Antioxidant use and the athlete: should you or shouldn’t you?

There is nothing more disappointing than doing everything you possibly can to prepare for an event… and then the week before you wake up with a scratchy throat. Panic sets in. WTF?! You’ve been diligent about rugging up before heading out for your training. You’ve gotten extremely adept at opening the fridge in your staffroom with your elbow, and the unexpected benefit of not touching the escalator handrail is that your balance has improved exponentially. All of that, along with religiously popping two of those yummy fizzy orange lollies masquerading as vitamin C tablets daily to fight those pesky free radicals that your body is subjected to week in, week out as part of your normal training load. Yet this feels like the beginning of a worrying week pre-race that could derail what was looking like a PB race.

The problem with being an athlete is that you’re constantly teetering on the edge of becoming sick – when you add training on top of an already busy life load, you run the risk of becoming run down and, for some, chronically so. It must be said, though, that athletes are often the least likely to come down with the winter ills. Regular training affords us positive adaptations in cardiovascular, skeletal muscle and respiratory systems, which benefit both everyday wellbeing and prevent against metabolic diseases.  However, despite the undeniable health benefits, exercise increases the production of free radicals in your body, and in excess these may promote increased oxidative stress and damage in the DNA structure. This leads to impaired skeletal tissue function and increased muscle pain, affecting our ability to train and thus perform. Not to mention looking about 81 years old when you’re barely 50. Hmm… there are definite downsides to training. In order to combat this, many athletes and sports professionals have a regular regime of antioxidant supplements (such as vitamin C) they take daily as part of their overall training strategy.

While there can be benefits with taking additional supplements, there are questions around the usefulness of these for athletes. Recently it’s been established that, contrary to strengthening our resilience against illness, we may be doing ourselves a disservice, as physical activity itself causes adaptations in the tissue and increases the expression of receptors that are responsible for producing our internal antioxidant defenses. This stress is important to help us become stronger for the next session, and thus become fitter (termed mitohormesis.)  A recent study investigating this concept also found that regardless of training status, supplementing with antioxidants blunted the ability of exercise to increase insulin sensitivity, and the release of adinopectin, a hormone with a role in blood glucose regulation and fatty acid oxidation.

Does this mean, then, that you should throw away your vitamin C tablets? Actually – to my mind, no. There is a time and place for additional antioxidant supplementation and a blanket approach, taken as an insurance to ward off ills is not the answer. In the literature, there are questions around the use of antioxidants and, like a lot of scientific trials involving humans, this stems from methodological differences, alongside individual differences which garner different results. Many studies didn’t control for overall diet, the training status of the participants differed, along with the definition of ‘endurance’ – I know that many people would view a definition of ‘training 4-5 x per week for up to 60 minutes at a time’ does not an endurance athlete make. The active ingredient in the supplement along with the way it is formulated can also affect the absorption and thus its effectiveness.

There are times in your training cycle where it’s beneficial to expose your body to the adaptive effects of training – as you’re building up your base your body is undergoing many of these, learning to go longer, lift heavier, potentially go faster. This is not the time to take the supplement, as your main goal is to become a better athlete through these changes. In the lead up to the race, however, the adaptive phase is done. Your main concern is getting to the start line in as good a condition as possible. Consider taking a supplement in the week leading up to the event to protect your antioixidant status (which will undoubtedly give you a psychological boost). In addition, it appears that particularly after an event, antioxidant status is reduced (which makes sense, given the stress that racing places on the body) and ensuring a nutrient rich diet with additional supplementation makes sense in the few days afterwards. There are no guidelines around dosage in the literature, but a supplement in a chelated form (along with an amino acid, perhaps powdered form) will help absorption of a vitamin C supplement.

Of course, throughout your normal diet, however, there is much more benefit to take on board these nutrients in their natural state. Vitamins, minerals and phytochemicals that work as antioxidants in the body work in a synergy that can’t be emulated by a pill. While there is increasing interest in the use of ‘functional foods’ such as gogi berries, black tart cherry juice, beetroot juice and the like, your antioxidant status is enhanced through consuming an abundance of nutrient-dense foods that provide this synergy, and there are plenty of studies to show this.

