Maximizing Body Composition and Metabolism with Exercise and Nutrition |

Thank you. A big thanks to Joan for
that very nice introduction. And thanks for all
of you for coming. This is quite a
large auditorium. So it’s nice to see
a number of bodies. I’ll try and span the room
when I talk, but very honored to be here and excited. NSCA is one of my
favorite organizations, particularly because
of the diversity. And so it’s really fun
for me, as a researcher, to be able to take some of the
things that we do in the lab and provide them to a
lot of practitioners that can really change and
utilize what we’re doing. However, it’s a little
bit hard to put together a talk to touch upon
the practitioners, and the clinicians, as
well as the researchers. So my hope today is to
really be able to provide some information and at
least allow you to take away one pearl of knowledge to
use in your everyday life, or using with your
clients, or stimulate a question for me that
maybe can help me come up with a new research idea. So the title of my talk– I’m going to really be talking
about some aspects of body composition, metabolism,
and incorporating exercise and nutrition. Before we begin, just a general
conflict of interest nature, I do have research
funding from the NIH and some industry
sponsored trials. And that is based on some of the
data that I’ll present today. So general objectives today– I think there’s a
big misunderstanding of body composition. So I want to briefly give an
overview there and maybe give you a different
insight on how to view body composition, measurement,
and what those values mean; talk about evidence-based
strategies for improving body composition,
maximizing fat loss, and nutritional manipulation. I’m sure many of you just came
from Bill Campbell’s talk. He did a great foundational
view of some of the things I’m going to talk about. And to be honest, I
was a bit selfish. I wanted to pack a ton
in this to give you all a different view or
at least, like I said, take a diverse view on some
aspects of the research. And then I also briefly wanted
to talk about metabolism, or some key pieces of metabolism
that are often overlooked, and maybe a
different perspective that you can look at with your
clients or in the research lab. So to begin, body composition
is a passion of mine, partly because it’s
widely misunderstood. And it’s an area that we can
do a lot more research in. But also because there’s a
big practical application. And let’s be honest,
most of us want to be a little bit leaner, or
lighter, or bigger muscles, right? So it’s nice to study that. So first, just a brief
overview, just to set the tone with body composition. It can play an important
role in a number of things. But when you think about how
you might apply it in the lab or with your clients, you can
really use body composition to formulate more
evidence-based diet and exercise recommendations. We can evaluate sex-based
differences with an exercise or nutrition program. So I’m really interested in
how men and women respond differently or the same
to exercise and nutrition. And then we’ve also used
it as an interesting way to monitor injury status,
injury risk, and return to play. But it’s rarely used. And so I can’t see any of
you because the lights are so bright, but I would ask
you who uses body composition. And some of you probably do. But it’s expensive. It’s really hard to interpret. It takes a lot of time. And it’s costly. But there are some key things. And what I would even
encourage you to do is to collaborate with
your resources around you or dedicate your time to one
small piece of measurement, whether it be skin folds
or A-mode ultrasound, or collaborate with
someone that does DEXA. I want to give you some
key things to look at. And another view, too,
is that you really can’t tell by looking at
a person what their body composition is. Sometimes, it does
need to be measured. And it really allows you
to track some changes. So one thing I just
wanted to put out there– when I was going through
school, the gold standard was underwater weighing
or hydrostatic weighing. It’s still in some textbooks. However, what we know
is the gold standard is the multi-compartment model
or 4C model, which is here. And basically, we
know that the more compartments you measure
the more accurate the body composition. So we use that as
a gold standard. But it takes a lot of time,
and money, and resources. And so what we’ve
done in our lab is to create a four compartment
model just using DEXA and a body water measurement. So essentially, we can measure– let’s see– we can measure
fat mass, lean mass, and bone from DEXA, and determine body
volume, which we would normally use from a BOD POD. We can use the DEXA and then use
a total body water measurement. So essentially, creating a gold
standard with much less time. And partly, why I share
this is really more for an accuracy description. So I’ve given you
an example here. If we’ve done a 4C model, if
we take a 20-year-old female, you can see her stats there. Body volume measured by
BOD POD, total body water by a bioelectrical impedance. DEXA is going to give
bone mineral content. You can see the body volume
differences from BOD POD 76.2 liters versus DEXA
derived body volume 76.1, so very accurate, very similar. When we apply this, comparing
different types of body composition measures, you
can see the 4C gold standard gives us a 35.7% body fat. BIS alone, which is a body
water, very hand-held cheap, inexpensive, you can see 32.6%,
BOD POD, so forth, and so on. You can see that 4C
model DEXA-derived is fairly accurate with
that 4C gold standard. So why I’m telling
you this is it’s important to recognize the
error within the device that you’re using and be
comfortable with that error. So it could be plus or
minus 3%, plus or minus 6%. And let me show you an
application to that. So really, we’re usually
more interested in the change or how sensitive a
measurement might be. So I would generally
consider a good device error of 3%, plus or minus 3%. So that would mean maybe
today I’m 30% body fat, maybe tomorrow I’m 33% body fat. And that would still
be fairly reliable. So that means when you
measure body composition, you need to make sure
you’re not measuring it too frequently because you won’t
be able to detect that change. So for example, if you have a
200 pound male at 20% body fat, you can see the stats. After a 3% loss, fat loss,
that’s a weight of 194 pounds. That’s a 6 pound loss of fat. Which any of you trying to
lose weight with your clients or induce that, that’s
a pretty big change. But basically, if you split
that up one to two weeks that gives you a
minimum of three weeks. And I bring this up because
when I was a college athlete– I don’t know if Dr.
