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  • Monday, March 31, 2014

    Footcare for Backpackers, Part 1: An Interview with AAPSM President, Paul Langer

    By far, the most read post on this blog is my article on hiking shoes vs. boots, so I wanted to revisit the topic with an expert’s advice. I contacted Paul Langer, president of the American Academy of Podiatric Sports Medicine and D.P.M. at one of the largest orthopedic groups in the country, Twin Cities Orthopedics in Minnesota. Paul was more than happy to answer all of my questions and those asked by fellow hikers on the WhiteBlaze.net forums.

    Part one will focus on footwear for backpackers and part two will be on foot care and maintenance on the trail, although there will be some overlap. I started my questions with the subject of my previous article, shoes vs. boots.

    RG: Possibly the most common footwear debate among hikers is trail runners vs. hiking boots. I prefer, and often recommend to thru-hikers, trail runners with a sturdy wide sole over boots. What are your thoughts? Do you see advantages or disadvantages to either? 
    PL: Footwear and comfort are highly personal and subjective topics - not just for hiking and sports, but also for daily living. As background, I worked in running shoe stores when I was a podiatry student and I couldn’t understand why people would have such different experiences with the shoes I showed them in terms of comfort.
      "...shoes are like quarterbacks. They get too much credit when things are good and too much blame when things are bad."

      -Paul Langer
    Research on comfort seems to show that our footwear preferences are influenced by our movement patterns and sensitivity, among other things, which are highly unique person to person. Our bodies are programmed to move in the manner that uses the least amount of energy and causes the least amount of discomfort or pain. No one moves in the exact same way. Our movement pattern is as unique as our signature.
    If a shoe works with our movement pattern then it will feel more comfortable. If it works against our movement pattern then it will feel uncomfortable or at least less comfortable than a "better" shoe.
    There is also a hierarchy in comfort factors. For example, some people feel that cushioning is of primary importance and arch support or weight are less so. Others might place higher priority on weight and firmer feel. Neither is wrong. In working with athletes and non-athletes, I have learned that unless there is a very specific injury or source of chronic pain that can be addressed by a specific shoe, insole, or shoe modification, I encourage them to trust their instincts on what shoes have the fit and feel that they prefer for the given activity.
    Most hikers know their body and feet well and know their preferences. I always respect personal footwear preferences and then try to offer the simplest changes to address pain or injuries as needed. 
    Out of the gate, and I'm rightfully put in my place. Although, it seems to be the conventional wisdom that hikers need boots, so I've noticed new backpackers gravitating toward them by default. Often, because of a belief that a high-collar will offer better ankle support. That seems to make sense, but in practice I don't find them to be very effective. Would ankle wraps do more to protect someone prone to ankle injuries than high-collared footwear? 
    Yes. Ankle wraps - especially lace-up or Velcro ones are able to provide better ankle protection than high-collared boots.

    What footwear do you prefer on the trail?

    Can high collars on boots actually cause injuries by restricting ankle movement and put more stress on hips and knees? 
    If a boot were too restrictive at the ankle it would likely cause discomfort there before affecting the hip or knee.
    Is there any truth to the idea that high-collar boots hinder the development of the support structures inside the ankle?
    I've never seen a study that showed high-collared boots inhibit balance or ankle strength long term. In fact, there are no studies that show ankle braces cause this either. Maybe if a person wore their high-collar boots all day, every day, they might have issues, but I would argue that a person who hikes regularly in high-collar boots probably has better balance and strength than a sedentary person who wears flat shoes all day. 
    Alright, I admit I may be trying to reinforce my opinion that trail runners are far superior, but I have one final question about ankle support. A hiker going by the name Trailweaver on WhiteBlaze.net, asks, "I'm now recovered from a severe fracture of the tibia-fibula, but now that ankle swells so much that it's impossible to wear boots (with ankle support) which I always wore before. How do I best protect myself from twisted ankles in low cut shoes? And what should I do about the swelling when I'm hiking?
    Unfortunately, after many ankle fractures people develop arthritis. Her swelling is related to the arthritis. I would recommend wearing a compression stocking or adjustable ankle brace that is comfortable. No one can predict how much compression or ankle support is ideal for any given person, so she would need to experiment with different levels of ankle support and find what works for her. She should also be very diligent about doing ankle balance and strength exercises to minimize her risk of re-injury. (Click here to download an exercise sheet provided by Paul that covers foot and ankle exercises)
    On a long hike, minimizing swelling early is important because once it starts it can be hard to reduce. On the trail, taking advantage of cold streams can help. Elevating the foot when resting is beneficial as well.
      "I look at footwear as tools and I select the best tool for the given conditions of the trail and how my feet or legs feel."

