Why EVERYBODY Should be Talking About Metabolic Syndrome

Stories about the obesity epidemic flood the news. Practically all of us can quote the statistics: a third of adult Americans are overweight or obese; future generations are looking even more dire. And, hand in hand with obesity, the increasing pervasiveness of Type II Diabetes, a completely lifestyle-induced disease, is becoming so ubiquitous that it seems like a non-event to see someone with a glucose meter at the lunch table.

These problems seem insurmountably huge and irreversible to most of us. According to analyses of various nutritional studies, 95% of standard diets fail to produce results. Diabetes is a disease that seems to be "someone else's problem" -- until the day the doctor tells you it's now yours. How do you hope to make progress against such a tide?

Graphic courtesy of Nature.com

The answer: understanding and addressing metabolic syndrome.

What? You don't know about metabolic syndrome? You've never heard of it? It affects an estimated 25% of Americans right now. That's okay. A year ago, I'd never heard of it either, and my father has had Type II Diabetes for the last 10 years.

What the heck is Metabolic Syndrome?

Put simply, metabolic syndrome is pre-diabetes. It's a set of conditions that set you up for that next step. The central condition is insulin resistance, which is the point where your muscles and other tissues can't effectively process and take up sugars from the blood anymore because insulin levels have been elevated chronically for an extended period of time.

A few quick words on insulin. It's a hormone, produced by the pancreas. Like cholesterol, it has been defamed because it is frequently mentioned in association with conditions like diabetes and Alzheimer's syndrome. But insulin isn't a bad thing at all. Like cholesterol, It has an extremely important job, to regulate energy by distributing glucose from your bloodstream to your brain, muscles, and organs. You want insulin doing its job, and doing it well. Hence, being insulin resistant is a problem for your body. It is a lifestyle-induced hormonal imbalance.

I want to break down the vicious cycle of events:

• Any time you eat, insulin is released to handle the carbohydrate energy. But - your blood sugar is particularly spiked from high glycemic index foods (sugars, refined flour in cereals and bread, rice, potatoes, etc)


• The liver calls for insulin to distribute the sugar from your bloodstream


• Your muscles can't take up the sugar they need. The sugar/insulin combo sort of "bounces off" the cell walls.


• Blood sugar remains high, so more insulin is sent out


• Cells become more resistant to the already elevated levels of insulin, requiring more each time to overcome the barrier


• Insulin is the body's primary signal for fat storage


• So, while your muscles and other tissues are literally starving for energy that can't get through, your body is happily depositing all of that in fat cells instead

Throughout this cycle, your energy levels are on a roller coaster, but you can't seem to get on top of the tasks you need to accomplish. Internally, your pancreas and liver are working on overload to continually respond to the ever-increasing task of producing insulin and regulating blood sugar.

Do this long enough and - yep - you've got Type II Diabetes.

People who consume the Standard American Diet (which most do, that's why it's called standard) normally have cereal products for breakfast, sandwich items for lunch with a side of fries or chips, and pasta, potatoes, and breaded foods are dinner time staples. And that's not including the snacks, sodas, and sweets. Simple refined carbohydrates are built into virtually every bite we take. These foods spike insulin severely, over time leading to the cycle above.

I want to say it again: 25% of Americans have metabolic syndrome. Those same Americans are also struggling with weight. This is everybody's problem.

The good news about metabolic syndrome

There is actually quite a silver lining to this dire picture. First, understanding the preconditions that lead to diabetes and which are so closely linked with the weight epidemic sheds some very interesting light on both (I'll go into detail on that in a moment). Second, unlike full-blown Type II Diabetes, metabolic syndrome has been shown to be entirely reversible.

Two approaches that are regularly used successfully to reverse the insulin resistance syndrome: strength training (getting those muscles to deplete and consume all those sugars), and removing refined carbohydrates (those with the highest glycemic index/load) as much as possible from your diet. This two-pronged approach works from both ends of the cycle to restore the hormonal balance your body needs to effectively regulate insulin, fat, and weight.

Now let's take a moment to examine what metabolic syndrome reveals about obesity. Insulin is the primary signal for fat storage in the body. Fat metabolism, under normal conditions, is in a constant state of storage and release, providing your body the steady stream of slow, efficient energy it needs throughout the day. When insulin is continually released to address the blood sugar spikes from our sugary and starchy diet, the fat storage signal is increased. When we are insulin resistant and blood sugar levels remain high, the insulin redoubles its efforts. The signals increase still more and there is plenty of blood glucose that needs to be stored.

Did you know that diabetics often report a ravenous, insatiable hunger? Think about it. The cells themselves are starving in a sea of energy just out of reach.

The flip side of this metabolic cycle is when, through activity or stress, you need to consume energy at an increased rate for a time. Adrenaline, sex hormones, and growth hormone are the primary signals to call for additional energy. But this call only goes out from the liver when your blood sugar has reached a low threshold. If you're continually supplying your body with that "cheap energy", the liver will delay the need to call for that all-important fat energy to fuel the body.

