Author name: laura@lauracipullo.com

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5 Tips to Deal with Body Changes During Pregnancy

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Embracing Body Changes During Pregnancy: 5 Empowering Tips By Rebecca Jaspan, MPH, RD, CDN, CDCES, and Laura Cipullo, RD, CDCES, CEDRD-S, RYT   Having a positive body image is challenging for many women and can be especially difficult during pregnancy.  While this is an exciting time, it is also a time when you are facing many physical changes as well as mental and emotional ones.  Even those in eating disorder recovery for years face body image struggles during pregnancy.   Additionally, we live in a society full of “bounce back” images and we may feel pressure to look a certain way during pregnancy and after giving birth.  The reality is that despite what we see on social media or the societal pressures we face, the most important thing you can do is focus on nourishing your body and moving in a way that works for both you the baby. .   Here are five tips to help you work through body images struggles before, during and even after pregnancy so you can focus on self-care and a creating a healthier relationship with your body and the baby.   Remind yourself that weight gain is normal Not only is it normal, it is absolutely necessary for having a healthy pregnancy.  Even though it is what your body is supposed to do during pregnancy, watching yourself change can also be scary or bring up uncomfortable feelings.  Try to reframe these thoughts with words of acceptance and normalcy.  It is ok to have conflicting feelings about your changing body; each day will bring new feelings and emotions. Flow with it as best as you can.   Focus on body acceptance and appreciation Whether trying to conceive or pregnant, it can be very difficult to imagine getting to a place where you love your changed body.  If body-love feels too out of reach, it can help to focus on body-neutrality or body appreciation.  You can start with “I am okay.” Another idea is to try shifting your focus from your body’s external appearance to the internal experience of the amazing things your body is attempting to do to provide for a safe and healthy pregnancy. Consider thanking your body for supporting you and your soon to be baby through this process.   Find comfy clothes with an expanding waistband If putting on clothes that are too tight becomes triggering, it may be a good idea to store these clothes (especially jeans or tight-waisted outfits). Head to the store and buy a pair of pregnancy jeans with an elastic band and some stretchy leggings. Buy a few items that are loose and flow on top so that you can wear these items throughout your pregnancy and even the first few months after giving birth.   Ditch the scale You may already have a practice of not weighing yourself or are working towards this goal.  Pregnancy is an especially great time to take the focus off of the number on the scale.  Seeing the number increase can be distressing for many women even though this is normal and healthy.  To make matters more challenging, there is often an emphasis on gaining the “correct” amount of weight during pregnancy. Many women are afraid to exceed this number or feel shamed by their OB if they go above the number. Instead, ask your doctor to weigh you blindly, or backwards. Let go of the number and tune in to what your body actually needs. Focus on self-care behaviors and allowing the body to change as needed.  You can also practice weight exposures by seeing the number and accepting it will indeed increase each week regardless of what a book or blog says.   Act on your values In moments when you find yourself unhappy with your body image or speaking unkindly about it, try to bring the focus back to your core values.  Identify what is really important to you in life.  Maybe it is your family, your health, your career, and or your altruism.  Focusing on your body and wanting to change it brings you further away from attending to your values.  In the moment, accept you may not be fond of the body changes, but commit to working towards behaviors that align with your values.   If you plan on becoming pregnant, are pregnant and are concerned about weight gain, body image struggles, or appropriate nutrition, speak with your LCWNS dietitian.  We are here as a source of support and can give you the skills to help you feel more confident in handling whatever pregnancy questions or discomforts may arise.

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Supplements for Athletes Part 2

