Saturday, November 9, 2013

More on Nutrition - Ken Leistner (1982)

Hideaki Inaba

Fred Hatfield

Let's talk some nutrition. I occasionally make up handouts for my office patients, things to provide important information, things to entertain, all related to health, lifting, and related areas. I want to share some excerpts from these.

It may be easier to find someone who is NOT dieting these days. Interest in fashion, concern for health and longevity, a greater awareness in attaining physical fitness, and good old ego have prompted a rash of dieters and diets. Unfortunately, many so called experts have convinced the public that their particular approach to attaining the body beautiful is the final word. Many of the current dietary trends can prove to be useless, and worse, dangerous in some cases.

The primary concept to keep in mind is that calories do count, count more than anything else. No one can violate the laws of thermodynamics and if one consumes more calories than he burns, additional tissue will be added to the body. Forget those diets that tell you that you can eat all you want without gaining weight. Many of these diets recommend the ingestion of one or two particular foods and the dieter soon finds that it is impossible to gag down much of it, thus, he loses weight. The loss of weight results from reduced caloric intake, not any magical power invested within the particular foods eaten. On the 'Banana Split Diet' you might be able to eat three banana splits per day, but after a week it might be tough to even look at the messy concoction. Result? No intake, not weight gain. Fine, but a very unhealthy way to do things. So, the first thing remember is that in order to lose weight, calories must be reduced, or the body must burn more calories than it takes in, regardless of intake.

Exercise will help to burn calories, and more importantly, will produce tonus in the muscles which are exercised. Additional muscle tone improves the appearance of the area (making it look 'trimmer') and if the exercise is proper (more on t hat another time), the cells will be turned on for growth, leading to the addition of muscle tissue, another factor which improves physical appearance. Thus, a sensible exercise program should accompany any attempt to lose weight.

Limiting intake to protein only, or a combination of protein and fat, is erroneous and can be dangerous. The most recent research indicates that if two laboratory animals consume the same number of calories per day, and maintain the same activity levels, the animal receiving most of its calories in the form of protein will gain more weight than the animal receiving the majority of its calories in the form of complex carbohydrate. Thus, the time honored method of losing weight by ingesting a diet primarily composed of meat, chicken, fish and other protein items, in addition to being unbalanced will, if anything, encourage weight gains. Whenever one begins a diet of  this type, they usually notice a rapid loss of weight. The explanation for this is obvious: each gram of carbohydrate binds almost four times its weight in water within the cells of the body. When carbohydrate intake is limited, there is a relative loss of body water, giving the individual the impression that the body fat is being lost. This loss in water is easily and quickly replaced. Most proteins of animal origin are high in fat as well as protein, and the high protein diet is most often one that is actually a 'high fat' diet and contraindicated by most medical authorities. Although protein is an important component of any diet, it is but one component and must be kept in relative proportion to other macro-nutrients.

While some foods are looked upon as 'fattening', every food can be fattening, and any food is fattening if eaten to excess. Some foods, primarily those high in refined sugars, do not fill the stomach with sufficient bulk, leave the stomach quickly (encouraging further consumption), and are processed too quickly by the body. Most foods, however, are neither dietetic nor fattening. Peanut butter is a concentrated source of calories, but if eaten sparingly will not cause the addition of fatty tissue, if the overall calorie intake is less than that required by the body. Most foods can be viewed similarly.

Assuming that it is understood that caloric intake must be limited to an amount that is below baseline level (that number required to maintain already existing bodyweight), one is now faced with the age old question of 'What should I eat?' No matter how much rancor one has for organized science medicine, the facts remain clear - one needs a variety of nutrients that can best be obtained by eating a wide variety of foods.

