Just Beet It for Improved Performance

In the back of the produce section, hidden behind sections of beautiful bright, shiny vegetables, in an array of eye-popping Crayola-crayon colors, there’s an unassuming, misshapen dusty-looking vegetable that can catapult your training and support heart and artery health at the same time. Consider beets nature’s perfect sports and heart-friendly food wrapped up in one sweet, though unusual looking, package.

Beets are special because they contain more nitrates than their neighbors in the produce isle, green leafy vegetables including spinach, kale, celery and Swiss crest. When you eat nitrate-rich foods, thebacteria on your tongue convert about 20% of dietary nitrate cto nitrite, which enters the bloodstream where it is converted to a small signaling molecule called nitric oxide. Nitric oxide controls blood flow and many metabolic processes. Increased nitric oxide production causes blood vessels to expand, increasing blood flow to working muscles. Think of your blood vessels like a garden hose. If you can open that hose even wider, more water will flow through it. In terms of blood vessel expansion, “the increase in blood flow improves the delivery of oxygen and nutrients to active muscles, and the removal of metabolic by-products that can interfere with muscle contraction and have an adverse effect on performance. In addition to improving the delivery of glucose to the muscles through better blood flow, nitric oxide also increases glucose (sugar) uptake by the muscle cell,” states John Ivy, PhD, Professor Emeritus, Department of Kinesiology and Health Education, College of Education. Bloodglucose is a major source of fuel for working muscles.

But, the benefits of nitric oxide don’t stop there. It also expands airways, making breathing easier. In addition, our cells become more efficient at producing ATP, the fastest source of energy for muscle contraction. Greater ATP production translates to improved speed and explosive power. “Nutrients that we take in through our diet such as carbohydrates and fats are broken down and the energy released from the breakdown of these fuels is used to make ATP in the presences of oxygen. As nitric oxide levels increase, less oxygen is required to produce ATP reducing the oxygen cost of exercise,” says Ivy. And therefore, along with greater ATP production less energy is required to sustain the same level of effort while you are working out. And finally, nitric oxide may improve recovery between training sessions and allow you to exercise at a higher intensity before fatigue sets in.

Go Red for Heart Health

Dietary nitrates from beetroot juice and green leafy vegetables haveother, more profound, benefits for your body aside from affecting your training and sports performance. Consistent intake can help lower blood pressure andimprove blood vessel functioning. Research also shows dietary nitrates may improve artery health by decreasing inflammation, platelets clumping together (a step in the formation of blood clots) and artery stiffness (stiff arteries do not easily expand to accommodate increases in blood flow, which may occur when blood pressure increases). With aging we aren’t able to produce as much nitric oxide, which may make regular consumption of nitrate-rich foods even more important to support nitric oxide levels in the body.

Don’t Confuse Beets with Similar Sounding Compounds

Though beets and therefore beetroot juice, are nitric oxide boosters, you won’t want to confuse them with another nitric oxide booster – l-arginine. Beets and other nitrate-rich vegetables work through the nitrate-nitrite-NO pathway – one that functions when oxygen isn’t as readily available and therefore when you are sucking wind during a spin class. L-arginine works through a very different nitric oxide boosting pathway, one that requires the presence of enzymes and oxygen and therefore isn’t effective when you are exercising at a very high intensity.

Beets and other vegetables rich in dietary inorganic nitrate are also not the same as nitrite salts (typically sold over the internet), which can be harmful, even deadly in low doses. Also, organic nitrates and nitrites are totally different than the inorganic nitrates found in beets and green leafy vegetables. Organic nitrates and nitrites are potent vasodilators (substances that open blood vessels) found in the drugs nitroglycerine and amyl nitrite and should only be prescribed and used under the care of a medical doctor.

How Much is Enough?

Research studies show 16 oz. of beetroot juice (equivalent to approximately 300 – 500 mg nitrate) consumed daily, 3 hours before exercise, for a period of several days will effectively increase your body’s production of nitric oxide so you notice a benefit while training. According to a few research studies, single doses of beetroot juice won’t make a dent in your training.

If you are loading up on beets, keep in mind that you need the bacteria in your mouth to convert nitrates to nitrites, the very first step in nitric oxide production. If you use anti-bacterial mouthwash or antibiotics, you’ll kill both bad bacteria and good bacteria and therefore make significantly less nitrite. Of course you shouldn’t stop using a prescribed antibiotic without your physician’s consent but anti-bacterial mouthwash might be optional, talk to your dentist.

Keep in mind that the amount of dietary nitrateintake varies in beets (as well as other vegetables) based on growing conditions including the nitrate content of fertilizer used, the level of nitrate in the water supply, soil conditions, time of year and how the vegetables are stored. “There are commercial products on the market that are made from different vegetables that claim to have high nitrate, but they aren’t. Consumers need to do their homework if they are looking for a commercial source of dietary nitrate,” says Ivy.

Though vegetables rich in nitrates are considered safe for healthy individuals, they may turn your urine and stools red (don’t worry, this is harmless). However, anyone with pre-existing cardiovascular disease should of course tell their cardiologist about any dietary changes they plan to make since certain foods can interact with specific prescription drugs. For instance, while green leafy vegetables are rich in good nutrition and contain nitrates that are important for cardiovascular health, they contain a good amount of vitamin K, a nutrient that can interfere with some blood thinningmedications.

