Take it With a Grain of Salt

I love blog requests, this came from a client last week:
  I'd like to know what you think about salt.  My husband says I shouldn't put it in anything, even when the recipe calls for it.  I know that my body reacts negatively to it and that it is better to avoid it (and given the paucity of salt we eat, things, especially fast food, tend to taste overly salty).  But soy sauce on sushi, salt on edamame, and even on some scrambled eggs, tastes good.  What do you think?  Is a sprinkle a good thing or a bad thing?

First, I think whomever is making the recipe gets the final say on what goes in it. Just so you don’t think your husband is the only one with questionable salt habits, my husband salts everything before tasting it. So we don’t all “shake” the same but I’m getting off topic.

We do need some salt. It's  particularly important for people, like yourself,  who bike and run outside in the heat. Salt or sodium is lost in sweat. The higher the temperature and humidity, the more sweat and the more sodium you lose. While I don’t think salt replacement during exercise is warranted for workouts or races under 90 minutes. I do think some salt does an athlete good.

While dangerous hyponatremia or low sodium is rare. Too little salt is as dangerous as too much. Salt is needed for muscle contractions (our heart is a muscle), salt moves nutrients and water into our cells and interestingly salt may be a mood food or mood mineral. Research from the University of Iowa showed rates deficient in sodium chloride (table salt) shy away from activities they normally enjoy.  I provided the link if you’d like to learn more about rat fun but let’s suffice it to say we’re very similar to rats.

The amount of salt we need isn’t all that much. The AI or “adequate intake” which differs slightly based on age is 1500 mg or about ¾ of a teaspoon of salt. The UL or “upper limit” is 2300mg and 2000mg is 1 teaspoon so this is a little over that. To put this into food context show how easy the AI is to hit:

• 1 medium pickle has about 800 mg of sodum
• 4 slices of smoked salmon have 500mg
• canned beans have 500mg in ½ cup (rinsing reduces this number almost in half).
• Sushi Roll (naked, sans soy) 500-1000mg per 6-piece roll.

As to what type of salt to use, there are a few I love. Himalayan Sea Salt is unrefined so it’s a more natural product in a more raw state and contains more minerals (84 different minerals) than processed table salt. I like the Himalania brand. I also used Kosher salt and received a gift of Sicilian Lemon Salt recently. Table salt contains iodine (can throw off taste) and can contain additives so look at your labels. The only ingredients should be salt.

So salt via soy sauce (unless you're gluten free) or with edamame or eggs is absolutely fine.  You mentioned “reacting negatively” and I assume you were referring to bloat. Bloat may be telling you you over salted. Salt can be sneaky, here’s a list of some surprising salt sources. So don’t close the salt cellar just hide it from your husband.

Are you pro or anti salt? What type do you use? What are your favorite salty foods?

Why I Died

A couple of weeks ago I somewhat foolishly ran the Queens half marathon in sweltering temperatures. As I was recovering from the race I received the following email:

Oh my gosh did you really run the Queen’s Half today? You are my hero. I am working in the ER today (thankfully not one in Queens) and we were all saying how happy we were not to be working in one of the Queen’s ERs. I have worked in some of the medical tents during marathons, halves and triathlons and all I can say is WOW…healthy people can get sick fast.

This email was from a star Foodtrainee who is training for the NYC marathon. We’ll call her Dr O (or in this case maybe I should say Dr Oh No!). It was opportune to hear from Dr O as I happened to have a few questions for her. Not only had I crashed and burned in Queens but I also observed countless fellow runners “losing their Gatorade” and lying down on the sidelines in what yogi’s aptly call corpse pose. I emailed Dr O some of my questions:

In hot weather what do you see in the medical tents, it sounds like MASH?
We see hyperthermia, heat stroke, dehydration, hyponatremia and general orthopedic injuries like pulled muscles, stress fractures etc.

