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18 May 2015

More “AND”, Less “OR”

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Side note: This image has nothing really to do with the topic at hand. It’s just funny.

It seems – to me at least – that in the health and fitness world, everyone likes to boil big questions down to dichotomous choices. What’s more important for weight loss, diet OR exercise? Should I follow a paleo diet OR eat less meat? Is CrossFit better OR should I be running?

Dan Heath, a very smart business guy who wrote a couple of books with his brother on decision making, spoke at the IHRSA Convention a few years ago, and emphasized the importance of “yes, and”. We talk about this a lot at work when we’re planning projects for the coming year, trying not to limit ourselves with false dichotomies. It wasn’t until I saw a recent article on exercise being “pointless” (or some such dismissive word) for weight loss that I put the two together.

You see, it doesn’t have to be diet OR exercise. I foresee very few situations in which a person truly has to make a feet to the fire choice between just one or just the other. If you want to lose weight you should clean up your diet AND get plenty of exercise (at least 150/75 minutes of moderate/vigorous exercise a week for baseline health, more for weight loss). If you’re interested in a sustainable diet, you can go paleo/primal AND eat less meat. They’re called vegetables, and you should eat far more of them than you eat meat. If you want to be in the best shape possible, you should do CrossFit AND you should also go running sometimes. You don’t have to choose between eating organic fruit and exercising daily. You don’t have to choose between coming to CFB 6 days a week or running on the treadmill at 6.3 mph 6 days a week.

Asking the “either, or” question limits what we can do and achieve. So unless your question is “should I eat a cannoli OR an ice cream sandwich for dessert tonight,” you should be thinking AND far more than OR.

PS. I vote cannoli. There’s a Mikes in Harvard Square now.

Photo c/o https://www.flickr.com/photos/brazucany/

Today is, apparently according to the Today Show, National Eat Whatever You Want Day. My first reaction was, well…

But then I realized I basically eat what I want most days. Maybe not whatEVER I want, but for the most part I don’t dread lunch, I don’t hate breakfast, and my dinner isn’t boring. I like what I eat, and it’s not like I’d actually enjoy eating a cheeseburger everyday. There is a way to eat healthy AND like what you’re eating. I think that’s actually something the Paleo community has done better than any other diet – instead of trying to make some sort of frankenfood no carb no calorie bread or tortilla, they just said F the grains, let’s use delicious herbs and spices to make meat and vegetables taste amazing. Or, let’s repurpose vegetables into old favorite (e.g. Cauliflower rice or “mashed potatoes”). For many, that focus on good food is what makes Paleo sustainable – if your Paleo diet is grilled chicken and broccoli most of the time, you’re either one of those weird people who don’t much care what they eat, or you’re going to run into trouble.

There’s a quote I remember hearing (I don’t remember who said it) that went something like:

“Happiness isn’t having everything you want. It’s wanting everything you have.”

I think that’s a relevant message when it comes to diet. It’s not about being able to eat the things you love when your habits aren’t ideal and achieve your goals, it’s about wanting the foods that are healthy. About choosing baked sweet potato wedges over Ore Ida fries, or choosing cage free eggs and fruit over a waffle. About wanting a healthy, home cooked meal more than you want Shake Shack.  And LIKING that choice.

Photo c/o TMAB2003

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If you’ve read my blog long enough, you know my skepticism of the US food system is pretty healthy. Just this weekend I was shopping for chicken, and stumbled upon the lovely scene above. In just this frame alone the word “natural” is used over 5 times. And that’s only part of the chicken section! I’ve written before about how “natural” basically means nothing, but it is nonetheless confusing. I am always telling people to eat foods closest to their natural form, meaning cheese versus Cheez-Its (although eating them a few times a year at the beach isn’t going to kill you) or roasted potatoes versus potato chips. Generally the “closer to earth” (I will avoid using the word natural because like I said, it means squat) variations of a food are less calorically dense and contain more nutritional value (and nutritional bang for your calorie). So the question is: how do you choose the right meat when everything is labeled natural?

