Holiday weight gain? Read this.

Easter and Anzac has meant that, for many, it’s enough for more than just a mini-break. And who doesn’t love a holiday? A break away from early alarm clocks, work and household chores. When out of your own space you’re forced to leave behind the normal routines that are well established in everyday life, which is obviously why we come back feeling refreshed and ready to get back into it. The problem, though, is that many people panic about getting out of routine with their food and exercise – what if that 10 days in Fiji goes and undoes the last three months of hard work and they end up gaining weight?

Well, it won’t. Why?

1. You are a LOT more active on holiday compared to real life: driving to work and sitting in an office does not afford the same opportunity to be as active as sight-seeing does. I clocked up almost double the number of steps as I normally would when I was away. Even on days we didn’t run, relying on both public transport and my feet to see a city racked up enough steps so I was regularly doing 23,000 or more each day. However, if you’re a lounge-around-the-pool kind of vacationer, if you had a hit out in the hotel gym, you can avoid weight gain for a short term holiday in the face of a calorie excess.

2. You sleep more: lack of sleep will drive up insulin and cortisol levels and create a hormonal environment that is unfavourable for fat loss. Even if you have the perfect diet (if there is such a thing), no amount of calorie counting, carb watching, or protein eating will make up for the string of 5-6 hours a night you manage during the week when work, exercise and home duties take up so much time, you stay up later than you know you should just to enjoy a little time out.

3. You’re generally more relaxed. The everyday stress created by school pick-ups, work deadlines and weekend sport might be ‘normal’ life, but don’t underestimate the effect this can have on your ability to lose weight. While we may not know the underlying mechanisms, like the effects of sleep deprivation, a chronic overload of stress will increase hormones responsible for fat gain regardless of what you eat or how much exercise you do. In fact, for some, their normal stress relief of going for a run or doing an F45 class will only add to the stress bucket, further exacerbating a weight loss stall. And, when stressed, we often reach for food that is high in calories, low in nutrients.

What if it does?

If you were maintaining or losing weight prior to going away on holiday, then that tells me you’ve got the tools necessary to help you refocus on an eating style and exercise routine that will easily shed any fat gain that is the result of too many cocktails by the pool.

Actual fat gain will be quite minimal, and pretty easy to shift – potentially easier than what you were finding before your holiday. The additional calories eaten on holiday aren’t all stored as fat (at all!) We restock depleted glycogen, and for some, short term overfeeding  increases resting metabolic rate in response to increased food (as many of the overfeeding studies conducted under laboratory conditions have found). Even if you have a predisposition for weight gain, the amount of weight you can is usually far less than the excess calories eaten would predict.

However, for those panicking about the additional fat gain (if any):

1. Up the protein intake. This will help reduce any carb-related cravings from too many pancakes/baked goods/fat chips. Aim for foods that will provide 30g of protein per meal (as an example, a 150g beef steak has about 37g of protein, 3 large eggs around 24g of protein). This will help fill you up and regulate blood sugar, preventing any dip in energy that might be exacerbated by lack of sleep or jetlag. Combined with strategies listed below, it’s a recipe for fat loss.

2. Lay off the alcohol. I tend to drink a bit more wine and beer when on holiday. Despite that I don’t drink any more than 1-2 glasses, it is more than what I’d normally drink in ‘real life’. If you’re like me, then take a break for a week or two  – not a long time, but enough to help get over my post-holiday blues (alcohol is a depressant after all) and to ‘break the habit’ as it were.

3. Drop back the fat intake – if you’ve gained excess body fat, then we want your body to tap into this (potentially) accessible fuel source – this obviously requires a calorie deficit. There is no need to seek out ‘low fat’ foods or avoid foods that naturally contain fat (i.e. egg yolks), however reducing down the amount of added fat to meals (via sauces, dressings, cooking oils, nut butters etc) will help reduce the calorie content of your diet with minimal effort.

4. Drop back the carbohydrate intake – some people benefit from doing a 21 day low (er than normal) carbohydrate diet. I know what you’re thinking – if I drop the fat AND the carbs, what do I eat? I’m talking short-term here – you base your meals around protein and titrate fat and carbohydrate according to that. If you know you feel better with a bit of carbohydrate in your diet, that’s no issue – just make it good quality (i.e. kumara, potato) and make it a moderate serving. However, ample amounts of even low sugar carbohydrate (like rice, pasta, bread etc) will make it more difficult to shift.

5. Include plenty of vegetables – base your meals around these. The prebiotic fibre can help improve the gut environment after a week or more of too much fried foods (though that cheese hoagie was delicious) and too much alcohol. Splashing raw apple cider vinegar (ACV) on steamed vegetables ups the taste factor and helps reduce post-prandial (post-meal) blood sugar, making you less likely to search for something sweet. In addition, you can go for gold on most non-starchy vegetables, so fill your plate to help fill you up.

6. Lift weights. Heavy ones. If you don’t have access to a gym then even body weight exercises (such as press-ups, squats, lunges) if not doing them, will create stress to help you build muscle. I’m not suggesting you avoid lacing up for your long run – I’m a long-distance runner after all! –  resistance training, though, is metabolically demanding in the short term, and in the long term will preserve your resting metabolic rate to allow you to burn fat in everyday life. Plus, you’ll improve strength. Bonus.

7. Consider fasting. Be it the 5:2 protocol that I utilise in my fat-loss plans, a 16:8 protocol that is popular (i.e. fast from 8pm to 12pm the next day, or Super-fasting as per the Schofield/Zinn protocol outlined in What the Fast, it’s consistently found to improve metabolic health markers and can reduce calorie intake to elicit a fat-loss response. Note: I’m not talking about some excessive ‘not going to eat till Friday’ type fast. But shorten that eating window.

8. Get plenty of sleep – try to get back into a 7-8h per night habit with this one and be disciplined about it, for reasons I outlined above.

