Do you need to eat less meat to lower your LDL levels?
TL;DR: LDL particles carry a mix of cholesterol, triglycerides, and proteins. Often, the amount of triglycerides our liver produces - and not the amount of cholesterol we eat! - determines the LDL levels in our blood. Supporting our liver & reducing triglyceride production can help lower LDL levels, regardless of your meat intake. (about 9 min read)
Tips on lowering LDL cholesterol (but not HDL):
1. Increase fiber in your diet.
2. Time your carbohydrates with your movement - reduce simple carbs (anything without fiber) when you're stuck sitting at your desk. Save carbs for before workouts (provide energy) or after workouts (restore glycogen levels).
3. Move around for 5-15min after meals.
4. Reduce stress. This includes mental overload, emotional stress, sleep deprivation, dehydration, bad vibes, or nutrient deficiencies.
5. Relieve stress. This includes taking stretch breaks/short walks throughout the day, balancing mental load, getting enough sleep, staying hydrated, and eating enough "whole foods" since they contain micronutrients.
What is LDL & where does it comes from? LDL particles contain more than just cholesterol - they are a mixture of triglycerides, cholesterol, and certain proteins. It's often called LDL-cholesterol because the biochemical assay measuring the amount of LDL particles specifically looks at the cholesterol portion, but this is a historical practice. Someone could measure the triglycerides (TGs) or the proteins to get an idea of the total LDL particles if they wanted to. In fact, it’s becoming more common to measure LDL-triglycerides or total TGs to get a measure of someone’s risk of disease, rather than total cholesterol or LDL:HDL ratios.
More LDL is made when our livers are overwhelmed with something that causes too many triglycerides (TGs) to be made and safely stored in the liver. Those excess TGs get packaged on to LDL particles and secreted into our blood system.
To reduce LDL-"cholesterol", we need to reduce how much TGs the liver is making & packaging up to put into our blood. For most people, this is not from eating too much meat. A common reason a lot of people have increased TG production comes from the liver trying to lower blood sugar levels when a person isn't moving around.
This doesn't necessarily mean that someone is eating too much sugar - it means that there is too much sugar in the bloodstream for the amount of movement we're doing at a certain time.
If a person is not gaining weight, but their LDL levels went up, there isn't a mismatch in their total food/nutrient intake vs energy expenditure. There is a mismatch between when their food/nutrient intake is happening, or when their BGLs are rising, vs. when their movement is happening.
So what can we do to lower the amount of LDL that our liver secretes into our blood? We need to match our blood glucose levels with our movement. We can do this by helping our guts absorb nutrients more effectively, reducing how many simple carbs we eat when we’re not moving, reducing cortisol levels, and taking stretch/movement breaks throughout the day. Here’s how it works:
1. Increasing fiber in your diet will help lower LDL levels. This is because fiber helps other nutrients get absorbed across your gut more slowly. Low-fiber foods that contain simple carbohydrates (aka "sugar") will get absorbed very quickly and raise your blood glucose levels (BGLs).
Your body then has to lower BGLs either by moving around (even for as little as 5-15min) or by secreting insulin. If you aren't moving, then insulin will signal to your liver & fat cells (adipose tissue) to take glucose out of the blood. The liver will store sugar first as glycogen, but once you have enough glycogen, your liver will make fats (mainly triglycerides; TGs). Some of those TGs will be secreted into your blood on LDL particles. And your serum LDL levels will rise.
2. Reducing simple carbohydrates when you are stuck at your desk will help lower LDL levels. Again, simple carbs (aka "sugar") like crackers, fruit, toast, cereal, etc., will get absorbed quickly and raise your blood glucose levels (BGLs).
If you aren't moving around, your muscles can't help stabilize your BGLs and it will be up to your pancreas to secrete insulin & your liver & fat (adipose) tissue to respond to that insulin by clearing glucose and turning it into TGs. Reducing how many simple carbs we eat when we aren't moving reduces how many TGs our liver makes and packages onto LDL particles = our serum LDL levels rise.
3. Moving around for 5-15min after meals will help lower LDL levels. Simple carbs get a lot of attention for "making people fat" but this isn't really the case. Carbs get turned into fat when the food we eat increases our BGLs but we aren't moving.
When we are moving (or have moved recently), carbs will get taken up first by our muscles and either used for energy or stored as glycogen. Carbs will be taken up by our liver next and stored as glycogen.
All of this glycogen makes it easier to have energy to move later and to keep steady BGLs when we're "fasting" (fasting = any time we go longer than ~6hrs without eating, meaning when we SLEEP or have a longer gap between meals or we're sick/recovering from illness/injury. I don't mean the fasting fads). We don't have to "burn the calories we ate" to keep them from becoming fat - we can just encourage our muscles to take glucose out of the blood & store it as glycogen.
If we don't move, then our liver will take glucose and make a little into glycogen and then the rest into TGs. Excess TG production = more LDL particles secreted from liver = our serum LDL levels rise.
4. Reducind stress will help reduce LDL levels. "Stress" always has a physiological component regardless of the initail cause. Harsh workdays, sleep deprivation, dehydration, negative vibes will all convergene on the release of more cortisol.
Cortisol prepares our body for movement. When our brains' release cortisol and we DON'T MOVE, we then have to compensate for the physiological changes that our body made in response to cortisol that prepared us for movement. This creates confusing signals inside the body and has negative health consequences.
One of the ways cortisol prepares us to move is by telling the liver to break down glycogen & release it as glucose into our blood streams. If we release cortisol, raise our BGLs, and then don't move, we need to increase how much insulin is released to bring our BGLs back in line.
More insulin also means means more glucose is taken up by the liver - which is now stuck in between being told by cortisol to breakdown glycogen & release glucose AND being told by insulin to take up glucose to make more glycogen. The liver can't successfully respond to both cortisol & insulin at once. The result is that the liver takes up glucose and makes more triglycerides (TGs) which leads to more LDL particles being packaged up & secreted out of the liver = our LDL levels rise.
Cortisol release & increased BGLs aren't a problem if we do start moving. It's only a problem is we are routinely stressed out and not moving. The other option is to reduce sources of stress and reduce overall cortisol levels.
5. Relieving stress will help reduce LDL levels. The release of cortisol and then SITTING DOWN is really tough on our bodies because it causes an imbalance & mixed signals to our organs about what they should prepare to do.
If we don't rebalance our internal signals, we end up causing inflammation. The signals that tell our body that we have unrelieved stress also tell our liver to make more triglycerides. More TGs produced = more TGs packaged onto LDL particles = increased LDL cholesterol levels.
An easy fix to this is to reduce the amount of mixed signals - getting enough sleep, staying hydrated, moving around for a few min, or taking deep breathes (box breathing, meditating for a few min) will help our bodies rebalance. Eating "whole" foods (veggies, unprocessed meats, fruits, grains) will make sure we have enough micronutrients that all our cells function properly.
The “4 D’s” of metabolic management.
TL;DR: Yes, these are the same 4 D’s of time management that you are already a pro at using in your professional life to get projects done. Here’s how you apply them to your metabolism to get metabolic balance done. (about 5 min read)
The 4D’s of metabolic management:
DO focus on eating protein & fat FIRST in your meal
DELEGATE out food prep of protein & fiber meals, if you don’t have time to cook everything else yourself
DEFER making everything from start to finish for each individual meal with a “go-to foods” plan
DROP tasks that are nice, but not strictly necessary, when you’re running low on resources
Managing your metabolism is an ongoing project. This is literally something you will do for the rest of your life. Just like with our financial investments, the best way to be financially healthy is to set up good habits: make small investments on a regular basis and let them appreciate over time. It’s the same for our health - we invest in our health when we reduce metabolic stress. It’s not about being sexy. It’s about being consistent.
Break up that big, long-term, vaguely defined goal of “being healthy” into bite-sized chunks. Instead of having a checklist of things we must do to stay “healthy” (which doesn’t give us options for when our schedule or resources change), we can think of health as a project with actionable tasks that will end in achieving specific metrics. Our Foundation Five Habits are actionable tasks that we can do to maintain metabolic balance and reduce stress.
