Sunday, July 31, 2011

The Road to the 2011 90kg Missouri State Arm Wrestling Title: 7-30-11

The Road to the 2011 90kg Missouri State Arm Wrestling Title: 7-30-11

What went in

7am: EAS Myoplex shake, 1 L of water, 2 double strength fish oil caps, 2000 IU Vit D, 1 MVI

2pm: Chinese Buffet with my brother.  All that shootin' made me hungry! Took out two plates and then became really full and called it.

Training:
none

And now for the fun stuff!

I met my brother in Columbia yesterday and we put a bunch of lead downrange at Target Masters. One thing that is fun/irritating about TM is the air/fans are on so high that the targets dance so it's more challenging but tight groupings can be elusive LOL. 

Here's Jake with his first 2 15rd mags of 9mm at 21yds.  Ignore the shots in the center of the pic; those are from a different mag.


Here's my first 2 15rd mags of 9mm at 21yds; as you can see I'm still yet to beat him!

Jake got a new Colt New Agent.  It's a compact 1911 and it's pretty sweet; awesome carry gun.  It has trench sights for rapid target acquisition and a snag free draw. You're not going to win any target competitions with it but you can keep within the green targets fairly easily.  We did a drill where we put the target out at 15 yds or so, put the gun on the table, and then when ready, picked it up clicked the safety off, and fired as fast as we could while keeping it on target. This was a fun little exercise with this gun and even though it's small the recoil isn't bad at all.

Friday, July 29, 2011

Don't mess with Dietitians!

I thought I'd have a little fun tonight and see if I could bend a padlock out of shape, barehanded..er almost.  As you can see, we Dietitians might be strong but we're not the best videographers LOL. 


and the annotated version


The Road to the 2011 90 kg Missouri State Arm Wrestling Championship Title: 7-29-11
What Went In

7am: EAS Myoplex shake, 1 liter of water, Cherry Coke Zero, 2 double strength fish oil caps, 2000 IU Vitamin D, 1 MVI

12 noon: 2 chicken breasts with thai curry seasoning/sauce

Training
felt like training but I was still pretty beat up from practice so I just hit some ISG
Ivanko Super Gripper: all reps no-set:
-RH: 9,7x10,9
-LH: 8,5 x 12,12

Post-Workout
EAS Myoplex shake

Dinner: Texas Roadhouse: 1/2 rack of ribs, loaded fries, salad with light ranch on the side, 2 large waters

9:30: 2 double strength fish oil caps, 2000 IU Vit D

The Road to the 2011 90kg Missouri State Arm Wrestling Title: 7-28-11

What went in

7:00 am: about 1/2 of a EAS Myoplex shake; I spilled the other half :) 1 liter of water, 1 diet dew, 2 double strength fish oil caps, 2000 IU Vit D, 1 MVI

12 noon: 2 chicken breasts with Jamaican Jerk Seasoning, 1/2 plate sweet potatoes, large green salad with balsamic vinnaigrette, 8oz of water

pre-practice snack: 1 EAS Myoplex shake

post-practice: 2 EAS Myoplex shakes, 1 Liter of water

Training
AW practice
post-practice
RT work from high cable to simulate sucking someone in on a hook/cupping
 front lever holds with 4' x 2" thick dowel rod and 3# on the end
high rep rotations with wrist reinforcer

Thursday, July 28, 2011

The Road to the 2011 90kg Missouri State Arm Wrestling Title: 7-27-11

What went in

7am: EAS Myoplex shake, 1 liter of water, 1 diet dew, 2 double strength fish oil caps, 2000 IU Vit D, 1 MVI

12noon: 3 ladles of chorizo, 1.5 cups of butter pecan ice cream

7pm: ~10oz of baked pork chops with mushroom soup over the top and 2 of Ryleigh's chicken tenders and 1/2 cup of vegetable medley, small slice of ice cream cake, 3 diet dews

9:30 pm: .75 Liter of water, 2 double strength fish oil caps, 2000 IU of Vit D

Misc:
black coffee with splenda all throughout the day

Wednesday, July 27, 2011

The Road to the 2011 90kg Missouri State Arm Wrestling Title: 7-26-11

Day 3

What went in

-7:00 am: EAS Myoplex shake, 1 liter of water, 2 double strength fish oil caps, 2000 IU Vit D, 1 MVI

-12 noon: ~10 oz of Tuscan Steak, ~3 oz of smoked beef brisket, ~1oz of smoked pulled pork, 1/2 plate of sweet potatoes, 1 cookie ice cream sandwich

-6:30: one EAS Myoplex shake, 1 Liter of water, 2 double strength fish oil caps, 2000 IU Vit D

No training, still entirely too sore from the previous night and I need to be rested up for practice on 7-28-11.

Tuesday, July 26, 2011

The Road to the 2011 90kg Missouri State Arm Wrestling Title: 7-25-11

Day 2 on the road to the title.

What went in

7am:
-EAS Myoplex and 1 liter of water
-2 double strength fish oil caps, 2000 IU Vit D, 1 MVI

12 noon:
- 2 chicken breasts with Jerk seasoning/sauce
-170 cals worth of mini cookies from the Quill cookie tin (Thanks Quill!)

Preworkout Snack: 5:40ish
-EAS Myoplex

Post-Workout: 9:00ish
2 EAS Myoplex shakes
Liter of water
2 double strength fish oil caps and 2000 IU of Vit D

10pm
-EAS Myoplex shake

Training:

Grip
-Ivanko Super Gripper: all reps no-set: LH: 1,10:x12x12  RH: 1,12: x12x12
-2 Hand Pinch Deadlift: 169#x5 then regrip 4 then regrip then 3 (one set) 9 then regrip then 4
-Appollon's Axle Thumbless Reverse Curls: 53# x 10 x 2 sets

Gym
Modified version of the Diesel Crew Shoulder prehab circuit. See video below if you want to bulletproof your shoulders or you can not watch it and continue to get injured and whine about why you can't bench.


-Gravitron One arm pull-up training: 100# of deload: R: 9,7 L: 10,8 finished with holds to failure at lockout.  Think it's safe to say I'm still plenty sore from practice LOL

-Rear delt flys on machine: 40#x12, 110#x12,12,8

-Low incline, neutral grip, DB benchpress with the fat gripz  These things freakin' rock!  There is no excuse to not have a pair of these in your gym bag!  Anyhoo, I went: 40#x12, 60#x9,8,6

-Trap bar shrugs with the fat gripz: 90#x20, 180#x12,10,10 then stripped the fat gripz off and did another 12. Weights do not include the bar. I have no idea what it weighs.