And, finally (and most importantly), does it matter? I mean, does it truly matter that you come back from an awesome time away with a couple of additional kilograms? Part of the beauty of a holiday is leaving behind all of the routines of your day to day life, including exercise and your normal foods for breakfast, lunch and dinner. Many of us need a mental break almost as much as a physical one, and this includes a break from your usual diet and exercise regime. You will come back feeling refreshed and ready to embrace these with renewed energy (or being in a mindset of change for the better, if that is more appropriate).

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LCHF and IF for the female endurance athlete (IMHO).

Following on from the couple of blogs I wrote about Dan’s LCHF athlete lifestyle, I got a lot of messages from women regarding my opinion of it for the female endurance athlete. Great question, especially as – if you look at social media – there are nutritionists who warn against the danger of LCHF (and intermittent fasting) for women, to the point that the blanket statement is that it is harmful and not to be undertaken. Whilst it is hard to be objective in the nutrition space – all of us influenced to some degree by our own experiences – the low carbohydrate and fasting space seems to bring with it its own special degree of hysteria. The prevailing message is that both low carbohydrate diets and fasting is too stressful on the endocrine system of females (which regulates hormones) and causes a reduction in metabolism and reproductive potential. Thus, it is to be avoided at all costs. This point of view may be drawn from clinical experience of the practitioner and be dependent on the type of client they see. If their target audience are women who have struggled with maintaining a healthy weight and have problems with eating enough, then the opinion of the practitioner could well be influenced by this (and is entirely sensible!) Likewise, I see many women who’s hormones benefit from periods of intermittent fasting while utilising a LCHF protocol. What we see in clinic will dictate our points of view, regardless of how objective we try to be.

I have in the past written about the negative impact of fasting and calorie restriction on the expression of genes that regulate kisspeptin in the body, a hormone involved in our reproductive cycle. However I will point out that the effects seen in studies conducted in rodents may be more dramatic than if they were carried out as clinical trials in humans. Rodents have a much faster metabolism, thus a 24h fast for a mouse is equivalent to a 3 day fast in humans. Likewise, chronic caloric restriction over a week, where the mice lose close to a quarter of their body weight (and which is thought to be responsible for the downregulation of the kisspeptin receptors that result in negative effects) may be equivalent to 12 or more weeks. Rodent models in science are great for illustrating potential mechanisms, but can never be viewed as hard data as it pertains to humans.

Alongside any scientific data that exists, I think it’s important to step back and consider perspective here. What we should all be aware of is that there is no one right dietary approach for everyone, and often there is no one dietary approach to suit someone for the rest of their lives. As things change, so do our nutritional requirements. Low carbohydrate diet and intermittent fasting is not exempt from this – therefore to say that it is not suitable for any woman is, quite frankly, erroneous and misrepresents what we see in the literature and what we see clinically. While certainly a vast majority of the studies investigating lower carbohydrate diets have been conducted in males, there are studies showing a positive impact for overweight women with infertility. Further, it is accepted best practice to include periods of low glycogen availability in the training schedules of athletes. Even in the researchers who err on the side of pro-carbohydrate diets recommend cycling carbohydrate intake to be sometimes low, and sometimes high, to upregulate fat oxidation pathways that allow the athlete to become more efficient at burning fat. To state that no female athlete should start an exercise session in a fasted state goes against current best practice for endurance performance.

Possibly the negative impacts of fasting and low carbohdyrate diets are not about the fasting period or the carbohydrate content – it’s much more likely to represent chronic underfuelling – i.e. a lack of calories over an extended period of time, with no thought given to cycling of both energy intake and/or macronutrients. It’s just low, full stop. That’s why it is important to work with an experienced sports nutrition practitioner (like me, Kaytee Boyd, Caryn Zinn as some top picks) to ensure these training tactics are used to the advantage of the athlete in a training cycle, not to the detriment of them.

Don’t misread this as a recommendation to do all sessions in a fasted state, to undergo an intermittent fasting protocol that involves skipping breakfast every day of the week, or that everyone should adhere to a very low carbohydrate approach. If you’ve read any of my information (or followed anything I’ve suggested) then you’ll know this isn’t the case. The point of this blog is to remember that there is no one right dietary approach for everyone, and that if you’re successfully adhering to a lower carbohydrate diet with periods of intermittent fasting and feel it’s working well for you (ie no sleep, hormone, training or recovery problems), don’t be concerned with the rhetoric that exists regarding the harmful nature of this. You are your own best investigator when it comes to your nutrition, and your experience is the most important data when it comes to you.

Intermittent fasting

Post on IF, cue picture of empty plate with clock. #standard (PC http://www.stack.com)

The Plews on racing LCHF

Last week I detailed Kona Ironman age-group champion Dan Plews’ daily and training nutrition using a LCHF approach. How does this change in the lead up to an event, and what does he do on race day?

Like conventional sports nutrition principles, there is somewhat of a carbohydrate loading phase pre-race. This isn’t the 500-600g of carbohydrate that is recommended for most athletes in the three days before (which generally leaves an athlete feeling lethargic and bloated), however it is more than he would generally eat. Don’t forget that tapering for a race is, in effect, carbo loading, as the muscle glycogen stores are not depleted during training and it allows them the chance to be replenished and not in the deficit they normally are. Based on Rowlands paper which showed that a higher fat diet with a preload of carbohydrates, he’s dialled in his approach that Dan now feels works really well for him. He lifts his carbohydrate intake from the 80-100g he typically eats in the days prior. On the Wednesday (for a Saturday race), he will include additional potato or sweet potato in his evening meal, taking him to ~125g carbs per day. This increases to ~175g per day on Thursday and Friday (the two days before the race) – including fruit alongside the potato or sweet potato. In addition, he makes sure snacks etc on hand are low carbohydrate so  not to be caught out during the lead up period with having to rely on the petrol station or four square options. If you do have to rely on these, and are looking for lower carbohydrate, then biltong, cheese snacks, even lower carbohydrate protein bars can be good stop gaps. On race morning before Dan’s Kona race he opted for was porridge: oats with a bit of Super Starch added, which is a slow release carbohydrate to not inhibit fat burning, and is a higher molecular weight carbohydrate, so it is easier to digest.

