Nutrition – The Fitness Grub®

The Benefits of Water

April 1, 2016 emmamartinfitness

We’ve all read varying pieces of advice about needing to drink 2-3 litres a day of water but have you stopped to think about why? And is this pure water, liquids in general, does water from food count? So many of us don’t drink enough water, which is more detrimental to the body than we realise. The body is like a car: if you don’t give it petrol or motor oil or wiper fluid or air in the tyres, the car will break down and stop working. The body, just like a car, needs to be provided with nutrients and water in order for it to be able to survive and work properly. It is able to live longer without food than it is without water, as hydration allows the body to be able to function properly.

Between 45% and 60% of the body is made up of water around (45% for children, 55% for women and 60% for men) and all of our tissues, organs and fluids have water as a main constituent. It allows the body’s organs (such as the lining of mucus membranes, the digestive tract and the bronchial tubes) to be kept moist and hydrated enough to the allow them to function without putting added pressure on other organs. If we take the kidneys as an example, their primary task is to remove waste and excess water from the body in the form of urine, as well as maintain a balance of salts and other substances in the blood. If the kidneys are not functioning properly because they are not hydrated enough, they will transfer most of their functions to the liver, which in turn will not be able to perform one of its mains tasks which is to metabolise stored fat. If there is no fat metabolisation then it means that the person in question will start to gain weight.

Water also helps to lubricate joints and membranes; it transport nutrients throughout the body; it dissolves minerals and other substances for the body to absorb; and it holds substances in colloidal suspension; it stays as a liquid over various temperatures. Water also acts as an appetite suppressant, therefore the feeling of satiety is reached quicker. If there is a higher intake of water, the person will eat less and the body will metabolise fat more efficiently.

There are 3 hormones that regulate fluid loss (antidiuretic hormone and aldosterone which help with slowing down fluid loss in the urine; and atrial natriuretic peptide which increases urine flow rate). Fluid intake is made up of fluids that are ingested, food that is ingested and metabolic water (resulting from metabolic reactions in the body). Water loss is made up of excretion/evaporation from the GI tract, the lungs, through the skin and the kidneys. This typically accounts for 2500 ml in water gain/loss. Exercise/illness will cause an excess of fluid excretion, therefore, replacing the water lost is important. It is also important to understand that the fluids in the body (digestive juices, mucus, saliva, blood, lymph, sweat, urine) also have an impact on regulating fluid loss as they account for varying amounts of fluid in the body.

It is important to ensure that there is not an overload of fluids at any one time, therefore allowing the body to process the fluids. This can be achieved by regular intakes of fluid throughout the day (regularly spacing out the normally recommended 2 litres a day throughout the day) to ensure the right balance in the body. Over-hydration can also impact the body by creating hyponatremia (a reduction in the salt level in the blood) resulting in an electrolyte disturbance.

When the body doesn’t receive any nutrition it goes into starvation mode and holds on to the fat that is currently in the body to allow it to feed off it to ensure its survival. The same happens with water – if the body doesn’t receive any fluids it will start to hold on to the fluids it currently has (in the extracellular spaces in the body), known as fluid retention. Fluid retention generally results in swollen feet, ankles, legs and hands. Once the body starts to receive liquids it then starts to release the water that it has been holding on to for survival. Fluid retention can also be caused by the person’s sodium intake being too high, which requires an excess of water to dilute it before it then goes to the kidneys to be processed.

Fluid retention also causes other organs to start to become dehydrated as the body tries to hold on to water. One very obvious sign of water retention (and therefore dehydration in that specific organ) is constipation – the colon becomes less moist (which has a direct impact on bowel movements) as the body retains the moisture in other organs. In the case of the kidneys, water retention can actually cause kidney failure as the kidneys are no longer able to remove excess water from the body in the form of urine.

The average person requires around 2 litres of water a day (and an additional 250ml for every 25lbs they are overweight by). In hot climates or during sport the requirement will be higher given the loss of fluid through sweating. Many of us can suffer mild symptoms of dehydration during the day (which include fatigue, loss of appetite, headaches, light-headedness, nausea or feeling excessively hot). You can also tell easily by the colour of your urine whether you are dehydrated – anything darker than pale yellow indicates that you need to drink more water.

