Archive | Health RSS feed for this section

Why Is Optimizing Protein Intake So Important?

23 May

Why Is Optimizing Protein Intake So Important?

By Tim Skwiat, MEd, CSCS, Pn2

When it comes to improving overall health, performance, body composition, appetite control, and satiety, there is arguably not a single more effective, well-established dietary factor than optimizing one’s protein intake. Research has shown that consuming diets higher in protein are not only safe for otherwise healthy individuals, they may provide a host of benefits. Higher protein diets may:

  • Accelerate fat loss and spare lean body mass while following a reduced-calorie diet.
  • Attenuate weight regain and contribute to long-term weight maintenance.
  • Optimize 24-hour muscle protein synthesis and facilitate the maintenance or building of muscle mass.
  • Boost metabolic rate.
  • Preserve metabolic rate after weight loss.
  • Increase satiety and improve appetite control.
  • Improve carbohydrate metabolism and glycemic regulation.
  • Increase calcium absorption.

++++

Establishing the ‘New Normal’

While the Institute of Medicine (IOM) has established a recommended dietary allowance (RDA) of protein intake at 0.8 grams of protein per kilogram of body weight per day (or, about 0.36 grams of protein per pound of body weight), research illustrates quite clearly and convincingly that an increase in dietary protein intake to at least TWICE (i.e., ≥ 1.6g/kg or 0.72 g/lb) that of the IOM recommendations may be “metabolically advantageous,” particularly for individuals looking to improve body composition (e.g., lose fat) as well as older adults (who are likely to lose muscle mass as they age) and physically active folks (e.g., athletes, military personnel, recreational exercisers).1

The International Society of Sports Nutrition’s (ISSN) Position Stand on Protein states that “protein intakes of 1.4–2.0 g/kg/day [0.63 – 0.91 grams of protein per pound] for physically active individuals is not only safe, but may improve the training adaptations to exercise training.” Further, the ISSN states, “While it is possible for physically active individuals to obtain their daily protein requirements through a varied, regular diet, supplemental protein in various forms are a practical way of ensuring adequate and quality protein intake for athletes.”2 Further, the American College of Sports Medicine, American Dietetic Association, and Dietitians of Canada support higher protein intakes in this range to optimize body composition and performance.3

According to a study published in the Proceedings of the Nutrition Society, renowned protein researcher Dr. Kevin Tipton from the University of Sterling suggests that a high-protein diet may be defined by as much as 35% of total daily caloric intake.4 What’s more, in a breakthrough study published in the journal Applied Physiology, Nutrition, and Metabolism, researchers revealed the RDA (Recommended Dietary Allowance) for protein has underestimated protein requirements by as much as 30 – 50%. Using a novel, validated scientific method, researchers have established that folks should be consuming as much as 35% of their total daily caloric intake from protein. Along these lines, researchers posit that one can optimize protein intake by eating 1.5 – 2.2 grams of high-quality protein per pound of body weight per day.5

++++

Show Me the Data

High-protein diets have been shown to accelerate fat loss and spare lean body mass while following a reduced-calorie diet. In one study published in the Journal of Nutrition, researchers from the University of Illinois found that women consuming 0.72 grams of protein per pound of bodyweight (about 125 grams per day or 30% of their total daily caloric intake) for 10 weeks had a 66% better ratio of fat to lean body mass loss compared to the “normal” protein group (who consumed half the amount of protein). This means the high-protein group lost MORE fat and LESS muscle—despite consuming the EXACT same amount of calories.6

Interestingly, when the same group of researchers, led by Dr. Donald Layman, combined exercise (5 days of walking plus 2 days of strength training), the effects of the high-protein diet were amplified. Over the course of 16 weeks, the folks combining a high-protein diet (about 30% of calories per day) with exercise lost 43% more fat than the “normal” protein group, who consumed the same number of calories and followed the same exercise program. Even more, compared to the normal protein group that dieted without exercise, the high-protein plus exercise group lost 75% more fat over the course of the 4-month study.7

In a recent randomized control trial published in The American Journal of Clinical Nutrition, researchers from McMaster University found that men combining a reduced-calorie high-protein diet (about 1 gram per pound of body weight per day) with a strenuous exercise program lost over 10 pounds of fat in 4 weeks—37% more than the low-protein group eating the same number of calories and performing the same exercise routine. What’s more, the high-protein group gained over 2.5 pounds of muscle­—despite heavy calorie restriction—while the low-protein group experienced no change. That’s the holy grail of body composition: Fat loss PLUS muscle gain!8

In a recent randomized control trial, a group of researchers from UCLA, led by Dr. Lorraine Evangelista, found that study participants consuming a high-protein diet for 12 weeks lost 77% more weight and dropped more than TWICE as much body fat than the standard protein group.9 In another recent randomized control trial, a group of German researchers, led by Dr. Marion Flechtner-Mors, found that folks consuming a high-protein diet for 12 months lost over TWICE as much weight as the standard-protein group.10

In yet another randomized control trial conducted at the University of Navarra in Pampalona, Spain, a research team led by Dr. Idoia Labayen found that obese women consuming a high-protein diet (about 30% of daily caloric intake) for 10 weeks lost nearly 10 MORE pounds (or, 92% more weight) and 88% more fat than the standard-protein group—once again, despite both groups eating the exact same number of calories.11

In another recent study, researchers from the University of California-Davis, led by Dr. Sidika Karakas, found that overweight women consuming a high-protein diet lost THREE times more weight and over SIX times more fat than the standard-protein group despite sticking to the same amount of reduced calories.12

One of the most objective analyses of the effects of an intervention (like high-protein diets) is something called a meta-analysis, in which researchers gather all of the studies on a particular topic and perform a highly sophisticated statistical analysis. Along these lines, in a meta-analysis of 24 weight-loss studies published in the American Journal of Clinical Nutrition, researchers from the University of South Australia found that high-protein diets led to significantly greater losses in body weight and body fat and spared losses in lean body mass and reductions in metabolic rate, which are common with standard-protein, reduced-calorie diets.13

The study authors concluded that, compared to standard-protein diets, high-protein diets (between 25 – 35% of total daily caloric intake) provide benefits for weight and fat loss and for mitigating losses in lean body mass and resting metabolic rate.

++++

No One-Trick Pony

What’s more, high-protein diets help attenuate weight regain and contribute to long-term weight maintenance. That’s right, not only have high-protein diets been shown to lead to greater fat loss and improvements in body composition during dieting trials, researchers have also found that high-protein diets increase compliance and long-term weight management.14 In a study published in the New England Journal of Medicine, researchers found that after dropping over 20 pounds during an 8-week weight loss trial, folks consuming a higher protein diet (25% of daily caloric intake) maintained body weight over the next 12 months whereas individuals consuming a standard-protein diet regained some of the weight lost.15

As mentioned above, high-protein diets also help preserve metabolic rate after weight loss.16 A common concern and consequence of standard-protein, reduced-calorie diets is a significant decline in metabolic rate, which frequently leads to weight regain. However, studies have shown that high-protein diets may conserve metabolic rate, and therefore, prevent weight regain. In one study published in the Journal of the American Medical Association, researchers found that metabolic rate was conserved to a significantly greater extent in folks who consumed a higher protein diet (30% of total calories) compared to individuals who consumed a lower protein diet (20% of total calories).17

One way by which high-protein diets may improve weight-loss outcomes is through increased satiety and improved appetite control. High-protein meals boost satiety, which means that protein-dense foods are much more likely to make you feel full and satisfied.18 What’s more, diets rich in high-quality proteins improve appetite control, as well as reduce daily food intake.19 In a recent study published in the Nutrition Journal, researchers from the University of Missouri found that consuming higher protein, dairy-based snacks (e.g., yogurt) improved satiety, appetite control, and limited subsequent food intake when compared to higher fat and higher carbohydrate-based snacks.20

++++

Balanced Bites

Many people tend to follow a skewed pattern of protein intake throughout the day. In other words, they might have a carbohydrate-dense breakfast (e.g., oatmeal, cereal, bagel) that contains just a few grams of protein, and at lunch, they may have a salad, sandwich, and/or soup that contain less than 20 grams of protein. Then, at dinner, they tend to have a large meal with their largest portion of protein for the day.

In fact, many people consume as much as 50% of their daily protein intake at a single meal in the evening.21 Contrary to this common pattern (referred to as a “skewed” intake of protein), research shows us that a “balanced” intake of protein throughout the day appears to be optimal to take advantage of the many beneficial attributes of protein.

For instance, in a study published in The Journal of Nutrition, researchers found that balancing protein intake over the course of three meals (about 30 grams of protein per meal) significantly increased muscle protein synthesis (by 25%) when compared to a “skewed” protein intake typical of the American diet.22

Why is this so important? Maximizing protein synthesis is paramount to looking, feeling, and performing your best regardless of your age or goals, and it’s especially important for improving body composition, optimizing metabolism, improving carbohydrate tolerance, avoiding age-related declines in muscle mass and metabolic rate, improving performance, and optimizing physical function.

