Friday, August 31, 2012

Day 4: Trending Downward

Well, there's a surprise!

8/30 AM: 183.5 (BMI 24.9)
8/30 PM: 185.5

8/31 AM: 181.5 (BMI 24.6)

Breakfast: 2 coffee with cream
Lunch: Tomatoes, red onion, mozzarella, EVOO, balsamic, iced tea with lemon
Dinner: Cheeseburger, ketchup, mayo; bacon, tomato

Calories: 2189 (target 1,600-2,200)
Fat: 188g
Protein: 105g (target 80-100g)
Carbohydrate: 21g, 3g fiber, 18g net (target 20g net)
n3:n-6 ratio: 1:6 (target <1:4, ideally 1:1)


Thursday, August 30, 2012

Day Four: Normal by BMI

8/29 AM: 184 (BMI 25)
8/29 PM: 188.5

8/30 AM: 183.5 (BMI 24.9)

Breakfast: 2 coffee with cream
Lunch: Italian sausage, red-green-orange peppers, onions, iced tea with lemon
Dinner: Cheeseburger, ketchup, mayo; salad, iced tea with lemon

Calories: 1909
Fat: 155g
Protein: 98g (target 80-100g)
Carbohydrate: 32g, 10g fiber, 22g net (target 20g net)
n3:n-6 ratio: 1:5 (target <1:4, ideally 1:1)

Wednesday, August 29, 2012

Day Three

8/28 AM: 185 (BMI 25.1)
8/28 PM: 189
8/29 AM: 184 (BMI 25)

Breakfast: 2 coffee with cream
Lunch: sharp aged cheddar, cucumber slices
Snack: Artisana cacao bliss, 1 packet
Dinner: tenderloin steak, asparagus (with butter), salad (romaine, tomato, carrots, red cabbage, feta, radicchio, red onion)

Calories: 1960
Fat: 162g
Protein: 92g (target 80-100g)
Carbohydrate: 42g, 14g fiber, 28g net (target 20g net)
n3:n-6 ratio: 1:4 (target <1:4, ideally 1:1)

Tuesday, August 28, 2012

Day Two

Each day I'm just going to do a short update post.

8/27 AM: 185
8/27 PM: 189
8/28 AM: 185

Breakfast: 2 coffee with cream
Lunch: tuna + hard boiled egg, mayo, celery, red onion, tomato, iced tea with lemon
Dinner: Turkey soup (turkey, celery, onions, carrots, spinach, mushrooms, garlic, salt, pepper), iced tea with lemon

Calories: 1589
Fat: 119g
Protein: 98g (target 80-100g)
Carbohydrate: 34g, 7.7 fiber, 26.3g net (target 20g net)
n3:n-6 ratio: 1:5 (target <1:4, ideally 1:1)





Protein Is Essential, But Too Much is Too Much

Why do I consider protein the important focus for the short and long-term?

In a word, it's satiety.

That and animal based protein is nutrient-dense; when in included at adequate levels in your diet, it is much easier to meet nutrient needs each day.

Most calorie restricted diets not only reduce calories, they significantly reduce protein intake. I think this is the cause of the hunger often reported once an individual is into their lower calorie diet after a few weeks. While starvation does work in the short term, long-term 95% of people who lose weight will gain it back within three years, 99% will within five.

When you do not eat enough protein, you are starving, slowly but surely; and that holds true even in a state of excess calorie consumption.

Protein is a really neat macronutrient, not only does it provide us with essential amino acids, it also is used throughout the body to repair and build muscle, cells and tissue. Amino acids are critical to maintain our health, but they're not really a great energy source - when the body's energy sources are low, it begins to degrade proteins for use as an alternative energy source. Amino acids can be classified as glucogenic or ketogenic.



