Category Archives: Fitness - Page 2

Mobility and Health: Some Thoughts

Posted by on July 27, 2011 35 comments

I’d like to thank Todd Hargrove for his guest post (How to Do Joint Mobility Drills, July 26, 2011). It was thought-provoking, and I thought I’d share my reflections on it.

What Is the Goal of Exercise?

When it comes to fitness, the blogosphere tends to emphasize strength and athleticism. This is great, but there are other dimensions to health and fitness that are maybe a bit under-discussed.

As a 48-year-old recovering chronic disease patient, I am not looking to become a competitive athlete, enjoyable though that might be. Rather, I want to maximize health and longevity, and be able to freely and pleasurably move through all the challenges and opportunities life may present. I’ll be happy if I can:

  1. Be strong enough to freely manipulate my body plus a heavy load.
  2. Be fit enough to run 3-4 miles with pleasure, play an hour of tennis without getting sore, and sprint faster than common criminals.
  3. Be mobile enough to move freely and gracefully through the full natural range of motion of all joints without crackling, stiffness, or soreness.
  4. Develop good posture, circulation, and neurological function, so that my body naturally arranges itself in healthy positions.

The first three goals are not too different from Jamie Scott’s prescription for surviving a natural disaster. He asks: Could you lift yourself over a wall or up to a balcony to escape a tsunami? Sprint-jog 3-4 miles over shattered ground and obstacles to escape the liquefaction zone of an earthquake? Walk 3-4 hours over hills daily when roads are impassable? Get into a low squat to fit in a small shelter, or squeeze through a small opening?

But I have a special interest in neurological health. I had chronic ear infections as an infant, culminating in surgery, and ever since have had poor balance. My central nervous system infection made it much worse. Three years ago I had to sit down to put pants on or take them off; walked into doors; and fumbled and dropped things, as the complete loss of our former collection of wine glasses can attest. With diet and antibiotics I’ve recovered; my balance is now similar to what it was in my 20s – which is to say, poor.  I can now stand on one foot for about 20 seconds before I have to put down the other foot to balance myself; that would have been 1 or 2 seconds three years ago, but Shou-Ching can do it indefinitely. When we go hiking in the mountains, Shou-Ching clambers up or down steep rocky slopes like a mountain goat; I have to move with care.

Falls are a major cause of health impairment, broken bones, and mortality in the elderly. It would be great if I can improve nervous system function and balance before I get old and falls become dangerous.

I’m very pleased to start this blog’s discussion of fitness with Todd’s post, because mobility and neurological function are critically important to fitness at all ages – and may be crucial to good health as we age.

The Concept of Body Maps

Let me paraphrase one of the key points of Todd’s post this way:

The brain maintains “maps” of the body … These maps may become inaccurate, out of synch with the physical body … As a result the brain may believe a movement is impossible or dangerous and block its performance, even if the body is fully capable of performing the movement … With training the brain can learn the true movement capabilities of the body and revise its maps to more accurately reflect reality, thus increasing the body’s ability to move freely.

The idea that brain “maps” of the physical body, rather than the actual body, are what sets the limits to motion reminded me of a TED video I had seen by Dr. Vilayanur Ramachandran. He is a neuroscientist who investigated the problem of “phantom pain” in the lost limbs of amputation victims, and showed that the pain could be cured by “mirror box” therapies that fooled the brain into manipulating the lost arm and thereby re-drawing the brain’s body maps. Here is his fascinating TED talk:

Todd explains how improper brain maps can lead to chronic pain, and how repairing the brain maps can end the pain. This is an important idea for those suffering from chronic pain.

Use It Or Lose It

Todd observes that

While movement will clarify maps, lack of movement will tend to blur them. In a famous experiment, researchers found that sewing a monkey’s fingers together for a few weeks caused its brain to map the fingers as one unit, not as two separate parts capable of individual movements.

So if I want my brain to remember what my body is capable of, I need to regularly take my body through a diversity of movements.

This is an important reminder for someone who spends 12 hours per day at a desk. Get away from the desk, even if only for a few minutes a day, and move!

The Strategy of Slow, Mindful Movement

When I was young I wanted to do everything fast. (Shou-Ching complains that when I’m behind the wheel of a car, I think I’m still young.) But now I’m starting to appreciate the benefits of slow motion.

