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health news, letter from a worried father, interview, british banana cake, ncaa championship results, guinea pigs for a day, book review, tomato risotto, back to newsletter page,
B-FIT home
Updates from
the Project Director
Kristin Cobb
| Welcome to the spring issue of the
B-FIT newsletter. We have made some progress since the winter term.
We now have 77 athletes randomized (just over half-way), with 42 in the
control group and 35 in the treatment group. We have also had 16
athletes return for their second year bone density tests. Thank you
to all the new-comers and to the returnees.
For those of you in the LA-area, please welcome our new bone technician, Anna McDivit. Unfortunately, we had to say goodbye to our former technician, Roz Ushigome. Roz (a runner herself) put a great deal of extra effort into B-FIT, and we thank her tremendously for her enthusiasm. We look forward to working with Anna, who is equally dedicated. Our apologies once again to the collegiate athletes in New York who have been patiently waiting since the fall to have their bone densities measured. Although there has been progress since winter, the technical difficulties are still being resolved. It appears that the Army is finally satisfied with the wording of our informed consent; however, we still need all the official approvals and signatures. Our plan is to recruit non-collegiate athletes from New York later this summer, and to start the collegiate athletes at the beginning of the next academic year. Thank you all for remaining eager and interested. We will keep you updated. Approval to recruit non-collegiate athletes in the LA-area appears imminent. We will be sending a mass mailing of flyers to women distance runners in the LA-area in the next month. This should help us inch closer to our recruitment goals. Recruitment has been a slow and difficult process. We want to emphasize again how much we appreciate all of you who have volunteered. In fact, through our work on B-FIT, Katrina and I have become very sympathetic to the difficulties of recruiting research subjects. |
When a colleague
asked us to participate in his worthy experiment, we couldn’t refuse. If
you thought being a B-FIT participant was challenging, read page 7 to find
out what we had to do! Katrina tells the story on page 7, with pictures.
A reminder for second-year athletes: some of you are still due for your second-year bone density measurements. We are waiting for about 14 of you. Please, please make those appointments. I cannot stress enough how important it is that we don’t lose any of you at this point in the study. See page 3 for information on how to schedule those appointments. Also, if you need to wait until the fall semester to attend your appointment, please contact Katrina or me to let us know of this delay. Much thanks to all of you who have been in for your second-year appointments. The $100 Gap gift certificate was won by a Boston-area participant. Congratulations to all those who made their appointments on time and participated in the raffle. I will be out of the office for the next three weeks, so please contact Katrina if you need any assistance. I am actually taking a vacation that does not involve recruiting for B-FIT. I will be biking through France and a bit of Spain. Injuries have prompted me to explore alternative sports, including bike touring. Read the inspirational interview with Rosa Gutierrez on pages 4 and 5 to learn more about how injuries can be valuable learning experiences. Congratulations to all those who participated in the recent NCAA Championships in outdoor track. See page 6 for the results of all three division nationals. As always, I encourage you to send news, writings, suggestions, or questions for future publication. We like to hear from you. Have a wonderful summer. Enjoy the warm weather and the open trails as you prepare for the cross-country season. |
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 Letters |
| Dear
Kristin,
