My diet approach: less rigidity and more ‘real life’

A couple of comments on my Facebook page, a comment from a client that she wasn’t  ‘my perfect client’, and a post from one of my good nutritionist friends inspired me to have a bit of a think about how I approach nutrition, or the expectations that others have of my nutrition approach.

Whenever I put something out on social media, people will read from it what they will – I want them to comment and engage (why else would I put a post up?)  One of these was a comment I got after posting a recipe up on my page. Someone commented that she was very concerned that I say I follow a minimally processed diet approach, yet used a protein powder in my pancake recipe, clearly a highly processed ingredient*. She’s not wrong – protein powder is highly processed for sure, even the brands that I use and recommend others do: those that don’t have a lot of added ingredients bar the protein powder, some flavouring and stevia-based (or thaumine) sweetener . It got me thinking though. This person was annoyed that I was straying from their perception of what I advocate. If I could include protein powder in my recipes, clearly I’m not an advocate of the real food approach. How could people trust anything I say if I suggest that protein powder is okay? I wasn’t living up to her expectations of me, and she was disappointed.

It’s a tough balance: when I changed my philosophy around food I think I was a lot like other people – went too far in the extreme of finding the perfect real-food approach in an effort to ditch processed food. Legumes and all grains were off the menu (regardless of dietary tolerances, as this was the ‘perfect paleo’ way). All bread was to be avoided at all costs. Only drink red wine (less sugar) … It was 95% of what you’d call a ‘primal’ approach.

Like most people, though, I have settled in an approach to eating that is more practical to real life and, frankly, less exhausting. I have my diet non-negotiables –for me, I don’t touch diet soft drinks and chewing gum. In fact, I had a dream a few months ago that someone offered me a piece of gum and I took it. I woke up in a panicked state. This is because around 6 years ago I couldn’t go a day without having Wrigley’s Extra gum, and now I am scared that if I have it again that it would be a quick slide back into a daily habit that I couldn’t stop (even though when I gave it up it was literally like a switch had gone off in my brain and I couldn’t imagine having it again). I don’t have food allergies, so unlike other people, there isn’t anything that I must avoid or I’d be seriously compromising my health. That said, if I was eating the way I did during my Master’s degree at Otago, I couldn’t last during the day – I’d regularly have to nap in the afternoon under my desk after a diet coke and a massive ciabatta bun from Il Panificio bakery for lunch, which was backing up a large milky trim cappuccino and a dark rye sesame bun for breakfast. A carb overload and no fat or protein will do that to me (and a lot of people) – and don’t get me wrong – I LOVED it (and still would!) Just not how it makes me feel and, unfortunately, now I know too much about the long-term implications of eating such a nutrient-void diet). Huh. And I was doing a Master’s in nutrition at the time…

For everything else, though it is more about dietary principles rather than strict rigidity. Less religion and more realness. I try to avoid vegetable seed oils and artificial sweeteners that impact on blood sugar levels. However, if there is a dip that someone has brought along to a dinner party that has canola or sunflower oil as the second ingredient, I would likely have some if I thought it sounded nice, even if I wouldn’t buy it myself.  I avoid eating soy – especially products that use it as a cheap protein filler as you’ll find it in many packaged goods, though by now living in a vegetarian/vegan household, I eat organic tofu around once a week – and really enjoy it. I consume gluten when I have (for example) a date scone, or I really feel like toast. This might be once a fortnight. I drink wine. I have 3-4 alcohol free nights per week, but enjoy red wine (and coming into summer, white wine too – even though it has a higher residual sugar count). Not a lot – 1-2 glasses, and what they serve at the local bar is probably a more generous pour than we have at home. I like chocolate. I eat Quest protein bars (the varieties that don’t have sucralose as a sweetener in them – some do, some don’t) and use these as a bit of a stop gap as when training intensity ramps up (as it has over the last couple of months). I’m just hungrier in general and am not always organised. Despite their ‘organic’ label, these are about as far away from real food as you can get.

We buy white bread – the stock standard cheap loaves – as this is one of the only things that never comes home in the school lunch box during the week. If you’re wondering, I don’t think there is too much difference between white and multi-grain bread, really – it is all rubbish. I don’t eat it myself (any toast I have would be out at a cafe, a more delicious type of sourdough or ciabatta, probably), and can justify it till the cows come home but truth be told, getting any food in some kids can be difficult, so if they will eat a white bread egg or cheese sandwich that is going to at least fill them up, then so be it. A friend of mine commented on how she laughs when I post about lunchbox options for kids – and how (for her at least) it’s just a little unpractical and/or even if the kids show interest one day, the next they won’t have a bar of it. Now I get it. I really think I didn’t have a true appreciation for this and if I can somehow crack the nut that is ‘school lunches’ then I’d probably be a gazillionaire. One day. Maybe. (And if you have any bright ideas that I might not have thought of, pass them on!)

So, yeah. I still call my dietary principles ‘minimal processed food’ relative to the food environment and where I was at 7 years ago. Sorry to disappoint or concern anyone. Or perhaps this just makes you feel a little relieved that, despite best intentions, it doesn’t read like a perfect food environment or a perfect food diary, even for someone with my nutrition qualifications and practical experience. But that’s real life, and we do what we can. Some days are awesome, some weeks are awesome, and some, well, some just aren’t. That’s life, right? And when the dust settles, I’m pretty happy with it actually.  If you do what you can and have the best intentions going into it – then you’re always going to do better than if you didn’t try at all.

So please don’t think you have to be perfect – I’m not and nor should you stress about striving to be so. If you want some guidance at reaching your ‘happy spot’ click here to book a consultation or check out my online nutrition coaching services.

Jan’s story: a real food success story

When I met Jan, she had already lost 10kg through Jenny Craig but was super unhappy and hungry, experiencing bouts of hypoglycaemia (and used dates to help lift her blood sugars again, which would exacerbate the problem), had knee pain, was experiencing patterns of low mood and overall didn’t feel very good. Further, her HbA1c, measure of long-term blood sugar control, placed her in the pre-diabetic range (above 41 mmol/L). To my mind, this cut-off seems a little arbitrary. There really is nothing different between 40 and 42 mmol/L where one is ‘fine’ and healthy, and the other is ‘pre-diabetic’. Many GPs I talk to feel the same, but I digress.

We talked through her diet, which was a little like this:

  • Pre-breakfast: Cup of tea plus piece of fruit (off to do some work on the farm)
  • Breakfast: 2 eggs on toast with butter
  • Snacks: scroggin mix, fruit, rice crackers
  • Lunch: salad with greens with grated cheese and tomatoes
  • Dinner: standard kiwi dinner food, with some adjustments made thanks to Jenny Craig programme.

It certainly wasn’t a junk-food diet the way we understand ‘junk food’ to be, however it was low in protein with the balance of macronutrients geared towards higher carbohydrate choices: fruit, toast, dried fruit, rice crackers etc.

We talked through dietary changes and lifestyle changes, and I made several recommendations based on the information she provided and subsequent blood tests that she had conducted. The main shifts in her diet were to:

  • Anchor meals around protein, fibre and fat to stabilise blood sugar
  • Avoid snacking where possible
  • Removal of most carbohydrate (including fruit) to help lower her overall blood sugar level
  • Including raw apple cider vinegar around meals (to help with glycemic control)
  • Remove dairy (clinically I see many women in their late 40s and above benefit from removing dairy from their diet)
  • Supplementing with magnesium and chromium for blood sugar control, and supplements to help support her liver function
  • Slow cook meat wherever possible (to reduce the formation of advanced glycated end-products which are toxic, especially for someone with poor blood sugar control).

Over the course of the next 14 weeks, Jan has experienced the following:

  • Sleep has improved
  • Knees no longer sore when moving
  • Blood sugars have stabilised, no signs of hypoglycaemia
  • Mood has infinitely improved
  • Skin and hair are better
  • No cravings
  • Appetite is good, feels satisfied with food
  • Body composition changes: she has dropped 15 kg
  • HbA1c had dropped to 37 mmol/L (out of the ‘danger’ zone).

Importantly, her overall wellbeing is SO much better than it was. She sounds so much brighter on the phone, she feels so much better about herself and she has achieved so much. When we caught up two months ago at our previous appointment her weight had stabilised around 5 kg heavier than it is now, though she continued to notice body composition changes – her shape was changing but on the scales, it was the same. I see that frequently, and nothing is linear, of course. It can be weeks of plateauing on the scales before they shift. Is this a metabolic adaptation? Not sure. Usually it’s compliance to diet, though Jan had been consistent with her approach. Of course, there are things you can do to help move the needle a little bit if necessary, but sometimes it can just be a matter of waiting it out before the trend down continues. The key is to not be demotivated by this. Scales can be a good indicator of progress, but remember not to rely on them as the sole indicator. Luckily for Jan, she was experiencing the benefits of eating well every day, so even though the number on the scale hadn’t changed, she still felt good about her lifestyle change. Her husband has also benefited from her lifestyle change, dropping excess body fat by virtue of eating from the same food supply.

A typical day’s food intake for Jan now would be:

  • Breakfast: 2 eggs plus bacon and mushrooms
  • Lunch: salad, chicken, a boiled egg
  • Dinner: salmon, roast pumpkin and carrot and salad

OR

  • Breakfast: 3 scrambled eggs, tomatoes, spinach
  • Lunch: sushi (no rice), cabbage slaw
  • Dinner: butter chicken with cauliflower rice

If she feels like a sweet treat, she makes something like this Pete Evans nut bar, or mixes up some coconut yoghurt and frozen berries to make a sorbet-type dessert, and is completely satisfied. She was initially worried about my reaction to the nut bar, given it’s got some dried fruit in it, however she reiterated that she cut it into 30 pieces, froze it, and brings it out “not every day” to have with a coffee. Honestly, though, had she told me she ate it every day and got these physical and psychological benefits, then it is working for her regardless of what I think (in the context of an already stellar food intake). One food doesn’t make or break a diet.

