Nancy Clark's Sports Nutrition Guidebook PDF

Sports Nutrition Guidebook Fourth Edition Nancy Clark, MS, RD, CSSD Healthworks Fitness Center Chestnut Hill, MA Human Kinetics Library of Congress Cataloging-in-Publication Data Clark, Nancy, 1951- [Sports nutrition guidebook] Nancy Clark’s sports nutrition guidebook / Nancy Clark. -- 4th ed. p. cm. Includes bibliographical references and index. ISBN-13: 978-0-7360-7415-5 (soft cover) ISBN-10: 0-7360-7415-5 (soft cover) 1. Athletes--Nutrition. I. Title. II. Title: Sports nutrition guidebook. TX361.A8C54 2008 613.2'024--dc22 2007051946 ISBN-10: 0-7360-7415-5 (print) ISBN-13: 978-0-7360-7415-5 (print) ISBN-10: 0-7360-8086-4 (Adobe PDF) ISBN-13: 978-0-7360-8086-6 (Adobe PDF) ISBN-10: 0-7360-7877-0 (Mobipocket) ISBN-13: 978-0-7360-7877-1 (Mobipocket) ISBN-10: 0-7360-7878-9 (Kindle) ISBN-13: 978-0-7360-7878-8 (Kindle) Copyright © 2008, 2003, 1997, 1990 by Nancy Clark All rights reserved. Except for use in a review, the reproduction or utilization of this work in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including xerography, photocopying, and recording, and in any information storage and retrieval system, is forbidden without the written permission of the publisher. This publication is written and published to provide accurate and authoritative information relevant to the subject matter presented. It is published and sold with the understanding that the author and publisher are not engaged in rendering legal, medical, or other professional services by reason of their authorship or publication of this work. If medical or other expert assistance is required, the services of a competent professional person should be sought. The Web addresses cited in this text were current as of January 2008, unless otherwise noted. 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Box 5076 57A Price Avenue Champaign, IL 61825-5076 Lower Mitcham, South Australia 5062 800-747-4457 08 8372 0999 e-mail: [email protected] e-mail: [email protected] Canada: Human Kinetics New Zealand: Human Kinetics 475 Devonshire Road Unit 100 Division of Sports Distributors NZ Ltd. Windsor, ON N8Y 2L5 P.O. Box 300 226 Albany 800-465-7301 (in Canada only) North Shore City e-mail: [email protected] Auckland Europe: Human Kinetics 0064 9 448 1207 107 Bradford Road e-mail: [email protected] Stanningley Leeds LS28 6AT, United Kingdom +44 (0) 113 255 5665 e-mail: [email protected] With appreciation for their patience, understanding, and love, I dedicate this book to my husband, John, and my children, John Michael and Mary. They feed my heart, nourish my soul, and empower my spirit. Contents Preface vii Acknowledgments ix Part I Everyday Eating for Active People Chapter 1 Building a High-Energy Food Plan 3 Chapter 2 Eating to Stay Healthy for the Long Run 29 Chapter 3 Breakfast: The Key to a Successful Sports Diet 57 Chapter 4 Lunch and Dinner: At Home and on the Run 75 Chapter 5 Snacks and Snack Attacks 93 Chapter 6 Carbohydrate to Fuel Muscles 103 Chapter 7 Protein to Build and Repair Muscles 127 Chapter 8 Replacing Sweat Losses 147 Part II The Science of Eating for Sports Success Chapter 9 Fueling Before Exercise 167 Chapter 10 Fueling During and After Exercise 183 Chapter 11 Supplements, Performance Enhancers, and Engineered Sports Foods 199 Chapter 12 Age-Specific Nutritional Needs 215 iv Part III Balancing Weight and Activity Chapter 13 Assessing Your Body: Fat, Fit, or Fine? 229 Chapter 14 Adding Bulk, Not Fat 249 Chapter 15 Losing Weight Without Starving 265 Chapter 16 Dieting Gone Awry: Eating Disorders and Food Obsessions 289 Part IV Winning Recipes for Peak Performance Chapter 17 Breads and Breakfasts 315 Chapter 18 Pasta, Rice, and Potatoes 329 Chapter 19 Vegetables and Salads 341 Chapter 20 Chicken and Turkey 353 Chapter 21 Fish and Seafood 367 Chapter 22 Beef and Pork 377 Chapter 23 Beans and Tofu 385 Chapter 24 Beverages and Smoothies 395 Chapter 25 Snacks and Desserts 403 Appendix A: For More Information 415 Appendix B: Selected References 428 Appendix C: Engineered Sports Fuels and Fluids 443 Index 449 About the Author 460 v Preface “My diet is horrible. I’m so good at exercising—but I am so bad at eating right.” “I’m training hard but not getting the results I want. Something must be wrong with my diet.” “I feel so confused about what to eat. What is a well-balanced diet?” These are just a few of the questions and concerns both casual exercisers and competitive athletes share with me when I’m coaching them to win with good nutrition. More than ever, they feel confused about what and when to eat; how to fuel before, during, and after exercise; how to find their way through the jungle of engineered sports foods; and how to choose the best diet to help them lose fat and build muscle. There is no doubt in my mind that eating the right foods at the right times significantly improves performance and weight—as well as future health and well-being. I’ve helped many competitive athletes build bigger muscles, run faster marathons, and compete with higher energy. I’ve also helped many fitness exercisers train better, lose weight, and achieve dra- matic results. Yet, too many active people fail to eat well and are reluctant to do anything about it. They think eating well equates to denying their hunger and depriving themselves of flavorful and fun foods. This is not the case. Nancy Clark’s Sports Nutrition Guidebook, Fourth Edition, clarifies the confusion about how much carbohydrate, protein, and fat you should consume and teaches you how to enjoy a variety of tasty, nutrient-rich foods that can give you the winning edge. You’ll learn the latest informa- tion about the topics that matter most to active people: vii viii Preface How to lose undesired body fat and have energy to exercise When to eat so you optimize energy, muscle growth and repair, and performance—no more running out of gas during workouts (or the workday, for that matter!) The proper balance and best sources of carbohydrate, to fuel your muscles, and protein, to build your muscles, including sample menus and suggestions How much dietary fat is OK to eat and how to choose foods with health-protective fats How to consume enough protein at meals, even if you are a veg- etarian How to sneak more fruits and veggies into your daily food plan so you effortlessly enjoy these nutrient-dense sources of vitamins and minerals Ways to tame the cookie monster (hint: the cookie monster visits when you get too hungry) If your goal is to move to the next level of performance and health, the up-to-date information in this book can help you get there. You’ll find answers to your questions about the glycemic index, amino acids, energy drinks, commercial sports foods, high fructose corn syrup, muscle cramps, organic foods, hyponatremia, and recovery foods as well as tips on how to apply this information to your sports diet and training program. Whatever you do, don’t show up for exercise but neglect to show up for winning meals and sports snacks! With best wishes for good health, high energy, and success with food, Nancy Clark, MS, RD, CSSD Healthworks Fitness Center 1300 Boylston Street Chestnut Hill, MA 02467 www.nancyclarkrd.com Acknowledgments I’d like to acknowledge and express my sincere thanks to my family. With- out the love and support of my husband, John; my son, John Michael; and my daughter, Mary; I would lack the purpose, meaning, and balance that brings energy and inspiration to my life. To my running buddies, Jean Smith and Catherine Farrell, I extend my appreciation for sharing life’s marathons with me. To my clients, who teach me about sports nutrition up close and per- sonal, I extend my gratitude. By entrusting me with their experiences, they help me to help others with similar nutrition concerns. Throughout this book, I have shared their stories, but I have changed their names and occupations to protect their privacy. I’m appreciative of the numerous recipe contributors as well as my faithful recipe testers: my neighbors, Joan and Rex Hawley; my mother and brother, Janice and Warren Clark; and my immediate family. And last but not least, I thank the staff at Human Kinetics for their support of this book, from the first edition to this fourth edition. Special thanks to Rainer Martens, Martin Barnard, and Jason Muzinic as well as Heather Healy, Alexis Koontz, Kim McFarland, Sue Outlaw, Nancy Rasmus, and Carla Zych. ix Part I Everyday Eating for Active People Chapter 1 Building a High-Energy Food Plan “Nutrition is my missing link. I know I could feel better, have more energy, and have better workouts if I were to eat better. But I get confused about what to eat and overwhelmed by my busy lifestyle. Help!” —Paul If you are like Paul and the majority of my clients, you know that food is important for fueling the body and investing in overall health, but you don’t quite manage to eat right. Perhaps you sleep through breakfast, work through lunch, skimp on meals, or stuff yourself with not-so-healthful snacks. Students, parents, business people, casual exercisers, and com- petitive athletes alike repeatedly express their frustrations about trying to eat high-quality diets. The stress and fatigue associated with long work hours, well-intentioned attempts to lose weight, and efforts to schedule exercise can all mean that food becomes more of a source of stress than one of life’s pleasures. Given today’s grab-and-go culture, eating well can seem harder than ever. In this chapter, you’ll learn how to eat right and fuel your body appro- priately all day long, even if you have a stressful lifestyle. Whether you work out at the health club, compete with a varsity team, aspire to be an Olympian, or simply are busy playing with your kids, you can nourish yourself with a diet that supports good health and high energy, even if you are eating on the run. 3 4 Nancy Clark’s Sports Nutrition Guidebook A key to eating well is preventing yourself from getting too hungry. When people get too hungry, they tend to care less about what they choose to eat and more about rewarding themselves with a treat. To prevent hunger, you need to eat throughout the day in order to offer your body and your brain a steady supply of fuel. This is contrary to the standard pattern of undereating by day only to overeat at night. By preventing hunger, you can curb your physiological desire to eat excessive treats as well as tame your psychological desire to reward yourself with, let’s say, a scrumptious chocolate brownie. In the upcoming chapters, I offer information on how to manage meals—breakfasts, lunches, dinners, and snacks—but in this chapter, I cover the day-to-day basics of how to choose the best foods to build a winning sports diet. Creating a Winning Eating Plan As you start to create your healthful eating plan, keep in mind these three concepts: 1. Eat three kinds of food at meals. The more different types of foods you eat, the more different types of vitamins, minerals, and other nutrients you consume. Instead of eating a repetitive menu with the same 10 to 15 foods each week, target 35 different types of foods per week. You can do this by eating not just Bran Flakes topped with banana for breakfast, but many different brands of cereal topped with a variety of different fruits; not just a turkey sandwich for lunch, but different types of breads and sandwich fillings; not just spinach in the salad, but lots of different colorful vegetables. Start counting! 