-neck bridges: to the rear: 1 min in bridge, 25# plate pullovers x 12; to the front: bw reps: 12, 12

Misc

One of the trainers approached me and they're doing a lift-a-thon for charity on 8-13.  It will be bench and deadlift.  I probably haven't done either in almost 2 years but I couldn't turn down a chance to lift weights competitively and especially since it's in my backyard and for a good cause.  I'm hoping to still be able to pop a 300# bench press and pull 405# on the deadlfit. 

We got to talking and he really wants to get more things for those interested in strength at the Y.  He said he's going to get some platforms and hopes to hold several lift-a-thons throughout the year.  I had my Grip Nats shirt on and since we now have a RECOGNIZABLE, BRANDED, logo (THANK YOU JEDD JOHNSON!!!) he immediately asked what it was.  I gave him the spiel and he was excited about it.  He wants to incorporate some grip lifts into upcoming lift-a-thons.  This could be great!  This is a huge Y, in upper-middleclass area, so it has some potential to really draw some new faces into grip.  I'm thinking I'll bring a blob and maybe a RT with 185# on it and if they can lift either they get a free assessment with the trainer (just have to talk him into it but I'd think he'd like it as it's an easy sales call and that job is a lot of sales). We'd charge them a dollar to try and the money would go to the same charity that the lift-a-thon is for.  Ideally, we could hold a qualifier there.  I'm pretty excited, this trainer seems to have a strength background and wants to do some cool stuff.





Monday, July 25, 2011

The Road to the 2011 90kg Missouri State Arm Wrestling Title

The 2011 Missour State Arm Wrestling Championships are 9-24-11 and I want some redemption this year. Last year I performed horribly; probably something about cutting 12# in 5-5.5 days. Now that the National Grip Championships are over, I'm fully focused on pulling again.  I'm going to post my food intake as well as my workouts on the blog so the readers can get a feel for how arm wrestlers train and how this Dietitian eats (it all fits!)!  I hope to dispel quite a few myths in both arenas.

I will post the previous day's intake and any type of training I did.  My starting weight is 210# as in I just weighed that about 30 seconds ago.  In reality, I'm probably closer to 208# as I'm about 3 large cups of coffee deep into my morning but we'll go with 210#. Here's Sunday (7-24-11)!

7-24-11: What's going in
4:30am:
-EAS Myoplex shake.  I basically got about 60 cases of this for free otherwise I certainly wouldn't be drinking it.  They're expensive and I like to eat real food but hey, I like free better.
-1 Liter of water
-2 caps of double strength fish oil, 1 MVI, and 2 Vit D caps

8:30
-1.5 cups of scrambled eggs with hot sauce

10:30am
-EAS Myoplex shake

12:30am
-6oz of turkey/roast beef/ham on whole wheat with lettuce, tomato, onion
-small chef salad with 1oz of light ranch
-6oz of beef and barley soup
-1/2 cup cottage cheese
-1 med steak fries and a stupid amount of ketchup
-32oz Diet Dr. Pepper

3:30 pm
-1 EAS Myoplex shake

6:30
-6oz of BBQ pork chops
-1/2 baked potato with ketchup
=2 caps of double strength fish oil and 2 Vit D caps
-Diet Mountain Dew

8:30
-Large Georgia Mud Fudge Blizzard from DQ

misc: I drank black coffee with splenda all day.

Training
-none, worked 5:45am-6:30pm

Thursday, July 21, 2011

Diesel Crew Grip Challenge: The Plate Curl

Every week Jedd Johnson over at Diesel Crew (http://www.dieselcrew.com/) puts out a grip challenge on video. People film themselves doing the challenge and whoever does it the best (most reps, highest weight, etc..) wins a prize.  It's a great way to promote Grip and for those of us that thrive on competition, it allows you add that octane booster to your training without traveling or having to be lucky enough to have some Grip training partners. 

This week Jedd threw out the plate curl. I won't attempt to describe it; just watch the video. This is probably the best wrist exercise you've never heard of. The first time I'd heard of this exercise was in Mastery of Handstrength by John Brookfield. I tried it and have been hooked ever since. I actually prefer the plate wrist curl but they're both greath.  When I used to pass trays at St. Luke's hospital I got quite a kick out of gripping a tray on the short side and just handing it to somebody with one hand and watching them get flustered.  They would instinctively grab it with one not paying attention and immediately realize that was a bad idea.   As a point of reference, a 25# plate is hard for most people, a 35# stops all but the strongest guys, and Adam Glass, owner of The Movement Minneapolis, http://www.movementminneapolis.com/ is the only one I've ever seen do a 45# with strict form. Make no mistake a plate swing does not count!  It's called a plate curl!  Enough talk; enjoy the video!



Wednesday, July 20, 2011

Diet Soda Part II

I had a reader ask a couple of great questions so rather than see them get buried in the comments section I thought I would address them in a separate entry. 

My responses are in bold.

People's Dietitian,

From a more general nutritional standpoint and based upon what the studies show as an insulin increase causing appetite suppression what are your thoughts related to these effects of soda/diet soda:
1. Suppression of appetite due to diet soda consumption giving a false sense of being "full" with a nutrient empty food/beverage in place eating even a moderately "healthy" snack/meal.


First, the false sense of full you're referring to could be a couple of things.  It might be the carbonation and the consumer just needs to let loose a burp.  They might have just been a bit dehydrated and replenishing fluid levels (diet soda is mostly carbonated water) was just what the body needed to send the hunger packing.  If you are poking around at a discussion on cephalic-phase insulin release and/or GLP-1, this is a good article.  Let me know if you would like me to discuss it in a separate entry.

Second, but certainly MOST IMPORTANT; the million dollar question regarding the bulk of debates on what is good or bad in nutrition is "What are your goals?".  For example, a cancer patient that is experiencing involuntary weight loss due to decreased appetite is not doing themselves any favors by guzzling down the diet soda, especially if it's leaving them feeling full.  As you mentioned, there are no nutrients in diet soda. However, what about the obese, type 2 Diabetic with an insatiable appetite?  Diet soda will not raise their blood sugar and will not put any additional weight on them and if it gets them to feel full and thus consume fewer calories, that's fantastic.  The aforementioned patient needs to create a caloric deficit to generate weight loss and so replacing a zero calorie/zero nutrient drink with a "healthy" snack/a calorie containing food, is not cohesive with their goals.  "Healthy" is an individualized term and thus has different parameters for different people (eg what's healthy for person might be unhealthy for another)

2. Using Diet Soda as a thirst quencher instead of good ole fashioned water and subsequently its effect on the metabolic process.

