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PO Box 51236, Albuquerque, NM 87181-1236
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Clarence Bass by Guy Appelman


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Problems with the Vegan Diet?

Q: I’m thinking about going vegan. Not eating anything that comes from a living being with legs, wings or shells appeals to my sense of compassion and fairness. I’ve also heard that it is a very healthy way to eat. Are there any pitfalls of which I should be aware?

A: “As far as I can discern, the best balance of evidence suggests that the healthiest diet is one centered on unprocessed plant foods,” Michael Greger, MD, uber researcher and founder of NutritionFacts.org, wrote in How Not To Die (Flatiron Books, December 8, 2015). “On a day-to-day basis, the more whole plant foods and the fewer processed and animal products, the better,” he continued. So beer and fries won’t cut it. You need a healthy balance of unprocessed fruits, vegetables, whole grains, nuts, and legumes.

A newly discovered benefit is that those eating meat-free diets consume an average of 364 fewer calories daily. “Meaning [that] a meatless diet could be considered an all-you-care-to-eat version of a calorie-restricted weight-loss diet, without having to count calories or restrict portion intake,” Dr. Greger explained. (See also “Unlock Your Fat Cells” GO Article)

Dr. Greger is a savvy true believer. He realizes that extreme vegetarianism is not for everyone; it takes discipline and careful planning. He doesn’t claim it’s all or nothing. “Strictly from a human health standpoint, you would be hard pressed to argue, for example, that the traditional Okinawan diet, which is 96 percent plant based, is inferior to a typical Western, 100 percent vegan diet,” he acknowledges. “Any movement toward more plants and fewer animal products can improve your health.”

There are several caveats for you to keep in mind. I’ve already alluded to the first one. Going vegan is not a license to chow down on highly refined plant foods. Bone up on the difference between processed and unprocessed foods. See the FAQ below on the subject.

The others are dietary essentials: complete protein, omega-3 fat, and vitamin B12.

It is quite possible to satisfy the body’s need for protein without eating animal foods. In fact, it’s easy, if you understand how to go about it. The combination of varied grains and legumes constitutes a “complete” protein, with the nine essential amino acids the body requires to function properly.

“It would be very hard to not eat enough protein and not be seriously underweight,” Dr. David Seres, director of medical nutrition in the Institute of Human Nutrition at Columbia University Medical Center in New York City, told the The Wall Street Journal. (February 1, 2016) It isn’t even necessary to consume a complete protein at every meal, or even every day. “Your body has a great ability to store these proteins for days,” Seres says.

His advice to vegetarians: “Go for the bean and the grain, and you should be fine.” (Carol and I include a wide variety of beans in our diet throughout the day. We also include small amounts of animal protein with most meals; we both eat eggs and I drink whole milk. Too much animal protein can stress the kidneys.)

The other two essentials, however, are not so easily provided without animal food.

I’ve written extensively on the need for omega-3 polyunsaturated fatty acids, which the human body cannot synthesize and must get from outside sources; for the basics, see http://www.cbass.com/AHAfat.htm  

As noted there, vegetarians may be able to satisfy this nutritional requirement with flaxseed and other vegetable oils and some types of nuts. The problem is that the omega-3 fats in plants are less efficient in the body than those in fatty fish. Significantly, many studies ignore the omega-3 fat found in plant foods, because humans convert less than 5% to the type found in fish. While there is some evidence of benefit, but it is much weaker.

Dr. Greger says the crucial question is whether the body can make enough omega 3 from plant sources for optimal brain function. He rejects fish oil caps because of possible contaminants. He suggests eating algae, which is what fish make omega 3 from in the first place. It’s not clear (at least to me) how that would overcome the body’s inability to efficiently convert plant sources.

The only sure fire way of supply the body and the brain with this essential fat is to eat fatty fish. I include a small serving of sardines (mixed with a hard-boiled egg, beans, and vegetables) in my breakfast every morning. Most doctors and nutritionists urge you to include fish in your diet once or twice a week. Salmon is what most people prefer. Trust me, you’ll enjoy it.

Now we come to the hurdle that Dr. Seres calls too high for pure vegans.

