Optimal nutrition during prolonged exercise

Prolonged exercise is considered more than 60 minutes of activity. If you exercise for more than 60 minutes or participate in an endurance race lasting more than 60 minutes, you will benefit from drinking a carbohydrate/electrolyte solution during the exercise.

It is generally accepted that 600 to 1200 ml per hour of fluid should be consumed, containing between 30 and 60 grams of carbohydrates and 0.5 to 0.7 grams of sodium (Na) per liter of fluid (Von Duvillard SP, et al. 2004). One liter is 1000 ml.

The carbohydrates help to prevent glycogen depletion and will help to improve performance. Carbohydrates are stored in the form of glycogen in the muscles and the liver and used as needed for energy. When glycogen stores are completely used up and energy has to be supplied mainly by fat, performance will be substantially reduced. The body will also start to break down its own protein at that point to help supply energy.

Sodium is important to help maintain fluid balance and prevent muscle cramping.

What is the best form of carbohydrates to use for this purpose and how much can we utilize?

The carbohydrates without doubt are important because they help improve performance, but it’s a limit to what we can absorb because the rate of gastric emptying. What has been commonly used is a solution of 4% to 8% carbohydrates per 100 ml of fluid.

Comparatively new research shows that a combination of glucose and fructose allows for more carbohydrates to be absorbed than if only a single source like glucose is used by itself.


It has been documented that during 120 minutes of cycling exercise when glucose of 1.2 grams per minute and 0.6 grams per minute of fructose was combined, it improved performance by 8%, compared to when glucose only was used (Currell K, Jeukendrup AE. 2008). This amount of carbohydrate would be 108 grams per hour, which is considerably more than the 60 grams commonly used.

Glucose is a high glycemic index carbohydrate and another source of high glycemic carbohydrate which has been used in many studies is maltodextrin.

Summary: When competing in an endurance race or exercise for more than 60 minutes, drink a carbohydrate solution consisting of glucose or maltodextrin and fructose. The drink should also include 0.7 grams of sodium per liter of fluid. The ratio of glucose to fructose should be 2:1 and the amount of total carbohydrates should not be exceeding 108 grams per hour, not exceeding 1200 ml of fluid per hour.

Start to drink early, probably before the first 60 minutes of activity, and drink every 15 minutes.

Don’t drink this type of high glycemic index solution when you are not exercising because that would, with time, make you less insulin sensitive.

You want to be as insulin sensitive as possible to allow maximum amount of glucose to be transferred into the cells for energy.

To maintain insulin sensitivity the main meals you eat during the day should be low glycemic index, but high in carbohydrates and nutrients. Read one of the books “Effective Nutrition for Effective Healing” or “The Food Connection” for explanations and recipes.

To read the original abstracts, click on the references below.



References:

Currell K, Jeukendrup AE. Superior endurance performance with ingestion of multiple transportable carbohydrates. Med Sci Sports Exerc. 2008 Feb;40(2):275-81.

Von Duvillard SP, Braun WA, Markofski M, Beneke R, Leithäuser R. Fluids and hydration in prolonged endurance performance. Nutrition. 2004 Jul-Aug;20(7-8):651-6.

How to improve recovery from exercise.

One of the most important aspects of training is the recovery. Incomplete recovery will result in tissue breakdown and optimal benefits from the exercise are not realized.

A lot of research has been published on this topic. What you will find here is a synthesis of the most relevant information.

It is important to ingest carbohydrates, proteins and amino acids after both aerobic endurance exercise and anaerobic resistance exercise to get maximum benefits from training.

As a general rule, 1g of carbohydrate per kg of body weight and 0.5g of protein per kg of body weight should be ingested within 30 minutes after exercise as well as a high carbohydrate meal within 2 hours following exercise (Kreider RB, et al. 2010).

The exercise recovery process can possibly be improved even further by using supplements.

Exercise results in depletion of muscle glycogen. When protein is added to the carbohydrates in the recovery period the insulin response is significantly greater than when carbohydrates are used by itself (Zawadski KM, et al. 1992). This is the case even if a high glycemic index carbohydrate source like glucose or maltodextrine is used.

Insulin acts as an anabolic hormone and stimulates the uptake of both carbohydrates and amino acids into the tissue.

Ingestion of hydrolyzed whey protein and maltodextrine after exercise, have shown to increase the synthesis and repair of muscle protein not only after resistance exercise, but also after endurance exercise (Howarth KR, et al. 2009).

If you want to improve recovery even further, add amino acids to the carbohydrates.


Carbohydrates and essential amino acids have been documented to maximize the anabolic response to resistance exercise and suppress the exercise induced cortisol (a stress hormone) response (Bird SP, et al. 2006).

Responsible for that is most likely leucine, which is one of the branched chained amino acids.

When a drink consisting of carbohydrates in the form of 50% glucose, 50% maltodextrine and whey protein was compared with the same drink, except with the addition of leucine, it was documented that the drink with added leucine stimulated muscle protein synthesis more than the carbohydrate, protein drink when consumed 45 minutes of resistance exercise (Koopman R, et al. 2005).

