Category: Nutrition

Carb Cycling

Our bodies primarily run on two sources of fuel, carbohydrates and fats.

Carbohydrates provide us with readily available energy and are used as our default fuel.  Carbohydrates fuel our workouts and allow for muscle growth.  In addition, carbohydrates cause a spike in insulin levels which in turn promotes fat storage.   Carbohydrates are stored as glycogen by the liver and in the muscles.  When your carbohydrate intake is high, these stores fill up.  In this case, carbohydrates are converted to fat and stored by the body as potential energy.

The ability for the body to store excess energy is endless.  Your body will simply continue to store fats in the fat cells if there is an excess of energy intake.   Fat cells release leptin.  As was stated in a previous article, leptin is a hormone that regulates energy expenditure and appetite.  When circulating levels of leptin are high, your appetite will decrease and your energy expenditure will go up.   Conversely, when leptin levels are low (as with a high carb, low fat diet), your body increase your appetite and decrease your resting metabolic rate to store energy.

The caveat to the above statement is that in people with significant obesity, their leptin sensitivity decreases.  Because circulating leptin levels are directly proportional to the amount of fat or adipose tissue present, obese individuals have consistently high circulating leptin levels.  The constant elevation of leptin results in decreased sensitivity to leptin, or leptin resistance.  The result is that despite high levels of fat, these individuals are still hungry and continue to store fat.

Fat metabolism is turned on by the body when glycogen stores get low or circulating levels of leptin decrease.  Compared to carbohydrates, fat provides the body with a more sustainable form of energy.  About 100 grams of glycogen is stored in the liver and the rest is stored in the muscles.  These glycogen stores in the liver can be depleted in just one day of fasting.  When glycogen levels drop, it takes different individuals varying amounts of time before their body can efficiently metabolize fat to makes ketone bodies.  Ketone bodies can then be used as a form of energy.

The theory behind carb cycling is to provide the body with the beneficial effects of carbohydrate intake (i.e. muscle growth, fuel workouts, gut health) without the drawback of increased fat storage due to elevated levels of circulating insulin.

By eating a low carb diet, insulin sensitivity is increased and glucagon (a hormone which increases the synthesis of glucose from glycogen) production is increased as well. The ultimate result is more efficient fat burning for energy.  In theory, a prolonged low carb diet can lead to decrease in thyroid hormone production, elevated cortisol levels (a stress hormone), loss of periods (amenorrhea), bowel dysfunction and immune dysfunction.   According to Paul Jaminet, PhD, low carb diets can also cause the body to decreases production of certain proteins and molecules resulting in symptoms of dry eyes, dry mouth, and decreased healing times in superficial wounds.  Persistent low carb diets also can stress the liver.  When needed, the liver synthesizes glycogen from proteins (or fats) in a process called gluconeogenesis.

Carb cycling is used to allow the beneficial effects of low carb dieting, but to offset or prevent the above mentioned potential side effects.  In individuals consuming a consistently low carb diet, the body becomes very efficient at burning ketone bodies(fat).   Often these individuals reach a plateau or stall with their weight loss attempts.  By adding in a higher carb meal or “cheat meal” this essentially jump starts your metabolism and up-regulates the fat burning process through the effect of leptins.

It is important to note that using complex carbs such as sweet potatoes, brown rice, slow cooked oatmeal, yams, etc. is more beneficial than using simple carbs such as breads, sugary foods, candies etc during your high carbohydrate days.  This is because complex carbohydrates are digested more slowly and do not cause as much of an insulin spike.  Complex carbohydrates that are not processed also contain vital vitamins, minerals and nutrients your body requires. In addition, it is felt that the undigestible (resistant) starches found in certain plant-based complex carbohydrates may have a beneficial effect on gut flora and increase mucin (one of the main parts of mucous, which helps to lubricate/ moisten body surfaces) production to offset symptoms of dry eyes or dry mouth.

The timing of carb cycling is very important.  For example, eating a meal high in carbohydrates before bedtime will promote fat storage due in increased insulin levels and decreased energy demand.   At this time, research indicates that the best time to increase carbohydrate intake is after a heavy training, lifting or sprinting day when the glycogen stores are depleted.   The carbohydrate influx will be used by the body to refuel the glycogen stores instead of stored as fat.   This increase of carbohydrate intake will also raise the leptin levels transiently.  The rise in leptin levels will result in a decrease in hunger cravings and prevent down-regulation of hormones which would otherwise decrease the overall metabolism.

The reason for fat cycling or decreasing fat intake on the high carb days is to allow an individual to maintain a fairly consistent calorie intake.  On the lower carb days, high quality fats can be eaten to increase calorie intake and stimulate satiety.  On higher carb days, fats should be limited so that overall calorie intake for the day remains constant.  In addition, the combination of high carb and high fat intake can result in an unfavorable changes in the type of fats found in the blood stream.

