Fat Advantage: 61% Lower Rates of Metabolic Syndrome in High Fat, 101% Higher Rates in Low Fat Dairy Lovers

"Got milk" is not the question health conscious supermen and -women should pose. "Got full fat milk, fermented dairy and cheese" is the line to remember (the original image was part of the "Got Milk Campaign")

While diet fads come and go, the advice the wise (not seldom obese or otherwise sick) experts on the boards and panels of our well-meaning governments is calling "dietary recommendations" is about as resistant to reform as the dreaded MSRA strains are to the antibiotics doctors are throwing at you whenever you sneeze. Against that background the recent trend we are seeing with respect to an increase in the recommended amount of dietary protein does almost amount to a quantum leap; a leap with a significant caveat, however. A fat caveat, so to say:

"A healthy diet includes [...] lean meats, poultry, fish, beans and fat-free or low-fat dairy products" (NIH. 2013).

Luckily, you as a SuppVersity reader do not have to rely on the NHI's thwarted interpretations of the latest research they claim to use, when they are "turning discovery into health" (no joke, this is a literal citation from the footer of the NHI website!), but can compare it to my thwarted interpretations of the latest research and cherry picked data ;-)

Cherry pick of the day: Longitudinal large scale study on dairy intake and metabolic health

 For Today, this means that you get to enjoy the latest results of a large scale observational study from the University of Sydney that's based on datasets from the Blue Mountains Eye Study (BMES) a population-based cohort study of common eye diseases and other health conditions in residents aged 49 years and over in the Blue Mountains area, west of Sydney. A longitudinal study the baseline information was obtained in 1992/1994 from  and complemented by follow-up ten years later.

The data sets included food frequency questionnaires, as well as anthropometric and biochemical assessments all of which were included in the present analysis of the association betweenn dairy consumption with the ten-year incidence of Metabolic syndrome (MetSyn) and type 2 diabetes. What's so special about this dataset, is that the food questionnaires were actually detailed enough to assess the effects of full- and low-fat dairy, separately - a very important advantage, as a cursory glance at the data in figure 1 reveals.

Figure 1: Odds ratios (95% confidence intervals) of incident metabolic syndrome according to quartiles of reduced/low fat,
regular fat and total dairy product intake (data based on Louie. 2013; adjustments for age and sex (basic model), smoking status, physical activity (metabolic equivalents), dietary glycemic load, fibre from vegetables, total energy intake and family history of type 2 diabetes (model 1) and calcium (model 2))

While the standard analysis for total dairy consumption (figure 1, left) yielded neither conclusive, nor statistically significant results (the p-values for the different models can be found in the upper right corner of the respective graphs). The categorization into low- and high fat dairy and the adjustments for age and sex (basic model), smoking status, physical activity (metabolic equivalents), dietary glycemic load, fibre from vegetables, total energy intake and family history of type 2 diabetes (model 1) and calcium (model 2) yields very clear and, after adjustment for calcium intake, pretty unflattering result the formulators of the afore mentioned "dietary recommendations" will probably file in their already bristling "statistical outliers"-folder:

• after adjustment for calcium intake subject in quartiles 2 / 3 / 4 of low-fat dairy are 50% / 145% / 101% more likely to be struck by metabolic syndrome, than those in the lowest quartile of low fat dairy intake (p = 0.043), while
• subjects in the highest quartile of full-fat dairy intake are - depending on the adjustments made -  48% / 59% / 61% less likely (base model / model 1 / model 2) to suffer frommetabolic syndrome, than those in the lowest quartile of high fat dairy intake (p-values:  0.018 / 0.004 / 0.004)

Yet while the scientists are well aware, that these results stand in stark contrast to the initially cited dietary recommendations, is it not this contrast that surprises them, but rather the fact that a similar significant benefit was not observed for type II diabetes, which is, after all, one of the hallmark features of the rather loosely defined triad of obesity, insulin resistance and cardiovascular disease(s), we usually refer to as 'metabaolic syndrome':

"Due to its higher saturated fat content, regular fat/high fat dairy products were previously believed to increase the risk of type 2 diabetes as a high saturated fat intake is associated with insulin resistance . However, cohort studies and a meta-analysis now suggest otherwise, with higher regular fat/high fat dairy consumption being considered mostly neutral or protective for type 2 diabetes. The results of the present study are consistent with these findings that higher regular fat dairy consumption may be protective of MetSyn and type 2 diabetes. The potential harmful effects of higher saturated fat from regular fat dairy products may have been offset by the protective components of regular fat dairy such as trans-palmitoleate, a fatty acid nearly unique to ruminant foods. Circulating level of trans-palmitoleate was shown to be significantly associated with reduced risk of type 2 diabetes (Q5 vs Q1: 62% reduced risk, p-trend < 0.001). Moreover, the protective effect of trans-palmitoleate may be exerted via the suppression of hepatic fat synthesis, where the latter was strongly associated with insulin resistance." (Louie. 2013; my emphases)

In view of these mechanism, it is all the more surprising that the study at hand and many previous studies didn't find any significant correlations between (regular fat) dairy intake and type II diabetes.

