Each time I speak at the local Running Room, we always talk about chocolate milk. Is it or isn't it? Should you or shouldn't you?

Back in 2008, the ISSN (International Society of Sports Nutrition) made a research-based statement that the optimal ratio of carbohydrate to protein will help stimulate glycogen synthesis as well as muscle protein synthesis. That ratio is 3-4:1.

The chocolate milk people then gasped and shouted this imaginary quote, "Hey, that's us!" And the rest is marketing history. Yes, the ratio is correct with its 192 calories per 250ml yielding 27 grams of carbohydrate and 9 grams of protein. But what about the quality?

There are few nutritional components more pro-inflammatory than good ol' sugar. Guess what's used to sweeten up milk to result in that chocolately goodness? Now, milk does have naturally occurring sugars which those of us lactose-intolerant people know all too well. Lactose is milk sugar. There are also a lot of other added ingredients in chocolate milk extending far beyond its ideal carbohydrate-to-protein ratio and these are mostly stabilizers and thickeners, but also artificial flavour and sometimes even 'modified milk ingredients'. The CBC wrote an article about it a few years ago and broke it down wonderfully (milking meaning from the ingredients label).

Since many people that I see in my clinic don't do well with milk on the digestive front, this is clearly not a very good option. For everyone else, leave this as a treat. There are better options out there for regular use.

Alternative Delicious Chocolate Recovery Drink - natural style.
Two options exist here: A chocolate-banana one, or my personal go-to: a PB-chocolate one which is like drinking a peanut butter cup. Mmm....

For 1 serving (~320 calories)
1 cup almond milk, unsweetened
1/2 banana
1 tbsp cocoa powder
1 tbsp raw honey (or maple syrup)
1 tbsp all-natural (nothing added...check the ingredients label) peanut butter OR 1 tbsp hemp hearts
Blend, drink, recover.

This mix will give you:
~10 grams of protein
~40 grams of carbohydrate
~13 grams of fat
Electrolytes: 180 mg sodium, 450 mg potassium, 40 mg magnesium.
[The exact numbers will vary depending on if you're using PB or hemp, banana size, brand of almond milk, etc, but you'll land in the same ballpark.]
And won't give you: crazy inflammation, antibiotics, gas, bloating, or excess mucous. In other words, a winning combination.

References:
Kerksick, C et al. International Society of Sports Nutrition position stand: Nutrient timing. JISSN 2008, 5:18.
Nutritiondata.com for nutritional information on ingredients.

Obesity has now been declared a disease in the US. The health risks of carrying around a spare tire are nearly endless: diabetes, insulin resistance, heart attack, stroke, blood clotting, fatty liver, etc, etc, ETC. Know all this but can't quite make the huge shift? Start small and simple.

Central obesity specifically refers to the increased amount of fat around the midsection, or the 'spare tire'. The issue here is that it's an indicator that fat isn't only in the skin, it's packing in around your organs. Not to mention the amount of fat you carry influences your hormones. Abdominal fat acts differently than, say, thigh fat (ladies, we'll discuss the saddle bags further on another day) in that it increases inflammatory markers associated with diabetes, cardiovascular events, and also infertility in both men and women by affecting sperm quality, egg quality, and ovarian function. The insulin resistance induced by obesity contributes to hair loss (looking at you men out there...) or hair growth in women in all the wrong places as we see in polycystic ovarian syndrome, or PCOS.

Ditch the spare tire. You will be amazed at the health benefits that follow. They are endless. Your loved ones will also thank you.

Wondering where to start? 9 not-so-fancy starting tips for you:

1. MOVE. You don't have to train for a marathon, just get moving. Walk, bike, hike, play the Wii, park farther away, get off the bus/subway one stop early, get a pedometer... JUST MOVE.
2. Stop the pop.
3. Cut the booze. Limit to one drink per day.
4. Cut the sweet treats in half for 2-3 weeks. Then cut them in half again, but always leave yourself time to indulge. Be gentle yet strict.
5. Make sure half your plate is veggies. Potatoes don't count. And they can't be fried.
6. No fried foods. Grill, sautee, stir-fry, or steam.
7. Night snacker? Try popcorn, veggies & hummus, edamame, frozen fruit sorbet (blend frozen fruit, a dash of vanilla extract, and a wee bit of milk), roasted veggies, or a bowl of soup.
8. Breathe. Reducing stress reduces cortisol. Cortisol will help pump up the spare tire.
9. Be accountable. To anyone. Find yourself a team and get them cheering for you.