      -Paul Langer
    How are knee and hip pain related to improper footwear and how can we prevent some of these issues down the trail? 
    The term "improper footwear" is a controversial one. There is no formal definition and many philosophies on the term. For those with knee or hip pain, I would focus on those joints and then functional movement patterns and core strength, which are more likely contributing to pain than shoes. I've said often, especially in relation to knee, hip, and leg injuries, that shoes are like quarterbacks. They get too much credit when things are good and too much blame when things are bad. 
    It's common practice for long-distance hikers to purchase shoes that are one size larger than you need to accommodate the foot growth that happens on a long-distance hike. Is that good advice to follow? Is this perceived foot growth due to bones growing, arches collapsing, soft tissue swelling, or something else?
    There is evidence that cultures who go barefoot or wear only sandals have wider and longer feet in relation to body size, but for thru-hikers it would be unlikely that their feet could grow or expand while wearing footwear that minimizes expansion of bones/joints/soft tissue.
    Any perceived change in foot size would be most likely due to soft tissue edema (swelling). If this happens then it would be expected that the feet would return to previous size within a few days or weeks of completing the hike. I haven’t actually seen any research specifically on thru-hikers and foot size, but it would be interesting if we had some data.
    I do recommend fitting the boots bigger to accommodate swelling, but not too big. One to 1.5 sizes bigger than street shoes should suffice for most people. In general, I recommend that the boot be snug in the heel and mid-foot to minimize pistoning of the heel and forward slipping on downhills. The boot should allow for wiggle room in the toes to accommodate the swelling.  So basically, the boot should be snug in the back two-thirds.   
    HeartFire from WhiteBlaze has a question about insoles. "Do rigid insoles shift your posture or spine?" She said that within 100 miles of switching to rigid Superfeet insoles, she experienced knee pain, shoulder pain, and back pain. When she got rid of them, the problems went away. 

