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Creatine For Athletes

Properly used, creatine monohydrate improves performance – every time. In a comprehensive research review in 2010, the International Society of Sports Nutrition, composed mostly of university sports scientists and top trainers, gave creatine a strong thumbs up.(1)
If you have used creatine monohydrate and not had good results, you are using the wrong form of creatine, or oxidized creatine, or using it wrongly. There is a lot of inferior creatine for sale out there, and a lot of bad advice on how to use it. Here I will briefly explain creatine, and give you a creatine supplementation program that will certainly improve your sports performance.
How Creatine Works
Adenosine triphosphate (ATP) is our energy molecule. It is composed of one molecule of adenosine and three molecules of phosphate. Muscle can store pre-formed ATP for enough energy for only 4-5-seconds of sprinting at maximum speed. . This energy is instant. You can use it as fast as your brain can react to move your legs.
Creatine phosphate is the second string of your energy cycle. When ATP releases energy to power muscular contraction, it discards one of its phosphates to become adenosine diphosphate (ADP), ADP then has to be regenerated back into ATP by creatine phosphate in the muscle.
After all the stored ATP is gone, muscle stores enough creatine phosphate to continue sprinting for another 5-6 seconds. But only the first five seconds of sprinting is at maximum speed. The 5-6 seconds after that is at a slower speed because creatine phosphate is not instant. It takes time to regenerate ADP to ATP.
Creatine phosphate in muscle donates its phosphate molecule, which turns ADP back into ATP to fire again. Most of the newly empty creatine molecules from the creatine phosphate then catch the phosphates discarded from ATP to regenerate muscle creatine phosphate again. The creatine that escapes this cycle is excreted as creatinine through your kidneys in urine.(4)
So we get 5 seconds of maximum speed, then 5-6 seconds of near maximum speed. That`s why the sprint is 100 meters. And, as every sprinter will tell you, the second half of the race is all about fighting the slow down. .After 100 meters, we have to rely on glycogen and fat to make ATP, a much slower process, which is why the 200 and 400 meters are a lot slower.
Scientists have known this basic biochemistry for a century. But no one worked out how improve it chemically until Paul Greenhaff and Roger Harris at the world famous Karolinska Institute in Sweden in the late 1980s. They knew the research showing that muscle creatine levels in wild animals are much higher than in domestic animals. This difference was explained by the higher level of exercise required in the wild.
Greenhaff and Harris reasoned that athletes might also benefit from increasing their creatine levels. In very smart experiments, they showed that creatine monohydrate supplements, combined with strenuous exercise, could increase an athlete’s muscle creatine by up to 50%. They found that the creatine supplementation also increased maximum muscle contraction by 5%, (3)
After examining the research, a number of trainers, including me, started to use creatine monohydrate with athletes training for the 1992 World Track and Field Championships and the 1992 Barcelona Olympics. Top British coaches used it also. The London Times reported on August 7 1992 that Sally Gunnell trained with creatine. when she won the 400 meter hurdles Gold Medal. In 1993, she broke the World Record.
Linford Christie also trained with creatine for the 1992 Barcelona Olympics, and won the 100-meter Gold Medal in 9.96 seconds, at age 32, the oldest sprinter to do it.
Since then we have used creatine as part of our program at the Colgan Institute. The latest research not only confirms the early work at the Karolinska Institute, but extends it handsomely. After more than 1000 controlled studies, of both recreational and elite athletes, creatine is still coming up trumps. In a review of 500 of these studies, eminent sports scientist Richard Kreider, of Texas A&M University, found the rare result that not a single one of the studies showed a negative effect of creatine on performance.(6)
Overall, together with daily training, creatine monohydrate increases muscle creatine phosphate stores by 10-40%. Done correctly, creatine supplementation improves maximum power by 5-15%, and maximum muscle contraction by 5-15%. In running, it improves single-effort sprint performance by up to 5%, and sprint repeats by up to15%.(6) There is no other nutrient supplement that gets even close to such results.
Creatine Also Works for Endurance
The fastest you can go in an endurance event is your anaerobic threshold, (similar to but not the same as VO2max, or lactic acid threshold). When doing so you are constantly tapping into the edge of the creatine system, to provide a little extra energy. So It makes sense to load the creatine system to give you a bit more reserve at the anaerobic threshold. Then you can run just that bit harder, without emptying your stored ATP and going completely anaerobic and dying within a couple hundred meters.
In a recent study representative of the evidence, researchers measured the endurance performance of elite rowers. Eight elite rowers received 20 grams of creatine monohydrate daily for five days. Equivalent controls received a placebo. The creatine subjects raised their lactic acid threshold significantly, and showed a significant improvement in endurance performance.(7)
A recent study is particularly relevant to the track sessions (Chapter 5) and the strength exercise sessions (Chapter 6) of the Colgan Institute Running Speed Program. Forty-two male recreational athletes were tested for maximum oxygen consumption (VO2max) on a cycle ergometer. They were then randomized into a group given four weeks of high intensity interval training ( 5 x 2-minute sets with 1-minute rests), plus 10 grams of creatine per day, or a placebo group given only the training. The creatine group significantly increased their power at sub-maximal loads, to almost double the improvement of the control group without creatine.(9)
Creatine plus Carb Loading
For the last seven years, we have used creatine loading immediately prior to carb loading for marathon training, because each strategy pulls a lot of water into the muscle cells and enhances the other. In a representative study, sports scientist Arnold Nelson and colleagues, at Louisiana State University, tested 12 young, active men on two glycogen loading schedules, one of which was preceded by five days of creatine loading of 20 grams per day. The creatine loading significantly enhanced the glycogen loading by 16%.(10)
Creatine and Kidney function
Creatine loading greatly increases kidney creatinine excretion. At the Karolinska Institute, Roger Harris showed that 80 kg athletes given 30 grams of creatine monohydrate per day excreted 40% on the first day, rising to 68% on the third day.(11) Because of these findings, some medical folk have warned athletes that such elevated creatinine clearance could damage the kidneys.
After numerous studies, normal subjects given repeated cycles of creatine loading, do not show evidence of kidney damage. In a well-controlled study representative of the evidence, healthy men aged 18-35 were given a moderate intensity aerobic training program, plus 10 grams of creatine per day, for three months, and compared with controls given only the training. Serum creatinine remained high in the creatine group throughout the training. Other indices of kidney function showed no damage.(12)
The best test of creatine and kidney function has just been completed. Creatine supplementation is known to improve insulin function. But it was thought to be risky as a medical intervention in diabetes, because diabetics are likely to have compromised kidneys already. In a study to examine whether creatine has therapeutic value, researchers at the University of Sao Paulo, School of Medicine, gave patients with Type-2 diabetes 5 grams of creatine per day for 12 weeks, plus an exercise program, and compared them with controls.
The creatine improved glycemic control in the patients, and lowered their hemoglobin-A1c (HBA1c) an accurate measure of blood sugar stability. The creatine showed zero adverse effects on kidney function.(13)
In agreement with numerous sports scientists, and after 20 years of use with athletes without adverse reports, we are confident that creatine loading, properly done, is a safe and very effective strategy to improve performance in athletes in normal health. Here is how to do it.
Form of Creatine
Use only pure creatine monohydrate, the form used in almost 100% of the successful research. There is a lot of poor quality creatine out there with ludicrous advertising claims trying to sell it. All other forms of creatine are simply marketing hype, with no controlled studies to support them.
Do not buy big tubs of creatine. Keep your creatine in tightly closed air-proof, light-proof containers. Use small containers, and use them quickly to minimize oxidation. Best is single-serve airtight packets of creatine.
For maximum effect load creatine in divided doses, one dose before your workout and another dose within 30 minutes after each training period together with your protein shake. A
Amount of Creatine
Bodyweight, 50 kg (110 lbs), 4 x 3 grams per day. Bodyweight, 65 kg (143 lbs), 4 x 4 grams per day. Bodyweight, 80 kg (176 lbs), 4 x 5 grams per day.
We have measured case studies of continuous and intermittent use of creatine in athletes for up to four years. Other variables, such as injury or cessation of training aside, the plotted slope of improvement in performance continues to rise as long as the creatine is used properly, in combination with training. In athletes who cease or change the routine of creatine supplementation, but continue training, the slope of improvement declines. Used properly, creatine works every time to enhance athletic training and performance.