The Best

The best way to get humanely raised, non CAFO beef, chicken, eggs, and pork is to buy it from your local farmer. Visit the farm or farmer’s market and buy it on the spot, or join a meat CSA. Take a look at how the farmer does things – how much time to cows hang out outside. Do chickens get to eat bugs? Look at the egg yolk – it should be more orange than yellow. And make sure the cows have plenty of room to rut around and get muddy. That’s natural for them. Side note: there’s a lot of irony in the fact that this “all vegetarian fed chicken” is promoted as “natural”. In nature (or on the farm), chickens eat bugs. They’re not vegetarians, and it’s not good for them, and may explain higher rates of illness and tendency to turn on each other among industrially raised chickens. This Chicago Tribune article sheds more light and is highly recommended. Seriously, READ THIS. Mainly because I feel strongly and want you to, too.

Back to our topic. As is usual, the right way is also the most expensive option. Patrick and I are currently trying to buy better meats, and this summer our goal is to get all our meat from a local farmer. Hopefully we can also make rent :)

If the above option is too many dinero, then…

The Next Best Thing

After getting it right from Old McDonald, the next best option is buying organic. I’m not super familiar with all of the ins and outs of organic regulations, and I’ve heard buzz recently about organic foods still containing some chemicals and maybe not being as rigorous as we thought.  I haven’t done enough digging to decide if this is a Food Babe rumor or a real concern, but it doesn’t change the fact that organically raised meat is still better than conventional farming right now when it comes to meat. So if you can’t get it form your local farmer, get it from a grocery store that buys from an organic farmer somewhere.

If all organic all the time doesn’t fit,

Buy Organic As Much As Possible

Figure out what works for your budget, and buy organic when you can, conventional the rest of the time. I would start with organic dairy and butter, as those won’t add too much to the grocery bill. Move onto eggs next. Then go to meats, as those are probably going to be the biggest increase.

29 Apr 2015

What Does Vitamin C Actually Do?

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We see vitamin C a lot these days, mostly in the context of cold prevention (or treatment). Vitamin C is a water soluble vitamin found in certain foods and added as fortification to others. Humans don’t synthesize vitamin C, so it’s essential that we include it in our diet.

Roles of Vitamin C

Vitamin C is essential for the synthesis of collagen, L-Carnitine, and some neurotransmitters, and is also involved in some protein metabolism. It is also an antioxidant thought to help regenerate other antioxidants like vitamin E, helps the body absorb non-heme iron (meaning iron from plant based foods), and plays an important role in immune function. Vitamin C deficiency results in scurvy (often linked to pirates and sailors, who went long periods without fresh produce), which causes fatigue and connective tissue weakness.

Collagen synthesis and immune function are the most notable and widely recognized roles for Vitamin C. Collagen is the most abundant protein in the body, found in muscle, bone, and tendons among other important tissues.

When Do You Need Vitamin C?

Vitamin  C has been linked to a few conditions over the years.

Cancer Prevention  – numerous studies show that a diet high in fruits and vegetables lowers the risk of many cancers, although similar to vitamin A, there is no research that demonstrates vitamin C alone is responsible for this reduced risk or that supplementation would offer any benefit. It seems the pattern of eating fruits and vegetables is more important than single nutrients.

Cardiovascular Disease – research suggests that higher consumption of fruits and vegetables reduces the risk of heart disease, potentially due in part to the antioxidant content of these foods. This makes sense because oxidative damage is one of the causes of heart disease. One British study found that those with the top 25% in blood vitamin C levels had a 42% risk of cardiovascular disease, but the Physicians Health Study found no significant decrease after 5 years of supplementation.  Most clinical interventions and several larger prevention studies have showed no benefit from supplements. As with cancer, you are better off eating a diet rich in fruits and vegetables than supplementing one single nutrient.

The Cold – evidence indicates that vitamin C intake greater than 200 mg a day does not prevent a cold. One study showed a small reduction in cold duration – 8% for adults and 14% for kids. Although if you think about the common cold lasting about 2 weeks, that adds up to about a day. Taking vitamin C after symptoms have already started provided no benefit. Research has shown vitamin C intake of 250 mg – 1 g/day to reduce the incidence of a cold by 50% among people exposed to large bouts of physical exercise and extreme cold – including marathoners, soldiers, and skiers. So, it would appear supplementation is mostly effective for people exposed to extreme environments.

How Much Do You Need?

