When is it OK to Cheat On My Diet?

If there is one thing I’ve repeatedly tried to iterate on this website it’s that moderation is a key to health living. Too much of anything is bad and too little of something beneficial is also no bueno.

Kryptonite for a certain pharmacy brute.

Kryptonite for a certain pharmacy brute.

First, lets define diet. Our culture has given this word many meanings. It is a verb, adjective and noun. Lets boil down diet to a simple meaning; what one habitually puts into their mouth. That’s not the official dictionary definition, but it is simple, direct and clear.

For one then to say they are on a diet is akin to saying, “I’m breathing today as opposed to not breathing tomorrow for fear of inhaling something bad, but only tomorrow, since I’ll likely be crashing my breathing again the following day. I just can’t help myself. Breathing is so good!”

Doesn’t that sound a bit silly?

So diet is what one habitually puts into their mouth and actually swallows. And saying that you’re on a diet is like saying that you also breathe. So the next question is this; do you ever eat pie? Or cookies? Or cake? Or some Hot Cheetos? Or a Coke?

Are monster burgers part of your diet. If you eat them from time to time then yes they are!

Are monster burgers part of your diet. If you eat them from time to time then yes they are!

Sorry, that was 5 questions. If you answered yes to any of those or anything else in your mind that would count as a junk food, then yes, it is a part of your diet. So if someone offers you a piece of pie or cake and you tell them you’re on a diet so you can’t, then you’re straight up lying. Maybe the frequency is once in a blue moon. Maybe just at Thanksgiving or Christmas or some other major event (I just ordered 3 desserts at a nice restaurant because it was my anniversary).

The truth is, “junk” is a part of most people’s diets, just in small amounts for some, and large amounts for others. Frequency, as mentioned above also plays a role. So the question of when is it ok to cheat on my diet becomes moot because the reality is, if you eat it, it’s already part of your diet.

Let’s take a look at an example. My life and my diet.

Here’s a sample of one of my days and things I might eat during that day. In no way should this be a template for you since you aren’t me. Remember this is just an example of one pharmacist in rural America.

5:10 AM Wake up

5:20-5:30AM Protein shake

6AM Workout

7AM Protein shake

7-8AM Make breakfast for kids, shower and get cleaned up for work

8-8:30 Eat chicken, beef, pork, eggs or some other protein source, usually with some oatmeal or quinoa.

9AM Start work at the pharmacy

1PM Lunch: Eat chicken, beef, pork or tuna with some rice or oatmeal or quinoa and some veggie (usually broccoli)

2PM Resume work

6PM Go home, make dinner for wife and kids. My dinner is usually weighed out if I’m calorie counting, and if I’m not then I just TRY to eyeball it (usually fails and revert back to weighing)

Dinner may be anything from some sort of pasta (we love angel hair) to rice to potatoes(not often) accompanied by pork roast, beef roast, chicken and some fruit (usually melon because right now it’s melon season).

If the kids eat all of their food, including their veggies, we’ll sometimes have some dessert. Ice cream, jello, a little cake or pie (depending on availability from my wife).

8:30 Bedtime for kids. Teeth brushed before hand.

10:30 I try to get to bed by this time, doesn’t always work.

Rinse, Repeat.

I don’t always have dessert. Sometimes I do. Most nights I don’t. The weekend, when I’m home and have more ready access to food, is usually when I partake of something wonderful. Last Friday I made blueberry scones for dessert which we had with some ice cream on the side. Oh man was that good! But do I have blueberry scones every night? My mouth and brain say “ABSOLUTELY!” My will and my waistline say otherwise.

Focus on being happy and healthy before you think weight 90lbs will create both

Focus on being happy and healthy before you think weight 90lbs will create both

I’m not saying I’m fat. I’m just saying I know better than to have dessert every night. If pie is involved I can’t stop till it’s gone. The desirability of dessert is also proportional to my stress level during the day and the amount of carbs I had. Low carbs and high stress = recipe for disaster if I’m not careful. Moderate carbs with low stress and dessert just isn’t as appetizing.

I wrote about eating intentionally a while ago. You can look at the links here:

https://pharmacybrute.wordpress.com/2014/07/10/how-to-intentionally-eat/

https://pharmacybrute.wordpress.com/2014/11/14/eating-intentionally-during-the-holidays/

Rather than ask when can I cheat, the better question to ask might be, how often do I include junk into my diet? Remember that diet is something that you put into your mouth habitually. I would consider every weekend or even every month habitual. It really depends on you. If you were to deny yourself and good hamburger for the rest of your life and truly eliminate it from your diet, then yes if offered, you could then say, “sorry I’m on a diet that includes no hamburgers. Ever!”

But I ask you…Why? If you have a gluten allergy, then obviously you wouldn’t be eating scones, at least with wheat flour. If you’re a vegetarian or vegan then you’d avoid meat at all costs, which you are free to do. But why? These are wonderful foods and indulging from time to time is ok. Just make sure indulgence doesn’t become overindulgence and that includes one too many ounces of steak.

