Bone Health and Calcium

We’ve all heard from childhood that we should drink milk for healthy bones. Milk is one of the most common sources of calcium which is a vital ingredient in bone development and maintenance. Many people stray from consuming milk as they enter adulthood for a variety of reasons whether it is fat content, lactose issues or preferences for other beverages. While it is most commonly found in milk and dairy products such as yogurt and cheese, calcium can be found in alternative sources such as calcium-fortified soy milk and juices, as well as breakfast cereals, spinach, broccoli and almonds. However, you would need larger quantities of these products to achieve the recommended amount of calcium (10 cups of spinach; 3.5 cups of broccoli, about 88 almonds). Calcium supplements are also available and can help boost intake, they do not contain the protein found in milk or soy milk or the other nutrients they contain. It is also important to know that dairy sources of calcium also contain Vitamin D which enhances the absorption of calcium and is needed not only to protect bone health but also to reduce the risk of high blood pressure, diabetes, and heart disease; enhance immune function and reduce inflammation. Vitamin D is not readily available naturally in other foods. Active individuals and athletes are recommended to check with their health care provider to make sure that they have adequate Vitamin D levels.

Paying attention to bone health should be a life-long effort. Whether you have young developing bones or you are concerned about developing bone issues such as osteoporosis, bones require a matching life-long intake of calcium.

Reference from the SIRC Collection: Clark, Nancy (2009). Calcium concerns. Ultr-FIT, 19(8), 40-41.

Fuel your body for winter

This time of year life gets tends to get a little busier and with all the events during the holiday season it's easy to let good nutrition habits fall to the wayside. The transition to colder, darker days has an impact on our bodies, especially when trying to keep up with work and family, as well as trying to stay healthy and fit. As the weather gets colder it's good to remember that you don't need to eat more, just differently.

Vitamin D - Statistics Canada found that more than 1.1 million Canadians are Vitamin D deficient which is low enough to cause nutritional rickets in children and osteoporosis in adults. While you can get Vitamin D through foods like milk, egg yolks and fish with bones, it's important to spend some time in the sun as well. If you are unable to get the required amount of Vitamin D through the above methods, supplements are an option, although it's a good idea to talk to your doctor first.

Omega 3's - For those Canadians that suffer from Seasonal Affected Disorder (SAD), nutrition experts recommend introducing  Omega-3 fats in your diet since these have been shown to relieve symptoms of mild depression. Salmon, walnuts and flax seeds are all good sources of Omega-3 fats.

Include seasonal vegetables - Seasonal vegetables can be great sources of anti-oxidants, Vitamin C, folic acid, among others.  Some of the super stars include winter squash, red bell peppers, oranges, collard greens and other dark leafy vegetables.

Zinc and Vitamin E - Whole nuts and seeds are rich in Vitamin E which is a strong anti-oxidant and foods like oysters, beef, turkey, ricotta cheese and beans all contain zinc which helps your boost your immune system.

Eating out regularly is very accessible nowadays, especially during the holiday season and when done occasionally, it can be a nice change from eating at home. However, starting from scratch with as many natural and seasonal ingredients as possible is your best option. With a little planning, your winter nutrition should keep you fit, happy and healthy all the way to spring.

References from the SIRC Collection:

1. Burke L. Nutrition for Winter Sports: An Interview with Sports Dietitian Susie Parker-Simmons. International Journal Of Sport Nutrition & Exercise Metabolism. October 2005;15(5):567.
2. Burrell S. Getting Through the Tough Winter Months. Bicycling Australia. May 2008;(151):88-89.
3. Clark N. Winter Nutrition—Fueling for Cold Weather Exercise. ACSM Fit Society Page. Winter2012 2012;:8-9.
4. Cort M. Nutrition: AVOID TIPPING THE SCALES DURING WINTER. Modern Athlete & Coach. July 2009;47(3):17-18.
5. Meyer N, Manore M, Helle C. Nutrition for winter sports. Journal Of Sports Sciences. December 2, 2011;29:S127-S136.
6. The role of vitamins and dietary-based metabolites of vitamin D in prevention of vitamin D deficiency. Food & Nutrition Research. January 2012;56:1-8.

Exercise and bone health

It is well known that regular exercise is excellent for your heart, health and well-being. There is also plenty of evidence that proves that regular exercise is essential in warding off various health-related issues; what's not as well known is that people who perform non-weight bearing exercises such as cycling or swimming as their sole method of exercise could be putting themselves at risk for osteoporosis.

 
Bone is living tissue that responds to loads placed on it. If you perform  non-weight bearing exercises your bones won't retain their density like they would with a weight bearing exercise. If cycling or swimming is currently your only form of exercise, you can be proactive in preventing the disease by adding a little variation in your training.

• Weight bearing exercises such as walking, running, skiing, dancing or jumping all help to retain bone density
• Cross training
• Resistance or weight training
• Improving core strength
• A diet that meets your calcium and vitamin D requirements

A common misconception is that osteoporosis is a disease that is limited to aging women since low estrogen causes bone deterioration, in fact it can affect men as well. Care should be taken for young people in particular, since bones keep growing and do not reach peak density until the age of 30.

