How Endurance Athletes and Ultramarathon Runners Stay Fueled


“Marathon Club of Ireland” by Peter Mooney of Fickr Creative Commons. (Notice the gel packs attached to this guy’s shorts!)

Today is the first of the series of articles I introduced last week about the nutritional habits of various unique groups of people around the world. I’ve always wondered how endurance athletes and runners who work out so hard for hours on end manage to not only stay hydrated, but to maintain enough energy in general. Think about it: an ultramarathon is any race that is longer than the traditional 26.2 mile marathon and can commonly reach distances of 100 miles or more! Even short runs can leave me feeling like a hungry limp noodle if I haven’t eaten well that day!

Here are some of the tricks I’ve learned about that endurance athletes, and particularly marathon and ultramarathon runners use to keep them fueled during such a long workout:

-Carbo-loading is a real thing. Carbohydrates are the body’s fastest sources of energy and prevent the breakdown of other bodily tissues for fuel, such as fat and muscle. Every athlete is different, but most agree that it’s best to eat a carbohydrate-rich meal 1 to 3 hours before the big race to give the food time to digest and store that energy.

-Many also agree that it’s best to get carbohydrates from complex, whole food sources before a race, such as whole-wheat products, because they are digested more slowly than simple sugars in white bread, for example. The slower digestion means that all of the carbohydrates aren’t released into the bloodstream at once and provide a more prolonged source of fuel.

-During races, however, the goal is to replenish energy and carbohydrates and do it quickly! There are a variety of products dedicated specifically to this purpose:

While you’re running or working out in general, your body diverts blood flow away from your digestive system because your muscles need improved blood flow and nutrient accessibility during a workout. When runners eat during a long-distance run, it can be hard on the stomach because the diverted blood flow makes the digestive system slow down when it’s not expecting food. For this reason, endurance runners frequently consume mushy, easily digestible sources of fuel packed with carbohydrates. These include gel packs, gel chews, jellybeans made specifically for endurance athletes, baby-food pureed fruit packs, and more.

Experienced runners suggest starting to eat theses sources of fuel early (within the first hour) of a long athletic event before the digestive system gets too slow or completely shuts down. Some people with sensitive stomachs constantly eat small amounts of the gel or other fuel as they run, such as every 15 minutes, to keep a constant source of fuel and a minimum amount of material in the stomach.

It’s important for endurance athletes using these high-sugar sources to also drink plenty of water along with the sugar to dilute the sugar in the stomach, slow the absorption slightly, and remain hydrated.

-The body can never quite absorb as many calories per hour as most endurance athletes are running, but eating these energy sources during an event can help narrow the deficit gap. Ultrarunners who run for hours on end in those 100 mile races also realize that you can’t survive only on gels and simple sugars for more than four hours, or so.

These athletes get creative and find ways to incorporate “real food” with fats and protein into their running diet as well. Apparently, some ultrarunners have trained themselves to eat “turkey or PB&J sandwiches, chicken-noodle soup, potatoes, pretzels, and bananas” during races!

-Ultrarunners also need to drink nearly a liter of water per hour to stay hydrated, but taking in pure water at this rate can lead to hyponatremia, an extremely dangerous condition in which the electrolytes in the body become too diluted and bodily functions such as nerve firing fail with the improper concentrations of these ions. Many athletes try to eat salty foods during their endurance workout for this reason. If they start to feel puffy (one article mentioned that a watchband becoming tight is often an indicator of the beginning of hyponatremia), ultramarathon race stations sometimes provide runners with a tiny cup of water with up to 4 bullion cubes dissolved in it to quickly replenish a large quantity of salt in the body. Some runners who have experienced this problem even take sodium tablets while they run.

After these extreme endurance events, it is suggested that athletes immediately consume carbohydrates and protein to enhance muscle recovery rate and start to replenish all of that lost energy! An example of a post-race meal could include a bagel with cream cheese and chocolate milk, according to one article. Many ultrarunning events also have weigh stations at the beginning and end of the race, and sometimes throughout, to monitor percent body weight lost during the race. If more than 3% body weight is lost, this indicates significant dehydration that needs to be quickly replenished.

As you can see, these endurance events are not just a one-time decision or an enjoyable casual hobby for the people who do them. They require significant lifestyle modification and careful attention to nutrition to allow their bodies to reach the capacity to achieve these amazing feats! Careful attention to nutrition is required before, during, and after the race to maintain health under these extreme conditions!

(As applies to all of the unique dietary niches I will be describing in this series of articles, make sure you consult with a doctor of registered dietician before starting any new extreme dietary or exercise habits to make sure you can make all transitions in a healthy and safe way!)


Aschwanden, Christie. How to Fuel Up During An Ultra. Runner’s World. 19 August, 2014.

Gaudette, Jeff. Everything You Need To Know About Energy Gels. 10 Jul, 1024.

Kohn, Jill. Eat Right for Endurance Sports. Eat right: Academy of Nutrition and Dietetics. 13 April, 2015.

Nutrition for Endurance: Running. Eating Free.

Coming Up: Unique Dietary Patterns Around the World and Their Effects on Human Health

Earlier this week, I wrote about calories and one thing I love about writing for the Tar Heel Tone Up is that I always learn new things with every article I write! Writing about calories got me thinking about how we all need them for survival, no matter where we are in the world, but depending on our culture and lifestyle, people in different parts of the world get their necessary calories in vastly different ways!

Because this topic sparked my interest, I wanted to introduce a small series of blogs I’ll be writing over the next couple of weeks about unique dietary patterns among certain groups of people around the world. Some of the groups I’ll be writing about will include:

Extreme endurance athletes including Olympic swimmers, marathon runners, and Ultramarathon (100 miles) runners – what kind of foods do you need to support such intense physical activity for extended periods of time? Does it matter what they eat all the time, or only before practice or a big race?

