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3/26/2020 2 Comments Diet and Infectious Disease - Does what we eat affect our risk of contracting illness?In order to stay healthy, it is crucial that we avoid exposure to disease and practice preventive hygiene like handwashing. Additionally, maintaining a strong immune system is crucial for defending against infection, and nutrition certainly helps support immunity. Amidst the current coronavirus pandemic, many of us may wonder what specific nutrients play a role in fighting a disease like COVID-19. Research is limited on natural remedies specifically for coronavirus, but there is information indicating positive effects of various vitamins and minerals on preventing or treating infectious illnesses.
Vitamin D is found in dairy products, egg yolks, and fatty fish, like salmon. However, the best source of vitamin D is exposure to sunlight - just 10 to 15 minutes of sunshine on the arms and legs each week can generate enough vitamin D to meet most adults’ needs. For individuals living in Northern parts of the world, sun exposure may not be adequate to synthesize enough vitamin D, so a vitamin D supplement may be appropriate to maintain optimal health. Research demonstrates that in people who are vitamin D deficient, adding a moderate vitamin D supplement may reduce the risk of respiratory infection (1). N-Acetyl Cysteine (NAC) is the supplemental form of cysteine, an amino acid found in protein-rich foods like pork. NAC is needed to regenerate glutathione, an important antioxidant that serves to prevent cellular damage. A clinical study demonstrated that twice daily supplementation with NAC reduced symptoms in people with the flu (2). Polyphenol compounds are found in a variety of plant foods and are especially rich in deeply pigmented fruits, such as elderberries. Black elder has been used for centuries as a treatment for viruses and is one of the most popular medicinal plants worldwide. Some preliminary research suggests that elderberry extract may reduce the duration of the flu. Vitamin C is necessary for white blood cell function and enhances iron absorption. Iron deficiency is common among women and dancers, and inadequate levels can increase susceptibility to infections. While adequate vitamin C intake is important for immune function, mega-doses can lead to adverse side effects, such as upset stomach, diarrhea, and interference with medications. Rather than supplementing vitamin C, consider a food-first approach by including several servings per day of fruits and vegetables. Foods rich in vitamin C include kiwi, citrus, bell peppers, berries, strawberries and Brussel’s sprouts. Zinc has anti-viral properties and certain zinc supplements have been shown to reduce the severity and duration of colds (3). Laboratory studies suggest increasing intracellular zinc concentration can impair the replication of a variety of viruses, including influenza and SARS-CoV. Zinc may not prevent infection entirely, but adequate intake certainly supports immune function. Keep in mind that excessive supplementation with zinc may interfere with copper absorption, so limit use of zinc lozenges to once a week. Natural sources of zinc include legumes, nuts, whole grains, seeds, meat and shellfish. For more information about COVID-19, check out the Centers for Disease Control and the World Health Organization’s Myth Busters.
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Inflammation is the body’s normal response to promote healing when the body is fighting infection related to injury, wounds, allergens, toxins, or infection. Typical signs of inflammation include swelling, pain, and redness. In contrast, signs of inflammation may not be apparent with chronic inflammation. Chronic inflammation is typically caused by excess body fat or immune dysfunction. While acute inflammation promotes healing, chronic inflammation can result in DNA damage and increase cancer risk.
Despite the numerous “anti-inflammatory diets” promoted online, research is barely emerging in regards to diet and inflammation. So far, scientific studies indicate that consuming a variety of nutritious foods may help reduce inflammation and keep chronic inflammation at bay. Foods that enhance immune function are also important in fighting inflammation. Here is what we know thus far about foods and inflammation:
Tips for reducing inflammation:
In addition to a healthy diet, inflammation can be reduced by getting adequate sleep, remaining physically active most days of the week, and maintaining a healthy weight. Dancers train vigorously and encounter intense competition when trying to achieve peak potential. In an attempt to excel, it is tempting to experiment with dietary supplements. Although these supplements claim to improve strength, weight management, and agility, most do not live up to their claims.
