Podcast Episode 48 Transcript – Q&A #3

Leah Higl

Welcome to the Ideal Nutrition Podcast. I am one of your hosts, Leah Higl, and I’m here with my co-host Aidan Muir. So today we’re going to do a Q&A style episode, so we’ve asked some questions on our Instagram and we’ve chosen a few that we thought were pretty interesting. And we’re just going to go through them in this episode.

[00:00:30] So, first question is: “Easy ways to increase calories in meals for endurance athletes?”

Aidan Muir

So there’s quite a few ways. The first one I’m going to touch on is eating frequently throughout the day. I’ll tell a story that’s always made this resonate with me. That’s always like, I always think back to this.

So basically I was working with a client who had bariatric surgery, so they had a limited amount of stomach capacity. In their case, they would be full after one and a half cooking cups of food. [00:01:00] So, this was somebody who was quite large and that amount would fill them up. And everything was going great, but, then he had a fall. He was also a veteran, so he had PTSD, and when he had the fall, just a wave of like depression hit him. He was just like, he didn’t really care about food. And, he, during that timeframe gained 10 kilos in about six or seven weeks or something like that.

And like mathematically, he had to be eating over 3,000 calories during that timeframe. And I look back at that, and I’m [00:01:30] like, judgment free, like quite literally just being like, “I wonder how he did that.” And when I did ask him, he was like, “Yeah, I was just like, grazing across the day.”

I had certain snacks in his plan. I had like, muesli bars in there, I had fruit. He only really liked bananas, so he was having bananas. UP&GO Energize was in there, so like UP&GOs, yogurts was in there. And he’s like, “Yeah, I was having like, three yogurts, three bananas, three UP&GOs, like two or three muesli bars.”

And the reason why I talk about [00:02:00] that example, cause it doesn’t really paint me in a good light as a dietician, because it was a client who was struggling … eventually things got back on track after that. It was just a phase. But I like to share that story because it’s kind of like, this man had a very limited capacity to eat food, and he was able to get over 3,000 calories in. What can everyone else do?

Leah Higl

Yeah. It’s a good way to kind of, yeah, think about it in this context.

Aidan Muir

Yeah. Like, he wasn’t even trying to do that he just happened to like … Yeah, anyway. He was also sitting at home all day, so. But like, [00:02:30] anyway. I like to use that example of being like, if you graze across the day, it’s easier to get more food in.

Another way that makes it easier to get more food in is liquid calories. It’s easier to drink than it is to eat. You can probably finish a meal and wash it down with fluid as well. Using bariatric surgery, once again, as an example, a lot of people who do regain weight post bariatric surgery are having liquid calories because it doesn’t fill up their stomach as much. It is a way that they can get more calories in. Once again, for somebody without bariatric [00:03:00] surgery, it’s still an easier way to get more calories in.

Another one is just focusing on more energy dense foods. So, lower volume foods that contain more calories. For example: nuts, seeds, avocado, nut butters. Like everyone talks about peanut butter and like how many calories you can get from it.

Leah Higl

You get so many calories from peanut butter.

Aidan Muir

A hundred percent. And on that topic, you can look at it in terms of just calories. In terms of, it doesn’t have to be, quote unquote, healthy food. Like, [00:03:30] those examples I just used there are really nutrient dense. But this is something to consider being, like … if you are trying to stick to “clean foods” and you have really high calorie requirements, it could be hard to reach those requirements. So sometimes it could make sense to include more processed foods or anything like that. Like if you really want to stick to more nutrient rich foods, go for those nuts, seeds, avocado, peanut butter, all those kind of things. But you could be a little bit more flexible to [00:04:00] get that food in.

And then the last piece of advice I have is making sure that you don’t overdo it with fiber. Like, you don’t end up with super high fiber, cause that would be really feeling maybe some GI distress. Yeah. Those would be the things I’d be looking at.

The next question we’ve got is: “How can we increase our metabolism?” So that’s a common question we get.

