Wellness Refocused Education: Does stretching make an impact?

I’m sure many of you have been told that stretching and warming up as well as cooling down are an important part of your workout. Have any of you ever really thought about why or if there are better ways to warm up and stretch?

Would you laugh if you learned that you may want to stretch on a daily basis even if you’re not exercising?

There are a lot of activities that we do that can put stress on our bodies, many we don’t typically think of such as sitting or standing for long periods of time or walking. Crossing your legs or sitting on your wallet can actually be a literal pain in the ass…and lower back.

Just like there are different styles of exercise to achieve different health goals (i.e. strength training, endurance training, etc), there are also a variety of stretches with unique purposes, but first what are we stretching.

Our skeleton is compromised of  206 bones, which makes up about 20% of out mass (Marieb & Hoehn, 2016). Our skeletons are “divided” into two sections: axial and appendicular portions. The axial includes the skull, vertebral column and the thoracic cage. This section of the body has 80 bones. The other 126 bones are found in appendicular portion, which includes the pectoral girdle and the upper limb, the pelvic girdle and the lower limb. This section of the body is what helps us with mobility (Marieb & Hoehn, 2016).

Our bodies have different kinds of muscle tissue, but for this post, we’re talking about skeletal muscle also known as voluntary muscle (Marieb & Hoehn, 2016). Skeletal muscle attaches to bones and during contractions they pull on the bones or skin and create movement. The amount of work a muscle can do is based on stimuli acted on the muscle and the muscle reacts and adapts. Overload helps the muscle increase strength and endurance.

There are three functional classifications for joints:

  1. synarthroses – immovable joints (ex. skull bone – cranial and facial bones)
  2. amphiarthroses – slightly moveable joints (ex. pubic symphysis – pubic bones)
  3. diarthroses – freely moveable joints (ex. shoulder – scapula and humerus)

Within these classifications are structural classifications: fibrous, cartilaginous and synovial. Synovial are considered diarthroses.

The way we move is determined by our range of motion or ROM at our synovial joints (Page, 2012). A synovial joint is where articulating bones are separated by a membrane of fluid. These joints are reinforced with ligaments. There are sixkinds of synovial joints in the human body:

  1. Hinge
  2. Pivot
  3. Plane
  4. Saddle
  5. Ball-and-Socket
  6. Condyalar

“Joints are the weakest part of the skeleton”, but there are ways to stablize them (Marieb & Hoehn, 2016). The shape of the bone plays a small role in stablization whereas ligaments and muscle tone  are the most important for stablizing the joint. Muscle tone in this sense is defined as “low levels of contractile activity in relaxed muscles that keep the muscles healthy and ready to react to stimulation (Marieb & Hoehn, 2016).”

It’s clear that stronger muscles assist our joints, but does stretching prevent injury or even soreness post-workout? Well, there’s research on both sides, but first what kinds of stretches are there to utilize?

There are three kindsof stretches: static, dynamic and pre-contraction.

A static stretch involves holding a muscle in specific position to allow and create tension. This style stretch is repeated and can be done on your own or with a partner.

A dynamic stretch is an active stretch will moves a limb through its full ROM. This style of stretch can also be repeated and done on your own or with a partner.

A pre-contraction stretch involves a contraction of the muscle being stretched such and can be performed with resistance provided by a band, strap or partner.

Both static stretching and dynamic stretching commonly suggested in training, however, studies show that dynamic stretching may have more benefits than static stretches.

A 2009 study examined the effects of dynamic and static stretching on vertical jump and activity of the muscle tissue. Researchers found a signification increase in activity in the muscle tissue after participants engaged in dynamic stretching in comparison to static stretching (Hough, P.A., 2009). “In this investigation electromyographic activity was significantly greater after dynamic stretching compared with static stretching indicating an increase in muscle activation post dynamic stretching.” Dynamic stretching engages the muscle in a movement, versus holding it like static.

This ties back to the amount of work a muscle is capable of is determined by the amount of stimuli placed upon it, repeatedly. It’s hard to say if while the dynamic stretching had more of an impact than static stretching did if it was a combination of positive factors that contributed to the improved jump.

Researchers also found that there was an increase in neuromuscular mechanisms, meaning the contact between the brain and muscle fibers were able to increase communication. Dynamic stretching may better assist in preventing injury because of the potential growth of muscle fibers and the impacts on strength.

A pre-contraction stretch, may be suggested to assist ROM and flexibility. Similarly to dynamic stretching, muscle activation in this kind of stretch may remain the same or increase after the stretch is executed (Page, P., 2012).

The kind of stretch can determine the amount of benefit and overall stretching may play a role in decreasing injury in certain sport disciplines. However, post-workout muscle soreness or “delayed onset muscle soreness (DOMS) can occur after single bouts of high-intensity running and/or unfamiliar activity (Herbert et al., 2011).” This is the body’s reaction to a new activity, which can include doing the same exercise with a different load than previously used such as increasing weight or changing the repetition range or even variations of form. The way the stretching is incorporated into programming can play a role in the amount of benefit.

Literature from a review in 2017 found that acute stretching versus long-term chronic stretching could have different affects on performance, DOMS and chronic injury in endurance runners (Baxter et al., 2017). The review found that much of literature argued that acute stretching during a warm-up may have actually decreased efficiency. Other research examined in the review found that joint stability was a result of muscle strength in general, not acute stretching.

Other research examined in the review argued that engaging in chronic stretching wouldn’t hinder immediate performance and could increase flexibility (Baxter et al., 2017). However, even chronic stretching research came back to discussing the important of muscle strength and stiffness in relation to joint stability.

The same review found that many studies were investigating the benefits of static stretching, not comparing benefits of variations of stretching, which would give different results or incomplete results.

Other research that I found interesting has looked at the exercise interventions – not necessarily just stretching, but incorporating exercises that contribute to prevent. A review on the effectiveness of exercise interventions to prevent sports injuries sought to determine if exercises such as strength training, stretching, proprioception or a combination of these could reduce acute or overuse injury. They examined 25 trials that included 26,610 participant with 3,464 injuries and determined that strength training in general “reduced injuries to less than a third and overuse injuries could be almost halved (Lauresen et al., 2013).”

This I found this interesting because the components of dynamic stretching are similar to components of strength training such as shoulder circles and arm circles, which can be done with or without weight, squats, which can also be done with or without weight. There are some dynamic stretches that are just stretches such as leg swings or neck flexion/extension.

This past spring, when I got back into a structure lifting routine I had less low-back pain, less muscle spasms and tightness and less likeliness of my SI dislocating, which meant less trips to the chiropractor. She explained that exercises like the back squat, even with light weight helped elongate the muscle and stretch it out. I had been seated more often than I ever had been while in school and that was causing an issue for muscle and joints because it meant that it wasn’t being activated as much.

I used a dynamic warm up without my workout and I incorporate components into my lifting, even though I’m doing a prewritten program. My favorite dynamic warm up is of course for legs:

  1. Hip abduction with a medium resistance band (both sides): 10 reps
  2. Hip abduction with a medium resistance band (both sides): 20 reps
  3. Forward hip height knee lifts with a medium resistance bands (both sides): 15 reps
  4. Standing kickbacks with a medium resistance band (both sides): 10 reps
  5. Side hip height knee lifts with a medium resistance bands (both sides) 15 reps
  6. Banded forward hip hinge: 2 sets of 10 reps
  7. Banded barbell squats with just the bar: 10 reps

I do this before I start my workout, but I’ve also incorporated some of these into my routine. I always warm up large lifts like squats, deadlifts, bench press, over head press – mostly, anything with a barbell. I’ve utilized banded clam shells – and those are no joke.

There’s importance in developing strength and flexibility in both joints and muscles, but I think the research shows that it can come from a number of source. It’s not just about one kind of stretch or just resistance training. Together these can lead to less pain and a decreased chance of daily injury.  Regularly activity can also increase circulation by assisting blood to flow into your muscles.

I’m pro-stretching, but I think it needs to be dynamic and it should compliment what you’re doing that day in the gym. My upper body/back day warm up is very different than my lower body warm up.

Do you stretch or do you focus on multiple movements in your programming to assist in muscle and joint development?

❤ Cristina

References:

Claire Baxter, Lars R. Mc Naughton, Andy Sparks, Lynda Norton & David Bentley (2017) Impact of stretching on the performance and injury risk of long-distance runners, Research in Sports Medicine, 25:1, 78-90, DOI: 10.1080/15438627.2016.1258640

Herbert, R., de Noronha, M., & Kamper, S. (2011). Stretching to prevent or reduce muscle soreness after exercise. The Cochrane Database of Systemtic Reviews, 1-50.

Lauresen, J. B., Bertelsen, D. M., & Andersen, L. B. (2013). The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomised controlled trials. British Journal of Sports Medicine, 871-877.

Marieb, E. N., & Hoehn, K. (2016). The Skeleton. In E. N. Marieb, & K. Hoehn, Human Anatomy and Physiology (pp. 199-250). New York: Pearson Learning Solutions.

Marieb, E. N., & Hoehn, K. (2016). Muscles and Muscle Tissues. In E. N. Marieb, & K. Hoehn, Human Anatomy and Physiology (pp. 278-320). New York: Pearson Learning Solutions.

Page, P. (2012). Current concepts in muscle stretching for exercise and rehabilitation. International Journal of Sports Physical Therapy, 109-119.

Hough, P. A. (2009). Effects of Dynamic and Static Stretching on Vertical Jump Performance and Electromyographic Activity. The Journal of Strength & Conditioning Research, 507-512.

Perrier, E. T. (2011). The Acute Effects of a Warm-Up Including Static or Dynamic Stretching on Countermovement Jump Height, Reaction Time, and Flexibility. The Journal of Strength & Conditioning Research, 1925-19231.

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Wellness Refocused Education: Alcohol

I can’t have wine. I can’t have beer. I can’t go out.

I’ve heard this from a few clients. I’ve read it and heard it from a few people online. When I started, it’s something that I said myself.

It’s possible to still have a beer or a glass of wine and lose weight and create a healthy lifestyle. I kept alcohol in my plan during my last competition prep and saw the lowest body fat percentage I have ever had. This isn’t something many people practice, but in my last prep, it’s something I wanted to keep in for when I wanted a drink with dinner or date night. I wanted the ability to have a drink if I felt comfortable with having one work in my day.

Alcohol consumption and weight loss comes down to a few things.

  1. Maintaining a caloric deficit consistently over time.
  2. Determining how you feel about the choice of having a drink.

Weight loss/fat loss occur over time. While weight can fluctuate greatly day-to-day, true fat loss occurs over a period of time longer than a few days. You need to be in a caloric deficit over that period and that can be created through your nutrition protocol and workout programming.

The mental aspect of dieting is something that I talk about heavily with my clients because I don’t believe in eating things you don’t like (you won’t adhere to your plan if you don’t like it) and you also need to be comfortable or at least ok with the ramifications (if any) of your choices.

Three questions I get often are:

  • Why doesn’t alcohol have a nutrition label?
  • How do I track alcohol?
  • Should I leave space in my diet for alcohol? i.e. should there be an allotted number of calories or macros for alcohol to replace food?

Before we answer these questions, let understand alcohol a little bit better.

When we talk about alcohol as a consumable like beer, we’re meaning ethanol. Ethanol is a specific type of alcohol that you find in beer, wine and distilled spirits. Alcohol and ethanol are used interchangeably.

Alcohol is technically a macronutrient.

Chemically they are structurally similar to carbohydrates. Chemically, carbohydrates are C6H12O6 whereas ethanol alcohol is C2H5OH. Alcohol is similar to carbohydrates because they’re created from fermented carbohydrates in a process called ethanol fermentation or alcoholic fermentation.

Image result for alcoholic fermentation formula

Alcohol has 7 calories associated per gram. This makes them more calorically dense than carbohydrates and protein, but less calorically dense than fat (Thompson & Manore, 2015). Ethanol is a specific type of alcohol that you find in beer, wine and distilled spirits.

Alcohol provides no nutritional value, but it has energy.

