Exam Room Nutrition: Where Busy Clinicians Learn About Nutrition

15 | Fueling Your Workout: Sports Nutrition Tips for Plant-based Eating

October 10, 2023 Colleen Sloan, PA-C, RDN Episode 15
Exam Room Nutrition: Where Busy Clinicians Learn About Nutrition
15 | Fueling Your Workout: Sports Nutrition Tips for Plant-based Eating
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Join Colleen as she chats with Natalie Rizzo, leading sports dietitian and author of Planted Performance. Today's discussion gives you everything you need to know about sports nutrition and how to perform at your best on a plant-based diet. Whether you're an athlete, considering a plant-based diet, or a healthcare professional seeking reliable nutrition information, join us in this impactful journey through sports nutrition. 

What we cover:

  • Learn the role of carbohydrates and protein and the ins and outs of pre and post-exercise fueling. 
  • Discover the importance of variety in a plant-based diet to ensure the intake of vital amino acids and proteins, the building blocks for muscle repair.
  • Understand electrolytes and their significance in a plant-based lifestyle for athletes. Natalie enlightens us on the importance of replacing essential minerals lost through sweat during workouts. 
  • Discover post-workout snack ideas packed with nutrients essential for recovery.

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Disclaimer: This podcast is a collection of ideas, strategies, and opinions of the author(s). Its goal is to provide useful information on each of the topics shared within. It is not intended to provide medical, health, or professional consultation or to diagnosis-specific weight or feeding challenges. The author(s) advises the reader to always consult with appropriate health, medical, and professional consultants for support for individual children and family situations. The author(s) do not take responsibility for the personal or other risks, loss, or liability incurred as a direct or indirect consequence of the application or use of information provided. All opinions stated in this podcast are my own and do not reflect the opinions of my employer.

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Natalie:

So I always say what you eat depends on when you eat. When it comes to exercise, so you want to really think about when you're going to work out and how far ahead you space out your meals.

Intro:

Are you ready to transform the way you communicate about nutrition with your patients? Welcome to Exam Room Nutrition, the podcast where the worlds of nutrition, medicine and communication collide. Whether you're a seasoned physician or a healthcare student, this podcast is for you. So stick around and let's make our patients healthier, one Exam Room at a time.

Colleen:

Welcome back to the Exam Room Nutrition podcast. I'm your host, colleen Sloan. I'm a registered dietitian and pediatric PA. In the words of Kerry Walsh Jennings, she once said it's going to be a journey it's not a sprint to get in shape, and I couldn't agree more. So today we're going to unpack the topic of sports nutrition for those who follow, or want to start to follow, a plant-based diet. You've probably heard somebody say how do you possibly get enough protein? Or maybe somebody follows a plant-based diet, but what they really mean is that they eat bread, pasta, chips and sweets. So our guests today will help us properly fuel our patients and clear up any misunderstandings about carbohydrates and protein in a plant-based diet.

Colleen:

I'm so thrilled to have Natalie Rizzo here to provide us with expert advice on how to embrace this nutritious lifestyle while performing at your absolute best. Natalie is a registered dietitian based out of New York City. She's the owner of Greenletes, a successful sports nutrition practice and blog, and the author of Planted Performance Easy Plant-Based Recipes, meal Plans and Nutrition for All Athletes. You can follow Natalie on Instagram @greenletes, and I highly suggest you do. That's where we met and I think her content is fantastic, so go ahead and check her out on Instagram

Colleen:

Natalie, thank you so much for your time. Welcome to the show. Thank you for having me. Now let's jump right in, because I know a lot of my listeners either work with athletes, have patients who are athletes, especially the pediatricians, maybe in the teen world, or maybe are athletes themselves, and we've heard a lot of information about the role of carbohydrates and protein and like fueling before exercise, fueling after, but I think there's some misconceptions about the purpose behind each nutrient. Would you be able to start out by clarifying what role each of those plays for us? Sure?