Though my daughter is too young for your study (she is currently 14 ½), I was wondering if you knew of any one who is conducting research on the interactions of diet, exercise (running especially) and weight in pre-menstrual and just menstruating girls. My daughter is a competitive cross country and track runner (1,600m and 3200m), who placed 26th of 250 in last fall's south Texas regional cross country finals. She might have made the regional finals in track this last weekend, if she had not suffered a stress fracture about 4 weeks ago. My daughter is very slight (86 pounds and 5' 5"), with very little subcutaneous fat. I believe the stress fracture was caused by a combination of changing from running on the road to running on a track, a change in shoe style, and an increase in training intensity after a layoff over Christmas and early new year. By the end of the cross country season she was running about 40-45 miles a week. It seems to me that there is very little advice available on what are appropriate training regimens for premenstrual teenagers, and which are the best ways to build body mass. If you have any comments (and time to respond), I would appreciate them. Sincerely, David Forbes |
| Dear
David,
Unfortunately, there have not been a lot of studies done on elite young women athletes who are pre-menarche (before their first period). What is known is that girls who start training intensely before their first period will often have delayed menarche and will be at higher risk for irregular menstruation as teens and young adults. The concern with this is that regular menstruation is necessary for healthy bones. Women who do not menstruate through their teens and early adulthood may not build their skeletons properly and may develop osteopenia (low bone strength) and even osteoporosis at a young age. The current recommendation is that girls should be encouraged to train at the level at which they are able maintain normal menstruation. The current hypothesis is that diet plays an important role in maintaining the menstrual cycle; it is believed that women who do not menstruate are at a slight caloric deficiency. Increasing energy intake has been shown to restore the menstrual cycle. I would encourage your daughter to eat more calories and fat, or to cut back slightly on her mileage. Running confers a lot of health benefits to young women. Women runners are often very successful in other areas of life. However, there are real health risks. It is great that you are concerned and aware. It's hard for young girls to have a long-term perspective, so that's where a parent's wisdom is helpful. I wish your daughter continued success. Sincerely,
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| This recipe was submitted by Niamh Nicholas, who is a 2:37 marathoner (see Issue 2, Winter 2000 for feature interview with Niamh), a former All-American in the 10,000 at the University of Oregon, and currently runs for New Balance. She says that this recipe will help you with those extra calories you need for marathon training! |
British Banana Cake  |
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For the frosting, combine powdered sugar, butter or soft margarine, and some instant coffee dissolved in a very small amount of hot water. I was never given the measurements for the frosting, so I usually just mix the sugar, butter and some coffee dissolved in a small amount of water and taste it until it tastes good and the consistency is right! I usually use almost an entire box of powdered sugar and probably about a cube of butter that I've softened in the microwave. You have to experiment with it a bit, or I guess you could buy frosting at the store! |
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Running in a New Light…
Interview with Rosa Gutierrez, three-time Olympic Trials marathoner
Rosa Gutierrez has been running competitively for 23 years. Her list of accomplishments is impressive. She was a 10-time state champion in high school, an All-American at the University of Oregon, and has run in 3 Olympic Trials (1992, 1996, 2000). Her PR’s range from 9:10 in the 3k to 2:35:55 in the marathon. Remarkably, at 36 years old, her best days may still be ahead of her. In recent months, she has won such prestigious road races as the Up and Running 10k, the Houlihans to Houlihans 12k, the Devil Mountain Run, and the LSI Race. This is after placing 16th at the Olympic Trials marathon in February. In addition to running, Rosa is a full-time physical education teacher at the Joseph George Middle School in San Jose, CA, where she has been teaching for 13 years.
