Category Archives: athletes

“high protein” vs “low protein”

In a recent Facebook thread Richard Morris of 2 Keto Dudes fame said:

The lipophobics and the aminophobics are both talking past each other at strawmen.  

The hysteria is not just humorous, it’s confusing and turning away novices.  

This phony controversy causes people to recommend insane amounts of protein at BOTH ends of the spectrum.

Protein tends to be a passionate topic of discussion n the online macronutrient wars.  So I thought it would be useful to set out arguments at both extremes of the ‘protein controversy’ and detail some responses to bring some balance.  My hope is that this article will bring some clarity to the civil war in the low carb/keto community.

The TL:DR summary is:

  • appetite is a reliable driver to make sure you get enough protein to suit your needs,
  • our appetite decreases when we get enough protein,
  • it’s hard to overeat protein because it’s hard to convert to energy, so the body doesn’t want more than it can use,
  • most people get adequate protein without worrying about it too much,
  • people who require a therapeutic ketogenic approach should pay attention to their diet to ensure that they don’t miss out on essential micronutrients while maintaining a low insulin load, and
  • if you prioritise nutritious whole foods, you’re likely getting enough protein but not too much.

If you want more detail, read on! The arguments and responses of the two sides are outlined below.  The article then concludes with some learnings and observations from the Nutrient Optimiser about how we can optimise protein intake to suit our goals and situation.

High protein bros

This section outlines the arguments and responses from the “high protein bro” extreme end of the debate.

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“There is no such thing as too much protein.”

Refined protein supplements do not contain the same quantity of much vitamins, minerals or essential fatty acids as whole foods.

As shown in the plot of percentage protein vs nutrient score, a focus on obtaining adequate vitamins, minerals and essential fatty acids from whole foods typically leads to obtaining plenty of amino acids.  Meanwhile, actively avoiding protein tends to dilute overall nutrient density in terms of vitamins and minerals.

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The body typically down-regulates appetite before it consumes ‘too much protein’.  It is physically difficult to eat ‘too much protein’ from whole foods (although hyperpalatable whey protein shakes may be another matter).

While protein is beneficial, we also need a balanced diet that provides the other vitamins and minerals (e.g. electrolytes that will enable the kidneys to maintain acid/base balance which is critical to insulin sensitivity which is hard to obtain from protein supplements).

In summary, it is possible to focus too much on protein to the point that you are missing out on other important micronutrients.  Conversely though, if you chase micronutrients from whole foods you will get adequate amounts of protein.

“Fasting will cause you to lose muscle due to a lack of protein intake.”

A high-fat diet reduces the need for glucose and therefore the requirements for protein from gluconeogenesis decrease.  Someone who is ‘fat adapted’ with lower insulin and blood glucose levels will also be more readily able to access their stored body fat for fuel.

The body defends lean muscle loss by upregulating appetite.[1]  People with more body fat and/or lower insulin levels will likely find fasting easier than people who are lean and/or have high insulin levels.

Fasting will drive autophagy, which is beneficial, to an extent.  Fasting and feasting is a cyclic process of building and cleaning out.  We need to balance both parts of the cycle.  Humans generally do this well in the absence of hyper-palatable processed foods.

One of the benefits of fasting is that when you re-feed, your body will be more insulin sensitive so you will build back new muscle more efficiently with less protein and insulin required.  People doing regular multi-day fasts should ensure their average protein intake is adequate over a number of days and not just on the days they eat.

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You should target more nutritious foods on your eating days to ensure you are getting adequate nutrients over the long term.  If your goal is to lose body fat, then re-feeding to satiety on very high-fat foods may be counterproductive in terms of fat loss and micronutrient sufficiency.[2]

“Everyone needs to lift heavy weights and be jacked.”

Not everyone wants to look good with their shirt off or is willing to invest the dedication that it takes to have a six-pack.  However, being active and having sufficient lean muscle mass is important to maintaining insulin sensitivity and delaying the diseases of ageing.  Doing something is better than nothing.  Having sufficient lean muscle mass is arguably better than manipulating macronutrients if your goal is glucose disposal and fat burning.

Low protein “ketonians”

This section outlines a number of arguments against ‘too much protein’ along with some responses.

“Too much protein will turn to glucose like chocolate cake in your bloodstream”

Protein can be converted to glucose via gluconeogenesis if there is no other fuel available.  However, gluconeogenesis does not come easily, and the body only resorts to increased levels of gluconeogenesis above baseline levels in emergency situations.  Gluconeogenesis yields only 2 ATP from 6 ATP.[3]

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“Too much protein is dangerous for your kidneys”

High levels of protein are only a concern if you have a pre-existing kidney issue,[4] and even then not everyone is in agreement.

“Protein is expensive and a waste to use for fuel”

The fact that using protein for fuel is metabolically expensive can be beneficial if our goal is fat loss as it increases overall energy expenditure.[5] [6]  By contrast, fat and carbs are more efficient fuel sources.  Higher levels of protein intake will drive satiety as well as being less efficient and cause more losses.

High protein foods are often financially expensive.  Processed high fat and high carb foods are cheaper to produce and hence can have a higher markup applied to them.  Thus, food companies tend to promote cheaper foods with a higher carb and/or fat content.

“Too much protein is dangerous for people with diabetes.”

People with diabetes convert more protein to glucose through uncontrolled gluconeogenesis (i.e. due to insulin resistance in Type 2 and a lack of insulin in Type 1).[7]  They also find it harder to build muscle due to a lack of insulin.  Hence, people with diabetes may benefit from consuming more protein to maintain or gain muscle.

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Conversely, people who are insulin sensitive may require less protein because they can use it more efficiently to build and repair muscle.

Older people tend to require more protein to prevent sarcopenia.[8]  A loss of lean muscle mass is a significant risk factor for older people.[9]

As shown in the chart below, people with diabetes (yellow lines) produce more insulin in response to protein than metabolically healthy people (white lines).[10]  Forcing more protein beyond satiety may make diabetes management more difficult.  However, most people get the results they require from reducing carbohydrates.  The fact that protein turns to glucose can be a useful hack for people with brittle diabetes who want to get their glucose without the aggressive swings that refined carbohydrates can provide.

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“Too much protein will make it hard maintain healthy blood sugar levels because protein stimulates insulin and glucagon.”

Protein requires insulin to metabolise.  Insulin also works to keep glycogen stored in the liver.

As shown in the charts below,[11] an increase in protein in the diet typically forces out processed and refined carbohydrate and so decreases your insulin and glucose response to food.[12] [13] [14] [You can check out the interactive Tableau version of these charts here.]

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People with Type 1 diabetes don’t have enough insulin to metabolise protein and maintain healthy blood sugars at the same time and hence require exogenous insulin.

People with Type 2 diabetes often have plenty of insulin but need to ‘invest’ their insulin wisely on metabolising protein to build muscles and repair their vital organs rather than ‘squandering it’ on refined carbohydrates.

People with hyperinsulinemia will often see their blood sugars decrease after a high protein meal as the insulin released to metabolise the protein also works to reduce their blood sugars.[15]

If you see your blood sugars rise after a high protein meal you may have inadequate insulin.  IF you have an insulin insufficiency, you may need to learn to accurately dose with insulin for protein rather than avoiding protein.[16]

“High protein will shorten life due to excess mTOR stimulation.”

Humans need to balance growth (i.e. increased IGF-1, insulin and mTOR) with repair (i.e. autophagy, fasting and ketosis).  Driving excess growth through unnatural means may not be beneficial for long-term health.

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However, the research into protein restriction and longevity is either theoretical or in worms in a petri dish where they grew more slowly when protein and/or energy was restricted.  Free-living humans typically don’t manage to voluntarily restrict energy intake.  We seem to have an inbuilt drive to protect ourselves from a loss of muscle mass, depression (note: good nutrition, especially amino acids is crucial to brain function) and loss of sex drive, and generally feeling cold and miserable.

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Longevity research in monkeys suggests that energy restriction or at least a reduction in modern processed foods is beneficial.  However, there is no research in mammals that demonstrates that protein restriction extends lifespan or health span.

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The low target protein values proposed by some for longevity (i.e. 0.6g/kg lean body mass or LBM) are practically impossible to achieve from whole foods without the addition of a significant amount of oils and refined fats and/or substantial calorie restriction to the point of rapid weight loss (e.g. check out the Nutrient Optimiser analysis of Dr Rosedale’s diet here).

There is a difference between lifespan and healthspan. Humans in the wild who are frail risk fractures and other complications related to muscle wasting and lethargy.

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As shown in the chart below, there is an optimal balance between growth and wasting.[17]  Too much insulin and you grow to the point that you get complications of metabolic disease.  Too little growth and you become frail, lose your muscle and bone strength then you may fall, break your hip and never get up again.

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“Just eating protein won’t give you gainz!”

Yes indeed!  You need to force an adaptive stress to cause muscle gains, not just eating protein.  If you work out, you will likely crave more protein.  This is natural and healthy and ensures that we can recover, adapt and get stronger.

“Overeating protein will make you fat.”

Excess consumption of any macronutrient will make you fat.  However, eating more protein and fewer carbs and fat tends to increase satiety.[18]

Research in resistance-trained athletes shows that overeating protein does not cause an increase in fat mass.[19] [20]  Research in sedentary adults shows that overeating protein causes a more favourable change in body composition than overeating the same amount of calories from fat and/or carbohydrate.

“Too much protein will lead to rabbit starvation.”

Healthy people can metabolise up to 3.5g/kg protein per day and digest up to 4.3g/kg per day.[21]  This makes sense in an evolutionary context (or even in more recent times before we had refrigerators) when there wouldn’t have been a regular supply of food but we would have needed to be able to use the food when we came across a big hunt after a long famine.

Theoretical research suggests there is no upper limit to protein intake to the point it is dangerous.   However, the practical upper limit seems to be around 50% of energy intake.  If you force extreme levels of protein, you get thirsty and pee out the excess protein.

Growing children and active people tend to crave higher levels of protein to build and repair their muscles (i.e. 10-year-old Bailan Jones, shown on the right here with his brother, who is a growing young man with Type 1 who consumes 4.4g/kg LBM).

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If you’re obese and eat only lean protein, your body will be forced to use body fat for fuel.  If you are very lean and eat nothing but very thin protein satiety will kick in and you will not have enough body fat to burn.  This is dangerous and leads to death.  So if you are already very lean and going to live in the wilderness with only wild rabbits to eat, make sure you take some butter.  However, most people will have adequate body fat to use for fuel for a significant period of time before rabbit starvation would be an issue.

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“If you’re not losing weight, you should cut your protein and your carbs and eat fat to satiety.”

Reducing processed carbs helps to lower insulin and stabilise blood sugars and helps a lot of people reduce their appetite and lose body fat.[22] [23]  However, not everyone reaches their optimal weight with this method.

LCHF / keto works until it doesn’t.

Many people find that they need to reduce dietary fat in addition to carbohydrates to ensure they burn body fat.

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Restricting protein and carbs while eating ‘fat to satiety’ may lead to an inadequate intake of vitamins and minerals which can lead to cravings and a lack of satiety.[24] [25]

While reducing the insulin load of your diet to the point that we achieve healthy blood glucose levels often helps improve satiety, effective weight loss diets typically involve some permutation of reduced fat and/or carbs to achieve a reduction in energy intake.

Medical weight loss clinics typically use a version of a protein sparing modified fast which provides adequate protein to prevent loss of lean muscle mass while restricting carbohydrates and fat.[26] [27] [28]

People on a low carb or keto diet may have an increased requirement for protein due to the body’s increased reliance on protein for glucose compared to someone who is getting their glucose from carbohydrate.[29]  Protein is the most satiating macronutrient and eating more fat when your appetite is actually craving protein, or other nutrients may lead to excess energy intake.[30]

“Too much protein will kick you out of ketosis and halt fat burning.”

Contrary to popular belief (which is often propagated by people marketing ketogenic products), ketosis is only one of a number of pathways that we burn fat.

