How To Keep Your Athletic Daughter Healthy and Thriving

Photo credit:  Pixabay

Photo credit: Pixabay

Young female athletes may be at risk for what is called the female athlete triad.

If your daughter is a ballet dancer, gymnast, or if she plays other competitive sports she might be at risk.

Other risk factors for the female athlete triad include girls that are required to check their weight often or maintain a certain weight for their sport, those that exercise more than they need to for their sport, or that are being pushed by a coach or their parents to win no matter what.

The female triad refers to a combination of symptoms that include menstrual irregularities, not eating enough calories, and decreased bone mineral density. 

Girls with this condition may reach puberty later, or may not even get their period.

Preventing this from happening in the first place is important, however if the problem already exists, recognizing it early can help keep it from getting worse, and can help resolve the issue so that it doesn’t lead to more serious health problems.

Partnering with a team of health care providers like a doctor, nutritionist, and a psychiatrist or psychologist is often helpful, especially when eating disorders are involved. A nutritionist can advise on maintaining good nutrition and a healthy weight to match her lifestyle. The goal is to help your young athlete focus on health and performance instead of weight. Exercise doesn’t need to stop, but decreasing it is recommended while her weight is being brought back to normal levels, and while dealing with deeper, emotional issues.

At this age your daughter is growing, developing, and already needs extra energy for this. When athletic activity increases those energy needs are even higher. Additional protein, and vitamins and minerals are needed too. 

Competitive athletes need about 500 to 1,500 extra calories per day during their playing season to meet their energy requirements. The table below outlines energy needs assuming there is light to moderate levels of activity, so your athlete may need an extra 500 to 1,500 calories per day beyond this. She may also need increased amounts of calcium, magnesium, vitamin D, B vitamins, and vitamins C and E (among other nutrients). This can be assessed via nutrient testing.

Jennifer Caryn Brand Nutrition, Female Athlete Triad

Other guidelines for athletes include:

  1. Eating a pre-event meal about 2 to 3 hours before the event, and avoiding foods high in fat, protein and fiber since these kinds of foods take longer to digest

  2. Meals after the event are recommended and should contain about 400 to 600 calories, mostly from carbohydrates (complex ones like whole grains or sweet potatoes), as well as caffeine free fluids (and ones that are not sugary).

  3. Adequate hydration is important. Fluid intake is so important because young athletes can be more easily affected by heat, or they may be so into the activity that they are not paying attention to whether or not they are thirsty. Your daughter should drink about 6 to 8 oz before her activity, and 4 to 6 oz every 15 to 20 minutes during her activity. After the event, she should have about 8 oz of fluid. Also, each pound of weight lost during the activity requires 16 oz of fluid to maintain hydration. This is because weight lost during the activity is due to fluid loss.

Brown JE. Nutrition Through the Life Cycle, Fifth Edition. United States: Cengage Learning; 2014.

Nazem TG, Ackerman KE. The female athlete triad. Sports Health. 2012;4(4):302-311. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3435916/. Accessed March 13, 2019.

Hobart JA, Smucker DR. The female athlete triad. American Family Physician. 2000;61(11):3357-3364. Available from: http://www.aafp.org/afp/2000/0601/p3357.html. Accessed March 13, 2019.

10 Tips To Manage Your Stress

Photo credit: Victor Garcia

Photo credit: Victor Garcia

Chronic stress, whether it’s physical, chemical, or emotional, burns through nutrients and steals them from other needs your body has.

Chronic stress can lead to nutrient insufficiency and deficiency over time. This can cause imbalances in your body, and symptoms and health problems follow.

  1. Examples of physical stress include restricted diets, over exercise, and physical trauma

  2. Examples of chemical stress include prescription medications, environmental pollutants, pesticides and processed foods

  3. Examples of emotional stress include personal, financial, and work related concerns

Stress is a complex phenomenon and everyone has their own tolerance for it. Your stress response is triggered by a variety of factors, like the examples noted above. When you are exposed to ongoing stress, it becomes chronic.

Your body responds to stress by initiating a series of reactions that effect your behavior, nervous system function, the secretion of hormones, and cause other physical and chemical changes.

Your body doesn’t differentiate between the different kinds of stress, these changes happen regardless of where your stress comes from. In fact, chronic psychological stress is associated with the body losing its ability to regulate its inflammatory response, and this can promote the development and progression of disease.

All of the extra work your body does while under stress uses more fuel, and that fuel is in the form of nutrients.