Todd’s list of ways to “maximize the benefit of mobility exercise” emphasizes slow, mindful movements. A few thoughts on each:

“Avoid pain and threat.” Since the purpose of the brain’s body maps is to prevent dangerous movements from happening, to re-draw the maps we have to teach the brain that “dangerous” movements are actually safe. For this to be persuasive, they must actually be safe. But this corollary may be less obvious:

Make sure the movement does not … create other signs of threat such as holding the breath, grimacing, collapsing your posture, or using unnecessary tension.

I’m a fan of the mobility videos of Kelly Starrett at mobilitywod.com, and he frequently advises one never to make a “pain face” or grimace, but rather to maintain a cheerful “Zen face.” A grimace during a challenging stretch or movement may be enjoyable, but it might detract from the value of the exercise. Interesting!

“Be mindful and attentive.” This one comes easily to me: I am introspective and enjoy listening to my body and paying attention to muscles, breath, and blood flow during exercise. It’s good to know that’s beneficial.

“Use novel movements.” I like routine, but routine mobility drills are unproductive. Movements need to explore new capabilities.

“Easy does it.” Move slowly and gently. This calls to mind the classic Chinese exercise forms, like Qi Gong and Tai Chi; they are characterized by slow, flowing, graceful movements.

“Be curious, exploratory, and playful.” I like the evolutionary inference Todd makes here:

All animals engage in the most play during the times of their lives when the educational demands are the highest. This means that play is the best solution to difficult education problems that evolution has found.

I think we sometimes fall into the trap of thinking that adulthood implies seriousness and sobriety. No! Rather, good health implies lifelong playfulness.

In Boswell’s Life of Johnson, in the Dedication, Boswell writes:

It is related of the great Dr. Clarke, that when in one of his leisure hours he was unbending himself with a few friends in the most playful and frolicksome manner, he observed Beau Nash approaching; upon which he suddenly stopped. “My boys,” said he, “let us be grave – here comes a fool.”

Let us not be fools, and play!

Can Rhythmic Movement Be an Ultradian Therapy?

I’ve done several posts on the subject of circadian (day-night) rhythms, and how enhancing these rhythms with diet, light, sleep, and exercise may be therapeutic for many diseases. See, for instance, Intermittent Fasting as a Therapy for Hypothyroidism (Dec 1, 2010) and Seth Roberts and Circadian Therapy (Mar 22, 2011).

But humans have other natural biorhythms that cycle more frequently. These “ultradian rhythms” can be quite short. For instance, some hormones are released in pulses – I believe insulin and thyroid hormone may operate this way – and I believe a common interval between pulses is 6 seconds.

Many classic movement forms, like yoga or qi gong, emphasize that movement should be synchronized with breathing, and that breathing should be slow and rhythmic – often with about ten breaths per minute, or six seconds per breath.

The coincidence between these numbers intrigues me. If enhancing circadian rhythms is therapeutic for disease, might enhancing ultradian rhythms by mindful “synching” of the breath to their period be therapeutic for hormonal dysfunction?

It’s just a thought. Many people with glucose regulation issues have disrupted ultradian rhythms for insulin secretion. The ultradian clocks in their pancreatic beta cells aren’t working properly. Wouldn’t it be interesting if mindful breathing, as in yoga, could improve insulin secretion and glucose regulation?

This is not such a far out idea. Consider these quotations from recently published papers:

Mind-body modalities based on Eastern philosophy, such as yoga, tai chi, qigong, and meditation … have many reported benefits for improving symptoms and physiological measures associated with the metabolic syndrome…. Findings from the studies reviewed support the potential clinical effectiveness of mind-body practices in improving indices of the metabolic syndrome. [1]

Participation of subjects with T2DM in yoga practice for 40 days resulted in reduced BMI, improved well-being, and reduced anxiety. [2]

Yoga-nidra practiced for 30 minutes daily up to 90 days, parameters were recorded every. 30th day. Results of this study showed that most of the symptoms were subsided (P < 0.004, significant), and fall of mean blood glucose level was significant after 3-month of Yoga-nidra. This fall was 21.3 mg/dl, P < 0.0007, (from 159 +/- 12.27 to 137.7 +/- 23.15,) in fasting and 17.95 mg/dl, P = 0.02, (from 255.45 +/- 16.85 to 237.5 +/- 30.54) in post prandial glucose level. Results of this study suggest that subjects on Yoga-nidra with drug regimen had better control in their fluctuating blood glucose and symptoms associated with diabetes, compared to those were on oral hypoglycaemics alone. [3]

