Coenzyme Q10: Implications for Health & Human Performance (And 20 Top Food Sources)

Coenzyme Q10 is a member of the ubiquinone family of compounds, named for the ubiquitous nature of these compounds in humans and all living organisms.  

Coenzyme Q10 is made naturally in the human body, therefore it’s not considered a vitamin, however it has many fundamental roles in human physiology and health.(1) 

In this article, I’ll review the roles of CoQ10 in the body, highlight its potential role in athletic performance, review CoQ10 rich food sources, and discuss considerations for special populations and supplementation. 

What Is It?

Coenzyme Q10 is a fat-soluble compound made in your body and acquired from your diet. The highest levels are found in the heart, liver, kidneys, and pancreas.

At the cellular level, the greatest concentration of CoQ10 is found in the mitochondria – the tiny powerhouses of your cells – and thus it plays a fundamental role in aerobic energy production.

To convert the carbohydrates and fats you eat into adenosine triphosphate (ATP), the primary energy currency used by your cells, it’s necessary to have CoQ10 present in the inner mitochondrial membrane.

Coenzyme Q10 also plays a key role as a fat-soluble antioxidant in your cellular membranes and lipoproteins, the latter responsible for ferrying lipids around the body. For example, oxidized low-density lipoprotein (LDL) is a biomarker associated with increased risk of heart disease, and when LDL is oxidized, the CoQ10 antioxidant is the first called into action.(2)

Coenzyme Q10 also plays an important role in recycling other antioxidants in the body, in particular, alpha-tocopherols (vitamin E) and ascorbate (vitamins C).(3)

High concentrations of CoQ10 are also found in lysosomes, the garbage collectors of your cells which clean up all the cellular debris. 

CoQ10 & Athletic Performance

If you’re an athlete, can CoQ10 help your athletic performance?

Only a few small studies have looked into whether supplementation with 100-150mg/day of CoQ10 could impact physical performance in recreational and trained athletes. To date, CoQ10 supplementation has failed to produce benefits for maximal oxygen consumption (VO2 max), time to exhaustion, aerobic power or anaerobic markers.(4,5,6,7,8)

There may be some potential benefit for muscular recovery from intense exercise, specifically with respect to oxidative stress and low-grade inflammation, however the research is limited.(9,10,11) 

CoQ10 & Human Health 

Coenzyme Q10 plays a key role in supporting cardiovascular health.

Atherosclerosis is a condition where arterial walls become inflamed and accumulate fatty substances called plaques, narrowing and stiffening arteries and increasing your risk of heart attack and stroke. 

An early sign of the development of atherosclerosis is the oxidation of in your arterial walls. A reduced form of coenzyme Q10 - the first antioxidant called into action - works together with vitamin E to quench the pro-inflammatory oxidative fires in the artery wall.  

Supplementation has been shown in multiple studies to increase the concentration of CoQ10 in LDL in humans.(12, 13) Ensuring sufficient levels of coenzyme Q10 may be a promising strategy to reduce LDL oxidation and therefore the early progression of atherosclerosis.

Some studies have shown mild benefit for blood pressure, endothelial function, and blood flow however the effect size does not appear to be large.

Fibromyalgia is another condition where coenzyme Q10 may play a supportive role in symptom management. Several small, double-blinded studies found a dose of 300mg per day reduced fatigue and tiredness, as well as pain and soreness in fibromyalgia sufferers.(13,14)

COQ10 Food Sources

What foods are richest in coenzyme Q10? 

Currently, the US National Academy of Medicine does not have a specific dietary intake recommendation for CoQ10.(15)  The estimated daily intake of CoQ10 in the general population is approximately 3-6mg per day.(16)

The dietary sources with the highest concentration of CoQ10 are animal-based foods, such as organ meats, venison, beef, chicken and fish.(16) The next best sources include nuts and oils. (See 20 Top Food Sources infographic below)

Want to learn more?    Listen to expert Dr. Cate Shanahan    talk Deep Nutrition: Why Your Genes Need Traditional Foods on the Dr. Bubbs Performance Podcast, Season 1 Episode 28.

Want to learn more? Listen to expert Dr. Cate Shanahan talk Deep Nutrition: Why Your Genes Need Traditional Foods on the Dr. Bubbs Performance Podcast, Season 1 Episode 28.

