Waterloo Chiropractor, Waterloo Physiotherapist, and Massage Therapist (RMT)

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2019

Our registered dietitian, Stephanie Boville, is in the process of being certified to accurately measure body fat percentage using the skin fold calliper technique (this is the gold standard- no more electrodes, no more guessing)!

As part of completing her program, she will conducting the test on 20 athletes free of charge ($60/ session normally).  This will provide a great baseline to see if you are making the gains you are aiming for.  If you are interested in learning more about Steph’s weight loss program to complement this, click here. 

Call (519)885-4930 or info@drdelanghe.com if you are interested

stephanie boville nutritionist registered dietitian-01-01-01

 

What is the certification?

It is through the International society for the advancement of kinanthropometry.
This certification has developed standards for practice in the area of measuring body composition and body measurements. This allows practitioners to compare and have equal athlete testing, thus decreasing the differences between different techniques. This course is designed for sport scientists, researchers and nutrition and health professionals to be able to accurately and precisely measure and interoperate body measures and skin folds.

What about my electronic scale?

Many places will have Bioimpedance analysis where you stand on and or hold electrodes and which will then estimate body composition. This works off of how quick the electric current goes through the body from electrode to electrode.  As a result, there is a high probability of error.  For instance, water content/ hydration status can cause fluctuations in readings.  Im addition, these systems back calculate the body fat percent which is riddled with assumptions and error.

Skin fold testing can precisely measure your overall body fat percent and is the gold standard for looking at body fat.

steph b

Why is this helpful to know?

Knowing your body fat percentage is a great way to quantitatively determine if your nutrition plan is helping to reduce your body fat as you approach your race season.

This information also help us to determine if you are adequately fed.  For instance, if you have gone through a period of severe energy deficit, this information is crucial for guiding good, healthy weight gain.   No more guessing if that weight you are gaining is muscle or fat!

However, this it not for everybody!  If you are struggling with body image and disordered eating this is not a test for you at this time. We test body composition to make sure you are in a healthy range and do not promote unhealthy restrictive dieting to achieve below average body fat percent. Body fat is necessary for a healthy body!

Call (519)885-4930 or info@drdelanghe.com if you are interested

Caffeine is one of the better researched and most effective ergogenic aides (performance enhancing) out there. Research shows that caffeine can be beneficial in many sports, from sprints or power events to team sports and endurance activities. Interestingly enough, a lot of sport nutrition principles originally were studied in military personnel due to their high activity level and training intensity and then applied to sports. Caffeinated gum has been researched for military purposes in order keep the solders awake and alert in the field. In this article, we will be looking at the use of caffeinated gum to boost sport performance.  

What does caffeine do? 

There are many different theories of how caffeine exerts its affects on athletic performance. Firstly, caffeine blocks the adenosine receptors in the central nervous system. This makes us feel more alert, decreases our perception of how hard we are working and can even decrease our perception of pain. Research also shows that caffeine can have a direct effect on the muscle, where it can enhance the motor unit recruitment and coupling reactions which increases the force produced by the muscle units. It may also have an effect on the calcium release in the muscle which is needed for muscle contraction. 

 Dose

A caffeine dose of 3-6mg/kg body mass is effective for most athletes t
o see a boost in performance. Therefore, a 60kg individual would need 180-360mg of caffeine. It is theorized that regular caffeine users (coffee/tea drinker) may need the higher end of that range as they may be less sensitive to the effects of caffeine. 

Benefits of caffeine gum?

Most research studies look at the effect of caffeine capsules taken before exercise. The caffeine levels from the capsules peak within 45-60 minutes of ingestion. Chewing the gum will allow for quicker absorption (5-10 minutes) compared to a capsule, as it is partially absorbed in the mouth. If you were to try and get 300mg of caffeine through drinking a coffee, you would have to consume a Grande (16oz) Starbucks Pikes Place close to your race. That much coffee right before a race or event may not sit well with some people or may lead to some unplanned pit stops along the way. Therefore, it may be beneficial to chew gum verses drink a coffee to get your caffeine fix! 