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Ketones (i.e. AcetoAcetate or AcAc) are produced when there we don’t have enough Oxaloacetate (OAA) to produce citrate in the Krebs cycle.[31]

If you are consuming enough protein and/or carbs to provide OAA you will still burn fat but through the Krebs cycle rather than via ketogenesis.  Thus, you may be “kicked out of ketosis” if you eat more protein but you’re still burning plenty of fat.[32]

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fat burning via Krebs cycle or ketosis (via Amy Berger)

If you have high levels of NADH (which is associated with ageing and diabetes),[33] [34] [35] more of your AcAc will be converted to BHB in the liver.

Most people will see ketones in their blood increase when fasting or restricting energy intake due to the lack of OAA as they burn body fat.  As shown in the chart below, blood glucose levels decrease while BHB increases.

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There are a number of beneficial processes (e.g. autophagy, increased NAD+, increase in sirtuins) that current during fasting/energy restriction that is associated with increased BHB.  It is possible that many of the benefits related to BHB may actually be due to these other beneficial processes that occur in endogenous ketosis (i.e. it’s probably not the ketones).

We can force higher levels of BHB in the blood by eating more dietary fat and less protein and carbohydrates.  In this case, high BHB may be an indication that you are eating more fat than can be burned in the Krebs cycle and it is building up in the blood.   High levels of BHB in the blood do not mean you are achieving the same benefits via exogenous ketosis as we do in endogenous ketosis.

If your AcAc is not converted to BHB due to a low NAD+:NADH ratio you will tend to see more breath acetone (BrAce).  If you do not have metabolic syndrome, you may see higher levels of BrAce (i.e. measured with the Ketonix) and lower levels of BHB in the blood.   You should also be aware that exercise and an adequate intake of B vitamins in the diet will also increase your NAD+ levels and ‘kick you out of ketosis’.

Before you get caught up chasing ketones by whatever means possible, you should keep in mind that someone who is metabolically healthy and easily able to access their body fat stores for fuel (i.e. low insulin levels) will have lower overall levels of energy floating around in their blood (i.e. from blood glucose, ketones or free fatty acids).  Higher levels of energy in the bloodstream is a sign of poor metabolic health and reduced ability to access and burn fat.

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High levels of glucose lead to glycation.  High levels of free fatty acids lead to oxidised LDL.  High levels of glucose and free fatty acids tends to lead to glycated LDL.  High levels of ketones can similarly lead to metabolic acidosis if not balanced with an adequate mineral intake which may also ‘kick you out of ketosis’.[36]

Learnings from the Nutrient Optimiser

What is everyone else doing?

The Nutrient Optimiser Leaderboard demonstrates that low carbers have a wide range of protein intakes.

  • The average fat intake of these people is 60%, with half the people between 54% and 68% calories. The average carb intake is 11% with half the people between 6 and 15%.   So, we can see that this is generally a CLHF population.
  • Half of the people lie between about 1.4 and 2.5g/kg LBM with an average of 2.1g/kg LBM. In terms of percentage, half of the people sit somewhere between 18 and 29% of energy from protein with an average of 24% energy from protein.
  • Dr Rhonda Patrick, who is sitting at the top of the leaderboard, seems to be eating about 2.5g/kg LBM protein even though she says she is not particularly active and eats heaps of veggies.
  • People who are active tend to eat more protein (e.g. Brianna, Andy Mant and Alex Leaf).
  • “High” protein advocates Luis Villasenor of Ketogains and Dr Ted Naiman both seem to be consuming around 2.4g/kg LBM to support recovery from their higher activity exercise levels.
  • People following a zero carb approach tend to be eating more protein (e.g. Shawn Baker at 6.1g/kg LBM and Amy on 3.3g/kg LBM) as more of their energy comes from animal food. Perhaps many of the satiety effects of a Zero Carb dietary approach are actually due to the high satiety effects of protein.
  • The people with less than 1.0g/kg LBM tend to be relying on a significant amount of added fats and do not tend to achieve the highest overall nutrient score (see examples here, here and here).

What are the recommendations?

The very wide range of protein intake levels can be confusing.  Some are outlined below for reference.

  • In long-term fasting, we use about 0.4g/kg LBM protein from our body via gluconeogenesis.
  • The Estimated Average Requirement is 0.68g/kg body weight for men to prevent protein related deficiencies and 0.6g/kg body weight for women.  For a woman with 35% body fat, this equates to 0.92g/kg LBM as a minimum protein intake.[37]  (Note: These standard values are in the context of someone eating a conventional diet where they would typically be getting plenty of glucose from carbohydrates and are not particularly active, and protein requirements may be higher where someone is active and using some protein for glucose via gluconeogenesis.)
  • The Recommended Daily Intake is 0.84g/kg body weight for men to prevent protein related deficiencies and 0.75g/kg body weight for women (Note: For a woman with 35% body fat this equates to 1.15g/kg LBM as a minimum for someone who is sedentary).[38]
  • Steve Phinney recommends 1.5 to 2.0g/kg reference body weight (see slide below from his recent presentation in Brisbane) which equates to around 1.7 to 2.2g/kg LBM for someone wanting to lose 10% of their body weight to achieve their ideal ‘reference weight’. This increased level allows for some glucose to come from protein via gluconeogenesis and allows adequate protein for people who are not eating carbs and active.

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  • Ketogains suggest 0.8 to 1.0g/lb LBM or 1.8 to 2.2g/kg LBM for people who are looking to maintain or build higher levels of muscle mass.
  • Mainstream bodybuilding recommends 1.7 to 2.5g/lb body weight or 3.7 to 5.5g/kg body weight.[39] For someone with 15% body fat, this equates to 4.3 to 6.4g/kg LBM!!!

What happens to micronutrients when we chase protein?

When I first started tinkering with nutrient density, I assumed that we would want to boost all the essential nutrients (i.e. similar to Dr Mat Lalonde’s approach[40]).  The chart below shows the nutrients provided when we prioritise foods that have higher amounts of all the essential micronutrients.  The amino acids are shown in maroon.

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The ‘problem’ with this array of foods is that, because protein is easy to obtain, this group of foods ends up being very high in protein!  Even the “high protein bros” won’t be able to consume seventy percent of their energy from protein.

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As you can see from the figure below, we typically can’t eat more than 50% of our energy from protein.  However, satiety levels tend to be highest, and hence energy intake is the lowest at around 50% protein (dark blue area).[41]

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There is generally no need to prioritise amino acids because it is easy to meet the Recommended Daily Intake for amino acids if we eat whole foods.

Emphasise only harder to find nutrients

Rather than prioritising all the micronutrients, the chart below shows the micronutrient profile that we get if we prioritise the harder to obtain micronutrients (shown in yellow) without prioritising any of the amino acids (shown in maroon).   (Note:  Vitamin E and Pantothenic Acid haven’t been prioritised as the target levels are based on population averages rather than deficiency studies).

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As you can see, we still get heaps of protein. However, we get a much better micronutrient profile in the vitamins and minerals because we are only prioritising the harder to find micronutrients.

Maximising nutrient intake while minimising energy intake appears to be central to reducing natural energy intake and minimising nutrient related cravings and bingeing.  It’s not hard to see how we could reduce our energy intake eating these foods while still getting plenty of the essential micronutrients.

Highest protein foods

For comparison, the chart below shows the nutrient profile of the highest protein foods.   It seems when we prioritise foods based on their protein content we end up missing out on a number of the vitamins and minerals.  Thus, there appears to be a danger that we will miss out on micronutrients when we focus only on protein.

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Do plant-based diets provide enough protein?

The one situation I have seen people not meeting the recommended daily intake levels for protein is people following a purely plant-based diet.  In the nutrient profile shown below, Sidonie is only getting 11% of her calories from protein and you can see that leucine is not meeting the DRI levels while methionine and lysine are just meeting the minimum levels.  This may be a legitimate concern for someone on a plant-based diet as amino acids tend to be less bioavailable from plans in comparison to animals.

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The image below shows the foods that will help to fill in the gaps in her current nutritional profile which is focused on high protein vegetables and legumes.

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This food list shows the foods that would fill in Sidonie’s nutritional gaps if she was open to adding animal foods.  This is an interesting contast to the typical food list for someone on a low carb diet which has a much longer list of vegetables to rebalance the vitamins and minerals.

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Most ketogenic foods

The chart below shows the nutrient profile of the most ketogenic foods (i.e. the ones that require the lowest insulin by limiting carbs and moderating protein).  It seems that, if you actually require therapeutic ketosis (i.e. to manage epilepsy, cancer, dementia or Alzheimer’s), you will need to pay particular attention to getting adequate micronutrients (i.e. notably, choline, folate, potassium, calcium and magnesium).

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Lowest protein foods

And finally, the chart below shows the micronutrient profile if we actively avoid protein.

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It seems that actively avoiding protein has a diabolical impact on the micronutrient profile of our food.  However, when we focus on balancing our diet at a micronutrient level, everything else seems to work out pretty well.

So what should I eat?

With all the conflicting opinions it can be confusing to know what to eat.

In the end, it comes down to eat good food when hungry. 

If we remove hyperpalatable processed foods, I think we’ll have a much better chance of being able to trust our appetite to guide us to the foods that will be good for us.

The food lists below have been prepared to provide the most nutrients while aligning with different goals (e.g. therapeutic ketosis, blood sugar control weight loss, maintenance or athletic performance).  There are a whole lot of other lists in the Optimal Foods for YOU article that are tweaked to suit different goals.

I think if you limit yourself to these shortlists of healthy foods you will be able to listen to your appetite to guide you towards the protein rich foods, the mineral rich foods or the vitamin rich foods depending on your need right now.

approach average glucose (mg/dL) average glucose (mmol/L) PDF foods nutrients
well formulated ketogenic diet > 140 > 7.8 PDF foods nutrients
diabetes and nutritional ketosis 108 to 140 6.0 to 7.8 PDF foods nutrients
weight loss (insulin resistant) 100 to 108 5.4 to 6.0 PDF foods nutrients
weight loss (insulin sensitive) < 97 < 5.4 PDF foods nutrients
most nutrient dense < 97 < 5.4 PDF foods nutrients
nutrient dense maintenance < 97 < 5.4 PDF foods nutrients
bodybuilder < 97 < 5.4 PDF foods nutrients
endurance athlete < 97 < 5.4 PDF foods nutrients

Once you’re eating well and want to further refine your diet you want to check out the Nutrient Optimiser.