During the race:

Despite research studies in this area using a ‘train low glycogen, race low glycogen’ model to determine the efficacy of a LCHF approach for sports performance, in practice Dan follows what practitioners advocate: a ‘train low, race high’ model. Ideally, the train low approach has enabled you to increase your efficiency to burn fat as a fuel source in addition to using carbohydrate that you have stored or take on board, thus maximising the amount of fuel you have available. Dan takes in around 50g carbohydrate per hour;  because he is very efficient at burning fat, he doesn’t need as much carbohydrate as he would otherwise. A real benefit of this is that it minimises the likelihood of gut issues many endurance athletes experience during a long event – the more carbohydrate fuel you have to take on board, the more opportunity there is to get the dose wrong. Importantly though, the more fatigued you become, the more your body will divert blood supply away from the gut to the muscles, and thus impacting on your ability to digest the fuel.  During Kona Dan used energy blocks with gels on the bike, and a couple of gels with some swigs of sports drink or coke during the run. His paper Different Horses on the Same Courses outlines how to take this individualistic approach to fuelling, as will his online course that you can sign up to by clicking here.

Finally, post-race, Dan gets back on board the LCHF approach fairly swiftly, as he has seen the impact that a higher carbohydrate fuelling day has on his blood glucose level across the course of the following week. It certainly doesn’t reduce down to normal levels the day after, and it’s likely that inflammation and muscle damage impacts on this too. Your best bet is to (as soon as possible) get back to your LCHF diet and help your recovery process.

LCHF for the top end:

Whilst LCHF is increasingly more accepted in the endurance space as part of the approach, what about at that top end – does it limit performance there? There is very little quality research on this, however Dan’s research group found that there was no detriment to perform high intensity intervals (as I blogged about here), but the jury is definitely out on this point and I wonder if, like many things, it is individual. A person’s ability to metabolise fat as a fuel source and use it at a higher intensity is trainable for sure (that’s what fat adaptation is all about), but there could be individuals who are less able to produce ketones to be used for energy – this is speculation though on my part. Yes, there is a down regulation in pyruvate dehydrogenase which helps turn stored carbohydrate into glucose for energy, however the importance of this is questionable given the increased availability of fat for fuel, and there may be other enzymes upregulated to counteract this change in the fuel use. A potential way around this issue (and to ensure glucose metabolism is continued on your LCHF approach) is to do higher intensity efforts in training that force liver to convert glycogen to glucose – thus keeping glucose oxidation pathways high. I’m also beginning to recommend that people take on a small amount of glucose pre-high intensity sessions if they are beginning the fat adaptation phase during a training cycle that incorporates higher intensity efforts. Ideally your fat adaptation phase will occur during base training when we can keep intensity low. But that isn’t always possible. Fifteen-20g glucose prior to training for these high intensity sessions can keep output high but is unlikely to be enough to “ruin” your adaptation process. Again, there is no research behind these numbers, but from a practice perspective I’ve seen this work well.

Finally, you know I’m an advocate of ketones to help support training whilst lower carbohydrate, and it certainly has helped me and many of my clients. We don’t at this point know enough about ketone utilisation in the body and whether taking exogenous ketones downregulates the body’s ability to produce them. This is an emerging field we are looking at with interest with regards to dosage, timing, type of ketone supplement etc. There has been decades of research into carbohydrate as a performance enhancer, and we can probably expect that it will take a few years of research for these questions to be answered in the science research space. Trying them yourself is likely the best approach to see how they impact your own performance (and I can help you with that).

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Plews at Kona (PC http://www.trizone.com.au)

LCHF and the athlete: The Plews approach

Sfuels, a ketogenic fuel for endurance athletes recently had Dan Plews host a Facebook live event regarding his LCHF training and daily diet. Now those of you have listened to our Fitter Radio podcast will know Dan from the Plews and Prof segment. He’s an exercise physiologist who last year was the overall age group winner at Kona World Championships in a record time of 8:24. He’s been working in exercise physiology for the last 15 years and has a number of research papers both related to this, and in the ketogenic diet space (for athletes), one of which I posted about last year. Because I love Dan’s work (and this area in general) I wanted to outline for you what he spoke about in the Facebook live for those people, athlete or otherwise, that are interested. This week, due to length, I’ll cover the normal diet, and next week I’ll outline his pre-race and race-day strategy.

As a bit of background, Dan has been doing triathlon forever, however came into LCHF when he was at the Olympics as an exercise physiologist and came across work by Tim Noakes (who has heralded the latest Banting movement in South Africa). From 2012 he made a decision to give it a crack. Even now, though, six years after embarking on LCHF training and nutrition, Dan notes that adaptations are still occurring, and puts his incremental improvements in performance in the Ironman distance finishing times (in hours:minutes) being: 9:22, 9:11, 9:12, 8:54, 8:35 and 8.24 Kona 2018) down to not only the consistency of training , but the consistency of the dietary approach.

What is important in LCHF and endurance training? The end goal for performance is to conserve as much energy as possible – fuel availability is the limiting factor over such a long distance. We can’t store too much carbohydrate – around 2000 Calories compared to 40000 Calories of fat that is stored in even the leanest individuals. The problem, though, is that people can’t access their fat stores to exercise at a high intensity. Or even, for many endurance athletes, at a lower intensity (where we should be able to burn fat). The type of diet we eat influences our fuel preference when we exercise, and the modern diet (where carbohydrate is the predominant available nutrient) makes athletes much more reliant on carbohydrate which – like kindling on a fire – is likely to run out quickly.  We want to be metabolically flexible, that is, to burn more fat as a fuel source and only use carbohydrate when we really need it. Dan has tested his fuel utilisation in a laboratory and can burn fat at 1.3g/minute (the FASTER study reported around 1.6g/minute) – most people are around 0.6g/minute or thereabouts. However research such as that done by Volek and colleagues have shown it is possible to shift that if you go LCHF. From the testing that Dan has done, he knows that at his race intensity on the bike, an average 260 watts, his fuel utilisation is around 66% from fat stores. This allows him to preserve a lot of carbohydrate when working at this race pace intensity.

