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Archive for January, 2014

A calorie is a calorie.

People always come to me saying that they cannot lose weight, that they have tried everything from exercise to diet but still can´t get rid of those extra kilos. They say that they have  a ¨slow metabolism¨ or some other excuse and they are basically lying ( click here). Lying to themselves and to the  people around them because, listen closely I´m going to tell a secret, to lose weight you have to eat less and move more. Yes, that´s right, eat less and move more, don´t believe me, look at the studies (1-4).

People don´t understand but you can actually lose weight eating ¨junk food¨ as long as you are in a calorie deficit. You see, there is no evidence that junk food is more fattening that healthy food if both foods have the same number of calories (5) because a calorie is a calorie.  Well ok, consuming  proteins causes a greater energy expenditure than consuming fat or carbohydrates (6), but still for the sake of simplicity a CALORIE is A CALORIE. If you want to lose weight create a calorie deficit, meaning burn more than what you are eating. And that is exactly what John Cisca did a couple of months ago. He lost 37 pounds in 90 days eating just McDonald’s, it´s a true story (click here). And how did he do it, you ask?? That´s right – by creating a calorie deficit.

Even after explaining this to people you will still hear (at least I do), that ¨I exercised and  I ate less and still I didn´t lose weight¨. So what do you do with these people? First, you tell that in almost 100 years of weight loss research, there hasn´t been a single human that didn´t lose weight when they were in a caloric deficit, so they probably aren´t the exception. Second, you explain to them that people are horrible at counting calories and most of the time eat more than what they think (excellent video – you have to watch  both parts) and also move less (burn less calories) . If they still don´t believe you (which some actually won´t), smile and walk again.

Now there are some exceptions to this rule,people who have a thyroid problem will have a problem losing weight(7) and also some medication can hinder weight loss;

  1. Paxil- used for anxiety
  2. Depakote- used to treat bipolar disease
  3. Prozac- It is associated with weight loss in the first 6 months but after it causes the opposite effect. It´s used for depression
  4. Remeron- Anti-depressant
  5. Zyprexa- used for bipolar disease
  6. Allegra-Zyrtec
  7. Deltasone- Treats asthma and inflammatory bowel disease
  8. Thorazine
  9. Elavil- Anti-depressant
  10. Diabines, Insulate- Type 2 diabetes drugs
  11. Insulin- stops protein breakdown.
  12. Tenomin- Beta-bolcers, drugs used for high blood pressure

* if you are on a medication NEVER stop unless you have talked to your doctor first.

 

Hoped you like it, until next time

References

  1.  Buchholz AC, Schoeller DA. Is a calorie a calorie? Am J Clin Nutr.2004;79(5):899S-906S
  2.  Schoeller DA. The energy balance equation: looking back and looking forward are two very different views. Nutr Rev. 2009;67(5):249–254.
  3. Schoeller DA, Buchholz AC. Energetics of obesity and weight control: does diet composition matter? J Am Diet Assoc. 2005;105(5 Suppl 1):S24–8.
  4.  Westerterp KR. Physical activity, food intake, and body weight regulation: insights from doubly labeled water studies. Nutr Rev. 2010;68(3):148–154.
  5. Surwit RS, Feinglos MN, McCaskill CC, et al. Metabolic and behavioral effects of a high-sucrose diet during weight loss. Am J Clin Nutr. 1997;65(4):908–915
  6. Westerterp KB. Diet induced thermogenesis. Nutr Metab (Lond),2004 Aug 18;1(1):5
  7. http://www.ncbi.nlm.nih.gov/books/NBK28/

 

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Diet

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Protein: part 2

Hey guys, so in the first part of proteins, I talked about what they are and why they are so important. I also mentioned that we should be consuming a little bit more than the recommended daily intake, especially if we exercise. Now, I will explain why that is.

