Sunday, February 20, 2011

Healthy Eating 101

I.   Introduction
II.  Each meal should consist of complex carbohydrates, lean protein, healthy fats, and a fruit/vegetable.
     2.1 - Carbohydrate Digestion
     2.2 - Simple vs. Complex Carbohydrates
     2.3 - Protein
     2.4 - Healthy Fats 
III. Eat smaller, more frequent, high-protein portions (every 3 hours)
IV. Drink at least 64-128 oz. of water
V.  Caloric intake to lose weight 
VI. Bibliography

Key words: healthy, healthy eating, healthy weight, healthy weight loss, eating healthy, eat healthy, healthy eating plans, build muscle, high protein, high carb, low carb, healthy weight loss, healthy snacks, healthy living, how many calories, calories per day, calorie calculator, calorie counter, calorie counting, glycemic index, get abs

I.  Introduction
I receive many questions regarding day-to-day eating habits for losing fat and building muscle.  So I decided to write a short blog on some of the basics.  But then it turned into a long blog (Sorry!)…Some (or all) of this may be repetitive to some of you, so I apologize for that.  But for those who are trying to start a new healthy life and don't know where to begin, this is for you!

Here are the rules:
II.  Each meal should consist of complex carbohydrates, lean protein, healthy fats, and a fruit/vegetable.  

   2.1 - Carb Digestion (ACSM, 2007)
When carbs are digested, they are converted into glucose, and absorbed into the bloodstream.  This induces a rise in blood-glucose levels and initiates the release of insulin into the blood.  Insulin allows glucose to be converted into glycogen for stored energy in the liver and in muscles.  However, when muscles and the liver are full of glycogen, remaining blood-glucose is converted to fat and stored.  Therefore, you should be avoiding frequent, large spikes in blood-glucose throughout the day.  

The use of glycogen as energy also spares muscle protein from being used as energy.

   2.2 - Simple vs. Complex Carbohydrates (ACSM, 2007)
Simple carbohydrates are made up of one or two sugar units (saccharides or disaccharides).  Because of their simple structure, they are quickly converted into glucose and absorbed into the bloodstream, resulting in large, rapid spikes in blood glucose and insulin.  High levels of blood glucose and insulin can lead to a variety of health issues, including excess fat storage.

Complex carbohydrates (polysaccharides) are made up of at least three sugar units.  Because of their complex structures, they require a longer period of time for digestion and conversion into glucose.  Therefore, they increase blood-glucose levels more slowly, avoid large insulin spikes, and storage of excess glycogen as fat.

With the use of the glycemic index, you can easily differentiate between carbs that increase blood-glucose levels quickly or slowly.  Carbs are compared with the ingestion of glucose, which has a glycemic value of 100.  Therefore, carbs that cause quick rises in blood-glucose have a high-glycemic index, whereas, carbs that cause slow rises in blood-glucose have a low-glycemic index.  

Common foods with a high-glycemic index (GI ≥ 70) are:

Baked potato - 85
Sugar - 70
White Bread – 70
White Rice – 75
Corn - 70
Cooked carrots – 85
Bagels – 72
Honey - 85

Common foods with medium-glycemic index (56 ≤ GI ≤ 69):

Oatmeal - 58
Raisins - 64

Common foods witih low-glycemic index (GI ≤ 55):

Orange juice - 50
Black Beans, cooked - 20
Banana, ripe - 52
Apple – 38
Grapes - 46
Sweet Potato - 50
Peach - 30
Brown rice - 50
Cherries - 22
Kidney, navy beans – 40
Stone Ground Whole Wheat – 53
Whole wheat pasta – 50
Rye bread – 40
Pumpernickel bread - 40
English muffin, whole grain - 45
Split peas – 22
Yams - 37
Chickpeas - 28
Lentils, boiled - 30
Raw Carrots - 30
Broccoli - 10
Spinach - 10
Cabbage - 10
Lettuce - 10
Mushrooms - 10
Peanuts - 15
Walnuts - 15

For your carbohydrate choice, stick to complex carbohydrates, such as whole grains, fruits and vegetables, that are have a medium to low-glycemic index.  There are plenty of options, no excuses!