Let's recap

Even though there is heated debate on the most effective methods and means for weight loss in the medical community, strangely, the processes described above are accepted as gospel. The line of thinking is hard to miss, though. Most Americans eat a certain way. Those eating habits irrefutably result in a strain on the pancreas and liver to handle all the sugar. The body has a limited tolerance for this kind of abuse. Insulin signals fat storage. Metabolic syndrome is insulin regulation run amok. 25% of Americans have metabolic syndrome and almost all of them are overweight or obese.

It's reversible. We know how to treat it. Nutrition and rigorous exercise (particularly strength training) are the key. Strength training also releases adrenaline, sex hormones, and growth hormone, the fat releasing signals. So why aren't we talking about it and what are we waiting for?

Spread the word. Learn about how different nutrients affect and fuel your body. Make your health an immediate priority. Have a glucose test to check for insulin resistance. And get into a strength program. And join us here often for more information and to share your success with us and others.

Mastering Macronutrients (Part 3) - Protein

In our first two posts of the "Mastering your Macronutrients" series, we covered carbohydrates and fats as part of your nutrition plan. Part three addresses the "mother of all macros": protein.

Before going on, I want to recap why we felt it was so important to put together this series. Dieters, whether they are successful in losing weight or not, by definition give over control to someone else to "fix" their problem. Whether you are purchasing a meal plan, using shakes, or simply following a plan someone else laid out for you, at some point a person decides "I can't do this on my own and I need someone else to tell me what to do." If you were successful, great. But what happens when you come off the diet? Or, what if your goals change? If you weren't successful, do you know why you weren't? Or are you just frustrated?

We want to give you the tools and understanding to build your own nutrition plan. To sustain it for months and years to come. And, to make adjustments to it, whether it is fine tuning or an outright overhaul. When you own the knowledge, you will be more likely to make the very best use of it. You simply can't buy that kind of personal authority.

Onward...

Protein, an introduction

Proteins, as a food component, provide amino acids which are required to renew and replace body tissue, including muscle, organ, and skin. There are over 20 amino acids used by the human body, nine of which must be consumed in the diet, as the body cannot synthesize them from other compounds. The body breaks down and distributes amino acids throughout the body through the digestive tract and liver.

Your body is continually breaking down and renewing tissues at a cellular level. The cycle of daily regeneration of tissue is known as "protein turnover," which is, in itself an energy-consuming process. Lower rates of protein turnover are associated with aging. Protein turnover has been shown to increase through exercise and training, particularly strength training.

Insufficient levels of energy in the body from carbohydrate (glucose) and fats will result in the body consuming dietary protein or muscle tissue to supply its needs (a process known as ketosis). Excess protein can be stored by the body as fat, but it is not an efficient process, as 1/4 of the potential caloric energy is consumed in the conversion process. For the most part, your body would rather just get rid of the unused protein, rather than keep it around.

Why protein should be the centerpiece of your nutrition plan

Protein is unique among the macronutrients. First of all, protein has the unique ability to trigger the satiety response in your brain. This shouldn't be that surprising, as we have evolved for millions of years to be a large carnivore. There is literally nothing as satisfying. I'm talking about the difference between feeling "full" which is the result of overeating and physical discomfort, and feeling "satisfied" which is your brain's "thank you" for giving the body some much needed building material. Even food marketers are catching on and have added the "fills you up with protein" message to an ever-increasing number of their campaigns. This is not an endorsement for their products, however, as most will far overstate the virtues of their product while simultaneously glossing over nagging issues like sugar content. Still, it's a fact - protein-forward meals trigger the "I'm full and satisfied" response.

Protein is inefficient. What? How can that be a good thing? When it comes to something called the thermic effect of food (TEF), inefficiency is a great thing. That's because protein takes work to break down. Work, as in: calories. Protein has the same caloric content per gram as a carbohydrate food, but carbs are absorbed easily, while protein actually burns energy to digest and absorb. Therefore, consuming the same calories in protein instead of carbohydrate will actually create a little more of a calorie deficit for you overall.

With me so far? Here's where it gets interesting.

Calorie counters (i.e. calories in < calories out = weight loss) operate on the assumption that a calorie is a calorie. It's nothing but a piece of potential energy waiting to be expended or stored in the body. Even those that have gone to great pains to create sophisticated equations to account for basal metabolic rate (BMR) and TEF are missing something critical. Protein is the only macronutrient that can be used to build new muscle tissue, which does more work and burns more sugar when it does. So, rather than just being a piece of potential energy, it is a piece of potential ability to do work and consume more energy. It's like the cold fusion of nutrition!

Granted, you have to be working on getting stronger to create those adaptations, but that's why we recommend a combination of nutrition and training, including strength training to optimize your body composition.

Another point that is not well accounted for in the calorie counting mindset is that, biochemically, it is extremely difficult for protein to be converted into available energy, which means it's very hard to store as fat. So, no, a calorie isn't exactly a calorie.

How much protein do I need?

