Diet Confusion

Those of us that grew up in the 90’s and early 00’s we were saturated with ideas such as

“Nothing tastes as good as skinny feels”.

This built some poor mental images women in particular had of their bodies. We all wanted to be as skinny as possible and associated that with beauty and health. We wanted to be like the models we saw and were starving ourselves away.

Fast forward to now and it’s become how juicy can your butt be but maintain a tiny waist. Whilst this is a healthy aspiration in some instances, we are advocating to get to such large sizes in some cases that it is not healthy for us as an individual.

“Big is beautiful”

is the other end that is trying to counter that original poor image of being so skinny. But your body weight is not your worth or your beauty. That is also very different to what healthy is. Which I will discuss later, because healthy on my body, versus healthy on your body looks totally different due to my size, shape and genetics vs yours. So this is not a big vs skinny debate one is not better than the other, I’m not trying to shame anyone but talk about finding your healthy medium your healthy size – not the extremes. And this has nothing to do with the weight on the scales. We want balance in all things and the body likes balance.

Just like fat shaming is not ok- we are more than our size and shape and its more complicated than everyone being a certain weight and shape.

Fear Mongering With Diets- Which Is Best?

There has been NO proven diet by science that is superior to the other. The diet with the most research and health benefits associated that can be proven is the Mediterranean diet. Which has oils/fats, meat, breads, pasta and lots of vegetables and fruit.

The Mediterranean diet has been shown also multiple times in trials to improve mental health as seen in the SMILES trial (in particular major depression). These patient with depression 3x fold increase in remission from those with the diet intervention. Please also see my eBook on anxiety where we go into the benefits diet can have on mental health balance and conditions. And explore the impacts of stress which is what anxiety is on the body.

What we can agree on is that we need adequate protein for your body (not excessive), more vegetables and fruit, less sugar/processed sugar and more fats from plants than animals.

A diet is something you can adhere to and makes you feel your best. There is going to be conflicting information as there is no right diet for everyone. For example, if you have Celiac disease, lactose intolerance, or ethical concerns and personal preferences; than certain diets are not going to be right for you. Cultural differences play more of a role than genetics in a lot of diet preferences. That doesn’t mean your diet is superior to any other it just means it is right for you.

Vegan is not superior to the ketogenic diet (keto), the keto is not superior to the vegetarian the vegetarian is not superior to the alkaline diet (although the alkaline diet is not a real thing and I fell pray to this in my early 20’s). We will talk adequate protein in another discussion and dive into what we should be having for brain health and longevity.

Food is not good or bad- there are just some foods that contain more nutrients and will provide more benefits when we eat it than others. In knowing this not fearing food but knowing that it can serve different needs and how to balance that, that is what is crucial in people’s diets.

If you live on a super strict diet thinking its “healthy” depriving yourself and then once you have finished the diet (because its too hard to stick to) you binge and put on a whole heap of extra weight that is more detrimental to have these high and low yo-yo diet swings than it is to have some of those sweets and things you love in there regularly.

Orthnorexia is a thing

We all know about anorexia and bulimia but orthnorexia is a way of hiding an eating disorder pretending to be “healthy” whilst severely restricting your intake under the guise of health and its becoming a big problem as we fear food and shame each other for food choices.

A diet needs to be something you enjoy, that meets your goals it is not a punishment and is not something to religiously beat other people with just because you found something that works for your body.

Intermittent Fasting

There has been a lot of hype that came out studies particularly in 2015 around lowering calories increasing longevity. That a 25% reduction in calories and in particular sticking to eating within a restricted window (around the circadian rhythm) will increase longevity by as much as 10-15% (mortality reduction). A similar benefit as seen by smokers stopping smoking.

However, the benefits in further studies from the CALERIE to the DunedinPACE have failed to show this as the superior way to eat. That time restricted eating versus just a reduction in calories is no different. So skipping breakfast is not needed to loose weight. In fact, a lot of people if they eat a larger meal at the start of the day will feel fuller for longer and that might help them stop snacking later in the day. The weight loss benefits come from the fact that if you time restrict eating you just can’t eat the same number of calories in a day as you do when you have 3 main meals. Its just simply harder to do as you have less time.

