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viernes, 5 de abril de 2019

No, we don’t need to talk about thin privilege

 Update: I have modified slightly my opinion on the term thin privilege which can be read here

This is an opinion piece by Wayne Bradley and does not reflect anybody else's views associated with this blog.

Recently I found myself in a debate with fellow nutritionists and dietitians on the Build Up Dietitians Facebook page regarding the concept of thin privilege. Thin privilege is as follows, we “thin” people live in a world where we don’t experience the stigma and prejudices that overweight people experience. We can find clothes easily, we don’t get stared at when we eat in public and so on. 

Ok, so far so good, nobody would argue with that fact. But I have several issues with labelling it “thin privilege”, firstly the word privilege and the tone of the articles I have read regarding this topic indicate that being thin, or “skinny” which gets thrown around lightly but no-one will dare say fat, is something that has been gifted to us, we haven’t earned it and we should thank our lucky stars that we’re in this position. 
Most people, especially those in the health & nutrition industry know only too well how hard maintaining/losing weight is and to hint that normal weight people are somehow blessed or “privileged” is quite insulting, but sadly nothing new. Now of course because I said I eat well and do a lot of exercise that also means I think every large person is bone idle and just eats pizzas all day long! No, it doesn’t! It means making ANY assumption about a person’s body shape is wrong. 

I feel very proud of myself when I see those scales going down, or when I get up 8am on a Sunday to go riding even though the sun is shining and I’d much rather have a few beers with my wife and friends. To suggest I should somehow feel privileged for that completely undermines the hard work and effort I (or anyone) does to maintain their healthy lifestyle. That doesn’t make me unaware of the battles large people go through, in fact, what I do with my life has nothing to do with what my patients do with theirs, which leads me on to my second issue.  

My second issue is also to do with the term “thin privilege”. It is a nonsense term and completely unnecessary. When our patients come to visit us, they will discuss with us the problems they face, not only with their food choices but with self -esteem, health issues and so on. We will listen to them and if we do not share the same problems we will use empathy to understand them and guide our patients through their journey. 
We already have the word, it is empathy, we do not need a new Insta-trendy, buzzword. If as a healthcare professional you are unable to empathise with your patients then may I suggest a career change? Politics perhaps. 

To repeat a previous point, what I do with my life has no bearing on my patient's lives and has no place in a consultation. They are there to talk about their lives not mine. If the boot was on the other foot and my coach was "acknowledging" their superior athletic ability or shall we say "athletic privilege", I would feel extremely patronised and would probably sever ties with that coach very quickly. 

Perhaps I am being too pedantic around terminologies and the use of words. However, I worry that we are going down a particular path where we will not be able to openly discuss weight, obesity and it's related health problems. Body size and shape should not be attributed to attractiveness, I will vigorously defend that there is not one "perfect" type of body in terms of what is "hot" or "sexy". We all have our own tastes and that is what makes the human race so amazing! However, obesity is not healthy, it just isn't. Many co-morbidities exist with obesity, we all know it and not discussing them does not make them go away. 

Saying "you're fat therefore ugly" is disgusting and should be stamped out immediately. But saying "you are overweight and need to make a change to improve your life" is not the same thing and should be what we are saying, but I fear we are becoming too scared of being labelled as "fat shamers". 

To repeat, I acknowledge that larger people have a tough time in regards to the society we live in, but as nutritionists/dietitians we are there to help them and we owe it to them to be honest. What use is saying "yeah I know I'm thin and my life is easier than yours"? 

During the debate, the topic of the genetic influence on body weight continued to appear, while it was beside my original point I will address it here.Yes genetics plays a large role in a person's size. The size of that role varies. However, does that mean we all just give up and say "its the genetics"? Because if that is the case then dietetics is dead!! I don't believe that is the case, some of us have been dealt a good hand in genetics, some haven't. That doesn't mean we can't make the best with what we've got. We can still strive to be the best version of ourselves and I strongly believe that externalising ourselves to the genetically thin and fat does us all a huge disservice. 