Glucogenic amino acids can be degraded to pyruvate or an intermediate in the Krebs Cycle. They are named glucogenic because they can produce glucose under conditions of low glucose. This process is also known as gluconeogenesis, or the production of "new glucose." Amino acids form glucose through degradation to pyruvate or an intermediate in the Krebs Cycle. The intermediates can then be converted to oxaloacetate, the main precursor for gluconeogenesis. (glucogenic amino acids: alanine, cysteine, glycine, serine, threonine, tryptophan, asparagine, aspartate, phenylalanine, tyrosine, isoleucine, methionine, threonine, valine, arginine, glutamate, glutamine, histidine, and proline).

In contrast, ketogenic amino acids can produce ketones when energy sources are low. Some of these amino acids are degraded directly to ketone bodies such as acetoacetate (leucine, lysine, phenylalanine, tryptophan, and tyrosine). The other ketogenic amino acids can be converted to acetyl CoA. Acetyl CoA has several different fates, one of which is the conversion to acetoacetate. Although not a preferential energy source, acetoacetate can be metabolized by the brain and muscle for energy when blood glucose is low and acetoacetate cannot be used in gluconeogenesis, since acetyl CoA cannot be converted directly to oxaloacetate.

The above is what happens when you consume adequate protein each day. So, what happens if you consume too many calories and/or too much protein? Basically, when energy sources are high, both glucogenic and ketogenic amino acids are converted to fatty acids through the intermediate acetyl CoA. Other amino acids that are degraded to intermediates in the Krebs Cycle are siphoned off into the production of urea, a nitrogenous carboxyl compound that is filtered through the kidneys and secreted in the urine.

Put another way, you now have fatty acids that can store as body fat.

It is for this reason one should not consider a low-carb diet as an all-you-can-eat buffet, just hold the carbs. Whether you're new to carbohydrate restriction, or a long-term veteren, you need to know how much protein you need at minimum, and also understand where the maximum is for weight loss and weight maintenance.

How does one know how much is enough and how much is too much?

It depends largely on weight. In fact, it is really all about how much one weighs. Protein requirements are based on body weight because body weight takes into account mass, lean body tissue and structural maintenance. The more you weigh, the more protein you need; the less you weigh, the less you need.

The absolute minimum, to meet EAA requirements is considered 0.8g/kg body weight. On a low-carb or carb-controlled diet, one does require more to fuel gluconeogenesis and most agree that protein requirement ranges, from 1.0g/kg to 1.5g/kg. A good middle maximum is 1.2g/kg if someone is active. For this reason, I usually provide individuals with a minimum target for protein each day based on the EAA minimum (0.8g/kg) from animal foods, then provide a range of maximum from all sources, including the vegetables they'll consume, that ranges 1.0g/kg and 1.2g/kg. In the years I've helped people understand how much protein is enough, I've only encountered a couple who were very active and could consume 1.5g/kg.

The chart below provides protein requirement and upper protein range for those restricting carbohydrate in their diet.

WEIGHT
PROTEIN
EAA MIN
PROTEIN
GNG RANGE
350-plus
125g
160-190g
340
123g
154-185g
330
120g
150-180g
320
116g
145-175g
310
113g
140-170g
300
109g
136-165g
290
105g
131-160g
280
102g
127-155g
270
98g
122-150g
260
95g
118-145g
250
91g
114-140g
240
87g
110-135g
230
84g
105-130g
220
80g
100-125g
210
76g
95-120g
200
73g
90-115g
190
69g
86-110g
180
66g
86-100g
170
62g
77-95g
160
59g
72-90g
150
56g
70-85g
140
55g
70-85g
130
55g
70-85g
120-less
55g
70-80g

Monday, August 27, 2012

Day One

It's been a while since I winged it, but yesterday I did to see how I do just eating whatever seemed good. Turns out, even with all the experience I do have, I ate pretty crappy.

I am not, nor have I ever been a breakfast person - it's usually a cup or two of coffee in the morning, then later in the morning, I'll eat something. I do not plan to change that, but will need to make some adjustments with regard to cream in my coffee.

