What pisses me off about nutrition is an over reliance on equations and numbers (and macros)?
For instance, we have the Mifflin St. Jeor and the Harris Benedict equation, WHO standards, or calculating caloric intake off lean body mass. There are a lot of ways to calculate how many calories you need to eat to supposedly stay where you are or lose/gain weight. You will need to calculate tons of fun acronyms in the process: RER, FFM, TEF, BMR, etc. You know – Math. Yet, the very first problem is that these equations are just estimations, very rough estimations. It will depend on the paper you read, but in a recent review of 29 of these equations by AJCN the best are a little more than 20% off at estimating Resting Energy Expenditure. Then you get into what the body does in response to certain foods, exercise, the validity of the gold standard used, and the snowball grows.
Peter Attia M.D., perhaps one of the smartest men on the planet put himself in a whole room calorimeter (the only real gold standard) to see how good these equations were at calculating his energy needs when he was doing his exercises, reading his books, and just chilling in the dark. The equations were about 40% off! Peter works out and although he may be an outlier, it at least raises the ideology that the wrench in the equation game may be much bigger for those of us who train at higher levels. This may also be one of the reasons Dr. Attia puts much more weight into food quality than being overly worried about measuring your food to the milligram or making sure your myfitnesspal has exactly 1,862 calories on it (we then get into the reliability of people to estimate, measure, and report food accurately – I will stop now.)
Dr. Attia has a great post on calories and the First Law of Thermodynamic here.
Why don’t these equations work?
Well, the human body is a math equation, it’s just one built and invented by nature which moves everything around all the time to try to make the answer 0 (homeostasis). AND as the body loses its ability to balance this teeter totter the way nature intended, guess what else goes out the window? Health.
So now you think you are going to get health back by trying to input the perfect numbers back into a broken ever changing pissed off equation? It’s almost laughable. Wait it is.
Thus, please make sure that you have food quality on board before you start overanalyzing food quantity. IIFYM? NO.
Now what pisses me off about the people who value food quality and completely disregard food quantity?
This could be alternative medicine folks, paleo people, my father, whoever. They believe that you can slurp grass-fed butter, pound cashew breads, and that if it doesn’t come in a bag it won’t make you fat. Truth is it will be harder to get fat lapping up coconut oil on the hour and for most of us this may completely reset our insulin sensitivity, but over time it will not end well. People need a ton of fiber and nutrients to make the equation above run effectively. In fact there are 75,000 enzymes in the human body and all of them are pH dependent and most need cofactors (nutrients and stuff) in order for them to run effectively. Now throw in GI issues and genetic polymorphisms and again the snowball grows.
The Final Rub.
I haven’t met too many conventional nutritionist or doctors who are even contemplating how to measure health, let alone have practices in place that drive health and performance. They are pounding square low calorie and low fat blocks into round holes, exasperated that none of this works long term. Equally, I know many folks in the alternative health care realm who can get people healthy, but almost none of them can create, manage, and monitor an individualized diet, exercise, and lifestyle strategy effectively. They give great recommendations in the office, but they don’t use any numbers or equations. They generally just hope and pray that the power of food restriction and coming to a fancy office will get the job done. Generally, not gonna happen, especially long-term. Too much will power not enough tools, direction, or accountability.
So where is the truth?
Well you need both sides. You need some math, but it needs to be flexible, and please for the love of Zeus find ways to round and talk in food not numbers. You also absolutely have to make sure that your body isn’t missing something that would kick the above math in the nuts, AKA GI, brain, kidney, liver, thyroid, gonadal, or pancreatic dysfunction (the list is much longer).
Fundamentals. Eat the highest quality food that YOU thrive on. Eat it at the amount you need based on the lifestyle you have right now. Find a professional or practice who can help you dial it all in forever and not get lost in the matrix of the nutrition blogosphere.
By: Ben House PhD Candidate, FDN, fNMT
*Don’t think for a second think I haven’t screwed the pooch on any this with clients (or myself) over the last ten years, I have. But I really do believe that Coach Davis and I are getting our individualized vehicles tuned up and firing on all cylinders. Yet, even with these approaches and uber amounts of monitoring tools the environment (such as food addictions, food advertising, peer pressure, and social obligations) can completely still derail the best of programs. Thus, the most important thing is still making sure the client really wants to do this, like really really, and that they have dug deep and come up with the “why” that reverberates to their core.