   2.3 – Protein
Proteins are complex compounds made of various amino acids and play many roles in the body, such as (ACSM, 2000; Manore and Thompson, 2000): 

1.  Tissue and enzyme synthesis
2.  Hormone production
3.  Energy
4.  Growth and Tissue Maintenance
5.  Balance of fluid between the blood and surrounding tissues

Sources for high-quality lean protein include:

1.  Chicken Breast
2.  Turkey Breast
3.  Wild Caught Fish (Sockeye Salmon, Cod, Orange Roughy, Haddock, etc.)
5.  Canned Fish (Salmon, Tuna)
6.  Egg whites
8.  Free-range whole eggs
7.  Lean Beef

   2.4 - Healthy Fats
Polyunsaturated fatty acids play a role in lowering cholesterol in the blood. The most popular examples of polyunsaturated fatty acids are linolenic acid (omega-3), linoleic acid (omega-6), and oleic acid (omega-9).  Since the human body cannot synthesize omega-3 and omega-6 fatty acids, they are considered "essential" and can only be obtained through one's diet.  Omega-9 fatty acids are synthesized in the body, but only in limited amounts.  Therefore, a diet with omega-9 fatty acids is also necessary.  These fatty acids play a vital role in supporting MANY systems in the body, such as the immune (Calder, 1999), nervous (Alessandri et al., 2004) and cardiovascular system (Richard et al., 2009). Omega-3 deficiencies have been linked to increased LDL (bad) cholesterol levels, excessive inflammatory factors throughout the body, hypertension, depression and Alzheimer’s Disease (Alessandri et al., 2004; Calder, 1999; Richard et al., 2009).

Monounsaturated fats also lower "bad" (LDL) cholesterol while maintaining "good" (HDL) cholesterol levels (Spiller et al., 1992). 

Good sources of these fats are:
1.  Olive oil
2.  Coconut oil (saturated fat from coconuts is GOOD FOR YOU!)
2.  Flaxseed oil
3.  Flaxseeds
4.  Walnuts
5.  Salmon
6.  Almonds
7.  Brazil nuts
III.  Eat smaller, more frequent, high-protein portions (every 3 hours)

The research on this section is pretty interesting.  A common rule of thumb is that just by eating smaller portions, you can increase your metabolism and lose more weight.  However, once you look into the research, this isn’t the case.  In fact, a very recent review paper on this subject discusses this very issue.  While there are lower peaks in perceived appetite, satiety, glucose, and insulin with greater meal frequency, the total values of these parameters throughout remain unchanged (Leidy and Campbell, 2011).  So simply eating smaller, more frequent meals is not enough.  The type of foods in these meals is of the utmost importance.  Additionally, high-protein meals facilitate fat loss and weight maintenance more effectively than high-carbohydrate meals (Claessens et al., 2009; Clifton et al., 2009).  So to reiterate, each meal should consist of lean protein, complex carbohydrates, healthy fats, and a fruit/vegetable, and should be eaten every 3-4 hours.  This allows you to take advantage of the lowered peaks in perceived appetite, satiety, glucose, and insulin throughout the day while earning the weight loss and health benefits of these eating habits.
IV. Drink at least 64-128 oz. of water

One of the major roles of water in the body is to carry nutrients to cells and carry waste away from cells.  All of our lean tissue consists of 70% water.  However, we constantly lose water through breathing, urination, bowel movements, sweating, and even through the skin when there is no sign of sweat (ACSM, 2000; Williams, 2002).  Therefore, it is very important for you, especially athletes and active individuals, to replenish these fluids throughout the day.  Some benefits of being hydrated during exercise include (Manore and Thompson, 2000):

1.  Less dramatic increase in heart rate or core body temperature
2.  Improved skin blood flow
3.  Reduction in net muscle glycogen use --> more endurance

Here are a couple of other tips (ACSM, 2000; Horswill, 1998):
1.  Don't use thirst as a signal to drink water - this signal occurs after 1-2 liters of fluid in the body has already been lost.

2.  Spread it out throughout the day - drinking large volumes in a short period of time can cause gastrointestinal distress and affect exercise performance
V. Caloric intake to lose weight

First, it is important to know that everyone's caloric requirements are different!  Factors such as genetics, age, gender, and weight all play a role in an individual’s requirements.  So, just because your girlfriend lost weight on some X-calorie diet does not mean it will work for you.  You need to know how know how many calories your body needs to maintain your current body weight.  One of the most common methods for finding this value is the use of the Basal Metabolic Rate (BMR) formula.  

