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Dr. John Leddy talks about sports nutrition in Buffalo News


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*Article from a Buffalo News article written by Greg Connors, Buffalo News Sports Reporter 7/13/2003 STEADY DIET – ENDURANCE ATHLETES…
March 13, 2007

*Article from a Buffalo News article written by Greg Connors, Buffalo News Sports Reporter 7/13/2003


“Good carbohydrates are complex, unrefined carbohydrates like multigrain bread, real oatmeal…fruit, vegetables, even pasta’s not bad compared to things like bread and potatoes.” Dr. John Leddy, associate director of UB’s Sports Medicine Institute.

The best-seller lists are filled with diet plans that promise to teach us how to combine foods or time our meals, to almost fool our bodies into losing weight: Barry Sears leads us into “the Zone;” the late Dr. Robert Atkins took away our bread and pasta; we’ve had our sugar busted and our tummies “Somersized.”

When you talk to endurance athletes, however – people who need their bodies to be at their best – you’ll find few takers for these seemingly magical formulas. Whether you are a marathon runner, an Olympic cyclist or a weekend softball player, adhering to nutrition fundamentals – with a little tweaking made possible by scientific research – is still the best bet.

While there is debate over what percentage of an athlete’s diet should be devoted to carbohydrates, carbohydrates are not the enemy of healthful nutrition, despite what some best-selling diet books claim.

Few athletes would indulge in the high-fat type of diet advocated by Atkins, but many, if not most runners would benefit from a modest increase in the amount of fat they eat.

An athlete’s baseline diet – what he or she consumes over the long term – is more important than short-term adjustments, such as carbo-loading before a race or pounding an energy bar during competition.

George Carlin has a comedy routine about the slogans on license plates issued in various states. New Hampshire’s tags say “Live free or die.” Idaho’s plates say simply “Famous potatoes.”

“Hmm,” Carlin muses, “live free or die…famous potatoes. I suspect the truth lies somewhere in between.”

That’s a pretty good description of where the truth is found concerning carbohydrates – “in between.” When Nancy Clark, a nationally known sports nutritionist, author and columnist who works in Boston, wrote a column last year criticizing the carbohydrate-bashing diet doctors, some of her readers were all over her like white on rice.

“Dr. Atkins’ fans turned out in force to bash carbohydrates and praise protein,” she wrote.

Clark disagrees with Atkins’ premise that fat doesn’t make a person fat, carbohydrates do.

“Some athletes eat too few carbohydrates because they believe them to be fattening,” Clark writes in her best-selling “Sports Nutrition Guidebook.”

“The inaccurate advice from diet gurus of years past still lingers among dieters who fear bread as being fattening. Carbohydrates are not fattening! Excess fats are fattening – butter on bread, oil on pasta, mayonnaise in sandwiches, cheese on crackers….The conversion of excess carbohydrates into body fat is limited because you burn the carbs when you exercise.”

On the other hand, many experts do agree with the premise of the late Dr. Atkins (who died this past winter after slipping on ice and hitting his head) that in the last 20 years or so, many Americans, in their belief that fat is bad and carbohydrates are good, overreacted by gorging themselves on what are called simple carbohydrates.

Simple carbohydrates, found in foods such as sugar, rice, potatoes and white bread, are absorbed very quickly into the bloodstream, which triggers a rapid release of insulin. This causes a roller-coaster effect on one’s blood sugar, which can feel like a sudden surge in energy followed several minutes later by the urge to take to one’s recliner and see what’s on The History Channel – or what’s in the refrigerator.

This effect in foods is measured by the Glycemic Index. White rice, for example, has a higher Glycemic Index number than table sugar. That means, at the risk of oversimplifying, that a diabetic – for whom blood-sugar control is critical – might have more to worry about from a bowl of Uncle Ben’s than from a Baby Ruth.


Dr. John Leddy is associate director of the University at Buffalo’s Sports Medicine Institute. He also gives presentations on nutrition issues in the institute’s annual Runners’ Medical Forum, where he educates runners about eating “good” carbohydrates, among other things.

“The good carbohydrates are these complex, unrefined carbohydrates like multigrain bread, real oatmeal – not the instant stuff – fruit, vegetables, even pasta’s not bad compared with things like bread and potatoes,” Leddy said during an interview in his office on UB’s South Campus.

“Those foods are high in fiber and complex carbohydrates and those foods are absorbed more slowly over time so you don’t get the rapidly rising insulin levels in your blood after a meal.”

The Atkins diet program, based on eliminating nearly all carbohydrates other than vegetables and eating lots of high-fat, high-protein foods, reached its highest peaks of popularity in the past year.

Critics, such as Leddy, find the Atkins approach to be an over-reaction. A high-fat diet is risky for athletes or anyone else trying to control their weight, Leddy said, because it means consuming a large amount of calories.

“If you consume too many calories as fat, you will gain weight,” he said. “If you consume too many calories as carbohydrate, you’ll still gain the same amount of weight. It doesn’t matter where the calories are coming from, the problem is you’re out of balance, your intake exceeds your expenditure.”


Lauren Lorek of Cheektowaga is living proof that bringing one’s life into caloric balance – through exercise and smart eating choices – can produce dramatic results.

Lorek, now 32, decided in her late 20s that she had spent too many years being overweight.

“One day I was watching Oprah and she had on a lady who was determined to lose 41 pounds by her 41st birthday,” Lorek said. “I was 28 and figured I could lose 29 pounds by the time I was 29.”

Lorek began by exercising to “tae bo” tapes in her home. Then a friend helped her get started in running. Since then, Lorek figures she has lost 107 pounds.

“I love when people ask me how I did it,” she said. “It was all through diet and exercise – no diet pills or protein formulas.”