While I did keep carbohydrate low and did stay within my target calories, I fell short on protein and essential nutrients!

Breakfast: 2 large cups coffee with cream
Mid-AM: 2 hard-boiled eggs with mayo
Mid-PM: 5 slices organic ham, 1 sllice provolone
Dinner: Pork sausage, tomato-cucumber-red onion-basil salad with EVOO & red wine vinegar
Beverages: Water, brewed iced tea with lemon wedge

Calories: 1833 (target 1600-2200)
Fat: 159g
Protein: 75g (target 80-100g)
Carbohydrate: 27g, 4 fiber, 23g net (target 20g net)
n3:n-6 ratio: 1:5 (target <1:4, ideally 1:1)

8/26 Sunday AM: 187 (mid-day)
8/27 Monday AM: 185

With that, today includes some planning based on which foods are nutrient-dense. Today's goal is to again remain low with carbohydrate, but increase protein and nutrient-density.

Sunday, August 26, 2012

Beyond Maintenance

Back in 2001, I tipped the scales at 275 and knew I had to do something or face 300 pounds before I turned 40. After looking at a bunch of different diets, I settled on the Atkins diet since it didn't have me weighing and measuring everything or keep track of calories. While it sounded too good to be true, I did have a couple of friends that had followed it and lost weight, so I jumped in with both feet to give it a try.

It worked, by the following summer I'd lost 80-pounds and felt great; despite my BMI still classed "overweight" I felt it was a good weight to try to maintain and figured I could lose more later after I'd maintained the loss for a while.


As luck would have it, my first significant gain didn't come from "falling off the wagon" but from pregnancy. Over the course of nine-months I gained weight and went into delivery at 260 pounds. I hadn't returned to eating a high carb diet, but did increase my carbohydrate and picked nutrient-dense foods, like sweet potatoes to maintain a dietary intake of between 90g and 150g in pregnancy. After delivery and weaning, I my weight was back to 215 with little effort and soon after I got serious and lost the 20 pounds of baby weight I'd allowed to stick around. Back to 195, maintaining was now my priority.


Again I maintaned the (+/- 10) for what seemed like ages, and then in 2010 I was pregnant again. And again, I went into delivery at 260 after eating pretty much the same as I did with my first. I laughed at the time that my body apparently really liked being 260 at term! Much like after my first child, following delivery I lost about 40 pounds in six weeks, then maintained while breastfeeding. Once my second was weaned, I decided to target a lower weight - 185 - as my goal, and then maintain. Within four months I reached 185 and have since maintained my weight once again, now 90 lighter than I was in 2001.


While I feel great, I do want to lose a bit more, so that my weight is within normal by BMI. As it is now, at 185 my BMI remains in the overweight category (25.1) and it'd be nice to see "normal weight" and then maintain that lower weight before I near menopause. So today, along with a hundred or so others from Your Lighter Side, I've started again with a goal of 165. That weight will leave me with a BMI of 22.4, smack in the middle of normal weight. I haven't weighed that since my early 20's and I honestly do not know if it's even reasonable to lose 20 more pounds, but we'll see.


Why am I posting about this?


Well, after eating a carbohydrate restricted diet for over a decade and maintaining my weight loss excpet for while pregnant and the year after delivery, I think this is a good opportunity to show others exactly what I do and explain why I do the things I do and why it's foolhardy to think I can eat the way I did losing weight when I was 275, 250, 200 and now 185. While I will eat ad libitum for the most part, I eat very differently today than I did ten years ago - I just don't eat nearly as much food as I did when I weighed 275, I just can't, it's too much!


Maintaining my weight at 185 works out to require a calorie level between 2,300 and 2,500 calories a day. I usually eat about 100g of protein and my carbohydrate ranges between 90g and 150g, sometimes dipped below 60g, and while rare, sometimes nears 200g. I don't specifically track what I eat, but when I've entered a day or two into an online program to take a peek, it's consistently within the range above.


