Tag: Nutrition

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The 411 on the Microbiome

There is an evolutionary theory suggesting the first living cells on the planet needed a place to reside in for protection. So, they created humans to be their safe haven. While I don’t believe this 100%, I do find it captivating to consider.

I love telling my patients that we are more microbial than human. Because we have more bacteria cells than actual human cells. To say that the microbiome is important is an understatement. The more science reveals correlations between microbiome composition and disease, the more it validates that cliché Hippocrates’s quote:

“All disease begins in the gut.”

What is the microbiome?

The term microbiome refers to the world of trillions of bacteria (among other creatures) that inhabit our bodies. The microbiome is as individualized as a fingerprint – unique to you. The bacteria predominantly reside in your colon (AKA large intestine). However, there was a time that you did not have a microbiome; you were a clean slate.

For one thing, back when you were a fetus in mom’s belly, you were germ-free. Everything changed the moment you entered the world. As you left your mom’s body, you received your first dose of bacteria. This single moment determined the foundation of your microbiome. If you were a vaginal birth, the bacteria in the vaginal canal inoculated your little face. If you were a c-section, you likely collected hospital-acquired bacteria.

Babies that are born c-section have a higher risk of developing a multitude of medical conditions (including asthma and obesity). Indeed this is due to missing the first dose of germs from the vaginal canal. Don’t be alarmed if you were born c-section, though. It is necessary to keep in mind your mode of delivery so you can take preventative actions.

The next determinant that developed your microbiome is breastmilk. Breastmilk contains a prebiotic called human milk oligosaccharide (HMO). Evidently this prebiotic fiber feeds your infant microbiota so they may flourish and grow as you do. Again, don’t be too distressed if you were not breastfed – this was not in your control (as you were only an infant). And most baby formulas contain the HMO prebiotic. However, some studies show that breastfed vs. formula-fed humans have different microbiomes.

Probiotics vs. Prebiotics

You may have a bottle of probiotics in your supplement cabinet. You may have heard probiotics improve gut health – this is true. Probiotics are beneficial bacteria that can help build a healthy microbiome. But probiotics aren’t only found in tiny capsules. You can get probiotics from food too. Anything fermented (even wine) will contain beneficial bacteria.

Dietary probiotics:

  • Yogurt
  • Kefir
  • Kimchi
  • Tempeh
  • Sauerkraut
  • Kombucha
  • Sourdough bread
  • Pickles

You can even find a type of probiotic called soil-based organisms (SBOs) on your garden vegetables. If you have a dog, this is another way to obtain SBOs. (I’ve heard of a doctor that recommends his patients get a dog – not only are dogs a great companion, but dog owners have been shown to have healthier microbiomes).

Probiotics supplements alone won’t drastically change your health, especially if you depend on the little capsule to act as a magic pill. Taking a probiotic supplement is like adding one cup of water to a bathtub each day.

Probiotics are only half the gut health equation. These guys are alive and need fuel to reproduce and proliferate (which is the primary driver of any life-form with DNA: to reproduce and proliferate).

The other half of the equation are prebiotics. You can think of prebiotics as the food for the probiotics. Prebiotics are a type of fiber that can be fermented by the microbiota. Fiber is found in every plant food: vegetables, fruits, beans, nuts, and seeds. There are different types of fiber that I will not bore you with. Just know that fiber is essential because it feeds your bacteria.

Humans are missing an enzyme to breakdown fiber. This results in an undigested food mass traveling through the small intestine to the large intestine (where food remains for 2-3 days before it is excreted while you sit on your throne.) Once fiber meets the bacteria in the colon, the feasting begins—bacteria breakdown and ferment the fiber. Bacteria create healthful byproducts during this fermentation/feasting process. It’s a symbiotic relationship – we feed them, and they make short-chain fatty acids (among other things) that feed our intestinal cells.

Dietary Prebiotics

  • Banana (the greener the better)
  • Oatmeal (ditch the instant oats)
  • Onions
  • Garlic
  • Leeks
  • Strawberries
  • Asparagus
  • Jerusalem artichoke
  • Apple

Particularly, prebiotic fibers will best promote a healthy microbiome; though, all plant foods are beneficial. Next time you cook a meal, remember that you are eating for “two”.

There is a Tanzanian tribe that eats 100-150 grams of fiber per day. Gastrointestinal diseases and obesity are practically nonexistent there. It is believed to do with their high fiber diet creating a diverse microbiome.

What happens when you don’t eat fiber?

Things can go very wrong if we don’t feed our bacteria. Exhibit A: The United States of America (obesity rates >30%). The majority of Americans aren’t eating enough fiber. The current fiber intake recommendation is 28-38 grams per day. Most people are only eating about 15 grams. Is it possible that the rise in obesity and other health problems is partly due to the havoc going on in the microbiome?

Technically the hallowed part of your colon is “outside” of your body. Our incredible body has developed a layer of protection from the outside world, called the mucosa membrane. This mucous membrane is crucial for gastrointestinal and immune health.