For those of you that have already been diagnosed with osteoporosis, it doesn't mean you have to stop moving. Instead, perform exercises that strengthen the back, core and hip, and ensure that you supplement your routine with alternate workouts. Before you run out and buy calcium supplements or change your training schedule, it is always a good idea to talk to your doctor for their recommendations first.

References from the SIRC Collection: 

1. Campion F, NeviII A, MedeIIi J, et al. Bone Status in Professional Cyclists. International Journal Of Sports Medicine. July 2010;31(7):511-515.
2. Cedaro R. Osteroprorosis And Cycling. Triathlon & Multi Sport Magazine. July 2, 2012;15(7):76-78.
3. CYCLISTS AT RISK FOR OSTEOPOROSIS. IDEA Fitness Journal. July 2009;6(7):12.
4. Giles M. Bone strength matters. Bicycling Australia. May 2006;(139):52-54.
5. Hamilton A. Cycling health: a bone of contention. Cycling Weekly. September 30, 2010;:50-51.
6. Hawkins K. Cycling: Bad for the Bones?. Bicycle Paper. August 2012;41(6):1-5.
7. Nichols J, Rauh M. LONGITUDINAL CHANGES IN BONE MINERAL DENSITY IN MALE MASTER CYCLISTS AND NONATHLETES. Journal Of Strength & Conditioning Research (Lippincott Williams & Wilkins). March 2011;25(3):727-734.

Introducing the 'sunshine' vitamin!

Canadian winters mean short days and bundling up against the cold, so getting the required amount of sunlight for absorbing Vitamin D can be difficult. Vitamin D (sometimes called the 'sunshine vitamin') is unique in that it requires the skin to be exposed to ultraviolet-B radiation for optimal absorption. Because it is present in very few foods and many people use sunscreen to protect themselves from the harmful effects of UV rays, it has become common for athletes to use supplements to obtain vitamin D.

Why should athletes consider vitamin D?

Vitamin D functions to maintain normal levels of calcium and phosphorus in the blood, as well as aiding in the absorption of calcium to form and maintain strong bones. Research suggests that it may be important for prevention of osteoporosis, hypertension, inflammation, asthma, and seasonal affective disorder.

Factors that may contribute to vitamin D deficiency include skin pigmentation, early or late day training, indoor training, geographic location and sunscreen use. Athletes that may be at higher risk are those that spend the most time indoors; gymnasts, ballet dancers, figure skaters, and wrestlers.

While vitamin D can be obtained in the diet, it would be difficult to consume the amount food you would need for optimal performance. For example, it would take six cups of orange juice or 14 eggs to get the recommended amount.

Foods that contain Vitamin D:

• Fatty fish (tuna, salmon, swordfish) and fish liver oils like cod liver
• Beef, egg yolks and some cheeses contain small amounts
• Fortified foods like milk, orange juice and cereal, although they include small amounts

A recent survey done by Statistics Canada found that 32% of the Canadian population have vitamin D levels that are below recommendations. Adding vitamin D supplements to your diet carries a low risk for side effects, however it's recommended that you talk to your coach and/or health professional first.

References from the SIRC Collection:

1. Asp K. Running on D. Runner's World. December 2009;44(12):36-37.
2. Close G, Fraser B. Vitamin D supplementation for athletes: Too much of a good thing?. Sport & Exercise Scientist. September 2012;(33):24-25.
3. HAMILTON B, CHALABI H. VITAMIN D: AN UPDATE FOR THE SPORTS MEDICINE PRACTITIONER. Sportex Medicine. January 2010;(43):11-16.
4. Larson-Meyer D, Willis K. Vitamin D and Athletes. Current Sports Medicine Reports (American College Of Sports Medicine). July 2010;9(4):220-226.
5. Shuler F, Wingate M, Moore G, Giangarra C. Sports Health Benefits of Vitamin D. Sports Health: A Multidisciplinary Approach. November 2012;4(6):496-501.
6. The Vegetarian Athlete. Running & Fitnews. May 2009;27(3):10-12.
7. Willis K, Peterson N, Larson-Meyer D. Should We Be Concerned About the Vitamin D Status of Athletes?. International Journal Of Sport Nutrition & Exercise Metabolism. April 2008;18(2):204-224.

Stress Fractures

Stress fractures are a common injury in athletes and are most often associated with participation in sports involving running, jumping or repetitive stress. A stress fracture is a micro fracture of a bone that results when the rate of healing is unable to keep up with the rate of breakdown that is being caused by repetitive stress placed upon it. Stress fractures occur most frequently at the beginning of a sports season due to the increase in physical activity that is required. Studies have shown that athletes participating in tennis, track and field, gymnastics, and basketball are particularly susceptible to this type of injury.

Stress fractures can occur in two ways:

1. The redistribution of impact forces resulting in increased stress at focal points in bone.
2. The action of muscle pull(s) across bone.

