Red meat doesn’t kill you (and a problem with nutrition science)

This week is world iron week. I’ve talked about iron deficiency on my blog and you will be aware of the risk factors and risks associated with iron deficiency. I know, though, there are those among us who are wary of consuming one of the best sources of iron in the diet: red meat. Because, well, you know – meat kills. The most recent of these news headlines came from this study published in June of this year.

It is challenging being an advocate for eating red meat, and (in a lot of cases) encouraging clients (particularly young and not-so-young women) to eat MORE red meat, in a climate of meat avoidance. It isn’t a popular message, particularly with the bad press that red meat consumption (and production) has received over the last few years. So I thought it timely to remind you of some of the pitfalls associated with nutritional research, and why it is problematic to rely on population based research for our nutrition wisdom. This has been well covered by people much smarter than I am (read here) and relates to the above study looking at red meat and all-cause mortality.

The Nurses’ Health Study is an observational-based study – in that, it wasn’t a study that went in to try and test the effects of a certain dietary condition, instead it merely reported on what the population was doing. The food data was collected using food frequency questionnaires (FFQ), a memory based method, to determine the intake of foods spanning a four-year period. Now, if you’re reading this, you likely think more about food and what you eat than the average population. How difficult, then, would you find it answering questions related to your food intake four weeks ago, let alone four years ago? Imagine then being someone who typically doesn’t give it a second thought. A separate analysis of the data collected in this study revealed that 67% of women and 59% of men participating reported a caloric intake so low that a 70-year-old frail woman wouldn’t be able to live on, much less people who are in the prime of their lives. It has been described as ‘physiologically implausible’. Further, the caloric intake of people categorised as obese or overweight was reported as being ‘incompatible with life’. As all nutrients we eat are attached to calories, this makes all nutrient information completely unreliable.

Secondly, any of the findings are, by virtue of being an observational study, correlational in nature and not cause and effect. Given a data set large enough, enough dietary variables and a number of statistical methods at your disposal, you are likely to see significant correlations if you go looking for them. An example I saw on a blog of Chris Kresser’s was s study reporting that eating 12 hazelnuts a day increased lifespan by 12 years. Or that two slices of bacon equated to a shortened lifespan by 10 years. Yet, all headlines reporting on the study we are talking about here, and indeed the language used by study authors, suggest causality – something that cannot be determined by observation alone. Quite possibly one of the only robust findings from correlational research is that on lung cancer and smoking, where a 2000 times increase in risk of diagnosis of lung cancer was found in those who smoked. The increased risk in the study regarding red meat consumption? 10%. In most fields of science, it takes an increase in risk of at least 200% to garner interest. In nutrition, most relative risk increases are to the tune of 10-50% in either a positive or negative direction. Almost not worth writing about. Remember, too, this is relative risk. Absolute risk (when these numbers are reported) looks quite a bit different (see infographic here, a great description).

Thirdly, the prevailing message in the last 30 years is that red meat is bad for us and we should be minimising our intake of it, something that health conscious people will make a concerted effort to do. Therefore (as the research shows) those people who tend to consume the most red meat aren’t generally those that follow public health messages. They are more likely to smoke more, drink more, do less physical activity and eat less fruit and vegetables – all things which place an individual at greater health risk. While the research statistician ‘adjusts’ for these factors by way of an algorithm, it is well acknowledged that no amount of statistics will account for these unhealthy lifestyle behaviours. This is the inverse (if you like) of a ‘healthy user bias’.

