Creatine? Protein Shakes? High-calorie diet? Need to gain weight

[storm]

Hi Everyone. Not sure if it's ok that I'm the wife of a Crohn's patient. My husband, J, is 6'3" and 145lbs. He's had Crohn's since he was 9years old and he's now in his mid-30's. We've been married almost 10 years and I've really tried to be involved with his health. When we first met, he was maybe 140lbs; in the past 10 years, he's been less than that and has maxed out at 150. Since I'm the main cook (actually only cook!) in the house, I would like some suggestions for high-calorie foods. We're a high-protein household as it is but have been told different things with regards to red-meat, high-fat foods, etc.

Currently he drinks Boost with Extra Calories but sometimes he'll get an upset stomach also. When I read the ingred. on the back, the first 4 ingredients is all sugar? His previous specialist (who was very pro-supplement/proper diet, etc.) told him to avoid high sugar (he had documented research which I can't remember all the details for right now).

Also, a few people have suggested weight-lifting and taking Creatine but we have no clue what? From what I understand, a lot of them just have a lot of filler that causes bloating so any recommendations would be great. Also, what's the difference between creatine and creatine monohydrate?

J has tried one type of protein shake in the past (can't remember which brand) and has had upset stomach with them. Are there ones that don't cause bloating?

Now for the weight-lifting part...NO CLUE! J has always had a hard time having enough energy or stamina to do a lot of exercising. We bike and swim for health but I think that would burn calories more than anything right? Any recommendations for a beginner weight-lifting program? How often, etc. We have 3 very young kids and he works full-time so going to a gym regularly is tough, but doing weights at home seems like a good start?

Any suggestions would be so appreciated.

P.S. Just in case it matters, this is what his diet is right now:
Breakfast:
2 eggs & white bagel and pomegranate juice
Snack:
Boost with Extra Calories
Banana or fruit sauce
Lunch:
Leftovers--always has meat with white rice/potatoes and cooked vegetables
Snack:
Energy bar (ie. Cliff's, etc.)
Supper:
Meat with rice/potatoes/noodles, etc. and cooked vegetables


He doesn't tolerate milk well--if it's cooked in food, it's ok but straight milk or yoghurt always gives him upset stomach.

 

[kiny]

food:

If he's just starting out I wouldn't take creatine, someone staring with weight lifting is going to put on muscle no matter what (unless they don't eat enough), if he wants to take something I wold suggest glutamine instead. (creatine helps in the gym, glutamine outside the gym, creatine will help you lift slightly more, especially if you load it, glutamine will help recovery)

But really if you just begin the most important thing is simply eating enough. To gain muscle he needs to eat and be in remission, the best foods would be poultry like chicken breasts, protein snacks etc Chicken breast is pure muscle, you get everything you need from that to build up your own mucsle. Like you mentioned in the title, high calorie. High calorie doesn't mean eat unhealthy really, if you eat enough meat (can avoid red if he wants), enough healthy snacks, enough fruit between meals, a tablespoon of olive oil, some nuts here and there, you are easily at 3000+ Kcal a day.

weights:

I would use free weights and what they call "compound" exercises, all he needs is a bech for that and maybe a pull up bar for his lats. Compound is good for mass and weight building (because it hits multiple stabilizer muscles to keep the free weights in balance), unlike isolation which tends to hit just one muscle. Dumbell are the best for compound, unlike machines, machines = isolation, which usually doesn't involved stabilizers. Machines are good if someone gets injured, other than that dumbells are way way way better for putting on weight. Can't stress enough how much compound is better than isolation to put on weight.

You are right about the calorie burning, he wants to do low rep low set exercises and build in rest days, without rest or enough food you get muscle breakdown.

