Counteracting Muscle Glycogen Depletion

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Because Low carbs is all the rave right now, I felt an article about Carbs for athletes (particularly endurance) is timely.

Carbohydrate is typically the limiting energy substrate in exercise, meaning that it will run out before protein or fat runs out. Glycogen depletion is a term used to describe when carbohydrates are used up and no longer exist as a fuel source for working muscles. In other words energy stores are depleted, which can result in cells and muscle tissue being damaged and the immune system being stressed if exercise continues. Some of theses metabolic processes, which can lead to muscle soreness and damage, can be counteracted to a degree by dietary factors.

What and How Much should I eat

Before the workout

It is important to fuel your muscles before the workout begins. A good analogy to remember is that you do not drive your car to its destination, and then put gas in it – our bodies work the same way. Fill the tank by eating a meal comprising mostly of low- to moderate-glycemic carbohydrates two to three hours before exercise (e.g. oatmeal). A good preworkout meal should contain some protein, which in turn decreases the body’s reliance on muscle protein as an energy source, sparing the muscle to focus on the workout. It also enhances the recovery period by being available as amino acids for protein synthesis (e.g. add a scoop of whey protein powder to the oatmeal).

 

During the workout

 

The aim is to increase sparing of muscle glycogen and simultaneously improve endurance. Maintaining a continuous source of glycogen during intense training minimizes muscle tissue damage and further aid in post-workout recovery. There is consensus that 8 to 10g of carbohydrate per kg of body weight will maintain appropriate glycogen levels during heavy training. Recommendations for an endurance event include liquid carbohydrate right before the event, and a regular consumption of glucose polymers (e.g. maltodextrin) during the event, to delay fatigue. A 6 to 8% solution containing 15 to 20g of carbohydrate per 7oz of water is ideal (such as Gatorade or Powerade). Such sports drinks are easily absorbed during workouts, as well as provide water and electrolytes to prevent dehydration. New research shows that in addition to the glucose intake, a small amount of protein during workouts may also stimulate more insulin, which further aids the transportation of glucose to the muscles. Amount of appropriate consumption will depend on the type of athlete, the intensity and duration of the event, and the temperature.

After the workout

A first priority after a workout should be recovery in order to return to be fully prepared with a full tank of fuel for the next training bout, as quickly as possible. It is not possible to consume enough carbohydrate during moderate- to high-intensity exercise to replace the glycogen that has been depleted. Furthermore, the muscle degradation during exercise requires protein to fully recover. It is therefore important to consume additional carbohydrate and protein after the workout. This should be done as soon as possible, a period known as “the muscle recovery window” or “the glycogen replacement window” (the first two hours after exercise). This is because the enzyme (glycogen synthase) responsible for storing glycogen is highly elevated immediately after exercise. Again, a combination of carbohydrate and protein is the best source of macronutrients for post exercise recovery. Sports drinks are highly recommended for the recovery period due to their ability of rapid absorption, and their water and electrolyte content.

Consequences of unrecovered glycogen depletion

Failure to appropriately replete glycogen may result in chronic glycogen depletion. There is evidence linking muscle glycogen depletion with both fatigue and injury. Symptoms are very similar to those of over-training. Muscles that are fatigued lose their strength, and thus their ability to protect joints, with the unfortunate risk of injury. The purpose of a good recovery nutrition strategy is to avoid chronic glycogen depletion that can take place over several days of training and avoid injury. Furthermore, consistency in glycogen repletion results in effective and recovery between workouts and competitions and thus overall improved performance during competition.

Tips to avoid gastrointestinal distress for training/racing

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Ilana Katz MS, RD, CSSD

voodoo

If you think you are alone when your first focus for any race is gastrointestinal distress, you are not. Are you always plotting your day based on where the bathrooms are going to be (even the ones along the course), or always having to get to races early knowing that you will be standing in the line multiple times, and do you plan your training days around where the pit stops have to be.  Believe it or not, athletic GI distress affects more than 60% of athletes.

Some of the reasons include pre-race anxiety, eating a bigger than normal breakfast in anticipation of extra fuel requirements, and then the all too familiar jostling stomach and intestines experienced in any sport that includes ground reaction forces (particularly running).

Hopefully these tips can shed some light onto your individual struggles and help reduce your stomach troubles.

Prone to the jostle…

You may be surprised about this one but often something tight around your waist may help prevent organs from jostling.  I personally discovered this one when my own GI issues were reduced after investing in a fairly tight fuel belt. On race day, the race belt used to pin race numbers too can also assist in this cause. Now of course this is hit or miss, and may just be a band-aid to a deeper problem, therefore always record fuel and fluid consumption for every training and racing day, noting all the specifics, like weather, humidity, pre-exercise meal, etc.,     Detailed data can often uncover the triggers for side stitches, onset of diarrhea or nausea, and the like.  Data helps create optimal solutions and some slight dietary tweaks during the days and weeks leading up to events will eventually have zero-runs runs.