Natalie:

So there's three main macronutrients carbs, carbohydrates, protein and fat. Carbohydrates tend to get a bad reputation, but for athletes that are incredibly afforded, they're the primary fuel source for exercise and they're also the primary fuel source for just everyday living, fueling the brain. Protein is for muscle building, which most people know, but it's also for a variety of things within the body. It's the building blocks of your hair, your skin, your nails, your organs. It helps with hormones, it helps with metabolism, it helps with hunger and appetite. It does so much, but in terms of exercise, really, it's mostly known for muscle building, muscle regrowth, muscle repair. And then fat doesn't actually play that much of a role in exercise, although it's the fuel source for low intensity exercise, which is interesting. For instance, if you're doing something like yoga, your body may use fat as a fuel source, but it's more so focusing on the carbs for giving you the energy and then focusing on the protein and also some carbs for after a workout, to help your muscles rebuild, regrow and then have energy for the next workout.

Colleen:

That's awesome. Before we get into sources of plant-based protein, I wanted to linger here a little bit and talk about pre-exercise fuel and post-exercise fuel, because there's a lot of conversation about how much protein, how much carbs Should we be eating both before and after we exercise, or what would that look like?

Natalie:

I always say what you eat depends on when you eat when it comes to exercise, because anyone who's done any form of exercise whether you consider yourself an athlete or not has probably had the experience where they eat too close to a workout and then they feel terrible. That is probably because of what you chose to eat. Then you want to really think about when you're going to workout and how far ahead you space out your meals. Say you are running out the door for some workout, whether it's a spin class or you're running or whatever, and you only have 30 to 60 minutes. You really want to go towards something that's just carbs. We're saying just carbs. That could be a piece of fruit, a piece of toast, some dried fruit. Sometimes people even just do a granola bar, a swig of sports drink. The reason for that is because your body is digestive very quickly and it gives you the energy you need just for that quick workout. If you have more time say you have two hours before you're going to workout and this is for people, maybe, who workout later in the day they're eating a lunch and then maybe they workout after work you can eat something that's more balanced, that's carbs and protein and maybe a little bit of fat. The reason for that is because protein and fat take longer to digest, but some protein does help, even before a workout, with the muscle repair after a workout, but you need time to digest it.

Natalie:

It really depends on when you're eating in relation to the workout. After the workout, you're going to want to look to two nutrients, which are protein and carbs. People always think of protein. We talk about protein shakes all the time. After a workout, people have their protein shakes, but what people don't realize is the energy that you use during a workout, which is carbs. Your body stores that in something called glycogen and you use it during a workout. It's gone after like 30 minutes. You will need to replace it, because replacing it helps you have energy for the rest of what you're doing throughout the day and then the workout you're going to do tomorrow. There's a lot of research that shows putting protein and carbs together helps with replenishing your muscles after a workout, making them grow more than just protein alone.

Colleen:

Super helpful. I have heard that so many times and I actually see a lot of people doing that. They just really focus on the high protein shakes that don't have a lot of carbs. They think that they're doing and fueling themselves properly, but thank you for clarifying that, because you do need those carbohydrates to replenish your energy. All right, Since you are the plant-based queen, I'd love to jump into that topic now. If we've got a patient that we're discussing nutrition with and they want to follow more of a plant-based diet, they might ask hey well, where does my protein come from? How would you suggest we answer that question?

Natalie:

It depends on what plant-based means to you. First off, because I always start by saying that there's no real definition of it For my purposes. I've been a vegetarian for more than a decade. I eat dairy. My husband is a vegan.

Natalie:

There's different ways that you can go plant-based. Some people say plant-based and they still eat some meat, but I think for most people who are thinking plant-based, they're thinking okay, I'm going to eat mostly plants, maybe some dairy, and realistically, the majority of the protein has to come from a variety of sources which, when you're eating animal foods, you could eat chicken for lunch and dinner and probably meet all your protein needs. But when you're eating plant-based, you kind of have to vary your intake of different proteins because they don't have as much and you want to get different amino acids, which are the building blocks of protein, to make sure that you're getting everything that your muscles need. So that's things like soy is one of the highest sources of protein. So that's tofu, tempeh, soy, milk, edamame, and then, of course, people think of beans and I think we kind of forget about legumes like lentils and peanuts.

