Hello and welcome to Fast Talk, your source for the science of endurance performance! I’m your host Coach Trevor Connor here with my pasta-loving co-host Rob Pickels.
Carbohydrates, particularly simple sugars, are a complicated topic in the world of endurance sports science—and also one of the most controversial. In Episode 259, we talked with Dr. Asker Jeukendrup who, along with Dr. John Hawley, have led the way in strongly supporting the need for carbohydrates to perform based on decades of research. But there are equally respected researchers on the other side of the camp who believe that we can perform just as well on a low-carbohydrate diet.
One of those respected researchers is Dr. Paul Laursen. He’s been involved in recent research that shows endurance athletes have no loss in performance after adapting to very low carbohydrate diets like the keto diet—even during short, explosive efforts.
Our talk with Dr. Laursen will be a follow-up to our episode with Dr. Jeukendrup about the pros and cons of carbohydrates. As Dr. Laursen points out, they agree on 95% of the science. But that other 5% can be important.
During our conversation, we dive into whether endurance athletes can truly perform on a very low carbohydrate diet. But, more importantly, we discuss the health implications of a diet based on simple carbs. As Dr. Laursen points out in one of his recent papers, there is such a thing as an unhealthy high-performing athlete. This includes a deep-dive into the impact of a high-carbohydrate diet on the immune system and why endurance athletes have higher rates of diabetes and autoimmune disease. Finally, we talk about the impact of exogenous ketones on both performance and recovery.
So, grab a plate of pasta or salmon—your choice—and let’s make you fast!
Episode Transcript
Trevor Connor 00:04
Hello and Welcome to Fast dog, your source for the science of endurance performance. I’m your host coach Trevor Connor here with my past the loving co host Rob pickles. Carbohydrates, particularly simple sugars are a complicated topic in the world of endurance sports science, and also one of the most controversial. The reason episode 259. We talked to Dr. Asker, you can group who along with Dr. John Hawley have really led the way and strongly supporting the need for carbohydrates to perform based on decades of research, but they’re equally respected researchers on the other side of the camp who believe that we can perform just as well on a low carbohydrate diet. One of those respected researchers is Dr. Paul Larsen. He’s been involved in recent research that shows endurance athletes have no loss in performance after adapting very low carbohydrate diets. Like the keto diet, even during short, explosive efforts, our talk with Dr. Larson will be a follow up to our episode with Dr. Youcan group about the pros and cons of carbohydrates. Dr. Larson points out they agree on 95% of the science, but the other 5% can be important. During our conversation, we dive into whether endurance athletes can truly perform on a very low carbohydrate diet. But more importantly, we discussed the health implications of a diet based on simple carbs. As Dr. Larson points out in one of his recent papers, there is such a thing as an unhealthy high performing athlete. This includes a deep dive into the impact of a high carbohydrate diet on the immune system, and why endurance athletes have higher rates of diabetes and autoimmune disease. Finally, we talk about the impact of exogenous ketones on both performance and recovery. Unfortunately, we used up all our carbohydrate site interviews for episode with Dr. Youcan. droop. And that’s okay because we didn’t have a lack of things to discuss with Dr. Larson today. So grab a plate of pasta or salmon, it’s your choice, and let’s make it fast.
Rob Pickels 01:49
There are more female athletes and endurance sports than ever before. Yet, until recently, female athletes simply follow the advice and protocols that have been designed and tested on men. This is now rapidly changing. And there are a host of experts bringing light to the perils and pitfalls associated with female athletes following guidelines that are male specific. Check out our latest crafted coaching module coaching female athletes for expert guidance on coaching women.
Trevor Connor 02:18
Well, welcome everybody to another episode. We are really excited to have Dr. Paul Larson with us, Dr. Larson. I’m embarrassed to say this, but this is the first time we’ve had you on the show. Not the first time we mentioned you because we recently did an episode talking about a bunch of the research that you did, which was a really fun episode for Rob and I but great to have you in person on the show.
Dr. Paul Laursen 02:40
Thanks, Trevor. And Rob, it’s great to be here. I did listen to that episode. And my ego is was this high? So yeah, it was it was awesome. Yeah, great job on it.
Rob Pickels 02:50
Yeah. Thank you.
Trevor Connor 02:52
Well, obviously, we know you as a researcher, and you have produced some absolutely fantastic research. But I think something worth mentioning here as you are now venturing into also being a businessman, you have a couple businesses that you’ve recently started up.
Dr. Paul Laursen 03:08
Yeah, I don’t know if it’s recent. But I yeah, I mean, in the last five years, I guess, I left the sort of research area in terms of focused and then went to write a book write science and application of high intensity interval training. And basically, after we wrote that book, we just kind of said, well, we can’t just have a book, we need to have a course. So the course turned into a business, ultimately, that’s called hit science. And then the second business so you know, we can’t just have a course this whole area of AI is moving quite rapidly. Let’s be in that as well, because it doesn’t look like it’s slowing down. So yeah, the second business is called Athletica AI. And it’s the technology version of the hit science startup brand, the the educational platform that that is so yeah, those are the two businesses but I’m also still a an adjunct professor at two universities, actually both at University in New Zealand. And I’ve just joined Stephen Siler, you have an orphan as well at the University of Agder. So I’m still into the research thing there as well sort of, you know, try to be in that nexus between science and application, I actually think that the whole AI stuff is where the next level of research is gonna go, we’re gonna actually going to get more information. And that’s why I actually want Athletica to be a little bit of a research platform. We’re already running studies on that. So um, yeah, that’s me in a nutshell, in the last five years,
Trevor Connor 04:33
that was one of the things that I thought was really unique about your platform. There are several AI training platforms out there that are really focused on just building training plans, but yours is far more than that. And you are going to be using it for research which is really exciting to see.
Dr. Paul Laursen 04:47
Yeah, and we already are so we’re already running a female menstrual cycle study in collaboration with HRV for training and mirror care fertility as one example, just to look at whether different phases So the cycle are impacting training, load and training, load response performance. So and you know, should a woman train specifically harder or softer, depending on the phase of the cycle,
Trevor Connor 05:11
and ethic? Well, it’s gonna be exciting research to see.
Rob Pickels 05:14
Interestingly, Dr. Larson, you have quite a wide range in scope. Because today we’re not talking about any of that, are we, Trevor?
Trevor Connor 05:22
No, we’re not. But this is something you’ve been doing research on lately. And today’s episode is kind of a continuation episode. So not that long ago, Episode 259, we had Dr. You can droop on the show. And we talked about carbohydrates. And I can’t remember the final title we had for the episode. But the the working title I was using was carbohydrates, the double edged sword because there’s a lot of researchers out there who are saying to perform at a high level to be able to do really high intensity work. You need carbohydrates. But there is a health impact to simple sugars. And that’s what we really want to cover in the episode. And obviously Dr. Jochen droop, is very much on that side of yes, you need carbohydrates. It’s a huge topic in that episode, I remember I built this big outline for it. And as we’re going through the show, and going well, we’ll have to skip that we’ll have to skip this, we’ll have to skip that. Because there was just no way in an hour, we could cover everything. So Dr. Larson, this is kind of the continuation this is let’s cover those things that we weren’t able to cover in that episode. And more importantly, get your perspective on this. So maybe we just start before we dive into this. What’s your one two minute summary of your position on the need for carbohydrates in high performing athletes?
Dr. Paul Laursen 06:47
Well, first of all, I was just I love that podcast. And I just want to start by saying that I agree with, like, 95% of the take home messages in that one. And I highly recommend that, you know, people go back and listen to that this is as Rob kind of called it at the end, the parody podcast that you guys would do after that one. So but yeah, I mean, my stance on carbohydrate, and and its need in performance can be summed up in the word context. So it really depends on the context of what sort of sitting in front of you, that’s where I, that’s where I’ve landed on like today, when I look at the field. So if you are, like Rob, a high carbohydrate athlete, if you indeed you are Rob, then all of the rules that are currently out there, they, they apply. But I also deal with very low carb ketogenic athletes that go very well win win races win big Ironman events in the world. And in their context, that’s not necessarily the case, there’s something different that’s kind of going on. And this is where, you know, this is what we’ll probably dive into a little bit in the research is, can we do things a little bit differently? You know, and I’m definitely in agreeance, with everything you’ve said on that podcast with respect to the fact that on game day, you definitely want to throw gasoline on the fire, to, you know, to kind of get everything you can out there, but maybe it’s not as much as every week. We started here there, you know, with 90 to 120 grams per hour and stuff. I’ve seen it done a different way. And maybe that other way could be healthier. Maybe the jury’s still sort of out on that. But that’s yeah, that’s sort of a two minute some of where I sort of sit on the area.
Trevor Connor 08:34
No, it’s a good summer. And I’m glad you brought that up. I think even at a topic like this, you know, we’ve had Dr. Hawley and Dr. Noakes on the show, Dr. Hall, he was very much you need carbohydrates and eat carbohydrates. You need carbohydrates, Dr. Noakes has been very much on the I think you can perform on a ketogenic diet. So that’s, that was big a difference, as you could see yet when we had them on the show when we were bringing up the others points. They’re kind of going Yeah, no, I agree with that. I agree with that. And principle. So it was ultimately in kind of those details that you saw the disagreements.
Dr. Paul Laursen 09:08
Totally. Yeah. And again, when I want to review back that podcast she did with Oscar. Yeah, you guys are talking about eating dinner in Oscars words. It’s like yeah, if you’re going out for like a 90 minute two hour ride, you probably don’t need anything. So he’s saying that and he’s, you know, X Gatorade, Sports Science Institute leader and those sorts of things. And so that was great to hear. But yeah, if you want to perform, and it really matters, well, then you can throw gasoline on the fire and you’re probably going to be okay, you are probably going to get a little bit of an inflammatory response. But on a one off, you’ll definitely you’ll recover from that.
Rob Pickels 09:43
Well, so far, this episode is starting off much too nice. Not enough conflict. We know that people thrive on conflict and so I’m just going to bring this up. I’m going to bring this up right now to the both of you. I prepared for this episode while eating a bowl of noodles go Go ahead and take the carbohydrate out of my cold dead hands. I want you to try to convince me otherwise, go. Nice. Nice. All right,
Trevor Connor 10:09
so we got our theme we go after your noodles, but we can say some of that until a little bit later.
Rob Pickels 10:14
Oh, you want you want some noodles? Whatever, you’re hungry.
Trevor Connor 10:17
You know, when’s the last time I actually ate noodles Half past never. I knew you. It’s been like 10 years.
Rob Pickels 10:23
Whatever, carrot boy.
Trevor Connor 10:29
My team used to want to do interventions on me when I went paleo because we’d be at races and they’d be having the giant past the parties and I’d be eating salmon with vegetables. And they’d be like, Trevor, you can’t perform on that. And just get really upset at me and try to convince me to eat their noodles.
