Weight training & cardio
Dr Amanda’s Answer
I would strongly recommend that you keep the 5-10 mins of cardio at the start of your weight training session – this offers a valuable warm-up period for your body with many benefits. This relatively short bout of cardio exercise would certainly not be enough to drain your energy and compromise your weight training performance – quite the contrary!
Overall, the key thing that could compromise energy levels and compromise your weight training (or any workout) is if your diet is not sufficient, in particular, if your carb intake is too low relative to too much protein (and fat). Carbs are your primary fuel source during exercise (weight training included). A low-carb diet has been proven to decrease energy levels, exercise performance, limits your ability to keep a high intensity for a long periods and could also compromise your muscle-building capacity.
A balanced intake of all the nutrients is always the key to get the best training and performance results!
Cardio and weight training – which should I pay more attention to?
Dr Amanda’s answer:
The short answer: Pay equal attention to cardio and weight training!
Traditionally, cardio exercise (long hours slogging away) was thought to be the main focus for weight loss. We now know that a combo of cardio and resistance training provide the best results. Resistance training (2-3 sessions per week) helps to build muscle mass and more muscle means more fat burning capacity.
But there’s also a new (and better way) of doing your cardio sessions:
The latest research indicates that we don’t necessarily need hours of low-intensity cardio exercise to burn fat (or build fitness). You can get the same, if not better, fat burning results if you push the intensity of your cardio session higher while reducing the duration of the session. Better yet, take your cardio session and do it in the form of a high-intensity interval-training session.
You do this by doing an interval of high-intensity exercise (e.g. 1-2 min. of running) followed by a rest period. The rest period can be complete rest or “active rest” doing low-intensity exercise (e.g. 1 min. of walking). By doing a couple of these “reps” (e.g. 10 x intervals) you not only make your exercise routine less boring, but it really boosts your metabolism during and after the exercise session to maximise your fat-burning capacity. It is also time-efficient for people who don’t have a lot of time to spend on exercise. You can build the intensity and duration of your intervals as you get fitter to lose more excess body fat. You can do interval training on a treadmill, bike, rowing machine, or the super-circuit which is ideal for interval training. You don’t need more than 2-3 high-intensity interval sessions per week (and it’s not recommended).
Remember if you’ve had a hard training session (interval or weight training session) on one day, then the next day should be easy or a rest day.
Health & Wellness
Advice to get back into shape and quit smoking
Dr Amanda’s Answer
Well done for already creating a healthy exercise habit! But it sounds like you need a bit of a change in your general exercise routine so that it becomes more of challenge – and keep it interesting and fun! You can get an exercise programme in your personal online folder by logging onto www.virginlifecare.co.za (this is a value-add as part of your CAMAF benefits). And/or you could ask one of the trainers in the gym to show you a new exercise routine, and try out a new group exercise class(es). For weight loss you need to do about 300 minutes of moderate intensity exercise per week; or if you up the intensity then you need about 150 min of more vigorous-intensity exercise (e.g. doing the super-circuit or an advanced group exercise class). A 50:50 balance between cardio and weight training is the ideal mix to assist with building muscle, increasing fitness and maximising your fat burning capacity!
As far as quitting smoking goes – it’s a tough behaviour to change! But so worth the effort of doing it! Quitting smoking is one of the most critical investments you can make towards your future health and longevity. Patches could assist with braking the habit, but the crux of the matter is that you need to dig deep to find the determination and perseverance to quit. Different strategies work for different people – e.g. gradually scaling down on the number of cigarettes per day vs going cold turkey. I suggest you go and read the ‘success story’ on our Virgin Life Care blog for inspiration: http://blog.virginlifecare.co.za/kick-the-habit-in-the-butt-and-start-fresh/
All the very best!
Sharp muscle pain
Dr Amanda’s Answer
I unfortunately would not be able to assist you on this one – I would suggest you have this properly checked out by a physician and/or see a physiotherapist to get a clearer diagnoses of the nature and degree of your injury and how to rehab it properly. If you don’t do this, you risk either further injury and/or delayed recovery… It is well worth getting it checked out so you can get back into your soccer soonest!
All the best!
Maintaining energy levels after exercise
It is great that you are so committed to exercise and staying fit. Here are some tips to help with recovery and to assist with building and not depleting your energy levels:
- The first obvious thing that comes to mind when you say “I feel depleted” is whether you are eating enough?
- Are you following a balanced diet with wholesome foods from all the different food groups? Especially plenty of fruit and veggies.
- Are you drinking enough water during the day? Even mild dehydration can cause tiredness, and headaches
Your physical activity
- Are you over-doing the exercise and other daily-life activities versus not getting enough rest and relaxation?