Mayhew is in the room– but he used to measure
body composition on the cross-country
team every two weeks. And it was my least
favorite day of the season. And my argument would be they’re
really not detecting changes, right? That’s not real
enough to change. So that’s something
to keep in mind is the device error and then
how frequently of measurement. And then I just wanted to
put this in perspective. Obviously, the amount or cost
of the device is important. So if you’re measuring
using total body water, that’s going to be
a higher percent fat needed to be
deemed real, so as you can see, up to 4%, 3.84%. BOD POD is fairly reliable,
so a smaller change, same thing with DEXA by itself. But the more compartments
you can measure, for example, if you can do total body
water and a BOD POD, your error becomes less. And you become more
sensitive to that change. So with that, I want to show
you how we can apply this. So one concept that
my lab is interested is in the concept of
fat free mass index. This is the original
paper that we published. Really looking at the previous
published fat free mass index data demonstrated that upper
limit of fat free mass index that someone could
have was fairly low, so, basically, 25 kilograms
per meter squared. And what this all means
is or the way I view it is a value that you can use to
anticipate how much muscle mass someone can hold. So if you have someone that’s,
let’s say, a freshman coming in to work with you or
someone that’s untrained, if you can estimate their
fat free mass index, you can see maybe where they’re
at for their male counterpart– I’ll give you some
female values here– and say, OK, they’re on the
low end of the spectrum. And they can gain 5
kilograms of fat free mass. Or maybe they’re
on the upper limit, and we know that they’re
at their upper limit. So you can see this is a neat
figure, one of my doc students put together, looking at a
fat free mass index spectrum. And you can see at
the upper limit is 32 kilograms per meter squared. So in this case, if you
have a football player that has a fat free mass
index of 30, you know that he’s at
that upper limit. And to date, there’s
no data on females. So I pulled this together. And one of my other
doc students presented some of this data earlier. You can see the upper
limit is much lower. But the best example
here is, notice, that a 12.8 is a very low value. So we generally have that from
our cross-country runners. If you’re on the
low end, we know, which I’ll show you
here in a second, that low lean mass is more of a
predictor of injury and stress fracture in
cross-country athletes. So we can maybe shoot to
increase their fat free mass index and put them
on a better spectrum. So let me show you– and this
we’ll eventually write up. But seeing some of the
sex-related maximum fat free mass index may be
valuable to calculate. The other thing to think about
is muscle characteristics. So this is probably more of
a laboratory-based measure. But I want to provide it because
it’s kind of insightful when we look at some of
the applications, so basically, being able to
measure muscle size or quality, what’s in the muscle,
so for example, about how much adipose
tissue, connective tissue. I always like to show
a picture of steak. You may never look
at steak the same. But that fatty
infiltration arm muscles are very similar, right? And a lower muscle quality has
less or better muscle quality has less fat infiltration and
is more like a filet, right? So when we look at some of
the applications of this, muscle characteristics
can be helpful. So let’s look at one approach
to exercise in cross-country. We have some interesting data
on cross-country endurance-based athletes and how it may
influence body composition. So specifically, we wanted to
characterize body composition in this group because
there’s very little data, as well as look at stress
fracture, and some indicators there because there’s
also very little data. And so you can see, one
thing I’ll point out is the percent fat category. Notice that these
individuals, despite being male and female
cross-country athletes, are really not that
lean, so about 20%, 16%, 17% to 20% body fat. And then there’s
significantly more or higher body fat in that group of
individuals with a stress fracture. And then when we look at some
other muscle characteristics, they have lower lean mass, lower
muscle size, and poorer muscle quality. So essentially, we took
this, and shared this with our strength staff,
and basically said, there’s one way you can fix
all these reoccurring stress fractures. And that’s lift heavier
weights or incorporate that into volume. And they listened. We need to retest and
look at some of this. But you can notice too that
bone mineral density and bone mineral content were not
different between groups, so a different
view of how muscle may be a better indicator
or maybe a better approach to injury prevention. Now, I have a big interest
in high intensity interval training. And so just brief
education– so a lot of the data, the
foundational work, is on sprint interval training. And that’s like a repeated
Wingate, very effective. Hands of who’s done
a Wingate in here? OK, so most of you. It sucks, right? And then for sprint
interval training, you generally have to
do four to six of them with four minutes
of rest in between. And so it works, right? But part of what my lab
spends a lot of time doing is looking at practical