    For me personally, Superfeet worked great. I started my first long distance hike with minimalist shoes and regretted it after about 400 miles ($1000 x-ray and emergency room visit). On doctor's orders, I switched to a stiffer shoe with rigid Superfeet insoles and my feet improved significantly after only a couple weeks. Are softer insoles better than rigid or is it as subjective as “proper” footwear? 
    This a very big topic and source of confusion, not just in hiking, but in sports medicine in general. What I always keep in mind, as I mentioned above, is that individual movement patterns are highly unique. In addition, people do not respond in systematic ways to biomechanical interventions. What this means is that prescribing insoles or orthotics (or footwear for that matter) is not like prescribing antibiotics, for example. I can prescribe the same antibiotic to 10 people and expect consistent results in their infection with small variations in side effects. But I can prescribe an insole or orthotic for, let’s say, 10 people with plantar fasciitis and similar foot types and I might get 10 different responses in terms of comfort, pain relief or potential side effects. I explain this to every patient who I speak to about shoes, insoles or orthotics.
    My general approach is to do as little as possible to negatively affect their preferred movement pattern, but the problem is that we do not know how a given person will respond, ever. There has been much research done on this topic, which shows that approximately 70% of people respond positively to insoles and orthotics. We do not understand why and the reasons would probably be different person to person anyway.
    Benno Nigg, PhD, one of the foremost footwear researchers has said that there is probably an ideal amount of cushioning for each of us in terms of footwear. We just don’t yet know how to determine what that might be. I rarely recommend cushioned insoles for most foot conditions except for older patients who have lost the natural fat pad on the bottom of the foot. For athletes and hikers, semi-rigid insoles like Powerstep, Superfeet and others are better at distributing foot pressure, supporting the arch and being durable enough to hold up.
    Many backpackers are switching to minimalist footwear. As a barefoot runner and someone injured on the trail due to minimalist footwear, I’d like to know your opinion on this topic. Is it good or bad for the foot? Are there pros and cons? 
    This is a huge topic. I'll preface this by saying that I run in Vibram FiveFingers, New Balance Minimus, Merrel Trail Gloves, and other minimalist footwear, but I also wear conventional shoes and occasionally insoles and orthotics. I look at footwear as tools and I select the best tool for the given conditions of the trail and how my feet or legs feel. I run more than I hike and I'm lucky enough to live along the Mississippi River, so have miles of grass and parkland right outside my front door. 
    I love my VFF's for grass runs of up to 8 miles. I probably could condition myself to go longer than that in them but don’t feel the need. For long runs or speed workouts, I use my conventional shoes because I tend to get a bit more beat up. On rocky surfaces or if I'm sore from the previous day's workout, I will also use a more structured shoe or my insoles/orthotics. I spent three years transitioning to VFF's and at one point used them for 50% of my mileage. 
    Okay, enough about me. I have treated many athletes who have hurt themselves trying barefoot or minimalist shoes. What I find, as far as mistakes made with minimalist shoes, is that people assume that the impact forces of running or hiking magically disappear. They do not - they are merely redistributed. So while knee and hip loading may be decreased, the loads on the calf muscles, Achilles tendons, and metatarsals (long skinny bones of the foot) are increased. This is a big change for most of us who have been using conventional shoes for all of our lives. 
    Anyone who is interested in trying them needs to do so gradually, listen to their body's feedback and never ignore pain. I give my patients exercises to do to increase strength and flexibility of the calf and Achilles prior to starting (download Paul's exercise pamphlet here). Personally, on very rocky terrain and especially with a pack on my back, I would not likely use my minimalist shoes. I would never say nobody should backpack in minimalist shoes, but I would strongly emphasize a very smart, safe and gradual build up to it - likely over the course of many months or years. 
    One more question about minimalist footwear and I'll move on to the topic of foot maintenance and care on the trail. A minimalist footwear hiker named Meriadoc, from WhiteBlaze.net, has a question about zero drop shoes. "Why are some manufacturers going with a 4 to 5 mm drop in their minimalist shoes?"

    He also asks, "When I go on the trail if I push too hard my Achilles starts to ache with a dull pain that gradually increases until it forces me to stop. Why would this happen? Shouldn't my Achilles already be at the full length from walking and hiking in zero drop shoes every day? Is it similar to overuse injuries in the knee tendons?"
    The pre-activation and loading of the calf muscles and Achilles tendon complex is higher in shoes with zero drop. Higher heel heights decrease this load. Because we have been using elevated heel design shoes for decades, our bodies need to adapt to the altered load. I don’t know how old Meriadoc is, but if he is over 35 then he is already prone to Achilles tendonopathy because of age related changes to the tendons. He should be doing the eccentric calf muscle exercises I mention above to improve strength and elasticity of the tendon and maybe until he resolves the issue stick to shoes with 4-10 mm of heel elevation. How long should it take to adapt to zero drop? No one can answer that question. It would be highly unique to each individual.
    In part two, Paul will answer our questions about how to take care of our feet on the trail, and the causes and solutions to many common foot issues. 

    Related article:
    Footcare for Backpackers, Part 2
    Should I Buy Hiking Shoes or Boots?

