The advent of convenience and fast foods has made it easy, a little too easy, to reach daily calorie requirements (2000 calories for women, 2500 calories for men). But calorie-dense food is not the same as nutrient-dense food. The typical Western diet has become very calorie dense, but often lacks the vitamins, minerals and phyto-compounds that make the body work efficiently.

A typical example is white bread. In order to make it white, wholemeal flour is processed to within an inch of its life, removing all the fibre and most of its vitamins and minerals. Some of these are added back in via the euphemistically named ‘fortification’ process, but not all. The result? White bread is calorie dense and nutrient poor compared to its wholemeal relative. White rice, white pasta and many breakfast cereals go through a similar process

An abundance of highly processed and sugary convenience foods, cereals, cakes, biscuits and confectionery adorn the supermarket aisles. Food manufacturers and supermarkets seem determined to push these ‘non-foods’, which are both cheap and addictive. Furthermore only one in five people in the UK meet the five-a-day target for fruit and vegetables. The net result is a phenomenon called Type-B malnutrition. Not malnutrition from a lack of food, but rather nutrient deficiency in spite of above average calorie consumption – in other words overweight but under-nourished.

Obesity is at almost epidemic levels. In 2009 (the last set of figures available), 61.3% of adults (aged 16 or over) and 28.3% of children (aged 2-10) in England were overweight or obese. Whilst the detailed nutrition status of these people is not studied, it is reasonable to assume that many, if not all, consume sub-optimal levels of certain essential vitamins and minerals.

Nutrient dense foods include fruit, vegetables, nuts, seeds, whole grains (e.g. wholemeal bread and brown rice as oppose the their white alternatives), lean meats, fish, and low-fat dairy foods. Convenience foods, fast food, and most things that come in a packet are often calorie dense and nutrient poor.

Take a look at your daily food intake and find areas where you can switch to a nutrient dense alternative. Small changes performed consistently over time produce big results, so wholesale change is not necessary or recommended to begin with. Start with one thing like swapping your mid-morning latte and muffin for green tea and a piece of fruit and a handful of nuts, then work from there.

The American Society for Nutrition recently assembled a meeting of experts in the field of obesity to better understand the limitations of the energy balance model. Perhaps the most striking part of their subsequent report (1), is how the conventional method for calculating the potential rate of weight loss through calorie restriction grossly overestimates what is possible.

Conventional wisdom suggests that cutting food intake by 500 calories per day (3500 calories per week) equates to weight loss of approximately 0.5-1Kg (1-2lbs) per week. Yet a model based on recent research finds the rate is much lower. For example, the old calculations suggest it will take a mere five to ten weeks to lose 5Kg based on a 500 calorie per day restriction, whereas the new model estimates it taking over six months – assuming 100% compliance with the diet. Significant weight loss necessary for obese individuals to reach a healthy weight will take several years. No wonder so many weight loss regimes end with disillusionment, disappointment and failure – in short, unrealistic expectations.

Accurate estimations of weight loss based on calorie restriction can be found at www.pbrc.edu/the-research/tools/weight-loss-predictor and a more complex version taking account of exercise changes at http://bwsimulator.niddk.nih.gov.

Energy balance is only one part of the story though and the contribution of other factors and their interactions need to be addressed if weight loss efforts are to be ultimately successful.

Homoeostasis

Essentially, this describes how your body maintains physiological balance. Homeostatic mechanisms control essential systems like body temperature, breathing rate, heart rate blood pressure and so on. Homeostatic mechanisms also exist to maintain even weight in the face of fluctuating energy intake. In other words decreasing your food intake triggers regulatory processes designed to maintain weight. For example levels of the hormone grehlin rise with time since you last ate. Grehlin stimulates appetite, making you feel hungry. Another hormone, leptin, is an appetite suppressor and promotes fat burning, with levels rising during and after eating. Leptin is secreted by fat cells so as fat begins to accumulate leptin levels rise to suppress appetite and promote fat burning, thereby regulating weight back to normal. Why then, you might ask, do we get fat in the first place if these processes are so effective? It appears that the modern high fat, highly refined diet combined with certain lifestyle factors disrupt or override these balancing mechanisms.