She finds it is super easy for her to follow this way of eating and eating out or with other people is not an issue. She asks for dressings for salads, and sauces for steaks on the side to control how much of these she has, and to help avoid hidden added sugar or industrial seed oils that are commonly found in these foods. She is ‘busy’ but not overly active, and we are working on getting her resistance training up to help protect her bones AND increase muscle mass. These two things will help her overall health and prevent sarcopenia in later years. We are starting with home based activities for this. While she could have started this earlier, it’s sometimes easier to focus on one health behaviour and bring the others in – everyone is different though; so this needs to be considered on a case-by-case basis.

One thing she does find interesting is other people’s reaction to her weight loss, with some people asking when she will stop doing what she’s doing (as if it is a ‘diet’, which Jan isn’t on), or saying that she is getting ‘too thin.’ This regularly happens when someone loses weight and gains health; people are used to seeing a different version of them. To deviate from this can be unsettling. For others, they subconsciously take the actions of someone like Jan personally, like she (who is adopting the improved health behaviour) is doing it to highlight some failing of their own. While that might seem ego-centric of them, I don’t think it’s on purpose for most people! These people are often good friends and want to see you succeed. The important thing for Jan in this instance is to not take on board what others say and stay confident and strong in her approach.

So that’s Jan. Awesome, huh? She’s booked a holiday too – something she said she wouldn’t have contemplated previously. This has less to do with her weight (though certainly she can move around much more freely) but more about the increase in overall wellbeing that has occurred through adopting these changes. It makes me feel so privileged to work with people like Jan and share in their success. While I gave Jan the tools to guide her, the hard work was up to her. If you’re in a position to do the same, click here to set up an appointment, or check out my online nutrition coaching options here.

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Delicious food! (PC: runningcompetitor.com)

Trouble shifting body fat? Two solutions (which are free! And simple).

Lots of good things happen when you eat well (and by well, I mean forgoing the advice of the dietary guidelines and following a less processed, more whole food kind of approach). Your sleep can improve, your skin clears up, your eyes sparkle with an increase in vitality and that brain fog you were struggling with for years (it’s just age!) has cleared. Your concentration levels are second to none.

But your weight isn’t budging. And you’re frustrated as hell. I get it. I talk to many clients and online coaching members about this. If all other aspects of your health improve with the change in diet and lifestyle, then by default, excess body fat should begin to shift. But, unsurprisingly, not for everyone*.

What,then, are two diet ‘hacks’ that could help you push through the weight loss stall?  Well it could be pretty simple, actually. You could either eat more, or eat less.

Eat more

If you are consistently trying to eat fewer calories, this can backfire on you – over an extended period of time this will break down muscle tissue and reduce overall metabolic rate, sending signals to your hypothalamus to shut down all unnecessary metabolic processes as energy needs to be preserved. In this context, the last thing your body wants to do is shift body fat. This is something that the physique athletes (such as bodybuilders) have known for years and often use a ‘refeeding’ period (of more calories or carbohydrates in one or more meals per week) that sends a message to the hypothalamus assuring it that there is enough calories coming in that it doesn’t need to slow anything down, or shut any processes off. While this is used a lot anecdotally, in research we see an increase in the hormone leptin with an increase of carbohydrate calories during periodic overfeeding, though the metabolic changes are modest at best. Despite lack of scientific verification, I’ve seen many weight loss stalls broken through once calorie cycling is introduced (and overfeeding, something I term a metabolic reset meal – I should really ™ that one).

Some options could be to:

  1. Include a meal based around kumara or potato, and make it a large one (for example, jacket potato with taco mince for dinner.
  2. Have dessert – it doesn’t have to be processed, refined carbohydrate if you don’t want it to be (though it can be! 90/10 and all that…) How about a fruit crumble or real banana icecream made with frozen banana and coconut cream?
  3. Eat whatever you want, one meal a week – this isn’t a license to binge, but rather a recognition that it’s what you do typically that makes the overall difference – one meal is neither here nor there, really. Have McDonalds if you really want to (not judging or anything, though I can’t imagine why you’d want to.)

Your body responds well to changes in energy flux – consuming a higher number of calories on days where you expend more energy (ie a high energy flux) will encourage hormone signalling in your body that allows for more lean tissue to be laid down, and is great for bone health.

Eat less

Conversely, if you’re eating too many calories on every day of the week, then you’re…eating too much. I know, can it really be that simple? Think about it: you’ve changed the types of foods you’re eating, and this has equated to better appetite regulation so you’re no longer eating because of insulin surges and blood sugar crashes. However you may still be in the habit of eating a certain amount of food which could be preventing you from dropping body fat. If you’re following a low carbohydrate, higher fat approach as a means to lose weight, a common mistake is that people eat too much fat. Don’t forget that you want to utilise some of those calories stored on your body, and part of the ‘HF’ of LCHF should come from this reserve rather than be provided by the diet. You don’t need to count calories to do this, either. It might be as simple as:

  1. Dropping out one or more snacks (if you’re in the habit of snacking) –those nuts mid-morning, the bier stick mid afternoon or the 70% cocoa chocolate at night. What is the worst that can happen? You’ll feel hungry, likely. This doesn’t mean you need the calories, it’s more likely your body’s used to eating at that time, therefore it’s anticipating a feeding period and releasing ghrelin (our ‘hungry’ hormone) because of this. It will pass. Have a drink of sparkling water and brush your teeth instead.
  2. Dropping the fat content on days you aren’t as active – this is an easy way to drop calories (thus cycling calories) – but without the feeling that you’re depriving yourself. I’m not suggesting you use products that have had their fat removed (ie trim milk), but don’t use as much added fat as you normally might on the days where energy expenditure is lower. Forgo the almond butter on your cottage cheese and berries for breakfast, omit the nuts that you’d normally add to your lunchtime salad, or serve salmon with the skin on at dinner with steamed vegetables rather than creamed or roasted ones. If you are hungrier, then up the amount of protein you consume on these days by about a third per meal (as we know that this will likely benefit body composition). This won’t make up for the number of calories you’ve saved by making these small changes.
  3. Experiment with fasting. You’ve got nothing to lose with this one and, if you do it in a way that is sustainable for your lifestyle, then you’ll naturally drop body fat with little effort. I know many people are afraid to fast for the additional stress it might place on their body. To be honest, I think there’s almost been a disservice to our stress response – we hear so often of how everyone is ‘too stressed’ and while this is true, I speak to many people who are now too afraid to exercise due to the metabolic damage they could incur due to their already stressed state. Stress is really healthy for the body – it adapts and becomes more resilient. Fasting is a type of stressor (and I’ve written about it in more detail here) and it might be the thing you need to kick your fat loss into gear. You may have more to gain from a 5:2 protocol, where your normal food intake is cut by a third on two (non-consecutive) days of the week. You may wish for this to be one meal or two smaller meals. Go easy on the activity on these days (and time your workouts to be before your larger meal), and when you do eat, make them protein and vegetable based – the caloric restriction doesn’t allow for a large fat intake, and protein will be more satiating anyway. I suggest not doing back to back calorie-restricted days- you may eat slightly more food the day after the fast (or not, it’s quite individual) and if you fast for a second day after a refeed meal, this could put you in a bit of a hungry/hangry spin.

So, these are just a couple of things you could try. Of course, there may be more going on that is preventing you from shifting fat, and that’s where talking to a professional can help. But if you’ve not tried either of the above, then give it a whirl. For a good 4-6 weeks I think. Your body needs time to adjust to a change in environment.

* Now I don’t use scales in my clinic, nor make it a blanket recommendation for people to do so as their measure of fat loss. How your clothes fit, your waist measurement, what you see in the mirror –these are far more accurate ways of assessing changes in body composition. In saying that though, some are motivated by what the scales say and if they can remove their perception of self-worth from the number on the scales, then it’s not a problem. In addition, some find them a very useful monitoring tool and can keep on target if they use scales daily – research does support the daily use of scales for helping people reach their body composition goals.

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PC: eatTV.com

Six things I think you should know about LDL cholesterol

Does bacon deserve the health halo it now seems to have in light of what is becoming common knowledge about saturated fat? Mm. Good question, and it probably comes down to context. If we were to position bacon against Flora Proactive, then that changes the question somewhat: which is better for your health? I mean, one is designed specifically to lower low density lipoprotein (LDL), aka ‘bad’ cholesterol (something we’ve been told for years to strive for) and is ridiculously expensive; the other is … well, bacon. Due to its saturated fat content (or perceived saturated fat, it contains less than 50% of its fat from saturated sources), it is always the second food which people think of when it comes to elevating cholesterol levels and causing heart disease – the first being butter.

Many clients come into my clinic with a total cholesterol above 5 mmol/L and are told by their GP that they should bring their cholesterol level down by way of eating low saturated fat, low total fat and reducing animal protein in their diet. OR (worse) go on cholesterol lowering medication (why is medication worse? Check out here and here). There are many things contributing to a higher cholesterol level, and the risk this poses to you is based on many factors. I’ve covered some of these (and what you can do about it) previously.