So, if it’s a macronutrient why isn’t it on a nutrition label?

While the FDA and USDA are regulatory entities for food and supplements, they don’t regulate alcohol. That’s the short answer. Alcohol is regulated by the Alcohol and Tobacco Tax and Trade Bureau (TTB). This organization doesn’t require that companies provide nutritional information on their products. However, in 2004 a ruling called the Federal Alcohol Administration Act allowed TTB to implement labeling regulations as long as the information was accurate and not misleading to consumers. The FAA Act also had restrictions about marketing and statements in relation to benefits of alcohol. Since the FAA Action, more alcohol companies have tried to appease health conscious consumers by adding nutrition labels, however, if you look closely, you’ll see in many cases the calories don’t match the nutritional values provided on the label.

The reason – alcohol isn’t a nutrient that is usually provided on a label, and since much of the carbohydrates are converted into alcohol only those not converted are accounted for on the label.

Below is a label of Angry Orchard Hard Cider. We all know that apples are carbohydrates and we know carbohydrates is a fancy name for sugar. You’ll see that calories, carbohydrates and sugars are accounted for on the label, but if you multiply 31g of carbohydrates by 4 calories per gram, you get 124 calories, not 210. That’s not to say that there are truly 84 calories or 12g of alcohol in this bottle, but you get the idea – the energy is accounted for, but not the nutrient.

This was in the fridge at JP’s parents house. Notice how it lists carbohydrates as 5g (which is 20 calories) and at the top it says calories from alcohol 120 (roughly 17g). I’m not sure if this is something that we will be seeing more of, but I do think it allows people to make more healthful decisions – nutritionally and psychologically.

How do you track it if you’re counting macros?

I recommended threeways to accommodate alcohol into their plan.

1. Since it’s chemically similar to carbohydrates, you can over-accommodate by taking the total calories of the drink and dividing by 4 calories (1g of carbohydrates) to determine how many grams of carbohydrates you would use to account for your drink.

2. Calorically, since they’re close to fats at 7 calories per gram, you can divide by 9 calories (1g of fats) and determine how many grams of fats you want to use to account for your drink.

Both of these ways to accommodate alcohol aren’t going to be perfect – there’s no perfect way to account for it. Even if you’re counting calories, many people aren’t measuring all of the ingredients in their drinks and are estimating their consumption – especially if they’re ordering out.

3. The most common way I recommend they accommodate alcohol into their plan is to calculate it similarly to above and accepting and allowing themselves to eat in a surplus that day. I hardly ever recommend that clients substitute alcohol for food. Not only is alcohol not nutritious but decreasing food will also amplify the impacts that alcohol can have on a body such as stimulant effects.

Early in my journey, I made the mistake of attempting to leave space in my day for a drink to go out and it hits you like a ton of bricks if you’re not careful. Now, if I have a drink I’ve actively made the decision to have it and go over my calories for the day. This doesn’t mean that I load up and go over excessively. In many cases I’m putting my body into maintenance range, not necessarily a surplus.

We’ve talked about how the body breaks down certain nutrients from complex to simple forms and we’ve talk about how some things are broken down at different rates. As a liquid, alcohol is readily absorbed from the both the stomach and the small intestine – it’s not digested before reaching these two organs (Thompson & Manore, 2015). Foods containing protein, fat and fiber help slow down absorption rates of alcohol and therefore slowly the effects of it.

After alcohol enters the bloodstream, it moves to the liver where it’s broken down. The liver produces two enzymes that break down alcohol – alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) (Thompson & Manore, 2015). These enzymes break down alcohol so that it’s energy can be readily available to the body.  After the energy has been made ready, the body only has two options – use it for energy if caloric needs haven’t been met or convert it to fatty acids and store it for later.

While age, gender and weight can impact how alcohol impacts a person, the rate at which alcohol breaks down once it reaches the liver can’t be altered regardless of the myths out there.

Why do so many people cut it out of their diets if you can still lose weight and fat when consuming alcohol?

Again, there’s no nutritional value and it’s easy over consume energy through alcohol consumption. It’s not just from alcohol in beverages that the calories come from, many who enjoy mixed drinks are adding calories through sugary mixers and additions likes cherries and whipped cream. Other negative behaviors like over-eating as well as heavy drinking are also associated with alcohol consumption.

It’s possible that there are some benefits to light or moderate alcohol consumption. Resveratrol is a phytochemical found in red wines, grapes and other plants that can play a role in limiting cellular damage and help lower risk of certain chronic diseases (Thompson & Manore, 2015). However, the amount of resveratrol in wines may be too little to make a meaningful impact and therefore a purified supplement of resveratrol would be recommended. Much research has found links between moderate alcohol consumption and lower chronic disease, but not causation. “Clinical studies are limited by their observational nature as well as for the difficulties to abstract the benefits of wine from other confounders” meaning that it can be hard to determine if the benefits were from the wine or other healthy positive behaviors (Artero, Artero, Tarin & Cano, 2015). There are clear risks to drinking too much alcohol such as higher risk of chronic disease like impaired bone health, pancreatic injury and diabetes, abdominal obesity, cancer.

There is no recommended daily allowance (RDA) for alcohol, however, moderation per gender is encouraged. Moderation for women is one drink per day and no more than two drink per day for men.

Similarly to deciding if you should have a dessert after dinner or an extra serving of what would be considered a treat, you should feel confident in the decision to participate. Having a glass of wine or a bottle of beer shouldn’t make you feel derailed or feel like you’re ruining progress. It should be accounted for in whatever way you believe will be helpful. If it’s moderating the rest of the day and acknowledging that you will be out of a deficit that day – then so be it. If it’s not counting it, but going about your day tracking other items – then so be it. Just don’t allow yourself to become out of control.

As for me, I enjoy a beer with dinner. I like a cocktail when it’s hot. Sometimes I put liquor in my coffee when we make brunch.

Cheers!

❤ Cristina

References

Alcohol and Tobacco Tax and Trade Bureau. (2018, July 2). Beverage Alcohol. Retrieved from Alcohol and Tobacco Tax and Trade Bureau: https://www.ttb.gov/alcohol/bev-alc.shtml

Artero, A., Artero, A., Tarin, J. J., & Cano, A. (2015). The impact of moderate wine consumption on health. Maturitas, 3-13.

Department of the Treasury: Alcohol and Tobacco Tax and Trade Bureau. (2004, April 7). Caloric and Carbohydrate Representations in the Labeling and Advertising of Wine, Distilled Spirits and Malt Beverages. Retrieved from Department of the Treasury: Alcohol and Tobacco Tax and Trade Bureau: https://www.ttb.gov/rulings/2004-1.pdf

ScienceDirect. (2018, July 2). Ethanol fermentation. Retrieved from ScienceDirect: https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/ethanol-fermentation

Thompson, J., & Manore, M. (2015). Nutrition: An Applied Approach. Boston: Pearson.

Wellness Refocused Education: Snacking intentionally

When I started competing I thought I had to eat every few hours. This was something that I had read about, but more importantly (at the time) it was something that I saw over and over again in practice online.

For me, every few hours meant every three hours. I was on a cycle of eating about seven or eight meals or snacks, which were small in volume. I didn’t have macronutrient goals per meal (I still don’t). I didn’t have calorie goals per meal (I still don’t).

Now, there’s nothing wrong with eating in this structure. I do think small meals can help you get through the day, but naturally, this method also has you in a cycle of wondering what time it is and when the next meal is coming. This kind of focus on meal timing has the potential to be harmful mentally. This concept can be considered grazing, since meals are consumed steadily throughout the day instead of in two or three large meals.

Transitioning away from this approach to eating when I was hungry was a slight struggle at first. However, after a few months, I relearned my body and now I have an idea of meal timing that works for me as well as how full certain combinations of foods make me so that I can plan when I’m on the go.

One positive thing from this eating structure is that I started to eliminate labels from food like breakfast, lunch and dinner.

By removing labels and eating what I’m interested in, I gave myself more flexibility and diversity to my meals. Some days I just want eggs for dinner – they’re also quick and no hassle.

I hear often, that snacking is bad, can lead to weight gain and in some cases can lead to going “off-track”. I think many confuse having a snack with negative snacking behavior like what we describe as mindless eating. I do also understand that some foods can lead an individual to not stay on track and in that case, I would encourage that person to dig deeper and think about why that food has that power.

So snacking, what’s the science say?

A 2011 study investigated the definitions of snacking, perceptions of snack foods and snacking behavior defined “having a snack” as “eating food between meals or eating a light meal (Chaplin & Smith, 2011).”

Other research has defined a snack by caloric consumption, social interactions and the time of day for the consumption, but “these definitions fail to consider the influence of social patterns and/or cultural norms on timing and size of eating occasions (Chaplin & Smith, 2011).” These definitions also don’t take into consideration a person’s motivations to eat such as not triggered by hunger or social environment.

Another article that reviewed definitions of snacking and motivations to snack found that without a consistent definition of the words snack and snack, it’s hard to determine if prevalence has increased and if it does in fact contribute to weight gain (Hess, Jonnalagadda, & Slavin, 2017).

For the purpose of this post, the definition that I’ll use is:

Snack: an individual food or light meal consumed between meals with or without intent.

Researchers of the 2011 study also found that language used to describe and talk about food influenced how it was reported such as labeling “healthy foods” as snacks (Larson, Miller, Watts, Story, & Neumark-Sztainer, 2016). Gender also made a difference.

While having a snack can simply mean that you have consumed an individual item or light meal with intent, snacking behavior is typically associated with over-consumption of calories.

A 2016 study in the Journal of Nutrition examined snacking behavior from 2,793 adolescents to determine the influence this behavior had on weight status (Larson, Miller, Watts, Story, & Neumark-Sztainer, 2016). Researchers were interested in this examination because there is a lot of conflicting findings that suggest snacking behavior may or may not contribute to weight status in young people, which impacts the strategies provided to those seeking to improve dietary adherence.

What they found was that snacks have the potential to be calorically-dense, which may cause someone to over consume calories; however, the behavior on its own of having a food or light meal in between meals isn’t inherently harmful to health (Larson, Miller, Watts, Story, & Neumark-Sztainer, 2016).

However, paired with other behaviors, there’s greater potential for calorie-dense snacks to be chosen such as watching television (mindless eating) and skipping legitimate meals.

As an adult, I look back on times in childhood and think about the things I missed out on – the hours of naps I said ‘no’ to and the snacks I missed out on. As an adult, these things have greatly helped me maintain my health, even when there are times it doesn’t seem so great.

Being “allowed” to have a snack truly comes down to the psychology of dieting and eating behaviors. It comes from having all or nothing mindset. What we thought we knew about a healthy lifestyle has been made more complicated by the reality that we need to be healthy mentally as well and understanding that creating lifestyle change doesn’t happen in a bubble.

Be intentional

Going back to the definition that I created above – the ending, with or without intent. I think this part is key. Having a snack with intention means it’s part of the plan.

When I plan out my day, especially if I know I will be in and out of the house, I intentionally pack them with me. There’s potential that I won’t need them, but having a snack planned helps me with dietary adherence or “staying on track”.

I know if I’m truly hungry, I can wait about 30 minutes before I feel like I need to find something. If I don’t have a snack with me I’m more likely to not care about my choice, which will more than likely be calorie-dense.

As a society, we’ve changed greatly in the past 50 years. The workforce is larger with more women going to work, many of us work jobs with longer hours or nontraditional hours, we’re are living at home longer, having children later, obtaining more education, etc. If our schedules have changed and adapted with the needs of society, why not adapt our eating to our lifestyles?

There is no right way to go about meal timing, which means there’s no wrong way either. If we can take away labels and change the language that we use when we describe food, we may be able to create eating behavior that encourages adherence and gives us the satisfaction of participation.

When labels are removed the possibilities are endless. Eating well doesn’t have to be expensive and it doesn’t have to be complicated. I carry one or two protein bars in my purse, but I will also put some crackers or pretzels for the when I’m running around.

