Tag Archives: optimum nutrition

analysis of what a nutritionist eats and hospital food

An article in Business Insider, A Nutritionist Shares Pictures of Everything She Eats in a Day, caught my eye recently.  I thought it would be interesting to run the numbers to see how the food diary logged by this nutritionist compared to the four hundred or so meals that I’ve analysed.

Check out the original article if you want to see the daily food log chronicled in photos by the popular and published “Registered Dietician”, who claims to specialise in diabetes and is “passionate about being a good role model.”[1]

The quantities and foods that I analysed in the recipe builder at SELFNutritionData are shown below.  Besides the fact that the only green things she ate during the day were M&M’s, the food log is not particularly divergent from mainstream dietary advice (i.e. no full-strength Coke or McDonald’s).  The nutritional analysis would be much worse if it was a diet full of junk food, which is pretty common for a lot of people these days in this fast-paced convenience-loving world.

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This dietician is a national media spokesperson for the Academy of Nutrition and Dietetics.  She has published books and written for several magazines.[2]  Like most nutritionists, she argues for less fat and more whole grains.[3]

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So, let’s see how her daily diet stacks up.  The analysis below shows that, when we compare this daily diet against mainstream dietary advice that nutritionists prescribe, it ticks the following boxes:

  1. avoids trans fats,
  2. is low in fat, and
  3. is low in cholesterol.

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However, even though the diet is fairly low in fat, it has 29g of saturated fat which is greater than the Heart Association’s recommendation for a maximum of 16g of saturated fat per day.[4]   Unfortunately, the recommended limit of saturated fat is actually quite hard to achieve without relying on low fat highly processed foods.

Ironically, due to the focus on avoiding fat and trying to incorporate more “heart healthy whole grains”, the food recommended by nutritionists ironically tends to be lacking in nutrients.  It makes no sense!

The registered nutritionist’s daily food log also contains more than 400 grams of carbohydrates which will be a massive challenge to someone who is insulin resistant, would likely generate insulin resistance and eventually diabetes in someone who isn’t there yet.

For comparison, check out the analysis shown below of one of my regular meals (stir-fry veggies with some butter and sardines) which has a much higher vitamin and mineral score (94 compared to 55) and better protein score (139 compared to 66).

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When it comes to nutrient density and being diabetic friendly, this nutritionist’s daily food log ends up at the bottom of the pile of the four hundred meals that I’ve analysed!

It’s sad that this myopic one-size-fits-all dietary advice is forced on anyone who asks what they should be eating, or anyone whose food is influenced by government nutritional guidelines (e.g. hospitals, schools, jails, nursing homes etc).

Then we are told that dieticians are the only ones that are qualified to give dietary advice, even though the dietary advice that they give revolves around avoidance of saturated fat and more “heart healthy whole grains” and does not actually lead to high levels of micronutrition.

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Where it gets even sadder is that this sort of short sighted advice is also given to the people who are the most vulnerable.  The photo below is of Lucy Smith in hospital after being diagnosed with Type 1 Diabetes.  The diet given to her, as a newly diagnosed Type 1 Diabetic, is Weet-Bix, low fat milk, bananas, low fat toast, orange juice, and peaches.

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The analysis for Lucy’s hospital-provided breakfast is shown below.

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This single meal contains more than 200 grams of carbohydrates (82% of calories).  This breakfast would require a ton of insulin to be injected into her little body, and she would be on a blood glucose / insulin rollercoaster for days to come.

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When it comes to nutrient density, this meal has an even lower score than the day in the life of the nutritionist’s own diet discussed above!  Ironically, this hospital prescribed meal ranks at the very bottom of the list of four hundred meals when ranked to identify the best recipes for people with diabetes!

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Unfortunately, things don’t seem to have changed much from thirty years ago when my wife Monica was diagnosed with Type 1 Diabetes.  In hospital, after diagnosis, she was given so many carbs that she hid the food in pot plants in her hospital ward room because she just couldn’t eat anymore!  Twenty-five years later, she learned about the low carb dietary approach and she was finally able to reduce the high levels of insulin required to cover her food.

I’ve witnessed firsthand the massive improvements in quality of life (body composition, inflammation, energy levels, dental health etc) when someone comes off the blood glucose/insulin roller coaster!

Monica has been able to halve her daily insulin dose since no longer ascribing to the dietary advice she has been given by the dieticians and diabetes educators.  Her blood glucose levels are now better than ever and when she goes to the dentist, podiatrist and optometrist they tell her she’s doing great and they wouldn’t even know she’s diabetic.  And I get to have my wife around for an extra decade or two!

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By the way, Lucy is doing well now too.  Her parents are some of the most knowledgeable people I know when it comes to optimal foods for diabetics and monitoring blood glucose (as shown in this video from her father Paul).

My friend, Troy Stapleton, is another example of someone living with Type 1 Diabetes who has benefited immensely from a low carbohydrate dietary approach that aligns with his metabolic health.  His story and approach have been an inspiration to me.  You can also check out the Standing on the Shoulders of Giants article for a few more encouraging stories of people with Type 1 who got their life back after going against nutritionists orders.

As detailed in the article How to optimise your diet for your insulin resistance, if you have the luxury of being more metabolically healthy (i.e. not diabetic) you can focus on more nutrient dense foods or lower energy density if you’re looking to lose some weight.

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It amazes me that dieticians can be so militant and belligerent when they are largely passing on the recommendations of the US Department of AGRICULTURE (i.e. the USDA, also known as “Big Ag”), whose mission it is to promote the economic opportunity and production of AGRICULTURE[5] (i.e. grains and seed oils).  Talk about putting the fox in charge of the hen house!

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Speaking of conflicts of interest, it’s worth noting that major nutritionist organisations funding ‘partners’ are big food manufacturers.[6]  Does this influence the recommendations they give?  They claim not.

It’s hard to believe their published research or dietary recommendations could be impartial when so heavily sponsored by the food industry.