In addition to the numerous vegetable and fruit sources of these constituents, animal based foods are more nutrient dense with regards to cofactors responsible for decreasing oxidative stress in the body. Free range eggs, naturally occurring fats, fish, meat, all contribute either antioxidants themselves (such as co-enzyme q 10 and glycine) or provide the proteins necessary to build our body’s own antioxidant defense. It goes without saying that removing seed oils and processed foods which contribute to the omega-6 load of our diet (thus promoting inflammation) is an important factor here.

Of course, as an athlete, diet is just one factor that contributes to your ability to fight off infection. If you’re not getting adequate sleep, ensuring your training sessions include enough recovery to enable your body to adapt to the training stress, and allowing some downtime in every day life outside of training to just relax, then your risk of coming down with a cold or flu at this time of year will exponentially increase. That said and done, if you do feel the beginnings of a scratchy throat? One of the best things you can do is take a tonic. Check out this below that Chris Kresser talked about. Sounds potent, but it does the trick for him. Many people swear by ginger, manuka honey and lemon to help ward off colds, and ginger is well known for its antioxidant and anti-inflammatory properties as is manuka honey.

(over to Chris for the last word…)

“Juice 1 kg pf ginger in a juicer. And then you put 3 to 4 tablespoons of ginger in a cup with the juice of one lemon and some honey, like a couple of teaspoons or a tablespoon of honey, and you sip on that all day.  You’ll probably need to make it a couple more times throughout the day, but you just keep sipping it throughout the whole day.  It’s really intense, that much fresh ginger juice.  You’ll really understand when people say that ginger is spicy when you drink that!  You sprinkle a tiny bit of cayenne pepper, like a pinch of it, too.  That really helps a lot.  The fresh ginger is antiviral, and it actually prevents the adhesion of the virus to the upper respiratory mucosa.  If you do it right at the beginning of getting sick, it can really prevent you from getting sick at all. Taken 3-5 times a day. That’s enough for two people over 1.5 days, might make 2-3 batches.”


Is sugar the only sweet poison?

Have you heard sugar being referred to as ‘sweet poison‘? Probably. You’ve likely also heard rumours that the sugar alternatives (such as Equal and Splenda) could potentially be worse for our health in the long term, yet (like I did), brushed off the propaganda-type campaigns that suggested our insides would rot and we’d grow a second head. There was a time not so long ago (err… 18 months prior) where I used to use a LOT of artificial sweetener. To the point that it could have been considered a food group all on its own. For a good 22 years. So I wasn’t sure how to react when my friend Helen forwarded me an email from The Lancet Journal of Oncology this week that reported the International Agency for Research into Cancer (IARC) have made investigating the carcinogenic effects of Aspartame and Sucralose a priority over the next couple of years.

Aspartame is a methyl ester comprised of phenylalanine and aspartic acid, two amino acids found naturally in foods such as meat and dairy, and certain fruit. It’s used as a replacement for sugar in products such as diet soft drinks, sugar free gum and other artificially sweetened foods. A quick google search brought up this list of foods in New Zealand containing Aspartame and while many of these have changed to using Splenda, the active sweetener in Splenda is Sucralose – the other sweetener under the spotlight (which I’m not talking about in this post). You will notice that many of the products on the list are pharmaceutical and in fact that was how these products originally entered the food supply – as a way to make medicine more palatable. Stevia – a non sugar sweetener which I’ve actually been using of late due to the ketogenic diet (usually I would use rice malt syrup or another sugar alternative if making anything sweet) – has been used for 1000s of years. More recently sweeteners were developed to make pharmaceuticals more palatable and the first to be manufactured was saccharin in the 1890s. Aspartame specifically has been in the food supply since its creation in the 1960s, with the Food and Drug Administration (FDA) approval for wide-spread use since 1996 in all food types.

