Adelfo Cerame: Carbophobia a Thing of the Past - How a Love-and-Hate Affair Turned into a Productive Friendship

The very latest progress pictures from "Your's Truly"; Adelfo Cerame Jr. posted only a couple of hours ago on Facebook - I guess there is no doubt about the success he has with his old fiend and new friend - in "moderation" as he says ;-)

It's Thursday and about time for another update of "Your's Truly" Adelfo Cerame Jr. from the photo Adelfo posted on facebook earlier today (see image on the right), you can see already that he actually not approaching, but more or less already in contest shape, but before I hand the virtual microphone (actually I should type keyboard ;-) over to Adelfo, here is the brief primer on today's SuppVersity Science Round-Up on Super Human Radio.

As you should really know by now, you have three options (not listenting to it is not among them ;-)

1. listen live at 1PM EST,
2. download the show ~2h later either from the "Physical Culture for Your Ears" menu in the sidebar of the SuppVersity, or
3. download the podcast load it right over right over at www.superhumanradio.com

And just to make sure that you know that it will be well worth it, here's the sneak peak on the topics Carl Lanore and I have lined up for you, today:

• the real-world benefits of caloric restriction - what's that all about?
• intermittent fasting works - regardless of whether you do it w/ liquid or solid foods
• alpha lipoic acid (ALA) - still a potent supplement - but who benefits?
• the usual suspects - omega-3, omega-6 & vitamin D
• acidity, diabesity, muscularity and ... ahm, there is no "-ity" for chronic fatigue, I guess

As you should know by now, additional topics and things I mentioned that ended up not making it into the show due to time constraints will be part of tomorrow's SuppVersity Science Round-Up Seconds... that's it. Let's go Adelfo!

Fully and completely getting over my phobia of carbohydrates

It's plain to see and hard to deny: Me + Carbs a.k.a. Mrs. Jones = Got a Thang Goin’ On…

In light of some of the comments I’ve been getting on FB about my carbohydrate intake being very high, I thought it would be prudent to address the issue in my weekly blogpost. Firstly, this saves me hours of precious time, since I don't have to answer the same questions dozens of times, and secondly - my gut tells me I would have benefited, if someone had written a post like this in the past: an article that would have had me rethink my own nutritional regimen, which and this is something I want to point out before I even get into any details clearly isn't "high carb"! With 150-200g of carbohydrates and thus <800kcal of my daily energy intake from carbs this may be high for a "carbophob", as I've been one myself before, but it would still be considered "low carb" both, in the mainstream, as well as in the context of classic bodybuilding diets. Be that as it may, I personally feel a huge relief now that I have finally liberated myself from my personal fears of carbohydrates and have learned to embrace "carbs" in all its forms - my diet has become more flexible, I have a greater variety and - what's most important - I see nothing but benefits from it.

I’ll be the first to tell you that Mrs. Jones (I’ll refer to her as that because this is how I felt about carbs for a while) and I were not on the best terms. It was a 3-year love hate relationship. Just like cash, I thought she was the root of all evil. The first time I ever downloaded and read Dr. Mauro DiPasquale’s Anabolic Solution, I for sure thought I found the Holy Grail to dieting and bodybuilding (true story!), and that’s where my phobia and our tragic love-hate relationship actually began. I thought that I would be shredded year round if only I lived the low carb lifestyle. It worked for a while but then eventually the magic I thought I was experiencing, when I started out, didn’t work any longer. 

Even during my bulk I thought I would still manage to look ripped because I was on low carbs, but again I was wrong! Lol. But I still insisted that carbs were evil just because… honestly, I don't even know why!? Probably because for 2 years I had avoided my Mrs Jones like the plague and only devoured her on my refeeds, cheat days and special social events, which eventually turned into binge fests and late nights in my bed being in a fetal position because I would eat myself silly.

No, carbs just had to be bad,... otherwise I would have had to admit that I'd a mistake, yet not only once, but 365 days a year!

Suggested read: Adel's old post "Carbohydrate Shortage in Paleoland" The article explains pretty well why 150g CHO is something any not 100% sedentary diabetic can easily handle.

If you have a closer look at Not until last year did my opinion start to change towards carbohydrates. My relationship with Mr. Jones gradually improved ever since I started using Intermittent Fasting a la Leangains last year to prepare for my 2013 bodybuilding shows. But even then I still shied away from breads, oats, grains and even rice and just stuck to your typical sweet potatoes and yams. I guess you could say that she and I were at a truce, but not necessarily friends, like secret lovers we knew our boundaries and kept our distance… I stayed away for the majority of the week with the exception of 1-2 days of debauchery out of the week (refeeds).

During the last year, however, a revelation started to dawn on me. Finally, I began to understand the importance of carbohydrates, when it came to performance and the importance of performance, when it comes to making progress - regardless of whether we are talking, cutting, bulking or becoming stronger! More and more foods I had avoided or restricted, because I deemed them "bad" or "extremely detrimental" for my physique found their way back in my diet and not one of my fears about what would happen, when I consumed them more than maximally once per week materialized.

Me + Carbs = Best Friends

Though carbohydrates are not an essential nutrient like fats and amino acids; I’ve realized when it comes to performance and bringing in your best physique… carbs are necessary.

