Nancy Onyett, FNP-C

The Role of Glycogen Metabolism in Competitive Bodybuilding

In competitive bodybuilding we start a contest preparation 12-16 weeks out from the competition.  This consists of a structured meal plan and a change in training intensity that includes a six day routine. The meal plan is continually altered over the time period to burn fat and deplete interstitial water through carbohydrate lowering. The last four weeks  a competitor is focused on selection of a song to pose to, a routine that is choreographed, cardio, and lastly continued weight training. As a competitor, the overwhelmed feeling sinks in and pure chaos with a scattered brain takes over. 

Why and what is the chemistry behind the mental, physical and emotional exhaustion that the body is going through  until the end? This crucial time period is when the carbohydrates are dropping weekly along with changes in protein for the body to burn quickly. The last four weeks of dietary changes dial a physique into a tight sculpted body with deep definition enhanced by continued cardio and weight training. Usually the protein is dropped from chicken or turkey to Ahi Tuna then lastly to Tilapia (a white very low fat fish). This is when competitors develop problems due to drastic dietary cuts with the intense training along with their daily life. The "dead in the head" or "deer in headlights" feeling is prevalent.

The biochemistry involves gluconeogenesis in breaking down protein and the very small amount of carbohydrates for energy. This occurs in the liver where glycogen is stored.  A competitor develops a negative balance quickly as protein is the main molecule active in the cycle and a small amount of carbohydrate. When the glycoen stores are exhausted in the liver the symptoms of hypoglycemia are prevalent and a competitor needs to be in a situation to rest and restore through a protein drink or their next meal  but not to add anymore carbohydrates to the diet. Muscle glycogen stores become depleted as well which promotes the overwhelming fatigue and weakness.  At this point a competitor's body fat is very low without much reserve to burn. A difficult time  to think and stay awake all day long.  

Most competitors have very easy jobs or make arrangements to take off work the last four weeks before a competition due to these biochemical processes in the liver and muscles depleting the body further of interstitial water and fat content. Depending  how a competitor looks the last two weeks and especially the last week the diet is stripped of the protein drinks and the quanity of green vegetables with Tilapia is lowered with each meal. Usually this is the roughest period and competitors do not work. At the time of competition women are 7-10% body fat and men are 4-5% body fat.

What I have learned as a competitor myself is do it right or don't do it at all. The judges are looking at parameters of development, symmetry, body fat, presentation and lastly the overall package. The overall package captures the judges eyes as the competitor artisically displays their physique  on stage. I have been on stage over the last 15 years and sometimes I am just off in a body part lagging or I feel so miserable I can't display the artistic presence.  When I am at my best I can artisically display muscle groups through the mandatory poses. Competitive bodybuilding is a difficult sport and one that is demanding and scientifically intricate to mold that physique for stage presence. Competitors sacrifice social engagements, friends, food, and sometimes their families to achieve their goal.

Bodybuilding is a sport that I love and will continue to do the rest of my life.  I was two weeks out from the Western Regional Bodybuilding, Fitness, and Figure Competition when hypoglycemia was overtaking me to either stop working or postpone competing. I am in a position as a health care provider in my own practice and I could not take off work; therefore, I will plan carefully for the next show so this will not happen again.

All of now, please leave a comment if you wish.

 

                                                                     

Hormonal Effects of Male Obesity

In a prior blog "Male Andropause vs. Oxidative Stress Hypogonadism", I discussed the typical age  of men who are in andropause and younger men who are suffering from hypogonadism related to oxidative stress. In review of these two syndromes, both have similiar signs, symptoms, and a subtle onset. The end result in both syndromes is obesity.

In this blog I want to discuss the hormonal effects in male obesity. Obesity is largely due to stress, a poor diet, and lack of exercise. A poor lifestyle leads to oxidative changes within the body which causes insulin to rise in response to a poor dietary regimen. When insulin rises approximately midway there is unwanted weight gain usually in the abdomen first, then all over. Men, who have a family history of diabetes are at a higher risk of developing adult onset diabetes quicker than men who do not have a family history of diabetes. As a result, the insulin level rises as the body's tissues become resistant causing blood sugars to rise  above a normal range. Usually, the postpriandial blood sugar rises before the fasting blood sugar. Other metabolic  changes include an elevated LDL , triglycerides, and lowered HDL. Hypertension and hypothyroidism are other metabolic diseases that are manifested from oxidative changes within the body.

Testosterone is produced in the testes from FSH secreted from the pituitary gland.  In obese males with insulin resistance  a hormone disturbance  is created with lowered testosterone levels and elevated estradiol levels. The hormonal changes cause decreased metabolism, rising blood sugars, mood instability, lethargy, altered lipid levels,erectile dysfunction, infertility and decreased libido.  The physical and emotional symptoms are similar to the women's menopausal symptoms. A cycle of unwanted weight gain with carbohydrate craving  further complicate obesity and hypogonadism.

In young men who want to have children, the treatment is focused on a structured medical weight loss program. The insulin resistance is treated with a low glycemic diet and metformin. Also they are encouraged to start weight training which will enhance their natural testosterone and weight loss. Success in reversing the hormone imbalance depends on the patient's attitude to lose the weight. After six months of a structured weight loss program and no progress then HCG is offered at 500IU per day to start and titrated accordingly to the testosterone level. Once HCG is started it is not stopped or the testosterone level will drop and the estradiol level will rise contributing to weight gain and other previously mentioned symptoms. HCG stimulates the testes to make more testosterone which helps to lower  the estradiol level.

In older middle aged men, the difference in treatment is they can be started on compounded testerone cream, if they do not want more children. Also, they are started on a  weight loss program with metformin and if there is presence of cardiac risk factors  a stress test is done before exercise is prescribed. In the healthy older men a weighted exercise program is prescribed with a low glycemic diet to follow. The testosterone cream is weight based and titrated according to testosterone levels. If any other metabolic disturbances are diagnosed they are treated according to the standard of care such as hypertension, hypothyroidism,  and dyslipidemia with appropriate medications. 

All men on the medical weight loss program are seen every two weeks for evaluation. Other supplements include Vita-Cell B injections, B50 Complete, and Lap Band in a Bottle. The supplements, medications along with dietary restrictions and weighted exercise will enhance weight loss which corrects the hormonal disturbance.