Interview with Dr. Liz Applegate about Nutrition

Dr. Liz Applegate is an author, consultant, and respected expert in the area of nutrition and fitness. She has authored six books in the field including Nutrition Basics for Better Health & Performance, Eat Smart Play Hard, Bounce Your Body Beautiful and Encyclopedia of Sports and Fitness Nutrition. She is a column writer for Runner’s World magazine and is also on the faculty at the University of California, Davis, where she teaches courses in nutrition. Dr. Applegate has worked with a wide range of competitors from professional sports teams to USA Olympic athletes. She is a Fellow of the American College of Sports Medicine and her prestige in the field has made her a sought out keynote speaker at nutrition and fitness conferences, forums, and seminars.

Here are the 5 questions with Dr. Applegate and my summary of her answers:

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1) What are some good glycogen boosters for endurance athletes? And is it true with respect to glycogen boosters that effectiveness, regarding both type and dosage, is going to vary amongst different people?

People underestimate the power of training and what that does in terms of muscle adaptation. So rather than discussing a particular supplement or food, let’s look at the body’s adaptation to exercise. Adaptation to exercise is dramatic adaptation – changes in different proteins occur, we increase our ability to store glycogen – all as a result of endurance training.

Also, there isn’t a consensus on the right way to influence glycogen efficiency. There are carbohydrate recovery products made for the purpose of promoting glycogen resynthesis and recovery. There is also another camp of researchers with fairly substantial evidence regarding the notion of “training low”. This means maintaining a low carbohydrate diet and training twice in a day, so that during training sessions you are exercising in a carbohydrate deficit. There is evidence that shows that one’s muscles respond and adapt with increased mitochondria and aerobic capacity in this state even better than those that maintain a carbohydrate rich diet during training. Talk to someone like Dr. Ed Howley, and he’ll tell you not to worry about carbohydrates and to, “train low, and compete high.”

My approach is to look at the athlete’s history and ask questions like, “How many hours are they training? What’s their mileage? What is the time spent doing aerobic exercise?” I then examine what their typical training diet consists of, how they are responding to their diet, and then make a judgment on what I see fit for them to change. I am not a proponent of a one-size-fits-all plan. With many of the athletes I see, the discipline is usually there with regards to strict regimen adherence and control, but they come to me a mess because the particular system that they prescribed themselves to does not work for them. This has a negative psychological and physiological impact, and as such their training sessions are not as productive. By the time they get to their event they are so beat up that they end up not doing very well.

So I start by looking at the hours one spends training, and come up with a formula to baseline carbohydrate intake and go from there. I am not a supplement person. In my opinion, the best legal ergogenic aid is caffeine. That aside, one has to eat real foods. I’m dealing with 20 year olds that want to take a supplement approach to their diet. So given this case I will probably, in reality, weed supplements out and replace them with real foods. So to truly answer your question when looking for “glycogen boosters” I will look at what carbohydrate foods a person likes, what foods they are missing in terms of micronutrients and phytonutrients that may be beneficial for muscle recovery and anti-inflammatory response, and I will try to implement those foods into their diet until I am satisfied with the carbohydrate availability based on the feedback and response to these changes.

2) Is the latest research on DNA dieting more hype than science (http://www.lvrj.com/news/dna-driven-diets-fitness-plans-catch-on-121485479.html)?

In general terms, these findings are very intriguing. I don’t know when it is going to happen, but in broad futurist terms I do think there is some appropriateness to the idea, and we are already seeing it in the most basic of recommendations. The United States Dietary Guidelines basically speak to a range of intakes that are meant to help prevent chronic diseases such as diabetes and heart disease. Again, there isn’t a one-size-fits-all diet and it is good we are recognizing that.

Should I sit down with a 28 year old who is now done with their cross-country career, their focus isn’t joining a national team, but they are still an avid elite runner… would I recommend this person go get their cheek swabbed? No, probably not, there just isn’t enough evidence yet. I think they, at least from what we know now and the current costs of these tests, are better off sticking with the diet that has gotten them this far and tweaking it where appropriate.

But I’m holding the hope that we’re going to be there soon. I was just at the Olympic Training Center earlier this week, and while they are not doing genetic testing on these athletes they certainly are doing very specific diet counseling based on that athlete’s sport. Periodization is being looked at not only in regards to training but with one’s diet now as well. In other words, where is the athlete in their training schedule? For example, if they are in the pre-competition stage or in the competition stage of a 52 week cycle, I would ask, “how many weeks do they have away from their sport? How many weeks will they have in competition? How many for preparation and training?” And then you periodize their diet based on those demands… again, for any given athlete there isn’t a one-size-fits-all plan. So our field is already highly customizing athlete’s diets, just not based on a DNA test yet… because we just don’t have the research to back up that method.

However, there is a lot here. And to answer your question, I don’t think it is more hype than science. I mean we’re always looking for the next great thing. There’s very intriguing science to back up the method… but as it relates to both sport performance and chronic diseases we simply have more to learn… and there’s more to come.