You can’t go wrong by picking up those oddly shaped red, yellow and orange bulb-looking veggies tucked away in back of your produce isle. Beets are a good source of the B vitamin folate and contain more dietary nitrates than any other vegetable. When consumed regularly they may improveyour training and also support cardiovascular health.

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Slow Digesting Carbohydrates for Fat Loss and Better Performance?

Consume fewer calories, use more body fat and feel great during exercise – these are the claims behind slow digesting carbohydrates. Before you ditch your typical sports drink in favor of a slow digesting carbohydrate, check out the truth behind each of these lofty claims.

In this post I will cover:

  • One big fat myth – slow digesting carbohydrates won’t help you burn body fat
  • Trying to burn fat during exercise is pointless
  • Fast carbohydrates are better for high-intensity athletes
  • Advice for those on a low carbohydrate diet

According to Generation UCAN, makers of a slow digesting starch (a type of carbohydrate), typical high sugar sports nutrition products cause a rapid increase in energy followed by low blood sugar leading to a sharp crash, leaving you feeling tired with a bad case of the munchies (“post-workout cravings” according to their website). Generation UCAN’s starch will keep your blood sugar levels nice and steady while delivering long-lasting energy for hard-working muscles. The payoff? You need fewer carbohydrates (and therefore calories) to fuel activity and your insulin levels (a hormone that helps store body fat among other functions) are kept low so your body can pull from a larger supply of body fat (multiple times larger than the amount of carbohydrate stored in muscle and liver).

All of this sounds great in theory. Yet none of it holds up in real life.

Typical sports nutrition products do not cause a sharp crash (symptoms of low blood sugar) when consumed before or during exercise (1). Instead, your body will use the sugar pretty quickly to fuel hard working muscles (2). What about post-workout cravings? Typical sports drinks, gels and gummies won’t lead to cravings, despite possible changes in blood sugar, even if you consume them when your body doesn’t need them – when you are sitting on the couch scrolling through Snapchat videos (3).

One Big Fat Myth – Slow Digesting Carbohydrates Won’t Help You Lose Body Fat

Trying to burn fat during exercise is pointless (unless you are a ultra distance athlete and therefore relying on large amounts of fat for energy to run for several hours at a time). Otherwise it doesn’t matter if more fat is used during exercise. What matters most if you want to lose weight? The total amount of calories burned over time.

You are better off burning fat while sitting in front of your computer or sleeping then trying to maximize fat used during exercise. Why? Fat is a slow source of energy – if you are seriously tapping into your fat stores during exercise you aren’t exercising very hard and therefore you aren’t burning very many calories. If you want to make the most of your exercise sessions, burning as many calories as possible, you’ll need carbohydrates to help you sustain your exercise intensity. It’s the difference between walking and sprinting. You have to walk for a much longer period of time to burn as many calories as you will if you are sprinting or doing intervals.

Fast Carbohydrates are Better for Athletic Performance

slow digesting carbohydratesCarbohydrates are the best source of energy to keep up with the calorie demand of high-intensity exercise. The less carbohydrate you have stored in your muscle (stored from the carbohydrate you eat each day), the more your body will rely on carbohydrate consumed during exercise in the form of sports drinks, gels, beans, gummies etc. Fast carbohydrates (the mix of sugars in common sports nutrition products) have been successfully used for decades. Yet some athletes get an upset stomach when exercising. Generation UCAN says their product will lower risk of stomach upset. Unfortunately, a well-designed study found athletes actually had greater stomach upset on UCAN (a slow digesting carbohydrate) than they did on traditional sports nutrition drinks (8). If you don’t want the nitty-gritty science, skip the next section and move to the following paragraph.

In this crossover study (each study subject experienced each type of drink) 10 male cyclists consumed 1) 60 grams of carbohydrate from a typical sports nutrition drink (sucrose and glucose blend) 30 minutes before and 60 grams of carbohydrate per hour during exercise (Sports Drink); 2) 60 grams of carbohydrate from UCAN (hydrothermally-modified starch; HMS) before and 60 grams of carbohydrate per hour during exercise (Isocaloric HMS); 3) 60 grams of carbohydrate from UCAN before and 30 grams of carbohydrate per hour during exercise (Low HMS). They spent three hours exercising (one hour at a moderate pace followed by intervals and sprints). There was no difference in performance between the Sports Drink and High HMS. Both the Sports Drink and High HMS resulted in slightly better performance compared to Low HMS (less carbohydrate during exercise). Consuming UCAN, whether 30 or 60 grams per hour, led to greater incidence of nausea compared to consuming 60 grams of carbohydrate per hour from a typical Sports Drink (8).

Typical carbohydrates used in sports nutrition products are digested quickly and used by muscles right away so you can train harder than you would if you relied on slow carbohydrates. The body can use about 30 – 60 grams of carbohydrate per hour, and possibly up to 90 if a mix of different sugars is used. Fat metabolism kicks in after around 20 minutes of aerobic exercise. “After about two hours of continuous endurance exercise, fat is a major source of energy. However, carbohydrate is still essential. Without enough carbohydrate present there is incomplete burning of fatty acids resulting in ketone bodies as a byproduct. When ketones build up, the body’s pH drops (metabolic acidosis) and the body attempts to compensate via respiratory hyperventilation,” states sports dietitian Sally Hara, MS, RD, CSSD, CDE. You won’t improve performance if you consume slow carbohydrates before or during exercise (5).