Many bodybuilders and other athletes often limit their intake to protein and fat in the mistaken belief that protein will 'build muscle' and any excess protein will be used to supply energy. While the  body can convert protein to a source of fuel, this process is inefficient and not without certain side effects. Excess protein is more likely to be stored as bodyfat. If an athlete burns 3000 calories per day and eats 4000 calories per day, he will get fat, no matter what the makeup of the diet. Limiting the diet to protein only or protein and fat will only encourage ketosis, and is an inefficient way to run the body. Although much controversy exists regarding the role of cholesterol and fat intake in the development of atherosclerosis, most of the evidence definitely implicates these substances as being contributory to the buildup of fatty deposits within the vessels. The production of ketones may, as a number of highly advertised diet books will tell you, be 'good', but these byproducts of fatty acid metabolism can lead to a variety of degenerative conditions, and ketosis should be avoided if possible. Symptoms of hypoglycemia, another of the popular fad disorders which is actually rare, are often fostered by a diet in which carbohydrate intake is limited, and protein becomes the primary source of energy production. If one were to make inquiries of a number of reputed experts, they would state that the symptoms of fatigue, weakness, headache, and general malaise were due to a diet rich in carbohydrate and would suggest increased consumption of meats, cheese and fowl. The aforementioned symptoms are often due to the ketosis of fat metabolism (and again, almost any high protein diet is a high fat diet), and a lack of glucose.

Many of those interested in a high protein diet with limited caloric consumption have turned to commercially prepared protein preparations. Liquid proteins have been properly skewered in the scientific literature with the major complaints related to a horrid deficiency of a number of necessary nutrients. These extracts of animal collagen (hides, hair, and end products such as ears and snouts) are an unbalanced source of amino acids and have been linked to cardiac and kidney problems. The various powders offer the consumer what initially appears to be a safe way to lose weight. These powders are often made from the byproducts of milk and/or eggs, soy powder, yeast, or a combination of ingredients. Some of the less popular products consist of what Dr. N. Smith has referred to as 'slaughterhouse refuse which has no place in anyone's diet': spleen, thymus, intestines, stomach and other organs. Despite the claims of the national distributors who push these products, they contain nothing special, no magical ingredients designed to supply the body with the ability to shed weight or pack on muscle tissue. If one consumed nothing but protein powder mixed in milk or juice it might be possible to obtain most of the necessary nutrients, but these products are often lacking in a number of vitamins and/or minerals. Additionally, one will quickly get bored of this monotonous diet, can find it difficult to eat in most social situations, may be inconvenienced by the preparation necessary to keep a fresh supply of drink on hand, and, as many have discovered, could have difficulty maintaining proper habits of elimination.

In order to answer the question, 'Should one drink with meals', it is necessary to march through a bit of technical information first. Let's assume that our model patient is in the midst of devouring half a chicken and is wondering if his gastric hydrochloric acid (HCL) will be diluted by the ingestion of juice or water, a thought that seems to be distracting quite a few patients these days.  

Despite the glut of fad diet information here are some facts: gastric (in-the-stomach) digestion of protein is totally unnecessary for the complete utilization of that macronutrient! Specialized cells in the stomach, called chief cells, secrete something called pepsinogens. These pepsinogens, eight of them exist, all varying slightly in their makeup, are converted to active proteolytic enzymes (called pepsins). This conversion is made possible by acid (and already existing pepsins) within the stomach. It may come as a surprise, especially if you're addicted to those television commercials extolling the benefits of the various antacids, but the contents of the stomach do not become acidic until digestion is well under way, thus, only a fraction of the ingested protein in the diet is affected by pepsins in the stomach.

As protein, undigested, and as they say in Texas, semi-digested, leaves the stomach and enters the small intestines, up to 50% of it is further broken down into small peptides (chains of amino acids) and amino acids. This is done by enzymes that are secreted in their inactive form by the pancreas, which then become active, through a series of reactions, in the small intestines. Within four to six hours complete digestion and absorption of the chicken occurs. Of course, the time may vary from one individual to the next,but this figure will apply to the majority of the population. Some individuals may be surprised to learn that complete hydrolysis (breakdown) of protein is not necessary for complete absorption. In fact, small polypeptides, or chains of two or three amino acids, are better absorbed by the intestinal cells than individual free amino acids. Many of these polypeptides are hammered down to their constituent amino acids at the border of these intestinal villi cells, with the free amino acids being immediately transported into the cells. In the presence of certain electrolytes, the amino acids will be transported from the intestinal cells properly.

The eventual fate of all of these amino acids is beyond this particular discussion. It should be obvious, though, that if one has the desire to drink with meals, he should not be deterred by the fear of 'diluting the stomach acid'. Remember, most of the protein digestion does not take place in the stomach anyway, so this is one more myth from the nutrition subculture that deserves to be put to rest. In fact, there are some reports that indicate that a small amount of wine will enhance digestion of proteins due to a stimulatory effect upon the flow of gastric acid. As always, moderation is encouraged: a bottle of Ripple will do little for the digestion of your Chateaubriand.