us-en-amped-power-webWe are now using the new AMPED Power supplement that the Isagenix Science team, which includes Dr. Colgan, has just created. It combines creatine monohydrate with citrulline and nitrosigine (a new form of l-arginine), making this supplement the best for athletes before and after your workout. To learn more about this supplement go to the Colgan Institute website.
References
1. Greenhaff PL. Influence of oral creatine supplementation of muscle torque during repeated bouts of maximal voluntary exercise in man. Clin Sci (London) 1993;84(5):565-571.
2. Greenhaff PL. Creatine and its application as an ergogenic aid. Int J Sports Nutr, 1995;5:S100-S110.
3. Balsom P, et al. Creatine in humans with special reference to creatine supplementation. Sports Med, 1994;18:268-280.
4. Prommer N, et al. Total hemoglobin mass and blood volume of elite Kenyan runners. Med Sci Sports Exerc, 2010;42:791-797.
5. Saltin, B., et al. Aerobic exercise capacity at sea level and at altitude in Kenyan boys, junior and senior runners compared with Scandinavian runners. Scandinavian Journal of Medicine & Science in Sports 1995;5:209-221.
6. Kreider RB. Effects of creatine supplementation on performance and training adaptations. Mol Cell Biochem. 2003;244(1-2):89–94. doi: 10.1023/A:1022465203458.
7. Chwalbinska-Moneta J. Effect of creatine supplementation on aerobic performance and anaerobic capacity in elite rowers in the course of endurance training. Int J Sport Nutr Exerc Metab. 2003;13(2):173–183.
8. Nelson AG, et al. Creatine supplementation alters the response to a graded cycle ergometer test. Eur J Appl Physiol. 2000;83(1):89–94. doi: 10.1007/s004210000244.
9. Kendall KL, e al. Effects of four weeks of high-intensity interval training and creatine supplementation on critical power and anaerobic working capacity in college-aged men. J Strength Cond Res. 2009;23(6):1663–1669.
10. Nelson AG, Arnall DA, Kokkonen J, Day R, Evans J. Muscle glycogen supercompensation is enhanced by prior creatine supplementation. Med Sci Sports Exerc. 2001;33(7):1096–1100.
11. Harris R, et al. Elevation of creatine in resting and exercise muscles of normal subjects by creatine supplementation. Clin Sci, 19992;83:367-374.
12. Gualano B, et al. Effects of creatine supplementation on renal function: a randomized, double-blind, placebo-controlled clinical trial. Eur J Appl Physiol, 2008;103(1):33-40.
13. Gualano B, et al. Creatine in type 2 diabetes: A randomized, double-blind, placebo-controlled trial.Med Sci Sports Exerc, 2010 Sep 24. [Epub ahead of print]
14. Watson G, et al. Creatine Use and Exercise Heat Tolerance in Dehydrated Men J Athl Train, 2006;41(1):18–29.

Are You Acidic?

The abbreviation pH stands for power of hydrogen. It is a measure of the hydrogen ion concentration in a solution. An acid is a chemical that releases hydrogen into a solution. An alkali is a chemical that removes hydrogen from a solution. The acidity or alkalinity is critical to body function because many of your essential chemical reactions work properly only within a narrow range.

As shown below, a solution with a pH of 7.0 is neutral. Above 7.0 is alkaline; below 7.0 is acid. Your blood is slightly alkaline at 7.35-7.45, a balance your body tries to maintain at all times. If blood becomes too acid, as is the usual case when eating modern food, it will draw calcium and other acid-buffering minerals from your bones in order to raise the pH back to normal.1

pH scale bw

Various parts of the body have different acid/alkaline balances depending on what you eat and what you do. Skeletal muscle pH varies from 6.0-7.2, depending on the exercise you do. Exercise makes muscle more acid. At rest, skeletal muscle is neutral at 7.0. The healthy heart, brain and liver are all slightly alkaline between pH 7.0-7.2.

Your saliva varies between 6.0-7.4, depending on the ambient level of acidity of your body overall, and what you put in your mouth. Urine can get very acidic, ranging in pH from 4.5-8.0. Your urinary tract will not be comfortable at a pH of 4.5-6.0. And, if your saliva gets down to an acidity level of 4.5 pH, it will gradually burn the enamel off your teeth.

Almost all foods release either acid or alkaline ash (bicarbonate base) into your gut and bloodstream. Because of the large amount of plant material in their diets, the gut, blood and organs of our ancient ancestors were almost always alkaline, probably between pH 7.0-7.5, except when they gorged on meat after a successful hunt. In contrast, the average American and Canadian diet is acidic, releasing about 50 milli-equivalents of acid each day.2

That’s not very acidic but it is very damaging. The average citizen is constantly in a state of acidosis of about pH 6.5. That is why antacids in America make $7 billion every year, and rising. If we simply made our diets more alkaline, almost all that self-induced discomfort, and the gastrointestinal disease it turns into, would disappear.