[F]asting plasma insulin was significantly lower in the yoga group. The yoga group was also more insulin sensitive (yoga 7.82 [2.29] v. control 4.86 [11.97] (mg/[kg.min])/(microU/ml), p < 0.001). [4]

There are fifty-six papers in Pubmed on “yoga diabetes”, and only four of them date before 2002. Most were published after 2008. This is an emerging area of research, but it would be interesting if slow, mindful movement proves to be an effective therapy for metabolic disorders. Maybe exercise doesn’t need to be vigorous to heal disorders like diabetes and obesity!

The Best Exercises for Mobility

I asked Todd what traditional movement forms he would most recommend. He replied:

In my blog I made some lists of exercises styles, traditional and modern, which are in line with what I recommend: the Feldenkrais Method, Z-Health, Alexander Technique, and tai chi are at the top of the list.

My favorite is the Feldenkrais method, but I think for purposes of your blog, some tai chi videos would be perfect, because they really provide a picture of what I’m talking about. You can’t do tai chi without observing all of the guidelines I provide at the end. And it looks cool.

You might include a point that the magic of tai chi is not so much in the specific forms they use, but in the WAY they move – smooth and slow. And the mind state while moving – mindful, relaxed, attention to small details and subtleties. You could apply this tai chi style to anything and get benefit – sitting, standing, walking, lifting weights or doing joint mobility drills.

All of these movement disciplines are extremely interesting, and I hope to get help exploring them in future blog posts. I know that a number of Z-Health Master Trainers have read our book, and hopefully one of them will teach us about Z-Health.

In closing, here are some videos of Qi Gong and Tai Chi movements. With videos available on DVD or on YouTube, there’s no need to join a class to learn mobility drills. You can play a video in your TV and practice slow, mindful, relaxed movements at home.

Perhaps the most valuable movements, in my view, are those used as “warm-up” exercises in Tai Chi or beginning movements in Qi Gong. Here is a well-made introductory video:

Here is a beautiful exhibition of Tai Chi:

Thanks, Todd. I very much appreciate the opportunity to learn about fitness from an expert!

References

[1] Anderson JG, Taylor AG. The metabolic syndrome and mind-body therapies: a systematic review. J Nutr Metab. 2011;2011:276419. http://pmid.us/21773016.

[2] Kosuri M, Sridhar GR. Yoga practice in diabetes improves physical and psychological outcomes. Metab Syndr Relat Disord. 2009 Dec;7(6):515-7. http://pmid.us/19900155.

[3] Amita S et al. Effect of yoga-nidra on blood glucose level in diabetic patients. Indian J Physiol Pharmacol. 2009 Jan-Mar;53(1):97-101. http://pmid.us/19810584.

[4] Chaya MS et al. Insulin sensitivity and cardiac autonomic function in young male practitioners of yoga. Natl Med J India. 2008 Sep-Oct;21(5):217-21. http://pmid.us/19320319.

How to Do Joint Mobility Drills

Posted by on July 26, 2011 22 comments

Todd Hargrove is probably familiar to many readers as a highly intelligent and good-humored commenter on Paleo blogs. He has a fantastic blog, Better Movement, which Mark Sisson calls one of the “18 Underrated Blogs You Should Be Reading”. Todd began his career as an attorney, but dealing with a chronic pain issue led him to become a therapist with “an obsessive interest in learning about how the body works and a strong empathy for others going through chronic pain”. He is now a rolfer and teacher of The Feldenkrais Method in Seattle.

I’ve noticed that the most sophisticated health and fitness practitioners place a heavy emphasis on brain and nerve function. Todd is one of these; as you’ll see, he offers a brain centered perspective on physical performance, pain and exercise.

Mobility is an extremely important part of good health, whatever one’s age or degree of athleticism. I’m therefore delighted to present this guest post by Todd on “How to Do Joint Mobility Drills.”

Mobility work is about the brain

Dynamic joint mobility drills are becoming very popular, and are starting to replace static stretching as a way to warm up, train healthy movement patterns, and (p)rehab injuries. Mobility work can be defined as deliberate movement through a defined pathway, done repetitively, usually without resistance. Examples include wall slides or arm swings for the shoulders, clam shells or leg circles for the hips, and cat/cows or rotations for the spine.