Extreme backpackers and hikers – what kind of foods do you eat when you know you’re going to have to carry their weight on your back for weeks or months on end? How do you get all of the necessary vitamins and nutrients when you can’t carry around fresh sources of fruit, vegetables, or protein?

The Brazilian dietary pattern of eating rice and beans at multiple meals almost every single day – Are people who eat this type of diet at a nutritional disadvantage due to decreased food variation or are they at a nutritional advantage due to this healthy daily combination of protein and carbohydrates?

The astronaut diet – what on earth (or the moon) do astronauts eat and how much planning goes into preparing meals and balanced nutrition in space? Do astronauts ever get dessert? Do they ever have trouble with swallowing in zero-gravity? Do space station teams have a team of specialized dieticians on staff to address these concerns?

The Maasai tribe of Kenya and Northern Tanzania – this African tribe subsists mainly from a traditional diet of raw milk, meat, and drinking blood for at least a portion of their lifetime. Does this dietary pattern cause noticeable differences in their health compared to other, more varied, diets? With a diet so high in fat and cholesterol, do they have extremely high rates of obesity, high blood pressure, and cardiovascular disease?

Traditional Asian diets – Although western culture and foods have spread throughout the world, traditional Asian dietary patterns still influence the food choices of the majority of the world’s population! Asian diets traditionally included high amounts of tea, fish, soybeans, rice, and fresh vegetables while being much lower in sugar and fat than the typical Western diet. What interesting health differences arise from these divergent dietary patterns?

Keep checking in over the next few weeks to learn more about these unique world diets, what they eat, and what health benefits or detriments arise from differences in our sources of nutrition around the world!

The Tricky Parts of Counting Calories

Last week, I wrote about some of the basics of calories:

  • What is a calorie?
  • Why are calories included on food labels?
  • Do different food groups contain more calories than others?
  • How do food companies measure the amount of calories in the foods?
  • How concerned should I be about counting calories?

Today, I’m including more interesting information that most people might not know about calories, including why a Scientific American article title claims that “Science Reveals Why Calorie Counts Are All Wrong.” Following are just a few of the many reasons that it may never be possible to make an accurate estimate of the amount of calories present in the foods we consume every day!

  1. Plant material (carbohydrates and fiber, mostly) varies greatly in digestibility. Think about how many different plant parts we consume on a regular basis—stems, leaves, and roots—and how much these parts can differ between two types of plants. Kale leaves and rhubarb are both plant material, but they have completely different textures, showing that stalky plants such as rhubarb have thick, hearty cell walls and young, tender lettuce leaves have thin, more pliable and more easily digestible cell walls. Rob Dunn, for Scientific American, says:

“Generally speaking, the weaker or more degraded the cell walls in the plant material we eat, the more calories we get from it. Cooking easily ruptures cells in, say, spinach and zucchini, but cassava (Manihot esculenta) or Chinese water chestnut (Eleocharis dulcis) is much more resistant. When cell walls hold strong, foods hoard their precious calories and pass through our body intact (think corn).”

Unless your zucchini is going to come with a different nutrition label for every possible method of cooking or preparation, we will never know exactly how many calories our body is extracting from it! The caloric food labels are just an estimate!

  1. In some cases, we’re not getting as much caloric value out of our food as we think we are. Certain plants adapt over time so that they are appetizing, but also so that their seeds are extremely difficult to digest. This adaptation is favored because such as state means that more animals are likely to eat the plant and then distribute the still-intact seeds more widely in their waste.

Many of the nuts that we consume in our diets are essentially seeds, and evidence shows that some of them do indeed cling tightly to their nutrients, reducing their digestibility. Two studies have supported this assumption: one noted that “peanuts, pistachios, and almonds are less completely digested than other foods with similar levels of proteins, carbohydrates and fats, meaning they relinquish fewer calories than one would expect.” The other study measured unused calories in feces and urine among people who were eating the exact same diet other than the amount of almonds they consumed. Their data showed that on average, people received 129 calories from one serving of almonds, even though the accepted caloric value of one serving of almonds is 170 calories, according to the food label.

  1. The original method of burning foods to estimate calories does not account for the energy expenditure of our individual bodies to break down those foods. Robert Dun suggests that proteins may require a significant amount of energy to digest depending on how intricately and tightly the strings of amino acids are arranged, or how some foods (such as raw and undercooked meat) can prompt our immune systems to perk up and address any invading pathogens. This also requires energy, so our net caloric gain depends on how much nutrition we extract from the food, minus the energy required to digest the food.
"Llama / Flame" by Ana of Flickr Creative Commons

“Llama / Flame” by Ana of Flickr Creative Commons

  1. Food labels don’t account for cooking methods. Rachel Carmody, a former graduate student in the lab of Harvard biologist, Richard Wrangham, conducted an experiment along with her collaborators in which they fed mice either sweet potatoes or lean beef and served the foods each in different ways: raw and whole, raw and pounded, cooked and whole, or cooked and pounded. The mice were allowed to eat as much as they wanted for four days and the results were measured after this short period of time. The mice eating cooked meat and potatoes, whether pounded or whole, gained weight over the four-day period, while the mice eating raw meat and sweet potatoes, pounded or whole, lost weight. This makes sense considering the fact that cooking weakens the structures of the food proteins, making them more available and digestible to the body so that we can extract more calories and use less calories for digestion and immune response to bacteria.

This process of give and take not only applies to a difference between cooked and raw foods; it also applies to how pre-processed foods are before they ever make it into our stomachs. Another study by Rachel Carmody found that people who ate “whole-wheat bread with sunflower seeds, kernels of grain, and cheddar cheese expended twice as much energy to digest that food as did individuals who consumed the same quantity of white bread and ‘processed cheese product’,” leading to fewer calories obtained overall by the wheat-bread, cheddar cheese group.