An individual's BMR represents the amount of energy expended by the body in one day if you didn't move at all.  For fat loss and maintaining a lean body, you’d like your BMR to be as high as possible.  Here's the formula:

Women: BMR = 655 + ( 4.35 x weight in pounds ) + ( 4.7 x height in inches ) - ( 4.7 x age in years )

: BMR = 66 + ( 6.23 x weight in pounds ) + ( 12.7 x height in inches ) - ( 6.8 x age in years )

BMR calculators can also be found online with a simple search.

Then, your BMR can be used in the Harris-Benedict equation to determine your daily energy expenditure in calories (Harris and Benedict, 1919).  In this equation: 

If you do little or no exercise: BMR x 1.2
If you are lightly active (light exercise 1-3 days/week): BMR x 1.375
If you are moderatetely active (moderate exercise 3-5 days/week): BMR x 1.55
If you are very active (hard exercise 6-7 days a week): BMR x 1.72
If you are extra active (very hard exercise & physical job or training twice a day) : BMR x 1.9

The result of this equation will give you the number of calories your body needs to maintain your current body weight.  If you want to lose fat, reduce this value by 500-1000 calories.  For those with only a small amount of fat to lose, your caloric deficit should be closer to 500 calories.  Extreme caloric deficits are NOT the way to go!  Starvation and extreme caloric deficits can lower your BMR.  The American College of Sports Medicine recommends that daily caloric intake should be no lower than 1200 calories in women and 1800 calories in men.  However, this doesn’t mean you should be aiming for this low values.

Dr. O 
"I don't live to eat...I eat to live!"

ACSM. 2000. Position statement: nutrition and athletic performance. Med Sci Sports Exerc 32(12):2130-2145.
ACSM. 2007. ACSM's Resources for the Personal Trainer. Baltimore, MD: D. Mark Robertson.
Alessandri J-M, Guesnet P, Vancassel S, Astrog P, Denis I, Langelier B, Aid S, Poumes-Ballihaut C, Champeil-Potokar G, Lavialle M. 2004. Polyunsaturated fatty acids in the central nervous system: evolution of concepts and nutritional implications throughout life. Reprod Nutr Dev 44:509-538.
Calder PC. 1999. Dietary Fatty Acids and the Immune System. Lipids 34:S137-S140.
Claessens M, van Baak MA, Monsheimer S, Saris WHM. 2009. The effect of a low-fat, high-protein or high-carbohydrate ad libitum diet on weight loss maintenance and metabolic risk factors. Intr J Obesity 33:296-304.
Clifton PM, Bastiaans K, Keogh JB. 2009. High protein diets decrease total and abdominal fat and improve CVD risk profile in overweight and obese men and women with elevated triacylglycerol. Nutr Metab Cardio Dis 19(8):548-554.
Harris JA, Benedict FG. 1919. A biometric study of basal metabolism in man. Washington, DC: Carnegie Institute of Washington, Publication no 279.
Horswill CA. 1998. Effective fluid replacement. Int J Sports Nutr 8:175-195.
Leidy HJ, Campbell WW. 2011. The Effect of Eating Frequency on Appetite Control and Food Intake: Brief Synopsis of Controled Feeding Studies. Nutrition 141(1):154-157.
Manore M, Thompson J. 2000. Sports Nutrition for Health and Performance. Champaign, IL: Human Kinetics.
Richard D, Bausero P, Schneider C, Visioli F. 2009. Polyunsaturated fatty acids and cardiovascular disease. Cell Mol Life Sci 66:3277-3288.
Spiller GA, Jenkins DJ, Cragen LN, Gates JE, Bosello O, Berra K, Rudd C, Stevenson M, Superko R. 1992. Effect of diet high in monounsaturated fat from almonds on plasma cholesterol and lipoproteins. J Amer Col Nutr 11(2):126-130.
Williams MH. 2002. Nutrition for Health, Fitness & Sport. Boston, MA: McGraw-Hill.

