Filed under: Diet
The American Academy of Orthopaedic Surgeons defines a stress fracture as a tiny crack in a bone that occurs when fatigued muscles lose their ability to absorb shock and then transfer stresses to the bone. Most stress fractures occur in the lower extremities, and more than half occur in the lower leg and foot.
A stress fracture is an overuse—sometimes referred to as chronic—injury, which means that it develops over a long period of time—from weeks to months. According to a 2011 systematic review published in Military Medicine, stress fracture incidence is high among U.S. military recruits, ranging anywhere from 3% for men to 9.2% for women.
Since it can take several weeks or months for a stress fracture to heal, the best approach is to avoid getting one. Here are some tips for prevention:
- Apply the progression principle of training—gradually increase your training intensity. Slowly incorporate higher-stress activities such as jumping and interval training into your workout. Setting incremental goals can be helpful in carrying out your training routine in a gradual way. And check out HPRC’s Physical Fitness Resources for more information on training and ways to avoid injury.
- Check your footwear and make sure it matches your training. Replace footwear that is old or worn.
- Pay attention to the surface where you train, since some are easier on the bones and joints of the lower extremities. For example, it is better to jog on softer surfaces such as rubber track or grass rather than on concrete. Also, it’s better to begin training on a flat surface and then progress to hills.
- Monitor your diet, specifically calcium and vitamin D intake, and read the National Institute of Health’s Dietary Supplement Fact Sheet on calcium. To learn more about nutrition take a look at HPRC’s Nutrition Resources.
What do you put in your body to boost your performance, increase your energy, shed pounds, build muscle, or otherwise supplement your diet? What’s in that drink, pill, or powder? What will it do for you? What will it do to you? Is it worth the risk?
More and more Warfighters are taking dietary supplements, most without being fully informed that some of the ingredients could have harmful side effects. HPRC has just unveiled its Dietary Supplement Classification System to provide this kind of information and help you make informed decisions about a particular supplement. To start exploring this new resource, visit HPRC’s new web pages. If you have a question, contact us via “Ask the Expert.”
Warfighters must be in excellent physical condition to endure a variety of physical tasks for extended periods. Healthy eating will greatly affect your physical performance. For good health and performance, eat the energy-providing nutrients (known as macronutrients)—carbohydrates, proteins, and fats. These foods supply fuel and are involved in many functions in your body. For detailed information on each of the macronutrients, see the Warfighter Nutrition Guide.
Whether you are at home or on operations, healthy snacking can sustain your mind and body so your performance is maximized. Keep high-nutrient foods on hand at home, while at work, or during night operations. For specific suggestions and tips on healthy snacking, see the Warfighter Nutrition Guide.
The Paleo Diet, also known as the Paleolithic or Caveman Diet, is based on the notion that by consuming what humans ate during the Paleolithic Era—wild animals, plants, eggs, tree nuts, vegetables, roots, fruits, and berries—we will be healthier, have lower disease risk, and live longer. Hunters/gatherers during that time had to rely on what was available and had no agriculture. But what are the implications of this type of diet for the athlete, let alone the average individual?
Foods that were grown and introduced after the Agricultural Revolution (roughly 10,000 years ago) are not allowed in the Paleo Diet. That means dairy and dairy products, grains, and legumes (beans, peas, and lentils) are excluded. Proponents of the Paleo Diet believe that we are “genetically programmed” to follow the diet of the hunters/gatherers. A specific book has been written for athletes who want to follow this diet, which accommodate athletes by allowing some carbohydrates: The authors present five stages of eating for the athlete to follow, based on the glycemic index (GI; how quickly food raises blood glucose levels). The stages are: (1) eating before exercise, (2) during exercise, (3) and 30 minutes after exercise, and (4) during post-exercise extended recovery and (5) long-term recovery. Low- to moderate-GI carbohydrates are recommended at least two hours prior to exercise. Sports drinks or high-GI carbohydrates are recommended for exercise lasting longer than 60 minutes. Immediately after exercise a recovery drink with carbohydrate and protein in a 4:1 to 5:1 ratio is recommended. Stage IV recovery foods (extended recovery) should be a 4:1 to 5:1 carbohydrate-to-protein ratio, with carbohydrates such as raisins, potatoes, sweet potatoes, and yams. Stage V recommends focusing on eating from the main Paleo Diet, with carbohydrates coming from fruits and vegetables. So one could argue that the Paleo Diet for Athletes is like most diets for athletes in that it requires carbohydrates. However, the Paleo Diet for Athletes is higher in protein and fat and lower in carbohydrates than what is recommended for athletes by most health professionals.
What we do know from scientific research is that carbohydrates provide the energy needed for endurance and resistance training, competitive athletic events, mental agility, and healthy living. Complex carbohydrates such as fruits, vegetables, whole-grain pasta, rice and grains, beans, and other legumes contribute to an overall healthy eating plan. By limiting consumption of some of these to only a brief time after exercise, the athlete runs the risk of not having enough fuel for the body, so the body will use protein for energy. Low-fat dairy products also contribute to a healthy lifestyle, providing much-needed calcium and vitamin D as well as probiotics. The Paleo Diet eliminates dairy entirely, even for athletes.