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Supplements for Athletes: Enhancing Performance and Recovery By Rebecca Jaspan, MPH, RD, CDN, CDCES   If you’re an athlete, you may have read about or were recommended to add supplements to your nutrition and workout regimen.  Whether your goal is to increase muscle size and strength or maximize endurance, supplements may help you to achieve those goals.  From creatine to branched chain amino acids, the world of supplements can be very confusing and you may not know what is right for your body and level of activity.  Working with a registered dietitian to come up with the best plan for you and your goals can help take out the guesswork.  Always consult with your doctor before beginning anything new.   There are many dietary supplements on the market that claim to enhance exercise and athletic performance.  Athletes may choose to take supplements to improve strength or endurance, increase exercise efficiency, achieve a performance goal faster, and increase tolerance to more intense training.  Some supplements also help enhance recovery from exercise and reduce chance of injury.1  Supplements come in a variety of forms including capsules, liquids, powders, and bars.   While there is evidence that supplements can enhance athletic performance, a nutritionally adequate diet and sufficient hydration are imperative for any individual to perform at his or her best.  Athletes require enough carbohydrates, protein, fat, and fluids as well as vitamins and minerals.  Dietary supplements are only effective when they are adding to an already adequate diet, not substituting important macro and micronutrients from food.  Some individuals may also need to increase their micronutrient intake through supplements based on their food intake and lab values.  Athletes engaging in endurance activity for more than an hour or in extreme environments, such as high altitudes or very hot or cold temperatures, may benefit from supplements to improve performance, gain a competitive edge, and recover from training.2   So, what’s the evidence behind these supplements?  Do they really work as claimed?  Let’s take a deeper dive into 6 of them.     Creatine   Creatine is thought to improve strength, increase lean muscle mass, and help muscles recover more quickly.  Creatine is found naturally in your muscles, but your body can only produce so much, which is why it is taken as a supplement by those engaging in certain sports.  It is used most commonly in activities such as weight lifting and sprinting because its muscular boost helps achieve bursts of speed and effort.  Studies show that creatine is a safe supplement with few known side effects.  The most common adverse effect is water retention when just starting the supplement.  When combined with other supplements or taken at high doses, there have been cases of kidney and liver complications.3   There are two main types of creatine, creatine hydrochloride (HCL) and creatine monohydrate.  Creatine monohydrate is more commonly used than creatine HCL and there is extensive research that shows it increases energy, power, and stamina.  Creatine HCL has a water molecule attached, which increases its solubility and absorption.  You can take less of this kind and there is no risk of water retention.   Pre-workout    Pre-workout supplements are gaining in popularity to improve fitness and energy to power through challenging workouts.  Some fitness experts say that they are not necessary and potentially dangerous.  Pre-workout supplements are typically taken as a powder that you mix into water before exercise.  They usually include amino acids, beta-alanine, caffeine, creatine, and artificial sweeteners.  Since these substances are not regulated by the FDA, many have not been tested for purity or quality.  There is limited research showing pre-workout’s effectiveness, but some studies suggest that some may have a benefit on athletic performance.4    Whey Protein   Whey protein is frequently recommended for athletes because it is easily and quickly digested.  Research shows that whey protein can help improve your muscles’ ability to recover faster and adapt to more intense exercise because it is found to stimulate muscle protein synthesis more effectively than casein or soy proteins.5. One study showed that supplementing with whey protein during a prolonged period of strength and resistance training lead to significantly greater increases in muscle mass and strength compared to the same training without protein supplementation.6  While it is certainly possible to consume adequate protein through food, whey protein supplementation may be helpful for increased muscle strength.   Branched-Chain Amino Acids   Branched-chain amino acids are essential amino acids leucine, isoleucine, and valine. They are primarily found in meat, dairy, and legumes and they help stimulate the build-up of protein in muscle and they reduce muscle breakdown. Research also shows that drinking branched-chain amino acids during a workout may help speed up recovery.  A study published in the International Journal of Sports Nutrition and Exercise Metabolism found that those who took 100 milligrams per kilogram branched-chain amino acids had significantly less muscle soreness after a high-volume squat workout.7   Ashwagandha   Ashwagandha is an adaptogen, which refers to an herb that is thought to have health benefits.  While adaptogens are most frequently used for their effects on decreasing stress and anxiety, ashwagandha is thought to have benefits for athletic performance.  One review looked at 12 studies in men and women who took 120mg to 1250mg of ashwagandha per day.  The studies showed that the athletes had enhanced strength and oxygen use during exercise.8.  Additionally, few studies show ashwagandha’s potential benefit in increasing muscle strength.  Much more research is needed on benefits and dosing of ashwagandha for athletic performance.   Fish Oil   For both strength and endurance athletes, intense training may cause tiny muscle tears and lead to muscle damage and inflammation.  Too much inflammation can delay the recovery process and result in injury over time.  Fish oil is an excellent source of omega-3 fatty acids known for their anti-inflammatory effects and may be a good addition to a recovery regimen.  Research shows that taking omega-3 fatty acids may reduce post-exercise soreness and speed up the recovery process.10     References Kreider

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althete drinking beverage to supplement recovery

Supplements for Athletes

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Supplements for Athletes: Maximizing Performance and Recovery By Rebecca Jaspan, MPH, RD, CDN, CDCES   If you are an athlete, you may have considered taking supplements to enhance performance. While it is certainly possible to receive all of your nutrients through food, athletes may find it helpful to supplement their diets with extra vitamins and minerals to fill in any nutritional gaps.  Supplements can be a helpful tool to beat fatigue and help athletes perform at their best when pushing their bodies to high levels of activity.  Athletes may use supplements to improve strength or endurance, increase exercise efficiency, achieve a performance goal, or increase tolerance to more intense training.1   While supplements can play an important role in enhancing the nutritional status of athletes, they are just that, a supplement to what you eat on a daily basis.  It is imperative that the athlete consumes enough food with adequate amounts of protein, carbohydrates, and fat to promote more endurance and recovery from injuries.  Athletes have increased energy needs, which gives them the opportunity to eat a wide variety of foods.  This can also leave an athlete with the challenge of obtaining all the nutrients they need to maintain their health and performance.  Supplements alone cannot make up for an inadequate diet, but a well-planned diet with enough calories and macronutrients can help ensure maximum benefit from supplements.2  Unsure if you should be taking a supplement?  Always be sure to speak with your doctor and dietitian and review blood work to decide if a supplement is necessary.   There are some common micronutrient deficiencies that athletes need to look out for.  Deficiencies in these nutrients can not only impact both physical and mental performance, but also overall health.  Deficiencies commonly seen in athletes include B vitamins, calcium, vitamin D, iron, and magnesium.   B Vitamins   B vitamins are necessary for energy production from intake of carbohydrates, protein, and fats. Athletes, especially female athletes, may be at risk for deficiencies in vitamins B12, B6, and niacin.3  Vitamin B12 plays an important role in the health of nerves and cells.  When deficient, the athlete may feel weak and fatigued.  Food sources of vitamin B12 are primarily animal products such as meat, poultry, and dairy, so deficiencies are commonly seen in vegans and vegetarians.  Other food sources of B vitamins include seafood, eggs, legumes, leafy greens, and fortified breakfast cereal and nutritional yeast. Calcium   Calcium is important for nerve function, muscle contraction, release of hormones, and bone strength and health.  Calcium is also secreted through our sweat.  Since athletes put their bodies under such extreme stress in their sports, they may put themselves at risk for bone breaks or fractures.  Eating an adequate amount of dairy, fortified nondairy milks, dark leafy greens, and fish with soft bones such as sardines and salmon can help ensure enough calcium intake.  If athletes are not eating enough calcium, they may need a supplement.   Vitamin D   One of the most common deficiencies in athletes and non-athletes alike is vitamin D.  The best source of vitamin D is through sun exposure, which many people do not get enough of during the cooler months or through diet alone.  Vitamin D is important for mood, energy, and bone and muscle strength.  Food sources of vitamin D include salmon, swordfish, and tuna, fortified orange juice and dairy and plant milks, sardines, and beef liver.   Iron   Iron deficiency can occur in males and is more common in females, particularly during their menstrual cycle.  One review found that the rate of iron deficiency among teenage female athletes was up to 52%.4  The role of iron is to transport oxygen to the muscles, so low iron levels can cause reduced endurance, weakness, and fatigue.  Iron is found in red meat, turkey, shellfish, beans, lentils, tofu, spinach, dried fruits, and nuts.  Pairing a food high in iron with a food high in vitamin C, such as oranges or peppers, helps increase the absorption.  Research recommends to try correcting an iron deficiency with food first before taking a supplement, as iron supplements can cause constipation and other adverse side effects.5   Magnesium   Magnesium is a vital electrolyte and electrolytes are lost through sweat.  During periods of increased activity and high-level training, your body may require up to 20% more magnesium.  Magnesium is involved in several processes that affect muscle function, oxygen uptake, energy production, and electrolyte imbalance.  Research shows that magnesium deficiency impairs exercise performance and that increased dietary intake of magnesium or supplementation will have beneficial effects on exercise performance in individuals who are deficient.6  Food sources of magnesium include whole grains, dark leafy greens, milk, yogurt, legumes, pumpkin seeds, and nuts.     If you feel you may need a supplement to complement your training, speak with your LCWNS dietitian.  We will take a deep dive into your diet and make individual food and supplement recommendations to increase your energy levels, optimize your performance, and ensure overall health for you to meet your training goals.   References   Office of dietary supplements – dietary supplements for exercise and athletic performance. Larson-Meyer DE, Woolf K, Burke L. Assessment of Nutrient Status in Athletes and the Need for Supplementation.Int J Sport Nutr Exerc Metab. 2018;28(2):139-158. Woolf K, Hahn NL, Christensen MM, Carlson-Phillips A, Hansen CM. Nutrition Assessment of B-Vitamins in Highly Active and Sedentary Women. Nutrients. 2017;9(4):329. Published 2017 Mar 26. doi:10.3390/nu9040329 Clénin G, Cordes M, Huber A, et al. Iron deficiency in sports – definition, influence on performance and therapy. Swiss Med Wkly. 2015;145:w14196. Published 2015 Oct 29. Rogerson D. Vegan diets: practical advice for athletes and exercisers. J Int Soc Sports Nutr. 2017;14:36. Published 2017 Sep 13. doi:10.1186/s12970-017-0192-9 Nielsen FH, Lukaski HC. Update on the relationship between magnesium and exercise. Magnes Res. 2006;19(3):180-189.        