Explaining the thirst mechanism in its entirety goes well beyond the scope of this blog but this is as detailed an explanation as you'll find.  The short of it is that increases in osmotic pressure get us parched.  I'm not an expert on hydration but I would think that if increases in osmotic pressure are what are triggering thirst that you would want to look for a beverage that is low in osmolality to quench it/not add to the problem. This is purely my opinion; I don't specialize in sports nutrition, I'm not an exercise physiologist, so if a true expert knows, by all means, chime in.  I also want to make it clear that I'm talking about literally quenching the thirst mechanism.  I fully realize there are advantages to consuming electrolyte-laden drinks such as Gatorade but I'm just talking subjective thirst. As I mentioned, diet soda is mostly carbonated water, keyword, "mostly".  So if you have 12 oz of diet soda and 12 oz of water, assuming the water is reasonably purified, the water should have a lower osmolality.   Here is a table I found from this  online paper from a crime lab.



As you can see diet soda has a higher osmolality than tap water, so IMO, it would not quench your thirst as well. However, tap water does not contain Na and K which you excrete and need to replace during hard athletic adventures to keep that Na/K pump system up and running, so Gatorade/sports drink might be the better choice while you are performing, even if it doesn't subjectively quench your thirst as much. This is a nice piece on Gatorade and the whole subjective thirst vs. rehydration argument. In fact, the Na in Gatorade is actually supposed to prompt you to drink more so you get beyond simple mouth thirst and get more rehydrated. To put this in simple terms, 8oz of water might make you feel less thirsty than 8oz of Gatorade but you really need 12 oz to get rehydrated so the fact that the Gatorade leaves  you wanting more is better in the long-run. Let's be real though, we're splitting hairs, if we're thirsty, an ice cold Gatorade seems to do just fine.  BUT, what if we have an obese pt that is blasting through a hard workout; should we encourage them to consume a calorie filled beverage like Gatorade?  Do the electrolyte replenishment benefits outweigh the caloric costs?  I say "no way".  Give them water or even a Crystal Light.  I don't even have an issue with diet soda as long as the carbonation didn't cause GI stress. Like I said, it all depends on your goals.

Basically under the realm of both points that while Diet Soda (from my point of view) doesn't necessarily directly cause weight gain but rather inhibits the consumption of better alternatives and good nutrient practices to ensure an efficient metabolic process. Thus I refer to the People's Dietitian to set the record straight. Great post though. 

The "good nutrient practices"  and "efficient metabolic process"are  broad strokes.  Entire textbooks are written on metabolic processes and some people study a few enzymes and their effects on certain parts of various metabolic processes as their entire career! Again, this comes down to "What are your goals?". For example, please provide me with a better alternative than a zero calorie beverage for an obese pt. Counterpoint: the anorexic model that drinks Diet Coke all day to stave off hunger and is no doubt malnourished, is not doing herself any favors with her diet soda habit.  This runs much deeper than diet soda though and is essentially the "guns don't kill people" argument. 

Thank you for reading the blog and I hope I answered your questions satisfactorily.

Josh
Beverage Osmolality Database [mOsm/kg]
Beverage Type
Range
Average
Number
Water; Purified, Mineral, Tap
0-28
7
10
Diet; Sodas, Teas
13-44
29
19
Fruit Waters
24-39
36
5
Brewed Coffee [Black]
28-53
39
7
Sports Beverages
190-428
390
12
Sugar Containing Sodas, Fruit Drinks
537-1112
760
95
Energy Drinks; Red Bull, etc
673-1030
878
5

Monday, July 18, 2011

Fructose Showdown: Dr. Geoffrey Livesey vs. Dr. Robert Lustig

In this month's issue of Journal of the American Dietetic Association (JADA), Dr. Geoffrey Livesey has penned a scalding letter to the editor regarding Dr. Robert Lustig's article in the September 2010 JADA.  As is the custom, they let the original author respond.  For those of you that share a love of nutrition and cage fighting and I have no doubt the two are highly correlated, this is comparable to UFC 100.  You have two metabolism heavyweights duking it out over one of the most buzzworthy topics in nutrition; fructose! First, I fetched my warped, highlighted, and annotated copy of Dr. Lustig's article and then I grabbed my beloved Diet Dew. Next, I snuggled up to my kitchen table and splayed both issues out like I was planning the next SEAL Team 6 mission.  A snort of Diet Dew and I was off to the races!

Ideally I could just post the links as a point of reference but the articles are not free.  I'll list the citations and if you have acess to a medical library, online or not, you should be able to get your pizza skidders on them.  In the meantime, I'll post my thoughts on some of their major points of contention. There is a lot of information to cover so I will post one argument at a time and depending on the response, I might address all five.  I will however, flesh out their points in great detail, so prepare for a meaty discussion!

Dr. Lustig gets style points for rebutting Dr. Livesey in a numbered and orderly fashion and I will shamelessly follow his fantastic format. Lustig is an MD and Livesey is a PhD so both of these individuals have likely forgotten more about metabolism than I will ever know. I'm not going to be disputing their thoughts per se but instead playing the voice of reason.  In otherwords, I'll weigh in on how much of this information is actually useful outside of academia, with useful being defined as "Does it change how we educate a client?" and how much of this is just some intellectual pissing match.

Dr. Robert Lustig's original article
-Lustig RH.  Fructose:  Metabolic, hedonic, and societal parallels with ethanol.  J Am Diet Assoc.  2010;110:1307-1321.

Dr. Geoffrey Livesey's letter to the editor and Dr. Robert Lustig's response
-Livesey G.  More on Mice and Men: Fructose Could put Brakes on a Vicious Cycle Leading to Obesity in Humans.  J Am Diet Assoc. 2011;111:986-993.

First Basic Argument:
Does Fructose increase De Novo Lipogenesis (DNL)?  (In simple terms, DNL is a metabolic pathway for converting carbohydrate (CHO) to fat.)

-Dr. Livesey: He cites a truckload of studies saying NO or not enough to matter

-Dr. Lustig: Lustig claims that Livesey is not interpreting the results in context and that he (Dr. Lustig) is stating the fructose does indeed increase DNL in: nonfasted state, hypercaloric feeding, obese and insulin resistant individuals, and "most importantly" with glucose. Dr. Lustig is especially concerned with this last point because he states that fructose does not occur alone anywhere in nature, fructose and glucose together have a synergist effect thus tripling DNL compared to fructose alone, and that fructose alone is poorly absorbed while glucose and fructose together have almost 100% absorption.

-My thoughts: my initial reaction to this was "who cares?".  To clarify: I'm sure my DNL goes buckwild after I dominate the Chinese Super Buffet but it's not like I'm one crab rangoon away from NAFLD or Type 2 Diabetes. DNL is not a felony record that stays with your body until the end of time. As long as you're not consistently hypercaloric/are eucaloric most of the time, the fat you just created through DNL gets used aka lipolysis and the net balance is zero, all is well, and your butt still fits into your silly-ass hipster jeans. 

