Tuesday, February 28, 2012

Optimized Fat Metabolism (OFM) Part 5: Ketone Bodies

Ketone Bodies: Low-Grade Gasoline or Super-Fuel?
A great deal of controversy and mis-conceptions surround ketone, ketone bodies and ketosis . . . this post attempts to clarify these mis-conceptions.
Here is a recent “Women’s Health” article which calls ketones “low-grade gasoline” (link)
Here is what is posted on the American Diabetes Website (link):
Jane Brody has said ketones are toxic. 
Stuart Berger bashed them in How To Be Your Own Nutritionist.
Ann Louise Gittleman writes in Your Body Knows Best: “Without some carbohydrates to maintain blood sugar levels and fuel the system, ketone bodies - fatty substances generated from the breakdown of stored fats or triglycerides - are soon formed in the blood.   Ketone bodies mask your appetite even though your brain demands glucose.  The result is ketosis: headaches, light-headedness, and mental fatigue.  Eventually, [on a low fat diet] your body will begin to convert protein from your muscles into blood sugar.  You lose weight, but it is from muscle mass, not from fat.” (Pocket Books, 1997)
(This is what the public is reading)
Compare this with what recent studies and reviews by researchers are suggesting (link):
In the above review George Cahill, Jr. writes: “Recent studies have shown that D-f3-hydroxybutyrate, the principal "ketone", is not just a fuel, but a "superfuel" more efficiently producing ATP energy than glucose or fatty acid.” (link & link)

The title, “Ketonuria after Fasting may be Related to the Metabolic Superioritypretty much sums up the take home message of this study (link) (note Prof. Clarke states ketones yield 28% more energy upon combustion than glucose).
Don’t know about you, but I’ll place my bet (i.e. my health & athletic prowess) on what the research shows.
Ketones, and Ketosis are still largely associated with starvation and any diet which induces ketosis is regarded as fringe, fad, extreme and even dangerous due to mistaking ketosis for keto-acidosis. However, the VESPA/OFM athlete is not in a starvation state, hardly so….what many “experts” fail to recognize is ketosis is easily induced by a diet low or practically devoid of the macronutrient carbohydrate.
Many indigenous “primitive” cultures and the vast majority of pre-agricultural humans existed in a state of ketosis (most of the time) yet were hardly in a state of starvation nor did they lack athletic prowess (link & link).
Additionally, it was a diet high in fat, moderate in protein and low in carbohydrates which led to human development of large brains (link).
So a logical conclusion would be that KETOSIS IS A NATURAL METABOLIC STATE not a state of starvation etc.
In conjunction with inter-muscular oxidation of fatty acids, ketosis not only produces more sustainable energy substrates, but cleaner burning ones as well. Not only is the energy more sustainable but oxidative stress is dramatically reduced, thus reducing muscle breakdown and catabolism for improved recovery from repeated bouts of strenuous exercise. Ketosis stabilizes blood sugar (glucose) levels and spares glycogen to yield sustainable high intensity exercise levels. This allows the brain and nervous system to function optimally resulting in greater mental clarity/focus and optimal motor skills/coordination.
What about Glucose?
In a well fed state of ketosis glucose is NOT created via gluconeogenesis using amino acids from the breakdown of muscle protein but from fatty acids. This is often cited in textbooks as not possible but here is a great explanation of the pathway in which glucose is supplied during a well fed state of ketosis (link).
VESPA helps drive Ketosis:
In a Japanese study using VAAM, a supplement composed of an industrially synthesized amino acid profile found in the naturally-occurring VESPA peptide, serum non-essential fatty acid levels (fatty acids which are used for energy) increased over 2 times their resting levels, ketone body production increased 60.3% and serum lactate levels were significantly reduced. In this study when mice were administered this supplement they demonstrated significantly greater time to exhaustion than the control or mice using glucose or casein supplementation (link).
In a separate study where the Wasp Extract found in VESPA was also compared along with VAAM and other formulations two adjoining sentences were written mentioning the wasp extract saying: “The effects of hornet larval saliva were stronger than those of VAAM. VAAM therefore showed the major effect of the -saliva.” Figure 7 of the same study also referenced the wasp extract being superior to VAAM in maintaining glucose levels (link).
Note: Both of the above studies were funded by Meiji Dairies, a Japanese Pharmaceutical Company and the manufacturer of VAAM so it is understandable why there is scant reference to the naturally occurring peptide found in VESPA which demonstrated superior results.

