T Nation

LL Prime Time 8-9-05, 8-11-05

Hi All,
I’m here if you’d like to talk… er, write.

Got questions?

EDIT: Okay, It’s now Thursday

Hey Lonnie! Doing well I hope.

Id like to know what dietary recommendations you would give to a 23 yr old heart-attack victim who currently has BP issues. His BP even shoots up after he eats just about anything. Im going to be visiting him, hes my younger brother, in about a week and Im making sure he cleans up his diet and Im going to put him on a solid training plan. But any tidbits of info would be helpful

Thanks!

Amir

Hey LL, my multivitamin has 8mg of iron per serving and I have a six week supply left. I’m going to switch to a iron-free brand and I’m wondering what kind of damage, if any, would come from finishing off my present supply.

Thanks!

Hi Lonnie, I’m not sure if you have any expertise in this area, but I thought I would throw the question out there anyway.

How much time should a woman who has just had a baby wait until getting back to the gym? From what I have read, for a regular birth one month is recommended and six weeks for a C-section. One month seems like a very long time to me. Would it be okay to just go off how you feel instead? Is there some other reason that you know of why they recommend waiting for so long?

Thanks!

LL, I noticed recently that apple cider vinegar is actually alkalaine on the PRAL svale.

I was wondering if you had any idea how an acidic compound could end up being alkalaine promoting in the body.

Also, do you have any figures on the average level of muscle glycogen stores in a human male? IE how many carbohydrates can be stored as muscle glycogen in the body.

Amir,
This definitely falls into the category of “check with the primary care physician”.

I can offer this general info., though. For post-MI patients and post bypass patients, adequate intake of omega-3 fatty acids (e.g. starting with a gram of EPA+DHA daily, or about three standard “fish oil” capsules) could help reduce future complications like restenosis (re-blocking of arteries) and arrhythmias (skipped beats). An eventual increase to 1.0-3.0g EPA+DHA could help further. It could also help bring down the hypertension. I’ll bet his MD will agree. If a multi-vitamin/multimineral isn’t already in place, that’s a good thing as well when he’s ready.

Food-wise, fruits, veggies and low-fat dairy can provide a better sodium:potassium ratio, and overall outcome, too.

Perhaps this info. is worth discussing with the DR., too…
"Milk proteins, both caseins and whey proteins, are a rich source of ACE inhibitory peptides. Several studies in spontaneously hypertensive rats show that these casokinins and lactokinins can significantly reduce blood pressure. Furthermore, a limited number of human studies have associated milk protein-derived peptides with statistically significant hypotensive effects (i.e., lower systolic and diastolic pressures). J Nutr. 2004 Apr;134(4):980S-8S.

This doesn’t mean to tell him to load up on protein, however. It’s just something to discuss with the MD.

I advice caution and close interaction with the cardiologist regarding the exercise program as well. Although lighter weights are becoming an increasingly large part of rehab, they are not the focus like controlled-intensity cardio is.

thrasher,
No damage, per se, is likely by finishing a single bottle of multivit/mins that includes iron. The negative effects of excess iron (i.e. buildup in a man’s body) are generally slower and more subtle. They’re even debated among healthcare authorities.

If you have no reasons contraindicating (ill-advising) a blood donation, this is a way to rid oneself of considerable iron over time - and something I personally do. And they won’t (or shouldn’t) take a donation unless your blood iron level is adequate. Perhaps read “Keep the Iron on the Bar” for more.

JPBear,
It depends on the individual case (surgical wounds, etc. as you point out) but at least some physical activity like walking can be started when a woman feels ready and her MD says okay. A simple phone call to him/ her mgiht be all that’s necessary for a fast answer.

My own wife really pushed the envelope and was back in classes at university the day after she left the hospital! (Not necessarily recommended.)

Hi Helix,
Well, I honestly don’t know much about apple cider vinegar but I can comment on the glycogen storage thing.

A typical man can carry about 90-100g in his liver (varies greatly with intake and time of day) and about 300-400g more in skeletal muscle (which is more “trapped” once it’s in there. It depends on how much muscle mass is present. Actually hepatic tissue (liver) is far better at storing glycogen per unit of weight, but it can’t compete with the sheer amount of skeletal muscle on a man’s body.

PS A glycogen load (up to 9g/kg carbohydrate daily) can more than double bodily glycogen stores. Cool, eh?

Thankyou very much! Ill take this info to his doc.

Take care

Amir

quote]Lonnie Lowery wrote:
Amir,
This definitely falls into the category of “check with the primary care physician”.

I can offer this general info., though. For post-MI patients and post bypass patients, adequate intake of omega-3 fatty acids (e.g. starting with a gram of EPA+DHA daily, or about three standard “fish oil” capsules) could help reduce future complications like restenosis (re-blocking of arteries) and arrhythmias (skipped beats). An eventual increase to 1.0-3.0g EPA+DHA could help further. It could also help bring down the hypertension. I’ll bet his MD will agree. If a multi-vitamin/multimineral isn’t already in place, that’s a good thing as well when he’s ready.

Food-wise, fruits, veggies and low-fat dairy can provide a better sodium:potassium ratio, and overall outcome, too.

Perhaps this info. is worth discussing with the DR., too…
"Milk proteins, both caseins and whey proteins, are a rich source of ACE inhibitory peptides. Several studies in spontaneously hypertensive rats show that these casokinins and lactokinins can significantly reduce blood pressure. Furthermore, a limited number of human studies have associated milk protein-derived peptides with statistically significant hypotensive effects (i.e., lower systolic and diastolic pressures). J Nutr. 2004 Apr;134(4):980S-8S.

This doesn’t mean to tell him to load up on protein, however. It’s just something to discuss with the MD.