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The Scoop on Supplements for Teens

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Key Supplements for Teens: Supporting Adolescent Nutrition By Reva Schlanger, MS, RD   Adolescence is a time of excitement and dread. Changes are happening both physically and mentally at this period in a person’s life. According to the World Health Organization, adolescence is the phase of life between childhood and adulthood, from ages 10-19.1 This is a crucial time to create healthy habits as it lays the groundwork for adulthood. While a lot of our needs can be fulfilled through our dietary intake, teenagers tend to be missing out on one or more key nutrients. This is related to several things including picky eating, allergies, growth, and hormonal changes.   In this blog we will explore the key micronutrients (i.e., vitamins and minerals) needed for proper teenage health, how to get an adequate amount of these micronutrients, when dietary supplements are indicated, and the safety of taking supplements.   Which Vitamins/Minerals are Most Important for Teenagers?   While teenagers need all the same vitamins and minerals as everyone else, there are a few important ones to highlight. Calcium, Vitamin D, and Iron are particularly important for puberty and proper growth development. Note that while a child can take individual supplements, multivitamins are usually the easiest way to ensure your child is adequately and safely meeting his/her needs without the risk of over supplementing.   Calcium Calcium is vital for the healthy development of bones and teeth. Children grow mostly during their teenage years so adequate calcium is especially important now. This will help allow a child to grow and develop properly. Not getting enough calcium can lead to osteoporosis (weak, porous bones) which is irreversible. Calcium is found in a lot of dairy products including milks, cheese, and yogurts. It can also be found in some dark leafy green vegetables (think broccoli or kale). Having a dairy allergy or following a vegan diet can put your teen at risk for deficiency. One helpful way to get the RDA (recommended dietary allowance) for calcium is to take calcium supplements. Remember to speak to your medical profession or registered dietitian prior to choosing a supplement. Vitamin D Vitamin D is a fat-soluble vitamin (meaning we need adequate fat in our diet to absorb it) that we can get through sunlight – hence why it is called the sunshine vitamin. We can also find it in certain foods like oily fish (salmon, sardines, herring), egg yolks and fortified foods like milk, orange juice and cereals. Vitamin D helps increase intestinal absorption of calcium and phosphate. This means that if you are deficient in Vitamin D, you likely will be deficient in calcium. If you remember, calcium is needed for bone growth and strength so Vitamin D deficiency can stunt normal development in adolescence. Summertime may be easier to get enough Vitamin D since the sun is shining daily. In the fall and winter, it is more difficult to get our daily dose of Vitamin D. Taking a Vitamin D supplement in tandem with eating vitamin D rich foods can help reduce risk of deficiency. The NHS recommends that all children and adults over the age of four take 10 micrograms (mcg) of vitamin D each day during fall and winter.2 Those who spend most of their time indoors all year round may need to take Vitamin D supplements daily no matter the season. Iron Iron is a mineral that helps build red blood cells – very important for growing teens. Since iron helps our blood cells carry oxygen, which gives our bodies energy. Teenage girls are at high risk of iron deficiency when they hit puberty. Having your period means you bleed regularly so you will lose some iron. For most teenage girls, this occurs monthly and can cause significant iron loss. Not getting enough iron in your diet and/or having very heavy periods can lead to iron deficiency anemia which can cause tiredness, lack of energy, and shortness of breath. Iron can be found in a lot of different foods including red meat, poultry, spinach, seeds, and legumes. Iron supplements can be tough on the body and should be recommended by a health professional first. To Supplement or Not To? Dietary supplement use is common among children and adolescents. During 2013–2014, approximately one third of children and adolescents (persons aged ≤19 years) in the United States were reported to use a dietary supplement in the past 30 days.3,4 For anyone who struggles with eating a variety of different foods, dietary supplements can be beneficial. While you can take individual supplements, multivitamins are the most popular as they come in different forms (pill/gummy/liquid) and help with meeting all nutrients for children and adolescents. Dietary supplements can contribute substantially to overall nutrient intake, having the potential to both protect against nutrient shortfalls as well as to lead to nutrient intake above recommended upper limits.5,6 Note that overdoing supplements is not beneficial and can produce adverse side effects. Before you start taking any new supplements it is recommended to check with your medical provider or dietitian.     References: World Health Organization. Adolescent health. World Health Organization. Retrieved March 8, 2022. https://www.who.int/health-topics/adolescent-health#tab=tab_1 Vitamins and Minerals. NHS choices. Retrieved March 8, 2022, from https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/ Qato DM, Alexander GC, Guadamuz JS, Lindau ST. Prevalence of dietary supplement use in US children and adolescents, 2003–2014. JAMA Pediatr 2018;172:780–2 Jun S, Cowan AE, Tooze JA, et al. Dietary supplement use among U.S. children by family income, food security level, and nutrition assistance program participation status in 2011–2014. Nutrients 2018;10:1212. Bailey RL, Fulgoni VL 3rd, Keast DR, Lentino CV, Dwyer JT. Do dietary supplements improve micronutrient sufficiency in children and adolescents? J Pediatr 2012;161:837–42. Stierman B, Mishra S, Gahche JJ, Potischman N, Hales CM. Dietary Supplement Use in Children and Adolescents Aged ≤19 Years — United States, 2017–2018. MMWR Morb Mortal Wkly Rep 2020;69:1557–1562. DOI: http://dx.doi.org/10.15585/mmwr.mm6943a1external icon    