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Despite these conflicts of interest and a poor track record of success over the past four decades, I don’t think we should be gagging the Accredited Dietitians from publishing poor nutritional advice.  Everyone should be entitled to their freedom of speech and freedom to choose what they eat.

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What I do find ironic is that dieticians can bring spurious cases of malpractice against doctors to their governing bodies when they are acting in line with the latest research and their personal, professional and clinical observations (e.g. Tim Noakes in South Africa and Gary Fettke in Australia).  At the same time, the Registered Dieticians have no governing body to report to, only their board of directors[7] and their ‘partners’.

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While they purport to be protecting the public interest, one could be excused for thinking that the dieticians’ associations are another marketing arm for big food companies and are protecting commercial interest rather than acting on behalf of public health.

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Is it just a coincidence that Nestle’s Milo, which is half sugar, is prescribed by hospital dieticians for pregnant and breastfeeding mothers with diabetes?

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Unfortunately, the situation isn’t that much different with the diabetes associations.[8]  Why would these institutions ever make recommendations to their members that reduced the amount of medications they needed or reduce the amount of processed food when their financial partners are pharmaceutical companies who manufacture insulin and drugs for diabetes?

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What would happen to this financial structure if a significant amount of people started eating whole unprocessed food without a bar code?  The share price of these massive medical and pharmaceutical companies would tank!

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After battling cancer himself and studying the role of nutrition in metabolic and mitochondrial disease in depth, Gary Fettke now spends his days as an orthopaedic surgeon amputating limbs mainly due to the complications of diabetes.

No, it’s not pretty, but unfortunately it’s very very real.

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Each year Gary volunteers as an orthopaedic surgeon in Vanuatu.[9] [10]  The contrast between the native people living in their natural environment, eating their native foods, and their relatives in town, eating processed foods, is stark.

I took this photo in a traditional village during our holiday in Vanuatu a couple of years ago.  These people eat lots of coconuts (which contains plenty of saturated fat, one of the remaining nutrients that Registered Dieticians still say we should avoid) and fish. These Vanuatu natives are some of the most beautiful, healthiest and happiest people I have ever seen!

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Unfortunately, in the capital Port Vila, it’s not so pretty.  The diabetes rates are the third highest in the world.  One in fifty Vanuatu natives have had an amputation!

It is such a big problem. Their diet has changed quite rapidly over the years, so instead of eating their island’s food, they now eat very large quantities of white rice and of course all the liquid sugar, like Coca-Cola and Fanta, and it’s literally killing them.[11]

After seeing the impact of diet, Gary has been outspoken in Australia, bringing attention to the quality of food that people are eating, especially in hospitals.[12]

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Gary and his Nutrition for Life Centre also worked with Chef Pete Evans on the “Saving Australia Diet” on national TV with great results achieved.[13]

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Then, in return for his efforts, Gary has been reported by the certified dieticians to the Australian Health Practitioner Regulation Agency; and he has been told he can no longer tell his patients to limit sugar even if they have just had their leg amputated due to the complications of diabetes.

Similarly, Tim Noakes has developed a massive following after realising that he needed to go against his own previous publications and advice when he found he was developing diabetes. The recipe book that he helped write, The Real Meal Revolution, is filled with nutrient dense low carb meals that help people with diabetes achieve normal blood glucose levels, has been massively popular.

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Despite his impressive track record of real results, which goes against the general trend of the explosion of diabetes and obesity in western society, Professor Noakes has been reported to the Health Professionals Council of South Africa (HPCSA) and charged with unprofessional conduct, after suggesting that a mother wean her baby on to whole foods rather than processed “baby food”.

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This has led to a long and expensive court case which really appears to be more about maintaining the status quo on the supermarket shelves rather than public health.[14]

I think most nutritionists believe that they are doing the right thing by advising their clients to prioritise the avoidance of fat, cholesterol and saturated fat, and eat “heart healthy whole grains”.  However, the foundation of this advice seems to be crumbling from underneath them with the most recent updates to the US Dietary Guidelines that now remove the upper limit on fat and removing cholesterol a nutrient of concern.[15] [16]

However, if we have to rely on Big Food to provide processed food products to achieve the reduced saturated fat aspirations of the dietary guidelines (and in so doing produce very otherwise nutrient poor foods), then perhaps we need to declare them broken and look for new ones?

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Makes you wonder how we survived (let alone thrived) with the food that was available to us before the highly-processed foods and the low fat dietary guidelines that came to dominate our food choices in the 1970s.

Unfortunately though, fear of saturated fat still dominates the majority of mainstream dietary recommendations out there and leads to nonsensical food rankings that only suit the grain based food industry.[17] [18]

For example, the simplistic Australian Health Star Rating is based on the energy, saturated fat, sodium, sugar content along with the amount of fruits and vegetables in a product.[19]  This avoidance-based process gives little consideration for the amount of essential nutrients in a product, regardless of where they came from, and hence often returns nonsensical results.

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It’s hard to tell whether the attacks on people like Fettke and Noakes are motivated by:

  1. Well-meaning nutritionists who earnestly believe that higher levels of fat and a lack of “heart healthy whole grains” is going to harm people,
  2. Nutritional institutions sensing that they are becoming irrelevant and making a last-ditch attack at their adversaries in an effort to hold onto their jobs,
  3. Processed food manufacturers (i.e. big food) using their “partner organisations” to attack these outspoken thought leaders so they can maintain their strangle hold on nutritional advice that suits them and sells more of their product (i.e. it’s not a conspiracy, it’s just business), or
  4. Some combination of each of these options.

To cut through the confusion and conflicts of interest, wouldn’t it be great if there was an unbiased quantitative way to judge whether a particular food or meal was optimal based its nutrient density?  Perhaps we could even tailor food choices based on blood glucose and metabolic health (i.e. using insulin load), or by manipulating energy density of someone who is insulin sensitive but just needs to lose weight.