One of my favorite images!
Blue: intestinal cells
Green: mucous membrane
Pink, yellow, orange: bacteria

A diet low in fiber can result in a decreased protective layer. If you don’t feed your bugs, they will feast on what’s there: your mucous membrane. Studies have found that a low fiber diet will result in an eroded mucus later, resulting in our intestinal cells being exposed to the “outside” environment of the microbiome. If there are harmful bacteria present and no mucus barrier, things can go wrong…

A 2016 study on mice
A dietary fiber-deprived gut microbiota degrades the colonic mucus barrier and enhances pathogen susceptibility.

Besides an eroded mucus barrier, dysbiosis can occur. Dysbiosis is the term used to describe an imbalanced microbiome (more bad bacteria than good bacteria). There is an extensive list of conditions associated with dysbiosis.

Dysbiosis Associated Conditions:

Autoimmune disease
Bacterial vaginosis (BV)
Bloating
Celiac/gluten sensitivity
Chronic fatigue syndrome (CFS)
Depression
Diabetes
Food allergies and sensitivities
Food cravings
Inflammatory bowel disease (IBD)
Irritable bowel syndrome (IBS)
Leaky gut (AKA intestinal permeability)
Multiple sclerosis
Obesity
Parasites
Sinitis
Skin conditions (acne, rosacea, eczema)
Small intestinal bacterial overgrowth (SIBO)
Thyroid disease
Weight gain
Yeast infection
Yeast overgrowth

Dietary habits that can cause dysbiosis:

  • A low-fiber diet
  • Excess, refined sugar
  • Artificial sweeteners (especially aspartame found in diet coke)
  • Hydrogenated and trans fat
  • High-protein (animal products) diet
  • Highly processed food

Other factors that can negatively impact your microbiome:

  • Alcohol
  • Antibiotic use (especially frequent antibiotic use)
  • Inadequate sleep
  • Stress
  • Other medications (NSAIDs, PPIs, opioids)

Steps to start nourishing your microbiome

  1. Increase your fiber intake to 28-38 grams daily (and be sure to increase water as you increase fiber) – Tips to increase fiber here.
  2. Eat dietary probiotics – Or trial a probiotic supplement (but make sure you are still eating prebiotic fibers!)
  3. Get enough sleep each night (7-9 hours)
  4. Manage stress through breathwork, prayer/meditation, or journaling
  5. Avoid eating late at night and consider a Circadian Cycle Fast (eating window sunrise to sunset)

A fiber-rich diet feeds the good gut bacteria. When we feed these beneficial bacteria, they produce short-chain fatty acids that provide energy for our intestinal cells. Our nourished intestinal cells make mucous adding on to the barrier. It is a wonderful process.

Eat Fiber -> fiber feeds gut bacteria -> bacteria make short-chain fatty acids (SCFA) -> SCFA nourish the intestinal cells -> intestinal cells produce mucous -> mucous membrane protects our intestinal cells -> healthy gut 🙂

Remember that you are not alone. You have trillions of little organisms that do a lot of good for you. You are always eating for two.

If you want to learn more, I recommend reading The Good Gut – check it out my book list!

Need a gut health starter recommendation? Trial a one-month gut health starter with a nourishing prebiotic and high quality probiotic: Here.

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A Message to the Body Shamers

A message to the body-shamers out there (including healthcare professionals, family, friends, and strangers):

Hi, I’m Tatiana. I’m your [patient/child/friend/spouse]’s dietitian. My patient has told me about you and your comments during our appointment. They expressed feelings of hurt, shame, and embarrassment about their weight due to your remark. I understand that you are trying to help, perhaps even motivate them. I must inform you that body-shaming does all harm and no good. Weight loss is NOT easy. Healthy, permanent weight loss is an enormous obstacle, especially when my patient struggles with body image (which is 90% of my patients). 

To The Healthcare Professional: 

My patient was told to lose weight at your medical clinic (likely because their BMI was over 30). The patient brought back the already-known information to our nutrition session. “The doctor said I need to lose weight. I should reduce calories and exercise more.” 

But what you didn’t know was my patient is in the process of making healthful lifestyle changes. She/He was too embarrassed to tell you that they are already trying to lose weight.

To my fellow healthcare worker, I ask you to change your approach. Before you preach the ineffective calorie-in/calorie-out method for weight loss, ASK your patient what lifestyle changes they have already made. You don’t even need to bring up their weight. They may ask you for some additional advice, sensing a safe, open environment. If you don’t have time to discuss weight loss, ask if they have ever met with a dietitian. If not, write a referral. If yes, don’t worry, they are likely in good hands. 

To The Parents:

Never ever, ever use the F-word (fat) in front of your child. Don’t even use that word to describe yourself or another person. You may think it’s helpful to remind them about their weight and health, but it does not motivate them whatsoever. In fact, it hinders their progress in practicing positive body image. Did you know that positive body image is associated with weight loss? Probably not because we live in a shame-filled society. The least you could do as a parent is avoid adding to that shame. 

You play a role in my patient’s success. Words are powerful, and body-shaming is dangerous. I discuss this reality with them during our sessions together, in a safe, non-judgemental environment. Please, do your best to create this same environment at home. Be encouraging and tell them the positive truth: Your daughter/son is enough just the way they are. 