Although the U.S. Food and Drug Administration regulates dietary supplements, the process is different than the regulation of drugs and conventional foods. Manufacturers are responsible for ensuring their products are reasonably safe and not misleading, but are not required to show evidence of supplement effectiveness prior to marketing or sale. Organizations such as the US Pharmacopeia or NSF International test supplements for purity Looking for their label on a supplement indicates at least some standards have been met. Nontheless, evidence is usually lacking or conflicting, supplements are expensive, and side effects are common. As an alternative, a balanced diet can provide the nutrients you need for overall health and peak performance. Foods can provide many of the substances found in popular supplements, for example: Creatine - produced naturally in our muscles for energy production and also found in fish and meat. Creatine supplements are taken to increase exercise intensity and improve strength and muscle gains. Results tend to vary greatly depending on the study and particular athletic event. Branched-Chain Amino Acids (BCAAs) - leucine, isoleucine, and valine are amino acids found in protein-rich foods. BCAAs are often taken to delay fatigue and boost muscle growth, but studies are inconclusive regarding the effectiveness of taking BCAA supplements for performance. Fish, chicken, eggs, tofu and dairy are great sources of BCAAs. Chromium Picolinate - a supplement used for weight loss or muscle building and a naturally occurring mineral found in fruits and vegetables, and whole grains. Supplement doses may cause oxidative damage and can potentially interfere with iron functions in the body. Include sources of the mineral in the diet, but supplementation is not recommended. Collagen and Bone Broth - collagen is a protein needed for rebuilding bone, skin, and connective tissue. It is present in many high-protein foods that are also rich in minerals and contribute flavor and satisfaction to meals. Collagen and bone broth may be useful when solid foods are being avoided due to surgery or illness, but are not necessarily more nutritious than high protein whole foods. It is also important to note that bone broth and collagen water can be high in sodium, so if using for a soup or stew, opt for a low-sodium broth or stock. You will still obtain the protein and nutrients without consuming excessive sodium, which can contribute to dehydration and high blood pressure. While supplement companies may provide interesting information about their products, it's best to take a balanced approach and review unbiased sources as well. You can find reliable information about dietary supplements from trusted online resources, such as the National Institute of Health’s Office of Dietary Supplements. For more information, consult a registered dietitian to assess your individual needs.  Once a dancer is cleared to begin pointe work, they must find the most appropriate pointe shoe. Locating an experienced pointe shoe fitter is essential. Josephine Lee is the founder of ThePointeShop and is a former dancer and highly experienced pointe shoe fitter. Here are some of the tips she offers to the novice pointe student:
Should pointe work hurt? Pointe work is not comfortable but it should not be so painful that you would want to quit. If it is, the dancer may need to get reassessed to look at the fit of the shoe and/or address any technical faults. Will I always stick with the same shoe type? The shoes you start with will typically be different than shoes you wear as you reach a more experienced level. Some dancers stick with the same shoes throughout their career but it is more common to see them switching shoes especially when you are starting out. How often do I need to get re-fitted? For the first couple years you are en pointe, it is recommended that a dancer gets re-fitted every time they need new shoes. Once you become a bit more experienced and are reordering shoes more frequently, you can just get reassessed every year or whenever you are experiencing issues. Why can’t I get over the box? This can be attributed to the wrong box shape, incorrect vamp length, incorrect shank hardness, foot/ankle weakness, or lack of range of motion in the foot/ankle. Why is my foot unstable en pointe? It could be due to the box being too tapered or narrow, or a shank that is too soft or hard. A tapered box results in a more narrow base of support, making it difficult to balance. A shoe that is too soft may not give enough support while a shoe that is too hard may be too difficult to control. Do stronger feet need a harder shank? Stronger feet don’t usually require a hard shank. What type/how much padding do I need? Less is more. Less padding creates better control for foot articulation and balance. The purpose of padding is to fill in the spaces of the shoe so that your foot fits the shoe better. Do soft shoes die faster? Not necessarily. Sometimes hard shoes may snap and die faster. Having poor muscle/motor control will cause a shoe to break in faster. On the other hand, if the shoes are too soft, the shank may bend under the weight easier. How do I get my pointe shoes to last? Moisture kills the shoe, so keep the shoe dry! It takes 36 hours for a pointe shoe to die and it is recommended to rotate shoes. Using jet glue and carrying the shoes in a mesh bag outside of the dance bag will help reduce excess moisture. Why does my foot sickle when I go en pointe? This could be a result of the shoe being too tapered, incorrect shank hardness, pain in the big toe, or the shoes may be the wrong width. What is the best time of day to get fitted? It depends on how the dancer’s foot responds to dancing. Some feet shrink after dancing, and others will swell. It is very individualized. 12/3/2019 1 Comment Finding the Right Pointe Shoe With a vast number of various pointe shoes and styles, finding the right balance between shoe flexibility, correct fit, and support can be challenging. The shoes must have enough movement to allow the dancer to get fully onto the toe box in order achieve full plantar flexion. They must also have adequate support to allow the dancer to put full weight through the tips of the toes without collapsing. Without adequate support, the dancer will place excess load on the muscles, ligaments, and joints of the foot/ankle.
