Monday, March 28, 2011

Low carb diets

Analyzing low carbohydrate diets

Let me first put it out there; I am not claiming to be a low carb guru or anything.

My knowledge comes from 2nd hand sources. I NEVER participated in a low carb diet for any extended period. With this in mind, my thoughts on a low carb diet are purely from a technical and research point of view. I have no bias one way or another. Next let me just reiterate that I am not a nutritional scientist, and my views are purely amateur and based on personal research. Take my information and opinions for what they are worth.

What does the term "low carb" mean? That's not as easy to answer as it first may seem. There are a lot of people and companies out there pushing "low carb" diets these days. Their definitions depend solely on who you are talking to or reading from. In general there are two main categories of low carbohydrate diets. The first being the most extreme approach, these are called ketogenic diets, where carbs are kept so low that the body remains in a state of ketosis. The second is a non-ketogenic low carb diet. Where carbohydrate levels are kept lower than the FDA recommended amounts, but not so low that the body enters a ketogenic state. I will attempt to briefly outline both, give the low down on how they generally effect the body, and summarize how I feel low carbohydrate diets should be used.

The human body uses 3 forms of macronutrients as fuel. Carbohydrates, fats, and protein are all considered food and fuel for the body. While all 3 macronutrients can be used as energy, evolution has chosen carbohydrates as the primary fuel source for the human body. Dietary carbohydrates (carbs with value to the human body) come in two forms, fiber and non-fiber. Fiber is indigestible to the body and plays a role as a cleaner and digestion governor in the body. Non-fiber carbohydrates can be broken down into sugars and eventually turned into glucose for energy in the body. Glucose is the primary energy source the human body uses. Carbs are broken down quickly in the stomach and intestines and transported mainly to the liver where they are recombined into glucose and distributed throughout the body. When there aren't enough carbohydrates coming in, the body relies on dietary fat, dietary protein, stored fat, and lean tissue to produce its energy. The process of converting fats to energy is somewhat slower than glucose production. Protein is the slowest conversion rate of the three and is usually considered the last resort. The human brain requires glucose or ketones for energy as does the central nervous system. The energy derived from fat cannot be used to fuel the brain directly as free fatty acids (FFA) that can substitute for glucose in many organs and muscle groups are large molecules, and cannot pass the blood-brain barrier. This means that in order for the brain to use alternate fuel, that fuel must first be converted in the liver to glucose or ketones. The body knows how to do this, but the process is slower, and produces less total energy to do so (called the Krebs or citric acid cycle). When there isn't enough carbohydrate in-take to satisfy all energy requirements, the body prioritizes any carb. conversion for the brain, the rest of the body must take what it can from the rest, using fat and protein to balance out its fuel.

When we lower our carbohydrate in-take levels enough, in the short term the body does not make any changes, stored glycogen in the liver and muscles will take up the slack for a period of days or weeks depending on how low our total caloric in-take is. Eventually though, the lowering of carbohydrates depletes glycogen stores, when the stores are depleted enough, the body will begin producing more and more ketones, these ketones take over for the role of glucose in the body, providing energy. By itself this is not a bad thing, but many things happen when we move from a glucose metabolism to a ketogenic metabolism. Without making an informed and conscious choice to choose ketogenisis, you could be putting your body and your health at risk.

Lowering carbohydrate levels to a point where they affect your energy balance does a few things chemically. First and foremost, it changes the amount of water in the body. Because glucose is mainly distributed and stored in a water based solution called glycogen, hundreds of grams of water are no longer needed in the body. As hydration levels lower, weight goes down. In some cases, a person can drop as much as 20 lbs of water weight in a matter of a few days or weeks. "Dieters" and people touting low carb diets for weight loss flaunt this fact as "proof" of weight loss, but it's nothing but a temporary weight loss, no real fat stores have been lowered because of these phenomena. It should be known that once carbohydrate in-take is restored, the water levels will quickly return to their former state and you will gain that water weight back. When protein is used for energy instead of as a building block for lean tissue, it has by-products. Those by products include carbon dioxide, water, urea, and ammonia. The last two, urea and ammonia need to be expelled from the body as they are considered poisons. This forces the liver and kidneys to work harder (stressing them). It is unknown as of yet, whether this can have a long term detrimental effect on a healthy adult, but common sense says that when we increase the work being done by an organ over the long term, the extra stress can be detrimental to its health. Obviously, someone with liver or kidney issues should never be on this type of high protein, low carb. diet, without consulting their doctor first.

