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10/6/2019 4 Comments

Dance Training, Exercise and Nutrition During Pregnancy

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Photo credit: Pacific Northwest Ballet
During pregnancy, a woman’s body will change more in nine months than it’s likely to change during any other life stage. Because of these changes, pregnant women are generally encouraged to rest and enjoy “eating for two”. For dancers, taking it easy is not always ideal or even possible. Pre-professional and professional dancers often continue to train until their due date and will return back to the studio soon after delivery. What does training while pregnant involve?  Will dancing while pregnant harm an unborn child?

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4 Comments

8/8/2019 1 Comment

The Vegan Diet - Benefits & Concerns

Research indicates that a vegetarian diet does not negatively impact athletic performance. On the contrary, an energy restrictive and nutrient poor diet leads to a variety of deficiencies that diminish health and impede dance training. Is a vegan diet guaranteed to make you healthier and give you more energy? Not necessarily. A plate of fries may be free of animal products, but offers zero nutrients and contains hydrogenated oils. The effect of a vegan diet is also influenced by your training, lifestyle habits, and body weight. 

Benefits of a vegan diet include: 
  • Plant sources of protein contain antioxidants and are lower in fat
  • Carbohydrates from plant sources optimize muscle glycogen
  • Plant carb intake also provides polyphenols, tannins, phytate and fiber
  • Reduced risk of obesity, diabetes, and heart disease (Melina et al., 2016)

Concerns about a vegan diet include:
  • Lack of key nutrients - calories, protein, fat, vitamin B12 and calcium: For most vegan foods, you need to eat larger volumes in order to get the same amount of calories. For example, you would have to eat 35 cups of green beans to get the same number of calories in a pound of hamburger meat. Dancers burn more calories than the average person so they need to fuel adequately - eat more, not less. By eating calorie-dense foods, like avocados and dried fruit, your energy needs can be met. It is also crucial to eat something starchy at every meal such as whole-wheat varieties of cereal, pasta, bread, rice or potatoes. Nuts and seeds are also excellent options for snacking.
    • ​Vitamin B12 only exists in animal products (IOM, 1999). Animals obtain vitamin B12 by eating foods that are covered in bacteria or from the bacteria that already line their own guts. One study showed that over 85% of vegans were B12 deficient. This is alarming, considering the role of B12 in nerve function and neurological function. Over time, deficiency can cause severe anemia and paralysis (Pawlak et al., 2014).  Solution: The daily requirement for adults is 2.4 micrograms of B12 per day. Eat fortified foods two or three times a day to get at least three micrograms (mcg or µg) of B12 a day. As an alternative, take one B12 supplement daily providing at least 10 micrograms or a 2000-mg B12 supplement weekly.
    • ​Dancers are prone to stress fractures, so bone-building calcium is especially important. It is true that there are plant sources of calcium,but in limited amounts that are a fraction as absorbable as the equivalent of calcium. Solution: females ages 9 to 18 should aim for 1,300 mg of calcium a day from sources like tofu fortified with calcium, kale, broccoli and calcium-fortified soy foods or cereals. A calcium supplement with magnesium may also be helpful if you are concerned about your intake.
  • Protein from plant sources is not as complete as animal sources, This means that individual plants do not provide all the essential amino acids needed by your body. Examples of appropriate protein combinations include a peanut butter sandwich on whole-grain bread, brown rice and black beans, or lentils and barley.
    • Because animal and soy products are complete proteins, they can be consumed with any grain, legume, or nut/seed. Quinoa also happens to be a complete protein, although it has fewer grams of protein per serving compared to animal products.
  • Not having enough fat in your diet can lead to inadequate body fat, which can influence your hormones and  menstrual cycle. Vegans have to get the fat elsewhere which can include avocados, nuts, canola oil, or grapeseed oil. 
  • Excess fiber and phytate may interfere with mineral absorption. Green leafy vegetables are a great source of vitamin C and K as well as minerals such as iron and magnesium. Vegetables also contain high amounts of fiber and a substance called phytates. Both bind minerals and hinder their absorption. Include these foods, but be conscious of consuming them too frequently and avoid juices with high concentrations of green vegetables.

To prevent long-term deficiencies, vegan dancers should be especially diligent when preparing and managing food intake and should consider working alongside registered dietitian to ensure their needs are being met.