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references

[1] http://www.nature.com/ejcn/journal/v71/n3/full/ejcn2016256a.html?foxtrotcallback=true

[2] https://optimisingnutrition.com/2016/10/29/the-complete-guide-to-fasting-book-review/

[3] https://www.youtube.com/watch?v=Og8PTdjVAWE

[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4031217/

[5] http://www.tandfonline.com/doi/abs/10.1080/07315724.2004.10719381

[6] http://ajcn.nutrition.org/content/87/5/1558S.long

[7] https://www.ncbi.nlm.nih.gov/pubmed/15836464

[8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4555150/

[9] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4066461/

[10] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC524031/

[11] https://public.tableau.com/profile/marty.kendall7139#!/vizhome/foodinsulinindexanalysis/insulinloadvsFII

[12] https://optimisingnutrition.com/2015/06/29/trends-outliers-insulin-and-protein/

[13] https://public.tableau.com/profile/marty.kendall7139#!/vizhome/foodinsulinindexanalysis/fatandFII

[14] https://optimisingnutrition.com/2015/06/29/trends-outliers-insulin-and-protein/

[15] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC524031/

[16] https://optimisingnutrition.com/2015/08/10/insulin-dosing-options-for-type-1-diabetes/

[17] http://press.endocrine.org/doi/full/10.1210/jc.2011-1377

[18] http://ajcn.nutrition.org/content/97/1/86.full

[19] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4617900/

[20] https://jissn.biomedcentral.com/articles/10.1186/1550-2783-11-19

[21] http://www.sciencedirect.com/science/article/pii/S0261561417302030

[22] http://annals.org/aim/article/717451/low-carbohydrate-ketogenic-diet-versus-low-fat-diet-treat-obesity

[23] https://jamanetwork.com/journals/jama/fullarticle/205916?rel=1

[24] https://optimisingnutrition.com/2017/03/19/micronutrients-at-macronutrient-extremes/

[25] https://optimisingnutrition.com/2017/03/11/which-nutrients-is-your-diet-missing/

[26] http://www.mdedge.com/ccjm/article/96116/diabetes/protein-sparing-modified-fast-obese-patients-type-2-diabetes-what-expect

[27] https://www.dropbox.com/s/rjfyvfsovbg9fri/The%20protein-sparing%20modified%20fast%20for%20obese%20patients%20with%20type%202%20diabetes%20What%20to%20expect.pdf?dl=0

[28] https://optimisingnutrition.com/2017/06/17/psmf/

[29] https://www.ncbi.nlm.nih.gov/pubmed/15836464

[30] 2http://ajcn.nutrition.org/content/87/5/1558S.long

[31] http://www.tuitnutrition.com/2017/09/measuring-ketones.html

[32] https://itunes.apple.com/us/podcast/mastering-nutrition/id1107033358?mt=2#Really

[33] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4869616/

[34] https://www.hindawi.com/journals/jdr/2015/512618/

[35] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3683958/

[36] https://optimisingnutrition.com/2016/11/19/the-alkaline-diet-vs-acidic-ketones/

[37] https://www.nrv.gov.au/nutrients/protein

[38] https://www.nrv.gov.au/nutrients/protein

[39] https://www.youtube.com/watch?v=3PhVURDZi1c

[40] https://www.youtube.com/watch?v=HwbY12qZcF4

[41] https://www.ncbi.nlm.nih.gov/pubmed/24588967

nutritious high energy density foods for athletes

If you’re an athlete, the “problem” with nutrient-dense foods like non-starchy vegetables and organ meats is that it can be hard to get enough fuel to support your activity.

Foods designed for athletes are energy dense but are not nutrient dense but rather are fast burning foods that don’t contain a lot of essential nutrients.  These foods may provide fuel for the short term, but they can lead to gut distress in the short term and as well as inflammation and insulin resistance in the long term.

To overcome these problems, this list of foods has been designed to be both nutrient dense and energy dense to ensure someone who is very active can get enough fuel while maximising nutrient density as much as possible.

Energy density

The energy density of the foods listed below comes out at 367 calories per 100g compared to 231 calories per 100g for all foods in the USDA foods database.  They will contain enough energy to fuel an active life without spending all day chewing or overfilling your stomach.

Macronutrients

From a macronutrient perspective these foods will provide you with:

  • more protein for muscle recovery,
  • more fat to produce energy,
  • more fibre due to the lower level of processing, and
  • less non-fibre carbohydrates which will normalise blood glucose levels while still providing some glucose for explosive power.

Micronutrients

The chart below shows that these foods are quite nutrient dense, with all of the nutrients achieving greater than the daily recommended intake.

Nutrient dense, energy-dense foods for athletes

Listed below are the top 10% of the foods using this ranking including:

  • nutrient density score (ND)
  • energy density (calories/100g) and
  • their multi-criteria analysis score (MCA).

Vegetables

While the vegetables and spices in this list aren’t particularly energy dense, they will ensure that you get the vitamins and minerals you need to perform at your best.  The lower energy density vegetables have been removed because they won’t be that helpful fueling for race day.

food ND calories/100g MCA
spinach 17 23 1.6
yeast extract spread 11 185 1.4
seaweed (wakame) 13 45 1.3
portabella mushrooms 13 29 1.2
shiitake mushrooms 7 296 1.1
broccoli (sulforaphane) 11 35 1.0
shiitake mushroom 11 39 1.0
seaweed (kelp) 10 43 0.8
cauliflower 9 25 0.7

seafood

Seafood packs some nutrient density and energy density at the same time.

food ND calories/100g MCA
cod 13 290 1.9
crab 14 83 1.4
anchovy 10 210 1.3
salmon 11 156 1.3
lobster 13 89 1.3
fish roe 11 143 1.3
caviar 8 264 1.2
halibut 11 111 1.2
trout 10 168 1.2
sturgeon 10 135 1.1
crayfish 11 82 1.1
pollock 10 111 1.0
oyster 10 102 1.0
shrimp 10 119 1.0
haddock 9 116 0.9
rockfish 9 109 0.9
sardine 7 208 0.9
octopus 8 164 0.9
flounder 9 86 0.8
white fish 9 108 0.8
perch 8 96 0.8
mackerel 4 305 0.7
whiting 7 116 0.7
herring 5 217 0.7
tuna 6 184 0.7
clam 6 142 0.6
scallop 7 111 0.6

eggs and dairy

Eggs are nutritionally excellent.  Butter has plenty of energy.

food ND calories/100g MCA
egg yolk 6 275 0.9
butter -5 718 0.7
whole egg 5 143 0.5

fats and oils

Fats and oils don’t contain a broad range of micronutrients, but they’re a great way to fuel without excessively raising your blood glucose or insulin too.  From an inflammatory perspective, they’re going to be better than process grains and glucose for fueling as well as keeping insulin levels low to enable you to access your fat stores during endurance activities.

food ND calories/100g MCA
grapeseed oil -4 884 1.3
peanut oil -5 884 1.1
olive oil -6 884 1.1
soybean oil -6 884 1.1
beef tallow -6 902 1.1
duck fat -6 882 1.1
soy oil -6 884 1.1
lard -6 902 1.1
coconut oil -7 892 1.0
walnut oil -7 884 1.0
palm kernel oil -6 862 1.0
mayonnaise -4 717 0.8

grains and cereals

The more nutrient dense bran component of wheat makes the cut. However, the more processed and more popular grains don’t make the list. Many people find the “train low, race high” approach to be useful to ensure you are fat adapted through fasted or low glycogen training but have some glucose in the system for explosive bursts on race day.

food ND calories/100g MCA
wheat bran 10 216 1.3
baker’s yeast 12 105 1.2
oat bran 5 246 0.8

legumes

Legumes are moderately nutrient dense and have a higher energy density than most vegetables.  Properly prepared legumes can be a cost-effective way of getting energy and nutrients, though not everyone’s gut handles them well.

food ND calories/100g MCA
peanut butter 1 593 1.1
soybeans 2 446 0.9
peanuts -1 599 0.9
cowpeas 2 336 0.6
black beans 1 341 0.5
broad beans 1 341 0.5

nuts and seeds

Nuts and seeds are a great way to get some energy in, though they’re not as high in the harder to find nutrients.

food ND calories/100g MCA
sunflower seeds 4 546 1.4
pumpkin seeds 1 559 1.1
almond butter 0 614 1.1
almonds 0 607 1.0
pine nuts -2 673 1.0
walnuts -1 619 1.0
brazil nuts -2 659 1.0
flax seed 1 534 1.0
sesame seeds -2 631 0.9
sesame butter -1 586 0.9
hazelnuts -2 629 0.9
macadamia nuts -4 718 0.8
pecans -4 691 0.8
cashews -2 580 0.7
pistachio nuts -2 569 0.7

animal products

Organ meats also do well in terms of nutrient density.  Fattier cuts of meat will pack some more energy.

food ND calories/100g MCA
lamb liver 12 168 1.4
veal liver 10 192 1.2
ham (lean only) 11 113 1.2
lamb kidney 11 112 1.2
beef liver 9 175 1.1
chicken liver 9 172 1.1
turkey liver 9 189 1.0
pork chop 8 172 0.9
chicken breast 8 148 0.9
pork liver 7 165 0.8
beef kidney 7 157 0.8
pork shoulder 7 162 0.7
veal 7 151 0.7
leg ham 6 165 0.7
ground pork 6 185 0.7
lean beef 7 149 0.7
sirloin steak 5 177 0.6

 

post updated October 2017

energy density, food hyper-palatability and reverse engineering optimal foraging theory

In Robb Wolf’s new book Wired to Eat he talks about the dilemma of optimal foraging theory (OFT) and how it’s a miracle in our modern environment that even more of us aren’t fat, sick and nearly dead.[1]

But what is optimal foraging theory[2]?   In essence, it is the concept that we’re programmed to hunt and gather and ingest as much energy as we can with the least amount of energy expenditure or order to maximise survival of the species.

In engineering or economics, this is akin to a cost : benefit analysis.  Essentially we want maximum benefit for minimum investment.

image13

In a hunter-gatherer / paleo / evolutionary context this would mean that we would make an investment (i.e. effort / time / hassle that we could have otherwise spent having fun, procreating or looking after our family) to travel to new places where food was plentiful and easier to obtain.

In these new areas, we could spend as little time as possible hunting and gathering and more time relaxing.  Once the food became scarce again we would move on to find another ‘land of plenty’.

The people who were good at obtaining the maximum amount of food with the minimum amount of effort survived and thrived and populated the world, and thus became our ancestors.  Those that didn’t, didn’t.

You can see how the OFT paradigm would be well imprinted on our psyche.

OFT in the wild

In the wild, OFT means that native hunter-gatherers would have gone bananas for bananas when they were available…

image28

… gone to extraordinary lengths to obtain energy dense honey …

image16

… and eat the fattiest cuts of meat and offal, giving the muscle meat to the dogs.

image02

OFT in captivity

But what happens when we translate OFT into a modern context?

image09

Until recently we have never had the situation where nutrition and energy could be separated.

In nature, if something tastes good it is generally good for you.

Our ancestors, at least the ones that survived, grew to understand that as a general rule:

 sweet = good = energy to survive winter

But now we have entered a brave new world.

image19

We are now surrounded by energy dense hyper-palatable foods that are designed to taste good without providing substantial levels of nutrients.

image05

Our primal programming is defenceless to these foods.  Our willpower or our calorie counting apps are no match for engineered foods optimised for bliss point.

image14

These days diabetes is becoming a bigger problem than starvation in the developing world due to a lack of nutritional value in the foods they are eating.[3]

The recent industrialisation of the world food system has resulted in a nutritional transition in which developing nations are simultaneously experiencing undernutrition and obesity.

In addition, an abundance of inexpensive, high-density foods laden with sugar and fats is available to a population that expends little energy to obtain such large numbers of calories.

Furthermore, the abundant variety of ultra processed foods overrides the sensory-specific satiety mechanism, thus leading to overconsumption.”[4]

what happens when we go low fat?

So if the problem is simply that we eat too many calories, one solution is to reduce the energy density of our food by avoiding fat, which is the most energy dense of the macronutrients.

Sounds logical, right?

The satiety index demonstrates that there is some basis to the concept that we feel more full with lower energy density, high fibre, high protein foods.[5] [6]   The chart below shows how hungry people report being in the two hours after being fed 1000 kJ of different foods (see the low energy density high nutrient density foods for weight loss article for more on this complex and intriguing topic).

image21

However the problem comes when we focus on reducing fat (along with perhaps reduced cost, increased shelf life and palatability combined with an attempt to reach that optimal bliss point[7]), we end up with cheap manufactured food-like products that have little nutritional value.

image10

Grain subsidies were brought in to establish and promote cheap ways to feed people to prevent starvation with cheap calories.[8]  It seems now they’ve achieved that goal.[9]

image07

Maybe a little too well.

image01

The foods lowest in fat, however, are not necessarily the most nutrient dense.     Nutritional excellence and macronutrients are not necessarily related.

In his blog post Overeating and Brain Evolution: The Omnivore’s REAL Dilemma Robb Wolf says:

I am pretty burned out on the protein, carbs, fat shindig. I’m starting to think that framework creates more confusion than answers.

Thinking about optimum foraging theory, palate novelty and a few related topics will (hopefully) provide a much better framework for folks to affect positive change. 