Take each on as the start and end of a new “metabolic project”. Every week, start by making a list of what you want to accomplish (ex: get 25g of fiber every day this week), and the tasks you need to do. At the end of the week, review which tasks were easy for you to do on your own and which ones weren’t. Make a new plan for the next week with whatever adjustments would help you reach your goals.
Use the “4 D’s of time management” to work on your metabolic balance. The “4 D’s of time management” are (1) Delegate, (2) Defer, (3) Drop, and (4) DO.
How can we apply this to our metabolism?
1. Delegate who actually cooks. Ex: Choose take-out that has a good veggie base, has essential fats, & is a good source of protein.
2. Defer making "full meals" on busy days. Ex: Have protein + fat sources on hand for when you don't have time to cook full meals or don't have time to move around much around the time you're eating (cheese, nuts, olives, a cheesy olive spread for carrots or Wasa crackers). Another example: Making a bunch of heritage rice, quinoa, roasted sweet potatoes or squash, pre-cut veggies, overnight oats, or breakfast chia seed pudding at once and then portioning those out for the rest of the week.
3. Drop tasks that are nice, but not necessary. Ex: Identify what is most important to you about a meal and do those things first. For me, I want a meal to be well-balanced with adequate protein, fat, and fiber first. I don't care if I end up eating traditionally "warm" food after it's cold. I end up tossing cold meat on top of greens a lot. For my dad, as a counter-example, he wants stuff that can be heated up easily bc he really likes the "warmth" of warm food. He makes more chilis and stews in the crockpot that he can then heats and eats over the week. We'd both prefer to have warm food that was just made, but if we don't have time, we cut out the "just made" part.
4. DO the tasks that are the most nourishing for you. Ex: If cooking is also a creative expression for you that brings you joy, set aside time in the week to be the one who cooks your meal. If logic puzzles are fun for you, try making a list of meals you could eat during the week and a list of foods that are easy to prep/have on hand, then play Tetris to see how many meals you can build with your pre-determined snack blocks. If spending time with friends is the nourishment you need most, cook together or have a potluck.
The 4D’s of metabolic management:
DO focus on eating protein & fat FIRST in your meal
DELEGATE out food prep of protein & fiber meals, if you don’t have time to cook everything else yourself
DEFER making everything from start to finish for each individual meal with a “go to” foods plan
DROP tasks that are nice, but not strictly necessary, when you’re running low on resources
When should you add prebiotics & probiotics to your nutrition plan?
TL;DR: You can heal your guts and enjoy your food by building your meals around protein and fiber first. This will help your gut microbes and reduce GI distress more than taking probiotic or prebiotic supplements. (about 5 min read)
Metabolic tips for a healthy gut microbiome:
Use the “get to 25g of fiber guide” to get enough fiber to support a healthy gut microbiome!
Add some fermented foods to increase diversity in your guts microbiome and reduce inflammation!
Avoid simple carbohydrates when you’re not going to be moving - simple carbs increase bloating and GI distress when we don’t absorb them fast enough.
What are “probiotics” and “prebiotics”? Probiotics are foods with live (“active”) microbial cultures. And prebiotics are nutrients that support the growth of those microbial cultures.
Okay, so what are “microbes”? Microbes are organisms that are very small; these are all of the bacteria and fungi that live in our guts to help us digest food and absorb nutrients, live on our skin to help us fight infections, and help us make foods like cheese, yogurt, bread, kimchi, sauerkraut, and all other fermented foods. The microbes that help us be healthier and should live with us are called “commensal microbes” and those that cause disease are all called “pathogenic microbes”.*
Your gut needs a diverse set of microbes that eat fiber and produce short-chain fatty acids (SCFAs) to be healthy. Many different types of microbes can live in your guts, but not all of them help promote good gut health. And some of them can increase inflammation (this causes leaky gut syndrome) or cause food poisoning (like too much E. coli.*). There’s still a lot we need to learn about which microbes do what and how they interact together, but what is clear is that we need DIVERSITY in our gut microbiomes and we need those gut microbes to produce short-chain fatty acids (SCFAs). SCFAs can then interact with the immune cells that line our guts to reduce inflammation and bloating, as well as increase vitamin absorption. How do feed our gut microbes so that they are diverse and make SCFAs for us? We eat prebiotics.
Your gut wants prebiotics and probiotics from YOUR FOOD. Probiotics are foods that contain living microbes (bacteria and yeast) that should live in your gut. Your gut naturally has a mixture of microbes that you’ve ingested from different sources - coming out of the vaginal canal when we’re born, eating dirt when we’re kids, on the surface of fruits/veggies, from the surface of our own hands as we touch/prepare our food (yes, even after we wash our food and our hands; no this isn’t gross and if the skin microbes were missing, we’d get sick). You can also intentionally add prebiotics into your diet with fermented foods. Or supplements.
Prebiotics are biologically active compounds that stimulate and support the growth of “good bacteria”. That’s marketing talk for fiber. You can buy a month’s worth of prebiotic supplements for anywhere from $25 - $150. You can also buy probiotic supplements for about the same price. If someone did both, they could easily spend $50 a month to help their gut. We can also eat 25g of fiber per day with some fermented foods, and since we have to eat anyway, we can choose fiber + fermented foods instead of processed foods that lack fiber or are sterile and save ourselves the supplement money.
Can we take probiotics alone and skip the 25g of fiber from food? No. There’s a misconception that we got bloated, or constipated, or have other types of gastrointestinal (GI) distress because we don’t have enough microbes. And that taking probiotics can solve the problem. If this was true, we wouldn’t have to keep taking probiotics if we all felt better once we got those “good bacteria” into our systems. “Of course not,” some of you may be thinking, “if you want those probiotic bacteria to stay, you have to also take pre-biotic supplements.” Pre-biotics = fiber. We may benefit from adding probiotics to our diet, but if we don’t also get sufficient fiber, the microbes we ingested will just pass through us.
Does a fiber supplement work just as well as fiber from your food? It doesn’t seem like it, but even if it did, a fiber supplement ONLY has fiber it in. A fiber-rich food has other essential vitamins and minerals in it. You could take supplements for both probiotics to get a more diverse microbiome, and then take a prebiotic supplement to get fiber. Or you could eat a roasted squash (fiber, potassium, vitamin C, vitamin B6, magnesium) with Greek yogurt (protein, vitamin A, vitamin Bs (B2, B5, B12), potassium, calcium), and spiced, crushed walnuts (fiber, protein, essential omega-3 fatty acids). You know, a regular meal.
So what’s the best way to avoid bloating and GI distress? You can enjoy your food AND heal your gut. Build your plate with protein and fiber first. Add some fermented foods to help increase gut diversity. Contrary to popular belief, we get bloated when we eat more simple carbohydrates than we can absorb at a fast enough rate, so the best way to avoid bloating is to reduce simple carb intake when we’re not moving. Remember that “carbohydrates” refers to fiber (aka “slow carbs”) and sugar (aka “fast carbs”) - any carb that isn’t fiber is seen as sugar by our bodies. More about when we need simple carbs to fuel our movement here. And stay hydrated so that you can actually absorb the food you’re eating!
Metabolic tips for a healthy gut microbiome:
Use the “get to 25g of fiber guide” to get enough fiber to support a healthy gut microbiome!
Add some fermented foods to increase diversity in your guts microbiome and reduce inflammation!
Avoid simple carbohydrates when you’re not going to be moving - simple carbs increase bloating and GI distress when we don’t absorb them fast enough.
E. coli and other “pathogenic” bacteria that often cause food poisoning make us sick because there’s too much of that one type of bacteria at once. Not because that particular bacteria produce a toxin or something that is guaranteed to make us sick. There’s a natural amount of E. coli found in all of our guts; the problem comes from the lack of diversity and the overgrowth of certain types of bacteria when we eat too much simple sugars and not enough fiber.
Shah, BR et al. (2020) Effects of prebiotic dietary fibers and probiotics on human health: with special focus on recent advancement in their encapsulated formulations. Trends in Food Science and Technology.