References:
Melina, V., Craig, W., & Levin, S. (2016). Position of the Academy of Nutrition and Dietetics: vegetarian diets. Journal of the Academy of Nutrition and Dietetics, 116(12), 1970-1980
Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes: Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. Washington, DC: National Academy Press, 1998.
Brown, D. D. (2018). Nutritional Considerations for the Vegetarian and Vegan Dancer. Journal of Dance Medicine & Science, 22(1).


1 Comment

6/20/2019 1 Comment

Navigating Food Choices When Traveling

Traveling to a summer intensive or performing on tour can be exciting and educational, however being away from home presents several challenges related to good nutrition. Many factors may be out of your control, so it is important to be prepared and resourceful as you try to maintain some semblance of your usual routine. Below is some practical advice for nutrition during travel.
  • Check with hotel or schools ahead of time and research menus of restaurants that will be convenient to access during your trip. Options may be limited where you are traveling, but don’t overlook grocery stores or coffee shops that may offer healthy options. Even if your friends choose to stop at Taco Bell after rehearsal, make a trip to the grocery store to purchase prepared fruit cups, peanut butter, whole-grain bread, and rotisserie chicken. Even if it is not a traditional evening meal, oatmeal with almond butter or yogurt with granola are still good options for a satiating and nutritious bedtime snack.
  • If storage and refrigeration are a problem - pack nut butter and crackers, tuna in a pouch, and nuts or seeds. Use an insulated lunch bag to carry cheese sticks, yogurt, and hard-boiled eggs.
  • Make sure to practice food safety to avoid food poisoning, especially if traveling overseas. Don’t eat raw or undercooked meat and eggs or unpasteurized dairy. If the tap water is not safe to drink, use bottled or disinfected water to drink and wash produce.
  • Food establishments may not be open by the time you finish rehearsal or performance for the day. Plan ahead so that you have a hearty snack to eat right after the show as well as something ready to eat when you return. Having a more filling lunch is also appropriate to ensure you have enough energy to get you through the long evening.
Cafeteria-style dining can be convenient and healthy if you make the right choices.
  1. Be aware of all options prior to making selections for a meal.
  2. Choose fruit bowls and use the salad bar.
  3. Inform cafeteria staff if you have allergies.
  4. Allow enough time to pack a lunch if you are to take the cafeteria food to the studio for the day.
  5. ​Just because there is an ice cream machine doesn’t mean you should have ice cream with every meal - but remember it is ok to indulge in an occasional treat!
  6. Make a new friend to sit with at meals.

Have a safe, successful and healthy trip!

1 Comment

4/3/2019 1 Comment

The Female Athlete Triad - Are You At Risk?

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The Female Athlete Triad is a condition that includes three components:
– Low bone density (risk for stress fractures and osteoporosis)
– Disordered eating
– Amenorrhea (no menstrual cycle for three months or more)
(Matzkin et al., 2015).

The consequences of the Female Athlete Triad can be long-term and irreversible, and include stunting of growth, reproductive dysfunction, and osteoporosis. Any female athlete is at risk for this syndrome, but women who participate in dance are more susceptible because of the desired lean aesthetic and rigorous training schedule (Barrack et al., 2014). Peak bone density is achieved between ages 18 to 25 years. Poor nutrition (i.e., insufficient calories, calcium and vitamin D), stress, and intense training lead to hormonal disruption during the peak-forming period. Reduced estrogen production leads to bone resorption, and this can occur despite the fact that load-bearing physical activity such as dance usually improves bone-mineral density. Some female athletes have bone density similar to older postmenopausal women, which is dangerously low. One study reported that 80% of female dancers diagnosed with stress fractures of the second metatarsal started their menstrual period late (O’Malley, 1996). This type of bony injury  requires at least 6-8 weeks to heal and even longer to rehab.

The remedy for Female Athlete Triad requires that energy needs be met consistently, either by modifying diet or reducing exercise. If body fat is inadequate, restoring body weight to a healthy level is the best strategy for normalizing menstrual periods and improving bone health.

