1 THE RUN FAST EAT SLOW WAY Figuring out how to optimally nourish your body for an active, happy, and healthy life is surprisingly challenging. We live in a culture that both celebrates food and fears it. We know we should eat better, but health food has a reputation of being bland and boring. Nutrition science and the media are constantly fluctuating on what's good versus bad for us. On top of all this, we are just too busy to take the time to cook nourishing meals. Unfortunately, the bombardment of misinformation around healthy eating has led to an epidemic of disordered eating habits amongst young athletes. "While disordered eating does not necessarily mean an athlete has an eating disorder (i.e., anorexia nervosa), there is a huge overlap. Many athletes are often unaware of just how many calories they require for their high level of activity. Other athletes may adopt a special diet in hopes of improving their performance, yet not make up the calories that are missing when specific foods are being eliminated, " says Jennifer Carlson, MD, who has extensive experience treating amenorrhea and the female athlete triad at Stanford University (read our complete interview with Dr. Carlson on page 30). Restrictive fad diets can easily spiral out of control, leading to an unhealthy relationship with food and malnourishment. In fact, in a study of Division 1 NCAA athletes, over one-third of female athletes showed tendencies that put them at risk for anorexia nervosa (nationaleatingdisorders.org). Even seemingly healthy eaters are often undernourished. Exact statistics are unknown, but experts estimate more than half of female endurance athletes have experienced athletic amenorrhea, with some studies concluding it affects upward of 65 percent of collegiate distance runners. Athletic amenorrhea, also called secondary or hypothalamic amenorrhea, is the absence of menstruation directly related to an energy deficiency. When the body isn't getting enough high-quality fuel, it begins to shut down systems that aren't necessary for survival, and the female reproductive system is one of the first to go. In the short term, poor nutrition puts athletes at an increased risk of injuries, stress fractures, anemia, fatigue, low immunity, irritability, poor concentration, and more. The long-term repercussions include low bone density, hormone imbalances, decreased metabolism, infertility, chronic diseases, cardiovascular risks, and depression. In this chapter, we'll explain how to eat healthy without counting calories, why you should ignore the latest diet trends, and how to get back in tune with listening to your body's hunger signals. We'll debunk the big fat myth around fat (bring on the butter!). And we'll teach you how to celebrate real food for the wealth of benefits it provides for both your body and mind. DIETING DOES NOT WORK Restrictive diets can be pretty enticing with all their promises for weight loss, six-pack abs, and eternal beauty. It's not surprising that we easily fall victim to the latest diet trend. The $64 billion weight loss industry is working hard in every media space to get our attention, which can make grocery shopping a confusing, panic-inducing activity. But the truth is dieting does not work and leads to an unhealthy relationship with food. In the long term most dieters regain the weight lost plus a few new pounds. There are many compelling reasons why dieting does not work. For starters, it's counterproductive to how your body functions. The body is constantly working hard to maintain balance, and when we restrict calories our metabolism outsmarts us and slows down. The body produces stress hormones in response to less nutrition, and these hormones signal cells to store up reserves resulting in weight gain. Dieting also leads to thinking about food around the clock, which doesn't help keep hunger signals at bay. The mind wants what it can't have. A month without chocolate can lead to binge eating an entire box of cookies, which can lead to negative feelings and anxiety around food. Additionally, restricting healthy fats and complex carbs leads to an energy deficiency, which causes sugar cravings. Our bodies end up wanting the quickest fuel source possible, which are simple sugars from refined carbs. And sugar is one of the leading culprits of weight gain. Lastly, dieting is simply no fun. Healthy eating should not be restrictive, bland, and boring. Nor should healthy eating become obsessive. Food should be celebrated--it nourishes our minds, bodies, and souls. The recipes within will help you indulge in real food with confidence. COUNT SPLITS, NOT CALORIES "In the past I would feel a burden with my diet. I worried about whether I was eating the right