  1. Fifthly, and perhaps most importantly, if two people eat the same quantity of the same food item cooked in exactly the same way, those two people will still extract a different number of calories from that food. This is because no two individuals have the exact same digestive tract; people differ in every category from the size of the gut to specific digestive enzymes they lack to the billions of digestive bacteria living inside the intestines. Recently, nutrition researchers have been interested to discover that obese people different gut microflora than lean people, which could cause them to be more efficient at metabolizing food. Other types of gut microbes are specific to certain ethnic groups. For example, some Japanese individuals have been found to have a “microbe in their intestines that is particularly good at breaking down seaweed.”
"Seaweed Salad Edo Sushi" by Steven Depolo of Flickr Creative Commons.

“Seaweed Salad Edo Sushi” by Steven Depolo of Flickr Creative Commons.

For these many complicated reasons, calorie counts and estimates are not great predictors of healthy eating, or even nutritional value. To improve the estimates of calories on our food labels would require a long, expensive, and majorly unpleasant process of studying human waste to measure the calories that are ultimately lost due to incomplete digestion.

We might not be able to determine an accurate calorie count, but the various studies mentioned above do suggest that less processed, whole foods are often more nutritionally and calorically favorable and also have the added effect of keeping our gut bacteria balanced and happy. Turns out those little things called calories might not be as important as diet companies would like to make us believe.


Dunn, Rob. Science Reveals Why Calorie Counts Are All Wrong. Scientific American. 20 August, 2013.

*A big NC shout-out to Rob Dunn, the biologist who wrote the thrilling Scientific American article that was the source of inspiration for this blog and who also happens to work down the road at that red school known as NC State University.

What are Calories and How Important Are They?

We’ve all heard people talk about calories, and we all see them on food labels every single day! What do those famous numbers actually mean, and what is their significance to our health and nutrition?

What is a calorie?

The simplest definition of a calorie is just that it is a unit of energy. More specifically, it is the amount of energy necessary to raise one kilogram of water by one degree Celsius. The Calories that we refer to in food and on nutrition labels are defined this way, which means that they are actually kilocalories, because a calorie is the amount of energy required to raise one gram of water by one degree Celsius, not one kilogram.

However, we still colloquially refer to them as Calories and sometimes represent this type of Calorie with a capital “C” to distinguish the two definitions. I’ll stick with the lowercase “c” in this article, however, for simplicity’s sake. Just know that I am referencing kilocalories, the number found on food labels. Just store the difference between the two types of calories in the back of your mind and chuckle at the fact that a small apple that says it contains 100 calories on a label actually contains 100 kilocalories and 100,000 calories if we’re being really technical! (The smaller number is also much more convenient and comforting on a food label).

Why are calories included on food labels?

Calories are essentially an estimation of the potential energy a specific food provides to the body. Our bodies need this energy for daily activities and the simplest of bodily functions, such as breathing. As many of us already know, if we consume an excess of calories, our bodies store this extra energy as fat, so eating only the amount of calories the body needs is important for maintaining a healthy weight.

"PISTACIOS!" by Stefan Lins of Flickr Creative Commons

“PISTACIOS!” by Stefan Lins of Flickr Creative Commons

Do different food groups contain more calories than others?

Yes they do! Here is the breakdown of the caloric value of each of the 3 major nutritional macromolecules:

  • 1 gram carbohydrates = 4 calories
  • 1 gram protein = 4 calories
  • 1 gram fat = 9 calories
  • (Not a major macromolecule but 1 gram alcohol = 7 calories)

This is part of the reason that some people are scared of eating fat, because they learn that it has the most calories per gram and fear that eating fat will make them gain weight! This is not necessarily true, however, because many fats are extremely healthy and even necessary for the body (think omega-3s and avocados) and foods that contain fat take longer to digest than carbohydrates, keeping us feeling fuller for longer periods of time.

How do food companies measure the amount of calories in foods before they put the number on the label?

Originally, a measured quantity of the food was literally placed in an apparatus called a bomb calorimeter (scary, right?), which was a sealed container completely surrounded by water. The food was completely burned in this container, and the rise in water temperature from this reaction was measured to calculate calories!

This method is not typically used today; instead, total caloric value of a food is calculated indirectly by measuring the quantities of carbohydrates, protein, fat, and alcohol in a food and then adding up the appropriate number of calories per gram. Those numbers of calories per gram for each macronutrient listed above were originally determined by taking the average of many sample results after burning.

For example, say a food had 20 grams of carbohydrates, 7 grams of protein, and 10 grams of fat. Here is the caloric calculation for this mystery food:

20 g carbohydrate x 4 kcal = 80 calories

7 g protein x 4 kcal = 28 calories

10 g fat x 9 kcal = 90 calories

Total: 198 calories

How concerned should I be about counting calories?

There are many diet programs and apps concerned with counting calories consumed every day as part of a weight loss or weight maintenance program. Researchers in the field of human nutrition have become increasingly interested in studying the human microbiome, which is the collective name for the colonies of necessary bacteria that live in our gut to help us process and digest food. This research has produced some interesting results concerning the calorie estimates placed on food labels and the amount of calories we are actually able to digest from our food.

After all, these values are only estimates, but the relationship is much more complex than we originally understood. An article published in Scientific American on this very subject states:

“To accurately calculate the total calories that someone gets out of a given food, you would have to take into account a dizzying array of factors, including whether that food has evolved to survive digestion; how boiling, baking, microwaving or flambéing a food changes its structure and chemistry; how much energy the body expends to break down different kinds of food; and the extent to which the billions of bacteria in the gut aid human digestion and, conversely, steal some calories for themselves.”

