“Stop using medicine to treat food.”—Dr. Sarah Hallberg.
First, let me start by reminding the reader that no diet is going to be effective for losing body fat unless it is hypocaloric (calories in < calories out). It is possible to gain body fat on an otherwise healthy diet. To gain muscle, of course, one needs to consume adequate calories. (I don’t say “excess”, because most of us who are fatter than “lean” are already eating more than our body needs—or we would be losing fat. “Excess” calories are any calories above what are needed to maintain a healthy body composition.)
Beyond caloric balance, macro balance—that is, the balance of protein, fat, and carbohydrate—in the diet is of great importance. Unfortunately, we have been misinformed by nutritional recommendation as to what these should be, and there remains confusion and controversy over what is best for a healthy body composition. Moreover, there are questions over what is best for “optimal” health. Truth be told, there is no “one-size-fits-all” prescription for macro balance—e.g., “40-30-30” (carbohydrate-protein-fat). Macro balance will largely depend upon physical activity levels, exercise timing, and a variety of intangible genetic factors.
Once one has established his or her caloric needs, it remains to determine how those calories will be distributed. It is becoming increasingly clear that “low-fat” recommendations have been unfounded. This has led to an increasing emphasis of what is referred to as a ”keto” diet. “Keto” is intended to refer to a “ketogenic diet”—one that causes the body to maintain a state of ketosis. In short, ketosis occurs when fats cannot be fully metabolized in the absence of glucose and, thus, acetyl CoA (by-product of fat metabolism) gets converted into ketone bodies (e.g., acetone, acetoacetic acid, and b-hydroxybutyric acid) which build up in the blood (known as “ketosis”). This is effective for weight loss (when hypocaloric, of course) because fat is inefficiently burned (I tell my students that it is like putting premium gasoline in a ’73 Dodge Dart). The challenge with ketosis is that it is hard to maintain. To know that one is truly in ketosis, one must regularly measure ketone levels (usually in the urine). Maintaining ketosis require diligent monitoring of carbohydrate and fat intake. Carbohydrates are kept extremely low (e.g., <25 g per day), and one spike in carbohydrates can easily disrupt ketosis and the body’s adjustment to these. Therefore, I tend to refer to attempts at a ketogenic diet with quotation marks—i.e., “keto”. What most consider a “ketogenic” diet is likely better referred to as a “low carbohydrate” diet.
There is reason to consider reducing carbohydrates—particularly if one is overfat/obese and quite sedentary. Insulin and insulin sensitivity play a significant role in obesity and the subsequent health issues that result. The degree to which one reduces carbohydrates will depend largely on goals and activity levels. Most athletes and moderate/heavy exercisers will need some carbohydrates to fuel muscle contraction and to promote muscle hypertrophy. Very low carbs will impact performance. In general, though, most of us are probably consuming too many carbohydrate. More specifically, we are likely consuming too many of the wrong carbohydrates. We should consider limiting starchy carbs and grains and favoring more vegetables. When we eat carbs is also going to be important to ensure that the carbohydrates we eat go where we want them to go—in the muscle.
A simple rule of thumb is to manage carbs according to the overall activity for the day and to consume the bulk of those carbohydrates in proximity to physical activity (i.e., exercise). I like to use <0.5 g, 1.0 g, 1.5 g, and ³2.0 g (per pound of body weight) for sedentary/non-training days, light training days, moderate training days, and heavy training days, respectively. Most, who are recreationally training, are training in the “light” range.
Protein can be pretty straight-forward with a target of 1.0 g/lb BW. There is wiggle room here, but it is pretty safe set this as a target and distribute the protein across the number of meals for the day.
This leaves us with fat. Fat is not the demon it was once made out to be. There are, however, healthy and unhealthy fats. Ideally, we want to consume fats such as olive, avocado, and coconut oil, from nut sources such as almonds and cashews, and from fish oils. We want to avoid excessive saturated fats and, especially, trans-fats. Fats increase our sense of fullness and satisfaction. As such, they make us feel fuller and, moreover, promote less of an insulin response. Fats can make up the remainder of our daily caloric needs, will be higher on low-activity days, and should not be eaten in excess (as they do come with more calories be weight than proteins and carbohydrates).
Consider eating more “keto”, as a rule. Shift from wheat grain flours to almond flours, or the like. Cut sugar—replacing sugar with non-caloric sweeteners (I prefer erythritol). Above all, begin to fill your plate with plenty of colorful vegetables. One does not have to deny one’s sweet tooth to eat healthier. Small changes to recipes can make them more “keto-friendly”, and when one does indulge in desserts that do not fit with keto (or enjoy a slice of pizza—or two—or other “forbidden” carbs) they should be well worth it. That is, don’t eat what will leave you with regrets.
Avoid the traditional high-carb American breakfast. Opt instead for protein and fat to break-fast. This will leave you more satisfied through the morning and help to avoid an insulin spike. Only eat higher carbohydrates in the morning if they are to be consumed in proximity to your exercise.
Most of us don’t have to go to the extreme of ketosis, but we can likely manage our insulin better. Eat right and exercise,
Be your best today; be better tomorrow.
Carpe momento!!