Leah Higl

Yeah, of course everyone wants to increase their metabolism. Find ways to be able to eat more food whilst maintaining or even losing weight. But I guess we [00:04:30] have a pretty dire answer for this in that, really the only ways we can increase our metabolism to a significant amount would be A) eating more calories. So we have done episodes on metabolic adaptation, but it really goes back to this.

So if you eat more calories, your metabolism will adjust up to, not meet that, but it’s going to come up a little bit, and vice versa. If you’re in a calorie deficit or if you’re eating less calories, it’s going to adapt down. So [00:05:00] your metabolism, isn’t this stagnant thing. It is going to adjust to the calorie availability. So if you want to increase your metabolism, a good way is to simply increase your food intake. Whether or not that aligns with your goals and what you want to get out of it. Maybe not, but it is one way to do it.

Secondary to that, you could just get gain weight. I mean, whether it’s fat or muscle, gaining weight and being heavier, it’s going to increase your metabolism. So getting [00:05:30] bigger could be one.

People talk a lot about changing their body composition in regards to increasing muscle mass and reducing body fat, and having that kind of body composition burning more calories. So increasing their metabolism. When you kind of crunch the numbers on this, cause we’ve done this before in the past, like if you were exactly the same weight, but you had a slightly different body composition muscle to body fat ratio wise, it doesn’t make a huge difference to your metabolism. It’s not like you’re going [00:06:00] to be eating an extra 500 calories at maintenance or anything like that. Unless it was like a crazy significant change in body composition.

Aidan Muir

Yeah. And like putting numbers on that, cause I think we probably have talked about in a podcast, but I still want to do it anyway. Like, every kilo of muscle seems to burn about 12 to 13 calories just at rest, just existing, 12 or 13 calories. Every kilo of fat burns about four calories. That’s a huge difference. That’s three times a difference.

But as you said, even a significant transformation, say you stay the same weight, you gain [00:06:30] 10 kilos of muscle and you lose 10 kilos of fat, which is a very impressive transformation. That’s 80 calories difference, based on that mathematics. I obviously do think it is more in practice because that’s just your metabolic rate.

What if you burn more calories when you exercise or just in your general everyday movement and stuff like that, because you got more muscle, less fat or all those kind of things? It probably carries over to slightly more calories.

Leah Higl

Yeah, especially if you’re like really active generally.

Aidan Muir

Yeah. Though it’s not as big as you’d [00:07:00] think. And I used to be one of the big proponents for like, “Yeah, just build more muscle.” Cause I was like, I was looking at like what bodybuilders were saying they were eating and stuff like that. And like heaps of people were struggling to get enough food in to maintain their body weight and stuff like that. But there’s a lot more factors that go into that as well.

Leah Higl

Yeah. A hundred percent. So I mean, just, like gaining weight, like if you just gain 10 kilos and it was a mix of fat and muscle, you’d pretty significantly increase your metabolism, but body composition changes maybe a little less.

So another thing that kind of fits into this would be talking about the [00:07:30] thermic effect of food. So it’s a bit different to your basal metabolic rate, which is really what we’re talking about when we talk about metabolism. But there are a lot of people that kind of lump this together as well. So generally if you are, well, A) eating more calories, you’re going to be burning more calories digesting that food. A higher protein diet means that you’re burning more calories from your thermic effect of food. And even having more whole foods over processed foods takes more calories to [00:08:00] digest.

Look, the thermic effect of food doesn’t usually make up a whole heap of your total daily energy expenditure. So it’s not one I … like, I’m not going to tell someone to eat a high protein diet for that alone. But you know, it is something that slightly increases the amount of calories you’re burning.

So those would be the main three things I talk about in regards to, yeah, these things can increase your metabolism or your total daily energy expenditure in that way. Things that are [00:08:30] less so would be things like, caffeine and fat burners. So they can increase your metabolic rate a little bit, and your fat oxidation. But when we’re talking about this from a weight loss perspective, it’s just not a really significant change. So they’re not going to be hope. They’re not going to be very useful for you.

