May 2012: Dr. Matt Poteet (Part 2)by John Meadows on May 23, 2012
John: Ok friends, we are back this month with the rest of our interview with Matt Poteet.
Matt, we left off talking about inflammation, and how correcting Omega 3 and Omega 6 ratios is a key step in reducing inflammation more specifically. What other tips can offer our readers on reducing inflammation given that most generative diseases seem to tie back directly to high levels of inflammation?
Matt: Well, there are two sides to the inflammation problem. First is correcting the fatty acid environment in the body with the optimal ratios of dietary essential fatty acids. We talked about that in part 1, and that enables the body to respond appropriately to an inflammatory event. The second part is limiting the intake of the inflammation-causing substances in the diet. This is much harder for most people to pull off because we are so accustomed to our society’s food choices and availability. For instance, pasteurized and homogenized commercial milk products are extremely inflammatory foods. The process of heating the milk denatures the natural proteins, eliminates many of the natural co-factors that were in the milk to begin with, and fundamentally alters the fatty acid structure of the milk. So they turn an extremely healthy, low-inflammatory food into something that wreaks havoc on our inflammatory system. Natural milk is the answer, but you can’t get it unless you really try. So that leaves us with the unfortunate conclusion that you need to avoid milk entirely. A whole lot of people will simply not go for that. Milk isn’t the only culprit by a long shot. Excess sugars, wheat products, MSG and many others are very pro-inflammatory. The easy solution is to adopt a natural diet of minimally-processed foods. This, along with correcting the essential fatty acid intake, will produce the correct balance of inflammation in the body.
John: Yes, the milk thing kills me. It really does. When I started drinking raw milk (I think it was about 4 years ago), my joints instantly felt better, I felt more energetic, and on and on. For those of you interested in trying fresh raw milk, visit http://www.realmilk.com and see if you can find a herdshare program to participate in. I have had my kids drinking it since they were 1 year old if that tells you how strongly I feel about it.
What are your thoughts around carb consumption just generally speaking? People have mistakenly thought that I am a carb hater. This is not true, I just prefer that the large majority (usually 70 – 80%) of carbs are consumed around training to help with energy to get through higher volume training sessions, and to help with recovery. In other words, they serve a purpose. How do you like to structure carbs when dealing with many of the folks you help, given they might not be hard training athletes?
Matt: This question came up the other day on a forum and it is a very good question. When you think about it, carbohydrate is the one macronutrient which displays very high variability genetically from person to person in the hormonal environment that it creates. And, just to remind everyone, creating the optimal hormonal environment really is the name of the game in regards to both general health and body composition. The hormone that gets all of the press in this instance is insulin, but insulin is really only the star of the movie. There is a whole cast of characters underneath insulin which never get talked about but which are just as important. So I refer to it as a “hormonal environment” to encompass all of the players. Some folks have a great “environment” and can process carbohydrate efficiently, effectively, and very thoroughly. Higher level athletes, like competitive bodybuilders, figure athletes, D-1 athletes, etc. are usually in this group. Then you have the “average” person who, through years of consuming a standard western diet, has degraded his hormonal environment. The good news is, we can fix this environment through dietary and lifestyle strategies. The bad news is that it takes a while. So working with an average guy or gal we really have to make correcting the hormonal environment the first priority, and that calls for really buckling down on carbohydrate consumption for a while. Once you do that, the physiology begins to recover and eventually the hormonal environment is back to the person’s physiological normal. At that point in time you can start using carbohydrate in a positive manner to do good things for body composition and health.
John: Yes, great point. Are you thinking of insulin resistance Matt? This is a really tough condition to deal with, because as you said, it takes time correct. Can you tell us a little more about what kind of advice you might give someone who comes to you, and just simply can’t process carbs well, that has perpetually high levels of blood glucose? Do they just reduce carbs to a certain level, eliminate them etc.?
Matt: Well, in a sense they do usually have to completely eliminate them for a time. You won’t find this in any textbook, but my hypothesis on it is the receptors need a period of time to restore their structural integrity after a prolonged period of hyper-insulinemia. They are conformationally “shot”, and the problem is they have been constantly stimulated for such a long period of time they lose their ability to change into their “active” shape. By eliminating the high glucose, we eliminate the high insulin and allow the receptors time to structurally repair. Once that occurs, and it is very individualized as to the time frame, then appropriate carb sources can be reintroduced gradually.
John: Another common challenge I see is with female physique competitors. They work so hard to get into “bikini” or “figure” competition condition, that they literally kill their metabolisms with starvation diets, excess beta agonists, excess thyroid chems, etc. When someone has done this, what are a few things you would have them do to start the repair process. In my experience, this is extremely tough, and take a significant amount of time to correct.
Matt: Oh, you are right, of all the scenarios we deal with reducing female lower body fat is one of the most challenging. After they have peaked for a show, they are a wreck. I once knew a female bodybuilder that competed at 114 lbs, and 19 days later she weighed 145 lbs and it was all in the hips! So, ladies you have to be very careful after a show. It is also an individual issue, but there is usually a common theme; beta receptor down-regulation and hypo-thyroidism. A strategy that I have found that works pretty well is to keep the athlete on beta-agonists after the show, and taper off over 8-10 weeks. At the same time, add calories back in very slowly (if they were on a very low calorie diet) of about 100 calories a week, with the majority of that being fat and protein. Then once they are within 90% of their maintenance calorie level, I will begin adding their carb sources back in. It usually works well, but as you know it isn’t fool-proof. That’s why any figure competitors out there doing their first show or who have trouble with this issue would be wise to give an expert like John Meadows a call! It can be very difficult to navigate without professional assistance.
