From Soil to Sport: Sweet Potatoes to Power You

by Hannah Meier

As the temperatures slowly, and not so consistently, increase in Boston this spring, more of us will find ourselves out in the field, on the trails, or on the sidewalks soaking in the sunshine and working up a sweat. Even if you aren’t competitive, you have probably noticed the difference in how you feel during, and after, exercise when you are—or are not—properly fueled. Look no further for easy and delicious recipes to power your active spring using the grad student’s pantry staple: The sweet potato!

 

Photo: Hannah Meier

Photo: Hannah Meier

Feeling our best, and performing our best (who wants to be that person in a soccer game to miss a pass because you’re too fatigued to run for the ball?) is contingent on having the right amount of fuel to use for energy during activity. Nutrition beforehand is important to power your workout or game, and nutrition afterward is crucial for making physical improvement, gaining strength and replenishing tired tissues. Sure, you may be able to get through a game or a run without thinking about nutrition, but I bet you a million bucks (really) that you’ll make strides with appropriate nutrition.

 

Sweet potatoes come close to what I view as an athlete’s ultimate food. Rich in carbohydrates and easy on the stomach, they provide a spectrum of nutrients that help convert calories to available energy for our cells (ex. B-Vitamins), along with a generous amount of potassium, which is an essential electrolyte for heart and muscle function that can be lost in sweat. One medium (about 5” long) sweet potato provides 10% of the daily value for iron, which is a nutrient of concern for many athletes, especially women. Compared to white potatoes, orange sweet potatoes are rich in Vitamin A as beta-carotene, and provide more of the vitamin than a cup of carrots. Why should athletes or active people care about Vitamin A? During exercise, our tissues can become damaged and more prone to forming free radicals, especially in long, intense endurance training. Beta-carotene, as a powerful antioxidant, combats this free radical formation, keeping cell membranes better intact and less prone to destruction.

What about fiber? While sweet potatoes, like many vegetables, contribute to an adequate fiber intake, the average potato contains about 4 grams of fiber, mostly from the skin. This amount of fiber helps to slow down digestion enough to prevent sharp spikes in blood sugar. This keeps both our hunger and our cells satisfied, with sustained energy for hours. Athletes or competitors looking for a snack to eat less than an hour prior to their event could remove the skin to avoid the digestive slow-down that fiber provides. Many of the nutrients are found in the flesh of the potato, so removing the skin does not take away all the nutritional benefit of the tuber.

Since sweet potatoes offer a powerhouse of beneficial nutrients for exercise, I came up with four ways to dress them up before and after a workout. Feel free to use regular white potatoes or even purple potatoes. All potatoes provide a mix of nutrients valuable for exercise, but the darker the color, the more concentrated the antioxidants you’ll get. These recipes use medium sweet potatoes that were roasted in the oven for about 45 minutes at 375˚F. Just wrap each potato in foil, place on a baking sheet, and throw in a hot oven. They are ready when they are slightly soft to the poke of a fork.

 

Before Exercise

Before exercise, the goal of nutrition is to provide a boost of fuel for your muscles to burn for energy. While glycogen, the stored form of carbohydrate, is typically available, having full stores is crucial if you plan to exercise for longer than 2 hours. Even for shorter events, providing a boost of nutrition leading up to your workout can stimulate better performance. Combining carbohydrate sources with protein increases the satiety factor and provides your body a boost in amino acids to have available for protein re-synthesis.

Pre-Race Burrito

Inspired by many athlete’s favorite pre-race meal, the burrito bowl, this sweet potato highlights traditional burrito ingredients, which happen to be wonderfully rich in carbohydrate. This meal is a bit fiber-heavy thanks to the beans, so should be consumed at least 3 hours before exercise, or the night before an early start. The corn sauce is a recipe adapted from food blogger Pinch of Yum, and breaks down the corn’s fibrous coating so the carbohydrates are more easily available to be absorbed. Peppers and onions contain natural sugars that provide quick energy and delicious sweetness, as well as an additional boost of antioxidants. A little bit of Greek yogurt rounds out the potato with a bit of easily digested protein.

  

Photo: Hannah Meier

Photo: Hannah Meier

 

Makes 1 Serving

INGREDIENTS

  • One medium – large sweet potato, baked
  • 2 Tablespoons corn sauce (recipe below)
  • 1/4 Cup black beans, cooked or canned
  • ¼ Medium red pepper, sliced
  • ¼ Medium Onion, sliced
  • Salsa
  • Plain Greek yogurt of choice

Total Time (after baking potato) 10 minutes

DIRECTIONS

  • Cut baked sweet potato in half, lengthwise and set aside (reheating if necessary). Mash the flesh with a fork.
  • In a pan with a little oil, sauté the pepper and onion slices on medium heat until desired softness.
  • Top sweet potato with onions and peppers, black beans, corn sauce, salsa and Greek yogurt.
  • Enjoy!

CORN SAUCE RECIPE

Inspired by Pinch of Yum

Makes about 8 Servings (2 tablespoons each)

INGREDIENTS

  • 1 cup corn kernels, from fresh or frozen (I used Trader Joe’s frozen Fire Roasted Corn)
  • 1 tablespoon fresh garlic
  • 1/2 cup water, milk, or broth (I used almond milk)
  • 1 tablespoon butter or olive oil

Total Time: 15 minutes

DIRECTIONS

  • Heat the butter or olive oil in a pan over medium heat.
  • Sauté garlic until fragrant. Add the milk and stir to form a creamy mixture.
  • Add corn kernels and sauté for another 5-10 minutes until very soft.
  • Transfer to a blender or food processor and puree until very smooth.

 

After Exercise

After exercise, along with hydration, the primary goals with nutrition are to provide your muscle cells with a replenishing dose of carbohydrate to store as glycogen, and amino acids from protein to aid in muscle tissue repair and growth. The post-exercise meal is also a chance to load up on vitamins and minerals that keep body processes functioning normally at the higher intensity that exercise demands.