It is becoming clear that calculating all carbohydrates as containing 4 calories per gram is too simplistic of an estimation; some carbohydrates are fully digestible and others contain structures and parts that may only be able to be partially digested, meaning that they pass through the digestive system entirely without donating all of their calories to the body. For example, the Scientific American article says that:

“Studies suggest that peanuts, pistachios and almonds are less completely digested than other foods with similar levels of proteins, carbohydrates and fats, meaning they relinquish fewer calories than one would expect.”

Each person’s body and gut microbiome is different, causing them to process the same foods in different ways and receive different amounts of calories than anyone else. For this reason, more health programs and individuals are starting to realize that counting calories may not be the best answer. Now, the growing trend is tracking our physical activity and trying to move more as part of a healthy lifestyle. Not only does this have positive effects on body weight, it also has profound health benefits independent of weight, such as a reduction of the risk of cardiovascular problems in the future.

I’m personally happy to see people moving more and spending less time on calorie counting math as part of a healthy lifestyle, but I do think the growing amount of information on calories is interesting as research continues. Check back in next week for more fun facts and answered questions about calories!


Dunn, Rob. Science Reveals Why Calorie Counts Are All Wrong. Scientific American. 20 August, 2013.

Painter, Jim. How do food manufacturers calculate the calorie count of packaged foods? Scientific American. 21 July, 2006.

What are calories? Medical News Today. 26 September, 2014.

We Need to Learn that It’s Okay Not to Be Okay

In this world of omnipresent social media, we have changed the way we see others and ourselves, whether we realize it or not. We used to spend real face-time with friends and family, and by doing so, we not only knew all of the good things about them but we also knew their faults, imperfections, and personal struggles. We knew more about each other because real life leaves less room and opportunity for concealment of the parts of ourselves that we wish we could hide from others.

Now, our face-time comes in the form of an app. “Selfies,” Photoshop apps, filters, and the general disconnect from human interaction allows us (and others) to share much more of our lives with a much larger group of people than ever before. And not only do we share; we have complete control over what we choose to share and what we choose to keep hidden from the prying eyes of social media.

For many people, that means that social media gives them the opportunity to push the unpleasant realities of their personal lives under the rug while we instead portray our best selves, our happiest selves – our perfect selves and our perfect lives.

"Perfect Day" by Juan Diego Jiménez of Flickr Creative Commons

“Perfect Day” by Juan Diego Jiménez of Flickr Creative Commons

Today, we scroll through pictures and see that beautiful girl with a flawless body and a perfect dress with her hot boyfriend and we are just so sure that her life must be perfect. How could it not be? We don’t see how lonely she is after the last of her siblings left for college, and we don’t see how hurt she is by her parent’s divorce. We see a beautiful dress and a big smile and we assume that her life always looks like that and that surely she must live in the glowing utopia of her favorite Instagram filter.

We see that star of the basketball team and his new shoes and perfected trick shots and we wish that we could be as naturally talented as he is. Life must be so much easier for him, right? We see the pictures of success and the montages of the greatest dunks and victories. We don’t see the hours and hours of work and sweat and pure pain that were paid to achieve this point. We don’t see how exhausted he is because all of that practice time doesn’t leave enough time for schoolwork and friends and sleep, and we don’t see how much pressure his coach or his parents are putting on him to succeed and “make them proud.”

This mirage of effervescent happiness and perfection has bubbled over from a phone and infected the minds of many people. It is this double life that led to the death of one University of Pennsylvania student just last year. Madison Holleran lived the perfect life of a varsity athlete at an Ivy League school until the very hour before she leapt off the top floor of a parking garage, according to her Instagram account.

In her many pictures, she was always smiling and surrounded by beaming friends and family. No simple Instagram acquaintance would have noticed that anything at all might have been going wrong in her life, but her family had their suspicions. The stress of running track at the varsity level and keeping up with the coursework of college had become too much for Madison, and those Instagrammed moments of happiness were ephemeral and fleeting; they were a cover for the pain and anxiety that she felt at her inability to be perfect in school and on the track.

Close friends assured her that they were struggling with the same problems and that their lives were equally full of challenges and failures since they started college together. Ironically, Madison couldn’t bring herself to believe them because their Instagram accounts just showed them looking so perfect and she didn’t understand why she felt that she couldn’t achieve the same balance and happiness.

The signs were there, and her parents even helped her talk to therapist over Christmas break, hoping to help her overcome her anxiety and be prepared for a better second semester. But the internal hurdles that Madison faced were more than garden-variety anxiety over a tough first semester at college. She was suffering from serious depression and mental health disorders that needed the treatment and assistance of experienced professionals, but she never asked for the help she needed, even when she admitted that it was “not normal to feel this way.”

May we honor the mission of her parents to help others, especially in college, to understand that sometimes, it’s perfectly okay to admit that we are not always okay. In a challenging university atmosphere, we are thrown into a place where are no longer “top of our class” because so was everyone else in your class when they were in high school. We struggle in subjects that used to seem easy to us, and we fail midterms even though we never made less than an A in high school.

This year, TIME published a brief list of 5 “red flags” that may indicate to you that a friend is in need of support and even professional help to help them to overcome a variety of challenging situations:

1. “He/she doesn’t seem like him/herself lately.” Is your bubbly roommate suddenly quiet and sullen? Does your friend suddenly not like certain activities or foods that you remember they used to love?

2. “He’s/she’s unusually moody or edgy.” Has your friend’s normal composure and soft-spoken mannerism changed to be course or antisocial all of the sudden?

3. He’s/she’s acting a bit more withdrawn.” Does he or she make up excuses to avoid meals or activities with you and other friends, even when you’re sure he or she have no other plans?

4.”She’s/He’s less put together than usual.” Has your friend suddenly started drinking more or caring less about their physical appearance? Do they stay up too late and never catch up on sleep, exercise, or healthy eating?

5. “He seems overwhelmed by life.” Honestly, we’ve all been there, but most of us find our way out fairly quickly. For others, a single failed test grade can spark an enormous mental spiral that focuses only on failures instead using logical reasoning about the relatively tiny effect that one test grade will have on her life success in the future.