Joint mobility drills have several advantages over static stretching. First, they involve movement, which is good, because you probably want to get better at moving, not just staying still with your limbs splayed out. Second, most of the work in a static stretch is done at end ranges of motion that don’t get used very often. By contrast, joint mobility drills usually involve movements through the middle ranges of motion where most of life and sport occur. So they promise to have more applicability to real world tasks. Healthy athletic movement at most joints has far more to do with quality of motion than quantity of motion.

So the trend toward mobility drills is a very positive development. However, I believe that people often fail to obtain the full benefit of mobility exercises, mostly because they do not appreciate the neural mechanisms by which they work. The mainstream idea is that joint mobility drills work by making changes to the local muscular and connective tissues involved in the movement. In my opinion, mobility work has only a limited ability to cause significant adaptations in the mesoderm. Instead, it works by making changes to the virtual representations of those structures in the brain. In other words, mobility work is about function not structure, the brain not the body, the software not the hardware, the ectoderm not the mesoderm, the driver not the car.

OK, enough with the metaphorical distinctions. Here’s a detailed explanation what I mean.

Joint mobility drills are a weak stimulus to the mesoderm

There is little reason to believe that joint mobility drills have any notable effects on the local mesodermal tissues that are being mobilized.

Unlike weight training or endurance training, mobility work does not provide enough resistance or energetic demand to cause adaptations in the size or endurance of muscle cells. Unlike stretching, it does not involve enough time at the end ranges of motion to permanently add more muscle or connective tissue length. Unlike sports or other habitual physical activities, it does not create enough mechanical stress to the tendons and ligaments and joint capsules to cause any significant connective tissue remodeling (unless you did thousands of repetitions at a pretty good speed.) Joint mobility drills will provide circulation and warmth to the local tissues and synovial fluids, which is great and totally necessary for health. However, we would expect similar benefits from almost any repetitive motion in the same area.

So why would the specific form of a mobility exercise matter? Why not just move all your joints through all their ranges of motion in any old way? My answer is that mobility exercises work by communicating with the brain, and it will only communicate effectively when it sends the correct signals. Here is a discussion of some neural mechanisms by which mobility drills could improve coordination and reduce pain.

Joint mobility drills improve coordination by clarifying movement maps

Coordination happens in the brain not the body. Some key networks in the brain that sense and coordinate the muscles are called the body maps. The body maps are discrete parts of the brain that are organized in such a way as to represent the different body parts, just as lines on a map represent roads. Each part of the body has a separate area of the brain dedicated to moving and sensing that body part.[1]

Body parts that have greater sensory motor demands have bigger maps. Not surprisingly, the map for the hand is significantly larger than the map for the elbow. Thus, larger and more detailed maps means better coordination. The information necessary to maintain and build the maps is provided by proprioceptive signals from the body. Proprioception occurs when movement or touch stimulates nerve mechanoreceptors, which are located all over the body and primarily in joints.

You can sense the effects of mechanoreception on your maps instantly by doing a simple experiment. Try to imagine or sense the exact shape and position of your ears. Now rub just the left ear for a few seconds and then compare your ability to sense the left ear and the right. You will note that it is much easier to form a clear picture of the left ear. The simple reason is that touching the ear activated its mechanoreceptors, which sent a signal to the brain, which excited the neurons in the map for that area. Of course, the additional clarity in the map is only temporary, and after a minute your ears will feel the same.

In order to make long term changes in the maps, you need to place demands on them consistently over a long period of time. When a certain movement is used repeatedly in a coordinated and mindful fashion, there are actual physical and observable changes in the part of the brain that controls that movement. For example, the finger maps in a braille reader’s brain are observably larger than the counterpart of the average person.[2]

While movement will clarify maps, lack of movement will tend to blur them. In a famous experiment, researchers found that sewing a monkey’s fingers together for a few weeks caused its brain to map the fingers as one unit, not as two separate parts capable of individual movements.[3] We would expect similar map blurring to occur when any joint movement is neglected for a certain period of time. This loss of control over previously accessible movements is the neural version of the “use it or lose it” principle, and is sometimes called sensory motor amnesia.

