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Body Composition

2/17/2021

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WHAT IS IT AND HOW DO YOU ASSESS IT? KNOWING HOW TO MEASURE AND MONITOR YOUR BODY COMPOSITION IS ONE OF THE FIRST STEPS YOU CAN TAKE IN ACHIEVING (AND TRACKING) HEALTH AND PERFORMANCE PROGRESS.
Assessing body composition is not about getting ripped, let’s get this clear. Your body composition is important for both health and performance reasons. From a health perspective, poor body composition can be associated with a myriad of diseases including diabetes, heart disease, cancer, osteoporosis, sarcopenia, and metabolic syndrome. From a pure performance perspective, improving body composition can be an effective way to improve your power to weight ratios that can help bring about improvements in cycling and running, but it’s also equally important to understand that there can be diminishing returns here, too—that is, get too lean and you could start to lose power and run the risk of injury. 
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When first assessing body composition, it is good to establish a baseline measurement and then, from there, objectively assess the effectiveness of a nutritional and/or exercise intervention. By monitoring change over time you can adjust and assess what you need. There are multiple ways in which to assess body composition. These range from girth measurements, bioelectrical impedance, skinfolds, DEXA, and underwater weighing. These varied methods have both pros and cons associated with them that we’ll explore below. The method you choose may be dictated by your budget and also your commitment to assessment—some are more involved than others.
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Body Composition: Methods of Assessment

A Piece of String

Perhaps the most simple place to start is a girth measurement. Take a piece of string and measure your height. Next, take that same piece of string and fold it in half. Place it around the narrowest part of your waist and the two ends should touch or overlap. Essentially, the narrowest part of your waist should be half your height (waist to height ratio =/< 0.5). You can calculate your actual ratio by simply using this formula: Waist to height ratio = waist divided by your height. 
Ideally, you want to see a range of around 0.45-0.55. If it is under 0.45 you may be underweight; if it is over 0.55 you may be overweight. Both carry potential risks: being underweight could leave you open to osteopenia, osteoporosis, or Relative Energy Deficit Syndrome (REDs) while being overweight could leave you at risk of metabolic syndrome, Type II diabetes, heart disease, and stroke. Of course, other factors do contribute to the relative risk of these diseases too.
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Conclusion: This is a simple, quick, and effective way to measure body composition. It may be the starting point for investigating further. ​

​Skinfolds

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If you are going to get a skinfold measurement done, seek out a practitioner who has completed their International Society for the Advancement of Kinanthropometry (ISAK 1). This will ensure that the assessment is thorough, consistent, and reliable. The assessment will likely be done over seven places on your body and should take 15-30 minutes to complete. The practitioner will mark your body and perform the measurements twice to ensure accuracy and minimize measurement error. If there is an error then a third should be taken. Skinfolds do not relate to hormones and any practitioner who explains your skinfolds are related to cortisol, oestrogen, or your thyroid should make you very wary of them.
Conclusion: Choose an ISAK practitioner to ensure accuracy of measurements.

Bioelectrical Impedance Analysis (BIA)

These are machines that you stand on, sometimes with a pair of handles to grab, while a current passes through your body to estimate your fat free mass (FFM) and fat mass (FM). The principle is that lean muscle consists of water and electrolytes and acts as a good conductor while fat mass does not and is a poor conductor. Be aware that there are a lot of confounding factors related to BIA including hydration status, nutrition status, menstrual cycle, and the electrodes themselves. Bioelectrical impedance analyzers use equations to describe statistical associations based on a specific population, and as such the equations are only useful if you closely match the specific population in body size and shape. Significant improvements have been made with these machines lately and some do now use multiple frequencies and bioelectrical impedance spectroscopy (BIS) to assess total body water (TBW), even breaking this into extracellular and intracellular water. Despite these improvements, the real use of BIA is for describing the average body composition for groups of individuals rather than individual changes due to the often large measurement error.

Conclusion: FFM is often underestimated in normal-weight individuals while overestimated in obese individuals, especially when compared to DEXA measurements (see below).
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Dual Energy X-Ray Absorptiometry (DEXA)
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This method assesses body fat (visceral and subcutaneous), muscle, and total body bone mineral (TBBM) density. It is considered the gold standard for bone mineral density measurements, so if you are a female endurance athlete this is certainly worth considering for your body composition assessment. In my opinion, if you are a female endurance athlete with a waist to height ratio </=0.5 and you have also had some irregular eating episodes that have resulted in underfueling your training and performance then a DEXA scan is key. When it comes to body composition measurements it is not 100% accurate as it does assume a constant hydration status which could result in an error of 1-2% in body fat and lean tissue measurements.