Understand your individual transit time

Dreaded diarrhea is a major concern for many athletes, as mentioned above. The jostle reduces blood flow to the intestines which is more likely diverted to the exercising muscles. With reduced blood flow when needed, the intestinal hormones may get thrown off balance and this in turn will quicken the transit time (what is clinically called the gastric emptying rate).  Many athletes in the early phase of their fitness journeys unaccustomed to stress of hard and intensified exercise are more likely to experience runners’ trots.  As the body adjusts, intestines will revert to their normal bowel patterns and ease up this syndrome. However, not always… unfortunately even experienced athletes may experience the dreaded liquid stomach especially if there are pre-existing gastric concerns, various intolerances and allergies, and irritable bowel syndrome.

These tips may help:

  • Warm up before a race day or an intense training day. Exercising lightly stimulates the bowels to empty.
  • Adjust training times to different times of the day to help understand your transit time better. For early morning, try drink something hot like coffee, hot lemon water, tea, etc., but be sure to allow for time to sit on the thrown with patience.
  • Find stress reducing exercises for race day with the goal of reducing anxiety and fretting. Many sports psychologists suggest meditation, breathing exercises, yoga poses and practicing positive visualization of a stress free environment.
  • Eliminate high fibrous foods the day leading up to the race, and especially the morning of. Fiber increases transit time and usually at a very inconvenient time when racing.
  • Do not chew gum or drink carbonated beverages or anything else that either causes the swallowing of air or the popping of air bubbles intestinally.
  • Sugar-free products that contain sugar alcohols are even more the devil than one would think. Sorbitol (found in many sugar-free gums and processed products) is a stimulant for the onset of diarrhea.

seat-yourself

An interesting way of getting to the bottom of your personal transit time is to eat and monitor elimination with foods that are visible in the feces like corn, pumpkin or sesame seeds, or beets (based on color changes).

Hydrate consistently and well

Often diarrhea is related to dehydration, and moreover, exercise-induced dehydration – which is related to sweating out more fluid than is optimally comfortable replacing. Athletes are too quick to blame the ingredients in many of the available sports nutrition products. This means hydration each and every day, not just days before a race, or race day itself.

Eliminate suspected culprits

We typically know our own bodies and suspect various foods that may be contributing factors. For a week, eliminate any suspicious foods such as coffee, dried fruits, beans, high fiber breads or cereals, dairy-based foods and whatever else you feel is necessary. Next, eat a bigger than usual dose of the one suspected food and observe. Typically changes in bowel movements provide the best answers. If your GI symptoms reduce when you cut out dried fruit for example, but have a worrisome situation when you then eat an extra-large portion, the answer becomes obvious: don’t eat dried fruit.

bathroom-time

Do not forget to investigate medications’ possible side effects

More than often, athletes forget to incorporate any pharmaceuticals or even over the counter supplements they may be taking into the equation.  If all else fails, consult with your doctors, especially if you are on medications for any reason (even the reason may become symptomatic during races.)  Furthermore, doctors may be able to suggest anti-diarrheal ideas such as Imodium to help.

In summary

Races can be won or lost at the porta john.  Although many athletes experience gastrointestinal difficulties, it is an individual struggle with an individual solution. Hopefully some of these tips can reduce the frustration of your bathroom issues and prevent a derail of your perfect training regimen on race day.   But to genuinely help yourself, start a food and distress log which may help eliminate suspicious culprits.

poop-before-race

Eat to beat Cramps

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The physiology of cramps can be complex. Nutrition may or may not have a role to play behind the why!!
Stretching out and massaging muscles can certainly be a good start but this is often NOT enough, since electrolyte balance plays a major role in muscle function and recovery.
Key nutrients include sodium, potassium, magnesium, chloride and calcium.
On a personal level, having participated in master’s swim meet, while training for Ironman races, it is not uncommon for me to observe swimmers gathering at the lanes end in-between sets to mention their cramps. It amazes me how everyone in the pool suddenly becomes a nutritionist, and I bet you can guess which foods they suggest?
Did you have a banana in your thought processing just then? (well you are not alone) – as most of us know, bananas are a good source of potassium. Interestingly enough, they also have a decent source of magnesium and calcium. Its no wonder most of you would be right about recommending a banana at the side of the pool…. But, there may be the fine line between some other factors as to whether bananas may eliminate the cramps, or in fact preserve the cramp.
Did all you swimming nutritionists consider some very important physiology of sweat and muscle movement. What else may play a role?
– Hydration
– Supplementation
– Intensity and duration and type of exercise/training
– Medication side effects (probably the one you would want a professional to chime in on)
Why wait for the why, why not avoid the onset? Or at very least, fix the problem rather than exacerbate it.
TRAIN STRONG,
ILANA

AUGUST NEWSLETTER 2023

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 Happy August

Wow, can you believe we are now into the second half of the year? Time flies…. and with time, comes renewals, regroupings, recommitments to all those earlier goals that somehow waiver as we get too comfortable with them. Take a moment to rethink, and hope you are on your way to health and happiness as the second half of this year progresses. If you re not half way there, hop, skip and jump, or just break a sweat everyday !!