Natalie:

Whole grains have protein, like oats, quinoa, brown rice, and then nuts and seeds. So nuts have some protein. But people forget about seeds as well. So, like chia seeds, flax seeds, hemp seeds, what you're trying to do throughout the day is get a mixture of all of these things, because you really need to eat more. You need to get a higher volume of food, which people don't realize as well, because they think if I eat more, I'm getting more calories and I'm going to gain weight. These things have less calories than animal foods, so you, technically, should probably eat more, kind of still meet your calorie range and meet your protein range.

Colleen:

That's excellent. So, yeah, it does make sense that you really should be spreading it out and getting a good variety throughout the day. So walk us through maybe, like what your day would look like. What is a typical plant based breakfast? Look like that's got some protein in it.

Natalie:

So I'm a big oatmeal fan. My husband's a big chia seed fan. I do oatmeal with the fruit and nuts and nut butter in there and then sprinkle some seeds on top. I work out in the morning, so a lot of times I'll do oatmeal before and then smoothie afterwards. And I use a lot of soy milk and smoothies because soy milk is one of the only plant based milks that actually has the protein of regular milk. My husband does a lot of chia seed pudding, which is a lot of seeds with. You know like you can do that with soy milk as well and do fruit in there kind of thing. And even my baby, who's one and a half he's a vegetarian. He likes oatmeal too, but he'll do whole grain toast with nut butter and fruit. So there's, there are a bunch of different things you can do. It's just making sure that you're kind of varying it.

Colleen:

Yeah, exactly, and I love that your son also follows this pattern, because I have a lot of patients being in pediatrics that maybe want to follow, but they're concerned that their child might be missing out, and I think this is a valid point. Like I had said at the beginning, you can eat a very unhealthy plant based diet right If you're just really focusing on those simple carbs and not really giving a lot of variety and a lot of different sources of protein and sources of carbs in there. It can be a pretty basic diet that misses a lot of nutrients, but it can be done properly for kids too, and I love that. Now, what do you guys do for lunch? What do you suggest that we might offer our patients for lunch ideas?

Natalie:

One of the recipes in my book which is like the simplest thing and I love is a chickpea smash. So I take chickpeas and avocado and lemon juice and salt and I literally take a fork and kind of mash it together and then I'll put it in a whole wheat wrap with some lettuce and, like I said, whole grains have protein. So this is what. Like you're mixing things together, you're getting some protein from the chickpeas. There's a little bit in the avocado, but then when you do like a whole grain wrap or a whole wheat toast, a lot of times you don't realize that maybe there's five to six grams in a slice of toast. So, mixing all those things together, I think there's probably like 20 grams of protein there. So we do something like that which is super simple.

Natalie:

My son is a huge fan of edamame, which is funny because you think kids don't like that kind of stuff, but they do. He loves it. So we do a lot of edamame and brown rice, which I add more vegetables for myself that he's probably willing to eat. We do like a miso dressing on top. So it's really simple stuff, but just putting all those things together and a lot of times like I have a one and a half year old and I'm pregnant so I don't have a ton of time to cook, but a lot of this stuff. Like you can buy frozen rice. You can buy frozen edamame chickpeas come in a can, so it's not as complicated as people think it is.

Colleen:

It honestly sounds easier because, like meat, you have to cook, you know, and it usually takes 20 minutes to an hour and a half, depending on how you're preparing it. So I think a chickpea smash sounds way easier than trying to make some grilled chicken or baked chicken. So for you busy moms out there to try to follow more of a plant-based diet, I wanted to bring up the topic of meat alternatives and get your thoughts on that. Do they have sources of protein? Would we recommend those? Are there additives that we need to be aware of? Educate us on that topic.

