Is TMAO from Fish, Meat and Eggs Harmful?

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In another confusing nutrition story that should be titled “is there anything left for us to eat?” recent research threw a curveball. Fish, a staple of the Mediterranean diet, as well as meat and eggs may be doing more harm than good thanks to a compound called trimethylamine-N-oxide (TMAO). TMAO is found in fish and produced in the body after eating meat and eggs. TMAO is linked to greater risk for heart attack, stroke and death; yet the research isn’t crystal clear. Is it time to give up fish meat and eggs or ignore the recent media headlines?

This post will cover:

  • TMAO: More than a Gut Reaction—What gives us higher TMAO levels?
  • TMAO and health?
  • The bottom line

TMAO: More than a Gut Reaction

Blood levels of TMAO are ~ 50 times higher after eating fish compared to eggs or beef. The human body absorbs intact TMAO like the kind found in fish, easily. However, the human body’s production of TMAO, after eating foods containing the essential nutrient choline (found in eggs and meat) and the compound l-carnitine (found in meat and pork and in much smaller quantities in chicken breast and dairy products), depends on the makeup of bacteria in your gut, kidney functioning and genetics.

In one study, regular meat eaters produced more TMAO than a vegetarian did after eating steak (which contains ~ 180 mg of l-carnitine). After wiping out their gut bacteria with antibiotics, the carnivores didn’t produce any TMAO after consuming 250 mg l-carnitine. The makeup of gut bacteria in the habitual meat eaters was presumably responsible for greater TMAO production compared to the vegetarian, yet this was a small study and we don’t know anything else about the participants’ diet. Was it the meat that altered gut bacteria or something else in their diet? After all, a steady diet of red meat may mean double cheeseburgers on white bread with regular servings of French fries and soda on the side. This isn’t exactly the diet you want for promoting good bacteria in your gut.

Another study found blood levels of TMAO were greater in those with a less diverse makeup of microbes and greater amounts of a less healthy type of bacteria (firmicutes), compared to one that is healthy (bacteroidetes). A diet higher in saturated fat will promote this environment.

While bacteria seem to influence TMAO production from l-carnitine, l-carnitine also influences the makeup of gut bacteria. A study in mice found those with their gut bacteria wiped out thanks to antibiotics produced a different makeup of bacteria in the gut after consuming l-carnitine while also doubling the risk of plaque buildup in their arteries.

Higher TMAO levels come from:

  • Eating fish
  • Less diverse array of gut bacteria and increased levels of bad versus good bacteria
  • Consuming l-carnitine (mouse study)

TMAO and Health

A few human studies found higher blood levels of TMAO were associated with greater risk for heart disease. However, all research isn’t pointing in the same direction. One study in over 300 patients found blood TMAO levels were not associated with heart attack or heart disease over the course of eight years, following the initial test for TMAO. However, TMAO levels were higher in those with diabetes, patients with metabolic syndrome and those with declining kidney functioning. Another study examined over 800 people between the age of 33 and 55 and found blood TMAO levels were not associated with clogged arteries, insulin resistance (this comes before type 2 diabetes) and inflammatory markers or negative changes in blood lipids suggesting TMAO levels might not contribute significantly to the progression of clogged arteries. However, this study shows TMAO levels were significantly lower than in previous research, showing an association between TMAO and heart disease.

TMAO is considered a risk factor for cardiovascular disease. In those with type 2 diabetes, higher TMAO levels are associated with greater risk for death, heart attack, heart failure and unstable angina (chest pain). Also, higher levels of circulating TMAO are associated with higher risk of death in those with chronic kidney disease and greater risk of certain cancers. Yet, there are several confounding factors. Fish is the primary culprit for higher acute circulating TMAO levels, yet fish-based diets are associated with reduced risk for heart disease. Also, levels of TMAO are dependent upon disease state and the makeup of gut bacteria. Therefore, at this time it isn’t entirely clear which came first – does TMAO cause disease or does TMAO increase due to disease?

The Bottom Line

The story on TMAO isn’t crystal clear, so there’s no reason to avoid fish, meat and eggs in an effort to decrease TMAO levels. All three of these foods are good sources of several nutrients important for health. Though processed red meats are linked to higher risk of colorectal and stomach cancers, when cooked appropriately (lower, moist heat for example) red meat can fit into a healthy diet and deliver important nutrients including iron, zinc and vitamin B12. Eggs are an economical source of protein and contain many nutrients and compounds that contribute to health including two antioxidants important for eyesight.

Though there is no reason to completely avoid these foods, you can alter your diet to help diversify gut bacteria and also increase the amount of good versus bad bacteria. Probiotic rich foods such as yogurt and kefir with live and active cultures, miso soup, tempeh and other fermented foods contain good bacteria. Fiber-rich plant foods (fruits, vegetables, legumes) are important food sources for bacteria to thrive in your body.

Disclosure: this post was sponsored by USFRA. All views are my own and backed by research.

References
Koeth RA, Wang Z, Levison BS et al. Intestinal microbiota metabolism of l-carnitine, a nutrient in red meat, promotes atherosclerosis. Nat Med 2013 Apr 7.