Fast carbohydrates are also preferential right after exercise – your body can rapidly replenish carbohydrate stores in muscle for use during her next training session. This is very important for athletes who train more than once over the course of an 8-hour period and also important for those who train again less than 24 hours later (6, 7). Anyone who doesn’t train again less than 24 hours later can re-stock their carbohydrate in muscle by consuming enough carbohydrate in their diet from potatoes, rice, quinoa, and other higher carbohydrate foods.

You can function on fewer carbohydrates. However, “there is a difference between functioning and performing your best. Athletes and high-intensity sports to follow a low carbohydrate diet are more likely to get tired early and make mental errors,” states Hara. If you want to perform well and burn more calories while lowering risk of stomach upset, choose a traditional sports nutrition product instead of being swayed by the false marketing promises behind slow digesting carbohydrate products.



1 Jeukendrup AE, Killer SC. The myths surrounding pre-exercise carbohydrate feeding. Ann Nutr Metab 2010;57 Suppl 2:18-25.

2 Marmy-Conus N, Fabris S, Proietto J, Hargreaves M. Preexercise glucose ingestion and glucose kinetics during exercise. J Appl Physiol 1996;81:853-857.

3 Schultes B, Panknin A, Hallschmid M, Jauch-Chara K, Wilms B, de Courbiere F, Lehnert H, Schmid SM. Glycemic increase induced by intravenous glucose infusion fails to affect hunger, appetite, or satiety following breakfast in healthy men. Appetite 2016;105(1):562-566.

4 Roberts MD, Lockwood C, Dalbo VJ, Volek J, Kerksick CM. Ingestion of a high-molecular-weight hydrothermally modified waxy maize starch alters metabolic responses to prolonged exercise in trained cyclists. Nutr 2011;27(6):659-665.

5 Burdon CA, Spronk I, Cheng H, O’Connor HT. Effect of Glycemic Index of a Pre-exercise Meal on Endurance Exercise Performance: A Systematic Review and Meta-analysis. Sports Med 2016:1-15.

6 Stephens FB, Roig M, Armstrong G, Greenhaff PL. Post-exercise ingestion of a unique, high molecular weight glucose polymer solution improves performance during a subsequent bout of cycling exercise. J Sports Sci 2007:1-6.

7 Aulin KP, Soderlund K, Hultman F. Muscle glycogen resynthesis rate in humans after supplementation of drinks containing carbohydrates with low and high molecular masses. Eur J Appl Physiol 2000;81:346-351.

8 Bauer DA, Vargas F CS, Bach C, Garvey JA, Ormsbee MJ. Slow-Absorbing Modified Starch before and during prolonged cycling increases fat oxidation and gastrointestinal distress without changing performance. Nutrients 2016;8(392):1-16.

Tackling Concussions Head-On: How Nutrition Can Improve Outcomes


I sat on the floor hunched over and crying. My elbows were raised – close to my eyes as my arms hugged my head, hands clenched at the base of my neck. My brain felt like a percussion instrument shaking inside my skull. As the pounding grew more intense the pain became unbearable. I had a concussion, my second in two years, which earned me a night in the ER.

Concussions are common in sports and recreation. Though considered a mild type of traumatic brain injury because they are usually not life-threatening, all concussions should be taken seriously. A single blow to the head can result in short-term loss of brain functioning or long-term changes in thinking, language, emotions and sensations including taste, touch and smell (1). Repeated concussions can be very dangerous and may lead to permanent changes in brain functioning or in extreme cases, death (2). Though widely recognized in football players, concussions happen in all sports – even in everyday activities – and they are occurring at younger ages. Athletes who have had one concussion have a greater risk (2 – 5.8 times higher) of experiencing another concussion (3). Multiple blows to the head could lead to chronic traumatic encephalopathy (CTE), a progressive neurodegenerative disease associated with poor memory, changes in personality, behavior, speech and gait (4). Posthumous examination of some former NFL players in addition to a few college football players who committed suicide revealed CTE. In March 2016, the NFL acknowledged the link between traumatic brain injury and CTE. The movie ‘Concussion,’ set for release in late December, 2015 highlights concussions in former NFL players though the league has gone to great lengths to make today’s game safer.

Decreasing the Damaging Effects from Concussions

Anyone who experiences a blow to their head or body (a forceful blow to the body can cause the brain to shake inside the skull) should be immediately examined by a physician with experience in the evaluation and management of concussions. Though the person may say they feel fine and can continue with regular activities, symptoms of concussion do not always appear immediately and may instead be delayed for several hours. Continuing to play or perform mental tasks like studying can increase severity or symptoms and cause complications including the possibility of developing permanent brain damage.

Symptoms of Concussion may include:

  • Confusion
  • Headache
  • Vision changes
  • Memory loss
  • Difficulty with coordination, clumsiness or stumbling
  • Dizziness
  • Irritability
  • Personality changes
  • Slurred speech
  • Delayed response to questions
  • Nausea or vomiting
  • Sensitivity to light and noise
  • Problems sleeping
  • Seizures
  • Loss of consciousness

In addition to the symptoms that occur soon after a concussion, some people experience Post-Concussion Syndrome (PCS) days or weeks later. PCS can cause many of the same symptoms experienced after a concussion as well as trouble concentrating, apathy, depression and anxiety. Symptoms may last a few weeks. If you suspect PCS, have the patient evaluated by a psychiatrist (5).

