Tuesday, January 29, 2008

Sleep Yourself Slim: The Impact of Sleep Loss on Hormones, Appetite, and Weight

Hi Jean,

You mentioned even sleep being an important factor in Christa's regimen. Any articles you can link to explain the benefits or even consequences of its deficiency (I'm legend for sleeping only when dead tired). Thanks in advance JJ!


I hate sleep; I’m always eager to pop out of bed and start. Start anything: writing, making omelets, whatever. Though, sometimes, I wake up on a Saturday, get excited about wakefulness, and realize that it’s only 5:30am. I feel good enough to wake up and get going. But with only 6 hours of sleep, I convince myself to close my eyes, and think about anything relaxing that is not sleep. Then I usually wake up a couple of hours later. After 7.7 hours of sleep, I am really ready to start my day. But why all the fuss about sleep?

It’s important!

First, there is conclusive research that constant, inadequate sleep puts you at risk of obesity and diabetes. Specifically, sleep loss messes with 1) how your body uses glucose (sugar/carbs) and secretes insulin 2) increases appetite; and 3) decreases energy burned during a 24 hour period.

Don’t Mess with Insulin

Insulin resistance

Insulin resistance is a problem that starts to rear its ugly head in the early stages of Type 2 diabetes. Despite the fact that the body (pancreas) is still making and releasing insulin, a person still cannot get rid of the sugar in her blood fast enough. This lingering sugar is very harmful to blood vessels, nerves, and eyes; it's also bad for the kidneys, since extra sugar is eliminated through the urine. As a result, your body has to make more and more insulin to get the glucose (sugar) out of your blood and into fat (usually) or muscle cells. Eventually, your pancreas says

“Screw it, I work hard to clean up the blood and my insulin doesn’t work anymore.”

In the advanced stages of diabetes, when your pancreas gives up, you have to start injecting insulin to use clean up carbs.

Listen up college students, shift-workers, and parents of small children, MANY studies show that a couple days of less than 4 hours of sleep per night causes insulin resistance (1). In essence, your body starts acting more like a diabetic’s body, and your pancreas has to work too hard. As a result, many researchers think that chronic loss of sleep may contribute to the development of type 2 diabetes and the metabolic syndrome (which are both also linked to obesity and overweight).

Increased Desire to Eat High Carbohydrate Foods

In conjunction with insulin resistance, sleep loss also induces cravings for high-carbohydrate foods (1,2). As such, the problem detailed above is made worse because the pancreas has to secrete even more insulin to take care the gummy bear binge.

Increased Cortisol

Sleep deprivation also increases the stress hormone cortisol, which is associated with obesity, high blood sugar, and lowered immunity (disease-fighting ability). Furthermore, cortisol acts as a stimulus to BREAK DOWN MUSCLE, in order to raise the blood sugar.

The result of 2-3 restless nights is 1) greater intake of high-carb foods; 2) increased cortisol levels, which results in muscle destruction; and 3) a large spike in insulin to cope with excess blood sugar and insulin resistance. These hormonal imbalances, when you are feeling lethargic and snacky, can lead to significant weight gain.

I Can’t Eat Enough

Cortisol and insulin aren't the only hormones affected by poor sleep. A number of hormones that directly influence appetite are also manipulated.

Lower Leptin

Scientists used to think that fat was an inert place to store extra energy. Now researchers recognize fat tissue as a powerful hormone-releasing organ that influences diet and activity behaviors. Leptin is a hormone secreted from the fat tissue itself. The more fat you have (extra energy in your body) the more leptin is secreted, generally. Leptin is a hormone that tells your body:

“You’re too fat, stop eating and burn more energy (Calories)”

As a result, appetite diminishes and the body naturally burns more calories, mostly through non-exercise activities (1,2).

But if a person doesn't get enough sleep, leptin levels decrease. Low leptin levels tell the body that energy levels are low. As a result, appetite increases!

Increased Ghrelin

It is easy to think of ghrelin as a hormone that is exactly the opposite of leptin. Increased ghrelin tells your body:

“You are not getting enough energy; eat more and move less!”

As a result, you eat more and move less! As little as 2-3 days of sleep deprivation (4 hours per night) is sever enough to significantly increase the ghrelin in your blood. Combined, the ghrelin and leptin changes after a couple of days of crappy sleep is enough to make you overeat, no question. Research strongly supports this conclusion (1,2,3)!

Increased Time to Eat

Let’s say you’re the kind of person who likes to eat every 2-3 hours. And let’s also assume you’re sleep deprived. Your body is giving you signals that you don’t have enough energy and you are craving high-carb junk food. A sleep loss of 3-4 hours hours would translate into at least one extra meal of poor-quality food, combined with little motivation to move and burn off the extra Calories. In addition, both population and lab-based studies (3) show that people actually eat more, on average, the less they sleep!

Don’t Ask Me to Move; I’m Tired!

