Health & wellbeing

Jonny Wilkinson: How to eat well – and get well

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Jun 092010

What do top athletes eat to stay in peak condition? England rugby player Jonny Wilkinson shares his daily dietary habits. Plus: he reveals how to bounce back from an injury

I am lucky: I get to play the game that I love every day. To sustain this level of activity, I need to drink and eat well. As my job requires my body to be at its best at all times, I have developed a dietary routine that I tend to stick to most days.

Breakfast

Water. Your body is at its most dehydrated in the morning. Considering that you have spent eight hours without any intake of fluids while you have been sleeping, it is a good idea to start the day with a drink of water to make sure you are hydrated from the outset.

Muesli with fruit. One of your five-a-day, and also thought to help lower blood cholesterol concentration.

Low-fat skimmed milk. I tend to steer clear of high-fat foods.

Eggs/egg-white omelettes. Egg whites are fat-free and rich in high-quality protein. I try to have high-protein foods at every meal.

Carbs. You need energy at all points during the day, so carbohydrates such as toast or porridge could be incorporated into your morning routine.

Lunch

Fruit, protein, salad. I tend to keep my lunch healthy and simple.

Healthy fats. I often eat avocado – it contains monounsaturated fat and is great for energy release throughout the day.

Carbs. Carbohydrates such as pasta and potatoes make sure your energy levels are at performance level for the rest of the day.

Beetroot. Beet greens are a very good source of calcium, iron, and vitamins A and C. Beetroots are an excellent source of folic acid, which helps you rebuild your body after training.

During training

Water. I take on water whenever possible, especially since moving to France, to make sure my body is fully hydrated and in tip-top condition. I keep a Volvic bottle with me and take sips little and often. This technique has made the challenge of drinking 1.5 litres a day really easy.

Dinner

Few carbs. In the evening it is best to avoid a high intake of carbohydrates, as they will release energy during the night that could affect your sleep.

Oily fish and chicken. I love eating out and normally order chicken or oily fish, as they are an essential source of Omega 3, protein, vitamins and minerals.

Recovering from injury

Unfortunately, injuries are something that I have had a little bit of experience with. Immediate physical treatment is necessary to reduce the swelling and avoid further injury, such as elevating the injury above the heart and applying ice to the affected area. Your immediate mental response to injury, however, can often be more important than your physical response, because it sets you up for your long-term attitude towards recovery.

Something I have learned is that remaining positive is one of the best things that you can do to aid recovery. You can often tell how bad an injury is the second that it happens, and remaining positive is extremely important. Even when I am in pain and shock I try to block out any negative thoughts. Combating the initial stress can be really hard, but staying open-minded and focusing on recovery, rather than worrying, is the best way to avoid “locking in” any negative feelings that can linger throughout your recovery period.

Modern medicine can work wonders if you are in the right frame of mind and do everything possible to help out the doctors. When I sustained an ankle injury before the 2007 World Cup, many people wrote me off for the entire tournament. Thanks to the great work by the medical staff and physiotherapy team, and by doing everything I possibly could to aid my own recovery, I ended up missing just two games of the championships. I was back playing weeks before most people thought I would be.

I put this down to the positive approach that I took to my recovery, which helped me heal at the fastest possible rate.

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Running on empty

Diet and Nutrition, Exercise Help, Features, Fitness, Health & wellbeing, Health and Fitness News, Life and style, running, The Guardian No Responses »

Jun 082010

Ultramarathons are increasingly popular. But do they also pose a health risk?

This Sunday in New York, a small knot of runners will start running around the block. They will resemble any other running club although they might look a little slow. They will run one lap of the 0.5488-mile block. Then they will do it another 5,649 times.

: Image via Wikipedia

The 3100 Transcendental Race is the longest certified foot race in the world. Every day for the next six to eight weeks, the entrants will race from 6am until midnight – averaging 75 miles a day. For no payment or prize.

While few subject themselves to the lunacy of the 3,100 mile race, ultramarathons (anything longer than a marathon) are becoming increasingly popular, with races popping up all over the world. Keith Godden, editor of ultramarathonrunning.com, says there are already more than 100 such established races every year in the UK; with, he estimates, “a couple of thousand” British ultramarathon runners. “The sport now offers a great variety of very different challenges,” he says, “whether it’s 32 miles on the roads across Dartmoor, 24 continuous hours going around in circles on a running track in London, 145 miles non-stop alongside the Grand Union Canal in less than two days, or a marathon per day for three days along the Jurassic coast.”