    Paul R. Langer, DPM (paullangerdpm.com) is a board certified podiatrist who specializes in sports medicine, foot disorders, biomechanics, surgery and diabetic foot care. He has lectured at and served on the medical staff of international athletic events including the Boston Marathon and China’s Gobi March. He is a clinical advisor for the American Running Association, and an associate of the American College of Foot and Ankle Surgeons. He is the author of Great Feet for Life: Footcare and Footwear for Healthy Aging and has been featured in the following publications:

    Athletic Footwear and Orthoses in Sports Medicine
    The Big Doctors Book of Home Remedies
    Breakthroughs in Drug-Free Healing
    Barefoot Running Step by Step

    Education: Dr. Langer received his podiatric education at Des Moines University and completed two years of residency and surgical training at the Veterans Affairs Medical Center.

    Hospital Affiliations: Fairview Ridges Hospital Fairview Southdale Hospital Minnesota Valley Surgery Center University of Minnesota Medical Center - Fairview

    Professional Affiliations and Memberships: American Academy of Podiatric Sports Medicine, President Foot & Ankle Quarterly, Board Member

    Special Achievements and Awards: Top Doctor: Voted a top doctor by his peers in Minneapolis/St. Paul magazine (2006 - 2010)

    Monday, March 17, 2014

    Grocery Shopping with a Thru-hiker, Part 2

    A Thru-Hiker Shopping List

    In part one, I wrote about the features of the best backpacking foods (calorie dense, easy to prepare, nutritious, non-perishable, appetizing, inexpensive, and versatile). Below are common items on my resupply shopping list that take all of that into account with more nutrition advice from New Orleans Saints sports dietitian, Tavis Piattoly.

    Obviously, taste is too subjective to tell you specifically what to buy, so my goal instead is to give you new things to consider when buying food. It's inevitable that I will miss something, so please share your own suggestions in the comments below.

    Olive Oil
    Oil is all fat, so it's the most calorie dense thing you can pack (about 242 calories per ounce). By adding olive oil to pasta, potatoes, rice, beans, etc, you can increase all of their calorie density. Instant potatoes, for example, have about 111 calories per ounce, but has 176 if you mix in two tablespoons of olive oil.
    That brings up an important point: If you need 6,000 calories per day, and your meals average 110 calories per ounce (the average number of calories in freeze-dried pasta meals and instant potatoes), you'd need 3.5 pounds of food per day. If you instead carry meals that average 150 calories per ounce, you will reduce your food weight by 1 pound for every day's worth of food in your pack.
    There are lots of oils to choose from, but olive oil has a nice buttery flavor, it's easy to find in resupply towns, and it's cheap (as low as US$0.99 per 1,000 calories), which brings up another important point: If you want to do a long distance hike on a budget, think of the cost of food per calorie, not the shelf price or the price per meal.
    Another benefit to olive oil is that it's nearly 75% monounsaturated fatty acids, which is a healthy dietary fat. It also contains Omega-3 Fatty Acids, which help reduce joint and muscle inflammation.
    One more thing, even if you can find the small plastic bottles of olive oil, I found that an empty soda bottle works better to prevent leaking. 
    Instant Potatoes
    Instant mashed potatoes taste good and cook quickly, but nutritionally they're not great. Their glycemic index (GI) is higher than table sugar. I put them high on this list, however, to talk about blood sugar spikes from consuming a high GI diet.
    In the morning, and during the day while hiking, high GI foods will provide you with an immediate source of energy, but pair that with fats, protein, and fiber: 
    "Adding fat or protein to any high glycemic carbohydrate source will blunt the spike in blood sugar," says Tavis Piattoly, MS, RD, LDN and Sports Dietitian and Nutrition Consultant for the New Orleans Saints. "I wouldn't recommend high GI foods while you are resting (before bed or during any period of inactivity) as your blood sugar could drop quickly and a hiker could experience fatigue. It would be best to have a meal mixed with protein, carbs, and fat to keep blood sugar in check." 
    For example, when eating a high GI food like instant potatoes, mix in olive oil and bacon bits to add fat and protein to help blunt the spike in blood sugar. Add a side like peanut butter on whole-wheat bread or tortilla for additional fiber, fat, and protein.
    Nuts
    Some of the best backpacking foods are nuts and seeds. Macadamia Nuts and Pecans pack about 200 calories per ounce. Most other nuts average about 185 and peanuts have about 150 calories per ounce (Peanuts are higher in protein, however, and considerably cheaper). Nuts are also versatile, since most are great mixed with oatmeal, trail mixes, or eaten plain.
    My favorite are walnuts. They offer a good balance of calories and protein per ounce. They are not the best in those categories, but a good average in both. What really makes them my top choice are their high levels of Omega-3 fatty acids, which can reduce muscle and joint inflammation. No other nut has more.
    Peanuts are my second choice for cost, taste, and protein per ounce, but eating a variety of nuts and seeds is always a better choice.
    Here is a comparison of commonly available nuts in a variety of categories:
    Nut Calories / oz Protein / oz Cost / 1000 cal. Omega-3
    Walnuts1894.72$2.99 2.50 g
    Macadamia Nuts  2132.02$3.940
    Peanuts152 6.07 $1.460
    Almonds172
    6.07
    $1.830
    Pecans2002.83$2.880.29 g
    Cashews1625.06$2.450
    Mixed Nuts172 6.07$1.95-