Some of the snacks I’ve been enjoying lately are:

  • Snyder’s mini pretzels
  • Wheat Thins
  • Individually wrapped cheese bricks
  • Quaker caramel rice crisps
  • KIND bars
  • Fruit: grapes, bananas and apples
  • Protein bars and protein shakes are always a staple
  • Nuts: pistachios for JP, walnuts for me!

snacks 1

A helpful tip, that I still implement is to portion my snacks when I get them home from the store since I typically plan and prep the day I grocery shop. This isn’t necessarily ideal for all foods because some could get stale, but  portioning a few snacks can be helpful. If you don’t plan out your week and prefer to take it a day at a time, you can still portion out some snacks so that they’re easier to grab when you’re on the go.

If you don’t mind buying individually wrapped snacks, that’s also fine. I don’t buy everything individually wrapped because it’s not cost effective for us., however, if you know that the packaging makes a difference in your decision-making then you need to find a strategy that works for you.

Tell me, how are your choices impacted when you don’t have something on hand or something planned?

 

References

Chaplin, K., & Smith, A. P. (2011). DEFINITIONS AND PERCEPTIONS OF SNACKING. Current Topics in Nutraceutical Research , 53-60.

Hess, J. M., Jonnalagadda, S. S., & Slavin, J. L. (2017). What Is a Snack, Why Do We Snack, and How Can We Choose Better Snacks? A Review of the Definitions of Snacking, Motivations to Snack, Contributions to Dietary Intake, and Recommendations for Improvement. Advances in Nutrition, 466-475.

Larson, N. I., Miller, J. M., Watts, A. W., Story, M. T., & Neumark-Sztainer, D. R. (2016). Adolescent Snacking Behaviors Are Associated with Dietary Intake and Weight Status. The Journal of Nutrition, 1348-1355.

Tartakovsky, M. (2015, August 3). 5 Ways to Expand All-or-Nothing Thinking. Retrieved from Psych Central: https://psychcentral.com/blog/5-ways-to-expand-all-or-nothing-thinking/

 

 

Wellness Refocused Education: Steel Cut Oats v. Rolled Oats

One of my clients and I were talking about oats the other day. She said she had to eat steel cut oats, and I asked, “why do they HAVE to be steel cut?”

She said well they’re healthier for you.

I told her that wasn’t necessarily true.

So, let’s talk oats – what’s the difference between them?

Steel-cut oats are minimally processed, meaning they have only been cut a few times from their original form of oat groats. They can take up to a half hour to cook.

Rolled or old-fashioned oats are oat groats that been steamed and rolled – this makes for faster cooking.

Quick-oats are rolled oats that have been chopped – even faster cooking.

Nutritionally, these are all made from oat groats, so they should contain the same number of calories, protein and fiber. However, the biggest nutritional differences will occur when you compare brands. Oats made from Quaker may differ from oats that are store brand.

Oats are a great source of vitamin E (a fat soluble vitamin) and B-1 and B-2 (both water soluble vitamins).

The biggest difference is how your body digests steel cut versus rolled oats.

The steaming and rolling process that the rolled oat goes through make them easier on digestion in comparison to steel cut oats. This is because the outer layers of the steel cut oats have insoluble fiber, which is harder for digestive enzymes to breakdown (Rasane, Jha, Sabikhi, Kumar, & Unnikrishnan, 2015). While steel cut may help with satiety, they may also result in bloating (Rebello, O’Neil, & Greenway, 2016). To further help with oat digestion you can soak your oats overnight or slow cook them. Here’s how I make mine overnight.

So why does it seem like there are more differences nutritionally?

Serving size matters. I’ve seen some brands list the serving size as a ½ cup of dry oats where I’ve seen other’s list it as 1/3 cup. The serving size dictates the caloric and nutritional value.

Add-ins and topping make a difference. I buy plain rolled oats because sometimes I actually enjoy plain oat meal, but mostly because I enjoy the chance to experience with different toppings and flavors. I love using protein powder in my oats – it adds protein and flavor, which allows me to add minimal toppings. I also love berries and peanut butter in my oats.

If you look at some of the instant oatmeal’s available in the store you’ll see packets that include high sugar flavors like maple brown sugar, apple cinnamon, etc.

Below is a comparison of steel cut oats, rolled oats and apple cinnamon from Quaker Oats.

oats photo 1oats photo 2

You’ll notice that steel cut and rolled oats are pretty much the same, except steel cut has 2g of insoluble fiber, which comes from the lack of rolling the oat groats (soluble v. insoluble fiber). Comparing these two to the Quaker Instant: Apples and Cinnamon flavor, you may noticed that the serving size is the same weight, but as you scroll through the table you’ll also see an additional 6g of carbohydrates, but 12g of sugar – this is because a portion of oats have been replaced with sugar, spices and apple pieces, all of which add weight and sugar.

Really what this comes down to is asking yourself 1. What texture do you prefer? 2. How much time do you have?

If you like oats in general, they have a lot of benefits like the vitamins listed above but can also help with maintaining a healthy cholesterol level as well as satiety throughout the day, which can assist with dietary adherence.

Remember, there’s a lot of marketing tactics used to make us as consumers believe something is much healthier than it truly is. Don’t get fooled. Read labels, ask questions and do a little digging on your own.

Lastly, how do you take your oats?

❤ Cristina

 

References:

Rasane, P., Jha, A., Sabikhi, L., Kumar, A., & Unnikrishnan, V. S. (2015). Nutritional advantages of oats and opportunities for its processing as value added foods – a review. Journal of Food Science and Technology, 662-675.

Rebello, C. J., O’Neil, C. E., & Greenway, F. L. (2016). Dietary fiber and satiety: the effects of oats on satiety. Nutrition Reviews, 131-147.

 

 

 

Wellness Refocused Education: Vitamins Part 2

In part 1 we discussed how there are two categories of vitamins: fat soluble and water soluble. We dove into fat soluble vitamins in part 1. We talked about what they are, where they come from and what can happen if you get too much or don’t get enough.

This post is about water soluble vitamins: Vitamin C (ascorbic acid) and B vitamins such as:

  • Thiamin (B1)
  • Riboflavin (B2)
  • Niacin/nicotinamide/nicotinic acid
  • Pyridoxine/pyridoxal/pyridoxamine (B6)
  • Folate (folic acid)
  • Cobalamin (B12)
  • Pantothenic acid
  • Biotin

Like we talked about in the last post, solubility is about transportation through the body. Water soluble vitamins are easily absorbed in the intestinal tract and go into the blood stream. They aren’t stored, so toxicity is less likely than with fat soluble vitamins.

This isn’t to say that toxicity can’t occur, it’s just less likely with a healthy functioning body.

To see more about toxicity and deficiency symptoms, check out the last post here.

Vitamin C is commonly associated with oranges and “curing a cold”, however, it’s a bit more complicated than that and it has a lot more functions than just immunity.

Vitamin C is required for a few specific functions like creating collagen, L-cartnitine, some neurotransmitters, hormones and DNA (protein)(Office of Dietary Supplements, 2018). That’s a bit more than what we typically think about when we think Vitamin C or a glass of juice. These functions are a part of our immune system, cardiovascular system, endocrine system and our nervous system.

Collagen is a kind of connective tissue (fibrous protein) in the body and it plays a big role in healing, which is why Vitamin C is important (Marieb & Hoehn, 2016). As an antioxidant, ongoing research has shown that Vitamin C helps with oxidative stress (an imbalance of free radicals and the body’s ability to detoxify itself) limit damaging effects of free radicals, which may prevent or delay disease and illness.

Other immune functions are include improving nonheme iron transport. Nonheme iron can be found in plants and as you imagine is recognized by the body differently than meat-based sources. This also means that it’s transported through body differently. Decreased oxidative stress by Vitamin C helps with allow for transport.

So does Vitamin C cure sickness?

Vitamin C plays a role in keeping the body healthy, however, once immunity is weakened, Vitamin C consumption may not do a lot for you other than give you peace of mind (Thomspon & Manore, 2015). There has been research conducted looking at how Vitamin C prevents disease and illness like types of cancers. “Epidemiologic evidence suggests that higher consumption of fruits and vegetables is associated with lower risk of most types of cancer, perhaps, in part, due to their high vitamin C content” (Office of Dietary Supplements, 2018). This is in connection to the decrease of free radicals in the body. Other research has shown the taking vitamin C may not prevent a cold, but may decrease their duration. A varied diet with “excellent sources of vitamin C will also help you maintain a strong immune system” (Thompson & Manore, 2015).

So how much should you consume? The Recommended Daily Allowance (RDA) for men is 90 mg/day and for women it’s 75 mg/day. If you’re a smoker, it’s recommended to consume about 35 mg/day more than the RDA and the upper limit is 2,000 mg/day.

B complex vitamins are the other water soluble vitamins.  They help with a number of functions and are most known for helping the body regulate energy metabolism. They act as a coenzyme, “which is a molecule that combines with an enzyme to activate it and help it do its job  (Thompson & Manore, 2015).” The cellular functions they assist with are interconnected across organ systems and also include various aspects of brain function (Kennedy, 2016).

Thiamin (B1) assists  with breaking down glucose for energy as well as the creation of amino acids leucine, isoleucine and valine – which are branched-chain amino acids that I briefly mentioned in the post about protein and amino acids. These amino acids are used in muscle and help produce glucose when needed (Thompson & Manore, 2015). Humans store very small amounts of thiamin in the liver, and since the vitamin has “a short half-life…continuous supply of it from the diet” is necessary (Office of Dietary Supplements, 2018).

Riboflavin (B2) assists with carbohydrate and fat metabolism and occur in chemical reactions to produce energy.

Niacin (B3) is acutally two compounds – nicotinamide and nictinic acid, which work to activate enzymes to metabolize carbohydrates and fat. Niacin plays a role in DNA replication and differentiation as well as repair. Without niacin, the digestive system, nervous system and integumentary system (skin) can be disrupted.

Pyridoxine/pyridoxal/pyridoxamine (B6) similarly to thiamin, helps with carbohydrate and protein metabolism. In coenzyme form, B6 engages in over a 100 enzyme reactions that deal primarily with protein metabolism. It’s involved in hemogloblin (the component that transports oxygen in the blood) formation, helps synthesize neurotransmitters for cognitive function and normal brain activity.

B6 vitamin is sensitive to both heat and light, so it can be degraded during cooking, however, it can be found in many foods that are consumed regularly in a normal diet such meats, fish, poultry, many vegetables and fruits.

Folate (folic acid) is required for some of the body’s most basic cellular functions such as DNA synthesis, which is why it’s so important for women who are newly pregnant to have adequate intake during the first few weeks. Folate combined with the sperm-egg cell quickly develops tissues and structures of the human body. It’s not just in these developing stages that folate is necessary, throughout life, it helps with tissue maintenance and repair. Folate also contributes to the development of amino acids serine, glycine, histidine and methionine as well red blood cells. Without folate or B12, which we will get to in a minute, RBC have the opportunity to become enlarged from their inability to divide and mature. This can result in macrocytic anemia.

Cobalamin (B12) assists with DNA synthesis, which helps with proper red blood cell formation (Thompson & Manore, 2015).  Like we’ve talked about before, red blood cells transport oxygen and nutrients throughout the body. B12 along with adequate levels of B6 help reduce the risk of cardiovascular disease (CVD). The conversion of folate to its active form is dependent on adequate amounts of B12. If the conversion process is unable to occur, then folate is unable to be utilized properly even if  adequate amounts are consumed regularly through diet (National Center for Biotechnology Information, 2018). Individuals who have malabsroption disorders such as celiac disease may have a higher chance of deficiency because of decreased intrinsic factor – a protein that helps with absorption that occurs in the small intestine.

Pantothenic acid  is an important in the breakdown and synthesis of fatty acids (Thompson & Manore, 2015). It’s role allows for foods in our diet to be utilized for energy, but also assists with excess fat storage for later.  It can be found in a many foods, which is where it got it’s name – pan meaning every where. This vitamin isn’t typically measured in a healthy person since it is abundantly consumed and adequate intake is so small.