2. Choose foods in their natural state. For instance, choose oranges rather than orange juice, bananas rather than commercial energy bars, whole-wheat bread rather than white bread, baked potatoes rather than French fries. Foods in their natural state and foods that have been lightly processed have more nutritional value and less sodium, trans fat, and other health-eroding ingredients. 3. Think moderation. Enjoy a foundation of healthful foods, but don’t deprive yourself of enjoyable foods. Rather than categorize a food as being good or bad for your health, think about modera- tion, and aim for a diet that offers 85 to 90 percent quality foods and about 10 percent foods with fewer nutritional merits. This way, even soda pop and chips can fit into a nourishing diet, if desired; you just need to balance them with healthier choices during the Building a High-Energy Food Plan 5 rest of the day. You can also compensate for an occasional greasy sausage and biscuit breakfast by selecting a low-fat turkey sandwich for lunch and grilled fish for dinner. What Shape Is Your Diet? Whereas a well-rounded diet is the desired shape of good nutrition, many of my clients eat a linear diet: apples, apples, apples; energy bars, energy bars, energy bars; pasta, pasta, pasta. Repetitive eating keeps life simple, minimizes decisions, and simplifies shopping, but it can result in an inadequate diet and chronic fatigue. If your diet looks more like a line than a circle filled two-thirds with fruits, vegetables, and whole grains and one-third with protein- and calcium-rich foods, keep reading. You’ll learn how to eat more of the best foods, eat less of the rest, and create a food plan that invests in high energy, good health, top performance, and weight management. The Food Pyramid Every five years, the U.S. government updates its nutrition recommen- dations. In 2005, it also updated the food pyramid. The new pyramid, with no words or hierarchy of foods, has left many athletes confused about how to build a better diet. Here’s a brief summary of some of the pyramid’s key points: Each of the different wedges in the pyramid represents a different food group. The variety of wedges symbolizes the variety of foods that we need to form a balanced diet. The larger the wedge, the larger the recommended number of serv- ings from that food group. The broad base and narrow top of each wedge symbolize that we should choose portion sizes that vary according to our calorie needs. The wedge shape also suggests we should eat a big base of nutrient- dense foods and taper off our intake of processed foods with less nutritional value. (That is, eat more apples, less apple pie; enjoy more carrot sticks, less carrot cake.) The stairs symbolize the message of taking small steps to a healthier lifestyle. The person running up the stairs symbolizes the importance of daily exercise. 6 Nancy Clark’s Sports Nutrition Guidebook yogu rt Grains Vegetables Fruits Oils Milk Meat & Beans The food pyramid. From the U.S. Department of Agriculture (USDA). www.MyPyramid.gov The person also symbolizes that the pyramid can be personal- ized. At www.MyPyramid.gov, you can get a personalized online food plan, based on your estimated calorie needs, that defines the amounts of fruits, vegetables, grains, protein, and dairy foods you need forE4426/Clark’s/figf1.1/306211/alw-pulled good health. One key to building a healthy sports diet is to consume a variety of nutrient-dense foods from the five basic food groups (fruits, vegetables, grains, lean protein, and low-fat dairy foods). For more details about each food group, keep reading this chapter. The food pyramid’s guidelines for an 1,800-calorie food plan (a mini- mal amount for most athletes, including most of those who want to lose body fat) include the following: Fruit: 1 1/2 cups of fruit or juice per day. This is easy—a refreshing smoothie with a banana, berries, and orange juice will do that job. Vegetables: 2 1/2 cups (about 400 g) per day with a variety of colors. A big bowlful of salad with tomato, peppers, carrots, and baby spinach fulfills the vegetable requirement, no sweat. Building a High-Energy Food Plan 7 Grains: 6 ounces (175 g) of grain foods, of which at least half are whole grain. (Look for whole before the grain name on the ingredi- ent list.) One ounce = one slice bread or 1/2 cup cooked pasta or rice. Eating whole-grain Wheaties at breakfast and a sandwich on rye bread at lunchtime can balance white rice or pasta served at dinner. Dairy: 3 cups (720 ml) of low-fat or fat-free milk or yogurt. One and a half ounces (60 g) of natural cheese or two ounces of processed cheeseequates to 1 cup (240 ml) of milk. Meat and alternatives: five one-ounce equivalents. One ounce (28 g) of meat is equal to 1 egg, 1 tablespoon of peanut butter, or 1/2 ounce of nuts. This translates into a small portion of a protein at two meals per day. Don’t Just Eat, Eat Better To help you select a high-quality sports diet—even if you are eating on the run and prefer to cook as little as possible—use the following information to help you not just eat, but eat better. Whole Grains and Starches If you eat well, there is a “whole” in your diet—whole grains! Wholesome breads, cereals, and other grain foods are the foundation of an optimal diet, particularly a high-performance sports diet. Grains that are unrefined or only lightly processed are excellent sources of carbohydrate, fiber, and B vitamins. They fuel your muscles, protect against needless muscular fatigue, and reduce problems with constipation if they’re fiber rich. And despite popular belief, the carbohydrate in grains is not fattening; excess calories are fattening. Excess calories often come from the various forms of fat (butter, mayonnaise, gravy) that accompany rolls, sandwich bread, rice, and other types of carbohydrate. If weight is an issue, I recommend that you limit the fat but enjoy fiber-rich breads, cereals, and other whole grains. These foods help curb hunger and assist with weight management. Wholesome forms of carbohydrate should be the foundation of both a weight-reduction program and a sports diet. Grains account for about 25 percent of the calories consumed in the United States, but unfortunately for our health, most of the grains we eat are refined—white bread, white rice, products made with white flour. The refining process strips grains of their bran and germ, thereby removing fiber, antioxidants, minerals, and other health-protective compounds. People who habitually eat diets based on refined grains tend to have a higher incidence of chronic diseases, such as adult-onset diabetes and 8 Nancy Clark’s Sports Nutrition Guidebook heart disease. People who habitually eat whole grains enjoy a 20 to 40 percent lower risk of heart disease and stroke (Flight and Clifton 2006). When selecting grains, try to choose ones that have been only lightly processed, if processed at all. For example, brown rice, whole-wheat bread, and stoned-wheat crackers offer more B vitamins, potassium, and fiber than do refined white rice, white bread, and white crackers. Other whole grains include rye crackers, Triscuits (preferably the low-fat variety), pop- corn, corn tortillas, whole-wheat pita bread, bulgur, and barley. How Much Is Enough? To get adequate carbohydrate to fully fuel your muscles, you need to consume carbohydrate as the foundation of each meal. You can do this by eating at least 200 to 300 calories of grain foods per meal—one bowl of cereal, two slices of bread, 1 cup of rice. This is not much for hungry exercisers who require 600 to 900 calories per meal. Most active people commonly need to eat (and should eat) double or even triple the standard servings listed on the label of a cereal or pasta box. Top Choices If refined white grains (white flour, bread, rice, pasta) dominate your grain choices, here are some tips to boost your intake of whole grains, which offer more health value yet are tasty and readily available. Note that wheat on a label may not mean whole wheat, and a dark color might be just from food coloring, so be sure to look for the word whole. And whatever you do, don’t try to stay away from grains, thinking they are fattening. That is not the case. Put a “Whole” in Your Diet Whole grains offer hundreds of phytochemicals that play key roles in reduc- ing the risk of heart disease, diabetes, and cancer. For a food to be called a whole grain, one of the following should be listed first in the ingredient list on the food label: Amaranth Triticale Brown rice Whole-grain barley Buckwheat bulgur (cracked wheat) Whole-grain corn Millet Whole oats or oatmeal Popcorn Whole rye Quinoa Whole wheat Sorghum Wild rice Building a High-Energy Food Plan 9 Whole-grain cereals. Wheaties, Cheerios, Total, Kashi, and Shredded Wheat are examples of whole-grain cereals. Look for the words whole grain on the cereal box or in the list of ingredients. Oatmeal. When cooked into a tasty hot cereal or eaten raw as in muesli, oatmeal makes a wonderful breakfast that helps lower cholesterol and pro- tect against heart disease. Some people even keep microwaveable packets of instant oatmeal in their desk drawers for cozy afternoon snacks. Oatmeal (instant and regular) is a whole-grain food with