If you’ve been following this blog, you may have seen the optimal food lists tailored to specific goals.  To this end, I have devised a system to identify foods for different goals and situations. The table below will help you choose your ideal dietary approach and optimal foods based on your blood glucose levels and waist to height ratio.

approach average glucose waist : height
(mg/dL) (mmol/L)
therapeutic ketosis > 140 > 7.8
diabetes and nutritional ketosis 108 to 140 6.0 to 7.8
weight loss (insulin resistant) 100 to 108 5.4 to 6.0 > 0.5
weight loss (insulin sensitive) < 97 < 5.4 > 0.5
nutrient dense maintenance < 97 < 5.4 < 0.5

The first step in improving your nutrition is to minimise processed food that is laced with sugar.  These food lists can help you further optimise your food choices to suit your goals whether they be blood glucose management, weight loss or just maintaining optimal health.

Once you normalise your blood glucose levels, you can then start to focus more on nutrient density.  If you still have weight to lose, then you can focus on foods with a lower energy density to force more energy to come from your body while still maximising nutrition.   You can also find the highest ranking of the four hundred meals that I have analysed listed here.

Several people recently have suggested that I turn the nutrient density ranking system into a mobile app for easy implementation of the ideas and theories outlined on the blog in the real world.

So, my current project is to develop a Nutrient Optimiser that would rank the foods you have eaten based on your current goals (e.g. therapeutic ketosis, diabetes management, weight loss or maximising nutrient density) and recommend new foods to try.  The Nutrient Optimiser would progressively retrain your eating patterns towards ideal by helping you to maximise the more optimal foods, and progressively eliminate the foods that don’t align with your goals.   Whether you are trying to eat less Maccas, or you are practising Calorie Restriction with Optimal Nutrition (CRON) and trying to live to 120, the Nutrient Optimiser would push you forward to truly optimise your nutrition.

The idea is not to simply create another calorie counting app.  There are plenty of those out there already.  Rather, the Nutrient Optimiser will help you to maximise nutrient density as much as you can while catering to your other goals.

Rather than being centred on outdated “science” and avoiding boogeymen such as cholesterol, fat and saturated fat, or serving the interest of “financial partners” (e.g. BigFood and BigPharma), the Nutrient Optimiser uses a quantitative algorithm that will help you maximise the nutritional value of the food you eat.

The Nutrient Optimiser, based on the foods logged in the past few weeks, helps you to identify foods that would provide the nutrients that you haven’t been getting as much of.  Rather than just tracking calories, the app will continually adapt to what you eat, ensure that you are getting a broad range of foods that contain the nutrients you need, and ensure you don’t get stuck in a nutritional rut.

For people just starting out, it will help them gently move forward, without the judgement of someone looking over their shoulder.  It will suggest foods they should buy more of, new foods to try, and maybe which foods they should bin and never buy again.

For people who are truly wanting optimal nutrition, it will hopefully be the ultimate tool to continue to refine their food choices to maximise nutrient density while optimising blood glucose, insulin and body fat levels.

As you continue to log your weight, blood glucose levels and whatever other metrics you want to track, the app will progressively prompt you to “level up” to a more optimal nutritional approach.  Then, with your nutritional deficiencies filled, the cravings will dissipate and you will naturally be satisfied with less food.[20] [21]

If something like this is of interest to you and you want to be an early adopter or just check it out the nutritional analysis of other people food logs that have been done so far then then take a look at the Nutrient Optimiser Facebook page and to stay posted as things develop.

 

references

[1] https://www.amazon.com/Ruth-Frechman/e/B007HDN5IW

[2] http://www.ruthfrechman.com/Meet_Ruth.html

[3] https://www.youtube.com/watch?v=LAugDpr16Jg

[4] http://www.heart.org/HEARTORG/Conditions/Cholesterol/PreventionTreatmentofHighCholesterol/Know-Your-Fats_UCM_305628_Article.jsp#

[5] https://www.usda.gov/documents/usda-strategic-plan-fy-2014-2018.pdf

[6] http://daa.asn.au/advertising-corporate-partners/program-partners/

[7] http://daa.asn.au/?page_id=136

[8] https://www.diabetesaustralia.com.au/corporate-partners

[9] http://www.hopeforhealthvanuatu.com/volunteers/

[10] https://www.facebook.com/permalink.php?story_fbid=857965770964542&id=393958287365295

[11] http://www.radionz.co.nz/international/programmes/datelinepacific/audio/201818486/hope-given-to-amputees-in-vanuatu

[12] http://www.nofructose.com/2014/12/19/hospital-food-is-crap-and-its-killing-my-patients-and-what-to-do-about-it/

[13] https://au.news.yahoo.com/sunday-night/features/a/31538041/the-saving-australia-diet/#page1

[14] http://foodmed.net/tag/tim-noakes/

[15] http://time.com/3705734/cholesterol-dietary-guidelines/

[16] https://therussells.crossfit.com/2017/01/05/big-food-vs-tim-noakes-the-final-crusade/

[17] http://healthstarrating.gov.au/internet/healthstarrating/publishing.nsf/Content/How-to-use-health-stars

[18] http://www.nuval.com/

[19] http://healthstarrating.gov.au/internet/healthstarrating/publishing.nsf/Content/excel-calculator

[20] http://sydney.edu.au/news/84.html?newsstoryid=12632

[21] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2988700/

 

post last updated July 2017 

how long does it take to digest protein?

One of the limitations of the food insulin index data is that the tests were undertaken over a period of three hours, while protein takes a lot longer to fully digest.

As shown in the chart below (from Andreas Einfeldt / Diet Doctor) simple carbohydrates cause blood sugar to rise and fall quickly, however slower digesting protein causes a rise in blood sugar (in a healthy non-diabetic) between four and six hours after a meal (green line).

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One of the challenges for type 1 diabetics is that, even if they limit their carbohydrates, their blood sugar will often spike a number of hours after a high protein meal.  And sometimes faster digesting proteins such as protein powder raise the blood sugar much faster than a slow digesting steak.

