Sugar and Diabetes Risk: Perspective on the Study

A few days ago, a new study on sugar and diabetes risk hit the news and BOY has it been exciting! Mark Bittman ran an op-ed piece titillatingly titled ‘It’s the Sugar, Folks‘ that has been widely circulated among the Real Food, carb-gnostic, and fad diet communities. It sure sounds, based on the press this study has received, that we’ve definitively proven that sugar is the culprit behind diabetes and other ‘diseases of Western Civilization’. Hooray! We have our answer. And a path forward is clear, lets simply eradicate sugar and all our problems will go away!

I’m not going to pick apart the study (you can read it for yourself here). I suspect others will do that better than I could (Alan Aragon, I’m lookin’ at you). And truth be told, this is the kind of study I like. It’s large and mathy. The study authors put a lot of thought into it and controlled for multiple factors that are frequently ignored. I’m willing to accept their conclusions at face value, because I think their conclusions are fair and well supported. What I’m going to do is put those conclusions into perspective so you can decide how to apply them to your life.

First, lets talk about what those conclusions are and what they’re based on. This study examined the statistical correlation between sugar availability (availability, not consumption. Although it stands to reason that consumption is probably reflected by availability) and diabetes prevalence on a population scale. That means that they measured how much sugar was available in a population’s food supply and correlated it with diabetes rates in that population. Lets frame that with something you’re familiar with: the BMI scale. The BMI scale measures the statistical correlation between weight-to-height ratio and mortality risk. Most people know that the BMI scale is actually a very poor indicator of an individual person’s risk because it takes only two data points (out of thousands) into account. On a zoomed out, population scale level, a pattern emerges that as a population’s average BMI increases so does it’s mortality risk, but it’s very difficult to apply that statistical correlation at an individual level because so many other factors come into play in determining an individual’s risk (such as genetics, physical activity, body composition, diet quality, medications, epigenetics, gut microbiota, etc). This study is showing exactly the same kind of zoomed out, statistical correlation.

The main conclusion of the study was that for each 150 calories of sugar availability per person in a population’s food supply, there was an increase of roughly 1% in diabetes prevalence in that population. 150 calories of sugar is about 1 soft drink, so basically, for every soft drink’s worth of sugar per person per day, diabetes risk went up 1%. Remember though, this is at a population level. It’s very difficult to apply this at an individual level because of mitigating factors (like genetics and physical activity and weight and body composition etc), but lets imagine that we can. Lets pretend that we can safely say that for every soft drink you consume a day, your diabetes risk increases by 1% (we can’t say that based on this study, we’re pretending here). Got that? Your diabetes risk increases by 1%.

Lets put that risk into perspective. This study found that low levels of physical activity conferred a 71% increased risk of impaired glucose tolerance (a precursor to diabetes) over high levels of physical activity across ethnicities, cultures and genders. In this study, inactive individuals had more than a 100% increase in prevalence of diabetes over those who got 150 minutes or more of exercise a week. In this study, inactive lean women were at twice (100% more) the risk of diabetes as lean active women, and obese inactive women had 16 times (1600%) the risk of lean active women. This study on almost 6000 men showed that for every 500 calories expended per week on physical activity (that’s like an hour of brisk walking), diabetes risk decreased by 6%. This study suggests that inactivity confers a 30% increased risk of Type 2 diabetes in women. These risk ratios make that 1% increase from sugar look pretty measly, don’t they?

My take on the whole thing? Sugar may be relevant. This study certainly raises some questions that should be further explored in clinical and epidemiological settings. I suspect, though, that sugar only becomes problematic under certain conditions and in certain individuals. That is certainly what my research has led me to believe. If you are metabolically healthy, regularly physically active, eat a nutritious diet and maintain a healthy weight and body composition, you probably don’t need to worry about having some sugar here and there. If you are NOT metabolically healthy, are obese, are sedentary or have a genetic predisposition to diabetes, you should probably be mindful of your sugar consumption (but you should ALSO be mindful of increasing your activity level, losing excess body fat, and optimizing your energy balance, as those things will improve your metabolic function and may ultimately make sugar much less of an issue for you).

Here’s the big problem with the way this study is being interpreted in the media: sugar is not THE problem. Sugar may be (and probably is, under some circumstances) A problem, one of many. But if we’re going to treat sugar as THE problem, and then ‘solve’ that problem by simply eliminating sugar, we’re missing the forest for the trees. Well, for one tree. A bush really. Inactivity is a bigger problem than sugar, and fixating on sugar gives the inactivity a free pass. To improve metabolic health we really need to address all the problems. Don’t get hung up on Sugar As The Bad Guy. You cheat yourself out of vibrant good health, and miss out on some yummy and perfectly appropriate desserts.

Paleo Magic?

Click me! To see study.

This study is making the rounds of the paleosphere, so I thought I’d take a moment to look into it and see if it lives up to it’s claims that a paleo-‘type’ diet ‘has strong and tissue-specific effects on ectopic lipid deposition in postmenopausal women’ (‘ectopic lipid deposition’ = fat deposits on organs and skeletal muscles).

I got my hands on the full text and had a look. Quick synopsis: researchers put 10 overweight and obese, sedentary, post-menopausal women on a diet that they call ‘paleolithic type’ and measured changes to several metabolic and anthropometric measures. The main areas they were looking for changes were fat deposits in the liver and skeletal muscles, and insulin sensitivity, but they measured several other things as well, including:

-waist circumference and waist-hip ratio
-blood pressure
-blood glucose

The diet:

“All meals were prepared by the food service at Ume University Hospital and were weighed and frozen after preparation. The diet included lean meat, fish, fruit, vegetables (including root vegetables), eggs and nuts. Dairy products, cereals, beans, legumes, refined fats and sugar, added salt, bakery products and soft drinks were excluded. Participants were instructed to complement the provided food with other included food items from the list, ad libitum. To enable preparation of additional complete meals at home, the women received 14-day menus together with recipes and instructions regarding portion sizes. They were also advised to
use only rapeseed (canola) or olive oil in food preparation.”

The diet worked out to roughly 30% protein, 40% fat (predominantly PUFA as saturated fat was limited in this study by design, and most of the fat the subjects consumed came from nuts, fish and canola and olive oils. Wait, canola oil? DO YOU EVEN PALEO?). They ate to appetite and documented their intake.

The results were quite good. The subjects lost an average of 10 pounds, blood pressure improved, both waist circumference and waist-hip ratio decreased, and heart rate decreased! And there was indeed a reduction in liver fat! Good stuff! Lets look a little deeper at that. From the study:

“The dietary regimen resulted in a significantly reduced energy intake (520 kcal/day reduction) despite the ad libitum approach. This may be one of the factors contributing to the striking decrease in liver fat content. A series of studies have indeed shown that hypocaloric diets reduce the amount of liver fat.”

Layman’s terms: the subjects spontaneously ate about 500 calories less per day than they had been eating before the study (I talk about why diets high in protein and fiber, like the one in this study, can lead to a spontaneous reduction in caloric intake here. Protein and fiber are satiating and highly thermic foods. Diets rich in protein and fiber, paleo or otherwise, are very good at producing a spontaneous caloric deficit. It’s not magic, it’s science). It’s been established that hypocaloric diets (hypocaloric = fewer calories consumed than burned) reduce liver fat. Rut roh. Are they saying it might have been the calorie reduction that decreased liver fat, not the magic of paleo? Why yes, yes I think they are.

Speaking of which, you know what else a caloric reduction decreases? Weight. Could it be that the subjects lost weight because they were eating fewer calories? That’s certainly where my money is. The study authors note that the weight loss seems out of proportion to the degree of calorie reduction but then go on to acknowledge:

“Possible explanations include over-reporting of energy intake, increased thermogenic effects of protein (versus other macronutrients) and loss of glycogen which may contribute to loss of body water during the study period. Of note, increased
urinary volumes were commonly reported among participants during this intervention.”

