Originally Posted by
vingtor
Over the years, and after working with thousands of clients, I have
found that poor eating habits are the leading reason for failure in attaining
optimal health and fitness. The habit of eating a balanced and satisfying meal
is very often the missing link in optimal health and fitness. There are many
reasons for not following a healthy diet; I have found that a lack of
knowledge, and an abundance of misinformation, tend to be the most
common reasons. With that in mind, I decided to write this article to
“demystify” nutrition, and to educate you, the fitness professional, along with
the general public on the topic. I have learned that people learn more easily
with the use of analogies. Because everyone is familiar with how automobiles
function, I have chosen to use them as the “vehicle” (no pun intended) to
make this information even easier to understand.
In view of the fact that we are bombarded with so much nutritional
information, it is very hard to decipher whether the source is legitimate or not.
All the information in this article was based on clinical studies, along with my
many years of experience as a clinical and sports dietitian.
The question I get asked most often is “what and when should I eat?"
There is a wealth of contradictory nutritional information available including:
eat carbohydrates or don't eat carbohydrates; eat before going to bed, do not
eat three hours before bed, or do not eat after 6 p.m.; combine foods, or do
not combine foods. It appears that there is no end to this litany; hence, you
should ignore the folklore and the hype and get your nutrition information
only from a reputable source.
Most of my clients’ goals are to gain or maintain their muscle mass
and get rid of some body fat. Although one may think that these are mostly
aesthetic concerns, the truth of the matter is that body composition or body
fat percentage is a true measure of health as opposed to how much we
weigh. We are not concerned with how much you weigh, and neither should
you. It may surprise you to know that a pint of water (two cups) weighs a
pound; and that you may gain or lose a pound or more of body weight based
on your hydration status and daily fluid intake. Thus, your success or
progress cannot be based on your body weight. If I were to weigh you, have
you drink a pint of water, and then weigh you again, you would be a pound
heavier. Will you be fatter? No, you will just be less thirsty, and a pound
heavier!
As you begin an exercise program, your body starts to store more
"fuel" in your muscle cells. This fuel is called glycogen, which is simply many
glucose or blood sugar molecules hooked together and stored in your
muscles and body cells for later use. These glycogen molecules are so
highly concentrated that your body must also store water in your cells along
with glycogen in a ratio of 1:3 (one molecule of glycogen to three molecules
of water). Because water weighs a pound for every pint and glycogen also
weighs considerably, your weight is sure to increase as you increase your
exercise levels, and your glycogen and water storage increases in response
to the increase in exercise.
An analogy helps illustrate this phenomenon quite easily: If your fuel
tank is on empty and you are going on a long trip by automobile, you will
most likely fill up your tank. However, if your tank is on empty and you are
only going to the corner store, you will most likely not go out of your way to fill
up your tank. The same is true with your glycogen storage; the more you
exercise, the more your body begins to store glycogen and water. Certainly,
your car does not weigh as much when it is empty as it does when it is full.
Well, does a car "get fat" every time you fill up the tank? Of course not! A car
has only one gas tank; in the body, in contrast, there are thousands of cells
that fill up with glycogen and water so you can use it as fuel next time you
exercise, causing an increase in body weight, but not necessarily in body fat.
The only way to know the difference is to track your body fat percentage by
measuring it weekly.
When looking at your body composition weekly, we look for the
following four signs:
• A gain in muscle and a loss in fat = you have a perfectly designed meal
plan.
• A gain in muscle and a gain in fat = the meal plan includes too many
calories.
• A gain in fat and a loss in muscle = you are not eating enough calories.
• A loss in muscle and a loss in fat = you are not eating enough protein.
This is why it is critical to meet with your registered dietitian (RD) or Certified
Fitness Nutrition Specialist™ (CFNS) weekly for the first month of the
program so that a "baseline" on how your metabolism is working and how it
reacts to the nutrition and exercise plan introduced can be established.
Typically, a month of weekly follow-ups is sufficient for making
adjustments until the right trend (gaining or maintaining muscle while getting
rid of fat) is established. At that time, a biweekly meeting with your RD or
CFNS is adequate for ensuring that the trend persists. Once you have
reached your goal(s), you can meet once every three to four weeks to make
sure you continue in the correct path and/or establish a maintenance
program, depending on what your goals may be. Finally, you should consult
with your RD or CFNS as you establish new goals, or as your workout
routine and schedule changes.
