It depends! The goal of electrolyte supplementation is to replace lost sweat which supports rehydration and helps maintain thermal balance. More likely circumstances where sweat rate increases include 1) engaging in prolonged intense exercise (>1h), 2) working outdoors 3) engaging in activity at higher temperature, humidity, or elevation.
How Much Fluid do I Need? Calculating Sweat Rate
Sweat rate can vary greatly from person to person for the same activity; a useful way to personally assess how much sweat must be replaced by fluid is by measuring your sweat rate:
1. Before exercise, weigh yourself in a minimal amount of clothing you can train in.
2. Take defined amount of fluid with you for the training session and drink as needed during the session….e.g. 20 oz.
3. After the workout, towel off excess sweat and weigh yourself again in minimal clothing.
Example: let’s say I run for one hour. I weigh 150.2 lbs. initially and drank 20 oz. (1.25 lb.) of water during the workout. After the workout I weighed 148.3 lbs:
Fluid loss = initial weight – final weight – weight of fluid consumed.
150.2 – 147.3 – 1.25 = 1.65 lbs. = 16 oz./hr.
For high intensity exercise extending 90 minutes or more, it becomes increasingly important to ensure fluid regulation and fuel supply. Sip a drink containing electrolyte (and carbohydrates) throughout exercise.
Comparison of Electrolytes
The below table compares popular electrolyte brands versus the reference ranges in 1 L (33.8 oz.) of human sweat. Electrolytes are reported in milligrams (mg) and values reported are per the manufacturer serving size. Replacement of sodium and potassium lost through sweat are more important than calcium and magnesium, which are lost at a lower rate and easier to replace through diet. Certain products such as Tailwind, regular Gatorade, Skratch also incorporate a tangible amount of carbohydrate to support training performance (but you may require additional carbohydrate supplementation).
Many of these products cost a premium for extremely low cost individual components. The lowest cost and most customizable way to supplement electrolytes it to make your own.
If you would like other products added to this table, email me and I will add.
Do Electrolytes Prevent Exercise-associated Muscle Cramps?
The cause of exercise-associated muscle cramps is not well understood and not attributable to a single factor. [1] Many studies in endurance athletes show no association between cramping and level of hydration and blood electrolyte concentrations. System-wide full body cramping or bilateral cramping does appear to have a stronger association with hydration status and blood electrolytes.
More than likely, hydration status and blood electrolytes are a contributing factor for cramping, but more recent evidence suggests that exercise-associated muscle cramps may be mediated by muscle fatigue that alters neuromuscular control. Note in the table above there is an * by pickle juice and mustard. The beneficial action of these sodium sources may not be the sodium itself as it relates to cramp prevention. Rather they are sources of acetic acid, a compound of interest related to prevention or shortening the duration of cramps [2-4]. The proposed mechanism of acetic acid is to decrease alpha motor neuron activity through oropharyngeal neural reflexes. In short, a strong sensory stimulus could cause alpha motor neurons to become less excited which could prevent or reduce the severity of a cramp.
1. Miller KC, McDermott BP, Yeargin SW, Fiol A, Schwellnus MP. An Evidence-Based Review of the Pathophysiology, Treatment, and Prevention of Exercise-Associated Muscle Cramps. J Athl Train. 2022 Jan 1;57(1):5-15.
2. Hooper Marosek SE, Antharam V, Dowlatshahi K. Quantitative Analysis of the Acetic Acid Content in Substances Used by Athletes for the Possible Prevention and Alleviation of Exercise-Associated Muscle Cramps. J Strength Cond Res. 2020 Jun;34(6):1539-1546.
3. Hoffman MD, Stuempfle KJ. Muscle Cramping During a 161-km Ultramarathon: Comparison of Characteristics of Those With and Without Cramping. Sports Med Open. 2015;1(1):24.
4. Miller KC, Mack GW, Knight KL, Hopkins JT, Draper DO, Fields PJ, Hunter I. Reflex inhibition of electrically induced muscle cramps in hypohydrated humans. Med Sci Sports Exerc. 2010 May;42(5):953-61.
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Staying hydrated – it’s important. Water supports many roles in human health and performance, including regulation of body temperature, delivery of nutrients to cells, organ function, lubrication of joints and ligaments, and mitigating infection. Hypohydration (result of dehydration), or hyperhydration (excessive rehydration), can lead to performance impairment. At the extremes, it poses a significant risk to health and life. Through proper replenishment of fluids, euhydration (body water balance) contributes to optimum performance.
Human water and water loss
The human body is 60-70% water. Fat tissue stores about 10% water, while muscle tissue is about 70% water. Given that a high proportion of our total weight is attributable to water, it’s intuitive that hydration status can play a meaningful role in day-to-day fluctuations in body weight. Excluding activity, adults lose anywhere from about 30 to 100 oz. water/day (~ 1 to 3 L) in the process of dehydration. About 60% is lost through urine, 35% through evaporation from the respiratory tract and sweat, and about another 5% in poo.
The impact of dehydration on performance
Appropriate fluid intake to limit dehydration is the single most effective way to maintain exercise capacity during training. Depending on physical and environmental factors, an additional 15 to over 170 oz. (~ 0.5 to 5L) of water per hour can be lost through sweat during exercise. Replenishment of water during a variety of activities demonstrates improved physiological function [1] and time to exhaustion [2]. Failure to replace water has demonstrated significant consequences to performance and risks health issues.