Layman’s terms: maybe the subjects were overreporting their food intake. Maybe there’s something to the Thermic Effect of Food dealio (if you didn’t read my post that I linked above on food thermogenesis, you can do it now). Or maybe, just maybe, the low-carb diet they were on did what low-carb diets always do: flushed out several pounds of water weight as the body’s glycogen stores depleted. The subjects did report peeing more, after all.

So, we looked at the anthropometric changes the diet produced, lets take a look at the metabolic changes. Some good news. Blood glucose and insulin both decreased, and total cholesterol, LDL and triglycerides decreased. HDL also decreased though (that’s the good cholesterol), and cortisol increased (cortisol is a stress hormone). So the metabolic measures were a mixed bag, but overall more good than bad. Not so fast though, glucose, insulin and cholesterol all respond favorably to weight loss, as does blood pressure. Could these improved markers be a response to the subjects’ weight loss, which was a response to reduced calorie intake? That conclusion is certainly supported by decades of credible science.

Back to the original aim of the study: to determine if a paleo diet reduces liver fat and increases insulin sensitivity. Liver fat did decrease, but it turns out that whole-body insulin sensitivity didn’t change, nor fat deposition in skeletal muscles:

“…lipid content in skeletal muscles, as determined by 1H-MRS, was unaltered, as was peripheral insulin sensitivity…”


“…exercise regimens must be included to demonstrate effects on muscle/whole-body insulin sensitivity…”

Layman’s terms: to improve insulin sensitivity you gotta move yo’ ass.

Bottom line: paleo is, as fad diets go, pretty decent. It encourages eating nutritious, whole foods, and accentuates protein and vegetables (staples of weight loss diets from the beginning of time). But it’s not magic. The positive outcomes experienced in this study fall right in line with decades of credible science showing similar outcomes from weight loss due to reduced caloric intake. I’m not hating on paleo: paleo is a healthy diet. But promoting the myth that eating paleo will magically reduce weight and improve metabolic markers is irresponsible for one very big reason: it won’t work for everyone, because not everyone will spontaneously eat fewer calories on a paleo diet. Some people will even eat MORE calories on paleo. And when those people don’t magically lose weight and get healthier, they may blame paleo. Or they may blame themselves. They may think they’re just not ‘paleo-ing’ hard enough. Let be honest: paleo is a healthy diet, and some people may lose weight and see health improvements on it because they spontaneously eat less. But it’s the eating less that is responsible for the weight loss, and if you’re NOT one of the people that spontaneously eats less on paleo, it’s not because paleo is bad, or because you’re doing it wrong, or because you’re destined to be fat or whatever else people have come up with to rationalize away undesired results. Paleo is a pretty decent way of eating but it’s not magic, it can’t rewrite the laws of physics.

Improving the quality of your diet is GREAT, and paleo can help some people do that. There are other ways of improving the quality of your diet, though, and there are other ways of optimizing your calorie intake. Lets sweep away the dogma and magical thinking and be realistic. This study shows what countless other studies have shown before it: that calories matter, that food quality ALSO matters, and that exercise is essential for healthy metabolic function. If paleo provides a framework that helps you succeed in those aras, that is fantastic! But it’s one possible helpful tool out of many, and what works for some doesn’t work for others, we must look critically at the causative factors here (calories, weight loss, exercise) if we want to create a balanced and effective path forward and help more people achieve better health.



My Weight Loss Progression Pictures

Most people understand why I post my weight loss progression pictures here and on my facebook page, but every now and then someone will express a concern that those pictures conflict with my general message of body acceptance. I’d like to take a moment to explain why I keep those pictures front and center.

By far, the main reason is to convey the TRUTH that there is no magic to weight loss and fitness. I did this without gimmicks, without fad diets, without restricting foods or macronutrients, without spending hours in the gym, without starving myself, without pills and potions, without dicipling myself to any fitness or diet gurus. My results have been dramatic, but the steps I took to achieve them were not. The key to my success, and to yours, is consistency. Good habits, practiced consistently, over time. Its not low carb, or low fat, or crossfit, or clean eating, or raw vegan, or paleo, or zumba, or gluten free or any other fad-du-jour with promises of easy weight loss and ‘ripped abs in 30 days’. It’s consistency. If I could put consistency in a pill and sell it to you, I’d be a millionaire. Because consistency WORKS. The evidence is right there in my progression pics.

I think it throws some people for a loop that I’m showing you these pictures, but not using them as a marketing ploy to sell you a magic pill. People don’t quite know what to make of that. Before/after pics are almost always used as a marketing ploy to sell magic pills (or fad diets, or workout programs, etc). But there’s no magic pill here, no promise of fast and easy weight loss and ripped abs in 30 days. Just the truth: if you make healthy choices, consistently, over the course of several years, you will have results as dramatic as mine. You won’t look exactly like me, because you have different genetics, but you WILL have dramatic results. Your health will improve and your body will change. It’s true.

I also share these pictures because I am NOT traditionally beautiful,
I frequently am on the receiving end of personal attacks against my body and my appearance…and yet I still think I’m awesome and love my body and believe that I am a valuable human being. I want to show my daughters (and you guys) that it’s OK to not fit into society’s little boxes. It’s ok that some people don’t like the way I look. People can call me ugly and say I look like a man until they’re blue in the face, and I still think I’m just fine exactly the way I am, and I think my daughters are fine exactly the way they are, and I think all of YOU are fine exactly the way you are. I share my pictures and allow the hate to roll off my back so that my daughters learn that they can allow hate to roll off their backs. Their worth is not defined by how well they fit into society’s boxes, or by what anyone else thinks of them. I’m proud of what my body is capable of, and I’m proud of the way I’ve turned my health around! The aesthetic changes are fairly insignificant in the grand scheme of things, I’d MUCH rather show you pictures of my improved insulin sensitivity, or my no-longer-cystic ovaries, or my anxiety- and depression-free brain, or the migraines I no longer get. But I can’t, so I show you pictures of the ways the shape of my body has changed.

Finally, I share these pictures for a very pragmatic reason: they get people’s attention.
They draw people in, especially people who are trapped in the fad diet mental maze of restriction and dysfunction. And once I have their attention I can tell them the truth. You’re valuable. You’re worthy of love and respect. Your worth is not defined by your abs. I have visible abs and I’m telling you, they do not define me, and they do not define you. When was the last time someone with visible abs told you that you don’t have to have visible abs to be loved? Never? Well, maybe it’s time someone with visible abs told you: you’re worthy of love and respect regardless of the status of your abs. Maybe it’s time MORE people with visible abs started telling the truth: visible abs are not a barometer of health, or fitness, or desirability. Visible abs are nothing more than an indication of low body fat in the abdominal region. Nothing more. NOTHING MORE. And that’s the truth.

Sometimes, when you’re trying to change the world, you have to meet the world where it is.

Magic Pills, Food Villains and the Allure of the Shiny Red Herring

Bread doesn't make you fat. Your behavior makes you fat. Bread is a red herring.

“Carbs make you fat.”

Do you see the allure of that statement? It, and “Food Villain” statements like it, allow a person to shift the responsibility for their problems onto an outside entity. Carbs are a wildly popular Food Villain. Other examples of popular Food Villains are: High Fructose Corn Syrup, sugar, wheat, fat, fruit, PUFAs, processed food in general, dairy, animal protein, grains, gluten, starch and legumes. Food Villains are an evolved, more sophisticated form of Magic Pill. In days of yore, it was easier to sell people a Magic Pill that would miraculously cure all manner of ailments, but people are wiser now, and less likely to fall for spectacularly unrealistic marketing claims. Or so they think. Enter the Food Villain.