Metabolic Syndrome

Elevated blood glucose levels, high cholesterol, elevated blood pressure and fat accumulation around the abdomen are collective called ‘the metabolic syndrome’. The underlying problem is one of hormone imbalance, specifically insulin, the hormone that transports sugars from the blood into cells to be used for energy. Consumption of highly refined carbohydrates such as processed food, fast food, white bread, cakes, biscuits and confectionary trigger insulin release. In time cells become resistant to insulin’s effects resulting in both high levels of insulin and sugar in the blood. As insulin is an anabolic hormone it promotes the storage of excess energy as fat, particularly around the abdomen and internal organs leading to weight gain. In addition excess sugar in the blood is linked with increased cardiovascular disease risk.

Metabolic syndrome therefore highlights one of the key limitations of the energy balance model, which considers all calories equally no matter what their source. Where 100 calories from a sugary soft drink are counted the same as 100 calories from wholemeal bread despite their very different effects on physiology. Recent studies show that following a diet that emphasises low glycaemic index foods such as wholemeal bread, whole grains, brown rice, beans, legumes, vegetables and includes adequate lean protein and fibre is most effective for promoting sustainable weight loss (2).

Leptin Resistance

Obese people tend to have high levels of the hormone leptin, which under normal circumstances is an appetite suppressant. In obesity though, the brain becomes indifferent to leptin’s usual effects and the normal feedback of feeling full when eating is effectively switched off. This is called leptin resistance and explains why when leptin drugs were developed to combat obesity they did not work. Eating refined carbohydrates, sugars and especially high fructose corn syrup (as used in many soft drinks) contributes to leptin resistance. Other factors include lack of sleep and cellular toxicity.

Toxicity

It is estimated that around eighty thousand new chemicals have been introduced into the environment in the last hundred years or so. Industrial activities, intensive farming methods, household and personal care products, cigarette smoke, plastics, tetraethyl lead hanging around in the atmosphere from the old leaded petrol days, the list goes on and on. Environmental toxins appear to affect thyroid function, and therefore metabolic rate, as well as triggering inflammation and disrupting hormonal controls of appetite and fat burning, including leptin. To make matters worse many toxins are stored in fat tissue, so the more overweight you are, the more toxic you are likely to be. In fact there is evidence that the release of toxins from fat stores during weight loss may actually inhibit further weight loss, providing another possible reason why hitting a weight loss plateau is so common (3).

Sleep

Recent research conducted in the USA found that American adults sleep 1-1.5 hours less than their counterparts in the 1960s and that since then those sleeping less than 7-hours has increased from 15.6 to 37.1% (4). One theory is that the advent of the internet, 24-hour TV, email, longer working hours, longer commuting times and more evening and weekend work has resulted in more sedentary behaviour. In addition, more time awake means more opportunities to eat, and with increasingly busy lifestyles, poor food choices are more likely. It is also possible that sleep deprivation and poor sleep patterns disrupt our old friend leptin, further increasing the likelihood of weight gain (4).

Stress

Stress hormones disrupt blood glucose levels exacerbating insulin resistance and metabolic syndrome symptoms (5). Stressed people tend to eat more refined and sugary foods, smoke more and drink more, increasing toxin exposure. And of course stress can disrupt sleep quality and duration. In short, if you are stressed you are making weight loss even harder than it already is.

The Bottom Line

For sustainable weight loss calorie restriction of only 250-500 calories less than normal weight maintenance intake is sufficient, but needs to be sustained consistently for many months, if not years. Opt for low GI carbohydrates such as wholemeal bread, whole grain cereals, brown rice, beans, legumes and vegetables with adequate protein from lean meat, fish, eggs, nuts, seeds and legumes. A varied diet that includes fresh fruit and vegetables, nuts and seeds provides vitamins, minerals a myriad of plant compounds that support detoxification, hormone regulation, inflammation control and energy metabolism. Ultimately weight control is not about ‘doing a diet’ for a few weeks, it is about a lifestyle that provides balanced eating with adequate physical activity and sufficient rest. It is time to move beyond calories!

References

1.            Hall KD et al. (2012). Energy balance and its components: implications for body weight regulation. Am J Clin Nutr. 95(4):989-94.

2.            Thomas DE et al. (2007). Low glycaemic index or low glycaemic load diets for overweight and obesity. Cochrane Database Syst Rev. (3):CD005105.

3.            Hyman M (2007). Systems biology, toxins, obesity, and functional medicine. Altern Ther Health Med. 13(2):S134-9.

4.            Chaput JP et al. (2008). The association between sleep duration and weight gain in adults: a 6-year prospective study from the Quebec Family Study. Sleep. 31(4):517-23.

