Blog Athletes and IE

Can Athletes Eat Intuitively?

by with No Comment Blog PostsPittsburgh Dietitian

Written by: Devon Kroesché, MS, RDN, LDN

I am the CSN Lead Dietitian at our Robinson office and the Director of Marketing. Last weekend, I ran in the Pittsburgh marathon. During my marathon training for my last race in November, the Philadelphia marathon, I implemented principles of intuitive eating (IE) into my training program. I want to share how I accomplished this training method and if it is possible and/or recommended for other athletes

 

First, you may be familiar with IE, but let’s define it. Intuitive eating is not just eating without tracking or following a meal plan, but rather it is a weight-neutral framework that focuses on internal cues (aka listening to your body) and learning how to respond to these cues without explicit “rules.” It focuses on nourishing your body properly rather than restricting it to the constraints of a certain diet or caloric intake. It is a practice that incorporates elements of mindfulness as well as what is sometimes referred to as “gentle nutrition” to determine your body’s energy needs.

 

You may be wondering if you should incorporate this way of living into your life. It is a powerful mindset that can help you achieve freedom surrounding food and nutrition. For example, just as having an understanding of your own unique energy needs and how to meet them is an essential skill for properly fueling as an athlete (or as a person in general), knowing how to tune in to your body’s natural hunger and fullness cues is absolutely critical skill in being a “healthy eater” long term. The reality is you are not always going to know the exact calories in what you’re eating, and energy needs estimates are just that, estimates. The best way to know if you’re meeting your specific energy needs is paying attention to your body: how it is performing, how are your energy levels, possibly looking at weight trends, etc. It can also be helpful for people who are trying to develop a better relationship with food, and for whom monitoring their intake closely is not helpful for them at this stage of their journey. They have been hyper-aware of their dietary intake and are trying to distance themselves from that mindset. 

 

Can an athlete practice IE? Yes, but I wouldn’t necessarily dive head first into this. As a dietitian, I like to make sure my athletes have an in-depth understanding of their energy needs and how to meet them properly. First, I want to make sure my clients understood how much they need to eat (that might include knowing about calories or it might not, depending on the client and the level of appropriateness). Secondly, I want them to know their hydration needs, electrolyte needs, protein needs, carbohydrate needs, etc. I also want them to be able to tell me how they can effectively meet their needs through food. I want my athletes to be aware of where they can find the nutrients they need through food. For example, tell me good sources of carbs, protein, salt, and others for training and fueling. Personally, a bagel with peanut butter, a banana, and skim milk is an adequate breakfast for me.

 

Once an athlete has a good foundational knowledge of nutrition and they are confident they have been appropriately fueling, we can transition into a less-focused approach. They can move away from tracking or following a close plan, and start listening to their bodies while keeping some of those foundational principles front of mind. For example, maybe they deviate away from a PB bagel with a banana and skim milk and instead do overnight oats with fruit, nuts or seeds, and greek yogurt because they know it offers comparable benefits. It is IMPORTANT TO NOTE: we should be implementing intuitive eating throughout the entire process. I’ll share a story with you. I had an athlete whose energy levels felt better when he ate a lower carb lunch as long as he met his carbohydrate needs over the course of the day. The high carb lunch was making him feel sluggish in the afternoon, a fairly common phenomenon especially if you work a desk job. So we adjusted his plan accordingly to meet his energy needs.

 

You may also be wondering some of the limitations of IE as an athlete and that is valid. One thing that can occur with exercise is decreased appetite. Intense exercise results in increases in leptin sensitivity; leptin is a metabolic hormone that helps your body sense fullness. People who are very active tend to be highly leptin sensitive, meaning their body will sense they are full quite quickly and more effectively compared to more sedentary people, putting them at higher risk for undereating. Athletes have very high energy needs and sometimes their body’s cues might not be able to account for this increased need. You may need to time your nutrition in a specific way that might not be in line with your body’s natural cues. For example, you might need high amounts of quick-digesting carbs before a workout even if you are not necessarily hungry for that at the moment. Athletes that are aiming to be in an energy surplus (in order to gain strength or size) may not be able to eat enough if they rely on hunger/fullness cues alone. The same thinking applies to those who are trying to lean out for their sport. Although, IE is not applicable in this instance as it goes against the IE framework of being a weight-neutral approach to eating. Some athletes – like marathon runners – may have to undergo carb loading. Nobody is going to intuitively eat enough carbs for an optimized carb load. It often takes planning an intention and a registered dietitian can help you with this journey. 

 

I want to share my journey of marathon training while practicing IE with you. At first, I wasn’t using an IE approach. I sat down and planned my training, calculated my energy needs, and cross referenced it with Andrew, founder of CSN. I realized I wasn’t eating enough and increased my intake which led to me performing better. Then, I tracked my food intake for a few weeks to make sure I was meeting my needs. I also paid attention to how my body reacted to this fueling. Was I getting gassed during runs? I also paid attention to my hydration, sleep, stress levels, and other aspects of recovery. Once I had a good idea of exactly how much I needed to eat throughout my day and my week, I stopped tracking my food. I prioritized eating around the same times, every 3 hours or so, and prioritized carbs at every meal. I made sure most of the time my plate was filled up with at least 50% carbohydrates, mostly from high quality sources like sweet potatoes, bananas, oats, beans, and whole grain breads. 