What Does the Research Say? 

Let’s take a look at some new research! I have reviewed two studies published this year where investigators looked at the efficacy of caffeinated gum in rugby and endurance runners. 

Rugby Players

Ranchordas et al. (2019) recruited 17 university level male rugby players to participate in the study. This group was instructed to consume 200mg of caffeinated gum, providing 2.3mg/kg on average. After a warm up, they performed a battery of rugby specific testing which included countermovement jump test for power, Illinois agility test which measured the athlete’s ability to change direction in a 6x30m repeated sprint and a yoyo IR2 test which is like the beep test where they increase running speed to complete 2x20m runs. They found that the caffeinated gum improved jump height by 3.6%, and significantly lowered fatigue index compared to placebo. They also found that the caffeine group had prolonged preservation of energy levels during sprinting, allowing them to cover significantly more distance in the endurance sprint test (426m vs 372m or 14.5% improvement). They did not observe any improvements in agility. One last interesting note was that there were no adverse effects of the caffeinated gum. This is a positive because it may be an easier option for caffeine intake for those who have negative GI effects from coffee before a game or athletic event.

Endurance Runners 

A study by Dittrich et al. (2019) looked at the effect of caffeinated gum on the performance of 12 trained male endurance runners. Runners chewed 3 pieces of gum equaling 300mg of caffeine (~4mg/kg) after their warm up. Participants were asked to run until exhaustion at a predetermined speed of half way between their VO2max  and their first lactate threshold. After their run, they tested their maximum voluntary muscle contraction. Caffeine intake resulted in significantly increased time to exhaustion (or exercise tolerance) by 18% resulting in significantly larger distance covered (1.9km). The maximum voluntary muscle contraction and peak twitch both decreased from the pre-run measures, however they did not find any significant benefit of the caffeine compared to the placebo. The fact that the caffeine trial ran a further distance may have resulted in no differences in the neuromuscular function, as their muscles would have been more fatigued from the longer run. However, this is just speculation and more research should be done in this area to confirm this theory. 


Recap 

  • Caffeine intake can help increase alertness, decrease perceived exertion, possibly help with muscle force production and contraction  
  • Dose of 3-6mg/kg body mass is enough to produce effects on performance 
  • Caffeine can increase exercise tolerance, running distance and jump height 
  • Chewing caffeinated gum is an easy way to quickly get a caffeine boost prior to your race without chugging a few cups of coffee 
  • Caffeinated gum doesn’t seem to have adverse effects, so it’s great for people who cannot tolerate coffee before a game or race 

References

Ranchordas MK, Pratt H, Parsons M, Parry A, Boyd C, Lynn A. Effect of caffeinated gum on a battery of rugby-specific tests in trained university-standard male rugby union players. Journal of the International Society of Sports Nutrition. 2019;16(17). https://doi.org/10.1186/s12970-019-0286-7.  

Dittrich N, Serpa MC, Lemos EC, De Lucas RD, Guglielmo LGA. Effects of caffeine chewing gym on exercise tolerance and neuromuscular responses in well trained runners. Journal of Strenght and Conditioning Research. 2019. 00(00)1-7. 

Do you ever get the “runs” on the run?? What about stomach pains, burping, nausea or flatulence? If the answer is yes, you are not alone. In fact, 30-50% of endurance athletes struggle with gastrointestinal (GI) issues and is a common reason for underperformance. This rate sky rockets to 90% in athletes training and competing in ultra-endurance events. In this article you will learn how a few nutrition tactics can help you have a GI issue free run!

Why do we experience these GI issues?