5.            Nieuwenhuizen AG & Rutters F (2008). The hypothalamic-pituitary-adrenal-axis in the regulation of energy balance. Physiol Behav. 94(2):169-77.

The reality is that some people do very well on a vegetarian diet, some don’t. Some do fantastically well on a protein rich diet, others don’t. It is the same with exercise. Some people lose weight by running long and slow, others don’t. For some high intensity intervals work wonders, others see no difference. Again we are all individual, but what is it that determines these differences? How do you know you are eating and exercising in the right way for YOUR body? The answers lie in your genes.  Your genes, your DNA,  determine how you respond to food and exercise and explain how different people respond differently to the same diet and exercise regimes.

DNA tests have now been developed that unlock valuable information in your genes that can help determine your ideal intake of carbohydrate, protein and fat. This makes long-term weight management so much easier. In addition the test highlights the type of exercise that will get you the best results, and indeed whether exercise is something that will help with weight control at all– some people have genes that mean they won’t typically lose weight through exercise. It will also flag up potential issues such as inflammation or detoxification problems that are triggered by the wrong type of diet.

Once you know your specific genetic type you can adjust your food intake and exercise regime, optimising the beneficial effects of both and therefore maximising weight loss and overall health.

The test requires a simple saliva swab from the inside of your mouth, which is then analysed by the lab. It is so simple you can do it at home.

Increasingly genetic factors reveal the reason there are differences in response to diet and exercise recommendations. This simple test now provides a reliable way to find out your specific nutrition and exercise needs. No more guessing. No more trial and error. DNA testing is the future of nutrition and exercise prescription and allows for the first time truly personalised recommendations.

Find out more about DNA testing here.

Yet if you go out into the street and ask people how much fruit and veg they should eat as part of a healthy diet I suspect, although I have no actual data, that the vast majority of people would know the five-a-day mantra. The millions of pounds that have been spent on the five-a-day marketing campaign have, in my view, been hugely successful in raising awareness about the existence of a campaign. However, looking at the trend from 2006 to 2012, it is hard to view ‘five-a-day’ as anything but a failure.

The problem is that eating habits are just that – habits. And habits by their very nature are difficult to change. As a nutrition consultant working with a variety of clients in sport, business and every other walk of life, I face this exact same problem on a daily basis. People sit in front of me and nod enthusiastically when I explain what changes they need to make, and why, but getting someone to actually change what they are doing can take several sessions and many months of coaching, nudging and nagging. I see it at conferences and lectures too. I look out on people nodding, taking notes and fundamentally understanding what I’m saying. How many actually go away and change what they are doing I cannot say, but I suspect it is very few.

So the problem for the government and other organisations tasked with getting us to live healthier lifestyles is not one of getting philosophical agreement because by and large we have consensus. Smoking is bad, sedentary behaviour is bad, five portions of fruit and veg is good etc.. The challenge is to get the population at large to actually do something with the information, to actually change something, however small. In recent times there has been a greater emphasis on nudging rather than nannying. For example rather than simply telling people to cycle to work because it is healthy some towns and cities have invested in cycle lanes and cycle to work incentives.  In Bristol a scheme set up in 1998 has reduced the number of people commuting by car from 50 to 32%, whilst walking and cycling have both increased from a combined 26% to 42% ⁽³⁾. Moreover, those commuters getting to work under their own steam achieve 80% of the recommended weekly physical activity simply by going to work. That’s good nudging.

Convincing my clients to make dietary changes, when they have sought me out, paid me a fee and generally committed to a process of change is one thing. Convincing the wider population to make healthy dietary choices is quite another. I certainly do not have the answers, but perhaps the time has come to think beyond ‘five-a-day’ and its newer relative the ‘change4life’ campaign. Education is a crucial part of the process, but it is easy for people to nod, agree, then carry on doing what they were doing. The solution requires us to turn those nods into action, giving people realistic and practical ways to make small but important changes – something as simple as having fruit available in the workplace, for example. So rather than relying on the government for all the answers, perhaps we all need to think about what we can do to influence change in ourselves, our families our workplace, schools and local community. Philosophically we are all agreed, now let’s take some action.