Reduction in metabolic risk, but no effect on type diabetes? Hold on...

Wolverine could be the only face of the "Got Milk" campaign who does not have to care about potential negative health effects of homogenized milk.

And upon a cursory read of the latest literature it does in fact seem as if "null findings" like this, were nothing special. Only recently by Sluijs et al. who had analyzed datasets from a nested case-cohort within 8 European countries of the European Prospective Investigation into Cancer and Nutrition Study (n = 340,234; 3.99 million person-years of follow-up) includind a random subcohort (n = 16,835) and incident diabetes cases (n = 12,403; cf. Slujis. 2013):

"This large prospective study found no association between total dairy product intake and diabetes risk. An inverse association of cheese intake and combined fermented dairy product intake with diabetes is suggested, which merits further study." (Sluijs. 2013)

If we do yet take a closer look at the actual results the actually not so surprising truth is that there was a statistically significant inverse association with diabetes for cheese (p = 0.01) and fermented dairy (p = 0.02).

An association that suggests a 12% reduction in diabetes risk in those study participants who consumed the most cheese and fermented dairy (cheese, yogurt, and thick fermented milk)

And since you all know your real foods, I guess I don't have to tell you that despite the fact that there are low fat varieties of cheese yogurts and other fermented milk products, 90% of them contain way more than the 1.5% let alone 0.1% fat the allegedly healthy low fat "milk" is boasting of. Mere coincidence? I don't think so. Reason to assume that low-fat milk will make you sick? No, but certainly not an argument to avoid the full-fat variety simply because it contains fat (which is the only argument the average dietitian has to favor low- over full-fat dairy products).

Mutant Milk!? New Research Fuels the Flames on Hushed Up Concerns About Ill Health Effects of Homogenized Milk 

Ask Dr. Andro: Are Colostrum and Milk Products in General Healthy Muscle Builders, a Waste of Money or Toxic Waste?

All about milk: Browse past news and articles at the SuppVersity

^ Suggested reads

Additional recent dairy science:Similar beneficial findings for all-cause mortality and fermented dairy (yet inconclusive results for CVD and diabetes) come from the recently published Whitehall II study (4526 subjects,72 % men, mean age 56 years; Soedamah-Muthu. 2013) and for dairy intake during adolescents and diabetes (-38% risk reduction for 2 servings per day or more) from a reanalysis of somewhat questionable data (who remembers exactly how much dairy he had during his adolescence?) from the Nurses' Health Study II cohort that comprises 37,038 women who completed a food-frequency questionnaire about their diet during high school were followed from the time of return of the questionnaire in 1998-2005 (Malik. 2013).


References:

• Louie JC, Flood VM, Rangan AM, Burlutsky G, Gill TP, Gopinath B, Mitchell P. Higher regular fat dairy consumption is associated with lower incidence of metabolic syndrome but not type 2 diabetes. Nutr Metab Cardiovasc Dis. 2013 Sep 26. pii: S0939-4753(12)00193-7. 
• Malik VS, Sun Q, van Dam RM, Rimm EB, Willett WC, Rosner B, Hu FB. Adolescent dairy product consumption and risk of type 2 diabetes in middle-aged women. Am J Clin Nutr. 2011 Sep;94(3):854-61.
• NIH. Health in the News: Love Your Heart. February 2013. < http://newsinhealth.nih.gov/issue/feb2013/feature1 > retreived Oct 02, 2013.
• Soedamah-Muthu SS, Masset G, Verberne L, Geleijnse JM, Brunner EJ. Consumption of dairy products and associations with incident diabetes, CHD and mortality in the Whitehall II study. Br J Nutr. 2013 Jun 7:1-9.
• Sluijs I, Forouhi NG, Beulens JW, van der Schouw YT, Agnoli C, Arriola L, Balkau B, Barricarte A, Boeing H, Bueno-de-Mesquita HB, Clavel-Chapelon F, Crowe FL, de Lauzon-Guillain B, Drogan D, Franks PW, Gavrila D, Gonzalez C, Halkjaer J, Kaaks R, Moskal A, Nilsson P, Overvad K, Palli D, Panico S, Quirós JR, Ricceri F, Rinaldi S, Rolandsson O, Sacerdote C, Sánchez MJ, Slimani N, Spijkerman AM, Teucher B, Tjonneland A, Tormo MJ, Tumino R, van der A DL, Sharp SJ, Langenberg C, Feskens EJ, Riboli E, Wareham NJ; InterAct Consortium. The amount and type of dairy product intake and incident type 2 diabetes: results from the EPIC-InterAct Study. Am J Clin Nutr. 2013 Aug;96(2):382-90.