3) Does creatine supplementation provide any benefit to endurance athletes? And what is the deal about avoiding caffeine when supplementing with creatine, is there a valid concern?

To answer the first question, does creatine supplementation provide any benefit to endurance athletes, my answer to that is no. A majority of the research shows that it doesn’t support endurance performance and can be detrimental, even for athletes that might be anaerobic competitors (ex. swimmers) but train in an endurance format. For an endurance athlete you have to consider the weight gain and muscle hypertrophy that creatine promotes, and that’s not optimal for a lot of endurance athletes. I can tell you of the athletes I have seen, that have come in and come out of creatine supplementation, usually in the end they don’t really want to have anything to do with creatine.

Now, for some athletes, such as shorter distance track athletes at the 400 to 800 meter range, there are certainly some potential benefits there. However, you have to deal with the modification in body weight and what the implication is for a runner at that level.

In my experience, people that really track improvements see better results by asking questions like… how well do I sleep, how good is my training program, how consistent am I with my eating, and what diet works best for me… rather than looking to creatine or glutamine or any of these other type of things. So what I see is that the people who get into a supplement get right back out and realize it’s more the day to day consistency that fosters results.

Regarding your question about caffeine and creatine, actually when you look at the research, caffeine supplementation combined with creatine actually enhances anaerobic performance. I appreciate your question, and the fact that people try their best to fine-tune their effort but if an athlete came to me, that was a strength training athlete, and she or he was taking creatine would I suggest avoiding caffeine? No, I would not.

4) Can l-glutamine be effective at raising one’s growth hormone levels (http://www.ajcn.org/content/61/5/1058.short)?

In the mid-90s there was more of a push with glutamine in that regard, if you look at the research now it is really relating glutamine to possibly being an immune boosting amino acid. So to your question… do I view it as an effective growth hormone stimulant… my answer is no. That is not how athletes are using it these days. I remember going through that research a number of years ago but today glutamine just is not talked about in terms of performance boosting, but rather its effect on immune health.

Weight bearing exercise is a better option than supplementation. Take a look at the author Dr. Keith Baar. He is from UC Davis as well. He is a molecular biologist that looks at protein synthesis within the muscle and the factors that stimulate it in terms of nutrient timing, particularly with amino acids. If anything, the amino acid that people should be focusing on is glycine as far as enhancing and remasking. It has been shown repeatedly that one can get greater lean mass gains if, after exercise, they ingest a dose of protein which includes glycine – because glycine enhances the availability of protein in the body.

So I look at the glutamine story as more of an issue of immune health and the glycine story as directly impacting protein synthesis within the muscle fiber. So those readers interested in your question might want to look at the possible benefits of glycine instead.

5) Beer drinkers like me rejoiced after hearing that beer might be better than water after a race (http://www.foxnews.com/story/0,2933,307518,00.html). In 2007, however after learning a little bit since then I’m under the impression your best bet is always to try and get a carboprotein drink in right after a race. If alcohol retards glycogen uptake, should someone looking to recover from an endurance event wait awhile before grabbing a celebratory beer?

In June, I actually spoke to the researchers of a more recent publication on the subject (than the one you cited), their article is titled Non-Alcoholic Beer Reduces Inflammation and Incidence of Respiratory Tract Illness. Their participants drank a fair quantity, about a liter and a half every day, which you know… if you ask a person to do that, that’s a commitment! Of course it was non-alcoholic beer in the study and the concept was to look if the phenols and other compounds in beer are potentially beneficial in one’s immune response. What these researchers chose to look at was the immune response following the Munich Marathon. Lots of runners get sick following a big effort like a marathon, and in this study fewer of the runners got sick on the beer protocol than the control group. So the story is, okay who’s going to drink a liter and a half of non-alcoholic beer? Certainly not me. So I don’t know if today we can translate the findings to regular beer. Especially considering that while alcohol is metabolized in the liver it can impair glycogen resynthesis, particularly after an overnight fast. So when you look at when beer is typically consumed, later in the day, this could be problematic for somebody who might be working out in the morning who really does want to have a good workout. One might say, “Oh I’ll drink beer and go glycogen depleted during my 10 mile run”. Well, there is a possibility you may be OK, but there is a chance you may feel so lousy during that 10 mile run that you train at a slower pace and the whole training benefit is impaired… it becomes a Catch 22.

To answer your question direct, if your goal is to optimize recovery so that you can workout the next day my answer would be a carbohydrate protein drink over beer. But if your goal is a set lifestyle – i.e. I’m doing these runs to be social as well as to be healthy – I would say pick the beer because we can’t be so concerned with every detail a hundred percent of the time. If you’ve trained hard then it’s fine to celebrate, but if you’re going to train the next day you want the product that’s going to offer you the nutrients that you need for recovery… plain and simple.