In summary, carb cycling is a way to allow an individual the benefits of eating a low carb diet, without the potential drawbacks of a persistently low carb diet.  Intermittent carbohydrate “refeeding” helps to prevent “stalls” in weight loss, refuel glycogen stores in the liver and muscles, regulate leptin levels and prevent possible thyroid or immune consequences of continuous low carb diets.   If one suffers from symptoms of worsening hypothyroidism or adrenal fatigue, it may indicate that more complex carbs should be added into the diet.  In those individuals with significant obesity, carb cycling is often not as effective in “jump starting” the metabolism due to persistently high levels of leptin, or leptin/insulin resistance.   To help decrease insulin resistance and increase leptin sensitivity, a low carb diet coupled with adequate sleep, routine exercising and stress relief is recommended.

Eating Time With Regard To Exercising

To answer this question, I have been reviewing the literature on this topic and it appears that there is not a general consensus on this subject.  The answers, which are still up for debate seem to depend on the goals you are trying to achieve.   It appears that not only the timing of meals, but the type of meals, and the timing of exercise plays a role on the metabolic effects.

In an animal study by Sasaki published in Nov 2014, his findings suggest that eating in the morning and exercising later in the afternoon or evening has a more beneficial effect with regard to body fat and weight gain.  In the group that ate early and exercised later, the was less body and fat weight gained.  In addition, there was an increase in skeletal muscle weight gain.    So according to his findings, eat earlier in the day and exercise later for increased fat loss and increased skeletal muscle weight gain.

Bo published a study in Dec 2015 in the International Journal of Obesity that found that the same meal consumed in the evening resulted in a decreased resting metabolic rate and increased insulin response. In English, this means that you will essentially burn more Calories by eating a meal in the morning then you would by eating the same meal in the afternoon or later evening. Furthermore, multiple studies have observed that skipping breakfast is correlated with obesity, elevated BMI (body mass index) and increased waist circumference.

According to KJ Hackney in a study published in the journal of Medicine and Science in Sports and Exercise, consuming protein before heavy resistance training (weight training) results in an increase in resting energy expenditure (increased metabolism) as compared to consuming carbohydrates prior to heavy resistance training.   Other research suggest that whey protein is beneficial because it is fast absorbing and contains branched chain amino acids, specifically leucine, which has anti-catabolic (muscle breakdown) and increased anabolic (muscle building) signaling.

For trained athletes who are competing in endurance (long time or long distance) exercises, the recommendation at this time is to consume low glycemic carbohydrates or complex carbohydrates such as oatmeal, heavy mixed grain breads, or most vegetables.  Exercising in a fasted state compromises fuel stores and results in less than optimal performance.    There is also some research to suggest that high fat or even protein intake before exercise can be beneficial as well.  Therefore, again there is no definitive consensus on the type of food to consume prior to exercise.

In another study, published by Sasaki in 2014 in the Journal of Nutritional Science and Vitaminology, eating between 1 and 4 hours before exercise resulted in no difference in the metabolism of trained subjects.    The metabolism of both carbohydrates and fat oxidation remained the same despite the timing of intake.  Thus, as long as you eat between 1 and 4 hours before exercise there is no difference in the body’s ability to metabolism fat and carbohydrates afterwards.

Obviously, eating a very heavy meal immediately before exercise is not recommended because your body will shunt blood to your stomach and GI tract to help with digestion and this blood flow will be at the expense of your muscles.    Small meals with moderate complex carbohydrates and protein, such as an almond milk smoothie, with protein powder and a little fruit, eaten at least 30 before exercise may be ideal.  This allows for some digestion to occur prior to exercise and allows for fuel stores to replenish.

With regard to eating after exercising, the British Journal of Nutrition published a study in 2013 by NM Farah, that contradicts the above studies, and demonstrated that there may be an advantage for body fat regulation exercising before breakfast instead of after breakfast.

Further research suggests that eating a meal right after resistance exercise (weigh training) may increase muscle mass and decrease adipose (fat) tissues as opposed to eating a meal several hours after weight training.  After your workout, your body needs to repair itself and restore the energy you just burned.    For the first 2 hours after your workout, your body uses your food intake to refill your muscle energy stores.  Two-hours post exercise, this ability to store energy decreases by about 50%, and then those Calories are more likely to be stored as fat.

As was discussed in prior articles, insulin sensitivity is very important.  The more resistant you are to insulin, the more likely you will have issues such as abdominal obesity, heart disease, high blood pressure, diabetes, etc.   By eating within 2 hours after exercise, there is a beneficial effect on your body’s insulin sensitivity for the next 24 hours.

A small meal at least 30 minutes to 1 hour prior to exercise appears to refuel your energy stores and enable more optimal performances during exercise.   Eating within 2 hours of completing exercise helps to refuel your muscle glycogen stores and appears to enhance metabolism and increase insulin sensitivity for the following 24 hours.    Our bodies are remarkably complex and depending on genetics, environment, and baseline level of fitness, our needs are different.   As always, it is important to listen to your body and eat accordingly.

Why No Gluten?

Gluten is one of the proteins found in wheat (durum, emmer, spelt, farina, faro, KAMUT ®, Khorasan wheat, and einkorn) as well as rye, barley and triticale.   Gluten is commonly found in breads, baked good, sauces, salad dressings, cereal, pasta, soups and sauces.  Barley is commonly used in malt, food coloring and beer as well.