foods and how it would affect my performance. I now focus my energy on the quality of food instead of measuring quantities. I spend enough time counting miles and calculating splits on the track. I don't need to bring math into the kitchen, too." --SHALANE FLANAGAN After our first cookbook launched, we received emails from runners who were upset that we didn't provide calorie counts and carb, fat, and protein measurements. Despite the complaints, we received more emails from happy fans relieved to eat without numbers dictating their appetites. For our second cookbook, we stand by our belief that calorie counts have no place in the kitchen. When you're slicing and dicing real food, all that matters is taste and satisfaction. A calorie is a unit of measure based on estimates. Think back to science class. Do you know what a calorie actually measures? We had to check Wikipedia ourselves. It's defined as "the approximate amount of energy needed to raise the temperature of 1 gram of water by 1 degree Celsius at a pressure of one atmosphere." Huh?! In 1824, a scientist calculated the number of calories in a gram of fat, protein, and carbohydrate. These rough calculations from nearly 200 years ago are still used to determine the calories listed on every single packaged food. We now know that everyone burns a calorie differently. Digestion and metabolism are intricate processes that vary greatly from person to person. How much energy one person extracts from a hunk of cheese is different from the next person. Different foods are also burned differently. A calorie from an almond does not provide equivalent energy as a calorie from a Twizzler. Complex stuff! Additionally, people who count calories depend on packaged foods, since these foods make it easy to calculate numbers. But packaged foods are the very foods that cause weight gain. Whole foods, without the pretty packages and fancy numbers, leave us better nourished, more satisfied, and less likely to overeat. Instead of following rules, we want to teach you to get back in tune with listening to your body's hunger signals. First, trust that your body knows best. It can be hard to listen to hunger cues if you're constantly eating while on the run or in front of the TV. Turn off electronics so you can eat mindfully. Enjoy your meals with friends and family. Slow down and chew your food so your stomach has time to register how much you're consuming (Eat Slow!). And most important, everything you eat should taste amazing so that you feel satisfied at the end of a meal. That leads us to our next point. Bring on the fat. BIG FAT MYTH "Maybe you need more butter in your life." -ELYSE KOPECKY For years we were told to eat less fat because it was believed to cause weight gain and high cholesterol. The reality is whole food fats are essential for maintaining a healthy weight and help your body produce good (HDL) cholesterol. Despite all the nutrition science out there that debunks the notion that fat is bad, many runners still have an ingrained fear of fat. While on our book tour, we often got asked, "I'm not running 100 miles per week like Shalane, so how can I eat like her?" Whether you're a beginner training for your first 5K and trying to shed a few pounds or an elite athlete training for a marathon, you still need healthy fats in your life. In the 1970s, Americans developed a fear of fat after the government came together with major food companies to declare that saturated fat causes heart disease. Soon after, the packaged foods industry boomed with aisles of low-fat and fat-free products. Not surprisingly, during this "fat-free" era, Americans gained weight at an alarming rate. Turns out a diet rich in whole food fats (even saturated fat) is essential for a healthy metabolism, balanced hormones, and satiation--all of which prevent weight gain. Nourishing fats are essential for brain function. Studies show that fat helps prevent depression, balances our emotions, and improves concentration. A high-fat diet is especially important for pregnant and nursing women, babies, and young children to help with brain development. Fat-soluble vitamins like A, D, E, and K can't be digested without fat in our diets. Fat helps transport these essential nutrients to every system in our body. Additionally, fat is one of the best sources of usable energy for endurance endeavors. It provides balanced energy instead of a sugar high and crash. Medium chain fatty acids (found in coconut oil, butter, and whole milk yogurt) are especially efficient, since they're metabolized faster than long-chain fatty acids. We're even convinced that butter is more nourishing for an athlete than kale! Can't believe it? Hear us out: >> High-quality butter (organic