Blood flow to exercising muscles is reduced during dehydration. This reduction in blood flow leads to impaired performance. Even at only a 2% loss of body water, endurance and strength-power capacity begins to substantially diminish. Beyond 3% bodyweight loss starts to impose significant health risk. The amount of liquid required to maintain favorable water balance is variable between individuals, but often necessitates drinking before thirst begins. During exercise, most people do not typically get thirsty until they have already lost a meaningful amount of fluid through sweat. Generally, thirst is a lagging indicator of hydration status.
Rehydration
Rehydration and maintenance of body water balance is achieved by consumption of drinks AND foods. Approximately 50% of water is recovered by drinking water and 30% by drinking other fluids. About 20% from food. While we don’t think too much about eating water, many whole foods are loaded with it. Most fresh fruits and vegetables are over 90% water by weight, egg and cooked potato is >70% water. Seafood, meats, poultry, cooked rice, are 60-65% water. Processed foods have lower water content, for example bread (35-40%), cake (15-30%), and biscuits and crackers (1-5%). Therefore, individuals with a diet comprising a higher percentage of processed foods.
Rehydration can be accomplished with drinks other than water. Check out this information about the Beverage Hydration Index.
How do I know if I’m hydrated?
Thirst alone may not be the best indicator. A multi-factor approach such as the WUT (Weight-Urine-Thirst) self-assessment method can provide a better picture of likelihood of hypohydration for athletes. If you have two or more of these markers, it’s likely you are hypohydrated, and highly likely if you have all three.
WEIGHT
Day to day body weight losses in excess of 1.1% may be an indication of hypohydration (assuming free access to food and drink) . Weigh yourself first thing in the morning every day. For example, a 1.1% loss would be 1.65 lb. for a 150 lb. individual. Take this information into context with thirst and urine characteristics.
URINE (Volume and Color)
Urination is more frequent when body water is high, and less when body water is low. Therefore, if water loss is high due to sweating from exercise, less urine may be produced even if fluid intake is increased. Further, reduced urine production results in darker color and is somewhat indicative of hydration status. Use a urine assessment chart like the one below (and remember that the toilet contains water, which will dilute the color). A reduction in urine frequency with darkening of color may be an indication of hypohydration along with weight and thirst as indicators.
THIRST
Thirst can be a lagging indicator of hydration status; even if you aren’t thirsty, you may still be hypohydrated. If you are thirsty, take this information into context with change in weight and urine characteristics.
Habits to stay hydrated
1. Have a glass of water when you wake up in the morning
2. Eating contributes to hydration. Nearly all veggies and fruits are more than 90% water – keep up with these in your diet to support hydration!
3. Rule of thumb for general water intake per day = 1/2 bodyweight in ounces or more depending on your physiology, general activity and environment.
4. If you’re behind on water intake before training, 15-20 oz. in the two hours leading up, and another 5-10 oz. 20 minutes before.
5. During training – replace fluids based on your sweat rate. A typical replacement range is 17-70 oz. (0.5 – 2L) per hour of fluid. If training longer than an hour it might be a good idea to drink back some sweat (electrolytes) plus carbohydrate if warranted. Read about electrolytes and how to calculate sweat rate here.
Hope you found this post informative! Reach out anytime with questions.
1. Nassis GP, Geladas ND. Effect of water ingestion on cardiovascular and thermal responses to prolonged cycling and running in humans: a comparison. Eur J Appl Physiol. 2002 Dec;88(3):227-34.
2. Samuel N. Cheuvront & Robert W. Kenefick (2016) Am I Drinking Enough? Yes, No, and Maybe, Journal of the American College of Nutrition, 35:2, 185-192
Other than water, coffee is the most consumed beverage in the USA. Americans drink more coffee than any other nation – over 400 million cups per day. Whether you are a die-hard coffee drinker or a casual sipper, read on for a detailed review of coffee health and performance impact, and some practical advice.
TLDR
Beyond the stimulating effects of caffeine which can improve exercise performance, there are many health beneficial chemical compounds in coffee. These include antioxidants, minerals, pro-vitamins, and polymers which behave somewhat like other dietary fiber.
For healthy, non-hypertensive adults, the potential heart protective benefits of coffee appear to outweigh the risks based on meta-analysis of human observational studies. Anywhere from 2-5 cups per day appears to be a sweet spot for cardiovascular disease risk reduction.
Decaf coffee and tea offer many of the same health protective benefits of coffee if you don’t like coffee or want to reduce caffeine consumption.
If you are attempting to reduce cholesterol by making dietary changes, swapping from unfiltered type coffees (e.g. espresso, french press) to filtered coffee might be worth exploring. Filtration will remove diterpenes, which can have a total and LDL cholesterol raising effect.
Coffee is not an effective tool for weight loss, but may help mitigate long-term weigh gain.
If you are interested in exploring caffeine to enhance exercise session performance, supplementation with 200-400 mg caffeine appears to be the most effective dose range for most people, taken approximately one hour before training. Personal experimentation on dose is warranted. If you choose to use coffee, a 16 oz. regular coffee is within the dosage range.
Compounds contributing to the health impacts of coffee
There are over 1,000 bioactive micronutrients in coffee. The concentration of these compounds can vary substantially depending on the beans, roasting process, and brew process. The most well-studied:
Caffeine
A stimulant of the central nervous system, caffeine indirectly affects the release of neurotransmitters which alters mood, memory, alertness, and cognitive function by blocking adenosine receptors. Caffeine content in coffee varies substantially depending on the bean and preparation method (see table at end of this post for estimated caffeine content of different coffees). Even decaf coffee has a small amount of caffeine.