I dedicate this newsletter to Lactose, since I get many queries on this monosaccharide. Hope I can teach you a fact or two, or at least offer some new, interesting recipe ideas…. Enjoy!!

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The Low-down on Lactose Intolerance

Approximately 4000 million people cannot digest lactose with about 75% of those being African American, Jewish, Native American, and Mexican American. 90% of Asian Americans are believed to also be lactose intolerant. Below is the RDA (Recommended Dietary Allowance) for calcium.

Table :   Recommended Dietary Allowances (RDAs) for Calcium [1]
Age Male Female Pregnant Lactating
0–6 months*

200 mg

200 mg
7–12 months*

260 mg

260 mg
1–3 years

700 mg

700 mg
4–8 years

1,000 mg

1,000 mg
9–13 years

1,300 mg

1,300 mg
14–18 years

1,300 mg

1,300 mg

1,300 mg

1,300 mg
19–50 years

1,000 mg

1,000 mg

1,000 mg

1,000 mg
51–70 years

1,000 mg

1,200 mg
71+ years

1,200 mg

1,200 mg

* Adequate Intake (AI)

 

Lactose is found in a variety of foods; however, not all foods containing lactose bother every individual. Many individuals with lactose intolerance can tolerate up to 1 glass (8 oz) of milk, yogurt, and hard cheeses without symptoms. Lactase supplements and lactose-free milk products are easily available and allow for individuals with lactose intolerance to consume an adequate amount of calcium.  Drinking milk with meals can also help to alleviate symptoms. Certain conditions may increase the risk of developing lactose intolerance such as Celiac and Irritable Bowel Syndrome. Lactose free milk and regular milk are almost identical- the only difference is the lactose has been broken down in the lactose-free milk.

Lactose in Common Foods
Milk, reduced fat 1 cup 11 – 14 g
Buttermilk, whole 1 cup 10 g
Yogurt, whole milk 1 cup 10 – 12 g
Ice cream ½ cup 5 – 6 g
Yogurt, plain, low fat 1 cup 5 – 19 g
Sour cream ½ cup 4 g
Cottage cheese ½ cup 3 – 4 g
Swiss cheese 1 oz 1 g
Cream cheese 1 oz 1 g

Common symptoms of lactose intolerance include:

  • Bloating
  • Abdominal pain
  • Diarrhea

If you believe you are lactose intolerant, keeping a food diary is a helpful tool. Elimination diets under the instruction of a health professional can also prove useful. Lactose intolerance, if on a restricted diet, can put some individuals at risk of calcium deficiency, osteoporosis, or other health conditions, typically most individuals can meet their daily needs by a few dietary modifications.

Fitness Corner: Dance It Off

Dance offers great value for burning calories while simultaneously having fun.

Kicking up the intensity of your dance steps can help expend more energy, which has a direct impact on the number of calories burned. At a more vigorous pace, you can expect to burn about 360 calories an hour at a weight of 125 pounds, while a weight of 155 pounds causes you to burn close to 450 calories per hour. At 185 pounds, you burn more than 530 calories per hour. With the increase in intensity, it becomes a little easier to reach the deficit needed to lose weight.

How to reach those intensities can be supported by a great dance studio. Check out Dance It Off in Sandy Springs (they are offering a free class to any of my followers, so tell them Ilana sent you, and Dance Off some extra calories). http://www.danceitoffstudio.com/

                                                

 

 

 Calorie Corner: Milk and Milk Substitutes

*per serving (1 cup); data from nutritiondata.self.com

Milk Calories Fat (Grams) Protein (Grams) Carbohydrates (Grams)

Milk, Buttermilk, Fluid, Cultured, Reduced Fat

 137 5 10 13

Milk, whole

 146 8 8 13

Milk, Lowfat, Fluid, 1% Milkfat, With Added Vitamin A

 102 2 8 13

Milk, fluid, nonfat, calcium fortified (fat free or skim)

 86 0 8 12

Silk Plain, Soymilk

 100 4 7 8

Silk Pure Almond Original Almond Milk

 60 3 1 8

Rice Dream, original, enriched

 120 2.5 1 23

Beat the Heat with a Watermelon Treat

Not only is watermelon is a favorite summer food selection and barbeque closer, it is equally beneficial to health.