And what about clinical trials looking at the harmful effects of meat? We must put it into context. A hamburger patty served with cheese and aioli, in between two slabs of bread, along with a large side of fries and a soft drink is clearly quite different to a medium rare steak with garlic butter and a side of broccolini. The overall nutrient quality and context of the diet matters whenever we are determining the healthfulness or otherwise of a food choice. Dietary patterns matter. In line with that, there is no good evidence to suggest that meat causes inflammation, and one trial in particular (out of Australia) looked at the differing effects of one 100g serving of wild game meat (Kangaroo) and the standard feedlot beef on inflammatory markers, finding no increases in inflammation after eating the Kangaroo meat. The authors suggest that the fatty acid profile of the beef (higher in proinflammatory omega 6 fatty acids) compared to the wild game meat was the potential mechanism here, but more research was required to establish this. What would be great is to see if differences existed in a clinical trial of a whole food diet that incorporated red meat, rather than there being no differentiation between sources of red meat. Grass fed meat (the majority of our meat supply in New Zealand) is higher in omega 3 fatty acids and antioxidants as a result of the way they are raised – both of which reduce inflammation.

Finally, the tri methylamine N-oxide (TMAO) story. An increase in this enzyme (generated from choline, carnitine and betaine in the gut) is associated with cardiovascular disease and there is suggestion that red meat intake is responsible for higher levels of TMAO. However, it needs to be pointed out that fish (consistently found to be a feature of healthy diets, however you look at it) raises TMAO levels well above what is found with meat. In addition, TMAO is produced in the gut, and we know how much the health of your microbiome is important for overall health. Therefore, if someone has sub-optimal gut health due in part to a poor diet, they are likely to be at increased risk of health concerns.

There is a lot to unpack and this isn’t to try to convince anyone to eat meat if they don’t want to. It is more to remind you that nutrition science is a challenging field. Regardless of assertations made by headlines, health professionals (including me!) or your next-door neighbour, studying what people eat is rife with problems and we need to take everything with a grain of salt. Which, as you probably know,  also will not (in isolation) kill you.

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!

plewsOAP

Kona 2018. (PC: oxygenaddict.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/)

Coffee: your friend or foe?

Coffee. It’s like the world’s favourite elixir. Mine included. For an athlete, there are many studies supporting its use as an ergogenic aid for athletes – helping reduce rates of perceived pain and effort, improving muscle fibre recruitment and enhancing glycogen repletion post-workout. These benefits are individual, however, and while research suggests that genetic differences in our ability to detoxify caffeine could account for this, it is not a universal finding. This is something true for athletes and non-athletes alike.

Other features of coffee are also salient for all individuals. Caffeine is ketogenic; not only can it help mobilise fatty acids to be used for energy, it increases the presence of ketones in the bloodstream – hence it is a good pre-workout fuel to help elicit fatty acid oxidation pathways and provide fuel for the workout in the absence of glucose. This doesn’t necessarily translate in additional body fat loss (more important lifestyle strategies are required for that, such as a caloric deficit, resistance training, reduction in stress etc), but can encourage these energy pathways to be upregulated, helping in the process of becoming adapted to a lower carb dietary approach.

Coffee improves insulin sensitivity and glucose tolerance (potentially related to the polyphenols present, though the mechanism is currently unclear), therefore enhancing the effects of both a lower carb approach, or a plan that includes fasting (either intermittent fasting, super-fasting, or a 5:2 approach such as the one in my fat-loss plans). Further, anyone doing my accelerated fat loss plans who have that 16h intermittent fast on the ‘fasting mimicking’ days could experience a more potent effect from the fast by including black coffee alongside water as their beverages of choice.

Autophagy, where our body starts to clear out damaged cells from the liver, heart and muscle tissue, is one of the benefits of fasting as you know. In mice models it might take just 16 hours for this to occur, in humans it is likely to take a lot longer given the differences in our metabolic rate (a mouse has a faster metabolism). Consuming caffeine on an empty stomach (or as part of a fast) promotes autophagy, which theoretically would shorten the time that is required to fast to stimulate this process. It also triggers AMPK, an enzyme that inhibits fat storage, promotes fat burning and activates antioxidant networks. These properties are thought to underpin much of the purported health benefits of drinking coffee.

It IS a balance though – if you’re following a fasting protocol, working out, and reading this at 3.30am in the morning, it’s a good sign that your brain is wired – raising cortisol to the extent that it’s (quite obviously) disrupting sleep. When we fast, like exercise, it places a stress on the body – this is where many benefits come from, as your body responds and adapts, becoming more resilient. However, too much of anything is too much! If coffee on top of your fasting regime or exercise program (or, life in general) is causing this stress response, then it is worth dialling it back a bit (or go 1/2 and 1/2 with decaf) to see if this changes your stress response.

