My clients’ standard complaint
Nutrition — Your Missing Link?
“Nutrition is my missing link. I’ve got my
training down, but my eating needs help…”
Nancy Clark MS RD CSSD FACSM
Sports Nutrition Services, Boston MA
www.nancyclarkrd.com
Nancy Clark, MS RD CSSD Focus of this presentation
Nancy Clark, MS RD CSSD MISSING LINK #1: Respect
for the power of food
on performance (and health)
• Exercise and weight management
•  Calories, carbs, protein, fat
•  Fueling before, during, and after exercise
“You know, Nancy, too many
athletes show up for training but
•  Caffeine, alcohol
don’t show up for meals. They might
•  Building a balanced sports diet, vitamin supplements
as well not show up for training.”
•  Hydration BC Hockey Coach
Next session on Engineered Sports Foods will cover:
Protein supplements, energy drinks, sports foods and drinks, sodium Nancy Clark, MS RD CSSD Nancy Clark, MS RD CSSD Even lean, fit athletes get heart disease….
• Brian Maxwell, founder of PowerBar and world class
marathoner, died at age 51 of a heart attack
• Andy Palmer, two-time Olympic marathon-trials qualifier
died at age 48 of a heart attack
MISSING LINK #2:
Breakfast!
The best energy booster: BREAKFAST
• Improves quality of overall diet
• Prevents the need for sugar fixes
• Enhances performance
• Ed Sheehan, two-time Olympic marathon-trials qualifier
died at age 47 of a heart attack
Nancy Clark, MS RD CSSD Nancy Clark, MS RD CSSD 1
Breakfast: The most important meal of the day
Breakfast: Better than a quick-fix
PC
I don’t have time for breakfast. And any ways, I’m not hungry
in the morning...
C
I might eat breakfast at 10 a.m. if food were available...
P
When I do make time to eat in the morning, I have better workouts that afternoon—and I don’t get as many headaches…
#1. Baseline: No fuel, only water
I generally eat breakfast. I just have to plan time...
#2. Sugar (180 cals glucose) + water
+10 %
I always eat breakfast!!! It boosts my energy, curbs evening overeating, and helps me control my weight. #3. Candy bar (270 cals) + water +10 %
#4. Breakfast 4 hrs before + Candy bar + water
+20 %
A
M STUDY:
Athletes with low glycogen stores biked hard
for 45 minutes, then sprinted for 15 minutes
Trial Improvements during final sprint
---
---Snack five minutes pre-exercise---
(800 cals)
Nancy Clark, MS RD CSSD MISSING LINK #3:
Knowledge of calorie budget
The body needs fuel for–
Estimating calorie needs Example: 140 pound female athlete
140 lbs x 10 cal/lb = • Resting metabolic rate (Wt x 10 cals/lb)
• Daily activities (±50% RMR)
• Purposeful exercise
(400-800 cals/hr)
50% RMR =
Nancy Clark, MS RD CSSD How to lose weight appropriately
Example: If an athlete maintains weight on 2,600 calories–
2,600 - 20% (~500 calories) = 2,100 calories/day
Breakfast
Lunch
11-12 noon
Second Lunch 3-4:00 PM
Dinner
7-8:00 PM
Nancy Clark, MS RD CSSD 1,400
Calories RMR
700
Daily activity
500
Purposeful exercise
2,600
To maintain weight Nancy Clark, MS RD CSSD • Subtract about 10 - 20% from total calorie needs
• Divide calories evenly throughout the day
1 hour cardio = Total calories = MISSING LINK #4:
Neufer, Costill J Appl Physiol 62(3): 983, 1987
Nancy Clark, MS RD CSSD 7-8:00 AM
500 calories
600 400 600 How to eat and be lean––
•  FUEL ADEQUATELY during the day
–  Have energy to exercise
–  Prevent ravenous hunger and food binges
•  EAT REASONABLY at night
Where’s the
snack…???
–  Eat appropriately but do not over-eat.
