1lb assorted baby potatoes (such as red-skinned, white-skinned and Peruvian purple), rinsed and halved
2 cloves garlic, minced
1 tablespoon chopped fresh Greek seasoning
1/4 tsp turmeric
1/4 cup extra-virgin olive oil
1/2 teaspoon salt
1/2 teaspoon ground black pepper
Directions:
Preheat the oven to 425 degrees F.
In a large bowl, toss together the potatoes, garlic, Greek seasoning, turmeric, olive oil, salt and pepper. Spread the potato mixture out evenly on a baking sheet with parchment paper; roast until the potatoes are tender, crispy and browned, 40 to 45 minutes.
Preheat Grill on high. Rub the Salmon with avocado oil. Drizzle with honey and spread all the spices on the salmon generously.
Transfer Salmon to the grill, skin side down. Cook for 8-10 minutes or until the white (coagulating albumin) starts to show. Remove from the Grill and cut each fillet in half.
Meanwhile, chop the tomatoes in half, dice the cilantro, and score the avocado. Mix all in a bowl with the juice of 1 lime, a dash of salt and pepper. Set aside.
Heat a cast iron pan with a small amount of avocado oil. Warm the tortillas (1 minute each side, or until cooked to desired liking).
The most common question I get asked around this time of year is, “how can I not get sick?”. While most people are often looking for some elaborate response, my reply is very simple – “Reduce your stress and get more than 7 hours of sleep so that your body has the strength to resist and fight off illness”. While the answer seems basic and (to some) maybe disappointing, I’ll expound a bit on the details below and discuss some of the things that expose us to a greater risk of getting sick and basic strategies you can follow to help mitigate this risk, as reported in a large GSSI publication.
Factors that increase the risk of sickness:
Fall and winter – common cold and flu season
Poor hygiene and exposure to sick people
Recent symptoms
Air travel
Poor sleep
Life stress, depression, anxiety
Low energy availability
Increases in training load
Strategies for combatting sickness:
Try to avoid sick people
Ensure good hygiene and proper vaccination
Avoid exposing yourself by touching eye, nose, mouth
Don’t train with below the neck symptoms
Manage all stress
Aim for >7 hours of sleep
Eat a well-balanced diet
Finally, around this time of year, supplements are always a hot topic. Everything from essential oils to supercompensation of vitamin C has been recommended for resistance to infection, but what does the research show?
Zinc Lozenges (Hemilia, 2017)
Zinc ions in oral lozenges inhibit rhinovirus replication and have antioxidant effects.
Benefit: decrease duration of the Upper Respiratory Tract Infection (URTI) by 33%. Side effects, bad taste.
Suck on Zinc Lozenges – 80mg/day which would be about 15 lozenges.
Probiotics (Cox et al. 2010)
These live microorganisms modulate immunity. Live microorganism administered orally for several weeks, can increase the number of beneficial bacteria in the gut.
A cochrane review shows about a 50% decrease in URTI incidence and 2 day shortening of URTI. (Hao, Dong, Wu, 2015)
Take 2 pills per day. Thorne FloraMend Prime has the correct strands.
Vitamin D (Berry et al. 2011) (He et al. 2013)
Vitamin D is an anti-inflammatory, essential fat-soluble vitamin. It influences innate immunity and has anti-inflammatory effects. Skin exposure to sunlight accounts for 90% of the source of vitamin D.
Meta-analysis showed protective effects for vitamin D for URTI. Deficiency associated with longer lasting URTI in athletes. Monitoring required.
Vitamin C is a water soluble antioxidant vitamin that quenches ROS.
A cochrane review of 5 studies in heavy exercisers shows about 50% decrease in URTI taking vitamin C .25-1g/day. The literature is unclear as to whether Vitamin C blunts adaptation in well-trained athletes. (Hemelia and Chalker, 2013)
To stay on the food side and avoid the detrimental effects to blunting adaptations with excess vitamin C, drink 1 – 16oz bottle 100% Orange Juice.
Polyphenols (Walsh, 2018)
Polyphenols are anti-inflammatory, plant flavonoid, antioxidants. In vitro studies have shown strong anti-pathogenic effects following polyphenol ingestion.
Meta-analysis of 14 studies show some reduction in upper respiratory infection (URTI), including during intensified training. However, there remains limited evidence for its enhanced influence on immunity.
While the results of polyphenols on immunity remain unclear, increase your consumption of grapes, pistachios, cranberries, blueberries will help to boost your resveratrol intake.
