Leah:
Hello and welcome to the Ideal Nutrition podcast. I am Leah Higl and I’m here with my co-host Aidan Muir and today we’ve got another Q &A episode. So this is our eighth Q &A episode in the history of the podcast. And we’ve got a few good questions to go through today. So we’ll kick it off.
Aidan:
The first one we’ve got is what are your thoughts on things like Up N Go poppers, particularly the protein version as a go-to option for people like myself who are chronically disorganised in the morning. Noting it is a fairly processed food and has extra sugar. Do you recommend using these types of food options in your practice?
Leah:
Yeah, I think, well, firstly, yes, I recommend products like this all of the time. I think the biggest thing to consider here is nutrition is always context dependent. There’s no, like you’ll hear dietitians say this all the time, but there’s no good foods and bad foods. It all depends on the context in which those foods are consumed.
So if we have an otherwise pretty whole food based, pretty well-rounded balanced diet, something that is like processed like this that does have some extra sugar content, it doesn’t really have downsides in that context. If this was the only thing you were consuming and the rest of your diet was pretty poor quality, okay, then that becomes a problem.
But again, it’s not this food that makes it a problem. It’s the entire context of that diet. Where I really love products like this that make nutrition a bit more simple. Like I would much rather most of the time for my clients to have that bit of calcium and protein and something in the morning as opposed to nothing. At least most of the time, right? There are times where I’m not the biggest breakfast advocate. I don’t think it’s like the most important meal of the day for everyone or anything like that. But for a lot of people who are on the go and need to get their nutrition in a very accessible way, I love products like this.
Aidan:
Yeah, I’ll add my two cents because I agree with pretty much everything you said there. Little things I’d note, obviously liquid calories are going to be less filling than solid calories. So if somebody had that instead of another solid thing, they could be hungrier. And if that happens to you, then it’s worth potentially adjusting, addressing, whatever. If that’s not an issue for you, then it’s a completely different topic.
I personally, honestly, I never recommend it unless a client wants it and they’re asking for them I am like, okay, sure. But with that, I don’t know. There’s certain things I do that I’m like, do I just do this? Cause this is the way I’ve always done it. Like would I do this differently if I thought about it deeply? But yeah.
Leah:
I think I work with so many neurodivergent people that ease of use is very important to my clients. So these products actually become a bit of a staple just to get nutrition in, in general for people that literally forget to eat most of the time.
Aidan:
Yeah, for sure. Yeah. I don’t know about you, but I think maybe 15, 20 plus percent of my clients now have ADHD. And like that’s a very big factor as well.
Leah:
100%. The next one is a little bit of a doozy in that someone attached a research article, but they’re basically like, what are your thoughts on this article? And it was titled eating too much protein is bad for your arteries and this amino acid is to blame by Science Daily.
Aidan:
So I read the article. The summary is that they interpreted based on a mouse study that eating greater than 22% of calories coming from protein could theoretically increase the risk of atherosclerosis. I thought I was going to butcher that.
Leah:
Yeah, that was a good, good job.
Aidan:
Fun fact for people listening to this, I couldn’t say TH up until like 20 years old. Like I just kind of resigned myself to being like, guess I’m not going to be able to say words that contain that. Like, I would just replace it with either like I’d replace it with F or V. So brother would be brother kind of thing. And then when I was like, I can change this. I just like Googled how to like, I just practiced every day. don’t know.
Leah:
Oh you did it yourself. You didn’t go to speech therapy?
Aidan:
So I did. It’s funny. Like, so speech therapy, tricky word, speech pathologist, tricky word. Anyway, I called up a speech pathologist to book in back when I was living in Wogga and the conversation just kind of put me off a bit. Firstly it was expensive and I’m like, is it worth doing this?
But secondly, they, everything I was talking about, they kept bringing it back to their work with children. And they’re like, what I normally do when I’m working with children is… I’m 20 years old. I don’t wanna hear this. I don’t know if that’s just me reading too much into it, but I was like, you know what? Screw this. I’m gonna go on YouTube.
Leah:
That would be off-putting.
Aidan:
Yeah. Anyway, so it’s funny that I have a podcast now, but that’s a hard word. Anyway, so leucine in particular was proposed as the trigger, based on mechanisms. I think the first step is to zoom out and look at this in the context of research as a whole particularly because it is a mouse study.
I have never seen plant-based protein intake as being something that is increasing the risk of cardiovascular disease risk within the context of an appropriate calorie diet. So obviously that does still have the problem of leucine often being lower in plant-based protein. So it doesn’t overcome that, but at a minimum it does kind of solve the like greater than 22% of calories coming from protein as a whole thing, like not necessarily being a bad thing.
