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Optimum Eating for Weight Loss, Weight Gain and/or Performance

 

Power Eating is the deliberate and planned manipulation of nutrients in order to facilitate and/or augment physiological and biochemical adaptations for weight loss, weight gain or performance enhancement.

In his book The Muscle Strength Nutrition Pyramid. Eric Helms, a natural bodybuilder and PhD candidate, describes a pyramid approach to nutrition.

This approach prioritizes nutrition as follows:

  1. Calories/Energy balance
  2. Macronutrients and Fiber
  3. Micronutrients and Water
  4. Nutrient Timing and Meal Frequency
  5. Supplements

 

Image result for eric helms nutrition pyramid

http://muscleandstrengthpyramids.com/wp-content/uploads/2015/12/The-Muscle-Strength-Nutrition-Pyramid-Sample-Chapter-v1.0.pdf

 

Energy and Metabolism

Calories/Energy balance

Total Energy Expenditure is comprised of:

  • Resting Metabolic Rate (RMR) 60%
  • Activity Energy Expenditure (AEE) 30%
  • Thermic Effect of Food (TEF/DIT)  10%

RMR and AEE

RMR is defined as metabolism during a time period of strict and steady resting conditions that assume physiological homeostasis.

AEE is the energy used during and after exercise as well as NEAT (Non-Exercise Activity Thermogenesis).

There are a number of online calculators that can help estimate RMR and AEE to determine your Total Daily Energy Expenditure (TDEE). These can be useful for weight gain and weight loss applications.

The TEF is the processing of food for use and storage. TEF is highest for protein and fiber.

 

Energy Manipulation for Healthy Weight Loss

A combination of a higher protein and higher fiber diet (TEF), a small amount aerobic exercise, and moderate amount of resistance exercise in conjunction with a moderate energy deficit, yields the greatest weight loss while preserving lean body mass.

http://www.precisionnutrition.com/  (Course notes and Text)

(Bryner, R. W., et al. 1999)
Online Tools

BMR Calculator:  

 http://www.bmi-calculator.net/bmr-calculator/

TDEE Calculator:

https://tdeecalculator.net/

 

Setting a deficit

There are three primary ways to set a deficit

  • Small: 10-15% below maintenance
  • Moderate: 20-25% below maintenance
  • Large: anything bigger than 25% below maintenance

In my opinion, a moderate deficit is the best approach. If calories restriction is too low, one is at risk for nutrient deficiencies (i.e. <1200 KCAL).
Energy Manipulation for Healthy Weight Gain

For athletes in a building phase, there are a few strategies that can be used to gain weight in a healthy way:

  • Eat more calories than you expend (+500 Kcal/day is a good start)
  • Eat nutrient-dense, calorie-rich food
  • Increase dietary fat and carbohydrate intake
  • Add a weight-gainer supplement
  • Lift heavy weights

Energy balance is also essential for performance where weight loss or weight gain is not the goal, but energy to perform the activity is. In these cases, sufficient calories to fuel an activity is important. This will be discussed further under the carbohydrate section.

 

Macronutrients

Macronutrients are both energy substrates and signaling molecules that can be strategically manipulated, along with exercise, to enhance and promote desired goals and adaptations.

Carbohydrates- Sugars, Starches and Fibers

Functions- Primary energy source for moderate-intense activity

Energy Supply- 4 kcal/g

High Glycemic (e.g. simple sugars)- rapid increase in blood glucose and insulin

Low Glycemic (e.g. Complex fibrous foods)- slow increase in blood glucose

 

Carbohydrates For Endurance Performance

Dose:

Rather than assign a general percentage of carbohydrate consumption, sports nutritionists have moved towards making recommendations that match the fuel needs of training and that optimize glycogen restoration:

  • Low Intensity/Skill based- 3-5g/kg BM
  • Moderate Intensity- 5-7 g/kg BW
  • Moderate-High Intensity (Endurance Program)- 6-10 g/Kg BM
  • Extreme- 8-12g/kg BM

 

Supplementation pre-exercise– is essential to improve exercise performance. It is suggested that 1-4 g/kg carbohydrate is needed 1-4 h before exercise. In addition, carbohydrate mouth rinse can improve exercise performance (~2-3%) mediated by receptors in the oral cavity and the brain, during exercise lasting less than 60 min. When the exercise duration is more than 60 min, the advice is to ingest 90 g/h of mixed carbohydrates (60 g/ h glucose plus 30 g/h fructose). This is important during prolonged endurance events of 3 hours or more.