While I get settled into restricting carbohydrate, I'll be tracking what I eat in Paleo Track and since I'll have all data points, I'll be looking at the following:


1. Meeting my nutrient requirements in my diet (vitamins, minerals, trace elements, EAA and EFA)

2. Attempt to maintain an omega-3:6 ratio of no more than 1:4, ideally 1:1
3. Making sure I eat at least 80g of protein each day, from animal sources; and not exceeding 120g total protein from all sources
4. Restricting carbohydrate to 20g net daily, total minus fiber present (not added fiber)
5. Maintaining a calorie intake of no less than 1,600 calories and no more than 2,200

I'll also be taking supplements as a "safety net" while losing weight and as I play around with what to eat to meet nutrient requirements, because this time, as in the past, the time losing weight is also time to learn what to eat for maintenance and part of that, I strongly believe, is getting your nutrients from food. If you aren't meeting nutrient requirements from food, something is wrong with your dietary habits!


I chose the calorie range I did based on my BMR (basal metabolic rate, the calories used for function of the body) estimate of 1,580 calories.


I use BMR as the minimum calories to consume to avoid what many term "starvation mode" - the calorie level, when habitually missed leads to a reduction of BMR energy expenditure to conserve until the perceived famine is over. I chose the high end of calories based on the fact that I maintain at 2,300-2,500 calories a day and that a deficit is needed when losing weight and 2,200 represents the mid-range of calories I will likely need to consume on average once I reach 165, with a range that is likely to be close to 2,200-2,400 a day.


While restricting carbohydrate to 20g net, no less than 10g net must come from non-starchy vegetables; ideally they'll account for most of my carbohydrate each day.


Each day, between now and when I either hit my goal of 165 or realize that it is too low of a weight for me, I am going to share with you what I'm eating and if I'm losing weight - I'll also present things I'm doing to tweak my menus along the way to meet nutrient requirements and maintain calorie range. Keep in mind, I do not believe it necessary (barring diabetes, PCO and a few other metabolic disorders) that it is necessary to restrict carbohydrate below 60g a day for the long-term. In time, you will see my menus ramp carbohydrate intake back up, to what level I am not sure yet, but it's fairly certain it will be at least 90g a day for me - to me that level provides the widest range of foods to choose from each day.


Long-term maintenance is possible - I know, I've done it for ten years - when you learn how to eat, not when you learn only how to restrict. Long-term health requires adequate nutrition and calories. It requires more than just counting carbohydrate. I'm hoping that over the next few months I can show you the ins and outs of not only weight loss, but maintenance in good health without obsessing over your food choices.

Saturday, August 25, 2012

Working Through a Stall

Jane Anyone started a low-carb diet about six months ago. She is 5'6" tall and 35 years old. When she started her diet, she weighed 250 pounds with a BMI of 40.3 (obese).

After six months of fairly steady weight loss, she is 200 pounds and she stalled. After thirty days she is frustrated and asks you for help to figure out why her low-carb diet isn't working anymore.

You ask to see what she's eating and she tells you it is the same as she's eaten since she started and she provides the following framework for you to look at:

Breakfast
4 large eggs
3 slices bacon
1 ounce cheese
1 tablespoon of butter to cook eggs
1/8 (wedge) of honeydew or canteloupe
2 cups of coffee with 4 ounces heavy cream

Lunch
6 cooked ounces of meat (usually a buger)
Topped with 2 sllces bacon & 1 ounce of cheese
1 tablespoon of ketchup (if a burger)
6 cherry tomatoes with 2 tablespoons mayo
1/2 avocado
16 ounce fresh brewed iced tea with 1 wedge lemon

Dinner
8 cooked ounces of meat
1 cup of cooked vegetables
2 tablespoons of butter on vegetables
1/2 cup blueberries or strawberries with 2 ounces heavy cream
16 ounce fresh brewed iced tea with 1 lemon wedge

In addition she drinks 32 ounces of plain water, takes a multivitamin, fish oil and vitamin D. She isn't sedentary, instead she would be considered "light" activity as her level of exercise.