The B12 Problem

“It is my opinion that veganism is not consistent with human life, because all vitamin B12 originated in an animal, and we all need B12,” Seres told The Wall Street Journal. A lacto-ovo-pescetarian (meaning he eats dairy products, eggs and fish, but no meat or poultry) for 35 years, the doctor walks his talk.

Dr. Greger suggests taking a B12 supplement. Dr. Seres counters that you have to supplement with an animal-derived B12 to be healthy. You simply can’t get around going animal to supply the B12 we all need. I believe that whole food is almost always the best choice. 

“The results of B12 deficiency can be devastating,” Greger acknowledges, “with cases reported of paralysis, psychosis, blindness, and even death.” He concedes that a regular, reliable source of vitamin B12 is “critical” for anyone eating a plant-based diet. He adds, however, that deficiencies for those starting out with adequate stores may take years to develop.

*  *  *

Like Dr. Seres, I’m a lacto-ovo-pescetarian and suggest that you consider this option.

You’ll be surprised, as I was, at the many variations of vegetarianism. For more details, read my earlier piece about a vegetarian diet for just about everyone: http://www.cbass.com/Vegetarian.htm

If you have more questions about plant-based eating, you’ll almost surely find the answers in Dr. Greger’s encyclopedic How Not To Die. The man is an indefatigable researcher; he and his team undertake to review every study that comes down on nutrition.

While some have criticized Greger for exaggerating the benefits of plant-based eating, Carol and I have found that he does an excellent job of laying out the options. “If you find you cannot do a plant-based diet 100 percent of the time, then aim for 80 percent,” he tells readers. “Any movement toward more plants and fewer animal products can improve your health!”

Think it over and decide what’s best for you. You can always change as you learn more and gain experience. The choice is yours. Make it wisely.

March 1, 2016


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Processed or Unprocessed Food?

Q: How do you tell and what difference does it make?

A: I wrote in RIPPED that unprocessed food is the key to calorie control. The findings of a new study by researchers from the University of North Carolina at Chapel Hill show why processed food leads to overeating--and unprocessed food encourages energy balance. (American Journal of Clinical Nutrition, online May 6, 2015) They analyzed foods found in more than 150,000 households in terms their processing and nutritional quality.

Here's the key to spotting the two forms of food.

Food processing is any procedure that alters food from its natural state. Some processing is, of course, necessary to make foods edible. That kind of processing is perfectly fine and desirable. The kind of processing that's a concern is the kind that reduces volume and concentrates calories. Highly processed foods are usually no longer recognizable as their original plant or animal sources. It makes food go down quick and easy--with minimal preparation and little chewing. Examples are hot dogs, margarine, baked goods, ice cream, and candies. A gym owner friend of mine used to call hot dogs "mystery meat." That says it all, doesn't it? Margarine is the same; the vegetable and animal parts are impossible to tell apart.

Processed food is almost always the result of alteration and packaging to appeal to consumers. Sugar and salt are almost always added. It's the kind of food we crave. It's in our genes. Our caveman ancestors would wolf it down. "When your brain registers the sensation of sweetness on your tongue," Dr. Michael Greger writes is his newly released compendium on nutrition and healthy living How Not To Die, "millions of years of evolution remind your brain to boost your appetite to eat as much as possible."

 My taste buds are with the caveman, but I know better. I'm satisfied with an occasional vanilla shake (small and thin)--at my favorite ice cream shop, almost never at home. Photo by Guy Appelman

Moderately processed foods are usually those that are altered for basic preservation. Examples are white rice, pasta, peanut butter, canned produce, cheese, yogurt, ham, and jam. They have many of the same characteristics as processed food, but less of it. The source of strawberry jam is not in doubt; the fruit gives it a nutritional leg up on sugar. 

Unprocessed or minimally processed foods are "whole foods" such as fresh or frozen fruit and vegetables, beans, nuts, eggs, whole grains, whole milk, and fresh seafood. These are the foods that fill you up without over-shooting your energy needs. They're packed with nutrients--without too many calories.

It's a no brainer to predict the distribution of the calories found in the 150,000 households. Let's see; here's what the researchers found.