Friday, February 24, 2012

Optimized Fat Metabolism (OFM) Part 4: Glucose Dependency

Signs your body is dependent on Glucose
The last post on Glucose Partitioning laid out the basic physiology of how the body deals with the literal “flood” of sugar into the bloodstream. Today’s short post helps you to identify if that flood is compromising your performance as an athlete as well as your overall health.

There are several easy ways to tell if you are dependent upon glucose for the majority of your energy needs. Here are some possible telltale signs

1.       You are “hungry” every couple of hours and need to eat something
2.       You need to eat and/or have coffee first thing in the morning
3.       You have to eat before exercise
4.       You are really hungry after exercise
5.       For prolonged physical activity you have to eat or else you will “bonk” (i.e. Hit the wall)
6.       In the days following and endurance event you are constantly hungry
7.       Your body won’t release any excess body fat
8.       Erratic HR patterns
9.       Asthma, breathing problems or easily triggered allergic reactions
10.   Itchy, red skin or eczema

While there are other factors which can be the cause of the above symptoms if you are showing most or all of the above signs you are probably dependent upon glucose (blood sugar), glycogen and exogenous intake of carbs to supply most of your energy needs. Monitoring Blood glucose and/or having a glucose tolerance test (not fasting glucose) will confirm this because, ironically, having chronically elevated glucose, thus insulin resistance, makes the body dependent upon glucose.

Factors Which Drive Glucose Dependency
1.       A diet high in carbohydrates and low in fat; i.e. A “Healthy” Diet
2.       A diet high in processed foods, especially those with lots of carb calories, preservatives and/or commercial vegetable oils (i.e. corn oil, canola oil, soybean oil, cottonseed oil) which use high temps and pressures to produce.
3.       Overtraining (cortisol)
4.       No warm-up and always training at a high intensity.
5.       Lack of sufficient sleep and downtime
6.       Overuse of stimulants like caffeine
7.       Disruptions in Circadian rhythm (elevated cortisol)
8.       Stress (elevated cortisol)
9.       Frequent doses of antibiotics
10.   Thyroid issues

If any of the above corresponds to your situation you may want to seriously consider changing the way you eat, train and live so your body burns primarily “fat as your fuel”.  OFM/VESPA offers the athlete an individualized, science-based approach.

Friday, February 17, 2012

FREE Triathlon Clinics - NUTRITION February 23

I am proud to announce that I have teamed up with George’s Cycles again to present our 5th season of the Tri Nite Series. Once again we are pleased to offer this series of FREE informational and interactive clinics to help you get ready for the upcoming race season. We will kick off this year’s clinics this coming Thursday February 23 with NUTRITION. We will be at George’s Cycles Fairview store [10178 Fairview Ave.] starting promptly at 6:15pm and plan to go until ~7:30pm. My friend, Linda Kees from Expert Nutrition Consulting, and I will be discussion what to eat prior to, during and after a race or training. Which products are fads and which ones really work. This is a good clinic for beginners and experienced athletes…runners, cyclists and triathletes. Everyone can benefit from the material we will cover.

Linda has over 20 years experience as a Registered Dietitian (R.D.) and is also a Licensed Dietitian (L.D.). With a B.S. in Nutrition and Foods from the University of Idaho and a graduate of American Dietetic Association Accredited Consortium Coordinated Undergraduate Program in Dietetics. She has also completed and passed the National American Dietetic Association Registration exam. She has vast knowledge of numerous disease states in relation to nutrition therapy and experience in working with endurance athletes and nutrition challenges they encounter during training and events. She understands how the timing of hydration and energy is crucial to your best performance during an endurance event. She has published articles in “Light and Tasty” magazine and “U.S.M.S. Swimmer” magazine along with recipes published in “Light and Tasty” magazine and “Today’s Dietitian Recipe Collection”. She is also the co-author of American Dietetic Association Research Abstract titled “Knowledge Retention and Diabetes Education”, which was presented at a National American Dietetic Association meeting and currently, the Boise Nutrition Examiner writer for http://www.examiner.com/.
Don’t think you are going to walk away with only a wealth of nutritional information. Hammer Nutrition & Power Bar have stepped up to provide some swag in the form of product samples.

