Healthy (and Happy) Holidays!

By: Jaimie Morgan, Dietetic Intern, Bastyr University

The holidays are here already! How do we stay healthy, active and avoid that dreaded holiday weight gain?

Here are some helpful holiday recipe and eating tips, to help reduce your intake of fat and calories during this long (three months!) holiday season:

• Continue with your regular exercise routine – studies have shown that people who keep the weight off are also the ones who stick as much as possible to their food and exercise programs
• Choose meats (such as turkey) without the skin
• Modify your favorite high-fat recipes
• Eat slowly – set your fork down on the table between bites, talk with others and enjoy their company!
• Choose foods wisely – When choosing from a tableful of rich holiday foods, go for the fruits and vegetables first, then go back for the higher fat items like casseroles and meats
• Never go to a holiday party starving! Have a small, healthy snack before departing, like whole-grain crackers, cheese and a piece of fruit.
• Take care of yourself – Taking time for yourself by doing exercise, meditating and making healthy choices will help to relieve holiday stress!

There's a great example of a typical vs. healthy holiday meal at:
http://www.dietbites.com/calories-in-holiday-meal.html
as well as some great tips on how to trim the calories and fat!

And don't forget about exercise! Stick to your routine as much as possible, or add some of these fun holiday exercise opportunities:
• Shoveling snow
• Snowball fighting
• Skiing/Snowboarding
• Hiding presents
• Kissing under the mistletoe!

Have a healthy and happy holiday season, from the team at HealthyHusky!

Tips for Healthy Holiday Recipes

Eating healthfully on Christmas doesn’t mean you need to avoid holiday food fare. Food often takes center stage today, causing fear of weight gain for many people. With some planning, fitting holiday treats into a healthful eating plan is easy.
You can eat smaller portions, replace high-calorie foods with low-fat options or slightly adjust recipes. By swapping out a few ingredients, even in Mom’s classic dishes, you can reduce fat and calories without sacrificing taste.

Here are some quick tips to help turn your holiday recipes into guilt-free pleasures:
- Use two egg whites in place of one egg.
- Try dried fruit instead of nuts.
- Use three tablespoons of cocoa powder and one tablespoon of oil in place of baking chocolate.
- Replace cream or whipping cream with evaporated skim milk.
- Try substituting an equal amount of applesauce for at least half the oil, margarine or butter in muffins and quick breads like banana bread.
- For dips, sauces and pie toppings, use non-fat yogurt or fat-free sour cream.
- Top casseroles with almonds instead of fried onion rings.
- Choose reduced-fat cheeses for salads and casseroles.

Subtle modifications can improve your recipe’s nutrition content without compromising taste.

Merry Christmas!

Produced by ADA’s Public Relations Team

Amenorrhea - Missed Periods in Athletes Can Cause Bone Lose and Osteoporosis

Athletes who stop having periods risk bone loss and osteoporosis


What is Athletic Amenorrhea?
Amenorrhea is a term used to describe the lack of a menstrual period. There are two types of amenorrhea:
Primary Amenorrhea, in which a woman never started having regular menstrual periods.
Secondary Amenorrhea, in which a woman who has begun regular menstruation suddenly stops having a regular period.
Amenorrhea in athletes, sometimes called exercise-associated amenorrhea, occurs when a woman doesn't have a regular period either because she exercises too much, eats too few calories or both. In order to have regular periods women need to consume a certain number of calories and maintain around 16 percent body fat or more. If a woman has too little body fat the ovaries stop producing estrogen and the woman stops menstruating.
There are many causes of amenorrhea, but in athletes stopping your period is a warning sign that the body is under too much stress and has too little energy stores to support healthy functioning. Experts speculate that a woman stops ovulating and menstruating to protect against pregnancy during extreme physiological stress and to use any available energy to support her basic physiological processes. Intense exercise and extremely low body weight has also been linked with lower levels of the hormone estrogen which is necessary to maintain healthy bones.

Athletic Amenorrhea and Health Complications
One of the first researchers to identify the complications of athletic amenorrhea was Dr. Barbara Drinkwater. She found that female athletes with amenorrhea had significantly lower bone density than women athletes who had normal periods. When these women resumed regular periods by decreasing their training or increasing their calorie intake, they did regain a small amount of bone density, but never completely returned to normal mass density levels. It is now clear that exercise-associated amenorrhea leads to irreversible bone loss.
This was ground-breaking research because at the time it was thought that weight-bearing exercise would increase in bone density and protect women from bone loss. When athletes started to show low bone density because of the lack of regular periods, it sounded an alarm in the sports medicine community and kicked off much more research on the female athlete triad, a combination of:

Low energy availability (eating disorders)
Menstrual irregularities (amenorrhea)
Weak bones (increased risk of stress fractures and osteoporosis)
The future health complications of loss of bone mass early in life can be devastating as a woman ages. The risk of stress fractures increases dramatically, but the long-term risk of severe osteoporosis that leads to bone fractures that may not heal properly as a woman ages is a real concern.

Treating Athletic Amenorrhea
Any female athlete who stops having a period should be very concerned about her health. Amenorrhea is not a normal part of training. It is dangerous and unhealthy. If you have stopped menstruating your first priority is to try to resume menstruation by:

Decreasing your training volume 10 to 15 percent
Increasing your calorie intake by 10 to 15 percent
Increasing your calcium intake
See your doctor, dietitian or athletic trainer

Women trying to overcome amenorrhea may need to gain from 2 to 5 pounds. Because body image and weight-related issues are often a part of this condition, it may be helpful for these athletes to work with a psychologist who specialized in athletes with eating disorders.