“Habit is the intersection of knowledge (what to do), skill (how to do), and desire (want to do).”
Sometimes my inspiration to write comes from very odd places, for instance the above bathroom sign. A visionary savings of your tax dollars at work on the UT campus or a sneaky joke at the reversal of gender roles and omnipresent endocrine disruption?
I will give these bathroom workers the benefit of the doubt in that this wasn’t meant as a crude joke to women with Metabolic Syndrome and/or Poly Cystic Ovarian Syndrome. The fact is that even these at risk women might not know that these type of diseases or conditions generally push them to a more masculinized state. Whereas, in men, increased abdominal fat will feminize us. So you can see at a very basic level, as both sexes age in our current environment, there is the reversal of gender roles and hormonal profiles.
Well unfortunately, our hormones naturally decrease with age (although some argue that the stark severity and harshness of this decline in both men and women only takes place in western societies). Regardless of your romanticism of the past, we are animals, and our utility will begin to diminish as we lose our ability to reproduce. Combine this decline with an onslaught of environmental xenoestrogens (which won’t be picked up in bloodwork), horrendous amounts of pesticides and pollutants, a never ending stream of stress, and a general lack of sleep and play, and our ability to gracefully age is severely compromised.
Think about it. How many men get docile as they age? They get a baby or not so baby gut and are bossed around by their wives. They drink beer and talk about the glory days of their youth. This sounds like an absolute joy for the women in these relationships who are now struggling to maintain their femininity through and past the menopausal years. They want to look sexy and want to want to have sex, but they can’t fight the internal dissonance of their hormonal levels. Whereas, the men may just be completely disinterested or unable to copulate.
On to some nerdery (mechanisms). Male hormones will diminish in western societies 1 to 2% per year starting in one’s thirties. DHEA, the most abundant androgen in circulation, peaks in the twenties and drops to 15 to 20% of youthful levels in old age. Furthermore, men on average lose 75% of their testosterone with age and sex hormone binding globulin generally increases with age in men, thus even less free testosterone. No bueno. Combine these factors with estrogen rising due to environmental sources as well as increased aromatase activity from increased fat mass and you have a very neuterizing public health recipe.
Women are usually much more complicated than men, and their hormonal orchestra is no different. Yet, in the post-menopausal years, the ovaries no longer provide much (if any) estrogen or progesterone, and this means that the adrenals become the major source of sex hormones. So one can already see how stress and HPA axis dysregulation can completely dismantle any chance of success in this already difficult time. Dr. Michael Cosgrove describes it very succinctly, ”After menopause, estrogen levels in women fall significantly, while testosterone levels continue their slow decline with age, leaving women relatively testosterone dominant after menopause.” To compound the problem, higher insulin levels from lifestyle are believed to stimulate 17,20 lyase, which pushes pregnenolone and progesterone towards the androgenic pathway. Increased insulin levels also lower sex hormone binding globulin, this means more free testosterone. Combine all this with impaired liver clearance, reduced GI and thyroid function, and the complications of estrogen metabolism, and the map towards feeling and looking great later in life becomes even more perplexing to follow.
Ladies, for more on this check out this post from Dr. Mark Hyman.
Thus, how do we avoid the writing on the wall which was so eloquently put there by these janitorial specialized construction workers?
Well…we take on our health early so that we have a shot to maintain our vigor and zest for life as long as possible – technically this is called increasing the health span. We don’t wait for the storm to come, we prepare for it, knowing that it will come. This is very hard for humans to do as we are not evolved to be able to live with a long view of time. But, with the right mindset and guidance, we can look for leading indicators of dysfunction on lab work and pay attention to potential early onset symptoms: a little excess fat around the belly, fatigue or increased energy after meals, cold hands or feet, constipation or diarrhea, excessive bloating and gas, dizziness when standing, overly sensitive to light, hair loss or hair growth, problems with short term memory, loss of libido, retaining fluid, and general fatigue, the list could go on for a while. Please don’t shove these “little” issues under the rug of my doctor says my lab work is normal. Because none of those symptoms are normal; they predict and indicate dysfunction, and although you may be able to live with them now, they will smolder and grow if left unchecked.