If Aspartame has been approved by the FDA as safe (and it’s touted that the level in the average diet is approximately 1/50th that considered to be the acceptable daily intake (ADI) limit – 50 mg/kg body weight (BW) in the US, 40 mg/kg BW in Europe), why now is the IRAC announcing that the safety of it (and Sucralose) is being called into question? I did a bit of digging around the literature and found a review paper based on the current evidence that was released earlier this year. This isn’t going to be an indepth review of all literature pertaining to aspartame – that would take me more time than I have on a Sunday to write the blog and, let’s face it, I’m no brainiac. I did, though, want to share the take-home messages I got from this review, in an effort to understand the sudden interest of the IARC into aspartame. Interestingly, this review paper was written in light of another organisation’s interest in the safety of aspartame, the European Food Safety Authority (EFSA). Along with a re-examination of the trials conducted using animal models, more recent trials showing a dose-response relationship between aspartame and cancer lesions in rats, their investigation also evaluated evidence from two large scale population-based studies.

The first of these evaluated dietary data from the National Institute of Health—American Association of Retired Persons surveillance, and included 473,984 individuals aged 50–71 who were surveyed in 1995, and followed until 2000 for signs of gliomas (a malignant tumor found in the nervous system) (315 cases) and hematopoietic tumors (tumours in the blood, 1,888 cases). The authors reported that for a daily intake of aspartame  greater than 900 mg/day (equivalent to 1.5 L a coke – yes, a lot!) no significant increase in risk of hematopoietic neoplasms (RR 0.98, 95% CI 0.76–1.27) or of gliomas (RR 0.73, 95% CI 0.46–1.10) was observed.

However, despite the large number of people followed, this conclusion has been criticised due to the limited duration of exposure and  follow-up, and the low exposure levels that reduced the statistical power to detect an effect. Because of the overly simple evaluation of the exposure (measured as the consumption of products containing aspartame during the 1 year immediately prior to the start of the 5 years follow-up), there were concerns about the validity of the results.

The second study examined data from the Nurses’ Health Study and the Health Professional’s Study – two large scale population-based studies where the intake of diet soft drink was observed across a 22y time period (1984-2006) every four years. In total, consumption levels were evaluated in over 77,000 women and close to 48,000 men. The researchers concluded there was a statistically increased risk of both multiple myeloma and non-Hodgkin’s lymphoma in men who consumed more than 1 serving diet soda per day. No clear effect was seen in women, which the authors speculated may be due to the increased activity of the alcohol dehydrogenase type 1 (ADH1) enzyme in men that is responsible for converting methanol (a constituent of aspartame) to formaldehyde. Remember, these are correlational studies and cannot establish cause and effect. However, it is from this foundation that we form questions in order to test in a more rigorous setting. In nutritional research, this would be by conducting a randomised controlled experiment where participants consume either a predetermined amount of a beverage containing aspartame or a placebo daily for 20 years, whilst observing the incidence of newly formed cancer. Hmm. There-in lies the problem. Studies like that are clearly unethical (and not mention hideously expensive!!) Much like the research related to the increased risk of lung cancer with tobacco smoking, many people argue that there is enough research now to recommend lowering our overall exposure to aspartame in the food supply.

Despite what might appear to be worrying reports based on quite a small dose of aspartame, the EFSA‘s review concluded that the base of the evidence was not strong enough to recommend a lower dose of aspartame and future animal model studies should be set up to determine the effect of aspartame with regards to reproduction and development (not cancer lesions). They also recommended the evidence base that would warrant a change in position stance should come from animal models and not epidemiological research. If they had decided that carcinogenic tumours were the endpoint of interest, would they have decided differently?

Now, then, the IARC are set to review the evidence for and against the use of aspartame in our diet. In light of what I learned through reading the review paper I’m both relieved that I no longer have it a regular part of my everyday diet, and slightly concerned of the effect that my long term consumption of foods containing it could have on my overall health. But  I’m not going to dwell on that as it’s completely beyond my control. My other thought is around the focus we’ve had on sugar in the diet of late. Many soft drink manufacturers have jumped on board the ‘no sugar’ bandwagon and have started heavily promoting their ‘no sugar wares’, Of course, the alternative could, down the line, be far worse for the health of the consumer. The best option? Choose real food and beverage options. If you like to cook and would normally use a sweetener, why not cut back the amount you use and choose a natural product over Splenda? Better yet, begin to reduce the amount of sweet foods in your diet (artificial or otherwise) so you can begin to retrain your palate and adapt to a diet that is high in nutrients, and lower in all types of the sweet poison.