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Kristin: To what do you attribute your longevity as a competitive runner? Rosa: I have 10 brothers and sisters, and we’ve always been involved with running and all kind of sports. It’s always been a part of my life. I love competition. I love seeing what develops. It is a wonderful progression. It’s just the positive experiences that I’ve had, that I desire to continue. Kristin: Out of your 23 years of running, do you have a favorite memory or race? Rosa: I would have to go back to that race [in 1982] in Oregon where I ran 9:10 in the 3000. The day before, my older sister came to visit and I gave her my bed, so I slept on the floor. I got up the next morning feeling like my back was not quite right and wondering how I’d do in the race. But it just all came together. It was so easy. It was one of those few instances that you have when it just feels easy. That was just a wonderful thrill to be running that fast, especially as a freshman. Kristin: What happened in college? Rosa: I had bursitis in the hip and knee, and I had problems with the IT band. I think a lot of it was overtraining. At Oregon, at that time, there were some great runners. I felt pressure to perform at a high level. When you’re trying to reach your highest level, you get caught up in ‘more is better.’ I started to feel the effects by having injuries. Kristin: What kept you coming back? Rosa: I truly love to run. I’ve had so many wonderful experiences through running. Even through the bad; even through the injuries. Those were some hard times, but they were also great learning experiences. I feel blessed to have gone through that. I feel like I’m a better runner, a better person through it all. Kristin: How were the injuries a blessing? I believe that my decision-making and training now is better. I try to listen to my body more. I don’t try to get into a routine and just go, go, go. If I need to take a day off, I’ll take the day off. That’s different for me. I used to just get into that routine, and I’d go whether I was tired or not. This time around, I’m getting a sense of my body and responding to it. Kristin: What other injuries have you faced? Rosa: In ’93, I started having some problems with the para formus ligament, deep down in the hamstring. It was just some achiness, so I continued to race and train, but my times were 2-3 minutes slower. I was getting frustrated. I was just off and on from ’93 to ’95, racing here and there, training here and there. Kristin: But you still ran the Trials in ‘96? Rosa: In 1996, I ended up doing the Olympic Trials in the marathon while still having this problem, while still having the injury. After the Trials in 1996, I decided, ‘I need to take a break. This is just too much. If I’m ever going to do anything with running, I just need to get away.’ So right after the Olympic Trials in 1996, I took time off. I stopped training at the high level. I was just running 5 miles a day and just doing it for health reasons. Kristin: How long did this last? Rosa: 2 years. It was a good thing. I’m so grateful that I did that, because I realized that running isn’t my life. I can have fun and enjoy life without running. I didn’t know that I could do that. [Running] has been such a large part of my life for so many years, that I didn’t think I could come to a point where I could give it up and be OK. Now, I know that when it comes time to give it up and to move on, I can do it. Kristin: How did you make this transition? Rosa: During those two years, it was difficult. I think it’s like an addiction. As long as you’re in that environment, you have a tendency to keep pushing. So, I no longer went to San Antonio Park and did training runs; I no longer went to the track. I was basically running the 5 miles at a new park, at a new place. That was good therapy for me. It was important to get myself completely out of that environment so that I could just see a different light, see a different way of living that I hadn’t been |
used to before. Kristin: How was your life different? Rosa: I was having a lot of fun doing things for other people. The running and the training takes so much time, and the focus is on self. I had an opportunity during those two years to focus on other people. That was just a wonderful, wonderful experience and joy. Kristin: What got you back into running? Rosa: I had come to a point where if I needed to give it up, then I was willing to do that. I had such peace in my heart that things were okay whether I had running in my life or whether I didn’t. I just prayed about it and had other people pray about it. I basically said, ‘Lord, if this is Your will, if You want me back in running, then I’m there. If it’s not Your will for me to be in running, shut the doors.’ Probably a month later, I just sensed that I needed to be back out there. For different reasons. Not so much for myself, but this time for helping others. There’s so much knowledge and experience that you can share with others that can help them in some way. That’s the bigger picture. Kristin: This was a major change? Rosa: Oh yes. Before, I was focused on myself. I didn’t talk to people. It was ‘isolate myself and get focussed and get prepared.’ Now I try to be more open. If it’s just a ‘hi’, if it’s just a smile, if it’s just a pat on the back, if it’s just sharing an experience or knowledge about running– if it motivates and encourages other people– then I feel like it’s a good thing. Kristin: How is your outlook different? Rosa: This time around, after my injuries, running isn’t everything. Running is not more important than my family. If something comes up with my family, I’ll drop everything with running and do whatever I need to do for family. God is number one one in my life. My faith in God, my trust in God, that’s my desire. To go out and do what I do– the running, the training, the teaching– to help others. That’s my focus now. Kristin: Who’s coaching you now? Rosa: Jeff Johnson (of the Farm Team) did the workouts for the [Olympic] Trials; I’ve felt like I have benefited tremendously from it. I believe in his program. The women on the Farm Team have also helped me tremendously. I just really feel blessed to be there and have the opportunity to train with some very talented women Kristin: How did you train for the Trials? Rosa: I was putting in 90-100 mile weeks every week. I was weight-lifting, swimming 2-3 times a week, and doing spin-bike 2-3 times a week. I felt that I got so strong doing that. At 20 miles [into a marathon], when things feel like they’re shutting down, and the legs are getting tired and fatigued, I can still hold on because of the strength that I have in my legs. A big part of this is the cross-training. Kristin: Tell us about the Olympic Trials. Rosa: I felt confident more than ever before in any other Trials. I felt like I had a good chance of making the team. I went for it. And I was 16th place. I was frustrated and disappointed at the time. But now that it’s over and I can reflect and look back, I’m just very thankful. I’ve had my struggles with running, and just to be healthy and strong and to go into that race feeling like I was in the best shape of my life– what more could I ask? It didn’t come out the way I wanted it to, but that’s the challenge of the marathon. I’ll just try again. I’m tired of hearing people say, ‘You’re getting up there; you’re getting older.’ As long as I’m healthy and having fun and the desire is there, I’m going to continue to pursue it. Kristin: So 2004 is on the agenda? Rosa: Definitely. I feel like I haven’t given the marathon the chance to see what I could really do. So I’m going to focus more. This last year I’ve run marathons every 3-4 months. I did Twin Cities in the fall [2:41], the Trials [in February], and I’m going to do Grandma’s next month. I’m just going to try to do more and get more experience. With more experience, I will know what to do when something comes up– when |
this is hurting or this is not quite right– and I’ll be able to make the adjustments that I need to make. Kristin: What’s your training like now? Rosa: For this marathon, I’m only running once a day. I’m trying to get the mileage on my interval days. Twice a week I do the intervals. I’m trying to do a long warm-up and a long cool-down; basically, getting anywhere from 18-20 miles on those interval days. I feel like this is going to better prepare me for the marathon. When you get out 20 miles for the marathon and you’re tired and fatigued, that’s the same feeling I get when doing a hard workout and then going out for another hour to run. Kristin: How do you balance it all, with training and working full-time? Rosa: It’s very difficult. During the intense times when I’m focussed on training and racing, it’s pretty much teaching and training and going to church, and that’s about it. Sometimes I do get really, really tired; I get exhausted working with kids. So I make adjustments along the way. I think that that’s where the change has been; normally I would just keep going, going, going. This time around, I’m really sensing my body. Kristin: Have you made many sacrifices? Rosa: Yes, I think that in the beginning I sacrificed a lot. In the past, I didn’t do a lot of things with my family because I felt like it would affect my training and racing and performance. Also, there are some young people that I could have helped through coaching that I didn’t because of running. I’ve spent a lot of time with training. Kristin: Do you regret that at all? Rosa: No, I don’t, because this is the time of life, right now, when I’m focussing on that. That doesn’t mean that I’m going to do it the rest of my life. When I was taking time away from running, I was able to help others and that was a wonderful experience; I’m not doing that as much because of the commitment that running is taking even now. But I believe that there is a time and a place that is for running and a time and place for those other things. Right now, I just sense that this is the time [for running]. Kristin: What advice do you want to share with the young women in B-FIT? Rosa: To listen to your body. If you’re feeling tired, to take a day off. To not get caught up in the miles, in a routine and schedule. To be flexible with training. You’re the only one who really knows deep down what is right and what is wrong; listen to that. Kristin: What else? Rosa: Sometimes, when you’re training and racing and doing everything, it seems like you have to do it [all] on your own. But there are people out there who can help you. The Runner’s Factory, for instance; they help me with shoes and clothing and things. If you look for it and you sell yourself, there are opportunities out there. I think too, just to keep your dreams alive with running. To never give up, to continue to pursue it as long as you’re having fun and as long as that desire is there. Not only will you benefit, but you will allow others to benefit from it as well through sharing and through your experiences. Sometimes it’s just your presence that blesses others. Kristin: What’s the future looking like? Rosa: I’m 36 years old and my PR’s are from ‘92, and, for some of the shorter stuff, clear back from ‘81 and ‘82. But I’m looking and seeing good things. I’m looking to run better times. I know that in the Trials I was in the best shape of my life. I’m excited because I don’t know what to expect. If you had asked me a couple years ago: ‘Where are you going to be in two years?’ I would have said, ‘Well, maybe running, but I don’t know how seriously.’ If you would have said: ‘Do you think you’ll run the Trials in 2000?’ I couldn’t have given you an answer. If you had asked me: ‘Do you think you’ll be in the best shape of your life?’ I would have said ‘I don’t think so.’ And yet it all happened. I’m here. I would encourage you, if you love running and desire to continue, never give up. Your days ahead may be your best. Keep the faith. |
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 Book
Notes
Stick Figure by Lori Gottlieb Stick Figure
is a compilation of the diaries of 11-year old Lori Gottlieb as she travels
in and out of anorexia nervosa. In the voice of a precocious adolescent,
Lori Gottlieb recounts the most genuine and insightful account of anorexia
that I have read.
