Macronutrients

Question 1

What are the five categories of macronutrients?

Answer 1

Protein
Fats
Carbohydrates
Alcohol
Water

Question 2

How many calories per gram of energy?

What does protein provide, and how used in the body?

Answer 2

4 calories per gram of energy

Protein provides amino acids that are then reassembled in the body into complete proteins needed for survival - such as enzymes, muscle, skin and more

Question 3

How many calories per gram of Fat?

What are the sub-categories of fat?

Answer 3

Fat has 9 calories per gram of energy

Subcategories of fat
Saturated - hydrogen at each carbon molecule
most animal fats, such as butter and eggs

Monounsaturated = one double bond between two carbon molecules with the remaining carbon atoms being single bonded to hydrogen
olive oil is 75% monounsaturated

Polyunsaturated two or more carbon-to-carbon double bonds. least saturated with hydrogen
nuts, seeds, fish

Question 4

How many calories per gram of Carbohydrate?

Categories of carbohydrates?

What do they provide for the body?

Answer 4

4 calories per gram

Categories:
Simple (glucose and sucrose)
faster/more dramatic increase in blood

Complex (rice, sweet potato, cassava root, turnips)
takes longer to digest and breakdown, often include some simple, complex and indigestible fiiber

Whole/natural sources of sugar also contain healthy nutrients​:​ ​sweet potato is a good source of potassium, vitamin A, phosphorus, magnesium, and calcium

Question 5

How many calories per gram of Alcohol? What does it do for the body?

Answer 5

7 calories for gram.

No nutrients

Question 6

Does dietary cholesterol raise blood cholesterol?

Answer 6

No - for most people it does not. Only about 20 percent of cholesterol in your body comes from the diet, the rest is made by the liver

Question 7

Does TMAO increase cause heart disease? What study indicated this, and why is it misleading?

Answer 7

A 2013 study in the New England Journal of Medicine​ proposed that choline found in
liver, eggs, and other animal foods is metabolized by bacteria in our gut and then
converted into TMAO, which increases the risk of heart disease. First issue that CK raises - TMAO is raised even more by eating fish than eggs. Even if eating food increases TMAO - most people quickly and efficiently clear from the blood through the urine.

Question 8

Are Saturated fats safe?

Answer 8

Saturated fat intake should be individualized, people with the APOE 4/4 genotype or with mutations in their LDL receptor or apolipoprotein B have trouble clearing LDL from their blood and may be more sensitive to the effects of dietary saturated fat.

Question 9

What is the impact of too much refined sugar?

Answer 9

Too much refined sugar can lead to weight gain, metabolic disorders, immune dysregulation, behavioral disorders, and a number of other issues.

Question 10

Are small amounts of refined sugar ‘toxic’ or addictive?

Answer 10

No, this has not been proven when sugar is consumed in small amounts within the context of a nutrient-dense
diet, with plenty of fermentable fiber and protein/fats that help to regulate appetite, there’s no reason it should cause a problem for the average person. *It might need to be avoided more strictly in cases of conditions such as SIBO and metabolic disorders.

*“Important to note because some people can get really neurotic about food, and I think that can cause more problems than just relaxing and eating a little bit of sugar now and then.”

Question 11

What are the biggest issues with refined sugar?

Answer 11

Biggest problems with refined sugar are:
■ It has no nutritive value.
■ It disrupts the gut microbiota.
■ It may promote overeating by interfering with hormone signaling that regulates appetite.

Question 12

What are common misunderstandings about fructose?

Answer 12

Critics of fructose hold that it is uniquely fattening and has adverse metabolic effects when compared to glucose, arguing that it is the most efficient substrate for de novo lipogenesis (DNL), which is the process the liver uses to convert carbohydrates to fat.

Most researchers now believe that DNL in humans is negligible in response to fructose and doesn’t comprise a significant source of dietary calories.

There’s no reason for most clients to avoid fructose when it naturally occurs in foods such as fruits.

Too much refined fructose should be minimized or avoided. - sugar sweetened beverages, and limited for those with SIBO or other guts issues, or impaired glucose tolerance

Question 13

Is the Glycemic Index effective for glucose control or weight loss?