and feasible approaches to exercise and nutrition. This is not practical
nor feasible. You need specialized equipment. And you need a
lot of motivation. So I’m not sure my
video will work here. I don’t think it– I don’t have a clicker. But this was an
example of a Wingate. You can go try it on your
own if you’d like to see it. Oh, it’s going to work. My friend over there
will hit it for us. [VIDEO PLAYBACK] – Go, go, go. Quick, quick, quick. So as she is doing it, part
of why it’s not feasible is because you have to have a
percentage of your body weight that’s dropped on
the weight as you go. And so this individual, who
happens to be in the audience– I won’t call her out. That’s part of the fun of
working in my lab, right? You torture yourself. But she’s very endurance based. So she is actually
doing a pretty good job maintaining power output. It lasts 30 seconds. And then, for the
sprint protocol, you rest four minutes. So one of the
aspects of HIIT that is supposed to be important
is that it’s time effective. [END PLAYBACK] If you’re resting for minutes
in between four to six reps, you might as well just go do
something else in my opinion. So we’ve looked at some other
approaches of HIIT, which is more 10 bouts of one
minute on, one minute off, five bouts of two minutes
on, one minute off, or three to four four-minute
bouts of three minutes rest. We’ve used this in a
number of situations and clinical populations. Maybe you can play that quick. This one is a running version. And I just want to show
you part of how we do it is we have the treadmill going. You jump on. This is running about
11 miles per hour. And then we have the
individual jump off. Obviously, we modify it. We’ve done this with a lot
of clinical populations. So some of the
applications of this– I just wanted to show you how it
might be an effective approach. And I’m sure you guys all know. HIIT has caught
on like wildfire. But I want to show you
some of the evidence and really to think
about how you do it. So these papers are
based on the two minute on, one minute off, or one
minute on, one minute off in overweight,
obese individuals. When I first tried to do
this study, a lot of people said, there’s no way you’re
going to get overweight and obese people to do this. And actually, it was the
most highest compliance group I’ve had with no
adverse effects, significant improvements
in body composition and even greater in women, and
improvements in VO2 and insulin sensitivity. And then the other thing that
we know, and data is gathering, is that we actually see a
greater loss in abdominal and/or visceral
fat based on some of the physiological
mechanisms that visceral fat is targeted more. So this can be a very
practical approach to improving cardiovascular
and metabolic health as well. And then ours is one
of the first labs to look at the influence
of HIIT on muscle. So can you increase muscle
from an aerobic-type exercise? And you can. So we just published this paper
that basically demonstrates that HIIT increases
lean mass significantly as well as improves
cross-sectional area and echo intensity. And that’s muscle quality. So essentially, in
this particular study, we showed that one minute
on, one minute off 10 times– three times a week in
this particular study– significantly improved
muscle cross-sectional area and lean body mass. So if you think about that,
that becomes very important or a potential
importance for being able to maintain or improve
cardiovascular health by also improving body composition. We need to look
a little bit more at mechanisms, the
neuromuscular changes. But some of that
conversation came up, and maybe some studies
moving forward there. So let’s talk a little bit
about combining some of these, or some views on
nutritional approaches. So this was a study that I did
a long time ago, but it’s still, I think, one of the
quintessential studies that looks at and
supports that notion that interval training
combined with nutrition can actually be anabolic. And so this is three weeks
of running on a treadmill. This protocol used two
minutes on, one minute off. And it was originally designed
to look at a supplement. So I necessarily wouldn’t
pick this supplement, but I think it’s
pretty insightful. So it was a
pre-workout supplement that incorporated whey,
creatine, a mushroom, and caffeine versus
a carbohydrate. Significantly increased VO2
max– that’s pretty standard. But body composition
or lean mass was significantly elevated
in that treatment group only. And I’ll show you that
here, so pretty interesting. And so it was about one and a
half kilograms in three weeks. And I’m a body composition
nerd, so the first question you should all ask– is
that really significant? Did that pass the
measurement error? And it did. So this tells me that there
was a legitimate, real change in lean mass. And so that started
me thinking, OK, what if we provide whey
in our pre-workouts? Many of you will have amino
acids in your pre-workouts, but you need all nine
essential amino acids to stimulate muscle
protein synthesis. So that whole whey may
be anabolic combined with that interval training. So speaking of protein,
Bill did a good job talking about the importance. And we all know there’s
some really great data that talks about how
much protein, and if not, there’s another
pearl of knowledge. We know that it
used to be thought that you should consume only 20
grams of protein per setting, per meal. That’s all you could
digest and absorb. What we now know is that it’s
