The 4 pillars of health are lifestyle factors that encompass all variables of health, wellness, and performance. Having even just one weak link will hold you back. We discuss each of the four pillars with our clients and focus on areas needing the most attention. For long-term success, we need to find balance between all four pillars and then work to improve them all from there.

The 4 Pillars of Health

#1: Sleep

We all sleep. It is essential to life. It is how we recover from the day and recharge for the next day. For some reason, people love to ignore sleep. By that, I mean that they don’t give any thought to their sleep hygiene, patterns, routine, etc. Not getting enough sleep will result in poor energy, mood swings, lack of recovery, increased food cravings, and reduced motivation.

Both quality and quality of sleep are important to address. Even if you feel like you can get away with running on little sleep, you are leaving a lot on the table. You will be better if you are well rested. It will catch up to you.

#2: Stress Management

Stress is one of the most neglected things in life, especially in the health and fitness world. Interesting fact: The body cannot differentiate between physical and emotional stressors. Your health can be affected by too much of any kind of stress.

Too much stress (or poorly managed stress) will lead to musculoskeletal pain, headaches, irritability, weight gain, reduced muscle protein synthesis (muscle building), reduced libido, gut health issues (like poor digestion), impaired immune system, and difficulty sleeping.

Reducing the amount of stress and proper management of stress are crucial to your performance and overall health. Stress can kill you. A bit dramatic...but true.

#3: Nutrition

You can’t outwork a bad diet. When I talk about nutrition, I am not speaking with weight loss in mind, although that may be necessary for some people. Proper nutrition is more than just limiting calories or seeing the number on the scale go down.

Your health, energy, mood, hormones, immune system, and inflammation are directly affected by your diet. A healthy diet with the right ingredients can be as potent as anti-inflammatory meds or even reduce/prevent the onset of some inflammatory conditions.

Focus on hydration, quality, and quantity. Drink plenty of water, limiting or eliminating any sodas or processed drinks. Consume food high in nutrients (and again, avoid processed stuff). Choose fresh produce and meat over anything in a can or freezer aisle. Find portions that work with your body and goals. Stick to these portions. If you only put the right amount of food in front of yourself and pack the rest up into meals, you will be more likely to stick with portion control.

#4: Movement

Movement is medicine. That is our mantra. If you want to live a long life, independent from the help of others, and be able to enjoy your older years, you must MOVE. Movement is essential to keeping your muscles, tendons, bones, and joints strong. Movement is needed to keep the heart and lungs healthy. Movement keeps all systems in check and balanced.

Overall, general movement is way better than not enough movement. Typically, what we see from our clients is a lack of movement diversity. Some people run, but don’t do any strength training or stretching. Some people do yoga, but haven’t touched a weight in their life. Some people can lift hundreds of pounds overhead, but can’t run a mile.

Balance across movement variables is essential. Start with mobility, strength, and cardio. You can make it more complex and fun from there, but try to move in different ways to challenge your systems and improve across all areas of movement.

#1: Have a clearly defined short-term goal

It all starts with a well-defined goal. Most people have now heard the term ‘SMART’ goals when it comes to goal setting. The SMART acronym stands for ‘specific,’ ‘measurable,’ achievable,’ ‘relevant,’ and ‘timely.’

Let’s specifically dive into ‘timely’ from the SMART goal acronym.

It often works best with nutrition goals to have short-term goals that provide a stepping stone to the next goal with overall goals broken down into more manageable short-term time frames. For example, if you want to lose 50 pounds, you may start with a goal of saying, ‘In the next 12 weeks I’m going to lose 10 lbs.’ Viewing it as a 12-week block of focused effort towards weight loss, with an achievable and sustainable amount of weight to lose provides a mental framework that keeps the workload approachable.

Often making the changes necessary to overhaul our nutrition and gain momentum towards achieving our goals takes a lot of effort and work. High levels of effort can only be sustained for so long before we begin to fatigue. Set an intention to sustain a focused and high level of effort and attention for 12 weeks. At that point, you can gauge success, take a ‘cruise’ period to simply maintain what has been achieved and determine what steps need to be taken next for the next wave of progress to occur towards the overall goal.

#2: Principles over methods

Principles are defined as, “a fundamental truth or proposition that serves as the foundation for a system of belief or behavior or for a chain of reasoning.”