Conclusion: DEXA is quick to use, safe, and as reliable as you can get. Ensure you are hydrated before each use and aim to standardize the time of day. Women should aim to get tested at the same time in their cycles, preferably during phase one or two. 
Body Composition Takeaways

No single method is the gold standard in body composition assessment and all have their advantages and disadvantages depending on cost, practicality, and measurement error. Whichever you choose to use, consider attempting to standardize the method as best as possible and stay with that choice for consistency purposes.

One other important consideration is that if your goal is improving body composition for performance purposes, be aware that maintaining a low percentage of body fat over a long period of time is not only difficult, it can also result in an increased risk of upper respiratory chest infections and other musculoskeletal injuries.

​Working alongside a professional practitioner to periodize your plan in order to hit targets when required would be sound advice to follow to ensure you are as healthy as you can be all year round. In short, peak for performance—not to get ripped. 

Thank you,

​Scott

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Acute Ashwagandha supplementation

2/2/2021

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Acute Ashwagandha supplementation improves cognitive function. Xing et al, 2020. Proceedings of the Seventeenth International Society of Sports Nutrition (ISSN) Conference and Expo
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Why is this important?
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Nootropics and adaptogens are all the rage at the moment. An adaptogen is a natural substance considered to help the body adapt to stress whilst a Nootropic is a substance used to enhance memory or other cognitive functions. Think “Smart drug” from the film “Limitless” with Bradly Cooper. Ashwagandha is one such herb known as the “King of Ayurvedic” that ticks both these boxes. Personally, I have found a lot of benefit from supplementing with Ashwagandha KSM-66. The benefits have been a reduction in perceived stress and an improved ability to focus. This is purely anecdotal and hence why this study was of interest. 

Conventional Wisdom
Research has indicated that chronic supplementation with Ashwagandha (Withania somnifera root extract) has resulted in reduced feelings of stress & anxiety, improved mood and attenuated cognitive function although a lot more research is required before definitive conclusions can be made (1-4). This is because a lot of the studies to date have poor methodology, mixed subject groups and varied supplementation routines. It appears a dosage of 300-500mg of root extract taken for 2-6 months has a beneficial impact on users. For now, the research is promising and the space should be watched closely.
Tinlane perspective
The source of Ashwagandha (NooGandha®, Specnova Inc., FL) is not one that has a lot of information on it, so I am unsure of the quality (% withanolides, % Withaferin A). The form I am familiar with is KSM-66 and it is the most researched form of Withania root extract, with the majority of studies using that form. Saying that the study was a double-blind, placebo-controlled, crossover study so the results should carry some weight. Participants completed a battery of cognitive function tests then consumed 400mg of Ashwagandha (NooGandha®, Specnova Inc., FL) or a placebo and repeated the tests every hour up to 6hrs post-consumption. They had a 7 day washout period then reversed the treatment.

Key Take-Aways
  • Short term memory, sustained attention, reaction time were all improved as time post-consumption of the Ashwagandha increased.
  • Whilst reaction times were improved, accuracy in that go/no go test were the same between groups.
  • Short term improvements in attention and memory were achieved in the short term following supplementation of 400mg Ashwagandha root extract.
  • Much like chronic supplementation, this area of research requires more attention to determine the optimal dose, routine along with what parameters this supplement can improve. 
References
  1. Chandrasekhar K, Kapoor J, Anishetty S. A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of ashwagandha root in reducing stress and anxiety in adults. Indian J Psychol Med. 2012;34(3):255-262.
  2. Cooley K, Szczurko O, Perri D, et al. Naturopathic care for anxiety: a randomized controlled trial ISRCTN78958974. PLoS One. 2009;4(8):e6628. 
  3. Chandrasekhar K, Kapoor J, Anishetty S. A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of ashwagandha root in reducing stress and anxiety in adults. Indian J Psychol Med. 2012;34(3):255-262.
  4. Choudhary D, Bhattacharyya S, Bose S. Efficacy and Safety of Ashwagandha (Withania somnifera (L.) Dunal) Root Extract in Improving Memory and Cognitive Functions. J Diet Suppl. 2017;14(6):599-612. 
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Can a protocol of fish oil be effective in reducing markers of inflammation and oxidative stress in athletes?