There are many studies that have been done recently (over the last 10 to 20 years) that have looked at the long term effects of a low carb diet vs. a balanced nutritional diet with a modest calorie deficit. In diets lasting longer than 6 months, participants generally had statistically insignificant differences in total weight lost. In some cases other systems benefitted from a low carb technique, such as blood cholesterol.

For those with reasons other than weight loss for their dietary changes, there are well documented and perfectly valid reasons to go on a low carbohydrate and/or ketogenic diet. Epilepsy is one reason. Without going into specifics, changing the brain's fuel levels and source has a profound effect on the amount and strength of seizures. Cancer research is also being done on fuel sources. On main theory is that cancer cells rely solely on glucose as fuel and thus starve if not provided, I have not delved deeply into this topic though, and would suggest talking to an oncologist for more details.

As to low carb as a way to quickly and efficiently shed pounds; I don't see the benefit. Studies don't show any additional fat loss from low carb diets over a normal, moderate calorie reduction diet. And the consequences for high intensity work are significant. Once glycogen levels are depleted, someone on a very low carbohydrate diet will take much longer to restore those glycogen levels, severely restricting their ability to perform anaerobic activity for any extended period. This limits the amount of weight training or high intensity (anaerobic) cardiovascular work you can do in any one period. Also hydration levels must be closely monitored, as dehydration can have serious and very dangerous side effects. Couple this with the unknown possible long term consequences of kidney and liver stress; I cannot endorse this method as a weight loss tactic. There is much great work being done in this area in the scientific community, and the facts change almost daily. I have merely hit the main points and barely scratched the surface of low carb. If you want to know more, I urge you to talk to many sources, not just the proponents of one type. There are benefits and drawbacks to low carbohydrate diets. But one thing I can tell you with certainty, it’s not a "quick fix", and done right, it's not easy or cheap. If you wish to be a "low carb. convert", walk into that lifestyle with eyes wide open, realizing that you will have to closely monitor yourself, and be aware of the side effects, and know that doing it short term does nothing for you.

I have not touched on low carb diets as a diabetic treatment or low carb. For those who have nutrient allergies or celiac disease. These are specific cases in which the treatment can have high benefit. Please talk to experts in your specific field if you wish to pursue this avenue. And best of luck to you!

Monday, March 21, 2011

Non-Scale Victories

When people try to lose weight, often times they begin to obsess about "the scale" and take measurements multiple times per week or even every day. As a general rule this can be a very self-destructive process. Media and specifically television shows such as "The Biggest Loser" focus on fast weight loss using what most experts would call extreme measures. What most people don't realize is that people who are morbidly obese have a lot larger cushion for weight loss than most of us, even those of us classified as obese. Expecting 3 or 4 or more pounds per week weight loss is unrealistic in the extreme. Occasionally you may see those numbers on the scale, but generally the numbers will fluctuate, and some weeks may even see a gain in weight. In my humble opinion, the only way weekly weight loss measurements are effective are if you can add them to a continuing monitor strategy and look for longer term trends. I recommend 1 month at a minimum. If you take 4 or 8 measurements over a month, and the trend is consistently sloping down, chances are you're doing things right and should continue on the path. If your trend is static, or upward, then you should adjust and compensate. Other than that, weight loss is a relatively poor measure for short period accuracy.