This has historically been the highest attended clinic of our series so be sure to get there early…and you may want to bring a pen and paper to take some notes.

The next clinic of the series continues two weeks later on Thursday March 8 for RECOVERY where we will be talking about sequential pneumatic compression pumps, compression gear including socks, recovery tights, calf sleeves and compression shorts as wells as Trigger Point Therapy, dynamic stretching, active recovery We’ll explore how each of these are important to maintaining peak performance. CEP will be onsite for custom Clone measurements before and after the clinic and you can compete for a chance to win a free pair of CEP Compression Socks…green of course!
Two weeks later, on Thursday March 22, we continue with the third portion of the series…TIPS, TRICKS and XTERRA. This year I’ve asked local Off-Road Professional Triathlete,Adam Wirth, to join me in sharing our “tribal knowledge” in the sport of Triathlon. We’ve been through the “school of hard knocks” so this is an opportunity to learn from our mistakes and our successes. The Off-Road, or often referred to as XTERRA, racing is a segment that we have not covered during clinics in previous years. I’m hoping Adam’s expertise will help enlighten those of us who enjoy racing off the beaten path.

True to tradition, we conclude the series on Thursday April 5 for TRANSITIONS. This is the only clinic that will not be held at George’s Cycles but instead at Guerber Park off Hill Road and highway 55 in Eagle. This is intended as an interactive clinic for you to practice setting up and going through T1 & T2. Some people are more comfortable watching which is fine too. Too often athletes make the mistake of not practicing their transitions before race day and then fumble through the process. As we get closer, I’ll provide another post with a list of gear you’ll want to bring.

Thursday, February 9, 2012

Optimized Fat Metabolism (OFM) Part 3: Crisis Management 101

This is post #3 of the OFM series. If you have not done so already, I recommend reading Optimized Fat Metabolism (OFM) - Introduction and Optimized Fat Metabolism (OFM): Variability before reading this post. - Trish

From Peter:
Glucose Partitioning & The High Carbohydrate Diet
To gain insight into how OFM works and why our bodies actually prefer to metabolize fat for energy it is first necessary to have a basic understanding of what really happens to all those carbs you are consuming.  
While based upon basic physiology this post is a greatly simplified explanation for a number of complex and interconnected pathways.  As a starting point here are a few salient physiological facts to consider:
FACT #1: To begin it is vitally important to understand most of the carbohydrates a person consumes end up as the blood sugar, glucose. Thus, CARBS = SUGAR as far as the body is concerned. Most people know “SUGAR” is “BAD” but somehow there is a disconnect with carbs and that somehow carbs, especially “complex” or “Whole Grain” carbs or even a lot of carb calories derived from fresh fruit are “healthy” and should be consumed in copious quantities on a daily basis, often several times a day.  Once again; CARBS=SUGAR!
FACT #2: Human blood glucose levels are VERY tightly controlled! In the normal non-diabetic human body normal fasting blood sugar constitutes approximately 20 calories of free glucose in circulation, about 2 teaspoons of sugar (Jeff S. Volek, 2011) (link)
(For the sake of clarification, sugar, sucrose, is half glucose and half fructose so two teaspoons of sucrose is the same as a teaspoon of glucose)  The medical measurement used commonly for diabetics and pre-diabetics is mg/dl with 76-86 considered optimal, up to a 100 normal, above 125mg/dl as diabetic which represents a VERY narrow range!
FACT #3: Insulin is a hormone whose primary metabolic role is maintaining stable blood glucose level. It performs this regulation of glucose in a number of ways depending upon the circumstances and variables and is “just doing its job” under the circumstances.
FACT #4: Fructose, which is metabolized in the liver, while not insulin stimulating, does stimulate glucokinase synthesis. This further drives glucose metabolism since glucokinase (and also hexokinase), combined with glucose and ATP, begin phosphorylation. So a small amount of fructose accelerates complex carbohydrate metabolism and conversion of glycogen to glucose.
FACT #5: Variability.  The short post on Variability was and is important to keep in mind throughout this and future posts. It is clear there is a very wide range of individual tolerance to carbohydrates and this tolerance is due to how each individual’s body processes this macronutrient group. Keep this in mind as you read this and begin to see signs for where you may lie on the spectrum of variability to carb tolerance. These insights into your personal metabolic profile are key to tailoring your OFM program.
The reason for the title, Crisis Management 101, is because physiologically, this is what your body is doing when you ingest significant amounts of carbohydrates. Everything else stops to get glucose levels down . . . NOW!  Literally, your blood sugar levels are being flooded with glucose and unless you go out for, say, a brisk run or Crossfit workout right after your meal there is no fast way of bringing those levels down to normal.  Ask any T1 diabetic what happens if they eat a lot of carbs and not inject insulin……glucose becomes toxic. This being said, the body has a number of pathways it employs to maintain stable blood sugar.  Unlike vigorous exercise, each pathway cannot, by itself, metabolize a large amount of blood glucose (such as occurs when a high carbohydrate meal is consumed) to rapidly normalize blood sugar.  However, collectively, they can and do normalize blood sugar until something like insulin resistance occurs. We will examine some of the principle ones here.