So… What does this all mean…
Practical Guidelines to Maintain immunity
Eat a well-balanced diet – lots of color and variety
Ensure adequate protein intake (1.2-1.7g/kg/day)
At the onset of cold take zinc lozenges (75mg/day)
Consider taking probiotics for illness prone/travelling (greater than 10 billion bacteria/day)
Consider 1000IU Vit D3
Consider vitamin C for illness prone/traveling and during intense competition >200mg/day
References
1. Walsh, N.P. (2018). Recommendations to maintain immune health in athletes. Eur. J. Sport Sci.18:820-831.
2. Hemila, H. (2017). Zinc lozenges and the common cold: a meta-analysis comparing zinc acetate and zinc gluconate, and the role of zinc dosage. J.R. Soc. Med. Open 8:2054270417694291.
3. Hemila, H., and E. Chalker (2013). Vitamin C for preventing and treating the common cold. Cochrane Database Syst. Rev.:CD000980.
4. Cox, A.J., D.B. Pyne, P.U. Saunders, and P.A. Fricker (2010). Oral administration of the probiotic Lactobacillus fermentum VRI-003 and mucosal immunity in endurance athletes. Br. J. SportsMed. 44:222-226.
5. Berry, D.J., K. Hesketh, C. Power, and E. Hypponen (2011). Vitamin D status has a linear association with seasonal infections and lung function in British adults. Br. J. Nutr. 106:1433-1440.
6. He, C.S., X.H. Aw Yong, N.P. Walsh, and M. Gleeson (2016). Is there an optimal vitamin D status for immunity in athletes and military personnel? Exerc. Immunol. Rev. 22:42-64.
Jäger R, Mohr AE, Carpenter KC, Kerksick CM, Purpura M, Moussa A, Townsend JR, Lamprecht M, West NP, Black K, Gleeson M, Pyne DB, Wells SD, Arent SM, Smith-Ryan AE, Kreider RB, Campbell BI, Bannock L, Scheiman J, Wissent CJ, Pane M, Kalman DS, Pugh JN, Ter Haar JA, Antonio J., International Society of Sports Nutrition Position Stand: Probiotics. Journal of the International Society of Sports Nutrition. Dec 21;16(1):62. 2019.
‘Probiotics’ has become a trendy word that you see added to all sorts of foods and marketed to all types of people for a wide variety of reasons. With all the information out there I wanted to give a summary from the latest position stand of what the latest research on probiotics in athletes has shown and what the recommendations are. Spoiler alert, we still need a lot more research in this area.
To know why probiotics may be important for humans, we first need to know what our microbiome is, and Harvard Public Health does a good job breaking Ursell’s research down:
Picture a bustling city on a weekday morning, the sidewalks flooded with people rushing to get to work or to appointments. Now imagine this at a microscopic level and you have an idea of what the microbiome looks like inside our bodies, consisting of trillions of microorganisms (also called microbiota or microbes) of thousands of different species. These include not only bacteria but fungi, parasites, and viruses. In a healthy person, these “bugs” coexist peacefully, with the largest numbers found in the small and large intestines but also throughout the body. The microbiome is even labeled a supporting organ because it plays so many key roles in promoting the smooth daily operations of the human body.
Each person has an entirely unique network of microbiota that is originally determined by one’s DNA. A person is first exposed to microorganisms as an infant, during delivery in the birth canal and through the mother’s breast milk. Exactly which microorganisms the infant is exposed to depends solely on the species found in the mother. Later on, environmental exposures and diet can change one’s microbiome to be either beneficial to health or place one at greater risk for disease.
The microbiome consists of microbes that are both helpful and potentially harmful. Most are symbiotic (where both the human body and microbiota benefit) and some, in smaller numbers, are pathogenic (promoting disease). In a healthy body, pathogenic and symbiotic microbiota coexist without problems. But if there is a disturbance in that balance—brought on by infectious illnesses, certain diets, or the prolonged use of antibiotics or other bacteria-destroying medications—dysbiosis occurs, stopping these normal interactions. As a result, the body may become more susceptible to disease.
What are probiotics and where are they found:
Probiotics are live microorganisms that, when administered in adequate amounts, confer a health benefit on the host (host meaning your gut microbes)
To break it apart literally it means:
Pro – for
Biotic – life
They are described by: genus, species, and strain
Ie. Lactobacillus acidophilus SPP (commonly found in yogurt)
Reported in CFUs on labels – colony forming units
Ie. 10 million CFUs
They are found naturally in fermented foods like: yogurt, kombucha, kefir, sauerkraut, miso, and some pickled vegetables. (Sorry, yes beer is fermented but the live microorganisms are killed in the beer making process – always look for labels that say ‘live and active cultures)
They were first research for their reported health benefits on the supporting/improving of the immune system, maintenance of the intestinal barrier, fight against pathogen adhesion to host tissue, and production of different metabolites such as vitamin, minerals, short chain fatty acids, and molecules that act as modulators in the gut-brain axis communication.