To The Stranger:

Take a moment to think about the pain and hurt you have experienced in your life. If you deny hurt/sadness, then you may be a psychopath or have alexithymia: unable to feel emotions. You are NOT the only one who experiences terrible days. Every person you come in contact with is struggling with something (relationship problems, insecurity, etc.).

I would think that judging my patient would be the last thing on your mind. However, sometimes you forget the reality of life struggles and embarrass my patient. Perhaps you assumed that my patient doesn’t care about their health or weight, which was exposed by your body language and dirty look. You looked at the items in their grocery cart in a disapproving manner. You avoided looking at them in the eye, pretending they weren’t there. 

I ask you to treat every person you meet with kindness, no matter their shape or size. Make eye contact and smile. Acknowledge their existence! You do not know what they are going through. Your smile could ignite my patient’s will to continue the process of gaining health.

To The Friend:

The type of relationship you have with my patient is crucial to their success. I hope you have an honest, real relationship. I hope he/she can come to you for comfort and reassurance. If you are comfortable, allow my patient to talk honestly about their body image struggles. Let them excitedly share their progress on making healthful lifestyle changes. Please, avoid talking about fad diets and losing 10 lbs in a week. The diet mentality doesn’t work. Fad-dieting doesn’t work. Calling yourself fat doesn’t work. Buying into the billion-dollar weight loss industry is just helping the enemy. 

To The Intentional Body Shamers:

I can see right through you without even looking at you. There’s insecurity that lives deep within you. I highly recommend looking at yourself before you cast any stones at my patient. My patient has been fixing the damage you’ve done during our sessions together. 

To Everyone:

We live in a sick, diet-culture. Working closely with weight loss patients has opened my eyes to the psychological component of losing weight. 

From Psychology Today: “80% of U.S. women don’t like the way they look, 50% attribute it to weight, and 34% of men are equally dissatisfied with themselves.” 

Body-shaming is cruel and cheap. Your words have deeply affected my patient. You have created more obstacles on their health journey to lose weight. Do your part in making the world a better place by not giving in to the insecure, weak world we live in.

Question the diet culture. Try practicing a positive body image and self-love yourself. 

To My Patient:

I’m so sorry that you have experienced body-shaming from family, friends, and strangers. This is not your fault. I know you care about your health; After all, you’ve sought my help. I have hope that you will succeed in making healthful lifestyle changes so that you may return to a natural weight. Do your best to question the diet culture and to loosen the tight chains around your mind. You are worthy now. Love your body now. It’s a true statement that your body has brought you this far in life, so be grateful. Shifting your perspective is key. You can love your body AND make lifestyle changes at the same time. Respect yourself. And always remember the things you CAN control. You may not be able to control the body-shamers. But you can control how you respond. Forgive and remind yourself how far you’ve come. 

Body Kindness

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The 411 on Intermittent Fasting

Intermittent fasting has become quite popular over the last three years. I was skeptical at first being a dietitian and whatnot. Long story short, after understanding the science, it all made sense. Frequent meals (4+ meals) and a prolonged eating window (13+ hours) do not promote longevity. 

Fasting is merely abstaining from food; do not get it confused with “starving.” Entering into the starvation state usually happens after five days of fasting. Yet, fasting for 16 hours can be daunting for many people. 

Back in the day, a human’s main concern was finding food. Access to food is no longer a problem in our society. We have pantries, refrigerators, and freezers to store food. We have grocery stores and food delivery services. At the touch of a button, I can have Chipotle delivered to my house within 30 minutes. We don’t have to hunt for our food anymore, and we rarely experience famine, the extreme scarcity of food.

With easy access to food, most people are over-nourished nowadays. The frequent meals, prolonged eating window, and excess protein keep the body in a growth state. Ask yourself, are you “growing” right now?

In addition, people have become carbohydrate dependent. The human body prefers to burn carbohydrates because it’s quick and easy energy. However, when one becomes “dependent” on carbohydrates, the body has a difficult time transitioning to the fat-burning state. 

Imagine a fire pit. Carbs are like paper – quick and easy to burn. Fat is like a log – it takes some time to start burning, but when it does catch fire, it provides a lot of energy. 

The reason why humans have body fat is for times of famine, which is something we don’t experience anymore. Fat is simply stored energy.

Being able to switch from burning carbs to fat is called metabolic flexibility. Metabolic flexibility is especially important for endurance athletes. What fuel source do you think you are using during a marathon? Fat. You run out of carbohydrate stores (glycogen) after about 2 hours of exercise.  

If you cannot go 2 hours without a snack, or have intense sugar cravings, this may be a sign of carbohydrate dependency.

Why Fast?

There are plenty of health reasons to practice intermittent fasting. 

Here are my top 6 reasons to fast:

  1. Metabolic flexibility 
  2. Increase insulin sensitivity 
  3. Decrease body fat or maintain weight 
  4. Longevity (live longer by decreasing risk of disease) 
  5. Give your digestive system a break 
  6. Mental clarity 

Due to limited research, I will not include the disease states fasting may improve. However, I am not ruling out the benefit of fasting as an eventual treatment for diabetes, cardiovascular disease, cancer, and autoimmune diseases. The scientific-evidence is coming, don’t worry.