Answer 13

Concept is that high-glycemic-index foods should be avoided because they are rapidly absorbed and will thus spike our blood sugar levels. However, most of the ​evidence suggests that the glycemic index is not a particularly useful concept and is not supportive for weight loss, insulin or glucose control, or anything else, really, that I could find.

Question 14

How does glycemic load address some shortcomings of glycemic index?

Answer 14

Considers cellular structure and serving side.

Cellular carbohydrates remain intact during cooking.

Acellular carbohydrates are highly processed (flour, refined sugar) and lack living cells. Far greater density than found in nature. Alters gut microbiota in a way that promotes inflammation and causes insulin and leptin resistance

A small amount of acellular carbs in the context of a diet rich in cellular carbohydrates would not cause problems except in limited circumstances

Thus, white potatoes and ripe bananas are perfectly acceptable for most people and should not contribute to weight gain or metabolic issues.

Question 15

Does higher protein consumption promote cancer due to high IGF-1 levels? What type of protein should be consumed?

Answer 15

Theory is that higher protein intake increase levels of IGF-1 and high IGF-1 levels encourage growth of cancer cells.

Recent research has found that the amino acid methionine is the primary driver of increased IGF-1 levels observed with higher protein intakes.
○ Methionine is found primarily in muscle meats and eggs.

Glycine, on the other hand, does not have the same potentially harmful effects as methionine.
○ Some studies have shown that consuming higher amounts of glycine may have the same life-extending, IGF-reducing, health-promoting effects as restricting intake of methionine or total protein.

Summary: Maintain a healthy methionine-to-glycine ratio by consuming glycine-rich foods like bone broth and more gelatinous cuts of meat such as oxtail, shanks, and brisket.

Question 16

Why does CK argue that Neu5Gc antibodies consumed in red meat don’t cause chronic inflammation which leads to chronic diseases?

Answer 16

If this were true, we would expect a strong correlation between these
inflammatory diseases and prevalence in cultures such as the traditional Maasai people in East Africa, whose diet consists mostly of the meat, milk, and blood of cows they raise—foods that are all very high in Neu5Gc.
○ Yet chronic inflammatory conditions like heart disease are practically nonexistent in the Maasai people.

Question 17

Should you eat saturated fats? What are sources?

Answer 17

coconut oil, dairy, lard, fattier cuts of beef, lamb, pork and egg yolks.

Aid bone health, protect liver from alcohol damage, can improve lipid level by increasing HDL, help deliver fat-soluble vitamins A, D, K and E

Question 18

Should you eat monounsaturated fats? What are sources?

Answer 18

Main dietary sources: macadamia nuts, olives/olive oil, avocados, almonds, some animal products (duck fat, egg yolks, lard, chicken fat, tallow (beef fat), butter).
○ Be aware that certain foods that are high in monounsaturated fats, like nuts and avocados, are also high in linoleic acid, an omega-6 polyunsaturated fat.
○ Linoleic acid can be pre-inflammatory if consumed in high amounts when intake of EPA and DHA are low
○ Have many health benefits, including:
■ Reduce LDL and triglycerides and increase HDL ■ Decrease oxidized LDL
■ Reduce oxidation and inflammation
■ May lower blood pressure

Question 19

Should you eat trans fats? What are the sources?

Answer 19

Trans fats
○ Natural trans fats:
■ Conjugated linoleic acid (CLA​) is a n​ atural trans fat​ formed when bacteria in the stomachs of grazing animals (cows or sheep) digest the grass the animal has eaten.
● Research indicates that CLA may protect against several diseases ● Lower risk of heart disease
● May help prevent type 2 diabetes
● Reduce cancer risk
■ Main dietary sources: Dairy and meat from pastured animals
○ Artificial trans fats:
■ Found in highly processed and packaged foods
■ Promote inflammation and increase risk of the diseases mentioned above
■ AVOID
○ Verdict: Eat pastured animal meat and dairy (if you tolerate it) to obtain CLA.

Question 20

Should you eat polyunsaturated fats? What are the sources?

Answer 20

Consumption of industrial plant oils should be minimized or avoided. They are high in calories, low in nutrients, and prone to oxidative damage.