Sweet Recovery

For those with more of a sweet tooth, sweet potatoes are a nourishing way to satisfy it. This sweet potato is topped with dark berries, rich in polyphenol antioxidants and natural sugars to reach muscles quickly. Almond butter provides a bit of protein and salt, which is an electrolyte athletes need to replace after very sweaty workouts. Full fat ricotta cheese rounds out the potato with easily digested dairy protein and a bit of satiating fat, without the overpowering taste and extra sugar that yogurt provides. Feel free to substitute more nuts and seeds for the cheese to make this vegan.

Photo: Hannah Meier

Photo: Hannah Meier

Makes 1 Serving

INGREDIENTS

  • One medium – large sweet potato, baked
  • 1/2 cup mixed berries of choice (aim for dark, bright colors; I used a frozen berry blend, thawed)
  • 1 tablespoon salted almond butter
  • 2 tablespoons ricotta cheese

Total Time (after baking potato): 5 minutes

DIRECTIONS

  • Cut baked sweet potato in half, lengthwise and set aside (reheating if necessary). Mash the flesh with a fork.
  • Top with berries, almond butter and ricotta cheese.
  • Enjoy!

 

Savory Recovery

For those of us who don’t crave sweet things post-workout, a sweet potato can still provide a canvas for a savory meal. This potato provides a rich carbohydrate base to refuel muscles and serves as the base for protein powerhouse eggs and hemp seeds, plus red cabbage and carrots for extra antioxidants and avocado for healthy fats. Top with hot sauce if desired—especially if you got sweaty and need to replace lost sodium.

Photo: Hannah Meier

Photo: Hannah Meier

 

Makes 1 Serving

INGREDIENTS

  • One medium – large sweet potato, baked
  • 1 large egg
  • 1/2 – 1 cup shredded red cabbage (I used a Trader Joe’s bagged mix)
  • 1/3 of a medium avocado, sliced or mashed
  • 1 tablespoon hemp seeds (or sunflower seeds)

Total Time (after baking potato): 10 minutes

DIRECTIONS

  • Cut baked sweet potato in half, lengthwise and set aside (reheating if necessary). Mash the flesh with a fork.
  • Whisk the egg well in a bowl, making sure to incorporate lots of air for a fluffier texture.
  • In a pan with a little oil over medium heat, sauté the cabbage until soft. When cooked, push cabbage to the side of pan to make room for the scrambled egg.
  • Spray the pan with a bit of cooking spray to prevent sticking, and add the whisked egg to the pan. Scramble the egg until cooked through.
  • Top sweet potato with cooked cabbage and scrambled egg, avocado, and hemp seeds.
  • Enjoy!

 

Rest Day

Everyone needs a day off to let the body truly recover, fully top off glycogen stores, and repair damaged tissues. Despite being often overlooked in terms of sports nutrition, rest days are an important opportunity to supply your body with nutrients in high-demand. So do some yoga stretching, cook up this Buddha Bowl inspired potato and go to bed early—your body needs it!

Yoga Night Buddha

This is a meal full of plant-based power. As always, the potato is a base rich in Vitamin A and is topped with a trio of steamed broccoli, carrots and edamame that provide their own chorus of plant chemicals (phytochemicals), vitamins, minerals, and even protein (broccoli and edamame are some of the higher-protein vegetables). Tempeh (fermented soy) is the primary protein source of the meal, and is ideal for rest days when quick digestion is not necessarily the goal. Likewise, plant proteins are broken down more slowly in our bodies than animal proteins and reach muscles at a slower rate. Finally, a delicious peanut sauce brings the dish together with the unsaturated fat our body needs to absorb many of the ingredients’ fat-soluble nutrients.

Photo: Hannah Meier

Photo: Hannah Meier

 

Makes 1 Serving

INGREDIENTS

  • One medium – large sweet potato, baked
  • 1/2 Cup Broccoli, steamed
  • 1 small carrots, sliced or shredded (about 1/4 cup)
  • 1/4 Cup edamame, fresh or frozen
  • 1/4 Block Tempeh, sliced
  • Peanut sauce (recipe below)

Total time (after baking potato, including peanut sauce): 15 minutes

DIRECTIONS

  • Cut baked sweet potato in half, lengthwise and set aside (reheating if necessary). Mash the flesh with a fork.
  • In a steamer or pan with just enough water to cover the bottom, add broccoli, carrots, and edamame and steam until cooked through to desired softness.
  • In a pan with a little oil over medium heat, sear tempeh slices for ~2 minutes on each side, until cooked through.
  • Meanwhile, make peanut sauce (recipe below).
  • Top potato with steamed veggies, edamame, and peanut sauce.
  • Enjoy!

Makes 1 Serving

PEANUT SAUCE INGREDIENTS

  • 1 Tablespoon peanut butter
  • 1 Teaspoon rice vinegar
  • 1 Teaspoon reduced sodium soy sauce or liquid aminos
  • 1 Teaspoon water
  • ½ Tablespoon honey
  • Optional additions: ground ginger, red pepper flakes, garlic powder

DIRECTIONS

  • In a liquid measuring cup or bowl, whisk ingredients together until well blended. If the peanut butter is very thick, you may need to add more water to thin out the mixture.
  • Season to your taste. Add ginger for a bit of sweetness, red pepper flakes for heat, or garlic powder to make it more savory.

 

Hannah Meier is a registered dietitian and second-year student in the Nutrition Interventions, Communication and Behavior Change program at Friedman. She works one-on-one with undergraduate Jumbo athletes and sports teams at Tufts University, educating them on fueling for their best performance and mastering the fundamentals of nutrition for an active life.

8 Small But Worthwhile Changes You Can Make to Eat Healthier

by Katelyn Castro

Every March, the Academy of Nutrition and Dietetics celebrates National Nutrition Month® with new (and a little cheesy) nutrition theme each year. This year’s theme is “Put Your Best Fork Forward.” While this can be interpreted in many ways, here is my spin the theme, including a step-by-step guide on how healthy eating can fit into your lifestyle.

National Nutrition Month 2017: Put Your Best Fork Forward! For more information about National Nutrition Month and the Academy of Nutrition and Dietetics, visit www.eatright.org.

National Nutrition Month 2017: Put Your Best Fork Forward! For more information about National Nutrition Month and the Academy of Nutrition and Dietetics, visit http://www.eatright.org.