Gluten has been around for only about 10,000 years.  Its use in food dates back to the Industrial Revolution where it was used as a type of food glue to help foods maintain their shape.  Because gluten was not part of our evolutionary diet, our bodies are not equipped with the proper enzymes to fully digest this protein.  There are no nutritional benefits derived from eating gluten.  In addition, though the quality of the gluten in our foods has not changed significantly over the past few centuries, the quantity found in foods has increased significantly.

Approximately 70-80% of the population are able to tolerate gluten with no problem.  Because we all lack the enzymes to fully digest gluten, gluten is only partially broken down by the GI tract.  According to studies done by Dr. Alessio Fasano, the head of the Department of Pediatric Gastroenterology and Nutrition at Mass General Hospital for Children, the undigested fragments of gluten and gliadin cause transient intestinal inflammation and can release a molecule called zonulin.

Zonulin causes an opening in the barrier of the GI tract.    Essentially the spaces between the cells lining the gut wall open up and allow foods and other toxins to cross into the blood stream, which would not normally get through.  In 70-80% of the population this is not a problem because the immune system works properly and can remove any offending bacteria, toxins, etc.

The immune system is remarkably complex, however essentially it is composed of two branches.  The innate and adaptive immune system.  The innate immune system is the first line of defense in the GI tract.  The innate immune system is immediate and is not very specific. It will release molecules that destroy or eliminate anything it thinks is foreign.  For example, when the innate immune system is exposed to gluten and gliadin fragments, cytokines (small proteins released by cells that are important in cell signaling and can affect the behavior of other cells) are released in an attempt to breakdown these gluten and gliadin fragments.  Cytokines can induce an attack on the gluten, but can also cause a local inflammation in any tissues nearby.  This can cause very microscopic damage to the gut wall which is not always seen on biopsy because repair occurs fairly quickly.

If the innate immune system is unable to handle the “foreign invader”, then the adaptive immune system takes over.  This branch of the immune system is much more specific, sophisticated and takes more time.  The adaptive immune response can lead to either an antibody-mediated attack or to a cell-mediated attack.

In the case of the antibody-mediated the body customizes antibodies to attack the gluten and gliadin protein fragments.    Occasionally, the immune system malfunctions and the antibodies customized to attack the gluten and gliadin can cross-react or get activated by cells in our body.  When this happens, in addition to destroying the gluten fragments, these antibodies also destroy important tissues in our bodies. Depending on which tissue is being attacked will determine a person’s symptoms.  For example, if the antibodies cross-react with joint tissue, a person can develop arthritis.

According to Dr. Fasano, there are three scenarios which could occur when you eat gluten.

  • The gluten is eaten and partially digested. The undigested gluten causes the release of zonulin which opens up the spaces between the gut lining and these protein fragment breach the intestinal barrier.  The innate immune cells respond appropriately and eliminate the fragments and the tiny amount of local inflammation is repaired quickly and the person has no consequences from eating gluten.
  • A person eats gluten and the partially digested fragments activate the immune system as above. However, the innate immune system is unable to eliminate the protein fragments and the adaptive immune system gets activated.  There is a miscommunication between the two branches of the immune system.   The adaptive immune system builds antibodies (or cells) to attack the gluten and gliadin fragments which cross-react with the cells found in the intestinal tract.  The immune cells stay locally in the gut and inflammation persists.  In this scenario the person will develop celiac disease.
  • The third possibility is that the scenario 2 occurs, except that instead of the antibodies (or cells) staying the in the gut and cross-reacting with tissues in the GI tract, the antibodies and/or activated cells travel throughout the body and cross react with different body tissues. In this case, there will be minimal damage in the GI tract, but the personal will have chronic inflammation elsewhere in the body.  Depending on the tissues which cross-react with the antibodies or activated cells, will determine the person’s symptoms.   This scenario is termed non-celiac gluten sensitivity.

Non-celiac gluten sensitivity can cause multiple symptoms.    Symptoms can often be vague, such as abdominal pain, headaches, foggy mind, chronic fatigue, and depression.

People can live for years without any issues with gluten intolerance.  However, it appears that a change in gut flora (as was addressed last week) can be one of the inciting event which can activate gluten intolerance.   There are no nutritional benefits from ingesting gluten, in addition, it causes inflammation in the gut and the release of zonulin leading to increased intestinal permeability.  Interestingly, it appears that zonulin also causes an increase in permeability of the blood brain barrier and may be associated with inflammatory disorders of the brain.

 

Fermented Foods

The gastrointestinal tract is the barrier between the outside world and the inside of our bodies.  Pretty much anything that we put into our mouth either gets digested and absorbed to be utilized or stored by our body, or gets excreted as either solid or liquid waste.

