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Questions and Answers about Nutrition
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Q: Outline the physiological consequences of eating disorders such as anorexia nervosa and bulimia?
A: The physiological signs and symptoms of anorexia nervosa include the following:
* Significant weight loss
* Recurrent overuse injuries and stress fractures
* Cold hands and feet and extreme sensitivity to cold temperatures
* Lightheadedness
* Inability to concentrate
* Hyperactivity
* Compulsive exercise beyond normal training
* Dehydration
* Electrolyte imbalance
* Irregular heartbeat and cardiac arrest
From Mental Health Net: “Profound physical symptoms also occur in cases of extreme starvation. These include loss of head hair, growth of fine body hair, constipation, intolerance of cold temperatures and low pulse rate. Certain endocrine functions also become impaired. In females this results in a cessation of menstruation (amenorrhea) and the absence of ovulation. Menstruation usually will not resume until endocrine balance is restored. Ovulation is suppressed because production of certain necessary hormones decreases. Anorexia in boys has effects similar to those in girls: severe weight loss, psycho-social problems and interruption of normal reproductive system processes.”
The medical/clinical signs and symptoms of bulimia include the following:
* Weakness, headaches, dizziness
* Frequent weight fluctuations
* Difficulty swallowing and retaining food
* Bloodshot eyes
* Erosion of tooth enamel because of repeated exposure to acidic gastric contents
* Dental cavitities and sensitivity to hot or cold food
* Swelling and soreness in the salivary glands (from repeated vomiting)
* Stomach ulcers
* Ruptures of the stomach and esophagus
* Abnormal buildup of fluid in the intestines
* Disruption in the normal bowel release function
* Electrolyte imbalance
* Dehydration
* Irregular heartbeat and in severe cases heart attack
* A greater risk for suicidal behavior
* Decrease in libido
Q: What are basal metabolic rate and resting metabolic rate?
A: The basal metabolic rate and resting metabolic rate both measure the energy required to maintain the systems of the body and to regulate body temperature at rest. The differences are usually based on research settings.
Basal metabolic rate (BMR) is usually measured after the subject has stayed overnight in a metabolic chamber or research ward and has not eaten in the last 12 hours.
Resting metabolic rate (RMR) usually means the subject slept at home and drove or was driven to the research lab for testing, but still followed a 12-hour fast.
These usually differ by less than 10 percent. RMR usually accounts for 60 to 80 percent of total daily energy expenditure in most sedentary adults. This percentage will vary greatly in active individuals.
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Q: What are the best ways to measure body fat?
A: There are a number of different ways to measure body fat, each with pros and cons, depending on your circumstances.
Underwater (hydrostatic) weighing
Known as the gold standard, this method is generally done in a health-care or research setting and is not widely available to the public. It requires the subject/patient to expel the breath and then hold like this under water so that an accurate underwater body density can be measured. The results are highly reliable, but this may be a difficult procedure for some individuals.
Skin fold (Skinfold) measures
This is a very technique-sensitive method, and results vary from operator to operator. Consistency is dependent on the skill of the operator. There can be a 2 to 4 percent standard deviation, and this can easily be much greater depending on the skill of the operator. This method is commonly available to the public through dietitians and personal trainers.
Bioelectrical Impedance Analysis (BIA)
Commonly found at health clubs, gyms, and health-care offices, BIA is a relatively new body-composition analysis technique and is highly dependent on hydration levels. BIA results are often very similar to those of skin-fold analysis. For consistent and accurate results, measurement conditions should be as consistent as possible:
Do not consume alcohol within 48 hours prior to test
Avoid intense exercise 12 hours before test
Avoid eating or drinking (especially products containing caffeine) 4 hours before the test.
Empty bladder 30 minutes before the test. Avoid all diuretics for 7 days before test (if possible)
Measure in bare feet
Measure 3 hours after waking
Dual-Energy X-Ray Absorptiometry (DXA)
Available only at major medical centers, DXA assesses regional and total bone mineral content as well as regional and total fat and fat-free content of soft body tissues. Promising research has validated DXA as an approach for assessing body composition.
Q: What is body mass index?
A: Body mass index (BMI) is a mathematical ratio of height to weight that can be linked with body composition (or body fat percentage) and with indices of health risk. People with a BMI of 25 to 29.9 are considered overweight, and people with a BMI of 30 or above are considered obese. A high BMI assumes a higher percentage of body fat, which places a person at greater risk for developing chronic diseases such as diabetes mellitus, hypertension, heart disease, and even cancer.
However, for some people the BMI is not a reliable indication of health. A highly muscled individual who is very fit and healthy may have a somewhat heavy body weight because muscles pack on a lot of pounds. This person may have a high BMI that improperly puts him or her in the overweight or obese categories. Likewise, thin individuals who have a low body weight with very little muscle and a higher percentage of fat may have a normal BMI, which would be an incorrect indication of healthiness.
Q: Can caffeine enhance athletic performance?
A: This depends on the user. Caffeine will certainly hurt the athletic performance of individuals who are sensitive to the effects of caffeine. So if you get “caffeine jitters,” don’t use it. Caffeine is also a mild diuretic. If you are not well hydrated to begin with, caffeine may exacerbate your dehydration, which will hurt performance. Caffeine is also a natural cathartic, so if you are getting ready to compete in a long race and are sensitive to this effect of caffeine, it may not be very helpful, either.
Caffeine is the most widely used drug in the world. In the athletic world caffeine has been touted as an energy-promoting and fat-burning aid. In athletic competition, caffeine is a “controlled or restricted drug” and is banned by the International Olympic Committee if urine levels exceed allowable limits. It is also banned by the NCAA in amounts that exceed urine levels of 12 micrograms of caffeine per milliliter of urine.
Numerous research studies have examined the influence of caffeine on athletic performance. The results are not crystal clear, but laboratory studies have shown that moderate doses of caffeine (3 to 9 milligrams per kilogram of body weight) at least one hour prior to exercise can enhance exercise performance. (A typical 5 to 6 ounce cup of brewed coffee contains approximately 100 milligrams of caffeine.)
Note that the research has shown positive impacts on performance primarily when the subjects have been trained athletes who habitually use caffeine. The majority of this research has been done in laboratories rather than at actual competitions, so no one is really sure if it works in the field the same way it does in the laboratory.
According to the researchers, many factors can affect exercise performance and the physiological response to caffeine during exercise, including a person’s typical or habitual caffeine intake. Caffeine appears to increase fat oxidation (burning) at rest, but it does not increase fat oxidation after the first few minutes of exercise.
The use of caffeine as a significant fat-burning aid during exercise is not supported by the scientific literature.
Q: Can calcium supplements increase your risk for kidney stones?
A: According to the National Research Council’s Recommended Dietary Allowances (10th edition), it’s better not to exceed the recommended daily allowance (RDA) for calcium. Too much calcium may cause constipation, deteriorated kidney function, and other problems. It can also increase the risk of developing urinary stones in healthy males with already high levels of calcium.
The recommendations, called Daily Reference Intakes (DRIs), for calcium from food and dietary supplements are as follows:
* Women aged 19-50: 1,000 milligrams * Women aged 51-70+: 1,200 milligrams * Pregnant women: 1,000 milligrams * Lactating women: 1,000 milligrams * Men aged 19-50: 1,000 milligrams * Men aged 51-70+: 1,200 milligrams
Q: What is a calorie?
A: A calorie is a unit of energy. A calorie spelled with a lowercase c is the amount of heat required to raise the temperature of 1 gram of water 1 degree Centigrade. This is the term used by scientists in chemistry and biochemistry, and it is equal to 4.184 joules (J).
A calorie is such a small unit of measurement that food scientists tend to express the energy value of food in terms of a Calorie spelled with a capital C, or more accurately, a kilocalorie (kcal). A kilocalorie is the amount of heat required to raise the temperature of 1,000 grams (or 1 kilogram) of water 1 degree Centigrade. Calorie and kilocalorie are synonymous terms used in human nutrition and metabolic studies.
Q: How many calories does an athlete need each day?
A: Athletes’ calorie needs range widely, depending on the age of the athlete, the time of year, the intensity of training, and the sport. Calorie needs commonly fall within the range of 15 to 25 calories per pound of body weight.
Those on the low end are often smaller individuals who are trying to maintain a low percentage of body fat and who do not participate in endurance exercise events. These might include gymnasts, figure skaters, dancers, and wrestlers.
On the higher end are athletes who are trying to build muscle and/or perform endurance exercise, such as weight lifters, long-distance athletes, and mountain climbers.
Q: What are carbohydrates and why are they important in a healthy diet?
A: Carbohydrates, along with protein and fat, make up the energy-yielding nutrients found in food. The major role of carbohydrates in the body is to provide fuel or energy for all the body processes. In fact, certain tissues in the body, such as the brain and nervous system, derive energy only from glucose, a form of carbohydrate.
A diet that is rich in carbohydrates means that the body does not need to use protein as a fuel source, freeing protein to perform its primary job of making and maintaining muscles and other body tissue. Additionally, using carbohydrate as fuel places less stress on the body and its organs than using protein as fuel.
Good food sources of carbohydrates include fruits, vegetables, grains, breads, cereals, and dairy foods. These carbohydrate sources are also important sources of vitamins, minerals, fibers, and other important phytochemicals.
Q: I have had weight issues for many years. I have found that if I eat carbohydrates I am very tired with no energy at all. If I steer clear of carbohydrates I have more energy and I seem to be able to make it through the day. What is the least amount of carbohydrates I can have and not do any damage to my body?
A: The body actually needs very little carbohydrate to survive. But 'just surviving' is probably not your goal.