When January rolls around, reflecting on the past year leaves many people vowing to lose weight or eat healthier. Yet, about 80% of New Year’s resolutions fail by the second week of February, according to U.S. News. Why? More often then not, we set our weight loss goals too high or make our diets too extreme, asking our bodies to work in overdrive and making failure is inevitable. Our high expectations can leave us feeling defeated and too frustrated with ourselves to even consider a different approach.

Creating SMART—Specific, Measurable, Attainable, Realistic, and Timely— goals on the other hand, can set us up for success. By working on a behavior, like eating more mindfully, rather than focusing on an outcome, like weight loss, lofty goals can become more reasonable. Now, three months into the New Year, is the perfect time to re-evaluate resolutions and take a more practical approach to health and wellness with SMART goals.

“Put Your Best Fork Forward,” the theme of this year’s National Nutrition Month® aligns perfectly with this sustainable approach to healthy eating. National Nutrition Month® 2017, recognized by the Academy of Nutrition and Dietetics, is all about making small changes in our food choices—one forkful at a time—to develop lifelong, healthy eating habits.

Below is a list of eight small changes that you can make to shift towards healthier eating. Since our priorities, like our food choices, are personal and unique to each of us, I included eight suggestions so you can focus on a goal that fits into your lifestyle Make the goal specific, measurable, attainable, realistic, and timely with the help of this resource, and give it a try!

1. Cook more meals from home.

When you take the time to cook your own meals, whether it’s English muffin pizzas or an elegant chicken marsala dinner, you can choose the ingredients and manage the portions. Even if you choose to add some oil, butter, or salt while cooking, most homemade meals are still lower in unhealthy fats, sodium, and calories than the restaurant or fast food version, according to research. Homemade meals also save money and time. In the time it takes to have a pizza delivered or a meal served at a restaurant, your dinner can be prepared and ready to eat—especially if you choose simple, tasty recipes like these.

SMART Goal Idea: If you eat out frequently on weekends, skip your Saturday restaurant plans and spend time with your family or friends cooking a meal from home instead.

2. Switch one of your daily grains to a whole grain.

Many of us have at least one go-to starch, whether it’s pasta, rice, or bread. Choosing the whole grain version of one of your mainstay starches is an easy way to add fiber, vitamins, and minerals, and reduce added sugars. For example, swap white bread or honey wheat bread for whole grain bread, switch white or veggie pasta to whole wheat pasta, or replace Cinnamon Toast Crunch cereal with Kashi Heart to Heart Warm Cinnamon cereal.

To find whole grains at the grocery store, ignore the front of the package labeling or the whole grain stamp of approval—these health claims can be deceiving! Instead, go straight to the ingredient list: the first ingredient listed should include the word “whole” followed by the name of the grain in the product. For example, if “whole wheat flour”, “whole oat flour”, or “whole rye flour” are listed as the first ingredients, then you’ve found yourself a whole grain!

SMART Goal Idea: If you add rice to your meals on a regular basis, swap out the white rice for a brown rice, or try one of these lesser-known whole grains.

3. Change the way you use fat in cooking.

Adding butter to a skillet for pancakes or pouring oil into a pan for a stir-fry can seem like second nature after a while. However, it’s easy to overdo it with these calorie-dense foods—one tablespoon of oil has about 120 calories! Using oils, like canola and olive oil, instead of butter when cooking can be a simple way to replace saturated fats with more heart-healthy unsaturated fats in meals. Also, investing in an oil mister or an oil spray like PAM can make a little oil go a long way, sparing you some calories.

SMART Goal Idea: If you like to sauté or roast foods like meats, veggies, or potatoes on a daily basis, skip the butter and layers of oil and use an oil mister. Spray the bottom of the pan before cooking, then add food and lightly spray the oil again over the top of food.

4. Aim for two to three servings of vegetables each day.

Eighty-seven percent of Americans do not meet the recommended servings of vegetables (2 1/2 cups daily), according to a national report from the Center of Disease Control. If you fall into this group, then you’re probably missing out on some essential nutrients. Vegetables are loaded with fiber, vitamins, minerals, and antioxidants, which are all important for skin, eye, heart and immune health. For some veggie inspiration, check out these flavorful vegetable-filled recipes.

If you already eat enough veggies, focus on increasing the variety of your vegetables since different colored vegetables have different vitamins and antioxidants. Aim for a combination of green vegetables like broccoli and spinach, red/orange vegetables like carrots and tomatoes, and starchy vegetables like peas and potatoes.

SMART Goal Idea: If you are a pasta lover, steam or roast some veggies while your pasta is cooking. Fill half your plate with pasta and fill the other half with a colorful array of cooked vegetables and some protein like beans, chicken, or shrimp. Broccoli and squash, tomatoes and spinach, mushrooms and cauliflower are a few tasty veggie combinations.

5. Sweeten your breakfast and snacks naturally.

Flavored yogurt, sweetened cereal, and packaged oatmeal are some of the sneakiest sources of added sugars. Even a serving of Raisin Bran cereal has 18 grams of sugar—equivalent to 4 to 5 teaspoons of white sugar! Unless you’re eating Raisin Bran for dessert, save those added sugars for times when you’re really craving sweets. Stick to the unsweetened yogurt, cereal, and oatmeal, and flavor them yourself with fruit, nuts, or seeds. Even drizzling some honey or a sprinkle of brown sugar on unsweetened oats, cereal or yogurt, will still give you less added sugar than most sweetened versions.

SMART Goal Idea: If you rely on sweetened oatmeal packets for breakfasts, replace them with plain quick oats or rolled oats. If you like your oatmeal fruity, try this recipe. For a more savory and creamy oatmeal, give this recipe a try.

6. Make water your beverage of choice.

If you’re a regular soda drinker, switching to water could be the simplest change that you can make to improve your health. Replacing soda and other sugary drinks with water doesn’t just save you calories, but it eliminates empty calories so you can make room for other calories from more nutritious food.

If you’ve already cut out soda from your diet, focus on drinking enough water. Since many metabolic pathways rely on water, dehydration can make our metabolism work less efficiently. Memory, concentration, mood, energy level, and muscle movement are also negatively impacted by dehydration, even mildly dehydration. Though eight cups of water daily is generally recommended, the best way to find out how much water your body needs is to check your urine. Yes, I’m talking about your pee—you want it to be a light, almost clear color. If it’s dark yellow, then you may not be drinking enough water throughout the day. To up your H2O intake, set a reminder on your phone to drink more water with one of these apps or try one of these drinks to give your water some more flavor.

