10 tips to help reduce your water-bloat

I got a question on my members’ Facebook page a couple of weeks ago regarding water retention. There is nothing worse than a bloated tummy – it can not only make you feel physically uncomfortable, but can also wreak havoc on your psychological state (as many people equate the bloating to ‘feeling fat’, despite there being no relationship between the two). Further, a bloated stomach impacts on your ability to move properly. We can’t engage our core muscles, so aren’t able to move, lift, push or pull in a way that is functionally optimal. This has important implications for our core strength and injury prevention. Of course water rentention affects more than just our stomach – a long haul flight to somewhere warm can turn anyone’s lean calves into kankles due to changes in the pressure in the capillaries, causing fluid to leak out into the body tissues. There can be many reasons for this, so I thought I would investigate the most common causes and possible solutions.

  1. Minimize your sodium intake. Although sodium (aka salt) is an essential mineral because it’s used to regulate the fluid levels in body tissues, bringing water into the cells. Excess intake of sodium may cause excessive fluid retention in the body tissues. While the evidence behind this recommendation suggests it isn’t something that affects everyone, this may help some people, particularly those who are salt sensitive or hypertensive. Do note, though, that if you follow the types of principles that I suggest, your diet is probably quite low in salt anyway, as most salt comes from processed foods (around 70%). However, there are whole foods that are high in sodium, such as cheese, miso, cured meats and biltong, so you could reduce these, and avoid adding salt to your food to see if this makes a difference.
  2. I probably don’t need to tell you to avoid eating too many refined carbohydrates – these tend to spike insulin, which causes sodium (often found in these foods) to be re-absorbed back into the kidneys, thus increasing water retention. Your best bet for carbohydrate foods are those whole-food, minimally refined varieties that have negligible sodium for a start, and that you eat in a mixed meal with good fats and proteins to help slow down the release of carbohydrate into your bloodstream, minimising insulin response.
  3. Any form of dehydration can cause your body to hold onto water. Therefore, ensure that if you drink alcohol, do extended exercise training sessions, or are in a hotter environment that you remain well hydrated to offset any potential for dehydration. The fluid you lose during exercise should be replaced in the three hours after training, and at 1.5 times the amount lost – you can work out how much this is by weighing yourself before and after an exercise session. The amount of weight lost roughly equates to the amount of fluid lost. Prior to drinking alcohol, have a couple of glasses of water (this will also help slow down your drinking). And be an adult about how you drink: is it necessary to drink more than a few in any one sitting?
  4. Take adequate amounts of vitamin B6 combined with magnesium. For women, prior to your period you can feel a little bloated and that you are retaining water. Interestingly, however, some research investigating the timing of this around the menstrual cycle has found bloating occurs more in the onset of your cycle (day 1) after which is rapidly declines, despite the perception of puffiness or bloating in the week prior to menstruation. This puffiness, however, could well be related to food choices in that week, as the intake of higher sugar choices can increase for some.
  5. If you have water retention before your period, you may, however, benefit from taking both a magnesium supplement (at 250mg per day) combined with a vitamin B6 supplement (40mg) daily – a study found this combination the most effective for decreasing premenstrual symptoms when administered for two months by balancing your hormone levels.
  6. Potassium works in conjunction with sodium, pumping fluid out of the body cells. Therefore, if you aren’t consuming enough then it could cause problems with water retention. The reality is, though, that you are following the meal plan and including plenty of vegetables, your potassium intake is likely fine. However, if you don’t have a good intake of vegetables (at least 7 serves per day) then increasing these is a good idea. This will also bump up your fibre intake, which can further help reduce fluid retention.
  7. Take natural diuretics. Dandelion root has long been used to help flush water out of the body – therefore investing in a good tea such as this Golden Fields one is not only delicious (often used as a substitute to coffee), it will also be beneficial. In addition, this kidney cleanse tea from Artemis has other natural diuretics to help flush water out.
  8. Exercise regularly. Exercise can help reduce water retention, not just by increasing sweating, but by moving water from the intercellular compartments to the muscles.
  9. Increase your caloric intake, if only for a day. I know – this one sounds weird, but a ground-breaking study in the 1950s called the Minnesota Experiment found something interesting mid-way through their study. The study followed men on a 1500 Calorie diet for 6 months, and subjected to hours of hard labour per day. Half way through the trial the men were allowed a celebration meal, effectively increasing their caloric intake to 2300 Calories. Following a night of getting up to go to the bathroom several times, the men were a few pounds lighter the following morning. Obviously, the weight lost was water weight – but why would this be the case? Potentially the long-term calorie deficit caused an increase in cortisol levels, and this increases water retention in the body. By increasing caloric load, the body reduced cortisol levels and this reduced water retention.
  10. Reduce overall stress load. As we have just discovered, higher cortisol levels will increase water retention, therefore anything you can do to reduce stress is going to impact favourably on water loss. Let’s not forget the impact that high stress levels have on blood sugar levels, inflammation and fat gain (to name just three areas it impacts). While stress is a perception of a situation, and changing your mind-set is one of the best things you can do to lower stress levels, ensure you are getting adequate sleep, time in nature, time with loved ones and taking time just for yourself. These are going to help lower your cortisol levels and combat any stress-related water retention.

So… not a definitive list, but hopefully a few pointers to help you get to the bottom of your fluid retention issues and make some improvements. For more individual advice, don’t hesitate to contact me for a consultation or for online nutrition coaching. Further, if you’re in the Bay of Plenty, Queenstown, Nelson or Wellington regions, then I’m headed your way for an evening of ‘real food’ talk – click here to find out more information and to book tickets!

 

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 🙂

pres2

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)

14 reasons to ditch the toast and jam (and 7 key tips to help you do this).

After feeling like I’d taken a trip back to 2003 with some of the sports nutrition posts and articles I’d been reading lately, I got tagged in a cool picture from a listener of our Fitter Radio podcast  – a triathlete who has switched from the traditional higher carb, lower fat diet approach to eating lower carb, higher fat, real food whilst training and commented she ‘didn’t know her 41 year old body could be the best body I have ever had’ (Woot! high fives all around!!) This coincided with finishing Mark Sisson’s Primal Endurance book.

Mark outlines 115 reasons why athletes should train and eat the Primal Endurance way. I concurred with pretty much all of them. I have added my own 2c worth, added some literature below (and cut it down to 21 for brevity’s sake). While geared towards athletes, hands down this is applicable to everyone. Everyone.