or local, grass-fed, cultured) is incredibly nutrient-dense, providing vitamins A, D, and E. Vitamin A is essential to a healthy cardiovascular system. >> Butter is antioxidant-rich--move over pomegranates and blueberries. >> Grass-fed butter is rich in conjugated linoleic acid (CLA), a fatty acid proven to help your body repair its hard-working muscles. Athletes often obsess over protein, but protein isn't the only macronutrient essential for recovery. >> Butter has anti-inflammatory and antimicrobial properties. So does butter raise your cholesterol? Numerous studies show likely not. Cholesterol-rich whole foods are essential to help our body repair its 6 trillion cell membranes (cell walls are made out of cholesterol). Cholesterol is used to manufacture essential hormones, and you need good (real food) cholesterol to balance out the bad stuff. This doesn't mean you should go chomp on an entire stick of butter. But it does mean you should enjoy your kale sautéed in butter (see Miso Fast Greens, page 169), and don't be afraid to add a smear of butter to your toast, broccoli, or steak. If you're following a vegan diet, extra-virgin olive oil and avocados are great alternatives. Not all fats are created equal. It's still important to limit consumption of cheap vegetable oils like canola, soybean, and safflower oils, which are found in most packaged foods. Refined vegetable oil is highly inflammatory and high in trans fats, which can raise bad (LDL) cholesterol. Fat also stores toxins and chemicals, so when buying high-fat foods organic is the way to go. Studies show nutrients are much lower in factory-farmed, grain-fed meat, and the good fatty acids are higher in grass-fed meat (plus pasture-raised tastes significantly better). Butter is just one example of many fun fats to introduce into your culinary endeavors. Variety is best. Here are our favorite real food fats that we use frequently in the recipes within these pages: >> Grass-fed cultured butter >> Nuts, seeds, nut butter >> Extra-virgin olive oil >> Virgin coconut oil >> Avocados (and cold-pressed, unrefined avocado oil) >> Pasture-raised eggs (eat the yolk!) >> Grass-fed red meat (beef and bison) >> Organic dark meat chicken (dark meat is more nutritious than white) >> Wild salmon >> Canned sardines in extra-virgin olive oil >> Organic, plain, whole milk yogurt >> Aged cheeses (Parmesan) and goat cheese REAL FOOD FOR THE WIN "You are imperfect, permanently and inevitably flawed. And you are beautiful." --AMY BLOOM In our first cookbook, Run Fast Eat Slow: Nourishing Recipes for Athletes , we talk in detail about how we define "real food" and what ingredients we keep stocked in our pantries and fridge. If you haven't read those chapters lately, they're worth checking out; here's a brief review. "Real foods" are minimally processed ingredients that are close to their natural, whole food form. This means they look like they came from the land and not from a shiny, crinkly package. While foods like plain yogurt, aged cheese, nut butter, and extra-virgin olive oil are processed, we still consider these to be whole foods, since they are have minimal alterations and a short ingredient list. If your great grandmother ate the food, it's probably a safe bet. The foods that are staples in our diet include whole grains, beans, cultured dairy, grass-fed eggs and meat, wild fish, seasonal vegetables and fruit, nuts, seeds, and more. We eat a varied diet to ensure we're getting the full spectrum of micronutrients. This doesn't mean we eat strictly whole foods all the time, and you shouldn't either. Stressing that everything you put in your body is organic or whole can easily spiral out of control into obsessive eating habits. If you love ice cream, go ahead and enjoy a bowl. There's barely a day that goes by in Elyse's home where there isn't a baguette or bowl of tortilla chips on the table to go with dinner. And Shalane wouldn't survive without her coffee creamer or favorite dark chocolate bars. Fill up on nourishing, wholesome foods, enjoy favorite treats in moderation, spend more time in the kitchen, and you'll be on the right path. Read inspiring real food transformation stories from our fans starting on page 240. EPIDEMIC OF DISORDERED EATING HABITS AN INTERVIEW WITH JENNIFER CARLSON, M.D. We caught up with Dr. Jennifer Carlson, clinical associate professor of adolescent medicine at the Stanford University School of Medicine, and a leading researcher in the treatment of amenorrhea and the female athlete triad, to learn more about the prevalence of harmful energy deficiencies in athletes. We spoke to her specifically about the issues that develop for female athletes, but it should be noted that male endurance