References:
  1. Barrack, M. T., Gibbs, J. C., De Souza, M. J., Williams, N. I., Nichols, J. F., Rauh, M. J., & Nattiv, A. (2014). Higher Incidence of Bone Stress Injuries With Increasing Female Athlete Triad–Related Risk Factors: A Prospective Multisite Study of Exercising Girls and Women. The American journal of sports medicine, 42(4), 949-958.
  2. Little, M., Brown, K., Brown, A. F., & Meenan, M. (2017). Dancers' Risk for the Female Athlete Triad, Disordered Eating, and Changes in Triad Knowledge Following Educational Intervention. Journal of the Academy of Nutrition and Dietetics, 117(9), A85.
  3. Matzkin, E., Curry, E. J., & Whitlock, K. (2015). Female athlete triad: past, present, and future. Journal of the American Academy of Orthopaedic Surgeons, 23(7), 424-432.
  4. O’Malley, M., Hamilton, W, Munyak, J., DeFranco, B. (1996). Second Metatarsal Stress Fractures in Dancers. Foot and Ankle International, 17(2): 89-92 ​​
1 Comment

2/3/2019 1 Comment

Preparing for Auditions Part 2 - Fueling with Nutrition

Looking and performing your best for auditions should not involve suffering or engaging in crash diets. Obtaining ideal body composition may require you to be more aware of  the quality and quantity of your food choices as well as the intensity of your training regimen.
Some simple suggestions for staying lean include:
  1. At big feasts, fill half your plate with vegetables dishes and salads, then enjoy reasonable portions of the heavier items.
  2. Skip the creamy cheese sauces, heavy gravies and excess oils or butter.
  3. During breaks from dance training, consider cross-training with moderate-intensity cardiovascular exercise (e.g., brisk walking, elliptical, lap swimming) to maintain stamina and metabolic rate.
Fueling for auditions:
  • Rapid weight loss before an audition is NOT healthy, safe, or helpful
  • Consume adequate calories (~105 calories/pound body weight)  with 65% of calories from carbohydrate during intense training to prevent fatigue
  • Aim for three balanced meals each day; include complex carbs, protein, and unsaturated fat
  • Stay hydrated and replace lost fluid by drinking water
  • If traveling to audition, plan ahead by packing lunch and healthy snacks
    • String cheese and a large apple
    • 24 raw almonds and a banana
    • A cup of skim milk or unsweetened soy milk and an orange
    • A cup of low-fat Greek yogurt with 2 Tbsp ground flaxseed or granola

Remember, don’t be intimidated by other dancers or their bodies - focus on doing your best and shining in areas you excel at! Allow nutrition to help fuel you during the audition season - you need adequate food fuel to provide energy, build strength, and maintain a healthy immune system.
1 Comment

11/30/2018 2 Comments

Healthy Chicken Noodle Soup for Winter Nights

Homemade chicken noodle soup made in the crock pot for a set-it-and-forget-it easy dinner. You can evan prep all the ingredients ahead of time and store them in the freezer to pull out on a day where you forgot to plan dinner. Just make sure you thaw the ingredients before adding it to the slow cooker to prevent it from staying at an unsafe temperature for too long.

8 ounces whole-wheat egg noodles or other whole-wheat noodles
3 pounds bone-in chicken breast, skin removed
2 cups chopped onion
1 cup chopped carrot
1 cup chopped celery
2 sprigs thyme
8 cups low-sodium chicken broth
2 teaspoons kosher salt
2 cups frozen peas
¼ cup chopped fresh dill, plus more for garnish
2 tablespoons lemon juice
  1. Cook noodles according to package directions. Drain and rinse with cold water to cool.
  2. Meanwhile, place chicken, onion, carrot, celery and thyme in a sealable gallon-size freezer bag. Place the cooled noodles in a separate sealable gallon-size freezer bag. Freeze both bags until ready to use. Let the bags defrost in your refrigerator for 1 day before cooking (see Tip).
  3. Combine the chicken mixture, broth and salt in a 6-quart slow cooker (reserve the noodles). Cook on High for 4 hours or Low for 8 hours. Add peas during the last 10 minutes of cooking.
  4. Transfer the chicken to a clean cutting board. When the chicken is cool enough to handle, remove the meat from the bones and shred into bite-size pieces. Stir the chicken into the soup along with the noodles, dill and lemon juice. Garnish with more dill, if desired.
  5. To make ahead: Freeze the prepared bags (Step 1) for up to 3 months. Defrost in the refrigerator for 1 day before cooking (Step 2).​​
2 Comments