- Remember that you should build your fitness up gradually. For general fitness you don’t need to push yourself to the max everyday!
- Alternate hard training days with easier days, and if you had a super hard day then you should follow it with a rest day. “Active rest days” are also good e.g. light walking or an easy cycle.
- Vary your exercise routine to keep it fun and exciting, and to prevent exercising the same muscles day-in and day-out.
Your health and wellness
- Is your iron levels ok? Iron deficiency can lead to anaemia and constant tiredness. It is easily corrected when your iron levels are back to normal. A well-balanced diet and lean red meat (about once per week) can help keep your iron levels optimal. If you have a deficiency then the route of the problem needs to be corrected and you might need a short-term iron supplement.
- Are you getting enough, quality sleep to rest and repair your body (muscles), but also your mind?
Remember, feeling energetic is more than just being fit; it involves physical as well as mental and emotional well-being. Hopefully, the tips given above can help you pinpoint and rectify your source of tiredness and how to remedy it. Keep in mind that when one feels tired and depleted on a daily basis there might be a range of other reasons behind it – so if the tips above don’t help, then it might be time for a good medical check-up with your doctor.
All the best!
Running and low blood pressure
Dr Amanda’s Answer
The dizziness after the race could be due to low blood pressure, but could also be due (or worsened) by low blood sugar levels – so we should look at both of these factors.
Preventing low blood sugar levels:
If possible, have a breakfast (1-2 hrs before) that includes a wholesome source of carbs e.g. 1-2 slices toast with Marmite / Bovril / Fish paste or cottage cheese + tomato (add a sprinkle of salt-savoury / salty foods may help your BP) OR cooked porridge or cereal or banana + low fat milk or yoghurt.
+ Drinking a carb-energy drink (e.g. Energade or Powerade) during the race instead of water only is good.
Aim for ~2 cups of energy drink per hour of running (experiment with how much you feel best with). It’s ideal to spread it out instead of drinking it all in one go (e.g. have 150ml every 20-30 min) during the race.
Start refuelling with carbs within the first hour.
Do the same during long (>60 minute) training runs.
Instead of a carb-drink you can try carrying a sachet of carb-gel which you wash down with water. Typically 1 sachet per hour should be enough to keep your blood sugar and energy levels up – it has also been shown to boost your performance!
OR you would need ~6 jelly babies or Super C sweets per hour of running (and don’t forget to drink some water during the hour as well).
Preventing low BP
- Having beetroot (in juice or cooked form) before your race is NOT GOOD. There’s evidence to show that beetroot can reduce BP – so in your case this could make matters worse!
- Apart from the above there are not many things you can do to help raise a ‘naturally low’ BP. And though I mentioned having a bit of salt, I’m not recommending that you ‘go wild’ with the salt shaker either! Moderation is still key.
If your dizzy spells persist then you should consult your GP for a more detailed investigation and advice.
Good luck with taking your training and racing to the next level!
All the best,
Rheumatoid arthritis and exercise
Dr Amanda’s Answer
Having a specific condition such as RA always makes ‘general exercise advice’ over email a bit difficult. But I discussed your question with one of our Registered Biokineticists and incorporated her advice below (Bio’s have particular expertise in exercise rehab for medical conditions).
The correct type and amount of exercise can help to reduce pain, morning stiffness, and reduce fatigue which is great news for those RA patients who enjoy their exercise.
As with all medical conditions, we always recommend that individuals have their condition assessed by a biokineticist so that an exercise plan can be designed and tailored to the person’s needs. This is important because each individual experiences symptoms differently and as a result has different limitations which need to be understood and managed effectively. Typically exercises for RA should include a combination of aerobic and strength training.
For aerobic training, cycling, walking and swimming are all extremely beneficial and can help improve aerobic fitness, muscle strength and joint mobility. It should ideally be performed at a moderate intensity (raised heart rate and breathing but still able to talk whilst exercising), for 30 minutes per session, for 3 days per week. The ideal is to gradually increase the intensity and duration to 60 minutes per session for 4-5 days per week. Exercise in water is very effective in reducing joint tenderness, improving range of motion and improving general wellbeing.
As RA most often is accompanied by a loss of muscle mass, we do encourage regular strength training to help build muscle. 8-12 repetitions of large muscle group exercises (such as the leg muscles), performed at a moderate (not high) intensity. No more than 2-3 sets need be performed and the routine can be repeated 2-3 days per week.
Maintaining core strength (e.g. abdominal muscle exercises) is another vital component of an exercise programme for rheumatoid arthritis so the stability ball is a useful piece of equipment to improve this aspect.
