Spaghetti Squash a la Microwave

Spaghetti squash is a tasty alternative or addition to a pasta recipe. It adds fiber and flavor, and another serving of veggies! Plus, it cuts down on calories (if that is your goal). Regular pasta has about 200 calories per 1 cup serving, where as the squash only carries 40 calories per cup.

Get squash (butternut, acorn, pumpkin) now while it is in season. Try roasting other varieties and even blending for a soup. Butternut squash tastes great roasted with shallots and ginger - add stock and blend! But I'll post those pics later.

For tonight, spaghetti squash with all natural chicken sausage, garbanzo beans (chickpeas), yellow onion, and yellow and green squash. Go with yellow or red onions, or even shallots, to get more bang for your buck. These varieties have more phytonutrients and help blood vessels dilate, allowing blood to flow more easily, thus helping the heart out.

Step 1 - Cut holes in the spaghetti squash with a butcher knife to let the steam escape. Microwave on high, 4min/pound of squash. Most will need about 12 - 15 minutes.


Step 2 - Using a hot pad, take the squash out. Slice in half lengthwise and scoop out the seeds and inside gunk.

Step 3 - Separate "spaghetti" strands with a fork. Season with garlic (powder or chopped fresh), olive oil, and Parmesan cheese. Top with turkey spinach meatballs, Italian chicken, or lean sausages. Enjoy!
Note - chicken sausages are a quick, weeknight meal. Most varieties come pre-cooked and with lots of yummy seasonings and flavors. I used roasted red pepper. Consider the breakfast links for added protein in the morning. Or what I will do is warm up half of the regular sized sausage and chomp on it with some cereal and fruit.

The answer is....

1.2 - 1.4 grams protein per kilogram per day

For example, if you weigh 110 lbs, this is equivalent to 50 kg (kilograms=pounds/2.2)

50 kg x 1.2 = 60 grams
50 kg x 1.4 = 70 grams

So a 110 lb runner needs somewhere between 60 and 70 grams protein per day.

Although carbs are your body's primary source of fuel, protein is crucial for endurance training. Protein is necessary for muscle growth and repair, hormone production, hair and nail health, immune function, and red blood cell production. During intense training, protein may be used for fuel as well. The carbon backbone of amino acids converts to acetyl-coA, which is able to enter the Krebs Cycle to produces ATP (fuel for muscles). This generally only occurs when there is excess protein after growth and repair or if their is insufficient energy from carbohydrates and fatty acids.

More important than overall protein intake is making sure to get some source of protein with every meal and snack. Have you ever found yourself hungry very quickly after a bagel and cream cheese or a big plate of pasta? Carbohydrates are digested very quickly, starting with the production of the salivary enzyme amylase. The carbs enter the bloodstream, blood sugars go up, and insulin is released from the pancreas to (1) shuttle glucose into cells so it can be used for energy and (2) to lower blood sugars back to a normal level. The greater carbohydrate load at a meal, the more insulin that is released and the further our blood sugars will fall. You may be hungry before actually having metabolized the carbs. Including a protein (or healthy fat) helps slow the release of the glucose into the blood, thus providing sustained energy.

You don't want to eat too much protein close to a workout because of the slower digestion (it takes about 4 hours for proteins to be completely digested), which may lead to cramping due to poor blood flow to the gut. You do want to include adequate protein at breakfast and after hard workouts. Breakfast is especially important for blood sugar balance. Your blood sugars are the most susceptible for peaks and valleys in the morning. You have essentially been fasting for 8-12 hours and blood sugars are low. You will most likely crave carbs in the morning because of low blood sugars and low serotonin levels (carbs help produce serotonin), but you must balance them with protein or you can find yourself hungry the whole day, crashing in the afternoon, and craving sweets after dinner. Next time you find yourself wanting a sweet after dinner or caffeine in the afternoon, take a look at the protein in your breakfast.

Breakfast options for protein - yogurt (look for low sugar varieties and/or higher protein Greek yogurt), cottage cheese, nut butters (all natural almond, cashew, peanut), all natural chicken breakfast sausages, nuts or seeds, whey protein powder, or eggs.

Milk does have 8grams protein per 8 ounce serving, but it also has 12grams carbs due to the milk sugar lactose. When consuming cereal and milk, look for an additional protein source.