Wayne Bradley BSc (hons) MSc PG cert

viernes, 12 de enero de 2018

The number one mistake to avoid when you start your January fitness regime

 Here we are again, its January, it’s cold and miserable and we all feel fat and ugly! After overindulging over the Christmas period we are all determined to get back in shape. 
The internet is currently awash with detox plans and miracle regimes to get everyone thin, fit and strong. 
We’re not going to add to the list but we are going to offer you a piece of advice that you should always take into account when deciding if you going to try to lose weight.

Do not start a block of hard training if you are dieting

This is a mistake people make over and over again and (in our opinion) why many “I must get fit” New Year’s resolutions fail around mid to late February. 
People will have spent most of December drinking and eating and probably not doing much exercise, and when January arrives they go on a strict diet and flog themselves in the gym. 
The usual result is they become either sick or injured and then the new regime falls by the wayside. 
As we have said previously you have to match your nutrition to your training needs. If you are going to start a very hard exercise regime, depriving your body of the necessary nutrients to provide energy and make the adaptations will result in, at best poor training sessions and at worst, getting sick and/or injured.

If you want to go on a diet some key points to remember are
  • Make sure you maintain an adequate intake of protein, 1.5-2g/kg of bodyweight
  • Make sure you do resistance training in the gym to maintain muscle mass (remember nothing crazy)
  • Keep any cardio work to a moderate intensity and duration
Once you have reached you goal weight you can start to increase the intensity of you fitness regime.

For any more questions regarding diet and exercise email info@gabinetederueda.es 

jueves, 19 de octubre de 2017

¡¡Cuidado con las cañas después de entrenar!!

Todos nosotros, los atletas no profesionales (y algunos pros también), disfrutamos de una cerveza después de entrenar y sabemos que consumir alcohol en exceso es perjudicial para la salud. Pero ¿puede ser también perjudicial para nuestra recuperación? 

En este estudio de la universidad de North
Texas investigaron el efecto del alcohol después de una sesión de entrenamiento con pesas. Contaban 10 hombres y 9 mujeres, todos bien entrenados que hicieron 6 series de sentadillas y después tomaron alcohol o un placebo. Todos los participantes hicieron ambos: ejercicio y alcohol y en otro momento ejercicio + placebo. Los investigadores tomaron biopsias musculares antes del entrenamiento y tras 3 y 5 horas. Los investigadores esperaban encontrar proteínas asociados con el crecimiento celular y diferencias entre el grupo alcohol y el de placebo.


El principal hallazgo fue que en los hombres la fosforilación de la proteína mTORC1 (una proteína que está involucrado con el crecimiento celular muscular) fue atenuada con alcohol.


Los autores concluyeron que el consumo de alcohol puede influir negativamente en la recuperación, inhibiendo la proteína que permite que el músculo aumente de tamaño tras el entrenamiento con pesas (al menos en hombres).

Este es un artículo muy interesante. Nos advierte de que tomar esa cervecita tras el ejercicio, aunque apetecible, nos puede alejar de ese objetivo para el que hemos estado trabajando tan duro. Desde aquí nos preguntamos si el efecto sería el mismo tras realizar un ejercicio de resistencia. 


miércoles, 20 de septiembre de 2017

An Introduction to Periodised Nutrition

If you regularly read articles about training or subscribe to any of the millions of training magazines, you will almost certainly be familiar with the term “periodised training”. Basically, it means instead of doing the same thing day in day out, you plan your training sessions to ensure you reach your optimal state of fitness for your given sport at the right time. As with most ideas regarding training it has been tweaked over the years and now we have versions such as, inverse periodisation, block periodisation so on and so on, but the idea remains the same, plan your training.

When people ask me how much carbs/protein/fat they should eat I always answer, “it depends on your training”. Initially they think I have given them a rather vague and unhelpful answer, but once I explain that their nutrition should match their training and go into detail they understand why I gave that answer.
This is the concept of periodised nutrition, depending on the type/duration/intensity of your training regime determines what you should eat. This is one of my main arguments against the LCHF craze, if during your training regime you have any periods of high intensity training or races, then chronically following a low carb diet will not be of much help. Of course, the opposite is true. If you are not doing any kind of intense or long duration training then a high carbohydrate diet is not necessary.

