Posts tagged nutrition
Training With the Flow by Amanda Roe, ND

Having a uterus and ultrarunning is generally pretty rad. There is nothing like running into some badass women in the woods, tearing up the trails and having a great time. We push each other to be better, dream bigger, run stronger. How many times have you been digging deep for the next internal power surge to arise and been inspired either by thinking of another woman runner, or witnessed within yourself that core sense of knowing you’ll rise to the occasion? We lift one another up in this sport. In the interest of elevating women in sports, let’s lift the mystique of that monthly visitor that can throw a bit of a wrench into an otherwise finely tuned machine. Periods run interference on even the best training schedules and can set you back a week or two at a time. Most of us are already balancing our running with career, family, and the odd (gasp) other pastimes besides running. Raise your hand if any of the following scenarios sounds familiar. I know.

“I was packing the car up a few months ago to leave for an early morning race. I ran back in the house to pee only to find that Aunt Flo came by to wish me luck. The race was set to start in 2 hours. I thought she was coming on Tuesday!”

“I’m scheduled for a long run on the weekend, but have been bleeding and cramping for the past two days. My legs feel weak, my back hurts, and I would eat a Taco Bell Party Pack faster than a gaggle of teenaged boys right now. How can I cement the wherewithal to get 20 miles in bright and early? My 50K is 6 weeks.”

“Looking ahead at my race calendar, again I count the weeks to go: seven weeks until the next race. I have my period this week. It should be 8 more weeks until ‘that time of the month’, but it’s going to be a close call. Can’t I just plug it up and pretend it’s not happening??”

There are so many factors that affect our biggest days out there racing and training, and uterine behavior (or misbehavior) doesn’t need to be another big unknown. Getting a general sense of your cycle can empower you to do all the right things to guide your body toward training and racing strong, before, during, and after your period.

HERE COMES AUNT FLO: Running before period (Days 15-28 of cycle)

Hydration is key. There are a lot of hormones leaving the system during this time, and it can feel akin to a detox. For women who experience premenstrual headaches, be extra sure to keep those electrolytes balanced and the excretion (ahem, peeing and moving your bowels) humming along. If you’re up for it, a trip to the sauna or hot yoga class can aid with the processing. Decreasing inflammation is also vital, particularly if you get bad cramps or have endometriosis. Focus on foods high in essential fatty acids, known for decreasing cramping and clotting, like olives and olive oil, avocado, nuts, seeds, fatty fish (like salmon, cod and halibut). Decrease coffee, alcohol, and limit sugar, as these amplify inflammatory pathways in the body.

SHARK WEEK: Running during period (Days 1-7 of cycle)

Use your discretion in determining when and how much to run. For some women, the increased circulation from exercise actually helps relieve cramping and clotting. For other women, running can cause more fatigue. Eat iron-rich foods: dark leafy greens, eggs, beets, poultry, and beef. Combining iron-rich foods with Vitamin C or foods high in Vitamin C (citrus, spinach, berries) will help your body absorb more iron naturally. Magnesium can also help a bunch. Epsom salt baths are great way to relieve muscular tension from cramping, low back pain, and leg pain.

GETTING OFF THE COTTON PONY: Running after period. (Days 7-14 of cycle)

Sleep is your buddy, and you’re likely to be feeling much better now that your body is resetting. Treat it to some daily nourishing blood-builders like spinach, black beans, dates, and carrots to stay on top of your game. Run strong, and tear it up out there, my friends!

Naturopathic care for Postpartum Mood Issues

Naturopathic doctors are trained to look for the root problem causing someone's symptoms, rather than just making the symptoms go away.  If we address the underlying cause, we can allow the symptoms to recede for good.  This is no different for postpartum women, and there are a number of reasons WHY women develop postpartum mood disorders.  Naturopathic doctors, especially those trained in the art of midwifery or who have had special training in pregnancy and birth, are very well-equipped to figure out how to best help each woman on an individual basis. Dr. Adriana Azacarate-Ferbel is a Portland area Naturopath who has studied Postpartum depression extensively.  I met with her last fall when I began researching this topic more myself.   She outlined the most common underlying reasons for development of Postpartum depression:

  • Fatigue and Sleep Deprivation
  • Hypothyroidism
  • Hyperthyroidsim
  • Immune system dysregulation
  • Pain
  • Low Cholesterol levels
  • Hormone imbalance
  • Neurotransmitter
  • Insulin resistance

