Eating Well After a Stroke

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Eating well after a stroke is key to recovery. Choosing healthy foods can help control blood pressure, body weight, reduce a persons risk of having another stroke, and may help with the demands of stroke therapy and other daily activities. Preventing another stroke and staying healthy can be achieved when you take appropriate steps to control your weight and blood pressure. Making healthy food choices is a major step in the right direction, and you can enhance the impact diet plays in your risk by meeting with a registered dietitian. A dietitian can teach you how to prepare and plan meals and snacks to enhance your health.

This educational tool is provided to get you started on the road to recovery. No two people have the same results; therefore, incorporate these healthy eating strategies with frequent check-ups with your physician and proper administration of prescribed medications.

Food groups within MyPyramid

Grains: Make sure at least half of your choices from this group come from whole grains. Vegetables: Choose often nutrient-rich dark green and orange vegetables and remember to regularly eat dried beans and peas. Fruits: Eat a variety of fresh, frozen or dried fruits each day. Dairy: Choose low-fat or fat-free dairy foods, or a variety of non-dairy calcium-rich foods each day. Protein: Choose low-fat or lean meats, poultry; and remember to vary your choices with more beans, peas, nuts, seeds and fish sources. In terms of fats, make most of your fat sources from fish, nuts and vegetable oils. Limit fat sources from butter, stick margarine, shortening or lard. For more information on MyPyramid, visit the USDAs interactive website at www.mypyramid.gov

Eight strategies to reduce your risk of a stroke

Eat a variety of foods each day
Because no single food can provide our bodies with all of the nutrients we need for good health, choose a variety of foods each day. Incorporating a variety of foods as suggested by the MyPyramid Food Guide Pyramid is a great way to get started.

Eat a rainbow of colorful foods at each meal

In order to reap the health-protective nutrients found in fruits and vegetables, its important to choose a variety of colorful foods at each meal. Go for a rainbow approach by choosing an array of fruits, vegetables and legumes dark reds, oranges, vibrant yellows, deep greens, blues and purples. By choosing a rainbow of color youll be sure to take in a wide range o f nutrients.

Choose 5 or more servings of fruits and vegetables each day

Research shows that the best way to reap the benefits of a healthy diet is to bump up your fruits and vegetables. So, in addition to steps 1 and 2, make sure you eat a minimum of 5 servings each day. One serving of vegetable is equal to:

1 cup raw or leafy vegetable cup cooked vegetables 6 ounces vegetable juice One serving of fruit is equal to: 1 medium sized (tennis ball size) piece of fruit 1 4-inch banana cup fruit cocktail, in own juice grapefruit 1 cup diced melon or berries 2 Tbsp dried fruit 4 ounces 100% fruit juice

Reading food labels

Reading food labels is a great way to learn more about the foods you are eating. By law, most foods must have nutritional information listed in a standard way. When selecting foods for reducing your risk of stroke, focus on the following information on the food label for each serving:

Calories Total fat Saturated fat Trans fat Cholesterol Sodium Dietary fiber Once you get used to reading food labels, youll become a healthier shopper.

Limit your intake of saturated and trans fat and cholesterol

Cholesterol is a fatty, waxy substance made by your body and found in foods of animal origin. Your body needs cholesterol to maintain the health of your bodys cells. However, too much cholesterol in your blood can increase your risk of stroke and heart disease. High levels of blood cholesterol are the result of two factors: how much cholesterol your body makes, and how much fat and cholesterol are in the food you eat. Diets high in saturated fats are linked to high cholesterol and an increased risk of cardiovascular disease. Saturated fats tend to be solid at room temperature and are found in animal products like meat, cheese, egg yolks, butter, and ice cream, and some vegetable oils (palm, palm kernel and coconut). Limiting the amount of saturated fat you eat from these foods is key to stroke prevention. To cut the saturated fat in your diet, make the following substitutions: Instead of Butter Regular cheese Creamer or half & half Whole or 2% milk Choose Light or diet margarine Low-fat or nonfat cheese Nonfat creamer or nonfat half & half 1% or nonfat (skim) milk

Instead of Cream cheese Regular ice cream 2-4% milk fat cottage cheese Alfredo or other cream sauces Mayonnaise Prime grades of beef Spareribs Chicken with skin on Whole egg

Choose Reduced fat or nonfat cream cheese Nonfat or low-fat frozen yogurt or sorbet 1% or nonfat cottage cheese Marinara, primavera or olive-oil based sauce Light or nonfat mayonnaise Choice or Select grades of beef Tenderloin Chicken without skin Egg whites or egg substitutes

Diets high in trans fats are also associated with high cholesterol and increased risk of cardiovascular disease. Trans fats are formed when an unsaturated vegetable oil is turned into a more saturated one through a process called hydrogenation. Food products that contain partially hydrogenated vegetable oils should be avoided. Trans fats are found in:

Anything made with partially hydrogenated fats (e.g., many processed foods including cookies, crackers, fried snacks and baked goods) Stick margarine Vegetable shortening Most fried foods Choose the following substitutions to limit the trans fat in your diet. Look for foods that are labeled trans fat free or those that use liquid vegetable oils instead of hydrogenated ones in their ingredients. Instead of Stick margarine Deep fried foods Crackers made with hydrogenated oil Granola bars made with partially hydrogenated oil Energy bars dipped in frosting or chocolate Powdered creamers containing hydrogenated oils Choose Trans-free margarine or liquid margarine Baked, grilled or broiled foods Baked crackers or crackers made with vegetable oil Granola bars containing canola or other liquid oil Plain, non-coated energy bars Nonfat half & half, skim milk

Limiting cholesterol in foods is another important step to cholesterol control and stroke management, and can be achieved by:

Trimming visible fat from meats and removing the skin from poultry Cutting back on how frequently you eat meats, poultry and other animal-derived foods Limiting your portion size of meat to no more than 3 ounces at a sitting (size of a deck of cards)

Limiting butter Eliminating lard Choosing nonfat or low-fat dairy foods

Trim the sodium in your diet

Most Americans eat much more sodium than they need. Eating too much sodium may cause you to retain fluids and increase your blood pressure. Not adding salt to foods at the table is one way to cut down on your sodium, but it isnt enough. Cut down on sodium by following these tips:

Substitute herbs and spices for table salt. Table salt is one of the largest sources of sodium in our diet. Instead of using salt, try using herbs and spices. Avoid mixed seasonings and spice blends that include salt or garlic salt. Use fewer processed and canned foods. In addition to adding flavor, sodium is also used to preserve foods. In fact, the more the food is processed, the higher its sodium content. To cut your sodium intake, limit convenience foods such as canned and instant soups or vegetables, canned meats, frozen entrees, frozen side dishes with sauce packets, instant cereal and puddings, gravy and sauce mixes, and quick cooking boxed mixes for rice, pasta and potatoes. Low-sodium canned soups may be used. Think fresh. Use fresh ingredients when possible and foods with no salt added. Select frozen entrees that contain 600 milligrams or less of sodium. Limit to one of these per day. Check the package label for sodium content. Choose snack foods wisely. Most snack foods like potato chips, peanuts, pretzels and crackers are high in sodium. Choose low or reduced sodium versions of snack foods or eat more natural snacks like plain popcorn, vegetables or fruit. Read medication labels. Although not a significant source of sodium in your diet, read cold, headache, and stomach medication labels. Many contain sodium in the ingredients. Understanding the sodium content in foods Low-sodium: the food contains 140 mg or less sodium per serving. Very low sodium: The food contains 35 mg or less of sodium per serving. Reduced sodium: The food has 25% less sodium than the comparable food product. Light or Lite in sodium: The food has at least 50% less sodium than the comparable food product. No salt added: No salt was added in the processing of the food product. However, naturally-occurring sodium may be present in the ingredients.

How much sodium should you consume each day?

Most health professionals limit persons with a history of heart disease or stroke to 2,000 milligrams each day. However, if you have high blood pressure, it is strongly recommended that you limit your sodium to 1,500 milligrams daily. Talk with your doctor to determine what your sodium level should be.

Choose foods high in fiber

As part of a heart-healthy diet, fiber can reduce cholesterol and your overall risk for cardiovascular disease. Dietary fiber is the part of plants the body cannot digest. As it passes through your body it affects the way your body digests foods and absorbs nutrients. How much fiber you eat affects not only your cholesterol level and risk for stroke, but may have other health benefits: helps control blood sugar, promotes regularity, prevents gastrointestinal disease and helps in weight management. Most of us fall short of the recommended daily fiber guidelines

38 grams for men 50 and under 25 grams for women 50 and under 30 grams for men over 50 21 grams for women over 50

How to get more fiber in your diet

Start the day off right with whole grain cereal or whole grain toast (if your cholesterol is high, choose oatmeal or oat bran cereal or toast). Instead of fruit juice, have a whole piece of fruit. For a fiber-packed lunch toss cup garbanzo beans into a dark leafy green salad. Choose whole grain buns, bagels, English muffins, crackers and bread instead of enriched or white varieties. Purchase whole-wheat pasta and brown rice instead of enriched or white varieties. Top yogurt or cottage cheese with fresh fruit or nuts.

Give zest to broth soup by adding veggies, dried beans or barley. Substitute brown rice for white. Grab fruit, veggies, a granola bar or trail mix for a change-of-pace healthy snack. The best sources of dietary fiber are raw or cooked fruits and vegetables, whole-grain products, and legumes (e.g., dried beans, lentils, split peas). Refined foods like soda, fruit juice, white bread and pasta and enriched cereals are low in dietary fiber. The refining process strips the outer coat (called the bran) from the grain, lowering the fiber content. Substituting enriched, white pasta and rice and other refined foods with whole-grain varieties is a great way to boost dietary fiber intake and help to prevent blood sugar fluctuations throughout the day. This, in turn, helps keep you feeling satisfied and can help prevent sudden cravings for sweets or other quick-sugar foods later in the day. The end result: weight control.

Maintain or achieve a healthy body weight

Another important strategy to reducing your risk of a stroke is to achieve a healthy body weight. Watching your portion sizes, eating foods high in fiber and low in fat, avoiding fad diets, increasing your activity, and keeping track of your eating habits are all ways to achieve a healthy body weight. Keep in mind weight loss does not happen overnight, so establish realistic short and long-term goals from the start.

References

Diabetic diet

Display showing refined, high fat/carbohydrate foods, which are generally discouraged for diabetics

Diabetic diet refers to the diet that is recommended for sufferers of diabetes mellitus. There is much controversy regarding what that diet should consist of. The diet most often recommended is high in dietary fiber, especially soluble fiber, but low in fat (especially saturated fat) and low in sugar. Recommendations of the fraction of total calories to be obtained from carbohydrate are generally in the range of 40 to 65%, but recommendations can vary as widely as from 16 to 75% .[1] Diabetics may be encouraged to reduce their intake of carbohydrates that have a high glycemic index (GI), although this is also controversial.[2] (In cases ofhypoglycemia, they are advised to have food or drink that can raise blood glucose quickly, such as lucozade, followed by a long-acting carbohydrate (such as rye bread) to prevent risk of further hypoglycemia.) However, others question the usefulness of the glycemic index and recommend high-GI foods like potatoes and rice. It has been claimed that oleic acid has a slight advantage over linoleic acid in reducing plasma glucose.[3]

Carbohydrates[edit]
The American Diabetes Association in 1994 recommended that 6070% of caloric intake should be in the form of carbohydrates. As mentioned above, this is controversial, with some researchers claiming that 40% [11] or even less is better, while others claim benefits for a high-fiber, 75% carbohydrate diet.[12] An article summarizing the view of the American Diabetes Association[13] contains the statement: "Sucrosecontaining foods can be substituted for other carbohydrates in the meal plan or, if added to the meal plan, covered with insulin or other glucose-lowering medications. Care should be taken to avoid excess energy intake." Sucrose does not increase glycemia more than the same number of calories taken as starch. It is not recommended to use fructose as a sweetener. Benefits may be obtained by consumption of dietary fibre in conjunction with carbohydrate; as Francis (1987) points out, evidence suggests that carbohydrate consumed with dietary fiber will have a less major impact on glycemic rise than the same amount of carbohydrate consumed alone. What has not generally been included in diabetic diet recommendations is the variation in effect from different carbohydrates. It has been recommended that carbohydrates for diabetics should be complex carbohydrates. Despite a common belief that table sugar contributes to the development of diabetes, it has medium (55 69) glycemic index that actually produces lower blood glucose levels than the same number of calories

obtained from some other sources of carbohydrates. The Canadian Diabetes Association recommended that table sugar be included as part of the diabetes diet.[14] Some studies have suggested that adding vinegar to food may help to prevent carbohydrates putting up blood sugar too dramatically.[15]

