Aidan Muir:
Hello and welcome to The Ideal Nutrition podcast. My name is Aidan Muir and I’m here with my co-host Leah Higl. And this is episode 75 where we will be doing another Q&A. So the first question we’ve got is why is there a huge range in recommendations for B12, for vegans?
Leah Higl:
So definitely up my alley this question. I think it’s for a few reasons. So I think generally people do way overcomplicate B12 recommendations, particularly around supplementation, but that’s probably because there is so much just noise around this subject. So there are different kind of dosages, different kinds of B12 that you can take, different frequencies, you can get your injections or you can supplement. There’s different methods of taking supplements. So I think it is a bit of a confusing topic, but just to set the record straight, my general recommendation is that if you are a plant-based, you should probably be taking a B12 supplement, relying on fortified foods probably not the best option just given the fact that if you leave B12 deficiency untreated for a long time, that it can have pretty devastating consequences in terms of nerve damage and brain damage.
So supplementation for vegans, definitely a must, but how you go about that is generally I recommend over anything probably cyanocobalamin… In the form of cyanocobalamin instead of any other kind of B12 in that range of 2 to 500 micrograms daily or a thousand micrograms a few times per week. I think that’s probably one of the most confusing points when you’re looking at all the B12 supplements is they’re all different dosages. It’s not like Vitamin D where it’s pretty consistent across the board.
Aidan Muir:
Yeah, everything’s like a thousand.
Leah Higl:
Yeah, there’s just so many different dosage kinds in B12, but that’s what I would recommend if you’re going for a supplement. And then in terms of how you would take it, so there’s tablets, there’s sublingual that you kind of dissolve under your tongue, there’s spray and there’s a lot of discussion of which one is better, et cetera, et cetera. They’re all fine. In my opinion, they’re all good. Usually the dosage is so high that the little bit of difference in absorption from method to method doesn’t really matter. So any are good. And then of course if you don’t want to supplement, you can get B12 injections every two to three months with your GP. So in terms of B12 supplementation, I would leave it at that and not overthink it. So second question is, why does being in a deficit make you feel sick/nauseous? Is it low blood sugars?
Aidan Muir:
Starting with the low blood sugars aspect, I say it’s unlikely for that to be an explanation. I have had a lot of clients who will feel sick, nauseous or lightheaded or anything like that and assume that it’s low blood sugars so then they’ll have sugar or carbohydrates or something like that to feel better. And often they do feel better when they do that. But one of the things that definitely comes to my mind first in that situation is if that’s something that does happen regularly, what I personally would do is I would test blood glucose levels. I’ll get one of those things that you can test, they’re relatively cheap to get and I’ll test, because you can confirm your hypothesis really easily. Say the fasting range is 3.5 to 5.5 and obviously you can go high when you’re eating and stuff like that. But what we define as low blood sugars is below four with symptoms.
If you’re experiencing these symptoms and you’re below four, that would be defined as a hypo. Those are actually quite rare in people who are not injecting insulin. They do happen but they’re quite rare. And if you commonly experience these symptoms, I take that test and if that’s not it, then I’d be looking for another explanation, which is probably more likely. In terms of other explanations, lightheadedness, which could factor in with the nauseousness and stuff like that. In some cases, that can be low blood pressure, particularly for people on medication. But even with somebody who’s just made a significant change in their diet, particularly if you have gone from a higher sodium diet to a lower sodium diet relatively quickly, some people find that if they add sodium they just feel better, they feel less nauseous as well. That’s one option.
Same thing with other electrolytes as well. If you go from eating more foods to eating less food, you might be having less electrolytes. And then what I think is more likely to be the case is just being on quite few calories in relation to your needs. Eating far less food than normal. Being hungry and being nauseous often go hand in hand as well.
Leah Higl:
Yeah, I think that’s a big one. I think people overlook that as being a thing and like if you’re excessively hungry, you’re probably not going to feel awesome. Might be a bit nauseous and lightheaded.
Aidan Muir:
Yeah. So I feel like there’s a few solutions to this. One of them I personally would go to with a lot of people if it is out of hand is a smaller calorie deficit or not being in the deficit for so long potentially. But yeah, there’s many ways to approach it. The next question we’ll be looking at is what are your thoughts on body weight set point?
Leah Higl:
I feel like this could almost be a whole podcast in itself.
Aidan Muir:
I thought this as well when I saw this question.
