Defining "Fit"

“What does she look like?”

“Maybe 5'10", beautiful smile, fit …”

If a friend described a girl he liked this way, you would probably immediately assume that she is slim. But is that what it really means to be “fit?” On UrbanDictionary.com, the first score of definitions conveys something to the effect of: “Extremely good looking, synonymous with ‘hot’ and ‘sexy.’ British slang, relatively unknown in U.S.” And we know that Black Eyed Peas and Sir Mix-A-Lot, for instance, both point out that “hot” and “sexy” aren’t exactly synonymous with “tiny.” We often assume that tiny is fit, but Brits and music artists think differently. Athletes and scientists are starting to think differently as well.

Fellow runner Jing Mai pointed out to me a New York Times article entitled “Slimmer Doesn’t Always Mean Fitter.” In it, reporter Gina Kolata describes the quest for the perfect weight for peak performance in a number of sports like running, cycling, and tennis. The overwhelming conclusion among the athletes and trainers she interviews is that the ideal weight is not necessarily the lowest weight, nor is it possible to calculate with a formula. Kolata quotes former marathoner Tom Fleming who explains that “the perfect weight is the weight you are the day you … [reach your personal best] in your event,” and tennis coach Gill Reyes, who condenses it down to “feeling strong and fit.”

And what if you’re not going for a first place finish? How is being fit related to being healthy? At the John Hancock Center On Physical Activity, Nutrition, and Obesity Prevention, researcher and Tufts University professor Jennifer Sacheck decided to look into this question. In a 2009 study of 564 undergraduate students, she and her team compared how being slim (having a low percent body fat) measured up with being fit (having high maximum oxygen uptake during exercise) when it came to unhealthy metabolic risk factors, such as low HDL, high LDL, and high triglycerides. They were intrigued to find that having better fitness was more important for reducing chronic disease risk than being slim. “We’re better off thinking about getting healthy first,” Sacheck expresses.

Rather than obsess about weight, let’s spend that time going for a run. Pretty hot.

Food & Energy Experiment

 Good morning all,

As Marina mentioned, I'm my own guinea pig in an experiment to discern the relationship between what I eat and how I feel with respect to physical power/endurance, GI (gastro-intestinal tract), and emotions. I had read passing stories touting one way of eating over another and wanted to investigate which one(s) actually have a positive impact on me.
Read more...

-Evan

Taking Note

Last week, your very own blog manager Evan sent me an invitation to view a Googledoc. Recently, Evan decided to start on a venture of trying out different types of diets for one week each, wanting to see how they make him feel, how they affect his exercise, and how easy they are to implement. What works and what doesn’t. The document was a log where he recorded all these things, first on a normal diet and then on his first experimental diet: no over-processed foods. To tell you the truth, looking at the log was a little strange. I don’t frequently examine other people’s diets, and it was quite surprising to see everything Evan was eating and to realize that it was kind of like getting an ultra-close look into a friend’s day-to-day life. The thing is, you can experience a similar reaction of surprise if you record your own diet.

There are many reasons for writing down what you eat. You may just be curious. You may want to see how food relates to how you feel during your runs. You may want to lose weight or lower cholesterol. You may want to see how your diet measures up to what is recommended. Once you do this you can say “okay cool” or you can make improvements. As Evan wrote in his blog (publication forthcoming), “the first step to making any worthy change (or knowing if any is needed) is being conscious of what is actually going on.”

That being said, several aspects of your diet may be worth looking at. Food is made up of macronutrients, micronutrients, and water. Macronutrients – carbohydrates, proteins, and fats – are consumed in large amounts and contribute calories (4 calories per gram of carb or protein, 9 calories per gram of fat). Micronutrients – vitamins and minerals – are consumed in small amounts and do not contribute substantial calories.

You may want to find out, for instance, how many calories you eat in one day – you have heard the golden number 2,000, but your ideal value depends on body weight and weight loss ormaintenance goals. Or you may want to see what proportions of those calories are contributed by the three macronutrients – the Institute of Medicine recommends 45-65% calories from carbohydrates, 10-35% from protein, and 20-35% from fat. (All recommendations are published in the Dietary Reference Inakes, see “Salt’s Predicament” blogpost.) Or perhaps you may want to see whether you are getting enough vitamin C, potassium (see “Go Potassium!” blogpost), or iron.