SMART Goal Idea: Once you determine out how many cups of water your body needs, split the volume in three and aim to drink that amount every three to four hours throughout the day. For example, if you need nine cups of water, try to drink 3 cups before noon, 3 more cups in the afternoon, and 3 more cups before you go to sleep.

7. Go meatless once a week.

Since the World Health Organization identified processed meats as “carcinogenic” and red meat as “probably carcinogenic,” concern continues to grow over the potential risks of eating too much of these meats, especially processed meats like bacon, sausage, hot dogs, and deli meats. While avoiding all processed meats and red meats may be unrealistic, try committing one day of the week to not eating meat. Making this small change has several health benefits including reduced risk of heart disease and lower risk of some cancers, according to research from the Meatless Monday campaign. Going meatless once a week may seem a little less daunting, when you consider everything you can add to your plate like whole grains, beans, lentils, and vegetables. For some delicious meatless meals, check out these recipes.

SMART Goal Idea: Instead of ordering a burrito with steak, cheese, and rice, fill your burrito with black beans, rice, corn salsa, and guacamole­—you’ll still get plenty of protein, with the addition of fiber, healthy fats, vitamins, and minerals.

8. Check in with your hunger, fullness, and cravings.

Not ready to change anything about your eating habits? That’s okay too! Start by getting more curious about how, when, and why you eat. Before meals, ask yourself how hungry you are. After eating, consider how full you are: satisfied or uncomfortably full? When you have an intense food craving, ask yourself what may be triggering the craving. Are you overly hungry, stressed, or distracted? Is it emotional hunger or physical hunger? Keeping track of how certain foods make you feel and identifying what may be influencing your food choices can give you perspective for when you’re ready to make changes.

SMART Goal Idea: Pick one meal each day and spend 10 to 15 minutes tracking your hunger, fullness, and cravings before, during, and after the meal. Keep a journal, write a note in your phone, or get an App to track your intake and make you more mindful.

Katelyn Castro is a second-year student in the DI/MS Nutrition program at the Friedman School. She’s a foodie, runner, and part-time yogi on a mission to make healthy eating easy, sustainable, and enjoyable. You can find her thoughts on all things relating to food and nutrition at nutritionservedsimply.com.

 

Opportunities for Exploring Fall in Boston

by Dani Bradley

New to Boston? Now is the time to get outside before winter arrives (and appears to never leave)!

Fall is the perfect time of year to get outside, it’s not too cold, not too hot, and the air is crisp and refreshing. Not to mention, getting outside is a great way to spend those well-deserved breaks from work or studying.

Here are some ideas for taking advantage of the beautiful weather and foliage in the greater Boston area! (Ordered in increasing distance from Tufts’ Boston campus.)

The Esplanade

The Charles River Esplanade is a public park that runs along the Charles River in downtown Boston. It offers everything from running and biking routes to kayaking and paddle boarding. There is even an outdoor exercise area between the entrances from Mass Ave and Boston University. Check out a map of the park to plan a great running route or just pick a place to have a picnic and view the foliage!

esplanade

Instagram: dani_bradley

Castle Island

In South Boston, Castle Island is a fantastic area to get outdoors and go for a walk or run. This map indicates the amenities and trails available here. And it’s only about three miles from the Tufts Boston campus!

castle-island

Emerald Necklace

Boston also offers a series of about seven parks and green spaces, which are called the ‘Emerald Necklace’. Use these maps and see if you can check off all of the amazing parks before winter comes!

emerald-necklace

Chestnut Hill Reservoir

This reservoir, located near Boston College and accessible from the end of the green line’s B and C branches, offers a fantastic one and a half mile running or walking loop. Get out there early in the morning and you will see tons of local residents and Boston College students enjoying the sunrise behind the iconic Boston skyline!

Instagram: dani_bradley

Instagram: dani_bradley

Brookline Reservoir

The Brookline Reservoir is another great option for a walking or running path. This one-mile loop is a perfect place to visit if you want to get out of the city but don’t have the transportation to get too far. It is under five miles from the Tufts Boston campus and accessible by the green D line! From here you can see the Boston skyline peeking out behind the trees from the far end of this reservoir!

Instagram: dani_bradley

Instagram: dani_bradley

Larz Anderson Park

This next park is quite different from the typical outdoorsy or green parks. While it offers all the greatness a park should (green space, picnic tables, ball parks, and walking paths), this park also houses a car museum on its premises. This park is only open between April and October, so be sure to check it out before it is too late!

larz-anderson

Arnold Arboretum of Harvard University

The Arboretum, located just past Jamaica Plain, is another amazing green space offered by the city of Boston. It is a ‘living museum’ operated by Harvard University and dedicated to the study of plants. Its many walking, running, and biking paths become even more beautiful during peak foliage season in Boston.

arborium

If you are looking to get a little further from the city…

Blue Hills Reservation

Blue Hills Reservation is located in Canton, MA and is only a 20-minute drive from the Tufts Boston campus. It offers beautiful paths for walking, running and hiking, and when you make it to the top you will be rewarded with stunning views of the city. The trails are no more than five miles long and the hiking is only moderately difficult. This is a great option for a weekend outing with friends!

picture8

Walden Pond – Concord, MA

Walden Pond is a located a bit further from the city, but it’s well worth the scenic half-hour drive if you can get your hands on a car (keep in mind there is a small parking fee)! Once you arrive you will have access to a walking path around the lake that measures to be a bit less than two miles. This park may be especially enjoyable for all of you literature geeks; you can see Henry David Thoreau’s’ cabin! And don’t worry history nerds, there’s something for you too! After you’ve spent some time at Walden Pond, take the quick five-minute drive to downtown Concord where you can walk Main Street, grab lunch, and view the historic architecture that dates back to the Battle of Lexington and Concord.

Google Maps route from Walden Pond to Concord Center

Google Maps route from Walden Pond to Concord Center

These are only a few ideas for getting outside and staying active during Boston’s peak foliage time. Enjoy!