Natalie:

It depends so much because the market on that has grown tremendously in the past few years. So, for instance, say, you get a veggie burger out of the frozen aisle like a Dr Prager's veggie burger or even like a Trader Joe's brand or whatever. A lot of times those don't have a ton of protein. Maybe one patty has four or five grams and there are only 150 calories, which maybe sounds great, but it's not enough. It's not enough calories to sustain you. So that could be an addition to a meal. For instance, like, say, you really love the taste of those, put it on a salad but add other sources of protein, whether it's lentils or chickpeas or black peas or whatever, because you're not going to get enough out of those. The other ones which are like the impossible burgers, the Beyond meat, all of that stuff, that stuff's really interesting. First off, if you miss the taste of meat, it tastes like meat to me because I haven't had meat in 10 plus years and it tastes like that. It does have a decent amount of protein.

Natalie:

So an impossible burger. I don't know off the top of my head, but I think it's probably upwards of 15, 20 grams. The problem with those is that to make them have this meaty, fatty, tastes like a hamburger. They put in a lot of coconut and coconut has a lot of saturated fat. So if you look at the nutrition label of something like that, compared to a beef burger, it's almost the same. So you're not really getting any less fat or anything like that by choosing one of those. I think the missions of those companies a lot of times is to like help with environmental stuff and not necessarily, you know, improve on your nutrition. So you can definitely eat that and get plenty of protein. If you're gonna eat an impossible burger or something like that three or four times a week, it's basically like eating red meat three or four times a week. So keep that in mind.

Colleen:

Good point. I think this was an excellent introduction to the plant-based diet and what it looks like. But I'm sure a lot of Clinicians might be wondering are there any supplements that are needed or that I should recommend? Are there things that they're missing in their diet that we need to supplement elsewhere?

Natalie:

I Think if you were completely vegan. There's a few things you need to think about. So one is vitamin D. Honestly, even people who eat meat probably need vitamin D. Most people don't get enough. Most people are deficient. I'm sure a lot of physicians know this. On a plant-based diet, the only sources of vitamin D are really mushrooms and some nuts, like Brazil nuts. Most people aren't eating enough of them. So that's one of the things that you could probably take every day and most people could use it. There's really no reason not to take a vitamin D supplement. Calcium is the other one. If you don't eat dairy but you eat plenty of soy, you probably get enough calcium. I don't necessarily recommend that everyone takes calcium, but it's just something to be aware of. For instance, if you're a woman and You're going into that pre-menopausal stage, maybe you're worried about bone loss. That could be something to think about.

Natalie:

And Then there's omega-3, which is fatty acids are the good unsaturated fats. There's different types of those, which you get plenty of them on a plant-based diet, but what's really interesting is there is two different types. There's ALA and DHA. Ala is in nuts and seeds, and plant-based eaters usually get a lot of that. Dha is in fish and the DHA that's in fish is found to be what's linked to cognitive health and heart health and all the good stuff that omega-3 does for us, and Plant-based eaters don't really eat that, so the only way to really get that is through a plant-based DHA omega-3 supplements, and that comes from seaweed or algae, so it's it's a little more expensive than a fish oil supplement, but it is something worth considering. If you have a history of heart disease in your family or something like that, you could definitely look into that awesome, very helpful.

Colleen:

Now when we're recording this, it's the death of the summer, at least where I am in South Florida, so it's hot, we're all sweaty and I know our athletes sweat a lot. So if the clinician gets asked about electrolyte replacement, where do we take this conversation? Because I know it will vary from person to person and there's so many things on the market now. There's electrolyte drinks, but I know also there's some food sources of electrolytes. So talk to us and break down electrolytes and who we should supplement for and the best sources of electrolytes.

Natalie:

I Actually just posted about this because I find that electrolytes are super trendy right now and people are Taking them when they don't necessarily need them. But what most people are thinking of when they think of electrolytes is really sweat. When you're sweating, you're sweating out Four main minerals, which are sodium, potassium, magnesium and calcium. When you look at something like a Gatorade, which is the original electrolyte drink, it has electrolytes in there. It has those things in there because it was made for athletes who were sweating out in the sun I think in Florida the Florida Gators, that's where it came from and they needed to replace those electrolytes that they lost and sweat, because that's a really important part of staying hydrated. You can't just drink water when you're sweating out a ton. You have to make sure you get those minerals back in. So for anyone who is exercising in the summer I know I work with a lot of runners who are training for fall marathons, which means you're running in the heat of the summer you need electrolytes in Whatever fluid you're taking in because you're sweating a lot. This isn't necessarily the case in the winter, because maybe you're not sweating as much. So it's really about the environment outside if it's super hot and then the duration of your workout. So say you're working out for just 30 minutes or something, you probably don't need to replace your electrolytes, but if it's 60 minutes or more generally, you do so.