What happens in our bodies when we fast?

About 12 hours after your last meal, your body begins entering the fasted state. At this point, your glycogen stores are depleted. (Remember, glycogen is stored carbohydrate.) Because your body needs energy at all times to function, it begins to breakdown body fat for energy. Several other physiological responses occur:

  • Lipolysis – Fat breakdown for energy
  • Autophagy – The recycling of cells (the breakdown of old cells so your body can regenerate newer cells). Autophagy promotes longevity. 
  • Low fasting insulin – Increases insulin sensitivity and promotes the breakdown of fat.  
  • Ketones – An energy source when glucose is low – Ketones may play a part in the increase of mental clarity experienced during the fasted state.
  • Stem cell production – This occurs during longer fasts (5+ days). Stem cells are unique cells that can develop into many different cell types. In some cases, they can also fix damaged tissues.

Electrolyte excretion also occurs while fasting. It is important to replenish your electrolytes with meals/drinks. Specifically sodium, potassium, and magnesium.

Popular ways to intermittent fast:

The following are listed in order of popularity. Most studies on intermittent fasting utilize the Alternate Day Fasting method.

  • Time-restricted eating – A prolonged overnight fast lasting anywhere from 13-18 hours. 
    • Leangains method 16/8 or 18/6 – Fasting for 16 hours with an 8-hour eating window. Example: 11 am to 7 pm eating window.
    • Early time-restricted eating consists of an earlier eating window. Example: 8 am to 4 pm eating window.
    • Circadian Cycle Fast – The eating window lasts from sunrise to sunset. After sunset, the overnight fast begins. It mirrors the day/night cycle, AKA circadian rhythm. 
  • One meal a day (OMAD) – Fasting for the majority of the day, to eat one meal. OMAD tends to be a 22-hour fast with a 2-hour eating window. 
  • Full-day fast (usually done once a week) – Fasting for a full day can equate to 36+ hours. For example, you consume your last meal on Sunday evening (7 pm) and break the fast on Tuesday morning (7 am). 
  • Alternate Day Fasting (full-day fast every other day) – The 5:2 falls under this type. Fasting occurs two days of the week. Some practice a low-calorie diet (less than 500 calories) instead of completely fasting.
  • Fasting Mimicking Diet (A 5-day low calorie, low protein diet which tricks your body into thinking it’s fasting despite eating) – You can purchase this program at https://prolonfmd.com
  • Prolonged Fast (4+ days) – An advanced form of fasting in which no food is consumed for more than 4-5 days. 

There is no “best” type of intermittent fasting – it’s ultimately up to you and your lifestyle. Things you want to consider are your daily schedule, social life, and health goals. You can follow one regimen, or you can incorporate a mixture of all of them. 

How to Start Intermittent Fasting for the Newbie: 

1. Trial a 12 hour overnight fast. Finish dinner by 7 pm and eat breakfast no earlier than 7 am. Follow this 12/12 plan for a week or two.  

2. Shorten your eating window by an hour. Bring breakfast up to 8 am or finish dinner by 6 pm. This step is when you start to personalize your fasting regimen to fit your lifestyle. You may stop here if you are comfortable. 

3. If you find a 12-14 hour overnight fast easy, you can attempt a longer fast. Experiment with different eating windows (9 am-5 pm, 10 am-6 pm, 11 am-7 pm) – Customize to your lifestyle and schedule. 

Most people adopt intermittent fasting as a lifestyle. The main downside to intermittent fasting is the difficulty of starting, especially if you’ve been a snacker/grazer or if you like to eat late at night. Keep this in mind if you are a newbie. The hunger pangs can be extreme in the beginning. Allow yourself 2-4 weeks to fully adjust to your intermittent fasting regimen before you write it off.  

Is Longer Better?

If you are trying to lose weight, a longer fast will keep you in the fat-burning state. A 16-hour and 20-hour fast differ by spending an extra 4-hours in the fasted state, primarily using fat for fuel. 

If your goals include longevity, longer is also better. Stem cell production occurs on the fifth day of a water-only fast or FMD. This regimen is not recommended for a newbie faster, but it can be something to consider down the road. 

What’s allowed during a fast?

  • Water
  • Sparkling water (without sweetener or sugar alternatives). I recommend La Croix. 
  • Black coffee
  • Plain tea 
  • Salt or electrolytes (without sweetener or sugar alternatives)

Water is extremely important when you are fasting. If you find that you are experiencing headaches while fasting, try drinking more water with added electrolytes.

Can you eat whatever you want during the eating window?

Intermittent fasting’s focus is not on WHAT to eat, rather WHEN to eat. The primary reason for fasting is entering into the fasted state. With that being said, most people do eat whatever they want during their eating window. However, it’s essential to clarify your goals of fasting. I would argue that refeeding is just as important as fasting.

It’s crucial to replenish the nutrients lost during the fast. Also, choosing foods that nourish your body will be beneficial for longterm health. If fasting is an excuse for you to binge on nutrient-poor foods (low fiber, processed), you may be causing more harm than good. 