You can support the needs of your body and help it cope with stress by nourishing it. Eating whole, real foods and not restricting foods, food groups and categories of foods has powerful stress reducing benefits. It can improve brain function, strengthen your immune system, improve circulation and lower blood pressure, and lower levels of toxins in your body.

Nutrients your body needs to respond to stress include complex carbohydrates, protein, omega 3 fatty acids, vitamin C, vitamin E, B vitamins, magnesium, selenium, zinc, calcium, iron, and antioxidant nutrients. These nutrients play MANY roles in your body in addition to helping you cope with stress, so make sure to include foods rich in these nutrients in your diet.

Stress also adversely affects the gut and can lead to leaky gut and imbalanced gut flora, so addressing gut health is an important cornerstone of a comprehensive stress management protocol because if you can’t digest, absorb, and use nutrients from the foods you eat, eating the right foods won’t matter much, nor will it help reduce your stress levels.

In addition to nourishing your body and restoring your gut health, there are strategies you can implement to help manage stress to prevent the detrimental effects it can have. Find strategies that work for you, everyone is different. Techniques to relax your mind and body include:

  1. Stop hyper-focusing on your health problems. Now. What we think we manifest. I’ve experienced this personally and see it in my clients.

  2. Write/journal about your stressful experiences for about 10-15 minutes per day. Getting them out of your head and on paper can help. Once they are on paper, read them back to yourself. Some may not even seem realistic once you read it back. For those that are list ways you may better cope with each of them. Develop your solutions.

  3. Keep a daily list of 3 or more things that happen each day that made it a good day. Some days this may be easy. Other days it may be simply that you got out of bed, or did your laundry. Always look for the positives.

  4. Express your feelings. It’s ok to talk, cry, laugh or express anger. Talk to friends, family or a professional about your feelings.

  5. Do what you enjoy. Set aside some time each day to do something just for you. Your favorite hobby, exercise, volunteer work, spending time with animals, spending time in nature, arts and crafts. This is not selfish, this is feeding your soul with the fuel you need to be a better person so that you can be there and show up for those that need you.

  6. Be present. Living in the past causes depression and living in the future leads to anxiety. Meditation focuses your attention on the present. Anything that allows you to be present is meditation. Whether you meditate cross-legged and chant “om” or can get into the zone during a cardio session at the gym, find your method for being present and do it regularly (most days if not every day).

  7. Relax your body with exercise.

  8. Try breathing techniques, massage, tai chi, or yoga.

  9. Find a favorite online mentor. Look to Facebook or YouTube for motivational people and videos, find someone you connect with and subscribe to their feed. A daily dose of positive, professional motivation does a body, and mind, good.

  10. Put your phone away more often, and keep it on vibrate/turn the sound off. Being tied at the hip to our mobile devices creates a state of hypervigilance, which can lead to anxiety and stress.

 

https://www.sciencedaily.com/releases/2012/04/120402162546.htm

https://www.omicsonline.org/open-access/nutrient-and-stress-management-2155-9600-1000528.php?aid=76425

https://academic.oup.com/ajcn/article-abstract/61/3/631S/4652003?redirectedFrom=fulltext

10 Tips To Improve Your Sleep

Photo credit: Vladislav Muslakov

Photo credit: Vladislav Muslakov

If you have problems sleeping you are not alone.

It is estimated that 50-70 million Americans have chronic sleeping problems. 

Getting enough sleep is crucial to good health, and unfortunately there is a wide range of medical barriers to it.

Health problems associated with lack of sleep:

Often issues with sleep are a symptom of another medical problem, and by addressing that underlying problem, we can improve sleep.

There are a variety of reasons for insomnia:

  • Things we eat or take that can keep us awake include alcohol, nicotine, caffeine, cocaine, decongestants like Sudafed, diet pills, Ritalin or other stimulants, herbs like ginkgo biloba, guarana, Siberian ginseng, ephedra, ma huang, bitter orange, and kola nut, and medications including beta blockers, albuterol, Wellburtin, SSRIs (antidepressants), prednisone and other steroids.

  • All sorts of conditions can interfere with sleep.

    • Take anxiety for example. Diet, sleep and anxiety affect each other. Anxiety makes getting restful sleep challenging and difficulty sleeping can cause anxiety. Reducing levels of anxiety is important, and meditation, yoga, and breathing exercises are examples of interventions my clients find helpful in reducing their anxiety levels.

    • Depression is linked to poor sleep. Insomnia can cause depression, and remember that antidepressants (like Prozac or Wellbutrin) can adversely affect sleep.