slow-to-digest carbohydrate that offers sustained energy and is perfect for a preexercise snack. Bagels and muffins. Bagels (pumpernickel, rye, whole wheat) and low-fat muffins (bran, corn, oatmeal) are more healthful than doughnuts, buttered toast, croissants, pastries, or muffins made with white flour. Add a tub of yogurt plus a small container of orange juice and you have a meal on the run that’s easily available from a convenience store or cafeteria, if not from home. Whole-grain and dark breads. When it comes to choosing bread prod- ucts, remember that whole-grain breads tend to have more nutritional value than do white breads. At the supermarket, select the hearty brands that have whole wheat, rye, or oatmeal listed as the first ingredient. Keep wholesome breads in the freezer so that you’ll have a fresh supply on hand for toast, sandwiches, or a snack. When at the sandwich shop, request the turkey with tomato on dark rye. Stoned-wheat and whole-grain crackers. These low-fat munchies are a perfect high-carbohydrate snack for your sports diet. Be sure to choose wholesome brands of crackers with low fat content, not the ones that leave you with greasy fingers. Look for Ak-Mak, Dr. Kracker, Finn Crisp, Kavli, RyKrisp, Triscuit Thin Crisps, Wasa, and Whole Foods 365 Baked Woven Wheats (among others). Popcorn. Whether popped in air or in a little canola oil, popcorn is a fun way to boost your whole-grain intake. The trick is to avoid smother- ing it in butter or salt. How about sprinkling it with Mexican or Italian seasonings or a seasoned popcorn spray? Vegetables Like fruits, vegetables contribute important carbohydrate to the foun dation of your sports diet. Vegetables are what I call nature’s vitamin pills because they are excellent sources of vitamin C, beta-carotene (the plant form of vitamin A), potassium, magnesium, and many other vitamins, minerals, and health-protective substances. In general, vegetables offer a little more nutritional value than fruits. Hence, if you don’t eat much fruit, you can compensate by eating more veggies. You’ll get similar vitamins and minerals, if not more. 10 Nancy Clark’s Sports Nutrition Guidebook How Much Is Enough? The recommended intake is at least 2 1/2 cups of vegetables per day (preferably more). Many busy people rarely eat that much in a week. If you are vegetable challenged, the trick is to eat large portions when you do eat vegetables—a big pile rather than a standard serving—and that can equate to 2 1/2 cups in one sitting. Then, to really invest in your health, try to do that twice a day, such as eating a big colorful salad with lunch and a bunch of broccoli with dinner. The food industry is working hard to make eating vegetables as easy as opening a bag of leafy greens, baby carrots, or peeled and cubed butternut squash. Top Choices Any vegetable is good for you. Of course, vegetables fresh from the garden are best, but they are often impossible to obtain. Frozen vegetables are a good second choice; freezing destroys little nutritional value. Canned veg- etables are also a good choice; rinsing them with plain water can reduce their higher sodium levels. Because canned vegetables are processed quickly, they retain many of their nutrients. Overcooking is a prime nutrient destroyer, so cook fresh or frozen vegetables only until they are tender-crisp, preferably in the microwave oven, steamer, or wok. Heat canned vegetables just until warm; there’s no need to boil them. Dark, colorful vegetables usually have more nutritional value than paler ones. If you are struggling to improve your diet, boost your intake of colorful broccoli, spinach, peppers, tomatoes, carrots, and winter squash. They are more nutrient dense than pale lettuces, cucumbers, zucchini, mushrooms, and celery. (In no way are these pale vegetables bad for you; the colorful ones just offer more vitamins and minerals.) Here’s the scoop on a few of the top vegetable choices. Broccoli, spinach, and peppers (green, red, or yellow). These low-fat, potassium-rich vegetables are loaded with vitamin C and the health-pro- tective carotenes that are the precursors of vitamin A. One medium stalk (one cup) of steamed broccoli offers you a full day’s worth of vitamin C, as does half a large pepper. I enjoy munching on a pepper instead of an apple for a snack; it offers more vitamins and potassium and fewer calories. What a nutrition bargain! Tomatoes and tomato sauce. In salads or on pasta or pizza, tomato products are another easy way to boost your veggie intake. They are good sources of potassium, fiber, and vitamin C (one medium-size tomato pro- vides half the vitamin C you need each day); carotenes; and lycopene, a phytochemical that might protect against certain cancers. Tomato juice and vegetable juice are additional suggestions for fast-laners who lack the time or interest to cook. They can enjoyably drink their veggies! Commercial Building a High-Energy Food Plan 11 tomato products tend to be high in sodium, however, so people with high blood pressure should limit their intake or choose the low-sodium brands. Some “salty sweaters,” however, welcome tomato or V8 juice after a hard workout; the sodium helps replace the sodium lost in sweat (see chapter 8). Cruciferous vegetables (members of the cabbage family). Cabbage, broccoli, cauliflower, brussels sprouts, collards, kale, kohlrabi, turnip, and mustard greens may protect against cancer. Do your health a favor by focusing on these choices. You can’t go wrong eating piles of these. If you are eating too few vegetables, be sure the ones you eat are among the best. The information in table 1.1 can help guide your choices, as can the information in the salad section in chapter 4. Table 1.1 Comparing Vegetables A C Potassium Vegetable Amount Calories (IU*) (mg) (mg) Asparagus 8 spears cooked 35 980 30 260 Beets 1/2 cup boiled 35 30 5 260 Broccoli 1 cup cooked 50 3,500 75 330 Brussels sprouts 8 medium cooked 60 1,100 100 500 Cabbage, green 1 cup cooked 30 200 35 145 Carrot 1 medium raw 30 20,250 10 230 Cauliflower 1 cup cooked 30 20 55 180 Celery 1 7-in. stalk 5 55 5 115 Corn 1/2 cup frozen 65 180 5 120 Cucumber 1/3 medium 15 220 5 150 Green beans 1 cup cooked 45 180 15 370 Kale 1 cup cooked 40 9,600 55 300 Lettuce, iceberg 7 leaves 15 455 5 160 Lettuce, romaine 2 cups shredded 15 2,900 30 320 Mushrooms 1 cup pieces raw 20 0 2 260 Onion 1/2 cup chopped 30 0 5 125 Peas, green 1/2 cup cooked 60 530 10 135 Pepper, green 1 cup diced 30 630 90 180 Potato, baked 1 large with skin 220 0 50 1,700 Spinach 1 cup cooked 40 14,750 20 840 Squash, summer 1 cup cooked 35 520 10 345 Squash, winter 1 cup baked 80 7,200 20 890 Sweet potato 1 medium baked 120 25,000 30 400 Tomato 1 small raw 25 770 25 275 Recommended intake: Men >3,000 >90 >4,700 Women >2,310 >75 >4,700 *International units Created from data in J. Pennington, 1998, Bowes & Church’s food values of portions commonly used, 17th ed. (Phila- delphia, PA: Lippincott, Williams & Wilkins). 12 Nancy Clark’s Sports Nutrition Guidebook Fruits Fruits add to the strong foundation of carbohydrate needed for your sports diet. Fruits are rich not only in carbohydrate but also in fiber, potassium, and many vitamins, especially vitamin C. The nutrients in fruits improve healing; aid in recovery after exercise; and reduce the risk of cancer, high blood pressure, and constipation. How Much Is Enough? The food pyramid recommends at least 1 1/2 cups of fruit or juice per day—this translates into only one or two standard pieces of fruit. The Centers for Disease Control and Prevention (CDC) encourages consuming even more to help prevent many of the diseases of aging. If you have trouble getting even a little fruit into your daily menus, I recommend scheduling it into your breakfast routine. An 8-ounce (240 ml) glass of orange juice and a medium banana on your cereal will cover your minimum fruit requirement for the entire day. Strive to consume more fruit at other eating occasions throughout the day by having dried fruit instead of an energy bar for a preexercise snack, or drink a fruit smoothie for a postexercise recovery shake. Any fruit is better than no fruit! Top Choices If you have trouble including fruit in your diet because it spoils before you get around to eating it or because it is not readily available, the fol- lowing tips will help you balance your fruit intake better. Make these foods a top priority in your good nutrition game plan. Citrus fruits and juices. Whether it’s the whole fruit or fresh, frozen, or canned juice, citrus fruits such as oranges, grapefruits, clementines, and tangerines surpass many other fruits or juices in vitamin C and potassium content. If the hassle of peeling an orange or a grapefruit is a deterrent for you, just drink its juice. The whole fruit has slightly more nutritional value, but given the option of a quick glass of juice or nothing, juice does the job. Just 8 ounces (240 ml) of orange juice provides more than the daily reference intake of 75 milligrams of vitamin C; all the potassium you may have lost in an hour-long workout; and folic acid, a B vitamin needed for building protein and red blood cells. Choose the OJ with added calcium to give your bone health a boost. To boost your juice intake, stock up on cans of frozen juice concentrate, buy juice boxes for lunch or snacks, and look for cans or bottles of juice in vending machines. Better yet, stock whole oranges in your refrigerator and pack them in your gym bag. Building a High-Energy Food Plan 13 Bananas. This low-fat, high-potassium fruit is perfect for busy people, and it even comes prewrapped. Bananas are excellent for replacing potas- sium lost in sweat. The potassium protects against high blood pressure. To boost your banana intake, add sliced banana to cereal, pack a banana in your lunch bag for a satisfying dessert, or keep them on hand for a quick and easy energy-boosting snack. My all-time favorite combination is banana with peanut butter, stoned-wheat crackers, and a glass of low- fat milk—a well-balanced meal or snack that includes four kinds of foods (fruit, nuts, grain, dairy), with a nice foundation of carbohydrate (banana, crackers) and protein (peanut butter, milk) as the accompaniment. To prevent bananas from becoming overripe, store them in the refrig erator. The skin may turn black from the cold, but the