According to recommended daily allowance (RDA) – a level that should be sufficient to meet the needs of 98% of the population –  the average adult male needs 90 mg a day and the average female 75 mg a day. This is super easy to attain, and most people get way more than that. If you eat 1/2 cup of red bell pepper, a cup of broccoli, and a glass of OJ, you’re already well over 200% of your daily recommended intake.

My Recommendation?

Eat your fruits and veggies. If you ski a lot in the winter, consider taking a supplement if you get sick often. Once you are sick though, forget about the vitamin C. Consider taking a zinc lozenge instead. Or just sleep and drink a lot of fluids.

One caveat: I do often recommend – and take myself – EmergenC when sick. I know, I just said vitamin C does not good, why would I recommend a supplement with 1,000 milligrams of it right? Well, for one because it makes me feel better. It has other vitamins besides vitamin C (including B6 and B12), and because it makes me drink more water. I like it because it works for me, even if the Vitamin C isn’t the reason.

Source: http://ods.od.nih.gov/factsheets/VitaminC-HealthProfessional/

Image c/o Keith Williamson 

Since we have a throw down coming up this weekend – and presumably a few more this summer – I thought this old post on what to eat when you’re competing would come in handy. I believe this was posted around the Open last year. Share your competition fueling plan in the comments!

Before The WODs

Before a workout, your body should have a topped off fuel tank. This means you should have enough glycogen (the body’s stored form of carbohydrate) stored as well as some more readily available from food. In general, pre workout meals or snacks should be:

  • Enough energy to prepare you for the workout without leaving you hungry or with undigested food in your stomach
  • Low in fiber and fat
  • Higher in carbohydrates
  • Moderate in protein

Meals low in fat and fiber will allow your stomach to empty in time so you can avoid stomach discomfort. The carbohydrates will top off glycogen stores (which is important, since the body relies on glycogen rather than fat stores for energy during shorter CrossFit WODs), maintain blood sugar levels, and provide energy.  Protein will help you avoid hunger. In addition, it is important to be hydrated before exercise. The recommendation is that athletes drink 2-3 milliliters of water per pound of body weight at least 4 hours before working out to hydrate and get rid of any excess fluid (Rodriguez et al 2009).

After The WODs

Post Workout/Recovery is the most important time, as it is the time when your body reaps the benefits of all the hard work you’ve done. During the workout your body burns through your stored glycogen, you lose fluid to sweating, and muscle tissue is broken down. Recovery is when you can replenish your stored glycogen, replace lost fluid, and rebuild damaged muscles.

We used to think the precise timing of recovery was very important, advising that within one hour of a workout you had to have 30-60 grams of carbohydrate and15-20 grams of protein because this was during the time your metabolism was most active. The consensus was that eating right after the workout improved muscle strength and hypertrophy. However now we know that eating within this window is less important than previously thought (Schoenfeld et al). So, as long as you eat a good, nutrient rich (read: lots of vegetables and fruits) meal with protein and carbohydrates, and maintain an adequate calorie intake throughout the day, you will continue to build strength and fitness.

What To Eat

Try to eat something that not only provides these nutrients but also provides vitamins and minerals. Research has shown that chocolate milk may be a good recovery option because the milk provides calcium and magnesium, two minerals important in muscle contractions, and potassium, which is an important electrolyte lost in sweat. Other good options include a veggie omelet with fried plantain, sweet potato, or wheat toast and grilled steak with roasted vegetables.

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I stumbled on an article in Gawker yesterday by syndicated fitness columnist from the Chicago Tribune James Fell that was too funny not to share. It is an excellent rant about dark chocolate that can be applied to any food with a health halo, and with enough swearing to make a CrossFitter happy. But, amusement aside, I also share this because it makes a bunch of great points.

Remind me again, what are health halos?

“Health halos” result when a healthy quality of a food (say, the fact that it is organic) is viewed in such a way that it seems to make any food to which it is applied seem healthier than it is. For example, organic grapes are a great choice – grapes are a healthy source of sugar and fiber and since they have a permeable skin, it’s a good idea to buy them organic (they are on the dirty dozen list). However being “organic” doesn’t make brownies or candy any healthier than non-organic brownies and candy. I’ve often used the paleo example as well – a paleo meal can be healthy, but paleo chocolate truffles not so much.