–  To lose weight: “I’d rather be leaner than eat more...”
Nancy Clark, MS RD CSSD 2
Exercise ≠ weight loss
Exercise enhances weight loss if it
contributes to a calorie deficit.
TRUTH:
TRUTH:
What are you doing with the other non-exercise hours in your day?
The sedentary athlete syndrome….
30 minutes of exercise = 300 calories
3 minutes of “rewards”= 300+ calories
Be aware of compensatory changes in daily activity!
Nancy Clark, MS RD CSSD Nancy Clark, MS RD CSSD Marathon training ≠ Weight Loss!
Gender differences: Exercise for weight loss
Among 64 novice runners (55% women) in a 3-month marathontraining program:
Range of weight changes: -27.5 lbs to +12 lbs
11% lost weight (n=7) due to change in eating habits
11% gained weight (6 of the 7 were women)
• Men:
High level of physical activity
contributes to a lower % body fat. • Women:
No relationship between
physical activity and % body fat
78% stayed about the same weight (n=50)
Kennedy, ACSM 2010
Nancy Clark, MS RD CSSD Gender differences: exercise and appetite
18 Women did 350 cals of low or high intensity exercise Their food intake was monitored for 3 days
Conclusion:
--Hard exercise does not suppress hunger the same way
for women as for men.
Exercise + obese women = weight loss
Three trials (19 days each)
1. Sedentary (baseline): maintained energy balance
2. Light exercise: burned 10% more cals; ate -114 fewer cals
3. Moderate ex: burned 25% more cals; ate -370 fewer cals
--Hard exercise increases attractiveness of food for women
Pomerleau, Am J Clin Nutr 2004; 80:1230-6
Nancy Clark, MS RD CSSD Westerterp Int’l J Obesity 1997; 21(3):184
Nancy Clark, MS RD CSSD No compensation in energy intake
Woo, Pi_Sunyer Am J Clin Nutr 1982; 36:470
Nancy Clark, MS RD CSSD 3
The E in Exercise is for Enjoyment
MISSING LINK #5:
Adequate carbohydrates
Common belief: “Carbs are fattening”
Exercise = to train, improve athletic performance
= to feel good, relieve stress,
improve health, build muscles
A survey of 425 female collegiate athletes across the US reports—
• The athletes wanted to lose 5 pounds, on average
• 43% felt terrified of becoming overweight
Exercise ≠ punishment for having body fat
≠ motivated by the desire to burn calories
Beals, Manore Int’l J Sports Nutr, 2002
Nancy Clark, MS RD CSSD Nancy Clark, MS RD CSSD Carbohydrates = muscle glycogen
24
What kinds of carbs should I eat?
Carbohydrate Diet
Carb
20
16
GLYCOGEN
12
CONTENT
(GM/KG MUSCLE)
8
Protein & Fat Pro
Diet +
Fat
4
0
Rest/
5
hard exercise
15
25
35
45 hours
RECOVERY TIME
Nancy Clark, MS RD CSSD 5 days
Bergstrom, 1967
Quick & slow carbs
Nancy Clark, MS RD CSSD MISSING LINK #6:
Wrong amount of dietary fat
24
• Pre-endurance: Slowly digest carbs (Low GI)
In theory:
• Post-exercise: Quickly digested carbs (High GI)
Carbohydrate Diet
Carb
20
16
• The glycemic index of a food varies In reality:
—depends on where grown, how processed, etc.