Research has shown that our GI (gastrointestinal tracts) contain between 2-6 pounds of gut flora (bacteria, viruses, fungi, parasites, etc).  These microbes (also called flora, or living organisms) can be helpful, harmful or neutral.  Due to necessary and sometimes unnecessary use of antibiotics to treat illness, environmental chemical exposures, and use of antibiotics in our food sources, the population of flora in our GI tract can be greatly altered.

If the balance between the good and bad flora shifts, this can lead to significant issues; such as improper digestion of foods, malabsorption of nutrients, overabsorption of nutrients leading to weight gain, and possibly a breakdown in the gut barrier.    This breakdown in the gut barrier theoretically can enable toxic substances and possibly microbes to enter into the bloodstream.   Our bodies have multiple ways to defend against bacteria and toxins transiently entering our body and bloodstream.   However sometimes these defense mechanisms may not work properly and illness can ensue.

The process of fermenting foods increases the beneficial bacteria count in the foods, and makes nutrients more bioavailable or easier for the body to absorb.    Eating fermented foods, seems to help better regulate the immune system.   Fermented foods can contain a wide variety of beneficial bacteria and the levels found in these foods far exceeds the level of beneficial bacteria found in over-the-counter supplements.  Consuming probiotic supplements alone though, hasn’t really been shown to increase the levels of beneficial bacteria in the gut.   Adding  prebiotics found in fermentable fibers (chicory root, Jerusalem artichoke, yams, dandelion greens, leeks, onion, garlic and banana) have been shown to stimulate the grown of beneficial bacteria in the gut.  Therefore it is recommended to consume both prebiotics and probiotics.

It is crucial to introduce fermented foods, such as sauerkraut, kimchi and kombuchi very slowly into the diet.  This is because fermented foods can have high levels of histamine and aldehydes.  Histamine is substance that causes a local immune response such as hives, rashes, nausea etc.   Some people have decreased ability to break down histamine or aldehyde quickly and therefore can be intolerant to higher levels of these substances.  If you notice that when you eat fermented foods, you develop headaches, abdominal pain and bloating, hives, rashes or nausea it may be due to the high histamine or aldehyde load.    In this case, one would require an individualized assessment to determine the safety of consuming such foods.

Raw fermented foods are becoming more readily available for purchase.  In addition, there are more kits available to ferment foods at home.  It is important to realize that when commercially purchased, fermented foods are often pasteurized or preserved for safety.  This kills the beneficial bacteria.  In addition, commercially available foods often contain high amounts of refined sugar and processed dairy.     Therefore, the benefit of foods such as kefir and yogurt, that have a high concentration of probiotics, is offset by the amount of sugar and processed dairy.   As was discussed last week, pasteurized dairy can have many unwanted side effects.

If possible it is best to select foods such as sauerkraut, kombuchi and kimchi rather then milk based products such as yogurt and kefir.  When eating yogurt and kefir it is recommended that you select full fat products without any additional sweeteners or sugars added.

Currently, there is a fair amount of debate in the literature regarding prebiotics, probiotics and fermented foods.  Just remember no one specific food or supplement is best for everyone.   We all have different genetic make ups and environmental factors that influence our responses to food and supplements.

Hope this helps to bring some light onto the subject of probiotics and fermented foods!

Recommended Nutrition For Vegans?

Vegetarians are at risk for certain nutritional deficiencies if you are not careful about selecting nutrient dense foods for your diet.  It is common for vegetarians to be deficient in B12, zinc, calcium, iron and essential fatty acids.  In addition, sources of protein are more limited.

B12 is mainly found in animal products but may be found in fortified tofu and fortified cereals.  It is not always well absorbed and if you are feeling tired or fatigued often, it is a good idea to have your B12 level checked.  Low B12 levels are also associated with nerve pain, numbness and tingling of the hands and feet.   Some people have problems with B12 metabolism and may benefit from methyl-B12 which is one the active forms of B12 used in our bodies for multiple pathways.

Calcium does not need to be obtained from Dairy, and can be found in may fortified foods, or occurs naturally in collard greens, broccoli, edamame, kale, bok choy, figs, oranges and white beans.    Calcium is important for a multitude of functions in the body.  Just a few of roles that calcium plays is to help maintaining strong bones and teeth, nerve signal transmission, muscle relaxation and contraction, modulating hormonal release, maintaining a regular heart rate.

Zinc can be found in beans, legumes, mushrooms, spinach, broccoli, kale, garlic, pumpkin seeds, pine nuts, chia seeds, steel cut oats, and brown rice.  Zinc is important for proper immune system functioning.  It also plays a role in cell division, wound healing, cell growth and carbohydrate metabolism (breakdown).  Zinc is needed during pregnancy and childhood for proper growth.  In addition, Zinc is enhances the action of insulin.

Some recommendations for sources of protein for Vegans include:  Chia seeds,  pumpkin seeds, spinach, broccoli, asparagus, tahini, Spirulina, Chick Peas, almonds, oatmeal, hemp seeds, peas and eggs (if you eat these).

Fish is a very good source of omega 3 fatty acids (essential acids that the body cannot make), therefore, if you are not eating fish, it is important to supplement your diet with either fish oils  (if you will use these), walnuts, flaxseed, flax seed oil and leafy vegetables.  Omega three fatty acids play numerous roles in the body.  They are important for brain function, cardiac function, and are anti-inflammatory.