 

I challenged my inner food police. As a dietitian, I tended to stray away from quick digesting carbohydrates and ultra-processed foods. During training I realized that these foods are okay in limited amounts, and actually quite convenient when it comes to things like carb loading. I bought my favorite breakfast cereal, fruity pebbles, and had a bowl every night before a long run to top off my glycogen stores. I also incorporated foods like poptarts, rice krispy treats, and gummy worms on runs as quick-digesting carbs. I would need some quick sugar anyway, and I figured why not get it from some of my favorite foods rather than relying on less appetizing energy gels (nothing against them of course). I recognized the limitations of my intuitive eating during my training, especially when it came to carb loading for my race or for a long run. I ate slightly past fullness, and ate more frequently than I would have done intuitively. 

 

I learned training for an endurance event like a marathon IS possible without having to track everything you’re eating. In fact, leaning into your body’s natural cravings can even enhance your performance. Often, I craved salt several hours after a run. Scientifically, this made sense because of the salt lost from sweat. I incorporated a salty snack that both satisfied that craving and helped replenish my electrolytes in a way I enjoyed. Eating intuitively, made fueling more FUN. I got to enjoy foods I don’t usually eat as often and challenge my unconscious food rules and be more flexible with my diet. I was way more in touch with my body than I ever have been. I learned to push myself out of my comfort zone and proved to myself that I can do hard things. No matter how you plan to approach your training, you will have to iterate along the way. Be willing to be flexible. If you want to take this approach to fueling for your sport, WORK WITH A DIETITIAN by emailing scheduling@casespecificnutrition.com. Even if you yourself are a dietitian! 

Copy of Debunking Nutrition Myths Blog

Debunking Nutrition Myths Pt.2

by with No Comment Blog PostsPittsburgh Dietitian

Written by: Ava Elliott, Marketing Intern & Future Dietitian

Reviewed by: Devon Kroesché, MS, RDN, LDN

Continuing with last month’s evidence-based discussion, I will help debunk common nutrition myths we may hear in the media or out in public. It can be hard to know who to listen to for nutrition advice, but I am here to remind you to seek out a registered dietitian, a food and nutrition professionals, who reviews research to relay nutrition information to you.

 

“Eating healthy is too expensive.”

Food can be expensive, especially with increased prices from inflation. There are some ways that grocery shopping can be budget-friendly, while supporting high nutrition quality in our dietary patterns. First, frozen or canned fruits and vegetables can be as nutritious as fresh produce.1 When shopping for frozen fruit, check the label for unsweetened fruit to reduce added sugars.1 These products will have a natural sweetness from the fruit without the added sugars. On the other hand, choose frozen vegetables with lower fat and sodium content if this pertains to you, so you can use spices at home to flavor the veggies.1 Another budget-friendly choice is to buy canned products. It is helpful to use canned fruits and veggies right away once opened to maximize nutritional value and the flavor.1 More tips include planning out meals. By meal planning, you can stick to your budget and use a list to decide what you want to buy for the week. You can also try making larger quantities of a meal to freeze and save for later.2 (For recipe ideas, visit our Pittsburgh Dietitians Blog.) Another trick to eating healthy for less is to look for your local grocery store coupons and deals. By planning out meals and using a grocery list, you can incorporate items on sale that week into your prep.2

 

“Eating after a certain time causes you to gain weight.”

I have heard this statement more times than I can count. Let’s look at the research behind it. This myth is associated with the idea that when you fall asleep, your metabolism slows down and your snack will be converted into extra weight. Luckily, our metabolism never stops and works at all hours of the day and night.3 Confusion on this topic can arise when thinking the timing of food causes weight gain, when our food choices can contribute to this statement. When eating at night, it is an extra snack or meal you are consuming. By increasing meal frequency during the hours you are awake, you can consume more food than your body may need on that day.3 Eating more than three average meals or six smaller meals in a day could lead to weight gain in some.3 We must remember that we are individuals with individual needs for our bodies. Try not to stress about the timing of your meals and snacks, but rather the quality of food on your plate, tuning into your body’s specific needs.

 

“Vitamins are just expensive urine.”

Dietitians recommend food first, to a point. If you have confirmed bloodwork that shows a vitamin or mineral deficiency you may need a vitamin supplement. It is important to work with your doctor or registered dietitian to determine your specific needs. You may need a supplement if you are not getting enough of a certain nutrient through your diet, or maybe your body is having trouble with absorption. In this case, choosing a vitamin may be necessary. Supplements are not regulated by the FDA as drugs, so you can look for brands with a USP label or a brand your health care professional trusts.4 Two types of vitamins are absorbed by our bodies: fat-soluble and water-soluble. Fat-soluble vitamins (A, D, E, and K) are absorbed by fat and stored in the liver.5 Water soluble vitamins are absorbed in the intestines6 and excreted via urine if in excess. It is important to note that if you need vitamins, they will be absorbed and not excreted in excess by the body.7

 

I would like to encourage you to speak with a registered dietitian if you want to discuss these topics further or have more questions about other nutrition myths not mentioned. Please email scheduling@casespecificnutrition.com to make an appointment.