Ideally, that preservation of carbohydrate stores to use at the back end of a race when energy availability is limited should be the aim of the endurance athlete (and is extremely challenging if they are burning predominantly carbohydrate from the start). In addition, the lower LCHF diet means having lower blood glucose levels on a day-to-day basis,  important for overall health and body composition goals too. Higher sugars equals higher insulin, which is a nutrient delivery hormone – therefore there is more opportunity for fatty acids in the blood stream being stored in our fat tissue. Don’t go thinking we want rock bottom insulin levels all of the time, as insulin itself is critical for life! However ideally our levels would be low outside of the time period around meals, as elevated insulin is linked to a number of metabolic disease processes. In addition, when following a LCHF approach, we have lower stores of carbohydrate, which makes us more sensitive to the signalling for fat adaptation and upregulating of fat oxidation pathways.

So… the details?

Dan’s diet on a day-to-day basis:

  • Coffee with cream, collagen and MCT (medium chain triglyceride, our body can’t store this and is an easily used energy source)
  • SFuel bar (low carb snack)
  • Training – doesn’t eat during training, but if he does it may be a SFuel drink (MCT/branched chain amino acid (BCAA) drink mixed with some other compounds, but it is a higher fat option)
  • Breakfast is eggs, avocado, some vegetables
  • Lunch is tuna salad or similar. During heavier training load, he may add a bit of paleo bread (around 20g carbohydrate, similar to normal bread but this is made of better quality ingredients)
  • Dinner is salad with a steak
  • Snacks may be macadamias, almonds and pickles.
  • Fruit may come into it from time to time, particularly as the training load and intensity ramps up.

While not ketogenic in way that he eats, he will still likely be in ketosis during the day – by virtue of training and his normal diet is low carbohydrate – it’s around 80g – 100g carbs per day, thus naturally depleting his stored carbohydrate (glycogen). Ketogenesis is a is a physiological state, not a diet, thus it’s less important to stick rigidly to foods labelled as ketogenic and to think more globally about it. My athlete plan  is based around these dietary principles, and there are likely some nuances for the female athlete, but this general approach works well for most people I work with. It could be important for a carbohydrate refeed 1-2x per fortnight if following a very low carbohydrate diet, and that’s something I recommend to my athletes on the basis that hormonal responses will be favourable. This isn’t something I’ve seen a lot in the literature, but based more on clinical experience (and may be more important for the leaner athlete).

As I mentioned, I’ll cover off the race day side of things next week. However, if you’re keen to know more about what Dan recommends, then definitely check out his new site – he’s developing an online course that details specifics for coach and athlete alike, and is releasing it soon!

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Kona 2018. (PC: oxygenaddict.com)

Another reason to love coffee…

Love your coffee? Here’s another reason to pour yourself a cup. A recently published study should the consumption of a dark roasted coffee brew (500ml) daily for one month resulted in a 23 percent reduction in DNA damage to white blood cells compared to baseline levels. The protective feature of coffee is thought to be the polyphenols that are found in coffee. These bioactive ingredients (such as caffeic acid, catechol, hydroxyhydroquinone, trigonelline and the alkylpyridinium compounds) have been studied for their antioxidant and anti-inflammatory properties. They are able to mop up reactive oxidative stress (ROS) molecules that are the byproduct of metabolism. Obviously a small amount of ROS is necessary, however too much can overwhelm our anti-inflammatory and antioxidant system, causing increased inflammation and the reduction in the ability for these pathways to function, causing DNA damage.

DNA damage accelerates ageing and is the underlying cause of the growth of carcinogenic cells in the body. It leads to telomere shortening – telomeres are like small caps on the end of your DNA chromosomes, protecting them from damage, and are used as a biomarker for ageing. The study was a randomised controlled trial; therefore, it is able to establish causation (unlike a lot of nutrition research, which is largely observational in nature).It is consistent with other studies that show a reduction in DNA damage after even short term exposure (such as this study, where healthy volunteers showed a reduction in damage after only 2h of drinking coffee). The current research was conducted in both healthy men and women, and the 500ml of coffee per day equated to around 372mg caffeine daily – equal to around four cups of espresso. That sounds like a lot of coffee (and it is!) however this is consistent with other observational and clinical trial research that has shown a reduction in cardiovascular disease risk, cancer incidence and all-cause mortality for people who habitually consume around 4-5 cups of coffee per day. This latest study adds to a body of knowledge regarding the health benefits of coffee. The polyphenols mentioned above help protect us from type 2 diabetes, stroke and cardiovascular disease, with improvements being seen in glucose and insulin metabolism (important for blood sugar control), blood pressure and markers of inflammation in the body.

I’ve talked before on the health benefits we see in coffee, and though this is great news for coffee drinkers, let’s not forget there is a fairly substantial proportion of people who are sensitive to the caffeine in the coffee and can’t tolerate its stimulant effects. Caffeine is metabolised in the liver, with the CYP1A2 enzyme responsible for detoxifying most of the caffeine. Our ability to produce this enzyme is coded by our genes, and there is variation as to how active this is for each individual. Those that have an active gene are able to metabolise caffeine efficiently, therefore the stimulating effects of caffeine are mild and short-acting. This may affect their enjoyment of caffeine and clearly their ability to tolerate it. The opposite is also true – someone with reduced activity of the gene will metabolise caffeine more slowly and its effects will be longer lasting and more noticeable. You can find out your genetic ability to tolerate caffeine through a Fitgenes DNA test(PM me for more information).  In addition to the genetic differences, environmental elements also influence our ability to tolerate caffeine. Even if you are a fast metaboliser, stress and lack of sleep can impact on caffeine’s effects – ramping up cortisol levels and with it anxiety and blood sugar dysregulation. Three coffees a day when on holiday and in a relaxed state may not be a problem, however when a work deadline is looming and you’ve been running on little more than petrol fumes rather than sleep, it is a different story.

With the present research, as the health benefits are from polyphenols present in the coffee, rather than the caffeine, the reduction in DNA damage may well be seen in decaffeinated coffee too, with previous research finding benefits with regards to type 2 diabetes and liver damage when consuming both decaffeinated and caffeinated coffee. has found health benefits from drinking this. However, without clinical trials to confirm this, at this stage it is unknown.