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Should My Child Be Taking Vitamins? Which One(s)?

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Navigating Children’s Vitamins: Which Ones Are Necessary? By Paige Mandel, MS RD CDN     The supplement space can be incredibly confusing for adults and children alike. But as a parent, the gray area can be overwhelming and frustrating, as you only want the best for your kiddo’s growth and development. Interestingly, the American Academy of Pediatrics doesn’t even have an official position on the subject, because it believes healthy kids receiving a well-balanced diet do not need vitamin supplementation.1 This means that you are their advocate, along with their pediatrician and dietitian, to determine what is best based on their individual diet, lifestyle and needs.   Here at Laura Cipullo Whole Nutrition, we often will recommend a multivitamin for most children. Let’s be honest and compassionate with ourselves – a “healthy well-balanced diet” is a pretty nuanced term, and not always attainable. Yes, as parents the goal is to include dairy, fruits, vegetables, whole grains, and a variety of protein sources for your kids, but this is not always the case, nor is it expected to be. Whether you have a selective eater or an adventurous eater, many children do not receive all the vitamins and minerals important for their growth and development at the levels recommended. Reminder – this is ok, and totally normal! While we will explore ways to boost the nutritional density of your child’s diet to more appropriately meet their needs through food, we also encourage a multivitamin for some extra help to fill the nutritional gaps. We also will recommend looking at your child’s labs and evaluating their current diet to screen for more common deficiencies such as vitamin D, B12, iron, and calcium to assess for further supplementation not fully covered through a multi.   The Linus Pauling Institute, a molecular nutrition research institute at Oregon State University recommends “children between the ages of 4 and 13 take a daily multivitamin with 100% of the daily value for most vitamins and essential minerals, keeping in mind the RDA and UL for certain micronutrients in particular age groups.”2   Which Multivitamin Should I Get? We always recommend consulting with your child’s pediatrician and/or individual dietitian before trying a supplement. Some brands that our clients love (by no means an endorsement):   Flintstones Complete Chewable Tablets Metagenics® Multigenics® Chewables – Outrageous Orange Flavor Smarty Pants® Multi and Omega 3s Rainbow Light Kid’s One Renzo’s Picky Eater Multi w/ Iron   What form? Chewable, gummies, liquid or powder The most important part is that your child will take their multi consistently. Chewables and liquid vitamins will be more shelf stable than the gummies, and less likely to contain added sugars and be considered candy.   Should the Daily Value be 100% or more than 100%? Just 100%! Consuming higher than recommended doses of certain vitamins such as vitamin A, C, or D can produce harmful adverse effects.   Should it contain iron or not? In short, it is the dosage that is most important, and ensuring your child takes only the recommended dosage of their vitamins. “Iron supplements are a leading cause of poisoning in children under age 6, according to the National Institutes of Health”3. Most children’s multivitamins do not contain iron, but some do as most children in the US do not get enough iron in their diets.4   Do any of them have calcium? Flintstone Complete Chewable Tablets = 100mg calcium Metagenics = 30mg calcium Rainbow Light Kid’s One= 100mg calcium     “ The Food and Nutrition Board (FNB) of the Institute of Medicine establishes dietary reference intakes (DRIs) for each micronutrient; these reference values should be used to plan and assess dietary intakes in healthy people (4, 5). The DRIs include the estimated average requirement (EAR), the recommended dietary allowance (RDA), the adequate intake (AI), and the tolerable upper intake level (UL).”5   Linked here is the Dietary Reference Intakes set by the FNB: RDA for Micronutrients during Childhood, Ages 4-8 years and ages 9-13 years.   If you have any questions or concerns about your child’s nutritional needs or supplements, reach out to our dietitians at LCWNS, we would be happy to assess for any nutritional gaps that indicate supplementation and work with you and your family to get all of your nutrition needs met together!   References Where We Stand: Vitamins. HealthyChildren.org. Accessed March 7, 2022. https://www.healthychildren.org/English/healthy-living/nutrition/Pages/Where-We-Stand-Vitamins.aspx Acosta K. Best Multivitamins For Kids Of 2022, According To Experts. Forbes Health. Published October 20, 2021. Accessed March 7, 2022. https://www.forbes.com/health/family/best-multivitamins-for-kids/ Can Kids Consume Too Much Iron With Multivitamins? Healthy Eating | SF Gate. Accessed March 7, 2022. https://healthyeating.sfgate.com/can-kids-consume-much-iron-multivitamins-4894.html Nutrition and Supplement Use. HealthyChildren.org. Accessed March 7, 2022. https://www.healthychildren.org/English/healthy-living/nutrition/Pages/Nutrition-and-Supplement-Use.aspx Children. Linus Pauling Institute. Published April 29, 2014. Accessed March 7, 2022. https://lpi.oregonstate.edu/mic/life-stages/children