 References

1. World Cancer Research Fund. Press Release: Only a fifth of Britons getting their recommended 5 A DAY. Accessed14/5/12.

http://www.wcrf-uk.org/audience/media/press_release.php?recid=194

2.  Daniel Martin. Great five-a-day flop: Despite £4m campaign, number eating correct amount of fruit and veg FALLS. Mail Online. Accessed 14/5/12.

http://www.dailymail.co.uk/news/article-1379776/5-day-campaign-number-meeting-fruita-nd-veg-target-falls-despite-4m.html#ixzz1uqwfConY

3. Brockman, R., & Fox, K. R. (2011). Physical activity by stealth? The potential health benefits of a workplace transport plan. Public Health, 125(4), 210-216.

All you need to do is have an enormous bowl of pasta the night before the race.

The Background:

Firstly, carbohydrate loading is only necessary where exercise lasts longer than about 90-minutes, which clearly includes the marathon distance. The purpose of carbohydrate loading is to promote maximum storage of muscle glycogen, the stored fuel that the muscles use during exercise. ‘The wall’ happens when glycogen stores become depleted, so carbohydrate loading is one of the strategies that will help avoid this undesirable outcome – others include doing plenty of long runs in training to train muscles to use fat more effectively, and consuming carbohydrates from drinks and gels during the race to spare muscle glycogen.

The History:

The legendary Ron Hill was the first athlete to use a carbohydrate loading strategy, doing so at the 1969 European Championship marathon, which he won. Early carbohydrate loading schedules included a period of carbohydrate depletion prior to the loading phase, which was thought to promote ‘supercompensation’ of glycogen. Athletes reported feeling dreadful during the depletion phase and it may even increase risk of injury. Fortunately the science of performance nutrition has evolved a great deal since then and the modern day protocol is much easier to follow.

The Facts:

An effective carbohydrate loading phase takes 3-4 days, so relying on one large bowl of pasta the night before is not going to cut it. The fact that you are tapering your training before the race automatically contributes to loading, assuming you keep eating your usual intake of carbohydrates. However in the final 3-4 days you want to aim for between 7-10g of carbohydrate per kilogram of body weight. So a 70kg runner will require between 490 and 700g per day. Eating this amount of carbohydrate requires a concerted effort, but rather than obsessively weighing all your food and doing sums simply ensure that all your meals are carbohydrate rich and include additional carbohydrate snacks and drinks over and above your normal intake. Breakfast cereal, fruit juice, dried fruit, bananas, bread, pasta, rice, pancakes and potatoes are all examples of carbohydrate rich foods that can be included in your loading phase diet.

Many athletes opt for a low-fibre diet on the final day of loading, which can help prevent abdominal gas and bloating in the race. Stick with white bread/rice/pasta, and avoid eating large quantities of beans and pulses (unless you know you get on well with them), and go easy on the vegetables and salads.

The Final Word:

By all means go to the pasta party the night before the race. Hopefully by that time most of your carbohydrate loading work is done, so opt for a normal sized portion and go easy on the high-fat salad dressings. You can also chose from the wide variety of other carbohydrate choices, so if you prefer a risotto go for it! Finally, after eating your normal carbohydrate-rich pre-race breakfast plan to do a final glycogen top-up by sipping a sports drink in the hour before the start, or consuming a gel about 15-20-minutes before.

Have a great race!

Paul Chamberlain is a sports nutritionist in Berkhamsted, Hertfordshire. Find out more.

Effective marathon training requires a dedicated, committed and disciplined approach to a programme lasting several months. During this time sacrifices need to be made, physical fatigue increases and there are likely to be highs and lows throughout the training period. Identifying this from the start will help prepare you for the long road ahead and means you can be better equipped mentally to cope with the reality of marathon training and racing. Here are some training and race day mental strategies to help you achieve your marathon goals:

During Training

Goal setting – Set both training and racing goals. The selection of achievable and realistic short-term goals for training (either time or distance) and long-term goals (build-up races such as 10km and a half-marathon) can help improve motivation and build confidence during preparation. For example set yourself mini targets each week of how much mileage you want to achieve and enter yourself into a couple of mid-distance race races with a time target to aim for and/or a race strategy that you want to rehearse. Remember to be realistic about your progress and build in flexibility to take into account your existing work and family commitments. With a realistic programme from the outset, you may find you can squeeze in the occasional extra run that will help boost your fitness and confidence.

Acceptance – One of the most important areas to focus on if you become ill or injured is acceptance. The resulting failure to adhere to a training programme may leave you feeling frustrated and disappointed. Try to accept the situation and focus on what you can do. For example, resting properly and eating well to aid recovery from illness, or rehab exercises after injury. You may have to reassess your goals, depending how close you are to race day.