A common area for sensory motor amnesia is the thoracic vertebrae. Most people probably have one or two vertebrae in their upper back that haven’t moved in a certain direction with respect to its neighbor in years. The movement isn’t physically impossible, it’s just not part of the brain’s current movement programs due to neglect. A good analogy might be a language that you could once speak fluently that you haven’t spoken for years. The knowledge is in there somewhere, but a good portion of it is not readily accessible without some brushing up.

The right mobility drill would be structured to require the brain to brush up on its thoracic movement skills and reactivate some rusty movement programs. If the brain remembers how to move a currently static vertebra, the result is an immediate qualitative change in the movement of the entire spine. The decisive change is not to the physical tissues of the vertebral joint, but to the way that the brain maps the vertebrae for sensation and movement.

Blurred maps can create pain

Accurate maps also have important consequences for how we feel. Phantom limb pain is a dramatic example. Many people with an amputated limb experience pain in the missing body part. This is because even though the arm is gone, the virtual arm in the brain lives on, and can be stimulated by cross talk from nearby neural activity. When this occurs, the brain creates a sensation of the missing arm that is incredibly realistic and often excruciatingly painful.

Some pain researchers believe that less severe instances of mapping errors may be involved in many chronic pain conditions. Numerous studies have shown that sensory motor illusions caused by mirrors or other tricks can cause pain. For example, if you immerse your index and ring fingers in warm water and the middle finger in cold water, this will often cause your middle finger to feel painfully hot. Other studies have shown that pain from these illusions can be alleviated with proprioceptive input that corrects distortions in the maps.[4] For example, an amazing treatment for phantom limb pain involves placing the remaining limb in a mirror box in such a way that it fools the brain into thinking the missing limb is alive and well! Based on these and other studies, many pain researchers believe that clarifying the maps is a promising treatment for many forms of chronic pain.[5]

Movement creates sensory gating

Mobility drills can also reduce pain by sensory gating. Sensory gating means that the processing and perception of sense information is reduced by the presence of competing sense information. If your nervous system is busy trying to process signals resulting from movement or touching, it has less ability process signals caused by tissue damage (nociception). Most people will instinctively take advantage of sensory gating by rubbing an area that has just been injured. The rubbing sends sensory signals to the brain which compete with the damage signals. If you feel temporarily better after a massage, exercise, or yoga, sensory gating is probably a major reason why.

How to maximize the benefit of mobility exercises

Based on the foregoing, there is good reason to believe that the brain should be the primary target for joint mobility work. With this in mind, here is a quick list of rules to keep in mind when doing mobility work.

1. Avoid pain and threat. If you create pain while doing joint mobility drills, the brain will attend to the pain and ignore the potentially interesting proprioceptive information.  Further, the brain is not interested in adopting a new movement pattern that is threatening. Make sure the movement does not cause too much discomfort or create other signs of threat such as holding the breath, grimacing, collapsing your posture, or using unnecessary tension.

2. Be mindful and attentive to what you are doing. Attention enables neuroplasticity, which is the goal. The brain receives massive amounts of sensory information each second and will ignore any inputs it deems irrelevant, uninteresting or redundant. If you pay careful attention to what you are doing during mobility drills, the brain will place a higher value on the resulting proprioceptive information and be far more likely to make changes to your movement maps.

3. Use novel movements. The brain is more likely to pay attention to a stimulus that is novel. Most joint mobility drills incorporate novelty already and that is why they work. However, endlessly repeating the same drill will have diminishing returns. So you might want to change things up from time to time to keep the brain interested.

4. Easy does it. The benefits of moving slowly and gently to improve coordination have been recognized by martial artists, elite athletes and musicians for a long time. The scientific explanation for why slow and easy works requires a post of its own, but here is a start. Slow and easy movement works because it: is inherently non threatening; is less likely to cause pain; allows you to find movement angles that would be missed at higher speeds; improves the proprioceptive signal to noise ratio; allows greater opportunity to focus on the subtle differences in joint movements; and, under the Weber Fechner rule, less force equals greater ability to discriminate in the amount of force used.[6]

5. Be curious, exploratory and playful. Motor learning is greatly facilitated by a curious playful attitude. All animals engage in the most play during the times of their lives when the educational demands are the highest. This means that play is the best solution to difficult education problems that evolution has found. With this in mind, use mobility work as a way to experiment with subtle variations of how to move and figure out which ones work best.

