This month Dr. Sears is answering your questions on how to fuel pre and post workout, his thoughts on BMI and weight bias, and inflammation fighting habits. See what he has to say in his latest blog.
Q. What do you recommend eating before or after a workout?
A. One should consume a small balanced snack containing both protein (about 7 grams) and carbohydrate (about 9 grams) and containing no more than 100 calories. This should be consumed about 45 minutes before exercise. This provides enough protein and carbohydrates to stimulate insulin and glucagon levels in the blood without diverting too much blood flow to the intestine for digestion.
Within less than two hours after working out, I recommend consuming a larger meal of a similar protein to carbohydrate balance to reload muscle glycogen more effectively. After that two-hour window, it is more difficult to reload muscle glycogen levels.
Download our 7 Day Meal Plan for Athletes Here
Q. What do you consider the best inflammation-fighting habits and why?
A. Reducing inflammation is best done by following the 80:15:5 rule. Eighty percent will come from your diet, 15 percent from exercise, and 5 percent from stress reduction. Breakfast is the most important meal of the day since you have been fasting during the night and your fuel supplies are empty. Try to get at least 25 grams of protein at breakfast balanced by about 35 grams of low-glycemic carbohydrates and limited amounts of fat. Examples might be a 4-egg (ideally 8 egg-white) omelet with vegetables, 1 ½ containers (250 grams) of low-fat yogurt with a little fruit, or a smoothie containing 25 grams of protein powder and some fruit. Each will provide about 400 calories. The balance of protein-to-carbohydrate in each breakfast will stabilize blood sugar levels for about 4-5 hours. This is also a good time to take fish oil as the best anti-inflammatory supplement. Try to get at least 1-2 grams of EPA and DHA with your breakfast. If you want a cup of coffee, consider a cappuccino, as the added milk has the correct protein-to-carbohydrate ratio.
Relative to exercise, try to do something you can do at home as time is always premium. Try some stretching with light weights or resistance.
The best time for stress reduction is before you go to bed to get a better night's sleep.
Q. Why is BMI an inaccurate measure of health?
A. BMI often underestimates your percent body fat, which correlates better with health. Excess body fat is pro-inflammatory and is caused by insulin resistance. Insulin resistance is the driving force for developing obesity, diabetes, and heart disease because it disrupts your metabolism.
Q. What are examples of weight bias?
A. Some people can fall into the metabolically healthy obese category. However, with time as their metabolism continues to degrade because of ongoing insulin resistance, they become metabolically unhealthy obese individuals. Elite athletes can be obese by BMI because of their high muscle mass levels and low body fat. However, this is a tiny percentage of the population. On the other hand, if you have visceral obesity (i.e., belly fat), you are not healthy at any BMI.
Q. What are ultra-processed foods?
A. Ultra-processed food is constructed of basic agricultural products that are broken down into their core ingredients to make new food products that can be mass-produced at a lower cost and with additives that enhance their palatability and shelf-life. The primary components removed in ultra-processed food are fermentable fiber and polyphenols which are critical for gut health and overall health. Although I don’t recommend eating ultra-processed foods, for those that do adding more fruits and vegetables that contain those ingredients back into the diet is critical.
Q. What are "inflammatory dietary advanced glycation end-products" and how are they connected to weight loss?
A. An AGE-product can interact with their receptors (RAGE) to transmit signals to activate the gene transcription factor (NF-kB) to generate inflammatory compounds. These compounds include cytokines that can induce insulin resistance by inhibiting AMPK (the master regulator of metabolism). Inhibition of AMPK will decrease oxidation of stored body fat for energy. The result would be increased weight gain.
Weight loss and better health come from reducing insulin resistance by activating AMPK. Reducing calories is the best approach to activate AMPK as long as the composition of the diet is nutrient-sufficient.
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