 

 

References:

1. Ellis E. Fresh, Canned or Frozen: Get the Most from Your Fruits and Vegetables. Eat Right Academy of Nutrition and Dietetics. Published March 30, 2020. Accessed April 16, 2023. https://www.eatright.org/food/nutrition/nutrition-facts-and-food-labels/fresh-canned-or-frozen-get-the-most-from-your-fruits-and-vegetables

2. 6 Tips for Eating Healthy on a Budget. CDC. Updated September 20, 2022. Accessed April 16, 2023. https://www.cdc.gov/diabetes/healthy-eating-budget.html

3. Reid KJ, Baron KG, Zee PC. Meal timing influences daily caloric intake in healthy adults. Nutr J. 2014; 34(11): 930-935. doi: 10.1016/j.nutres.2014.09.010

4. Dietary Supplements. FDA. Updated December 21, 2021. Accessed April 16, 2023. https://www.fda.gov/consumers/consumer-updates/dietary-supplements#:~:text=Dietary%20supplements%20are%20regulated%20by,medical%20condition%20you%20may%20have.

5. Nebot C, Cardelle-Cobas A, Cepeda A, et al. Chapter 10 – Fat-soluble vitamins (A, E, D, and K). In: Lorenzo JM, Munekata PES, Pateiro M, et al. Food Lipids. Academic Press; 2022:207-229. Accessed April 16, 2023. Doi: 10.1016/B978-0-12-823371-9.0000508

6. Said HM. Intestinal absorption of water-soluble vitamins in health and disease. Biochem J. 2011; 437(3): 357-372. doi: 10.1042/BJ20110326

7. Shibata K, Hirose J, Fukuwatari T. Relationship Between Urinary Concentrations of Nine Water-soluble Vitamins and their Vitamin Intake in Japanese Adult Males. Nutr Metab Insights. 2014; 7: 61-75. doi: 10.4137/NMI.S17245

Debunking Nutrition Myths Blog (1)

Debunking Nutrition Myths Pt.1

by with No Comment Blog PostsPittsburgh Dietitian

Written by: Ava Elliott, Marketing Intern & Future Dietitian

Reviewed by: Devon Kroesché, MS, RDN, LDN

A lot of misinformation is out there, including nutrition claims. When you need nutrition advice, a dietitian is your best friend because they are the food and nutrition professionals that research science and provide you with evidence-based recommendations. Can you say that about everyone on the internet? Let’s dig into some nutrition myths that are spreading.

 

“Seeds oils are bad for you.”

There has been a lot of talk about seed oils being bad lately–let’s look at the science behind these claims. Seed oils come from plants or seeds and contain different types of fats. First, I’d like to point out that our bodies need fat (one of our macronutrients) for many functions like a source of energy, absorb other nutrients, produce hormones, support function of our cells, etc.1 Our bodies obtain fat from plant and animal sources. Plant sources include olive oil, canola oil, vegetable oil, and sunflower oil to name a few. A few animal sources include butter, lard, and milk fat. In general, plant oils provide our bodies with more monounsaturated and polyunsaturated fats–the ones that provide heart healthy benefits and are healthful. Animal oils provide more saturated and trans fats–the oils we want less of in our dietary patterns. That being said, most plant oils are pressed from seeds to extract the healthful oils.2 Therefore, we actually want seed oils in our diet to provide essential fatty acids that our bodies can’t make.3 These omega-3 fatty acids are found in plant and seed oils like flaxseed, soybean, and canola oils.3

 

“Processed foods are unhealthy.”

I’ve heard many people claim processed foods are unhealthy, so I want to share some research about this nutrition myth. First, let’s define “processed foods” for a clearer picture. The United States Department of Agriculture (USDA) defines processed foods as any commodity that has been changed via washing, cooking, baking, smoking, marinating, milling, chopping, heating, or has been canned, packaged, frozen, dried, pasteurized, blanched or altering its natural state in any way.4,5 Now after reading this definition, are you thinking that not all processed foods are “unhealthy?” Are you thinking when you cook or prepare food and now it is defined as a “processed food,” is it still unhealthy? For example, think about a bag of spinach–a “processed” item–but spinach provides our bodies with many nutrients like potassium, fiber, iron, and zinc. There is a wide range of processing, and the Academy of Nutrition and Dietetics ranks minimally processed foods to mostly processed foods as:6

  • Minimal processed foods like fresh strawberries, bagged spinach, cut fruit, and roasted peanuts are prepared for convenience to make cooking and preparing foods more efficient
  • These are processed to maintain the highest nutritional content and quality: canned tuna, frozen fruits and vegetables, canned olives
  • Foods with added flavor and ingredients for added texture like, spices, oils, sweeteners, and other preservatives–yogurt, pasta sauce, granola bars, cupcake mixes
  • Ready-to-eat foods are mostly processed like crackers, cereal, deli meat, and frozen meals

Overall, stating that processed foods are unhealthy isn’t the full picture. To minimize intake of foods with higher processing, you can aim to cook and prepare foods at home or eat whole fruits and vegetables, whole grains, beans and legumes. Or if you are choosing a ready-to-eat frozen dinner, focus on what you can add to it. For example, for a chicken and rice meal you can add vegetables to your plate or some yogurt and fruit for dessert.