It may be appropriate to add a comment regarding the absorption of B12 at this time. A small amount of protein can be absorbed through the intestinal cells without being broken down. 'Intrinsic factor' is a glycoprotein (combination of carbohydrate and protein) that is secreted by specialized cells in the stomach. It combines with vitamin B12 (from dietary sources) and this complex is absorbed intact into the cells of the intestine. The vitamin is then transferred to carriers in the plasma. If one is lacking the intrinsic factor he will be unable to properly utilize the B12 he is ingesting. This may lead to deficiencies and a number of problems, including a specific type of anemia. If one is ingesting plenty of B12 through the diet, but not utilizing it due to the lack of intrinsic factor, a B12 tablet will also be inadequately utilized. Remember, it is not a lack of B12, it is lack of the carrier for that B12 that is the problem. In such a case, injections of the vitamin may be indicated.            

For the past 10 years of so it has been quite fashionable to ingest copious quantities of various vitamin and mineral tablets, powders, liquids and crystals. In the athletic community these practices have been long established, but the general public has been carrying the ball for the supplement manufacturers and distributors lately. Is this necessary, or more importantly, is it healthy?

All athletes are looking for an edge and no doubt always will be. As most top performers know, there is no direct substitute for hard work, the development of skill, the production of stamina, and the acquisition of superior strength. All of this comes via getting up in the morning and, as old line coaches are prone to say, 'strapping on your jockstrap.' One has to dedicate himself to his particular sport and work at it, long and hard. In this way, and only in this way, can one excel. If the principles of good nutrition are followed one should, according to the experts, be able to supply the body with all of the macro and micro nutrients necessary to allow muscle tissue growth, and the development of other desired physical attributes.

For the non-athlete, the individual concerned with 'staying in shape' or one who gives weekends over to chasing a tennis ball, the development of 'athletic qualities' is also very desirable and this often leads to the mimicking of the athlete's behavior. 'If the pro athlete needs lots of vitamins and minerals, then so do I.' Well, that in fact is the question: Does the pro athlete, or any athlete, need lots of vitamins and minerals, or at least, are supplemental doses needed after the fare from the table has been consumed?

This question has raged for decades now. Keep in mind that normal is best, not sub-normal (although this is obvious), and not supra-normal. If normal truly is best, if the body's wisdom has, through the ages, brought about the evolution of a system that is finely tuned and must be fueled within a narrow range for optimum efficiency, then too much of anything will be as detrimental, or could be as detrimental as too little of anything.

The body is at a disadvantage when trying to operate with 'too much' as the overload must be eliminated. In the case of vitamins and minerals, most of the excess is passed off via the urine and feces. But it's not as simple as getting up and walking into the bathroom. In order to process the excess the bodily systems are called upon to do more work than is usual: the excretory system, respiratory system, digestive organs, and in fact almost every body system is called upon to process the overload, eliminate it, and restore homeostasis. One cannot be 'supranormal' for this is abnormal and again, normal is best, thus overindulging in supplements will not bring about better performance. Once the needs of the body have been met, there is no need for more of anything. One can't supersaturate the body with nutrients, although this is a common belief among competing athletes.

If the body cannot use all of these preparations, why does the athlete use them? Simply, this is one more 'advantage' that the competitor feels he has over his opponents. And of course, this raises another legitimate question: does the athlete, through this activity, create a need for more, provide a real reason for taking what would normally be an overload? The jury is out on this one, but more and more research now points to the fact that stress situations, both physical and psychological, increase the demand for certain vitamins. High intensity muscular contractions may deplete mineral stores more rapidly than is done in a sedentary individual. The same is true for many of the water soluble vitamins, especially C and members of the B complex. Hot weather and/or increased sudoresis (profuse sweating) may also bring about the need for replacement of these same water soluble nutrients. Thus, in some cases, additional quantities of various vitamins and minerals may be necessary, and for many a commercially prepared supplement may be the best way to meet this increased need. If one feels that there is a need for supplementation, especially if the daily intake of food is limited, sporadic, or of poor quality, keep in mind that the best supplement will give a broad spectrum of vitamins that are not excessive.

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