There is the misconception that soft drinks or flavoured water can be counted towards the daily water intake requirement. While these will provide your body with the hydration needed, unfortunately, the amount of added sugar and chemicals that are in them will far outweigh any hydration benefits as you could be at risk of putting weight on, causing tooth decay or suffering an increase in blood sugar levels. Obesity in children is on the rise in Europe. In the UK the consumption of fizzy sugary drinks has doubled over the last 15 years and studies have shown that children and adults are missing out on essential nutrients in food because they are eating less at mealtimes following the constant consumption of fizzy drink.

It’s easy to drink water throughout the day. People who know me know that I never go anywhere without a bottle of water. If I am going to meetings at work (which is here I spend most of my day nowadays) I am usually clutching my 1L bottle of still water and I periodically sip it. I always carry a bottle of water in my handbag also. If you can make 1 important change to your lifestyle, decrease your consumption of sugary drinks and replace them with water. Sparkling water with a fresh berry or a slice of lemon in the glass will satisfy your craving for taste. Your body will love you for it!

Lifestyle, Nutrition, Training

The Importance of Weight Management in Sport

March 1, 2016 emmamartinfitness

When discussing weight management in sport, it is important to discuss not only the physical importance of weight changes but also the mental effects they have on athletes. Weight loss is used in sport usually to qualify for a competitive weight category or to enhance performance. In order to lose body fat, the athlete needs to be expending more calories than are being consumed. This works best through a combination of diet and exercise as opposed to one or the other, and over a gradual period of time as opposed to through a quick crash diet. If we give the body time to adapt to the weight loss then there is a better chance that we will be able to maintain the weight loss, as opposed to if the weight loss is sudden, which can create secondary health issues.

While a certain amount of body fat is important in order to survive, most sports require a loss of body fat in order to enhance performance. Carrying around an excess of fat can slow an athlete down (such as in explosive sports that require the athlete to move their body weight or a loaded bar quickly, as mechanical efficiency and power are reduced), it can affect their endurance (as an increase in fat can increase fatigue) and strength. One of the only sports where an increase in weight (typically body fat) is considered advantageous, is Sumo wrestling. While in most sports where being of a larger size allows for an increase in the momentum required for throwing an object or knocking an opponent over, Sumo wrestling is the only sport where the weight increase is generally fat as opposed to lean tissue; Strongman competitors, for example, are usually heavier but this is typically muscle mass as opposed to fat.

There are 2 types of fat: essential fat and storage fat. Essential fat makes up around 3% of our body weight and is present around our organs to protect against damage, our brain tissue, cell membranes, nerve sheaths and bone marrow. Women have an additional sex-specific fat which makes up a further 5%-9% (usually around the hips and breasts) and aids with oestrogen production. As soon as a woman’s body fat starts to fall below 15%-20% there can be an impact on menstrual function. This is especially important to take into consideration with sports such as bodybuilding, where there is a requirement to have extremely low body fat percentage and hydration levels in order for the muscle bulk and fibres to be more visible. Storage fat is used as an energy reserve and is usually located subcutaneously (under the skin) and intra-abdominally (around the organs). Fat loss can occur from any area of the body and it is not possible to target one specific area for the fat to decrease as our fat utilisation patterns are based on our genetic make-up and our hormonal balance. Exercising (especially weight training) can help with increasing the muscle mass of that area but it will not affect the fat storage in that area as muscle and fat are two separate types of tissue and are non-interchangeable.

Bodybuilding is a good example of weight gain and weight loss in sport, as there are 2 phases that the athlete goes through in order to prepare for a competition: there is the bulking phase (also known as off-season) which lasts a couple of months (although there is no set timeframe) and then there is the cutting phase that usually happens in the months leading up to a competition where the aim is to lose body fat without jeopardising the muscle gains too much. During the bulking phase, the emphasis is on increasing the calorific intake (normally from an increase in lean meat, complex carbohydrates and healthy fats) versus expenditure so that the athlete puts weight on and more specifically muscle mass (as opposed to fat). This is the time where the athlete makes 95% of their improvements in their physique and therefore the right nutrition is required for this. While protein is usually used to build and maintain muscle mass, carbohydrates are especially important post-training as they increase the insulin levels and help the muscle to absorb the glycogen. Fats are also essential in building muscle, reducing cortisol, providing energy and increasing testosterone levels (the higher the testosterone levels, the more muscle mass; the more muscle mass, the higher the testosterone levels).

