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The Nutrition InvestigatorThe health and nutrition blog by Dr. Roc Ordman.

Notes for long distance runners from ProfRoc

by Roc (click here for full post)

I was asked by an ultramarathon runner to investigate health issues. Below is the results of this search, brief and then long notes.

 BRIEF

Competitors of 70.3-mile triathlons should carefully weigh the benefits of higher race-morning energy, carbohydrate and caffeine intakes against their potential to increase GI distress; Exercising can help you age gracefully by keeping you fit. But it turns out that endurance exercise, like running, doesn’t just tone muscles, it enhances muscle stem cells; Eating a healthful diet, exercising regularly, maintaining a healthy body weight, and avoiding tobacco are of utmost importance to maintain good health. I also think that some dietary supplements are critical for optimum health. I continue to take combined lipoic acid and carnitine (Juvenon) and 500mg vitamin C. I exercise regularly and avoid red meat.” Balz Frei, former director of the Linus Pauling Institute; “The carb loading will raise the glycogen levels in your muscles, and taking in carbs during the race will keep your blood glucose levels up.” Includes carboloading instructions; Protein/Carbohydrate consumption during 2 hours of exercise builds muscles much better than just water ; Feeding Meals Containing Soy or Whey Protein after Exercise Stimulates Protein Synthesis; BCAA supplement may attenuate muscle damage induced by exercise and promote recovery from the damage; Do not exercise when angry. Risk of heart attack triples then; . Turns out, people who work out too hard for too long may be less healthy than sedentary people, and are more likely to die than moderate exercisers; Evidence-based clinicians considering the use of platelet-rich plasma in their patients with musculoskeletal injuries should be weary that the literature appears to be inconsistent and thus far, inconclusive;

LONG NOTES

Eur J Sport Sci. 2016;16(4):448-54. doi: 10.1080/17461391.2015.1046191. Epub 2015 Jul 29.

Dietary and non-dietary correlates of gastrointestinal distress during the cycle and run of a triathlon.

Wilson PB1,2.

Author information

Abstract

The purpose of this investigation was to assess whether pre-race dietary and non-dietary factors were associated with gastrointestinal (GI) distress during the cycle and run of a 70.3-mile triathlon. Fifty three participants recorded dietary details the day before and morning of the triathlon and retrospectively reported GI symptoms from the cycle and run. Occurrence and severity of nausea, regurgitation and fullness were combined into an upper GI (UGI) category, while lower abdominal cramps, flatulence and urge to defecate were combined into a lower GI (LGI) category. Spearman’s rho coefficients were used to examine whether UGI and LGI were associated with: (1) pre-race diet (kilocalories, carbohydrate, fibre, fat, protein, caffeine); and (2) non-dietary factors (age, body mass index, experience, weight change, GI distress history, finishing time). Of non-dietary factors, only a history of GI distress showed significant associations with GI symptoms during the triathlon (ρ = .32-.36; P < .05). Morning kilocalorie (ρ = .28, P = .04) and carbohydrate (ρ = .36, P < .01) intakes were modestly, positively associated with UGI during the cycle, while morning caffeine intake (ρ = .30, P = .03) showed a modest positive association with LGI during the run. The associations between diet and GI distress variables remained significant after adjusting for non-dietary factors. Competitors of 70.3-mile triathlons should carefully weigh the benefits of higher race-morning energy, carbohydrate and caffeine intakes against their potential to increase GI distress.

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BOOST MUSCLE STEM CELLS WITH EXERCISE – Science 330: 573 (2010) – Exercising can help you age gracefully by keeping you fit. But it turns out that endurance exercise, like running, doesn’t just tone muscles, it enhances muscle stem cells, too. Younger rats showed a 20% to 35% increase in the mean number of stem cells per muscle fiber, whereas older rats showed a 33% to 47% increase. These cells regenerate muscles after injury or illness, so the boost could explain why human exercisers have better muscle function than nonexercisers as they age. Better muscle quality could also delay sarcopenia, the decline in muscle mass that occurs with aging.