You see, your body is constantly building up and tearing down tissue. When there is tissue growth it´s called anabolism, and when there is tissue breakdown, it´s called catabolism.  When we exercise, especially resistance exercise (that is with weights), we are creating tissue damage, in other words CATABOLISM. To recover from that ¨catabolism¨, the body uses hormones and nutrients (proteins) to recover itself and build up more muscle (1). If we don´t have proteins at that moment, the body breaks down tissue (catabolism) somewhere else to get those amino acids……. in other words you could be losing muscle tissue!! The opposite of why most of us train and also really bad for those who want to lose weight.

When we consume proteins, that stimulates protein synthesis (build-up), and can reduce protein breakdown (catabolism) (2). But how much should we consume? Well, according to a recent study the greater the amount of protein individuals consumed, the greater the overall anabolic response. And when individuals consumed 80% of their daily protein in a single meal, it caused a greater overall anabolic response for the day than when the protein was split up over several meals (2). With all this said, there is still no consensus on how many grams of proteins you should consume per day but you should take into account a couple of things:

  1. If you are consuming a caloric surplus (taking in more calories than you are spending) you will require less protein.
  2. If you are in a caloric deficit (to lose weight, you consume fewer calories than what you burn), you will need more protein, so that you don´t lose muscle (4) Mettler et al. 2010)
  3. Women are better able to preserve lean mass (muscle) compared to men during times of reduced caloric intake (3)
  4. And lean individuals in a caloric deficit need more proteins than overweight individuals (4). So, if you weigh 80 kilos and have a lot of muscle, you will need to consume more  proteins than an 80 kg man who is ¨overweight¨ or has very little muscle.

With all this said, the ¨experts¨ recommend taking in between 0.70-1 gram per pound (5).

Now let us get to the topic if too much protein is bad for the kidney.  Within wide limits, there is no evidence that a diet high in protein has any detrimental effect on those with normal renal function(6-8). Now, if you have problems with your kidneys you should NOT be on a diet high in protein. Also, a recent study done in a Spanish university said a diet high in proteins increases the changes of experimenting renal dysfunction (click here). However, this study was done in rats and they were on a diet where the proteins represented 45% of that diet!! The normal recommendations are that proteins should represent just 10%,  45% is 4 times the recommend averages! So of course, I don´t think that is healthy. On top of that I don´t know how much the rats where exercising.  With all this said, I still think that people who want to lose weight should be on a diet high in protein, also those that exercise or are active. On the other hand, those who are  couch potatoes have no reason to be eating more proteins.

Hope you guys liked it. Till next time!

References

  1. Kumar V, Atherton P, Smith K, Rennie MJ. Human muscle protein synthesis and breakdown during and after exercise. J Appl Physiol 2009, 106(6):2026-39.
  2. Wolfe R, Deutz N. Is there a maximal anabolic response to protein intake with a meal. Clinical Nutrition.2013.
  3. Lemon PW. Beyond the zone: protein needs of active individuals. J Am Coll Nutr.200 Oct;19
  4. Mettler, S., Mitchell, N., & Tipton, K. D. Increased protein intake reduces lean body mass loss during weight loss in athletes. Medicine and Science in Sports and Exercise, 2010.42, 326-337.
  5. Schoenfeld B. The Max Muscle Plan. Human Kinetics.2013
  6. Lowery LM, Daugherty A, Miller B, Bernstein E, Smurawa T. Large chronic protein intake does not affect markers of renal damage in healthy resistance trainer. The FASEB Journal.2011;25:983.25
  7. Lowery LM, Devia L. Dietary protein safety and resistance exercise: what do we really know?. J Int Soc Sports Nutr.2009 Jan12;6:3
  8. Martin WF, Armstrong LE, Rodriguez NR. Dietary protein intake and renal function. Nutr Metab (lond),2005

 

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Diet

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Proteins- Part 1

We have all heard of proteins at one point or another in our life but do we really know what they are or do? Let´s find out.