More than 90 percent of daily calories found in U.S. households came from highly processed (63%) and moderately processed (30%) foods. Unprocessed or minimally processed foods accounted for a paltry 7% percent.

The researchers also observed that highly processed foods have higher saturated fat, sugar, and sodium content than lesser processed foods. That, of course, helps to explain why we overeat on processed foods. They stimulate our appetite more than satisfy it.

The predictable results add credibility to the New Dietary Guidelines for Americans: lots of vegetables, fruit, whole grains, seafood, legumes, nuts and dairy products, occasionally red meat, and rarely processed meats, sugar-sweetened foods and refined grains. (The government guidelines recommend skim or low-fat milk, not recognizing that whole milk is the unprocessed choice. We'll have more on that soon.)

It's up to you to decide whether to go with the crowd or the new guidelines. You know where I stand.

Remember that any kind of preparation or processing that substantially reduces volume and concentrates calories is moving in the wrong direction.

February 1, 2016

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How Can I Avoid Hip Replacement?

Q: X- rays show that both of my hips are moderately degenerated. My primary care doctor told me to stop all squatting and trap bar dead lifting, which I have done. I get some pain in the groin when I lift up my foot to change shoes. Sometimes I get a sharp stabbing pain in the groin. I don’t get pain from walking and free hand squatting.

The last thing I want is a hip replacement. Can I prevent it? How?

A: The only thing I can tell you for sure is that judicious exercise will improve your odds of avoiding surgery—and speed your recovery if you do have hip replacement.

A new study from Norway (Annals of the Rheumatic Diseases 2015; 74:164-169) found that patients who exercised for one hour at least twice a week for 14 weeks were 44% less likely to need hip replacement within the 6 year follow-up period. (Surprisingly, this study is a first.) The training program prescribed for the patients with hip osteoarthritis consisted of strengthening, flexibility, and functional exercises. They exercised two or three times a week, with at least one session supervised by a physical therapist. (The study is open access, so you can read it online without charge.)

The August 2015 Cleveland Clinic Arthritis Advisor explained that proper exercise helps strengthen and balance the support system around the hip joints. “[That] takes a lot of pressure off the joints” Cleveland Clinic physical therapist Kristin Miller said. “As a result, the progression of the arthritis is either halted or slowed significantly,” she continued. “This can greatly delay or help avoid surgery altogether.”

Be sure to warm-up and gently stretch (in that order) your hips before you work out. The walking and free hand squatting you are doing now would be a good warm-up. As part of the main workout, I recommend the Glute Ham Developer, an adjustable bench which strengthens the lower back, hips, and hamstrings without putting undo pressure on the hip joints; see the photo of Carol below. You’ll find the Glute Ham Developer or something similar in many fitness centers; it’s also a relatively inexpensive purchase for home use.

Carol Bass demonstrates the Glute Ham Raise

If you can do leg presses without grinding or discomfort, I suggest that as well; do the movement slow and controlled, 15 to 30 reps. That said, I recommend that you ask your doctor for an order to see a licensed physical therapist to go over the “Dos and Don’ts” of conditioning your hips. Better to be safe than sorry. If an exercise hurts or aggravates your hips it should probably be avoided.

If you are overweight, losing weight is probably the best thing you can do for yourself; less weight mean less wear and tear on your hips. Exercise, of course, helps you lose excess pounds.

*  *  *

Hip pain that keeps you awake at night or limits your ability to train effectively is a signal that it’s time to talk to your doctor about hip replacement. Once you are debilitated from lack of sleep, weak and shrunken muscles, and uneven gait, your rehabilitation will be greatly prolonged. Don’t dig your hole so deep that it takes an inordinate period of time to dig your way out, if ever. The better your shape prior to surgery, the better you will do post-surgery. Waiting too long will come back and bite you after the surgery. It’s a fine line to walk, but the better you time joint replacement, the better your outcome will be.

If you decide to go the replacement route, find a surgeon who does hip replacements regularly on fitness-minded people like you, the more the better. It’s important to develop a rapport with your surgeon; you want someone you like and trust to do everything reasonably possible to meet your needs.