Cho CE, Caudill MA. Trimethylamine-N-Oxide: Friend, Foe, or Simply Caught in the Cross-Fire? Trends Endocrinol Metab 2016 Nov 4. [Epub ahead of print]

Cho CE, Taesuwan S, Malsheva OV, Bender E, Tulchinsky NF, Yan J, Sutter JL, Caudill MA. Trimethylamine-N-oxide (TMAO) response to animal source foods varies among healthy young men and is influenced by their gut microbiota composition: A randomized controlled trial. Mol Nutr Food Res 2016 Jul 5.

Carnitine. Health Professional Fact Sheet, NIH. https://ods.od.nih.gov/factsheets/Carnitine-HealthProfessional/

Mueller DM, Allenspach M, Othman A, Saely CH, Muendlein A, Vonbank A, Drexel H, von Eckardstein A. Plasma levels of trimethylamine-N-oxide are confounded by impaired kidney function and poor metabolic control.Atherosclerosis 2015;243(2):638-44.

Meyer KA, Benton TZ, Bennett BJ, Jacobs DR Jr., Lloyd-Jones DM, Gross MD, Carr JJ, Gordon-Larsen P, Zeisel SH. Microbiota-Dependent Metabolite Trimethylamine N-Oxide and Coronary Artery Calcium in the Coronary Artery Risk Development in Young Adults Study (CARDIA). J Am Heart Assoc. 2016 Oct 21;5(10). pii: e003970.

Get Cultured: Probiotics can Help You Lose Weight & Stay Healthy

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From Greek to Icelandic Skyr, yogurt is everywhere. Choose the right kind, one packed with probiotics and protein, and yogurt can help you trim your waistline while supporting overall health at the same time.

In this article, I’m covering:
• How gut bacteria influence your weight and health
• Probiotic-rich foods for health & healthy weight

Your Gut Bacteria Influence Your Weight & Health

There is an entire community of over one trillion microbes (bacteria) taking up valuable real estate in your gut. Some are good, some are bad and the rest are neutral. The good guys are key players for digestive and immune functioning (remember about 70% of your immune system is located in your gut). They have many other functions as well:
bacteria, probiotics and body weight

Research studies show lean and obese people have a different makeup of bacteria in their gut. In addition, lean individuals have a greater diversity of bacteria in their gut. Diversity is important –  think of bacteria like a team of people each one has a different job and they work better together than in isolation.

If an obese person loses weight their overall makeup of bacteria more closely resemble’s a lean person’s gut. Greater weight loss = even greater the changes in gut bacteria. Also, changing bacteria seems to influence weight, though scientists know less about the influence of altering gut bacteria and changing body weight. Lean mice transplanted with bacteria from obese mice experienced a 60% increase in body fat without changing their food intake (calories in) or physical activity (calories out). The authors of this study believe the change in gut bacteria resulted in an increased absorption of some carbohydrates, increase in the production of fat and increase in fat storage. Authors from another study, this one examining human twins, also found a connection between types of bacteria in the gut and body weight, particularly visceral fat – deep layers of fat that coat the organs and are tied to higher risk of certain chronic diseases such as heart disease. The authors of this study believe, like the study in mice, obese individuals may be absorbing more calories from the food they eat.

Probiotic-Rich Foods for Health & Healthy Weight

How did they swap out bacteria in studies? Poop transplants. This isn’t exactly something you should try at home. But there’s another, easier way to keep your gut healthy. Get cultured by picking up foods that contain healthy bacteria including yogurt (with live and active cultures), kefir (drinkable yogurt, it’s so good!), miso soup, homemade sauerkraut, and tempeh (made from soy, this has a nutty taste). There might be something special about yogurt – a meta-analysis (a study that combined the results of other studies) looked at dairy intake and weight changes over time. They found greater yogurt intake was associated with lower body weight. Plus the protein in Greek yogurt seems to help people feel full so they eat less at their next meal. Also, feed the bacteria by eating plenty of fruits, vegetables and whole grains, particularly onions, greens, beans, legumes, berries and bananas, to get enough prebiotics (food) to support their growth.

 

References
Benno Y. Mitsuoka T. Development of intestinal microflora in human and animals. Bifidobacteria Microflora 1986; 5:13-25.

Quigley EMM, Quera R. Small Intestinal Bacterial Overgrowth: Roles of Antibiotics, Prebiotics, and Probiotics. Gastroenterology 2006;130:S78-S90.

O’Hara AM, Shanahan F. The gut flora as a forgotten organ. EMBO Rep 2006;7:688-93.

Ramakrishna B. The normal bacterial flora of the human intestine and its regulation. J Clin Gastroenterology 2007;41:S2-S6.

Douglas LC, Sanders ME. Probiotics and prebiotics in dietetics practice. J Am Diet Assoc 2008;108:510-521.

Million M, Maraninchi M, Henry M et al. Obesity-associated gut microbiota is enriched in Lactobacillus reuteri and depleted in Bifidobacterium animalis and Methanobrevibacter smithii. Int J Obesity 2012;36:817-825.