11/4/2018 3 Comments

Eating for Immunity

The immune system provides protection from seasonal illness such as the common cold as well as other health problems including arthritis, allergies, abnormal cell development and cancers. Dancers are exposed to physical stress from training, which increases susceptibility to illness. Additionally, working in close proximity with other dancers increases exposure to infection. Nutrition plays an important role in maintaining immune function to protect against infection. Learn how to boost your immunity by including these nutrients in your eating plan.
Proteins form many immune cells and transporters. Try to consume a variety of protein foods including seafood, lean meat, poultry, eggs, beans and peas, soy products and unsalted nuts and seeds.
Vitamin A helps regulate immune function and protects from infections by maintaining healthy tissues in skin, mouth, stomach, intestines and respiratory system. Vitamin A is found in foods such as sweet potatoes, carrots, kale, spinach, red bell peppers, apricots, eggs or foods labeled "vitamin A fortified," such as cereal or dairy foods.
Vitamin E works as an antioxidant to neutralize free radicals.  Include vitamin E in your diet with fortified cereals, sunflower seeds, almonds, vegetable oils (such as sunflower or safflower oil), hazelnuts and peanut butter.
Vitamin C protects stimulates the formation of antibodies, which are necessary to fight infection. Citrus fruits such as oranges, grapefruit and tangerines, red bell pepper, papaya, strawberries, and tomato juice are good sources of vitamin C.
Zinc is critical for wound healing and aids the immune system. This mineral can be found in lean meat, poultry, seafood, milk, whole grain products, beans, seeds and nuts.
Other nutrients, including vitamin B6, folate, selenium, iron, as well as prebiotics and probiotics, may also influence immune response.
References:
Academy of Nutrition and Dietetics (2017). Protect Your Health with Immune-Boosting Nutrition. Retrieved at eatright.org.


3 Comments

10/3/2018 2 Comments

Pre- and Probiotics and Health

Probiotics are beneficial bacteria that exist in our gastrointestinal tract. Prebiotics feed the beneficial bacterial colonies and work synergistically with probiotics. In other words, prebiotics nourish and maintain probiotics, which restores and improves gut health. Probiotic sources include yogurt, kimchi, sauerkraut, miso, tempeh and cultured non-dairy yogurts. Some good sources of prebiotics are bananas, onions, garlic, leeks, asparagus, artichokes, soybeans and whole-wheat foods. Products that combine both are called synbiotics. For best results, try combining pre- and probiotics in your usual diet by enjoying bananas with yogurt or stir-frying asparagus with tempeh.

Are probiotic supplements necessary for everyone? Probably not. In fact, there are risks associated with use of probiotic supplements. These include: systemic infections, metabolic disruption, excessive immune stimulation in compromised individuals, gene transfer, and gastrointestinal side effects (Doron & Syndman, 2015). By consuming regular food sources of probiotics, you can safely maintain the integrity of your gut and avoid disrupting your body's natural microbiome. At a minimum, prebiotics and probiotics are keys for optimal gut health. Research indicates that the gut bacterial environment has implications beyond digestive health. The microbiome may impact weight management and risk of central nervous system diseases (Shreiner et al., 2015). Incorporating health-promoting functional foods, such as foods containing prebiotics and probiotics contributes to a healthier you!

Our registered dietitian, Nasira, can provide more advice on obtaining pre- and probiotics for your specific health needs, especially if you have gut issues or a weakened immune system, Contact her today:
(425) 445-3914 or [email protected].

References:
Doron, S., & Snydman, D. R. (2015). Risk and safety of probiotics. Clinical Infectious Diseases, 60(suppl_2), S129-S134.
​
Shreiner, A. B., Kao, J. Y., & Young, V. B. (2015). The gut microbiome in health and in disease. Current opinion in gastroenterology, 31(1), 69.