I really kept an open mind when approaching my 2013-2013 contest preparations. Just as I had an open mind with giving intermittent fasting a go last year for my prep, I’ve also had an open mind with giving IIFYM a try this year and combining the two, and needless to say I am very happy that I did. I thought that I enjoyed the perks of Intermittent fasting last year?... Well I’m really enjoying the perks of applying both IF & IIFYM this year! A

Admittedly, it certainly helped to have a coach I can trust. It gave me a lot of reassurance in keeping an open mind – especially when you’re still trying to grasp the fact that all foods are OK to eat in moderation - and yes this includes ice cream, beer and bacon (before some of you new readers out there go nuts and tell me how unhealthy my new protocol is, please refer to my last article and the follow up discussion, so you’ll understand what I’m taking about).

My Take Away: As I always say, balance, moderation & consistency are the keys to a long-term successful diet. Though carbohydrates and I are pals now, I still show the same amount of love to protein and fats as I did before; the only difference is that carbohydrates is treated as an equal now ;-)

8x Increase in "Mitochondria Building" Protein PGC1-Alpha W/ Medium Intensity Exercise in Glycogen Depleted Elite(!) Cyclists: Training Revolution or Recipe for Disaster?

With only 2-7x increases in PGC1-alpha expression HIIT seems to lag behind compared to this "eat low, train low, gain high" strategy, but not every protein essay that glitters in the petri dish will turn into Olympic Gold in the real world ;-)

As a diligent student of the SuppVersity you should by now have at least a preliminary understanding of how the adaptive machine you call your "body" adapts to the various nutritional and physical challenges most people subsume under the all-encompassing and pretty nondescript terms "diet" and "exercise". Against that background it should not really come as a surprise that researchers from the The Swedish School of Sport and Health Science are soon going to publish the data of an experiment that shows that even (you could probably also say, in particular, although respective evidence is still missing) highly trained athletes can benefit from exercising in a glyocogen depleted state - at least if the yardstick you use to measure the "benefits" is an increase in mitochondrial biogenesis (Psilander. 2013).

Train high, eat low (carb), train low and...?

To elicit the differential effects of 6x10 min bouts of cycling at 60% of the individual VO2max (4min of active rest in between) with normal vs. depleted skeletal muscle glycogen stores, Psilander et al. had their 10 highly trained male national elite level competitive road cyclists and mountain bikers (27.8±1.6 years, 74.7±2.0 kg, 183±2 cm, and 4.9±0.1 l/min VO2Max) perform an 8x4min interval training at 88% of their individual VO2Max ~16.5h before they had to report back at the laboratory on the actual testing day (the intervals were seperated by 4min of active rest, i.e. cycling at 100W+).

Figure 1: Graphical outline of the experimental protocol and its effect on the glyocogen stores of the from the vastus lateralis muscle (based on Psilander.. 2013)

The protocol (see figure 1) was repeated twice, with adequate time in-between and in random order, with the subjects consuming water only and low carbohydrate meals

• low carb meals (LC) were eggs and bacon (0.02 g CHO, 0.6 g protein and 0.8 g fat/kg bw) for dinner and breakfast, providing a total of of <0.04 g CHO, 1.2 g protein and 1.6 g fat/kg bw

before the glycogen depleted trial (LC) and high carbohydrate beverages (maltodextrin-dextrose powder Carbo 134 w/ 1.0g CHO/kg bw) + high carbohydrate meals

• high carb meals (HC) were pasta with meat sauce and lemonade for dinner (1.83 g CHO, 0.53 g protein and 0.14 g fat/kg body weight bw) and oatmeal and orange juice (1.54 g CHO, 0.31 g protein and 0.12 g fat/kg bw) for breakfast and additional bananas with beverage 3,5,7 and 8 for a total of 12.6 g CHO, 0.9 g protein and 0.3 g fat/kg bw

before the glycogen repleted trial (HC).

... get impressive increases in PGC1-alpha, but no AMPK response at all!

As the data in figures 1 & 2 goes to show you the nutritional intervention was not without effect the factual glycogen levels (figure 1, right) and the glucose, insulin and fatty acid levels before and after the workout (figure 2) - and, as you would expect it, the corresponding changes in gene and protein expression in the muscle samples the researchers collected approximately 15 min before the depletion (S1) and test exercise (S2), as well as 3 h after the test exercise:

Figure 2: Free fatty acid levels before depletion (S1) and before (S2) and after (S3) exercise trial, as well as PGC1-alpha and p-AMPK expression (data calculated based on Psilander. 2013)

Now what you probably won't have anticipated, though is the absence of the expected p-AMPK response to exercise in the low glycogen (LC) trial.

"The mRNA content of the master regulator of mitochondrial biogenesis (PGC-1a) was not changed 14 h after depletion exercise (pre-test exercise) but was significantly increased 3h after the test exercise in both conditions (Fig.2). The increase was, however, much more pronounced in LG than in NG (8.1-fold vs. 2.5-fold, P<0.01). The mRNA content of two other regulators of mitochondrial biogenesis (PRC and Tfam) also increased significantly but with no difference between conditions (time-dependent effect, Py0.01; [not shown in my graph]). The mRNA content of genes for oxidative metabolism enzymes (PDK4 and COX I) only increased after LG with a significant difference between the two conditions. The mRNA content of CS, Sirt1, NRF1 and PPAR[-delta] did not change under any conditions." (Psilander. 2013)

Almost 8x elevated levels of PGC-alpha but no change in the "fat burning, GLUT-4 pomoter" AMP-activated protein kinase? How can that be? The answer to this question is actually pretty simple: If the phosphorlyation of AMPK changes in response to changes in the ATP to ADP ratio (the name is misleading, here as scientists have initially believed that the main determinant was the ATP to AMP ratio, which is yet not the case), it should be obvious that it won't change, if the ATP levels are already so low that at most the ADP to AMP, but not the already rock bottom ATP do AMP ratio will be changing.