Carbohydrate is the body's preferred source of fuel. When added appropriately to the diet, the right amount of carbohydrate should make you feel energetic. You should choose whole grain cereals and breads, raw and cooked vegetables, and fruits as your primary sources of carbohydrate. Combine these foods at meals and snacks with other foods that contain small amounts of protein and/or fat—a turkey sandwich, for example, or cereal with milk—to slow absorption times and maintain more even blood sugar levels.
A generally healthful diet contains approximately 60 to 65 percent carbohydrate, 15 percent protein, and less than 30 percent fat.
My first suggestion is to begin to track what you are actually eating by keeping a log. This will let you know how much carbohydrate, protein, and fat you are actually eating, as well as calories.
There are several possible explanations for your situation. Most likely, the explanation is a combination of several factors.
1. The foods that you describe as carbohydrate foods may also contain large amounts of fat, such as a baked potato with sour cream, a bagel with cream cheese, or a commercial muffin. The high amounts of fat are slowly digested and absorbed, and they may make you feel sluggish.
2. When you eat foods that are predominantly high in carbohydrates, and especially refined carbohydrates, you may not be combining them at the same meal with foods high in protein and/or fat. In this case, the carbohydrate is rapidly digested and absorbed, resulting in a surge of the hormone insulin, which rapidly moves the digested carbohydrate (blood sugar) into your cells. This causes a short-lived drop in blood sugar levels that may make you feel fatigued, or low on energy.
3. Less likely explanations include various metabolic disturbances, which should be checked by your physician.
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Q: What is creatine, and what effect can it have on athletic performance?
A: Creatine is a substance produced in the liver and kidneys—at a rate of about 2 grams a day—from the nonessential amino acids arginine, glycine, and methionine.
About 95 percent of the body’s creatine travels by the blood to be stored in the muscles, heart, and other body cells. Inside muscle cells, creatine is turned into a compound called creatine phosphate (CP).
CP serves as a tiny energy supply, enough for several seconds of action. CP thus works best over the short haul, in activities like strength training that require short, fast bursts of activity. CP also replenishes your cellular reserves of adenosine triphosphate (ATP), the molecular fuel that provides the power for muscular contractions. With more ATP around, your muscles can do more work.
You can load creatine into your muscle, just like endurance athletes do with carbohydrates. Consequently, you can push harder and longer in your workouts because creatine boosts the pace of energy production in your muscle cells.
Creatine supplementation does not build muscles directly, but it does have an indirect effect. It allows you to work out more intensely, and this translates into muscle gains. More muscle equals more power equals enhanced athletic performance.
Q: Why is a diet high in fat dangerous?
A: First, a high-fat diet is often a high-calorie diet, which will promote obesity and being overweight. Being overweight or obese is a primary risk factor for the development of many diseases, including heart disease, diabetes mellitus, many types of cancers, and degenerative osteoarthritis.
Even if you aren’t obese or overweight, a high-fat diet has a negative influence on the risks of developing many of the same diseases, including heart disease and cancer. People who have high-fat diets often do not consume enough other important foods and nutrients. These include fruits and vegetables, vitamins, minerals, phytochemicals, and fibers, which are important for promoting health and preventing disease.
Q: What are the symptoms of dehydration?
A: I have broken the symptoms of dehydration down into early signs and severe signs.
Early signs: Fatigue Loss of appetite Flushed skin burning in stomach Light-headedness Headache Dry mouth Dry cough Heat intolerance Dark urine with a strong odor
Severe signs: Difficulty swallowing Stumbling Clumsiness Shriveled skin Sunken eyes and dim vision Painful urination Numb skin Muscle spasm Delirium
Q: Is there a difference between a nutritionist and a dietitian?
A: There is a difference between a registered dietitian (RD) and any other title referring to an individual who works with food and/or nutrition. A registered dietitian has a minimum of a four-year undergraduate college degree in nutrition or a related field that meets the requirements set by the Commission on Dietetic Registration (CDR, a national certifying body). Registered dieticians must also complete a supervised field experience (internship) that meets requirements set by the CDR and pass a national examination certified by the CDR.
Q: You recommend eating a small snack before working out. Other experts say the best time to work out is first thing in the morning and on an empty stomach. What are the benefits of eating before working out?
A: Eating an hour or more prior to exercise has several benefits:
1. It fuels and hydrates the body.
2. It prepares the body with necessary nutrients for recovery and muscle growth after exercise.
3. It may limit the amount of tissue damage that naturally occurs with intense exercise.
If it is difficult for you to eat early in the morning before your workout, make sure that your daily nutrition meets your body's needs. Drink water or a sports drink before your workout to enhance hydration and to provide a small amount of fuel for your body. You could also try a blended beverage, like a homemade smoothie or a liquid meal replacement beverage of around 200 calories of carbohydrate and protein. You’ll feel better during your workout and afterward.
Q: I've recently gained about 5 pounds for seemingly no reason. I work out for an hour and a half most days (5-6/week), I eat a mostly vegetarian diet, and I seldom drink alcohol. I haven't changed any of my habits lately, so I'm wondering if it's possible my weight gain could be because I'm consuming too few calories and my body is in 'starvation mode.' Also, I live in NYC, so I walk everywhere and climb a lot of stairs! I've started cutting back even more food, for fear of gaining more weight, but this hasn't helped. Why have I gained weight when I hardly eat anything??
A: The syndrome of starvation adaptation can occur over a period of time when the number of calories consumed is so low that the body slows down its metabolism to meet the available energy supply. By continuing to lower your calorie intake, you will only make this problem worse.
However, it is impossible to diagnose this problem without a physical examination by a physician and a nutritional history by a registered dietitian working with the physician. There are also other possible medical explanations. I encourage you to seek medical advice from your physician and a registered dietitian. To find a registered dietitian in your area, go to the Eat right Web site for a referral from the American Dietetic Association.
Q: How do egg protein and soy protein compare?
A: The quality of protein is generally classified in one of two ways. The traditional method, called the Protein Efficiency Ratio (PER), determines the weight gain of growing rats fed a particular protein in comparison to a standard protein (egg whites). The higher the PER value, the better the protein.
The more contemporary method compares the amino acid profile of a protein to the essential amino acid requirements in humans established by the United Nations Food and Agriculture Organization. This method, known as the protein digestibility corrected amino acid score (PDCAAS), is recognized internationally as the best method of comparing proteins for humans. A protein with a PDCAAS of 1.0 indicates that the protein exceeds the essential amino acid requirements of the body and is an excellent source of protein.
Protein (PDCAAS/PER) Comments
Ovalbumin (egg); PDCAAS 1.00 / PER 2.8
Protein from egg whites is considered the reference standard to compare protein quality. Egg protein powders were once considered the best source of protein for supplements. However, egg protein is fairly expensive compared to other forms of quality protein. Therefore, use of egg protein in supplements has decreased.
Soy; PDCAAS 1.00 / PER 1.8–2.3
Soy is a high-quality protein extracted from soybeans. Soy protein concentrate (70 percent protein) and isolate (90 percent protein) are particularly good protein sources for vegetarians. Soy protein also contains isoflavone glucosides, which have a number of potential health benefits.
Q: How does regular exercise reduce body fat?
A: Exercise accomplishes two goals. First, it burns calories, which when combined with a calorie-reduced diet will help reduce body fat. Second, exercise builds muscle, the energy-burning tissue in the body. The more muscle you have, the more energy you burn to reduce fat in your body.
Q: Does exercise stimulate appetite?
A: Appetite is a highly individualized characteristic. It waxes and wanes depending on the intensity of exercise, as well as with the perception of the individual. Research studies are not wholly in agreement, but it appears that in general, appetite may be stimulated by exercise that is low to moderate in intensity. High-intensity exercise seems to inhibit appetite immediately after exercise. For people who exercise every other day, appetite seems to be stimulated on the non-exercise day. This may make up for any caloric deficits created on the exercise day.
Q: Do fat-free foods contain any fat?
A: According to labeling regulations, “fat-free” foods can contain no more than 1 gram of fat. So yes, they can contain some fat.
Q: What is the difference between saturated and unsaturated fat?
A: Dietary fats are composed of a string of carbon atoms bonded to hydrogen atoms. A fat in which all bonds between the carbon atoms are single bonds is known as a saturated fat because all the carbon atoms are filled to the brim, or saturated, with hydrogen atoms. Unsaturated fats have one or more double bonds between carbon atoms. They are called unsaturated because their structure still has room to bond with additional hydrogen atoms. Unsaturated fats with just one double bond between carbon atoms are known as monounsaturated fat. Those with two or more double bonds between carbon atoms are known as polyunsaturated fats.
Saturated fats have a hard consistency at room temperature. Foods high in saturated fats include beef, dairy products, commercially prepared baked goods, and tropical oils, such as coconut, palm, and palm kernel oils. These fats can raise blood levels of low-density lipoprotein (LDL) cholesterol to potentially dangerous levels. LDL cholesterol, commonly referred to as bad cholesterol, carries cholesterol in the blood to body cells. High levels of LDL cholesterol can lead to an increased risk of heart disease caused by cholesterol and fat deposits in the arteries.
Unsaturated fats are liquid at room temperature. They contain key nutrients, called essential fatty acids, which cannot be manufactured in the body and so are required in the diet in order to promote normal growth, skin integrity, and healthy blood and nerves. Two of the most important fatty acids are linoleic acid, found mostly in vegetable oils like corn and sunflower, and alpha-linolenic acid, found mostly in soybean and canola oils.
Both monounsaturated fats and polyunsaturated fats have been associated with lower levels of blood cholesterol. Monounsaturated fats have also been shown to lower LDL cholesterol in the blood while maintaining higher levels of high-density lipoproteins (HDL) cholesterol, often referred to as the good cholesterol. HDL cholesterol removes excess cholesterol from the body. People who have high blood levels of HDL cholesterol typically have a lower risk of heart disease. Monounsaturated fats are plentiful in olive oil, canola oil, peanut oil, shellfish, and fish from cold waters, such as salmon, halibut, mackerel, swordfish, black cod, and rainbow trout.