Meal Timing, Glycemic Index & Load: Human Study Probes Whether "Hitting Your Macros" Really is All That Counts

High or low GI, carbs in the morning or in the evning, cookies and dingdongs or all bran. So many questions and way too many answers from rodent studies or studies in obese diabetics... but what are Mr. and Mrs. Healthy Average Joe supposed to do?

In a recently published paper, Linda M. Morgan, JiangWen Shi, Shelagh M. Hampton and Gary Frost take yet another look on a concept that has lost much of the momentum it had only a decade ago: The GI and / or GL paradigm (GI: glycemic index (abstract unit); GL: glycemic load, i.e. GI / actual amount of food) and combines another paradigm, which is still gathering momentum within the medical science community - the issue of nutrient timing, in order to answer the following questions:

• Will a large evening energy and carbohydrate load cause an increase in postprandial glucose that is comparable to the same amount of energy and carbohydrates in the morning?
• Will a high glycaemic excursions in the evening be ameliorated by decreasing the glycaemic index (GI) of the meal?

Or put simply: Does carbohydrate and energy timing make a difference and can this difference be mitigated by chosing the "right", i.e. low glycemic carbs (e.g. sweet potato vs. white bread)?

White bread king or all-bran pauper - is that  the question?

To answer this world-shattering question and actually prove their hypothesis that both, i.e. having carbs in the evening and having those in the form of high glycemic index foods, will have negative consequences on postprandial glycemia, the scientists picked six healthy volunteers (four females, two males; mean age 30 +/- 4.3 years, BMI 21·6 +/- 1.3 kg/m²) and randomly assigned them to a follow one of the four following dietary protocols:

• Low GI (average GI = 34), with the majority of energy load consumed in the morning (LGI-am)
• Low GI, with the majority of energy load consumed in the evening (LGI-pm)
• High GI (average GI = 84), with the majority of energy load consumed in the morning (HGI-am)
• High GI, with the majority of energy load consumed in the evening (HGI-pm)

with identical energy content of approx. 8368 kJ (2000 kcal) for the whole day on four individual intervention days with a minimum of 7 days between each of the tests. Breakfast was given at 09.30 hours, lunch at 13.30 hours and the evening meal at 20.30 hours - subjects were at the laboratory for the whole day. Blood samples were taken 2h postprandial and blood glucose levels were monitored continuously via a "MiniMed continuous glucose monitoring system" that senses interstitial glucose by electrochemical detection in subcutaneous interstitial fluid in 5 min intervals.

Figure 1: Composition of the two test diets (low GI, blue; high GI read) and individual macronutrient breakdown of the test meals the subjects consumed on two seperate occasions (based on Morgan. 2013)

It does not take a nutrition expert to see that despite the obvious differences with respect to the glycemic index and load, even the allegedly healthy low GI diet with all-bran for dinner* and a macronutrient composition 72% carbohydrates 14% protein and 14% fat is not exactly what the latest research would suggest to be a healthy, let alone a "physique enhancing" diet.

*note: The scientists probably chose similar foods for breakfast and dinner, because the study design required those to be exchangeable.

Against that background it is still astonishing how much of a difference...

• 99% higher fiber content,
• -60% lower glycemic index (GI), and
• -63% lower glycemic load (GL)

... actually make when it comes to the effect of isocaloric meals with identical macronutrient compositions (see figure 1, right):

Figure 2: Total area under the curve for interstitial glucose (0–20 h), postprandial plasma insulin, TAG (**mind the text for info a potential typo, here) and NEFA (0–2 h after each meal) in six healthy volunteers following either a high-glycaemic index (HGI) or a low-glycaemic index (LGI) diet, with most of the energy consumed either early (LGI-am, HGI-am) or late (LGI-pm, HGI-pm); all values expressed relative to respective statistical mean (data calculated based on Morgan. 2013)

I guess I don't have to tell you that the image that emerges here stands in line with the as of late largely ignored glycemic index paradigm the underlying message of which is: It is not simply the amount of sugar you eat,  but rather how fast / hard it hits your blood stream that determines it's impact of on your glucose metabolism. And with respect to the latter, the researchers remark:

"Glucose and insulin responses showed broadly similar patterns. Both meal timing and quality of carbohydrate affected postprandial glucose and insulin responses (P < 0.01). The area under the glucose and insulin response curves was greatest for the HGI-pm meal regimen. The HGI-pm meal regimen produced a significantly greater postprandial area under the glucose curve than for any of the other three meal regimens (P < 0.05). The postprandial area under the insulin curve was significantly greater than both the LGI regimens (P < 0•05). Postprandial insulin resistance measured by homeostatic model assessment was also significantly greater for the HGI-pm meal than for the two LGI meals (P < 0•05)."