Why No Dairy?

We have been taught that dairy is very important for us due to calcium and vitamin D (which promotes bone health) and for potassium (which helps offset to much salt in the diet and helps to regular blood pressure).  In addition, in small children dairy is important for the fats it contains to promote brain health and for the calories it provides.  However, about 75% of the population lack the enzymes necessary to digest milk.   This leads to lactose intolerance and bloating.   Milk has been found to aggravate irritable bowel syndrome.

In addition to prevent illnesses, which we might get from milk, the milk is pasteurized and homogenized.  These processes, while helpful for eradicating bacteria, destroys the beneficial enzymes in milk, eliminates vitamins, denatures (breaks down) fragile milk proteins, destroys vitamin B12 and Vitamin B6, and kills beneficial bacteria.  There are some people who promote the benefits of raw milk, however it is unavailable for purchase in New Jersey at this time.

According to Walter Willett, MD, PhD, from the Harvard School of Public Health, a professor of epidemiology and the head of the nutrition department at the Harvard School of Public Health, “ there is very little evidence that milk consumption is associated with reduced fracture”.   It appears that the Vitamin D plays a more important role in fracture prevention.  Milk has Vitamin D2, which requires sunlight to be converted into the active form Vitamin D3.

Milk lead to increased IGF-1 (insulin/ insulin like growth factor-1) which has been associated with cancer promotion.  In a study of patients who have a mutation that leads to decreased IGF-1 (Laron Syndrome) it was found that these patients have decreased rates of acne, diabetes and cancer.

Other side effects of dairy in some individuals include allergies, sinusitis, recurrent ear infections, anemia and constipation.

While dairy intake remains controversial, it is possible to obtain the beneficial elements of milk by  supplementing our diets though other foods with less potential side effects.

Optimizing Nutrition In Our Diets

If you are eating a cleaner more nutritious diet, you should be feeling the beneficial effects of your efforts.  In theory, if you are eating a variety of fresh fruits, vegetables and meats, you should be able to get the majority of your nutrients from your diet.  The problem is that many fruits and vegetables are grown in over-farmed soil devoid of vital nutrients.

In addition, the way food is cooked can denature or destroy nutrients found in food.   For example a study published in 2009 in the Journal of Zhehiang University Science, was done which examined the effects of steaming, microwaving, boiling, stir-frying and stir-frying follow by boiling on broccoli in China.  The study found that all types of cooking except steaming resulted in “significant losses of chlorophyll and vitamin C and significant decreases in total soluble proteins and soluble sugars”.  The study goes on to say that “indole glucosinolate were significantly modified by all cooking treatments but not steaming”.  Indole glucosinolates are sulfur-containing compounds that have been associated with a possible decrease in lung cancer and colorectal cancers.

Lilli Link and John Potter from the Mailman School of Public Health in Columbia University reviewed 9 years of medical studies and published an article in 2004.  They found that consumption of vegetables (raw or cooked) was associated with a lower cancer risk, however 9 of the 11 studies reviewed showed an even lower risk with raw vegetables as opposed to cooked vegetables.   They suggested that “cooking changes the availability of nutrients, destroying digestive enzymes and changes the structure and digestibility of food”.  So it appears that consumption of vegetables in general is beneficial but consumption of raw vegetables may be even more beneficial to your overall health.  That being said, make sure that you carefully wash and clean vegetables, because raw vegetables often contain bacteria which can be harmful.  Furthermore, it is important to do your best to remove as much pesticides as possible from the surface of the vegetables.

Amino acids provide the building blocks for protein production in your body.   Amino acids are divided up into groups, Dispensable (our bodies can make these under almost all circumstances),  Indispensible or Essential (can never be made by our body and must be consumed through diet or supplements) and Conditionally Indispensible (can be made by our body under many circumstances but not always).

Consuming foods such as fish, eggs, sea vegetables, salmon, brussel sprouts, broccoli, garlic onion, chicken legumes, dairy (occasionally) and soy will help to provide you indispensable amino acids.    It appears that you do not need to eat these foods at every meal, but it is important to eat them over a period of several days to help maintain your body’s amino acid stores.

There are many nutrients which are helpful to add into your diet, possibly via supplements, such as Vitamin D3, Calcium, Magnesium, Omega-3 Fatty Acids and Glutamine.    In the following weeks articles, I will be addressing the importance of each of these supplements as valuable additions to our diet.

To summarize the above information, adding well cleaned, raw vegetables and fruits to your diet, and adding high quality proteins such as eggs, chicken, legumes and fish will increase the nutritional density in your diet and provide your body with important building blocks to function optimally.

Water

As infants our bodies are composed about 75% of water.  The percentage of water present decreases as we age.  By middle age we are about 60% water and by old age we are composed of about 55% water.  This water is found both within our cells (intracellular water), and outside of our cells (extracellular water).  Extracellular water can further be divided into the water found in our blood stream (plasma) and the water found in the spaces between our cells (interstitial).   More muscular individuals contain more total body water because muscle cells contain glycogen (sugar stored for energy use) and glycogen binds water.  In contrast, fat cells contain very little water, so individual with more fat tissue will have less total body water.

