HPN 4: ‘Hanger’ Problems, Fasted vs. Fed Adaptations, and Keto Runs (Yes, Those Runs)

February 20, 2019

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Welcome to episode 4 of Holistic Performance Nutrition (HPN) with Julie McCloskey, registered holistic nutrition coach, and Tawnee, a certified sports nutritionist and holistic endurance coach.

Anonymous male athlete asks:

I am a 31-year-old man from Norway. The last years I have been running and trained for trail-marathons. I started my running for about 5 years ago, with the goal to get in better shape, and lose some weight. I am 181cm high, and my weight is now about 67kg. The last year I switched my training to triathlon (half ironman distance), but I still have focus on keeping my running endurance because I still want to participate on a couple of marathons. I am training 7 days a week, about 10 hours. I do the most of my training in the morning (5 o clock) so I don’t lose too much time with my family. One of my biggest concerns, I am always hungry for food, but I feel that I am eating too much already. Do you have any advices on how I can eat to feel a little less hungry and still not increase my weight? Some days (1-3 times a month) I get so hungry so I am «over-eating» on greens and oats, typical on the evening. How can I avoid this?

A typical eating day for me is:

• After morning workout: some muesli, sometimes a banana and 1 dl yoghurt
• Breakfast: 2dl Oatmeal porridge, mad on water, with 4 dl fat-free milk to drink
• Snack: 1 Carrot
• Lunch: 3 slices of bread with cheese and a little caviar, 1 slice crispbread, 1 bell pepper, a tomato and one orange
• Snack 2: 1 banana
• Dinner: Lots of greens and vegetable, chicken or fish, and a little bit of rice or pasta
• Evening meal: 1 slice crispbread with 1 egg, and one slice crispbread with mackerel. 2dl yoghurt with oats.
• I am drinking a lot of water, and some coffee during the day.
• I am only drinking alcohol (1-2 glasses of wine, or some beers) max one Saturday a month, and only eating 1 little chocolate every Saturday.
• Snacking in between meals Is always fruits or vegetables, and I eat a lot of carrots, maybe too much.
• ALSO: I feel that I am not able to push as hard as I should on my run intervals, or my bike intervals. On the bike, I feel too weak to push my heart rate up in zone 3-4 on the flats. Any advices? Should I differ more on my training and go more slow on more of my workouts?

The coaches say:

• This is a heavy carb diet, consider replacing some meals with LCHF especially meals that are separate from training times.
  • Best way to find out is to log on MFP or another app that calculates macros.
• Carb cycling would be a good strategy to avoid too low carb too fast.
  • As carbs increase, you can lower fat grams; keep protein stable (20% calories, or aim for around 80-120 g/day – 1.4-2.0 g protein per kg bodyweight a day if training)
  • Also can carb cycle within a day – e.g. LCHF B/L, then carb refeed at night, or vice versa – higher carb post workout in AM then LCHF rest of day.
• Training with MAF complements development of metabolic efficiency i.e.higher reliance on fat for fuel
• Focus on higher satiety foods
• Could have low leptin and not getting the signal to “put down the fork” so he is always hungry
• Leptin is made in fat cells, and at 5’11 147ish he may not have enough fat cells to generate hormone balance
• Possible nutrient deficiencies, I’d increase variety and cut the refined carbs for sure
• Cravings for oats and greens? Both high in manganese and although a rare deficiency, could be a thought – Deficiency results in joint pains, clicking of joints, weak ligaments/muscles
• Don’t eat so close to bed, save carbs for dinner, and balance that BS
• Carb ranges
  • Ketogenic/very low carbohydrate diet: ~0.5 g CHO/lb (~1 g/kg).
  • Lower/moderate carb diet: ~1 g CHO/lb (~2 g/kg) or slightly more.
  • A typical high-carbohydrate diet: ~2-3 g CHO/lb or more.
• Also may consider monitoring blood sugar levels with at-home blood glucometer. Some norms to watch for:
  • <90 mg/dL fasting in morning
  • <140 mg/dL 1 hour postprandial
  • <120 mg/dL 2 hours postprandial
  • Back to baseline (fasting levels) 3 hours postprandial

Mike asks:

From my understanding the main benefit to a fasting run is to teach the body how to better utilize fat as an energy source due to the lack of available sugar/carbohydrates.  If we run after eating a breakfast with little to no carbohydrate would it have the same benefit since we would not be adding additional sugar to our system? (E.g. my typical breakfast is 4 eggs with butter and cheese with some bacon.). Would we help or hinder our fuel adaptation if we added a faster finish to a fasted or carb-depleted run?