The precise amount of protein you need depends on a lot of things: the amount and type of training, your specific goals (weight loss, muscle gain), your age, as well as how you are managing your other macronutrients. That said, the current consumption level for Americans is somewhere around 15% of total intake.  This is lower than anybody should be consuming. A healthy nutrition plan should generally consist of anywhere from 30-40% of intake from protein, depending on your activity.

If you're at a stable weight and not accelerating protein turnover with heavy exercise, then somewhere between 0.6 and 0.8 grams per pound is fine. If you are working out hard and trying to lose fat while preserving muscle mass, then between 0.8 and 1.2 grams per pound of your target weight should be your daily goal. If you are trying to gain muscle, then between 1.2 and 1.5 grams of protein per pound of your desired body weight is a better target.

Choosing quality protein sources

Protein content of common foods.

There are three major considerations when choosing the protein elements of your nutrition plan. First, of course, is the actual protein content of a particular food item. The heavy hitters are pretty intuitive, but some may surprise you.


Second, most protein sources are also sources of fats and, to some degree, carbohydrates. This, in itself is a great reason to choose your protein meal element first when building a macronutrient-friendly plate. Then you can select and manage additional elements with the fats and carbohydrate from your protein source added in.

The third is "bioavailability." Simply put, your body will be able to more effectively absorb some protein sources than others. Below is a table of the bioavailability index of some common foods.

Bioavailability of certain protein sources.

Putting it all together

Using the information in this series, you're in a position to build and customize a powerful nutrition plan. Let's flesh it out with a few additional points.  This could almost be a separate post, but I think it fits well into the big picture.

Calories or Macros? Everybody approaches problem-solving differently. Some need precise counts, while for others, directional "big picture" indicators suit their needs. We met and exceeded our weight and body fat goals without counting a single calorie. If counting calories helps you, then do it. But: DO NOT rely on anybody else's formula for calculating how much you need or how much you burned. Track the calories you consume and track it against your progress. If you're making progress, then you don't need to reduce. If you aren't, you STILL might not. Are your macronutrients in an appropriate proportion? You can substitute protein for carbohydrate calories and you may see progress without reducing. You can substitute protein for some fat and instantly reduce calories without reducing total portion consumption. The point is, you are the only baseline that matters.

Optimize Your Systems: Increase protein turnover and insulin sensitivity through a training program that focuses on building strength. The adaptations you create will not only make you stronger and burn calories, but your body will also become more effective at digesting and processing the nutrients you consume. On a related note, ditch the scale (or at least put it in time-out), because it is a one-dimensional measure that doesn't tell the whole story of everything you are doing to improve your body. How do you feel? How do your clothes fit? If you're going to weigh yourself, include a body fat measurement as well so you can see the change in your body composition.

Eat Fresh, Whole Food: Cooking using fresh ingredients removes countless issues from managing your nutrition. You don't have to decode labels and seek out hidden traps like sugars, highly refined carbohydrates and others, such as added gluten. You are in control of every single ingredient in your nutrition plan. This will also free you from flavor profiles that have been designed by their manufacturers to be addictive, rather than satisfying. Honestly - you'll be amazed how much more you enjoy your meals.

Think of food as fuel and building blocks I'm not saying don't enjoy your food. We LOVE to eat and really enjoy meal times. But we also make sure that we have quality ingredients that meet our nutrition needs from the start. That way, as you combine and prepare your menu, all the pieces are already there for you to make as delicious as you like.

Take Control: Don't let anybody else dictate to you how to manage your nutrition or achieve your goals (even us). That's because everybody is different and every body is different. You are starting with a completely unique set of factors, behaviors, and goals. Using these tools WILL work. But exactly how you put them to work is completely in your hands.

Mastering Macronutrients (Part 2) Fats

In part 1 of Mastering Your Macronutrients, we demystified and provided practical guidance to the carbohydrate element of a solid nutrition plan. In part 2, we delve into dietary fats. Let's start by making a clear distinction: the fat you consume is not interchangeable with the fat cells in your body. Much of fat's reputation comes from this obvious, but incorrect, assumption.

Your body has a relatively fixed number of fat cells. They don't come and go when you gain or lose weight (unless the person is morbidly obese, in which case the person has literally filled their fat cells to capacity and must create more to handle the load). Rather, they empty out or fill up, like water balloons. The biochemical processes that store excess sugar as fat in the body are a means of balancing your blood sugar levels, not taking fat molecules one-for-one and sticking them to our belly, butt, or thighs.

Eating fat does not make you fat. If you question that, then consider this: in the last forty years, American fat consumption has dropped dramatically with hundreds of low-fat alternatives to whole milk, butter, cheeses, and dressings, not to mention the shift in meat consumption toward much leaner varieties. Yet, as a nation, we get heavier and sicker.

Fats, an introduction

Fats come from animal and vegetable sources. The human body can produce most of the specific varieties of fats it needs from a healthy nutrition plan, except for two. These Essential Fatty Acids come in the form of a type of Omega 3 (ALA) and a type of Omega 6 (LA). Human beings must consume these fatty acids in their diet.