Dani Bradley is a MPH/FPAN dual degree student. She began at the School of Medicine in January 2016 and is currently in her first semester at the Friedman School. In her free time, she serves as the Volunteer Coordinator for the organization Girls on the Run and loves spending time outside.

A Second Life for Fitness Trackers

by Marissa Donovan, RD

Lately it seems everyone is getting into wearable activity trackers, and though I thought being a Friedman student made my sample biased, the fact is 1 in 10 Americans owns a wearable tracker. Activity trackers are a great way to motivate you to move more, from group competitions to setting personal goals and even monitoring your heart rate. However, like most new toys, the novelty wears off—1/3 of people stop using them after just 6 months—and many times these trackers find a new home in a drawer or stashed away elsewhere. This is where RecycleHealth comes in.

“Many populations who stand to benefit most from wearables do not have access to them.” This sentiment shared by Lisa Gualtieri—RecycleHealth Founder and Program Director, as well as an assistant professor at Tufts—inspired her to launch RecycleHealth last year.

Lisa Recycle Health.jpg

Lisa Gualtieri, Founder and Program Director of Recycle Health, models a few of their most recent donations for a recent TuftsNow article. (Photo: Alonso Nichols/Tufts University)

Sandra Rosenbluth (a recent Friedman alum) serves as the Program Coordinator and Communications Specialist at RecycleHealth. As a former student of Lisa’s, Rosenbluth watched RecycleHealth transform from an idea to a (very successful) reality. She admits that she knew little of wearables before coming to Tufts, which encouraged her to join RecycleHealth, increasing access and awareness of this new technology. “Through this program we are able to help those who really need that extra push to be more active,” says Rosenbluth.

RecycleHealth collects used wearables and redistributes them to populations in need of these technologies. Currently, the team accepts all kinds of wearables and chargers, though the most popularly donated are Fitbits and Jawbones. “We actually got a rush of unopened boxes sent to us right after Christmas this year,” laughs Gualtieri, “though the bulk of what we get are used.”

Most are donated through mail—they offer postage-paid mailing labels online—and some are collected through strategically placed donation boxes. The team has also seen success tying RecycleHealth advertising and offering donation boxes at conferences, like the HIMSS conference in Las Vegas earlier this year.

“Right now the bulk of our efforts has been in collecting them, and we have over 200 to date,” explains Gualtieri. So after they have gathered, tested and cleaned all of these wearables, what’s the next step?

RecycleHealth Program Coordinator and Communications Specialist Sandra Rosenbluth poses with an influx of donations around Christmas time this year.

Sandra Recycle Health.jpg

RecycleHealth Program Coordinator and Communications Specialist Sandra Rosenbluth poses with a few donations. (Photo RecycleHealth Facebook)

Numerous organizations and researchers have approached RecycleHealth with an interest in distributing wearables to their community members and patients. Gualtieri explains, “Our target populations have always been those with low SES, minorities, seniors… and people who don’t own them, of course.” So when researchers studying these populations approached her, it was a perfect fit. But why donate them to research studies instead of just giving wearables to these populations?

“Part of this program is redistribution—from peoples’ drawers to those who want to (and will) use them,” says Gualtieri. “But we also see this as a research vehicle. We want to learn if knowing your baseline activity level or seeing the impact of small changes in daily activity helps people in increasing and sustaining fitness levels.” Rosenbluth echoes, explaining that using the collected devices through RecycleHealth will help to establish which wearables best support behavior change. “We are having research participants complete surveys for us to see if the wearables are having different effects in different groups, which will allow us to be more focused in larger, future research studies,” says Rosenbluth.

It’s possible down the line that RecycleHealth will offer wearables through public health programs, though Rosenbluth admits, “we need to first formalize how we decide who gets them.” Gualtieri adds that the research is a priority because they want to establish the best health efforts for their target populations. For example, wearables may add small increments to daily activity level in seniors, aiding in fall prevention and increasing overall health. There is a thought that seniors and technology don’t mix but many already track their health indicators on paper or in their heads, so giving them devices with training in how to use them may make this easier.

There is an ecological side to this too. Unwanted wearables are not meant to be thrown away and until now there has not been a formalized process to recycle them. Gualtieri says that many donors actually stumble upon RecycleHealth while searching terms like “recycle Fitbit” online.

Certain populations are not even aware of the benefits available with wearables and RecycleHealth is helping to increase knowledge of this public health tool. “We have a wonderful opportunity here to help people and, through our surveys, learn how to better help people,” Gualtieri says.

So what’s next for RecycleHealth? The team is working on targeting another underserved population: veterans. Because of struggles re-acclimating to civilian life and difficulty accessing resources, many veterans experience (sometimes undiagnosed) mental health issues. “We are just starting to get the ball rolling with potential efforts in this community,” explains Rosenbluth. “But we are very interested to see if RecycleHealth can assist veterans recovering from mental health and other concerns to use trackers as part of their therapy.”

group recycle health.jpg

From left to right: Matthew Holt, Lisa Gualtieri, Sandra Rosenbluth, Karen Mcintosh at HxRefactored conference April 5-6 in Boston, MA. 

Though RecycleHealth is still in its infancy, the team is already making measurable impacts in the public health realm. This need-based non-profit fills a perfect niche, proving mutually beneficial for both the donors, recipients (and researchers) of wearables. To learn more about RecycleHealth (or if you have a wearable to donate!!) check out their website or Facebook page.

Marissa Donovan is a registered dietitian and second-year student in the MS Nutrition Communication & Behavior Change program with a focus in US Food and Nutrition Policy at Friedman. She loves hiking, traveling, finding new restaurants, and, of course, Netflix.

Yoga: Treatment for Type II Diabetes?

by Connie Ray

Scrolling through your Facebook and Instagram feed, you might think yoga is just another avenue for the uber fit and flexible to show off their hot bods at the beach. But research has consistently shown yoga helps improve mood, reduce stress, and increase strength and flexibility.

800px-Downward-Facing-Dog.JPG

By Iveto (own work) via Wikimedia Commons

There is also a growing field of evidence that yogic interventions can help treat and prevent chronic diseases. Published earlier in 2016 in the Journal of Diabetes Research, Innes and Selfe’s systematic review concluded that yoga may be beneficial for managing Type II Diabetes.