fruit itself will be fine. Another trick is to keep (peeled) banana chunks in the freezer. These frozen nuggets taste just like banana ice cream but have far fewer calories; they also blend nicely with milk to make creamy smoothies. (See the recipe for fruit smoothies on page 398.) Without a doubt, bananas are among the most popular sports snacks. I once saw a cyclist with two bananas safely taped to his helmet, ready to grab when he needed an energy boost. Cantaloupe, kiwi, strawberries, and other berries. These nutrient- dense fruits are also good sources of vitamin C and potassium. Many of my clients keep berries and chunks of melon in the freezer, ready and waiting to be made into a smoothie for breakfast or a pre- or postworkout refresher. Dried fruits. Convenient and portable, dried fruits are rich in potassium and carbohydrate. They travel well; keep baggies of dried fruit and nuts (as in a trail mix) in your gym bag instead of yet another energy bar. If you are eating too little fruit, be sure that the fruit you eat is nutrition- ally the best. The information in table 1.2 can help guide your choices. Is Organic Better? Many of my clients wonder if they should spend their food budgets on organic fruits and vegetables. Are organic foods better, safer, and more nutritious? The simple answer is they can be better for the small farmers and are possibly better for the environment, but they are not significantly better in terms of nutritional value. It’s debatable whether they are signifi- cantly safer. Here’s a closer look at the story as we know it to date. To start, organic refers to the way farmers grow and process fruits, vegetables, grains, meat, poultry, eggs, and dairy products. Only foods that are grown and processed according to USDA organic standards can be labeled organic. (Note: The food-label terms natural, hormone free, and free range do not necessarily mean organic.) Organic farmers do not use chemical fertilizers, insecticides, or weed killers on crops. 14 Nancy Clark’s Sports Nutrition Guidebook Table 1.2 Comparing Fruits A C Potassium Fruit Amount Calories (IU) (mg) (mg) Apple 1 medium 80 75 10 160 Apple juice 1 cup 115 0 2 300 Apricots 10 halves dried 85 2,550 1 480 Banana 1 medium 105 90 10 450 Blueberries 1 cup raw 80 145 20 260 Cantaloupe 1 cup pieces 55 5,160 70 495 Cherries 10 sweet 50 145 5 150 Cranberry juice 1 cup 140 10 90 55 Dates 5 dried 115 20 — 270 Figs 1 medium raw 35 70 1 115 Grapefruit 1/2 medium pink 40 155 45 170 Grapefruit juice 1 cup white 95 25 95 400 Grapes 1 cup 60 90 5 175 Honeydew melon 1 cup cubes 60 70 40 460 Kiwi 1 medium 45 135 75 250 Orange, navel 1 medium 60 240 75 230 Orange juice 1 cup fresh 110 500 125 500 Peach 1 medium 35 465 5 170 Pineapple 1 cup raw 75 35 25 175 Pineapple juice 1 cup 140 13 25 335 Prunes 5 dried 100 830 2 310 Raisins 1/3 cup 150 5 2 375 Strawberries 1 cup raw 45 40 85 245 Watermelon 1 cup 50 585 15 185 Recommended intake: Men >3,000 >90 >4,700 Women >2,310 >75 >4,700 Created from data in J. Pennington, 1998, Bowes & Church’s food values of portions commonly used, 17th ed. (Phila- delphia, PA: Lippincott, Williams & Wilkins). Nor do they use growth hormones, antibiotics, and medications to enhance animal growth and prevent disease. Organic fruits and vegetables can cost about 30 percent more than standard produce, if not more. Are they worth the extra cost? In terms of taste, some athletes claim organic foods taste better. Taste is subjective and may relate to the fact that freshly grown foods have more flavor. In terms of nutrition, some research suggests that organic foods may have slightly more minerals and antioxidants than do conventionally grown counter- parts, but the differences are insignificant (Winter and Davis 2006). You could adjust for the difference by eating a larger portion. One important reason to buy organic—preferably locally grown organic—is to help sustain the earth and replenish its resources. Buying The Nutrition Rainbow Strive to eat a variety of colors of fruits and vegetables. Each color offers differ- ent kinds of the health-protective phytochemicals that are linked to reducing the risk of cancer and heart disease. Color Fruits Vegetables Red Strawberries, watermelon Red peppers, tomatoes* Green Kiwi, grapes, honeydew melon Peas, beans, spinach, broccoli Blue or purple Blueberries, grapes, prunes Eggplant, beets Orange Mango, peaches, cantaloupe Carrots, sweet potato, pumpkin Yellow Pineapple, star fruit Summer squash, corn White Banana, pears Garlic, onions *Technically, tomatoes are a fruit. The following tips can help you enjoy a more colorful diet: Breakfast Wake up with a big swig of orange juice. Add banana or berries to cold cereal. Cook hot cereal with raisins and dried fruits. Whip together a smoothie with berries, juice, banana, and yogurt. Lunch Include a handful of baby carrots. Munch on a red pepper, as you would an apple. Put dried cranberries or canned mandarin oranges in your salad. Choose vegetable or tomato soup. Snacks Keep dried apricots and pineapple in your desk drawer. Sip on V8 juice. Bring a week’s supply of fruit (five apples, five oranges) to work with you on Monday. Dinner Enjoy an extra-large portion of broccoli (fresh or frozen). Buy precut fresh winter squash that is ready to cook. Smother pasta with extra tomato sauce. Order pizza with extra peppers or broccoli. Choose Chinese stir-fry with extra veggies. 15 16 Nancy Clark’s Sports Nutrition Guidebook locally grown foods supports the small farmers and helps them earn a better living from their farmland. Otherwise, farmers can easily be tempted to sell their land for house lots or industrial parks—and there goes more beautiful open green space. Yet, if you buy organic foods from a large grocery store chain, you should think about the whole picture. Because organic fruits, for example, are in big demand, they may need to be transported for thousands of miles, let’s say from California to Massachusetts. This transportation process consumes fuel, pollutes the air, and hinders the establishment of a better environ- ment. Does this really fit the ideal vision of organic? The compromise is to buy any kind of locally grown produce whenever possible. A second potential reason to choose organic relates to reducing the pesticide content in your body and the potential risk of cancer and birth defects. The Environmental Protection Agency has established standards that require a 100- to 1,000-fold margin of safety for pesticide residues. They have set limits based on scientific data that indicate a pesticide will not cause “unreasonable risk to human health.” According to Richard Bonanno, PhD, agricultural expert at University of Massachusetts-Amherst and a farmer himself, 65 to 75 percent of conventionally grown produce has no detectible pesticides. (When used properly and applied at the right times, pesticides degrade and become inert.) Results of testing vegetables from farms in Massachusetts showed no pesticide residues in 100 percent of the samples. Bonanno reports that only 0.5 percent of conventionally grown foods (but 3 to 4 percent of imported foods) are above EPA stan- dards. A 2005 survey of 13,621 food samples revealed pesticide residue exceeding the tolerance was 0.2 percent (USDA Pesticide Data). Yet, watchdog groups (www.foodnews.org) remind us that small amounts of pesticides can accumulate in the body. This may be of particular concern during vulnerable periods of growth, such as early childhood. Clearly, whether or not to buy organic foods becomes a matter of per- sonal values. Bonanno sees “organic,” in part, as a marketing ploy; organic foods are portrayed as being safer and better. He argues that we do not have a two-tier food system in the United States—with wealthier people who can afford to buy organic foods being the recipients of safer foods. So what’s a hungry but poor athlete to do? Eat a variety of foods to minimize exposure to a specific pesticide residue. Carefully wash and rinse fruits and vegetables under running water; this can remove 99 percent of any pesticide residue (depending on the food and the pesticide). Peel foods such as apples, potatoes, carrots, and pears (but then, you also peel off important nutrients). Building a High-Energy Food Plan 17 Remove the tops and outer portions of celery, lettuce, and cab- bage. Buy organic versions of the foods you eat most often, such as organic apples if you are a five-a-day apple eater. Sometimes (if not all the time), buy organic versions of the fruits and veggies that are known to have the highest pesticide residue, even after having been washed. According to the Environmental Working Group (2006), the “dirty dozen” includes the following fruits and vegetables: apples, cherries, imported grapes, nectarines, peaches, pears, strawberries, red raspberries, potatoes, bell peppers, celery, and spinach. Save money by choosing conventionally grown versions of the “clean dozen” (with little or no pesticide residue): banana, kiwi, pineapple, mango, papaya (note that foods such as papaya, mango, and banana have their own protective shell, so this reduces pesticide exposure on the flesh of the fruit), asparagus, avocado, broccoli, cauliflower, onion, sweet corn, and green peas. When all is said and done, whether or not to make the extra shopping trip and pay the higher price is an individual decision. Yes, buying locally grown organic foods can help save the small farms, but whether or not organic foods are better, safer, and more nutritious is debatable. Low-Fat Dairy Products Dairy foods such as low-fat milk, yogurt, and cheese are not only quick and easy sources of protein but are also rich in vitamin D (if fortified) and calcium, a mineral that is particularly important, not only for growing children and teens but also for women and men of all ages. A diet rich in calcium and vitamin D helps maintain strong bones, reduces the risk of osteoporosis, protects against high blood pressure, and may help prevent weight gain (Caan et al. 2007). Vitamin D may be helpful in preventing and treating diseases other than cancer, such as fibromyalgia, diabetes mellitus, multiple sclerosis, and rheumatoid arthritis (Lappe et al. 2007). Dairy products are not the only natural sources of calcium, but they tend to be the most concentrated and convenient sources for those who eat on