Is a Calorie a Calorie?

The Modern American Table: Is a Calorie a Calorie? We've all heard the dictate that a calorie is a calorie regardless of its source. But are all foods truly created equal in terms of how they affect our health and weight?

Can You Retrain Your Taste?

Sugar consumption and your tastebuds

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A 2016 study published in the American Journal of Clinical Nutrition examined the effect of reduced simple sugar intake on a group of “healthy” men and women. The study broke the participants up into two groups, with one group assigned a low-sugar diet and the other group continuing to eat their usual high-sugar diet. After 3 months of this, both groups were left to eat however they pleased for yet another month. Each month during the study, participants were asked to rate the sweetness and “pleasantness” of vanilla puddings and raspberry beverages that varied in sugar concentration.

After the third month of dieting, the low-sugar group rated the pudding to be around 40 percent sweeter than the control group, regardless of how much sugar the pudding contained. The conclusion was simple: “changes in consumption of simple sugars influence perceived sweet taste intensity.” Meaning that the less sugar you eat over the long term, the more things taste sweeter and, therefore, tastier.

Researchers found that the low-sugar group took on average two months for their tastebuds to recognize any difference in sweetness and pleasantness—and yet another month for that sweetness to intensify.

The takeaway here? A little patience will yield long-term dividends.

But what about salt addiction?

If you’re a bit of a salt junkie, you might be keen on learning how to break the habit. It’s a perfectly reasonable goal to have, particularly if you’ve been diagnosed with hypertension. (You might want to find out if you’re among the “salt-sensitive” in the population—about 50% of those with hypertension by some estimates— before chalking up your high blood pressure to salt intake.)

Similar to sugar, lowering intake of sodium-rich foods has been shown to decrease your reliance on salt. An impressively long 1-year study found that “reduction in sodium intake and excretion accompanied a shift in preference toward less salt.” Researchers surmised that the mechanisms behind this reduction in salt addiction were varied, and included physiological, behavioral, and context effects. Not the ultra-conclusive reasoning you were hoping for, but it looks as if particularly overzealous salt cravings should drop significantly when you switch to a naturally salt-moderated, low processed-food diet.

Still, let’s not neglect some stubborn truths.

While the health and scientific community continues to hate on salt, very few studies have examined the importance of salt for maintaining a healthy body. While these studies may be relatively few, evidence suggests that salt may play an essential role in excreting cortisol (the “stress hormone”) from the body, thereby improving recovery time from stressful events and situations.

Salt has also been shown to decrease strain during exercise by increasing hydration. Studies indicate that knocking back a sodium-rich beverage prior to exercising increases plasma volume, which in turn reduces the strain on your body during exercise and helps you reach higher levels of performance.

And all those other clever uses…

And then there’s the point that salt just makes food taste better…. Just make a point of sticking with the good stuff—high quality sources like Himalayan pink salt, Real Salt, and Celtic sea salt. These natural, unrefined versions provide all of the taste of salt and, unlike table salt, still include all the essential minerals your body needs to rehydrate those cells and help to evenly distribute all that sodium.

The factors behind taste

If your body has been inundated with sugar-intensive processed foods for the last few years/decades, it may be a little confused as to what it actually wants to taste. Rewiring your tastebuds, then, is no small task for both your brain and your digestive system.

Luckily, all that’s required of you is to stay the course of good eating. That said, it’s helpful as always to understand the bigger picture.

Gut Health

There isn’t much it seems the gut isn’t involved in, and taste is no exception apparently. A team at the Department of Neuroscience at Mount Sinai School of Medicine discovered that the taste receptor T1R3 and the G protein gustducin are located in the gut, as well as the mouth. These taste receptors are essential to tasting sweetness in the foods we eat, and we now know that they play an important role in sensing glucose within our gastrointestinal tract.

This role goes far beyond simply “tasting” carbohydrates and other sugary or sweet foods within your gut. When you eat these foods, the sweet-sensing taste receptors in your large intestine activate the release of hormones that promote insulin secretion and regulate appetite. This means that if your gut health is lacking, its ability to sense carbs and produce insulin may be impaired.

Obesity

A 2012 study published in the British Medical Journal found that obese kids develop an insensitivity to taste. Researchers examined close to 200 children between the ages of 6 and 18, half of whom were a normal weight and half classified as obese. Each of the participants was asked to place 22 taste strips on their tongue, simulating each of the five levels of taste at varying intensities.

Obese children found it significantly more difficult to differentiate between the different taste sensations, and were particularly insensitive to salty, umami and bitter tastes. Children who were obese also gave lower intensity ratings to sweet foods, meaning they needed more sugar in foods to achieve the same sensation of sweetness.

The take-away is simple: the more weight we put on, the less likely we are to enjoy the food we eat or to recognize the mounting sugar or salt levels we likely take in for the same taste experience. There may be more of a lag time in rejuvenating full taste sensitivity if we’re reversing obesity as well as shifting our diets, but the end point is the same.

By Mark Sission

Food Manufacturers Are Fooling You

By Mike Sheridan

Fact: The unhealthiest foods you could possibly eat often have the most health claims on the label. Ironic, isn't it? Think about most breakfast cereals. You're basically eating a bowl of sugar and flour. But the front of the box is packed with health claims:

• Low fat!
• Heart healthy!
• High fiber!
• Gluten-free!
• Reduced sodium!
• Made with whole grains!

Flip that box around like a smart grown-up and take a look at the ingredient list: sugar, flour, sugar in another form, sugar in a different color, sugar with a pretty name, etc. It's Type-2 diabetes in a bright box featuring a cartoon character selling love handles and loneliness.

And now they have a new marketing angle: a clever blend of childhood nostalgia and "fat acceptance." They tell us to eat what we want and love our body no matter what it looks like. Presumably, this is because they've finally recognized that the only people still eating cereal for breakfast have already given up on their health and body composition.

Funny thing is, when looking at the evidence, it's clear that there were never really health benefits in the first place to back up all these "healthy" labels. Here's how many of them originated and why they're wrong.

1 – Low Fat

It's taken over 40 years to officially call BS on the fraudulent claims about fat. The fear of dietary fat started in the 60's and 70's and immediately moved breakfast cereal into the "healthy" category. Hey, sugar is fat free! Bacon, eggs, and butter were out. Low-fat indigestible roughage was in because the research of the time was suggesting that saturated fat was clogging our arteries and increasing our risk of heart disease.