The chart below shows a comparison of the micronutrients provided by the least nutrient-dense 10% of foods versus the most nutrient dense foods compared to the average of all foods available in the USDA foods database.

image18

The quantity of essential nutrients you can get with the same amount of energy is massive!  If eating is about obtaining adequate nutrients then the quality of our food, not just macronutrients or calories matters greatly!

Another problem with simply avoiding fat is that the foods lowest in fat are also the most insulinogenic, so we’re left with foods that don’t satiate us with nutrients and also raise our insulin levels.  The chart below shows that the least nutrient dense food are also the most insulinogenic.


what happens when we go low carb?

So the obvious thing to do is eliminate all carbohydrates because low fat was such a failure.  Right?

image20

So we swing to the other extreme and avoid all carbohydrates and enjoy fat ad libitum to make up for lost time.

The problem again is that at the other extreme of the macronutrient pendulum we may find that we have limited nutrients.

The chart below shows a comparison of the nutrient density of different dietary approaches showing that a super high fat therapeutic ketogenic approach may not be ideal for everyone, at least in terms of nutrient density.  High-fat foods are not always the most nutrient dense and can also, just like low-fat foods, be engineered to be hyperpalatable to help us to eat more of them.

image24

The chart below shows the relationship (or lack thereof) between the percentage of fat in our food and the nutrient density.   Simply avoiding or binging on fat does not ensure we are optimising our nutrition.

image12

While many people find that their appetite is normalised whey they reduce the insulin load of their diet high-fat foods are more energy dense so it can be easy to overdo the high-fat dairy and nuts if you’re one of the unlucky people whose appetite doesn’t disappear.

image08

what happens when we go paleo?

So if the ‘paleo diet’ worked so well for paleo peeps then maybe we should retreat back there?  Back to the plantains, the honey and the fattiest cuts of meat?

image27

Well, maybe.  Maybe not.

image06

For some people ‘going paleo’ works really well.  Particularly if you’re really active.

Nutrient dense, energy dense whole foods work really well if you’re also going to the CrossFit Box to hang out with your best buds five times a week.

image11

But for the rest of us that aren’t insanely active, then maybe simply ‘going paleo’ is not the best option…

image25

… particularly if we start tucking into the energy dense ‘paleo comfort foods’.

image03

If we’re not so active, then intentionally limiting our exposure to highly energy dense hyper palatable foods can be a useful way to manage our OFT programming.

enter nutrient density

A lot of people find that nutrient dense non-starchy veggies, or even simply going “plant-based”, works really well, particularly if you have some excess body fat (and maybe even stored protein) that you want to contribute to your daily energy expenditure.

image15

Limiting ourselves to the most nutrient-dense foods (in terms of nutrients per calorie) enables us to sidestep the trap of modern foods which have separated nutrients and energy.  Nutrient-dense foods also boost our mitochondrial function, and fuel the fat burning Krebs cycle so we can be less dependent on a regular sugar hit to make us feel good (Cori cycle).

Limiting yourself to nutrient dense foods (i.e. nutrients per calorie) is a great way to reverse engineer optimal foraging theory.

image04

If your problem is that energy dense low nutrient density hyperpalatable foods are just too easy to overeat, then actively constraining your foods to those that have the highest nutrients per calorie could help manage the negative effects of OFT that are engrained in our system by imposing an external constraint.

image22

But if you’re a lean Ironman triathlete these foods are probably not going to get you through.  You will need more energy than you can easily obtain from nutrient-dense spinach and broccoli.

optimal rehabilitation plan?

So while there is no one size fits all solution, it seems that we have some useful principles that we can use to shortlist our food selection.

  1. We are hardwired to get the maximum amount of energy with the least amount of effort (i.e. optimal foraging theory).
  2. Commercialised manufactured foods have separated nutrients from food and made it very easy to obtain a lot of energy with a small investment.
  3. Eliminating fat can leave us with cheap hyperpalatable grain-based fat-free highly insulinogenic foods that will leave us with spiralling insulin and blood glucose levels.
  4. Eating nutrient dense whole foods is a great discipline, but we still need to tailor our energy density to our situation (i.e. weight loss vs athlete).

the solution

So I think we have three useful quantitative parameters with which to optimise our food choices to suit our current situation:

  1. insulin load (which helps as to normalise our blood glucose levels),
  2. nutrient density (which helps us make sure we are getting the most nutrients per calorie possible), and
  3. energy density (helps us to manage the impulses of OFT in the modern world).

image30

I have used a multi-criteria analysis to rank the foods for each goal.  The chart below shows the weightings used for each approach.

image23

The lists of optimal foods below have been developed to help you manage your primal impulses.  The table below contains links to separate blog posts and printable .pdfs for a range of dietary approaches that may be of interest depending on your goals and situation.

dietary approach printable .pdf
weight loss (insulin sensitive) download
autoimmune (nutrient dense) download
alkaline foods download
nutrient dense bulking download
nutrient dense (maintenance) download
weight loss (insulin resistant) download
autoimmune (diabetes friendly) download
zero carb download
diabetes and nutritional ketosis download
vegan (nutrient dense) download
vegan (diabetic friendly) download
therapeutic ketosis download
avoid download

If you’re not sure which approach is right for you and whether you are insulin resistant this survey may help you identify your optimal dietary approach.

survey

I hope this helps.  Good luck out there!

post last updated OCtober 2017

 

references

[1] http://ketosummit.com/

[2] https://en.wikipedia.org/wiki/Optimal_foraging_theory

[3] http://www.hoajonline.com/obesity/2052-5966/2/2

[4] https://www.ncbi.nlm.nih.gov/pubmed/24564590

[5] http://nutritiondata.self.com/topics/fullness-factor

[6] https://www.ncbi.nlm.nih.gov/pubmed/7498104

[7] https://www.nextnature.net/2013/02/how-food-scientists-engineer-the-bliss-point-in-junk-food/

[8] https://en.wikipedia.org/wiki/Agricultural_subsidy

[9] http://blog.diabeticcare.com/diabetes-obesity-growth-trend-u-s/

Dom D’Agostino’s breakfast – sardines, oysters, eggs and broccoli

At first it sounds like a bizarre combination, but when the smartest guy in keto says that he has sardines, oysters, eggs and broccoli as his regular breakfast I wasn’t surprised to find this diet scored highly in the nutritional analysis.

Image result for king oscar sardines

Before he started saving the world by developing Warburg’s mitochondrial theory of cancer and oxygen toxicity seizures for DARPA Dominic D’Agostino studied nutrition and is rumoured to be able to do a 500-pound deadlift for 10 reps after a week of fasting.

Both physical and mental performance are undoubtedly critical to Dom, so it’s not surprising that he is very intentional about his diet and what he puts in his mouth to start each day.

As you can see in the plot from Nutrition Data below Dom’s breakfast scores a very high 93 in the vitamins and minerals score and a very solid 139 in the protein score.

You could say this meal was high protein (44%), low carb (10%) and moderate fat (46%), although his fatty coffee and high-fat desserts would boost the fat content to make it more “ketogenic”.

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Dom’s breakfast scores well against the 250 meals analysed to date in the meal rankings for different goals coming in at:

  • therapeutic ketosis – 176
  • diabetes and nutritional ketosis – 87
  • nutrient density – 9
  • weight loss – 16

I’ve heard Dom say that he aims for a ‘modified Atkins’ approach with higher protein levels rather than a classical therapeutic ketogenic diet which is harder to stick to and might be used for people with epilepsy, cancer, dementia, etc.  It was intriguing to see that Dom’s standard breakfast ranks the highest in nutrient density rather than therapeutic or nutritional ketosis.

Image result for tim ferriss dom d'agostino

Dom first mentioned his favourite breakfast concoction in his first interview with Tim Ferriss (check out the excellent three-hour podcast here).   You can hear the shock and slight repulsion in Tim’s voice in the sound check as he responds with

“Do you blend that up in the Vitamix?”

But now Tim, rather than following his own slow carb approach, has made sardines and oysters a regular breakfast staple and mentions it as one of the top 25 great things he learned from podcasts guests in 2015.

The stats for a 500 calorie serve of Dom’s breakfast are shown in the table below.

net carbs

insulin load carb insulin fat protein fibre
6g 38g 18% 46% 44%

6g

oyster20at20ettas

I was aware that broccoli, eggs and sardines are nutritionally amazing, but then the oysters fill out the vitamin and mineral score to take it a little bit higher.  Dom obviously understands the importance of Omega 3s which are hard to get in significant quantities from anything other than seafood.

I was surprised to see that oysters can be ‘carby’ (at 23% carbs) which is apparently due to their glucose pouch which varies in size depending on when they’re harvested.

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If you wanted to skip the oysters due to taste or cost considerations, the combination of sardines, egg and broccoli still does pretty well.  This option gives fewer carbs, a slight decrease in the vitamin and mineral score with a small increase in the amino acid score.

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The ranking for the sans-oyster option is:

  • therapeutic ketosis –  159
  • diabetes and nutritional ketosis –  67
  • nutrient density –  11
  • weight loss – 20

The stats for a 500 calorie serving are:

net carbs

insulin load carb insulin fat protein fibre
3g 30g 10% 48% 44%

6g

The combination of nutrient dense seafood with nutrient dense vegetables is hard to beat.  The chart below shows my comparison of the nutrients in the various food groups in terms the proportion of the Daily Recommended Intake (DRI) from 2000 calories (click to enlarge).

2016-08-15

I couldn’t get any photos of Dom’s breakfast, but I did get a picture of my current go to lunch.   Each weekend I get a bunch of quality celery and chop it up into tubs to take to work each day.  I have cans of mackerel and sardines in my drawer at work.

Celery does really well in terms of nutrient density per calorie and sardines and mackerel are high on the nutrient density lists without being outrageously expensive (e.g. caviar, anchovy, swordfish, trout).

mackerel and celery

When I feel hungry, I might start munching on the celery which is pretty filling and hard to binge on.  Then if I’m still hungry, I’ll have as many cans of mackerel or sardines as it takes to fill me up (which is usually 2 to 4).

At around 2 pm this is my first meal of the day (other than espresso shots with cream) at around 2 pm.  If I start to feel hungry before then I might check my blood glucose to see if I really need to refuel or if I think I’m hungry because I’m bored.   I’ll then go home and have an early dinner with the family around 6 pm.

I’ve been known to indulge in some peanut butter with, cream, Greek yoghurt or even butter if I’m still hungry (e.g. if I’ve ridden to work) but I try to not overdo it as I’m not as shredded as Dom yet.

The simple combination of celery and mackerel also does pretty well in the ranking of 250 meals and aligns well with my current goal of maximising nutrient density and ongoing weight loss now that I’ve been able to stabilise my blood glucose levels.

  • therapeutic ketosis – 137
  • diabetes and nutritional ketosis – 36
  • nutrient density – 16
  • weight loss – 8

net carbs

insulin load carb insulin fat protein fibre
8g 33g 25% 51% 35%

6g

the breakfast of champions (Chris Froome and Romain Bardet diet analysis)

My Facebook feed has been flooded lately with stories about Tour de France cyclists going low carb.[1]

image05[1]

Or is it high protein?[2]

image10[1]

Whatever is going on, it seems to help them run well too![3]

image09[1]

While I’m not sure you can say that these elite cyclists have eschewed all carbohydrate-containing foods,  the trend away from processed carbs to whole foods is intriguing.

So if they’re going low carb does it mean they’re now butter, cream, MCT oil after starting the day with BPC?

Dr James Morton, head of nutrition at Team Sky and an associate professor in the Faculty of Science at Liverpool John Moores University explains:[4] [5] [6] [7] [8]

We promote a natural approach to food.  Our riders eat food that grows in the ground or on a tree and protein from natural sources.

They need energy, but they also have to stay lean and healthy with a strong immune system. A natural diet is the best way to achieve this.

Fat is important for everything from energy release and muscle health to immunity, but by eating the right food the fat takes care of itself.  The riders eat eggs, milk, Greek yogurt, nuts, olive oil, avocados and some red meat for a natural mix of saturated and unsaturated fats.”

