In the ever-expanding health and fitness market, there are opportunities to do good work, and to expand business models. Wellness programs for the home healthcare market are a tremendous opportunity to do both.
One of the activities my wife and I used to really enjoy doing together was going to the gym. We had a personal trainer named Eric. Eric was funny, knowledgeable and understood how to maximize the workout for both me and my wife. Having a personal trainer that understood both our individual needs kept us motivated to workout. Eventually we moved and got a gym membership. However, we did not sign up with a personal trainer and the gym experience was no longer that unified activity we enjoyed together like we did when we worked out with Eric.
Some of my clients seem jealous of their teammates. “They eat twice as much as I do and they are skinny as a rail. I just smell cookies and I gain weight,” spouted one collegiate runner. She seemed miffed that she couldn’t eat as much as her peers—and she couldn’t understand why. They all ran the same mileage, did the same workouts, and were similar in body size. Life seemed so unfair!
Yes, life is unfair when it comes to weight management. Some people gain (or lose) body fat more easily than others. Unfortunately, fat gain (or loss) is not as mathematical as we would like it to be. That is, if you persistently overeat (or undereat) by 100 calories a day, in theory you will gain (or lose) 10 pounds of body fat a year. But this theory does not hold up in reality. People vary greatly in their susceptibility to gain or lose body fat in response to over- or under-eating.
In general, research has suggested when people overeat, about 85% of the excess calories get stored as fat and the rest gets lost as heat. Overfed fat cells grow in size and in number and provide a storehouse of energy. Obese people commonly have enough fat stores to last a year or more; even lean athletes have enough fat stores to fuel a month or more. Fat can be advantageous during a time of severe illness or a famine.
Lets take a closer look at the four primary ways you burn calories:
Purposeful exercise: This is what you burn during your workouts. This can vary considerably from day to day.To better understand why some people lose or gain weight more easily than others, Dr. James Levine PhD of the Mayo Clinic designed a study to look at the biological mechanisms that hinder fat-gain. Dr. Levine studied 16 non-obese subjects (12 males and 4 females), ranging in age from 25 to 36 years. They volunteered to eat 1,000 excess calories a day (above what they needed to maintain weight) for 8 weeks. The subjects were healthy, did not do purposeful exercise more than twice a week, and maintained a stable weight. Prior to being overfed, the researchers monitored the subjects for two weeks to learn how much food they regularly consumed to maintain their weight.
During the study, the subjects lived at their homes but ate supervised meals at the research center. The food had been carefully prepared and measured in a metabolic kitchen. The weight-gain diet was high in protein (20% of total calories) and fat (40% of calories), and low in carbohydrate (40%). The researchers accounted for almost all of the excess 1,000-calories a day. On average, ~430 of the 1,000 calories were stored and ~530 were dissipated via increased energy expenditure. The researches even measured 3 days of poop before and at the end of the study to be sure the subjects did not excrete calories during overfeeding. Only 38 calories a day got flushed down the toilet during overfeeding — 13 calories more than during normal eating.
Here is the fate of the 1,000 excess calories the subjects ate:
The researchers used highly accurate methods to measure changes in body fat (DXA). Some of the subjects gained 10 times more fat than others, ranging from 0.8 to 9 lbs (0.36 – 4.23 kg). The overall weight gain ranged from 3 to 12 lbs (1.4 -5.5 kg), some of which was additional muscle. NEAT explained the big variation in weight gain that occurred with the subjects in this overfeeding study. The subjects who were good fidgeters and putterers gained less.
The average increase in NEAT was 336 calories a day, but this actually ranged from burning 98 calories less than baseline to burning 690 calories more than baseline. The subject who burned the most calories strolled around the research facility (or did equivalent movement) about 15 minutes more per hour than the other subjects.
Despite popular belief, the ease of gaining weight is unlikely due to having a “slow metabolism.” Most often, athletes who are easy gainers are mellow, sit calmly, and don’t fidget. This contrasts to teammates that are bouncing around the locker room. If you are the mellow-type, blame your genetics — not a slow metabolism — for your ease of weight gain. And perhaps you can be grateful you can spend less money on food because you don’t eat as much?
References
Levine J, N Eberhardt, M Jensen. Role of Nonexercise Activity Thermogenesis in Resistance to Fat Gain in Humans. Science 283:212-214, 1999.