And despite the various top-notch review studies disproving this myth today, the cereal killers, sugar-water sellers, and big pharma phonies continue to lobby government officials, pay off medical and fitness professionals, and fund bogus research studies to keep it alive.

A low-fat diet isn't a benefit because eating fat doesn't cause disease. NOT eating it probably does, and we now know the body even needs some saturated fat to function optimally.

2 – High Fiber

Once you understand the origins of the low-fat guidelines it's easy to see how the advice to eat more fiber came about.

Denis Burkitt was the man behind the 1970's research linking high-fiber diets to lower rates of disease (colorectal cancer specifically). Just like Ancel Keys (the fat fraud), his evidence was awful. He basically claimed that African tribesman were healthier than Westerners because they ate their grains whole (with the fibrous outer shell). He conveniently failed to include a number of disease-free tribes thriving on starch-less diets high in saturated fat and animal protein, like the Masai.

Nonetheless, the bran we were throwing in the garbage became a prized possession, Burkitt wrote a best-selling book, and the "high-fiber" stamp fit perfectly next to the "low-fat" one on our breakfast bowl of blood sugar and body fat. It remains there today, right along with the misconception that whole grains are healthier than refined grains and that more fiber is a good thing, regardless of the source.

Meanwhile, the only study looking at the long-term impact of eating a high-fiber diet (DART, 1989) found an INCREASED risk of heart disease (23%) and mortality (27%). Those studies looking at colorectal cancer saw no benefit to upping our fiber intake:

"Our data do not support the existence of an important protective effect of dietary fiber against colorectal cancer or adenoma." (Fuchs CS et al. NEJM, 1999)

"In this large pooled analysis... high dietary fiber intake was not associated with a reduced risk of colorectal cancer." (Park Y et al. JAMA, 2005.)

3 – Cholesterol

The "lipid hypothesis" suggests that elevated cholesterol is associated with heart disease. And when we add it to what high-fiber, low-fat fanatics tell us, it's no wonder we think the way we do and fall for bogus health claims.

Right around the time all this low-fat, high-fiber evidence was surfacing, doctors and scientists were convinced they'd found the underlying cause of atherosclerosis – the narrowing and hardening of arteries. Nearly every doctor was on board with the theory. In the early 80's the National Institute of Health gathered 14 experts who voted unanimously that, "Lowering elevated blood cholesterol levels will reduce the risk of heart attacks caused by coronary heart disease."

They did so despite the fact that a causal relationship was never established, there's a library of evidence disproving it, and the original experiments used rabbits (herbivores that can't process dietary cholesterol) and a chemically prepared bare-cholesterol, which tends to oxidize.

But along came the prescription statins, and all of a sudden the questions and doctors aggressively opposing the theory disappeared. This created an environment where we dish out damaging side effects to more than 32 million Americans to lower the thing that's NOT associated with heart disease and does nothing to prevent it.

If cholesterol were associated with heart disease, there would be fewer heart attacks in those on statins and those with lower cholesterol, but there aren't. And there would be more heart attacks in those not on statins with higher cholesterol, but there aren't. The two variables aren't even related.

What we do see is statins causing mitochondrial and hormonal dysfunction, and lower cholesterol levels associated with cognitive and neurological impairment (Alzheimer's, Parkinson's, depression). This shouldn't come as a surprise when you understand that cholesterol is a building block for cell membranes, precursor to steroid hormones and essential nutrients, and fuel provider to neurons who can't generate it on their own.

"Our finding that low plasma cholesterol is associated with depressive symptoms in elderly men is compatible with observations that a very low total cholesterol may be related to suicide and violent death." (Morgan RE, et al. 1993, Lancet.)

Cereal fiber's ability to lower cholesterol is more of a detriment than a benefit. And realistically, the people getting heart attacks are the ones with elevated triglycerides, low HDL cholesterol, and excess small-dense (oxidizable) LDL particles – the same thing eating less saturated fat, more high-glycemic carbs, and vegetable oil-filled boxes of stuff claiming to "lower cholesterol" provides.

4 – Sodium

Heard the one about the obese, pre-diabetic guy with high triglycerides? Doc told him to eat less salt!

That's a joke. Or at least it should be. Salt doesn't make you fat and it's probably the last thing the average person needs to be worrying about when it comes to health.

High blood pressure is the fourth and final phase that turns Syndrome X into the Deadly Quartet. When you have metabolic syndrome, eating less salt won't do anything to solve the real problem.

• 2 weeks – insulin resistance (hyperinsulinemia)
• 2 months – elevated triglycerides (hyperlipidemia)
• 6 months – obesity (high bodyfat)
• 12 months – high blood pressure (hypertension)

People with high blood pressure don't need to eat less salt. They need to stop drinking liquid fructose and start driving-past instead of driving-thru.

More importantly, trying to abide by the FDA and AHA's recommendations to keep salt intake below 2400 mg per day (1tsp) increases cardiovascular disease risk and mortality from a heart attack or stroke. Ironically, this appears to be the result of elevated triglycerides and reductions in insulin sensitivity – the same thing driving the high blood pressure in the first place.

"The inverse association of sodium to CVD mortality seen here raises questions regarding the likelihood of a survival advantage accompanying a lower sodium diet." (Cohen HW, et al. AJM, 2006)

Therefore, one could say that your low-salt food is a double-whammy since you're consuming the food that's elevating the cause of high blood pressure and opting for the "lowers blood pressure" variety that's making it worse.

5 – Gluten

The gliadin proteins in wheat can be damaging to many people because of those proteins' ability to induce inflammation and increase intestinal permeability. Wheat itself may also cause cravings and interfere with your appetite-regulating mechanisms.

However, this doesn't mean all products with a "gluten-free" stamp of approval are suddenly health foods. Pizza is still pizza, pancakes are still pancakes, and a slab of pound cake beside your coffee is and always will be a bad choice... gluten-free or not. This should be common sense, but millions are willingly fooled every day because it's pretty easy to convince us that a delicious junk food is fine when it has an official-looking health claim on the box.

Just like we were tricked into selecting low-fat and low-sodium packaged products because of their apparent health benefit, food marketers have simply found another way to convince you that their bag or box of garbage is healthy.

Gluten-free cereal may be better than gluten-filled cereal, but it's still cereal. And you'd be better off leaving both for the birds.