During postexercise recovery, optimal nutritional intake is important to replenish endogenous substrate stores and to facilitate muscle-damage repair and reconditioning.

After exhaustive endurance-type exercise, muscle glycogen repletion forms the most important factor determining the time needed to recover.

The postexercise carbohydrate (CHO) recommendations is 1g.kg/ BM hour for four hours, then match activity needs. This is the most important determinant of muscle glycogen synthesis.

Since it is not always feasible to ingest such large amounts of CHO, the combined ingestion of a small amount of protein (0.2−0.4 g · kg−1 · hr−1) with less CHO (0.8 g · kg−1 · hr−1) stimulates endogenous insulin release and results in similar muscle glycogen-repletion rates as the ingestion of 1.2 g · kg−1 · hr−1CHO.

 

Furthermore, postexercise protein and/or amino acid administration is warranted to stimulate muscle protein synthesis, inhibit protein breakdown, and allow net muscle protein accretion. The consumption of ~20 g intact protein, or an equivalent of ~9 g essential amino acids, has been reported to maximize muscle protein-synthesis rates during the first hours of postexercise recovery.

Consuming CHO and protein  (4:1) during the early phases of recovery has been shown to positively affect subsequent exercise performance and could be of specific benefit for athletes involved in multiple training or competition sessions on the same or consecutive days.

(Burke, L. M. 2015) (Smith-Ryan, A., & Antonio, J. 2013) (Beelen, M., et al. 2010)

 

Ingestion of bananas before and during prolonged and intensive exercise is an effective strategy and comparable to ingesting a 6% carbohydrate drink, both in terms of fuel substrate utilization and cost, for supporting performance.

(Nieman, D. C., et al. 2012)  

 

Train Low/Compete High

Performance Considerations- Train Low for adaptations

When carbohydrate availability is low, AMPK, a metabolic sensor, stimulates the production of  PGC-1α, a transcriptional co-activator that regulates gene expression and energy metabolism. This results in increased mitochondrial enzyme activities, increased lipid oxidation, lactate removal and improved exercise capacity/performance.

(Liang, H., & Ward, W. F. 2006)  (Knuiman, P. et al. 2015)
Compete High for Optimal Performance

When it comes to game day, carbohydrates are important for:

  • Attenuation of central fatigue
  • Maintenance of CHO oxidation rates
  • Muscle glycogen sparing
  • Reducing exercise-induced strain
  • Maintenance of excitation-contraction coupling
  • Glycogen availability to meet the needs of sprinting or higher intensity

(Smith-Ryan, A., & Antonio, J. 2013)

 

Proteins-  Large macromolecules of one or more long chains of amino acid residues.

Protein functions:

  • Catalyzing metabolic reactions
  • DNA replication
  • Transporting molecules
  • Muscle Protein Synthesis (MPS).  Leucine “triggers” mTOR, a kinase, which in turn promotes MPS
  • Energy Supply- 4 kcal/g

Sources:

Complete (All Essential Amino Acids)- Animal products- beef, poultry, pork, lamb, fish, eggs, dairy

Incomplete- Plant products  (Quinoa and Soy are complete proteins, but there is an energy trade off, i.e. more calories/serving to get the same amount of leucine)
Protein and Performance (Hypertrophy/Strength/Power)

  • Leucine dose: 3 g is optimal to stimulate muscle protein synthesis (MPS)
  • Protein Dose: 1.6-2.0g/kg BW (20-30g of high quality whey protein)
  • 0.5-0.5 g/kg BW/meal in 4 divided meals
  • The addition of 50 g of carbohydrate with protein pre and post exercise can augment hypertrophy (decreases muscle breakdown)
  • Consuming 1-2 small protein rich meals in the first 3 hours post-exercise can capture the peak of MPS
  • Whey: fast-digesting (consume protein close to training session)
  • Casein: slow-digesting (take before bed)

 

(Dreyer, H. C., Drummond, et al. 2008) (Norton, L. E., & Layman, D. K. 2006) (Smith-Ryan, A., & Antonio, J. 2013)   (Naderi, A. et al. 2016)  

 

Consuming a high protein diet (3.4 g/kg/d) in conjunction with a heavy resistance-training program may confer benefits with regards to body composition. Furthermore, there is no evidence that consuming a high protein diet has any deleterious effects.

(Antonio, J., et al. 2015).