Sit down and enjoy your food. Even if you only have 5 minutes, sit down, put your phone away, and enjoy your food. Savor the flavor. Enjoy the texture. Let it be an experience.

 

CIAO

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College Students and their Health

When I first attended college back in 2003, the types of food I was eating, or seeking out, was not on the top of my priority list, and it certainly didn’t cause me to think how it might affect my health. I’m willing to bet most people don’t think about their food choices when they are in college, unless they are in a nutrition degree or some other health related course of studies.

Slice em up good! Sweet Potatoes are a great source of nutrition, can be filling, and are super tasty.

Slice em up good! Sweet Potatoes are a great source of nutrition, can be filling, and are super tasty.

This is broad and I’m sure there are others who do take care of themselves. I am speaking from personal experience though, and I can say that there aren’t many that I knew who were really taking into consideration what they were eating. Unless of course they were trying to lose tons of weight, or put on lots of muscle.

I do remember eating lots of whatever Costco had to offer in the way of baked goods for breakfast. A Costco blueberry muffin after all is big, tasty, and no cooking is required. When on sale, I could get frozen pizzas for $1 and after 15 minutes, I had a toasty pizza. In honesty I tried to eat half, because hey, it’s a pizza. My stomach petitioned for more though and more times than not I would oblige. Both examples were calorie rich, but nutrition poor.

It’s no wonder to me why so many will gain the “freshman fifteen”, or the 10-15 pounds of body weight that accompanies so many new students.

A study done looking at what the authors call “food insecurity” looked at students and determined, based on surveys, that they had poor access to nutritious food, either by limited funds or uncertainty. [1] The study, done in Australia, found that students who worked, relied on family, or received government aid, were more insecure than those who were financially able. As many as 25% even experienced hunger.

The study also found that the food insecurity was higher in college students than the general population.

A study in Hawaii found that as many as 45% of students experienced this food insecurity. [2]

Yet another study found similar patterns to the one in Australia, that students with low-income, low GPA’s, having fair/poor health, or working all have higher rates of this food insecurity. [3]

It could be argued that people with lower levels of health have this problem cause by lack of nutrition and not the other way around. I do agree that the healthiest foods and the more expensive variety. Congress subsidizes things like soy and corn, not green beans and broccoli.

So what’s a student to do to stay healthy? After all poor nutrition leads to poor outcomes. One thing I couldn’t stand were the colds I would get while in college. I’m sure stress had something to do with that too.

If a student has a fridge and can cook their own meals, then they should store some good food and cook their own meals. Frozen veggies and fruits store longer than fresh and are better than canned. Canned is better than nothing, but fresh and frozen is best. They take little to heat up in a pan and with some chicken and seasoning make for a quick and healthier option than pizza.

Veggies, fresh or frozen, are a must have for college students.

Veggies, fresh or frozen, are a must have for college students.

Fruit is good too, but can be pricey. If you can get a bargain on some apples, get some. If not, be careful with how much fruit you buy. While healthy, it’s not the biggest bang for your buck.

Rice is a good source of carbs since you can store it almost indefinitely and a little goes a long way. It does require a little time, but if you get a cheap rice cooker, you can cook rice, and a few minutes before it’s done, throw in the frozen veggies to have ready for when the rice is done. Saves time and is inexpensive. Plus you can make double or triple and save some for lunch the next day.

Chicken can usually be found for reasonable prices, especially if you’re willing to deal with bone in. It makes for a good protein. Tuna is another one, in the can of course ( don’t get it with the oil though). If you can’t stand either, ground beef might be a likelier option, though you’ll have to do some shopping to find a good price, or just find it on sale.

For those that go to the cafeteria, it’s a little different picture. The cafeteria is great if you have a food plan because it’s saves the time of cooking and clean up. It’s the options presented that can be problematic.

Pizza, as mentioned earlier, is full of a lot of empty calories. I’m not saying don’t ever eat it, just make sure it’s once in a while rather than 3-4 times per week. Load up on veggies along with whatever protein source you can. You’ll feel full longer than if you load up on carbs. Fruit once or twice a day is good too during lunch or dinner at the cafeteria. Sometimes it can add up though, depending on how the cafeteria is run. .

Stick to regular milk rather than chocolate milk. Again that’s most of the time. One time a week of chocolate milk won’t hurt, but every single day is a lot of extra sugar. Water should be a staple. Get a good water bottle and keep it filled up. There’s no need to buy water all the time, especially when it’s free.

Cherry pie will make you happy. GUARANTEED! Although it will be shortlived. So only indulge once in a while. So make it a real treat and not a waistline gainer.

Cherry pie will make you happy. GUARANTEED! Although it will be shortlived. So only indulge once in a while. So make it a real treat and not a waistline gainer.

