Home / Articles / Q & A / Going Postal / Oct 25 2002

Going Postal
We respond to the good, the bad, and the ugly of this month's mailbag.

You often write about creatine supplementation and I understand that you include it in the programs of most of your clients and athletes. Why?

While some people may argue this point with me, I think that continual creatine supplementation is essential for good health as well as athletic performance. While creatine has been discussed in the athletic context quite extensively, it has some amazing regenerative effects on all tissues of the body including brain. I think that historically we humans have had a high creatine intake (due to eating a lot of meat) and we've physiologically adapted to this intake. Now, unfortunately, most people dont get enough of it in the diet so there is a subclinical deficiency. There are others, of course, that eat enough meat or have upregulated endogenous creatine production and we call these people "non-responders". But the majority of people out there will receive benefit from creatine supplementation.

Therefore, to give the body what it requires, I usually recommend 3-5g per day, every day. Using this amount of creatine should increase power output by about 10%. For youngins, this means heavier loads in the gym, more explosive lifts, and increased athletic performance. For older folk, this means more daily functional capacity. Since 3-5g per day is a rather modest dose, water retention, cramping, etc. isn't an issue (cramping isn't usually an issue even at higher doses).

For the record, I do believe the theory behind proper food combining (i.e. your Massive Eating ideas) is valid, but every once in a while I come across the skeptics, especially on the Internet. Some claim that the digestive system is very adaptable and can handle all three macronutrients at the same time. Others claim that there was a recent study comparing food combining to regular "balanced" eating and there were no advantages to food combining. What say you?

Although I could write about this all day, I'll keep it simple and stick to the basics. First of all, there are many types of "food combining" diets out there. Now, my ideas, unlike many other "food combining" gurus, are not about the digestive system's "handling" of nutrients as some might suggest, they're about the endocrine response to those nutrients. Of course the digestive system is adaptable and can process all the macronutrients at the same time! That's what I'm afraid of. If the body dumps large amounts of protein, carbs, and fat into the blood at the same time, you're in an ideal fat gain situation.

As far as the one research study they often mention, I've read that study and it uses obese people on hypocaloric diets. The results - both the food combining and the "balanced eating" approaches yielded the same results. Neither was better than the other. So as I see it, there are a few problems with trying to use these data to refute my ideas. The biggest problem with that approach is that Massive Eating is designed for lean people on hypercaloric diets.

Results and feedback from hundreds, if not thousands of my clients/readers have demonstrated that my Massive Eating ideas work. They allow people to eat far more calories in a day with far less fat gain. As with all scientifically "unproven" theories, there are always opponents. I just wonder if the opponents have ever even bothered to try out the very ideas (on themselves and enough others to objectively assess them) they rail against.

Some people are too resistant to the possibility that things might change. Perhaps more data will show that I'm off my rocker and that my Massive Eating ideas don't work. But regardless, when you hear people refuting ideas that seem to make a whole lot of sense, remember that there are still people out there that believe a calorie is a calorie.

I've been following your Creation of A T-Man article and I'm making great progress and loving it. At this point, it's about the 5-week mark and the program requires a week of active rest. What would you suggest?

In my opinion, the whole point of an active rest week is physical and mental rejuvenation. Therefore during the active rest week I would do very little of anything programmed. I might do some cardio if so inclined, might lift a little bit (lighter weights, higher reps), or might just skip the gym altogether and play some squash/racketball, go bike riding, or play some football with friends. My buddy Austin goes out and surfs. As you can see, active rest is a way to take a week away from heavy loading on your joints and muscles. So go out and explore the things that you enjoy most outside of the gym.

I have a quick question for Tammy regarding diet for autoimmune conditions. Some web sites have suggested that diets low in starchy carbs and sugars are helpful in individuals with autoimmune disease. I realize that most nutritional "experts" think that low carb/high protein diets are a mistake but as a RD, what are your thoughts?

After trying everything, I have become a critical reader about the information floating around out there. Every source will say something different in terms of therapies and diet. To this end, I haven't heard about avoiding starchy carbohydrates and sugar for our conditions, although the new breaking news is that a certain type of carbohydrate found in the joint (glucosaminoglycans) has been recently implicated in the disease process of RA. Any dietary connection, however, wasn't mentioned.

Anyway, I would say that watching the starchy carbs and sugars is good advice for the general population! Although starch can serve a purpose in maximizing glycogen stores, say after weight training and before ultra endurance exercise, our society eats more than the recommended portions. As a 'dietitian,' I was taught that the perfect ratio of carbs, protein, and fat should be 55-60%, 12-15%, 25-30%, respectively. However to prescribe this general ratio to the masses that vary in activity levels and exercise types (for those who do exercise), doesn't make sense to me. I believe a high carb ratio, (especially with carbs being over 60% of total calories) can easily happen when individuals pig out on carbs and fat-free foods to loose weight, and may have created a backlash with an increased incidence of insulin resistance, syndrome X, and now polycystic ovary syndrome in women. So I may be one of the few dietitians who doesn't completely subscribe to the traditional recommendations. I tend to personally gravitate towards a more balanced approach of 50/25/25 and sometimes 40/30/30. However, I do not personally calculate my caloric intake on a regular basis. I do eat pretty clean, with high fiber breads, lots of fruits and veggies, a minimal amount of processed foods, and healthy fats. Like I mentioned, I do supplement protein to ensure I get my 2g/kg/day!