Nutrition Management

In addition to rest, following a graduated return-to-play and school protocol, and other steps you should take to treat concussions, emerging research suggests nutrition may play an important role. Certain nutrients seem to help reduce some of the damaging effects from concussions:

Protein: 1 – 1.5 grams of protein per kg body weight per day is recommended along with sufficient calories to reduce the inflammatory response (6).

EPA and DHA Omega-3 Fatty Acids: EPA and DHA, omega-3 fatty acids found in fish and algae, increase fluidity of cell membranes, reduce inflammation and enhance cerebral blood flow (which is reduced for up to a month or longer in athletes that recover slowly) (7). Cell membranes are like gateways allowing substances to enter cells or blocking their entry. When cell membranes are more fluid (and therefore less rigid), they perform better, opening the gate for nutrients to come in. DHA, in particular, makes up 97% of the omega-3 fatty acids in the brain and is essential for normal brain functioning (8). Several animal studies show EPA and DHA supplementation before or after a traumatic brain injury helps limit structural damage and decline in brain functioning (9, 10, 11, 12, 13, 14, 15).

There is no clear consensus regarding optimal intake of EPA and DHA prior to or after a concussion. Given that many Americans do not eat enough fish and an estimated 75% of American diets are too low in EPA and DHA, it makes sense to start by meeting the general guidelines for recommended intake of EPA and DHA by:

  • Consuming fatty fish varieties that contain high levels of omega-3s, including salmon, tuna, mackerel and herring at least twice per week;
  • Take an omega-3 supplement providing EPA+DHA daily (be sure to look for high-quality fish oil, algal oil or krill oil supplements in your local grocery or health store);
  • Eat and drink DHA omega-3-fortified foods and beverages, including milk, 100% juice, and yogurt.

Research has yet to identify exactly how much EPA + DHA may be helpful after a concussion. However, according to the Food & Drug Administration (FDA), doses of EPA + DHA up to 3 grams per day are considered safe.

Zinc is necessary for optimal brain functioning while a deficiency of this mineral may compound oxidative damage from concussions. Though zinc supplementation may be an effective treatment modality, additional research needs to determine if zinc supplementation is safe after concussions. The Upper Limit for zinc is 40 mg per day.

Animal and human studies suggest creatine helps prevent secondary brain injury after traumatic brain injury. However, animal studies show long-term creatine intake may decrease its beneficial effects on the brain after injury. Future research needs to better elucidate the relationship between creatine pre-TBI and creatine post-TBI and outcomes.

Other potential approaches to addressing concussions through nutrition include ketogenic diets which are very high-fat, minimal-carbohydrate diets that are effectively used to decrease both the incidence and severity of seizures in children with epilepsy. Ketogenic diets provide an alternate energy source for brain functioning – ketones derived from the breakdown of fat. This may be important since available glucose, the primary energy source for brain functioning, may be decreased after a concussion.

Current research supports the integration of a dietitian into the team of health professionals treating concussions. Though nutrition interventions are considered preliminary at this time, consideration should be given to nutrition strategies that may reduce long-term effects while causing no further harm.

Disclosure: I am a GOED/Omega-3 Science Advisory Council Member supporting the research behind omega-3 EPA and DHA for a healthy brain, heart and eyes.


1 What are the Potential Effects of TBI? Injury Prevention & Control: Traumatic Brain Injury. CDC. http://www.cdc.gov/TraumaticBrainInjury/outcomes.html

Concussion (Traumatic Brain Injury). Pubmed Health.

3  Harmon KG, et al. American Medical Society for Sports Medicine position statement: concussion in sport. Br J Sports Med 2013;47:15-26. http://www.amssm.org/Content/pdf%20files/2012_ConcussionPositionStmt.pdf

4  McKee AC, Cantu RC, Nowinski CJ, Hedley-Whyte T, Gavett BE, Budson AE, Santini VE, Lee H, Kubilus CA, Stern RA. Chronic Traumatic Encephalopathy in Athletes: Progressive Tauopathy following Repetitive Head Injury. J Neuropathol Exp Neurol 2009; 68(7): 709–735.

Post-Concussion Syndrome. PubMed Health 

6 Nutrition and Traumatic Brain Injury: Improving Acute and Subacute Health Outcomes in Military Personnel. The National Academies Press. 2011. http://www.nap.edu/catalog/13121/nutrition-and-traumatic-brain-injury-improving-acute-and-subacute-health

7  Meier TB, Bellgowan PS, Singh R, Kuplicki R, Polanski DW, Mayer AR. Recovery of cerebral blood flow following sports-related concussion. JAMA Neurol 2015;72(5):530-8.

8 Salem N Jr, Litman B, Kim HY, Gawrisch K. Mechanisms of action of docosahexaenoic acid in the nervous system. Lipids 2001; 36(9):945-59.