Excess sugar can cause things like increase weight and problems with stress. Dessert should be an ocassional treat, not a daily event. I know it’s hard at times because sweets relieve stress, at least temporarily, but they add up to a ticking time bomb if not kept in check. Exercise, emotional support, mediation, church groups, or maybe a weekend of Star Wars is a much better coping mechanism to stress than dessert.

Alcohol is another leacher of nutrition, specifically B vitamins. I recommend not drinking at all. If it is a must, benders, keggers, 21 runs, and frat parties should be avoided. They do nothing to further academic achievement and void your body of essential things it needs to help you in studying. I remember a few times in the anatomy lab trying to help students that had horrible headaches from the previous night’s parties. They had a spectacularly difficult time in anatomy.

If it’s in the budget, a multivitamin is probably a good call. It can help fill in some of the gaps. If not, stick to the veggies.

In short, tupperware and a little thinking ahead (look at the paragraph about rice) can keep a college student fed and with some nutritious foods as well. I personally believe that if we actually taught people health and then made them accountable for it, many health problems in this country would soon disappear. I’m talking actually teaching nutrition and not just show teenagers slides of STD’s in “health” class.

In the end your health, and your nutrition status is your responsiblity. Learn about it and learn what you can do to better it.

CIAO

 

1.Hughes R, Serebryanikova I, Donaldson K, Leveritt M. Student food insecurity: The skeleton in the university closet. Nutrition & Dietetics. 2011;68(1):27-32

2.Chaparro MP, Zaghloul SS, Holck P, Dobbs J. Food insecurity prevalence among college students at the University of Hawaiʻi at Manoa. Public Health Nutrition.
2009;12(11):2097-2103

3.Prevalence and Correlates of Food Insecurity Among Students Attending a Midsize Rural University in Oregon Patton-López, Megan M. et al. Journal of Nutrition Education and Behavior , Volume 46 , Issue 3 , 209 – 214

What is Your Health Worth?

The answer to the above question really is priceless. Your health is one of the few things that truly affects you directly every single day. No one escapes it. Whether you feel like a million bucks or feel like someone just stomped a hole in you, you get to deal with your health and only you have the power to change it.

That’s right, only you have the power to change it. No one else can.

Sure you can visit a doctor to seek out treatment or advice, but it is you that made the decision to go, not the doctor. It is you that made the decision to take the prescribed medication. It’s you that decided to eat or not to eat something. It’s you that has control.

I thought it’d be fun to put some numbers up to look at this question. They won’t be exact, especially since everybody’s situation is different, but it will give an idea of money attached to healthcare.

Without any major hospitalizations here are a few things to consider:

If you have been diagnosed with hypertension at the age of 35 (something that isn’t uncommon) you can expect to be taking something for that, usually lisinopril is one of the first choices. You can get a 90 day supply at your local WalMart for $10. That’s $40/year. At first you’ll have a couple visits to the doc from the time you’re diagnosed as follow up to make sure you’re doing well on the medication. If you have a $35 copay that’s between $70-$105 total visits for the year, at least for the first year and assuming you go to the doctor for nothing else that year.

3 visits = $105

1 year of meds = $40

Total = $145

Subsequent years would look like this:

1-2 follow up visits/year = $35-$70

1 year of meds = $40

Total = $75-$110

Over 20 years ~ $1500-$2300

Now this is assuming a few things. First you don’t ever have problems keeping your blood pressure from going up after the initial diagnoses and treatment, which is rarely the case for most. This also assumes you have no problems with the initial medication and have to get it changed, although this wouldn’t add a whole lot.

If you’re on two blood pressure medications, this jumps to $2300-$3000 over 20 years. This of course is no mortgage but still it adds up. If you happen to be taking a beta blocker like metoprolol as one of those blood pressure medications your cholesterol might go up just enough to trigger a prescription for something like simvastatin. Add another 10 dollars a month for that one.

Simvastatin $120/year

Metoprolol (assuming the cheap immediate release) $40/year

Lisinopril $40/year

2 visits/year $70

Over 20 years ~ $5400/20 years or $270/year

If you become borderline diabetic because of the simvastatin and the metoprolol in combination or were already there and these push you over you might add some metformin into the mix for blood glucose control. Three months of twice daily metformin will run you another $40/year.

Total ~ $6200/20 years or $310/year

We’re still not even close to a mortgage, but we’re increasing.

Now we’ve only discussed the financial part of all of this. Metoprolol is also going to sap some of your energy because it prevents chemicals like epinephrine and norepinephrine from having their full phsyiological effect. What does this mean? Well as I said it will probably sap some of your energy depending on the dose. It won’t necessarily make you drowsy, but it will make you tired easily.

Simvstatin as well as others have the tendency to cause muscle pain and weakness. I’ve had members of my family experience this, and I’ve experienced it myself. Many older folks attribute this to older age. I call nonsense. Yes we do degenerate as time goes on but my own grandmother was able to walk again in her 80’s after stopping simvastatin. It really can be that bad for some.