• Each person has unique glycemic response —can vary 43% on any given day (Vega-Lopez, 2007)
• Athletes should choose well-tolerated carbs
Nancy Clark, MS RD CSSD Donaldson “Glycemic Index and Endurance Performance”
Int’l J Sports Nutr 20(2)154-165, 2010
GLYCOGEN
12
CONTENT
(GM/KG MUSCLE)
8
Protein & Fat Pro
Diet +
Fat
4
0
Rest/
hard exercise
5
15
25
35
45 hours
RECOVERY TIME
Nancy Clark, MS RD CSSD 5 days
Bergstrom, 1967
4
Too little dietary fat hurts performance
Fat: A valuable part of a sports diet
Fat is needed to absorb vitamins A, D, E, K
Trained runners ate 16% or 31% fat diet for 1 month
• self-selected diets were supposed to be isocaloric but
the runners ate 19% more calories with moderate-fat diet
• body fatness did not change Female runners with irregular menses
--restricted fat intake (~60 gms/day; 24% fat; 2,400 cals)
-- had sub-normal vitamin E levels compared to • had 14% more endurance Regularly menstruating runners
-- ate more fat and calories (98 gm/day, 30% fat, 2,900)
Conclusion: Runners can perform better with (healthful) dietary fat—as long as they eat enough carbs and calories
Nancy Clark, MS RD CSSD MISSING LINK #7:
--normal vitamin E levels Horvath, J Am Coll Nutr 2000; 19 (1): 52-60
Nancy Clark, MS RD CSSD Tomten. Serum vitamin E concentration and osmotic fragility in
female long distance runners J Sports Sci 2009; 27(1):69-76
Too little protein
The right balance of protein
Grams Protein/lb Safe intake/lb
Vegetarian Gymnast, 100 lbs
Current RDA, sedentary adult
0.4
Athletic adult
0.5 - .75
2
0.7 - 1.0
6 oz Yogurt
Adult building muscle mass
0.7 - 1.0
1
Athlete restricting calories 0.8 - 1.0
Growing teenage athlete
Nancy Clark, MS RD CSSD Egg whites
2 Tb Hummus Luna Bar
1/4 cake Tofu
0.7 - 1.0
g Protein/day
70 - 100
7 g Protein
2
6
10
9
Total: 34 g
Nancy Clark, MS RD CSSD Too little protein can lead to low iron intake
Collegiate female varsity athletes screened for anemia
Iron-deficiency (without anemia) is prevalent!
•  2% of men in the general population. •  21% of male cross country/distance runners (ages 18-22)
-Anemia (hemoglobin <12 gm/dL) found in:
20% volleyball and basketball players
50% soccer players
•  14% of females in the general population •  ~50% of female athletes (ages 18-22) •  Taking an iron supplement for the 7 days during menses
can help maintain a strong iron status. Be responsible—eat iron-rich foods!
Nancy Clark, MS RD CSSD Eichner, Sports Science Exchange, 14(2) 2001
Nancy Clark, MS RD CSSD ACSM 2010
5
Too much protein
HS Football player, 200 lbs
Safe intake / lb
0.7 - 1.0 To build muscles—
g Protein / day
140 - 200
• Adequate protein (esp. pre- & post-exercise)
6 lg Eggs / whites 4 Tb Peanut butter
1 qt Milk
1 can Tuna (6 oz)
6 oz Chicken breast 42 / 18 g Pro
16
32
35
48
Total: 173
Nancy Clark, MS RD CSSD Problem with high protein diets
If eat too much protein—
• Displaces carbs … • Can be high in saturated fat, cholesterol
• Expensive
300 cals chicken breast = $2.00
300 calories pasta = $0.30
Nancy Clark, MS RD CSSD HS Sophomore who wants to be massive
• Strength training (+ maturity)
• Extra calories (from carbohydrates)
• Frequent eating throughout the day
Nancy Clark, MS RD CSSD High School Sophomore
“I want to gain weight ... I want to be massive.”
• 5’ 8” (still growing)
155 lbs
His goal 175+
• Lifts weights 2 hours per day
• Spends $80+ per month on protein supplements
• Asks about the best protein supplement...
Nancy Clark, MS RD CSSD Teaching points: Bulking up
B.
Skips breakfast
• First, optimize your diet. Add 500-1,500 cals/day.
L.
Not much; doesn’t like school lunch
• Be consistent. Don’t skip meals; fuel at the right time.