Keto update week 4: same old, actually!

Four weeks in…. how do I feel? This morning I could have turned a corner, I had an awesome run. If you had asked me yesterday, I would have said: hard to say – actually the same as what I have the last couple of weeks really. My sleep has been better than ever, other than a couple of nights but I put that down to life events and not diet related. Interestingly, I feel that I’ve started letting myself relax more in some instances. For example, I will come to the end of the day and typically I’m doing client or AUT related work in the evening. However I’ve been better at being disciplined about just going to bed and not thinking that I must finish X, Y, Z before doing so. I don’t necessarily think this has been as a result of the change in eating directly. But I do think that when you’re forced to step out of normal routines and reflect on them, it is hard to isolate it to just one area. And it’s fair to say I’ve been doing a bit of reflection lately on a lot of things. Perhaps that is just a product of that.

My day to day energy has been up and down, but again, I think it’s just that I’ve got a lot going on and it’s the impact of feeling stretched in many different directions. My training has been interesting. I’ve noticed that I seem to feel awesome up until about an hour, therefore probably push it a bit on that hour, then I seem to all of a sudden die. I’m still only doing long runs of up to 90-95 minutes, with a lot of my sessions being 60 minutes or less. That’s a bit of a change too actually. Being an endurance girl, it’s hard to take a step back from that – and 15 years of being hardwired in thinking that ‘the longer the better’ particularly where both fitness and body weight is concerned, this could be the toughest nut of all to crack. It’s right up there with the ‘fat makes you fat’ thinking. And this n=1 experiment is certainly teaching me how absolutely wrong that last statement is. I will always train – my head requires it more than my body does and actually my head often does my body a disservice because of it. But the physical effects of this diet necessitates me to reduce the amount of time spent training. That, combined with other commitments, has meant that I’ve had to be okay with not doing as much. Surprisingly, this hasn’t been as difficult as I imagined.

What is my general diet over this ketogenic experiment?

Breakfast is a mix between a chia/coconut cream/cream pudding with a small piece of fruit (like feijoa), or it’s been eggs (mix of scrambled, omelette – ditching the whites, poached) with added avocado, cheese, some greens. The rhubarb crumble with cream has been a favourite.

Lunch has been salad greens, leftover meat with dressing, nuts, some cheese – watching my protein component carefully, and the overall volume of salad is a lot smaller than it would normally.

Dinner has been a mix of vegetables that have been roasted (i.e. swede chips), mashed (cauliflower), creamed (spinach with creme fraiche), and meat. I was staying with my Dad this week in Dunedin and he loved that I added cream and balsamic vinegar to the mushrooms and bacon we had at dinner. Not a ‘Mikki’ thing to do.

I’ve been snacking on macadamia nuts and cheese, adding cream to coffee. I thought I would be fancy and order a vienna, but I had to explain to a café what a ‘vienna’ coffee was.. FYI, a vienna is whipped cream and cinnamon. However, I suspect that ordering a vienna is akin to ordering a ‘cappuccino’ (i.e. not the choice of serious coffee drinkers) after getting mocked by my friend Ash. My friend Chris put me on to this sugar-free Well Naturally chocolate which I have to say is delicious. I’ve actually avoided products like this for the better part of 18 months, and am not sure why I feel the need for it now. But I do.

So that’s me in a nutshell. I am waiting for the feeling of amazing energy; that has yet to happen despite my ketones being around 1 mmol/L every time I’ve measured them, bar twice, after being hungry and eating too much twice in the evening. I suspect that it’s easy to go out of ketosis in that instance, and have read Peter Attia saying the same thing. On those days I recognised that teaching across two campuses on opposite sides of the city, combined with seeing clients, left me little time to prepare, and I suffered for it. I am measuring these less, though, as I become more confident in my choices to ensure a ketotic state (and more mindful of just how expensive those ketone strips are).

My friend Bee is also undertaking the ketogenic experiment. Bee is an amazing athlete who has seen considerable success in Ironman over the last few years, taking some time out right now to focus on her career. Out of the five friends that I hit up, she was the one that dived in boots and all. I asked her a few questions three weeks into it to see how she was feeling.