Caffeine (or coffee), though, may not be good for anyone with gut issues. As it can stimulate the stomach cells to release more gastric juices, aiding in digestion, we often hear that too much coffee promotes a highly acidic environment and as such, could increase the risk of damage to the cells and subsequent gut issues. The literature, though, reports that caffeine does not negatively impact gastric or duodenal ulcers, and in fact when administered in vitro, could help repair cells damaged by inflammatory bowel conditions such as ulcerative colitis, and is also protective for the mucosal layer of the gut. Research suggests this is because caffeine increases blood flow to the gastrointestinal tract. Conversely, caffeine can lower the tone of the oesophageal sphincter – the valve that controls the release of stomach acid into the oesophagus, thus may promote heartburn and reflux.

With all research studies, it’s important to remember you are your own best investigator when it comes to how coffee affects you. I’ve said this before, but a good point to reiterate. The best advice, then, is to pay attention to how you feel when you drink coffee. Does drinking coffee make you more wired, especially when you fast, indicating it stimulates your stress (or cortisol) response? Does it give you reflux or heartburn? Does it upset your digestive tract more than settle it? Everyone has a different tolerance level to coffee, and further, our ability to detoxify it may also be different. If you feel great when you have coffee, and you don’t have any gut-related issues, then it is likely absolutely fine for you. If you notice an irritated gut, or you feel a bit wired, then it isn’t worth persevering with coffee for the purported health benefits – in your case, it might be making things worse.

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Ahhh… coffee 🙂

Does HIIT take a hit on a ketogenic diet?

Much of the research points to the utility of a keto diet for increasing fat oxidation for longer, slower training. After a period of adaptation, athletes are then able to tap into an alternative fuel source which affords them an extensive supply of fuel at a steady rate, unlike carbohydrate (glycogen) stores which are limited and easily depleted in a moderate-long training session. Thus, it stands to reason athletes are able to go for longer than if they are straight carb-burning athletes in an endurance event – something that Maunder and colleagues discuss in this most recent paper outlining the practical application of a low carbohydrate diet for athletes of varying abilities. However many of the recent randomized trials (such as this one here) have found that performance, particularly at the top-end of the spectrum, is compromised when athletes switch to a lower carbohydrate approach. Further, the relative effort at a given heart rate is increased. You go slower, but it feels harder. Ouch. This understandably makes an athlete’s coache a little nervous to recommend their athletes go on a lower carbohydrate diet.

Interesting though, this is not the experience of many people I work with who transition to a lower carb diet. If anything, performance improves for the athlete (something I’ve written a lot about over the last few years, including this blog here). Given enough time, any reduction in power that occurs early in the transition phase appears to be reversed and the athlete comes out leaner, stronger and fitter in their endurance training. Reducing reliance on carbohydrate as a training fuel reduces the oxidative damage that occurs during training, thus inflammation is reduced. They aren’t placing their body under as much oxidative stress and therefore the athlete can train more consistently during the season with less risk of stress-related injury and illness. This may also be due to a higher presence of beta hydroxybutyrate in the bloodstream, which act as signalling molecules and increase the transcription of enzymes that encode antioxidant genes superoxide dismutase, catalase 2 and glutathione peroxidase. This helps scavenge free radicals created through training and protects the athlete from tissue damage. This may be one of the reasons why they are seeing better results with their key races.

Two of my mates felt similarly, and experienced similar benefits of adhering to a low carbohydrate diet, experiencing no detriment to high intensity training, despite what the research deemed. So they decided to test the hypothesis.

They took 18 male endurance athletes who were habitually eating a standard western diet, and randomised them to consume either their normal diet (control group), or a very low carbohydrate ketogenic diet, consisting of no more than 50g carbs per day for four weeks, and performed graded exercise tests before and after the experiment, and a HIIT session (5x3min, work/rest 2:1, passive recovery, total time 34min) before, and after 2 and 4 weeks.