Just finishing one of these punishing events is an achievement – but may come at a price. Personal trainer Rob Blakeman, who has trained boxers Ricky Hatton and Mike Tyson, explains: “We’re very specific organisms, with very specific requirements and very specific limitations. More training is not necessarily better training. If you do a really tough workout, the next day you often feel as though you have the flu. It’s a systemic stress. If you don’t allow that systemic stress to subside before you go back to the gym, you break the cycle of improvement.”

These flu-like symptoms, says Geraint Florida-James, senior lecturer in sport and exercise sciences at Edinburgh Napier University, are explained by the “open-window theory” which suggests that a prolonged bout of running weakens the immune system, leaving the window open for infections to attack the body. “Any stress that you come across, whether physical or psychological, will cause a response in the immune system. If you saw any of the interviews before the London marathon, everybody’s carrying a bit of a niggle, or they’ve got an illness. People trying to do ultra endurance events are taking it to a further extreme level.” If you keep on pushing yourself, disaster can strike. “If they go into overtraining syndrome, it can take years to recover from. We’re not sure, long-term, with an ultramarathon runner, how much damage they may be doing.”

Worryingly, ultramarathons could affect athletes’ hearts, says Florida-James. “Research has looked at cardiac damage within ultramarathon runners, and has shown that there are some temporary changes in terms of the functionality of the heart.”

One of Britain’s most celebrated ultramarathon runners, Geoff Oliver, president of the 100km Association, seems to bear this out when he says of the days following a long race: “I feel very weak. My heart rate is normally 48-52, and it goes down to 40-42 for a few days – I certainly feel more tired. The body is not functioning properly. It also affects my liver and my kidney sometimes. There may be blood either in my urine or out of the other end. Usually within four days I’m back to normal.”

He confesses that this has caused him to question whether he’s pushing himself too hard, but says “I’ve spoken to other runners and it’s quite common. It never lasts long.” And it’s clear that Oliver is in remarkably good shape – he recently ran the London marathon in “a disappointing 3:45.” He’s 76.

Florida-James is quick to point out that, with the proper preparation, ultramarathon running need not be unhealthy. Many people can run 100 miles without damaging themselves. That means adequate training, but also sufficient recovery time. “Everybody is different, and it will affect some people more than others.”

So why do some thrive under these harshest of regimes, while others simply crumble under the physiological stress? This, it seems, is the area that fascinates scientists and athletes alike. “I do it out of sheer interest. What can the human body cope with?” says Oliver. “I’ve always had this nice little mantra, an Alexander Pope couplet: “Know then thyself, presume not God to scan; The proper study of mankind is man.”

Five tips for ultramarathon runners

1. Go for long runs, on consecutive days, bookended by two days of total rest.

2. Splice running with periods of walking. That’s how you’re likely to complete the event.

3. If you’re finding the going tougher, the instinct is to push harder, when you should ease off.

4. Eat and drink on your runs. You should take on 400-500 calories per hour.

5. Taper off training three weeks before the race. In the last week, do almost none.

Benjie Goodhart

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Checking your blood glucose

BMJ Group, Diabetes Information, Diabetes, type 2, Diet and Nutrition, Editorial, Health & wellbeing, Health and Fitness News No Responses »

May 312010

Image via Wikipedia

To control your diabetes, you need to get a good balance among the treatments you take (insulin, tablets or both), the food you eat and your physical activity.

Your doctor may suggest you check your blood glucose regularly, to see if it’s in the right range. Regular checks will also tell you if your blood glucose is dropping too low (hypoglycaemia or hypo) or climbing too high (hyperglycaemia). Both of these can be dangerous.

For example, if you’re about to do some exercise and you find that your blood glucose level is quite low, you need to eat something before you exercise. If you don’t eat anything, exercising could lower your blood glucose level even more. You could have a hypo.

Testing your blood glucose is most important if you use insulin. People with type 2 diabetes who use insulin need to be sure that they don’t have a dangerous hypo. But we don’t know whether testing your blood glucose yourself is helpful if you have type 2 diabetes but don’t use insulin.

Testing kits

There are kits to help you test your blood glucose. The kits make testing simple. Here’s what you do. You can test your own blood glucose level regularly using a simple kit.

First, take some of your blood, usually one or two drops from your finger or your forearm. To get blood for the test, most people use a special needle that springs out when they press a button. You put this needle on your finger. When you press the button, the needle makes a prick that gives you exactly the right amount of blood.
When you have a drop of blood on your finger, you touch the drop to a test strip. The test strip is usually held in place on a meter.
There are many types of meters. But they all do the same thing. The meter analyses your blood. Then it tells you how much glucose is in it. The number usually shows on a little screen on the meter.