There are a few reasons why with intense prolonged activity there seems to be a higher prevalence of GI issues:

  1. Increased blood flow to the muscles and away from the gut may result in malabsorption of nutrients
  2. Increased blood flow to the muscles and away from the gut may result in damage of the gut lining resulting in bacteria and nutrients passing through the gut (increased permeability leading to endotoxemia)
  3. Delay gastric emptying (ie slower movement of the food from stomach to intestines) can cause upper GI issues such as nausea, reflux or burping
  4. Change in transit time of food leading to speeding up or slowing down of food movement through the GI tract

Interesting note: research is showing that the gut damage is highest in those who ran their marathon fastest yet had the least symptoms, leading the researchers to believe that some people are more sensitive to the higher levels of gut permeability and damage. One other possible reason for this is the individuals gut microbiome, where an imbalance of good and bad bacteria (dysbiosis) may be the difference from having symptoms or not.

What can we do about it?

First off, you want to consider if your GI issues are constant. If the answer to that is yes, you should consult your doctor to rule out any underlying GI diseases such as crohn’s or ulcerative colitis.

Secondly, you want to make sure you employ good nutritional habits prior to making major changes to the diet like we will discuss below. First things to consider are meal and snack composition and timing. Eating the wrong thing too close to exercise can lead to inadequate time to digest the food leading to cramping and stomach discomfort. Keeping balanced larger meals 3-4h before exercise is recommended. As you move closer to the exercise consuming smaller, more carbohydrate based snacks tends to work best. Avoiding high fat, high protein, high fibre foods close to exercise can be another strategy to reduce stomach discomfort. Limiting coffee/caffeine and lactose (sugar in milk/yogurt) close to workouts can be helpful. It is also important to train the gut to handle carbohydrates during your workouts, and NEVER EVER try something different on race day.

What about Gluten?

If you have tried the above recommendations and are still finding it difficult to make it through your workouts and races without GI issues, there are a few new strategies that have been researched. Gluten is often eliminated by elite athletes on the assumption that it causes them GI pain. About 40% of non-celiac athletes will eliminate gluten for at least 50% of the year due to GI reasons. Although they anecdotally find this helps reduce symptoms, research does not always support this and often shows gluten elimination in non-celiac individuals does not result in decreased GI symptoms or inflammation.

Another line of thought regarding why athletes anecdotally see GI improvement when eliminating gluten-rich foods is they are also eliminating fructans (which are considered to be a FODMAP)

FODMAP’s are a collection of short chain fermentable carbohydrates. If they are malabsorbed and or are present in the colon they can be used to feed the good bacteria (prebiotic) causing gas, bloating and other GI symptoms.

Fermentable

Oligosaccharide- carbohydrate chain with 3-10 sugar units (barley, rye, black beans, cashews,   garlic, onion, beets)

Disaccharide: carbohydrate chain with 2 sugar units like lactose (cows milk, yogurt, sour cream)

Monosaccharide: single sugar unit like fructose (found in fruit, apples, fig, mango, pears and sweeteners like high fructose corn syrup)

and

Polyols: sugar alcohols found in sugar free gum and candy (sorbitol, maltitol, xylitol)

A recent research study by Wiffin et al. (2019) investigated the effect of a short term (7 day) high and low FODMAP diet on GI symptoms during exercise. They had 16 participants, both male and female complete the two dietary interventions in a random order with a one week wash out period between trials. They found that low FODMAP diet resulted in overall improvement of GI symptoms. On an individual basis 69% of the participants reported a positive effect of the low FODMAP diet on symptom management, specifically for pain and bloating. They also show that participants perceived they were able to train more frequently and intensely on a low FODMAP diet.

Warning: Low FODMAP is not a lifestyle!

Low FODMAP should not be followed on a daily basis as it can be restrictive and alter your gut bacteria as these carbohydrates are important prebiotics (they feed the good bacteria in your gut). It is also important to make sure you have a good dietary plan if you follow this diet to make sure you have adequate carbohydrate provision for your activity, especially if you are trying this before a big race. Following the diet for 3-7 days prior to a race is recommended if you do find it helpful to reduce your GI symptoms. If you continue to have GI pain during training, doing a FODMAP elimination and reintroduction technique should be used to find foods that you are more sensitive to and how much your body can handle.