more probably dependent on how much lean mass you have. So if you have more
lean mass, you probably could consume upwards
to 40 to 50 grams. And then this is a
really great study, more of a review
that looks at, OK, so let’s say that I’m already
consuming a high-protein diet, but my goal is still
to increase lean mass. You probably have
people like that, especially in this
low-carb phase. And what we know is that
increasing lean mass and strength made me more
dependent on that change in protein intake. So let me show you an example. So this review
particularly suggests that you need a 60% increase
in the amount of protein that you consume. So if we take a baseline
1.3 grams per kilogram per day of protein– here, I’ve given you just
a male and female example. So your male would be about
a hundred grams of protein. Your female would be
about 83 grams of protein. And so a 60% increase
from that 1.3 is going to be about 2.01
grams per kilogram per day, which some would
suggest is that that’s on the high-protein diet. But it’s getting that change. And so you can look at
that value of protein, 155 grams for the male,
128 grams for the female. What the current
literature suggests is that’s really not too
high, and it’s maybe just a different way to look. Or even if you yourself are
trying to put on lean mass, maybe it’s that change. So let’s say you’re
already consuming two grams per kilogram of protein. Look and calculate a
60% greater increase, and that may be what you
need to increase lean mass or stimulate lean
mass and strength. And then the other
concept I want to talk about that is often
overlooked but, to me, is a very simple, practical
way to look at body composition changes is manipulating
macronutrients. So in this particular study, it
was a weight-loss intervention, 10 weeks, 1,700 calories,
so nothing drastic. They labeled it a carbohydrate
group and a protein group. But what I want you to view
is really the ratio of carb to protein. So you can see, in the
carbohydrate group, that’s how most typical Americans eat. 3 and 1/2 to 1 is
the ratio, so about three and a half grams
of carbohydrate to one gram of protein. So you can see that’s
about 240 grams of carbs versus 68 grams of protein. That’s a pretty typical
American’s consumption. Or a lower carb
to protein ratio– you can see 1.4
grams of carbohydrate to one gram of protein. So you can see that’s
more of 171 grams to 125 grams of protein. So I want to talk
about this because– I’ll show you some
more application here. But basically, this study
showed similar caloric intake, but that lower
carb-to-protein ratio lost more fat and
maintained more lean mass and were more
satiated, essentially. And that happened at about
four-week time period. And so I like this
because, in my mind, it’s not really
saying, eat less. And it’s not saying,
eat less carbs. It’s really just saying, pair
your protein with your carbs. And if you change your mindset
with researchers, with clients, it actually oftentimes means
eating more food and thinking, being more conscious. And so it’s an easy behavior
change without saying, don’t eat all this, or
eat a whole lot less. And I’ll show you some
of that application. This is not a follow-up
study, but I’m not sure if you guys are aware. Well, one, I should
make a disclaimer. I’m a big proponent of
supplements because they’re feasible and some of them work. And this study was in the New
England Journal of Medicine in 2013 and basically said,
second to bariatric surgery, a meal replacement is the most
effective way for weight loss. And if you think about
it, it makes sense, because it’s the least minimal
changes to behavior, right? And so we did this study as a
follow-up– or not a follow-up but in conjunction when I was
at University of Oklahoma, and basically provided a very
high-quality meal-replacement shake and had them consume
whatever else they wanted throughout the day. We did have a supervised
exercise group, and we measured a
number of things. So I wanted to show you
the supplement facts panel. And I’ll call out,
this meal replacement is actually a 1 to 2
carb-to-protein ratio. And that’s partly why
it was so effective, because it’s giving
boluses of protein, and it was also high fiber. And you can see 300 calories. And we actually had
them consume two of them a day throughout the study. So I’m going to show
you some of the results. So when we look at
that total calories, calories did not change
even though we said, you can eat whatever you want. But the
carbohydrate-to-protein ratio was significantly
reduced when they started consuming one shake. And that, in my opinion,
was the biggest factor why we saw changes that we did. So percent fat was
significantly reduced in that meal-replacement group. And also, we saw a
number of blood changes, but total cholesterol
was also reduced. And that’s a fiber component. So if you’re looking for
a way to feasibly modify your clients or
a research study, my evidence-based opinion
is a meal replacement is potentially effective. And we’ve done this. It’s just finding the right
one and the right amount. And so that may be
an effective way to modify carb-to-protein ratio. I’ll show you some
other examples, too. This study Bill just
presented, but I actually have a different view of it. So he talked about high protein
versus low protein and weight loss. And it was with some
resistance-trained females. They incorporated resistance
training and HIIT. And you can see they had