Fasted Exercise

The safety and efficacy of exercising in the fasted state is ultimately dependent on the type of workout you are doing. Reflect on your current lifestyle, including your exercise regimen and goals, before choosing a fasting method. 

  • Lose weight: Beneficial to exercise in the fasted-state (low-moderate intensity such as walking or jogging)
  • Endurance: Beneficial to exercise in the fasted-state 
  • Build mass: Safe to weightlift in the fasted-state; however, you may feel weaker. Human growth hormone is significantly increased during the fasted state. Refeeding is critical to repairing muscles after weight lifting in the fasted state. 
  • Strength/Speed: Not beneficial to exercise during the fasted-state as you will need your glycogen stores filled for explosive workouts. 

People who should not fast (more than 12 hours):

  • children
  • pregnant/lactating women
  • type 2 diabetics on insulin (MUST be medically supervised and working with endocrinologist)
  • those with an eating disorder
  • low BMI (<18)
  • gallbladder disease

Overall, fasting is a safe practice to incorporate into your healthy lifestyle. It is not for everyone, so keep that in mind. Also, more research is needed to categorize intermittent fasting as a treatment method.

If you would like medical supervision as you integrate intermittent fasting, feel free to make an appointment with me, or any dietitian specializing in longevity nutrition.

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5 Nutrition Guidelines for Increasing Health Span

Would you rather increase your lifespan (the number of years alive and breathing) or “health-span” (the number of years free from disease)? Imagine yourself at age 80. You’re dancing and laughing with your great-grandkids. You remember all of their names. You can still do daily activities of living, like brushing your teeth, showering, and getting dressed. Doesn’t that sound nice: to be free from diseases of aging?  The topic of anti-aging isn’t new, but it has been picking up speed in recent years. I’ve indulged myself in reading the nutrition research on slowing down the aging process. If you want to be dancing around a living room full of loved ones at age 80, you’re reading the right article. There are a few lifestyle behavior changes that can increase health-span, one being nutrition. Here are 5 nutrition guidelines for increasing health-span.

Timing of Meals

At this moment, the timing of meals is the most important piece of nutrition/health advice I can give. When to eat is almost as important as what to eat. According to an ongoing study by Dr. Satchin Panda, the average eating window is 15 hours. This is more than half of the day spent eating, digesting and metabolizing food. Every time we eat, our body produces enzymes and hormones necessary for digestion and metabolism. Unfortunately, our body isn’t meant to be metabolizing food for more than 12 hours. Also, as it gets dark outside, our body starts preparing for sleep and digesting food is no longer a priority. 

Intermittent fasting has become a popular topic of discussion over the last few years. Many public figures and intellectuals, such as Joe Rogan, Dr. Rhonda Patrick, Dr. Jason Fung, and Dr. Valter Longo are talking about it. 

Time-restricted eating, a form of intermittent fasting, has been a practice and recommendation of mine over the last year. Time-restricted eating is a daily practice in which a person abstains from eating for at least 12 hours each day. For example, a 12 hour overnight fast can last from 7pm to 7am the following morning. This is the first regimen to adapt if you want to start intermittent fasting. If you are trying to lose weight or increase healthspan, I recommend increasing the fasting period to 14, 16 or 18 hours. I personally fast from 8pm to 12pm for a total of 16 hours of fasting. Occasionally, I’ll eat a little earlier, but I always remain within the 12-hour eating window.  

After about 12 hours of fasting, glycogen stores become depleted (glycogen is stored carbohydrate found in the liver and muscle). After glycogen stores are gone, our body must make new glucose (gluconeogenesis). Fat is the next source of energy for breakdown (a process called lipolysis). 

Fasting is beneficial for overall health because it results in lower fat mass, increased insulin sensitivity, and unnoticeable caloric restriction. Caloric restriction has been found to increase lifespan in many organisms.

Guideline #1: Practice time-restricted eating. Eat all meals within a 12-hour period. If you are trying to lose weight, increase your fasting window by 2-6 hours for a total of 14-18 hours of fasting daily. 

Increase Fruit and Vegetable Consumption  

The first recommendation I usually make when consulting with a patient is consuming more fruits and vegetables. Fruits and vegetables provide fiber, vitamins, minerals, and phytochemicals. Many diets tend to focus on restriction, which is not effective in creating a healthful relationship with food. Rather than restricting, think of what you can ADD to your diet (wink, wink: fruits and vegetables). Adding 5 servings of fruits and/or vegetables to your diet will be challenging but easier than a restrictive diet. If you love fruits and vegetables, I recommend having a variety! Try to consume different colors (green, blue, red, orange, yellow).

In regards to increasing longevity, eat more cruciferous vegetables (Brussels sprouts, broccoli, cabbage) as they contain a phytochemical called sulforaphane.

Fruit as a food group is under investigation right now due to the fructose it contains. I don’t think there is an issue with fructose if it’s bound to fiber. It’s not concentrated like high fructose corn syrup. If you are wary about adding fruits into the diet, start with berries. Raspberries and blackberries have the least amount of net carbohydrates. 