So if you’re currently eating toast and jam pre OR post training (or in general), I’ve outlined the 14 reasons why you need to ditch that junk and become a fat burning beast, and 7 key tips to help you get there.

  1. Western diet is based on excess grains and sugars (and low fibre) which stimulates excess insulin production, leading to lifelong insidious weight gain, chronic inflammation and elevated disease risk factors.
  2. A high carb, grain-based diet can leave endurance athletes nutrient deficient (due to phytic acid effects on minerals), inflamed and more susceptible to the oxidative damage of the stress of training, general life and poor nutrition.
  3. The way that most people consume modern grains (cereals, breads, pasta) ends up being a cheap source of calories which are immediately turned into glucose upon ingestion and offer minimal nutritional value. There are no good reasons to consume these types of grains and many good reasons not to, especially for those who are sensitive to gluten and other anti-nutrients found in wheat.
  4. Everyone is sensitive to the health compromising effects of grains at some level, especially the pro-inflammatory effects of gluten and the propensity for the lectins in grains to cause leaky gut syndrome.
  5. Even lean people suffer from the consequences of carbohydrate dependency, such as chronic inflammation, oxidative damage, and accelerated ageing and disease risk factors.
  6. Carrying excess body fat despite careful attention to diet and a high training load is largely due to carbohydrate dependency caused by a grain-based diet and chronic training patterns.
  7. Carbohydrate dependency cycle looks like this: consume a high carbohydrate meal – elevate bloods sugar – stimulate an insulin response – shut off fat metabolism and promote fat storage – experience fatigue and sugar cravings – low blood sugar elicits stress response and we consume more carbohydrates – stimulate the fight or flight response to regulate blood sugar – dysregulate and exhaust assorted hormonal processes, and end up in burnout and weight gain (potentially lifelong)
  8. Weight loss through portion control, low fat foods and calorie burning is ineffective long term. And while we think calories burned through exercise stimulate a corresponding increase in appetite – research might not back this up. I tend to think that people are more likely to eat more because they ‘reward’ themselves OR the long slow training allows increased opportunity to eat sports ‘junk food’ and the amount of calories burnt through training is far less than you think – and overestimated more so in females in certain instances. At any rate, the secret to weight loss is hormone optimisation, primarily through moderating excess insulin production.
  9. Endurance athletes can begin to dial in to their optimal carbohydrate intake by asking themselves the question ‘do I carry excess body fat?’ Any excess body fat calls for a reduction in dietary carbohydrate intake to accelerate fat burning.
  10. Endurance athletes who already have an optimal body composition but are looking to optimise training and recovery should choose high nutrient value carbohydrates. These include a high volume of vegetables, a moderate fruit intake, kumara/potatoes and other starchy tubers, dairy for those that tolerate, wild rice, quinoa and small amounts of dark chocolate.
  11. Endurance athletes with high calorie needs who also have an optimal body composition can enjoy occasional treats, but the habit of unbridled intake of nutrient-deficient carbohydrates should be eliminated in the interest of health and performance.
  12. Primal style eating (or eating minimally processed foods) is fractal and intuitive, and when escaping carbohydrate dependency and becoming fat adapted, you don’t have to rely on ingested carbs for energy. Eating patterns can be driven by hunger, pleasure and maximal nutritional benefit.
  13. Escaping sugar dependency and becoming fat adapted gives you a cleaner burning engine, since glucose burning promotes inflammation and increased oxidative stress
  14. Ketones are an internally generated, energy rich by-product of fat metabolism in the liver when blood glucose and insulin levels are low due to carbohydrate restriction in the diet. Ketones are burned efficiently by the brain, heart and skeletal tissue in the same manner as glucose. You do not need to be on a ketogenic diet to upregulate your ability to produce ketones – you can do this via a lower carbohydrate approach.

HOW TO DO THIS: 7 KEY TIPS

  1. Step one: omit sugars, grains, industrial seed oils for 21 days. Step two: emphasis highly nutritious foods such as meat, poultry, vegetables, eggs, nuts, fish, fruits, some full fat dairy, seeds, and kumara/potato.
  2. 100g or less of carbohydrate promotes fat loss, 150g is around maintenance level and over this could promote lifelong weight gain and over 300g could promote disease patterns.
  3. While transitioning to primal there are some struggles initially due to lifelong carbohydrate dependency and the addictive (for some) properties of sugar and excess grains and wheat. Headaches, dehydration, lower blood pressure and ‘dead legs’ are all initial side effects when removing processed food. Trust me – this too will pass.
  4. To minimise side effects, start the transition in a base-training phase of your training where training occurs at an easy pace. The transition phase can take anywhere from 2-12 weeks initially.
  5. Consume salt. Don’t underestimate the importance of this! Lower circulating insulin affects your body’s ability to retain sodium (and other electrolytes) – so we need more, particularly as processed food (of which you are no longer basing your diet around) is where you got around 70% of your sodium from.
  6. You can accelerate the process of fat adaptation by instigating some of the tactics used by athletes who opt to ‘train low’ – i.e. in a low glycogen training state. Some of these are naturally undertaken if you train without eating in the morning, or work out after dinner in the evening and don’t consume anything post-workout. If you’re new to this, have a read through to establish which might suit you best, and start instigating 1-2 x per week. Don’t undertake all of them as this aggressive approach could cause too much additional stress, derailing your plans to become a fat-burning beast.
  7. The FASTER study and Peter Attia, Sami Inkinen suggests any endurance athlete can become fat adapted and deliver performances that may be superior to carb-fuelled efforts all of the way up to anaerobic intensity. This is a new and growing research space, one AUT is testing, among other Universities around the globe.
Strong, lean and awesome at 41y.

Strong, lean and awesome at 41y.

 

PS What the Fat Sports Performance – currently an ebook, about to be published is one I can’t WAIT to read as well – sure to be a goody.

An endurance athlete’s ‘real food’ success story: making it work for you.

I got this email this week from a client that I have worked with since just before mid-year. She is an endurance athlete that came to me as her overall energy levels were low and she was carrying a few extra kilograms that she wasn’t used to.