Coffee cup with saucer and beans on wooden table.

Obligatory cup of coffee (PC:stockphotos)

Should you take probiotics after a round of antibiotics? The answer may surprise you!

Two recent studies have recently been published that cast doubt on taking probiotics to help recover from a course of antibiotics. Crazy right? Ask anyone and they would tell you the opposite (as I would have). However sometimes research comes out that contradicts what we would previously have thought, and we have to be open to the idea that what we believed was in fact incorrect. The saturated-fat-heart-disease hypothesis is a clear example of dietary dogma that has been turned on its head* (and the difficulty that people have getting their heads around).

Gut health 101: The gastrointestinal (GI) tract is like a hollow tube, and the cells of the GI tract are covered by a thick protective gel, and that is the mucus layer (the inside cells of the gut are called the lumen). Each of these areas have a distinct microbial community, however these are rarely studied as they are difficult to get to (unless you have an invasive colonoscopy). The stool microbiome is also part of this gut picture and is the most often studied proxy marker as the gut microbiome and these are often used interchangeably (i.e. the bacteria you see in the stool is what we would expect to find in the gut). Interestingly, one study found that the stool microbiome is not representative of the gut mucosal or lumen microbiome, which really presents a challenge to any practitioner or patient who wants a better understanding of their gut health. It also doesn’t tell us about the gut endothelial microbiome which may be the closest to explaining our gut health as it is the closest bacteria to the gut tissue. They found that there was only a 20% correlation between the stool and the gut microbiome. While stool testing can be helpful for identifying pathogens or parasites, it’s not so useful for us to understanding the presence of ‘good’ or ‘bad’ bacteria. Stool testing is one piece of the puzzle, but it’s better alongside other tests (such as a SIBO test).

When you take probiotics, the presence of these in your gut is transient, and this is something that people are unaware of. Hundreds of trials have showed the safety and efficacy of probiotics in benefiting people, but it’s not typically through the colonisation of our gut. Like many things, we are different in the level of colonisation that occurs when bacteria is introduced into the gut – some people are more permissive than others, and some are really resistant to it. The researchers were not able to determine exactly what makes someone a ‘permissive’ coloniser and a ‘resistant’ coloniser, however suggested that the presence of certain bacteria in the gut may play a role in this. However, they are still beneficial despite this – with significant changes in the gene expression of people who took the probiotics (19 downregulated and 198 upregulated genes), confirming the idea that probiotics work at a cellular level and can enhance the activity of genes in the gut, aid in digestion, stimulate the immune system etc.

A surprising finding from a second study was that probiotics slowed the recovery of the gut microbiome after a round of fairly potent antibiotics. In fact, this is what I (and other practitioners) always recommend their clients do. Flooding the system with good bacteria has been thought to prevent the adverse effects of the antibiotics. The study wanted to see how the probiotics affect the long-term gut ecosystem after a single dose of the broad-spectrum antibiotic ciprofloxacin and metronidazole (to ensure all gut microbiome was wiped out). This particular study (conducted in both mice and humans) split the participants into three groups: one took no probiotic and were left to spontaneously recover; one group took an 11 strain bacteria probiotic for four weeks immediately upon finishing the antibiotics and the final group actually had what is called an autolagus fecal microbiome transplant (aFMT) – this is when a person takes capsules of their own fecal matter that had previously been collected when their gut is in a good space. Remember, the gut doesn’t like change, so what better than to replace the bacteria with some of your own? The results found that treating the gut with a course of probiotics delayed the return of the normal gut microbiota by as long as five months after stopping the probiotic treatment, and microbiota diversity stayed low too – well lower than the group who took nothing. In fact, the researchers found the group left to their own spontaneous recovery had no major differences in their stool microbiota within 21 days post-antibiotics. This is so different to what we understood about the ability of the gut to recover post-antibiotics. Again, there will be differences in what practitioners recommend, but to the best of our knowledge we thought that it took a good 18-24 months for the gut to fully recover from a round of potent antibiotics. This is actually incorrect too: previous research (when you delve further) shows that this may be the case for one or two strains of bacteria, but the majority actually recover fairly quickly and the composition of the gut microbiota resembles pre-treatment composition.

The gut microbiome is resilient, perhaps more so than what I (and others) had believed. This is only good news!

The researchers found the lactobacillus in the probiotic was what prevented the colonisation of the native bacteria in those that took the probiotic. This is the most commonly used bacteria in most probiotic strains. Again, this doesn’t mean that probiotics are NOT helpful in general (from the immune regulating benefits and what I’ve mentioned above) and we also don’t know how other probiotics which don’t contain the lactobacillus bacteria affect the gut (such as the yeast saccharomyces boulardis). There are so many different combinations of antibiotics and probiotics out there – and this is specific to this particular strain of probiotics and the type of antibiotic used. So it’s by no means the nail in the coffin for probiotics post-antibiotics, however it does call into question the broad recommendation and is something worth talking to your health practitioner about.

*I’ve linked to one academic’s thoughts, and could have also linked to many many more (and studies) such as this one or this one. But this isn’t a post about saturated fat so I didn’t.

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LIttle microbiota in your body are more resilient than you think… so we may need to leave them to do their thing. PC: oregonsportsnews.com

What’s the best exercise for longevity?

