Natural Ketosis Blog Archive

November' 2014

Don’t Sweat the Small Stuff

Guest blogger Richard Chessor, the lead nutritionist for Scottish Rugby, discusses the importance of not getting caught up in the minor nutritional details, but rather to focus on your goal and the process required to get you there.

 

Focus on the process, not the details.

 

As a nutritionist I am regularly faced by a lot of technical questions: “What’s the optimal nutrient composition of a meal after this type of training session?“ or “How many milligrams of this vitamin do I need each day?”

I like technical questions and enjoy answering them but when the details dominate the process it’s time to take a step back and readdress.

When it comes to diet and nutrition I see lots of people trying very hard to focus on the details but often at the expense of the process.  The details do matter, but they only matter in context.  Without taking a wider view and understanding the context there is no chance of getting the details right.

For example, a pre-bed snack is commonplace with athletes to help support overnight recovery and fuel the next morning’s early training session.  On the simplest level the snack should provide some carbohydrate to support liver glycogen replenishment and protein to provide amino acids for muscle repair and growth.  However, many people get caught up in trying to achieve the perfect balance of nutrients, the optimal timing and avoiding foods that may seem counterproductive at this time.

With all this focus on the details and not the context the value of the process can be lost.  The pre-bed snack doesn’t just provide nutrients; it can be the first step in preparing for a restful sleep, it maintains the regular meal structure of the day and it can balance the content of the evening meal by acting as a delayed dessert option.

When viewed in this sense the pre-bed snack is just as valuable a process as it is an opportunity to provide functional nutrients.  By taking a step back to assess the context of the snack there is a greater understanding of the process and (if the process is valuable and robust) the subsequent details don’t matter nearly as much.

Another example is the post-training recovery snack:

Content and timing have long been contentious points with the post-training recovery snack.  How much protein?  How much carbohydrate?  What BCAA ratio?  How soon after training?  How quickly will it be absorbed?….

 

Lots of details that are rarely (if ever) confirmed by research but are perpetuated by a fitness and supplement industry that markets and promotes new products with “faster absorption rates” or containing “essential muscle building formula”.  It’s no surprise that there’s a pressure to conform to the messages.

Focusing on the details of the post-training snack is all fine and well but the remainder of the diet rarely meets this level of attention.  For example, a perfectly composed post-training shake providing the optimal balance of nutrients to complement the session and training goals pales into insignificance if the proceeding meal is a junk food meal from the gym café or local fast-food joint.  In this case, the post-training snack is a valuable process (and would be considered best practice) but the time spent deliberating on its details would be far better invested in addressing the wider diet.

Away from sport, the detail can also complicate eating in social situations.  Following a restrictive diet can be tricky when eating out or when complete control over food choices is not possible.  However, when the restrictions come at the cost of enjoying the environment and associated social wealth then the process has been devalued for the details.  For example, being unable to select the optimal meal that conforms to the diet’s restrictions should not elicit a stress that prevents the process being enjoyed.  Better to relax the dietary choices and achieve the primary outcome of the meal – social interaction with good company over good food.

If the nutrition were the priority you would have stayed at home.

So the next time you are stressing about diet details, challenge yourself to think about the context and ask if the details are worth the hassle.  If so, then go for it.  If not, then take a step back and readdress the basics.  Don’t ignore the details, but don’t let them overshadow the basics.

 

Richard Chessor

@RJC_Nutrition

Weight Loss Surgery and Diabetes Management

This week one of the main health stories has been surrounding the latest announcement that weight loss surgery will indeed reduce the risk of developing Type 2 diabetes. With World Diabetes day on the 14th of November, in this blog we look at the article at the heart of this story and what it means for overall health and sustainability.

 

 

What does the reports actually say?


With the media reporting that this piece of research should be used to bring about more widespread bariatric surgery in order to help tackle the current obesity and diabetes epidemic, a closer look at the article itself will show that even the authors themselves are cautious about their findings as they acknowledge the several limitations of this study.  


This paper looked at a large section of the population who had undergone bariatric surgery for obesity reasons, but had not been diagnosed as being diabetic before surgery. This population, was then “matched” with individuals who were also obese and had no history of diabetes.


These two groups of patients’ records were analysed over a 7 year period and incidence of diabetes was recorded i.e. how many individuals from each group developed diabetes over this period - this was the only aspect under investigation.


Analysis


Whilst this study has a lot of strong points, mainly that it looked at such a large population which was widespread throughout the UK. But also taking into account other health issues present within the two groups at the start of the 7 year period, mainly looking at depression diagnosis, smoking status, cholesterol markers, hypertension, as well as stroke and coronary heart disease, all of which were more prevalent in the group that underwent bariatric surgery.


It is important to note that the group which underwent surgery had a higher incidence of depression diagnosis, higher blood pressure, higher cholesterol all of which were not due to chance.


It would be interesting to see if the individuals who underwent bariatric surgery went on to lower their BMI and indeed improve their overall health on the same level as seen for diabetes.


Comments


A key issue that has been raised within the paper is the fact that the individuals who undergo bariatric surgery have greater medical follow up. Could this also mean that the lower incidence seen in this group is due to better education on how to maintain their weight? As the control group i.e. the individuals who did not undergo surgery were not given any differential treatment than currently seen as standard care.


Could it be that the answer to the obesity and diabetes epidemic is better follow up with individuals who start showing signs of ill-health? Could it be that if these same individuals were given the same after-care given to the surgery patients, they would have also seen an improvement in diabetes incidence?


The way we at Natural Ketosis see it is that this paper is saying that an improvement in current primary clinical care is required for prevention and treatment of diabetes and obesity rather than simply stating that surgery is the answer.


References:


Incidence of type 2 diabetes after bariatric surgery: population-based matched cohort study

Helen Booth MSc,Omar Khan FRCS,Prof Toby Prevost PhD,Marcus Reddy FRCS,Alex Dregan PhD,Judith Charlton MSc,Mark Ashworth DM,Caroline Rudisill PhD,Prof Peter Littlejohns MD,Dr Prof Martin C Gulliford FFPH

The Lancet Diabetes & Endocrinology - 3 November 2014

DOI: 10.1016/S2213-8587(14)70214-1