Here are 6 things I found useful to know about LDL cholesterol. I’m not talking about particle size, particle number, patterning of particles or Apo A or B, reverse transport cholesterol etc. Keeping it kind of simple. If you know more than your average Joe about cholesterol this will likely be a bit elementary. Otherwise:

  1. Most studies and media reports that report a reduction of risk of heart disease when taking cholesterol lowering medication focus on the relative risk. Relative risk – takes a small effect and it amplifies it. This makes the medication look far more effective than it actually is. Let’s explore what this means:

If you have a clinical trial whereby 100 people are given a placebo drug* and 100 people are given the experimental drug, you might find that 2 people in the placebo group go on to have a heart attack (2%), 98 have no adverse events. In the drug-treated group, 1 person has a heart attack (1%), and 99 people have no adverse events. The difference is 1%, however the relative risk reduction is 50% and a much more impressive number, don’t you think? Those reporting in the media certainly do.

  1. We need cholesterol to synthesise naturally occurring steroids in our system. It is necessary for life. It is the substrate for every sex steroid, for vitamin D, to make new neurons and new synapses to consolidate memories. Many people think cholesterol is in our body solely to clog arteries, and the lower the better. This is not the case. For example, in some populations a low total and LDL cholesterol are linked to higher incidence of depressive symptoms. A low cholesterol level may also result in less synthesising of vitamin D in the body, lower hormone production and an impaired immune system.
  2. LDL is an innate part of the immune system. When there is damage to the artery, you have susceptibility to infection, and there is evidence of pathogens present in plaques. When there is damage to the artery and artery wall, resulting in atrophy, there is an infusion of white blood cells as well as LDL cholesterol which work together to promote inflammation (for healing purposes). Blaming LDL for creating damage is like blaming the fireman for creating a fire.
  3. There is NO level of LDL that is unhealthy. There is an assumption that LDL cholesterol is inherently atherogenic and that above a defined level it is dangerous – there is something about the LDL packaging of cholesterol that causes heart disease. That’s not the case, and some experts in the field believe there is no level of LDL that should be treated with a statin. Researchers reviewing the literature have found people with high LDL with no heart disease. The cut-off of 4mmol/L or 5mmol/L depending on your reference point is an artificial distinction that has been created to suggest LDL is inherently toxic to the heart and cardiovascular system. Now there are people who have a genetic predisposition to storing cholesterol, so they have an increased risk? Actually research looking at the lifespan of people with familial hypercholesterolemia (FH, a mutation in the LDL receptor whereby the end result is elevated LDL cholesterol) have found that, aside from a subsection of the population, there is normal lifespan, with just a small number of these people going on to develop heart disease. There are people who have other genetic variants which do result in build up of LDL cholesterol, and we don’t know enough to say that a very high LDL level is NOT dangerous – however the likelihood of harm will be increased with the presence of other risk factors for cardiovascular disease, such as high blood pressure or smoking.
  4. It is not LDL that is causing heart disease. Blood cholesterol (including LDL) is high in people consuming a higher fat diet. However, research shows that other biomarkers are not only fine, but can be improved when transitioning to a higher fat diet from the standard western diet. A recent paper found that people 60 years and older who have the highest LDL live as long or even longer than those with low LDL. They have lower rates of cancer and lower rates of infectious disease.
  5. If it’s not LDL cholesterol, then what is causing a heart attack? A critical trigger factor is coagulation. We rely on the coagulation factors in our bloodstream to create a clot when we become wounded and begin to bleed. However, our blood can clot without there being a wound. High stress, tobacco smoke, high blood sugar all trigger clotting mechanisms. It looks like this:
    1. In our artery wall, there are tiny arteries which feed to the inside of the artery (called vasovasorum).
    2. Vasovasorum are easily blocked or clogged by clots.
    3. If these can’t feed our artery wall, the wall essentially becomes hypoxic and the tissue dies.
    4. When the tissue dies, the LDL cholesterol comes in to repair it, and this happens repeatedly, causing the artery wall to become thicker and thicker until it chokes the artery.
    5. When you combine this thickening of the artery wall with something that might trigger clotting of the blood (such as high blood sugar, smoking or a stressful or emotional event etc), a clot will pass through the narrowed artery,
    6. The clot will eventually block the artery entirely and the result is a heart attack.
    7. None of this is caused by LDL cholesterol.

What really matters is keeping your clotting factors inactive until they are needed. Most people (unless they are haemorrhaging) don’t need their clotting factors on high alert all the time.

So, which is better for your health? IMO – while bacon may not be a health food, I’d choose it over the Flora (preferably free range, minimal added preservatives, along with an abundance of vegetables). Flora doesn’t have a lot going for it, TBH, and while it may lower your cholesterol level, how important is that really? If your cholesterol levels are high and you’re not sure of your risk, get in contact with someone like me who can work with you to address the lifestyle factors that might be driving up your cholesterol levels and contributing to health risk.

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This bacon isn’t preservative free, however it’s the only one I could see that had less preservatives and was free-farmed, so using it as an illustration. Henderson’s is free of preservatives but only select supermarkets carry their free-farmed variety FYI

 

Starving? Read this and you won’t be.

One of the biggest downfalls I see with diet is the lack of protein across the course of the day. A typical pattern I see when I talk to people about their food intake and their appetite is:

“I’m ‘good’ all day, but can’t control myself come 5pm”

OR

“I’m fine all day, but after dinner regardless of how full I feel, I’m not ‘satisfied’ ”

OR

“I’m ‘good’ till Wednesday then it’s all downhill from there”

Any of this ring true? The reason I bring this up is that many people report being absolutely starving, constantly thinking about their next meal and (more often than not) their frustration with being unable to lose body fat as they view their diet as being pretty good. When we delve further, I see quite clearly that when people are “good” it generally means they are undereating during the day, and this leads to almost a binge-like pattern later in the evening, or just an inability to stop snacking. A typical pattern might be:

  • Breakfast: cereal + fruit + trim milk (cos, you know, fat is bad)
  • MT piece of fruit/trim latte OR nothing
  • Lunch: chicken salad perhaps 50g chicken, no-fat dressing, no carbs (hey, we got rid of them back in the 90s!)
  • AT: nothing, or a carrot or similar
  • 5pm: a small handful of nuts, then a slightly larger one.
  • 13pm: a carrot. And hummus
  • 21pm: a few spoons of PB,
  • 47pm: cheese while making dinner
  • 10pm: leftovers off the kids plate,
  • 32pm: dinner (full!)
  • 20pm: piece dark chocolate
  • 35pm: bite of icecream *well I’ve blown it now*
  • 40pm: bowl of icecream *I’ll be better tomorrow*
  • 10pm: 3 rows of chocolate…..

Does this look familiar? While they may be low calorie/fat/carb during the day, people with this dietary pattern will generally consume more calories than they realise in that pre-post dinner window. This isn’t just about calories and fat loss though. Many people also suffer from anxiety around their food intake, gut or digestive issues from consuming more food than what is comfortable, sleep issues due to an excess of food close to bedtime, and unhelpful self-talk related to their perceived lack of control. This last point can be particularly damaging to long term success, as for some this can perpetuate feelings of failure and subsequent behaviours which make it difficult to change in the long term. Other long term consequences of a low protein and low dietary energy early in the day include reduced muscle mass, reduced metabolic rate, low mood and a greater propensity for fat gain in the long run.

How to prevent this?

Eat more protein at the start of the day – it is more satisfying and is digested a LOT slower than other nutrients, and will prevent overeating later in the day. What you eat at the start of the day really impacts how you feel and what you eat at the end of the day. Many experts in the field of protein research view 0.8-0.9g protein per kilogram of bodyweight, based on nitrogen balance studies, are likely underestimating overall protein requirements. This is especially true for those in the older age bracket and for people wanting to drop body fat where studies such as this have found that 2.4g protein per kg bodyweight can help maintain metabolic rate and protect muscle mass. Clinically (which, to my mind, is as important as what the literature says), very few of my clients thrive on a lower protein diet. Athletes (FYI) are recommended around 1.7-2.2g per kg bodyweight and in general a higher protein intake will benefit mood, sleep, blood sugar and appetite.

So what does 2.4g per kilogram look like for the myriad of people out there wanting to drop body fat? IE if you weigh 75kg, your protein intake should be around 180g. If we consider the standard protein sources available, then it might look a little like this (amount of protein in brackets):

  • Breakfast: 4 eggs (29.2g) – with vegetables, scrambled, cooked in butter, coconut oil or olive oil
  • Lunch: Medium chicken thigh 146g (34g), sliced up into salad with olive oil dressing and lemon
  • AT: ½ cup of cottage cheese (18g) with pesto mixed through
  • Dinner: Medium steak (186g) with roast vegetables 57.3g

Well, that is 139.4g of protein per day, around 1.86g per kilogram body weight, leaving an additional 40g of protein being derived from plant sources. You can see that you have to eat a lot of food to get your protein in – which is completely different from the ‘being good’ scenario above.

While the run down of foods to eat above may freak you out if you’re used to a cereal and salad diet – don’t be scared. If your dietary pattern looks much as I described above, allowing more protein earlier in the day will have a huge influence on your overall intake – the pattern of grazing late afternoon into the evening will change. I promise. I’ve written about the protein leverage theory before when discussing the National Heart Foundation’s food guidance system (click here for that post) – that the body has an innate requirement for protein and will drive appetite until this is requirement is met. If you eat a lower protein diet, research suggests you may eat more overall calories (and calories from refined carbohydrate) compared to people consuming a moderate protein diet. I know many people don’t like eating more food earlier as they don’t believe they have the willpower to stop. I recently wrote about the main physiological driver of ‘lack of willpower’, and eating more protein will kill this response pretty quick. You just have to try it. When combined with fibre, a bit of fat and carbohydrate that takes longer to digest, protein is (to my mind) the nutrient to focus on for controlling appetite, hunger levels and helping maintain an optimal body composition.