Baws (Boston for "Bars")

As far as bars go, I mainly stick with KIND bars. They are full of nuts and a little dried fruit. They are not super high in protein like most bars, only 5 grams, but they make a very balanced and low glycemic snack because of their combination of healthy fats, carbs, and protein. Low glycemic means the sugars enter your bloodstream slowly, providing sustained energy. They fit in a gym bag or a purse and will not melt in the sun. Delicious flavors include the above fruit and nut, nut delight, almond coconut, almond and cashew, cranberry almond, and a ton more. Some are fortified with antioxidants (great for repair of cells after a workout), others with calcium or B vitamins (for energy and metabolism). I will eat the fruit and nut pre- or post-run because of the dried fruit and chewy consistency. I like the nut delight paired with Greek yogurt for a mid-morning snack. I'll chomp on the almond coconut to shake things up a bit.

Why do I prefer KIND over other bars? Most other bars main protein source is soy. Not whole soy, but a very processed form of soy. Labels might read soy protein isolates or soy protein concentrate. The soybean has gone through heat processing and extraction, and what is left is a chemical-like bar. Soy is a phytoestrogen, meaning it mimics estrogen and can change hormone levels in both males and females. Men naturally have low levels of estrogen, which helps support bone density, but these levels should remain low. Women need to maintain a balance between progesterone and estrogen to keep a healthy cycle.

To keep estrogen levels balanced, stick with soy-free bars and protein supplements for the most part. Another bar to look for is Larabars, which are yummy chocolate flavored and made from dates (1 serving of fruit in each bar) and nuts. My go-to flavor is chocolate coconut. I like to include coconut into my diet once in a while for its multitude of benefits. Coconut has the same component as breast that provides immune enhancing properties, lauric acid. Coconut is a vary stable fat, meaning its chemical bonds can withstand high temperatures without being damaged. Once a fat changes structure, it creates inflammation in our bodies. Coconut is also very good for digestion since it is a medium chain triglyceride, a fat that is absorbed easily because of its structure. You can cook with coconut oil, add unsweetened coconut to cereal or a trail mix, or stir fry or blend light coconut milk in a smoothie.

Close to Home

I have struggled with iron deficiency and anemia basically since I started running. I have always been a healthy eater eating lots of fruits and vegetables and anything else I was offered; I have never been picky either. I remember going for a physical as a young kid, probably my fifth grade physical, and being slightly anemic. My sister on the other hand, whose answer to the doctor's question of, "Do you eat vegetables?" was, "Yes, raisins," had perfect lab results. It seemed ironic to me the kid who ate exactly what she was supposed to was anemic, and the chicken fingers and French fries feen got a clean bill of health.

As I became more competitive in high school, I started to feel the effects of low iron counts. I couldn't finish quarter workouts and watched over 90 other runners pass me at the 1/2 mile to go of the conference race despite my fitness levels. In college I was frustrated to find that I was still anemic despite eating the prescribed red meat and taking iron supplements. I just crossed the non-anemic barrier only by consuming two pills daily. Just last summer I was feeling light-headed often, and once again, lo and behold, pronounced slightly anemic!

The happy ending to this story is that I haven't been anemic since. Soon there after, I chose to venture into the wheat-free zone. After spending many nights doubled over in pain or in the bathroom with gastrointestinal discomfort to say the least, I thought it was worth a try. After one week of avoiding my standard cereal, sandwich, pasta diet, I was symptom free. And one year later, my hematocrit is "like a man's," according to my doctor. Simply by eliminating wheat from my diet, I improved the absorption of the iron. I apparently have had a wheat sensitivity for years, contributing to my chronic anemia.

I do not have Celiac and I really am not allergic to wheat. It is more of an intolerance, or a sensitivity. Whenever I eat wheat, antibodies are released to protect against the foreign invader, wheat. A chain inflammatory reaction occurs, causing absorbance to be sacrificed and my gut to be swollen. When nutrients are not absorbed properly, vitamin and mineral deficiencies result, hence the anemia. If you have had multiple bouts of anemia and follow an iron-rich diet, consider your ability to absorb the nutrient. Look for common culprits in your diet - wheat, milk, and eggs as well as nuts, shellfish and fish, and other gluten containing grains are the most likely allergies and sensitivities to food. Other symptoms of food sensitivities may include skin problems (acne, eczema), poor immune system, chronic congestion or sinus infections, headaches or migraines, or frequent cravings or mood swings.