I’ve talked to others who’ve told me about lisinopril or losartan (angiotensin converting enzyme inhibitor and angiotensin receptor blocker respectively) who describe feeling like people who are on metoprolol do, with a lack of energy. Not enough to keep them from being out and about, but enough to make a few dread having to do anything because they have no energy to do it with.

Instead of medications doing some physical activity 2-3 times per week and backing off on total calories every day will likely achieve what most medications are seeking to achieve. Going on a brisk walk and having only one plate at dinner are two things that go a long way in improving health.

Think about it for just a moment; if you have only 1 plate, or maybe a smaller portion, you save on food and caloric intake. Eating till you have to undo your pants button is ok on Thanksgiving, Christmas and your birthday,…ok and maybe 1-2 other times/year but that’s it. If having to loosen your belt regularly after eating is a habit I can tell you that the belt is only going to get tighter and tighter.

Taking a brisk walk or going on a hike or riding the bike or whatever it is you might find joy in will get your heart pumping and muscles working. Blood pressure will go down as some of the fat comes off and you will feel more energized and not get out of breath while doing things you love.

I personally wish I could go back to Tahiti now that my heart is conditioned better to be able to stay underneath the surface while snorkeling with the fish longer.

Having a plan and sticking to it will pay off dividens in the long run. It’s sad to see people who take their medications exactly as the doctor directs and have been doing so for a long time only to see them deteriorate. Don’t be a statistic. Change now! Plan for the future, however long that may be, and make a difference in your life.

I know the amount of money that we went over above isn’t a lot in the grand scheme of things, but that’s assuming you take the meds and nothing ever happens and you never deteriorate any further than where you are. Not having to deal with the side effects and not having to visit the doctor is worth going biking and feeling awesome at the same time.

CIAO

Cardio and Metabolism Part Deux

In part one we discussed a little about thyroid and cardio. You can access it here if you missed it:

http://wp.me/p1WCTB-aq

The skinny of it was that people who perform chronic cardio are at risk of causing problems with their thyroid function, especially if calorie intake drops too drastically. In one study we reviewed women who were eating 8kcal/kg/day (or 454 kcal for 125lbs women) and performing exercise had a decrease in T3, your primary thyroid hormone.

Lowering T3 is like taking your foot off the gas pedal and expecting your car to speed up, it just ain’t gonna happen no matter how frustrated you get or how much you scream.

Thyroid 102

Since we discussed about thyroid hormone itself today we’re going to discuss a little about thyroid testing.Welcome to thyroid 102.

Thyroid testing by many doctors usually consists of testing TSH or thyroid stimulating hormone. This is the hormone shot out by the pituitary in response to TRH or thyrotropin releasing hormone. When TSH is released it binds to the thyroid gland to produce T3 and T4. As T3 and T4 are released they tell the pituitary to slow production of TSH since the thyroid hormones are in place. When the thyroid hormones are used up the cycle repeats.

Testing TSH is important but doesn’t tell you everything. In fact, TSH can be “normal” and your thyroid status might still be messed up. Some people have a hard time converting T4 to T3. Too little carb intake may be one reason. But if all the doctor looks at is TSH and doesn’t pay attention to T4 and T3 and some others like reverse T3 the full picture of what might going on won’t be seen and thyroid according to TSH alone will appear normal.

In short talk to your doctor about doing a full thyroid panel which includes these other measures because many doctors will consider a full thyroid panel as TSH not all of them, but many of them.

Glycogen

Now that we’ve discussed thyroid a little more in detail, I think it behooves the conversation to discuss glycogen. Glycogen is a substance that is concentrated in the muscles and liver for use as energy. In fact muscle glycogen is the first thing that skeletal muscle will turn to for energy. And if you haven’t figured out from the name, glycogen is made from glucose.

Weight lifting and sprinting and running will use glycogen but at different levels. A bout of lifting can decrease glycogen by ~25-40% depending on duration and intensity where one 30 second sprint can deplete stores by 33% and 2 sprints by 47%. [1-3]

Glycogen needs to be repleted. Enter in carbs. People that are very active and using their glycogen without eating carbs to replenish them will have to use ketones for energy and/or breakdown protein to create glucose to then be stored as glycogen. For people who have lower activity levels this may be ok, key word being may. For individuals who are very active the level of glucose needed is going to increase to keep things even keel.

Gluconeogenesis in the liver can supply about 100g glucose/day at the most (it is likely to be less) in most people. [4] It is controlled hormonally by insulin and glucagon. Insulin stops the process and contrary to popular belief protein stimulates insulin production. There’s a great article on it here:

http://weightology.net/weightologyweekly/?page_id=319

So when you aren’t getting enough glucose your body will turn on gluconeogenesis for blood glucose to be utilized throughout the body. This is all fine and dandy unless you are working really hard day in and day out and burning calories like a furnace. It’s going to be difficult to replace glycogen without glucose and glucose primarily comes from carbs.