Biotin is a coenzyme for five different enzymes that breakdown all macronutrients providing energy for the body to function properly (Office of Dietary Supplements, 2017). Like Folate, it’s important during pregnancy because of it’s role in cellular development of hair, skin and nails, but recommended amount are in micrograms, which is a very small measure. Biotin is found in a number of foods, and while rare, if deficiency does occur it can lead to brittle nail, skin infections and hair loss or thinning.

How much should you consume for B-complex vitamins?

Below is a chart with the RDA for a general healthy individual. Many personal variables will change the necessary intakes such as if disease and illness like autoimmune disorders, age, activity level, current or desire to become pregnant.

water solube

Currently, no research shows concerns with toxicity in relation to water soluble vitamins consumed through dietary means since they are not stored in the body, however, you shouldn’t take a vitamin just to take one.

Be thoughtful and talk with your doctor about what a vitamin can do for you and if it’s necessary. Examine the variety in your diet and make sure that you’re getting enough real food with your fun foods.

Again, potency is important to be mindful of and with supplementation there’s an increase risk of toxicity.

❤ Cristina

References:

Kennedy, D. O. (2016). B Vitamins and the Brain: Mechanisms, Dose and Efficacy – A Review. Nutrients, 8(2), 68. http://doi.org/10.3390/nu8020068

Marieb, E. N., & Hoehn, K. (2016). Chemistry Comes Alive. In E. N. Marieb, & K. Hoehn, Human Anatomy and Physiology (pp. 23-59). New York: Pearson Learning Solutions.

National Center for Biotechnology Information. (2018, June 4). PubChem Compound Database; CID = 6438156. Retrieved from National Center for Biotechnology Information: https://pubchem.ncbi.nlm.nih.gov/compound/6438156#section=Top

Office of Dietary Supplements. (2018, March 2). Strengthening Knowledge and Understanding of Dietary Supplements. Retrieved from National Institutes of Health: https://ods.od.nih.gov/factsheets/VitaminC-HealthProfessional/

Office of Dietary Supplements. (2017, December 8). Strengthening our Knowledge of Supplements: Biotin. Retrieved from National Institute of Health: https://ods.od.nih.gov/factsheets/Biotin-Consumer/

Thompson, J., & Manore, M. (2015). Nutrition: An Applied Approach. San Francisco: Pearson Education.

 

Wellness Refocused Education: Vitamins Part 1

When you hear the word supplements what do you think of first? Do you think of fish oil? Do you think of a multi-vitamin? Do think of protein powder? Do you think of steroids?

For the beginning few months of last year when I went back to school, I worked at Vitamin Shoppe. This gave me the opportunity to be around everything from apple cider vinegar to protein powder to BCAAs to fish oil to probiotics. Vitamin Shoppe is a really well rounded store if you’re looking for something to help fill in the gaps.

The store is divided into two sections.

When you walk through the front door, the left hand side was what you could consider lifestyle health. It had all of the vitamins and minerals, it had digestive aids like probiotics and enzymes. It also had greens powders and gender-specific care.

On the right hand side was where the sports nutrition lived. It was protein powder, fat burners, energy drinks, BCAAs, pre-workout products.

The middle of the store is where the tea, protein bars, beauty products lived.

While it was retail, Vitamin Shoppe doesn’t provide commission, so you can have an authentic conversion with customers about what their goals are and what they’re looking to buy to match those goals. They provided us with a lot of education about the products we were selling including information from studies published from the NIH for additional research. At the same time, I was just starting my health science courses and was reading everything I could about vitamins and minerals and how they cause specific functions in the body to occur. Timing couldn’t have been more perfect.

You could see the wheels turning as a customer decided which side of the store they needed. In some cases, we would have to introduce them to the other side of the store.

For many who trained hard, they typically went to the right, but every now and then we would get them to go to the left.

For a better conversation, there will be a few posts about supplementation.

We’re going to start with the left side of the store with vitamins.

First, there are 13 vitamins considered essential, just like essential amino acids, this means that the body must consume these through diet because it can only make a small amount of none at all (Thompson & Manore, 2015). If you have variety in your diet and have healthy functioning organ systems, you’re probably consuming enough of all of these vitamins through dietary means.

Individuals that have malabsorption disorders such as celiac disease are more likely to have deficiencies because of ability to absorb dietary fat. Individuals who also consume too little fat could be at risk as well. For better assistance to determine deficiencies, talk to you doctor and have a conversation about getting blood work done.

There are two kinds of vitamins:

  1. Fat soluble
    1. Vitamins A, D, E and K
  2. Water soluble
    1. Vitamin C and all B-vitamins

These two categories determines how a vitamin is absorbed, stored and then removed from the body.

Fat soluble vitamins need dietary fat to assist with transport and absorption (Thompson & Manore, 2015). They are also stored in adipose tissue (fat tissue), which means we don’t need to consume these every day. Since they can be stored in the body, consuming more than what is utilized can lead to toxicity. This occurs much more often when utilizing supplements, food rarely leads to toxic levels of fat soluble vitamins.

Toxicity of fat soluble vitamins can lead to a number of symptoms. The symptoms below don’t occur as a reaction for every fat soluble vitamin, but is a list of symptoms of all fat soluble vitamins.

  • fatigue
  • bone and joint pain
  • birth defects
  • nausea
  • diarrhea
  • liver damage
  • blurred vision
  • hair loss
  • skin disorders
  • hypercalcemia

Deficiency of fat soluble vitamins can lead to a number of symptoms. The symptoms below don’t occur as a reaction for every fat soluble vitamin, but is a list of symptoms of all fat soluble vitamins.

  • night blindness
  • impaired growth
  • impaired immunity
  • impaired reproductive function
  • osteomalacia or osteoporosis in adults
  • rickets in children
  • impairment of nerve, muscle and immune function
  • impaired blood clotting

Water soluble vitamins can be found in a larger variety of foods than fat soluble vitamins and are easily absorbed through the intestinal tract directly into the blood stream (Thompson & Manore, 2015). Our bodies don’t store water soluble vitamins, any excess is excreted in our urine after filtration from the kidneys. Since water soluble vitamins are removed through urine output it can be difficult to reach toxicity levels. It’s not impossible, but it’s not likely – at least through dietary consumption.

Toxicity of water soluble vitamins can lead to a number of symptoms. The symptoms below don’t occur as a reaction for every water soluble vitamin, but is a list of symptoms of all water soluble vitamins.

  • flushing
  • liver damage
  • blurred vision
  • glucose intolerance
  • nerve damage
  • nausea
  • diarrhea
  • nosebleeds
  • increased kidney stone formation

Deficiency of water soluble vitamins can lead to a number of symptoms. The symptoms below don’t occur as a reaction for every water soluble vitamin, but is a list of symptoms of all water soluble vitamins.

  • fatigue
  • decreased memory
  • confusion
  • muscle weakness
  • anemia
  • swollen mouth and/or throat
  • pellagra
  • vomiting
  • constipation
  • diarrhea
  • tingling and numbness of extremities
  • neural tube defects in a developing fetus
  • depression
  • fractures and bone pain
  • nerve damage

Some of the symptoms for both fat soluble and water soluble vitamins could be mistaken for other illnesses, but again to determine toxicity or deficiency for you as an individual, talk to your doctor.

This post is about fat soluble vitamins. We’ll get to water soluble a bit later, but now you know that there are two kinds of vitamins and what vitamins are categorized where.

fat soluble

So we have an idea of what fat soluble means, what is their purpose?

Fat soluble vitamins play an important role in specialized functions in the body by assisting complex systems.

Vitamin A is has multiple uses in the body, but Vitamin A isn’t just one compound. You may have heard of retinol, retinal or retinoic acid – these are different forms of it.

It’s required for eye functions. It assists our eyes in the ability to adjust to light changes, it also protects color vision.

During cellular development Vitamin A helps with cell differentiation, meaning it helps cells change their composition so they can each have different functions like hair growth or body growth.

In the reproductive system, Vitamin A helps with the production of sperm in men and fertilization in women as well as fetal development during pregnancy.

Vitamin A is important to the immune system (Stephensen, 2001). It assists innate immunity (the kind your born with) by allowing for the development of mucosal barriers and allow cells to work properly. In adaptive immunity it plays a role in developing T helper cells and B cell. A example of adaptive immunity would be developing antibodies after chicken pox exposure – you weren’t born with the chicken pox or the immune cells, but you adapted to the infection and developed them.

Vitamin D is best known for assisting with calcium absorption and helping keep bones strong. It also assists calcium with muscle contraction by allowing calcium to flow into muscle cells. If calcium levels are too low, normal contraction and relaxation can be inhibited with can lead to both skeletal muscle and cardiac muscle issues (Thompson & Manore, 2015). Vitamin D can help with the reduction of inflammation.

We can obtain Vitamin D when sunlight triggers synthesis in our skin (Office of Dietary Supplements, 2018). Individuals who live in regions that experience more darkness may not obtain enough through sunlight, but can obtain Vitamin D through food and if necessary through supplementation – but we’ll get to supplementation later.

Vitamin E is a name for a group of compounds with antioxidant properties.  Antioxidants protect cells from the effects of free radicals, which can lead to the development of cardiovascular disease and cancer (Office of Dietary Supplements, 2018). A free radical is an uncharged molecule and is highly reactive (Timberlake, 2018). Free radicals can be introduced to the body from the environment such as air pollution or ultraviolet radiation from the sun.

Vitamin E also works in the immune system and impacts T helper cells.

Vitamin K is less known, but not any less important. Similar to Vitamin E, Vitamin K is a name for a group of compounds that assist the body with blood clotting and bone metabolism (bone remodeling and growth). Healthy functioning individuals don’t typically need to worry about Vitamin K. However, individuals who take anticoagulants or have bleeding disorders will have Vitamin K levels assessed regularly to determine the need for supplementation.

The amount of Vitamin K recommended is so small that most diets in the United States meet minimum needs through diet (Office of Dietary Supplements, 2018). Vitamin K isn’t typically used in supplement form like other vitamins because the need is so small. In the case of individuals who have disorders that prevent proper absorption, a doctor may recommend a specific dosage.

Supplementation?

So, while deficiency and toxicity aren’t common, they can happen.

Toxicity is most common through supplementation, which is why it’s important to be careful when deciding to add a fat soluble supplement to your routine. While it may seem silly to consult your doctor on something of this nature, a quick phone call could assist with preliminary direction. Proper blood work will be able to assist in guiding the conversation.

A study published in 2015 examining adverse effects of supplementation found that supplements in general were the cause of over 23,000 emergency room visits per year (Geller, Shehab et al). The study was conducted over a 10-year period and researchers “defined “dietary supplements” as herbal or complementary products, and vitamin or amino acid micronutrients.”

A large concern with supplementation is toxicity, but quality of product and claims should also be on your radar.

Poor quality could lead to adverse effects and false claims can encourage individuals take products they don’t actually need. Supplements also are more likely to have a higher chance to interacting with prescription medications.

You will notice that labels on supplements ranging from vitamins and minerals to protein will say “these statements have not been evaluated by the Food and Drug Administration.” At the top of the latest consumer report on dietary supplements from the FDA, you will find the statement “The U.S. Food and Drug Administration (FDA) does not have the authority to review dietary supplement products for safety and effectiveness before they are marketed.”

I think this approach protects the FDA and doesn’t fully look out for the consumer. They do have marketing regulations, which sets a baseline, but it also shows the holes and what companies are able to get away with too.

According to the NIH, it is the responsibility of manufacturers to have evidence of label claims, but they don’t need to provide them to the FDA prior to products going to market. Once on the market, these products will be monitored. A good example of product monitoring, while not vitamins – the protein claims for the Lenny and Larry Complete Cookies were found to be false. The cookies had varied amounts of protein, mostly under the claims. This led to the reformulation of the cookies. While this is an example of a food item, it’s also used for protein supplementation and can be found in health stores.

What foods can they be found in?

