Ketogenic Diets: Fat-Filled Lies Won’t Make You Slim (or a Better Athlete)

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How do you turn your body into a fat burning machine, run faster than Usain Bolt, recover from exercise immediately and wake up each day bursting with energy? According to some people, the ketogenic diet is your answer (learn the basics of this diet here). This high-fat, moderate protein diet that is practically void of carbohydrates forces your body to use fat for energy. LeBron James supposedly tried it and offensive lineman decided to give it a shot after an ex-NFL center and O-line coach LeCharles Bentley recommended it. However, the offensive lineman and LeBron weren’t actually following a ketogenic diet. Though these athletes didn’t really know what they were following (no worries LeCharles, I’m sure your nutrition advice is on par with me coaching the O-line), people who actually follow it swear by it. Could this be an unconventional path to weight loss and better health? Unfortunately, the ketogenic diet craze has been fattened with misinformation.

Here is what I am covering in this post:

  • Eat Fat, Lose Fat? Does the ketogenic diet make you lose weight?
  • How does this diet impact muscle?
  • The ketogenic diet and athletic performance.
  • The issue with ketogenic research studies.

I am not covering “training low” or low carbohydrate  / non-ketogenic diets in this article.

Eat Fat, Lose Fat?

During the first several days on a ketogenic diet your weight will take a nosedive. Carbohydrate is stored in the form of glycogen in liver and muscle. Each gram of carbohydrate is stored with 3 – 4 grams of water. Decrease your carbohydrate intake, use glycogen and you’ll lose water weight very quickly. Weight loss, even if from water, can motivate people driven by the number on the scale. Given that adherence is the number one predictor of weight loss when on a diet, we can’t discount psychological effect of the number on the scale going down.

What happens if you stay on the diet? A group of NIH researchers admitted seventeen overweight or obese men to a metabolic ward and placed them on a high carbohydrate baseline diet for four weeks followed by four weeks on an isocaloric ketogenic diet (this diet contained the same amount of calories as the high carbohydrate baseline diet). The men lost weight and body fat on both diets. The ketogenic diet did not lead to greater fat loss as compared to the high carbohydrate diet and in fact body fat loss slowed during the ketogenic diet and subjects lost muscle (1). Time to chuck the “carbohydrates make you fat” books in the recycling bin.

What about other studies showing ketogenic diets help athletes lose body fat and maintain performance? These studies were not actually using a ketogenic diet protocol but instead were high fat, high protein, low carbohydrate diets. Also, none of the studies measured if the study subjects were actually in nutritional ketosis (2, 3, 4).  See the section on The Issue with Ketogenic Research Studies for more information on this topic.

Ketogenic diet and weight

Regardless of the studies indicating the ketogenic diet will not lead to greater weight loss as compared to a diet composed of the same amount of calories, some may lose weight because they will end up cutting down on their favorite foods. Fewer food choices often means fewer calories consumed.

Muscle Up with the Ketogenic Diet?

The ketogenic diet isn’t high enough in protein for maximal muscle gains. Using the lower end of fat intake on a classic ketogenic diet (80% of calories), one could consume 15% of calories from protein (112 grams) on a 3,000-calorie diet. Protein requirements are at least 1.2 – 1.8 grams of protein per kilogram bodyweight (or 0.55 – 0.82 grams per lb. bodyweight) per day if training and eating a diet with enough calories to maintain weight. Protein needs go up if you are cutting calories to spare the breakdown of muscle tissue when dieting. On this diet, 112 grams of protein equals just under 1.3 grams of protein per kg bodyweight for a 200 lb. person and even less for anyone who weighs more.

In addition to inadequate protein intake, “the ketogenic diet reduces many of the signaling molecules involved in muscle hypertrophy (growth),” states Dr. Antonio Paoli, M.D., B.Sc., Associate Professor and Vice Dean of the School of Human Movement Sciences, University of Padova. Without getting too technical, even with sufficient calorie intake, the ketogenic diet suppresses the IGF-1 / AKT / mTOR pathway (5). Using ketones for energy slows muscle breakdown. However it doesn’t stop this process (5).

The Ketogenic Diet and Athletic Performance

Once fully adapted to a ketogenic diet, athletes can supposedly rely on a seemingly endless supply of body fat for energy. No need for carbohydrate gels, beans, gummies and sports drinks every 15-30 minutes during long runs, rides or triathlons to sustain energy levels. Fewer calories consumed may make it easier for some people to stay within their total daily calorie needs (though if you are training that much staying within your calorie requirements shouldn’t be difficult).

Trading carbs for fat seems like a huge benefit for athletes, particularly endurance athletes who train and compete for several hours at a time (6). In addition to utilizing body fat, fat actually produces more energy (ATP) (5). However, fat is a slow source of fuel (see graphic below), the human body cannot access it quickly enough to sustain high-intensity exercise and therefore, this diet is really only (potentially) applicable to ultra-runners and triathletes competing at a relatively moderate to slow pace.