People who are glucose deficient, or are expending lots of energy doing things like cardio and weights regularly will need a shift in metabolism to compensate. That’s when the body starts reducing T3. It needs to conserve somewhere so T3 goes down.

Homer's problem isn't glycogen....it's lack of burning glycogen.

Homer’s problem isn’t glycogen….it’s lack of burning glycogen. The opposite problem of having no or little glycogen and trying to run endlessly is also problematic.

Cortisol

Cortisol is the second part of this equation and is generally regarded by many anti-cardio folk as one major reason a person shouldn’t engage in regular cardio. When there is a deficiency of glucose cortisol will increase to help mobilize gluconeogenesis (glucose production from protein) and decrease glucose utilization.

As with everything else, certain amounts of cortisol are absolutely necessary for proper functioning. High cortisol is considered our stress hormone and too much can cause sleep problems, decrease in immune function, gaining weight while exercising and eating “right”, problems in the bedroom or lack of desire altogether, headaches and the list goes on.

Again cortisol, in the right amounts is super important. Too much for too long can eventually lead to adrenal fatigue and then more powerful hormones like epinephrine take over because your adrenals just can’t take it anymore. Then you’re really up the creek without a paddle.

So cortisol becomes chronically elevated and T3 becomes low….essentially a recipe for fat gain, lethargy, anxiety and sliding down a slope that if not corrected will cause chronic health problems.

What to Do?

Some people may be thinking to themselves, “I do heavy cardio routines and have been losing weight and feeling great”. Good for you. No really, I’m serious. I don’t deny there is bioindividuality that can be a boon for a select few. But for people that are going to engage in something that is stressful on the body they have to be willing to treat the body in the right way and not the “right” way.

If you are losing weight doing what you’re doing and feeling good, then keep it up. At some point though you will hit a plateau. It’s as that point that you have to be careful about doing endless hours of cardio and not feeding your body because the effects may be very detrimental including all those things just mentioned.

As noted in the study from part 1 [5] women who ate sufficient amounts of calories were able to maintain T3. But if they ate too little T3 dropped. Bad mojo that is. I don’t know that 30kcal/kg/day is required to keep that T3 up, maybe 25 instead. For 125lbs (56.8kg) woman that is about 1400 kcal/day of food intake.

Now this isn’t a set number if you are a female and weigh 125lbs. It might need to be a bit more or a bit less depending on your energy expenditure and what you’re trying to accomplish but you can use it as a guide. While this study wasn’t done in men, using similar numbers again gives us an estimate. For a 175lbs (79.5kg) the equation gives us just under 2000kcal/day.

Remember too that carbohydrates are not evil, just like cholesterol isn’t evil, just like insulin isn’t evil, just like cherry pie isn’t evil. In fact I think I could go for a piece right now. But too many carbs, above and beyond what you need isn’t so healthy if done regularly. Eating an entire cherry pie 1 time probably isn’t going to do a whole lot other than make you feel like a glutton and bloated. Doing it regularly is problematic.

Moral of the story, get enough to provide for what your body needs. There is no exact number. If you are feeling lethargic and are having problems with energy and weight gain and are working out like there is no tomorrow then check to see if your at a large calorie deficit. If you are already fairly lean then shoot for an isocaloric diet (a calorie amount to maintain bodyweight) and give your body a break.Look at getting around 3-4g of carbohydrate/kg/day for a couple of days and let your metabolism get what it needs to reset.

Summary and Conclusion

Cardio workouts are a good way to keep your heart and body healthy provided you’re smart about it. Going for long distances every single day and not supplying your body with the macronutrients it needs to sustain such activity is not the way to do it. Get Liftin!

Too little fuel will shut down thyroid and increase cortisol and make any attempts to maintain or achieve a desired look or feel nearly impossible.

People that perform moderate amounts of exercise and eat few carbohydrates and have no problems with thyroid or weight gain are probably right where they should be activity and calorie wise. But be careful. Remember that carbs aren’t evil.

People that are having problems with it need to give their bodies a break and recouperate. Remember that you really can’t fool your body. Treat it right and it will treat you right.

CIAO

1.Haff, G. Gregory, et al. “Carbohydrate supplementation and resistance training.” The Journal of Strength & Conditioning Research 17.1 (2003): 187-196.

2.Haff, G. Gregory, et al. “Carbohydrate supplementation attenuates muscle glycogen loss during acute bouts of resistance exercise.” International journal of sport nutrition and exercise metabolism 10.3 (2000): 326-339.

3.Esbjörnsson-Liljedahl, Mona, et al. “Metabolic response in type I and type II muscle fibers during a 30-s cycle sprint in men and women.” Journal of Applied Physiology 87.4 (1999): 1326-1332.