The last time I went to Dr. Katz’s office, he showed me pictures of all these bony-looking women that had the words, “Anorexic, Female” written underneath. I guess Dr. Katz figured that the pictures would scare me into eating, because he kept looking at my face to see if I was getting grossed out. But when I told him how neat it was that humans actually do have two separate bones in the bottoms of our legs, even though it looks like only one, he just blew all this air out of his mouth and said my brain wasn’t working right because I’m so malnourished…That’s when I looked below my knees, and this time I actually saw those two separate bones in the bottom of each leg. I couldn’t believe it!…And then I felt great, because I figured that Dr. Gold might be right about something for once in his life. I mean, maybe I really am an “excellent case.” Stick Figure is a charming, funny, compassionate book that you will enjoy reading. At the same time, it is a shrewd and telling narrative that you will teach you about the interconnectedness of the human mind and body. |
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guinea pigs for
a day
By Katrina Mogielnicki
Kristin and I decided to find out what it was like to be guinea pigs by participating in a study on gastric acid here at Stanford. We know firsthand the difficulties of recruiting participants for a study, and we also know that our participants are taking up their valuable time to help us out with B-FIT. Joining this study seemed like “killing two birds with one stone.” We would learn what our B-FIT participants felt like to have their bodies used to advance humankind, and we would also do our part to help advance scientific research at Stanford. The study turned out to be quite an experience!I was in a grumpy mood when we arrived at the research center on the first morning of the testing since we had not been allowed to eat since midnight the night before. The laughter of the two very cheerful and bouncy nurses who took our vital signs was kind of infectious though, and before long both Kristin and I were relaxed and ready to become guinea pigs for the day. Or so we thought. Once we had gotten settled into our adjacent hospital beds, the nurses places IV lines in our arms and gave us each a milligram of Adivan, an anti-panic drug. Dr. Passaro, the study director, came in and began to explain the process that was to take place. He was very fond of diagrams, and furiously scribbled different parts of the anatomy on a piece of paper as Kristin and I tried to follow his explanation. As a table of cups, pumps, and long probey-looking tubes was wheeled into the room, I looked over at Kristin, wondering if she was feeling the effects of the anti-panic drug yet. If my heartbeat and sweaty palms were any indication, the Adivan had yet to take its effect on me.
Dr. Passaro was testing a new method of measuring the level of gastric (stomach) acid in patients. The currently accepted method involves taking a sample of liquid from a person's stomach; this is an awful, invasive procedure involving a tube down the throat and into the stomach. Dr. Passaro had found a way to test stomach acid by having his patients eat some quinine and then drawing their blood. If there was gastric acid present, the quinine would show up in the blood sample. If there was no gastric acid, the quinine would not. Taking blood from a patient was much easier and less invasive than putting a tube down his or her throat, and if his method worked, many less people would have to have such a procedure done. Kristin and I were glad to be helping out. However, in order to prove his theory and have a successful study, Dr. Passaro needed to take a blood sample and a stomach sample from his study participants.