In a separate study published in the American Journal of Physiology, researchers from McMaster University discovered equally impressive findings when they compared a balanced to a skewed protein intake combined with calorie restriction (i.e., dieting). In general, dieting results in a marked decrease in muscle protein synthesis, which typically leads to muscle loss. In fact, losses in lean mass may account for as much as 25% of the weight lost.23,24

The researchers found that a skewed protein intake combined with calorie restriction led to significantly greater reductions in muscle protein synthesis. In other words, a balanced protein intake “rescued” much of the normal decline seen in protein synthesis with dieting. Even more, they found that combining resistance training with a balanced protein intake completely rescued the decline in protein synthesis seen with energy restriction and skewed protein intake.25

As far as how much protein to eat, the research suggests at least 30 grams per meal (3 – 4 meals per day) as a starting point. More specifically, researchers suggest that about 0.18 grams per pound of bodyweight per meal seems to be optimal.26

++++

Take-Home Points

  • Optimizing protein intake is a well-established nutrition priority for looking, feeling, and performing your best.
  • Studies show that higher protein intakes accelerate fat loss, preserve lean body mass, promote recovery and performance, increase satiety, improve appetite control, reduce cravings, improve glycemic control, preserve metabolic rate, and attenuate weight regain.
  • The evidence suggests that an optimal protein intake may be between 0.7 – 0.9 grams of protein per pound of bodyweight per day as a starting point.
  • Research also suggests that a balanced intake of protein (versus a skewed intake) throughout the day may be optimal to maximize muscle protein synthesis. Based on the current body of research, an intake of around 0.18 grams of protein per pound of bodyweight per meal may be a good starting point.
  • Combining resistance training with an optimal protein intake appears to be superior (for body composition, health, performance) than a higher protein intake alone.
  • High-quality sources of protein are likely best and include: lean meats, poultry, fish/seafood, and wild game (preferably pasture-raised, wild, organic, etc., when appropriate); eggs (preferably pasture-raised); dairy (e.g., Greek yogurt, cottage cheese; preferably organic); protein supplements. [Note: Many protein studies use milk-based protein supplements (e.g., whey, casein), which are considered superior due to their protein quality (e.g., leucine content) and are often used to establish key baselines.]

++++

References:

  1. Pasiakos SM. Metabolic Advantages of Higher Protein Diets and Benefits of Dairy Foods on Weight Management, Glycemic Regulation, and Bone: Benefits of higher protein…. J Food Sci. 2015;80(S1):A2-A7. doi:10.1111/1750-3841.12804.
  2. Campbell B, Kreider RB, Ziegenfuss T, et al. International Society of Sports Nutrition position stand: protein and exercise. J Int Soc Sports Nutr. 2007;4(1):8. doi:10.1186/1550-2783-4-8.
  3. Rodriguez NR. Position of the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and Athletic Performance. J Am Diet Assoc. 2009;109(3):509-527. doi:10.1016/j.jada.2009.01.005.
  4. Tipton KD. Efficacy and consequences of very-high-protein diets for athletes and exercisers. Proc Nutr Soc. 2011;70(02):205-214. doi:10.1017/S0029665111000024.
  5. Pencharz PB, Elango R, Wolfe RR. Recent developments in understanding protein needs – How much and what kind should we eat? Appl Physiol Nutr Metab. April 2016:1-4. doi:10.1139/apnm-2015-0549.
  6. Layman DK, Boileau RA, Erickson DJ, et al. A reduced ratio of dietary carbohydrate to protein improves body composition and blood lipid profiles during weight loss in adult women. J Nutr. 2003;133(2):411-417.
  7. Layman DK, Evans E, Baum JI, Seyler J, Erickson DJ, Boileau RA. Dietary protein and exercise have additive effects on body composition during weight loss in adult women. J Nutr. 2005;135(8):1903-1910.
  8. Longland TM, Oikawa SY, Mitchell CJ, Devries MC, Phillips SM. Higher compared with lower dietary protein during an energy deficit combined with intense exercise promotes greater lean mass gain and fat mass loss: a randomized trial. Am J Clin Nutr. 2016;103(3):738-746. doi:10.3945/ajcn.115.119339.
  9. Evangelista LS, Heber D, Li Z, Bowerman S, Hamilton MA, Fonarow GC. Reduced body weight and adiposity with a high-protein diet improves functional status, lipid profiles, glycemic control, and quality of life in patients with heart failure: a feasibility study. J Cardiovasc Nurs. 2009;24(3):207-215. doi:10.1097/JCN.0b013e31819846b9.
  10. Flechtner-Mors M, Boehm BO, Wittmann R, Thoma U, Ditschuneit HH. Enhanced weight loss with protein-enriched meal replacements in subjects with the metabolic syndrome. Diabetes Metab Res Rev. 2010;26(5):393-405. doi:10.1002/dmrr.1097.
  11. Labayen I, Díez N, González A, Parra D, Martínez JA. Effects of protein vs. carbohydrate-rich diets on fuel utilisation in obese women during weight loss. Forum Nutr. 2003;56:168-170.
  12. Kasim-Karakas SE, Almario RU, Cunningham W. Effects of protein versus simple sugar intake on weight loss in polycystic ovary syndrome (according to the National Institutes of Health criteria). Fertil Steril. 2009;92(1):262-270. doi:10.1016/j.fertnstert.2008.05.065.
  13. Wycherley TP, Moran LJ, Clifton PM, Noakes M, Brinkworth GD. Effects of energy-restricted high-protein, low-fat compared with standard-protein, low-fat diets: a meta-analysis of randomized controlled trials. Am J Clin Nutr. 2012;96(6):1281-1298. doi:10.3945/ajcn.112.044321.
  14. Layman DK, Evans EM, Erickson D, et al. A Moderate-Protein Diet Produces Sustained Weight Loss and Long-Term Changes in Body Composition and Blood Lipids in Obese Adults. J Nutr. 2009;139(3):514-521. doi:10.3945/jn.108.099440.
  15. Larsen TM, Dalskov S-M, van Baak M, et al. Diets with High or Low Protein Content and Glycemic Index for Weight-Loss Maintenance. N Engl J Med. 2010;363(22):2102-2113. doi:10.1056/NEJMoa1007137.
  16. Soenen S, Martens EAP, Hochstenbach-Waelen A, Lemmens SGT, Westerterp-Plantenga MS. Normal protein intake is required for body weight loss and weight maintenance, and elevated protein intake for additional preservation of resting energy expenditure and fat free mass. J Nutr. 2013;143(5):591-596. doi:10.3945/jn.112.167593.
  17. Ebbeling CB, Swain JF, Feldman HA, et al. Effects of dietary composition on energy expenditure during weight-loss maintenance. JAMA. 2012;307(24):2627-2634. doi:10.1001/jama.2012.6607.
  18. Halton TL, Hu FB. The effects of high protein diets on thermogenesis, satiety and weight loss: a critical review. J Am Coll Nutr. 2004;23(5):373-385.
  19. Leidy HJ. Increased dietary protein as a dietary strategy to prevent and/or treat obesity. Mo Med. 2014;111(1):54-58.
  20. Ortinau LC, Hoertel HA, Douglas SM, Leidy HJ. Effects of high-protein vs. high- fat snacks on appetite control, satiety, and eating initiation in healthy women. Nutr J. 2014;13:97. doi:10.1186/1475-2891-13-97.
  21. USDA Agricultural Research Service. Energy Intakes: Percentages of Energy from Protein, Carbohydrate, Fat, and Alcohol, by Gender and Age, What We Eat in America, NHANES 2009–2010.; 2012. http://www.ars.usda.gov/Services/docs.htm?docid=18349.
  22. Mamerow MM, Mettler JA, English KL, et al. Dietary Protein Distribution Positively Influences 24-h Muscle Protein Synthesis in Healthy Adults. J Nutr. 2014;144(6):876-880. doi:10.3945/jn.113.185280.
  23. Weinheimer EM, Sands LP, Campbell WW. A systematic review of the separate and combined effects of energy restriction and exercise on fat-free mass in middle-aged and older adults: implications for sarcopenic obesity. Nutr Rev. 2010;68(7):375-388. doi:10.1111/j.1753-4887.2010.00298.x.
  24. Areta JL, Burke LM, Camera DM, et al. Reduced resting skeletal muscle protein synthesis is rescued by resistance exercise and protein ingestion following short-term energy deficit. AJP Endocrinol Metab. 2014;306(8):E989-E997. doi:10.1152/ajpendo.00590.2013.
  25. Murphy CH, Churchward-Venne TA, Mitchell CJ, et al. Hypoenergetic diet-induced reductions in myofibrillar protein synthesis are restored with resistance training and balanced daily protein ingestion in older men. Am J Physiol – Endocrinol Metab. 2015;308(9):E734-E743. doi:10.1152/ajpendo.00550.2014.
  26. Moore DR, Churchward-Venne TA, Witard O, et al. Protein Ingestion to Stimulate Myofibrillar Protein Synthesis Requires Greater Relative Protein Intakes in Healthy Older Versus Younger Men. J Gerontol A Biol Sci Med Sci. 2015;70(1):57-62. doi:10.1093/gerona/glu103.

 

Detox Diets and Cleanses: Health Boost or Recipe for Disaster?

4 Jan

Detox Diets and Cleanses: Health Boost or Recipe for Disaster?

By Tim Skwiat, MEd, CSCS, Pn2

There’s no doubt about it, the promises of detox diets and cleanses are alluring:

  • “Jump start your weight loss”…
  • ”Eliminate impurities”…
  • ”Drop 21 pounds in 10 days”…
  • ”Expel toxins”…
  • ”Revitalize and re-energize your body”…
  • ”Whisk away polluting nasties”…
  • ”Fast, easy weight loss”…
  • ”Purify the body”…
  • “Lose weight like the celebrities”…
  • ”Flush away toxins”

But do these plans work? Can they provide the health boosts they guarantee? Are they the perfect recipe that the proponents would like you to believe? Or, are they a recipe for disaster and self-sabotage, contributing to a vicious cycle and reinforcing poor eating habits and relationships with food?