different caloric intake, and that was by accident. I don’t know if you
were in his talk. But when I looked at this,
it was high protein, two and and a half grams
per kilogram per day. But when I calculated their
carb-to-protein ratio, it was a 1 to 1, even
more ideal for fat loss, whereas the low-protein group
was actually in a 3 to 1 carbohydrate-to-protein intake. So if you start to
change your mindset– and here’s what they saw,
no change in body mass, significant increase
in fat-free mass and that high protein or
reduced carb-to-protein ratio, significant decrease in fat
mass, percent fat, and then, also, that fat
mass and body fat. So obviously, increasing
protein, but again, it’s that manipulating
macronutrients. And there’s some
interesting data out there in addition to this
just giving some application. So then another key piece
that is not controversial, but people are very strong
about their opinions, is nutrient timing. And I thought, what better place
to talk about it than NSCA? And so this is a
classic study that basically got us all thinking. And it’s old, but I think it’s
still great, basically saying, if you take the calories
that you normally eat in morning, evening and put
them around your workouts, what will happen? And basically, this
study showed that you’re going to double the
increases in lean mass, see greater losses in body
fat, and that also translates to changes in strength. So this is not old. We know that we should
nutrient time before and after. Now, there’s debate on how long
is the window, how effective is it. And I say, does
it really matter? Is it going to help you? And what we know is that,
yes, it will help you. It won’t hurt you. But maybe the windows
aren’t that close. So I want to show you a
different perspective. Maybe it’s beyond
body composition. Maybe it’s metabolism. Maybe it’s recovery. And so it’s a nice
transition into looking at things a little
bit different, metabolically speaking. So I wanted to
view this before I give you some that
nutrient-timing application. This is a study that–
it’s more of a review that nobody ever talks about. And like I said,
you guys use it all, so you can use it or think
about it differently. But when we talk about
metabolism and calories, a calorie is a calorie. There’s a lot of debate
of, is a calorie a calorie? This is a different
way to look at it. Inefficiency happens. Just like when we
put gas in our car, we expend energy
or waste energy. The same thing
happens with food. And in weight loss,
we actually want to be inefficient with our
exercise, with our food. So this is a lot of
mumbo jumbo down here. But I basically
wanted to demonstrate that if I’m eating carbohydrate,
that is very efficient for me to make energy. That’s why we have carbohydrate,
especially during exercise. However, in weight loss, I
don’t want to be so efficient. And so the most
inefficient pathway is actually consuming
protein, building a protein, and then expending a protein. So that does not mean I’m going
to use amino acids for energy during exercise. Instead, that means I have
adequate amino acids available, I stimulate the muscle via
resistance training or HIIT, and then I rest, and
I rebuild that muscle. And then I go exercise again. It’s that constant cycle
is very inefficient. And so potentially
taking advantage of some of these
inefficiencies may potentially help with weight loss. And so just another
view– when we look at some of
the inefficiencies, well, fat is the most efficient. So if you sit down and have
a bunch of peanut butter, it will likely
make you fat if you overeat with any macronutrient. But carbohydrate’s
not far behind. And then notice that
protein is least efficient, meaning that I’m
going to require more energy to break
that down than I am my other macronutrients. So when we look at that
or look at metabolism, I’m just having you view
some things differently when we start
thinking about weight loss, our little
pockets of areas that we can take advantage of. The other things with
metabolism to consider are caloric imbalance. So a lot of times, in a weight
loss or with individuals, if we’re talking
about metabolism, we’re worried about
overexpending calories or undereating– this is
very common in weight loss– which can influence
metabolism in a negative way, intentional weight loss
or caloric restriction. And I say intentional because
sometimes it’s not intentional. Sometimes, people are just
overexercising and not meeting caloric needs. And then training status– so you guys probably
know this, but just as a friendly reminder,
training tests– the more trained you are,
the more efficient you are. So the more exercise I
do, the fewer calories I will burn during
that exercise event. So, one, do a new exercise. So I just thought I’d ask– I thought I would be
able to see you all. But who swims in
here for exercise? OK, so maybe like 5% of you. So if you all went
swimming, you’d burn a whole lot
of calories, right? And if you did HIIT in
the pool, you’d be wiped. So the idea, though, is if you
can stimulate the metabolism or choose exercises that
you are less efficient at, you’ll burn more calories. So with weight loss or
maximizing metabolism, maybe you want to think about it
that way, and then also mode, so modifying mode. And then that’s one of the
keys with that higher-intensity exercise, is that
we know it trumps some of that inefficiency, or