What happens if your body senses that it cannot fuel his energetic demands with glucose?

In the presence of borderline hypoglycemic glucose levels (the normal range starts at 4.4 mmol/L; after the depleted test the subject were at 4.3 mmol/L!) your body would be ill advised to increase glucose uptake. So if this is not an option the only way to make up for the lack of energy are fatty acids. Unfortunately the amount of fatty acids your skeletal muscle can oxidize is strictly rate-limited by your mitochondrial capacity ... now, I am asking you what's the "natural", the logical and in the case of the 10 cyclists in the study at hand also the factual reaction that will get you out of this mess? Right! To build more powerful mitochondria and thus widen the "bottle neck"! And what's going to do just that? Yeah! The ~8x increase in PGC-1alpha expression you see in figure 2. 

Practical implications: From protein essays to results?  

 Now that we have gotten the mechanisms straight, there is but one question we have to answer - what does that mean for you? When and for whom does it make sense to train with depleted gycogen stores? And in an even broader context - what does that tell us about low-carbing and (intermittent) fasting?

1. 

   Before you even consider making this a staple of your regimen, I would encourage you to read the whole SuppVersity Athlete's Triad Series

   Even (or especially?) for trained athletes competing in largely aerobic sports, training in a state of depleted glycogen store can serve as a viable tool to elicit even higher (2-7x; cf. Gibala. 2009, Nordsorg. 2010. Psilander. 2010) increases in increases (8x!) PGC1-alpha and (allegedly) mitochondrial biogenesis as you would see them in response to high intensity interval training at much lower intensities (but correspondingly longer durations). 
2. Training in a fasted state does not per se guarantee / put you at risk of being glycogen depleted, neither does intermittent fasting and or "training on empty". As long as you replete your glycogen stores after your workouts you won't see similarly pronounced increases in PGC1-alpha in response to "regular" aerobic training at a low intensity. You will, on the other hand, still see increases in AMPK and, what's even more important, you will be able to perform at much higher intensities! A fact that is particularly important for the strength trainees out there.
3. While it may make sense on occasion, and merely based on it's beneficial effects on purported  mitochondrial biogenesis (I don't have to remind you that we don't have any information on whether the increase in PGC1-alpha did even translate into an increase in mitochondrial biogenesis in the absence of adequate glycogen / ATP levels!), I want to reemphasize the scientists very hint that "[l]ongitudinal studies examining protein levels and performance are required" before it can be recommended to include this practice as a staple into your routine!

4. 

   Life is to complex for black-and-white thinking, and so are AMPK, mTOR & co! Learn more in the Intermittent Thoughts.

   Long-term exercise in a glycogen-depleted state without adequate carbohydrate intake and thus glycogen repletion is not for nothing one of the causative factors of the athlete's triad (see Part I & II of the SuppVersity Athlete's Triad Series). I would therefore be very surprised if the long-term outcomes of low-carbing + (intermittent) fasting w/out regular glycogen repletion would be anything but negative, regardless of its beneficial effects on PGC1-alpha. After all, the study at hand clearly shows that you will also be missing out on the benefificl effects of increased p-AMPK expression of which you know based on what you have read in the Intermittent Thoughts on Intermittent Fasting Series that it is one of the, if not the central argument in favor of intermittent fasting.

The practical take home message of this study is therefore that exercise + diet induced targeted glycogen depletion before a workout (not via an overnight fast, only; that would leave your muscle glycogen stores largely intact, while your body is burning fat and tapping into your hepatic glycogen reserves) can become one among a whole host of tools in your workout-toolbox. You can use it sporadically, but you should not need another study to be able to predict that the downsides of chronic use are going to outweigh (purported - again, we are measuring markers only, here!) short term benefits.

On a last note: I guess you know that the SuppVersity is the place where you will hear about respective longitudinal data first, right? To make sure you don't miss that I suggest you go to www.facebook.com/SuppVersity like the page or register for updates at twitter.com/ProfDrAndro!

References:

• Gibala MJ, McGee SL, Garnham AP, Howlett KF, Snow RJ, Hargreaves M. Brief intense interval exercise activates AMPK and p38 MAPK signaling and increases the expression of PGC-1alpha in human skeletal muscle. J Appl Physiol. 2009 Mar;106(3):929-34.
• Nordsborg NB, Lundby C, Leick L, Pilegaard H. Relative workload determines exercise-induced increases in PGC-1alpha mRNA. Med Sci Sports Exerc. 2010 Aug;42(8):1477-84.
• Psilander N, Wang L, Westergren J, Tonkonogi M, Sahlin K. Mitochondrial gene expression in elite cyclists: effects of high-intensity interval exercise. Eur J Appl Physiol. 2010 Oct;110(3):597-606. Epub 2010 Jun 23.
• Psilander N, Frank P,  Flockhart M, Sahlin K. Exercise with low glycogen increases PGC-1agene expression in human skeletal muscle. Eur J Appl Physiol. 02 Oct 2013 [ahead of print]

Particle Size & LCAT Analysis Shows: Three Whole Eggs per Day Improve Lipid Profile in Men & Women W/ MetSyn. Plus: Up to 700% Increased Lipid Oxidation in Hardboiled vs. Fresh Omega-3 Eggs From Hens on Fish Oil Enriched Diet

"Not the yellow part of the egg!", is the literal translation of "Nicht das Gelbe vom Ei!", which is German and means "not exactly brilliant" - telling isn't it?

