- The Authors
Jeff Thiboutot
Matt Schoeneberger
Whole Body Vibration – the jury is still out
Review: mikhael et al. and Cardinale
Vibration devices like these http://www.wholebodyvibrationmachine.com have been studied for their effects on various measurements (muscle strength/power, bone density) for over a decade. I’ve been asked about it recently by a few clients and a practitioner I work closely with, so I decided to dig around a little and find out what researchers are saying about it.
I found many studies, two of which were recent reviews. I’ll start with Cardinale and Wakeling from the British Medical Journal in 2005.
“…current knowledge on appropriate safe and effective exercise protocols is very milited, and claims made by companies and pseudo-experts can be misleading”
I was happy to see that quote, getting right to the bottom-line in one of the opening paragraphs. The authors go on to explain why vibration training may work in different populations, but repeat that much more research is needed to arrive at any conclusive answers. The basic jist from this paper is vibration training is probably not worth it for athletes (trained subjects) but may provide a benefit for older or special populations (improved vertical jumping ability, increase in muslce strength, increase in fat free mass), especially since almost no technique or effort is required.
Mikhael et al.
Interestingly enough, after the positive words for elderly populations by Cardinale and Wakeling, this paper dives into WBV for elderly populations specifically. After a literature search, only 6 papers meet their criteria for review. The authors state:
“There appears to be no consensus as to the efficacy of WBV for bone and muscle outcomes in older adults.”
While the authors are encouraged by the few studies that show a positive result, much more research is needed before we can draw conclusions about WBV training in the elderly population. In rehabilitation situations, it is likely these wouldn’t be used by the individual consumer anyway, due to cost. So, they would most likely be prescribed by a therapist and use in their office or clinic.
These conclusions aren’t all that surprising. Something like WBV training is hard to study. When you have a few different variables, like amplitude and frequency, of the device in addition to the usual variables of exercise research, you end up with a big mess of maybes and what ifs. Some of the studies I’ve looked over in addition to these reviews are pathetic in terms of design, which basically makes them worthless. But, we can rely on the quality information we do have and hold out for some better evidence!
Of course, if any of you are willing to shell out a few thousand dollars and try one, a little anecdotal evidence might be fun!
-Matt
References:
Cardinale M, Wakeling J. Whole body vibration exercise: are vibrations good for you? Br J Sports Med. 2005;39:585–589
Mikhaela M, Orra R, Fiatarone Singha MA.The effect of whole body vibration exposure on muscle or bone morphology and function in older adults: A systematic review of the literature. Maturitas. 2010 Feb 18. [Epub ahead of print]
Filed under: Exercise, Research, Uncategorized — Tags: vibration exercise — Matt Schoeneberger M.S. @ 1:32 pm
Saturated fat and insulin function; should low-carbers be concerned?
There have been some recent rumblings about the ingestion of saturated fat, particularly butter, having a negative effect on insulin sensitivity. The study demonstrating this affect is discussed in the Lopez et al paper.
I think there are some aspects of this study and its conclusions that should be kept in mind.
There are a number of things about this study that can reduce its external validity. First, this was a very short-term study, 5 separate test meals. Therefore, the results may not be the same when this type of eating style is followed long-term. There does seem to be 1-4 week time lag/adaptation phase to a high fat/low carb diet and most likely vice versa (Phinney). Related to this aspect is the fact that low carb and keto type diets, compared to low fat/high carb diets, have far better results on indices of lipids and blood sugar control (Westman et al; Reaven; Sharman et al). Also related to this aspect is the evidence of extraordinary health from a number of groups, such as the Masai and the Pukapuka/Tokelau (high fat diet mostly from coconuts, therefore high saturated diet) that eat a high fat diet. Therefore, over the long-term, a high fat diet, including a high saturated fat diet, is not likely to be pathological. Another shortcoming of this study is that there were only male subjects; therefore this may not apply to females. The macro ratios were not what are typically recommended for many low carb or keto diets, particularly the protein. Typically the fat intake is closer to 60% (72% in this study), protein is 20-30% (6% here, big difference) and carbs are 10-20% (22% here) and usually the carbs are derived from non-starchy vegetables, nuts and seeds, not pasta, bread and sugary yogurt (Westman et al; Volek et al). Therefore, this diet does not represent what is typically recommended. Interestingly, ALL of the fat-enriched challenge meals produced negative results. The authors (Lopez et al) state; “All the indexes [which include the insulin sensitivity ones] were significantly higher after the high-fat meals [high poly, MUFA & SAT] than after the control meal” (p.640). The saturated fat (butter) did do the worst, but they all did poorly. This conclusion seems to be in opposition to the evidence of high fat diets not causing insulin resistance and actually improving glycemic control (Westman et al). For instance, Cordain et al stated “…fat alone and under isocaloric conditions, unlike refined sugars, does not cause insulin resistance in humans…a range of isocaloric diets containing up to 83% fat did not directly cause insulin resistance, and the 83% fat diet actually improved certain aspects of glucose homeostasis” (p.100). Is this the difference between short-term verses long-term metabolic processes?