Q. What is an essential fatty acid, and why is it important in a healthy diet?
A. Fatty acid is the chemical term for the individual strands of molecules that make up the larger compound that we think of as fat. There are many fatty acids. Among all the fatty acids used by the body only two cannot be synthesized by the body in adequate amounts, and must therefore come from our diets. These two are linoleic acid and alpha-linolenic acid, and are called essential fatty acids. Essential fatty acids are required by the body for optimal health, normal growth, skin integrity, and healthy blood and nerves. Good sources of essential fatty acids include vegetable oils, nuts, and seeds.
Q: What is fiber, and why is it important in a healthy diet?
A: Fiber is an indigestible carbohydrate found in plant foods. Food nutritionists classify fiber according to its ability to dissolve in water. Water-soluble fibers, found in barley, rice, corn, oats, legumes, apples, pears, citrus fruits, bananas, carrots, dried plums, cranberries, seeds, and seaweed, have been shown to help regulate blood sugar and lower blood cholesterol. Water-insoluble fibers assist with the elimination of bile acids, preventing the formation of gallstones. In addition, cellulose, the roughage found in water-insoluble fibers, acts as a stool softener and bulk former, improving elimination and flushing carcinogens from the system. Good food sources of water-insoluble fibers include root and leafy vegetables, whole grains, legumes, unpeeled apples and pears, and strawberries.
Diets low in fiber have been linked to dozens of medical problems, including heart disease, cancer, diabetes mellitus, diverticulitis, and gallstones. The American Dietetic Association recommends that a healthy diet include 20 to 35 grams of fiber per day.
Q: What are food additives and do they add any nutritional benefits to food?
A: A food additive, broadly defined, is any substance used in or around food that may become a component of the food. Some food additives—called intentional additives—are introduced specifically for the purpose of improving the nutritive value, taste, texture, or shelf life of the product. Other additives enter food as residues after some stage of production or manufacture; these are known as incidental additives.
Q: What is food irradiation?
A: Food irradiation is a preservative process that is being considered more widely in our food supply as an alternative to chemical additives. It treats food with radiation to kill pests and bacteria. In this process, food is conveyed through a lead-lined chamber, where it is exposed to cobalt-60, a radioisotope that has been used in hospital settings for more than 30 years. The Food and Drug Administration (FDA) regulates the doses, which are carefully measured and monitored. The food has no chance to become contaminated with radioactivity.
Even so, this process raises some legitimate concerns. Studies have shown that food irradiation alters nutrients and chemicals in foods in much the same way canning, freezing, pasteurization, and cooking do. Not only that, irradiation forms new substances in foods—substances not present prior to processing. As yet, we have limited information on the health effects of consuming these by-products of irradiation. Tests on the process are ongoing.
However, the FDA has already given a go-ahead to the use of irradiation within specified doses for spices, some meats, fruits, and vegetables. The process is supposed to thwart insect infestation, kill Trichinella spiralis (the pork parasite responsible for widespread disease), and keep tuberous vegetables (such as potatoes) from sprouting.
Q: What are the health benefits of green tea?
A: The media and marketing claims for green tea are that it is a strong antioxidant and anticancer agent, that it protects the heart, and that it fights viruses and bacteria.
Although much more research is needed before we can draw conclusions, evidence from laboratory, animal, and population studies suggests that green tea does in fact have anti-carcinogenic effects, meaning that it might protect against cancer. Also, chemicals found in green tea called polyphones have demonstrated antioxidant capabilities both in the laboratory and in humans.
At this time research does not support claims that green tea protects the heart from high cholesterol levels or promotes resistance to the oxidation that causes arterial plaques. Preliminary evidence shows that green tea extract might inhibit bacterial growth and the influenza virus, but more research is needed to confirm these studies.
Q: What is the difference between HDL and LDL cholesterol?
A: HDL means “high-density lipoprotein,” and LDL means “low-density lipoprotein.” There are many fractions of total cholesterol in our bloodstream. HDL and LDL are two of the fractions that carry cholesterol.
Research shows that LDL and HDL are highly associated with risk of developing heart disease. LDL, also called “the bad cholesterol,” allows cholesterol to build up in arteries and can ultimately clog arteries enough to cause a heart attack or a stroke. HDL, also called “the good cholesterol,” helps clear cholesterol out of the bloodstream and ultimately out of the body.
The higher your levels of LDL, the greater your risk for heart disease. The lower your LDL levels, the lower your risk for heart disease. The opposite is true for HDL. The higher your HDL levels, the lower your risk for heart disease. Low HDL levels are associated with a greater risk for developing heart disease.
The American Heart Association Web site offers the following information:
Cholesterol is measured in milligrams per deciliter of blood (mg/dL). Healthy LDL and HDL cholesterol levels:
LDL: less than 160 mg/dL (less than 130 mg/dL if you have two or more other risk factors for heart disease)
HDL: greater than 40 mg/dL
Total cholesterol
Less than 200 mg/dL = desirable blood cholesterol
200 to 239 mg/dL = borderline-high blood cholesterol
240 mg/dL and over = high blood cholesterol
Q: Will drinking a beverage high in sugar content within an hour of exercise help or hinder athletic performance?
A: I don’t recommend that you consume sweet foods and beverages within an hour of exercise primarily because they will not be emptied quickly from the stomach, and they may even have a dehydrating effect on cells by drawing fluids out of the cells to create an osmotic balance or equilibrium.
In some individuals, insulin levels may peak to cover the high intake of carbohydrate, causing a drop in blood sugar levels early into exercise that may diminish performance. However, consuming a carbohydrate snack or a beverage containing 6 to 8 percent carbohydrate, such as a sports drink, within an hour of exercise may enhance both hydration and energy availability, thereby helping performance.
Q: What happens in the body when an athlete “bonks” or ”hits the wall”?
A: An athlete “hits the wall” when stores of muscle glycogen (the stored carbohydrate in muscle) get too low. An athlete who “hits the wall” during a race will feel tremendous fatigue and want to quit.
Different from “hitting the wall,” “bonking” is when liver glycogen stores are depleted, with or without a depletion of muscle glycogen. During exercise, stored glycogen in the liver maintains normal blood sugar levels so that the brain can function. When liver glycogen levels are depleted and blood sugar levels drop, athletes feel weak, uncoordinated, light-headed, and unable to concentrate.
Q: You recommend eating a full meal two hours after working out. But it’s 9 p.m. by the time I’m done working out, and I'm trying to lose a few pounds. What should I eat so late at night?
A: It is hard to eat so late at night, but your body needs nourishment after exercise to recover, build, and refuel for your next workout. Fluids and carbohydrates are the most important. And if you still need protein to balance out your day's needs, you should have it before you go to bed too. The meal can be small, about 250 to 300 calories. Make sure to drink water. You could also eat a bowl of cereal with milk, a turkey sandwich, or a tuna salad with a baked potato. If you prefer to drink rather than eat, try a meal replacement beverage that contains about 300 calories of carbohydrate and protein.
Q: What are very low calorie diets and who benefits from them?
A: Very low calorie diets (VLCDs) usually provide fewer than 1,200 calories per day. Anyone following this type of program should be under medical supervision. These types of diets have been shown to be useful for obese individuals who are beginning a weight-loss program. However, in order to maintain any weight loss, individuals must move toward and be instructed in planning and preparing a well-balanced diet of food. They must also be educated in lifestyle modification techniques, including exercise and stress reduction.
Q: What is the best meal to eat before a marathon?
A: In her book Eating for Endurance, Ellen Coleman recommends the following:
“Consume 1-4 grams of carbohydrate per kilogram of body weight, 1-4 hours before exercise. To avoid potential gastrointestinal distress, reduce the size of the meal—making it smaller as it is consumed closer to exercise time. For example, a carbohydrate feeding of 1 gram per kg of body weight (4 calories per kg) is appropriate an hour before exercise, whereas 4 grams per kg (16 calories per kg) can be consumed 4 hours before exercise.”
Consumption of fatty foods should be limited in the pre-event meal since they are digested more slowly and may make you feel sluggish. Watch out for high-protein foods that are also high in fat, like egg yolks, fried eggs, and cheese. Limit the amount of fiber in your pre-event meal, too. It will slow down digestion and make you feel full.
Good pre-event choices include fruit, bread products, jams and jellies, nonfat or low-fat yogurt, fruit juices, and nonfat milk. Liquid meals or high-carbohydrate supplements may also be useful. They are rapidly emptied from the stomach, making the nutrients readily available without leaving you feeling too full.
Make sure you are well hydrated, and don’t depend on drinking a couple of glasses of water before your event. It takes at least 24 hours for the body to become fully hydrated once it has been dehydrated. So have a fluid plan before your race, just like you have a food plan.
Lastly, try out your pre-event fluid and food plan during a training run before race day to make sure it works for you. Never try something on the day of the race that you have not tried before.
Q: Do multivitamins contain other ingredients besides vitamins and minerals?
A: A multivitamin may contain only vitamins, or it may contain vitamins and minerals. Other nonessential nutrients may also be added. Since there is little regulation of the nutritional supplements industry, it is wise for all consumers to read labels and be well informed prior to purchasing nutritional supplements.
Fillers, such as cellulose, are often used to bulk the vitamin pill and hold it together. Drying agents, such as silicon, may be used to keep the pills from becoming soggy from water in the air.
There are a number of agents that are used to coat the pills as well. All of these should be listed clearly on the label. If you have any questions about these ingredients, you should contact the manufacturer and/or the U.S. Food and Drug Administration.
