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Interview with Emma-Leigh
Interview with Emma Leigh
by Jamie Hale

Recently I conducted an interview with Emma Leigh a soon to be star in the exercise and nutrition industry. She provided me with in-depth answers and I learned a great deal from speaking with her. She is very passionate about what she does and has a great deal of experience working with various populations. The interview was originally going to be one article but her answers were so precise and informative I turned the interview in to a two-part article.

Thanks for doing the interview and thanks for all the Scientific Research papers you have sent me.

Hey Jamie. You are welcome for the papers, and thank you for asking me about the interview. I will have to warn you now though - I tend to ‘waffle’ on a bit sometimes, so you’ll have to bear with me!

About how much time do you spend on a daily basis reading scientific papers?

Now this varies markedly. Some days? None - I am too busy with my job(s), training, general life and other things…. Or there is nothing particular of interest that I want to look at…. Where other days, especially if I am researching something in particular, I can spend a good few hours browsing pubmed or medline or trailing through the bazillion copies of things I have either in hard or soft copy. For this – It really helps that I get a LOT of automatic updates in my mailbox (TOC releases/automatic search functions such pubcrawler/ journal watch/biomed central) – if know what you are looking for and hey take a lot of the search work out.

What are your job duties at the Biochemistry and Nutrition Centre (Univ of Sydney)?

Don’t get me wrong – it wasn’t a ‘job’ by any stretch of the imagination. It was a clinical attachment/placement at the end of my Veterinary Degree (we had the opportunity to do a self initiated elective in an areas of interest).
But to answer the question – I did mainly ‘lab monkey’ work in two areas:
- I worked at the sugar clinics (where they test the GI of foods). And in this I was mostly a ‘pair of hands’. So I helped collect blood for insulin/glucose tests, as well as prepare ‘meals’ (and I use this term lightly – as a bowl of jelly/ jam is hardly a meal), and I also did a small research project looking into the role of insulin in fat loss (yes, it has a role it isn’t all evil)….

- The second was as a data collection assistant for a clinical trial being run by Prof Caterson at MOS (Metabolism and Obesity Service), Royal Prince Alfred Hospital. It was a trial looking into the use of a novel peptide to assist in weight loss and I was basically helping to collect, tabulate and calculate patient data/ results.

I understand the University of Sydney is where the Glycaemic Index clinics are based. What are your thoughts on the Glycaemic Index? What about the Glycaemic Load?

Hmmm…. Do you have a year?! I shall start by stealing a much the commonly used phrase: ‘It depends - as the usefulness of the GI/GL depends on the situation. Overall, as you will probably go on to read, one thing that I work hard in stressing for the people I work with - is that there are relatively few ‘absolutes’ in most areas of fitness, diet and health. What is right for a ‘dieter’ (those with purely aesthetic goals) is not necessarily correct for someone who wants a specific ‘health’ or medical benefits. And this is different once again for someone who has a very precise athletic goal or target.

The problem therefore with the GI is that, like many things in the world of health/ fitness, although it is a tool that has a role for some situations, it is often misunderstood, taken to extremes and used completely out of context!

If you really examine the readings, and you understand how the figure is calculated, you start to see there are many holes in it (when you consider that a snickers bar has a lower GI than watermelon, and could therefore be seen as ‘better’ you can see the limitations in its usefulness). But most people DON’T know the how/what and why of the scale. As a result - People immediately put ‘rules’ in place. They associate ‘high GI’ and ‘bad food’. In reality, ‘high GI’ foods are not ‘BAD’. They can, in fact, be very useful in certain instances but people just paint them with this ‘black or white’ mentality – and this is where you get into trouble.

Just on this note of trying to pigeonhole foods as ‘good’ and ‘bad’ – overall, I REALLY discourage most people from attaching emotive terms to food (‘cheat foods’, ‘good foods’, ‘bad foods’, ‘clean foods’ etc etc). When you take someone who is already prone to disordered thinking /eating patterns with food (as many in the fitness/ athletic industry are) – the last thing they need to do is attach guilt & self-hatred to situations where they feel they are eating ‘bad food’ or something considered ‘unclean’. All that happens is that they start to develop more self-restrictive eating patterns and spiral into an all out eating disorder….