The image below shows the continuous glucose monitor plot of a type 1 diabetic after a protein shake (46.8g protein and only 5.6g of carbs).  Without insulin to blunt the glocogenic effect of the protein, the blood sugar rise from the fast acting protein is not dissimilar to what you would see from carbohydrates.

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On the positive side, protein does not spike blood sugar as much as carbohydrate and is therefore easier to manage.  Though for type 1 diabetics it is important to be conscious of the amount of protein in the diet and manage it accordingly, particularly if they have their carbohydrate intake dialed in and want to achieve optimal blood sugar control.

Similarly, it’s important for type 2 diabetics and people trying to lose weight via a controlled carbohydrate carbohydrate diet to keep in mind that excess protein, although it might not have a significant effect on their blood sugars, will also raise their insulin levels and work against weight loss or nutritional ketosis.

[next article…  is the insulin reaction to protein dose dependent?]

[this post is part of the insulin index series]

[Like what you’re reading?  Skip to the full story here.]

optimal foods for YOU

It’s no secret that there is no perfect diet for everyone.  Your nutritional requirements depend on many factors, including your age, health status, activity levels, and goals.

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I’ve spent a lot of time over the last couple of years designing prioritised food lists to suit a range of goals and situations.  This article summarises this labour of love into what I hope will be a useful resource that will help a lot of people.

I have grouped the various food lists into the following categories:

  • foods to optimise your metabolic health (e.g. therapeutic ketosis, diabetes management, weight loss, bodybuilding, and athletic performance, etc.),
  • foods that boost specific nutrients associated with common health conditions,
  • ethical, philosophical and religious considerations, and
  • macronutrient and micronutrient extremes (low carb, keto, high protein, low protein, etc.).

For those of you who just want to know which foods you should eat more of, I have included the food lists up front.

If you want to understand how I have developed the various food lists, continue reading to the end of the article.

Metabolic health, diabetes management, weight loss and athletic performance

Most people do well if they eat more nutrient dense foods.  However, we can tailor our food choices beyond nutrient density to better suit different people with different goals.

The table below contains optimal food for various metabolic situations.  In the table below you can:

  • click on the ‘PDF’ to open a printable list of ‘foods’,
  • download the list as graphic to save to your phone by clicking on the ‘foods’, or
  • click on the ‘nutrients’ to see the amount of each nutrient that those groups of foods contain.
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
protein sparing modified fast (PSMF) < 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

I hope that these lists will help all those people who just don’t know what to eat.  Lots of people, my family included, have found these useful to print out and stick to their fridge or take it shopping for some inspiration.

If you belong to the 50% of the population that has diabetes or pre-diabetes,[1] your priority should be to normalise your blood glucose levels with a lower insulin load diet.  You can use your current blood sugar levels to choose the nutritional approach that will best support your journey towards optimal metabolic health.

The well- formulated ketogenic diet approach is designed for someone who has very high blood sugars or requires therapeutic ketosis.  The diabetes and nutritional ketosis approach will be more nutritious and suit people looking to manage their diabetes.  Before too long, with the reduction of processed carbohydrates, your blood sugar levels will stabilise to more optimal levels.

Once you have your blood glucose levels under control, you can then focus even more on increasing nutrient density and reducing energy density if you are looking to lose weight.   The weight loss (insulin resistant) foods will help you to reduce the energy density of your diet while keeping the insulin load down.  Stabilising blood sugar levels, normalising insulin levels and reducing hyper palatable processed carbs will help many normalise their appetite, reduce food cravings and naturally eat less.

The protein-sparing modified fast (PSMF) approach aims to provide all the essential vitamins, minerals and amino acids with the minimum amount of energy to enable you to achieve aggressive weight loss while minimising your chance of developing nutrient deficiencies, keeping cravings at bay and losing your lean muscle mass.

In the long run, you may even find you have the energy to work out or build muscle for fitness and longevity.  This increased level of activity may require higher levels of protein and other nutrients.   You may also need higher energy density foods to enable you to ingest enough energy to support your activity levels.

The bodybuilder food list will provide you with plenty of amino acids and minerals to support recovery while the endurance athlete food list increases energy density to fuel increased activity levels while still keeping nutrient density high to fuel activity levels.

How do I implement all this information?

Not that long ago, before the advent of artificial flavours, colourings, refrigerators and packaged food, we were more in touch with our actual nutritional needs and went hunting and gathering in search of the foods that contained the nutrients we needed.  We ate until we got what we needed from the food and stopped.

The idea is that these food lists would help you to refine your food choices and make up for your appetite that might have been corrupted by the modern food system.  When you go shopping each week try to buy more of the foods that are at the top of your list and make sure you find a way to incorporate them into your cooking during the week.  You will not be able to eat all of the foods on the list.  You may find that you like some more than others.  Keep working down the list until you find foods that you enjoy and can easily eat lots of.

You will likely need to prepare your food more than relying as much on processed and pre-packed foods.  It may take a little bit more effort, but your health is worth it!

Nutrients to address deficiencies associated with common conditions

Most people are somewhere on the spectrum of metabolic health and will do well focusing on the foods that keep their blood sugars stable.  However, there are others that have developed specific conditions exacerbated by long term nutrient deficiencies.  Hence, focusing on the foods that provide more of the nutrients associated with these conditions can help manage or even reverse some of these conditions for some people.

The table below contains a range of food lists that are designed to provide more of the nutrients related to a diverse range of common health issues.  Eating these foods will not guarantee a reversal of a particular condition.  However, prioritising these foods will improve your chances of recovery and minimise reliance on drugs and other medicines.

If you don’t yet have any of these conditions, simply focusing on the most nutrient dense foods[2][3] may reduce your chances of developing poor health.