Rob Pickels 10:43
Well, let’s start there. Right? Do we need carbohydrate to perform? And maybe for the people who haven’t listened to Episode 259? Trevor, I would love to hear your recap on when we say carbohydrate when we’re talking about that. What specifically are you referring to? Yeah, so
Trevor Connor 11:02
I’ll give the the quick definition. And then I’ll give the summary of some of Dr. You can do its points. And then Dr. Larson, please take it away from there. So just taking a step back, there are three major and what are called macronutrients in our foods, there’s proteins, fats, carbohydrates. What’s important about the macronutrients is we can use all of them to produce energy. So any function or body that uses energy, actually, the direct energy sources something called ATP, but our body needs to produce ATP from a MP and ADP. And we use carbohydrates, fats, and protein to create that ATP. And they can do it at different rates. So vantage of carbohydrates is it can produce ATP very quickly. But a single molecule of glucose can’t produce that much. A fat molecule produces ATP much slower, but it can produce a lot of ATP from a single molecule. And then protein, it actually takes energy to use protein to produce ATP. So your body preferentially will always use carbohydrates and fats before it will use protein for fuel. So you have to be pretty deep into a long ride before your body starts going. Okay, let’s let’s burn that protein. Let’s let’s get some energy there. I get that right. Dr. Larson?
Dr. Paul Laursen 12:22
I would say so for sure. The only thing that again, back to my context comment is that, you know, in a fat adapted athlete, I think they can probably utilize fat at a faster rate than we might think. Otherwise, absolutely saying.
Trevor Connor 12:35
And then there’s also something I wasn’t gonna go too much into. But there’s something called oxidative priority, which is which of the macronutrients your body’s going to burn for so if you eat a mix of carbohydrates, protein, and fat, which of those is going to oxidize first and the order in something you know, some people consider alcohol a carbohydrate, some people consider it actually a fourth macronutrient. But the order tends to be burned alcohol first, then carbohydrates and fat and then burn protein. For some
Rob Pickels 13:01
people. It’s a totally separate food group. Yep. We can
Dr. Paul Laursen 13:04
also add in the the ketone is the fifth macronutrient as well. Yep.
Trevor Connor 13:08
The reason I was explaining what I did about these macronutrients is the argument that doctor you can group and Dr. Holly have made is, well, we can go forever on fat. Their argument is you can’t do really high intensity work on fat. So if you’re chugging along at a kind of a slower pace, yeah, your body’s gonna be completely fat reliant. And the point that he made is as you increase intensity, you start seeing a ramping up of of carbohydrate oxidation. And you’ll see fat oxidation kind of plateau at a certain point and then actually start to decrease. And this was Dr. Hawley, an argument that he made in one of his papers is, well, you can improve your fat oxidization at the same relative intensities. So if you’re at 90% of vO to max, no matter how much training you’re doing, you’re always going to be realigned about the same amount on carbohydrates or fuel. Meaning at high intensities, it doesn’t matter how trained you are, you’re gonna be mostly burning carbohydrates. And so his argument is fats great for lower intensity work. But if you’re in a race that requires jumping, sprinting really high intensity, if you don’t have those carbohydrates, you’re not going to win the race.
Rob Pickels 14:25
And I would say that for most individuals who are eating a very diet, we have all experienced kind of that glycogen depletion that ultimately limits our ability to work at those high heart intensity levels. I know that my legs can certainly feel heavy, I can struggle at efforts above threshold. But Dr. Larson something that I think that you’re especially keen to talk about is if we change that context, right, if people adapt their bodies to the usage of fat as a fuel You will source instead of, I’m going to call it a normal, even though maybe that’s not the right word, a normal mixed diet, you know that one diet leads us kind of on one set of of results. But by altering the metabolism of individuals through training through daily diet, maybe through supplementation, we can alter the pathways that we otherwise thought that we knew really well and have completely different results.
Dr. Paul Laursen 15:27
That’s right. That’s exactly it. So if you go through, this is what the research is now showing is that if you go through an adaptation period on a well formulated low carbohydrate, high fat diet, that you can increase the maximal rate of fat oxidation. So it doesn’t have to be down in you know, 0.1 to 0.3. What is it grams per minute, it can be upwards of one plus two, you know, 1.3 1.5 is what these these are these studies are now showing at high exercise intensities, higher exercise intensities. And I totally know the research and the studies that Dr. Holly is referring to, with respect to the fact that we should think that 90% of VO2max carbohydrate is, is king and fat is not. But there’s other research that’s out there on the falsity of this analysis. And it’s in the fact that when we are oxidizing high carbohydrates, we’re also producing lactate and hydrogen ions. And what winds up happening inside the body is we see a meeting of that those hydrogen ions with sodium bicarb. And that produces of course, carbon dioxide. So you get outside at those higher exercise intensities, you’re also getting a lot more carbon dioxide. Well, why is that important? What’s important because that is blinding us from what’s actually going on when when there’s a whole bunch of carbon dioxide that’s being spewed out, it’s making the situation look like there’s a whole lot more carbohydrate, that’s actually being oxidized than actually is and the tracer data, then there’s very few because these studies are very expensive and hard to do. But there is tracer data to suggest that fat can be burned at a much higher rate than we originally thought. And really think about it from a practical standpoint, do you think that the muscle cell that’s low in energy is going to throw away a perfectly good source of energy in terms of its, you know, fat being there? Does fat disappear in the muscle cell? I just don’t believe it does. So I think if you change the context, you can have much higher rates of fat oxidation at high exercise intensities than we think right now. And again, anecdotally, Trevor, I know you would know as a as a low carb ish athlete, my athletes would know that as well. And yeah, I think everything that you said in the intro, Trevor, is, is right. But when you do change that context, I don’t think it matters as much with respect to the the energetic sort of properties, like you know, in terms of the carbohydrates burning hot versus the fat not, I think that those carbons and hydrogens still pushing through there can be burnt by oxygen at the cell level. And we can we can get a lot more ATP out than we think at high intensity exercise from fat.
Rob Pickels 18:29
Before we go any further, I want to take one step back and explain the concept that Dr. Larson is talking about here. When we’re in the laboratory, and we are trying to determine what fuel source or mix of fuels ultimately, an athlete is using across different intensities. Then we have that athlete hooked up to a metabolic cart, and we are capturing the gas exchange that’s occurring. So we know the ambient environment, we know the ratio of oxygen and carbon dioxide. That’s what the athlete is breathing in. But we’re also capturing everything that the athlete is breathing out. And through looking at the ratio of oxygen and carbon dioxide, we can back calculate because we know based on the chemistry, the biochemistry, the stoichiometry within the body, we can back calculate with relatively good accuracy, the substrate that is being burned or the mix. So when that ratio is closer to point seven than the athlete is burning, we would assume kind of a pure fat or a high fat situation. And as that number climbs towards 1.0, then we would assume that the athlete was in more of a carbohydrate burning situation. But as Dr. Larson is pointing out, anything that skews that carbon dioxide, right, if that carbon dioxide isn’t purely metabolic, then it can skew the number toward the carbohydrate end of the spectrum. And as he’s pointing out the buffering we’ve talked about bicarbonate buffering in the past here, and we might even have talked about soda loading as an ergogenic aid. is going to produce additional carbon dioxide. And that can make it look like somebody is burning more carbohydrate. Whereas the tracer data that he’s referring to is consuming carbohydrate that’s laced with carbon 13, if I remember correctly, and then being able to look specifically for those carbon 13 molecules, so we’re not looking at the ratio anymore, you’re counting the carbon 13 and the exhaled breath. And that can be a little bit more of an accurate way to say, Yes, this molecule specifically was broken down for fuel. And I know that because they ate it, and now they’re breathing it out. So metabolism must have occurred.
Dr. Paul Laursen 20:38
Yeah. Excellent summary, Rob. Thank you.
Trevor Connor 20:41
I think another angle to look at this from we actually just did an episode on Dr. Hawley and read a review he did in 1997, or 98. I can’t remember which year where he addressed that Mises said, there’s no research to back this. But one of the counter arguments, Dr. Larson that I think you’re making is a lot of those studies were just let’s have eat a high fat diet for 710 days, and they didn’t really have a chance to adapt to it. And if you had done get on that high fat diet for several months, you might see very different results.
Rob Pickels 21:15
Yeah, I mean, or worse still, right. They’re taking athletes who are otherwise adapted to a high carbohydrate diet, they’re acutely causing glycogen depletion, and then they’re putting them into a performance test. And, of course, in that situation, you’re taking somebody completely out of, you know, their normal working conditions, so they’re going to perform poorly regardless.
Trevor Connor 21:36
So Dr. Larson, what are your thoughts on this?
Dr. Paul Laursen 21:38
I think you guys nailed it, there is the fact that the bulk of the research to date and you know, to coin some of Louise Burke’s papers, you know, nail in the coffin and stuff on fat adaptation, was it unfortunately, that those studies were just, they were all a max of around around seven days, you know, sometimes there were three or five days. And then I think anecdotally people were just saying when that when they went longer on this kind of came from the health area where they started going longer and longer and, and seeing more and more adaptations and benefits. So anecdotally, the people were saying, Well, no, this is my actually actually feeling and performing and recovering a whole lot better when I go longer on this. And then you know, to do these studies are so hard and expensive and time consuming. For for researchers, they’re not easy to do. They require a lot of money and patience. And now we’re starting to see more of these, you know, one month, three months kind of studies going on. And now we’re finally starting to see the data coming in to support the fact that maybe you can get away short term at least on not having carbohydrates, ultimately, in your diet to perform at higher exercise intensities. Well, maybe you can even go even better.
Trevor Connor 23:02
Where you have several D studies, you have a four week study and a 12 week study where you are looking at Fat adaptation and in high intensity interval training and found no loss in performance.
Dr. Paul Laursen 23:13
Yep. And that was, so kudos to Lucas Cyprian, out of out of the Czech Republic. He’s done some incredible work with his team out there. And I’ve been fortunate to be a part of those. And yeah, exactly to your point where we asked the same sort of question and we went for we started with a four four week experiment. And we had two different groups on two different diets high or low carb. And basically we just looked at pre versus post and it was vo to max performance on the first one. And indeed, We found no difference in via to max performance, you know, it just a standard test in recreationally trained subjects. So that was just sort of the starting. So it was just interesting. They didn’t have any carbs in their diet. But their vo two max performance, you know, standard step test was the same pre versus post. And then we did that one for 12 weeks, we brought it out even further. And we’ve added in some high intensity interval training work in there as well. And once again, there was no difference in high intensity interval training performance. This is on a 3015 intermittent fitness test in more kind of team sport athletes throughout that study. So again, there was there was more data for that. And then of course, we took even more biomarkers throughout these sorts of lengths of time as well, right? We weren’t just looking at the performance, but we’ll get into this as later on, I’m sure but the the striking finding was was that there was evidence that there was a lot more you know, there was a better health outcome ultimately, and no, no decrement in performance with the sort of well formulated lower carbohydrate high fat diets. So that was Yeah. And that’s, that’s our work. And then and now we’re seeing the group of printers at all Tim Noakes, Andrew Karlovic, you know, these guys are doing some incredible work with, with showing, again, even more detailed work and long durations and showing really high fat oxidation rates and no decrement in performance. And these guys are doing one mile time trials. And this is easier in runners. And again, no, no decrement in one mile performance, and they did a repeated measures designed to which is even more powerful. So you got to go through both diets, there was even like, you know, some subtle differences in terms of not statistically but subtle differences in terms of performance outcome in the in the lower carbohydrate diet, and concomitant with fat loss as well, or the body composition data was even better as well. So yeah, there’s, we’re, you know, these, these are still early days. But when the this context is changing, we’re not seeing this same typical outcome that we have thought for so many years, where you have to have carbohydrates in your diet to perform at higher exercise intensities. And to your point, you made this as well, Trevor a little bit is that it’s we’re not saying carbohydrate isn’t used for that. But I’ve heard you guys say it before, there’s a whole process of gluconeogenesis that’s going on, the liver is just doing things the body is doing things in a different way to get that that carbohydrate, and it’s you know, it’s it’s ultimately all down to the liver livers up incredible machine to be able to create the carbohydrate that we need out of the fat and protein that we put in our bodies. So we don’t have it doesn’t have to be carbohydrate from the start. It can be fat and protein to do the same job.