I generally advise clients to use something termed on many weight loss and nutrition sites as Non-Scale Victories (NSV for short). A non-scale victory can be anything from an exercise performance increase, to a size of jeans you wear. It can be an instance where you resisted the temptation to eat a cookie at a company gathering, or maybe hitting the 10 minute mile mark on a run. A weight loss strategy that tracks both weight loss and non-weight loss progress is the healthiest way to gauge progress. If you have a trainer or someone who you work with for dietary information, you should work with them to clearly state and write out your goals, including the goal, a timeline for completion, and a method to achieve that goal. Your goal should be precise, and can have smaller "waypoints" to help you track progress in smaller, more manageable chunks. Make sure your goals are challenging, but also achievable, it’s perfectly fine to ask others if they think your goal is achievable. Sometimes choosing our own goals can be a little daunting. Make sure you don't make your goals so long term that you could procrastinate, and make sure you don't set open ended goals (I.E. "My goal is to be in a size 6." This has no timeline, and no strategy for completion.). An example of a solid goal is as follows: "I would like to drop 4 inches from my waist within 4 months by eating a healthy diet with a moderate deficit, and by exercising 3 to 5 times a week for at least 30 minutes. I will track my progress by using a tailor’s tape measure every other week and record the results in my nutrition notebook." Here you have a challenging but reasonable goal, a timeline with which to achieve that goal, and a basic strategy to follow.

Setting goals is a way to help you keep to a plan, it can hold you accountable if you choose to share that goal to others, encourage those you trust to ask you about your progress, and don't be afraid to adjust your goals "on the fly" if you realize you made a goal that was overly challenging, or maybe a bit too easy. Have a lot of goals, you may or may not reach all of them, but that's not important, the important part is being accountable to something, and learning how to celebrate your victories, and stay on the right path.