Another aspect related to this study is the flawed view that saturated fat should not be thought of as a single type of fat. There are a number of different types, i.e., carbon chain lengths, of saturated fats each with potentially different biological functions (Enig). This is the same as acknowledging that polyunsaturated fats are not all the same; the omega 6 and omega 3 fats, although they are both poly’s, have very different biological effects. Drilling down a bit further, the different types of omega 3’s, EPA and DHA, can have different effects. Therefore, it would seem important to not lump all types of saturated fats affects into one category. Until research is done on other types of saturated fats, the effects of butter should not represent the affects of all types of saturated fats.
This is not the first study to look at what type of effects different types of fats would produce. In fact, a 2008 review paper looked at this specific question. The authors of the paper concluded “Most studies (twelve of fifteen) found no effect relating to fat quality [relative amounts of saturated, mono, or polyunsaturated types] on insulin sensitivity” (Galgani, p.471). It would seem that the weight-of-the-evidence does not support a deleterious effect of saturated fat on insulin function.
One final thing before concluding; I am assuming that the butter the authors used was not from grass-fed cows. I wonder if the effects would have been different, due to the different fatty acid profile of grass-fed vs. grain-fed, if this type of butter was used?
Based on the recent Lopez et al study and the many other papers on this specific topic (high saturated fat diet and insulin function), and related topics (high fat, low carb diets and long-term health) I would conclude that a person transitioning (metabolically, likely 2 to 4 weeks) to a low-carb, high fat diet should not get a majority of their fats from saturated fats, particularly the long-chain type (palmitic, myristic and stearic acid). From that point forward a high saturated fat intake may be okay, but it would seem wise to get a good amount of monounsaturated fats as well as the proper amount of omega 3’s and the proper ratio of omega 3 to omega 6. This last scenario would typically be the natural result of following a high-quality low-carb diet, i.e., one based on quality meats, seafood, eggs, nuts, seeds, olives, avocados, some butter and cream (preferably from grass-fed cows), lots of non-starchy veggies and a bit of fruit. Therefore, from a real world perspective, any concern of using butter or other high-saturated fat foods should not be overblown.
References:
Enig, M. (2000). Know your fats: The complete primer for understanding the nutrition of fats, oils, and cholesterol. Bethesda Press. Silver Spring, MD.
Galgain, J. et al (2008). Effect of the dietary fat quality on insulin sensitivity. Br J Nutr; 100: 471-479.
Lopez, S. et al (2008). Distinctive postprandial modulation of b cell function and insulin sensitivity by dietary fats: monounsaturated compared with saturated fatty acids. Am J Clin Nutr; 88: 638-644.
Phinney, S. (2004). Ketogenic diets and physical performance. Nutrition & Metabolism; 1(2).
Reaven, G. (2005). The insulin resistance syndrome: definition and dietary approaches to treatment. Annu Rev Nutr; 25: 17.1-17.6.
Sharman, M. et al (2002). A ketogenic diet favorably affects serum biomarkers for cardiovascular disease in normal-weight men. J Nutr; 132: 1879-1885.
Volek, J. & Westman, E. (2002). Very-low-carbohydrate weight-loss diets revisited. Cleveland Clinic J Med; 69(11): 849-862.
Westman, E. et al (2007). Low-carbohydrate nutrition and metabolism. Am J Clin Nutr; 86: 276-284.