This is the amount of the different ingredients used in this study per hour per kg body weight: 0.3g of carbohydrates, 0.2g of hydrolyzed whey protein and 0.1g of leucine. For a 60 kg (72 pounds) individual that would amount to 18g of carbohydrates, 12g of protein and 6g of leucine per hour which what approximately can be emptied from the stomach per hour.

As a summary: For the fastest recovery including increased protein synthesis after both endurance and resistance exercise, use higher glycemic index carbohydrates with either essential amino acids or branched chain amino acids.

Just remember you don’t want to eat or drink high glycemic index foods or beverages when you don’t exercise, that will make you more insulin resistant.
To stay as insulin sensitive as possible allowing maximum glucose to be transferred into the cells for energy, you need to eat low glycemic index meals.

To learn about the benefits of low glycemic, high nutrient food read one of the books, “Effective Nutrition for Effective Healing” or “The Food Connection.”

To read the original abstract, click on the references below.




References:

Bird SP, Tarpenning KM, Marino FE. Independent and combined effects of liquid carbohydrate/essential amino acid ingestion on hormonal and muscular adaptations following resistance training in untrained men. Eur J Appl Physiol. 2006 May;97(2):225-38. Epub 2006 Mar 24.

Howarth KR, Moreau NA, Phillips SM, Gibala MJ. Coingestion of protein with carbohydrate during recovery from endurance exercise stimulates skeletal muscle protein synthesis in humans. J Appl Physiol. 2009 Apr;106(4):1394-402. Epub 2008 Nov 26.

Koopman R, Wagenmakers AJ, Manders RJ, Zorenc AH, Senden JM, Gorselink M, Keizer HA, van Loon LJ. Combined ingestion of protein and free leucine with carbohydrate increases postexercise muscle protein synthesis in vivo in male subjects. Am J Physiol Endocrinol Metab. 2005 Apr;288(4):E645-53. Epub 2004 Nov 23.

Kreider RB, Wilborn CD, Taylor L, Campbell B, Almada AL, Collins R, Cooke M, Earnest CP, Greenwood M, Kalman DS, Kerksick CM, Kleiner SM, Leutholtz B, Lopez H, Lowery LM, Mendel R, Smith A, Spano M, Wildman R, Willoughby DS, Ziegenfuss TN, Antonio J. ISSN exercise & sport nutrition review: research & recommendations. J Int Soc Sports Nutr. 2010 Feb 2;7:7.

Zawadzki KM, Yaspelkis BB 3rd, Ivy JL. Carbohydrate-protein complex increases the rate of muscle glycogen storage after exercise. J Appl Physiol. 1992 May;72(5):1854-9.

Vitamin D and risk of Parkinson disease

A lot of research has been published recently on the importance of vitamin D.

The research reviewed here investigated vitamin D levels and its association to Parkinson disease (Knekt P, et al. 2010).

The follow-up period was 29 years and serum 25-hydroxyvitamin D level (the most common way of testing vitamin D) was determined from frozen samples stored at baseline.

The results showed that individuals with higher serum vitamin D concentration had a reduced risk of Parkinson disease.

This is one more reason to be sure you get enough vitamin D.

It is very common to have low levels of vitamin D because of inadequate sun exposure or regular use of sunscreen.

Taking between 1000 IU to 2000 IU of vitamin D3 daily will help. It is not recommended to take huge amounts of vitamin D, since vitamin D is not only a vitamin but also a hormone the body regulates. More is not always better.

You can safely take 1000 IU-2000 IU daily of vitamin D, but it is recommended to have a vitamin D test before taking higher amounts.

To read more about the benefits of vitamin D, click here.

To read the original abstract, click on the reference below.


Reference:

Knekt P, Kilkkinen A, Rissanen H, Marniemi J, Sääksjärvi K, Heliövaara M. Serum vitamin D and the risk of Parkinson disease. Arch Neurol. 2010 Jul;67(7):808-11.

Fish oil and breast cancer

Omega 3 fatty acids from fish oil have been documented to provide numerous health benefits.

The study reviewed here investigated the association between the use of fish oil and the risk of breast cancer (Brasky TM, et al. 2010).

The participants who were postmenopausal women age 56-76 years completed a questionnaire about their use of supplements. Data about their current and past use were obtained as well as frequencies and duration of use.

The results showed that ten years average use of fish oil was associated with reduced risk of breast cancer.

Considering all the research on fish oil showing anti-inflammatory benefits and cardiovascular benefits, this is certainly one supplement to take.

To read more about benefits from fish oil, click on “Better Fish Oil” which is a pharmaceutical grade fish oil.

To read the original abstract, click on the reference below.


Reference:

Brasky TM, Lampe JW, Potter JD, Patterson RE, White E. Specialty supplements and breast cancer risk in the VITamins And Lifestyle (VITAL) Cohort. Cancer Epidemiol Biomarkers Prev. 2010 Jul;19(7):1696-708.

Want to avoid getting a stroke?

Avoiding ten risk factors can substantially improve your odds of not getting a stroke.