Low Leptin; Decreased Energy Expenditure

Low leptin and high ghrelin levels are shown to reduce Non-Exercise-Activity-Thermogenesis (NEAT) HUH? Well, NEAT is basically any movement you do that is not planned exercise. Most of the daily Calorie-burn is used to keep the body tickin'; NEAT is second and exercise is third. So if NEAT activities subside significantly, the result can be more detrimental than skipping the gym! For instance, when you are tired at 3:00pm, do you feel like playing with your little niece or getting up to go talk to a co-worker? It’s unlikely, and you’ve just given up some NEAT calorie-burn!

Lower Thyroid Stimulating Hormone (TSH)

TSH is the hormone that stimulates, well, your thyroid, which then releases the thyroid hormones T3 and T4. These hormones are STRONGLY related to your metabolism. Sleep deprivation causes a lowering of TSH. In short, the thyroid gland will not be stimulated as much; T3 and T4 will not be fully made/released. Do not pass go; do not drop 20 lbs! Capisci?

Faster Metabolism in Second Half of Sleep

Ghrelin levels lower in the second half of sleep-night (2). Remember that lower ghrelin means less appetite and more movement! If you wake up too early, this ghrelin drop will not happen and you may wake up hungrier than you should be, in addition to all the other obesigenic fun already described. Furthermore, REM (dream) sleep is greater during the second half of the night. REM sleep is very important for a number of other reasons (long-term memory, etc), but you also burn more calories during REM that during the deeper sleep that predominated the earlier sleep cycles. So pass the 800 TC sheets and silence the cell phone!

Obesity Sleep Apnea

Sleep apnea is a chronic sleep-disturbing condition where an afflicted person actually stops breathing repeatedly throughout the night. This condition is highly detrimental for a variety of reasons and really screws with all the hormones mentioned above. Obesity very strongly correlates with sleep apnea, which results in a positive feedback loop in the person with sleep apnea. For instance, a woman gains a lot of weight, is diagnosed with sleep apnea and never has quality sleep; her hormones go wild, and she becomes even more obese. Folks, this is just one more reason to eat your veggies!

Baby Fat

A really interesting study done by Gunderson et al (4) also shows that women who sleep less after giving birth (less than 5 hours a day as opposed to 7 or more hours) are more than twice as likely to retain an extra 13 pounds one year after giving birth! The women (over half of a large sample) who managed to collect at least 7 hours throughout the day and night were more likely to return to their pre-baby weights within a year.

Sleep All Day?

Interestingly enough, too much sleep is also associated with obesity and other chronic diseases (1)! So what’s perfect? It really depends. Everyone is different and some lucky people (though VERY few) only need 5-6 hours/night to be fully functional. For the rest of us, one study showed the lowest risk of disease and obesity at 7.7 hours/night (3). That means if you set aside 8 hours and count sheep, then you should be good to go!


1. Knuston et al. The metabolic consequences of sleep deprivation. Sleep Medicine Review. 2007;11:163-78.

2. Tahen et al. Short Sleep Duration is Associated with Reduced Leptin, Elevated Ghrelin, and Increased Body Mass Index. Plos Medicine. 2004;1:e62.

3. Spiegel et al. Sleep loss: a novel risk factor for insulin resistance and Type 2 diabetes. Journal of Applied Physiology. 2005;99:2008-19.

4. Gunderson et al. Association of Few Hours of Sleep at 6 Months Postpartum with Substantial Weight Retention at 1 Year Postpartum. American Journal of Edidemiology. 2007; DOI: 10.1093/aje/kwm298

Friday, January 25, 2008

Eat Out; Loose Weight? A Week of Meal Plans for the Time-Pressed and Frequent Diner

Ideally, food is made in the kitchen from an assortment of freshly chopped vegetables, trimmed lean meats, and grains that take an hour to soften. Unfortunately, few people have the time or desire to compulsively pack six daily meals into little labeled containers--hello reality!
So, in response to emails from individuals who spend a lot of time traveling on the job, taking care of kids, or simply don't enjoy cooking, I've developed a week of meal plans that emphasize portion control and allow you to make the best choices when dining out!
The meal plan are set up at about 1800 Calories; this energy level may be appropriate for a sedentary man or a moderately active woman. If you are a sedentary woman, I would, in addition to starting a walking program, cut the portions of the two snacks in half or omit the afternoon snack. Also, you ask for an extra portion of veggies instead of the rice side dish that accompanies some of the dinner meals. The meal plans are designed to include all portable foods or foods that you may purchase outside of the home and eat immediately.
Although fast food has a terrible reputation, which is well-deserved in many cases, certain chains have made an effort to provide healthy options. Notably, McDonald's with their varieties of salad and Applebees and their Weight Watchers menu. The menu options emphasize reasonable portions and are high in fruits and vegetables!

Jean offers nutrition coaching for weight loss, muscle gain, or any of your personal goals at her office in the Alico building in downtown Waco, TX right in the heart of central Texas. She also offers personal training services at Ironhorse gym on the corner of Franklin and 17th, which is also very convenient to downtown Waco. Contact information can be found on her personal website.