Low-carbohydrate alternatives[edit]
Some studies show that a low-carbohydrate diet or low GI diet may be effective in dietary management of type 2 diabetes, as both approaches prevent blood sugars from spiking after eating. [16][17] Dr. Richard K. Bernstein is critical of the standard American Diabetes Association diet plan. His plan includes very limited carbohydrate intake (30 grams per day) along with frequent blood glucose monitoring, regular strenuous muscle-building exercise, and, for diabetics using insulin, frequent small insulin injections if needed. His treatment target is "near normal blood sugars" all the time.[18] Another critic of the ADA program is futurologist and transhumanist Ray Kurzweil, who together with Dr Terry Grossman co-authoredFantastic Voyage: Live Long Enough to Live Forever (published 2004). They describe the ADA guidelines as "completely ineffective". Their observations are that the condition, particularly in its early stages can be controlled through a diet which has sharply reduced carbohydrate consumption. Their guidelines for patients with type 2 diabetes is a diet that includes a reduction of carbohydrates to one sixth of total caloric intake and elimination of high glycemic load carbohydrates. As a previously diagnosed diabetic who no longer has symptoms of the disease, Kurzweil is a firm advocate of this approach. However, Kurzweil's prescription changed somewhat between his 1993 book The 10% Solution for a Healthy Life in which he recommended that only 10% of calories should come from fat, andFantastic Voyage which recommends 25%.

Vegan/vegetarian[edit]
Based on the evidence that the incidence of diabetes is lower in vegetarians, some studies have investigated veganinterventions.[19][20][21] These studies have shown that a vegan diet may be effective in managing type 2 diabetes.[22][23] Switching diabetics to a vegan diet lowered hemoglobin A1C and LDL levels.[22] A vegan diet may improve blood filterability.[24] Vegan diets may lower advanced glycation endproducts.[25] Diabetes U.K. state that diabetes should not prevent people from going vegetarian in fact, it may be beneficial to diabetics to go vegetarian, as this will cut down on saturated fats. Recent evidence suggests that diabetics may benefit from as many as eight portions of fruit and vegetable a day.[citation needed] Due to their high levels of dietary fibre certain foods are considered particularly beneficial for diabetics such as legumes, nuts, fruits, and vegetables.[26]

Timing of meals[edit]
For people with diabetes, healthy eating is not simply a matter of "what one eats", but also when one eats. The question of how long before a meal one should inject insulin is asked in Sons ken, Fox and Judd (1998). The answer is that it depends upon the type of insulin one takes and whether it is long, medium or quick-acting insulin. If patients check their blood glucose at bedtime and find that it is low, for example below 6 millimoles per Liter (108 mg/dL), it is advisable that they take some long-acting carbohydrate before retiring to bed to prevent night-time hypoglycemia.

Special diabetes products[edit]

Recently, Diabetes UK have warned against purchase of products that are specially made for people with diabetes, on the grounds that:[27]

They may be expensive, They may contain high levels of fat They may confer no special benefits to people who suffer from diabetes.

It should also be noted that NICE, the National Institute for Health and Clinical Evidence (based in the United Kingdom), advises doctors and other health professionals to "Discourage the use of foods marketed specifically for people with diabetes".[28] Research has shown the Maitake mushroom (Grifola frondosa) has a hypoglycemic effect, and may be beneficial for the management of diabetes.[29][30][31][32][33][34] The reason Maitake lowers blood sugar is because the mushroom naturally acts as an alpha glucosidase inhibitor.[35] Other mushrooms like Reishi,[36][37] Agaricus blazei,[38][39][40][41] Agrocybe cylindracea[42] andCordyceps[43][44][45][46][47] have been noted to lower blood sugar levels to a certain extent, although the mechanism is currently unknown.

Alcohol and drugs[edit]

Moderation is advised with regard to consuming alcohol and the use of some drugs. Alcohol inhibits glycogenesis in the liver and some drugs inhibit hunger symptoms. This, together with impaired judgment, memory and concentration caused by some drugs can lead tohypoglycemia. Diabetics who take insulin or tablets such as sulphonylureas should not, therefore, ever consume alcohol on an empty stomach, but take some starchy food (such as bread or potato crisps) at the same time as consumption of alcohol.[citation
needed]

Specific diets[edit]
The Pritikin Diet consists of fruit, vegetables, whole grains, and so on, and is high in carbohydrates and roughage. The diet is accompanied by exercise.

G.I. Diet lowering the glycemic index of one's diet can improve the control of diabetes.[48][49] This includes avoidance of such foods as potatoes cooked in certain ways, and white bread, and instead favoring multi-grain and sourdough breads, legumes and whole grainsfoods that are converted more slowly to glucose in the bloodstream. Low Carb Diet It has been suggested that the gradual removal of carbohydrates from the diet and replacement with fatty foods such as nuts, seeds, meats, fish, oils, eggs, avocados, olives, and vegetables may help reverse diabetes. Fats would become the primary calorie source for the body, and complications due to insulin resistance would be minimized.[18] High fiber diet It has been shown that a high fiber diet works better than the diet recommended by the American Diabetes Associationin controlling diabetes, and may control blood sugar levels with the same efficacy as oral diabetes drugs.[50][51][52] Paleolithic diet The Paleolithic diet has been shown to improve glucose tolerance in humans with diabetes type 2,[53] humans withischemic heart disease and glucose intolerance,[54] and in healthy pigs.[55] These are a limited number of studies in a limited number of subjects, but the knowledge about the benefits of the Paleolithic diet in diabetes is emerging. The scientific foundation for the Paleolithic diet and the relationship between what humans eat and diseases of the western world (including diabetes, hypertension,obesity, ischemic heart disease, stroke) is the subject of a comprehensive textbook, which is geared towards both professionals and interested laypeople alike, and which spans over 2000 references.[56] Vegan diet A low-fat vegan diet improves glycemic control similar to the ADA diet.[23]