Chlorogenic Acids (CGAs)
CGAs are a subset of naturally occurring polyphenolic compounds found in coffee beans and many other plants. Metabolized products of CGAs can induce antioxidant and anti-inflammatory effects. In espresso or other higher-pressure extraction processes such as a moka pot, CGA content can be much higher due to the larger amount of coffee is used per volume of water versus brews prepared by drip filter. CGA content will also be higher with beans that are lighter roasted. Generally, cold brews with short infusion periods and lower temperatures tend to yield lower CGA levels.
Melanoidins
Melanoidins are polymeric compounds formed during the coffee bean roasting process from a reaction of carbohydrates, amino acids, and phenolic compounds. They contribute to the sensorial properties of coffee via the Maillard reaction which is the thermal process of “browning” (the same is responsible for the crust on bread, searing on steak). A diet rich in coffee, bread, and cereals can provide up to 10g of melanoidin per day. Interestingly, melanoidins seem to act much like dietary fiber in the colon and contribute to gut health.
Cafestol and Kahweol
Cafestol and Kahweol are esterified fatty acid compounds that impart some of the oily texture of coffee. These compounds are retained in unfiltered coffee, but largely removed in filtered coffee. Cafestol and Kahweol can have total and LDL cholesterol raising effects, but on the other hand also demonstrate potentially beneficial anti-inflammatory and anticarcinogenic activity. Further research is needed on the pharmacological properties of these compounds.
Trigonelline
A vitamin B3 (niacin) precursor that gives coffee some of its bitter taste and can help upregulate our antioxidant defense system. Trigonelline may have therapeutic potential as a hypoglycemic, neuroprotective, and anticarcinogenic agent per rodent models and limited studies. More research in the area is required to better elucidate the action of trigonelline within coffee.
Minerals
The mineral content in coffee varies considerably depending on the bean, brew method, and of course the water source. A review of research spanning 2000 – 2020 notes that one portion of coffee brew can cover 7.5% or 6.4% (for women and men) and 6.6% of the daily requirement for magnesium and potassium, respectively. Coffee provides slightly lower amounts of phosphorus (up to 2.2%), sodium (up to 2.2%), and calcium (up to 0.7% of the daily requirement for women and 0.6% for men).1
Coffee and Cardiovascular Disease (CVD)
A dose-response meta-analysis of observational, prospective cohort studies (35 studies comprising 1,283,685 participants analyzed) conducted by Ding et. al indicates a J-shaped non-linear relationship between coffee consumption and risk of CHD and stroke.2 cardiovascular disease (CVD), with modest effect. Lowest risk was associated with consumption of 3-5 cups/day.
The “J-shape” of the curve likely reflects a combination of beneficial and detrimental effects. For moderate coffee consumption; beneficial effects may be greater than adverse effects; whereas for heavy consumption, detrimental effects may counterbalance beneficial effects.
Association of Coffee Consumption with CVD risk reduction.2
No association was found with decaffeinated coffee and CVD risk, however this may be related to reverse causation (people with CVD-related conditions may switch from regular coffee to decaf), or that the overall consumption of decaffeinated coffee is much lower than caffeinated coffee, providing a less significant pool of data. It’s also worth noting that tea consumption (3 cups/day) is associated with reduced risk of coronary heart disease.3
Another meta-analysis regarding the association between habitual coffee consumption and heart failure risk found that 3-4 servings of coffee/day provided the strongest risk reduction.4
There does not appear to be a significant dependency on age. Certain previous studies in the scientific literature conflict with these findings.5 However, these studies do not appear to have risk-adjusted for enough cofounding health-related variables. Given the effect size of coffee on CVD risk is only mild to moderate, it stands to reason that statistical adjustments and assumptions within individual studies can lead to divergent findings.
Coffee and Blood Pressure
Light to moderate coffee (and tea) consumption is likely to confer some cardiovascular protective benefit in non-hypertensive individuals.
Coffee can acutely raise blood pressure by the action of caffeine, more notably in individuals who are not habituated to caffeine. These effects are typically transient, with blood pressure returning to normal level within a few hours. A recent metanalysis found no long-term blood pressure raising effects of coffee.6 A large prospective study in non-hypertensive female nurses found that coffee consumption mildly reduced risk hypertension risk.7
Although caffeine has an acute hypertensive effect, the other active compounds found in coffee in tea may have an anti-hypertensive effect (such as chlorogenic acids, soluble fiber, and potassium) which could exert a beneficial effect in the cardiovascular system. Green and black tea has also been shown to reduce blood pressure for individuals who are pre-hypertensive or hypertensive.8
A number of compounds in coffee and tea can work as long-term anti-hypertensive agents, but because people with hypertension are more susceptible to the effects of caffeine, caffeine’s harmful effects may outweigh its protective effects and increase the risk of mortality in people with severe hypertension.
Heavy coffee consumption was associated with an increased risk of CVD mortality among people with severe hypertension,9 but not people without hypertension. In contrast, green tea consumption was not associated with an increased risk of CVD mortality across all categories of blood pressure. Although the precise nature of the relation between coffee and blood pressure is still unclear, most evidence suggests that regular intake of caffeinated coffee does not increase the risk of hypertension, in non-hypertensive individuals.