The body of research is growing in athletes and probiotics:
Studies are now looking at the effect on: gut health, exercise performance, recovery, physical fatigue, immunity, and even body composition (based on positive rat studies)
On the flip side things that improve your microbiome outside of probiotics:
Exercise has a positive relationship on gut biodiversity (your microbiome)
Protein has a strong positive impact on the microbiota
Carbohydrates are well known for their profound effect on the gut microbiota with fiber (coming from whole grains and fruits/vegetables) associated with microbial richness and diversity
Benefits of Probiotic supplementation that are being researched:
One thing we know of athletes with high training volume – Strenuous and prolonged exercise places stress on the gastrointestinal (GI) tract and increases the likelihood of multiple symptoms associated with a disturbance of gut microbiota (ie. Diarrhea, bloating, cramps, etc.) and decreased performance.
The GI tract is also heavily protected by the immune system as it is a major gateway for pathogens, therefore much research has been done on probiotics defense against upper respiratory tract infections (URTI).
Probiotics may also regulate mucosal immune response, improve macrophages (pathogen fighters), and modulate expression of genes associated with macrophage activity.
Although this all seems promising it is important to remember: research is quite new in athletes
Of the 24 studies – 17 reported null effects and 7 reported significant improvements
With multi-strain probiotics seeming to have more positive effects than single strain
Within those studies some of the positive results are below:
Lactobacillus planetarium has been shown to activate cell growth signaling pathways in gut enterocytes which in turn increases protein metabolism in the gut as well as maintain gut permeability (essentially they control of what passes through the gut wall)
Bacillus coagulans GBI-30, 6086 enhances the health of the cells of the gut lining through improved nutrient absorption including minerals, peptides, and amino acids by decreasing inflammation and encouraging optimum development of the absorptive area of the gut villi. They have been shown to increase protein absorption (Kimmel et al. 2010) (Maathuis et al., 2010) when added to a protein post-workout drink.
B. subtilis – no performance improvement, but lower serum TNF-alpha concentrations (which is your immune system regulator – concentrations are typically higher in the case of infection/illness).
Although a few studies have found multi-strain probiotics increase VO2 max, aerobic power, training load, and time to exhaustion, more studies have found no such effect.
The effect of probiotics on body composition is mixed, and many of the studies are poor study design, as of now the research is lacking.
Let’s talk about the Immune System:
The mucosal lining of the GI tract is the first-line-of-defense against invading pathogens and is an important border with the host immune system with approximately 70% of the immune system in the gut.
Exhaustive exercise is known to negatively impact immunity.
Therefore, many studies have focused on this effect of probiotics and immuity:
Of the studies on athletes and immune system (22), 14 showed significant improvement and 8 showed no effect.
B. animalis ssp. Lactis Bi-07 in active people showed 27% reduction in URTI episode and 0.8 month delay in time to illness
However, most studies are conducted on endurance athletes
Note: The body of evidence favors probiotics in reducing URTI, however there is large differences in stains used, duration, population, and effects measured.
The beneficial effect from probiotics on incidence of URTI is possibly linked to enhanced systemic and mucosal immunity.
In summary for the immune system, probiotic supplementation may be viable to support immune function during intense training.
Let’s talk about GI tract health
Exercise induced redistribution of blood can result in splanchnic hypoperfusion (meaning blood is diverted from the abdominal region and your gut) as a possible mechanism for gut dysfunction or the up and down movement of running can increase the frequency of gut symptoms.
Disruptions in the GI system can impair the delivery of nutrients and may affect performance.
Of the 10 studies, 6 reported no effects – 4 reported positive effects
In the positive results, zonulin and endotoxin concentrations were reduced (markers of gut permeability).
Several lactobacillus species have been noted to increase mucin expression in human intestinal cell lines and thus may help restore mucus layer.
Adhesion of probiotics to the intestinal mucosa have shown to favorably modulate the immune system and the fighting of pathogens by preventing pathogen binding and creating a hostile environment that may inhibit the colonization of pathogenic bacteria.
Probiotic Safety:
They have been used safely in foods and dairy products for over 100 years in adults and infant formula (unknown in vulnerable population)
It is important if you are looking to take supplements that you take a reputable brand (and NSF certified if possible). Many probiotics, when tested, didn’t have the stated amount or strains in them.
