NUTRITION PART II

How to develop your nutritional framework for energy intake and macronutrient management

?Energy Intake

Asses yourself by trying to answer the following questions:

1. are you overnourished (overweight/obese)
2. are you adequately nourished (Balanced)
3. are you undernourished (underweight/anorexic
4. are you adequately muscled
5. are you under-muscled

Questions 1-3 can be answered by measuring your WHR (BMI is not robust enough). Questions 4-5 would best require a DEXA scan (very much worthwhile)

Of course over all of this comes the question am I metabolically healthy? As you have read in the previous newsletter making the Metabolic Syndrom Test is a good start to find out.

The problem cohort is those who are overnourished, under-muscled, and metabolically unhealthy.

If you are overnourished the main focus must be on reducing energy/calorie intake: Yes I know it is boring, we all know this, but it doesn’t hurt to recall the basic principles :)

There are 3 ways to consume less calories (energy):

1. CR (Caloric Restriction)

• most direct way (pure arithmetic)
• no restriction on what and when you eat
• requires a lot of willpower, effort, and planning

CR does not belong to my favorite coaching methodology as it is just too hard for most of people to adhere sustainably

1. DR (Diet Restriction)

This is the thing most of us are most familiar with because whenever you think of a diet you are generally thinking of some form of dietary restriction: e.g. LowCarb, Vegan, Keto, Paleo etc. With DR you are cutting out certain elements from the diet. The more restrictive you apply it the more likely you are to achieve your ultimate objective which is calorie restriction.

There is nothing magical about any particular type of dietary restriction that guarantees you will be in a negative energy balance.

3. TR (Time Restriction)

In some ways, TR is the easiest one to do and the easiest one to conceptualize. It simply means limiting the time in which you eat. The greater the amount of time restriction the greater the amount of calorie restriction. The smaller the eating window the more likely you are to reduce intake.

There is a drawback though with regards to protein intake. It is rather challenging to consume your daily requirement of protein to optimize lean muscle mass if you are eating in a narrow window (e.g. 18:6).

I do suggest my clients who undergo time restriction to apply the time restriction for normal meals, but outside of that period to supplement with protein shakes. Studies show that people conducting an IR might lose weight but it can come along with loss of muscle mass and that is not what we want.

Macronutrient Management

Overall caloric intake is important but it isn’t the whole story. Just purely applying a calorie restriction might be true from an energy balance perspective but not necessarily from a health perspective. That is why we also have to include the macronutrients in the equation. Let's quickly repeat the four macros:

Alcohol/Ethanol ?

• Very calorie dense (almost like fat with 7 calories/gram)
• There is zero added benefit at all (except the buzz feeling :)
• It tends to lead to poor eating choices
• The body generally metabolizes ethanol first (but as an overnourished, you want to oxidize primarily your extra fat deposits)
• It can get rough on your liver

So how we should deal with alcohol? My recommendation (far from scientific) to people who just like alcohol is not to drink more than 5 -7 drinks per week. A drink is defined as a beer, 0.5 dl of liquor, or 1.5 dl of wine.

I like very much red wine. Together with my wife we mostly enjoy 1 bottle of red wine during the weekend.? But forget this myth that alcohol in moderation can have a health-promoting effect: this purely belongs to the category "BS".

Protein

The most important nutrient - RDA is 0.8 grams/kg which is far too low: it is maybe enough to not waste away…

• Leading experts like Stuart Philips recommend 1.5-2 grams/kg/day
• Most of us consume not enough protein - supplementing with a protein shake can help to achieve the daily target
• Ideally 3-4 servings per day (30-50 grams/serving)
• Protein intake is important after strength training (ideally protein shake)

?Carbohydrates

• we can most quickly get ATP (energy currency) out of carbs
• Technically we do not have to consume them but glucose is essential for life: our body can make glucose out of protein and fat (gluconeogenesis). But here we talk about getting carbs by eating them (not being on starvation or on a very strict keto-diet)
• Genetics play a role in how we metabolize carbs
• Hormones (e.g. testosterone and estrogen) play a role in how we metabolize carbs: with age testo (men) and estrogen levels (female) go down and so does carb metabolism. Rising cortisol levels (stress) can impair glucose metabolism. Disrupted sleep has a profound impact on glucose metabolism as well.
• Exercising also strongly influences carb/glucose metabolism
• Carb/glucose metabolism can strongly fluctuate and is very individual

Certain tools can provide insights into the dynamics of glucose

1. CGM (Continuous Glucose Monitor)

Originally devised for people with type 1 diabetes, then expanded to people with type 2 diabetes, and now people like myself who have neither type 1 nor type 2 diabetes use it periodically as a way to understand carb tolerance. The device allows you to see in real-time what your glucose level is in response to the carbs you consume.