Situation Training – Rehearsing pre-race and in-race fuelling strategies before the event, trialing the race kit and training at the same time as the race are all strategies than can have a reassuring effect, and limit distractions on race day. Find what works for you in training and stick to it on race day. Use build up races to fine tune your pre-race routines.

Self-awareness – Keeping a journal of successful behaviours after training runs can help to reinforce the behaviours that work well for you. For example, recording thoughts and feelings that occur during ‘flow states’ (when you are in the ‘zone’) and how you keep going during challenging training runs or build-up races provide a great source of evidence that will boost your confidence for race day.

Race Day Strategies

Race strategy – Determine a realistic pace and stick to it. The excitement of the start can mean you go off too quickly. Be prepared for that and manage it on race day. During a marathon you will typically experience physical highs and lows that require mental control, so use this time to think well and focus on positive self-talk rather than negative, self-defeating thoughts. Choose a couple of key meaningful statements that you can repeat to yourself when the going gets tough e.g. “I’m doing really well”, “I’m tough and strong”, “I’ve trained for this, I can do this, I just need to keep putting one foot in front of the other”.

Grounding techniques – Using techniques to help you feel ‘grounded’ at the start line and during the race can help bring your thoughts and feelings into the present, promoting moment-by-moment attention. This can help you stay focused on task related thoughts during the race, such as maintaining smooth rhythm and fluidity, rather than wasting energy on anxious thoughts. Grounding techniques may also help you to stay relaxed leading up to the big day. One simple grounding technique is to simply become aware of the feeling of your feet on the ground. Walk around and slowly become more and more aware of how your feet feel on the ground. Focus all your attention on those feelings. In this way you can quickly become grounded and in the present – the ideal state in which to enter ‘the zone’.

Body-scanning with visualisation – An effective way of focusing your awareness on what each part of your body is doing on race day. This can be a very relaxing experience for mind and body and when practised regularly can allow your body to feel more fluid and loose, improving your technique and allowing you to feel more comfortable. To body-scan use your sense of touch and visualise how each part of your body is working. Start at your feet and slowly scan over your body becoming aware of how each part functions. For example, “The soles of my feet feel springy as I make contact with the ground and I can feel the blood pumping through my calf muscles into my knee joints which feel flexible, soft and oily”. Just use your imagination and let your mind be free to describe how each body part is functioning. As with all the above techniques you will achieve the greatest benefits by using them regularly on training days before incorporating them on race day.

For more information on how sport psychology can help you to reach your marathon goals and overcome your limitations please contact:

Zoe Chamberlain – BASES accredited Sport Pychology Consultant. zoe.chamberlain@me.com            www.beyondsportpsychology.com

Readings:

Clough, P., Shepherd, J. & Maughan, R. (1989). Marathon runners and pre-race drop-outs. British Journal of Sports Medicine, 23, 97-101.

Dosil, J. (2006). The Psychology of Athletics. In: Dosil (ed.), The Sport Psychologist’s Handbook. Chichester: John Wiley & Sons Ltd.

Noakes, T. (2003). Lore of Running (4th ed.). Human Kinetics: Champaign.

Ogles, M. & Masters, K. (2003). A typology of marathon runners based on cluster analysis of motivations. Journal of Sport Behavior, 26, 69-85.

Salmon, P., Hanneman. S,  & Harwood, B. (2010). Associative/dissociative cognitive strategies in sustained physical activity: Literature review and proposal for a mindfulness-based conceptual model. TSP, 24, 127-156.

Stevinson, C. & Biddle, S. (1998). Cognitive orientations in marathon running and ‘hitting the wall’. British Journal of Sports Medicine, 32, 229-235.

Syer, J & Connolly (1984). Sporting body, sporting mind: An athlete’s guide to mental training. Cambridge: Cambridge University Press.

The words ‘golf’ and ‘nutrition’ are not obvious bedfellows in the eyes of many. When I mention to my sport scientist friends that I work with some elite golfers reactions range from raised eyebrows to full blown disdain. Golf, it seems, is still not regarded as a proper athletic endeavour in some circles. I’m talking about the elite players here, not your average weekend hacker, and anyone that knows about the game knows how hard many of these guys work on becoming better athletes. That means periodised strength and conditioning plans built around their tournament schedule, it means cardiovascular training, strength and power training, flexibility exercises and removing physical limitations.