Filed under: Uncategorized, nutrition — Tags: insulin function, saturated fat, weight loss — Jeff Thiboutot M.S. @ 9:31 am
I have heard the following statements many times from clients; “I will add some peanut butter to my toast to get some protein” or “I will have a handful of almonds to increase my protein intake” and other similar statements equating nuts with protein. While these statements are not completely false they are really not representative of how nuts affect your nutrient intakes.
For starters, let’s look at what is in a typical serving of peanut butter and almonds. Keep in mind that most nuts have very similar macronutrient amounts.
| Protein | Carbs | Fats | |
| 1 tbs peanut butter* | 4g (15%) | 3g (13%) | 8g (72%) |
| 1 oz almonds* | 3g (13%) | 5g (13%) | 7.5g (74%) |
For comparison, let’s look at two common protein foods, cottage cheese and chicken breast.
| Protein | Carbs | Fats | |
| 1 cup 2% cottage cheese* | 27g (59%) | 8g (16%) | 6g (25%) |
| 4 oz chicken breast* | 32g (82%) | 0g (0%) | 4g (18%) |
Hopefully it is clear that nuts do not have a lot of protein per serving. In fact, nuts and seeds should be thought of as high fat foods. The two examples above show that nuts get about 72% of their calories from fat. This is not a bad thing, but because of the high amount of calories a large serving size of nuts has, using nuts for a primary protein source could lead to an excess calorie intake. For example, to get the equivalent of protein found in the cottage cheese example (27g) you would have to eat 7 tbs of peanut butter, which would equate to the following:
| Calories | Protein | Carbs | Fats | |
| 7 tbs peanut butter* | 658 | 28g | 21g | 56g |
However, when it comes to nut consumption and weight, the majority of evidence has found an inverse relationship. Both population and clinical trial studies have found that nut intake is associated with a lower bodyweight. (Sabate) Therefore, even though nuts are a high fat food they do not seem to contribute to weight problems.
Before concluding I wanted to highlight a few facts about nuts. Nuts are a great source of many nutrients. For example, nuts have a lot of magnesium, potassium, zinc, vitamin E, and most of the B vitamins. Nut consumption is also associated with lower rates of heart disease. (Kris-Etherton et al) Additionally, nuts have a low amount of carbohydrates and because most of their carbohydrates are fiber they have a very low net-carb count. Because of these and other aspects of nuts, nuts should not be avoided because they have a relatively high amount of fat.
I hope it is cleat that nuts are not a high protein food and most people should not try to get the majority of their protein from them. However, because nuts contain many valuable nutrients and have health promoting affects, most people should incorporate some nuts into their diet on a regular basis.
References:
Kris-Etherton, P.M. et al (2008). The role of tree nuts and peanuts in the prevention of coronary heart disease: Multiple potential mechanisms. J Nutrition; 138: 1746S-1751S.
Sabate, J. (2003). Nut consumption and body weight. Am J Clin Nutr; 78(suppl): 647S-650S.
* NutritionData.com
Filed under: Uncategorized, nutrition — Tags: nuts — Jeff Thiboutot M.S. @ 11:24 am
Jillian Michaels on PBS – useful information?
I was doing a bit of TV surfing last weekend and came across a PBS special called Master Your Metabolism. The talk was being given by Jillian Michaels, the famous trainer from The Biggest Loser show and author of a recent book called Master Your Metabolism. It had just started so I decided to watch the whole thing. I then went to the book store and looked through her book. Here are my thoughts on the information presented on PBS and in her book.
First, I would give an overall rating of 3.5 stars (out of a possible five) for the book/presentation. So, overall, I think the information is pretty good. Here is the list of things I liked:
- Hormones are very important for health and weight management
- Foods and exercise can modify hormone levels making it easier or harder to be healthy and maintain a healthy weight
- Eat real food
- Avoid processed foods
- Eat more organically produced foods
- Minimize your exposure to chemicals from personal care products and other commonly used products
- Minimize carb intake at night so that there is a better growth hormone output while you sleep
- Eat a good amount of protein, about 30% of your diet
- Drinking alcoholic beverages is very counterproductive for weight loss
Okay, good so far. However, things start to fall apart.