I help my clients achieve their goals of gaining muscle and losing body
fat by teaching them three basic rules of success that are easy to follow no
matter where their travels may take them. Before we discuss these rules,
let's review some basic nutrition information as well as the mechanism by
which fat is stored in our body.
Food consists of three macronutrients (so called not because of their
size, but because of the amounts in which we need them), namely,
carbohydrates (CHO’s), fats, and proteins. Whenever we eat CHO’s they first
go to the stomach where they are digested, and then proceed to the
intestines where they are absorbed into the bloodstream in the form of
glucose (blood sugar or blood glucose). As blood glucose levels rise, the
body secretes insulin, a hormone that is responsible for storing glucose in
muscle and organ cells in the form of glycogen. Normal blood glucose levels
are between 80 and 120 mg/dl (a way of measuring glucose concentration,
how much sugar is dissolved in our blood, or “how thick blood gets”).
Whenever blood glucose levels fall below 80mg/dl we feel hungry. If the
glucose concentration were to fall well below 80 mg/dl the body would react
by slowing down its metabolism to save energy. Continuing with our car
analogy, this is very much as if we would let off the accelerator pedal and
turn off the air conditioner in our car to conserve energy when we are running
low on fuel. Of primary importance to us, however, is the fact that whenever
our blood glucose levels rise above 120 mg/dl the residual glucose is stored
as fat. Hence the secret to dietary success is to control blood glucose levels
throughout the entire day as a means of maintaining a high metabolism and
therefore minimizing fat storage. The practice of maintaining normal blood
glucose levels alone will have the secondary benefit of helping you avoid
food cravings and overeating.
Because blood glucose control is very important in controlling
diabetes, many studies have been conducted to determine how different
foods affect blood glucose levels. One study is the "gastric emptying time
test," which measures how long it takes food to leave the stomach. The
reason this is a very important study is that the more quickly carbohydrates
leave the stomach, the more quickly blood glucose levels rise. Usually, the
more quickly blood glucose levels rise, the more effectively glucose gets
stored as fat due to larger insulin secretions, and because of these larger
insulin secretions, the more quickly blood glucose levels drop (right after the
insulin secretion causes blood glucose to be stored), causing us to get
hunger pangs and/or cravings.
Gastric emptying time studies show that the longest time that CHO’s
will stay in the stomach is one hour. In contrast, protein will stay in the
stomach two hours, and fats will stay in the stomach three to five hours. This
is why you find yourself getting hungry 20 to 40 minutes after having a piece
of fruit, or some bread, pasta, rice, veggies, or even some cereal. This is also
why you feel stuffed for four hours after having a high fat containing meal.
These studies also found that when you combine a protein with a
carbohydrate, both the protein and the fat contained in the protein (since
most proteins have some fat in them) cause the carbohydrate to stay in the
stomach longer (approximately three and a half to four hours), which
basically means that this increases gastric emptying time, a good thing,
because a longer gastric emptying time also means a slow and controlled
increase in blood glucose, which lessens the chances of storing a large
portion of this meal as fat due to a quick and high increase in blood glucose
followed by a large secretion of insulin.
A longer gastric emptying time also means mild successive increases
over time, as well as mild or slower successive decreases in blood glucose
levels caused by the longer time that it takes for food to leave your stomach.
As a consequence, you do not get hungry as quickly, and are able to do
away with your sweet cravings, which are usually caused by the need to
raise low blood glucose levels after such a drop as described above occurs.
With this understanding, it makes sense to eat protein every time you
eat a carbohydrate. This will increase the gastric emptying time, temper
blood glucose swings, and control your appetite/cravings.
This raises the question, "what is a protein?" Even today after all fad
protein diets, people are still confused about the difference between a protein
and a carbohydrate. It's simple: If it walks, swims, or flies, it is a protein; if it
comes from a plant or grows out of the ground, it is a carbohydrate. Surely
vegetarians and other readers must be squirming at this broad
generalization. Indeed beans are high in protein, as are many other legumes,
plants and even some vegetables. However, in an effort to simplify things
and to justify our generalization, we have looked at the largest component of
a food, and grouped foods based on this component.