Guideline #2: Eat 5 servings of fruits and/or vegetables each day. 1 serving of fruit is 1 medium piece or 1 cup. 1 serving of vegetables is ½ cup cooked or 1 cup raw. 

Increase Healthful Fat Consumption 

I get some fearful responses when I recommend increasing healthy fat consumption. Fat has been demonized for SO long, and I’m pretty tired of it. Fat is not the problem; the COMBINATION of excess fat and excess sugar is. To shorten my rant, WE NEED FAT. A dietitian friend of mine once had her audience hold their right hand in the air and say out loud: “Fat is my friend”. Now, I’m not talking about bacon, sausage and processed fat (hydrogenated oil). I’m pretty against anything processed. I’m talking about plant-based fats such as avocado, coconut, nuts/seeds, olives, and olive oil! Don’t even get me started on the importance of omega 3 fatty acids from fatty fish like salmon and ahi for overall health. Omega-3 fatty acids (ALA, DHA, and EPA) are ESSENTIAL fatty acids. “Essential” means that our body does not make this, and we must get it from food. I have personally started taking fish oil with EPA and DHA daily. A supplement is not necessary, but if you do not eat fish twice a week, I recommend starting a supplement (high quality, of course). 

Fat does have a lot of calories per gram, but it’s satisfying. A high fat, low carbohydrate diet is effective for weight loss. Lowering body fat mass is important in increasing healthspan. Recent studies have shown a ketogenic diet being an effective method for treating the disease of obesity. 

Supplementation with high doses of omega-3 fatty acids has been studied in many disease states. The omega-3 fatty acids are anti-inflammatory, unlike the omega-6 fatty acids found in animal products. Studies supplementing DHA and EPA have found improvements in those with cardiovascular disease, cognitive decline (Alzheimer’s and dementia), depression, inflammatory bowel disease, ADHD and more. All of the diseases above are diseases of aging and/or inflammation. 

My favorite fats: walnuts, almonds, flaxseeds, chia seeds, hemp seeds, cacao nibs, olive oil, coconut (shreds, milk, oil), salmon, and raw ahi tuna. 

Guideline #3: Consume healthful fats daily, especially nuts and seeds. Avoid processed fats and hydrogenated oil. 

Get the Appropriate Amount of Protein 

I’ve switched sides on this macronutrient. I strived to eat protein every 2 hours back in the day when I was weight lifting 6 times a week. I was OBSESSED with protein and gaining muscle. Unfortunately, protein speeds up the aging process. In the discussion of longevity, excess protein is a known nutrient for increasing the risk of aging diseases (cardiovascular disease and cancer). For my mechanism lovers, dietary protein increases mTOR which in turn inhibits autophagy. Autophagy is the recycling of cells and is important in slowing down aging. 

Protein is a necessary nutrient during times of growth: infancy, childhood, pregnancy/lactation, and athletic training. Those older than age 65 also benefit from increasing protein due to increased muscle loss. If you do not fit in any of the groups above, you do not need excess protein. 

Animal protein is a great, bio-available source of protein. Unfortunately, it’s TOO nutritious for those of us that are not in a growth state. I recommend eating more plant-based protein to ensure you do not exceed your protein needs. If you strive to increase your health-span, I recommend limiting your protein to 0.8 grams per kilogram of weight. If you REALLY want to calculate the minimum amount of protein you need, instead of using kilograms of total weight, use kilograms of lean body mass. I personally do not eat much meat, maybe once or twice a week. I have incorporated more beans, lentils, nuts/seeds into my diet. All of which are protein, but are less bioavailable, keeping my protein intake to a minimum. 

If you can’t give up eating beef and chicken, I recommend choosing a high-quality source of protein. When reading food labels, be sure to pick up “grass-fed” or “pasture-raised” animal products. For eggs, look for “cage-free” or “omega-3” on the label. Consuming 4 oz of meat (about the size of the palm of your hand) will provide 28 grams of protein.

Guideline #4: If you are not in a “growth” state, limit protein intake. Consume fewer animal products and more plant-based proteins. 

Calculate your protein needs:
You’ll need: current weight, calculator 

 Multiply 0.8 and weight in kilograms (or lean body mass if you know this number).
Example: I weigh 110 lbs. Divide by 2.2 to get kilograms. 110/2.2 = 50kg
50 kg x 0.8 = 40 grams of protein daily

Limit Processed/Simple Sugar 

Sugar is not an essential nutrient. That’s right, our body does not need sugar to survive. Yes, our body prefers to use sugar for energy, but in excess, sugar is harmful. Excess sugar is stored as fat in cells and can cause insulin resistance and inflammation. Sugar also has an impact on our microbiome (the microorganism world that lives inside of us). Excess simple sugar can cause “bad” bacteria to flourish and wreak havoc. Dr. Rhonda Patrick provides a wonderful explanation of the impact a poor diet (high in refined sugar, low in fiber) has on our microbiome, causing inflammation resulting in cardiovascular disease. For my mechanism lovers, here is a short clip of Dr. Patrick explaining endotoxin and cardiovascular disease.