Or if you prefer the medical version "In humans, de novo lipogenesis was shown to respond to several energy supply scenarios (3, 8). For example, de novo lipogenesis increases linearly with increased energy intakes of 25% and 50% above energy balance and decreases with underfeeding at the same levels of energy deficiency in lean subjects" (http://www.ajcn.org/content/74/6/737.long).  I'm sure many will harp on "lean subjects".  Yes, DNL does somewhat increase with overfeeding in obese subjects compared to lean but the issue is obesity or more specifically how they got there.  This is where we should focus our education and as I've said many a time, I believe it will take a multi-disciplinary approach.  Why are we getting wound up on a DNL rate when the real problem is longterm, consistent, hypercaloric feeding that has caused obesity?  This is akin to arguing over which level of tire pressure will give you the maximum gas mileage when your air filter is 30K mi past due; change the dang filter!!!!!

DNL Lies, Damned Lies, and Statistics

The fructosophobes love to toss out these massive percent increases in DNL with fructose vs. glucose or even fat but let's dig a little deeper shall we? This table (table 6) shows "Daily carbohydrate intake and estimated amounts of absolute fat production from rates of de novo lipogenesis (Table 2) after 96 h of dietary treatment in lean (n = 8) and obese (n = 5) women" and is from the previously cited study.  Let's talk about a little thing called percent change. Percent change is figured as new minus old/old.  Crank up the fear machine and let's compare just how much fat all this DNL actually turned out in lean subjects in the control group (fed in energy balance) to obese subjects in the 50% overfed group (overfed sucrose).  Lean individuals, in the control, in energy balance, busted a whopping 1.79g of fat/d after 96 hrs of dietary treatment vs. obese being overfed 50% with sucrose (remember it's half fructose and as Dr. Lustig points out glucose and fructose have this terrifyingly synergistic relationship) had a heart shattering 7.84g/d so you're essentially saying that if we take lean individuals and feed them a eucaloric diet they synthesize 6 grams of fat LESS per day than obese individuals that we overfeed by 50% with the extra calories being sucrose.  Hmmmmphh...that's not very impressive so how about obese individuals overfed 50% with sucrose exhibit a 347% increase in DNL fat production!!!!!!!!!!! ~454 grams is one pound so this obese individual being overfed by 50% with the 50% being sucrose would need almost 58 days to accumulate one pound of bodyfat; WOW that really blows some air up my skirt!  You can practice your new found percent change abilities with table 2 in the article. Table 2 actually shows Hepatic DNL rates (who cares?) but we can see from table 6 that very little fat in terms of grams is really produced. I've only cited one study here but if we're going to get bent out of shape on DNL, show me some studies where all this DNL actually significantly contributes to gains in fat AND MOST IMPORTANTLY show me some where the subjects were in caloric balance. Don't waste my time with percents, you can keep those in the back pocket of your skinny jeans...oh yeah, they don't have pockets.

My Liver, My Liver!!

There is no question that NAFLD is on the rise and the carb police are looking to frame fructose for the trend. Dr. Lustig appears to be the lead detective on that raid. In fact, his original article seemed to bash fructose alone although the masses no doubt extrapolated that into a crusade against HFCS.  Where it gets interesting is when Dr. Livesey points out things like DNL with fructose ingestion alone is low and subbing fructose for glucose in DM pts might be a good thing given it does not raise blood glucose; Dr. Lustig astutely points out that fructose is not found by itself in nature and thus it is worthless to talk about it's properties in isolation.  To clarify; you will be consuming it with glucose which allows fructose to work its voodoo. What this means is Dr. Lustig was really making a case against sucrose (glucose and fructose) or sugar.  You can't have it both ways.  In othewords, you can't write an article comparing fructose to the evils of alcohol and then when somebody points out the benefits of fructose (in isolation); rebuff them by saying it doesn't occur by itself as a foodstuff. 

The Case Against Fructose
1. Fructose is capable of skipping phosphofructokinase 1 and thus creates a massive amount of pyruvate, quickly. Pyruvate heads into the mitochondria and is converted to Acetyl-CoA for the tricarboxylic acid cycle which you can think of as the fuel source for producing ATP.  To simplify: too much pyruvate, too soon.
2.  Well, the TCA cycle much like the TSA has a set speed and gets overwhelmed easily.  When this occurs, extra pyruvate gets their admit bracelet revoked and through a series of events gets converted to citrate and hops the citrate shuttle back into the cytoplasm.
3. Once back in the parking lot/cytoplasm, citrate gets converted to Acetyl CoA by an enzyme called ATP citrate lyase.  Then Acetyl  Coenzyme A carboxylase, another enzyme, jumps on the newly minted Acetyl CoA, carboxylates it and forms Malonyl-CoA. The individual you just threw out of the club is now going to ensure nobody else gets in.
4. Malonyl-CoA is essentially the cop that you never should have thrown out of the club because now he'll see to it that nobody gets in.  Malonyl-CoA stops carnitine acyl-CoA transferase-1 from shuttling in additional fatty acids for beta oxidation.  So all the cabs bringing customers to your bar are getting stopped at the entrance to the parking lot and being told there is no entry tonight.
5. Malonyl isn't the end of the problems though.  When the pyruvate cap was exceeded you also get fatty acid synthase going to work.  FAS takes charge of all this additional acetyl CoA that is now available and adds them to carbon backbones, then esterfies them with a pinch of glycerol and viola! you get triglyceride formation. This is a very short explaination of how a hypercaloric, low fat, high carb diet can raise TG levels; keyword "hypercaloric".
6. Triglycerides then get there marching orders but need a ride so they bind to apolipoprotein B to make VLDL or very low density lipoprotein. The VLDL then hits the road and leaves the liver to find refuge in your body's adipocytes (muffin tops, cottage cheese arms, etc..)
7. Big finish for the jury here! So, in addition to adding to your adipocytes, which in and of itself terrifies most people (although not enough for them to exhibit moderation) it is hypothesized that not all of the fatty acetyl CoA products  make it into VLDL and that some escape and stay in the liver, leading to Non-Alcoholic Fatty Liver Disease.  Again, fructose is blamed for this because it hits the liver so hard and fast and with so much pyruvate that it can't even keep up with making fat or more accurately, exporting fat. Fat accumulation in the liver is a bad thing for a number of reasons.  For one, it lowers hepatic insulin sensitivity.  If your liver can't hear insulin, it doesn't get the message to turn down glucose production and this manifests as a high fasting blood glucose.  When it is 100-125 we call it pre-diabetes or insulin resistance and when it hits 126 we call it diabetes but it's all the same thing; you're on a path you don't want to be on.

Fructose's Defense
1. While fructose can certainly skip phosphofructokinase 1, it doesn't have to and in the case of caloric balance it can head that way for the formation of glycogen.

2. What may surprise many is that TGs, not glucose, are your body's main source of energy. Glycogen (stored glucose) comes with baggage, specifically about 4 grams of water for every gram of glycogen, so you would need to weigh somewhere in the neighborhood of 4x your current weight if we relied exclusively on glycogen for energy.  TG are a convenient and storeable energy source for us. The process of turning these TG into energy is called lipolysis.  The fatty acids can be used in beta oxidation to make more acetyl CoA to fuel the TCA and produce more ATP and the glycerol can actually be used to create more glucose.