Leah Higl:
But let’s kind of give it a crack. So set point theory proposes that your body has a weight where it kind of naturally likes to sit and it will compensate in certain ways to have you sitting within that body fat or body weight range. I come from two perspectives with set point theory. I think on one hand, it is something that may be a thing. I think some people sit naturally leaner than other people regardless, just genetically. So I think that is part of set point theory in that some people are going to be leaner, some people are naturally going to hold a little bit more body fat and sit more comfortably there.
But I think there’s quite a few ways in which it does fall apart. I think the biggest one that always crops up for me is the environment thing. So we know that the environment that you are living in, and your behaviors are going to dictate a lot of what your body looks like or where you sit weight-wise. And that’s going to be regardless of the genetic stuff, I think that’s going to have a lot more of an impact overall. So that definitely comes into play.
Aidan Muir:
I very much think that the compensations are very real. These are measurable phenomenons, we see metabolic adaptation, we see both as a metabolic rate reduce and also non-exercise activity thermogenesis like energy burns through informal movement typically decreases when people go into a calorie deficit, particularly the larger deficit is or if it’s going on for longer. And we also see it go the other way. If somebody goes into a calorie surplus, it decreases. So those compensations exist, I think they’re less relevant than a lot of people would think of. If you read a lot about set point theory, you start feeling like the body has this massive compensation that prevents weight loss after a certain point. But those are relatively small but they are real and they are a factor in all of this. Beyond that, something I think is a bigger factor is changes in appetite and changes in desire to eat as well.
When people lose a lot of weight on average, the desire to eat and the amount of calories that they would consume under what we’d call an ad libitum environment where it is eating freely or whatever, typically increases pretty significantly. We see this particularly in scenarios where people get quite lean, like body building shows and stuff like that. If people eat ad libitum after being super, super lean, they often eat a lot of calories. Those things are very real, but adding onto those compensations, I personally think that these compensations are stronger under weight loss conditions than they are under weight gain conditions. And set point theory kind of implies that, say somebody normally sits around 80 kilos, that if they lost weight down to 75 kilos or something like that, that the pool is going to be relatively equal to if they had gained up to 85 or something like that.
It doesn’t directly state that, but it’s kind of implied that it goes in both directions almost equally, is how I’d assume it. And this is where I’m talking into about semantics because it’s kind of like that’s my own interpretation. That’s not actually the evidence based way of looking at it or whatever. But when I look at it from that perspective, it seems at a population level it is easier for people to gain weight than is to lose weight. It seems like we have a lot more compensations that are stronger preventing weight loss than preventing weight gain. And when I look at it from that perspective, I start thinking in terms of my definitions of do I believe we have set points in compensations and stuff like that? I do think so to a certain degree, but I also extend that to being, I just think it’s very hard for people to lose weight and maintain that weight loss because of some of these compensations. I think that is a stronger pool than the other direction.
Leah Higl:
Yeah, I’d a hundred percent agree with that. So the next question is, for clients looking to lose weight, do you set protein targets based on goal body weight or current body weight?
Aidan Muir:
I do neither, to a certain degree.
I’ll address why I don’t do either of them in all cases. So with the goal body weight, I find it silly in some cases. What I mean by that is I work with some people who are 200 kilos and I work with others who are 50 kilos and it’s kind of like if I work with that 200 kilo person and they tell me their goal weight is 100 kilos, should I be setting them a different protein target to somebody who’s 200 kilos who tells me their goal weight is 150? I personally don’t think so. I think I should deal with them in the situation they’re currently in.
Leah Higl:
Yeah, I think the goal body weight is kind of irrelevant at that point to the protein intake.
Aidan Muir:
And even though I’ve used an extreme example, I like to use extreme examples to kind of extrapolate my thinking to smallest case scenarios. But using that, it’s like okay, well, then does that mean should I use current body weight? And the reason why I don’t do current body weight in that 200 kilo example is because our protein needs a far more links to how much lean body mass we have than how much we weigh overall. So we do have research showing that for people who are in a calorie deficit trying to maintain as much muscle mass as possible, we’re looking at 2.3 to 3.1 grams per kilogram of fat-free mass. It’s like well if we have that I might use that. And some people will be like, “Well, how do you know what that person’s lean mass is? Or their fat free mass?” I could get them to have a DEXA or something like that. But instead what I think makes more sense is just estimating, right?
Leah Higl:
100%.