Methods can be thought of as the means to put a principle into action or to carry out a principle.

All too often, especially regarding nutrition, people get way too deep into the weeds on the methods being used.

Stick to principles.

For example, for weight loss, given the first law of thermodynamics, a guiding principle is to take in less calories than you burn. Caloric restriction is tried and true when it comes to losing weight. Whether you do this through intermittent fasting, counting calories and macros, skipping breakfast, not eating 3 hours before bed, it all boils down to adhering to the general principle of caloric restriction.

Guide your plan with sound principles and find the methods that work best for you as an individual.

#3: Protein as the key macronutrient to target

#4: Staying properly hydrated to help manage hunger

Hunger is tricky and gauging when we are truly hungry and in need of food can sometimes be difficult.

Sometimes signals we interpret as us being hungry may be our bodies signaling a need for something else. One example being that we may, in fact, need hydration.

While it does not appear that water intake directly causes people to eat less, it does appear that staying properly hydrated can affect our perception of hunger throughout the day.

Sometimes drinking a glass of water initially when we receive a signal of hunger in our minds, might be just what is needed to allow us to decide that we really don’t need food or a snack at that moment in time and this may indirectly lead to less calories being ingested, overall, throughout the day.

Shoot for half your bodyweight in ounces of water each day.

#5: Manage your environment to set yourself up for success

If you took psychology 100 in college, you heard about the concept of classical conditioning.

This is the behavioral principle that states learned behaviors begin to occur when a neutral stimulus becomes associated with a learned response over time.

An example of this is a dog owner using a leash every time they take their dog outside for a walk. The dog begins to associate their owner grabbing the leash with going outside for a walk. So, every time the owner grabs the leash the dog gets excited and runs up to the door waiting to go outside.

Many of our behavioral patterns can simply boil down to classical conditioning, including nutrition behavior habits.

For example, if every time we watch our favorite show on Netflix we also grab our favorite bag of candy and eat it while watching the show. Over enough time, we may just grab the bag of candy and start eating it when we are watching our favorite show on Netflix without even considering if we are even hungry or want food at that time.

Do an inventory of some of your eating habits that you know are detrimental to your goals. Are some of these habits simply just automatic responses to a certain activity, place in your house, feeling/emotion, etc.? If so, create a strategy to change the pattern and break the habit. For example, in the scenario above, maybe you skip buying the candy during your next trip to the grocery store and replace the candy with a bowl of fruit while watching your show.

How to Improve Meal Prepping to Maintain Better Nutrition Habits

1. Dedicate a specific time for meal prepping. 

The most common day for this is Sunday because most people have the time on Sunday and the food can be prepped for the work week. That being said, each person has a different schedule and you can do this whenever is best for you. You can block out a time of a few hours for grocery shopping, meal prepping, and cleaning up. I would block 3-4 hours at first.

2. Choose food items and recipes that will stay fresh in the refrigerator throughout the week. 

Typically, this includes crunchy vegetables, starchy vegetables, whole grains, lean meats, sliced snacking veggies, hummus, etc. You can decide to cook separate items or full recipes. If you cook full recipes, then your week is simple. Just make enough servings to make it through the week. If you elect to cook separate items (for example: chicken, pork, rice, broccoli, cauliflower, brussels sprouts, and asparagus all in separate containers), then you can mix-and-match these items throughout the week to avoid eating the same exact meal everyday. There are a bunch of apps out there these days to look at recipes. Pinterest is one of the easiest ones to find and save recipes.

3. Use your meals to make a grocery list, and make sure you stick to your list.

This is important because you don’t want to go buy a bunch of random items that will sit around. You don’t want to fill your pantry and fridge with unnecessary options when you have already planned out the week. If you know you will snack, then build that into your prep and cut up some fresh produce or buy your favorite protein bars accordingly. You are much less likely to eat a bag of chips or a package of Oreos if they aren’t already in your house.

4. Consider using a slow cooker.

My wife and I use our slow cooker all the time. The total time for cooking may increase, but it’s passive time that we can spend doing other things. Simple recipes will allow you to dump all or most ingredients into the slow cooker and not have to worry about it for hours. When it’s done, just divide up your portions into containers and clean the slow cooker. Done.