The bulking phase can be a mentally difficult phase for the athlete as the emphasis is on putting muscle mass on but it is impossible to do this without putting on body fat also. This can sometimes cause the athlete to start questioning themselves and adapting their nutrition to not include as much fat or as many carbohydrates as are required to build muscle, given the visible increase in fat. If the athlete cuts too soon, they risk losing the muscle mass they have worked hard to put on. It then becomes a question of whether the athlete can cope mentally with their larger appearance whilst they wait for the cutting phase.

During the cutting phase the emphasis is on reducing the body fat percentage while losing as little muscle mass as possible. While some muscle mass loss is expected, the diet is changed to decrease the carbohydrate intake and increase the protein intake (in order to save muscle mass) but having a carbohydrate-depleted diet can create a lack of energy which can also be mentally draining for the athlete who is trying to still exercise at the same level of intensity but with nowhere near the same amount of nutritional support. The cutting phase is also equally mentally challenging for the athlete, as while they look at their strongest because their muscle bulk and fibres are becoming more visible, they are actually at their weakest because their bodies are depleted of nutrition and their body fat is approaching dangerously low levels the closer they get to competition time.

This type of lifestyle can be rewarding for a short space of time after all the hard work, however, there are also health risks, both physical and mental. Constant yoyo dieting can increase heart disease, because when the athlete’s nutrition starts to normalise, the fat is usually re-deposited intra-abdominally (and therefore closer to the liver), rather than peripherally (the hips, thighs and arms); yoyo dieting can also cause a loss in lean organ tissue, which can damage the heart muscle. So while bodybuilders need to ensure that they are as lean as possible for their chosen sport, it can come with risks. It is, however, not only physical risks that can be associated with bodybuilding, but also emotional and mental issues, as the constant yoyo dieting and changing in body size can cause the athlete to start changing the way that they view themselves. This is known as body dysmorphic disorder and can be suffered by both men and women, where they are unable to see the true image of what they look like. They are not satisfied by their physical appearance and are in most cases unable to see the muscle bulk increase or body fat loss that the people around them can see. This causes them to keep pushing the boundaries and in some instances either develop an eating disorder or consider taking performance enhancing supplements to reach the next level; except that they will never reach the next level because of this disorder.

Any competitive sport is difficult to train for and excel in, as it is a combination of training periodization and the right nutrition that will give the athlete the tools to be able to prepare their body for competition day. Weight management plays a huge role in whether the athlete will make the necessary weight category, whether they will have enough strength to overpower their opponent, or whether their muscles will be more defined and symmetrical than the next competitor. The right nutrition can give an athlete the edge that is needed to reach the next level, however, yoyo dieting may not necessarily be the key to optimum health, given the mental and physical risks associated with it. It is therefore always preferable to manage weight in a more steady manner that allows the body to acclimatise to it and maintain the changes.

Hip Arthroscopy, Nutrition, Training

Road to Recovery After a Left Hip Arthroscopy

February 1, 2016 emmamartinfitness

On Wednesday 22^nd October 2014 I underwent a left hip arthroscopy because of the femoroacetabular impingement (FAI, mixed impingement) with labral tears that were diagnosed following months of pain, an MR Arthrogram and a CT scan.

DAY OF THE OPERATION

The operation was a success but the hours following the operation were awful because of the anaesthetic and the morphine. I was awoken from the operation in tears (I was confused and couldn’t formulate a sentence – the nurses thought I was in pain so they gave me more morphine). While patients are usually discharged after 4 hours, I had to wait 8.5 hours because of the nausea (which prevented me from having the mandatory pre-discharge physiotherapy session). The morphine had relaxed my bladder muscles therefore I wasn’t able to pass urine. Any hip pain wasn’t really that apparent – I would occasionally get some instant and sharp pains if twisted or moved into an awkward position but my main focus was trying to ease the nausea. I was sick a few times in the afternoon, which allowed my body to start getting rid of the drugs from my system; I had my physiotherapy session at 6pm and I passed urine at 7.15pm.

My surgeon came to see me mid-afternoon to explain what he had done but I was so high and nauseous I barely remember the conversation. I do remember seeing pictures of the destroyed labrum and the cartilage that had started to peel away.

RECOVERING FROM THE OPERATION

While I breezed through the physiotherapy exercises on the day of the op, the 1^st day post-op was quite tough. I slept beautifully but woke up feeling like a bus had hit me. I couldn’t move well, I was still groggy and incredibly nauseous. My sister helped me to shower – I dropped the soap and just looked helplessly at it as I couldn’t bend down to pick it up or wash my lower body. I needed my crutches for everything, even just to shuffle a few steps, as my leg was too heavy for me to be able to lift unaided.