the run. If you prefer to limit your consumption of dairy products because you are lactose intolerant or are biased against dairy, you may have difficulty consuming the recommended intake of calcium from natural foods. For example, to absorb the same amount of calcium that you would obtain from one glass of milk, you’d need to consume either 3 cups of broccoli, 8 cups of spinach, 2 1/2 cups of white beans, 6 cups of pinto beans, 6 cups of sesame seeds, or 30 cups of unfortified soy milk. 18 Nancy Clark’s Sports Nutrition Guidebook Calcium-fortified foods, such as calcium-enriched soy milk, orange juice, or breakfast cereals such as Total, can help you reach your calcium goals. Table 1.3 lists a few of the more common calcium sources and the amount of the source that provides a serving of calcium (300 mg). The table also provides the amount of vitamin D supplied by these common sources. Fat-free or low-fat milk (cow’s or soy) and other foods rich in calcium and vitamin D should be an important part of your diet throughout your lifetime. Because your bones are alive, they need calcium and vitamin D daily. Children and teens need calcium for growth. Adults also need cal- cium to maintain strong bones. Although you may stop growing by age 20, you don’t reach peak bone density until age 30 to 35. The amount of calcium stored in your bones at that age is a critical factor in your susceptibility to fractures as you grow older. After age 35, bones start to thin as a normal part of aging. A calcium-rich diet, in combination with resistance exercise and strong muscles, can slow this process. Many of my clients tell me, “I don’t drink milk, but I do take a calcium supplement.” I remind them that calcium supplements are incomplete Table 1.3 Calcium Equivalents Calcium-rich food Amount* Vitamin D (IU) Dairy Milk (fortified) 1 cup (240 ml) 100 Milk powder 1/3 cup dry (75 ml) 100 Yogurt 1 cup 100 Cheese, cheddar 1.5 oz (45 g) 5-15 Cottage cheese 2 cups — Frozen yogurt 1 1/2 cups — Pizza, cheese 2 slices — Protein Soy milk, enriched 1 cup (240 ml) 40-120 Tofu 5 oz (150 g) — Salmon, canned with bones 4 oz (125 g) 700 Sardines, canned with bones 3 oz (90 g) 230-400 Almonds 3/4 cup (170 g) — Vegetables Broccoli, cooked 3 cups (500 g) — Collard or turnip greens, cooked 1 cup (200 g) — Kale or mustard greens, cooked 1 1/2 cups (200 g) — Bok choy 2 cups (340 g) — Calcium-fortified foods Total cereal 1 cup (30 g) 40 Orange juice, calcium & D enriched 1 cup (240 ml) 100 *The amount represents 1 serving of calcium (300 mg). Building a High-Energy Food Plan 19 substitutes for calcium-rich dairy products. Low-fat milk and yogurt offer a full spectrum of important vitamins, minerals, and protein; a calcium supplement offers only calcium (and maybe vitamin D). Milk, for example, is rich in not only calcium and vitamin D but also potassium and phospho- rous—nutrients that work in combination to help your body use calcium effectively. Milk is also one of the best sources of riboflavin, a vitamin that helps convert the food you eat into energy. Active people, who generate more energy than their sedentary counterparts, need more riboflavin. If you don’t eat dairy products, your riboflavin intake is likely to be poor. Granted, taking a calcium supplement is better than consuming no calcium. But I highly recommend a nutrition consultation with a registered dietitian to ensure appropriate calcium intake from your daily food choices. This nutrition professional can help you optimize your diet so that you get the right balance of all the nutrients you need for good health and optimal sports performance. (See the Dietitian section in appendix A for information on finding a registered dietitian in your area.) How Much Is Enough? As you can see in table 1.4, calcium needs vary according to age, with growing teens needing four servings and most adults three servings. This may seem like a lot if you are not a milk drinker, but even weight-con- scious athletes can easily consume the recommended daily minimum of three servings of low-fat dairy foods for only 300 calories. Try to get at least half, if not all, of your calcium requirements from food. Table 1.4 Calcium Requirements Age Calcium target (mg) Number of servings Children 1-3 years 500 2 4-8 years 800 3 Teenagers 9-18 years 1,300 4 Women 19-50 years 1,000 3 >50 years (menopausal) 1,200-1,500 4-5 Amenorrheic athletes 1,200-1,500 4-5 Pregnant or breastfeeding 1,000-1,500 3-5 Men 19-50 years 1,000 3 >50 years 1,200 4 20 Nancy Clark’s Sports Nutrition Guidebook Some people have trouble digesting milk because they lack an enzyme (lactase) that digests milk sugar (lactose). These lactose-intolerant people can often tolerate yogurt, hard cheeses, or even small amounts of milk taken with a meal. They can also drink soy milk or Lactaid milk, a lactose- free brand available at supermarkets. All too often, my lactose-intolerant clients neglect the fact that their bodies still need calcium from alternative calcium sources. Boosting Your Calcium Intake Here are some tips to help you boost your calcium intake to build and main tain strong bones: For breakfast, enjoy cereal with 1 cup of low-fat or skim milk (or soy milk). With crunchy cereal, such as granola, use yogurt in place of milk. With hot cereal, cook the cereal in milk, or mix in 1/3 cup of powdered milk. When grabbing a quick meal, choose pizza with low-fat mozzarella cheese or sandwiches with low-fat cheese. Choose a postworkout chocolate milk chug for an excellent recovery food. Boost the calcium in salads by adding low-fat grated cheese, cottage cheese, or tofu cubes. In a blender, mix soft tofu or plain yogurt with salad seasonings for a calcium-rich dressing. Read the labels on the tofu containers, and choose the brands processed with calcium sulfate; otherwise, the tofu will be calcium poor. Drink a glass of low-fat, skim, or soy milk with lunch, snacks, or dinner. Add extra milk (instead of cream) to coffee, and enjoy lattes. Take powdered milk to the office to replace coffee whiteners. Drink milk-based hot cocoa in place of coffee. Make shakes and smoothies using milk as the base. Snack on fruit-flavored yogurt rather than ice cream. Enjoy pudding made with low-fat milk for a tasty low-fat calcium treat. Eat canned salmon or sardines with bones for an easy lunch option; serve with crackers. Add tofu to Oriental soups or stir-fried meals. Building a High-Energy Food Plan 21 Top Choices To consume the amount of calcium you need to build and maintain strong bones (1,000 to 1,500 mg per day), you should plan to include a calcium-rich food in each meal. Milk, low-fat or nonfat, fortified with vitamin D. Low-fat or skim milk is an excellent source of calcium. It has most of the fat removed but retains all the calcium and protein. A glass of whole milk (3.5 percent fat) has the same amount of fat as two pats of butter, but skim milk (0 percent fat) has almost no fat. Calcium-fortified soy milk is also a fine alternative. Yogurt, low-fat or nonfat. Plain yogurt is one of the richest food sources of calcium. Note that frozen yogurt product (and ice cream for that matter) is only a fair source of calcium. I consider both types of treats sugar-based foods that contain a little milk, not milk-based foods. One cup of soft-serve frozen yogurt equals 1/3 a cup of milk in terms of calcium but comes with twice as many calories. Low-fat cheese. Because many brands of fat-free cheese tend to be unpalatable, I suggest that you enjoy small portions of the low-fat options. They are usually tasty and add both calcium and protein to sandwiches, pasta, chili, and other vegetarian meals. Dark green veggies. Broccoli, bok choy (a vegetable common in Chi- nese cookery), kale, and collards are among the best vegetable sources of calcium. Spinach, Swiss chard, and beet greens also contain calcium, but your body can absorb very little of it because these veggies have a type of fiber that binds the calcium and hinders absorption. Protein-Rich Foods Protein from animal sources (meats, seafood, eggs, and poultry) and plant sources (beans, nuts, and legumes) is also important in your daily diet, but you should eat protein as the accompaniment to the carbohydrate found in fruits, vegetables, and grains. If one-quarter to one-third of your plate at two of your daily meals is covered with a protein-rich food, you can get the right amount of the amino acids you need to build and repair muscles. By choosing darker meats with iron and zinc, you reduce the risk of iron-deficiency anemia. How Much Is Enough? Athletes tend to eat either too much or too little protein, depending on their health consciousness, accuracy of nutrition education, or lifestyle. Some athletes fill up on too much meat. Others proclaim themselves vegetarian, yet they sometimes neglect to replace the beef with beans and are, in fact, only non-meat-eaters—and often protein deficient, at that. 22 Nancy Clark’s Sports Nutrition Guidebook Although slabs of steak and huge hamburgers have no place in any athlete’s diet—or anyone’s diet—adequate amounts of protein are impor- tant for building muscles and repairing tissues. (Excess protein isn’t stored as bulging muscles.) The purpose of this section is to highlight quick and easy protein choices. See chapter 7 for sport-specific protein needs. For most people, including athletes, a daily total of about 5 to 7 ounces (150 to 200 g) of protein-rich food plus the protein you get in two to three servings of milk, yogurt, or cheese (which you consume for calcium) offers adequate protein. Five ounces for a day is much less than the portions most Americans eat in one meal: 10-ounce steaks, 6-ounce chicken breasts, slabs of roast beef. Many athletes polish off their required protein by lunchtime and continue to eat one to two times more than they need. Other people, however, miss out on adequate protein when they eat only veggies in a salad for lunch or stir-fried for dinner. Dieters, for example, who dine exclusively on salads and vegetables commonly neglect their protein needs. Top Choices All types of protein-rich foods contain valuable amino acids. See table 1.5 for a comparison of some popular protein-rich foods. The following choices can enhance your sports diet. Chicken and turkey. Poultry generally has less saturated fat than red meats, so it tends to be a more