As a regular here at the SuppVersity you will probably have come across a line like "make sure to get at least 20g of quality protein (meats, poultry, eggs, fish, dairy) with every meal!" at least once. If we discard the fish, which is, outside of the occasional discussions about mercury and other heavy metals in our food chain, about the only of these highly nourishing foods, the various experts appear to agree is healthy for you, all of them are to be consumed only "on occasion", "in moderation" and preferably in their "lean" or "low-fat" varieties. And while you (should ;-) have read about the beneficial effects of full-fat dairy, yesterday, and about the actually not so bad "bad meats" in the "Meat-O-Logy" post from August 17, 2013, I thought I'd take the forthcoming publication of a paper by Christopher N. Blesso, Jeff Volek et al. as incentive to remind you not to make the mistake and flush the yolk, the best part of the egg, down the toilette.

Recipe for disaster? Take 20 men and women with metabolic syndrome, 5040 whole eggs...

With 40 men and women aged 30–70 years who had been classified with metabolic syndrome the researchers from the University of Connecticut and University of Antioquia in Medellin, Columbia, intentionally picked a representative sample from the ever-increasing number of people with metabolic syndrome for their 12-week dietary intervention trial. I mean, who if not the men and women in this high risk group should suffer from the negative side effects of the cholesterol-laden yellowy, orange-yellow heart killers in disguise?

AHA Definition of Metabolic syndrome

according to Grundy. 2004

Abdominal obesity (waist)
Men	>102 cm
Women	>88 cm
Triglycerides	≥150 mg/dL
HDL cholesterol
Men	40 mg/dL
Women	50 mg/dL
Blood pressure	≥130/≥85
Fasting glucose	≥110 mg/dL

The assumption that subjects with established metabolic syndrome (for the "official" criteria check out the table on the right) is however one of the very few things the study at hand and studies like the one that triggered such an upheaval in August (see Sciencedaily. 2013) have in common. Instead of relying on total, low density and high density lipoprotein levels in the sera of their study participants, Blesso et al. conducted a differential analysis that included paricle number, size (measured by nuclear magnetic resonance spectroscopy), apolipoproteins (apos), oxidized LDL (oxLDL), cholesteryl ester transfer protein (CETP) and lecithin-cholesterol acyltransferase (LCAT) activities at baseline and after 12-weeks on a carbohydrate-restricted diet (25%–30% energy) that contained either  3 regular whole eggs/day (EGG, n = 20) or the volume equivalent in form of a yolk-free egg substitute (manufactured by Sysco Corporation, Houston, TX).

Accordingly, the subjects in the "real egg group" (EGG) consumed approximately 534 mg cholesterol, 0 g carbohydrate, 16 g protein, 12 g fat per day (186 kcal) from hole eggs, while a single serving of the cholesterol and fat-free substitute (SUB) contained approximately 2 g carbohydrate, 14 g protein, no fat, no cholesterol and only 60 kcal.

To minimize possible confounding factors and allow for "blinding" (you can't tell me you don't taste the difference between egg whites and whole eggs, but alas...), the eggs / egg supplements were prepared in advance.

"Compliance was monitored by use of weekly questionnaires and collection of empty product containers. Participants were asked to maintain their normal physical activity, medications, and dietary supplement usage upon starting the 12-week study." (Blesso. 2013)

To be able to track the dietary intake of the subjects, all participants had to fill out 5-day dietary intake records (3 weekdays + 2 weekend days) at baseline, week 6 and week 12 of the study period. Based on the analysis of the respective data, the scientists determined that

• increased relative protein intake from 17.3%± 3.0% to 23.9%± 4.1%
• increased relative fat intake from 38.6%± 6.4% to 45.7%± 7.4%

• reduced total energy intake of -24% for all participants
• reduced relative CHO intake from 40.9 ± 7.4 to 28.3 ± 9.5% of total energy 
• reduced absolute CHO intake from 211.9 ± 51.8 to 114.5 ± 55.0 g/d 

Moreover, there were "significant differences between groups for dietary cholesterol intake (EGG vs. SUB, P < 0.0001) and dietary choline intake (EGG vs. SUB, P < 0.0001)"

• Δ cholesterol intake +106% in EGG vs. -38% in SUB
• Δ choline intake +52% in EGG vs. -12% in SUB

In that, it is important to point out that these changes and their metabolic effect should not be seen in isolation, because choline plays a major role in the metabolism, transport and incorporation of cholesterol into the cell membrane (read more about choline in "Old School Supplements - Choline: Stronger, Faster, Leaner & More Muscular, or Just Another Dumb-and-Barbell Story?").

"So, the men and women in the egg-group did not die?"

Not exactly, no. Rather than being as bad as cigarettes (as the aforementioned "study" that was published roughly 2 months ago would make us believe; Spence. 2013), the consumption of three eggs per day lead to rather favorable changes in the lipoprofile of the EGG consumers:

Figure 1: Lipoprotein serum levels (left), particle size and ratio of LDL to HDL count (right) of the 37 participants who completed the 12-week trial (data expressed relative to baseline; calculated based on Blesso. 2013)

Contrary to the lipoprotein metabolism, which showed differential (and general positive) effects in response to whole egg consumption, the reductions in circulating insulin, HOMA-IR and triglycerides did not show statistical significant inter-group differences:

triglycerides: -29% vs. -18%
• insulin: -21% vs. -14%
• HOMA-IR: -22% vs. -18%

The existing changes were yet on average still somewhat more pronounced in the EGG group, which is an observation you could interpret as joint effect of low carb dieting + egg eating.