ANYWAY – I digress…. And moving back to the GI…. To give readers a little more understanding of the figure à
As I discovered in the sugar clinics - The GI ranking (was at least initially) is calculated using starving Univ students volunteers as test subjects. It was done first thing in the morning (some point in time between 6am and 9am depending on when said Univ student can drag themselves out of bed), and done by having the person consumes an exact quantity of a single food type (to the 0.00g) which gave an exact quantity of carbohydrate (usually 25 or 50g). They then sit in a room for the next two hours to get their blood taken to measure the rise in blood GLUCOSE. There is NO mention of calories, fat, other forms of carbohydrate (e.g.: galactose/ fructose) or a myriad of other variables. They have to follow a set of ‘food rules’ about what they eat the night before. They can’t exercise in the morning. If their readings are ‘funny’ they are disregarded. If they have a history of certain diseases/ illness they are also not included. So – you can see it is a highly artificial situation.

Thee actual ‘GI’, in terms of ‘real world’ applicability, have little function. When is someone going to be in this situation where they eat one specific food at a level of exact carb content? To give an example - going back to my jam (or jelly to you Americans) - I remember weighing out 83.56g of a particular jam in order to feed to someone. Who in their right mind sits down to a bowl of jam?

For this reason - The Glycaemic load of the carbohydrate is *somewhat* better and more applicable. The GL refers to the ‘load’ of glucose a person will get when given a typical serving size. So, for my previously mentioned watermelon – although it has a GI of about 75 (so on 'GI' alone it would be a 'no-no') the water content is so high that for a regular serving size (~120g) you only get about 6g carbs and, as a result, the GL is very low (about 3-4) and you would have to eat pounds to get a significant rise in blood glucose. To use my Jam/jelly example - For 1 serve (15g) the average of most ‘fruit’ jams is about GI = 50/ GL = 3. Reason being, once again, that the serve of carbs you get is reasonably small.

While I think of it – many people might see the figure of ‘jam’ (a sugar) and wonder why it is only 50? Yes? Well – this is one common mistake people make. They assume all things high in sugar, processed foods, and ‘unclean foods’ are ‘high GI’. In reality - there are many ‘sugars’ that are low to moderate GI – fructose, lactose, even table sugar (with a GI of ~ 55). To give some examples – Corn, which most people will not touch due to the 'sugar', is assumed high GI. But is actually pretty low (GI ~50-54) and is ‘better’ than things people find acceptable like sweet potato (GI of ~70). They also have roughly the same GL (~ 17). It also has a reasonable amount of fibre, vitamin C, some of the B vitamins and some of the minerals as well... And it is actually not *high* in sugar either (100g of corn = 3g sugar where 100g of sweet potato has ~4g sugar). Another example is carrots (which will forever be tainted with a ‘bad name’ after their initial testing was incorrectly found to be in the 90’s (since corrected to being in the 40’s). But I often get asked ‘are carrots ok – they are high sugar/ high GI’…. Seriously - Even IF they were high GI…. In terms of ‘weight loss’ (for most people) it is NOT the carrots that are the problem!!

Back to fruit - So much confusion there!! e.g.: Banana… *gasp* is a fantastic fruit – packed with potassium and other micronutrients yet ‘dismissed’ by many because it is considered ‘high GI’ because of the ‘sugar’. In reality – the GI is *usually* moderate, about 55-60 (depending on the ripeness of the banana – the riper it is, the higher the GI becomes) – yet people assume it is HIGH. Just on a side note with this - Fruit in general has a lower GI due to the fructose in it. Those higher in fructose tend to be lower vs. those higher in glucose. Which is humorous when people avoid fruit because of the fructose, but say ‘when I do eat fruit I make sure it is the low GI ones’. I also shake my head when these same people use Agave Nectar to sweeten things thinking it is ‘clean’ (because it is low GI)… Little do they realize it is low GI because it is about 95% fructose!

Brown vs. white is another mistake. Be that in relation to bread, rice, pasta etc etc. And to use rice as an example – the immediate mistake is to correlate ‘brown’ with lower GI than ‘white’. A number of different things actually determine the GI of a grain/starch (e.g.: type of starch, cooking method, length of grain, fibre content etc etc). So brown rice (GI ranging from 50-87, average about 68) can be higher than some of the white high amylose rice available (e.g.: Basmati rice & Doongara rice which are something between 40-70 and average 54 and 57 respectively).