Well, that’s a bit of a loaded question, really. As any is better than none, and there will be different points of views by different experts (of which I am not one of them). However, the older I get, the more I am interested in the effects of ageing on our overall health span. Ageing is unavoidable; it happens to the best of us. Listed below are some of the physiological and biological changes that can occur the older we become:

  1. Insulin resistance – this is in healthy weight older adults also, with research showingthere is more peripheral insulin resistance compared to a younger population (an inability to dispose of glucose into the tissue).
  2. Decreased availability of anabolic hormones, and increased frailty with lower levels of hormones
  3. Increased anabolic resistance, so not only is there a decrease in the hormones that signal tissue growth, the muscle tissue is less responsive to the stimulus of amino acids (protein) and exercise, and there is less muscle protein synthesis in comparison to breakdown.
  4. Greater protein requirementsfor the same relative gains in muscle, strength and function compared to a younger population
  5. Decreased motor neuron function, therefore less neural signalling to muscle tissues and reduced motor function.
  6. Increased intracellular oxidative stress, causing inflammation and reduced cell functioning
  7. Reduction in satellite (stem) cellsnumbers and regenerative capacity – these cells are essential for the maintenance and repair tissues in normal physiological processes or in response to muscle damage/trauma.
  8. Elevated myostatin signalling, a protein that blocks our ability to build muscle
  9. Increased chronic inflammation (also known as inflamm-aging)
  10. Changes in autophagy, where ageing reduces our ability to clear out damaged DNA
  11. Mitochondrial functioning abnormalities, where we can’t utilise energy metabolites as effectively to fuel mitochondria
  12. Reduced ability to be physically active (due to many of the reasons listed above)

This is a long, daunting and rather depressing list of what can occur as we age – and we are an ageing population. There is no doubt that if we don’t look after the body we have got, then we really are staring down the barrel of a loaded gun. The list above describes many of the mechanisms to explain the loss of muscle mass and function. It’s not about being ripped or having gainz, it’s about having proper functioning of the muscle so it can work effectively in our older years. This is what is shown to have the most positive impact on our cardiovascular, neurological and musculoskeletal systems.

Inactivity is the broader environmental issue that we need to address any (and all) of the physiological issues I have mentioned above. We need to be active – in everyday life, and with some structured activity too. Hanging out washing and housework isn’t going to cut it, I’m afraid. I see a lot of people who have this idea that you don’t need to exercise in order to lose weight, and you can do it solely on diet alone. This is true, of course, but when you embark on any weight loss plan that restricts calories (i.e. any weight loss plan that is out there), then you will lose both fat weight and muscle mass – lowering your overall metabolic rate along with it. This is one of the reasons why weight regain is so prevalent, however the powerful combination of diet plus exercise helps sustainable weight loss. As I alluded to above, exercise isn’t just moving around the house, doing chores – this should just be part of everyday living. Data looking at the effects of exercise show that resistance training confers benefits over and above what we would see if we were just doing 30 minutes exercise per day.

The right type and duration of exercise:

The challenge is to get people exercising. And this is especially so for those who read what I have said above, and think that – on top of 30 minutes of aerobic training they don’t have time to do, they then need to put some resistance (or weight) training in.

I’m not writing this to encourage you to find an additional 3 hours in your week, though.

In fact, a study that is yet to be published (I heard about it on STEM talk) suggests that just 72 minutes a week in total is enough to help many of the conditions associated with ageing and poor health that I’ve mentioned above. Egan and colleagues found a combination of both resistance and cardiovascular exercise in a circuit-type setting for adults over 65 years just three times a week for 24 minutes increased walking speed, leg strength and reduced trunk fat. These measures speak to better muscular function, obviously increased strength, and will help reduce metabolic health risk. The improvements were more potent in this combined group than either resistance training or aerobic training for the same duration.

So this was a very long preamble to the main message: if you are currently NOT exercising, then please start. While there are modalities that are better than others, seriously, anything will be better than nothing. The study I talked about is in older adults, you likely don’t need me to tell you that any age you start is obviously better than not starting at all. AND the earlier you start, the better the overall health outcomes.

Exercise-1

Seriously. Those pink dumbbells. Because obviously an older female couldn’t possibly lift anything heavier, right?! (PC:www.fabafterfifty.co.uk).

 

Exercise for longevity – is there a best approach?

The older I get, the more I am interested in the effects of ageing on our overall health span. Ageing is unavoidable, it happens to the best of us. Listed below are some of the physiological and biological changes that can occur the older we become:

  1. Insulin resistance – this is in healthy weight older adults also, with research showing there is more peripheral insulin resistance compared to a younger population (an inability to dispose of glucose into the tissue).
  2. Decreased availability of anabolic hormones, and increased frailty with lower levels of hormones
  3. Increased anabolic resistance, so not only is there a decrease in the hormones that signal tissue growth, the muscle tissue is less responsive to the stimulus of amino acids (protein) and exercise, and there is less muscle protein synthesis in comparison to breakdown.
  4. Greater protein requirements for the same relative gains in muscle, strength and function compared to a younger population
  5. Decreased motor neuron function, therefore less neural signalling to muscle tissues and reduced motor function.
  6. Increased intracellular oxidative stress, causing inflammation and reduced cell functioning
  7. Reduction in satellite (stem) cells numbers and regenerative capacity – these cells are essential for the maintenance and repair tissues in normal physiological processes or in response to muscle damage/trauma.
  8. Elevated myostatin signalling, a protein that blocks our ability to build muscle
  9. Increased chronic inflammation (also known as inflamm-aging)
  10. Changes in autophagy, where ageing reduces our ability to clear out damaged DNA
  11. Mitochondrial functioning abnormalities, where we can’t utilise energy metabolites as effectively to fuel mitochondria
  12. Reduced ability to be physically active (due to many of the reasons listed above)

Clearly, these are not all inevitable. However, it is a long, daunting, and rather depressing list of what can occur as we age – and we are an ageing population. There is no doubt that if we don’t look after this body we have got, then we really are staring down the barrel of a loaded gun.

The list above describes many of the mechanisms to explain the loss of muscle mass and function. It’s not about being ripped or having gainz, it’s about having proper functioning of the muscle so it can work effectively in our older years – this is what is shown to have the most positive impact on our cardiovascular, neurological and musculoskeletal systems.