 

Fats

Fats and oils are categorized according to the number and bonding of the carbon atoms in the aliphatic chain.

The degree of saturation determines the melting point and stability.

Saturated fats – no double bonds. Solid at room temperature

Unsaturated fats – one or more double bonds. Liquid at room temperature

Functions:

  • Energy source and energy storage
  • Hormone production
  • Inflammation

Sources:

Monounsaturated- Avocado, olive oil, macadamia nuts

Omega 6- Seed and vegetable oils, e.g. canola, corn, peanut, sunflower, safflower

I recommend using olive oil for salads and low heat and  avocado and coconut oil for moderate heat cooking.

 

Omega 3 Considerations

The Standard American Diet (SAD) is notoriously pro-inflammatory, with the  Omega 6:Omega 3 greater than 4:1 (closer to 18:1).

Athletes should focus on getting the fats in their diet from dark green leafy vegetables, flax/hemp seeds, walnuts, cold water fish, grass-fed beef, omega-3 eggs; and limit omega-6 (vegetable and seed oils). Saturated fat should come from grass fed, pasture raised animals.

(Simopoulos, A. P. 2008)
Omega 3 ((EPA/DHA)

Fish Oil Applications In Athletes

  1. Anti-Inflammatory
  2. Anti-Catabolic
  3. Anabolic
  4. Metabolic Wellness (Insulin sensitivity and Body Composition)

 

Fish Oil Supplementation- What you should consider

  • Fresh (low levels of peroxidation)
  • Molecularly distilled and pure (low levels of heavy metals and contaminants)
  • Third-party tested
  • Triglyceride vs ethyl esterified molecular form

 

DOSE:

AHA recommends 1g/day for general health

To reduce soreness: 6g dose, spread over the course of a day  

(Smith-Ryan, A., & Antonio, J. 2013)

 

Ketogenic Diets

Ketogenic diets are becoming popular as a weight loss and performance strategy. There are a few studies with mixed results. Most exercise physiologists and sports scientists agree that ketogenic diets decreases performance, especially at higher intensities. In addition, exercising in a ketogenic state can:

  • Increase RPE (Rate of Perceived Exertion)
  • Down-regulate the ability to use carbohydrates
  • Adversely affect metabolic flexibility- we were meant to use different substrates under different situations preferentially, not exclusively
  • Adversely affect immune function, recovery and stress

 

Low Fat/High Carb or High Fat/Low Carb?

How about being Flexible?

Metabolic Flexibility is the preferential state of substrate utilization. It allows for an individualized and periodized approach to fuel availability during training whereby substrate utilization is based preferentially on exercise intensity and duration, thereby allowing for optimal utilization of all energy substrates.

(Burke, L. M. 2015)

 

Micronutrients

Micronutrients and Phytonutrients

Micronutrients are comprised of vitamins and minerals which are required in small quantities to ensure normal metabolism, growth and physical well-being.

When it comes to micronutrients I say JERF- Just Eat Real Food.

If you’re diet is 50-75% plant based and includes healthy fats and adequate protein, you are likely to get the vitamins, minerals and phytonutrients you need without having to rely on supplementation.

 

Phytonutrients

Phytonutrients, also called phytochemicals, are chemicals produced by plants. Phytonutrients can provide significant health benefits. Phytonutrient-rich foods include colorful fruits and vegetables, legumes, nuts, tea, cocoa, whole grains and many spices.

 

Some of my favorite phytonutrients with ergogenic properties include:

Green Tea

Polyphenols known as catechins  (EGCG) are abundant in green tea. Green Tea Extract (GTE) has been shown to enhance endurance by increased metabolic capacity and utilization of fatty acid as a source of energy in skeletal muscle during exercise.

(Murase, T., et al. 2006)

 

Human studies suggest that green tea may contribute to a reduction in the risk of cardiovascular disease and some forms of cancer, as well as to the promotion of oral health and other physiological functions such as anti-hypertensive effect, body weight control, antibacterial and antivirasic activity, solar ultraviolet protection, bone mineral density increase, anti-fibrotic properties, and neuroprotective power.

(Cabrera, C. et al 2006)

 

Cocoa (Cacao)

Cocoa consumption can be useful in maintaining good physical fitness due to the favourable effects on muscle and redox status during exhaustive exercise.

(González-Garrido, J. A. et al 2015)

 

Antioxidants- Too much of a good thing?

