Leah:
Hello and welcome to the ideal nutrition podcast. I am Leah Heigl and I’m here with my cohost Aiden Muir and today we are doing a Q and A episode. So just answering a few questions that we have gotten through Instagram and from our listeners and yeah, go through them, answer them and see what we can make of it. So the first question is, is the Mediterranean diet the gold standard for health?
Aidan:
The first classic dietitian answer would be obviously I’d be hesitant labelling anything as that for sure. It is up there though. If we looked at purely through the lens of reducing the risk of chronic disease and living an overall healthy life, it very much ticks a lot of boxes. There’s consistent evidence that reduced the risk of cardiovascular disease and also cancer as well, where almost everyone talks about it from the cardiovascular disease perspective, but the reason why I’ve put both of those together is how that likely impacts longevity.
Like if you live long enough, typically it’s one of those two things that gets most people. So therefore if something reduces the risk of those two things, it typically also translates to longevity to a certain degree. So that’s another huge bonus of the Mediterranean diet. It’s also high in micronutrients and healthy fats, so there’s lot of benefits there.
It also indirectly makes it hard to over consume calories since it’s all unprocessed food. A little point I make to a lot of people is that a tiny under appreciated fact is that the traditional Mediterranean diet has an absurd amount of olive oil in it. Typically has like 30 to 60 millimetre olive oil per day. But the reason why that fits surprisingly well into the Mediterranean diet is because if those people weren’t consuming that, like for context, that’s about 500 calories somewhere around that range. If they weren’t consuming that, they would just have a below ideal calorie intake in most cases.
And that would have issues like being too frail and stuff like that, increasing the risk of falls as you get older. So once you kind of factor that in, it’s like, well, why they in that position where the 500 calories or so of olive oil is suddenly like more beneficial than it normally would be as well? It’s just because it’s very hard to overeat the other stuff. Like it’s hard to overeat things like fruits, vegetables, legumes, healthy fat foods like salmon and like avocado.
I know those are more energy dense, but in that context of mostly minimally processed foods, it’s harder to over consume. The other angle though is that I don’t really view it as a performance focused diet. I know we’re talking about health here, but like anyone who has performance-related goals, I’m probably not going down this route so much. I might take a few like key takeaways from it, but I’m not going down this route properly.
And the other very open-minded perspective is that there are many equally healthy options out there. And it would be silly to kind of like box yourself in and be like the Mediterranean diet is the gold standard when there’s a lot of options. The next question we’ve got is, do any micronutrient deficiencies impact energy levels?
Leah:
Yeah, so there are a few that I would just think about right away when it comes to energy levels. And the one that comes up first is always going to be iron. So iron deficiency can reduce blood cell function and oxygen transport and anyone that has been anaemic or has had low iron levels actually got an iron infusion this week. So I’m like very well versed in this. But anyone that’s been there knows how much fatigue you can feel. You can have all the sleep eat enough calories do have enough rest, but you just feel tanked every day. So absolutely iron deficiency is a big one that can have people feeling with pretty low energy levels.
Another one is in general B vitamins, but specifically B12 deficiency can have a huge impact on energy levels and increase fatigue by a lot. And it’s something that I see a fair bit in my practice because I work with plant-based people and B12 is harder to get on a plant-based diet. And for those who are even like still within the clinical range, but on that lower end, like close to being deficient, I still see them complain of issues around fatigue that do improve with supplementation. So that could be something to consider.
And then two kind of lesser ones, like the iron, B vitamins, particularly B12, they’re up there. The first things that I would check from a nutrient deficiency point of view with someone that’s chronically fatigued. But another couple are magnesium and vitamin D. So magnesium is linked with a lot of functions in the body and deficiency is linked with fatigue in the research overall.
Magnesium deficiency can potentially lead to issues with sleep. So that can be a bit more of an indirect impact. If you’re not getting as good quality or quantity of sleep, obviously that can reduce your energy levels, but magnesium in general, due to its many functions of the body could also contribute to fatigue in other ways.
And then vitamin D does have a pretty huge role in things like regulating mood, mental health, and also mitochondrial function. So it wouldn’t be difficult to put two and two together and go maybe if your vitamin D deficient that may lead to reduced energy levels. So that could be something that you would consider as well.