    Peanut Butter

    My favorite backpacking food is peanut butter. It has a lot of calories per ounce (about 169), it keeps for a very long time, and it is one of the cheapest foods per calorie (as low as 88¢ per 1,000). It's also a great substitute for meat protein, which can be limited on the trail.
    Perhaps the best thing about it as a backpacking food is its versatility. Slather some on a tortilla, bread, or crackers, make a peanut butter sauce for pasta (see recipes in part 3), add it to oatmeal to increase protein in your breakfast, or just eat a big spoonful with any meal or snack for extra fat, protein, and calories.
    It’s tempting to buy powdered peanut butter (like PB2) to save weight, but it has almost 40% fewer calories per ounce, so it's actually heavier. It also costs nearly twice as much, is less nutritious, and in my opinion tastes absolutely terrible. It should be ashamed to call itself peanut butter. 
    Tortillas, Breads and Crackers
    Unlike bread or crackers, whole wheat tortillas can take a lot of abuse when stowed in a backpack. Per calorie, however, tortillas cost about twice as much. Cheaper bread alternatives that can take more abuse are bagels, pita bread, and English muffins. (Campfire English muffin pizzas are amazing on the trail, by the way, more on that in part 3.)
    If you want more calories per ounce, consider whole wheat Ritz crackers with your peanut butter, tuna, meats, or cheeses. They have twice as much as bread and tortillas. 
    Always go with whole wheat when possible to get all the fiber you can get:
    "I typically recommend trying to get 10 g [of fiber] for every 1000 calories consumed," said Tavis. "The importance and benefits for a hiker would be to help regulate blood sugar and keep you full longer. The more stable your blood sugar and insulin levels are, the more energy you should have throughout the day. A more stable carbohydrate [from whole grains] will be better utilized as an energy source and keep you more full during a long day of activity." 
    Whole Wheat Pasta
    It’s tempting to go with cheap ramen noodles or Knorr Pasta Sides (and sometimes I still do), but with regular whole wheat pasta you can improve your diet without adding to your food budget. Unlike ramen noodles and many prepackaged pasta meals, whole wheat pasta is high in fiber and protein, it has a lower glycemic index, and it has no saturated fat. Diets high in saturated fat can lead to sluggishness and inflammation.
    Whole Wheat Pasta is also versatile and, with only slightly more effort, you can make some meals every bit as good as a freeze-dried Mountain House meal, which will weigh less per calorie and at a fraction of the cost. 
    Save fuel by purchasing thinner pastas, like angel hair pasta or mini rotini, which cook much faster (al dente in about 4-7 minutes, 30-50% faster than regular spaghetti). Also, cooking it al dente, so it's still firm when bitten, has the added benefit of slowing digestion, which levels out the spike in blood sugar and makes you feel fuller longer.
    My last pasta tip, you don't need a giant pot of boiling water to cook pasta. This of course wastes fuel and would be impractical in a small backpacker cook pot. Instead, fill your pot with enough water to cover the pasta and stir regularly, especially in the first minute or two when the sticky starches are at a high concentration on the surface of the pasta. Your pasta will cook just as well as if you had a large pot of boiling water and without clumping. After the pasta is finished boiling, save that starchy water to use in sauces to make them thicker and creamier.
    Cheeses
    Unlike soft cheeses, hard block cheeses like Parmesan and Romano do not need to be refrigerated. They can last for several days if sealed and if temperatures do not exceed 85°F. 
    Other reasons to carry Parmesan is that it has 11 g of protein per ounce. That's more than nuts, peanut butter, powdered milk, and non-dehydrated meats. It can be added to prepackaged pasta dishes or used with whole wheat pasta and olive oil to make Parmesan Noodles.
    Softer cheeses, when individually sealed, can keep for a few days if it isn't too hot. String cheese, in particular, packs well. On a warm day, keep cheese in the center of your pack to keep it cool. 
    Mac and Cheese
    Skip the box of Kraft Macaroni and cheese and make it from scratch using versatile ingredients that can be used in multiple ways. Just cook your pasta, add powdered whole milk, olive oil, and melt in shredded cheese or block cheese that has been shredded or cut into tiny pieces. 
