It’s not just your pre-and post-event meals that influence your performance. Consuming a high carbohydrate diet every day will help you reach peak performance. The G.I. factor of the carbohydrate is not important here, only the amount of carbohydrate. It has been proven scientifically, unlike many other rumours involving dietary supplements, that eating lots of high carbohydrate foods will maximise muscle glycogen stores and thereby increase endurance.

The reason for this is that carbohydrate stores need to be replenished after each training session, not just after a race. If you train on a number of days per week, make sure you consume a high carbohydrate diet throughout the whole week.

Keep alcohol intake moderate—no more than one to three standard drinks per day and try to have two alcohol-free days a week. A standard drink is equivalent to one glass of wine (120 ml), one middy of beer (285 ml) or one nip of spirits (30 ml).

Beer is not a good source of carbohydrate. When athletes fail to consume adequate carbohydrate each day, muscle and liver glycogen stores may eventually became depleted. Dr Ted Costill at the University of Texas showed that the gradual and chronic depletion of stored glycogen may decrease endurance and exercise performance. Intense work-outs often two to three times a day, draw heavily on the athlete’s muscle glycogen stores. Athletes on a low carbohydrate diet will not perform their best because muscle stores of fuel are low.

If the diet provides inadequate amounts of carbohydrate, the reduction in muscle glycogen will be critical. A heavily training athlete should consume about 500 to 800 grams of carbohydrate a day (about two to three times normal) to help prevent carbohydrate depletion. In practice, few Australian athletes achieve this enormous figure. As a comparison, a typical Australian man or woman eats only 240 grams of carbohydrate each day.

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New research on the effects of ageing on body fat suggest that there are a number of components of ageing which mean that gaining fat stores with age is a ‘natural’ process and that losing fat becomes more difficult. Changes with age that promote fat gain are:

• a decrease in lean body mass: and therefore a reduction in metabolic rate. This may be compensated for by such activities as resistance training, although the extent to which this can occur is not dear at this stage. Metabolic rate is thought to decrease naturally by about 2 per cent per decade after the age of 20.

• changes in fat oxidation. The rate at which the body bums fat as an energy source in contrast to blood sugars, decreases with age, possibly as a result of the increase in body fat mass. This means fat is stored more readily and used less easily as a fuel source in the elderly.

changes in the influences of stimuli which ‘break down’ fat (lipolytic stimuli). Hormones such as growth hormone and testosterone all decrease with age and catecholamines from the adrenal glands appear less effective with age. Hence, the normal status of older people promotes fat gain

As well as a decrease in physical activity (through sport and games) it now appears that even if older people consciously exercise vigorously to lose fat, they may unconsciously decrease their rate of physical activity at other times during the day: they simply get more tired than young people as a result of exercise, and unless an effort is made to maintain SPA, the net effect may be no real gain in overall physical activity.

• increased associated health conditions: heart disease, arthritis and other muscular-skeletal problems.

• a decrease in intra-muscular fat as an energy source. There are significant stores of fat in muscle tissue. The storage of fat in the muscle tissue decreases with age as the binding protein decreases. This means fat from the muscle is less readily available as an energy source during exercise and a greater reliance is placed on other energy stores.

• increased eating. Although this is often under-reported, there is evidence to suggest that eating and drinking may actually increase with age, rather than decrease or remain stable, as would be necessary to stabilise body fat. Accurate monitoring of food intake in the elderly will be necessary before this can be verified.

On the positive side, it appears that moderate fat gains with ageing do not appear to be as dangerous as those in the young and a BM up to 27kg/m2 is considered within the normal range for older people. However, this point is still hotly debated and in the meantime caution is still advised.

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When dealing with the area of managing body fat levels we must have a basic understanding of how energy is balanced in the body. We consume on average anywhere from 1500kcal-2500kcal per day. This adds up to an energy intake of about 555 000-1 million kcal (2.33-4.17 kj) per year. But what about expenditure? How does the body balance energy intake with expenditure? Why can some individuals seemingly consume relatively greater quantities of food than others, and at the same time end up with lower stores of body fat? Dr Klaas Westerterp and his group from the University of Limberg in the Netherlands, have estimated that over the course of a lifetime, there is an actual discrepancy between energy intake and energy expenditure of only around 1 per cent, making the system an extremely well balanced one.2 What this implies, of course, is that body weight is not just equal to the amount of energy intake minus energy expenditure, but that energy intake + expenditure must change, as a function of a number of factors, to help balance the system. To understand this, we need to understand the components of energy expenditure. There are three main components of energy expenditure.

1. Resting metabolic rate (RMR) or basal metabolic rate (BMR), which equals sleeping metabolic rate (SMR) and arousal.


3. Exercise, or daily physical activity and spontaneous physical activity (SPA).

The vast majority (i.e. around 70 per cent) of daily energy expenditure (EE) in the average person is accounted for by RMR. Thermogenesis contributes about 15 per cent and daily physical activity is the most variable being around 10-25 per cent in sedentary individuals.