Thursday, January 17, 2008

The Resolve To Reach Resolutions: Healthy Eating and Exercise for the Long Haul

The following is an interview I did for Jimmy on his Livin La Vida Low-Carb Blog

Think back in your life to a time when you were not in the most ideal situation for living healthy. That time could be RIGHT NOW for many of you, but for Jean Jitomir that was in her childhood when circumstances out of her control put her in a position that would later motivate her to do something meaningful not just in her own life, but in the lives of others.Today, I want to share Jean's story with you because hers is one of transformation and rising up to new challenges in the face of certain failure. None of the past really matters to her now because she knows she is light years away from where she used to be thanks to her own hard work ethic and undying spirit to excel at everything she does.

As you can see from those before and after photos at the top of this post, Jean has changed her life and health through her diet and regular resistance training routine. Since I am new to weight lifting and in the midst of making this a regular part of my healthy lifestyle, I decided to interview Jean Jitomir from the "Built Nutrition" blog to learn more about how she incorporated bodybuilding into her life and to dispel some of the myths about women lifting weights. You won't agree with everything she says (especially regarding diet), but it's hard to ignore the final results. ENJOY!

1. I'm pleased to welcome to the "Livin' La Vida Low-Carb" blog today a woman who knows what she's talking about when it comes to getting into shape. Not only can she talk about it, but she LIVES it herself. I'm describing for you registered dietitian, exercise nutrition doctoral candidate, and national light weight bodybuilding competitor Jean Jitomir. As you can see from her pictures at the top of this blog post, she has sculpted and built her body into one bad mamma jamma! Welcome Jean! Lifting weights has traditionally been a "man" thing, but you have proven that stereotype is just not true. What got you interested in resistance training to begin with? Were you ever worried about "bulking up" too much and losing your femininity?

First of all, thanks a lot for the warm welcome and opportunity to do this interview! The very first experience I had with weight lifting was with my dad's 25-pound dumbbells as a 15 year old. I could do military presses, which is for shoulders. I had some really jacked shoulders, for a girl of 15 anyway. I lifted a little once I got into track in high school when the team converted my math teacher/coach's classroom to a weight room. The weights were concealed by upright gym mats during class time. When it was time for practice, the desks got pushed aside and we'd bench our little hearts out.The serious lifting and working out began in my sophomore year of college, however.I have never been concerned about losing my femininity because I simply don't take physique-enhancing drugs! Read my Times New Roman "you will not get big and freaky from lifting the heaviest weights you possibly can!" Rinse. Repeat.

Women who look unnaturally muscular are doing something illegal to get that way. There is absolutely nothing you can do to look like that otherwise, trust me, I have only gained about one pound of real muscle mass in a good year; its gets less every year (I'm pretty close to maxing out my genetic capabilities). I'm a woman who is trying to gain as much muscle as possible and I'm still 30 pounds lighter than I was as the overweight version of myself.Sometimes people think I look big and muscular in pictures, but are shocked to meet someone who is 5'2" and a size 0. Getting lean is a wonderful illusion that makes you look "bigger"; this applies to both men and women.

2. You came from a very modest upbringing where the household income for five people was just $20,000 annually. And yet I found it very interesting to hear your perspective on what those limited resources meant regarding your family's diet. The typical poor American household nowadays would use their financial status as an excuse for stocking up on cheap high-carb, sugary junk foods (what you like to call "craptacular" food) and yet that wasn't what you and your family feasted on. Instead, you ate what you describe as "a hearty chunk o' meat" with spring water. In essence, you were consuming a zero-carb diet for survival. What do you say to those people who use the excuse that their lack of money forces them to buy unhealthy foods? Share how people can avoid the high-carb crap and make better choices even with only modest means.

I think there is a distinction to be made between living off the land and home-raised livestock as a member of the rural-poor and the experience of living in America as an suburban or urban poor person. We also had carbs in our diet in the form of vegetables, milk, and rice, usually. It's just that the focus of most of our meals was certainly a chunk of organic, free-range, grass-fed beef—-an item that is quite pricey in any supermarket!That said, eating healthfully is possible on a budget; it just requires planning. For instance, there are a number of very inexpensive protein sources. For example, frozen non-breaded chicken tenders, eggs, beans (from dry or canned!), frozen edamame, tofu, ground turkey, milk, cottage cheese, and powdered whey or soy protein.

One of my favorite, under-known protein products is Fearn Soya Granules. These defatted bits of goodness all almost pure protein and fiber and ring in at about $2-3 for a large container! They are high in antioxidants and can be cooked like hot cereal or added to boost the protein content of a bean chili or, to some extent, a baked product. Soya granules can be found in many health food stores and online.

Another fun high-protein, high-fiber ingredient is partially de-fatted peanut flour. Many manufacturers add these to bars to get a super-peanuty flavor. You can buy this flour online and make low-fat peanut-flavored shakes that are off the charts!

Furthermore, many vegetables and fruits are cheap year round including bagged spinach, other dark green (mustard, collard, kale), broccoli, green peppers, carrots, zucchini, and apples. Furthermore, purchasing local foods in season at the farmer's market may help to cut costs. When all else fails, frozen vegetables are very high in nutrition (sometimes even better than fresh) because they are frozen at their peak ripeness and preserved. Frozen vegetables taste great and are usually substantially cheaper than fresh, not to mention convenient!

The best sources of grains are the uncracked, unprocessed kernels and there is really nothing cheaper! Some, like quinoa and bulgur, have moderate amounts of protein and cook within 15-20 minutes!