Acidity Causes Osteoporosis

In my book Nutrition For Champions (2007) I examine how excess salt and low levels of potassium in the average diet cause chronic acidosis. Salt (sodium chloride) is acidic because of the chloride ion. The major problem with acidosis in the blood is bone loss. Even low-grade acidosis causes the body to pull calcium from your bones, and is a major risk factor for osteoporosis. Osteoporosis is a major epidemic in the US and accelerating out of sight, and it is never prevented simply by taking extra calcium.

Bone is extremely sensitive to acidity. In their research on bone health, experts Russell Jaffe and Susan Brown provide excellent, simple explanations of how we destroy our skeleton. All cola drinks, for example, vary between pH 2.4-3.2. That’s acid! To buffer it, and return the pH of the system to normal after drinking a can of cola, your body needs to use about 4000 mg of calcium and a lot of water.3 Daily calcium intake can’t cut it, so the balance, well, a lot of it, because potassium and other nutrients also buffer acid, has to come from your bones. Over a decade, daily cola drinks will eat up a lot of bone.

Alkalinity Builds Bone

Bringing your body back to the slightly alkaline state it was designed for, prevents calcium loss from bone. In a representative study, Anthony Sebastian and colleagues at the University of California, San Francisco, examined the effect of potassium supplementation. They selected a group of post-menopausal women who showed the typical American condition of low-level chronic acidosis in their blood, and supplemented them with 60-120mmol per day of potassium bicarbonate (pH, 8.2) an alkaline chemical. The supplement neutralized the excess acid in the subjects’ blood almost overnight. During the next two weeks of supplementation, their urinary loss of calcium declined dramatically, and measures of bone loss reversed to show bone formation. Their acid excretion declined by 80%.4

Seems too easy doesn’t it, with osteoporosis rampant in America. It is that easy, if you respect your miraculous genetic design and eat accordingly. I have to admit though, that potassium bicarbonate, (KHC03), takes particular advantage of the way we function, advantage that puts it ahead of a plate of green veggies. As potassium bicarbonate circulates in the bloodstream the lungs do the job they are designed for and remove the carbon dioxide (CO2). The potassium bicarbonate then becomes dilute potassium hydroxide, (KOH), one of the most caustic alkaline substances around, with a pH of 13.0. In chemistry, its common name is potash lye, a very corrosive alkali used in making bleach and alkaline batteries. So don’t play with this supplement on your own. Even in the stomach it can upset you badly. Your physician knows the safe medical forms and the way to take them.

Test Your pH

You can get a reasonable estimate of your own acid/alkaline balance, and quickly ascertain if a change in diet is needed, or if a change you make is working. Obtain pHydrion strips from your local pharmacy. Measure your first urine in the morning. It should range between 6.2-7.0 pH. If it is consistently below 6.2, you are probably too acidic. Your buffering and elimination system cannot cope with the acid in your food.

Measure your fasting saliva in the morning also. It should range between 6.5-7.5 pH. If it is consistently below 6.5, your body is probably producing too much acid, or cannot eliminate the acid efficiently. Either way, you need to change your food.

Go Alkaline

Our ancient diet was alkaline, producing a net input of bicarbonate of about 85 milli-equivalents per day. We lost this healthy state because of development of multiple high-acid foods. Cereal grains are big villains: wheat, rice, corn, rye, spelt, millet, and barley are all acid-producing. The only cereals that are nearly neutral are old-fashioned, uncut oatmeal and wild rice.5

Made from grains, sugar and fat, almost all baked goods, jams, jellies, and puddings are acid-producing. All fish, shellfish, dairy products and meats are acid-producing, too, but we need some of these for their protein content. Some nuts and seeds are acid; others are alkaline. Alkaline-producing nuts are almonds and chestnuts.5

As you might guess from our evolution, all leafy green vegetables are highly alkaline. Most other vegetables are, too. So are citrus fruits. Even though a lemon or lime may taste acidic, it produces a net input of bicarbonate inside you. Only the odd fruit is acidic, such as pomegranates and some tomatoes. The ideal diet is about 75% alkaline –producing, 25%acid –producing. Our quick list for an alkaline diet is given below. Most legumes, however, are acidic. Some scientists contend that legumes were only minor items in the pre-agricultural diet.15

In all of us, eating an alkaline diet not only saves our bones. It also reduces the acid excretion load on our kidneys, so that they function better and last a lot longer. And it saves us from a whole spectrum of related illnesses, not the least of which is muscle loss, which occurs when the ambient pH level of the blood is acid. Muscle loss occurs both in acidic young athletes, as they add to the background acidity with a whole lot of acid produced by training. It also occurs slowly but inexorably in all acidic adults as they age.6 Lose your muscle and you lose the source of your glutamine that supports the immune system. Then you become subject to every wandering microbe seeking an easy lunch.

To help keep your kidneys and liver functioning at optimal level and your whole system in pH balance we recommend a regular cleanse day, about once every few weeks. This will help to re-set your system especially if you have trouble with acidity. To see what cleanse system we use visit www.drmichaelcolgan.com or www.colganinstitute.com.

  1. Buschinsky DA. Metabolic alkalosis decreases bone calcium efflux by suppressing osteoclasts and stimulating osteoblasts. Am J Physiol, 1996; 271:F216-F222.
  2. Sebastian A, et al. Estimations of the net acid load of the diet of ancestral pre-agricultural Homo sapiens and their hominid ancestors. Am Soci Clin Nitr, 2002; 76:1308-1316.
  3. Brown SE, and Jaffe R. Acid-alkaline balance and its effect on bone health. J Integ Med, 2000; 2:1-8.
  4. Sebastian A, et al. Improved mineral balances and skeletal metabolism in post menopausal women treated with potassium bicarbonate. New Engl J Med, 1994; 330:1776-1781.
  5. I am indebted to Dr. Russell Jaffe, Senior Fellow of the Health Studies Collegium for information on acid-producing and alkaline-producing foods. It is the best I have read.
  6. Alpern RJ, and Sakhaee S. The clinical spectrum of metabolic acidosis: homeostatic mechanisms produce significant morbidity. Am J Kidney Dis, 1997; 29:291-302.

p29616960-4In gyms all over, I see hundreds of folk pounding treadmills and ellipticals in vain attempts to lose body fat. Most are miserably unsuccessful, mainly because they don’t understand the body’s amazing design to store fat and guard it as its energy reserve, and release it only to exactly the right stimulation.