Some foods make an appearance on many of the lists (e.g. spinach, watercress, broccoli, organ meats).  However, as you look through each of the lists, you will see that they are unique in their ranking of the various foods required to provide the prioritised nutrients.  While eating any of the foods on the list will be helpful, focusing on the foods towards the top of the list will maximise the nutrients you need for your condition.

approach score PDF foods nutrients wheel references
most nutrient dense foods 99.0% PDF foods nutrients
aggressive weight loss (PSMF) 98.4% PDF foods nutrients wheel references
adrenal fatigue 99.1% PDF foods nutrients
asthma 98.5% PDF foods nutrients wheel references
autism 95.5% PDF foods nutrients wheel references
depression 98.3% PDF foods nutrients wheel references
dyslipidemia 99.1% PDF foods nutrients wheel references
estrogen 98.4% PDF foods nutrients wheel references
fatigue 98.1% PDF foods nutrients wheel references
female fertility 98.3% PDF foods nutrients wheel references
hypertension 98.2% PDF foods nutrients wheel references
hypothyroidism 98.8% PDF foods nutrients wheel references
inflammation 98.3% PDF foods nutrients wheel references
methylation 97.6% PDF foods nutrients wheel references
sleep and insomnia 98.8% PDF foods nutrients wheel references
telomeres 96.9% PDF foods nutrients wheel references
low carb autoimmune friendly 97.3% PDF foods nutrients
alkaline (diabetes friendly) 96.9% PDF foods nutrients
testosterone 97.7% PDF foods nutrients wheel references
alkaline 96.4% PDF foods nutrients
autoimmune & SIBO 95.7% PDF foods nutrients
weight loss (insulin resistant) 99.3% PDF foods nutrients wheel references
diabetes friendly, autoimmune, & SIBO 76.0% PDF foods nutrients

The nutrients prioritised in these lists are generally based on research compiled by Spectracell which identified nutrients that are typically deficient in a range of conditions.  You can click on the “wheel” and “references” in the table for more details.   Check out the full Spectracell nutrient wheels for a range of conditions here.

Where there is no Spectracell “wheel” available, the nutrients used in the analysis were based on the Nutrient Bible by Henry Oseki which is an excellent detailed resource on the individual nutrients as well as the likely nutrients to support various conditions.

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The value of real food

Many modern foods are fortified with synthetic nutrients (e.g. folic acid, B vitamins, vitamin A, vitamin D, iron, iodine, etc.).[4]  While it may appear that the food companies are doing this for the benefit of your health or to make up for deficiencies in their processed foods grown quickly using chemical fertilisers, there is good research suggesting that fortification helps to ensure that we don’t lose interest in what would otherwise be bland unpalatable foods.[5] [6] [7]

By adding in a smattering of nutrients that our body actively seeks (e.g. iron, folate, B vitamins, sodium etc) we will maintain an increased appetite for these foods while not getting the range of other nutrients that are also important but do not drive our appetite to the same degree (e.g. potassium, magnesium, choline and vitamin E).

Paul Jaminet in his Perfect Health Diet[8] says “Potassium is the intracellular electrolyte while sodium is the extracellular electrolyte.  Cells continually pump sodium outside the cell and potassium inside.  Good health depends on the proper dietary balance between potassium and sodium.  Paleolithic diets were high in potassium, low in sodium; salt was rare and highly valued.  So we evolved mechanisms for protecting against the threat of low sodium levels: a food reward system that powerfully rewards salt consumption, and a hormonal network that shuts down urination and sweating whenever sodium is scarce.  There are no similar mechanisms to protect us against low potassium levels, even though they are every bit as devastating for our health.”

While supplements can be helpful, obtaining nutrients from whole foods will also maximise your chance of absorption and increase your chance of getting all the necessary complementary micronutrients in adequate quantities without being excessive. Note: excess supplementation of minerals can quickly cause diarrhoea, or the kidneys will excrete excess nutrients from supplements.’

I have not included fortified foods that may score highly due to a narrow range of synthetic micronutrients that have been added to highly processed and sugar ladened products.

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Nutritious whole foods will provide you with not only the essential nutrients that we can quantify but all the other beneficial non-essential nutrients, phytonutrients, enzymes, and cofactors[9] [10] that are not yet quantified or in the USDA database.

Ethical, philosophical and religious considerations

Many people choose to base their food choices on moral convictions or religious beliefs.  I do not have any issue with people making their food choices based on ethical considerations or religious beliefs.  I do, however, object to people claiming that their approach is nutritionally superior and forcing it onto others on that premise which is not supported by science.

The lists in the table below will help you find the most nutrient dense foods associated with each of these approaches.  The food lists have been sorted based on their nutrient score from highest to lowest at the bottom of the table.

approach score PDF foods nutrient profile
the most nutrient dense foods 99% PDF foods nutrients
nutrient dense Paleo 99% PDF click nutrients
low carb Paleo foods 97% PDF foods nutrients
pescetarian 95% PDF foods nutrients
bivalve vegan 92% PDF foods nutrients
low carb pescetarian 95% PDF foods nutrients
whole food plant based 80% PDF foods nutrients
plant based (diabetes friendly) 76% PDF foods nutrients
zero carb 76% PDF foods nutrients
Paleo (without ND) 64% nutrients
zero carb (no offal) 58% PDF foods nutrients
plant based (without ND) 57% nutrients
zero carb (without ND) 42% foods nutrients

As you might expect, we achieve the most nutritious selection of foods when we focus purely on nutrients.   If you chose to limit your food choices due to other ethical considerations, then you should pay particular attention to the foods that will provide you with more of the harder-to-find essential nutrients.

In the long run, the goal is to get the nutrients we need from our food to enable us to thrive without over consuming energy.  This will give us the best chance of maintaining an ideal body weight, energy levels, performance and avoid the modern diseases of ageing.[11]

See the discussion below detailing the pros and cons of each approach and the nutrients that may need to be supplemented based on the various approaches.