3. A VERY simplified version of lipolysis goes something like this: We need some ATP so a few hormones get the page to get lipolysis started!  Epinephrine and glucagon, among others get busy and through a series of calls ramp up production of cyclic adenosine monophophate or cAMP.  Well, cAMP then calls protein kinase A and he gets to work on alerting the various lipases around the body.  They begin to break down fat in the adipocytes and TG are transported to via lipoproteins (their ride) to the parts of the body in need of energy. The free fatty acids are used for acetyl CoA and the glycerol portions head back to the liver and kidney where through a series of steps it gets refurbed to go back into the glycolysis/gluconeogenesis pathway for glucose production.

4. As you can see, lipolyis is the balance to lipogenesis and thus whichever one occurs most over a given time frame, wins.  For example, if you create 500 grams of bodyfat in 5 days through lipogenesis but you oxidized 501 through lipolysis, you are still losing weight.  To clarify, this is why the immediate boost we see in DNL with fructose, no matter how we tease the numbers, is irrelevant because in caloric balance, all that TG formation, will get used up. 

5. But don't take my word for it, the Wash U Crew actually did a fantastic study on it comparing different macronutrient ratios and the effects on insulin sensitivity (fatty liver = bad news for insulin sensitivity).  They compared a low carb group and a high carb group.  Both were on a 1000 calorie/day deficit defined as (REE x 1.3) - 1000.  The LC group was 10% CHO/75% FAT/15% PRO and the high carb group was 65%CHO/ 20% FAT/ 15% PRO. The low carb diet lowered intrahepatic TG content 3x more in the first 48 hours BUT....there was no significant difference after 7% weight loss/11 weeks!  Like I said, it's lipolysis vs. lipogenesis; DNL ain't permanent!
Please read the full text document to hear about a ton of other interesting findings (their explaination of the Euglycemic Clamp is fantastic!).  I've listed the citation below because again, it's not free.

 Kirk E, Reeds DN, Fink BN, Mayurranjan MS, Patterson BW, Klein S. Dietary Fat and Carbohydrates Differentially Alter Insulin Sensitivity During Caloric Restriction. Gastroenterology 2009;136:1552-1560.
 
 Summary
-Dr. Livesey and Dr. Lustig are both brilliant but I think this spat is more of a pissing match than anything that will change the way we fight Type 2 DM, Obesity, Metabolic Syndrome, NAFLD, etc..

-DNL with fructose alone is relatively low (point to Dr. Livesey) but you aren't going to find it in isolation in nature (point Dr. Lustig) and frankly since it only goes "high"(practice your percent change formula boys and girls!) with overfeeding and is reversible (a la Wash U study), who really cares?

-Excess calories, not fructose or sucrose are the problem or to take it a step further; poverty, various mental health issues, and lack of education are the larger concerns with the obesity epidemic.

Sunday, July 17, 2011

2011 National Grip Championships Part 3: More 2HP

Here are some videos of Adam Glass and myself on the two hand pinch deadlift at the 2011 National Grip Championships.  Adam went 242#110 KILOS and some change to take the number 9 spot in the world on the 2HP list.  I hit 215# and just missed 220#.  It was a 3# PR for me and it eradicated the monkey on back since my last contest where I pinched a dismal 185#.

Here's Adam taking the #9 spot on the worldwide 2HP Deadlift list and dominating it!


Here's my 220#/100 KILOS attempt

Here is my sucessful pull with 215#.  This should(?) move me to the #30 spot on the Top 50 2 Hand Pinch list.  This is a worldwide list and is the most popular lift in grip, so I'm fairly happy with it.

Here's a few of my buddy Austin Acree from Moline, IL.  He really guts it out and nails his last attempt. That is HARD to do with a few misses under your belt.  You start to doubt yourself, which changes your position and on the most technical lift in grip you don't want to be switching things up on the go.

2011 North American Grip Championships Part 2:

The highlight of the 2011 North American Grip Championships was Jedd Johnson of Diesel Crew (http://www.dieselcrew.com/) breaking his own world record in the 2 Hand Pinch Deadlift. This event is the most popular in grip and it is tested all over the world.  Weight plates and the official implement must be weighed on certified scales, only a certain number of attempts is allowed, it has to be a sanctioned contest, etc..  This is SERIOUS business, this is NOT some backyard world record.  Jedd destroys his own world record with ease and become the first man to break into 120 KILOS!  This is the equivalent of breaking the 4 min mile IMO.

Enjoy the video!


Here's his attempt at 271#

2011 North American Grip Championships

I just returned from Crooksville, OH, home to the North American Grip Championships this year.  WOW! WOW!, WOW!  If you missed Nats this year, you should be thoroughly disappointed in yourself.  As usual the Rice family defined hospitality and made a centralized National Championships possible.  Holding Nats in Mid-America made a big difference and the turn-out was the best it had been in years.  Thank you so much to Chris, Theresa, Josh, and David!

Here's a teaser list
-The Farm Strong guys came in with an incredible level of sponsorship.  How about the fact they GAVE away a Fat man Blob (open market value several hundred dollars) to the Diesel Award winner.  How about the $500 they donated as prize money! Oh and how about the QUALITY t-shirts they GAVE away to all the competitors!  They are selling these now so head over to their website and pick one up.  These are nice shirts, these aren't hanes with cheap silkscreen.  Check out http://www.farmstrength.wordpress/

-Jedd Johnson DESTROYED his own WR in the two hand pinch deadlift and became the first man to pinch 120 Kilos/!!!  That's 264# with a pinch grip.


If you don't know what Grip or Grip Nationals are; allow me to explain.
 
What the heck is Grip?:  Grip is like World's Strongest Man, which you've probably seen on tv but each event is based on hand and wrist strength and as one of my friends likes to say, "it's the last strength sport for the common man".  Each grip contest essentially tests: crushing grip, pinch grip, support grip, wrist strength, and then has some type of medley which is a combination of everything and usually has a time limit.

So what are Grip Nationals?: As the title suggests, it is the National Championships of  Grip.  There was a series of qualifying events and/or wildcard challenges leading up to this.  Nats consisted of three classes; Novice, Open, and Elite.  I believe if it was your first Nats you could compete in the Novice but given the quality of the Novices, I think it was tits on a fish and I believe we'll see this class either  go away in the future or see the qualifying standards dropped for the Nat's novice class.  To clarify, they all could have competed in the opens and been in the money.  Open was the largest class and was for everybody that wasn't a novice or an elite.  You earn Elite status by totaling 800# between three lifts: parallel set on calibrated grippers, double overhand axle deadlift, and two hand pinch deadlift (eg 180# gripper, 220# 2HP, 400# axle DL).