The first problem is the lack of discussion of the psychological and social aspects of eating behavior. As Matt and I stress in SPEED, it is not just about exercise or diet and how they affect our metabolism/hormones. Her focus on the nutritional and exercise components makes this book incomplete. To be fair, most weight loss books take this same approach and look at only a single or small number of potential variables. As you know from our book, we feel that this is a major reason for the poor success rates.
There were a number of statements that were a bit bombastic. For instance, she stated that “genetics does not contribute to aging or disease” and “hormones do not naturally decrease with age” really!? I believe that both of these statements are completely false. The following are more appropriate statements; “Genetics play a part in the development of disease but lifestyle factors, such as diet, exercise, etc. can modify how the genetics are expressed” and “Hormones do decline during aging, but a good amount of that decline can be reversed by following certain lifestyle habits”. Both of the latter statements are clearly not as enticing and do not have the same WOW factor but they are much more in-line with our current knowledge of these factors.
She also said that high sodium would cause an increase in cortisol levels as well as an increase in blood sugar and make you hold onto water, i.e., make you feel bloated. First thing, there is only a small percentage of the population that is salt sensitive. This means only a small percentage of people may have a negative reaction to high salt intakes, such as an increase in blood pressure. Additionally, the reaction to higher salt intakes also depends on the intake of other minerals such as potassium and magnesium. If these are also high then it is possible that the high salt intake will not have a negative effect. Anyway, when it comes to salt intake and cortisol the evidence for this connection is weak. Like the blood pressure affect, it seems that only salt sensitive individuals may have a change in increase in cortisol levels with a high sodium intake. However, the affect in one study was very small. (Kerstens et al) Another connection I found regarding salt and adrenal function is something called adrenal fatigue. (Wilson) This condition is caused from low adrenal function (the adrenal cortex produces cortisol) resulting in many common symptoms; fatigue, poor exercise tolerance, poor sleep patterns, sugar cravings and so on. People with this condition are recommended to make sure they get enough salt in their diet. Overall, I would not worry too much about salt intake as long as you are getting plenty of real, whole foods (i.e., eggs, beef, salmon, veggies, avocados, nuts, etc.) in your diet.
Related to the issue of cortisol and nutrition is the cortisol and exercise connection. It seems that high amounts of exercise, particularly a combination of high intensity and high duration, and coupled with unfit individuals, will cause a strong stress reaction and increase cortisol levels. Chronically elevated cortisol levels are bad for our weight and our overall well-being. Therefore, why would Jillian and the other trainers on The Biggest Loser show use this type of training? If Jillian is so concerned with high cortisol levels why would she do this to her clients? It would seem counterproductive to health. However, from the results on the show, it does not seem to inhibit weight loss. This is because there is a big caloric deficit. Certainly this strategy, in the short term, will result in weight loss, but is it good for long-term results and health? The exercise and stress/cortisol literature seems to point to shorter duration (less than 60 minutes) and relatively high intensity as the more appropriate exercise recommendations for positive hormone changes, particularly during energy restriction (i.e., reduced calorie intake).
She also states that Atkins, South Beach, no carb and no fat diets are fads and should not be followed. She, like many other people, continually refers to low carb eating plans as fads. Low carb eating is not a fad and has an abundance of clinical and epidemiological evidence to support the efficacy and safety of this type of eating style for weight management and health benefits. She also continues to perpetuate the myth that Atkins, South Beach and other low-carb eating plans tell you to eat NO carbs. The low-carb plans recommend you eat lower amount of carbs, often less than 40% of total calorie intake, not zero carb. Usually 10-30% of calories as carbs are the recommendations of many low-carb plans. But, yes, there are ketogenic food plans that do recommend very low carb intakes, 5-10% of calories, but still not zero.
The final thing that she really stressed was to never skip meals and to eat every four hours. This is apparently necessary to keep the metabolism going and to make sure that blood sugar stays at a proper level. Jillian, like many other fitness and nutrition gurus, are very concerned about eating often and not skipping meals. Why? First, eating more often does NOT speed up your metabolism. Second, from her statements about eating frequency, we can assume that she has not read the large body of research on the health benefits of intermittent fasting (eating every other day) (Johnson et al; Varady et al) or the eating frequency literature (Mattson)? Third, why 4 hours between meals? Why not 3.5 hours or 4.5 hours or 4.25 hours? There is no magic to eating every 4 hours. Third, blood sugar regulation is controlled by many mechanisms and eating frequency is just one of them. Overall, the body can go many hours, even days, without eating and maintain a healthy blood sugar level. (Mattson) For example, usually every day the body goes without food for 10 hours, the hours between your last meal and breakfast, and seems to do just fine.