The human body needs fat to function effectively. Fats in the blood are required to absorb and utilize proteins and certain vitamins. Fats are an essential component of joint health. Fatty acids are required to promote and support synaptic activity in the brain. And fats are essential to cell health. We don't think about our cells much. But damaged cells are a problem. Beauty commercials talk about free radicals, but what are they? Free radicals are damaged cells on a mission. Our cells have a natural "self destruct" code that causes them to die off and then be replaced by new, healthy cells. Free radicals are cells that refuse to die. What's more, they seek out other cells and damage and mutate those as well. Cancer occurs when damaged cells multiply and spread. So, without putting too fine a biochemical point on it, free radicals are "baby cancer" which may or not grow up into something nasty. Suffice to say - we need fats in our diet.

Cholesterol:
Cholesterol is an incredibly complex subject and there is still a good deal of controversy in the medical and nutritional communities about risks, benefits, and management mechanisms. But sometimes a simplified version is what you need for a foundation to build on.

Cholesterol is the natural mechanism for all mammals to transport fats (lipoproteins) through the body to repair and support cells of all types. You can't get rid of it and you wouldn't want to. Unfortunately, in an effort to warn people about the risks of heart disease, the medical community and, along with it, many government agencies have managed to demonize an essential function without creating a lot of clarity. Clarity is good, don't you think?

Most people understand the difference between arteries and veins. Arteries circulate oxygen throughout the body while veins return the oxygen-depleted blood back to the lungs to get more. When we work hard, our muscles need more oxygen. Our heart beats faster, our lungs pump harder, and the rate of circulation increases. This is all to maintain a constant level of balance of oxygen at the cellular level.

Apply that thinking to cholesterol. In general terms, Low Density Lipoprotein (LDL) is associated with distributing essential fats to our cells. High Density Lipoprotein (HDL) is associated with clearing unneeded fats from the blood. Instead of the heart, this system is controlled by the liver. Just like oxygen, the body strives to maintain a certain balance of cholesterol in the blood. If there is plenty present, the liver decides not to produce more. And, just like oxygen, if you decided to take it upon yourself to breathe heavily and quickly for no particularly good reason, you'd overload yourself and get dizzy, with no benefit, because your cells didn't need the extra boost. With cholesterol, you can "breathe heavily" by over-ingesting fats and dietary cholesterol that spills directly into the bloodstream through the digestive process. The liver isn't making any, but you're still shoving it into your system. And, because you've overridden the body's natural regulation system, you're pumping a lot of LDL in without a corresponding increase in HDL.

I want to say it again: I'm oversimplifying an immensely complex process, but in principle it stands.

At this point, we have to come back to carbohydrates. As I said earlier, the organ that regulates cholesterol production ("good" and "bad") is the liver. Constant overconsumption of refined carbohydrates in the form of refined flour, rice, and sugars overloads the liver. This overload (it's not clear precisely how) inhibits the production of HDL - the "clearing out" cholesterol. As a result, you have more in than out. Anybody that's had a backed up sink can identify with this principle.

Restricting your refined carbohydrate intake will improve your liver function and reduce your insulin resistance, which will improve your ratio of HDL to LDL, which, in turn, is a major factor in reducing your risk of heart attack or stroke.

"Good" fats and "Bad" fats

The pop fitness world has sold us a dizzying array of "good" and "bad" fat messages over the years. As I said in Part 1, "good" and "bad" as universal labels aren't helpful. But, like gas station sushi (thank you esurance commercials), some choices are clearly better than others.

The first thing that makes classifying foods by their "good" or "bad" fat content is that most foods have a combination of fat types.  For example, lard, about as "uncool" a fat selection by today's standards as you could find, is about equal parts saturated and monounsaturated fats, with 10 percent polyunsaturated as well. Nature, it seems, likes to keep some of her mystery. In the graphic below, examples are given based on the primary source of fat provided by the food.

The Fat Pyramid. More from the bottom, less from the top.

So, how many fat calories do I need?

Fats are more than twice as dense, calorically, as carbohydrates and protein (9 cal/gram as opposed to 4). Depending on your specific health conditions, activity level, and personal goals, you may choose a different threshold, but a good rule of thumb is to keep your fat intake somewhere around 30% of your total calories. As a simple guideline that would mean keeping your portions of fats to 1/2 the size of carb or protein, by weight, as a portion of your total intake.

If you are taking dietary supplements for essential Omega 3 (ALA) and Omega 6 (LA), and are looking for a way to reduce your total calorie intake somewhere, you could trade some fat grams for protein, taking it down to as low as 20% for a while, but for most, there's no need to do this as part of a long-term nutrition plan.

Since fats are most often a component of food that also includes protein, you aren't going to have to look very hard to find ways to supplement with additional fat sources. If you're eating whole meats, eggs, and dairy products, you're probably doing just fine for fat intake. And don't forget your cooking techniques. We use a couple tablespoons of extra virgin olive oil in virtually all of our stovetop cooking, some of which makes its way onto your plate.