Why was Queens so miserable? I trained well, felt good, hydrated appropriately what is it about the heat that killed me?
I think the Queen's 1/2 was so miserable for many reasons. One, it was in Queens (I did that run a few years ago and it is not pretty). It was so hot that your core body temp had to have been very high which makes the muscles and heart demand more fuel and oxygen, also it was humid...humidity is dangerous. One way for the body to cool itself is by sweating and then having that sweat evaporate. When the air is already saturated with water (high humidity) the sweat does not evaporate....and you don’t cool ! With no way for your body to cool your internal temperature rises. Throughout the race your core temperature was rising which is why, despite fuel, things felt harder as the race went on. If you want to keep up a certain pace, either the blood (and oxygen) goes to your muscles to keep up with the pace demands and you start to overheat because less blood is going to the skin for cooling or the blood goes to the skin for cooling, but less blood goes to your working muscles. Either way demands exceed supply. When we have a hyperthermic patient we cover them in ice and put fans on them (well we did before we got a $250,000 hypothermia machine). No machine at the half marathon though.

What does your GI system take a toll when running in the heat?
Dehydration seems to exacerbate GI symptoms and that may be why it’s worse in hot weather. Also, blood is redistributed during extreme exercise and there is some ischemia to the diaphragm. At rest 15-20% of the blood goes to skeletal muscle but during exercise this increases to 80-85%. The jolting of running stresses the ligaments that support the abdominal wall. You see more GI issues in running than in cycling. Vomiting can be a sign of hyponatremia, which though extremely dangerous is still fairly rare and usually involves hydrating 2-6 liters beyond what is suggested.

Thanks Dr O. I now understand what was happening. I’m still slightly flummoxed (and jealous if I’m honest) that some people seemed to be unaffected by the heat. They ran well and finished respectably. Maybe it’s A/C. In my obsessive research I read to truly acclimate to hot weather one shouldn’t spend the majority of their time in A/C….too bad that’s not going to change!
Do you have any medical questions for Dr O about eating or exercise? Do you prefer extreme hot or extreme cold (seems people pretty split)?

Questionable in Queens

If you live on the East coast,  you recall this past Saturday’s weather. If you do not, chances are you heard about it. When a day stands out weather-wise in the midst of a summer long heat wave it has to be pretty hot. Saturday was also the day of the Queens half marathon. Last week, I started to hear rumblings of a super hot day on Saturday but didn’t think much about it. I had signed up for the ½, it was on my rigid running schedule, I was excited about it and wasn’t about to cancel because it was going to be hot. A couple of my running friends dropped out but I wasn’t budging. My running coach, who to give you an indication of his mental stability was in Napa doing a ½ ironman in similar weather the week prior, said I should give it a try. He told me if the Kenyans cancelled their runs due to especially hot weather they would never run. As a New Yorker and not a Kenyan, I wasn’t entirely buying this logic but was set to run.

I made a playlist, packed my Honey Stinger drops, money and a Metro card and left the house a little before 6am Saturday morning. I tried to ignore that it was already steamy. Before you start to think I’m this tough and determined person please note I took a car service from Manhattan to Queens. Throughout the ride the radio repeatedly mentioned the weather, warning signs of heat stroke and many other things that helped calm me down (not!). In about 25 minutes we were in Flushing Meadows right near Citi Field and the site of the US Open. I paid the driver and followed a pack of runners toward the starting area. I then did what all runners do before a race and located the porto potties. I smiled to myself as looming over the line-up of green porto pots was the top of the exquisite Unisphere (pictured above). Little did I know that the scenery, though not the course, was mostly downhill from there.

I checked my small bag and headed to the corral, the lovely equine term used for the starting area. I stretched and set my watch (Garmin forerunner 405 with GPS in case you’re curious). As runners lined up it seemed like business as usual. There was no talk of the temperatures and at least a few thousand people. I was convinced all the “you’re crazy to run” talk was hogwash. And then Mary Wittenberg president of NYRRC said a few words into the microphone. I listened carefully for encouragement and heard “BE CAREFUL, IT’S DANGEROUS OUT THERE, THIS IS NOT THE DAY FOR PRS (PERSONAL RECORDS), THIS IS A DAY TO TAKE IT EASY.” So much for a pep talk. Minutes later the horn sounded and we were off.

After about 30 seconds I realized I was already sweating but then, as is the case with races, I settled into a groove and just ran. We exited the park and ran for a few miles down a Queens Avenue that couldn’t be less scenic. We passed bodegas and bagel shops and breathed a sigh of relief with each mile marker. I was feeling absolutely fine, used my GPS watch to make sure I didn’t go out to fast, and stuck to my race plan. I decided I would use my iPod at the 6 mile mark so for the first half of the race I was just looking around. There were heavy people and tiny people, couples running together and a girl whose shorts were definitely going to fall down at some point in the 13.1 miles. There was also a noticeable quiet. I didn’t hear the usual chatting that can sometimes be a nice distraction for a few miles. I am not one to chat but love to eavesdrop.