4.http://www.medbio.info/Horn/Time%203-4/homeostasis1.htm

5.Loucks AB, Callister R. Induction and prevention of low-T3 syndrome in exercising women. Am J Physiol. 1993 May;264(5 Pt 2):R924-30.

Cardio and Metabolism Part 1

Due to a heinous error in the World Wide Web half of this post was deleted somehow, someway by mysterious cosmic forces. Thus I’m obligated to give you the first half of this post and completely rewrite the other 1000 words or so of the second half. My apologies. It will be a couple of days before I’m able to get to the second half, …..again. Essentially this became a two part post so enjoy Part 1.

Every time I go to the gym I see something that sometimes drives me nuts. Not for my own personal sake mind you because this doesn’t affect me at all. But I worry about how it may adversely affect others who do it. I’m talking about people who go to the gym to run and run and run or use the eliptical for endless hours a week.

Please don’t misunderstand, I don’t believe that doing cardio is bad, quite the contrary. It can be beneficial. Yet if you’re sole purpose for a gym membership is to get on the treadmill then please consider a few things about how you’re metabolism is affected by endless running.

Please do not make this your goal!

Please do not make this your goal!

I’m not going to go into some of the benefits of a MODERATE amount of cardio. So if that’s what you’re looking for please don’t read on. I’m going to discuss the problems of doing more than a moderate amount of cardio.

Thyroid

Simply put too much cardio will wreak havoc on your thyroid. First lets do some thyroid 101 for anyone that needs to be up to speed. This won’t be super in depth seeing as this is a 101 course so if you want more information please use a good anatomy and physiology text.

Your thyroid gland is located in the neck and pumps out what is known as triiodothyronine (T3) and thyroxine (T4). T4 is a much less active form and T3 is the most active form. These are your thyroid hormones.

T4, while just mentioned is active, isn’t super active like T3 and in fact is transformed into T3 in the body. Some think that T4 may act as a pool for T3. it’s also interesting to note that carbs help this conversion. More on that in a bit.

Pretty much all your cells have thyroid receptors. They are important for growth and metabolism. Thyroid hormone is responsible for heat production and that’s why some people who are hypothyroid have cold intolerance, they just don’t generate enough heat to withstand the cooler ambient temperature.

If you haven’t guessed already, thyroid is also responsible for fat metabolism. This is also why some who are hypothyroid gain weight. If no T3 is getting to the fat cells then the fat cells aren’t receiving any signal to give up the fat for energy. This can make it difficult or impossible to lose weight if not enough thyroid hormone is around.

What does cardio have to do with thyroid?

The answer to this is that it can thrash thyroid hormone. [1-6]

When a person does a lot of steady state cardio the body requires a lot of energy to move that much. Energy requirements of the cells go up. Rightly so. You will burn more energy running like a maniac down the street than if you casually mosey on down. Cars are the same way. My truck burns way more fuel at 85mph than 35mph.

But that’s where the similarities between cars and bodies end.

Your body is an adaptive organism that wants to live. It’s programmed to live. When you start running endlessly it wants to conserve energy if nothing else has changed because it wants to live tomorrow. Your truck doesn’t know if it’s going to get fueled or not it just keeps burning gas at whatever rate you tell it. Your body doesn’t know if it’s going to get fueled or not or with how much so it shuts down energy production for you. How kind.

One quick way to shut down energy usage is to slow down the thyroid. This way your body can conserve energy for other things. Without as much T3 roaming your veins the cells aren’t getting the signal to burn and create heat.

Moderate to intense exercise actually can make the fat cells unwilling to give up their precious cargo for energy as well, compounding the problem. [7,8]

Another issue with thyroid is carbohydrate consumption. Many people, not all, but many are going low carb in the hopes of losing all kinds of fat. “Not so!” says the science.

In one trial of active men, three different diets were given at the same caloric values but differing carbohydrate intake. 88%, 44% and 2% percent of calories from carbs were the ratios and the group with 2% calories from carbs ended up with lower T3 and more nitrogen in their urine (ie more muscle wasting).[9]

In one of the trials already cited, women performed aerobic exercise and were given different amounts of calories in their diet, either 8kcal/kg/day or 30kcal/kg/day. The women who received 8kcal/kg/day had reduced T3 by 18%. Exercise quantity didn’t affect thyroid in the women, as long as they were receiving 30kcal/kg/day.[4] If you’re a 125lb woman that’s 1700 calories/day. If you were taking in 8kcal/kg that would be 454 calories/day. This is a fairly drastic cut and definitely not sustainable but makes sense. If you are working your body you have to feed it to keep energy production up or your metabolism will shut down to conserve energy.

In part two we’ll talk more about diet and how to avoid shutting down the metabolism while trying to lose a pound or two.

CIAO

 

1.Baylor, L., and A. Hackney. “Resting thyroid and leptin hormone changes in women following intense, prolonged exercise training.” European journal of applied physiology 88.4-5 (2003): 480-484.