 

“Eating makes me bloated.”

Eating can sometimes cause bloating, but not always. When our bodies digest food, gas is a natural byproduct produced and can sometimes make us feel bloated.7 Additionally, fiber can cause slight bloating if you do not consume a lot routinely. With gradual intake of fiber from whole fruits, vegetables, and whole grains, fiber will help your digestive system do its job, and bloating will not occur much. Sometimes, bloating can happen from a digestive issue if you have a food intolerance or other complications.7 Hormones can also cause bloating, like during your menstrual cycle. The good thing is that it comes and goes and is not of concern. Drinking enough water throughout the day will encourage digestion as well as moving; going for a walk with your dog, jogging, walking up and down the stairs in your house will all help your digestive system and bloating reduction. Focus on eating slower and practicing mindfulness (read about Mindful Eating & Slowing Down) to aid in digestion.7

 

Please email scheduling@casespecificnutrition.com to work with one of our dietitians if you’d like to discuss more myths. Also, stay tuned for part two for more!

 
 

References:

1. American Heart Association editorial staff. Dietary Fats. American Heart Association. Updated November 1, 2021. Accessed March 16, 2023. https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/fats/dietary-fats

2. Native Plant Oils. United States Department of Agriculture. Updated 2023. Accessed March 16, 2023. https://www.fs.usda.gov/wildflowers/ethnobotany/oils.shtml

3. Omega-3 Fatty Acids. National Institutes of Health. Updated July 18, 2022. Accessed March 18, 2023. https://ods.od.nih.gov/factsheets/Omega3FattyAcids-Consumer/

4. Harguth A. What you should know about processed foods. Mayo Clinic Health System. Published March 21, 2022. Accessed March 18. 2023. https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/processed-foods-what-you-should-know

5. USDA Country of Origin Labeling. Frequently Asked Questions. USDA. Updated 2021. Accessed March 18, 2023. https://www.ams.usda.gov/sites/default/files/media/FAQs%20for%20Consumers%20-%20English.pdf

6. Klemm S. Processed Foods: A Closer Look. Academy of Nutrition and Dietetics. Published February 11, 2019. Updated January 30, 2023. Accessed March 19, 2023. https://www.eatright.org/health/wellness/diet-trends/processed-foods-whats-ok-and-what-to-avoid

7. Bloated Stomach. Cleveland Clinic. Updated September 10, 2021. Accessed March 19, 2023. https://my.clevelandclinic.org/health/symptoms/21740-bloated-stomach

CSSD Pic (4)

What is a CSSD?

by with No Comment Blog PostsPittsburgh Dietitian

Written by: Ava Elliott, Marketing Intern & Future Dietitian

Reviewed by: Allison Wade MS, RDN, LDN, CSSD & Lisa Balestrino MS, RD, LDN, CSSD

What is a CSSD?

The Board Certified Specialist in Sports Dietetics (CSSD) is a professional credential for registered dietitians (RD) with experience in sports dietetics. The components of a CSSD encompass sports nutrition and performance optimization, diet and exercise for chronic diseases management and eating disorder intervention and prevention. This advanced credential is vital to look for in a dietitian if you are seeking advice on sports related topics.

 

Who would benefit from working with an RD who has their CSSD credential?

Anyone from the weekend warrior to the collegiate athlete. An RD can help those with their fitness goals while providing professional insight into all things sports dietetics related. Maybe you are wondering about which supplements for hydration are best. Maybe you have diabetes and you are active, and need help managing your blood sugar levels. Maybe you are an advanced athlete or a high school football player. Maybe you need help to fuel your body to perform your best at your sport or competition. A sports dietitian can help you be fit as you age and help you meet your health goals during all stages of life.

 

CSSD vs Personal Trainer, Nutrition Coach…Look for the Credentials

Dietitians in practice for at least two years with documentation of 2,000 hours of sports dietetics practice are eligible for the CSSD credential. All dietitians have background knowledge in all disease states, metabolism of the body, and so much more. But, when seeking professional advice on anything sports-dietetics related, the RDs with the CSSD credential are the preferred professionals. Think about the difference between a “nutritionist” and a registered dietitian nutritionist here…RDs have a minimum of a bachelor’s degree or master’s degree in nutrition and dietetics and graduated from an accredited program in dietetics. They also have completed their dietetic internship with 1200 hours of supervised experiential learning under a dietitian, have passed their national board certification exam to become a dietitian, and became licensed to practice in their state. On the other hand, anyone can call themselves a nutritionist because there are no mandated requirements. I don’t know about you, but I’m choosing a dietitian over a “nutritionist” 10/10 times.

