What You Think You Know (but Don’t) About Wise Eating

From the New York Times, DECEMBER 31, 2012, 12:01 AM, By JANE E. BRODY

Let’s start the new year on scientifically sound footing by addressing some nutritional falsehoods that circulate widely in cyberspace, locker rooms, supermarkets and health food stores. As a result, millions of people are squandering hard-earned dollars on questionable, even hazardous foods and supplements.

For starters, when did “chemical” become a dirty word? That’s a question raised by one of Canada’s brightest scientific minds: Joe Schwarcz, director of the Office for Science and Society at McGill University in Montreal. Dr. Schwarcz, who has received high honors from Canadian and American scientific societies, is the author of several best-selling books that attempt to set the record straight on a host of issues that commonly concern health-conscious people.

I’ve read two of his books, “Science, Sense and Nonsense” (published in 2009) and “The Right Chemistry” (2012), and recently attended a symposium on the science of food that Dr. Schwarcz organized at McGill.

What follows are tips from his books and the symposium that can help you make wiser choices about what does, and does not, pass your lips in 2013.

CURED MEATS Many health-conscious people avoid cured meats like hot dogs and bacon because the nitrites with which they are preserved can react with naturally occurring amines to form nitrosamines. Nitrosamines have produced mutations in cells cultured in the laboratory and cancer in animals treated with very high doses.

As an alternative, sandwich lovers often buy organic versions of processed meats or products without added nitrites. Without preservatives, these foods may not be protected from bacterial contamination. And despite their labels, they may contain nitrites. According to Dr. Schwarcz, organic processed meats labeled “uncured” may be preserved with highly concentrated, nitrate-rich celery juice treated with a bacterial culture that produces nitrites.

If you’re really concerned about your health, you’d be wise to steer clear of processed meats — organic, nitrite-free or otherwise. High saturated fat and salt content place them low on the nutritional totem pole.

MEAT GLUE Never heard of it? You may have eaten it, especially if you dine out often. At WD-50 in New York, the chef, Wylie Dufresne, makes his famous shrimp noodles with the enzyme transglutaminase, a k a meat glue. It binds protein molecules, gluing together small pieces of fish, meat or poultry.

The Japanese use meat glue to create artificial crab meat from pollock. Others use it to combine lamb and scallops, or to make sausages that hold together without casings.

Sound frightening? It shouldn’t. The enzyme is classified by the Food and Drug Administration as “generally recognized as safe,” and there is no reason to think otherwise. Our bodies produce it to help blood clot, Dr. Schwarcz points out. When consumed, it breaks down like any protein into its component amino acids in our digestive tracts.

There is, however, one possible indirect hazard: If glued-together animal protein is not thoroughly cooked, dangerous bacteria that originally contaminated the meat could remain viable within the fused product.

TRANS FATS The removal of heart-damaging trans fats from processed foods is a much-ballyhooed boon to health. But “not all trans fats are fiends,” Dr. Schwarcz notes. Certain ones can legally, and healthfully, be added to dairy products, meal-replacement bars, soy milk and fruit juice.

The word “trans” refers to the arrangement of hydrogen and carbon atoms in a fatty acid. The trans formation linked to heart disease is formed when vegetable oils are hardened to prolong shelf life in a manufacturing process called hydrogenation. Natural trans fats, like those in meat and dairy products, take a slightly different form, resulting in an entirely different effect on health.

The most widely consumed “good” trans fat is conjugated linoleic acid, which research has shown can help weight-conscious people lose fat and gain muscle. Various studies have suggested that C.L.A., now widely sold as a supplement, also can enhance immune function and reduce atherosclerosis, high blood pressure and inflammation.

ORGANIC OR NOT? Wherever I shop for food these days, I find an ever-widening array of food products labeled “organic” and “natural.” But are consumers getting the health benefits they pay a premium for?

Until the 20th century, Dr. Schwarcz wrote, all farming was “organic,” with manure and compost used as fertilizer and “natural” compounds of arsenic, mercury and lead used as pesticides.

Might manure used today on organic farms contain disease-causing micro-organisms? Might organic produce unprotected by insecticides harbor cancer-causing molds? It’s a possibility, Dr. Schwarcz said. But consumers aren’t looking beyond the organic sales pitch.

Also questionable is whether organic foods, which are certainly kinder to the environment, are more nutritious. Though some may contain slightly higher levels of essential micronutrients, like vitamin C, the difference between them and conventionally grown crops may depend more on where they are produced than how.

A further concern: Organic producers disavow genetic modification, which can be used to improve a crop’s nutritional content, enhance resistance to pests and diminish its need for water. A genetically modified tomato developed at the University of Exeter, for example, contains nearly 80 times the antioxidants of conventional tomatoes. Healthier, yes — but it can’t be called organic.