Food Villain Mythology is usually supported by a handful of (cherry picked) scientific studies and an elaborate and sophisticated web of logical fallacy. The resultant construct usually holds that the Food Villain in question is the root cause of either modern society’s obesity and diabetes epidemic, or the root cause of an individual’s obesity and illness. There is usually some kernal of truth in the claim. Take wheat for instance: it is true that wheat can be problematic for some individuals who have an allergy or intolerance, and for anyone who consumes it in excess or to the exclusion of other foods that would provide a more well rounded nutritional foundation. There are other issues with wheat too, involving it’s cultivation, processing, ubiquitousness and nutrient profile. But Food Villain Mythology has taken those issues and created what amounts to mass hysteria in some circles, with an entire mythology centering on wheat’s Magical Ability to single-handedly drive obesity and disease. Scary stuff.

Food Villains are generally foods that can cause problems for some people, under some circumstances. They are factors that can indirectly contribute to illness and weight gain. There is merit to many of the arguments against Food Villains. But Food Villain Mythology morphs those foods into primary drivers of obesity and illness. This is so very appealing to a desperate and suffering audience. Why? Because it gives them something to blame. It allows them to focus on an outside entity as the source of their suffering. It serves the human need for a Bad Guy. And shifting focus onto a Bad Guy is bad because…?

Because the REAL primary driver of obesity and illness is human behavior. Inactivity and poor eating habits specifically: too much or too little food (also known as ‘energy imbalance’), inadequate nutrient intake, lack of dietary variety, etc. There is a MASSIVE body of scientific evidence that supports this, it is so overwhelming that The Mayo Clinic, Johns Hopkins, the NIH and the NDIC and countless other credible scientific establishments state definitively on their websites and in their literature that obesity, diabetes, insulin resistance and metabolic dysfunction are caused by inactivity and energy imbalance.

Food Villains are secondary contributors at worst. But they are a bright, shiny red herring that deflects attention away from the big elephant in the room, the primary drivers of obesity and illness: human behaviors. And who wants to focus on the primary drivers anyway? That would require taking personal responsibility for one’s own behavior, and doing WORK to change it. It’s so much more appealing to blame the [carbs/sugar/wheat/fat/animal protein/PUFAs/gluten/starch/etc]. This is normal human behavior. We always look for a scapegoat. And Food Villains are a GREAT scapegoat. People get very passionate about their personal Food Villains, so much so that they lash out violently at anyone who threatens their world view that their Food Villain is the cause of all their problems.

You can eliminate every Food Villain in the world (and there are certainly good reasons to eliminate some of them!) but even if all you eat is organic kale and coconut oil, if you ignore the primary drivers, physical activity and energy balance, you will never totally overcome your problems. Likewise, if you optimize your physical activity and correct your energy imbalance, you will be surprised at how harmless most of the Food Villains you’ve been living in fear of become. A person with healthy metabolic function can pretty much eat whatever they want and remain healthy. Food Villains, by and large, only become problematic once metabolic function has been compromised. Metabolic function is compromised by inactivity and energy imbalance, not by Food Villains. Eliminating Food Villains treats the symptoms of metabolic dysfunction, not the cause. The cause is inactivity and energy imbalance.

So why do ‘they’ (ie, the diet book authors and the bloggers) want to keep us fixated on Food Villains and not the primary drivers? Because focusing on Food Villains keeps us sick and fat, and when we’re sick and fat, we keep buying their Magic Pills…oops, I mean ‘books about Food Villains’.

If a food causes problems for you, don’t eat it. It’s pretty simple. But if metabolic health is your goal, you must shift your focus away from the secondary contributors and on to the primary drivers, or you will continue to spin your wheels and make the Food Villifiers rich.

My PCOS Story

(Warning, this post contains some graphic descriptions of female bodily functions. If you’re easily offended by such things, you might want to consider not reading any further.)

By age 8 I was struggling with my weight, and by my early teens it was evident there was something amis hormonally. I started menstruating around the same time as all my friends, but then I stopped for several years. Yes, years. For some reason this didn’t seem to raise any flags with my health care providers. I had horrible cystic acne starting right around age 13, on my face and also on my chest and back. Two courses of Accutane barely made a dent. I started growing hair in places girls aren’t ‘supposed’ to grow hair (like my chin). My weight was all over the place and by the time I graduated from high school I was clinically obese. My periods, once they started up again, were beyond irregular. I’d get them a few weeks apart for a while, and then not again for 6 or 8 months.

For some reason, I thought this was all normal.

A young Go Kaleo, already exhibiting visible signs of hormonal dysfunction.

My 20’s were much of the same, with the addition of chronic yeast infections, migraines, thinning hair and crippling bouts with anxiety and depression. My doctors would periodically put me on birth control to try to regulate my periods, and antidepressants to combat the depression. I continued to struggle with my weight and my cystic acne, sometimes seeing some mild success, but mostly just frustration. As I got closer to 30, my blood pressure started to read high here and there, although not consistently. When I asked my doctors about all this, they would say something about exercise and weight loss, but to me it felt like a brush off.

I got pregnant quite unexpectedly at 30, and for a few years my own health took a back seat. I suffered some pretty intense PPD after my first baby, but otherwise I actually have very little recollection of those first two years of motherhood. I don’t think I ever got a checkup, and acne and my weight were really low on my priority list at the time. I felt like crap all the time, I can tell you that.

When I got pregnant with my second baby, all hell broke loose. The beginning of the pregnancy was uneventful, but the second half was awful. I gained weight way too fast. I swelled up like a water balloon. I developed pre-eclampsia and had to go to the hospital for monitoring twice a week for the last several weeks of the pregnancy.

After my second daughter was born, I had problem after problem with my milk supply. My weight continued to go UP. My blood pressure remained high. I started losing hair in clumps, specifically on the front of my head, in the typical male-pattern baldness. I had an epic case of PPD, complete with daily panic attacks. My period returned about 6 weeks post partum, but it was crazy irregular, and heavier than it had ever been and I started passing chicken-egg sized clots. In 2006 I had a breast ultrasound to diagnose some recurrent pain I’d been experiencing. It turned out to be cysts. In 2007, another ultrasound to diagnose recurrent pelvic pain showed multiple ovarian cysts. I reached my highest weight of 231 pounds.

I’d started to put the pieces together and asked my doctor about the possibility that I might have PCOS. She was hesitant to give me a formal diagnosis because I didn’t appear to have infertility issues, and as she explained it, the only good a diagnosis would do would give her the option to prescribe fertility treatments, and since I didn’t want any more babies anyway, there wasn’t really a point of getting a formal diagnosis. She told me to exercise and lose weight. I felt brushed off again. I ate pretty healthy. I was active. I walked a lot, and chased my kids around I told her (and myself). I wanted an answer, a treatment, but she was just giving me the ‘exercise and lose weight’ brush off. I felt frustrated and hopeless.

So, like many women reading this, I started doing some research on my own. Every time I researched one of my symptoms, the trail I picked up led to the same place: metabolic syndrome and insulin resistance. Through my research, I identified other symptoms I had that I’d never thought could be connected to my hormonal issues, especially my panic attacks, which I’d determined were probably being triggered by wild blood sugar swings. I had virtually every symptom of metabolic syndrome and insulin resistance in the book, and in 25 years no one had put the pieces together.