Aidan Muir

Yeah. I typically call the Miller 1 to 3% improve or increase in total daily energy expenditure. I was speaking with [00:09:00] Tyler about this because he did a deep dive on it cause he’s going to do an Instagram post on it. And he was saying that, if you do look at the studies, like sometimes there’s a 20% increase in metabolism for a couple of hours. And because we’re burning calories 24/7, like, that’s how it averages out. So it does look significant on a very short timeframe, but like it just doesn’t really matter over long term. And I like caffeine, but like often to get this effect, you need a decent amount of caffeine and that probably [00:09:30] outweighs … like it’s probably a bigger variable than the improvement in total energy expenditure. Like it’s probably not a fair trade off. Like I’d rather just have the amount of caffeine I want to have than have … and eat maybe 1 to 3% less in terms of calories, than use something specifically for this purpose. Particularly if it is taken at a time that would affect your sleep or anything like that too.

Leah Higl

Yeah. A hundred percent. So next question is: “How accurate are Apple Watches for tracking calories [00:10:00] burned?”

Aidan Muir

So I want to try and keep this one brief. I spent heaps of time looking into this because I was making an Instagram post about this as well. But the answer is they’re surprisingly accurate, but there also is a bit of margin for error and you definitely shouldn’t take it like as a hundred percent accurate.

So what I mean by that when I say surprisingly accurate is, because like when I was looking at research a few years ago, it’s just like, ah, this isn’t even worth paying attention to it. It probably does more harm than good paying attention to it. But like, devices [00:10:30] that use multiple ways of tracking your energy expenditure, like if they measure your heart rate and they measure heat, and then they also measure your movement, and Apple Watches do actually use multiple things, they can get kind of close, and they’re better at some forms of exercise than other forms.

But there was one study in particular that stands out to me where they measured four devices. So Apple Watches, Fitbit’s Charge HR and a Samsung one and on … Oh sorry, Fitbit Charge HR, Samsung [00:11:00] one, and then one called Mio Alpha. And they got 23 people to exercise for an hour. And their percentage of error in terms of under reporting energy expenditure on average was 9 to 43, and I’m going to go … 9 to 43 percent. I’m going to go into more detail on that. But like, just like, personal experiences, have you ever had a client who’s just like, “Yeah, I burned 1,400 calories in a training session.”?

Leah Higl

All the time, all the time.

Aidan Muir

And like some of the numbers some people will report are just ridiculous. Like they’re just like [00:11:30] out of this world. And I often do think, in some cases just like, let’s just ignore that number. Let’s just not even think about it because it shouldn’t be dictating your nutrition strategy.

Like for example, if you are aiming for a calorie deficit and you’re not losing weight, we know factually you’re not in a calorie deficit. If that goes on for long enough, it doesn’t matter what the watch is saying you’re burning or anything like that. And that’s why I come back with the under reporting thing of like 9 to 43%, like 43% under reporting is [00:12:00] pretty huge. And anecdotally, some of the things some people say I’m like, well, in some rare cases, it seems to be more than that. Like this study only had 23 subjects. So it wasn’t like-

It’s not really like summarizing everything that’s ever happened. But, more recently there was a 2020 systematic review that covered 60 studies, so it was a decent amount of studies. And they were just measuring, not Apple Watches specifically, but activity trackers on average. And they were trying to figure out how well activity trackers do.

And the most accurate device they had was something called the SenseWear [00:12:30] Armband Mini, but even its error report in studies ranged by underestimating as much as 21.27% to overestimating by as much as almost 15%. So it has like a 30% range of error, and that was the most accurate one they found.

So like, I view them as kind of good, probably better than you’d expect, but it’s also not like, gold standard information that should sway your decisions. It’s more of something that like, it’s maybe useful information [00:13:00] to see how many calories you’ve burned in one session in relation to other training sessions. But it probably shouldn’t, you shouldn’t be like, trying to eat the amount of calories you’ve burned for example.

Leah Higl

Yeah. And I think sometimes it does add confusion, especially to athletes. Where they’re like, “Oh, I feel like I should be eating more than this,” but where like they’re maintaining their weight, they’re recovering really well. But because of what’s coming up on their watch, and that’s overestimating how many calories they’re burning. I think it just, yeah, it adds a bit of confusion to the situation.