The researchers found that (as expected) fat oxidation levels increased in the experimental group throughout the tests, and total time to exhaustion, performance in the HIIT session and rate of perceived exertion was no different between the groups. Ergo, the ketogenic diet did not impact the athlete’s ability to undergo high intensity training (nor make it seem harder for them). Interestingly, the level of protein in the diet was around 29%, higher than the 17% used in other studies – this could account for the level of ketones present in the blood stream that were lower at the end of the study (0.4 mmol/L), just out of the ‘nutritional ketosis’ range. The difference this may have made to the athletes’ performance, however, we don’t really know.

Many of the studies conducted that have found performance is reduced are likely too short to allow the athletes to adapt to a ketogenic diet, which is thought to take several weeks to months. Hopefully this new research makes you think twice about taking the results of a study like such as the one here, as a reason to dismiss the low carbohydrate diet for athletes.

To recap, then, of what we know is possible for athletes following a lower carbohydrate approach:

As a side note, lots of peeps look at the elite athlete who chows down on carbohydrate in racing and during everyday life and thinks to themselves that, if they can perform to that standard eating a higher carb approach, then why can’t I? A couple of points to note:

  • The elite athlete may train from 20-30 hours per week – by default they spend a lot of time in a depleted state, meaning they are likely training low glycogen as it is impossible to replenish carbohydrate at the rate they are burning it. This is going to afford them the same capacity to train in the lower carb state that provides enhanced training adaptations. The average age grouper may have time to train 12-18h a week maximum, and don’t have the volume available to get into the low glycogen state.
  • They are elite for a reason. They are able to go harder and faster than most people –psychologically they are able to hurt more and potentially go longer before they bonk – we age-groupers have more of a preservation mindset. They may also be able to train harder when in an inflamed state for this reason. I’m not saying this is ideal (far from it). I’m just putting it out there as a reason why there are professionals who are able to see results where others don’t.
  • Even at the top of the field the elite athlete can suffer, and far more than an age-grouper. Years of a nutrient-poor, carbohydrate rich diet and overreaching to the point of overtraining will leave an athlete burnt out and unable to continue on at the level they previously enjoyed. It might appear that elite athletes are bullet proof but I’m sure as you’re reading this you’re thinking of someone who falls into this category. Things aren’t always as they appear, and the golden glow of success can be pretty fleeting.
  • Of course, there are others who are just awesome and continue to turn up and take it out year after year, regardless of diet, training methods, lifestyle etc. Like the people who drink every day, smoke like a chimney and don’t eat vegetables, yet live to 102 years.
  • Re: racing high carbohydrate – that Maunder paper again – worth a read.

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48 real snack ideas for the uninspired

Regardless of how much you love thinking about food and trying different ideas, sometimes you just need some inspiration, especially when you’re up against it with the usual convenience carbohydrate-based foods that adorn our supermarket aisles – readily available and at your disposal. This is true of both the recently converted person and the seasoned LCHF’er* (that sounds a bit religious, really, but to be fair, nutrition is a religion for a lot of people!)

We’ve got to be realistic – a good diet (and decent snacks) don’t happen by accident. These types of ideas take some preparation and planning. However I encourage you to do it as you are totally worth it! You know how bad you can feel when you eat something you don’t want to, but it was the only choice. Like that double-sized Kit Kat at the petrol station because you were starving and this was the first thing you could see and, hey, cheaper than the single sized one.

I’m not talking ‘bad’ as in feeling guilty – let’s try to remove any emotional attachment to food. I mean, I love talking, preparing and eating delicious food – it brings me joy! But I have long realised that any negative emotion (such as guilt and shame) that is attached to food choices does not serve anyone. It creates such negative energy and can perpetuate behaviours that we are trying to avoid, such as:

  • eating quickly without really chewing (so no one notices!),
  • eating more than we need (as we don’t appreciate what we are eating, our appetite hormones and taste buds don’t register that food has been consumed),
  • eating it to ‘get rid of it’, along with declarations of ‘that’s the last time I’m going to eat X so I’m going to make the most of it.’ (Okay – so it’s unlikely to be the last time that you eat whatever food X is, and unless you have an allergic reaction that makes it dangerous to eat (ie gluten for a person with coealics) or extremely uncomfortable, then there should be no reason to avoid it forever.)