3. Just like you, I had to endure the pain of divorce as a child. It's a very confusing time in the life of a child because you feel like your entire world is collapsing all around you and it's YOUR fault. This stress can lead to some erratic behavior which can change an otherwise good kid into one who's looking for trouble. How were you able to overcome this inevitability and get back on the path you are traveling down today?

I think I had two good parents who were acting VERY stupidly and selfishly due to their own stress. Despite that, they were both showed love in their own ways; this is what ultimately saves anyone. Also, the influence of dedicated mentors and teachers cannot be overlooked! If it were not for my school nurse, who listened to endless hours of frustration, and my coach/teacher who made me work to meet his clear and reasonable expectations, I don't know where I would be today. The credit for my current and future success is owed, in part, to selfless individuals who supported me during the worst time of my life.

4. Tell us about your experience when you were subjected to a series of physical tests as a freshman in high school and you performed horribly. Was that what lit a fire within you perhaps for the first time to get your body into shape? What role did you mother play in motivating and inspiring you in this newfound journey to better health and fitness?

I think most of us can remember the dreaded timed-mile! In NY state, as in most other placed in the country, throughout elementary, middle, and high school students are required to perform yearly tests of the mile, pull-ups, and body fat. I performed terribly on these tests every year and was always embarrassed to cross the finish line last in the mile, not be able to do half a pull-up, and be told by my gym teacher that I was over-fat in front of everyone (those are the teachers I could have lived without! ;) As an overweight freshman in high school, my math teacher described how he would start a "cross-country" team, a sport where you would run 2 miles a day, minimum! I informed him that he was "crazy" to believe anyone would sign up for that.

During that year, I literally could not catch a couple of kids I was babysitting as they ran up the road and I knew I had to do something to be in better shape. I started "running," which consisted of about 50 feet of jogging to a "goal." Right before I reached that mini-goal, I would add another, until I really needed to take a walking break. The following Fall, I went out for cross-country and did the 5K (about 3.1 miles) in roughly 30 minutes on average; the next year I brought my time down to about 23-34 minutes. I was never a stellar runner, but I lost about 15-20 pounds and became fit and healthy!

5. Recalling my own undergraduate college experience at the University of Tennessee, it was extremely difficult to eat healthy in between two full-time jobs and a full load of classes each semester. The stress of all that as well as the added pressures that most people go through during that time in their lives caused my weight to suffer. You can certainly relate to this from your first year at Cornell University. You went through some trying circumstances that caused you to put on 30 pounds and fall into a deep pit of depression. What happened during that summer that followed to get your mind and body back in sync again? Why did you decide to ultimately change your major to nutrition and dietetics?

After a very bad second semester at college, I returned home to find myself unhappy and 30 pounds heavier—-I brought up the curve on the Freshman 15! I ran into one of my high school friends who got even more athletic in college; I started going to the gym with her—-it's so useful to have a partner in fitness! I also became a girl scout camp counselor, which involves a lot of chasing after 10 year olds. I lost about 20 pounds that summer and maintained that loss throughout college.

I started as a plant science major in undergrad, which didn't thrill me because, hey, plants don't do much. I had already taken a whole bunch of chemistry, biology, and math--I didn't want to start from scratch in a new major. I chose Nutritional Sciences initially because I thought it was interesting enough and I could graduate on time. The department required me to pursue dietetics because they wanted me to prove myself in the more rigorous track than general nutrition. I got high grades in dietetics and finished the degree on time.

My mother has always been a huge source of motivation and inspiration for me. She grew up fatherless, exceedingly poor, and dropped out of high school to give birth to my older sister. Two divorces later, she was on welfare with three kids. However, she went on to finish community college at the top of her program and was accepted to Cornell University to finish her bachelor's. After that, she attended Cornell Law School. She went from being a high school drop-out to an Ivy League lawyer in less than 10 years. She demonstrated that even if society looks down on you, anything is possible when you are sharp, motivated, and believe in yourself!

6. You never expected to actually compete in bodybuilding, but it sorta fell in your lap. You bought a book by Arnold Schwarzenegger to help you learn how to begin lifting weights and you grew to love it. How did you get past the initial soreness that I'm just now discovering happens when you begin a resistance training regimen? How long was it before you saw the results you were looking for? What was it like competing against other women in a bench press competition for the first time?

Soreness will recede as you become a more experienced lifter. That sensation goes away, for the most part, after several months! Also, soreness is not an indicator of "how good you hit your muscles"--research does not support this notion, though you probably will experience delayed onset muscle soreness (DOMS) within 24-48 hours after your workouts when starting a weight-lifting program. Slowly work through it, be consistent, and I promise it will get better!

I still haven't seen the results I'm looking for—-that's just how it goes. I just strive to be better all the time. If you become content with where you are, then you stop working hard. I don't want that. Though I will say, it took about 3-4 years of consistent lifting before I looked visibly more muscular than an average woman, so it's a long process to gain muscle mass naturally.