++++

One of the most challenging aspects of assessing the various detox diets and cleanses, which are typically characterized by severe food and energy (i.e., calorie) restriction, is that you’d be hard-pressed to find a specific scientific definition of either, which are typically interchangeable terms.

In the Detox Dossier, an investigation by the Voice of Young Science (VoYS) into 15 different products and special diets that are widely promoted as detoxes, a group of researchers found that no two companies use the same definition for “detox.”1,2 Not only that, the VoYS found that no program or company could name the supposed “toxins” targeted by its detox, and the proponents provided little—and in most cases, no—evidence to back up detox claims.

The VoYS concluded, “No one we contacted was able to provide any evidence for their claims, or give a comprehensive definition of what they meant by ‘detox.’ We concluded that ‘detox’ as used in product marketing is a myth. Many of the claims about how the body works were wrong and some were even dangerous.”

In other words, there’s virtually no agreement on what a detox diet is, and what’s more, not even the creators of these detox diets can verify what toxins they aid in eliminating nor provide any evidence that they actually “work.”

Along those lines, while the detox industry promotes “purification,” “cleansing,” and “elimination,” it’s incredibly important to point that the human body has evolved highly sophisticated mechanisms for eliminating toxins. The liver, kidneys, gastrointestinal system, skin, and lungs all play a role in the excretion of unwanted substances, without chemical intervention. For example, the liver and kidneys both serve as exceptionally effective “detox” organs, converting toxic chemicals into less harmful ones and promoting the excretion of unwanted chemicals.

In its Debunking Detox Leaflet, the VoYS echoes the above: “Your body is capable of removing most potentially harmful chemicals you will encounter in your daily life. The human body has evolved to get rid of unnecessary substances through your liver, kidneys, and colon. It isn’t possible to improve their function without medical assistance.”3

The VoYS is not the only group of health professionals that’s out to set the record straight on the topic of detox diets. The Dietitians Association of Australia have also heavily criticized several popular detoxes, which can result in the loss of healthy gut bacteria and electrolytes.4

Dietitian Melanie McGrice says, “The problem with fad diets is that they’re all about restrictive eating patterns that you can’t stick to over the long haul and may even undermine your health. What you lose on these detox diets is usually fluid, healthy gut bacteria, electrolytes—all the things to keep your body healthy—rather than fat. And you don’t need to go on a severe detox because your body has an inbuilt detox system: the lungs, liver, and kidneys working every minute of the day.”

In a study published in the Journal of Human Nutrition and Dietetics, researchers Professor Hosen Kiat, Head of Cardiology at Macquarie University Hospital and the Australian School of Advanced Medicine, and Dr. Alice Klein from the Cardiac Health Institute conducted a thorough review of the currently available research to assess whether there was any clinical evidence to support the use of detox diets for weight management or toxin elimination. They concluded, “Although the detox industry is booming, there is very little clinical evidence to support the use of these diets. To the best of our knowledge, no randomized controlled trials have been conducted to assess the effectiveness of commercial detox diets in humans.”5

The researchers also identified a number of concerns and potential health risks. For instance, detox diets typically involve severe calorie restriction and nutritional inadequacy. Professor Kiat said, “In assessing one detox diet we found that, based on the average person’s minimum daily energy requirement, it does not meet daily protein requirements for anyone who weighs more than 23 kg [i.e., 50 pounds].”

The take-home point is that there’s no medical evidence indicating that specialized detoxification programs are needed to rid the body of toxins. With that being said, just because the body is equipped with the machinery it needs to “cleanse” and “detoxify” itself and to do so remarkably well, that does not mean that exposure to pollutants, pesticides, food additives, etc., is not a big deal. That point should not be lost; however, it is to say that these approaches do not appear to be effective solutions or quick fixes in that regard.

++++

As mentioned above, another reason that folks turn to these drastic approaches is to promote weight management. As Professor Kiat and Dr. Klein’s extensive review demonstrated, there’s very little clinical evidence to support this.5 But there’s much more to the story to consider.

While these popular diets help control energy balance, detox diets typically involve severe energy restriction and nutritional inadequacy, which can lead to protein and vitamin deficiencies, electrolyte imbalances, lactic acidosis, as well as decrements in performance (mental and physical), hormonal imbalances, hair loss, and much, much worse. (Yes, even death.)

Even more, this type of approach lends itself to weight cycling, which may be more commonly recognized as “yo-yo dieting.” Numerous studies have provided evidence that weight cycling increases one’s risk of insulin resistance, type 2 diabetes, and cardiovascular disease.6–8 While very-low-calorie diets (VLCD) like these may lead to significant short-term weight loss, VLCDs do not lead to greater long-term weight loss compared to more moderate reduced-calorie diets.9

For those folks who find themselves resorting to this vicious cycle, it’s important to mention that long-term calorie restriction has been shown to lead to significant reductions in metabolic rate that rival that of life-threatening malnutrition and starvation.10 In other words, chronic dieters—who are often the type to gravitate toward extreme approaches such as detox diets and cleanses—are at risk of a drastically reduced metabolic rate that significantly exceeds what would be predicted by age, sex, and body composition.

It’s also noteworthy to point out that a significant percentage of the short-term weight loss associated with VLCDs is fat-free mass (e.g., muscle mass, glycogen, body water), not body fat. This disproportionate loss in fat-free mass (FFM) is one contributor to a decreased metabolic rate, as FFM comprises the metabolically active tissues of the body, and may also predispose one to weight regain.11,12

When talking about extreme energy restriction, such as the case with the majority of these programs, it’s also important to discuss metabolic adaptation (i.e., adaptive thermogenesis), which refers to the decrease in energy expenditure beyond what can be explained by a loss in FFM.13 In the face of dangerously low energy supplies and stores, this form of energy conservation, which is characterized by reductions in key hormones (e.g., leptin, thyroid hormone, insulin, catecholamines), is a biologically meaningful survival mechanism.10,14,15

However, most people who engage in these restrictive diets generally aren’t trying to get themselves ready for some sort of apocalypse involving a food shortage. Rather, they tend to be using them as a vehicle to optimize body composition, health, and/or performance, and considering that studies show that metabolic adaptation is proportionate to the degree of energy imbalance, this shouldn’t be viewed favorably. Not only are intense energy-restrictive diets tough to maintain, they trigger the body to suppress its resting metabolic rate (RMR) by as much as 20%.9,16

Another fundamental concept to consider is that a crucial component of effective weight management plans and an overall healthy lifestyle is regular physical activity. Rarely do detox diets or cleanses promote exercise, and considering that many of these programs severely restrict caloric intake, not enough calories are being consumed to fuel physical activity. This is important for a number of reasons, one of which is that adding exercise to a weight loss program tends to help spare FFM.17–19

A key objective during weight loss is to reduce body fat while minimizing loss of FFM to promote optimal overall health, metabolic function, cardiovascular health, and physical functioning. This is why an emphasis should be placed on fat loss as opposed to weight loss.

++++

Some might consider highly-restrictive plans like these (i.e., detox diets, cleanses) as “quick fixes,” but truth be told, they’re not really fixing anything. In fact, as outlined above, they’re quite possibly making things worse. With reductions in RMR (via reduced FFM and adaptive thermogenesis), one is putting him/herself at a greater predisposition for weight regain.

This is particularly true because these plans do little to teach folks how to eat or help them overcome individual limiting factors (e.g., creating a healthy food environment, preparing healthy food choices, cultivating a healthy relationship with food). Not only that, programs like these that heavily restrict both calories and specific foods and food groups make folks more prone to oversconsumption of high-calorie, highly palatable foods via metabolic adaptation and through the activation of hedonic pathways.20 Severe restriction increases appetite (via “hunger hormones”), as well as the activity of hunger and food reward centers. That’s right, “junk food” becomes even tastier, and an even greater amount of it is craved by the body to satisfy its “needs.”

It’s indeed plausible that one could feel better during a detox diet or cleanse. With that in mind, it’s important to point out where some of these plans may go “right.” This most likely is a result of dietary displacement, which simply means replacing less-healthy options with healthier ones. On one hand, if the detox increases one’s consumption of vegetables and fruits, then s/he is going to be bringing in copious amounts of micronutrients, fiber, and phytonutrients, all of which can have a beneficial effect on healthy, body composition, metabolism, feelings of wellbeing, and energy levels.

Conversely, dietary displacement also takes into account you are not eating when following one of these detox diets. If one’s diet resembles anything like that of the typical Western diet, then these types of programs will substantially reduce the overconsumption of energy and processed foods, and that means reductions in calorie intake, sugar, refined grains, and added fats and oils (i.e., industrial vegetable oils).

Research shows that the typical Western diet leads to increased incidence of obesity, metabolic syndrome, oxidative stress, chronic inflammation, cognitive dysfunction, and various chronic diseases and forms of cancer.21–24 Simply by process of elimination, one may look and feel better. That’s not to say that a detox diet is a “good” plan; rather, this highlights how poor typical eating behaviors truly are.

++++

Rather than resorting to an extremist approach that does nothing to promote good nutrition behaviors, teach you how to eat, encourage a healthy relationship with food, or promote a healthy food environment, focus on making changes that support long-term healthy habits. Not only do you not have to suffer and deprive yourself through dramatic restriction, you can enjoy great-tasting whole foods and fully support your health and body composition goals.