So, since all trails were leading back to insulin resistance, I decided to look a little deeper into it. I wanted to know WHY I was having these symptoms, not just how to ameliorate them. WHY was my hormonal system all whacked out (insulin is a hormone)? As a critical thinker and skeptic, I was pretty good at spotting dubious sources. A lot of the ‘information’ I ran across in my internet research was actually thinly veiled advertising for supplements and diet books. In fact, I was sort of appalled by how much of that I ran across. I started to identify credible sources, and I followed the science. What I realized was that all of the established, reputable medical and scientific organizations were in a fair bit of agreement on the cause of insulin resistance. The common theme I kept running across was energy imbalance (and its role in obesity), inactivity, and genetics. According to Johns Hopkins, Metabolic Syndrome and IR are caused by “…obesity, coupled with a sedentary lifestyle…[as well as] genetic variations in a person’s ability to break down lipids (fats) in the blood.” The Mayo Clinic says “Some people may be genetically prone to insulin resistance, inheriting the tendency from their parents. But being overweight and inactive are major contributors.” The NIH and NDIC are very clear that “scientists have identified specific genes that make people more likely to develop insulin resistance and diabetes. Excess weight and lack of physical activity also contribute to insulin resistance.” Notice none of the resources I link to are bloggers or alternative practitioners selling remedies and ebooks. I like science. I looked for science, and favored science from reputable sources. I found study after study after study after study after study after study after study after study after study after study after study after study (I have more) showing that physical activity levels are inversely correlated with the incidence of insulin resistance, and that insulin sensitivity is improved with physical activity. The science was pretty clear: genetics, energy imbalance and obesity, and inactivity are the drivers of insulin resistance. And all that advice to lose weight and exercise my doctor had given me wasn’t a brush off. She was right. She was giving me the evidence-based solution to my problems, and I was brushing HER off.

I don’t have a huge genetic factor. A few of my grandparents and aunts and uncles developed diabetes when they were older, but my parents and siblings are so far relatively metabolically healthy. I was obese though, and I was obese for one reason: I ate more food than my body needed. And when I was honest with myself, I wasn’t really that active. Yeah, I walked a little, but it wasn’t really as much as I kept telling myself (and my doctor). And I certainly didn’t walk vigorously enough to raise my heart rate or break a sweat. In fact, when I was really, truly honest with myself, I had to admit that I spent most of every day sitting down. So, at 35, I decided to actually do what my doctor had told me to do all along: lose weight and exercise.

I ate more vegetables and protein, but I never restricted carbs. Mostly because I’d tried it before and hated it. And besides, the EVIDENCE pointed to inactivity, not carbs, as the driver of IR. The main change I made was to track my calories, keeping them at a level that would support my activity but allow for gradual weight loss. I’ve talked elsewhere about how I determined the proper energy balance that would allow me to lose weight gradually and keep my metabolism from tanking. It took me about 6 months to get that figured out. I explain what I mean by ‘energy balance’ in this video:

It also took me about 6 months to get into an exercise routine. Those first six months were frustrating and frequently discouraging. I lost about 15 pounds, which was really disappointing to me considering how much effort I was putting in. I had some small improvements in some of my symptoms, but I still felt like crap most of the time. I nearly quit so many times. But I kept telling myself that I needed to be a good role model for my daughters, who I knew would follow in my footsteps, and I wanted them to be footsteps in the direction of health and self-care. So I kept going.

That six month mark was really a turning point, for a couple reasons. A BIG one was that I started weight lifting. I have since done more research and decided that weight lifting/strength training is VITAL to improving insulin sensitivity because muscles, very simply, behave very differently, metabolically, than fat. Muscles suck all that sugar out of the blood and USE it. I also had improved my endurance and conditioning to a point that I was able to perform the amount and intensity of physical activity that I think was necessary to really improve my metabolic function. When I was just doing cardio, the magic number seemed to be 60 minutes a day of an activity that kept my heart rate elevated (once I added a significant amount of muscle mass from strength training, I could get away with much less, these days I typically average half that). I also got my diet ‘dialed in’, in that I settled into an calorie and nutrient intake that gave me the nutrition and energy I needed but wasn’t more than my body could use in a day. Over the next six months I dropped about 50 pounds. I also saw my periods normalize into a steady 28 day cycle for the first time in my LIFE. I never got another panic attack or migraine after that. To this day. About a year in I realized my hair had started to grow back, fuller than it had been in my adult life, and over the next year my acne had all but disappeared save for a little breakout before my period. My blood pressure has been optimal at every checkup since then. My HDL, which has been hovering in the high 30’s before I started all this, is now in the high 60’s. My triglycerides are routinely in the 30s and 40s. My glucose is ALWAYS in the low 80’s no matter what I’ve eaten or not eaten beforehand. In short, I am, for the first time since I was 8 years old, metabolically healthy.

And I did it by following my doctor’s advice: lose weight and exercise.

Fancy that.



(***I am not a doctor. AS ALWAYS, if you suspect you have a metabolic problem, please find a qualified, reputable medical professional to work with, and never, ever, EVER rely on bloggers for your medical information and health care.***)

Finding Your Ideal Weight

*Note: this is an alternative way to approach weight loss and maintenance that has worked well for me. I hope that it might be helpful to people who are struggling to find a balance, and not finding success with more traditional approaches. If what you are doing is working for you, please keep doing it! My sharing my experience and approach is by no means a mandate that everyone should do it my way.*

**Note 2: I use the terms ‘energy intake’ and ‘calorie intake’ somewhat interchangably in this post. In general, when I say ‘energy intake’ I’m referring to the energy provided by the food you eat, which is measured in calories (much like distance is measured in meters).**

***Note 3: this post is a little more applicable to weight loss than weight gain. That said, if weight gain is your goal, you might find some valuable tools here.***

All my adult life I’ve had a weight that I thought would be ideal for me. Whenever I went on a diet, it was with the intention of dieting down to that weight. None of those diets worked, for a variety of reasons that I’ve discussed in other posts. I’ve learned a few things over the last few years, though, that have helped me reframe my approach to finding my ‘ideal weight’, and today I’m going to share them with you.

First lets establish the basics: a person’s weight is the product of their energy and nutrient intake (what and how much they eat) and their activity level. The more active a person is, the more energy intake they will need to support their weight. For instance: at my activity level, a calorie intake of about 2800-3000 a day will support a weight of roughly 160 pounds. My height isn’t a factor here, as long as I maintain this activity level and consume around 2800-3000 calories a day, my weight will be fairly stable at 160 pounds. Whether I were 4 or 7 feet tall, this activity level and calorie intake would support 160 pounds. The kinds of calories a person chooses CAN have some impact on how many calories they need to consume to support their weight, but that’s a topic I’ve already discussed. The basic idea here is that your activity and calorie intake will determine your weight. So lets reframe this whole subject. Instead of trying to figure out what your ideal weight is, lets instead work on figuring out what your ideal level of activity and calorie intake is. Once you have that dialed in, your body will eventually normalize at the weight those two variables support.

When I started this lifestyle change, I tracked my diet pretty closely. I wasn’t actively trying to lose weight at the time, although it was definitely something I was interested in! But in those early months I was more interested in seeing what and how much I was eating and figuring out ways I could improve my diet. I realized pretty quickly that I was consuming in excess of 4000 calories a day, sometimes considerably more. No surprise then, that I weighed 230 pounds and was gaining weight at a steady pace. So in addition to working on improving the quality of my diet, I also began to trim away the excess calories. For awhile, I tried to keep my calories relatively low, 1800 a day, but found myself constantly hungry and dealing with lots of cravings and binge eating episodes. Not good. So I added calories until I found an intake that allowed me to eat when I was hungry, feel satisfied at every meal, and meet all my nutrient requirements (both macro and micro nutrients). It took a LOT of trial and error, in fact it was about 6 months of fiddling before I really felt like I’d found my sweet spot. The magic number: 2800 calories a day. During those 6 months of fiddling, I lost about 15 pounds. During the 6 months after I ‘figured it out’, I lost 50 pounds without ever feeling deprived or hungry, and without horrible cravings and binges. I ultimately stabilized ay 160 pounds, a weight that I’ve maintained ever since fairly effortlessly. I know what you’re thinking, ‘how the HECK can a person lose weight eating 2800 calories a day?!?!? All the magazines say you have to eat 1400 calories to lose weight!’ Well, 2800 calories simply won’t support more than 160 pounds at my activity level. It just won’t. That is physics. Because 2800 calories won’t support more than 160 pounds, my body had to burn off the excess fat to get to the weight my calorie intake supported. It wasn’t fast. It took about 18 months. But I never had to go hungry, and I didn’t crap out my metabolism by undereating. Now, at this weight, I’m able to eat when I’m hungry, I feel satisfied after meals, and I don’t struggle with cravings and binge eating. For the first time. Ever.