    Another reason I suggest versatile ingredients such as these, is because the more ways you use them the larger quantities you can buy, which will save you money on a long distance hike. 
     Oatmeal
    Oatmeal also has a high glycemic index and instant oatmeal, although convenient, is loaded with additional sugar. Plain rolled oats are often less expensive per calorie and can be prepared in a number of healthier ways.
    Reduce the overall glycemic index of the meal by adding nuts, peanut butter, whey protein, and/or powdered milk. You can also add a little olive oil or butter (if it's cold enough to carry butter) to increase the calories and improve flavor. Oatmeal can also be mixed with dried fruit or cocoa mixes such as Nestle or Ovaltine. It's great with a freshly chopped apple or fresh picked berries too.
    In the photo of my oatmeal above, I added walnuts, peanut butter, blueberries,and protein powder for a 1,000 calorie breakfast with about 30g of protein 80g of carbs, and 35g of fat. 
     Dried Fruit
    Dried fruit is not calorie dense, but a variety of dried fruit will prevent some vitamin deficiencies on your thru-hike. Not only are they a convenient quick snack, but many dried fruits are great in oatmeal, trail mixes, and when used to sweeten certain rice and pasta dishes.
    Tart cherries are particularly excellent on the trail, because they have been shown to reduce joint and muscle inflammation. 
    Powdered Whole Milk
    You can find powdered whole milk in the Hispanic section in most grocery stores, usually the Nestle Nido brand. Whole milk has 50% more calories (151 per ounce) than powdered skim milk and is usually a little bit cheaper per calorie. 
    Another reason many people, including myself, prefer whole milk is that it's creamier and tastes better in recipes, but both are a great way to add calories and protein to coffee, hot cocoa, oatmeal, and many other meals.
    Cocoa drink mixes
    Ovaltine with powdered milk will mix well hot or cold, which is why I stopped taking hot cocoa mix on the trail. It also tastes better to me than hot cocoa mix and is fortified with vitamins and minerals. It can also be added to oatmeal, coffee, or used in other trail recipes.
    Instant Coffee or Cider
    Definitely not a necessity, but when it's cold I like to have hot beverages in my pack. It can do a lot for morale at the end of a long cold day. 
    For more protein and calories, mix instant coffee with cocoa and powdered milk to make a trail mocha. Add a little sugar to that, drink it cold, and it tastes similar to a Frappachino from Starbucks. 
    Cereal
    Breakfast cereals with powdered whole milk are like dehydrated foods that don’t require a stove, which is great when going stoveless or when you're unable or unwilling to cook. They are usually fortified with vitamins and minerals that hikers may become deficient in without taking a multi-vitamin.
    The major drawback to cereals on the trail is they take up a lot of space in your pack. Many cereals also have a high glycemic index, so look for ones that are high in fiber and protein, such as Kashi Go Lean Cereal or shredded wheat. Dried or freshly picked fruit is a great addition.
    Some cereals are also great in trail mixes and oatmeal. Cinnamon Toast Crunch, although not a healthy option, makes nearly all trail mixes better. Actually, it makes life better in general. Cereal is my comfort food.
    Candy Bars
    Candy bars are a cheap and convenient snack to carry and I'm always in the mood for them. Energy bars are generally higher in protein and lower in saturated fat, but they are 2-4 times more expensive and not as calorie dense. And I personally don't like the taste of most energy bars. Anyway, there are much cheaper ways to get that protein you need.
    I'm a big fan of Snickers bars, but possibly the best candy bar for backpacking is Payday. It's about the same cost per calorie and has about the same calories per ounce as Snickers (134 calories per ounce), but Paydays have nearly 60% more protein and half as much saturated fat. They also don't melt on a hot day.
    Peanut Butter M&Ms are also popular on the trail for their high calorie content (150 cals/oz.). They are lower in protein than Payday, however, and nearly three times as high in saturated fat. They are great in trail mixes though.
    Foil pouch of Chicken, Tuna, and Salmon
    Salmon and Tuna costs about $21.00 per 1000 calories. What salmon and tuna do provide, however, is protein and omega-3 fatty acids.
    Tuna is a decent protein source (7g/oz), but foil pouches of chicken have just as much at half the price ($10.20 per 1000 calories). 