it allows us to burn some more calories, which I’ll show you. So this is a classic view– just want to demonstrate
that with weight loss, basal metabolic rate goes down. Some of our fidgeting goes down. However, we’re not really
sure about our thermic effect of feeding, meaning we
think that we can still take advantage of that
if we eat that lower carb-to-protein ratio. And then exercise-adaptive
thermogenesis, or how many calories do
we burn during exercise– we become more efficient
unless you switch the mode and the intensity. So let’s draw upon that. So Bill briefly
mentioned this, but this is a big passion area of
mine, is metabolic adaptation. Sometimes, we hear about it
as adaptive thermogenesis. And I think it’s a
little bit misunderstood. But the best way
to describe it is that when someone loses
weight or is very fit, our metabolism becomes adapted,
meaning that we basically can maintain the calories
that we need without expending or needing a lot of calories. That’s exacerbated with
weight loss and underfeeding. And that is driven by
mitochondrial adaptations. And why I say that is
because that’s the whole goal of why we exercise. We want to become
more efficient. Our mitochondrial doubles
and become more efficient. So we want to think
about it two ways. One, we want to prevent
this from happening or stimulate our metabolism
so that it doesn’t happen. There’s also
hormonal changes that happen with metabolic
adaptation, which essentially means that, generally,
our catabolic hormones are elevated, and our anabolic
hormones are decreased. And I’ll show you our
theoretical model. And so a lot of
times, if someone becomes very efficient– in weight loss,
the best example is when we plateau,
or let’s say you’re working with someone who’s
trying to lose weight, and then they stop. Or, for example,
sometimes we’ve looked at some physique
competitors, and they get so lean that they stop
losing fat mass or that return to normal life, a preferential
gain of fat over time. And so let me just show
you our theoretical model. And so what happens,
generally, with weight loss is we reduce energy intake, which
creates an energy deficit– that’s on the left
side of the model– which basically results in a
decrease in energy expenditure and a decrease in weight, which
is all part of weight loss, right? But at some point,
that catches up and can result in some
changes in hormones. But essentially, and
even Bill’s research is supporting some of this,
is if we make small dietary changes that can modify or
slow this down and prevent that preferential gain of fat
over time, or also periodic refeeding or basically
providing that– I don’t like to
call it a cheat day. It’s not a cheat day, but
essentially increasing calories and macronutrients
every certain number of days to maintain metabolism. So this is an area– the best way to describe it is
if you’ve ever dieted and then gained weight and
then lost weight, you likely gain more
weight over time, or your clients do, or
your research subjects do. So this is an area
that definitely needs more exploration, but we
have some interesting insight. So I’ll give you a practical
example here with a female. So here, the key thing of
what I want to point out is oftentimes, or
what the theory is, is that it’s the lean
mass that prevents that fat from regaining or stops
that cycle of weight regain. So if you can see here,
the start of a diet, 19.4% body fat. You can see the lean
mass, 145 pounds. End of the diet– they obviously
sufficiently lost body fat. They’ve lost about 10
pounds of lean mass and 15 pounds of fat mass. So this is more drastic, more
of a physique competitor. Obviously, they have
to regain weight. You can’t maintain
that body composition. And so they gain fat more
quickly while hormones adjust. And the theory is, if you
see that late regain, that’s essentially potentially where
the fat loss or fat regain would stop when lean mass has
matched the start of the diet, so just a better even view
of why lean mass in your jobs are so important with
clients even in weight loss or preventing weight regain. OK, so the other view of
metabolism and, with that, macronutrient manipulation–
something to consider is oxidation and how
much fat are we using. And so I’ll be honest. Fat oxidation doesn’t
always lead in fat loss. But it’s a concept I want
to talk about because I think it’s a sound theory. And so basically, if we
manipulate macronutrients like they did in this study,
essentially high carbohydrate or high carb-to-protein ratio– in this study, they
call it a high fat, but it’s essentially a
low carb-to-protein ratio. They demonstrated that
high-carbohydrate diet blunts fat oxidation. And that’s how most of
us, most of our subjects, most of our clients eat. If you consume a
high-carbohydrate diet, you will be less efficient
at burning fat for fuel, particularly at rest
and during exercise, which is what we
were meant to use. And so the idea, too, is by
manipulating macronutrients– so in this case, a higher
fat, higher protein diet– they were able to increase fat
oxidation, which may result in greater fat loss or fat use. This is another classic study
that is often overlooked. And so, again, giving
you some pearls of wisdom, the idea of
if we do not consume food before we exercise– the media tells you that
that actually burns more fat. That’s fasted
cardio, good for you. You may be miserable,
but it works. Actually, what the
science shows is that’s not so good
for males or females and essentially shows