Stretching is advised to help increase range of motion, flexibility and improving joint health. 10-15 minutes is all that’s needed so try to include this in your fitness routine. Tai Chi as well as yoga or pilates is another favourite and can be performed 2 days per week.
Try to incorporate both aerobic and strength training into your weekly exercise routine as both bring with them a host of benefits in helping manage this condition.
We hope that this advice will help give you direction and that it will assist with performing an enjoyable exercise routine!
I suffer with my lower back
Dr Amanda’s Answer
An individualised exercise programme to rehab your back could be of tremendous value. However, it is not something that could be done over an email. I would strongly recommend you see a registered biokineticist – they are trained at providing individualised exercise advice to help with your lower back condition. The biokineticist can do a detailed assessment of your current strength, fitness, exercise ability (and liase with your doctor if needs be) and can then provide you with a programme to rehabilitate your back. It would also be important that your progress is re-assessed regularly and the programme adjusted for the best results over time – and with good progress you might be able to avoid a back operation.
Also be aware of your posture when you are sitting at your desk during the day – correct posture can help take strain off your back and reduce pain.
As far as dietary advice go – if you are overweight, for example, then losing the excess body fat would greatly reduce strain on your lower back and reduce discomfort and pain.
Consider doing a Virgin Life Care fitness assessment with a biokineticist where you will get further advice on exercise as well as a dietary plan that will show you what to eat / how much.
Partial knee replacement surgery
Dr Amanda’s Answer
It is good that you are keen to stay active! I am sure that there will be a form of exercise that will suit your needs. However, this would all depend on the outcome of the operation. Non-weight bearing exercise like cycling might be fine, or perhaps swimming, rowing or upper body exercises – all these provide great health benefits!
I have also asked the opinion of one of our Virgin Life Care Biokineticists, who is an expert at post-op rehab. She also agreed that some form of exercise will definitely be encouraged, but that the precise MODE of exercise e.g. cycling vs swimming, for how long and how often would be decided following the outcome of the procedure and staying healthy!
What I would suggest is that you discuss this with your doctor/surgeon before and after the surgery. He/she would do a post-surgery assessment and together with a physiotherapist or biokineticist, they would then advise the best way forward in terms of a rehabilitation programme that would best suit your needs, your post-op rehab and exercise options going forward.
All the very best for your operation – I’m sure it will alleviate a lot of discomfort so you can enjoy being active again!
Nutrition – protein specific
I can talk about this all day (and every day!), but I will try and keep it short and to the point!
1. Normal food (variety, from the various food groups) is the cornerstone and safest, most effective and enjoyable way to support health and longevity. It is for various reasons the far superior route to take compared to supplements.
You CAN meet energy and nutrient needs from a ‘normal’ wholesome food intake, spaced around your exercise regime. The same goes for meeting your protein needs – especially if you include lean fish / chicken / lean meat / dairy in your diet – it provides ALL essential amino acids and other nutrients for healthy, active adults. I suggest you also read the following blog article: http://blog.virginlifecare.co.za/do-you-really-need-a-protein-shake/
There are some products that could safely and effectively be used to supplement your nutritional intake, only if needed once a ‘gap’ is identified… A good carbo-energy drink for example is valuable during / after long endurance sessions.
If you are unsure if you are meeting your needs and how best to do it, then I would highly recommend you invest in seeing a registered dietitian (ideally with sports nutrition experience).
2. The vast majority of nutritional supplements have NOT been tested for safety, ‘purity’, efficacy, and there is no legislation controlling that claims that are put on the label is indeed accurate. Anything sold as a ‘supplement’ does not need to undergo the rigorous testing and trials as required by prescription medication drugs. In fact, there is ample proof of products randomly sampled from the SA and international market where actual testing found harmful ingredients and contaminants that are not indicated on the label, or ingredients listed on the label that is either completely absent or present in doses far higher than indicated (which can lead to toxicity etc.). You just don’t know what you’re going to get! Even for the products that claim to be ‘scientifically tested’ are MOST OFTEN at closer inspection found to be bogus, or the research is of low standard and/or not applicable to humans etc. The ‘Sports supplements’ and ‘weight loss pills and potions’ are particularly prone to false claims and marketing practice.
3. Whether you get these ‘supplements’ from manufacturers, bottled with its misleading claims, or from the factory, you sit the same problem. In addition, ALL represents a processed and/or synthetic form of a nutrient(s) which is an imitation of what is found naturally in food. Even products that claim to be ‘natural’, is NOT necessarily safe and ‘natural’ – I don’t think that anything that has gone through extraction, drying, put in powder or pill format can be called natural or pure anymore…
Hope this helps to confirm you ‘supplement suspicions’ and help forge the way forward!