2.Boyden TW, Pamenter RW, Rotkis TC, Stanforth P, Wilmore JH. Thyroidal changes associated with endurance training in women. Med Sci Sports Exerc. 1984 Jun;16(3):243-6.

3.Wesche MF, Wiersinga WM. Relation between lean body mass and thyroid volume in competition rowers before and during intensive physical training. Horm Metab Res. 2001 Jul;33(7):423-7.

4. Loucks AB, Callister R. Induction and prevention of low-T3 syndrome in exercising women. Am J Physiol. 1993 May;264(5 Pt 2):R924-30.

5.Rosolowska-Huszcz D. The effect of exercise training intensity on thyroid activity at rest. J Physiol Pharmacol. 1998 Sep;49(3):457-66

6.Hohtari H, Pakarinen A, Kauppila A. Serum concentrations of thyrotropin, thyroxine, triiodothyronine and thyroxine binding globulin in female endurance runners and joggers. Acta Endocrinol (Copenh). 1987 Jan;114(1):41-6.

7.Jones, N. L., et al. “Fat metabolism in heavy exercise.” Clinical Science 59.Pt 6 (1980): 469-478.

8.Romijn JA, Coyle EF, Sidossis LS, Zhang XJ, Wolfe RR. Relationship between fatty acid delivery and fatty acid oxidation during strenuous exercise. J Appl Physiol. 1995 Dec;79(6):1939-45.

9.Bisschop, P. H., et al. “Isocaloric carbohydrate deprivation induces protein catabolism despite a low T3‐syndrome in healthy men.” Clinical endocrinology54.1 (2001): 75-80.

 

B12: Are You Getting Enough?

B12Many people in the United States suffer from what very well could be a vitamin deficiency. In fact it wouldn’t surprise me at all. With the food supply seriously lacking in essential nutrients and minerals it isn’t a surprise at all that people are having issues with things like lethargy, anxiety and depression, and even disorders such as Alzheimer’s. These are just a few problems associated with B12 (cobalamin) deficiency. So lets talk about it shall we?

B12 is a vitamin responsible for healthy nerves, blood cells, DNA production….essentially stuff to keep you alive. B12 is available in many foods including but not limited to; shellfish, liver, fish, meat, eggs, and dairy. It is very noteworthy that plant products don’t have significant amounts of B12. Don’t be fooled by claims that state otherwise. Many of these foods are fortified with B12, but don’t have it naturally occurring or at very small amounts. And the foods that do, like seaweed, have pseudovitamin B12, which competes for absorption with regular B12. [1] One exception may be green and purple lavers, a type of algae. [2]

This is corroborated by studies that show that vegetarians and vegans are 50% and 80% deficient respectively. [3,4]

If you choose to not eat any animal products whatsoever, you need to supplement. More about that in a minute.

As mentioned above, B12 is really important for certain functions in the body. One problem associated with low B12 is many people don’t even know they are deficient. Working in a clinic I do see lab tests a lot, mostly for CBC’s and Cholesterol or A1c’s for diabetics. I don’t see B12 tests unless the doctor suspects something like anemia. But if there is neurological dysfunction, I don’t see it. The point is that since it isn’t something routinely checked for, it gets missed.

As Chris Kresser pointed out in an article:

In Japan and Europe, the lower limit for B12 is between 500-550 pg/mL, the level associated with psychological and behavioral manifestations such as cognitive decline, dementia and memory loss. Some experts have speculated that the acceptance of higher levels as normal in Japan and the willingness to treat levels considered “normal” in the U.S. explain the low rates of Alzheimer’s and dementia in that country.” [5]

The normal reference range in the USA by comparison is 247-911 pg/mL. That’s like the Rockies, one big mother range.

On top of that, a good deal of the population may have deficiency. [6] According to this study as many as 2/5 of America may have a problem. That’s around 125,000,000 people. While not everyone with deficiency show signs, it is still disconcerting. The article which I linked said that there was nothing to worry about though because we can get adequate B12 from more dairy and fortified cereals…..

……

……

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Modern dietary advice giving us the only reasonable response.

Modern dietary advice giving us the only reasonable response.

Yeah because hey, fortified cereals are where it’s at nutritionally.   ……NOT!

Make no mistake, the addition of niacin to the US flour supply was probably one of the very few smart things the federal government was able to do to actually influence in a POSITIVE manner the population’s health. By helping people get enough niacin they were able to eliminate pellagra, a very serious condition that resembles schizophrenia. The problem with fortified cereals are the only nutrition you get from them are the spray on vitamins. That might be helpful for some, but meat or liver or fish is probably the much better option.

Another issue is that people experience symptoms even when their levels on are on the lower end of “normal”. It’s entirely possible that our range, like many other medical ranges may be off and probably needs to be increased.

Lets Talk About Absorption Baby, Lets Talk about You and Me!