References

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10. Fuch CS, et al. 1999. Dietary fiber and the risk of colorectal cancer and adenoma in women. N Engl J Med 340(3):169-76.
11. Park Y, et al. 2005. Dietary Fiber Intake and Risk of Colorectal Cancer: A Pooled Analysis of Prospective Cohort Studies. JAMA 294(22):2849-2857.
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14. Stehbens WE. 2001. Coronary heart disease, hypercholesterolemia, and atherosclerosis. I. False premises. Exp Mol Pathol 70(2):103-19.
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16. Krumholz HM, et al. 1994. Lack of Association Between Cholesterol and Coronary Heart Disease Mortality and Morbidity and All-Cause Mortality in Persons Older Than 70 Years. JAMA 272(17):1335-1340.
17. Braunwald E. 1997. Cardiovascular Medicine at the Turn of the Millennium: Triumphs, Concerns, and Opportunities. N Engl J Med 337:1360-1369.
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19. Superko HR, et al. 2002. Small LDL and its clinical importance as a new CAD risk factor: a female case study. Prog Cardiovasc Nurs 17(4):167-73.
20. Kendrick M. 2007. The Great Cholesterol Con: The Truth About What Really Causes Heart Disease and How to Avoid It. John Blake.
21. Corona G, et al. 2010. The effect of statin therapy on testosterone levels in subjects consulting for erectile dysfunction. J Sex Med 7(4 Pt 1):1547-56.
22. West R, et al. 2008. Better memory functioning associated with higher total and low-density lipoprotein cholesterol levels in very elderly subjects without the apolipoprotein e4 allele. Am J Geriatr Psychiatry 16(9):781-5.
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26. Perez-Rodriguez MM, et al. 2008. Low serum cholesterol may be associated with suicide attempt history. J Clin Psychiatry 69(12):1920-7.
27. Seneff S. 2009. APOE-4: The Clue to Why Low Fat Diet and Statins may Cause Alzheimer's
28. Morgan RE, et al. 1993. Plasma cholesterol and depressive symptoms in older men. Lancet 341(8837):75-9.
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Grains - The Real Cereal Killer

Watch now/download: https://www.yekra.com/cereal-killers Distribute this film to your audience: http://bit.ly/1kZ1kL2 Synopsis The film follows Donal -- a lean, fit, seemingly healthy 41 year old man -- on a quest to hack his genes and drop dead healthy by avoiding the heart disease and diabetes that has afflicted his family.

By Dr. Mercola

The persistent myth that dietary fat causes obesity and promotes heart disease has undoubtedly ruined the health of millions of people. It's difficult to know just how many people have succumbed to chronic poor health from following conventional low-fat, high-carb recommendations, but I'm sure the number is significant.

In the featured documentary, Cereal Killers, 41-year-old Donald O'Neill turns the American food pyramid upside-down—eliminating sugars and grains, and dramatically boosting his fat intake. In so doing, he improves his health to the point of reducing his hereditary risk factors for heart disease to nil.

Watching people's reactions to his diet brings home just how brainwashed we've all become when it comes to dietary fat. Most fear it. Yet they will consume sugar in amounts that virtually guarantee they'll suffer all the devastating health consequences they're trying to prevent by avoiding fat, and then some!

Fat versus Carbs—What Really Makes You Pack on the Pounds?

The fact is, you've been thoroughly misled when it comes to conventional dietary advice. Most dietary guidelines have been massively distorted, manipulated, and influenced by the very industries responsible for the obesity epidemic in the first place—the sugar and processed food industries.

Shunning the evidence, many doctors, nutritionists, and government health officials will still tell you to keep your saturated fat below 10 percent, while keeping the bulk of your diet, about 60 percent, as carbs.1 This is madness, as it's the converse of a diet that will lead to optimal health.

A recent Time Magazine2 article highlighted a report by the Environmental Working Group (EWG), which showed that many breakfast cereals contain more than 50 percent sugar by weight! Cereals marketed specifically to children are among the worst offenders. Kellogg's Honey Smacks and Mom's Best Cereals Honey-Ful Wheat topped the list with 56 percent sugar by weight. If you're looking for alternatives for your family you could try Snackimals from Barbara's. Snackimals is not on the EWG's list because it is a newer product. All of their flavors have only 7 grams of sugar per serving.

Even diabetes organizations promote carbohydrates as a major component of a healthy diet—even though grains break down to sugar in your body, and sugar promotes insulin resistance, which is the root cause of type 2 diabetes in the first place.

As noted in the film: "If we could get all diabetics to eat a high-fat, high-protein, low-carbohydrate diet, we would cut the insulin requirement so dramatically that it's been estimated that six pharmaceutical companies would go out of business tomorrow."Contrary to popular belief, you do not get fat from eating fat. You get fat from eating too much sugar and grains.

Refined carbohydrates promote chronic inflammation in your body, elevate low-density LDL cholesterol, and ultimately lead to insulin and leptin resistance. Insulin and leptin resistance, in turn, is at the heart of obesity and most chronic disease, including diabetes, heart disease, cancer, and Alzheimer's—all the top killers in the US. 

Don't Fear the Fat

In the film, O'Neill switches over to a diet where 70 percent of his calories come from healthy fat—most of it in the form of macadamia nuts (my personal favorite)—and the remaining 30 percent of his caloric intake is divvied up between protein and fibrous fruits and vegetables. Over the course of 28 days, O'Neill:

• Loses weight and body fat
• Increases his lean muscle mass
• Feels more energetic and improves his athletic performance
• Increases his resting metabolic rate
• Improves his blood pressure, cholesterol, and other measurements to the point that he no longer has any risk factors for heart disease, which he's genetically predisposed for

Of particular importance here is that O'Neill's total cholesterol and LDL levels wentup, which initially caused significant concern. However, once they tested the LDL particle numbers, the results showed that his LDL particles were the largest species known, and he had virtually no small LDL particles at all.

This is phenomenal, as it's the small, dense LDL particles that cause inflammation. Large particles do not. Also, the markers for inflammation were virtually nonexistent, showing that he has no inflammation in his body at all. All in all, his one-month long high-fat, no-carb diet experiment proved that:

• Eating fat helps you lose fat
• Eating saturated fat decreases your risk factors for heart disease
• Regardless of your genetic predisposition your diet is, ultimately, the determining factor

I would also add that his results show the benefits of a high-fat, low-carb diet for athletes, many of whom are still convinced that this type of diet will make them heavy and sluggish. On the contrary, O'Neill breaks his own athletic record during his experiment, and refers to his renewed sense of vigor as feeling like a "spring lamb."