Sometimes, it may be a combination of one or more of these that can cause postpartum mood disorders to develop.  Because this is true for many women, the Naturopathic approach is multifactorial as well.  The earlier we can recognize the symptoms and determine what's actually going on, the better.  In my office, a primary work-up to determine the underlying cause may include:

  • Thyroid testing, followed by nutritional supplementation and/or medicine to balance the thyroid gland (if needed)
  • Combination Hormone and Adrenal Saliva testing, followed by treatment with herbs and nutrients known to balance female hormones, DHEA, and/or cortisol (and are safe for breastfeeding).
  • Lipid panel, to look at cholesterol levels, followed by nutritional counseling to ensure adequate levels.
  • Comp. metabolic screen, Iron panel, and Complete blood count, to assess for blood sugar issues, anemia, and immune system problems
  • Musculoskeletal assessment to determine sources of pain that may be adding to increased stress and fatigue, followed by massage, acupuncture, or other forms of physiotherapy
  • In some cases, neurotransmitter testing will be done first.  This is especially true if someone has a marked history of depression, anxiety, or psychosis.

I could write pages and pages on this topic.  This is just a jumping-off point.  There is still a lot to learn about this realm of women's health, but we have a very good grasp on how to make the transition to motherhood a happy and healthy time.

Be strong.  Live healthy!images

Postpartum Nutrition

Good Morning!  It looks to be another beautifully sunny morning here in Portland, Oregon.  Wow, we have really been blessed with some fantastic weather the past few weeks.  Our clinic garden is looking great as well as the garden my family and I are growing at home.  I'll be taking some photos to show you all just what I mean! imagesToday I'd like to round out this series on Nutrition during pregnancy by providing some guidelines about postpartum dietary needs.  The postpartum period is defined as the time from the birth of the baby and placenta to 6 weeks afterwards.  I personally believe that this extends to 3 months after the birth at minimum, with the first 6 weeks being the time when the body makes most of it's transition back to "normal".

I put normal in quotations because it is very common for women to feel like they have a totally new body after having a baby.  images-1To a certain extent, it's true.  It's not the same body.  It looks, acts, and feels different than before pregnancy.  Therefore, it has different needs.  This is especially the case if the new baby is breastfeeding. Let's have a look at some guidelines for women in the postpartum period:

  • During pregnancy, women need 200-300 extra calories per day to grow a baby.  During breastfeeding, women may need up to 500 extra calories per day to make enough milk to feed their new baby.
  • Also needed for milk-making is WATER.  Most women will need between 2-3 LITERS of water a day to keep up with the demands of making milk.  I like to get the whole family involved in the process, stashing bottles full of water wherever mom might end up nursing the new baby.  Intense thirst universally follows feeding the new baby, and moms everywhere love having a big glass of water while they nurse.
  • Many women need extra iron after having a baby.  Moms who had a lot of bleeding with childbirth are in a higher risk category for developing postpartum anemia.  To prevent severe anemia (which can lead to excessive fatigue and lowered mood):
  1. Increase iron in the diet: red meat, eggs, enriched cereals, and blackstrap molasses are good ways to get iron.
  2. Increase Vitamin C intake: Vitamin C helps you absorb more iron from your food.  Take with meals.  Do not exceed 3000mg/day unless being supervised by a health care practitioner.
  3. No black tea: Tannins in the tea decrease iron absorption.
  4. Cook with cast-iron pots and pans.  Believe it or not, you will get good doses of iron from doing so.
  • Continue to take your prenatal vitamins through the end of breastfeeding.  You still need the nutrients.  Plus, the extra B vitamins will give you much-needed mental and physical stamina.
  • Omega-3 fatty acids with a higher DHA:EPA ratio.  Studies show that infants benefit (neurodevelopmentally) from DHA supplementation in pregnancy and breastfeeding.  Moms also need these healthy fats to help heal and replenish the reproductive and nervous system.  DHA can be found in coldwater fish and algae most readily.  Taking an encapsulated form of DHA is a sure-fire way of getting enough.

Next week I'm going to address Postpartum depression, anxiety, and mood disorders.  It's more common than you think, and there's more that can be done to help prevent it from affecting you and the ones you love.  images-2

Herbal Nutrition in Pregnancy

DSC_0606Herbal Nutrition for Pregnancy Red Raspberry Leaf (Rubus Idaeus): tones the uterus during pregnancy, prevents hemorrhage, provides excellent source of Vitamins C and E.  Also good source of Calcium and Iron.