Inactivity is the broader environmental issue that contributes substantially to the physiological issues I have mentioned above. We need to be active – in everyday life, and with some structured activity too. Hanging out washing and housework isn’t going to cut it, I’m afraid. I see a lot of people who have this idea that you don’t need to exercise in order to lose weight, and you can do it solely on diet alone. This is true, of course, but when you embark on any weight loss plan that restricts calories (i.e. any weight loss plan that is out there), then you will lose both fat weight and muscle mass – lowering your overall metabolic rate along with it. This is one of the reasons why weight regain is so prevalent. However the powerful combination of diet plus exercise helps sustainable weight loss. And exercise isn’t just moving around the house, doing chores – this should just be part of everyday living. Data looking at the effects of exercise show that resistance training confers benefits over and above what we would see if we were just doing 30 minutes of cardio-based exercise per day, something that many of us maintain, but it doesn’t offer the same benefits.

The right type and duration of exercise:

The challenge is to get people exercising. And this is especially so for those who read what I have said above, and think that – on top of 30 minutes of aerobic training they don’t have time to do, they need to then put some resistance (or weight) training in.

This is not a call to encourage you to find an additional 3 hours in your week, though. In fact, a study that is about to be published (I heard about it on STEM talk) suggests that just 72 minutes a week in total is enough to help many of the conditions associated with ageing and poor health that I’ve mentioned above. Egan and colleagues found a combination of both resistance and cardiovascular exercise in a circuit-type setting for adults over 65 years just three times a week for 24 minutes increased walking speed, leg strength and reduced trunk fat. These measures speak to better muscular function, obviously increased strength, and will help reduce metabolic health risk. The improvements were more potent in this combined group than either resistance training or aerobic training for the same duration. It wasn’t olymic lifting from the sounds of it,  but it also wasn’t lifting pink dumbbells, either.

So this was a very long preamble to the main message: if you are currently NOT exercising, then please start. While there are modalities that are better than others, seriously, anything will be better than nothing. The study I talked about is in older adults, you likely don’t need me to tell you that any age you start is obviously better than not starting at all. AND the earlier you start, the better the overall health outcomes.

There is often an argument as to which is best; exercise or diet for improving health. That’s a weird argument to my mind. Both are important and should be prioritised if you want more life in the years you’ve got left.

stronger-effect-of-resistance-training-when-combined-with-protein-supplementation

One of the only pics I could find that didn’t involve pink dumbbells. (PC: https://www.frieslandcampinainstitute.com/)

Holiday weight gain?

Who doesn’t love a holiday? A break away from early alarm clocks, work and household chores. When out of your own space you’re forced to leave behind the normal routines that are well established in everyday life, which is obviously why we come back feeling refreshed and ready to get back into it. The problem, though, is that many people panic about getting out of routine with their food and exercise – what if that 10 days in Fiji goes and undoes the last three months of hard work and they end up gaining weight?

Well, it might not. Why?

1. You are a LOT more active on holiday compared to real life: driving to work and sitting in an office does not afford the same opportunity to be as active as sight-seeing does. I clocked up almost double the number of steps as I normally would when I was away. Even on days we didn’t run, relying on both public transport and my feet to see a city racked up enough steps so I was regularly doing 23,000 or more each day. However, if you’re a lounge-around-the-pool kind of vacationer, if you had a hit out in the hotel gym, you can avoid weight gain for a short term holiday in the face of a calorie excess.

2. You sleep more: lack of sleep will drive up insulin and cortisol levels and create a hormonal environment that is unfavourable for fat loss. Even if you have the perfect diet (if there is such a thing), no amount of calorie counting, carb watching, or protein eating will make up for the string of 5-6 hours a night you manage during the week when work, exercise and home duties take up so much time, you stay up later than you know you should just to enjoy a little time out.

3. You’re generally more relaxed. The everyday stress created by school pick-ups, work deadlines and weekend sport might be ‘normal’ life, but don’t underestimate the effect this can have on your ability to lose weight. While we may not know the underlying mechanisms, like the effects of sleep deprivation, a chronic overload of stress will increase hormones responsible for fat gain regardless of what you eat or how much exercise you do. In fact, for some, their normal stress relief of going for a run or doing an F45 class will only add to the stress bucket, further exacerbating a weight loss stall. And, when stressed, we often reach for food that is high in calories, low in nutrients.

What if it does?

If you were maintaining or losing weight prior to going away on holiday, then that tells me you’ve got the tools necessary to help you refocus on an eating style and exercise routine that will easily shed any fat gain that is the result of too many cocktails by the pool.

Actual fat gain will be quite minimal, and pretty easy to shift – potentially easier than what you were finding before your holiday. The additional calories eaten on holiday aren’t all stored as fat (at all!) We restock depleted glycogen, and for some, short term overfeeding  increases resting metabolic rate in response to increased food (as many of the overfeeding studies conducted under laboratory conditions have found). Even if you have a predisposition for weight gain, the amount of weight you can is usually far less than the excess calories eaten would predict.

However, for those panicking about the additional fat gain (if any):

1. Up the protein intake. This will help reduce any carb-related cravings from too many pancakes/baked goods/fat chips. Aim for foods that will provide 30g of protein per meal (as an example, a 150g beef steak has about 37g of protein, 3 large eggs around 24g of protein). This will help fill you up and regulate blood sugar, preventing any dip in energy that might be exacerbated by lack of sleep or jetlag. Combined with strategies listed below, it’s a recipe for fat loss.

2. Lay off the alcohol. We definitely had more wine and beer on holiday, and in the space of 15 days I had 2 days where I didn’t consume any during the holiday. Despite that I’m not drinking any more than 1-2 glasses (3 on a couple of occasions), it is more than what I’d normally drink. Post-holiday I went for a week without any – not a long time, but enough to help me get over my post-holiday tiredness and to ‘break the habit’ as it were. And I have to say, feel quite virtuous.

3. Drop back the fat intake – if you’ve gained excess body fat, then we want your body to tap into this (potentially) accessible fuel source – this obviously requires a calorie deficit. There is no need to seek out ‘low fat’ foods or avoid foods that naturally contain fat (i.e. egg yolks), however reducing down the amount of added fat to meals (via sauces, dressings, cooking oils, nut butters etc) will help reduce the calorie content of your diet with minimal effort.