Why are people taking Ozempic to lose weight (and is it a good idea?)
TL;DR: Ozempic is a drug that mimics the signaling molecule GLP-1, which is naturally released in your body to suppress appetite. Taking ozempic is a good idea if someone is also making lifestyle changes and needs to see results fast to prevent more serious health conditions. Taking ozempic is not a good idea if someone is not maintaining metabolic balance, getting enough essential nutrients, or moving enough to support good circulation, digestion, and liver function. (about 6 min read)
Metabolic tips for raising your body’s natural “ozempic” (aka GLP-1) levels:
Start your meal off with some essential fats (ex: olive oil, avocados, nuts) to release GLP-1 and reduce how “hungry” you feel as you eat.
Save your simple carbohydrates for the end of a meal, or for when you’re moving. Carbohydrates release less GLP-1 than fat or protein, so you don’t get as much “I’m full” signals if you eat carbs before fat.
Move around for 5-15min after you eat to increase circulation so that your brain can get the signals your guts are sending them.
Ozempic is a drug that supplements our body’s GLP-1 levels. GLP-1 is a signaling molecule that is produced in our guts in response to eating foods that are “high energy” - meaning, we release the most GLP-1 in response to eating fat, and then protein, and then carbohydrates. We always release some GLP-1 whenever we eat. GLP-1 has a number of actions in our body and on our brain. Two of the most important are (1) causing our pancreas to release some insulin and (2) causing our brain to release signals saying if we’re full (aka “suppressing our appetite”).
Our guts help monitor our how much nutrient we’ve eaten so that we don’t overeat. Our guts release the most amount of GLP-1 in response to fat since fat has the most calories/gram; ie. it’s the most “calorically dense”. If we eat a food that’s mostly just fat (like a hard cheese or bacon or an avocado), the insulin release will be small since there’s no simple carbs in those snacks. The GLP-1 will tell our brains that we ate something calorically dense and we don’t need to eat that much more to maintain proper energy levels. GLP-1 signaling should suppress our appetite and we should eat less after it’s release (unless there are other competing signals coming into our brains).
How “hungry” we feel is based on what types of signals our brain is getting from different parts of our body. There are times when we definitely ate calorically-dense foods, and have released GLP-1 to our brains, but we still feel hungry. Here are some reasons why we might be eating “enough” but still feel hungry (click here for more info).
1. Our muscles are giving signals that we’re moving a lot and we’re using a lot of energy up quickly.
2. Our brains are also getting signals that our BGLs are low and aren’t being brought up fast enough by our liver.
3. Our fat cells are giving signals that we don’t have enough fat stored on our bodies for proper functioning.
4. Metabolic imbalance (aka stress) is increasing inflammation that encourages our bodies to store, and not burn, fat.
So how is ozempic helping people lose weight? Ozempic is essentially increasing our GLP-1 signaling so that we can feel “full” faster. Can we do that naturally? YES. YES WE CAN.
We can increase our body’s natural “ozempic” (aka GLP-1) levels by eating fat and protein at the beginning of our meals. Start your meal off with some olive oil (fat!) and greens (essential nutrients!). Have a mid-day snack of nuts (fat! and fiber! and protein!) or hard cheese (fat! and protein!) instead of pretzels. Swap your sandwich out for a salad, drink a glass of water, and eat your fav local bakery’s sourdough after the salad. Save your bagels for before your workouts (fuel that movement) or after you’re done working out (build those muscles, store that glycogen). Smash an avocado (fat! and fiber!) straight into your face. JK, put it on some whole grain toast where you can “see the seeds” (fiber! and iron!). Walk around for 5-15min after you eat to increase circulation around your guts to help you digest AND to help the signals your guts are giving off actually get to your brain!
Moving around for 5-15min after eating will HELP YOUR BRAIN GET THE SIGNALS YOUR BODY IS ACTUALLY PUTTING OUT. If someone is considering taking a drug to lose weight but is not also doing things to increase metabolic balance, they are just going to throw their system out of whack and they are going to spend a lot of money doing it. What is the point of “feeling full” if you aren’t getting enough essential fats, proteins, vitamins, and minerals? So you’ll feel full but then become vitamin deficient? Or throw your hormones out of balance? What is the point of suppressing your appetite when you can eat delicious food that also provides essential nutrients that you need to eat anyway? What is the point of losing weight if you are ignoring other health conditions that come along with metabolic imbalance?
Ozempic, and other drugs for Type 2 Diabetes Mellitus, are appropriate for people who are managing their health. They aren’t “weight loss” drugs. Yes people without T2DM can lose weight by taking ozempic, but seriously, this is a fixation on weight and not on health. Being ten lbs thinner doesn’t make you feel better. Having better metabolic balance makes you feel better. Caring about yourself and your health makes you feel better. Maintaining your foundational 5 habits makes you feel better. Weighing less just makes you weigh less.
1 in 3 people in the United States is currently insulin-resistant (pre-diabetic or has developed Type 2 Diabetes (T2DM). This is a serious condition that significantly increases the likelihood of dying from a heart attack (the #1 cause of death in America, coincidently, also 1 in 3 people), of developing an immune condition, and of developing cognitive dysfunction including Alzheimer’s Disease. Pre-diabetes and Type 2 Diabetes are both manageable and reversible. Maintaining metabolic balance is essential for maintaining, and restoring, insulin sensitivity.
Baggio, L. and DJ Drucker. (2007) Biology of Incretins: GLP-1 and GIP. Gastroenterology.
Wang, XC et al. (2015) Multiple factors related to the secretion of Glucagone-Like Peptide-1. International Journal of Endocrinology.
Why do we feel still feel hungry even if we’ve eaten “enough”? (and what we can do about it)
TL;DR: Your brain get many different signals from your body to help you decide if you need to eat more or not. We need enough calories to keep moving and we need enough essential nutrients to be healthy. Not moving around after eating, or being chronically stressed out, or eating “nutrient poor” foods keep us feeling hungry even when we “enough” calories. (about 5 min read)
Metabolic tips for feeling full after we eat:
Drink a glass of water before eating and move around for 5-15min after eating. This increases circulation and helps our brains get the “we’ve eaten” signals that our guts send out.
Time your carbohydrates with your movement: eating carbs before and after moving helps maintain glycogen stores and reduces how hungry we feel after exercising.
Limit alcohol intake since it blocks your liver’s ability to put glucose back into the bloodstream and will trick your brain into thinking you need to eat more.
Here are some reasons why we might be eating “enough” but still feel hungry:
1. Our muscles are giving signals that we’re moving a lot and we’re using a lot of energy up quickly. It’s important to eat enough protein and carbohydrates before intense exercise to fuel that movement, and after exercise to replace glycogen stores and allow our muscles to get stronger. Eating “enough” calories but at times of the day that aren’t paired with movement can leave us feeling hungry because our “metabolic timing” is off.
2. Our brains are also getting signals that our BGLs are low and aren’t being brought up fast enough by our liver. This is a sign that our liver is stressed out, or that we haven’t eaten enough protein, or that there’s too much insulin around and it’s stopping our livers from putting glucose back in to the blood stream, or that there’s too much alcohol around and our livers can’t make new glucose molecules to put into the blood stream.
3. Our fat cells are giving signals that we don’t have enough fat stored on our bodies for proper functioning. We use fat as our main energy supply when we’re moving throughout the day, we use fat to keep our energy levels constant when we’re fasting (like when we sleep), AND we use fat (and cholesterol) to make a variety of hormones that allow our bodies to function properly. Some of these hormones include testosterone (very low body fat makes it hard to build or keep muscle because there’s less testosterone) and estrogen (very low body fat can stop people from having regular periods because there’s not enough estrogen).
4. Metabolic imbalance (aka stress) is increasing inflammation that encourages our bodies to store, and not burn, fat. This isn’t just in your head: being stressed out makes you hungrier. Our bodies respond to stress in the short term as if we are about to start running from our problems (the “fight or flight” response). Running requires a lot of energy, and you can end up with a short-term sugar craving. The “short term” stress response comes into play when something stressful first happens and then goes away (like one bad night of sleep, or one bad convo with your boss).
