Tuesday, March 10, 2009

Food RX: Eating For Injury Prevention

As I nurse a tweaked knee this month - wondering if it's an injury or just old age (ha!) - this article by Liz Applegate, Ph.D., of Runner's World gave me some hope of recovery...

As I write this, I'm in a wheelchair. It's the latest result of numerous knee surgeries to repair my cartilage. I wish I could say that I injured my knee doing something athletic and impressive, such as running a killer speed workout, squatting six times my body weight at the gym, or even winning the three-legged race at a summer picnic. But I did it in my kitchen. I slipped on a phantom slick spot that mysteriously evaporated within seconds. I landed on my knee hard. I didn't know it at the time, but that quick, hard fall punched a hole in my cartilage.

Ever since, I've been researching every conventional (and unconventional) way to heal my knee. I've had state-of-the-art surgery. I've taken supplements that I use to scoff at...and realize that they work. I've changed my eating habits. (No, I didn't give up chocolate.) In the process, I've made some startling discoveries about nutritional remedies that can help heal injuries and even prevent them in the first place. Here's what's been working for me.

Eating for Injury Prevention

There's no doubt that smart training helps prevent injuries. But so will a wholesome nutrition plan, filled with foods that will enable your body to mount a strong defense against muscle strains and tears. Here are three nutritional strategies to prevent injuries:

1. Eat more. If you followed Survivor: The Australian Outback TV series, you may have noticed how gaunt the participants appeared after subsisting for weeks on daily rations of rice. This type of chronic malnutrition puts your body in prime "injury-waiting-to-happen" mode. So, how do you know if your body needs more calories? Keep track of your weight and eating patterns. If your weight fluctuates for no apparent reason, or if the quality of your eating is sporadic and generally unhealthful, you should consider a slight increase in high-quality calories.

2. Pile on the protein. True, a high-carbohydrate diet will fuel your running. But many runners take this advice to the extreme, living on bagels, pasta, and energy bars. Besides carbohydrate, you also need 80 to 100 grams of protein a day to maintain your muscles and other soft tissues. A small 3-ounce serving of chicken provides about 25 grams of protein, a glass of milk 10, a soy burger 14, and a hard-boiled egg 6. If you're only eating one protein source a day, you're not consuming enough. Try to include some protein in every meal.

3. Don't forget zinc and iron. Athletes often skimp on these two important trace nutrients found predominantly in red meat. Though research hasn't linked zinc and iron deficiency with increased injury rates, I've noticed the connection when working with injured athletes, and so have many of my sports-nutrition colleagues. You need 15 milligrams of zinc and 18 milligrams of iron a day. Foods that are good sources of both zinc and iron include lean beef, poultry, seafood, and lentils.

Dining During Downtime

If you get injured, the length of your downtime is determined by the severity of your injury, and the degree to which your body is nutritionally prepared to handle this new stress. If you have a severe injury, you're probably wondering: "How can I avoid gaining weight?"

Relax. Even though you're not running, you're still burning calories between 5 to 15 percent more than usual to repair your tattered body. Also, for most injuries, total downtime usually lasts about 2 weeks. After that, you might not have the green light, but you may be able to do other forms of exercise, such as swimming or pool running.

But if you restrict your calories too much during this initial 2-week period, you might lengthen your recovery because your body won't have enough protein to both repair your injury and carry out typical bodily functions. Don't cut back more than 500 calories a day. And if you notice that you're losing more than a desired weight, start eating more immediately.

4. Calcium: If you have a stress fracture or a broken bone, your body really needs this important mineral. You should take in up to 1,500 milligrams a day. If you don't eat dairy products, take a supplement, or drink calcium-fortified juice.

5. Vitamin A: Your body uses this vitamin to make new skin and other tissues that are vital to your healing. New research shows that your body isn't as efficient as we thought at converting the carotenes from fruits and vegetables into vitamin A. This means you need to eat even more of them. You should have two servings of leafy greens and yellow and orange vegetables every day during your recovery. Drinking vitamin A-fortified milk is also a good idea.

6. Vitamin C: Your body needs this antioxidant to make collagen, an adhesive-like protein found in your bones, connective tissues, and blood vessels. When you're injured, collagen is the substance that glues the injured area back together. Women need 75 milligrams of vitamin C each day, and men need 90 milligrams. If you eat a diet rich in berries, cantaloupe, oranges, and other fruit, you'll easily meet this requirement.

7. Other supplements If you've been given the green light to start training again, you may want to add a supplement to the mix. Once you've injured a joint, you're at higher risk for developing osteoarthritis (a degenerative joint condition not uncommon among aging athletes). Fortunately, the supplements glucosamine and chondroitin sulfate have been shown to help decrease inflammation and improve mobility in people with osteoarthritis. You can also find many of these vitamins in a gender specific multi-vitamin.

These two supplements may also help promote cartilage growth. But it's not certain whether glucosamine, an amino sugar, and chondroitin, one of the substances that make up cartilage, work alone or need to be taken together. So for now, take 1,200 to 1,500 milligrams of each, three times a day. Why so often? These supplements don't last long in your body, so frequent supplementation ensures that they're present at all times to nourish your joints. (Warning: If you take blood thinners such as Coumadin, do not take chondroitin.)

The better you feed your body, the more likely you'll remain injury-free, and the faster you'll bounce back if you do happen to get injured. Just be patient. You'll be training again in no time.

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