Good luck

Monday, March 14, 2011

Starting a new healthy lifestyle Part II – Exercise

I apologize for the length; this is an important topic and requires much knowledge.
For the out of shape or obese person, becoming healthy is essentially a two part game, part 1 is nutrition, and we covered that last week, this week is exercise. Everything I post here is contingent on you being checked out and approved by a trained medical professional first. Whenever I recommend an exercise, it’s always under the assumption that you can reasonably perform exercise at the level I suggest. If you are thinking of beginning a new exercise or nutrition program, please consult the appropriate medical personnel first, for exercise that usually means having a talk with, and maybe receiving a cursory exam from your primary care physician. If you have any medical conditions, known or unknown to your medical professional, be sure to disclose them before they check you out, things that may seem trivial to you can often be important to a doctor.
Exercise is vital to living a healthy, happy, and long life. Besides the vanity issue of looking good and feeling confident, exercise helps your body in a number of ways. Exercise burns calories, and consequently exercise burns fat. Exercise helps muscle and bone retain it’s mass, and In some cases grow. Exercise can force the cardiovascular system to become stronger and more efficient. Exercise releases hormones in the body that help it with metabolic function. Exercise helps with immune system health. When we talk about exercise, many people cringe, but exercise doesn’t have to be a chore, it can be fun.
For the beginner, starting with a new plan can seem daunting. Forget choosing an exercise, many new exercisers can’t even choose between the types of exercise they need or want. Let me clear something up for any people having a hard time deciding where and how to begin. You need all types to be successful. Let’s discuss the two main types of exercise. Cardiovascular exercise (cardio) or “aerobic” exercise is exercise performed at a low enough level so that muscles can continue to perform that exercise for long periods. Muscles use oxygen as a catalyst for energy consumption. The more intense the exercise, the more oxygen is required. The primary muscles used in cardio are specifically designed to burn less oxygen over long periods, allowing for sustained burn at a level your body can provide. It is possible, however, to overtax these muscles and become “anaerobic”. The term “aerobic threshold” is the intensity level of cardio where your body can no longer provide sufficient oxygen to power the muscles. Reaching this threshold is not considered a bad thing by itself, but it will induce shorter exercise sessions as the body will need to slow down as this point is reached. You will notice this state almost immediately when you reach it. Breathing becomes labored, muscles weaken, and the “burn” begins. This type of exercise triggers certain responses in the body. When you reach this level on a semi-consistent basis, the body will take steps to increase the following functions: lung capacity, level of oxygen in the blood, and the efficiency at which muscles extract oxygen from the blood.
Working below the aerobic threshold means long periods are possible. If you work below your aerobic threshold, your muscles in use will tire and deplete before your ability to deliver oxygen does. The feeling that comes from this is less of a burning, sudden weak feeling and more of a general slowdown in your ability to work, the decrease is less sharp and more difficult to discern, and your ability to continue working at a slightly reduced level remains. This means that you can continue to exercise after this point is reached. The results of longer, lower level exercise are training the muscles that specialize in this type of activity to be stronger and have higher endurance. Another benefit of training at lower levels is the ability to burn fat. Body fat is burned as a supplement to carbohydrate burn. When you increase the amount of calories you burn, inevitably you burn some fat as well, the longer you train cardiovascularly, the higher the percentage of fat burned becomes as glycogen (the quick energy your body stores for work) levels deplete, the body requires more and more energy from the fat storage mechanisms as cardiovascular work continues. “wind” or oxygen levels and efficiency see only moderate improvement when one works cardiovascularly (below the aerobic threshold), although there is some improvement.