Nettles (Urtica dioica): great tonic.  Has lots of Vitamins A, D, C, and K. Provides Calcium and Potassium as well.  The Vitamin K is instrumental in preventing hemorrhage during birth.  Also good for leg cramps and hemorrhoids.

Mint family (Mentha spp.): safe and helpful in pregnancy for digestive issues: morning sickness and indigestion.

Oatstraw (Avena sativa): good source of minerals for growing baby and for integrity of veins.  Oatstraw is calming and nourishing.  This herb is a personal favorite!

Specific issues during pregnancy*

Morning sickness:  1-2 cups Raspberry leaf tea, 1-2 spoonfuls of ginger root (Zingiber off.) decoction, peppermint of spearmint tea, alfalfa (Medicago sativa) tea for B vitamins

Varicose veins/Hemorrhoids: 1-2 cups daily of Oatstraw tea, 1-2 cups of nettles tea, raw parsley (Petroselinum sativum) in salads, witch hazel (topically)

Anemia: 1 TBS Yellow dock (Rumex Crispus) decoction per day.  Can also try teas of Dandelion root (Taraxacum off), Parsley, and Nettles.

Heartburn/Indigestion: Anise or Fennel seed tea for after meals, Papaya enzymes, raw almonds, Slippery Elm (Ulmus fulva)

Bladder Infections: unsweetened cranberry juice, Uva Ursi leaves infuse for 8 hours, then drink one cup every 12 hours.  Can add yarrow (Achillea millefoilium) if not clear with just Uva ursi.

Hypertension: garlic, cucumbers, Hops (humulus lupulus)—only during 3rd trimester, Passionflower tincture (15 drops per day), Skullcap (Scutellaria off.) 1-2 cups per day, Hawthorn berries (Crataegus off.)

Late Pregnancy uterine tonics: Black and Blue Cohosh (Cimicifuga racemosa and Caullophyllum thalictroides), Squawvine (Mitchella repens)

*Please consult a helath care practitioner before beginning any new herbal or nutritional regimen

Vitamin D and you!

Winter in the Pacific NW generally means very little opportunity for sun exposure.  When you're talking about a nutrient that is made in the body when skin gets exposed to UV light, the lack of rays can be a problemo grande. I've been checking my patients' Vitamin D levels this winter with surprising results.  I have yet to get a normal result back.  The normal range isn't even all that high.  People still have symptoms of Vitamin D deficiency at the "normal" level.  Symptoms like: lethargy, decreased mood, body aches, soreness, headaches, decreased libido.  Any of this sound familiar?

When I was in medical school, a family member called me with what sounded like a classic case of fibromyalgia.  She was having difficulty sleeping, had lots of pain in her body, and was tired all the time.  One of my mentors at the time suggested Vitamin D.  She got her levels checked and they were extremely LOW.  She started taking 1000 IU/day.  Her levels have been in the optimum range now for years AND she doesn't feel like she has fibromyalgia.

Aside from feeling good in the winter, Vitamin D is important for long-term health issues.  Check out this article in the American Journal of Clinical Nutrition.  It talks about how Vitamin D appears to delay aging and diseases of aging by slowing the turnover rate of white blood cells.

Taking a high quality Vitamin D supplement daily is a good idea if you live somewhere gray.  It's also a good idea to get your nutrients from food sources whenever possible.  The best sources of Vitamin D are:

  • Herring, 85 g (3 ounces (oz)) provides 1383 IU
  • Catfish, 85 g (3 oz) provides 425 IU
  • Salmon, cooked, 100 g (3.5 oz]) provides 360 IU
  • Mackerel, cooked, 100 g (3.5 oz]), 345 IU
  • Sardines, canned in oil, drained, 50 g (1.75 oz), 250 IU
  • Tuna, canned in oil, 85 g (3 oz), 200 IU
  • Eel, cooked, 100 g (3.5 oz), 200 IU
  • One whole egg, provides 20 IU

images*amounts provided by Wikipedia.*

Women of childbearing age and children should not eat mackerel  or more than 6oz of tuna per week due to mercury content.

There are rare cases of people overdosing on Vitamin D.  You should always consult with your doctor before adding anything new to your daily intake of nutrients.  It is advisable to have your Vitamin D levels checked to assess the proper dosage for your body.