Water is integral to our health and well-being.  Humans can survive for up to 3 weeks without food, but without any water, death with ensue within days.  The location of the water within our bodies can be an indication of health status. For example, swelling in the legs and feet can be an indication of blood clots, cardiac disease, lymphatic disease, kidney disease or even infection.  In general, our water homeostasis (balance) is tightly controlled.   Some of the many  factors that affect the distribution of total body water include:

  • Kidney Function
  • Nutritional Status – (protein content in the blood)
  • Cardiac Function
  • Water loss (such as through sweating and breathing)
  • Specialized Receptor Function (can detect over-hydration or dehydration)
  • Hormone level

 

Recently, a significant amount of attention has been devoted to different types of water and the various health benefits.

There are several different types of commercially available water.

These include:

Tap Water:  water from the faucets that has been treated, purified and disinfected.  Can contain fluoride and chlorine

Bottled Water:  can be either bottled tap water, or water that is from a spring that has been purified

Purified water:  physically treated to remove impurities

Distilled water: water that is boiled and evaporated to remove dissolved minerals and then re-condensed without any minerals

Reverse Osmosis: usually acidic, water forced through membranes to remove large particles, pollutants and minerals

Alkaline water:  water that has been separated and contains electric charges such as those found in magnesium and calcium ions

Deionized or demineralized water:  minerals ions and impurities have been removed, but may still contain germs and bacteria

Soft water:  water that only contains sodium

Hard water:  any water with dissolved minerals

Alkaline water has been popping up on grocery shelves everywhere.  Pure water has a pH of 7.0.  Alkaline water has a pH of greater then 7.0, and acidic water has a pH less then 7.0.

 

What is pH and why is pH important?

pH is a measurement of the relative amount of free hydrogen ad hydroxyl ions in water.  When water has more free hydroxyl ions it is basic and when it has more fee hydrogen ions it is acidic. The pH of water is important because it determines the amount of a substance that can be dissolved in water, the amount of dissolved substances that are biologically available, and the the toxicity of heavy metals found in the water.  In general, heavy metals are more toxic at lower pH’s because of they are increasingly solubility (higher concentration of heavy metals can be dissolved in the water).

Our blood pH is tightly regulated between 7.35 and 7.45.  When our blood pH gets too high (alkaline) or too low (acidic) it can be very dangerous and even fatal.

Just like our bodies tightly control our water homeostasis, our bodies have numerous intricate mechanisms to maintain our blood pH in the very narrow optimal range.  When our blood pH is abnormal it is usually due to an underlying cause which needs to be further evaluated and treated appropriately.  We cannot change our blood pH dramatically just by controlling our intake of acidic and basic foods/waters (unless your body’s control mechanisms are severely malfunctioning).

The theory behind the use of alkaline water is that it is ionized and can serve as an antioxidant to counteract the acidity of your blood.   The theory is that this “acidity” can lead to conditions such as cancer, arthritis and other inflammatory issues.   This has not been definitively borne out in the literature to date.   At this time, it does not appear that alkaline water has enough support to promote it efficacy in cancer prevention.   Drinking it occasionally should not have any significant effect on your health and well-being.

What is most important is to make sure that you are drinking adequate amounts of water.  This recommendation varies some depending on your physical activity, kidney function, amount of water loss, medications, etc.  The current general recommendation is about 2.7 liters per day for women and 3.7 liters per day per men.  That being said, look at your urine, if you have no known kidney issues, and your urine is very dark that is an indication that you may need to increase your water intake.    If your water intake is not adequate you are at risk for dehydration.

Some side effects of dehydration include:

  • Decreased physical performance (can occur with just 2% dehydration)
  • Reduced endurance
  • Increased fatigue
  • Decreased motivation
  • Mood disruption
  • Impaired cognitive function
  • Decreased alertness, increased delirium
  • Decreased short term memory
  • Constipation
  • Impaired kidney function
  • Decreased blood pressure (can cause fainting, light-headness)
  • Headache
  • Poor skin complexion

The take home message at this time seems to be to drink filtered, purified water if possible with naturally occurring minerals but without contaminants (such as heavy metals, hormones, plastics, and antibiotics) and artificial sweeteners.  In addition, it is important not to store water in plastic bottles which when heated (left out in the sun) can release BPA and other potentially toxic compounds into our water.     Currently, it appears that spring water, mineral water or purchasing a filter for your tap water are the best choices.

 

 

 

What’s the Story with Plastic?

The controversy surrounding the use of plastics is widespread and exceptionally polarizing. Numerous compounds found in plastic are thought to potentially cause adverse human and animal effects.  Plastics are found everywhere in our environment.  Learning which plastics to avoid may improve your health and quality of life.