Sn. Sometimes a protein shake pre-workout (if time)
• Consume adequate protein, extra carbs.
D.
• Finish growing. Don’t tamper with your healthy body.
Big meal made by his mother
PM. Protein shake or protein bar
• Honor genetics. Apple doesn’t fall too far from the tree.
Q. Why do you want to be massive?... Sports? Girls? Fights?
Nancy Clark, MS RD CSSD Nancy Clark, MS RD CSSD 6
Does too much protein damage kidneys?
Case Study: Athlete with one kidney
Theoretically, high protein diet + dehydration = stressed kidneys
College student wanting to bulk up
STUDY: 20 Body builders vs Other athletes (cyclists, rowers)
Protein intake > 300 gms / day (4 gms/kg)
• Protein intake from 7 day food records:
Body builders: 2.0 g Pro/kg Other athletes: 1.4 g Pro/kg Blood tests: Renal stress and damage
170 g Pro/day
100 g Pro/day
Prescribed diet: 0.8 gm Pro/kg (70 gm Pro), 4,000 cals
• Nitrogen balance achieved at 1.3 g Pro / kg.
16 oz. milk 4 oz. meats 800 cals grains • No indication of renal impairment (even at 2.8 g Pro / kg)
Poortmans. Int’l J Sports Nutr 10(1):28, 2000
Nancy Clark, MS RD CSSD MISSING LINK #8:
1000 cals juice
600 cals fruit
200 cals veggies
Liberal fats, sugar Nancy Clark, MS RD CSSD Recommended Fluid Intake
Too little fluid
Standard advice—
• 12-13 y.o. soccer players at summer camp drank too little, despite encouragement, availability of fluids
• Pro basketball players started & ended dehydrated
during two-a-day practices
• Skiers and winter athletes at high risk
Nancy Clark, MS RD CSSD ACSM Position Stand—
• Weigh pre-post exercise; learn personal needs
Int’l Marathon Medical Directors Assoc.—
• Drink to thirst
Nancy Clark, MS RD CSSD Med Sci Sports Exerc May 2004 #1236, 1239
Goal: To prevent dehydration
• During Training -Learn sweat rate
-Practice drinking
• During Events
Nancy Clark, MS RD CSSD • Prevent dehydration; drink before thirsty!
What about caffeine… ?
•  …Does it enhance performance?
…Is it dehydrating?
-Drink on a schedule
Urine Color Chart
L. Armstrong PhD
Nancy Clark, MS RD CSSD 7
Caffeine and exercise
Caffeine—not dehydrating
Pro: May make exercise seem easier and enhance performance (for both regular caffeine consumers and non-consumers alike)
• No diuretic effect in caffeine-tolerant athletes in
moderate (250-300 mg) doses
• Does not increase heat stress
• OK to drink caffeinated beverages in hot weather
Con: May cause nervousness, upset stomach.
Each person responds differently.
Know your body!
Nancy Clark, MS RD CSSD MISSING LINK #9:
• 59 coffee drinkers consumed 1.5 mg caf/lb (~12 oz mug)
• Performed 86 vs 75 minutes in heat
Nancy Clark, MS RD CSSD - One group took supplement immediately before and after strength training mid-afternoon
Suggested fueling patterns
Fueling at the right time
Two groups of recreational body builders; trained 4/wk x 10 weeks
Roti, Armstrong Med Sci Sports Exerc 36(5):S18, 2004
Exercise time:
Suggestions to fuel-up and then re-fuel
Morning Smoothie // bagel + yogurt
Noon
Half sandwich // rest of lunch - One group took the supplement in morning and late evening
Afternoon Energy bar + latte // choc milk
Immediate pre- post-exercise fueling resulted in— Before dinner Bagel w PB // smaller dinner - 5.5 lbs gain LBM vs 3.3 lbs
- 27 lb gain in bench press vs 20 lbs
Eat on a time-line, not in a crescendo!