In a ketogenic diet study examining athletic endurance, researchers had subjects cycle at a snails pace (equivalent to a heart rate of about 120 beats per minute for anyone 20-30 years old or 115 for a 40 year old) until they became exhausted before and after 4-weeks on a ketogenic diet. There were no differences in the amount of time they were able to cycle before getting tired prior to or after the four-week ketogenic diet (7). In studies examining high fat diets (not ketogenic and ketones weren’t measured) and endurance performance, study subjects relied on more fat as opposed to carbohydrate during low intensity exercise, yet there was no clear performance advantage on the higher fat diet (8). A recently published study examined 20 elite ultra-marathoners and Ironman distance triathletes. Some were habitually consuming a traditional high carbohydrate diet while the other group was following a ketogenic diet (slightly adjusted macronutrient ratios yet they were in ketosis as measured by blood ketone levels). As expected, those following a higher fat diet used a greater percentage of fat for energy while the higher carbohydrate diet group used more carbohydrate for energy during a 180 minute submaximal running test (I’d call that leisure running intensity). There was no difference in calories burned over the course of the run. Both groups had the same level of perceived exertion and there was no test to determine performance differences between groups (9).

If there’s no performance benefit and we know carbohydrates work, why follow this diet? If your primary goal is weight loss, it doesn’t matter if you use more fat than carbohydrate while exercising (SN: can we please stop talking about the fat burning zone) as long as you’re burning more total calories over the course of the day. Plus, in the interest of (if you are not an ultra endurance athlete) jack up the intensity and burn as many calories in a short period of time as possible. Unfortunately, a ketogenic diet won’t help you do that – when relying on fat for fuel, the intensity of your exercise will drop – the body simply can’t access fat (a slow source of energy) quickly enough to sustain high-intensity exercise. Instead, carbohydrates are necessary for high intensity activity.
ketogenic diet and sports

The Issue with Ketogenic Research Studies

Here’s the issue with many ketogenic research studies and media reports based on them: in most cases, the study subjects were not actually following a ketogenic diet – they were following a higher fat, high-protein low carbohydrate diet (10, 11, 12). Each person’s carbohydrate and protein limits needed to stay in ketosis vary and therefore, measuring ketones through blood or urine is the only definitive way to determine if you are in ketosis. Complicating matters more, low carbohydrate diets (including ketogenic diets) lead to a substantial drop in carbohydrate content, and associated water stored with it, in muscle. This change overestimates the drop in lean body mass as measured by DEXA.

ketogenic and low carbohydrate diets

There are no modifications, higher protein intakes or “on again, off again” (where you go on it one day and off it the next) to this diet. You must be in a state of nutritional ketosis or you will need to decrease carbohydrate and protein intake even further to get into nutritional ketosis and rely on ketones for energy.

Is There Any Benefit?

Ketogenic diets help decrease incidence and severity of seizures in epileptic patients (this is what the diet is intended for). Also, ketogenic diets may be beneficial when implemented soon after a traumatic brain injury (including concussion) (13). In addition, scientists are examining if this diet is beneficial for diseases that affect the brain such as Alzheimer’s.

If you want to lose weight, the ketogenic diet is not superior to a reduced calorie diet. Also, unless you are an ultra endurance athlete who just loves dietary fat, hates eating at social occasions and can put up with the potential side effects from this diet it isn’t for you.
Now where is the O-line? I’ve got some coaching to do…

References

1 Hall KD, Chen KY, Guo J, Lam YY, Leibel RL, Mayer LE, Reitman ML, Rosenbaum M, Smith SR, Walsh BT, Ravussin E. Energy expenditure and body composition changes after an isocaloric ketogenic diet in overweight and obese men. Am J Clin Nutr. 2016 Jul 6. [Epub ahead of print]

2 Zajac A, Poprzecki S, Maszczyk A, Czuba M, Michalczyk M, Zydek G. The effects of a ketogenic diet on exercise metabolism and physical performance in off-road cyclists. Nutrients 2014;6(7):2493-508.

3 Rhyu HS, Cho SY. The effect of weight loss by ketogenic diet on the body composition, performance-related physical fitness factors and cytokines of Taekwondo athletes. J Exerc Rehabil 2014;10(5):326-31.

4 Paoli A, Grimaldi K, D’Agostino D et al. Ketogenic diet does not affect strength performance in elite artistic gymnasts. JISSN 2012;9:34.

5 Paoli A, Bianco A, Grimaldi KA. The ketogenic diet and sport: a possible marriage? Ex Sports Sci Reviews 2015.

6 Volek J, Noakes T, Phinney SD. Rethinking fat as a fuel for endurance exercise. Eur J Sport Sci 2014;2:1-8.

7 Phinney SD, Bistrian BR, Evans WJ, Gervino E, Blackburn GL. The human metabolic response to chronic ketosis without caloric restriction: preservation of submaximal exercise capability with reduced carbohydrate oxidation. Metabolism 1983;32(8):769-76.

8 Burke LM, Kiens B. “Fat adaptation” for athletic performance: the nail in the coffin? J Appl Physiol 2006;100(1):7-8.

9 Volek J, Freidenreich DJ, Saenz C, Kunces LJ, Creighton BC, Bartley JM, Davitt pm, Munoz CX, Anderson JM, Maresh CM, Lee EC, Schuenke MD, Aerni G, Kraemer WJ, Phinney SD. Metabolic characteristics of keto-adapted ultra-endurance runners. Metab Clin Exp 2016;65(3):100-110.