Hempel S, Newberry SJ, Maher AR, Wang Z et al. Probiotics for the Prevention and Treatment of Antibiotic-Associated Diarrhea. A Systematic Review and Meta-analysis. JAMA 2012;307(18):1959-1969.

An Introduction to Probiotics. National Center for Complementary and Alternative Medicine. National Institutes of Health. http://nccam.nih.gov/health/probiotics/

Marik PE. Colonic flora, probiotics, obesity and diabetes. Front Endocrinol 2012;3:87.

Bäckhed F, Ding H, Wang T, Hooper LV, Koh GY, Nagy A, Semenkovich CF, Gordon JI. The gut microbiota as an environmental factor that regulates fat storage. Proc Natl Acad Sci U S A. 2004;101:15718-23.

Ley RE, Turnbaugh PJ, Klein S, Gordon JI. Microbial ecology: human gut microbes associated with obesity. Nature 2006;444(7122):1022-3.

Kalliomäki M, Collado MC, Salminen S, Isolauri E. Early differences in fecal microbiota composition in children may predict overweight. Am J Clin Nutr 2008;87(3):534-8.

Yang YX, He M, Hu G, Wei J, Pages P, Yang XH, Bourdu-Naturel S. Effect of a fermented milk containing Bifidobacterium lactis DN-173010 on Chinese constipated women. World J Gastroenterol 2008;14(40):6237-43.

Yaeshima T et al. Effect of yogurt containing Bifidobacterium longum BB536 on the intestinal environment, fecal characteristics and defecation frequency: a comparison with standard yogurt. Bioscience Microflora 1997;16:73-77.

Hempel S et al. Probiotics for the Prevention and Treatment of Antibiotic-Associated Diarrhea
A Systematic Review and Meta-analysis. JAMA 2012;307;1959-1969.

Semova I, Carten JD, Stombaugh J et al. Microbiota Regulate Intestinal Absorption and Metabolism of Fatty Acids in the Zebrafish. Cell Host & Microbe 2012;12:277.

Schwingshackl L, Hoffmann G, Schwedhelm C, Kalle-Uhlmann T, Missbach B, Knuppel S, Boeing H. Consumption of Dairy Products in Relation to Changes in Anthropometric Variables in Adult Populations: A Systematic Review and Meta-Analysis of Cohort Studies. PLoS One 2016; 11(6): e0157461.

The Ketogenic Diet Craze: Fat-Filled Lies, Part 1

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ketogenic diPicture this: a thick, juicy, tender eventeak grilled to perfection with melted butter glazed on top, gently dripping down the sides. Lying next to the steak there’s a side of dark green asparagus sautéed in coconut oil and dusted with a sprinkle of sea salt. Could a diet loaded with fat help you lose diet-resistant body fat that’s been taunting the seams of your dress pants and poking through buttons on your shirt? Will eating fat turn you into an all-star athlete? This is part 1 of a 2 part series on the ketogenic diet.

Here is what I will cover in this blog post:

  • What is the ketogenic diet?
  • Adverse health effects.

Here is what I will cover in tomorrow’s blog on this topic:

  • The issue with ketogenic research studies.
  • Is the ketogenic diet superior for losing fat?
  • How will the ketogenic diet affect muscle?
  • How will the ketogenic diet impact athletic performance?

What is the Ketogenic Diet?

For nearly a century, epileptic patients have used ketogenic diets to control seizures when common medications provide no relief. Scientists aren’t sure why following a ketogenic diet decreases the incidence and severity of seizures but it works.

The ketogenic diet contains – 80-90% of calories from fat, 15% from protein and 5% from carbohydrate (1, 2). Food choices may include heavy cream, bacon, eggs, non-starchy vegetables, mayonnaise and sausage while fruits, starchy vegetables, breads, pasta, cereal and other carbohydrate-rich foods are not allowed.

During the first several days on a ketogenic diet, your body’s limited supply of carbohydrate stored in liver and muscle tissue decreases dramatically. As a result, you will feel like you have mono – exhausted, with headaches and easy exercise will feel like you’re climbing Mount Everest (3). Once your stored carbohydrate has dwindled, ketones, formed from the breakdown of dietary fat, become the primary source of energy for brain and body. Ketogenic means “ketone forming.” It takes at least seven days to reach nutritional ketosis and several weeks to fully adapt to the diet (12). If you aren’t in nutritional ketosis (as measured by blood, urine or breath ketones; ketone levels > 0.5 mmol/L), then you aren’t following a ketogenic diet, you are on a low carbohydrate diet.