John: One thing that I am really interested in getting your insight on, is the post workout window related to nutrition. Bill and I co-wrote an article on it a while back (http://www.t-nation.com/free_online_article/most_recent/maximize_protein_synthesis&cr=) What are your thoughts around nutrition around training (pre, intra, and post) assuming someone is training hard and with some volume?
Matt: That was a great article, and I really enjoyed reading the series that you and Bill put together. I am glad that you focused on mTOR and explained it to the reader as it is appears to be the most important signaling factor in muscle protein synthesis in the latest research. I really think you hit the nail on the head for bodybuilders and serious athletes. I recommend something very similar to athletes who partition nutrients well, and those who have a lower bodyfat. For those who have insulin resistance issues, like big offensive lineman, I will hold off on the carbohydrates until I am sure that that is fixed. For these folks, protein alone will still give them an adequate insulin release to blunt muscle degradation. I then add in carbohydrate intra-workout and post-workout beginning at about 0.3 g/kg total and will titrate up to a max of about 1 g/kg total. This is plenty for us, as we are hard training “cross-trainers” so to speak, not marathoners. Our glycogen will be repleted from an hour’s worth of hard training with that much carbohydrate for sure.
John: For the intraworkout carb source, any preferences on what to use? Any favorite protein and carb sources post workout?
Matt: Well I have found that you sometimes have to be careful in choosing the type of intra-workout carb source. In many athletes, selecting a carb source that produces a rapid insulin response, like a lot of POST workout formulas and you develop hypoglycemia about halfway through your workout, feel faint, and just want to lay down. Because of this, I like a drink with a muted insulin response for intra-workout. There are several decent products out there, Biotest Surge Workout Fuel is decent. You want something with longer carbohydrate chains such as glucose polymers, oligodetrans, maltodextran, etc. Those type molecules will provide the energy you need while not giving you the vicious insulin spike that is desired in a post-workout drink.
John: I have always felt that adding fat to preworkout carbs and protein helps to stabilize blood sugar as well. I know that fiber, and protein, etc can slow down the glycemic response, but in my experience, not like fat can.
Ok, so we have to touch on this. What do you think about the recent surge in popularity of intermittent fasting? Any general thoughts?
Matt: It has certainly been overblown, but I suppose that is the problem with almost any idea nowadays. If we peak through the marketing and hype, we do see some useful science that we can selectively use for fat loss over short periods of time. The concept at the heart of intermittent fasting is manipulating the time your body experiences sympathetic nervous system dominance during the day. This is the “fight or flight” that we all have read about since 8th grade science class. Normally the body is in and out of sympathetic dominance all day long. It shares the day with the parasympathetic nervous system, the “rest and digest” system. The good thing for dieters about the sympathetic system is, while it is in charge, the hormones floating around in the blood stream are “fat burning” type hormones. Intermittent fasting takes this sporadic, in and out sympathetic daily cycle and extends it throughout the day. The theory is, the longer you are in it, the more fat you will burn. Well, that is true to a degree, however there are other physiological changes which aren’t so advantageous for those who want to lose fat and keep pretty muscles, in particular mTOR suppression. Most people who use intermittent fasting do end up losing a lot of weight, but their physique quality suffers as well. They end up carrying less muscle than they could with a conventional diet, and are never able to lose the last few pounds of fat. They end up stuck in the high single digits/ low teens in body fat percentage. That is fine for 98% of the population, but for bodybuilders that isn’t such a good thing. A much more logical use of this concept is small, targeted extensions of sympathetic dominance such as a couple hours in the morning or evening. This will allow for modestly-extended fat burning without compromising muscle quality. Over the course of a diet, the additional fat loss adds up.
John: It is very hard for me to conceptually grasp growing a significant amount of lean tissue when you are going 16 hours without eating every day. For someone advanced, I just have a hard time seeing this work out in the real world, and I haven’t seen it work out yet at all in advanced bodybuilders, despite numerous attempts.
How would you suggest someone use a more targeted morning approach in the morning?
Matt: You are absolutely right, John. There are numerous problems biochemically when trying to use Intermittent Fasting for mass gaining or for contest prep. It simply does not preserve enough lean tissue as a percent of bodyweight for anyone to look their best. By “small, targeted” extensions of sympathetic dominance I am alluding to things many bodybuilders already do that work for fat loss, they just may not know why. For instance, the morning fasted cardio, shower, then eat protocol many of us have used for years. Well if you think about it, that is extending the overnight fast for around 2 hours. Small periods of time like that are about the max that you want to try to do in order to preserve the most muscle tissue, retain the “full” look, and come in hard on stage. Any longer, and the catabolic hormonal state really makes that look impossible or extremely difficult to achieve. I don’t recommend the true 16/8 intermittent fasting for anyone for a variety of reasons, but for bodybuilders it’s a terrible idea.