10 Tinsley GM, Willoughby DS. Fat-Free mass changes during ketogenic diets and the potential role of resistance training. Int J Sport Nutr Exerc Metab. 2015 Aug 12. [Epub ahead of print]2 Rouillier MA, Riel D, Brazeau AS, St. Pierre DH, Karelis AD. Effect of an Acute High Carbohydrate Diet on Body Composition Using DXA in Young Men. Ann Nutr Metab 2015;66:233-236

11  Paoli A. The ketogenic diet and sport: a possible marriage? Ex Sci Sports Sciences Rev 2015;43(3):153-62.

12  Johnstone AM, Horgan GW, Murison SD, Bremner DM, Lobley GE. Effects of a high-protein ketogenic diet on hunger, appetite, and weight loss in obese men feeding ad libitum. Am Society Clin Nutr 2008;87(1):44-55.

13 Nutrition and Traumatic Brain Injury: Improving Acute and Subacute Health Outcomes in Military Personnel (2011). The National Academies Press, Institute of Medicine. Washington DC. 2011 http://www.nap.edu/read/13121/chapter/15

 

Can You Lose Fat and Gain Muscle at the Same Time?

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Eat fewer calories than you burn each day and you’ll lose weight. There’s one major issue with this time-tested approach: you’ll probably strip away more than just body fat. Weight loss, especially fast weight loss, achieved after crash dieting or drastically slashing calorie intake, leads to a decrease in muscle mass and subsequent drop in metabolism. A slower metabolism means your body needs even fewer calories to maintain your new weight (weight loss alone = fewer calories needed to carry around a smaller body, add muscle loss and your calorie needs drop even more). In addition, with less muscle you won’t be able to push yourself as hard during workouts (and therefore burn as many calories). This can put you on the fast track to yo-yo dieting, weight loss and regain. There’s a much better approach and a recently published study highlights how you can lose body fat and gain muscle at the same time.

crash dieting leads to muscle loss

In this article I’ll cover:

  1. How dieting can slow your metabolism;
  2. The latest evidence on losing fat and building muscle at the same time;
  3. Why researchers didn’t use a low carbohydrate diet;
  4. How you can keep the weight off.

How Dieting Slows Your Metabolism

When you eat fewer calories than you need each day, your body is forced to pull from its backup supply, body fat and muscle, to maintain your energy (calorie) needs. Some people lose a substantial amount of muscle when dieting, 30% or more, of their initial muscle mass. In addition to a decrease in muscle mass and slower metabolism, lower calorie diets decrease the intracellular signaling necessary for the synthesis of new proteins in muscle. Plus, muscle tissue may be less sensitive to protein when you’re dieting. In other words, it’s really tough to build muscle when dieting to lose weight. Based on these physiological changes, there’s an age-old theory suggesting it’s impossible to gain muscle and lose fat at the same time. However, scientists from McMaster University in Canada found it is not only possible but also, doable even when losing a substantial amount of body fat in a relatively short period of time.

Building Muscle While Losing Body Fat

In the McMaster University study, young overweight recreationally active men (prior to the study they exercised 1-2 times per week) were placed on an intense four-week diet and exercise program. Their diet contained 40% fewer calories each day than needed for weight maintenance. All meals were prepared and provided to participants during the study. The men were randomly selected for one of two diet groups:

  Higher Protein Group

 

Lower Protein (Control Group)

 

Total daily calorie intake 15 calories per pound of lean body mass 15 calories per pound of lean body mass
Macronutrients 35% protein, 50% carbohydrate and 15% fat 15% protein, 50% carbohydrates, 35% fat
Total daily protein intake 1.09 grams of protein per lb. body weight (2.4 grams of protein per kg) 0.55 grams of protein per lb. bodyweight (1.2 grams of protein per kg) – 2x the RDA (0.8 g/kg) for protein

 

Per meal protein intake 0.22 grams of protein per lb. of body weight

 

0.10 grams of protein per lb. of body weight

 

Dairy shakes 3- 4 / day including one after exercise (depending on body weight; higher protein, lower carbohydrate shakes compared to the Lower Protein Group)

 

3- 4 / day including one after exercise (depending on body weight; lower protein, higher carbohydrate shakes compared to the Higher Protein Group)

 

Training Program
Supervised workouts consisted of full-body resistance circuit training twice per week and high intensity interval training six days per week. In addition to their structured exercise program, all participants were instructed to get at least 10,000 steps per day as monitored by a pedometer worn on their hip.

Resistance Training Circuit
2 times per week
3 sets of 10 reps at 80% 1 RM with the last set of each exercise to failure
No rest between sets
1-minute rest between each circuit

Sprint Interval Training
1 time per week
Four to eight 30-second bouts on a stationary bike (participants started with four sets and progressed to eight sets)
4 minutes rest between bouts

Modified High Intensity Interval Training
1 time per week
10 bouts of all-out sprint for one minute at 90% VO2max
1-minute rest intervals at 50% VO2max

Time Trial
1 time per week as fast as possible until approximately 250 calories were burned

Plyometric bodyweight circuit
30-second rest between exercises

Results
Both the lower protein and higher protein groups lost weight with no significant difference between groups. Men in the higher protein group gained 2.64 lbs. of muscle and lost 10.56 lbs. of body fat while men in the control group gained little muscle (0.22 lbs.) and lost 7.7 lbs. of fat. Both groups improved all but one measure of strength in addition to aerobic and anaerobic capacity. There were no differences between groups in strength, power, aerobic fitness or performance at the end of the study.