What is the best way to keep a diet log? Actually, it all depends on preference. Evan uses a Googledoc because he can get to it from any computer with internet access. That way, he can update it more frequently to ensure that nothing is left out. Another fellow runner, Becky (not-necessarily-food-related-but-very-cool-blog at www.apostrophecatastrophes.com), has been doing Weight Watchers for about five months, and she carries a paper tracker where she hand-writes foods and corresponding point values. It’s interesting how these two methods are different: Evan’s Googledoc is just the raw data – the food he eats. Becky’s Weight Watchers points collapse all the nutrient information into numbers that are based on a system designed for weight loss.

I’m a big fan of the online nutrition journals because they straddle these two approaches, and many are available for free. You input what you eat with corresponding amounts, and the website creates charts that present all the nutrient information discussed above. My favorite is www.fitday.com which shows you a pie chart of the relative amounts of macronutrients you eat as well as a bar graph that displays how close you are getting to each vitamin and mineral recommendation. Another site, www.nutridiary.com , has similar features, and includes a linear display of how your relative amounts of macronutrients change over time. These features are fairly common, and it is also typical to see combination food and exercise logs. Even if you don’t record everything you eat, you can use these sites for nutrition information on a wide range of specific foods.

Information is one principal way that logging what you eat may help you eat healthier. Accountability is another. Some websites have gone so far as to take accountability up a notch by making people accountable to others, not just themselves. Online communities communicate via blogs and “friend feeds” on pages like www.myfitnesspal.com and www.sparkpeople.com . These provide both accountability and support for those wanting to make dietary changes.

These are fun to play around with, but it does take time. Evan, who has been thinking about trying his diet experiment for a while, admits “I procrastinated doing it because I knew it would be a change and a bit of work.” True, change does require work. “It has made me a little bit antisocial at times because I don't want to go out to restaurants because it's much harder to track,” says Becky about her Weight Watchers program. It may seem funny, but it’s true! If you are very committed, that can happen. Here is my advice: try logging your diet for a few days. Just get an idea of what it’s like, see how what you eat relates to your runs, make some changes if you find something you would like to improve. Use whatever method you like. Be flexible, and know that logging what you eat (as well as how you feel and exercise) is a cool tool you can use to improve your health and performance.

Go Potassium!

Since Marina wrote about sodium last week, I thought a nice follow up topic should be about potassium. As runners, we often hear about the importance of getting enough potassium, but what does it really do? Potassium, like sodium, is an electrolyte. Most of us hear about electrolytes in the context of sports drinks, like Gatorade, where they claim to aid in activity and recovery. What exactly is an electrolyte and why is it so important? An electrolyte is a substance that dissolves into charged particles in a solution which makes it capable of conducting electricity. This factor becomes important in our bodies because sodium and potassium help maintain membrane potentials. Basically, this means that sodium and potassium are both important in the functions of muscle contraction, nerve impulse transmission, and heart functionality. It also plays a role in numerous other functions in our bodies. Because sodium and potassium are lost through sweat during exercise, we need to replenish it.

We all know that it’s fairly easy to maintain a high intake of sodium, but many of us have trouble getting enough potassium. So the balance between sodium intake and potassium intake is heavily balanced on the sodium side (Americans often eat as much as 3 times the amount of sodium as potassium!). This imbalance can lead to high blood pressure as well as other problems such as stroke and kidney stones. The adequate intake for potassium (the amount most adults should aim to consume) is 4700 mg/day. Now we all have heard that bananas are a good source of potassium, but did you know each banana only has a little over 400 mg each? You would have to eat almost 10 bananas to get a day’s worth of potassium! Luckily, many of the foods we eat every day contain as much or more potassium than bananas. These include beets, artichokes, potatoes (1 potato has over 1000 mg!), sweet potatoes, winter squash, beans, orange juice, broccoli, dates, tomatoes, milk, and the list goes on.