I shot a ton of video footage at Nats and I'm going to do a series of entries on it.  If you feel like I'm leaving anything out, please stay tuned before you get too upset with me.  First up is the winners of the Diesel Duel.  Jedd Johnson of Diesel Crew (http://www.dieselcrew.com/)  and essentially the President of North American Grip Sport  (http://www.gripsport.com/) gave out an award to the two competitors who had the fiercest rivalry of the day.  This went to Andrew Durniat and Adam Glass.  Andrew Durniat owns Durniat Strength and Adam owns The Movement Minneapolis.  Check out their sites respectively at http://www.durniatstrength.com/ and http://www.movementminneapolis.com/ 

The device they're lifting on is called the Plateau Buster and it is brutal, hence the reason it helps you break through your rut.  It would be a support grip event and is similiar to a Dinnie Stone lift if you're familiar with that. It's essentially a high one hand deadlift without the hassle of the bar rotating on you.  It also has a long handle which enables you to use two hands for swings if that's your pleasure.  Adam made this device popular in grip and he was the favorite IMO.  Andrew and Adam didn't even start taking attempts until the weight was so high that there was nobody left. 

Enjoy this video of Andrew Durniat and Adam Glass going at 600# with one hand!


And for the anti-climatic finish here is my video of 470#.  I was happy considering I'd never touched the implement before. Tim Struse and I tied for 1st in this event in the open class



There are plenty more posts to come so please stay tuned!

Monday, July 11, 2011

The Magic Johnson Effect Returns

As someone who works with HIV/AIDS patients, especially a good deal of newly diagnosed patients, I've probably been asked about Magic Johnson more times than Larry Bird himself.  The questions usually fall into two basic categories: Has Magic been cured? and Which meds are Magic on because they have to be the best since he's lived so long (or substitute "cured")?  Well as many of us know or should know, there is no cure for HIV and "undetectable", which is defined as a viral load of <20 copies per ml, is often thought to be interchangeable with "cured" by those that are newly diagnosed.  As I often explain, Magic is not on any magic meds and his meds are not right for everybody.  Recently though, I've had to amend this a bit to account for an exciting new case.

Enter the Berlin Patient

I'm not writing a blog entry to retell the story of the Berlin patient.  You can Google it until your heart is content and you'll be able to find out more than enough information to get you up to speed.  However if you're too lazy to do that, here are three other options:

A Basic Description
 http://www.examiner.com/city-buzz-in-san-francisco/the-berlin-patient-first-reports-of-an-aids-cure

Infectious Disease All-Star Clinician
Blood Journal's piece is excellent. http://bloodjournal.hematologylibrary.org/content/117/10/2791.full.pdf

The Quick and Dirty

 -HIV + man with Leukemia receives a stem cell transplant with the kicker being his uber-smart doc, Dr. Gero Huetter,  scored him HIV resistant stem cells aka The Delta Deletion!

-HIV uses two basic "doorways" or co-receptors to enter a CD4 cell.  The main door if you will is CCR5.  The side door or less popular one is CXCR4.

-The Delta Deletion refers to CCR5-delta 32.  These lucky individuals are naturally somewhat resistant to HIV because their CD4 cells don't have the CCR5 receptors.  The fly in the ointment is that different strands of HIV can use different doors.  Dual tropism refers to a virus that can either the CCR5 or the CXCR4.  This is where the "somewhat" comes in as someone with the delta deletion is ABSOLUTELY NOT resistant to HIV that can use CXCR4.

-The Delta Deletion is not absolute as in if you inherit it from one parent you might only have a lower amount of CCR5 receptors.  The Berlin patient was lucky enough to score a donor with two parents with the deletion.

-The patient remained on HAART until the day of his transplant

-Next Dr. Huetter and the team, as is SOP with Leukemia, destroyed his immune system/"conditioned" him and gave the usual regimen of drugs to prevent GVHD

-This would not only kill off most of the Leukemia but the cells infected with HIV as well. 

-They repopulated his immune system with the Delta Deletion donor cells which should make short work of the Leukemia.

-The biggest barrier to curing HIV is getting the viral reservoirs to empty or purge their stash. If we could get them to do that, then it's easy enough to kill it.

-With the barrier to the cure in mind; it's HYPOTHESIZED that the viral reservoirs started emptying out.  They then began hunting for susceptible cells and killed what few were available BUT...once those were gone, they now had no where to go because the new cells aka the Delta Deletion cells, were immune. The virus is simply SOL at this point and dies off.  There are a few holes in this theory though and I'll discuss them in the Burning Questions section.

-Post-transplants-he had two because of a leukemia relapse- he has remained HIV free both at the plasma and tissue levels.

-Short of a brain biopsy (totally inaccessible and believed to be a virus super hide-out), he has been HIV free for ~3.5 years.

My Burning Questions

-As alluded to earlier, he is still susceptible to CXCR4 virus so why didn't the viral reservoir stowaways just use the side door and take over the new cells?  What's that you say-The Delta Deletion down regulates CXCR4 expression?  I'm way ahead of ya blood!  According to Blood, as in Blood Journal, as in the issue I cited above, " in the patient described here, we found no evidence for an abnormal CXCR4 expression on recovered CD4 T Cells 

ADDENDUM 10-6-11: After speaking with a pharmacist and reviewing the Blood Journal article it was brought to my attention that the pt was not dual tropic.  Using deep sequencing techniques it was determined that he does have CXCR4 variants but he does not have a dual tropic virus.  Some concerns are that eventually these variants will surface and he will be "re-infected" but from what I understand there is a big difference between using deep sequencing techniques to detect variants and a true dual tropic virus.

-Paging Maraviroc! Paging Maraviroc! Am I the only one that knows about the CCR5 antagonist currently in use?  Have I sipped too many coffees and Diet Mountain Dews and succumbed to the mysterious but never articulately described poisons of caffeine that the judging eyes always warn me about? Maraviroc already blocks the CCR5 receptors in patients who have a virus that only uses the front door.  In fact, one of the big issues with Maraviroc was/is when to use it.  You see, pts are more likely to have dual tropism viruses as the dz progresses, at which point Maraviroc is useless and until a more sensitive assay came out, it was not approved for HAART naive pts.  This brings us back to the beginning! So if Maraviroc is useless in dual tropism pts, then why did replacing the Berlin pt's immune system with a CCR5 free version work because he was 100%, absolutely confirmed, CXCR4 capable

ADDENDUM 10-6-11: Again see above.  Several blogs and nonprofessional sources have listed him as dual tropic but he just had CXCR4 variants using deep sequencing techniques.  This is NOT the same as a dual tropism.

-While everyone is very impressed with this "cure", the Debby-downers, myself included, are quick to point out that giving the ~33 million HIV+ patients in the world, chemo and stem cell transplants isn't feasible....BUT is it?