In this study, a higher protein, reduced calorie diet combined with a high intensity circuit-training program including interval training and sprints helped participants build muscle. In addition to their total protein intake, participants in the higher protein group also consumed more protein per meal (approximately 49 grams per meal) than those in the lower protein group (approximately 22 grams per meal).

Why Didn’t They Cut Carbohydrates?

Low carbohydrate diets are not only popular, but they may lead to greater weight loss (in overweight and obese individuals), initially, than higher carbohydrate, low fat diets (some of this is water weight). However, when giving up carbohydrates you also sacrifice something else, intense training. Carbohydrates are the primary source of fuel used during high-intensity exercise because your body can readily access and utilize them for energy. Fat is a slow source of energy and therefore, your body cannot access and use fat quickly enough to sustain high intensity training. In this study, both groups of participants consumed 50% of their calorie intake from carbohydrate. If the study authors cut carbohydrates, the participants wouldn’t make it through their high intensity training program that was specifically designed to take off fat and increase muscle mass.

Keeping the Weight Off

Consider a program like the one used in this study a short-term jumpstart. It isn’t sustainable over a long period of time. The transition to a longer-term approach after weight loss should include a gradual increase in calorie intake while maintaining a higher protein diet (at least 0.55 grams of protein per lb. of body weight to maintain muscle while considerably more, along the lines of 1.09 – 1.41 grams of protein per lb. of body weight may be necessary to continue building muscle during periods of reduced calorie intake). This gradual increase in calorie intake is important because substantial weight loss results in a slower metabolism even if you maintain or build muscle during your jumpstart weight loss program. It isn’t entirely clear why this happens and the drop is greater than scientists can predict based on a decrease in muscle mass. Even if you build some muscle, this won’t rev fire up your metabolism to make up for a drastic decrease in body weight.

One pound of muscle burns a measly 5.9 calories per day at rest while a pound of fat burns 2 calories per day at rest.

Greater weight lost while dieting means an even greater drop in metabolism – something dieters must account for so they can maintain their new weight.

In addition to slowly increasing calorie intake and consuming a higher protein diet, each meal should contain at least 25 – 30 grams of protein. We don’t know the exact amount of protein per meal needed to maximally stimulate muscle building.

Your exercise regimen should continue to include resistance training and you’d be wise to continually vary your training program. Be sure to move each day as well. Research shows many people naturally adjust to greater amounts of aerobic exercise by decreasing their activities of daily living. They exercise intensely at the gym and then sit the rest of the day. Circumvent this by using one of the many devices that counts steps each day. Also, consider doing more work around your house including cleaning, mowing your lawn, gardening, and washing your car. Get moving and stay moving all day long.

If you want to get rid of your love handles while building a six-pack at the same time, combine an effective resistance training and high intensity interval-training program with a reduced calorie, higher protein diet. Your diet and exercise program does not need to be as rigorous as the one in this study. Instead, you can adjust the McMaster University approach to fit your lifestyle, though your results may take more time. Once you reach your goal weight, slowly transition your training program and diet to an approach you can live with.

References
Weinheimer EM, Sands LP, Campbell WW. A systematic review of the separate and combined effects of energy restriction and exercise on fat free mass in middle-aged and older adults: implications for sarcopenic obesity. Nutr Rev 2010;68:375–88.

Stiegler P, Cunliffe A. The role of diet and exercise for the maintenance of fat-free mass and resting metabolic rate during weight loss. Sports Med 2006;36(3):239-62.

Heymsfield SB, Gonzalez MCC, Shen W, Redman L, Thomas D. Weight Loss Composition is One-Fourth Fat-Free Mass: A Critical Review and Critique of This Widely Cited Rule. Obes Rev 2014; 15(4):310–321.

Deurenberg P, Weststrate JA, Hautvast JG. Changes in fat-free mass during weight loss measured by bioelectrical impedance and by densitometry. Am J Clin Nutr 1989;49(1):33-6.

Johannsen DL, Knuth ND, Huizenga R, Rood JC, Ravussin E, Hall KD. Metabolic Slowing with Massive Weight Loss despite Preservation of Fat-Free Mass. J Clin Endocrinol Metab 2012; 97(7): 2489–2496.

Ravussin E, Bogardus C. Review Relationship of genetics, age, and physical fitness to daily energy expenditure and fuel utilization. Am J Clin Nutr 1989; 49(5 Suppl):968-75.

Phillips SM. A Brief Review of Higher Dietary Protein Diets in Weight Loss: A Focus on Athletes. Sports Med 2014; 44(Suppl 2): 149–153.

Longland T, Oikawa SY, Mitchell CJ, Devries MC, Phillips S. Higher compared with lower dietary protein during an energy deficit combined with intense exercise promotes greater lean mass gain and fat mass loss: a randomized trial. Am J Clin Nutr 2016;103:738-46.

Heydari M, Freund J, Boutcher SH. The effect of high-intensity intermittent exercise on body composition of overweight young males. J Obes 2012;2012:480467.

Areta JL, Burke LM, Camera DM, West DW, Crawshay S, Moore DR,Stellingwerff T, Phillips SM, Hawley JA, Coffey VG. Reduced resting skeletal muscle protein synthesis is rescued by resistance exercise and protein ingestion following short-term energy deficit. Am J Physiol Endocrinol Metab 2014;306:E989–97.