For the record, 160 pounds is 15 pounds heavier than the ‘ideal’ weight I’ve had stuck in my head my whole life. Trying to force my body down to that weight was always unsuccessful, because in order to maintain that weight I have to restrict my energy and nutrient intake below what my body seems to require to function optimally. I have gotten down to about 150 pounds a few times over the last 3 years that I’ve been maintaining, and each time I’ve had to really be disciplined with my eating, and I’ve experienced cravings, compulsions and binges. My body has made it very clear that it wants/needs 2800 calories a day, and the weight that 2800 calories supports is 160. My interpretations: 160 is my body’s ‘ideal’ weight. At least at this stage of my life.

I don’t eat exactly 2800 calories a day. Most days I actually eat more than that. 2800 is more like the minimum requirement for optimal function and performance. Without fail, if I feel hungry at bedtime and add up what I’ve eaten that day, it comes out below 2800. Without fail. If I undereat for a couple days, I notice cravings start to creep in. This is why I harp so incessantly on eating enough to support your activity. Your brain starts sending out SOS signals in the form of cravings and compulsions when you’re not getting the nutrition you need. It is so important to find that sweet spot, the energy and nutrient intake that gives your body what it needs to function at it’s best, and that supports a healthy weight.

So how do YOU do all this? I’m going to give you the tools to skip over a lot of that trial and error I had to do. You will still need to do some fiddling, but I’m going to give you a head start.

1. Keep a food log. This will show you what and how much you’re consuming, and give you a realistic idea of the areas you’re doing great, and the areas you need to work on optimizing. If you are overweight and want to lose weight, you need to eat a little bit less than you’re eating now, so knowing how much you’re eating now is important! Don’t worry, you won’t need to track your diet for the rest of your life. It’s a great tool for getting a handle on where you are, and for helping you create new, healthier eating habits. Once those habits are in place, you won’t need to log your diet any more.

2. Once you’ve got a good picture of where you are, use the calculators in my Calorie Primer to get an idea of what calorie intake would support the weight you think is your goal. Be sure to figure your activity level into the calculations. That will give you a starting ‘target’. It will probably be higher than you expect, the reality is that it takes a fair amount of calories to support a healthy weight (hopefully your goal weight is a healthy one!).

3. Now start modifying your diet. Using that initial calorie target, put together an eating plan that will provide roughly that number of calories. It doesn’t have to be exact every day. Anything within about 300 calories on either side of the target is going to be fine. You will find that you simply eat more on some days and less on others, the balance over time is what is important. If you experience hunger, cravings, binges and compulsive thoughts about food, move your calorie target up. Make sure you’re getting plenty of protein, for a variety of reasons that I’ve discussed elsewhere. Aim for 1 gram per pound of bodyweight per day. That’s a little more than you need, but I find that simply aiming for that much covers most peoples’ needs, even if they don’t quite get there. Experiment with fat and carb ratios until you find what works best for you. Every body is different. Spend some time working with different ratios and total calorie intake until you find your sweet spot. Your sweet spot will probably be within a stone’s throw of the target you got from the calculators, but if it’s higher it probably means your body’s ideal weight isn’t the same as your mind’s ideal weight. Go with your body on this one. It knows better.

4. Step 4 is patience. You likely won’t ‘get it right’ on the first day. It might take weeks. It might take months. But the beauty of doing it this way is that once you find that spot, you can just go on cruise control. Your body will take care of the weight thing, gradually, over time, with very little stress on your part. You just focus on giving your body the nutrition it needs. And that’s a much kinder, gentler way of approaching weight loss than fighting your body and trying to force it down to a weight that might simply be too low to allow for a sane, sustainable life. This way, you follow your body’s intuition, you support it’s needs every step of the way, and you give it the time and nutrients it needs to stabilize at a weight that is both healthy and sustainable for the long haul.

Hopefully this gives you a new way of approaching the subject of weight optimization. Working WITH your body is so much more pleasant than fighting and forcing it. It is also far more likely to yield positive results. I know this from personal experience.

Body Composition: That ‘Last Five Pounds’, and How to Deal With ‘Problem Areas’

This post is an excerpt form my eBook ‘Taking Up Space: a Guide to Escaping the Diet Maze’. If you enjoy this post, be sure to check out the book here.

Almost daily I get a question along the lines of ‘Help! I don’t need to lose any more weight, but I’ve got this (belly/thigh/butt/arm/back) fat that just won’t budge!’.

We all have that ‘last’ bit of stubborn fat that just won’t respond to dieting. The first thing I want you to consider is that maybe it’s not as bad as you think. Our bodies need a little bit of fat reserve to function optimally, and for most of us that last little bit is all in one stubborn spot. For many people it’s the belly. For me, and lots of other women, it’s the hip and thigh area. For some people it’s the arms or upper back. Everyone has ‘that’ spot, and it annoys us, but the reality is that in the vast majority of cases it’s not a health threat, so from a health perspective you can let go of the pressure to lose it.

Doesn’t make it much better from the aesthetics perspective though, right? I hear ya. So today I’m going to talk about body recomposition. Here is exhibit A. Two pictures of me at the same weight, but dramatically different body compositions:

There’s 2+ years between these pics. This is not a fast process! Patience and consistency is key.

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170 in both pics.

I was actually in pretty good shape in the first picture, I was competing in triathlons and eating a nutrient rich diet and had recently begun weight lifting. But I had just come off 18 months of losing weight, so while my fitness had improved, the calorie deficit I’d been maintaining had prevented me from adding any appreciable muscle mass (you need a calorie surplus to build muscle mass). So the result was a healthy weight but a higher fat-to-lean mass ratio (I have no idea what my body fat percentage was but it was probably in the 22-27% range). I was not unhealthy in any way, so hopefully no one will interpret these images as casting aspersions on my less-lean self, or on anyone who looks like my less-lean self. I had a healthy beautiful body then, as I do now.

In any case, there I was at 160 pounds, a weight that I’m comfortable at, so I stopped losing weight and turned my focus to body recomposition. Building muscle requires a different dietary approach than losing fat does, so I changed the way I was eating. I ate more, lots more. Instead of eating at a calorie deficit with the goal of losing weight, I began eating at maintenance, or even a small calorie surplus. As always, I made sure I was getting plenty of protein (I aim for about 1 gram per pound of body weight per day) and adequate fat, so it was really carbs that I increased to bump up my calorie load (note: I’m not saying that my way is the best or only way (find what works for you), but there a popular mythology that carbs make you fat, and as you can see from looking at the second picture, eating more carbs definitely did NOT make me fatter, in fact, it made me leaner). My weight fluctuated about 5 pounds either way over time, so I wasn’t exactly 160 on the nose every day in between the two photos, and what was probably happening was that my body was very organically cycling between building muscle and burning fat, but the end result was that over time my body mass shifted from fatter to leaner. Fat cells don’t turn into muscle cells, what happens is that as muscles get bigger, fat cells get smaller as your body burns off the fat inside them.

