Fuel Better at Every Age - Beef. It's What's for Dinner · April 10, 2018 Webinar will begin at the...
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April 10, 2018
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Fuel Better at Every Age:The Role of Nutrition for Improved Body Composition and Strength
Stuart Phillips, PhD, FACN, FACSM
Jim White, RD, ACSM EX-P
2
Awarded for 1 Continuing Education Credit
–Commission on Dietetic Registration (CDR)
Certificates will be awarded via email
–Claim credit no later than May 17, 2018
–Contact AKH Inc. with questions: [email protected]
Webinar is being recorded
–Will be available at www.beefitswhatsfordinner.com
CONTINUING EDUCATION INFO
JIM WHITE, RD, ACSM EX-P
3
• Nationally recognized registered dietitian nutritionist,
past spokesperson for the Academy of Nutrition and
Dietetics and an American College of Sports Medicine
Exercise Physiologist
• Owner of three Jim White Fitness and Nutrition Studios,
three medical nutrition therapy practices and a
workplace wellness corporation
• Quoted in thousands of publications and featured in
hundreds of television and radio segments nationwide
with experience conducting seminars, interviews and
appearances all around the country
• Enjoys giving back through his very own non-profit, the
LIFT Fitness Foundation, which focuses on creating a
foundation of wellness to empower individuals in need.
DISCLOSURE – JIM WHITE, RD, ACSM EX-P
4
STUART PHILLIPS, PHD, FACN, FACSM
5
• Tier 1 Canada Research Chair in Skeletal Muscle
Health.
• Director of Physical Activity Centre of Excellence
(PACE) and McMaster Centre for Nutrition,
Exercise, and Health Research.
• Professor in kinesiology and adjunct professor in
the School of Medicine at McMaster University.
• Research focused on the impact of nutrition and
exercise on human skeletal muscle protein
turnover, and diet- and exercise-induced changes
in body composition.
DISCLOSURE – STUART PHILLIPS, PHD FACN, FACSM
6
• Former consultant: Nestec AS – Nestlé SA
• Former consultant: Ajinomoto
OBJECTIVES
7
• Define the role of the diet, including high-quality protein, in building and repairing
muscle.
• Translate evidence-based research on the role of high-quality protein in supporting
improved body composition and physical and mental strength.
• Share practical application tips with peers and clients, including physical activity
tips and nutrition information on how to include high-quality protein foods in a
healthy dietary pattern at various life stages.
Stuart M. Phillips, Ph.D., FACN, FACSM Professor, McMaster UniversityOntario, Canada
@mackinprof
FB: www.facebook.com/SMPPh.D
single fact
an additional 30 plus years to life expectancy
Age (yr)
Early Adult Older
Mu
scle
ma
ssM
uscle
fun
ction
Birth 20 30 40 50 60 70 80 90
Disability threshold
Time (h)
protein proteinRat
e o
f M
PS a
nd M
PBMPS MPB
protein
T.A. Churward-Venne, N.A. Burd, and S.M. Phillips. Nutr. Metab. 9(1): 40, 2012.
Time (h)
protein protein
Rat
e o
f M
PS a
nd M
PBMPS MPB
protein
T.A. Churward-Venne, N.A. Burd, and S.M. Phillips. Nutr. Metab. 9(1): 40, 2012.
Variations in protein synthesis affect muscle mass: affected by protein ingestion and loading
What can offset muscle loss in aging?