Wednesday, February 9, 2011

Overtraining and Your Well Being

I.   Introduction
II.  The Immune System
         2.1 - Inflammatory Signaling Molecules
         2.2 - Natural Killer Cells
         2.3 - Neutrophils
         2.4 - Secretory Immune System
III.  Glutamine 
IV.  Cortisol
V.   Overtraining Symptoms
VI.   Overtraining Symptom Avoidance

Key words: amino acid benefits, antioxidant, arthritis, arthritis symptoms, glutamine benefits, joint pain, joint pain causes, knee pain, l-carnitine benefits, muscle growth, muscle recovery, overtraining, stress, stress relief

Exercise and weight training is a different form of stress that the body endures.  Every weight training or cardio session involving resistance causes injury to skeletal muscle fibers.  The injured muscle cells signal to the entire body that that some type of trauma has occurred.  Most of these responses are necessary for muscular development and fat loss.  However, if insufficient recovery time is given to muscles, these responses from the body may last much longer than necessary and cause more harm than good.  A large imbalance in exercise and recovery time is often referred to as overtraining syndrome.  In this blog, I’ll discuss some of the bodies’ reponses to overtraining and how that can negatively affect your work in the gym and your well-being.

P. S. - Please do not confuse overtraining with the normal soreness you get from good workout.  This blog is no excuse to start slacking off!!  I just want people to understand that there is such a thing as "too much working out".

Following skeletal muscle injury, various signaling molecules are released to orchestrate the cellular response to muscle injury.  Various growth factors attract satellite cells to the muscle injury site to facilitate the repair and growth of damaged muscle tissue and increase the size and number of proteins involved in muscle contraction. Molecules known as cytokines are also released to attract immune cells from the entire body to the injury site to remove cellular debris and heal the injured muscle cells.  These immune cells include macrophages, lymphocytes, neutrophils, and monocytes.  These cells continue to release cytokines (pro-inflammatory and anti-inflammatory) to attract other immune cells until the injury is healed. 

While this response is important for muscle growth, excessive exposure to pro-inflammatory cytokines by overtraining can result in muscle fatigue, loss in muscle protein, loss of muscle mass, and reduced muscle function (Reid and Li, 2001).  It can also induce a ‘whole-body response’, in which the brain induces sickness, vegetative, or recuperative behaviors, leading to mood and behavior changes that allow the body to get rid of the excess inflammatory factors (Smith, 2000).  Some of these behaviors include disinterest in exercise, reduced libido, arthritis, or a common cold (Smith, 2000). 

NK (natural killer) cells are a type of lymphocyte that play a major role in protecting the host (i.e. – you) from infections, by destroying infected or compromised host cells.  Many studies have characterized the changes in NK cell concentration following moderate to high-intensity exercise for short or long periods of time.  Following long periods of intense exercise, NK cell concentrations and cell activity decreased below normal levels, with the largest decrease being observed 2-4 hours after exercise (Mackinnon, 2000a; Mackinnon, 2000b).  Some high-intensity exercises included in these NK cell studies were:

1.  10-day interval running in military personnel (Fry et al., 1992).
2.  7 months of swimming training - 20-25 hrs/wk of pool training and 5 hrs/wk of training outside of the pool (Gleeson et al., 1995).
3.  4-wk intensified training in competitive swimmers (Gedge et al., 1997)

Neutrophils are another type of immune cell and acts as one of the first responders to an inflammation or injury in the body.  Like NK cells, many studies of investigated the effects of exercise on neutrophil activity.  And once again, these studies did show significant decreases in neutrophil concentrations following high-intensity exercise.  Here are some of the details from certain studies:

1.  The ability of neutrophils to engulf and remove bacteria (phagocytosis) was significantly lower among distance runners when comparing high-intensity training to moderate intensity training (Hack et al., 1994).

2.  Neutrophil activity, but not neutrophil number, was significantly decreased in swimmers in a 12-wk training program for a major competition (Pyne et al., 1995). 

These results show that intense exercise can not only reduce immune cell concentration, but also immune cell activity, resulting in greater overall vulnerability.

The secretory immune system in the upper respiratory tract is also affected by exercise and overtraining.  This system secretes a specific antibody, called Immunoglobulin A (IgA), which protects the respiratory tract from infection-causing pathogens.  However, several studies have linked decreases in IgA secretion with high-intensity exercise.  In a study by Mackinnon (1994), IgA secretion concentrations were compared between:
1.  Recreational joggers who ran on a treadmill for 40 min at 55% and 75% V 02 max, and
2.  Competitive distance runners who ran on a treadmill for 90 min at the same intensities.
(both considered 'moderate intensity', see HIIT blog for more info:

In both groups, IgA secretion concentrations did not significantly decrease after exercise.  However, runners that ran on a treadmill for 90 min at 75% VO2max on 3 consecutive days showed 20-50% decreases in IgA secretion after 3 days.  Post-exercise IgA levels on day 2 and 3 were also significantly lower than on day 1 (Mackinnon and Hooper, 1994). 