Since pointe shoes have poor shock absorption, dancers must rely on good core stability and lower body strength to reduce the impact on the foot/ankle. Poor technique, fatigue, and improper fitting pointe shoes can increase the risk for injury. For example, the vamp of the shoe must match the foot shape. If the vamp is too low, the foot spills out of the shoe and loses stability. This can increase the risk for fracture at the midfoot or second metatarsal. If the vamp is too high, the dancer won’t be able to point the foot. Improper length of a pointe shoe can result in adverse consequences for a dancer: excess length of a shoe leads to instability and a short-fitting shoe can cause compression of the toes. The vamp/platform of the shoe loses its stability when the shoes have excess wear and tear, and dancing on dead shoes can increase the risk of stress fractures, ankle sprains, metatarsal/tarsometatarsal sprains, Achilles tendinitis, Flexor Hallucis Longus tendinitis, and injuries to the knees, hips, and spine. Next month’s post will feature Josephine from The Pointe Shop. She will provide more tips on finding the right pointe shoe. References: 1) “Principles of Dance Medicine, Functional Tests to Assess Pointe Readiness.” A webinar through the Harkness Center for Dance Injuries. Accessed Feb 23, 2017. 2)Shah S. Determining a Young Dancer’s Readiness for Dancing on Pointe. Curr. Sports Med. Rep., Vol 8, No. 6, pp. 295-299, 2009. 3) “Matching the shoe to the dancer.” A webinar through the Harkness Center for Dance Injuries. Accessed Nov 20, 2019. The autumn season is upon us, bringing cooler temperatures, holiday traditions, and countless hours of Nutcracker rehearsal. For dancers, this time of year can be busier than ever, contributing to fatigue and susceptibility to illness. Good nutrition is especially important in the months ahead to keep you healthy through the season. We hope an easy and nourishing recipe idea will help - this complete meal can be prepared ahead, is portable, and delicious. Ingredients:
  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?
Dancers are known for their extreme flexibility and they often prioritize flexibility over strength. Forcing flexibility in the adolescent or hypermobile dancer can have detrimental effects to developing structures. When we move beyond normal range of motion, the joint becomes less stable and the surrounding structures become compromised. It is essential to establish dynamic lumbo-pelvic stability and hip control at a young age to support flexibility gains and ensure proportional improvements in strength.
Risks of over-stretching in splits (Howell, L):
Signs that you may be stretching incorrectly:
It is important to establish appropriate goals and determine what structures could be responsible for decreased flexibility in splits or developpe. Poor range in splitsmay actually be due to a lack of neural or fascial mobility versus muscle extensibility. If this is the case, gentle dynamic stretching will be more effective thanprolonged static holds. In terms of developpe, limited height is often a result of poor lumbo-pelvic strength/stability and hip control required to hold full range against gravity. Thus a stability program should be implemented. It is important to seek out a qualified healthcare professional to help with safe mobility gains and establish a program to achieve optimal mobility and stability. References: Howell, L. (n.d.). Is Over Stretching Bad? Retrieved from https://www.theballetblog.com/portfolio/is-over-stretching-bad/ Mitchell, R. J., Gerrie, B. J., McCulloch, P. C., Murphy, A. J., Varner, K. E., Lintner, D. M., & Harris, J. D. (2016). Radiographic evidence of hip microinstability in elite ballet. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 32(6), 1038-1044. 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:
Concerns about a vegan diet include:
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).  Cardiovascular demand during dance performances and rehearsals is much greater than during dance classes. Because of the low requirement during technique classes, many dancers lack adequate aerobic power. Therefore, supplementary cardiovascular training is needed to improve aerobic capacity and reduce the risk of injury during performances. High-intensity interval training, which involves short bursts of intermittent exercise, is recommended to meet the strain of performance (Wyon et al, 2005). The goal is to get your heart rate to a maximum level, and then recover quickly (Howell, L, 2019).
Designing a cardiovascular program:
Benefits of cardiovascular training:
Regardless of your dance goals, incorporating cardiovascular training can have lasting benefits for health and overall fitness level. References:
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