All the best,
Nutrition recommendations for tired athlete
Dr Amanda’s Answer
For your amount of training it is critical that you follow an adequate diet – with nutrients in the right proportions to meet your increased needs. Most often, the reason for lack of energy as in your case would be due to not eating enough overall, or eating too little of the ‘right’ critical fuel foods (like carbs) in relation to other nutrients such as protein and fat.
Performance nutrition principle no. 1:
Sufficient energy for training, competition, recovery Proper fuelling (correct type, amount, timing) during training and competition is key. Carbohydrate is the body’s primary fuel source, and plays a key role in recovery. It is THE nutrient with the biggest effect on energy levels, with a direct and indirect impact on performance.
Fuel-up: Have regular meals spread throughout the day containing a nutrient-rich carb source (grains, pasta, rice, starchy veggies, dairy);
Top-up: Easily digestible (high GI) carb-rich snacks / drinks (savoury and sweet) could be used to top-up energy stores – ideal as snack 1-2 hrs before and during long training sessions (90 min plus) and during competition (e.g. energy drink at half-time / breaks in the game).
Recover fast: Refuel with easily digestible carbs (moderate to high GI) immediately post-exercise, followed by a balanced meal asap thereafter.
Nutrient-rich carb foods and meal examples:
Breakfast cereal with milk or yoghurt; fruit and flavoured yoghurt; fruit smoothie; sandwich with cottage cheese or meat & veggie filling; stir-fry with rice or noodles; pasta with low fat sauce (tomato, veg, lean meat); liquid meal supplement (scrutinised to be free of banned substances).
Moderate to high GI carbs:
Majority of breakfast cereals; most types of rice; white and brown bread; potatoes; tropical fruits and juices; sugar jam and honey; sports drinks and regular cooldrinks; carbo-gels, sweets; savoury rice crackers.
The IOC (IAAF and other) experts warn athletes against the performance pitfalls of low carb diets. And we’re not only talking about low energy levels and poor muscle performance (strength, endurance, speed etc.). Insufficient carbs can also cause dehydration, hamper concentration, mood, recovery, immune system function, and hormones that affect several aspects of performance, growth and health – A situation not to be risked by any athlete.
2: Sufficient protein to maintain (and/or build) muscle mass:
An optimal carb diet that provides 1-2 g protein / kg body weight will ensure that muscle repair, building and recovery needs are met.
It’s easy getting to this amount by eating nutrient-rich carbs (which also contains protein naturally), combined with dairy and/or protein-rich animal or vegetable sources added to most meals and snacks.
For a recovery boost: add 10-20g protein to the carb-rich recovery meal/snacks to boost recovery.
Eating too much protein at the expense of carbs could compromise fuel availability and performance.
3. Sufficient weight control – body fat vs muscle mass:
A high level of muscle mass but low body fat (yet still within healthy limits) is of benefit to most sports. Though you have high energy needs, excess calories (from any source – carbs, protein, fat, alcohol) would compromise body fat.
Fat and alcohol are particularly fattening, providing double the calories per gram compared to carbs or protein, and the body doesn’t need a lot of fat to stay healthy, AND it gets stored as body fat most easily and once stored it’s difficult to ‘tap into’ again… So a low fat diet, optimised for fuel (carb) and protein availability is the best approach for weight control while sustaining a high level of training and competition performance.
There is good evidence that cutting calorie intake too low (e.g. to try and drop body fat drastically, quickly) has drastic impairments in energy, performance and health.
I suggest you also read the Virgin Life Care Blog articles about energy drinks, eating before or after exercise for further insight and ideas on how to optimise your dietary intake. Sleep is also important, I suggest you read the blog article on that.
Pre-prepared healthy meals
Dr Amanda’s Answer
It’s good to hear that you recognise the value of a balanced eating plan in conjunction with your training regime. And, from what I can gather you’ve come to realise also that though protein is important, too much protein could be detrimental.
Finding a healthy, reasonably-priced meal delivery service is quite difficult – I don’t know of any service that has a wide-enough footprint to recommend. Another practical suggestion I can make is that you to have a look at the wide range of low-fat ready-made meal portions, soups, quick-cook veggie portions, salads etc. available from Woolworth’s and Pick n Pay. On weekends you could get your meal supply for the week – and with the wide selection you could vary your intake to keep it healthy and interesting.
What is the best product or way to hydrate after exercise?