Aerobic exercise does burn some fat, but nowhere near what most folk think. To lose any fat at all, you first have to coax the adipose cells to release it. Then you have to oxidize the fat, that is, mix it with a whole lot of oxygen to turn it into energy. That requires a lot of deep breathing, roughly 8 times the usual person’s breath while walking (1).

High school chemistry will tell you that fat molecules are mainly carbon. Given enough oxygen they are turned into carbon dioxide and expelled through your breath. Your lungs are the final exit point for most body fat. Unless you take in much more oxygen than usual, you haven’t a prayer of losing fat (1).

Mixing the fat with oxygen happens mainly in your muscles. So you also need to have a lot of muscle to burn fat well. Most folk who come to us for fat loss programs, don’t have enough muscle to burn the fat, and never get enough oxygen to do it anyway.

It’s easy to lose water and muscle, which is what happens on most fat loss programs. But it’s not easy to lose substantial fat. If you follow the rules dictated by the design of the human body, however, it works like a charm. People who don’t like rules, or mistakenly think there are magic ways to slim down in 30 days, often want to just grit their teeth, get their head down, and sweat the fat off. Not going to work. Sweat is a measure of water loss, not fat loss.

Anyone who has run a sweaty marathon knows well they lost a lot of water, but very little fat. From those we have measured, an average 4-hour marathoner is lucky to lose a quarter pound of fat while running 26.2 miles. Some folk who stuff with, gels, bars or other ineffective goop during a marathon, actually GAIN fat. They may be 7 lbs lighter from water loss at the finish, because the carbs inhibit water absorption from their gut, but their weight rebounds to include more fat within 24 hours.

Here’s a typical research study that measured fat loss in men and women over a 20-week training program for a half-marathon. They did 20 weeks of fairly intense endurance exercise. On average they did 80 workouts each. Workouts were all runs of 1-3 hours. The average training time over the whole study was 150 hours per runner.
Note well. That is 150 HOURS of aerobic exercise. For the average person, that’s 150 days of workouts at the gym. If you go 3 times a week, that’s a year of workouts.

Over the 20 weeks of training in the study, that is, 80 workouts totaling 150 hours, the men lost an average of 5.3 lbs of fat. That’s only half-an-ounce of fat loss per workout. The women lost an average of only 2.0 lbs of fat in the 80 workouts. That’s a tiny one-quarter ounce of fat loss per workout (2). That’s about the best you can expect from most exercise programs for fat loss.

The average person doing aerobic exercise at the gym to lose fat, may go three times a week and spend an hour on the treadmill. That’s 3 hours per week of the wrong exercise. Under the very best conditions, they will lose only about one ounce of fat per week. If they watch their diet, and work out religiously, every single week for a year, they can lose 52 ounces. That’s 3.25 lbs of fat loss in a year. Divide the 20 lbs of fat they need to lose by 3.25. It will take more than 6 YEARS of these workouts to lose 20 lbs of fat.

This miniscule loss of body fat with the usual aerobic exercise is confirmed again and again by science (2,3). But it’s very depressing for the average person, because the weight loss media, especially shows by prick-me-dainties like the Wizard of Oz, claim just the opposite. To listen to them you just need to walk around gobbling raspberry ketones to flush body-fat like magic, or green coffee beans, or whatever hokum is the magic of the month.

Unfortunately, the Wizard sells no magic, as the Federal Trade Commission has recently ruled, fining him and others on his show $9 million for misrepresentation. The real magic lies only in the science. Follow it and you can become permanently slim. Look at the photo at the top of this article. It shows my youngest daughter Tamara, age 23, at 11.9% bodyfat. It also shows me, age 75 at 5.3% bodyfat. It works with anyone at any age.

Here are 10 top things from the Colgan Team Program. They are mandatory on our program, and anyone failing to comply is politely asked to leave, because we know from long experience they are not going to succeed.

1. You will get 8 hours sleep per night. We all have a built-in circadian clock in the brain linked to light. Our circadian clock regulates almost everything, 24 hours a day, for life, including sleep-wake cycles, hormone cycles, brain growth, muscle growth and recovery, and, of course, fat loss. (4-6). The extra sleep is essential to get the fat loss and muscle growth you need.
2. You will work out every day, seven days a week, so that you provide an adaptive stimulus to the body each day, This adaptive stimulus will be used by the sleep recovery system that night, for fat loss via the breath, and for muscle recovery and growth. Do not lose a single circadian cycle. Once passed, the opportunity for growth during each cycle is gone forever (4-6).
3. You will join a yoga breathing class for two sessions each week to raise your habitual breathing volume by 6-8 times, to get the necessary oxygen to oxidize the fat (1).
4. You will work out in the mornings, the most anabolic time of the day (7).
5. You will work out on an empty stomach, except for a strong cup of coffee, or a proprietary energy shot we use, taken 30 minutes before workout, to maximize the anabolic response of your muscles (8).
6. Each day at the gym, first you will do 30 minutes aerobic exercise. You will do this exercise in the fat-burning zone. This is essential to make the complex hormonal changes that switch the body from burning mainly sugar to higher fat burning (7). The aerobic gym device you use does not matter. We advise clients to jog to the gym to fulfill this requirement if possible.
7. Each day at the gym, you will do 60 minutes of a resistance program individually designed for your body, age, and condition. We set a goal of 2-4 ounces of muscle gain per week, depending on gender, age, weight, and condition. With the aerobic exercise, each workout burns an average of 450 calories, with about 225 calories from sugar and 225 calories from fat. The resistance exercise, plus our nutrition program prevents muscle loss. As muscle increases, you will burn more fat, about 500 calories per workout, with about 250 calories from fat. Our aim is to burn 8 ounces of fat per week.
8. You will not slurp juice, or eat cookies or muffins or fruit or chocolate or whatever after workout. Instead, you will have a whey protein concentrate shake containing 35 grams of protein, within 30 minutes of finishing. This timing is essential to take advantage of the anabolic window of 90 minutes after workout, the period when the body will take most protein into muscle (7).
9. You will hire a mentor. More than 90% of people who try to lose fat fail repeatedly. It’s a very hard job alone. You need a personal mentor. Find an expert, someone who has done what you want to do, someone who is a living example of what they know, someone who walks their talk along the same path as yourself, lifelong.
10. You will follow the Team Colgan Nutrition Program – religiously.