-Let's just assume that this medical miracle was as sure as death and taxes and would cure anybody infected.  What are the real barriers?

-How about a lack of donors: <2% of Western Europeans have the Delta Deletion.  Northern Europeans carry the highest prevalence with a whopping 4%.  For you trivia buffs, this is believed to have originated as an evolutionary response to the Plague.

-Going through chemo and a transplant is akin to walking into the bar and copping a feel on Mrs. Death's fanny, spitting in Death's drink, and then headbutting him. Make no mistake my friend, there will be consequences and to think you can just run everybody through "conditioning" and a transplant like some ride at Six Flags is infantile.

-Let's assume you win the bar fight against the Reaper.  How about cost? I have an MBA and tend to think of everything in dollars which tends to make opinions about me very divisive.  The dollar literally makes the world go around and for those of you that have had an Econ class you know I'm right. Assuming it would work and everyone would survive, is it cost effective?

-There are numerous things to nitpick about these figures but I tried to be as conservative as possible and while they may not be precise, I don't think you can argue with the overall message.

-The average life expectancy for a 19 y/o diagnosed with HIV is ~40 years.  Treatment cost estimates range from $14,000 to $20,000 per year according to http://www.everydayhealth.com/hiv-aids/can-you-afford-hiv-treatment.aspx.  Let's be conservative and go high for a total of $800k for the lifetime. According to http://www.businessweek.com/magazine/content/05_36/b3949007_mz001.htm a transplant runs about $260K and according to http://www.everydayhealth.com/leukemia/the-high-cost-of-leukemia-treatment.aspx they could run as high as $500k.  One round of chemo runs $150k according to http://www.benzene-illness.com/html/medical-expenses.html.  The Berlin patient had at least two rounds of chemo and two transplants but let's run some scenarios shall we..

-One round of chemo and one transplant: $150K + $260K = $410K  $410K<$800K.  Assuming there are no other costs, which is likely assuming ENTIRELY too much, this is cost-effective.

-One round of chemo and one expensive-er transplant: $150K + $500K = $650 K.
$650K < $800K  Assuming there are no other costs, which is likely assuming ENTIRELY too much, this is cost-effective.

-Two rounds of chemo and two transplants: $300K + $520K = $820K. $820K>$800K so this IS NOT cost effective and I'm sure you can do the math from here.  However...are you going to let them go through one, have it not work and then pull the plug on the project? Unless your name ends in "bub" that's pretty harsh.

-To play Devil's/bub's advocate: there are about 33 million people with HIV in the world that we know of.  $33M x an average cost of $400K per lifetime (the conservative trend continues!) $13,200,000,000,000.

-According to  http://www.avert.org/aids-funding.htm we spent $15.6 Billion in 2008.  Divide $15.6 Billion by $33 Million and it comes out to $472.73.  Remember, on the low end, we were saying it costs about $14K/year to treat.  Even without everybody on HAART, you can see we can't and DON'T afford this epidemic.  Have you come down with compassion fatigue?  Well read that twice and call me in the morning.

Summary

-Short of a brain biopsy, YES, they have cured HIV but it's about as functional as touting winning the lottery as a cure for poverty

-While the advancements in HAART have largely neutered HIV from it's death dealing ways, not everyone can afford the meds.  In fact almost no one can, hence the disability route and the ever-crippling financial co morbidity of the epidemic.  Furthermore, just by looking at the math you can see that we as a civilization can't afford this epidemic and we don't.

Thursday, July 7, 2011

Grease the Groove

Tonight I wanted to do some "grease the groove" training on the 20 mm block set grippers.  This will be an event at the North American National Grip Championships in OH, on July 16th.  I've been training table no-set only after speaking with Nick Zinna at the KC Grip Qualifer II a couple months ago but I know I need to get used to the 20mm block stuff again.  "Grease the groove" is just slang for maximizing your CNS recruitment.  The more neurons and thus motor units you can recruit, the more fibers you can fire, and thus the better the performance.  This is one of the reasons beginning weightlifters see such huge improvements around the 6-8 week mark. All of sudden they can fire a greater percentage of their fibers because of the improved neural abilities.  Longstory-short, I want my 20 mm block set motor units back for the 16th!  Enjoy the video.

An Evening with the Ruger Mark III

I managed to squeeze in a quick 100 rds before we ran out of daylight last night.  The Mark III continues to be flawless and we're at 700 now without a single misfeed, jam, etc..  I'll keep the tally up and see how far we can take it.  I've cleaned it twice which consisted of 3-4 passes with the bore snake and oiling it.

Here's 10 rounds at 25 feet. Some nice groups of 3 but I had four get out on me.

Here's 18 rounds at 25 feet. I thought it was 20 but then realized at the end of the night I had two left, validating my thought that it was a quick mag. Looks like three went awry.

Here's 50 rounds at 25 feet. I'm getting better but it's a process.

Tuesday, July 5, 2011

Diet Soda

Recently  Justin24601  wanted to know what I thought of this article about diet soda http://articles.latimes.com/2011/jul/01/news/la-heb-diet-soda-weight-gain-20110701 .  Happy to address it Sir!

What I like

-"Note that this doesn’t mean artificially sweetened sodas make you gain weight. (See "For the record" below.)* As Richard Mattes, a nutrition scientist at Purdue University, points out: Heavy people simply might choose to consume diet drinks more."
YES! Correlation is not causation!

-"Mattes has studied how artificial sweeteners affect appetite and food intake. He believes that many studies reporting a link between diet soda and weight gain are actually hitting on a behavioral phenomenon—people think they can eat more calories because they’ve swapped their regular soda for a Coke Zero.
“That’s not a fault of the product itself, but it’s how people chose to use it,” he says. “Simply adding them to the diet does not promote weight gain or weight loss.”

The second to the last sentence sums it up beautifully. I really don't feel I need to explain it any further but will if requested.  Unfortunately, that's not an exciting headline and won't sell anywhere near as many papers as "Diet Soda Makes You Fat".

Starting to come off the rails

-"In rodent studies, researchers have observed artificial sweeteners stimulating cells in the pancreas to change insulin secretion, altering the pH in the gut, and affecting hunger-regulating cells in the brain. Fowler and colleagues also reported this week that diabetes-prone mice exposed to aspartame for three months had higher blood-sugar levels than those not exposed at all"

Not a fan of rodent studies when talking about humans but the bigger issue here is that insulin actually blunts appetite, not increases it.  James Krieger, who wrote the phenomenal series on insulin addresses this. James cited this study http://www.ncbi.nlm.nih.gov/pubmed/16933179?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=66 but again, it's well known, at least among professionals, that insulin is an appetite suppressant, so unless the change is a drop in insulin levels (which I'd bet a dollar to a dime that's not what they're implying), I fail to see how that's concerning.  What else were done to the mice?  Are we saying the only different variable was aspartame exposure?  I doubt it but who would know since they didn't list which studies they were talking about.