Resist the Risk of Iron Deficiency

Food sources of iron come in two forms - heme and non-heme. Heme iron is found in animal products such as dark meat poultry and red meat. Non-heme iron is found in foods such as spinach, iron-fortified cereals, beans and raisins. Heme iron is absorbed a lot better by the body - between 10 and 30 percent is absorbed. Non-heme iron, on the other hand, is only absorbed 2 to 10 percent of the time. Natural compounds called phytates in these plant foods prevent iron-uptake. Phytates are phosphorus-containing compounds that block iron absorbance. Natural occurring polyphenols and tannins found in non-herbal teas and coffee block in a similar fashion.

Heme sources (per 3 ounce serving) - Beef liver (6mg), beef (3.5mg), pork (3.4mg), shrimp (2.6mg), dark meat turkey (2mg), chicken breast (1mg), tuna (1mg), flounder (1mg)

Non-heme sources - Iron-fortified cereal (2-18mg/ounce), kidney beans (3mg/0.5 cup), molasses (2.3mg/1 Tbsp), baked beans (2mg/0.5 cup), cooked spinach (2mg/0.5 cup), enriched bread, pasta, rice (~2mg/slice or 1 cup)

Other Sources of Iron (Heme and Non-heme)

Although non-heme iron absorbancy is compromised, these foods can still be great sources of dietary iron. Consider eating non-heme sources with heme sources for best results. For example, include beans in a lean ground beef chili, or add spinach to a shrimp pasta. Also, cooking these foods in a cast iron skillet helps. Eat all iron-rich foods with a source of vitamin C. The vitamin helps chelate the iron, making it more soluble in the intestines. Good sources of vitamin C include citrus fruits, bell peppers, tomatoes, melon, papaya, broccoli, spinach, Brussel sprouts, strawberries, kale, and cauliflower.

Proton pump inhibitors such as prilosec used for acid reflux can be detrimental to iron absorbancy. The pH of the stomach influences aborbance in the intestines. Other nutrients can compete for absorbance as well. Zinc, manganese, and calcium all naturally exist with a +2 charge (review your chemistry!), so they will all compete for the same ion channels in the body. In other words, do not eat milk, dairy, oysters (zinc) , or pineapple (manganese) with iron-rich foods.

When looking for an iron supplement, look for iron in the ferric (+2) form. Ferrous (+3) iron is not absorbed as well, and must be first oxidized to its +2 form. Look for a supplement with at least 100% of the daily value (18mg for adult females, 10mg for males) and take separate from other supplements. Consider taking with a vitamin C (ascorbic or citric acid) supplement. If iron causes constipation, which it can, include more fiber in your diet or take a fiber supplement (cellulose, flax seed, psyllium husk, pectin) but remember to take at a different time than the iron since most fiber-rich food contains phytates.

Fact: On my test to become a dietitian, they asked what the best vegetarian source of iron was. Answer according to the test: Baked beans! Double check the sugar content or make your own. Most canned baked beans have lots of added sugars.

The Science Behind It

The hemoglobin within a red blood cell is responsible for carrying iron. Oxygen then attaches to the iron. Anemia can result from insufficient RBCs, not enough hemoglobin, or not enough iron. A hemoglobin molecule has four protein, or globulin, subunits, each with a heme group and iron atom in the center. The iron atom combines with oxygen molecules.

Oxygen binds to hemoglobin in a cooperative manner, meaning after one oxygen molecule binds, the structure changes shape, making it easier for other oxygen molecules to bind.

Fe3+ , or the ferric form of iron, cannot bind oxygen. It must first be oxidized, so it is best to take ferrous (Fe2+) form.

How much iron do we need? The Recommended Dietary Allowance (RDA) is 8 mg for adult males and 18 mg for adult females. Because of the higher levels of red blood cell destruction in runners, we can get away with supplementing with 100% of the RDA even without deficiency. Iron should be taken in the more absorbable ferrous state. There are three forms of supplemental iron - ferrous fumerate, ferrous sulfate, and ferrous gluconate. Ferrous fumerate has the highest percentage (33%) of elemental iron, meaning it is the best absorbed. Ferrous sulfate and ferrous gluconate have 20% and 12%, respectively.