You can see from the pictures that I carry/carried a lot of my fat on my thighs. As I built muscle all over my body, the fat on my thighs burned off, because that is where the fat was. So building up my arm, back and core muscles was just as much a part of making my legs leaner as working my leg muscles was. The message I’m attempting to convey here (however inelegantly) is that you need to work your whole body, not just the body part that bothers you. Bigger biceps means less belly fat. It’s true! Add a pound of muscle to your shoulders, and assuming your weight stays the same, that means there’s a pound less of fat on you, and if your fat is on your belly, that’s where it will come off of.

So how do you know it’s time to stop trying to lose weight and focus instead on body recomposition? Here’s my tips:

1. You’re at, or close to, a healthy weight, even if it’s higher than you wish
2. Your weight loss has stalled and simply won’t budge no matter what you do
3. Your eating habits are solid, you’re getting accurate hunger and satiety signals from your body, and you’re able to eat to your appetite without gaining weight
4. All of your health markers are normal and you feel good

Alternately, here’s some signs you may be at a weight that’s simply unsustainably low, and gaining some lean mass may be of benefit:
1. you’re able to maintain a low weight, but must be overly restrictive with diet
2. you need to do lots of cardio to keep from gaining weight
3. you frequently feel hungry and struggle with compulsive eating
4. you struggle with fatigue
5. you recover slowly from workouts

In both of the above scenarios, shifting your focus away from fat loss, and toward increasing lean mass, may be what your body needs in order to continue making progress.

So how do you do that, you ask? Well, here’s some jumping off points:

1. Eat at LEAST maintenance calories. Finding that target will take some trial and error, but the calculator in my Calorie Primer post can give you a good target window. Keep in mind that if you’ve been undereating or eating at a deficit for a while, you’ll see an initial ~5-10 pound bump in weight almost immediately when you increase your calorie intake, as your body replenishes it’s glycogen and water stores. IT’S NOT FAT, so don’t panic.
2. It’s ok to go over maintenance calories by a few hundred, especially on days after workouts, your body needs the extra calories to build muscle mass.
3. A healthy female body can gain about 2 pounds of lean mass a month under optimal conditions, so if you keep any weight gain around this level you can be confident that you’re gaining mostly lean mass. If you gain more than that, IT’S OK, but more of it will be fat. Again, IT’S OK. Gaining a little fat along with muscle won’t kill you, you can always lose it later (if you want. You may be surprised at how nice that extra fat looks when it’s over a foundation of added muscle!).
4. Get plenty of protein! I generally recommend aiming for 1 gram per pound of your goal body weight, or just 100+ grams a day. Getting protein from real foods is best, but an occasional protein supplement isn’t going to derail you and can help bump up your intake if you’re having trouble getting enough from food alone.
5. Carbs are great! Unless you have an active metabolic condition that necessitates a specific diet (in which case you should be working with a medical professional and not getting your nutrition information from blogs) don’t restrict carbs. They give you energy for workouts, and nutrients and calories your body needs to create new muscle mass. As always, get them from real, whole foods for the most part, but IT’S OK TO HAVE A TREAT now and then.
6. Don’t restrict fat either. Most people do well getting 20-35% of their calories from fat. As with carbs, get it from real, whole foods.
7. EAT EAT EAT, and don’t feel guilty about it. Your body NEEDS fuel to meet your daily obligations, to recover from workouts, and to build new muscle mass. Some days you will feel like all you do is eat. IT’S OK. If you’re feeling piggish, just tell yourself ‘Go Kaleo eats like a linebacker and is lean and healthy’. Enjoy!
8. Experiment until you find what works best for you. I do great on tons of fruit, others go for sweet potatoes or bacon or coconut. There isn’t one right way, and trying to do it someone else’s way will ultimately not be as effective and sustainable as finding YOUR best way. You don’t have to ‘get it right’ on the first day. Pay attention to how your body feels and functions in response to what you eat. Keep a log so you can start to see patterns.
9. LIFT. Do a full body resistance routine at least twice, preferably 3 times a week. Alternately, some people prefer to follow a body part split routine, which is effective as well, but I’ve found to be a little more time consuming. It really is up to you what you prefer. Both styles will give you good results. For more on weight lifting styles and specifics, check out my Taming the Weight Room program.
10. Take regular rest days. Your body needs rest to recover properly. Cardio is fine on off days, but take at least one, preferably two, full rest days a week.
11. Say no to guilt, shame and restriction. Has it worked for you in the past? No? Then you don’t need it.

And last but not least, know that most people are too busy focusing on their own ‘problem areas’ to focus on yours. So don’t kill yourself trying to perfect them. It’s not worth it, you’re valuable and lovable just the way you are.


Putting The (Calorie) Pieces Together

I have several posts on calories, how they work, how many one should consume, what kinds should we eat, how to figure out how many we’re burning. I realized they’re spread out all over my blog, so decided to cobble them together in one post to make it a little easier to get the whole picture. There are two main themes: how much should we eat (how many calories), and WHAT should we eat (what KIND of calories). I attempt to simplify it for the folks who don’t want to spend all their free time reading scientific studies. So without further ado…

How Much Should I Eat?

There’s a lot of confusion out there, so in the name of clarity, I’ll give you the basics on calorie intake, as simply as possible. A calorie is a unit of energy. Your body uses energy to fuel your daily activity. If you take in more energy than your body uses, it stores the excess, usually as fat, but if you’re lifting heavy and using your muscles it can and will use that excess energy to build muscle too. That’s what we want.

If you’re at a healthy weight and your goal is body recomposition, you need to eat AT LEAST as many calories as your body burns, preferably a little bit more. Your body needs raw materials to build muscle, and if it’s using all the calories you eat to fuel your activity there will not be any left to build muscle with. If you’re undereating at a healthy weight, your body will do whatever it can to burn fewer calories, so will slow down your metabolic processes and start burning muscle for fuel, because muscle requires more calories to maintain than fat. If you’re undereating, that muscle is taking up energy (calories) that your body would rather use to fuel your heartbeat and brain activity.

If you’re obese or overweight, you need to burn more calories than you consume to lose weight. Not too many more, I generally recommend keeping a 500 calorie deficit (or less) to keep your metabolism healthy. That deficit should get smaller as you get closer to your goal. Alternately, you can use a calorie calculator to figure out how many calories your body will need to maintain your goal weight (including your activity), and eat that many calories. Your body will take care of the rest (that’s how I did it). If you keep your deficit relatively small and lift weights and get regular exercise, your body will tag your muscles as ‘in use’ and preserve them, burning stored fat to make up the deficit in energy in vs energy out. If you’re sedentary, your body will burn lean mass as well as fat to make up for that deficit.

NONE of this means that diets that don’t require calorie counting don’t work. It just means that, for some people, those diets help them to naturally and instinctively consume the number of calories that will support their goals. Different people can experience this with different diets. Some people (like me) don’t ever experience it (or at least I haven’t yet, and I’ve tried all the diets) and need to be at least somewhat aware of our energy requirements. And we need to eat enough to fuel our activity and support our goals. Restricting calories below that level is counterproductive and will ultimately lead to failure. For most people, including women over about 100 pounds, that means eating at least 2000 calories a day, much more for most of us (I eat about 3000 most days). Even to lose weight, very few of us will need to drop below that, and if we do we are setting ourselves up for a damaged metabolism and fat storage.

Here’s a calorie calculator that I find realistic and helpful, it won’t give you an unsustainably low calorie target, in fact you will likely be surprised by just how much you need to eat to stay healthy and support your goals:


What Should I Eat?

Invariably, every time I say that weight is a product of energy balance (ie, calories in vs. calories out) I get at least one person arguing ‘calories don’t matter! different kinds of calories affect the body differently!’.