-Dariush Mozaffarian, a Harvard epidemiologist who recently studied how a long list of food and drinks contribute differently to weight gain, says zero-calorie soda could be a good choice for people trying to lose weight, calling it an “intermediate step” to going “cold turkey” with sweets and soda.
“Artificial sweeteners may be a good short-term option to bridge people away from refined sugars, but consuming moderate or high amounts long-term should be avoided as possible," he wrote in an email.
The main issue, he said, is again, less about biological reactions than about our perception of sweetness: “We don't know how consuming artificially sweetened drinks and foods alter tastes and preferences for other healthy foods, especially in children.  For example, do apples or carrots taste just as sweet to someone who consumes high amounts of artificial sweeteners?"

I enjoy Mr. Mozaffarian's work but this is not his best stuff.
Let's break this down a bit:
1. Refined sugars are bad at least in the context of people that are trying to lose weight/maintain weight because on a limited calorie budget, they're calorically expensive and don't give you much bang for your buck.  Agree with Mr. Mozaffarian so far.
2. Why do we need to bridge away from sweetness if the sweetness we enjoy is calorie free?
3. Does anybody really think that they eat less carrots and apples because they drink diet soda?  Come on!  Think about who you see that drinks diet soda? People trying to stay thin/maintain weight and people trying to lose weight.  Think about those two populations relative to their fruit and vegetable consumption.  One usually already has the good habits formed and the other is drastically trying to increase it because they're "healthy" they're "low calorie", their trainer told them they must eat them, etc..  Carrots and apples shouldn't be thought of as sweet foods.  it's like going to school to be a social worker and being pissed off that you're not making six figures.  How about educating on the real benefits of fruits and nonstartchy vegetables instead of trying to paint them as something they're not!

Summary
-Diet soda in and of itself can not and will not make you gain weight (fluid weight excluded).  It is physically impossible.
-We can blame diet soda for increasing our sweet expectations or we ask the better questions like "why do I expect carrots to taste as sweet as soda?" or better yet "Why do I need sweet foods all the time?".  In my experience, obesity almost always has a mental health component, yet that is rarely addressed.  The fact that we're even discussing if a zero calorie product can cause weight gain proves this in spades.  We can call it altered taste perception if we want but the bigger issue is people are overconsuming calories, for a variety of reasons (emotional pain, boredom, habit, etc..), and that is what needs to be addressed.  Don't get me wrong, I like salty, fatty, and sweet foods (the terrible synergist combination!) and I certainly like them more than carrot sticks but I can control myself, not because I just have so much willpower but because I'm not eating as a coping mechanism.

In closing, I hope this was helpful and I look forward to your comments.

Josh

Monday, July 4, 2011

The Good Guys

As a Registered Dietitian, I live and breath nutrition and appreciate people that do the same.  The individuals listed below are who I'd consider "the good guys" of the nutrition blogosphere.  You see anybody can be a nutrition expert on the Internet, but these guys truly are and back it up with studies proving their claims.  There are no doubt many more but these are my favorites. Here's a quick breakdown:

Alan Aragon

http://www.alanaragon.com/

Alan has a funny and saracastic writing style and his articles toe the line between layperson and medical expert, which keeps them right in the sweetspot of readability.  He's coined such terms as "Broscience" which is a fun dig at the bodybuilder types who make up the nutrition as they go (eg "don't eat fat and carbs together bro, it will cause an insulin spike and drive all that fat right into your cells!)
Make no mistake though, he is an expert.

My favorite Aragon article would be his rebuttal of Dr. Lustig, appropriately titled "The Bitter Truth About Fructose Alarmism"

http://www.alanaragonblog.com/2010/01/29/the-bitter-truth-about-fructose-alarmism/  Enjoy!

Pros:
-funny, engaging writing style but still plenty meaty enough for the clinician
-great t-shirt shopping for those of us that want to take our love of nutrition one step further
-outstanding free articles on various sports nutrition topics
-Alan specializes in interpreting the most current research and relaying it for the non-epdemiologist in all of us

Cons:
-not updated as much recently, but it's a free site and he turned down a full time job with The LA Kings professional hockey team so you know his private practice is booming!

James Krieger

James has a more serious style than Alan and sometimes likes to play logician or debate team captain a bit too much but his articles are excellent.  His series on insulin blew my mind.  If you think you know about insulin, insulin resistance, etc.. I highly suggest you read his series on it.  Read the WHOLE series, it's free and it's worth it!

http://weightology.net/weightologyweekly/?page_id=319

James has switched his website, weightology.net over to a pay version so I no longer frequent it but he has a great series of free articles available.

Pros:
-This guy used to run the BS detective blog.  IMO, he specializes in breaking down junk science, no matter how high up it comes from and he always backs his claims with studies that are hyperlinked within his articles.
-Like Alan, he makes professional reading, more readable

Cons:
-The debate/logic jargon gets a bit tiresome but usually that's because his readers antagonize him.
-It's a pay site now.  I'm sure it's well worth it but my Glock 19 is entirely too hungry to be spending my dough on this.

Dr. Stephen Guyenet

http://wholehealthsource.blogspot.com/

This guy is incredibly smart and I have no problem admitting I have to read some of his articles multiple times before I really get it but the information is golden.  He's probably the most anti-dietitian of the three which seems to mostly stem from his disdain for Ancel Keys, the high carb, low fat diet that followed and is still being followed, and IMO, a false sense that we as dietitians are anti-fat. To clarify; it seems like he wants to dismiss us as not knowing the differences between fats and we would likely dismiss him because he's not an RD.  The shame of it is, we could both learn so much from one another. 

This is one of my favorites from his site.  It's an article on oxidized LDL. 

http://wholehealthsource.blogspot.com/2009/07/diet-heart-hypothesis-oxidized-ldl-part.html

Pros:
-Detailed, clinician-level articles that address hot topics in nutrition
-Articles that explain mechanisms and provide reasoning for why the lipid hypothesis is bunk (if you choose to believe that way)
-Dr. Guyenet just does a wonderful job of explaining the physiology of various studies.  Anyone can read and site studies to back of their claims but Dr. Guyenet's blog is a fantastic resource for learning the how's and why's.

Cons:
-Appears to be somewhat anti-dietitian.  This seems to mostly be from the fact that we educate on AHA Step I type diets/paint saturated fat as the bad guy
-He states that randomized controlled studies are the only type that show that saturated fat increases cholesterol.  In otherwords, he's saying that we can't show that with longterm studies.  IMO, he's grasping at straws here because RCT with humans are the gold standard and by implying otherwise he's lowering his credibility.  However, he's the PhD so maybe he knows something I don't.