Macronutrient extremes

Some people like to define their nutritional approach in terms of large or small quantities of a particular macronutrient (e.g. low carb, low fat, high protein, low protein, high or low saturated fat, etc.).  The analysis in the table below shows the implication on the nutrients available if you follow any of these approaches.

I think it’s useful to understand the pros and cons of these extremes, particularly in terms of the micronutrients available and the range of foods involved in any of these more extreme approaches.

While high protein, low carb or ketogenic appear to have some positive impact on nutrient density, focusing on the most nutrient dense foods provides a vastly superior micronutrient outcome.

approach score PDF foods nutrients
the most nutrient dense foods 99% PDF foods nutrients
average of all foods in USDA database 75% nutrients
high protein foods 58% PDF foods nutrients
lowest carb 54% nutrients
most ketogenic 42% PDF foods nutrients
highest fat 33% PDF foods nutrients
lowest saturated fat 32% nutrients
lowest fat 31% PDF foods nutrients
highest saturated fat 29% nutrients
lowest fat 31% PDF foods nutrients
the most insulinogenic foods 27% PDF foods nutrients
highest carb 15% nutrients
lowest protein 5% PDF foods nutrients
the avoid list 3% foods nutrients

So that brings us to the end of the food lists section.  I hope you find an approach that will suit your current goals and situation and have a glimpse of how you can continue to move your health forward.

I have intentionally included a lot of data in these tables to allow you to fully understand the pros and cons of each approach and compare the nutritional options you might be interested in.  I hope you will dig into the data in the table for the short list of approaches that you may be interested in.

If you want to learn more about how these lists were developed I invite you to read on to learn about nutrient density, insulin load and energy density, and how they can be combined, using the Nutrient Optimiser algorithm to optimise our food choices.

 

Nutrient density

While there are a range of useful parameters that we can use to optimise our nutrition, the most important is arguably nutrient density.

Nutrient density is simply the amount of nutrients per calorie or the amount of the essential nutrients you get in your food each day.  Ideally, we want to be meeting the daily recommended intake for all of the nutrients.

Micronutrients seem to have been largely overlooked in our current discussion about nutrition. Perhaps this is because micronutrients are harder to quantify.  Without an easy way to quantify micronutrients we tend to focus on simpler metrics such as fat, carbs, saturated fat, protein, vegan, plant based, Paleo, keto, etc.

Unfortunately, neither avoiding a particular nutrient (saturated fat, salt, cholesterol, etc) or aiming for a macronutrient extremes (high fat, low fat, low carb, high carb, high fibre, low protein, etc) or even following our religious or ethical convictions (vegan, vegetarian, plant based etc ) are especially useful when it comes to identifying foods that provide us with the most micronutrients.

But what if we could quantify the micronutrient content of the food we eat?

Enter nutrient density!

The graph below shows the average of the micronutrients in the eight thousand or so foods in the USDA food database as a proportion of the daily recommended daily intake (DRI).  Imagine you ate just a little bit of all of these eight thousand foods to make up your 2000 calories for the day.

The nutrients at the bottom of this chart are easy to obtain in our food system (e.g. vitamin C, vitamin B12, vitamin K, and various amino acids).  There is little need to worry about these easier to find nutrients.  However, where this analysis is useful is that it highlights the nutrients that we might have to pay extra attention to obtaining in adequate quantities (e.g. vitamin D, choline, vitamin E, potassium, magnesium, calcium, etc.).

After a lot experimenting with different approaches to develop a quantitative analysis method for optimising nutrient density, I found that:

  1. Prioritising foods that are high in only one nutrient (e.g. potassium, omega 3, magnesium, vitamin D, niacin, etc.) means you risk missing out on all the beneficial and complementary nutrients that typically come with real food and isn’t particularly useful.  You usually come up with a range of obscure processed foods that have been supplemented with that nutrient.
  2. Focusing on maximising the quantity of all the essential nutrients gives us a VERY high protein list of foods.  Protein is relatively easy to obtain in our food system.  Prioritising the amino acids provides a list of foods that will be very hard to consume because they are 70% protein.  We tend to get more than enough protein when we focus on the harder-to-obtain vitamins and minerals.
  3. Using the Nutrient Optimiser we can focus on the foods that contain more of the nutrients that are harder to find.  When we maximise a range of the harder-to-find nutrients, we get a variety of whole foods that contain a broad spectrum of the essential nutrients.

The chart below shows the nutrients provided by the top 10% of the foods in the USDA database when we prioritise for the harder-to-find nutrients (i.e. vitamin D, choline, vitamin E, calcium, potassium, magnesium, zinc, pantothenic acid, selenium, and niacin).  The red bars denote the nutrients that have been prioritised.   That is, foods that contain more of these micronutrients per calorie rank higher in the analysis.

If you compare the chart below to the chart above, you will see that by focusing on the foods that contain harder-to-find nutrients we significantly boost all thirty-four essential nutrients!

If you focus on eating foods in this list, you will have a good chance of getting plenty of the essential micronutrients.  The most nutrient dense foods in each category are at the top of the list, so you would ideally focus more on the food at the top of the list as much as you could.

I don’t think it matters too much if you want to focus more on animal or plant based foods.  We tend to achieve the best nutritional outcome when we include a range of vegetables, animal products and seafood.

  • What is notably missing from all of these lists is sugar and refined grains which have a very low nutrient density.
  • Fruits also do not feature in the lists (other than the exclusively plant based lists) due to the lower nutrients per calorie compared to nonstarchy vegetables and animal foods.
  • Dairy and nuts make an appearance on the lists only where it is not a priority to keep energy density low or to lose weight.
  • Red meat tends to feature more prominently when we need to boost nutrients such as glycine, cysteine and glutamine which are not as prevalent in seafood.

The nutrient score

You will notice the “nutrient score” for the most nutrient dense foods is 98.7%.  But what does this mean?