To achieve optimal weight, Dr Morton asks the riders to “periodize” their carb intake by eating more when they train hard and cutting back when they’re less active.

They routinely train in the morning after eating a protein-rich omelette, instead of carbohydrate-dense bread, to encourage their bodies to burn fat for fuel.[9]

image03[1]

So how does low carb real food thing work?

According to Dr Terry Wahls, it seems that nutrient density is a vital part of maximising energy output.

To produce ATP efficiently, the mitochondria need particular things.  Glucose or ketone bodies from fat and oxygen are primary.  

Your mitochondria can limp along, producing a few ATP on only these three things, but to really do the job right and produce the most ATP, your mitochondria also need thiamine (vitamin B1), riboflavin (vitamin B2), niacinamide (vitamin B3), pantothenic acid (vitamin B5), minerals (especially sulfur, zinc, magnesium, iron and manganese) and antioxidants.  Mitochondria also need plenty of L-carnitine, alpha-lipoic acid, creatine, and ubiquinone (also called coenzyme Q) for peak efficiency.  

If you don’t get all these nutrients or if you are exposed to too many toxins, your ATP production will become less efficient, which leads to two problems:

Your body will produce less energy so they may not be able to do everything they need to do.

Your cells will generate more waste than necessary in the form of free radicals.

Without the right nutrient sources to fuel the ATP production in the mitochondria – which in turn produce energy for the cellular processes required to sustain life – your mitochondria can become starved.  The cells then can’t do their job as effectively.[10] 

So let’s look at the macro and micro nutrient analysis of Chris Froome’s “rest day breakfast” (pictured above).   The analysis indicates that it does very well in both the vitamins and minerals score as well as the amino acids score.

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If we throw in some spinach Froomey would improve the vitamin and mineral score of his breakfast even further.  The addition of spinach increases the nutrient balance score from 57 to 77 while the amino acid score stays high.

image14[1]

Froome’s wife says eating more protein has been one of the keys to losing weight and building muscle leading up to the tour.[11]  Getting a quarter of your calories from protein is more than the 16% most people consume, however with 65% of the energy coming from fat you could also call this meal low carb, high fat, or even “ketogenic” depending on which camp you’re in.

image01[1]

This simple but effective meal would be a pretty good option for just about anyone.  Froome’s breakfast ranks well regardless of your goals.  Based on the ranking system of meals for different purposes it comes in at:

  • #10 (with spinach) and #31 (without spinach) out of 245 meals analysed for the low carb diabetes ranking,
  • #18 and 52 on the therapeutic ketosis ranking, and
  • #26 and 64 on the overall nutrient density ranking.

image00[1]

It seems it’s not just the low carbers, “ketonians”[12] and people battling diabetes who are training their bodies to burn fat more efficiently.  Maximising your ability to burn fat is critical even if you are extremely metabolically healthy.

The chart below shows a comparison of the fat oxidation rate of well-trained athletes (WT) versus recreationally (RT) athletes (who are not necessarily following a low carb diet).[13]  The well-trained athletes are clearly oxidising more fat, which enables them to put out a lot more power (measured in terms of their VO2max).   It seems that your ability to efficiently burn fat for fuel it a key component of what sets the elite apart from the amateurs whether you call yourself vegan, ketogenic or a fruitarian.[14]

image07[1]

While carbohydrates help to produce maximal explosive power, it seems that the glucose turbocharger works best when it sits on a big power fat fueled motor.  According to Peter Defty (who spent the last couple of years helping 2016 Tour de France second place getter Romain Bardet refine his ability as a fat adapted athlete using his Optimised Fat Metabolism protocol), fat can yield more energy more efficiently with less oxidative stress which requires less recovery time.[15]

Dr Morton also understands the importance of keeping carbohydrates low to maximise mitochondrial biogenesis and to access fat stores.  If you want to learn more about his thinking on the use of diet to drive mitochondrial biogenesis you might be interested in checking out his array of published papers on the topic.[16] [17] [18] [19] [20] [21] [22]   On the topic of carbohydrate intake Morton says:

Amateur riders are taught the importance of carbohydrates for training and racing, perhaps too much actually.

From our research at Liverpool John Moores University, we now know that deliberately restricting carbs around carefully chosen training sessions can actually enhance training adaptations.

But then of course we must ensure higher carbohydrate intakes for key training sessions and hard stages in racing.

I believe this concept of periodising daily carbohydrate intake is the most exciting part of sports nutrition in the last decade and our challenge now is to address how best we do this practically.

Essentially, exercising your mitochondria in a low insulin and low glucose state forces your body to adapt to using fat for fuel and to use glucose and oxygen efficiently and effectively.[23] [24]

image06[1]

Not only is this useful for endurance athletes and people battling diabetes, training your body to use fat and oxygen more efficiently is also claimed to be important to minimise anaerobic fermentation which is said to increase your risk of cancer.[25] [26] [27]

Many of us struggle to cope in an environment of excess energy from low nutrient density highly insulinogenic food.  If we can’t obtain the necessary nutrients from our food to efficiently produce energy our bodies seek out more and more food in the hope of finding the required nutrients and enough energy to feel OK.

image13[1]

Our bodies do their best to use the energy that we give them, but they are working overtime to pump out insulin to store the excess energy that is not used.  Over time our bodies adapt by becoming resistant to insulin to stop the excess energy being stored in our liver, pancreas and eyes when our fat stores in our muscles and belly can’t take any more.[28]  Then to overcome the insulin resistance the body has to pump out more insulin which makes even less of the energy we eat available for use.

image04[1]

When we call on our mitochondria to produce intense bursts of energy with minimal fuel (i.e. fasting) or glucose (i.e. low carb), we force our bodies to more efficiently the limited carbohydrate.  Suddenly our bodies become insulin sensitive.

Recent studies indicate that people who are fat adapted are able to mobilise higher rates of fat at higher exercise intensities.[29]

image08[2]

With a higher reliance on fat, they are able to conserve the precious glucose for explosive efforts.

image02[1]

Then, when they really need the power, they have both fuel tanks available to cross the line first… and second!

image11[1]

 

 

references

[1] http://realmealrevolution.com/real-thinking/great-news-for-lchf-first-and-second-place-riders-of-the-tour-de-france-are

[2] http://www.businessinsider.com.au/chris-froome-weight-loss-tour-de-france-2016-7?r=US&IR=T

[3] https://www.youtube.com/watch?v=UPqxUA70ulo

[4] http://www.telegraph.co.uk/men/recreational-cycling/how-to-eat-like-a-tour-de-france-cyclist/

[5] http://www.teamsky.com/teamsky/home/article/68342#CpWWiwr2TyE0EA2P.97

[6] https://www.ljmu.ac.uk/about-us/staff-profiles/faculty-of-science/sport-and-exercise-sciences/james-morton

[7] http://www.ncbi.nlm.nih.gov/pubmed/23364526

[8] http://www.ncbi.nlm.nih.gov/pubmed/23263742

[9] http://realmealrevolution.com/real-thinking/great-news-for-lchf-first-and-second-place-riders-of-the-tour-de-france-are

[10] https://www.amazon.com/Wahls-Protocol-Autoimmune-Conditions-Principles/dp/1583335544

[11]

[12] http://ketotalk.com/2016/04/19-inflammatory-keto-foods-build-muscle-on-moderate-protein-baby-boomer-ketonians/

[13] http://m.bmjopensem.bmj.com/content/1/1/e000047.full

[14] http://www.30bananasaday.com/profile/durianrider

[15] http://www.vespapower.com/mighty-mitochondria/

[16] https://www.ljmu.ac.uk/about-us/staff-profiles/faculty-of-science/sport-and-exercise-sciences/james-morton

[17] http://ajpregu.physiology.org/content/304/6/R450

[18] http://www.ncbi.nlm.nih.gov/pubmed/23263742

[19] http://www.ncbi.nlm.nih.gov/pubmed/19265068

[20] http://journals.lww.com/acsm-msse/pages/articleviewer.aspx?year=9000&issue=00000&article=97464&type=abstract

[21] http://www.sciencedirect.com/science/article/pii/S0891584916000307

[22] http://www.tandfonline.com/doi/abs/10.1080/17461391.2014.920926

[23] https://www.fightaging.org/archives/2011/04/calorie-restriction-increases-mitochondrial-biogenesis/

[24] http://www.marksdailyapple.com/managing-your-mitochondria/#axzz4G2D39DgB

[25] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4493566/

[26] https://www.amazon.com/Tripping-Over-Truth-Metabolic-Illuminates/dp/1500600318

[27] https://www.youtube.com/watch?v=PuG5XZSR4vs

[28] http://www.ncbi.nlm.nih.gov/pubmed/25515001

[29] http://www.vespapower.com/the-emerging-science-on-fat-adaptation/

post updated July 2017

nutrient dense insulinogenic foods for bodybuilding

As well as identifying nutrient dense diabetic friendly foods, we can use the food insulin index to highlight more insulinogenic nutrient dense higher energy density foods for use by athletes or people wanting gain weight.

This article highlights more insulinogenic nutrient dense foods that could be used by metabolically healthy people to strategically “carb up” before events, to intentionally trigger insulin spikes (e.g. Carb Back-Loading, Alt Shift Diet or the targeted ketogenic diet) or to maximise growth for people who are underweight while still maintaining high levels of nutrition.

insulin load, a refresher

Many people with diabetes will try to reduce the insulin load of their diet to normalise blood glucose levels.  It’s the non-fibre carbohydrates, and to a lesser extent protein, that drive insulin and blood glucose, particularly for someone who is insulin resistant.

image02

Managing the insulin load of your diet is an effective way to get off the blood glucose roller coaster and stabilise blood glucose levels.  We can calculate the insulin load of our diet based on the carbohydrates, fibre and protein using the formula shown below.

image00

We can also calculate the percentage of insulinogenic calories to identify the foods that will affect our blood glucose levels the least, or the most.

image01

but why would you want to spike your glucose levels?

Much of the nutrition and diabetes world is focused on helping people who are struggling with insulin resistance and trying to normalise blood glucose.  However, there are others who are blessed to be metabolically healthy who may want to strategically refill their glycogen tanks or raise their insulin levels.

  • Some follow a targeted ketogenic diet and strategically replenish glucose around workouts by eating higher carbohydrate foods.
  • Some bodybuilders use a cyclical ketogenic diet where they deplete glucose and then replenish glucose periodically.
  • Some fat adapted endurance athletes will look to ‘carb up’ before an event so that they have both glucose and fat based fuel sources (a.k.a. train low, race high).

  • Others find success with dietary approaches such as the AltShift Diet, Carb Back-Loading which alternating periods of extreme high and low carb dietary approaches (not always with the most nutritious high carb foods).

the mission…

Dr Tommy Wood approached me to design a high insulin load and a low insulin load diet regimen that he could try for a month of each to see how his body responded. The constraint was that both the high and low insulin load foods would have to be nutrient dense whole foods so as to be a fair comparison of the effect of insulin load.

image03

The foods listed below represent the top 10% of the USDA food database prioritised for higher insulin load, higher nutrient density and higher energy density.  In terms of macronutrients they come out at 36% protein, 15% fat and 44% net carbohydrates.

While these foods might not be ideal for someone with diabetes they actually look like a pretty healthy list of foods compared to the “food like products” that you’d find in the isles of the supermarket.

This chart shows the nutrients provided by the top 10% of the foods using this ranking compared to the average of all foods in the USDA foods database.