All of the these vitamins can be found through a diverse diet and since they can be stored in fatty tissue they don’t necessarily need to be consumed daily. Below are a few examples of foods that have these vitamins – it’s possible that you’re getting enough of them already.

fat vitamins

But what if my app tells me to?

Something to be mindful of – tracking applications. For those who track their food with a phone application like My Fitness Pal, be mindful of the information those applications report to you. The daily values (DV) are based on a 2,000 calorie diet and don’t always self-adjust to the calorie goals for individuals. Since there can be variance in the foods found in the database, they might not be 100% accurate. Lastly, deficiency and toxicity may happen over time, so if you believe you’re low or high with consumption of a vitamin one day, you may balance it out another day. Don’t supplement just because “My Fitness Pal told you to.” It’s a helpful tool for macronutrients, fiber and sodium, but I don’t believe the vitamin and other mineral amounts need to be monitored with it unless stated by a doctor.

While vitamins don’t work to provide you energy, they assist in the hundreds of reactions to keep you going allowing macronutrients to be broken down and utilized effectively.

Next time, we’ll talk about water soluble vitamins, what they do and where they can be found.

 

❤ Cristina

 

References

Geller, M.D., A. I., Shehab, Pharm D., MPH, N., Weidle, Pharm. D., N. J., & Lovegrove, MPH, M. C. (2015). Emergency Department Visits for Adverse Events Related to Dietary Supplements. The New England Journal of Medicine, 373:1531-1540.

Office of Dietary Supplements. (2018, March 2). Strengthening Knowledge and Understanding of Dietary Supplements. Retrieved from Naational Institutes of Health: https://ods.od.nih.gov/factsheets/VitaminK-HealthProfessional/

Office of Dietary Supplements. (2018, March 2). Strengthening Knowledge and Understanding of Dietary Supplements. Retrieved from National Institues of Health: https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/

Office of Dietary Supplements. (2018, March 2). Strengthening Knowledge and Understanding of Dietary Supplments. Retrieved from National Institutes of Health: https://ods.od.nih.gov/factsheets/VitaminE-HealthProfessional/#h7

Stephensen, C. (2001). Vitamin A, infection, and immune function. Annual Review of Nutrition, 21:167-92.

Thompson, J., & Manore, M. (2015). Nutrition: An Applied Approach. San Francisco: Pearson Education.

Timberlake, Karen. (2018). Chemistry: An introduction to general, organic and biological chemistry. New York: Pearson.

U.S. Food & Drug Administration. (2017). Dietary Supplements. Washington, DC: FDA.

Wellness Refocused Education: Protein and Amino Acids

We’ve talked about fats and carbohydrates (part 1 and part 2) already, but what about protein?

Like the other macronutrients, protein can be misunderstood.

Like dietary fat, I’ve heard from people including trainers that protein can make you fat if you consume too much. Let’s be clear – too many calories can lead to fat gain, not necessarily any one specific macronutrient. However, with that in mind, we need to be thoughtful about what is paired together with protein as well as how protein is utilized in the body. Is eating a whole egg really a problem, or is it that many people won’t just eat one or two yolks, but will pair the meal with buttered toast, multiple pieces of fatty bacon and top it all with salt? While these components may not always be the “healthiest” choice, individually they can be fine in moderation, but together – it’s like a league of villains, or can be if they are consumed too often.

Ok, so what is protein?

Chemically, protein is a polypeptide of 50 or more amino acids that have biological activity. Protein is found in our DNA, which means it is found in our muscle mass, blood, bones and skin. “They function in metabolism, immunity, fluid balance, and nutrient transport, and in certain circumstance they can provide energy (Timberlake, Karen, 2018).”

Nutritionally, we know that one gram of protein has four calories associated with it. We know that protein needs are lower in comparison to carbohydrates and fats because the body utilizes carbohydrates as a first line of energy followed by fat (Thompson & Manore, 2015). This doesn’t mean that protein isn’t important. Dietary protein helps us conduct daily business. It helps the body to function without depleting protein found in the body (i.e. muscle mass).

But, you can consume too much protein and we will get to that, but first some background.

In chemistry, protein is called a polypeptide, which a chain of amino acids.

Amino acids are called building blocks because they are single units that bond together to make protein.

There are 20 amino acids found in our bodies (Timberlake, Karen, 2018). We can make 11 of them, but there’s another nine that we need to get with our diet. Amino acids that must be consumed are called essential amino acids. They’re essential because without them our bodies can’t make other proteins for other body functions like neurotransmitters. The 11 amino acids we can make are called nonessential amino acids.

  1. Alanine
  2. Arginine
  3. Asparagine
  4. Aspartate
  5. Cysteine
  6. Glutamate
  7. Glutamine
  8. Glycine
  9. Histidine*
  10. Isoleucine*
  11. Leucine*
  12. Lysine*
  13. Methionine*
  14. Phenylalanine*
  15. Proline
  16. Serine
  17. Threonine*
  18. Tryptophan*
  19. Tyrosine
  20. Valine*

*essential amino acids

I’m sure many of you have heard of BCAA’s or branched chain amino acids. You’ve probably seen them in the store in a pill or powdered form. Simply, these are specific amino acids that have a branch. They can assist in decreasing protein synthesis, which means they can help prevent muscle breakdown and losses, however, there isn’t much research the proves this to be true or consistent (Wolfe, 2017). There are three BCAA’s out of the nine essential amino acids: leucine, isoleucine and valine.

I’ve heard people say that amino acids are inferior to protein. You can’t confused BCAA’s with all amino acids. I would say that drinking or consuming a BCAA if you recognize deficits or holes in your nutrition can be helpful, however, I would recommend that you eat a complete protein rather than drink amino acids or a protein shake. But – remember, it’s also about preference too – drinking BCAA’s won’t hurt you and some people just like protein shakes. I’ve tried BCAA’s, but I never noticed a difference and that could be because of dietary diversity even when in a caloric deficit.

Moving on.

So an amino acid is equal to a single unit, protein is equal to many units of amino acids. As you can imagine, there are many combinations of amino acids and the combination determines the function of the protein in our bodies.

Here are some things in our bodies made up of amino acids:

  • endorphins
  • hemoglobin
  • collagen
  • insulin
  • enzymes
  • muscle

Above, I mentioned complete protein. A complete protein has all of the essential amino acids in it.

Examples of complete proteins:

  • egg whites
  • meat
  • poultry
  • fish
  • milk

An incomplete protein lacks one or more essential amino acids.

Examples of incomplete proteins:

  • corn – missing lysine and tryptophan
  • beans – missing methionine and tryptophan
  • almonds and walnuts – missing lysine and tryptophan
  • peas and peanuts – missing methionine
  •  wheat, rice and oats – missing lysine

Dietary protein helps us build our bodies (Thompson & Manore, 2015). Our bodies are resilient and function smartly. When protein is broken down in the body, the amino acids are recycled into new proteins. Like mentioned above, protein helps with hormone balance, fluid and electrolyte balance, repairs our bodies and helps us grow, but as an energy source our needs are pretty low. This is due in part because we recycle amino acids because our bodies don’t have a “specialized storage form” of protein.

So how much should you eat?

At one point, the recommended daily allowance (RDA) suggested .8g per kilogram body weight per day for both inactive and active individuals. However, more research has shown that individuals who are active may need more. The ranges should vary based on a number of factors such as gender, age, size, but also the kind of activity you do, which is where I slightly disagree with the 2010 Dietary Guidelines for Americans. A 2009 review of these guidelines determined the following concepts:

  1. protein is a critical part of the adult diet
  2. protein needs are proportional to body weight; NOT energy intake
  3. adult protein utilization is a function of intake at individual meals
  4. most adults benefit from protein intakes above the minimum RDA

They examined current perceptions about protein as well as benefits to treat and prevent obesity since 35.7% of U.S. adults were considered obese and 16.9% of U.S. children and adolescents were obese at the time of the review. The most recent NHANES data from 2013-2014 shows that 38% of adults are obese with 19% of children and adolescents being obese. A major flaw pointed out by this review highlighted the proportion of protein to carbohydrates and fats may be adequate with high energy consumption, but that as “total daily energy intake is often below 1400 kcal/day” when individuals seek to lose weight it could be potentially harmful to limit protein needs to the RDA as a loss in lean muscle mass could result (Layman, 2009).

In 2011, a study looking at required and optimal amounts of dietary protein for athletes found that while the RDA was .8g per kilogram, it was would be appropriate for athletes, both endurance (distance runners) and strength (bodybuilding and weightlifting) to consume between 1.6 to 2.25 times the RDA or 1.2g to 1.8g per kilogram (Phillips & Van Loon, 2011). The study also suggested that protein consumption between 1.8 to 2.0 per kilogram could be helpful depending on caloric deficit for the preservation of lean muscle mass.

Now, remember this study looked at protein consumption for very active people.

If you’re sedentary, there’s no reason to consume as much as an athlete. If you are active, you may also need to consider how much potential lean muscle mass you have. If you’re overweight or obese, your protein needs may be less.

I formerly had a client who was consuming 1g per pound she weighed and it was over 200g of protein because a former coach had recommended it. She had an equal amount of protein to carbohydrates, which is a common calculation, but necessary.

A 1:1 ratio of protein to weight in pounds is a common suggestion and it’s one that I utilized when I first started tracking macros, but as I started looking at my specific goals and needs, I realized what I was consuming wasn’t helping me and I redistributed my nutrient goals.

While this client was very active and participated in weightlifting multiple times a week this 1:1 ratio of protein was inappropriate for her because it wasn’t taking into consideration lean mass, but instead overall mass. It also left her feeling bloated, hungry and often with disproportionate nutrients to be satisfied.

So what can happen if you consume too much protein?

There are a few health conditions that have raised concerns, but they may not impact everyone – there’s also some contradictory research and you need to figure out what side of the fence you’re on.

Concerns around heart disease and high protein consumption also involve high amounts of saturated fat found in animal products (Thompson & Manore, 2015).”. High saturated fat levels have been know to increase blood cholesterol levels and increase risk for heart disease. However, a moderate protein diet that is low in saturated fat can be good for the heart. Again, this is correlation, not necessarily causation.

Another concern is that excess protein found in the urine due to kidney impairment. “As a consequence, eating too much protein results in the removal and excretion of the nitrogen in the urine and the use of the remaining components for energy (Thompson & Manore, 2015).”

When protein is found in the urine it’s called proteinuria. As part of the body’s fitration system, kidneys remove waste from your blood, but allow nutrients like protein to return to the bloodstream to be recycled through the body. Protein in your urine can be a sign of impaired kidney function. It’s important to note there is no evidence that more protein causes kidney disease in healthy people that aren’t susceptible to the disease, however, more water should be consumed to flush out the kidneys because of protein metabolism (Thompson & Manore, 2015).

Bloating is also possible if “too much” protein is consumed in one meal and your body doesn’t produce enough enzymes to assist in digestion. Chemical protein digestion occurs in the small intestine as a result from the enzyme pepsin. “Too much” is relative. I get bloated if I have more than 40g of protein in a meal. Depending on planning I can prevent too much consumption, but that’s not always the case.

Like mentioned above, athlete and highly active individuals may need more than the RDA, but the average person may not need as much. Much recent research I found that examines the impacts of high protein consumption utilizes athletic bodies in high resistance training settings, which isn’t necessarily a sample that will provide data that can be used for recommendations for an inactive or lightly active person.

resistence training and protein

The data is still interesting, but may not be helpful to the average person.

When I did find research articles discussing higher protein needs in obese individuals, I found many studies designed diet plans for participants with sub-1000 kcal/day. This is an extreme diet that may not typically be suggested for one to conduct without being monitored. An example of this extreme design is a study published in 2015 that examined normal protein intake versus high protein intake as well as carbohydrate reduction to determine success in weight loss and maintenance. Researchers assigned adult participants to 800 kcal/day for eight weeks and once participants had an 11 kg loss they randomly assigned them to a new plan with varying protein intake for six months. They found that individuals with higher protein intake were able to adhere to the plan, which not only resulted body fat losses, less inflammation and better blood lipid panels, but also were capable of maintaining losses. Researchers also suggested that less restrictive approaches also lead to higher adherence (Astrup, Raben, & Geiker, 2015).