Sugars in the form of sugar-sweetened beverages (juice, soda, coffee, sweet teas) are the WORST food item you can put in your body. Drinking 8 oz of apple or orange juice is easy and contains 15-20 grams of sugar. To put it into perspective, that’s the equivalent of eating 4-6 teaspoons of sugar. Now, imagine eating 4 apples or 4 oranges. Could you do it? If there is one thing to get rid of besides smoking and binge drinking, it’s soda and other sweetened beverages. 

If you are still unsure where you stand in this carbohydrate war, I recommend choosing whole foods for the time being. Choose complex carbohydrates such as beans, lentils, quinoa, millet, buckwheat, oatmeal, fruits, and vegetables. Fiber is a carbohydrate that is necessary for a healthful microbiome. Not all carbohydrates are bad but simple, processed carbohydrates should be limited if you want to increase your healthspan. 

Guideline #5: Limit simple/processed carbohydrates. Avoid all sugar-sweetened beverages.

I understand life is life. Sometimes we will go to Chick-fil-A and order a 3-piece chicken strip with a buffalo, CFA, and ranch sauce. Sometimes we will eat a soft chocolate chip cookie in the work office. It’s fine to indulge every once in a while as long as the majority of days are spent eating right and following the guidelines above. I wish you good luck on your health journey. May we all optimize our health by means of nutrition!

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The Truth About Intermittent Fasting – My Journey

A little more than a year ago, I tried intermittent fasting (IF) to prove my husband wrong. During the last year of my nutrition program, I did all my projects on the topic of fasting but came to conclusion that this might not be just another fad diet. One project included trying a diet for 2 weeks. Of course, I decided to finally attempt a type of IF called time restricted eating by following an 18-hour fast with a 6-hour feeding window. 

The beginning was brutal. I was a breakfast person! I loved making overnight oats, eggs and don’t even get me started on pancakes, waffles and cereal. The first 2 days of the time-restricted eating regimen were terrible. I binge ate both nights. I decided to switch my feeding window from 6 hours to 8 hours to make it a little easier on myself. After a few days, my body started getting used to eating at 11am. I wasn’t as ravenously hungry as I used to be in the mornings. I was able to drink my black coffee and plenty of water until my feeding window began. A small confession here; I am usually running late to everything. About a week into IF, I realized that the new regimen was convenient for me! I didn’t have to spend any time in the mornings making breakfast or eating! That saved me 20 minutes each day (and helped with my time management). Not only was I saving time in the morning by not eating breakfast, but I was also more productive! About a month in, I noticed a difference in my mental clarity. I was able to concentrate more in the mornings up until after lunch. I clearly noticed a difference in my ability to process information. It was like night and day! At that time, I did not know that this was the start of a life-long endeavor. 

Before I started working as a dietitian, I used to exercise 5-6 days a week which helped maintain my weight at 112-115 lbs. After starting IF, I lost 8 lbs and now my set point weight ranges from 108-110 lbs WITHOUT exercise (I couldn’t find much time for it once I started working full-time plus commuting). Back in the day when I was eating 3 meals and 2 snacks, I would gain weight pretty quickly if I didn’t exercise. Daily fasting became my “metabolic exercise”. I was reaping some of the benefits of exercise through fasting without actually exercising. In Dr. Jason Fung’s book, Obesity Code, he explains that IF drops your set point weight where as other fad diets do not. There’s a hormonal change that occurs during fasting that other calorie restriction diets do not do. 

Now, let’s fast forward 7 months to when I started working with weight loss patients. The dietitian before me recommended books to read, one being the Ultimate Guide to Fasting (by my favorite MD at the time, Jason Fung). I didn’t know that dietitians could recommend a fasting regimen, but I quickly reminded myself that I am an evidenced-based dietitian. The science and mechanisms were clearly there and I didn’t understand why the Academy of Nutrition and Dietetics (AND) wasn’t making this a standard of care for those with type 2 diabetes, obesity and metabolic syndrome. That’s when the reading started. I was commuting 2-4 hours a day to my work, which left a lot of time-opportunity for audiobooks. At first, it was difficult but after a few months, my brain was able to listen to audiobooks on 1.75 speed and absorb more than 75% of what was being said. I also began reading science literature on fasting to better understand mechanisms.

When I started seeing weight loss patients, I decided quickly that fasting may not be for everyone, but 6 months later, I’d take that back.  Seeing my patients follow a time-restricted eating regimen daily and lose weight with ease was very satisfying and only solidified my belief in fasting even more. I started sharing this information with my dietitian friends but not everyone was convinced. I kept reading and bringing more evidence back to them only to receive more doubts and counterarguments. Of course, I am grateful that they were skeptical as it has only made me a more informed dietitian on the subject of fasting. 

I concluded that IF was the perfect “diet” for weight loss. I don’t like to call it a “diet” because there are no requirements on what to eat; IF is focused on the timing of meals. Of course, eating a healthful diet in combination with a fasting regimen is ideal but that’s a topic for another blog post. 