Furthermore, most women simply don't have the genetics to gain a whole lot of muscle mass—-I am certainly born with a decent amount of potential, which I have realized through consistent, hard work! That said, resistance and cardiovascular training are both important to fitness and anyone will improve and be closer to his or her potential through the same efforts; the end result will be different for different individuals, however. I was so scared to do my first bench-press competition! My heart was racing and I was afraid to weigh-in and nervous about missing my lifts. I still was able to win that small contest and many other, though I'm still nervous every time!

7. Obviously, your early success in those competitions gave you confidence to try even more of them in the future. In September 2005, you competed in your first bodybuilding competition--AND WON! You won your class and the overall title to go to the national competition. CONGRATULATIONS! Although you were not as muscular and big as the other women at that level, tell us why you were less concerned about winning and more interested in how far you've come from your humble upbringing.

It's so hard, especially in physique competition, to keep your progress in perspective. When you are being compared to other equally motivated, talented, or possibly chemically-enhanced individuals, priorities often become blurred. That's why there needs to be a motivator that is larger than the contest at hand. For me, I am rewarded by an e-mail by someone who was benefited by information on my blog or motivated by my story.

I am also flattered by the great health and nutrition questions I receive from inquiring minds. I currently have a Certified Strength and Conditioning Specialist and practicing Medical Doctor who are good enough to guest-blog on my site, so even if your training or health question is out of my scope of practice, I may be able to find a good answer and get it posted!

8. Today, you are at Baylor University studying to receive a PhD in Exercise, Nutrition, and Preventive Health. As a registered dietitian, you are able to tweak your menus to coincide with your next bodybuilding competition. I'm curious, have you discovered anything extraordinary about what kind of diet maximizes your ability to compete on the highest levels? Do you believe in the theory subscribed to by so many in the fitness industry that you need to "carb up" to fuel your workouts? Why or why not?

Athletes need carbs. Period! Carbs are the primary source to fuel any intense workout and you will injure yourself if you train or compete at a high level and do not take in adequate amounts! I have seen and met with several triathletes in particular who have made the mistake of taking their carbs too low and suffer from poor performance and over-training.Many sedentary or carb-sensitive individuals, however, will benefit from a diet that is a low to moderate in overall carbohydrate. If your daily activity is low, you do not need a lot of carbs to fuel your expenditure.

Furthermore, numerous studies conducted in my own lab at Baylor and by Dr. Donald Layman et al (early 2000s) provide strong evidence that a weight loss diets that is fairly high in protein, low-moderate in carbs, and moderate in fat is beneficial for weight loss and retaining muscle mass during a period of energy restriction, especially in overweight women ages 35-60 or so.If you workout intensely, carbs after your workout are a must; the insulin response is a signal for muscle-building after a workout and is also essential for recovery. Please refer to my blog for specific posts on this topic!

9. If the United States continues down our current path, then obesity and related diseases will eventually become the norm (if it isn't already) and the concept of health will be lost forever. With such ridiculous statements as "fat is bad" and "sugar is healthy," there's little wonder why Americans are so confused and baffled about what they need to do to eat better. What do you think can be done to get people more interested in living a healthy lifestyle both through diet and exercise?

I think that food processing is a huge industry with a lot of advertising money and political control. Our previous recommendations have not been influenced by optimal health outcomes and the result is manifest in reduced quality of life and increased healthcare costs.
The motivation issue is paramount. It's an important area of research and thought—-what will inspire the American people to pass up the bargain buffet and opt for smaller portions of whole food and regular exercise? If I knew the answer to that, I could just post in on my blog and retire!Generally speaking, Walter Willett (Harvard) is a good nutrition expert to look to for advice in term of healthy living and eating.

Based on the research of Willett and colleagues, the principal advice is moderate portions of whole food equals good; processed food, especially in large portions is bad.

Whole: Vegetables (not in a can!), nuts (controlled portions!), fish, fruits (not sweetened in a can!), beans/lentils, lean meat and fish (less than 5 grams fat per 3oz serving, exception is fatty fish), whole grains: brown rice, old-fashioned oats, quinoa; lean dairy in moderation

Processed: everything else, especially 1) grains that have been smashed, kneaded, heated, chop-up, and wrapped in air-tight plastic; 2) high-fat meats that have been treated with God-only knows what and are not hospitable to microorganisms of any kind; and 3) most "foods" that come in cans, wrappers, and boxes. These are foods that really were never intended to go in the human body!

10. Jean, thank you so much for being here with us today at my blog. You are an important voice in the health debate and I am encouraged to know there are people like you out there espousing common sense and proven experience in regards to fitness and health. And you look absolutely fantastic! What an inspiration to all of us who hope to follow in your footsteps getting our bodies in the best shape of our lives. Is there anything else you'd like to share with that person who thinks lifting weights and eating a healthy diet is useless?

I know it's very hard to start and stick with it. In my own young life, I have already started twice! Almost everyone feels unsure about exercising or going into the gym for the first time; it's normal. But it's also very important to find what helps you work past those feelings and be consistent about exercising regularly and eating a diet that will help you maintain a healthy weight and reach your goals.