2 Comments

7/26/2018 3 Comments

Keep Cool With Nutrient-Dense Summer Fruits

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According to the Center for Disease Control and Prevention, nutrient dense foods are those that provide an average of 10% or more daily value per 100 calories of 17 nutrients, including potassium, protein, fiber, iron and calcium (DiNoia, 2014). While there are several fruits and vegetables that are nutrient dense, there are some in particular that are best in the summertime, because they also happen to be refreshing and help with hydration. Citrus fruits and berries are excellent choices for summer snacking. According to CDC’s nutrient density approach, the healthiest of them all is the strawberry, with a nutrient density score of 17.6 (DiNoia, 2014). According to the FDA, strawberries have more vitamin C than any citrus fruit, and are also rich in potassium and fiber. As an added bonus, strawberries are a good source of flavonoids (Odriozola-Serrano et al., 2008)  group of phytonutrients linked to reduced risk of diabetes, heart disease, and some cancers (Arnoldi, 2004). Strawberries are about 92% water (NNDS, 2016) a proportion similar to that of watermelon; and, because of their electrolyte content, strawberries are an ideal source of hydration on warm days. If you aren’t a fan of eating a portion of plain fresh strawberries, the flavor of strawberries is delicious when sliced pieces are added to your ice water. There are also many healthy summer recipes, both sweet and savory, that contain strawberries, such as the Caprese Salad with Strawberries recipe below.

Refreshing Caprese Salad with Strawberries
2 pounds fresh strawberries, stemmed and halved
2 cups bite-sized fresh mozzarella balls (Bocconcini), drained and halved
2 tablespoons extra virgin olive oil
1/3 cup balsamic vinegar
3-4 fresh basil leaves, finely diced
Salt, pepper to taste
In medium sized bowl, toss strawberries and mozzarella balls with olive oil. Season mixture with salt and pepper. Add basil and toss again. Drizzle balsamic syrup over and around salad. Grind more pepper on top and serve.

References:
Di Noia J. Defining Powerhouse Fruits and Vegetables: A Nutrient Density Approach. Preventing Chronic Disease. 2014;11:E95.
Odriozola-Serrano, I., Soliva-Fortuny, R., & Martín-Belloso, O. (2008). Phenolic acids, flavonoids, vitamin C and antioxidant capacity of strawberry juices processed by high-intensity pulsed electric fields or heat treatments. European Food Research and Technology, 228(2), 239-248.
Arnoldi, A. (Ed.). (2004). Functional foods, cardiovascular disease and diabetes. Elsevier.
National Nutrient Database for Standard Reference, Release 28 slightly revised May, 2016, Software v.2.6.1.


3 Comments

6/4/2018 1 Comment

Adjusting Food Intake for the Off-Season

Rest is essential for recovery and healing. It is a recommended to take a couple weeks off after a summer intensive. Adjustments in food intake should be made during these rest periods.  Typically, one week is not enough time for your metabolic rate to decrease or for lean mass to dissipate significantly. However, durations longer than one week can result in loss of muscle mass and fat gain if you're not supplementing with resistance training and/or adjusting calorie intake. Plan to make small, simple changes to account for the reduced calorie expenditure when you're not dancing. Be careful not to overcompensate with extreme calorie restriction.This is counterproductive and can cause muscle loss, illness, and injury when you begin training again.

What adjustments should be made to diet during the off-season?


  • Continue to practice healthy nutrition habits as recommended during training.
  • Slightly reduce portions of meals and snack sizes. Approximately 250 fewer calories per day are needed if your goal is to maintain your weight during your break. A larger reduction in calorie intake can lead to loss of muscle mass and should be avoided.
  • Be aware of hidden and unhealthy fat in foods like salami, biscuits, pastries, sausage, and other processed meats. Some of these convenience foods that you might eat while training for hours a day become a serious problem when you are sedentary.
  • Increase the proportion of vegetables in your meal and slightly reduce the starch or protein portions. Do NOT cut out entire food groups.
  • Consume at least 2 cups of fruits and 2½ cups of vegetables a day.
  • Don't skip meals and avoid fad diets (e.g., Paleo, detoxes, juicing).
  • ​Drink at least 6 to 8 glasses of water each day. Have no more than 2 to 3 cups of caffeinated drinks a day. Be aware of calories from alcoholic beverages.
​Cross-Training During Off-Season
Rather than restricting calories during vacation or off-season, consider cross-training with cardio and resistance training. Low-impact, moderate-intensity cardio such as swimming or fast walking are excellent options to allow for extra calorie burning and promote muscle retention. Walking at ~3.8 to 4 miles per hour (3 to 4 miles/day) or swimming for 30 minutes at a moderate intensity are good options. Add light resistance training with weights, Pilates, or yoga while on a break from dance in order to maintain flexibility and promote muscle gain.
Enjoy your summer and remember that you deserve a break!
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