Nutrient Dense Diet Part 2

Question 1

what is metabolism?

Answer 1

total energy expenditure (TEE) = resting metabolic rate (RMR) + thermic effect of food (TEF) + physical activity energy expenditure (PAEE)

RMR (resting metabolic rate)
-energy used to maintain vital functions (heart, liver, brain, kidneys)
-includes muscle and adipose tissue
-ranges between 50-70% of TEE

TEF (thermic effect of food)
-increase in metabolism after eating
-accounts for 10% of TEE

PAEE (physical activity energy expenditure)
-includes exercise and non-exercise activity
-ranges between 15-30% of TEE

Question 2

what is metabolism?

Answer 2

the sum of all chemical reactions in cells that provide energy for vital processes and for synthesizing new organic material

Question 3

Metabolism and CICO: Calories In, Calories Out

Answer 3

the basic equation:
calories in, calories out (CICO) = calories in (food intake) - calories out (total energy expenditure)

common misconceptions:
-often oversimplified to imply that weight management is straight forward
-frustrating for those who struggle with weight management

inaccuracy in estimation

Question 4

CICO for weight management

Answer 4

basic principle:
-weight gain = calories in > calories out
-weight loss = calories out > calories in

the problem is in the details

hormone driven homeostasis affects metabolism

this model is overly simplified and does not account for individual variations

difficulty in accurately measuring calories in and calories out

Question 5

calories in

Answer 5

human error: most people, including dietitians, underreport caloric intake

inaccurate food labels: FDA reports up to 20% error in calorie counts on food labels

cooking & processing: cooking, chopping, blending foods can alter caloric availability

measurement issues: weighing food is more accurate but still not precise

micronutrient variability: different macros have carying caloric values and absorbability

Question 6

calories out - total energy expenditure (TEE)

Answer 6

mifflin-st. jeor equation
accurate within 10% of calories, 82% of the time

limitations:
the equation is not 100% accurate. there’s an 18% chance of less accurate results

Question 7

calories out - thermic effect of food (TEF)

Answer 7

how much metabolism increases after eating

macronutrient impact:

fat: 0-3%
carbs: 5 - 10%
protein: 20-30%

implications:
TEF makes up about 10% of total expenditure.
miscalculations in TEF can contribute to weight mgmt difficulties

Question 8

calories out - exercise related activity thermogenesis (EAT)

Answer 8

calories burned during exercise

common challenges:
-inaccurate reporting of exercise duration & intensity
-wrist worn devices often provide inaccurate estimates of energy expenditure

additional considerations:
-EPOC (excess post-exercise oxygen consumption)
-over training can be as problematic as a sedentary lifestyle due to impacts to stress hormones
-activity factor used in “calories in” calculations are prone to error
-body’s natural tendency to maintain current weight

Question 9

calories out - non exercise activity thermogenesis (NEAT)

Answer 9

calories burned through daily activities not related to exercise

common challenges:
-different tasks, frequencies, and body movements make it hard to track
-unconscious movements like fidgeting can add between 300-500 extra calories burned per day

large margin of error, estimating NEAT is alrgely guesswork

Question 10

two sides of metabolism

Answer 10

anabolism & catabolism

drivers: calories, hormones, exercise, sleep, inflammation, mindset

common misconceptions:
“you have to eat fat to burn fat”
“eating fat makes you fat”

importance of nuance:
-understanding when a concept is valid and when it’s not
-providing meaningful education to clients

Question 11

anabolism

Answer 11

the body uses energy to create more complex molecules

body’s capability:
-tissues can be added to or taken away
-involves recycling of proteins, glycogen, and adipocytes

key hormones:
-human growth hormone
-insulin
-insulin like growth factor (IGF-1)
-testosterone
-estrogen

insulin’s role:
-anabolic outcomes: glycogenesis, lipogenesis, muscle protein synthesis
-prevention of catabolism: signals the body to store energy
-risks of insulin absence: diabetic ketoacidosis (DKA)

Question 12

catabolism

Answer 12

the body breaks down complex molecules to release energy

glucagon’s role:
-produced by the pancreas to stabilize blood sugar by breaking down stored energy
-inhibited by insulin and struggles in a high insulin environment

cortisol:
-increases during sustained stress
-mobilizes fat and glycogen but also stores fat

epinephrine/adrenaline:
-increases during acute stress

Question 13

catecholamines, cortisol, and muscle protein

Answer 13

SAM (sympathetic-adrenal-medullary) axis:
-produces epinephrine/adrenaline
-precursor: amino acid phenylalanine
-active when stress presents as a challenge

HPA (hypothalamus-pituitary-adrenal) axis:
-produces cortisol
-precursor: cholesterol
-active when stress presents as a threat