1) Eating a healthful diet, exercising regularly, maintaining a healthy body weight, and avoiding tobacco are of utmost importance to maintain good health. I also think that some dietary supplements are critical for optimum health. I continue to take combined lipoic acid and carnitine (Juvenon) and 500mg vitamin C. I exercise regularly and avoid red meat.” Balz Frei, Director “Here is a good profile – low total and LDL cholesterol, high HDL cholesterol, low t riglcerides, normal blood pressure, normal blood glucose, healthy body weight and waist circumference, and low inflammation (CRP levels). LPI Newsletter Spring/Summer 2013

Workouts activate genes for proteins that promote the growth and repair of neurons, which stress can damage.–Moderate aerobic exercise 3x weekly for a year increased the size of the hippocampus important for memory and stress regulation. US Government recommends 75 min. of intense workouts weekly like running or swimming or twice as much moderate exercise like mowing the lawn or walking fast, and also 2 days of muscle strengthening.  On a biological level, social ties stimulate the release of oxytocin, that reduces anxiety by limiting cortisol [which  vitamin C does, too]. SCIENTIFIC AMERICAN MIND JUL/AUG NOTES PG. 39

(37) Blueberry consumption can increase natural killer cell [anti-viral, anti-cancer, innate] immunity and can improve gene function by reducing damage to gene transcripts: McAnulty LS, Nieman DC, Dumke CL, Shooter LA, Henson DA, Utter AC, Milne G, McAnulty SR. Effect of blueberry ingestion on natural killer cell counts, oxidative stress, and inflammation prior to and after 2.5 h of running. Appl Physiol Nutr Metab. 2011 Dec;36(6):976-84. doi: 10.1139/h11-120. 

http://www.ncbi.nlm.nih.gov/pubmed/22111516 

THE ANSWER TO CARBOLOADING? Science 330:567 (2010) –Up against the wall – Which is better, chowing down days before or grabbing some sugar during the race? “Both,” says sports nutritionist Edward Coyle of the University of Texas, Austin. “The carb loading will raise the glycogen levels in your muscles, and taking in carbs during the race will keep your blood glucose levels up.” And now Rapoport even has an app for that: Athletes will soon be able to calculate their thresholds at http://endurancecalculator.com/.

Poster with details of carboloading

Carboloading is primarily for long-term athletic events using both fast and slow-twitch muscles. Thus cycling and long-distance running are activities for which it is most likely to be appropriate. But talk to your coach to be sure.

One recipe for one day’s intake: 10 g carbs/kg lean body mass = 70% total intake, thus total = 2900 kcal.

One reasonable suggestion of how to do it: CarboLoadingFOR MEN: The traditional method of carbo-loading is usually a six day process prior to competition. For the first three days, eat minimal carbs. This will deplete the glycogen stores. Your body is ‘tricked’ into thinking that there is a carbohydrate problem and should store more glycogen. During the last three days, cut back on training and consume primarily carbs. The glycogen stores are replenished and ‘topped up’. During the final three days of loading, athletes usually eat pastas, breads, potatoes etc. There are many “carbo-loading-in-a-bottle” products out there that will give you the correct amount of complex- and simple carbohydrate ratios. These products are usually stacked with other minerals and vitamins that aid the body during the loading process and also speeds up the recovery process afterwards.Golden rule: Drink PLENTY of water during the loading phase (your urine should be faint yellow to clear).FOR A POSTER ON DETAILS OF CARBOLOADING, CLICK HERE.

1. Protein/Carbohydrate consumption during 2 hours of exercise builds muscles much better than just water – We investigated the effect of carbohydrate and protein hydrolysate ingestion on whole-body and muscle protein synthesis during a combined endurance and resistance exercise session and subsequent overnight recovery. Twenty healthy men were studied in the evening after consuming a standardized diet throughout the day. Subjects participated in a 2-h exercise session during which beverages containing both carbohydrate (0.15 g·kg–1·h–1) and a protein hydrolysate (0.15 g·kg–1·h–1) (C+P, n = 10) or water only (W, n = 10) were ingested. ..During subsequent overnight recovery, whole-body protein synthesis was 19% greater in the C+P group than in the W group…We conclude that, even in a fed state, protein and carbohydrate supplementation stimulates muscle protein synthesis during exercise. Ingestion of protein with carbohydrate during and immediately after exercise improves whole-body protein synthesis but does not further augment muscle protein synthesis rates during 9 h of subsequent overnight recovery.