Recap:

  • Is your GI pain occurring all the time? If so, seek medical advice and testing
  • Look at meal timing and composition
  • Train your gut and practice your race day nutrition to avoid unexpected surprises
  • Potentially employ a short term low FODMAP diet prior to important races

I hope this information helps you run free of GI pain. If you would like more information on implementing a low FODMAP diet, I am ready to help. It is my passion and goal to help you be the best athlete you can be. For more information, visit the clinic website!

References:

Lis, Dana M. Exit gluten free and enter low FODMAPs: A novel dietary strategy to reduce gastrointestinal symptoms in athletes. Sport Medicine. 2019. 587-597. https://doi.org/10.1007/s40279-018-01034-0

Wiffin Melanie, Smith Lee, Antonio Jose, Johnstine James, Beasley Liam, Roberts Justin. Effect of a short-term low fermentable oligosaccharide, disaccharide, monosaccharide and polyol (FODMAP) diet on exercise-related gastrointestinal symptoms. Journal of the International Society of Sports Nutrition. 2019. 16:1. https://doi.org/10.1186/s12970-019-0268-9

Sigma Nutrition Radio Danny Lennon Episode 246 with Jamie Pugh- Gastrointestinal Symptoms in Athletes.

marathonnurition

** H+P, Run Waterloo members, Runners’ Choice running club members and WCC members receive a $50 discount!

Let us help you take full advantage of what the latest research is showing with regards to endurance sports nutrition!  Stephanie has 6 years of post-secondary education at her disposal.  Learn more about her HERE.  Along with adapting to each individual’s needs, each session will include the following topics (and more):

Session 1: Initial Assessment and Workout Nutrition Optimization (1 hour)

Initial assessment and key initial changes such as protein distribution and pre/post workout.

Session 2: Training the Gut & Nutrition During (45 minutes)

How to train your gut to tolerate more carbs, how and when to take your carbs acutely before and during, how to accurate calculate and plan your fluid intake.

Session 3: Hydration continued and GI distress (45 minutes)

Other factors to consider when optimizing hydration and exactly how to modify your diet in the days leading into race day to decrease the odds of GI distress.  Touch open sleep and recovery.

Session 4: Carb loading (45 minutes)

How to shift your diet away from protein/fats/fibre toward carbs in that week pre-race.  How much and when to eat your carbs in the days leading into your competition.

Session 5: Supplement Review (45 minutes)

Vitamin D, dietary nitrates (beat juice), caffeine, salt pills, Omega-3s and beyond.  What do you need to be taking during?  What do you need to take directly before and during a race?  What actually works, and what should you stay away from?

PLUS:

  • 3 follow up e-mail discussions leading into your 2-3 key races.
  • A custom, detailed carb loading plan leading into your A-races.

This plan will arm you with what the most up-to-date research shows works.  Stephanie will help you ensure that you are properly fuelled and energized for race day so that you can reveal your full fitness potential!  If you are interested for yourself or a loved one, please contact us at (519)885-4930 or info@drdelanghe.com.

If you haven’t seen it, here it is- Canada’s NEW food guide.   So what exactly are the differences, and has it really changed that much?  Our registered dietitian, Steph Boville, has some thoughts!

foot guide

What I think of the new Canada’s Food Guide

To be perfectly honest, I rarely pulled out the old rainbow Food Guide when talking to my patients. If you don’t remember the old guide, it was a rainbow representing the 4 different food groups which were arranged in order of foods you needed the most servings from to the least. The main focus of the diet was on vegetables and fruit, followed by whole grains, milk and alternatives and finally the food group you needed the least servings of was meat and alternatives. From there they gave guidelines such as eat more vegetables than fruit, eat at least half your grains as whole grains, choose beans and lentils often etc. They then prescribed a number of servings for each food group based on age and gender.

The reason I didn’t use the guide was because it was meant to be an education tool to learn about different food groups and their purpose rather than provide practical steps to get someone to follow the prescribed servings.  Plus, people generally know the focus of their diet should be on vegetables and fruit but this needed to be more visual, practical and user friendly. For these reasons I found easier and more effective ways to communicate the information in the guide in my own way, not to mention nutrition is not a one-size fits all and therefore did not use the guide in my practice.