Rob Pickels 26:49
Something I want to point out from Dr. Larson study is that the athletes who were on the high fat, low carbohydrate diet, were consuming less than 50 grams of carbohydrate per day. And to put that into context, that is a third of a cup of pasta. Right? So think about one of the everything in terms of pasta. Yeah, man, that’s noodles. That’s my life right there. But that’s not a lot. And that’s the total amount of carbohydrate, right? So ultimately, these people, you’re not eating pasta, this is what you’re getting from eating probably just some vegetables, not even fruits, right? Because that’s not a lot of fruit either. And so when we talk about low carbohydrate, it’s quite a small amount, quite radically different from the typical diet that most people are consuming.
27:39
You are in Quito territory, this is a ketogenic diet.
Dr. Paul Laursen 27:42
That’s right. And yeah, I mean, it’s often it’s a good way to go about research. Sometimes it’s is you kind of we often look at the extremes. I mean, you go back to the podcast you did with Dr. Jason Drew 259. And that was, you know, he was talking about a very extreme sort of situation where he had a, he had his guys on a lot of, you know, some really high high carbohydrate contents, right. And again, sort of same same sort of thing for this, we’re looking at very low carbohydrate content in the diet. But that’s not to say that the nutrient density wasn’t exceptional as well with this. So you know, there’s the micro new micros and and vitamins that were coming in, would be pretty solid. And they built a I believe they built a healthy and robust individual and those one month to three month periods of time,
Trevor Connor 28:34
which is one of the biggest challenges. It’s why I haven’t been a proponent of a straight keto diet. Because when you are cutting fruits and vegetables out of your diet, which a lot of people on a keto diet, do you lose a lot of those micronutrients you need, and you end up with a diet that can be deficient. But I
Rob Pickels 28:51
do think it’s important that there are good ways and there are bad ways to go about any diet right and they’re terrible ways to do a high carbohydrate diet and they’re terrible ways to do a low carbohydrate diet and health needs to be first and foremost,
Dr. Paul Laursen 29:07
anytime yet we’re all on all on page there. You know, in the whole battle, whatever you want to call it, you know fight that kind of rubs rub started with, it’s often been about the macronutrients and the micros have just sort of been forgotten in the whole thing. And they might be way more important than we than we realize. In fact, I believe they are because they’re the They’re the building blocks of all of the machinery that are in the body like the mitochondria and you know, all of the various processes that that go on and the the various aminos and essential, essential fatty acids that are required to build the structures in the body. I just think those are just they really were forgotten. Like when people fight about these sorts of things. That’s my opinion.
Trevor Connor 29:54
No, I agree with you. And I actually, several years ago now wrote a an article with the Dr. Cordain, about the importance of nutrient density, and we actually created a table showing the average density of the different food groups. And the argument we made is you can actually eat a very healthy diet just by focusing on nutrient density.
Dr. Paul Laursen 30:16
I agree. And that’s like, in my own personal diet, that’s what I like, where I’ve kind of landed, I’ve gone through all I’ve gone through everything in my life, right, like, so I’m in my 50s now, and I’ve been vegetarian. I’ve been extreme keto. And, you know, and everything else in between high way too high carb sugar based, you know, when I was when I was killing it as a as a young Iron Men battler and today I’m, I’m all about just the focus on the whole foods, and the micro, and the density of of nutrients that I’m taking in. So
Trevor Connor 30:53
and you know, this is a bit of a tangent, but an argument I will make there, when you get to people say, you know, I have problems managing my weight. I’m a big believer in this. And there’s definitely research to back this, that hunger is not an on off signal. When we are hungry, we’re usually hungry for something. And I think one of the best examples of this is pregnant women, because if they are deficient in a nutrient, the body gives priority to the child, the growing child. So that means the woman come very, very deficient. And you see these what everybody thinks of these crazy cravings. But when you look at the things they’re craving, they’re usually really high in a particular nutrient. And so there’s, they just have this sense of here’s what I need, here’s what I’m really deficient in. And the argument I will make is, when people are hungry, their body is usually hungry for something. And it’s not just calories, it’s often particular nutrients. And so if you go and have a Big Mac, and some fries, your body’s gonna go, well, that’s great, I’ll store all those calories. But there wasn’t a lot of nutrient density in that I didn’t get what I needed. So I’m not going to turn off the signals. And I’ve always told people stop counting calories, if you want to manage your weight better. Just focus on a nutrient dense diet, you’d be amazed how quickly you’re going to be satiated and not feel that need to keep eating.
Dr. Paul Laursen 32:18
Yeah, that’s such such good advice. And it’s very similar to the one I give my athletes as well. And yeah, it’s focusing on real food eating when you’re hungry, listening to your APA stat. And unfortunately, the I think we were sabotaged a little bit with, you know, the processed food that we’re, you know, makes up the majority of the supermarket’s out there and fast food outlets. And they’re all dopamine based products ultimately, that they give you that short fix. But they don’t turn off the APA stat, they don’t turn off your appetite and you’re always kind of constantly hungry, you know, you’ll be the dopamine block will be there for a moment. And you’ll just kind of go go back for more of that and it’s it’s it winds up forming an addiction, I actually wanted to share just how bad it can get with, you know, I’ve got I’m working with an athlete right now. And like just the diet plan, like so we’re out you know that he’s just come to us. So it’s just just just sort of starting, but here’s like this is a top 20 is a top 20 swimmer in the world that I’m working with right now. And the distance swimmer so this is just how good you can get on crap ultimately, like I mean, I’ll just read you some of the some of the diet plan stuff that we’re that we’re getting. So he starts he wakes up in the morning he has a carbo drink for breakfast. I don’t know what that is, but then he goes and does his training. He finishes his training with a protein bar and a pack of Doritos. Then he for lunch he has 500 grams of pasta with tomato sauce Robert like that one. For a snack. He has half a chocolate bar then goes to a carbo drink for primer for his next training session finishes that has a protein bar and for dinner. This is one one of the days he has KFC large Maxi popcorn and a chicken combo. And then on to the next day. And again, it just repeats right? And then we go McDonald’s 24 Nuggets and large fries. And like it’s a complete this is how a top 20 swimmer in the world is actually performing. And when I even bring up the topic of some of the stuff that we’re speaking about today, there is very much a an alarm that goes off in this individual’s mind to even start to contemplate about eating whole dense, dense foods. Because there’s an addiction problem in here with this what I’ve just said, right, the he that’s that’s he needs that sort of dopamine hit constantly around his training. That’s how he he exists. So this can be a very, very tough ask for me and the dietician that are working with him, but you know, yeah, so um, I don’t necessarily have the answers just yet, but this is it Good, good professional development for me as well to get him inside his head and work on some mindfulness sort of stuff to be able to give him the tools to be able to switch this because continuing to do this is not going to help him be a top 20 And podium swimmer in the future.
Trevor Connor 35:16
No agreed. And that I think it was a good transition to you wrote a paper that I quite enjoyed. It was just titled athletes fit but unhealthy raising this fact that, you know, we think of top performing athletes, oh, they’re such healthy people. But if they’re not eating well, are they truly healthy?
Dr. Paul Laursen 35:33
And no, they’re not, you can only imagine, right? I won’t say too much more. But it’s like, he’s obviously been doing this for a long time. The processes in his body are not not optimal, you’re not going to be recovering well, and this yet, we’ll come back to get him. And but it is, it’s just amazing that you can be completely, very unhealthy on the inside, but looking like, you know, the athletes that, you know, we look up to, and we idolize and bronzed and muscular and all that sort of stuff. But there can still be some, you know, a lot of various high inflammatory processes that are going on inside the body that aren’t aren’t optimal. It’s amazing what the body can do. It’s all stress at the end of the day, but the diet that I just listed off is a very stressful diet, that exercise and the training, that’s that’s getting done that stress, but the diet is adding stress, and it’s not doing the good job in the recovery sort of phase to heal and rebuild. It’s just Yeah, it’s not an optimal process.
Rob Pickels 36:34
Yeah. And so to discuss the difference performance in kind of being an athlete, right, that’s the ability to do a specific task and to do it well, to run a mile as fast as you possibly can. But health is different from that, right health is the optimal function of the internal systems in our body health is being free of disease, health is longevity. And sometimes those two things are potentially at odds with each other. And I think that as individuals, we need to be able to have a holistic view, and not necessarily give up one for the other. But ultimately, how do we maximize both health and performance? Because we’re all athletes?
Dr. Paul Laursen 37:16
Yeah, well, yeah, very well said. Exactly. It is, it is kind of a holism sort of thing. It’s all systems in balance. That’s what it’s sort of all about. I also reflect on a classic example, I’ll just sort of say you can get away with this for a certain period of time. And again, our messaging with the high carbs through, you know, the gator aids and those sorts of things. I was here as well, I did this too. Not that bad. But there was elements of my diet in my early 20s as an Ironman triathlete doing the same sort of sort of stuff. And my belief was that I could kind of get away with that, what winds up happening, and again, I know this intuitively from my own health. And I know this also, we can look at the Prinze data as well. But over time, even the athletes, you can outrun a bad diet, you start to develop these chronically high levels of blood glucose, so much so that in the Prinze data, there’s 30%, three out of the 10 athletes were pre diabetic in terms of their their blood glucose levels. So they’re sitting at in the I think it was around 115 120 grams per deciliter in terms of the blood glucose levels. So they’re, they’re sitting elevated high like that. So it’s not the exercise is no longer holding, you know, you guys in the Asperger’s, you can do a podcast, you guys spoke about how exercise can control a little bit of that because of the insulin independent marker and ways of actually getting sugar into the cells. But over time, you will start to develop this hyperglycemia or hyper and then you get a hyper insulin EMIA and various different cascade of health implications. So, over time, it’s it will kind of catch up with you. And the example that I was also thinking about was Steve Redgrave. I don’t know if you guys would know who that is. But he’s, sir. Steve Redgrave. So he’s a very famous rower from the UK, multiple gold medals. He’s diabetic now, right? And there’s, unfortunately, you know, I’m seeing this in other rowers. So follow the rowing programs a little bit. I’m seeing this also happening too. And it’s just the pattern or the behavior and the habit of always having that high carbohydrate, high sugar, the fact that we can kind of get away with it, you sometimes don’t leave it later on. And a lot of our athletes, we can see them actually getting unhealthy as they as they continue. If they don’t do something about that, and many don’t, unfortunately,
Trevor Connor 40:00
Pass talk listeners. This is Trevor Connor. Would it be cool to decide what Rob and I are going to chat about on an upcoming show? Or how about we answer a question the polarized training you’re dying to know what about a 30 minute zoom call with Robert me on your favorite sports and dirts topic. This is all possible to become a fast talk Patreon member, we have four monthly membership levels to fit your level of support. If you enjoy fast talk, help us stay independent in dishing out your favorite sports science topic by becoming a fast talk Patreon member, you can join us at patreon.com/fast Talk podcast. Something I always remembered from back in my racing days when I was traveling with teams. This is gonna sound a little bit gross. But I always noticed this particularly as I got to understand the physiology and understand nutrition better. But you know, we’d be sitting there in the van or the bus getting changed for a race. And I’d watch all these young guys take their their shirts off. And they all their chests were covered in pimples. And I always noticed that and something our listeners might not understand. They’ll try to give the the very quick version of this. But an interesting fact for you is what sparks puberty. So we go through puberty and we go through that big growth spurt is initially we become insulin resistant. So it’s almost like a type of diabetes. insulin and insulin like growth factor are what produce puberty, what causes us to grow. If we start becoming insulin resistance, our insulin is gonna go up our so the insulin growth factor IGF one is going to go up. And this has been shown in the science that basically what causes pimples is I can remember was insulin or IGF one, I think it was IGF one binds to the basolateral side of our hair follicles and causes inflammation in them and they seal up. And that’s what actually causes the pimple. And so when I see that when I saw that with my teammates, when I was going to the races, these these pimples all over their chest, and like you’re showing early signs, you’re actually becoming insulin resistant, even though you’re in your 20s and 30s. Yeah, I’ve
Dr. Paul Laursen 42:12
heard I’ve heard of that one as well. And that’s it’s kind of I can’t turn it off anymore. When I see individuals, often athletes with a lot of pimples in no sort of now what’s going on in their insights, you know, for those of you out there if that’s if that’s ringing a bell, or if you know others, it’s, yeah, it’s it’s an opportunity to potentially change something and do it a little bit more wholefood,
Rob Pickels 42:38
Dr. Larson, when you were speaking earlier about hyperglycemia and hyperinsulinemia. It sounded a lot like, you know, we hear from Dr. innego, San Milan about metabolic flexibility, the body needs the ability to utilize both carbohydrates but also fat. And you know, a researcher like Dr. San Milan, very much his philosophy is that the ability to do this comes ultimately from exercise intensity, right. And this is why he proposes a lot of longer, slower work zone to base in addition to the high intensity, I’d love to hear your stance on how much of this Metabolic flexibility I’m just going to use that term, you can use a different one if you want, how much of that should come from diet, how much of that comes from training, as you pointed out athletes and training alone doesn’t necessarily protect you? What’s the best way to make sure that we have this flexibility as we move forward so that we’re not, you know, burning carbohydrate in an appropriate manner?