The next question is does the glycemic index matter?
Aidan:
For most people I wouldn’t focus on it at all This isn’t the place I’d normally go straight to but if somebody was concerned about the impact on fat loss It doesn’t have any impact on fat loss directly like if you were specifically concerned about insulin you might think that it would be more likely to. You could either take my word for it or you could look at outcomes. It doesn’t affect fat loss directly. The hunger side of things is a bit more nuanced in that lower GI foods typically keep us fuller for longer to a degree. Like that is a pretty nuanced topic by itself.
But in my opinion, if you prioritise high fibre foods, this largely takes care of itself without you even thinking about the glycemic index. For people with diabetes and PCOS, I do factor it in. But even in those cases, I care more about the glycemic load, which is basically the combination of glycemic index and total carb intake. The example I always use is, let’s say you had a low GI food in a large amount. At the end of the day, it still has to break down to a certain amount of glucose in the blood and it still will increase glucose levels pretty massively. If you have a tiny amount, like a single grain of sugar, it’s high GI, but it’s still nothing. Like it’s not really moving the needle.
So I care a lot more about the combination of those two things. And there is also a lot more individual variation with glycemic index than is often talked about. We often have like numbers in our head and things like this food is high GI and this food is low GI. But if you actually look at the research that is used to like identify those numbers and then get the averages from that, there is so much individual variation. There’s crazy differences there.
So even if you wanted to go down the route of focusing on the glycemic index, it wouldn’t make sense to take the actual numbers too seriously and just factor in that there is a bit of margin there for individual variation. The next question is, can probiotics help with bloating?
Leah:
So with this one, research is a bit mixed, but the short answer would be yes, they have the potential to help, but there is kind of a big question mark there at the same time. So some strains have been found to help with bloating in some cases, but you do have to be quite strain specific. And we’re to be quite vague about this because you kind of have to be when it comes to probiotics.
Probiotic research is, it’s a deep, deep rabbit hole. I think we have done a couple of podcasts.
Aidan:
Yeah, we’ve done a few episodes on this.
Leah:
So we go into a lot more detail. But you do want to be strain specific. In practice, would potentially, if someone wanted to try this, A, it wouldn’t be my first line approach for bloating because that’s very factorial and multifactorial. But if someone wanted to try it, then I would just choose an IBS specific probiotic option like the LifeSpace IBS support and ones that do contain those strains that are more so linked with positive outcomes from a IBS bloating perspective.
Although again, research is really mixed. So identifying those strains and the quantities in which you need to consume them can be quite difficult. When it comes to bloating in general, there is so much so many other things that you can do to move the needle in a shorter time frame that I would be looking at before I even went down the probiotic route.
Aidan:
Yeah, I had a bit of a light bulb moment many years ago with probiotics where it was one of those things where I was like, why is nobody, why is nobody giving specific recommendations unless they’re being paid? Like anytime I ever saw a dietitian recommending a specific brand, they were being paid. And I was like, no, as somebody who tries to give away everything for free where I possibly can.
I found that odd being like, oh, I’ll just go get the answers myself and then I’ll give that away for free. And then I went deep down the rabbit hole. was like, I get it now. I see why nobody’s like being specific in a public forum. I’ll be very specific in private with people and just give my best interpretation. But in a public forum, you have to defend why you have that stance. And if somebody’s like, why did you pick this product over that one?
And then you look at the research and see that like, there hasn’t been that much looking at different strains and everything like that showing a noticeably different outcome with different dosages and so on and so forth. It’s very hard to defend why you think one product would be better than another, but in private it’s a lot easier to just have a crack and just like give the best interpretation.
Leah:
Yeah. And I’m, I, I’m so obsessed with the IBS gut space that I was like, I’ve gone down this rabbit hole so deep and I’m still like scratching my head a little like, oh yeah, it’s not, it’s not very clear. The next question is how does protein help fat loss?
Aidan:
So three mechanisms. first one is satiety. It makes it easier to stay fuller. I often talk about this, um, Jose Antonio study where they aimed for like 4.4 grams per kilo of protein. Just clarifying if somebody is hundred kilos, that’s aiming for 440 grams. It’s an absurd amount. Um, going even further in case it doesn’t resonate, like a hundred grams of chicken breast is like 25 grams of protein. Think about trying to get to 440. Crazy.