In the grand scheme of things, your health, fitness, performance, and body composition are contingent on your entire body of “nutrition work”—not an individual food or special diet. In other words, there’s no “magic bullet.” Instead of viewing foods in isolation as “good” or “bad” or thinking you need to “go on a diet,” think about weight management and “deep health” as the product of practicing healthy eating habits, creating a positive food environment, and choosing high-quality, nutritious foods in appropriate amounts relative to your goals and activity levels regularly and consistently over time. Good nutrition takes practice, and just like getting better and mastering anything in life, it’s about progress—not perfection.

Start where you are and make small changes that you are ready, willing, and able to take on; focus on mastering those new behaviors, one step at a time.

Helpful next steps:

++++

References:

  1. Voice of Young Scientists. THE DETOX DOSSIER. Sense About Science; 2009. http://www.senseaboutscience.org/data/files/resources/48/Detox-Dossier-Embargoed-until-0001-5th-jan-2009.pdf.
  2. Sense about Science. Debunking detox. Sense Sci. January 2009. http://www.senseaboutscience.org/pages/debunking-detox.html.
  3. Voice of Young Scientists. Debunking detox leaflet. January 2009. http://www.senseaboutscience.org/data/files/resources/49/Detox-leaflet-Final-Embargoed-until-050109remargin.pdf.
  4. NewsMail. Dietitians reveal the three worst diets for your health. January 2014. http://www.news-mail.com.au/news/dietitians-reveal-three-worst-diets-your-health/2132566/.
  5. Klein AV, Kiat H. Detox diets for toxin elimination and weight management: a critical review of the evidence. J Hum Nutr Diet Off J Br Diet Assoc. 2015;28(6):675-686. doi:10.1111/jhn.12286.
  6. Li Z, Hong K, Wong E, Maxwell M, Heber D. Weight cycling in a very low-calorie diet programme has no effect on weight loss velocity, blood pressure and serum lipid profile. Diabetes Obes Metab. 2007;9(3):379-385. doi:10.1111/j.1463-1326.2006.00621.x.
  7. Waring ME, Eaton CB, Lasater TM, Lapane KL. Incident Diabetes in Relation to Weight Patterns During Middle Age. Am J Epidemiol. 2010;171(5):550-556. doi:10.1093/aje/kwp433.
  8. Olson MB, Kelsey SF, Bittner V, et al. Weight cycling and high-density lipoprotein cholesterol in women: evidence of an adverse effect. J Am Coll Cardiol. 2000;36(5):1565-1571. doi:10.1016/S0735-1097(00)00901-3.
  9. Tsai AG, Wadden TA. The evolution of very-low-calorie diets: an update and meta-analysis. Obes Silver Spring Md. 2006;14(8):1283-1293. doi:10.1038/oby.2006.146.
  10. Weyer C, Walford RL, Harper IT, et al. Energy metabolism after 2 y of energy restriction: the biosphere 2 experiment. Am J Clin Nutr. 2000;72(4):946-953.
  11. Müller MJ, Bosy-Westphal A, Kutzner D, Heller M. Metabolically active components of fat-free mass and resting energy expenditure in humans: recent lessons from imaging technologies. Obes Rev Off J Int Assoc Study Obes. 2002;3(2):113-122.
  12. Faria SL, Kelly E, Faria OP. Energy expenditure and weight regain in patients submitted to Roux-en-Y gastric bypass. Obes Surg. 2009;19(7):856-859. doi:10.1007/s11695-009-9842-6.
  13. Camps SGJA, Verhoef SPM, Westerterp KR. Weight loss, weight maintenance, and adaptive thermogenesis. Am J Clin Nutr. 2013;97(5):990-994. doi:10.3945/ajcn.112.050310.
  14. Heilbronn LK, de Jonge L, Frisard MI, et al. Effect of 6-Month Calorie Restriction on Biomarkers of Longevity, Metabolic Adaptation, and Oxidative Stress in Overweight Individuals: A Randomized Controlled Trial. JAMA. 2006;295(13):1539. doi:10.1001/jama.295.13.1539.
  15. Rosenbaum M, Leibel RL. 20 YEARS OF LEPTIN: Role of leptin in energy homeostasis in humans. J Endocrinol. 2014;223(1):T83-T96. doi:10.1530/JOE-14-0358.
  16. Knuth ND, Johannsen DL, Tamboli RA, et al. Metabolic adaptation following massive weight loss is related to the degree of energy imbalance and changes in circulating leptin. Obes Silver Spring Md. 2014;22(12):2563-2569. doi:10.1002/oby.20900.
  17. Garrow JS. Exercise in the treatment of obesity: a marginal contribution. Int J Obes Relat Metab Disord J Int Assoc Study Obes. 1995;19 Suppl 4:S126-S129.
  18. Redman LM, Heilbronn LK, Martin CK, et al. Effect of calorie restriction with or without exercise on body composition and fat distribution. J Clin Endocrinol Metab. 2007;92(3):865-872. doi:10.1210/jc.2006-2184.
  19. Stiegler P, Cunliffe A. The role of diet and exercise for the maintenance of fat-free mass and resting metabolic rate during weight loss. Sports Med Auckl NZ. 2006;36(3):239-262.
  20. Greenway FL. Physiological adaptations to weight loss and factors favouring weight regain. Int J Obes. 2015;39(8):1188-1196. doi:10.1038/ijo.2015.59.
  21. Heinonen I, Rinne P, Ruohonen ST, Ruohonen S, Ahotupa M, Savontaus E. The effects of equal caloric high fat and western diet on metabolic syndrome, oxidative stress and vascular endothelial function in mice. Acta Physiol Oxf Engl. 2014;211(3):515-527. doi:10.1111/apha.12253.
  22. Lutsey PL, Steffen LM, Stevens J. Dietary Intake and the Development of the Metabolic Syndrome: The Atherosclerosis Risk in Communities Study. Circulation. 2008;117(6):754-761. doi:10.1161/CIRCULATIONAHA.107.716159.
  23. Cordain L, Eaton SB, Sebastian A, et al. Origins and evolution of the Western diet: health implications for the 21st century. Am J Clin Nutr. 2005;81(2):341-354.
  24. Kanoski SE, Davidson TL. Western diet consumption and cognitive impairment: Links to hippocampal dysfunction and obesity. Physiol Behav. 2011;103(1):59-68. doi:10.1016/j.physbeh.2010.12.003.

Habits of Highly Effective Nutrition Plans

5 Nov

Habits of Highly Effective Nutrition Plans

Tim Skwiat, CSCS, Pn2

While there are quite a few effective nutrition programs out there, there’s not necessarily a single, universal “best” option. In fact, in a recent article published in the prestigious Journal of the American Medical Association, researchers compared various popular diets differing in macronutrient composition, and they found that differences in weight loss and metabolic risk factors were small (i.e., less than a couple of pounds) and inconsistent.1

What they did find, however, was that the single-most important factor influencing weight loss and improvements overall health (i.e., disease-risk outcomes) was adherence, or the ability of folks to stick with a program and consistently meet program goals for diet and physical activity. This led for the researchers to “call for an end to the diet debates.”

In the POUNDS Lost study, published in the New England Journal of Medicine, researchers compared four different diets (with varying amounts of carbohydrates, proteins, and fats), and they found that “reduced-calorie diets result in meaningful weight loss regardless of which macronutrients they emphasize.”2

With all of that being said, there are some common themes—criteria, if you will—amongst the most effective nutrition plans, including:3

  • They raise awareness and attention.
  • They focus on food quality.
  • They help eliminate nutrient deficiencies.
  • They help control appetite and food intake.
  • They promote regular exercise and physical activity.

While there may be no universal “best” diet, there may be a best option for you, and that’s what’s most important. How can you begin to find what works best for you? The following Habits of Highly Effective Nutrition Plans is a great place to start.

++++

Habit 1: Eat slowly and mindfully. For fat loss, there are two habits that you’ll need to master, and speaking generally—when combined with good food quality and done consistently—these two simple tools are typically enough for almost all clients to lose fat:

  • Eat slowly.
  • Eat until 80% full (i.e., just until satisfied; no longer hungry, but not “full”).

Slow eating provides a host of benefits:

  • Slow eating helps you “check in” and be present, pay attention, and sense into the cues that your body is sending you, why you’re eating, etc.
  • Slow eating allows you to sense into your body’s internal hunger/satiety cues.
  • Slow eating creates awareness of food textures, tastes, and smells.
  • Slow eating enhances digestion.
  • Slow eating doesn’t depend on controlling what you eat. It can be done any time, anywhere, and no matter what’s on your plate or who’s around, you can always eat slowly.
  • Slow eating makes you and your body the boss. You don’t have to rely on eternal cues and control methods (e.g., calorie counting, weighing/measuring food, points, etc.), and relinquishing external control gives you more real control.

Slow eating also ties into another extremely important component of how to eat: Learning appetite awareness. This is key to distinguishing when you feel that want to eat, need to eat, and have eaten enough (or too much). This ties into the concept of eating until 80% full, which you can track using this handy 80% Full Food Journal. Incorporating an Appetite Awareness Tracker along with the aforementioned food journal can be quite helpful in this regard as well.

If you can master the art of eating slowly and mindfully and learn to sense into (and listen to) your physical cues, you will be well on your way to improving your health, body composition, and vitality. You’ll be a nutrition ninja!