Your doctor will help you decide how often to test your blood. You also need to decide when you will do the test. Some people need just one test a day. Others need to do it before they take their insulin therapy (three or four times a day).

You also need to get used to adjusting your insulin dose or your activities based on what you find in your test. You will get used to this over time. But if you’re not sure what to do, ask your diabetes nurse or your doctor for advice.

If you are having a treatment called peritoneal dialysis because your kidneys aren’t working or if you are getting injections called immune globulin to boost your immune system, check with your doctor. Some blood glucose meters might not give you a reliable reading. Your blood glucose might read high when it isn’t. It is very important to have a reliable reading to avoid getting low blood glucose.[2]

It’s a good idea to keep track of your blood glucose level over a period of time. This will help your doctor see how you’re controlling your diabetes. You can carry a notebook with you to write this down. Or you can plot your blood glucose levels right onto a graph. This will help you see how your levels change.

Also, most modern meters have an internal memory. This means that you don’t have to keep a record yourself. You can simply show the meter to your doctor.

Keeping a record of your blood glucose level helps your doctor decide if you need to change your treatment, change to a different kind of insulin or change when you give yourself insulin (this is called your dosing schedule). For example, when you go to bed, you might find that your blood glucose is always a little bit higher than it should be. If this happens, your doctor may advise you to take more insulin before your evening meal.[1]

Haemoglobin A1c test

Another test you’ll get used to is the test for haemoglobin A1c (HbA1c for short). Haemoglobin A1c is a chemical found in your blood. You might hear it called glycated haemoglobin, glycosylated haemoglobin or glycohaemoglobin.

Your haemoglobin A1c level gives your doctor an idea of what your glucose level has been over time. It is kind of an average of your blood glucose level over the previous weeks. If your blood glucose level is often higher than normal, you will also have a high haemoglobin A1c level. So this test is useful for seeing how well you’re keeping your diabetes under control. Most people with diabetes should have their haemoglobin A1c checked every three months to six months.

The result of this test is given as a percentage. A good result is 7 percent. Your ideal result depends on your own situation, but it should usually be between 6.5 percent and 7.5 percent.[3] The higher the number, the greater your chance of getting complications from your diabetes. But most likely it would have to stay high for many years before you got problems.

Driving

If you take insulin, you must inform the Driver and Vehicle Licensing Agency (DVLA) about your diabetes. You must also tell the DVLA if you control your diabetes with tablets or diet and you have a complication that could affect your driving, such as a problem with your eyes.

You need to be especially careful about checking your blood glucose level when you’re driving. If it drops too low when you’re at the wheel, you could have a hypo and black out. To reduce your chances of getting hypo while driving, check your blood glucose level just before you get into the car.[4] If it is low, have a snack and check again before you set off. Try to always have some sugary drinks or sweets in the car. If you feel you’re going into a hypo, you can stop and have a drink or sweet, to boost your blood glucose.

If you feel you’re going into a hypo while you’re driving:[4]

Stop the vehicle in a safe place
Switch off the engine
Have a sweet drink or snack, such as a sweet or glucose tablet. Wait until you feel better before setting off. This can take 15 minutes
It’s a good idea to check your blood again before driving.

References

Williams G, Pickup JC. Handbook of Diabetes. Blackwell Science, Oxford, UK; 1992.

U.S. Food and Drug Administration. 2005 safety alerts for drugs, biologics, medical devices, and dietary supplements: parenteral maltose/parenteral galactose/oral xylose-containing products. November 2005. Available at http://www.fda.gov (accessed on 18 November 2009).

National Institute for Clinical Excellence. NICE issues national guidelines for the management of blood glucose levels in people with type 2 diabetes. September 2002. Available at http://www.nice.org.uk/36734 (accessed on 18 November 2009).

British National Formulary. Insulins. Section 6.1.1. British Medical Association and Royal Pharmaceutical Society of Great Britain. Also available at http://bnf.org (accessed on 18 November 2009).

Glossary

kidney

Your kidneys are organs that filter your blood to make urine. You have two kidneys, on either side of your body. They are underneath your ribcage, near your back.

immune system

Your immune system is made up of the parts of your body that fight infection. When bacteria or viruses get into your body, it’s your immune system that kills them. Antibodies and white blood cells are part of your immune system. They travel in your blood and attack bacteria, viruses and other things that could damage your body.

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