Protein quality definitely counts here too. This measure has been revised recently to reflect updated knowledge regarding the digestibility of protein, however regardless of technique used to establish bioavailability of protein source, animal protein consistently scores higher than plant protein in terms of protein quality (with 0.75 as a cut-off for good digestibility – see here for some food-based tables). This will have implications for their effect on appetite (i.e. ability to keep you satisfied). In part this is due to the presence of anti-nutritive factors in plant based proteins (such as lecthins, tannins, phytates etc) that prevent our absorption of them (see here for a comprehensive report on the digestibility of protein). This is not to say that plant protein doesn’t count. I have many clients who are vegetarian and, for them we ensure a good intake of eggs, cheese and protein powder (whey, pea or egg white protein powder for a good variety). People following a vegan diet are a little more challenged. While they will get protein from legumes, nuts, edamame beans, tempeh and seeds, I recommend (again) protein powders, and incorporating a variety of these (such as pea, hemp and sacha incha) in their daily diet. These are lower in overall protein compared to, say, whey (sacha incha has around 12g per 20g serve (60% protein), compared to whey protein (17-18g, or 85-90%). But if we are looking to increase protein across the course of the day, these will certainly be useful.

So…what about you?

If you’re a numbers person, think about your goals (weight loss, muscle maintenance etc) and shoot for the grams per protein I’ve mentioned above. Use Easy Diet Diary, My Net Diary, Fat Secret or Cronometer to find out how much protein is in the foods that you’re eating, and what the distribution of it is across the course of the day. Then use the information provided to plan for a higher protein intake and a more even distribution. At the very least, aim for around 25-30g of protein in your meals. If you’re not a numbers person, then use tables like these to give you an indication of where protein is in food. Aiming for:

  • 3-4 eggs at breakfast, or 120g protein-based food or 1-2 fist-sized worth; and
  • at least 120-150g of protein-based food at lunch (or 1-2 fist-sized); and closer to
  • 160-200g protein-based food at dinner (or 1-2 fist-sized); and

shooting for the higher numbers the more active or the bigger you are and THEN base the remainder of your macronutrient intake (carbohydrate and fat) around this – and don’t forget the abundance of non-starchy vegetables. If you want some help with this, get into contact with me or sign up for my online nutrition coaching – this is pretty much how I build my meals. While initially you may feel hungry, this will likely be habit rather than actual hunger (or a hormonal response, as your body’s appetite hormones work on a circadian rhythm and ghrelin may well be released as your body is used to eating at that time. Brushing your teeth is one of the best things to do to cut that hunger. If you wait it out, it will eventually pass and you’ll easily eradicate the feeling of hunger, the grazing later in the day and regain the feeling of control around your food (rather than letting the food control you).

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Thankfully, it hasn’t come to this. There is an easier way to control your appetite… (PC healthycompare.com/diet-pills)

No willpower when it comes to food? Read this.

‘ The chocolate bar calls my name. No, really – I can’t NOT eat it if it’s in the house.’

Many people I talk to lament that they can’t control themselves when it comes to sugar or junk food – that they don’t have the willpower to say ‘no’ despite their best efforts. This implies that they have all the control. Now I’m not saying there isn’t an element of discipline that may initially be required when changing the way you eat, especially for people who have lost touch with their appetite and satiety signals which can happen when the food eaten drives unfavourable hormone responses in the body; a phenomenon which is common in the current food environment. However, there are other more powerful forces at play here. Your No physiology has far more say in your food decisions than you think, and I’m going to cover one of the main ones I see (and one of the easiest ones to correct) that will help people control their food intake, rather than let their food control them: the blood sugar rollercoaster

This is one of the biggest drivers of cravings in my experience. The type of diet that many people follow is either carbohydrate heavy or devoid of protein and fat. Both situations are going to set your blood sugar up for rise and fall of (what can be) epic proportions. When carbohydrate is broken down into the bloodstream into glucose, this takes our blood glucose level out of homeostasis (normal). One thing our body likes is homeostasis – a blood sugar level too high or too low will send signals to the brain that this needs to be corrected. The greater the fluctuation, the louder this signal is. Insulin is the hormone responsible for removing glucose from the bloodstream to be used immediately for energy or to store it for later use (in our muscles and liver) and return the blood glucose level to homeostasis (normal). However, a meal that has a large amount of carbohydrate (a high carbohydrate load) will accelerate this process, as will a meal that has minimal protein or fat (even with a lower carbohydrate load, as the proportion of carbohydrate will still be greater). This is because insulin responds first and foremost to carbohydrate, with a minimal response to protein containing foods, and (for most people) a negligible response to foods predominantly containing fat. When this process is accelerated, insulin moves too much glucose into cells and our blood glucose level rapidly drops to below normal (an over-correction). The signal to our brain therefore becomes a panic signal: blood sugar has dipped below normal and needs to be rapidly restored – enter sweet food cravings as our brain recognises these foods are going to return our blood glucose levels back to within that normal range much quicker than, say, a salad. Along with the cravings, we may experience ravenous hunger (where 15 minutes earlier you felt fine), irritability (‘hangry’) and (in particularly bad cases) dizziness, light-headedness, sweating and vision loss.

The quicker the carbohydrates are digested (especially in the absence of fat and /or protein), the higher the rise and fall in blood sugar, and the greater the effects on energy and subsequent cravings for food (and ‘lack of willpower’). You may be fine for the morning and rapidly cave in post 3pm. Or it might be that Monday and Tuesday you are sweet, but by Wednesday you are raiding the kids ‘treat’ box in the pantry.

This isn’t just an issue with regards to blood sugar management and fat loss goals, but more importantly it can make you feel pretty rubbish. So many people start a tirade of negative talk that they weren’t able to say ‘no’ to a paleo muffin or chocolate biscuit, that they have ‘failed again’ and they ‘may as well finish the entire packet as it’s the last time they’ll eat X food again.’ Or their inability to resist a sweet treat clearly indicates they aren’t worthy of whatever health goal or life goal they’ve set themselves, and will eat junk food as a form of punishment (or undereat to try to get it under control), and so starts the rollercoaster ride of the blood sugar crash.

While I’d like to say it’s really easy to figure out which foods are most likely to cause this process, recent research tells us that there is wide individual variation. You are your own best investigator when trying to figure this out. It is useful, of course, to know where carbohydrate comes form in the diet and starting to explore how these foods affect you specifically. You can use an app like Easy Diet Diary, My Net Diary, Fat Secret to help you determine where the carbohydrate is in your usual diet if all of this is new to you. That said, an energy dense, carbohydrate source is more likely to trigger a blood sugar response. These include (but are not limited to):

  • Dates
  • Other dried fruit
  • Honey
  • Rice malt syrup
  • Bread
  • Pasta
  • Rice
  • Cereal (including Nutrigrain, Cheerios, most cereals with a Health Star Rating)
  • Honey
  • Coconut sugar
  • Kumara
  • Potato
  • Grapes
  • Fruit juice
  • Vegetable juice with a fruit juice base
  • Vegetable juice with beetroot/carrot base

This doesn’t mean that all of the above choices are bad! At all, however, in the wrong amounts, and when eaten in isolation of other food choices, these are more likely to spike your insulin levels than other foods. Artificial sweeteners do not get a free pass either, unfortunately, with some showing the same physiological effects as sweet foods, eliciting a glucose/insulin response.

So… it’s not willpower, people – it’s physiology.

The easiest and *best* way that helps mitigate this is NOT a supplement. While these can be useful in certain situations or medical conditions, for most people it comes down to food timing and balancing. Protein and fat don’t have the same insulin effect, so they are not going to cause the same blood glucose rollercoaster that carbohydrate does. Incorporating these as the majority of your energy source is going to slow down the digestion of the carbohydrate you eat and the subsequent rise in blood glucose. Without reaching the same ‘highs’, your blood glucose doesn’t have the same drops – and cravings, hunger and crashing energy levels are FAR less likely. Fibre from non-starchy vegetables are another way to have this effect and help maintain a homeostatic state.

Despite what I say, what other experts tell you or what the literature or dietary guidelines tell us, you are your own best investigator when it comes to figuring out what works for you. One of the easiest ways to measure how food affects your blood sugar control is to assess the qualitative signs after eating: do you feel like falling asleep after a carb-based meal? Do you get moody, irritable, ‘hangry’ a couple of hours after eating? Are you fine, fine, fine, STARVING a few hours after eating? These are all good indicators that your blood sugar is in control of your actions (rather than you). From a quantitative perspective, getting a glucometer (finger-prick blood glucose reader) from the pharmacy and testing your blood sugar two hours after eating a particular food or meal is another good way to see how this affects your blood sugar levels. If it lurks above the 7 mmol/L mark at this point, then potentially the carbohdyrate type (or the context with which you ate it) isn’t ideal for you. Remember, this isn’t just about the food you’re eating at that time, it has implications for your food decisions later in the day. This is potentially more important if you find you have ‘no willpower.’ If you need help figuring out what to do from here, contact me for a consultation, we can sort it out.

Finally, pro-tip: when eating a meal, eat the protein and vegetables before tucking into the carbohydrate component. This will lower the post-prandial glucose response and the overall effect on your energy levels, levelling them out as opposed to leading to a crash.