FARMED SALMON Most of the salmon consumed nowadays is farmed. Even if we all could afford the wild variety, there’s simply not enough of it to satisfy the current demand for this heart-healthy fish.

There may be legitimate concerns about possible pollutants in farmed salmon, but one concern that is a nonissue involves that “salmon” color, produced by adding astaxanthin to fish feed. This commercially made pigment is an antioxidant found naturally in algae, and it is carried up the food chain to give wild salmon its color, too.

NUTS Growing up, I was often warned to avoid nuts because they’re “fattening.” Now I know better. Although about three-fourths of the calories in peanuts, for example, come from fat, people who regularly eat nuts and nut butters in normal amounts weigh less, on average, than nut avoiders.

The fat in nuts is unsaturated and heart-healthy. Nuts are also good sources of protein, antioxidants, vitamins, minerals and fiber, and can help keep between-meal hunger at bay. The same is true of avocados — just don’t go overboard.

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Nutrient Timing For Training Days – Post Workout

Hierarchy of Importance:

  • The total amount of macronutrients by the end of the day (24hrs) is most important, timing is secondary.
  • Through the day, there is a constant overlap of meal absorption, negating the need to split hairs over the precision of meal placement.

Post Exercise

  • Positioning macronutrients immediately surrounding training results in superior effect.
  • During training carbs, protein, and electrolyte concerns are practically nil when training does not exceed 60 minutes when proper pre nutrition is in place.
  • Post exercise nutritional demands vary according to the intensity, duration and frequency of the activity.
  • Post exercise nutrition should function as an extension of the objectives of the other phases.

Protein Post Exercise

  • An all-purpose recommendation for the immediate post exercise protein dose is 0.25g/lb. of target body weight.
  • Total amount for the day is far more important than the specific amount post exercise.
  • The total amount of high quality protein should be the primary focus, with type/speed of absorption being a secondary concern.

Carbs post Exercise

Endurance athlete

  • Daily needs for an endurance athlete range from 7-10g/kg.
  • Maximal post exercise glycogen synthesis rates occur at a dosing range of 1-1.85g/kg ingested every 15-60 minutes for up to 5 hour post exercise.
  • An hourly dose of 1.2g/kg appears to yield maximal glycogenesis

Power Athlete

  • Daily needs for a power athlete range from 5-7g/kg.
  • Rate of glycogen synthesis rates is not a concern, as long as it can be comfortably consumed without impinging on total allotment for the day.
  • An immediate post exercise target is 0.5g/lb. of ideal target weight.

Miscellaneous

  • Speed of glycogen resynthesis is only a concern when pre and during training carbs are absent or insufficient and multiple bouts of depletion training in a single day.
  • After glycogen depletion, delaying post exercise carbs by 2 hours versus immediate ingestion has resulted in a 45% slower rate of glycogen resynthesis.

Fat Post Exercise

  • High Amounts of post exercise fat (165g) does not reduce 24 hour glycogen synthesis.
  • If you do not train the same muscles to glycogen depletion more than once a day shouldn’t be concerned with a normal fat intake.
  • There is no need to spike insulin for recovery purposes.
  • Getting enough total substrates surrounding the training bout suffices.

Luther Allison – Bad Love

Medical care is 3rd leading cause of death in U.S.

Crazy article from the Chris Kresser blog

The popular perception that the U.S. has the highest quality of medical care in the world has been proven entirely false by several public heath studies and reports over the past few years.

The prestigious Journal of the American Medical Association published a study by Dr. Barbara Starfield, a medical doctor with a Master’s degree in Public Health, in 2000 which revealed the extremely poor performance of the United States health care system when compared to other industrialized countries (Japan, Sweden, Canada, France, Australia, Spain, Finland, the Netherlands, the United Kingdom, Denmark, Belgium and Germany).

In fact, the U.S. is ranked last or near last in several significant health care indicators:

  • 13th (last) for low-birth-weight percentages
  • 13th for neonatal mortality and infant mortality overall
  • 11th for postneonatal mortality
  • 13th for years of potential life lost (excluding external causes)
  • 12th for life expectancy at 1 year for males, 11th for females
  • 12th for life expectancy at 15 years for males, 10th for females

The most shocking revelation of her report is that iatrogentic damage (defined as a state of ill health or adverse effect resulting from medical treatment) is the third leading cause of death in the U.S., after heart disease and cancer.

Let me pause while you take that in.

This means that doctors and hospitals are responsible for more deaths each year than cerebrovascular disease, chronic respiratory diseases, accidents, diabetes, Alzheimer’s disease and pneumonia.