The tibia, which is the larger and stronger bone of the lower leg, is the site of approximately 50% of all stress fractures in athletes. - Running & Fitnews

 Symptoms of a stress fracture:

• Localized bone pain
• Pain is aggravated with physical activity and relieved with rest
• Area may be tender to the touch, with occasional swelling and redness

Recovery

One of the biggest mistakes athletes make after being diagnosed with a stress fracture is returning to training too quickly. It's important to let the body heal and if it's rushed, there is a greater risk that the injury will reoccur. Depending on the severity of an injury, the healing process can be anywhere from eight to seventeen weeks. Clinicians recommend that training begin slowly with a low intensity and be pain free. Cross training is a great option for recovery and may include deep water running, cycling and gym work.

Prevention

Stress fractures are managed best by taking preventative measures. Stress fractures are directly related to training loads and how fast an athlete increases the frequency, intensity, and duration of their activity. Bones can adapt to repetitive stress but extreme stress, if it occurs too often, can overwhelm the body's ability to adapt. Having a varied training schedule is essential for prevention as well as having the proper athletic gear. Distance runners are particularly susceptible to this type of injury and it's recommended that athletes replace athletic shoes as they wear out, approximately 700-1,000 kilometres or 6-12 months.

Other risk factors beyond training schedules and loads are nutrition and gender. Calcium and vitamin D deficiency decreases bone density which can increase the chance of injury. For female athletes, amenorrhea (infrequent menstrual cycle), osteoporosis and/or an improper diet can all contribute to the occurrence of stress fractures.

Coaches and athletes should be aware of the effects of overtraining and the importance of taking rest days. If you think you may have a stress fracture, keep in mind that this type of injury should not be self treated. Proper diagnosis should come from a physician and depending on the location and severity, recommendations for treatment will differ.

References from the SIRC Collection:

1. Avoiding a Stress Fracture is Largely up to You. Running & Fitnews. July 2012;30(4):9-13.
2. Dawson-Cook S. STRESS FRACTURES. American Fitness. September 2010;28(5):56-57.
3. Ekstrand J, Torstveit M. Stress fractures in elite male football players. Scandinavian Journal Of Medicine & Science In Sports. June 2012;22(3):341-346.
4. Hunt A. IT'S JUST SHIN SPLINTS... RIGHT?. Triathlon Life. Winter2009 2009;12(1):54-56.
5. Moran D, Evans R, Hadad E. Imaging of Lower Extremity Stress Fracture Injuries. Sports Medicine. February 2013;43(2):345-356.
6. POLLOCK N. STRESS FRACTURES IN SPORT. Sportex Medicine. October 2011;(50):20-24.
7. Poynton E. Stress Fractures. Modern Athlete & Coach. January 2011;49(1):16-17.
8. Smith R. Stress Fractures of the Hip in Young Athletes. Hughston Health Alert. Spring2007 2007;19(2):6.

Warm weather training

In Canada, we are accustomed to long winters. As a society, we have adjusted fairly well by moving many of our sporting activities indoors. However, some people still have to do some or all of they’re training outside, or come up with a way to remain in shape during the winter months. Cyclists are relegated to stationary bikes, while runners tend to do their hard training on indoor tracks; however most runners choose to do their easy days outdoors.

For those looking to escape the recycled air of indoor facilities or the frigid cold, consider warm weather training. Most high performance athletes try to escape to warm weather training camps at least one or more times during the winter months. Warm weather training can benefit athletes psychologically. It also enables them to spend a period of time training consistently, with out having their workouts dictated by the weather.

Warm weather training brings about a welcome change from all the layers you have to wear when training outdoors, and from the early and dark days which are so characteristic of the winter months in Canada. Warm weather also exposes us to sunshine, and to a dose of natural vitamin D. Heading south also provides a change of scenery, allowing you to refocus and become rejuvenated for the upcoming season.

Benefits of Warm weather training:

• Psychological – It can get the athlete motivated, refocused on their training and give rise to a period of consistent training without the distractions that come with daily life. 
• Vitamin D - The sun allows you to get a daily dose of natural vitamin D. 
• Reduced risk of injury - With warm weather the muscles are more pliable, reducing the risk of muscle strains and tears. 

Warm weather training can have great psychological benefits. It can also allow athletes to train consistently without worrying about the cold, dark and sometimes icy winters. It is a way to get a jump on your training and competitive season.

References from the SIRC Collection:

1. Barrie Shepley's warm-weather training camps. Active Living. January 2008;17(1):17.

2. Gage T. Baseball Was Designed To Be Played On Warm Summer Days. Baseball Digest. July 2005;64(5):88.

3. Keller M, Fredrickson B, Wager T, et al. A Warm Heart and a Clear Head. Psychological Science (Wiley-Blackwell). September 2005;16(9):724-731.

4. Longden B. Warm weather training. Athletics Coach. 1997 1996;30(4):8-9.

5. Lowes D. Training dilemma: altitude or warm-weather?. Athletics Weekly (Descartes Publishing Ltd.). June 18, 2009;:28-29.

6. Makin J. How much sun is enough for vitamin D?. ACHPER Active & Healthy Magazine. August 2012;19(2):8.