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Thread: Starting Strength Radio: Abeel Mangi MD: Cardiac Rehab and Strength Training

  1. #11
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    • starting strength seminar april 2024
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    Quote Originally Posted by Ray Gillenwater View Post
    Maybe we should change the tittle to, “What heart doctors REALLY THINK about lifting weights,” and then a close up shot of you, mouth agape, as if you’ve just heard something shocking.
    You jest, but this might actually be part of the solution. It’s worth a shot, in my opinion. This is important stuff.

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    Quote Originally Posted by Mark Rippetoe View Post
    The amazing thing is that there are only 2421 views on YouTube right now.
    YT watchers and podcast listeners are not the same audience. The short excerpts are what get things in front of the former. 3% for the 3%!

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    Quote Originally Posted by Satch12879 View Post
    From this discussion, two questions/points of a completely serious nature:

    1. What is an appropriate definition of what constitutes a “processed” food? This has increasingly become a pop-culture bullshit term, at least to me. All substances that are appropriate for human consumption require some level of human intervention in order to make their nutrients readily available, either mechanically, thermally, biologically, and/or chemically. What’s the criteria? Beyond the obvious distinction of Kraft Mac and Cheese versus Grandma’s Sunday macaroni.

    2. Rip and Dr. Mangi, how do your opinions on “high carb” diets square with the recommendations given by Santana, et al., regarding nutrition for trainees? Are you referring to general population? Does the relatively high protein content that we advocate and recommend mitigate any deleterious effects? (I think I may have answered my own question here; if you are eating 200g of protein as a male, it’s pretty hard to get to the USDA’s recommended percentage of carbohydrates intake per day.)
    A high complex carbohydrate diet that is high in fiber is necessary to maximize performance. My position on fat is that you don't have to worry about it in the sense that you will accidentally get enough of it in your diet without even trying. On the same token I do not think that any professional on either side of the spectrum will argue against a diet high in fruits, vegetables, and whole grains in favor of pizza, beer, donuts, and Cheetos. People forget these foods are high in carbohydrates and fat. To answer your question regarding protein, yes eating a high protein diet is known to improve glycemic control. Eating a meal that has both carbohydrate and protein is going to have a lower glycemic response than one with carbohydrate alone. The same effect has been observed with fiber. Carbohydrate quality is the key here. Lastly, when protein needs are met and fat is held moderate then it is difficult to meet the USDA standards (~45-65% of calories from carbohydrate), which is why eating properly to drive progress under the bar is Not Easy.

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    Excellent. It should have more views. Pearls before swine.

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    This is a terrific series of posts. I am certainly a believer in terms of "getting the word out," and believe that physical activity is an incredibly important tool that we should all use in order to ward off disease, and to prepare us to fight off disease (and recover from it) should it befall us - because it will befall all of us at some point. Getting sick does not mean that one cannot re-discover, or find for the first time, the inner reserves to re-invent oneself and to do something new and exciting, to improve oneself in at least one dimension. As my trainer John Kenney has often told me: "There is no better feeling as an adult, than being able to surprise oneself!" Having said that, if you are recovering from a disease, you want to start training under supervision. You want to be sure that you develop the capacity to train hard over time. Its hard to accomplish anything meaningful overnight.

    I personally tremendously strength training and believe in its benefits, but also advocate high intensity interval training, endurance training - or whatever gets us off the couches and motivates us to move. I do some or all of these 5-8 times a week depending on how I feel. Having specific goals to train towards can be a powerful motivator for certain people.

    I am not "anti-carb." I think that discovering and using complex cardohydrates with low glycemic index to support physiology and training goals is important. I am not sure that one needs to eat a lot more protein than most of us Americans already do. I just believe that if we start to pay attention to what makes up one's food - one may be surprised. If its more chemicals than things you recognize as food - its probably not food. If its sweet potatoes, vegetables, fresh meats, fruits - then its safe to say that that is probably food.

    My only point is that we need to move, we need to challenge ourselves - physically, mentally, emotionally, spiritually, intellectually, etc., to stretch ourselves past the point where we are comfortable. The human body is a wondrous machine and if challenged, if stressed, it can generate adaptation that is truly remarkable. We may even surprise ourselves.

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    This was amazing, thank you!

    I will use this video.

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    Why are “complex carbs” that keep blood sugar and insulin elevated for hours and hours considered superior to “simple carbs” that get quickly shuttled into liver and skeletal muscle, which then allows blood sugar and insulin levels to fall to normal/baseline/low levels again?

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    Dr. Mangi, great video. As has been said, one of the best I've seen put out. You mentioned the concept of a partnership in the video.I know it's a challenge, but how would you recommend we go about forming a partnership with cardiologists (or any other doctors for that matter)? I've thought about this myself, possibly reaching out to show them what we do to reduce the stigma of barbell training. Any thoughts on how best to form such a partnership would be greatly aprpeciated!

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    Quote Originally Posted by FatButWeak View Post
    Why are “complex carbs” that keep blood sugar and insulin elevated for hours and hours considered superior to “simple carbs” that get quickly shuttled into liver and skeletal muscle, which then allows blood sugar and insulin levels to fall to normal/baseline/low levels again?

    1) Complex Carbohydrates typically contain fiber
    2) Glycemic response is greater when carbohydrates are consumed alone
    3) Glycemic response is blunted when carbohydrates are mixed with protein, fiber, and fat
    4) Simple carbohydrates are useful around workout times when need is higher

    Also "hours and hours" of hyperinsulinemia and hyperglycemia is unlikely a healthy individual.

  10. #20
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    Quote Originally Posted by FatButWeak View Post
    Why are “complex carbs” that keep blood sugar and insulin elevated for hours and hours considered superior to “simple carbs” that get quickly shuttled into liver and skeletal muscle, which then allows blood sugar and insulin levels to fall to normal/baseline/low levels again?
    I have no background as a health expert. I have just been reading a lot of non-academic literature on the subject so allow me to test how well I understand the answer.

    The simplest of carbs is glucose and fructose, which combine to make sucrose. Indigested sucrose quickly separates into its component parts.

    Glucose triggers an insulin response signally “make fat of unburnt glucose. I include ready stores of glucose in the brain and muscles as burnt. Fructose creates no insulin response and cannot be used in muscles or brain (I will skip repeating “brain” from here on due to the main focus of this website.) Fructose has to be processed with alcohol in the liver before the body can use fructose byproducts. The liver creates triglycerides of those byproducts that it spews into the blood stream. Those triglycerides are easily made into fat tissue. Glucose triggered insulin acts as an accelerant to building fatty tissue.

    Without the presence of fiber, protein, or fat to slow the decomposition of sucrose, these fatty depositing processes go into high gear. Complex carbs then keep adding fuel to the fatty depositing process when the fructose byproducts are nearly spent, making it last even longer.

    In the absence of sucrose, complex carbs must be more slowly decomposed by the body. The glucose does not set off nearly the insulin surge. The fructose has more time to move from triglycerides to conversion to glucose in the muscles as a workout or protein build occurs.

    Without the insulin screaming for fat deposits to be built out of fructose byproducts, the body has more chance to “make good choices,” to quote the neighbors’ 4-year old, about how to use the nutrient components in the blood stream.

    In other words introduction of sucrose makes insulin run around like Chicken Little screaming the sky is falling or the end is nigh and that you should stock your bomb shelters now.

    Complex carbs without Chicken Little are like a fine meal overlooking the countryside with no worry in the world. The body has time to reflect and leisurely build the best body it can.

    That’s all I got. How did I do?

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