1.      I know I asked you to do this (keto) but what made you give it a go?

Firstly, I’ve been following the inspiring Bevan McKinnon’s Fatman Ironman campaign over the last couple of years (beginning with the disaster that occurred last year, to the turnaround performance at Ironman New Zealand 2014), and reading his blog on Fitter Facebook page sparked some interest. It makes sense to me, and I want to feel like that when I race again!

And I’m curious. I am a carb burner. I have a high carb diet and when training and racing I relied heavily on carbs, sweet yummy triple caffeinated chocolate bomb power gels (from the health food stores of course!). I almost believe I won’t be able to change energy sources and burn fat, it’s too different. So I am keen to see what can happen.

2.      What is a typical day’s food prior to keto?

When the news first started to trickle through that fat was now ‘ok’ I was stoked and I celebrated with the re-introduction of butter, cream and full fat meats into my diet… but I was the typical mainstream observer and didn’t really cut out many carbs or sugar treats, other than switching cereals to pumpkin / root vegetables for breakfast (yes weird), and from sandwiches to wraps for lunch. Dinners were typically meat/fish and vegetables.  I would eat frequent but smaller servings of chocolate and cakes or sweets each day, I have/ or more so I had a seemingly uncontrollable sweet tooth. When I was a kid I used to want to own a lolly shop when I grew up so that I could have endless supplies of sweet goodness.

3.      What is a typical day’s food now on keto?

Lots of good yummy foods. Breakfast is a variation of eggs, coconut cream, cheese and vegetables. I have them as omelettes, scrambled, or using mushroom or avocado instead of toast.

Lunch is a salad with leafy greens and salad vegetables, protein could be smoked salmon or smoked chicken, eggs or just macadamia nuts. All mixed with cheese and garlic infused oil, tahini or aioli.

Dinner meat and vegetables (dependent on carb allowance) and cheese and oils.

I’m loving the food choices and have not been eating any sugar or sweeteners, I haven’t wanted to.

4.      What have been the main challenges to changing to a keto diet? (energy, appetite, sleep, training …)

The diet itself is surprisingly really easy to follow, I’ve been weighing food where possible and while a little annoying, it’s not the end of the world.  When I’m out I just do the best I can with what’s available, I’m not going to take this so far that the diet prevents a meal out.

The biggest challenge has been in my running and I’m finding it pretty annoying. I have slowed down a lot, I’m missing the extra gear I used to have. I can’t keep up with my usual running pals, forcing them to do hill repeats so I can catch them up (good to see them suffer though). On many runs I’ve wanted to throw the towel in and just eat a damned sandwich. But this is just part of the experiment to see if this carb burner can change.

5.      What, if any, benefits have you seen in the three weeks since going keto?

I don’t eat sugar. I don’t think about sugar. I admit I still walk into a café and drool at the sweet goodness of cakes and cronuts, but I don’t finish a meal and think hmmm a bit of chocolate would go down well right now.  If you could only understand what a change this is for me, if I gain anything from this change in diet the shift from sugar is more than enough. Happy days.

Building beautiful from the inside out

On Wednesday night I’ll be talking with over 100 beautiful women at the Women’s pamper evening in Newmarket that is being hosted by Auckland’s original Paleo café, Wilder and Hunt. I’ll be sharing what I know are the building blocks of beauty from a nutrition perspective.

What makes a woman beautiful? Print and digital media influence what we perceive as beautiful in a woman and objectively speaking, we aren’t all going to agree – beauty is, after all, in the eye of the beholder. If you look through the last 50 years of beauty as defined by the media there is a definite change in the physical features of woman – from Marilyn Monroe with a softer, curvier shape, to Twiggy, whose name aptly describes her physical features, to Elle Macpherson (The Body who, in my opinion, is more gorgeous now than the early 90s and her supermodel days) to Kate Moss. The focus on a women’s shape has largely been the determining factor, and the changing shape of a beautiful woman is telling of society’s acceptance of messages that are portrayed around beauty. While once we were bombarded with the ‘thin is in’ message, this has largely been replaced by images of a muscular yet equally lean woman with ‘strong is the new skinny’ as the tag line. Both, for the majority of woman, are unattainable and – if achieved – unsustainable in the long term. This definition of ‘the body beautiful’ is largely created from the narrow perspective of industry, media and the thousands of available diet and beauty products that try and sell you a magic bullet to solve your perceived beauty woes.