Coffee and Type 2 Diabetes (T2DM)
Chlorogenic acids can reduce fasting plasma glucose concentrations, increase sensitivity to insulin, and slow the appearance of glucose in circulation after a glucose load. A systematic review of nine cohort studies compared minimal to low coffee consumption (<2 cups/day) with that of heavy coffee consumption (>6 cups/day) for the risk of the development of type 2 diabetes mellitus (T2DM). The study concluded that the risk of the development of T2DM was lowest in subjects who drank >6 cups daily but also significantly reduced in subjects who consumed 4-6 cups per day.10 A prospective study of >88,000 women 26 to 46 years of age established a linear relationship of coffee consumption with the reduction in T2DM, whereby even small amounts of daily coffee conferred benefit. Associations were similar for noncaffeinated and caffeinated coffee.11
Green tea consumption has also been shown to reduce the risk of T2DM, which is possibly mediated through the antioxidant and anti-inflammatory effects of catechins. A 2020 meta-analysis showed that green tea significantly reduces the incidence of T2DM; however black tea did not. The authors concluded that different types of tea have varying protective mechanisms on metabolic syndrome although the explanation for this observation is unclear.12
Coffee (and green tea) may have protective benefits against T2DM, and this seems to be independent of caffeine content.
Coffee and Cholesterol
Contributing to the bitter taste of coffee, cafestol and kahweol are natural diterpene fatty esters extracted from coffee beans, and the concentrations of these compounds is strongly influenced by the preparation method. They are present are present in larger amounts in unfiltered coffee such as Turkish coffee, cold press, and espresso. They are mostly removed when coffee is filtered, or during processing in the case of instant coffee.
A meta-analysis of 14 randomized controlled trials examining the effect of coffee consumption on serum cholesterol concentrations indicate that the consumption of boiled coffee dose-dependently is associated with higher serum total and LDL cholesterol concentrations, while the consumption of filtered coffee results in slight increase in serum cholesterol.13 Cafestol seems to be the more potent actor in elevation of serum cholesterol.
While Cafestol and Kahweol may increase total and LDL cholesterol, these compounds also enhance our built-in antioxidant defense system against oxidative damage and inflammation.
If you drink unfiltered coffee and are actively trying to reduce your cholesterol, consider swapping to filtered coffee. If your cholesterol is normal, there’s no strong long-term evidence of chronic elevation of serum lipids or negative outcomes associated with this elevation.
Coffee Impact on Weight and Appetite
Studies to date indicate a very small but not insignificant association between coffee consumption and suppression of fat accumulation leading to lower long term weight gain.14, 15, 16 To understand how coffee can potentially mitigate weight gain, consider the action of the constituents:
Coffee’s potential impact on energy expenditure
Caffeine elicits thermogenesis (production of body heat), increases the energy cost of movement resulting in increased total daily energy expenditure, resting metabolic rate, and exercise activity expenditure. The impact appears to be dose dependent, even caffeine doses of 100 mg can induce an increase in resting metabolic rate of 3-4%. The magnitude of energy expenditure increases near linearly with caffeine quantity; doses of 200-250 mg increases RMR by 10-12%. For reference, a 5% increase in RMR within a 24-hour period represents and additional expenditure of 75-100 kcal/day depending on the individual (it appears that dosage should be based on body weight versus absolute values). This may seem like a small number, but accumulated over weeks, months, and years it is a viable hypothesis for caffeine to mitigate weigh gain over time.
A 2023 prospective cohort study investigated coffee consumption and weight gain. Increase in intake of unsweetened caffeinated and decaffeinated coffee was inversely associated with weight gain, and each 1 cup per day increment in unsweetened caffeinated coffee was associated with a reduction in 4-y weight gain of -0.12 kg. The addition of sugar to coffee counteracted coffee’s benefit for possible weight management.17
Coffee’s potential impact on energy intake and appetite control
The impact of coffee on intake and appetite is not clear. There are some plausible mechanisms by which coffee could potentially reduce energy intake or appetite. Compounds in coffee could decrease the rate of gastric emptying, causing food to stay in your stomach longer promoting satiety. Coffee could alter the secretion of certain hormones, specifically 1) downregulating ghrelin (a gastric hormone that stimulates appetite, 2) upregulating PYY (released in the intestinal tract to suppress hunger), 3) upregulating leptin a hormone released mainly from fat cells which supports feeling of satiety. Caffeine specifically could reduce appetite by increasing the release of adrenaline and cortisol. On the other hand, some report appetite stimulation from caffeine.
Very few studies that have examined caffeinated coffee consumption reduces appetite and energy intake, and those that are available are contradictory in their results. In a small, limited study decaffeinated coffee yielded significantly subjective lower hunger during the whole 180- minute study period and higher plasma PYY for the first 90 minutes versus water placebo.18 Caffeine in water had no effects on hunger or PYY. Caffeinated coffee showed a pattern between that of decaffeinated coffee and caffeine in water. There were no significant changes in ghrelin or leptin. In another limited study, a moderate coffee amount (2- 4 cups, 6 mg/kg body weight reduced reduce energy intake in the following meal and in the total day compared to lower or no coffee intake in overweight/obese participants but had no impact on normal-weight individuals.19
One rodent model study may provide us some understanding of complex nature of the relationship between caffeine and hunger.20 Caffeine administered acutely to mice at moderate to high doses can increase binge eating when the subjects had already stablished a pattern of excessive eating. However, this same dose led to clear reductions in food consumption if the mice were in an environment promoting high anxiety levels. Another consideration is fatigue – one the effects of caffeine wear off; appetite may be stimulated due to tiredness.
Coffee may help prevent weight gain through the action of a number of its constituents including caffeine, but it’s not a good as a primary strategy for weight loss. Assess personally if coffee helps take the edge off hunger, or if it makes you prone to eat more under certain circumstances.