Q: I have a friend who runs long distances—marathons and such. He says he can't bend over and touch his toes because his muscles are so tight. I am a molecular biologist, and I seem to recall that lactose dehydrogenase may play a role in my friend’s condition. Is there a dietary connection? If not, what could be causing this? Is there any way to reduce his muscle tightness?
A: Flexibility is influenced by a number of things, most notably genetics and training. To maintain and increase flexibility, one must practice flexibility routines, just as one must exercise to enhance exercise performance. It is unlikely that lactase buildup in the muscles would be responsible for chronic muscle tightness, since lactase buildup is a transient condition that follows exercise. I suggest that your friend consult with a certified personal trainer and/or a sports medicine physician to resolve the issue.
Q: What does the term “organic” on a food label mean?
A: Foods that are certified organic are grown in soil enriched with organic fertilizers, rather than synthetic fertilizers, and are treated only with nonsynthetic pesticides. More specifically, it means that the food has been produced, stored, processed, and packaged without the use of synthetic fertilizers, herbicides, fungicides, or pesticides for one year prior to the appearance of flower buds in the case of perennial crops and one year prior to seed planting in the case of annual crops.
Organic farms use a soil-building program that promotes vibrant soil and healthy plants, usually including crop rotations and biological pest control.
Q: Will a diet high in milk and other dairy products prevent osteoporosis?
A: A diet high in milk and other dairy products that provide the nutrients essential for building and maintaining bones is one important factor in decreasing the risk of developing osteoporosis. There are other ways that a person can decrease the risk of developing osteoporosis. These include getting at least 30 minutes of moderate exercise each day, not smoking, and limiting alcohol and caffeine intake.
Other factors are difficult or impossible to control. People with a family history of osteoporosis are more likely to develop the disease, as are women who have gone through menopause and people who take certain medications. Women who have gone through menopause, women who experience an abnormal absence of menstrual periods (amenorrhea), and individuals who have a low bone density in early adulthood are also at higher risk.
Q. What is protein, and why is it important in a healthy diet?
A. Protein is a macronutrient with a chemical structure containing carbon, hydrogen, oxygen, and nitrogen. It is the nitrogen that gives protein its unique properties. Protein is made up of smaller units called amino acids, which are connected together like a strand of pearls. If two strands of pearls were wound together and then twisted to double up on each other, they would resemble a protein molecule.
Your body breaks down protein from food into amino acids and reshuffles them into new protein to build and rebuild tissue, including muscle. Protein also keeps your immune system functioning up to par, helps carry nutrients throughout the body, has a hand in forming hormones, and is involved in important enzyme reactions such as digestion.
There are 20 different types of amino acids, and all can be combined to form the proteins necessary to build the body and keep it healthy. Some of these amino acids can be made by the body and are called nonessential amino acids.
Others have to be supplied by the foods you eat. These amino acids are termed essential amino acids.
Animal and plant foods contain all 20 amino acids (but in different amounts depending on the food). Animal proteins and soy protein are of higher quality because they contain all the essential amino acids in larger amounts and better proportions. In plants, amino acids exist in smaller concentrations. For the body to make proteins properly, all 20 amino acids must be present at the same time.
Although amino acids work together to form body proteins, individual amino acids have specific roles to play in the body. Certain amino acids, such as tryptophan and tyrosine, are involved in the formation of chemical messengers called neurotransmitters for the brain and nervous system. Three amino acids (leucine, isoleucine, and valine) are constituents of muscle tissue.
Q: How do Recommended Dietary Allowances (RDA), the U.S. Recommended Daily Allowances (U.S. RDA), Reference Daily Intakes (RDI), and Daily Reference Values (DRVs) differ from one another?
A: The Recommended Dietary Allowances (RDA) was developed by the Food and Nutrition Board of the National Academy of Sciences in 1943. It provides a guide for the amounts of specific nutrients healthy people of the same gender and of similar ages need to consume to prevent deficiency problems. The recommendations have been revised every four to six years in response to new scientific information. These guidelines serve as the scientific basis for programs such as the United States Department of Agriculture’s Dietary Guidelines and National School Lunch Program.
The United States Recommended Daily Allowances (U.S. RDA) is the old name used for standards established by the Food and Drug Administration (FDA) that were used on food nutrition labels. The U.S. RDAs are a compilation of the guidelines found in the RDAs using the highest RDA values within specific age and gender categories, including children over 4 years and adults, infants less than 1 year, toddlers 1 to 4 years, and pregnant and lactating women.
Partly because the U.S. RDA was often confused with RDAs, in 1993 the FDA changed the name of U.S. RDAs to Reference Daily Intakes (RDI). In addition, the FDA established the Daily Reference Values (DRV) for nutrients such as fat and cholesterol for which no set of standards previously existed. Today the RDI and the DRV are used to form a single list of nutrient values known as Daily Values (DV) that are now used on nutrition labels.
Q: What factors determine if a weight loss program is sound and not a fad?
A: A healthy weight loss program should include a daily intake of at least 1,200 calories and should include all the food groups: fruits and vegetables, grains, dairy, protein foods, and fats. It should promote lifestyle modification such as exercise and offer techniques for learning how to change habits.
The basis of the diet should be food. A sound program helps people move from using a tool to help control calories and food choices toward a diet based solely on whole foods. The goal should be achieving and maintaining a healthy weight.
Ultimately, the dieter should be able to maintain weight loss without using any weight-loss tools. A fad diet will often make unsubstantiated claims, be very low in calories, eliminate whole food groups, use scare tactics and fear to attract the consumer, require that the dieter purchase foods only available from the program purveyor, and avoid teaching the dieter how to manage weight without the diet product.
Q: I have a B.S. in biochemistry and a master’s in education. I am currently teaching, but I’m extremely interested in your field. What are the options for a career in sports nutrition?
A: The field of sports nutrition is just taking off. Options include academic research and teaching, positions in industry (working for food or supplement manufacturers), consulting, and private practice. Individuals build a consulting business through experience in several ways, including spending time at a fitness facility, doing individual counseling, consulting with business and industry, writing and media work, and working with sports teams. This is a highly specialized field, and it requires academic degrees in nutrition and exercise science. Personal experience as an avid exerciser or athlete is also beneficial.
Q: Can tofu increase a person's risk for dementia?
A: There is one study published by researcher Lon White in the Journal of the American College of Nutrition that documented an association between the consumption of two or three servings of tofu per week in midlife (as a lifelong habit) and the early development of senile dementia and Alzheimer-related diseases in Japanese American men living in Hawaii. These dementias occurred about five years earlier than would have been predicted. A much less significant effect was observed in the women in the study.
The quantity consumed by the subjects of the study is much greater than the average American intake of tofu and soy. And this is just one study; it is not definitive proof of anything. Other documentation shows that the benefits of soy foods are hundredfold. I advise clients that, just like anything else, moderation is the key. When eaten in extremes, anything can become harmful.
Q: What are trace minerals and why are they important in the diet?
A: The body requires minerals in minute amounts. Like vitamins, they don’t yield any energy, although some play a behind-the-scenes role in energy production. Trace minerals are found in the body in the smallest concentrations and are needed in smaller amounts than the major minerals. The trace minerals are iron, iodine, chromium, fluoride, and molybdenum. In the following list, the trace minerals are given along with their function and the best food sources for obtaining them.
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Iron
Function: Oxygen transport to cells; formation of oxygen-carrying red blood cells; required for the production of certain antioxidant enzymes
Sources: Liver, oysters, lean meats, green leafy vegetables
Iodine
Function: Energy production; growth and development; metabolism
Sources: Iodized salt, seafood, sea vegetables, mushrooms
Chromium
Function: Normal blood sugar; fat metabolism
Sources: Corn oil, brewer’s yeast, whole grains, meats
Fluoride
Function: Bone and tooth strengthening
Sources: Fluoridated water
Molybdenum:
Function: Fat metabolism
Sources: Milk, beans, breads, cereals
Q: What are triglycerides?
A: Triglycerides are the chemical form in which most fat exists in food as well as in the body. They're also present in blood plasma and in association with blood cholesterol. Triglycerides in plasma are derived from fats eaten in foods or made in the body from other energy sources, such as carbohydrates. Calories ingested in a meal and not used immediately by tissues are converted to triglycerides and transported to fat cells to be stored.
Hormones regulate the release of triglycerides from fat tissue to meet the body's needs for energy between meals. Excess triglyceride in plasma is called hypertriglyceridemia. It's linked to the occurrence of coronary artery disease in some people. Elevated triglycerides may be a consequence of other diseases, such as untreated diabetes mellitus. Increases in triglyceride levels can be detected by plasma measurements.
According to the American Heart Association Web site, the Second Expert Panel on the Detection, Evaluation and Treatment of High Blood Cholesterol in Adults defined levels for hypertriglycerides. Here are their definitions:
Normal triglycerides - less than 200 mg/dL Borderline-high triglycerides - 200 to 400 mg/dL High triglycerides - 400to 1,000 mg/dL Very high triglycerides - greater than 1,000 mg/dL. These are based on fasting plasma triglyceride levels. *From the American Heart Association Web site.
Q: Which is better to drink during exercise—water or a sports beverage?
A: This depends on the exercise intensity and duration. When exercise is moderate in intensity and lasts one hour or less, water is the best sports drink around.
Sports beverages will enhance your performance if you are exercising at high intensity for 45 minutes or more, doing intermittent bouts of high-intensity exercise (such as soccer) for 45 minutes or more, or exercising at moderate intensity for 60 to 90 minutes or more.
Research shows the best beverages to drink during physical activity are 6 to 8 percent carbohydrate solutions (6 to 8 g of carbohydrate per 100 ml of beverage).