We chatted through not only nutrition but lifestyle-related changes that she could make to help support her busy lifestyle. This included changes to her diet, additional supplemental support, working on sleep-related behaviours and finding the middle ground between ensuring adequate energy levels and losing body fat to a level that was sustainable and achievable. You can appreciate this is a delicate balance! I discussed with her that when we sorted her energy levels, the body fat loss would take care of itself – she was aware of this and that her energy levels were the priority.

As an endurance athlete she often trained at both ends of the day and came home late, stayed up a little later than she thought she should, and relied quite a bit on carbohydrate-based choices such as bread and cereal to boost her energy levels during the day. While she didn’t recognise it, I immediately flagged this as one of the reasons she was feeling exhausted. She was also hungry a lot, eating at multiple times during the day. This was another indicator that her food choices were not geared towards an optimal balance of good quality carbohydrate, protein and fat. A detailed discussion on her diet proved this to be true.

This client was very motivated to feel better, and took the suggestions that I made and found a way to work them into her lifestyle. We had four sessions together, the last being just before a race that she was doing – the first one for her in a while.

I asked if she minded if I shared her email – she was happy for me to do so.

“Thanks for the item on Thyroid on Fitter Radio this week – it was really helpful. Good to know low thyroid is not something you are necessarily stuck with for life.

Following our catch-up at the end of September I just thought I’d update you with how things have gone since then, and where I have found a really comfortable place with training and nutrition.

Update:

So in summary, I performed well at my last race and was very happy with my placing in my age group. I really noticed that getting extra sleep made a big difference to how I felt, two nights before the race I had 9 hours and felt amazing the next day.

My weight has stabilized at around 53kg so I think this is possibly the happy place for my body, and it’s the same as it was a couple of years ago when I was running at my best.  I feel good at this level and I’ve figured out how to keep it there – for me it’s:

  • at least 7.5 hours sleep;
  • not eating late; and
  • doing some kind of activity in the evening, even if that’s just a walk.

Food wise, what seems to be working and manageable is:

Prep: (crucial to ensuring that I’ve got options available during the week):

  • Bulk making a week’s smoothies at the weekend, then freezing and using during the week
  • Ordering Primal Kitchen for weekday lunches and weekend main meals
  • Making a few wraps at the weekend for weekdays when I do something straight after work. For example, Farrah chia wrap* with Vital Vegetables Slaw, lemon juice, a flavour (Thai spice mix, peanut butter or salsa) + a protein such as smoked salmon or chicken

*yes I know it’s has wheat in it and is a carb but it seems to give me enough energy/and is practical – if I eat fewer carbs than I am I don’t seem to have enough energy.  I have tried other things instead of a wrap like cabbage leaves/sushi sheets/… but they just don’t work as well, they fall apart. The thing that does work is the Vietnamese rice paper wraps but they are very fiddly so I would tend to buy the Farrah wraps instead – very good place in central Wellington to get them! 

Breakfast – usually 5:30-6:30 depending on day

  • Smoothie and a hot drink + a spoon of peanut butter – I usually make the smoothie quite thick and eat it out of a bowl with a spoon!
  • If I’m doing something hard-ish like a swim squad or a run/bike then I have something else too. This tends to be either a sachet of plain oat porridge with the smoothie on top, or 2 hard-boiled eggs with some salt (or on a race day 1-2 x banana depending on length or race).

Mid morning – usually have a coffee with rice milk but don’t need to snack much now. If I do it’s 1-2 Brazil nuts

Weekday lunch – usually eaten around 11am-noon

  • Primal kitchen – 1/2 a warrior size shared with partner + handful baby spinach
  • 2 squares of dark chocolate and maybe a couple of strawberries.
  • Raspberry white tea

Mid afternoon – usually have a Redbush tea with rice milk but don’t need to snack now. If I do it’s a carrot and maybe a few almonds.

Weekday dinner – on days when I do something around 5 or 6pm in the evening, I just eat this around 4pm which seems early but it gives me fuel for the activity then I don’t need to eat a meal later. This way I get a semi-fasted thing happening (as per train-low principles) without it feeling hard. And it means I don’t eat a bunch of rubbish in the afternoon. So it works!

  • Wrap
  • 2 squares of dark chocolate
  • Redbush or green tea

Evening – Usually have a hot drink (not caffeinated), and maybe a swig of wine or my partners beer, but I don’t need to snack as much now – if I do it’s because I’ve just been for a hard-ish training session or MTB ride, and, something like a gold kiwi and few nuts does the trick.

Weekends, similar but we have Primal Kitchen in the evening but I try make sure we eat early, like by 6. For lunch something like sardines on toast if at home with salad, or eggs on toast if we are at a cafe.

Overall

It’s working well and although probably to you getting Primal Kitchen for most of our main meals will probably seem like a bit of a cop out!! But actually takes the stress out of everything – otherwise I would end up doing all of the thinking ahead/planning for both of us on food and basically end up spending more of my free time on it which to me wouldn’t feel fair! (My partner is wonderful but he just isn’t as organised as me and has lean genes and the fastest metabolism on earth so can eat anything. To him, super healthy food isn’t so much of a priority). I think it also works out the same cost or cheaper, definitely frees up some time and makes logistics easier. I’m sure at some point in my life I’ll enjoy doing more food prep and cooking more but this works right now and keeps the balance of effort fair!**

I am planning on giving up triathlon after this summer and just focus on running, mostly trail running and doing other stuff I enjoy for fun.

So, that’s it! Thanks for everything and your podcast, the whole experience of getting nutrition consultation has been a really positive one and the result for me has been to shift a good couple of kilograms and change my mental attitude in a very positive way.  🙂 ”

You can see from the discussion of her food choices, her diet isn’t low carbohydrate per se – though it is definitely LOWER in carbohydrates than it was. There is a lot more protein here than what she was having, and overall the nutrient density has improved.

Overall I think this is such a good ‘real food’ success story and that’s why I asked if I could share it. Does she eat ONLY non-processed food? No – however it’s all about context and finding the middle ground with what can be achieved in the context of the individual’s lifestyle.  That, to me, is success. 🙂

Merry Xmas.

 

**to be clear, I don’t think that getting meals from a place like Primal Kitchen (or ordering through My Food Bag etc) is a cop-out at ALL. I think it’s a smart strategy to help people meet their nutrition goals and not fall back into bad habits that could contribute to poor overall health status. It’s really interesting here that it works out MORE cost effective too. It saves on buying food that they would have to throw out as they haven’t found the time to cook it. It also saves the temptation of just having toast or cereal in the evening, or a sandwich that doesn’t provide enough protein and important nutrients. Primal Kitchen is a great choice.