Coffee and Athletic Performance
Caffeine: supplementation with caffeine can provide a degree of performance benefit, most notably increase time to exhaustion when aerobic and muscular endurance or is required,21 or sleep deprivation is considered. Effective dosages typically fall within the range of 3-6mg/kg of body weight22 – this is about 200 – 400 mg for a 150 lb. individual. It takes some experimenting to find the appropriate personalized dosage as some are more sensitive to caffeine than others. The recommended timing for ingestion is about one hour before exercise.
As a reference, here is the average caffeine content of different coffees, normalized per fluid ounce and then reported on a typical serving basis. Note that the values reported here are averages – caffeine content can vary *substantially* by coffee bean type and brewing conditions.
Caffeine Content in Coffee and Tea
Regarding the role of chlorogenic acids and other bioactive compounds to mitigate oxidative stress (protein, lipid, and DNA damage) and mediate antioxidant capacity, data is limited and results are conflicting related to the lack of control on types of coffee and dosage, brew procedures as well as biomarker test methodology.
Hope you found this post informative! Reach out anytime with questions.
1. Olechno E, Puścion-Jakubik A, Socha K, Zujko ME. Coffee Brews: Are They a Source of Macroelements in Human Nutrition? Foods. 2021 Jun 9;10(6):1328. doi: 10.3390/foods10061328.
2. Ding M, Bhupathiraju SN, Satija A, van Dam RM, Hu FB. Long-term coffee consumption and risk of cardiovascular disease: a systematic review and a dose-response meta-analysis of prospective cohort studies. Circulation. 2014 Feb 11;129(6):643-59.
3. Zhang C, Qin YY, Wei X, Yu FF, Zhou YH, He J. Tea consumption and risk of cardiovascular outcomes and total mortality: a systematic review and meta-analysis of prospective observational studies. Eur J Epidemiol. 2015 Feb;30(2):103-13.
4. Mostofsky E, Rice MS, Levitan EB, Mittleman MA. Habitual coffee consumption and risk of heart failure: a dose-response meta-analysis. Circ Heart Fail. 2012 Jul 1;5(4):401-5.
5. Liu J, Sui X, Lavie CJ, Hebert JR, Earnest CP, Zhang J, Blair SN. Association of coffee consumption with all-cause and cardiovascular disease mortality. Mayo Clin Proc. 2013; 88:1066–74.
6. Han M, Oh Y, Myung SK. Coffee Intake and Risk of Hypertension: A Meta-Analysis of Cohort Studies. J Korean Med Sci. 2022 Nov 21;37(45):e332.
7. Winkelmayer WC, Stampfer MJ, Willett WC, Curhan GC. Habitual caffeine intake and the risk of hypertension in women. JAMA. 2005 Nov 9;294(18):2330-5.
8. Yarmolinsky J, Gon G, Edwards P. Effect of tea on blood pressure for secondary prevention of cardiovascular disease: a systematic review and meta-analysis of randomized controlled trials. Nutr Rev. 2015 Apr;73(4):236-46.
9. Teramoto M, Yamagishi K, Muraki I, Tamakoshi A, Iso H. Coffee and Green Tea Consumption and Cardiovascular Disease Mortality Among People With and Without Hypertension. J Am Heart Assoc. 2023 Jan 17;12(2):e026477. doi: 10.1161/JAHA.122.026477.
10. Huxley R, Lee CM, Barzi F, et al. Coffee, decaffeinated coffee, and tea consumption in relation to incident type 2 diabetes mellitus: a systematic review with meta-analysis. Arch Intern Med 2009;169:2053–63.
11. van Dam RM, Hu FB. Coffee consumption and risk of type 2 diabetes: a systematic review. JAMA 2005;294:97–104.
12. Liu W , Wan C , Huang Y , Li M . Effects of tea consumption on metabolic syndrome: a systematic review and meta-analysis of randomized clinical trials. Phytother REs 2020;34(11):2857–66 .
13. Jee SH, He J, Appel LJ, Whelton PK, Suh I, Klag MJ. 2001. Coffee consumption and serum lipids: a meta-analysis of randomized controlled clinical trials. Am J Epidemiol 153:353–362.
14. Larsen SC, Mikkelsen ML, Frederiksen P, Heitmann BL. Habitual coffee consumption and changes in measures of adiposity: a comprehensive study of longitudinal associations. Int J Obes (Lond). 2018 Apr;42(4):880-886.
15. Nordestgaard AT, Thomsen M, Nordestgaard BG. Coffee intake and risk of obesity, metabolic syndrome, and type 2 diabetes: a Mendelian randomization study. Int J Epidemiol 2015; 44: 551–565.
16. Lopez-Garcia E, van Dam RM, Rajpathak S, Willett WC, Manson JE, Hu FB. Changes in caffeine intake and long-term weight change in men and women. Am J Clin Nutr 2006; 83: 674–680.
17. Henn M, Glenn AJ, Willett WC, Martínez-González MA, Sun Q, Hu FB. Changes in Coffee Intake, Added Sugar and Long-Term Weight Gain – Results from Three Large Prospective US Cohort Studies. Am J Clin Nutr. 2023 Dec;118(6):1164-1171.
18. Greenberg JA, Geliebter A. Coffee, hunger, and peptide YY. J Am Coll Nutr. 2012 Jun;31(3):160-6.
19. Gavrieli A, Karfopoulou E, Kardatou E, Spyreli E, Fragopoulou E, Mantzoros CS, Yannakoulia M. Effect of different amounts of coffee on dietary intake and appetite of normal-weight and overweight/obese individuals. Obesity (Silver Spring). 2013 Jun;21(6):1127-32.
20. Correa M, SanMiguel N, López-Cruz L, Carratalá-Ros C, Olivares-García R, Salamone JD. Caffeine Modulates Food Intake Depending on the Context That Gives Access to Food: Comparison With Dopamine Depletion. Front Psychiatry. 2018 Sep 6;9:411.