Levine J, Vander Weg M, Hill J, Klesges R. Non-exercise activity thermogenesis: the crouching tiger hidden dragon of societal weight gain. Arterioscler Thromb 26(4):729-36, 2006.
From The Athlete’s Kitchen; Copyright: Nancy Clark, October 2014
Boston-area sports nutritionist Nancy Clark, MS, RD offers one-on-one consults with both casual and competitive athletes. Her private practice is in Newton, MA (617-795-1875). For information about her Sports Nutrition Guidebook (2014) and food guides for runners, cyclists and soccer players, see www.nancyclarkrd.com. For online education, see www.NutritionSportsExerciseCEUs.com
October is National Breast Cancer Awareness Month, when pink ribbons remind women to schedule their mammograms and honor those who have died from or survived breast cancer. According to the National Cancer Institute, one in eight American women (12.3%) will develop invasive breast cancer during her lifetime.
After being unemployed for over two years and receiving several reject letters from jobs I applied for, I decided to add volunteer service to my resume. This was some of the most rewarding work I’d done in a long time.
What should I eat before I exercise?
That’s the question athletes of all ages and abilities most commonly ask when I’m presenting a sports nutrition workshop. While most people expect a simple response, such as “Eat a banana” or “Have a slice of toast,” the answer is actually complex and depends on many factors. After all, we are each an experiment of one.
The following information can help you figure out the best way to fuel your body before you exercise.
Does what you eat within 30 minutes of exercise offer performance benefits?
Your body can actually digest and use the food you eat before you exercise as long as you are exercising at a pace you can maintain for more than 30 minutes. Research also suggests that eating a snack just five minutes before moderate exercise can improve performance compared to exercising on empty. Yet, if you will be doing intense exercise—an erg test, track workout, or heavy weight lifting session, you should experiment to determine the best time to eat. You will likely feel more comfortable allowing two or three hours for your pre-exercise food to digest and empty from the stomach.
Will pre-exercise food cause heartburn or nausea?
While many people can comfortably tolerate pre-exercise food, others experience stomach distress. If the food you eat within the hour pre-exercise “talks back to you,” figure out:
What if I exercise in the early morning, before my stomach is awake?
If you drag yourself out of bed to exercise at early o’thirty, before your body and your mind are fully awake, you might not want to eat much of anything. I know of 
many rowers, runners, swimmers, and ice hockey players who eat their breakfast the night before. That is, instead of eating a bowl of cereal at 5:30 a.m., they enjoy it at 10:00 pm, before going to bed. This food helps them wake up in the morning with a normal blood glucose (blood sugar) level, and provides energy for an enjoyable and effective workout.
What if pre-exercise food contributes to diarrhea and undesired pit stops?
Food generally takes one or two days to travel through the intestinal tract. Hence, an undesired pit-stop during a long run on Sunday might relate to food that you ate the day or two before. That is, if you ate an unusually large bowl of high-fiber bran cereal on Saturday when carbo-loading for the Sunday long run, you might end up wishing you’d carbo-loaded on low-fiber corn flakes or Rice Chex. Or maybe that bean burrito on Friday night caused the problem? You can try tracking your food and fiber intake, looking for suspicious patterns.
In general, exercise speeds up intestinal motility. With time, most bodies can adjust if you train your intestines to handle pre-exercise food. For example, one runner started by nibbling on one pre-exercise pretzel, and then two, and gradually built up his tolerance to the suggested 100 to 300 calories of carbs consumed within the hour pre-exercise. He enjoyed the benefits of feeling stronger at the end of his runs.
Should I purposefully not eat before I exercise because I want to lose weight while I exercise?
One client reported she didn’t eat before she went to the gym because she was exercising to burn calories. Why would she want to add calories to her diet? Wouldn’t that defeat the main purpose of her workouts?
Think again: If you consume 100 to 300 calories before you workout, you will be able to exercise harder, at higher intensity and burn more calories than if you schlep through the session on fumes, with little enthusiasm or enjoyment. (Plus, you will not be as hungry afterwards and will be able to refrain from over-indulging.) Trust me, the plan to exercise-on-empty is hard to sustain; it is not fun. Just notice the drop-off in attendance at the gym between Jan. 1 and Feb. 1…
Food is fuel. As an athlete or a fitness exerciser, you need to fuel your body appropriately—including pre-exercise. Just as you put gas in your car before you take it for a drive, you want to put fuel in your body before you embark on a busy day. Be as nice to your body as you are to your car, please!