Extra Credit ==> Mindful Eating: HOW Do You Eat?

++++

Habit 2: Eat protein-dense foods with each meal. When it comes to improving body composition (e.g., losing fat, building/retaining muscle), optimizing protein intake may be one of the single most important dietary and lifestyle changes that one can make. Protein-dense foods increase satiety (i.e., feeling of fullness) and thermogenesis (i.e., boost the metabolism), and high-protein diets have consistently been proven to be effective at improving body composition (e.g., fat loss), preserving metabolic rate, and improving overall health (e.g., better blood lipids, blood sugar management, insulin concentrations).4–6

Increasing protein intake means moving from “surviving” to “thriving” and from “adequate” to “optimal.” Ideally, you should aim to consume a portion of protein-dense foods with each meal. Generally speaking, one palm-sized portion of protein is equivalent to approximately 20 – 30 grams of protein, and we recommend that:

[If you like to “count,” then a good rule of thumb is probably somewhere around 0.18 grams of protein per pound of bodyweight per feeding.]

Your best protein options include:

  • Lean meats, poultry, fish/seafood, and/or wild game (preferably grass-fed, pasture-raised, organic, etc., when appropriate)
  • Eggs (preferably pasture-raised, which is distinct from free-range and cage-free)
  • Lean dairy, especially Greek yogurt (with live cultures) and cottage cheese (preferably grass-fed, pasture-raised)

As noted above, there are a number of beneficial outcomes associated with a higher protein intake, and most experts tend to agree that folks can optimize protein intake by consuming about 0.7 – 0.9 grams per pound of bodyweight per day. This can be tricky, and this is why a protein supplement like BioTRUST Low Carb is “foundational” for the overwhelming majority of folks.

Bonus recommendation ==> Branched-chain amino acids, which play an intricate role in muscle building and recovery (particularly leucine), reduce muscle breakdown, and help regulate blood sugar levels. BCAAs are particularly useful during exercise, and they may also be especially applicable when protein needs aren’t being met (e.g., fasting, not enough protein at a given meal). What’s more, there’s some evidence to suggest that BCAA supplementation may be especially important (to help maintain muscle and metabolic rate) for older folks, whose protein absorption mechanisms may not be as effective.7

++++

Habit 3: Eat vegetables with each meal. Mom and grandma were right: Veggies are good for your health and your body composition. Studies show folks who eat more veggies tend to do a better job of losing fat and keeping it off. What’s more, a diet high in vegetables helps balance the body’s pH, which is important for both bone and muscle strength. Vegetables have a high nutrient-density and low energy-density, which means that you can consume a relatively large volume comparative to their calorie content. (See Move More, Eat MORE for more on this.)

While vegetables are also packed with important micronutrients (e.g., vitamins and minerals), they are also loaded with important phytochemicals that are necessary for optimal physiological functioning. These same plant chemicals often serve as anti-oxidants that combat oxidative stress, one of the most important factors mediating the deleterious effects of aging.8–10

Vegetables can essentially be prepared any way that you like (and it’s a good idea to include some healthy fats to maximize absorption of key nutrients),11–13 and while there’s not a limit on the number of non-starchy vegetables that you can include, the following is a good starting point:

Generally speaking, the more color (and the more varieties of colors) means the greatest array of beneficial phythonutrients, and it’s a good idea to consume a variety of vegetables each day. To optimize health, you may consider trying to include at least one serving of each of the primary colors each day:

  • Greens: Various lettuces, spinach, kale, arugula, Brussels sprouts, broccoli, asparagus, zucchini
  • Reds: Tomatoes, red bell peppers, red cabbage
  • Oranges: Carrots, orange bell peppers, various squashes, pumpkin
  • Whites: Onions, garlic, parsnips, cauliflower, yellow squash
  • Purples: Eggplant, purple cabbage, beets

For more examples, please see the World’s Healthiest Foods list.
Bonus recommendation ==> Supplement with a greens powder, which contain vegetables, fruits, grasses, etc., that have been distilled into powder form. While not necessarily a substitute for eating whole vegetables and fruits, greens powders are a good option to add to smoothies, when traveling, and for folks who struggle with adding vegetables to each meal.

++++

Habit 4: Carbohydrate intake should match activity levels. For fat loss, most people will do better by reducing carbohydrate intake, but it doesn’t mean that a low-carb diet is necessary. Rather, a controlled-carbohydrate diet seems to work best. Generally speaking, most people will do best with some carbs, with appropriate adjustments made for activity level, goals, and body type. In other words, the more active you are, the more smart carbs you’ll need; on the other hand, sedentary folks, especially those who are trying to lose fat and/or have more endomorphic body types, typically need fewer carbohydrates.

While there is often debate about low-fat versus low-carbohydrate diets and whether or not there are any metabolic advantages (there doesn’t seem to be any given the data at this time), there is some evidence to suggest that an individual’s insulin sensitivity status may influence the outcome of a reduced-calorie diet.14 For instance, in a study published in the journal Diabetes, Obesity and Metabolism, researchers found that folks with poor insulin sensitivity lost less weight on a low-fat, high-carbohydrate diet compared to more insulin sensitive folks (as well as compared to folks who followed a high-fat, low-carbohydrate diet, regardless of insulin sensitivity status).15

Why? Adherence (or lack thereof): Folks with a poor insulin sensitivity status had a much more difficult time sticking to the low-fat, high-carbohydrate diet, and as a result, they were much less likely to lose weight. Why did they have trouble sticking to it? It’s hard to say for certain, but we can speculate that their less-than-stellar carbohydrate metabolism induced a sequence of hormonal and metabolic changes that increases hunger and energy intake (after consuming a low-fat, high-carbohydrate meals).

Overall, when it comes to choosing smart carbs, the emphasis should be placed on whole, minimally-processed foods that are slow-digesting and high in fiber. Some folks find that consuming the majority of these carbs after exercise is best for body composition and recovery. When carbohydrates are added to meals (not necessarily every meal), the following is a good starting point:

Again, carb intake should be proportionate to activity levels, and particularly when the goal is fat loss, a portion may not be included at each feeding. For advanced folks, focusing on including carbs in the hours after exercise may be optimal. When you do choose to add carbs to a meal, the following are the best choices:

  • Colorful, starchy vegetables (e.g., sweet potatoes, purple potatoes, winter squashes)
  • Colorful fruits (e.g., berries)
  • Other sweet/starchy fruits and vegetables (e.g., bananas, plantains, potatoes)
  • Legumes (e.g., lentils and beans)
  • Whole, intact grains (rather than foods made from processed flours), including whole or steel-cut oats; wild, brown, or red rice; quinoa, amaranth, or buckwheat groats; sprouted grains; kamut or spelt grains; maize; millet; and barley
  • Other whole grain products (e.g., sprouted grains)

Bonus recommendation ==> Managing blood sugar and insulin concentrations are key to optimizing body composition, health, and performance. Supplements like IC-5 can help improve carb tolerance, insulin sensitivity, and metabolic flexibility, which are key players in weight management.

++++

Habit 5: Eat healthy fats daily. Don’t fear the fat! Despite a bad rap, fat does NOT make you fat. In fact, healthy fats from whole foods play important roles in manufacturing and balancing hormones. They also form our cell membranes and brains and nervous systems. They also transport important vitamins and minerals.

Healthy fats are critical for recovery and repair and supporting mental health and feelings of wellbeing. Fats slow gastric emptying and the release of glucose into the bloodstream (i.e., reduce the glycemic response), and furthermore, studies show that consuming fats can reduce the amount of food eaten in subsequent meals.

Generally speaking, the following are good starting points for portion sizes:

The key is to balance fats, and a variety of healthy fats usually does the trick:

  • Raw nuts (e.g., walnuts, almonds, cashews, etc.) and nut butters (e.g., almond butter)
  • Raw seeds (e.g., pumpkin seeds, chia seeds, hemp seeds)
  • Olives and extra-virgin olive oil
  • Avocado
  • Butter (preferably from grass-fed cows, e.g., Kerrygold)
  • Fresh coconut, coconut milk, and extra-virgin coconut oil
  • Cold-pressed, extra-virgin oils (e.g., walnut, macadamia nut, avocado, hemp, pumpkin, flax)
  • Fatty fish (e.g., wild salmon, mackerel)

Bonus recommendation ==> Supplement with omega-3 fatty acids, which, for the overwhelmingly majority of folks, will be “foundational.” For more on why this (i.e., fish oil) is such an important supplement, please refer to the following article:

The Benefits Of Omega-3 Fatty Acid Supplementation

++++

In sum, for most people who are eating 3 – 4 meals per day, the following is a good starting point:

  • 1 – 2 palm-sized portions of protein
  • 1 – 2 fist-sized portions of vegetables
  • 1 – 2 thumb-sized portions of healthy fats
  • 1 – 2 cupped-handful portions of carbohydrates can be added as needed (i.e., not every meal), depending on activity levels, goals, and body type.

With all of that being said, this is just a starting point. Remember to practice the first Habit, which emphasizes how you eat. Tune into your internal cues (e.g., satiety, appetite) to gauge what works best for you. In other words, find and do what works (for you). Focus on food quality and emphasize building a solid foundation of high-quality nutrition, done consistently.

Depending on where you are in your journey, you might start with something small, like adding a fish oil supplement to help balance your fat intake and reduce inflammation. From there, you might want to make sure that you consume a portion of lean protein at each feeding. Once you’ve nailed that, you might make sure that you’re consuming some colorful vegetables and/or fruits with each feeding.