21. Wang Z, Qiu B, Gao J, Del Coso J. Effects of Caffeine Intake on Endurance Running Performance and Time to Exhaustion: A Systematic Review and Meta-Analysis. Nutrients. 2022 Dec 28;15(1):148.
22. Guest NS, VanDusseldorp TA, Nelson MT, Grgic J, Schoenfeld BJ, Jenkins NDM, Arent SM, Antonio J, Stout JR, Trexler ET, Smith-Ryan AE, Goldstein ER, Kalman DS, Campbell BI. International society of sports nutrition position stand: caffeine and exercise performance. J Int Soc Sports Nutr. 2021 Jan 2;18(1):1.
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GBF hosts one-of-a-kind endurance event experiences intended to test physical and mental limits. If you need something new and are looking for new fitness tests, check out the variety of events they have to offer. Owner Gregg McLeod designs many of the events based on his experience as a British Army Officer. Operation Dark Horse was unique, fun, and challenging – I’ll certainly be back for more GBF events.
Specific for Operation Dark Horse, the unique challenge is carrying a piece of expensive functional equipment long distance and ensuring it remains in working order throughout. Teams of two carry a Concept2 rowing machine approximately nine miles through the mountains. If you are not familiar with the rowing machine, it’s about 57 lbs. of long, very unevenly distributed weight. The course spanned three peaks, and at the top of each peak the team rows 10,000m. Fastest teams (completing the course in under 6.5h) earned dog tags and some great prizes by Born Primitive and Concept2.
Thanks to Dark Horse Rowing for supplying the rowers. A few years back, I used their 12-week training program to complete a marathon row. If you want to become a stronger rower, it’s excellent programming.
Setting Off
It was clear all teams were excited to start the epic adventure and the weather was cool. I was thrilled to see many friends I hadn’t seen in awhile. The admin phase was brief and logistically smooth. Gregg provided the rules and shared some of his background and experience. We had a required packing list including water, but gear was not checked. Even though the 11 teams who showed up comprised experienced athletes, there is usually always someone who shows up short on water for events. Adequate hydration is critical; thirst is not often a good indicator of hydration during exercise and thirst drive may decrease in cooler weather. Frequent sipping is highly recommended no matter the case.
Surpriiiise! Each team had to row 2K before setting off, then another 2k at the finish. My friend and teammate Steph had a strong row out of the gate. Can I highlight that Steph is a beast? She’s got the physical AND mental chops to endure which means she has a long an successful career ahead as an Athlete and Coach. Most of the time when I describe an event to someone and ask them if they want to do it, they look at me like I need to be checked into a mental hospital. Steph is my people…..she quickly said, “OK let’s do it”.
First lesson learned – we assumed the rower was precious cargo and needed to come back in identical condition, including keeping dust out of it. We lost a little bit of time here rigging up protections after the 2k row. It was unnecessary.
Second lesson learned – we lost significant time by deciding to keep the rower in one piece and carrying it together. We trained this way, and I didn’t think to change plans after Gregg told us we could break down the rower. Moving is MUCH faster by breaking the rower in two pieces (there’s an easy latch right behind the foot pads) and have each teammate carry one piece, trading off on the heavier end. Taller teams may even be able to carry the full rower solo and switch off.
Steph and I were about 2 miles in before “figuring it out”. Once we dialed in the carry we moved quickly, but it was not enough to make up the time we lost.
On the move
I found the easiest way to carry the heavier flywheel piece is draping it across both shoulders supporting it slightly on top of the ruck versus keeping full weight on one shoulder. Even distribution across the shoulders also helps maintain balance on the steep downhills (which were slippery due to gravel and rocks). I used bumper straps as loops which provided extra stability when moving quicker.
Rowing
Communication and volunteers were well planned at the event. Thanks to our amazing San Diego Triton Ruck Club, people were posted at each of the peaks to help keep track of us. In addition to the teams having to provide checkpoint texts to Gregg, the volunteers noted when we arrived and left each peak. The volunteers were also patient ambassadors explaining to random hikers what the heck the event was about.
It was surreal rowing with a mountaintop view! Steph and I made solid time on the 10K rows, trading off every 1K. Keeping cadence/stroke rate discipline at target pace ensures you aren’t too gassed before stepping off again. We looked forward to each row as a break from lugging it around. Each of us having a few minutes break during the row was a great time to fuel and rest.
Self-learnings
Although it didn’t go quite as we expected and Steph and I had a lot of gas left in the tank, we did get a nice dose of odd-object carrying suck.
Any event where you get a real “test” out of yourself is a worthwhile event – and it might not be fitness that’s tested. It is exceedingly hard for me to slow down and be present in the moment. This event forced me to mentally pivot from “drive” to “stop and smell the roses”.
I think I needed this lesson, on this day.
When I’m 100 years old, I’m not going to remember carrying a rower. I’ll remember how the sky looked like a painting, and Steph and I laughing at the absurdity of what we were doing. I’ll remember trodding around and giggling with Jessica, just like always.
The dog tags can wait until next time (the 6.5h cutoff time is reasonable).
Considering the goal of Operation Dark Horse is to move as quickly as possible in the hills with weight, glycogen replenishment through ingestion of fast digesting carbohydrates is important to maintain muscle force production, demands intensified by work that is both load bearing and eccentric aka increased mechanical strain due to controlled lengthening of certain muscles during downhill movement. If you’re unaccustomed to this work, it’s a recipe for delayed onset muscle soreness (DOMS).