My mom is a good example. For years, she tried to lose weight for cosmetic reasons. Even considering all she had accomplished, she could not get her weight under control using vanity as her source of inspiration. Then about two years ago, she was diagnosed with serious hypertension and Type 2 Diabetes; she was told she would die early if she did not lose a certain amount of weight. A serious health risk motivated her to lose 40 pounds and improve her health.

Hopefully, the wake-up call doesn't have to be that severe for the majority people who have not already made a commitment to living a healthy lifestyle. Find a way to stick with a regular exercise plan and a diet consisting mostly of natural, whole foods; the rewards will be evident within a month or two and serve as an internal source of inspiration!

Saturday, January 12, 2008

Some Solid Advice for the Hard-gainer

Victor Dean MS, CSCS
Hey Jean,
I'm pretty much a hard-gainer. I've been lifting pretty intensively and (I think) followed a diet that should be fostering some real growth (3000+ calories on lifting days; 40/40/20; whey first thing in the morning and pre/post workout, etc.), but I just seem to have stalled at my current weight (mid 170's). I put on about 5 pounds when I ramped up my diet, but can't seem to push much higher. Any advice?

Very best regards, Mike

If the weight loss stalled, your diet is not giving you enough calories to foster growth, considering the activity you do! The most important part of building lean mass is eating extra calories. The extra calories should come from high quality protein, carbohydrates and fat, primarily before and after workouts. Note that a “bulking” diet is not a license to eat piles of wretched, processed junk-food! There are several points I would like to address. Also, since I am not a hard-gainer, I asked my friend Victor Dean, trainer (CSCS) and owner of Victor Dean Training, for his advice as well. His contribution follows my points and is written all bold.

1. Make sure that you are supplementing your workouts properly and giving your body important nutrition at the proper times.

The carbohydrates and protein surrounding workouts are essential. The supplements are recommended to maximize muscle size. I am only mentioning supplements that have unequivocal research to support their use!

Research supports the notion that meal timing around exercise increases the amount of lean mass gained. In one study, researchers supplemented two groups of men with the same supplement, except one group got the supplement immediately before and after resistance training; the other group received the supplement several hours before and after working out. The group that received the supplement immediately before and after the workout gained significantly more lean mass than the group that did not practice good nutrient timing.

Carbohydrates before after a weight-lifting workout:

I consume about 0.5 grams/kg of carbohydrates (roughly 25g for a small woman; 50g for a man) before a weight-lifting workout, and between 0.5-1.0g/kg after a workout (weight in kg is your weight in pounds divided by 2.2). A slow absorbing carbohydrate is appropriate before a workout; a good example is oats. A fast absorbing carb is good for after a workout, I eat dates. The dried fruits are absorbed even faster than regular table sugar and are a completely natural source of fast-absorbing carbohydrates.

Protein before and after a workout:

Generally, protein supplementation enhances lean mass gain during periods of resistance training-- thousands of studies support this conclusion. A study conducted at Baylor University in young men showed a significant increase in muscle mass with about 40 grams of protein supplementation per day. Before a work-out, whey protein, casein protein or mixed protein sources (like whey and casein/egg and whey).

Supplement with 0.25 to 0.5 grams/kg of protein before your workout.

Creatine before you workout:

Numerous published studies show the benefits of creatine supplementation for increased lean mass and strength. One study, conducted at Baylor University, showed about twice as much lean mass gain for men taking creatine over the placebo group when completing the same resistance training program. In this study the men supplemented with 20 grams/day during a one week loading phase and 5 grams/day for the rest of the twelve week study for maintenance. If you choose to do a loading phase, be sure to split the creatine up into 4 or 5 doses throughout the day to minimize stomach upset.

Creatine monohydrate is the form of creatine that has been studied the most and has been proven effective in research; 500g should not cost more than $15. Furthermore, there is evidence that creatine is absorbed better with carbohydrates and protein. This means that you may take creatine with your pre-workout carbohydrate and protein meal.

BCAA before and after weight-lifting:

Consume about 0.05 g/kg of BCAA before and after workouts; at least half of your BCAA should come from the amino acid leucine. Leucine is special because it signals cells to “turn on” the genes that promote muscle growth. A pure BCAA powder is the most economical way to take this supplement; one rounded teaspoon is about 5 grams. A container containing 500g should cost you about $22-30 and last 1-2 months, depending on your weight. BCAAs have a bitter taste, however, so many people prefer to supplement in pill form.

If you do not own a copy of Dr. John Ivy’s Nutrient Timing, I would suggest buying it reading it, and following it.

2. Beware of cardio-overkill

The muscular adaptations that occur with weight training (increased muscle mass and strength) and the adaptations that occur with endurance training (smaller muscles that are more energy efficient—meaning they burn FEWER calories to do the same work) are directly contradictory. If you are logging several hours a week on the treadmill in an attempt to stay lean while gaining muscle, switch to a few 20-30 minute, high intensity interval workouts 3-4 times a week and skip the marathon training!

3. Include Power Days

High-intensity sessions that emphasize short rest periods and super-setting have a place in any program; however, you will not get maximal size or strength without maximal weight load. Your muscle, nerves, and hormone-secreting glands respond in a special way to the heaviest weight you can lift. A heavy workout approach may require longer rest periods and fewer reps (4-6) a couple of times per week.