Natalie:

There's so many different things you could take in. There's electrolyte powders, like you said, and those are just straight electrolytes. Add them to your water and all you're getting is just essentially what you're sweating out. There are electrolyte dummies and shoes which also have extra sugar added into them. The reason for that is because we talked about before the glycogen. That's the sugar that your body is using to power you through a workout. It only lasts for so long. So say you are doing something for that 60 minutes or more and you need to bring in more sugar to give yourself more energy. So it's paired with electrolytes. Electrolytes and sugar come together in those to give you everything that you need. So it's really about what your training level is and what you're doing at that time, of what kind of electrolyte thing you choose. So whether it's sports drink, electrolyte powder or a chew or something like that, it's just about really what you're doing.

Colleen:

So for the average 40-year-old who's maybe doing yoga and then does her nails afterwards, maybe not recommending an electrolyte because they're not sweating enough.

Natalie:

Exactly. Also, if you're working out inside in the heat of the summer, you probably don't need electrolytes at all. It's really about being out in the hot and humid weather. I would say everyday athletes could be people who are training for marathons or training for triathlons, but it could also be people who are just doing yoga or Pilates or whatever, but it's really about your sweat level when it comes to electrolytes.

Colleen:

Awesome. Thank you so much for clarifying that. You've said those key nutrients, the sodium, potassium. Now we know that there are those elements in foods as well, so could we use a food to replenish some electrolytes if needed?

Natalie:

It depends again on how intense your workout is, but definitely there are electrolytes in foods. For instance, potassium is in potatoes or magnesium is in leafy greens, calcium is in soy, sodium is in pickles and pretzels and things like that. So if you are out again in the heat of the summer really doing something intense, you can add those foods into your diet, but you probably still need an electrolyte powder. If you feel like you just had kind of a decent workout and you're feeling a little dehydrated, it's not going to hurt you to eat some potatoes or some leafy greens and make sure that you're getting enough of those electrolytes in your diet, because that's definitely going to help with hydration.

Colleen:

Awesome. Well, and it kind of sounds like those have dual function because they are carbohydrates too. So post-workout, if you need to refuel the glycogen stores, a salty pretzel might be exactly what you need to hit the electrolytes and the carbohydrate source too.

Natalie:

Exactly. It's interesting with sports nutrition. I always say sports nutrition is different than regular nutrition because I'm telling you the pretzels and have the chews with the sugar in them and people are like, oh, I don't want more sodium or sugar. But it really is different if you're thinking about performance and what you're trying to do there, and so you kind of have to think about those things?

Colleen:

Oh yeah, exactly. I mean, I've had plenty of talks that everybody's saying no, no, no salted and snacks, nothing like that. But for the athlete and this could be our teen athletes or our adult athletes these topics and key nutrients are very important and very different for the athletes. Okay. So if I have a patient who says, hey, I want to start following more of a plant-based diet, a plant-based lifestyle, what are some best practice recommendations that the clinician can start to offer the patient so they can get on the right track?

Natalie:

I think the first thing is kind of start small and figure out what it means for you, because I know people this happens in January when people are trying to lose weight they'll be like I'm going vegan this year and it's not necessarily that easy to just go vegan out of nowhere.

Natalie:

And you said it before, it's not always healthy to have a plant-based diet. I always say Oreos are plant-based, so you can eat that kind of stuff and have a plant-based diet. So you really need to start small and think about what are some of the nutritious things that I can add. And maybe it's not necessarily about cutting out all the animal foods at once. It's about adding in more plant foods and then eventually those will start to replace the animal foods. So for instance, like I was talking before about some of the things we do for lunch, maybe you do that for lunch one day and then that day you didn't eat chicken or whatever you normally eat. So just kind of starting small there and going more into it over time, I think it's probably the best way to do it. That's really most nutrition things we always tell everyone is you have to start small Behavior change takes a while.