athletes are also prone to health issues related to undernourishment and can equally benefit from the advice within Run Fast. Eat Slow. Q WHAT PERCENTAGE OF YOUNG COMPETITIVE RUNNERS DO YOU THINK SUFFER FROM ATHLETIC AMENORRHEA? >> The numbers really vary between different studies and may reflect a number of factors: which athletes are being studied, how the questions are being asked, and whether a study is looking at amenorrhea or the range of menstrual dysfunction that may affect an athlete. In the literature, anywhere from 3 to 65 percent of female athletes are reported to be amenorrheic, though rates of other types of menstrual irregularities (oligomenorrhea, luteal phase deficiency) are even higher. In my clinic, this is an extremely common concern and the one that often triggers an athlete to visit her physician for further evaluation. Q FROM YOUR LATEST RESEARCH, WHAT IS THE LEADING CAUSE OF THE ABSENCE OF MENSTRUATION IN SO MANY FEMALE ATHLETES? >> Though there are many different reasons that an athlete (just as any woman) can have an absence of menstruation, the leading cause in athletes is an energy imbalance leading to low estrogen (estradiol) levels. If an athlete is not eating enough calories to compensate for her baseline metabolic needs as well as the increased amount of calories burned in exercise (particularly for runners), then she will have an overall negative energy balance. This negative energy balance results in the suppression of the hormones that control menstruation. With an estrogen level that is too low, periods will not occur regularly, and an athlete will be at risk for some of the other medical complications associated with low estrogen levels (like muscle and bone injuries and low bone mineral density). Q HOW COMMON ARE DISORDERED EATING HABITS AMONG HIGH SCHOOL AND COLLEGE ATHLETES? >> Disordered eating is extremely common among high school and college athletes. While disordered eating does not necessarily mean an athlete has an eating disorder (i.e., anorexia nervosa), there is a huge overlap. Many athletes are often unaware of just how many calories they require for their high level of activity. Other athletes may adopt a special diet in hopes of improving their performance, yet not make up the calories that are missing when specific foods are being eliminated. I see many athletes who are eating large volumes of food, but the calorie and nutrient content is way too low to meet their energy needs. Q WHAT IS CAUSING THIS EPIDEMIC OF UNDERNOURISHED ATHLETES AND EATING DISORDERS? >> There are likely several reasons contributing to the link of athletes and eating disorders. Athletics, in general, are becoming more competitive with youth often specializing in a sport at incredibly young ages. There is a lot of dietary advice being given to athletes at all levels that may not reflect the increased needs of the growing and developing bodies of adolescents and young adults; it is a setup for undernourished athletes. Our food culture also touts many different food fads that may not be appropriate for athletes with high caloric needs. For example, if an athlete chooses to become vegan and gluten-free, it is going to be a time-consuming process to get in the volume of food that she will need for her energy needs and nutrient balance. Eating disorders are slowly losing the stigma associated with them, and people are starting to speak out about their struggles. With more awareness, individuals who may not have discussed their struggles in the past may be feeling more supported to do so now. Q WHAT CAN BE DONE TO HELP PREVENT EATING DISORDERS AMONG YOUNG RUNNERS? >> Education about energy needs and balance in intake are critical components to maintaining good health for an athlete. Athletes and all the people who support athletes (parents, family, coaches, trainers, teammates) need to be educated about the importance of appropriate nutrition and the signs of an energy imbalance. Athletes need to be aware that missing a period during their season should not be considered a normal, possibly convenient, side effect of training. Rather, it is a sign that one's body is not functioning normally and is at increased risk of short- and long-term complications. For more help on this topic, check out the National Eating Disorder Association (NEDA) at nationaleatingdisorders.org. The website is full of resources, including a free, online tool kit for athletes (and coaches). The Female Athlete Triad Coalition (femaleathletetriad.org) is also a great resource for athletes and coaches. Excerpted from Run Fast. Cook Fast. Eat Slow: Quick-Fix Recipes for Hangry Athletes by Shalane Flanagan, Elyse Kopecky All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.