Finally, consider a surgeon who does the anterior approach, a tissue-sparing alternative to traditional hip replacement that prevents muscles from being cut, lessons pain, and speeds recovery. The downside is that there is some danger of injury to the nerves in the area of the incision on the front of your upper thigh. An experienced surgeon helps lessen the risk.

As you may know, I had a very good experience with the anterior approach. I was walking the evening of the surgery, out of the hospital the next day, and climbing stairs (up and down) without holding on in the first week. I had virtually no pain, but some numbness and hip flexor weakness. You can read all about it—and see photos of the main Glute Ham Developer movements—in my article “Miracle in Houston.” http://www.cbass.com/Hiprep.htm

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Strength Gains for Older Adults?

Q: I read on The Huffington Post that grip strength is an excellent indicator of vitality. I’d like to get stronger and healthier. Should I work on grip strength?

A: The finding that hand grip is a stronger predictor of mortality than systolic blood pressure was a delightful surprise. But it doesn’t mean that grip training builds overall muscle mass and strength—the gold standard for overall vigor. Muscle mass and strength are the leading markers of physiological age; see “Biomarkers 15 Years Later: 10 Determinants of Aging You Can Control.” http://www.cbass.com/Biomarkers.htm

Resistance training counters the strength and muscle loss that typically comes with aging and often leads to frequent falls, bone fractures, obesity, diabetes, heart disease, and untimely death. The good news is that getting started is easier than you might think. UK researcher James Fisher and his colleagues have shown that brief effort-based resistance training twice a week can lead to significant strength gains in older adults.

“By performing resistance training a person can improve their strength, cardiovascular fitness, metabolic health, and [Body Mass Index],” Fisher et al wrote in introducing their study in the Journal of Sports Medicine. “Data suggests that ~2 decades of age-associated strength loss can be regained in ~2 months of resistance exercise,” they continued. With that hopeful beginning, let’s look at the Fisher study.

Participants were previously untrained members of a private UK based fitness center. Fisher and his team analyzed the results of 33 members (14 male and 19 female, average age 55) who did brief (15 minutes or less per session), twice-a-week training on 5 resistance machines (chest press, leg press, pull-down, seated row, and overhead press). One set of each exercise was performed to voluntary repetition maximum or until the person determined that he or she couldn’t do another rep in good form. The men trained for 12 weeks and the women for 19 weeks. Each training session was supervised and recorded.

Note that all exercises are multi-joint and designed to work the maximum amount of muscle. That allowed members to train the whole body with only 5 exercises. “Previous research has suggested that the addition of single-joint [think biceps curl] to multi-joint (MJ) exercises does not increase muscle hypertrophy beyond that of MJ exercises alone,” the researchers explained. “The efficiency of performing only 5 exercises compared to larger volumes suggests practical benefits if the same adaptations are obtainable,” they continued. MJ exercises and doing only one set allowed training sessions to be kept to about 15 minutes. It also proved to be a very productive way to train.

Participants showed significant increases in both total training load and relative to body mass in all exercises. Changes in absolute training load did not significantly differ between males and females. Increases in training loads varied from ~88 pounds in the pull-down to ~22 pounds in the overhead press. Increases in relation to body mass varied from a little over 50% in the pull-down to ~15% in the overhead press. Interestingly, females showed greater relative strength increases in the leg press and the pull-down than the males.

“Evidence has supported a greater magnitude of improvement in upper body compared to lower body strength between males and females,” the researchers observed. “However, there appears no prior evidence supporting the present data that females show greater relative increases in lower-body strength than males. We suggest these differences in relative strength increase may be a result of the significant strength differences at baseline between males and females and also that females engaged in a longer duration of training than males in the present study.”

Another important aspect of the study is the level of effort. Fisher et al suggest that the results might have been better if sets had been continued to the point of momentary muscular failure. “However, training to volitional fatigue represents a very pragmatic approach, especially in the present population group. The data herein represents real people, doing real resistance exercise from which they are intending to acquire the aforementioned health and fitness benefits. We might surmise that their aims are to function more efficiently and for greater longevity in their day-to-day life. As the discomfort and debilitation associated with delayed onset muscle soreness (DOMS) which might arise as a result of high volume and/or very high intensity of effort resistance exercise seems counterintuitive to a person wishing to have a more functional life.”