Anyway, in that study, like they were trying for this absurdly high intake. And they still didn’t gain weight just because it’s, it’s very hard to over consume calories if you have a really high protein intake or it’s a lot harder. So that’s one angle. It fills people up more per calorie. At my old place of work, I had a funny, discussion with my employer slash manager where I made the claim that protein is the most satiating food or macronutrient per calorie.
And they’re like, no, fat’s more satiating. And I’m like, per calorie, like per gram fat is more satiating because fat has nine calories per gram, protein has four. And they were basically like, nah, I checked with like the clinical lead of our company, fat is more satiating per calorie. And I’m like, this is a well-documented thing. And it’s so like, this is part of why I like working for myself.
It’s the tiniest detail, but it’s like, nah, this sucks. Anyway, so that was point one, satiety. The second point is the thermic effect of food which I need to make a little correction on myself. Cause last podcast I said that the thermic effect of food of protein was like 15 to around 30%. And I did even in that podcast say, 30% seems high. Actually I know if it was the last, it might’ve been a few episodes ago.
Anyway, I did say I was like 30% actually does seem high. The correction I’m making is it was 15 to 25%. So it actually was a little bit high. Anyway, so of the calories you consume while consuming protein, 15 to 25% kind of just like goes missing. It increases your energy expenditure by that amount. That’s not a big deal and I would never like change somebody’s plan just to increase the thermic effect of food, but it is a nice bonus of a higher protein intake.
And then the one that I do care about the most is the muscle retention side of things. Just through the lens of, I care about muscle and I hope most people do, but even if you didn’t indirectly, if you’re in the same size calorie deficit and you’re retaining more muscle. By definition, you end up losing more body fat because those calories have to come from somewhere. The next question is, should endurance athletes take creatine? Feel free to ignore everything we spoke about off-air in this one. Just answer it.
Leah:
I’m just going to answer with what I kind of previously thought about, which turns out kind of aligns, like we both think the same way about creatine in this space. I think, I mean, I’m generally a big proponent of creatine. I think there’s very limited downsides to taking it. And typically there’s just upsides.
But when it comes to endurance athletes, I actually don’t think it has that much potential to significantly help for an endurance athlete and performance. But I’m going to unpack that a little bit and go through it. So creatine itself is well known for helping with those short bursts of activity. So more your high intensity short bursts.
So when we’re thinking endurance sports, often that’s, you’re doing something for a long period of time and it’s a lot lower intensity. So all of like, starts to the mechanism of creatine and how it works doesn’t really add up in that space if you’re just thinking about it from a mechanistic point of view. And then you’ve also got some other considerations. Like, I mean, some people are concerned with the water weight negatively impacting performance when they’re thinking endurance.
We don’t necessarily see that in practice, plus that kind of increase in water weight is only really noticeable in cases where people are doing that loading phase of creatine. And then even still, it seems to be more transient in that it will not always be there if you consistently take creatine over time. So I think that’s something or an argument we can kind of take out of this analysis or interpretation in general. But creatine is particularly helpful for resistance training.
For all of my strength athletes, anyone doing a decent amount of strength training where the goal is to get stronger and to build muscle, I’m obviously going to recommend creatine. There is enough research in that space for it to be like, yup, this definitely does help to a certain degree. Probably should take it if you want to optimise things. But when we’re thinking the resistance training that endurance athletes do
Okay, sometimes when they’re building up their base, so when their goal really is to increase muscle mass, increase strength, and they’re doing a fair bit of resistance training, I think creatine has its place there. But as you move to a more advanced endurance athlete where you’re really only doing resistance training maybe a couple of times a week, it’s not really high impact or high intensity. You’re not taking everything to failure. You’re not necessarily trying to grow a tonne of muscle or get really strong.
I just don’t think creatine is going to be overly helpful in those situations. I don’t think you’re pushing the resistance training hard enough for creatine to like really start playing a role in performance there. I think the most compelling argument I see from experts in this particular space is talking about specific portions of endurance events like sprint finishes, trying to overtake people, those times where you actually do have those short bursts of high intensity activity.