The best athletes, in theory, should make the best golfers – at least physically. With the amount of time the modern professional golfer spends in the gym, it makes perfect sense for them to consider the nutritional aspects relating to their training, just like athletes undertaking strength and conditioning training in any other sport. That means paying attention to nutrient timing for fueling and recovery strategies, ensuring correct daily carbohydrate and protein intake and getting the right ratios of saturated, monounsaturated and polyunsaturated fats. Not to mention the necessary micro and trace nutrients required to support muscle repair and hormonal balance.

On top of the physical conditioning aspects, elite players have demanding tournament schedules that see them traveling all over the world to compete in far-flung time zones, often living out of a suitcase for many weeks on end. Eating a lot of hotel and restaurant food makes it harder to eat healthily so players need to understand what foods will help them achieve their personal nutritional goals, and in particular how to time the intake of foods to optimize for energy and recovery. This is pertinent when considering that a typical tournament day comprises at least one hour of warm up routines, a five hour tournament round, and usually some sort of warm down routine. That’s a long time to maintain energy levels and concentration, especially for four days of a typical tournament. Many tournaments take place in hot environmental conditions, making hydration strategies of paramount importance. Players need to understand their individual fluid requirements in a variety of conditions and when it might be appropriate to supplement with electrolyte solutions.

Finally, golf careers tend to be longer than in most other sports, with senior tour golf available to those over the age of 50 that want to continue to play competitive tournament golf. So there is also a role for nutrition in the promotion of long term health and injury prevention that perhaps has greater significance than for athletes in other sports.

To date there are no scientific studies on the role of nutrition in golf performance or training. Of course as far as the strength training aspects go there is a multitude of research literature on which to draw, but as far as the effects of different fueling, hydration and recovery strategies for playing the game itself, that work is yet to be undertaken. However, by understanding the demands of the sport it is possible to make solid nutritional recommendations to individuals based around their individual requirements. With some basic nutrition education tour players can make good nutritional choices that will maintain energy and concentration and help them recover quickly from the physical effects of relentless tournament play and travel.

Nutrition in golf is not critical to performance outcomes like it is in sports like marathon running, where if you get it wrong you do not finish. However, nutrition could be worth a shot or two due to consistent energy and concentration, and that could be the difference between winning and losing, making the cut or going home. Yes, you can get away with eating what you like, when you like, but many players are now approaching the game with a more scientific approach, and for them good nutrition is as important as swing mechanics and club fitting.

So what does this all mean for athletes? Do athletes need more vitamin D than the general population? Not according to the American College of Sports Medicine (ACSM), who recommend that athletes in northern latitudes and those training indoors should supplement with 200IU (5ug) per day(3). To date very little research has been conducted with athletes, and questions remain as to whether they will benefit from supplementation. A recent review concluded by saying that more research was necessary to determine whether vitamin D deficiency increases an athlete’s risk of injury and whether supplementation improved athletic training and performance (4). Fair enough I suppose. It would be great to see more research on vitamin D specifically in athletic populations. However, does that mean we should wait before recommending athletes to supplement? Not in my view.

Like the rest of the population athletes do no derive much vitamin D from the diet, typically between 100 and 300IU (2.5-7.5ug) per day (4). And like the rest of the population, athletes rely on UVB rays from the sun acting on the skin in order to synthesise the vast majority of daily requirements. In fact over 90% of vitamin D should be derived from the sun (1), and of course therein lies the problem. Athletes training/competing indoors most of the time do not get sufficient exposure to meet their daily vitamin D needs, and neither do the athletes training outside who slap on sun cream in accordance with government advice to protect against skin cancer. Factor 15 sun cream reduces UVB absorption by some 99% (1). In the winter it is even worse. In northern Europe the sun does not get high enough to provide any vitamin D benefit at all. In reality then, athletes are no different to the rest of the population in that vitamin D insufficiency is likely to be common, and in the winter at least, supplementation is the only viable option.

Whether athletes derive ergogenic effects from vitamin D is not the issue. Vitamin D deficiency and insufficiency increase the risk of a number of diseases, including cancer. So clearly the issue is one of maintaining long term health as a priority, with any performance benefits a secondary concern. Athletes may be at higher or lower risk of vitamin D deficiency than the general population depending on their training and competing environment, diet and other factors, and more research will help us understand this better in the future. For now though, my recommendation is for athletes to get a vitamin D test, either through their GP, or through one of the private laboratories that offer tests with finger prick home blood collection. As the lab test is relatively cheap, usually around £40-50, it is worth testing 2-4 times per year to ensure levels stay within the ideal range.