Type II Diabetes (DM2) is characterized by high blood glucose levels (hyperglycemia) and insulin resistance. It affects approximately 366 million people worldwide, a number which has doubled over the last 30 years. By 2030, this number is projected to reach 552 million.

In the United States, the CDC estimates that 29.1 million people suffer from DM2. In 2010, diabetes was the seventh leading cause of death in the US, and the number of cases is believed to be underreported. DM2 is the country’s single most costly chronic disease, accounting for at least 10% of all US healthcare costs ($245 billion annually).

Rather than an inherited disease like Type I Diabetes, DM2 is a preventable disease, and while certain factors like race, age, and genetic predisposition play a role in its prevalence, it is believed that over 90% of DM2 cases are attributable to lifestyle factors.

Lifestyle factors that increase risk of DM2 include physical inactivity, overnutrition, and obesity as the primary factors, with sleep impairment, chronic stress, and smoking as secondary contributing factors.

Yoga may be an ideal intervention for treating a multifactorial condition like DM2. Yoga is a mind-body approach to exercise, with roots in India over 4,000 years ago. The traditional practice of yoga incorporates 8 “pillars” or aspects of teaching, and the physical poses you see on Instagram, or “asanas” are only one of the 8. As yoga has become more prevalent in Western culture, it has branched into many different styles, including Bikram (hot yoga), Ashtanga (power yoga), Vinyasa (flow yoga), Iyengar (basic hatha yoga), Kundalini (awareness yoga), and restorative yoga. Most yoga styles incorporate physical poses (asanas), with breath practice (pranayama), focus (dharana), and meditation (dhyana).

Authors Innes and Selfe believe yoga’s mind-body approach suits it to a multifactorial lifestyle disease like DM2, and the results of their systematic review uphold their hypothesis. They analyzed 33 papers from 25 original controlled trials investigating the impact of yogic interventions on adults with DM2, and the results overwhelmingly demonstrated the benefits of a regular yoga practice on several health-related outcomes. Trials varied in duration and frequency of practice from 2-3 times a week to daily practice, spanning 6 weeks to over a year. In all cases, they compared results of the yogic intervention to “standard” DM2 care and in some cases, to a second control group subject to a standard exercise program.

Insulin Resistance: 22/24 relevant trials, or 92%, reported statistically and clinically significant improvement in at least one biomarker for insulin resistance (PPBG, insulin, and HbA1c).

Lipid Profiles: 15/16 relevant trials, or 94%, reported significant improvement in one or more lipid indices, including reduction in total cholesterol, LDL cholesterol, VLDL cholesterol, or triglycerides, and/or increases in HDL (“the good cholesterol”).

Body Weight & Composition: 8/9 relevant trials found significant improvement in at least one measure of body weight/composition, including weight, BMI, and waist-hip ratio, even in trials that compared a yoga intervention to standard care with regular exercise.

Blood Pressure: 3/5 relevant trials reported significant drops in both systolic and diastolic blood pressure compared to standard care and standard care with walking.

Oxidative Stress: 5/5 relevant trials indicated positive change in oxidative stress with the yoga intervention groups as measured by increased glutathione/Vitamin C serum levels, increases in superoxide dismutase levels, and reductions in malondialdehyde.

Mood & Sleep Impairment: 3/4 relevant trials reported significant improvements in quality of life, psychological well-being, symptoms of distress, and insomnia. One notable study of 41 adults practicing yoga nidra (yogic sleep) daily saw a decrease in insomnia prevalence from 43% to 5%.

Nervous System Function: 3/3 relevant trials reported improvement in cardiac autonomic function and reductions in heart and respiratory rate, all suggesting that yoga shifts the body’s nervous system from sympathetic to parasympathetic.

Pulmonary Function: 2/2 relevant trials reported improved pulmonary function (increased expiratory volume, forced vital capacity, peak flow rate, and maximum voluntary ventilation).

Medication Use: 3/3 relevant trials reported significant reductions in diabetes medication use in yoga intervention groups compared to standard care and comprehensive exercise programs. In one trial of 154 adults with DM2, there were 26-40% reductions in medication use at a 3-month follow-up.

“Overall, findings of these studies suggest that yoga-based practices may have significant beneficial effects on multiple factors important in DM2 management and prevention, including glycemic control, insulin resistance, lipid profiles, body composition, and blood pressure,” Innes and Selfe concluded.

Naturally, any systematic review has its limitations, and this one is no exception. Innes and Selfe found that several of the studies suffered from methodological problems or poor reporting, and the heterogeneity of study design, duration, and subject make it difficult to compare results across trials.

Yet even with its limitations, it is clear: yoga has obvious benefits in treating and managing DM2. As awareness of its benefits spreads, one would hope that more health practitioners will incorporate a yoga recommendation into their standard diabetes treatment plans.

Connie Ray is a first-year MNSP student at the Friedman School. She currently lives in Virginia, where she raises her two sons and teaches yoga.

The 26.2-mile Cheer Tunnel: What It’s Like to Run the Boston Marathon

by Ally Gallop

“Welcome to Hopkinton: it all starts here.” Or so the famous marathon billboard reads…

On a windy and chilly morning in Boston, a continuous stream of yellow school buses shipped athletes from the Boston Common to Hopkinton, the marathon’s traditional start. Dropped off at a middle school, runners filtered onto its grassy fields. The temporary banquet tents, with flailing walls allowing the gusts of wind through, were for the 26,610 shivering runners to take refuge in. Abandoned blankets, clothes, and food wrappers littered the tents’ grassy floors. All were remnants of its previous tenants, waiting for their call to the starting line. Long after the wheelchair, elite, and hard-earned qualifying runners heard the gunshot to begin the race, my own 11:15 am journey loomed.

Meteorologists warned of a rainy day, and like clockwork their 11 am prediction arrived. Walking through a neighborhood for over a mile in the rain with no end in sight, entrants shed their remaining outer layers that once kept them warm. The crowds lining the roads became larger and BBQ parties more frequent as we approached the holding corrals. Waiting and shivering from the lousy weather conditions and nerves, this was the moment my weeklong qualms subsided. The marathon announcer and the town’s residents remained positive, cheering on the stories of local runners imbedded throughout the crowd. Though the jury’s recent guilty verdict was known, the pride that this marathon embraced persevered.

