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Ask The Doc: Dr. Tommy Wood on Familial Hypercholesterolemia in Athletes, Restless Leg Syndrome, His ‘Elite Performance Analysis’ Test and Much More
Dr. Tommy Wood is back on the show for another edition of Ask the Doctor, Tommy’s sixth time as our resident doc. You can find Tommy over at NourishBalanceThrive, and be sure to check out their Elite Performance Analysis quiz. On this show, we catch up with Tommy and he tackles the following listener questions:
Tommy’s published Letter to the Editor in the Strength & Conditioning Journal, written in response to a point-counterpoint article:
A Case for and Against a Ketogenic Diets in Athletes
Point: Matthew Kavalek and Ryan Gannon
Counterpoint: Mike T. Nelson
Both sides made great points, but Tommy had some extra thoughts!
Point:
“the beneficial effects of a KD on aerobic performance are fairly well established”
Wish that were true, but isn’t yet
Probably due to the nature of the studies
Louise Burke
Race walkers
Ketone ester in cyclists
Recent Caryn Zinn study
5 cyclists on keto for 10 weeks
All of them lost weight
Peak power decreased
All of them saw worse time to exhaustion
But one had an increase in VO2Max
Counterpoint:
Metabolic flexibility is important
Risk of “losing metabolic machinery”
This is only really true if you look at PDH
The rest of glycolysis is working just fine (FASTER study)
Extra pyruvate either via PC to OA
Or converted to lactate (Cori cycle)
If wanting to boost PDH and maintain metabolic flexibility on keto, do HIIT
Remember:
For performance, some carbs are likely to always be important
Keto for the sake of keto doesn’t make much sense from a performance standpoint
Keto athletes still eat carbs!
Questions:
Ironman athlete, 50-year-old female, with familial hypercholesterolemia (FH) – LDL’s been high since 20s, on medications (Lipitor, Crestor), being advised a low-fat diet, training for Kona, having adverse effects from meds – what to do!??
* Everything MUST be discussed with a doctor/cardiologist
* FH is a result of mutations that reduce the expression or function of LDL-R
Reduces uptake of LDL into the liver
Increased LDL levels
When it comes to heart disease risk, LDL-P matters much more than LDL
High LDL-P isn’t enough
Need some damage to the artery for cholesterol to accumulate
Most people have heterozygous FH
Only one receptor mutation
Increase in death from heart disease
Highest risk is in the 20s-40s
Once you reach your 60s, risk is the same
Lower cancer risk
Overall mortality rate is normal
You have to die of something!
Family tree mortality study in Holland
Mortality risk and cause of death varied widely
Lower in 19th Century
Higher in 1950s
Determined that environment was much more important than the mutation itself.
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By Endurance Planet Inc.
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Dr. Tommy Wood is back on the show for another edition of Ask the Doctor, Tommy’s sixth time as our resident doc. You can find Tommy over at NourishBalanceThrive, and be sure to check out their Elite Performance Analysis quiz. On this show, we catch up with Tommy and he tackles the following listener questions:
Tommy’s published Letter to the Editor in the Strength & Conditioning Journal, written in response to a point-counterpoint article:
A Case for and Against a Ketogenic Diets in Athletes
Point: Matthew Kavalek and Ryan Gannon
Counterpoint: Mike T. Nelson
Both sides made great points, but Tommy had some extra thoughts!
Point:
“the beneficial effects of a KD on aerobic performance are fairly well established”
Wish that were true, but isn’t yet
Probably due to the nature of the studies
Louise Burke
Race walkers
Ketone ester in cyclists
Recent Caryn Zinn study
5 cyclists on keto for 10 weeks
All of them lost weight
Peak power decreased
All of them saw worse time to exhaustion
But one had an increase in VO2Max
Counterpoint:
Metabolic flexibility is important
Risk of “losing metabolic machinery”
This is only really true if you look at PDH
The rest of glycolysis is working just fine (FASTER study)
Extra pyruvate either via PC to OA
Or converted to lactate (Cori cycle)
If wanting to boost PDH and maintain metabolic flexibility on keto, do HIIT
Remember:
For performance, some carbs are likely to always be important
Keto for the sake of keto doesn’t make much sense from a performance standpoint
Keto athletes still eat carbs!
Questions:
Ironman athlete, 50-year-old female, with familial hypercholesterolemia (FH) – LDL’s been high since 20s, on medications (Lipitor, Crestor), being advised a low-fat diet, training for Kona, having adverse effects from meds – what to do!??
* Everything MUST be discussed with a doctor/cardiologist
* FH is a result of mutations that reduce the expression or function of LDL-R
Reduces uptake of LDL into the liver
Increased LDL levels
When it comes to heart disease risk, LDL-P matters much more than LDL
High LDL-P isn’t enough
Need some damage to the artery for cholesterol to accumulate
Most people have heterozygous FH
Only one receptor mutation
Increase in death from heart disease
Highest risk is in the 20s-40s
Once you reach your 60s, risk is the same
Lower cancer risk
Overall mortality rate is normal
You have to die of something!
Family tree mortality study in Holland
Mortality risk and cause of death varied widely
Lower in 19th Century
Higher in 1950s
Determined that environment was much more important than the mutation itself.
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