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Questions and Answers about Nutrition
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Q: Outline the physiological consequences of eating disorders such as anorexia nervosa and bulimia?
A: The physiological signs and symptoms of anorexia nervosa include the following:
* Significant weight loss
* Recurrent overuse injuries and stress fractures
* Cold hands and feet and extreme sensitivity to cold temperatures
* Lightheadedness
* Inability to concentrate
* Hyperactivity
* Compulsive exercise beyond normal training
* Dehydration
* Electrolyte imbalance
* Irregular heartbeat and cardiac arrest
From Mental Health Net: “Profound physical symptoms also occur in cases of extreme starvation. These include loss of head hair, growth of fine body hair, constipation, intolerance of cold temperatures and low pulse rate. Certain endocrine functions also become impaired. In females this results in a cessation of menstruation (amenorrhea) and the absence of ovulation. Menstruation usually will not resume until endocrine balance is restored. Ovulation is suppressed because production of certain necessary hormones decreases. Anorexia in boys has effects similar to those in girls: severe weight loss, psycho-social problems and interruption of normal reproductive system processes.”
The medical/clinical signs and symptoms of bulimia include the following:
* Weakness, headaches, dizziness
* Frequent weight fluctuations
* Difficulty swallowing and retaining food
* Bloodshot eyes
* Erosion of tooth enamel because of repeated exposure to acidic gastric contents
* Dental cavitities and sensitivity to hot or cold food
* Swelling and soreness in the salivary glands (from repeated vomiting)
* Stomach ulcers
* Ruptures of the stomach and esophagus
* Abnormal buildup of fluid in the intestines
* Disruption in the normal bowel release function
* Electrolyte imbalance
* Dehydration
* Irregular heartbeat and in severe cases heart attack
* A greater risk for suicidal behavior
* Decrease in libido
Q: What are basal metabolic rate and resting metabolic rate?
A: The basal metabolic rate and resting metabolic rate both measure the energy required to maintain the systems of the body and to regulate body temperature at rest. The differences are usually based on research settings.
Basal metabolic rate (BMR) is usually measured after the subject has stayed overnight in a metabolic chamber or research ward and has not eaten in the last 12 hours.
Resting metabolic rate (RMR) usually means the subject slept at home and drove or was driven to the research lab for testing, but still followed a 12-hour fast.
These usually differ by less than 10 percent. RMR usually accounts for 60 to 80 percent of total daily energy expenditure in most sedentary adults. This percentage will vary greatly in active individuals.
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Q: What are the best ways to measure body fat?
A: There are a number of different ways to measure body fat, each with pros and cons, depending on your circumstances.
Underwater (hydrostatic) weighing
Known as the gold standard, this method is generally done in a health-care or research setting and is not widely available to the public. It requires the subject/patient to expel the breath and then hold like this under water so that an accurate underwater body density can be measured. The results are highly reliable, but this may be a difficult procedure for some individuals.
Skin fold (Skinfold) measures
This is a very technique-sensitive method, and results vary from operator to operator. Consistency is dependent on the skill of the operator. There can be a 2 to 4 percent standard deviation, and this can easily be much greater depending on the skill of the operator. This method is commonly available to the public through dietitians and personal trainers.
Bioelectrical Impedance Analysis (BIA)
Commonly found at health clubs, gyms, and health-care offices, BIA is a relatively new body-composition analysis technique and is highly dependent on hydration levels. BIA results are often very similar to those of skin-fold analysis. For consistent and accurate results, measurement conditions should be as consistent as possible:
Do not consume alcohol within 48 hours prior to test
Avoid intense exercise 12 hours before test
Avoid eating or drinking (especially products containing caffeine) 4 hours before the test.
Empty bladder 30 minutes before the test. Avoid all diuretics for 7 days before test (if possible)
Measure in bare feet
Measure 3 hours after waking
Dual-Energy X-Ray Absorptiometry (DXA)
Available only at major medical centers, DXA assesses regional and total bone mineral content as well as regional and total fat and fat-free content of soft body tissues. Promising research has validated DXA as an approach for assessing body composition.
Q: What is body mass index?
A: Body mass index (BMI) is a mathematical ratio of height to weight that can be linked with body composition (or body fat percentage) and with indices of health risk. People with a BMI of 25 to 29.9 are considered overweight, and people with a BMI of 30 or above are considered obese. A high BMI assumes a higher percentage of body fat, which places a person at greater risk for developing chronic diseases such as diabetes mellitus, hypertension, heart disease, and even cancer.
However, for some people the BMI is not a reliable indication of health. A highly muscled individual who is very fit and healthy may have a somewhat heavy body weight because muscles pack on a lot of pounds. This person may have a high BMI that improperly puts him or her in the overweight or obese categories. Likewise, thin individuals who have a low body weight with very little muscle and a higher percentage of fat may have a normal BMI, which would be an incorrect indication of healthiness.
Q: Can caffeine enhance athletic performance?
A: This depends on the user. Caffeine will certainly hurt the athletic performance of individuals who are sensitive to the effects of caffeine. So if you get “caffeine jitters,” don’t use it. Caffeine is also a mild diuretic. If you are not well hydrated to begin with, caffeine may exacerbate your dehydration, which will hurt performance. Caffeine is also a natural cathartic, so if you are getting ready to compete in a long race and are sensitive to this effect of caffeine, it may not be very helpful, either.
Caffeine is the most widely used drug in the world. In the athletic world caffeine has been touted as an energy-promoting and fat-burning aid. In athletic competition, caffeine is a “controlled or restricted drug” and is banned by the International Olympic Committee if urine levels exceed allowable limits. It is also banned by the NCAA in amounts that exceed urine levels of 12 micrograms of caffeine per milliliter of urine.
Numerous research studies have examined the influence of caffeine on athletic performance. The results are not crystal clear, but laboratory studies have shown that moderate doses of caffeine (3 to 9 milligrams per kilogram of body weight) at least one hour prior to exercise can enhance exercise performance. (A typical 5 to 6 ounce cup of brewed coffee contains approximately 100 milligrams of caffeine.)
Note that the research has shown positive impacts on performance primarily when the subjects have been trained athletes who habitually use caffeine. The majority of this research has been done in laboratories rather than at actual competitions, so no one is really sure if it works in the field the same way it does in the laboratory.
According to the researchers, many factors can affect exercise performance and the physiological response to caffeine during exercise, including a person’s typical or habitual caffeine intake. Caffeine appears to increase fat oxidation (burning) at rest, but it does not increase fat oxidation after the first few minutes of exercise.
The use of caffeine as a significant fat-burning aid during exercise is not supported by the scientific literature.
Q: Can calcium supplements increase your risk for kidney stones?
A: According to the National Research Council’s Recommended Dietary Allowances (10th edition), it’s better not to exceed the recommended daily allowance (RDA) for calcium. Too much calcium may cause constipation, deteriorated kidney function, and other problems. It can also increase the risk of developing urinary stones in healthy males with already high levels of calcium.
The recommendations, called Daily Reference Intakes (DRIs), for calcium from food and dietary supplements are as follows:
* Women aged 19-50: 1,000 milligrams * Women aged 51-70+: 1,200 milligrams * Pregnant women: 1,000 milligrams * Lactating women: 1,000 milligrams * Men aged 19-50: 1,000 milligrams * Men aged 51-70+: 1,200 milligrams
Q: What is a calorie?
A: A calorie is a unit of energy. A calorie spelled with a lowercase c is the amount of heat required to raise the temperature of 1 gram of water 1 degree Centigrade. This is the term used by scientists in chemistry and biochemistry, and it is equal to 4.184 joules (J).
A calorie is such a small unit of measurement that food scientists tend to express the energy value of food in terms of a Calorie spelled with a capital C, or more accurately, a kilocalorie (kcal). A kilocalorie is the amount of heat required to raise the temperature of 1,000 grams (or 1 kilogram) of water 1 degree Centigrade. Calorie and kilocalorie are synonymous terms used in human nutrition and metabolic studies.
Q: How many calories does an athlete need each day?
A: Athletes’ calorie needs range widely, depending on the age of the athlete, the time of year, the intensity of training, and the sport. Calorie needs commonly fall within the range of 15 to 25 calories per pound of body weight.
Those on the low end are often smaller individuals who are trying to maintain a low percentage of body fat and who do not participate in endurance exercise events. These might include gymnasts, figure skaters, dancers, and wrestlers.
On the higher end are athletes who are trying to build muscle and/or perform endurance exercise, such as weight lifters, long-distance athletes, and mountain climbers.
Q: What are carbohydrates and why are they important in a healthy diet?
A: Carbohydrates, along with protein and fat, make up the energy-yielding nutrients found in food. The major role of carbohydrates in the body is to provide fuel or energy for all the body processes. In fact, certain tissues in the body, such as the brain and nervous system, derive energy only from glucose, a form of carbohydrate.
A diet that is rich in carbohydrates means that the body does not need to use protein as a fuel source, freeing protein to perform its primary job of making and maintaining muscles and other body tissue. Additionally, using carbohydrate as fuel places less stress on the body and its organs than using protein as fuel.
Good food sources of carbohydrates include fruits, vegetables, grains, breads, cereals, and dairy foods. These carbohydrate sources are also important sources of vitamins, minerals, fibers, and other important phytochemicals.
Q: I have had weight issues for many years. I have found that if I eat carbohydrates I am very tired with no energy at all. If I steer clear of carbohydrates I have more energy and I seem to be able to make it through the day. What is the least amount of carbohydrates I can have and not do any damage to my body?
A: The body actually needs very little carbohydrate to survive. But 'just surviving' is probably not your goal.