The same goes for the increase in LCAT activity the researchers observed only in the EGG group. Since LCAT is critically important in facilitating HDL particle stability and HDL maturation, its elevation in the EGG group

"[...] could be indicative of an enhanced capacity for HDL maturation and may help explain the shift towards larger HDL particles seen with egg feeding" (Blesso. 2013; my emphasis)

and would thus favor enhanced HDL-mediated reverse cholesterol transport from (e.g. the endothelium of your coronary heart arteries) back to the liver.

What about the lipid oxidation?

If we assume that part of the negative effects that have been ascribed to the consumption of egg(-yolks) are brought about by oxidized fatty acids and respective byproducts, it appears wise not to hard-boil your eggs, because the prolonged heat exposure during hard-boiling increases the oxidation of fatty acids. Aside from temperature and duration of the heat exposure, Cortinas et al. also identified the fatty acid composition of the eggs and their vitamin E content as crucial factors that will influence the formation of oxidized lipids. Since the fatty acid composition of the eggs depends on the diet the hens are fed, you would be particularly ill-advised to hard-boil eggs from hens who were fed a diet enriched in fish oil.

As you can see in the figure above the "fish oil eggs" with their readily oxidized long-chain PUFAs had by far the highest  TBA values (expressed as ng MDA/g dry matter) - specifically, if the hens did not receive additional vitamin E that would be transfered to the eggs and reduce the heat-induced oxidation of the long-chain PUFAs in the "omega-3 eggs" during cooking.

So what's the verdict? In conjunction with the aforementioned additive effects on glucose management and the slightly more pronounced decrease in oxidized LDL (both are probably rather a result of the -12% reduction in carbohydrate content of the participants' diets than the effect of the eggs), the statistically significant improvements in LCAT activity in the EGG eater group speak in favor of the notion that three whole eggs a day will still help you keep the doctor away. Whether they will suffice to throw his statins away, as well (see "Eat Whole Eggs All Day and Throw Your Statins Away?"), will yet have to be elucidated and appears overall questionable - and this goes regardless of whether you belong or don't belong to the relatively small subgroup of people who actually benefit from taking a statin, or not.

What stands out of question, however, is that the "side effects" of three egg yolks per day are quite distinct from those of cigarettes, the consumption of which the headline of the aforementioned ScienceDaily.com article implicitly equates with "egg yolk consumption". And just like smoking and eating eggs are two very different pairs of shoes, there is a huge difference between this well-controlled trial, on the one hand, and the undifferentiated observational hokum that got Spence et al. so much media attention back in August, when they concluded "Our findings suggest that regular consumption of egg yolk should be avoided by persons at risk of cardiovascular disease." (Spence. 2013), on the other hand.

References:

• Blesso CN, Andersen CJ, Barona J, Volek JS, Fernandez ML. Whole egg consumption improves lipoprotein profiles and insulin sensitivity to a greater extent than yolk-free egg substitute in individuals with metabolic syndrome. Metabolism. 2013 Sep 26.
• Cortinas L, Galobart J, Barroeta AC, Baucells MD, Grashorn MA. Change in α-tocopherol contents, lipid oxidation and fatty acid profile in eggs enriched with linolenic acid or very long-chain ω3 polyunsaturated fatty acids after different processing methods. J. Sci. Food Agric. 2003; 83: 820–829.
• Grundy SM, Brewer HB Jr, Cleeman JI, Smith SC Jr, Lenfant C; American Heart Association; National Heart, Lung, and Blood Institute. Definition of metabolic syndrome: Report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation. 2004 Jan 27;109(3):433-8.
• ScienceDaily. Egg yolk consumption almost as bad as smoking when it comes to atherosclerosis, study suggests. August 13, 2013 < http://www.sciencedaily.com­ /releases/2013/08/120813155640.htm > accessed on October 03, 2013.
• Spence JD, Jenkins DJ, Davignon J. Egg yolk consumption and carotid plaque. Atherosclerosis. 2013 Oct;224(2):469-73.

Adelfo Cerame: Intermittent Fasting Done My Way - How I Break My Fast, Plan & Time My Macros and Use Caloric Zigzagging & Re-Feeds on a LeanGains Inspired IF Regimen

Image 1: Intermittent fasting, breaking the fast, macronutrient ratios and timing, caloric zigzagging and refeeds - learn how it can be done, learn how Adelfo does it!

Today's thursdaily SuppVersity post by Adelfo Cerame starts with an advertisement... "What? I thought the SuppVersity was ad-free!"... I see you are shocked!? Well, actually it ain't a real ad anyway, it's more a plug and what's best, I am plugging myself, or rather the new, likewise thursdaily radio show I am going to do with Carl Lanore. Those of you who have tuned in live or listened to the podcast (click here to download) last Thursday, when Carl was sitting alone in the studio going over the latest news-stories from the realms of health, nutrition and exercise science and I shot him an email, whether he did not want to call me to have some company, will probably already know what to expect. For the rest, I would say, the best way to describe what you will  hear today at 1PM EST on Super Human Radio would be "On Short Notice", or, in SHR-terms "Casual Sciency Thursday" - call it whatever you like, but don't forget to tune in live, or come back and download the podcast (update: click here to download the podcast), in case you already missed it

But now, without further delay Adelfo Cerame's Thursdaily Suppversity post for YOU to enjoy (the rest is ad-free, I guarantee ;-)

The intermittently fasted physique (re-)engineering nutrition 101 ;-)

If I had to name one question I get most, by clients, but even more so, by people who see me train in the gym or read my blogs, here at the SuppVersity is how I am timing my carbohydrates and meals. Especially with the folks who follow an IF style protocol, questions such as ...