When you look at research on animal-based protein intake, there’s a lot of other variables going on that skew things. For example, saturated fat, dietary cholesterol, among other things as well. It’s worth being aware of the proposed mechanism that they’re talking about in this study, but at this stage, it’s not something I’m overly concerned about, particularly without human research on the topic in large sample sizes and knowing everything else that I know about nutrition.
We know there are a lot of things to focus on to minimise the risk of cardiovascular disease. Like we know a lot of things that we can take action on. I wouldn’t be focused on this thing that is a very small potential thing that may or may not matter at all. When there are so many easy wins for people that have been very clearly identified.
Leah:
Yeah, it’s very much like missing the forest for the trees if we’re just focusing on this small study and looking at leucine when it comes to cardiovascular disease as a whole.
Aidan:
Yeah. So next thing is, we’re doing two back to back creatine questions coming up. So, GI symptoms from creatine common? And is there anything that can be done to help?
Leah:
Yeah. So if we look at research, so in research, the GI issues are uncommon in that it’s not a general trend that we see in this kind of population or sample data. In practice though, I like to say it’s a mixed bag in that I do have a lot of clients report GI issues from taking creatine.
And just because the research doesn’t suggest that as a general trend doesn’t mean I’m going to go to a client and be like, no, you’re making this up. It’s all in your head. I think for some people there may actually be very real gastrointestinal issues caused by creatine. Typically, I want to keep creatine in this person’s diet regardless, because usually it’s like they’ve got a muscle building goal, they’re an athlete or they’re doing something where creatine ideally, you know, it’s a nice cherry on top to keep.
So in terms of overcoming the GI issues, you could try just reducing your dosage down. Like if you’re taking the full five gram per day recommendation, well, why don’t you try two to three and see if that gives any gastrointestinal issues at such a small dose. It’s highly unlikely that it will. For some of my clients taking the creatine with food as opposed to an empty stomach can help reduce GI issues or even just splitting up the dosage.
So even if it’s like, how alot of people consume beta-alanine to reduce the paresthesia, like that tingly feeling you get, they’ll break it up into two to three doses across the day. All right, why don’t you try that with creatine? Because that could be a way to get around that as well.
Aidan:
Yeah, diving deeper on a few things. So with the research that if you do just say five grams per day, when that’s compared to placebo, it seems like the odds of GI upset is the same, noting that a lot of people in the placebo group still report symptoms at probably a relatively similar frequency or maybe a little bit less than what we see in practice.
When they do the higher loading dosage, there is a bit of a discrepancy between placebo and say 20 to 25 grams of creatine, which therefore is a bit of an indication coming back to the logic of maybe going lower dosage is a way around this obviously. And then in amongst reducing and splitting the dosage, another thing that I actually very rarely recommend, but it is a way around this is using creatine HCl instead of monohydrate. Not because there’s anything magical about it, but my understanding is that a standard serve of that is about 1.5 grams versus a standing serving of monohydrate is like three to five grams for like a maintenance type of dose. So although it’s not magical, once you get as low as 1.5 grams, the odds of it causing GI upset suddenly gets so low as well.
Leah:
The next question is, would you recommend creatine for someone who is under 18 but semi-elite in regards to being an athlete?
Aidan:
I don’t see any reason not to. There is obviously, I don’t think moral is the right word, but like some people would be concerned about pushing supplements first on somebody who’s younger. But say, let’s use 17 as an example. Say somebody’s 17 years old. They are prioritising their food, they’re prioritising their training, they’re semi-elite and then all you did on top of that was add creatine. I don’t see any downsides of that, particularly if it’s communicated in an effective way.
You can start having discussions about younger and younger and it becomes a little bit more of a debate, but how many semi-elite 10 year olds are there? So let’s be realistic with some of this stuff as well.
Leah:
I see creatine as more like taking a protein powder or an amino acid or something along those lines where it’s like this grey area between food and performance supplement. So I’m more ready to rec… and given that there’s so much research on creatine being safe, I’m more ready to recommend something like that to a teen athlete than other performance supplements.
Aidan:
I don’t know if I was talking about this on the podcast or even to you, but have I told you about how I almost got kicked out of home for having protein.
Leah:
You did.
Aidan:
It’s funny that you say that. like, no, I wasn’t allowed to as a teen.
Leah:
I grew up with a bodybuilding mother, so I feel like very different context here.
Aidan:
Very different context. That’s funny. Yeah, okay. Another tangent, but something that I’ve got my tinfoil hat on about the fact that heaps of elite athletes probably use performance enhancing drugs, even in drug testing sports. I don’t know, not an evidence based take. You don’t have to believe me on that one, but it’s my opinion.
Interesting. I don’t know if you’ve had this experience working with like semi elite, just under seven, under 18 year old athletes, the amount of like 16 or 17 year old people I’ve worked with who are top three in Australia in their respective sports, who I have brought up creatine supplementation and they have been so concerned and they have been like, I don’t want to take anything I don’t want to take.