YOU CAN DO THIS. If I can be of help, or if you need a team member, please ask. :)

Just a few of the many research papers supporting weight loss:
Abdominal fat and inflammatory markers. http://www.ncbi.nlm.nih.gov/pubmed/23712970
Effects of 4 different diets on adipose tissue. http://www.ncbi.nlm.nih.gov/pubmed/22258266
Effects of abdominal fat on insulin resistance. http://www.ncbi.nlm.nih.gov/pubmed/23739143
BMI and sperm quality. http://www.ncbi.nlm.nih.gov/pubmed/22693175
Adipokines and infertility. http://www.ncbi.nlm.nih.gov/pubmed/21510912
Androgenic alopecia and insulin resistance. http://www.ncbi.nlm.nih.gov/pubmed/19094069

I give vast amounts of gratitude to my friends at The SportLab in Huntsville for posting this on their facebook page today. So good, just had to share. I may have had one for breakfast this morning...

High fibre, high protein, gluten-free, can be dairy-free, egg-free... but don't let that scare you. These things are easy and so, SO tasty. Oh, and they're actually pretty good for you.

1 ¼ cups chickpeas (or 1 can, drained and rinsed)
½ cup natural peanut butter
2 tsp vanilla
¼ cup honey
2 tbsp coconut oil
1 tsp baking powder
a pinch or two of salt
2/3 cup dark chocolate chips (dairy-free if you need)

Directions:
1. Preheat the oven to 350°. Line a cookie sheet with parchment paper.
2. Puree chickpeas in a food processor. Scrape down the edges, and pulse again a few times until the "dough" is completely smooth.
3. Add all the remaining ingredients (except the dark chocolate chips). Puree!
4. Simply stir in the chocolate chips - no more whizzing.
5. Scoop out heaping spoonfuls of dough and drop them onto the parchment. Flatten them slightly with a fork.
6. Bake for about 15 minutes. Allow to completely cool before trying to move them or they might squish a bit or fall apart.
7. Share.

It's around now that I start to hear about falling off wagons. I see the most injuries and concerns regarding weight loss (no one has ever, literally, fallen off a wagon as of yet...phew).  For many, it really is a fresh start at a new lifestyle. For others, more of a social pressure and short-lived burst of steam.  Here's the top resolution traps I see (all aimed at quick-fixes, you'll notice):

1. Too much, too fast. This usually ends in very demotivating injuries. Like any fitness activity, think of your new goal as "starting training". You will get fit, but you need to give your body some time to figure out the new demands placed on it and to adapt to them. The human body does this incredibly fast but needs a gradual increase rather than sudden. If you feel anything start to hurt or "not feel right", take it down a notch. Breathe. It might be a good idea to see an ND or chiropractor to evaluate your form so you can hit the ground running...properly! Set yourself up for a long-term goal. Start slow and get stronger.

2. Switching to "diet ___". There's actually little evidence to support artificial sweeteners helping with weight loss, and even some linking them to weight gain. We do know that the body's physiological mechanisms don't respond well as simply as had hoped (big surprise!) so it's best to just cut down on the sugar. Again, this can be a gradual transition. Drop by one sugar in your coffee, switch to water with a lemon (or cucumber, sprig of mint, etc) instead of pop, or switch to dark chocolate.

3. Eating more brown bread and pasta. Yes, there's a bit more fibre. No, it will not help with weight loss. Flour-based carbohydrates are simple carbohydrates, even if there's a few seeds sprinkled in for good measure. This might help to understand the difference between a simple carb and a complex carb: If you put it in water and come back in an hour what does it look like? Mushy, gooey, soup-like grossness? Then it's a simple carbohydrate (think bread, pasta, cookies, muffins, etc). Does it look the same as when you put it in the water? Then it's a complex carbohydrate (think rice, beans, sweet potatoes, veggies, fruits). What happens in the water is what happens in your body. More energy and enzymes are needed to break apart complex carbs, meaning they don't spike blood sugar or insulin the way that simple carbs do. Don't get me wrong, whole grain options are definitely better options than their simple white alternatives, but you may be disappointed of you're using them for weight loss.

4. Skipping breakfast. Even if you're still putting your pants on as you head out the door, there's fast options for how to ramp up your metabolism first thing. Starting your day with a healthy dose of protein will get your metabolism going and keep you feeling fuller for longer. This helps with carb cravings later on in the day. Smoothies can be assembled the night before (or thrown together in the morning), eggs can be boiled ahead of time, and steel-cut oats can be made in large batches. 

5. Eating less. Less calories in means weight loss, right? In its extreme, yes. When you're not providing the body with the basic caloric needs, metabolism slows, cortisol increases, and physiology favours storage of energy. The body thinks there's a shortage of energy coming in, so it slows everything down a bit to accomodate. Also, when people don't eat regularly they tend to overeat later in the day or at night. Try snacking throughout the day, eating every 2-3 hours, and keep your protein up. Begin tracking your nutritional intake on fitday or myfitnesspal and see how you're doing. Compare how you feel on days you eat more to days when you're not. 

Approach it not as a new year's resolution but as a get healthier lifestyle. If you need some specific guidance or want to know what you can do differently, ask your ND or nutritionist. We love food plans!