P R O T E I Nand
A C T I V I T Y
resistance exercise
muscle strength
resistance exercise
muscular strength
muscular strength
Muscular strength
Muscular strength
muscular strength
muscular strength
• Aging is associated with reduced food intake, predisposing to energy-protein
undernutrition (Morley, AJCN, 1997)
• N excretion, muscle area, & strength, decreased in older subjects fed an isocaloric diet
containing the protein RDA (Campbell et al, J Gerontol, 2001)
• Older adults may need more protein than the RDA: 1.0-1.2g/kg/d to maintain muscle
mass and even greater benefit may be seen with higher intakes (
• Older adults are not consuming these intakes! (Fulgoni, AJCN, 2010)
↑25-50%*
↑50-88%*
↑150%*
Pro
tein
Le
vels
1. DRIs for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients). (2005) National Academy of Sciences. Institute of Medicine. 2. Bauer J et al. Evidence-based Recommendations for Optimal Dietary Protein Intake in Older People: A Position Paper From the PROT-AGE Study Group. JAMDA. 2013;14:542-59. 3. Deutz NEP et al. Protein intake and exercise for optimal muscle function with aging: Recommendations for the ESPEN Expert Group. Clinical Nutrition (2014) In Press; http://dx.doi.org/10.1016/j.clnu.2014.04.007.
0.8g/kg
RDA (19+yrs)1
1.0-1.2g/kg
Minimumprotein intake
for healthy people2,3
1.2-1.5g/kg
Acute or chronic
disease2,3
Up to 2.0g/kg
Severe illness or injury,
or marked malnutrition2
Current1 New Recommendations >65 years2,3†
*increase above current Protein RDA1
†Older people with severe kidney disease who are not on dialysis may need to limit protein intake.
Adjusted lean mass (LM) loss by quintile of energy-adjusted total protein intake. n = 2066.
Houston D K et al. Am J Clin Nutr 2008;87:150-155 ©2008 by American Society for Nutrition
0.7 0.8 0.85 0.9 1.0
0 . 0 0 . 1 0 . 2 0 . 3 0 . 4 0 . 5 0 . 6 0 . 7
0 . 0 0
0 . 0 2
0 . 0 4
0 . 0 6
0 . 0 8
0 . 1 0
0 . 1 2
0 . 2 4 g / k g ( 0 . 1 8 - 0 . 3 0 )
P r o t e i n ( g / k g )
MP
S
0 . 0 0 . 1 0 . 2 0 . 3 0 . 4 0 . 5 0 . 6 0 . 7
0 . 0 0
0 . 0 2
0 . 0 4
0 . 0 6
0 . 0 8
0 . 1 0
0 . 1 2
0 . 3 9 g / k g ( 0 . 2 1 - 0 . 5 7 ) *
P r o t e i n ( g / k g )
MP
S
Moore et al. J. Gerontol. A Biol. Sci. Med. Sci. 70(1): 57-62, 2015
Time (h)
protein protein
Rat
e o
f M
PS a
nd M
PBMPS MPB
protein
Time (h)
proteinproteinR
ate o
f M
PS a
nd M
PBMPS MPB
protein
and muscle performance
What amount of beef is optimal to stimulate MPS with/without exercise?
0g 57g 113g 170g0.000
0.025
0.050
0.075
0.100
*
*FED
FED+EX
MPS
(%
• h
-1)
Robinson et al. Appl. Physiol. Nutr. Metab. 38(2): 120-5, 2013
170g of beef (6oz) is optimal to stimulate MPS
with/without exercise
3. Mustafa J, Ellison RC, Singer MR, Bradlee ML, Kalesan B, Holick MF, et al. Dietary Protein and Preservation of Physical Functioning Among Middle-aged and Older Adults in the Framingham Offspring Study. Am J Epidemiol. (2018)
1 9 9 2 1 9 9 6 2 0 0 0 2 0 0 4
1 6
1 8
2 0
2 2
2 4
2 6F
un
ctio
na
l S
ta
tu
s S
co
re
< 0 . 8
0 . 8 - 1 . 1
> 1 . 2
Mustafa et al. Am. J. Epidemiol. In press, 2018
Mustafa et al. Am. J. Epidemiol. In press, 2018
nutrient-rich
nutrient-rich sources of protein
reduce energy intake nutrient-dense foods
*
*
*
*
* Good – Excellent sources of protein and amongst the top 10 protein-containing foods (NHANES 2007-2010) currently consumed by Americans
no data
• There are no data that link higher protein diets to renal disease: the FAO/WHO report says this, as does the current IOM document that sets the DRI for North Americans
not related to progressive decline in kidney function
• There are no data that link higher protein diets to renal disease: the FAO/WHO report says this as does the current IOM document that sets the DRI for North Americans
• In the most recent round of discussions in setting the new DRI, the IOM concluded, “…protein content of diet is not related to progressive decline in kidney function with age.”
can be attenuated by reducing the protein in the diet has no foundation.