2017-02-19 (7).png

Also included in the tables below are the nutrient density score, percentage of insulinogenic calories, insulin load, energy density and the multicriteria analysis score score (MCA) that combines all these factors.

vegetables

image19

food ND insulin load (g/100g) calories/100g MCA
watercress 19 2 11 1.2
seaweed (wakame) 13 11 45 1.0
shiitake mushrooms 5 72 296 0.9
spinach 17 4 23 0.9
brown mushrooms 11 5 22 0.7
asparagus 15 3 22 0.7
chard 14 3 19 0.7
seaweed (kelp) 9 10 43 0.7
yeast extract spread 8 27 185 0.6
white mushroom 11 5 22 0.6
spirulina 10 6 26 0.6
mung beans 9 4 19 0.6
Chinese cabbage 12 2 12 0.5
celery flakes 4 42 319 0.5
portabella mushrooms 11 5 29 0.5
broccoli 11 5 35 0.4
parsley 12 5 36 0.4
lettuce 12 2 15 0.4
radicchio 8 4 23 0.4
shiitake mushroom 9 7 39 0.4
peas 7 7 42 0.4
dandelion greens 9 7 45 0.3
endive 15 1 17 0.3
okra 10 3 22 0.3
pumpkin 6 4 20 0.3
bamboo shoots 8 5 27 0.3
beet greens 12 2 22 0.3
snap beans 8 3 15 0.3
zucchini 11 2 17 0.3

animal products

7450703_orig

food ND insulin load (g/100g) calories/100g MCA
ham (lean only) 11 17 113 0.7
veal liver 9 26 192 0.7
beef liver 9 25 175 0.7
lamb liver 11 20 168 0.7
lamb kidney 11 15 112 0.6
chicken breast 8 22 148 0.5
pork liver 7 23 165 0.5
chicken liver 9 20 172 0.5
pork chop 7 23 172 0.5
veal 6 24 151 0.5
beef kidney 8 20 157 0.5
lean beef 7 23 149 0.5
leg ham 7 22 165 0.5
turkey liver 8 21 189 0.5
pork shoulder 6 22 162 0.4
ground beef 6 20 144 0.4
sirloin steak 6 24 177 0.4
ground pork 6 25 185 0.4

seafood

food ND insulin load (g/100g) calories/100g MCA
cod 14 48 290 1.5
crab 15 14 83 1.1
lobster 14 15 89 1.1
crayfish 12 13 82 0.9
shrimp 11 19 119 0.9
pollock 11 18 111 0.8
octopus 9 28 164 0.8
halibut 11 17 111 0.8
fish roe 13 18 143 0.8
haddock 10 19 116 0.8
white fish 10 18 108 0.8
clam 9 25 142 0.8
scallop 8 22 111 0.7
rockfish 10 17 109 0.7
salmon 11 20 156 0.7
whiting 9 18 116 0.7
perch 10 14 96 0.7
oyster 11 14 102 0.7
flounder 11 12 86 0.6
anchovy 9 22 210 0.6
trout 10 18 168 0.6
caviar 10 23 264 0.6
sturgeon 10 16 135 0.5
tuna 6 23 184 0.3
orange roughy 4 17 105 0.3
sardine 7 19 208 0.3

legumes

image11

food ND insulin load (g/100g) calories/100g MCA
cowpeas 2 68 336 0.8
black beans 2 63 341 0.6
soybeans 3 49 446 0.6
pinto beans 1 64 347 0.6
kidney beans 1 63 337 0.6
broad beans 2 54 341 0.5
peas 0 57 352 0.4

grains

image08

food ND insulin load (g/100g) calories/100g MCA
oat bran 6 65 246 0.7
baker’s yeast 10 16 105 0.5
baking powder 2 45 97 0.4
wheat bran 8 34 216 0.4
rye flour 0 58 325 0.4
quinoa 1 22 120 0.1

dairy

image08

food ND insulin load (g/100g) calories/100g MCA
whey powder 10 82 339 1.6
cream cheese (low fat) 12 19 105 1.0
cottage cheese (low fat) 6 14 72 0.5
parmesan cheese 3 35 420 0.4
cottage cheese (low fat) 7 13 81 0.4
cheddar (non-fat) 6 20 173 0.3
mozzarella 4 26 304 0.3
kefir 6 7 41 0.3
gruyere cheese 3 23 413 0.3
low fat milk 6 8 56 0.2
Greek yogurt (low fat) 5 11 73 0.2
Swiss cheese 3 22 393 0.2
gouda cheese 3 21 356 0.2
cheddar cheese 3 20 410 0.2
egg yolk 6 12 275 0.2
edam cheese 3 21 357 0.1

other dietary approaches

The table below contains links to separate blog posts and printable .pdfs detailing optimal foods for a range of dietary approaches (sorted from most to least nutrient dense) that may be of interest depending on your situation and goals.   You can print them out to stick to your fridge or take on your next shopping expedition for some inspiration.

dietary approach printable .pdf
weight loss (insulin sensitive) download
autoimmune (nutrient dense) download
alkaline foods download
nutrient dense bulking download
nutrient dense (maintenance) download
weight loss (insulin resistant) download
autoimmune (diabetes friendly) download
zero carb download
diabetes and nutritional ketosis download
vegan (nutrient dense) download
vegan (diabetic friendly) download
therapeutic ketosis download
avoid download

If you’re not sure which approach is right for you and whether you are insulin resistant, this survey may help identify the optimal dietary approach for you.

image02

the most nutrient dense foods for different goals

While a lot of attention is often given to macronutrient balance, quantifying the vitamin and mineral sufficiency of our diet is typically done by guesswork.  This article lists the foods that are highest in amino acids, vitamins, minerals or omega 3 refined to suit people with different goals (e.g. diabetes management, weight loss, therapeutic ketosis or a metabolically healthy athlete).

I’ve spent some time lately analysing people’s food diaries, noting nutritional deficiencies, and suggesting specific foods to fill nutritional gaps while still being mindful of the capacity of the individual to process glucose based on their individual insulin sensitivity and pancreatic function.  The output from nutritiondata.self.com below shows an example of the nutrient balance and protein quality analysis.

image001

In this instance the meal has plenty of protein but is lacking in vitamins and minerals, which is not uncommon for people who are trying to reduce their carbohydrates to minimise their blood glucose levels.

The pink spokes of the nutrient balance plot on the left shows the vitamins while the white shows the minerals.  On the right hand side the individual spokes of the protein quality score represent individual amino acids.

A score of 100 means that you will meet the recommended daily intake (RDI) for all the nutrients with 1000 calories, so a score of 40 in the nutrient balance as shown is less than desirable if we are trying to maximise nutrition. [1]

I thought it would be useful to develop a ‘shortlist’ of foods to enable people to find foods with high levels of particular nutrients to fill in possible deficiencies while being mindful of their ability to deal with glucose.

essential nutrients

The list of essential nutrients below is the basis of the nutrient density scoring system used in the Your Personal Food Ranking System article, with equal weighting given to each of these essential nutrients. [2]

The only essential nutrients not included in this list are the omega-6 fatty acids which we typically get more than enough of in our western diet.  [3]

essential fatty acids

  1. alpha-Linolenic acid (omega-3) (18:3)
  2. docosahexaenoic acid (omega-3) (22:6)

amino acids

  1. cysteine
  2. isoleucine
  3. leucine
  4. lysine
  5. phenylalanine
  6. threonine
  7. tryptophan
  8. tyrosine
  9. valine
  10. methionine
  11. histidine

vitamins

  1. choline
  2. thiamine
  3. riboflavin
  4. niacin
  5. pantothenic acid
  6. vitamin A
  7. vitamin B12
  8. vitamin B6
  9. vitamin C
  10. vitamin D
  11. vitamin E
  12. vitamin K

minerals

  1. calcium
  2. copper
  3. iron
  4. magnesium
  5. manganese
  6. phosphorus
  7. potassium
  8. selenium
  9. sodium
  10. zinc

the lists

Previously I’ve developed short lists of nutrient dense foods also based on their insulin load or other parameters (see optimal foods lists).

But what if we want to get more specific and find the optimal foods for a diabetic who is getting adequate protein but needs more vitamins or minerals?  What about someone whose goal is nutritional ketosis who is trying to maximise their omega-3 fats to nurture their brain?

To this end the next step is to develop more specific lists of nutrient dense foods in specific categories (i.e. omega-3, vitamins, minerals and amino acids) which can be tailored to individual carbohydrate tolerance levels.

I’ve exported the top foods using each of the ranking criteria from the 8000 foods in the database.  You can click on the ‘download’ link to open the .pdf to see the full list.  Each .pdf file shows the relative weighting of the various components of the multi criteria ranking system.  The top five are highlighted in the following discussion below.

It’s worth noting that the ranking system is based on both nutrient density / calorie, and calorie density / weight.  Considering nutrient density / calorie will preference low calorie density foods such as leafy veggies and herbs.  Considering calorie density / weight tends to prioritise animal foods.  Evenly balancing both parameters seems to be a logical approach.

You’re probably not going to get your daily energy requirements from basil and parsley so you’ll realistically need to move down the list to the more calorie dense foods once you’ve eaten as much of the green leafy veggies as you can.  The same also applies if some foods listed are not available in your area.

weighting all nutrients omega-3 vitamins minerals aminos
no insulin index contribution download download download download download
athlete download download download download download
weight loss download download download download download
diabetes and nutritional ketosis download download download download download
therapeutic ketosis download download download download download

all nutrients

This section looks at the most nutrient dense foods across all of the essential nutrients shown above.  Consider including the weighting tables.

no insulin index contribution

If we do not consider insulin load then we get the following highly nutrient dense foods:

  1. liver,
  2. cod,
  3. parsley,
  4. white fish, and
  5. spirulina / seaweed

Liver tops the list.  This aligns with Matt Lalonde’s analysis of nutrient density as detailed in his AHS 2012 presentation.

It’s likely the nutrient density of cod, which is second on the list of the most nutrient dense foods, is the reason that Dwayne Johnson (a.k.a. The Rock) eats an inordinate amount of it. [4]

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It certainly seems to be working for him.

Duane Johnson 2 - Copy

athlete and metabolically healthy

If you have no issue with obesity or insulin resistance then you’ll likely want to simply select foods at the top of the nutrient dense foods list.  However most people will also benefit from considering their insulin load along with fibre and calorie density.   Most of us mere mortals aren’t as active or metabolically healthy as Dwayne.

When we consider insulin load we get the following foods at the top of the list:

  1. basil,
  2. parsley,
  3. spearmint,
  4. paprika, and
  5. liver

We grow basil in a little herb garden and use it to make a pesto with pine nuts, parmesan and olive oil.  It’s so delicious!   (And when I say ‘we’ I mean my amazing wife Monica.)

Aaron Tait Photography

You’ll note that spices and herbs typically rank highly in a lot of these lists.  The good news is that they typically have a very low calorie density, high nutrient density and are high in fibre.

The challenge again is that it’s hard to get all your energy needs from herbs alone, so after you’ve included as many herbs and green leafy veggies as you can fit in, go further down the list to select other more calorie dense foods to meet your required intake.

weight loss

If we reduce calorie density, increase fibre and pay some attention to insulin load for the weight loss scenario we get the following foods:

  1. wax gourd (winter melon),
  2. basil,
  3. endive,
  4. chicory, and
  5. dock

If you’re wondering what a winter melon looks like (like I was), here it is.

image008

The winter melon does well in this ranking because it is very fibrous, has a very low calorie density and a very low 8% insulinogenic calories which means that it has very few digestible carbohydrates.

Again, basil does pretty well along with a range of nutrient dense herbs.  Basil is more nutrient dense than the winter melon while still having a very low calorie density.

diabetes and nutritional ketosis

If we factor carbohydrate tolerance into the mix and want to keep the insulin load of our diet low we get the following foods:

  1. wax gourd (winter melon),
  2. chia seeds,
  3. flax seeds,
  4. avocado, and
  5. olives

Wax gourd does well again due to its high fibre and low calorie density; however if you’re looking for excellent nutrient density as well, then chia seeds and flax seeds may be better choices.  When it comes to flax seeds are best eaten ‘fresh ground’ (in a bullet grinder) for digestibility and also freshness and that over consumption may be problematic when it comes to increasing estrogens.