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To Supplement or Not to Supplement?

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To Supplement or Not? Navigating the World of Dietary Supplements By Rebecca Jaspan, MPH, RD, CDN, CDCES   Dietary supplements include vitamins such as vitamin C or E, minerals such as calcium or magnesium, fish oil, and herbs. As registered dietitians, our clients ask us about supplements on a regular basis.  There is so much confusing information in the wellness space about taking supplements, it can be challenging to know if or what kind of supplement is right for you. While food is frequently the best source of vitamins and minerals, some individuals do not get enough nutrients through food and need an extra boost.   In a 2018 survey, the Council for Responsible Nutrition found that 75 percent of people in the United States take dietary supplements1.  The survey also showed that vitamin D and calcium are the most popular supplements and the use of herbals and botanicals, especially turmeric, have increased in popularity in the past 5 years.  The first step is to speak with your doctor and dietitian to point you in the right direction of which supplements you may need to support your body.   Before starting a supplement, it is a good idea to get bloodwork taken to determine if you have any deficiencies. At Laura Cipullo Whole Nutrition, we provide our clients with a recommended list of labs to bring to their doctors’ visit to gather the information we need to help determine if a supplement is necessary.  Once we get your results, we use your medical and food history to create a meal structure together to help meet your nutrition needs.   There are a number of reasons why supplements are an important part of your diet, particularly if you have a condition or eating pattern that prevents you from absorbing or eating certain nutrients.  Some of these reasons include gastrointestinal disorders, eating disorders, vegetarianism and veganism.   Gastrointestinal Disorders   Gastrointestinal disorders such as irritable bowel syndrome, inflammatory bowel disease, and celiac disease frequently cause malabsorption of nutrients due to damage in the mucosal lining of the small intestine where the majority of our nutrients are absorbed.  While eating nutritious foods is important, you may not absorb all nutrients provided from the food.  Dietary supplements may provide the extra boost of nutrition your body needs.   It is common to see deficiencies in vitamin B12, calcium, iron, folate, vitamin D, and magnesium in individuals with gastrointestinal disorders. The degree of deficiency will depend on the severity of the disease2.  Micronutrient deficiencies occur in more than half of people with inflammatory bowel disease, such as Crohn’s or ulcerative colitis.  Deficiencies are more common in Crohn’s than ulcerative colitis.  In addition to medication to decrease the inflammation in the gut, patients with inflammatory bowel disease need to be tested for common deficiencies of iron, B12, vitamin D, and vitamin K3. In celiac disease, deficiencies most often seen are iron, B12, calcium, vitamin D, copper, and zinc.  In newly diagnosed and untreated celiac disease, inflammation and destruction of the small intestine leads to malabsorption.  Once the individual with celiac disease switches to a completely gluten-free diet, inflammation decreases and nutrients from food and supplements are better absorbed.   Additionally, GI disorders can cause fat malabsorption. Fat is necessary to increase the absorption of fat-soluble vitamins A, D, E, and K.  Dietary changes may need to be made to include lower fat foods that are more easily digested and absorbed.  Supplements may also be added to make up for nutrients that aren’t absorbed as well.     Eating Disorders   Individuals with anorexia, bulimia, or binge eating disorder may benefit from dietary supplements. They may deprive their bodies of essential macronutrients, such as carbohydrates, protein, and fat, and micronutrients, such as vitamins and minerals necessary for red and white blood cell production, and muscles, bone, and organs growth and development.  Prolonged eating disorder behaviors such as restriction, binging, purging, and laxative use can cause damage to bones, teeth, the digestive system, heart, and other organs.  Treatment focuses on refeeding with adequate food as well as the possible addition of supplements.   Common supplements include calcium and vitamin D to support bone health, iron to reverse anemia, and omega-3 fatty acids to aid in brain and nerve functioning.  Research on omega-3 fatty acid supplements show they can have a positive effect on the nervous system, by decreasing inflammation and protecting against oxidative stress, helping with mood and anxiety-depression symptoms.  Taking an omega-3 supplement in addition to supporting your body with adequate food intake can help your physical, mental, and emotional states to help in your recovery journey4.   Vegetarians and Vegans   A lacto-ovo vegetarian eats dairy and eggs, but avoids meat and fish.  Vegans avoid all animal products.  Vegetarian and vegan eating patterns can be nutritionally complete with some careful planning, however, there may be gaps that need to be filled with a supplement.  Common deficiencies in vegetarian and vegan diets are vitamin B12, vitamin D, omega-3 fatty acids, iron, calcium, and iodine.  Many of these essential vitamins and minerals are found in animal foods so will need to be supplemented in a vegetarian or vegan diet.   It is challenging to get enough protein in vegetarian and vegan diets and protein foods are where many of these nutrients are found.  Vitamin B12, calcium, and vitamin D are primarily found in dairy foods, which would be omitted in a vegan diet and many vegetarian diets.  While there are many plant-based sources of iron, the most efficiently absorbed form of iron is found in animal proteins, resulting in iron deficiencies in many vegans and vegetarians.  Additionally, omega-3 fatty acids are mainly found in fatty fish such as salmon and tuna.  This essential nutrient will need to be supplemented in a diet that does not contain fish.     If you are concerned you are not meeting your nutritional needs and may need a supplement, talk to your dietitian at Laura Cipullo Whole Nutrition.  We will collaborate