that food before exercise actually enhances fat oxidation. And it’s even more
important for women. And so essentially, we know
that postprandial, or post-food, can actually increase
fat oxidation. And so that got
me thinking, well, what about the type of food
we eat before exercise? And I guess, before
we get there, energy expenditure is another
key piece of the picture, right? So this study, then, looked at
timing of nutrients, protein or carbohydrate, and how it
influences energy expenditure in addition to fat oxidation. And so they demonstrated
that protein– particularly 18 grams,
so nothing crazy– prior to exercise before
high-intensity resistance training elevates energy
expenditure up to 24 hours post. And so partly why I like
this is that, I mean, I used to do the same thing. Why on earth would we
eat before we exercise, particularly if we were going
to do HIIT or HIRT, right? Well, we know that the data
shows that you’ll burn more fat and you’ll also
burn more calories, so if weight loss is our
goal, convincing your clients, or in your research
study, that food before can actually be more
metabolically advantageous. And so this study also
supports the type of exercise. So we know that
HIIT, on a whole– this is just one study– elevates energy expenditure more
than our endurance exercise, more control. But this particular
study shows that it’s the same despite
half as much work. So I’m all about getting it
in and getting it done quickly for a bigger bang for your buck. And basically, we
know that HIIT will expend more calories both during
and after for much less work. So here, we’re talking
about literally 10 minutes of work versus 50
minutes of aerobic exercise can burn the same
amount of calories. And so in my lab, we looked
at an acute view of this, asking two separate questions. First, we wanted
to ask, OK, well, what happens if you
eat protein before you exercise versus carbohydrate? And what happens if you do an
energy-matched, so calorically matched, aerobic exercise
bout versus a high-intensity exercise bout, high-intensity
interval training bout versus a high-intensity
resistance training bout? And first, we saw
that that protein, so that nutrition piece– the protein group significantly
increased energy expenditure, primarily 30 minutes
and 60 minutes post. So we know that
eating protein may be better than carbohydrate
before exercise. And I think this is really
important because you ask– obviously, I teach
college students. But you ask them, what do
you eat before you workout? Oh, a banana. So that’s your carbohydrate. If you reframe your thinking
and add that protein, that could be potentially
advantageous for increasing energy expenditure. And then we also see that that
protein augments fat oxidation up to 60 minutes post-exercise
compared to carbohydrate. And then I didn’t present the
exercise data or the mode data, but basically we saw that
the HIIT trumped all three groups when it’s
matched for energy, meaning that it increases energy
expenditure most and induces fat oxidation most opposed
to aerobic and HIRT. And then we just finished
this study really looking at– OK, so hopefully I
have convinced you that pre-exercise timing does
have some metabolic advantages. We wanted to look, is
pre better than post, particularly in women? Because if you’ve ever looked
at the nutrient-timing data, there’s no data in women. It’s all in men. So we are different
physiologically, right? And so basically,
this study looked at a six-week
high-intensity resistance trained study looking at pre
versus post nutrient timing versus the control. And essentially, body
composition wise, there was no difference
pre and post. Potentially, some of
that pre-nutrient timing is showing up in metabolism
with our resistance training as well, basically saying
that that pre-intake nutrient timing may be advantageous
even with resistance training in our
energy expenditure as well as our fat
oxidation, even in women. And then, yeah,
just summarizing– there was no difference in
some of our strength, our body composition. And then, lastly, just
that one application study here with some
branched-chain amino acids. I think this is
interesting, too. It’s based on some old data,
how we created this study, but looking at BCAAs between
meals, particularly in females. So most people consume
it during exercise as a means of protein synthesis. But we really wanted to know,
how does it elevate or change fat oxidation if you provide
branched-chain amino acids between meals, so between
breakfast and lunch, lunch and dinner, dinner and
sleep, and basically saw a significant increase
in energy expenditure by just providing
branched-chain amino acids, a significant decrease in
carbohydrate and sugar intake, and also improvements in
satiety prior to sleep, so another view of
how a minor change in nutrient timing or
even supplement use may have a small impact. And so I want to give you
two applications here. And so there’s a number of
ways you can apply this, but I just thought
these were interesting. So here, we have a female
endurance athlete that’s young, high carbohydrate
intake, very common. So here’s body fat
percentage, 26.2%. VO2 is high, so very trained. You’d look at her and say,
there’s nothing to change. Volume is good. When we measured a fat oxidation
via RER, is what that means, early in was at a 9,
basically telling me that she was burning mostly
carbohydrate at a very low intensity. That’s not really good, not