• “When should I eat my carbs?”
• “How should I distribute my carbs?”
• “What should my carb intake be on training days & rest days?”
• “What about caloric zigzagging”

are things male and female gymrats appear to waste more time thinking about than about their significant others! As funny as that may sound - and to a certain degree it certainly is - there is actually an often overlooked correspondence between finding the ideal partner and the ideal nutrition regimen. Not only is it rarely your first love that you will end up marrying and spending a part if not your whole life with, it is also a matter of personal preference: Luckily, I mean if it wasn't all the guys would be chasing the same girl and all the girls would jump at just one guy ;-)

Image 2: When you are approaching this degree of leanness, you can still start worrying about all the intricacies of dieting many people waste far too much time on, when it would not even matter for them.

With nutrition things are not so much different and yet strangely people tend to lose themselves over details that would be equivalent of the size of your significant others right ear in comparison to her/his left one. What I am hinting here is that you must not lose sight of the big picture and lose yourselves in intricacies like these and their respective nutritional counter-parts before you haven't laid the nutritional foundations: Get rid of processed food, learn to cook, learn the basics about macronutrients and micronutrients how much you need and what your body needs them for and develop a sense for the energetic content of the foods you eat... "What? Calories, but I thought..."

Yeah, I know you thought "A Calorie is Not a Calorie" - that may be true, but only as long as you are referring to the black on white figures you see printed on the labels of the junk you can buy at the supermarket - intermittent fasting or not, at the end of the day, the most important determinant of whether you are or aren't progressing towards your goal is still the difference between the energy you derive from the foods you eat and the energy your body actually expends. 

You may notice that I am not talking about simple "calories vs. calories out" calculations you could do based on calorie tables and the figures your stupid heart rate monitor or treadmill are displaying. I am talking about the BIG PICTURE you always have to keep in mind and which must be set straight and be geared to your goals, i.e. weight loss, muscle or strength gains, etc., before you even start thinking about whether any those  "optimizations" of which I found that they work for me will work for you, as well.

My Twist to the Original Leangains Regimen

For those of you who have been following my Thursday Blogs for the past year or so, it won't be news that follow a 16/8 intermittent fasting protocol (this means 16h of fasting are followed by a 6h feeding window) - this protocol is based on the same fundamental principles as Martin Berkhan’s Leangains regimen. I don’t follow the exact protocol to a “T’’ (you know I am not changing Martin's girlfriend either ;-), but I stay along the guidelines, with added tweaks here and there to what’s suitable and work well for me… So here is what I prefer to do   when I break my fast and do my meal/carb timing during my 8 hour feeding window.

• When do I eat my carbs? On training days, I prefer a protein + fat meal before I train because I feel my body runs better on dietary fats, when I train as oppose to having a big carb meal – so a protein shake + coconut oil (as a sponsored athlete I obviously use Myotropics Physique 2.0 and while I would recommend you give it at least a try, you can certainly use your favorite protein powder - preferably no whey isolate, but something "slower", like milk or a protein blend). The nourishing and long-lasting mix of WM-HDP, milk protein + MCTs from the coconut oil  is more than enough for me to fuel my workouts.
  
  

  

  Image 3: As it turns out the "anabolic window" is more of a barnyard door, than ...read more

  When I am back home from my workout my first real meal of the day is the one, where I place the lion's share of my carbohydrate intake. So, the meals after I train are usually high in protein and moderate to high in carbohydrates, while keeping the fat intake very modest. The reason I use this strategy is to make full use of the repartitioning effect after the workout, when your muscles will suck up more glucose in the presence of relatively moderate insulin levels. Since this "post workout window" (suggested read "Opening the 'Anabolic Barn Door' With the Key of Exercise and Nutrition Science!") also happens to fall in the evening, I don't have to worry about (a) bunking later in the day or (b) overeating and feeling sluggish, I just fill myself up with carbs and relax... when I go to bed later, I am still happy and satiated and ready to get some quality sleep.

• Which carbohydrate sources do I use on workout days? While I am now going to give you a list, the latter is not supposed to be extensive - it's more to give you an idea of the broad range you can pick from without ever having to resort to the "carbage" that's making people fat and sick and has brought all carbs into disrepute.

  

  Figure 1: Recommended (mean) carbohydrate intake in %-age of total calorie consumption ... read more

  • sweet fruits like ripe bananas, pineapples, mangoes, cherries, papayas 
  • starchy carbs like sweet potatoes, organic russets, yams, colored potatoes, butternut squash, rice
  • variety of veggies
  If my macros allow for it and I can sneak it in – ice cream, Hawaiian bread, peanut butter and jelly sandwich, cheesecake, mochi - but occasionally!
  
  On non-training days I spread my macros pretty evenly across the 6h feeding window, with a lower carb intake on non-workout days and mostly being from veggies and fruits this will allow for optimal insulin levels all-day. Consequently, all my meals are high protein + high fat based; I've always fared very well with this strategy and feel that my body doesn’t need much carbohydrates on days I don’t train and those I do eat mostly come from...
  • a variety of veggies, which I always eat to satiety
  • a couple of slices of tropical fruits such as pineapples, papayas, plantains, kiwi, mango, coconuts, guava…
  In the end, most of my non-training day meals will thus be more or less "Vince Gironda"-ish, such as the food he consumed on his steak & eggs diet, or his Hawaiian diet that consists of a combination of lean meats and tropical fruits.
   