Doing 10.5 hours exercise plus 2 hours yoga breathing a week is a lot of work. But, combined with our nutrition plan, it works like a charm for your health. An average woman of 30-something can reliably lose 20 lbs of fat, and gain 5 lbs of muscle in 40 weeks, without disrupting hormonal systems. With more muscle to burn the fat, and no hormonal drag, they are in a good position to stay that way for life. We have several clients who have lost over 100 lbs, and gained 20 lbs of muscle in 2 x 40 week programs, and have improved their bodies and their lives permanently.

Our results are in sharp contrast to fat loss achieved by dieting. Contrary to the muscle gain under our system, the average muscle loss with dieting is about 25% of the weight lost (2,3) Dieting also induces long-term detrimental hormonal changes that make fat regain almost inevitable (3,9). Also, the reduction of muscle mass makes fat loss much harder in repeat attempts. Research shows that approximately 97% of people who lose weight by dieting regain it, and more, within 2 years (2). In sharp contrast, our records show that almost all those who have stayed with us long-term, have maintained a slim body for up to 21 years.
If you think you might be a fit for our winning team, go to drmichaelcolgan.com

1. Meerman R, Brown AJ. When somebody loses weight, where does the fat go? BMJ 2014: 349:g7257 doi:10.1136/bmj.g7257 16 December 2014.
2. Miller WC, Koceja DM Hamilton EJ. A meta-analysis of the past 25 years of weight loss research using diet, exercise or diet plus exercise intervention. Int J Obesity, 1997;21:941-947.
3. Sumithran P et al. Long-term persistence of hormonal adaptations to weight loss. New Engl J Med. 2011; 365:1597-1604.
4. Aldabal L, Bahammam AS. Metabolic, endocrine, and immune consequences of sleep deprivation. Open Respir Med J. 2011;5:31-43.
5. Maury E, et al. Circadian rhythms and metabolic syndrome: from experimental genetics to human disease. Circ Res. 2010 February 19;106(3): 447–462.
6. Cipolla-Neto J1, Amaral FG, Afeche SC, Tan DX, Reiter RJ. Melatonin, energy metabolism, and obesity: a review.J Pineal Res. 2014 Mar 21. Doi 10.1111/jpi.12137.
7. Colgan M. Optimum sports Nutrition. New York: Advanced Research Press, 1993.
8. Van Proeyen K, et al. Beneficial metabolic adaptations due to endurance exercise training in the fasted state. J Appl Physiol. 2011 January; 110(1):236–245.
9. Saderi N, Alteration of biological rhythms causes metabolic diseases and obesity. Reviews Neurology. 2013 Jul 16;57(2):71-8.

Fibromyalgia is a disabling clinical condition of unknown cause. Symptoms include muscle and bone pain, muscle weakness, muscle cramps, leg numbness, chronic fatigue, a foggy mind, and an irritable gut. These symptoms overlap with the symptoms of celiac disease to the extent that cursory diagnosis often mixes the two up.

Conventional medicine offers only symptomatic treatment for fibromyalgia with very limited benefit. Patients who come to us have often been unsuccessfully treated for years on a variety of regimens, including opioid pain killers which inevitably fog the mind further.

There are several things going on here that it took us a while to work out. But I was hesitant to write about them in the absence of controlled trials. The necessary research has just been published, and it supports our ideas that sort out fibromyalgia, celiac disease and gluten.

Conventional medicine teaches that gluten sensitivity is linked to celiac disease, and that one symptom of celiac disease is weight loss. This is often correct. Because of mal-absorption of nutrients caused by their irritable gut, celiac patients tend to be thin. We were puzzled because about half the people we saw, who had been previously diagnosed with “celiac disease”, were overweight. So were about 60% of patients presenting with fibromyalgia.

So we began to routinely to run an antibody test on all patients presenting with fibromyalgia or “celiac disease”, called the anti-transglutaminase test. A positive score on this test is considered a strong marker of celiac disease. Surprisingly, most of the overweight patients presenting either with fibromyalgia or “celiac disease”, had a negative test result, meaning that they were very unlikely to have celiac disease.

So, were their often debilitating symptoms simply gluten sensitivity? Removing gluten from their food constituted a fairly simple treatment that certainly could do no harm. It was very successful. Simple removal of most of the gluten from their diets reduced symptoms dramatically in most patients. The improvement has now continued in some we have tracked for up to 8 years. Some also gradually lost considerable body fat without reducing their food intake, though that was not a major aim of the treatment.

These cases convinced us that gluten sensitivity can cause almost all the symptoms of celiac disease in folk who do not have it. Except, most of those we saw were overweight, not a marker of celiac. But, even though other researchers had reached similar conclusions (1), there was no controlled evidence either way. Now we have some. The first controlled trial was published last November (2). Gluten sensitivity without celiac disease, can cause fibromyalgia, and removal of gluten from the diet is a potent strategy to treat it.
Here is the Mayo Clinic Gluten-Free Diet we use.
ALLOWED FOODS
Beans, seeds and nuts in their natural, unprocessed form
Fresh eggs
Fresh meats, fish and poultry (not breaded, batter-coated or marinated)
Fruits and vegetables
Most dairy products
It’s important to make sure that they are not processed or mixed with gluten-containing grains, additives or preservatives. Many grains and starches can be part of a gluten-free diet, such as:
Amaranth
Arrowroot
Buckwheat
Corn and cornmeal
Flax
Gluten-free flours (rice, soy, corn, potato, bean)
Hominy (corn)
Millet
Quinoa
Rice
Sorghum
Soy
Tapioca
Teff

FOODS TO AVOID
Avoid all food and drinks containing:
Barley (malt, malt flavoring and malt vinegar are usually made from barley)
Rye
Triticale (a cross between wheat and rye)
Wheat
Avoiding wheat can be challenging because wheat products go by numerous names. Consider the many types of wheat flour on supermarket shelves — bromated, enriched, phosphated, plain and self-rising. Here are other wheat products to avoid:
Durum flour
Farina
Graham flour
Kamut
Semolina
Spelt
Avoid unless labeled ‘gluten-free’
In general, avoid the following foods unless they’re labeled as gluten-free or made with corn, rice, soy or other gluten-free grain:
Beer
Breads
Cakes and pies
Candies
Cereals
Cookies and crackers
Croutons
French fries
Gravies
Imitation meat or seafood
Matzo
Pastas
Processed luncheon meats
Salad dressings
Sauces, including soy sauce
Seasoned rice mixes
Seasoned snack foods, such as potato and tortilla chips
Self-basting poultry
Soups and soup bases
Vegetables in sauce
Certain grains, such as oats, can be contaminated with wheat during growing and processing stages of production. For this reason, doctors and dietitians generally recommend avoiding oats unless they are specifically labeled gluten-free.
Food additives, such as malt flavoring, modified food starch and others.