Keep in mind, this is how she has eaten since she started her diet and lost 50 pounds, that is until she stalled recently. Now she's frustrated.

What would you advise and why?

In one week, I will share with you what I advised and what happened after the changes I suggested were followed.

Do Calories Count?

We often hear, and even I've said, do not count calories on a low-carb diet. The advice, on its face, is sound because when someone starts a low-carb diet, overweight or obese, counting only grams of carbohydrate, they reduce their calorie intake even when eating ad libidum; so having to count calories over-complicates a dietary approach that already lowers calorie intake anyway.

But saying "don't count calories" does not mean that calories do not matter. I wrote about how it is a myth that calories don't count back in 2005 (here).

They do, they always have and always will - but they're not always perfectly matched to calories-in/calories-out (CICO) since nutrient-density of the food you eat also matters, along with the fact that the body compensates daily with homeostsis and how much we move, so it's not always burning exactly the same calories each day. But over a long-term average, calculated active metabolic rate (AMR) is a fairly accurate target for calories needed on average each day to maintain weight when you're meeting requirements for essential nutrients.

So, should you count calories?

Based on years of experience, my suggestion remains - when you start a low-carb diet, do not count calories.

If you stall, look at calories - you may be eating too many, or (gasp) not enough.

If you gain, look at calories - I can promise you that if you're keeping your carbohydrate restricted, gaining almost always means you're eating surplus calories from fat and protein in excess of your active metabolic rate (AMR); small fluctuations are normal, but gain on gain on gain while restricting carbohydrate is excess calories.

It is a MYTH that you cannot gain weight if you just keep your carbohydrate restricted, the fact is calories do matter. In addition,hormones, glycogen stores, and metabolic rate matter too, but if you're gaining weight while keeping carbohydrate restricted, you're not gaining in a calorie deficit, you're gaining in a calorie surplus.

Tuesday, August 14, 2012

Where Are We Today?

When I started this blog back in 2005, in my second post, Hunter-Gatherers, I looked at a review by Loren Cordain et al, about the maronutrient estimations in worldwide hunter-gather diets.

I noted,

Their findings included

  • Most (73%) of the worldwide hunter-gatherer societies derived >50% (56–65% of energy) of their subsistence from animal foods, whereas only 14% of these societies derived >50% (56–65% of energy) of their subsistence from gathered plant foods.

  • This high reliance on animal-based foods coupled with the relatively low carbohydrate content of wild plant foods produces universally characteristic macronutrient consumption ratios in which protein is elevated (19–35% of energy) at the expense of carbohydrates (22–40% of energy).

So, most of the hunter-gathers are eating 56-65% of their energy from animal foods, providing 19-35% of their calories as protein and just 22-40% of their calories from carbohydrate.

In a "real world" 2000-calorie a day diet, what does such a macronutrient mix look like?

19-35% of calories from protein = 380 to 700 calories or 95g to 175g of protein, with most coming from animal foods

22-40% of calories from carbohydrate = 440 to 800 calories or 110g to 200g of carbohydrate

The remaining calories, from fat = 500 to 1180 calories, or 25-59% or 55g to 131g of fat


And continued by stating that "[t]hese ratios are very much in line with controlled-carbohydrate nutrition ratios, which generally holds that carbohydrate is limited to 40% or less for daily calorie intake. The mix of fat and protein calories in a controlled-carb approach is highly individualized and the goal is to include quality protein in adequate amounts and only include quality fats and oils."

Six years later, I still hold the opinion that today, controlled-carb nutrition can model the diet of our ancestors; typically called Paleo and/or Primal eating. In fact, I'd say it would be difficult to consume a diet high in carbohydrate (greater than 40% of calories from carbohydrate) without specifically focusing on eating a high level of carbohydrate each day.