A good example would be somebody training for an Ironman, whilst the event is still several months away and they are wanting to optimise their fat utilisation capacity, they will most likely be doing sessions of fasted training or sessions of fairly low intensity. At this point, I would recommend a diet low in carbs with higher fat. Once they got nearer to race day and the intensity of training increased, I would increase the amount of carbohydrate in their diet. And of course, for the event itself, ensuring they take on plenty of carbohydrate will be vital.
In summary, your diet should provide fuel for your training and your recovery, the more intense your training is the more you will need carbohydrate in your diet.

Over the next few months we will be looking in-depth at different strategies of periodised nutrition, but in the meantime any questions or comments leave below or contact www.gabinetederueda.es

lunes, 18 de septiembre de 2017

Amino Acidos Ramificados: ¿Merecen la pena?

Los aminoácidos ramificados (también conocidos como BCAAs) son uno de los suplementos más populares, quizá más que la creatina. Siempre se ha dicho que los BCAAs son imprescindibles para los aficionados de entrenamiento de fuerza y resistencia, porque al parecer los BCAAs provocan un estado de anabolismo o impiden un estado de catabolismo.
Mientras la creatina tiene décadas de apoyo científico, ¿podemos decir lo mismo sobre los BCAAs?
En este post resumimos el artículo de Robert Wolfe de la publicación Journal of the International Society of Sports Nutrition. Te dejamos el original aquí (en inglés), te recomendamos que leas, aquí abajo tienes los puntos claves. 

Antes de que empecemos a repasar la evidencia, vamos a repasar brevemente qué son los aminoácidos. Hay en total 20 aminoácidos, 9 son esenciales y 11 no esenciales. Esencial quiere decir que nuestro cuerpo no los puede construir y tenemos que obtenerlos través de la dieta. De los 9 aminoácidos esenciales (AAE) 3 de ellos se llaman los amino ácidos ramificados o “branched chain” (BCAAs) son: leucina, isoleucina y valina. Las proteínas musculares están en un estado continuo de rotación, es decir, que siempre hay síntesis de proteínas musculares (SPM) y descomposición de proteínas musculares (DPM). Hay un estado de anabolismo cuando hay más síntesis que descomposición, y cuando pasa lo contrario lo llamamos estado de catabolismo. Se puede alcanzar un estado de anabolismo al aumentar SPM o al inhibir DPM, pero para la SPM hacen falta todos los aminoácidos.


La evidencia

  • En los estudios que demuestran un efecto positivo de la SPM los sujetos son ratas. Los estudios de músculos en ratas tienen casi ninguna relación con los estudios de músculos de los humanos.
  • En estos estudios, los BCAAs que les dieron a las ratas fue por la vía intravenosa, no vía oral, un método poco práctico en realidad.
  • En los estudios con sujetos humanos, también les dieron los BCAA por la vía intravenosa, pero esta vez hubo una disminución de la SPM.
  • En los estudios de humanos hubo también una disminución de descomposición (DPM) pero los sujetos se quedaron en un estado de catabolismo.  

Actualmente la evidencia sugiere que los BCAAs solos (sin otras proteínas, carbohidratos etc.) reducen la rotación de las proteínas musculares (síntesis y descomposición). El autor nos advierte que una reducción en la rotación de las proteínas musculares puede tener un efecto negativo en el esfuerzo del músculo debido a una reducción en la construcción de nuevas fibras musculares.
La evidencia actual indica que los BCAA (particularmente leucina) aumentan la señal de SPM, sin embargo, una señal más potente no significa más SPM si todos los AAE no están presente. Es como intentar arrancar un coche sin combustible.
Para conseguir la SPM necesitamos todos los aminoácidos. Después de una comida con proteínas, nuestro cuerpo puede utilizar los AAE de la comida, pero entre comidas, en el estado post-absortivo, la única fuente de AAE es a partir de la descomposición de las proteínas musculares, por eso la proteína del músculo está siempre en un estado de rotación.
Si tomamos una dosis de BCAA muy grande sí reducimos DPM, pero eso significa que estamos reduciendo la cantidad disponible de AAE, por lo que como resultado también reducimos la SPM.