International Olympic Committee recognizes benefits of probiotic supplementation with a daily dose of 1 x 10 billion taken for 14 days prior to competition or event.
Duration of effect: After 8 days of ceasing probiotic intake levels reduce back to non-detectable in the gut so they only are effective if you are taking them
Timing or consumption: 30 minutes before a meal or with a meal – improves bacterial survival rate (also better taken with milk or oatmilk)
Probiotic supplementation is more likely to alter the microbiome composition of dysregulated microbiomes compared to healthy ones, like in the case of diarrhea or antibiotic use.
Summary:
Research in athletes shows promising benefits for immune and gut health.
Here is a quick guide to which probiotic may be beneficial and when:
Probiotic
Effect
Food/Supplement
L. acidophilus
Treat travelers and antibiotic related
Certain brands of yogurt and milk, miso and tempeh and supplements
L. helveticus and B. longum
Immune and psychological health
Kefir, Yogurt, fermented cheeses and supplements
L. plantarum
Psychological health, increased immunity and improved metabolic conditions, preliminary research on endurance performance
Kimchi, fermented beets, pickles cucumbers, and sauerkraut, and supplements
L. reuteri
Reduce inflammation and allergies
Fermented vegetables, dairy products and supplements
L. rhamnosus GG, or LGG,
Most effective probiotic in treating infectious diarrhea
Kefir, Kombucha, yogurt, and supplements
B bifidum
Hopeful treatment for certain GI conditions, such as constipation, traveler’s diarrhea, IBS, ulcerative colitis and H. pylori
Kefir, yogurt, buttermilk, miso, tempeh, pickles, kimchi, cured meats, sauerkraut and sourdough, and supplements
S. boulardii (yeast)
Used for years to treat several gastrointestinal conditions, including travelers’ diarrhea and C. diff
Supplement
B coagulans
Beneficial effects on protein and other nutrient absorption
Supplement
L rhamnosusB bifidum, B lactis, E faecium, L acidophilus, L brevis, and L lactisL salivarius
Linked to improved gut health in athletes
Supplements and yogurts
L fermentumL caseiL delbrueckii bulgaricus, B bifidum, and S salivarus thermophilus (in yogurt drink)B animalis lactisL gasseri, B bifidum, and B longumB bifidum, B lactis, E faecium, L acidophilus, L brevis, L lactisL helveticus Lafti
Have been shown to improve immune health in athletes
Kimmel M, Keller D, Farmer S, Warrino DE. A controlled clinical trial to evaluate the effect of GanedenBC(30) on immunological markers. Methods Find Exp Clin Pharmacol. 2010 Mar;32(2):129-32. doi: 10.1358/mf.2010.32.2.1423881.
Maathuis AJ, Keller D, Farmer S. Survival and metabolic activity of the GanedenBC30 strain of Bacillus coagulans in a dynamic in vitro model of the stomach and small intestine. Benef Microbes. 2010 Mar;1(1):31-6. doi: 10.3920/BM2009.0009.
Ursell, L.K., et al. Defining the Human Microbiome. Nutr Rev. 2012 Aug; 70(Suppl 1): S38–S44.
Preheat the oven to 350 degrees F. Line a large baking sheet with parchment paper and set aside. In a medium bowl, whisk together flour, baking powder, baking soda, and sea salt. Set aside. Using a mixer, cream butter and sugars together. Add in the eggs and vanilla and mix until combined. Add the dry ingredients and mix on low until just combined. Fold in the chopped Cadbury Mini Eggs and chocolate chips.
Form the cookie dough into balls, about 2 tablespoons of dough. Place on prepared baking sheet, about 2 inches apart.
Bake cookies for 10-12 minutes or until the edges are slightly golden brown. Remove from oven. Let cookies cool on the baking sheet for 5 minutes. Transfer to a wire cooling rack and cool completely.
Chicken: I made the chicken in the crock-pot ahead of time. Toss the can of tomato, taco seasoning, and chicken in the crock-pot on low for 6 hours. Take out the chicken and shred it.
Preheat oven: 400 degrees, grease a square Pyrex pan and coat with a layer of enchilada sauce.
For the Filling: In a medium cast iron pan in coconut oil saute the diced sweet potato and minced garlic for 10 minutes covered until soft. Add the drained and rinsed black beans, the chopped kale and shredded chicken and mix.
Place the filling in the whole wheat tortillas and place in the pan and twist to fully wrap. Once all are in the pan top with enchilada sauce and and shredded cheese. Bake in oven for 25 minutes.