I managed 1 flight of stairs, with crutches, using the method the physiotherapist had taught me: bad foot down to hell, good foot up to heaven – operated leg first when walking down stairs (so that it remains straight) and non-operated leg first when walking up stairs (so that the operated leg remains straight again).

On the 2^nd day post-op I was moving a lot better and felt as bright as a button when I woke up. I still had to stare at the soap when I dropped it (again) but I could walk (as opposed to shuffle) around my flat most of the day without my crutches. Putting socks and pants on was difficult because I couldn’t bend the leg or my body to reach down properly so I was glad I had someone around to help me to dress and shower.

On the 3^rd day post-op I could walk and do stairs unaided. I didn’t drop the soap but I still needed some help washing and drying my ankles and feet. Overall there was significant improvement in my mobility for every day activities. The physiotherapy exercises were becoming easier so I increased the reps, modified the exercises so that my foot was hovering above the floor and I added some other exercises that I knew would help to strengthen the hip joint without fatiguing the supporting muscles too much. While rest is important I do also think that the body needs to be challenged in order to keep improving – but at no point did I feel any pain from these modifications.

On the 4^th day I was finally able to wash/dry my ankles and feet unaided. I was a little concerned about some hip clicking that I had also experienced pre-surgery (due to the labrum being torn) but my physiotherapist assured me this was common as it was most likely post-op fluids and the inflammatory process happening in the joint and that it could be expected for up to 3 months post-surgery.

MEDICATION

I was still experiencing some nausea after 3 days and after investigating the medication I was taking, I was horrified by the list of side effects for Pregabalin (Lyrica) that I was expected to take for 2 weeks for nerve damage. I came off it after 5 days (with the surgeon’s blessing) as I had no nerve damage (I can’t fire up my left glute properly but I have a sport tens machine to help with that). I am taking Celebrex for 4 weeks to prevent bone forming in the muscles and I didn’t need painkillers for more than a couple of days.

PHYSIOTHERAPY EXERCISES

While the improvements were quite significant initially (for every day activities such as walking, going up/down stairs, bending/squatting down to pick something up), I have seen fewer obvious improvements since then and am now primarily focusing on improving my internal and external rotation. I can squat properly (with a Swiss ball between the wall and my back), I can bridge very well and have increased the intensity by elevating my feet and using a resistance band around my knees but I can’t do bent knee fall outs without pain at the end of the movement because of my lack of rotation. I am swimming to move the hip joint more (only crawl; can’t breaststroke yet) and using the upright cycle. Any other cardio machine will put too much pressure on the hip joint with the repetitive movement.

I had my initial post-surgery physiotherapy session after 9 days and my physiotherapist was pleased with my progress as I can already do exercises from the 4-6 week post-op section of the rehab chart. I put this down to how physically active and mobile I was pre-op and the quality of my nutrition. My focus is to improve my lower body mobility as much as possible so that when I have my left shoulder arthroscopy at the end of November I will still be able to exercise my lower body whilst my upper body recovers in time for my right hip arthroscopy at the end of January 2015.

ADJUSTMENT PERIOD

I have a gym bench at home and some dumbbells so I created a little upper-body circuit of seated exercises (so as to not put any pressure through the hip joint) as I am a little concerned about the effect that this no-exercising is having on my muscle mass. The tens is helping to stimulate the muscles but I’m worried about losing all of the muscle mass that I have built up over the past couple of years. Even just doing a little bit really helps to keep my motivation and positivity up as mental attitude is extremely important when recovering from surgery. It’s easy to become deflated by the lack of progress, putting weight on through inactivity, giving in to the pain – exercise helps to stimulate the blood flow, the mind and get the serotonin pumping through your body.

Not being able to exercise properly has required a mental adjustment as I used my interval training to lose body fat and my metabolic weight training to maintain muscle mass. I am now relying on my nutrition to save as much muscle mass as possible and also not put on too much body fat – my carbs are low (max. 80gr/day), my protein is high (around 220gr per day) and my fats are reasonable (max. 30gr per day). I am keeping my weekly sessions with my personal trainer as it is important to have a focus and he has weighed me every week since we started training together in order to ensure that I am on the right track. While our training over the coming months may be very different to what I’m used to given my physical limitations, there is no reason I shouldn’t be able to stay on top of my fitness and my nutrition with some discipline and a positive mindset.