Dr. Amanda’s answer
“Normal” rehydration after a workout can easily and effectively be done in one of two ways:
1. Have a meal and snack with any form of fluid to hydrate
The first and best way is to have your next meal or snack (providing carbs, some protein and a bit of salt or spices added) along with any form of fluid.
What type of fluid do you need to drink to hydrate?
You don’t need a ‘special product’ – it could just be water. The carbs and electrolytes from the meal or snack will help with fluid absorption and rehydration. You don’t need to go wild with adding salt to your food either – regular savoury-type meals are typically more than sufficient and highly effective at replacing electrolytes and assisting with rehydration. If you sweat a lot and you see the ‘white salt’ stains on your exercise clothing, then you can perhaps add a little extra salt to your food. Some foods such as fruit and vegetables are also high in fluids, and something like soup may also be a great rehydration option.
If you don’t have a weight (body fat) problem and the rest of your diet is healthy, then your rehydration fluid source could be fruit juice (packed with other nutrients) or an energy drink or cooldrink. I would nevertheless still recommend having some additional water as well.
2. Use an energy drink to hydrate when a meal or snack is not an option
If a meal or snack is not an option, then an energy drink could do the trick – the carbs and some electrolytes typically added will assist with rehydration. But most sports drink available – despite the marketing hype – are not actually very high in electrolytes as high quantities makes the drink less palatable. This is where a meal or snack comes in handy as it is a more palatable and sufficient way of replacing electrolytes and assisting the rehydration process.
If one is more severely dehydrated (e.g. with ultra-endurance racing, multi-day competition, diarrhoea, and so on) then using one of the specifically formulated rehydrate solutions (e.g. Rehydrat®) could be an option. Due to its high electrolyte content, it does taste unpleasant, and most people find it difficult to drink. Formulated rehydrate solutions would not be a typical choice for regular post-exercise rehydration, nor is it necessary.
The amount of fluid needed to help you hydrate
Your fluid needs are highly individual as sweat rates differ; sweat rates also vary with different types of exercise, weather conditions, and so on. If you want to be spot on with your fluid needs then it’s best to weigh yourself before and after a typical workout or race. Then, multiply the weight (kg) that you’ve lost by 1.5. Example, if you’ve lost 1.2 kg during your workout, then multiply 1.2 kg x 1.5 = 1.8 litres of fluid that you should replace during recovery. If this is too complicated then an easier way to check your level of hydration is your urine colour – the darker the colour, the more fluid you need to drink. Light pale yellow means you are well hydrated.
All the best!
Is a high protein, no carbs diet safe and side-effect free?
Dr Amanda’s answer:
In short, in my opinion, which is based on current available scientific evidence and opinion from around the world, I don’t believe there is good and sufficient evidence to say that this type of diet is safe and side-effect free, especially in the long-run. In fact, the evidence indicates the contrary, which makes me extremely cautious of advocating many of the principles of this diet in a blanket fashion, to everyone. If you want the ‘longer-version’ explanation of my opinion – then please read more in the blog article on this topic that will be published later this week.
In my opinion, the safest and effective recipe for weight loss, exercise performance, improving insulin sensitivity, health and longevity:
- Everything in moderation…but a lot of activity!
Find any type of activity you like – that gets the heart pumping – and do it as often as possible! Try something new every so often to keep things interesting!
- Eat fewer calories but don’t starve yourself to the extreme either! Include a variety of foods, in the right proportions instead of completely excluding any food group(s);
- Wholegrains, legumes, and a variety of fruit and veggies are healthy – the fresher and less processed, the better. But there is room for a treat – proportions of treats depend on how good the rest of your diet and activity routine and health are.
- Go easy on your fat intake and focus on ‘healthy fats’ mostly e.g. mono- and polyunsaturated fat vegetables oils like canola oil, olives, avo, nuts, fish (salmon, tuna, pilchards, mackerel, herring).
And ENJOY it!
Dr Amanda’s answer:
Glad the response was useful!
If you are a Virgin Life Care or Virgin Active member, then you can already get a meal plan that is fairly tailored to your needs (weight loss, gender, age, activity level) by accessing your personal profile online – this might be a good start to give you ideas on how to combine foods, portion sizes, pattern of eating etc. Taking small but consistent steps towards making dietary changes is often the best – so start with your biggest downfall dietary-wise, come up with a workable solution to address it (e.g. from now on have smaller portion of your favourite treat or have it less often or do more activity; if you normal skip breakfast then start by having a small yoghurt or fruit). Do it for at least 1-2 weeks consistently, then tackle the next obstacle and so you progress.
Another important part of weight loss is to track your progress, weigh yourself at least once a week and track it, or if you are a Virgin Active member then use the Tracker in the gym where your measurements will automatically be saved to your profile for you to track over time.