In other words, take it one step at a time and focus on working on one change or new habit. Direct all of your time and energy into something that you are ready, willing, and able to do. Master that task or habit, and then take that next step. As Robert Collier said, “Success is the sum of small efforts, repeated day in and day out.”

Many find this step-like, habit-based approach to be far more tolerable, and more importantly, successful for long-term behavior change and weight management. However, some folks need or desire to make bigger changes, faster (e.g., athletes making weight, preparing for an event). In these cases, it’s important to understand that you’ll need to tolerate a greater amount of discomfort and disruption to your routine. Worry not, we’re here to support and encourage you every step of the way.

Notice and name what you do well and where you need help. Are there certain challenges that you face? The more awareness (here’s that mindfulness thing again) that you have of your habits, behaviors, and triggers, the more proactive that you can be in your approach to good nutrition. Remember, good nutrition (and being healthy) is not about perfection; it’s about improvement. It’s about the process—the journey. It’s about making the best, wise choices, as often as possible. It’s about living with purpose and getting up each day being your “best self,” with integrity. It’s about chasing health and wellness.

++++

Bonus resources:

Additional references used for this article: 16,17

References:

  1. Pagoto SL, Appelhans BM. A Call for an End to the Diet Debates. JAMA. 2013;310(7):687. doi:10.1001/jama.2013.8601.
  2. Sacks FM, Bray GA, Carey VJ, et al. Comparison of Weight-Loss Diets with Different Compositions of Fat, Protein, and Carbohydrates. N Engl J Med. 2009;360(9):859-873. doi:10.1056/NEJMoa0804748.
  3. Berardi J. Paleo, vegan, intermittent fasting…Here’s how to choose the best diet for you. Precis Nutr. http://www.precisionnutrition.com/best-diet.
  4. Paddon-Jones D, Westman E, Mattes RD, Wolfe RR, Astrup A, Westerterp-Plantenga M. Protein, weight management, and satiety. Am J Clin Nutr. 2008;87(5):1558S – 1561S.
  5. Soenen S, Martens EAP, Hochstenbach-Waelen A, Lemmens SGT, Westerterp-Plantenga MS. Normal protein intake is required for body weight loss and weight maintenance, and elevated protein intake for additional preservation of resting energy expenditure and fat free mass. J Nutr. 2013;143(5):591-596. doi:10.3945/jn.112.167593.
  6. Westerterp-Plantenga MS, Nieuwenhuizen A, Tomé D, Soenen S, Westerterp KR. Dietary protein, weight loss, and weight maintenance. Annu Rev Nutr. 2009;29:21-41. doi:10.1146/annurev-nutr-080508-141056.
  7. Casperson SL, Sheffield-Moore M, Hewlings SJ, Paddon-Jones D. Leucine supplementation chronically improves muscle protein synthesis in older adults consuming the RDA for protein. Clin Nutr Edinb Scotl. 2012;31(4):512-519. doi:10.1016/j.clnu.2012.01.005.
  8. Floyd RA. Antioxidants, oxidative stress, and degenerative neurological disorders. Proc Soc Exp Biol Med Soc Exp Biol Med N Y N. 1999;222(3):236-245.
  9. Betteridge DJ. What is oxidative stress? Metabolism. 2000;49(2 Suppl 1):3-8.
  10. Fernández-Sánchez A, Madrigal-Santillán E, Bautista M, et al. Inflammation, Oxidative Stress, and Obesity. Int J Mol Sci. 2011;12(12):3117-3132. doi:10.3390/ijms12053117.
  11. Unlu NZ, Bohn T, Clinton SK, Schwartz SJ. Carotenoid absorption from salad and salsa by humans is enhanced by the addition of avocado or avocado oil. J Nutr. 2005;135(3):431-436.
  12. Brown MJ, Ferruzzi MG, Nguyen ML, et al. Carotenoid bioavailability is higher from salads ingested with full-fat than with fat-reduced salad dressings as measured with electrochemical detection. Am J Clin Nutr. 2004;80(2):396-403.
  13. Goltz SR, Campbell WW, Chitchumroonchokchai C, Failla ML, Ferruzzi MG. Meal triacylglycerol profile modulates postprandial absorption of carotenoids in humans. Mol Nutr Food Res. 2012;56(6):866-877. doi:10.1002/mnfr.201100687.
  14. Pittas AG, Roberts SB. Dietary Composition and Weight Loss: Can We Individualize Dietary Prescriptions According to Insulin Sensitivity or Secretion Status? Nutr Rev. 2006;64(10):435-448. doi:10.1111/j.1753-4887.2006.tb00174.x.
  15. McClain AD, Otten JJ, Hekler EB, Gardner CD. Adherence to a low-fat vs. low-carbohydrate diet differs by insulin resistance status: Research Letter. Diabetes Obes Metab. 2013;15(1):87-90. doi:10.1111/j.1463-1326.2012.01668.x.
  16. Berardi, J, Andrews R. The Essentials of Sport and Exercise Nutrition. Second Edition. Precision Nutrition; 2013. http://www.precisionnutrition.com/cmd.php?Clk=5266221.
  17. Berardi J, Scott-Dixon K. Precision Nutrition Level 2 Certification: Master Class. Precision Nutrition; 2014. http://www.precisionnutrition.com/pn-level-2-vip.

All About Probiotics

15 Oct

By Tim Skwiat, MEd, CSCS, Pn2

What Are Probiotics?

According to the International Scientific Association for Probiotics and Prebiotics (ISAPP), probiotics are defined as “living microorganisms that, when administered in adequate amounts, confer a health benefit on the host.”1

The digestive tract alone contains roughly 100 trillion bacteria. To put that into perspective, we have 10 trillion cells that make up our bodies. In other words, the bacterial ecosystem that makes us who we are outnumbers our cells on the order of 10 to 1. From a DNA perspective, the genes of the microbes that inhabit our bodies exceed the amount of human DNA we each have by a factor of 100.

small world

Cani PD, Delzenne NM. Pharmacol Ther. 2011;130(2):202-212.(2)

Building and maintaining a healthy gut flora—which involves optimizing the balance of “good” to “bad” bacteria—is critical to digestive system health and function, overall health, immune system function, mental health and wellbeing, metabolism and weight management, respiratory (i.e., lungs) and integumentary (i.e., skin) systems, and more. When the gut flora is at a healthy balance, it provides immense support to digestive function, immune system, metabolism, skin health, mental wellbeing, and more.

However, when the gut is unbalanced and unhealthy, a number of issues can ensue. In fact, research suggests that having inadequate levels of healthy bacteria in your gut may contribute to over 170 different health issues, including weight gain and difficulty with weight management, as well as digestive-, skin-, and mental wellbeing-related issues. Along these lines, there are many common factors that can upset the balance of gut bacteria, including:

  • Aging
  • Environmental factors
  • Food choices (e.g., Certain artificial sweeteners like sucralose have been shown to reduce the levels of beneficial bacteria in the gut and negatively alter the gut flora.11)
  • Stress
  • Medications (e.g., antibiotics12)
  • Smoking

In other words, a modern lifestyle—characterized by poor food choices, stress, and antibiotics, as well as factors outside of your control like nutrient-deplete soil, environmental toxins, and pollutants—can wreak havoc on the gut flora. The great news that there is a solution to an unhealthy gut, and you can begin restoring your gut health by supplementing with high-quality probiotics.

western living

Adapted from Schippa S, Conte M. Nutrients. 2014;6(12):5786-5805.(5)

This leads us into a discussion of how probiotics may be helpful. In the GI tract, probiotics serve a number of important functions, as they:

  • Support a balance of healthy bacteria in the gut
  • Keep pathogenic bacteria from settling and growing
  • Help digest and absorb nutrients and support a healthy GI tract
  • Help regulate and support a healthy immune system
  • Produce key nutrients (e.g., B & K vitamins, short-chain fatty acids)
  • Keep the system moving
  • Help metabolize chemicals and phytonutrients
  • Synthesize polyamines
  • Produce coagulation and growth factors
  • Promote a healthy balance of cytokines
  • Regulate secretion and use of intestinal mucus
  • Help regulate blood flow to internal organs
  • Provide gut barrier reinforcement
Hill C, Guarner F, Reid G, et al.(1)

Hill C, Guarner F, Reid G, et al.(1)

A Lesson in ProBiology

Symbiosis refers to a “mutually beneficial relationship between two different organisms living in close approximation.” Pertinent to the conversation on probiotics, humans have evolved intimate symbiotic relationships with gut microbes. In fact, human beings can be considered “superorganisms” as a result of their close symbiotic associations with the gut microbiota.3 Optimal human health and homeostasis revolves heavily on this symbiotic relationship, which entails maintaining a healthy balance of bacteria in the gut.

Along these lines, dysbiosis refers to microbial imbalances on or within the body. In other words, dysbiosis describes the state of an unhealthy imbalance of bacteria in the gut flora, characterized by excessive levels of pathogenic bacteria, inadequate amounts of commensal and probiotic bacteria, and/or reduced bacterial diversity. Fundamentally, gut dysbiosis destroys the symbiotic relationship between humans and microbes; in fact, gut dysbiosis has been linked to numerous human health issues, including obesity.4–9

This is leads into why probiotics are critical to restoring gut health and fortifying the gut microbiome. By their very definition, probiotics are non-pathogenic, healthy bacteria that confer a clear beneficial effect on the host (i.e., humans). Supplementation with these commensal bacteria—which supply essential nutrients and defend against pathogens—helps restore a normal, healthy microbiome. Beyond restorative and reactive measures, probiotics help to prevent a normal, healthy individual from acquiring dysbiosis in the future.