I’m talking chocolate, biscuits, chips, etc – high sugar, high fat high caloric and low nutrient foods. Sure, these types of foods aren’t ideal to consume on an everyday basis for most people, however no one food ruined your diet and subsequent health goals. It’s more unhelpful behaviours and habits that are driven by our physiological response to these foods. These ultra processed foods (combination of sugar, starch, vegetable oils) leave little work for our body to do when we eat them, meaning the starch and sugar hit our blood stream quickly. This increase in blood sugar will drive an insulin response that clears the blood of nutrients (sugar and fat), and takes it to where it’s required, or to store it for later use. The body prefers to keep things relatively stable, so if there is an excess of sugar in your bloodstream, it is going to be on it to clear it out. If you’re very active and eating for fuel, it will go to the working muscles. If you’re behind a desk on a standard work day, then it’s more likely to be the latter. That can happen at such a rapid rate that your sugar level dips below normal (an over-correction), sending stress signals to your brain to resolve the issue and bring your blood sugar levels back up to within normal range. Cue: hunger, potential light-headedness, loss of concentration and cravings for sugary or starchy foods – the foods your body knows will solve the immediate ‘crisis’.

So, what to do?

First: do you need to snack? If you eat three decent meals a day, you probably don’t and by decent, I mean meals that include a good hit of protein, some fat for satiety, may include some carbs (of good quality, such as kumara, potato, some fruit, dairy for the dairy tolerant) and an abundance of non-starchy vegetables. How much? Check out the graphic below. If you hit this and you don’t have high energy needs BUT still snack, think about whether it is out of habit or hunger? Habit can drive our appetite to eat almost as much as a physiological need for nutrients.

And if you do need a snack?

These snack options listed combine any carbs with fat and/or protein to slow down the release of glucose into the bloodstream and will help keep you fuller for longer. Perfect. These are from a FB post I put up last week, and a few of my own thrown in there too. Some are grab and go, some require a little bit of preparation to be ‘grab and go’, and some require a bit more time in the kitchen, but it will be worth it when you need something to tie you over.