Sapone A, Bai JC, Ciacci C, et al. Spectrum of gluten-related disorders: consensus on new nomenclature and classification. BMC Med. 2012;7(10):13. doi: 10.1186/1741-7015-10-13.
Isasi C, et al. Fibromyalgia and non-celiac gluten sensitivity: a description with remission of fibromyalgia. Rheumatol Int. 2014 Nov;34(11):1607-12. doi: 10.1007/s00296-014-2990-6.

For more information visit Dr. Colgan’s website and our Colgan Institute website.

Where Does The Fat Go?

where does fat goGiven the prevailing flapdoodle that fills the weight loss marketplace, it’s not surprising most folk are confused about what happens to their fat if they manage to lose some. Asking some of our clients we got a wide variety of wrong answers. Most common were,
“Fat is released from fat cells and flows down the body under the skin to come out in sweat and that greasy gunk between your toes”.
Wrong. Only a minuscule bit of fat comes out in sweat {less than 1%} and even less in what is rudely called toejam. Sweat is a measure of water loss, not fat loss.
“Fat comes out in feces and urine, which is why daily regularity is so important for good health.”
Wrong again. Excretion of daily waste is important, because no creature, including us, can live in their own waste, which is made into waste precisely because it is toxic to the body. But the amount of fat loss by this route is negligible.
The body can lose fat in waste by going into the pathological condition of ketosis, and producing ketone bodies from the fat which are then excreted as toxic waste. Reducing food intake to the point of ketosis, however, in not a healthy condition, and also involves loss of lean muscle mass, though it is often used to kick start a fat loss program.
The most common answer we got was;
“Fat is converted to energy and/or heat, and simply disappears.
Wrong again. Like all matter in the Universe, your body fat is subject to the laws of physics. Disappearing fat would violate the law of conservation of mass.
So. Where does the fat actually go? Despite clear instruction about the fate of fat in college textbooks, including the one I used to teach from (1), even many health professionals have little or no idea. A survey just published in the British Medical Journal asked 50 family doctors, 50 dietitians, and 50 personal trainers. More than 95% of all three categories of professionals got it dead wrong. Not a single one of the physicians, or the personal trainers knew where the fat goes. Only six of the dietitians got the right answer (2).
It might be useful to know the right answer if you intend to control your body fat, especially if you are just starting a New Year – New Body for 2015. Here it is, simple and unadorned by the complex science behind it.
Body fat can only be lost through oxidation. First you have to encourage the fat molecules to leave the fat cells, which happens efficiently only by the right exercise. Then you have to mix the fat molecules with oxygen to oxidize them, which only happens efficiently if you take in a lot of oxygen. (I will leave out the hundreds of biochemical steps involved here.)
Suffice to say that if you don’t persuade the fat molecules to leave the safety of the fat cells, it does not work. And if you fail to provide enough oxygen, it does not work.
So you can restrict your eating to starvation level, but without regular exercise to increase oxygen uptake, and correct breathing to provide a big supply of oxygen, all you will get is a temporary loss of some body fat. You will also get a loss of muscle that is much harder to correct..
Here is the bottom line. To lose 10 pounds of body fat you have to inhale approximately 14 pounds of extra oxygen which then oxidizes the fat you have persuaded into the bloodstream by exercise, This activity produces about 13 pounds of carbon dioxide that you exhale, plus about 8 pounds of water.
The average person in North America exhales only about 1.5 lbs of carbon dioxide per day from all bodily functions So it takes a at least a month of heroic effort to exhale 13 lbs more in order to dump the fat. Most of us never get enough oxygen or exercise to do the job, which is one big reason for the obesity epidemic.
We are a carbon based creature, and what you are really trying to do is to get the carbons of your fat out of the body. The weight of fat that you exhale in your breath as carbon dioxide is the weight of the 55 carbon atoms in each fat molecule (plus 4 oxygen atoms). That works out to about 80% of the all the weight of the fat you lose. Thus, by simple physiology, your lungs are the main organ of fat loss. To maintain control of body fat for life you have to increase your carbon footprint and breathe it all out.

Got fat to lose for 2015? Join the team that knows the science www.drmichaelcolgan.com! To see the weight loss systems we use go to www.colganinstitute.com.

1. Stryer L. Biochemistry, 4th Edition, New York: WH Freeman, 1995.
2. Meerman R, Brown AJ. When somebody loses weight, where does the fat go? BMJ 2014: 349:g7257 doi:10.1136/bmj.g7257 16 December 2014.

sleepMost common question I get at conventions is: “I was doing really well on my diet but it just stopped working. Now I’m still doing it but I’m gaining fat again”. The mantras of weight loss companies chant multiple reasons for the waddling evidence of the failure of many people to maintain fat loss. Most common are:

1. You have been using a fad diet, not our diet.
2. You have been using their pills, not our super fat-loss pills.
3. You have been using their packaged meals, not our superfoods.
4. You failed to exercise daily and lost muscle along with the fat. Maintaining muscle during fat loss is essential because fat is oxidized for use mainly in muscle. Fat is easy to regain. Muscle is hard. So you put yourself in the worst possible state to maintain fat loss; insufficient muscle to keep on burning it.
5. You reduced calories too fast in order to reach some completely false level of fat loss that we see pictured on Facebook and Celebrity News every day. (Well-known weight loss celebrities are reported losing so much fat from time to time that we calculated they would have leaned down to toothpicks long ago) Fast calorie reduction lowered your metabolic rate, and caused rebound regain of the fat.
6. You confused the body with low calories and depletion of essential nutrients, causing complete disruption of hormonal controls of eating.

All these reasons for regaining fat are correct, but are only part of the problem. Very few companies address another big cause of regaining fat – lack of sleep. In conjunction with other agencies, the US National Center for Sleep Disorders has plotted the rise in deficient sleep in America against the rise in obesity. Both problems have increased in almost exact synchrony (1) Recent studies now confirm that sleep below 7 hours per night, and poor sleep quality, are both risk factors for fat gain and obesity in children and adults alike (3-6).

The biggest culprit is the hormone leptin. Leptin is our main appetite control hormone, and also has roles in energy expenditure and capacity for exercise. Circulating leptin levels have a precise circadian rhythm rising to maximum at night and dropping to minimum during the day.