Where you could absolutely make an argument that creatine supplementation could actually come into play and be helpful for performance in that aspect. For example, one study had athletes perform 30 minutes of exercise at an intensity just below the lactate threshold, followed by 10, 15 second sprints. And they found that creatine did improve the sprinting power output by 18%.
So in that case, it actually did make a difference to performance. So there is quite a lot of promising evidence in this space, but how much it actually matters for overall performance and overall race times, I think it’s still bit of a question mark. My general consensus is that if you’re an endurance athlete who is actively really pursuing muscle gain, strength and resistance training at that point in time is a big focus for you, probably makes sense to take creatine as opposed to if you’re doing a low amount of strength training at a low intensity and kind of just maintaining.
But I also have the view that again, there are very little downsides to creatine. And if it’s something that you want to layer on top because you might, think it may give you that extra 1%, well do it because there are no downsides realistically.
Aidan:
I also see like in different sports, maybe, maybe it matters even more. Not a big cycling guy, but I’ve watched a little bit of Tour de France. The sprint finishes there. I’m like, actually very much think it’s relevant. And because it is so like tactics focused that it’s almost like they haven’t given everything yet. They get to that point for the sprint finish. And then the sprint finish actually does determine things at the end.
Like I say it so much more relevant there versus another more steady state the entire time up until like a bit of a sprint finish to the end still, but like I do see it more applicable and even breakaways. And there’s like so many examples in cycling versus even other ones, but yeah.
Leah:
Do you go out of your way to recommend creatine to your endurance athletes or is it something that you’ll talk more about with them and see if it’s appropriate?
Aidan:
It’s so low priority for me. Yeah. It’s one of the lowest ones, but if they’re interested, I would be, yeah, like I will say yes to it if they want to take it, but I’m less likely to go out of my way to recommend it.
Leah:
Yeah, absolutely. And the last question we have for today is can certain foods boost your metabolism?
Aidan:
So certain foods can have a mild effect on your metabolism, but the impact is generally small and not significant enough to lead to major changes. being specific with some stuff, the first one that’s an obvious one is like the protein thing I talked about with the thermic effect of food. Technically, that’s not metabolism in terms of your basal metabolic rate, but it is your part of your total daily energy expenditure. So that’s pretty relevant.
So the next one is capsaicin, which we were talking about in that last episode about fat burners where it’s often found in chilli powder and also fat burning products as well. And has been found in studies to like increase energy expenditure by around 50 to 75 calories per day. That is meaningful as we kind of touched on there.
Does it really matter long-term? Like I, I am mostly of the opinion that if you do stuff that increases your energy expenditure, your appetite’s probably going to increase proportionally. But that’s obviously a bit of a different case if you’re just like a robot that just eats, eats what you eat regardless of how you feel. But it is still a thing I think most people should factor in.
And then caffeine has been found to increase energy expenditure by 60 to 200 calories, likely scaling based on how much you consume. Like if you had, I think we even referenced something in the last one about if you had like 90 milligrams of caffeine, it was as low as like a 25 calorie increase or something.
Leah:
It was 25.
Aidan:
Yeah. I’ve got a, got a memory for numbers apart from the protein thermic effect of food. Usually do pretty well. But, yeah, so caffeine, like I think if you absolutely send it on caffeine and have a really high intake of it, you can get towards that top end. So like that makes sense, but that effect very likely diminishes noticeably with extended juice. Like if you get somebody who forward as well, most caffeine studies are done with a decent, like a decent or a sensitisation period before where they like don’t have caffeine. So they get people who aren’t having caffeine and they give them a really high dosage out of nowhere.
And a lot of the effects of caffeine looks so much more pronounced under those circumstances than if you get somebody who’d had like 300 milligrams every single day for the past year. You’re just not going to see that type. You’re just not going to see that type of difference. So I do think with the combination of a few of these things you can see a small increase, but it’s not an outcome that I personally would chase. And I don’t think many people should, particularly when you factor in my other thoughts about the fact that I do think like appetite often adjusts over time in relation to a bunch of this stuff too.
LeahL
And that wraps up episode 197 of the Ideal Nutrition podcast. If you haven’t yet left a rating or review, it’s always greatly appreciated for you to do so. But otherwise, thank you for tuning in.