The coaches say:

• We conclude that aerobic exercise performed in the fasted state induces higher fat oxidation than exercise performed in the fed state. – although doesn’t say what the macros were in the “fed state”
  • Twenty-seven studies – with a total of 273 participants – were included. There was a significant increase in fat oxidation during exercise performed in the fasted, compared with fed, state (-3·08 g; 95 % CI -5·38, -0·79; I 2 39·1 %).
• Fat oxidation rates have been shown to decrease after ingestion of high-fat diets, partly as a result of decreased glycogen stores and partly because of adaptations at the muscle level.
  • Furthermore: The duration and intensity of exercise training required to induce changes in fat oxidation is currently unknown. Ingestion of carbohydrate in the hours before or on commencement of exercise reduces the rate of fat oxidation significantly compared with fasted conditions, whereas fasting longer than 6 h optimizes fat oxidation.
• It is evidenced that pre-exercise feeding blunted signaling in skeletal muscle and adipose tissue implicated in regulating components of metabolism, including mitochondrial adaptation and substrate utilization.
• Adding a fast finish to a fasted run?
  • That’ll really empty your glycogen stores and enhance fat-burning (?) but at what price? That can quickly wreck ya if you don’t replenish afterwards with complex carbs, or if you’re pushing it when you don’t have the fuel. But if you have the energy towards the end? Maybe every so often could help challenge your body and as long as you’re recovering well it could be a solid mental/physical tool to have at least

James asks:

I started the keto diet with a protein focus on New Year’s day. I am a mesomorph. I started off at 188 pounds and weighed in this morning at 179 (so almost 10 pounds in a month). I think I will continue for another month and start adding more carbs back into my diet. So, at 169 while I am in the heart of my Marathon training.

General questions about keto: 1) I am having regular diarrhea or loose stools.  Is this common and, if so, how can I fix it? 2) During my long Runs, I am bonking. Am I supposed to  take in some kind of carbs during these runs? Yesterday’s 17 miles wiped me out. Water only.

The coaches say:

• On keto diarrhea:
  • Pretty common because you’re eating foods in quantities you’re not used to
  • MCT oil overload?
  • Gall bladder could be overloaded and needs more time to adapt
  • Solutions: activated charcoal, digestive enzymes lipase/ox bile/pepsin/HCL (Thorne has good blends), more soluble fiber, recalibrating your fat intake.
    • Thorne options:
      • Bio-Gest – HCl, pepsin, pancreatin, and ox bile
      • Dipan-9 – undiluted pancreatin: lipase, protease, and amylase
      • Betaine HCl & Pepsin
  • May be eating too much fat at one sitting, no more than 60g of fat per meal.
• Bonking on long runs:
  • Add in more carbs for sure
  • 100-150 cals an hour on long runs.
  • More natural gels, homemade energy balls, honey packets, any simple carb, tailwind powder, UCAN!!!! UCAN goes hand in hand with athletes looking to control BS and who are lower carb.
  • This bonking may also show that body still may have work to do on fat adaptation, or you are running your long runs too fast. At MAF or sub MAF should be able to go 2hr on an aerobic run w/o bonking (2-3 hours on the bike with same result). You can test ketones post workout to see.
  • Don’t make mistake of going on a low-cal diet by being low carb, huge mistake for athletes!
  • Also food for thought, not saying periods of keto are bad, but for athletes it’s still up for debate on its effect on performance:
    • “A Case for and Against Ketogenic Diets in Athletes.”
    • With long-term keto, glycogen levels in muscle and the liver may or may not be compromised but “the athlete will likely lack the metabolic machinery needed to fully use them as fuel sources.”
    • “Although ketone bodies may serve as a substitute for CHO, they may also paradoxically reduce endogenous CHO availability through inhibition of hepatic glucose output, therefore lowering the capacity to sustain higher intensity efforts (6,9). These findings emphasized the point that although glycogen levels in muscle and the liver may or may not be compromised with long-term KD, the athlete will likely lack the metabolic machinery needed to fully use them as fuel sources. It also suggests that while long-term KD may allow time for adaptation, short-term (i.e., 4 weeks) CHO restriction may compromise muscle glycogen stores.”
  • Consider taking in PerfectAmino during long workouts as well.

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