Time restricted eating: when you eat matters

Intermittent fasting is an increasingly popular phenomenon among people wishing to improve their body composition and their overall health – almost as much as consuming the latest superfood.

Intermittent fasting (or time restricted eating, as it is known in the scientific literature) is when we restrict our eating during the day to a window of from around 8 hours to 12 hours, and has been popularised by the fitness industry in recent years. There are different ways to approach it, though from a health perspective, eating earlier in the day to allow for the feeding to align with our body’s circadian rhythm may optimise the health benefits for overall longevity. Fasting has been a practice undertaken for centuries in some cultures, and research reports favourable effects on many markers of metabolic health, including blood lipid profile, blood glucose metabolism and hypertension when these populations have been studied. More recently, researchers have investigated different time restricted feeding protocols in relation to risk of cardiovascular disease, neurological disorders, diabetes and some cancers using rodent and human trials. The longer time spent fasting may have pronounced health benefits, though recently a more conservative method (of even an 11 hour fast) has emerged as being beneficial for certain populations. Indeed, time restricted eating is being thought of as an easy to implement, effective lifestyle intervention that could help improve appetite control, markers of overweight, inflammation, blood glucose metabolism and hypertension, all reducing risk of cardiovascular disease, diabetes and some cancers. This recent small study found that late night (or prolonged eating periods) increased fasting glucose, blood triglycerides, insulin and weight gain.

When healthy adults eat meals that are identical in terms of macronutrients (ie carbohydrates, proteins and fats) and caloric load at breakfast, lunch and dinner, the postprandial (ie. after eating) glucose response to the meal is lowest after breakfast and highest after dinner, even though the meal is identical. This is one example which suggests that our metabolism, and response to food, changes across the course of the day (see here). We are diurnal creatures – we do most of our activities during the day (including eating, working, exercising) and we rest at night. This is controlled by our internal clock in the brain, the superchiasmatic nucleus (or SCN) which in turn influences smaller internal clocks (or oscillators) in the peripheral tissues of our body. These clocks control thousands of genes within our body, including those that regulate our metabolic processes, which accounts for around 10% of our entire genome. While light is the major cue for the SCN in our brain, timing of food intake influences the circadian rhythm in the other tissues, including the liver, which has implications for metabolism. This tells us that our basic metabolic physiology is supposed to behave differently according to the time of day – this is everything from making neurotransmitters, to making insulin, to glucose transport inside of cells, to fatty acid oxidation and repairing cellular damage. It makes sense then that when we eat has just as important implications for our health as what we eat. Research investigating the health effects of fasting has found that anything that breaks the fast will break the fasting period, including no calorie options such as black coffee and even herbal teas. This is because there are compounds within these fluids that require breaking down by the liver. That is not to say that people don’t experience benefits from fasting if they consume a hot beverage earlier in the day (as is often recommended to help get through the morning hours and comply with a 16:8 protocol) or limited calories (for example, 50 calories), however longevity benefits may well lie within the strictest definition of fasting.

With the advent of artificial light, and the changing structure of work schedules (combined with the increasing busy-ness of everyday life), this has elongated the period of time that people eat, which has negative health consequences. While you may have heard in media reports of scientific studies that eating late at night makes no difference to overall weight loss, the focus on weight ignores the more important, underlying metabolic and chronic disease risk that eating late into the evening can have on health outcomes. It may be easier to regulate appetite too, as  research suggests that appetite hormones respond more favourably to eating earlier (8am to 7pm) than later (noon – 11pm), and the level of satiety achieved with this could prevent overeating. This is relevant with time restricted feeding as research has shown that more frequent eating patterns can be detrimental to metabolic health if consumed close together. One study found that participants who ate excess calories consuming their food over three meals and three snacks had increased visceral (stomach) fat deposition, liver triglycerides and lower liver insulin sensitivity compared to those consuming the same number of calories over three meals. The snacks were consumed later in the day, and after each meal, so elongated the overall eating period.

Animals limited to 9-12 hours feeding period, but not limited in the number of calories they eat have experienced benefits including decreased fat mass, increased lean muscle mass, improved glucose tolerance and blood lipid profile, reduced inflammation, higher volume of mitochondria (the energy powerhouse of our body), protection from fatty liver and obesity, and a more favourable gene expression. In humans, research studies suggest that eating within a time restricted window of 11 hours (say, 7am to 6pm) is associated with a reduction in breast cancer risk and occurrence by as much as 36%. Earlier eating time has resulted in more effective weight loss in overfat people, and every 3 hour increase in fasting duration was linked with 20% reduced odds of having an elevated glycated haemoglobin (HbA1c), a marker of long term blood sugar control. For every 10% increase in calories consumed after 5pm there was a 3% increase in c-reactive protein, a biomarker used to measure inflammation (the underlying process that, when elevated long term, can influence risk of diabetes, cardiovascular disease and some cancers). Finally, when meal times were constructed earlier in the day this resulted in a 10% decrease in c-reactive protein. Eating within a 12-hour window improved sleep and weight loss within an otherwise healthy population. You can see then, the myriad of potential benefits to eating within a time restricted eating – could it be worth trying to fit into your lifestyle? And if so, how to do it?

There are many different time restricted eating protocols to choose from – and the type of fast you choose to do really comes down to what works for you. The 16:8 protocol that seems to be most popular is a little aggressive for anyone new to fasting, and this may ultimately leave you feeling hungry, cranky, and vulnerable to overeating later in the day – undoing any potential health benefit that has been shown in the research. Indeed, many people I see that try this as their first experience report that they can successfully get to 11am or lunchtime without eating, but once they are home from work, no amount of food will keep them full, eating right up until bedtime.  My advice is to start a little more conservatively. Given that (in an ideal world), we sleep for 8 hours a night, not eating in the 3 hours leading up to bed time should be a good place to start for most people, thus it gives that 11 hours where some of the health benefits begin to be realised. From there, once adapted, you could try to push it out by an hour. While the most potent benefits occur with the strictest definition of fasting, the blood glucose and lipid improvements, along with fat loss can still occur in those whose definition of fasting refers to calories, not coffee and tea as mentioned above. That the benefits occur in the absence of caloric restriction is important to reiterate, however by restricting the eating period, many people also reduce overall caloric intake, which can further improve overall metabolic health and body composition. Fasting doesn’t appear to be something you must do every day to see the health benefits either, and even 3-4 days a week could be beneficial for metabolic health.

That said, this reduction in calories and extended time NOT eating may not be good for all, especially if your notice increased anxiety, sleeplessness or disruptions in hormone balance, so it is always best to proceed with caution. It would also be prudent for any individual with a health condition to discuss with their health professional before embarking on time restricted eating, especially the more aggressive protocols.

(PS I’ve got dates booked for Nelson, Wellington, Dunedin and Christchurch for my talk! Click here to find out more details, would love to see you 🙂 ).

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As with many things, it could be all about timing…

LCHF…why isn’t it working for me? (Part 2)

Last week I posted three reasons why many people undertaking a LCHF diet stall with their success or never get it off the ground to begin with. The following delve a little deeper into the less obvious reasons why people struggle with their diet, and offer some options to help troubleshoot.