Reactive oxygen species (ROS) and reactive nitrogen species (RNS) are free radicals that are produced during exercise that can cause skeletal muscle damage, fatigue and impair recovery. However, ROS and RNS also signal cellular adaptation processes.

Many athletes attempt  to combat the deleterious effects of ROS and RNS by ingesting antioxidant supplements (e.g. Vitamins A, E, C, and the minerals Se and Zn)

Unfortunately, interfering with ROS/RNS signalling in skeletal muscle during acute exercise may blunt favorable adaptations and can attenuate endurance training-induced and ROS/RNS mediated enhancements in antioxidant capacity, mitochondrial biogenesis, cellular defence mechanisms and insulin sensitivity.

In addition, antioxidant supplementation can have deleterious effects on the response to overload stress and high-intensity training, thereby adversely affecting the remodelling of skeletal muscle following resistance and high-intensity exercise.

The bottom line is that physiological doses (from the diet) are beneficial whereas supraphysiological doses (supplements) during exercise training may be detrimental to one’s gains.

(Merry, T. L. and Ristow, M. 2016)

 

Hydration- How much Water Do You Need?

Water acts as a building material, solvent, reaction medium and reactant. It is a carrier for nutrients and waste product, aids in thermoregulation and helps to serve as a lubricant and shock absorber. Water balance is regulated by changes in plasma osmolarity.

There are numerous factors that affect water requirements and needs, e.g. climate, physical activity and diet.

The Institute of Medicine of the National Academies recommends as a base line that women consume an average of 91 oz and men consume 125 oz.

(Jéquier, E., & Constant, F. 2010)

http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=10925

http://www.nationalacademies.org/hmd/Reports/2004/Dietary-Reference-Intakes-Water-Potassium-Sodium-Chloride-and-Sulfate.aspx
Endurance Sports Considerations

  • Early consumption of at least 150% of fluid lost with dilute sodium solution (</= 50 mmol/L. e.g. isotonic sports drink)
  • Events greater than 90 minutes require pre-event hydration strategies 2-3 days prior, e.g. Consume 400-600 mL of  fluid every 2-3 hours containing Na 40-100 mmol/L

(Smith-Ryan, A., & Antonio, J. 2013)

 

Nutrient Timing

Nutrient timing was once believed to have a narrow window. More recently, it is thought to be more analogous to a “garage door.” Some basic guidelines include:

  • Whey protein dosed at 0.4–0.5 g/kg of LBM pre- and post-exercise                  
  • Maximal acute anabolic effect of 20–40 g                                              
  •  Pre- and post-exercise meals every 3–4 hours  
  • Carbohydrate dosing and timing relative to resistance training should be commensurate with intensity guidelines outlined under the carbohydrate section

(Aragon, A. A., & Schoenfeld, B. J. 2013)
Intermittent Fasting (“Power not eating)”

Intermittent fasting, limiting food consumption a couple of days per week, has a positive effect on longevity and can lead to numerous health benefits including: improved insulin sensitivity, increased sirtuin levels (anti aging genes) and increased DNA repair.

These changes lead to improved stem cell function, improved mitochondrial function, and increased autophagy (cellular cleanup) and tissue repair.

https://nootrobox.com/biohacker-guide/intermittent-fasting/longevity

(Moore, J., & Fung, J. 2016)

 

Summary of Key Points

  • Follow a Pyramid prioritization for weight loss, weight gain and performance enhancement: Energy balance, macronutrients, micronutrients, nutrient timing, supplements
  • JERF- Just Eat Real (and a Rainbow of) Food
  • Periodize nutrition with exercise
  • Understand what adaptation(s) are you looking to augment with exercise, diet and supplementation

Recipes

Power smoothie (makes about 2 servings)

  • 1 cup Water
  • 1 cup Kale or spinach
  • ½ cup Frozen organic berries
  • 1 Banana
  • ½ avocado
  • ½ tsp raw cacao

Sample Breakfast

Smoothie: Water, 2 cups Kale or Spinach, 1 cup organic berries, 1 banana, 1 tbsp Flaxseeds

Protein (25g)- Choose one: Eggs, Turkey bacon, Chicken or Turkey sausage, Fish, or add Whey Protein to smoothie

Carbohydrate/Fat (Choose one):

  • 1 Cup Steel Cut Oats and 2 tbsp Walnuts
  • 1 sliced plantain fried in coconut oil
  • 1 cup diced sweet potato stir fried in olive oil and seasoned with salt