Cribb P. Med Sci Sports Exerc 38(11):1918-1925, 2006
Nancy Clark, MS RD CSSD Pre-exercise calorie targets
Benefits of fueling before morning workouts
After an overnight fast, 8 athletes biked hard (80% VO2max)
for 50 minutes + 10 minutes sprint to exhaustion
Recommended intake:
Time pre-exercise
1 hour
4 hours
Gm. Carbs / lb
0.5 2.0
Gm carb / 150 lb person 75 300
Calorie targets
300 1,200
____________________________________
Sample 300 calorie options: PowerBar + Gatorade
Banana + Vanilla Yogurt
Oatmeal + raisins
Nancy Clark, MS RD CSSD Nancy Clark, MS RD CSSD Work generated in the last 10 minutes:
+ 6% better with adequate water vs minimal water
+ 6% better with carbs vs no carbs (and minimal water)
+12% better with carbs + water (sports drink)
$2
$1
$0.50 - $0.80
If eat a pre-exercise snack, sports drink during exercise does not boost
performance during short-term exercise.
Nancy Clark, MS RD CSSD 8
Pre-exercise fuel: costs and benefits
Fueling just 5 minutes pre-exercise has benefits
STUDY:
Athletes with low glycogen stores biked hard
for 45 minutes, then sprinted for 15 minutes
Trial Improvements during final sprint
#1. Baseline: No fuel, only water
---
Benefits:
--Restores liver glycogen after overnight fast
--Tops off sub-optimal muscle glycogen stores
--Offers fuel for exercise >60-90 minutes
Costs:
---Snack five minutes pre-exercise---
Intestinal concerns–
Upper GI: #2. Sugar (180 cals glucose) + water
+10 %
#3. Candy bar (270 cals) + water +10 %
#4. Breakfast 4 hrs before + Candy bar + water
+20 %
Lower GI: Cramps, gas, urge to defecate, diarrhea (800 cals)
Nancy Clark, MS RD CSSD Nancy Clark, MS RD CSSD MISSING LINK #10: Train your intestinal tract! Too little fuel during prolonged exercise
(20-50% of runners have GI problems)
Risk factors for gastrointestinal problems
• high intensity exercise • dehydration • being female
Burping, reflux, heartburn, bloating, cramps,
stomach ache, nausea, vomiting
Exercise duration
• running sports that jostle the intestines
<45 to 60 minutes
Eat a pre-exercise snack
--
100-300 calories of oatmeal,
banana, granola bar, etc.
• inadequate training / novice athletes
1 to 2.5 hours
30 - 60
120-240 calories • intake of fiber, lactose, fat, protein before/during exercise
• pre-existing GI problems (IBS, Crohn’s disease)
Suggestions
Carbs during exercise
Grams/hour
(sports drinks, gels, gummi
candy, dried pineapple,
banana)
>2.5 hours
60 - 90
240-360 calories plan a variety of foods to
Nancy Clark, MS RD CSSD When swallowing won’t work…try swishing!
• Runners “swished and spit” ~1 ounce sports drink every 15 min
during a one-hour time trial. • They ran faster/longer (by 211 meters) compared to the placebo
Why does swishing result in self-selecting to run faster?
–Has no impact on blood glucose
–Does it trigger reward centers in the brain? –Does it suppress fatigue signals?
Influence of Mouth Rinsing a Carbohydrate Solution on 1-h Running Performance. Rollo I,
Williams, C et al. Med Sci Sports Exerc 43(4):798-804, 2010
Nancy Clark, MS RD CSSD prevent flavor fatigue
Nancy Clark, MS RD CSSD MISSING LINK #11:
Alcohol education
On a Friday night, Southern Methodist University students were asked about
alcohol use on the previous night: • Did you drink last night? 28% • What % of SMU students do you think
drank last night? Perception
>50%
• Did you get drunk last night?
8%
Perception
>33%
• What % of SMU students do you think
got drunk last night?