I advice caution and close interaction with the cardiologist regarding the exercise program as well. Although lighter weights are becoming an increasingly large part of rehab, they are not the focus like controlled-intensity cardio is.

[/quote]

Hey Lonnie,

I’ve read some research about drinking a simple carb/protein mix drink during a weight training workout with the aim of increasing anabolism/decreasing catabolism, in the hopes of increasing muscle size.

The ratio is 3:1 of simple sugar (I use kool-aid) to preferably whey protein isolate, which I also use. Do you have any opinions/expereince/rebuttals to this method?

[quote]Thank you very much! Ill take this info to his doc.

Take care

Amir
[/quote]

You are very welcome!

(Good question, BTW - and one that should be addressed during his visit with the cardiac rehab dietitian, too.)

Lonnie,

I’ve seen it written numerous times that it is prefferable to consume carbs predominantly in the morning, and fats later at night. I used to follow a high carb low/no fat diet for a long time, but after switching to a more balanced split I have noticed I don’t seem to tolerate carbs well in the am, especially breakfast. A bowl of oats is enough to induce a sort of flying feeling which leaves me crashing and tired soon after. Higher carb Pre-Work out also causes a decline in my work out performance, and higher overall fatigue. Some fruit in the am though seems to be well tolerated (except bananas). PWO and/or after midday, however, all mental fogginess, odd sensations, and fatigue does not occur upon carb consumption, no matter how high I push it. Is this cause for concern? Diabetes runs in my family (im 21) and my fasting blood glucose always comes back normal.

Dr. Lonman, why are you hogging all of the Prime Time traffic tonight? Are you giving away free candy or something?

No, everyone just wants to hear how his recovery is coming along!

[quote]David Barr wrote:
Dr. Lonman, why are you hogging all of the Prime Time traffic tonight? Are you giving away free candy or something?[/quote]

Bauer97
That’s a reasonble approach. Sucrose and whey are often dirt cheap and do “work” for peri-workout recovery. You may want to check with those who develop various sports drinks with additional potential benefits, though. For example, added leucine may help anabolism and specific amino acid / carbohydrate blends could lead to an even better metabolic result.

swiperfox,
Whew! Lots of embedded questions, I think; see below…

[quote]swiperfox wrote:
Lonnie,

I’ve seen it written numerous times that it is prefferable to consume carbs predominantly in the morning, and fats later at night.

[/quote](well, fats in the afternoon/ evening, yes) [quote]

I used to follow a high carb low/no fat diet for a long time, but after switching to a more balanced split I have noticed I don’t seem to tolerate carbs well in the am, especially breakfast. A bowl of oats is enough to induce a sort of flying feeling which leaves me crashing and tired soon after.
[/quote]
As you point out, “more balanced” should indeed be a goal. We need dietary fat to maintain T levels, maintain metabolic “fat burning” effects and offer nutraceutical benefits. It’s natural for the body to start adapting to its last meal (Robertson, et al Am J Clin Nutr. 2002 Mar;75(3):505-10.) If it was low in carbs, then its logical that the subsequent meal, even much later to some extent, is less “carb ready”. But eating a lot of carbs on the prior evening is more detrimental in my opinion. It supresses fat oxidation (“fat burning”) and increases fat storage for say eight hours throughout the night. Also, data suggest that next-morning insulin concentrations are a bit lower after a higher fat dinner, if anything - which would lessen rather than enhance “food coma” in many people. Still, everyone is different, eh?

You know, a lack of physical activity in the morning could also be the culprit. I often suggest brisk morning walks, pre-breakfast, which could be helpful to some who have tiredness issues.

This seems odd, as most research shows a direct relationship between carb intake and performance as well as reduced fatigue. Again, everyone is different, though. In fact, I think some carb restriction 90-120 minutes prior to “fat loss cardio” is helpful.[quote]

Some fruit in the am though seems to be well tolerated (except bananas).
[/quote]
bananas are higher glycemic index, which may be the reason[quote]

PWO and/or after midday, however, all mental fogginess, odd sensations, and fatigue does not occur upon carb consumption, no matter how high I push it.

[/quote]
This may have something to do with adaptation to prior diet habits or sleep patterns or supplementation; I can’t say. Insulin secretion can be lower in the evening, which might partly explain a lack of “food coma” but muscle receptivity to dietary carbs is also poorer, making it an inopportune time to eat lots of them.

[quote]
Is this cause for concern? Diabetes runs in my family (im 21) and my fasting blood glucose always comes back normal.[/quote]

It may be worth having your fasting insulin concentrations checked by an endocrinologist, if you have concerns. They may or may not be abnormally high and I can’t say if this has anything to do with what you are experiencing. I’m only offering some general information.

Good luck finding your best lifestyle approach!

Thanks Mike - I think. (Okay, okay, maybe I should stop logging my recovery efforts). And yes, David, I am offering the sweet candy of knowledge. :stuck_out_tongue:

[quote]Mike Robertson wrote:
No, everyone just wants to hear how his recovery is coming along!

David Barr wrote:
Dr. Lonman, why are you hogging all of the Prime Time traffic tonight? Are you giving away free candy or something?

[/quote]

Hi Doc,

Man I need to drop bodyfat fast. Perhaps over the next 8-9 weeks. I have slowly been dropping calories from the ‘massive eating’ diet. Result are coming slowly but surely and I was wondering, are there negative effects of dropping calories quickly. I know it’s not a good idea to drop protein too fast but does the principle remain for carbohydrate. At the moment I’m on 350g Protein, 250g Carb, 90g Fat. Would it be unwise to drop carbs by 100g or more. Any tips or advise would be appreciated. Thanks.

Ben

Okay all,
It’s 10:00 PM, past my (rated PG) bedtime. I’m signing off.

Take Care,
Lonnie