    All of these only have about 30 calories per ounce, so I rarely buy more than one or two pouches on a resupply. Of course, if you have the time and it's legal in your area, fishing makes the weight and cost of fish irrelevant. 
     Dehydrated and pre-cooked meats
    Beef Jerky is more calorie and protein dense than tuna or chicken, with about 81 calories and 14 grams of protein per ounce. The price is comparable too, at $12.48 per 1000 calories or more.
    Pepperoni is one of my favorite trail-suitable meat sources, due to its higher calorie density (132 calories/oz.) and its versatility. It's good on crackers, tortillas, trail pizzas, or eaten plain. It's also the cheapest meat suitable for the trail, if you buy a pound unsliced it can be as low as $2.63 per 1000 calories if you order it from Walmart.com. (I'll be testing out using Walmart.com for a few mail drops on the PCT, I'll let you know how that works out in a future post.) Grocery store pepperoni runs more like $4.60 per 1,000 calories, so still the cheapest meat on my list.
    Another great meat option on the trail is pre-cooked bacon or bacon bits. They're great in instant mashed potatoes, salads, sandwiches, wraps, mac and cheese, and other pasta dishes. The "Fully-cooked" bacon has 126 calories per ounce and "real" bacon bits have 101, but bacon bits are half the price per ounce, at about $7.30 per 1000 calories.
    If you like the taste, foil packs of Spam have 101 calories/oz., 12 g of protein/oz., and cost about $7.73 per 1,000 calories.
    Lentils and other beans
    Lentils are not lightweight calories, at only 33 calories per ounce, but they make my list for a lot of reasons. They are the cheapest source of calories, protein, and fiber (as low as 26¢ per 1,000 calories).
    They are 1/5th the cost per gram of protein of the next cheapest protein source on my list, whey protein powder. They are not a complete protein, however, but if eaten with whole grains you can create a more complete protein dish. 
    Other than being one of the best sources of fiber on this list, lentils are also full of many things thru-hikers may lack in their normal diet, such as, iron, folate, vitamin B1, and several essential amino acids.
    Cook time can be reduced by soaking them in a zip-loc bag of water a few hours before cooking, but I haven't found this to be necessary unless I'm trying to conserve fuel. I tend to eat them al dente to reduce cook time as well.
    Whey Protein
    It may seem expensive, and it is per calorie, but it's one of the cheapest, most versatile, and most convenient protein sources you can buy. It has over 24 grams of protein per ounce. Nothing else on my list even comes close. It's great in protein shakes, oatmeal, cereal, or hot cocoa.
    Fruits and Vegetables 
    A lot of produce, although heavy calories, will pack out well: potatoes, sweet potatoes, broccoli, onions, cucumbers, squash, garlic, apples, avocados, hot peppers, carrots, and celery, for example. Also, consider picking up a bag of complete ready-made salad for your first night's dinner after a resupply. Keep produce in the center of your pack where it is coolest. 
    Pastries
    Little Debbie snacks, honey buns, pop-tarts, and donuts may not be the healthiest food choices, but they can be cheap (pop-tarts as low as 88¢ per 1000 calories). They also require no time to prepare and are an excellent comfort food. I've said it before, but don't underestimate the power of comfort foods to improve morale on a long-distance hike. 
    And I'll repeat myself again, pair high GI foods like these with foods that are high in unsaturated fat, dietary fiber, and protein to blunt the blood-sugar spike. If you're going to eat them, have them with breakfast or during a mid-day snack break for their immediate source of energy, but not before bed or during periods of inactivity so you can avoid the subsequent drop in blood sugar.
    Spices and sauce packets
    Soy Sauce, hot sauce, mustard, honey, sugar, salt, pepper, and other restaurant condiment packets are a great way to improve recipes without carrying large quantities. I pick up a few when I'm eating in restaurants in town. You can also purchase single use sized portions of spices in many grocery stores. 
    Drink Mixes/Electrolyte replacement
    Drink mixes with electrolytes are vital when getting this much physical activity, especially on a hot summer day climbing up mountains. Drink mixes will also make creek or lake water taste better, which helps ensure you'll drink enough. Electrolyte replacement is important enough to consider it part of your first aid kit.