Do not hit the same muscle group every day, he need to divide up his muscle groups. Monday do chest, tuesday shoulders, wednesday rest, thursday back, friday rest, saturday legs, sunday rest. Something like that. He also shouldn't spend more than 30 minutes a day exercising, putting on muscle is not the same as losing fat, you need to preserve your energy wisely (don't start jogging + aerobic + weight lifting, ... you'll end up losing weight super fast). His last rep should be the failure rep, that means the last rep is the rep right before his next one will be failure, this requires weights that are heavy enough, you won't put on weights by using aerobic weights, he needs dumbells with exchangeable weights so he can change them out on a need basis.


Here are some good and safe compound with dumbell for him to start with (do these exercises controlled, do not throw the weights around and don't abuse momentum, time under tension is important)

bent over row (you can do bent over flys too to hit the upper back, but I hate them since they put much more strain on the shoulder):

military press (you can do these standing, I much prefer doing them standing)

shrugs (for his trapezius, you can do individual neck exercises too if you want)

hammer curl (this will hit both his biceps and his forearm unlike bicep curls which tend to only hit the biceps)

bench press (he can do flys too for his chest)

push ups

lunges

squats (don't overdo the weight on these and do them correctly, he doesn't want to end up hurting his back)

If you start with those you will hit major muscle groups and he'll be safe, build up some strength, and all you need is a small bench and some dumbells. To hit more muscles I would get a chin up bar (or use a gym) to hit the latissimus on the back, and incorporate some hamstring exercises and maybe use a hip machine in the gym if needed, calves have so many exercises I can't name them all. If he wants bigger forearms he can also do wrist curls to hit the flexors of the forearms and wrist extension to his the extensors, he will hit the brachioradialis (big forearm muscle) with the hammer curls mentioned above)


If he can do them safely you can get a bar to do deadlifts and T-bar rows, those are the best compound exercises you can do, but if you don't know how to do them safely you will end up killing your lower back, dumbells are (imo) a bit safer. I do them sometimes, but I try not to overdo them, as even doing them correctly puts a lot of strain on the lower back even with a belt.

The most important things is that he is comfortable in what he does, he should not be overly tired, his muscles might hurt a bit in the morning and that's fine, but he should be comfortable and happy with what he does. If he doesn't like the gym then don't use the gym, if he doesn't like using a bar, then don't use a bar, if he wants to use some music then use a small MP3 player or something, if 30 minutes is too much then do 20. The happier he is doing it the more chance he won't give up.

 

[storm]

Wow!! This is wonderful--the pictures are exactly what we need since we know nothing about weights. What would you recommend for glutamine and dose? J eats over 3000cal a day for sure. We probably could up the chicken meat--we eat a lot of beef (his preference!). Do you have any suggestions for snacks that are high-cal? I've been experimenting with homemade granola bars that aren't so high in sugar, he also eats Cliff energy bars, bananas. All other snacks in my baking repetoire are probably unhealthy (ie. cookies, etc.)

Really really appreciate you taking the time to answer my questions.

 

[kiny]

For glutamine, it should be taken on the days he works out (if he takes a break for a week or something, then don't take glutamine). After his workout 1000mg to 2000mg of glutamine should be fine. Like I said though, if he's able to put on weight without the glutamine, then don't use the glutamine, if he's a beginner weight liften and he eats right and does low rep and heavy weight, he will put on weight after a few weeks (even protein restrictured people put on weight, simply because they're beginners). Once you hti a certain plateau, it's harder to put on weight, but the beginning should be easy.

If after a month he still put on no weight, then ask what you're doing wrong, is he eating enough, is he getting enough rest, then you might consider creatine, but glutamine is both safer and I feel recovery is more important, especially for people with crohn, if he does fine without, then just make sure he eats enough.

 

[EthanPSU]

Hey storm, i am in the process of gaining weight and working out everyday as well...Here is a post I posted in another thead on the same subject that might help....

This is what I use and it has been great for my stomach...

http://www.amazon.com/Optimum-Nutrit...&keywords=whey

A little pricey I know, but it will last almost 3-6 months. And you mix it with milk and it tastes great.


I am currently in your boat, trying to gain mass and weight training. I have currently gained 12lbs the past month and a half just bulk eating and putting on mass. I have just recently started weight training. I have however did about 2 years of weight training in high school so have some experience.