Sleep deprivation studies show that short sleep duration disrupts the whole circadian rhythm of leptin, so appetitie fails to turn off. This disruption causes irresistible food cravings, weight gain, obesity, and increased risk of diabetes (2-8). Loss of the daily leptin rhythm also reduces the body’s capacity to use energy, and reduces the capacity to exercise. These effects can completely offset any other efforts you may make to lose bodyfat (5-8).

As we discuss in our book, The Perimenopause Solution, effects get worse in women, especially after they enter perimenopause at about age 35 (9). Effects get worse again after menopause, which is linked to high levels of sleep disturbance. Postmenopausal American and Canadian women have a very high risk of fat gain, the metabolic syndrome, and diabetes (10-14).

In the latest study researchers examined the link between sleep duration and quality and leptin and their effects on dietary energy intake and diet quality among post-menopausal women. The study found leptin disruption and much higher energy intake among women sleeping 6 hours or less per night, compared to those sleeping 7 hours or more. Other studies have also confirmed that short sleep causes a large decline in the quality of the diet. People sleeping 6 hours per night or less, eat more snacks, more processed carbohydrates, and more fats (15).

The solution is clear. Do not undertake a weight loss program unless you also make the lifestyle modification to get sufficient, deep sleep of 7 hours plus per night. Treat your bed as a shrine to fat loss and you will reset your circadian rhythm of leptin and literally lose fat while you sleep. All members of the Colgan Team make sure of it with the right supplements. Meet with us and you will see how well it works.

For more information go to www.drmichaelcolgan.com and www.colganinstitute.com.

1. 2009 Sleep in America Poll, Summary of Findings. National Sleep Foundation; Washington: 2009.
2. Taheri S, Lin L, Austin D, Young T, Mignot E. Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index. PLoS medicine. 2004;1:e62. [PMC free article] [PubMed]
3. 12. Gonnissen HK, Hursel R, Rutters F, Martens EA, Westerterp-Plantenga MS. Effects of sleep fragmentation on appetite and related hormone concentrations over 24 h in healthy men. The British journal of nutrition. 2012:1–9. [PubMed]
4. 13. Spiegel K, Leproult R, L’Hermite-Baleriaux M, Copinschi G, Penev PD, Van Cauter E. Leptin levels are dependent on sleep duration: relationships with sympathovagal balance, carbohydrate regulation, cortisol, and thyrotropin. The Journal of clinical endocrinology and metabolism. 2004;89:5762–71. [PubMed]
5. 14. Spiegel K, Tasali E, Penev P, Van Cauter E. Brief communication: Sleep curtailment in healthy young men is associated with decreased leptin leve
ls, elevated ghrelin levels, and increased hunger and appetite.Annals of internal medicine. 2004;141:846–50. [PubMed]
6. 15. Nedeltcheva AV, Kilkus JM, Imperial J, Schoeller DA, Penev PD. Insufficient sleep undermines dietary efforts to reduce adiposity. Annals of internal medicine. 2010;153:435–41. [PMC free article] [PubMed]
7. 16. Thomson CA, Morrow KL, Flatt SW, et al. Relationship Between Sleep Quality and Quantity and Weight Loss in Women Participating in a Weight-Loss Intervention Trial. Obesity [PubMed]
8. 17. Booth JN, Bromley LE, Darukhanavala AP, Whitmore HR, Imperial JG, Penev PD. Reduced physical activity in adults at risk for type 2 diabetes who curtail their sleep. Obesity. 2012;20:278–84.[PMC free article] [PubMed]
9. 18. Benedict C, Hallsch
mid M, Lassen A, et al. Acute sleep deprivation reduces energy expenditure in healthy men. The American journal of clinical nutrition. 2011;93:1229–36. [PubMed]
10. Colgan M, Colgan LA. The Perimenopause Solution. Vancouver Science Books, 2010.
11. 19. Dzaja A, Arber S, Hislop J, et al. Women’s sleep in health and disease. Journal of psychiatric research.2005;39:55–76. [PubMed]
12. 20. Broussard JL, E
hrmann DA, Van Cauter E, Tasali E, Brady MJ. Impaired insulin signaling in human adipocytes after experimental sleep restriction: a randomized, crossover study. Annals of internal medicine.2012;157:549–57. [PubMed]
13. 21. Mullington JM, Chan JL, Van Dongen HP, et al. Sleep loss reduces diurnal rhythm amplitude of leptin in healthy men. Journal of neuroendocrinology. 2003;15:851–4. [PubMed]
14. 22. Wing RR, Matthews KA, Kuller LH, Meilahn EN, Plantinga PL. Weight-Gain at the Time of Menopause. Arch Intern Med. 1991;151:97–102. [PubMed]
15. Stern JH et al. Short sleep duration is associated with decreased serum leptin, increased energy intake and decreased diet quality in postmenopausal women. Obesity (Silver Spring). 2014 May;22(5):E55-61. doi: 10.1002/oby.20683. Epub 2014 Jan 9.

In 1967, Scandinavian researchers Bergstrom and Hultman rocked the athletic world with a brilliant study showing how endurance athletes can load their muscles with glycogen and run farther and faster (1). I was training marathon runners at the time and adopted their procedure right away. Done correctly it works like a charm.

But today, after more than 200 studies, commercial greed to sell gels, modified starch drinks, high-fat gunk, and other tomfoolery, have distorted carbohydrate loading into a complete mess. Most of the protocols on the internet are next to useless. Some of them likely REDUCE performance. So much so, that the best coaches have long since stopped giving public advice on loading except to warn folk it’s complicated and uncertain.

In this article I try to sort out the mess, and give you a clear and concise method that can DOUBLE your usual glycogen store, and raise your available calories from fat as well. To do so makes running a marathon, or completing an Ironman, not only easy and fun all the way, but also a source of personal pride that’s difficult to beat.

The Race Distance
The distance you are trying to race is critical. Some trainers get people to carb load for a half-marathon. Waste of time. Here’s why.
In my 28 Jan article, Fuel for an Ironman, I pointed out that the average trained, amateur runner, of 154 lbs (70 kg), normally stores about 400 grams glycogen. (It varies quite a bit but I can only talk averages in this short article) That’s 1,600 calories of fuel without carb loading.

As an endurance runner you should always run at a speed below your lactic acid threshold, that is, at the top of the non-panting, “fat-burning zone”. (Run any faster and your body will stop burning fat, and burn up all your glycogen within a few miles.)

At the right speed, the fit body will pull about 400 calories from its fat store during a marathon. So, running right, you have about 1,600 calories from stored glycogen + 400 calories from fat. That’s 2,000 calories available without carb loading.