Here is an easy and healthy recipe that includes plenty of potassium in the form of acorn squash, tofu, and pineapple:

Stuffed acorn squash
(serves 4)

Ingredients:
2 acorn squash
1 package firm tofu, drained
1 can crushed pineapple in its own juice (8 oz)
1 tsp cinnamon
1 tsp vanilla extract
1 tbsp butter, melted
2 tbsp chopped walnuts

Directions:
Preheat oven to 425. Cut each squash in half lengthwise and discard seeds. Place facedown in a baking dish. Cook for 30 minutes. While squash is cooking, cut tofu into small cubes. Combine with pineapple (including juice), cinnamon, vanilla, butter, and walnuts. Remove squash from oven and turn over. Divide tofu mixture among the 4 squash halves and place into squash hollow. Return to oven and continue cooking for 15-20 minutes, until mixture is heated through and squash is tender.

Enjoy!

-Marcy

(illustration by Inna Komarovsky)

Salt's Predicament

This is a blogpost about salt -- an essential component of our food, a star ingredient of energy drinks, a culprit which contributes to the prevalence of high blood pressure, an indispensable player in the four great bodies of water that cover over 70 percent of the Earth's surface.

It is also a blogpost about an article -- one of those health articles that appears on the New York Times home page some mornings, before Obama has had a chance to sign anything or to make any speeches, and before any statements summing up the day's talks on the other side of the world have been released.

“Citing Hazard, New York Says Hold the Salt,” wrote William Neuman. (http://www.nytimes.com/2010/01/11/business/11salt.html) Upon reading this headline, I immediately relayed the news to the other nutrition student in my cubicle. It was exciting news: NYC Mayor Michael Bloomberg challenged restaurants and food manufacturers to voluntarily curtail the salt (or sodium chloride) content of their products by 25% over five years as a means to reducing high blood pressure and heart disease. I pasted the link in a googledoc and went back to work. But when I had the chance to read the article carefully, a couple of misrepresentations jumped out at me -- hence the reason we need to be critical of the news, especially when it relates to making decisions, whether they concern whom to vote for or how to eat.

Misrepresentation #1: "Never been done" for Dramatic Effect

"The city's initiative, if successful in reducing salt, would amount to an uncontrolled experiment with the public's health." This quote actually appears to imply that reducing salt is dangerous, and that it has never been done. No, no, adding huge quantities of salt to foods in the first place was a dangerous experiment which has resulted in rising blood pressure and heart disease. According to the Mayo Clinic, 77% of sodium in food comes from processed foods. And guess what, before those foods hit the market, we had been consuming less for years.

Misrepresentation #2: Numbers Game

"The federal government recommends that sodium intake from salt be limited to 1,500 to 2,300 milligrams per day, with the latter figure equaling about a teaspoon." How would you interpret this statement? It seems like a recommended range. But where do these numbers come from?

The 2,300 mg/day maximum can be found in the Dietary Guidelines for Americans, a publication providing nutritional guidance to citizens and planners of food programs. The U.S. Department of Health and Human Services and the United States Department of Agriculture release this document every five years (http://www.health.gov/dietaryguidelines/). However, there is a specification that people with hypertension, African Americans, and the middle-aged and elderly should consume less than 1,500 milligrams. Now ... those "high risk groups" already represent a very large proportion of the population.

Investigating further ... The Institute of Medicine publishes the Dietary Reference Intakes, where all quantities are broken down by age. Here we see that actually, the "adequate intake" of sodium -- or the amount that is believed to be sufficient for everyone in the population (and thus excessive for some) -- is 1,500 (not 2,300) mg/day, and only for those under fifty, with lower adequate intakes for those who are older.

Then where did the 2,300 mg/day come from? Oh ... that's the upper limit. Going above this amount is considered harmful, But the average intake in the U.S. is actually fifty percent higher. And to be exact, this number only applies to children and adults older than fourteen. Younger children should consume less, which is worrisome given that kids consume a lot of salty processed snack foods.