If taking more than one pill to supplement, it is best to split up the pills - only a set amount of iron is absorbed at one time. When hemoglobin levels are below normal, physicians often measure serum ferritin, the storage form of iron as well.

Dinners Decoded

Chicken Parmesan

• Natural chicken breast in an egg coating dipped in spelt (wheat-free) flour, Parmesan cheese, Italian seasonings (sage, basil, oregano, thyme, parsley), sauteed in olive oil, baked with tomato sauce (rich in lycopene), topped with part-skim organic mozzarella
  
• Steamed broccoli with red pepper flakes -high in sulphoraphone, a cancer fighting component that blocks the replication of tumor cells
• Brown rice noodles - gluten free, whole grain pasta

**Adding vitamin C rich broccoli to chicken makes the iron easier to absorb!

Am I Anemic?

Anemia is defined as insufficient red blood cells (RBC) to carry oxygen to your tissues and brain. Anemia can be a result of disease or vitamin deficiency as well as blood loss. Besides needing iron to make red blood cells, the body must also have sufficient vitamin B12 and folate for RBC production. Females are more susceptible to an iron deficiency because of menstruation. Runners are at a greater risk for iron deficiency for many reasons.

Nutrient absorption in runners is impaired after long runs or intense workouts. With a strenuous effort, blood is predominantly flowing to the muscles, heart, lung, and brain. The gut is the bottom of the blood totem pole at this point. Unfortunately, this results in poor digestion and absorption of nutrients due to villus blunting. Villi in the small intestine are responsible for nutrient absorption. Blood flows to the top of each villus "mountain," but when the blood isn't flowing to the gut, the villus tip temporarily dies and cannot absorb nutrients. As blood returns to the villi, absorption is resumed, but in the meantime, malabsorption and diarrhea are common.

Runners also are at a higher risk of anemia as a result of iron lost through sweat and red blood cell destruction from mechanical trauma, ie the pounding of each foot strike. Training at altitude further puts an athlete at risk.

Mechanical trauma, also called foot strike hemolysis (hemo- meaning blood and -lysis meaning death of a cell) occurs from vascular and red blood cell trauma in the foot. Also, red blood cells are more prone to oxidative damage, naturally occurring during exercise, which will speed the destruction of the cells.

Pseudoanemia, common in athletes, is caused by an expansion in overall blood volume. This dilutes the red blood cells, causing a false representation of anemia in blood tests, but does not usually cause problems with athletic performance. Actually, the increased blood flow aids in oxygen delivery.

Symptoms of anemia or iron deficiency include fatigue, pale skin, shortness of breath, dizziness, cold hands and feet, and headache. These symptoms normally do not appear in pseudoanemia. It is important to still get a blood test (CBC or complete blood count) to confirm a deficiency because iron can be toxic and harmful to the liver if too much is stored. A blood test will look at the following markers and help determine the cause of anemia:

• Serum Ferritin - levels of stored iron, 18-270 mcg/L (m), 18-160 mcg/L (f)
  
• Total iron binding capacity - protein that carries iron in the blood, measures how much transferrin in the blood is not carrying iron, 20-50%
  
• Red blood cell (RBC) - total number of red blood cells in that sample of blood, 4.2 - 5.6 mill/mcl (m), 3.9 - 5.2 mill/mcl (f)
  
• Hemoglobin (Hb) - protein in red blood cells that carries oxygen, 14-18 g/dl (m), 12-16 g/dl (f)
  
• Mass Cell Volume (MCV) - average volume of a red blood cell, clue to the cause of the anemia because cells are small in iron deficiency anemia as compared to a B12 or folate deficiency (pernicous anemia), 80-100 fl
  
• Hematocrit (Ht) - proportion of red blood cells in overall blood, 42-54% (m), 38-46% (f)
  
• Mean corpuscular hemoglobin (MCH) - average hemoglobin in the average red cell, 27-33 pg
  
• Mean corpuscular hemoglobin concentration (MCHC) - average concentration of hemoglobin in a given volume of red cells, 32 - 36 %

Over the course of the next few days, I will further discuss iron deficiency and anemia. I will describe the red blood cell structure, ways to increase absorbency therefore preventing a deficiency, and my own personal experience with anemia. I look forward to questions and comments!