Vitamin D levels can be boosted easily in the summer simply by exposing arms and legs to 15-20 minutes of sun daily. Through the winter supplementation will be necessary and the level will depend on test results. 1000-2000IU of vitamin D3 per day may be adequate as a maintenance dose, but it is always worth seeking the advice of a sports nutritionist to help interpret test results and make appropriate supplementation recommendations.

For an excellent overview on vitamin D I recommend this article by Jack Challem.

References

1.         Pearce SH, Cheetham TD. Diagnosis and management of vitamin D deficiency. BMJ. 2010;340:b5664.

2.         Hathcock JN, Shao A, Vieth R, Heaney R. Risk assessment for vitamin D. Am J Clin Nutr. 2007 Jan;85(1):6-18.

3.         Rodriguez NR, Di Marco NM, Langley S. American College of Sports Medicine position stand. Nutrition and athletic performance. Med Sci Sports Exerc. 2009 Mar;41(3):709-31.

4.         Larson-Meyer DE, Willis KS. Vitamin D and athletes. Curr Sports Med Rep. 2010 Jul-Aug;9(4):220-6.

However, previous research with CoQ10 looking at both oxidative stress and performance outcomes have shown no benefit. For example, in a study of 10 male trained cyclists, supplementation with either CoQ10 or a placebo resulted in no difference between the groups in either a ride to exhaustion test, or in blood markers for oxidative stress after an eight-week supplementation and training regime (Braun, Clarkson, Freedson, & Kohl, 1991). Similarly, six weeks of supplementation with 120mg per day in a group of 11 male marathon runners and triathletes resulted in no difference in markers for oxidative stress and performance actually got worse in the CoQ10 group (Laaksonen, Fogelholm, Himberg, Laakso, & Salorinne, 1995).  In a double-blind, placebo controlled trial with 37 marathon runners, 90mg of CoQ10 and 13.5mg of vitamin E failed to inhibit muscle damage or oxidative stress any more than the placebo following a marathon race (Kaikkonen et al., 1998). In fact, it is difficult to find any other studies that support the hypothesis that CoQ10 prevents muscle damage in chronic exercise.

So what about these latest findings? Well, one explanation might be that endurance training appears to increase the body’s own antioxidant enzyme systems such as superoxide dismutase (SOD), glutathione peroxidase and catalase. In human subjects a correlation between VO_2max and cellular antioxidant capacity has been established, with both catalase and SOD significantly elevated in athletes with a VO_2max in excess of 60mL/Kg/min compared to moderately trained individuals (Jenkins, Friedland, & Howald, 1984). Changes in antioxidant enzyme status have even been reported after a single bout of exercise in healthy but untrained adults (mean VO_2max 44 mL/Kg/min) with total antioxidant capacity increased by around 8% compared to baseline immediately following exercise on a cycle ergometer (Berzosa et al., 2011). So it is possible that the athletes in this latest study were not elite. Fit, yes, but not elite. Their exact VO_2max is not specified, but their average age was 41.25 ± 2.84 years in the CoQ10 group and 39.75 ± 2.92 years in the placebo group, suggesting sub-elite status. Additionally, CoQ10 levels tend to decline with age, so perhaps this group were more likely to see effects from CoQ10 supplementation than a group of younger elites?

What the literature does seem to suggest is the better trained the athlete, the better their antioxidant capacity, and the less prone they are to inflammation and oxidative stress in spite of high training loads. Therefore CoQ10 and other antioxidant supplements may offer some benefits to less well-trained athletes, as long as you don’t subscribe to the theory that oxidative stress is necessary for training adaptations to take place – but that’s another story! As with all these things, the reality is somewhat more complex than the headlines would suggest, and the more you delve, the more confusing it can get. More research is required to validate these latest findings, and suffice to say, there’s absolutely no substitute for good training and good eating, and whilst supplements do have their place, the fundamentals have to be in place first.

References

Berzosa, C., Cebrian, I., Fuentes-Broto, L., Gomez-Trullen, E., Piedrafita, E., Martinez-Ballarin, E., . . . Garcia, J. J. (2011). Acute exercise increases plasma total antioxidant status and antioxidant enzyme activities in untrained men. J Biomed Biotechnol, 2011, 540458. doi: 10.1155/2011/540458

Braun, B., Clarkson, P. M., Freedson, P. S., & Kohl, R. L. (1991). Effects of coenzyme Q10 supplementation on exercise performance, VO2max, and lipid peroxidation in trained cyclists. Int J Sport Nutr, 1(4), 353-365.