However, since Morgan, Shi, Hampton and Frost also state that "[p]ostprandial TAG and NEFA levels were not affected by meal timing or carbohydrate quality", I do suspect that there is a typo in table 3 of the original study, where it says that the TAG would be 5.04 mmol/l x h (probably is 6.04) and thus more than 15% lower than the average (TAG levels and insulin resistance usually go hand in hand, so it is really very unlikely that the 5.04 mmol/l x h is correct).

So what's the take home message here?

The only question that still has to be answered would be "King or pauper? At least with regard to the former, the best thing I can to is to suggest you read both the posts on "Breaking the Fast" and the "Carbs Past 6PM Posts"  (Part 1 & Part 2). When you have done that your perspective on the importance of breakfast and the purported fallacy of having a large dinner should already have changed. The things that are still left to do is not fool yourself into the false belief that you can pound whatever junk you want (as long as it fits your macros). As the glucose curve of the high GI arms (light color) in the figure above goes to show you, your body won't be happy when you get your "carb macros" from sugary junk.

Stick to starchy (or "save carbs", if you will) and fruit. Use veggies to fill you up. Use coconut & olive oil and the fats that are already in your meats, fish and dairy products to achieve baseline fat intake of at least 40-50g (all together). Aim for a 100-120g carbohydrate basis, diverge towards the lower side, when your body fat is high, you can't train or you're dieting and towards the higher side, when you are already very lean, have a high training volume, or are trying to build muscle. Complement that with min. 20g of quality protein with each meal. Don't deprive yourself on any nutrient completely and ramp up the total amount of food (at the given ratio) to fulfill your energy requirements.

In that, avoid processed food sand rely on whole foods, whenever possible (>90%),. Use food supplements* only where it makes sense, e.g. a protein shake post workout (*creatine for example would not be a "food supplement", since you can NEVER get the amounts that are necessary to supersaturate your stores from meat alone) and don't forget to live about all that "dieting" and thinking about the best ways to eat, please!

So if we assume that my assumption with respect to the triglyceride values in the originally published study are correct and we are simply dealing with a typo here, the next questions which arise here, are...

1. What is / are the reason/s that the lipid metabolism did not suffer?
2. How reliable is the HOMA-PP, i.e. the postprandial assessment of insulin sensitivity via the homeostasis model assessment? 
3. What does all this mean for you? Does meal timing not make a difference and are macros all that counts? 

As far as (1) goes, the answer is pretty simple: With a diet that was that low in fat and not overabundant in energy (2,000kcal for both diets) any potential the negative downsides on lipid metabolism will take their time to show. The acute ingestion of three high GI meals on a single day or modifications in their distribution across the day won't have much of an effect in healthy individuals, such as the four women and two men in the study at hand (in diabetics and especially patients with NAFLD things will probably look different, though).

The absence of changes in lipid metabolism after one day on high vs. low GI diets w/ different meal timing patterns yields answer #1 to question (3): If you are healthy the occasional day with junk food won't hurt you as long as you keep the total amount of energy at bay and jump back on the "healthy diet" wagon the very next day.

On the other hand, if only a single day of high GI food consumption can have such a pronounced impact on the postprandial HOMA levels, this raises the question how reliable this "long term measure" of glucose sensitivity actually is. Obviously, you should not go to the doctor's office and have your HOMA measured, at a morning after a day with three SuperSize Meals from McDonalds (even if you have been fasting after supper at night before, as the participants in the study at hand did) - unless you want a prescription for meformin, of course ;-)

It would however be likewise unwise to "do everything right" for three (maybe even just one day) before you head to the doctor to get blood drawn, just to be able to rejoice over a HOMA reading that does by no means represent your "normal" insulin sensitivity. This may make your doctor happy and spare you getting ticked off, but could have you run around pre-diabetic unnoticed for months if not years - maybe so long until the first irreversible damage has already been done.

The high susceptibility of HOMA measures to acute dietary modifications yields answer #2 to question (3): If you want know where you stand, don't make last minute changes to your diet before you get blood drawn. After all, the 90:10 rule (better 95:5 rule ;-) applies both ways - the 90/95 days of consistent eating patterns will decide whether you are lean, muscular and above all healthy or fat, undermuscled and sick.


References:

• Morgan LM, Shi JW, Hampton SM, Frost G. Effect of meal timing and glycaemic index on glucose control and insulin secretion in healthy volunteers. Br J Nutr. 2013 Oct;108(7):1286-91.