A few words about fat myths and misconceptions

"Low-fat foods = healthy:" As a cooking component, fat provides taste and texture to food. It is also essential as an emulsifier, binding particles together in the cooking process. When you take fat out, you have to replace it with other components that will substitute for these functions. Enter sugar, gluten, and a host of other things that are difficult to pronounce. Low fat foods will likely have more total calories (and empty ones at that), be less satisfying in texture and bite, and may well aggravate the systems of those who are gluten sensitive. Have you ever looked at a 5lb bag of sugar boasting the label "Naturally Fat Free"? Not exactly a believable health claim.

"Eggs yolks are bad for you:" This particular tidbit arose out of the storm against cholesterol. Unfortunately, it was based on lowering total cholesterol, rather than maintaining a healthy ratio of HDL to LDL. As long as you are mindful of your total intake of fats and cholesterol within your 30% (or whatever you choose), eat eggs. They're delicious and a great source of protein.

"Frying food is bad for you:" So many people jump to blame the "grease" in pan or deep frying food, while completely ignoring the food that got fried. The majority of popular fried foods are either low grades of meat or high carb items like potatoes, breaded in white flour. Oil conducts heat very effectively to allow food to cook extremely quickly, resulting in a nice sear and more tenderness than methods which take longer. At sufficient heat levels, very little of the oil is absorbed into whole foods like vegetables or whole cuts of meat. Look to the quality of the dish as a whole. There are a lot worse things than "grease". Just select the right oil for the job from the pyramid above. Another great resource is a detailed review of oils on Mark's Daily Apple.

"Fat will make you fat:" I know I started out with this, but it's really worth repeating. You need fat. Stored body fat is principally composed of excess carbohydrates (sugar) in the diet.

So, to recap: fear not the fat!  It is an essential part of your nutrition plan.  And, when managed effectively, makes for tasty choices and increased variety in your menu.  In our final installment of the series, we will cover the "mother of all macros" (my term of endearment), protein.  Until then!

Mastering your Macronutrients (Part 1) - Carbohydrates

Welcome to the first post in a series that I believe may be some of the most meaningful material we can share with you. Those of you that have followed our writing so far know that we believe that a combined approach of nutrition and training are the keys to weight (fat) loss, reversing the impacts of metabolic syndrome and other "natural" companions of aging, and building a healthy body that will take us into our golden years.

A recent post showed that precise calorie counting is not the best solution (as the primary measurement) for achieving the goals of a healthy, strong, balanced body. Instead, we believe that mastering your calorie composition is the key to taking control of your body again and optimizing all of your body's systems to work together. That means mastering your macro- and micronutrients.

Carb's: an introduction

We start with carbohydrates because they are both the most misunderstood and the potentially most problematic of the macros when it comes to weight and body function. Foods that contain carbohydrates provide two components to your nutritional intake: sugars in the form of glucose and/or fructose, and dietary fiber. Yes, that's right, all carbohydrates are basically some form of sugar.

We need carbohydrates. Your muscles and brain burn glucose in order to function. Dietary fiber is critical for digestive health. But that's it. It's energy, or potential energy anyway. You can either burn it, store it, or - well - get rid of it. You can't build muscle with it; you can't restore cellular health. Those are jobs for proteins and fats. I believe this is an important point: as a macronutrient, carbohydrates have a purpose, and they should be used as intended.

"Good" carb's and "Bad" carb's

Okay, unless it's toxic somehow, let's stop classifying any particular food as good or bad. For one thing, it sets you up for the moment when you choose a food and then feel guilty for having been "bad" in your eating. Remember, every food has a purpose.

However! Like any food selection, there are a range of choices available, and some of them are clearly superior selections. "Better" carb's have fewer calories relative to the sugar content, include micronutrients (vitamins and minerals), and significant amounts of dietary fiber. Checking the Glycemic Index of a particular food is a good (but not the only) way to evaluate the quality of your carb selection.

There are a number of ways to classify and select the higher quality or "better" carb's. One is by their complexity. Simple carb's have sugars that are readily absorbed in the digestive tract and flow straight into the bloodstream. Complex carb's take longer to digest and break down slowly. This results in a more gradual impact to insulin levels. Another way to break them up is by starchiness. The more "starchy" a carbohydrate is (e.g. white potatoes, corn, refined flour, refined rice), the higher the sugar impact to your bloodstream.

"The Carb Pyramid" - my own version anyway.  Eat more of the bottom and less (or none) of the top.

Using the diagram, I try to give a sense of which carbohydrate choices are more beneficial as well as a visual of how much of each a person should consider as part of their daily intake.

Note the "tipping point" in the fruit layer. This is the point in the pyramid where your choices can start to snowball and cause you to get more sugar than you really want in your nutrition plan, especially for the relative nutritional value they provide. Among fruits, your best selections are berries. Bananas, often the choice of athletes to prevent cramps by virtue of their potassium, are one of the most sugary fruits you can eat.

So how many carbohydrate calories do I need?

As I mentioned earlier, this macronutrient group is a little complicated when it comes to dietary planning. Let's break it down.