● Moderate consumption of linoleic acid in whole foods like avocados, nuts, and chicken is unlikely to cause a problem as long as intake of preformed EPA and DHA (from fish and seafood) is adequate.

● Clients who do not consume fish or seafood should limit their consumption of linoleic acid regardless of the source to ensure adequate conversion of plant-based omega-3s into EPA and DHA.

Question 21

What is Omega-3 ?

Answer 21

Omega-3 - found in polyunsaturated fats
■ Present in green leaves and algae (and the animals that eat them, like salmon)
■ One essential omega-3 fat is alpha-linolenic acid (ALA)
● Found in fruits, vegetables, nuts, and seeds, especially walnuts and flax
● Verdict: Consume in moderation​. Avoid large amounts of flax oil and flaxseed.

■ Long-chain omega-3 fats are ​eicosapentaenoic acid (EPA) and
docosahexaenoic acid (DHA)
● Evidence indicates that EPA and DHA consumption is essential to health:
○ Reduces risk of heart disease
○ DHA essential for proper brain development/function
○ Decreases systemic inflammation

■ Two ways to increase your levels of EPA and DHA
● Significantly reduce the amount of LA you consume
● Eat sufficient amounts of preformed EPA and DHA

■ We evolved to consume preformed EPA and DHA, so the best way to get your preformed EPA and DHA is cold-water, fatty fish or shellfish.
● Also, they contain beneficial nutrients that fish oil does not contain, like selenium, zinc, iron, and highly absorbable protein.
Try to consume 10 ounces per week. (Can increase to 20 ounces per week if you are at risk for heart disease.)

■ For those not consuming fish, I recommend one teaspoon of cod liver oil per day, which contains about one gram of combined EPA and DHA.

Question 22

What is Omega-6

Answer 22

Omega-6
Most important long-chain omega-6 fat is​ ​arachidonic acid (ARA)
● Can be produced in our bodies using linoleic acid (LA) or found in
animal products such as meat, poultry, and eggs
● ARA ​is present in cell membranes, involved in cell signaling,
necessary for growth and repair of skeletal muscle tissues, and
along with DHA, is the most abundant fatty acid in the brain
● Verdict: Eat liberally

One essential omega-6 fat is​ ​linoleic acid (LA)
● Found in whole foods like nuts, seeds, poultry, avocados; also present in large amounts in industrial seed oils
● There is debate in the research community about the effects of linoleic acid on human health.
● One side argues that eating too much linoleic acid is a major contributor to the epidemic of modern, chronic disease because it promotes inflammation.
● The other side holds that it is only important to limit linoleic acid if intake of EPA and DHA are low. This is because high intakes of linoleic acid reduce the conversion of plant-based omega-3 fats like alpha-linolenic acid into EPA and DHA.

Question 23

What fats are OK to cook with? And why?

Answer 23

Foods that have a higher smoke point are ok to cook with. Smoke point is the temperature at which the flavor and nutritional integrity of the fat or oil being to break down. If smoke point is exceeded the oil usually produces bluish and pungent smoke that irritates the eyes.

Ghee, extra-light olive oil, palm oil, coconut oil (expeller pressed), avocado oil, and beef tallow.

Avocado oil ????
Ghee 485
Olive oil (extra light) 455
Palm oil 450
Coconut oil (expeller pressed) 450
Beef tallow 400
Duck fat 375
Coconut oil (extra-virgin) 350
Olive oil (extra-virgin) 320
Butter 250–300

Question 24

Where is glucose found? What use does it have in the body?

Answer 24

Fruits, starchy vegetables and grains.

Protein can be broken down into glucose

Glucose has three main uses in the body:
■ It forms structural molecules called glycoproteins.
■ It is absorbed by cells and used as an energy source.
■ It’s a precursor to compounds that play an important role in the immune system.

Question 25

What is fructose? Do you need to avoid fructose in fruit?

Answer 25

Fructose is another simple sugar found in fruits and vegetables
○ It is shunted directly to the liver for conversion into glucose or fat.
○ Thus, excess fructose, such as that found in high-fructose corn syrup, has
harmful metabolic effects and contributes to weight gain.
○ Fructose in fruit does not need to be avoided, since fruit contains fiber and other
nutrients.
○ Appropriate amounts are individualized and depend on your tolerance and
metabolic health.