We respond to stress in the longer term as if we’re about to walk through the desert for 40 yrs (the “famine” response). Surviving a famine takes a lot of fat stores. The “long term” stress response comes into play when something stressful is happening and not going away (like telling yourself less than 5 hrs of sleep is okay and you’ll “catch up on sleep” over the weekend, or telling yourself that “next week will probably be better” when your workplace has consistently placed unrealistic expectations and deadlines as part of its company culture.)*
So how can we reduce the chances that we overeat? We will continue to feel hungry, despite how many calories we eat, if we’re missing essential nutrients (like omega-3 fatty acids or essential amino aicds) or if our liver can’t bring our blood glucose levels up when they start to fall. Our liver can’t put glucose back into our bloodstream if there’s a lot of insulin around or if we’re drinking alcohol. We will also slow down how quickly and easily our brain can get the signals that “we’re full” if we’re dehydrated, since dehydration can cause changes in our BGLs that confuse our brain. Reducing stress can also help us not overeat.
Overall, food is not just nutrients. In order to not feel “hungry”, we have to feel nourished. This means physically nourished but also psychologically nourished. Eating good food, with friends or family, nourishes all parts of us. Here’s a guide to helping decide if we need to eat less (you probably don’t). And here’s a reminder that getting 25g of fiber/day and building muscle will have a bigger impact on your metabolism that eating less or losing weight.
Metabolic tips for feeling full after we eat:
Drink a glass of water before eating and move around for 5-15min after eating. This increases circulation and helps our brains get the “we’ve eaten” signals that our guts send out.
Time your carbohydrates with your movement: eating carbs before and after moving helps maintain glycogen stores and reduces how hungry we feel after exercising.
Limit alcohol intake since it blocks your liver’s ability to put glucose back into the bloodstream and will trick your brain into thinking you need to eat more.
*Don’t let your job kill you. You’d literally be better off walking into the desert. Sleep deprivation and chronic “low level” stress = higher cortisol levels over a long period of time = extra pressure that builds up on your heart = you are being asked to put yourself at risk of having a heart attack. Look up the medical costs of having & recovering from a heart attack, then look at the rates of heart attack survival, and then look at your paycheck. Then look back at the medical costs. Now back at your paycheck. Don’t let your job kill you.
I know this is easier said than done. America’s healthcare system is tied to employment, and health insurance + pay rates for different jobs are not tied to how much we work or how important our jobs are (hi, fellow teachers, anybody in the healthcare industry, anyone doing childcare, anyone who was a “critical worker” during the COVID19 pandemic). It’s a real problem. Which is why it is so important that we understand the real consequences to our health, and so important that we leverage ways to maintain balance when/where we can…
Why you need to add muscle (and don’t need to lose fat) for better metabolic balance.
TL;DR: How much our muscles weigh - and not our total body weight - has the biggest impact on how “fast” or “slow” our metabolism is. We can maintain better metabolic balance by moving our muscles than by trying to lose fat. (about 6 min read)
Metabolic tips for increasing metabolic balance:
Add some resistance training to your routine to build muscle mass and burn more calories at rest.
Move around for 5-15min after eating so that more blood glucose gets stored in your muscles. This helps stabilize BGLs and reduces metabolic stress.
Focus on moving throughout the day and building muscle, instead of losing fat. Movement + muscle mass will have a much bigger impact on your health than obsessing over body fat or total weight.
The weight of your muscles is the biggest factor in how much food your burn for energy. Now we’re going to actually break down why you can eat more (and worry less about how much you’re eating) when you have more muscle mass. Your “resting metabolism” - the number of calories your body needs at rest to stay alive - is mostly determined by the weight of your muscles. So having more muscle mass means you actually can burn calories for energy without even moving.
Let’s say two people both have 150 lbs of total body weight (BW). Their skeleton is going to weigh about 85 lbs. The 85 lb skeleton + non-muscle needs about 1200 cal/day. The rest of their body (muscle + fat) will weigh 65 lbs. Your fat cells store energy; they don’t use that much energy and their calories are part of the 1200 cal/day that your skeleton + non-muscle needs. Your muscles need about 11 cal/lb/day. Let’s estimate how many calories these two people use when they aren’t moving around.
Example 1: 150 lb person with 15% body fat needs a minimum of ~1650 cal/day. Their total BW is 150 lbs, so their fat weighs about 22.5 lbs. This means their muscle mass is about 42.5 lbs. (85lb skeleton + 22.5 lbs fat + 42.5 muscle = 150 total lbs). If the muscle is going to use ~11 cal/lb, then this person needs to eat about 1650 cal/day to maintain their weight if they aren’t moving around. (11* 42.5 = 467 cal for the muscle + 1200 cal for the skeleton + non-muscle = ~1650 cal/day when doing nothing).
If this person does some movement throughout the day, their muscles will burn some of their body fat and they’ll lose weight OR they will need to eat more to stay the same weight. Some movement throughout the day will bring their calorie needs up from ~11 cal/lb BW to about 11.5-12 cal/lb BW (depending on the person and their movement patterns) and they will burn about 1700-1800 cal/day.
Example 2: 150 lb person with 25% body fat needs a minimum of ~1500 cal/day. This person’s body weight is still a total 150 lbs, their skeleton will still weigh about 85 lbs, and their skeleton + non-muscle still needs about 1200 cal/day.
However, with 25% body fat, this person’s muscle mass will only be 37.5 lbs and their fat will be 27.5 lbs. Now, 37.5 lbs of muscle will burn 302 cal/day if this person isn’t moving, and their total cal needs/day go down to 1500 cal (11 * 37.5 = 302 cal for the muscle + 1200 cal for the skeleton + non-muscle). Having 25% body fat drops this person’s “metabolic rate” from 11 cal/lb to 10 cal/lb.
If this person does some movement throughout the day, their calorie needs will go from ~10 cal/lb BW up to about 10.5-11.5 cal/lb BW and they will burn about 1575-1700 cal/day.
Having a “slower” metabolism can be due to having less muscle than another person who weighs the same. You can see that the person with 15% body fat may burn 1700 cal/day (the lower end of their estimated calorie needs) and the person with 25% body fat may also burn 1700 cal/day (the higher end of their estimated calories needs) when both people are moving throughout the day. However, at rest, the person with more muscle mass (and it’s the muscle mass that’s important! not the lower body fat!!!) will consistently need more calories than a person with less muscle.
Our muscles will burn fat for energy first. Our muscles will rely on burning fat for energy when we are moving enough to increase our heart rates but not too much - you can carry on a decent conversation while doing this (I mean, you could do a decent job of talking and breathing when you’re moving. Whether or not the conversation itself is decent depends on who you decided to hang out with). This amount of movement has gotten the flashy title “fat-burning zone” which is kind of inaccurate bc all zones are fat-burning up until you move faster than your blood can get fat to your muscles fast enough (and then your muscles switch to burning glucose). The switch from fat to blood glucose doesn’t happen until you start going fast**.
How much do we need to be moving our muscles to help our metabolism? You may have heard of “heart rate zones” or “perceived exertion” as other ways to know if your muscles are burning fat or have switched to glucose. Heart rate and perceived exertion are helpful metrics if you have a heart rate monitor or think about your exertion level when you have nothing better to think about on the treadmill. For people who don’t have heart rate monitors - or have better things to think about than exertion on a treadmill - here’s a table I put together to help people find their estimated cal/day based on activity level.
Losing fat does not “speed up” your metabolism. Reducing metabolic stress and increasing muscle mass does. Actually, nothing really “speed up” your metabolism. A more accurate way to describe what’s happening is “metabolic stress slows down your metabolism”. You can still increase the rate you burn calories by reducing metabolic stress and lowering the amount of growth factors and inflammation signals that tell your body to store fat. And by increasing muscle mass so you burn more calories at rest. “Speeding up” your metabolism is really just maintaining metabolic balance.