This high and sustained energy is a hallmark of ketogenesis, where your body is burning fat rather than sugar as its primary fuel. When your body burns fat, you don't experience the energy crashes associated with carbs.

Saturated Fat and Cholesterol Are Both Necessary for Optimal Health

Contrary to popular belief, saturated fats from animal and vegetable sources provide a number of important health benefits, and your body requires them for the proper function of your:

Cholesterol—another wrongly vilified dietary component—also carries out essential functions within your cell membranes, and is critical for proper brain function and production of steroid hormones, including your sex hormones. Vitamin D is also synthesized from a close relative of cholesterol: 7-dehydrocholesterol. 

Your body is composed of trillions of cells that need to interact with one another. Cholesterol is one of the molecules that allow for these interactions to take place. For example, cholesterol is the precursor to bile acids, so without sufficient amounts of cholesterol, your digestive system can be adversely affected. It's also critical for synapse formation in your brain, i.e. the connections between your neurons, which allow you to think, learn new things, and form memories. In fact, there's reason to believe that low-fat diets and/or cholesterol-lowering drugs may cause or contribute to Alzheimer's disease.3

Replacing Refined Carbs with Healthy Fat—The Answer to Most of Your Health Concerns

Underlying most chronic diseases, including obesity, type 2 diabetes, heart disease, and cancer are inflammation and insulin/leptin resistance. When you eat carbohydrates, your blood sugar, insulin, and leptin will all temporarily rise, and these spikes are very pro-inflammatory. Where you have inflammation, disease and dysfunction follows. An excellent editorial in the journal Open Heart4 reviews the cardiometabolic consequences of replacing saturated fats with carbohydrates, which includes the following:

The answer, then, lies in avoiding these inflammatory spikes in blood sugar, insulin and leptin, and reversing insulin and leptin resistance. To do this, you need to:

• Avoid refined sugar, processed fructose, and grains. This means avoiding processed foods, as they are chockfull of these ingredients, along with other chemicals that can wreak metabolic havoc
• Eat a healthful diet of whole foods, ideally organic, and replace the grain carbs you cut out with:
• Moderate amounts of high-quality protein from organic, grass-fed or pastured animals (this is to ensure you're not getting the antibiotics, genetically engineered organisms, and altered nutritional fat profile associated with factory farmed animals)
• High amounts of high-quality healthful fat as you want (saturated and monounsaturated). Many health experts now believe that if you are insulin or leptin resistant, as 85 percent of the US population is, you likely need anywhere from 50 to 85 percent of your daily calories in the form of healthful fats for optimal health. Good sources include coconut and coconut oil, avocados, butter, nuts (particularly macadamia), and animal fats. Avoid all trans fats and processed vegetable oils (such as canola and soy oil). Also take a high-quality source of animal-based omega-3 fat, such as krill oil.
• As many vegetables as you can muster. Juicing your vegetables is a good way to boost your vegetable intake

Another "add-on" suggestion is to start intermittent fasting, which will radically improve your ability to burn fat as your primary fuel. This too will help restore optimal insulin and leptin signaling.

What's the Deal with Protein?

Dr. Rosedale, who was one of my primary mentors on the importance of insulin and leptin, was one of the first professionals to advocate both a low-carb and moderate protein (and therefore high-fat) diet. This was contrary to most low-carb advocates who were, and still are, very accepting of using protein as a replacement for the carbs.

The problem is that, along with grains, most Americans tend to eat far too much protein. While your body certainly has a protein requirement, there's evidence suggesting that eating more protein than your body needs could end up fueling cancer growth.

Dr. Rosedale advises limiting your protein to one gram of protein per kilogram of lean body mass (or 0.5 grams per pound of lean body weight). For most people, this means cutting protein down to about 35-75 grams per day. Pregnant women and those working out extensively need about 25 percent more. I believe this theory is worthy of consideration. The key though is to add healthy fat to replace the carb and protein calories you're cutting out of your diet. Again, sources of healthy fat include:

Your Health Is Within Your Control

Groundbreaking research by the likes of Dr. Robert Lustig and Dr. Richard Johnson (author of the books, The Sugar Fix and The Fat Switch) clearly identifies the root cause of obesity, diabetes, heart disease, and numerous other chronic diseases, and it's notfat. It's refined sugar—particularly fructose—consumed in excessive amounts. Their research, and that of others, provides us with a clear solution to our current predicament. In short, if you want to normalize your weight and protect your health, you need to address your insulin and leptin resistance, which is the result of eating a diet too high in sugars and grains.

For a comprehensive guide, see my free optimized nutrition plan. Generally speaking though, you'll want to focus your diet on whole, ideally organic, unprocessed or minimally processed foods. For the best nutrition and health benefits, you'll also want to eat a good portion of your food raw.

Sugar is highly addictive, and if you're like most people, you're no stranger to carb cravings. Just know that once your body gets used to burning fat instead of sugar as its primary fuel, those cravings will vanish. Many cereals and other grain products would not be quite as harmful if they didn't also contain so much added sugar. Even many organic brands contain excessive amounts. This is unfortunate, since many (Americans in particular) are really indoctrinated to eat cereal for breakfast. I've been working on a low-sugar cereal line for some time now, to provide a healthier alternative for those who really don't want to give up their breakfast cereal. I hope to have it ready sometime this summer.

Last but not least, for those of you still concerned about your cholesterol levels, know that 75 percent of your cholesterol is produced by your liver, which is influenced by your insulin levels. Therefore, if you optimize your insulin level, you will automatically optimize your cholesterol, thereby reducing your risk of both diabetes and heart disease.

Also, remember that even if a high-fat, low-carb diet was to raise your total cholesterol and LDL, it doesn't automatically mean that your diet is increasing your risk factors for heart disease. As O'Neill did in this film, you need to test your LDL particle number. Large-sized particles are good, while the smaller, denser particles can penetrate the lining of your arteries and stimulate the plaque formation associated with heart disease. The former does NOT increase your heart disease risk, while the latter one will. To learn more about LDL particle numbers and how to test them, please see my previous interview with Chris Kresser, L.Ac., which goes into this in some detail.