9 Mills JD, Hadley K, Bailes J. Dietary supplementation with the omega-3 fatty acid docosahexaenoic acid in traumatic brain injury? Neurosurgery 2011;68:474–81

10 Wu A, Ying Z, Gomez-Pinilla F. Omega-3 fatty acid supplementation restores mechanisms that maintain brain homeostasis in traumatic brain injury. J Neurotrauma 2007;24:1587–95

11 Wu A, Ying Z, Gomez-Pinilla F. Dietary omega-3 fatty acids normalize BDNF levels, reduce oxidative damage, and counteract learning disability after traumatic brain injury in rats. J Neurotrauma 2004;21:1457–67

12 Wang T, Van K, Gavitt B, Grayson J, Lu T, Lyeth B, Pichakron K. Effect of fish oil supplementation in a rat model of multiple mild traumatic brain injuries. Restor Neurol Neurosci 2013;31:647–59

13 Mills JD, Bailes J, Sedney C, Hutchins H, Sears B. Omega-3 fatty acid supplementation and reduction of traumatic axonal injury in a rodent head injury model. J Neurosurg 2011;114:77–84

14 Wu A, Ying Z, Gomez-Pinilla F. The salutary effects of DHA dietary supplementation on cognition, neuroplasticity, and membrane homeostasis after brain trauma. J Neurotrauma 2011;28:2113–22

15  Wu A, Ying Z, Gomez-Pinilla F. Exercise facilitates the action of dietary DHA on functional recovery after brain trauma. Neuroscience 2013;248:655–63

Should Endurance Athletes Switch to a Low Carbohydrate Diet?


High carbohydrate pasta with tomatoes
Pasta – a typical meal for endurance athletes.

Should endurance athletes trade in their high carbohydrate gels, gummies, and pasta for fatty steak and butter?  A recent study found elite ultra-marathoners and iron distance triathletes on a low carbohydrate diet  burned significantly more fat while running than  their counterparts on a typical higher carbohydrate diet. There was no difference in the level of glycogen depletion between groups after a 3-hour run.

Why Carbohydrates Matter

For several decades endurance athletes have relied on a carbohydrate rich diet to fuel their training and performance. Carbohydrates are the primary source of energy used during activity. They’re also a fast fuel – your body can use gels, gummies and sports drinks very quickly while also accessing the carbohydrates stored in your muscle when your energy needs outpace how quickly you can squirt more gel in your mouth. Regular intake of carbohydrates during  prolonged activity provides an important source of energy for working muscles and helps spare dipping into your reserves in muscle tissue (in the form of glycogen). Once glycogen levels start getting too low, your performance will subsequently decline.

If carbohydrates are important for performance why would anyone go on a low carbohydrate diet?

The longer you run, bike, swim or exercise in general, the more carbohydrates you need to keep up with energy demands. There are three main reasons athletes (particularly ultra endurance athletes) want an approach that doesn’t require carbohydrate during long bouts of exercise are:

  1. Your taste buds get tired –  Eat any food over and over again and you will get sick of it eventually. Now imagine running 30, 50 or 100 miles and eating a gel every 30 minutes. The consistency, sweetness and flavors will make your taste buds revolt.
  2. Your stomach might get upset. Exercise + eating (even seemingly easy to digest carbohydrate products) can cause stomach upset in some people.
  3. You are trying to lose body fat. If you are exercising for long periods of time it may sound counterintuitive to consume 30-60 grams of carbohydrate (or 90+ depending on the type of carbohydrate, your stomach’s tolerance and the type of exercise you’re doing) each hour while training.

If any of these apply to you, a diet that doesn’t force your body to rely on carbohydrates for energy may sound very appealing.

The Study & the Low Carb Diets for Endurance Athletes

The body has amazing ability to adapt to changes in the macronutrient composition of your diet.  In other words, if you eat more fat you’ll burn more fat. If you are adapted to a low carbohydrate diet, you will rely on your body fat for fuel and will not need to consume gels, gummies or any other carbohydrates while running, biking or swimming. However, there is an adaptation period.  It takes time for your body to switch over from relying on carbohydrate to fuel activity to using primarily fat. The study subjects included elite male ultra-endurance athletes who habitually consumed a high carbohydrate diet (> 55% of calories from carbohydrate) and a separate group of those habitually consuming  a low carbohydrate diet (< 20% of calories from carbohydrate and > 60% from fat though the average was 70% from fat) for at least 9 months. Both groups slept, reported to the lab fasted and then drank a 343 calorie shake (the shake contained 4.3 grams of carbohydrate for the low carbohydrate group and  42.7 g of carbohydrate for the high carbohydrate group). Ninety minutes later they ran on a treadmill.


As expected, the low carbohydrate high-fat diet group used a lot more fat when jogging then the high carbohydrate group (88% of calories from fat vs. 56% in the high carbohydrate group). They also used more fat at a higher intensity than the high carbohydrate diet group. They were able to use fat at a good rate – fat is typically a slow source of energy but the rate of fat use in this fat-adapted group was pretty compatible to the typical rate (but not the maximum) at which an athlete can use carbohydrates. Glycogen levels at rest, glycogen breakdown during exercise and re-synthesis after exercise was the same in both groups. * There was no difference in the amount of calories burned between the two groups.

Is This Diet Right for You?

Ultra endurance athletes can adapt to and train on a higher fat diet.  They can also do this without glycogen depletion – glycogen depletion can come with other negative consequences including potential suppression of immune system functioning.  At this time, we do not know if regularly following a lower carbohydrate diet = better endurance performance.

What you need to consider:

  • According to this study you will not burn more calories during exercise when on a low carbohydrate, high fat diet. ** See note below.
  • Your body needs at least 1 month to adjust. The first week will probably suck (you’ll feel terrible and have low energy).
  • You might not improve performance (we don’t know).
  • Can you stay on a low carbohydrate, high fat diet? Do milkshakes made of  heavy cream, olive oil, walnut oil and whey protein sound yummy? Is this diet practical for your lifestyle? If you answer yes to those 2 questions,  then it might be worth a shot. Work with a nutrition expert to ensure you are getting all of the fiber, vitamins, and minerals you need for performance and health.