The nutrient score is designed to compare the various nutritional approaches quantitatively.  We want to meet the daily recommended intake of a particular nutrient.  However, there may not be much value getting more than twice the DRI.  Once you’ve achieved two times the DRI your efforts would be best spent seeking out other nutrients.  If we achieved two times the recommended daily intake for all the nutrients, we would get a score of 100%.  That is, we get a perfect score if the entire red rectangle was filled in.

A lot of these food lists score close to a perfect score because they contain a range of the most nutrient dense foods.  This is not practical in real life.  The nutrient score of a real life diet will be lower than the optimised short list of nutrient dense foods.  We tend to choose more energy dense foods that may not be as nutrient dense, or we don’t consume the range of foods that would be necessary to attain a very high nutrient score.  Dr Rhonda Patrick currently holds the record for the highest scoring food log with 82%.  You can check out her Nutrient Optimiser analysis here.

At the other end of the spectrum, we can see from the chart below that focusing on the least nutrient dense foods will provide an inferior outcome.   If all we have to eat is these nutrient poor foods, we will likely develop nutrient deficiencies.  Our cravings will drive our appetite to derail even our best calorie restriction intentions.

Energy density

The great thing about nutrient dense whole foods is that they typically force out the energy dense processed foods in our diet.

Whether it be low carb, whole food plant based or Paleo, the magic happens when we switch out nutrient deficient foods for foods that provide you with the nutrients we need with less energy.

The ‘problem’ however with nutrient dense whole foods is that they make it hard to ingest enough energy.  If you are active and are not wanting to lose weight, you may need some higher energy density foods.

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Over at KetoGains, they talk about using ‘fat as a lever’.[12]  If you are not worried about being low carb or ketogenic or your blood sugar control, you can also think of ‘energy density as a lever’ to manage the amount of energy you can get from your diet.  While a ketogenic diet is typically higher fat, if you want to lose body fat then some of the fat contribution to your diet should come from your body, with less fat required from your plate or coffee mug.

Energy density is a simple concept that can help you fine tune your food choices and is calculated by dividing the calories in a food by its weight.  Used in isolation it isn’t particularly useful, but can be helpful whne considered along with nutrient density once you have stabilised your blood sugars by tweaking the insulin load of the food you eat.

If you have stabilised your blood sugars and are trying to lose weight, then minimising the energy density of the foods you eat will help you feel physically full with less energy intake.  Practically this might involve filling up on more nonstarchy veggies and perhaps leaner cuts of meat.

Focusing on foods with a lower energy density can help you to get the nutrients you need without overdoing the energy intake.

Alternatively, if you are an athlete and need to ingest a lot of fuel, then focusing on higher energy density foods may be helpful.

Insulin load

As shown in my analysis of the food insulin index data below, the amount of carbohydrate correlates with how much our blood sugar rises in response to food.  [You can click on the images below to see more detail or click here to drill down into the data more in Tableau online.]

However, carbohydrates alone don’t do a great job of explaining our insulin response to the food we eat.  As you can see in the chart below, some high protein, low carb foods still elicit a significant insulin response.

We get a much better prediction of our insulin response to food once we account for the fibre and protein content of our food.  Thinking in terms of insulin load (i.e. net carbs + 0.56 x protein) is useful if you are manually injecting insulin to manage your diabetes.  If you are insulin resistant, you can reduce the insulin load of your diet to the point that your pancreas can keep up and maintain normal blood sugars.

Reducing the insulin load of your diet will help achieve more stable blood sugar levels and get off the insulin rollercoaster that drives hunger and energy levels.  While various studies have not been able to demonstrate a metabolic advantage of one macronutrient versus another, it seems that appetite control is easier for people who are insulin resistant when they manipulate their diet to stabilise their blood sugars.

While too much energy from any source can promote insulin resistance in the long run (note: the pancreas secretes insulin to stop the flow of energy out of the liver when we have plenty of energy coming in via the mouth), increasing the proportion of fat in your diet will lessen the amount of insulin required by your food.

Increasing the percentage of calories from fat in your diet will also reduce your glucose response to food.

Although protein does need some insulin to metabolise, higher protein foods will typically force out the processed carbohydrates and reduce your insulin levels.

So what does all this mean?

If you are part of the 50% of the population that has diabetes or prediabetes, then manipulating the insulin load of your diet will help you stabilise your blood sugar levels.  This is a critical priority.

The problem with focusing only on insulin load, however, is that the least insulinogenic foods are primarily refined fats (cream, butter, olive oil, etc.) and do not contain a lot of the essential vitamins, minerals, and amino acids that we need to thrive and be metabolically healthy.

The solution is to find the optimal balance between insulin load and nutrient density.  As your blood glucose levels start to improve you can start to focus more on nutrient density and then on reducing energy density if you still need to lose weight.

The various food lists have been developed using a multi-criteria analysis algorithm that uses nutrient density, energy density and insulin load to highlight the ideal foods for a particular person.

Pros and cons of different dietary approaches

The table below outlines the pros and cons of each of the higher level nutritional approaches, who they will be appropriate for and which nutrients are harder to find.