Diaz-Castro, J., Guisado, R., Kajarabille, N., Garcia, C., Guisado, I. M., de Teresa, C., & Ochoa, J. J. (2011). Coenzyme Q(10) supplementation ameliorates inflammatory signaling and oxidative stress associated with strenuous exercise. Eur J Nutr. doi: 10.1007/s00394-011-0257-5

Jenkins, R. R., Friedland, R., & Howald, H. (1984). The relationship of oxygen uptake to superoxide dismutase and catalase activity in human skeletal muscle. Int J Sports Med, 5(1), 11-14. doi: 10.1055/s-2008-1025872

Kaikkonen, J., Kosonen, L., Nyyssonen, K., Porkkala-Sarataho, E., Salonen, R., Korpela, H., & Salonen, J. T. (1998). Effect of combined coenzyme Q10 and d-alpha-tocopheryl acetate supplementation on exercise-induced lipid peroxidation and muscular damage: a placebo-controlled double-blind study in marathon runners. Free Radic Res, 29(1), 85-92.

Laaksonen, R., Fogelholm, M., Himberg, J. J., Laakso, J., & Salorinne, Y. (1995). Ubiquinone supplementation and exercise capacity in trained young and older men. Eur J Appl Physiol Occup Physiol, 72(1-2), 95-100.

I bring this up because I am a big fan of eggs and consider them to be, in moderation, a great addition to a healthy diet. Eggs contain a wide variety of nutrients (USDA, 2009), most notably; eggs are a good source of very high quality protein, about 6g for a medium sized egg, with relatively low total fat content compared to other protein sources such as meat. They are rich in monounsaturated fats (similar to the fats you get in olive oil), and polyunsaturated fats, specifically omega-3 and omega-6. These ‘essential fatty acids’ are important for cell membrane health, nerve function, hormone health and skin health, to name but a few. They are also a source of vitamin D, the sunshine vitamin, which supports immune function and mood and tends to be in short supply in the UK during the winter months. Eggs also provide vitamin B12, which is necessary for a number of metabolic processes including energy production from fat. B12 is predominantly found in meat and fish, so eggs provide an important source for vegetarians.

So what about cholesterol? Well, a medium egg contains around 185g of cholesterol – all within the yolk. However, early studies suggesting a linear correlation between egg consumption and cardiovascular disease appear to have been flawed, and in a review of all the available literature a study in 2009 concluded that the risks had been over stated. Furthermore the authors suggested that up to seven eggs per week was ‘harmonious with a healthful diet’ (Jones, 2009). Even in those with elevated cholesterol, evidence suggests that eggs will not elevate it further, although cutting down may improve matters (Njike, Faridi, Dutta, Gonzalez-Simon, & Katz, 2010). Whilst the link between eggs and cardiovascular disease has been over stated some caution is still advised among certain populations, notably those with diabetes, a disease strongly linked with cardiovascular disease (Djousse & Gaziano, 2008).

So in moderation, eggs can contribute to a healthy diet. They are great at breakfast, versatile, quick to make into tasty meals and relatively cheap compared to other protein sources. So as the science becomes clearer it seems high time eggs lose their cholesterol stigma and are enjoyed by more people with a clear conscience.

 References

Djousse, L., & Gaziano, J. M. (2008). Egg consumption in relation to cardiovascular disease and mortality: the Physicians’ Health Study. Am J Clin Nutr, 87(4), 964-969. doi: 87/4/964 [pii]

Gray, J., & Griffin, B. (2009). Eggs and dietary cholesterol – dispelling the myth. Nutrition Bulletin, 34(1), 66-70. doi: 10.1111/j.1467-3010.2008.01735.x

Jones, P. J. (2009). Dietary cholesterol and the risk of cardiovascular disease in patients: a review of the Harvard Egg Study and other data. Int J Clin Pract Suppl(163), 1-8, 28-36. doi: IJCP2136 [pii] 10.1111/j.1742-1241.2009.02136.x

Njike, V., Faridi, Z., Dutta, S., Gonzalez-Simon, A. L., & Katz, D. L. (2010). Daily egg consumption in hyperlipidemic adults–effects on endothelial function and cardiovascular risk. Nutr J, 9, 28. doi: 1475-2891-9-28 [pii] 10.1186/1475-2891-9-28