Diabetes Diet Chart

In India 4.5 million people are victims of diabetes. The main reason is irregular meal, mental stress, lack of exercise. Diabetes disease related to metabolic, in which oxidation of carbohydrates and glucose is not fully detected. The role of diet in diabetes Meal of diabetic patient is depending on calories. Which decides on its age, weight, gender, height, working etc. Depending on each persons different different dietary chart is created. We must take special care of time and amount of food in diabetes. Here we are giving diet chart for general diabetes patient. Diabetes Diet Chart Morning at 6: teaspoon fenugreek powder + water. Morning at 7: 1 cup sugar free tea + 1-2 mary biscuits. Morning at 8.30: 1 plate upma or oatmeal + half bowl sprouted grains + 100ml cream-free milk without sugar Morning at 10.30: 1 small fruit or 1 cup thin and sugar free buttermilk or lemon water Lunch at 1: 2 roti of mixed flour, 1 bowl rice, 1 bowl pulse, 1 bowl yogurt, half cup soybean or cheese vegetable, half bowl green vegetable, one plate salad 4 pm: 1 cup tea without sugar + 1-2 less sugar biscuits or toast 6 pm: 1 cup soup 8.30 pm: 2 roti of mixed flour, 1 bowl rice, 1 bowl pulse, half bowl green vegetable, one plate salad 10.30 pm: Take 1 cup cream -free milk without sugar. When you feel hungry intake raw vegetables, salad, black tea, soups, thin buttermilk, lemon water. Avoid it: molasses, sugar, honey, sweets, dry fruits. Advice for diabetes patient:

35-40 minute faster walk every day. Diabetic person should eat food between times intervals like take breakfast in morning, lunch, some snakes and dinner. Avoid oily food.

Intake more fiber foods in meals. It increases glucose level gradually in blood and keeps control. Do not take fast and also dont go much party. Diabetic person should eat food slowly.

DIET FOR A 60-YEAR OLD WOMAN

Diet plays a key role in maintaining the overall health of a sixty year-old woman. By the age of 60, most women have completed menopause, and may notice significant changes in their bodies, including weight gain and a reduced metabolism. By maintaining a healthy diet and exercising regularly, you can keep yourself healthy and help battle several diseases and health problems that come with getting older.

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POSTMENOPAUSE AND HEALTH

Most women finish going through menopause by the age of 60.You know you have completed menopause when you have completely stopped menstruating for more than 12 months. After menopause, your estrogen production drops by 40 to 60 percent, and her body almost completely stops producing progesterone. Due to these dramatic decreases in hormone levels, a 60-year-old woman experiences changes in her body, and becomes much more susceptible to health risks. Your metabolism decreases after menopause, which makes you more vulnerable to weight gain. Additionally, postmenopausal women become much more susceptible to cardiovascular disease and osteoporosis.
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CALORIC CONSUMPTION
As a 60-year-old woman you should eat a diet that is low in calories, since your body's metabolism has decreased. Aging causes a natural decline in appetite, so you may notice that you need fewer calories. It is healthiest to eat only when you are hungry, and to consume enough food to satisfy your hunger. It is better to eat multiple small meals throughout the day then to overeat at any one meal.

NUTRITION AND DIET

Avoid over-processed foods which have excessive fat, sodium and preservatives. Instead, eat a balance of whole foods, including fruits, vegetables, lean protein, dairy, whole grains, healthy fat and fluids. Fruits and vegetables in particular are extremely important for women at this age. Regular consumption of fresh, colorful vegetables and vegetable juices is one of the best ways to protect yourself against heart disease and cancer. Fruits and vegetables are high in antioxidants and vitamins which also help fight osteoporosis.

EXERCISE
As a supplement to your diet, it is vital for a 60-year-old woman to exercise regularly, ideally 30 minutes per day. Exercise helps increase your metabolism and burn fat. You can find activities in your daily life that keep you active, such as gardening, dancing, bike riding and walking. Aerobic exercise and strength training help increase muscle mass, boost metabolism, and strengthen bones. Exercise helps battle osteoporosis, heart disease and cancer.

The Tennis Player's Diet

Guest Author - Clare Chambers The field of sports nutrition is a favourite of mine and I aim to research and write more about this in the months to come. Sports nutrition is an often neglected area of tennis for non-professional players, probably because not much is at stake if they dont perform at their best in every match. However, most people dont realise that because they dont take their nutrition seriously in order to prepare them for sport theyre quite literally damaging their body every time they play. To put nutrition into a tennis context: A serious tennis player drills the same strokes every day. All players know that without the basic strokes, they cannot play. The same is true of a players diet without consistent practice of basic healthy eating habits a player will not be able to remain strong, healthy and competitive for years to come. Studies conducted in the last decade have shown that we know enough about the nutritional intake of tennis players but don't necessarily always use the information to best effect. Those by Love (1993) and Sinofsky (1996) for example collected data utilising general sports nutrition questionnaires, food frequency questionnaires, and 24-hour recalls as well as food records, and they found that both professional and elite junior players have inadequate intakes much below the predicted requirements for many micronutrients. So its likely that studies into the nutritional status of non-professional players would show worse results. The problem seems to be that there are many sources all over the internet containing the best advice on how and what to eat all geared towards different situations and it can be confusing as to which to take advice from. There are three key stages you should prepare for every time you play: Before the match During the match After the match Before a tennis match begins, your carbohydrate stores should be full. To ensure this, the emphasis on consuming pre-match complex (not simple carbs like sugar and white bread) carbohydrates ought to begin at least during the previous evening. You should focus on carbohydrate intake over several days before the start of an event, and at the same time decrease overall training session duration. This can better optimise your internal carbohydrate stores and fluid electrolyte balance before beginning a match. You should drink fluids on a regular basis (beginning at least the night before). This can include water, but a variety of other drinks can and should be consumed such as juice, milk, and sport drinks in addition to water. In an effort to stay hydrated, some players drink too much fluid. In some cases, rapid or regular consumption of too much no- or low-sodium fluid (e.g., water) can reduce the sodium concentration the blood which can cause problems ranging from headaches and nausea to cramps or even death in extreme instances. If you are using the bathroom every 30-40 minutes, you may be drinking too much. If you anticipate sweating a lot during play (and/or you are particularly vulnerable to experiencing heat cramps), extra salt intake (via food and fluid) should be considered.