But the idea that you body “turns off” digestion when we don’t eat makes the assumption that your body is a machine and turns on and off like a robot. But our bodies don’t every stop it’s a living organism. Not eating for 12hrs is not really fasting because your body will still be processing food, metabolising that food you had eaten before the 12 hrs. If you are truly fasting it needs to be days! This is more time restricted eating when you don’t eat for 12hrs for example and only have lunch and dinner.

Now there was a study last year that came back with a lot of negative press: A 2022 cohort study looking over 25year period with 24,000 people.

40% increase in cardiovascular disease mortality if they just skipped breakfast.
30% relative risk increase in the groups eating 1 meal per day vs 3 per day of mortality
80% relative risk increase in mortality if they ate 1 meal per day

Does this mean intermittent fasting/time restricted eating is bad for you?

No this was one study -If this approach works for you then it works for you as a way to manage what your intake is i.e. shift workers might find this beneficial. But it depends on what works for you- if you are feeling hungry, angry and binge out on this diet, then it’s not ideal for you. Look at spreading your calories more evenly throughout the day. It’s about finding a diet that works for your lifestyles and activities and having the calories and macro targets to match your goals. One size does not fit all.

Genetics With Diets

People of various background may have susceptibility to different conditions. For example, east Asian and south Asian background people cannot get as “large” BMI wise before becoming at risk of type 2 diabetes compared to Caucasian people and Polynesian people- who can have larger BMI’s and not get type 2 diabetes as fast. African Americans are more likely to get heart disease for example so some things with health are clearly linked to genetic predisposition. The saying goes:

“Genetics loads the gun but your diet and lifestyle pull the trigger. “

So don’t see genetics as something you will be a future you must have.

There are more than 100 genes for weight gain. There is a gene that has been labelled the “obese gene” when this study was conducted in mice that affects Leptin regulation in the body. It lets your body know how much fat you have on board and to feel full.

MC4R is like a thermostat and there are thousands of mutations for this gene- you can predict how much someone will eat if this is 50% function versus non function. 0.3% of people have this mutation making them more likely to have obesity because they can’t regulate what they eat- they don’t get the signalling they are full.

Body shape plays a role where do you hold your fat (stomach, lower body), how tall are you etc. and how healthy that is. How heavy is heavy in you before it becomes a problem.

We can test genetically and also look for intolerances- such as lactose intolerance, ability to metabolise caffeine, alcohol as well. Because these are linked to single genes.

Looking at Coeliac- you need to avoid gluten or it is extremely detrimental to your health. Coeliacs disease is serious. And this can be done via a tolerance test with subsequent blood testing to look for antibodies as well as a gastro-scope/endoscopy to look at the health of your intestine. This is done by your doctor and a referral to a gastroenterologist. If you think you have Coeliacs you should see your doctor and get tested because the repercussions of not sorting this can lead to cancer and the lack of ability to absorb any nutrients later. Due to inflammation causing the “microvilli” to flatted in the gastrointestinal track- we need these ridges and grooves to absorb food from the gastrointestinal tract. The also house enzymes, immune cells, bacteria etc.

Lactose intolerance develops in certain populations as we grow up. As babies we can handle lactose (so we can drink breast milk) but as we age 65% of adults loose the lactase enzyme. The gene is turned off in most adults so our tolerance and ability to absorb and breakdown lactose decreases. 15% of white northern Caucasians can handle milk and this doesn’t get turned off as well as some populations in northern Africa- where milk drinking continued from goats, sheep and cows and they do not turn off the lactase gene.

Intolerance the other hand makes your body work harder does stimulate some inflammation but isn’t as extreme as an allergic reaction. Gluten for example is something a lot of people have an intolerance to (this is different from coeliac) as it can be very irritating to the gastrointestinal tract. Most people can handle this minor irritation but for others if their immune system or gut is already inflamed they cannot.