Adverse Health Effects from the Ketogenic Diet

Much of the research on adverse effects comes from studies in epileptic children since they have been on the diet for long periods of time. These studies show soon after starting a ketogenic diet, blood cholesterol levels and artery stiffness increase (4, 5). High total and LDL cholesterol are risk factors for cardiovascular disease (diseases of the heart and blood vessels). When arteries are stiff, they cannot expand as well in response to changes in blood pressure. Think of this like a garden hose when you turn up the water pressure, your hose either expands or the water bursts out of the space between the faucet and the hose. When arteries cannot open widely to accommodate increases in blood flow, blood pressure increases leading to microscopic tears on artery walls, development of scar tissue and the perfect surface for plaque buildup (6). Blood cholesterol levels returned to normal in patients who went off the diet and in those who stayed on it, they returned to normal after 6 to 12 months. Artery stiffness returned to normal after 24 months on a ketogenic diet.5 Studies in obese patients suggest ketogenic diets improve blood sugar and blood cholesterol levels over time, either due to the diet, weight loss from the diet, a combination of the two or carbohydrate restriction (7, 8). Lose weight, regardless of what you eat and blood cholesterol, blood pressure, inflammation, blood sugar and many other disease risk factors will improve.

Ketogenic diets are typically low in calcium, vitamin D, potassium, magnesium, folic acid and fiber. There are several potential consequences associated with consistently low intake of each of these micronutrients including softening of the bones, decreased bone density, muscle damage, muscle weakness or spasms, and abnormal heart rhythm. However, with careful planning, a fiber supplement, multivitamin and under the guidance of a physician who may prescribe potassium and sodium supplements (blood sodium could drop to dangerously low levels while on this diet), nutrient needs can be met. Also, to prevent constipation when on a ketogenic diet, a fiber supplement may be necessary along with more water / fluid intake then you are used to.

Here are some other potentially bad side effects from following a high fat diet:

  • Harm to your Brain. Studies in mice show a high fat diet, even when followed for as little as two months leads to chronic inflammation, sedentary immune cells in the brain – these cells typically act like janitors picking up trash and infectious compounds but when they become sedentary they stop doing their job, leading to cognitive impairment (9).
  • Mad Bacteria in Your Gut. A diet with no probiotics (healthy bacteria) and low in prebiotics (certain types of fiber that the healthy bacteria much on for food keeping them happy) will likely change the composition of bacteria in your gut so you have more harmful and less beneficial bacteria.
  • Leaky Gut. High saturated fat meals increase bacterial toxins (endotoxins) in the intestines and intestinal permeability. In other words: leaky gut (10, 11).
  • Free radicals in overdrive? If you can’t eat a number of colorful foods including blueberries, beets, corn, oranges, and more, chances are you won’t get a wide array of antioxidant compounds to quench free radicals (compounds that are important for good health but can wreck your body when they aren’t tamed by antioxidants) as well as other plant-based compounds that keep your arteries, muscles and other parts of your body healthy.

Are the side effects and potential negative side effects worth it if you can lose weight on this diet? Stay tuned for tomorrow’s post on how the ketogenic diet impacts body fat and athletic performance.

References

1 Freeman JM, Freeman JB, Kelly MT. The ketogenic diet: a treatment for epilepsy. 3rd ed. New York, NY: Demos Health; 2000.

2 Paoli A, Bianco A, Damiani E, Bosco G. Ketogenic Diet in Neuromuscular and Neurodegenerative Diseases. BioMed Research International 2014, Article ID 474296, 10 pages, 2014.

3 White AM, Johnston CS, Swan PD et al. Blood ketones are directly related to fatigue and perceived effort during exercise in overweight adults adhering to low-carbohydrate diets for weight loss: a pilot study. J Am Diet Assoc 2007;107(10):1792-6.

4 Tanakis M, Liuba P, Odermarsky M, Lundgren J, Hallböök T. Effects of ketogenic diet on vascular function. Eur J Paediatr Neurol 2014;18(4):489-94.

5 Coppola G, Natale F, Torino A et al. The impact of the ketogenic diet on arterial morphology and endothelial function in children and young adults with epilepsy: a case-control study. Seizure 2014;23(4):260-5.

6 Cecelja M, Chowienczyk P. Role of arterial stiffness in cardiovascular disease. JRSM Cardiovascular Disease 2012;1(4):1-10.

7 Dashti HM, Mathew TC, Hussein T, Asfar SK, Behbahani A, Khoursheed MA, Al-Sayer HM, Bo-Abbas YY, Al-Zaid NS. Long-term effects of a ketogenic diet in obese patients. Exp Clin Cardiol 2004; 9(3): 200–205.

8 Volek JS, Feinman RD. Carbohydrate restriction improves the features of Metabolic Syndrome. Metabolic Syndrome may be defined by the response to carbohydrate restriction. Nutr Metab (Lond) 2005;2:31.

9 Hao S, Dey A, Yu X, Stranahan AM. Dietary obesity reversibly induces synaptic stripping by microglia and impairs hippocampal plasticity. Brain Behav Immun 2016 Jan;51:230-9.

10 Mani V, Hollis JH, Gabler NK. Dietary oil composition differentially modulates intestinal endotoxin transport and postprandial endotoxemia. Nutr Metab (Lond) 2013; 10: 6.