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therapeutic ketosis

Then if we’re looking for the most nutrient dense foods that will support therapeutic ketosis we get the following list:

  1. flax seeds,
  2. fish oils,
  3. wax gourd,
  4. avocado, and
  5. brazil nuts.

Good nutrition is about more than simply eating more fat.  When you look at the top foods using this ranking you’ll see that you will need to use a little more discretion (e.g. avoiding vegetable oils, margarine and fortified products) due to the fact that nutrients and fibre have such a low ranking.

ganze und halbe reife avocado isoliert auf weissem hintergrund

fatty acids

Omega-3 fats are important and most of us generally don’t get enough, but rather get too many omega-6 fats from grain based processed foods.

Along with high levels of processed carbohydrates, excess levels of processed omega-6 fats are now being blamed for the current obesity epidemic. [5]

The foods highlighted in the following section will help you get more omega-3 to correct the balance.

no insulin index contribution

If we’re looking for the foods that are the highest in omega 3 fatty acids without consideration of insulin load we get:

  1. salmon,
  2. whitefish,
  3. shad,
  4. fish oil, and
  5. herring

I like salmon, but it’s not cheap.  I find sardines are still pretty amazing but much more cost effective. [6]  If you’re going to pay for salmon to get omega 3 fatty acids then you should make sure it’s wild caught to avoid the omega 6 oils and antibiotics in the grain fed farmed salmon.

Sardines have a very high nutrient density but still not as much omega 3 fatty (i.e. 1480mg per 100g for sardines versus 2586mg per 100g for salmon).

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athlete and metabolically healthy

If we factor in some consideration of insulin load, fibre and calorie density we get:

  1. salmon,
  2. marjoram,
  3. chia seeds,
  4. shad, and
  5. white fish

It’s interesting to see that there are also  excellent vegetarian sources of omega-3 fatty acids such as marjoram (pictured below) and chia seeds (though some may argue that the bio-availability of the omega 3 in the salmon is better than the plant products).

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weight loss

Some of the top ranking foods with omega-3 fatty acids for weight loss are:

  1. brain,
  2. chia seeds,
  3. sablefish,
  4. mackerel, and
  5. herring

While seafood is expensive, brain is cheap, though a little higher on the gross factor.

image018

Cancer survivor Andrew Scarborough tries to maximise omega 3 fatty acids to keep his brain tumour and epilepsy at bay and makes sure he eats as much brain as he can.

diabetes, nutritional ketosis and therapeutic ketosis

And if you wanted to know the oils with the highest omega-3 content, here they are:

  1. Fish oil – menhaden,
  2. Fish oil – sardine,
  3. Fish oil – salmon,
  4. Fish oil – cod liver, and
  5. Oil – seal

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amino acids

This section will be of interest to people trying to build muscle by highlighting the foods highest in amino acids.

no insulin index contribution

So what are the best sources of protein, regardless of insulin load?

  1. cod,
  2. egg white,
  3. soy protein isolate,
  4. whitefish, and
  5. whole egg

Again, Dwayne Johnson’s cod does well, but so does the humble egg, either the whites or the whole thing.

We have been told to limit egg consumption over the last few decades, but now, in case you didn’t get the memo, saturated fat is no longer a nutrient of concern so they’re OK again.

And while egg whites do well if you’re only looking for amino acids, however if you are also chasing vitamins, minerals and good fats I’d prefer to eat the whole egg.

image021

athlete and metabolically healthy

If you have some regard for the insulin load of your diet you end up with this list of higher fat foods:

  1. parmesan cheese,
  2. beef,
  3. tofu,
  4. whole egg, and
  5. cod.

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weight loss

If we aim for lower calorie density foods for weight loss we get this list:

  1. bratwurst,
  2. basil,
  3. beef,
  4. chia seeds, and
  5. parmesan cheese

The bratwurst sausage does really well in the nutrition analysis because it is nutrient dense both in amino acids and high fat which keeps the insulin load down.

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diabetes and nutritional ketosis

If you’re concerned about your blood glucose levels then this list of foods may be useful:

  1. chia seeds,
  2. flax seed,
  3. pork sausage,
  4. bratwurst, and
  5. sesame seeds

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Therapeutic ketosis

And those who are aiming for therapeutic ketosis who want to keep their insulin load from low protein may find these foods useful:

  1. flax seed,
  2. pork sausage,
  3. sesame seeds,
  4. chia seeds, and
  5. pork

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vitamins

People focusing on reducing their carbohydrate load will sometimes neglect vitamins and minerals, especially if they are counting total carbs rather than net carbs which can lead to neglecting veggies.

I think most people should be trying to increase the levels of indigestible fibre as it decreases the insulin load of their diet, [7] feeds good gut bacteria, leaves you feeling fuller for longer and generally comes packaged with heaps of good vitamins and minerals.

At the same time it is true that some high fibre foods also come with digestible carbohydrates which may not be desirable for someone who is trying to manage the insulin load of their diet.

The foods listed in this section will enable you to increase your vitamins while managing the insulin load of your diet to suit your goals.

no insulin index contribution

These foods will give you the biggest bang for your buck in the vitamin and mineral department if insulin resistance is not an issue for you:

  1. red peppers,
  2. liver,
  3. chilli powder,
  4. coriander, and
  5. egg yolk

Peppers (or capsicums as they’re called in Australia) are great in omelettes. image031

Liver is also very high in vitamins if you just can’t tolerate veggies.

athlete and metabolically healthy

If we bring the insulin load of your diet into consideration then these foods come to the top of the list:

  1. paprika,
  2. chilli powder,
  3. liver,
  4. red peppers, and
  5. sage

It’s interesting to see so many spices ranking so highly in these lists.  Not only are they nutrient dense but they also make the foods taste better and are more satisfying.

image034

Good food doesn’t have to taste bland!

weight loss

If weight loss is of interest to you then this list of lower calorie density foods might be useful:

  1. chilli powder,
  2. chicory greens,
  3. paprika,
  4. liver, and
  5. spinach

It will be very challenging to eat too many calories with these foods.  We find spinach to be pretty versatile whether it is in a salad or an omelette.

image036

diabetes and nutritional ketosis

These foods will give you lots of vitamins if you are trying to manage your blood glucose levels:

  1. chilli powder,
  2. endive,
  3. paprika
  4. turnip greens, and
  5. liver

Most green leafy veggies will be great for people with diabetes as well as providing excellent nutrient density and heaps of fibre.

image037

therapeutic ketosis

If you really need to keep your blood sugars down then getting your vitamins from these foods may be helpful:

  1. chilli powder,
  2. liver,
  3. liver sausage,
  4. egg yolk, and
  5. avocado

image039

minerals

no insulin index contribution

Ever wondered which real whole foods would give you the most minerals per calorie without resorting to supplements?

Here’s your answer:

  1. coriander,
  2. celery seed,
  3. basil,
  4. parsley, and
  5. spearmint

Even if you found a vitamin and mineral supplement that ticked off on all the essential nutrients there’s no guarantee that they will be absorbed by your body, or that you’re not missing a nutrient that is not currently deemed ‘essential’.  Real foods will always trump supplements!

As you look down these lists you may notice that herbs and spices top the list of foods that have a lot of minerals.  Once you have eaten as much coriander, basil, parsley and spearmint as you can and still feel hungry keep doing down the list and you will find more calorie dense foods such as spinach, eggs, sunflower seeds, and sesame seeds etc which are more common and easier to fill up on.

image041

athlete and metabolically healthy

If we factor in some consideration of insulin load then we get this list:

  1. basil,
  2. spearmint,
  3. wheat bran (crude),
  4. parsley, and
  5. marjoram

Wheat bran (crude) features in this list but it’s very rarely eaten in this natural state.  Most of the value is lost when you remove the husk from the wheat.

As much as we’re told that we shouldn’t eliminate whole food groups, grain based products just don’t rate well when you prioritise foods in terms of nutrient density.

image043

weight loss

If you’re looking for some lower calorie density options the list changes slightly:

  1. basil,
  2. caraway seed,
  3. marjoram,
  4. wheat bran (crude), and
  5. chilli powder

image044

diabetes and nutritional ketosis

If you’re trying to manage your blood sugars then this is your list of foods that are packed with minerals:

  1. basil,
  2. caraway seed,
  3. flax seed,
  4. chilli powder, and
  5. rosemary.

image045

therapeutic ketosis

If you’re aiming for therapeutic ketosis then the higher fat nuts come into the picture to get your minerals:

  1. flaxseed,
  2. sesame seed,
  3. pine / pinon nuts,
  4. sunflower seeds, and
  5. hazel nuts.

OLYMPUS DIGITAL CAMERA

application

So what does all this mean and how can we apply it?

I don’t think it’s necessary or ideal to track your food all the time, however it’s well worth taking a typical day of food and entering it into the recipe builder at nutritiondata.self.com to see where you might be lacking.

Are your vitamins or minerals low?  Protein?  What about fibre.

If you find these are lacking you can use these food lists to fill nutritional gaps while keeping in mind your ability to process carbohydrates and attaining your personal goals.

references

[1] http://nutritiondata.self.com/help/analysis-help

[2] http://ketopia.com/nutrient-density-sticking-to-the-essentials-mathieu-lalonde-ahs12/

[3] The omega 6 fatty acids are also classed as essential however it is generally recognised that we have more omega omega 6 than omega 3.

[4] http://www.muscleandfitness.com/nutrition/meal-plans/smell-what-rock-cooking

[5] http://ebm.sagepub.com/content/233/6/674.short

[6] http://nutritiondata.self.com/facts/finfish-and-shellfish-products/4114/2

[7] https://optimisingnutrition.wordpress.com/2015/03/30/what-about-fibre-net-carbs-or-total-carbs/

fine tuning your diet to suit your goals – Chris Kelly

I’m a big fan of Chris Kelly’s Nourish Balance Thrive podcast[1]

It’s sort of like listening to Jimmy Moore, Dave Asprey and Ben Greenfield all rolled into one, but even nerdier and more intellectually challenging.

I first heard the term “glucogenic protein” on one of Chris’s podcasts [2] and went searching  to learn more and the epic Insulin Index V2 article was the result.

I also have really enjoyed Chris’ discussion about heart rate variability (HRV), gut health and a range of other intriguing subjects. [3]

Chris is a software engineer who used to work for a hedge fund and has now chosen to go into full time nutritional therapy counselling with a bit of pro-mountain biking on the side!  He’s also into kettlebells.

He has basically mastered all my passions and hobbies and taken them to the elite level!  I’m not that jealous, really.

Chris is another endurance athlete who found he had pre-diabetic blood sugars (like Tim Noakes, Ben Greenfield and Sami Inkenen), and has turned to the ketogenic diet to normalise his blood sugars.

image001

Chris’s diet

Chris posted his daily food dairy outputs from cron-o-metre [4] on Facebook recently and gave me permission to run the numbers on it to see what we could learn.

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Using cron-o-metre is superior to MyFitnessPal because it tracks your micronutrients in addition to calories and macronutrients.

As shown in nutritional analysis below, Chris’s nutrient dense diet has achieved the RDI for all of the key micronutrients.   His protein intake is solid but not high at about 1.5g/kg LBM.

Chris uses MCT oil to fuel his cycling with some slow release Superstarch to top off his glycogen stores for races without throwing him out of ketosis.

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The plot of Chris’s macronutrients from his daily food diary shows that his diet is certainly ketogenic.  When he occasionally measures his blood ketones they’re pretty high at around 2.1mmol/L. [5]

At the same time he gets a really solid 46g of fibre per day (compared to the RDI of 30g for men), with a low 5% net carbs and a very low 16% insulinogenic calories.  One of the issues I see for a lot of people trying to reduce their carbohydrates is that they struggle to get enough fibre for digestion and good gut health.

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nutritional analysis

But can a diet that is so highly ketogenic also provide adequate nutrition?   I ran his daily food diary though nutrientdata.self.com and the results are solid.