El lado bueno (más o menos)

Con una señal de SPM aumentada gracias a los BCAA puede que, en combinación con una comida rica en proteína, el efecto de la proteína resulte aumentado. Un estudio ha demostrado que una dosis de 5g de BCAA en combinación con 6.25g de proteína de suero tenían el mismo efecto en la SPM que 25g de proteína de suero solo.  
Aunque esto es interesante, si pensamos en el precio de los BCAA en comparación con el precio de proteína de suero o mejor todavía, COMIDA, ¿merecen la pena los BCAA? Recuerda que más no es necesariamente mejor, si añades más BCAA a tu batido de proteínas no significa aún más SPM.
Otro punto a recordar, como decimos en nuestro blog de BCAA e inmunidad, es que los BCAA compiten por el mismo sitio de absorción y normalmente el aminoácido en mayor cantidad (casi siempre leucina) es absorbido a costa de los otros dos. 

Conclusión

No solo hay una falta de evidencia que demuestra un efecto anabólico de los BCAA solos. El autor concluye que sin la presencia de una fuente de AAE (a través la comida o de la DPM), no es posible para los BCAA aumentar la síntesis de las proteínas de musculares. Nuestro consejo es: olvídate de los BCAA y asegúrate de que tu dieta tiene una buena cantidad de proteínas de fuentes animales y vegetales.     

Si quieres saber más sobre nutrición deportiva visita nuestra web. www.gabinetederueda.es   

lunes, 11 de septiembre de 2017

BCAAs: Are they really worth it?

Branched chain amino acids (BCAAs) are in some way the creatine of the 21st century, what I mean by that is, that they have become the “go to” supplement for every gym goer. Strength and endurance enthusiasts alike are sold the idea that BCAAs are an essential component of their nutrition regime because they supposedly induce an anabolic/avoid a catabolic state in humans.
Whereas creatine now has decades of convincing research behind it, can we really say the same about BCAAs?
This post will summarise the recent review by Robert Wolfe in the Journal of the International Society of Sports Nutrition. I strongly recommend that you read the full paper (link here) after you have read the main points below.

First, a quick recap on amino acids. There are 20 amino acids in total, 9 are essential and 11 are non-essential. The term “essential” means that the body cannot synthesise these amino acids so we must obtain them from food. Of the 9 essential amino acids (EEAs) 3 of these are called the branched chain amino acids (BCAAs) these are, leucine, isoleucine and valine. 
Muscle protein is in a continued state of turnover, meaning proteins are constantly being broken down and synthesised (built up). The term anabolic state refers to when muscle protein synthesis (MPS) is greater than muscle protein breakdown (MPB), in other words, our muscle tissue is being built up as opposed to being broken down. When muscle protein breakdown is greater than synthesis this is known as a catabolic state. The anabolic state can be achieved by either increasing muscle protein synthesis or by reducing muscle protein breakdown. For MPS to be greater than MPB all 20 amino acids must be present.

We are sold BCAAs under the premise that they stimulate muscle protein synthesis and so we can avoid the dreaded catabolic state. But what does the actual evidence say?


The Evidence 

  • The studies that show an increase in MPS after ingestion BCAAs were conducted on rats. Muscle protein studies on rats have little if any relevance to humans.
  • These studies also administered the BCAAs intravenously as opposed to orally
  • Studies on humans, (who also administered the BCAAs intravenously), actually showed a decrease in MPS
  • The human studies also demonstrated a decrease in muscle protein breakdown but overall net effect was that the subjects remained in a catabolic state. 

When all the evidence is considered, it appears that taking BCAAs alone reduces protein turnover (synthesis and breakdown). The author points out that this may have a negative effect on muscle strength due to a reduction in new muscle fibre construction.
Current evidence suggests that BCAAs (in particular leucine) increase the “signal” for MPS, however an increased signal will not lead to increased MPS if the other EAAs are not available. Think of it as turning the key in the ignition, without fuel the engine won’t start.
In order for MPS to occur all amino acids must be available. After a meal containing sufficient protein, MPS is achievable because the EAAs will be taken from the ingested food. However, in the post-absorptive state (in between meals) the only source of EEAs is from the breakdown of muscle protein. This is why muscle is in a constant state of turn over.
If we take a huge dose of BCAAs we reduce MPB, however, by reducing MPB we reduce the amount of EEAs available for MPS so in turn, both MPS and MPB are reduced.