Symptoms of CoQ10 Deficiency 

Lower plasma levels of CoQ10 are found in people with diabetes (type-1 and type-2), regularly taking cholesterol lowering medications called statins, congestive heart failure (CHF), and cancer.

Insufficient coenzyme Q10 status may also occur as you get older, research showing  plasma concentrations declining with age.(17) Therefore, some experts believe it may play a role in supporting longevity. However, it’s not clear whether this reduction over a lifespan is indeed a sign of deficiency or a natural phenomenon.

If your intake of coenzyme Q10 is deficient or insufficient, you may experience some of the following symptoms; physical fatigue, poor memory and difficulty concentrating, poor immunity, muscle pain, and increased risk of heart disease.

It is possible to perform a blood test to assess CoQ10 status, the general population reference range is 0.36-1.59 ug/mL.

Drugs Interactions & Supplementation

If you’re taking CoQ10 supplements, be sure to check with your doctor for potential interactions with medications. 

For example, if you’re taking a blood-thinning medication like warfarin (coumadin), as well as a CoQ10 supplement, you may experience a potentially dangerous reduced anti-coagulant effect of your medication.(18)

A common side-effect of statin medications is lowered plasma levels of CoQ10.

If you’re taking a statin medication – drugs classified as HMG-CoA reductase inhibitors – you will experience a drop in your CoQ10 levels because the enzyme HMG-CoA reductaseis responsible for both cholesterol and coenzyme Q10 production. 

It’s been well-established that lipid-lowering statins like Crestor, Lipitor, etc. consistently reduce CoQ10 levels in patients.(19,20,21,22) That said, experts believe CoQ10 levels are reduced when patients take statins because overall circulating lipid levels are reduced on statins, rather than a direct inhibition of CoQ10 synthesis.  

(Talk to your doctor about supplementation if you’re currently taking a stating drug).

The best evidence for the benefit of supplementation of CoQ10 is with respect to genetic mitochondrial disorders caused by mutations in CoQ10 genes (at very high doses). CoQ10 may be somewhat effective as an adjunct therapy for congestive heart failure and coronary artery bypass surgery. And currently, there is no evidence it improves diabetes, neurodegenerative conditions or breast cancer. 

If you’re supplementing with CoQ10, be sure to consume with meals that contains some dietary fat to improve absorption. Supplement doses can range from 30-100mg per capsule.

This well above the estimated average daily intake, therefore it’s probably best to consume smaller doses more frequently throughout the day. Finally, CoQ10 production may be impacted by inadequate intake of pantothenic acid (vitamin B6).

The Bottom Line

Coenzyme Q10 is made naturally in the body and an important compound for human health, playing key roles in aerobic energy metabolism and as a fat-soluble antioxidant. 

While it has not shown the ability to directly improve athletic performance, it may be able to support recovery from intense exercise via its role in buffering oxidative stress and low-grade inflammation. 

A “Food First” approach is ideal for athletes and upgrading health, with organ meats and animal proteins the richest natural sources of CoQ10. Incorporate more foods high in coenzyme Q10 to support your best mental and physical performance.

Dr. Marc Bubbs ND, CISSN, CSCS



1)   Acosta MJ, Vazquez Fonseca L, Desbats MA, et al. Coenzyme Q biosynthesis in health and disease. Biochim Biophys Acta. 2016;1857(8):1079-1085. 

2)   Ernster L, Dallner G. Biochemical, physiological and medical aspects of ubiquinone function. Biochim Biophys Acta. 1995;1271(1):195-204.

3)   Navas P, Villalba JM, de Cabo R. The importance of plasma membrane coenzyme Q in aging and stress responses. Mitochondrion. 2007;7 Suppl:S34-40. 

4)   Laaksonen R, Fogelholm M, Himberg JJ, Laakso J, Salorinne Y. Ubiquinone supplementation and exercise capacity in trained young and older men. Eur J Appl Physiol Occup Physiol. 1995;72(1-2):95-100.  

5)   Malm C, Svensson M, Ekblom B, Sjodin B. Effects of ubiquinone-10 supplementation and high intensity training on physical performance in humans. Acta Physiol Scand. 1997;161(3):379-384.  

6)   Weston SB, Zhou S, Weatherby RP, Robson SJ. Does exogenous coenzyme Q10 affect aerobic capacity in endurance athletes? Int J Sport Nutr. 1997;7(3):197-206.  