 

What this nutritionist ate on Wednesday.

So after the Business Insider profiled the typical diet of a nutritionist this week, I got a number of people asking to see what I ate in a day. Happy to talk you through the photo essay that represented what I ate on the following day, a Wednesday. It’s a fairly typical ‘non-typical’ day for me. I have busy client days on Tuesday and Wednesday and if I’m not that prepared then it can end up a bit all over the place (as with most people). However I wanted to be genuine with it and not stage the perfect day. Because I don’t eat a perfect diet! Yes I follow the dietary principles that I advocate, but am pretty….normal?! If you follow me on Instagram then you’ve seen all of this before. What follows is going to be of no interest to anyone who isn’t interested in food or my general musings/setting the scene.

A bit of diet preamble: I would describe my diet as low carb,  healthy fat (LCHF). Not low carb high fat – the hangover from being an overweight teen/young adult and from preaching the low fat guidelines up until around four years ago. What does this mean? It means that if you come to my house for dinner then I’m unlikely to serve all of the vegetable dishes swimming in butter, cream, cheese or olive oil.  In fact, that kind of grosses me out to be honest. You might get one vegetable side dish like this. I will also typically drink my coffee black unless I feel a bit on edge for whatever reason, and I will have it with cream – I’ve tried to find some literature to support the idea that cream dampens down the cortisol response of coffee (which makes sense to me, as caffeine and other constituents of coffee stimulates insulin and cortisol) but have yet to do so. It also means that I no longer freak out if someone serves me a meal that DOES have the vegetables swimming in butter or coconut oil (and I will probably like it).  It means that I cook curry-type meals with coconut cream and not yoghurt, that I am no longer afraid to use more than a teaspoon of coconut or olive oil when I cook, that I add fat to my salads by way of mayonnaise or pesto. That I snack on cheese and that I add nuts and seeds to salad. That I don’t purposely buy food that has had the fat removed.

This may not be your LCHF diet, but for me it’s the healthy addition of fat in normal amounts (on my plate at least). If I was keto (as I have been before) then clearly this would be different.  It’s funny, there’s always backlash when I post a food that is (naturally) low in fat from the hard-out LCHF’ers. I use my ‘I know better than you’ nutritionist stance to remind them LCHF is a dietary pattern, not a food category. It doesn’t mean that every food you eat should be low carb, high fat. I prefer fresh and crisp, light and colourful, and I probably eat more of a ‘Zone’ type diet actually (if I was going to ‘label’ it in regards to macronutrient content). I haven’t put my food intake into an food database analysis to check this – but in my job you pretty much know things like calories, fat, protein, carb content of what you eat. Just like a personal trainer knows what muscles they are working when they do a set of mountain climbers. You don’t need a database to tell you the basics.

Anyway: this is what I ate on Wednesday:

  1. A tribute picture...forgot to take one at time so I staged this. You get the drift.

    A tribute picture…forgot to take one at time so I staged this. You get the drift.

    Up at 4.40am (yes, early! I channelled my inner elite athlete or morning radio host here) to do a longer run before an early client. I had a coffee (instant – Moccona. I have a Nespresso that sits on my bench that gets little use) and some coconut butter. I don’t always eat before a run, I base it on how I feel more than a schedule as such. Sometimes I eat before an easy run, sometimes I go fasted before a long run. I have coffee before a long run or a harder effort, and sometimes I have a teaspoon of coconut oil with the coffee. Alongside it, not in it. Not tablespoons of it blended with butter and labelled ‘bulletproof’, just a small amount. Perhaps more psychological than anything else. FYI this run isn’t a ‘long run’ in runners terms, but as I’m building up from Gold Coast many months ago, it was longer than normal.

  2. Sometimes I put psyllium husk in it. Not today.

    Sometimes I put psyllium husk in it. Not today.

    Two glasses of water, one of them with vital greens in it. The bonus of writing down what I’m eating is that I’m thinking about my water intake! (Women particularly shouldn’t just rely on the thirst mechanism to encourage drinking – while drink to thirst might be approrpriate for men, hormonal differences mean it may not be true for women. Anyway. Water FTW*

  3. It's v cool to ensure your feet are in pictures too right now.

    It’s v cool to ensure your feet are in pictures too right now.

    This is coffee – my travel plunger from Kathmandu that I’ve had for years AND LOVE IT. Yes it probably contains enough caffeine for 4 shots in here (!) but it is actually just for me. Sometimes I finish it, sometimes I drink just half of it. My question is: if it was meant for more than just one person, why put a sipper lid on it?! This coffee experience has ruined others for me though, as I demand a strong coffee, and like a lot of volume. Alongside this is a grapefruit custard thing that I’m testing as part of recipe development for my online nutrition coaching members. ½ grapefruit, an egg, ½ cup coconut milk, 2 tsp Great Lakes gelatin, 1 tsp psyllium husk. I also had a hardboiled egg alongside it. And (not shown) ½ a Canterbury bierstick (sorry I ate that before I photographed it). FYI The Canterbury brand has no nasties and, while sugar is in the ingredients, it is minimal – maybe 1.3g per 100g.

  4. Love this straw.

    Love this straw.

    Off to the Go Healthy Superfood launch. Get handed a smoothie tester made by one of my food heros Kelly Redmond (bonnie delicious blog). We have bonded via Instagram over a shared love of nutrition and health podcasts and she is as much of a geek as I am. The snoothie had cacao powder, date, almond milk, coconut water (I think?) and possibly another superfood super powder. I have about half of this. I’m not that enamoured by coconut water actually, so just put it to one side. I also have a couple of glasses of sparkling water.

  5. We've got zoodles, vegetable dips, raw cookie, a cacao brownie and some chocolate mousse.

    We’ve got zoodles, vegetable dips, raw cookie, a cacao brownie and some chocolate mousse.

    The recipes that we made as part of the launch. A tasting plate and there is no size distortion in this picture. It’s a small plate. FYI recipes developed by Kelly and Mon from The Snack Pack – she’s the creator of Amazeballs and has made a lower sugar Amazeball (a woman after my own heart). I’m not a big fan of raw treats that are heavy on honey, dates and the like – obviously from the ‘health halo’ perspective of ‘no added sugar’ but I’m mentioning it here not from a zealous nutritional stance, but just a taste preference actually. Another cup of water.