 

Similarly, a dietitian with their CSSD is going to be a qualified health professional to help you on your fitness, disease management, and sports journey. A personal trainer is a certified fitness professional, but a dietitian with their CSSD will have the expertise on tying nutrition with fitness. They will be able to provide medical recommendations and evidence-based research advice regarding your health and fitness goals. Dietitians always are grounded in science and practice with evidence-based scientific knowledge. A sports dietitian can help you bridge the gap between in-season and out of season nutrition, help with muscle cramping, overtraining syndrome, balancing your electrolytes, and so much more!

 

More About Allison & Lisa

Allison Wade, Founding Dietitian and Lead Dietitian at the Raleigh office is very passionate about sports and how food can modify the body. Allison obtained her CSSD credential about a year ago and her passion for sports stemmed from her youth. Growing up, Allison loved watching and playing sports. She was always interested in how food made her feel and affected her performance and energy levels for marathons or competitions. Allison was inspired by Leslie Bonci, former sports dietitian for the Pittsburgh Steelers, and saw just how important food and exercise were tied together. In college, Allison was fascinated with how the RDs helped fuel athletes at the fueling stations and during practice and began to study the role of a dietitian in sports. Now, Allison works with a lot of athletes and enjoys weightlifting and helping others fuel properly for performance.

 

Lisa Balestrino, Lead Dietitian at the South Hills office grew up an athlete on a farm with homegrown food. She quickly realized if she fueled and ate a certain way then she’d feel better for workouts. Lisa grew up in a very active family and has done half marathons, CrossFit, and a bodybuilding competition, to name a few activities. Lisa experienced disordered eating habits and started learning she needed to eat more to fuel her body; she saw connections between underfueling (underfeeding) and fueling for performance. Lisa began learning more about sports dietetics and the value of having a qualified credential, like the CSSD. Now with her experience and credentials, Lisa uses tools and training to help others have better outcomes that are tangible. For example, working to educate clients about food and nutrition for shaving off mile time helps her clients to see how food connects to performance.

 

You can connect with Allison and Lisa via email by scheduling an appointment at scheduling@casespecificnutrition.com. If you would like to work with a sports dietitian like Allison or Lisa, it can be a great experience to work with a qualified professional to fuel your body for your health and fitness goals.

Copy of Five Reasons (1)

Five Reasons Why Your New Year’s Resolutions Suck

by with No Comment Blog PostsPittsburgh Dietitian

Written by: Ava Elliott, Marketing Intern and Future Dietitian

Reviewed by: Devon Kroesché, MS, RDN, LDN

New Year’s Resolutions get a bad rap – just because most fail before February doesn’t mean yours has to! Andrew Wade, CEO and Founder of Case Specific Nutrition joins Devon Kroesche, Registered Dietitian (RD) and Marketing Director of Case Specific Nutrition to tell you why your New Year’s Resolution SUCKS, and how to make a better one. Read below for a recap or click here to watch.

 

  1. You view it as a chore.
    • Nobody likes chores.
    • If this resolution should make your life better, why do something that makes you miserable?
    • Instead, choose habits that you enjoy. For example: exercise – movement is the goal of your exercise. How do you like to move? Maybe you go for walks with your dog or play pickup basketball with your friends.
  1. You don’t have a why.
    • Having a good why behind your resolution is a necessity for change.
    • Why are you choosing this goal and how does it make you feel?
    • Is improved health going to decrease your knee pain so you can play catch with your kids?
    • Choose something that is important and do it for you.
  1. It’s too vague.
    • Vague = VAPID
      • Goals are Vague, Amorphous, Pie in the sky, Irrelevant, and Delayed
    • Maybe you are choosing to eat more veggies, but how often? When? Why?
    • Set SMART goals that are Specific Measurable Attainable Realistic and Time sensitive
    • Now to change the “eating more veggies” to be SMART: include veggies at lunch and dinner, daily. This will set a timeline and make the goal more realistic. You can look up recipes to add more veggies to your day.
  1. You don’t have a plan.
    • If you fail to plan, you plan to fail.
    • What do you want to accomplish and how will you look get there? Make a plan.
    • Going back to the goal of exercise, do you have gym membership, or will you go for weekly walks with a friend?
    • SMART goals will help you build a plan.
    • RDs help evaluate their client’s stages of change and assess how ready you are to make a change.
    • Often times, people get stuck in the preparation phase because of a lack of plan.
  1. You have not identified your cheerleaders.
    • Making changes and going against our normal habits of day-to-day life can be a challenge. Identifying your cheerleaders will help you succeed.
    • Professionals, like RDs at CSN, are part of your team.
    • In your house, identify your cheerleaders: spouse, family members, loved ones.
    • In your life, identify your friends and people you spend time with. They are the people you’ll make plans with and will support you to help you stick to your new habits.