Is there any research you may be aware of that talks about the physiological difficulties in gaining mass with an RA affliction? (I'm talking about outside of being able to actually do the exercises). Have you by any chance in your studies come across any info (or personal experiences) about diet/exercise for bodybuilding purposes while afflicted with RA or AS? I have been scouring the internet and school library on this subject for the last week or so and haven't gotten much other than exercise is recommended, be careful of joint pain, etc., but nothing on how, or whether it is possible, to achieve appreciable amounts of lean mass. Any advice, info, people to talk to, etc. that you could pass on would be greatly appreciated.

To answer your question, as far as I know, the muscle atrophy that takes place in RA, or I suspect other deformity diseases, would be due to eroded ligaments that cause pain and the inability to achieve normal range of motion, and structural deformities, causing the inability to to train those muscles. And there's something called, "cytokine hyper metabolism, or cachexia."

In autoimmune diseases, the pro-inflammatory proteins that are increased during flare can signal the central nervous system to induce appetite changes, depression, and anxiety, which, along with the pain and abnormal physiological changes, can create a environment for muscle wasting. However, I haven't seen anything yet on the disease process, itself, attacking the muscle. In other words, I don't think RA is a 'muscle disease.'

I think in my case, the synovial lined joints and the surrounding cartilage is affected. If so, this is good news. It means, that I can possibly halt the progression of any atrophy. However, I think dreams of being a professional bodybuilder may be a bit lofty. Unless one has minimal damage and is in remission, I don't think gaining huge increases in muscle mass is realistic. If one is training that hard to gain muscle, it may be at the expense of their affected joints and tissues. You will really have to pay attention to how you're feeling and obey your body signaling you that it's too much. You may need to revise your fitness goals, perhaps focusing on strength and function, rather than mass and weight. I say this, because for me, going into the gym with a bodybuilder attitude and with my bodybuilding goals became too painful and discouraging for me. I had to change the way I saw myself in the gym and revise my reasons for being there. With that said, I still have great results! And a better attitude. Although I don't compare to the buff 20 year olds in the gym, I would still blow away women at my class reunion. I've had to learn to keep things in perspective this way!! So I would say, go for it, pay attention to your body, eat enough and be sure to get enough protein!!

I have a question regarding your article Precision Nutrition. I'm using the article for a literature summary in my technical communication class. In explaining the Acute-Phase Response, you stated, "Simultaneously, growth factors from a place outside the cell called the extracellular matrix are brought into the cell." What are these "growth factors"? I don't need anything detailed, just a name for them would be great. Thank you in advance.

Some of these growth factors may be GH, IGF-1, and probably others that we dont know about or are too speculative to mention.

Well here's a follow-up to that one. You said: "Some of these growth factors may be GH, IGF-1,..." However, earlier in your article you said that the endocrine response probably had little to do with increasing muscle mass. Is there another way that these hormones cause an anabolic response, during tissue repair and something else? I would greatly appreciate any clarification.

The IGF-1 and GH may be located right there in the matrix, hanging out and waiting for repair. So, when the muscles are injured, satellite cell activity is stimulated and this signals the GH and IGF1 to bind to the membrane, signaling a cascade of repair events. When I stated that the "endocrine response isn't that important", per se, I meant that the release of additional hormones and their measurement in the blood is not as important as most people think. In this case the hormones are already there and therefore simply bind the receptor sites.

In addition, there are other peptides that may act in this process. I've heard so many speculated about that I dont even want to mention any of them. A lot of these discussions are theoretical.

I'd like to go in for some comprehensive bloodwork, and this requires a 12-hour fast. Depending on when you wake up, how long you wait in the office, I bet this fast could stretch to 16 hours. Is there any supplement (amino acids, antioxidants, etc.) I can take during the "fast" that won't screw up the bloodwork? If not, what should I take or eat before and after to reduce the damage? Finally, would these bloodsuckers affect my training--either before or after the test?

Quick answer...dont worry about it! One night of prolonged catabolism (liver glycogen depletion with consequent gluconeogenesis and reduced muscle anabolism/decreased muscle catabolism) can be corrected within the first 2 - 3 meals after the fast without issue. Besides, even if it wasn't, it's my opinion that it's more important to get accurate blood work than preserve a few milligrams of muscle amino acids/protein.

Or you could just take a whole bunch of anabolic steroids. They reduce muscle protein breakdown and increase muscle protein synthesis.

As far as eating before and after the fasting period, eat before a fast just like you would before bed (see my Bedtime Story article) and eat after a fast like you would in the morning (quicker digesting protein and carbs).

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