• Caloric ZigzaggingCaloric zigzagging is another one of those advanced techniques I hinted at in the introductory part of this blog, it can facilitate and optimize fat loss, but is neither necessary to make progress nor optimal for everyone.
  
  
  Caloric zigzagging is not a must and not for everyone, either: In my opinion, caloric zigzagging, is not a beginner technique and the benefits are too small to risk getting totally confused . For beginners or people that just get confused with tracking numbers its much easier to just diet down and incorporate re-feed days rather than having to remember “x amount of carbs on this day, and x amount of carbs on that day” … But for individuals like myself… I don’t mind. Plus, with the protocol I follow, where I eat starchier carbs on training days and more fibrous carbs on non-training days; my caloric intake will tend to be lower on rest-days, anyways.
  Rather than just following a regular downward spiral, where you continuously decrease a constant daily calorie intake (independ of whether you work out or not) over a pre-defined, short timespan (4-6 weeks), caloric zigzagging will add an andditional "zigzag" component to the regimen, where you will now vary your calorie (and macronutrient intake according to whether you train or rest on a given day: Basically the idea is you will eat a little bit more, when you train to make use of the priming effect workouts have on the departments (muscle vs. fat) your body is going to store the nutrients, respectively the energy it derives from it in. On non-training days, on the other hand you eat less, and have your body feed of his body fat stores. There is however one thing you must never forget: At the end of the day it’s still about energy in, energy out, and your overall food consumption. Caloric zigzagging is just another one of those little pieces to the BIGGER PICTURE in which, as Dr. Andro would say it,  "weight gain and weight loss are nothing but the two complementary and yet incommensurable sides of the same coin".
  
  So, for example, my training day macros can look something like this; 200g protein/ 150g carbs/ 65g fat – then my rest day macros would look like this: 200g protein/ <100g carbs/ 65g fat. And again, different scenarios or phases in your cut will dictate how you make your macronutrient adjustments. Sometimes I can start off doing caloric zigzagging and by the tail end of my diet; I’m back to the good old proven and effective downward dieting.
   
• How do I incorporate refeeds into my intermittent fasting routine? Re-feed days are usually incorporated into a diet once an individual starts to get leaner, calories are decreased, and metabolism starts to level out. In my experience, I did not have to incorporate re-feeds into my diet for the first 3 months. I had a cheat day, when Thanksgiving, Christmas and New Years came around but those were the only cheat days I incorporated into my diet for the first 3 months from October – January. The rest of the days out of those 3 months, I did just fine.
  
  I didn’t start incorporating re-feed days until around maybe mid-January, when I was really starting to dip into the single digit body fat % range. I would then still follow my 16/8 protocol and break fast on Sunday as I would any other day, but the leaner I got, the bigger and more important my Sunday refeeds became - to the point, where I was starting my re-feeds and breaking fast @ 10am and ending my them at 11pm. Lol.
  
  During my first contest prep of this year my re-feed days were pretty ridiculous. I never kept track of what I ate on my Sunday re-feeds. The only guidelines I followed were keep protein moderate, fats low, and carbs HIGH! And I ate literally the whole day. I never kept track but one Sunday I was curious to see how much carbs I was taking in, and I must have had almost ate 800+ grams of carbs that whole Sunday! And just in case you’re curious about this type of re-feed type style, it’s called skiploading (google it, and you’ll get the concept of it)! Or you can just double back to one of my re-feed blogs from a couple months back.
  
  

  

  Image 4: It's not just the nasty subcutaneous water you can avoid, when you don't abuse your refeed days to binge like a maniac!

  During my 2nd contest prep of this year my re-feeds were a bit more controlled this time around. I learned from a couple of Dr. Andro’s articles (esp. "Carbohydrate Shortage in Paleo Land") that the average indidual would not need more than max. 400g of carbs  to refill his glycogen stores (needless to say that those must not all come from dextrose or be eaten in one meal).
  
  Moreover, our glycogen stores don’t get as depleted as we think. It’s damn near impossible to fully deplete your glycogen stores during a single workout. Even after an intense session of high volume training, I don’t think even 50% of our glycogen stores get depleted – So long story short, I realized that I didn’t need to go overkill on the re-feeds 400g is more than enough to fill glycogen stores.
  
  I stuck to this principle and it has not just always worked well for me, but also helped me to avoid the nasty bloating, the gastrointestinal distress and the all the other dreaded short term and often overlooked negative longterm health effects of stuffing yourself with carbage fooling yourself to believe you were "refuelling your glycogen stores".

I hope this helps you answer some of your questions, provide orientation and give you inspiration to design and tweak your own (intermittent fasting) diet routine. And while this is all I have for you today, SuppVersity readers you are of course welcome to post additional questions and comments in the comment area below! So, tune in next week for another session with yours truly ;-)

Carbs Past 6PM Reloaded: Circadian Shifts in Leptin and Ghrelin + Rising Adiponectin During the "Carb-Fast" Could Explain the Efficacy of Eating All Carbohydrates at Night

Image 1: Paul Bart (Kevin James) in Mall Cop (Columbia) probably would be better off weight- and health- wise without his Segway, which is by the way among the "50 Worst Gadgets of the Decade" in the Business Insider hall of shame from 2009 (Barret, Brian. 2009)

The SuppVersity was the first place you read about the how "Carbs past 6pm Will Make You Lean" (at least about the non-anecdotal scientific evidence) and for 99% of you, this will probably be the first time you read about the "follow up paper" on the original study, which was originally intended to induce a shift in the circadian pattern of leptin secretion in order to make use of its fat burning effects over night. Exactly this is the focus of a follow up paper that's soon going to be published in Nutrition, Metabolism & Cardiovascular Diseases (Sofer. 2013).