So the range 1,500 to 2,300 mg/day is not really a range of recommended minimum and maximum at all. Rather, it represents the maximum allowances for groups at higher and lower risk for hypertension and heart disease, and doesn't cover all ages at that.

However

The article definitely does represent that salt intake is a controversy. Salt is an electrolyte that is in fact essential for muscle contraction and relaxation, nerve impulses, and fluid balance -- all of which, as a matter of fact, are key for running! Because we sweat out salt along with water during exercise, it needs to be replenished -- hence all the sport drinks which contain salt. A Powerade beverage contains only about 150 mg of sodium, which is approximately equivalent to a can of low-sodium chicken noodle soup from Campbell's. However a classic can of Campbell's chicken noodle soup contains more than five times that amount! Salt intake also needs to be balanced with water intake. Otherwise, it has a dehydrating effect which is unhealthy and detrimental to your workout.

So the moral of the story: be critical of what you read and consider where information is coming from. Opinions can be misinterpreted as facts and accepted facts can be presented in many different ways, not to mention change as more research is conducted. Also, keep in mind that you may not need as much salt as you think, so limit salt intake in your diet by eating fewer processed foods or eat foods with low sodium recipes. Hydrate during your runs, and a small dose of electrolytes wouldn't hurt during a long one. Flavor for food, electrolyte for exercise, harbinger of heart disease, and everywhere in nature -- can't live with it can't live without it, salt means so much.

~ marina komarovsky

Can your BMI affect your health insurance premium?

I wanted to write about this topic, not only because health care is all anyone is talking about lately, but also because BMI seems to be the new “trend” in regulation. Many areas seem to be now using BMI as cut off for numerous things. First, let’s take the example of Lincoln University in Pennsylvania. I’m sure many of you have heard about this college that will not let students graduate with a BMI over 30 unless they take a required fitness course, meeting 3 hours a week. Should colleges have the right to impose this restriction? Will other colleges start to follow suit? And what about high schools? Do public schools have the right to enforce restrictions like this?

The health care regulation that I mentioned earlier is along the same lines. There are currently two states that have imposed a penalty for being obese in terms of insurance rates. Starting in July 2011, state workers in North Carolina who have a BMI higher than 40 will be placed in the more expensive insurance plan (along with tobacco users). Alabama was the first state to impose extra fees for state workers with a BMI of 35 and higher. Using these two examples, it is easy to see how more and more states might adopt something like this (and how it maycould lead to similar regulations in private businesses).

Why impose this in the first place? Health care costs are rising and it seems that those who are obese cost more in terms of health care. In a study released by the CDC (http://www.cdc.gov/media/pressrel/2009/r090727.htm), health care costs from obesity may be close to $147 billion per year. It Results also showed that the proportion of health care costs from obesity is also rising (6.5% in 1998 to 9.1% in 2006). So these states do have some justification in trying to reduce health care costs.

But is BMI the right indicator to use to judge obesity levels? In most cases BMI (weight in kg / height in Mm²) is a fairly accurate measure of overweight and obesity, but it does not work in all cases. Most notably is that of the body builder, where someone with high muscle density is going to have a high BMI, but not be “overfat”. Another example is that of someone who has a BMI in the normal range, but has a higher fat percentage (as often happens in the elderly). Will there be any special regulation for these cases?

These are just some starting points to think about. I am not sure I agree with using BMI to “punish” people. I think a more effective strategy might be to offer a positive incentive to lose weight. Whole Foods just announced a new program for its employees in offering them an increase from their 20% in-store discount to 30% for those employees who maintain a healthy profile, using measures such as blood pressure, cholesterol, and BMI, as well as nicotine use. In this case it is not one factor, like BMI, but a host of measures that will judge an employee’s’ overall health. This seems more encouraging to me than using just BMI as well as using it as a punishment.