Body Set Point

Our body likes to keep us at our “body set point”. Set point theory states that the human body tries to maintain its weight within a preferred range. Many people stay within a more or less small range of body weight throughout their adult life. In set point theory, if you suddenly start eating fewer calories, the way your body burns fuel (your metabolism) will slow down. You will burn fewer calories even if your activity level does not change. Your body may also change the way it absorbs nutrients. Your hormones could change and make you hungrier. These factors could make it easy for you to put weight back on. ‌

We have a body set point due to our body being designed to live in an environment for a feast and then famine environment. So out body wants to keep us at a stable weight for survival. When this set point is threatened we subconsciously change behaviours and also have some metabolism changes to adapt to thIs.

Lower calorie burn. Having a smaller body means that you use fewer calories. You may have to cut your intake again in order to keep your weight from returning.
Hormonal adjustments. Your levels of leptin may go down. Leptin is the hormone that makes you feel full. You may have to eat more to feel full. You may experience rises in ghrelin, the "hunger hormone." Your appetite may increase.
Focus on food. People who restrict calories often think about food more often. Research suggests that their sense of smell may be enhanced. When food smells and tastes better, we often eat more.

Now does that mean you can’t gain a new set point?

No- interestingly research is slowing if you keep weight off for 1-3years you can get a new set point. It is theorized that losing more than 10% of your body weight causes the body to fight back and make it more difficult to maintain weight loss. So Loosing weight in stages can help offs et this as your body adjusts to you new “normal”.

In 2021 a study published in Nutrient found probiotic supplementation helped slightly reduce body weight and fat percentage. If you’re thinking about supplementing or eating more probiotic-rich foods, talk to an RD or your doctor first to see how it can fit in with your goals.

Our metabolism itself doesn’t dip in our 40’s like many think- it dips in our 60’s. Why do we see weight gain in the 40’s/50’s then?

Metabolically the most active part of your body is your muscles. So the more muscle mass you have the faster your metabolic rate. Hence when you see those big muscle builder guys in the gym they can eat some crazy amounts of calories just to maintain that mass.
As we get older we exercise less and loose muscle mass due to this reduction in activity.
Women hormone changes as become peri-menopausal in later life and then menopausal – which affects metabolic rate and metabolism due to hormone changes.

The amount of muscle mass is one of the main factors for longevity that determinants for our health. Therefore exercise is so so so important. It should be its own prescription for health. But exercise is beneficial for so many other reasons such as the mental benefits etc. This mean resistance training in particular but cardio training is good for general health as well. That doesn’t mean a run but walking to increase NEAT.

The moment-to-moment calorie burn is known as non-exercise activity thermogenesis (NEAT). When you’re losing weight (and taking in fewer calories), you tend to subconsciously move less as your body wants to conserve energy and maintain weight. The fix: Add more NEAT to your life by taking the stairs, working at a stand-up desk, tending to your garden instead and cleaning up around your house when you have downtime.

Your basal metabolic rate (BMR) is the number of calories your body burns when you’re at rest (aka when you’re just sitting around breathing or while you’re sleeping). One way to shift your weight into a healthier range is to raise your BMR,

The weight on the scales is a tool. But if its triggering for you there are ways to track progress without using it.

BMI

BMI is another tool that helps look at populations for how we are tracking.

BMI= weight (kg) / height (m2)

At an individual level it is not so useful. Why? Because it is only taking height and weight into consideration, not bone structure, muscle mass etc. On a population level the higher the BMI usually the higher the body fat. But that’s my no measure should be used in isolation.

What is the problem with obesity- its not the weight itself it’s the diseases that are associated with this. I’m not saying big can not be beautiful and no matter your size you aren’t worthy of love. But overall we are becoming larger in society and that isn’t great for our health. But what that looks like for each individual is very different I’ll use me as an example: me at 90kg would be obese but on someone with a bigger bone structure more height that might be completely healthy and sexy 😊

We don’t gain fat cells

Now I used to think this in my 20’s as well if I gained weight- if I gained fat I must be gaining fat cells. But they don’t work like that. we have a certain number of fat cells in our body. But what they do is they soak up the excess carbs convert them to fats and the excess fat not used and become larger like a balloon being blown up. They can only store so much before there isn’t room left in these cells and then fat start being stored in the liver and elsewhere causing major health issues especially for the cardiovascular centre. Everyone fat cell’s ability to expand out and hold fat is different and this is based on your genetics. So a little bit of excess fat on me might be a problem but on your body with your genetics completely ok- because you can store more. That is why you can see skinny people with type 2 diabetes and larger people that are healthy. We each have our own safe fat carrying capacity. So this is why we need to judge less for those that are “fat” and those that are “skinny”. Because you don’t know if that is healthy or not just looking at the person.