What I do to gain muscles and not tone is to do High weight but Low Reps. Here is my current weight training guide...

Push Ups 12 Reps / 3 Sets
One-Arm Dumb Bell Rolls 6-8 Reps / 3 Sets
Standing Shoulder Press 6-8 Reps / 3 Sets
Dumb Bell Curls 6-8 Reps / 3 Sets
Triceps Extension 6-8 Reps / 3 Sets
Trap Raises 15 Reps / 3 Sets
Dumb Bell Bench Press 6-8 Reps / 3 Sets
Crunch w/ Feet Up 30 Reps / 3 Sets
Reverse Raised Crunch 30 Reps / 3 Sets

Here is a video that explains most of these exercises...
http://www.youtube.com/watch?v=mgEd_jqkg0M

I currently only use free weights (Dumb Bells) no machines, I find it better because your muscle can fluently move naturally. Also find a high weight that you can do 6-8 reps and stick with that for about a week or so till you think you can move up like 2.5lbs.

For my current diet during weight training, I just mainly eat meats and try to eat high calories. I also use this website to track my meals for the day and to make sure I'm getting the amount I need....
http://www.myfitnesspal.com/

Remember, I am a beginner too so I am just recommending some stuff that is currently helping me, it may not be all correct lol.

 

[hugh]

If you are not digesting and absorbing what you eat you will not gain weight

i found that it didn't matter how much i ate, i kept loosing weight
(5 meals a day plus snacks)
It wasn't till i cut out most of the 'foods' i was eating and went paleo that i gained weight

I would suggest lots more saturated fats, grass feed meat, green vegetables and NO grains especially gluten grains and NO sugar and avoid 'white carbs'.
Stay away from all processed vegetable oils and processed foods
White rice may be OK if you think he needs more Carbs (i eat rice about once a week)

Ensure and Boost and all those crap sugar drinks are keeping him unwell.

 

[EthanPSU]

If you are not digesting and absorbing what you eat you will not gain weight

i found that it didn't matter how much i ate, i kept loosing weight
(5 meals a day plus snacks)
It wasn't till i cut out most of the 'foods' i was eating and went paleo that i gained weight

I would suggest lots more saturated fats, grass feed meat, green vegetables and NO grains especially gluten grains and NO sugar and avoid 'white carbs'.
Stay away from all processed vegetable oils and processed foods
White rice may be OK if you think he needs more Carbs (i eat rice about once a week)

Ensure and Boost and all those crap sugar drinks are keeping him unwell.

Just remember it different from person to person. I eat a ton of grains and my body handles it perfect. Its a main part of my diet

 

[storm]

If you are not digesting and absorbing what you eat you will not gain weight

i found that it didn't matter how much i ate, i kept loosing weight
(5 meals a day plus snacks)
It wasn't till i cut out most of the 'foods' i was eating and went paleo that i gained weight

I would suggest lots more saturated fats, grass feed meat, green vegetables and NO grains especially gluten grains and NO sugar and avoid 'white carbs'.
Stay away from all processed vegetable oils and processed foods
White rice may be OK if you think he needs more Carbs (i eat rice about once a week)

Ensure and Boost and all those crap sugar drinks are keeping him unwell.

Thanks for sharing your thoughts--however, J has been on a gluten-free diet in the past which did nothing for him. He already eats at least 2 eggs a day, cook with saturated oils and eat organic, grass-fed beef. As for green vegetables & avoiding white carbs, green vegs are the hardest on him--during one of his colonoscopies, the doctor found residue of the shell of peas all throughout his intestines, even though he flushed for 2 days prior. We pretty much have to cook all vegetables otherwise he's in trouble--but with the cooking, you lose a lot of nutrients too! Whole grains (high fibre breads) also give him grief--too much fibre I guess??? His one specialist told him to cut down on the sugar, which Ensure & Boost have TONS of--which got me to look for other snack/drinks that could give him more calories or help with weight gain. I'm unsure about white versus brown rice...
Thanks for sharing!