It’s easy to see physical wounds and injuries, but it is much harder for us to really get to know each other well enough to be brave and confront the topic of mental health with a friend or family member. In this time of disconnected social media portraying the best of other people’s lives, it’s easy to feel down about our own imperfections. By maintaining strong friendships with frequent social interaction, we can be the friend with enough original “face-time” experience to know when our friends need help before it quickly becomes too late.

No one is perfect, no matter what his or her filters may show. However, we all have the ability to find joy if we choose to do so, even if it takes a long journey with many guides to find it. It’s okay if we don’t always exactly feel like life is even going “okay,” but it’s not okay to ignore the personal battles of a friend when there may be a way for you to help bring them back safely to happiness.

To find help on campus for yourself or a friend, click here and never be ashamed to ask for guidance. I sincerely believe that if we all did so more often, we would find life’s path much less empty and treacherous than it may sometimes seem.


Fagan, Kate. Split Image. ESPNW. March 07, 2015.

Oaklander, Mandy. Changing Your Mind. TIME Health Briefing. March 16, 2015. P. 24. Print.

Does Diet Soda Satisfy Your Sweet Tooth?

Many people love soda but are aware of the negative consequences of the calories, acid, and high sugar content on oral and overall health. More and more people with a soda addiction are switching to diet soda as a way to reduce their caloric intake, and soda companies are making diet sodas that taste more and more like the regular version, such as Coke Zero.

The effects of diet soda and artificial sweeteners on overall heath have been a matter of concern for a while, but a new study published in the Journal of the American Geriatrics Society showed that adults 65 years and older who were long-time regular diet soda drinkers gained three types as much abdominal fat over the study follow-up period than did the people who did not drink diet soda regularly! The study enrolled 749 Mexican- and European-Americans age 65 or older between 1992 and 1996, and then measured diet soda intake, waist circumference, height, and weight at the time of enrollment. The same measurements were then repeated in 2000-01, 2001-03, and 2003-04 for a total of 9.4 follow-up years.

The measurements showed that the average waist circumference increases during each measurement interval was 0.77 cm for never-diet soda drinkers, 1.76 cm for occasional diet soda drinkers, and 3.04 cm for daily diet soda drinkers. This discovery of a triple increase in abdominal fat also took into account potential confounding factors such as initial waist circumference, demographic characteristics, physical activity, diabetes status, and smoking before reaching this surprising conclusion!


“ODC – What doesn’t belong?” by Brandonw365 of Flickr Creative Commons.

Diet soda intake has increased dramatically in the past 30 years, but so have obesity rates in America. This study again supported an association between the two; why might this be the case?

Dr. Helen Hazuda, one of the authors of the study and professor of medicine at the University of Texas Health Science Center at San Antonio, offers one explanation:

“Regular sugar has caloric consequences. Your body is used to knowing that a sweet taste means you are ingesting energy and that if you don’t burn them (calories) off, it’s going to convert to fat.”

There are natural mechanisms in our bodies to help us reach a stopping point, or satiety (a feeling of satisfaction). However, artificial sweeteners in diet sodas are more than 200 times sweeter than sugar, yet the lack of calories also means that the satiety mechanism is not triggered in the same way as when we eat caloric sugar.

This means that instead of satisfying your sweet tooth, diet soda could make you want more and more. TIME cited another recent study in which two groups of rats were fed yogurt sweetened with saccharin (an artificial sweetener), and yogurt sweetened with regular sugar. The rats consuming the artificially sweetened yogurt ate fewer calories overall, but they gained more weight than the rats eating regular sugar-sweetened yogurt! Results of both the animal and human studies shows that artificial sweeteners interfere with the body’s natural ability to regulate the calories we consume in a way that we may not fully understand yet, leading to possible weight gain and increased sugar craving.

The reason this relationship may be difficult to completely understand is that artificial sugar affects the body in many separate ways. One such way was alluded to in a recent study in Nature, showing that artificial sweeteners “changed the colonies of gut bacteria in mice in ways that made the animals more vulnerable to insulin resistance and glucose intolerance, which are metabolic disorders that can lead to weight gain and increase in the risk of Type 2 diabetes” (Oaklander).

This damaging relationship was also supported by 9,500 dietary questionaires that showed that the people who reported drinking at least one can of diet soda per day had a “34% higher risk of metabolic syndrome—a cluster of risk factors that can lead to heart disease and Type 2 diabetes—than those who didn’t drink diet soda” (Oaklander).

It would seem that while drinking diet soda as an alternative to regular soda is indeed a way to cut calories, it may not be a good move for people trying to lose weight or simply improve their overall health. Artificial sweeteners and the increasing obesity epidemic have provided many interesting avenues for continued research as to how our bodies adapt to changing environments and changing dietary patterns.

An association between weight gain and diet soda consumption does not necessarily imply causation; the relationship could be due to other lifestyle factors specific to chronic diet soda drinkers. Either way, for some, the existing research might already be enough to convince them to kick the can.


Fowler, Sharon P.G., Ken Williams and Helen P. Hazuda. Diet Soda Intake Is Associated with Long-Term Increases in Waist Circumference in a Biethnic Cohort of Older Adults: The San Antonio Longitudinal Study of Aging. Journal of the American Geriatrics Society, March 17, 2015 DOI: 10.1111/jgs.13376

Oaklander, Mandy. The Skinny on Diet Soda: Is it time to kick artificial sugars out of the can? TIME Health Briefing. March 31, 2015. Print.

Wiley. Diet soda linked to increases in belly fat in older adults. ScienceDaily. ScienceDaily, 17 March 2015. <>.