Size, intensity, duration, training status (including GI training), body composition, will all factor into personal carbohydrate requirements per hour. Assuming that one would be fast hiking and running with the rower, and then periodically rowing with intensity, liquid carbohydrate and electrolyte consumed in water on the move is an excellent idea to cover most calorie replacement (and caffeine is an excellent supplement to reduce perception of pain), supported by a smaller amount of low fiber and low fat food. Fluid intake requirements should be based on climate, environment, and sweat rate. As a bare minimum in San Diego fall weather – 0.75L/h of water and 60g CHO/h, ramping higher in the later hours of the event.
1:1 Nutrition Coaching for Endurance Athletes
Contact me to review and discuss your goals. Look forward to hearing from you!
The American Heart Association (AHA) recently issued a scientific statement evaluating popular diets against current recommendations for diets promoting cardiometabolic health. This review explores which diets may be better for long-term sustainability and how popular diets overlap with nutritional considerations for athletes.
Diet types have different levels of flexibility based on rules or recommendations. While flexibility is important, vague rules can also lead to misunderstandings or unintended food choices that may work counter to long-term health goals. For example, certain popular diets may fall outside of certain macronutrient distribution ranges and/or exclude major food groups. Popular media, and even some clinicians, misunderstand the evidence base of dietary patterns promoting cardiometabolic health. The goal of the statement is to compare popular diets to evidence-based AHA Dietary Guidance and provide clarity regarding the implementation of these diets.
What are the 2021 AHA Dietary Guidelines?
Refreshed every five years based on scientific reviews of available evidence, the AHA Dietary Guidelines associated with good cardiometabolic health and prevention of disease are based on ten criteria. AHA established these guidelines considering diets require flexibility based on individual, social, and cultural preferences in order to support healthy behaviors.
Popular diets defined and scored vs. the AHA Guidelines
The researchers conducted a review of publicly available literature regarding diet trends, including randomized control trials and descriptions from health organizations. They excluded diets designed to manage non-cardiometabolic diseases, short-term diets, and commercial diets with unclear definitions. After these exclusions, the researchers established the defining features of each remaining diet type.
Ten dietary patterns emerged based on similarities in macronutrient profiles, emphasized food groups, and restricted food groups.
Each of the diets was scored using a points system against the AHA guidelines, where a score of 1 point per guideline was given if the diet matched the guidance, 0.75 points if it mostly matched, 0.5 points if it partially matched, and 0 points if the diet was contrary. The subject matter experts discussed their scores to achieve consensus. A normalized score of 100 indicates perfect alignment.
Only criteria 2-9 were scored. Criteria 1 (maintain a healthy weight by adjusting energy intake and expenditure) is not directly attributable to a specific diet. Weight loss, maintenance, or weight gain can be achieved through any diet type by adjusting calorie energy intake. The authors note, “Low energy-dense foods such as vegetables and fruits are associated with greater satiety, and some evidence suggests that higher intakes of fiber and protein promote satiety. Energy balance may also be influenced by dietary restraint: Highly restrictive diets can support short-term energy restriction and weight loss, but have been associated with higher food cravings and attrition over time, although that may be modulated by individual characteristics. In addition, food availability and exposure to highly palatable, often ultra-processed foods may affect energy balance.”
What were the results?
DASH, Mediterranean, Pescatarian, and Ovo/Lacto Vegetarian diets had highest alignment with the AHA Guidelines.
Low-fat diets (<30% of calories from fat) and Vegan diets were mostly in alignment with the AHA Guidelines.
Very low-fat diets (<10% of calories from fat) and low carbohydrate diets (30-40% of calories from carbohydrate) had some partial alignment with the AHA guidlines.
Paleo and very-low carbohydrate diets (<10% of calories from carbohydrate) were poorly aligned with the AHA Guidelines.
DASH earned the top score. This dietary pattern was developed upon AHA recommendations.
Analysis
Considering health-promoting diet and long-term sustainability
I’ve plotted the AHA scores versus the number of food groups eliminated. Assuming no necessary dietary restrictions, the elimination of food groups or foods may make long-term adherence to a particular diet more challenging. In the short term, some find that diets with more food restrictions can be beneficial for their goals by reducing the number of daily decisions about food. However, these restrictions can be challenging to adhere to in the long term, considering the social, mental, and emotional aspects of food beyond simply “fueling the body”.
Diets that align best with the AHA Guidelines (DASH, Mediterranean, Pescatarian) also tend to have fewer food restrictions. Low fat (20-30%) and low carb (30-40%) diets also offer higher flexibility, although low-carb diets show lower alignment with AHA recommendations.
Due to the exclusion of meats, poultry, seafood, eggs/dairy, ovo/lacto vegetarians and vegan diets have more food restrictions, but still score well along AHA recommendations. Very low-fat diets are also almost necessarily vegan diets in order to achieve <10% of calories from fat, with additional elimination of nuts, oils, and seeds.
Paleo and very low-carb diets have poor alignment with heart-healthy diet guidelines and also tend to have more restrictions.
What to consider as an athlete
The AHA heart-healthy diet recommendations were created to promote good health and prevent disease at the general population level. They don’t take into account inter-individual variability within a group, nor the specific dietary needs of athletic populations.
I’ve prepared a summary of AHA alignments and areas requiring more attention by athletes. Diets scoring higher for promoting cardiometabolic health can also be strongly aligned with the needs of athletes towards performance improvement and other beneficial training adaptations.
Take Home Points
Not all popular dietary patterns are well aligned with diets supporting long-term cardiometabolic health.