11 Lam YY, Ha CW, Campbell CR, Mitchell AJ, Dinudom A, Oscarsson J, Cook DI, Hunt NH, Caterson ID, Holmes AJ, Storlien LH. Increased gut permeability and microbiota change associate with mesenteric fat inflammation and metabolic dysfunction in diet-induced obese mice. PLoS One 2012;7(3):e34233.

12 Paoli, A, Grimaldi K, D’Agostino D, Cenci L, Moro T, Bianco A, Palma A. Ketogenic diet does not affect strength performance in elite artistic gymnasts. J Int Soc Sports Nutr 2012;9:34.

Should Endurance Athletes Switch to a Low Carbohydrate Diet?

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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.

Results

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.

Go Green for Earth Month & Improve Your Diet at the Same Time

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You don’t have to run out and hug a tree or play hackie sack while barefoot in the park to celebrate Earth Month. Instead, Earth Day and Month were designed to designed to inspire awareness for our environment. What’s in it for you? A polluted environment leads to pollution in our food and water supply that ends up on our plates and in our bodies. And therefore, a healthier earth means a healthier you. You can do your part by recycling, disposing of hazardous wastes properly (so they don’t end up in the water you drink or on the plants you eat) and changing your diet by incorporating foods that are not only good for you but also use fewer environmental resources to produce and/or are produced in an earth-friendly manner. On a recent segment on WBAL NBC Baltimore MD, I shared the top 3 steps you can take right now to help protect the environment and improve your diet at the same time:

1) Choose green seafood – seafood that’s both good for you and good for the ocean.  The DC-based Environmental Working Group has a guide to seafood that is high in omega-3 fats and low in methylmercury. This is especially important for pregnant women and young children. Growing fetuses are exposed to methylmercury in the womb when their mom eats fish and shellfish that contain methylmercury. Methylmercury can harm a baby’s growing brain and nervous system. Recent government data suggests an estimated 1.4 million women of reproductive age have blood mercury concentrations that may increase the risk of learning disabilities in their unborn children. Exposure to mercury is harmful to all people and may have toxic effects on the nervous, digestive and immune systems, and on lungs, kidneys, skin and eyes. EWG top choices for lower mercury omega-3 rich seafood: wild salmon, sardines, Atlantic mackerel, mussels and rainbow trout.

2 ) Go Meatless. Now, I’m not suggesting everyone go completely meatless (because animal based sources of protein are typically better for building and maintaining muscle) but, adding more plant based proteins or going completely meatless for 1 day a week has the environmental impact of taking your car off the road for 320 miles, according to the Environmental Working Group. How does this help your body? Plant based sources of protein are typically lower in calories yet they are packed with good nutrition including vitamins, minerals, and dietary fiber. How can you get enough protein – choose soy, beans, lentils and nuts. I often mix animal-based proteins with plant-based proteins at meals.

3) Cook with canned foods. Americans throw away approximately 15 to 20 percent of the fresh fruits and vegetables they purchase every year. Stock up on canned foods because they help reduce food waste, saving us time and money, and reducing our impact on the environment. Canned food portion sizes are just right for both individuals and families, and most recipes are designed around these sizes. Plus, metal cans are endlessly recyclable and in fact, are the most recycled containers in America today, keeping metal out of landfills and saving significant energy. Looking for convenient, wallet-friendly sources of protein? Check out this resource (and easy recipes) Quality Protein – It’s in the Can – Fact Sheet 

Marie Spano, MS, RD, CSCS, CSSD is a proud Can-bassador – helping educate and communicate the benefits of cooking with canned foods.

 

 

Are You Getting the Nutrients You Need for Maximum Energy & Good Health?

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Take one quick peek at dietary survey data and you’ll find many Americans don’t consume enough vitamins and minerals through food alone. How does this impact your health? A nutrient deficiency could affect your energy levels, mood, ability to concentrate, structure of your skin, teeth, nails, bones and more. So, how can you be sure you are getting enough of the vitamins and minerals you need for optimal health? First, focus on consuming foods that are particularly rich in the nutrients many Americans fall short on. Secondly, consider taking a multivitamin to make up for any nutrient gaps. But first, here’s a look at the food groups:

To watch my Talk of Alabama TV segment on this topic, click here.

Nuts and Seeds

Nuts and seeds contain a wide variety of nutrients including magnesium – which is necessary for a healthy metabolism, good energy and muscle strength – yet many people get very little magnesium in their diet. On average, most women get about ½ of the magnesium they need each day. Nuts & seeds also have zinc for immune system functioning, wound healing, muscle growth and repair and some nuts, like almonds, also contain calcium, which we need for strong bones. If you are worried about the calories in nuts and seeds, stick to the right portion size (about 1/4 cup for nuts) and keep in mind that research shows people who eat nuts regularly tend to weigh less than those who consume nuts infrequently.

A few of my favorites based on nutrient content (including magnesium): pumpkin seeds, sesame seeds and Brazil nuts.