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This is one of the most serious, and potentially most dangerous surgical emergencies of childhood. It is most common between the ages of five and twelve months. It is not often seen and most family doctors will see only a small number of cases in their professional lifetime, unless dealing with large numbers of infants. In most cases no specific cause can be found.

The chief event is telescoping of one part of the bowel into the part of the bowel that follows on. It can only get worse, and the risk is that the blood supply to the telescoped part is impaired. If this happens, the bowel will die. It is essential that the bowel be disentangled as urgently as possible. Necrosis (death) of the affected part of bowel may take place within 12 to 36 hours.

Symptoms are usually clear cut. The child appears fit and healthy. Then there is a sudden onset of sharp recurring abdominal pain. It comes and goes. The child tends to perspire with the discomfort and draws the legs up in an attempt to gain relief from the pain. For the first two hours, the child seems all right in the pain-free intervals between the attacks. Vomiting may set in, but not necessarily. The condition tends to become progressively more severe with the passage of time.

A fever sets in. After five hours or more, the patient becomes dehydrated. The eyes tend to sink in. Often a sausage-shaped mass can be detected in the abdomen by the doctor, when carefully felt. If there is a bowel action, it may have a dark red coloration.

Treatment

With symptoms of this nature, urgent medical attention is essential. Never neglect abdominal pain occurring in a child. This is even more vital in a normally healthy child who suddenly complains. If associated with vomiting, a fever or abnormal bowel actions, the situation becomes more acute. Surgery is the usual method of treatment. When carried out early, the results are excellent. The longer the child is left, the higher the risk factor, and the chances of a prompt, successful outcome progressively lessen also.

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At birth, the brain has many inborn factors. But these are constantly being added to or altered by the input from the surrounding environment, via the various sense receptors. Emotions, and tensions and stresses from the environment—such as a family that is constantly feuding and fighting—are similarly transmitted to the subconscious where they are likewise stored. Bit by bit, an individual’s reaction to any situation will be governed by the combined program that the brain’s subconscious computer system holds. It cannot be any other way.

With advancing years, the system tends to attune to situations that are taking place in the surroundings, and learns how to cope with them. But as the input from emotional stresses, frustrations, fights, anxieties and tensions keeps recurring, the reaction often shoots off on an interesting tangent. Instead of passively receiving this material, accepting and storing it all, the mind may suddenly overflow. It’s a bit like a telephone switchboard. As long as the input of calls is normal and steady; the operator can readily cope with the situation, answering each and directing each caller to the number required. But as the board hots up and increasing numbers of lights start flashing, the operator reaches a stage where he simply cannot cope with the massive input. Finally, he might throw up his hands, and run from the board yelling, probably holding his head which by now has a thrashing pain searing through it.

Similarly, as the input to the brain steps up, a stage is easily reached where it cannot cope. Result? Symptoms suddenly loom in some part of the body. It may be a sudden outburst of temper, maybe the sudden development of pains, in the head, abdomen or limbs. It may be a sudden sharp bout of vomiting, or diarrhoea, or the onset of an attack of asthma. Or a young boy may start biting his fingernails, resort to food and overeat, start twitching his face, or have nightmares or night horrors. Blushing, fainting, refusal to eat, rushing headlong into obvious danger and sustaining an accident, are all part of the scene. Infants might develop colic, or hold their breath. The variation is enormous.

Some children will unconsciously channel their tension overflow regularly into the same region. Others get a knot in the stomach, others have sleep disorders. Often it is a recurring pattern for each individual.

Frequently, certain symptoms are related to certain age groups. A list is given at the end of this section setting out the better-known types of disturbance and the age range in which they are most likely to occur. It is not an exact list, and by no means a complete one, but it does give some idea of what parents might expect. They all have the same underlying cause: stress, tension and anxiety.

It is worth noting that children have an enormous capacity for absorbing data. In fact, it is claimed that during the first five years of life more data are absorbed and stored in the brain than during all succeeding years combined. After all, baby starts at zero, and apart from what is naturally programmed into the brain at birth everything else must be learnt; from walking, eating, and performing actions we put down as normal, to everything else.

But children are also frequently a mirror-image of their environment. In short, they tend to reflect what goes on about them, and this includes the actions of their parents. The way those around them behave becomes part of them, for all actions witnessed are also interpreted for storage in their memory system. Therefore, how they will subsequently react to situations is governed by the way in which their parents (and others with whom they have greatest, most intimate and most frequent contact) react. Therefore, infants bred in a family full of obvious stress and with obvious outbursts, will tend to react similarly. If everybody in the family tends to develop aches and pains at every setback, the young child will tend to have that type of personality also. Once established, these patterns will tend to persist throughout life.

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