CARBS! It's What Fuels Michael Phelps's Olympic Fire

In Wednesday’s (8/13/08) Sun-Sentinel, the reigning super Olympian and Boy Wonder Michael Phelps was asked about his dietary habits. His response was, “Lots of carbs.”
Phelps’ comment provides further evidence that carbs are truly the fuel of choice for the elite gold medal athletes among us. Which leads me to the topic at hand: that carbs have gotten a bad rap and it’s time to set the record (Olympic? world?) straight.
There are three types of macronutrients that supply energy (calories) for the human body: carbohydrates, fat, and protein. When it comes to eating for good health, it’s all in the balance, and “good” carbs should be the foundation of the diet, with a nice dose of added “healthy fats” and a smaller amount of lean protein. Carbohydrates are the most widely eaten food in the world and should comprise the bulk of any and all healthy diets, as carbs are truly the staff of life. Carbs supply quick energy for the muscles. Plus, if you eat the good whole-grain carbs, you get the added benefits of fiber, loads of vitamins and minerals, and tons of important phytonutrients (antioxidants and natural cholesterol-lowering phytosterols, for example). The best sources of “good” carbs are whole grains, fruits, vegetables, and beans.
So how much is enough? For the mere mortals among us (inactive or modestly active), carbohydrates should make up at least 50% of our total caloric intake. For the dedicated athlete (especially endurance athletes like swimmers, cyclists, and runners), carbs should make up at least 60% of their total calorie intake. Elite athletes are different. During peak training, elite endurance athletes often increase their carb intake to 70%, a necessary adjustment to give them the extra energy and nutrition required to train at an optimal level.
When my patients tell me that carbs are fattening, I always tell them to look at Lance Armstrong, who in the months leading up to the Tour de France routinely ate a 60% to 70% carbohydrate diet. If carbs make you fat, then why is he one of the leanest, fittest humans on the planet? Carbs are not fattening; too many calories, regardless of the source—excess carbs, fat, or protein—are what put on the pounds. So follow the lead of the great athletes among us: Eat a healthy higher carbohydrate, moderate fat, and protein diet and get that daily exercise in.

Does Cheese Really Bind Up Your Digestive System?

Q: Do certain foods like cheese really bind up your digestive system, or is that just a story?

A: Cheese, and for that matter, dairy products, have gotten a bad rap lately with the common misconception that they “bind you up” and are generally unhealthy. The fact is, dairy is the leading source of bone-building calcium in the American diet and most Americans simply are not consuming enough dairy. This is a huge health concern, particularly for our children, because a lack of sufficient calcium in the diet during the crucial bone-building years—the teens and young adulthood—will result in failure to reach peak bone mass, which could predispose them to contracting osteoporosis later in life.

What’s more, calcium helps lower blood pressure, as shown in the famous DASH diet studies. Dairy contains lots more nutrition than just calcium. Filled with vitamin D (if fortified), vitamin A, riboflavin, B12 and protein, dairy is truly a nutrient-dense food. Most major health organizations recommend that all Americans consume three serving of dairy foods per day. I suggest going for the 1% or fat-free varieties to cut out the artery-clogging saturated fat that comes bundled up with full-fat dairy foods.

Certain people cannot consume dairy products because of a situation called “lactose intolerance.” These people either lack or have a reduced activity of the enzyme lactase, required to digest the milk sugar lactose. For these individuals, consuming dairy products can result in severe gastrointestinal symptoms. Lactose-intolerant individuals should know there are plenty of lactose-free dairy products on the market, as well as lactase supplements that would enable them to obtain nutritious dairy foods in their diet.

How Can I Get In Shape After Having A Baby?

Q: How can I start to get back in shape after just having a baby?

A: One of the best ways to get back in shape after having a baby is to breast-feed. The physiological process of breast-feeding requires that a woman’s metabolic rate go into overtime as her body strives to produce milk to nurture her growing infant. This process requires an exorbitant amount of calories to sustain. If you combine breast-feeding with both a nutrient-dense, calorie-controlled diet (with enough calories to support lactation) and regular aerobic exercise (like taking the baby for long walks), you will surely be on the right track for getting back into shape and getting back your pre-pregnancy body.

If a woman decides not to breast-feed, she can still take a healthy approach to getting back into shape following the birth of her new baby. The extra fat that Mother Nature adds to a woman’s body to support her pregnancy can be taken off following the same general principles for all types of healthy weight loss: eat a healthy, balanced, calorie-controlled diet combined with regular exercise, and aim for a weight loss of no more than 1 to 2 pounds per week. There are registered dietitians who specialize in pregnancy, and I would highly recommend you consult with one to get on the right path. Go to www.eatright.org to find a registered dietitian in your area.

Supplements For More Omega-3s?

Q: I don’t like fish but want to get more omega-3s. Should I look to diet or to supplements?