The Good News (kind of) 

With an increase in anabolic signalling through BCAAs, it appears that it can increase the effect of a protein meal. One study demonstrated that 5g of BCAAs added to 6.25g of whey protein had the same effect on MPS as 25g of whey protein alone.
While this may seem interesting, when you weigh up the cost of BCAAs against the cost of whey protein or (shock horror) real food, are they really worth it? Remember the golden rule, more is not always better, so adding even more BCAAs to your shake will not have a greater effect on MPS.
Another point to remember is, as we mentioned in our amino acids and immune system post, the BCAAs compete for the same site of absorption so when taken in a large dose the amino acid in the greatest concentration (usually leucine) will be absorbed at the expense of the others. 

Conclusion 

Not only is there a lack firm evidence to demonstrate an anabolic effect of taking BCAAs alone, the author concludes that without a supply of essential amino acids (either through food or muscle protein breakdown) it is not possible for BCAAs alone to increase muscle protein synthesis. Our advice as always is ensure you have a diet rich in high quality protein before starting to consider supplements. 

For more info please see www.gabinetederueda.es 

jueves, 6 de julio de 2017

Energy Bar Recipe

Finding an energy bar that tastes good and is not full of rubbish has always been a huge challenge. I'm sure that I am not the only person who has ordered a large batch of energy bars for a cycling or training trip and then during a long ride as you unwrap probably the 20th bar you think "God! I am sick of this flavour!"

Taste fatigue is detrimental to both moral and performance. It may sound obvious but if don't like the flavour of something or you are sick to death of it, you will not eat it, which eventually leads to your performance suffering through lack of energy.
The finished article. 
Through years of trying several different brands of energy bars I have found that I really want them to taste like actual food and not a bunch of chemicals and flavourings. Eventually I decided to experiment with making my own bars.

The advantages of making your own bars are, you know exactly what is going into them, you can experiment with several flavours without having to buy lots of different types of bar, and generally speaking the cost of the ingredients will be cheaper than buying a box of energy bars from a well known brand.
I have always found that the energy bars you buy are very sweet so after 2 or 3  I get really sick of the flavour, especially if I am on a very long ride where I will be taking gels and sports drinks as well. By the end of the ride I am dying for something savoury!
With this recipe I have tried to find the right balance between carbohydrate for energy but not being too sweet. The great thing is that the recipe is pretty flexible so you can add or take away ingredients as you pplease to suit your taste preference. The only 3 ingredients that are essential are oil, oats and honey. This is the recipe to the bars I am currently taking out with me.

Ingredients:
100mls oil. (I use sunflower oil just for the fact it doesn't really taste of anything, I have tried both coconut and olive oil and find the flavour overpowers the rest of the ingredients.)
225g of oats
210mls Honey (The reason I put mls here instead of grams is that I use a protein powder scoop to measure my honey, 210 mls is 3 big scoops or around 300g. Yes that is a lot of honey but these are energy bars for long days in the saddle.) 

The ingredients above form the base of the bars and should be included in whatever batch you make. With the following you can be pretty flexible and change depending on your preferences.

40g Almonds (chopped)
10-12 Dates (chopped) 
2-3 tablespoons of peanut butter (this takes a bit of the sweetness away from the honey and dates, make sure you use a brand of peanut butter that isn't full of palm oil and sugar. I use bulkpowders 100% peanut butter.)
30g 100% cocoa grated or in powder (again this takes the edge off the sweetness and gives the bars a nice chocolate hint)


Here is a picture of all the ingredients. 