Dietary patterns that support the goal of improving athletic performance can strongly overlap with dietary patterns that support cardiometabolic health. Diet patterns that are misaligned with supporting cardiometabolic health also have more potential shortcomings for athlete health and performance.
When choosing a diet, think about what you can stick to long-term. It may be helpful to implement a diet that enables diversity/less restrictive food choices.
Feel overwhelming? If you need help navigating the nutritional landscape for your specific athletic needs, please contact me.
Cravings for tasty food (sugar, fat, or combination) can feel overwhelming. It has been suggested that an addiction to certain types of food, particularly highly processed, hyper-palatable foods, could be a factor contributing to overeating (and obesity) in parallel with dramatic changes in the food environment. But is it purely an addiction? Do we have any control over cravings?
Similarities between tasty food cravings and chemical addiction
Presently, there is no consensus that addiction to certain foods is a clinical disorder nor is there a universally accepted definition. Some criteria have come to light via mapping substance dependence diagnostic criteria to eating behaviors. These include: tolerance, withdrawal symptoms, larger amounts consumed than intended, persistent desire or unsuccessful attempts to cut down, time spent using or recovering from substance, continual use despite knowledge of consequences, activities given up due to use of substance, and withdrawal symptoms when cutting down on certain foods.* Indeed, there is an association with food addiction and increased frequency of cravings.
Limited studies have identified similarities in neural responses between addictive-like eating and traditional addiction. Therefore, physiological addiction to food has at least some similarities to the neural responses of traditional addiction – increases dopamine levels, alteration of expression of opioids linked to palatability, certain neurotransmitters in our brains during withdrawal acting on our central and peripheral nervous system.
Foods that are sweet or combine the taste of sweet may stimulate parts of the brain that are also stimulated by addictive drugs. Certainly, overeating/binging on palatable foods could lead to obesity and other deleterious health consequences, but it’s far too simplistic to classify uncontrolled overeating of sweets and other hyper-palatable foods the same as drug addiction.
Looking beyond addiction – other forces at play
In addition to the physiological rewardpathways of addiction, food intake and cravings are regulated by other factors. We have the ability to influence these directly:
Energy status – acute and chronic energy restriction influences hunger via hunger and satiety hormones ghrelin and leptin. Forgetting to eat for extended periods of time, as well as chronic dieting potentially magnifies cravings.
Sleep – short sleep is associated with increased hunger, cravings, higher food reward, and larger portion sizes.
Food cue reactivity – the thought, sight, or smell of food, or internal stress. Cortisol hormone (a regulator of metabolism and mediator of stress and inflammatory response) can elevate during food cue exposure.
With an understanding that we directly have levers to pull to mitigate cravings, here are a few considerations and ideas:
Accept cravings are going to happen. Cravings are natural, and almost always based on emotional or environmental triggers (needing to feed the reward pathway to feel better) and not actual hunger. We’re human!
Self-reflect and try to understand where the craving is coming from. Does the craving usually happen at the same time of day? Can you identify a specific trigger that brings on the craving?
Are you tired? Short sleep and the discomfort of being tired may amplify cravings. Be aware if cravings are higher on days with shorter sleep.
Disrupt the reward pathway. Indulging cravings when they hit reinforces the reward pathway and may make future cravings even stronger. This doesn’t have to mean elimination of foods that trigger cravings. Rather, consider incorporating these foods in a planned fashion (proactively deciding and having them for an enjoyable reason, in a certain amount), versus reactively eating when a craving hits. This strips away the guilt, categorization of certain foods as “bad” (mentality in a binge cycle).
Establish consistency with meals and snacks. If you are physically hungry/forgot to eat, you can bet that this will only magnify and emotional or environmental craving.
Audit your food environment. Always drive past a bakery that blasts out the smell of cookies? Are sweet and/or fatty snacks at your fingertips in the cabinet? Removing food cue triggers may help with craving frequency. Driving an alternate route or keeping certain snacks out of line of sight are a few examples of positive changes to your food environment.
Be prepared with healthier options. In the absence of having choices, the craving will always win. Be fair to yourself and keep a stock of healthy snacks handy in your bag, car, and office so that when a craving hits – you have the choice to consume something more aligned with your goals.
When a bad craving hits, you may find it beneficial to engage in a hobby or other enjoyable activity to satisfy the need for reward. Reducing cravings is long-term work and requires cultivation of personal systems that facilitate the behavior you want in yourself. Everyone is different in this regard so it’s important to experiment. You are not alone!
*‘‘Food addiction’’ is most frequently measured with the Yale Food Addiction Scale (YFAS) which conceptualizes addictive-like eating as eating patterns that share behavioral similarities with substance use disorders.
Nutrition coaching provides strategy and practical ideas to manage healthy eating and establish habits to help reduce cravings. Contact me to discuss your goals.
Many people struggle with having no time in the morning for breakfast. This 5 minute breakfast sandwich is so simple to make and can easily wrapped up to eat on the go – quicker than a trip to Starbucks drive-thru. Excellent source of protein, whole grains, and an opportunity for some more veg.
It may be possible to make the eggs in a small bowl (using a plate or plastic wrap as cover), however I recommend using mini-ramekins with lids. Microwave times will vary, so it may take some adjustment of the cooking time when you first attempt.
Customize the flavor with different seasonings and toppings. For example adding garlic powder or chili lime into the eggs, or a bit of soy sauce, mushroom, and teriyaki. A thousand different themes to keep it interesting – hot sauces, peppers, salsa, ketchup, or BBQ. If you prefer lower carbohydrates, swap the English muffin for a low carb bread.