We also know from the scientific literature that during the post-exercise period, within roughly 30-45 minutes of exercise, eating a carbohydrate/protein snack, generally with a 3:1 carbohydrate-to-protein ratio, is essential to stimulate re-synthesis of muscle proteins and replenish glycogen (the storage form of carbohydrate). It doesn’t stop there: It is important to maintain glycogen levels in the muscle and liver to sustain all activities, especially over the course of several days. Eating high-carbohydrate snacks between training sessions is important to replenish glycogen stores. Carbohydrate intake recommendations for athletes are 6 to 10 g/kg body weight per day, or roughly 55% of daily calories from carbohydrates.
What’s the bottom line? Grains and dairy products are staples of modern-day society and provide essential nutrients to an overall healthy diet. By eliminating one or more food groups, you run the risk of missing important nutrients. And can we really eat as humans did during the Paleolithic era? Their life expectancy was about one quarter to one half of what ours is, and we benefit from research showing that eating a variety of foods over the course of time provides us with energy and the important vitamins and minerals needed to sustain us in daily activities and exercise.
Salmon is commonly touted for its omega-3 fatty acids. HPRC recently received a question about what foods other than salmon are the best sources of omega-3 fatty acids. For a complete answer, including the recommended intakes from the American Heart Association, please see HPRC’s answer.
Vitamin C is a nutrient found in citrus fruits, broccoli, strawberries, cantaloupe, tomatoes, other fruits and vegetables, as well as fortified 100% fruit juices. Among other things, it acts as an antioxidant, helping to protect cells from damage caused by free radicals, which your body produces as it converts food into energy. How much you need depends on your age. For the average recommended daily amounts and other information about vitamin C, read the Office of Dietary Supplements Quick Fact Sheet.
Most people understand what it means to have high blood pressure, excess fat around the middle, a high cholesterol level, and the importance of addressing these health problems. What some may not realize is how serious the situation becomes when a person has been diagnosed with three or more such conditions in conjunction with other health issues.
This occurrence is called metabolic syndrome.
People who suffer from this combination of conditions (a reported one in four—50 million in the United States alone) have a dramatically increased risk for developing heart disease, type-2 diabetes, or a stroke. Individually, these symptoms pose a health risk, but identified together they raise the risk for cardiovascular disease.
Metabolic syndrome is characterized by a cluster of symptoms that include excess fat in the abdominal area (as measured by waist circumference), borderline or high blood pressure, high cholesterol that fosters plaque buildup in arteries, insulin resistance or glucose intolerance indicating the body can’t properly use insulin, raising blood sugar levels, and the presence of a protein in the blood, which can cause inflammation.
People with metabolic syndrome have at least three of the following risk factors:
- Excessive body fat around the waist
- Low levels of HDL ("good") cholesterol
- High levels of triglycerides (a type of blood fat)
- Elevated blood pressure
- Elevated glucose (blood sugar) levels after fasting
The complications of metabolic syndrome are serious and, if not addressed, can cause major health problems. If you are overweight and don't yet have these problems, keep in mind that the older you get, the more likely you are to develop them. Older adults can develop metabolic syndrome without being overweight, so it is important to get annual physical exams.
What can be done to prevent metabolic syndrome? If you are fall into the categories above or are overweight, one way to reduce your risk of metabolic syndrome is to incorporate healthy habits such as starting an exercise regimen. (But be sure to consult your doctor before starting a new exercise program, especially if you have not been active for a while.)
Diet is also key to reducing the risk of metabolic syndrome. By making small changes in your diet—such as decreasing the number of calories you take in per day; eating more fruits, vegetables, whole grain products, and low-fat meals, and avoiding fast/fried/fatty/oily foods—you can reduce your chances of developing metabolic syndrome.
If you would like to know more about metabolic syndrome, we recommend the following resources:
According to an Associated Press article from August 2, 2011, the Food and Drug Administration (FDA) has warned the manufacturer of the melatonin-laced brownies known as "Lazy Cakes" that the government considers them unsafe and could seize them from store shelves. The brownies were originally sold under the name Lazy Cakes, but the manufacturer of the product has changed the product name to Lazy Larry.
The FDA said that melatonin has not been found to be safe for use in conventional foods. “On the contrary, reports in the scientific literature have raised safety concerns about the use of melatonin,” said the letter, sent last Thursday by the agency’s acting director for the Office of Compliance. Melatonin is not approved for use in any food, the FDA said.
HBB, LCC, the Memphis-based company that makes Lazy Cakes/Lazy Larry, was given 15 days to respond to the FDA with details on specific steps it would take to correct its violation of the ban against melatonin use in food.
It should be noted that the HPRC has been covering Lazy Cakes since they first became available.
With the rise of obesity among children, restaurants are stepping up to help combat the issue by offering healthier menu items for children. Focusing more on fruits and vegetables, lean protein, and low-fat dairy items, the new initiative “Kids LiveWell” is working with restaurants to offer meals that are lower in unhealthy fats, added sugars, and sodium. Read more about this initiative at Kids LiveWell.