[00:13:30] Although I think they can be good in circumstances where you’re kind of comparing days to days, like in terms of how active you are and maybe different training days and managing your nutrition around that. But yeah, the numbers themselves-

Yeah. Like, that’s the thing. You shouldn’t be getting confused about that. Like that’s what I was saying, it’s like, if you’re maintaining, well, then you’re at maintenance. It kind of just doesn’t matter, like-

Yeah. But I do agree, like there is some use there. As a question for you: “Are there vegan collagen supplements and are these effective?”

Leah Higl

[00:14:00] Yeah, so, as far as I’m aware, there are no collagen supplements that are vegan that are trying to replicate what collagen is. So there are supplements on the market that do contain ingredients that boost collagen synthesis in the body, or at least claim to do so, that are vegan. How effective these are, I’d say probably not very at this point, I’ve not looked into every single ingredient in every collagen booster supplement. But, [00:14:30] based on what we know about collagen, I’d say they’re probably not up to scratch just yet, at least.

So the one context that we know collagen supplementation might be helpful, so just talking about regular collagen, is in soft tissue injury. So it might be useful in that circumstance, in repairing things like ligaments and tendons. If we were to have a vegan version of that, what we’d really be looking for is something that’s replicating that amino acid profile that collagen has. [00:15:00] Cause it’s a very specific amino acid profile that we know is pretty effective for boosting that kind of synthesis in ligaments and tendons.

So, there’s nothing on the market yet, but I’m surprised that no one has done anything, that no one has replicated collagen in a vegan way. Because again, we’ve talked about this before, but we could just take all those individual amino acids and put it in the right ratio and make somewhat of a vegan collagen [00:15:30] supplement.

Aidan Muir

Yeah, like that’s what’s surprising cause there is a lot that are designed to like replicate the texture and like have similar-

Leah Higl

Yeah, those are the weirdest ones. Cause they don’t even do anything other than just the texture of collagen.

Aidan Muir

Yeah, yeah. And like they do have ingredients, like a lot will have vitamins and they will have those other things, but they’re all relatively low protein and they don’t have the amino acid. So yeah, it is an interesting space, but yeah.

The next one is: Is there any actual evidence that diet can help with depression/anxiety?

Leah Higl

You can [00:16:00] probably get started on this one because I know you know way more about the SMILES trial-

Than I do. And I think that’s probably where this discussion’s going to go.

Aidan Muir:      Yeah. So… So the short answer is yes.

There is evidence. I talk about SMILES trial because up until 2017, there were no randomized control trials in nutrition and depression. Before that we still had evidence, [00:16:30] it just wasn’t the controlled, like it wasn’t randomized control trials. It wasn’t that like gold standard style approach. We had a lot of observational evidence. We just didn’t have like, “These people have depression and anxiety. We did this nutrition intervention and now they no longer have it.” We didn’t have that before. We just had stuff being like, “These people have better “diets” and they’re less likely to have depression.”

And one of the issues there obviously is the chicken or the egg situation, like do people with better diets, are they just [00:17:00] less likely to develop depression, anxiety? Or is it like, as you develop depression and anxiety, does your diet start to change because you don’t feel like looking after your nutrition as much and stuff like that.

The really exciting thing with the SMILES trial … so that was 2017, and it has been studied since that, but I always point to this one because it’s the first one that really like moved the needle on this kind of discussion … the really good thing there was, they got people and they put them on a modified Mediterranean diet, and they did it for 12 weeks and they had dietician input and stuff [00:17:30] like that.

They had a placebo group where they got them to just insert … because like the dietician is a variable. What if speaking to somebody for an hour, seven times throughout 12 weeks, changes your mood in some way, shape or form? So they got a control group to do a similar type activity where they’d see somebody once a week or seven times throughout a 12 week process. And just talk shit, basically like just talk about nothing.

Leah Higl

Just talk about life.

Aidan Muir

Yeah, basically. And if they, if that was awkward, they got them to play board games and stuff like that. So they were just like doing [00:18:00] something, which I think is cool because the people in that group also had some small improvements too. So it’s like the control group is actually necessary because we can’t just pin this down just to diet.