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dancers stretching in dance studio

Nutrition for Dancers

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Nutrition Essentials for Dancers: Fueling for Performance and Health By Paige Mandel, MS RD CDN     Many sports highlight nutrition for performance and endurance, yet dance is one that is less-so discussed. Diet culture tends to infiltrate the dance industry heavily, with extreme focus on a lean physique, constant viewing of mirrors and an expectation of body confidence. There are many aspects of nutrition that largely impact a dancer’s performance, stamina, and prevent injuries. Focus must shift away from calorie counting and restriction, and lean in towards fueling the body adequately.   Sports like dance that emphasize low body weight for optimal performance are associated with an increased prevalence of disordered eating, and the female athlete triad (FT).1 The female athlete triad “is defined as a spectrum disorder of three interrelated components: (1) low energy availability due to disordered eating, eating disorder, or lack of nutrition relative to caloric expenditure; (2) menstrual dysfunction; and (3) low bone mineral density (BMD)”.2 This makes factual nutrition knowledge for this population even more important. It is essential to check the facts (from a Registered Dietitian, not a social media influencer) and truly understand how to eat as a dancer, not only to optimize performance but to fuel overall health and prevent medical complications/injury as well.   What Should a Dancer’s Diet Look Like? Balanced, Consistent, and Enough! A dancer’s diet should look like a balance of carbohydrates, proteins, and fats. While this is true of a balanced diet for any person, athletes and non-athletes alike, it is especially key for dancers who are consistently undergoing intense movement resulting in the need for adequate fuel and re-fueling of the muscles. Consistency of intake plays a large role in optimal nutrition for dancers to sustain the high energy needs of performance and prevent fatigue. Lastly, making sure to meet the caloric demands of both high and low intensity dancing is empirical to a healthy dancer. Why Carbs? For immediate and long-term energy + preventing muscle breakdown. Nutrition 101 in short: carbohydrates are the body’s most efficient source of energy and preferred fuel. Carbs break down to sugar (glucose) to be utilized by the body either immediately to sustain energy balance or stored as glycogen in your liver and muscles. These glycogen stores are used to fuel activity and could be quickly depleted.  In order to replenish these stores, we need carbohydrates consistently throughout the day. Additionally, carbohydrates have a protein sparing effect- this means that “as long as there are adequate amounts of carbohydrate in the diet, protein will function to build and repair muscle tissue rather than being diverted to supply the body with energy”3. This means preventing muscle breakdown- SUPER important for dancers. Therefore, to replenish our muscle glycogen stores that are being used through dancing activities (practices, trainings, classes, performances, competitions etc.) carbohydrates must be eaten consistently in meals and snacks throughout the day. Complex carbohydrates (i.e. whole grains, legumes, starchy veggies) will provide longer term sustenance and blood sugar balance due to the presence of fiber, and simple carbohydrates will provide a quick burst of energy often needed before or during long bouts of activity. It is recommended dancers consume 55-60% energy intake from carbs4.   Why Protein? For muscle building, repairing and preventing muscle breakdown. Protein is essential to sustain the muscle bearing actions of dance, to build muscle, support immune function, regulate hormone and enzyme production and maintain blood sugar control. The muscles of a dancer are significantly stressed by such constant use, requiring adequate protein needs for repair. Almost half of the body’s protein is stored in skeletal muscle, therefore if the body does not receive enough fuel, the muscles begin to breakdown in order to supply the body with amino acids for energy production. This phenomenon also then “re-routes” the function of protein from building and repairing muscle to providing the body with energy, resulting deterioration of muscle mass and thus strength. It is recommended dancers consume 1.2 to 1.7 g protein/kg per day, including a variety of quality protein sources5. If you adhere to a vegetarian or vegan lifestyle, it is important to consult with your dietitian to discuss how to best meet these needs.   Why Fat? To sustain energy (stamina), support muscle function, achieve satiety, and decrease inflammation. Fat supports organ and joint structure and function as well as aids in the absorption of fat soluble vitamins (A, D, E, K)3. Additionally, dietary fat is an essential component of all cell membranes, and hormones that regulate blood pressure, heart rate, inflammation and the nervous system3.  While often demonized in diet culture, fat is crucial to a healthy diet to supply the body with energy and promote satiety. Fat is the primary fuel for endurance exercise, thus dancers require an adequate amount of fat (a balance of omega-3s and omega-6s) to undergo long rehearsals, classes and performances. Omega 3 fatty acids are found in foods such as avocados, nuts, seeds, olive oil, fatty fish. Omega 6 fatty acids are found in soybeans, corn, safflower and sunflower oils, nuts and seeds. It is recommended dancers consume 20 to 35% of energy intake from fat5. Additional micronutrients to consider: iron, calcium and vitamin D – all essential for optimal bone density and muscle repair5.   Consistency. In order to achieve optimal nutrition and metabolic function, dancers should aim to eat consistently throughout the day, before, possibly during, and directly following performance. This will help maintain blood sugar levels to provide the body with stable, consistent energy to prevent energy spikes and crashes. Additionally, consistency will help prevent fatigue and aid in muscle repair to delay soreness and burnout. With such noise in the health and fitness space it could be difficult to navigate what it means to properly fuel your body, especially as a dancer. If you have questions about nutrition for dance performance, and how to best meet your needs, talk to a dietitian at Laura Cipullo Whole Nutrition.  We can help you create a