  6. IMG_1190Back up to the clinic in Ponsonby to have a quick snack before clients. Have a small cucumber with a couple of eggs. I also have a glass of water here. Normally I would have a salad actually, but I wasn’t sure if the launch was going to be lunch, or if it was going to be smoothies, or completely sans food, so I prepped some additional food just in case. Yes, those counting would see this is four eggs in one day. I don’t always eat four of them (as I try to vary my protein), however I do love them and they are super easy to just eat like this, so it’s not a major. This isn’t ‘lunch’ per se as it’s not big enough to be a meal – more like (along with the tasting plate and below) one of a series of snacks.
  7. The zucchini in a smoothie is an idea from Sarah Wilson. Makes it smooth and thick and adds vegetables. #winning

    The zucchini in a smoothie is an idea from Sarah Wilson. Makes it smooth and thick and adds vegetables. #winning

    Home to have a smoothie as the random eating pattern has made me hungry today. Usually I wouldn’t normally snack this often, and more often than not I don’t snack  – but if I’m hungry then I will eat. I’m also thirsty so this is perfect. It has cacao powder, zucchini, a cup of almond milk, a tablespoon of protein powder, some psyllium husk. I also have ½ a boerwors stick (found this Mrs Grills no nasties one at my local fruit and vegetable shop. Really hot though!!)

  8. IMG_1196I meet friends for a quick drink before dinner. I generally have 1-3 glasses of wine across the week. Not normally on a Wednesday.
  9. The usual.

    The usual.

    This is pretty standard and I love eating like this. Leftover chicken with assortment of vegetables (brussels, carrot, pumpkin, tomato, zucchini, red cabbage, avocado, almonds, carrot dip and babaganoush (both homemade), homemade mayonnaise and Be Nourished Ruby Raw Kraut. If not chicken (and rarely chicken breast) then it will be beef (mince, burgers), salmon (smoked, fresh), pork (belly, mince), lamb (roast, mince), liver (chicken or beef). I very rarely have vegetarian meals (unless doing some recipe development) and my days at Weight Watchers has put me off The Stirfry for life. It would be a rare event where (at home) I wouldn’t have a salad of some description. Weirdly I wouldn’t have canned salmon, tuna, eggs or sardines for dinner. Nothing wrong with that though – it’s almost like they aren’t on my radar past lunch. Of course if you serve them to me as part of a meal then I’m sure I will enjoy it immensely. I don’t often have steak as I have little confidence around cooking it. I’m no chef – more a food hack.

  10. IMG_1201After dinner treats. 99% of the time I eat a sweet treat after dinner because I enjoy doing it. This is a couple of squares of chocolate and some leftover genuine sugar free treat I made which is seriously delicious. I would often have some peanut butter and coconut after dinner if not chocolate. Yes that is a Starbucks cup. A different one from the one at the start of the day. I love these as they are big and hold a good volume. And cute too. I have a San Fran, a New York and a Los Angeles one.

So there you have it. Nothing was staged, this was my food for this day.  Unlikely to be interesting enough to go viral or to be picked up by a digital magazine (:-) – I mean these pictures are pretty dire even by MY standards). It reflects an ‘atypical’ day but gives you an idea of the choices I make on a day to day basis. I don’t avoid dairy but there’s none in my food intake for this day. I would definitely have a bigger lunch on a ‘typical’ day. I don’t avoid fruit either but I would probably eat more fruit during the summer months. I can’t think of any other disclaimers to add other than, like all posts such as these, it’s not up here for you to emulate (like I said, it’s not perfect! Not that I expect you to be perfect) as we are individual as to our nutrient, energy, meal, allergy requirements. General tips would be:

  • Include protein in all meals and snacks
  • Add fat for satiety and/or include fattier sources of protein
  • Your better sources of carbohydrate are always the starchy (potato, kumara, peas, corn) and fruit as opposed to pasta, bread, crackers etc. Your requirements for this are on a sliding scale from ‘none’ to ‘fist- 2 fist size’ depending on activity, metabolic flexibility (ability to burn fat as a fuel source), metabolic health, energy, mood….
  • Include vegetables where possible and I know you’re thinking Try for 5 or 5+ a day. Back yourself. Why not 8?! Your meal ideally would be based on an abundance of vegetables. As those over on Instagram like to boast #morevegetablesthanavegetarian

* FTW = for the win

Struggling to lose weight on a low carbohydrate, high fat diet?

“I’m a 5’10” guy who weighted 180 lbs. I run about once a week and honestly don’t do much else. I cut out beer and all refined sugars (which included a few servings/day of bread and pasta) and lost 15 pounds in 7 weeks.

I feel like a million bucks. It’s crazy how my legs and arms where there was seemingly no fat all became more defined and skinnier.

The best part – I make a full packet of bacon every Sunday and eat it over the course of the week and I absolutely stuff myself with the good stuff you’re supposed to eat – salted cashews, sweet potato fries, fruits and vegetables etc…”

– Taken from some random comments section from a blog (can’t remember where, sorry)

Not your experience? You’re not alone. Though I know those struggling to lose weight on a low carbohydrate high fat (LCHF) diet do feel they’re the only one not stripping off fat faster than they can pour the cream into their coffee. Unfortunately the mantra ‘fat doesn’t make you fat’ probably requires an asterisk, and an explanation. Along with ‘calories don’t count.’ These are related. A good friend of mine was struggling with unwanted weight gain on LCHF. She had listened to what people were doing with the diet and had swapped breakfast for a couple of coffees with cream, wasn’t eating lunch but perhaps grazing on some nuts or cheese during the day and having a big dinner at night that was eaten quite quickly because she hadn’t really had the pleasure of eating all day. Her one concession on LCHF was white wine and not that she drank often, but the couple of nights a week she did drink, it was definitely more than your standard two glasses. Lacking in energy, motivation, and frustrated with the betrayal of both her body and the diet, she asked for my advice. How come everyone else was losing weight but she wasn’t?