Energy stores are most effectively replenished if the player can consume a high-carbohydrate meal within the first 2 hours after a match. The longer you wait to eat, the longer it will take to replenish your bodys energy stores. After any match, your primary nutritional interest should be restoring fluids, electrolytes, and carbohydrates. If your next match is scheduled to begin soon (e.g, within 1 to 2 hours), re-hydration and carbohydrate intake (about 50-100 grams) needs to begin immediately! If your second match of the day begins 4 to 5 hours or more after the completion of the first, players should generally follow the same pre-match meal guidelines. High-carbohydrate sport drinks, along with sport bars, gels, and other carbohydrate-rich foods with a high glycemic index (e.g., bagels, crackers, ready-to-eat cereals, white bread, and jelly beans), are good choices to get going. Research suggests that a carbohydrate and protein combination might be better than just carbohydrate for rapid carbohydrate replenishment and total muscle recovery including protein rebuilding. Otherwise, certain combinations of breads, cereals, and dairy products, for example, can provide similar ratios of carbohydrate and protein. The following micronutrients should be taken on a regular basis to maintain good joint strength and flexibility and good bone density to prevent osteoporosis and similar conditions: Multivitamin: Take a multivitamin/mineral tablet daily. (Centrum or a look-a-like is good) as an insurance policy to allow for erratic schedules and high performance demands. Calcium: A diet consistently low in Calcium can contribute to stress fractures and longer recovery times if injured. Sources: milk, yogurt, cheese, calcium fortified juices and cereals, soy products, and calcium supplements. Iron: Essential for oxygen transport from lungs to working muscles. Low iron can lead to low energy and endurance. Sources: lean red meats, dark meat of chicken or turkey, fortified breads and cereals, beans and peas (dried). Supplements have side effects, see Dr. Porter before using. Sodium, Potassium: These nutrients are important for re-hydration. When you are playing tennis in high temperatures, be sure to use a sports drink for rehydration and recovery. These nutrients keep your immune system strong and help to avoid injuries. By using a good recovery strategy and providing your body with the nutrients needed for healthy joints, tendons and muscles injuries can be prevented and the recovery of injuries can be accelerated. This applies to both men and women, professional and non-professional tennis players.

Daily Calorie Requirement for male Athlete:

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In addition to regular training, consuming the proper caloric intake every day helps to boost an athlete's performance. Often this caloric intake depends upon a number of factors, including gender, body type and size, activities performed and performance goals. At the most basic level, athletes need to eat at least 1,800 calories per day, according to Fitness.gov. Additional calories increase based on the activity performed.

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Endurance
Endurance athletes, particularly runners should consume more calories based on their body weight, gender and average amount of miles ran per day. According to Runner's World magazine, men should consume 6 to 10 percent more calories than women each day because they require more calories for the muscles to properly function and tend to burn a greater number of calories on average than women. Consider this comparison: a 130-pound woman who runs 30 miles a week requires 18 to 20 calories per pound (about 2,400 calories a day) while a 160-pound man who runs the same amount should consume 20 to 22 calories per day (about 3,200 calories per day). Endurance athletes should consume a base of nutritionally sound foods, such as low-fat proteins, vegetables, fruits, low-fat dairy products, and soy foods. These type of athletes also should consume a meal high in carbohydrates and protein following a long run.
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Resistance Training
Compared to endurance athletes, resistance trainers require significantly less calories because they often perform less aerobic activity, which burns more calories than resistance training. However, resistance trainers often wish to increase muscle mass, meaning they should consume higher levels of protein. Resistance trainers looking to build muscle mass should consume an average of 1.5 to 1.7 grams of protein per kilogram of body weight, according to Columbia University. Weightlifters and bodybuilders often tend to focus not only on the amount of calories on the whole, but also the composition of carbohydrates, fats and protein contained within those calories. Athletes consider their daily caloric requirements based on their basal metabolic rate (BMR), which is the amount of calories needed to sustain a person's body weight. A person looking to build muscle mass should consume at least 500 calories more than his BMR each day in order to see muscle gains. For example, a 150-pound man whose body fat level is between 18 and 22 percent has a BMR of 1,620 calories. Therefore, a weightlifting athlete looking to gain muscle should consume at least 2,120 calories per day.

Competitive Athletes
Competitive athletes who practice and train daily for the equivalent hours of a full-time job have very high caloric needs in order to support their activity. According to the World's Healthiest Foods, competitive athletes may require up to 6,000 calories a day for men and as many as 4,000 calories for women. These types of athletes should consume five or six small meals per day in order to consume the needed calories to sustain athletic performance. These types of requirements are associated with professional football players, swimmers and tennis players

Nutrition for the Athlete

by J. Anderson, L. Young and S. Prior (12/10)
1

Quick Facts...
Athletes achieve peak performance by training and eating a variety of foods. Athletes gain most from the amount of carbohydrates stored in the body. Fat also provides body fuel; use of fat as fuel depends on the duration of the exercise and the condition of the athlete. Exercise may increase the athlete's need for protein. Water is a critical nutrient for athletes. Dehydration can cause muscle cramping and fatigue. Becoming an elite athlete requires good genes, good training and conditioning and a sensible diet. Optimal nutrition is essential for peak performance. Nutritional misinformation can do as much harm to the ambitious athlete as good nutrition can help.

Carbohydrates
Athletes benefit the most from the amount of carbohydrates stored in the body. In the early stages of moderate exercise, carbohydrates provide 40 to 50 percent of the energy requirement. Carbohydrates yield more energy per unit of oxygen consumed than fats. Because oxygen often is the limiting factor in long duration events, it is beneficial for the athlete to use the energy source requiring the least amount of oxygen per kilocalorie produced. As work intensity increases, carbohydrate utilization increases. Complex carbohydrates come from foods such as spaghetti, potatoes, lasagna, cereals and other grain products. Simple carbohydrates are found in fruits, milk, honey and sugar. During digestion, the body breaks down carbohydrates to glucose and stores it in the muscles as glycogen. During exercise, the glycogen is converted back to glucose and is used for energy. The ability to sustain prolonged vigorous exercise is directly related to initial levels of muscle glycogen. The body stores a limited amount of carbohydrate in the muscles and liver. If the event lasts for less than 90 minutes, the glycogen stored in the muscle is enough to supply the needed energy. Extra carbohydrates will not help, any more than adding gas to a half-full tank will make the car go faster. For events that require heavy work for more than 90 minutes, a high-carbohydrate diet eaten for two to three days before the event allows glycogen storage spaces to be filled. Long distance runners, cyclists, cross-country skiers, canoe racers, swimmers and soccer players report benefits from a precompetition diet where 70 percent of the calories comes from carbohydrates. According to the Olympic Training Center in Colorado Springs, endurance athletes on a highcarbohydrate diet can exercise longer than athletes eating a low-carbohydrate, high-fat diet. Eating a