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 ;-)

Mutant Milk!? New Research Fuels the Flames on Hushed Up Concerns About Ill Health Effects of Homogenized Milk

Image 1: Wolverine could be the only face of the "Got Milk" campaign who does not have to care about potential negative health effects of homogenized milk.

In view of the fact that even the Wikipedia article on milk mentions the long-touted hypothesis that the release of the  membrane bound (bovine) xanthine oxidase during the homogenization process and it's potential to generate reactive oxygen specimen could pose a serious health risk, it's quite funny that none of the multitude of papers on the pro- or anti-atheriogenic effects of milk ever mentions mentions the issue of homogenization.

Now even if we discard the potential negative effects of BXO, the results of a recently published paper from the Center of Specialized Nutrition in the Netherlands would still suggest that milk does at least lose some of it's beneficial health effects in the course of the homogenization process (Oosting. 2013).

Large and fluffy or small? That does ring a bell, doesn't it? 

In their experiments the Dutch scientists fed mice infant formulas with either small or large phospholipid coated lipid droplets. Probably to the utmost satisfaction of Danone, the producer of the large lipid droplet formula (Nuturis) and sponsor of the study, the mice who received the regular formula with small lipid droplets were fatter and had compromised lipid and blood glucose levels (see figure 1), as well as pathologically increased leptin levels (not shown in figure 1).

Figure 1: It may remind you of comparing apples and oranges, but let's be honest, if it were not for the disruption of the large fat globules during the homogenization process, similarly large phospholipids as those Danone plans to unleash onto our children would be present in milk, anyway.

Irrespective of the funding and product pimping, the results of this study could have major implications that reach way beyond infant formulas and parenteral nutrition. After all, homogenized milk is common used in all sorts of milk based or milk-containing products. It's shelf stable and above all highly standardized and easily processable by the dairy and food industry, who are still spending truckloads of money to find means to further reduce the unwanted clumping that's so characteristic for the naturally occurring large fat molecules most of the end-consumer don't want to float on top of their heated milk either.

So, if the bovine xanthine oxidase that's released during the homogenization process does not, as Ho & Clifford and other researchers argued in the late 1970s (Ho. 1977), pose a risk for heart disease, what about the structural changes in the lipid fraction of milk? Do we know anything about these at all and could they be the underlying cause of the increase in allergies, diabetes risk that have never been convincingly attributed to milk consumption in general or whole milk consumption in particular? Did we focus to much on the quantity and type of fat in the milk and overlooked its structural organization?

Though shalt not fix something that ain't broken!

In a 2007 review of the literature on the potential impact homogenized milk could have on our health, Mikalski discusses exactly this question: What's the physiological consequence of the physical "rupture of fat globules" which occurs during the heating and homogenization process and "creates a new interface" on the membrane of the fat globules so that "other surface active components" (Mikalski. 2007) will more or less randomly adsorb to the remnants and form a new structurally different membrane.

Figure 2: After the homogenization process took place none of the original functional large fat globules is left, smaller ruptured globules have taken their place and are used by other molecules as a "Trojan horse" (left), distribution of milk fat globule sizes in different types of whole milk - open circles - raw whole milk, full circles - whole milk homogenized at 5MPa, open squares - whole milk homogenized at 10 MPa, full squares - whole milk homogenized at 50MPa (partly adapted from Mikalski. 2007)

Unfortunately, the #1 compound that will bind to the now the disrupted surface structures of the molecules in the homogenized monster milk are casein micelles (Zahar. 1996). Yep, exactly those molecules, of which some scientists, though most of them discard the hypothesis that homogenized milk is not at least as good for you as regular milk, still speculate that they could be responsible for many if not all of the aforementioned negative health effects of milk (Kohno. 1994; Laugesen. 2003; Tailford. 2003).

Homogenized, fat reduced zombie milk?

Figure 3: Distribution of milk lipids in globule core, membrane and skim phase (top, based on Michalski. 2007) and electron micrographs at 15× and 100× augmentations of (A) raw, (B) pasteurised, (C) homogenised–pasteurised, and ultra-high-pressure homogenised milk samples at (D) 100 MPa (Zamora. 2013)

That the process of homogenization will also affect the normal distribution of tri- and diacylglycerols, which are necessarily released from the core of the ruptured fat molecules (figure 3, top - blue) and modify the intricate phospholipid structure of the membrane (figure 3, top - red) should be as obvious as the fact that those tri- and diacylglycerols, phospholipids, cerebrosides and gangliosides are suddenly part of the skim fraction are easily lost during further processing (such as the removal of fat) and will have different physical attributes, physiological effects, digestive properties and absorption kinetics (cf. Berton. 2013).