What does this have to do with dark chocolate?

Dark chocolate is marketed as “healthy” or “healthier” because it has flavonoids, which are linked to lower risk of heart disease. The problem is that you’d have to eat a LOT of dark chocolate to get any risk reducing benefit from those flavonoids. Nonetheless, as Fell’s article notes:

For about a decade, the sales of dark chocolate have soared, regardless of the fact that it tastes like someone melted down a bunch of brown crayons, mixed it with charcoal and then let it solidify into bar form. Why the boost? As a senior VP from Hershey said in 2006 of the 37% spike in sales of their Special Dark, “There are underlying benefits with the consumption of cocoa that give consumers the permission to enjoy chocolate.”

Wait. “Permission to enjoy chocolate”? Just… fuck you.

Exactly. Of course, as Fell says, if you like dark chocolate, go about your business. I tend to recommend it because it is richer than milk chocolate, so you can enjoy a treat without going overboard. Then again, I happen to like but not love dark chocolate so that works for me. As I’ve said often before, what works for one hardly works for everyone.

But if you don’t really like dark chocolate (not even a little bit), and you just eat it because it’s the healthy kind of chocolate (or if you just want to laugh a little), please read his article over at Gawker.

CrossFit knock aside, it’s hilarious and makes great points.

Image c/o Christi

For those unfamiliar, Food Babe is a consultant turned health/food blogger and public speaker whose mission it is to investigate and uncover “what’s really in our food”. Until this week I don’t think I ever paid her much attention. I knew she had a book out, and I may even have shared a graphic she made about pumpkin spice lattes with some commentary on how they’re not the best thing for your health. I’ve also heard some rumblings in the health professional community about her, mostly along the lines of she’s unqualified and uses fear mongering tactics to spread misinformation. But there’s a lot of people that educate themselves on the internet and pose as experts under the guise of inspiration, recipe sharing, and blogging.

Then I read this article in Gawker, entitled “The ‘Food Babe’ Is Full Of Shit”. It is a robust discrediting by another female blogger with a background in Chemistry and forensic science and toxicology. The health professional in me always trusts science backgrounds over Google prowess, I also appreciate skepticism about our current food system. So, is Food Babe, whether she is full of *%it or not, a good thing or a bad thing?

In Favor of Food Babe: There’s a lot wrong with the way food is produced and consumed in the US. Things banned in Europe are still in our food (seriously, if you can make it without something the Euros think isn’t safe why not just do it that way all the time?), food label claims are often bogus (“all natural” Cheetos anyone?), and there’s little government regulation. A crusader using social pressure to improve our food system should be welcomed.

Food Babe Issues: My issue with her is this: she is very easily discredited, as the article shows. She does use fear mongering tactics, which do no one any good. A lot of people can’t afford organic food, and scaring them into thinking they’re actively murdering their kids by feeding them conventional green beans is a bit too extreme for me. And like I mentioned, she’s easy to discredit. She has written (and removed once her mistakes were called out) articles on how air in airplanes has too much nitrogen (air IS majority nitrogen, a fact she apparently missed) and how your microwave is basically a nuclear reactor. Sometimes journalists don’t fact check (see: Rolling Stone debacle) but someone purporting to have expertise should not make such wildly inaccurate claims.

I also do disagree with her tactics. She takes things wildly out of context, and makes it easy for the industry to fight back and win the public debate in the future. A mad lib of what I predict:

Food Babe: We should all stop eating X Food by Y Big Food Company because it contains (insert chemical approved by the FDA for a certain functionality in food processing) which is also found in/used for (some other scary/non-edible item or use which is totally out of context).

Y Big Food Company: This product has been deemed safe by the FDA and tested by our food science department. These claims are wildly inaccurate and put forth by someone who thinks your microwave is the A-bomb. Who do you trust, SCIENCE or her?

Big Food 1, Food advocates 0.

Here’s the thing: questioning what’s in our food is important. Pressuring food companies to remove unsafe products is important. Voting with our wallets for items like free range eggs, humanely raised meat, and supporting local farmers is all important. But we have to pick our battles and use solid ammunition. Because yes, Subway’s dough thickening agents IS used in yoga mats. But is that what makes Subway a poor food choice? Or is it factory farm meat that is high in sodium, white bread, and the potato chips and cookie that accompany the sandwich? While it may sound weird to say “there’s a yoga mat ingredient in my bread”, I don’t think THAT is what is causing obesity, diabetes, and poor health in America.