When it Comes to Water, More is More

We all hear the phrase “less is more” frequently, and this important rule applies to many foods and drinks especially, for example: cilantro, garlic, Coke, and raw onion. Even though I agree with the “less is more” mindset in certain situations, I also believe that there are many notable exceptions to the rule in the food and drink category, for example: whipped cream, sour cream, guacamole, chocolate, and WATER – one of the important exceptions to the “less is more” mantra!

I <3 Water by Derek Gavey of Flickr Creative Commons

I <3 Water by Derek Gavey of Flickr Creative Commons

We’ve all heard that we should drink more water, and many people have heard of the 8 x 8 rule that says to drink 8, 8 oz glasses of water per day. Why so much water? First off, over half of your body weight is made up of good old water! If that’s not enough to convince you, here are some of the most important functions of water in the body:

  • Regulates body temperature
  • Maintains blood volume and aids in carrying nutrients and oxygen to cells
  • Helps to lubricate the joints
  • Helps maintain normal digestive function
  • Moistens tissues in the eyes, nose, and mouth
  • Helps the kidneys and liver to flush out waste products from the body

While the 8 x 8 “rule” isn’t a hard and fast rule that has been proven, it is a good way to remember to drink more water than you normally might. In actuality, your daily water intake depends on your height, weight, activity level, health status, and even the climate in which you live. The basic rule of thumb is that you should be drinking enough that you rarely feel extremely thirsty and your urine is never darker than a pale yellow color.

People who are realizing the value of drinking more water have turned to technology to help them keep track and stay hydrated. Free apps like “Waterlogged” help people track their hydration goals using pictures of their favorite bottles or cups to keep score! A new, super fancy water bottle called BluFit was just released this year as well. The bottle contains a flow meter and a Bluetooth chip that transfers your water-consumption data to a handy BluFit app on your iPhone or Android, allowing you to easily customize your hydration goals. The app even keeps track of the outdoor temperature and humidity to help you estimate your daily water intake requirements!

Not only is the increased hydration awareness leading to new technology, it’s also leading to new… water. That’s right – flavored waters with health claims galore have found a thriving market among those who are becoming more aware of the importance of staying hydrated! TIME even spent a whole page discussing some of the newest flavored water trends just last month.

These trendy flavored waters aren’t like your classic Propel or even the coconut water trend that was happening a year or so ago. Some attribute the growing water trend to the increased awareness of obesity in America and the contribution of sugar-sweetened beverages, such as juice and soda to this epidemic. While I’m always skeptical of advertised health claims, I’m happy to see people choosing water-like beverages without excess added sweeteners or calories as a healthy lifestyle change.

Here are some of the most interesting successful flavored water brands featured by TIME last month:

Brand name: Temple Turmeric

What is it?: Turmeric water (turmeric is a yellow powder made from the root of the turmeric plant and used for cooking, flavoring, and health benefits

Claims: Reduces inflammation in the body

What does Emily think about this?: Turmeric has a really strong flavor and I don’t imagine 13 grams of it tasting great in one bottle of water… but I haven’t tried it so I can’t say for sure.


Brand name: Blossom Water

What is it?: Flower water (lilac, jasmine, rose)

Claims: Love this! The founder of the company says: “People have told us it makes them real happy.” Now that’s a better claim than saying their water will cure all ills in my opinion.

What does Emily think about this?: I imagine it tasting like perfume or hand soap but I would be willing to try it just because the founder seems nice and slightly Southern.


Brand name: Botanic Water

What is it?: Organic rose-flower water

Claims: Natural anti-inflammatory; soothes sore throat and menstrual cramps

What does Emily think about this?: Once again, I imagine it tasting the way perfume smells if there is enough rose in there to make this any better for me than regular water.


Brand name: Caliwater

What is it?: Cactus water literally containing prickly pear cactus puree.

Claims: Antioxidants, hangover relief, body detox, and skin revitalization

What does Emily think about this?: Yummm, nothing like chugging down a bottle of delicious cactus puree after that workout… only still slightly prickly in my esophagus…


Brand name: Drinkmaple

What is it?: Maple sap water

Claims: Enough potassium to replace what’s lost in an hour of exercise, plus plenty of manganese

What does Emily think about this?: I mean I really like maple syrup… does pure maple sap taste anything like maple syrup? And can I have a waffle with this?


Brand name: Byarozavik

What is it?: Birch-tree sap water

Claims: Antioxidants and minerals

What does Emily think about this?: I just love the taste of the forest in the morning…


Brand name: Victoria’s Kitchen

What is it?: Almond water + vanilla extract

Claims: None! Quote: “Our beverage is refreshing and delicious, and it doesn’t do anything for you” according to founder Davie Meniane.

What does Emily think about this?: Ok this must taste pretty good if they’re not making any health claims and it’s still selling well. But what makes almond water different from almond milk? How is milking an almond possible in the first place? (Sarcasm; don’t judge me because you assume that I think almonds are mammals, even though that would be kind of cute.)


Brand name: WTRMLNWTR

What is it?: Watermelon water. Who needs vowels anyway?

Claims: Improved digestion and recovery after exercise; six times more electrolytes than a typical sports drink.

What does Emily think about this?: I am most willing to try this one out of the nine because watermelons are mostly water anyway and I think they’re delicious so surely this is pretty good.


Brand name: Arty Water

What is it?: Artichoke water; one baby heirloom artichoke per bottle.

Claims: Anti inflammatory, liver detox, immune booster

What does Emily think about this?: Do people seriously drink this? Why are we drinking artichokes when we could be using them in delicious spinach dips? Rephrase… why are other people drinking this… because I’d rather have the watermelon water. Or regular water.


As you can see, technology developers, the health-conscious, and even the commercial advertisement industry are all well-aware of the benefits of drinking plenty of water. I think I’ll stick to my classic water bottle with ounce-marking lines and my mental calculator to keep track for now, but if WTRMLNWTR wanted to replace the Red Bull distributors walking around in the library during finals well, I wouldn’t object!