* Keep in mind the results from this study are specific to endurance athletes.

** If weight loss is your goal, it makes no difference if you burn more fat during exercise if you aren’t burning more total calories in that exercise session. The only caveat here is if a low carb diet means you consume few to no calories during exercise. In this scenario, a low-carb diet may help you consume fewer total daily calories.

What Causes Muscle Cramps? How Can I Prevent Them?

Muscle cramp
There are two main types of muscle cramps. If you can identify which one you are experiencing you may be able to stop cramping sooner and prevent future cramps.

Localized Muscle Cramping

Localized muscle cramps happen suddenly when a muscle is overworked and tired.

They feel like: constant pain.

Risk factors include: several factors may contribute to localized muscle cramping including: older age, history of cramping, metabolic disturbances, poor conditioning (or increasing the intensity of your training before you are ready) and not stretching. 

Treatment: for this type of cramping should include passive stretching, massage, active contraction of the antagonist or opposing muscle group (for instance, if your hamstrings are cramping, contract your quads), and icing.

Prevention:  Stretching (hold your stretch for at least 30 seconds), using proper movement patterns (biomechanics) and making sure you are conditioned before increasing the intensity of your training.

Exertional Heat Cramps

Exertional heat cramps are due to extensive sweating and low sodium levels from not consuming enough sodium and/or losing too much sodium through sweat.

They feel like: initially you may feel brief, spontaneous contractions that take time to develop followed by debilitating, widespread muscle spasms.

Risk factors include: high sweat rate, little sodium intake (especially if you lose a lot of sodium through sweat or over consume water or other no or low sodium drinks).

Treatment: replacing both fluid and sodium losses as soon as you start cramping. You can use an electrolyte replacement product or table salt! IVs are sometimes used to expedite this process. Massage and ice can also help relax the muscles and relieve discomfort.

Prevention: if you are a “salty sweater” – you see white salt crystals on your clothes, face or other parts of your body, be sure to salt your food prior to training and competing and consume enough sodium in your sports drink to prevent excessive sodium losses.

If you know what type of cramps you are prone to, you can better incorporate prevention methods and have treatment options readily available to stop cramping as soon as possible [ice, sports drinks, electrolyte products, table salt (restaurant salt packets in a ziplock bag always come in handy), a good athletic trainer nearby etc.].

As a review, here are your prevention strategies for cramping:

  • If you have a history of heat cramping, know that your cramps will likely reoccur at some point during training or competition.
  • Make sure you are conditioned before increasing the load or intensity of your training.
  • Incorporate stretching or hot yoga into your training regimen.
  • Give your body time to adjust to changes in elevation, heat and humidity.
  • Salt your food!
  • Do not over-consume water or any other low or no sodium beverage or you’ll dilute your blood sodium level and set yourself up for cramps.
  • Weigh yourself pre- and post- training. For each lb lost, consume 20 – 24 oz of an electrolyte-replacement drink.
  • Work with a sports dietitian or athletic trainer (ATC) to develop a hydration-electrolyte plan that specifically meets your needs. Sports drinks do not contain enough sodium for salty sweaters and those prone to exertional heat cramps.



Electrolytes That Will Help You Stay Hydrated & Perform Better

tennis athleteElectrolytes are minerals that help you stay hydrated, regulate nerve functioning, and influence muscle contraction and relaxation. Any electrolyte disturbance can potentially hinder athletic performance and may lead to muscle weakness, muscle twitching, dehydration, and cramping.

Sodium and chloride (together they make table salt) are the major electrolytes lost through sweat followed by smaller amounts of potassium, calcium, and magnesium. Sodium is the primary electrolyte that needs replacing during exercise. In a healthy individual, blood potassium is well regulated. Also, supplemental potassium in high doses can be very dangerous therefore, while some electrolyte replacement products provide a tiny bit of potassium, this isn’t an essential ingredient.

Sweat sodium losses vary tremendously between athletes with reported losses ranging from the amount in a “pinch” of salt (0.2 grams of sodium) per liter (1 liter = 4.23 cups) of sweat to over 12.5 grams of sodium per liter (12.5 grams of sodium is the amount in 5.4 teaspoons of salt) of sweat. Sweat sodium losses are dependent on an athlete’s dietary sodium intake, sweat rate, adaptation to heat, and rehydration source (and how much sodium their during exercise beverage contains).

Hydrating with water alone can help prevent over-heating, though sodium helps your body hold onto the fluid you drink. In fact, relying solely on water and drinking tons of water (let’s say you only rehydrate with water during a four hour marathon) can dilute blood sodium levels and contribute to hyponatremia (dangerously low blood sodium that can result in muscle weakness spasms or cramps,  headache or confusion, low energy and at worst, brain swelling, seizure and coma). Drink tons of water after exercise to rehydrate and you’ll pee a good bit of it right back out. Popular sports drinks typically provide varying amounts of electrolytes though some athletes may need to add sodium to their sports drink to fully replace sodium lost through sweat.

If you find that you need more sodium, start by adding 50 – 100 mg for every 8 oz. of fluid. So for instance, mix ½ packet Gatorlytes into a 32 oz. bottle of Gatorade or PowerAde (or similar sports drink).

Electrolyte Comparison Chart

Product, Rating, Description Bottom Line
Gatorlytes   ****
1 packet; powder
– Mix in any amount of water or other beverages
– No calories– Sodium: 780 mg
– Potassium: 400 mg
– Magnesium: 40 mg
Easily mixes into any beverage; good amount of sodium and you can use part of a package if you want a partial serving.