Nancy Clark, MS RD CSSD 9
Social Norms—alcohol
MISSING LINK #12:
• Of students who drank, most reported only a few drinks/week
—Believed most students consumed 10 to 15 drinks/wk
• 35% reported abstaining from alcohol
—Very few believed many of their peers were non-drinkers.
(Appropriate) Post-exercise recovery food
“You haven’t finished training until you’ve refueled!”
• The answers showed major misperceptions about alcohol norms.
Social norm education can save lives!
http://smu.edu/healthcenter/alcoholeducation/adp_socialnorms.asp
Nancy Clark, MS RD CSSD Nancy Clark, MS RD CSSD The right balance of carbs, protein & fat
Lack of carbs hurts ice hockey performance
• During a hockey game, muscle glycogen declines 38-88%. Carbs
A motion analysis of elite ice hockey teams showed:
• Players with high (60%) carb diet skated 30% more distance-
and faster than the players who ate standard diet (40% carb).
(GM/KG MUSCLE)
In the final period: Pro + Fat
• The high carb group skated 11% more distance.
• The low carb group skated 14% less than in first period. Rest/
hard exercise
5
15
25
35
45 hours
5 days
Nancy Clark, MS RD CSSD Nancy Clark, MS RD CSSD Nancy Clark, MS, RN
Lack of carbs hurts ice hockey performance
The researchers conclude: 1) low muscle glycogen can jeopardize performance at the end of the game Optimal recovery choices: Carbs + water + protein (3 or 4:1 ratio C:P)
Fluid Gm Carb/8 oz.
Gm Pro/8 oz Beer 8
-- 2) three days between games (with training on two of those days) + a low carb diet does not replace glycogen (players with high carb diet had 45% more glycogen) Gatorade 14
--
Coke
26
--
Accelerade
15
4
3) the differences in performance between the groups Chocolate milk 29
8
(Whey)
was most evident in the last period of the game.
Nancy Clark, MS RD CSSD Akermark, Int'l J Sports Nutr 6:272-84, 1996
Nancy Clark, MS RD CSSD 10
Recovery foods
Recommended dose:
~0.5-0.75 g Carb/lb within 30 min.
~0.1-0.2 g Pro/lb
Repeat every two hours x 4-6 hours
Wt (lb) Carbs (g) Pro Cals
100 75 20 ~400 150 115
200 150 30
40
~600
~800
Carb (g) Pro (g)
Cals
Yogurt, flavored, 6 oz
26
8
160
Cheerios w/ milk 32
11
200
Pasta + meat sauce
80
20
Chocolate milk hastens recovery
• 9 trained males performed glycogen-depleting trial, refueled during a 4-hour
recovery period, and then cycled to exhaustion (70% VO2 max). • Consumed ~400 calories at 1 min post-ex and again at 2 hours of recovery
Time to exhaustion
450
(~400 calories; 63 g C, 14 g P, 9 g F)
Endurox
21 min (~400 calories; 73 g C, 19 g P, 2 g F)
23 min (~110 cals; same volume as Endurox)
Gatorade
Does higher fat content help chocolate milk be a better recovery drink?
Be responsible and plan ahead!
Nancy Clark, MS RD CSSD Chocolate milk 32 min Nancy Clark, MS RD CSSD MISSING LINK #13:
Thomas K, Appl Physiol Nutr Metab 34:778-82, 2009
Rest days ≠ “Being lazy”
Rest days to provide time to refuel
2.5
• Rest is an important part of a training program
–Muscles need time to heal and refuel
–Mind needs time to rest and recharge
2.0
MUSCLE
1.5
GLYCOGEN
(GM/100 GM TISSUE)
• On rest days, you won’t “get fat” or “lose fitness”
–Expect hunger; muscles need carbs to refuel
–Expect weight gain; glycogen holds water
1.0
0.5
10 miles
DAY 1
10 miles
DAY 2
10 miles
DAY 3
Nancy Clark, MS RD CSSD Nancy Clark, MS RD CSSD Nancy Clark, MS, RN
Double workouts…???