Proteins are made up of amino acids. There are 20 amino acids. These amino acids can be arranged in a million different ways to create millions of different proteins. Amino acids can be categorized as essential or non-essential. Essential amino acids are those that we cannot create through our own metabolism. Therefore we need to obtain them through foods. Non-essential amino acids are those that our body can synthesize (build). One gram of protein contains 4 calories (in comparison, one gram of carbohydrates also contains 4 calories, and one gram of fat 9 calories).  Proteins are used by the body to:

  1. Build, strengthen and repair/ replace things, such as tissue.
  2. Make antibodies for our immune system.
  3. Make hormones.
  4. Muscle contractions.
  5. Make enzymes.
  6. Transport things.
  7. Store things .

Dietary thermogenesis (DT)  is the process of energy production in the body caused directly by the metabolizing of food consumed. Consuming more protein causes a greater energy expenditure than consuming fat and carbohydrates (2) ( click here to read more). And diets high in protein are more important than the  low carb or low fat component in achieving body weight loss and weight maintenance (3). This is because, higher protein diets generally help people lose less muscle and more fat at the same calorie intake. (4-7). However, after a certain point eating more protein isn´t going to help you lose any more fat. And in extreme cases it could even make you gain fat (it´s quite hard to turn protein into fat but it could happen). But with all this said, most people probably eat less proteins than they are suppossed to. Here is what is recommend by the experts (8):

  • Infants require about 10 grams a day.
  • Teenage boys need up to 52 grams a day.
  • Teenage girls need 46 grams a day.
  • Adult men need about 56 grams a day.
  • Adult women need about 46 grams a day

but if you ask me, it probably woudn´t hurt if we consumed a little bit more especially if you are exercising (9)!  But, I will explain that in my next blog, where I will also talk about if eating too many proteins is bad for the kidneys and how much should we be consuming.

So to summarize:

  1. Proteins cause a greater energy expenditure, when you metabolize them, than consuming fat and carbohydrates.
  2. Diets high in protein are very important in achieving body loss and body maintenance. .
  3. Proteins are made up of amino acids. There are 20 amino acids, that can be divided into essential and non-essential.
  4. 1 gram of protein contains 4 kcla.

P.S . By the way here is a great page of a friend of mine who does customize cell, tablet and Ipad cases. Www.personalaizer.com

References

  1. http://www.ncbi.nlm.nih.gov/books/NBK26911/
  2. Westerterp KB. Diet induced thermogenesis. Nutr Metab (Lond),2004 Aug 18;1(1):5
  3. Soenen S, Bonomi AG, Lemmens SG, Scholte J, Thijssen MA, van Berkum F, Westerkep-Plantenga MS. Relatively high-protein or `low -carb´ energy-restricted diets for body weight loss and body weight maintenance. Physiol Behav, 2010 Oct 10;107(3):374-80.
  4. Layman DK, Evans E, Baum JI, Seyler J, Erickson DJ, Boileau RA. Dietary protein and exercise have additive effects on body composition during weight loss in adult wome. J Nutr. 2005;135(8):1903-10.
  5. Leidy HJ, Carnell NS, Mattes RD, Campbell WW. Higher protein intake preserves lean mass and satiety with weight loss in pre-obese and obese wome. Obesity.2007;15(2):421-29.
  6. Layman DK. Protein quantity and quality at levels above the RDA improves adult weight loss. J Am Col Nutr.2004;23(6)
  7. Wycherley TP, Moran LJ Clifton PM, Noakes M, Brinkworth GD. Effects of energy-restricted high-protein,low-fat compared with standard-protein, low-fat diets: a meta-analysis of randomized controlled trials. Am J Clin Nutr.2012;96(6):1281-98.
  8. Source for Acceptable Macronutrient Distribution Range (AMDR) reference and RDAs: Institute of Medicine (IOM) Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. This report may be accessed via www.nap.edu
  9. Wolfe RR, Deutz NE. Is there a maximal anabolic response to protein intake. Nutr, 2013 Apr,32(2):309-13
 

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I run and I run but I don´t lose weight!!