It’s too easy to think that the LCHF diet is the panacea for weight loss and weight maintenance – and absolutely, if you read my post a few weeks’ ago around LCHF diets for health and performance then you’ll know it’s at least as effective as your usual low fat regime. Certainly, too, for people I work with it’s an easier lifestyle approach to eating. If I had to put a number on it, about 75% of people I work with take the general guidelines of a LCHF diet, run with it and see considerable success. This includes people who have a history of weight loss, weight gain, and yo-yo dieting. However for some, the switch to a LCHF diet isn’t the magic bullet that it’s purported to be. After an initial drop in body weight (by perhaps 1-3 kg, largely attributable to fluid loss), the body seems to settle into a new ‘normal’ at that point and those last 5kg continue to remain elusive.

Is it the plan itself? No. Any plan that someone can adhere to is going to be successful. But there’s more to it than that. Even people who abide 100% to a LCHF approach can have weight loss stalls and, worse, begin to gain weight. Is it lack of sleep? Thyroid function? Work stress? Not enough exercise*? Too much exercise? Could be. But for some, it actually is the plan. Not in principle though, it’s how they execute the plan. And by all accounts, my good friend had also fallen into this trap.

Where once fat was vilified, it’s now carbohydrate that has been positioned as That Which Must Be Avoided. Problematic because actually there is no good or bad nutrient as a whole. Yes, there are certainly better choices within each obviously (i.e. butter is a much better choice than margarine, and potato or kumara will trump bread every time), but this blanket approach that demonizes an entire class of nutrients can set the scene for an unhelpful (and, at times unhealthy) approach to meals, snacks and eating behaviour. Carrots, pumpkin and beetroot – off the menu. Tomatoes are viewed with suspicion, onions don’t get a look in, and the rainbow of colour in a salad has now been limited to different shades of green and yellow. But it’s not from capsicum (too many carbs!) it’s from half a block of cheese. Now – I know that for some, this actually isn’t an issue and in fact, it’s the best thing they can do for their metabolic health. A LCHF diet makes perfect sense if someone is struggling with blood sugar and insulin control. In fact, for people with diabetes (type 1 and 2), having a very low carbohydrate diet is the best thing for them (why add fuel to an already out-of-control fire?) People either forget (or don’t realise that LCHF is generally 25% of so calories from carbohydrate which can still equate to a good amount of carbohydrate-containing foods. This all or nothing approach to carbohydrate (or… just nothing) is unnecessarily extreme for most people in my opinion. Like Weight Watcher’s ‘fat and fibre’ plan of the 90s, which saw meringue back on the menu for hundreds and thousands of delighted dieters worldwide (and unhelpful for most of those people), it is almost that the ‘no holds barred’ has been shifted from vegetables to foods high in fat. Cream in coffee, nuts in abundance, lashings of butter with everything – because ‘fat doesn’t make you fat’ and ‘calories don’t count.’ For those that can’t effortlessly lose weight with this approach and you have accounted for the lifestyle factors that I mentioned above (as my friend had), then actually you are eating more than you need. If that’s the case, then fat can make you fat and those calories do count.

So what now?

For my friend, and others who come to see me, what actually worked was taking another approach. Still LCHF. But not as LC. And not as HF. It also included a lot more protein. It is an­­ approach to eating that is sustainable in the long term. Remember that the premise of LCHF is a nutrient-dense, real food diet. For my friend:

  • I got her to drop dairy – not because it is inherently bad, but because her sources of dairy were only high fat and in larger amounts than I think she was aware of. It was easier to omit entirely in this instance.
  • I got her to start eating breakfast again and to include starchy carbohydrates. Not in large amounts! But enough to help her feel satisfied between her meals and also happy with a standard pour of wine from the bar and not a large. For some, restricting carbohydrate can lead to increased desire to drink more alcohol (or gave them licence to do so). This also helps people recognise that carbohydrates shouldn’t be vilified the way we did fats.
  • I also got her to sit down when she ate and told her to eat slowly, enjoying her meals and to never eat standing up. That way she knew what (and how much) she was eating.
  • I suggested that she cut nuts and seeds unless part of a salad meal and that she aimed for three meals a day and no snacks.
  • If she was hungry in between meals, then I asked her to increase the protein portions of her food, as this would keep her satisfied. For my friend, it wouldn’t have been helpful to focus on increasing the fat as it didn’t work for her previously.
  • The protein foods she ate weren’t necessarily lean, nor did she seek out the fattiest cuts she could find. She ate a broad spectrum of quality protein foods.
  • She ate non-starchy vegetables in abundance.

While initially suspicious of this approach, she very quickly saw success. In fact, over the course of four weeks, she had dropped 5.5kg. Her meals were still lower in carbohydrate, and higher in fat – but also included good amounts of protein and a lot more nutrients overall. For my friend, this ‘back to basics’ approach to diet was just what she needed. It was both the food choices and the behaviour around food that we needed to change. Though weight was her initial measure, she told me the change in how she felt about herself and about the food was far more important.

If you are struggling to lose body fat with a LCHF diet, then remember the devil could be in the details. In my opinion it really is the panacea for optimising your body composition goals, but it might be that the way you execute it needs adjusting.

*fat doesn’t make you fat: unfortunately, eating too much fat could make you fat – because too much of anything can lead to an excess in energy that your body can’t burn and therefore it has to go somewhere – deposited into your fat tissue is the likely scenario.

*calories don’t count: calories do count. But the finer details relate to how your body burns those calories and available energy.

Type 1 diabetes, endurance sport and the LCHF approach: Lewis’ marathon experience

Following on from Lewis’ post last week about life with type 1 diabetes and following a low carbohydrate high (healthy*) fat (LCHF) diet, here is a race report from the Auckland marathon:

I did my very first marathon (Auckland marathon) two weeks ago. As a reminder, I have type 1 diabetes, eating strictly LCHF for over a year. This is not a race report of the marathon, so much, but rather a detailed analysis of my blood sugar levels from before the gun went off to when I crossed the finish line.  I wear a Dexcom G4 Continual Glucose Monitor. I inject the sensor and carry a receiver with me. It gives me minute-by-minute live blood sugar readings, which I have downloaded for you. As a diabetic, my body is unable to regulate my sugar levels. If my sugar level is good, then the session is good.

The marathon itself, as my first, surprised me by how hard it was. Everyone says 30km gets tough but you have to really experience it to believe it. I could not believe how incredibly tough it was to keep going in the last 10km. My body was fine, but my brain was mush. I was trying to finish at 4hrs, and was on that pace until 30km, but then ended at 4:17. Definitely room to improve for next year. More physical training and certainly more mental toughness will help me last to the final 200 metres.