• 1 US Department of Agriculture, Dietary Guidelines for Americans 2010 (PDF)
• 2 Time May 15, 2014
• 3 Stephanie Seneff, APOE-4: The Clue to Why Low Fat Diet and Statins may Cause Alzheimer's
• 4 Open Heart March 5, 2014

Chocolate Milk For Post-Workout: A Look at the Research

Over recent years, there has been a massive initiative to promote chocolate milk as “the best” drink for post-training recovery. Milk advertisers use very high level athletes as spokespersons to sell a product to people who are indeed active, but often very far from the training level of an Olympic athlete.

Nautilus Plus is participating to this initiative: “Whether you are a professional athlete or a weekend sports enthusiast, recover from your next training faster with the Ultimate Chocolate Milk®.”(1) Do we really need to fill ourselves with all this added sugar after our training?

One litre of chocolate milk contains up to 100 to 110 g of sugar!!! The quantity of sugar that the body can absorb is limited. In fact, the sugar will be stored in the liver and muscles in the form of glycogen, which only represents 5 % of the body’s total energy reserves (2). If your objective is, as for the majority of people, to lose fat, you need to remember this: to allow yourself to consume a supplement rich in carbohydrates after your training, you will have to have emptied or seriously depleted your glycogen stores in order for the extra sugar absorbed to be used to renew your glycogen stores. And if you absorb more sugar than you need to renew your reserves, it will be transformed into fat (3).

Scientific studies

Many scientific studies have been done on sports nutrition supplements and some included chocolate milk. The purpose of these studies was to determine which mixture of molecules, and in what proportion, best promotes post-training recovery as well as athletic performance. Almost all these studies followed this particular protocol:

1.  Study participants were subjected to intense exercise at 70 to 85% of their VO2 max during 1 to 3 hours. The purpose of this step was to considerably reduce the muscle and hepatic glycogen stores since 70 to 80% of the energy spent at 85% VO2 max is derived from glycogen. Under 65% of VO2 max, mostly fatty acids are used (4, 5).
2. A recovery period between 4 and 8 hours followed to allow the participants to replenish their glycogen stores with the various sports nutrition supplements covered in the study.
3. Participants were then subjected to a second high intensity exercise (VO2 max between 70 and 85%) until exhaustion (loss of 85 to 95% of their hepatic glycogen and 65 to 85 % of their muscle glycogen) (6). The difference in time or distance between the performances will determine which sports nutrition supplements helped the athlete the most to recuperate between the two sessions.
   .

The role of these sports nutrition supplements is therefore to replenish as quickly and efficiently as possible the glycogen stores which were SIGNIFICANTLY depleted during the first training, in order to allow a second intense performance within 4 to 8 hours.

This situation is certainly frequent among Olympic athletes or athletes from the Tour de France who train several times per day or several days in a row at extreme intensities, but what about other people? Is chocolate milk a good supplement for “weekend athletes” or people who train leisurely, three of four times per week?

After your leisure strength training?

For a person who does resistance strength training, the glycogen stores will fall by 25 to 40 % after an intense strength training (7 to 12), which is relatively little. The glycogen stores lost during the training will be rebuilt through normal nutrition, WITHOUT ANY SUPPLEMENTS, within 24 hours of the training. However, some people consider it very important to MAXIMIZE the production of lean muscle mass. So the rapid intake of PROTEIN supplements after the training (within 1 hour if possible, up to 3 hours later) is important since it promotes maximum muscle synthesis(13 to 33). Recently, a research team questioned this principle claiming that it would be the total quantity of proteins ingested each day that would prevail over the moment at which they are ingested (34, 35). The same team also mentioned that if a “window” for taking a protein supplement and maximizing the production of lean muscle mass does exist, it would rather span over a 4 to 6 hour period following the strength training.

According to various recent studies, 20 to 25g of proteins would be the recommended amount to take after a resistance training (25, 33, 36). Witard et al., 2014 consider that 20 g of whey protein containing approximately 2 g of leucine optimally stimulates muscle synthesis (33). A litre of chocolate milk contains approximately 30g of proteins, including 80% of micellar casein and 20% of whey (37). Studies on post-training muscle synthesis clearly show the very poor efficiency of micellar casein for this purpose (26, 28, 38, 39, 40) because it precipitates in the stomach and the absorption of amino acids responsible for muscle synthesis is therefore very slow (26, 41, 42, 43). One argument that is often used by chocolate milk advocates is that milk (skim) is more efficient than soy protein or casein to promote muscle synthesis (23, 24). That’s true! It is actually the 20% of whey proteins contained in the milk that makes it efficient for muscle regeneration (26, 28, 40). What they don’t say is that purified whey protein (concentrate or isolate) is the best all around for lean muscle mass gain (26, 28, 40, 44, 45, 37) and, consequently, is better than milk. Whey protein is very rich in BCAA and is quickly absorbed by the intestine, as opposed to casein which is absorbed slowly. Therefore, why take a milk supplement if a whey protein shake is more efficient? Not only does chocolate milk contain large quantities of casein, but it can also contain saturated fat (if it’s full fat) as well as a large quantity of added simple sugars, on top of the lactose. So, is it useful to add all this sugar to the proteins (which are already not optimal) to maximize muscle synthesis after my resistance training?

Some studies show that carbohydrates (CHO) could inhibit muscle breakdown caused by training (10, 46, 47, 48, 49). A few groups claim that a carbohydrate/protein (CHO:PRO) supplement would facilitate a better muscle synthesis since it would inhibit muscle breakdown (15, 32, 46, 48, 50, 51). Nevertheless, some of these studies did not include a control group for the proteins (PRO) only. So it is difficult to evaluate whether adding CHO to PRO provides an advantage or not over PRO taken separately. As for the few studies that included a control group for the PRO, the quantity used was sub-optimal and was given in the form of amino acids (46, 48, 50). However, when a control group taking PRO optimally is included in the study, adding CHO to PRO did not show any advantage in terms of lean muscle mass gain (49, 52 to 57). CHO: PRO ratios used in the studies on resistance training varied between 1:1 and 3:1 whereas chocolate milk offers a ratio between 3:1 and 4:1. That is a lot of unnecessary sugar!

In turn, adding CHO to protein supplements can be necessary when several INTENSIVE resistance trainings are planned during the same day. In such a case, the athlete must quickly renew its glycogen stores (58, 59). To this end, 1g/kg of weight of CHO should be added to the proteins and consumed immediately after the training; moreover, a meal should follow 2 hours after the training (59, 60). So you must weigh at least 220 lbs and must train intensely more than once a day to allow yourself a litre of chocolate milk. Even then, you won’t achieve optimal results because of the casein, which constitutes 80% of the total proteins, and because of the 2:1:0.46 (glucose:fructose:galactose) ratio of the various sugars present in the chocolate milk (61).