7)   Porter DA, Costill DL, Zachwieja JJ, et al. The effect of oral coenzyme Q10 on the exercise tolerance of middle-aged, untrained men. Int J Sports Med. 1995;16(7):421-427.  

8)   Braun B, Clarkson PM, Freedson PS, Kohl RL. Effects of coenzyme Q10 supplementation on exercise performance, VO2max, and lipid peroxidation in trained cyclists. Int J Sport Nutr. 1991;1(4):353-365. 

9)   Abdizadeh L, Jafari A, Armanfar  M. Effects of short-term coenzyme Q10 supplementation on markers of oxidative stress and inflammation after downhill running in male mountaineers. Science & Sports. 2015;30(6):328-334. 

10)Díaz-Castro J, Guisado R, Kajarabille N, et al. Coenzyme Q(10) supplementation ameliorates inflammatory signaling and oxidative stress associated with strenuous exercise. Eur J Nutr. 2012;51(7):791-799.  

11)Leelarungrayub D, Rawattikanon A, Klaphajone J, Pothong-sunan P, Bloomer RJ. Coenzyme Q10 supplementation decreases oxidative stress and improves physical performance in young swimmers Open Sports Med J 2010

12)Mohr D, Bowry VW, Stocker R. Dietary supplementation with coenzyme Q10 results in increased levels of ubiquinol-10 within circulating lipoproteins and increased resistance of human low-density lipoprotein to the initiation of lipid peroxidation. Biochim Biophys Acta. 1992;1126(3):247-254.

13)Cordero, M et al. Oxidative stress correlates with headache symptoms in fibromyalgia: coenzyme Q₁₀effect on clinical improvement. PLoS One. 2012;7(4):e35677.

14)Cordero, M et al. Can coenzyme q10 improve clinical and molecular parameters in fibromyalgia? Antioxid Redox Signal. 2013 Oct 20;19(12):1356-61.

15)Weber C. Dietary intake and absorption of coenzyme Q. In: Kagan VE, Quinn PJ, eds. Coenzyme Q: Molecular Mechanisms in Health and Disease. Boca Raton: CRC Press; 2001:209-215. 

16)Pravst I, Zmitek K, Zmitek J. Coenzyme Q10 contents in foods and fortification strategies. Crit Rev Food Sci Nutr. 2010;50(4):269-280. 

17)Hernandez-Camacho JD, Bernier M, Lopez-Lluch G, Navas P. Coenzyme Q10 Supplementation in Aging and Disease. Front Physiol. 2018;9:44. 

18)Natural Medicines. Coenzyme Q10. Professional handout/Drug Interactions. Available at: https://naturalmedicines-therapeuticresearch-com. Accessed 1/21/19.

19)Folkers K, Langsjoen P, Willis R, et al. Lovastatin decreases coenzyme Q levels in humans. Proc Natl Acad Sci U S A. 1990;87(22):8931-8934.  

20)Colquhoun DM, Jackson R, Walters M, et al. Effects of simvastatin on blood lipids, vitamin E, coenzyme Q10 levels and left ventricular function in humans. Eur J Clin Invest. 2005;35(4):251-258.  

21)Mabuchi H, Higashikata T, Kawashiri M, et al. Reduction of serum ubiquinol-10 and ubiquinone-10 levels by atorvastatin in hypercholesterolemic patients. J Atheroscler Thromb. 2005;12(2):111-119.  

22)Bargossi AM, Battino M, Gaddi A, et al. Exogenous CoQ10 preserves plasma ubiquinone levels in patients treated with 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors. Int J Clin Lab Res. 1994;24(3):171-176.  