My sugar levels and my energy levels were excellent.

Interestingly, I tested my blood ketones (to test how “deep” in ketosis I am) before and after the race too, just to see what was going on. At the start, 05:30, my blood ketones were 0.5 mmol/L. This is pretty average for me. I really battle to get higher levels of ketones than that. After the race (11:00), my ketones were 1.5 mmol/l. This illustrated to me that my body is able to access fat burning when it needs it.

I have graphed it and the link below gives a good visual – however I’ve also provided it in detail below.

lewism

Background:

  1. Target range for blood sugar level is between 4mmol/l and 7mmol/l.
  2. During training/race, it is risky to have the sugar levels too low and if they drop below 4 mmol/l, then that causes all sorts of problems. At around 3mmol/l, you get reduced effort, an inability to push yourself, lethargy, and as it gets lower, I run the risk of passing out.
  3. Equally difficult for people with type 1 diabetes is the risk of the sugar level going too high. It is commonly understood that exercise reduces blood sugar level, but only if your blood sugar is below approximately 13mmol/l. Any higher than that, then exercise triggers a response that will increase the blood sugar level further. High blood sugars are extremely uncomfortable (not to mention dangerous), and exercise is not really possible.
  4. So during a race, my target range moves from between 4 – 7mmol/l to between 6 – 9mmol/l.

Race Day:

  1. Sugar levels were excellent during the night. Trending between 4mmol/l and 6mmol/l.
  2. There is something called the Dawn Effect, which causes everyone’s blood sugars to rise just at dawn. My Dawn Effect kicked off at 4am, and took my sugar (not caused by eating anything) from 4 to 7mmol/l.
  3. Before the race, my sugar level had stabilised. I take a cup of super-salty soup stock (taken from The Art and Science of Low Carb Living), and two coconut fat bombs (basically coconut oil, coconut butter sweetened with stevia). The fat bombs are to get in some good fuel from the coconut (which contain saturated fats) just before exercise – this is something you need to play around with, as everyone has a different tolerance level to coconut oil.
  4. You can see at the start of the race my sugar level then starts to rise again. This is a strange phenomenon that I have noticed. I think it is caused by the tiny amount of carbs in the fat bombs and soup stock, as well as the body utilising the last of the glucose stores in the muscles. This increase in sugar never lasts long. You can see here that it increased from 6am to 6:20am. The sugar level was taken from a stable 7mmo/l up to 10mmol/l.
  5. Then it becomes a waiting game. I take zero carbs, and wait for my sugar levels to drop. I know they will. It usually takes over an hour. I check my Continuos Glucose Monitor all the time. Blood sugar stays stable at around 9-10mmol/l for 90 minutes.
  6. Then, over the course of the next 60 minutes, my sugar level slowly descends from around 9mmol/l to 5mmol/l.
  7. I don’t let it drop below 5mmol/l, and therefore I take my glucose supplements that I carry with me. I use Dextro Tabs, where each tab is approximately 3g of carb. I end up taking 10 tablets as I am feeling my sugar levels dropping further. So I take a total of 30g carb around the 2:30 hour mark.
  8. You can see over the next 20 mins that my blood sugar levels stabilise and then drop again. At this point, I am feeling very poor on the marathon. I am not thinking clearly, and just trying to survive.
  9. Instead of taking more Dextro Tabs, I elect to take some coke at the water stations. I take a small serving of coke (100ml) at each of the last 3 water stations. This is a total of 300ml of coke or a further 30g of carbs.
  10. You can see what this extra boost of carbs did for my sugar level in the last 30 mins of the race.
  11. Immediately after the race, my sugar levels stabilised at 9mmol/l.
  12. About half an hour after the race, my sugar level started to increase again. I think this is a result of taking coke too close to the end of the race, and not having enough exercise to burn it up. I should have stopped drinking coke about 30 mins before the end.
  13. I corrected this high blood sugar by taking insulin, and then I treated myself to a binge meal (and beer – I did just complete a marathon after all 🙂 ) and that caused the last spike in sugar around 12:30pm.

So there you have it. 4 hours massive effort on 60g carb, and the 60g ended up being probably about 10g too much.

Comparatively speaking, 1 Gu gel is 22g of carb.

LCHF is the answer!

 *Dietitian and colleague Caryn Zinn aptly changed the acronym. It works.

Type 1 diabetes, endurance sport and the LCHF approach: Lewis’ story.

I first met Lewis about a year ago when he came in to see me for a consultation. He will explain his story below, but the crux of it was that he wanted to ensure he was on the right track with his food intake as he started on a low carbohydrate, high fat (LCHF) diet to help his blood sugar control and his endurance sport. In reality, I merely confirmed what Lewis was already doing. Lewis had some trouble finding a lot of information for people with type 1 diabetes who undertake endurance sport, so felt the more he could share his experience, the better it will be for others looking to transition to a low carbohydrate, high fat diet for their blood sugar control. Despite what you may believe, it is not dangerous to follow an LCHF approach to diet if you have diabetes (type 1 or type 2). In fact, it’s quite the opposite. Thanks, Lewis, and over to you.

I was diagnosed with Type 1 diabetes 30 years ago, aged 9 years. I have always been a well-controlled diabetic, (according to the ‘diabetes guidelines’). About 3 years ago, I started training daily. It started out being just gym, then moved on to training for triathlons. Doing exercise is a vital part of a control plan for someone with type 1 diabetes, but it isn’t always easy to balance the amount of sugar, exercise and insulin. It is this balance between the amount of sugar, exercise and insulin that they call the ‘three legs of a stool’. They all are vital, and without any one of them, the chair will fall over. I try and keep my sugar levels above 4 and below 8 mmol/L, what is considered ‘normal’ and is typically controlled by the body’s natural hormonal processes in a person without diabetes.

What I found as I was training was that I was having to supplement large amounts of glucose whilst exercising to stop my sugar dropping. Then, after the exercise, my sugar levels would sky rocket to 15 mmol/L or higher. I would have to take extra insulin to counter the extra high blood sugar, and that would drive my sugar right down low again. It is this extreme roller-coaster of sugar levels that I interpreted as being necessary if one wanted to participate in endurance training. I would typically require a Gu gel every 20 – 30 minutes to stop my sugar dropping. On a four hour bike ride, that would be a massive (and expensive) 8 Gu gels, taking in approximately 160g of carbs. My sugars would be ok during the ride but then would skyrocket afterward.