high-carbohydrate diet constantly is not advised. This conditions the body to use only carbohydrates for fuel and not the fatty acids derived from fats. For continuous activities of three to four hours, make sure that glycogen stores in the muscles and liver are at a maximum. Consider taking carbohydrates during the event in the form of carbohydrate solutions. The current recommendation is a 6 to 8 percent glucose solution. You can make an excellent home-brewed 7.6 percent sports drink with reasonable sodium amounts. Add 6 tablespoons sugar and 1/3 teaspoon salt to each quart of water. Dissolve sugar and cool. The salt translates into a sodium concentration of 650 mg/liter. This small amount is good for marathon runners. Electrolyte beverages can be used if the athlete tolerates them, but other electrolytes are not essential until after the event. Experiment during training to find the best beverage for you. Table 1: Sample menu of a high carbohydrate diet. Grams Food item Breakfast 8 ounces orange juice 1 cup oatmeal 1 medium banana 8 ounces low-fat milk 1 slice whole wheat toast 1 tablespoon jelly Lunch 2-ounce slice ham 1 ounce Swiss cheese 2 slices whole wheat bread 1 leaf lettuce 104 105 120 1 0 1 25 0 120 132 101 102 60 57 28 23 26 12 12 15 Calories carbohydrate

1 slice tomato 8 ounces apple juice 8 ounces skim milk 2 cookies Dinner 3 cups spaghetti 1 cup tomato sauce with mushrooms 2 tablespoons Parmesan cheese 4 slices French bread 1 slice angel food cake 1/4 cup sliced strawberries 1/2 cup ice cream Snack 16 ounces grape juice 6 fig cookies TOTAL

3 116 85 96

1 30 12 14

466 89 5 45 406 161 13 133

97 19 1 0 78 36 3 16

330 386 3236

83 81 613 (75% of total calories)

Eating sugar or honey just before an event does not provide any extra energy for the event. It takes about 30 minutes for the sugar to enter the blood stream. This practice may also lead to dehydration. Water is needed to absorb the sugar into the cells. Furthermore, sugar eaten before an event may hinder performance because it triggers a surge of insulin. The insulin causes a sharp drop in blood sugar level in about 30 minutes. Competing when the blood sugar level is low leads to fatigue, nausea and dehydration.

A diet where 70 percent of calories comes from carbohydrates for three days prior to the event is sometimes helpful for endurance athletes. (See Table 1 for a sample menu.) Water retention often is associated with carbohydrate loading. This may cause stiffness in the muscles and sluggishness early in the event. A three-day regimen minimizes this effect. The previously suggested seven days of deprivation/repletion is not recommended due to increased risks of coronary heart disease. In addition, electrocardiograph abnormalities may occur and training during the deprivation phase may be difficult.

Water
Water is an important nutrient for the athlete. Athletes should start any event hydrated and replace as much lost fluid as possible by drinking chilled liquids at frequent intervals during the event. Chilled fluids are absorbed faster and help lower body temperature. (See Table 2.) Table 2: Recommendations for hydration. Day before Pre-event meal 2 hours before 1/2 hour before Every 10-15 minutes during the event After event Next day 2 cups fluid for each pound lost Drink fluids frequently (it may take 36 hours to rehydrate completely). Drink fluids frequently 2-3 cups water 2-2 1/2 cups water 2 cups water 1/2 cup cool (45-55 degrees) water

Fats
Fat also provides body fuel. For moderate exercise, about half of the total energy expenditure is derived from free fatty acid metabolism. If the event lasts more than an hour, the body may use mostly fats for energy. Using fat as fuel depends on the event's duration and the athlete's condition. Trained athletes use fat for energy more quickly than untrained athletes. Consumption of fat should not fall below 15 percent of total energy intake because it may limit performance. Athletes who are under pressures to achieve or maintain a low body weight are susceptible to using fat restriction and should be told that this will hinder their performance.

Fat may contribute as much as 75 percent of the energy demand during prolonged aerobic work in the endurance-trained athlete. There is evidence that the rate of fat metabolism may be accelerated by ingesting caffeine prior to and during endurance performance. However, insomnia, restlessness and ringing of the ears can occur with caffeine consumption. Furthermore, caffeine acts as a diuretic and athletes want to avoid the need to urinate during competition.

Protein
After carbohydrates and fats, protein provides energy for the body. Exercise may increase an athlete's need for protein, depending on the type and frequency of exercise. Extra protein consumed is stored as fat. In the fully grown athlete, it is training that builds muscle, not protein per se. The ADA reports that a protein intake of 10 to 12 percent of total calories is sufficient. Most authorities recommend that endurance athletes eat between 1.2-1.4 grams protein per kg of body weight per day; resistance and strength-trained athletes may need as much as 1.6-1.7 grams protein per kg of body weight. (A kilogram equals 2.2 pounds.) Japanese researchers demonstrated that "sports anemia" may appear in the early stages of training with intakes of less than 1 gram/kg of body weight per day of high quality protein. To calculate your protein needs, divide your ideal weight by 2.2 pounds to obtain your weight in kilograms. Then multiply kilograms by the grams of protein recommended. A varied diet will provide more than enough protein as caloric intake increases. Furthermore, Americans tend to eat more than the recommended amounts of protein. Excess protein can deprive the athlete of more efficient fuel and can lead to dehydration. High-protein diets increase the water requirement necessary to eliminate the nitrogen through the urine. Also, an increase in metabolic rate can occur and, therefore, increased oxygen consumption. Protein supplements are unnecessary and not recommended.