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scoop of protein powder

The Scoop On Protein Powders

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The Essential Guide to Protein Powders: Types, Benefits, and Selection Tips By Reva Schlanger, MS, RD, CDN, LD   A lot of us know that protein in our daily intake is important but little know how much protein is enough. The RDA (recommended dietary allowance) reports that to prevent protein deficiency, an average sedentary adult requires 0.8g per kg of body weight. For example, a person who weighs 75kg (165 lbs) should consume a minimum of 60g of protein daily.  For those who are very active, your needs may be closer to 1g per kg of body weight. If pregnant or nursing, speak to your doctor/dietitian about how much protein you should aim for daily as these stages in life require higher protein needs. Getting enough protein is vital for building and repairing our bodies tissues i.e. building muscle instead of breaking it down. Protein also helps us recover faster from injury or illness. Unfortunately, many people do not get enough protein to fulfill their daily needs. That is why protein powders are a helpful supplement to hit our daily protein goal. Below we will discuss protein powders in greater detail.   What are Protein Powders?   Simply put, protein powders are dietary supplements created to help increase people’s protein intake. While once originally targeted for athletes, protein powder is now widely consumed by the general population. This is because protein powders are a fast and convenient way to get enough protein in throughout the day, especially in the morning or after a workout. A couple scoops of this powder can provide a nearly 30 g of protein!   Different Types of Protein Powders   There are two categories of protein powders: animal-based and plant-based. Animal-based protein powders often contain either whey or casein. Whey comes from the clear liquid part of milk while casein comes from the top solid portion of milk. Both contain all nine essential amino acids, an excellent protein choice. Plant-based protein powders typically include protein from soy, peas, hemp, rice, or chia seeds. Choosing between animal-based or plant-based is really your preference as they both give our bodies sufficient protein. Powders that come from whey are typically less expensive which is helpful if starting out on protein powders and not wanting to break the bank! If you follow a dairy-free or vegan diet, then plant-based protein powders are the best choice.   How to Choose   Below is a review of various protein powders however taste preferences are individualized. Lifestyle, budget, and personal protein goals may factor into your choice. That is why it is always helpful to look at the nutrition label to see how much protein per serving, what are the ingredients and if it has any other added benefits. Some protein powders contain other nutrients like added vitamins, omega-3 fatty acids or fiber increasing its nutritional profile. I recommend starting off with one brand in a vanilla flavor which is a great neutral base for smoothies or pancakes.   Review: What Is The Best Protein Powder?                         Orgain Organic Plant Based Protein + Superfoods Powder Orgain is typically a popular choice for those seeking a good plant-based protein option. It offers 21 grams of protein in every serving as well as a hearty dose of fiber. It comes in both chocolate and vanilla flavor making it the perfect addition to your morning smoothie. The taste is smooth and does not have that chalky aftertaste that some powders give you.   This powder contains high quality ingredients allowing you to increase your intake of several important vitamins and minerals.   It is also vegan, kosher, certified organic and gluten-free, making it a great choice for those with certain dietary constraints.   Naked Whey Grass-Fed Protein Powder This protein powder is a great animal-based powder designed for those looking to increase their protein intake. It contains 25g of protein per serving and is free of any artificial sweeteners, additives, and growth hormones. This brand also sources its whey from grass-fed cows on small dairy farms in California.   It comes in a couple different flavors: unflavored, vanilla, chocolate, and strawberry. All the flavors are sweetened with coconut sugar. If using the unflavored powder, I would recommend adding it to a smoothie with other flavorful ingredients like fruits and spices.   It is certified gluten-free and soy free, as well as tested by Informed Choice which is a third-party company that evaluates the quality and safety of ingredients.   Vega Sport Premium Protein Powder If you’re an athlete looking to refuel after a workout then this powder if for you. It contains a whopping 30g of protein per scoop as well as probiotics for proper gut health. Vega also has 5g of branch chain amino acids (BCAA’s) to help repair muscles after rigorous activity.   The powder also contains tart cherry powder, which may help reduce inflammation and improve endurance exercise performance.   It was a wide array of flavors including peanut butter, berry, mocha, and vanilla.   This powder is plant-based and is vegan, gluten free, and GMO-free. Additionally, this supplement is NSF Certified for Sport, meaning that it’s third-party tested to ensure that it’s free of substances that are banned among athletes.   Orgain Clean Whey This powder has a great taste and texture and is made with all organic and non-GMO ingredients — including whey concentrate from grass-fed cows. It comes in chocolate or vanilla.   A serving contains 21g of clean, grass-fed protein, a complete amino acid profile and nearly 5g of Branch Amino Acids (BCAAs). This powder is made without any additives or preservatives. It is kosher, gluten-free, and soy-free.   ALOHA Organic Plant-Based Protein Powder This plant-based powder is naturally sweetened and comes in two flavors (chocolate and vanilla). It contains 18g of protein and 5g of fiber per serving. Fiber helps stimulate regular bowel movements as well as stabilizing our blood sugar levels.   It is kosher, vegan,

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chocolate almond butter oatmeal bars

No-Bake Chocolate Almond Butter Oatmeal Bars

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No-Bake Chocolate Almond Butter Oatmeal Bars: A Delicious Energy Boost Inspired by recipe from Alexis Joseph, RD   These no-bake chocolate almond butter oatmeal bars are my favorite pre or post workout snack.  They are so easy to throw together and good thing because they do not last in the freezer for long!  The oats and almond butter are the perfect combination of carbohydrates and fat to keep me energized and satiated throughout a workout.   Ingredients: 1 ½ cup old fashioned oats ¼ cup ground flaxseed ¼ tsp sea salt 1 cup almond butter (peanut butter works too) 1/3 cup maple syrup or honey 2/3 cup semi sweet chocolate chips   Directions Line an 8×8 baking dish with parchment paper. In a medium bowl, add oats, flaxseed, and salt. Add almond butter and maple syrup, stirring until well combined into a thick and cohesive mixture. Spoon mixture into lined baking dish and push down into even layer using wet hands or the back of a spoon or spatula. Place chocolate chips in a small bowl and melt in 20 second increments, stirring each time, until melted. Pour melted chocolate onto bars and use a spoon to spread evenly. Place dish in freeze for about an hour or until chocolate is hardened.  Slice into 16 bars and enjoy!  They are delicious right out of the freezer!