I can’t really blame people for the confusion. There are a shit ton of diet gurus out there muddying up the waters with claims that combining foods ‘properly’ or cutting out certain foods or macronutrient groups is really the key to weight loss and that all you have to do is eat the ‘right’ foods and you’ll be able to eat all you want and still lose weight. Oh, and conveniently they just happen to be selling a list of those approved foods. Calories DON’T matter they claim, it’s the KIND of calories you eat that matters. “Those people who tell you to just eat less have got it all wrong” they say. “‘They’ have been misleading you, I’m telling you the TRUTH.”

All that black and white thinking has got people believing a false dilemma: It’s EITHER ‘calories in vs. calories out‘ OR ‘the kind of calories you eat‘ that matters! It’s a big ole’ moneymaker. They tell you they have the secret diet that will allow you to eat all you want and still lose weight, and you open up your wallet and buy it.

Here’s the truth, and I’m not going to charge you for it: weight is a product of energy balance, AND the kinds of calories you eat.

Lets start with the basic equation X +/- Y = Z, where X is calories in, Y is calories out and Z is total weight. The KINDS of calories you choose can affect the values of X and Y (Y moreso than X), but here’s where the diet gurus are misleading you: changing the values of X and Y doesn’t change the basic equation.

Some foods cause your body to burn more calories than others. Protein and fiber rich foods require your body to do more work to digest. It’s called the ‘Thermic Effect of Food‘. Eating foods with a high thermic effect makes your body burn more calories (Y), sometimes a LOT more calories. That’s why the list of approved foods your guru sells you will be comprised primarily of protein-rich foods and fiber-rich vegetables. Both are highly thermic. There’s also some evidence that whole, minimally processed foods are more highly thermic than equivalent processed foods (Y). Eating good quality nutritious foods can increase your energy level, which can lead to more spontaneous activity, which leads to a higher calorie expenditure (Y). Eating highly satiating foods can also cause a spontaneous reduction in total calorie intake (X). Protein and fiber, again, are highly satiating. As our understanding of the ways food affects our bodies grows, I suspect we will discover other ways that the kind of calories we choose can change the values of X and Y.

Eating a rich and varied diet full of whole, protein- and fiber-rich foods can absolutely change the way your body functions! In the end, however, it is still subject to the laws of thermodynamics. In an energy surplus it will store that surplus as mass (either muscle or fat depending on your activity level), and in an energy deficit it will burn stored energy reserves to fuel activity. Your task is to eat (and move) in a way that increases your energy expenditure to a level that exceeds your energy intake, if weight loss is your goal. Eating less isn’t the whole story, and sometimes eating MORE will produce a higher Y variable and weight loss will ensue, but optimizing your individual X and Y variables IS the way to get the Z you desire.

Creating your ideal diet: Macros and Micros

Protein and vegetables are GREAT and you should try to get lots, but eat fat and carbs too! Carbs are not the devil, eat lots of real whole foods like fruits and starchy vegetables, and grains if you tolerate them. If you have a medical reason to restrict carbohydrates, work with a registered dietician to make sure you’re meeting all yoru micronutrient needs. Fat fills you up and makes food taste good, and your body needs it for proper nutrient absorption and hormonal function. Tracking your diet can be helpful for many reasons, my favorite diet tracking website is because it gives a more realistic, sustainable calorie target than most other diet tracking websites, which ensures that you’re getting enough calories to support your activity. It's not just about calories, regular tracking will help you learn to meet your energy requirements with foods that also provide the vitamins, minerals and adequate amounts of fat and protein to support good health and weight management. It can be a pain at first, but over time it helps you fine tune your diet to suport your individual needs, preferences and goals. Calories DO matter, but most of us can eat a lot more than we think we can. Tracking calories is NOT about restriction, and reaching/maintaining a healthy weight is NOT about being hungry and denying ourselves proper nutrition. Quite the contrary, it is about feeding ourselves adequate amounts of (mostly) nutritious foods that support health, energy and vitality. Here is a tool that will help you determine how many calories your body needs to function properly. Many of you will be surprised at how high the number is. Mine is as much as 3500 a particularly active day. Hardly restrictive. Aim for, at minimum, .5 ' 1 gram of protein per pound of body weight a day. Fat should make up at roughly 20-35% of your calories (some people do well on lower or higher fat percentages, but 20-35% is a healthy range for most of us). The rest of your calories can come from whatever macronutrient you prefer (macronutrients = protein, fat and carbs). If you're doing a lot of endurance exercise, go for more carb dense foods. It’s looking like the only 'bad guys' are refined seed oils and trans-fats (even refined sugar can be helpful under certain circumstances such as recovery from anorexia and digestive malabsorbtion issues), and by including more whole foods in your diet you will be reducing your intake of those in the form of processed foods. So after all this, I come back to: eat real food, but don't obsess! Make mostly healthy choices, but it’s also ok to eat foods purely for pleasure. Your diet has got to be enjoyable to be sustainable.

**A note to the nutrition nerds: yes, I’ve simplified things. That’s what I do here on my blog. This post isn’t for you, it’s for non-nutrition-nerds who don’t want to spend all their free time reading diet blogs and scientific abstracts.**

I’m Calling for a New Paradigm

I grew up looking at underweight and yet impossibly perfect models on the pages of magazines. It did a number on me. Made me feel ashamed of my fleshy thighs, my broad shoulders, my small breasts. Sparked an unhealthy, decades long troubled relationship with food and my body.

A few years ago, when super-fit, uber lean models started to become popular, I celebrated! Progress, I thought! Perhaps my daughters wouldn’t have to grow up surrounded by such destructive images! Strength a desirable quality? Sign me up!

And as I began my journey towards health, I kept those images close. I replaced the skinny ideal with the super-fit, super-lean ideal as my goal. I began to hear the phrase ‘Strong is the New Skinny’ and was thrilled. I’ve kept a picture of Dara Torres at her leanest on my fridge for four years as inspiration. Crossfit gained in popularity and with it images of strong women accomplishing incredible feats of strength and fitness. How wonderful! Take that, skinny models and the magazines that pushed them on my impressionable daughters!

As I got closer to my goal of a lean, fit body though, something started to change. I began to realize how much time I spend thinking about my diet and my workouts. Don’t get me wrong. In our modern food climate, we need to be diligent and mindful about what we eat, and our lifestyles have become so sedentary and easy that we need to make time to get the exercise that was a built-in component of our ancestors lives. But as I got leaner, I needed to become increasingly disciplined about calories and macronutrients. At some point I realized I’d gone beyond simple mindfulness about food, and had ventured into the sort of behavior that some people might consider an eating disorder. Every calorie, every gram of protein, every micronutrient was being tracked. That’s what I needed to do to continue getting leaner. But oh, did I look great!

Do I want my daughters to grow up healthy and strong? Absolutely. Do I want them to feel pressured to be as disciplined about their diets as I am? Absolutely not.

I think most people can reach a healthy weight and body fat percentage by eating real food, keeping loose track of how much they’re eating and getting adequate exercise most days. I did that! I got down to about 165 pounds and 18-20% body fat fairly easily once I started eating well and exercising. But that wasn’t good enough. After all, I had a picture of Dara Torres at about 9% BF on my fridge. I sure didn’t look like that! Nor did I look like the models I saw in fitness magazines, or the women I saw competing in the crossfit games on TV. I had a lot of work still to do if I wanted to be what had clearly become the standard of beauty and desirability in the fitness world.

Last December, I decided enough was enough. This is ridiculous. That lean ideal is as unrealistic for most of us women as the underweight ideal I grew up with. I was maintaining at about 15% body fat and felt great, looked great, was getting stronger and healthier every day, had a husband who adored my body, and yet when I looked in the mirror I still saw the fleshy thighs. What was it going to take to be what I somehow had absorbed as the new standard of beauty?