If you don’t remember back or are new to the blog, a few weeks ago I discussed the adverse effects of taking acid reducers chronically. Here’s the link:

https://pharmacybrute.wordpress.com/2013/12/10/acid-supressing-drugs-lower-nutrients/

Acid in the stomach is an important part of the process to get B12 absorbed in the body. Acid cleaves B12 from the carrier it resides on so that it can be attached to intrinsic factor, allowing for absorption. No acid, no cleavage, no absorption. Other drugs can cause problems too. If you’re diabetic, metformin is known to reduce not only B12 but the other B vitamins as well.

People that have leaky gut or other inflammatory processes going on in the gut may have impaired absorption as well. Don’t assume just because you are a meat eater you’re getting all the B12 you need. Fixing your gut is important for many reasons and B12 is definitely one of those reasons.

Pernicious Problems

If you have problems with energy and have been able to rule out blood sugar dysregulation and sleep as potential problems, B12 might be a great place to look. People with anemia can have B12 or iron deficiencies. Since B12 is also required for myelin sheaths (the insulation on the nerves) it is thought that it is important for prevention of neurodegenerative disorders such as Alzheimer’s and Multiple Sclerosis. It may also play a part in anxiety and depression as well as autism and learning disabilities in children.

Maternal breast milk has a content of B12 that is linked with intake from mom. So if a mom is a vegetarian or a vegan, it is extremely important that she supplement to get adequate supplies for the baby.

Supplementation

You can find B12 in just about any B-Complex. It typically comes in the form of cyanocobalamin. I want to point out that this form of cobalamin is linked with cyanide, hence cyanocobalamin. This form is usually injected at a doctor’s visit. Methylcobalamin on the other hand seems to be the form that is most useful, especially in neurological problems. [7] This is the form most used by the Japanese. In fact they don’t use cyanocobalamin anymore because it doesn’t work very well if at all.

The British also don’t use cyanocobalamin. They use hydroxocobalamin. In a paper addressing some concerns about cyanocobalamin, researchers point out that hydroxocobalamin is preferrable to cyanocobalamin and that it’s use should be discontinued. [8]

Cyanocobalamin, methylcobalamin and hydroxocobalamin are the most common forms.

So if you need it, what do you use? I would recommend methylcobalamin in the oral form. There are sub-lingual tabs which absorb and bypass the gut altogether:

http://www.amazon.com/Source-Naturals-MethylCobalamin-Flavored-Sublingual/dp/B001G7R8J2/ref=sr_1_2?ie=UTF8&qid=1334825392&sr=8-2

This would be a good option to start with if you use acid reducers or have gut problems. The one I listed is 1mg which is likely enough. For those fighting off peripheral neuropathies or trying for nerve regeneration much higher doses are likely required, as in doses used in injections.

I would stay away from cyanocobalamin if possible. I know it’s cheap and for a simple anemia where a low dose is effective then it might be ok. But to really maintain good health it’s better to use the other forms. Much like folic acid is synthetic and not naturally occurring folate, cyanocobalamin is cheap (yes I said cheap) and not as effective.

Get the best forms from your food. Fish, shellfish, meat, liver and dairy are good sources. If your gut is in need of help, get it the help it needs so you can get the B12 you need from food. If you are a vegetarian or vegan please make sure to get enough through supplements. I recommend food first of course.

CIAO

1.Watanabe, Fumio, et al. “Pseudovitamin B12 is the predominant cobamide of an algal health food, spirulina tablets.” Journal of agricultural and food chemistry 47.11 (1999): 4736-4741.

2.Watanabe, Fumio, et al. “Characterization and bioavailability of vitamin B12-compounds from edible algae.” Journal of nutritional science and vitaminology 48.5 (2002): 325-331.

3.Antony, Aśok C. “Vegetarianism and vitamin B-12 (cobalamin) deficiency.” The American journal of clinical nutrition 78.1 (2003): 3-6.

4.Bissoli, L., et al. “Effect of vegetarian diet on homocysteine levels.” Annals of nutrition and metabolism 46.2 (2002): 73-79.

5.http://chriskresser.com/b12-deficiency-a-silent-epidemic-with-serious-consequences

6.http://www.ars.usda.gov/is/pr/2000/000802.htm

7.http://www.nutritionaltest.com/methyl.html

8.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2697096/

Disclaimer: All info on this website is for education purposes only. Any dietary or lifestyle changes that readers want to make should be done with the guidance of a competent medical practitioner. The author assumes no responsibility nor liability  for the use or dissemination of this information. Anyone who chooses to apply this information for their own personal use does so at their own risk.

Foods with Sugar

Here is a quick video discussing some foods with sugar in them and how much sugar is there. This isn’t anything novel but I thought it’d be fun to just show a few things and their sugar content. By the way, I know I say tomato soup in the video and a can of tomato paste shows up but both can have added sugar so just enjoy!

CIAO