Therefore, even though a 1-cup serving of beans has 15g of protein, it
also contains 40g of carbohydrates - beans are therefore deemed a
carbohydrate. In an analogous fashion, although an avocado is a fruit,
because of its high fat content it is considered a fat. And although milk,
yogurt, and buttermilk come from cows' milk, following the same logic, milk,
yogurt and buttermilk are all considered carbohydrates even though cows
fly……………………………………… …..No they don’t! I was just making
sure you were paying attention☺.
Given the short gastric emptying time of carbohydrates, no wonder
you can be hungry by the time you get to your office after having a bowl of
cereal with milk, several pieces of toast with jam or jelly, and a glass of OJ!
These are all carbohydrates that leave your stomach quickly and raise your
blood glucose levels quickly, which causes an insulin secretion that most
likely stores everything you ate for breakfast as fat, and in doing so, causes
your blood glucose levels to quickly drop. You then go on without eating until
1 or 2 p.m., further slowing down your metabolism (remember, low blood
glucose levels cause your metabolism to put on the brakes), which will most
likely cause you to overeat at lunch, or if you are "disciplined enough" and
just have a salad for lunch, by the time you have dinner at around 7:30-
8:00pm you find that you are ravenous and cannot be satiated no matter
what or how much you eat.
But stop! Haven't you heard that you are not supposed to eat after
6:00pm? So, you might as well go to bed hungry. After all, once you fall
asleep, you won't need any energy, will you? Actually, yes, you will need
energy while you sleep to repair tissues, and conduct all sorts of metabolic
functions that take place while you sleep. All these processes require energy.
Again, the “no food after 6:00pm” theory is just another fallacy. The truth of
the matter is that the human body will do anything to survive; that is its
number one priority. Since fat is long-term stored energy, the human body
will forego burning fat and will initiate a process called "gluconeogenesis,"
which simply means "the new formation of glucose." Sounds harmless until
you realize that the pathway by which new glucose is “formed” is by the
secretion of cortisol, a hormone responsible for breaking down muscle tissue
and turning it into sugar or glucose so that you can continue to breathe, walk,
talk, think, exercise, etc. So even though you think you are not eating, you
actually are eating - you are eating your own muscle -slowing down your
metabolism, and storing fat. These are most undesirable effects. Because
muscle weighs more than fat (muscle takes about two-thirds less room than
fat for the same weight), as you eat your muscle you lose weight, so, there is
no reason to get all excited about seeing lower numbers on the scale! In the
worst case, your body may be entering a downward spiral of continual fat
storage and suppressed metabolic rate……………………………...hmmm,
something to think about.
Based on gastric emptying studies and blood glucose control, we've
come up with three basic rules to help you keep your muscle mass and get
rid of fat. Rule No. 1 is to eat every three and a half to four hours, whether
you are hungry or not. Again reverting to the car analogy, you do not drive
your car until you run completely out of fuel and have to call the Automobile
Club to rescue you….well, hopefully that doesn’t happen to you too often.
The same applies to your body - you do not want to continuously run
out of “fuel” and have Snickers® come rescue you either. The strategy is to
control your glucose levels throughout the day as to prevent crashing and
craving cycles. Rule No. 2 - the most important rule - is to eat protein every
time you eat a carbohydrate. A recent study shows that if the protein has a
moderate amount of fat in it, blood glucose levels are better controlled.
Before getting to the third rule, let's discuss carbohydrate servings. As
blood glucose control is the most important aspect of a nutrition and exercise
program, and given that carbohydrates are the only macronutrients that really
have an effect on blood glucose levels, we must be able to determine in
some fashion what is an appropriate portion of carbohydrates. Along with a
portion of carbohydrates, we must also define a portion of protein and a
portion of fat so that we not only control blood glucose levels but also control
caloric intake. Fortunately, the American Diabetes Association, along with the
American Dietetic Association (both are abbreviated ADA), have taken care
of this task for us.