Generation UCAN Hydrate  **
1 packet; powder
– Mix in 16 – 20 oz. water
– No calories
-Lemon lime flavor
-Sweetened with Stevia -Sodium: 300 mg
-Potassium: 100 mg
-Magnesium: 50 mg
-Calcium: 15 mg
Already flavored so this can only be mixed with water. Best for the very light sweater – one who doesn’t sweat much or lose much sodium through sweat.


Not for serious athletes.

Hammer Endurolytes   *
2 electrolyte capsules
-Swallow capsules or open & mix in a drink
-Contains glycine to help neutralize the salty taste

-Sodium: 80 mg
-Potassium: 50 mg
-Magnesium: 50 mg
-Calcium: 100 mg

Low in sodium for an electrolyte product. Many athletes would need several capsules.


-Xylitol is a common ingredient in Hammer products, which like all sugar alcohols, has the potential cause GI problems

Infinit Nutrition :Speed < 3 hours  ****
1 packet :Speed < 3 hours
– 230 calories
– 55 g carbohydrate from maltodextrin and dextrose

-Sodium: 325 mg
-Potassium: 94 mg
-Magnesium: 5 mg
-Calcium: 3 mg

Good for the athlete who is looking for a sports drink with sodium.


Many athletes, especially those who are heavy sweaters or salty sweaters, will need to add additional sodium.

Klean Electrolytes   *
1 electrolyte capsuleThey recommend taking 1 – 3 capsules, depending on sweat rate, weight, and activity duration.

-Sodium: 40 mg
-Potassium: 25 mg
-Magnesium: 25 mg
-Calcium: 25 mg

Relatively low in sodium for an electrolyte supplement.
MyProtein  ****
-flavored Electrolyte powder

-Chloride: 320 mg
-Sodium: 210 mg

This is table salt (exact same ratio of chloride and sodium) with potassium sulfate, calcium di phosphate and magnesium added (it isn’t clear how much is added).
NUUN   *
Electrolyte tablets (12 per tube)
Comes in 3 drink options:1 NUUN Active Hydration Tablet
-Sodium: 360 mg
-Potassium: 100 mg
-Magnesium: 25 mg
-Calcium: 13 mg

NUUN All Day Hydration
– Sodium: 60 mg
– Potassium: 200 mg
– Magnesium: 20 mg
– Calcium: 0 mg

NUUN U Natural Hydration
– Sodium: 180 mg
– Potassium: 77 mg
– Magnesium: 20 mg
– Calcium: 0 mg

NUUN Active Hydration contains sorbitol which is a sugar alcohol that may cause GI (stomach) distress (sorbitol is one of the 2 worst ones for stomach uspet)


NUUN’s U natural hydration uses Stevia instead of sorbitol



Skratch Exercise Hydration mix   ***

Electrolyte mix that can be added into any drink
– 80 calories; 20 grams carbohydrate
– Uses fruit
– No artificial flavors or colors

1 scoop (20 gm) Lemons and Limes Skratch exercise hydration mix:

-Sodium: 240 mg
-Potassium: 40 mg
-Magnesium: 24 mg
-Calcium: 10 mg

As a powder this can be modified to fit a person’s individual needs. It contains carbohydrate though and therefore it may deliver too many carbs at a time when combined with a sports drink or other calorie-containing beverage. Too many carbs at a time = stomach upset.
The Right Stuff   ***

20 ml liquid electrolyte replacement designed as a pre-exercise hyperhydrator (to expand plasma volume via sodium fluid load)

-Liquid form
-Sweetened with Splenda

-Sodium: 1,780 mg
-Chloride: 1,379 mg
-Citrate: 2,953 mg

Good option for “heavy sweaters” or athletes exercising in hot and humid environments (due to its high sodium content). However, there is nothing to suggest The Right Stuff is better than other electrolyte products when equating for sodium content or, in the case of rehydration, other factors that may contribute to fluid balance including macronutrients (fat, protein, carbs).

The research listed on their website is less than impressive since most studies compared The Right Stuff against low and no sodium conditions (the studies were not designed to truly test The Right Stuff but instead make the product look good).
In one well-designed study, that included seven total beverages. Two contained the same amount of sodium, beverages 3 & 4 (The Right Stuff). Oddly beverage 3 is missing from the results data. Also, The Right Stuff didn’t fare better than a lower sodium beverage for improving hydration status after dehydration (technically termed hypohydration). Reference below:

Greenleaf et al. Vascular Uptake of Rehydration Fluids in Hypohydrated Men at Rest and Exercise. NASA Technical Memorandum. August 1992.

Your Best Bets for Super Bowl Party Food

Wings, nachos and beer are football party favorites. But, the typical Super Bowl spread can leave you with a food and alcohol hangover. If you’d rather not start your work week feeling like you can’t lift your body out of bed, try these ideas straight from my healthy & tasty playbook:

1) Eat Today – never skimp on food because you have a party later in the day. You’ll be starving by the time you hit the Super Bowl spread and you’ll already have that mindset that you dieted today so you can eat whatever you want tonight – a great strategy for a Super Bowl sized binge.

2) Hydrate Responsibly: use a Spacer – if you drink, alternate each alcoholic beverage you consume with a water or hydrating beverage spacer. If you aren’t likely to gulp down plain water try a bottled beverage that tastes great. And if you are at someone else’s party, bring a stash for everyone.

