally found in plenty of healthful foods, such as fruit, and even the occasional indulgent sweet treat can play a part in a balanced, healthy lifestyle. However, added sugars may contribute to weight gain because they add lots of extra, non-nourishing calories to food and also make that food much easier to overeat (after all, when's the last time you blacked out and overdid it on a bag of celery?). To keep added sugars in check take some sage advice from Nia Shanks: splurge on the sugary foods you truly love, and ditch the ones you can live without. Remember: it's perfectly okay to pass on the store-bought Safeway cake at your workplace's monthly birthday party, especially when you've got your eye on that delicious dark chocolate torte from the tapas place down the street this weekend instead.
    • In fact, the guidelines' 10% figure doesn't actually come from the absolute amount of sugar that's "bad" for you.  Instead, it's based on the idea that 50 grams (or 200 calories' worth) of sugar is the maximum amount you can fit into an average 2,000-calorie diet while still having enough room for all the other, more nutritious foods you need to meet get your fill of vitamins and minerals. Theoretically, if you need more than 2,000 calories to maintain a healthy weight (if you're, say, an endurance athlete or just a world-class fidgeter) you can probably fit a tad more sugar into your diet to fuel your daily activities with no health consequences. On this note, remember to match your fiber intake to your calorie consumption - at least 14 grams for every 1,000 calories.
      • Remember your estimated daily calorie needs from the calculator linked earlier? Take that number and divide it by ten. Then, divide again by four. The resulting number is a good rule of thumb for your daily sugar intake.
    • Extra sugars and calories can be hiding in foods that are branded as "healthy," such as canned fruits, granola bars, and sweetened yogurt. Try passing on the syrupy canned fruit cocktail, which adds empty calories, in favor of whole fruits or frozen fruit pieces.
  • Saturated fats - limit to 10% of your daily calories, or around 22 grams total per day.
    • The question of whether saturated fats (such as those found in butter and cream) cause more heart disease and death than unsaturated fats (found in plant and nut oils) is a subject rife with controversy in the world of nutrition science. Each time a study showing that saturated fats have no adverse health effects is published, several disgruntled scientists pop up to point out the study's flaws, and vice versa. In fact, the 2015-2020 DGAs dedicated an entire working group to looking at the studies on saturated fat in particular.
    • Like the 10% figure on sugar intake, the DGA's advice on saturated fat should be relative to your overall calorie intake - not one number that's the same for everyone. If you need more than 2,000 calories to fuel your body, you can stand to eat more than 22 grams per day.
      • To find your daily saturated fat intake, take your estimated calorie needs, divide by ten, and then again by 9. Shoot for around that number of saturated fat grams per day. 
    • We may not know for years about the true effect of saturated fat intake on health and longevity. For now, I'll choose to follow these guidelines, which echo the 2013 American Heart Association/American College of Cardiology guidelines advising a limitation on saturated fats for optimal heart health. 
  • Sodium - limit to 2,300mg per day (the amount in one teaspoon of table salt)
    • This recommendation will be another one to watch in 2020. Similar to saturated fat, there is plenty of controversy currently stirring in the medical research field about just how much sodium is bad for you.  Though the overall weight of the evidence may shift over the coming years, it's probably your best bet to find small ways to reduce your daily sodium intake - such as buying low-sodium broths, soups, and sauces - and generally being aware of how much sodium is in the foods you most often eat. 
    • Salt is a great way to make vegetables and other more "boring" foods much more tasty. If it's between reducing your salt intake and not getting your veggies in, go with the veggies every time. But there are other ways to dress up your vegetables, too - using plenty of different spices and seasonings adds flavor to your plate without the extra salt. As someone who struggles to moderate her own salt intake, I've personally found that adding balsamic vinegar to my soups and baked veggies makes them delicious!
  • Alcohol - limit to one drink per day for women and two drinks per day for men.
    • The current evidence on alcohol suggests that it's better for your health to drink some, but much worse to drink too much. Distilled liquors, such as vodka and gin, may even carry the same health benefits as beer and wine, meaning there might be something about the alcohol itself, and not whatever's used to make it, that could lead to better health. Most researchers still aren't sure why this is, but when it comes to the occasional glass of wine (or - who am I kidding? - vodka Sugar-Free RedBull) I won't ask too many questions.
    • Remember that the definition of "one drink" depends on the type of alcohol you're drinking. A bottle (12oz) of beer, a glass (5oz, or about 2/3 full) of wine, and a 1.5oz shot of liquor all count as "one drink." 