  1. Fat doesn’t fill you up. For some people, they don’t feel satisfied when swapping out their carbohydrate for more fat. If it takes a few handfuls of nuts or half a block of cheese to feel satisfied, then there can be some serious increase in calories that isn’t compensated for by an appropriate increase in satiety from the meal. Yes, cheese and nuts contain protein, but to be honest I treat them more as sources of fat than I do protein. If this is you, then.
    1. Increase the portion of protein you are consuming with your meals. I know many people are scared to consume more protein because protein can be broken down into glucose in the absence of carbohydrate, therefore pushing up their blood sugar levels. For people on a ketogenic diet (where 80% of their calories should come from fat), or those metabolically damaged (whereby there is a dramatic change in blood glucose response from a protein-rich meal), this may be a problem. For most people though? upping protein by 1/3 of a serve is no biggie. Still hungry? Up the protein some more.
    2. Drop out some fat –make room for the added protein by dropping out some of the fat – you could start with ½ – 1 serve and see how satisfied you feel when you do that. A serve of fat is typically 1 tablespoon of oil or butter, or ¼ avocado.
  2. You’re eating too much in one meal. A lot of people move from three meals a day, to two a day, to a ‘minimal food during the day’ approach, to sit down to a large meal at night, especially if they’ve been in the LCHF way of eating for a while and are further tweaking it. This may be awesome for some people, but not all. Eating most of your calories in one meal can, though, wreak havoc on your metabolic blood markers (such as blood glucose levels and insulin), increase fat gain, inflammation and reduce your day-to-day energy if this eating pattern doesn’t suit you. You’ll know if this is you, and if it is then:
    1. Spread your food intake out across 2-3 meals to lighten the caloric load and see if this makes a difference to your energy or other more objective markers mentioned above.
    2. Remember you’re still a rockstar even if you have to eat more often.
  3. You’ve got a high intake of dairy or nuts. Some, especially women, are not suited to high amounts of dairy or nuts, and when the begin to include more of these foods – ones they’ve avoided for years due to their fat content – they have a weight loss stall they can’t move past or, worse, they begin to store fat around their middle. While some suggest cheese is a food akin to crack, research investigating the addictive properties of the protein in cheese have not found this to be the case. Of course, if you personally can’t stop at one slice and find you’re eating the block, then perhaps it is for you. Nuts can also be trigger foods for some people, and they find it difficult to stop once they’ve started eating them. Ditto with a jar of peanut butter. What to do?
    1. Omit dairy for 30 days – sometimes it’s not the dairy per se, it’s the amounts that you’re eating it in that need to change. Removing it entirely will allow you to change your habits and then reintroduce it.
    2. Omit nuts and/or nut butter as per above in #6a.
    3. Swap snacks to those that are predominantly protein-based rather than fat based – despite the satiating effects of fat, for some, it’s just not like having protein. A hardboiled egg or some leftover chicken wrapped in lettuce or nori sheets (my current obsession) may satisfy you more.
  4. Genetically this isn’t the diet for you. If metabolic markers such as cholesterol, blood sugar or inflammatory factors go skewiff then it could be the LCHF approach doesn’t suit you. Genetic variation in the ApoE gene (ApoE4) is associated with LDL cholesterol not being recycled very well, and therefore it’s more likely to hang around the bloodstream and increase the chances of it becoming either oxidised or being transformed into smaller LDL particles, both highly atherogenic. Variants in the gene FTO can increase risk of obesity in the context of a high saturated fat and low polyunsaturated fat intake and may increase risk of high blood sugar and diabetes in individuals already overfat. The PPAR genes plays a role in ketogenesis (the oxidation of fat for energy) and storage of fat by activating genes associated with fatty acid transport and metabolism. Variants of this gene (particularly PPARa and PPARg ) are associated with increased risk of high triglycerides, total small dense LDL cholesterol and type 2 diabetes in the context of high saturated fat to polyunsaturated fat intake. Further, individual glycemic (blood sugar responses) vary considerably for the same amount of carbohydrate in food, suggesting there are a lot of factors to consider when determining the best diet for you (such as genetics, gut microbiome, activity level, stress etc), not just its macronutrient content. How to figure out if LCHF is not the diet for you? A few things to consider:
    1. Are you losing weight? If so, then wait until your weight stabilises and then retest your numbers – your body recycles triglycerides that are released from adipose (fat) tissue, therefore your triglyceride levels can appear high, but it is transient.
    2. Don’t get your cholesterol levels measured if injured, if you haven’t slept properly or you’ve been under significant stress. Cholesterol levels can change easily based on environmental triggers.
    3. Some people notice their cholesterol increases specifically in response to dairy fat, others to coconut fat – experiment for 6-12 weeks by dropping these out of your diet and get your cholesterol levels retested to see if this brings a drop in your numbers. Replace it with foods that have a more balanced fatty acid profile (such as lard or beef tallow) and foods high in monounsaturated fat or omega 3 fats, such as avocadoes, olive oil, nuts, seeds, salmon, mackerel, sardines.
    4. Here’s one I prepared earlier (and by ‘one’, I mean, ‘post on reducing your cholesterol naturally’. And by ‘naturally’ I mean ‘without Flora Pro Activ’).
    5. Get more in-depth testing of your cardiovascular disease risk profile – cholesterol is one measure and possibly not the most important one. CRP, fibrinogen, LDL particle size, number, oxidation and patterning can all give you more information than the run-of-the-mill lab test can. Contact me as I can help you arrange this testing which, for the most part, your doc might not even be aware of.
    6. Consider getting tested to find out your genetic predisposition (either through your doctor, or I can assist via Fitgenes gene testing).
    7. Consider dropping your fat intake, upping your protein intake and perhaps your carbohydrate intake too – ala the Zone diet approach. Despite its gimmicky name, it’s proven itself to be very effective for blood sugar stabilisation and blood cholesterol management. Some people just aren’t meant to eat a higher fat diet.
  5. You’ve got an intolerance you didn’t realise you had. Going LCHF means, for many, significantly increasing fat content in the diet from the obvious choices: cheese, nuts, seeds, avocados and coconut products. However, while these are awesome in terms of the nutrients they deliver, they can cause digestive issues in a number of people. Avocado, coconut, nuts and seeds are moderate-high in FODMAPs – a type of carbohydrate that can cause bloating, abdominal pain and other irritable bowel symptoms in many people. Further, the inclusion of larger amounts of cream, cheese or full fat yoghurt can be problematic due to an intolerance to the dairy protein or fat which can result in similar IBS in susceptible people. If you’ve been following a low-fat diet for many years, enzymes that help digest the fat and protein may be downregulated, so your body might not cope with the additional amounts. Sometimes it is a matter of backing down and building up, and sometimes it is that these foods just don’t agree with you. What to do? One of these tips may help:
    1. Follow a lower FODMAP approach to see if removing these foods settles down your discomfort. Doing this for at least 21 days and reintroducing a different food one at a time can pinpoint which one in particular might not agree with you.
    2. Introduce fermented foods as per #3e above to re-establish healthy bacteria in your gut.
    3. Replace dairy fat for alternative fat choices: nuts, seeds, avocado, coconut oil, beef tallow, lard.
    4. Ensure you chew your food properly at each meal to break it down, include lemon juice in water in the morning, and apple cider vinegar with meals to stimulate your digestive system, and consider ox bile supplement or a digestive enzyme that has lipase and/or pepsin enzymes to help you break down the fats and proteins.
  6. You’ve upped your alcohol intake because red wine and white spirits are “allowed” on LCHF. This might not even be intentional, but dropping your carbohydrate intake can lead to increased alcohol cravings, especially if your fat intake is too low, or your food intake is too low, or your stress levels are chronically too high. Or perhaps, you enjoy a moderate amount of alcohol but are continuing to gain weight on the LCHF diet.
    1. Be honest about how much you are drinking. Regularly consuming a ‘large’ as opposed to a ‘standard’ pour at the pub? Cracking open a bottle one night and then drinking to finish it off? Your plan to be alcohol free during the week has reduced to being alcohol free Monday – Wednesday? Evaluate if this is a problem for you … or not!
    2. Go alcohol free 5 nights a week, and enjoy a glass of whatever you fancy on the other nights. Ideally not those lolly water vodka mixes, but if you don’t like red wine, then choose something else. It’s not a deal breaker.
    3. Eat enough during the day so you’re not craving alcohol in the evening. This may mean including some additional starchy carbohydrate in your lunch meal – it doesn’t mean you’re not ‘low carb’ – as that in itself is a spectrum. This can really offset your cravings. Try it for 14 days to see if there is an effect.
    4. Lighten the load by choosing to have a low-fat meal if you drink. Old Skool 90s ‘dieting’ approach – those fat calories will only be missed by your adipose tissue, which is where they will be directed to when consumed with alcohol (which is processed first and foremost).
    5. Drink to ensure you are hydrated before you have your first alcoholic drink. This is like 101 really – we always drink more when we are thirsty, and then when we drink more, we become uninhibited and then all hell can break loose, right?
  7. Food timing: If you’re beginning your day with breakfast at 7am and winding down with a cup of tea and some dark chocolate at 10pm, you may be doing yourself a disservice. Eating over a time period of more than 12 hours can be deleterious to health. Recent research has found that restricting the eating period to 12 hours or less can improve insulin resistance and glucose tolerance, and reduce breast cancer risk even when the calories remain the same. Anything you consume that requires processing of any sort by the liver – including black coffee or herbal teas – will begin the metabolic process. When we eat is also important as our appetite hormones are on a circadian rhythm (food being an important signalling molecule for hormones), and eating late at night – even if overall eating window is short – can be problematic for your liver. The benefits derived from intermittent fasting (such as these) can still be realised if your version of fasting includes coffee in the morning, however it appears actual fasting (nothing but water) for at least 12 hours is most beneficial for metabolic health.
    1. Try to keep within a 12 hour window for consuming anything other than water. If you struggle with remembering to do this, there are apps that can help. It’s not as hard as it might seem – if you have breakfast at 7.30am and are done eating by 7.30pm then you’ve nailed it.
  8. You’ve focused entirely on diet without giving pause to consider other aspects of your lifestyle that contribute to your wellbeing. Lack of sleep, chronically elevated stress levels, over or under activity can all contribute to some of the common complaints people attribute to diet which have nothing to do with the food.
    1. Evaluate your sleep – are you getting to bed at a reasonable hour? Able to sleep through the night with ease? Feel refreshed waking up?
    2. Evaluate your physical activity – are you doing enough? Are you doing too much?
    3. Evaluate your stress levels – are you trying to do too much? Feeling overwhelmed? Or conversely is there not enough stress to keep you stimulated and motivated?

Of course these factors contribute to how your body responds to the food, but it isn’t the food per se. As I said last week, this isn’t a definitive list, however if any of these resonate with you then try some of the ideas I’ve listed, or enlist the help of someone like me to guide you to the best approach for you.

PS: I have organised a few talks over the next couple of months to talk about making a real food (aka LCHF) approach work for you. At the moment I have:

  • Takapuna 23 March @ Streetwise Organics, Byron Ave
  • Hawkes Bay 6 April – location TBC
  • Queenstown 25 May – location TBC

…with others to come, so watch this space 🙂

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Yes, I created this pic myself 🙂

 

LCHF…why isn’t it working for me? (Part 1)

It’s about this time of year that I start seeing people come through my doors needing some minor (or major) tweaks to their LCHF eating approach. There are usually one of two scenarios.

Scenario #1: When they embarked on LCHF they saw ALL of the benefits they heard about, effortlessly shedding body fat, boundless energy (in training and afterwards), improvement in skin tone, hair condition, sleep and digestive problems. But lately the opposite is true. Despite seemingly nailing this LCHF lifestyle, they’ve noticed they are lacking energy, gaining weight (especially around the middle), latest blood tests have seen their cholesterol levels have shot up (and perhaps triglycerides), they are unable to sleep… … yet if anything, they’ve instigated (and nailed) the hacks they’ve read to optimise their LCHF eating approach. What gives??