3) Eat some Meat – chicken, crawfish, lean red meat etc. are all great sources of protein and protein is more filling than carbohydrate or fat. So dig in, but leave the full-fat Bubba burgers for a guy who looks like a Bubba.

4) Substitute Potato Skins for Nachos – a serving of supreme nachos will load more than 700 calories and a day’s worth of sodium on your waistline. Opt for plain nachos or make potato skins instead. Easy to make and waistline friendly.

5) Go Nuts – plain, roasted or salted nuts are a great snack. All nuts contain heart-healthy monounsaturated fats, an array of nutrients and antioxidants and studies show they satiate your appetite. Choose nuts you have to crack open – it takes more work and time to eat.

6) Make Guacamole – this is my new favorite party dish. It takes no time to make and is 100% healthy (yet the other guests will have no clue that it’s actually good for them).  The staple of guac is the avocado and avocados are chock-full of antioxidants, vitamins and heart healthy fats. Here’s the easy recipe I made on NBC in Atlanta, GA.

Chew on This: Quercetin can Enhance Endurance

Last year a good friend/colleague of mine fed me Q-chews, the warfighter’s candy for helping soldiers (real soldiers not the kind Destiny’s Child sings about).

Q-chews were developed for the military to help ward off illness and physical stress while helping them maintain mental focus. Because let’s face it, the military on the front line of defense are elite athletes. A wrong move may mean life or death not just sitting on the beach with their head in a sweat-soaked towel.
These yummy, candy-like chews contain quercetin and vitamin C. Quercetin is an antioxidant found in some fruits and veggies. In a recently published University of South Carolina study (funded by the DOD), researchers found that quercetin may boost endurance.
They took 12 healthy, but untrained college-aged students and gave them 500 mg quercetin twice a day in Tang or placebo (straight up Tang) for 7 days and had them ride stationary bikes to the point of fatigue. Then they switched the groups so each person served as their own control. The quercetin group showed greater improvements in VO2max (max oxygen uptake; view it this way – Lance Armstrong has a high VO2 max, your sedentary smoker friends have a low VO2max) and endurance.
This study showed two things: 1) Tang still exists and 2) 1,000 mg/day quercetin may boost endurance in untrained people. Now I’d love to see the results of this study using trained athletes.

Nitric Oxide Products: Yes or NO?

In search of the next best thing (or just supplement variety), many athletes ask me about Nitric Oxide products. Anecdotally, many report a power boost from taking them. But the research is equivocal, at best.

Nitric oxide is short lived in the body, 6-10 seconds. It’s rate limiting substrate is believed to be arginine (turn over any NO product and you’ll see l-arginine or AAKG). In the body, NO relaxes smooth blood vessels which leads to greater blood flow in certain areas of the body. So the theory goes like this – increase NO production = increased blood flow = greater power which leads to training adaptations over time.
One of better studies on NO was done in 2006 by my friend and colleague Bill Campbell (now at Univ S FL). He gave resistance trained males 12 grams of AAKG for 8 weeks. At the end of this time period the subjects showed significant increases in bench press and anaerobic power but no change in lean tissue mass.
And last week at the NSCA conference (www.nsca-lift.org) in Vegas, study results for GNC’s Amplified Maxertion NO were presented. Subjects pedaled to exhaustion on a cycle ergometer pre supplementation and after 4 weeks of 1.5 and 3 grams of arginine. After 4 weeks both groups improved performance at fatigue. The application for this – endurance exercise. Hopefully the full study will be published soon.

Looking for Bigger, Stronger Muscles? Eat Some Sugar

Sugar has become the demon among gym goers, trainers and even some dietitians. The word on the street is that you better cut it out of your diet completely for a ripped bod. The problem with this all or nothing philosophy is that it completely ignores an entire body of research about what sugar can do for you, if you drink or eat it at the right time.

When it comes to building some serious size and/or strength in the gym, carbohydrate is the macronutrient of choice for fueling your muscles through your training session. In fact, studies conducted several years ago (Haff GG. et al 2000) show that resistance training depletes your muscle glycogen levels (glycogen is the storage form of carbohydrate in your body and it is tapped into for fuel during workouts). If you don’t replace this glycogen by consuming carbs either during and/or immediately after working out, over time your glycogen levels slowly become depleted and your training volume and intensity may suffer.
Other studies show that the combination of carbohydrate + essential amino acids can decrease protein breakdown from resistance exercise (as measured by blood cortisol and urinary levels of 3-methyl-histidine, (Bird SP, Tarpenning KM and Marino FE 2006). In one particular study, the combination of carbohydrate + amino acids taken during resistance training over a 12-week period decreased protein breakdown compared to placebo and led to an increase in muscle cross-sectional area in the carb + essential amino group compared to the placebo group.
So what’s the take-home message here? Some carbohydrate, namely from sports drinks or gels can decrease protein breakdown (the scales are tipped in favor of breakdown after a resistance training bout if you don’t ingest some combination of carbohydrate + protein), promote greater levels of muscle glycogen and increase muscle cross-sectional area. I.e. – if you want size and/or strength it’s time to lighten up a little and realize what a sports drink can do for you. If you are really serious about putting on mass, mix some unflavored essential amino acids (or BCAAs) into a sports drink and start sipping on it while you are stuck in traffic on the way to the gym.

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