Dr. Paul Laursen 43:38
Yeah, it’s a it’s an awesome point. One of the key ones for sure, is the fact that so there’s lots of different ways to skin a cat when it comes to your metabolic flexibility. So my my main sport is the sport of Ironman Triathlon. So for example, and you know, Dan, Dan Plews mineable no kind of world record holder and fellow colleague, we’ve sort of seen this where we know lots of individuals within the Ironman level at the at the highest level, they can train up to 30 to 35 hours or even 40 a week, right? So excessive excessive training to get that metabolic flexibility that they’re after, if they can grasp the concept around the diet stuff that we’re talking about, they can probably do the same thing. And bring that down to, you know, 20 to 25 hours, but more more quality, but still more metabolically flexible, and they’re ultimately getting a better adaptive response. And they’re ultimately, I guess, not inhibiting signaling in the post exercise sort of period. And that’s very anecdotal. I know, but that’s what we see. And you can tell from a from a performance standpoint, too, because these are all no one experiments, but they come in and they come in and they’ve done 35 to 40 hours, and then we can we bring them down to So, between 22 and 27, but we also switched, we do all that diet stuff as well. And yeah, this wind events. So yeah, they we’ve basically shown you can skin the cat a different way, and it’s likely a more sustainable behavior to take with you the rest of your life.
Trevor Connor 45:19
So Dr. Larson, I’m kind of excited about this, because when we talked with Dr. You can group I brought up some of the immunological effects of carbohydrates. And he said, you know, this, that wasn’t his area of expertise. So we kind of brushed over it, you have said, You are a game. So I hope you are ready. But you wanted to hear my take on this first. So maybe I’ll give the quick kind of 510 minute summary of some pretty complicated immunology. And hopefully, my summary doesn’t destroy it too much.
Dr. Paul Laursen 45:51
Can you start even Trevor? And just what’s the role of the immune system in the body? What’s its job?
Trevor Connor 45:56
Well, that’s the thing. You know, this is something when Dr. Cordain was advising me that he always loved to say is whenever nature evolution discovered something useful, it finds multiple multiple uses for it. So you know, we always think of the immune system as you get a cold, and it’s what fights the cold, that’s one function of it. But the immune system is actually a remarkably complex system of multiple, multiple signalers, multiple, multiple different types of cells. And our bodies have figured out a whole lot of ways of using them. So when you get sick, yeah, their job is to fight the illness. But as I’ll cover in a minute, the vast majority of our immune system actually lives around our gut, and, and protects us from any sort of invasion from the gut. But likewise, you go out and do a heart interval session, and you do damage to your muscles, the immune system that actually comes in and repairs all that damage. So it’s hard to in one sentence, say, here’s the function of the immune system, because our bodies are basically said, This is great, remarkably complex system, let’s see all the different ways we can use it. And that’s important because as we’re about to talk about diet, and even exercise can get the immune system out of balance. And when the immune system does this much in our body that’s can have really lasting negative effects on you if this system isn’t functioning, right.
Dr. Paul Laursen 47:26
Yeah, 100%, I liked it, its main role, I was doing some research before its main roles to kind of distinguish between self and non self and eliminate, eliminate anything that’s kind of doesn’t feel sort of right to the self, I even wonder, because we’re going to talk about sugar and its role is sugar, not feeling like the self to the body, or in the various concentrations, maybe that it’s getting, because it’s really, we know that sugar really fires it up, right?
Trevor Connor 47:53
Well, so that’s gonna get into something which I’m going to explain in a second. And we’ve talked about this on the show before, which is the the th 17, t reg balance, or T regulatory cell balance in our body. Before I get there, just one thing I want to explain to our audience is, and this is a weird concept, but I’m going to talk about our whole digestive tract, it’s really important to understand that even though that whole digestive tract, you think of it as inside your body, physiologically speaking, that is not inside that is still outside, and we have a huge protective mechanism to keep everything in the gut inside the gut, and only allow the things that we need to come in. So that’s our nutrients, that’s our proteins, carbohydrates, fats, all our vitamins, minerals. And this is why our immune system, most of the immune system is along the digestive track, it’s to make sure that only what we want to come in comes in and everything else stays inside the gut. And we have billions of bacteria in our gut, and we are fighting all the time to make sure they stay in the gut, when they’re in the gut, they do a lot of great things for us, when they get into the system, they can cause a lot of damage. And so going back to what you were talking about, of identifying self versus non self, you know, first of all, remember, food is not self. So there’s always an inflammatory reaction to food. But more importantly, we’re going to get out is talking about this th 17 T regulatory cell balance. So some of the most important cells in our body are these T cells. And T cells are very good at identifying things. So every T cell identifies one particular what’s called an epitope. So think of an epitope as a marker on bacteria, or a virus or anything that’s invading our body. It finds the epitope on it and says, Oh, this is something bad, we need to respond to it. And T cells have memory. So like I said, Every team cell responds to a particular epitope problem is their epitopes and all of our own cells and we don’t want our system attacking itself. So we have what are called T regulatory cells and T regulatory cells identify self. And their job is to say, I just identified a self epitope Hey, immune system, don’t worry about this down regulate let’s let’s not ramp up the inflammation here, that is their job. This other type of cell that I was talking about called th 17. Cell, and they were only really identified about 10 years ago. So we didn’t even know they exist until relatively recently. They are a very inflammatory type of cell. And the what the researchers knew or looking into th 17 cells believe at least from the research I’ve read, is their primary job is to deal with bacteria that get from our gut into our system. So when the defense systems of our gut break down, th 17 cells come in and take care of that bacteria. So they’re very damaging, they can do a really good job. But they’re not very specific, they’d kind of damage everything. This is the kamikaze pilots, like oh, something’s coming in, go in destroy everything, you’re gonna damage self, that’s fine. As soon as we’ve taken care of that bacterial infection, or whatever it is, then we’re going to ramp down the th 17. And one of the really interesting things they discovered a little later, because originally, th 17 cells were identified in mice and rats, and they function a little differently in mice and rats. In humans, it looks like T regulatory cells can convert to th 17 and then convert back to T Rex, which is really important because that means if a T regulatory cell converts to a th 17 cell, it can identify self, and it can attack self. Hence, you don’t want these th 17 cells around for very long. You want them to ramp up, do their damage and then disappear. This is why chronically elevated in inappropriately elevated th 17 cells precedes every single autoimmune disease. Autoimmune Disease is the body attacking itself.
Dr. Paul Laursen 52:06
So basically what you’re saying, Trevor, correct me if I’m wrong, but if you’re always having sugar in your diet, you’re always going to be converting, you’re going to always pushing be pushing the T reg cells more to th 17 kamikazes, which are always kind of wrecking wrecking havoc. And that’s the chronic inflammation that we see which you don’t want. And then you got the autoimmune problems. Yep. And
Trevor Connor 52:31
if you want to geek out a little more, I can explain some of the mechanisms of how that happens. Geek Trevor geek, you guys ready to kick deep? Yeah. Okay. So as I said, The belief is the th 17 cells, their primary role is to deal with bacteria that gets from the gut into our system. The worst type of bacteria that we’re the ones of our bodies are really concerned about what are called gram negative bacteria. And the epitope that our bodies identify or look for gram negative bacteria is something called lipid polysaccharides. LPs are immune cells have a receptor on them called CD 14. And CD 14 has one role, which is to identify LPs, and particularly monocytes that are CD 14 Positive. If that CD 14 identifies LPs, it’s those monocytes that then go and say, ramp up the th 17. So here’s where sugar here’s where high carbohydrate diets come in. Obviously, we want to keep all that bacteria in our gut, we don’t want it to keep getting in and ramping up that th 17 sugar has been showing to cause what’s called intestinal permeability. So normally all the cells in our gut are very tightly packed together. So there’s nothing can get through them. When we consume too much simple sugar, those junctions that those tight junctions between those cells open up. And that can allow bacteria to get in an even bigger mechanism. Sorry, Rob, going to your noodles. Everybody talks about gluten. Gluten is found in wheat.
Rob Pickels 54:09
Everybody talks about it because it’s awesome.
Trevor Connor 54:12
There is a particular protein in wheat called Gliadin. Gliadin can bind to the the cells in our gut and caused a release of something called Zonulin. And Zonulin really causes an opening up of those tight junctions. So it causes what everybody thinks of as leaky gut. And this is a mechanism. It’s much more severe and people who are celiac, but this happens in everybody. So the fact of the matter is, if you’re eating a lot of simple sugar, if you’re eating a lot of wheat, a lot of gluten, you’re going to have this consonant tensile permeability that’s going to let this bacteria in. That’s going to upregulate the CD 14 which is identifying the LPs and that’s going to go on Say, Hey T regs start converting to th 17. And it’s going to keep th 17 elevated. And over time, that’s going to lead to autoimmune disease. And this is my theory, I’ve always wanted to write this paper. And I think this has now been written. You know, the the old theory of autoimmune disease was that it was molecular mimicry that a bacteria or a virus would come in that looks like self, and the body would respond to it. And then all of a sudden, the body would be aware of self and identifying as something that’s an invader and attack it. My personal belief is, it’s this chronically elevated th 17 that has this ability to identify itself. And eventually it just hits a breaking point where our immune system will start attacking our own body.