Sample Lunch

Colorful Salad– Spinach or Arugula, Purple cabbage, Carrots, Red peppers, Radishes, Beets, Cherry Tomatoes, Red onion, Avocado, Toasted Walnuts

Dressing

  • XVOO- 1 cup
  • Apple Cider Vinegar- ¼ cup         
  • Lemon- 1
  • 1 tsp Dijon mustard
  • Garlic- 1 clove crushed
  • Honey- 1 tbsp

Protein (25g)- Choose one– Poultry, Steak, Fish

 

Sample Dinner- “Power Stirfry”

Ingredients (About 2-3 servings)

  • 1 lb cubed chicken breast
  • 3 cups Mixed Vegetables (Broccoli, Red pepper, Red onion, Shiitake Mushrooms
  • Garlic- 1 clove
  • Ginger- 1 tsp
  • Avocado Oil- 2 tbsp
  • Soy Sauce- to flavor
  • Sriracha- to flavor

Directions

  1. Put avocado oil into wok on medium heat
  2. Add garlic and ginger
  3. Add chicken and cook until white on outside
  4. Add vegetable mix
  5. Cook until chicken is cooked through and vegetables crisp
  6. Serve over brown rice
  7. Add Soy Sauce/Sriracha as desired

Sample Snacks

  • Greek Yogurt with raw or toasted walnuts and blueberries
  • Veggie sticks and humus or guacamole
  • Apple + Nut Butter
  • Paleo Cereal, blueberries, chocolate whey protein powder (mix with water)
  • Hard boiled eggs
  • Turkey slices wrapped around carrot sticks
  • Kale chips (homemade)
  • Kombucha
  • Saurkraut
  • Mocha Monkey Smoothie: 1 cup Unsweetened Almond or coconut milk, 1 frozen banana, 1 tbsp raw cacao, 1 tbsp organic peanut butter, 2 shots espresso

References

Aragon, A. A., & Schoenfeld, B. J. (2013). Nutrient timing revisited: is there a post-exercise anabolic window?. Journal of the international society of sports nutrition, 10(1), 1.

Antonio, J., Ellerbroek, A., Silver, T., Orris, S., Scheiner, M., Gonzalez, A., & Peacock, C. A. (2015). A high protein diet (3.4 g/kg/d) combined with a heavy resistance training program improves body composition in healthy trained men and women–a follow-up investigation. Journal of the International Society of Sports Nutrition, 12(1), 39.

Bar-Peled, L., & Sabatini, D. M. (2014). Regulation of mTORC1 by amino acids. Trends in cell biology, 24(7), 400-406.

Beelen, M., Burke, L. M., Gibala, M. J., & Van Loon, L. J. (2010). Nutritional strategies to promote postexercise recovery. International journal of sport nutrition and exercise metabolism, 20(6), 515-532.

Bryner, R. W., Ullrich, I. H., Sauers, J., Donley, D., Hornsby, G., Kolar, M., & Yeater, R. (1999). Effects of resistance vs. aerobic training combined with an 800 calorie liquid diet on lean body mass and resting metabolic rate. Journal of the American College of Nutrition, 18(2), 115-121.

Burke, L. M. (2015). Re-Examining High-Fat Diets for Sports Performance: Did We Call the “Nail in the Coffin” Too Soon? Sports Medicine (Auckland, N.z.), 45(Suppl 1), 33–49.

Burke, Louise, and Vicki Deakin, eds. Clinical sports nutrition. Beijing, Boston: McGraw-Hill, 5th edition 2015.

Cabrera, C., Artacho, R., & Giménez, R. (2006). Beneficial effects of green tea—a review. Journal of the American College of Nutrition, 25(2), 79-99.

Clark, M. A., Lucett, S., & Corn, R. J. (2008). NASM essentials of personal fitness training. Lippincott Williams & Wilkins.

Dreyer, H. C., Drummond, M. J., Pennings, B., Fujita, S., Glynn, E. L., Chinkes, D. L., … & Rasmussen, B. B. (2008). Leucine-enriched essential amino acid and carbohydrate ingestion following resistance exercise enhances mTOR signaling and protein synthesis in human muscle. American Journal of Physiology-Endocrinology And Metabolism, 294(2), E392-E400.

González-Garrido, J. A., García-Sánchez, J. R., Garrido-Llanos, S., & Olivares-Corichi, I. M. (2015). An association of cocoa consumption with improved physical fitness and decreased muscle damage and oxidative stress in athletes. The Journal of sports medicine and physical fitness.