Keto Diet & Running Economy – The Forgotten Factor

3.18.Blog_Keto & running Economy.png

Ketogenic diets hit the mainstream in a big way last year after more than a decade of build-up in athletes in the CrossFit and ultra-endurance scene, and more than 30 years after initial research into the diet. The very low-carb, high-fat keto diet has shown some impressive results in people who are overweight, obese, struggling with type-2 diabetes or metabolic syndrome.(1,2,3) The reduction in carbohydrates in these groups - typically from elimination of processed foods, sugars, desserts and alcohol – results in a significant caloric reduction which is the key underlying principle of all successful weight loss regimes. Keto diets also increase your ability to burn body-fat as a fuel source, and perhaps the most important factor, helps your feel full and satiated for much longer periods throughout the day, new research highlighting this may be due to a reduction in triglycerides crossing the blood brain barrier.(4)

Okay, so keto diet can be a very useful tool for weight loss and improving metabolic health, but what about performance? The internet is loaded with anecdotes about transforming yourself into a ‘fat burning machine’ by shifting to a keto diet, as well as emphasizing to recreational athletes that ‘carbs are for suckers’, implying endurance performance is superior when you follow a keto diet compared to the traditional high carb diet. Are all of these anecdotes correct? Are sport scientists missing out on something? And is there any research to back up these claims? Let’s dig a little deeper and find out.

There is actually very little research on ketogenic diets and endurance performance. The original study on keto diets and performance was done by Stephen Phinney in the early 1980s on five cyclists. Among this group, two cyclists improved their endurance, one saw no change and two cyclists got worse.(5) Not exactly a home run in terms of evidence, however this study was ground-breaking because it showed fat-adapted athletes could burn far more fat (1.5g/min) compared to what had previously thought to be the maximum rate (1.0g/min). It’s an impressive finding. Advocates of a keto strategy for endurance performance highlight the fact that body-fat stores provide a massive fuel source, because even an athlete at 10% body-fat has approximately 30,000 calories of excess energy. Unfortunately, a major shortcoming of Phinney’s study, if you’re trying to win a race, is that cyclists trained at 62-64% of their Vo2max, not exactly a speed that will win a race.

Fast-forward to 2016 and Phinney and colleague Jeff Volek published the FASTER (Fat-Adapted Substrate use in Trained Elite Runners) study in elite ultra-endurance triathletes and runners. The long-term keto adapted athletes (almost 2 years adhering to the diet) were found to burn fat at a high rate (1.2g/min) during a 3-hour submaximal aerobic test at 64% VO2max.(6) Another study in 2016 by Tim Noakes group comparing keto-adapted endurance athletes – following a diet of less than 50g of carbs and 70% fat for over year – were pitted against a group of higher carb athletes in a 2-hour ride at 70% VO2max. Researchers found the keto group did indeed burn more fat (1.2g/min) compared to the high carb group (0.5g/min).(7)

All of this information is really interesting, but it still doesn’t answer the most important question; what happens on race day? When you’re trying to beat the competition, does keto help or hinder an endurance athlete.

Dr. Louise Burke PhD, Head of Sports Nutrition at the Australian Institute of Sport, put this question to the test last year. Her research group took a collection of elite and Olympic race-walkers, adapted them to a ketogenic diet, and simulated a race to examine the impacts on performance.  To date, this is the best study on the impacts of keto diet on endurance performance. Let’s see what they found.

Twenty-one male racewalkers participated in the study at the Australian Institute of Sport (AIS), living in residences where all their meals and training was under strict supervision from the research team. These were not your run of the mill recreational race walkers. They were selected based on their performances and rankings by the IAAF (International Association of Athletics Federation) and made up of 7-time Olympic and World championship medalists to world-ranked juniors.

The study involved three different training groups; a high carb group, a periodized carb group and a keto group. All the participants underwent three weeks of intense training - race walking, lifting, and cross-training (running, cycling, or swimming) – and were tested pre- and post- competition to assess the impact of the three diets on performance.

What did Dr. Burke and her team uncover?

After the three weeks of training, all three groups of racewalkers improved their aerobic fitness regardless of which diet they were on.(8) (Not really surprising, considering they were all in a training camp setting. If they didn’t get fitter, something would really be off piste).

Next, the keto group of racewalkers did exhibit significantly higher rates of fat oxidation during the race walk competition over a wide range of intensities, averaging about 1.5/min.(8) (This is on par with Phinney’s earlier study in the 1980s).

Sounds great, but how did they the keto group perform in the 10km race and 25 km long walk event? In the 10km trial, both the high-carb and periodized-carb group improved their race time, by 6.6 and 5.3% respectively (over their pre-camp testing), following the three-week training camp.(8) Unfortunately for the keto group, their performance was marginally worse during the 10km race (see figure below).