heart-healthful choice. Just be sure to buy skinless chicken or discard the fatty skin before cooking. Cooked until crispy, poultry skin can be a big temptation. Fish. Fresh, frozen, or canned fish provides not only a lot of protein but also the omega-3 fat that protects your health. The recommended target is 12 ounces (350 g), or two to three servings, of canned or fresh fish per week. The best choices are the oilier varieties that live in cold ocean waters, such as salmon, mackerel, albacore tuna, sardines, bluefish, and herring, but any fish is better than no fish. Chapter 2 offers more fish information. Lean beef. A lean roast-beef sandwich made with two thick slices of whole-grain bread for carbohydrate is an excellent choice for protein as well as iron (prevents anemia), zinc (needed for muscle growth and repair), and B vitamins (help produce energy). Top round (such as you’d buy at a deli), eye of round, and round tip are among the leanest cuts of beef. A lean roast-beef sandwich is preferable in terms of heart health and nutritional value to a grilled-cheese sandwich, chicken salad sandwich, or hamburger because of these nutrients and the lower fat content. Peanut butter. Although peanut butter by the jarful can be a dangerous diet breaker, a few tablespoons on whole-grain bread, crackers, a bagel, Table 1.5 Comparing Protein Content of Commonly Eaten Foods Food sources Protein (g) Animal protein Egg white, 1 3 Beef, roast, 4 oz (120 g) cooked 30 Chicken breast, 4 oz (125 g) cooked* 30 Tuna, 1 can (6 oz) 30-40 Plant protein Nuts, 1 oz (1/4 cup or 30 g) 6 Soy milk, 1 cup (240 ml) 7 Lentils, 1/2 cup (100 g) 7 Hummus, 1/2 cup (125 g) 8 Peanut butter, 2 tbsp 9 Tofu, 4 oz (125 g) 11 Boca burger, 2.5 oz (70 g) 13 Dairy products Cheese, American, 1 slice (2/3 oz) 6 Milk, 1 cup (240 ml) 6-7 Yogurt, 6 oz (175 g) tub 6-7 Cheese, cheddar, 1 oz (30 g) 7 Milk powder, 1/3 cup (75 g) 8 Cottage cheese, 1/2 cup (113) 15 Breads, cereals, grains Bread, 1 slice 2 Cold cereal, 1 oz (30 g) 2 Rice, 1/3 cup dry (65 g) or 1 cup cooked 4 Oatmeal, 1/2 cup dry (40 g) or 1 cup cooked 5 Pasta, 2 oz (60 g) dry or cooked 8 Starchy vegetables** Peas, 1/2 cup cooked 2 Carrots, 1/2 cup cooked 2 Corn, 1/2 cup cooked 2 Beets, 1/2 cup cooked 2 Winter squash, 1/2 cup 2 Potato, 1 small 2 *4 oz (125 g) cooked (approx. size of deck of cards) = 5-6 oz (150-175 g) raw. **Whereas starchy vegetables contribute a little protein, most watery vegetables (and fruits) offer negli- gible amounts of protein. They may contribute a total of 5 to 10 g of protein per day, depending on how much you eat. 23 24 Nancy Clark’s Sports Nutrition Guidebook or a banana for a satisfying snack or a quick meal offer protein, vitamins, and fiber. A source of plant protein, peanut butter is cholesterol free and a good source of health-protective polyunsaturated fat. People who eat at least two servings of peanut butter (or peanuts) per week tend to have a lower risk of heart disease (Kris-Etherton et al. 2001). The all-natural brands have a tiny bit less “bad” trans fat, but the difference is very small. So enjoy this childhood favorite! Canned beans. Vegetarian refried beans (tucked into a tortilla sprinkled with salsa and shredded low-fat cheese and then heated in the microwave oven), hummus (as a dip with baby carrots), and canned garbanzo or kidney beans (added to a salad) are three easy ways to boost your intake of plant protein, which is also an excellent sources of carbohydrate. If you tend to avoid beans because they make you flatulent, try eating them with Beano, a product available at many health-food stores and pharmacies that takes the gas out of vegetarian diets. Tofu. Tofu is an easy addition to a meatless diet because you don’t have to cook it. It has a mild flavor, so you can easily add it to salads, chili, spa- ghetti sauce, stir-fry dishes, and casseroles. Look for tofu in the vegetable section of your grocery store. Buy “firm” tofu for slicing or cutting into cubes, “soft” or “silken” tofu for blending into smoothies or dips. Even those who don’t cook can easily incorporate adequate protein into a day’s diet. Simply buy lean roasted beef, rotisserie chicken, and turkey breast at the deli counter, or open a can or foil pouch of tuna, salmon, or chicken. Fat and Oils A food plan need not be fat free to be healthful. Fat may be nutrient poor, but it adds flavor and enjoyment to your diet. Hungry athletes will have a far easier time consuming the calories they need when the food is tasty and enjoyable. And despite popular belief, a little fat does not negate all the positive aspects of your overall healthful sports diet, although too much saturated and trans fat can be harmful to your health. In particular, you want to limit your intake of “hard” fat, such as beef lard and butter; use more “soft” fat, such as olive and canola oils; and stay away from partially hydrogenated trans fat, which, until recently, had been prevalent in many commercially prepared foods such as crackers, cakes, cookies, chips, pastries, and the chocolate covering on energy bars. Trans fat is created in an industrial process that adds hydrogen to mono- and polyunsaturated fats. This converts them into a partially hydrogenated oil (the term on the food label). The American Heart Association recommends avoiding trans fat because it raises the bad LDL cholesterol and lowers the good HDL cholesterol. Building a High-Energy Food Plan 25 Try to consume less than 1 percent of your calories from trans fat; that’s only 18 calories—2 grams of fat—if you eat 1,800 calories; a large order of French fries might have 6 grams of trans fat. With new laws that require trans fat to be identified on labels, food companies have scrambled to find trans-fat-free alternatives that offer the same light and flaky pastries and crunchy chips—a tall order! How Much Is Enough? About 20 to 35 percent of the calories in your diet can appropriately come from fat. According to the food pyramid, about 5 teaspoons of fat per day are appropriate for an 1,800-calorie food plan. Some people eat way too much fat—buttery, cheese-filled omelets for breakfast; burgers and fries for lunch; and fried chicken for dinner. If you tend to choose high-fat foods at each meal, strive to correct the imbalance by choosing lower-fat foods for at least two of your three meals. If you fill up on fatty snacks (chips, cookies, ice cream), try eating larger portions of wholesome foods at meals in order to curb your appetite for artery-clogging snacks. Top Choices The following forms of fat are a positive addition to your sports diet because they are health enhancing. Olive oil. This monounsaturated fat is associated with low risk of heart disease and cancer. Use it for salads, sauteing, and keeping pasta from sticking together. If you use olive oil for its health-giving properties, buy the unrefined extra-virgin olive oil (despite its higher cost). Extra-virgin olive oil offers more phenolic compounds—powerful antioxidants that can reduce inflammation (Fitó et al. 2007). Peanut butter (and other nut butters). All-natural brands are best because they are less processed, but even Skippy, Jif, and other commercial peanut butters offer predominantly health-protective fat. Walnuts, almonds, and other nuts. Thought to be protective against heart disease, nuts (and nut oils, such as walnut oil) are a fine addition to salads, cooked vegetables, and even pasta meals. Flaxseed (ground) and flax oil. Flax contains an omega-3 fat that the body converts into small amounts of the health-protective EPA and DHA contained in fish. Sprinkle ground flaxseed on cold cereal, blend it into shakes, and add it to pancake batter. Sugars and Sweets Even a well-balanced diet can include some sugar and sweets; the key is moderation. The plan is to first fill up on healthful foods, and then, if desired, enjoy a little fun food for a small treat. That is, there is little wrong 26 Nancy Clark’s Sports Nutrition Guidebook with enjoying a bit of chocolate after a lunchtime sandwich. But there is a lot wrong with eating chocolates for lunch. Given that 10 percent of your calories can appropriately come from sugar, the following foods are some of the better ways to spend those calories. Molasses. Confirming the rule that the darker the food is, the more nutrients it has, molasses is among the darkest of sugars, and it has the most nutrients. Molasses is a fair source of potassium, calcium, and iron— if you eat several tablespoons. For a change of taste, add a tablespoon to milk for taffy milk, mix some in yogurt, or spread it on a peanut butter sandwich. Berry jams. Because of the seeds in raspberry, strawberry, and blackberry jams, these sweet spreads have a little fiber that somewhat boosts their healthfulness. Preferable to strained jellies, the jams offer slightly more fruit value, but you still have to count them as primarily sugar. Building a Strong Sports Diet Now that you have read this chapter, you know which foods are the best choices. The trick is to assemble the best foods into wholesome meals and snacks. I recommend that you try to choose from at least three out of five food groups at each meal. The following chart shows how this might work. Food group Meal 1 Meal 2 Meal 3 1. Grain Oatmeal Whole-wheat wrap Pizza crust 2. Fruit Raisins Apple Green peppers 3. Vegetable Lettuce, tomato Tomato sauce 4. Dairy Low-fat milk Low-fat yogurt Cheese 5. Protein Almonds Turkey Foods made from a combination of ingredients can create a well- balanced meal in one dish. For example, vegetable pizza topped with pep- pers, onions, and mushrooms is far from junk food. It offers calcium-rich dairy food (from the low-fat mozzarella); vegetables rich in potassium, beta-carotene, and vitamin C (from the tomato sauce and vegetable top- pings); and carbohydrate-rich grain foods in the (preferably whole-wheat) crust. A dinner of thick-crust pizza with a foundation of carbohydrate better fits the pyramid plan than does a fried-chicken dinner that is mostly greasy protein. Building a High-Energy Food Plan 27 Eating well need not be a major task. You simply need to do the fol- lowing: Eat a variety of wholesome foods to consume a bigger variety of health-protective nutrients. Choose more of the best foods and less of the rest. Fuel your body on a regular schedule, eating every two to four hours