    Once again, thanks to Tavis Piattoly for helping me get some of my facts straight in this article. In an upcoming post, I'll use this list in a sample daily meal plan including recipes from the authors of the best-selling backpacking cookbook, "Lip Smackin' Backpacking." Please send me an email with your own recipes, comments, or suggestions, or leave them in the comments below.

    Thanks for reading

    -RG

    Related Articles:
    Nutrition for Thru-hikers: An Interview with Sports Dietitian, Tavis Piattoly
    Cooking Supplies and How to Make an Alcohol Stove
    Grocery Shopping with a Thru-Hiker, Part One
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    Tavis Piattoly, MS, RD, LDN is the Sports Dietitian and Nutrition Consultant for the New Orleans Saints, New Orleans Hornets, and the Tulane University Athletic Department where he coordinates nutritional assessments, provides nutrition education, and develops individual meal plans for athletes to improve their health, performance, and recovery. In addition, he consults for numerous high schools athletic programs throughout the state of Louisiana. Futhermore, Tavis worked closely with Roy Jones Jr. and Bernard Hopkins to help them retain their boxing titles and has been working with Lance Berkman since 2011.

    He is also the co-founder and Director of Sports Nutrition education for My Sports Dietitian (www.mysportsd.com), an online sports nutrition education company to help High School and College Athletes improve their eating habits to enhance performance, recovery, and health through the guidance of a Licensed Sports Dietitian.

    Tavis obtained a Master’s of Science Degree in Exercise Physiology from Louisiana State University and a Bachelors of Science Degree in Nutrition and Dietetics from Louisiana State University. He is a registered and licensed Dietitian/Nutritionist. In addition, he serves on the Louisiana High School Athletic Association Sports Medicine Advisory Board.