The fructose contained in chocolate milk comes from high fructose corn syrup (which has a very bad reputation) and from sucrose (1 glucose +1 fructose). In 2004, Bray GA et al. suggested that the obesity epidemic in the United-States was related to the HFCS found everywhere and in large quantities in our nutrition (62). However, the new report published by The International Journal of Obesity, 2015 (63) suggests that this epidemic cannot be linked to HFCS due to the lack of evidence demonstrating that HFCS would be worse than table sugar (sucrose) (63, 64, 65). Yet, chocolate milk contains both of these additives. The fructose contained in almost equal quantities in both these additives could be linked to obesity (66, 67). Some scientists are reluctant to establish such a link (63, 64). A small quantity of fructose consumed every day, such as normal consumption of fruits, is harmless. Unfortunately, fructose is now added in almost all processed food. So it’s easy to exceed the healthy daily quantities of “natural” fructose. The body metabolises fructose differently from glucose. The liver metabolises 70% of the blood fructose (compared to 15 to 30% for the glucose) (38) and will leave the remaining 30% to the other tissues, namely the kidneys, the testicles, the fatty tissues, the brain and the skeletal muscle (69). So the muscles will absorb a negligible amount of fructose (68). A large consumption of fructose can contribute to the development of the metabolic syndrome, consisting in weight gain, increased resistance to insulin, hypertension, and elevated triglyceride in the blood stream (67, 69). High quantities of fructose are also associated to increased cholesterol, LDL particles and visceral obesity (69).

After an intense cardiovascular training, such as a marathon, when the glycogen stores in the liver are low, the fructose present in a sports nutrition supplement will be used to replenish the hepatic stores. Furthermore, for marathon runners performing at high intensities for a long period of time, the intake of fructose in the form of supplements DURING performance at a ratio of 2:1 (glucose/maltodextrin:fructose), offers a definite advantage because it allows faster absorption of sugars through the intestines since different transporters are used for these two sugars. The supplement would also improve gastro-intestinal comfort and would increase these athletes’ performance (70 to 76). If, however, the quantity of fructose consumed is higher than what is needed to replenish the hepatic stores, the surplus could potentially be converted into fat (66). So for people who do resistance training, consuming fructose is of no value. Conclusion? If you need CHO to perform well during your second strength training, you should add glucose/maltodextrin to your whey proteins, in order to avoid consuming fructose unnecessarily.

Finally, at the beginning of 2015, Stuart M. Phillips’ team established that drinking 500ml of chocolate milk every day (18g of proteins) as a supplement, while following a resistance program three times per week over a period of twelve weeks, has no effect on muscle hypertrophy or on strength gain compared to a control group taking no supplements (77).

What about after leisure endurance training?

Many active people do endurance training several times per week such as jogging, spinning, swimming, etc. for one hour. The extent of the muscle and hepatic glycogen loss will vary according to the effort expended. To consume glycogen as a primary source of energy, the level of effort intensity must reach 70% and must be maintained for an extended period of time (4, 5, 78). Laboratory experiments have shown that glycogen stores decline by 50 to 75% after 3 hours of cycling at 70% of VO2max (79, 80). By increasing the effort to 80% of VO2max, you can continue your activity for 2 hours before running out of glycogen. Another example is that the glycogen stores depletion of marathon runners occurs, for 40% of them, around the 34th kilometre, commonly called “the wall”, when they sustain an effort of approximately 80% of VO2max(81, 82, 83) during more than 2h30. Do you think you will be burning as much glycogen during your hour of spinning?

The glycogen stores lost during the training, even if this loss is significant, will be rebuilt through normal nutrition, WITHOUT ANY SUPPLEMENTS, within 24 hours of the training  (84,85). Moreover, the meal frequency will have no incidence if the post-exercise recovery happens over more than 24 hours (85, 86, 87). It is unnecessary for someone coming out of an hour of spinning or jogging to ingest all the added sugars contained in chocolate milk since the subsequent meals will contain sufficient carbohydrates (CHO) to replenish the poorly depleted glycogen stores. Therefore, the person will be ready for the next training a few days later.

Without being Olympic athletes, some people will train intensely and frequently during a week. In such case, the quantity of CHO these people consume every day must be adjusted, spread throughout their meals according to the frequency and intensity of their training. Burke et al. 2011 recommend to take a quantity of CHO every day, depending on the type of training performed (intensity and duration) to allow for a good glycogen resynthesis during the 24 hours following the training (88).

If the objectives of the person doing endurance training don’t include maximum muscular development, the muscle regeneration following an effort, namely the replenishment of glycogen stores, will occur normally with the proteins contained in the subsequent meal, when taken in sufficient quantity.

Supplements are necessary when training sessions are very intense and close together (a few hours) and require to quickly replenish the glycogen stores (in less than 24 hours).

What about high level athletes? (1.3% of the American population are athletes and of which 0.006% are professional athletes) (89).

Although chocolate milk is not intended for Olympic athletes, choosing such athletes as spokesperson to promote chocolate milk as a post-training supplement is almost an obligation; indeed, practically only these athletes could ultimately use chocolate milk as a sports nutrition supplement. Moreover, most studies carried out on the subject are done in a top level training context. But is chocolate milk, as alleged by the television commercials, a good choice for this 1% of the population ?

The purpose of a supplement is to promote fast recovery between two trainings done very close together, mainly by QUICKLY regenerating the glycogen stores. So the muscle glycogen resynthesis speed is important. It was established that this synthesis is faster when CHO are taken right after the training (90, 91, 92) and can be maintained during 6 hours with frequent intake of this supplement (69, 90, 93). Delaying the intake of CHO by 2 hours decreases the resynthesis speed by 50% (16,90). This is particularly important for a fast recovery but is unnecessary for recovery over 24 hours or more (87). OPTIMALLY, the quantity of CHO should be 1.0 to 1.2g/kg of weight/h (94, 95, 96), consumed at 15 to 30 min intervals (97). At this volume and frequency, CHO alone are sufficient to ensure an optimal glycogen synthesis. Sure! But chocolate milk doesn’t only contain CHO!