At about 5 miles there was a turn around and we literally retraced our steps down the same urban avenue. I said to myself that I was going to keep to pace I was at and at 10 miles, if I felt good, I’d pick up it up. I dutifully stopped at all fuel stations for water or Gatorade or simply to get hosed down. At 6 miles I received my musical reward. I enjoyed my motley mix ranging from Paul Simon to Rihanna, Michael Franti and Madonna. At the 8 mile mark I noticed I had been running alongside a fellow from the Van Cortland track club for some time. I hadn’t looked at him but knew we had been running similarly. When I caught a glimpse of his face I realize he was well over 70! By the 9 mile mark it seemed they were placing the water stations further apart. Of course they weren’t but I was starting to feel off. At 10 miles I had transitioned into the put one foot in front of another strategy. Runners around me were having a hard time, many walked, and a good number got sick on the sidelines. I had never witnessed anything like this.

At the final water stop I stood under the hose for a good 2 minutes, my time goal wasn’t going to happen; I just wanted to finish. I did finish, though it was without the usual final burst of energy I tend to have upon spotting the finish line. I walked to the subway still out of breath a good 10 minutes later but I was already happy with my decision. It was hard and I was exhausted but also proud of myself. I am not one to climb mountains or bungee jump and though active stick to my comfortable cocoon running and yoga. It’s not often that I really push it but I did in Queens and I would do it all over again.
When was the last time you pushed yourself physically? Have you contemplated signing up for any sort of a race? If you haven’t what holds you back? Why do you think some people like a physical challenge and others do not?

Heat-beating Eating

I recently contributed this piece to a fantastic site called Blisstree. You can check out the original post (and my enormous head) there or read my pasted version below:

Summer means more outdoor exercise, but also beach, pool, and backyard parties with (let’s face it) lots of drinking. Plus, it’s hot, and (if you’re where we are) way too humid. We love a good summer afternoon barbecue, but heat waves and multiple mojitos can leave us feeling exhausted and sluggish. Foodtrainers to the rescue.
• Water and White Tea, Not White Wine: Much of how we feel during the summer has to do with our hydration status. Both sweating and alcohol can dehydrate us, so pump up your water drinking with 2-4 cups more than your norm (10 cups a day for most people). And bad news: Avoid drinking at lunchtime altogether. That glass of wine or couple of beers at a midday barbecue is a surefire way to crash. Instead, we’re huge iced tea fans in warm weather. Try Republic of Tea brand tea bags with fresh mint or lemon or orange slices.
• Olives and Pickles: Not what you’d expect from nutritionists, but we tell our active clients to include some salty foods in their summer food plan. This is something athletes are accustomed to and a trick we can all benefit from. Yes, sodium is the villain behind bloating, but it’s also one of the electrolytes lost via sweat. The key is striking that balance where you feel energized but not enormous. Note: Healthy salty foods only, so chips and the salt on your margarita don’t count. 1-2 healthy sodium sources a day is perfect during a heat wave.
• Be Cool – as a Cucumber: Choose fruits and vegetables with high water content. In addition to cucumbers nothing says summer like a slice of watermelon. And cukes and watermelon even work well together.
• M & M Smoothies: Don’t get too excited – last we checked, M&M’s didn’t have an anti-sluggish claim to fame. But smoothies are a refreshing way to get fluid into your breakfast or snacks. Our secret energy-boosting ingredients are matcha (a powdered green tea) and maca, which is a South American root with fatigue-fighting properties sold in powdered form.

• Summer Soups: Nobody wants to eat anything hot and steamy in the summertime. Cold soups made from celery, sweet potatoes, or avocados are perfect warm weather meals. And don’t forget gazpacho. Think of summer soups as vegetable smoothies eaten with a spoon. You get a couple cups of much-needed liquid, and often potassium or B vitamins which help with mood and energy.
• Stay in Good Humor: Ice cream may temporarily cool you down, but, sadly, it’ll leave you feeling like a summer slug. (Plus, it’ll blow your diet.) Instead, try frozen banana slices or frozen red grapes. And don’t roll your eyes until you try them, they’re really good.
Have you ever made any heat eating mistakes? Any of the foods above you're going to try? Do you agree with us that day drinking is a disaster?