The combined effect of errors and adverse effects that occur because of iatrogenic damage includes:

  • 12,000 deaths/year from unnecessary surgery
  • 7,000 deaths/year from medication errors in hospitals
  • 20,000 deaths/year from other errors in hospitals
  • 80,000 deaths/year from nosocomial infections in hospitals
  • 106,000 deaths a year from nonerror, adverse effects of medications

This amounts to a total of 225,000 deaths per year from iatrogenic causes. However, Starfield notes three important caveats in her study:

  • Most of the data are derived from studies in hospitalized patients
  • The estimates are for deaths only and do not include adverse effects associated with disability or discomfort
  • The estimates of death due to error are lower than those in the Institute of Medicine Report (a previous report by the Institute of Medicine on the number of iatrogenic deaths in the U.S.)

If these caveats are considered, the deaths due to iatrogenic causes would range from 230,000 to 284,000.

Starfield and her colleagues performed an analysis which took the caveats above into consideration and included adverse effects other than death. Their analysis concluded that between 4% and 18% of consecutive patients experience adverse effects in outpatient settings, with:

  • 116 million extra physician visits
  • 77 million extra prescriptions
  • 17 million emergency department visits
  • 8 million hospitalizations
  • 3 million long-term admissions
  • 199,000 additional deaths
  • $77 billion in extra costs (equivalent to the aggregate cost of care of patients with diabetes

I want to make it clear that I am not condemning physicians in general. In fact, most of the doctors I’ve come into contact with in the course of my life have been competent and genuinely concerned about my welfare. In many ways physicians are just as victimized by the deficiencies of our health-care system as patients and consumers are. With increased patient loads and mandated time limits for patient visits set by HMOs, most doctors are doing the best they can to survive our broken and corrupt health-care system.

The Institute of Medicine’s report (“To Err is Human”) which Starfied and her colleagues analyzed isn’t the only study to expose the failures of the U.S. health-care system. The World Health Organization issued a report in 2000, using different indicators than the IOM report, that ranked the U.S. as 15th among 25 industrialized countries.

As Starfied points out, the “real explanation for relatively poor health in the United States is undoubtedly complex and multifactorial.” Two significant causes of our poor standing is over-reliance on technology and a poorly developed primary care infrastructure. The United States is second only to Japan in the availability of technological procedures such as MRIs and CAT scans. However, this has not translated into a higher standard of care, and in fact may be linked to the “cascade effect” where diagnostic procedures lead to more treatment (which as we have seen can lead to more deaths).

Of the 7 countries in the top of the average health ranking, 5 have strong primary care infrastructures. Evidence indicates that the major benefit of health-care access accrues only when it facilitates receipt of primary care. (Starfield, 1998)

One might think that these sobering analyses of the U.S. health-care system would have lead to a public discussion and debate over how to address the shortcomings. Alas, both medical authorities and the general public alike are mostly unaware of this data, and we are no closer to a safe, accessible and effective health-care system today than we were eight years ago when these reports were published.

Nutrient Timing for Training Days – During Exercise

During Exercise

Hierarchy of Importance:

  • Remember the total amount of macronutrients by the end of the day (24hrs) is of most importance, timing is secondary.
  • Through the day, there is a constant overlap of meal absorption, negating the need to split hairs over the precision of meal placement.

During Training Nutrition Goals

  • The objective of during exercise nutrition is to maintain sufficient levels of hydration, blood glucose, and amino acids.

During Training Protein

  • 8-15g per hour is needed
  • A quick digesting protein such as whey is the best choice.
  • Protein consumed during exercise has consistently shown a greater suppressive effect on training induced muscle catabolism.
  • If training last less than 60 minutes, and a protein containing pre work out meal or shake was ingested within 90 minutes of training…during training protein is of no benefit.

During Training Carbs

  • Conservative: 30-60g per hour needed.
  • Liberal: 60-70g per hour needed.
  • Carbs during training can benefit endurance exercise approaching or exceeding 2 hours.
  • During training carbs, protein, and electrolyte concerns are practically nil when training does not exceed 60 minutes when proper pre nutrition is in place.

During Training Fats

  • Does not enhance performance and can cause gastrointestinal upset.

Nutrient Timing For Training Days – Pre Exercise

Hierarchy of Importance:

  • The total amount of macronutrients by the end of the day (24hrs) is the most important consideration. Timing is secondary.
  • Through the day, there is a constant overlap of meal absorption, negating the need to split hairs over the precision of meal placement

Pre Exercise

  • The objective of both pre and during exercise nutrition are to maintain sufficient levels of hydration, blood glucose, and amino acids.
  •  Positioning macronutrients immediately surrounding training results in superior effect.