Pathway #1: One of the biggest advantages endurance athletes have over relatively sedentary folks is conversion of glucose to its storable form, glycogen.   This is well studied and generally accepted. Due to this adaptation, glucose conversion to glycogen is one of the first pathways in which elevated levels of free glucose are taken out of circulation. It is because athletes, particularly endurance athletes are so well adapted that, compared to sedentary people, they can often, on the surface, remain lean and fit, and, as a group, demonstrate markedly better carbohydrate tolerance. Exercise is vital but we already know this.
Pathway #2:  Use of exogenous glucose sources for brain & nervous system energy requirements. When your glucose levels are elevated the brain burns glucose almost exclusively as another pathway to help get blood sugar down. Now this is a “like duh….” statement except when we consider the alternative ways our body produces energy for the brain & nervous system . . .
We have all heard “your brain needs glucose and cannot burn fat so you need carbs”.  This is a partial truth….. Yes, your brain and nervous system do not utilize fat as fuel and some glucose is necessary, however, the brain & nervous system run quite well on a mix of glucose and ketone bodies (which are synthesized from fats). Emerging research (link) suggests a mix of glucose and ketone bodies often approaching and even exceeding 50% as ketones may be superior to a fuel substrate made up of mostly or entirely glucose.
Contrary to the popular belief that dietary constant intake of carbs are necessary for  healthy brain and nervous system function, our body, via the liver,  makes both glucose (gluconeogenesis) and ketone bodies (ketosis) in ample amounts (under the right conditions) to fuel most of the athlete’s brain & nervous system needs under all but racing or long brick training conditions. These pathways, though more complex actually serve to stabilize blood sugar preventing the ups & downs in energy levels, mental focus and clarity, motor skills degradation, and fatigue.
The problem is this production of glucose and ketones is basically shut off when glucose levels are constantly elevated. The moderator is insulin and as long as insulin levels remain high the body, in an effort to reduce glucose levels, keeps the liver from producing ketone bodies. Interestingly enough though, gluconeogenesis may continue due to readily available glycogen stores in the liver and prompting from Fructose production of hepatic glucokinase…..this is a double edged sword….it can potentially have benefits during exercise, however, research also suggests as individuals develop insulin resistance, this fructose driven manifestation of gluconeogenesis maintains high glucose levels even during fasting, thus maintaining higher insulin levels.
Pathway #3:  “De novo Lipogenesis” . . .  While we are talking about the liver let’s segway into Pathways #3, de novo lipogenesis.  So, you have your conventional athletic high carb meal where say, 400-600 calories are derived from carbohydrate sources with more than half of those made up of starches (because the volume of veggies/salad etc. it would take to consume that many digestible calories is not practical),…
Via pathway #1, your liver is taking the easy route of converting glucose to glycogen as fast as it can (rate limited and possibly now the glycogen stores are topped off)
Via pathway #2, your brain & nervous system are running on glucose exclusively
Via pathway #3: De novo lipogenesis, latin for making “a fresh batch of fats”…and, (drum roll please!) guess what kind of fats are made from all those carbs when this occurs?...those Pattern B LDL’s (or VLDL’s) and Triglycerides which, when both are found in high levels, are generally accepted in the medical community as atherogenic (i.e. causing heart disease)…
This is where things start to get ugly, literally and metabolically.  This is because some of those carbs that are converted to fats wind up being deposited in first the liver, then in organs and tissue around the waistline creating “bellyfat” (or, as Dr. William Davis terms it “Wheatbelly” due to the particularly insidious glucose spike caused by wheat consumption) while the rest of those VLD’s and Triglycerides are spit out and circulating in the bloodstream and wind up on your blood panel! (more on this later). 