•A resource to check out: A Systematic Review of Renal Health in Healthy Individuals Associated with Protein Intake above the U.S. Recommended Dietary Allowance in Randomized Controlled Trials and Observational Studies. Van Elswyk et al. Advances in Nutrition, in press, 2018
• The acid-ash hypothesis: protein and grain foods, with a low potassium intake, produce a diet acid load, net acid excretion (NAE), increased urine calcium, and release of calcium from the skeleton, leading to osteoporosis
Current evidence shows no adverse effects of higher protein intakes.
only the LS showed moderate evidence to support benefits of higher protein intake.
• The acid-ash hypothesis: protein and grain foods, with a low potassium intake, produce a diet acid load, net acid excretion (NAE), increased urine calcium, and release of calcium from the skeleton, leading to osteoporosis
• Meta-analysis (Shams-White et al. Am J Clin Nutr. 2017): “Current evidence shows no adverse effects of higher protein intakes. Although there were positive trends on BMD at most bone sites, only the LS showed moderate evidence to support benefits of higher protein intake.”
protein's positive effect on bone health is augmented by increased calcium intake only be beneficial under conditions of adequate calcium intake.
Stuart M. Phillips, PhD, FACN, FACSM
Professor, McMaster University
@mackinprof
FB: www.facebook.com/SMPPh.D
2PRACTICAL APPLICATION
58
“STRENGTH AND GROWTH COME ONLY THROUGH CONTINUOUS EFFORT
AND STRUGGLE.”
- Napoleon Hill
59
“If you don’t use it, you lose it”
J Am Geriatr Soc. 2003 Mar;51(3):323-30.
After age 40, untrained people typically lose
8 percent or more of their muscle mass each
decade.
Study shows by maintaining muscle mass you can reverse the process of muscle decline.
60Wroblewski AP, et al. Phys Sportsmed. 2011 Sep;39(3):172-8.
61
PHYSICAL ACTIVITY• Fitness tips for improved body composition, physical strength and
mental stamina.
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PHYSICAL ACTIVITYBODY COMPOSITION is used to describe the percentages of fat, bone, water and muscle in human bodies
• Weight training
• Healthy diet
• Cardiovascular training
BODY FAT AND LEAN MUSCLE MASS MEASURED BY:
• Hydrostatic weighing - 98% Accuracy
• Bod Pod - 97.7-99% Accuracy
• DEXA Scan - 95-98% Accuracy
• Skin fold measurements - up to 89.4-92.4% Accuracy
• Bioelectrical impedance - 90-93% Accuracy
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BODY FAT PERCENTAGE
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Cardiorespiratory Endurance
• American College of Sports Medicine recommends for weight and body fat loss, 50-60 minutes per day to a total of 300 minutes moderate exercise.
Weight training
• Adults should train each major muscle group two or three days each week using a variety of exercises and equipment.
• Two to four sets of each exercise will help adults improve increase in lean muscle mass.
• For each exercise, 8-12 repetitions improve muscle growth.
TIPS FOR IMPROVED BODY COMPOSITION
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Resistance Exercise
• Adults should train each major muscle group two or three days each week using a variety of exercises and equipment.
• Sets: Two to four sets of each exercise will help adults improve strength and power.
• Volume: 8-12 repetitions for novice to intermediate; 2-6 sets of 1-8 repetitions for advanced.