Screen Shot 2018-02-02 at 12.38.18 PM.png


In the 25km long walk, the keto group showed an increase in heart rate compared the both carb groups who experienced reductions after the long walk. The perceived exertion was also greater in the keto group compared to carbs race walkers.(8)

Why did the low-carb group struggle to perform as well as the carbohydrate fueled racers? Ketogenic diets have a negative impact your running economy.(8) Running economy is how much oxygen you used up at a given running pace. A runner with a superior running economy uses less oxygen at a given speed, which is a reliable metric for who will win a race. In Burke’s study, the fat-adapted elite keto racewalker did burn more fat, but at the expense of a reduce running economy (which means higher oxygen demand) at real-life race intensities. This wasn’t the case for either the high or periodized carb groups. (And don’t forget, the more fat-adapted you are, it comes at the expense of your ability to burn carbs effectively for fuel - pyruvate dehydrogenase enzyme levels fall – which is another performance roadblock).(9)

What does all this mean for you?

If you’re an elite athlete or performance-driven, you need carbs to win on race day. Keto diets reduce running economy (increasing your oxygen demand) as well as increasing heart rate and perceived exertion. At the moment, there just is not enough evidence to support going 100% keto, nobody has beat the competition using this strict dietary strategy. (Even renowned ultra-marathoners in the blogosphere who are “keto” athletes rely primarily on simple carbs when it comes to race day).

Of course, this isn’t a black or white situation. There are definite advantages to training in low-carb states (called low carb availability in the research) during your training blocks to trigger beneficial adaptations in the lead up to competition. Dr. Burke and her team acknowledge this in their research, stating … “a periodized programme that includes some training sessions deliberately undertaken with low… carbohydrate availability (‘train low’) or a delay in replacing muscle glycogen after a session (‘sleep low’) may promote greater cellular adaptations to training and enhance performance to a greater magnitude than undertaking all sessions with high carb availability.” This is a powerful statement.

If you’re a low-carb or keto athlete, it’s effectively saying you can absolutely get benefits by using these approaches during your training block. It can be a great training-nutrition strategy. Just don’t confuse that with your “race-day” nutrition strategy, where carbs are still king.

This doesn’t mean you commit to 100% keto or 100% high carb all of the time. As Dr. Burke highlight in her study… “the quantity and timing of carbohydrate intake should be personalized to the athlete and periodized within the various micro- and macro-cycles of training and competition.”

Just like you wouldn’t train the same way every day of the week, so why do you eat the same way? Regardless if it’s keto or high-carb. (There is a lot of nuance in different fueling strategies, and I’ll get into these in more detail in future blog posts).

Individualizing your carb intake to match your goals is a crucial piece of the puzzle.

Also, take into account your current fitness level and body composition.

If you’re a recreational exerciser training up for a half-marathon or marathon with the aim to lose weight and improve health, yet you’re guzzling back sports drinks every session and seeing not shift in body composition, then your fueling strategy is flawed. Re-assess and adjust accordingly.

Bottom Line: At the end of the day, what are you trying to accomplish? If it’s to win the race or perform your personal best then the research shows race-day nutrition should definitely have carbs (as well as in the 24-hours leading up to the race). If it’s to lose weight and improve metabolic health, and not about your personal best, then you’re fine to err more on the side of low-carb to reap more benefits on the weight loss and health front. But, don’t be afraid to add more carbs on days when training intensity is higher to maximize your adaptations to training.

There is a lot nuance and no single correct answer when it comes to fueling for sport. Just remember to always consider the context of your specific athlete, and their individual goals, when designing the right nutrition strategy for them.

Dr. Marc Bubbs ND, MSc, CISSN, CSCS

Ps. Wonder how exogenous ketone supplements would impact endurance performance? Stay tuned for an upcoming podcast episode on this topic… (Subscribe here!)


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Top-3 Mineral Deficiencies On A Ketogenic Diet (And How To Fix It)


A common question I get asked after clients start a ketogenic diet is “why do I feel lousy?” Like them, you’re probably thinking going keto will provide an immediate mental and physical boost. For some, it will. For others, you may experience adverse symptoms, also known as the “keto flu”. When you start a very low-carb ketogenic diet, you’ll flush water and sodium out of your body in the first few weeks. As your sodium levels fall, so too will potassium levels. This can leave you feeling tired, sluggish, and wondering what you got yourself into. Fear not, it’s only temporary. Here are some suggestions for avoiding key mineral deficiencies when jumping into a ketogenic diet. 