Is it useful to add proteins to CHO? (98)

To determine which supplement is the best one, we need to compare the different supplements. It is difficult to compare the studies that analyze the effect of adding proteins to a CHO supplement because several variables differ: 1) intensity (% of VO2max) and duration of the first exercise that aims at reducing the glycogen stores 2) choice of exercise (jogging or cycling) 3) various types of supplements consumed (isocaloric or not, as well as the chosen sugars and proteins) 4) control groups used (lack of placebo or other control groups) 5) carbohydrates:protein ratios (CHO:PRO) will vary between 2:1 (Berardi et al. 2006/2008) (99, 100) and 6.2:1 (Betts et al. 2005) (101) 6) duration and intensity of the second performance (% of VO2max).

Nonetheless, it’s possible to draw certain conclusions.

1: Importantly, the drinks studied must be isocaloric (must contain the same amount of calories) :

Some studies show a performance improvement post-recovery when proteins (PRO) are added to CHO versus a control group taking only CHO (102 to 105). However, the quantity of calories between the two drinks was not adjusted, so it wasn’t possible to determine if the performance improvement could be attributed to the addition of proteins or to the aaddition of energy.

2: It is important to compare the CHO+PRO supplement to a control group taking CHO optimally (1.0 to 1.2g/kg of weight/h) AND which is isocaloric:

Some studies show that the addition of proteins to the CHO supplement improves the second performance when compared to a control group taking a CHO only supplement. But this supplement was given sub-optimally during recovery (96, 102, 104, 106, 107). When the control group took the CHO supplement OPTIMALLY, the studies did not show any improvement in the second performance when proteins were added to the mix, even with variable ratios. (95, 96, 101 to 115, 116). A study showed, however, an advantage (100) (see the “Ratio” section).

So the athlete can chose between taking a mix of CHO + PRO, when it is impossible to optimally take a CHO supplement during recovery (1.2g/kg/h every 30 min during 3 to 4 hours) (94, 95, 96, 117). This indeed makes for a lot of CHO to ingest. But at which ratio must the athlete take its proteins?

3: Ratio

Advocates of chocolate milk allege that a ratio of 4:1 is best to support athletic recovery. This belief comes from one of the early studies done on the subject and which showed that a sports nutrition supplement, Endurox R4, containing 4:1 CHO: PRO offered a performance advantage when compared to a control group taking CHO, namely Gatorade (102). However, Endurox R4 contained two and a half times more CHO than Gatorade, in addition to the whey proteins, which gave it almost four times more calories than the Gatorade supplement consumed SUB-OPTIMALLY by the participants. It is obvious that in these conditions, Endurox R4 improved performance compared to Gatorade given the significant difference in CHO and energy consumed between the two drinks. Since the ratio used in this study was 4:1, which is the same as the chocolate milk ratio, the dairy industry took the opportunity to pretend it was the best ratio. Nonetheless, research continued and more recent studies show that ratios containing less sugar are as efficient, if not more, than a 4:1 ratio. Berardi et al. 2008 show an advantage on the second performance with the CHO: PRO mix at a ratio of 2:1 (CHO: 0.8kg/kg/hand PRO: 0.4kg/kg/h), over the control group taking the CHO supplement optimally (100, 117). So why add more sugar than necessary with a ratio of 4:1 if it offers no advantage?

Studies done on chocolate milk (McLellan TM et al. 2014 (98)) :

There are 5 major studies comparing chocolate milk to a few other sports drinks during a short term recovery between two performances. (118, 119, 120, 121, 122)

• None of these 5 studies explained how the chocolate milk taste was reproduced for the control groups. If the athletes know which type of supplement they are given, it can certainly influence the results; in such a case, the study is no longer “blind”.
• Some studies did not include a placebo or a sub-optimal CHO supplement for the control group (118, 122).
• 4 studies on 5 did not administer the supplement optimally (118, 119, 120, 121). The fifth study did so for the first recovery hour only (122).
• Pritchett et al. 2009 show that chocolate milk (3.8:1) offers no advantage for the second performance over Endurox R4 (3.8:1, isocaloric and same quantity of CHO) (118).
• The other four studies indicated that chocolate milk presented an advantage for the second performance compared to the other drinks studied (119, 120, 121, 122). On the other hand, the studies also present other shortfalls:

For Karp et al. 2006 and Thomas et al. 2009, the glycogen stores reduction protocol was not standardized during the first training(119, 120). That means that the energy expenditure varies a lot from one person to another, even for each individual, from one training session to another. So some groups used more glycogen than others before starting the recovery phase. For Karp et al. 2006 for example, (similar to Thomas et al. 2009), the chocolate milk group (60.8 min) had trained 16% less than the CHO + PRO control group taking Endurox R4 (72.6 min), but equally to the Gatorade group (sub-optimal). These differences can explain the superior performance of the chocolate milk group during the second training. Furthermore, we must report that the study by Karp et al. 2006 was partly financed by the Dairy and Nutrition Council Inc (119).

In the study by Lunn et al. 2012, chocolate milk is compared to a control group taking CHO optimally during the first hour of recovery (122). Despite the fact that the regeneration of the glycogen stores was equal between the two groups, the performance of the chocolate milk group was superior to that of the CHO control group during the second performance (difference of a few seconds). However, the intensity of the second performance was at 100% VO2max and lasted a very short time (203 vs 250 sec). In these very high intensity and very short duration conditions, the more or less important level of muscle glycogen stores before the effort don’t seem to influence performance (123, 124, 125, 126), as opposed to a lower intensity and longer duration performance. So optimally replenishing the glycogen stores is probably not that important in this case. Even the authors admit that the type of test used and the inability to mask the taste of the chocolate milk may have influenced the results. The authors challenge this by emphasizing that the purpose of their study was to show that chocolate milk promotes a better muscle synthesis compared to CHO alone (122). Milk contains proteins whereas the CHO of the control group contained none. So it is not surprising that the results show that chocolate milk increases muscle synthesis. A control group also taking proteins would have certainly given results similar to the chocolate milk, and possibly even better results if whey protein would have been used.

 The study by Furguson-Stegall et al. 2011 compared a chocolate milk ratio smaller than 3:1 to an isocaloric CHO drink and to a placebo (water) (121). The drinks were given sub-optimally. The performance of the chocolate milk group was superior by a few minutes during the second training (40km of cycling) compared to the CHO control group. Nonetheless, the glycogen resynthesis was better with the CHO control group, a result that is slightly contradictory. This study was financed by a Chair established by The National Dairy Council, as well as The National Fluid Milk Processor Promotion Board.