A separate study monitored IgA levels in elite swimmers over a 7-month period as they trained for the World Championship Trials.  Each week, the swimmers took part in 20-25 h of pool training and 5 h of training outside of the pool.  Control subjects were limited to a maximum of 4 h per week of moderate exercise.  The 7-month training resulted in a significant decrease in NK cell number and IgA levels (Gleeson et al., 1995).  This exercise-induced decrease in IgA level has also been proven to be a predictor for the development of upper respiratory tract infections (Mackinnon, 2000a).  

Glutamine is one of the most abundant amino acids in the body and is important for human metabolism (Smith, 2000).  Skeletal muscle produces the largest amount of glutamine, while the immune system, liver, kidneys and gastrointestinal tract require its use as fuel for its normal function.  Following intense exercise, glutamine is released from skeletal muscle tissue, resulting in low glutamine availability in plasma (Pedersen et al., 1998).  One theory is that due to the loss of glutamine following intense exercise, the immune system is unable to produce immune cells properly and efficiently, resulting in reduced immune function (Mackinnon, 2000a).  However, no studies have confirmed this theory.  While glutamine supplementation has been shown to maintain normal glutamine concentrations in plasma, it has not avoided the decrease in immune cell activity (Gleeson 2008).  However, one study has shown a reduced incidence of upper respiratory tract infection with glutamine supplementation in distance runners (Castell et al., 1996).  So, it is possible that the loss of glutamine after exercise may have an indirect effect on immune function.  However, the more likely reason for low glutamine availibilty is its role in maintaining blood glucose levels in the body.  Following muscle tissue injury, glutamine and other amino acids act as initiators of gluconeogenesis in the liver to produce new glucose for organs in the body (Smith, 2000).
The stress hormone, cortisol, also plays a role in maintaining blood glucose levels.  In response to exercise, cortisol is released from adrenal glands and promotes protein breakdown by inhibiting protein synthesis (catabolism).  This leads to the formation of amino acids (i.e. – glutamine and others) that are taken up by the liver and the subsequent stimulation of free fatty acids from adipose tissue for use as fuel (Brown, 2007).  Excessive cortisol can also make it more difficult to lose body fat (Epel et al., 2000).    

So what is the point of all of this, you ask?  Well, all of these reactions to exercise need time to run its course.  Without sufficient time off from exercise, these responses may become chronic and lead to overtraining syndrome.  As I touched on earlier, signs of overtraining include:
1.  High perceived stress
2.  Extreme muscle/joint pain
3.  Decreased performance in high intensity exercise
4.  Sickness
5.  Disinterest in exercise
6.  Reduced libido
7.  Arthritis
8.  Maintenance of body fat
Potential ways to reduce overtraining responses from the body include:
1.  REST!!  When you’re in the gym, hit it hard!  But, you need time to recover.

2.  Eating a diet full of vitamins and minerals; nutrients and antioxidants from a good diet will help to eliminate excess toxins in the body

3.  Vitamin C supplementation – if you aren’t getting enough Vitamin C in your diet, consider supplements to help bolster your immune system

4.  L-Carnitine supplementation – has been shown to improve muscle tissue repair by improving blood flow during and following exercise (no specific link to reducing cortisol levels; it basically minimize catabolism) (Kraemer et al., 2005).

4.  Listen to your body! – Now, don’t confuse overtraining with just some soreness from a good workout.  But if you’ve been working hard for 4-5 days and you’re really dragging or feeling some of the symptoms listed above, maybe a day off wouldn’t hurt.

5.  Try to keep stress levels low. Some methods may be yoga, meditation, deep tissue massage, etc.  But try to reduce stress in your life as much as possible.  Your body is dealing with more than enough stress with your exercise. 

Also, if you were recently sick, DO NOT work out again until your sickness is gone and you have regained your energy.  Then, ease yourself back into your workout routine on your first day back in the gym. 

Dr. O 
"I don't live to eat...I eat to live!"

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