Exercise for longevity – is there a best approach?

The older I get, the more I am interested in the effects of ageing on our overall health span. Ageing is unavoidable, it happens to the best of us. Listed below are some of the physiological and biological changes that can occur the older we become:

  1. Insulin resistance – this is in healthy weight older adults also, with research showing there is more peripheral insulin resistance compared to a younger population (an inability to dispose of glucose into the tissue).
  2. Decreased availability of anabolic hormones, and increased frailty with lower levels of hormones
  3. Increased anabolic resistance, so not only is there a decrease in the hormones that signal tissue growth, the muscle tissue is less responsive to the stimulus of amino acids (protein) and exercise, and there is less muscle protein synthesis in comparison to breakdown.
  4. Greater protein requirements for the same relative gains in muscle, strength and function compared to a younger population
  5. Decreased motor neuron function, therefore less neural signalling to muscle tissues and reduced motor function.
  6. Increased intracellular oxidative stress, causing inflammation and reduced cell functioning
  7. Reduction in satellite (stem) cells numbers and regenerative capacity – these cells are essential for the maintenance and repair tissues in normal physiological processes or in response to muscle damage/trauma.
  8. Elevated myostatin signalling, a protein that blocks our ability to build muscle
  9. Increased chronic inflammation (also known as inflamm-aging)
  10. Changes in autophagy, where ageing reduces our ability to clear out damaged DNA
  11. Mitochondrial functioning abnormalities, where we can’t utilise energy metabolites as effectively to fuel mitochondria
  12. Reduced ability to be physically active (due to many of the reasons listed above)

Clearly, these are not all inevitable. However, it is a long, daunting, and rather depressing list of what can occur as we age – and we are an ageing population. There is no doubt that if we don’t look after this body we have got, then we really are staring down the barrel of a loaded gun.

The list above describes many of the mechanisms to explain the loss of muscle mass and function. It’s not about being ripped or having gainz, it’s about having proper functioning of the muscle so it can work effectively in our older years – this is what is shown to have the most positive impact on our cardiovascular, neurological and musculoskeletal systems.

Inactivity is the broader environmental issue that contributes substantially to the physiological issues I have mentioned above. We need to be active – in everyday life, and with some structured activity too. Hanging out washing and housework isn’t going to cut it, I’m afraid. I see a lot of people who have this idea that you don’t need to exercise in order to lose weight, and you can do it solely on diet alone. This is true, of course, but when you embark on any weight loss plan that restricts calories (i.e. any weight loss plan that is out there), then you will lose both fat weight and muscle mass – lowering your overall metabolic rate along with it. This is one of the reasons why weight regain is so prevalent. However the powerful combination of diet plus exercise helps sustainable weight loss. And exercise isn’t just moving around the house, doing chores – this should just be part of everyday living. Data looking at the effects of exercise show that resistance training confers benefits over and above what we would see if we were just doing 30 minutes of cardio-based exercise per day, something that many of us maintain, but it doesn’t offer the same benefits.

The right type and duration of exercise:

The challenge is to get people exercising. And this is especially so for those who read what I have said above, and think that – on top of 30 minutes of aerobic training they don’t have time to do, they need to then put some resistance (or weight) training in.

This is not a call to encourage you to find an additional 3 hours in your week, though. In fact, a study that is about to be published (I heard about it on STEM talk) suggests that just 72 minutes a week in total is enough to help many of the conditions associated with ageing and poor health that I’ve mentioned above. Egan and colleagues found a combination of both resistance and cardiovascular exercise in a circuit-type setting for adults over 65 years just three times a week for 24 minutes increased walking speed, leg strength and reduced trunk fat. These measures speak to better muscular function, obviously increased strength, and will help reduce metabolic health risk. The improvements were more potent in this combined group than either resistance training or aerobic training for the same duration. It wasn’t olymic lifting from the sounds of it,  but it also wasn’t lifting pink dumbbells, either.

So this was a very long preamble to the main message: if you are currently NOT exercising, then please start. While there are modalities that are better than others, seriously, anything will be better than nothing. The study I talked about is in older adults, you likely don’t need me to tell you that any age you start is obviously better than not starting at all. AND the earlier you start, the better the overall health outcomes.