Even with poor running technique, (about 70% of amateur runners I see), and carrying up to 20lbs excess fat (about 60% of amateur runners I see) , running at the right speed will use only 100-120 calories for each mile. So, the most calories you need to run a half-marathon is 13.1 miles x 120 calories. That’s 1672 calories.

You likely have about 2,000 calories available without carb loading – plenty for the half marathon.
Carb loading will not help you at all. If you are having trouble with the last couple miles of the half, you need to improve your running training not fiddle with your nutrition.

The Marathon
The marathon is a different story. At the worst case scenario of 120 calories a mile, total energy cost is 26.2 miles x 120 = about 3,350 calories, way above the average storage reserve of 2,000 calories.

As I pointed out in the previous article, you can absorb only about 300 calories per hour from food and drink on the run. And nothing works in the last 30 minutes because you can’t absorb it in time before the finish. If your marathon time is 3:30, you have just 3 hours to fuel – that’s 900 calories at the most.

So, without carb loading, you have 2,000 calories in store + 900 absorbed on the run = 2,900 calories – well short of the 3,350 calories you need to finish without dropping to a walk, or crawl. This is where carb loading becomes the miracle you need.

How to Carb Load
First, a few don’t’s. DON’T use high fat nutrition, (except when I tell you to). During exercise, carbs always yield more than twice the energy of fats. “Wait a bit,” some coaches say, who have been gulled into feeding their athletes high fat foods and supplements. “Fat is 9 calories a gram, carbs only 4 calories”.

Sorry guys, basic physiology – all the fuel has to be oxidized first. You forgot that fat needs more than double the oxygen of carbs to get the energy out. And fat can’t burn at all without carbs. Add oxygen into the equation and the energy from carbs during intense exercise jumps to nearly five times what you can get from fat (2,3). Carbs are always your limiting fuel.

DON’T use modified starches or sugars. It’s easy chemistry to modify a mix of carbs, change the molecular weight and digestibility, or alter the glycemic index, etc, etc. I’ve done it a few times for sports companies, who then give the mix a fancy name, and claim it’s the latest miracle for athletes. Bottom line – they have some medical uses in diabetes and insulin resistance, but they don’t improve performance for fit folk any more than natural carbs that cost pennies (4).

DON’T believe anyone (or product hype) that tells you that you can load glycogen on you run. You can decorate your shorts with gels like a Christmas tree, but it’s not going to help. As I wrote in the previous article, you can’t absorb more than 300 calories an hour while running. Think, most of your usual digestive blood is being diverted to the muscles.

Even after absorption, carbs are nowhere near as good as stored glycogen. Basic physiology again. Your body can use stored glycogen directly for energy. But not carbs absorbed on the run. They have to go through complex chemistry first. It’s called phosphorylation, and uses an enzyme called hexokinase. Hexokinase unfortunately happens to be sparse in human muscle, so conversion to usable energy is slow (2).

Used sparingly, bars and gels help a little while running a marathon. But they are nothing compared to the miracle of a proper carb load beforehand.

Day 7. The basic system we use is a glycogen depletion run seven days out from the marathon. Do not load with fuel before this run, and take as little fuel as possible during it. Do not restrict water. The run should not be an all-out effort, but it should be a long one, at least 3 hours. The more you deplete on this run, the more you will load (6).

Glycogen is depleted only in the muscles used (5). So, do not jog on a treadmill, or elliptical, or stair thingummy. They do not simulate road running, and will not deplete glycogen properly.

In elite runners that I and others have trained, muscle glycogen levels typically fall to 20% of normal levels (1-3). Do not eat carbs afterwards. If you must eat, take a protein drink. Do not restrict water.

Days 6, 5, and 4. Drop your carb intake to 30% of daily calories. During these days jog lightly for no more than 60 minutes. You will feel uncomfortable because your body is now burning more fat than usual, and increasing the ketones from it into your blood.

Day 3. Increase your carbs to 80% of daily calories. You need 11 grams per kg bodyweight per day. For a 154 lbs (70kg) athlete that’s 770 grams, a bit over 3,000 calories of carbs. And increase your water intake by 50%.

Use small frequent meals, 5-6 a day. Taper jogging to no more than 30 minutes. If you do it all right, you will feel great by the evening of Day 3.

Days 2 and 1. Maintain 80% carb intake and 150% normal water. Jog 15-30 minutes. For every gram of carbs you load, you automatically load 2.7 grams of water. Big bonus for hydration during the marathon, because the water is released gradually as the glycogen is used.

Some athletes more than double their normal glycogen levels in this way, from 400 to over 800 grams. Together with the water the extra glycogen stores, by Day 1, a 154 lbs athlete (70 kg), will be 3-4 lbs heavier than on Day 6 (7).

Race Day. 2-3 hours before the race have a high-fat meal. The meal should be at least 1,000 calories and about 60% fats. And sip a 12% carbohydrate drink up to 30 minutes before the race. The reasons are way complex but I will report the science shortly on www.drmichaelcolgan.com Members of the Colgan Team can also get detailed information on the foods and schedule there.

Finally, practice all this beforehand. Use the last long run of your marathon training, which should be 3-4 weeks out from your race. I advise athletes to work up to a 24-miler for the last training run. Start the practice carb load seven day before the last training run, exactly as set out for the race. You will be glad you did.

1. Bergström J, et al. Diet, muscle glycogen and physical performance. Acta Physiol Scand. 1967 Oct-Nov;71(2):140-50.
2. Colgan M. Optimum Sports Nutrition. New York: Advanced Research Press, 1993.
3. Ivy JL, et al. Skeletal muscle determinants of maximum aerobic power in man. Eur J Appl Physiol, 1980;44:1-8.
4. Ormsbee MJ et al. Pre-exercise nutrition: The role of macronutrients, modified starches and supplements on metabolism and endurance performance. Nutrients 2014, 6(5), 1782-1808; doi:10.3390/nu6051782
5. Richter EA, et al. Enhanced muscle glycogen after exercise: modulation by local factors. Amer J Physiol, 1984;246:E746-752.
6. Zachweija JA, et a. Influence of muscle glycogen depletion on the rate of re-synthesis. Med Sci Sports Exer, 1991;23:44-48.
7. Burke LM Nutrition strategies for the marathon : fuel for training and racing. Sports Med. 2007;37(4-5):344-7.
8. Murakami I, et al. Significant effect of a pre-exercise high-fat meal after a 3-day high-carbohydrate diet on endurance performance. Nutrients. 2012 Jul;4(7):625-37. doi: 10.3390/nu4070625.

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