Losing body fat without increasing muscle mass just decreases body fat. This may or may not be healthy for you - like, if you have extra weight putting pressure on your joints, losing fat can be good. If a lot of your body fat is stored around your internal organs and is pushing on them, losing fat can be good. But if your joints aren’t stressed, your blood pressure is good, and your internal organs aren’t packed with fat, you probably don’t need to focus on losing body fat for health reasons.
Metabolic tips for increasing metabolic balance:
Add some resistance training to your routine to build muscle mass and burn more calories at rest.
Move around for 5-15min after eating so that more blood glucose gets stored in your muscles. This helps stabilize BGLs and reduces metabolic stress.
Focus on moving throughout the day and building muscle, instead of losing fat. Movement + muscle mass will have a much bigger impact on your health than obsessing over body fat or total weight.
**Fast for you. This is where things get nuanced because “fast for you” is going to depend on how trained your muscles are (basically, how much muscle fibers you have), what type of training you’re doing (weights vs endurance exercises), and how well you actually fuel your movement and recovery (not enough fuel = not enough glycogen + fat stored in the muscle itself and more reliance on blood glucose levels and fuel stored in your liver and fat cells). Feed your movement so you can heal your bones, grow your muscles, and move faster.
*Heavy resistance and/or vigorous cardio should be done no more than 3-5 days/wk (depending on goals) so that bones and muscles have time to recover properly to prevent injuries. Moderate exercise can be done 6-7 days/wk but exercise plans should alternate muscle groups to allow tired muscles time to rest & properly recover to prevent injury. Light exercise can be done every day.
Jenson, J. et al., (2011) The Role of Skeletal Muscle Glycogen Breakdown for Regulation of Insulin Sensitivity by Exercise. Frontiers in Physiology.
Pontzer, H. et al., (2021) Daily energy expenditure through the human life course. Nature.
Having more muscle helps us store less fat, even if we don’t eat less.
TL;DR: Your muscles can help you store less fat by (a) burning more energy and (b) storing energy as glycogen inside the muscle, instead of storing energy as fat molecules inside liver and fat cells. (about 8 min read)
Metabolic tips for using muscles to decrease fat storage:
Move around for 5-15 min after eating so that your muscles will pull glucose out of your bloodstream and stabilize your BGLs.
Skip simple carbs when you’re not moving to keep insulin levels low so that you can actually burn fat when you do start moving.
Add some resistance training to increase your muscles’ ability to burn energy.
Your muscles burn more calories per pound than your other organs. If two people weigh the same, but have different amounts of muscle, the person with more muscle will burn more calories at rest WITHOUT EXTRA EXCERCISE than the person with less muscle. Obviously, you have to put in work to build muscles, but once you have them, muscles offer more buffer against gaining fat because they burn more calories per pound. This is because your muscles can burn energy, store food as glycogen, and can help maintain blood glucose levels (BGLs) without raising insulin levels.
You have probably heard that your muscle tissue is “denser” than your fat tissue. That means a chunk of muscle tissue will weigh more than the same size chuck of fat tissue, because the muscle tissue has more proteins and less stored fat molecules (aka lipids). You know this is true because if you personally went into the kitchen and put a fist-sized serving of cottage cheese on a scale and a fist-sized serving of chicken breast or pork shoulder on a scale, the cottage cheese would weigh less and the meat would weigh more.
Since the meat is denser, it weighs more even though it takes up the same amount of space. (I don’t usually measure cottage cheese by the fistful but not everyone has a scale in the kitchen and can see what 3 oz looks like, whereas everyone has fists that they pick up cottage cheese wi… everyone can visualize how much cottage cheese would fit in their fist…)
Your muscles are built for using energy. Your fat cells are built for storing energy. The structure inside all of your cells that turn stored energy (potential energy) into movement (kinetic energy) is called the mitochondria - if you’ve heard anything about mitochondria, it’s probably that they are “the powerhouse of the cell”. Your muscles’ job is to move, so they have more mitochondria, so you can have more kinetic energy. Your fat tissues’ job is to store energy for later, so fat cells have less mitochondria. More mitochondria = burning more energy.
Your body will store food you eat in two forms: (1) glycogen (aka starch for animal cells) and (2) fat molecules (aka lipids). We actually don’t use the food we eat to power our movement around the time we’re eating; we use the food we ate earlier and stored to power our movement. We use the food we just ate to replace those energy storage supplies. (The exception is when we’re moving fast for a long time; read more about that here). Your body will store food as glycogen first. You can store glycogen in your muscles and liver up to a certain point, and then you store “extra” food you ate as fat.
Having more muscle will help you store energy in your muscles instead of in your fat cells. Here’s where things get fun: when you eat, your muscles are the first line of defense against having high BGLs. Moving around for 5-15 min after a meal will help bring BGLs back down to non-stressful levels and allow you to release less insulin (a growth factor) into the bloodstream. Now, are your muscles using that energy to move during your 5 min stretch break? No. They are breaking down glycogen into glucose to move, and then they are using the glucose they took from the blood to replace the glycogen they just broke down.
More glycogen in your muscles leaves more room for glycogen in your liver. IF, AND ONLY IF, you move around for 5-15 min after you eat, you will first store energy as glycogen in your muscles. If you don’t move, then the glucose in your blood after a meal will get stored as glycogen in the liver, up until a certain point. So to maximize the amount of glucose stored as “not fat”, you want both your muscles and your liver to turn extra blood glucose into glycogen.
More food stored as glycogen means less food stored as fat. Once the liver’s glycogen bin is full, the extra glucose gets stored as fat in the liver. Once the liver’s fat bin is full, the extra glucose gets stored as fat in fat tissue. If your BGLs rose really fast, and your body released a lot of insulin (ie, you ate simple sugars and didn’t move around), then your fat cells will take glucose out of the bloodstream directly and make fat, regardless of what your liver is doing.
To reduce the amount of food we store as fat, we want to increase the amount we store as glycogen - which we can do by moving around for a few min after we eat and by eating foods that don’t cause a fast, dramatic increase in BGLs so that our insulin levels stay low.
You cannot access your energy stores when your insulin levels are high. If you eat and don’t move around, you are relying on just your insulin to bring your BGLs back down to a non-stressful state. If you eat simple carbs that cause a “sugar spike”, you will need to release a lot of insulin to bring your BGLs down, whereas if you eat essential fats and/or fiber and/or protein, you will not cause a “sugar spike” and you will need to release less insulin to bring your BGLs back down to normal.
Since insulin is a growth factor, it tells your body to store more energy and not burn the energy you have stored. Having high insulin levels makes it really easy to make fat and really hard to burn fat; you cannot access your fat reserves to burn for energy until your insulin levels go down.
Keep your glycogen high and your insulin levels low by working your muscles. That’s it. Just move your muscles. You can make the most of your muscles by adding some resistance training (bands, or weights, or moving through water, or wearing a heavy pack and walking uphill, or putting on snowshoes and breaking trail, or turning your bike up to a higher gear, or convincing your partner that you were actually right about that thing from 3 months ago*). Resistance training causes your muscles to make more mitochondria. More mitochondria = burning more energy. So not only can you store more glycogen in muscles when you use them, but you can also burn more energy at rest when you have more mitochondria. Ta da! Now go take a 5 min stretch break.
Metabolic tips for using muscles to decrease fat storage:
Move around for 5-15 min after eating so that your muscles will pull glucose out of your bloodstream and stabilize your BGLs.
Skip simple carbs when you’re not moving to keep insulin levels low so that you can actually burn fat when you do start moving.
Add some resistance training to increase your muscles’ ability to burn energy.
*Sorry, that’s the wrong type of resistance…
Ivy, J.L. et al. (1998). Muscle glycogen storage after different amounts of carbohydrate ingestion. Journal of Applied Physiology.
Christ-Roberts, C.Y. et al. (2004). Exercise training increases glycogen synthase activity and GLUT4 expression but not insulin signaling in overweight nondiabetic and type 2 diabetic subjects. Metabolism.
Reducing simple sugars in your diet has a bigger impact than reducing fat. Here’s why.