Therefore, the contradictory results, the lack of control groups, the questionable protocols and the inability to obtain blinded studies, do not allow to claim without any doubt that chocolate milk is the best supplement compared to the other supplements studied. The number of serious studies on chocolate milk will have to be considerably larger. Furthermore, these studies will have to be done more independently (not financed by the dairy industry, for example) to achieve more conclusive results.

It should be noted that chocolate milk has not been compared to a supplement offering a ratio of 2:1 previously shown to offer better performances than a CHO supplement taken optimally by Berardi et al. 2008 (100). For comparison purposes, a 200lbs (90kg) man who ingests a supplement offering a ratio of 2:1 will consume 72g of CHO/h instead of 85g/h for a chocolate milk supplement taken optimally. So this represents approximately 40g less of added sugar consumed, during a 3 hour recovery, to achieve the same result, if not better.

The composition of the supplement used by Berardi et al. 2008 is also very different from that of chocolate milk; it contained 33% of maltodextrin, 33% of glucose and 33% of whey (100). So in addition to the ratio, the choice of nutrients is important.

4: CHO

Maltodextrin (MD) seems to be the ideal sugar for muscle glycogen resynthesis after an intense effort. Piehl-Aulin et al. 2000 have shown that a supplement containing very high molecular weight polyglucosides such as maltodextrin would be 25% more efficient for muscle glycogen synthesis than a low molecular weight glucose, maltose or oligomer supplement (127). This would be due to the faster absorption rate of sugars by the intestines, as well as an increased rate of gastric emptying. As seen previously, while the addition of fructose to MD (ratio 2:1, MD: FRU) represents a major advantage DURING a long performance (more than 2h30) such as a marathon(128), it seems that for the rapid muscle glycogen resynthesis between two performances, the addition of fructose or galactose to MD offers no advantage (129). Regarding sucrose (glucose: fructose), no advantage was observed concerning glycogen resynthesis when compared to glucose alone (69, 129, 130, 131, 132), nor during the second performance (129 to 131). Again, we notice that the fructose and galactose portion found in chocolate milk is not useful for the post-training recovery.

5: Proteins

As for strength training, the type of proteins added to the CHO as a post-training supplement is important. However, few studies compare the different types of proteins and their effects on the glycogen resynthesis speed during a short term recovery. Morifuji et al. 2010 have shown, in rats, that adding whey hydrolysate to CHO is more efficient for glycogen synthesis than the CHO control group, followed by non-hydrolysed whey and BCAA. Casein ranked dead last, having no significant effect on glycogen synthesis compared to the intake of glucose alone (133). A large proportion of studies on athletic recovery used hydrolysed or non-hydrolysed whey protein isolate as a source of proteins in their mixes. The advantage over the chocolate milk proteins (mainly consisting of casein) is that in addition to being absorbed faster, the whey protein allows a higher protein concentration mix while restricting the volume to be consumed. It is a non-negligible advantage for the athletes as well as for achieving ratios of 2:1, for example.

Lactose

Milk contains 25g of lactose per 500ml. The capacity to break down lactose into glucose and galactose molecules depends on the presence of the lactase enzyme in the small intestine. “Normally” in humans, the presence or activity of lactase is very strong at the beginning of childhood and starts declining after the child is weaned until it almost disappears in adulthood. The person is then unable to digest lactose for the rest of his or her life (134, 135, 136). Between 65 and 70% of the world population is unable to digest lactose once they reach adulthood (137, 138). So only 30 to 35% of the population can actually digest lactose. Why? During the human evolution, four different mutations occurred, namely a major one that occurred in Europe, which kept the lactase gene active and thus allowing some Caucasians to digest lactose during all their life(137 to 139). These European Caucasians travelled, reached America and gave their descendants the possibility to also carry this mutation. Despite this, approximately 21% of North Americans who have problems digesting lactose are Caucasians (140). The ability to digest lactose is directly linked to the quantity of lactase produced by the intestine (134 to 136) and this quantity varies from one person to another. So some people have more difficulty than others to digest this sugar even though it may not be a true intolerance, rather an incomplete digestion that can sometimes be asymptomatic (140 to 143).

Making up 50% of the sugar contained in chocolate milk, we must seriously question the lactose digestion capacity to quickly regenerate the glycogen stores post-training, if we take into account the differences in the quantities of lactase present in the intestines of each individuals. It was shown that adding sugar (144, 145, 146, 147), fat (147) or chocolate (144, 145) in milk slows down the digestion process. This slowing down certainly promotes a better digestion of the lactose by the lactase present in various amounts, but does make digestion more efficient ? Since it can be very difficult for some people, around the world, to digest lactose, chocolate milk could only be used by a very small portion of athletes, which already represent a tiny portion of the population.

Who promotes chocolate milk?

Besides dairy producers in Quebec and Canada, many nutritionists promote chocolate milk as an ideal post-training supplement. The most relevant comment made to this effect by a nutritionist is the comment from Isabelle Charêt, coach and triple medallist in speed skating at the 1994, 1998 and 2002 winter Olympics (148). She says that chocolate milk would be a lot more useful to people who train intensively: “Someone who goes to the gym three times a week has plenty of time to recover. But I still recommend to drink chocolate milk because people in general don’t drink enough milk.” Ah! But that’s the issue! We have to drink milk!

I will not go into further detail on this subject, but very recently (2013), a team from Harvard University acknowledged publicly the need to decrease to less than two portions per day, or to stop all together, our milk consumption (149, 150). The powerful dairy industry lobby, which represents a third of Quebec’s agriculture and 5 billion dollars of Canadian GDP, imposed itself to maintain the dominant position dairy products hold in the Canadian food guide (151). Nonetheless, the following question remains: is it necessary to include chocolate milk in our diet? Many scientists seem to think that it’s not (149, 150, 151, 152).

Conscious of the extent of the damages caused by the overconsumption of added sugars to human health, how can we encourage the consumption of such sugars just to impose a supplement that is increasingly considered as unnecessary to our health?

Conclusion? If you enjoy a glass of chocolate milk once in a while, as a treat, it’s no big deal! But if milk commercials encourage you to drink one after each of your trainings, and you are not an Olympic athlete (and even then…), I hope you’ll think twice about it.

You know the saying: When it seems too good to be true…

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