I think there’s a good analogy here between Food Babe and Ted Cruz. If you follow politics at all, you know he’s kind of a nuts (or as John McCain would say “a wacko bird”). Now, he may have a good point or two about a few specific areas of policy (I haven’ t dug deep enough to actually verify this, so let’s not make this a political fight). But his “the world is on fire”, no grey area, loud mouthed tactics make his message completely unfounded to most people. And while Food Babe has good (even great) intentions, her delivery and tactics will ultimately be counterproductive to her aims. If we want someone to call out the Food Industry on its faults (and we definitely do), it needs to be someone credible.

What do you guys think?

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It sounds like the Navajo Nation has come up with a pretty good idea. Starting April 1, junk food sold on the reservation will be taxed at 2%, in addition to the removal of a 5% sales tax on healthier items like fresh produce. The money garnered from the sales tax will go towards promoting farmer’s markets and local vegetable gardens. An excerpt from Time Magazine:

With nearly half of the Navajo youth population facing unemployment and 38% of the Navajo reservation at the poverty level, supporters say the act may serve as a prototype for sin taxes to curb obesity in low-income communities across the U.S.

You can read the whole article at Time.

The argument over “sin” taxes like junk food and soda have been waged viciously over the past few years, in places like Berkley and San Francisco. In Massachusetts we’ve put a sin tax on alcohol, cigarettes, and now plastic bags but have yet to touch the beverage and food industry. There are good arguments on either side. The pro-tax group claiming it will promote better habits, even out the price gap between healthy and processed foods, and provide money to earmark for obesity research or other prevention programs. The anti-tax groups (notably funded heavily by industry) claim it will have a disproportional burden on lower income communities.

It sounds like despite the potential burden, the Navajo Nation is willing to give it a go anyway. I”ll be interested in how this plays out, and if it can push other communities to do the same.

Image c/o gaku.

Typically, I don’t endorse fast food. It’s generally of poor quality, low in nutrients and high in calories, fat, and carbohydrates. But sometimes you just have to eat and the only options are quick serve joints such as these. When I get stuck, there are my top go-to options. Remember that none of these are nutritionally ideal – most are still pretty high in sodium and can involve processed ingredients. But eating fast food isn’t about ideal nutrition, it’s about doing the best with what you have where you are.

1. The Burrito Salad

Screen Shot 2015-03-25 at 12.02.59 PMYou can actually get this at a number of places – Chipotle and BoLoco for starters – which is why no restaurant name is included. Choose the salad option and top with vegetables, meat of your choosing (preferably grass fed/free range if offered), salsa, guacamole, and beans if you eat them. This will run you in the range of 400-600 calories and provide a filling lunch. The typical chicken salad at Chipotle will also provide 110% of your daily vitamin A, 94% of your daily vitamin C, and 23% of your daily iron needs.

2. The Jimmy John’s “Unwich”

Screen Shot 2015-03-25 at 12.01.33 PMThe unwich is any of your Jimmy John’s favorites without the bread. My go to, the Beach Club, is 310 calories, 29 grams of protein, and 8 grams of carbs without mayo. If you remove the provolone too, you’re at 90 calories (in which case you should add something else or order it with half a slice of bread). Either way, you can also add an apple, banana, or yogurt from a nearby convenience store.

3. Sweet Green “Hummus Tahina” Salad or “Harvest Bowl”

Screen Shot 2015-03-25 at 12.00.12 PMWhile you cannot always assume that salad is the healthiest option (take most of McDonald’s salads), in this case they’re better than what you’ll find elsewhere. And there are now several Sweet Greens (or similar such places) in downtown Boston. My favorite is the mediterranean inspired Hummus Tahina salad (610 calories, not sure who much carbohydrate but with hummus, pita chips, and falafel in there, I would guess about 60 grams. Of course you can always ask those items to be disclosed or on the side) or the Harvest Bowl (685 calories). While neither of these is on the lower calorie side, quality makes up for it, and you can always save some for later (or share – Patrick is usually hungry enough to help me out when I can’t finish something).