Again, interesting, but this is an extreme that hopefully many won’t use or need.

What about if you eat too little?

While we don’t need as much protein for energy as many believe, we do need dietary protein to assist in building our bodies like mentioned above. Without dietary protein, our bodies breakdown stored protein i.e. muscle to be utilized to assist in daily functions such as creating amino acids. A true deficit of protein can result in a greater number of infections if the body is unable to produce enough antibodies. A true deficit occurs over time and in extreme circumstances; however, can be more likely if an individual is in a large caloric deficit.

So, easy question-  what food sources have protein in them?

 

Obviously meat is an excellent protein source, but there’s more than meat. Legumes like lentils, black beans and green peas as well as nuts have protein in them too. While oatmeal is a well-known grain, it also has about 5g of protein per half cup serving. Dairy, while also another carbohydrate source, is also an excellent source of protein and the mineral calcium – if you’re not lactose intolerant!

Vegetables that have protein in them that I recommend to clients who are trying to balance out density and volume in their eating include broccoli, Brussels sprouts and asparagus.

Like the other macronutrients, protein can be flexible within reason. Considering multiple factors to determine a specific plan for you will be key. It might take trial and error, it may also take some adjustments, but give yourself time.

Your nutrition should be specific to you and your goals. It should take all of you into consideration like have you approached menopause or had a hysterectomy? Hormones play a huge role in overall nutritional needs. What’s your sleep like? Are you on medications? What’s your stress like? Are you sitting more or less than before?

I know many of these questions can seem silly when posed, but they are important.

The body is a weird organism, just when we think we have it figured it out, it changes on us.

References:

Layman, D. K. (2009). Dietary Guidelines should reflect new understandings about adult protein needs. Nutrition and Metabolism, 6-12.

Phillips, S., & Van Loon, L. (2011). Dietary protein for athletes: from requirements to optimum adaptation. Journal of Sports Science, 29-38.

Thompson, J., & Manore, M. (2015). Nutrition: An Applied Approach. San Francisco: Pearson Education.

Timberlake, Karen. (2018). Amino Acids, Proteins and Enzymes. In K. Timberlake, Chemistry: An introduction to general, organic, and biological chemistry (pp. 548-583). New York: Pearson.

Wolfe, R. R. (2017). Branched-chain amino acids and muscle protein synthesis in humans: myth or reality? Journal of the International Society of Sports Nutrition, 14-30.

Wellness Refocused Education: Carbohydrates Part 2

The last post talked about what carbohydrates were at the molecular level. I know it can be boring and in many cases it’s a lot of information to be taking in, but it’s also a good base to understand what they do for our bodies, how much we need and where we can find them.

What do carbohydrates do for our bodies?

The simple answer – they provide energy for us. They are the first fuel source utilized and they are preferred by different organ systems like the nervous system. This doesn’t mean we can’t get fuel from other macro nutrients like fat, it just means that the optimal choice for a healthy body is typically carbohydrates. We get 4 calories per gram of carbohydrates consumed (Thompson & Manore, 2015).

The more complex answer glucose provides the necessary nutrients in cellular respiration for the creation of Adenosine triphosphate or ATP (Reece, Taylor, Simon, Dickey, & Hogan, 2015). Below is the process of cellular respiration – it utilizes glucose and oxygen, which breaks down to carbon dioxide, water and ATP, energy not used can be lost as heat (not pictured). This answer gets even more complicated, but if you’re interested and have 10 minutes, here a little video about it.

Image result for cellular respiration equation

ATP is needed in  almost all forms of cellular work. You want to dance – you need ATP. You want to run – you need ATP. You want to walk around the house cleaning – you need ATP, or maybe you don’t want it. Each action we do, from sitting at the breakfast table to lifting weights in the gym needs ATP to be performed, but they all use different amounts of energy.

Our cells can only store a limited amount of ATP, which means we need to continuously create it throughout the day.

I know some of you are thinking, yeah, but what about the keto diet and running on fat or ketones. I talked about that in this post. But for the sake of lessening carbohydrates as an enemy, we’re just going to talk about them here.

So how many carbohydrates does a person need in a day?

This question can be tricky because it goes back to the individual and the goals. Someone who is more active may need more than someone who is less active. Activity can be related to your job like a teacher who walks and stands most of the day or an office employee who sits most of their day. Activity also relates to additional exercise like lifting or running or yoga or swimming.

Currently, it’s recommended that carbohydrates make up the largest part of your nutritional intake between 45-65% of calories. The United States bases these numbers off of a 2,000 calorie diet – so for the sake of round numbers means 900 calories (225g) to 1,300 calories (325g) should be consumed (Thompson & Manore, 2015). That’s a lot of carbohydrates.

The U.S. National Academy of Sciences “estimates that the average adult needs to take in food that provides about 2,200 calories of energy per day” but they also acknowledge that this will vary ( Institute of Medicine, 2005). Regardless, that’s a lot of calories and when I think about the conversations I hear about weight loss and dieting – many doctors suggest low calories. My doctor years ago tried suggesting I stick to 1,200 calories to lose weight. So if energy balance is estimated at 2,000 to 2,200 calories, why do people suggest such drastic nutritional decreases? Faster progress? I don’t know the answer.

Anyway, my own carbohydrate consumption makes up 42% of my total calorie intake at around 185g on average.

After working with clients, my own trial and error and other research – I don’t fully agree with this recommendation and here’s why.

  1. Many people aren’t eating a 2,000 calorie diet.

This caloric recommendation is inflated and is all to hopeful that individuals are working out a specific number of times a week for a specific length of time – that’s just not realistic. Also, not everyone needs this many calories for optimal function plus exercise. I eat just under this recommendation, sometimes going higher when I go out to eat.

2. Even those who have healthy organ function, don’t necessary feel great eating this many carbohydrates regardless of the carbohydrate source – remember fruits and vegetables are carbs too!

I can attest to this. When I consume more than 240g of carbohydrates, I feel tired and sluggish – even when the carbohydrates are combined complex from grains and simple from veggies and fruit. Some vegetables also make me bloated like brussels sprouts and broccoli because of how they break down in the digestive system #enzymes, which also means I have to be mindful of how I build my meals and how many greens I’m eating. Yes, even without the cookies or process carbohydrates, I don’t feel great eating that much.

3. Those focusing on a whole foods, minimally processed approach can easily consume more carbohydrates through beans, quinoa, rice and higher carbohydrate veggies and fruit like sweet potato, apples and bananas – but this can still be a lot of volume.

Volume keeps us full, which can be a good thing and a bad thing. If you’re too full from breakfast, even five hours later, it’ll be hard to consume lunch, which can prevent someone from hitting caloric goals. It might be great in a deficit to be full, but not so great when you’re trying to maintain or build. The feeling of constantly being full isn’t pleasant. Also, if you think about how we discuss carbohydrates and the stigma that carbohydrates lead to obesity and general weight gain – a lot of people aren’t eating beans, quinoa, rice or carbohydrate dense vegetables and fruits.

I’ve had a number of clients tell me they weren’t allowed to eat bananas and apples before because it was too many carbohydrates. My suggestion – if it fits your plan calorically/macro nutrient-wise and keeps you satisfied, there’s no reason to get upset about eating fruits.

So, what are your goals because like I mentioned above the body uses different amounts of energy to fulfill different activities.

The more intense the activity, the more carbohydrates may be necessary. The reason behind varying amounts of carbohydrate consumption? Studies have shown that most people have more than enough stored fat (body fat) to support exercise, but because of how the body uses carbohydrates we need to replenish glycogen (stored carbohydrates) (Poole, Wilborn, Taylor, & Kerksick, 2010).

Both strength and endurance athletes need an adequate amount of carbohydrates. So whether you’re lifting in the gym or are an active runner or marathoner, you may need more carbohydrates. Not only does this provide fuel to conduct the activity, it can help with preventing muscle loss by utilization of glycogen. Carbohydrates post-exercise also replenish depleted stores.

So what is adequate for an athlete? The higher end of the recommended intake for carbohydrates (45-65%) would probably be more adequate, but you need to listen to your body and how it feels on carbohydrates. Old research used to suggest over 65% of calories coming from carbohydrates, but newer studies show that isn’t necessary.

According to a study conducted in 2010 examining the role of protein and carbohydrates post-exercise found both protein and carbohydrate consumption were necessary to promote protein synthesis (the process to develop proteins i.e. muscle) and glycogen synthesis (process to replenish glycogen stores). They found that amount and timing can be impactful for synthesis, but more importantly the quality or kind of source for both nutrients played a huge role (Poole, Wilborn, Taylor, & Kerksick, 2010).

This doesn’t mean that you need to drink a protein shake immediately or you need to gobble up a cup of oats as soon as you take your shoes off.

While this post is about carbohydrates, it would be irresponsible to divide the research in protein or carbohydrates because they go hand-in-hand in this case.

Here’s what you should know:

  • Protein consumption can happen within an hour of exercise for optimal protein synthesis.
  • The kind of protein matters:
    • Casein is slower digesting
    • Whey is faster digesting
  • Digestion happens in your stomach, which can result in some bloating if you do consume large quantities of protein – not a terrible thing, but can be uncomfortable.
  • The amount of protein matters. This study showed positive results from only 20g of protein consumed post-exercise.
  • Carbohydrate consumption post-exercise was found to be most effective in glycogen synthesis for up to two hours after exercise had ended.
  • Combining the two may have the best results.
    • “A small amount of whey protein in addition to carbohydrate consumption in the recovery phase of exercise is a more sufficient means of increasing protein synthesis (Poole, Wilborn, Taylor, & Kerksick, 2010).”

So go home, shower and make your food and grow.

So where can we find carbohydrates?

When we think of carbohydrates and when I hear people talk about carbohydrates they immediately think of this:

Image result for bread

Or they think of this:

Image result for dunkin

But really, carbohydrates can also mean this:

Image result for fruit

And it can mean this:

Image result for vegetables

While I share the fun eating that I do and how it fits into my plan and lifestyle, I also have a large number of fruits and veggies in my daily diet that also make up my carbohydrate total.

Here’s what’s I eat:

  • blueberries
  • Brussels sprouts
  • oats
  • sweet potato
  • broccoli
  • English muffins
  • rice
  • bell peppers
  • onions
  • tomatoes
  • black beans
  • pretzels
  • pickles
  • navy beans
  • asparagus
  • strawberries
  • romaine lettuce
  • avocado
  • jalapenos
  • spinach
  • bananas apples
  • spaghetti squash

In the previous carbohydrate post, we talked about simple and complex carbohydrates and the difference. It’s about the rates in which they breakdown. Fiber can help a food be more complex and slower digesting, which can help keep us fuller for a longer period of time. It also slows the increase in blood glucose levels, which is important for people who are diabetic.

When I talk to my clients about how they’re creating their meal plans for the week, we discuss how they’re combining food and how it makes them feel. I have one client who says that she feels great with oats and yogurt in the morning, but I have another client who says lunch has to be her carbohydrate dense meal because in the morning she’ll feel sluggish otherwise regardless of how much sleep she gets.

Like I mentioned when we talked about fat and the Ketogenic diet, I believe there’s no reason for elimination of food groups and nutritional sources for someone who has healthy functioning organs. The recommendations set by governing bodies are  created from studying a healthy functioning body. Having an allergy or intolerance or autoimmune disorder/disease is a completely different story and should be controlled differently.

Eating for fat loss is about being in a deficit, which is what elimination diets assist with, but moderation of all food groups assists your body in getting everything is needs down to the micronutrient. If I’m going to be blunt – being in a deficit takes self-control, elimination diets don’t teach you how to have self-control around “normal” food or how to make better choices when going out to eat. They teach you to say “I’m allowed” or “I’m not allowed”. We learn to categorize things are “good” and “bad” – the conversation surrounding food becomes a reflection of ourselves…But that’s also a tangent for another time.