Conclusion

Next time you do some joint mobility drills, move slowly and carefully, completely avoiding any discomfort. Reduce speed and range of motion as necessary. Use the minimum amount of force and effort to get the job done. Pay careful attention to exactly what you are doing and play with subtle variations to assess which are most efficient and comfortable. Try a few repetitions at the slowest speed you can possibly move. Then see how you are moving. I think you will see some improvements. Good luck!

Endnotes

1. http://en.wikipedia.org/wiki/Cortical_homunculus

2. http://www.sciencedirect.com/science/article/pii/S1364661398011723

3. http://jn.physiology.org/content/66/3/1048.abstract

4. http://www.cell.com/current-biology/abstract/S0960-9822%2810%2901060-2

5. http://www.ncbi.nlm.nih.gov/pubmed/12909433.

6. http://en.wikipedia.org/wiki/Weber%E2%80%93Fechner_law

Seth Roberts and Circadian Therapy

Posted by on March 22, 2011 80 comments

A while back I noted that hypothyroidism is a circadian rhythm disorder and that dietary steps that restore circadian rhythms, like intermittent fasting and daytime eating, should be therapeutic (“Intermittent Fasting as a Therapy for Hypothyroidism,” Dec 1, 2010).

Many other disorders besides hypothyroidism feature disturbed circadian rhythms:

  • Sleeplessness and poor sleep
  • Depression, bipolar disorder, and other psychiatric disorders
  • Dyslipidemia, metabolic syndrome and obesity.
  • Neurodegenerative disorders

Circadian rhythm disruption also suppresses immune function and increases vulnerability to infectious disease.

Restoring or strengthening circadian rhythm may be therapeutic for all of these conditions. Even for healthy people, tactics for enhancing circadian rhythms may improve health.

Which brings us to Seth Roberts.

Seth Cured a Sleep Disorder With Circadian Therapy

Seth is a well-known blogger, a Paleo dieter and psychologist, author of  The Shangri-La Diet, and a great self-experimenter.

Seth recently gave a talk that tells the history of his self-experimentation.

It turns out he suffered from disturbed sleep for many years. He experimented to find cures for 10 years; nothing worked. But then he got a lead.

When a student suggested he eat more fruit, he started eating fruit for breakfast. His sleep got worse! This was exciting to Seth because it was, in 10 years, the first thing he tried that changed his sleep.

He had the idea of trying no breakfast. It turned out that skipping breakfast improved his sleep. One of his slides:

This directly supports our idea that intermittent fasting (confining eating to an 8-hour window each day) should be therapeutic for circadian rhythm disorders such as disturbed sleep and hypothyroidism.

But what’s exciting is that Seth continued his experiments to find other ways to improve his sleep. As a psychologist, he knew that human contact controls when we sleep: people are most awake at the times they have contact with other people, and asleep when isolated.

He knew that watching TV can have effects similar to socializing. So he tried watching Jay Leno one morning. He slept very well the next night.

It turns out that looking at human faces is almost as good as real socializing. Here is Seth’s data relating mood to whether he looked at faces:

Seth also tracked his mood over the course of the day. The response of mood to seeing pictures of human faces clearly followed a circadian (24-hour) rhythm:

Another thing that relates to circadian rhythms is exercise: we normally exercise during the day and rest at night.

For a scholar, the easiest way to exercise is to stand rather than sit (for instance, by working at a standing desk). Seth tried standing 9 hours a day – and it cleared his sleep problem!

Of course, standing is not a very strenuous exercise. Seth found that if he just stood on one leg, the effect was much more intense, and he could fix his sleep problem with only minutes of one-legged standing per day.

He also found that eating more animal food improved his sleep. It’s possible that animal fat may enhance circadian rhythms more than other foods.

Conclusion

I found this fascinating – because it adds more evidence regarding the centrality of circadian rhythms in health – and exciting, because it shows that simple tactics can be therapeutic for circadian rhythm disorders.

In the hypothyroidism post, I suggested the following tactics for improving circadian rhythms:

  • Light entrainment: Get daytime sun exposure, and sleep in a totally darkened room.
  • Daytime feeding: Eat during daylight hours, so that food rhythms and light rhythms are in synch.
  • Intermittent fasting: Concentrate food intake during an 8-hour window during daylight hours, preferably the afternoon. A 16-hour fast leading to lower blood sugar and insulin levels, and the more intense hormonal response to food that results from concentration of daily calories into a short 8-hour time window, will accentuate the diurnal rhythm.
  • Adequate carb intake: Eat at least 400 “safe starch” carbohydrate calories daily during the afternoon feeding window. Relative to a very low-carb diet, this will increase daytime insulin release and, by increasing insulin sensitivity, may reduce fasting insulin levels. It will thus enhance diurnal insulin rhythm.