  1. Peanut butter slugs from Pics
  2. ½ cup coconut yogurt with a sprinkle of pumpkin seeds and cacao nibs
  3. This super easy coconut- peanut butter fudge
  4. Nuts – snap lock bags of these in ¼ cup amounts to grab – keep in freezer
  5. Coconut flakes mixed with walnuts – snap lock bags of this mix ( ¼ c amounts) to grab – keep in freezer
  6. 100% meat sausages, such as L’Authentique – cook in advance and grab one as a snack
  7. Cheese – chop 30g amounts of this and pop in a snap lock bag to grab
  8. ½ cup cottage cheese with couple of teaspoons of Sabato or Genoese pesto added
  9. Cucumber, celery, courgette slices – cut these and pop in a snaplock bag to grab to go along with any of the other ideas here
  10. Pate made with no added preservatives – L’Authinque again – (or make yourself such as this recipe here)
  11. ½ cup plain or Greek yoghurt with sliced almonds or other nuts
  12. Cottage cheese mug muffin
  13. Super discs of delciousness
  14. Homemade muesli (can be grain free, ideally minimal dried fruit) with unsweetened yoghurt and frozen blueberries.
  15. Low carb muffins (such as these sushi muffins) baked and kept in the freezer for when needed.
  16. Salted caramel cookie dough fat bombs
  17. Cook chicken or drumsticks in advance, debone (if full chicken) and keep in fridge
  18. Triangle of cheese between two slices of salami (a salami sandwich!)
  19. Mediterranean chicken meatloaf – slice, freeze and bring out when needed
  20. Delish gourmet soup pouches or Tasy Pot soups
  21. Psyllium husk loaf toasted with butter
  22. Canned sardines/salmon/tuna in olive oil – drain, flake, add a squeeze of lemon – or just have as is.
  23. Avocado sprinkled with salt and a grind of pepper, wrapped in nori sheet
  24. Good-quality cured meat (such as Canterbury Biltong)
  25. Meatballs/rissoles (home made) – freeze in snaplock bags in individual portions and grab
  26. Eggs – take 2 in a jar to work with a teaspoon of butter or coconut oil added and scramble in microwave
  27. Three ingredient Lemon fudge
  28. White fish with drizzle of olive oil and lemon oil/lemon zest: bake for around 10 mins on 200 or pan-fry
  29. Guacamole with carrot sticks or activated seed crackers
  30. Vanilla Bliss or Cacao Crunch Amazeballs – genuine no sugar added
  31. Pork crackling – such as Libby’s or Sniks (white bag, not blue!)
  32. Quiche – either crustless or made with an almond flour base
  33. Carrot zucchini slice
  34. Mashed cheesy cauliflower (pre made, reheat) – such as this: if dairy free, use coconut cream instead of the sour cream, and this cashew cheese instead of the cheese.
  35. Cauli broccoli and/or zucchini fritters – just process or grate the vegetables, add an egg, a tablespoon of almond meal, ½ tsp baking powder, your favourite spice or herb and salt! Panfry in coconut or olive oil
  36. Bacon – slow bake it in the oven for 20-30 minutes on a baking tray
  37. Grain free crackers with cheese,
  38. Leftovers from dinner (1/3 – ½ portions)
  39. Vege sticks ready in the fridge
  40. Roast kumara in advance, chop into pieces, roast in coconut oil with salt, keep in fridge
  41. Slice of cheese, spread with peanut butter (I tried this, didn’t really like it, FYI, and I love both cheese and peanut butter).
  42. 1/2 avocado, seasoned with salt and pepper
  43. Tablespoon of peanut butter with a tablespoon of coconut butter
  44. Square of 90% cocoa dark chocolate, spread with peanut butter or almond butter on top
  45. Square of 90% cocoa dark chocolate with small handful walnuts
  46. Slice of cheese, spread with marmite and topped with ½ a hardboiled egg (one of Simon Cochrane – elite triathlete – favourites)
  47. Cabbage leaf or lettuce leaf filled with ¼ avocado, small handful leftover lamb, smear tahini and miso paste
  48. Nori sheet spread with tahini, miso, some avocado and sauerkraut.

*I use LCHF interchangeably with ‘real food’ or ‘minimally processed’ as the reality is, when you switch out the processed, packaged food in your diet you will be lowering your carbohydrate intake. Anyway.

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One of my favourite snacks- nori sheets with tahini, miso and random vegetables

 

Random porridge post

I have been having a bit of a hankering for porridge – it’s cold and winter, after all. But I’m one of these people who, after having oats, has a blood sugar plummet within an hour – even with a decent hit of protein powder added which should help stabilise my blood sugars and keep me full.

So over the last few years I’ve been having some porridge alternatives. Here’s five that I have found to be quite delicious that I mentioned on our Fitter Radio podcast.

(PS Have loads more like this (and completely different ones!) – sign up to my monthly meal plans and online nutrition coaching to get plans, recipes, shopping lists and access to my brain through a messaging service, emails and a Facebook member’s page 🙂 )

  1. Flaxseed chia porridge: good fats, good protein and will keep you full
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Flaxseed chia porridge

2. Banana chai porridge: a nice spicy sweet start to the day (you won’t notice the cauliflower)

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Banana chai porridge

3. Almond butter porridge: grain free and filling

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Almond butter porridge

4. Lewis’ chia porridge: fuelling an endurance athlete who has type 1 diabetes since ages ago

5. Walnut chia porridge: seriously delicious, you won’t be missing oats with this one

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Walnut chia porridge