Grains

Grains provide approximately 43% of the fiber in an average American diet. Fiber aids digestion, helping prevent constipation and it adds bulk to your diet helping increase feelings of fullness, which makes it easier to control your weight. Whole and enriched grains also naturally contain a wide variety of important vitamins and minerals. For instance, grains provide about 2/3 of the folic acid in an average American diet. Folic acid makes healthy new cells. And, it is a nutrient of concern for women of childbearing age because inadequate folate (folic acid) intake during pregnancy increases one’s risk of having premature and low birth weight babies or babies with certain types of birth defects in the brain or spine. Here in the U.S., grains such as bread, cereal, flour, and pasta are enriched with folic acid (gluten free products might not be enriched).

Beans

Beans count as both a vegetable and protein-rich food. Not only are they packed with fiber but they also contain iron, magnesium and potassium. And diets higher in potassium may help lower blood pressure, especially if you consume too much sodium. Plus potassium supports muscle functioning and higher potassium diets may also decrease risk of kidney stones.

Here are 3 you should focus on based on nutrient content and versatility: black beans, lima beans and white beans.

Seafood

Seafood is another rich source of nutrients. For instance, oysters have more zinc than any other food and more iron than red meat (a 3 oz. serving provides almost half of the daily value for iron). Try canned oysters to save time and money. Canned sardines with the bones are an excellent source of calcium and vitamin D – you need both of these for strong bones. But, chew those bones carefully! And, if you are concerned about mercury (and small children, pregnant and lactating women should consume only low mercury fish), check out this guide from the Natural Resources Defense Council, which categorizes fish based on mercury content.

While eating a wide variety of nutrient-dense foods is the best way to get vitamins and minerals, the reality is that most Americans don’t get enough through food alone, especially those on lower calorie diets or adults over the age of 50. So, consider a multivitamin. Multivitamins are a great solution to fill dietary gaps.

I partnered with Centrum and the Wheat Foods Council for this segment though I wrote the content of this post and the segment based on the latest scientific research.

 

 

Pre-Workout and Post-Workout Meal Ideas

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You’ve seen them. The people who faithfully go to the gym day after day and spend quality time on the cardio equipment and in the weight room. Yet their bodies never seem to make any visible changes. They are training. But they aren’t training smart with a plan that is specifically designed to meet their goals, lifestyle and current state of conditioning. A plan that helps them progress and not just maintain. But, even with the best training program, a person’s progress will be limited if they don’t eat a diet that provides the energy they need while also facilitating training adaptations and helping improve recovery. And though eating well means choosing nutrient-dense foods 90 – 95% of the time, the most important meals for an athlete are pre- and post-workout:

Pre-workout:

In order to sustain your energy levels through your workouts, your body needs food. If you have just 2 hours before you hit the gym, track or field, opt for a lighter snack. Four hours beforehand, opt for meal that is higher in carbohydrate, contains some protein for staying power and is low in fiber and fat (both slow digestion and who wants their stomach busy digesting food when they are about to run sprints?). Lastly, don’t try something new before workouts that may make you a little queasy. For example, spicy food can give you heartburn and greasy food may make you sick to your stomach. Think familiar and easy-to-digest.

Half a cantaloupe with cottage cheese

Snack examples:

  • Cottage cheese and fruit
  • Banana spread lightly with almond butter or peanut butter
  • Yogurt
  • Granola bar
  • Pancakes or waffles

Post-workout:

The main purpose of eating after you workout is to turn a catabolic environment into an anabolic one. In other words – your post-workout meal will facilitate the processes underlying muscle growth, re-hydrate, help curb excess inflammation and restore muscle glycogen. In addition to improving recovery, your post workout meal will help you make training gains.

Post-workout meal ideas:

  • Protein pancakes (Simply pancake mix with added protein powder.)
  • Protein shake
  • Low fat chocolate milk (you’ll need more protein than this if you are lifting weights)
  • Bagel, bread or pita with melted cheese
  • Tunafish or turkey sandwich

Eat so you can train well, don’t hit the gym or run a few extra miles as an excuse to eat more food that doesn’t fit in your training program.

Written by: Rachel Rosenthal & Marie Spano

Keep Your Heart Health

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By Sara Shipley, nutrition student, University of Central Oklahoma

February is National Heart Month. With heart disease as the leading cause of death in the US and the leading killer of women, an increased awareness of this disease is important. The American Heart Association encourages awareness through their GO RED campaign and promotes a heart healthy lifestyle, including physical activity and smart eating habits. In fact, this past Friday, February 3rd marked “National Wear Red Day”, which promotes awareness and advocacy for the prevention of heart disease.

Although most Performance Nutrition readers are active, there are several important issues to consider when it comes to risk factors related to heart disease.

High cholesterol, high blood pressure, obesity and tobacco use are all factors that can normally be controlled without medication(some exceptions apply to certain people). In general, minor adjustments to your eating habits can have significant benefits to lowering your risk for developing heart disease.