When your appetite is raging, your first stop should be to drink a big glass of water and to then bulk up on your veggie portions (e.g. by having salad, chunky veggie soup, stir-fry, or chopped with a low fat dip for a snack). Lettuce, spinach, green beans, tomatoes, peppers, mushroom, cucumber, baby marrow, onion are virtually calorie-free so you can go wild on these without packing in calories!
If/when you’re at the point where you need more individualised guidance, then I would suggest you invest in seeing a Registered Dietitian who can do a detailed assessment of your circumstances and needs, and then come up with an individualised eating plan that fits into your lifestyle and geared to your unique goals (optimise weight loss, recovery, training and *racing nutrition – [*once you are recovered!]). This will likely be a process – your dietary plan would need to be adapted and tweaked over time (based on your response, recovery, progress etc…).
All the best!
What should I eat?
Dr Amanda’s answer:
The ‘best’ diet is one that contains the following:
1. It includes variety – that means that you get something from all the different food groups (fruit, vegetables, wholegrain high-fibre starches, meat, fish, chickenbeans & pulses, dairy (milk or yoghurt) and healthy fats or oils);
2. You pay attention to your portion sizes. Meaning that you eat the right amount from each food group – not over- or under-do it.
3. One food group that you can safely eat a lot of vegetables – it provides fibre, nutrients, are low in calories so it is healthy and can be slimming!
4. Choose healthy oils (e.g. vegetable oils, low fat soft margarine, nuts, seeds, avocado) instead of eating animal fat (fat on meat, chicken skin, cream, full cream milk). Seeing that all types of fats and oils are packed with calories, people who want to lose weight should ‘go easy’ on them.
5. Drink plenty of clean water throughout the day. An adult needs about 8 glasses per day.
6. Go easy on adding salt to your food. Rather use herbs, non-salty spices, garlic etc. to flavour your food.
7. Go easy on highly processed foods (biscuits, pies, polony, sausages), junk foods, sweets and sugary drinks. See it as a treat and not a daily occurance…!
8. Be active! Get your muscles moving for at least 30 min., most days of the week. Whether it be a brisk walk, washing the car, gardening, house-cleaning or activities with the kids.
Feeding your body with wholesome, healthy foods should be a pure pleasure and what you do at least 80% of the time. But remember there definitely is room to a enjoy a little treat at the end of a good week, especially if you’ve been active. As long as you watch the portion size and don’t overdo it!
Supplements and cholesterol
Dr Amanda’s Answer
There are several dietary components that can help to reduce high cholesterol levels and reduce your risk of heart disease. By relying on shakes you will definitely miss out on many of these benefits you could have gained from having wholesome foods instead. But of particular concern to me is the CLA and testosterone-booster supplements, that I advise you to stop taking with immediate effect. Fortunately we have good quality studies on these 2 particular supplements available, from which we now know that both have negative side-effects, such as increasing your risk for heart disease, and should therefor not be used.
Efficacy?Good-quality testing in normal, active individuals have shown that is does NOT effective for fat-burning nor weight loss.
Safety? But, it has shown a tendency to increase ‘Lipoprotein a’ levels in your blood, which is linked to increased risk of heart disease (your Lp(a) levels might already be increased due to your genetics, you definitely don’t want to be taking supplements that might increase this further). The other negative effect is that it could decrease your HDL or ‘good’ cholesterol – high HDL is good as it helps to remove cholesterol from your blood and protects you against heart disease.
Testosterone-boosters: (or any of the “pro-hormone” supplements claiming to boost hormone levels)
Efficacy? The high-quality studies in healthy, active individuals (including body-builders) show overwhelmingly that it does not provide the increases in muscle size, strength, fat-burning that is promised on the label.
Safety? But, the experts have found and warn against the increased risk of heart disease when using these types of supplements – it increases bad LDL and decreases good HDL cholesterol levels. This means increased plaque formation, clogging up your arteries, leading to heart disease, heart attack, stroke.
The medical experts also link the use of these supplements to a risk for cancer development – especially prostate and pancreatic cancer.
Despite what the product label says or the manufacturer claims, the majority of supplements available on the market has not been properly tested to prove its efficacy nor, most importantly, it’s safety…
In your case in particular, it seems clear that the risk(s) of taking these supplements far outweigh the potential benefits.
Focus the time, energy and ‘budget’ on a diet and exercise routine that will support your goals (- fitness, physique, health and longevity)!
All the best
Could you recommend a supplement for a 55 year old male who likes keeping fit?