BOOM! The gun went off, and the roar of the crowd intensified. Even two-and-a-half hours beyond the morning’s official start, Hopkinton’s residents went wild. So did the 6,000+ runners contained in the surrounding corrals. Tiptoeing past the starting line, we were officially running the marathon.

Hopkinton’s narrow highway, made snug with its road-hugging forests, contained the masses that crept through the first few miles. Forced to keep close, watch for flying elbows, and maintain a slower pace, we acknowledged how this leisurely beginning would save us the much-needed energy required in the miles to come. Small hills came and went, but the crowds hid them. Only our legs felt the climb.

“Gatorade! Gatorade! …Waaaaaaterrrr!”

We heard mile one before it was even seen. The masses split to either side of the highway to grab at the green cups. Forfeiting the stations for my handy water bottle, I took off to find my pace down the road’s centerline. But not for long. Running the majority of the race locked to the sidelines, this was where the fans were. I knew that these were the people that would help me through. All ages of supporters stood in their rain jackets and boots, hands out, orange slices ready, and high-fives available to any runner that required support. And they didn’t disappoint.

And then I heard music. Turning a corner somewhere in Ashland delivered the comforting sounds of Neil Diamond’s “Sweet Caroline.” Up until that point, my thoughts focused on maintaining pace, steady breathing, and swapping between Gatorade and sticky PowerBar gels. Now, I found myself screaming out, “So good! So good! So good!” From here on out, a massive smile plastered itself across my face that didn’t disappear until sometime Monday night.

As to contain fans, town centers roped off the course along the sidewalks. Everywhere else the lack of formal boundaries trusted fans to keep to the sidelines. Yet every so often, their own excitement for the marathon won over. Trickling onto the course, young kids wanted to deliver high-fives and encouragement as close to the action as possible. Youth celebrating the day with alcohol stumbled onto the road, only to be contained by watchful police officers and the military.

Traveling though a constant stream of runners and fans, no familiar faces were apparent. Acknowledging that the Tufts Marathon Team’s cheer crowd was stationed at mile nine in Natick, my energy surged as I anticipated seeing friends. As I scanned the sidelines, my coach Don Megerle appeared! Stopping to enjoy the familiarity, he then hurried me along to my awaiting fans. Standing in the rain for hours, the warm smiles and hugs of my loved ones and fellow Friedmanites shot a rush of adrenaline through me. This was a preview of what to expect in 17 more miles. My smile widened as I returned to the course.

Though Wellesley’s town center was only the halfway point, the condensed fans formed a cheer tunnel as if it were the finish. Fans relentlessly offered licorice, pretzels, and high-fives. The energy and cheers were deafening, which was a great distraction to how my body was reminding me that half-marathons were historically my finish line. The halfway marker came and went. With the feet blisters forming and the steady streaks of pain darting through my legs, there was a whole other race to run. One that included the impending Newton Hills.

Running down flat Washington Avenue, Newton’s infamous hills appear out of nowhere. A 90-degree turn at the fire station onto Commonwealth Avenue forces runners into a thick crowd of screaming fans. Practice on these hills all you want, but their 17.5-mile placement and sequence of a hill-plateau four times over can get the best of any runner. The first hill quickly shoots pain into the legs and reminds its climbers that the worst is yet to come. Jogs slowed to trots and finally to walks. Runners stopped peering down at their watches. There’s no making your pace on these hills. It’s all about fighting through. There is no end in sight, as the road relentlessly climbs and twists upwards like a staircase.

But good old Boston College: their fans encouragingly called us out, one-by-one. They knew these hills hurt, and they were ready to take on the task of urging runners along. Though my legs had become dead weights and my pace slowed to a crawl, the overwhelming and personalized encouragements kept me going. “You go girl!” “Keep smiling!” “Looking good, Tufts!” Sideline snacks now turned to cups of beer.

After 4-miles of slow-motion running, my eyes met those of a saint shouting, “See that flashing light at the top? That’s the end of Heartbreak Hill!”

Adrenaline took over. An end was now in sight, as my eyes locked onto that forever-flashing light. The relief first came from my legs, as they were the first to feel the hills behind me. From here on out, the course was essentially downhill.

From previous runs I knew to be on the lookout for three distinct distant markers: the Prudential Center, the John Hancock Tower, and the Citco sign. As both towers in the skyline appeared, the wet conditions forced my focus to the ground. Cleveland Circle’s trolley tracks are known tripping hazards. The mile markers counted down in an excruciating manner, yet Boston University’s crowd of students delivered an unexpected bout of motivation. Sure they cheered, yet as the runners surrounding me resembled parents the younger cohort of fans seemed to affiliate with my Tufts uniform. The ibuprofen I had consumed two hours prior was now no match for the pain screaming through my lower body. But I couldn’t stop. As the students cheered me on, I wouldn’t allow their efforts to go to waste.

As the red triangle of the Citgo sign emerged, the baseball fan in me came out. The small climb over the Mass Ave Turnpike was no match for running past Fenway Park. Peaking inside, the center field screen was streaming the finish line. That would soon be me! The game had just ended with the Sox defeating the Orioles 7-1. Rowdy fans transferred their adrenaline onto us, as they poured into the streets switching their baseball shouts into those of support.

Kenmore Square’s glass bubble T station, the Buckminster Hotel, and McDonald’s all became familiar sights. I knew where I was and how close I was to Copley. The professional, navy blue, John Hancock mile markers were consistent since Hopkinton, except for one. Though identical in format, mile 25 was replaced with marathon great Dick Beardsley‘s mantra: one more mile. That’s all it was. With a marathon distance behind me all I concentrated on was one more mile. The infamous “right on Hereford, left on Boylston” was near.

Turning right, barricades meant to restrict fans were overflowing with more dangling from apartment windows above. Their cheers bounced off the surrounding tall buildings, a roar I will never forget. Taking that last left, my smile grew. There was no fear running down Boylston. No thought of shifting to the side of the road closer to the library. This last half mile solidified that runners don’t run for themselves. We were running for our country, our team, and most importantly for Boston.