Pasiakos SM, Vislocky LM, Carbone JW, Altieri N, Konopelski K, Freake HC, Anderson JM, Ferrando AA, Wolfe RR, Rodriguez NR. Acute energy deprivation affects skeletal muscle protein synthesis and associated intracellular signaling proteins in physically active adults. J Nutr 2010;140:745–51.

Hector AJ, Marcotte GR, Churchward-Venne TA, Murphy CH, Breen, von AM, Baker SK, Phillips SM. Whey protein supplementation preserves postprandial myofibrillar protein synthesis during short-term energy restriction in overweight and obese adults. J Nutr 2015;145:246–52.

Murphy CH, Churchward-Venne TA, Mitchell CJ, Kolar NM, KassisA, Karagounis LG, Burke LM, Hawley JA, Phillips SM. Hypoenergetic diet-induced reductions in myofibrillar protein synthesis are restored with resistance training and balanced daily protein ingestion in older men. Am J Physiol Endocrinol Metab 2015;308:E734–43.

Chaston TB, Dixon JB, O’Brien PE. Changes in fat-free mass during significant weight loss: a systematic review. Int J Obes (Lond) 2007; 31(5):743-50.

Garthe I, Raastad T, Refsnes PE, Koivisto A, Sundgot-Borgen J. Effect of two different weight-loss rates on body composition and strength and power-related performance in elite athletes. Int J Sport Nutr Exerc Metab 2011; 21(2):97-104.

Churchward-Venne TA, Murphy CH, Longland TM, Phillips SM. Role of protein and amino acids in promoting lean mass accretion with resistance exercise and attenuating lean mass loss during energy deficit in humans. Amino Acids 2013; 45(2):231-40.

Helms ER, Zinn C, Rowlands DS, Brown SR. A systematic review of dietary protein during caloric restriction in resistance trained lean athletes: a case for higher intakes. Int J Sport Nutr Exerc Metab 2014; 24(2):127-38.

How Much Protein Can Your Body Use from One Meal?

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Steak is a high protein meal

How much protein can your body digest and use at a time? If you you eat the right amount of protein at every meal you’ll supposedly hit the sweet spot – maximum muscle growth and satiety (fullness) without wasting food or money. General guidelines based on short term trials and one cross-sectional study suggest adults need regular meals including 25 – 45 grams of protein per meal to maintain or build muscle mass and maximum strength (1, 2, 3). However, it is possible that more protein per meal may be beneficial in some instances while the per meal amount might not matter very much in others. Your body can and will digest all of the protein you eat in a sitting (it might take a while) and it doesn’t just discard any excess that isn’t used to build structures in the body.

In this article I’ll cover:

  1. Why should we focus on a “per meal” dose of protein?
  2. What happens to “leftover” protein;
  3. What influences protein requirements;
  4. How you can estimate your protein needs.

Does the Amount of Protein Per Meal Matter?

In a really cool study conducted by well-known protein scientists, the minimum amount of protein per meal found to maximally spike muscle growth was 0.11 grams per lb. of body weight in younger adults and 0.18 grams per lb. of body weight in older adults (over 71 years of age) (2). Older adults need more protein due to a decline in muscle response to protein intake that occurs with age. In addition to a minimum, there is an upper limit of protein intake; anything beyond this threshold dose will not be used to build muscle. For example, one study examined 4 ounces of beef containing 30 grams of protein compared to 12 ounces of beef containing 90 grams of protein. The larger serving did not lead to a greater increase in acute muscle protein synthesis compared to the 4 ounce serving (4). So now we know we need some protein, but not 90 grams in one sitting. However, we still don’t know what the minimum upper limit is, beyond which higher intakes do not lead to increases in muscle mass or muscle functioning over time (5).

More evidence for a per meal dose came from a short-term study that found an even pattern of high quality protein at each meal (30 grams per meal; 1.2 g/kg for the day) as opposed to a skewed pattern (10 grams at breakfast, 15 g lunch and 65 g at dinner; 1.2 g/kg for the day) may be best for maximally stimulating muscle building in young adults (1).

Despite the evidence in favor of an even distribution of protein intake throughout the day, a short-term study in older, resistance trained adults given 2x the RDA – 0.68 grams of protein per lb. bodyweight (1.5 grams per kg) per day in an uneven or even pattern (see chart at the end of this article) or the RDA of 0.36 grams of protein per lb. bodyweight (0.8 grams per kg) per day again in an uneven or even pattern found the pattern of intake didn’t matter. Consuming 2x the RDA, regardless of whether it was consumed in an uneven or even pattern, led to a significantly greater increase in muscle protein synthesis compared to consuming 1x the RDA. The pattern of protein intake didn’t matter, possibly due to age-related decline in muscle response to protein intake,  greater total daily protein intake or some other factor (6).

What Happens to Excess Protein Intake?

There is no long-term storage site for amino acids, the building blocks of protein. After eating a thick juicy steak, creamy bowl of split pea soup or sizzling soy fajitas, your body digests the protein and absorbs the amino acids, using them to build new structures, including muscle. When excess protein is consumed, more than the body needs at that point in time, the rest is used for energy or  converted to body fat. The nitrogen (from amino acids) is combined with other compounds to form urea, a harmless waste product, which is processed by the kidneys and excreted in the urine.

What Influences Protein Requirements?