What's New This Year?

The things I found most exciting about the new DGAs were their focus on following the scientific evidence on hot-button topics like artificial sweeteners, cholesterol, and caffeine.
  • Artificial sweeteners are a-okay. The new 2015-2020 DGAs finally gave more than lip service to an array of products that can have a real impact on healthy weight management for Americans. Decades of repeated studies on sweetener consumption have shown that consuming these low-calorie sweeteners in moderation poses no health threat, either short- or long-term. In fact, several large studies suggest that swapping out sugary drinks and snacks for those made with artificial sweeteners can help you lose weight and keep it off without giving up all the foods you love. 
  • Cholesterol is out of jail. For decades, the DGAs have recommended an upper-limit on cholesterol intake. However, all of the recent evidence shows that the cholesterol on your plate (from eggs, fatty meat and dairy) does not contribute to blood cholesterol. Rather, a host of more important factors are at play: physical activity, family health history, body weight, and saturated and trans fat intake chief among them. Current data suggest that most Americans eat all that much cholesterol anyway. So enjoy that egg sandwich (but remember - watch the sat fats).
  • Enjoy caffeinated beverages in smart moderation. Caffeine was another hot topic in this year's guidelines - in fact, the mere mention of "caffeine" shot up from 0 in 2010 to 205 in the 2015 edition. The guidelines restate the evidence on caffeine consumption, which shows that up to 400mg of caffeine per day has no ill effects. In fact, coffee - where Americans get approximately 80% of their caffeine buzz - may even impart some health benefits.
    • 400mg of caffeine can take many forms. It may come in any of these forms (all data from Caffeine Informer):
      • Three 8oz cups of brewed coffee
      • Five 1.5oz shots of espresso
      • Three-and-a-half medium-sized (12oz) cans of RedBull
      • Almost 6 (5.8) cans of PepsiMax
      • Nine-and-a-half 8oz cups of brewed black tea
      • 16 8oz cups of brewed green tea

Stray Points about the New Guidelines and Their Application

  • There's a reason these guidelines are required to be updated every five years. What we know, and what we think we know, in the field of nutrition is constantly changing. However, there are a few solid standbys, as seen in the list of "dos" from the latest guidelines, that haven't changed for many years and will be your best bet for finding healthful eating habits you can stick with for life. 
  • Nutrition science is complicated and messy. A recent article summed up this point quite eloquently: just because owning a dog is associated with eating egg rolls, this doesn't mean eating egg rolls causes canine ownership (or vice versa!) The ways in which we gather data about nutrition, such as asking someone to recall everything they ate for a week, doesn't always give us a perfectly accurate snapshot of true eating habits. It's important to take a critical eye whenever you read a study that claims a certain food is the silver bullet to any and all ailments. On the other hand, we've come a long way in studying the effects of food on the body, and the more well-designed studies that all point to the same idea pile up, the more confident we can be that we're getting closer and closer to the truth. 
  • Some things never change. The most important take-home points made in the 2015-2020 guidelines are simply echoes of general pillars of good nutrition that have been known and well-accepted for years. If you can find a way to meet your needs for fruits and vegetables, base your carbohydrates around less-refined, whole-grain sources, save your sugary splurges for the foods you truly love, and find ways to cut down on saturated fat (such as choosing lean meats and/or plants for your protein sources) you are well on your way to establishing a diet that will not only do your body good, but one that helps you be the happiest and most whole person you can be.
  • True nutritional health stands at the precipice of physical, social, and emotional well-being. I think Amber Rodgers of Go Kaleo says it best with the way she describes her "Food Foundation":