 Has this ever happened to you or have you ever heard this from someone? I sure have, I hear it all the time…. ¨I go running everyday 45 minutes and I´m still not losing weight, I must have a slow metabolism¨ (BIGGEST Bullsh%t out there). Well, as always, let me explain.

First, there is no such thing as a slow metabolism, I talked about that in one of my previous posts (https://sports-diet-pain.com/2013/10/17/metabolism-the-myth-behind-slow-and-fast-metabolism/), please watch the video attached to that post as it is GREAT!!

Second, you are probably not losing weight for a couple of reasons:
1. You do the same training over and over. You see, the body adapts and if every time you go running you do the same thing it´s not going to cost you as much as it did at the beginning and you will also be burning fewer calories. So change the training plan!!!
2. The intensity is always the same. When we do finally change the training plan we only change the time, forgetting sometimes that intensity is more important than time (https://sports-diet-pain.com/2013/10/18/high-intensity-interval-training/). The higher the intensity, the more calories you will be burning after the training. Try incorporating series into your trainings plan.
3. Don´t just run, change activity. Go swimming, go bike riding, GO LIFT WEIGHTS. Yes, resistance training is great and not just for bodybuilders but for everyone. A recent study showed that 10 weeks of resistance training may increase lean weight by 1.4 kg, increase resting metabolic rate by 7%, and reduce fat weight by 1.8 kg (1).
4. Rest. Some people don´t know this but sometimes less is better. They body has to recover after a training. When you train everyday for long periods of time the body starts releasing cortisol. Cortisol is the ¨stress¨ hormone and can have negative effects (3-4). Cortisol isn´t always bad and is sometimes necessary but high levels of cortisol usually aren´t that good. A recent study thas shown that endurance athletes have higher levels of cortisol (2). So take a rest, don´t run so much!
5. Overcompensation. People sometimes eat more after exercise because they think they have burned so many calories but, you see, running really doesn´t burn that many calories. For example: 30 minutes of steady pace running will probably burn you in between 300-350 calories. That is not that much….. a simple cheeseburger in McD%& has 300 calories (5). So of course running is good and burns calories but don´t ruin it afterward by not watching what you eat.

So, in conclusion: change your training plan, play with the intensity and time, change sport activity and, most importantly, sometimes more is not better. Keep running!!

References
  1. Westcott WL. Resitance training is medicine: effects of strength training on health. Curr Sports Med Rep 2012 Jul-Aug;11(4):209-16.
  2. Skoluda N. Dettenborn L, Stalder T, Kirschbaum C. Elevated hair cortisol concentrations in endurance athletes. Phsychoneuroendocrinology, 2012 May;37(5):611-7.
  3. Kanaley JA, Weltman JY, Pieper KS, Weltman A, Hartman ML. Cortisol and growth hormone responses to exercise at different times of day. J Clin Endocrinol Metab 2001 Jun;86(6):2881-9.
  4. Heitkamp HC, Schulz H, Rocker K, DickHuth HH. Endurance training in females: changes in beta-endorphin and ACTH. Int Sports Med.1198 May;19(4):260-4.
  5. http://nutrition.mcdonalds.com/getnutrition/nutritionfacts.pdf

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Exercise

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Running shoes – are they really that important?

Running shoes can make a simple person go crazy. I went to buy some the other day, thinking it would be an easy task and, boy, was I wrong. First, they asked me if I was a pronator or supinator, I answered that I was more of terminator. Then they asked me about stability, I´ve always been afraid of that issue so I decided not to answer. After that scare, they put me on a treadmill and asked me to walk and run and when that was over they told me they had the perfect shoe for me, it was called the SUPERAXICS BALANCE NEUTRAL STABILITY POWER 1000  and it only costed 165€. I almost had a heart attack!!