Doctors and nutritionists recommend 9-11 servings of vegetables a day. A minuscule percentage of the population actually reach this number. So, on one hand, we can all eat more carbohydrates of the vegetable variety. So, let's just say, fresh or frozen, eat as many veggies as you like.

As we move up the pyramid, complex carbohydrates has its own section, which may be a little confusing.  Colorful vegetables are complex carbs, but not all complex carbs are what most think about as vegetables.  Sweet potatoes are a favorite at our house for a filling and tasty side dish that make a "better choice" carb selection.

Dietary fiber can be found both in the vegetable section and in other complex carbohydrates, but is commonly thought of and found in most abundance in whole grains.  Whole grains are just that: things that still look like the kernel of grain as it was harvested. "Big chunk of processed grain" is not the same as whole grain. Rolled oats are just one example of these "sorta whole" grains. Steel cut (also known as Irish) oats are the truly "whole" variety. In their whole form, these grains retain dietary fiber, oils, and vitamins that make them beneficial and satisfying to eat.

Up to this point, you'd be in a safe zone if you kept these carbohydrates up to as much as 40% of your daily calorie intake, although you could certainly take it lower if you chose. Some of this depends on your activity level and the nature of the training that goes along with your nutrition plan.

Once we get to starches and sugars, you're in the zone where you want to watch your intake very seriously. In many cases, these foods spike insulin every bit as much as drinking a cup of straight glucose. You get virtually no nutritional value, don't feel satisfied, put your metabolism on the roller coaster, and, some studies suggest, actually build an ever-increasing craving for these foods. Eat these foods by exception.

Processed food alert! Many of the packaged, processed foods, including cereals, pastas, and anything labeled low-fat, are loaded with refined, processed carbohydrates, because they last longer and create that "crave-able" taste. Don't be fooled by labels like "whole wheat" or "whole grain" either. The standards to apply these labels are widely variable and some companies stretch even those definitions.

A few words about the impact of highly refined carbohydrates

The impact that the onslaught of highly refined carbohydrates has had on our systems cannot be overstated.  Sticking to the concept that any particular food is neither "good" nor "bad" in and of itself, let's just say that it would be extremely helpful to think of these foods much in the same way as one thinks about alcohol (the fact that alcohol is a carbohydrate is actually beside the point here).

People know about alcohol.  People understand that it has both immediate and cumulative effects on our bodies and our health.  Some people can't handle it at all (for a variety of reasons), some people engage only rarely, and some go nuts.  But nobody is fooling themselves about what it does.

Highly processed/refined carbohydrates are no different.  They flood our system with sugar, can lead to fatty liver syndrome (the non-alcoholic version of cirrhosis), make us feel "high" and then sluggish later, and, if abused long enough, can progress to life-threatening conditions.  The science shows that they are quite addictive, stimulating the brain's pleasure center when consumed (or in many cases, even thought about).  Oh - and make us really, really obese too.

So if you're going to include these ingredients in your nutrition plan, go ahead.  But do so knowingly and intentionally, fully aware of the fact that your body neither needs nor wants these things and, eventually you will pay the piper if you abuse them.

A few more words about some of the popular assertions surrounding carbohydrates and low carb diets

The lowly carbohydrate molecule has been so smeared and maligned over the years, it's like a bad political campaign.  Now, I've just given plenty of reasons that some forms are worth avoiding.  But, with all of the exposure, a lot of mythology and conventional wisdom has built up that is worth dispelling.

1. "Sugar is Sugar": made famous by our friends in the corn syrup industry, they really want you to think of it that way.  I'm sorry, but glucose is glucose and fructose is another animal altogether.  Fructose is thought in some circles to be more benign, because it doesn't have the insulin spiking effect that glucose does.  That's because fructose is processed and absorbed in the liver, not immediately upon digestion like glucose is.  But, while it's there, it puts a strain on things.  And, because it's already in the body's fat processing center, guess where it goes?
2. "A calorie is a calorie": as I mentioned above, calories ingested as carbohydrates can only be consumed as energy or stored as potential energy - fat.  So if you're getting most of your calories from carbohydrates, you've got a lot of "potential" to deal with.
3. "Gluten is evil": gluten is actually a protein.  It's found naturally in most flours, which is why people who have gluten sensitivity stay away from most breads and cereals.  The actual incidence of celiac's disease is pretty rare, but it's flashy, so it gets a lot of press and food marketers have jumped right on the bandwagon.  Even those that may not have gluten allergies may be "gluten sensitive" to some degree if it's overdone. And there's the problem with gluten: the food industry significantly increased use of gluten as an additive in many foods as a substitute for fat.  Fat acts as a binder and an emulsifier in food, giving it texture and form.  When they took the fat out, they had to find a food component that would play the same part.  Gluten is what gives bread its structure so that it can rise and be light in texture.  It is the perfect candidate.  So, when you see "low fat" on a label, there's a good chance it's got added sugar and gluten to make up for the flavor, texture, and structure profiles the fat provided.  This means you're probably getting a lot more gluten than you think, and gluten sensitivity has been linked with IBS and lots of digestive unpleasantness.  Hence the upswing on sales of things like Activia and Benefiber.
4. "Low carb diets are dangerous": first of all, I don't like "diets" per se.  But, the theory here is that low carb necessarily means high fat and high protein, which are more difficult to digest and therefore harder on your kidneys and liver.  The other assertion that comes with this is that dietary fat is the root of all cholesterol problems, so by increasing intake of fat, you're putting your arteries at risk.  Unless a kidney or liver specialist tells you specifically that your organs are somehow damaged and unable to handle certain foods, this statement simply doesn't hold water.  Refined carbohydrates have been shown to have even more dramatic effects on blood lipids (particularly the more harmful LDL particles) than fats.
5. "You only lose water weight on low carb diets":  This one makes me smile.  Anybody who has gained a lot of water weight can tell you its an indicator that something is wrong (or at least out of balance).  When you are deluged with refined carbohydrates, your blood chemistry can get out of whack.  The body is pretty effective at regulating blood chemistry, but to deal with all of that extra sugar, the body retains salts and extra water to balance the equation overall.  When you stop flooding your system, the body lets it go.  You lose water weight first as a result of your blood chemistry righting itself.  That doesn't sound like a bad thing to me.  And, after a week to two, all weight loss is "real".