2/2/2021

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EFFECT OF 8-WEEK N-3 FATTY-ACID SUPPLEMENTATION ON OXIDATIVE STRESS AND INFLAMMATION IN MIDDLE- AND LONG-DISTANCE RUNNING ATHLETES: A PILOT STUDY
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Why is this important?

Strenuous exercise causes oxidative stress and inflammation in the body. This is a normal response and required in order to create an adaptation to the applied demand. When the inflammatory response gets out of control and a lack of recovery occurs then the athlete could be at risk of illness and/or injury as a result of muscle damage. Finding the balance is key to an effective training program. Research focusing on anti-oxidants and in particular high dose anti-oxidants (6-8g/day vitamin C & E) to reduce this effect has been found to be effective in the short term yet blunting skeletal muscle adaptation (1) in the long term (28 days) and being seen as deleterious to performance This study (2) explored a high dose (~4g/day) supplementation program of Omega-3 (EPA: DHA) oils for 8 weeks to 17-30-year-old middle and long-distance runners who were training at least 5 hours per day every day compared to a sedentary group (less than 1hr training twice per week). The investigators were interested to see if there was a difference between exercising individuals and sedentary ones with an identical supplementation program. 
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Conventional Wisdom

Previous research has investigated omega 3 supplementations to assist with reducing inflammation and oxidative stress in athletes. Jouris et al, 2011 (3) investigated the effect of 7 days of 3g/day of omega 3 on delayed onset muscle soreness (DOMS) after eccentric exercise and found ti to be effective in reducing perceived soreness in the participants. Omega 3 supplementation has been found to be effective in chronic inflammatory diseases such as bowel disease and rheumatoid arthritis yet the data on athletes is equivocal with varying results across varying studies. Omega 3’s have the ability to act as anti-oxidants and anti-inflammatory mediators via inhibition of pathways associated with inflammation as well as their direct action on macrophages and neutrophils. 


Tinlane Perspective

This study was very interesting as it investigated a group that is very much in line with or actually performs more training than the athletes that we work with. They measured a multitude of markers including testosterone/cortisol, oxidative damage (TNF-alpha, urine 8-OHdG, MDA, PCc), anti-oxidant ability (GPx, CAT), muscle damage (creatinine, CPK, LDH, IGF-1) and lipids (TAGs, Total cholesterol and HDL). The actual supplementation was 4 capsules contained 600mg DHA and EPA with a total of 950mg of omega 3 fatty acids. So the actual dosage of EPA: DHA was 2.4g/day and not 4g/day of those specific fatty acids. This is actually less than what we typically recommend on a daily basis at Tinlane. What we do not know is whether or not this supplementation protocol had any effect on adaptation to training as measured. It is important to note that diet was not controlled in this study although the baseline PUFA 6:PUFA 3 ratio intake was assessed at baseline to assess the groups habitual intake, The authors did not comment on the ratio’s the groups - so it is unclear of there was a difference at baseline.


Key Takeaways
  • Triglycerides decreased in the athlete group only and total cholesterol decreased more markedly in athletes than the sedentary participants
  • Creatinine was higher than baseline in athletes. This may be due to higher workloads and increased protein intake during the 8 weeks. So in terms of muscle breakdown, Omega 3s at this dose appears to have little effect.
  • MDA, the key lipid peroxidation marker was significantly lower in both groups after 8 weeks and this effect was more pronounced in the athletic group. The main effect of lipid peroxidation on biological membranes is the overall decrease in their fluidity and severe damage to the membrane proteins (4)  It was absent in urine in the athletes! 
  • PCc and 8-OHdG did not change indicating that oxidative stress was not completely blunted or knocked out. I read this as being a positive effect.
  • TNF-alpha decreased in both groups yet more so in the athlete group indicating a reduction in inflammatory damage markers.
  • GPx and CAT (anti-oxidant effect) increased in both groups 
  • Cortisol was found to decrease in athletes yet increased in the sedentary group
  • Overall, the effect of omega 3 supplementation on the markers investigated was more pronounced in the athletic group. The amount being recommended is not high dose and can be achieved through diet and supplementation very easily.
  • Focus on finding good quality omega 3 supplements that contain at least 950-1000mg EPA:DHA per capsule.
  • The other alternative in whole food form which Tinlane always recommends first and foremost is herring, mackerel, sardines, kippers on a daily basis!