 

[storm]

Hey storm, i am in the process of gaining weight and working out everyday as well...Here is a post I posted in another thead on the same subject that might help....

This is what I use and it has been great for my stomach...

http://www.amazon.com/Optimum-Nutrit...&keywords=whey

A little pricey I know, but it will last almost 3-6 months. And you mix it with milk and it tastes great.


I am currently in your boat, trying to gain mass and weight training. I have currently gained 12lbs the past month and a half just bulk eating and putting on mass. I have just recently started weight training. I have however did about 2 years of weight training in high school so have some experience.

What I do to gain muscles and not tone is to do High weight but Low Reps. Here is my current weight training guide...

Push Ups 12 Reps / 3 Sets
One-Arm Dumb Bell Rolls 6-8 Reps / 3 Sets
Standing Shoulder Press 6-8 Reps / 3 Sets
Dumb Bell Curls 6-8 Reps / 3 Sets
Triceps Extension 6-8 Reps / 3 Sets
Trap Raises 15 Reps / 3 Sets
Dumb Bell Bench Press 6-8 Reps / 3 Sets
Crunch w/ Feet Up 30 Reps / 3 Sets
Reverse Raised Crunch 30 Reps / 3 Sets

Here is a video that explains most of these exercises...
http://www.youtube.com/watch?v=mgEd_jqkg0M

I currently only use free weights (Dumb Bells) no machines, I find it better because your muscle can fluently move naturally. Also find a high weight that you can do 6-8 reps and stick with that for about a week or so till you think you can move up like 2.5lbs.

For my current diet during weight training, I just mainly eat meats and try to eat high calories. I also use this website to track my meals for the day and to make sure I'm getting the amount I need....
http://www.myfitnesspal.com/

Remember, I am a beginner too so I am just recommending some stuff that is currently helping me, it may not be all correct lol.

Thanks. That's great that you've found something that works. It seems from a lot of people in this forum agree with the low rep/high weight using free weights. J's definitely going to give that a try. Thanks for the link for the calorie-counting. As for the whey link--it wouldn't take me there. Also, do all protein shakes have to be mixed with milk? J's not very tolerant of milk or yoghurt.

Thanks!

 

[storm]

For glutamine, it should be taken on the days he works out (if he takes a break for a week or something, then don't take glutamine). After his workout 1000mg to 2000mg of glutamine should be fine. Like I said though, if he's able to put on weight without the glutamine, then don't use the glutamine, if he's a beginner weight liften and he eats right and does low rep and heavy weight, he will put on weight after a few weeks (even protein restrictured people put on weight, simply because they're beginners). Once you hti a certain plateau, it's harder to put on weight, but the beginning should be easy.

If after a month he still put on no weight, then ask what you're doing wrong, is he eating enough, is he getting enough rest, then you might consider creatine, but glutamine is both safer and I feel recovery is more important, especially for people with crohn, if he does fine without, then just make sure he eats enough.

J is wondering about something to help with energy while he's tapering off his prednisone. He's on the last 8mg of pred and is now tapering but has always had trouble at 4mg--would creatine or glutamine help? (He's come off prednisone a few times already so he knows what to expect--plus within a week or so after being off, his energy comes back). My understanding was that creatine helps your body access the energy in your cells more efficiently. So we were thinking that if he needs help in the energy department in the last few mgs of pred, creatine could get him through that???? Are we totally out to lunch?

 

[EthanPSU]

Heres the link...

http://www.amazon.com/Optimum-Nutri...8&qid=1343269939&sr=8-1&keywords=whey+protein

Comes in diff sized. I usually get the 2lbs thats 30$ and Double Rich Chocolate.

But no you can mix it with water but I wouldn't get the chocolate flavor for that. There are 18 diff flavors. Maybe get a 1lb one of a flavor that sounds good and mix it with water and see if it tastes good.