An incredibly common concern that I treat is back pain. Low back, upper back, mid back - it doesn't matter! Steroid injections are the usual go-to along with pain medications for life that have their own side effects with long-term use. Is there any other way to live comfortably? Yes.

Acupuncture is one of the first-line treatments that I use. Hate needles? No worries. We'll talk about other options momentarily. Acupuncture for back pain has research behind it. It's shown to be as effective as other alternative therapies, such as TENS or massage. I use a combination approach which involves the insertion of acupuncture needles locally as well as points that, in Chinese medicine, help to relieve back pain as well. I almost always connect the microcurrent to the local needles which helps aid healing and relieve pain. This allows an electrical current to pass between the needles which enhances the way the cells function, helping to speed the healing process as well as relax tense muscles.

If you're not up for the needles, we can work around that using things like cupping, massage, or microcurrent and TENS machines with sticky pads instead of needles. As I mentioned earlier, the research shows these work as well. 

Whether or not you opt for acupuncture, be prepared for homework. Core strength is an integral part of easing low back pain. The principle behind this is simple: a strong core takes the load off the spine and spinal muscles. Those abs aren't just for washing laundry.

The tip: Activating the core muscles that count is a bit tricky, so here's how to tell if you're working the right ones. The "6-pack" rectus abdominis is not the one we're going for. Find the front pointy bit of your hip bone and roll off the front of it into your belly muscles. You'll find if you do a simple crunch, that part remains squishy, but when you pull your belly button in and try and make your waist as small as possible, that little part contracts. The core exercises you do, should contract that squishy part, or the transverse abdominis. The best ones are the yoga plank moves (front, side, reverse). 

The workouts: Pilates is a great one to add into your rotation because of it's amazing core-strengthening, though you want to be careful not to aggravate injury. Yoga or any kind of gentle stretching has been shown effective for back pain specifically. Always listen to your body and let pain be your guide. If it hurts, don't try to be the hero. 

Exercise: there’s nothing quite like it. Many people know they should be exercising more, but there always seems to be a reason not to. Life does have a way of interrupting our routines and it can take some extra work to get back on track. 

The impact of exercise on lifestyle-related disorders such as high cholesterol, high blood pressure, diabetes, insomnia, and metabolic syndrome is massive and exercise is often considered one of the first-line therapies. If you have been diagnosed with any of these, consider exercise as important as your other treatments or medications. If you’ve never exercised before, it’s best to start out slow and get your body used to the extra strain placed on both the muscular system and the cardiovascular system. 

When I make exercise plans for people, I am always listening to what is realistic for them. No two exercise plans are ever the same, same as all of my treatments.

Here’s the top 5 excuses I hear and why they don’t work:

1. I have kids: Excellent! Take them to the park more often. The trick here is to not sit and watch them, but to get climbing up where they go. Play tag, soccer, or frisbee. Getting the kids to help you be active not only gets you into great shape, it provides a great role model for your kids to lead healthy, active lifestyles.

2. I'm tired: This is a tricky one. Exercise most definitely helps fatigue, but getting over that hump to put the trainers on can be difficult. If the fatigue is severe, see a healthcare practitioner as there may be something medically relevant. If the fatigue is more mental than physical, this should subside shortly into beginning your workout. Always start out with a warm-up and take an easy walk on days that you’re just not feeling it. My personal mantra on “zombie days”:  the first step out the door is the hardest, after that it’s endorphin-high all the way. 

3. I have no time: There’s always time to fit exercise in. Always. Take the stairs instead of elevator, go for a walk on your lunch hour, park farther away from your work or the mall entrance, bike to work a few days per week if possible, use your grocery bags as weights, and walk for the first or last subway stop rather than sitting all the way (on average, one TTC subway stop is 10-15 minutes of brisk walking). Try for one full workout on the weekends.

4. I'm in pain: If you suffer from chronic pain, a visit to a healthcare professional is a good idea to correct the problem. Many people suffer from osteoarthritis, particularly in the knees, which may affect your ability to participate in activities such as running, walking, stairs, etc. Low impact cardio exercise can be done in the pool, or hope on a bike (stationary or not) or elliptical machine. Yoga and pilates improve strength and flexibility, and may help to improve pain symptoms. Regardless, a healthcare professional will be able to assess and provide treatment options for pain and injury management and recommend an appropriate exercise for you. 

5. I have no equipment: Use your neighborhood as your gym. Walking or jogging can be done anywhere, and is best done in a local park solely for ambiance. Splice in some strengthening moves such as lunges, squats, pushups, and crunches. Local playground equipment can be used for pull-ups, steps, and hanging abdominal crunches. If you prefer to exercise at home, cardio can be done using stairs or workout videos. Weights are an inexpensive investment, or alternatively soup cans, books, or water bottles will do in a pinch. Yoga and pilates only require a comfy floor. 

Many people simply need someone to be accountable to. If that’s the case, buddy up with someone with similar goals, get a personal trainer, or mention your goals to your ND. Now, get out there!