5. Pack your meals or food items into clear containers and refrigerate or freeze them.

Clear containers allow you to see what is inside very easily. This simple step makes the meal more appealing. Ideally, you are only cooking for a length of time that all items can be left in the refrigerator to keep things simple. If your refrigerator looks crazy and you have a bunch of people in your house, you can also consider labeling each container with the name of the person to eat it and the date for consumption. The goal is to make enough for the week so that you do not need to order out but also so you are not throwing away meals because you cooked too much.

6. Be consistent. 

While starting a new habit (or improving on a habit), you need to be purposeful and consistent. If you are tired on Sunday, still do what you set out to do. If you are busy on Sunday, maybe set yourself up and meal prep on Friday or Saturday instead of giving up for that week. In extreme situations where you are unable to give any time (out of town and get home late on Sunday), you could either prep and freeze before your trip or use a meal prep service (some examples near Baltimore are Territory, Jimmy’s Famous Meals, and John’s Fit Meals) for those weeks. They have a premium cost, but are beneficial when you cannot put in the work yourself.

Healthy Fats Vs. Unhealthy Fats

There are various types of fat: monounsaturated, polyunsaturated, saturated, and trans. Foods that are high in fat will be healthy or unhealthy based on which type of fat it is made up of. Too much of any type of fat is bad and will lead to weight gain, but the same could be said about eating excess of any type of food.

What Are Fats?

Fats, also called fatty acids or lipids, are made up of 3 molecules (called triglycerides). Our bodies produce many of the fats that we need to survive. Essential fats are the fats that we need but our bodies do not produce. Essential fats can be omega-3 or omega-6.

We need to eat fats for many reasons. Here are some of the many benefits:

• Improving absorption of vitamins A, D, E, and K

• Improving heart health

• Improving skin health

• Reducing LDL cholesterol levels

• Feeling satisfied longer after a meal

Monounsaturated fats are known as heart healthy fats and they also help regulate cholesterol levels.

Sources of monounsaturated fats are:

• Nuts

• Vegetable oils

• Peanut butter

• Almond butter

• Avocados

  
  

Polyunsaturated fats are known as essential fats. These are usually found in fish and plant-based foods. These are further categorized by omega-3 and omega-6.

Unhealthy Fats

The 2 main types of unhealthy fats are saturated and trans fats.

Saturated fats are typically found in meats and dairy. These are meant to be consumed sparingly.

Sources of saturated fats include:

• Fatty cuts of beef, lamb, or pork

• Dark chicken meat

• Poultry skin

• Whole milk

• Butter

• Cheese

• Sour cream

• Ice cream

• Tropical oils (coconut oil, palm oil, cocoa butter)

• Lard

Trans fats should be avoided as much as possible. These are the worst fats.

Eating a well-balanced diet includes eating fats. That being said, you should eat the right types of fats to promote wellness. Focus on the healthy fats (monounsaturated and polyunsaturated) when deciding what to cook/eat.

Benefits of Turmeric

Turmeric is touted as one of the best nutritional supplements. Turmeric is a cousin to ginger. Most of its benefits are linked to curcumin, which is the main active ingredient in turmeric.

Important to know: Most studies showing the benefits of turmeric use extracts, not the spice. You may need to seek out highly concentrated supplements in order to see significant benefits. Curcumin becomes more effective when taken with piperine (exists in black pepper).

  1. Anti-Inflammatory Effects

Turmeric/Curcumin is a strong anti-inflammatory. Some studies suggest that curcumin is as effective as anti-inflammatory drugs without the side effects.

2. Antioxidative Effects

Curcumin is a powerful antioxidant and also boosts the body’s natural antioxidants. Antioxidants protect the body from free radicals, which are responsible for aging and many chronic diseases.

3. Improved Brain Function

Curcumin helps to boost brain-derived neurotrophic factor (BDNF), which acts like a growth hormone in the brain. This suggests that curcumin can be beneficial in preventing and treating brain diseases, however more studies need to be done to confirm this. Increasing your BDNF levels can improve memory and overall brain function.

4. Helpful in Preventing and Treating Medical Conditions 

With the anti-inflammatory and antioxidative benefits of turmeric/curcumin, it’s clear that this supplement can help with preventing and treating many medical conditions. Common diseases that would be targeted are osteoarthritis, hypertension, heart disease, depression, and even cancer.