By eating nothing before my morning workout, won’t I burn more fat?
You may have heard you can burn more fat during low-level “fat burning exercise” if you do not eat beforehand. Yes, you might burn more fat than carbohydrates, but burning fat differs from losing body fat. You lose body fat when, at the end of your day, you have created a calorie deficit. That is, you will lose body fat (weight) if you have eaten only 1,800 calories by bedtime, even though you burned off 2,200 calories during the day. By fueling pre-exercise, you can have a better workout—and perhaps burn more calories than if you were to run on fumes.
To lose body fat, I suggest you fuel adequately by day, so you will have energy to enjoy an active lifestyle, and then lose weight at night by eating a lighter dinner. Fueling by day and dieting by night (so you lose weight when you are sleeping), is far preferable to restricting by day only to over-indulge at night due to extreme hunger.
Can training on empty enhance endurance?
Some recent research suggests that highly competitive athletes might be able to enhance their performance if they train under-fueled a few times a week. These depletion workouts can alter muscle metabolism so that the muscles are able to compete better when fully fueled.
If you want to “train low,” be sure to do your important high intensity workouts when you are well fueled. You cannot (enjoyably) exercise hard when you are running on fumes. Your performance will suffer unless you do some high quality hard workouts when you are well fueled.
From The Athlete’s Kitchen; Copyright: Nancy Clark, September 2014
Boston-area sports nutritionist Nancy Clark, MS, RD offers one-on-one consults with both casual and competitive athletes. Her private practice is in Newton, MA (617-795-1875). For information about her Sports Nutrition Guidebook (2014) and food guides for runners, cyclists and soccer players, see www.nancyclarkrd.com. For online education, see www.NutritionSportsExerciseCEUs.com
The specialized program, combining structured physical activity with health education to build self-efficacy and effect behavior change, helps to reduce lower extremity joint pain.
Like it or not, every one of us is getting older, day by day. As a fitness exerciser or an athlete, you might wonder how aging impacts performance—and what you can do to retain youthful fitness. The following information is gathered from a workshop (www.sportsnutritionworkshop.com) presented by Dr. William Evans, an exercise physiologist and expert on aging, muscles, and protein. The following information can help you chart a healthy course into your future.
What percentage of my diet should come from carbohydrates? … Should I exercise on empty? … How much protein should I eat after I lift weights? … Is whey the best source of protein?
These are just a few of the questions addressed at the annual meeting of SCAN, the Sports And Cardiovascular Nutritionist’s practice group of the American Dietetic Association (www.SCANdpg.org). Over 400 sports dietitians gather to learn the latest news from prominent sports nutrition researchers. I hope this information will help you choose a winning sports diet.
Louise Burke, PhD, Director of Sports Nutrition at the Australian Institute of Sport, addressed the following questions:
• What’s the best percentages of carbohydrates, protein, and fat for a sports diet — 40-30-30 or 60-25-15?
Neither! A better approach is to define nutrient needs according to body weight. For example, the International Olympic Committee developed these guidelines:
Intensity of exercise gram carb/kg body wt gram carb/lb body wt
Low intensity 3-5 g 1.5-2.5
Moderate (~1 hour/day): 5-7 g 2.3-3.2
Endurance (1-3 hours/d): 6-10 g 2.5-4.5
Extreme (>4-5 hours/d): 8-12 g 3.5-5.5
• How much should I eat during exercise?
During exercise that lasts 1 to 2.5 hours, you want to target 30 to 60 grams of carbohydrate (120 to 240 calories) per hour. That’s about 1 to 2 gels or 16 to 32 ounces of a sports drink per hour (after the first hour, if you ate a pre-exercise meal or snack)
During endurance exercise, 60 to 90 grams of different sources of carbohydrates (such as sports drink, banana, gummy candy) per hour is appropriate, as tolerated. Consuming the higher end of the range (90 g, as compared to 60 g) is associated with greater stamina and endurance.