Vitamins and Minerals

Increased caloric intake through a varied diet ensures a sufficient amount of vitamins and minerals for the athlete. There is no evidence that taking more vitamins than is obtained by eating a variety of foods will improve performance. Thiamin, riboflavin and niacin (B vitamins) are needed to produce energy from the fuel sources in the diet. However, plenty of these vitamins will be obtained from eating a variety of foods. Carbohydrate and protein foods are excellent sources of these vitamins. Furthermore, the B vitamins are water soluble and are not stored in the body, so toxicity if not an issue. Some female athletes may lack riboflavin, so ensuring adquate consumption of riboflavin-rich food is important, like milk. Milk products not only increase the riboflavin level but also provide protein and calcium. The body stores excess fat-soluble vitamins A, D, E and K. Excessive amounts of fat-soluble vitamins may have toxic effects. Minerals play an important role in performance. Heavy exercise affects the body's supply of sodium, potassium, iron and calcium. Sweating during exercise increases the concentration of salt in the body.

Consuming salt tablets after competition and workouts is not advised as this will remove water from your cells, causing weak muscles. Good sodium guidelines are to: 1) avoid excessive amounts of sodium in the diet and 2) beverages containing sodium after endurance events may be helpful. Eating potassium-rich foods such as oranges, bananas and potatoes throughout training and after competition supplies necessary potassium. Iron carries oxygen via blood to all cells in the body and is another important mineral for athletes. Female athletes and athletes between 13 and 19 years old may have inadequate supplies of iron due to menstruation and strenuous exercise. Female athletes who train heavily have a high incidence of amenorrhea, the absence of regular, monthly periods, and thus conserve iron stores. Iron supplements may be prescribed by a physician if laboratory tests indicate an iron deficiency. Excess iron can cause constipation. To avoid this problem, eat fruits, vegetables, whole grain breads and cereals.. Calcium is an important nutrient for everyone as it is important in bone health and muscle function. Female athletes should have an adequate supply of calcium to avoid calcium loss from bones. Calcium loss may lead to osteoporosis later in life. Choosing low-fat dairy products, provide the best source of calcium.

The Pre-Game Meal

A pre-game meal three to four hours before the event allows for optimal digestion and energy supply. Most authorities recommend small pre-game meals that provide 500 to 1,000 calories. The meal should be high in starch, which breaks down more easily than protein and fats. The starch should be in the form of complex carbohydrates (breads, cold cereal, pasta, fruits and vegetables). They are digested at a rate that provides consistent energy to the body and are emptied from the stomach in two to three hours. High-sugar foods lead to a rapid rise in blood sugar, followed by a decline in blood sugar and less energy. In addition, concentrated sweets can draw fluid into the gastrointestinal tract and contribute to dehydration, cramping, nausea and diarrhea. Don't consume any carbohydrates one and a half to two hours before an event. This may lead to premature exhaustion of glycogen stores in endurance events. Avoid a meal high in fats. Fat takes longer to digest as does fiber- and lactose-containing meals. Take in adequate fluids during this pre-game time. Avoid caffeine (cola, coffee, tea) as it may lead to dehydration by increasing urine production. Don't ignore the psychological aspect of eating foods you enjoy and tolerate well before an event. However, choose wisely -- bake meat instead of frying it, for example.

Some athletes may prefer a liquid pre-game meal, especially if the event begins within two or three hours. A liquid meal will move out of the stomach by the time a meet or match begins. Remember to include water with this meal.

The Post-Game Meal

Regardless of age, gender or sport, the post-game.competition meal recommendations are the same. (See Table 3.) Following a training session or competition, a small meal eaten within thirty minutes is very beneficial. The meal should be mixed, meaning it contains carbohydrate, protein, and fat. Protein synthesis is greatest during the window of time immediately following a workout and carbohydrates will help replete diminished glycogen stores. However, consume food within the 30 minute window may be difficult for athletesthey often experience nausea or lack of hunger. Options to address this difficulty include: Carbs you can drink that contain protein. There are several liquid smoothies and beverages on the market that provide high protein and carbohydrates for replenishment. One classic is chocolate milk. If that is difficult, fruit, popsicles, oranges, bananas, bagels, melon, or apple slices all would be better than not consuming any food. Many athletes turn to protein/amino-acid supplementation in the form of powders or pills post-workout. These are unnecessary and have been linked to dehydration, hypercalciuria, weight gain, and stress on the kidney and liver. Furthermore, any athletes consuming supplements in replacement of meals should consult with their doctor or a registered dietitian before continuing. Maintain nutritional conditioning not only for athletic events, but all the time (See fact sheet 9.353, Dietary Guidelines for Americans). A pre-game meal or special diet for several days prior to competition cannot make up for an inadequate daily food intake in previous months or years. Lifelong good nutrition habits must be emphasized. Combine good eating practices with a good training and conditioning program plus good genes, and a winning athlete can result! Table 3: Two pre-event meal plans. Pre-Event Meal Plan I, 2-3 hours prior (approximately 500 calories) Lean meat or protein equivalent Fruit Bread or easily digestible carbohydrate 2 ounces 1 serving (1/2 cup) 2 servings

Pre-Event Meal Plan II, 3 1/2 - 4 hours prior (approximately 900 calories) Cooked lean meat or protein equivalent Fruit Pasta or baked potato Bread or carbohydrate substitute Low-fiber vegetable Fat spread Dessert: Angel food cake or plain cookies 2 ounces 1 serving (1/2 cup) 1 cup or 1 medium 2 servings 1 serving (1/2 cup) 1 teaspoon 1 piece 2 cookies

Sources of Information and Materials

Female Atlete Diet:

For an athlete to do her best, a nutrition plan is essential. The nutrition plan starts by scheduling the timing of your three meals and three snacks. As an athlete, it is important for you to eat every two or three hours. The next step is to write a menu, which will then help generate your shopping list for meals, snacks and beverages. Choosing foods you like to eat and know how to prepare for meals and snacks will help you meet your nutritional needs and fuel you for your sport. Sponsored Link

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Weekly Meal Plan

A weekly meal plan can be as simple or complex as you want it to be. Start with breakfast. Whether you prefer cereal or baked oatmeal, breakfast starts each day off right with energy for your sport. Next will be one of the three daily snacks. Have a snack with 100 to 200 calories, for example, sliced fruit or vegetables or a granola bar. For lunch, leftovers from the previous night's dinner will make a quick-and-easy meal. Alternatively, grab the bread and make a simple peanut butter and jelly sandwich.

Create a Grocery List

Once your menu is in place, make a shopping list. A list will not only help save you time in the grocery store, it will also help you focus on buying the right foods to fuel your body. Reach for whole grains and load up on the fruits and vegetables. Try to shop the perimeter of the grocery store and only grab those essential items in the aisles.