Though 90 grams in one sitting may be more than necessary for muscle, science has yet to figure out the exact threshold beyond which there is no benefit for muscle. This is a complicated question as there are many factors that influence a person’s daily protein needs as well as how much protein a person may need at each meal. These include but are not limited to: age, training status, total daily calorie intake (if dieting total protein needs are higher), overall amount of protein consumed each day; the type (anti-nutrients?), quality and leucine (or EAA) content of the protein consumed at each meal, other nutrients consumed at meal time, training program, lean body mass, health status and goals.

How Much Protein Do You Need at Each Meal?

Given the research to date, does a per meal does matter?

If you are dieting, yes.

If you don’t get at least 0.55 grams protein per lb. body weight (1.2 grams per kg), yes.

If you eat plenty of protein every day and a decent amount at regular meals throughout the day, it might not matter that much, or at all.

For now, stick to the general guideline of at least 25 grams per meal (the amount of an average female’s palm worth of chicken, turkey, red meat, fish). You may need more, per meal, to maximize muscle growth and repair  if:

  • You are older (relative term since we don’t know exactly what age qualifies as “older). Aim for 1.0 – 1.5 grams of protein per day (7) and regular meals with a good amount of protein per meal. If you have chronic kidney disease, follow the advice of your RD and MD.
  • You eat primarily vegetarian proteins.

Many factors influence a person’s nutrition needs. If you want to maintain or gain muscle mass and strength, concentrate on your total daily protein intake (at least 0.55 grams of protein per lb. of bodyweight; 1.2 grams per kg) followed by how much you consume at each meal. There is no one-size-fits-all ideal protein intake per meal and the body doesn’t just “waste” protein that isn’t used for muscle building. For now, research suggests 25 to 45 grams per meal is a good general guideline. More may be better for muscle. Less may be necessary if you have chronic kidney disease.

Table: Quantity of dietary protein intake, but not pattern of intake, affects net protein balance primarily through differences in protein synthesis in older adults (select data and average leucine intake calculated)

Amount Pattern Meal Protein (grams) Protein as a % of total calories Average leucine intake per meal (calculated)
1x RDA Uneven Breakfast 11.1 8 0.89
Lunch 14.9 8 0.89
Dinner 47.8 12 3.56
Total 73.7 10 4.45
Even Breakfast 22.3 15 1.63
Lunch 21.5 9 1.63
Dinner 22.0 9 0.81
Total 65.8 11 4.07
2x RDA Uneven Breakfast 18.1 15 0.80
Lunch 24.3 12 1.60
Dinner 78.4 22 4.79
Total 120.8 19 7.99
Even Breakfast 38.0 25 2.98
Lunch 36.5 17 2.98
Dinner 37.9 18 2.23
Total 112.4 19 8.2

References

1 Mamerow MM, Mettler JA, English KL, Casperson SL, Arentson-Lantz E, Sheffield-Moore M, Layman DK, Paddon-Jones D. Dietary protein distribution positively influences 24-h muscle protein synthesis in healthy adults. J Nutr. 2014 Jun;144(6):876-80.

2 Moore DR, Churchward-Venne TA, Witard O, Breen L, Burd NA, Tipton KD, Phillips SM. Protein ingestion to stimulate myofibrillar protein synthesis requires greater relative protein intakes in healthy older versus younger men. J Gerontol A Biol Sci Med Sci 2015;70(1):57-62.

3 Loenneke JP, Loprinzi PD, Murphy CH, Phillips SM et al. Per meal dose and frequency of protein consumption is associated with lean mass and muscle performance. Clin Nutr 2016 Apr 7.

4 Symons TB, Sheffield-Moore M, Wolfe RR, Paddon-Jones D. A moderate serving of high-quality protein maximally stimulates skeletal muscle protein synthesis in young and elderly subjects.J Am Diet Assoc 2009;109(9):1582-6.

5 Deutz NE, Wolfe RR. Is there a maximal anabolic response to protein intake with a meal? Clin Nutr 2013;32(2):309-313.

6 Kim IY, Schutzler S, Schrader A, et al. Quantity of dietary protein intake, but not pattern of intake, affects net protein balance primarily through differences in protein synthesis in older adults. Am J Physiol Endocrinol Metab 2015;308(1):E21-8.

7 Paddon-Jones D, Campbell WW, Jacques PF, Kritchevsky SB1, Moore LL, Rodriguez NR, van Loon LJ. Protein and healthy aging. Am J Clin Nutr 2015 Apr 29.

 

 

Get off the Dieting Cycle and Lose Weight for Good

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Are you a yo-yo dieter, stuck in a seemingly endless cycle of losing weight and gaining it back again?  If so, you aren’t alone. I’ve met many people who say they are experts at losing weight but they just can’t seem to keep it off. So I’m going to share my top tips for taking the weight off and keeping it off for good – the very same steps I shared with Fox 5 viewers this week. But first, let’s talk about dieting….