That’s a good point. We want to turn older adults “on” to resistance training, not make them dread workouts. Hard core trainers may revel in muscle soreness but the lady down the street who simply wants to be around to enjoy her grandkids is unlikely to share that view. She might also be interested to know that the same exercises or the equivalent can be done at home with free weights or even stretch bands that can be purchased on Amazon or at Walmart. It's also perfectly alright to take longer to do the exercises; 30 minutes might work better for many people.

“[This] study shows that resistance training need not be time consuming, dauntingly complex, or overly difficult, and that considerable increases in strength can be achieved,” Fisher and his team wrote. Indeed it does.

For the entire Fisher study: http://www.hindawi.com/journals/jsm/2014/731890/

The Free Squat is part of the brief general warm-up I do before every workout. Staying active between workouts is also a good idea.

Photo by Guy Appelman

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Big on Breakfast?

Q: Some people call breakfast the most important meal of the day, while others say skipping or skimping on breakfast is perfectly fine. What's your opinion?

A: I've always been big on breakfast. I don't believe there's ever been a time in my life when I didn't eat breakfast. What I have for breakfast has, however, evolved over time. From about 14 until I started serious bodybuilding training, I usually had a high-protein shake for breakfast--milk, several eggs, sometimes fruit, and flavored protein powder in a blender. It took about five minutes to make, drink, and clean up. That was my breakfast until I switched my focus from Olympic lifting to bodybuilding in my mid-30s. I also became my own boss about then with more control of my time. I started having solid food for breakfast when I became more concerned about calorie control. I wanted my breakfast to keep me satisfied as long as possible. My aim was to stay ahead of my hunger curve. By stabilizing my blood sugar first thing in the morning and keeping it on an even keel I was able to come to each meal under control, hungry but not famished. That's still my plan. You'll find many versions including my "Old Reliable" breakfast mixture spread throughout my books. My current breakfast is the biggest ever. I begin with a sliced hard boiled egg topped with chunks of sardines and tomato sauce; may not sound good but it really is. I have some orange or grapefruit slices with this while I make my Old Reliable mixture of cooked whole grains, frozen fruit and vegetables, nuts, and whole milk. Warm this in the microwave and I'm in business. This is my best ever breakfast, leaves me full and satisfied, not stuffed.

 My next door neighbor, Bill Vollendorf, took this photo shortly after I began to focus on bodybuilding.
 I had plenty of muscle from Olympic lifting, especially in the back and legs, but lacked refinement.

Two recent studies explain why eating a hearty breakfast is important, one that I've written about before and the other new. Both studies came from Israel.

The first study found that eating a high-carb, high-protein breakfast overcomes the hunger and craving that lead to long-term weight gain. Dieters who ate a hearty breakfast lost several times as much weight as dieters who ate the same number of calories, but skimped on breakfast.

Halfway into the 32 week study, both groups had lost about the same amount of weight: 33 pounds in the skimpy breakfast group and 30 pounds in the hearty breakfast group. Again, both groups consumed the same number of calories. What happened next is a real eye opener.

During the second 16 weeks, the men and women given the low-carbohydrate, low-calorie breakfast regained an average of 22 pounds per person, while the high-carb, high-protein breakfast group lost another 15 pounds. At the end of the study, those consuming the 600 calorie breakfast lost an average of 34 pounds more than those who were limited to 300 calorie at breakfast, 45 pounds compared to a net loss of only 11 pounds. For more details see my "Eat Hearty Breakfast" http://www.cbass.com/Breakfast.htm

The second study focused on blood sugar stability. Again, both groups ate the same number of calories. The difference was that one group consumed substantially more of the calories at breakfast and the other in the evening meal. Lunch was the same in both groups. The groups then switched diets--those eating the big breakfast had the big dinner and vice versa--to control for individual differences.

After following the assigned meal plans for six days at home, the participants spent a day at the clinic, where blood tests were done over the course of the day. The key finding was after lunch, where blood sugar levels were 20% lower and levels of insulin were 20% higher, when participants consumed the large breakfasts and small dinners. This was critical because the subjects all had type 2 diabetes and struggled with blood sugar spikes after meals.