This diagram makes clear that even if you ate every morsel of every meal completely by the book based on the latest dietary guidelines (which, as explained above, can be based upon constantly-shifting science) it wouldn't be a one-way ticket to making you feel good about what you're eating - which is the only real way to create lasting, lifelong healthy eating habits. Establishing a balanced, loving relationship with food and finding ways to eat that support your values and lets you participate in shared culture(s) with others is just as important to creating an overall sense of physical, emotional and social health. Making sure each of these pillars is strong will help you make and keep a healthy diet not just now, but for life.

What major part of the 2015-2020 Dietary Guidelines bummed me out, and why? And how does a typical day of eating for me stack up to the Guidelines? Stay tuned for the answers.

Saturday, June 14, 2014

FAI: A Beginner's Guide to Being Overly Hip

From now on, you can just call me Lady Gaga.

No, not because I'm a bottle blonde with a sometimes unorthodox fashion sense who at one point in my childhood owned an electric keyboard.  I recently learned that my kindredness with Ms. Germanotta goes much deeper than that - as deep as our hip joints, to be precise.  We both have a joint condition called femoroacetabular impingement (FAI or hip impingement, for short).

FAI occurs when the ball-and-socket hip joint is abnormally formed, usually during the fast-growing years of adolescence.  Ball-and socket joints normally fit together like a clenched fist into a curved palm (think paper-covers-rock style - which I think we can all agree is the outright lamest of the three paths to victory).  FAI occurs when either the "rock" develops into a funny, bumpy shape rather than round and smooth ("cam impingement") or the "paper" juts out too far over the rock ("pincer impingement" - like the awkward, clammy hand of your teenaged big brother who somehow always figured out a way to beat you at this supposedly chance-based game).

If you believe you may be suffering from rainbow-colored-socket syndrome, please hang up the phone and dial 911.

Typically, a thin layer of cartilage and fluid inhabits the small space between the head of the "rock," or the thigh bone (also lovingly referred to as the femur) and the "paper," or the round concave part of the pelvis (the acetabulum).  When the head of the femur fits snugly and correctly into the acetabulum, there is less friction within the hip joint than one-tenth of that felt while gliding on ice.  (Whether this analysis was done after two hours of family free skate or on a freshly Zamboni'd rink was not mentioned.)

The Signs and Symptoms of FAI: Is that a pulled muscle in your groin, or are you just happy to see your physical therapist?

FAI seems to be all the rage these days, with everyone from our favorite Poker-Face'd pop star to a handful of sports-legends-whose-names-I'll never-remember retrieving a diagnosis.  But for many years, FAI was commonly misdiagnosed as a muscular injury, due to the hard-to-describe and often-changing nature of the pain it brings.  Most patients report a deep, aching pain in their groin area that increases with long periods of physical activity or sitting, so this is usually described as classic FAI-related pain.  But because the pain comes from the very middle of the upper-hip area, and can affect any part of the hip joint in particular, the pain may also be more intense in the front and side (anterolateral region) of the hip.  Many patients describe this pain to their doctor by cupping their hand into a C-shape and placing it on the hip to indicate the range of pain, like this:

"My hips, or in this case the 'C-sign,' don't lie."

I personally have never felt any groin pain along this journey, making the several weeks in which I attempted to self-diagnose using my WebMD degree from Google University a complete failure.  What I did feel was a dull pain after sitting, while running or walking, when standing on one leg, when jumping on one leg (oh, Lord, did I feel it when jumping on one leg), and when raising my knee.  And the famed "C-shape" just so happens to be the exact sign I showed to my doctor, and then to my physical therapist after two straight months of dull aching punctuated by the occasional sharp shock of pain jutting from my hip bone and half-way down my thigh.  But they don't tell you this at Google University.  (This pain also made for two straight months of crabby complaining and tears of hypochondriasis mixed with frustration.  Thanks for putting up with me - you know who you are).