Also, I had no confidence what my sugar level at any one time would be. If it was in the “good” range, was it only temporary? Was it on its way up, or on its way down? After having diabetes for 25 years, I still had no idea at all. I was thin, muscular, getting fitter and fitter. But my sugar levels were extremely erratic. I was pre-occupied with food, and was always hungry.

Then, a number of things happened all in the same month, October 2013:

  1. I heard Grant Schofield speak about LCHF diets
  2. I watched a Youtube clip of Dr Troy Stapleton, an Australian doctor who developed diabetes and eats LCHF. He said his inspiration was Dr Richard Bernstein’s Diabetes Solution.
  3. I read that book, and it pretty much changed my life. Dr Bernstein is an engineer who was diagnosed with Diabetes in the 1950s. He was the first person to do “home glucose monitoring” and turned the industry on its head, saying patients needn’t go to hospital to check their blood sugar. He later became a doctor (in his 40’s) to specialise in diabetes, and further the cause for good blood control.

He was, and remains, and engineer at heart. His basis for blood sugar control is one only an engineer could come up with. In a nutshell, you can’t predict what your sugar level will do. You can’t get the balance right between sugar and insulin. You will always be wrong. If you happen to be right, it is only by accident. He was describing me, and my rollercoaster sugar control. He explains that if you don’t eat carbs, then you don’t need as much insulin. If you don’t take as much insulin, then you don’t need as much carbs. I switched to LCHF in October 2013, and did my first Half Ironman in Jan 2014. I had submitted a detailed race report to Grant about this race.  Fast forward a year later and I have never looked back.

In terms of the food, eating becomes easier and easier. I do the cooking at home, which is quite useful!

My typical breakfasts now comprise an omelette with 3 eggs, chopped mushroom and chopped tomato. Alternatively, I soft boil 3 eggs, and have them with an avo and tomato salad.

My typical lunch would comprise a green salad with left-overs from the night before. I take care to make enough supper to leave something for lunch the next day.

Typical suppers in our house are below; it is all organic, whole food and high in fat.

  • Spaghetti bolognaise with low carb mung bean pasta (less than 5g net carbs for a big bowl of pasta). covered with olive oil and cheese.
  • Pizza on pizza base made from 1 cup almond flour, 1 egg, 1tbs olive oil, 1 tsp salt. (makes enough for 2 pizzas. very filling)
  • Hamburger on a bread roll made from 1/3 cup almond flour, 1/3 cup ground linseed, 1tsp baking powder, 1 egg, 1tbsp olive oil, 1tbsp cream, 1/2tsp salt. Baked in a mini-round tin, comes out like perfect soft bread roll.
  • Creamed mushroom soup (lots of mushrooms, cream, soup stock) served with Almond bread toasted slices. I make a large almond and linseed loaf once a week, slice it and freeze the slices for ready toast.
  • Bangers and mash (using cauliflower mash)
  • Fried chicken thighs (fatty and juicy) served with a green salad laden with olives and cheese
  • Fish fingers and “chips”. The fish finger batter is coconut flour and seasoning. Fried in Coconut oil. The chips are the same recipe as the pizza base but rolled thinner. Baked until brown and crispy. Add salt and the kids love it.
  • Butter chicken and rice (using cauliflower rice)
  • Taco night where it’s all the Mexican trimmings on either cauliflower tortillas, or large fresh crisp iceberg lettuce pieces as tortillas.

I try keep the level of protein at every single meal the same. Approximately the size of a deck of cards.

With regard to my sugar control and insulin levels during the year…

There is a test called HbA1c, which measures the average blood sugar over the last 3 months. The traditional diabetes practitioners (such as where I go at North Shore Hospital) have this range up, and the red oval shows where the practitioners try to have you aim your sugar levels.

hba1c

A non-diabetic is supposed to be 5%. The reason the practitioners want us diabetics to be at an average of 8-10. (which is too high, as the non-diabetic body wants to be at 5%, is that (as a diabetic) when you eat regular carbs, you blood sugar will always rise after a meal. It can rise to 10 or 12, and then come back down again. This is “normal”. So, if your sugars are always rising to 10-12 after a meal, and your average is sitting at 5, it can only mean one thing. You have many many dangerous low blood sugar hypos.

I take 2 different insulin types. I take a long acting insulin called Lantis, which processes the natural sugars the body creates. (nothing to do with food). I also take a short-acting insulin (purpose made to handle carbs in food) each time I eat. My long acting Lantis dose has not really changed since going LCHF.

Now, when I was eating my traditionally healthy high carb low fat diet, I was taking between 10 and 12 units of short-acting Humalog each meal. My sugar would absolutely rise after the meal, then I would more likely than not correct it, then it would fall too low. Hence the terrible roller coaster. I assumed, as does the Diabetes Clinic, that to achieve non-diabetic levels of blood sugar control, it required a lot of low blood sugar hypos. I would have had to correct my low blood sugars hypos 3 – 4 times a day.

Nowadays, eating LCHF, I would typically take 1-2 units per meal. This is only for the hidden carbs in vegetables etc. If I was stricter in my eating, I could reduce that dose even further. I have since had to buy a “paediatric” insulin pen, which allows me to dose in half units. Which is quite something. My sugar never rises after a meal. Then, because I am taking very small insulin doses, it doesn’t drop down low either.

My last HbA1c reading was 5.6 and then 3 months later 5.3. A cause for celebration really, as this is approaching non-diabetic levels. The Diabetes Clinic sister on duty was extremely unhappy, and had to call a supervisor. They were not happy letting me drive home. They could only deduce that for my levels to be so low, I must have been having many many dangerous hypos.

I took it upon myself to explain diabetes to them. “If I take no carbs, then my sugar won’t go up. If take no insulin then my sugar won’t come down”. I can manage my sugar in a very accurate range. I have very few hypos, and when I do, their intensity to slight (ie, not powerful caused by large over-doses of insulin). And that by following their protocols, I would have many more.

lewis

Lewis completing the Auckland Marathon last weekend (November 2nd, 2014). Note the glucose monitor on his left arm.