Hormonal Balance The Impact of Diet and Exercise

1. Hormonal BalanceThe Impact of Diet and Exercise Robyn W. Jacobs, MD 24 January 2007

2. The What, Why and How of Hormones

3. What are Hormones? • Hormones are Chemical Messengers • They direct the biochemical reactions which happen inside of our body (our metabolism) • These reactions can be Building • i.e. making enzymes, building muscle, repairing DNA • Or Using • Breaking down fat, protein and carbohydrate stores for energy

4. What are Hormones? • Chemical Messengers • Our hormones translate our environment into chemical messages which tell our bodies whether they should be in “building mode” or “using mode” • We spend most of our waking hours in “using mode” • “Building mode” generally feels uncomfortable

5. Why are Hormones Important? • Our hormones allow us to move between using and building modes • We can’t keep our metabolism constant because our environment is always changing • Sometimes its hot, sometimes its cold • Sometimes food is plentiful, sometimes its scarce • Sometimes we are under stress, sometimes we are not • Without hormonal balance we lose the ability to adapt to our environment

6. How do our hormones regulate our metabolism? • Hormones work by a variety of mechanisms • Direct the creation/destruction of certain enzymes • Control the rate of action of enzymes • Control the ratio of activity of enzymes • i.e. which direction the enzyme moves our energy

7. How do our Hormones control our Metabolism? • Many hormones throughout our body interact with one another to send messages to our cells • The ratio of one hormone to another plays a role in cellular function • The amount of one hormone can up or down regulate the amount of another hormone

8. The Major Hormones • Major Hormones are those which are immediately necessary for life • We would not be able to survive if any one of these hormones was missing. • INSULIN – Building, Our “digesting” hormone • ADRENALINE – Using, Our “saber tooth tiger hormone” • CORTISOL – Mostly using (builds fat), Our “chronic stress” hormone.

9. The Minor Hormones • These hormones are not immediately essential for life but work to help keep the metabolism balanced for our health • Examples • Human Growth Hormone, Estradiol, Testosterone, DHEAS, Thyroid Hormone

10. Because our hormones keep us responsive to our environment,our hormonal balance changes based upon our environment. Therefore, we can utilize our environment to control our hormonal balance and subsequently our health.Diet and Exercise are two environmental inputs which significantly effect our hormonal balance.

11. The Dual Role of Food • Building Blocks/ Nutrients • Chemical messengers

12. Food as Building Blocks • Macronutrients • CHO – immediate energy, only energy source for the brain • Proteins – lean body mass, enzymes, energy • Fats – cell membrane, steroid hormones, energy, nerve conduction

13. Food as Building Blocks • Micronutrients • Vitamins – important in generation of energy and production of enzymes • Minerals – necessary for many enzymes and carrier proteins to function properly • Phytochemicals – compounds which interact with our hormonal receptors

14. Food as Chemical Messengers • Total and relative amount of macronutrients signals body as to availability and quality of food in our environment. • Macronutrient balance has significant effect on INSULIN • Total and relative amount of micronutrients determines which enzymes are functioning optimally and which are not • Lack of adequate micronutrients prevents body from going into “building” mode or impairs efficiency of “building” mode.

15. How we eat effects our metabolism • Consuming food too low in CHO robs our body of energy and forces us into a “using” mode even when we are trying to “build” • This is the premise of ultra-low carbohydrate diets which do cause weight loss but cause loss of lean body mass as well as fat mass. INSULIN is necessary to build muscle.

16. How we eat affects our metabolism • Consuming food to which we are sensitive causes inflammation in the GI tract and stimulates ADRENALINE release • Consuming foods high in refined CHO causes sudden steep rises in INSULIN • Chronic fluctuations in INSULIN or repeatedly elevated ADRENALINE lead to excess CORTISOL production

17. The Hormonally Balanced Diet • Frequent Small Meals • Ideally 3 meals and 2 snacks each day • Each meal/snack should have CHO and Protein in an approximately 2:1 ratio • Each meal/snack should have healthy fat • Each meal/snack should have a non-starchy vegetable • One ounce of pure water for each Kg of Body Weight (dehydration increases stress hormones)

18. When we eat correctly • We use carbohydrates for brain fuel • We use protein to build hormones, neurotransmitters and enzymes • We use fat to build hormones, cellular structures and nerve sheaths • We rebuild and restore (“building” side of metabolism) the biochemicals which were utilized (“using” side of metabolism) during the day.