Melted Honey

Method 


  • Preheat oven to 180C 
  • Place the oil in a saucepan and put on a low-medium heat (my electric hob is numbered 1-6 and I usually use 3) 
  • Add the honey and stir continuously until it has melted
  • Add the peanut butter and also stir until melted 
  • Once the both the peanut butter and honey have melted you can start to add your other ingredients and give them a good stir so they are totally covered by the mixture
  • Now you can start adding the oats. Add them a small amount at a time and make sure you keep stirring to get all the oats covered in the mixture. As you add more oats it will start to get thick and difficult to stir. At this point also add the cocoa. 
  • Transfer the mixture into a cake tin and place in the preheated oven for between 15-18 mins depending on how gooey you want your flapjacks. I usually take them out around 15 minutes.
  • Leave to cool. This may sound obvious but if you try and cut the flapjacks now they will just fall apart, I usually leave them overnight. 
  • Cut them up into sizes of your preference, I have recently started to cut them into smaller pieces as I have found it easier to eat in one go as opposed to taking a bite then putting it back in your pocket whist moving.



Adding the almonds and dates into the mixture  
Adding the oats 

Nutritional Info if you divide the finished block into 8 bars each bar contains 

  • Kcals 324
  • Carbohydrates 59g 
  • Sugar 36g
  • Fat 6g
  • Protein 6g  

For long endurance events, the magic number in terms of carbohydrate is 60g/hr which means one of these bars an hour should do the trick in meeting your carb needs. 

If you try this recipe please let us know in the comments section how you get on, or you make any tweaks 


http://gabinetederueda.es/ 







viernes, 24 de febrero de 2017

Sistema inmunitario y suplementación de carbohidratos


Éste es el primero de tres artículos sobre el sistema inmunitario, ejercicio y macronutrientes. Hemos extraído la información del periódico “Exercise and Immunology Review” y hoy empezamos con carbohidratos y ejercicio de resistencia.

Los beneficios de los carbohidratos para ejercicio de resistencia están bien documentados y aceptamos por la comunidad científica. Para sesiones de entrenamiento y competiciones largas, nos recomiendan 30-60g/h hasta 90g/h para competiciones muy largas como Iron Man. La razón fundamental para estas cantidades es mantener el nivel de glucosa en la sangre, aunque también parece que los carbohidratos tienen un efecto indirecto en el sistema inmunitario.

Durante el ejercicio, las hormonas de estrés (adrenalina, noradrenalina y cortisol) aumentan. Estas hormonas perjudican al sistema inmunitario. Ponerse enfermo o tener una infección es algo bastante común entre los atletas; estoy seguro de que has tenido que perder alguna sesión de entrenamiento por esta razón.

En general, no hay una diferencia notable entre una dieta habitual alta o baja en carbohidratos y su efecto en el sistema de inmunitario, es decir, con ambas dietas hay una depresión de la función inmune después de ejercicio. Pero suplementación de carbohidratos durante ejercicio sí que tiene un efecto sobre él.

Durante ejercicio, mientras el nivel de glucosa en la sangra baja, el nivel de cortisol aumenta. El cortisol estimula el catabolismo de proteínas y la gluconeogénesis (la creación de glucosa de fuentes que no son carbohidratos). También tiene efectos anti-inflamatorios e inmuno-depresivos. Hay una buena cantidad de evidencia que demuestra que con la suplementación de carbohidrato durante ejercicio de resistencia el aumento del cortisol está atenuado. Por otro lado, también existen estudios que demuestran un efecto positivo de los carbohidratos en el sistema inmunitario, independientemente del nivel del cortisol.

En resumen: la suplementación de carbohidrato durante ejercicio parece a disminuir la depresión de la función inmunitaria después de ejercicio. Por desgracia, esta suplementación NO parece a reducir la incidencia de las infecciones de tracto respiratorio superior, si no que el efecto es sobre otro tipo de infecciones.

Aplicación practica    

A pesar de que la suplementación de carbohidrato no nos protege contra las infecciones de tracto respiratorio superior, todavía tiene un efecto beneficiario en el sistema inmunitario durante ejercicio. Eso significa que puedes recuperar de una ITRS más rápido y evitar otras infecciones. Por otra parte, el link entre carbohidratos y sistema inmunitario demuestra que mientras estás siguiendo una dieta baja en carbohidratos o estás entrenando en ayunas no es recomendable sesiones de entrenamiento de alta intensidad. Tampoco os recomiendo seguir una dieta baja en carbohidratos o entrenar en ayunas tras un período de entrenamiento muy duro.

Reference
Berman S et al. (2017) Immunonutrition and Exercise Consensus Statement. Exercise and Immunology Review: Vol 23