Rob Pickels 55:51
Well, and Trevor, I ultimately have the triple whammy, because spicy food can actually capsaicin. Yeah, as far as I know, can cause the opening of the gap junctions as well. And I do have a little thing for hot sauce. I typically don’t put my hot sauce on my noodles. But if I’m eating like Thai or something, then I suppose I’m getting them all in one bite. Yep.
Trevor Connor 56:13
So hate to tell you. We just killed everything that tastes good. Sorry. So Dr. Larson was it was at Kiki enough?
Dr. Paul Laursen 56:21
It was incredible. Like, I’m not gonna call you, Trevor anymore. I’m I’m calling you Dr. Connor. That’s pretty sensational. Yeah, I love it. And I really hope that you write that paper.
Trevor Connor 56:32
I would love to. So it’s fascinating stuff. I have found this beyond interesting. So I hope we haven’t lost all of our listeners. But
Dr. Paul Laursen 56:42
well, maybe. I mean, it’s we kind of think you’re gonna segue to this. But it’s where does exercise and exercise intensity potentially come into this mechanistic bundle that you’ve that you’ve thrown us? I responded to one of the members on your forum on this is really, you know, he has this question. He’s experiencing leaky gut that you that you call it with high intensity exercise. So is there something there that you can kind of throw into the mix where potentially this this, this might also hit one or a number of those?
Rob Pickels 57:16
Are you talking about a quadruple whammy? Dammit, sorry,
Trevor Connor 57:19
we gotta go Drupal? Well, as you know, there, there are a lot of very interesting studies where you see a much higher incident of upper respiratory infections in endurance athletes, particularly when they’re training hard. And in many of those cases, they couldn’t identify any sort of viral invader. And so one of the thoughts is, it’s actually the exercise causing the immune system to get out of balance. So you’re basically having the sort of response you would see to a virus without actually having a virus, let me quickly give some context. So I was talking about gram negative bacteria getting into your system and really messing with the system. Everybody’s heard of something called endotoxemia. endotoxemia is just simply, a hole is punched in your gut, opening up with a tight junction, something allowed a whole bunch of gram negative bacteria to get into your system. And the immune response was so forceful, that actually that immune response is damaging you and in worst cases can kill you. That’s basically what endotoxemia is. So there are studies that have identified and I’m not looking at them right now. But I think they called it SRS, which is basically, you see an athletes who are doing a ton of high intensity work, and they just do way too much and push themselves over this edge, you see a response that’s virtually identical to endotoxemia, where they they see this huge inflammation, see their their immune system kind of attack. So that it has been demonstrated that too much high intensity exercise, or basically high intensity exercise can also cause intestinal permeability. So it can allow some of those gram negative bacteria and it’s also been proven and we’ll put all these these references in the show notes for anybody who’s interested and wants to read more about this. But there was a really fascinating study that showed that actually high intensity exercise can ramp up th 17 So the concern we have you went back to you know, everybody thinks as athletes as being super healthy, but if you have this endurance athlete that’s already causing some of this impact already seen exercise ramping up th 17 causing some of the slight endotoxemia type effect and they’re eating this high sugar diet and high carbohydrate see as sorry, Rob eating their noodles all the time. Is this additive? And can this be really damaging the athlete and one of the evidence that this study that I just mentioned, um, give me a second I’ll find the name of it as showing is that endurance athletes have a higher rate of autoimmune disease.
Rob Pickels 1:00:01
Well, it is additive when the only thing that makes your noodles better is a teaspoon of sugar on your noodles, just to say and if you haven’t tried it, you should it really it kicks it up a notch. So to say.
Trevor Connor 1:00:11
So the name of this study, just the title of it. endurance exercise diverts the balance between th 17 cells and regulatory T cells.
Rob Pickels 1:00:20
I think denial tastes great, so you guys can read it. Personally, personally, I’m not going to bother, you know, and I’m just, I’m fully depressed at this point. So, thanks, guys.
Dr. Paul Laursen 1:00:32
Yep, sorry, I’ll get you to connect with with my swimmer, Rob.
Trevor Connor 1:00:39
So sorry, that’s more talking than I normally want to do. Dr. Larson, what’s your feeling? What’s your response to all this?
Dr. Paul Laursen 1:00:47
I don’t know. I mean, it was I really enjoyed it, I was reflecting on my own, you know, way back when, as an athlete as well, I’m sure you guys good to where, you know, you finish say it’s like a five or a 10k race, right where you’re at via to max. And you’ve just get that, or, you know, half marathon, whatever, but you’ve been at a really high intensity for quite a long time. And you just, you can walk away and you feet, you’re you actually like you’re coughing, and you just like, why am I coughing when you know, and you actually do kind of feel sick, right? So I think the the listener, if they’re still with us here, they, you know, they might reflect on that themselves and say, I’m gonna, you know, have a crit race as well, right? Where you just right to the balls to the wall, or whatever you want to call it that. Yeah, that’s, I think that’s the kind of what’s happening in there. So maybe the take well, what’s the take home message for that, you probably don’t want to do those. You don’t want to race too too much. You don’t want to do high intensity interval training too, too much, you really need to make sure that you balanced that with the with the recovery, or zone two kind of periods of time, right back to the whole polarized stuff.
Trevor Connor 1:01:56
Those are my two takeaways is is that to me is an argument for the polarized training model. There’s a health reason. And then also I hate to in everybody listening is going to grow on right now. But the belief that will I do a lot of training, so I can eat sugar, and I can have my pastor parties and all that. And exercise is going to prevent any negative effects. Media does prevent some of the insulin response, but it is blocking of anything. It’s it’s accentuating the immunological effects. So you do have to be careful about that. If you’re particularly if you’re doing this more for health.
Dr. Paul Laursen 1:02:33
Yeah. And eventually health, you know, in all of us, it will become a priority. Right? Like when is as soon as health leaves you, it becomes the number one priority, right? So yeah, and I think I just think the earlier you can start to think about it and act on it, the better you the happier the long term and seeing beyond this plan a long time.
Trevor Connor 1:02:56
By the way, well, I remembered I said, I try to remember the name of that other study. So the one that talked about SRS, that that huge inflammatory response is called trauma and do systemic inflammatory response versus exercise induced immune modulatory effect.
Rob Pickels 1:03:12
So it goes, you know, we’ve been diving really deep into this topic that makes me quite upset. And so I would love to pull back a little bit and then switch over to more of a big picture question. And that is, you know, Dr. Larson, in your experience, or in your research, have you seen performance benefit, or performance degradation or health benefit, health degradation? With working across the genders? is sort of this advice applicable to male and female athletes?
Dr. Paul Laursen 1:03:43
Yeah, I believe it is, I think, you know, we’re all human beings. At the end of the day, you know, we’re equipped with some different different gonads and associated physiology around that, but still the, you know, the principles still do apply, females are naturally they tend to be better fat burners, in my experience, but they’re still equipped with the same organs that respond in a similar sort of way. So if there’s a sabotage that’s going on from a diet standpoint, they you know, in terms of excess sugar, let’s just call it there will be the same sort of problems. And we’ll also say that, you know, there’s been some, I’ve had some excellent and a one success with female athletes coming to me. And going on a bit of a more paleo, low carb kind of diet approach. One of the great tells in a female is the returning of the cycle, many will come to me with, you know, not not having a cycle present, or at least, yeah, not too much evidence of what and when the cycle gets back on track. It’s, it’s a really good sign that the things are back working as they should be. Yeah. And again, it really comes down to it’s not it’s It’s probably not the shape, necessarily of the macronutrients, but it’s probably the micronutrients that are going in there in the in the changing of the diets, getting away from that sugar having a more nutrient dense profile in the diet. And lo and behold, stress is reduced. And when stress is reduced, it was a relief of the HPA axis and the HPA axis is connected to the noddle axis. And then that comes back and, and performance is kind of coupled with it as well. So, yeah, it’s just similar principles. In my experience, I know that not everyone believes in that, that it is that way. But that’s, that’s my experience.
Rob Pickels 1:05:41
Terrific. Thank you. That’s it. I’m sorry, I
Trevor Connor 1:05:44
thought you only questions I was waiting for you
Rob Pickels 1:05:46
know, I mean, I’m getting carbohydrate depleted. And so my cognitive has declined a little bit. Plenty.
Trevor Connor 1:05:57
See, if we go there is a pass for them.
Dr. Paul Laursen 1:06:00
I mean, that’s really something we should have I don’t you wish we had like continuous blood glucose monitors on us? Because Trevor, and I would just be kind of, you know, flatline, and stable and raw, but we just we’d be seeing his CGM, low values just kind of going down and going down. And you know, he doesn’t want to doesn’t want to have his past on camera.
Rob Pickels 1:06:18
Hey, listen, you guys can be stoic if you want. But I experienced my highs, and I experienced my lows that’s live in life if you asked me.
Dr. Paul Laursen 1:06:28
Well, that I mean, I’m thinking of the prince study again. And that’s one of the cool things also that they showed started to go back there. But it’s kind of an important point. And it’s the fact that when they because remember, it’s a ruse repeated measures design when they went back and forth to the to diets. The profile on the CGM, continuous blood glucose monitors that something like index comm or super Sapiens, it was just like, it was way different, when in the well formulated low carb diet like it was just just this flatline of blood glucose levels compared to the ROB pickles method where it is quite, you know, like he’s sort of saying it’s a roller coaster. It’s spiky. So yeah, and I think there’s something probably pretty important there. And of course, it’s the it’s the insulin signaling, right? That’s that’s kind of changing. That’s a good one, Rob.
Trevor Connor 1:07:20
Perhaps that’s where we finish out this episode, because God knows I could talk another two hours on this, but No way. Are we all good.
Rob Pickels 1:07:28
I want to go eat. No, I want to touch on one on one more topic here. And this is one that that Dr. Larson brought up and it’s one that I’ve mentioned in the past. And that’s on ketone supplementation. That’s you know, ketones are very important to metabolism, especially in the high fat, low carbohydrate situation. So Dr. Larson, how does that tie into exogenous ketone supplementation?