These adjustments include:

  • Keep your blood pressure low by watching your sodium intake– high levels will increase BP.
  • High cholesterol levels will increase your chances of developing atherosclerosis. When your arteries are hardened- your heart works harder to function, if it works at all. This directly leads to heart attacks.
  • Lower your saturated and trans fat intake, as these types of fats             have been determined to increase ‘bad’ cholesterol levels in your blood.
  • Eat foods with more fiber– whole grains, fruits and vegetables. Increased dietary fiber is linked to decreased risk of high cholesterol levels, controlled blood sugar and weight loss. Obesity makes your heart work harder, and counters every benefit just listed above from fiber.
  • Sugar control– natural, unprocessed sugar found in fruits and vegetables is great! However, baked goods and sodas should be moderately consumed and not a staple in your diet.
  • Smoking is bad for you. Do I need to explain any further?

This message may be old news to you or maybe you forgot all the repercussions that a poor diet can have on your health. Regardless, take this short message to heart and remember that without a healthy, beating muscle in your chest- you will not be able to run, jump, swim, bike, shoot hoops or do anything. Heart health is essential, especially to athletes with added stress to our bodies.

Have a great day and don’t forget to wear red not just on Friday, February 3rd to support the GO RED initiative but throughout heart health month!

An Unexpected New Year’s Resolution

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By Sara Shipley, RD-to be, Nutrition Student at the University of Central Oklahoma

Yes, it’s that time again and the thought has probably crossed your mind as 2011 comes to a close. The annual New Year’s resolution. And, according to many popular media sources, losing weight tops many people’s resolution list. Yet our nation is in a major health crisis. Something isn’t adding up and though many people realize they should take charge of their health, they are not taking the right approach to fix the problem. If the majority of people continue to ditch their goals by February, we will continue to see the rate of obesity, diabetes and heart disease rise.

If losing weight is on your list of New Year’s resolutions, or even if it isn’t, I am going to tell you about one big dietary change that will yield big results: boosting your fiber intake.

Fiber is the indigestible part of a carbohydrate. We need fiber in our diet because our bodies do not absorb it. Rather, it acts as a vehicle to remove waste products from f our system.  Here are three reasons to eat more fiber:

Feel full longer: Fiber provides “bulk” to your diet which helps control hunger, as it takes time to move through your digestive tract leaving you full throughout the day. Eating a high fiber breakfast every morning will start your day off right.  Try oatmeal with berries and low-fat milk or whole wheat toast with peanut butter and a banana.

Digestion: Fiber will regulate your bowel movements and this helps keep everything moving out of your system, including some residual toxins.

Lowers LDL cholesterol levels and risk for heart disease: Increasing fiber may contribute to lowering LDL cholesterol levels, blood pressure and inflammation in the body. Controlling these health markers will help protect your heart.

Try this easy, high fiber hors d’oeuvre for your New Years Eve party. I have already made it for several holiday parties and it was devoured.

Bacon Wrapped Dates: Dates are dried fruit with a sweet flavor and chewy texture that will balance the salty bite of bacon. (Try turkey bacon if you want to cutback the fat, but it may not crisp as well.)

Yield: 30 pieces

  •  15 slices thick bacon
  • 30 pitted dates (Dole brand was perfect bite-size and a bag usually has approx. 30)
  • toothpicks

Pre-heat the oven to 425 F. Slice each bacon piece in half, short ways. Roll a piece of bacon around each date and pierce with a wooden toothpick. Place wrapped dates on a sprayed baking sheet (set ½ inch apart). Cook for 13-16 minutes, turning once to ensure the bacon crisps on all sides.

Place on a rack to slightly cool and serve warm.

Peas are also a high fiber food and Black Eye Pea dips and dishes are a big New Years Tradition here in Oklahoma. Get your fill of fiber with peas as you ring in the New Year!

 

 

 

 

 

 


 [SS1]What other word can you think of? I feel like ‘diet’ has already been over-used.

 [SS2]Marie- isn’t that right? Please delete if you think it sounds weird/incorrect.

Try this Winter Fruit for Great Taste & Good Health

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By Sara Shipley, RD-to-be and student at the University of Central Oklahoma

Looking for a reason to try butternut squash? I have plenty! This winter fruit, (yes it is technically a fruit because it has seeds) is packed with healthful benefits to round out any meal. Just a single cup provides an ample dose of vitamins A, B1, B3, B6, C, calcium, potassium, and fiber! The butternut squash has an inedible pale-yellow skin with a sweet, somewhat nutty flavored, deep orange flesh. The seeds must be removed prior to cooking, however they can be eaten as a snack after roasting.

Beyond the delicious taste, butternut squash is chock full of wholesome vitamins and minerals that you need in your daily diet.

THE BOON OF BUTTERNUT SQUASH:

VITAMINS: The primary source of vitamin A is from beta-carotene,     with more than 300% of the daily-recommended value in a single cup. It is also a great source for Vitamin C, which acts as an antioxidant and enzymatic cofactor in our bodies, both necessary to  regulate healthy function. Moreover, this squash provides a source of    approximately 10% each of multiple B vitamins, including B1-Thiamin,   B3- Niacin and B6.