1 cup cooked brown rice tossed with 1 tsp turmeric for serving
Persian cucumbers, arugula, tomatoes, and tzatziki/yogurt sauce for serving
Tatziki Ingredients:
1 cup yogurt
2 Tbsp mint
1/2 lemon juice and zest
1/4 tsp salt and pepper
2 Tbsp shredded cucumber
Directions:
Preheat the oven to 425 degrees F. Line a baking sheet with parchment.
Add the lamb, onion, garlic, lemon zest, cumin, oregano, cayenne, and a pinch each of salt and pepper to a bowl. Coat your hands with a bit of olive oil, and roll the meat into 2 tablespoon size balls (will make 10-12 meatballs), placing them on the prepared baking sheet. Transfer to the oven and bake for 15-20 minutes or until the meatballs are crisp or cooked through on the inside.
3. Meanwhile, make the tzatziki sauce. Combine all ingredients in a bowl and mix until smooth. Let sit to meld the flavors.
4. To serve, spread the hummus and tzatziki sauce on plates. Add the rice, meatballs, cucumber, tomatoes, and greens. Drizzle olive oil and lemon juice lightly over top of everything. Enjoy!
Goes great with fresh pita or the Greek Lamb Meatball Recipe I have
Serves 4-6
Ingredients:
16oz canned garbanzo beans, drained
1/2 tsp baking soda
1/3 cup lemon juice
2 cloves garlic, minced
1/2 tsp salt
1/2 cup tahini
1 tsp cumin
1 Tbsp olive oil
1-2 Tbsp ice cold water as needed
Extra olive oil and paprika for the top
Directions:
To get the creamy texture: Place the garbanzo beans in a medium saucepan and add the baking soda. Cover the garbanzo by several inches of water, then bring the mixture to a boil over high heat. Continue boiling, reducing heat if necessary to prevent overflow, for about 15-20 minutes, or until the garbanzo beans look bloated, their skins are falling off, and they’re quite soft. In a fine-mesh strainer, drain the chickpeas and run cool water over them for about 30 seconds. Set aside.
Meanwhile, in a food processor or high-powered blender, combine the lemon juice, garlic and salt. Process until the garlic is very finely chopped, then let the mixture rest so the garlic flavor can mellow, ideally 10 minutes or longer. Add the tahini to the food processor and blend until the mixture is thick and creamy.
Add the cumin and garbanzo beans to the food processor. While blending, drizzle in the olive oil. Blend until the mixture is super smooth, scraping down the sides of the processor as necessary, about 2 minutes. Add ice water by the tablespoon if necessary to achieve a super creamy texture.
I used to always be in such a hurry I would just buy marinara, but it truly is pretty simple to make and tastes amazing (and you can add veggies).
Ingredients Meatballs:
1 Tbsp olive oil
1/2 cup Parmesan cheese (for dairy-free omit)
1/3 cup almond flour
1/4 cup finely chopped basil
1 clove fresh garlic, pressed or diced
1/2 tsp salt
1/4 tsp black pepper
1 pound lean ground turkey
1 egg
Ingredients Marinara:
2 Tbsp olive oil
2 cloves garlic, minced or pressed
1 cup mushrooms, diced
1 zucchini, chopped
2 cups spinach, chopped
1/4 cup tomato paste
1 (16oz) can tomato sauce
1 (16oz) can crushed tomatoes (Muir Glen)
1 tsp salt
1/2 tsp pepper
1/4 cup fresh basil, diced
1 tsp dried oregano
1/2 tsp red pepper flakes (optional)
Whole wheat penne pasta (optional)
Directions:
Meatballs:
Preheat the oven to 400 degree F. Line baking sheet with parchment paper and drizzle with olive oil.
In a large bowl, combine Parmesan, flour, basil, garlic, salt, pepper. Add turkey and egg and use your hands to combine. Set aside for 15 minutes.
Spoon mixture into your hands and form 16 golf-ball sized meatballs and place them on the baking sheet.
Bake in the oven for 15 minutes, take them out flip and bake for another 15 minutes. Check for no pink to signal they are done.
Marinara Directions:
In a large dutch oven or sauce pan (I used a scan pan) heat olive oil over medium heat. Add garlic, zucchini and mushroom and saute until soft. Add spinach and basil and saute another 4 minutes until wilted. Add tomato sauce, mashed tomatoes, tomato paste, oregano, salt, pepper. Mix and let it simmer on low to combine flavors for 15-20 minutes.
Toss meatball in sauce or pour over pasta with meatballs.