There is often an argument as to which is best; exercise or diet for improving health. That’s a weird argument to my mind. Both are important and should be prioritised if you want more life in the years you’ve got left.

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One of the only pics I could find that didn’t involve pink dumbbells. (PC: https://www.frieslandcampinainstitute.com/)

Food rules.

I’m all for flexibility when it comes to what people eat. Labels like ‘vegan’, ‘paleo’, ‘keto’ for a lot of people aren’t particularly useful (even when self-imposed) if that means the structure of their food intake is tied up into the ‘rules’ of that particular diet. People panic when they are out of their own food environment and unable to eat according to the rules of their dietary ethos. While there are those who intuitively know they don’t need to rigidly eat the same foods or meals to be able to progress towards their health goals, this isn’t a widely appreciated concept. For some, diet ‘rules’ can create a certain degree of neuroticism around food; people argue it is a form of orthorexia at its worse – I’m not sure I agree with that, given the complexities associated with diagnosed eating disorders. Regardless, if the anxiety around food exists, it can lead the person to turn down invitations where their dietary rules will not be able to be adhered to, thus becoming socially isolated from their normal circle of friends. Or they may still attend with the intention not to eat, only to ‘cave in’; one small snack becomes a bit of a binge-fest because they have ‘blown it all.’ Both of these situations can make a person feel pretty terrible, and do nothing for their self-esteem.  You can see why, then, there are people who are adamantly against ‘rules’ around food.

However, I don’t agree that there shouldn’t be any structure around what, how, and when a person eats.  I think you’ll know I’m not suggesting this structure should equate specifically to a dogmatic dietary regime, such as only eating ‘paleo’ or ‘raw vegan’. I’m talking about rules that take the decision making out of some pretty common every day food experiences. Let’s face it, most people have a lot going on in their lives – we make 35,000 decisions per day (apparently!), 200 of them are food-related, though we are conscious of about 12-15 of them. Many people don’t have the bandwidth to be directly  making decisions about what to eat day-in, day-out (hence food plans like mine are awesome, btw). That’s what makes it so easy to ‘succumb’ to takeaways at the end of the day (I say ‘succumb’ as I know many people think it’s lack of willpower. Well, no, it’s more decision fatigue than anything else). Dogma around diet is, after all, the appeal of following it – someone else has deemed what you can eat and what you can’t. This takes the thinking out of it and works perfectly fine… until it doesn’t. And it doesn’t take long for it to start causing more headaches than not. The type of rules, then, that I’m thinking about are those which are akin to brushing your teeth. You just do them, they are non-negotiable. Once you get into the habit of them, you don’t even have the think about it.

The types of rules I’m thinking about include:

  1. Never eat standing up (therefore omitting mindless snacking).
  2. Brush your teeth after dinner (to avoid snacking later in the evening).
  3. Have at least one serve of vegetables at breakfast, and 2-3 at lunch and dinner.*
  4. Put all junk food in the house in an opaque container and keep high up in the pantry, so they aren’t having to see it every time they open the cupboard to prepare meals (out of sight, out of mind).
  5. Choose a protein choice (meat, eggs, fish) and vegetables first when eating a meal out, and then (if still hungry), choose something else. This will fill you up, so there is less room for other foods that are easy to overeat.
  6. Order dressings and sauces on the side (so you can control how much you use).

Instead of feeling anxious about having to decide what to eat, then constantly second-guessing what to do, simple guidelines like these can help you make better decisions in any context. They take the thinking out of it, therefore less energy is wasted and they aren’t constantly ruminating about what to eat. This creates less anxiety and neuroticism, and people can feel empowered and confident in their food decisions.  It’s less about the availability of specific food choices and more about way food is eaten, the environment it is eaten in, and the type of food. You don’t need to be perfect to be awesome, you just need to be consistent, and consistently approaching food in the same way (not deciding that you’ve ‘blown it all, so you’ll binge’ whenever you make a choice not deemed ‘suitable’ as part of your dietary regime).

From clinical experience, I find most people respond well to strategies such as those mentioned above.

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If only it were this simple. (PC: theironyou.com)

Coffee: your friend or foe?