Carbohydrate is the body's preferred source of fuel. When added appropriately to the diet, the right amount of carbohydrate should make you feel energetic. You should choose whole grain cereals and breads, raw and cooked vegetables, and fruits as your primary sources of carbohydrate. Combine these foods at meals and snacks with other foods that contain small amounts of protein and/or fat—a turkey sandwich, for example, or cereal with milk—to slow absorption times and maintain more even blood sugar levels.
A generally healthful diet contains approximately 60 to 65 percent carbohydrate, 15 percent protein, and less than 30 percent fat.
My first suggestion is to begin to track what you are actually eating by keeping a log. This will let you know how much carbohydrate, protein, and fat you are actually eating, as well as calories.
There are several possible explanations for your situation. Most likely, the explanation is a combination of several factors.
1. The foods that you describe as carbohydrate foods may also contain large amounts of fat, such as a baked potato with sour cream, a bagel with cream cheese, or a commercial muffin. The high amounts of fat are slowly digested and absorbed, and they may make you feel sluggish.
2. When you eat foods that are predominantly high in carbohydrates, and especially refined carbohydrates, you may not be combining them at the same meal with foods high in protein and/or fat. In this case, the carbohydrate is rapidly digested and absorbed, resulting in a surge of the hormone insulin, which rapidly moves the digested carbohydrate (blood sugar) into your cells. This causes a short-lived drop in blood sugar levels that may make you feel fatigued, or low on energy.
3. Less likely explanations include various metabolic disturbances, which should be checked by your physician.
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Q: What is creatine, and what effect can it have on athletic performance?
A: Creatine is a substance produced in the liver and kidneys—at a rate of about 2 grams a day—from the nonessential amino acids arginine, glycine, and methionine.
About 95 percent of the body’s creatine travels by the blood to be stored in the muscles, heart, and other body cells. Inside muscle cells, creatine is turned into a compound called creatine phosphate (CP).
CP serves as a tiny energy supply, enough for several seconds of action. CP thus works best over the short haul, in activities like strength training that require short, fast bursts of activity. CP also replenishes your cellular reserves of adenosine triphosphate (ATP), the molecular fuel that provides the power for muscular contractions. With more ATP around, your muscles can do more work.
You can load creatine into your muscle, just like endurance athletes do with carbohydrates. Consequently, you can push harder and longer in your workouts because creatine boosts the pace of energy production in your muscle cells.
Creatine supplementation does not build muscles directly, but it does have an indirect effect. It allows you to work out more intensely, and this translates into muscle gains. More muscle equals more power equals enhanced athletic performance.
Q: Why is a diet high in fat dangerous?
A: First, a high-fat diet is often a high-calorie diet, which will promote obesity and being overweight. Being overweight or obese is a primary risk factor for the development of many diseases, including heart disease, diabetes mellitus, many types of cancers, and degenerative osteoarthritis.
Even if you aren’t obese or overweight, a high-fat diet has a negative influence on the risks of developing many of the same diseases, including heart disease and cancer. People who have high-fat diets often do not consume enough other important foods and nutrients. These include fruits and vegetables, vitamins, minerals, phytochemicals, and fibers, which are important for promoting health and preventing disease.
Q: What are the symptoms of dehydration?
A: I have broken the symptoms of dehydration down into early signs and severe signs.
Early signs: Fatigue Loss of appetite Flushed skin burning in stomach Light-headedness Headache Dry mouth Dry cough Heat intolerance Dark urine with a strong odor
Severe signs: Difficulty swallowing Stumbling Clumsiness Shriveled skin Sunken eyes and dim vision Painful urination Numb skin Muscle spasm Delirium
Q: Is there a difference between a nutritionist and a dietitian?
A: There is a difference between a registered dietitian (RD) and any other title referring to an individual who works with food and/or nutrition. A registered dietitian has a minimum of a four-year undergraduate college degree in nutrition or a related field that meets the requirements set by the Commission on Dietetic Registration (CDR, a national certifying body). Registered dieticians must also complete a supervised field experience (internship) that meets requirements set by the CDR and pass a national examination certified by the CDR.
Q: You recommend eating a small snack before working out. Other experts say the best time to work out is first thing in the morning and on an empty stomach. What are the benefits of eating before working out?
A: Eating an hour or more prior to exercise has several benefits:
1. It fuels and hydrates the body.
2. It prepares the body with necessary nutrients for recovery and muscle growth after exercise.
3. It may limit the amount of tissue damage that naturally occurs with intense exercise.
If it is difficult for you to eat early in the morning before your workout, make sure that your daily nutrition meets your body's needs. Drink water or a sports drink before your workout to enhance hydration and to provide a small amount of fuel for your body. You could also try a blended beverage, like a homemade smoothie or a liquid meal replacement beverage of around 200 calories of carbohydrate and protein. You’ll feel better during your workout and afterward.
Q: I've recently gained about 5 pounds for seemingly no reason. I work out for an hour and a half most days (5-6/week), I eat a mostly vegetarian diet, and I seldom drink alcohol. I haven't changed any of my habits lately, so I'm wondering if it's possible my weight gain could be because I'm consuming too few calories and my body is in 'starvation mode.' Also, I live in NYC, so I walk everywhere and climb a lot of stairs! I've started cutting back even more food, for fear of gaining more weight, but this hasn't helped. Why have I gained weight when I hardly eat anything??
A: The syndrome of starvation adaptation can occur over a period of time when the number of calories consumed is so low that the body slows down its metabolism to meet the available energy supply. By continuing to lower your calorie intake, you will only make this problem worse.
However, it is impossible to diagnose this problem without a physical examination by a physician and a nutritional history by a registered dietitian working with the physician. There are also other possible medical explanations. I encourage you to seek medical advice from your physician and a registered dietitian. To find a registered dietitian in your area, go to the Eat right Web site for a referral from the American Dietetic Association.
Q: How do egg protein and soy protein compare?
A: The quality of protein is generally classified in one of two ways. The traditional method, called the Protein Efficiency Ratio (PER), determines the weight gain of growing rats fed a particular protein in comparison to a standard protein (egg whites). The higher the PER value, the better the protein.
The more contemporary method compares the amino acid profile of a protein to the essential amino acid requirements in humans established by the United Nations Food and Agriculture Organization. This method, known as the protein digestibility corrected amino acid score (PDCAAS), is recognized internationally as the best method of comparing proteins for humans. A protein with a PDCAAS of 1.0 indicates that the protein exceeds the essential amino acid requirements of the body and is an excellent source of protein.
Protein (PDCAAS/PER) Comments
Ovalbumin (egg); PDCAAS 1.00 / PER 2.8
Protein from egg whites is considered the reference standard to compare protein quality. Egg protein powders were once considered the best source of protein for supplements. However, egg protein is fairly expensive compared to other forms of quality protein. Therefore, use of egg protein in supplements has decreased.
Soy; PDCAAS 1.00 / PER 1.8–2.3
Soy is a high-quality protein extracted from soybeans. Soy protein concentrate (70 percent protein) and isolate (90 percent protein) are particularly good protein sources for vegetarians. Soy protein also contains isoflavone glucosides, which have a number of potential health benefits.
Q: How does regular exercise reduce body fat?
A: Exercise accomplishes two goals. First, it burns calories, which when combined with a calorie-reduced diet will help reduce body fat. Second, exercise builds muscle, the energy-burning tissue in the body. The more muscle you have, the more energy you burn to reduce fat in your body.
Q: Does exercise stimulate appetite?
A: Appetite is a highly individualized characteristic. It waxes and wanes depending on the intensity of exercise, as well as with the perception of the individual. Research studies are not wholly in agreement, but it appears that in general, appetite may be stimulated by exercise that is low to moderate in intensity. High-intensity exercise seems to inhibit appetite immediately after exercise. For people who exercise every other day, appetite seems to be stimulated on the non-exercise day. This may make up for any caloric deficits created on the exercise day.
Q: Do fat-free foods contain any fat?
A: According to labeling regulations, “fat-free” foods can contain no more than 1 gram of fat. So yes, they can contain some fat.
Q: What is the difference between saturated and unsaturated fat?
A: Dietary fats are composed of a string of carbon atoms bonded to hydrogen atoms. A fat in which all bonds between the carbon atoms are single bonds is known as a saturated fat because all the carbon atoms are filled to the brim, or saturated, with hydrogen atoms. Unsaturated fats have one or more double bonds between carbon atoms. They are called unsaturated because their structure still has room to bond with additional hydrogen atoms. Unsaturated fats with just one double bond between carbon atoms are known as monounsaturated fat. Those with two or more double bonds between carbon atoms are known as polyunsaturated fats.
Saturated fats have a hard consistency at room temperature. Foods high in saturated fats include beef, dairy products, commercially prepared baked goods, and tropical oils, such as coconut, palm, and palm kernel oils. These fats can raise blood levels of low-density lipoprotein (LDL) cholesterol to potentially dangerous levels. LDL cholesterol, commonly referred to as bad cholesterol, carries cholesterol in the blood to body cells. High levels of LDL cholesterol can lead to an increased risk of heart disease caused by cholesterol and fat deposits in the arteries.
Unsaturated fats are liquid at room temperature. They contain key nutrients, called essential fatty acids, which cannot be manufactured in the body and so are required in the diet in order to promote normal growth, skin integrity, and healthy blood and nerves. Two of the most important fatty acids are linoleic acid, found mostly in vegetable oils like corn and sunflower, and alpha-linolenic acid, found mostly in soybean and canola oils.
Both monounsaturated fats and polyunsaturated fats have been associated with lower levels of blood cholesterol. Monounsaturated fats have also been shown to lower LDL cholesterol in the blood while maintaining higher levels of high-density lipoproteins (HDL) cholesterol, often referred to as the good cholesterol. HDL cholesterol removes excess cholesterol from the body. People who have high blood levels of HDL cholesterol typically have a lower risk of heart disease. Monounsaturated fats are plentiful in olive oil, canola oil, peanut oil, shellfish, and fish from cold waters, such as salmon, halibut, mackerel, swordfish, black cod, and rainbow trout.