 

[kiny]

J is wondering about something to help with energy while he's tapering off his prednisone. He's on the last 8mg of pred and is now tapering but has always had trouble at 4mg--would creatine or glutamine help? (He's come off prednisone a few times already so he knows what to expect--plus within a week or so after being off, his energy comes back). My understanding was that creatine helps your body access the energy in your cells more efficiently. So we were thinking that if he needs help in the energy department in the last few mgs of pred, creatine could get him through that???? Are we totally out to lunch?

Glutamine won't help you with energy, it's purely something meant for recovery, both in the intestine and the muscles (many glutamine studies related to crohn because of it's ability to repair tissue)

Creatine is found in food in much lower amounts than in supplements and your body makes it too, creatine will give you more energy to lift for slightly longer periods, it won't give you more energy during the day, at least it didn't for me. When I lift weights yes, but not outside of the weight lifting.

Many people "load" the creatine for a few days, to reach saturation in the muscles, but many people don't, if you don't load it it will just take a bit longer.


If he doesn't have enough energy during the day I wouldn't recommend trying to fix it with creatine though, creatine is used to get another rep out of a set so you gain some more mass, if his energy is low it could be down to a more serious issue like iron or low blood pressure or the tapering of the corticosteroid like you said. Creatine only works to get another rep or two out of a set. If you begin lifting it's really not that needed, you will gain mass with or without creatine at the same rate since any weight is going to put a big strain on the body when you begin, without the need for that extra rep. No one really recommends creatine if you begin, everyone who begins weight lifting puts on mass no matter what.

 

[hugh]

"Just remember it different from person to person. I eat a ton of grains and my body handles it perfect. Its a main part of my diet"

Point taken EthanPSU, we're all different.

"found residue of the shell of peas all throughout his intestines"

i should have said green leafy vegetables, cooked is fine.
Pea shells are indigestible at the best of times.

Many (most?) will find an improvement after giving up grains and sugars so it's a simple and logical first step,
just giving up gluten (especially if you replace it with highly processed gluten-free foods - usually high in soy/sugar/vegetable oil/?) isn't enough.

A bit of investigation into "intestinal permeability" might lead you avoiding foods that increase it and raising your use of foods that help improve intestinal integrity.
There's a fairly comprehensive list of 'good' and 'bad' on this site, along with a heap of good ides
http://crohnsdad.com/2012/06/05/framework-matters-study-links-for-safe-effective-crohns-strategies/

Once integrity is compromised many foods become problematic (particularly dairy, eggs, and nuts) because proteins pass through the gut wall to where they are not wanted, when normal function is restored the foods can usually be reintroduced
It's a formula that works for many and is consistent with GAPS/SCD and paleo.

"White rice not brown, he doesn't need the fibre
Most rice toxins reside in the bran, so milled white rice is already low in toxins. The great majority of white rice toxins are destroyed in cooking."
If dairy gives him trouble - avoid it
Water is a pretty good drink ( a bit old-fashioned, i know)
Bananas are good snacks (so is a chicken drumstick - think outside the foil wrapper)

 

[EthanPSU]

J is wondering about something to help with energy while he's tapering off his prednisone. He's on the last 8mg of pred and is now tapering but has always had trouble at 4mg--would creatine or glutamine help? (He's come off prednisone a few times already so he knows what to expect--plus within a week or so after being off, his energy comes back). My understanding was that creatine helps your body access the energy in your cells more efficiently. So we were thinking that if he needs help in the energy department in the last few mgs of pred, creatine could get him through that???? Are we totally out to lunch?

I would also suggest laying off the creatine for the time being. Here is a good article on it....

http://www.menshealth.com/nutrition/creatine-side-effects-what-it-what-it-does

In other words. Unless he is training hard currently and working the muscles the creatine will just turn to water weight. It doesn't just give you energy like a 5-hour energy shot.

For energy maybe for now he should invest in some of those little energy shots for when he needs to be up and about. They are fine for you and way less expensive then creatine.