rather than having one or two big meals per day. Eat when you are hungry, and then stop when you are content. When eating at restaurants, be cautious of “value meals” that emphasize large portions. They lead to overeating and poor health. Take mealtimes seriously. The following chapters offer additional tips to help you choose a sports diet that will invest in good health and high energy for sports, exercise, and a nourishing life. Balancing Act How can I tell if I am choosing a well-balanced diet? You can consume the recommended intake of the vitamins, minerals, amino acids (the building blocks of protein), and other nutrients you need for good health within 1,200 to 1,500 calories if you wisely select from a variety of wholesome foods. Because many active people consume 2,000 to 5,000 calories (depending on their age, level of activity, body size, and gender), they have the chance to consume abundant amounts of vitamins and other nutrients. Dieters, on the other hand, tend to take in fewer calories, so they need to carefully select nutrient-dense foods— foods that offer the most nutritional value for the least amount of calories—to reduce the risk of consuming a nutrient-deficient diet. To determine if your daily food intake is balanced and adequate, you can track your diet on the Internet using any number of Web sites. See appendix A for a list of sites, or simply search the Web for “nutrient analysis programs.” Chapter 2 Eating to Stay Healthy for the Long Run Few people fully appreciate the power of food in the prevention and treat- ment of the so-called diseases of aging, which are, in reality, diseases of inactivity and poor nutrition. In this day and age where people are taking all sorts of medications to lower cholesterol, blood sugar, and blood pressure and to deal with other health concerns, we forget that, just as the wrong foods can be powerfully bad for your health, the right foods can be powerfully health protective. By eating wisely, you are investing in your good health and top performance; alternatively, you can eat poorly and end up with your poor health controlling you and your life. No single medicine is as powerful as a healthful diet. Luckily, the wholesome foods you need to protect your health are the same foods that should be part of your sports diet. By routinely choosing the best sports foods, you’ll be better able to enjoy lifelong health and high energy. Confusion abounds about foods that are “good” or “bad” for your health. My clients repeatedly ask me, “What foods should I avoid?” My standard answer is that the only “bad” foods are foods that are moldy or poisonous (or foods you are allergic to); all other foods, in moderation, can be balanced into a healthful food plan. Although there is no such thing as a bad food, there is a bad diet. Repeatedly eating meals and snacks of junk foods filled with saturated fat and refined sugars can, indeed, contribute to obesity, heart disease, cancer, hypertension, diabetes, kidney failure, and other diseases associated with 29 30 Nancy Clark’s Sports Nutrition Guidebook excessive eating. As I outline in chapter 1, choosing a nutrition game plan based on wholesome grains, fruits, vegetables, nuts, lean protein, and low- fat dairy foods—in addition to leading an active lifestyle—clearly invests in optimal health and sports performance. The purpose of this chapter is to help you make the best food choices for lifelong well-being. Diet and Heart Health Heart disease is the number one killer of both men and women in America. Women tend to think cancer is the number one killer, but that is not the case. Heart disease and stroke account for 38 percent of deaths among women (Mosca et al. 2007), whereas cancer accounts for about 22 percent. Two ways to reduce your risk of heart disease are being physically fit and eating wisely. Yet, active people often believe they are exempt from the food rules about heart-healthy eating; they assume that being physically fit protects them from heart disease. Wrong! A friend of mine, a seem- ingly healthy 48-year-old marathoner, died suddenly of a massive heart attack. He’d run 2 hours 10 minutes, stopped his watch, and was later found dead in the running path. Everyone was shocked. Unfortunately, even the most health-conscious people can find them- selves confused by the constant updates and changes to heart-health infor- mation. This leaves us wondering what the real answers are to questions such as the following: Is beef bad? What about eggs? Should I use butter or margarine? The answers vary from person to person because we each have a unique genetic makeup. It won’t be long before dietary recommen- dations will be based on genetic tests. But for today, here are suggestions for optimizing your diet, based on the latest nutrition studies. Know Your Numbers Cholesterol is a waxy substance that accumulates in the walls of the blood vessels throughout the body, especially those in the heart, and contributes to hardening of the arteries. This buildup limits blood flow to the heart muscle and contributes to heart attacks. You consume cholesterol when you eat animal foods; cholesterol is a part of animal cells. Your body also makes cholesterol. Foods with saturated fat (butter, lard) and partially hydrogenated or trans fat can increase the level of cholesterol in the blood, thereby increasing the risk of cardiovascular (cardio = heart; vascular = blood vessel) disease. Table 2.1 provides the amounts of cholesterol and fat found in common foods. Because genetics play a large role in heart and blood vessel health, you may have a blood cholesterol level that puts you at a high risk for Eating to Stay Healthy for the Long Run 31 Table 2.1 Fat and Cholesterol in Common Foods Cholesterol Food product Amount Fat (g) (mg) Milk Nonfat 1 cup (240 ml) 0 5 2% fat 1 cup (240 ml) 5 20 Whole 1 cup (240 ml) 8 35 Cheese Cheddar 1 oz (30 g) 10 30 Mozzarella, part skim 1 oz (30 g) 5 15 Cottage cheese, 1% fat 1/2 cup (115 g) 1 5 Ice cream Expensive brands 16% fat 1/2 cup (125 g) 12-18 40-50 Less-expensive brands 10% fat 1/2 cup (125 g) 5-10 30-35 Low fat 1/2 cup (125 g) 3-5 10-20 Meats and fish (cooked) Pork, roast loin 4 oz (125 g) 8 85 Beef, 90% lean hamburger 4 oz (125 g) 18 95 Ham, canned lean 4 oz (125 g) 6 50 Chicken, roast breast 4 oz (125 g) 2 95 Tuna, canned white 4 oz (125 g) 3 45 McDonald’s Big Mac 1 29 75 McDonald’s Filet-o-Fish 1 18 35 Nutrient data from food labels, McDonald’s Corporation (www.mcdonalds.com) and J. Pennington, 1998, Bowes & Church’s Food Values of Portions Commonly Used, 17th ed. (Philadelphia: Lippincott). developing cardiovascular disease even if you eat a healthy diet. One 28- year-old triathlete was dismayed when he discovered his cholesterol was very high. He likely inherited this trait from his father and grandfather, both of whom had heart attacks in their 50s. By knowing your cholesterol level, you can assess your risk of devel- oping heart disease. Make an appointment with your doctor to get your blood tested for these health indicators: Total cholesterol. Your body contains different types of cholesterol, including HDL and LDL. The sum of the types of cholesterol is called your total cholesterol. The desired level is less than 200 milligrams of total cholesterol per deciliter of blood. 32 Nancy Clark’s Sports Nutrition Guidebook HDL cholesterol. High-density lipoprotein cholesterol is the “good stuff” that carries the bad cholesterol out of the arteries. The desired level is more than 60 milligrams HDL per deciliter to protect against heart disease. LDL cholesterol. Low-density lipoprotein cholesterol is the “bad stuff” that clogs arteries. A level greater than 160 milligrams per deciliter is associated with a higher risk of heart disease. The optimal LDL level is less than 100 milligrams per deciliter. Ratio of total cholesterol to HDL. At least 25 percent of your total blood cholesterol should be HDL. Because exercise tends to boost HDL, active people often have a higher percentage of this good cholesterol. Their total cholesterol may be higher than that of a sedentary person, but as long as 25 percent of it is HDL, these individuals have a lower risk of heart problems. The higher the HDL percentage, the better. After you know your blood cholesterol level, you’ll be better able to determine how strict you need to be with your diet. For example, if your level is far less than 200 milligrams and your 97-year-old parents are still alive and thriving, you can be less obsessive about your eating habits than can your buddy whose cholesterol is a risky 250 milligrams and whose father died suddenly of a heart attack at age 54. Another possible blood test for people with a family history of heart disease but no obvious risk factors is a test that checks levels of artery- clogging particles called apolipoproteins and determines the ratio of apoB to apoA-1. A third possible test is for CRP, or C-reactive protein, a measure of inflammation. Arteries weakened by inflammation are also associated with a higher risk of heart disease. Although none of these tests will predict with certainty whether or not you will have a heart attack, they can offer a suggestion of where you stand when it comes to heart disease. Eat for Heart Health By tweaking your daily food intake to include heart-healthy choices, you can make several small changes that accumulate to make a big difference in the long run. The American Heart Association (AHA) recommends a variety of diet and lifestyle choices to reduce your risk for cardiovascular disease (Lichtenstein et al. 2006)*. You should review your physical activity and calorie intake to ensure they are in balance. Doing so will help you reach or maintain a healthy weight. You should also strive to consume a diet that is rich in vegetables, fruits, and whole-grain, high- Eating to Stay Healthy for the Long Run 33 fiber foods. The guidelines also recommend consuming 8 ounces (250 g) of oily fish per week. Another part of achieving a healthy diet is to limit your intake of satu- rated fats, trans fats, and cholesterol. Saturated fats should account for no more than 7 percent of your total calories, and trans fat for no more than 1 percent of your total calories. Limit your cholesterol intake to less than 300 mg per day. You can achieve these goals by choosing lean meats or vegetable