UNIVERSITY Contest Prep Diet Periodization (Cheat meals, Refeeds, Diet Breaks, Carbohydrate Cycling) Lesson Overview • What is Intermittent dieting versus continuous Dieting? • How we physically adapt during energy restriction? • What is the research on short term 24-72 hour refeeds? • Fat loss, muscle retention, hormones, adherence, performance • • • • • • • • • What is the research on long duration refeeds > days “diet breaks”? Why is the current research limited for physique competitors? What are the draw backs to using refeeds? Practical takeaway points from the literature How and When to apply 24-72 hour refeeds How and When to apply diet breaks How and when to apply High and low day rotations How and what to monitor for refeed peak week practice Sample contest prep diet and refeed diet Defining the Terms Continuous Energy Restriction (CER): Continuous calorie deficit daily to achieve weight/fat loss Intermittent Energy Restriction(IER): alternating periods of energy restriction with days at or above maintenance calories Cheat meals/days: No tracking of intake for a meal or day allowing a large influx of calories Refeed: Strategic 1-3 day period of calories at or slightly above maintainance calories primarily carbohydrate based Diet Breaks: Strategic 4-7+ days of calories at or slightly above weight maintenance Energy Restriction Adaptive Components Purpose of Intermitting Diet Approach is to offset adverse physiological effects of prolonged dieting and low body fat levels we see in Relative Energy Deficiency in Sport Syndrome (RED-s) Increased Hunger • Increased Ghrelin • Decreased PPY, Insulin, Leptin • Decreased dietary adherence Decreased Energy Expenditure • Decreases in resting metabolic rate, thermic effect of food, Resting metabolic rate, NEAT, exercise activity thermogenesis • Decrease body mass and fat free mass • Increase cortisol Decreased Muscle Mass Decrease testosterone and IGF-1 Decreased training performance Decreased mood, energy, libido, menstrual function, sleep quality and duration Decrease in LH, FSH, sex hormones Body builders anecdotally state benefits: prevent downgrade in energy expenditure dieting replenish intramuscular glycogen mental refreshment improved fat loss muscle retention Research on Short Term Refeeds 24-72 hours Fat loss effects? Potential Benefits and Harms of Intermittent Energy Restriction and Intermittent Fasting Amongst Obese, Overweight and Normal Weight Subjects-A Narrative Review of Human and Animal Evidence (Harvie 2017) • 13 studies comparing CER and IER • Overweight individual • Comparable reduction in body weight when energy intake is matched Muscle Retention? Effect of Alternate-Day Fasting on Weight Loss, Weight Maintenance, and Cardioprotection Among Metabolically Healthy Obese Adults: A Randomized Clinical Trial (Trepanowski 2017) • Randomized control trial 100 adults, overweight or obese • Alternate day fasting or CER for 24 weeks • FFM to total mass ratio same between groups Intermittent Energy Restriction Attenuates the Loss of Fat Free Mass in Resistance Trained Individuals A Randomized Controlled Trial (Campbell 2020) • 17-week trial in resistance trained males and females • Group CER 25% deficit days per week • Group IER 35% deficit days, maintenance calories w/ carb increase for days per week • IEF group retained more FFM (0.9kg) and CER group greater decrease in RMR (4%), IER group maintained RMR • body composition changes could be artifacts of the refeeds (glycogen increase, dry muscle tissue weight) Current statistical analysis is under review (Peos 2020) Research on Short Term Refeeds 24-72 hours Adherence? The benefits of behaving badly on occasion: Successful regulation by planned hedonic deviations (Coelho, 2016) • 7-day trial IER (6-day 1300kcal, 1-day 2700kcal vs CER (7 days 1500kcal) energy equivalent • IER group demonstrated a higher-than-expected self-regulatory ability • Improved long term adherence Menstrual Cycle? Slow restoration of LH pulsatility by refeeding in energetically disrupted women in women (Louks 1998) • days low energy availability (10kcal/kg lbm) in women (suppressed LH 57%, T3 22%) • day (90kcal/kg lbm) • single day spent far above maintenance calories could not reverse LH pulsaltilty or T3, commonly involved in menstrual cycle dysfunction in energy restriction Short-term fasting affects luteinizing hormone secretory dynamics but not reproductive function in normal-weight sedentary women (Olson 1995) • Women 27.6% body fat • Fasted for days on cycle day to • Refeed on (35kcal/kg/day) for 48 hours • maintenance calories did begin reverse LH pulsatile changes from fasting Research on Short Term Refeeds 24-72 hours How much glycogen we use? • 15 sets of multi joint quad exercise and sets of single joint quad exercise all to failure caused a 26% decrease in muscleglycogen (Tesch 1986) • rounds of full body circuit (3 set leg press, sets leg extension, upper body lifts, 10 reps at 80% 1RM) caused a 36% decreased in vastus lateralis muscle glycogen levels (Roy 1998) Training glycogen depleted? • Glycogen depletion followed by 2-day high(7.6g/kg ) or low (0.34g/kg) CHO diet, Short rest periods, sets to failure likely more intramuscular acidosis, fasted state, no difference b/w conditions (Mitchell 1997) • Glycogen depletion following 2-day CHO restriction 1.2g/kg or control, CHO restriction reduced total repetitions performed in squat testing no change on isokinetic knee torque during leg extensions (Leveritt 1999) Carbohydrate Restriction: Friend or Foe of Resistance-Based Exercise Performance? (Cholewa 2018) • Low muscle glycogen negative effects low volume 85% strength training • Increase blood glucose prior to high volume >10sets and moderate intensity 50-75% increase work capacity • Less server CHO restriction (30-40% kcal) does not impact hypertrophy outcomes, but more severe restriction, however 10% CHO can Breakfast: Omission Reduces Subsequent Resistance Exercise Performance (de Bin Naharudin 2020) • Resistance trained males, sets squat or bench press hours after consuming water or breakfast or low energy placebo after an overnight fast • Back squat performance 15% higher after placebo and breakfast; Bench press no difference • Hunger suppressed and fullness elevated during placebo and breakfast; Performance enhancement likely psychological and not glycogen related How long does it take to load CHO and improve performance? Carbohydrate loading in human muscle: an improved day protocol (Bussau 2002) • Glycogen replenishment needs 10g/kg carbs in a single day to fully max glycogen storage levels • endurance trained males The Effect of a Moderately Low and High Carbohydrate Intake on Crossfit Performance (Escobar 2016) • CrossFit athletes increased CHO to 6–8 g/kg/day for 3days demonstrated increased repeptions during a 12 minute test protocol vs control consulming 7 days Body composition changes? Intermittent energy restriction improves weight loss efficiency in obese men: The MATADOR study (Byrne, 2017) • RCT trial, 51 obese men • 16 weeks CER (23% kcal deficit) vs IER (Eight 2-week blocks 23% kcal deficit alternated with seven 2-week blocks of maintenance kcal) • Significantly greater weight loss (14.1 ± 5.6 versus 9.1 ± 2.9 kg) • FM loss (12.3 ± 4.8 versus 8.0 ± 4.2 kg) • Less compensatory reduction in REE (−360 ± 500 versus −750 ± 500 kJ·d−1) Effects of intermittent compared to continuous energy restriction on short-term weight loss and long-term weight loss maintenance (Keogh 2014) RCT overweight women • weeks of IER (1 week 5500 kJ ER per day alternated with week subject normal diet) vs CER (5500 kJ ER per day) • No significant difference, however, IER group spent ½ the time in ER, potential greater weight loss efficiency Short-term intermittent energy restriction interventions for weight management: A systematic review and meta-analysis (Harris 2018) • Five RCTs included, Overweight and obese • IER > 7days compared with CER • No significant difference in weight loss Hormone effects? Do adaptive changes in metabolic rate favor weight regain in weight-reduced individuals? (Weinsier 2000) • Postmenopausal women • 10 days of ER (3350 kJ per day) then 10 days in EB • REE and thyroid hormone returned to baseline The effect of varying carbohydrate content of a very-low-caloric diet on resting metabolic rate and thyroid hormones (Mathieson, 1986) • Overweight women • Very low energy diet for 28 days then one-week increased intake (4200kJ) • Suppressed serum thyroid returned to baseline Limitations in Research • Systematic reviews make it hard to differentiate IER protocols and protocols vary drastically • Many use ab libitum feeding periods vs controlled refeeding periods • Limited research in lean individuals, resistance trained; most are obese and overweight • RMR, hormones, and FFM debatable and need more data in population representative of bodybuilders • FFM retention during ER is much harder in lean athletes than obese likely from body fat having a protective effect, potential greater application for IER • IER may have application in bodybuilders doing multiple training sessions per day and timing refeed periods around high volume training days • IER allows for practice carb loading approach for peak week • Application in adherence, perception of deficit, and appetite control • Viable use for IER but not superior to CER Practical Takeaways Length of prep and time needed in deficit needs to be accounted for, if time permits days above maintenance Weekly average kcal intake should be in a deficit or plan for longer prep time Avoid severe daily deficit exceeding 35% likely increased risk for fat free mass loss, keep deficit days above 35% Focus refeeds and diet breaks around CHO increase to restore glycogen and potential for improved recovery and performance Psychology of athlete must be assessed for adherence, motivation, and risk of binge patterns 24 hour refeeds Application for adherence and hunger perception of “ease” of prep Close to show may have benefit for performance and gauging peak week CHO loading Potential greater training outcomes with higher CHO everyday rather than very high CHO day 48-72 hour more promise for hormonal reversal however large