Resistance based exercise is exercise that uses a whole different set of muscles primarily. These muscles are designed to provide maximum force for minimal amounts of time. Weight training is one type of resistance, plyometrics is another example. Resistance usually requires quick, short bursts of power, these quick bursts don’t use an abundance of oxygen, but they do use high percentages of available energy, more energy than the body can produce during the work period. A solid, 35 to 45 minute weight training session will deplete most of the existing glycogen stores in the body. It can take up to 24 hours or longer for the body to rebuild those stores, during this period a slightly increased metabolic rate is seen. So while you won’t burn as many calories with resistance, you will burn those calories over a far more extended period. Another aspect to resistance training is the concept of muscle fatigue and micro tears. Part of the process of growing muscle is creating tiny tears in the muscle fiber through training. The body recognizes and repairs these tears, and generally will repair them bigger and stronger than they were before. For a resistance program to ultimately be successful over the long term, it must be difficult to complete with good form. That means that more important than training for long periods, should be training at a resistance level that exhausts your ability to continue. In layman’s terms you want to be unable to do more work when done, or close to that point. If you find yourself doing resistance and realize that you are not extremely tired in that particular muscle group after finished, you probably need to re-evaluate the session and either up the intensity or the weight used to achieve a failure or close to failure level.
Hybrid routines are routines that combine elements of both resistance and cardio exercise. These routines are designed not to provide the maximum results from either routine, but to provide enough of each to satisfy the moderate exerciser. Time is usually a major factor in choosing this type of routine. Design and form are the two major components of this routine. In order to be a successful hybrid routine (for example, many boot camp classes are hybrids) there must be sufficient resistance to tire the muscles, and sufficient cardiovascular work to elicit the goals you are looking for (either increasing anaerobic threshold or growing the muscles that focus on aerobic work). Hybrids can be an excellent compromise for the functional, busy professional who doesn’t have a lot of time during the day. Three, solid 45 minute to 1 hour hybrid routines a week, mixed with 2 cardiovascular routines or 1 cardio and 1 resistance routine per week is a great way to get everything you need without devoting hours of time a day or sacrificing one type for another.
Stretching and static exercising considerations
While these are vitally important to your body’s functional strength and health, things like stretching, yoga, and Pilates, are something I generally allow clients to choose based on their level of flexibility. These programs can provide many benefits to both physical strength and flexibility and psychological health, but for a person who is just beginning, I generally try to focus on strength and endurance first, adding static and dynamic stretching as a warm up and cool down period. If you find yourself noticing posture and/balance issues, these types of routine can provide a wealth of benefit for you, do not ignore them as unnecessary.
For the beginner
When choosing an initial exercise routine. Many beginners go with steady state cardio (running, elliptical, stationary bike…etc.) alone and ignore resistance or anaerobic training. While steady state cardio absolutely has a place in every exerciser’s routine, it does your body an injustice to ignore the power and oxygen levels that they need. Anaerobic cardio is helpful for burning fat, but to truly become more healthy you must tell your body to increase muscle mass, and produce the hormones that increase lean tissue and bone health. These hormones are released during anaerobic exercise and resistance exercise. The hormones released also trigger the body to help burn more stored fuel, which means a better fat burn.
When starting out, the first thing you should do (after designing a weekly program and consulting your doctor) is find your limits. For each type of routine (cardio, anaerobic, resistance), choose your exercise types, and perform tests to find where your levels are. This is one place where a trainer can be very helpful, even if you decide not to use a trainer regularly; paying for an initial consultation and review can allow them to give you some basic starting points and can put you on the fast track to increasing levels with a minimum of trial and error. In any event be sure to include days of cardiovascular training, anaerobic training, and resistance training in your plan, also be sure to monitor your body, if you feel dizzy, nauseous, or pain, always stop and consult your doctor before continuing. Be aware of your routines, mindlessly reading a magazine while walking or jogging on a treadmill may seem easier, but it usually means you’re not focusing on how your body feels, if you want to achieve results, you must pay attention and increase your levels as your body becomes stronger and has more endurance. The last thing I will say about a new routine is to make sure you give your body a rest. Working out every day may feel like a great way to lose weight fast, but in the long term, your body needs recovery days, without them it can break down and stress injuries can become common.
This post just touches the absolute basics of exercise for the beginner. There’s a lot more information that can be learned and taught, a good trainer would be able to fine tune a program for you and increase your results dramatically. Consequently, a bad trainer can really hinder results. Be sure to vet your trainers fully and thoroughly before choosing them.