I bring up this information because it bothers me when poorly supported or non-supported recommendations are given by people who should know better. Jillian and other popular exercise and nutrition experts can have a strong influence on the behavior of many people. They should realize their influencing power and make sure that what they are saying is well-supported! For those of you who are aware of Jillian’s information, please keep the information presented here in mind when you are contemplating using her recommendations.
-Jeff
References:
Kerstens, M. et al (2003). Salt loading affects cortisol metabolism in normotensive subjects: relationships with salt sensitivity. J Clinical Endocrinology; 88(9): 4180-4185.
Johnson, J. et al (2006). The effect of health of alternate day calorie restriction: Eating less and more than needed on alternate days prolongs life. Medical Hypotheses; 67: 209-211.
Mattson, M. (2005). Energy intake, meal frequency, and health: a neurobiology perspective. Annu Rev Nutr; 25: 237-260.
Varady, K. & Hellerstein, M. (2007). Alternte-day fasting and chronic disease prevention: a review of human and animal trials. Am J Clin Nutr; 86: 7-13.
Wilson, J. (2001). Adrenal fatigue: the 21st century stress syndrome. Petaluma, CA. Smart Publications.
Filed under: Research, Uncategorized, book review, weight loss — Tags: fitness myths, jillian michaels, weight loss — Jeff Thiboutot M.S. @ 8:15 am
Is low carb right for a healthy-weight person?
This question came from one of our subscribers:
The role of insulin in weight loss is well understood. However, if a person is already healthy, trim, and muscular, why should they avoid carbohydrates? Some exercise experts even advise carbohydrates to enhance workouts. What are the upsides/downsides of a low-carb approach if weight loss isn’t a goal?
Short answer: They don’t have to.
Long answer: Assuming that a person is healthy, trim and muscular, it will be a matter of careful self-monitoring to understand what level of carbohydrate (CHO) intake is right for them. Some level of CHO restriction may be necessary to maintain a certain look, but a different level may be needed for athletic performance. So, a prioritized balance will need to be worked out and, most likely, constantly tweaked.
Much of the research on fat adaptation and sports performance has been poorly undertaken, in my opinion. Phinney dived into this topic in good detail in Nutrition and Metabolism in 2004. At that time, most of the research performed on endurance training while fat adapted (and including a CHO load prior to testing) allowed no longer than 2 weeks for fat adaptation, most less than 7 days. Since the time of Phinney’s article, there seems to have been more of the same.
Much more well-designed study of fat adaptation’s effects on exercise is needed, by researchers who understand or appreciate the time needed for fat adaption is likely more than a few days. Some plans, like Rob Fagin’s Natural Hormonal Enhancement and Dr. DiPasquale’s Anabolic Solution advocate fat-adapted states with intermittent CHO loading. The anecdotal reports from followers of these plans are not enough, but could give the research community a point in the right direction.
There are cultures who eat almost no CHO and are generally healthy, and also cultures who eat high amounts of CHO and are also healthy. So, CHO intake may not be a deciding factor in the health of an individual. Instead, the quality of the food eaten, almost regardless of macronutrient content, may have stronger implications for health.
There are plenty of anecdotal cases of people feeling better on low-carb diets than high carb, and just as many cases where people feel better after adding CHO back into their diet after a low-carb approach. Research is mixed on whether or not low-carb diets affect cognition in a negative way. (Brinkworth) So, it really all comes down to personal preference with no real solid evidence that either low or high CHO diets are better for the healthy person.
-Matt
References:
Phinney SD. Ketogenic Diets and Physical Performance. Nutr & Metab. 2004;1(2)
Brinkworth GD, Buckley JD, Noakes M, Clifton PM, Wilson CJ. Long-term Effects of a Very Low-Carbohydrate Diet
and a Low-Fat Diet on Mood and Cognitive Function. Arch Intern Med.2009;169(20):1873-80.