J Nutr Feb 2007 
Feeding Meals Containing Soy or Whey Protein after Exercise Stimulates Protein Synthesis and Translation Initiation in the Skeletal Muscle of Male Rats J. Nutr. 2007 137: 357- 362 [http://jn. nutrition. org/cgi/content/abstract/137/2/357] ” 

Dec 2016 brain 
Science 28 Oct pg 430 Physical exercise or exploration of a novel environment greatly influences the production, maturation, and connectivity of adult- born neurons. Sci Am Mind Jan 2017 We have 86 billion neurons connected by 100 trillion syn. 

Nov 2014 AJCN 
long chain amino acid intake prolongs muscle protein synthesis – At 1 h after exercise, mature men ingested 10 g of essential amino acids (EAAs) containing 3. 5 g of Leucine (BCAA). Leu- enriched EAA ingestion after RE may prolong the anabolic response and sensitivity of skeletal muscle to amino acids i. . 

Oct 2014 notes 
I. Journal of the American Aging Association, October 2014 1. Exercise improves cognition – Different exercise programs targeting physical fitness and/or gross motor skills may lead to equivalent improvement in cognition in healthy older adults.   2.  Melatonin is . . 

Feb 2015 AJCN 
SUBJECT: AJCN Feb 2015 Mature adults need 2g leucine after exercise to maintain muscles – The 2 key strategies for maintaining adequate muscle mass and physical functioning in older adults are regular physical activity, particularly resistance exercise, and sufficient dietary protein. . 

Sept 2016 notes 
and prognosis in elderly patients with AMI; People age 50 to 80 who exercise 40 min/day 3 times per week for 6 months had larger hippocampi, controls had smaller ones. Exercise reduced Alzheimer’s risk 50% in those over age 65. AARP Bulletin, Sept, 2016, pg 26.   Cognitively . . 

BCAA supplement may attenuate muscle damage induced by exercise and promote recovery from the damage. J. Nutr. February 2006vol. 136 no. 2 529S- 532S x . .

Dec 2016 notes 

Univ. of Maastricht in my country the Netherlands. AARP – Do not exercise when angry. Risk of heart attack triples then.   Best advice from top docs – 30 min daily walk, 7- 8 hrs sleep; see a friend; less junk food and refined carbs; avoid soda, eat veggies. For mature women, w. .

A 2% loss of water from the body will negatively affect exercise performance!] Theresa O Scholl, Maria Leskiw, Xinhua Chen, Melissa Sims, and T Peter Stein Oxidative stress, diet, and the etiology of preeclampsia Am J Clin Nutr 2005 81: 1390- 1396 Kate Gosselin feels best when she runs 10 miles every other day, according to Us Weekly. But what the 37-year-old mother of eight doesn’t know is that when it comes to vigorous exercise, more isn’t always better. Turns out, people who work out too hard for too long may be less healthy than sedentary people, and are more likely to die than moderate exercisers, according to an editorial recently published in the British journal Heart.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5632954/An evidence-based evaluation on the use of platelet rich plasma in orthopedics – a review of the literature

Nasir Hussain,1,* Herman Johal,2 and Mohit Bhandari2

Author information Article notes Copyright and License information Disclaimer

This article has been cited by other articles in PMC.

Abstract

Within orthopedics, the use of platelet-rich plasma (PRP) has been rapidly increasing in popularity, however, its true effectiveness has yet to be fully established. Several studies find that injecting PRP to the site of injury does not provide any significant benefit with respect to clinical outcomes; however, many others report the contrary. Due to the conflicting evidence and multiple meta-analyses conducted on the topic, a literature review of high-quality evidence on the use of PRP for common orthopaedic conditions was performed. Thus far, the evidence appears to suggest that PRP may provide some benefit in patients who present with knee osteoarthritis or lateral epicondylitis. On the other hand, evidence appears to be inconsistent or shows a minimal benefit for PRP usage in rotator cuff repair, patellar and Achilles tendinopathies, hamstring injuries, anterior cruciate ligament (ACL) repair, and medial epicondylitis. There is limited confidence in the conclusions from the published meta-analyses due to issues with statistical pooling, and limited subgroup analyses exploring the substantial heterogeneity across studies. Evidence-based clinicians considering the use of PRP in their patients with musculoskeletal injuries should be weary that the literature appears to be inconsistent and thus far, inconclusive

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