Using vitamin supplements to
compensate for poor eating.
MISSING LINK #14:
Six-week study with two groups of swimmers
- Group 1 trained 1.5 hrs (afternoon)
- Group 2 trained 3 hours (morning + afternoon) 50 College Football Players
-59% of calories from fat, sugar
Single-workout group: Improved sprint speed Double-workout group: Decline in sprint speed
-poor intake fruit, veggies, dairy
Rest is an important part of a training program!
Nancy Clark, MS RD CSSD Costill Med Sci Sport Exerc 23:371-377, 1991
Nancy Clark, MS RD CSSD 11
For vitamins: Eat healthful foods!
Do athletes need extra vitamins & minerals?
A review of 90 studies examining vitamin and
mineral status in athletes’ blood suggests–
• Athletes & non-athletes had similar vitamin status
The more you exercise–
• Exception: Athletes had lower serum ferritin
• the more food you can eat.
• Stronger vitamin status ≠ better performance (apart from anemia)
• the more vitamins you can get.
• CONCLUSION: Athletes generally eat extra vitamins!
Vitamins are re-used, not used up.
Nancy Clark, MS RD CSSD Fogelholm. I J Sports Nutr 5:267, 1995
Nancy Clark, MS RD CSSD Vitamin D “The sunshine vitamin”
What about antioxidants like
vitamins C and E? • Indoor athletes at risk for low D:
figure skaters, gymnasts, ballerinas, wrestlers
• Low serum D in 40% (8 of 20) of distance runners in Louisiana
Too many anti-oxidants become pro-oxidants
• D’s potential benefits to athletes is reduced risk of— x stress fractures total body inflammation
infectious illness impaired muscle function
• may hinder training adaptations
Natural sources of antioxidants:
Tart cherry juice, PomWonderful juice, grape juice, blueberries…
• Recommended intake (without sun exposure) 600-1,000+ IU D3 / day
Nancy Clark, MS RD CSSD Larson-Meyer. Curr Sports Med Rep 2010; 9(4):220-6
Breads, cereals, whole grains
DON’T JUST EAT; EAT RIGHT–
Foundation of every meal–for carbohydrates, fiber, B-vitamins
At each meal choose foods made from–
Wheat
Rice
Oats
Corn
Nancy Clark, MS RD CSSD DON’T JUST EAT; EAT RIGHT–
Nancy Clark, MS RD CSSD Fruits & vegetables
3 large or 6 small daily for fiber, carbs, phytochemicals, C, A
Best fruit choices include: Oranges Grapefruit
Melon
Bananas
Strawberries Kiwi
Whole grains should be at least half your choices
Carrots
Best vegetable choices are colorful:
Broccoli
Tomato
Pepper
Spinach
Squash
Nancy Clark, MS RD CSSD 12
Calcium-rich foods
1 cup
1.5 oz.
2 cups
3 - 4 servings daily
Milk or Yogurt (lowfat)
Cheese Cottage cheese
Protein-rich foods
DON’T JUST EAT; EAT RIGHT–
DON’T JUST EAT; EAT RIGHT—
Small amount at each meal for protein, iron, zinc
Chicken, turkey, fish
Lean beef, pork, lamb
Milk, yogurt, cheese*
Eggs
Non-dairy sources
1 cup
8 oz.
3 cup
3-4 oz.
Calcium-enriched orange juice
Tofu, soy milk
Broccoli, kale, leafy green vegetable
Salmon or sardines with bones
Nancy Clark, MS RD CSSD Nuts, peanut butter
*Poor sources of
iron and zinc
Lentils, beans, tofu
Nancy Clark, MS RD CSSD Fuel Responsibly!
If you find time to train, you can find time to fuel for training
For more information–
www.nancyclarkrd.com
Nancy Clark, MS RD CSSD Nancy Clark, MS RD CSSD Nancy Clark, MS RD CSSD 13