What does everyone think about this new trend? Will it help to lower obesity rates? Will it help with controlling health care costs? As runners, most of us probably feel we are healthy as well as have BMIs in the normal range. However, I believe it is important for everyone to be aware of policy debates affecting the general population. Just something to think about…

(Illustration by Inna Komarovsky)

Vitamins, Exercise, and Superheros Revisited

To prepare for action, Superman tears off his business suit, revealing the unmistakeable emblem and on his chest, and he is in full spandex gear and cape and ready to fight supervillains. Way back when, Popeye would consume large amounts of spinach to gain strength, and the Tarahumara super-runners described by Christopher McDougall in his 2009 book Born to Run eat iskiate made of nutrient-packed chia seeds to help them during day-long sprints through mountainous terrain.

On our runs, we may want to improve our performance or at least protect ourselves from injury, so we too have supergear and superfood. This is especially important in the winter, when the cold air and hard ground are tough on our bodies. So we whip out the Under Armour -- perhaps even a facemask to emulate Batman and for dramatic effect -- and we may prep in advance by loading up on antioxidant vitamins to help reduce muscle and respiratory damage. (After certain December events and e-mails, I'm inclined to think that some of us prefer to snap on a pair of red speedos and throw back a beer, but this really may not be the best idea for every day.)

Vitamins like C and E may neutralize harmful reactive oxygen species whose production rises during times of increased energy use, such as running, and potentially mitigate their effects on muscle. Vitamin E in particular has been shown to affect immune cells and reduced the number of respiratory infections experienced by elderly study participants at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University. Because cold weather running poses risks to muscle and to the respiratory tract, these antioxidant vitamins seem like a logical choice.

However if you browsed the New York Times or Boston Globe last May, you may have seen the headline "Vitamins Found to Curb Exercise Benefits." When you pick up your copy of O, The Oprah Magazine, this month -- I know you all read it -- you will see a similar article. So what's the deal here?

The argument is that reactive oxygen species, while they have adverse effects, are actually part of the whole system of biofeedback that enables the body to notify its natural defense mechanisms of the need to respond to stress. Large quantities of antioxidants, therefore, may undermine this response. The proposal is based on results of a trial conducted at the University of Jena in Germany in collaboration with Joslin Diabetes Center at Harvard University (Ristow et al. 2009), where 39 young men performed 85 minutes of exercise five days per week for four weeks while receiving vitamin C and E supplementation or a placebo. The group receiving vitamins showed very little activation of the natural defense response that kicked in after exercise in the group receiving placebo, creating -- as one might imagine -- a great deal of controversy about the implications of taking these vitamins, especially for athletes. If we take vitamins, are we actually making our bodies weaker and reliant on an outside source of protection and repair?

Hmmm. This sensation was caused by one particular study, which -- like all well-designed studies -- has both its credibility and its flaws. One criticism is that not all antioxidants may have the same effects. In addition, that the amounts of vitamins given were high -- more than ten times the daily amount recommended by the Institute of Medicine -- and would not typically be contained in food or even a multivitamin, and smaller amounts may not have the same effects. I would also add that the principal purpose of the study was actually to investigate the effects of exercise plus vitamins on insulin sensitivity as it relates to diabetes, and looking at natural defense response to reactive oxygen species was a secondary goal. While researchers did compare the expression of two genes (superoxide dismutase and glutathione peroxidase) implicated in this response, I wonder whether there would have been more analyses had this been the primary goal. Finally, this study evaluated the long-term effects (before exercise regime versus one week after conclusion of exercise regime), so results may also be different if natural defenses were measured directly after exercise.

The conclusion? There really isn't a clear message like "eat spinach" from Popeye. (Did that really work for kids? Somehow I doubt it ...) Should you eat vitamin C-rich kiwi and grapefruit and vitamin E-rich almonds? Yes. Fortified cereal and energy bars? Sure. Multivitamins? Probably fine. Vitamin C powder and vitamin E capsules? This is where you get into the high quantities used in this study and onto shaky ground. As always, more research is necessary but basically, we need to realize that it shouldn't be our superhero superfood. Instead you might learn from Popeye and the Tarahumara and go for simple, whole foods. These contain multitudes of compounds with many potential benefits, so they're a good bet even if one theory doesn't quite pan out. Happy New Year, and enjoy your run.

~ marina komarovsky

Illustration by Inna Komarovsky