4. Drop back the carbohydrate intake – some people benefit from doing a 21 day low (er than normal) carbohydrate diet. I know what you’re thinking – if I drop the fat AND the carbs, what do I eat? I’m talking short-term here – you base your meals around protein and titrate fat and carbohydrate according to that. If you know you feel better with a bit of carbohydrate in your diet, that’s no issue – just make it good quality (i.e. kumara) and make it a moderate serving. However, ample amounts of even low sugar carbohydrate (like rice, pasta, bread etc) will make it more difficult to shift.

5. Include plenty of vegetables – base your meals around these. The prebiotic fibre can help improve the gut environment after a week or more of too much fried foods (though that cheese hoagie was delicious) and too much alcohol. Splashing raw apple cider vinegar (ACV) on steamed vegetables ups the taste factor and helps reduce post-prandial (post-meal) blood sugar, making you less likely to search for something sweet. In addition, you can go for gold on most non-starchy vegetables, so fill your plate to help fill you up.

6. Lift weights. Heavy ones. If you don’t have access to a gym then even body weight exercises (such as press-ups, squats, lunges) if not doing them, will create stress to help you build muscle. I’m not suggesting you avoid lacing up for your long run – I’m a long-distance runner after all! –  resistance training, though, is metabolically demanding in the short term, and in the long term will preserve your resting metabolic rate to allow you to burn fat in everyday life. Plus, you’ll improve strength. Bonus.

7. Consider fasting. Be it the 5:2 protocol that I utilise in my fat-loss plans, a 16:8 protocol that is popular (i.e. fast from 8pm to 12pm the next day, or Super-fasting as per the Schofield/Zinn protocol outlined in What the Fast, it’s consistently found to improve metabolic health markers and can reduce calorie intake to elicit a fat-loss response.

8. Get plenty of sleep – try to get back into a 7-8h per night habit with this one and be disciplined about it, for reasons I outlined above.

And, finally (and most importantly), does it matter? I mean, does it truly matter that you come back from an awesome time away with a couple of additional kilograms? Part of the beauty of a holiday is leaving behind all of the routines of your day-to-day life, including exercise and your normal foods for breakfast, lunch and dinner. Many of us need a mental break almost as much as a physical one, and this includes a break from your usual diet and exercise regime. You will come back feeling refreshed and ready to embrace these with renewed energy (or being in a mindset of change for the better, if that is more appropriate).

escape

Get away from the routine of being in routine… (PC locokerala.com)

Food rules.

I’m all for flexibility when it comes to what people eat. Labels like ‘vegan’, ‘paleo’, ‘keto’ for a lot of people aren’t particularly useful (even when self-imposed) if that means the structure of their food intake is tied up into the ‘rules’ of that particular diet. People panic when they are out of their own food environment and unable to eat according to the rules of their dietary ethos. While there are those who intuitively know they don’t need to rigidly eat the same foods or meals to be able to progress towards their health goals, this isn’t a widely appreciated concept. For some, diet ‘rules’ can create a certain degree of neuroticism around food; people argue it is a form of orthorexia at its worse – I’m not sure I agree with that, given the complexities associated with diagnosed eating disorders. Regardless, if the anxiety around food exists, it can lead the person to turn down invitations where their dietary rules will not be able to be adhered to, thus becoming socially isolated from their normal circle of friends. Or they may still attend with the intention not to eat, only to ‘cave in’; one small snack becomes a bit of a binge-fest because they have ‘blown it all.’ Both of these situations can make a person feel pretty terrible, and do nothing for their self-esteem.  You can see why, then, there are people who are adamantly against ‘rules’ around food.

However, I don’t agree that there shouldn’t be any structure around what, how, and when a person eats.  I think you’ll know I’m not suggesting this structure should equate specifically to a dogmatic dietary regime, such as only eating ‘paleo’ or ‘raw vegan’. I’m talking about rules that take the decision making out of some pretty common every day food experiences. Let’s face it, most people have a lot going on in their lives – we make 35,000 decisions per day (apparently!), 200 of them are food-related, though we are conscious of about 12-15 of them. Many people don’t have the bandwidth to be directly  making decisions about what to eat day-in, day-out (hence food plans like mine are awesome, btw). That’s what makes it so easy to ‘succumb’ to takeaways at the end of the day (I say ‘succumb’ as I know many people think it’s lack of willpower. Well, no, it’s more decision fatigue than anything else). Dogma around diet is, after all, the appeal of following it – someone else has deemed what you can eat and what you can’t. This takes the thinking out of it and works perfectly fine… until it doesn’t. And it doesn’t take long for it to start causing more headaches than not. The type of rules, then, that I’m thinking about are those which are akin to brushing your teeth. You just do them, they are non-negotiable. Once you get into the habit of them, you don’t even have the think about it.

The types of rules I’m thinking about include:

  1. Never eat standing up (therefore omitting mindless snacking).
  2. Brush your teeth after dinner (to avoid snacking later in the evening).
  3. Have at least one serve of vegetables at breakfast, and 2-3 at lunch and dinner.*
  4. Put all junk food in the house in an opaque container and keep high up in the pantry, so they aren’t having to see it every time they open the cupboard to prepare meals (out of sight, out of mind).
  5. Choose a protein choice (meat, eggs, fish) and vegetables first when eating a meal out, and then (if still hungry), choose something else. This will fill you up, so there is less room for other foods that are easy to overeat.
  6. Order dressings and sauces on the side (so you can control how much you use).

Instead of feeling anxious about having to decide what to eat, then constantly second-guessing what to do, simple guidelines like these can help you make better decisions in any context. They take the thinking out of it, therefore less energy is wasted and they aren’t constantly ruminating about what to eat. This creates less anxiety and neuroticism, and people can feel empowered and confident in their food decisions.  It’s less about the availability of specific food choices and more about way food is eaten, the environment it is eaten in, and the type of food. You don’t need to be perfect to be awesome, you just need to be consistent, and consistently approaching food in the same way (not deciding that you’ve ‘blown it all, so you’ll binge’ whenever you make a choice not deemed ‘suitable’ as part of your dietary regime).

From clinical experience, I find most people respond well to strategies such as those mentioned above.

One Simple Health Rule copy

If only it were this simple. (PC: theironyou.com)