So there you have it, the lowdown on understanding and selecting the right carbohydrate components and amounts for your nutrition plan.  How you arrange them simply depends on what works best for you.  In part 2 of the series, we'll examine how to select the best fats for your plan.

Five Things You Need to Know About Joint Health

With posture like this, no wonder he didn't get away with it.
Darn meddling kids!

There are a few things that clearly mark "older" people in our society: demanding that loud rock and roll music be turned down, random shouting at neighborhood children to get off the lawn, and inexplicable and unwelcome aches and pains cropping up in various parts of our body.

Today, I'm going to cover an issue that is near and dear to those of us who are north of 40: our joints. Specifically, how to keep them healthy and pain free. Because the last thing we want is to get fired up to get back into the gym and, three days later, limp home defeated.

For me, I've dealt with lower back pain, some cranky hip flexors, and a right shoulder that reminds me every so often that I've got to check my ego on the bench press. But, the truth is, joint pain is not an inevitable and natural accompaniment to aging, as many of us have come to accept. Instead, it's the price we pay for extended bouts of inactivity and insufficient nutrition.

A few words about pain

Before we get into the heart of the post, let's talk about dealing with pain. Training involves pushing your body, making it adapt to new conditions. Some pain goes along with that, most notably Delayed Onset Muscle Soreness (or DOMS). DOMS is that sweet, sweet pain you get when you overdo it or when attempting something that your body hasn't been conditioned to do.  The only real way to treat it is to keep moving.  But it's important to recognize when you're dealing with ordinary pain and when you're facing a potential injury.

If your pain is very specifically localized and sharp and/or is accompanied by numbness or tingling, see a doctor or chiropractor before continuing your training program. Muscle strains and sprains don't have to keep you out of the gym entirely. Just throttle the weight back and lift carefully. Some exercises may need to be dropped for a while until the pain goes away, but in many cases, the combination of regular icing and lighter weight will get you through.

If you are feeling pain after a workout, treat with ice, not heat. Ice will reduce inflammation and swelling, which takes pressure off the joint.

1. Joint Health Basics

I'm going to focus on the "big three" - shoulders, knees, and hips, as these seem to be the most common problem areas that crop up.

The health of your joints is based on four basic elements: bone, cartilage, synovial fluid, and supporting tissue (tendons and muscles). In the joint itself, the bones are "capped" with a thin layer of cartilage that is the first line of friction protection in the system. Between the two bone surfaces is a thin layer of highly viscous fluid that functions much the same way as motor oil does in an engine cylinder, keeping the two bone and cartilage surfaces from coming into direct contact with each other.

Around your joints are systems of muscles and tendons that keep the bones in the proper position to each other.

2. Warming Up

Warming up seems to have become a bit passé in many circles. If you're squeezing in a training session before work or over lunch, it may seem like a no-brainer to skip it all together. But warm-ups play a very important role in preventing injury and reducing pain. The way your joint systems work, the act of movement itself causes a "splashing" effect of the synovial fluid, improving the coating quality on the joint surfaces. This is what is commonly referred to as "lubricating the joints." A light run at low to moderate pace for five minutes or some light calisthenics like jumping jacks will provide the kind of movement needed to get things going. Warmed up muscles are also less likely to strain or cramp during exercise.

Please note that this is not about stretching. Stretching before lifting actually reduces your ability to lift. Think about it: the act of lifting itself centers on contracting your muscle fibers. Why would you pull them further apart? Stretching itself is also not a long-term answer to improved range of motion. Practicing the motion often with proper form and manageable weight is your key to increased range.

3. Eating for Happy Joints

I don't know why I'm still surprised when my research continually leads me back to the same themes. But, yet again, our Standard American Diet as recommended by the ADHA has yielded some unfortunate consequences.  As a result, coaches, trainers, and medical professionals also recommend a nutritional component to support joint health.