Three values get measured:

• Average blood glucose: < 100 mg/dl / 5.5 mmol/L (optimal)
• Standard deviation or variability of blood glucose: Difference between highs/lows: less variability is better, as less insulin is cycling and that might lead to less hunger feelings
• Number of times that a peak level is reached within a week: minimum nr of peaks > 150 mg/dl (8.3 mmol/l)

CGMs products appear more and more on the market I like the product from UltraHuman for occasional testing.

2. OGTT (Oral Glucose Tolerance Test)

To go deeper in understanding your glucose tolerance situation you can ask your physician to apply an OGGT. It is a bit of an artificial test as you are forced to drink 75 grams of glucose in one slug: pretty disgusting I can guarantee you from my personal experience

Self-Test alternative: Eat 1 ? halve plane (baked is ok) bagels (about 150gr). Buy a finger glucose meter and check your glucose levels before you it it and 30, 60, 90, and 120 minutes after consumption. After 1.5 - 2 hours, your blood glucose should be back on the level before bagel consumption. The disadvantage of this bio-self-hack is you won’t get your insulin values as you do with an OGTT.

Importantly, there’s no “textbook definition” of what your blood sugars should be at any given time. It’s best to discuss this with your doctor.

3. HbA1c

is another informative blood marker (average blood glucose levels within the last 3 months). You can have it easily tested at your doctor’s practice. The lower that value the lower the all-cause mortality (e.g. 5.0)

Doing these tests (by yourself or with a doctor) shows a lot of valuable information about your glucose tolerance (how much carbs you can eat and metabolize healthily).

Fats

?There are three 3 types of fat:

1. SAFAs: Saturated fats

Sources: Animal products (e.g. butter, cheese, red meat, tropical oils (e.g. coconut oil)

?2. PUFA: Polyunsaturated fats

• Omega 3 (EPA, DHA, ALA). Benefits: critical for heart and brain health, reducing inflammation
• Omega 6: Benefits: Necessary for growth and development, though typically overconsumed relative to Omega3

Sources: Fatty fish (e.g. salmon, mackerel), flaxseeds, chia seeds, walnuts

Balance: Balance between Omega 6: Omega 3: Aim for 2:1 to 4:1

3. MUFA: Monounsaturated fats

Sources: cold-pressed, extra virgin olive oil, avocados, nuts, seeds (pumpkin), and certain fish (trout e.g. trout)

Benefits: can help to reduce LDL-C, increase HDL-C, and provide anti-inflammatory benefits

Keep in mind that no food is made up of just one type of fat – they all contain a combination.

Which fats are good for us?

Experimental and epidemiological data (Predimed Study and Lyon Diet Heart Study) shows that MUFAs seem to be the most favorable fats, especially concerning heart disease and all-cause mortality.

The debate over the relative health effects of SAFAs and polyunsaturated PUFAs is complex and ongoing, with different studies and experts coming to different conclusions. Some research suggests that replacing SAFAs with PUFAs can lower the risk of cardiovascular disease, while other studies have found that SAFAs may not be as harmful as previously thought and that the type of PUFA (omega-6 or omega-3) may be an important factor in determining health outcomes.

But we should keep the big picture in mind and try to keep it simple. If we consume fats we should focus on natural, unprocessed fats.

Try to avoid:

• Processed meat: Sausages, bacon, deli meats, ham, canned meat
• Seed oils: Sunflower oil, canola oil, soybean oil, corn oil, cottonseed oil, etc. (Omega 6 dominant)
• Palm oils: Hydrogenated palm oils, fractionated palm oils, palm kernel oil????
• Trans fats: Fried foods, baked foods, processed snacks, margarine and spreads, creamers and coffee mate

Emphasize on MUFAs

Include PUFAs (with a good omega6-omega3 balance)

Go mindful on SAFAs, especially on processed sources

KEEP IT UP!

P.S.

In the next newsletter (“Nutrition Part III) I will share general principles of good nutrition, how to implement them in the real world, and some thoughts about fasting.