Has this become clearer in the years since I started this blog?

Not really.

In truth, time has created a variety of differing opinions that leave many confused; worse is that some seek to create divisions where none need be.

Recently Jimmy Moore posted AHS12: A Dichotomy Of Differing Interpretations Of What Paleo Is. In it, he writes, "However, when it comes to starchy carbohydrate sources of nutrition such as white potatoes, sweet potatoes or white rice (the toxin-free “safe starches” identified as such by Paul Jaminet), there’s a definite divide between those who avoid them because they raise blood sugar and insulin levels as well as lipid numbers to unhealthy levels (...) and those who believe these starches provide the adequate glucose your body needs to perform and function as it was intended to. That’s quite a division within the Paleo community that doesn’t have an easy answer to bridge the chasm."

Is this really a division within the Paleo community? Is this really a chasm that needs a bridge?

Honestly, I don't think so.

As I noted in my comments on his link to the blog on Facebook, "Paleo is a guideline to the types of foods one can eat, not the amount one *should* eat of any particular macronutrient; low-carb is one dietary approach which fits in with a paleo diet. Both focus on quality protein, good fats and nutrient dense carbohydrate. What level of carbohydrate you consume is your business, Paleo is basically just the framework for what foods to choose from. I don't think paleo has to be low-carb to be effective. It really is dependent on the individual."

One of the things I've learned over the last decade is that nothing is set in stone when it comes to macronutrients - the diets of healthy, normal weight individuals, around the globe vary greatly, what matters most is the micronutrient composition in the overall diet; it's habitually meeting or exceeding essential fatty acids (EFA), essential amino acids (EAA), essential vitamins, minerals and trace elements. The Japanese do that by consuming copious amounts of fish and pork, but their overall diet is lower in fat than those in France, who also do that with a wide variety of meat, full-fat dairy and a boatload of non-starchy vegetables and fruits. Both diets also have starchier foods too, yet these populations are not, nor have they ever been, suffering alarming rates of obesity.

Why?

If you look at diet quality, both Japan and France are eating serious quality foods, real foods, compared to the US and other nations with exploding obesity rates.

Quality matters; it is the heart-and-soul of Paleo, it is the heart-and-soul of Primal. The focus of ancestral eating (Paleo and Primal) is real food, shunning the processed and choosing quality. It defines no specific level of macronutrients by gram or percentage, but does point to nutrient density and meeting essential nutrient requirements. While one can follow a low-carb diet and eat Paleo-Primal style, that does not mean Paleo-Primal is low-carb per se; although, as noted i the paper by Cordain et al, Paleo-Primal diets are lower in carbohydrate than the Standard American Diet (SAD).

I do not think we have this deep divide, I think what we're seeing is a wide variety of approaches to reach the same goal - eating healthfully for the long-term. For some that includes soaked and fermented grains (Weston A. Price Foundation), for others eliminating grains is important, but dairy and legumes, along with other foods that are newer in our history may be included (Primal), and still there are those who hold that those foods, eaten by others in the spectrum of eating "real food", are simply unacceptable, just say no (Paleo). At the end of the day, the common theme amongst all - eat real food!

As one commenter noted on Jimmy's blog, "We do not currently understand everything about the variation in individual response to carbohydrates, such as sex differences, or dependence on history of metabolic dysfunction. We also do not completely understand how an individual’s dietary needs may change as a function of time depending on external
conditions. In addition, how much carbohydrate a person will do best on will depend on their goals (performance, longevity, reproductive health), but once again we do not understand the complete picture!"


I concur! Many things factor into weight loss and long-term health, eating real food is the one thing that continues to be the most important aspect of a healthy diet.

Chris Kresser nailed it last year, in his post Beyond Paleo: Moving from a Paleo Diet to a Paleo Template.