Another mistake many make is that they feel low GI immediately = low insulin. But, once again, this assumption is incorrect. Milk is a great example of this. Low GI, but extremely insulinogenic. Many proteins will also raise insulin – the famous example I often give is BCAA's. Highly insulinogenic (one of the reasons that milk is highly insulinogenic) yet people who are on ‘low glycaemic / ‘low carb’ diets (to decrease insulin levels) happily suck down scoopfuls of this over a given day or before ‘fasted cardio’ not even realizing it gives them a significant hit of calories, let alone causes a consistently elevated insulin level.

More issues with it?? What happens when you alter the situation of the meal? If you combine foods? Add extra protein or fats? Add acids? Alter the particle size? Over cook something? If you are not fasted? All of these things change the results. For example: The ‘second meal effect’ is a term that refers to the fact that a previously ingested low GI meal will decrease the insulin response to a following meal. Fruit eaten before a meal will also decrease the insulin response. Acid added to a meal lowers GI. Other foods in the digestive tract will decrease absorption rates and alter the rise and shape of the glucose curve and also the speed/duration of the insulin response (in general – a given load of said food will create a set insulin release for any given person – but the shape of the insulin curve, or the way in which it is released will change).

Same can be said if you change the PERSON…. And in that I basically mean that there will be marked individual variability in responses to foods/ carbs (dependent on many things such as insulin resistance, physiological status, stage in hormonal cycles for females, if a person is trained vs. untrained, what their normal diet is like). So in this it is important to realize that the lists are just ‘normal’s’. As mentioned - students get ‘kicked off’ tests if they have readings that are not ‘predictable’. So if you have any such ‘wackiness’ that will cause similar ‘not predictable’ responses even IF you got up to eat a single food of xg carbs first thing in the morning on an empty stomach then the traditional listing wouldn’t apply anyway…

*phew*

What does all this mean?? Basically – don’t take it too seriously. Don’t treat it as all or nothing. Don’t feel ‘bad’ for not eating ‘low GI foods’. Use it like all other ‘nutritional tools’ – educate yourself about the real applicability of it, and then use it if it is needed for you to achieve your goals. And to quickly discuss different situations and how I think it is useful?

For the ‘general public’ who simply want to ‘get leaner’ or ‘get healthier’ and have no real time/ want or need to get into the ‘details’ about nutrition then it *does* have many benefits. Firstly à It is easy to follow. It also follows that ‘first premise’ of dieting - it results in a lower energy intake. Why? Obviously – if you cut out half your food choices you cut out half your sources of calories And as most low GI/ Low GL foods are less ‘energy dense’ than higher GI foods this usually also helps to decrease energy intake (just on this point – lower GI foods are often also help control calorie availability in another way – and that is that they also have less net energy – with more lost/wasted through digestion/fermentation/metabolism etc. Is it a LOT? No. But it can help). Many are also usually higher on the satiety index (so they fill you up more). (Just on this note of satiety - The satiety index is something people should look into, especially if you have problems with constant hunger…. BUT just know that low GI doesn’t ALWAYS = higher satiety… To give an example: white potato, despite its high GI, has a marked satiety effect and it is ranked better than those oats (porridge) – so it will keep you full for a long period of time).
Secondly à You can (usually) correlate GI with the ‘healthier’ foods. Although I don’t agree with the ‘clean eating’ philosophy, ‘healthy’ foods (e.g.: whole grains, legumes, vegetables, fruits, seeds, nuts etc) ARE ‘nutrient dense’. They are higher in minerals, vitamins, phytonutrients/phytochemicals, other anti-oxidants and a bunch of things we are only just discovering. They also usually give you more fibre, healthy fats, and protein. And all these things give a person a better health effect. And lastly à for those general folks who do have some specific types of health concerns (e.g.: insulin resistance/diabetes/ metabolic syndrome, some autoimmune diseases, and even acne) then research suggests that these diets can offer additional benefits in controlling symptoms and reversing pathology (although results are mixed, and there are relatively few studies directly looking at ‘causality’… But there is certainly evidence to suggest these diets are ‘associated’ with improved outcomes… which probably relates back to my overall ‘healthy diet’ type thing too).