• Rest period: 2-3 min for higher intense exercises that use heavier loads; 1-2 minutes between the lower intense exercises with light loads.
TIPS FOR IMPROVED PHYSICAL STRENGTH
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• Sleep
• Reduced Stress
• Time Management
• Use Visualization
• Find Balance
TIPS FOR IMPROVED MENTAL STAMINA
https://www.nichd.nih.gov/health/topics/sleep/conditioninfo/sleep-disorders
https://www.apa.org/news/press/releases/stress/2017/state-nation.pdf
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NUTRITION
69
70
• Incorporating high-quality protein into the diet
• How to use beef to fuel strong bodies and minds across the lifespan.
• Recipes and meal planning using various high-quality protein
• Early years
• Adulthood
• Later years
• Specific populations: active lifestyle, pregnancy, certain disease states
NUTRITION
PROTEIN’S ROLE IN A HEALTHY LIFESTYLE
Part of a Healthy
Diet
Weight Mgmt
Building Muscle
Increased Energy
Keeps Me Full
Longer
Leidy HJ, et al. Am J Clin Nutr 2015;101:1320S-9S.
Paddon-Jones D, et al. Am J Clin Nutr 2015;101:1339S-45S.Paddon-Jones D, et al. Am J Clin Nutr. 2008;87:1558S-61S.
WHAT DOES “LEAN” MEAN?
USDA. A guide to federal food labeling requirements for meat, poultry, and egg products. 2007.
Lean
<95 mg cholesterol
≤4.5 g saturated
fat<10 g
total fat
(per 3.5 ounces
cooked beef)
MANY OF AMERICAN’S FAVORITE CUTS ARE LEANNearly 65 percent of all beef muscle cuts sold in grocery stores are considered lean
*Per 3.5 ounces cooked serving
IRI/Freshlook, Total US MULO, 52 weeks ending 10/29/17; Categorized by VMMeat System
USDA, ARS. 2015. U.S. Department of Agriculture National Nutrient Database for Standard Reference, Release 28.
U.S Department of Agriculture. A guide to federal food labeling requirements for meat, poultry, and egg products. 2007.
Most popular lean beef
steaks in the retail meat
case:
Strip Steak
Top Round
Top Sirloin
Bottom Round
Tenderloin
Most popular lean beef
steaks chosen at
restaurants:
Tenderloin/Filet
Top Sirloin
Top Loin (Strip)
Flank Steak
Meet Grant
CASE STUDY
74
Before AfterSTATS
• Weight Loss: -40 lbs
• Body Composition: Lost 15% body fat
• Muscular Strength: Bench press 1RM
increased from 95lbs to 275lbs
• Mental Stamina: Starting Navy Seal
BUDS Training.
State: Early Years
CASE STUDY
75
• 8 ounces leftover cooked steak, cut into very small pieces
• 1 white potato, peeled and cut into small cubes
• ½ lb brussels sprouts, cut in half and ends removed
• 1 red pepper, cut into chunks
• 1 small onion, diced
• 2 Tbsp minced garlic
• 5 washed white button mushrooms, chopped or sliced
• 1 tsp cayenne pepper
• 1 tsp paprika
• 1 Tbsp olive oil
• Salt and pepper to taste
1. In a large skillet, heat olive oil on medium-high
2. Add sweet potatoes and brussels sprouts to skillet and cover for 5 minutes. Uncover and cook, stirring
frequently, for another 5 minutes.
3. Add peppers, onions, and garlic to skillet and cook uncovered for 8-10 minutes, stirring occasionally.
4. Add mushrooms and steak and cook until both are heated through.
5. Season with cayenne pepper, paprika, and salt and pepper if desired. Stir and serve.
*Makes 3 servings, 275 calories per serving, 25 grams protein
Grant’s Favorite High-Protein Recipe – Steak Breakfast Hash
Meet Grant
CASE STUDY
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State: Early Years
“Despite being very athletic, I have always struggled with weight gain. I tried countless diets and worked with personal trainers in the past, but to no avail. When I was 13 years old I began to incorporate more nutritious foods into my diet like lean proteins and vegetables, and the weight quickly began to come off. One of my favorite go-to meals was this steak breakfast hash which helped me feel strong and recover quickly after a hard workout, plus who doesn’t love steak in the morning after a grueling workout?