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soccer player with optimal nutrition kicking ball

Nutrition for the Soccer Athlete

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Nutrition for the Soccer Athlete: Fueling for Peak Performance By Rebecca Jaspan, MPH, RD, CDN, CDCCES   The average soccer player runs anywhere between 5 and 7 miles per game1.  For an athlete playing 1-2 games per week and practicing in between, fueling and hydrating adequately is of utmost importance to keep your energy levels high during training and games.  Soccer involves a combination of quick bursts of sprinting, moderate running, with occasional rest periods, requiring a unique approach to nutrition to achieve a high level of performance. Whether you’re playing in a recreational league or playing at a higher level, all soccer players can benefit from ensuring they are fueling properly and recovering quickly.   Soccer is a physically demanding sport and individual nutrition recommendations are determined by amount of training, level of competition, specific athlete needs, training goals, as well as overall health of the athlete based on their age and fitness level.  Whether you are an amateur or elite player, nutrition and hydration habits can make a big difference on and off the field2.   What Does a Soccer Player’s Diet Look Like?   A soccer player’s eating pattern should consist of high carbohydrate, moderate protein, and moderate fat.  Since our brain’s and muscles’ preferred source of energy is glucose from carbohydrates, soccer players need enough carbohydrates to sustain them throughout their games and practices.  When your body needs energy, it draws on its glycogen stores, which are glucose stored in your liver and muscles from the food you eat.  The amount of glycogen stored in liver and muscle cells depends on how active you are, how much energy you are using at rest, and the kinds of foods you eat.   Due to the physical demands on the athlete during a practice or match, glycogen stores in the muscle decrease, which can result in fatigue and slower running speeds2.  Low glycogen stores can also have a negative effect on cognition, resulting in slowed decision making on the field.  Research on soccer players consistently indicates that they trend toward diets that do not provide enough carbohydrates and support the use of nutrition counseling from dietitians for best results3.   The good news is with a little bit of planning, you can maximize your energy and performance on the field.     What to Eat Before Practices and Games   It is important to begin practices and games well-fueled.  The meal or snack should focus on carbohydrates with some protein and fat to provide satiety.  Athletes may want to eat a meal 3-4 hours before a game and a small snack 30 minutest to 1 hour before.  The meals and snacks should also be low in fiber so they are easy to digest and do not cause any gastrointestinal upset2.   Some pre-game meal ideas include (3-4 hours before):   Yogurt with granola with less than 5 grams of fiber and berries Chicken or tuna sandwich Pasta with meat sauce Chicken stir-fry with mini carrots and peas over rice or soba noodles   Some pre-game snack ideas include (30 minutes to 1 hour):   Banana and low fat yogurt Beef or turkey jerky and crackers Protein shake Pita chips and hummus   What to Eat During Practices and Games   Due to the high intensity of soccer, players often need to refuel during the games with a source of simple carbohydrates or sugar that is broken down quickly and used for fuel.  Something high in carbohydrates, quick, and easily digestible is key.  As a rule of thumb, 30-60 grams of carbohydrates should be consumed every hour and this may change depending on your activity level during games and speed.  Some good ideas are low fiber granola bars, bananas, sports drinks, and energy gels.  Energy gels are typically 15 grams of carbohydrates per gel, making them a quick and easy refueling tool.   What to Eat After Practices and Games   Post-game recovery meals should contain carbohydrates to maximize speed of recovery and replenish muscle glycogen stores, protein for muscle repair, and plenty of fluid to replace sweat losses2.  Right after the game or within 30 minutes, it is important to refuel with carbohydrates to replenish glycogen stores.  A meal containing carbohydrates, protein, and fat should be consumed within 1-2 hours after a game.   Post-game recovery snacks (within 30 minutes after a game):   Energy drink like Gatorade or Powerade Carbohydrate/protein granola bar Banana   Some post-game recovery meals (1-2 hours after a game):   Chicken avocado sandwich Peanut butter and banana sandwich Bean and cheese burrito     What About Hydration?   Soccer players need to replenish the fluid and electrolytes lost through sweating.  Children may lose 1-4lbs of sweat during a game while adults may lose 6-8lbs.  Research shows that many soccer players begin their games already dehydrated and while they may take the opportunity to drink during breaks in the game, fluid intake usually doesn’t match fluid loss4. While total replacement of fluid isn’t necessary, players should aim to replenish as much fluid and electrolytes through both water and salty snacks or sports drinks as they can after games and practices to prevent muscle cramps and dizziness.   It is helpful for players to drink fluids with all meals and snacks, carry a water bottle with them throughout the day and drink 200-600ml of fluid before starting a practice or game.  Athletes can also use sports drinks or electrolyte tablets or salt packs added to water.   Food and hydration choices are so important to support the performance of soccer players.  Food and drink consumed before, during, and after games and practices can have a major influence on your skills and ability.  If you have questions about nutrition for soccer performance, talk to your dietitian at Laura Cipullo Whole Nutrition.  We can help you create a realistic plan to maximize your nutrition for your sport while also taking into account your busy lifestyle and other commitments.   References Karpinski, PhD, RDN, CSSD, LDN C. Sports

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