• How long does it take to refuel from exhaustive exercise?
If you eat a carb-rich sports diet, you can replenish depleted glycogen stores in 24 to 36 hours post-exercise (with no exercise during that time). While it’s important to pay attention to your recovery diet, most athletes do not need to eat immediately after exercise unless they are doing double workouts. (Within an after exercise, yes; immediately, no.)
• What can I do if I cannot tolerate any food during exercise?
Try mouth swishing with a sports drink. This sends a message to the brain that energy is forthcoming and you’ll feel more energetic. Swishing can enhance performance by 2% to 3% if you are exercising on empty and have not eaten pre-exercise—as often happens with morning exercisers. (Swishing seems to be less beneficial after a pre-exercise meal, but more research is needed to verify those findings.)
• Should I train with poorly fueled muscles, as a means to teach my body to burn more fat, so it spares the limited glycogen stores?
Training with low glycogen stores (“train low”) drives up the metabolic adaptations to burn more fat. By burning fat instead of glycogen, you’ll spare the limited glycogen stores. Theoretically, this should enhance stamina and endurance because glycogen depletion is associated with fatigue. To date, “training low” has been most effective in research with untrained individuals. Athletes who exercise with depleted glycogen are unable to exercise at high intensity and that may hinder performance.
Training with low glycogen during lower intensity workouts might be one way to stimulate the muscle adaptations to burn more fat (and thus spare the limited glycogen stores). But athletes should do their high intensity workouts when they are fully glycogen-loaded.
Exercise physiologist and researcher John Hawley, PhD of Melbourne, Australia acknowledged that train low/compete high is receiving a lot of attention among serious endurance and ultra-distance athletes. Hawley suggests “train low” should be defined as “train at 50% of resting muscle glycogen, 50% of the time”—and only for selected sessions. Training with low carbohydrate availability can be achieved by exercising with 1) low blood glucose, or 2) low muscle glycogen stores. Both generate adaptations that promote the training response and might be advantageous to competitive endurance athletes. Hawley cautions serious athletes that “training low” compromises training intensity and may lead to inferior performance during an event, particularly if the athlete needs to do a competitive sprint to the finish. That final sprint often determines who wins…
Stuart Phillips, PhD, professor of kinesiology, McMaster University in Ontario, Canada presented an update on protein, answering these questions:
• Do athletes need more protein than non-athletes?
While the recommended protein intake for the average American is 0.4 gram protein per pound body weight (0.8 grm protein per kg), most exercise scientists agree that athletes need a more to optimize muscular development: 0.5 to 0.8 grams protein per pound (1.2 to 1.7 grams of protein per kilogram) body weight per day. However, most young women and men generally consume about 0.55 to 0.65 g protein/lb (1.2 g and 1.4 g protein/kg) body weight per day, respectively. They can appropriately meet their higher need without supplements.
• How much protein do I need after I lift weights?
Consuming 20 grams of protein-rich food (Greek yogurt, tuna sandwich, 16 oz. chocolate milk) after resistance exercise is plenty to optimize the rate of muscle synthesis. Athletes should then continue to eat protein and carbs at meals and snacks throughout the day.
The highest rate of protein synthesis is 3 to 5 hours post-exercise. This raises the question: Should athletes who work out twice a day plan to avoid exercising during that time frame? The “good stuff” (building muscle) happens during rest and recovery and the “bad stuff” (muscle damage) happens during exercise. Remember: rest is an essential part of a strength training program!
• Should I buy whey protein supplements?
Probably not, unless you are a frail, elderly person with a limited food intake. Drinking milk (20% whey, 80% casein) and eating a balanced sports diet with adequate protein from many sources can be as effective as whey supplements. Hard, hard work is the basic trigger for bigger muscles!
From The Athlete’s Kitchen
Copyright: Nancy Clark MS RD CSSD, April 2011
Nancy Clark, MS, RD, CSSD (Board Certified Specialist in Sports Dietetics) helps both casual and competitive athletes win with nutrition. Her private practice is in Newton, MA (617-795-1875). Nancy Clark’s Sports Nutrition Guidebook and her food guides for new runners, marathoners offer additional information. They are available at www.nancyclarkrd.com. See also sportsnutritionworkshop.com.