But regardless, they followed a modified Mediterranean diet and 12 weeks later, 32% were in remission based on the depression scores. And most of them had anxiety to start off with. And 20% of the people with anxiety went into remission. That really stands out, obviously, because it’s like, that’s a pretty huge impact. But the number that stands out to me [00:18:30] even more is every single person who finished the trial had an improvement in their depression score.

And as somebody who spent a lot of time working with veterans with PTSD and stuff like that, I’m not an idiot. I’m not going to be out here being like, “Yeah, this is going to solve-“

Leah Higl

A hundred percent.

Aidan Muir

“This is going to solve everything.” Like it’s obviously so, so, so much more complex. But the fact that every single person showed some level of improvement is enough for me to be like, well this is worth exploring.

And that’s just one approach. Like that was just the first study that happened to be done on it. [00:19:00] Like that’s just scratching the surface. So like, the short answer is yes, there is evidence that diet can help with depression and anxiety and there’s probably heaps of options.

Leah Higl

It’s going to be interesting to see where the research in that space goes. So hopefully they do a little bit more into it.

Aidan Muir

Yeah. Because it’s even like mechanisms, like they were talking about like the gut brain access or inflammation in the brain and there’s heaps of other things that go into it. And then like when I’ve spoken to people who have depression, a lot of them talk about it being like, well, what if it was just like taking control of their diet and like feeling like they were empowered [00:19:30] by it all, like there’s so many variables that go into it. So it is an interesting space.

Leah Higl

Next question we have is: “Does the increased water weight from creatine go away after loading?”

So I mean, we always talk about this in that people overthink this way too much. So you are not going to gain a ton of water weight, usually, in that loading phase of creatine. Like, typically in practice, I see about half a kilo to a kilo max [00:20:00] for most people. So it’s not going to be a whole lot and it is all going to be intramuscular. So I always say to my clients, like, “It might make you look a bit more jacked and what’s wrong with that?” Like there’s never anything wrong with looking a bit more muscular, but you know, looking at the research, at, you know, does this actually continue to stay around or does it dissipate over time?

So we do have a review that came out in 2021 called Common questions and misconceptions about creatine supplementation. And [00:20:30] they summarize a lot of key points around using creatine, and then the water weight that occurs. And they said that even though it occurred initially, it does seem to go back to baseline over time.

So likely this water retention that you see initially, whether it’s in the week of the fast loading protocol or like the month of the slow loading protocol, it probably does dissipate over the months that you take it. So it’s not even going to be a long term concern [00:21:00] for most people, which I think is relevant when we’re thinking about weight making athletes, at least.

Aidan Muir

Yeah. I agree. And that study was actually the one that was like … that came in 2021, and before that I had never thought about how it … I just assumed it just like sat around until you stopped using creatine.

Leah Higl

Yeah, I thought the same.

Aidan Muir

Yeah. But, and it was just written like offhand just being like, “No, it probably doesn’t.” And it makes sense. Just due to water homeostasis and everything like that.

One other caveat of that is like, it’s so much simpler and I wish … I toss [00:21:30] up whether I should just say this and leave it there but like, the water weight’s probably not all intramuscular, it’s either 50/50 intramuscular, extramuscular or extracellular, or like a pretty split in favor of being intramuscular.

So I like to say it’s mostly intramuscular, but like the hard thing about that is it feeds into people thinking, “Oh, this is going to make me look puffy. This is going to like-“

we know, and that was one of the other things that [00:22:00] was addressed in there as well, being like, well, it doesn’t make people look any different.

Leah Higl

You’re not going to notice the difference.

Aidan Muir

Yeah. You’re not going to notice the difference. And I do think, as you said, it makes people look more jacked.

Leah Higl

Yeah. And if that’s the thing you’re going to get from it, I think that’s great.

Aidan Muir

Yeah. It’s a nice bonus.

Leah Higl

So one of our last questions: “Do you need to do anything differently for weight loss if you have insulin resistance?”

Aidan Muir

So, not really. This is something I talk about for days, like it’s a really complex thing. A lot of people hypothesized [00:22:30] that low carb diets would be better, but, jumping to the chase, that’s not what the research shows.