To these, we can add several more based on Seth’s findings:

  • Looking at human faces: If you work at a computer, keep a window up that cycles among photos of faces, or shows a video of a talk show; keep photos of your family near your screen.
  • Standing: Work at a standing desk or, failing that, get in the habit of standing on one leg rather than two.
  • Animal fat: Eat a diet high in animal fats.

These tactics cured Seth’s sleep disorder. Might these tactics also cure or greatly improve other circadian rhythm disorders – including hypothyroidism and psychiatric disorders like depression and bipolar disorder? Could looking at human faces help the obese lose weight and improve their lipid profiles?

I don’t know but I’d certainly give these techniques a try before pharmaceutical drugs. I believe these techniques deserve clinical testing as therapies for all diseases associated with disrupted circadian rhythms. I believe that they may be just as beneficial for the healthy: by improving immune function, they may delay aging and extend lifespan.

A few weeks ago, when I posted a video of Don Rumsfeld defending the use of a standing desk (the same video was later linked by John Durant and Mark Sisson), I brashly stated, “There are few single life adjustments more likely to improve your health than working at a standing desk.”

Perhaps that statement wasn’t as exaggerated as it may have seemed!

Seth’s Talk

Protein for Athletes

Posted by on March 15, 2011 103 comments

How much protein should athletes consume?

Bodybuilders have long known that consuming extra protein makes it easier to add muscle. Yet low protein dieting can enhance immunity against viruses and bacteria, and extends lifespan in animals.

The Perfect Health Diet, because we’re positive toward saturated fats and starches, will often lead to lower protein consumption than other Paleo diets that restrict fatty or starchy foods. So it’s natural that some athletes and bodybuilders have asked how to optimize protein intake.

Robert recently asked about this, but let’s look specifically at the case of Advocatus Avocado:

I believe my performance improved (albeit marginally–the differences aren’t large) when I allowed my protein/carb/fat ratios to remain consistent despite my high caloric intake, which is ~3,600 calories/day. In other words, I had a sense of better performance when I lowered my fat% to around 65 and allowed around 200g/day of protein (I work out 2-3x a week for an hour).

At 3,600 calories per day, 65% fat is 2340 calories; 200 g protein is 800 calories; that leaves 460 calories carbs. How do these compare with Perfect Health Diet recommendations for athletes?

Nitrogen Balance, Exhaustion of Benefits, and Toxicity

There are a few magic numbers for protein intake that we want to be aware of:

  • Nitrogen balance. Nitrogen comes into the body in dietary protein and leaves the body in urine as ammonia, urea, and uric acid after proteins are metabolized. So when a person is in nitrogen balance, the amount of dietary protein matches the amount of metabolized protein, and the protein content of the body is unchanged. Very likely, the muscle content is unchanged too.
  • Exhaustion of benefits. We want to find the “plateau region” for nutrients. Athletes want to know: at what level of protein intake does protein no longer help build muscle?
  • Toxicity. At what level of protein intake does protein begin to damage health?

Luckily Ned Kock of the superb Health Correlator blog has done much of the work for us in his post “How much protein does one need to be in nitrogen balance?.”

He presents this chart, from a book on Exercise Physiology [1]:

There’s a great deal of variability across persons. Some people are in nitrogen balance at protein intake of 0.9 g/kg/day; others need as much as 1.5 g/kg/day. At 1.2 g/kg/day, half the sample was in nitrogen balance.