One of the biggest health and nutrition “myths” is that you should avoid salt. If you’re fit, healthy, and following a keto diet you’ll lose water and sodium in the first few weeks. For athletes, this problem can be compounded because you also lose sodium through your sweat, and as your sweat rate increases, your sodium and blood volume will decline. Not a good recipe for optimal energy and performance.

On the flip side, if you’re overweight, out of shape or in poor health then your body is likely already holding on to too much sodium from high consumption of packaged and processed foods (i.e. sodium is used as the primary preservative) or from chronically elevated insulin levels. Therefore, a low-carb or keto approach is great way to restore healthy levels.

Symptoms of low sodium include fatigue, headaches, compromised ability to perform (especially outdoors in the heat) and in more serious cases you may pass out. Remember that most of the sodium in your body is found in your bloodstream, so if your body gets deficient, you don’t have many reserves to tap into.

In the first few weeks on a keto diet, only about half of your weight loss is from body-fat. The other half is from water and sodium loss. Therefore, getting enough sodium is crucial.

Aim for an extra 1,000-2,000mg of sodium daily via:

  • Pink Himalayan or Celtic Sea salt (not standard table salt)

  • Broth or bouillon (1-2 cups per day)

  • Shellfish (i.e. oysters, mussels, crab, etc.)

Athletes should aim to take one gram 30 minutes before workouts to offset adverse effects of low sodium on performance.


When you lose sodium on a keto diet, the salt depletion causes a parallel loss of potassium. Common symptoms of a potassium deficiency - the medical term is hypokalemia - include weakness, muscular cramps, constipation, irritability or skin problems. In athletes, low potassium can compromise lean muscle mass which will ultimately impact performance, and in more severe cases, you may experience heart palpitations, irregular heartbeats, respiratory distress (and even heart failure with serious deficiency). 

Virtually all fruits and veggies contain significant amounts of potassium, but not all are keto friendly. In fact, most people don’t realize that animal protein is terrific source of dietary potassium, however the cooking process strips a great deal of it away (but the leftover juices from cooking can be used to keep your levels up).  

Here is a list of my potassium rich keto-friendly foods:

  • Spinach (2 cups) – 330mg

  • Chicken breast - 330mg

  • Salmon (3 oz) - 326mg

  • Beef (3 oz) - 315mg

  • Avocado (1/2 medium) - 320mg

  • Broccoli (1/2 cup) - 230mg

  • Asparagus (1/2 cup) – 202mg


Do you ever suffer from muscle cramps? Lack of magnesium is likely the culprit. Magnesium is the body’s “calming” mineral; helping to keep your brain, heart and muscles relaxed. It’s also essential for protein synthesis, blood sugar control, energy metabolism and over 300 other biochemical reactions in the body. Intense exercise, lack of sleep, and stress can all deplete magnesium levels.

Animal protein is also a great source of magnesium – in particular shellfish like oysters and mussels – along with leafy greens. Veggies get their deep green colour from chlorophyll, and the core of the chlorophyll molecule is magnesium, so make sure to always eat your leafy greens at mealtime. The darker the leafy green, the more magnesium.

Include the following regularly:

  • Spinach (1 cup cooked) – 157mg

  • Swiss Chard (1 cup cooked) – 154mg

  • Pumpkin Seeds (1/8 cup) – 90mg

  • Oysters (3 oz.) – 80mg

  • Yogurt (Plain) – 50mg

  • Avocado (1/2 medium)– 30mg

The Bottom Line: If you’re starting up (or already following) a keto diet, it’s important to make sure you keep your electrolytes in balance; boost sodium levels by adding Sea salt to meals and a bone broth drink, and keep potassium and magnesium levels up via nuts and seeds, dark leafy greens, fish and shellfish.

If you follow this approach, you can significantly reduce – and even prevent – many of the adverse symptoms associated with starting up a ketogenic diet. Try these simple tips to help you thrive with your keto diet this year.

Dr. Marc Bubbs ND, CISSN, CSCS


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Want to learn more about keto? Listen to Dr. Ryan Lowery PhD talk all things ketogenic diet in Episode #33 of the Dr. Bubbs Performance Podcast... 

Check out more articles in the "KETO" SERIES...


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Post-Training Protein – How Much Is The Right Amount?

Post-Training Protein – How Much Is The Right Amount?