The degree of homogenization increases according to the pressure that's used to force the the hot milk between valve needle and seat of the homogenization machine, so that  the aforementioned effects are particularly pronounced in the high-pressure homogenized milk (also "ultra-homogenized" milk). Accordingly even the last few "unwanted" (by the food industry) larger, intact fat globules that are left in the regular homogenized milk (figure 3, C) break apart.

What used to be a huge container-like fat molecule in the raw milk (figure 3, A), survived the pasteurization process relatively unharmed (figure 3, B) is now, after it has been pressed with 100MPa through the valve of the homogenization machine, nothing but a heap of very shelf-stable and non-clumping, highly convenient debris (figure 3, D) - awesome, right?

Bottom line: Aside from the disgusting taste of what we here in Germany call "H-Milch" ("h" as in "haltbar", which denotes the longer shelf-life) the structural changes and the potentially problematic downstream effects of the homogenization process, such as

Image 2: Assuming that the plastic canister the girl on the right holds in her hands contains homogenized milk, it may in fact be better for the girl on the left, if it was fat free :-o After all, when the homogenized whole milk is further processed into 0.2% = no fat milk ~95% of the previously created mutant fat molecules will be removed ;-)

• a rise in potentially artherosclerotic free bovine xanthine oxidase, which would otherwise be "locked" in the the intact milk fat globule membrane (MFGM),
• the formation of new lipid layers from casein and other milk components and milk fat globule membrane fragments with potentially allergenic, and inflammatory properties,
• a decrease in curd formation / stability, an increase proteolysis and lipolysis (=digestion of the proteins and fats) and the subsequent increase in nutrient absorption and speed in the gastrointestinal tract with its potentially detrimental downstream effects on blood lipids, and
• the increased absorption of casein molecules and the loss of the beneficial health affects such as the anti-viral, antimicrobial, anabolic and gut protective effects that have been ascribed to the natural MFGM structure of milk

should be reason enough not to make the most convenient, but the most natural choice - and that irrespective of whether the milk is for a toddler, a child, a teen or an adult... and by the way, the changes the fat molecules in the milk are undergoing and the subsequent "mutant" protein + fat fragment structures they are forming make the otherwise nonsensical advice to use "low" or better "no-fat dairy" actually appear quite sensible.

Apropos "high fat dairy", did I mention that the "bad high fat cheese" is not just almost always made from regular, non-homogenized milk (which is hard to get, these days, as even the cooled milk is routinely homogenized, so make sure to check the label), but that its consumption is also associated with a decreased risk of developing metabolic syndrome (Høstmark. 2011)? No... well, than that's even more food for thought ;-)

References

• Berton A,Rouvellaca S, Robertd B, Rousseaud F, Lopez C. Effect of the size and interface composition of milkfatglobules on their in vitro digestion by the human pancreatic lipase: Native versus homogenized milk fat globules. Food Hydrocolloids. 2013; 29:1, 123–134. 
• Ho C, Clifford A Bovine milk xanthine oxidase, blood lipids and coronary plaques in rabbits.J Nutr. 1977; 107, 758–766
• Høstmark AT, Tomten SE. The Oslo health study: cheese intake was negatively associated with the metabolic syndrome. J Am Coll Nutr. 2011 Jun;30(3):182-90.
• Kohno Y, Honma K, Saito K, Shimojo N, Tsunoo H, Kaminogawa S, Niimi H. Preferential recognition of primary protein structures of alpha-casein by IgG and IgE antibodies of patients with milk allergy. Ann Allergy. 1994 Nov;73(5):419-22.
• Laugesen M, Elliott R. Ischaemic heart disease, Type 1 diabetes, and cow milk A1 beta-casein. N Z Med J. 2003 Jan 24;116(1168):U295.
• Michalski MC. On the supposed influence of milk homogenization on the risk of CVD, diabetes and allergy. Br J Nutr. 2007 Apr;97(4):598-610.
• Oosting A, Kegler D, Wopereis HJ, Teller IC, van de Heijning BJ, Verkade HJ, van der Beek EM. Size and Phospholipid Coating of Lipid Droplets in the Diet of Young Mice Modify Body Fat Accumulation in Adulthood. Pediatr Res. 2013 Jul 31.
• Tailford KA, Berry CL, Thomas AC, Campbell JH. A casein variant in cow's milk is atherogenic. Atherosclerosis. 2003 Sep;170(1):13-9.
• Zahar M, Smith D- Adsorption of proteins at the lipid-serum interface in milk systems with various lipids. Int Dairy J. 1996: 6, 697–708.
• Zamora A, Ferragut V, Guamis B, Trujillo AJ. Corresponding author contact informationChanges in the surface protein of the fat globules during ultra-high pressure homogenisation and conventional treatments of milk. Food Hydrocolloids. 2013; 21:1, 135–143.