Q. What is an essential fatty acid, and why is it important in a healthy diet?
A. Fatty acid is the chemical term for the individual strands of molecules that make up the larger compound that we think of as fat. There are many fatty acids. Among all the fatty acids used by the body only two cannot be synthesized by the body in adequate amounts, and must therefore come from our diets. These two are linoleic acid and alpha-linolenic acid, and are called essential fatty acids. Essential fatty acids are required by the body for optimal health, normal growth, skin integrity, and healthy blood and nerves. Good sources of essential fatty acids include vegetable oils, nuts, and seeds.
Q: What is fiber, and why is it important in a healthy diet?
A: Fiber is an indigestible carbohydrate found in plant foods. Food nutritionists classify fiber according to its ability to dissolve in water. Water-soluble fibers, found in barley, rice, corn, oats, legumes, apples, pears, citrus fruits, bananas, carrots, dried plums, cranberries, seeds, and seaweed, have been shown to help regulate blood sugar and lower blood cholesterol. Water-insoluble fibers assist with the elimination of bile acids, preventing the formation of gallstones. In addition, cellulose, the roughage found in water-insoluble fibers, acts as a stool softener and bulk former, improving elimination and flushing carcinogens from the system. Good food sources of water-insoluble fibers include root and leafy vegetables, whole grains, legumes, unpeeled apples and pears, and strawberries.
Diets low in fiber have been linked to dozens of medical problems, including heart disease, cancer, diabetes mellitus, diverticulitis, and gallstones. The American Dietetic Association recommends that a healthy diet include 20 to 35 grams of fiber per day.
Q: What are food additives and do they add any nutritional benefits to food?
A: A food additive, broadly defined, is any substance used in or around food that may become a component of the food. Some food additives—called intentional additives—are introduced specifically for the purpose of improving the nutritive value, taste, texture, or shelf life of the product. Other additives enter food as residues after some stage of production or manufacture; these are known as incidental additives.
Q: What is food irradiation?
A: Food irradiation is a preservative process that is being considered more widely in our food supply as an alternative to chemical additives. It treats food with radiation to kill pests and bacteria. In this process, food is conveyed through a lead-lined chamber, where it is exposed to cobalt-60, a radioisotope that has been used in hospital settings for more than 30 years. The Food and Drug Administration (FDA) regulates the doses, which are carefully measured and monitored. The food has no chance to become contaminated with radioactivity.
Even so, this process raises some legitimate concerns. Studies have shown that food irradiation alters nutrients and chemicals in foods in much the same way canning, freezing, pasteurization, and cooking do. Not only that, irradiation forms new substances in foods—substances not present prior to processing. As yet, we have limited information on the health effects of consuming these by-products of irradiation. Tests on the process are ongoing.
However, the FDA has already given a go-ahead to the use of irradiation within specified doses for spices, some meats, fruits, and vegetables. The process is supposed to thwart insect infestation, kill Trichinella spiralis (the pork parasite responsible for widespread disease), and keep tuberous vegetables (such as potatoes) from sprouting.
Q: What are the health benefits of green tea?
A: The media and marketing claims for green tea are that it is a strong antioxidant and anticancer agent, that it protects the heart, and that it fights viruses and bacteria.
Although much more research is needed before we can draw conclusions, evidence from laboratory, animal, and population studies suggests that green tea does in fact have anti-carcinogenic effects, meaning that it might protect against cancer. Also, chemicals found in green tea called polyphones have demonstrated antioxidant capabilities both in the laboratory and in humans.
At this time research does not support claims that green tea protects the heart from high cholesterol levels or promotes resistance to the oxidation that causes arterial plaques. Preliminary evidence shows that green tea extract might inhibit bacterial growth and the influenza virus, but more research is needed to confirm these studies.
Q: What is the difference between HDL and LDL cholesterol?
A: HDL means “high-density lipoprotein,” and LDL means “low-density lipoprotein.” There are many fractions of total cholesterol in our bloodstream. HDL and LDL are two of the fractions that carry cholesterol.
Research shows that LDL and HDL are highly associated with risk of developing heart disease. LDL, also called “the bad cholesterol,” allows cholesterol to build up in arteries and can ultimately clog arteries enough to cause a heart attack or a stroke. HDL, also called “the good cholesterol,” helps clear cholesterol out of the bloodstream and ultimately out of the body.
The higher your levels of LDL, the greater your risk for heart disease. The lower your LDL levels, the lower your risk for heart disease. The opposite is true for HDL. The higher your HDL levels, the lower your risk for heart disease. Low HDL levels are associated with a greater risk for developing heart disease.
The American Heart Association Web site offers the following information:
Cholesterol is measured in milligrams per deciliter of blood (mg/dL). Healthy LDL and HDL cholesterol levels:
LDL: less than 160 mg/dL (less than 130 mg/dL if you have two or more other risk factors for heart disease)
HDL: greater than 40 mg/dL
Total cholesterol
Less than 200 mg/dL = desirable blood cholesterol
200 to 239 mg/dL = borderline-high blood cholesterol
240 mg/dL and over = high blood cholesterol
Q: Will drinking a beverage high in sugar content within an hour of exercise help or hinder athletic performance?
A: I don’t recommend that you consume sweet foods and beverages within an hour of exercise primarily because they will not be emptied quickly from the stomach, and they may even have a dehydrating effect on cells by drawing fluids out of the cells to create an osmotic balance or equilibrium.
In some individuals, insulin levels may peak to cover the high intake of carbohydrate, causing a drop in blood sugar levels early into exercise that may diminish performance. However, consuming a carbohydrate snack or a beverage containing 6 to 8 percent carbohydrate, such as a sports drink, within an hour of exercise may enhance both hydration and energy availability, thereby helping performance.
Q: What happens in the body when an athlete “bonks” or ”hits the wall”?
A: An athlete “hits the wall” when stores of muscle glycogen (the stored carbohydrate in muscle) get too low. An athlete who “hits the wall” during a race will feel tremendous fatigue and want to quit.
Different from “hitting the wall,” “bonking” is when liver glycogen stores are depleted, with or without a depletion of muscle glycogen. During exercise, stored glycogen in the liver maintains normal blood sugar levels so that the brain can function. When liver glycogen levels are depleted and blood sugar levels drop, athletes feel weak, uncoordinated, light-headed, and unable to concentrate.
Q: You recommend eating a full meal two hours after working out. But it’s 9 p.m. by the time I’m done working out, and I'm trying to lose a few pounds. What should I eat so late at night?
A: It is hard to eat so late at night, but your body needs nourishment after exercise to recover, build, and refuel for your next workout. Fluids and carbohydrates are the most important. And if you still need protein to balance out your day's needs, you should have it before you go to bed too. The meal can be small, about 250 to 300 calories. Make sure to drink water. You could also eat a bowl of cereal with milk, a turkey sandwich, or a tuna salad with a baked potato. If you prefer to drink rather than eat, try a meal replacement beverage that contains about 300 calories of carbohydrate and protein.
Q: What are very low calorie diets and who benefits from them?
A: Very low calorie diets (VLCDs) usually provide fewer than 1,200 calories per day. Anyone following this type of program should be under medical supervision. These types of diets have been shown to be useful for obese individuals who are beginning a weight-loss program. However, in order to maintain any weight loss, individuals must move toward and be instructed in planning and preparing a well-balanced diet of food. They must also be educated in lifestyle modification techniques, including exercise and stress reduction.
Q: What is the best meal to eat before a marathon?
A: In her book Eating for Endurance, Ellen Coleman recommends the following:
“Consume 1-4 grams of carbohydrate per kilogram of body weight, 1-4 hours before exercise. To avoid potential gastrointestinal distress, reduce the size of the meal—making it smaller as it is consumed closer to exercise time. For example, a carbohydrate feeding of 1 gram per kg of body weight (4 calories per kg) is appropriate an hour before exercise, whereas 4 grams per kg (16 calories per kg) can be consumed 4 hours before exercise.”
Consumption of fatty foods should be limited in the pre-event meal since they are digested more slowly and may make you feel sluggish. Watch out for high-protein foods that are also high in fat, like egg yolks, fried eggs, and cheese. Limit the amount of fiber in your pre-event meal, too. It will slow down digestion and make you feel full.
Good pre-event choices include fruit, bread products, jams and jellies, nonfat or low-fat yogurt, fruit juices, and nonfat milk. Liquid meals or high-carbohydrate supplements may also be useful. They are rapidly emptied from the stomach, making the nutrients readily available without leaving you feeling too full.
Make sure you are well hydrated, and don’t depend on drinking a couple of glasses of water before your event. It takes at least 24 hours for the body to become fully hydrated once it has been dehydrated. So have a fluid plan before your race, just like you have a food plan.
Lastly, try out your pre-event fluid and food plan during a training run before race day to make sure it works for you. Never try something on the day of the race that you have not tried before.
Q: Do multivitamins contain other ingredients besides vitamins and minerals?
A: A multivitamin may contain only vitamins, or it may contain vitamins and minerals. Other nonessential nutrients may also be added. Since there is little regulation of the nutritional supplements industry, it is wise for all consumers to read labels and be well informed prior to purchasing nutritional supplements.
Fillers, such as cellulose, are often used to bulk the vitamin pill and hold it together. Drying agents, such as silicon, may be used to keep the pills from becoming soggy from water in the air.
There are a number of agents that are used to coat the pills as well. All of these should be listed clearly on the label. If you have any questions about these ingredients, you should contact the manufacturer and/or the U.S. Food and Drug Administration.