The first stage of the study was easy. We had to eat some quinine, (in delicious chocolate pudding of course,) and the jolly nurses took blood samples from us every fifteen minutes. However, the second stage of the study was not so simple. In order to sample our stomach fluid, Kristin and I each had to insert nasal-gastric tubes into our own stomachs. Yes, the name says it all; the tubes went down our throats via our noses! Unlike some people, I wasn't one of those who had lost various objects, (peas, erasers, kernels of corn,) up my nose as a wee child. In fact, I don't think I have even experienced that often joked about phenomenon of milk coming out of my nostrils when laughing. Truth be told, I very rarely consider the fact that my nose is actually connected to my throat. But here we were confronted with the harsh reality that the connection is there, and we needed to find it.
Dr. Passaro gave us each a really long Q-tip and a little bottle of gel. We dipped the Q-tips into the gel and started probing around in the backs of our noses. The sensation was like nothing I have ever felt before. The purpose of the gel was to numb the (quite sensitive!) nerves in the back of the nose, and Kristin and I were nice and liberal about applying it; there was goo all over. Finally, after about ten minutes of steady probing, Kristin hit the jackpot when she found the promised hole in the back of her nose that lead down into her throat. The smiling nurses went over to her bedside. Kristin said she could feel the NG tube tickling at the back of her throat. As I sat there still poking around, (now in both nostrils), Kristin was instructed to take a deep breath and start swallowing water through a straw at the same time that she fed the two-foot long NG tube down her esophagus and into her stomach. It didn't look fun at all. It's one thing to swallow something all at once; however, it is completely different to get half of something into your stomach while its other half is coming out your nose. I was impressed with Kristin's courage. The task completed, she sat on the bed looking sort of shocked and trying to get used to the feeling of the tube resting against the back of her throat.
Just as I was about to notify the nurses and Dr. Passaro that I was sorry but I was lacking that tiny hole in the back of my nose, I felt the small NG tube slide down into the back of my throat. I coughed and nodded, and the nurses came over to my bedside. I can only describe the process that ensued as one that was quite uncomfortable and that thoroughly rejected the way Mother Nature intended. Thank goodness for the Adivan, which by now we knew was also a gag reflex suppressor. After swallowing the NG tube, I too sat there stunned and woozy. It was difficult to take a deep breath without triggering the desire to choke the tube back into the room. But the worst was definitely over. Now all we had to do was relax for the next two hours as the nurses drew our blood and samples from the depths of our stomachs at fifteen minute intervals. The nurses applauded our guts and, as a sort of congratulatory gift, gave us each another milligram of Adivan. This time I felt the effects of the drug almost immediately. It was time for a nap.
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Amanda Gerhardt, Olympic Marathon Trials qualifier (2:49:35), brought this recipe back to us from her recent travels in Italy. This recipe was given to her by the chef at La Frateria di Padre Eliaio. Recipe direct from Italy: Tomato Risotto
Ingredients:
320 g. Riso Carnaroli ("superfino")
4 T. tomato sauce (made with garlic,
basil, olive oil, and tomatoes)
vegetable broth (made with water, celery, carrot, and onions)Directions:
In a pan, put two spoonfuls of butter and add the rice, stirring quickly for 2-3 minutes. Add 1/2 a glass of white wine, and when it's completely evaporated, add the tomato sauce and stir. Add the broth (boiling) a little bit at a time. Give it about 15 minutes cooking time, starting from the moment you add the tomato sauce. Once the rice is ready (you'd better taste it once in a while) add one spoonful of butter and parmigiano cheese and, if you like, some chopped basil, and serve. Serves 4.
With Love, Walter and the staff of La Frateria di Padre EliaioFor NCAA championship results, click here www.ncaachampionship.com
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