Obviously, I exaggerated a little but I wanted to get the point across, buying running shoes can sometimes be a nightmare. But, does it have to be? Is pronation-supination really that important? Do you really have to buy expensive shoes to prevent an injury? What about those new stability shoes, do they really work? Let´s find out….

Running shoes were invented around 40-50 years ago, before that there were only normal shoes or something to cover your feet with and way before that we didn´t even have shoes, but we were still able to run.  And that´s what the book Born to Run talks about. It says that we were meant to run barefoot and that the invention of the shoes has altered our footstrike. You see, when you run barefoot you land with the forefoot because if you landed with your heel it would hurt. However, when you run with running shoes you tend to land with the heel, that´s why running shoes tend to have a lot of cushion in the back.  So now you see a lot of people running with these minimalist shoes, like the five fingers. And you may ask yourself what´s better? In my opinion, the best thing is to buy a normal shoe and alter your footstrike, meaning sometimes you land with the forefoot and sometimes with the barefoot. You see, in his book, Born to Run, the author states that humans were meant to run barefoot and I agree with that, but we were not meant to run MARATHONS or SEMI-MARATHONS. We ran to catch our food and that was it!! I know a lot of people who are running marathons and semi-marathons with minimalist shoes, heck I have a friend who just last month ran the MALAGA MARATHON in SANDALS, yes sandals (here is the picture to proof it). And he is perfectly fine, still runs with the sandals and loves them. He is also a trainer and a great physical therapist.

chema

Still, I wouldn´t recommend people to run marathons with minimalistic shoes, 5-10km yes (that´s probably what we ran to catch our food), but 41km, hell no.  And do minimalistic shoes prevent more injuries than ¨normal¨ running shoes? Well, according to a recent study published in the British Journal of Sports Medicine, they don´t (1). They found no difference in injury rates between runners who wore soft-soled shoes and those who wore firm-soled shoes. But, you can also read this the other way – RUNNING SHOES DO NOT PREVENT MORE INJURIES THAN MINIMALISTIC SHOES.

So with all this said, you can imagine that running shoes are really not that important and various studies have demonstrated that. For example, researchers have NOT found a strong link between pronation and injury, that is why stability shoes don´t seem to help people who have been diagnosed as ¨over pronators¨. Another paper in 2009 concluded that ¨prescribing cushioned, motion-controlled shoes to distance runners was not evidence-based (2).

So what do we do……. well, I guess each person is different and has to find their shoe in which they are comfortable.  But the point I´m trying to get across, is that we really don´t need expensive shoes to run, heck, we don´t even need shoes to run.

chema2

(My friend Chema again, but this time WITHOUT SANDALS)

And I also wouldn´t bother too much about pronation, supination and stability, I don´t think the sandals my friend ran with had any of those features. So, until next time keep running!!!

I leave you with a nice article that talks about pronation and a video that talks about ¨Born to run¨.

http://www.runnersworld.com/running-shoes/does-pronation-matter

References:

Theisen D, Malisous L, Genin J, Delattre N. Influence of midsole hardness of standard cushioned shoes on running-related injury risk. Br J Sports Med.2013

Richards CE, Margin PJ, Callister R. Is your prescription of distance running shoes evidence-based. Br J Sports Med.2009 Mar;43(3):159-62.

 
 

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Exercise

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Controlling inflammation and pain through NUTRITION

Happy New Year!! My first post of the year will be about nutrition and the importance of a good diet in dealing with pain and inflammation. But before that, I just want to mention that I have gotten some feedback saying that my post are too long, so from now on I will try to make them shorter. If there is something someone doesn´t understand or wants me to go into greater detail please don´t hesitate to comment or write me an email.