In terms of pure ‘weight loss’ / ‘aesthetic’ goals in those who are more complex with their diets - If people are willing to count calories, then the GI is probably ranked issue number 22349409234 on the list of ‘things to do to improve my outcomes’…. Once you talk about ‘getting shredded’ or if you start to get into cyclic diets that involve refeeds then it is more applicable / useful – but, once again, it isn’t going to be the ‘make it or break it’ issue and each person needs to take their own response to carbs into consideration (e.g.: individual insulin sensitivity etc etc).

And, lastly, for the ‘Athlete’ it can certainly be of benefit. For example – for peri-race/during race and post event nutrition. But, once again, it is going to be different for any given person based on their sport and them as an individual…

Ermm… I think I answered the question in there somewhere yes??

Tell the readers about your consultation business.

In a nut shell – it is my passion…. It initially started out in 2002-3 when I had gained a thirst for the area during, of all things, the nutrition component of Vet!! Initially I spent a few years reading/ researching/ experimenting (this is when I started my journal junkie habit)! From this I started ‘helping out’ a few people with training & diet but on graduating (and during my med degree) it turned into a fully-fledged business (2004-2005).

So - I work with people from all walks of life and all areas of the world. Athletes (e.g.: triathletes, marathon runners, endurance racers), body-builders and figure contestants, folk who may have special medical needs (e.g.: thyroid disease, auto-immune disease, Irritable bowel, cancer), those who simply want a challenge or to improve their fitness/ health (e.g.: weekend warriors, ‘mum’s and dad’s’, menopausal women) and I also work a lot with recovering eating disorder sufferers who are trying to get back to a state of metabolic/ mental and physical health. Lastly – I give talks/ lectures/ seminars in health/ wellness (at the moment it is primarily to small fitness groups/ community events but we are working on that).

As everyone has different goals (be they aesthetic, athletic, psychological needs or general Health / wellness) I do a number of things. Depending on the person I could cover nutrition/supplementation and set up cals/ macro’s / supplements protocols; I could write exercise/training programs… I might do counseling or help with mental strategies for psychological issues, or I could help a person tackle a particular medical or health concern (as a health practitioner I can also prescribe nutritional supplements or practitioner only high strength supplements).

With most people I work with, I take the stance that TRUE fitness & health is about more than just ‘physical’ things. It has mental/psychological, emotional, social and physiological aspects to it. What good is being cut if you are so socially isolated that you can’t enjoy a meal with friends? And what good is being physiologically ‘fit’ for an event only to break down MENTALLY on race day? I am also strong believer in ‘individualization’. And what I mean there is that what works for one person doesn’t necessarily work for another. So everything I do is tailored to a particular person’s life, body and goals. You wouldn’t train a 40 yr old female road cyclist like a sumo wrestler, and the same goes for bodybuilders and ‘weekend warriors’.

To give more info on different needs and to use the example of those who want to lose weight you have:
1. The simple stuff: For those ‘every day’ people who just want to shed a few pounds/ get healthy/ be fit. And for them I use the approach of simple, realistic, reliable and reproducible! YES I still cover all areas (e.g.: if they want a training plan we still cover cardio/ weights/ rehab/ prehab, and if they want ‘diet advice’ I still go through all the important areas of portions/ protein/ healthy things etc) but they are not going to need, nor want, anything more complicated than the basics
2. The nitty-gritty stuff: For the ‘I want to have striations in my butt cheeks’ types! And this is where the complexities matter a little more. So with these individuals get more detailed and manipulate cals/ macro’s/ supplements as well as workouts (timing/ intensity/ type) to get superior results. And then we continue to alter these, as the person gets leaner.

For the psychological aspect of things - I LOVE seeing the results of challenging people to ‘step out’ of what they know. Human beings, by our nature, are usually creatures of habit and comfort (and I use the word usually here because there are those who walk among us who, for some unknown reason, actually seek the complete opposite – and I have a few crazy clients who come to mind here)! But as a species we tend to like what is *known*, what is *stable* and what is *secure*. We like to know we are in control. Unfortunately…. I also feel that, for most people, this ‘comfort seeking’ often breeds stagnation. And fear of the unknown leads them to believe any number of weird and wonderful… But when we get too comfortable and ‘mindless’ in our beliefs, we recoil from anything that pushes otherwise. BUT change (mental/ physical) is often precipitated by moving beyond the comfort. As you are well aware - adaptation to training is an example. You need to challenge the body and make it ‘uncomfortable’/ ‘stressed’ to create a change – be it an improvement in strength, endurance, speed etc. Can you get results without ‘pushing into the uncomfortable’? To an extent, yes…. And do some people take it too far? Yes. And do some people need to do less? Yes again. But, for MOST, you get somewhat proportional results based on the effort placed into obtaining them. ‘If you only do, what you have already done, you’ll only get what you already have’. So if you want to create waves you have to make some changes in yourself, your way of doing things, and your patterns of thinking…. And this is something I work on a LOT > challenging thinking patterns which will, ultimately, help to change someone physically and mentally.