Like the research … there was one study I read in 2016/2017, I don’t know what date the study was published, but that was when I read it, that showed there was a difference. And I remember I made a post on Facebook about it being like, “Well maybe low carbohydrate diets are superior.” And then every single study outside of that that I’m aware of basically just shows no difference.

We can tell in type two diabetes, where insulin resistance is most prevalent, that people lose fat just as well on a lower carb or [00:23:00] a lower fat style diet. So it is quite clear, and we see long term outcomes as well in terms of health outcomes, being like, if people do lose body fat with either approach, they still become more sensitive to insulin and they can better tolerate glucose and everything like that.

So that’s really useful to know. The mechanism doesn’t even really necessarily make sense to me as well, in terms of, the concept that a lot of people think about is because people are insulin resistant, they need more … they have more insulin in their body. And that’s where people talk about it being like, oh, [00:23:30] you’re going to store more body fat if you have more carbs or whatever. But the mechanism, my way of thinking about it is that insulin is used to take glucose out of the blood. So it can be stored its glycogen or body fat, or be utilized for other functions. If you’re resistant to insulin, it’s not as good at doing that job anymore.

Leah Higl

Yes. It’s like almost the opposite from a mechanistic point of view.

Aidan Muir

Yeah. It’s almost the opposite. And this is what we see in type 1 diabetes where they don’t have insulin, like where insulin’s not able to take glucose out of the blood cause they’re not producing the insulin. They lose weight, because their [00:24:00] blood glucose levels are going up. Same kind of thing here. Like, it’s a different explanation but it’s another way of thinking about it being like, glucose is harder to get out of the blood to be stored as body fat, if you’re insulin resistant.

Either way though, mechanisms … like I prefer to think about outcomes and the outcomes show that it doesn’t really matter. Body fat is still made up of calories. And at the end of the day, whether those calories are coming from carbs or fats or whatever, like it still has to come from somewhere, which is why this all works out. And then the last thing that I always like to point out, like [00:24:30] just because almost everybody who talks about insulin resistance will kind of ignore this point, and so I want to touch on it, is that protein also raises insulin.

Almost everybody who talks about insulin acts as if carbs is the only thing that raises it. And this is a kind of way to like see through a message a lot of people are trying to pitch: if they always talk about insulin, but they never mention protein. And they’re just trying to, it’s an oversimplification, if they’re always trying to pin it on carbs.

[00:25:00] The last question, and this is obviously way more up your alley than mine, is: “I have just gone vegan. What are the most important supplements and vitamins I should be aware of?”

Leah Higl

Yeah, we’ll keep this short. So I’m going to list them out, the usual ones I go over with all of my vegan clients. The first, from a supplement perspective, is B12. So I recommend that across the board to pretty much anyone that’s reducing, like actively reducing animal products, but particularly vegan. So you can’t really get B12 [00:25:30] from plant-based foods. It is in some fortified foods, but it’s not a reliable source. So I always say supplement with B12. You won’t regret it.

I don’t have any other supplement recommendations that I have, again, across the board. Common ones are like omega-3s, so, like EPA and DHA from microalgae, particularly in my athletes, but again, not necessary for everyone.

Vitamin D is another one that tends to be lower [00:26:00] in vegans due to lack of animal products, so we may supplement with that. But generally just talking about other vitamins and minerals, to be aware of. Generally iron and zinc, because our requirements are higher on a plant based diet than an animal based diet. So they’re something to be aware of. And other things like calcium, cause you’re not going to be eating dairy anymore. And a few other things like iodine and selenium that would also usually be rich in animal products. So that’s kind of my short list of things to [00:26:30] at least be aware of when going vegan.

Aidan Muir

Perfect. We’ll wrap it up there. Well, this has been episode 48, and, I really like Q&A ones because it’s easy content. We don’t have to come up with ideas. You guys come up with it. So I really appreciate that.

But apart from that, thank you to everybody who’s listening. As always, if you can please leave a rating and review if you have access to and you have not already done so, that would be massively appreciated. Thank you.