Q: I have a friend who runs long distances—marathons and such. He says he can't bend over and touch his toes because his muscles are so tight. I am a molecular biologist, and I seem to recall that lactose dehydrogenase may play a role in my friend’s condition. Is there a dietary connection? If not, what could be causing this? Is there any way to reduce his muscle tightness?
A: Flexibility is influenced by a number of things, most notably genetics and training. To maintain and increase flexibility, one must practice flexibility routines, just as one must exercise to enhance exercise performance. It is unlikely that lactase buildup in the muscles would be responsible for chronic muscle tightness, since lactase buildup is a transient condition that follows exercise. I suggest that your friend consult with a certified personal trainer and/or a sports medicine physician to resolve the issue.
Q: What does the term “organic” on a food label mean?
A: Foods that are certified organic are grown in soil enriched with organic fertilizers, rather than synthetic fertilizers, and are treated only with nonsynthetic pesticides. More specifically, it means that the food has been produced, stored, processed, and packaged without the use of synthetic fertilizers, herbicides, fungicides, or pesticides for one year prior to the appearance of flower buds in the case of perennial crops and one year prior to seed planting in the case of annual crops.
Organic farms use a soil-building program that promotes vibrant soil and healthy plants, usually including crop rotations and biological pest control.
Q: Will a diet high in milk and other dairy products prevent osteoporosis?
A: A diet high in milk and other dairy products that provide the nutrients essential for building and maintaining bones is one important factor in decreasing the risk of developing osteoporosis. There are other ways that a person can decrease the risk of developing osteoporosis. These include getting at least 30 minutes of moderate exercise each day, not smoking, and limiting alcohol and caffeine intake.
Other factors are difficult or impossible to control. People with a family history of osteoporosis are more likely to develop the disease, as are women who have gone through menopause and people who take certain medications. Women who have gone through menopause, women who experience an abnormal absence of menstrual periods (amenorrhea), and individuals who have a low bone density in early adulthood are also at higher risk.
Q. What is protein, and why is it important in a healthy diet?
A. Protein is a macronutrient with a chemical structure containing carbon, hydrogen, oxygen, and nitrogen. It is the nitrogen that gives protein its unique properties. Protein is made up of smaller units called amino acids, which are connected together like a strand of pearls. If two strands of pearls were wound together and then twisted to double up on each other, they would resemble a protein molecule.
Your body breaks down protein from food into amino acids and reshuffles them into new protein to build and rebuild tissue, including muscle. Protein also keeps your immune system functioning up to par, helps carry nutrients throughout the body, has a hand in forming hormones, and is involved in important enzyme reactions such as digestion.
There are 20 different types of amino acids, and all can be combined to form the proteins necessary to build the body and keep it healthy. Some of these amino acids can be made by the body and are called nonessential amino acids.
Others have to be supplied by the foods you eat. These amino acids are termed essential amino acids.
Animal and plant foods contain all 20 amino acids (but in different amounts depending on the food). Animal proteins and soy protein are of higher quality because they contain all the essential amino acids in larger amounts and better proportions. In plants, amino acids exist in smaller concentrations. For the body to make proteins properly, all 20 amino acids must be present at the same time.
Although amino acids work together to form body proteins, individual amino acids have specific roles to play in the body. Certain amino acids, such as tryptophan and tyrosine, are involved in the formation of chemical messengers called neurotransmitters for the brain and nervous system. Three amino acids (leucine, isoleucine, and valine) are constituents of muscle tissue.
Q: How do Recommended Dietary Allowances (RDA), the U.S. Recommended Daily Allowances (U.S. RDA), Reference Daily Intakes (RDI), and Daily Reference Values (DRVs) differ from one another?
A: The Recommended Dietary Allowances (RDA) was developed by the Food and Nutrition Board of the National Academy of Sciences in 1943. It provides a guide for the amounts of specific nutrients healthy people of the same gender and of similar ages need to consume to prevent deficiency problems. The recommendations have been revised every four to six years in response to new scientific information. These guidelines serve as the scientific basis for programs such as the United States Department of Agriculture’s Dietary Guidelines and National School Lunch Program.
The United States Recommended Daily Allowances (U.S. RDA) is the old name used for standards established by the Food and Drug Administration (FDA) that were used on food nutrition labels. The U.S. RDAs are a compilation of the guidelines found in the RDAs using the highest RDA values within specific age and gender categories, including children over 4 years and adults, infants less than 1 year, toddlers 1 to 4 years, and pregnant and lactating women.
Partly because the U.S. RDA was often confused with RDAs, in 1993 the FDA changed the name of U.S. RDAs to Reference Daily Intakes (RDI). In addition, the FDA established the Daily Reference Values (DRV) for nutrients such as fat and cholesterol for which no set of standards previously existed. Today the RDI and the DRV are used to form a single list of nutrient values known as Daily Values (DV) that are now used on nutrition labels.
Q: What factors determine if a weight loss program is sound and not a fad?
A: A healthy weight loss program should include a daily intake of at least 1,200 calories and should include all the food groups: fruits and vegetables, grains, dairy, protein foods, and fats. It should promote lifestyle modification such as exercise and offer techniques for learning how to change habits.
The basis of the diet should be food. A sound program helps people move from using a tool to help control calories and food choices toward a diet based solely on whole foods. The goal should be achieving and maintaining a healthy weight.
Ultimately, the dieter should be able to maintain weight loss without using any weight-loss tools. A fad diet will often make unsubstantiated claims, be very low in calories, eliminate whole food groups, use scare tactics and fear to attract the consumer, require that the dieter purchase foods only available from the program purveyor, and avoid teaching the dieter how to manage weight without the diet product.
Q: I have a B.S. in biochemistry and a master’s in education. I am currently teaching, but I’m extremely interested in your field. What are the options for a career in sports nutrition?
A: The field of sports nutrition is just taking off. Options include academic research and teaching, positions in industry (working for food or supplement manufacturers), consulting, and private practice. Individuals build a consulting business through experience in several ways, including spending time at a fitness facility, doing individual counseling, consulting with business and industry, writing and media work, and working with sports teams. This is a highly specialized field, and it requires academic degrees in nutrition and exercise science. Personal experience as an avid exerciser or athlete is also beneficial.
Q: Can tofu increase a person's risk for dementia?
A: There is one study published by researcher Lon White in the Journal of the American College of Nutrition that documented an association between the consumption of two or three servings of tofu per week in midlife (as a lifelong habit) and the early development of senile dementia and Alzheimer-related diseases in Japanese American men living in Hawaii. These dementias occurred about five years earlier than would have been predicted. A much less significant effect was observed in the women in the study.
The quantity consumed by the subjects of the study is much greater than the average American intake of tofu and soy. And this is just one study; it is not definitive proof of anything. Other documentation shows that the benefits of soy foods are hundredfold. I advise clients that, just like anything else, moderation is the key. When eaten in extremes, anything can become harmful.
Q: What are trace minerals and why are they important in the diet?
A: The body requires minerals in minute amounts. Like vitamins, they don’t yield any energy, although some play a behind-the-scenes role in energy production. Trace minerals are found in the body in the smallest concentrations and are needed in smaller amounts than the major minerals. The trace minerals are iron, iodine, chromium, fluoride, and molybdenum. In the following list, the trace minerals are given along with their function and the best food sources for obtaining them.
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Iron
Function: Oxygen transport to cells; formation of oxygen-carrying red blood cells; required for the production of certain antioxidant enzymes
Sources: Liver, oysters, lean meats, green leafy vegetables
Iodine
Function: Energy production; growth and development; metabolism
Sources: Iodized salt, seafood, sea vegetables, mushrooms
Chromium
Function: Normal blood sugar; fat metabolism
Sources: Corn oil, brewer’s yeast, whole grains, meats
Fluoride
Function: Bone and tooth strengthening
Sources: Fluoridated water
Molybdenum:
Function: Fat metabolism
Sources: Milk, beans, breads, cereals
Q: What are triglycerides?
A: Triglycerides are the chemical form in which most fat exists in food as well as in the body. They're also present in blood plasma and in association with blood cholesterol. Triglycerides in plasma are derived from fats eaten in foods or made in the body from other energy sources, such as carbohydrates. Calories ingested in a meal and not used immediately by tissues are converted to triglycerides and transported to fat cells to be stored.
Hormones regulate the release of triglycerides from fat tissue to meet the body's needs for energy between meals. Excess triglyceride in plasma is called hypertriglyceridemia. It's linked to the occurrence of coronary artery disease in some people. Elevated triglycerides may be a consequence of other diseases, such as untreated diabetes mellitus. Increases in triglyceride levels can be detected by plasma measurements.
According to the American Heart Association Web site, the Second Expert Panel on the Detection, Evaluation and Treatment of High Blood Cholesterol in Adults defined levels for hypertriglycerides. Here are their definitions:
Normal triglycerides - less than 200 mg/dL Borderline-high triglycerides - 200 to 400 mg/dL High triglycerides - 400to 1,000 mg/dL Very high triglycerides - greater than 1,000 mg/dL. These are based on fasting plasma triglyceride levels. *From the American Heart Association Web site.
Q: Which is better to drink during exercise—water or a sports beverage?
A: This depends on the exercise intensity and duration. When exercise is moderate in intensity and lasts one hour or less, water is the best sports drink around.
Sports beverages will enhance your performance if you are exercising at high intensity for 45 minutes or more, doing intermittent bouts of high-intensity exercise (such as soccer) for 45 minutes or more, or exercising at moderate intensity for 60 to 90 minutes or more.
Research shows the best beverages to drink during physical activity are 6 to 8 percent carbohydrate solutions (6 to 8 g of carbohydrate per 100 ml of beverage).
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