By now, most people are aware that plastic containers are numbered.  These numbers correspond to the type of plastic resin used to create the product or container.  The plastics are numbered from 1-7.  It appears this time that #7, #3 and  #6 are the most potentially toxic, while #1, #2, #4, #5 seem to be somewhat safer.

Currently the Most Dangerous plastics with regard to human health include:

#3  PVC  (Poly Vinyl Chloride)

PVC’s are found everywhere.  PVC is the world’s third-most widely produced synthetic plastic 1.   IV tubing, shrink wraps, sandwich bags, toys, lunch boxes, table clothes and blister packs are just a few of the products manufactured with PVC.  PVC’s contain DEHP (di-2-ethylhexyl phthalate) a type of phthalate.   Phthalates are plasticizers which make products more flexible.  When phthalates are manufactured and incinerated, dioxin is released.  According to the World Health Organization, International Agency for Research on Cancer, TCDD, a dioxin, is classified as a “known human carcinogen”.

Phthalates have been found to disrupt hormones in wildlife causing problems such as infertility, testicular cancer and genital malformations.   The research on the effect of phthalates on human health is more limited. However, it appears that phthalates are associated with the development of childhood asthma and possible reproductive issues in males and females.

My Recommendation:  AVOID, DEFINITELY DO NOT HEAT, DO NOT MICROWAVE

#6 – PS (Polystyrene)

Polystyrene is also called “Styrofoam”.  It is found in many disposable containers such as, cups, bowls, take-out containers, egg cartons, coffee cups and is used in egg cartons, disposable plates, cups and bowls, take-out containers, coffee cups and meat trays.

Heated polystyrene releases a compound called styrene. According to the EPA.gov website, short term exposure to styrene can cause irritation in the linings of the mouth, nose and lungs as well and the GI tract.    Headaches, weakness, hearing loss and nerve damage appear to be the result of more chronic long term exposure.   In addition, several studies suggest an association between styrene and leukemia and lymphoma.  As of yet, the EPA has not formally named styrene as a carcinogen.

My Recommendation: AVOID, Especially any hot foods and drinks in Styrofoam

#7 All “other” Plastics

All products that contain either a combination of plastics or any plastics not included in #1-#6.  The issues with products made from plastics in category #7 is that you don’t know what type and the amount of toxins to which you are exposed.

Often times these plastic products contain BPA (Bisphenol-A) or BPS (Bisphenol-S) the chemical that replaces BPA.   Research on Bisphenol-S is currently limited.

My Recommendation:  AVOID, If using Do Not Heat

Currently plastics found in #1, #2, #4, and #5 seem to be slightly safer with less data to suggest human and animal toxicity.

#1 PET (polyethylene terephthalate)

This type of plastic is commonly found in water bottle, juice bottles, soft drinks, peanut butter, and salad dressings.  While this type of plastic is touted as safer, studies have found that heated bottles (i.e. water bottles left outside in the sun) can leach antimony – a toxic chemical.   Chronic exposure to antimony leads to irritation of the eyes, lungs, skin and GI tract.   It appears that the longer the plastic bottles sit on the shelves in the grocery stores and at home, the more antimony found in the liquid it contains.   In addition, placing these plastics in the dishwasher or using detergents can break down the plastics further, increasing the amount of antimony released.

My Recommendation:  USE ONLY ONCE, DO NOT LEAVE WATER BOTTLES OUTSIDE IN HEAT

#2  HDPE  (high-density polyethylene)

This plastic is found in butter tubs, shampoo bottles, folding chairs, and cereal box liners.  This plastic is thought to be less toxic because it can withstand higher heats.   However, even these plastics, which are free of BPA, still test positive for estrogenic chemicals which can disrupt your hormones.

My Recommendation:  Use sparingly

#4 – LDPE (low-density polyethylene)

This plastics is found in bread bags and grocery bags.  It is flexible but breakable.  As with #2 plastics, it does not contain BPA but can also leach estrogenic chemicals which can potentially disrupt hormones.

My Recommendation:  Do not leave food in these bags for prolonged times

#5 – PP (polypropylene)

This plastic is found in straws, plastic cups, baby bottles, and microwavable plastic containers.  These plastics can withstand high heat and will not deform in shape.

My recommendation:  Can be used to store foods at room temperature, do not place in the microwave, do not place hot food directly into plastic containers.

BPA  (Bisphenol-A)

In 2014 the FDA released a report based on the review of available scientific studies published between November 1, 2009 and July 23, 2013.   At the time of the publication, the FDA had “not found any information in the evaluated studies to prompt a revision of FDA’s safety assessment of BPA in food packaging at this time.”  Since that time, multiple studies have been published that appear to run contrary to this statement.

For example, it appears that exposure to BPA during development is associated with neurological and behavioral changes as well as effects on sperm growth and development2,3.   In addition, the higher the amount of BPA in amniotic fluid during the second trimester of pregnancy, the more likely the baby will have a low birth weight.4

Due to the concern over the use of BPA, other similar plastics have been developed to replace BPA.  However, a recent article found that some of the metabolites (break down products) of these alternative plastics may still have endocrine disrupting activities in humans.5

Possible side effects of BPA exposure in utero6,7:

  • Genetic errors
  • Spontaneous miscarriages
  • Decreased sperm quality
  • Early puberty
  • Cancer
  • Heart disease
  • Reproductive dysfunction
  • Increased risk of Diabetes

My Recommendation:  AVOID

So what can you do?