The information on how much turmeric to consume is still highly variable in studies, making it difficult to give a proper recommendation. You are more likely to see benefits by using a turmeric/curcumin extract from a reputable company rather than by using a spice from the grocery store. Do some research before you buy the first turmeric supplement you see.

Postoperative Nutrition Considerations

Surgery is something that we hope to avoid throughout our careers in both competitive athletic pursuits and in our recreational exercise years. However, as the saying goes, stuff happens. 

So, if we’re faced with a situation where surgical intervention is the necessary approach to resolving an injury we have sustained, then our goal shifts towards the most effective and efficient rehabilitation from that surgery. Just as there is ‘optimal’ when it comes to performing in our sport or activity, there is also ‘optimal’ when it comes to post-surgical recovery. And ultimately, optimizing our post-surgical rehab gets us back to the activity or sport we want to be participating in as quickly as possible. 

There are certainly other considerations when optimizing post-surgical rehab, such as optimizing sleep, hydration, and consistently performing your physical therapy exercises. But, in this article, we want to provide some insight on a sometimes under-appreciated aspect of recovery, which is nutrition. 

Think optimize and minimize

Having realistic goals is vital. Avoiding the above altogether is impossible. The body is going to have to go through a natural healing process. However, what we can do is minimize the amount of atrophy and strength loss that occurs and ensure that we are providing our bodies with the appropriate building blocks to aid in the repair and recovery process to make it as efficient as possible. 

A crucial building block to the repair process after surgery is amino acids. Stores of amino acids in the skeletal muscle will be used by the body after surgery to aid in healing. So, we have to ensure that our protein intake is adequate to provide the body both a sufficient amount of amino acids to heal AND to maintain and restore our muscle mass and strength. Because of the healing process that is also occurring, post-surgical daily protein requirements will be even higher than normal. 

A 2016 paper in the Clinical Nutrition Journal showed that post-surgical amino acid supplementation effectively reduced whole-body and muscle catabolism (breakdown) by stimulating a 40% increase in muscle protein synthesis and caused a 20% reduction in whole-body protein/amino acid breakdown. Further, a 2021 paper in the Journals of Gerontology Series A, showed that essential amino acid supplementation following total knee replacement surgery led to less quadriceps and hamstrings muscle atrophy at 2 and 6 weeks following surgery compared to placebo. So, as we can see, protein and essential amino acids are vital for recovery and best outcomes after surgery. Now, the next question, how much?

Protein recommendations 

A general recommendation for daily protein consumption during post-operative rehab is 1.6 g/kg/day at a minimum and up to 2.0-3.0 g/kg/day. What this means is that an individual who weighs 160 lb, or 72.5 kg, should consume 116 to 217.5 grams of protein per day. 

Other post-surgical nutrition considerations 

Hopefully if you have made it to this point in the article you now are on board with the importance of nutrition in optimizing recovery following surgery. To conclude, here is a list of some other post-surgical nutrition considerations for most efficient and effective recovery:

• Reduce intake of inflammatory foods (i.e. sodas and other sweetened drinks, cookies, chips, fried foods, refined grains, foods with a lot of added sugars, etc.) 

• Eat sufficient fiber to avoid constipation 

• Appetite may be reduced, especially, in the first several days following surgery. This may be a time when amino acid supplementation or protein shakes in powder/drink form is advantageous.   

• Ensure adequate nutrition to fuel exercise sessions when you are performing your rehab/physical therapy exercise. Make sure you are eating around the window of your rehab sessions just like you would before and after your training sessions in the gym.

• Creatine monohydrate, omega-3 fatty acids, and probiotics are other supplements that have been shown to have an ability to aid in supporting muscle function and strength and may be worth researching further and adding to a post-surgical supplementation regimen. More on these supplements and their potential for aiding muscle building and strength can be found here and here. 

Speed Up Healing with these Foods

Nutrition actually plays a powerful role in managing your inflammation. Nutrition is also super helpful in preventing injuries and getting back to full strength at the end-stages of recovery, but we will cover those in other posts.

Before we dive in, I want to mention that some of these foods, herbs, and supplements may interact with medications. Most notably, taking ginger may hinder the effectiveness of blood-thinning drugs. Consult with your physician or a nutritionist prior to making big changes to your diet if you are taking medications or have gastrointestinal issues.