This post is not meant to be all doom and gloom, but a warning to take action. The human body is nothing short of amazing in its ability to heal and adapt. We have seen hormone levels in men nearly triple in just 90 days of exercise, lifestyle, and functional medicine interventions. For some, the situation will be a much more intricate web of symptoms and causes, and it will take a very skilled functional medicine practitioner to decide what to do, when. It will be a much longer road. Yet, the earlier you start this process, the more likely you are to catch things before they can’t be fixed and have to instead be managed. If you need help finding a guide for this area of your life, feel free to email; if you are in Chicago, Austin, Dallas, or Houston, I can likely link you up with a really solid match for your particular situation. If you are not in those cities, you can search for a practitioner on the Institute of Functional Medicine website.
By: Ben House PhD Candidate, FDN, fNMT
Sleep. Eat. Enjoy Life. If you are going to try some low carb or lean down protocol – this is the week.
Load it up. Sleep 8+. Deload Coming. Keep it quality.
Over the past decade I have looked at thousands upon thousands of dietary recalls or diaries and I can count the number of goody two shoes humans who have eaten enough vegetables on one hand. Davis and I are always looking for the simple side of complexity and to me after we get the dietary wheels on the car, it all comes down to snacking.
To give props where they are due, after some tug of rope, my clients generally do a very good job with their main meals. A plate of organic meat, veggies, quality fat, and depending on their activity and goals a clean carb source (individualized to them). The biggest eff ups happen either at breakfast or in-between meals. Why? Because this is when we culturally lose our marbles. Donuts and coffee. Fistfuls of jelly beans. Melted candy bars hidden under car seats. Dr. Pepper and hot Cheeto fingers. I have seen it all.
Now do I think that trail mix is a step up from the aforementioned atrocities? Well, yes, but honestly not much. Much like high school, I want the vast majority of the eating occasions that my clients consume to be positive influences. Nuts may have some quality fats, but they honestly aren’t that high quality (walnuts are the qualitiest), and people tend to forget that calories do matter and these bad boys a dense. Also, nuts that aren’t properly prepared have more phytates than grains and nuts are very common allergens. Mix all this with M&Ms and I am just not sold. Yet, the biggest reason I am not a fan of trail mix and bar-itis, is the fact that people aren’t eating vegetables. And honestly, who in their right mind counts and eats 7 almonds.
My clients then ask, “Well fancy nutrition man, what do I snack on?”
*if they have solid blood sugar control combined with an HPA axis that is online I will just take out snacks completely and add more real meals if necessary. **This may be even more rare than the goody two shoes veggie eaters.
and for those that really do need to eat more often.
Enter the mini meal.
To their dismay I say, “Have another meal….just a little smaller.”
“You mean more high quality meat, fat, organic vegetables, and maybe a clean carb source?”
They start loading their glocks and sharpening their knives. No you will not take my cashews you heathen! Freedom…and they come back 4 days later.
I know this isn’t easy and it really does take some grit to live counter culturally. It also means you need to be prepared and have some stocked Pyrex containers handy in the fridge with tasty mini meals that you look forward to grubbing down on.
But, for real I have seen way too many nice people convince themselves they are eating all high and mighty well when they have a handful of vegetables with lunch and dinner mixed with 16 servings of gorp, 12 bars, and 4 gluten free muffins each week. Don’t believe me? Run an experiment. Drop all the non-sense packaged snacks and pre-made items (paleo, vegan, kosher, or otherwise) and eat only real food that you prepare for a few weeks and see how it feels.
By: Ben House
*Now that you are eating all good and stuff, try chewing, getting some extra sleep, scheduling some time for play, and lifting enough weights for you. The ball just keeps on rolling. Enjoy it.
** I know what some of you may be thinking, well there is no way I can eat that many vegetables. To which I would counter perhaps you have an underlying GI issue that we need to look into. Ba-dom-ting.
***Out of respect for Ron Swanson, there are no Ron Swanson references in this post.