For some unlucky folks, mysterious lower-back pain on the side of the affected hip as well as sciatic pain may also occur, making the diagnosis even more confusing.

Further complicating the differential diagnosis for FAI is the fact that the results of an x-ray, if ordered by a concerned but stumped doctor, will be labeled "normal."  "Normal" is radiologist speak for "no scary cracks or crevasses in your bones that we know of," but it doesn't mean your joint is necessarily shaped the way it should be.  One possible clue: my x-ray results suggested "minor calcification of the femoral acetabular area," meaning that the grinding bone-on-bone action (I see you in the back, snickering) had already caused some disturbance to the joint.  If that motion continues, I can look forward to an early-onset case of arthritis and possibly a bionic hip later in life.  Well, that's a bummer.

Who gets FAI?

Here's what makes FAI a complete bugger of a diagnosis.  Anyone can have FAI - all it takes is to unwittingly develop some wonky-shaped hip bones.  But FAI only starts to hurt when the bones have come into contact with each other due to constant, full-range motion.  Once any pain is felt, that means a certain amount of damage to the hip joint has already occurred.

The condition is usually asymptomatic (and therefore benign) unless you are an active individual who loves to get outside and breathe the fresh air, break a glistening sweat or feel the stuff of life pumping through your veins - be it in running shoes, a kayak, baseball cleats, or hockey skates.  That's right.  The stuff that puts zest into your life, that you anxiously await the weekend for, that makes life an adventure worth taking and a game worth playing...  is also causing you considerable, restricting pain that may give you arthritis way before all your friends get it.  And maybe even a shiny new hip before you can afford that retirement hotrod.

Well, this wasn't my exact idea of a mid-life crisis purchase.

In other words, FAI is most likely to affect individuals who just really can't have that kind of negativity in their life - who will be stopped by physical pain from fulfilling their life-enhancing hobbies and passions.  The pain can be at worst unbearable and debilitating, and at best nagging and guilt-inducing because should I really be out here running in the sunshine/shredding some gnarly powder/swimming with dolphins right now because my hip hurts kinda bad.

Generally, the populations most affected by FAI are recreationally active women in their 20s, 30s, and 40s, and young-to-middle-aged male athletes.  Women are more likely to suffer from pincer ("paper") impingement, while men are more likely to be diagnosed with cam ("rock") impingement.

But don't go running for the Cherry Garcia just yet.  It's going to be ok (it better be).

Some stone fruit-flavored ice cream to take your mind off all the horrible things I just told you.

What can be done about FAI?

If you've only been dealing with pain for a few months to a year, a conservative course of anti-inflammatory meds and a round of physical therapy can be successful in alleviating symptoms and getting you back to doing the things you love.  Remember, this line of treatment cannot cure  FAI, but can reduce and prevent the pain and damage associated with it.  Physical therapy for FAI typically involves the use of targeted stretching techniques and devices that will help alleviate pressure in the joint and restore space between the femur and the acetabulum.  Special exercise routines can also help strengthen certain muscles that will help stabilize and protect the hip joint in the future, preventing further pain and damage as you eventually return full-force to your favorite activities.

Clamshell exercise using a resistance band, a common therapeutic technique for FAI.  Also, what Mickey Avalon was secretly writing about when he wrote about doing the Jane Fonda.

If ibuprofen and physical therapy don't appear to alleviate the symptoms of FAI, surgery may be considered.  For these forsaken athletes and active individuals who want to live free of pain and prevent joint damage, surgery can physically remove the bone overgrowth that is causing the impingement, as well as stimulate cartilage repair if needed.