 

Those are all five reasons why your new year’s resolutions suck, but let’s flip it around to…the five steps that you need to take to make a New Year’s resolution that will last.

  1. Find something you do not view as a chore.
  2. Find your why.
  3. Make it SMART.
  4. Make a plan.
  5. Identify your cheerleaders.

If you’d like to work with one of our RDs as your cheerleader, please email scheduling@casespecificnutrition.com to schedule an appointment and begin working on your new goals.

 

What to do if you think your child has an eating disorder

What to Do If You Think Your Child Has an Eating Disorder

by with No Comment Blog PostsPittsburgh Dietitian

Co-Written By: Ava Elliott, Marketing Intern & Danielle Marzella MS, RDN, LDN

Reviewed by: Devon Kroesché MS, RDN, LDN & Danielle Marzella MS, RDN, LDN

The prevalence of eating disorders (ED) and disordered eating is still being studied and results vary based on specific types and subtypes of EDs. However, the nationwide prevalence for children with EDs is increasing and can continue into adulthood. It is vital to prevent disordered eating from developing into a clinically diagnosed ED. After speaking with Danielle, who specializes in counseling clients with eating disorders (ED) and disordered eating, we compiled a list of “do’s” and “don’ts” if you suspect your child may have disordered behaviors. Additionally, some general tips on how to proceed with getting professional help.

 

Tips To Do

Make an appointment with a professional. There is no point that is too soon to schedule an appointment with a Registered Dietitian (RD), counselor, or doctor. It is important to get help and establish a path towards recovery. As a parent, be aware of the conversations your children are having with their friends and conversations that occur around your children. Is anything triggering? Is there a lot of diet talk?

Step 1: Express concerns to a doctor and see their opinion.

  • Danielle recommends speaking with a pediatrician or RD who has background knowledge in working with EDs and disordered eating. Look for the Certified Eating Disorders Specialist (CEDS) credentials or a provider with a specialty in EDs. It is vital to work with a professional who is trained and can help your child on the path to recovery. Some RDs and doctors have experience with appetite stimulants, how to manage medications, and can also refer you to another qualified provider.

Step 2: Be an advocate for your child.

  • If you start working with a health-care professional that you do not feel comfortable with, switch to another provider. Children are easily imprinted upon, and you want them to get the best help possible. Speak up to help your child maximize their experience.

Step 3: Support your child.

  • Encourage your child and always support them, but do not force any diet talk. Forcing certain food patterns will create a negative environment around food and you want to create a welcoming environment in your home. All foods fit.
  • Your tone of voice as a parent is vital to support your child. For example, you might say to your child in private, “I’m noticing (behavior) and wondering if you are feeling some type of way? Why don’t we find someone that can help us explain this behavior. We can both learn more together.” Sharing the burden with your child will help them feel loved and supported in this complex environment.

Step 4: Be aware of your tone of voice.

  • Remain inquisitive and supportive.
  • If you are struggling to get your child to attend a meeting, spin it in way that your child needs to hear it. This conversation might look like:
    • “Okay, detective. If you’re concerned, let’s seek help.”
    • “You want to maximize your nutrition and a dietitian can help us with our bodies and nutrition.”
    • “You think nothing is wrong with your habits. Let’s go prove your point and see a professional to provide proof you are right.”
  • Your child may know something is wrong deep down and not want to do anything about their disordered behaviors. Meet them where they are. Remain supportive and you can say, “I want to feel my body too. Let’s go find a dietitian that understands us.”

 

Please, Do Not:

  • Minimize a person’s experience.
  • Say, “just eat it” or “it doesn’t matter.”
  • Do not comment on your child’s food choices, body shape, or size.
  • Do not say foods are “good” or “bad” for you.
  • Do not align morality with food.
  • Do not talk about dieting and expect your children not to diet.

 

Once you and your child are ready to seek help, you want to feel comfortable with your RD and trust them to help your child through this tough time. RDs will work with you and your child to develop a level of care that is most comfortable for both of you. Keep in mind, throughout the process you can evaluate YOU. Are you contributing to triggering thoughts and talking about how foods are good and bad for you? Or are you supporting your child on the journey to create a positive relationship with food and their bodies?

You can be an advocate for your child even outside of counseling sessions. Normalize shutting down body talk and food talk. During the holidays, you can tell your family members, “do not say comments about food in front of my child.” You are their biggest support system. What is your child comfortable with? Make sure you are on the same page with how to handle things in public. If you think your child may have disordered eating and you want to minimize further disordered thoughts, you can schedule an appointment to speak with a dietitian by emailing scheduling@casespecificnutrition.com.