Lorek runs 25 to 35 miles per week. She doesn’t consider herself an elite runner, but she has completed one marathon, last year’s Valley of the Sun Marathon in Mesa, Ariz.

“I belong to Checker’s (Athletic Club), and I do some of their speed workouts; I take them off the Internet, but I usually do them on my own,” Lorek said.

Lorek, who works as a chef in a Wegmans’ store, said she follows a strict low-fat diet. She always packs a lunch to bring to work. She leaves cases of bottled water in her car to remind herself to drink enough.

Lorek has no interest in the high-protein fads – “those diets scare me,” she said. She also focuses on eating good-quality carbohydrates and staying away from the bad ones.

“I love my simple sugars, like anybody else,” she said. “Those are my downfalls if I don’t avoid them.”


Just as there are good carbohydrates, there also are useful fats, Leddy points out.

“…The liquid fats, the oils, the vegetable fats like olives, avocados, nuts, the fats in fish, even the fat in lean meats is fine,” he said.

“All this fat is good and will help you – if you are a training athlete with a high caloric expenditure – to maintain your caloric intake and would not be detrimental to your cholesterol.”

Leddy added that consuming these types of fats is more beneficial than eating a high-carbohydrate diet, which has been shown in studies to decrease a person’s level of HDL – or “good cholesterol” – and increase the level of triglycerides, which is linked to clogging of the arteries.

Most people, athletes or not, can afford to add some fat into their diets as long as they choose the “good” fats and don’t take in more calories than they are expending. That can actually improve their “lipid profile,” Leddy said, meaning the risk factors in their blood that are associated with heart disease and stroke.

Runners have even more to gain from adding some good fats to their diets, according to Leddy. In his suggested plan for men and women who run at least 30 miles per week, Leddy advises a diet of 50 percent carbohydrates (high-fiber, low-Glycemic Index), 15 percent protein (nuts, legumes, soy, poultry, fish and lean meat), and 35 percent “good” fat.

The diet still must contain a sufficient amount of complex carbohydrates to maintain muscle glycogen stores, Leddy said. Glycogen is a key fuel that the body makes from carbohydrates.

Clark, the sports nutrition author, advises most athletes to eat at least 60 percent carbohydrates, or 65 to 75 percent before an endurance event. She recommends 15 percent protein and 25 percent fat.

“I disagree with (Clark) on this,” Leddy said. “If a runner is maintaining (caloric) intake equal to expenditure, they can consume higher-fat diets with no problems on their blood lipid or cholesterol numbers.

“Also, once you get to be a well-trained runner you use fat as an energy source in your muscles much better than someone who’s not trained. It would actually become a fuel that helps you to spare your muscle glycogen, so you use up your muscle glycogen much less rapidly. Trained runners adapt to higher fat in their diet.”


Leddy, who is 43 and lean from running 5-10 miles a week, doesn’t have any personal fondness for dietary fat. His recommendations are based on medical studies on the subject, including a major one in which Leddy participated in the mid-1990s at UB.

In one report on the study, published in the journal “Medicine and Science in Sports and Exercise”, researchers measured the effects of high- and low-fat diets on a group of male and female runners from Western New York who trained at least 35 miles per week. The six men and six women who were put on a 42 percent fat diet showed no adverse affects in their cardiovascular health risk factors. The subjects who were restricted to 16 percent fat in their diets had less desirable cholesterol levels than those eating higher fat.

Another component of the study was athletic performance. Testing found that runners who increased their fat intake to 30 to 42 percent of their calories, so long as their calorie consumption kept up with their expenditure, improved their endurance performance at a high percentage of their V02 max – a popular test of aerobic performance.

Also, a study just recently completed at UB showed that female runners consuming less than 30 percent of their daily calories as fat had a significantly greater rate of “overuse” injury over one year than those female runners who consumed more than 30 percent of daily calories as dietary fat.

“…Women runners in particular…tend not to take in enough calories for their training,” Leddy said. “This can lead to inadequate training. They don’t have enough fuel to train right, and also they don’t take in enough nutrients.”


Leddy stressed that for all athletes, eating a healthful diet over the long term is more important than what is eaten on any given day.

Learning that lesson is part of the education of a cyclist, who competes in a sport in which carbo-loading, nutrition bars and a gel named “goo” are part of the ritual.

“Power Bars were originally developed for cyclists riding in the Tour De France,” said 36-year-old Alan Cote of East Aurora, who has been a competitive cyclist for 21 years.

“That whole category of products (including sports nutrition bars and gels) sprouted from the needs of cyclists.”

Bicycle racers at the elite level often face what seems like a nice problem to have – they fret about how to consume enough calories.

“At the real extremes of the sport, like the Tour de France, those riders are burning 5,000 to 6,000 calories a day. It’s at that level when you’re worried about keeping enough food in you,” said Cote, who makes a living writing about cycling for Bicycling and Outside magazines, among others.

Kate Farrell-Gray is a friend of Cote and, like him, is a “category 2” cyclist, the second-highest ranking in the sport. Farrell-Gray, 26, rode for a professional team for two years and progressed all the way to the Olympic trials in 2000. Last year she cut back on her racing schedule (“It was kind of a rest year”), yet she made only slight changes to her diet when not training heavily.

“I found that I ate less synthetic food (such as gels or nutrition bars) when I wasn’t racing,” said Farrell-Gray, who teaches physics at Amherst High School. “But good nutrition has always been important to me, that never changes.”

Farrell-Gray most feels the effect of her diet during a multiday (stage race), such as the format used in the Tour de France.

“Alan (Cote) and I have a favorite saying you feel like tissue paper in a blast furnace (in a multiday race),” she said. “When you are racing three, four or five consecutive days you can’t eat enough.

“It is very important that it be nutritious foods, not empty calories. You need good carbohydrates, enough protein and not a lot of fat.”