4. Include enough overall dietary fat

For getting super-lean, you may need to take your fat down to 20% of total calories; however, if you are trying to gain weight, limiting fat is counter productive. When I asked Victor Dean, trainer and business-owner, about the hard gainer issue, he had this to say.

Victor’s response:

Mike’s situation is common; countless bodybuilders have difficulty gaining size. A number of possible solutions have been thrown at this problem, some with more success than others. One common method is to consume carbohydrates excessively and hope that muscles will swell in response to the extra glucose. This approach has some validity it its base-- carbohydrates are used during heavy weight training and ample carbohydrates are used by the body to recover from workouts. However, loads of high-glycemic, processed carbohydrates immediately after a workout may be in excess of post-workout needs. Consequently, lifters relying simply on extra carbohydrate may gain primarily body fat from the extra carbohydrates.

There are a couple of problems with excessive carbohydrate consumption. First, muscle tissue can only absorb a limited amount of glucose in a given time period. Some experts estimate that the muscles require 50g glucose every 2 hrs for the average 200lb bodybuilder. I think that actual muscle needs vary largely, depending on the individual and his or her current state of nutrient demand, but let’s stick with the 50g glucose/hour number for now. If a bodybuilder throws in an additional 75-100g at a time, the additional carbohydrates overwhelming the muscle will be converted to fat and stored as such. Your body does this to clear the blood of excess sugar.

I am also concerned that your gaining diet is only 20% fat. Bodybuilders consuming diets chronically low in fat are susceptible to aches and pains that don’t go away; furthermore, strength and mass gains are limited and great pumps are MIA.

Once post-workout carbohydrate needs are satisfied, an effective approach is to add more fat. As long as carbohydrate intake is high enough to replace muscle glycogen stores and provide an anabolic insulin spike after a workout, the best way to fully recover and gain quality body mass is to slowly add more fats to your diet, specifically healthy mono and poly-unsaturated fats. The calorie-dense fats will give your body more fuel to run on, conserve carbohydrates consumed and liver glycogen, and they will provide you with the necessary energy to repair damaged tissues and produce key hormones, like testosterone. In fact, research shows that chronically low fat intake is directly associated with lower testosterone levels in men. A higher fat intake will yield better results for you, as well as a long and happy life for your joints and tendons.

To gain weight, you must eat more calories than your body can burn. That said, if you are not ravenous, it’s much easier to eat a handful of almonds than a huge plateful of pasta. So Mike will have an easier time gaining weight if he adds some fat to his meal plan. He should ensure he is getting in 40-50g of carbohydrates every couple hours but also add a serving of fat to each meal and see what happens! Examples of good, healthy fat sources are almonds, olive oil, natural peanut butter, flax oil, and fish oil. Fats with more omega-3’s (fish oil, walnuts, canola oil) have a beneficial impact on cholesterol and reduce inflammation; adding extra saturated or trans fats to a diet will contribute to heart disease and inflammation. Make sure the fat is increased gradually; even healthy fats will cause you to pack on fat pounds if overdone. Play with it a little and I’m sure you will be happy with the results.

Best of Luck!


Jean offers nutrition coaching for weight loss, muscle gain, or any of your personal goals at her office in the Alico building in downtown Waco, TX right in the heart of central Texas. She also offers personal training services at Ironhorse gym on the corner of Franklin and 17th, which is also very convenient to downtown Waco. Contact information can be found on her personal website.

Wednesday, January 9, 2008

Variety: The Spice of Life or Dietary Doom?


A glaring apparent contradiction in diet and nutrition mantra seems to be whether or not a healthy diet contains "variety." Critics balk at the lack of variety and exclusion of food groups that characterize many fad diets. But this is an important part of the reason why some fad diets help you to loose weight! Is it okay to exclude entire food groups and limit dietary variety during the quest for a better body?
More importantly, loosing weight through Atkins or another low-carb type diet will result in weight loss. If you have a health condition that is significantly improved through weight loss alone (high blood pressure is a good example), doesn't that mean that severely limiting the diet is good for you in that case?

On the other hand, we are continuously discovering new compounds and new function of old compounds. Each natural food is so special in the mixture of chemicals that give it its color, taste, and health benefits. For instance, resveritol, the newly discovered antioxidant in red wine and other foods. Researchers recently discovered the ability of phytosterols to lower cholesterol. By the way, phytosterols are not only supplemented in margarine but exist in every plant-based natural food (fruits, vegetables, whole grains, etc).

Furthermore, my lab has been involved in research looking at specific proteins in dairy products that may contribute to weight loss. In research, meat-eaters have lower body fat percentages than vegetarians consuming a diet of the same macronutrient breakdown; meat is a natural source of creatine. By limiting entire food groups, you are surely missing out on a host of health benefits.

Variety or limited variety?

A study published out of Tufts University in the Journal of Nutrition sums it up pretty clearly. The variety of sweets, snacks, condiments, entrees and carbohydrates consumed was positively associated with body fatness, whereas the variety of vegetables was negatively associated with body fatness. Practically speaking, what does this means for you on a long-term healthy diet that allows you to loose weight?