Question 14

important pieces to consider

Answer 14

outlook matters: how we perceive stress can shift our physiological response from threat to challenge, reducing the negative impacts of stress

chronic stress and catabolism: chronic stress, driven by cortisol, promotes a catabolic state that decreases muscle tissue and increases fat storage

counter-signaling: exercise and adequate protein intake can counteract the catabolic effects of chronic stress

internal stress: factors like systemic inflammation, toxicity, gut dysbiosis, and nutrient deficiencies also induce a stress response, increasing cortisol levels

caloric deficit = chronic stress: consistent caloric deficits increase cortisol levels

cortisol and insulin resistance: cortisol inhibits insulin, leading to insulin resistance. insulin resistance is problematic in the presence of high levels of insulin and insulin spiking foods

Question 15

metabolism, homeostasis and nutritional therapy

Answer 15

metabolism & homeostasis:
-multiple factors regulate metabolism
-a straightforward guide to help clients understand weight mgmt

weight mgmt:
-more common client request
-to be discussed in the context of weight loss

Question 16

weight mgmt

Answer 16

the complexity of weight shifts

adaptations and homeostasis:
how the body adapts to new environments and how this affects weight

variability in outcomes:
weight can shift dramatically, or not at all, depending on multiple factors

three basic categories:
-weight gain
-weight loss
-weight maintenance

Question 17

maintaining weight

Answer 17

aging = slower metabolism and loss of muscle mass

as we age, our metabolism slows down and we lose muscle mass, requiring proactive measures to maintain weight

protein and weight bearing exercise

these are essential to maintain muscle mass, fight against sarcopenia and bone loss, and improve quality of life

Question 18

gaining weight

Answer 18

healthy calorie increase: more food, larger portions, calorie dense foods

healthy insulin increase: balance meals with protein, fats, and carbs to stimulate insulin controlled manner

reducing excess movement: limit unnecessary physical activity that burns calories

Question 19

realistic goals

Answer 19

diet and lifestyle changes should be sustainable over long term

you should enjoy the process, or it will be hard to stick with it

make sure you can afford the diet and lifestyle changes

ensure you have the time to commit to necessary training and meal prep

Question 20

exercise

Answer 20

get an accurate assessment of the individuals current diet and exercise program

dietary habits: not about counting calories, but understanding when and how they fuel themselves

exercise habits: what are their preferred methods of movement? how often and how intense?

adjusting exercise

-shift to weight training focus on exercises that induce an anabolic response to build muscle
-rest days are important for muscle recovery and growth
-if cardio is a must, choose less intense, and shorter duration exercise to avoid excess calorie burn

Question 21

Protein

Answer 21

muscle protein synthesis: aim for about 30-40g of protein per meal to induce muscle protein synthesis

leucine: about 2.5g of leucine is needed to trigger this anabolic effect

protein rich shakes:
caloric density: shakes can easily add an extra 500-1000 calories

caution: do not overeat protein. too much protein can curb appetite and induce thermogenesis, burning more energy

Question 22

maximize impact of insulin

Answer 22

insulin is both anabolic (muscle building) and anti-catabolic (prevents muscle breakdown)

consuming carbs along with protein can help utilize insulin surges for muscle growth

while ultra-processed foods can be effective for weight gain, it is not advised to consume them in large quantities

Question 23

inflammation and muscle growth

Answer 23

inflammation and hypertrophy:
-post-workout inflammation is a natural response that contributes to muscle growth

avoid overuse of NSAIDS:
-chronic use of anti-inflammatory drugs like NSAIDs can actually hinder muscle growth

mobility and stretching:
-incorporating mobility training and stretching can alleviate stiffness without compromising muscle growth

stretching for growth:
-stretching can loosen the fascia around muscle fibers, providing more room for growth

Question 24

principles that crossover to weight loss

Answer 24

weight loss:
-increase protein
-increase weight training
-reduce cardio
-higher satiety foods
-lower insulin levels

weight gain:
-increase protein
-increase weight training
-reduce cardio
-lower satiety foods
-increase insulin levels

Question 25

losing weight

Answer 25

medications:
-some medications, like antidepressants can contribute to weight gain

genetics, age, sex: women and older individuals may find it more challenging

bio-individual: what works for one person may not work for another due to unique metabolic and lifestyle factors

Question 26

safe vs unsafe weight loss

Answer 26

goals need to be realistic and safe

weight loss often begins with a quick loss followed by a plateau

ideally, weight loss should occur at a rate of 1-2 pounds per week

to lose 1 pound of fat, a caloric deficit amounting to 3500 calories is needed. that is 500 calories per day for a week

avoid crash diets and rapid weight loss gimmicks

Question 27

a homeostatic-based approach to weight loss

Answer 27

sleep: effects hormone balance, stress levels, and overall well being

exercise: impacts metabolism, insulin sensitivity, and mental health

stress: chronic stress can lead to hormonal imbalances and weight gain

diet: the cornerstone of weight loss, affecting blood sugar regulation and digestive health

celebrate small wins: even if the scale does not move, consider improvements in other health markers and victories