"Our study demonstrated that a large breakfast and reduced dinner is a beneficial alternative for the management of glucose balance during the day and should be considered as a therapeutic strategy in type 2 diabetes," Dr. Daniela Jakubowicz of Tel Aviv University told Medscape.com.

The same advice would hold for people trying to guard against type 2 diabetes--and keep their blood sugar and hunger on an even keel throughout the day.

Those who skip or skimp on breakfast might want to consider a change.

For full details on the second study: Jakubowicz et al, Diabetologia online March 1, 2015

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Low Carb or Low Fat?

A: You’ll lose weight on both diets, but the price is steep. This was vividly demonstrated on the BBC’s Horizon. (Mail Online, January 29, 2014) Two identical twins, Alex and Chris Van Tulleken, 35 and medical doctors, Alex overweight and Chris not, squared off to settle the issue. Alex went low carb and Chris low fat—for a month. A manufactured match for sure, but the face-off tracks history. For years, we were told that fat is the enemy; it’s fattening and unhealthy. I can remember my father, a medical doctor, telling patients not to eat any fat they could see. That left them eating more carbohydrates. A few years later, Dr. Atkins came along and told people to avoid carbs—and eat all the fat and protein they want. We had two camps: low fat and low carb. Both unbalanced and unpleasant. (I tried them both.)

Alex choose low carb, thinking it be more likely to help him lose weight. Chris went very low fat. They were both allowed to eat all they want, just no carbs or no fat. Obviously, neither extreme is possible—you need a little of both to survive. With the help of a nutritionist, they toed the line as closely as they could. Alex chowed down on meat, chicken, fish, eggs, and cheese—but no sugar and no carbs. Chris on the other hand, loaded up on bread, fruit, vegetables, pasta, and sweets, anything with little or no fat.

Both sound too good to be true—and they were. They were both miserable.

Alex was never hungry, but he was constipated and tired, with terrible breath. Chris didn’t fare much better. He never felt full and was constantly snacking. He missed the satisfaction fat provides. Pasta without oil was hardly worth eating. The joy of eating was gone. He never felt contented.

Both twins lost weight. Alex lost the most, but the downside was worse.

While Alex wasn’t distracted by constant hunger, he felt “thick-headed.” Chris was the clear winner of an hour long stock trading contest with make-believe money, ending up with triple the amount Alex earned.

Chris was also the winner in physical performance, trashing Alex in uphill cycling. “Even though I seemed to be losing more weight, everything became harder to do,” Alex grumbled.

Alex lost weight eating all the fat he wanted, but he didn’t feel good doing it. “I thought I would stick to low carbs after we finished,” Alex wrote, “but...my first meal with carbs—and the boost in energy and alertness it gave me—reminded me that for a month I had been under-performing in all areas of my life, and I’d felt dreadful.”

Chris found that he could lose weight on a low-fat diet—but unlimited consumption of sugar was bound to have negative health consequences. Whether or not that's the case, feeling constantly unsatisfied is no way to live.

The doctor twins ended the month convinced that both fat and carbohydrate are necessary in order to be happy and healthy. Extreme diets don’t work for long.

Most revealing, they decided they were asking the wrong question. “It’s not which is worse for you, fat or sugar, but which foods are making so many of us gain weight and why?” Alex wrote.

The real reason obesity has become such a problem isn’t fat or sugar—it’s both. Sugar or fat alone are not the villain. How many people do you know who can't get enough sugar cubes? By the same token, few if any sit down to enjoy a stick of butter.

The problem is the two together. “What we relish is fat/sugar combinations—chocolate, ice cream, French fries,” Alex explained. (The added salt makes French fries even more of an appetite stimulant.)

“If you want to lose weight it will be much easier if you avoid processed foods made with sugar and fat,” the brothers concluded. “These foods affect your brain in a completely different way from natural foods and it’s hard for anyone to resist eating too much.”