Surgeries can be of the arthroscopic or open variety, the latter of which is usually only used in complex cases of FAI.  In arthroscopic surgery, a small hole is made near the hip, and a videocamera is inserted.  The surgeon then uses tiny tools to remove the offending bone material, using the video feed as a guide.  This procedure typically takes 1-2 hours and can be done as an outpatient.  In an open hip surgery, a larger, 7-10" incision is made on the side of the leg, and the joint is purposefully dislocated in order to remove bone material and repair damaged tissue.  A couple screws are then used to reattach the femur to the acetabulum.  This type of surgery takes a few hours to complete, and an overnight stay is usually recommended.  For either type of surgery, recovery time includes 3-4 weeks on crutches, 2-3 months of rehabilitation and strengthening, and another 3 months getting activity back to pre-pain levels.  Most patients report a full return to hop-, skip- and jumping after the 6-month mark.

Given that I became a blubbering bag of nerves and saline when I saw the IV needle before the teenage rite of passage called getting my wisdom teeth pulled, it's safe to say that I will be doing everything in my power to treat my hip pain surgery-free.  Needles are not welcome for an extended stay in the temple that is my body.  Rather, lots of stretching, traction devices resembling new-age torture machines, and the rubbery stench of Thera-bands are in my near future.  A slow and patient return to full activity is in my long-term plan.  But while I can't see myself going into a surgery without tearing through two boxes of Puffs, a few brown paper bags, and maybe a bottle of Xanax, it's even less likely that I will allow my condition to keep me from doing the things I love forever, including running with abandon - not gingerly limping - through the rain.  I've crossed my fingers that it won't have to come to that decision.

Thursday, September 6, 2012

Cravings Rehab: Ice Cream Edition

"Guess what 'You have a sweet tooth' means?  It doesn't mean you like candy; it means you want some!"

That esoteric quote is taken from an episode of Kid History, a homemade video series crafted by several Utah-based brothers who, after recounting various stories from their childhood to their young sons and daughters, have their children retell the yarns while adding in their vivid imagination and often-times irrelevant babbling.  The adults then act out the distorted scenes to the sound of their kids' helium-pitched voices.

The result is hysterical - and, just as innocent wisdom from a five-year-old is wont to be, unwittingly wise beyond its years.  Think about this: we often think of someone with a "sweet tooth" as having a chronic disease of sorts - an irreversible condition, able to be temporarily quelled with frequent shocks to the pancreas but never curable.  The sufferer of this condition believes he or she must simply eat enough nutritionally devoid, sucrose-laden treats to maintain some sense of normality while attempting to balance this with dreadful hours of cardio or steamed kale benders to pay for his or her "sins."

Health communicators, educators and practitioners typically prefer to speak in terms of infections or illnesses instead of diseases or conditions because this way of framing health issues moves the focus away from the "badness" or "other-ness" of the person who is afflicted and toward the actual illness itself - most importantly, how it can be best managed, treated and/or cured.  Seeing health issues through this lens re-humanizes and de-stigmatizes the patient so that his or her best interest, rather than social forces that turn the patient into an "other," guide interactions and drive solutions.

In reality, having a sweet tooth is much less about having a chronic disease in which you like candy and more about a temporary infection - a time and situation in which you just really, really want some.  I propose that it's high time to destigmatize the sweet-toothed "others" in our lives and instead focus on a treatment plan that can curb the effects of the illness and help these persons lead sustainable, vibrant, healthful lives - no hours upon hours logged on the treadmill needed (unless you're just really into that).

Are you ready for my brilliant idea?

The answer is, d'uhhhh - healthful ice cream!  Instead of being laden with heavy dairies and added sugars, all of these "nice cream" recipes use only plants for the creamy, sweet base of the dessert.  The best part?  There's a recipe for just about every occasion of your sweet-toothed life.