Remember that when it comes to water, more is more and you should make it a priority to stay hydrated as part of your healthy lifestyle, especially in this upcoming North Carolina weather!


Functions of water in the body. Healthy Lifestyle: Nutrition and healthy eating. Mayo Clinic.

UNC Campus Rec – Your Summer Fitness Update

mountain biking

Hi Tone Up Readers!

We hope that you are enjoying the end of semester festivities, despite final exams and studying.

Here are some important upcoming summer updates:

  1. Check out the facility summer hours for updates to plan your workouts if you’re staying on campus this summer.
  2. There are several incredible UNC Outdoor Recreation Excursions planned for this summer. From kayaking Hyco River to hiking Hanging Rock, be sure to attend at least one excursion to get a taste of nature this summer.
  3. I will be taking a summer hiatus from blogging to focus on studying for the MCAT and interning at CNN. I will miss all of you and writing articles – but I will be back next fall ready to provide valuable health and fitness information. Stay tuned- Emily will continue to keep all of you updated with summer fitness tips :)

Have an active and fulfilling summer, Tar Heels!

10 Ways to Recover after Finals

1. Sleep until your heart’s content.


“sleeping cat” by Ana Sofia Guerreirinho of Flickr Creative Commons

No matter how far in advance we try to start studying, we all inevitably end finals week feeling pretty sleep deprived. At no other time will you find that the library is just as bustling in the middle of the night as it is in the middle of the day! After being on such a strict regimen of classes and studying for so long, sometimes we all just need a chance to go to sleep without setting an alarm in the morning. If you sleep for 12 hours straight, so be it… you deserve it! After you’ve had a long night of catch-up sleep, try to get yourself on a semi-schedule where you’re sleeping for 7-8 hours a night instead of the crazy anti-schedule you’ve been on during finals week. It is AMAZING how much more energy you’ll have with more sleep!

2. Relaxation day.

Oh to live the life of an elephant seal... "Elephant seal" by Rene Rivers of Flickr Creative Commons

Oh to live the life of an elephant seal…
“Elephant seal” by Rene Rivers of Flickr Creative Commons

Spend an entire day at home doing whatever it is you like to do there. If you feel the need to catch up on a whole season of your favorite show on Netflix, or just watch the Food Network in between naps, go for it! Doing these things every day might get boring and unproductive, but sometimes we all need a chill day at home after an especially stressful week.

3. Fun evening out!

"A party animal" by Uber Prutser of Flickr Creative Commons

“A party animal” by Uber Prutser of Flickr Creative Commons

Go out for dinner and whatever your idea of a fun evening out is with a group of friends or your significant other. Chances are that you haven’t been spending enough time together lately, or maybe you haven’t been seeing the best side of each other with all of the stress and studying you’ve been dealing with. Enjoy some good food and good company without having to worry about getting up early for class the next morning!

4. Spend a day outside.

Déjeuner sur l'herbe -- Picnic lunch

“Déjeuner sur l’herbe — Picnic lunch” by Gilles Gonthier of Flickr Creative Commons

Get that vitamin D after being cramped up inside at a desk all day! Go on a hike, walk, or swim and pack a picnic (and sunscreen)! The Campus Rec Outdoor Education Center still offers expedition trips during the summer for you to kayak, canoe, and explore various beautiful areas in North Carolina!

5. Read a book you actually want to read.

"Book royalties = cookies!" by wombatarama of Flickr Creative Commons. (I don't understand the name either...)

“Book royalties = cookies!” by wombatarama of Flickr Creative Commons. (I don’t understand the name either…)

Or you can always listen to an audio book as you drive or clean. Even though reading might seem unappealing after spending multiple dedicated “reading days” studying between exams, it can be surprisingly relaxing and enjoyable to read a book that isn’t assigned! Combine reading with spending time outside and bring your book and blanket out into the grass in your front yard, or favorite park. If you don’t think books can hold your interest, pick up “Gone Girl” and get back to me with your final opinion.

6. Make a delicious meal and invite friends!

"Puppies eating" by Christian Haugen of Flickr Creative Commons

“Puppies eating” by Christian Haugen of Flickr Creative Commons

Who doesn’t like being invited over for yummy homemade food at a friend’s house?  Make a lasagna or another favorite entrée and then invite your friends to bring their favorite side or dessert! It’s an easy way to make for a fun evening that will be sure to last long past dinner.

7. Buy yourself a treat.


“As though we hadn’t known it all along: Ridgebacks are fashionable dogs!” by Andre Hagenbruch of Flickr Creative Commons

I like to buy myself a new Carolina tee shirt at the end of every semester after I finish my exams as a mini reward. It’s nice to reward yourself with a little something that you’ve been wanting but that you don’t necessarily need after you’ve worked so hard all semester! Buying yourself frozen yogurt after every single final all week is also completely acceptable.

8. Movie night!

"POPCORN ! ! !" by R Kurtz of Flickr Creative Commons

“POPCORN ! ! !” by R Kurtz of Flickr Creative Commons

Either enjoy a movie night at home or go out to see a new movie if you haven’t been to the theater in a while. Overpriced popcorn is lame but movies are fun (and let’s face it… the fact that the popcorn is expensive doesn’t change the fact that it still tastes really good).

9. Spend time with (or at least call) your family.

"Tortoise Family" by Sam Lavy of Flickr Creative Commons

“Tortoise Family” by Sam Lavy of Flickr Creative Commons

I’m pretty good at staying in touch with my family on a weekly basis, but sometimes when I’m really stressed during the end of the semester our conversations get shorter or turn into text messages. It’s always nice to catch up with Skype or Facetime, and grandparents and other relatives always love to hear how you’re doing as well, whether you normally talk frequently or not.