I believe that paying attention to the source of carbohydrate and how it makes you physically feel teaches us how to create a nutrition plan that fits our needs. I don’t like being bloated so I try to not eat broccoli and Brussels sprouts on the same day, unless I’m also taking a digestive enzyme. I know I feel better with moderate carbohydrates so I stay between 150 to 200g of carbohydrates.

I challenge you to think of carbohydrates in this way. Ask yourself:

  1. What carbohydrates you enjoy eating and how they make you feel?
  2. What foods are your surprised to learn are carbohydrates?
  3. Does your daily diet consist of simple and complex carbohydrates?
  4. Do you consume more simple or more complex carbohydrates?
  5. Could you be more balanced in how you create your daily plan so that you stay satisfied to stay on track and accomplish your nutritional goals whether they’re for fat loss, maintenance or building?

There are days I know I can be better and choose a piece of fruit over a piece of chocolate – we all have those days. But I also know that a piece of chocolate won’t hurt me just like one serving of fruit or vegetable won’t exactly help me. It takes a string of good days to add up to progress. Just like it takes a string of bad days to really make a detrimental impact.

Be kind to yourself. Don’t yell at the cookies when you walk by the snack aisle. Remember vegetables are carbohydrates too.

 

References

Institute of Medicine. (2005). Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein and Amino Acids. Washington, D.C.: The National Academies Press.

Poole, C., Wilborn, C., Taylor, L., & Kerksick, C. (2010). The role of post-exercise nutrient administration on muscle protein synthesis and glycogen synthesis. Journal of Sports Science Medicine, 354-363.

Reece, J. B., Taylor, M. R., Simon, E. J., Dickey, J. L., & Hogan, K. (2015). Campbell Biology: Concepts and Connections. New York: Pearson Education.

Thompson, J., & Manore, M. (2015). Nutrition: An Applied Approach. San Francisco: Pearson Education.

Wellness Refocused Education: What Are Carbohydrates?

Did anyone else feel bad for Regina George when she was duped by Cady Herron when she asked if butter was a carb? I found myself laughing at the time the movie came out, but after a year of working with clients and more time talking with others, it’s clear that it can be hard for people to think about food in terms of their macro nutrients, especially carbohydrates.

So what is a carbohydrate and why is it important?

This post will talk about the what because it’s slightly more complicated that you think. There’s a little bit of the why in here, but that will mostly come in the next post.

Ok, so what are carbohydrates?

Carbohydrates are the first source of energy for us. They are fuel for us when we are sitting, sleeping, exercising or thinking of doing all of those things.

The Acceptable Macronutrient Distribution Range (AMDR) suggests that carbohydrates make up 45 to 65% of your diet…if you’re consuming 2,000 calories a day. We’ll talk about this more in the next post because I think it’s safe to say that most people won’t fit these guidelines.

The Institute of Medicine set the Recommended Dietary Allowance (RDA)  for carbohydrate intake to a minimum of 130g a day. Obviously, this amount wouldn’t fit the AMDR – it would be too little based off a 2,000 calorie diet. The RDA number is set based off the estimated minimum use of glucose for the brain for an average body, which means it’s relative (Institute of Medicine, 2005). It might be slightly lower or slightly higher.

Since we have some of those basics out of the way, let’s start small, molecular small.

This is where biology and chemistry meet.

Carbohydrate means hydrated carbon (Reece, Taylor, Simon, Dickey, & Hogan, 2015). At the molecular level (and trust me this is helpful to know later) carbohydrates are made up of CH2O – 1 carbon, 2 hydrogen and 1 oxygen. In biology we actually learned a little upbeat rhyme of the abbreviates to memorize the molecular make up for carbohydrates, lipids (fats), nucleic acid and protein: CHO CHO CHOPN CHON, but you had to study so you knew how many of each were needed. Moving on…

The simplest carbohydrate is a monosaccharide – you’ll find these in glucose and fructose, which are sugars that carbohydrates break down to (Reece, Taylor, Simon, Dickey, & Hogan, 2015). You’ll find fructose in fruit. Glucose can be found in corn syrup and plants and found in the blood stream after certain carbohydrates are consumed and broken down. No your blood isn’t made of corn syrup.

Below are the chemical layout for glucose and fructose at the molecular level so you can see the difference.

Glucose and Fructose molecules

When you add two monosaccharides together, they form a disaccharide. For this binding to happen, water has to be lost. This is how we get maltose, which is used to make beer, malt whiskey and malted milk candy (Thompson & Manore, 2015).

Below is a picture of maltose, so you can see how glucose joins together. It’s like they’re holding hands if molecules had hands.

 

maltose

We also get sucrose when glucose and fructose join together. Sucrose is found in plants and it’s how we get table sugar (Thompson & Manore, 2015).

Below is a picture of sucrose. See more water is lost. Goodbye H2O!

sucrose

A longer chain, known as a polysaccharide are made up of hundreds of thousands of monosaccharides connected by water loss. Starch is an example, this is found in plants and contains glucose mononers. Glucose is stored in us in the form of glycogen in our muscles as a form of energy.

There’s a lot of ‘oses.

Here’s a few other ‘oses:

  • galactose – doesn’t occur alone in foods. It combines with glucose to create lactose.
  • lactose – “milk sugar”. A common disaccharide found in cow’s milk and breast milk.
  • ribose – five-carbon monosaccharide produced in our bodies from eating other carbohydrates. Can be found in the genetic material in our cells

Knowing the information above can be helpful for this next part. Carbohydrates are considered either simple or complex (Thompson & Manore, 2015). Like stated above the simplest carbohydrate is a monosaccharide and consists of one sugar; disaccharides are also simple and consist of two molecules of sugar. As you imagine, the most complex is the polysaccharide that is made up of hundreds of thousands of monosaccharides.

What is considered simple?

  • fruit (fructose)
  • vegetables (fructose)
  • milk (lactose)
  • fermented beverages (maltose)
  • sweeteners like honey, maple syrup, table sugar, brown sugar (sucrose)

What is considered complex?

  • starches including grains like rice, wheat, corn, oats and barley
  • legumes like peas, beans and lentils
  • tubers like sweet potatoes and yam

The digestion process is different for each macronutrient (fat, carbohydrates and protein), which means they breakdown at different rates (National Institute of Diabetes and Digestive and Kidney Diseases, 2017). Carbohydrates breakdown the fastest out of the macronutrients with fat being the slowest.

There are a few enzymes that help breakdown carbohydrates.

  • Salivary Amylase is found in the mouth in your saliva
  • Pancreatic Amylase and Maltase are found in the pancreatic juices (yes, gross I know) that are released into the small intestine to breakdown maltose
  • Sucrase and Lactase are found in the small intestine and help breakdown sucrose and lactose, respectively
*side note: when your body lacks the ability to create enough enzymes you may find intolerances like lactose in tolerant – you lack enough lactase enzyme to breakdown lactose. This can result in bloating or other digestive issues.

This is important to know the rate of digestion for a couple reasons:

1. Simple carbohydrates are digested and absorbed more easily causing a quicker energy utilization, which is why you may feel a “spike” in energy after eating something high in sugar, but then feel a “crash” later. This is also why individuals who are diabetic are encouraged to eat low-glycemic foods – foods that will breakdown at slower rates causing less of an increase in blood glucose since their bodies can’t produce insulin at all or don’t produce enough.

2. Our bodies can’t utilize complex carbohydrates in their consumed state, they need to be broken down to glucose (Thompson & Manore, 2015). These foods also contain fiber, which impacts how satiety controlling hormones are released (Chambers, McCrickerd, & Yeomans, 2015). This is why these foods keep us fuller longer even though protein has the highest satiety effect out of all three macronutrients.

When there’s not enough carbohydrates for this process the body turns to fat. To learn more about that, please check out this post.

Understanding the difference between simple and complex carbohydrates can be helpful for a  couple of reasons.

1. You can create a meal plan that combines complex carbohydrates with other foods to not only provide energy in the immediate time, but help you stay feeling full longer. That’s why oats and peanut butter “stick” with you for a long time. Being satisfied for a longer period of time prevents snacking and can assist you in staying in  caloric deficit if you are seeking fat loss.

2. You can create a meal plan that prevents or lessens “energy crashes”. Like stated above, complex carbohydrates take a longer time to breakdown a, which means glucose enters the blood slower so feeling tired or fatigued are less likely or are less impactful.

Carbohydrates that aren’t easily digested and broken down into this simple state are classified as fiber.

What is fiber?

Fiber is also a carbohydrate and is considered a polysaccharide, but it’s not easily digestible so it doesn’t provide energy to us (Thompson & Manore, 2015). There are two kinds of fiber:

  1. dietary – nondigestible parts of plants that make the form of the plant like leaves
  2. functional –  nondigestible parts of plants that are extracted or manufactured in a lab that is added to foods for health benefits

Even though fiber doesn’t provide energy to us, fiber is important because it helps regulate blood sugar. It also helps prevent constipation when consumed in a moderate (relative to an individual) amount, however, it can also cause constipation when over consumption occurs (also relative to an individual) (Anderson, et al., 2009). Foods with fiber also help regulate satiety hormone leptin, which tells our brains that we’re no longer hungry.

Currently, the recommended amount of fiber daily is 14g per 1,000 calories consumed, however, this number is relative to an individual and may be a little more or less based on your own caloric intake, weight and activity level. You should listen to your body to determine true needs. I personally need a little less fiber or I get bloated and constipated #everyonepoops.

 

 

Ok, so we know carbohydrates are the first source of energy for us. We know they breakdown at different rates. We know they’re relative to each individual. We know that they are found in fruits and veggies just like they are found in cookies and pizza.

Before we get into why they’re important and what the do for us, think about the carbohydrate sources you consume on a regular basis. Do they make you feel energized? Do you crash quickly in the day? Do you feel bloated? Do you combine simple and complex in your diet? Do you get enough fiber?

 

 

 

References

Anderson, J. W., Baird, P., Davis, R. H., Ferreri, S., Knudtson, M., Koraym, A., . . . Williams, C. L. (2009). Health Benefits of dietary Fiber. Nutrition Reviews, 188-205.

Chambers, L., McCrickerd, K., & Yeomans, M. R. (2015). Optimising Foods for Satiety. Trends in Food Science and Technology, 149-160.

Institute of Medicine. (2005). Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein and Amino Acids. Washington, D.C.: The National Academies Press.

National Institute of Diabetes and Digestive and Kidney Diseases. (2017, December). Your Digestie Syste & How it Works. Retrieved from National Institute of Diabetes and Digestive and Kidney Diseases: https://www.niddk.nih.gov/health-information/digestive-diseases/digestive-system-how-it-works

Reece, J. B., Taylor, M. R., Simon, E. J., Dickey, J. L., & Hogan, K. (2015). Campbell Biology: Concepts and Connections. New York: Pearson Education.

Thompson, J., & Manore, M. (2015). Nutrition: An Applied Approach. San Francisco: Pearson Education.

Wellness Refocused Education: Fat and the Ketogenic Diet

For a long time there was a war on fat, like over 30 years long. I’ve talked a lot about the importance of reading labels and understanding what you’re consuming. Not necessarily saying no to the processed food, but understanding or knowing what is in it. Well, taking that a step further – we need to also understand that the guidelines that back those labels up are created by governing bodies that may or may not benefit by creating certain guidelines or encouraging certain studies.

I’m not saying that the FDA or USDA or other regulatory groups are bad, but I am saying that the information can be misleading or a generalization in some cases.

A good example: the nutrition label you see on your boxed and canned goods is based off of a 2,000 calorie diet. This means the percentage listed as daily value is based off of 2,000 calories, but you may not be eating 2,000 calories – you may be consuming more or less.

Another example: the most recent guidelines by the USDA have a caloric recommendation for individuals based on gender, age and activity level with all numbers being whole, round numbers. These numbers are only below 1,400 daily calories for children under the age of 6, sedentary males peak at 2,600 calories for a 19/20 year old with sedentary females peaking at 2,000 calories for ages 19-25 – individuals who are more active peaked calories up to 3,200 daily.  The guidelines state that the sample bodies used to determine were an average height and a “healthy” weight (page 77-78).