Over the next several months, I was losing about two pounds per week and have lost over 40 pounds and have completely transformed my lifestyle. Fitness and nutrition have become part of my daily routine and will continue to be part of my future.”
Meet Jean
CASE STUDY
77
Before AfterSTATS
• Weight Loss: -30 lbs
• Body Composition: Lost 10% body fat
• Muscular Strength: Biked 100 mile
race
• Mental Stamina: Confidence has
increased and she feels like she can do
anything.
State: Adult
Jean’s Favorite High-Protein Snack Recipe – Mango Ginger Protein Ball
CASE STUDY
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• 1.5 C Almond Meal
• 1.5 C Oat Flour
• 1/3 C Protein Powder, vanilla
• 2 C Dehydrated Mangos, chopped
• 1 C Walnuts, raw
• 1/2 C Medjool dates, chopped
• 1/4 C Maple Syrup
• 1t Ginger, fresh and grated
• 1t Lemon Zest
Mix in food processor until wet. Form into compressed balls with large melon baller.
100 calories, 11 grams protein, for each ball 1.25" in circumference.
“Riding my first century [a bicycle ride of 100
miles] had been an elusive goal until my trainer
and dietitian created a plan, provided
encouragement and gave me confidence. We
timed my training perfectly, and I lost 30 pounds
and gained strength in the process. I completed
day one 100 miles in great form and followed
that with 75 miles day two of the Bike MS. One of
my favorite snacks to fuel me through those
miles were these Mango Ginger Protein balls.
The higher protein yet lower calories helped
me feeling fuller longer and being satisfied
yet it didn’t leave me feeling overly stuffed as I
biked throughout the day. What’s next? The
possibilities seem endless!”
Meet Lynn
CASE STUDY
79
Before AfterSTATS
• Weight Lost: -72 lbs
• Body Composition: Lost 14% body fat
• Muscular Strength: Is able to do step
ups with 10 lbs
• Mental Stamina: Started dating again,
traveling, decreased depression.
State: Later Years
CASE STUDY
80
“The need for many seniors to lose weight and shape up has been in the news lately. In one story, a doctor doubts “whether you’re going to see people lose 50 to 100 pounds as they’re older.” Oh, really? This senior has lost over 70 pounds since first waddling in to see a dietitian and personal trainer— with borderline diabetes — less than a year ago.
It hasn’t always been easy but my dietitian managed to change my eating habits so I don’t miss the bad old stuff; and we keep tweaking the plan so it’s something I can live with permanently. My dietitian taught me that incorporating protein helps to build and maintain muscle. Not only that, but it helps continue the fight against type-2 diabetes and osteoporosis, all pesky diseases that seem to be more prominent in my mature stage of life.”
Meet Lynn
State: Later Years
Meet Jenny
CASE STUDY
81
Before After STATS
• Weight Lost: -14 lbs
• Body Composition: Lost 6% body fat
• Muscular Strength: Leg press before:
110lb | now: 200lbs
• Mental Stamina: Has more energy to
handle workday, take care of 2 girls,
and to live strong through the day.