10. Put your life back in order once you have the energy.


“Puppys dream” by smerikal of Flickr Creative Commons

Sometimes I get so busy that when things finally calm down, I realize that I’ve been so distracted that I’ve just let a lot of things go. Clean the house, do the laundry, and get back into a pattern of healthy eating and exercise once your finals are over; you’ll feel more organized and less stressed when the simple things in your life are in order.

But most of all… glory in the fact that you successfully made it through another semester and hopefully your load of responsibilities just got a whole lot lighter. Happy May 1st everyone… we’re almost there!



The Best Fresh Foods of Spring

Ah, today is the day: the day of both joy and dread because classes are over but the heavy weight of finals week is swiftly descending upon us. Soon we will be free to truly enjoy all of the freedom and benefits of the beautiful spring season, and once you’re away from your meal plan, you might be ready to venture out of your comfort zone to cook some new and delicious foods.

Since many places in North Carolina, Chapel Hill included, are home to fantastic local farmer’s markets, here are a few items to look now, in early spring, to hit their time of peak deliciousness:


Arugula is delicious to mix into a blend of salad greens! It is known for it’s peppery flavor and one cup of arugula has 27% of your recommended daily value of vitamin K. Try this arugula salad with goat cheese, toasted pecans, and a super simple recipe for a homemade cranberry vinaigrette.


“arugula” by elana’s pantry of Flickr Creative Commons


Guacamole, anyone? Avocados are also delicious in chunks on a salad, spread on toast with salt and pepper, and on turkey sandwiches with pesto. Not to mention that you’ll be getting fiber, omega-3 healthy fat, and more potassium than a banana.


“Avocado” by threelayercake of Flickr Creative Commons

Meyer Lemons

Meyer lemons are less sour than other types of lemons and are perfect for making vinaigrette! You can get 31% of your daily vitamin C from one little Meyer lemon! Mix with olive oil, salt, and pepper for a super simple vinaigrette or check out 22 other delicious Meyer lemon recipes for a new flavor experience!


“Naked Meyer Lemons” by Sara Cady of Flickr Creative Commons


Chives seize their chance to sprout at the first hint of warm weather and provide 16% of your daily vitamin K in just 2 tablespoons! They make a great garnish, add light onion-y flavor to salads and various other dishes, and are the perfect topping for your classic baked potato. Check out this yummy recipe for sauteed chicken breasts with a creamy chive sauce!


“Prince of Chives” by greg of Flickr Creative Commons

 Swiss Chard

This leafy green contains 22% daily value of iron and 716% daily value of vitamin K in just one cup! A common way to eat Swiss chard is wilted with butter and vinegar, so if you’re a fan of southern collard greens, you should definitely give Swiss chard a try using this recipe, for example.


“Swiss Chard” by Nature’s Art and Life of Flickr Creative Commons


A single red radish can have up to 124% daily value of vitamin C packed into such a small size! The key to getting maximum vitamin value out of almost any produce is to eat them raw. Many people like to eat raw radish on their salads for a bright and crunchy kick! Check out 13 tasty radish recipes if you’re not sure what to do with them!


“Radishes” by Jorge Luis Zapico of Flickr Creative Commons


Although asparagus is usually pretty easy to find year-round, it’s always the best in early spring when it is in season locally and you can find fresh, super thin green stalks that are tender instead of tough and stringy. I’ve never found a way to eat it that I like better than a simple sauté in butter or olive oil with a sprinkling of salt and pepper.


“Asparagus for New Year’s Eve” by Seth Anderson of Flickr Creative Commons


Broccoli has been one of my favorite vegetables since I was a child; I mean what kid doesn’t like to pretend that they’re eating tiny trees? It’s delicious raw on a salad or mixed with peas, red bell peppers, pasta, chicken, and alfredo sauce. Broccoli is even a pretty good source of calcium, but it’s harder for the body to absorb the calcium in green vegetables than it is from dairy products, so you might want to sprinkle some sharp cheddar cheese over your perfectly steamed broccoli.


“Broccoli” by Steven Lilley of Flickr Creative Commons

Romaine Lettuce

Romaine is the perfect salad lettuce: it has more fluffiness and texture than spinach, and it has more flavor and leafiness than iceberg. Mix with arugula, nuts, fresh cheese, and fruit with a new dressing that I recently tried: strawberry vinaigrette. Or, mix a large handful of crisp romaine into your favorite taco salad for dinner for more fresh, crisp flavor.


“Romaine lettuce” by Seth Anderson of Flickr Creative Commons


This basically needs no explanation; strawberries are delicious and they are WAY more delicious when you buy them in season than when you buy the huge but watery ones available in the grocery store all winter. Treat yourself to homemade strawberry shortcake or mix them into a salad with candies pecans and bleu cheese. Strawberries and balsamic or champagne vinaigrette are one of the most delicious combinations that undeniably tastes like spring.


“strawberries” by kahvikisu of Flickr Creative Commons


Turnips are an often-neglected root vegetable that can be used in a variety of ways, from buttery mashed turnips to roasted turnips with mushrooms. The “baby turnip” variety is more tender and flavorful and the preferred choice for most turnip recipes. You can also cook the turnip greens similarly to Swiss chard for that tangy, slightly bitter flavor that people love in collard greens. I honestly always thought that turnip was another word for radish, but apparently the two are different but similar root vegetables and turnips are more commonly served cooked while radishes are frequently eaten raw.


“Turnips” by Greg Hirson of Flickr Creative Commons

You can throw together an inexpensive, colorful, healthy, and delicious meal by going to a nearby farmer’s market and buying fresh produce in season! You might even be surprised by what vegetables you like if you’ve never tried them during their peak season before. Happy last day of class everyone!


Oaklander, Mandy. Early Bloomers: Spring brings a rush of nutritious foods at peak flavor. TIME: Health. 23 March, 2015. P. 60. Print.


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