Question 26

What are the two types of fiber? What do they do in the body?

Answer 26

Soluble fiber
■ Dissolves in water, is fermented by bacteria in the colon to create a gel-like substance.
■ Bacteria eat it and form short-chain fatty acids such as butyrate, propionate, and acetate.
● Short-chain fatty acids have been associated with health benefits such as: anti-inflammatory effects, increasing insulin sensitivity, delaying the development of neurodegenerative diseases, and possibly helping with disease of the colon.
■ Soluble fiber binds cholesterol, increases LDL receptor activity in the liver, improves insulin sensitivity, increases satiety, and may protect against heart disease.

Insoluble fiber
Does not dissolve in water, is not fermented in the colon (except for resistant starch), and adds bulk to stool.
■ Excess insoluble fiber can bind nutrients such as magnesium, calcium, and iron, preventing their absorption, and has not been shown to have the health benefits mentioned above like soluble fiber.
■ Resistant starch​ is unique in that it can be fermented by bacteria in the large intestine to produce short-chain fatty acids.
● It can also increase uptake of minerals like calcium and boost Bifidobacteria, improve gut motility, and does not spike blood sugar level.
● Found in green bananas, cooked and cooled potatoes and rice, plantain flour, tapioca flour, and some legumes.

Question 27

What type of fiber should you eat?

Answer 27

Verdict: Obtain fiber in the context of a whole-foods diet. ​Best to avoid grains high in insoluble fiber and low in bioavailable nutrients.

Paleo-friendly sources include: yams, sweet potatoes, carrots and other root vegetables, green leafy vegetables, fruits with edible peels, berries, and seeds and nuts.

Question 28

What are the best sources of carbohydrates? And how many should you eat a day?

Answer 28

Non-starchy vegetables​ – eat liberally
○ Fruits ​–​ about three servings daily ​is fine for most. Those with insulin
sensitivity, diabetes, or metabolic syndrome many need to restrict fruit or choose
fruit lower in sugar content.
○ Starchy plants​ – include tubers like potatoes and roots (taro and yuca)
■ Note that some individuals many not tolerate these as well if:
● They produce less amylase, the enzyme needed to break down
these starches
● They have bacterial overgrowth, as the bacteria will ferment in the
stomach, creating gas and bloating
● They have issues with blood sugar regulation
● Key is to experiment for yourself!

Question 29

What factors determine protein quality?

Answer 29

Amino acid profile​: Complete proteins contain all essential amino acids, whereas incomplete proteins are lacking in one or more of the essential amino acids.
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Bioavailability​: No matter how much protein a food has, it will not benefit you if you cannot digest and absorb it.

Toxicity​: Some proteins are more likely to cause an immune response or allergic reaction.

Question 30

Are animal proteins higher in protein quality than plant proteins?

Answer 30

● Without exception, animal proteins are of a higher quality than plant proteins.

Question 31

What is the PDCAAS? What shortcoming does it have?

Answer 31

Protein Digestibility-Corrected Amino Acid Score​ – this method combines the amino acid profile of the protein (complete or incomplete) with the true fecal digestibility of the protein (how much of the protein is actually absorbed).

● One shortcoming with this method is that anti-nutrients are not taken into consideration.
○ If anti-nutrients are taken into consideration, soy protein, other legumes, and cereal grains would be significantly lower on the list.

Question 32

What foods are the best protein sources?

Answer 32

● Meat, poultry, seafood, and eggs should form the bulk of your protein intake.

● Seafood, poultry, and red meat are the most concentrated sources of protein.

● Dairy products can also be a source of high-quality protein as tolerated.

● Fruits, vegetables, nuts, and seeds are good sources of micronutrients but are low in
absorbable protein.

Grains and legumes are poor sources of protein compared to animal products. They also
contain anti-nutrients that reduce the absorption of amino acids and can provoke the immune response. That said, a moderate amount of grains and legumes properly prepared, such as soaking and sprouting to decrease toxicity, may be well tolerated by some individuals.