State: Special Populations, Active
Sample Meal PlanCASE STUDY
82
Jenny’s Meal Plan - BEFORE
• Breakfast: 1 cup of sugary cereal with milk
• Snack: Skipped
• Lunch: Chicken ranch wrap with chips and
a coke
• Snack 2: Gold fish
• Dinner: 2 slices of pizza
• 14 glasses of wine/week
Jenny’s Meal Plan – AFTER (Competition Diet)
• Breakfast: 3 eggs + 1 whole egg, veggies and
½ cup oatmeal
• Snacks: 1 protein shake (1 scoop of whey
protein) with almond milk and berries or 1
Greek yogurt with walnuts and strawberries
• Lunch: 4 oz chicken, 1 cup brown rice and 1
cup cooked veggies
• Dinner: 4 oz flank steak, 1 cup of sweet
potatoes and 1 cup of cooked brussels sprouts
• Only 2 glasses of wine/week
Meet Krista
CASE STUDY
83
During After STATS
• Body Composition: Gained an 8 lbs 10
oz healthy baby.
• Muscular Strength: Focused on
consistent weight training 2-3x a week
up until birth
• Mental Stamina: Focused on deep
breathing and meditation to get ready
for natural child birth.
State: Special Populations, Pregnancy
Key Notes: Throughout pregnancy, your body needs about 10 extra grams of protein each day to
support the growing baby.
Sample Meal PlanCASE STUDY
84
Krista’s Meal Plan – BEFORE Pregnancy
• Breakfast: Bagel with light cream cheese
• Snack 1: Skipped
• Lunch: Turkey sandwich with crackers and
fruit
• Snack 2: Skipped
• Dinner: Crackers with cheese and fruit
• 1 small dessert and glass of wine
Krista’s Meal Plan – During Pregnancy
• Breakfast: 2 whole grain waffles with 2 tbsp
almond butter and fruit
• Snack 1: Rotisserie Chicken with crackers and
baby carrots
• Lunch: Chipotle Bowl with black beans, steak,
brown rice, lettuce, salsa and guacamole
• Snack 2: 1 Greek yogurt with hummus and
veggies and fruit
• Dinner: Salad with grilled chicken and a small
sweet potato
Meet Mark
CASE STUDY
85
Before After STATS
• Weight Loss: -90 lbs
• Body Composition: Lost 13.7% body
fat, 6.9 increase in skeletal mass
• Muscular Strength: Increased 7
pushups to 37 pushups
• Mental Stamina: Improved mental
stamina for his work as computer
scientist, more energy to play with
grandchildren, can drive for first time
in years. Went from body age of 80 to
56.
• Health Status: Went off his cholesterol
and blood pressure medications, off C-
pap machine and no more episodes of
vertigo.
State: Special Populations, Disease State
Sample Meal PlanCASE STUDY
86
Mark’s Meal Plan - BEFORE
• Breakfast: Eggs with cheese, grits with
butter and a muffin
• Snacks: Skipped
• Lunch: 12 inch sub with chips and 20 oz
mountain dew
• Dinner: Lasagna with Caesar salad
• Late night snack: Ben and Jerry’s Ice
cream, chips, cookies
• 3 beers/night
Mark’s Meal Plan - AFTER
• Breakfast: ¾ cup plain nonfat Greek yogurt, ¼
cup low-sugar granola (plain), 6 almonds,
½sliced banana
• Snacks: 1 oz reduced-fat cheese with 1 serving
whole-grain crackers or 1 rice cake with 1
tablespoon nut butter and 1 teaspoon dark
chocolate chips
• Lunch: Lean burger - 4 oz 96% lean beef, 1
slice alpine lace cheese, 1/8 avocado slice,
lettuce, tomato with whole wheat bun and baby
carrots.
• Dinner: 4 oz salmon, 1.5 cups cooked quinoa
and 1 cup of broccoli spears
• Late night snack: 1 cup Halotop chocolate ice
cream
87
3Q&A
89
Awarded for 1 Continuing Education Credit
–Commission on Dietetic Registration (CDR)
Certificates will be awarded via email
–Claim credit no later than May 17, 2018
–Contact AKH Inc. with questions: [email protected]
Webinar is being recorded
–Will be available at www.beefitswhatsfordinner.com
Slides
–Will be shared in a follow-up email after the webinar.
THANK YOU