I’m like, hmm, this is kind of like making me question my tinfoil hat thing a little bit because I think this guy in two years is taking drugs.
Leah:
I think the slope is very steep when it comes to as soon as you find out about that stuff. Yeah. But yeah, when it comes to creatine and teen athletes, it’s something that I would recommend a batch tested option just in supplements in general for any elite athlete, but I see it as being a problem to be honest.
Aidan:
No, and once you look at the data on being like, is there any downside? There is no downside. It’s not like it’s harmful at the age of 15 and suddenly it’s totally fine at age of 19. Like the pros and cons are exactly the same at the different ages.
Aidan:
How is high protein yogurt like Chobani made as opposed to other yogurts that are low fat with less protein? Am I answering this or?
Leah:
You answer that. As a plant-based dietician, I have less, I have no idea on this.
Aidan:
Yeah, I’ll answer this. So Chobani is made of a straining process that removes a portion of the liquid and lactose, leaving a higher concentration of protein left. For people listening, obviously you probably noticed that lactose is a form of sugar, which therefore that reduces the sugar and carbohydrate content because in yoghurt, initially at the start of the process, all of the carbohydrates are lactose. We could then talk about how the bacteria breaks some stuff down and everything like that, but this process reduces the sugar and carb content. They’ve obviously taken out the fat content by making it low fat. This is how they end up with protein as being higher.
So that straining process basically concentrates the yoghurt’s protein even further and the end result brings up higher without the need to add other ingredients like protein powder. So Chobani Fit and the regular Yo-Pros don’t have protein powder added. Actually I don’t know about Chobani Fit, I know the regular Chobani definitely doesn’t. Whereas Yo-Pro Perform, which is 20 grams of protein instead of 15, they make up that difference by adding some protein powder to it. And then other lower protein yoghurts just undergo less straining or none at all.
Aidan:
How can you lose weight while breastfeeding?
Leah:
In terms of weight loss, the rules kind of stay the same in that obviously we do need to be in a caloric deficit. I guess the major consideration when I’m working with someone that’s breastfeeding is that they are obviously having, like a new child. So the logistics get harder around weight loss. Whether it becomes like the lack of sleep, the responsibility of just looking after a child, which I have kids of my own, but I assume as very, that’s a lot of work, which is why I don’t have kids.
But most of my clients in this space where they’ve just given birth and they’ve still breastfeeding, they’re up several times of a night. Often weight loss becomes hard just due to the logistics of maintaining a caloric deficit. Even though the energy expenditure is usually going to be three to 500 calories higher per day because of all the energy that goes into the breast milk supply. So you actually have a higher kind of calorie output just at like a baseline level because of that. But there’s so much individual variation there and it depends on what your breast milk supply is actually like.
Obviously it’s going to be very different for someone who is exclusively breastfeeding versus someone that maybe doesn’t have enough of a supply to do that and is doing a bit of a mix. But there is this kind of general increase in energy expenditure. I always like to say with these clients, it is best to avoid going super low calorie just in general, especially if you want to protect your breast milk supply.
If you go into a very steep deficit and you’re like, I just really want to lose this weight, there is a high chance that the breast milk supply is gonna go down. And if that’s something that is important to you, it makes sense to either be in a very small deficit or kind of maintain maintenance and just focus on kind of fuelling and appropriately and giving your body what it needs to continue that milk supply. So again, like the rules don’t really change, the logistics sure do get a hell of a lot harder. And in general, I would avoid going super low calorie here.
Aidan:
Yeah, for sure. And there’s so many reasons to avoid going super low calorie. I had an interesting DM maybe a year ago that’s really made me contemplate this topic a lot, where somebody DMed me by being like, the body prioritises milk supply. So even on quite low calories, it doesn’t drop. This is what the research shows. And I did go and look at research after that and it doesn’t like from the research, it doesn’t seem as clear cut.
I’ve worked with a lot of people and a lot of people have reported drops if they’re in a calorie deficit and stuff like that. But it’s also hard to interpret that. I don’t know if you’ve ever seen data, have you seen data specifically on it?
Leah:
I’ve actually not, no. So as soon as you brought that up, I’m like, that’s interesting. I only have my kind of practical experience in that I have had clients say, look, my breast milk supply is less now that I’m in a deficit and maybe it’s best that I go back to maintenance and I’m always on board with that.
Aidan:
Yeah, and that’s exactly what I do. I think it makes sense to be cautious. But I’m like, it is an interesting point that somebody did bring it up. And that person who brought it up is somebody who works very heavily in this space and is clearly like kind of passionate. I don’t know, interesting feedback to hear from people as well.