Pre-Exercise Protein Intake (60 min before training)

  • A solid meal consisting or shake of .25g/lb. target body weight…stick to foods that you prefer. *A solid meal consisting or shake of .25g/lb. target body weight…stick to foods that you prefer.
  • A quick digesting protein such as whey is the best choice.
  • Total amount for the day is far more important than the specific amount pre-exercise.

Pre-Exercise Carbs Intake (2-4 hours before training)

  • 140-330g is recommended if carbs are limited or nonexistent in competition.
  • A solid meal consisting or shake of .25g/lb. target body weight…stick to foods that you prefer.
  • Low to moderate volume resistance training bouts may not be depleting enough to derive performance benefits from pre exercise carbs.

Pre-Exercise Fat Intake

  • Pre loads do not increase performance or decrease glycogen breakdown during training.
  • Fat loading carries more risk than benefit.

Tomorrow I will post during exercise intake

The Controversial Science of Sports Drinks

An interesting article in The Atlantic by Lindsay Abrams

The British Medical Journal published a scathing investigation yesterday into the influence of the sports drink industry over academia, in the interest of marketing the science of hydration. The lengthy piece by Deborah Cohen documents how, over the past several decades, mandates regarding the necessity of hydrating during exercise entered the public consciousness to the point that they’re now thought of as common sense. Here are some highlights:

  • The key players: Pepsico, which produces Gatorade, the Coca-Cola company, which ownsPowerade (the official sports drink of the Olympics), and GlaxoSmithKline (GSK), which makes the British sports drink Lucozade.
  • Before the hype: The first New York marathon, in 1970, inspired a new interest in running. At the time, however, little scientific attention was played to the role of hydration in runners’ performance. Throughout the 1970s, in fact, “marathon runners were discouraged from drinking fluids for fear that it would slow them down.”
  • Undermining the body’s signals: Cohen claims that one of the greatest accomplishments of the Gatorade Sports Science Institute, established in 1985, was to convince the public that thirst is an unreliable indicator of dehydration. There is ample evidence of ways in which the experts who propagated this information were funded or “supported” by sports drinks companies, and while this in itself isn’t necessarily wrong, she argues that researchers who have conflicts of interest are not objective enough to be writing guidelines, as is the case here. There is no good evidence to support the ideas, for example, that “Without realizing, you may not be drinking enough to restore your fluid balance after working out” (Powerade), or that urine color is a reliable indicator of the body’s hydration levels.
  • A better alternative to water: The journal recounts that hyponotraemia — a drop in one’s serum sodium levels — has a bad track record of causing illness and death in marathon runners, and that we know that drinking too much water can cause hyponatremia. But it then makes the point that sports drinks do not preclude hyponatremia and that there was an article in The New England Journal of Medicine that found no correlation between hyponatremia and the type of fluid consumed.
  • Starting young: Both GSK and Gatorade have developed school outreach programs that further the case for sports drink consumption during exercise. Though the Institute of Medicine says that, in children, “Thirst and consumption of beverages at meals are adequate to maintain hydration,” studies either directly funded by or involving authors with financial ties to Gatorade make a major case for the need to promote hydration, claiming, for example, that “children are particularly likely to forget to drink unless reminded to do so.”
  • Distinguishing between Olympic athletes and the rest of us: The European Food Safety Authority upheld the claims that sports drinks hydrate better than water and help maintain performance during endurance exercise — but added that this did not apply to the ordinary, light exerciser. Says Tim Noakes, Discovery health chair of exercise and sports science at Cape Town University, “They are never going to study a person who trains for two hours per week, who walks most of the marathon — which form the majority of users of sports drinks,” and the majority of people at whom sports drinks marketing is aimed.
  • Flawed research: GSK was the only company that provided the BMJ with a list of studies attesting to the beneficial effects of sports drinks, which identified a number of major flaws in their methodology: small sample sizes, poorly designed research, data dredging, and other problematic practices. Upon analysis, the journal concludes that “only three (2.7%) of the studies the team was able to assess were judged to be of high quality and at low risk of bias.”  Scientists with links to the manufacturers of sports drinks have prominent editorial roles in key journals in sports medicine. Cohen suggests a link between this and that negative studies questioning the role of hydration are, according to sources, extremely difficult to get published in journals.
  • Harmful, not healthful: And, of course, there is the suggestion that sports drink consumption among children is contributing to growing obesity levels. Their association with hydration and athletics means they’re not thought of as being unhealthy in the way that other sugary drinks, like soda, are (note that Mayor Bloomberg included sports drinks in his super-size ban). Several studies highlight consumer beliefs that sports drinks are healthy, even essential, showing just how far marketers have been able to push exercise science in the support of sports drinks.

Cohen concludes with an argument that dehydration has been overblown into the “dreaded disease of exercise,” in yet another example of fear mongering for the sake of corporate interest.