Protein intake around exercise is always a hot topic around the gym water-cooler. Is it better pre-workout? Post-workout? Intra-workout? The options seem endless. It’s well recognized from previous research that the minimum amount of protein required to stimulate muscle protein synthesis (MPS) is 20g post-training and that increasing to 40g post-training had no impact on muscle gains after exercise. That said, if you can get some marginal gains from ramping up your protein post-training, why not? A new study attempts to uncover if ratcheting up your intake to 40g post-training is really worth the effort and if bigger athlete require more protein post-training.

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Vitamin D has been gaining significant momentum recently in the research for its ability to influence over 1,000 different genes in the body and subsequently some important performance parameters. Failing to get sufficient vitamin D regularly can negatively impact many endurance parameters, including maximal aerobic capacity (VO2 max), susceptibility to colds and flu, inflammation, recovery, and stress fractures.

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21 Foods To Boost Your Immunity

2017_21 Foods To Boost Immunity.png

The darker, shorter and colder days of winter are upon us and with it comes an increase in colds and flu. The first wave of patients with sore throats and congestion has already passed through my office, so now is a great time to think about how you can support your immune system. There are several key deficiencies that commonly rear their ugly heads over the fall and winter months and contribute to increased frequency and severity of colds and flu. Nothing will slow your productivity at work, in the gym, or family time at home quicker than sick days.

If you are working long hours, exercising intensely, or have kids in daycare or school, then you’ll likely be more exposed to bacteria and viruses that can leave you stuck at home in bed. The research tells us that as your cortisol stress levels increase (from busy days, meeting deadlines, or getting up early with the kids) your first-line of immune defense or innate immune system function decreases.1This leaves your immune defense team short-handed.

Staying active is a great way to enhance your immunity but the more intensely you train (or the greater your training load), the quicker you deplete critical ‘immune soldiers’ called natural killer cells (NK).2 Studies show your immune system can be depressed for 24-72 hours after intense training, which means you need to provide the right support to reduce your risk of colds and flu.3

What can you do to boost your immunity this winter? (The answer is on your dinner plate!)


If you live in a northern climate with a true fall and winter season, obtaining the right amount of vitamin D is critical for keeping your immune system firing on all cylinders. Vitamin D deficiency is associated with decreased innate immunity and increased risk for infections.4

The best part of a Food First approach to your nutrition strategy is that it provides you with nutrient-dense food choices. To keep your vitamin D levels from plummeting over the winter months, increase your intake with these five vitamin D containing foods:

  • Cod Liver Oil – 1,400 IU per tbsp. (your grandma knew best!)
  • Cold-Water Fatty Fish – trout (645 IU per 3 ounce), salmon, or mackerel
  • Medicinal Mushrooms – Portobello (375 IU per mushroom) or maitake
  • Pork – 78 IU per 3 oz. serving
  • Eggs – 44IU per egg

The Vitamin D Society recommends maintaining your vitamin D levels between 100-150 (nmol/l), so if you struggle with colds and flu, or low mood over the winter, then getting your levels tested would be beneficial.5


If you are low in Vitamin A, it will significantly impair your mucosal immunity and leave you more prone to upper respiratory tract infections (URTI).6 If you work in an office, have kids in daycare or school, or train intensely than you’ll be a much greater risk of URTI, especially through the winter months.

Traditiona diets around the world are loaded with nutrient dense meats that are the richest source of preformed vitamin A. You can also get significant beta-caretene (which converts to vitamin A) from fruits and veggies.

Try these five foods rich vitamin A foods to keep your immune system robust:

  • Turkey and Beef Liver – 17,000 IU and 6,400 IU per 2.6 oz., respectively.
  • Cod Liver Oil – 4,150 IU per tbsp.
  • Sweet potatoes – 1,100 IU per medium size
  • Pumpkin -1,000 IU per ½ cup
  • Carrots – 700 IU per ½ cup


Vitamin C and zinc is a powerful combo for ramping up your immune army and fighting off bacteria and viruses. Vitamin C improves the response of neutrophils and lymphocytes, important immune cells that are the ‘front-line soldiers’ of your innate immune system.7,8 Zinc is essential for optimal function of your thymus gland, responsible for developing the ‘special forces’ immune cells of your adaptive immune system.9 This is the seek and destroy arm of your immunity, crucial for knocking out foreign invaders once they’ve breached your first-line of defense.