In my reading, I have come across some people that should not do a prolonged overnight fast (more than 12 hours). This includes children, pregnant/lactating women, type 2 diabetics on insulin, and those with an eating disorder, low BMI (<18) or gallbladder disease. If you are one of the above, I recommend talking with your doctor before starting any fasting regimen. 

That leaves everyone else! If you are wondering if you could do it, even though you aren’t trying to lose weight, I highly suggest starting with an overnight 12 hour fast daily. Most people think they already do this; however, an ongoing research study suggests that the average “feeding” window is 15 hours. This exhausts our digestive system. Every time we eat, our bodies have to produce hormones and digestive enzymes. Towards the end of the day, especially as it gets dark outside, our metabolism does not work as efficiently. It slows down in preparation for sleep. Humans are not meant to be eating all day and all night, just like we aren’t meant to be awake all day and all night. This is where I bring in a concept called circadian rhythm. This is usually associated with our sleep and wake cycle. We are diurnal creatures! What most people don’t realize is that our digestive system is also on a biological clock. If we eat at 8am every day, our body will eventually get used to receiving food at 8am. That is why it may be difficult initiating a time-restricted eating regimen initially. When you change the time of your meals, your body will be confused so it’s best to eat your meals at the same times every day. This is why it was difficult for me and many others to start IF. Our circadian clock gives us cues (hunger/ghrelin) that it’s time to eat; However, your body can get used to eating at 11am or even once a day with minimal hunger after some time and consistency. 

IF is not just for weight loss, though. The main reason why I continue doing it is for longevity. The science of aging and increasing health span is picking up speed. I’ve recently gotten into the research on fasting and increased longevity. Caloric restriction increases longevity in many animals. Even the Japanese people in Okinawa (one of the blue zones) believe that one should eat until they are 80% full. This is caloric restriction. Obviously, when we restrict calories, we need to ensure we get enough nutrients to avoid malnutrition. There are no benefits to being malnourished. A slight reduction in calories DOES, though. I’ll explain the mechanisms. 

1.    Insulin – keeping insulin levels low and insulin-like growth factor low has been shown to increase life span not only animals, but also humans. Loran Dwarfs lack IGF-1 (there is a defect in the receptor). Despite eating the same diet as their relatives, those that did not have the syndrome, had 20% rate of cancer. Remember, cancer is a leading cause of death in the USA. 

2.    mTOR – dietary protein activates this guy. Decreased intake of protein increases life span. Increased mTOR turns off autophagy, a very important recycling process in the body. As we age, autophagy decreases. Autophagy is a very important component in increasing health span and preventing diseases such as cancer.

3.    AMPK – increases when we have low ATP (energy). AMPK increases glucose uptake into the cell, increases autophagy and increases lipid metabolism. 

I could go on and on about mechanisms, but I want to keep this article simple. 

How to start IF: 

1.    Start with a 12 hour fast daily. For example, abstain from eating between 7pm to 7am. Follow this strictly for a couple weeks.  

2.    Start shortening your “feeding” window by an hour each week. Bring breakfast up to 8am or finish dinner by 6pm. 

3.    If you find this easy after a couple weeks, you can attempt a 16 hour daily fasting regimen. Most people follow a 11-7pm feeding window regimen while other follow 12-8pm. Some even have breakfast and follow a 9-5pm feeding window. Customize to your lifestyle and schedule. 

4.    Continue this for as long as you’d like. Most people adopt IF as a lifestyle. I, for example, rarely eat breakfast and feel great without eating until 12pm.

5.    If you still have difficulty, make an appointment with a registered dietitian to help. I see patients in Irvine, Ca. 

Dietitians/Nutritionists/Doctors are too focused on macronutrients (fat, protein, and carbohydrate) and calories. I think it’s the timing of our meals that is MOST important in overall health. Eating multiple meals, multiple snacks and the elongated “feeding” window (12+ hours) is not the answer. Obviously, fiber intake and healthful fat intake are both very important nutrients in preventing many diseases but timing is right up there with basic general healthful nutrition guidelines.

I predict that fasting will become standard of care within the next couple decades. Whether it’s a 12 hour overnight fast, a 24 hour fast once a week, or a Fasting Mimicking Diet, I say with confidence, this is the solution to our obesity epidemic. Fasting increases insulin sensitivity so it can be used as a treatment method for those with type 2 diabetes. Fasting helps reduce caloric intake (in a much easier way) which can be used to treat obese people. Fasting even lowers triglycerides and inflammation which lowers cardiovascular disease risk! There needs to be more research published, I know, to officially become standard of care. It’s coming, though. 

Disclaimer: This article was written off the top of my head but there is evidence for every single claim I make in this article. I’ve been wanting to write an article for months now but I have limited time. I will eventually be adding references to this article but I would be more than happy to send you specific articles if you need me to do so. 

Who I follow for new evidenced-based fasting information:

1. Dr. Rhonda Patrick 

2. Dr. Satchin Panda

3. Dr. Valter Longo

4. Dr. Peter Attia 

If you feel at all skeptical, please go to the “Research” tab in the upper left side of the page. Feel free to leave questions below. 

Tatiana Keay, MS, RD