As the finish line neared, the crowd’s cheers were like that of an approaching ambulance. They became louder and louder and louder… until running over the finish line, where for the first time the fans were no longer welcome. Their cheers quickly faded. Medical teams surrounded finishers with wheelchairs, insulated covers, and bottles of water. I could now feel the rain coming down and the pre-race shivers return, as my joints began to stiffen.

Never throughout the 26.2-mile course did it feel as if the crowd grew weary of the constant stream of runners. Town after town, they cheered as if we were the first of the day. As I walked towards my friends, my feeling of pride won over. Though not a born and raised Bostonian, for the past 3 hours and 42 minutes I sure felt like one.

Relive the Boston Marathon by watching a 15-minute video of a runner who captured the entire race while wearing a camera or with the Boston Athletic Association’s official trip from Hopkinton to Copley.

Ally Gallop, BSc, RD, CDE is studying towards an MS/MPH focusing in nutrition communication and behavior change. Her next running adventures include Philadelphia’s “Broad Street Run” in May, Ragnar’s “Reach the Beach” relay in September, and hopefully the Boston Athletic Association’s half-marathon come October.

How Does a Ketogenic Diet Affect YOU? Part 3: C-Reactive Protein: A Marker of Inflammation

by Katie Mark

The latest craze surrounding the ketogenic diet has us further investigating whether or not a high-fat/low-carbohydrate lifestyle might be an appropriate dietary approach for some people. In this 3-part series (click here for part 1 and part 2), we’re evaluating how the ketogenic diet affects biomarkers.

The ketogenic diet is a very low-carbohydrate (<10% of total calories), moderate protein and high-fat (>70% of total calories) diet. After at least two weeks of keto-adaptation, the body’s energy source switches from glucose to fat.

In part one of “How Does a Ketogenic Diet Affect YOU?” we found studies suggesting that nutritional ketosis lowers fasting glucose and insulin levels and possibly increases insulin sensitivity. In part two, we investigated the impact of ketosis on cortisol. We found that a high-fat, carbohydrate-restricted diet may increase certain forms of cortisol, but blood cortisol levels are only half the story. Further research is needed to clarify the relationship between ketosis and an increase in certain forms of cortisol: the active form (cortisol), the inactive form (cortisone) and metabolites of cortisol from enzymatic breakdown.

Now let’s evaluate how the ketogenic diet affects C-reactive protein (CRP).

Increased CRP: Is there a need to worry?

C-Reactive Protein

C-Reactive Protein Model

CRP is considered a marker of inflammation. The liver makes CRP when inflammation in the body is present. High levels of CRP are influenced by genetics, high stress, exposure to environmental toxins and a sedentary lifestyle. Diet can also impact CRP levels, especially diets high in refined and processed foods.

There are two blood tests to measure CRP. The non-specific test indicates acute CRP levels that result from general inflammation in the body. The more sensitive measure is the highly sensitive CRP (hs-CRP) test, which accurately measures basal levels of CRP by measuring inflammation in blood vessels. The hs-CRP test is the accepted measure to determine the risk for cardiovascular disease (CVD).

Higher CRP levels signify a higher risk for developing CVD and abdominal obesity. Weight loss is known to decrease markers of inflammation such as CRP.

It is believed that a high saturated fat and very low carbohydrate diet (VLCARB) increases the risk for CVD. A study published in Nutrition Metabolism (London) compared a VLCARB diet to two low saturated fat, high carbohydrate diets to determine their effect on body composition and CVD risk. The isocaloric (similar calorie composition) diets were: very low fat (CHO:fat:protein; %SF 70:10:20), high unsaturated fat (50:30:20; 6%) and VLCARB (4:61:35, 20%). The study concluded that weight loss resulted in a reduction of CRP regardless of the dietary macronutrient composition. Yet, it is uncertain whether or not the macronutrient composition of a diet influences inflammation.

A study published in The Journal of American College of Nutrition found an increase in CRP in overweight women who followed a short-term low carbohydrate, high-fat weight loss diet. The study reported that an increase in CRP might have resulted from the oxidative stress caused by this type of diet.

Another study published in Obesity (Silver Spring) looked into the inflammatory response caused by a high-fat, low-carbohydrate weight loss diet (HF) by randomly assigning 19 overweight men and women to either an antioxidant (AS) or placebo (P) supplement. The objective was to see if the antioxidants vitamins C and E could decrease the inflammation reported in a HF diet.

CRP decreased 32% in the AS group and increased 50% for the P group; however, this was statistically insignificant. The HF diet did not decrease CRP within the short-term 7-day study even though other markers of inflammation decreased.

The study could not confirm if oxidative stress was causing the inflammation. It was concluded that further research is needed to determine the different CRP responses over the long term, especially while using antioxidant supplements. This is important considering most fruits and vegetables, which are low in fat, contain antioxidants.

The Verdict

A ketogenic diet may increase CRP levels, but weight loss reduces CRP levels. The reason for the increase in CRP is unclear. One plausible explanation is that low intakes of magnesium, vitamin C and other nutrients while on a ketogenic diet may lead to this effect. When magnesium is low, CRP increases. It has been reported that increased vitamin C intake may reduce high CRP levels.

An imbalance between anti-inflammatory fats (omega-3 fatty acids) and pro-inflammatory fats (omega-6 fatty acids) is another possible explanation. Polyunsaturated vegetable oils primarily contain the pro-inflammatory omega-6 fatty acids. Eating less grain-fed meats and chicken and more grass-fed meats and free-range chicken is also important to consider. Grain-fed animals have higher omega-6s whereas grass-fed animals have higher omega-3s. Omega-3s are anti-inflammatory and important for normal body functions, including regulating blood clotting and building cell membranes in the brain. Omega-3s are also suggested to protect against heart disease.

An elevated CRP level is never a good thing. If you are opting for a ketogenic diet, increasing magnesium and vitamin C intake as well as choosing grass-fed products may reduce CRP levels.

Katie Mark is a first year Nutrition Communication/Master of Public Health student who enjoys road cycling and traveling.