The antioxidant lycopene is a chemical  found in plants that gives certain foods (watermelon, tomatoes, red grapefruit, and guava) their red color. Part of the large class of plant compounds called carotenoids, which help protect and preserve body cells from oxidation and damage, lycopene may reduce one’s risk of various cancers, particularly prostate cancer. Watermelon is also a good source of antioxidants, that work towards preventing heart disease, lowering cholesterol.

CHOOSING THE PERFECT WATERMELON

Choose a firm, symmetrical fruit that is free of bruises, cuts, and dents.

Pick up the melon, it should feel heavy. (A good watermelon is 92% water.)

The underside should have a creamy yellow spot where the melon sat on the ground and ripened in the sun.

RECIPE SELECTION

Watermelon-Strawberry Smoothie

(16 oz serving)
1 cup seeded watermelon, diced
¾  cup lemon sorbet or sherbet
8 frozen whole strawberries
1 tablespoon lemon juice

4 cubes of ice

1 cup water
Place all ingredients in a blender. Blend until smooth.
(cals; 224, carbs: 50g carbs, 4g fiber (net carbs = 46g  (mostly natural sugar: fructose), 2g pro,  0 g fat.

 


Watermelon Parfait

(2 servings)
½  cup low fat granola
1 cup seedless watermelon, cut into small chunks
2 cups of low fat vanilla yogurt
1 sliced banana, sliced
¼ cup of Almond slivers

In 2 tall glasses
Layer ½ of each of the granola, watermelon, yogurt  and banana
Repeat Layers with the other half of the ingredients.

Garnish with slivered almonds.

(cals per serve: 230 cals, 4g fat, 9g pro,  35g carbs, 5 g fiber)

Culinary herbs and spices : Can they interact with your medicine?

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Ilana Katz MS, RD, CSSD

spices

One of the major responsibilities a dietitian/nutritionist may have is to analyze an individual’s intake and ensure most appropriate and healthy solutions to goals and needs.

For people who regularly take medications, even over the counter products, this can become quite challenging.  So then, can some ingredients in various dishes have a pharmalogical interaction?

Specific examples best defines what a pharmalogical interaction is:  Combining a statin drug (most likely prescribed to lower cholesterol) and  a daily dose of grapefruit juice may likely cause too much of the statin to stay in the metabolic system, increasing the risk of liver or kidney failure.  Another example is that certain nutrients in grapefruit juice (and some other juices too) may decrease the effectiveness of some medications, the most well-known in this category is for allergy symptoms.

What then should we be concerned of in multiple ingredient recipes? A tablespoon of this, a teaspoon of that, a dash, a dollop or a pinch…

As a supplement for example, Ginger is thought to remedy nausea or upset stomach and  garlic is reported to reduce risk of heart disease and cancer. But did you know that both ginger and garlic may also slow blood clotting when interacted with an anticoagulant drug such as warfarin or Coumadin. The practioner prescribing the anticoagulant should warn the patient against eating garlic or ginger, and this should also be reinforced by the pharmacist dispensing the anticoagulant drug. But what about these ingredients used in small quantities in many recipes?

It is likely a different story when one compares cooking and baking to supplementation. The amounts in a recipe are typically significantly smaller compared to their use as a supplement. Interactions may lurk in the background but would typically not be clinically significant. Unfortunately there is very little published research on the potential for drug interactions with herbs and spices that are typically used for culinary purposes versus supplements. The research that is available usually focuses on specific compounds in the herb or spice and will usually use concentrated preparations which logistically do not match the culinary amounts.  An example to demonstrate this is an alkaloid called piperine, found in black pepper: piperine has been proven to increase the bioavailability of several drugs yet no interactions have been found with the use of pepper as an ingredient in a recipe. Other examples where research has discovered a drug interaction, yet no significant reaction as a culinary spice are anise, cayenne pepper, fennel, and several curry spices. It thus seems that research in food and medication reactions is complicated with many variables besides the amount used that need consideration.

The variety of the herb/spice, the potency, how much may be taken in throughout a day and over a time period, even specific genetics of the individual in question may determine the metabolic effects of their medications and thus the potential interaction between the herb or spice and their medications.

Mixing a sprinkle of all spice or a teaspoon of cinnamon into a recipe for a dozen muffins or blending chopped garlic into lasagna is not usually a concern for a drug interaction.

Unfortunately there is very little published research on the potential for drug interactions with herbs and spices that are typically used for culinary purposes versus supplements.

However, before taking any supplements, speaking to a physician, pharmacologist or dietitian about potential interactions is recommended.

“It may be a case of the dose makes the poison”  (Paracelsus – a 16th century physician)