All diets have one thing in common – they help you cut calories so you lose weight. And when you lose weight you’ll lose both fat and muscle. However, when you go on a juice fast or low calorie diet that doesn’t contain enough protein (and most don’t), you will lose a considerable amount of muscle tissue. And that’s a huge problem because muscle burns more calories at rest than fat (just a few but it adds up over time) so when you lose muscle you’ll need fewer calories each day just to maintain your weight. Over time, repeated bouts of protein poor diets could decrease your calorie needs even further, making it increasingly difficult to keep the weight off without dieting. And therefore, if you want to go on a diet there are two things you need to do:

  • Feed the Muscle to Keep the Muscle. You’ll need even more protein when you cut your calories to help ensure you are preserving muscle while losing fat. A good rule of thumb, start by consuming at least 25 – 30 grams of protein per meal. At breakfast consider mixing a packet of protein powder in 6 oz. of milk or higher protein soy milk, eggs (2 large egg whites + 2 large eggs = about 28 grams of protein and just 200 calories), plain Greek yogurt + 2 Tbsp. of peanut butter or eat foods that aren’t traditionally associated with breakfast (last night’s leftovers). At lunch and dinner, you’ll need about the serving size of a female’s palm worth of chicken, turkey or fish or mix and match proteins by adding tofu, tempeh, beans, bean pastas, nuts and seeds.
  • Have an exit strategy – a plan for transitioning off your diet. Don’t stay on a very low calorie diet for an extended period of time. You will decrease your metabolism – the amount of calories you need each day. If you are cutting calories for more than just a few months, take a day or two each week and don’t drop your calories – eat what you need to if you wanted to maintain your weight (bump up your calorie intake).

Now let’s focus on fitness. There are two mistakes I see people making over and over – spending hours on cardio machines and sitting around the rest of the day. If you spend some quality time burning calories on the treadmill, bike or other cardio machine, its time to trade in some of your aerobic sessions for resistance training – lifting weights, power yoga, or anything that requires you to exercise a muscle or muscle group against external resistance. As we age we lose muscle. Losing muscle means your body will require fewer calories each day (again, this means you’ll need to eat less over time just to stay at the same body weight). Maintaining muscle will be easier to maintain your weight. If you already lift weights, change your routine to continue to make gains. Incorporate different exercises, lift until failure – until you can’t squeeze out any more reps (you do not necessarily have to use a heavy weight but instead can lift lighter weights using more reps till failure) or try doing compound sets – two or more exercises in a row targeting the same muscle group without rest.

Last but certainly not least, get moving and stay moving. Simply going to the gym isn’t enough to help you maintain your weight or counteract the health hazards of sitting most of the day. Sitting for long periods of time slows blood circulation, increases your risk of developing blood clots, leads to tight muscles and, sedentary behavior is tied to an increased risk of heart disease. So get moving and stay moving all day long. Ignore modern conveniences including escalators, elevators, the drive-through, pay at the gas pump and more. All of these rob you of the chance to move your body, burn calories and improve your health. If you need a little motivation, buy a fitness tracker. I prefer the ones that show you how many steps you’ve walked on the device versus those that require you to log on to your computer or smart phone just to see how active you are.

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.

 

 

Effective Strategies for Weight Loss

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Last Friday I spoke at the NSCA’s Personal Trainers meeting in Las, Vegas. They put on one heck of a meeting and I love meeting NSCA members and learning from them as well as the speakers. And one thing I really liked about this meeting was the fact that several speakers challenged commonly held beliefs about nutrition and exercise. Here’s a condensed overview (not all points included) of my talk on Effective Strategies for Weight Loss:

1) Lift Weights or engage in some other type of resistance training, regularly. Muscle tissue doesn’t burn many more calories than fat (despite what people say) – about 4 calories more per day per pound. But, those calories add up over time and more importantly, adults start a gradual slow progression of losing muscle around age 40 (sarcopenia). Less muscle means you can’t exercise as hard which means you won’t burn as many calories while working out (and those activities of daily living like washing your car or lifting groceries will seem tough at some point).

2) Calories Matter. I hate to burst anyone’s bubble who thinks you can eat as much as you want as long as you slash so called “bad calories,” but calories count. If you don’t believe me, check out how nutrition professor Mark Haub lost 27 lbs and significantly improved his blood lipids on a 10-week diet of Twinkies, Doritos, sugary cereals and Hostess cupcakes. Want more evidence published in research journals? Okay, check out the POUNDS LOST trial which found that how much you eat matters more than the proportion of fat, carbohydrate and protein. And, that adherence to a diet determines success (and sticking with extreme diets that cut out food groups sucks so many people don’t last long on them).

3) Calories Matter but Protein is Crucial. Protein preserves muscle during weight loss and the lower your diet is in calories, the more you need protein. How important is protein for preserving muscle? Well, I love the overfeeding study published in JAMA earlier this year in which the study authors overfed participants by 40% more calories than they needed to maintain their weight. The participants were randomized to receive either 5%, 15% or 25% of their calories from protein. Now, 5% may seem low but because of their total daily caloric intake that 5% meant 47 grams per day – that’s 1 gram more than the protein RDA set by our government for women! All groups gained a similar amount of fat and the 15% and 25% group also gained muscle (and therefore more total weight) but, the group consuming 1 gram of protein more than the RDA set for women LOST 0.70 kg lean body mass! Take home points: over consume calories and you’ll gain fat. Make protein a greater proportion of the calories you over consume and you’ll also gain muscle. Follow the RDA and you may lose lean body mass.

4) Change your Environment for Success. Eat off smaller plates and bowls, choose smaller packages, get the food you don’t want to eat out of your house (if it is there, you will eat it at some point). Put healthy food within your line of vision. Avoid constant refills (chip basket at restaurants, bread basket, that never ending tub of beer bottles). And, surround yourself with people who encourage your success vs. those who will get in the way.

5) Keep your stress levels down. For more information on how stress impacts weight, click here.