In both cases, probiotics promote probiosis (i.e., an association of two organisms that enhances the life processes of both) and support and fortify the symbiotic relationship between humans and gut microbes.

The symbiotic relationship between humans and gut bacteria. Commensal bacteria supply the host with essential nutrients and defend the host against opportunistic pathogens. They are involved in the development of the intestinal architecture and immunomodulatory processes (i.e., healthy immune system function). On the other hand, the host provides the bacteria with nutrients and a stable environment.(10)

The symbiotic relationship between humans and gut bacteria. Commensal bacteria supply the host with essential nutrients and defend the host against opportunistic pathogens. They are involved in the development of the intestinal architecture and immunomodulatory processes (i.e., healthy immune system function). On the other hand, the host provides the bacteria with nutrients and a stable environment.(4)

What Does This Mean for You?

Building and maintaining a healthy gut flora—which involves optimizing the balance of “good” to “bad” bacteria—is critical to digestive system health and function, overall health, immune system function, mental health and wellbeing, metabolism and weight management, respiratory (i.e., lungs) and integumentary (i.e., skin) systems, and more. When the gut flora is at a healthy balance, it provides immense support to digestive function, immune system, metabolism, skin health, mental wellbeing, and more.

However, research suggests that having inadequate levels of healthy bacteria in the gut may contribute to over 170 different health issues (including weight gain and difficulty with weight management), and a modern lifestyle characterized by stress, processed foods, sugar, artificial sweeteners, antibiotics, nutrient-deplete soil, and environmental toxins can wreak havoc on the gut flora and disrupt the natural balance of healthy bacteria.

With that in mind, I would consider a high-quality probiotic (recommendation: BioTrust Pro-X10) “foundational” for nearly everyone to support optimal levels of probiotics, establish and maintain a healthy balance of bacteria in the gut, promote a healthy digestive system, and support a robust immune system. Along with probiotic supplementation, you can also fortify your gut by eating plenty of traditionally fermented foods:

  • Kefir, yogurt
  • Sauerkraut, pickles, and other properly fermented vegetables
  • Miso, tempeh
  • Kombucha
  • Red wine

Establishing optimal gut health is a balance between what’s there and what’s not there. Along those lines, it’s also advised to be mindful of and reduce exposure to the controllable factors (e.g., diet, stress, medications) that may negatively impact the composition of the microflora, gut health, and every other aspect of human health and function mentioned above.

References:

  1. Hill C, Guarner F, Reid G, et al. Expert consensus document: The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol. 2014;11(8):506-514. doi:10.1038/nrgastro.2014.66.
  2. Cani PD, Delzenne NM. The gut microbiome as therapeutic target. Pharmacol Ther. 2011;130(2):202-212. doi:10.1016/j.pharmthera.2011.01.012.
  3. Li M, Wang B, Zhang M, et al. Symbiotic gut microbes modulate human metabolic phenotypes. Proc Natl Acad Sci. 2008;105(6):2117-2122. doi:10.1073/pnas.0712038105.
  4. Martín R, Miquel S, Ulmer J, Kechaou N, Langella P, Bermúdez-Humarán LG. Role of commensal and probiotic bacteria in human health: a focus on inflammatory bowel disease. Microb Cell Factories. 2013;12(1):71. doi:10.1186/1475-2859-12-71.
  5. Schippa S, Conte M. Dysbiotic Events in Gut Microbiota: Impact on Human Health. Nutrients. 2014;6(12):5786-5805. doi:10.3390/nu6125786.
  6. Ley RE, Turnbaugh PJ, Klein S, Gordon JI. Microbial ecology: Human gut microbes associated with obesity. Nature. 2006;444(7122):1022-1023. doi:10.1038/4441022a.
  7. DiBaise JK, Frank DN, Mathur R. Impact of the Gut Microbiota on the Development of Obesity: Current Concepts. Am J Gastroenterol Suppl. 2012;1(1):22-27. doi:10.1038/ajgsup.2012.5.
  8. Turnbaugh PJ, Hamady M, Yatsunenko T, et al. A core gut microbiome in obese and lean twins. Nature. 2009;457(7228):480-484. doi:10.1038/nature07540.
  9. Zhang H, DiBaise JK, Zuccolo A, et al. Human gut microbiota in obesity and after gastric bypass. Proc Natl Acad Sci U S A. 2009;106(7):2365-2370. doi:10.1073/pnas.0812600106.
  10. Ridaura VK, Faith JJ, Rey FE, et al. Gut microbiota from twins discordant for obesity modulate metabolism in mice. Science. 2013;341(6150):1241214. doi:10.1126/science.1241214.
  11. Abou-Donia MB, El-Masry EM, Abdel-Rahman AA, McLendon RE, Schiffman SS. Splenda alters gut microflora and increases intestinal p-glycoprotein and cytochrome p-450 in male rats. J Toxicol Environ Health A. 2008;71(21):1415-1429. doi:10.1080/15287390802328630.
  12. Jernberg C, Lofmark S, Edlund C, Jansson JK. Long-term impacts of antibiotic exposure on the human intestinal microbiota. Microbiology. 2010;156(11):3216-3223. doi:10.1099/mic.0.040618-0.

Getting Healthier By The Day

6 Apr

Getting Healthier By The Day

Tim Skwiat, MEd, CSCS, Pn1

Recently, one of my clients offered some truly sage advice when she shared her recipe for health and fitness success: Getting Healthier By The Day. This approach—this mindset, this attitude—is a key component to a sustainable long-term, successful journey to improved health, body composition, and performance. Getting healthier by the day:

  • Highlights action (i.e., what can you do right now, today)
  • Emphasizes the variables within your control: your attitude and behaviors
  • Encourages a proactive mindset
  • Focuses attention on behavior-based goals
  • Highlights progress, not perfection
  • Encourages self-compassion
  • Emphasizes a sustainable, habit-based approach
  • Promotes awareness and mindfulness

The “Getting Healthier By The Day” mindset is really cool because it highlights action, and it emphasizes the variables within your control: your behaviors and your attitudes. It also helps you take on a more proactive attitude overall, instead of relying on being reactive. Along these lines, when we talk about goals, it’s important to distinguish between outcome- and behavior-based goals.

Outcome-based goals (e.g., lose ‘x’ pounds) specify what we’d like to happen at the end of a certain time period. Generally speaking, outcomes are usually out of our control. On the other hand, behavior-based goals are typically within our full control, and they specify what actions must be taken to get to the desired outcome. From an exercise standpoint, you might have a behavior-based goal of exercising for 45 minutes five times per week. From a nutrition standpoint, the following “cheat sheet” identifies some of the most important “behaviors” of good nutrition that you might practice:

5 Habits on Highly Effective Nutrition Plans: Cheat Sheet

This mindset is also key because it highlights progress, not perfection. In other words, good nutrition and being healthy is not about perfection; it’s about improvement. It’s about the process—the journey. It’s about making the best, wise choices, as often as possible. It’s about living with purpose and getting up each day being your “best self,” with integrity, and it’s about being self-compassionate and kind to yourself. It’s about pursuing health and wellness.

The “Getting Healthier By The Day” mindset encourages a habit-based approach, which is sustainable and breeds success. In his book, The Power of Less, author Leo Babauta demonstrates the power and importance of taking things one step at a time. Specifically, Babauta conducted some informal behavior change experiments, and he found that:

  • If he assigned himself one practice/task/habit, he could do it consistently 85% of the time, which is very good.
  • If he assigned himself two new practices at a time, his success rate dropped dramatically, down to 35%.
  • If he assigned himself three or more new practices at a time, he was barely able to do anything!

The take-home point is, for lasting change, it’s crucial to focus on one small thing at a time. If possible, it’s often best to make it a daily practice. The more conscious you are of your “task,” the more likely you are to be mindful of it and stick with it.

This attitude promotes a nonjudgmental awareness that encourages progress and growth. Awareness—paying attention to what is happening and why—allows us to:

  • Gain control
  • Lower stress and frustration
  • Prevent bad decisions before they happen, rather than feeling guilty afterward
  • Learn what we like and don’t like, what our “triggers” are, and how to work proactively
  • Recognize that we’re human
  • Bring out our best selves

Embrace the “Getting Healthier By The Day” attitude, and take control of your health, nutrition, and body transformation journey. As yourself, “What’s one thing that I can do today, right now, to improve my health, fitness, and performance?”

Feel free to share below. I look forward to supporting you in your efforts!

Focus: Clear the Clutter

28 Mar

Focus: Clear the Clutter

By Tim Skwiat, MEd, CSCS, Pn1

We live in a fast-paced world with myriad distractions. It’s easy to get caught up in “multi-tasking,” continually investing only your partial attention to multiple activities (i.e., putting your eggs in many baskets). It’s not your fault; there are so many things demanding your attention that focus, to put it gently, is a challenge.

Focus is an essential mental skill, and those folks who can harness and sharpen their mental ninja skills are more likely to execute key tasks efficiently and effectively, stay focused on what they want, and are more likely to accomplish their goals.