Scenario #2: They’ve given it a good go on their own for the last 5 weeks, following it to the letter and despite this, it’s ‘not working for them.’ Worse, their husband/workmate/training partner has taken to it with ease.

Frustrating, much?

While we are all individual as to what is going to work for us, the LCHF approach is a really good one for most people, most of the time. Despite that, there are small things that can derail your best efforts to improve your diet, so I want to cover off the basic (and more nuanced) reasons people don’t fare well on a LCHF approach, and some tips on how to overcome them. I’ve ended up splitting this post into two parts as it was so long!

  1. Too low carb. The internet is a wonderful and terrible thing – information is everywhere, everyone is an expert and the version of paleo/LCHF/JERF that you’ve adopted based on what others are doing may well be too low carb for you. LCHF is a spectrum, and what is low carb for one person may well be higher carb for someone else – generally speaking, anything up to 200g of carbohydrate/day could be low carb. It all depends on context. I see a lot of people who are trying to stay strictly below 25g of carbohydrate a day – too strict (and unnecessary) for most people. Even Prof Tim Noakes, staunch advocate of a LCHF approach to eating (“banting”) has loosened up on this. The people who really benefit from a diet this low would be those embarking on it for therapeutic reasons: diabetes (both types), epilepsy, cognitive health (Alzheimer’s, for example). That’s not to say that others out there can’t make this level of carbohydrate work for them. But if you’ve noticed fat gain (especially around the middle), irritability, hormone imbalances (such as a missed menstrual period), lack of energy (past the initial phases of the LCHF approach), irregularity of bowel motions, sleeplessness – to name a few symptoms, then you may have gone too low. What to do?
    1. Track your diet for 4-5 days to get an average of the grams of carbohydrate you eat per day. If it’s on the very low end of the scale (less than 50g*, for example), then try adding back in some good quality starch to see if any of your symptoms improve. Don’t be pedantic about vegetables. Really. That includes carrots and tomatoes. To be honest, you don’t have to track your carbs if you’re not a numbers person – but it can be a good way to assess if this really is the problem. Use My Fitness Pal, Cron-o-meter, My Net Diary or Easy Diet Diary as nutritional tracking tools. (If you’re embarking on a lower carb diet, this is a good first step regardless, so you don’t make the jump from 400g a day to 60g a day).
    2. If your carbohydrate intake is in the realm of 80-100g carbohydrate, you may not be too low, it might be more of a timing problem – ensuring you have carbohydrate in the meal after a high intensity (i.e. CrossFit or F45) or long duration exercise session can help improve recovery and alleviate a lot of fatigue/irritability. If you’re struggling with insomnia, then adding in some kumara or potato into your evening meal increases production of precursors to melatonin.
    3. Is it more protein you need? Protein can help keep you fuller for longer, stabilise blood sugars (therefore has implications for focus/energy/concentration), promote recovery and help with sleep. Many people fear protein because of the potential for it to be converted to glucose in the body (via gluconeogenesis). For someone following a LCHF diet this isn’t an issue. Try upping your protein portions by 1/3 – ½ at each meal.
    4. If it’s in the initial phases, then up your intake of sodium – to levels more than you think you need. When we drop the carbohydrate content of the diet, we drop a lot of water stores too (hence a rapid loss on the scales) – this is because for every gram of carbohydrates stored, we store an additional 3g of water. Add salt to your meals, a pinch in your water bottle, make a miso drink or drink bone broth.
  2. Not low carb enough. I see this a lot. People equate carbohydrate to bread, pasta, rice and cereal and don’t think about other foods that are predominantly carbohydrate –fruit, dried fruit, ‘green smoothies’ with a fruit base, bliss balls, natural fruit and nut bars… In addition, many products are promoted as ‘sugar free’ when they contain dried fruit, maple sugar, rice malt syrup or some other type of natural sweetener. This may seem elementary to you, but I know many people are confused by this point. Regardless of what you hear, sugar IS just sugar – that one sugar is lower in fructose doesn’t mean it’s not going to influence your blood sugar levels, it’s likely to affect them more. This has to be my biggest bugbear of the ‘real food’ movement; not that these products contain sugar – but that they are marketed as not. This is no better than being told that Nutrigrain is healthy. We all know that’s not true.
    1. Again, track your numbers (as per above) via a tracking tool. A lower carbohydrate approach is not a fixed number, it’s a spectrum. But if you’re still consuming over 200g a day and not engaging in regular physical activity, then something might need to be tweaked (especially if you’re not seeing the results you’re after).
    2. Get rid of the bliss balls, the dried fruit, the paleo muffin or the smoothie from your favourite juice bar that you thought tasted suspiciously sweet for something ‘green’.
    3. Read the ingredient lists on the packages you buy. Sugar has over 56 different names. You probably don’t need to know them all, but it would be good to have an idea, right?
  3. Too many processed foods or snacks. Even if you’ve found a sweet spot with your macronutrient intake, having too many processed ‘low carb’ snacks can continue to drive your appetite hormones in a way that favours eating more than you need. Leptin is a hormone produced by fat cells that tells the body when we’ve had enough to eat, and is involved in the regulation of calories we burn and body fat that we store. A consequence of being over-fat is high circulating leptin levels in the bloodstream, and the brain stops reading signals sent by leptin that we’ve consumed enough food. Instead, it incorrectly believes that we are starving, thus we feel hungrier. Excess body fat increases Inflammation in the body, and is one of the drivers of leptin resistance, and processed food can drive inflammatory pathways in the body – even low carb processed food. And if you’re not over-fat? Well, vegetable oils and certain additives and preservatives found in these foods can drive inflammatory pathways in the body. In addition, an overabundance of processed flours may cause disruptions to our gut microbiome as they are easily digested, perhaps not even making it to the gut bacteria in our lower digestive tract. This can mean we are starving our good bacteria and instead feeding bacteria that release endotoxins, causing increasing inflammation. This can have a secondary effect of increasing your cholesterol level (see this post here). These foods are created in such a way to send signals to your brain’s pleasure centre and drive your appetite for more food that you just don’t need. One of the benefits of a real food approach (which naturally lowers your carbohydrate intake) is that inflammation reduces, insulin drops, gut bacteria can rebalance and the signalling pathways in the brain that regulate your appetite hormones can begin to normalise.
    1. Get rid of most foods or snacks that come in a package with ingredients you don’t recognise.
    2. Eat real food. Base your snacks around hardboiled eggs, cheese (for the dairy tolerant), vegetables, leftover meat, macadamia nuts, egg muffins.
    3. Drop the nut flours. Just because they’re low carb does not mean it’s a free for all with these processed flours.
    4. Increase foods that help balance out your fatty acid profile: more fatty fish (such as salmon, mackerel, sardines) and (grass fed) meat for omega 3 fats. Consider taking a fish oil or algae omega for those who don’t eat fish – and be picky about the supplement!
    5. Take care of your gut: consider a probiotic for 30-60 days (such as Lifestream Advanced, Inner Health Plus, Syntol or Prescript Assist) to help populate the gut with the good guys, but also keep them fed with fermented foods such as sauerkraut, raw apple cider vinegar, water kefir and an abundance of vegetable fibres.

I’ve got more – quite a bit more actually! – but will post that in Part 2 so as not to risk losing your attention ;-). These are three of the basics that people can get wrong (particularly in the initial phases), and the next post will cover some of the more nuanced reasons, and what you can do to correct them. If you’re not sure whether your LCHF diet is working for you, why not jump on and book a consultation with me? An expert eye can help take the thinking out of it for you and save a lot of stress long term.

*50g still pretty low actually! Again, it’s all context 😉

low-carb-zone

Are you in the zone? (PC: http://www.tripfitness.com)

Constant cravings? Here’s 18 evidence-backed (or anecdotal) tips that will curb them.

Are you back into the swing of things but your taste buds aren’t?  It happens! Especially around this time of year where intake of sugar, alcohol and processed carbohydrates tends to be higher for most people, and while going cold turkey can be the best move, it’s sometimes easier said than done. The good news is that by reducing these foods, you’ll begin to lose the taste for them, and they’ll no longer hold the appeal that they had. For some though, completely removing them is a better idea – even small amounts can continue to drive the appetite for them. Regardless of which camp you fall into, here are some proven, some anecdotal, and some interesting ways to combat those cravings.