Adelfo Cerame - 11 Days Out & Looking Back: 2013 vs. 2013, Things I Made Different & Things That Made a Difference

2013 ain't 2013: Different diet, different training, different macros, different physique... different placing!?

I am not sure if all of you read yesterday's SuppVersity Exercise Science Quickie, but those who did have probably already told their boss that they don't need an extended lunch-break today to listen to the "Thursdaily" 1PM EST installment of the SuppVersity Science Round Up on Super Human Radio. My voice did recover somewhat within the last 24h, but after a hefty dose of NAC I am now sniffin' and snortin' 24/7 - probably not exactly what you want to hear, I guess.

What you want (at least I'd suspect so) to read, however, is Adelfo's last blogpost before he is making his third and imho by far best-conditioned and thus promising attempt on winning his pro-card at the NPC Wheelchair Nationals on March 16, 2013... ah, I guess, I'd better let him tell the story... enjoy!

Roughly 11 days out & looking back

I am approximately 11 days out from CJ’s NPC Sunshine Classic & Wheelchair Nationals in Palm Beach, Florida, where I will try to make another attempt at trying to win the overall and possibly earn my IFBB pro card for the wheelchair division. So far I feel great! My food intake is high, my energy is up and I’m very confident that I have made all the right moves, adjustments and improvements this year to put myself in the best possible position to take it all down this year ;-) I joined a great team in 3DMJ, and am being mentored by a great coach in Alberto Nunez, who is a seasoned and experienced bodybuilder.

So, let's recap a couple of key features of this to previous ones....

As I reflect on this years contest prep/ bodybuilding season, I thought it would be interesting to compare notes from last years season to this year.  

Nutritional Regimen - Which "diet" have I been following?

• 2013 = IF (Leangains)

• 2013 = IF (Leangains) + IIFYM (flexible dieting)

From a physiological perspective,  125g of carbs per day shouldn't be a problem for any non-diabetic - even if he/she does not work out (learn more)

In 2013 I followed an intermittent fasting meal protocol using a 16h to 8h fasting vs. feeding window. This year I used the same IF meal protocol (since I found success with it last year and it’s a protocol that works with my daily life schedules) but combined it with a flexible style of dieting that is also known as the acronym IIFYM "If It Fits Your Macros".

As I mentioned in previous posts, I don't abuse the IIFYM paradigm to stuff myself with all sorts of junkfood, my diet is still mostly clean, but the leeway it gives you is refreshing and takes away a lot of stress related to picking, preparing, packaging etc. foods (see next point, i.e. Food Choices, as well).

Food Choices - What type of foods have I been eating?

• 2013 = Stuck to your so called “clean foods”  

• 2013 = I am not depriving myself of any type of foods; I’m eating what I want but use a 80/20 to 90/10 ratio of whole “nutrient dense” foods to processed foods, or what you would call “junk” food but I don’t like the word junk so I call it “fun” foods ;-)

Last year; even though I started to veer away from the whole “eating chicken breast and broccoli and brown rice” mentality and began to broaden my horizons in eating more variety of whole foods, I still basically stuck to your so called "clean foods" and I was just in the beginning phases of getting over my phobia of carbohydrates since I consider myself coming from a high fat/ low carb camp for almost 2 years on a dietary regimen that was more or less identical to the "anabolic solution diet".

So yes, even though I was eating a greater variety of lean meats, fruits, veggies, fats and whole food carb starches like tubers, I still deprived myself of foods like bread, oatmeal, grains, cereal because I still believed that they were evil, when it came to a body composition standpoint or even just when it came to general health.

Believe it or not, but the quote on the left, is actually from Adefo's very first post, here at the SuppVersity.

However, as you all know if you’ve ever read my very first Blog here on Suppversity and I’ll quote from it:

"My diet and training methods have evolved and will continue to keep evolving, because of my willingness to keep an open mind and apply and experiment with new strategies, methods and philosophies to my diet and training" - me

(Yes! I just quoted myself! Hahaha!)  And that’s exactly what I did, I kept an open mind and gave IIFYM a shot just like I gave “IF” a chance last year, and guess what?

It all worked out for the greater good because the combination of an IF meal protocol combined with a flexible method of dieting has really taken me a step closer to that goal of finding a perfect diet that I can convert into a lifestyle and do long-term. Like I mentioned before… A diet should be able to synergistically co-exist with your daily life and social schedules, and is something that you can convert into a lifestyle and do long-term  - that's fundamentally different from a "dietary intervention", under which you can easily subsume all the fad, single-sided and unflexible dietary regimen that work in the short run, but have you plateau before you even see your abs.