TL;DR: The Standard American Diet is NOT a high-fat diet; it is a high-fat, high-sugar diet. Excess fat, without excess sugar, can restore metabolic balance and is not associated with diseases like fatty liver or heart disease. Excess simple carbohydrates, without excess fat, can cause metabolic stress, insulin resistance, and heart disease. (about 10 min read)
Metabolic tips to reduce excess simple sugars in your diet:
“Excess” simple carbs are carbs we eat when we’re not moving (or didn’t recently move). Pair your simple carbs with your movement to reduce stress on your liver and decrease insulin levels.
Get adequate essential fats (like omega-3’s) from nuts/seeds, avocados, and olives to feel full.
Keep your liver happy by staying hydrated, not raising BGLs quickly, and let your liver keep BGLs steady by avoiding simple carbs when you’re not moving.
FIRST OF ALL, we have to admit that much of what we’re told which foods are high in “sugar” and “fat” in our diets is not correct. If you google “sugar vs fat” to try to sort out their effects on your health, you’ll get a bunch of pictures of a donut vs a cheeseburger. A donut is not sugar - it is a MIX of sugar and fat (sugar from the sugar, this one is pretty obvious; and fat from oil or butter). A hamburger is not fat - it is a MIX of fat, sugar, and protein (fat from cheese, mayo, and beef; sugar from the simple carbs in the bun and ketchup; and protein, mostly from the beef.) Reducing “sugar” in your diet does mean just cutting desserts. “High-fat” diets, especially those with saturated fats like animal meats, are usually high-fat AND high-sugar diets since so many things we eat with those “fats” are simple carbohydrates (eg. the buns or beers we eat with the beef).
The “Standard American Diet” is often called a high-fat diet when it is actually a high-fat, high-sugar diet. This creates a lot of confusion when people say that the “high-fat American diet is associated with increased heart disease” because it makes it seem like a high-fat diet causes heart disease. This statement is misleading because: (1) it’s very easy to mistake association for causation. Two things can happen together often - they're associated - but that does not mean that one causes the other. This is a logical mistake we just have to look out for. (2) Calling the Standard American Diet (SAD) a “high-fat diet” implies that it is only high in fat when it is not. This is not a mistake on our part; it is either ignorance by people talking about the diet or marketing by people who don’t want us to focus on the simple carbohydrates found in a lot of processed foods.
The Standard American Diet does cause heart disease. But is it the fat in the diet? Or the excess sugar? Or both together? How do we design a “healthy” diet if we don’t know which dietary component is causing metabolic imbalance, stress, and disease? When we talk about sugar vs fat, we have to look at how sugar and fat are metabolized individually, and then what happens when we eat them together.
It is clear that the combo high-fat, high-sugar diet is causing a lot of metabolic imbalance. Does a low-fat diet restore metabolic balance, if it still has excess simple carbohydrates? Does a low-carb diet restore metabolic balance, even if it is high in fat? We can answer this question by looking at how our bodies break down, or store, fat vs sugar.
Most of the energy you have comes from breaking down fat, not glucose. Your muscles, liver, and fat cells are all involved in breaking down fat for energy, but the different cells will do this in slightly different ways.
Your muscles will break down fat to use for energy themselves; they don’t share ketone bodies with the rest of your cells. Your fat tissue will break down fat to keep you warm (shivering in brown fat) but mostly will communicate with your liver to package up fat and ship it to your liver for further processing. Your liver will burn fat and share the ketone bodies with the rest of your body. Your liver is very involved in controlling whole-body energy levels.
If our energy comes from burning fat, why do we feel tired when our BGLs drop? Welp, like most things in metabolism, the answer is a little more nuanced than just “BGLs are low”. A more accurate answer is that BGLs got low AND YOUR LIVER DIDN’T RAISE THEM BACK UP FAST ENOUGH. Your liver should be putting new glucose into the blood when levels drop. If it doesn’t, it’s because your liver isn’t functioning at its best and it’s having a hard time making glucose to put in the blood (this is one reason why alcohol makes us “hungry” - it inhibits our liver from making + releasing glucose, our BGLs fall, and we can’t bring them back up as fast as our brain wants us to.)
A well-functioning, metabolically balanced liver will put glucose into the blood (by either making new glucose from proteins/other recycled molecules, gluconeogenesis; or by breaking down the animal starch glycogen; glycogenolysis). This will keep your BGLs from dropping and stop us from feeling tired when we don’t eat simple carbs.
Stop being afraid of fat in food. This flies in the face of the “low fat” advice that dominated nutrition and diet advice since the 1980s. And we currently have an obesity epidemic in America (currently, 1 in 3 people have insulin resistance and are considered overweight or obese). So it makes sense that people who have been told to watch their weight by their doctors, and been told to cut fat out of their diet in order to do that, might be afraid of dietary fat. This advice is just wrong, though.
Most of the fat that we store in our bodies comes from carbohydrates that we didn’t need to use for energy. High BGLs are really stressful biochemically and our bodies try very hard to not let BGLs stay high. If we aren’t moving, our pancreas should release insulin that tells our other cells to pull glucose out of our bloodstream to bring our BGLs back down to safe levels. (Type 1 and Type 2 diabetics have to do a lot of work to keep BGLs from getting/staying too high or they’ll end up with damage to their internal organs.) If we aren’t moving or didn’t just move, our cells will store that glucose as fat. (If we are moving/just moved, our muscles will take glucose out of the bloodstream without insulin and store the glucose as glycogen (aka animal starch) or fat*).
If you’re trying to reduce fat stored in your fat cells it’s more effective to cut sugars out of your diet to reduce body fat than it is to cut dietary fat. There are also some essential fats that you NEED to stay alive and you have to get them from your diet (just like you need to eat enough protein to get essential amino acids, or enough produce to get essential vitamins/minerals). And if you aren’t getting enough of an essential nutrient, you’ll continue to feel hungry even if you’ve eaten “enough calories”.
BTW, have you tried to over-eat on a high-fat, low-sugar diet? Foods with fat, or fiber, or fat + fiber together (hello nuts!) make us feel full and it’s hard to overeat them. “SARAH.” you might be saying now. “What are you talking about?? Nuts are so calorie-dense! If I eat more than 1 or 2 servings of nuts in a day - while on a low-sugar diet - SURELY I will be overeating and gain weight from dietary fat!” Try it. You won’t. You will also learn something about the regulation of fat absorption across your gut when your gut is healthy, has enough fiber, & isn’t stressed from too much simple carbs (sugar). Feel free to do this experiment for a week or two and tell me how it goes. ;)
If most of our energy comes from fat, why can it be hard to lose weight that’s stored as fat? Great question. If a person is metabolically balanced and their insulin levels (or other growth factors) are not unnecessarily high, it isn’t that hard to lose fat. Remember that insulin is a growth factor and it’s higher in our blood when we are eating a lot of simple carbs (sugar) but we aren’t moving around. Insulin tells cells to get glucose out of your blood and store it. It also tells your liver not to release glucose - so your liver can’t restore BGLs when they start dropping - and it tells your fat cells not to release fat. Lowering insulin levels and increasing dietary fiber, eating a low-sugar, ketogenic diet, and/or moving around more will help restore metabolic balance and make it easier to lose fat that’s stored in fat cells.
Metabolic tips to reduce excess simple sugars in your diet:
“Excess” simple carbs are carbs we eat when we’re not moving (or didn’t recently move). Pair your simple carbs with your movement to reduce stress on your liver and decrease insulin levels.
Get adequate essential fats (like omega-3’s) from nuts/seeds, avocados, and olives to feel full.
Keep your liver happy by staying hydrated, not raising BGLs quickly, and giving it a chance to practice its job of maintaining BGLs from getting too low by avoiding simple carbs when you’re not moving.
What is the “keto” diet and is it right for you?
An egg inside an avocado wrapped in bacon is a nutritious (albeit ambitious) low-sugar meal that promotes ketogenesis while adding 15g of fiber to your diet.
TL;DR: A ketogenic diet is a low-sugar (and sometimes low-total carb) diet where your body gets energy from burning fat and ketone bodies, instead of burning glucose for energy. Higher ketone levels promote metabolic balance by reducing inflammation and stabilizing blood glucose levels. (about 7 min read)
Metabolic tips for getting the most out of a ketogenic diet:
Really think about your movement goals and adjust protein & total carb intake appropriately.