MINERALS: We’ve heard they’re important, but how can you keep up with getting the right amount? Rather than taking a supplement, try incorporating just a single cup for a good source of calcium, potassium, and magnesium. Calcium contributes to strong bones and muscle function and potassium is an integral player in the fluid balance within our bodies. Without magnesium, many enzymatic processes required for normal function cannot proceed. These minerals are vital to a healthy diet.

FIBER: Ah, the digestive health rock star. Fiber keeps your body regular and it is involved in lowering cholesterol and maintaining blood sugar levels. That makes it heart healthy and a preventative measure towards pre-diabetes. Eat just a single cup of this squash and you will add at least 2 grams to your daily fiber goal, which should be approximately 15-20 grams.

There are also many other heart healthy attributes to this squash. Low in fat, there are only 80 calories in a cup (205g), primarily which come from complex carbohydrates. There is no cholesterol and less than 8 mg of sodium! Because this squash is naturally sweet, you don’t need to add much to enjoy the simple taste.

Steaming the squash for 7-8 minutes makes it so easy to enjoy and a quick addition to many basic dishes.  I have been cooking with butternut squash a lot lately and have found two recipes that I love, are easy to make and quite affordable.

Butternut Squash and Goat Cheese Tart: There is nothing fancy about this ‘tart’ and this recipe calls for only 6-7 ingredients. Don’t be detoured from the process of caramelizing the onions, because they pair so well with the squash and your family or guests will be asking for seconds (or the recipe).

Ingredients:

1 frozen puff pastry sheet, thawed

3 tablespoons extra virgin olive oil, separated

4 ounces goat cheese, slightly chilled

1.5 cups of cooked, 1-in. cubed butternut squash

3 large onions, thinly sliced

Thyme sprigs (fresh is best, dried works fine)

Salt and pepper to taste

Preparations:

Preheat the oven to 400 degrees and line a baking sheet with parchment paper.

With the thawed puff pastry, use a rolling pin to roll it out to approximately 10 by 16 inches. Carefully slice off half an inch from all sides of the rectangle, keeping the scraps as long strips. Transfer the pastry to the parchment paper. Wet your fingertips and the edge of the pastry. Reapply the scraps to their respective sides, creating a border. With a fork, pierce the inside part of the pastry, so when the puffing occurs in the oven, the unpierced border will rise around the inside and the middle will remain. Bake in the preheated oven for 12-15 minutes until golden. Set aside and turn the oven down to 375 Fahrenheit.

While the pastry is baking, heat a large skillet on medium heat with 2 tablespoons of olive oil and add the onions, a pinch of salt and pepper and several thyme sprigs. Place a lid on the skillet and stir often to prevent burning. Once they begin to soften and brown, keep the lid on for another 15 minutes and continue stirring.  Take the lid off as they begin to caramelize and turn heat to low. They will take another 15-20 minutes to caramelize entirely, but believe me it is worth every minute. When complete, turn off the heat and remove the thyme sprigs, as they will have done their job by imparting their flavors during that process.

After peeling and cubing the butternut squash into 1-inch cubes, steam the squash for 5-6 minutes. This will not entirely cook the squash, but it will be in the oven again so we do not want to initially overcook it.

Once the tart has been removed from the oven and the onions are caramelized, you can begin to assemble. With a large spoon, spread the onions over the entire pastry inside, as though it were a sauce on a pizza. Next, add the butternut squash and finally, crumble the goat cheese (it is easiest when chilled) in your hand and sprinkle generously over the onions and squash. You may want to brush a small amount of olive oil over the border, to add extra sheen to the pastry before baking again. Place back into the oven for 5-7 minutes, until reheated through. Take out and cut into 8 pieces. Enjoy!

Butternut Squash Risotto: I made this for a birthday dinner a few weeks ago and it was a huge hit. Besides the creaminess of risotto that everyone loves, the squash imparts a pretty orange color and adds to the rib-sticking goodness of this dish. With Parmesan cheese, this is a savory side of butternut squash I think anyone will enjoy. (Recipe adapted from Foodnetwork.com, Rachel Ray)

Ingredients:

  •  1 qt chicken stock
  • 1 cup water
  • 2 Tbsp extra virgin olive oil
  • 1 small onion
  • 2 cloves garlic, grated
  • 2 cups Arborio rice
  • 1 cup dry, white wine
  • 2 cups cooked butternut squash
  • 1 tsp. grated nutmeg
  • 7-8 sage leaves
  • salt and pepper
  • 2 Tbsp butter
  • 1 cup Parmigiano-Reggiano

Preparation:

Bring the 1-quart stock and 1 cup water to a simmer in a saucepot then reduce heat to low.

Heat a medium skillet with the olive oil over medium to heat. When oil becomes hot, add the onions and garlic. Cook until softened, about 3 minutes. Add rice and toast 3 minutes more. Add the wine, stirring occasionally until completely evaporated.

The risotto should take 18 minutes to fully cook so, patiently ladle the stock into the rice in intervals, allowing the liquid to evaporate each time. After approximately 15 minutes, stir the cooked squash into the rice. Season with nutmeg, salt and pepper and in the last minute of cooking time, add the butter in small pieces, sage and cheese.  Enjoy!