    • Pain from any number of conditions can lead to poor sleep. Arthritis, headaches, reflux, and fibromyalgia, anything that causes pain can make it hard to fall asleep, and hard to stay asleep. Pain gets worse with lack of sleep. Addressing the underlying cause of pain can help improve sleep quality.

    • GERD, or gastroesophageal reflux, is a common problem, and reflux symptoms reduce quantity and quality of sleep. One of the first things we look at is how close to bedtime are you eating? Eating too much and eating too close to bedtime can cause GI symptoms like GERD. Ideally, you should wait 4 hours between eating and going to bed. There is a wide range of other reasons for GERD, so this is also something we explore when reflux is present, and GERD has many other problems associated with it aside from sleeping disturbances, and there are nutritional interventions to address it.

    • Insomnia is considered a symptom of menopause. There are nutritional interventions that can help. Many are herbals. Keep in mind with herbal medicine that many pharmaceutical drugs are created based on the action of herbal medicines. Because of this, herbals can cause side effects and drug interactions just like pharmaceutical drugs can. The message here is don’t self medicate with herbals (for insomnia or any other reason). Talk to a professional to see what’s right for you.

    • Obstructive sleep apnea is disordered breathing during sleep. People that have sleep apnea have a greater risk for high blood pressure, heart attack, irregular heartbeat, diabetes, stroke, asthma, some cancers, cognitive and behavioral disorders in children and adults, and car accidents. Common symptoms include snoring or gasping during sleep, and feeling fatigued during the day. Many people that suffer from sleep apnea live in larger bodies, so nutrition plays a big role here. Appropriately nourishing your body to reach a healthy weight is a primary intervention for sleep apnea, and often helps resolve the issue.  There are numerous other reasons that someone may be experiencing sleep disordered breathing, and The Breathe Institute in Los Angeles, CA specializes in addressing all causes of sleep disordered breathing using a multidisciplinary approach.

    • Desynchronosis is a disrupted circadian rhythm. It’s common in jet lag, and it shift workers, so those who work at night. It’s when your body’s internal clock is out of balance. Our circadian rhythms tend to change based on our stage in life too. Teenagers generally like to stay up late and wake up late, and as we get older we tend to go to bed earlier and wake up earlier. Often those with this condition have abnormal hormone levels, in particular cortisol and melatonin.

    • Cortisol is your stress hormone and it should be higher in the morning and lower at night. Stress is an unavoidable factor in our lives, and more stress leads to higher levels of cortisol. There are many other causes of high cortisol levels, and cortisol stimulates insulin release, and over time, this can lead to diabetes, and weight gain, especially around your middle. So managing cortisol levels by working on reducing stress is important for sleep and for overall health.

    • Melatonin, is also important to help promote sleep. Low levels of melatonin lead to problems sleeping.

      • To learn more about your unique circadian rhythm and sleep cycles, fill out this questionnaire (it's free and provides helpful information): http://www.cet-surveys.com/index.php?sid=61524. It estimates the time of your melatonin onset, and what your natural bedtime should be! Going to bed before or after this time could be a recipe for a poor night's sleep.

      • Melatonin production increases when it's dark and decreases when it's light. This is a reason why blue light/screen time before bed disrupts sleep! I recommend avoiding all screens 2-3 hours before bedtime, and I know this is a major challenge, for me included. When we can’t avoid the screens, we can use glasses during those few hours before bed to help block the blue light. Here’s a great product I use:

I think you get a sense of the variety of factors that play roles in sleep problems. This is by no means an exhaustive list.

From a nutritional standpoint:

  • We look for dietary triggers for the problem.

  • We can look for underlying conditions that are preventing adequate sleep, like sleep apnea, and reflux.

  • We can look to food as medicine to address any nutrient deficiencies that may be contributing to the issue. For example, food is a source of neurotransmitter precursors, where your neurotransmitter balance regulates your sleep, and mood in general. Deficiency of certain vitamins and minerals can also disrupt sleep, so we can address these deficiencies by choosing foods containing the nutrients and supplement where necessary.

As you can see, sleep disorders cause a lot more than just feeling tired during the day. If you have problems sleeping, it is worthwhile to check out why. Contact me and we can explore diet, food, nutrients and lifestyle interventions to help bring you relief, and a good night’s sleep.

In the meantime, here are 10 of my favorite tips to improve sleep!