We know that the “apple” shape holding fat around our midsection it is more likely to be visceral fat, than subcutaneous fat. Visceral fat hugs the organs and impacts their function it not where we want fat to be and is the fat associated with increase cardiovascular risk. It is proinflammatory and as we know fats secrete hormones- the visceral fat cells for example have 4x the cortisol receptors of subcutaneous fat. Some studies have even shown that with an increasing midsection with this visceral fat that there is shrinking in the brain (lower brain volume).

Food Principles And Calories

Protein makes you feel fuller for longer, in the hierarchy protein makes you feel fullest, then fats, then carbs. Why is that? Because protein has a more complex chemical structure and therefore it takes longer and more effort to break it down into its amino acid components.

As a rule of thumb anything that has to travel further down in the gut to be processed will make you feel fuller i.e. fibre, protein.

Hitting your protein target first is the main priority and then making up your diet with carbs and fats.

Protein requires more energy to process into amino acids. When we metabolise protein, we are only ever able to use 70% of the protein we eat. Therefore 30% is used up in this process of metabolism and energy required to digest and then use the amino acids. Therefore if you eat 10 cals of protein you can only use 7 cals by your body.

Calories tracking is great for helping you track what you are intaking. But the important factor with this is you need to track the protein, carbs and fat breakdown within this. What people call “tracking your macros”. That is way more beneficial than just counting calories alone. Because you can hit your calories and loose weight but you can loose your muscle mass if you don’t have adequate protein. It’s also important for women to have adequate fats as they are required for hormone production.

Caloric extraction of a food is how many calories you can get from that food versus how much you intake. An example is corn- you eat corn from the cob and most of that you will not absorb (you will see it in you stool/poo the next day). But grind corn up and turn it into a wrap you will absorb more and intake those calories. So say you had 100 cals of corn on the cob and ate 100 cals of corn wrap you will absorb more calories from the wrap than the cob. Even though its both still corn.

Why? Because some foods are harder for us to digest raw or on their own and cooking or processing them i.e. grinding them up help with the digestion process. Even celery because of all the fibre- eat a raw stick and that is 6 cals but cook it and eat it is now 30cals.

This is why when you are sick it’s good to have slow cooked stews, bone broths, soups etc because it is easier for your body to digest than foods like a raw salad. Where your body must work harder to break it down and absorb those nutrients. The cooking helps speed up the digestion process.

Why say all this and cause confusion?

So you know calorie counting is a tool not the be all and end off of a diet. It helps you stay on track and learn about foods but is not the only measure we need to look at. But it certainly does give us results and helps us actually have something to measure even if it is relative.

Supermarket labels are also allowed to be up to 20% inaccurate with what they say on there. But if you are wanting to see what you are actually having calorie and macro counting in particular is a really useful tool to get you where you want to be. Especially if you have a coach helping you get to what the particular goal is ie grow muscle or loose weight. I’ll explain what “toning” is in another post.

So whether you want to tweak your diet for health reasons, loose weigh or gain muscle food can be the medicine you need. Food is something we need to eat everyday and if you want to know more sign up to my nutrition coach or have a holistic health consultation to review your needs.

I have a My Fitness Pal guide that is pretty helpful too for those that do sign up 😊

References:

https://www.science.org/doi/10.1126/science.abk0297

https://bmjopensem.bmj.com/content/8/1/e001206

https://www.nature.com/articles/s43587-022-00357-y

https://clinicaltrials.gov/ct2/show/NCT00427193

https://www.webmd.com/diet/obesity/what-is-set-point-weight

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7922558/

https://pubmed.ncbi.nlm.nih.gov/35964910/

https://www.sciencedirect.com/science/article/abs/pii/S0268005X1630340X

https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0791-y

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2933649/

Mediterranean diet evidence

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The Ultimate Diet for Health