6) Figure out WHY you are eating. You can have all the nutrition knowledge in the world and weight loss strategies but if you don’t delve into what is making you eat vs. using other coping mechanisms, long term success will elude you.

Now, you are probably wondering “well what about Forks Over Knives, the documentary that covered the supposed evils of animal protein?” I promise I’ll give my uncensored opinion (slashing) of that documentary in my next post in addition to more about protein 🙂

For a hilarious and insightful overview of this conference, check out fitness and nutrition expert Alan Aragon’s post. And, here’s a post from another one of my favorite writers, renowned fitness expert Brad Schoenfeld.

Muscle Injuries in NFL Players Related to Low Vitamin D?

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A new study presented at this month’s American Orthopaedic Society for Sports Medicine conference suggests that low vitamin D levels may increase the likelihood of muscle injuries in athletes, specifically NFL players.

Vitamin D deficiency is rampant. Few foods contain this vitamin (fortified milk and other fortified products, fish – but you must eat the bones) and many of us aren’t getting the sunlight required to make vitamin D (not the best route anyway if you want to protect your skin). And, football players – even though they practice outside, are covered up in so much gear that little to no skin is exposed to UV rays from the sun.

In this study, 80% of the NFL football team studied had vitamin D insufficiency (they weren’t deficient per se, but their levels certainly weren’t optimal). Of the 89 NFL athletes on this team:

  • 27 were vitamin D deficient (< 20 ng/ml)
  • 45 had low levels (but not true deficiency; 20 – 31.9 ng/ml)
  • 17 players had normal vitamin D levels (> 32 ng/ml)
Among the players who were deficient in vitamin D, 16 suffered from a muscle injury. Though this study doesn’t show cause and effect but instead a relationship between vitamin D and muscle injuries, there are some clues from other studies about the role vitamin D plays in athletes:
  • skeletal muscle has a receptor for vitamin D (which in the body acts like a steroid hormone)
  • vitamin D deficiency has been tied to pain, specifically low back pain
  • vitamin D deficiency is tied to fat infiltration in muscle tissue (fatty muscle = less effective functioning of muscle tissue)
Athletes have a greater risk of developing a vitamin D deficiency if they:
  • live in the Northern half of the country (above Atlanta, GA)
  • play indoor sports or are covered in clothing outside
  • have darker skin
  • those who take in little to no vitamin D in their diet (fortified milk, fish with bones)
Signs & Symptoms of deficiency:
  • fatigue
  • muscle weakness or cramps
  • joint pain, lower back pain
  • constipation

If you are an athlete and want to perform at your best, it makes sense to get tested. Go to your primary care physician, campus health center or a local testing facility (Lapcorp, Quest, directlabs.com). Ask for a 25(OH)D test and, get the results (don’t settle for them telling you that your levels are normal, low etc.). Ideally, for good health, your vitamin D should be 50 – 70 nmol/L or > 20 ng/ml (depending on the measure used).

 

Could “Bad” Cholesterol be Good for Muscle Growth?

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I’m all for maintaining a healthy heart. But, could America’s quest for heart health be damaging muscle tissue (and keep in mind that your heart is the most important muscle in your body)?

For decades dietary fat, and especially saturated fat, was demonized to the point where “fat free” and “low fat” rolled off of our tongues with ease. Our friends, family and the kids behind the counter at frozen yogurt shops became so used to the question “how many grams of fat are in that?” that they often beat us to the punch, proudly exclaiming “it’s fat free!”
But in our quest  to live heart healthy our recommendations for cutting salt and saturated fat have sometimes hit the wrong crowd – young athletes who have no issues with blood pressure or cholesterol. Athletes who cut their salt intake too low could overheat and increase their risk for dehydration and low blood sodium (which can be very dangerous). And, cutting your total fat intake too low could make you feel fatigued, constantly hungry and impair your body’s absorption of fat soluble vitamins and antioxidants. But, here’s the real kicker, cut your total fat or saturated fat too low and your testosterone levels could drop.

If we need fat and some saturated fat (ah, coconut, one of my favorite sources of saturated fat), is blood cholesterol important? You bet. Despite it’s bad reputation and our quest for low cholesterol, our body depends on the stuff for several essential functions in the body (it is a component of cell membranes, precursor to bile acids, steroid hormones and vitamin D). In fact, our cells need a continuous supply of cholesterol.

And according to recent research from Texas A&M, our “bad” cholesterol may be even more important than we once thought. In this particular study, previously inactive adults were put through a training program. The adults who gained the most muscle mass had the highest levels of LDL cholesterol indicating that we may need a threshold level of LDL for gaining muscle mass. In this case, low LDL may be too low if you want a strong body.

Given that heart disease is the #1 cause of death in the U.S. and LDL cholesterol  is the stuff found stuck like glue against our artery walls, slowing down blood flow and contributing to heart attack and stroke, how can we achieve a delicate balance between having enough LDL but not too much? Keep your cholesterol levels within normal limits, be mindful if your LDL gets very low and incorporate other practices that keep your heart healthy – maintain a normal weight, get and stay active, eat antioxidant-rich foods and heart healthy fats (fatty fish, oils, nuts, seeds). If you want a strong body, don’t cut your total fat or saturated fat intake too low unless your physician tells you to do so.

As a random aside, could lowering LDL be one of the mechanisms through which statin drugs lead to statin-related myopathy? Maybe the answer doesn’t lie completely in Co-Q10.