Body shapes aside, there are far more salient features that (to my mind) determine what makes a woman beautiful. We all know what makes a woman beautiful – even if you don’t think you ‘know’ or haven’t quite put your finger on why someone who might not be fit this narrow definition of beautiful but you find them attractive all the same.  It’s not their body size, their haircut, their muscle tone or the make up they are wearing. It’s the sparkle in their eyes, it’s the smile on their face, and it’s a sense of calm and confidence. It’s the glow of their skin and the condition of their hair. We know that beauty comes from within and this emanates health. How often have you met someone who you initially evaluate as attractive (because, let’s face it, we all make a judgment on someone upon meeting them). Then as you get talking to them this can change by (occasionally) what they say, but more by their body language, their facial expression, the lack of warmth. What makes a person, anyone, attractive, is the type of person they are – not what they look like. And what you eat plays a large part in that.

Beauty product manufacturers know that beauty comes from the inside out -however they deal in the superficial. They spend years and have big budgets to research ingredients for their top line products to ensure they help nurture good skin health. Beauty isn’t just about our skin, but one of the first places that reflect good health is certainly our skin. The skin is the body’s largest organ, is made up predominantly of collagen and reflects the health of our cells. The time it takes for our cells to turn over and regenerate increases with age, and goes from a few weeks to a few months. It’s not just chronological age though. If we don’t have the available nutrients to nurture good health from the inside out, then no amount of expensive skin cream is going to cover up the signs of a poor diet. The older we get, the slower our cells regenerate and turn over. At any age, however, this process can slow down if you don’t have a diet that supports healthy cell metabolism. You can encourage cell turnover through beauty routines that include exofoliation or microdermabrasion, however your best line of defence has to be your diet.

How can you easily find out which nutrients are important in cell health – take a look at the active ingredients in many skin care products. Vitamins A, C, E, along with omega 3 fatty acids have been found to be protective against inflammation in the skin and these may protect the whole body from sun damage – rather than the topical protection that sunscreen provides  These nutrients also play a valuable role in gut health, reducing oxidative stress in the body and (omega 3’s in particular) help with the elasticity of our arteries and cell walls – protecting against arterial stiffness and subsequent narrowing of the arteries. In addition, vitamin A works much better in the presence of vitamin K2 for encouraging cell renewal, and the antioxidant activity of both C and E is enhanced when they are delivered together

Likewise zinc, a mineral found in animal protein (the most available form in the diet) is essential for wound healing, cell regeneration and synthesis, and again plays a role in gut health.  A healthy gut is important for the absorption of all of the nutrients to ensure they are available to be utilized in the body. Co-enzyme q 10 is often touted as an essential ingredient in skin care and that is well warranted – research points to deficiencies in this leading to increased levels of reactive oxidative species (or oxidative stress) in the body due to it’s role as an antioxidant. And another important cofactor in skin (and overall health) is collagen – you could take Imedeen capsules – the original expensive skin care pill – or eat slow cooked meat or bone broth where the collagen has broken down and glycine is released – yet another important co-factor in our digestive health.

You know what? There are many different antioxidants, phytochemicals, vitamins and minerals that are responsible for cell health and regeneration in the body. I’ve scratched the surface here. But the main reason for writing this is to point out that the main building blocks for beauty aren’t purchased in a cream or a pill, nor are they necessarily sourced as an addition to an otherwise awesome diet. The co-factors responsible for building you beautiful are found in your everyday food choices: your fresh, seasonal vegetables, fruit, grass fed meat, free range eggs, full fat dairy and nuts and seeds. For otherwise healthy people, the benefit of whole food will shine through the skin, the eyes and the hair. In addition to that, the benefits of this for balancing stress and sex hormones, helping both energy levels and mood, the enigmatic aura that makes someone beautiful will shine through. And that’s the real benefit – how you feel. You can’t buy that in a bottle.