In short, de novo lipogenesis works. It gets blood sugar down by taking the glucose from the carbs we consume and converts them to fats. This is not bad because as stated, Glucose levels need to be normalized NOW! when elevated to the levels a high carb meal provokes.  However, long term, there are “unintended consequences” which are undesirable and avoidable. Unfortunately, most people (including athletes) do not understand when they reach for the carb laden, fat free foods found in the store that it is this process of de novo lipogenesis that is adding those extra pounds and inches to their waistline.
Pathway #4: Glycation. This is basically the haphazard attachment of excess free glucose to lipoproteins in the blood to lower elevated blood sugar.  This attachment is not a benign process since attachment of glucose to a lipoprotein makes it less stable and more susceptible to oxidation and even mutation.  So, if de novo lipogenesis did not scare you into re-considering the merits of the high carb diet then glycation will.  A simple Google search on Glycation and AGE’s (Advanced Glycated End Products) will explain more than you probably want to know. While little is known about the exact process (it is currently a hot area of investigation though) glycation is being implicated more and more as a major factor in several chronic illnesses like heart disease, cancer, and premature aging.  However, when blood sugar spikes with glucose reaching toxic levels and all the other pathways are at their rate limit glycation is an important contributor in managing the immediate crisis of bringing down blood sugar.
Pathway #5: At the same time the above glucose metabolic pathways are in full swing your body is also doing several things to inhibit fat metabolism . . . doing so clears the way for glucose to “cut to the front of the metabolic line” (this termed by Drs. Phinney & Volek). However, doing so makes our body much more dependent upon glucose as an energy source which is unsustainable.
With insulin as the mediator, metabolism of fatty acids in the muscles  is sharply inhibited in, the liver shuts down ketosis making the brain & nervous system entirely dependent upon exogenous intake of carbs and sporadic fructose induced gluconeogenesis, the liver is now making more triglycerides and LDL particles from carbs to add to the log-jam of fats that cannot be processed because the glucose “cut to the front of the line” ….worse yet, if a person is not carbohydrate tolerant and/or once a person’s other hormones begin to wane and they begin to lose insulin sensitivity the elevated levels of insulin continue to prevent fat metabolism even after blood glucose levels have fallen which means the body continues to be dependent upon glucose for fuel leading to hypoglycemia (i.e. low blod sugar, “Bonking” or “hitting the wall”). 
Pathway #6: At the same time insulin is busy at the fat cells facilitating storage of fats (triglycerides) while, at the same time sharply inhibiting the release of fat into the blood stream, again, forcing the body to be even more dependent upon insulin.  
Now all of these pathways are not “bad” in and of themselves. They are part of the body’s systems for maintaining homeostasis. In fact, they are well adapted mechanisms which, when understood in the context of the larger picture, can help an athlete utilize them to improve performance, recovery and health.
As an example, geese eat a quantity of carbohydrate laden foods in the late summer and early fall which causes deposition of fat including a large deposition of liver fat and glycogen, however, when they begin their migration this carb rich diet pretty much ceases as they spend most of their day flying in migration. Not only do these geese utilize fat as fuel for muscle metabolism but their liver fat stores become a readily available and concentrated substrate for conversion to ketone bodies and glucose.  Ironically, domestic geese producers have utilized the principles of Pathway #3:, De novo lipogenesis, as a way to make what is considered the best goose liver pates!
Again, let me remind you this is a simplified version of a series of very complex and interrelated metabolic processes.
Crisis Management 101: Take care of the immediate problem because it is so threatening yet ignore the consequences of the actions one has to take.
There has to be a better way . . . and there is: OFM Optimizing Fat Metabolism.