A nutrition strategy rich in animal protein is the best dietary source of zinc, while a mix of fruit and veggies are key for boosting your vitamin C intake (some sources may surprise you!). To ensure you’re meeting your body’s increased demands throughout the fall/winter months, be sure to include the following foods:

Vitamin C

  • Yellow Bell Peppers – 345mg per large pepper
  • Broccoli – 92mg per cup (chopped)
  • Kale – 80mg per cup (chopped)
  • Orange – 70mg per fruit (medium)
  • Kiwis – 64mg per fruit


  • Oysters – 33mg per 6 oysters
  • Beef – 14mg per fillet (4.5oz.)
  • Lamb – 7mg per 3oz.
  • Pork – 4.3mg per 3oz.
  • Ginger 


There is inherent ‘cross-talk’ between your gut and immune system, therefore ensuring the right balance of healthy microbiota in your intestinal tract will go a long way to fighting off colds and flus.10,11 Common fermented foods and Paleo staples like kombucha tea, sauerkraut, and kimchi, are great options for increasing ‘good’ gut bacteria. In addition, the polyphenols found in green tea also promote the growth of beneficial gut bacteria. If you struggle with frequent or persistent colds or flu, you may want to add a probiotic supplement to add further immune support.

Limiting the growth of ‘bad’ or dysbiotic gut bacteria is crucial to maintaining optimal intestinal microflora and therefore immunity. Short-chain saturated fats like butyric acid and lauric acid, found in butter and coconut oil, exert potent antmicrobial effects that help to keep bad bacteria in check.12,13

Don’t let the cold, dark months slow you down. Enhance your diet by incorporating the foods richest in the key immune boosting nutrients – vitamin D, A, C, zinc, and probiotics – to increase your resiliency this cold and flu season.

Enjoy a healthy winter!

Dr. Marc Bubbs ND, CISSN, CSCS


Check out the rest of our articles in the IMMUNITY SERIES...


[1]Nieman DC et al. Influence of carbohydrate on the immune response to intensive, prolonged exercise. Exerc Immunol Rev 1998;4:64-76.

[2] Nieman DC, Pedersen BK. Exercise and immune function. Recent developments. Sports Med 1999;27(2):73-80.

[3] Walsh PH et al. Position statement. Part one: Immune function & exercise. Exerc Immunol Rev.2011;17:6-63.

[4] Youssef D et al. Vitamin D’s potential to reduce the risk of hospital-acquired infections. Dermatoendocrinol. 2012 Apr 1;4(2):167-75

[5] Heaney R, Bggerly C, Sorenson M, Vieth R. Toronto Vitamin D Disease Prevention Symposium. November 6th, 2013. Toronto, ON

[6] Semba RD. The role of vitamin A and related retinoids in immune function. Nutr Rev. 1998;56(1 Pt 2):S38-48

[7] Douglas RM et al. Vitamin C for preventing and treating the common cold. Cochrane Database Systematic Review. 2004 Oct 18;(4):CD000980.

[8] Peters EM, Goetzche JM, Grobbelaar B, Noakes TD. Vitamin C supplementation reduces the incidence of post race symptoms of upper-respiratory-tract infection in ultra marathon runners. Am J Clin Nutr 1993 Feb;57(2):170-4.

[9] Mangini S et al. A combination of high-dose vitamin C plus zinc for the common cold. J Int Med Res. 2012;40(1):28-42.

[10] Rask C et al. Differential effect on cell-mediated immunity in human volunteers after intake of different lactobacilli. Clin Exp Immunol 2013 May;172(2):321-32.

[11] Madden J.A.J. et al. Effect of probiotics on preventing disruption of the intestinal microflora following antibiotic therapy: A double-blind, placebo-controlled pilot study. Int Immunophar 2005: 5: 1091-1097.

[12] Mortesen FV, Nielsen H, Aalkjaer C, et al. Short chain fatty acids relax isolated resistance arteries from the human ileum by a mechanism dependent on anion-exchange. Pharmacol Toxicoli 1994;75(3-4):181-5. 6.

[13] Mortesen FV, Nielsen H, Mulvaney MJ, et al. Short chain fatty acids dilate isolated human colonic reistance arteries. Gut 1990;31(12):1391-4.