  1. Avoid caffeine, nicotine, alcohol and other substances that interrupt sleep

  2. Your bedroom

    • Keep it set up for a good night’s sleep, and sex, only

    • Don’t eat, or watch TV in bed

    • Keep your room dark and quiet

    • Use something to create white noise to block out sounds that might awaken you

    • Use earplugs

    • Keep the temperature in your bedroom cool

  3. Create a soothing bedtime routine to help you relax

    • Meditate

    • Relaxation exercises

    • Read a book (hard copy to avoid blue light, or get those glasses mentioned above)

    • Take a warm bath

  4. Go to sleep when you are tired (work with your body’s natural circadian rhythms)

    • This is when you feel the first nudge of sleepiness (and when your melatonin is kicking in), don’t wait, you’ll miss the window (it’s short)

  5. Don’t watch the clock, and if you are a clock-watcher, turn it around so you can’t see it

  6. Keep a consistent sleep schedule and go to bed and wake up at the same time as much as possible (yes even on the weekends)

  7. Keep fluid intake at a minimum about 60-90 minutes before bedtime

  8. Make dinner a lighter meal, and earlier (don’t eat 2-3 hours before bedtime)

  9. First thing in the morning, go outside and let the sunlight hit you, which stimulates and regulates your hormones that regulate your body’s circadian rhythms, and get plenty of natural sunlight during the day/let as much natural light into your workspace as possible

  10. Exercise during the day, and at least 3 hours before bedtime

Sometimes we need more assistance. My favorite supplements are:

  1. Cortisol Manager - Integrative Therapeutics

  2. Best-Rest Formula - Pure Encapsulations

  3. Insomnitol - Designs for Health

  4. Sleep Reset - Integrative Therapeutics

  5. Melatonin 3mg - Pure Encapsulations

You can get these supplements through my online dispensary. Try one at a time and give it a few weeks to see if it helps. Click here to register for a free account. Once you do, you can search for the supplement you are looking for.

5 Ways To Incorporate Exercise

Photo credit: Bruno Nascimento

Photo credit: Bruno Nascimento

Jennifer Caryn Brand Nutrition addresses your health and wellness holistically. That means in addition to addressing underlying imbalances in your biochemistry that can be contributing to your health problems and working with you to create your customized optimal diet and nutrient supplementation plan, we need to look at lifestyle factors such as exercise for overall balance.

Exercise is important. It can help reduce stress, it keeps your body healthy, and it can help manage your health conditions. If you don’t currently exercise, start slow and work up to these recommendations (Table 1).

  1. YouTube has some awesome short and fun videos you can do in your own home, just search for your favorite type of exercise (yoga, pilates, stretching, tai chi, abs, etc.).

  2. Going for a walk is always an option.

  3. Look into your local YMCA or community college. Many have indoor swimming pools you can use year round.

  4. Join a local gym.

  5. Get your best friend or neighbor on board as your workout buddy and keep each other motivated, whether your exercise together or just hold each other accountable for doing it. 

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Need more assistance? Contact me today so we can craft your customized lifestyle plan.

How To Stay Healthy During The Holidays

Photo credit: Julia Gomelsky

Photo credit: Julia Gomelsky

Are you nervous about the holidays and your diet?

I get asked often to provide tips on how to stay on track during the holidays.

Of course, we can:

  • Not show up at holiday parties starving by having a healthy snack beforehand

  • Fill up at the veggie tray at the party, and eat your vegetables first

  • Chew thoroughly and eat slowly

  • If drinking alcohol, alternate with water (stay hydrated!)

  • Pay attention to your satiety (fullness) cues and stop before you are uncomfortably full

  • Go for a walk after dinner with friends/family

  • Enjoy your favorite treats in moderation

This is not news, right? We know what we are supposed to do.

My tip to you for the holidays is this:

Holiday time is wrought with stress and anxiety, and worrying about losing control around food only increases that stress and anxiety. This is no fun, and bad for your health. I’m going to go out on a limb and say that indulging may actually be the healthier option.

During the holidays we take the opportunity to spend more time connecting with loved ones, and often it’s around food. Give yourself permission to enjoy the experience! If you want to indulge, indulge.

If anyone asks, tell them your nutritionist said it was ok (your nutritionist also says to remember to take into account your health conditions and known diet related needs).

Once things don’t feel forbidden, there’s no guilt, and you become more in tune with your body’s hunger and fullness cues (and naturally less likely to way overdo it).

Hear it straight from me!

Happy holidays!
 
Your partner in health,
Jennifer, MPH, MS, CNS
Functional and Clinical Nutritionist