I decided to find out, and to blog about it.

I set out with a goal to drop down to the level of leanness we women are barraged with in the popular media. 15% wasn’t it, and I suspected it was going to be single digit body fat for me, given my genetics. I did set some limits out of concern for my health, though:

-I wasn’t willing to sacrifice my basic nutrient needs. If I got to the point that I had to drop my calorie, protein, fat or micronutrient intake below that which is essential for health, I would stop.

-If I started to experience negative health effects of underfat (missing periods, bleeding and bruising, fatigue, hair loss, etc) I’d stop.

How’d I do it? I restricted my calories to just a few hundred less than I burn per day. This was so my body wouldn’t perceive a sudden reduction in calorie intake as famine, and start burning lean mass for fuel in an effort to preserve fat mass. I averaged an intake of 2200-2500 calories a day, I typically burn 2600-3000 calories a day. This kept my metabolism from slowing down. (Important for anyone trying to lose weight! Better to lose it slowly and get to the finish line with a healthy metabolism than to drop weight quickly but kill your metabolism in the process!)

Next, I maximized my protein intake to aid in lean mass preservation. When losing weight, some of the weight you lose will be fat and some will be lean mass. This is true no matter how healthfully you lose the weight. Getting enough protein can help limit lean mass losses though. I was aiming for 150+ grams of protein a day (at a body weight of 160 when I started). It’s difficult to get that much protein from food on 2200 calories a day, even for omnivores. I used a protein supplement to reach that amount.

I did enjoy my food, I didn’t eat anything I hate, so there was that. But I had to be strict with portions, and I had to plan my days carefully to make sure I got everything I needed. And I’m not a fan of protein shakes, so trying to dress them up to make them palatable without adding extra calories was tedious and difficult. There wasn’t any room for creativity, and going out to eat was a nightmare! I’m sure I was no fun in that department. No alcohol, teeny tiny portions of chocolate, no impromptu evenings out because I would need to look at the menu beforehand to plan my meal, and the rest of the day around it!

I kept up with my lifting 3-5 days a week and intended to do more cardio, but in reality that sort of went out the window, mostly because, as I’ll discuss later, I just didn’t have the energy.

I lost 10 pounds over the course of 12 weeks, which is exactly what I would have expected given my 300-500 calories/day deficit. (It IS calories in vs out, people, don’t believe the hype).

My weight loss stalled out at 147 pounds. This is because my weight ‘caught up’ to the number of calories I was consuming. To lose more I would have to reduce my calories or increase my burn through activity. This is where things got really uncomfortable. See, I wasn’t willing to reduce my calories further, because I’d have to sacrifice nutrition. And increasing my activity? Well, by that time I was experiencing unrelenting, low level fatigue, and I simply didn’t have the fuel to do more exercise. I have been bouncing around 148-150 for almost a month now, and it’s one of the reasons I decided to end the experiment when I did. I simply hit a wall that I couldn’t get over without risking my health, and that had been my limit going into this.

I scheduled a hydrostatic body fat test and maintained my weight until the test. That was a few-week wait. During that time I began to see some symptoms of ‘underfat’. There was the fatigue, for starters. And I was constantly impatient and irritable with my family. My husband, bless his heart, really stepped up and ran a lot of interference between my kids and I so they didn’t have to deal with my short temper. I’ve been spacey and forgetful. My libido has completely vanished. Most worrisome, my period didn’t show up when it was supposed to. As I write this, it’s 17 days late. I’ve been like clockwork since I’ve been at a healthy weight.

It’s difficult to find scientific info on the health impact of underfat. Most of it there is is specifically about women who are underweight as well as underfat, and even now at 12% body fat my weight is still a very healthy 150 pounds, making my BMI 22.1, smack dab in the middle of the ‘healthy’ range on the weight charts. I have over 20 pounds worth of ‘cushion’ before I drop into the ‘underweight’ category. Given my declining health, though, it’s clear I can’t spare that weight without risking serious complications.

Here is my before and after photo, the difference in color is due to the natural lighting at the time of day the pictures were taken, I’m standing in front of the same wall in both pics. On the left, November 2011 at 160 pounds and roughly 15-16% body fat. On the right 150 pounds and 12% body fat. I look great, don’t I? Aside from some fluff on my knees, I’d look right at home on a fitness magazine cover. And that fluff can be photoshopped out, no problem! But according to the American Council of Sports Medicine, a body fat composition of less than 12 to 14 percent is considered too low and a health risk. Other sources suggest falling below 15 percent is a concern. According to this site, having too little body fat increases the risk of brittle bones, loss of menstrual periods, infertility, dry skin, poor concentration, low mood, feeling cold, constant thoughts about food and low sex drive. Body fat protects the internal organs and aids in proper nerve function. Maintaining too little body fat for any length of time can weaken your bones and contribute to osteoporosis. Too little body fat can effect not just your moods, but your neurological function, triggering full-blown eating disorders in people who’ve previously had a healthy relationship with food.

I like this picture because while it highlights how lean I am, the look on my face is a great illustration of how I feel. Spacey, out of it, low energy. You’ll also note my complete absence of breast tissue. This is pretty standard when a woman’s body fat gets this low. There are a few lucky women who maintain some semblance of breasts, but most of us, when this lean, will lose the fat in our breasts too. Hence all the surgically enhanced boobs in the fitness industry.

They don’t tell you this stuff when they bombard you with images of impossibly cut and defined women, do they? They also don’t tell you that the models in those pictures take diuretics (check out the last tip at the end of the article) and restrict water intake, to dehydrate themselves and make their muscles appear more defined. Or that every image you see in the media has been photoshopped and altered to better fit the standard image of beauty. And don’t even get me started on the fake tans, the strategic posing, the surgical enhancements, the flattering lighting, and the drugs some of these women take.

I know I’m going to get lots of comments from people who can maintain an uber-lean physique without experiencing health effects. That’s great! You are very fortunate that your body type has been declared ‘Good and Desirable’ by our culture. There are people who are able to maintain weights and body fat levels that classify them as obese and remain healthy, too. Do we glorify them and suggest that all women should aspire to that ideal? Of course not. Because most of us wouldn’t be healthy if we tried to maintain that physique. Just as most of us wouldn’t be healthy at the body fat levels that are being pushed on us by the media and each other.

I no longer appreciate the ‘Strong is the New Skinny’ meme, mostly because it is generally accompanied by images that are unrealistic and unhealthy for most of us. I believe in the original intention, the celebration of strength. Being strong is great, but you don’t need to be shredded to be strong. And you don’t need to be, or look, strong to be healthy. The original message has been co-opted, twisted and turned into a marketing tool to sell us a new mythology. I’m calling for all of us, even the fitness models and figure competitors, to reject the cultural mythology that there is one standard of beauty and health. Stop buying in! Stop buying the magazines that promote only one ideal, stop sharing and glorifying the pictures on facebook, stop looking at yourself in the mirror and focusing on the ways you don’t look like what you see in the media. Not even the models in those pictures look that way in real life. Health first. If you end up looking ripped because you’ve adopted a healthy lifestyle, great! And if when you are healthy you don’t end up ripped, join the club. It won’t be easy to change the way we think. I admit, I really like the way I look now! There’s a part of me that wants to say ‘screw my health!’ and stay here, or even lose a little more! We are so brainwashed that even when confronted with evidence that what we’re doing is dangerous, we still are tempted to keep doing it because of the positive reinforcement we get from society. I hate it, and want better for my daughters. I want better for myself. I want better for all of you! We all deserve better than this, and to be loved just the way we are.

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