Dr. Paul Laursen 1:07:52
Yeah, I think it’s a great one to kind of kind of finish on it’s a, because it’s such an exciting sort of area where we’re seeing a lot of this work coming out. So a little bit of history, I was very privileged back in the, I think it might have been like 2015, or whatnot. I got to visit Karen Clark and her lab in Oxford, and see like sort of the that was the first exposure of the of the delta G. And when I was there with Steven Siler and, and Peter Huntsville, and Tour de France riders and all these other kinds of folks and whatnot. And, and it was it was, again, there was just sort of all the anecdotal findings at that point in the game. But to two interesting ones, I’ll mention the very first one was the use of the delta G supplement in an individual with Parkinson’s disease. And this was fascinating because they showed the video of this individual with Parkinson’s disease, that classic shaky hand and then they they flashed to this individual, after they’ve taken the the the ketone supplement. And all of a sudden, the complete playing of this beautiful guitar that this individual could could play. So it was quite moving, and almost emotional to watch this response, right where it’s like, acutely, a dose of big high dose of this delta G, all of these ketones, these energetic ketones all of a sudden, masked this problem. So again, we started with ketones, as I mentioned, in the beginning as like the fourth or fifth macronutrient. We can use these ketones we produce them, when we sort of starve ourselves. When we are low on blood glucose and we’re low on insulin, all of a sudden, we have our brain needs to get a different form of energy. And we evolved, of course, the process of producing ketones. There’s three key challenges, but the main one, the big one is the beta hydroxybutyrate. And that’s ultimately what you get. When you take some of these ketone supplements that are on the market, right you get a big bolus and a hype are a physiological amount of ketone in your system upwards of between one to three to five millimoles. Right. So these super physiological levels of it. So he’s that was sort of the start. And then the other interesting thing from that meeting at Oxford was the anecdotal findings from some Tour de France riders, very successful Tour de France riders, I won’t mention names and stuff, but guys that have been around and they were using it. And one of the things that was really interesting, in conversations with them, was the fact that they weren’t really seeing any of these acute benefits from the supplement per se. You know, in order, like when they were just just taking a taking a supplement is like, yeah, I still felt good, but I didn’t feel like incredible or on fire, necessarily. There was, it was individual. Some did have that. But not everyone, at least not the one that I was talking about. But where he did see an incredible benefit was the fact that because he’d done multiple tours, right, and you can imagine, Trevor, you probably know, maybe you as well, Rob, I don’t know your background, but when you do these long Grand Tours, you feel pretty beat up after multiple days, right. And that was the big thing that he was saying, I’m just I was when I would have my ketone supplement, after the race was no longer beat up day after day, I kind of I slept a lot better, I recovered a lot better. And I just the whole, I performed better overall in a large Grand Tour. So that was interesting. And this again, fast forward to today with all these exciting sort of studies that are coming out now from Peter has as well as lab he was there, of course, so he went in, you know, it’s always starts with the athletes and the coaches first, and then the scientists kind of go into the and and try to prove these sorts of things. Well, lo and behold, Peter has Paul’s group showing the, you know, a reduction in the overreaching or overtraining type response, an increase in EPO and angiogenesis as well, some more capillaries being being produced. So all these kinds of things in the recovery phase, and that it almost sort of seems if I’m gonna go full circle, that seems to be the biggest bang for buck and benefit of these things that you’ll see out there kind of kind of coming out.
Rob Pickels 1:12:19
Yeah, a couple points to know, when we’re discussing ketones and exogenous or outside the body supplementation, and we’re talking specifically about ketone esters. And more often than not, I think every product right now is the BHB that you mentioned, we’re not talking raspberry ketones or sort of these other things for what it’s worth. It’s also interesting to the ketones have shown efficacy in traumatic brain injury and recovery, improved outcomes, as well, by reducing energy deficit by reducing inflammation. And for me, I will say acutely when I have used ketones, I don’t know that it’s necessarily a physical change because I am a high carbohydrate person when I’m writing I’m usually trying to pack in as many carbs as possible. But I do notice almost a mood change. My mind feels more clear, more energetic, I’m more likely to be in a flow state are more likely to be in the moment. And that seems like it happens immediately. But, you know, we talked about this briefly back in episode 270, which was a potluck that we did with Grant colicky where I used, you know, ketones for recovery in transport juggler. And I’ve only done one other mountain bike stage race before so I don’t necessarily think that I have enough data to form a good conclusion. But I will say I was surprised with my recovery and my ability to continue performing day in and day out. So I’m not going to tie that directly to the ketones but it was certainly part of the process that I used for recovery every day. To see season for spring knee, as March sunshine and early spring weather inspires us to ramp up our writing mileage. Our knees don’t always keep up. If you’ve got knee pain, we have the solution for you. Fast talk lab members can follow our new knee health pathway featuring our new Director of Sports Medicine, Dr. Andy Pruitt. See the introduction to the knee health pathway at fast talk labs.com.
Trevor Connor 1:14:23
I kind of hinted at this earlier when we’re talking about the the immunology side that food is foreign to our bodies, and food produces an inflammatory response. So it’s really important to understand that our bodies have have two states we have the Fed state and what’s called the fasted state. And it’s really both states are very important and really important things happen in those states. And if you’re not supplementing with ketones, your body does produce ketones and it only really produces them in that fasted state or simulated fasted state. And I do think one of the issues we have on the The modern Western diet is we all are eating all the time. And we tend to always be in that more inflammatory fed state and not be in that what tends to be a more anti inflammatory fasted state, we’re seeing with these ketone esters, some of the benefits of being in that other state.
Rob Pickels 1:15:18
Yeah. And, Trevor, I do think if we just really big picture on this, oftentimes, the nations or the diets that have some of the best longevity also have kind of a slight caloric deficiency as well. an overabundance of food is not necessarily the best thing for us.
Dr. Paul Laursen 1:15:34
Yeah, I mean, again, I’m keep going back to your episodes I was listening to but again, there was a part in the zoo conductors, you can do podcasts where you you went to someone that was an expert, who was training with some Kenyan runners, and he found it fascinating. The fact that he wasn’t meeting his, his window of refeeding sort of phase when he was with the Kenyan runners, they, you know, they’d go and train in the morning, hardly have anything and whatnot. And then he, you know, they were back on the bus. And ultimately, there was this big long fasted phase. Well, yes, they were having super high, high carbs in their diet. But clearly, there was a there was a fasted phase. And he said that it was, it was to make them tougher, or whatever it was, but it was like it was almost like, well, that could have been an important component of their whole training process was to go through that fasted phase.
Trevor Connor 1:16:25
Well, I always remember that there’s a great book that pulled together the notes of these explorers who had encountered a hunter gatherer society and spent, basically, I think, almost a year with this hunter gatherer society, learning about them. And from that I’ve read this 10 years ago, so forgive me, I’m forgetting all the names. I could, I could go and find it. But they said what was amazing about this society is they would get up in the morning, and they would go and hunt. And in the course of their hunting, they would basically walk run a marathon, and they wouldn’t eat a thing in the morning, they would get up, they’d be in that fasted state and go do a marathon. And then they’d come back and eat. And they would make fun of these European explorers, because European explorers couldn’t do it. They had to keep eating.
Dr. Paul Laursen 1:17:10
Yep. Now, I mean, yeah, there’s nothing wrong with the experimenting with some fasted some fasted periods of time. Rob’s suffering right now, but he’s looking for the next noodle.
Rob Pickels 1:17:27
Gotta get my noodle fix. Oh, guys,
Trevor Connor 1:17:29
I hate to say we’re at an hour and a half in the recording. I would love to keep going. But I think we’ve covered a lot is. On that note, though, is there any last things Dr. Larson that you’d like to leave our audience with before we go into our take homes?
Dr. Paul Laursen 1:17:43
No, I mean, want to say it’s a great topic, have really enjoyed the conversation. I really appreciate what you guys do at fast talk. And yeah, thanks so much for having me on.
Trevor Connor 1:17:52
was absolute pleasure having on the show, so let’s finish as we normally do. One minute take Holmes and Dr. Larson, if you need a second to think about it, but we’ll let you go first.
Dr. Paul Laursen 1:18:03
Yeah, I mean, the take homes for me would be again, as I began with, with the podcast is that, you know, we do have all these tenants that we believe in the in exercise literature, you know, whether it’s the carb fat crossover effect, that you have to have carbs for high intensity exercise performance. But the big thing is that if you do change the context, things might be different in all of that. So keep that in mind for the for the future. Don’t be afraid to consider tinkering with a lower carbohydrate approach, all these various different things that we said about having these fasted periods in your life. Don’t be afraid of them. But yeah, again, at the end of the day, it probably, you know, we’re not too different from the former podcasts that we started with, you know, eat whole food, high nutrient dense diet as the staple and fundamental component of your diet.
Trevor Connor 1:18:59
Good answer, Rob.
Rob Pickels 1:19:00
You want to go next? Yeah, of course. You know, in this episode, I certainly played up my love of noodles. And I’m not gonna lie. I do love myself a slice of bread and a, you know, some some nice Thai noodles every once in a while. But just like we’ve talked about, as Dr. Larson said, there’s, I think everybody understands what a healthy diet is. And if you don’t, then you’re lying to yourself. And that’s a diet that’s based off of Whole Foods. My diet in the whole scheme of things very much consists of lean meats, fruits and vegetables, right? Don’t get me wrong, I eat I eat more grains than Trevor does. But I probably don’t eat more grains than the average person does. So, you know, ultimately, health does come down to the choices that we’re making to put in our body. And when we do discuss this, then there is a lot of commonalities. Excess sugar is not healthy for you in general, right? I might allow a little bit more sugar in my diet, especially with a lot of high intensity work than somebody like try ever does. But that’s one of the great things about nutrition is that people are able to self experiment. And you know what, go try this diet, try eating less than 50 grams of carbohydrate, and maybe give it sufficient time to see if you get positive adaptations in your body. What’s the worst that can happen? Right, you can go back to eating all the pizza and pasta that you want. If it doesn’t work out for you, that’s great. But I always encourage people to try it, try it for yourself, educate yourself on all the various aspects. But at some point, the rubber has to meet the road and you need to put things in practice to really find out.
Trevor Connor 1:20:35
So I’d say my take home I’m going to start with I was listening to a podcast with that. Floyd Landis was the guest, and they were talking about nutrition and Floyd pointed out. Oh, yeah, no, our nutrition was awful. It was horrible. Even we’re racing into Tour de France. And as I was listening to him talk, I kind of realized, I think that’s part of why they were so reliant on doping products. Yes, there’s the performance enhancement, but I don’t think they were very healthy back then the way he was describing it, and they needed the both doping products to get through. So this kind of leads me to I really enjoyed that. That paper you wrote Dr. Larson about our athletes healthy, I think healthy and performance, as you said, in the paper can be two different things. But I do think to be a complete athlete, ultimately, you have to have both, even at the highest levels. I think it’s important to be both healthy and to have that focus on performance. And that’s hard to do. But I think it’s everybody needs to look at nutrition not just as what makes me a little bit faster, but also what makes me healthier so that I can have some longevity in the sport. Well, Dr. Larson absolute pleasure having you on the show. Thanks so much for talking with us.
Dr. Paul Laursen 1:21:53
Thanks so much for having me guys. It was awesome. Yeah, it was great.
Trevor Connor 1:21:57
That was another episode of fast talk described fast talk wherever you prefer to find your favorite podcast. Be sure to leave us a rating and a review the thoughts and opinions expressed on fast talker those are the individual. As always, we love your feedback. Tweet us at at pass talk labs or join the conversation at forums dot fast talk labs.com Learn from our experts at fast talk labs.com Or help keep us independent by supporting us on Patreon. For Dr. Paul Larson and Rob pickles. I’m Trevor Connor. Thanks for listening!