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The nutritional content would depend heavily on the source of his beef ground  beef  which makes up most of his protein on the day I have analysed.  I know Chris also goes out of his way to eat organ meats, and the locally sourced grain feed beef that he gets would likely have a higher protein quality score than the ground beef profile in the USDA database.

It should also be noted that the data from his daily food diary entered into nutritiondata.self.com hasn’t captured everything given, because it didn’t seem to have yerba mate tea, kim chi and bone broth which would have a bunch more nutrients.

increasing the protein score

The table below shows how Chris’s food diary stacks up against the 200 or so other meals and daily diaries that I have analysed.  I have used the diabetic / nutritional ketosis weighting in the ranking which prioritises a low insulin load with solid vitamins, minerals and protein.

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The only area where the “base” food diary is lacking compared to the other meals is the protein score.  The score of 0.01 for protein means that it is about average for the 200 meals analysed.

The calorie density score is low, however this is not a problem given that Chris is already quite lean (as you can see from the photo above).

Chris uses MCT oil to fuel his cycling, and weight loss is not a goal.  Trying to get him to reduce the calorie density of his diet with more broccoli and mushrooms would mean that he just couldn’t physically get in enough fuel!

You can see from the comparison of the nutrients and amino acids from various protein sources below that muscle meat is not necessarily the most nutrient dense source of protein.

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If we replace the ground beef with sardines which have a higher quality of amino acids we get the updated nutritional profile shown below.  Both the protein score and the vitamin score has increased with the sardines.

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So overall, Chris’s diet is currently well suited to his goals; however, refining the quality of the protein source could further improve the vitamin and mineral content of his diet.

Overall, I think Chris’s diet is a great example of how someone can get great nutrition and high amounts of fibre while still achieving ketosis.

references

[1] http://www.nourishbalancethrive.com/podcasts

[2] http://www.nourishbalancethrive.com/blog/2014/12/29/protein-transcription/

[3] http://www.nourishbalancethrive.com/blog/2014/12/16/how-track-hrv-measure-progress/

[4] https://cronometer.com/

[5] https://www.facebook.com/groups/optimisingnutrition/permalink/1462501844050859/

superfoods for athletes and the metabolically healthy

People who are metabolically healthy can focus on maximising nutrient density without worrying too much about their blood glucose or calorie density.

These foods are ranked using nutrient density per weight which prioritises higher calorie density foods which is more appropriate for an athlete wanting to replenish energy rather than minimise calories.  If you’re just completed a 100km ride it makes sense to reach for the nuts than the parsley to replenish energy.

Someone who is active and metabolically healthy will be able to tolerate higher levels of carbohydrates to replenish glycogen stores after intense exercise.  However there is no need to eat more carbohydrates than would raise blood glucose levels to 6.7mmol/L (12omg/dL).  Exceeding this level would indicate that the liver and muscle glucagon stores are overfull and excess carbohydrate could lead to insulin resistance and metabolic damage.

The list of veggies is not as long as you might think because they are not as nutrient dense as the other options.  Veggies more extensively on the weight loss list where a lower calorie density is more of a priority.

Who People doing intense exercise and / or people who are metabolically healthy:

  • HbA1c < 5.4mmol/L (ideally less than 5.0mmol/L)
  • Average blood sugar < 5.4mmol/L (100mg/dL)
  • Average fasting blood sugar < 5.0mmol/L (90mg/dL)
When If your blood sugars or weight deviate from optimum consider reverting to the optimal foods for weight loss or diabetes.
Macro
  • 5 – 30% carbohydrates
  • 15 – 30% protein
  • 40 – 80% fat
How Nutrient density, high fibre, and cost with less focus on choosing low insulinogenic foods.

For more details see

nuts, seeds & legumes

  • chia seeds
  • flax seeds
  • sunflower seed
  • same seeds
  • pumpkin seeds
  • soybeans
  • sesame butter
  • brazil nuts
  • peanuts
  • walnuts
  • almonds
  • hazel nuts
  • pistachio nuts
  • coconut meat
  • pine nuts
  • pecans
  • macadamia nuts
  • peanut butter
  • cashew nuts
  • lentils
  • coconut milk
  • coconut cream
  • bread beans
  • split peas
  • beans
  • natto
  • lima beans
  • mung beans
  • chick peas

vegetables and spices

  • parsley
  • basil
  • paprika
  • spearmint
  • rosemary
  • thyme
  • cinnamon
  • turnip greens
  • spirulina
  • alfalfa
  • spinach
  • artichoke
  • cauliflower

dairy and egg

  • egg yolk
  • whole egg
  • Parmesan
  • Gruyere
  • goat cheese
  • Edam
  • Gouda
  • cheddar
  • provolone
  • blue cheese
  • Colby
  • Limburger
  • brie
  • mozzarella
  • cream cheese
  • feta
  • sour cream
  • cream

animal products

  • bacon
  • caviar
  • beef
  • pepperoni
  • liver
  • chorizo
  • mackerel
  • lamb
  • salami
  • anchovy
  • herring
  • pork
  • salmon
  • foie gras
  • turkey
  • veal
  • roe
  • sardines
  • goose
  • chicken
  • halibut
  • bratwurst
  • ham

fats and oils

  • fish oil
  • butter
  • palm oil
  • avocado oil
  • walnut oil
  • coconut oil
  • lard
  • hazelnut oil
  • almond oil

fruit

  • avocado
  • olives

other

  • wheat bran (crude)
  • All Bran
  • rice bran (crude)
  • wheat germ
  • cocoa (unsweetened)

Download printer friendly version.

ND / cal

ND / weight fibre / cal fibre / weight calories / 100g

insulinogenic (%)

5%

30% 10% 5%

5%

45%

 

 

the latest food insulin index data

Understanding the factors that our requirement for insulin is critical to good managing and avoiding diabetes and maintaining good metabolic health.

Living with someone who has Type 1 Diabetes for fifteen years I’ve gained an intimate understanding of how different foods will take your blood glucose levels on a wild ride.

In this article, I will share my insights from the latest food insulin index data and how we can apply it to optimise our insulin and blood glucose response to the food we eat.

How to get off the blood glucose roller coaster

Since she was ten, my wife Monica’s had to manually manage her blood sugars as they swing up with food and then drop again when she injects insulin.

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High blood glucose levels make her feel “yucky”.  Plummeting blood glucose levels due to the mega doses of insulin don’t feel good either.  Low blood glucose levels drive you to eat until you feel good again.  This wild blood glucose roller coaster ride leaves you exhausted.  If you have diabetes, you are likely familiar with this feeling.

Young female injecting insulin in her abdomen

The dietary advice she received over the past three decades living with Type 1 has been sketchy at best.  When she was first diagnosed, Monica tells the story of being made to eat so much high carb food that she hid it in the pot plants in her hospital room.

When we decided we wanted to have kids, we found a great doctor who helped us to understand how to match insulin with carbs, but moderating the input of carbohydrate that necessitates insulin was never mentioned by physicians, endocrinologists or diabetes educators.

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We eventually stumbled across low carb, and she was above to significantly improve her blood glucose control.

The latest food insulin index data

Then in early 2014, I came across Jason Fung’s Aetiology of Obesity series on YouTube where he discussed the food insulin index research that had been carried out at the University of Sydney which seemed to provide more insight into our insulin response to food.

I hoped that by gaining a better understanding how different foods affect our requirement for insulin, I might be able to further refine our food choices to further reduce the amplitude of Monica’s blood glucose swings.

The initial research into the food insulin index was detailed in a 1997 paper An insulin index of foods: the insulin demand generated by 1000-kJ portions of common foods by Susanne Holt, Jennie Brand-Miller and Peter Petocz who tested the insulin response to thirty-eight different foods.

insulinindex

The food insulin index score of various foods was determined by feeding 1000kJ (or 239 kcal) of a range of foods to non-diabetic participants and measuring their insulin response over three hours.   This was then compared to the insulin response to pure glucose, which is assigned a value of 100%, to arrive at a “food insulin index” value for each food.

FII versus time chart

Considering how significant this information could be for people trying to manage their insulin levels (e.g. people with diabetes, “low carbers” or “ketonians”) I was surprised that there hadn’t been much further research or discussion on the topic.  I found a few references and mentions in podcasts, but no one was quite sure what to do with the information, mainly because only a small number of foods been tested.

After some searching, I came across a PhD thesis Clinical Application of the Food Insulin Index to Diabetes Mellitus (Kirstine Bell, September 2014).   Appendix 3 of the thesis contained an extensive food insulin index database of foods that had now been tested.  I plotted the relationship between carbohydrates and the food insulin index data.

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As you can see, the relationship between carbohydrates and insulin is not straightforward.  Some high protein and low-fat foods are sitting quite high up on the vertical axis while there are some high fibre foods with a lower insulin response than you might expect.  However, once we account for the effect of protein, fibre and fructose we get are able to more accurately predict our body’s response insulin response to food.  The foods in the bottom left corner of this chart are the least insulinogenic (or insulinemic).

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If you want to dig into this data a bit more, you can check out the interactive Tableau version here.

As detailed in the most ketogenic diet foods article, this improved ability to quantify our insulin response to food enables us to identify foods that require less insulin and reduce the amplitude of our blood sugar swings in response to food.  This understanding could also prove invaluable for who need a therapeutic ketogenic dietary approach as an adjunct to cancer treatment, epilepsy or dementia.

Calculating the proportion of insulinogenic calories is useful for people who require a very low insulin therapeutic ketogenic diet while insulin load is useful for people managing hyperinsulinemia, insulin resistance or diabetes.

Monica’s daily insulin dose has dropped from more than fifty units a day to closer to 20 units of insulin per day, and the amplitude of her blood glucose swings is much smaller.

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While living with Type 1 will never be fun, the journey towards normal blood glucose levels has been more than worth it, with Moni’s energy levels improving to the point she can go back to work and look forward to a long, healthy and happy life.

The problem with the food insulin index

The problem with looking at things purely from a food insulin index perspective is that the resultant high-fat foods do not provide a broad range of micronutrients.

A diet with a low proportion of insulinogenic calories also tends to be very energy dense which can make portion control more challenging for people wanting to lose weight.

This refined understanding of how to calculate our insulin response to food is a useful parameter, along with nutrient density and energy density, which enables us to prioritise our food choices to suit different goals.

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optimal foods for different goals

The table below contains links to separate blog posts and printable .pdfs detailing optimal foods for a range of dietary approaches (sorted from most to least nutrient dense) that may be of interest depending on your situation and goals.   You can print them out to stick to your fridge or take on your next shopping expedition for some inspiration.

dietary approach printable .pdf
weight loss (insulin sensitive) download
autoimmune (nutrient dense) download
alkaline foods download
nutrient dense bulking download
nutrient dense (maintenance) download
weight loss (insulin resistant) download
autoimmune (diabetes friendly) download
zero carb download
diabetes and nutritional ketosis download
vegan (nutrient dense) download
vegan (diabetic friendly) download
therapeutic ketosis download
avoid download

If you’re not sure which approach is right for you and whether you are insulin resistant, this survey may help identify the optimal dietary approach for you.

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the Nutrient Optimiser

Building on the ability to quantify insulin load, nutrient density and energy density, more recently I have been developing a novel tool.  The Nutrient Optimiser reviews your food log diet and helps you to initially normalise your blood glucose and insulin levels by gradually retraining your eating habits by eliminating foods that boost your insulin level and blood glucose levels.

Once your glucose levels are normalised the Nutrient Optimiser focusses on your micronutrient fingerprint to identify foods that will fill in your micronutrient deficiencies with real food.

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If you still have weight to lose, the Nutrient Optimiser will focus on the energy density of your diet until you have achieved your desired level of weight loss.  Alternatively, the Nutrient Optimiser can help you if you were looking to increase your insulin levels for bulking or identify higher energy density foods for athletes.

It’s early days for the Nutrient Optimiser, but the initial results are very promising.

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Post last updated October 2017