Anti-Inflammatory

Pro-Inflammatory Foods to Avoid

Proper nutrition can really speed up the healing process. It is equally important to avoid pro-inflammatory foods as it is to add anti-inflammatory foods.

Some people drink pre-workout drinks before a workout. Some people will go into a workout without eating. Some people snack before a workout. To figure out what the best pre-workout nutrition for you, we’ll have to take into consideration the time of day that you are exercising.

What should I eat before a workout?

What you eat depends on when you eat/workout.

If you are working out in the morning, then you don’t necessarily need to eat anything. Eating immediately before working out can upset your stomach. If you are exercising later in the morning or feel like you need to get something in your stomach before exercising, then go for something high in carbs so the body can digest it fast and utilize the energy. Examples include half of a banana, applesauce, and raisins.

If you are working out in the afternoon or evening, the recommendation is to eat a snack prior to exercise. If you are snacking 2 hours or more prior to the workout, then you can eat just about anything as the body will have time to metabolize and digest. That being said, focus on whole foods and don’t eat until stuffed. If you are snacking about 30-60 minutes before a workout, then you should choose your snack carefully. Limit the calories (about 100-200 calories is a good goal) and limit fats (i.e. peanut butter, avocado, coconut oils, butter spreads, etc.). High calorie and high fat foods can slow down your metabolism and cause gastrointestinal distress during the workout. Stick with fruit, yogurt, or protein shakes.

Everyone is different, so listen to your body and modify as needed.

Are energy drinks good for me?

Are protein bars good to eat before a workout?

Protein bars are good in a pinch, like if you are traveling a lot that day, didn’t have a lunch break, or are just on the go. They can supply you with some calories and are better than nothing. However, there are more bad ones out there than good ones. Pay close attention to how much sugar (shoot for under 10-12 g), protein (shoot for 15-20 g), and fat (shoot for under 8 g) are in the bar.

Some good options of protein bars include RXBAR, ONE, Quest, Vega, and Kirkland Signature.

Supplements to Consider Taking for Health and Longevity

Whether you are a veteran meathead and have memories of crushing NO-Xplode before workouts, a science nerd obsessed with the Huberman Lab Podcast, or someone new to fitness noticing all the shiny supplement labels at the front desk of the gym along with all the colorful shaker bottles floating around (I think I have fallen or do fall in to all 3 categories), if you have spent any time in the gym or at any point have started an exercise routine to improve your health, you have undoubtedly been exposed to supplements.

But the supplement world can be a tough one to navigate. So, what should you be taking?

We are going to discuss 5 supplements here that you should take if health, performance, and longevity matter to you. Let’s stick with our house analogy and discuss the ‘3 roommates’ that live in the house together.

The quality of ingredients used, sourcing, and production all matter and can make a difference in the effectiveness of a given supplement. There are a lot of great brands out there, but it can be challenging to find one company that makes all the supplements you are looking for and at the desired quality. We believe Thorne Supplements provides this option. Thorne’s ingredients are lab tested for purity, quality, and to ensure no contaminants. They also make a point not to use unnecessary fillers or binders and have over 30 supplements that are NSF certified for use by competitive athletes, which are some of the reasons why they have earned our trust and why we personally order supplements from Thorne as a staff at Outlast.

Because of our belief in Thorne’s quality, we have also chosen to partner with them to offer our clients a discount on their retail prices and to receive free shipping. If you wanted to take advantage of this offer, simply go to https://www.thorne.com/u/outlasthealth and create an account and follow the ‘Thorne Supplements’ link under the ‘Shop’ tab on the outlasthealth.com website and place your order from there.

Creatine for Women

What is creatine?

Creatine is a naturally occurring compound that is stored in muscles. A small quantity of creatine is also stored in the brain. Creatine helps synthesize adenosine triphosphate, or ATP, which is commonly referred to as the “powerhouse molecule” in your cells. ATP is critical for muscle function and growth, brain function, and for many of the body processes.

Creatine is produced in the liver and pancreas but much of the creatine in our body comes from our diet. Creatine can be found in red meat, fish, poultry, and dairy products. In order to consume the recommended amount of daily creatine solely from food, you would need to eat multiple pounds of meat daily. This is not happening for the vast majority of us, so creatine supplementation is highly recommended.