Various factors influence the interpretation of this data:

  • The sample was of endurance athletes. Endurance exercise increases protein needs, so most people would reach nitrogen balance at lower protein intakes. Resistance exercise doesn’t require as much protein: Experienced bodybuilders are typically in nitrogen balance at 1.2 g/kg/day. [2]
  • Most of the sample probably ate a high-carb diet. Glucose needs were met from dietary carbohydrates. Low-carb dieters would need additional protein for glucose manufacture.
  • As Ned states, in caloric deficit, protein needs are increased; in caloric surplus, protein needs are decreased. If you’re restricting calories for weight loss, expect to need a bit more protein to avoid muscle loss.
  • Supplementing leucine “increased protein synthesis and decreased protein breakdown” [2], thus leading to nitrogen balance at lower protein intakes.
  • The point of nitrogen balance is dynamic: if everyone in the sample ate 0.9 g/kg/day, then they’d eventually get into nitrogen balance at 0.9 g/kg/day. The body adjusts to conserve muscle at given food availability.

The average person needs much less protein to be in nitrogen balance. The US RDA for protein, 0.8 g/kg/day, was set so that 97.5% of Americans would be in nitrogen balance. [2] But just to be conservative, and because we’re developing advice for athletes, let’s consider 1.5 g/kg/day as the protein intake that brings our athletes into nitrogen balance.

What about the protein intake that exhausts benefits?  At what intake is muscle synthesis no longer promoted?

Ned, citing a review paper [2], offers the following answer: “[P]rotein intake beyond 25 percent of what is necessary to achieve a nitrogen balance of zero would have no effect on muscle gain.”

On my reading it’s not so easy to infer a clear answer, but let’s go with this. If so, then muscle gains would be exhausted at 1.25*1.5 = 1.875 g/kg/day even for the most strenuous athletes.

What about toxicity?

We deal with this in our book (p 25). At a protein intake of 230 g/day (920 calories), the body’s ability to convert ammonia to urea is saturated. [3] This means the nitrogen from every additional gram of protein lingers in the body as ammonia, a toxin.

Clearly marginal dietary protein is toxic, via ammonia poisoning, at this intake level. A reasonable estimate for where toxicity begins is between 150 to 200 g/day.

Putting it together: A prescription for athletes

Let’s say our athlete is an 80 kg man. Then maximum muscle gain will be achieved at a protein intake of 1.875*80 = 150 g/day. Toxicity will begin somewhere between 150 to 200 g/day. So the “plateau region” where all the benefits, and none of the toxicity, are achieved is between 150 g/day and some protein intake not much above 150 g/day.

The plateau region is quite narrow! What this tells us is that athletes should consume about 150 g/day protein.

This assumes a high-carb diet, so that no protein is needed for gluconeogenesis. The body utilizes about 600 calories/day of glucose, plus another 100 calories per hour of intense training.

With carb intakes below 600 calories/day, additional dietary protein would be needed, because protein would be consumed nearly 1-for-1 with the missing carbs.

So we can summarize these results as follows:

  • On a high-carb diet (>600 calories/day), 600 protein calories/day maximizes muscle gain.
  • On a low-carb diet (<600 calories/day), 1200 carb+protein calories/day maximizes muscle gain.

Looking back at Advocatus Avocado’s personal experience, he eats a low-carb diet with 460 carb calories per day. We predict therefore that he would need 740 protein calories a day to maximize his muscle gain (plus up to another 100 calories per hour of training, to replace lost glycogen).

Advocatus says he needs 800 protein calories/day to maximize muscle gain. Close enough for blog work!

At these protein intake levels, Advocatus is probably experiencing mild ammonia toxicity. He might slightly improve his health by eating a few more carbs, and cutting his protein intake a bit.

He might also find that leucine supplementation would reduce his protein needs a bit.

Overall, however, I think his experiences are consistent with our framework for understanding nutritional needs. Those who are content with maintaining an ordinary person’s muscle mass can get by with relatively low protein intakes of 0.8 g/kg/day or less. But muscle-building athletes need high protein intakes, around 1.9 g/kg/day, to maximize the rate of muscle gain. If they eat low-carb, they may need even more protein. Such high protein intakes are likely to exceed the threshold of toxicity.

References

[1] Brooks, G.A., Fahey, T.D., & Baldwin, K.M. (2005). Exercise physiology: Human bioenergetics and its applications. Boston, MA: McGraw-Hill.

[2] Wilson, J., & Wilson, G.J. (2006). Contemporary issues in protein requirements and consumption for resistance trained athletes. Journal of the International Society of Sports Nutrition, 3(1), 7-27.

[3] Rudman D et al. Maximal rates of excretion and synthesis of urea in normal and cirrhotic subjects. J Clin Invest. 1973 Sep;52(9):2241-9. http://pmid.us/4727456.