approach who harder to find nutrients Pros Cons
well-formulated ketogenic diet Someone with an average blood sugar greater than 140 mg/dL or 7.8mmol/L or people who require therapeutic ketosis (i.e. for the management of conditions such as epilepsy, cancer, Alzheimer’s, etc.) Vitamin D, choline, potassium, vitamin B5, zinc, niacin, magnesium, calcium selenium and folate. Aggressively lowers insulin load to stabilise blood sugars and drive ketogenesis.  Higher fat levels can help to increase satiety while in early adoption phase. High energy density and low nutrient density mean that it may not yield optimal weight loss or health in the long term for everyone.
diabetes and nutritional ketosis People with an average blood sugar of greater than 108 mg/dL or 6.0mmol/L. Choline, vitamin D, vitamin E, potassium, magnesium, vitamin B5, niacin, calcium and zinc. Helps optimise blood sugar control and eliminate the swings that can drive appetite. Higher energy density means that not everyone will achieve optimal weight without also focussing on energy density.
weight loss (insulin resistant) People who are slightly insulin resistant but want to lose weight. Vitamin D, choline, potassium, calcium, magnesium, vitamin E, zinc, niacin. Lower energy density will help ensure a reduction in energy intake.  Higher nutrient density will reduce cravings. Lower satiety due to lower energy intake.
protein-sparing modified fast (PSMF) Someone targeting aggressive short term weight loss while maintaining muscle mass. Vitamin D, choline, vitamin E, calcium, potassium, magnesium, zinc. Very nutrient dense and very low energy density will drive weight loss.  Very hard to overeat these foods. Significant discipline, racking and planning required.
nutrient dense maintenance Someone looking to maintain their current weight. Choline, vitamin D, potassium, calcium, magnesium, zinc. Higher energy density while still being nutrient dense.
bodybuilder Someone looking to repair and build muscle. Vitamin D, choline, potassium, calcium, magnesium, vitamin E, sodium, vitamin B5, zinc, folate and branched chain amino acids Support muscle growth. Not ideal for someone not working out.
endurance athlete Someone who is active Choline, vitamin D, potassium, calcium vitamin E, magnesium, vitamin B5 and leucine. Higher energy density foods to support activity.

This table summarises the assumptions used in developing the lists based on religious, ethical or philosophical considerations and provides some brief commentary for each nutritional approach.  I encourage you to look in more detail at the data to better understand your preferred approaches.

approach score Assumptions & constraints Comment 
the most nutrient dense foods 100% Prioritises the harder to find nutrients. Maximises nutrients per calorie.
nutrient dense Paleo 99% Excludes dairy, grains and processed foods as well as prioritising nutrient density. Very similar outcome to most nutrient dense approach, though with a reduced range of foods.
low carb Paleo foods 97% Reduced insulin load to stabilise blood sugars while also maximising nutrient density. Will stabilise blood sugars more than straight Paleo which can involve more high carb veggies.
pescetarian 95% Plant based plus fish prioritised for nutrient density. Some vegans or vegetarians are comfortable eating fish.
bivalve vegan 92% Plant based plus molluscs prioritised for nutrient density. Provides some nutrients that are harder to find on a purely plant based approach (omega 3, vitamin B12).  Some vegans are comfortable eating molluscs which are not considered by some to be sentient beings.
low carb pescetarian 95% Vegetarian plus fish with a focus on nutrient density and a lower insulin load. Provides a solid nutritional outcome without eating animals or dairy.
whole food plant based 80% Excludes processed foods and oils.  Prioritises nutrient density without focussing on amino acids It is hard to obtain adequate omega 3 or vitamin B12 on a WFPB approach and hence they may need to supplement.

Weight loss is likely due to the low energy density if you are able to stick to unprocessed foods only.

plant based (diabetes friendly) 76% Plant based only, with the focus on nutrient density and lower insulin load. It can be quite hard to achieve a low carb diet, at least in terms of percentages without using a lot of oils or nuts.
zero carb 76% Animal only foods prioritised for nutrient density. A zero carb dietary approach struggles to meet DRI for vitamins K, C and E, folate, potassium and calcium.

Although some argue that nutrient requirements are different in the absence of glucose, though there is limited research to date.

Paleo (without ND) 64% All Paleo foods without consideration of nutrient density. Limiting yourself to unprocessed “Paleo food” is no guarantee that you will achieve exceptional nutrient density.
zero carb (no offal) 58% Animal based foods excluding organ meats. Organ meats provide a lot of the nutrients in a ZC approach.  Not everyone enjoys and eats a lot of organ meats.
plant based (without ND) 57% All whole food plant based foods without consideration of nutrient density. A plant based nutritional approach is no guarantee that you will achieve high levels of nutrients.
zero carb (without ND) 42% Zero carb without nutrient density. A zero carb approach without consideration of nutrient density can provide a poor nutritional outcome.

Summary

Congratulations, you’ve nearly reached the end of this data-heavy article!!

My hope is that all this data will be useful for people seeking clear guidance on optimal food choices for them.  I hope it will help you cut through the confusion and conflicts of interest that so often plague our food system.

Nutrient density is the centre piece of the algorithm for optimising nutrition to suit people with different goals and to suit different circumstances.  When we focus on foods that contain more of the harder-to-find nutrients we tend to boost all nutrients across the board.

A range of optimal food lists have been prepared to suit different states of metabolic health by also considering:

  • insulin load and energy density,
  • pre-existing health conditions using targeted nutrients, and
  • optimal short list of foods that still fit within a person’s ethical or religious system.

Simply focusing on trying to consume more of the foods on these lists will go a long way to helping you achieve optimal nutrition, health and happiness.  If you’re still looking for further guidance to help you refine your food choices, then I invite you check out the Nutrient Optimiser which has been designed to identify areas where you could improve your nutrition and help you fine tune your food choices to help you move towards your chosen goal and dreams, whatever they may be.

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references

[1] https://optimisingnutrition.com/2015/03/22/diabetes-102/

[2] https://optimisingnutrition.com/2016/05/16/building-a-better-nutrient-density-index/

[3] https://optimisingnutrition.com/2015/03/22/towards-a-personalised-food-ranking-system/

[4] https://en.wikipedia.org/wiki/Food_fortification

[5] https://freetheanimal.com/2015/06/enrichment-theory-everything.html

[6] https://freetheanimal.com/2016/05/enrichment-promotes-everything.html

[7] https://freetheanimal.com/2015/10/fortification-obesity-refinements.html

[8] http://perfecthealthdiet.com/

[9] https://suppversity.blogspot.com.au/2017/08/vitamin-b6-b12-c-e-folate-iron.html

[10] http://suppversity.blogspot.com.au/2015/04/studies-confirm-natural-and-synthetic.html

[11] https://optimisingnutrition.com/2016/03/21/wanna-live-forever/

[12] https://ketogains.com/2017/06/energy-balance-macros-nutrient-density/