Aidan Muir:
Because if the range is 2.3 to 3.1 and I’m worried that I’ve got my estimation wrong, I can just go towards the higher end of the range and guarantee that we maximize that. And even in those cases it’s like that’s also kind of assuming that they’re capable of hitting the optimal target, realistically. If they’re not… I’ll just do whatever they’re realistically-
Leah Higl:
Whatever’s logistically possible in that scenario.
Yeah. And there’s always things like using adjusted body weight calculations and that’s something you could do if you are sitting, if have a higher body fat percentage and you don’t want to say, use that 200 kilos to set the protein target, adjusted body weight is something that you might use. But for me, I tend to just estimate lean body mass depending on what that person looks like, what they do and their weight.
Aidan Muir:
Does having salt pre-workout help performance in the gym?
Leah Higl:
So maybe. If you have a pretty low sodium intake and you’re experiencing things like low blood pressure during training, it could definitely make sense for you to have salt pre-training. But it’s not necessary for everybody. So I think generally when I think of the athletes that I work with, they’re going to be getting enough sodium usually through their diet, just naturally through eating that I’m not going to put more sodium intake on top of that unless they do have really high sweat rates and heaps of sessions a week and et cetera. Maybe an endurance athlete or something. But I’ve seen it in the context a lot lately of people who are just general strength training and people recommending that you use salt pre-training and I don’t think it is necessary for most people unless you have that experience of being lightheaded and feeling like you have low blood pressure during your session.
Aidan Muir:
Yeah, I agree. And then I see the exceptions. There’s two people who I really see promoting this, Stan Efferding and Stefi Cohen, they talk about it in heaps. And I can see where they’re coming from even though I wouldn’t extend it to the broad population of people who train and stuff like that because if you get the average person who trains relatively hard to do this, I don’t think it makes much difference. I think in some cases it could be detrimental particularly considering at a population level, blood pressure issues and everything like that. A lot of people have high blood pressure, but in the context of using Stan Efferding’s vertical diet as an example, it’s pretty much red meat, white rice, vegetables, fruit, if somebody followed that without adding sodium to their diet and they ate completely unprocessed foods and they didn’t add sodium to their diet, they end up on a really low sodium diet and then they also train hard and they sweat.
So they’ve got this combination of these two things and they end up experiencing these things, they end up getting lightheaded, they’re training suffering, they’re not as energetic and everything like that. You get that person to have salt pre-workout and they feel better. The example Stan often uses is the lightheaded feeling like when you watch somebody get up off a leg press and they feel a little dizzy and stuff like that. He’s like with that person, try this. If it helps, awesome. If it doesn’t, if you don’t feel any different then-
Leah Higl:
Then just don’t do it anymore.
Aidan Muir:
Just don’t do it anymore. So yeah, I think that’s how I’d look at it being like if you already feel good, and you eat salt in your diet, you eat packaged food and stuff like that, I really wouldn’t think about it. But if you think you’ve got a low sodium diet and you experience some of these things, it’s worth trying, heaps of people who do try it report having way better pumps because suddenly the sodium’s bringing water into their muscles and stuff like that. Better energy, less light head feeling. It has potential, but if I had to guess in terms of what percentage of people who walk into the gym do I think get benefit from it, I think it’s a relatively low percentage.
Leah Higl:
Pretty small amount.
Aidan Muir:
Yeah.
Leah Higl:
Yeah. So next question is what blood tests should you get if you are struggling with weight loss?
Aidan Muir:
This is a tough question to answer, but starting… I would personally recommend going to a GP for this and not necessarily going to anybody else, because there can be a lot of blood tests people would recommend. But starting off from a GP, looking at it from that perspective, firstly, not necessarily from the weight loss perspective, but I would get a general blood test just because it’s free in Australia. So it’s like let’s get this information from [inaudible 00:14:45]. So test cholesterol, test blood glucose levels, all these things, even just from a general health perspective, if you ask for a general blood test, you’ll get given all of these things. I would also add vitamin D, I’ve talked about this heaps as to why I really rate vitamin D and also the prevalence of deficiency. I would estimate that somewhere, we definitely know for sure that at least 30% of Australians are deficient. So it’s like there is a chance that you’ve-
Leah Higl:
Just chuck it on there. Anytime you’re getting a blood test, just ask for vitamin D.
Aidan Muir:
And that doesn’t directly affect weight loss, but it’s like you might get sick less frequently if you address this, you might get better sleep, you might feel better, you might feel more energetic. There’s a bunch of reasons why it’s worth looking at. But then specifically answering the question, the biggest one I’d look at is testing your thyroid hormones, specifically T3 and T4, they have a pretty decent size influence over our total daily energy expenditure. They are involved in our metabolism. If they are lower, so you have hypothyroidism or you’re on the brink of that or anything like that, then total daily energy expenditure will be a bit lower.