There was a study conducted that determined what size of
carbohydrate dose it would take to raise blood glucose levels a measurable
or noticeable amount. It turns out that it took exactly 15g of carbohydrates to
do it. Because the word "serving" had already been used by millions of
manufacturers of food products, we could not just redefine that word. The
ADA’s decided to come up with their own terminology and decided to call a
15g serving of carbohydrates an "exchange." Therefore, even though an
entire English muffin may be one serving, since it has 31g of carbohydrates it
is considered to be “two exchanges.” So, instead of having a cup of oatmeal
every morning, you're actually having two carbohydrate exchanges. You may
very well choose oatmeal, bread, cereal, pasta, rice, potatoes, pancakes,
muffins, etc., until you reach the prescribed number of 30g of carbohydrates
or two exchanges, or as many as your RD or CFNS recommends you have
for that particular meal. Keep in mind that when we cook carbohydrates, they
usually expand (rice triples in size, pasta and oatmeal, double, etc), and
meats shrink by approximately 20%. For this reason, we measure all foods
after they have been cooked. The one exception to this rule is oatmeal.
Because people have so many different ways of making it: soggy and watery,
stiff, like cement, etc, we measure oatmeal before it is cooked; therefore, it
does not matter how much or how little water is added to it because it will still
contain the same amount of carbohydrates.
There truly is a correct number of carbohydrate, protein, and fat
exchanges that an individual needs per day, and it is not a one-size-fits-all
40-30-30 or 60-20-20 recommendation. Thus, Rule No. 3 is to become aware
of what an exchange is and how many you need per day as well as in what
combination. To determine exactly how many carbohydrate exchanges you
need per day, as well as how many protein and fat exchanges to combine
them with, we really need to go through a nutritional assessment that takes
approximately one and a half hours. In this assessment, your basic metabolic
rate (BMR) will be determined. An RD and/or CFNS can simply use a formula
to estimate your BMR. This formula takes into account your gender, present
weight, height, and age. Once your BMR is calculated, the next step is to
measure your Resting Metabolic Rate or RMR. There are several ways of
measuring RMR. We can use a huge machine called a metabolic cart, which
is used in many hospitals and research centers; conversely, we can also use
the New Leaf System, which is a computerized gas analyzer (analyzes
oxygen and carbon dioxide), or a device called the ReeVue® or MetaCheck®
made by Korr Medical. These machines are 99.86% accurate and very easy
to use.
The way these machines measure our metabolism is really interesting.
Remember how we store glucose inside our cells? Each time we burn one
molecule of glucose, six molecules of oxygen are required. The burning of
glucose yields energy (which we use for blinking, thinking, exercising, etc),
water, and carbon dioxide. These machines measure how much oxygen you
inhale, how much carbon dioxide you exhale, their relative humidity and
temperature, and with the ease of an algebraic equation (you remember: a +
b = c? a being oxygen, b, glucose, which is the value we are looking for, and
c, carbon dioxide) it calculates how much glucose you are burning, which
translates into how many calories you burn at rest while sitting at my office,
also known as your RMR. Since you do not spend the entire day at my office,
the next step is to calculate your sedentary activity calories, or simply put,
how many calories you burn being yourself. This figure does not take
exercise calories into account; only activities of daily living are considered.
Once we have determined the calories spent in activities of daily living, the
next step is to determine how many calories you do burn while exercising.
These are calculated using a value for calories per kilogram per hour so that
we know exactly how many calories you burn during specific exercises, be it
lifting weights, taking a Spinn® Class, swimming, or even playing golf. Once
we calculate all these calories we then add your specific value for the thermic
effect of foods, which is a measure of how many calories you burn keeping
warm and processing, digesting, and absorbing your food. The next and final
step is to design an ideal meal pattern or plan for you.
An RD or a Certified Fitness Nutrition Specialist™ can put together a
sound meal plan based on all the above data which will let him or her know
how many exchanges of carbohydrates, protein, and fat your body requires
for its optimal performance. The number of carbohydrate exchanges you will
be eating per day depends solely on your body weight. The number of
protein exchanges that you will be eating per day also depends on your body
weight as well as the type of exercise routine prescribed for you. If you
already have an established routine, the RD or CFNS will take it into account
to ensure your body is fueled adequately for those activities. Finally, the
number of fat exchanges that you will be eating per day will be the equivalent
of 15 to 30 percent of your total caloric intake. Such a balanced meal plan
will ensure that you attain your goals of gaining or maintaining muscle mass
while getting rid of body fat.
For a quick review, here are the three rules and things to consider:
1. Eat every three to four hours; hungry or not!
2. Every time you eat carbohydrates, make sure you eat them with protein.
3. Find out what an exchange is, and how many you get per meal/day.
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