Question 28

eat less, exercise more - or not

Answer 28

ambiguity: the advice is too vague, offering no specific guidelines

on size does not fit all: traditional advice is not universally applicable

unsustainability: it is difficult to maintain reduced caloric intake and increased exercise indefinitely

stress and exhaustion: pushing this approach too far can lead to burnout, increased stress, and metabolic slowdown

Question 29

sleep

Answer 29

hormonal impact on lack of sleep:

cortisol: increases, leading to insulin resistance

ghrelin: increases, boosting appetite

leptin: decreases, reducing feeling of fullness

insulin: increases. promoting energy storage

cognitive impact: reduced impulse control

Question 30

exercise

Answer 30

common misconceptions:
-exercise as punishment: exercise should not be seen as a way to burn of calories consumed
-muscle mass as the ultimate goal: the aim is not solely to build muscle and burn fat

primary goals of exercise:
-improve insulin sensitivity
-improve satiety signaling
-stress mgmt
-improved sleep quality

resistance cs endurance training:
-resistance training is ideal for increasing metabolism without making it more efficient
-endurance training can make your metabolism more efficient, which is counterproductive for weight loss

the exercise spectrum:
-clients may range from sedentary to over training
-the goal is to find a balanced approach that is enjoyable and effective

Question 31

stress

Answer 31

the stress cycle

blood sugar: stress can both cause and be caused by blood sugar dysregulation

exercise: physical activity can both alleviate and exacerbate stress

sleep: stress can affect sleep quality, and poor sleep can elevate stress hormones

digestion: chronic stress can impair digestion, leading to a cascade of other issues

importance of safety

feeling safe can help maintain a healthy parasympathetic state, crucial for weight loss and overall well being

polyvagal theory: emphasizes the role of safety in maintaining a balanced nervous system

Question 32

diet

Answer 32

satiety: choose foods that are more satiating as a natural calorie restrictor

anti-inflammatory: choose foods that reduce inflammation levels
reduce insulin-increasing foods: cut back on foods that spike insulin levels

increase glucose tolerance: improve insulin efficiency by enhancing your body’s ability to handle glucose

fasting and time restrictive eating: allow insulin levels to naturally drop over time

Question 33

low carb, high fat

Answer 33

the focus is on reducing the need for insulin production by choosing a low carb, high fat diet

remove foods that spike insulin levels, such as ultra processed foods, refined carbs, and sugars

a low carb diet can be satiating and nutrient dense, allowing for meal and healthy fats

the diet allows for plenty of fiber, benefiting your microbiome

the goal is note necessarily to reach a ketogenic state but to reduce insulin needs

stress levels, sleep quality, and activity levels can influence how many carbs can be included

Question 34

high carb, low fat

Answer 34

this strategy focuses on high carb, low fat diet, emphasizing whole food carbs and minimal fats

higher fiber carbs primarily consisting of fresh veggies and fruits

low fat intake allows for fat to be burned as fuel when insulin levels drop between meals

promotes glucose tolerance, reducing the need for insulin

Question 35

fasting

Answer 35

insulin reduction: the longer you go without food, the more your insulin levels will drop

cortisol levels: prolonged fasting can increase cortisol levels, which may be better suited for those on a lower carb diet

time restricted eating: having set hours for eating can help control late night cravings

Question 36

inflammation & dehydration

Answer 36

addressing inflammation and dehydration can significantly improve allostatic load, reducing cortisol levels, and improving sleep

inflammation & insulin resistance: a vicious cycle where each exacerbates the other

hydration: dehydration can increase histamine and cortisol levels

gut health: a healthy gut can reduce inflammation and improve insulin sensitivity

Question 37

muscle fibers have three sources for ATP production

Answer 37

creatine phosphate

anaerobic glycolysis

aerobic respiration

Question 38

the food we ingest and absorb in the GI tract ultimately has 3 primary uses:

Answer 38

supply energy

serve as building blocks

storage for future use

Question 39

the majority of the energy released in catabolism is converted to what?

Answer 39

the majority of the energy released in catabolism is converted to HEAT

about 40% is used for cellular functions which might not seem efficient but is quite efficient compared to machines that average between 10-20% usage for work

Question 40

anabolism

Answer 40

anabolism is the process of BUILDING UP tissues, and involves multiple hormones, including INSULIN to accomplish this