Dr Amanda’s answer:
Well done on keeping healthy and fit – sounds like it’s a lifestyle choice which is the very best investment you can make in your life!
In general, the healthiest and safest option is to get your energy, nutrient and ‘health-boosters’ from eating a wholesome, balance diet (and staying active like you currently do). Wholesome food CAN provide you with the full package. The other good news is that as a Virgin Active member you can get detailed dietary guidance and an eating plan (tailored for you age, gender, BMI, activity level and goal) when you access your private Virgin Active member portal. Login to myvirginactive.co.za, answer a couple of questions and you will instantly get guidance on nutrition and exercise, designed by experts.
There are also many articles on various nutrition and fitness topics with tips and tools that can help keep your health and fitness journey interesting and fun!
Energy drinks and diabetics
Dr Amanda’s answer:
The short answer is ‘yes’, but it’s not completely a “one-size-fits-all” approach and depends on a range of factors. Here are a couple of pointers for you to consider:
Firstly, exercise is great as it helps the body to use glucose (and control blood sugar levels) more easily and effectively. However, with this there may be a higher risk of hypoglycaemia (low blood sugar) during exercise, particularly when using insulin. So, because exercise makes you more insulin sensitive, one might need to reduce your insulin dose (or oral glucose meds), combined with having a wholesome carb meal ~3 hours before exercise and refuel with carbs during long exercise sessions to prevent hypoglycemia. Adjusting your insulin dosing should be based on keeping a detailed food, exercise (type/duration) and blood glucose diary which you then discuss with your doctor (GP). Secondly, note that starting exercise on a too low (<4 mmol/L) or too high (>14 mmol/L) blood glucose level is not recommended.
How good are your blood glucose levels before exercise?
This may all depend on the timing and type of your last meal and timing of your glucose medication or insulin injection (type and dose of insulin and where you injected). And then also on what type of exercise you plan on doing? This is a rather complex aspect all on its own! However, let’s say your blood glucose control is relatively good (levels typically between 4 to 8 mmol/L), then the next aspect is more to the point in answering your particular question:
How long and intense are your exercise session(s)?
You typically won’t need an energy drink if you exercise for less than 60 min. and your blood glucose is well-controlled before the workout.
But diabetics who exercise at moderate to high-intensity for longer than 60-90 m. can benefit from the typical carb energy drink or snack to provide fuel to the working muscles, boost performance and help prevent hypoglycaemia. If your blood glucose levels are well controlled then the amount and type of carbs during exercise are no different to that for non-diabetics i.e. 30-60g of predominantly high GI carbs per 60-90 min. of exercise (see the “energy drink” article). To get the ideal amount and type that works for you, you may need to play around a bit with amount and type of drink whilst measuring your blood glucose at certain intervals – this may take a bit of planning and effort, but is totally worth it!
Similar to non-diabetics, a high GI drink is preferable and should be well tolerated (and has the advantage of the ideal rate of energy delivery to the working muscles). Most of the ready-to-drink brands on the market are moderate to high GI and fine to use. If all else fails and you feel a ‘hypo’ developing, then flat Coke (or any type of regular cooldrink) will also suffice. Research has also shown that it makes little difference whether your carb beverage is in liquid (drink) or solid form (food), as long as it’s easily digestible. So, go on what you prefer and works best for your blood glucose control and performance.
Well done on exercising – exercise is after all the THE best “medicine”!
Slimming products in HIV positive individuals
Dr Amanda’s answer:
My advice would be to first check the particular slimming product with your Doctor (GP) and to also get specific guidance as to whether weight loss would be in your best interest.
In general, I would advise against the use of slimming products in HIV positive individuals – the non-prescription types in particular, for the following reasons:
- The majority of over-the-counter slimming products have NOT been tested thoroughly enough to ensure that it is safe (not harmful to your health) or effective. In particular, it is even more unlikely that it would have been tested for safety in HIV positive individuals.
- These slimming products may contain ingredients (such as herbal mixtures) for which the side-effects are unknown.
- For people who are on HIV medication therapy, the ingredients in slimming pills and potions may ‘clash’ with the HIV treatment – so it may interfere with the treatment and have negative side effects.
Weight loss for an HIV positive person, especially with non-prescription slimming products, might not be in the best interest of one’s overall health. Managing your weight through a healthy diet and regular physical activity is key and will be the safest approach, short- and long-term.
All the best!
Overweight due to medication
Dr Amanda’s Answer
Without details about your medical condition it’s difficult to assist with specific advice, but perhaps you could benefit from the advice that typically works for people struggling to lose weight (body fat):
- Stick to a meal plan with set portion sizes that are customised to meet your calorie requirements and needs. You could start by following your Virgin Life Care meal plan (and select ‘weight loss’ as a goal). Or, depending on your medical condition I would suggest you invest in seeing a Registered Dietitian.