  • Change your diet to fresh foods without packages
  • Use Glass instead of plastic to store foods and drinks
  • By eggs in cardboard cartons instead of Styrofoam
  • Avoid canned goods, use frozen instead.
  • Do not reheat food in plastics, use glass or ceramic instead
  • Do not place hot food to store in plastics
  • Do not microwave in plastic – use glass, porcelain or ceramic
  • Use Glass or stainless steel for water, drinks, and coffee
  • Avoid plastic silverware
  1. (W. Allsopp, G. Vianello, “Poly(Vinyl Chloride)” in Ullmann’s Encyclopedia of Industrial Chemistry, 2012,)
  2. Nature Reviews Endocrinology: (Nov 2016) Braun JM
  3. Environ Toxicol Pharmacol. 2016 Nov 9;48:265-271
  4. Reprod Toxicol. 2016 Nov 6;67:1-9. doi: 10.1016/j.reprotox.2016.11.007. [Epub ahead of print]
  5. Environ Toxicol Pharmacol. 2016 Oct; 7:182-199. doi: 10.1016/j.etap.2016.09.014. Epub 20416 Sep 22.
  6. Int J Environ Res Public Health. 2016 Oct 6;13(10). pii: E989. Influence of Bisphenol A on Type 2 Diabetes Mellitus. Provvisiero DP1, Pivonello C2, Muscogiuri G3, Negri M4, de Angelis C5, Simeoli C6, Pivonello R7, Colao A8.
  7. J Appl Toxicol. 2016 Nov 20. doi: 10.1002/jat.3413. [Epub ahead of print]. Effects of oral exposure to the phthalate substitute acetyl tributyl citrate on female reproduction in mice. Rasmussen LM1, Sen N1, Liu X1, Craig ZR1.

Can You Calculate Nutritional Needs Based on Exercise Level?

The short answer to this questions is NO.  You cannot directly calculate your increased calorie allowance based on increased exercise levels.

This is because the equation Calories In = Calories Out is not entirely accurate.

While it is true that if you eat significantly more Calories then your body burns per day, then you will store these Calories as fat and likely gain weight.  This is because of the Law of Thermodynamics, which states that energy is neither created nor destroyed.    In addition, if you eat significantly less Calories then you burn per day, in theory you should lose weight.

However, the problem is that not all Calories are created equally.

Foods are processed via different biological pathways, and have different effects on complex hormones in the body.

For example, 100 Calories of protein consumed are not processed by your body the same way that 100 Calories of carbohydrates consumed are processed.

When you eat 100 Calories of protein, your body uses between 20-30% of those Calories just to chew, swallow and digest the proteins.  Therefore you are left with a net of 70-80 Calories for your body to burn or store.  In addition, eating protein provides your body with amino acids, which form the building blocks to make more muscle.  This muscle in turn is then able to burn more fat and boost the metabolic rate.    The protein also stimulates your satiety center, so you will feel full and satisfied.

In contrast, when you eat 100 Calories of carbohydrates (we will use fructose in this example) it only takes about 5-10% of those calories  to digest the fructose.  Therefore you are left with a net of 90-95 Calories for your body to utilize.  If your liver has room, it will store the fructose ultimately as glycogen.  However, if your stores are glycogen are full in the liver, then the body will convert the carbohydrates to fat and store them.   In addition, fructose raises insulin levels, a hormone which ultimately promotes fat storage,  and has no effect on decreasing hunger hormone ghrelin.  Therefore, you will likely still be hungry.   Furthermore, fructose can lead to insulin resistance, and increase your cholesterol and triglyceride levels and increase abdominal obesity.

With regard to fat metabolism, it takes only 0-3% of total Calories consumed to process fat.   Therefore, 100 Calories of fat results in a net of 97-100 Calories to be burned or stored by the body.  It is important to understand however that not all fats are bad, and they body needs fat for survival and brain function.   Trans fats lead to inflammation and insulin resistance.  However, good fats, can decrease inflammation and promote cardiovascular health.

When you diet, and begin to cut Calories, your body thinks you are starving, and will therefore decrease your metabolic rate to conserve energy.   A recent study done by Pontzer and colleagues and published on Jan 28 in Current Biology, found that for “less active people, energy expenditure increased alongside increases in physical activity.  But at higher levels of activity, calorie burn plateaued. “The body has a metabolic set point, which it works very hard to maintain.

The take home message from this study is in order to lose weight, it is more effective to focus on calorie intake, rather then increase activity above a certain point.

Not only is it important to limit calorie intake, but it is also important to eat the right types of Calories, at the right times, in the right portions.  This is because a proper diet is can optimize your nutrition obtained from high quality foods.  This in turn, positively impacts your body and targets weight loss hormones rather then promoting hormones which signal the body to store weight.