We all know how important a good diet is for our health (althought most of us don´t practice it), but I´m pretty sure that a lot of us don´t know that what we eat can have an influence on pain and inflammation. That´s right, whenever, for example, we twist our ankle or have a tendinitis, what we eat is going to either help us get better sooner or delay our recovery. Also, many of the current diseases develop and exist as consequence of chronic inflammation, such as cancer, heart disease, hypertension, osteoarthritis, diabetes, osteoporosis, etc. (1-4) Let me explain:

Inflammation is part of the healing process; however, chronic inflammation represents a lack of tissue healing and actually promotes on-going tissue damage (5).  The way we are eating is causing dietary imbalances and this, in turn, is leading to inflammation. Some of those dietary imbalances are: excessive omega-6 fatty acid intake, inadequate potassium intake, inadequate magnesium intake, and inadequate phytonutrient.  Now, I hope no one is  getting the silly idea that all they have to do is take supplementation pills to correct those imbalances, because it´s not that easy. The easiest way to correct it is by eating properly. And what is eating properly? Well, this list might help you:

Pro-inflammatory foods : Refined grains, Whole grains, Grain/ flour products, most packaged foods, most processed foods, deep fried food, trans fats, grain fed meats/eggs.

Anti-inflammatory foods: Fruits, Vegetables, Nuts Fresh Fish, Wild game, Dark Chocolate, Omega-3 eggs, Organic extra virgin olive oil, organic coconut oil, organic butter, red wine (a glass, not a WHOLE BOTTLE), spices: ginger, turmeric, garlic, oregano, potatoes.

Type 2 diabetes, which is caused by insulin resistance (https://sports-diet-pain.com/2013/10/31/sugar-the-hidden-enemy-part-2/), is also an inflammatory disease (7). Monounsaturated fatty acids found in nuts, olive oil and animal product promote insulin sensitivity and have anti-inflammatory properties, which lowers insulin resistance.  Another thing that causes inflammation is when we have an imbalance between omega 6 intake and omega 3 intake. Ideally, we should consume an omega 6:omega 3 ratio of 4 :1; however most of us are consuming a ration of 20-30:1. Here is a list of some common foods and what their ratios are (more than one might be surprising):

Food                                                                               N-6: N -3 Ratio

Grains                                                                                 20 : 1

Seed and seed oils (corn, sunflower)                    70 : 1

Soybean oil                                                                       7 : 1

Chicken (white meat)                                                  15 : 1

Chicken (dark meat)                                                    17: 1

Salmon                                                                              1 : 1

Potato chips                                                                  60 : 1

Fruit                                                                                   3 : 1

Nuts                                                                                    5 :1

Wild game                                                                        2.5 : 1                 (8)

So to summarize, food can have a big impact on pain and inflammation.  So next time you hurt yourself and you see that the pain or the inflammation is not going away, try to eat properly. It will probably help with the inflammation and in the long run you will be doing yourself a favour.

References

  1. Balkwill F, Mantovani A. Inflammation and cancer back to Virchow? Lancert.2001;357:539-45.
  2. Ban WA, Man SF, Senthilselvan A, Sinn DD. Association between chronic obstructive pulmonary disease and systemic inflammation: a systematic review and meta-analysis. Thorax 2004;59:574-80.
  3. Fernandez-Real JM, Ricart W. Insulin resitance and chronic cardiovascular inflammatory syndrome. Endo Rev 2003;24:278-301.
  4. Ross R. Atherosclerosis-an inflammatory disease. N Engl J Med 1999;340:115-26.
  5. Seaman DR. THe diet-induced proinflammatory state: a cause of chronic pain and other degenerative diseases? J Manipulative Physio Ther 2002;25:168-79.
  6. Liebenson C. Rehabilitation of the Spine. Lippincott Williams & Wilkins 2007. pg 730
  7. Pickup JC. Inflammation and activated innate immunity in the pathogenesis of type 2 diabetes. Diabetes Care 2004; 27:813-23.
  8. Ros E. Dietary cis-monounsaturated fatty acids and metabolic control in type 2 diabetes. Am J Clin Nutr 2003:78:61
  9. Liebenson C. Rehabilitation of the Spine. Lippincott Williams & Wilkins 2007. pg 733

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