really good for performance, not really good for metabolism
or for fat oxidation. So essentially, we
basically talked with her and we
decided together, then said, why don’t we lower your
carbohydrate intake slightly down to 55%– she was doing volume; she’s
an endurance athlete– and up your protein intake? So that same concept, lower
the carb-to-protein ratio to a 2 to 1. After three months– I’ll show you some data–
three months and nine months, you can see here pre. You can see body fat went down
after three months, so to 24%. Lean mass was about the same. Post, you can see body
fat went down even more. And then the other piece
down at the bottom– VO2 went up slightly. And then her RER was much lower
at the same relative component, or you could look
at it at– she was able to use fat
much longer, which has a glycogen-sparing effect,
meaning that in a longer endurance bout, she
could theoretically go much longer because now
she’s using fat for fuel. And those were minor tweaks. So let me show you
another example here, a young
female who is vegan. You can see baseline
weight, 22% body fat. You can see baseline
stats, not underconsuming calories, so about
2,000 calories, heavy on the carbohydrates. So you can see 58%
carbohydrate, 14% protein. She was complaining of fatigue,
just not a lot of energy. Basically, we didn’t
change her calories but modified her protein,
said, eat more protein. And you can see the
breakdown there, so more of a 50% carbohydrate,
26% protein, so same concept, lowering that
carb-to-protein ratio– pretty dramatic
changes, I would say. So you can see how weight
actually significantly went up. So 58.5 kilos is
where she started. 61.6 is where she ended
about a year over time. If we wouldn’t have
body composition, she’d probably be pretty
distraught, right? But look at lean mass
changes, pretty significant, so almost four kilograms of
lean mass over that year. And training didn’t
change a whole lot. These are just a
couple applications. So to wrap it up here,
some key pieces– so I’ll just encourage you to
think about body composition measurement as a tool
not only for tracking fat mass and lean mass but
also injury prevention. And then, depending
on your clientele, we actually use it a lot
for disease prevention or identification of disease. Increasing lean mass may be
a more important component than loss of fat mass,
too, for injury prevention. And that increasing of lean
mass may not necessarily be a set protein requirement
but more of a change, or that change from baseline
for that individual of about 60% to see an increase in lean mass. Changes in body composition–
it may not be saying, do one of these crazy fad
diets, like keto, or very low carbohydrate. Maybe it’s just saying, OK,
instead of having your one egg and cereal for breakfast,
maybe you have your cereal, you have two eggs,
and a Greek yogurt. It’s more food, but
you’re modifying that carb-to-protein ratio, or
essentially lowering the carbs and increasing the protein. We know that 2 or
less than 2 to 1 is that sweet spot
based on the data. And the nutrient timing, so that
taboo topic I feel like people like to argue. I would say the data
suggests that it’s important, and maybe that pre-window– it’s not maybe going to make
a huge difference, fat mass and lean mass, for a
short period of time. But it may make an impact on
metabolism and, over time, may have an influence. And then metabolism can be
influenced by type of calories as well as timing or
lack thereof, or fasting, essentially. High-carbohydrates diets,
fasting prior to exercise may actually be detrimental
to fat oxidation. And then consuming that protein
versus carbs before exercise may be more advantageous,
despite whether it’s resistance training or aerobic exercise. And then just a big thank
you to my lab team– we know that science
doesn’t happen individually, so this is my stellar lab team. And we do a lot of
great things, and it’s fun for me to share it. So big thanks to
them, and a big thanks to NSCA for allowing
me to speak. And I think I have enough
time for questions, which is what I was hoping, so
happy to answer some questions. [APPLAUSE] Yep, I can’t see you,
so you’ll have to– [INAUDIBLE] Yeah, that’s a great question. So he asked about nutrient
timing, let’s say, before basketball. There’s a talk specifically
on nutrient timing tomorrow, and there’s some really
great position papers. So there’s a lot of
details that go into it. But generally, it’s a full meal
about two to three hours prior to and then a small
bolus of what I would say was more of a lower
carb-to-protein ratio about 30 to 60
minutes prior to that event. Uh-huh. Yeah. [INAUDIBLE] Yeah, so he asked about
very early in the morning. That’s a good question. So I should say that
there’s some data that if you fast once
every couple weeks, that’s fine, maybe advantageous. But if you work out really
early, I’d say two things. If you’re recreationally
active, a good, slow-releasing
protein before bed– most people think casein,
but actually, the data shows that egg whites is a
better slow-releasing protein, so some eggs before bed. I would still argue
a bolus of protein, even if you work out
early in the morning. So the data shows
that it doesn’t have to be a huge meal,
90 calories of protein. That’s not very much, 20 grams
of protein, so a glass of milk, two glasses of milk. Have to holler. We good? All right, thank you. [APPLAUSE]

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