Research shows that women have 70-80% less creatine stores than men and tend to consume less creatine through their diets. This makes women ideal candidates for creatine supplementation.

What are the benefits of creatine for women?

Increases Energy

Creatine is literally involved in producing energy in the form of ATP in our cells. Creatine helps to improve work capacity and performance of your muscles and will help to give you that extra boost of energy to run faster, lift heavier, and have better mental acuity.

Improves Cognitive Function

Creatine has been proven in research to improve tasks utilizing the frontal cortex of the brain, such as learning, memory, and attention and contributes to creating a “pro-energetic” environment in the brain. There are many vitamins and supplements on the market that claim to improve memory, but creatine is unique in the fact that it holds up to these claims when thoroughly researched. A recent Grade A study proved that individuals supplementing with creatine had significantly improved memory as compared to a placebo. These effects were even greater in healthy, older adults (66-76 years old).

Because of these findings, current research is looking into using creatine supplementation as part of a treatment program for neurological conditions such as Alzheimer’s, Parkinson’s, PTSD, depression, and anxiety.

Improves Lean Body Mass

Many women have been reluctant to use creatine due to the fear of weight gain. This is a largely unfounded belief, especially for women. There may be a slight increase in weight initially due to an increase in cellular hydration but this is largely found in men and not women.

A recent study showed a significant increase in strength and decrease in body fat percentage using skinfold testing in women who utilized creatine supplementation in addition to a strength training program vs. women who did the same strength training program without creatine supplementation. So if you want to become a lean, mean, fighting machine and decrease your body fat percentage, creatine can help you get there.

Enhances Muscle Recovery

There appears to be a positive correlation between creatine supplementation and muscle recovery. However, more research is needed to determine the exact relationship between creatine and recovery.

Improves Homeostasis During Times of Hormone Fluctuation

Creatine synthesis is influenced by hormone levels. Unlike men, women regularly experience hormone fluctuation. When our sex hormones are low, creatine synthesis is also low. Having creatine supplementation on board can just help to off-set the times when natural creatine is low.

How does creatine specifically impact women throughout the lifespan?

Throughout a woman’s lifespan, naturally occurring creatine is highest during the menstrual years and lowest during pregnancy and menopause. It is worth considering creatine supplementation especially when pregnant or when entering menopause and throughout the aging process in order to combat those low periods of naturally occurring creatine.

For women experiencing a menstrual cycle, naturally occuring creatine concentration is highest during the ovulation phase when estrogen and progesterone are at their peak levels, and lowest during menses. Using a form of creatine supplementation can be helpful to mitigate those times when natural creatine is low so that you can still continue to feel energized, mentally sharp, and ready to exercise.

Are there any negative side effects?

No! This is amazing news. There is very little evidence to suggest any negative side effects for men or women to use creatine supplementation at any point in their lives. Both healthy and unhealthy populations can safely incorporate creatine into their routine. If you have any concerns, however, please speak with a health professional to get specific recommendations.

The 2020 study entitled Risk of Adverse Outcomes in Females Taking Oral Creatine Monohydrate: A Systematic Review and Meta-Analysis clearly outlined the lack of adverse effect of creatine supplementation on the gastrointestinal, renal, hepatic, or cardiovascular systems among women supplementing with creatine.

How much creatine should women take?

There are two approaches when it comes to introducing creatine into your routine. If you are looking for a fast way to see changes, you may want to take the “loading approach”. This is ideal for women that are training for a specific event in a limited time period.The loading approach is based on increasing creatine by 19% which typically works out to 15-20 grams a day for 3-7 days and then is followed by a consistent routine of 5-10 grams per day.

If you are not concerned with a fast turn-around, the most common recommendation for creatine supplementation is 5 grams a day. This approach will take 3-4 weeks in order to see an increase in muscle creatine stores.

Creatine absorption can be influenced by insulin availability. If you have issues with insulin metabolization, consult a professional on how much creatine you should add into your routine.

To recap, creatine has long been marketed towards men as the secret muscle building molecule and women had largely been left out of the conversation around creatine. Recent research proves that there are so many wonderful benefits and really no negative side effects and creatine supplementation can be safely implemented in almost all people. Women have less naturally occurring creatine stores than men which makes them even more ideal candidates for supplementation. Come on ladies, let’s reap all the benefits that creatine can give us!