1. Eat a variety of vegetables, and make them the base of your meals--don't smother them with a variety of condiments.

2. Choose several lean protein sources, including dairy, and include those at most meals--good examples are fat-free cottage cheese, chicken breast, any fish, and 96% lean ground beef--don't drench your protein in a variety of sauces.

3. Pick one whole grain you like and eat it sometimes (1 or 2 meals per day). My grain of choice is old-fashioned oats in the mornin'.

4. Pick only fresh seasonal, local fruits--you will maximize the vitamins and nutrients from your fruit; have 1 or 2 pieces per day.

5. Eat mostly plant-based fats and pick one or two that you like to use; use sparingly.

6. Limit processed foods in general! Note that the first three foods listed that have a high association to body fatness are all bottles/jarred/preserved, etc. They have lots of calories and no special nutrients, chemicals, or antioxidants that make them worth eating! 'Nuff said.

Monday, January 7, 2008

Two Terrific Tools for Your Best Bod Ever

Though the task is tedious, writing down every little thing that passes through your lips is effective for weight loss- period. I have never personally been able to get into my best shape without doing it. There’s something about having to write “3 semi-stale peeps: 180 Calories/0 protein” that makes impulse eats far less appealing.

1. http://www.fitday.com/

Though this site lacks fancy flash images and arbitrary food ranking systems, it is my favorite online diet tracker because it is simple to use and is not excessively loaded with distracting ads and banners.

Make fitday work for you:

1. Click on the link above and under the sign-in area on the right-hand side click “Get Your Free Account”

2. Type in the information as it pertains to you

3. You will directed to a page where you can start entering your food for that day: search for your daily foods in general terms

4. Do not skip a thing! That little piece of hard candy counts—so do those three pretzels. You will be shocked by how quickly it all adds up!

5. As you add foods throughout the day, pay attention to the percentages listed for you on the food page. If you are trying to loose weight, decide on an appropriate calorie level (the one fitday suggests will be too high) aim for: 25-35% protein, 15-25% fat, and 40-50% carbs.

2. http://www.calorieking.com/

What to do when fitday doesn’t have your food? You can add a custom food using the information directly from a nutrition label or you may also go to calorieking and look it up. Calorieking has a much larger database, as well as several chain restaurant listings. It’s wild to just look at the nutrition in some things—search Panera Bread and see what you come up with. It will provide some motivation to start bringing lunch!

A frequent problem people have with writing food is portion underestimation! The only way to be certain about you dietary content is to weigh or measure it. Weighing with a digital food scale is the easiest method, since you can put your bowl on the scale and weigh the portion directly after zeroing. It should save you a couple-few loads of dishes!

So am I some kind of nutrition maniac who advocates weighing and journaling every nibble of food consumed for the rest of your life? Not really. Using this approach for a while (several months) will give you a realistic view of what a 1500 Calorie diet looks like. Trust me; it ain’t much. Once a person is used to the reality of 1 teaspoon of mayo (5g), eating an appropriate amount should become more automatic.

Roasted Moussaka Stew: A High Protein/Low-Fat Recipe

Moussaka recipes boast a host of healthy, anti-oxidant-rich ingredients, but the nutritional value is compromised by high-fat meat, generous use of olive oil, and a rich cheese layer. This hearty stew highlights the flavors of the vegetables and herbs, while sparing the diner extra calories and fat. Cook a pot on Sunday and reheat for an easy, healthy meal throughout the week.

Preheat oven to 375oF


Cooking Spray

3 medium eggplants, cubed or thinly sliced

1 large sweet onion, chopped

2 cloves garlic, minced or pressed

1 lb 96% lean ground beef

3 14.5 oz cans fire-roasted, diced tomatoes

1 quart beef broth (low-sodium if preferred)

½ cup brown rice*

2 Tbsp dried oregano

½ teaspoon cinnamon

1 bay leaf

½ tsp ground cumin

1 tbsp plum vinegar (optional)

fresh ground pepper and sea salt to taste

top with fresh thyme or Romano cheese (optional)


  1. Spread eggplant in a single layer on several cookie sheets and top with salt and pepper
  2. Roast eggplant in the oven for 25-35 minutes, until outside is browned and chewy and middle is soft
  3. In a large soup pot, spray cooking spray and sauté the onions until translucent; add garlic and cook for another minutes
  4. Add the beef; break up and cook until lightly browned on the outside
  5. Add roasted eggplant and remaining ingredients to the pot
  6. Simmer for 1 to 1.5 hours; add extra water as needed
  7. Remove bay leaf; add salt, pepper, and thyme to taste.

Serves 6

Nutrition (1/6 of recipe or about 2 cups):

280 Calories, 24 g protein, 37 g carbs, 3 g fiber, 4.5 g fat, 1.5 g saturated fat, 700 mg sodium; 20% daily iron, 45% daily vitamin C

* omit the rice: 220 Calories; 25 g carbs

Jean offers nutrition coaching for weight loss, muscle gain, or any of your personal goals at her office in the Alico building in downtown Waco, TX right in the heart of central Texas. She also offers personal training services at Ironhorse gym on the corner of Franklin and 17th, which is also very convenient to downtown Waco. Contact information can be found on her personal website.