kcal influx may be needed and likely counterproductive to weekly weight loss Hormone changes likely to reverse once back in the deficit days week or more Some research in improved diet efficacy and less FFM loss Improved time course for removing diet fatigue and improving training performance Anecdotally greatest impact in restoring fat loss rate likely via increases in NEAT and training efforts Can greatly extend time in prep Caters towards more liberalized eating during “diet break”, potential weight gain 24 Hour Refeed When/Why? • Early in Contest Prep • Higher in body fat • Long term for adherence ”mental break” • No need for staving off metabolic adaptations • Mood improvement • Behind schedule and need more time in deficit (7-10 low days, high) • Practice for a peak week • Later in prep if client is very flat, continued need for single refeed days should lead to overall diet adjustment, increase food on all days • Potential application on weak body part training days For body parts that go flat quick and see largest gym performance decrease How? • Raise calories to maintenance level for one day • Estimate based off starting point from holding phase or last week weight loss • Remember one less day in a deficit • Increase via carbohydrates • Maintain or reduce protein and fat intake • Same food sources • Stick to foods you would use for peak week • TRACK foods • Time for days with high training load and life challenges • If training in PM same day, If training AM day prior The Cheat meal • One meal without tracking high carb and high fat • No metabolic effect • Acute increase in TEF, increased sodium blood pressure, HR (anecdotally reports of body temp rise, NOT metabolism) • Lead to binge eating psychology • Can exceed calorie intake goals for the week • Spend rest of the week digging hard to make up for it • NOT recommend unless macro and calorie controlled • Can be a social break and decrease cortisol, improve sleep 48-72 Hour Refeed Who/When? • Later stage of contest prep • Low body fat state (7 days Last week of contest prep or ready early Can be implemented 1-week mid prep if on track Can be used between shows if already stage lean 20-35% increase in kcal from CHO Sample Prep Diet with Refeed Diet Day • 20% kcal difference CHO based Summary Limited research is available for application and efficacy of refeed diet strategies in bodybuilding populations Anecdotally these strategies are prevalent in the community and lack of evidence does NOT mean lack of effect Current research points towards not detrimental effect buy likely improved dietary adherence Prioritize getting stage lean and if time permits implement refeed technique and take diligent notes to monitor the effect There are no tricks to get peeled except continued caloric deficit and hard work References Ha rvi e, M.; Howell, A Potential Benefits and Harms of Intermittent Energy Restriction and Intermittent Fasting Amongst Obes e, Overweight and Normal Weight Subjects-A Narrative Revi ew of Human and Animal Evi dence Behav Sci 2017, 7, Trepa nowski, J.F.; Kroeger, C.M.; Ba rnosky, A.; Kl empel, M.C.; Bhutani, S.; Hoddy, K.K.; Ga bel, K.; Freels, S.; Rigdon, J.; Rood, J.; et a l Effect of Al ternate-Day Fasting on Weight Loss, Weight Ma intenance, and Cardioprotection Among Metabolically Hea lthy Obese Adults: A Ra ndomized Cl inical Trial JAMA Intern Med 2017, 177, 930–938 Coel ho Vale, R.; Pi eters, R.; Zeelenberg, M The benefits of behavi ng badly on occasion: Successful regulation by pl a nned hedonic deviations J Consum Psychol 2016, 26, 17–28 Byrne, N.M.; Sa i nsbury, A.; Ki ng, N.A.; Hills, A.P.; Wood, R.E Intermittent energy restriction i mproves weight l oss efficiency i n obese men: The MATADOR s tudy Int J Obes 2017 Ha rri s, L.; McGa rty, A.; Hutchison, L.; El ls, L.; Ha nkey, C Short-term intermittent energy restriction interventions for weight ma nagement: A s ystematic revi ew and meta-analysis Obes Rev Off J Int Assoc Study Obes 2018, 19, 1–13 Di rl ewanger,M.;diVetta,V.;Guenat,E.;Battilana,P.;Seematter,G.;Schneiter,P.;Jequier,E.;Tappy,L.Effects of short-term ca rbohydrate or fa t overfeeding on energy expenditure and plasma l eptin concentrations i n healthy female subjects.Int J Obes Relat Metab Disord 2000, 24, 1413–1418 Peos JJ, Norton LE, Helms ER, Galpin AJ, Fournier P Intermittent Dieting: Theoretical Considerations for the Athlete Sports (Ba sel) 2019 Ja n 16;7(1):22 doi: 10.3390/sports7010022 PMID: 30654501; 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How and When to apply diet breaks How and when to apply High and low day rotations How and what to monitor for refeed peak week practice Sample contest prep diet and refeed diet Defining the Terms... strategies Preference is towards dieting on more total food over large refeeds Diet Break >7 days Last week of contest prep or ready early Can be implemented 1-week mid prep if on track Can be used... day and the look and body weight to achieve ? ?Diet Break” Implementation (>7 days) Who/When? • Dieting for longer than months • Ahead for contest prep • Limited ability to further lower carbs