A: The best advice for getting in those ultra-healthy omega-3 fats is to first focus on getting them into your diet from FOOD sources. There are two types of omega-3 fats: the short-chain plant omega-3 called alpha-linolenic acid (ALA), and the long-chain varieties known as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which are more physiologically active in the body. Ideally, you should aim for a daily serving of the plant omega-3 ALA and at least two servings per week of the long-chain varieties.

The best food sources of ALA include flaxseeds, walnuts, canola oil and green leafy vegetables. The best sources of EPA and DHA are fatty cold-water fish such as salmon, mackerel, halibut and herring. Since you don’t eat fish, you may want to consider taking a fish oil supplement. I would recommend discussing this with your personal physician. There is a prescription fish oil medication called Lovaza™ that I like because it is regulated by the FDA as a drug, so you know that what is described on the label is exactly what you are swallowing!

How Can I Tone Up "Fatty" Areas?

Q: Since turning 50 I have noticed a fat accumulation around the inside of my knees, making my knees look "fat." I realize this may be due to my age, but I believe it doesn't have to be. Any suggestions would be greatly appreciated.

A: The bad news is that as we age, and with each passing decade, we lose more and more precious muscle mass and at the same time gain body fat. Where we gain fat tends to be genetically determined, so the fat accumulation around the inner knee happens to be one area where your particular body tends to store fat.

The good news is that there is a lot you can do to lessen the decline in muscle mass with age and tone up your inner knee area. The best type of exercise for hanging on to that nice, shapely muscle tissue is to get in regular strength training exercise—a minimum of two times per week for at least 20 minutes. A good program of muscle building exercises should include exercises that target the major muscle groups. There are plenty of muscle building and toning exercises that target the inner thigh and knee area. I suggest making an appointment with a certified personal trainer (you can find one in your area on either www.acsm.org or www.nsca-lift.org) and have them set you up with a good program. That said, you should also include a daily bout of calorie-burning aerobic exercise and combine that with a nutrient-dense, calorie-controlled diet to help you whittle away at extra body fat. Put this all together and you will be taking the best course of action for a lifetime of health and fitness.

Are Dried Fruits Just As Nutritious As Regular?

Dried fruits have pros and cons associated with them. Dried fruits such as raisins are a highly nutritious and portable sweet snack. Filled with antioxidants, fiber, iron, potassium and selenium, raisins are a healthful alternative to sugary, empty calorie snacks. The downside of dried fruits is that they are dehydrated, so they have lost the bulk of water; hence, they are highly concentrated sources of calories and sugar. Considering that most of us are battling the bulge, eating the fresh fruit versus the dried is always a calorie-wise choice. Let’s make a few comparisons to drive home this point:

• 1 cup of grapes contains approximately 62 calories; 1 cup of raisins, 493 calories.
• 1 cup of blueberries contains 84 calories; 1 cup of dried blueberries, 480 calories.
• 1 cup of fresh pineapple chunks contains 82 calories; a 12-ounce package of dried pineapple, about 1,100 calories!

The bottom line is that dried fruits are a nutritious snack, especially if you’re on the go and need a quick source of energy. However, a piece of fresh fruit, such as an apple, is just as portable, more nutritious and a far better choice for weight control.

Is Working Out Safe For Children and Teens?

Considering that being overweight or obese is now epidemic among our nation’s children, encouraging daily exercise as a means to help kids control their weight is extremely important. In fact, the American Heart Association recommends that children and teens get in at least 60 minutes of moderate to intense physical activity every single day as part of a healthy lifestyle.

If your question is specifically regarding the safety of strength training in children and teens, strength training can be a wonderful form of exercise for kids. It can provide numerous benefits such as strengthening their bones, improving their self-esteem and boosting their metabolism, to name just a few. But is it safe? The Council on Sports Medicine and Fitness recently published a policy statement in the journal Pediatrics that addresses this question (you can download the article in PDF form here). The take-away message is that children and teens can safely enjoy strength-training programs, provided they:

• Have medical clearance from their personal physician.
• Have strict supervision by certified personnel qualified in pediatric strength training, to ensure proper technique.
• Avoid any potentially unsafe maneuvers such as maximal lifts.
• Include warm-up, cool-down and proper nutrition (including hydration).
• Begin with no resistance until proper technique is learned.
• Follow a general strength-training regimen that addresses all the major muscle groups.

To sum things up, a strictly supervised program of strength training using lighter weights and controlled movement is a safe and beneficial recommendation for kids and teens that may just provide the fuel for a lifetime of better health and fitness.

• Have medical clearance from their personal physician.
• Have strict supervision by certified personnel qualified in pediatric strength training, to ensure proper technique.
• Avoid any potentially unsafe maneuvers such as maximal lifts.
• Include warm-up, cool-down and proper nutrition (including hydration).
• Begin with no resistance until proper technique is learned.
• Follow a general strength-training regimen that addresses all the major muscle groups.

To sum things up, a strictly supervised program of strength training using lighter weights and controlled movement is a safe and beneficial recommendation for kids and teens that may just provide the fuel for a lifetime of better health and fitness.