19. Additional Tips • Avoid food allergens to minimize adrenaline spikes and inflammation. • Chew food thoroughly to prevent partially digested food particles from causing irritation to the GI tract and to maximize nutrient delivery. • SIT while you eat – eating is a “building” phase activity. We confuse our metabolism when we try to “use” and “build” simultaneously.

20. Additional Tips • Never skip a meal – metabolism becomes unbalanced if we fail to nourish ourselves adequately. • Avoid artificial sweeteners and preservatives – our body wasn’t designed to break these down efficiently • Eat “organic” or “natural” as much as possible • Avoid processed foods • Shop the periphery of the food store

21. Hormonally Balanced Exercise

22. Exercise • What is exercise • The American Heritage Dictionary, 1985 • 1. An act of employing or putting in to play; use • 3. Activity that requires physical or mental exertion, esp. when performed to develop or maintain fitness • Exercise = using our bodies • What side of our metabolism are we on here?

23. Three General Categories of Exercise • Aerobic/Endurance/Cardiovascular • Strength • Flexibility * See Table

24. Potential Benefits of Aerobic Exercise • Decreases risk of all-cause mortality by 30% • Improves Cardiovascular Function • Improves Endocrine Function • Improves Immune Function • Reduces Stress • Improves Sleep • Reduces risk of colon, breast and prostate cancers

25. Potential Benefits of Resistance Exercise • Builds more lean body mass • Improves metabolic rate • Aids in weight loss • Decreases risk of falls and injuries • Improves balance

26. Potential Benefits of Stretching Exercises • Helps to Maintain Range of Motion • Helps to Maintain Strength • Lowers Adrenaline

27. Impact of Exercise on Hormonal Balance A focus on the Major Hormones: Insulin Adrenaline Cortisol

28. Impact of Exercise on Insulin • Light to moderate exercise • Insulin levels unaffected • Prolonged (>40 minutes) or intense exercise • Insulin levels decline • Does not impact blood sugar levels in the short term due to alteration in counter-regulatory hormones

29. Impact of Exercise on Insulin • Training leads to decreased basal insulin levels • Training leads to increased sensitivity to insulin – increasing V02 by 15-20% can increase insulin sensitivity by 20-30% • Increased tissue binding of insulin • Rapidly reversed when exercise is stopped even for a few days • Not modified by acute exercise • May not be seen in obese men with high triglycerides and insulin resistance

30. Impact of Exercise on Adrenaline • Adrenaline increases with the onset of exercise and (with noradrenaline) is responsible for: • Increase in heart rate (E) • Redistribution of blood flow (NE) • Glycogenolysis/lipolysis (breaking down fat and glycogen for energy) (E)

31. Impact of Exercise on Adrenaline • Mild Exercise • Little or no Adrenaline response • Moderate Exercise • Signficant noradrenaline response (hemodynamics) • Minimal adrenaline response • Intense or prolonged exercise • Adrenaline increases significantly

32. Impact of Exercise on Adrenaline • Exercise induced changes in adrenaline levels persist for 24 hours • After the anaerobic threshold is reached adrenaline increases out of proportion to additional work load

33. Impact of Exercise on Cortisol • Low intensity exercise (<50% VO2 max) decreases Cortisol levels • Prolonged or high intensity exercise increases Cortisol • Ultra endurance exercises abolish the normal circadian rhythm of Cortisol • Cortisol can increase in ANTICIPATION of exercise

34. Impact of Exercise on Cortisol • For Women, Cortisol changes which occur during training will persist for some time after training stops (ie post season for seasonal athletes) • For Men, changes in Cortisol response to regular exercise return to baseline at the completion of the training season. • Training blunts the Cortisol response to exercise

35. Why are you working out? • Exercise – fitness, health, well being • Training – competition, goal oriented

36. Training • When we train we are choosing to stress (use) our bodies in order to reach a goal. This is OK but we must be sensitive to our bodies need to rebuild. Impeccable attention to diet and sleep/stress management is essential in order to keep our metabolism balanced while training.

37. Exercise • Exercising for fitness, health and well-being is important for all of us. In order to reap the benefits, without allowing our exercise to become an additional stressor we must remain cognizant of how exercise impacts our metabolism. Focus should be on low intensity exercise most of the time with moderate intensity exercise a few times a week. There is really NO ROLE for high intensity exercise in a wellness oriented routine.

38. Summary • Our Hormones are critical to our health and well-being • Hormonal Balance allows us to remain responsive to our environment • We can control our environment to maximize our hormonal balance and therefore our physiologic flexibility

39. Eat well, sleep peacefully, play joyfully