Filed under: Uncategorized, nutrition — Tags: Low-carb — Matt Schoeneberger M.S. @ 12:13 pm
Great News – Matt and I were interviewed by Jimmy Moore
Matt and I had the opportunity to be interviewed by Jimmy Moore, the low-carb blogging guru. The interview was for one of his Livin La Vida Low-Carb Shows (Podcast). Matt and I are glad we had the chance to discuss what our book is about and why we think our approach is very useful for people trying to lose weight and maintain a healthy weight. We think the interview went well. The only drawback is it will not air until the beginning of May.
Jimmy Moore’s blog has lots of useful information. Click here to go to it.
Filed under: Uncategorized — Jeff Thiboutot M.S. @ 11:47 am
We’ll be covering intermittent fastin (IF) and caloric restriction (CR). We’ll talk about whether these strategies are good for weight loss and long-term health.
Club membership is only $29.97/month and you get a free book when you sign-up. Learn more about the club here
Filed under: Uncategorized — Matt Schoeneberger M.S. @ 1:11 pm
Food, Inc. A documentary on food production – A must see
I rented Food Inc. this weekend. It’s a recent (2008) documentary on how most of the food in the U.S. is produced. I was aware of most of the information covered, but still found it educational. It definitely got me thinking again about the many problems with how food is typically produced and that it is clearly not the best method available. I would recommend everyone watch this video. I rented it @ Blockbuster. Let me know what you think of it after you watch it.
Filed under: Environmetn, Uncategorized, health — Tags: environment, health — Jeff Thiboutot M.S. @ 4:12 pm
Vegan athlete Brendan Brazier and his book
Brendan Brazier: Vegan Athlete
I (Jeff) just got back from a talk by Brendan Brazier at a local Whole Foods store. He is the author of Thrive: The Vegan Nutrition Guide to Optimal Performance in Sports and Life and formulator of Vega nutritional products.
I went to this because I like to hear what some other authors are saying. Plus, I was curious on how he was spinning the vegan athlete thing. For those who are not sure what vegan is, it is a completely animal product free diet. No dairy, eggs, chicken, fish etc. Interestingly, about 11 years ago, I actually followed a vegan diet for a couple of years.
I looked over his book and listened to him speak for about 60 minutes. Regrettably, it was what I expected, mostly the same old stuff that most vegans and raw food advocates spew. Basically, get yourself alkaline, plant foods are the best, you will have more energy if you eat raw foods, animal products are not very good for us, and cooked/processed foods are stressful for the body because they have no enzymes. He also emphasized the importance of keeping cortisol levels down because this hormone will basically make you fat, sick, and tired.
There are so many things that I could say but don’t have the time to cover now. I will try to give you a couple of take home messages. First, I do agree that chronically elevated cortisol levels are not a good thing. But, a vegan and/or raw diet does not automatically bring this down. His book had no in-text citations, but there is a reference section in the back. Therefore, we don’t know if there is any good evidence (I did it and I feel great, lost weight, etc. is not good evidence) that a vegan diet does what he says. It is not likely that it would bring down cortisol any better than an omnivore diet (animal products and plant products). It seems that there is an important ratio of testosterone to cortisol. The increase in one tends to decrease the other (Volek et al) (this is an in-text citation). The Volek et al (1997) paper states “Vegetarians also consume less fat, SFA, and a higher PUFA/SFA ratio compared with omnivores, and vegetarians exhibit lower concentrations of T compared with omnivores” (p.51). This would typically mean that cortisol levels would be higher in the vegetarian.
Second, typically these types of books, vegan/vegetarian/raw, are based on strong philosophical and environmental views. This means that eating certain foods or food manufacturing processes are bad for animals and/or for the planet. There is a good amount of factual information that backs up some of these views. However, there is typically a lot of faulty logic and poor or no evidence to support their views on what certain foods do to people’s health or athletic ability.
There is a lot more to this issue but for now just realize that most of what he talks about is not supported with good evidence and is not likely useful.
Reference
Volek, J. et al (1997). Testosterone and cortisol in relationship to dietary nutrients and resistance exercise. J. Appl. Physiol. 82(1): 49–54
Filed under: Uncategorized — Jeff Thiboutot M.S. @ 3:47 pm