Leah:
Next question is what are your thoughts on the dietary inflammatory index score?
Aidan:
So the dietary inflammatory index score is a tool that is used to assess the inflammatory potential of a diet. It scores food components based on their ability to increase or decrease inflammation in the body. Foods are classed as either pro-inflammatory like saturated fats, sugar, refined carbs, or anti-inflammatory like fruits, vegetables, whole grains, and healthy fats. Obviously it’s a bit more complicated than that, but it be a lot of work to go into the minutiae of how they kind of score. So I’ve really simplified there, but that’s how they basically do it.
And overall it’s technically the closest system we have to an evidence-based system for looking at what does and doesn’t cause inflammation at a large scale. It is based on a lot of research and it is updated relatively regularly over the years, but it has flaws. The main things I’d say is that there is obviously likely a level of individual variation. So this is a broad view about what are common trends, but there is individual variation and the overall dietary pattern likely plays a big role.
I don’t want to go too deep talking about what I mean when I say that because you can then start nitpicking certain things. I don’t know, like if somebody claimed that the carnivore diet reduced inflammation, there’s a lot to unpack there. There’s so many angles. Whereas everything I’ve set up until that point is like evidence based. I don’t want to go too deep into individual details, but using just a bit of a summary, it’s not a tool I personally ever use in practice. There’s very many common themes that I focus on, but I don’t actually use the dietary inflammatory index, but it is helpful to know that it exists.
Leah:
Yeah, I feel like it’s one of those things where I wouldn’t find it that helpful in that we already know that consuming more fruits, vegetables, whole grains, healthy fats is a good thing. We know that too much saturated fat, too much animal products, sugars and processed food, not so great. So it’s like, it’s just confirming what we already know. Like, do we actually need these numbers in detail? I don’t know. I question that.
Aidan:
Partly why I don’t you use it practice. Anyway, so I suppose like you could use that as an argument for somebody who was convinced that something was causing inflammation to population. Totally. specific whole grains, like you’d start digging into the research. anyway. So final question for today is, does your metabolism slow as you age?
Leah:
My go-to answer for this is yes, your metabolism tends to slow as you age. And this is something we do see in general population research, but it’s due to factors, mostly like muscle loss and decreased physical activity and not that physical activity necessarily leads, is like part of your metabolism, but still something to kind of factor in and it’s this gradual decline that can make it harder to maintain your weight or lose weight and that’s what most people are kind of talking about in this context. But for those that maintain regular exercise they’re doing strength training, they’re optimising their nutrition to maintain their lean mass that can all counteract these kind of general effects that we do see in the kind of drop in energy expenditure as we age.
So if we account for variables like lean mass and activity there is actually not a significant difference in basal metabolic rate as you age until you are like over the age of 60, over the age of 70, in which case the decline in your function of the organs like bodily organs can be what, somewhat noticeable in regards to changes in BMR.
But if we’re talking people in their 30s, 40s, 50s, the main components are really going to be the changes in muscle mass and general activity.
Aidan:
Yeah. I like how the answer starts with yes and then adds all the context. It doesn’t have to.
Leah:
Yeah. You have control over this. And that’s what I like about it in that it’s not something that just inherently happens to you as you age. Like you can do things to counteract it.
Aidan:
Yeah. And one of the things I’ve seen a lot on social media is people answering this question by starting with no, and then referencing the research you kind of talked about being like, capitalism doesn’t slow down with all these things. So there was this big Herman Ponzter study that came out that found between the ages of, I believe it was 20 and 65, I can’t remember the exact start of it, but it was up to about 65, where there was no difference in BMR when you accounted for those variables like lean mass and activity.
The bit that I wanted to jump on with that is if, we also looked at that study comparing men versus women. It had the same finding when men and women have the same lean mass and activity and total body weight and all of these variables, their metabolism or their BMR comes out the same on average person.
I do not see any of these same people making the claim that men and women have the same metabolism because it’s a silly claim. It’s a silly thing to say. Just the same thing as it’s silly to say as a blanket rule metabolism doesn’t decline as people age on average. But then also factoring all these things being like the average 6 year old probably has not been doing resistance training consistently from the time they were 20. They probably have not been doing exercise, general daily movement all the way throughout their life.
If you did these things, you would have a very noticeably different BMR for the same other characteristics as other people just by maintaining those things for a long period of time, trying to stay relatively injury free while doing those things so you still have good mobility, still able to be active and independent and all those things. So very much stuff we have control over, but it is interesting seeing these variables are similar when things like lean mass are equated for.
Leah:
This has been episode 176 of the ideal nutrition podcast. Hopefully you enjoyed this new Q &A episode. If you want to hear more stuff like this, definitely hit us up on Instagram and let us know. Give us some good questions. We always love that. But otherwise, thanks for tuning in.