Coffee. It’s like the world’s favourite elixir. Mine included. For an athlete, there are many studies supporting its use as an ergogenic aid for athletes – helping reduce rates of perceived pain and effort, improving muscle fibre recruitment and enhancing glycogen repletion post-workout. These benefits are individual, however, and while research suggests that genetic differences in our ability to detoxify caffeine could account for this, it is not a universal finding. This is something true for athletes and non-athletes alike.

Other features of coffee are also salient for all individuals. Caffeine is ketogenic; not only can it help mobilise fatty acids to be used for energy, it increases the presence of ketones in the bloodstream – hence it is a good pre-workout fuel to help elicit fatty acid oxidation pathways and provide fuel for the workout in the absence of glucose. This doesn’t necessarily translate in additional body fat loss (more important lifestyle strategies are required for that, such as a caloric deficit, resistance training, reduction in stress etc), but can encourage these energy pathways to be upregulated, helping in the process of becoming adapted to a lower carb dietary approach.

Coffee improves insulin sensitivity and glucose tolerance (potentially related to the polyphenols present, though the mechanism is currently unclear), therefore enhancing the effects of both a lower carb approach, or a plan that includes fasting (either intermittent fasting, super-fasting, or a 5:2 approach such as the one in my fat-loss plans). Further, anyone doing my accelerated fat loss plans who have that 16h intermittent fast on the ‘fasting mimicking’ days could experience a more potent effect from the fast by including black coffee alongside water as their beverages of choice.

Autophagy, where our body starts to clear out damaged cells from the liver, heart and muscle tissue, is one of the benefits of fasting as you know. In mice models it might take just 16 hours for this to occur, in humans it is likely to take a lot longer given the differences in our metabolic rate (a mouse has a faster metabolism). Consuming caffeine on an empty stomach (or as part of a fast) promotes autophagy, which theoretically would shorten the time that is required to fast to stimulate this process. It also triggers AMPK, an enzyme that inhibits fat storage, promotes fat burning and activates antioxidant networks. These properties are thought to underpin much of the purported health benefits of drinking coffee.

It IS a balance though – if you’re following a fasting protocol, working out, and reading this at 3.30am in the morning, it’s a good sign that your brain is wired – raising cortisol to the extent that it’s (quite obviously) disrupting sleep. When we fast, like exercise, it places a stress on the body – this is where many benefits come from, as your body responds and adapts, becoming more resilient. However, too much of anything is too much! If coffee on top of your fasting regime or exercise program (or, life in general) is causing this stress response, then it is worth dialling it back a bit (or go 1/2 and 1/2 with decaf) to see if this changes your stress response.

Caffeine (or coffee), though, may not be good for anyone with gut issues. As it can stimulate the stomach cells to release more gastric juices, aiding in digestion, we often hear that too much coffee promotes a highly acidic environment and as such, could increase the risk of damage to the cells and subsequent gut issues. The literature, though, reports that caffeine does not negatively impact gastric or duodenal ulcers, and in fact when administered in vitro, could help repair cells damaged by inflammatory bowel conditions such as ulcerative colitis, and is also protective for the mucosal layer of the gut. Research suggests this is because caffeine increases blood flow to the gastrointestinal tract. Conversely, caffeine can lower the tone of the oesophageal sphincter – the valve that controls the release of stomach acid into the oesophagus, thus may promote heartburn and reflux.

With all research studies, it’s important to remember you are your own best investigator when it comes to how coffee affects you. I’ve said this before, but a good point to reiterate. The best advice, then, is to pay attention to how you feel when you drink coffee. Does drinking coffee make you more wired, especially when you fast, indicating it stimulates your stress (or cortisol) response? Does it give you reflux or heartburn? Does it upset your digestive tract more than settle it? Everyone has a different tolerance level to coffee, and further, our ability to detoxify it may also be different. If you feel great when you have coffee, and you don’t have any gut-related issues, then it is likely absolutely fine for you. If you notice an irritated gut, or you feel a bit wired, then it isn’t worth persevering with coffee for the purported health benefits – in your case, it might be making things worse.

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Ahhh… coffee 🙂

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.

paleo-table

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…