Still aim for 25g of fiber/day while reducing total carbs to keep BGLs steady and get enough essential vitamins/minerals.
Stay hydrated! Breaking down protein to maintain BGLs will produce a lot of uric acid and will stress your body out (canceling out the benefits of reduced inflammation) if you don’t stay hydrated.
What is the “keto” diet? Keto is short for “ketogenesis”. This is a biochemical pathway that produces ketone bodies from the breakdown of fat for energy. Your cells can use ketone bodies instead of glucose for energy when blood glucose is low.*
Higher blood ketone levels help reduce inflammation and promote metabolic balance by stabilizing blood glucose levels. Ketone bodies, specifically the molecule beta-hydroxybutyrate, will inhibit a protein complex in cells and reduce inflammation by stopping immune cells from overreacting. This has been shown to be really beneficial to everyone in general, but especially useful for people with immune conditions, treatment-resistant epilepsy, systemic inflammation from metabolic disorders (eg. Type 2 Diabetes or gout, amongst others), some types of migraines, and other neurological disorders.
You can maintain steady blood glucose levels without eating simple carbohydrates. Your liver will produce glucose from other molecules (protein and fiber) if your BGLs get too low. You need to eat enough protein and fiber for your liver to do this. Someone could maintain steady BGLs by eating just enough protein alone to allow their liver to do gluconeogenesis, and skipping all carbs completely, if they wanted to. This is called the “ketogenic diet” and it’s often followed by people with immune disorders, who are dealing with treatment-resistant epilepsy or migraines, or who are trying to reverse Type 2 diabetes/pre-diabetes.
How much do you have to reduce total carb intake to maintain ketogenesis? If someone is really following a keto diet with the intention of raising their blood ketone levels as much as possible, they usually do this by limiting all carbohydrates (fiber and sugar) and also keeping their dietary protein levels down, since dietary proteins can also raise BGLs (your liver will use protein to make glucose via gluconeogenesis; you don’t store protein on your body). It’s a real balancing act between getting enough nutrition (essential fats, essential amino acids from protein, essential vitamins/minerals from fruits & vegetables) and what type of movement someone is routinely doing that will determine how much sugar, fiber, or protein someone can eat and maintain ketogenesis.
Anytime your body burns through your glycogen stores and your BGLs start to drop, your liver burns fat and put ketone bodies into the blood. So how many total carbs someone eats will depend on the type of movement they do. The most common advice I’ve seen thrown around is that you need to eat less than 50g, or even as low as 25g, of total carbs in order to maintain ketogenesis. A diet this low in total carbohydrates is probably leaving out fiber (we’d like to be getting 25g of fiber a day) and comes at the cost of moving fast. (I’ll discuss “slow” vs “fast” energy and how they relate to how fast we run/cycle in other posts).
If you’re new to a “keto” diet, it may take a few weeks for your liver to switch biochemical programs and start producing a measurable amount of ketone bodies. However, once you’re there, whether or not you maintain ketogenesis depends on what else you’re doing. I ate 100-150g of carbs/day while training for a half-marathon and maintained ketogenesis (2-5x more than “internet experts” said was possible! I measured them to answer this question for a friend). So really, the total carbs someone can eat depends on what type of movement they’re doing.
You need to drink more water when maintaining ketogenesis. Because your liver is now breaking down proteins to maintain stable BGLs, you will make more uric acid. Uric acid will cause inflammation if it builds up in a tissue (gout) and can damage your kidneys. You need to drink more water so you pee the uric acid out, or you’ll undo the positive effects of the ketone bodies with the negative effects of the uric acid.
Is the ketogenic (keto) diet right for you? That depends on other factors, like some hormone stuff, if you do endurance athletic stuff, and if you have a condition where you really want to limit inflammation. The trade-off with a keto diet (that lacks fiber) is that you do maintain steady BGLs and reduce inflammation, but you also make it easier to miss out on some essential vitamins/minerals that are found in fruits and vegetables.
A no-fiber keto diet will also lower the diversity of your gut microbiome (this is still being studied, so we know the gut microbiome changes but we don’t understand too many details right now). This can have long-term health implications, or not. More research on the gut microbes and the keto diet is needed. The changes in the gut microbes may make things wacky if/when you do introduce carbs back into your diet, especially if you make a drastic dietary change and you add a lot of simple carbs back at once.
Can you have the best of both worlds by eating fiber AND maintaining ketogenesis? Yes. Yes, you can. (Some people using keto diets to deal with medical conditions may still want to keep total carbs as low as possible if it’s more helpful for their condition than getting the full 25g of fiber would be.)
Fiber (a complex, “slow” carb) is treated differently by your body than simple carbs. A fast influx of simple carbs (sugar) will cause your liver to stop doing ketogenesis and start dealing with the sugar. However, a slow or minimal rise in BGLs won’t cause your liver to switch. Adding foods to your diet that are high in fiber but low in “other carbs” can allow your body to maintain high ketone levels while also getting extra vitamins/minerals from those high-fiber, low-sugar foods and help your gut maintain a healthy & diverse microbiome. Again, what a “minimal” rise in BGLs is for you is going to be determined by the type of movement you routinely do.
Foods* like avocadoes (15g fiber + 5g simple carbs for medium avocado), raspberries (8g fiber + 7g simple carbs in 1 cup raspberries), flax seeds (3g fiber +0g simple carbs in 1 tbsp flax seeds, cauliflower (2.5g fiber + 3g simple carbs in 1 cup cauliflower), or cabbage (2g fiber + 3g simple carbs in 1 cup of cabbage) are great options for people looking to keep their simple carb intake low without missing on vitamins/minerals or gut health.
Metabolic tips for getting the most out of a ketogenic diet:
Really think about your movement goals and adjust protein & total carb intake appropriately.
Still aim for 25g of fiber/day while reducing total carbs to keep BGLs steady and get enough essential vitamins/minerals.
Stay hydrated! Breaking down protein to maintain BGLs will produce a lot of uric acid and will stress your body out (canceling out the benefits of reduced inflammation) if you don’t stay hydrated.
Youm, Y.H., et al. (2015) The ketone metabolite beta-hydroxybutyrate blocks NLRP3 inflammasome-mediated inflammatory disease.
Richards, J.L., et al. (2016) Dietary metabolites and the gut microbiota: an alternative approach to control inflammatory and autoimmune diseases. Clinical and Translational Immunology.
*Type 1 Diabetics also have to make sure that their liver isn’t tricked into producing too many ketone bodies because will lower their blood pH and lead to ketoacidosis, a very serious condition. This occurs when there is too little insulin in the body, and doesn’t usually happen to non-Type 1 Diabetics even if they eat a low-sugar or ketogenic diet. This is because other foods, including protein and alcohol, will cause the pancreas to release some insulin. As long as some insulin is released, non-Type 1 Diabetics will avoid ketoacidosis.
**I put together a reference guide of foods that are good sources. It lists the serving size, the grams of fiber, and the grams of “other carbs” so you can make choices that fit your lifestyle and taste preferences. The guide also includes a comparison of some common snacks vs healthier alternatives. Like, Honey Nut Cheerios is the most common breakfast cereal and has 3g of fiber + 12g of added sugar. This can be switched out for cinnamon-vanilla Kashi Go which has 7g of fiber and 0g of added sugar. Boom. You’re already over a quarter of the way to your 25g of fiber/day. Sign up for the newsletter to get the “fiber guide”.
What are “carbs” and why is it so important to differentiate between “sugar” and “fiber”?
Choose whole grain breads where you can “see the seeds”.
TL;DR: Fiber (a large, “slow” carbohydrate) and sugar (a simple, “fast” carbohydrate) are treated very differently by our bodies. Fiber helps reduce inflammation in our guts, while sugar helps provide energy during endurance exercise if we are moving faster than we can burn fat or make new glucose molecules in the liver. Eating sugar when we’re not moving leads to storing more fat on our bodies. (about 8.5 min read)
Metabolic tips for dealing with fiber vs sugar:
Time your carbs with your movement - eat simple carbs when you’re moving so the sugar molecules get taken up by your muscles and not your fat cells.