  1. The basics: build your plate based around protein and fibre, with fat for satiety. Protein is well known to be the most satisfying nutrient, and along with fibre (also key for adding bulk and feeling full) will keep most people satisfied longer than either carbohydrate or fat. Any starchy or carbohydrate-based foods are best if they are minimally processed (such as potatoes, kumara, legumes, fruit) as these will provide more nutrient bang for your buck). How much of each? Protein-type foods (meat, fish, eggs, poultry) aim for 1-2 palm-sized portions. Starchy carbs (if included) at around a fist-sized amount.  Fat? 1-2 thumb-sized amounts, depending on the type of protein portion you’re eating: a fattier cut might be satisfying enough, however a lean chicken breast will likely require some added fat to help satisfy you. And vegetables? Go for gold – other than the starchier varieties (mentioned above) you could fill your boots with these. For some people, having a full plate is essential to feeling satisfied and if you can do that by adding more volume, it is going to have a positive effect on the satiety from a meal (that’s definitely me). For some ideas, check out my recipe e-book or my online coaching service.
  2. Get rid of anything that is ‘your poison’- if you are the person that hears the icecream calling you from the freezer, it is much better off out of the house. Out of sight, out of mind.
  3. Put all the ‘treat’ type food in one place in your house, preferably above eye level. This will save you seeing the Christmas cake when you are grabbing the eggs, and the chocolate almonds when you are searching for the bottle of olive oil. Constant reminders of all the things you are trying not to eat will NOT help your cause.
  4. Chew your food properly at each meal. Aim for 30 times per mouthful. That way you’ll digest your nutrients effectively, feel more nourished and less likely to be hungry an hour after eating because you wolfed that meal down.
  5. Do not substitute those refined sugars for ‘natural’ sugars. That dried fruit is pretty much just sugar – and (a few nutrients and fibre aside) no better than sugar and will continue to drive your sugar cravings. You shouldn’t rely on dried fruit (or any sweet food that is marketed as ‘refined sugar free’) as a substantial nutrient source . Any additional fibre or nutrients they provide in the diet is negligible compared to the whack of goodness you’ll get when you follow #1 above. When health bloggers or food producers market something based on the healthfulness of the ‘natural’ sugar, it is pure embellishment. 6 meedjol dates and a banana does not make a smoothie sugar free.
  6. Coconut oil – this is a favourite of Sarah Wilson’s: a teaspoon of extra virgin coconut oil can kill a craving in its tracks. If we head to the literature to find any peer reviewed papers on the topic (for what it’s worth, there is a LOT of research published by the Coconut Research Center), there isn’t a lot to definitively tell us that it will cut cravings. That said, there is some research has found that people who include more coconut oil in their diet (compared to other types of fat) have reduced food intake overall, particularly in the subsequent meals. Like most things, you have nothing to lose by trying it.
  7. Cocoa – chocolate is long associated with cravings, though right now, consumption of chocolate may well increase the cravings rather than stamp them out. It’s also not exactly useful if you’re trying to focus on reducing your intake of junk food! That said, chocolate is known for its cognitive and mood enhancing benefits. So how about some unsweetened cocoa (or cacao) in hot water with some milk to deliver the chocolate taste you are after. Add a touch of stevia if you wish. You could also do this cold with almond milk and ice – and add 1 tablespoon of psyllium husk or gelatin in there for some additional fibre or protein. If chocolate is what you’re after – go for the darkest that you can stand. Many people find they stop at 1-2 pieces of 90% chocolate instead of the 1-2 rows consumed of the 70%.
  8. Anything that lowers your blood sugar response to a meal is going to positively impact your cravings. The steep rise and fall of your blood sugar in response to a meal causes alarm bells to start going off in your brain. The body runs a tight ship and prefers when all systems are in homeostasis. Low blood sugar causes a release in stress hormones which tell your liver to dump glucose into the bloodstream, and create cravings so you can re-establish blood sugar to within a normal range. Including cinnamon can reduces glucose response after a meal (in amounts of 6g) and affects insulin response. Stabilising blood sugar is going to help reduce cravings. Sprinkle this gold dust on your breakfast, with your teaspoon of coconut oil, in your cocoa drink etc.
  9. Glutamine – can enhance secretion of GLP-1, a hormone which promotes insulin release that helps increase satiety and dampen appetite – this is only seen in some people however, suggesting there is individual variation of its effects. The flipside of this is that the insulin-releasing effects may override any satiety benefits, increasing hunger (and subsequent meal size) at the next meal. However, in practice this is a tool that many clinicians (myself included) have found useful for some (but not all) clients. The presence of glutamine in the bloodstream is associated with improved insulin sensitivity in healthy people. In addition to this, glutamine has been found to be beneficial for improving intestinal permeability and tight junction protein expression in the gut, being one of the most abundant amino acids in the body. If your cravings are related to gut dysbiosis then it could be useful from this perspective. In addition, it functions as part of neurotransmitter production. Taking L Glutamine by putting it under the tongue as a craving hits (1-3,000mg) may just work for you.
  10. Magnesium is a nutrient that is involved in over 250 processes in our body, and particularly when we are under stress, it is put under the pump. Sugar (or specifically) chocolate craving is often linked to a deficiency to magnesium, but that isn’t conclusive. At any rate, magnesium is perfectly safe to take, and as our food supply is relatively low in magnesium, looking for a supplement that is a magnesium glycinate, citrate or chelated with amino acids may be useful, at amounts of around 300-400mg elemental magnesium.
  11. Chromium is another supplement that some people have found useful for stopping cravings – research has found a reduction in carbohydrate cravings, food intake and an increase in satiety when supplementing with chromium…however this is in the laboratory using mice. There’s nothing definitive in the research to support using it for people who already have adequate amounts of this mineral. That said (as with anything), it’s individual – I know many clients who swear by using Chromium supplements when a craving hits. The only way to know if it works for you is to try it, by taking 1000mg chromium in two doses in meals that contain carbohydrate (due to its suggested benefits at reducing blood sugar response to carbohydrate meals)..
  12. Branched chain amino acids (BCAAs) are three amino acids that act as nutrient signallers which may help reduce food intake . Leucine (one of the BCAAs) activates mammalian target of rapamycin (mTOR) which is required for our brain to respond to leptin (a hormone that tells our body when we have had enough food). BCAAs are involved with hormone release in both the gastrointestinal tract and in fat deposits. BCAAs and dietary protein enhanced glucagon like peptide-1 (GLP-1) release and reduced the expression of genes required for synthesis and adsorption of fatty acids in a human intestinal cell line (NCI-H716), suggesting an intestinal mechanism for the beneficial effect of BCAAs. Those that have successfully used BCAAs suggest 5g in the AM and every few hours while you’re adjusting your diet back to baseline awesomeness.
  13. 5htp: 300-500mg taken with a meal to increase satiety of the meal – studies have found a reduced food intake (particularly carbohydrate). Studies conducted have focused on people who have reduced availability of tryptophan in the brain (a precursor to 5htp). Increasing 5htp increases tryptophan and therefore serotonin production, reducing cravings and overall food intake. (Don’t use if you are currently on antidepressants without clearance from your doctor.)
  14. Exercise. A no brainer, really, but research has found this to be super effective for reducing cravings. In fact, any activity done while in the midst of a craving will take your mind off it. So when a craving hits, doing something active for 10-15 minutes can reduce your desire for something sweet. Go for a powerwalk, shoot some hoops, do some hill sprints…
  15. Make sure you’re getting enough sleep! It’s hard this time of year with longer days and opportunities to take advantage of summer (when it shows up…) Sleep restriction enhances activity in brain regions involved in reward in response to energy dense, nutrient-void food (think: lollies, chips, chocolate), suggesting heightened sensitivity to rewarding properties of food. This can lead to increased cravings. If you are burning the candle at both ends and not yet back to your regular 7-8 hours sleep per night, then nailing this will go a long way to helping curb that sugar demon.
  16. Meditation: decentring – viewing your thoughts as separate from yourself – has been found to help reduce food cravings and want for unhealthy food items. Mindfulness practice is also useful for not only reduced cravings, but for reduced emotional eating, body image concerns. It doesn’t require a 90 minute class three times a week (though there’s nothing wrong with that!) Headspace, Calm or Buddhify are three smart phone applications which may help you get going and provide guided sessions of between 2-20 minutes long. It’s consistency and frequency that makes a difference (like any habit).
  17. Clay modelling to reduce cravings: yep. Researchers found that visual imagery plays a key role in reducing craving. Participants who worked for 10 minutes constructing shapes from plastacine had reduced cravings for chocolate compared to people who were left to their own thoughts or who were given a written task.
  18. Your gut bacteria can influence your cravings. There is indirect evidence for a connection between cravings and the type of bacteria lurking in your gut. For example, people who enjoy and crave chocolate have different microbial metabolites (i.e. bacteria by-products) in their urine than “chocolate indifferent” individuals, despite eating identical diets. In addition, gut bacteria can influence the production of our ‘feel good’ and motivation hormones (serotonin and dopamine), thereby influence food decision-making based on our mood. Finally treating mice with a probiotic reduced hunger-inducing hormones and food intake. Action points here? Yes, you could start with a probiotic, particularly when you’re in the thick of it all, as this will help ensure there are beneficial bacterial strains present in your gut. However, for ongoing gut health, the regular addition of probiotic and prebiotics through food will help you maintain a healthy gut microbiome. Therefore:
  • Include fermented vegetables into 1-2 meals daily, working up to 1-2 tablespoons at a time.
  • The addition of unsweetened yoghurt (dairy or coconut) as part of your everyday diet (as it contains beneficial bacteria).
  • Kombucha, at around 100-150ml per day (check the back of the label to ensure a lower sugar variety).
  • Water, milk or coconut kefir, start with around 100ml per day.
  • Raw apple cider vinegar in water – start with 1 tsp in a small amount of water, working up to 1 tablespoon. This will help stimulate stomach acid when taken prior to meals, helping you digest your food properly, and delaying gastric emptying, so your glucose response to the meal will be slower too.
  • Vegetables, in abundance, to include fibres that feed your gut bacteria.

(As a side note, any change to your gut environment can result in unintended (and unwanted) changes to your digestive tract! If you’re new to the fermented foods and/or probiotics, then start small and work your way up. If you end up spending way more time in the bathroom than you wanted, reduce back further. Consider yourself warned.)

You won’t need to do all of these – but I think #1-5, #14, #15, #16 and #18 would completely diminish that sugar demon so you can get back to feeling awesome.

cravings

Grab that cupcake and bin it immediately. Underneath something that will stop you from retrieving it later on. (PC: SamadiMD.com)