alternatives; by selecting fat-free (skim), 1%-fat, and low-fat dairy products; and by minimizing your comsumption of partially hydrogenated fats. Other choices that can reduce your risk of heart disease include con- trolling your weight by limiting your intake of beverages and foods with added sugars, choosing and preparing foods with little or no salt, and consuming alcohol in moderation (if at all). And when you dine away from home you can make reasonably healthful choices by following AHA’s recommendations for eating out. This book provides you with detailed information you can use to follow the AHA’s guidelines successfully. *Adapted from A.H. Lichtenstein et al., 2006, “Diet and lifestyle recommendations revision 2006: A scientific statement from the American Heart Association Nutrition Committee,” Circulation 114(1): 82-96. Lean Beef and Heart Health Athletes commonly shun beef, believing it to be an artery clogger. Although that is true for greasy burgers and sausages, small portions of lean beef aren’t so bad after all. In fact, lean beef is an excellent source of iron, zinc, and other nutrients athletes need. Despite popular belief, beef is not exception- ally high in cholesterol; it has a cholesterol value similar to that in chicken and fish. Additionally, we now know that cholesterol, which was once thought to contribute to heart disease, is less of a culprit than saturated fat. However, beef tends to have more saturated fat than chicken or fish, so that’s why it still has a bad name among health watchers. Saturated fat is hard at room temperature. For example, the hard fat on uncooked steak is different from chicken fat, which is softer and less saturated. The AHA recommends that we consume less than 7 percent of our calories from saturated fat; the average intake in the United States is about 11 percent. The Web site www.americanheart.org/facethefats has a fat calculator that helps you determine how much of each type of fat can fit into your daily food plan. If you are on an 1,800-calorie reducing diet, 7 percent is just about the amount of saturated fat you’d consume in a McDonald’s Quarter Pounder with Cheese. If you are very active and require 3,000 calories per day, 7 percent of calories from saturated fat equates to the amount in two double cheeseburgers. 34 Nancy Clark’s Sports Nutrition Guidebook But not all beef is fatty. In the past decade, the healthfulness of beef and other meats has improved because farmers have learned how to raise leaner animals and because butchers are trimming more of the fat from the meat in stores. You can easily fit beef (and pork and lamb) into a heart-healthy sports diet if you select lean cuts, such as eye of round, rump roast, sirloin tip, flank steak, top round, and tenderloin, and eat smaller portions, limiting yourself to a piece of lean protein about the size of the palm of your hand. You can more easily consume lean beef when you are preparing meals at home than when you are in a restaurant that prides itself on juicy, tender (read as “loaded with saturated fat”) beef. Fish and Heart Health If good health is your wish, get hooked on fish. Research indicates that fish may guard against not only heart disease but also hypertension, cancer, arthritis, asthma, and who knows what else. The omega-3 fatty acids, the special polyunsaturated fat found in fish oil, block many harmful biochemical reactions that can cause blood to clot (predisposing you to heart attack and stroke) and the heart to beat irregularly (as occurs during a heart attack). Some researchers believe that fish oils can prevent heart disease from beginning rather than merely having a beneficial effect after the onset of the disease. A comparison of the rates of death from heart disease of men in a fishing village and the rates of death of men in a farming village suggests a 4 times lower incidence of heart disease among the men in the fishing village. They ate 10 times more fish than the farmers and had much higher blood levels of the health-protective omega-3 fat (Torres et al. 2000). A study of almost 85,000 U.S. nurses suggests that women who ate fish two to four times a week had a 31 percent lower risk of heart disease compared with those who rarely ate fish (Hu et al. 2002). The American Heart Association recommends eating about 8 oz (250 g) of oily fish per week (that’s one large or two small fish servings) to help reduce your risk of heart disease. Eating fish for dinner not only contributes fish oil to your diet but also displaces meat-based meals high in saturated fat. Table 2.2 can help guide your fish choices so you select the fish highest in omega-3 fat. Just be sure that your fish is prepared in low-fat ways, not fried or broiled in butter. If you shy away from cook- ing fish, simply take advantage of precooked tuna (mixed with low-fat mayonnaise), salmon, and sardines in cans or foil pouches. Be careful about eating too much fish, however. Unfortunately, the fish highest in omega-3 fatty acids also deliver a dose of methylmercury from industrial pollution of the oceans. Long-term consumption of mercury can contribute to neurological and cardiovascular problems in Eating to Stay Healthy for the Long Run 35 Table 2.2 Fish Highest in Omega-3 Fatty Acids Fish, 6 oz cooked (8 oz raw); Grams of omega-3 175 g cooked (250 g raw) fat (EPA and DHA)** Salmon, Atlantic, farmed 2.0-3.6 Sardines, in sardine oil, 3 oz (90 g) 2.0-3.4 Salmon, Atlantic, wild 1.8-3.1 Swordfish* 0.7-3.1 Salmon, coho, farmed 3.0 Trout, rainbow, farmed 2.0 Trout, rainbow, wild 1.7 Salmon, coho, wild 1.4 Sardines, in vegetable oil, 3 oz (90 g) 1.0 Halibut 0.8 Tuna, albacore white, canned, 3 oz (90 g)* 0.7 Tuna, fresh* 0.5 Pollock 0.4 Lobster, 3 oz (90 g) 0.1-0.4 Shrimp, 3 oz (90 g) 0.3 Alternative sources Smart Balance Omega Plus spread, 1/2 tbsp 0.08 Orange juice, omega-3 fortified, 8 oz (240 ml) 0.05 Egg, 1 omega-3 rich 0.05-0.11 Silk Plus Omega-3 DHA soy milk, 8 oz (240 ml) 0.03 *Highest in mercury; limit to 6 oz (175 g) per week. **EPA and DHA are two types of omega-3 fat. Data from the American Heart Association and food labels. adults, as well as cause significant damage to the developing brains of infants and children. If you are into sport fishing, eating sushi, or having tuna every day for lunch—and enjoy high-mercury fish several times a week—take heed. The mercury can accumulate in your body and create health problems (numbness and tingling in hands and feet, fatigue, muscle pain). Yet, the FDA advises pregnant women that they can and should safely enjoy up to 12 ounces (340 g) of fish a week because fish oil is important for normal brain development. The 12 ounces includes a large safety margin, but pregnant women should avoid shark, swordfish, king mackerel, and tile fish and limit their intake of albacore tuna to 36 Nancy Clark’s Sports Nutrition Guidebook not more than one 6-ounce can per week. These fish are long-lived and large; they accumulate mercury in their tissues over time by eating a lot of smaller mercury-containing fish. The safest fish are shrimp, salmon, pollock, catfish, and canned light tuna. For a list of fish oil and mercury in commonly consumed seafood, visit the American Heart Association’s Web site and do a search for “fish.” To calculate your potential mercury intake, go to www.gotmercury.org. If you are not a fish fan, and if you have heart disease, the American Heart Association suggests fish oil capsules as an alternative: 850 to 1,000 milligrams EPA plus DHA; 2,000 to 4,000 milligrams if you have high triglycerides (Kris-Etherton, Harris, and Appel 2002; Mosca et al. 2007). But be aware: Fish oil supplements contain only a small amount of omega-3s compared with a fish dinner, so you may need to take several capsules to get the equivalent of one 4-ounce (120 g) serving of salmon. For more information about fish oil supplements, visit the Web site of the National Institutes of Health Office of Dietary Supplements (www. ods.od.nih.gov). An alternative way to ingest omega-3 fat is from plant sources, such as flaxseed oil, walnuts, tofu, soy nuts, canola oil, and olive oil. Plant sources offer a less potent type of omega-3s, but any omega-3 is better than none. You can also buy foods fortified with omega-3s, such as some brands of orange juice, margarine, yogurt, and eggs. Soy Foods and Heart Health At one time, soy was believed to lower the bad LDL cholesterol and increase the good HDL cholesterol. This shift would offer protection against heart disease. The current research suggests that soy—and substances in soy called isoflavones—do not protect against heart disease. Yet, soy products can still be beneficial because of their high content of polyunsaturated fat, fiber, vitamins, and minerals (Sacks et al. 2006). Soy foods are also low in saturated fat, so when you choose soy foods for dinner, you forgo prime rib and other artery-clogging choices. Eggs and Heart Health Eggs have gotten a bad rap when it comes to healthy eating. Medical experts have told us that eating eggs is bad because a single egg has 210 milligrams of cholesterol. This just about hits the American Heart Asso- ciation’s recommended limit of 300 milligrams per day. But more recent studies suggest that egg cholesterol may have little effect on many people’s blood cholesterol levels, especially in combination with an overall low- saturated-fat diet (Katz et al. 2005; Kritchevsky and Kritchevsky 2000). In fact, an estimated 85 percent of Americans can eat a high-cholesterol diet with no elevation of blood cholesterol. Among 49 healthy men and Eating to Stay Healthy for the Long Run 37 women who ate two eggs daily for six weeks, blood cholesterol levels remained stable (Katz et al. 2005). To date, it is unclear whether the cholesterol you eat affects the choles- terol in your blood, because most of the blood’s cholesterol is made in the liver. We do know that dietary fat affects the way the body disposes of cholesterol. In particular, saturated fat (such as butter and beef fat) appears to inhibit the body’s ability to get rid of the bad form of choles- terol (low-density lipoprotein, or LDL) that clogs arteries. We also know that some people respond more readily than others to a low-cholesterol diet, and dietary recommendations need to be individualized. So, when it

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