The first challenge of focusing is to clearly define what you truly want. Pertinent to this conversation is that your behaviors, actions, and attitudes (the variables that you control) are a direct reflection of your identity (i.e., who you are or who you want to be), your values (i.e., what’s important to you), and priorities (i.e., what you think should come first).

In other words, focus comes from a clear purpose—intention.

In order to help you stay on track—whether it be getting in your workouts, sticking with your nutrition plan, being a better parent, or performing better at work—here are a few strategies that can help you stay focused on what truly matters.

The Morning Check-In

  • Write down your goals, values, and priorities.
  • First thing in the morning, review these stated goals, values, and priorities.
  • Do this every morning.

The Bookend Ritual

  • Write down your goals, values, and priorities and review them in the morning.
  • In the evening, do a “post-game” analysis to see how your behaviors matched up. If your behaviors didn’t match up with your stated goals, values, and priorities, make adjustments accordingly.
  • Using your “post-game” analysis, create an action plan for the following day.
  • Next morning, review the previous day’s plan along with stated goals, values, and priorities.
  • This is a great option for evaluating your golf performance.

Daily Goals in Your Pocket
A personal favorite, this involves writing down your small daily goals on a piece of paper and keeping it in your pocket.

Goal Check-In
Take a moment to “check-in” before making any decision that feels impulsive or compulsive. Ask yourself:

  • What do I want right now?
  • What do I ultimately want?
  • Am I willing to sacrifice my goals and values for what I want right now?
  • Could I wait a little while? (Sometimes it only takes about five minutes of “delaying discomfort” to stay the course. Check out the Marshmallow Test…if little kids can do it, so can you.)

It’s okay if you get distracted. We all do. The best athletes, meditators, and successful professionals do too; however, they’re really good at returning to focus. In other words, if your thoughts wander or you get slightly off track, realize that it’s normal, pick up the pieces, “notice and name” (i.e., important lessons, patterns of behavior, environmental circumstances), re-focus, and bounce back as quickly as possible—better than ever.

Extreme Makeover: Kitchen Edition

5 Feb

Extreme Makeover: Kitchen Edition

By Tim Skwiat, MEd, CSCS, Pn1

In Switch, an influential book on behavior change, brothers Chip and Dan Heath conjured an image of a person riding an elephant to describe the challenge of the change-making progress. In short, the Heath brothers’ metaphor translates like this:

  • The rider is the voice of reason. He is the “logical” brain that “knows” what to do and tries to control the powerful elephant, something he’s successful at doing…for a very short period of time.
  • The elephant represents raw, powerful emotions. It is physically strong and overpowering, and it is both figuratively and literally significantly larger than the rider. At some point or another, the elephant—our impulses and deep emotional needs—overcomes the rider.

With that in mind, both the rider—or, the “thinky” brain—and the elephant—the primal, emotional brain—both need to be “addressed” appropriately along the path to behavior change.

Speaking of path, the Heath brothers also discuss its significance in the change-making process. Specifically, whether the elephant realizes it or not, it is constrained to a certain path, or environment. In fact, the elephant’s path has an even greater effect on its actions than the “smart” rider.

In tangible terms, this means that in order to build better nutrition habits, you need to consider your environment and shape your path. While your environment can be influenced by social (e.g., people), cultural (e.g., expectations), and intellectual (e.g., beliefs) factors, we’re going to focus our attention on your physical environment—notably, your kitchen.

According to nutrition coach extraordinaire Dr. John Berardi, the “first law” of good nutrition is as follows:

 If a food is in your house or possession, either you, someone you love, or someone you marginally tolerate, will eventually eat it.

This is particularly discerning for a number of reasons, and it gives powerful insight into how strongly your environment can affect your eating habits and health goals. This law can be taken at surface level (e.g., if a trigger food is around, it could lead to trouble), or it can take it a step further (e.g., if your living mates aren’t “on board” with your goals, then you could be set up for failure).

What’s also neat about this law is that it has a corollary:

If a healthy food is in your house or possession, either you, someone you love, or someone you marginally tolerate will eventually eat it. 

With all of that being said, you can see that you have the power to shape your path toward healthy eating habits and good nutrition behaviors by taking a look at your environment (i.e., kitchen) to identify (and trash) non-nutritious “junk” and “trigger” foods that promote overeating and poor eating habits and derail you from the path to optimal health, body composition, and performance. Likewise, this same process involves making sure that you have the nutrient-dense, health-promoting foods you need to support your goals, as well as the right tools to prepare them in a nutritious manner.

With that in mind, you are now the star of your own reality show: Extreme Makeover: Kitchen Edition!

This process can vary from person to person based on a number of factors (e.g., nutrition knowledge, socioeconomic background, roommates and family members), and a good place to start is with the following assessment:

PN Kitchen Makeover Questionnaire

This questionnaire helps to give you an idea of where your kitchen sits on the spectrum of makeover-ness, and it gives you an idea of the types of foods that you’ll find in a healthy kitchen—along with those that you won’t—as well as the tools that you should have on hand to make sure that you have the capability to prepare healthy meals. In addition, it can give you some feedback about your food-related behaviors (e.g., grocery shopping, prepare foods in advance) and thought processes.

Once you’ve completed the Kitchen Makeover Questionnaire, it’s a good idea to start to get an idea of what foods will stay (and why) and what foods must go (and why). One very effective way to do this is to create a “trigger” list of red, yellow, and green light foods. You’ll start by identifying the red and yellow light foods because these are the items you’ll want to get out of the house. Then, we’ll move on to the green light foods, which will be the locus of your kitchen restocking efforts.

Red light foods are the obvious “junk foods” as well as foods that tend to prompt overeating. While the latter may be a bit more unique to you—for me, it’s nut butters—the former may include:

  • Baked goods
  • Cakes
  • Candy
  • Cheese spreads
  • Chips
  • Chocolate
  • Condiments
  • Cookies
  • Crackers
  • Diet soda
  • Dips
  • Ice cream
  • Instant foods
  • Frozen dinners
  • Fruit snacks
  • Margarine
  • Processed meats
  • Salad dressings
  • Sauces
  • Soda
  • Sweetened drinks
  • Take-out leftovers
  • Vegetable oils
  • Alcohol is negotiable

Yellow light foods are a bit less obvious junk foods, and we like to call these “trick foods.” These foods are generally masqueraded as healthy, but they are far cry from whole, minimally processed foods. Some examples include:

  • Bagels
  • Breads
  • Breakfast cereals
  • Dried Fruit
  • Energy bars
  • Frozen yogurt
  • Fruit-flavored yogurt
  • Fruit juice
  • Granola bars
  • Light/fat-free yogurt
  • Organic “junk” food
  • Pretzels
  • Regular peanut butter
  • Trail mix

As we’ll talk about below, you don’t have to throw out everything. The makeover—just like your body transformation—is a journey. If you’re not ready to toss something, that’s okay. This is a dynamic process, and you’ll just want to continue to be aware (i.e., notice and name) of your relationship with any red or yellow light foods that you keep.

Some people find that getting rid of a couple of things each week—and displacing them with green light foods—works really well. They hold onto their lists of red and yellow light foods, and they cross them off as they go (and they don’t buy more of them).

Green light foods are those that are nutritious and health-promoting, and these are the foods with which you’ll want to stock your kitchen. Along these lines, the corollary to the “first law” of good nutrition says that having healthy foods available to prepare and eat is just as important as getting rid of the “junk” food.

The Kitchen Makeover Questionnaire is a great stepping stone to help you stock your kitchen with nutritious foods, and along with that, the following list may help you with this portion of your kitchen makeover:

Superfood Reference Guide

That guide is a great start, and it emphasizes that you can’t go wrong with whole, minimally processed foods. In addition, the following checklist provides some additional options, along with some coaching tips for navigating the aisles of the grocery store:

Super Market Survival Guide

If at any point during this process you’re feeling a little ambivalent or doubtful, that’s okay. It’s completely normal to want to hang onto that bag of potato chips like a life-saving flotation device or be a bit indecisive about throwing out and “wasting” food.

In the case of the former, this doesn’t have to be an “all or nothing” situation, and you can revert back to your red, yellow, and green light lists to establish a makeover continuum. Remember, this is your journey, and you have control over shaping the path.

If you choose not to remove something now, simply notice how you respond by keeping it around. You might find that the bag of chips is more like an anchor and less like a flotation device. Shaping the path is a dynamic process, and you may find that you add and subtract foods and tools over time, as well as maneuver your kitchen for optimal food prep.

In terms of “wasting” food, you might ask yourself a couple of questions:

  • Is this really “food” in the first place? It’s likely that most of the things that you’ll be tossing out are mere resemblances of food-related items with little to no health-redeeming qualities. With that in mind, you’re not technically wasting any “food.”
  • Also, you might ask yourself, what would be more of a waste: getting rid of the cheap “food” or ingesting it and allowing it to work against your health and body composition goals by increasing body fat and inflammation?

Remember, this is a process, but it’s an important one. Going back to the metaphor at the beginning, the elephant is stubborn and powerful, and yet it is constrained to its path, which has a much greater effect on the direction it travels (i.e., behavior) than the rider.

By modifying the path (e.g., the kitchen makeover), the job of the rider is considerably easier. Although you may experience some feelings of ambivalence and contradiction initially, changes in your surrounding environment relieve the rider and help to motivate the elephant. Ultimately, shaping your path makes it easier to adopt healthy nutrition behaviors and eating habits, and therefore, optimize your health, body composition, and performance.