REFERENCES
Avena, N. M., Rada, P., & Hoebel, B. G. (2008). Evidence for sugar addiction: Behavioral and neurochemical effects of intermittent, excessive sugar intake. Neuroscience & Biobehavioral Reviews, 32(1), 20–39. Retrieved from https://doi.org/10.1016/j.neubiorev.2007.04.019
Barrenetxe, J., Sánchez, O., Barber, A., Gascón, S., Rodríguez-Yoldi, M. J., & Lostao, M. P. (2013). TNFα regulates sugar transporters in the human intestinal epithelial cell line Caco-2. Cytokine, 64(1), 181–187. Retrieved from https://doi.org/10.1016/j.cyto.2013.07.004
Basaranoglu, M., Basaranoglu, G., & Bugianesi, E. (2014). Carbohydrate intake and nonalcoholic fatty liver disease: fructose as a weapon of mass destruction. Hepatobiliary Surgery and Nutrition, 4(2), 109–16. Retrieved from https://doi.org/10.3978/j.issn.2304-3881.2014.11.05
Beecher, K., Cooper, I. A., Wang, J., Walters, S. B., Chehrehasa, F., Bartlett, S. E., & Belmer, A. (2021). Long-Term Overconsumption of Sugar Starting at Adolescence Produces Persistent Hyperactivity and Neurocognitive Deficits in Adulthood. Frontiers in Neuroscience, 15, 670430. Retrieved from https://doi.org/10.3389/fnins.2021.670430
Benedini1, S., Codella1, R., Caumo2, A., Marangoni3, F., & 2, L. L. (2011). Different Circulating Ghrelin Responses to Isoglucidic Snack Food in Healthy Individuals. Hormone and Metabolic Research, 43(02), 135–140. Retrieved from https://doi.org/10.1055/s-0030-1269900
Chapman, C. L., Reed, E. L., Worley, M. L., Pietrafesa, L. D., Kueck, P. J., Bloomfield, A. C., … Johnson, B. D. (2021). Sugar-sweetened soft drink consumption acutely decreases spontaneous baroreflex sensitivity and heart rate variability. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 320(5), R641–R652. Retrieved from https://doi.org/10.1152/ajpregu.00310.2020
Charrez, B., Qiao, L., & Hebbard, L. (2015). The role of fructose in metabolism and cancer. Hormone Molecular Biology and Clinical Investigation, 22(2), 79–89. Retrieved from https://doi.org/10.1515/hmbci-2015-0009
Chen, Y. J., Wong, S. H. S., Chan, C. O. W., Wong, C. K., Lam, C. W., & Siu, P. M. F. (2009). Effects of glycemic index meal and CHO-electrolyte drink on cytokine response and run performance in endurance athletes. Journal of Science and Medicine in Sport, 12(6), 697–703. Retrieved from https://doi.org/10.1016/j.jsams.2008.05.007
Cipryan, L., Dostal, T., Litschmannova, M., Hofmann, P., Maffetone, P. B., & Laursen, P. B. (2021). Effects of a Very Low-Carbohydrate High-Fat Diet and High-Intensity Interval Training on Visceral Fat Deposition and Cardiorespiratory Fitness in Overfat Individuals: A Randomized Controlled Clinical Trial. Frontiers in Nutrition, 8, 785694. Retrieved from https://doi.org/10.3389/fnut.2021.785694
Cipryan, L., Plews, D. J., Ferretti, A., Maffetone, P. B., & Laursen, P. B. (2018). Effects of a 4-Week Very Low-Carbohydrate Diet on High-Intensity Interval Training Responses. Journal of Sports Science & Medicine, 17(2), 259–268.
Clark, A., & Mach, N. (2016). Exercise-induced stress behavior, gut-microbiota-brain axis and diet: a systematic review for athletes. Journal of the International Society of Sports Nutrition, 13(1), 43. Retrieved from https://doi.org/10.1186/s12970-016-0155-6
Clauss, M., Gérard, P., Mosca, A., & Leclerc, M. (2021). Interplay Between Exercise and Gut Microbiome in the Context of Human Health and Performance. Frontiers in Nutrition, 8, 637010. Retrieved from https://doi.org/10.3389/fnut.2021.637010
Clemente-Suárez, V. J., Mielgo-Ayuso, J., Martín-Rodríguez, A., Ramos-Campo, D. J., Redondo-Flórez, L., & Tornero-Aguilera, J. F. (2022). The Burden of Carbohydrates in Health and Disease. Nutrients, 14(18), 3809. Retrieved from https://doi.org/10.3390/nu14183809
Codella, R., Terruzzi, I., & Luzi, L. (2017). Sugars, exercise and health. Journal of Affective Disorders, 224, 76–86. Retrieved from https://doi.org/10.1016/j.jad.2016.10.035
Coker, J. K., Moyne, O., Rodionov, D. A., & Zengler, K. (2021). Carbohydrates great and small, from dietary fiber to sialic acids: How glycans influence the gut microbiome and affect human health. Gut Microbes, 13(1), 1869502. Retrieved from https://doi.org/10.1080/19490976.2020.1869502
Collin, L. J., Judd, S., Safford, M., Vaccarino, V., & Welsh, J. A. (2019). Association of Sugary Beverage Consumption With Mortality Risk in US Adults. JAMA Network Open, 2(5), e193121. Retrieved from https://doi.org/10.1001/jamanetworkopen.2019.3121
Dai, W., Kesaraju, S., & Weber, C. R. (2021). Transcriptional factors in calcium mishandling and atrial fibrillation development. Pflügers Archiv – European Journal of Physiology, 473(8), 1177–1197. Retrieved from https://doi.org/10.1007/s00424-021-02553-y
DiNicolantonio, J. J., & OKeefe, J. H. (2017). Added sugars drive coronary heart disease via insulin resistance and hyperinsulinaemia: a new paradigm. Open Heart, 4(2), e000729. Retrieved from https://doi.org/10.1136/openhrt-2017-000729
Dostal, T., Plews, D. J., Hofmann, P., Laursen, P. B., & Cipryan, L. (2019). Effects of a 12-Week Very-Low Carbohydrate High-Fat Diet on Maximal Aerobic Capacity, High-Intensity Intermittent Exercise, and Cardiac Autonomic Regulation: Non-randomized Parallel-Group Study. Frontiers in Physiology, 10, 912. Retrieved from https://doi.org/10.3389/fphys.2019.00912
Drago, S., Asmar, R. E., Pierro, M. D., Clemente, M. G., Tripathi, A., Sapone, A., … Fasano, A. (2006). Gliadin, zonulin and gut permeability: Effects on celiac and non-celiac intestinal mucosa and intestinal cell lines. Scandinavian Journal of Gastroenterology, 41(4), 408–419. Retrieved from https://doi.org/10.1080/00365520500235334
Draznin, B., Wang, C., Adochio, R., Leitner, J., & Cornier, M.-A. (2012). Effect of Dietary Macronutrient Composition on AMPK and SIRT1 Expression and Activity in Human Skeletal Muscle. Hormone and Metabolic Research, 44(09), 650–655. Retrieved from https://doi.org/10.1055/s-0032-1312656
Dridi, H., Kushnir, A., Zalk, R., Yuan, Q., Melville, Z., & Marks, A. R. (2020). Intracellular calcium leak in heart failure and atrial fibrillation: a unifying mechanism and therapeutic target. Nature Reviews Cardiology, 17(11), 732–747. Retrieved from https://doi.org/10.1038/s41569-020-0394-8
Fehrenbach, E., & Schneider, M. E. (2006). Trauma-Induced Systemic Inflammatory Response versus Exercise-Induced Immunomodulatory Effects. Sports Medicine, 36(5), 373–384. Retrieved from https://doi.org/10.2165/00007256-200636050-00001
Ferder, L., Ferder, M. D., & Inserra, F. (2010). The Role of High-Fructose Corn Syrup in Metabolic Syndrome and Hypertension. Current Hypertension Reports, 12(2), 105–112. Retrieved from https://doi.org/10.1007/s11906-010-0097-3
Frączek, B., Pięta, A., Burda, A., Mazur-Kurach, P., & Tyrała, F. (2021). Paleolithic Diet—Effect on the Health Status and Performance of Athletes? Nutrients, 13(3), 1019. Retrieved from https://doi.org/10.3390/nu13031019
Freeman, C. R., Zehra, A., Ramirez, V., Wiers, C. E., Volkow, N. D., & Wang, G.-J. (2018). Impact of sugar on the body brain and behavior. Frontiers in Bioscience, 23(12), 2255–2266. Retrieved from https://doi.org/10.2741/4704
Galgani, M., & Matarese, G. (2019). The Sweet Kiss Breaching Immunological Self-Tolerance. Trends in Molecular Medicine, 25(10), 819–820. Retrieved from https://doi.org/10.1016/j.molmed.2019.08.003
I, A., S, J. S., M, F., A, W., & H, A. A. (2018). Sugar Beverages and Dietary Sodas Impact on Brain Health: A Mini Literature Review. Cureus, 10(6), e2756. Retrieved from https://doi.org/10.7759/cureus.2756
Imai, S., Fukui, M., & Kajiyama, S. (2014). Effect of eating vegetables before carbohydrates on glucose excursions in patients with type 2 diabetes. Journal of Clinical Biochemistry and Nutrition, 54(1), 7–11. Retrieved from https://doi.org/10.3164/jcbn.13-67
Jang, L.-G., Choi, G., Kim, S.-W., Kim, B.-Y., Lee, S., & Park, H. (2019). The combination of sport and sport-specific diet is associated with characteristics of gut microbiota: an observational study. Journal of the International Society of Sports Nutrition, 16(1), 21. Retrieved from https://doi.org/10.1186/s12970-019-0290-y
Johnson, R. K., Appel, L. J., Brands, M., Howard, B. V., Lefevre, M., Lustig, R. H., … Prevention, A. H. A. N. C. of the C. on N., Physical Activity, and Metabolism and the Council on Epidemiology and. (2009). Dietary Sugars Intake and Cardiovascular Health. Circulation, 120(11), 1011–1020. Retrieved from https://doi.org/10.1161/circulationaha.109.192627
K., C. P., Rod, W., A., H. R., Ge, L., M., N. D., Hui, Z., … B., L. E. (2013). Glucose Levels and Risk of Dementia. New England Journal of Medicine, 369(6), 540–548. Retrieved from https://doi.org/10.1056/nejmoa1215740
Kaplan, A. D., Joca, H. C., Boyman, L., & Greiser, M. (2021). Calcium Signaling Silencing in Atrial Fibrillation: Implications for Atrial Sodium Homeostasis. International Journal of Molecular Sciences, 22(19), 10513. Retrieved from https://doi.org/10.3390/ijms221910513
Kearns, C. E., Schmidt, L. A., & Glantz, S. A. (2016). Sugar Industry and Coronary Heart Disease Research: A Historical Analysis of Internal Industry Documents. JAMA Internal Medicine, 176(11), 1680. Retrieved from https://doi.org/10.1001/jamainternmed.2016.5394
Kelly, R. K., Tong, T. Y. N., Watling, C. Z., Reynolds, A., Piernas, C., Schmidt, J. A., … Perez-Cornago, A. (2023). Associations between types and sources of dietary carbohydrates and cardiovascular disease risk: a prospective cohort study of UK Biobank participants. BMC Medicine, 21(1), 34. Retrieved from https://doi.org/10.1186/s12916-022-02712-7