Anti-inflammatory foods

Anti-Inflammatory Foods & Reducing Stress

by with No Comment Blog PostsPittsburgh Dietitian

Written by: Ava Elliott, Marketing Intern and Future Dietitian

Reviewed by: Devon Kroesché, MS, RDN, LDN

I often hear others around me express stress whether involving schoolwork, a job, or personal matters. I get it. I get stressed out too, but how can we reduce daily stressors to prevent our bodies from initiating an innate inflammatory response? I will highlight examples of anti-inflammatory foods and lifestyle changes that can help you reduce stress and inflammation in your life.

First, let’s discuss the inflammatory process that occurs in our bodies. When there is an inflammatory response caused by cell injury, the body sends immune cells to the site of infection/trauma to clear it. The immune cells help return the affected site back to normal and reduce local inflammation. Anti-inflammatory substances released are part of a healthy immune response.

Do you know the difference between acute vs chronic inflammation? Acute inflammation occurs for minutes to hours and is involved with things like wound healing. Chronic inflammation occurs for weeks to months, and sometimes years. It can occur in diseases like rheumatic disorders, autoimmune diseases, and other chronic illnesses. Our bodies are not built to deal with chronic inflammation. Long term, chronic stress can suppress the immune system and lead to complications. By adding anti-inflammatory foods into your diet, you can counteract inflammation.

Nutrition and lifestyle can help reduce inflammation and lessen symptoms. Many phytonutrients and other micronutrients have anti-inflammatory properties. Phytonutrients also have antioxidant properties that help reduce oxidative stress. This reaction is important because damage from oxidative stress can lead to chronic diseases and cause damage to cells. Antioxidants act as a safety net from this damage.

  • Examples of anti-inflammatory nutrients include:
    • Curcumin (in turmeric) and black pepper combined
    • Polyphenols in green tea, blueberries, and capsicum peppers
    • Carotenoids:
      • Lycopene in tomatoes, peaches, watermelon
      • Beta-carotene in carrots, sweet potatoes, spinach, broccoli
      • Astaxanthin in salmon, algae, shrimp
    • Omega 3 fatty acids in foods like olive oil, canola oil, fatty fish (like salmon and tuna), flax seeds, chia seeds, walnuts, fortified foods
    • Some herbs and spices like garlic, cinnamon, rosemary, sage, thyme

As you can see, there are many plant foods that contain phytonutrients that can be beneficial for our bodies and help reduce inflammation. Following a dietary pattern high in fruits and vegetables, eating legumes, sources of omega-3s, low-fat dairy products, lean meats, whole grains, and minimal alcohol consumption can provide our bodies with the essential nutrients it needs. The Institue of Functional Medicine has a great resource of foods rich in phytonutrients displayed by eating a “rainbow.”

As far as lifestyle habits to reduce stress and inflammation, it is important to practice mindfulness, exercise, spend time outdoors, avoid processed foods, drink water, and eat a variety of nutrients (especially fruits and veggies). Other important factors include getting adequate sleep, avoiding foods if you have an allergy/intolerance, and reducing oxidative stress (limit toxins, smoking, and eat your anti-inflammatory foods). If you want to speak with a registered dietitian about incorporating more anti-inflammatory foods and practices into your lifestyle, please email scheduling@casespecificnutrition.com.

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Functional Movement Screen

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Posted by: Ava Elliott, Marketing Intern and Future Dietitian

Hess Physical Therapy provides rehabilitation services in the west side of Pittsburgh. Their team of physical therapists uses a science-based approach to provide the utmost care for their patients. The following post is written by Jessica Homer, the Director of Operations, and her colleague about functional movement screening. Their services are similar to what Alex at Case Specific Athletics provides to the east side of Pittsburgh.

THINKING ABOUT YOUR FALL WORKOUTS AND TRAINING PROGRAMS?

THINK ABOUT FMS!

Functional Movement Screen

Written By: Jessica Homer, PT, DPT, COMT, HMS, OCS

Gage Swartz PT, DPT, COMT, CSCS, FMS, USAW

Alex Kalmar, CSCS

 

What is the FMS?

The Functional Movement Screen (FMS) is a screening tool used to evaluate fundamental movement patterns that are necessary for an individual’s optimal performance. The FMS is designed to provide an individual with opportunities to improve movement and maximize their training results.  The screen is a series of movements that highlight dysfunction where stability and mobility deficits exist. Many individuals who perform weightlifting, sports, and other activities at high levels are limited in fundamental movement, thus increasing their risk for injury. The desire to perform quantity over quality results in compensatory movements to achieve or maintain the level of performance required for that activity. The use of compensation during movement will lead to poor biomechanics. This limits gains in performance and reduces the body’s ability to remain adaptable against the risks involved in that activity or sport.

 

Why FMS?

FMS screening will provide an individual with a personalized report on areas of weakness, asymmetries, and movement dysfunction that correlates with their activity of interest. These results will highlight ways to optimize and improve performance, maximize results, and ultimately decrease risk of injury! If you want to learn how to improve your performance, maximize your results and decrease risk of injury, you will want to get an individual FMS score!

 

Summary

FMS is a great tool to observe someone’s movement quality and highlight any asymmetries they may have. A key focus to proper training is to balance out any asymmetries. This helps mitigate compensatory movements due to strength or mobility imbalances, which will hopefully improve biomechanics and limit risk of injury in all populations.