Israeli Police Diet Acadamy Reloaded!

Now the bad news is that the news are only partly new. In other words, the Israeli scientists only reevaluated the original data which was based on 63 overweight police officers who finished the original "don't eat carbs before dinner study."

And if that was not already enough, the complete hormonal profiles which had been collected on days 0, 7, 90 and 180 of the study period were only available for 39 of them.

Figure 1: 24h leptin profile before and after the intervention in the control (left) and experimental (right) group
(graph adapted from Sofer. 2013)

Still, the data in figure 1 does support the original hypothesis that the mechanism due to which the participant on the experimental diets (composition see figure 3 in "Carbohydrates Past 6PM Will Make You ... Lean!") lost ~2% more weight, and ~4% more body fat was in fact a shift in the circadian expression of leptin:

I suggest you go back to the original "Carbs past 6pm Will Make You Lean" post to read up on the details; unless you're a longstanding reader and this reminder is enough for you.

"On day 0 both groups demonstrated typical concave diurnal leptin curves, including a fall throughout the hours of 08:00-16:00, reaching a nadir at the afternoon and a rise from 16:00. On day 180, leptin curves were lower compared to day 0 in both groups. In the experimental group, the curve became more convex with a nadir only in the evening and not in the afternoon (figure 1, right). A significant difference was observed within the experimental group between day 0 and day 180 in the morning and in the evening (p = 0.023 and p = 0.021, respectively). For subjects in the experimental group that had complete data, the change in evening measurements from day 0 to day 180 was significant(p = 0.024). Using these data, the change in evening measurements was significantly greater than the afternoon and the noon change (p = 0.009 and p = 0.014, respectively). In the control group, a significant difference was observed between day 0 and day 180 at noon (p = 0.042). This result was also found for subjects with complete data (p = 0.045)." (Sofer. 2013)

What's also noteworthy is that the sparse information the scientists had on the ghrelin levels of their participants (believe it or not, but the nurse or whoever took the blood samples must have messed up, so that much of the data was lost) would suggests that the "post 6pm group" (=experimental group) were freaking hungry in the evening (see figure 1, right), but this was not the case, contrary to the subjects in the control group which had carbs from AM to PM, they did rather expose an "enhanced daytime satiety" an observation based on which Sofer et al. rigthly state that

"[...] the alteration in ghrelin’s peak from daylight hours to the evening just before dinner was another cause for the elevated daylight hour satiety, improved persistence in the weight loss process and better anthropometric outcomes that were reported [16]." (Sofer. 2013)

Next to with the circadian shifts in leptin and ghrelin levels, the pronounced increase in adiponectin (see figure 2), a reliable marker for an improved glucose tolerance, the "carb binges" which as you will probably remember included desserts such as ice-cream and co (see figure 3 in "Carbohydrates Past 6PM Will Make You ... Lean!"), probably is the third pillar of the superiority of the past-6PM carb regimen over the conventional "eat small amounts of carbs all day" approach  the control group was following.

Figure 1: 24h Adiponectin profile before and after the intervention in the control (left) and experimental (right) group
(graph adapted from Sofer. 2013)

In conjunction those three made the "impossible possible": Eat all instead of no carbs past 6PM and lose weight! Now the unfortunate truth is that this works well for people with compromised insulin sensitivity and anywhere between 15-20% body fat to shed before they approach the level of leanness (<20%) most of you probably started out with, whether it will work similarly well for significantly leaner, physically active individuals, on the other hand, remains to be seen.

Video 1: I don't want to be a spoil, but the weight loss program of the Stadtwerke Cologne which works by simply skipping dinner (!) and without any caloric restriction got some series attention here in Germany. Why? Well, it simply works... so what does this tell you? Maybe it's more about helping AMPK come to it's own, instead of stuffing yourself with readily available energy 24/7, than about exact timing or meticulously calculating macro compositions?
(click here to watch Quarks & Co.)

Bottom line: Irrespective of my all doubts about the applicability of the very same diet principle in a context, where the goal is to get really ripped and not simply non-obese, the study at hand (and I am referring to the whole experiment, here not just the last paper) does confirm that there is more to dietary success than calories in vs. calories out that having breakfast like a king is not a necessity (nuts + coffee, which was the standard breakfast in the experimental group, or nothing, which is Adelfo Cerame's standard breakfast, work just as well) and that the influence of circadian rhythms goes far beyond our sleep-cycles... which reminds me that I'll do my very best to get into more details on that in the coming episode III of the SuppVersity Circadian Rhythm Series on Sunday. Until then, try not to lose the beat ;-)

References:

• Barret, Brian. The 50 Worst Gadgets Of The Decade. Business Insider. Dec 31, 2009. < http://www.businessinsider.com/the-50-worst-gadgets-of-the-decade-2009-12?op=1 > retrieved on Aug 24, 2013.
• Sofer S, Eliraz A, Kaplan S, Voet H, Fink G, Kima T, Madar Z. Changes in daily leptin, ghrelin and adiponectin profiles following a diet with carbohydrates eaten at dinner in obese subjects. Nutr Metab Cardiovasc Dis. 2013 Aug 14.