*  *  *

Investigators led by David Ludwig, MD, from Boston Children’s Hospital, concluded much the same thing. In their study, published June 26, 2013, in the American Journal of Clinical Nutrition, 12 overweight or obese participants aged 18 to 35 years consumed, in random order, 2 to 8 weeks apart, two test milkshakes that had similar ingredients, calories, appearance, taste, and smell. The participants reported no preference for either meal. What they didn’t know is that one milkshake was low glycemic (37%) with slow-acting carbohydrate and the other was high glycemic (84%) with fast acting carbohydrate.

After eating the high-glycemic milkshake, participants had a surge in blood sugar level that was 2.4-fold higher than after the low-glycemic milkshake, followed by crash in blood sugar at 4 hours. The subjects also reported excessive hunger 4 hours after the high-glycemic meal. Importantly, the investigators also found different blood-flow patterns in the brain 4 hours after the high-glycemic meal and after the low-glycemic meal. 

“Every single subject showed intense activation in…the area of the brain related to addiction,” Ludwig told Medscape Medical News. (July 2, 2013) The results show that highly processed carbohydrates, such as white bread and concentrated sugar, “alter the brain activity in ways that make us crave them even more,” Ludwig added.

Dr. Ludwig said the take-home message is clear: “Avoiding highly processed carbohydrates could help overweight people avoid overeating.” One would expect that highly processed carbohydrate and fat combined, as found in candy bars and baked goods, are perhaps even more troublesome.

For more information on the need for carbohydrate and fat, and the value of eating whole, unprocessed foods, see “Carbs and the Brain—Grain Brain in the Spotlight" 

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No Frills Muscle Building?

Q: What’s the latest on training for muscle size? Do I have to spend an hour or two in the gym five or six days a week to put on some muscle?

A: Not unless you want to. I believe most people will be encouraged by recommendations made by UK exercise scientists from Southampton Solent and Manchester Metropolitan Universities. After an extensive literature review, James Fisher, James Steele, and Dave Smith identified and grouped 57 peer-reviewed journal articles providing evidence-based guidelines for training to build muscle. Their review distills muscle building to the essentials, including a few heartening surprises. (The full report can be found in Medicina Sportiva, 17 (4): 217-235, 2013)

The single most important requirement for building muscle is maximum effort to stimulate the growth of as many muscle fibers as possible. Pushing or pulling should be continued until you can’t do another repetition in good form, the point of momentary muscular failure.

That can be accomplished with high or low repetitions and heavy or light resistance. Single sets and multiple sets appear to achieve essentially the same results. Rest periods between sets or exercises appear not to affect results; rest as long as you need. Both slow and fast repetitions are effective, as long as muscular tension is maintained. Both full and limited range movements build muscle. Isometric contraction also works. "Muscle does not know what it contracts against; it simply contracts or relaxes," Fisher et al explained. 

"Our suggestion is to perform a variety of upper and lower body exercises, utilizing divergent grips and body positions to insure comparable hypertrophy for the entire muscular system," the UK researchers wrote. They warn, however, that muscle shape and response vary from person to person; they are largely beyond the control of the individual. Muscles respond differently for each person. Symmetrical development is not the norm.

In addition, combining endurance training with strength training does not appear to impede hypertrophy. “In fact, the addition of high intensity cycling might increase muscular hypertrophy,” the researchers added.

Importantly, no training for up to three weeks does not appear to cause significant muscle shrinkage, and may even increase results upon return to training. “This seems logical” the researchers wrote.  “The body does not grow during training, but rather whilst recovering from the training stimulus. Brief periods of excessive training require a similar period of no training to allow the body to recover and prepare for further training.”

The researchers ended with a word or two on expectations. While the time required for muscular growth varies from person to person, significant hypertrophy usually begins to appear within three weeks of starting resistance training. Untrained persons gain faster than trained persons. “It should be realized that once a person is in some degree of trained state that their rate of growth is likely to diminish,” the researchers observed.

While the vast majority of people respond positively to muscle training, it has been reported that roughly one percent are low responders and three percent are high responders. Most people fall somewhere in the middle.

* * *

Fortunately, the best way to build muscle is the way that you enjoy and do best. The main requirement is effort; the last rep or two should be hard. Also keep in mind that muscles grow after training, during the recovery period.

Stress and rest. Stress and rest. Stress and rest. That’s the formula for muscular gains. Remember that and you’re home free.

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