Snacks
Snacks are important for athletes, because they provide you with extra calories you need before and after a practice or workout. Depending on your sport, you may even need to eat during the workout. A good snack is easy for you to digest, high in carbohydrates and low in protein, fiber and fat. Some great examples of convenient snacks include granola bars, gold fish crackers, pretzels and chocolate milk.

Hydration
Hydration is often over looked by athletes. Carry a water bottle, refill it often and aim to consume one milliliter for every calorie consumed. In other words, if you eat 2500 calories, you need to drink 2500 milliliters throughout the day. Try to avoid caffeinated, carbonated and sugary drinks since they are dehydrating and negatively affect your performance.

Energy expenditure:

Resting energy expenditure: 1,300 kcal/day Total daily energy expenditure for an exercise training day: 2,200 kcal/day

Exercise training (representative day; training includes skill acquisition, artistic elements, aerobic, and strength sessions):

Description: Skill acquisition and repetition, e.g. triple jump

Intensity: Repeated bouts of high intensity work interspersed with lower intensity skating Duration: 1-2 hours Frequency: 6 days per week, 1-2 sessions/day Energy expenditure during exercise training: 250-300 kcal/hr

Sport nutrition guidance (for a 105 lb (48 kg) female singles figure skater):

Energy expenditure (includes drills and skill training on ice: 2-hour session) = 2,200 kcal/day Energy intake = 2,200 kcal/day Calorie distribution: 60% Carbohydrate, 16% Protein, 24% Fat

Nutrient Carbohydrate Protein Fat

g/kg BW Grams Calories % of Total Calories 6.9 1.8 1.2 330 88 59 Total 1320 352 528 2200 60 16 24 100

Sample menu: Breakfast 1 cup corn flakes 1/2 banana 1/2 cup skim milk 1/2 cup grapefruit juice Morning Snack 1/2 English muffin 1 tsp margarine Lunch

1 cup tomato soup 2 saltine crackers 1 sandwich: 2 slices bread 1 oz turkey breast 1 tsp mayonnaise 1 apple Afternoon Snack (after exercise session) 1 orange 1 bagel 1-1/2 tbsp light cream cheese Dinner 4 oz broiled beef steak 1 baked potato 2-1/2 tsp margarine 2 tbsp fat free sour cream 3/4 cup broccoli 1 cup skim milk 1 piece gingerbread Evening Snack 1 cup skim milk 1 large oatmeal cookie Nutritional Analysis: 2,250 calories

Nutrient 335g Carbohydrate 104g Protein 55g Fat

% of Total Calories 60% 18% 22%

Heart Disease: Helping Your Loved One With Heart Disease Eat Right
For a person with heart disease, proper nutrition is essential to managing symptoms and preventing further complications. Not only can proper diet help slow the artery-clogging process, but when combined with careful lifestyle modification, it may even stop or reverse the narrowing of arteries. For caregivers and their loved ones with heart disease, adopting a heart-healthy diet can help reduce total and LDL cholesterol, lower blood pressure, lower blood sugar, and reduce body weight. While most dietary plans detail what CAN'T be eaten, the most powerful nutrition strategy helps people with heart disease focus on what they CAN eat. In fact, heart disease research has shown that adding heart-saving foods is just as important as cutting back on others. Here are some strategies to help you plan meals for someone with heart disease: 1. Serve more vegetables, fruits, whole grains and legumes. These foods may be one of the most powerful strategies in fighting heart disease. 2. Choose fat calories wisely. Keep these goals in mind: 3. Limit total fat grams. 4. Serve a bare minimum of saturated fats and trans-fatty fats (for example, fats found in butter, salad dressing, sweets and desserts). 5. When you use added fat, use fats high in monounsaturated fat (for example, fats found in olive and peanut oil) or polyunsaturated fat (such as fats found in soybean, corn and sunflower oil). 6. Serve a variety -- and just the right amount -- of protein foods.Commonly eaten protein foods (meat, dairy products) are among the main causes of heart disease. Reduce this nutritional risk factor by balancing animal, fish and vegetable sources of protein. 7. Limit cholesterol consumption. Dietarycholesterol can raise blood cholesterol levels, especially in high-risk people. Limiting dietary cholesterol has an added bonus: You'll also cut out saturated fat, as cholesterol and saturated fat are usually found in the same foods. Give your loved one energy by serving complex carbohydrates (such as whole wheat pasta, sweet potatoes, whole-grain breads) and limit simple carbohydrates (such as regular soft drinks, sugar, sweets). 8. Feed your loved one regularly. Skipping meals often leads to overeating. By serving five to six mini-meals you can help your loved one control blood sugars, burn fat calories more efficiently and regulate cholesterol levels. Other Heart-Healthy Strategies De-emphasize salt. This will help your loved one control his or her blood pressure. Encourage exercise. The human body was meant to be active. Exercise strengthens the heart muscle, improves blood flow, reduces high blood pressure, raises HDL cholesterol ("good" cholesterol), and helps control blood sugars and body weight.

Encourage hydration. Water is vital to life. Staying hydrated makes you feel energetic and eat less. Encourage your loved one to drink 32 to 64 ounces (about one to two liters) of water daily (unless he or she is fluid restricted). An excellent motto to follow is: dietary enhancement, not deprivation. When people enjoy what they eat, they feel more positive about life, which helps them feel better. How Much Is In a Serving? When trying to coordinate an eating plan that's good for the heart, it may help to know how much of a certain kind of food is considered a "serving." The following table offers some examples.
SERVING SIZES Food/amount 1 cup cooked rice or pasta 1 slice bread 1 cup raw vegetables or fruit 1/2 cup cooked vegetables or fruit 1 ounce cheese 1 teaspoon olive oil 3 ounces cooked meat 3 ounces tofu Serving/exchange 2 starch 1 starch The size of tennis ball compact disc case

1 cup raw vegetables or fruit baseball 1 fruit or vegetable 1 high-fat protein 1 fat** 1 protein 1 protein cupcake wrapper full or size of ice cream scoop pair of dice half dollar deck of cards or cassette tape deck of cards or cassette tape

** Remember to count fat servings that may be added to food while cooking (oil for sauteing, butter or shortening for baking)

Reviewed by the doctors at The Cleveland Clinic Heart Center.