“For adults, the reference man is 5 feet 10 inches tall and weighs 154 pounds. The reference woman is 5 feet 4 inches tall and weighs 126 pounds.”

I’m 5’4″ and I weight about 138 pounds. I’m roughly 17% body fat, which is lean and considered athletic for a female. My measurements are small. I don’t fit the sample body. I also don’t know many “healthy” men that would fit this sample body either.

The first dietary guidelines were rolled out in the 1980s and at the time, the biggest concern was heart disease and heart attacks. Ultimately, the first guidelines recommended against all fat and foods that had cholesterol like red meat.  However, more research has shown that not all fats are created equal and that dietary fat is necessary for bodily function. In the most recent guidelines for 2015-2020, it’s stated that saturated fat consumption should be 10% or less of overall calories consumed (page 15 footnotes). It’s also recommended that you replace saturated fats with unsaturated fats.

Before we get ahead of ourselves, let’s talk about fats. Have you ever heard about triglycerides? It’s possible that your doctor has mentioned this term before when discussing blood work and overall health. These are the most common dietary fat we eat. This is also the form that fat is stored in our bodies.

The science of triglycerides

Triglycerides are a molecule consisting of 3 fatty acids attached to a 3 carbon glycerol backbone (Thompson & Manore, 2015). They are classified by their chain length (how many carbons are attached), their level of saturation (how much hydrogen is attached to each carbon) and their shape.

The first way to classify – chain length. The first thing we learned in biology is that structure determines function – if you have a wheel it can move things forward, right? It can’t make things fly. There are three chain lengths: short (6 or fewer carbon), medium (6 to 12 carbon) and long (14 or more carbon). The lengths determine the method of fat digestion and absorption as well as how the fat works within your body. As you imagine, the shorter the chain, the faster the digestion and absorption (Thompson & Manore, 2015).

Now, saturation level. What’s the difference between these two kind of fats?

The simple answer – saturated fatty acids have closely packed molecules because they lack a double bond that would “space” them out. This means they can solidify at room temperature, example: a jar of coconut oil. unsaturated fatty acids do have a double bond, which prevent them from solidifying at room temperature, example: olive oil (Reece, Taylor, Simon, Dickey, & Hogan, 2015).

Lastly, shape – the carbon molecules impact the shape. The lack of the double bond in saturated fat allows the chain to be straight and pack tightly together. The double bond in unsaturated fat prevents the chain from being straight and actually adds kinks, which makes them liquid at room temperature.

But what about  bottles of coconut oil at the store, how are those liquids? Coconut oil that is liquid at room temperature is manipulated during manufacturing. The removal of natural fatty acids that solidify allow liquid coconut oil to be just that. Lauric acid, the fatty acid in coconut oil known for its health benefits like being a germ killer, is actually removed in this process. This is because it’s melting point is over 100 degrees Fahrenheit. To read more about the production, safety and use of liquid coconut oil check out this article.

Coconut oil isn’t the only thing that is manipulated on the market. Unsaturated fats can also be manipulated by food manufacturing in a process called hydrogenation, which started in the early 1900s (Thompson & Manore, 2015). This process adds hydrogen molecules, which in unsaturated fats causes the double bonds to be partially or totally removed allowing the fat to become solid and store more easily for a longer period of time.

This is also where we get trans-fats, which actually is describing the double bonds in the molecule. This kind of fat is found mostly in foods that are manipulated, although a small amount of natural trans fatty acids are found in cow’s milk and meat.

Now that I’ve confused you, triglycerides do contain essential fatty acids that are important for health (Thompson & Manore, 2015). Essential fatty acids (EFA) are obtained from the foods we consume – our bodies cannot produce them. There are two groups of them: Omega-6 and Omega-3.

Omega-6 Fatty Acids have a double bond 6 carbons from the end (omega = end of the chain, 6 = number of bonds away from the end). Linoleic acid is an omega-6 that is essential for human health. This is found in vegetable and nut oils like peanut oil, sunflower oil, corn oil and soy.

Omega-3 Fatty Acids have a double bond 3 carbons from the end. Alpha-linolenic acid is the most common in our diets and primarily comes from plants like leafy greens, walnuts, flaxseeds.

Why are EFAs important?

They’re precursors to biological compounds found in every cell in the body that regulate cell function.

Why is fat in general important?Fat provides energy; it has 9 calories per gram, which makes it the most dense energy source. Our bodies use fat when we’re at rest and during physical activity.

  • Fat helps transport vitamins A, D, E and K throughout the body, which help regulate functions like calcium absorption and utilization, cell membrane protection, blood clotting, bone health and vision.
  • Fat regulates our hormone production and cell function. *
  • Fat contributes to satiety, which means we stop eating sooner and helps us feel full longer.

Fat Importance on Cell Function and Hormone Production

This is something I talk a lot about with my clients. Fat is important because of the reasons listed, but as someone who works predominately with women this is something I want to drive home with them. There’s no reason to fear dietary fat, but we do need to moderate it. Phospholipids are a major component of our cells (Reece, Taylor, Simon, Dickey, & Hogan, 2015). These are similar to fats, except they contain two fatty acids attached at the glycerol, not three. Steroids are hormones produced in the adrenal cortex, cortisol is an example of a steroid hormone, which regulates carbohydrate metabolism and provides an anti-inflammatory effect on the body.

Fat -loving and the Ketogenic Diet

As the war on fat has started to settle, the rise of high fat diets like the ketogenic diet have started to become increasingly popular for fat loss; however, this style diet isn’t for everyone and should be monitored because of other potential health outcomes.

So what is the ketogenic diet?In simple terms it’s a high fat, very low carbohydrate (~20g or less daily), moderate protein diet that has been utilized to help with refractory epilepsy since the 1920s (Gupta, et al., 2017). It’s especially helpful for children with epilepsy, but according to the Epilepsy Society, adults may also benefit from it. The ketogenic diet has also been found to assist with fat loss in individuals who are obese lose as well as help manage other disorders like polycystic ovarian syndrome (Gupta, et al., 2017). However, be reminded that less extreme diets that moderate calories will also result in fat loss as long as the individual adheres to it and a diet that moderates carbohydrate intake may also assist with PCOS.

So how does the ketogenic diet work?

Our bodies utilize carbohydrates that have been broken down to glucose as a main source of energy (Thompson & Manore, 2015). While our bodies also use fat as fuel, glucose is favorited by red blood cells, some nervous tissue and our brains for energy.

When we don’t take in enough carbohydrates…. let me pause…enough carbohydrates doesn’t mean hundreds of grams daily. Enough carbohydrates could be 100g a day depending on the age, gender and activity levels of the person. Ok continuing…our bodies start looking for another fuel source. In the process of ketosis, the liver converts fat into fatty acids and creates ketone bodies or ketones that will be utilized as fuel. These ketones are a natural appetite suppressant that can help control nutritional intake (Thompson & Manore, 2015).

What about the keto diet is beneficial to different populations?

The effects on the “central nervous system, cellular metabolism and metabolic pathways, have shown promising results in a variety of neurological disorders, traumatic brain injury, acne, cancers, and metabolic disorders (Gupta, et al., 2017).” “The ketogenic diet alters the energy metabolism in the brain, therefore altering brain excitability,” which impacts  how cells communicate with each other and regulate the CNS (Lee, 2012).

Is there one way to practice keto?

This is a tricky question. The classical diet of keto that is utilized with epilepsy patients suggests strict ratios of fat, carbohydrates and protein at every meal. It also includes little protein and carbohydrate because of the body’s ability to be “knocked out” of ketosis by too many of either.

The medium chain triglyceride (MCT) diet allows for a little more carbohydrates and protein. This version provides some flexibility and allows MCT oil to be used a supplement. Nutrients are also calculated by the percentage of calories for each group, meaning it’s not a specific number of grams, but a percentage of overall calories.

If keto can be helpful, why shouldn’t everyone utilize it?

A true ketosis diet should be monitored because of higher risks for other health concerns like osteoporosis (weak and brittle bones), hyperlipidemia (abnormally high fat in the blood), nephrolithiasis (kidney stones). Some of these health concerns can onset as we age, but nutritional deficiencies can increase risk. This means that supplementation is necessarily because there is a lack of diversity by lowering carbohydrate intake. This would be a recommendation for many people seeking fat loss with any diet – supplement appropriately.

The use of carbohydrates in our diets isn’t just for daily function like walking, talking and sitting; they’re also used for fuel during prolonged period of activity and protect again the use of stored protein as a fuel source  i.e. muscle loss (Thompson & Manore, 2015). When our bodies don’t have enough carbohydrates our bodies continue to find fuel sources, and while in a perfect world we imagine the body will find stored fat to utilize, it will also find stored protein. Not only does this result in muscle mass loss, but it can weaken our immune systems and prevent optimal function. However, this kind of loss can be associated with too little calorie intake because a nutrient group has be drastically decreased or eliminated.  

If ketone levels are too high the blood can become very acidic and can lead to ketoacidosis. This actually prevents optimal body function and ultimately can lead to damaged tissue.

Why don’t I believe the ketogenic diet should be prescribed to everyone?

My personal belief is that the ketogenic diet should be utilized for clinical conditions like epilepsy and other cognitive or metabolic disorders. I do believe that some people feel better on lower carbohydrates, but lower is relative.

I had a client who recognized she felt physically better on higher fat, moderate carbohydrate and protein. Her macros were 75F/100C/147P or 1,663 calories. Her goal was fat loss and this was a deficit for her. On days that she would run long distances (over 4 miles) she would increase her carbohydrates between 20-40g because it helped in those runs.

Yes, I eat processed food and things with real and artificial sweeteners in them, but I also know that’s not for everyone. I know not everyone can moderate these foods and that’s completely ok. I do believe that one way to work towards creating a healthier food plan is to examine the carbohydrates that are you taking in and how they make you feel. I ask my clients to do this often by making a list or notes when they recognize they feel bloated, jittery, exhausted, fatigued, etc.

Carbohydrates breakdown to sugars like stated above so in many cases they feel these things because of 1. too much sugar (real or added) 2. too many overall carbohydrates 3. the kind of carbohydrates they’re consuming (simple versus complex). I don’t think extremes need to be implemented to see change or progress unless specified by a physician.

Mentally, I think elimination diets that pull full groups of foods can be harmful over time to the relationship that we have with food. Creating a balance lifestyle also means enjoying foods that tastes good, but isn’t necessarily the greatest for us, but understanding that moderation is key. Eating out, attending and participating in parties and functions is a part of life and experience. While many suffer from auto immune disorders or illnesses that force them to create alternative eating styles to manage their health, many don’t need extreme measures.

Health coaches, lifestyle coaches, personal trainers, wellness coaches, etc. people assisting others like I do, should be encouraging individuals to bring in all their resources to find what ultimately works for them in a reasonable and safe way.

We shouldn’t fear fat in our diet, but we also shouldn’t fear other nutritional groups either – we just need to better understand them.

References

Epilepsy Society. (2016, March). Ketogenic Diet. Retrieved from Epilepsy Society: https://www.epilepsysociety.org.uk/ketogenic-diet#.WkzL6TdG1PY

Gupta, L., Khandelwal, D., Kalra, S., Gupta, P., Dutta, D., & Aggarwal, S. (2017). Ketogenic diet in endocrine disorders: Current perspectives. Journal of Postgraduate Medicine, 242-251.

Lee, M. (2012). The use of ketogenic diet in special situations: expanding use in intractable epilepsy and other neurologic disorders. Korean Journal of Pediatrics, 316-321.

Reece, J. B., Taylor, M. R., Simon, E. J., Dickey, J. L., & Hogan, K. (2015). Campbell Biology: Concepts and Connections. New York: Pearson Education.

Thompson, J., & Manore, M. (2015). Nutrition: An Applied Approach. San Francisco: Pearson Education.