Higdon, J. V., & Frei, B. (2006). Coffee and health: a review of recent human research. Critical reviews in food science and nutrition, 46(2), 101-123.

Hodgson, A. B., Randell, R. K., & Jeukendrup, A. E. (2013). The Metabolic and Performance Effects of Caffeine Compared to Coffee during Endurance Exercise. PLoS ONE, 8(4), e59561. http://doi.org/10.1371/journal.pone.0059561

Jéquier, E., & Constant, F. (2010). Water as an essential nutrient: the physiological basis of hydration. European journal of clinical nutrition, 64(2), 115-123.

Kimball, S. R., & Jefferson, L. S. (2006). Signaling pathways and molecular mechanisms through which branched-chain amino acids mediate translational control of protein synthesis. The Journal of nutrition, 136(1), 227S-231S.

Knuiman, P., Hopman, M. T., & Mensink, M. (2015). Glycogen availability and skeletal muscle adaptations with endurance and resistance exercise.Nutrition & metabolism, 12(1), 1.

Laplante, M., & Sabatini, D. M. (2012). mTOR signaling in growth control and disease. Cell, 149(2), 274–293.

Liang, H., & Ward, W. F. (2006). PGC-1α: a key regulator of energy metabolism. Advances in physiology education, 30(4), 145-151

Longland, T. M., Oikawa, S. Y., Mitchell, C. J., Devries, M. C., & Phillips, S. M. (2016). Higher compared with lower dietary protein during an energy deficit combined with intense exercise promotes greater lean mass gain and fat mass loss: a randomized trial. The American journal of clinical nutrition, 103(3), 738-746.

Merry, T. L. and Ristow, M. (2016), Do antioxidant supplements interfere with skeletal muscle adaptation to exercise training?. J Physiol, 594: 5135–5147. doi:10.1113/JP270654

Moore, J., & Fung, J. (2016). The Complete Guide to Fasting: Heal Your Body Through Intermittent, Alternate-Day, and Extended Fasting. Simon and Schuster.

Murase, T., Haramizu, S., Shimotoyodome, A., Tokimitsu, I., & Hase, T. (2006). Green tea extract improves running endurance in mice by stimulating lipid utilization during exercise. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 290(6), R1550-R1556.

Naderi, A., de Oliviera, E. P., Ziegenfuss, T. N., & Willems, M. E. (2016). Timing, optimal dose and intake duration of dietary supplements with evidence-based uses in sports nutrition. Journal of Exercise Nutrition & Biochemistry.

Nieman, D. C., Gillitt, N. D., Henson, D. A., Sha, W., Shanely, R. A., Knab, A. M., … Jin, F. (2012). Bananas as an Energy Source during Exercise: A Metabolomics Approach. PLoS ONE, 7(5), e37479.

Norton, L. E., & Layman, D. K. (2006). Leucine regulates translation initiation of protein synthesis in skeletal muscle after exercise. The Journal of nutrition, 136(2), 533S-537S.

Simopoulos, A. P. (2008). The importance of the omega-6/omega-3 fatty acid ratio in cardiovascular disease and other chronic diseases. Experimental biology and medicine, 233(6), 674-688.

Smith-Ryan, A., & Antonio, J. (Eds.). (2013). Sports Nutrition & Performance Enhancing Supplements. Linus Learning.

Solon-Biet, S. M., McMahon, A. C., Ballard, J. W. O., Ruohonen, K., Wu, L. E., Cogger, V. C., … & Gokarn, R. (2014). The ratio of macronutrients, not caloric intake, dictates cardiometabolic health, aging, and longevity in ad libitum-fed mice. Cell metabolism, 19(3), 418-430.

Thomas, D. T., Erdman, K. A., & Burke, L. M. (2016). Position of the academy of nutrition and dietetics, dietitians of canada, and the american college of sports medicine: Nutrition and athletic performance. Journal of the Academy of Nutrition and Dietetics, 116(3), 501-528.

Other Resources

https://examine.com/

 

About the Author

Dr. Geoff Lecovin

Naturopathic Physician/Chiropractor/Acupuncturist/Certified Strength and Conditioning Specialist/Corrective Exercise Specialist/Performance Enhancement Specialist/Certified Sports Nutritionist/

View all posts by Dr. Geoff Lecovin