 

So, before you begin developing your workout program, think about FMS! 

For functional movement screening in the North and West Sides of Pittsburgh, check out Hess Physical Therapy and their team at hesspt.com

For FMS on the East Side, reach out to Alex Kalmar of Case Specific Athletics at alex@casespecificathletics.com

 

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Does Cooking Food Make It Lose Its Nutrients?

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Written by: Ava Elliott, Marketing Intern & Future Dietitian

Reviewed by: Devon Kroesche, MS, RDN, LDN

 

A common question registered dietitians receive is: does how we cook food alter its nutrient content and absorption? The short answer is, yes – the way food is prepared can maintain or decrease nutrient absorption, and in this article, I’ll explain why. 

The six main nutrient groups consist of carbohydrates, lipids/fats, proteins, vitamins, minerals, and water. All of these nutrients are essential to our bodies, and it is vital to maintain the highest nutrient content during the cooking process.  

Vitamins and minerals function as antioxidants and provide many essential nutrients. Foods with a high vitamin and mineral content include meat, dairy products, egg yolk, fermented foods, and plants. There are certainly many others, so it is important to eat a variety of foods during the day.  

Cooking methods and preparation time are priorities you may have while cooking. Nutrient-breakdown is another important factor to consider during cooking because not all cooking methods are created equal. The goal is to maintain the most nutrients. For a lot of vegetables, it is necessary to cook them to improve digestibility; the softening of cellulose structure increases nutrient absorption (like calcium, magnesium, and potassium.) Boiling and cooking reduces the nutrient content, but about 75% is retained. As you know, cook the veggies until they are softened and have a bright color.  

Keep in mind, the nutrients most susceptible to nutrient loss are water-soluble vitamins. Instead of cooking, you can buy/prepare frozen, canned, and dried fruits and vegetables that retain water-soluble vitamins. If you are trying to shop on a budget, frozen or canned produce are budget-friendly and still provide many nutrients. Frozen fruits and veggies undergo blanching (boiling and steaming for a short period of time) prior to freezing, which helps maintain the vitamin and mineral content. The USDA has a table of Nutrient Retention Factors if you are interested in the exact amount of 16 vitamins and 8 minerals maintained for around 300 foods.  

Other foods like meat and eggs are cooked to eliminate bacteria. Make sure you follow proper food safety methods and cook food to the correct temperature. For example, chicken and poultry should be cooked until they reach an internal temperature of at least 165 degrees Fahrenheit. When frying, roasting, or boiling chicken, 40% of folate is lost. Many other nutrients are retained, so it is not a concern. On the other hand, eggs on the stove (fried or scrambled) lose folate the most from the heat process as well as a few other vitamins like vitamin C and vitamin B12. About 75-85% of these nutrients are retained, however.  

Overall, the cooking process does alter nutrients because of the heat. But, as long as you prepare food safely and for the correct time, you can maintain the most nutrients. If you’d like to speak to a dietitian about the way you prepare your food, schedule an appointment by emailing scheduling@casespecificnutrition.com. 

3 Things Your RD Wants You to Know Before Your First Appointment

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3 Things Your RD Wants You to Know Before Your First Appointment

Written by: Ava Elliott, Marketing Intern

Reviewed by: Devon Kroesché, MS, RDN, LDN

It can be intimidating to schedule an appointment with your new healthcare provider. You are wondering what a registered dietitian (RD) can do. Rest assured that the RDs at Case Specific Nutrition (CSN) are here to help. To prepare for your first visit, here are a few things your RD wants you to know:

    1. You are courageous. I’m proud of you for realizing that you can’t do this alone and seeking out an expert health professional, rather than trying the trendy diet you saw on TikTok. It takes bravery to reach out, schedule an appointment, show up and be vulnerable because, let’s face it, food is personal.
    2. You won’t be judged. Dietitians are not the food police. I won’t judge you if you eat fast food every day or even if you want to KEEP eating fast food every day. If you’re not sure if you want to give up your current diet like keto or beach body, I will meet you where you are to help you achieve YOUR goals. I will give you my honest opinion, but you decide where we go from there.
    3. Your life is about to change forever. Once you start working with a dietitian, you’ll relate to food in a whole new way and finally understand the root of your eating behaviors. You’ll have an arsenal of knowledge and tools that you will be able to use to make informed food decisions for the rest of your life!

Working with an RD can be very impactful and bring peace to your body and mind. Whether you are struggling with food intolerances/allergies, disordered eating, or wanting peace with food, CSN has a dietitian that is right for you. If you are interested in scheduling an appointment, email scheduling@casespecificnutrition.com.

Upcoming at CSN…

RDN Devon Kroesché and Dr. Sobel are hosting A Midsummer Night’s Dream on August 11th at 7pm on Zoom! They will be discussing seasonal plant-based meal prep that is both affordable and easy for a busy household. Click the button to join the Zoom.

A Midsummer Night's Dream