When you need some simplicity in your life:
The basic banana nice-cream
Serves 1

1 banana, as ripe as possible

Simply slice the banana into coins, then place the banana slices into a bag or airtight container and freeze for around 3-4 hours; you want the bananas almost completely frozen, but not rock-hard.  If you'd like to freeze overnight, simply thaw for 30 minutes before making your nice cream.

Place into a food processor or blender and blend, blend, blend until creamy!

Forget about dirtying another dish and eat it right out of the container - and go ahead, lick the blade.  I dare you.

The low-down: 105 calories per serving, 24 net carbs, 3 g fiber, 1 g protein

When you feel like shakin' your hips:
The Elvis nice cream
 Serves 1
Adapted from Chocolate-Covered Katie's recipe here

1 banana, as ripe as possible.
1 tbsp creamy peanut butter
1 tbsp semi-sweet chocolate chips
Optional: a few shakes of sea salt for a mouth-watering salty-sweet combo
Make your basic banana nice cream, then add to the blender or processor the peanut butter.  Blend until well-mixed.  Add in your chocolate chips and optional salt, you hound dog.

The lowdown: 269 calories per serving, 36 carbs, 4 g fiber, 5 g protein

When your insufferable aunt is coming to town:
The better-than-Midol salted peanut butter brownie banana nice cream
Serves 1

1 banana, as ripe as possible
1 tbsp creamy peanut butter
1 tbsp Dutched cocoa powder
1 tbsp peanut butter chips
Sea salt, to taste

Repeat the steps from the Elvis nice cream above, but adding in the tbsp of cocoa powder.  Substitute chocolate chips for peanut butter chips.  Be guiltlessly liberal in your salt intake - just this once.

The low-down: 300 calories per serving, 38 net carbs, 5 g fiber, 9 g protein

When Girl Scout cookie season is over:
Popeye's favorite Thin Mint nice cream
Serves 1
Adapted from Chocolate-Covered Katie's recipe here

1 banana, as ripe as possible, 
1 handful (~ one loose cup) fresh baby spinach
Couple drops mint extract
1 tbsp semi-sweet dark chocolate chips
Optional: green food coloring

By now, you're probably a whiz at making the basic banana nice cream.  Add in your spinach, mint extract and optional food coloring to the mix and blend until smooth and very green.  Add in your chips and feel your biceps bulging by the minute.

The low-down: 182 calories per serving, 33 net carbs, 5 g fiber, 4 g protein, and 55% of your daily Vitamin A requirement!

When you need some good old-fashioned holiday cheer:
Pumpkin pie nice cream
Serves 1

1 banana, as ripe as possible
1/4 cup puréed pumpkin (or sweet potato!)
1 tsp sugar or cup-for-cup sweetener, like Splenda granular
1 tsp pumpkin pie spice
Optional: 1 tbsp bittersweet chocolate chips, sprinkle of graham cracker dust

Start out with your basic banana nice cream.  Add to the processor the pumpkin, sugar and spice.  For an extra bit of autumnal indulgence, sprinkle some chocolate chips and crushed graham cracker.  Pray for the weather to get crisper, knowing full well that in three months you'll be sorry you ever could ever want such a thing.

The low-down (including chocolate chips and 1 tbsp graham cracker dust): 220 calories, 39 net carbs, 5 g fiber, 2 g protein, and 192% of your daily vitamin A requirement!

When you need a 10-minute tropical getaway and your UB40 disc is nowhere to be found:
Succulent mango nice cream
Serves 1
Adapted from Elaine Gordon's recipe here

1 cup frozen mango chunks (buying pre-cut mangoes makes this super-quick and convenient.  To make this dish only 19 net carbs and add 4 g protein, buy mango pulp instead)
1 tbsp Splenda or sweetener of choice - like light agave syrup
1 tbsp orange juice

By now, you know the drill.  Place the frozen chunks in your best processor along with the sweetener and OJ and blend to your little heart's desire.  

The low-down: 120 calories per serving, 28 net carbs, 3 g fiber, 1 g protein, and 84% of your daily recommended Vitamin C!