Reference: 
  1. Merry, Troy L, and Michael Ristow. “Do antioxidant supplements interfere with skeletal muscle adaptation to exercise training?.” The Journal of physiology vol. 594,18 (2016): 5135-47. doi:10.1113/JP270654
  2. Buonocore, D., Verri, M., Giolitto, A. et al. Effect of 8-week n-3 fatty-acid supplementation on oxidative stress and inflammation in middle- and long-distance running athletes: a pilot study. J Int Soc Sports Nutr 17, 55 (2020). https://doi.org/10.1186/s12970-020-00391-4
  3. Jouris, Kelly B et al. “The Effect of Omega-3 Fatty Acid Supplementation on the Inflammatory Response to eccentric strength exercise.” Journal of sports science & medicine vol. 10,3 432-8. 1 Sep. 2011
Richter C. Biophysical consequences of lipid peroxidation in membranes. Chem Phys Lipids. 1987;44:175–89.
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Never too old to make gains

1/3/2021

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“Effects of High Intensity Dynamic Resistance Exercise and Whey Protein Supplements on Osteosarcopenia in Older Men with Low Bone and Muscle Mass. Final Results of the Randomized Controlled FrOST Study.” 

Key Takeaways

The takeaway from this is that it is never too late to make a difference in your health. To quote the authors 
  • “In general, exercise or more dedicated resistance exercise—ideally supported by dietary supplements—might be the most promising strategy to positively affect all physiologic and functional outcomes related to the osteopenia/sarcopenia/obesity complex.”.  
  • By utilising a resistance training program that is structured and combined with a higher protein diet including a whey supplement, it is becoming clear that our parents and soon to be us can improve health in many ways. 
  • Bone health, lean muscle mass can all be improved with strength training and increased protein.
  • This age group is at risk of further deterioration in muscle mass, bone structure and mobility if a similar intervention is not applied​.

Why is this important? 
Whilst I appreciate this paper does not relate directly to triathletes, I think we can all accept that we will all become old at one point in our life or know some people (read parents or grandparents) that are older than us and this can be applied. Recently there has been a lot of interest in sarcopenia, sarcopenic obesity and osteosarcopenia. For those unaccustomed to these words, they relate to progressive loss of muscle as we age, loss of muscle as we age whilst getting fatter and loss of muscle with concurrent loss of bone density respectively. All pretty grim reading and a very real issue in today’s society and potentially a major health crisis in the making.

​What was studied?


This study was cool because they recruited a group of 74+-year-old men - think about your dad right about now. Forty-three in total and had them follow a resistance training program on machines over the course of 18 months. The training was performed twice a week and they periodised the training with changes to repetitions, sets, time under tension and speed of lifting in line with a training program that someone much younger may follow. 

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The Importance of sleep - what the experts are saying.

1/3/2021

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Consensus statement - Sleep and the athlete: narrative review and 2021 expert consensus recommendations

Key Takeaways
  1. Interruptions to sleep quality and duration will affect the individual in differing manners
  2. Despite a hard lack of research on the ideal amount of hours, there is no evidence to suggest increasing your hours is going to be detrimental. Increasing to at least 8 hrs per night is sound advice and then play around with more or less as required. (7-9 hrs range)
  3. Educate yourself on sleep hygiene and how to improve it (part of the Tinlane program).
  4. Take naps when you can if you are having poor quality sleep during the night - they can really help. Limit naps to 20 minutes.
  5. Train in line with your chronotype. “Larks” train early in the morning, “Owls” train during the day (if possible and practical).
  6. If you are having real issues with sleep and perhaps are worried about your sleep data, see a sleep specialist and get assessed. Dr Google is not your answer.

Why is this important?

Sleep is increasingly being recognised as a crucial element to health, recovery and ultimately performance. This performance element extends beyond the swim, bike or run and into everyday life and performing at your best. I have recently written a new article for Triathlete magazine that reviews the effect of alcohol on sleep, heart rate and heart rate variability (HRV) with me being the N= 1. There were certainly some insights and I encourage each of you to read it and to also explore what I describe with your own social experiment.
Please remember that wearables are only as good as the information they collect and as discussed later, most are likely to be inaccurate and overestimate (much like activity performed and calories burnt). Also, important to note, data is one thing, don’t obsess over it - how you wake and feel on a day to day basis is likely to be just as good an indicator to how you are sleeping.



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