Seeing Your Doctor for Athletic Amenorrhea
If you are an athlete with amenorrhea, your doctor may do various tests to find out why your stopped menstruating. She will begin with a complete medical history, a physical examination and blood tests. She will ask about your training schedule and eating habits and may ask about any history of an eating disorder such as anorexia, bulimia or an exercise addiction. You may be asked to reduce your training intensity and duration and increase your calcium intake as well as your overall calorie intake. It is recommended that women with amenorrhea get at least 1,500 milligrams of daily calcium.
You may have a DEXA scan which is a type of x-ray that measures bone density. This helps determine your risk of developing osteoporosis.

If regular periods don't begin again within six months of making changes in exercise and diet, you doctor may consider using hormone replacement or oral contraceptives.

Even though women with amenorrhea are not menstruating or perhaps ovulating, it is still possible to become pregnant. Amenorrhea should not be considered a form of birth control.

Overcoming Athletic Amenorrhea
Amenorrhea is a serious health condition that can result in irreversible bone loss and devastating long-term health consequences. If you are an athlete who has stopped having regular periods, don't ignore it. By addressing and treating amenorrhea early, you may prevent the loss of bone and avoid serious fractures as you age.

Sources:

The Female Athlete Triad, Position Stand, The American College of Sports Medicine, Medicine and Science in Sports and Exercise, 2007.

Warren MP, Chua AT., Exercise-induced amenorrhea and bone health in the adolescent athlete. Annals of the New York Academy of Sciences, 2008

Nattiv A, Agostini R, Drinkwater B, Yeager KK.,The female athlete triad. The inter-relatedness of disordered eating, amenorrhea, and osteoporosis. Clin Sports Med. April, 1994

By Elizabeth Quinn, MS(Sport Science), About.com
Updated: October 28, 2008

Comparing Diet and Nutrition Plans

Michael Dansinger, MD, from Tufts University, conducted a study to find out which commercial diet plan worked the best. His conclusion is that most commerical diet plans and nutrition programs work equally as long as participants stick with them. Although one plan may appeal more to some people for personal reasons, the overall finding is that weight loss and maintenance is due to more exercise and fewer total calories.
People who stayed on their diet for a full year experienced the most weight loss. Study results showed a 6 percent weight loss for the Ornish program participants, a 5 percent weight loss for those on both Weight Watchers and the Zone diets and a 4 percent weight loss for Atkins dieters.

Even with a moderate weight loss, participants significantly reduced their heart disease risk -- by 5 percent to 15 percent on average.

For the study, 160 overweight people were randomly assigned to one of the four diets. They followed a supervised program for two months and were left to continue the diets on their own. After only two months, 22 percent quit the study. After a year, 35 percent dropped out of Weight Watchers and the Zone diets, and 50 percent quit the Atkins and Ornish plans.

The researchers said the study suggests there is no one-size-fits-all diet best for everyone and any diet can work if it helps someone eat less and lose weight.

So while this study does seems to conclude that any diet can work, the drop-out rate raises other issues. It may be that finding and sticking with a balanced approach to eating for life is still the best long-term solution to maintaining a healthy weight.

By Elizabeth Quinn, MS(Sport Science), About.com
Updated: September 12, 2006

How Diet Choices Help Weight Loss and Weight Management

Whether you are an athlete or a couch potato losing body fat and maintaining a weight lose is not an easy thing to do. Anyone wanting to lose weight needs to reduce calorie intake and/or increase energy expenditure. It's simple math. But is there a way to decrease calories without feeling hungry? Barbara Rolls, a food nutrition researcher at Pennsylvania State University, offers the following tips.

Eat Some Protein
Research shows different foods and nutrients affect how full and satisfied people feel. For example, a number of studies indicate that calories-for-calorie, protein makes a person feel more full than carbohydrates or fats. This suggests that eating adequate lean protein can help control hunger and food intake.

Eat More Fiber
Additionally, dietary fiber has been shown to affect the feeling of being full and food intake. Research shows that eating an additional 14 grams of fiber per day is associated with a 10 percent decrease in calorie intake and a loss of body weight of a four pounds in four months. Eating more high-fiber foods such as fruits, vegetables and whole grains is a nutritionally sound way to not feel as hungry when reducing calorie intake. (Note: increase fiber gradually to avoid stomach upset, gas and diarrhea.)

About Energy Density of Food
In addition to nutrients such as protein and fiber, the energy content of food, gram for gram, also affects how full we feel. The term for this is energy density, which is simply the amount of calories in a gram of food. The relationship between the weight of food and its calories content is largely based upon the amount of water in the food. Water adds weight but not calories, so the higher the water content the lower the energy density.

Studies consistently show that over the course of a day or two, a person eats about the same weight of food. On average, the weight of food eaten is more constant than the daily calorie intake. So if you eat the same amount (by weight) of food, but lower the calories in each portion, you will consume fewer calories. Studies also indicate that you don't even miss the calories and feel just as full as the high calorie day.

Low Energy Density Eating Tips

- Eat more water-rich fruits, vegetables, and soups
- Add fruit to breakfast cereal
- Choose fresh fruit for snacks
- Add more vegetables to pizza, stir-fry, and pasta dishes
- Include a tossed green salad with lunch and dinner
- Choose broth-based soups before meals or as a meal
- Increase fiber intake by eating more high-fiber cereal, whole grains, legumes, vegetables and fruits.
- Limit intake of dry foods
- Limit consumption of dry foods such as pretzels and crackers, as they are dense in calories and are easy to overeat
- Drink water, low-calorie or calorie-free beverages such as fruit juice diluted with seltzer, diet soft drinks, etc.
- For snacks, "liquid foods" such as vegetable cocktails and drinks containing protein, such as those based on milk, are good choices to increase the feeling of fullness.

By Elizabeth Quinn, MS(Sport Science), About.com
Updated: October 26, 2008