The New Guide

The new Canada’s Food Guide encompasses many important aspects of eating and also provides consumers with more specific guidelines about foods to choose more or less often in a very visual way. There has been a lot of hype about the new food guide, both good and bad (like everything… everyone has their own opinion!). I honestly think that the information has not changed, rather how it has been communicated has.  These changes in communication have been extremely positive.  The new Food Guide is very similar to values that guide my counselling style and advice.

The visual of the plate, with half the plate covered in a variety of deep colourful vegetables and fruit, a quarter of your plate as your whole, unprocessed grains and starches and a quarter of your plate as your plant or animal protein sources. This communicates very easily and simply how you want your plate to look compared to the prescription like recommended servings of the past Food Guide. The new guide still promotes the same values as before: eat real foods, include lentils and plant proteins, lean proteins, whole grain carbohydrates and more vegetables, with less sodium, saturated fats, processed foods and sugar. All of these values line up with my own personal beliefs and what the evidence shows.

There are a few things I really like about the new guidelines. It is more interactive and web-based rather than a physical pamphlet which may be better for our tech-savvy population. Not only is the visual of the plate very easy to see, understand and apply, but it also acknowledges the social aspect of food and promotes building a healthy relationship with food. This is also a foundational value of Bodzii (personalized nutrition and lifestyle coaching), where we think it is important to have both good food quality and a good food mentality. For example, viewing food in a positive light such as thinking of what a food can do for you, not to you. There is a wide range of information for consumers on practical ways to be mindful of your eating habits, benefits of cooking more often, ways to enjoy your food, benefits of when you eat meals with others, how to use food labels, and how to be aware of food marketing along with much more.

What about the dairy? Everyone is freaking out that dairy is no longer a “food group”. One thing I think the Food Guide needed to do was separate themselves from organizations and give an unbiased, easy to use guide for consumers in which takes “food politics” or influences out of the equation. Dairy is still in the guide, just as the other food groups such as grains and meat and vegetables are. However, there is a shift from food groups to a “macronutrient” like approach. This means that the dairy products are now represented in the protein portion of the plate. This DOES NOT mean that milk is considered unhealthy. As always, milk (soy, pea and cow milk) still provides us with protein, vitamin D and calcium for strong bones, teeth and muscle function.

Overall, the new changes to the Canada’s Food Guide are more in line with I have been teaching and promoting all along. The guide may not satisfy everyone depending on what “nutrition camp” you belong to such as keto, paleo or even elite athletes. It is not meant to be a one size fits all model, rather what the best evidence shows a balanced diet looks like for a healthy normal human. The bottom line is to not over complicate your nutrition. Focus on getting your vegetables, whole grains and lean proteins to meet your needs. Also remember to find ways to enjoy your food and to be mindful of what and how you eat along with striving to enjoy home cooked meals when possible.

I hope this helps to clear up some confusion you may have been experiencing with regards to this new guide.  If you have any additional questions, don’t be afraid to contact me at the clinic! 

Oh hey, I’m back! It’s been a while. My hiatus from writing didn’t coincide with a break from reading though, and I have accumulated a number of tidbits and interesting thoughts on training and performance to bring to you in 2019!  No promises on the frequency of the articles, but I shall do my best.

Today, we’re starting with one we all need to know about: the warmup.

It’s something I’ve written about before- both in terms of cool additions that you really shouldn’t implement (such as here), how a warmup doesn’t literally mean warming up and what we’re actually after (glycogen mobilization and increase in blood flow to our running muscles), and even how it relates to carbohydrate ingestion (here).

Warmup Duration

One thing I get asked about often enough at H+P is why my warmup protocols vary so drastically from distance to distance. For instance, for 5K and under, the warmup is longer with drills. For the marathon, the warmup is just long enough to make sure your shoes won’t come untied and to keep the mind relaxed.

CLICK HERE to read the rest in the WRS Magazine 

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