4. Starbucks Bistro Boxes

Screen Shot 2015-03-25 at 12.08.08 PMStarbucks is my last ditch choice, but it usually works considering there’s almost one on every corner. Ranging from 270-480 calories, the bistro boxes are balanced and generally filling. The fruit and cheese one is generally my favorite, although all three get my relative thumbs up. As a bonus, they’re lower in sodium than the above options, with my favorite and the Protein Box ringing in at 470 mg (the Chicken and Hummus one is 580 mg). If you’re still hungry, Starbucks has a few other things you can pair these boxes with like bananas, Kind Bars (again, not ideal but not terrible), popcorn, or nuts.

Side note: should you stumble upon a Chik-Fil-A, I recommend you simply enjoy your breaded chicken sandwich or nuggets and waffle fries. You can eat vegetables later :)

What are your go to fast food meals?

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In light of events in the news last week, I need to take a minute to address the ethical dilemma that seems to be plaguing my professional organization (The Academy of Nutrition and Dietetics).

What Happened? 

kids-eat-right-logoLast week, it was reported in the New York Times that a new “Kids Eat Right” seal would be appearing on Kraft Cheese Singles. This was also riffed by the Daily Show, who noted “It turns out the Academy of Nutrition and Dietetics is an academy in the same way this is cheese.” Great. To add to my embarrassment, this morning, my mom texted me a picture of an article in her home newspaper (the Fort Lauderdale Sun Sentinel) about how nutritionists paid by Coca Cola have recommended mini Coke cans as a “healthy snack” in a number of blogs/articles during American Heart Month. You can see a photo of the article and my color commentary on Twitter. Her caption for the photo was “I guess there are unethical dietitians”. Ya think?

Did the Academy Have Anything To Say For Themselves ?

After much outcry (and plenty of it from dietitians inside and outside the Academy), yes. The “official explanation”is essentially that Kraft Foods contributes funds to the Kids Eat Right campaign, which “was launched to support public education projects and programs that address the national health concern of obesity among our children,” earning them the seal. In a vacuum that explanation works, but of course in real life anyone with half a brain knows that putting the logo of the professional organization for dietitians on a “food” that cannot even legally call itself real cheese (notice it is labeled as a “pasteurized processed cheese product”) will lead many consumers to believe the product is endorsed by nutrition professionals and thus healthier than it actually is.

Aso for the Cola article, the Academy isn’t really to blame for that. That one falls on the individual RDs (although they do take a good deal of sponsorship dollars from Coke, that’s a topic for another day).

Why Am I So Mad?

Because this is both embarrassing and unethical. Actually, the cola thing is beyond unethical. I spent 5 years in college and an intensive supervised practice internship learning about fundamentals of science (chemistry, biochemistry) and nutrition, how to use nutrition to treat and prevent disease, how to counsel clients, to communicate information, and how to interpret and incorporate scientific evidence into my practice. So for someone who has done the same to accept money to tell the American people that a beverage composed entirely of chemicals and high fructose corn syrup is a healthy snack is beyond unethical. Essentially, these “professionals” are using their credential to perpetuate the bad information – and help sell a product –  that has had a hand in destroying a number of peoples’ heath and driving chronic illness to record highs. Think about all the quality of life lost to diabetes, obesity, and heart disease (among others) over the last 20 years, and the role soda and junk food has played. Then think about a credentialed health professional promoting some of those products. Almost inconceivable.

The Good News?

Screen Shot 2015-03-18 at 11.30.09 AM

I’m not the only one who is upset. Many dietitians feel strongly that the Kids Eat Right seal should be repealed. There’s even a petition on Change.org that has over 4,000 signatures and a hashtag #RepealTheSeal with over 1,000 tweets since the news broke last week.

Why Am I Telling You This?

I hope many if not all of you view me as a credible nutrition resource, and I wanted to let you know that I don’t support unethical and deceptive practices in exchange for sponsorship dollars. When I make recommendation about what is a healthy snack or how to choose supplements, I am making it based on the available scientific evidence and my experience. I hope you’ll continue to trust me, even if there are a few bad apples in my profession.


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