Colleen:

I totally agree. And if you are a meat eater and moving towards plant-based lifestyle, it can be a little bit shocking because you're like, oh my gosh, you know really is how many animal products that you do eat, and then you kind of feel like, well, where do I come up with the other food, See? So I love that suggestion to really start small and define what it means for you, Because maybe you are plant-based for lunch only and then breakfast and dinner you're doing some meat and I think that that's fine and that's a great place to start. Is there anything else that you would like to leave us with that? You think it's really important for clinicians to know if they are helping their patients follow a plant-based lifestyle or they're working with athletes who are vegetarians or vegans.

Natalie:

Even clinicians think that plant-based means that you're not going to get enough of everything in your diet. And really, really you can. I promise you can. I've worked with many people who do this. So I think just knowing that you have to obviously add more food in there, but it's not going to be unhealthy, it's not going to cause stress fractures, it's not going to cause unintentional weight loss. I think over time you just have to know what you're doing or work with the right people to make sure that you're getting enough of what you need in there. So that's really the only other thing that I would stress.

Colleen:

Thank you so much, natalie. This has been such an interesting topic to me and I'm so grateful that you've given us the gift of your time. I know that this will help so many clinicians kind of clear up those misconceptions regarding plant-based lifestyles and help properly fuel their patients. If you want to connect with Natalie, if you are an athlete yourself or you work with athletes, please do follow her on Instagram at Greenletes. You can also send me a message if you'd like to connect or ask any other questions on Instagram at Exam Room Nutrition. Don't forget to like and subscribe if you're watching on YouTube, and please leave me a five star rating or even a review on your favorite podcast app. Natalie, thank you so much for being here. We'd love to have you back, and thanks again for your time. Thank you for having me. All right, guys. Now it's time for my nutrition notes. In this section, I will leave you with a nutrition tip and encouraging quote or an interesting case that I think might add value to your day.

Colleen:

In keeping with the theme of plant-based lifestyle for athletes, I thought I would close with giving you guys some more suggestions on plant-based recovery foods that you can recommend to your patients that they eat after a workout. One thing that I really like is whole grain bread with some peanut butter or your favorite nut butter, and a few slices of banana or some blueberries on top. It's an excellent source of carbohydrate from the fruit and the bread, and you've got a little bit of protein in there too. If you drink milk, you can also pair it with a glass of whole milk or soy milk to get an extra boost of calcium and protein. They also make plenty of vegetarian and vegan-friendly protein bars. Just make sure that there is some carbohydrates in there as well, again, because you need to refuel your glycogen stores. Also, remember that just because it's a post-workout snack doesn't mean you can't make it like a mini meal.

Colleen:

So you can have some lentil soup or a bean burger, have some leftovers if you had a rice bowl or maybe a quinoa bowl or something like that that was full of beans or edamame, and then, if you are in need of something quick, just something easy to drink, a smoothie is a really great way to get all of those nutrients that you need. You can make it with soy milk or regular milk. You can even throw in a scoop of a whole milk yogurt that has an extra source of protein, and then you can put your favorite fruits, throw in a handful of spinach for some antioxidants and some veggies. If you do need a little bit of sodium or you're trying to replenish your electrolytes, you can even sprinkle a little bit of salt in there as well, too, to replace those electrolytes.

Colleen:

Well, I hope this topic was helpful for you. If you or your patients are looking to lead more of a plant-based lifestyle and you are working with athletes, or you yourself are an athlete, I hope that this information was valuable to you. Well, that's all for today, guys, and, as always, let's continue to make our patients healthier, one exam room at a time. See you next time.

Sports Nutrition and Plant-Based Diets
Carbohydrates and Protein in Plant-Based Diet
Electrolytes and Plant-Based Lifestyles for Athletes
Post-Workout Snack Ideas and Tips