Training - Which type, how much and how intense was my training regimen?

• 2013 = Low volume/ high intensity – cardio was non-existent

• 2013 = hypertrophy/ strength split using an RPE scale – cardio was all throughout prep

Last year the majority of my training was very low volume/ heavy weight. My training consisted of 5x5 and EDT’s and reverse pyramids. The highest rep range I ever flirted with was 6-8. This year, I’m doing a split between hypertrophy and strength training using an RPE scale, and I would say the majority of my workouts would fall into the high volume category by common standards.

Does rest matter? Study finds 7-9% greater increase in muscle size w/ decreasing rest periods (learn more).

The main difference this year was the frequency of hitting the muscles and using just a handful of exercises as my staple and improving on them.

Last year I barely did any cardio except for probably the last 4 weeks of my prep to try to expend a little bit more energy but that was it. This year I incorporated a cardio regimen all throughout my prep... but to be honest: it was very easy – I started the first 2 to 3 weeks with none, then Alberto eventually prescribed 2x cardio session per week for 9 laps each session around a track. I completed those at a self-chosen until a couple o weeks ago, when he reduced the volume by 50%

As you may imagine this type of cardio regimen really wasn't a big issue... nothing compared o my previous HIIT sessions, for sure. I still feel that the additional laps on the track allowed me to keep my food high via carbohydrates -- and if I've learned one thing from this prep, then it is that the higher you can keep your carbs up while dieting the more beneficial it is for your physique.

Calories/ Macros - How much did I eat at the beginning of the prep?

Caloric zigzagging? (Re-)Read Adelfo's guest post "How I Break My Fast, Plan & Time My Macros and Use Caloric Zigzagging & Re-Feeds on a LeanGains Inspired IF Regimen" and learn more!

• 2013 = eeehhhh…??? around 1700/ 2000 kcal. (non-training/ training); 55-7g5 fat/ 150-200g carbs/ 150-200g protein (non-training-training) – skiploading style re-feed (basically eat as much high GI carbs as you can while keeping fat intake as low as possible.

• 2013 = 1960 kcal w/ a re-feed day 1x/ week;  40g fat/ 200g carbs/ 200g protein – 300g carb re-feed

Last year I experimented with caloric zigzagging, so my calories were higher on training days with a higher carb/ low fat intake and my calories were lower on non-training days with a higher fat/ low carb intake. And I didn’t start incorporating refeeds till later towards my prep or until I got lean enough to feel comfortable doing refeeds. This year I stayed consistent with my numbers and just had one re-feed day – so I had low days and one high day

Calories/ Macros - How much did I eat towards the end?

Adelfo has already written about the beneficial effects of a higher carb intake on your physique in a previous post onThursday, January 31, 2013: "Intermittent Carbohydrate Modulation as a Stepping Stone Towards an Anatomy Chart Physique"(read up on the article)

• 2013 = 1300/ 1600 kcal (non-training/ training days)
  50-60g fat/ 50-100g carbs/ 150-190 protein (non-training-training day) – skiploading style re-feed

• 2013 = 2305 kcal w/ a re-feed day 1x/week
  50g fat/ 240g carbs/ 200g protein – 325g carb re-feed

Last year I floated around sub 100g of carbohydrates for about the last 11 weeks of my prep and this year I started to gradually increase my food intakes 5-6 weeks out. I used weekly 25g increments (I’ll explain the process of how I started to bring my food later before I wrap up my blog)

With regards to my re-feeds; it was a bit more controlled this year compared to last years Sunday carb feasts I use to have. My fats this year were also on the lower end but still 20% of my total calories and I feel that this was another of the decisive factors that contributed to the clear improvements in my physique - with the low(ish) fat intake, I simply had way more room for carbs in my diet.

Comparison of Adelfo's pre-contest physique 2013 vs. 2013 (photos (c) Adelfo Cerame. 2013-13)

Well that’s all I got for today! I hope you enjoyed the notes PrimalKid ;-) but before I sign off, as I said I would; here’s a brief overview of how I started to gradually bring my food up to where it’s at now.

At about 6-5 weeks out is when coach Alberto started to gradually bring food back up via carbs but prior to that I was on about a  2 ½  week intensive dig of 100g/ day, then we increased 25g (125g) for about a week and a half, then increased another 25 the next (150g), then increased by 50g (200), then increased by just 25g last week (225g)  and now increased by 15g this week (240g)… Oh and fat got increased by 10 somewhere during that week. lol.

But yeah… Coach Alberto felt that my body was lean enough for carbohydrates to start having a positive stimulating effect on my physique, and that my body was more capable of partitioning carbohydrates much more efficiently now that I am leaner.