Either way, the key is tight portion control and eating the foods from the various food groups in the correct amounts. Once you do that and you still don’t see any results, then one can systematically start scaling down on portion sizes (but still within reason) until you start seeing results.
- Simultaneously, start doing daily structured exercise of at least 30 minutes in duration, or if you are already active then systematically increase the duration or intensity of your sessions.
This need not be a ‘hectic’ workout – anything that you can manage and enjoy. You can start by doing sets of 5 minutes with 3-5 minutes rest in-between.
- If your medical condition is limiting you, then I would highly recommend seeing a Registered Biokineticist who can assist with appropriate exercises that suit your ability and needs.
‘Exercise is the best Medicine’ and could be a valuable part of your treatment plan. Any type and amount of exercise could be beneficial! The more you do, the bigger the health benefits, and the best part is that the benefits are there regardless of losing weight.
- Try to remain active throughout the day
- Limit your time sitting by standing in meetings or while talking on the phone
- Do some exercises or stretches while watching TV
- Dedicate any sitting time to walking, gardening, house cleaning activities etc.
All the Best!
I’m exercising but my BMI is increasing. Any advice?
Dr Amanda’s answer:
It is great that you are following a regular exercise routine as it’s a great investment in your health and longevity. Keep it up. As far as the increase in BMI goes, I would suggest the following:
Tracking your weight and BMI is not the best way of actually knowing if you are increasing in muscle mass (good thing) or body fat (not so good). Maintaining or increasing your muscle mass is good as it increases your metabolic rate and helps you to burn fat, even while you’re asleep. As you get older your muscle mass and metabolic rate naturally declines and exercise is a good way of preventing this decline.
It would be great to track your body fat to ensure that it stays within the healthy range. If you are a Virgin Active member then use the Tracker in the health club to track both your BMI and body fat percentage.
How to keep your body fat in a healthy range
To help keep your body fat in a healthy range, you might need to pay a bit more attention to what, and most importantly, how much you are eating. Is your food intake really matching how much physical activity and exercise you are doing to burn energy, or are you overdoing the eating a bit?
OR, you might want to up your exercise efforts a bit by increasing your intensity, duration or frequency of your training sessions. Take it a step up if possible.
OR do a bit of both.
I suggest you keep a exercise and food diary for at least a week – by doing this you will become aware of what you are eating versus how much you are exercising.
Start by decreasing the frequency and portion sizes of the calorie-dense foods such as high-fat foods (marg, butter, oils, fried or creamy foods, chips, cheese, nuts, fatty meats or processed foods), take-aways or eat-out foods, as well as the sugary foods or drinks you have. Take stock of these and make some adjustments where needed.
After that you might also need to take stock of your portions sizes of the “good” foods from the other food groups (meat, and make tweaks these if needed. Portion control = calorie control = weight control.
Remember to fill up on the fruit and veggies (salads, soup, on sandwiches) and drink at least 6-8 glasses of water a day!
Hope this helps!
On an exercise and eating plan for 6 weeks but not losing enough weight. Please advise
Dr Amanda’s answer:
Well done on doing a fitness assessment and losing 3.2 kg’s – the equivalent of 13 x 250g blocks of butter! And you’ve lost it at the ideal, healthy rate of about 0.5 kg per week, which also improves your chances of keeping it off over the long-run.
Remember that your current age, weight (or body fat %) will determine your rate and amount of weight loss. More importantly, it will determine if further weight loss would be a healthy option for you.
If you can benefit from further weight loss: Then you probably need to kick things up a gear!
People commonly over-estimate the amount the calories they expend during exercise (and the rest of the day) versus how much they eat / drink. To boost your metabolism I would recommend that you either increase the intensity, and/or the duration of some of your exercise sessions, and or add another exercise session to your week.
Did you know?
The amount of exercise recommended for weight loss is 60-90 minutes of moderate-intensity exercise, most days of the week (or approx. 300 minutes per week) or 150 minutes of more vigorous-intensity exercise per week.
Start scaling down the portion sizes in your meal plan, and/or exclude the snacks inbetween meals.
(this will automatically be done next time you re-do your fitness assessment seeing that you weigh less and therefor need fewer calories).
and – where possible boost your activity levels during the rest of the day, for example, by breaking your periods of sitting (at desk, in front of computer, TV etc.) by periods of standing (when talking on the phone, during meetings), take the stairs, park far away and walk further and so on.
Try these and let me know how it goes!