Get a minimum of 25g of fiber to help your liver maintain blood glucose levels when they start to fall (via glycogenolysis)
Eat enough protein to help your liver maintain blood glucose levels when they start to fall (via gluconeogenesis)
Fiber has been getting a facelift recently. Not sure what I mean? Have you heard of “slow carbs” for athletes? Or “pre-biotics” for people who are trying to balance their gut microbiome to reduce bloating and irritation? Both of those are terms for fiber. I guess people really hate what they think “fiber” is, if there are two whole groups of marketers coming up with new words for it. Fiber is just a large carb.
First of all, we need to define what a “carb” is. Carb is short for “carbohydrate”. Chemists give the name “carbohydrate” to any molecule that has a carbon atom with a water molecule attached to it - the carbon is hydrated, carbohydrate.
Chemists are mostly concerned with the atoms that make up a molecule (here, carbon, oxygen, hydrogen) and how those molecules will react in different situations in a lab (chemists are a group of people who - no shade - don’t think about eating snacks all day so they’re less fun*). So for chemists, “carbohydrate” is descriptive enough and there’s no reason to distinguish between fiber (larger carbs, aka slow carbs) and sugar (simple carbs, aka fast carbs).
Biochemists are people who think about how molecules will react in our bodies. You may be “experimenting” with something in your life, but your body is still not a lab. The way that molecules behave inside your body is going to be determined by some rules of biology; for instance, the temperature that chemical reactions happen at inside your body is more or less constant. In a lab, you can light things on fire to catalyze a reaction (make two molecules interact or break down in some way). In your body, all of your chemical reactions (aka your “metabolism”) are going to happen at ~98°F (37°C). Even if you are a smoke show. Instead of extreme heat, your body uses proteins to move molecules and catalyze reactions.
Enzymes are what physically turn your food into your energy. Enzymes are proteins that carry out chemical reactions in your body. The reason why biochemists differentiate between fiber (large carbs) and sugar (simple carbs) is because different enzymes are responsible for breaking these molecules down. The different ways that fiber and sugar are processed by enzymes in your body has profound effects on your health.
“Slow” carbs vs. “fast” carbs: If you heard these terms before, congrats on being friends with an exercise physiologist. If you haven’t heard these terms and are about to start doing some endurance athlete stuff, then you will hear them and I want to get credit for telling you first.
“Slow” vs “fast” carbs is referring to how quickly different types of carbohydrates will get broken down so they can be moved from your guts into your bloodstream, and therefore, how fast they will raise your blood glucose levels (BGLs).
Fiber needs to be broken down into smaller pieces before it can be absorbed into your bloodstream, so it raises your BGLs slowly - it’s a “slow” carb. Simple carbs (sugar) do not need to be broken down before they can be absorbed (or, there’s only 1 chemical reaction that has to happen and it happens quickly, like in the case of sucrose and maltodextrin†). Simple carbs (sugars) raise your BGLs quickly - they are “fast” carbs.
When do you need to eat “fast carbs”? You need “fast carbs” (aka sugar) when you are running or cycling faster than your body can make new glucose molecules. This only happens when you’ve burned through your glycogen (animal starch stored in your liver and muscles) and you’re moving faster than your mitochondria can burn fat for energy.
Burning fat is also sometimes called “slow energy” but that is not because breaking fat down for energy is slow. It’s because breathing fast enough to get oxygen to all of your muscle cells has become slower than the rate at which your muscles using energy, and now your muscle cells have to find a way to make energy that doesn’t rely on using oxygen (which burning fat does). This is why a lot of professional cyclists and endurance runners are concerned about their hematocrit levels - it’s a way to measure how fast oxygen can get to their muscles so they can produce more energy, faster. And it’s also why those people eat Gu’s. I’ll talk more about this later.
But don’t you need to eat glucose to maintain your blood glucose levels? No. Your liver will produce glucose from other molecules (protein and fiber you broke down earlier) if your BGLs start getting low. Your liver makes glucose by breaking down glycogen (glycogenolysis) and making new glucose (gluconeogenesis). You do need to eat enough protein and fiber for your liver to do this.
Someone could maintain steady BGLs by eating enough protein alone and skipping all carbs (fiber included) completely if they wanted to. This is called the “ketogenic diet”** and it’s often followed by people with immune disorders or who are dealing with treatment-resistant epilepsy or migraines. Is the ketogenic (keto) diet right for you? I discuss that here, along with how adding fiber to your diet isn’t really at odds with maintaining ketogenesis.
This is what we mean when we say “time your carbs with your movement”. If you eat simple carbs (sugar) when you aren’t moving, your BGLs will raise quickly and your body will secrete a bunch of insulin to bring your BGLs back down to a safe and healthy level. If you aren’t moving or didn’t recently finish moving, your body will most likely store those simple carbs as fat. Eat carbohydrates when you know you’ll be moving so that you don’t store those sugars as excess fat.
Eating simple carbs (sugar) leads to more fat storage than eating fat. Excess dietary sugar leads to more fat accumulation than dietary fat and it also (eventually) leads to changes in your liver that raise your blood cholesterol levels more than dietary cholesterol. Processing dietary fat and cholesterol is a WHOLE THING that deserves its own discussion, so I will be discussing this in more detail in later posts. For now, if you are getting enough fiber and you are not eating simple carbs (aka sugar) that aren’t paired with movement, you don’t need to worry about how much fat you’re eating as long as you aren’t routinely over-eating.
ANYWAY. Stop saying “carbs” and start seeing fiber and sugar as different molecules. Your body sees them as different molecules. And you should too. Fiber is helping your gut stay healthy. Sugar is used in your body as a way to quickly transport a molecule that can be broken down into energy through your blood because it’s water-soluble and so it can be easily transported to different organs quickly. You do not need sugar in your diet to maintain steady BGLs (unless you’re doing some endurance athletics stuff) and you don’t have to avoid “carbs” when you’re trying to maintain steady BGLs or increase ketogenesis** if those carbs are fiber.
Metabolic tips for dealing with fiber vs sugar:
Time your carbs with your movement - eat simple carbs to support endurance athlete stuff
Get a minimum of 25g of fiber to help your liver maintain blood glucose levels when they start to fall (via glycogenolysis)
Eat enough protein to help your liver maintain blood glucose levels when they start to fall (via gluconeogenesis)
*Some chemists are actually fun (Hi, Mya and Lisa). Biologists who study microbes helped us understand how to better ferment things, aka biologists figured out beer, wine, cheese, and rising bread. The famous (or infamous) physicist Dr. Richard Feynman said that biologists were his favorite scientists to hang out with because all they do is talk about snacks and sex (genetics). But to their credit, chemists helped us understand how to better distill things and favor certain chemical reactions over others, aka chemists figured out liquor and new cooking techniques.
A lot scientists will tell you not to hang out with a chemist who can’t cook bc its’ a tip-off that either they aren’t a good chemist (cooking is just doing the right chemical reactions in the right order) or they aren’t a fun chemist (cooking does take practice and ppl tend to be bad at things if they don’t practice doing them).
**Ketogenesis is the production of ketone bodies from the breakdown of fats. Increased ketone bodies in the blood, especially the molecule B-hydroxybutyrate (BHB), is associated with a more balanced metabolism and lower inflammation. This is because BHB inhibits a protein complex inside immune cells and stops them from overreacting. Read more about it here!
†Sucrose is the chemical name for table sugar.
For my nerds, sucrose a dimer of glucose and fructose (both monomers). Sucrose is very similar to High Fructose Corn Syrup (the most common HFCS is a mix of ~55% glc and 45% fru) and they have the same effect on your body. Maltose is a dimer of two glucoses, and maltodextrin is multiple glucoses together, but with a different bond than fiber. Maltose and maltodextrin all get broken down so quickly that they have basically the same effect on your metabolism as eating pure glucose.
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