In terms of all round ‘health’ I want to act on two levels (again). In the individual (in a similar way to the above) to work on the body (and mind) at all different levels, but also more globally to redefine what we see as ‘medicine’ in modern society. Traditional doctor’s used to ‘keep people well’. They were paid to make sure everyone was healthy and ‘balanced’. Now? We doctors take a ‘fix it’ approach. Most don’t go to a doctor until they are sick, they don’t get meds until they are unwell, and they don’t act until it is too late! As a result we have one of the first generations who are likely to do of chronic disease before their parents! So if we are going to turn the tide we need to take complete shift in thinking – We need to reeducate at all levels to get people/ communities/ countries to become more proactive in ‘prevention’. And this means getting everyone ‘back to basics’. Better food, more exercise (both incidental and organized), more ‘green spaces’, more ‘community’ approaches. Essentially – we need to start to correct our ‘obesogenic environment’.

What are your job duties with the Diabetes and Obesity Group at the Garvan Institute of Medical Research?

Once again – not there currently. And once again, by no means was doing anything of anything of *real* significance. I was there for, once again, a placement as part of my degree (but this was with my second degree/ med degree). But it was a good introduction into clinical research into obesity and I got to meet and talk to a lot of very interesting researchers.

I was in the Clinical Research Unit and ‘attached’ to the research teams that used the area (mostly the Campbell team). It is a small purpose built facility run by nurses and clinicians set up to deal with patients enrolled in studies. So it is where participants get Resting Metabolic Rate tests (via Indirect Calorimetry), Muscle and fat biopsies (performed under sterile surgical conditions), Body composition Analysis (Bioelectrical Impedance Analysis), Insulin Clamp Studies (IV Glucose Tolerance Tests), hormone tests (OGTTs, IV Insulin Tolerance Tests, GH and Cortisol stimulation tests), and a variety of other weird and wonderful (Heart Rate Variability Measurements, Neuronanometry and Indirect Vascular Resistance Studies to name a few). The main studies there at that time were:
THE EXCESS STUDY with Heilbronn and Campbell [HERE]. Which was a study designed to investigate the effects of excess energy intake (specifically, dietary fats) on metabolic health. The aim was to determine whether overweight, lean and relatives of Type Two Diabetics differed in their responses to over-nutrition and weight gain, and to establish possible markers to distinguish those at risk of insulin resistance, for future therapeutic interventions. Basically I was a ‘hands on’ type of a helper – doing metabolic cart metabolic tests, bodyfat analysis, blood collection, biopsies, and a little lab work for gene extractions.

An IMMUNE RESPONSES TO MACRONUTRIENTS STUDY with Viardot - Which was a study addressing the alterations in immune cells and inflammatory markers seen in response to meals of different macronutrient combinations (and how this may be different in healthy individuals or those with a family history of type 2 Diabetes). Once again I was ‘hands girl’ - helping with calorimetry, blood drawing/ cannulation, aloquoting of serum and plasma samples, pulse wave analysis measurements, heart rate variability measurements, biopsies, meal preparation…..

There was also an interesting study being conducted on GUT DERIVED HORMONES, BODY COMPOSITION AND METABOLISM IN PRADER-WILLI SYNDROME - Sze and Viardot [HERE]. As you are probably aware (but to give more info to the other readers) - Prader-Willi syndrome is a genetic disorder that results in hypothalamic dysregulation. Among other things, it causes a marked increase in appetite (insatiable). And as a result, these people are obviously of interest to those who are looking into the control of appetite - so the aim of this study was to assess the effects of a novel drug (Exanatide) on satiety.

Lastly, I also perform my own ‘mini study’ which was a Cross validation experiment using volunteers to calculate a conversion equation for the two different metabolic carts used at the facility.

Be sure to tune in next week for Part two.

Max Condition

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