I’ve spoken about it previously, but the highest recorded decrease in, or in at least basal metabolic rate from these hormones being lower is about 15%. So it’s never going to be the sole explanation as to why weight loss is difficult, but it is a factor and it’s worth looking at for sure. But beyond that, if you are in a position where it’s making a big enough difference from a weight loss perspective, it’s also going to be making a big difference from a health perspective.
It’s going to be down regulating a lot of functions because that’s what it’s doing, and the body is conserving calories due to these being down-regulated and you will have a bunch of symptoms associated with that. So it’s like you want to address that anyway, so you might as well see it and check and everything like that. And then if you really want to cover everything, it’s worth adding cortisol onto this test as well. That’s a complex one. I don’t want to go too deep into that, but it’s like people call that a stress hormone, but beyond that people might hold onto more water if their cortisol’s high, they might find it more difficult to lose body fat. But I don’t want to hype that one up too much. That’s why I’ve listed it later in this kind of discussion.
Leah Higl:
And even if it is excessively high, again, it’s probably something you’d want to address in some way for multitude of reasons.
Aidan Muir:
Hundred percent. And then in men, I’d add testosterone too, just measuring that, not because increasing your testosterone should lead to weight loss because it doesn’t necessarily. But we do see in studies that people who have low testosterone and are looking to lose weight, if they increase their testosterone, on average, their weight does decrease a little bit. But there’s a lot of things that go into that. What if you just feel more energetic and more ambitious when you’ve got high testosterone and you’re like, maybe I’ll do a bit more movement or maybe I’ll like… It could be that kind of indirect factor more so than direct. For the next question we’ve got, during deload weeks, should we decrease our calories to maintenance?
Leah Higl:
I get asked this question a lot by clients, and I guess my general answer to it is that it’s not something I tend to bother with. If you are… I mean, I guess it depends on what you’re doing, whether you’re in a deficit or whether you’re in a surplus. But I wouldn’t usually change the approach during a deload week. I don’t think there’s enough change usually in that person’s training to really to want to make that difference. Is it something that you do with your clients?
Aidan Muir:
No, I do have a lot of similar thoughts to yourself. One of the reasons why I don’t is just keeping it simple but-
Leah Higl:
Keeping it simple. Yeah.
Aidan Muir:
I think it adds complexity without really improving results.
Leah Higl:
I agree.
Aidan Muir:
And even just looking anecdotally at a lot of top bodybuilders and stuff like that, I don’t see a lot of them actually doing that either. So it’s like firstly we don’t have research supporting it, but then we also don’t really have anecdotal evidence really supporting it either. But when I think about it theoretically, it makes sense to a certain degree. I’m like, well, firstly think about it being like, is your energy experiential lower on deload weeks? It’s probably a little bit lower. So it’s like if we wanted to keep exactly the same surplus as we’ve been doing, maybe we’d have to take away a couple hundred calories anyway. And then I’m like, is there a downside to decreasing to maintenance? I can’t see a downside to decreasing to maintenance.
Leah Higl:
Other than just logistics.
Aidan Muir:
Just logistics. And one of the difficulties is we can’t really measure energy expenditure perfectly. So it’s like we couldn’t even really find maintenance that quickly in that one week to start off with, we’d just be estimating and that’s fine. So I’m like, if somebody wanted to do it, I would do it. I wouldn’t hesitate to do it, but I also don’t needlessly want to add complexity when I can’t see it being better.
Leah Higl:
Yeah, I see the argument there. If you are in a surplus to gain muscle mass and you’re wanting to reduce the amount of body fat you put on in that deload week, you’re not really stimulating the muscles in the way you usually are. Yeah, I guess it makes sense to be in a smaller surplus or no surplus at all, but it’s just such a small timeframe that it just probably doesn’t matter.
Aidan Muir:
And I suppose both of us are really big on small calorie surpluses anyway.
Leah Higl:
Yeah, true.
Aidan Muir:
So it’s like you’re gaining so slowly anyway, that’s like, it just doesn’t matter.
Leah Higl:
It just doesn’t matter.
Yep. So this has been episode 75 of The Ideal Nutrition Podcast. If you could leave a rating or review on your podcast platform of choice, that would always be greatly appreciated. But other than that, thanks for tuning in.