Joint fluid and cartilage health is dependent on two primary macronutrients: sufficient protein and fat intake. Omega-3s are critical to the generation and replenishment of the essential synovial fluid. So, the low/no-fat, high carbohydrate diet pushed for decades hasn't done us any favors in the joint department.

Additionally, one of the main coincident symptoms of metabolic syndrome (the precursor to type II Diabetes, estimated to affect some 25-30% of adult Americans) is chronic inflammation throughout the body's systems. And the primary culprit in metabolic syndrome: a chronic overload of refined, processed carbohydrates in the form of white flour and sugars. Metabolic syndrome is characterized by insulin resistance, and one of the most important treatments decreasing insulin resistance is regular exercise, resistance/weight training in particular.

So, as with so many things associated with the chronic health conditions of our times, you are either subject to a self-perpetuating spiral or, if you turn it around, a synergistic set of factors that will slow and even reverse the damage we have done to ourselves. Your joints hurt because they are inflamed and they are inflamed because you haven't been fueling your body correctly, and you don't want to exercise because you don't have the energy and the pain is unpleasant. But - get on a training program and correct your nutrition plan, and the issues will likely resolve themselves.

Finally, proper hydration is essential for producing and replenishing synovial fluid, along with just about every other function the body performs. I know it's simple, but it bears repeating all the same. Drink lots of water.

4. Improving Supporting Muscles

For many of us that have either forgone exercise entirely or gone for the American Heart Association's universal prescription of light to moderate cardio three times a week, we haven't used our muscles for much. As I said earlier, strong muscles and connective tissue are a critical element in healthy joints. This involves a number of smaller supporting muscle groups that we don't normally think about. The best thing you can do is to work to make these muscles stronger.

For the shoulders, specialized "prehab" exercises will help build the necessary strength and support. They're not sexy, but neither is wincing when you put your shirt on. Here are a few that are simple to perform with light dumbbells or resistance bands:

• Internal Shoulder Rotation: Lie on your back on a bench or balance ball (for dumbbells) or standing with a resistance band anchored at the midpoint to create tension. Keeping your elbows fixed at your sides and your lower arms at a 90 degree angle from your body, slowly rotate the arm from the side to the front.  The only thing that should be moving is your shoulder joint.  Return to the side and repeat for 15-20 reps on each side.
• External Shoulder Rotation: This is the same as internal rotation, only reversed.  Lie face down or place the resistance band so it crosses your body from its anchor point.  Slowly rotate the arm from in front of you to the side and return.
• The Halo:  Performed with a kettle bell or exercise plate, the key to this exercise is the range of motion you can accomplish, not the amount of weight you can support. Raise the weight overhead with two hands and the elbows bent, move the weight in a circular motion around your head, mimicking a halo. Try to make as big a circle as possible. Do 20 reps and switch direction. You can also do one repetition in one direction, and then do the next repetition in the opposite direction.

For the knees, barbell squats are a fantastic way to build strength. If you're not ready for the squat rack yet, then the leg extension machine and lunges are good bets too, but they're no substitute for the kind of motion and stability involved in squats, even light weight ones.

The hip flexors are a special case. Most of us that have spent hours upon hours in front of a computer or at a desk have lulled our hips into a virtual immobilized stupor. For me, this translated in some chronic lower back pain right around my tailbone, which took an hour or two every morning to loosen up. Learning how to move and engage them takes a little practice. My recommendation here: take some yoga classes. There is no quicker way to learn how to engage muscles you didn't know you had than a basic yoga class.

And, last but not least, form, form, and form. There are so many poor examples of lifting out there that can really set you up for some major pain, particularly as you move to heavier weights. Keeping your elbows in tight during bench press or push-ups, making sure your grip is the proper width for shoulder presses, and keeping your knees lined up during squats are just a few. Get a trainer or review a reputable program and have a spotter to make sure you're getting it right.

5. Joint Supplements

Glucosamine and Chondroitin:  According to an article by the American Association of Orthopedic Surgeons, "One meta-analysis of randomized, placebo-controlled clinical trials from January 1980 to March 2002 found glucosamine to have “highly significant efficacy” for all outcomes, including joint space narrowing and Western Ontario MacMaster University Osteoarthritis Index (WOMAC)."  Chondroitin, has not had the same level of clinical success, but users still report a reduction in pain associated with joint movement after taking the supplement.

Omega 3 supplements:  As already mentioned in the nutrition section, fatty acids such as Omega 3s are essential to joint health.  If you're not getting enough through your diet (most of us aren't) then a high quality supplement isn't a bad idea for a number of reasons.  Just remember, it's fish oil, so if you're allergic to seafood, you need to stay away.

So, let's recap:
Warming up, eating the right components to support your joints, doing some prehab work for trouble areas, and, if needed, supplementing with glucosamine and/or Omega 3s are your best prescription to keep your pain down and your training on track.  When you're not sure if it's "normal" pain, see a doctor (which we are not). But if it's just plain ol' DOMS, get back on the horse; it will get better.

Now, get off my lawn!