Monday, March 7, 2011

Starting a new healthy lifestyle Part I - Nutrition

This will be a 2 part Blog on starting out with exercise and healthy nutrition. Today’s post will cover nutrition as I believe most people trying to become healthy are first and foremost trying to lose some weight, and specifically fat. While I emphasize that exercise plays a vital role in being healthy, you lose weight, and specifically fat, by eating healthy. Exercise forces your body to "shape up", gain or maintain muscle mass, keeps your cardiovascular system healthy, keeps your skeletal system healthy, strengthens the immune system, and burns excess fat. Eating a proper, healthy diet is how we give our body the building blocks they need in order to be strong and healthy.
The term "you are what you eat" is cliché and not very descriptive, but it's true. Let’s put some credence to that statement now. Starting out seems daunting, many people choose long term goals and they fail quickly, within weeks, because they don't also create reachable, short term goals that can help keep you focused. My first bit of advice is create 2 sets of goals; a long term goal, and multiple, short term waypoint goals that you can use to keep you on track. Make sure these are reasonable, attainable goals as well. Having a goal of your "high school weight" if you're 40 years old and have had children is probably not that reasonable. There are plenty of weight/height/age/sex charts that give you a range weight goal, this is what I would recommend. I also recommend having a long term goal weight RANGE instead of weight number. Having a single number can become obsessive to people, being 1 pound from your goal is not a failure unless you let it be.
On to your nutrition. I'm what most nutrition experts would consider a "generalist". I don't believe in restrictive or "crash" diet types. Any diet that eliminates or severely restricts either calorie amounts or types of macronutrients (macronutrients are the 3 main calorie types, I.E. carbohydrates, fats, proteins). While there are perfectly valid reasons for low carb or high protein diets, they aren't easy plans to follow, and require a lot of extra willpower to be successful with, and they won't help you lose weight any faster in the long term. LET ME RESAY THIS SO YOU UNDERSTAND. Macronutrient restrictive diets WILL NOT help you lose weight any faster. Also, diets like Atkins, or South Beach or Paleo diet are difficult under any circumstance, and even more so under social situations, beside the very strict adherence required, for them to be effective long term, they need to be a life choice (I.E. for the rest of your life), so if you aren't ready to make that kind of commitment, I would reconsider them.
For most people, I recommend just following the USDA food pyramid ( While I don't follow every tenant that they print to the letter, for most people, their percentages, amounts, and food types are close enough to keep you healthy and happy for a long long time.
So how do we begin? First, do a little research, figure out what a complex carbohydrate is, what lean protein means, and what healthy fats are. These are vital. Know that you need lots and lots of vegetables (learn to like them folks, there are plenty of choices, don't give me the "I don't like veggies" speech, I've heard it before, you need em, supplements won't cut it.). Understand that cheese sauces and cream sauces, white flour, white sugar, High Fructose Corn Syrup (HFCS), hydrogenated oils, and saturated fats are all not good things to have in large quantities. Fill your day's diet with veggies, berries (the best fruits are generally berries), whole grains, whole grain rice, beans, nuts, lean meats (including red meats in limited quantity, lower fat volumes are better with these), healthy fats (Extra virgin olive oil, coconut oil, some sunflower oil...etc.), fish (white fish, not shell fish usually).
Some of you may be thinking that this is a huge change. You'd be surprised at how easy it is to make most of the things you enjoy with these better ingredients. It just takes a modicum of effort. And a desire to treat your body right and live a healthy, long life.
As to losing fat. Generally the food choices I talk about above are a great start, and they'll give your body all the tools it needs to be chemically and hormonally happy. But unless you figure out how many calories you need daily, this won't help you lose fat. To do this you need to limit your calories. This may seem difficult, but it's generally not as hard as it seems. There are online diet tabulators (some pay, some free) that you can use, or if you don't like that, you can keep a journal, there are even IPhone and Android apps you can use. What you really want to change for LIFE is eat a moderate deficit for your situation, and monitor your food choices. I can talk individually to anyone who really wants to dig into how much their deficit should be, but generally, the more obese you are, the bigger the deficit can reasonably be (within reason here folks). This is especially true of body fat percentage. I don't recommend a "crash" diet with an extreme calorie deficit simply because it's unsustainable, and the ultimate goal is teaching your body, slowly, how to live off the correct number of calories, not how to quickly drop fat, and then be confused about calories once you reach your goal. What I try to do is take it slow with people, allow them to form good habits, which allow them to continue being health for life, I will slowly reduce their deficit over months or even years in extreme cases, until when they reach the goal weight (and fat %) they want, the change to eating maintenance calories is minimal, and easy to keep up with and with no change to the type of food they eat, there's really very little or no transition period to maintenance.

FYI, for those of you with small children. Don't use them as an excuse. I've heard "my child will not eat "; that's a cop out folks. They won't starve to death, kids are kids, not small adults, I know you love your child, but ask yourself this: Would you rather your kid not like you for a few hours because you didn't cave to their demands of hot dogs and chicken nuggets, or become one of the obese teen statistics we are seeing today, including full on type 2 diabetes, anxiety disorder, psychological trauma, and cardiovascular conditions? Those are essentially your two choices. Children follow parental examples, you can kid yourself all you want, but your child WILL eat what you let them eat. If you let them eat processed junk food, they will eat processed junk food.

A few notes on this topic.

-Recently I've heard a few folks tell me that they "can keep eating what I'm eating and just exercise more". Nope, sorry, you can't. That's not going to cut it. Food is vital. You can fool yourself all you want, it won't make it right.

-Doctors, personal trainers, and nutritionists are NOT the experts in this field. You want nutrition advice? Go see a registered dietitian. Doctors generally receive minimal training in this field, nutritionists have no standard to conform to, they may be great, they may be awful. Registered dietitians are required to pass certain, state wide requirements, so at least you know they meet minimum standards.

-You don't need to be super super restrictive for this to work. As long as you're honest and don't beat yourself up over your calories, going over or eating something "bad" every couple of weeks isn't the end of the road. It's only a failure if you let it stop you from continuing.

-Find a support network; whether that is a friend, neighbor, family member(s), an online group, or something else. You probably need to rely on someone else for support every once and a while. There's no need to be a "tough guy", sometimes we slip up, and having someone there for support is a good thing.