A recent published study in The Lancet, one the most respected medical journals in the world documented 10 risk factors associated with 90% of the risk of stroke (O’Donnell MJ, et al. 2010).

The study included patients from 22 countries and data was collected for three years. The stroke cases were categorized as ischemic stroke (stroke due to lack of blood supply to an area of the brain) and intracerebral hemorrhage stroke (stroke due to rupture of a blood vessel).

The risk factors significant for ischemic stroke were a history of hypertension (blood pressure more than 160/90 mmHg), smoking, high waist-to-hip ratio (fat around the waist), high diet risk score, low regular physical activity, diabetes, alcohol intake (more than 30 drinks per month or binge drinking), psychological stress and depression, cardiac causes (heart problems), and a high ratio of apolipoproteins B to A1 (blood markers of cardiovascular risk).

Hypertension, smoking, high waist-to-hip ratio and alcohol intake were significant risk factors for intracerebral hemorrhage stroke.

If you for the most part follow the food plan, recipes in the book, “The Food Connection,” you will reduce many of these risks. Your blood pressure would most likely be better and so would your waist-to-hip ratio. It would be unlikely that you would get diabetes, your cardiovascular risk would be reduced, your ratio of apolipoproteins B to A1 would be better and your diet risk score would be excellent.

The only other things would be to avoid smoking, not drink too much and get some physical activity.

Physical activity would also most likely make you feel less stressed and depressed.

It does not have to be that difficult to reduce your risks and it certainly would be worth it. Added benefits would be that you will feel better and also have more energy.

To read about “The Food Connection,” click here.

To read the original abstract, click on the reference below.


Reference:

O'Donnell MJ, Xavier D, Liu L, Zhang H, Chin SL, Rao-Melacini P, Rangarajan S, Islam S, Pais P, McQueen MJ, Mondo C, Damasceno A, Lopez-Jaramillo P, Hankey GJ, Dans AL, Yusoff K, Truelsen T, Diener HC, Sacco RL, Ryglewicz D, Czlonkowska A, Weimar C, Wang X, Yusuf S; INTERSTROKE investigators. Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. Lancet. 2010 Jul 10;376(9735):112-23. Epub 2010 Jun 17.

Interesting relationship between HDL-cholesterol and cancer risk

HDL-cholesterol (high density lipoprotein) the so called good cholesterol has for a long time been used as one of the risk factors for cardiovascular disease. High HDL is considered to be good and reduce cardiovascular risk.

A recent study investigated the relationship between HDL and cancer in large randomized controlled trials (Jafri H, et al. 2010). 24 trials were included in this study with 625, 477 person-years of follow up.

The results showed that it was an inverse relationship between HDL and the incidence of cancer. For every 10 mg/dl increment in HDL, there was a 36% relative lower rate of the development of cancer. This was independent of other risk factors like age, body mass index, diabetes and smoking.

Dietary habits and a lifestyle that will increase HDL-cholesterol are not only beneficial for the cardiovascular system, but it can also reduce the risk of cancer.

To learn how to implement the right foods to raise your HDL, read the book, “The Food Connection.” This book includes both explanations and a lot of recipes.

To read the original abstract, click on the reference below.


Reference:

Baseline and on-treatment high-density lipoprotein cholesterol and the risk of cancer in randomized controlled trials of lipid-altering therapy. Jafri H, Alsheikh-Ali AA, Karas RH. J Am Coll Cardiol. 2010 Jun 22;55(25):2846-54.

Simple way to avoid the immediate negative effect from a high fat meal on blood vessel function

Most people believe that high fat meals are not healthy. What is not that well known are the immediate effects of a high fat meal on the function of blood vessels.

The study reviewed is very interesting because it investigated the acute impairments of a high fat meal on endothelial function (Fahs CA, et al. 2010). The endothelium is the inner lining of the blood vessels.

The researchers measured several factors related to the endothelial function and arterial stiffness at rest and also 4 hours after a high fat meal supplemented either with a placebo or 1 gram of EPA and DHA, which are the active ingredients of omega 3 fish oil.


After the high fat meal supplemented with the placebo, the brachial artery flow-mediated dilation normalized for shear rate, was significantly impaired, but it remained unchanged when the high fat meal was supplemented with the fish oil.

Impaired flow-mediated dilation has been demonstrated many years before the appearance of plague and is a way to detect dysfunctional changes in blood vessels.

Omega 3 fish oil does not only provide a variety of long term benefits, but it also provides an immediate benefit.

To read more about the benefits of omega 3 fish oil, click here.

To read the original abstract, click on the reference below.



Reference:

The effect of acute fish-oil supplementation on endothelial function and arterial stiffness following a high-fat meal. Fahs CA, Yan H, Ranadive S, Rossow LM, Agiovlasitis S, Wilund KR, Fernhall B. Appl Physiol Nutr Metab. 2010 Jun;35(3):294-302.

Developmental biology: Birth of the blood cell. Momoko Yoshimoto & Mervin C. Yoder. Nature 457, 801-803(12 February 2009) doi:10.1038/457801a. (Use of picture)