Lakhan, S. E., & Kirchgessner, A. (2013). The emerging role of dietary fructose in obesity and cognitive decline. Nutrition Journal, 12(1), 114. Retrieved from https://doi.org/10.1186/1475-2891-12-114
Lenoir, M., Serre, F., Cantin, L., & Ahmed, S. H. (2007). Intense Sweetness Surpasses Cocaine Reward. PLoS ONE, 2(8), e698. Retrieved from https://doi.org/10.1371/journal.pone.0000698
Ma, J., Fox, C. S., Jacques, P. F., Speliotes, E. K., Hoffmann, U., Smith, C. E., … McKeown, N. M. (2015). Sugar-sweetened beverage, diet soda, and fatty liver disease in the Framingham Heart Study cohorts. Journal of Hepatology, 63(2), 462–469. Retrieved from https://doi.org/10.1016/j.jhep.2015.03.032
Maffetone, P. B., & Laursen, P. B. (2016). Athletes: Fit but Unhealthy? Sports Medicine – Open, 2(1), 24. Retrieved from https://doi.org/10.1186/s40798-016-0048-x
Malik, V. S., & Hu, F. B. (2015). Fructose and Cardiometabolic Health What the Evidence From Sugar-Sweetened Beverages Tells Us. Journal of the American College of Cardiology, 66(14), 1615–1624. Retrieved from https://doi.org/10.1016/j.jacc.2015.08.025
Mergenthaler, P., Lindauer, U., Dienel, G. A., & Meisel, A. (2013). Sugar for the brain: the role of glucose in physiological and pathological brain function. Trends in Neurosciences, 36(10), 587–597. Retrieved from https://doi.org/10.1016/j.tins.2013.07.001
Mohr, A. E., Jäger, R., Carpenter, K. C., Kerksick, C. M., Purpura, M., Townsend, J. R., … Antonio, J. (2020). The athletic gut microbiota. Journal of the International Society of Sports Nutrition, 17(1), 24. Retrieved from https://doi.org/10.1186/s12970-020-00353-w
Montonen, J., Järvinen, R., Knekt, P., Heliövaara, M., & Reunanen, A. (2007). Consumption of Sweetened Beverages and Intakes of Fructose and Glucose Predict Type 2 Diabetes Occurrence. The Journal of Nutrition, 137(6), 1447–1454. Retrieved from https://doi.org/10.1093/jn/137.6.1447
Moscow, I. M. S. F. M. S. M. U. of M. of H. of the R. F. (Sechenov U., Bragina, T. V., Sheveleva, S. A., Moscow, F. R. C. of N., Biotechnology and Food Safety, Elizarova, E. V., Rykova, S. M., & Tutelyan, V. A. (2022). The structure of blood gut microbiota markers in athletes and their relationship with the diet. Problems of Nutrition, 91(4), 35–46. Retrieved from https://doi.org/10.33029/0042-8833-2022-91-4-35-46
N, C. S., Yu, G. G., & V, F. A. (2021). THE DIET OF PERSONS ENGAGED IN SPORTS AT THE AGE OF 40 YEARS AND OLDER. “Medical & Pharmaceutical Journal “Pulse,” 74–79. Retrieved from https://doi.org/10.26787/nydha-2686-6838-2021-23-7-74-79
Nakamura, M., Satoh, N., Horita, S., & Nangaku, M. (2022). Insulin-induced mTOR signaling and gluconeogenesis in renal proximal tubules: A mini-review of current evidence and therapeutic potential. Frontiers in Pharmacology, 13, 1015204. Retrieved from https://doi.org/10.3389/fphar.2022.1015204
(NDA), E. P. on N., Novel Foods and Food Allergens, Turck, D., Bohn, T., Castenmiller, J., Henauw, S. de, Hirsch‐Ernst, K. I., … Vinceti, M. (2022). Tolerable upper intake level for dietary sugars. EFSA Journal, 20(2), e07074. Retrieved from https://doi.org/10.2903/j.efsa.2022.7074
Nettleton, J. A., Lutsey, P. L., Wang, Y., Lima, J. A., Michos, E. D., & Jacobs, D. R. (2009). Diet Soda Intake and Risk of Incident Metabolic Syndrome and Type 2 Diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA)*. Diabetes Care, 32(4), 688–694. Retrieved from https://doi.org/10.2337/dc08-1799
NIEMAN, D. C., & HENSON, D. A. (1994). Role of endurance exercise in immune senescence. Medicine & Science in Sports & Exercise, 26(2), 172. Retrieved from https://doi.org/10.1249/00005768-199402000-00007
O’Reilly, J., Wong, S. H. S., & Chen, Y. (2010). Glycaemic Index, Glycaemic Load and Exercise Performance. Sports Medicine, 40(1), 27–39. Retrieved from https://doi.org/10.2165/11319660-000000000-00000
Page, K. A., Chan, O., Arora, J., Belfort-DeAguiar, R., Dzuira, J., Roehmholdt, B., … Sherwin, R. S. (2013). Effects of Fructose vs Glucose on Regional Cerebral Blood Flow in Brain Regions Involved With Appetite and Reward Pathways. JAMA, 309(1), 63–70. Retrieved from https://doi.org/10.1001/jama.2012.116975
Pase, M. P., Himali, J. J., Beiser, A. S., Aparicio, H. J., Satizabal, C. L., Vasan, R. S., … Jacques, P. F. (2017). Sugar- and Artificially Sweetened Beverages and the Risks of Incident Stroke and Dementia. Stroke, 48(5), 1139–1146. Retrieved from https://doi.org/10.1161/strokeaha.116.016027
Payne, A. N., Chassard, C., & Lacroix, C. (2012). Gut microbial adaptation to dietary consumption of fructose, artificial sweeteners and sugar alcohols: implications for host–microbe interactions contributing to obesity. Obesity Reviews, 13(9), 799–809. Retrieved from https://doi.org/10.1111/j.1467-789x.2012.01009.x
Peake, J. M., Neubauer, O., Gatta, P. A. D., & Nosaka, K. (2017). Muscle damage and inflammation during recovery from exercise. Journal of Applied Physiology, 122(3), 559–570. Retrieved from https://doi.org/10.1152/japplphysiol.00971.2016
Perry, C., Pick, M., Bdolach, N., Hazan-Halevi, I., Kay, S., Berr, I., … Grisaru, D. (2013). Endurance Exercise Diverts the Balance between Th17 Cells and Regulatory T Cells. PLoS ONE, 8(10), e74722. Retrieved from https://doi.org/10.1371/journal.pone.0074722
Philp, A., Hargreaves, M., & Baar, K. (2012). More than a store: regulatory roles for glycogen in skeletal muscle adaptation to exercise. American Journal of Physiology-Endocrinology and Metabolism, 302(11), E1343–E1351. Retrieved from https://doi.org/10.1152/ajpendo.00004.2012
Prins, P. J., Noakes, T. D., Buga, A., D’Agostino, D. P., Volek, J. S., Buxton, J. D., … Koutnik, A. P. (2023). Low and high carbohydrate isocaloric diets on performance, fat oxidation, glucose and cardiometabolic health in middle age males. Frontiers in Nutrition, 10, 1084021. Retrieved from https://doi.org/10.3389/fnut.2023.1084021
Rippe, J. M., & Angelopoulos, T. J. (2016). Relationship between Added Sugars Consumption and Chronic Disease Risk Factors: Current Understanding. Nutrients, 8(11), 697. Retrieved from https://doi.org/10.3390/nu8110697
Ruff, J. S., Suchy, A. K., Hugentobler, S. A., Sosa, M. M., Schwartz, B. L., Morrison, L. C., … Potts, W. K. (2013). Human-relevant levels of added sugar consumption increase female mortality and lower male fitness in mice. Nature Communications, 4(1), 2245. Retrieved from https://doi.org/10.1038/ncomms3245
Shomali, N., Mahmoudi, J., Mahmoodpoor, A., Zamiri, R. E., Akbari, M., Xu, H., & Shotorbani, S. S. (2021). Harmful effects of high amounts of glucose on the immune system: An updated review. Biotechnology and Applied Biochemistry, 68(2), 404–410. Retrieved from https://doi.org/10.1002/bab.1938
SPENCE, L., BROWN, W. J., PYNE, D. B., NISSEN, M. D., SLOOTS, T. P., MCCORMACK, J. G., … FRICKER, P. A. (2007). Incidence, Etiology, and Symptomatology of Upper Respiratory Illness in Elite Athletes. Medicine & Science in Sports & Exercise, 39(4), 577–586. Retrieved from https://doi.org/10.1249/mss.0b013e31802e851a
Stanhope, K. L. (2015). Sugar consumption, metabolic disease and obesity: The state of the controversy. Critical Reviews in Clinical Laboratory Sciences, 53(1), 52–67. Retrieved from https://doi.org/10.3109/10408363.2015.1084990
Stricker, S., Rudloff, S., Geier, A., Steveling, A., Roeb, E., & Zimmer, K.-P. (2021). Fructose Consumption—Free Sugars and Their Health Effects. Deutsches Ärzteblatt International, 118(5), 71–78. Retrieved from https://doi.org/10.3238/arztebl.m2021.0010
Swan, G. E., Powell, N. A., Knowles, B. L., Bush, M. T., & Levy, L. B. (2018). A definition of free sugars for the UK. Public Health Nutrition, 21(9), 1636–1638. Retrieved from https://doi.org/10.1017/s136898001800085x
Thaiss, C. A., Levy, M., Grosheva, I., Zheng, D., Soffer, E., Blacher, E., … Elinav, E. (2018). Hyperglycemia drives intestinal barrier dysfunction and risk for enteric infection. Science, 359(6382), 1376–1383. Retrieved from https://doi.org/10.1126/science.aar3318
Wei, J., Raynor, J., Nguyen, T.-L. M., & Chi, H. (2017). Nutrient and Metabolic Sensing in T Cell Responses. Frontiers in Immunology, 8, 247. Retrieved from https://doi.org/10.3389/fimmu.2017.00247
Yang, Q., Zhang, Z., Gregg, E. W., Flanders, W. D., Merritt, R., & Hu, F. B. (2014). Added Sugar Intake and Cardiovascular Diseases Mortality Among US Adults. JAMA Internal Medicine, 174(4), 516–524. Retrieved from https://doi.org/10.1001/jamainternmed.2013.13563
Yin, J., Zhu, Y., Malik, V., Li, X., Peng, X., Zhang, F. F., … Liu, L. (2020). Intake of Sugar-Sweetened and Low-Calorie Sweetened Beverages and Risk of Cardiovascular Disease: A Meta-Analysis and Systematic Review. Advances in Nutrition, 12(1), nmaa084-. Retrieved from https://doi.org/10.1093/advances/nmaa084
Zdzieblik, D., Friesenborg, H., Gollhofer, A., & König, D. (2022). A high carbohydrate diet with a low glycaemic index improves training effects in male endurance athletes. International Journal of Food Sciences and Nutrition, 73(7), 965–972. Retrieved from https://doi.org/10.1080/09637486.2022.2091525
Żebrowska, E., Chabowski, A., Zalewska, A., & Maciejczyk, M. (2020). High-Sugar Diet Disrupts Hypothalamic but Not Cerebral Cortex Redox Homeostasis. Nutrients, 12(10), 3181. Retrieved from https://doi.org/10.3390/nu12103181
Zhang, D., Jin, W., Wu, R., Li, J., Park, S.-A., Tu, E., … Chen, W. (2019). High Glucose Intake Exacerbates Autoimmunity through Reactive-Oxygen-Species-Mediated TGF-β Cytokine Activation. Immunity, 51(4), 671-681.e5. Retrieved from https://doi.org/10.1016/j.immuni.2019.08.001
