Join Kelsey Kinney, MS, RD and Laura Schoenfeld, MPH, RD, as they answer your questions about ancestral and Paleo nutrition. A must-listen for anyone new to the Paleo diet or looking to improve their current Paleo diet based on their personal needs and health goals.
The content on this show reflects the opinion of Kelsey and Laura and does not represent the opinions of Chris Kresser, who has not reviewed the content of this podcast.
We have another Q&A episode this week! Thank you to everyone who has submitted questions so far, and we hope you’re enjoying the podcast.
Here are the questions that Laura and Kelsey address in this episode:
- My question is regarding Paleo Weight Gain. I have been Paleo for few years but don’t do any of the Paleo dessert cheating with nutbreads, muffins, sugar substitutes etc. No grains or sugar including honey or other substitutes. No fruit or nuts as these make me gain weight. I do include bone broth, cheese and butter and other good fats. In fact I have increased the fats in my diet significantly – coconut oil, coconut milk, avocado, olive oil, butter. Lots of vegetables and meat – everything is organic and/or grass fed as this is easy to get in Australia. I do have a couple of coffees every day with coconut oil/MTC blended. I eat 3 meals a day with no snacking as I don’t feel hungry between meals with the increased fats. I walk at a moderate pace for 1 hour a day, and I do yoga about 3 times a week. No intense cardio. My problem is that I am gaining weight. If these foods don’t spike insulin then why am I gaining weight, because all the low carb podcasts seem to agree that its insulin spiking foods that trigger fat storage. My fasting blood sugar averages about 80 mg/dL and goes up to about 90 mg/dL after eating – so its not spiking. I’m really confused and starting to think I have to go back to a more conventional calorie counting method, but this would mean cutting out the fats as they are so high.
- Is there a supplement I can take when eating gas producing foods? I have trouble with many of my favorite foods such as broccoli, brussels sprouts, and cabbage. I don’t want to eliminate them from my diet.
Podcast (ask-the-rd): Play in new window | Download
- Stephan Guyenet on the Carbohydrate Hypothesis of Obesity
- Calorie Needs Estimator
- Calorie Counting Website
- List of Paleo FODMAPs
About Laura: Laura is a Registered Dietitian with a Master’s degree in Public Health from UNC Chapel Hill. She is passionate about making traditional diets healthful and accessible for all her clients. You can learn more about Laura by checking out her blog or visiting her on Facebook.
About Kelsey: Kelsey is a Registered Dietitian with a Master’s degree in Human Nutrition and Functional Medicine. She works in private practice and recommends individualized dietary therapy focusing on biologically appropriate diet principles to aid her clients in losing weight, gaining energy, and pursuing continued health. You can learn more about Kelsey by visiting her website.
Thank you again to Amy Berger of TuitNutrition.com for the excellent transcription.
LAURA: Hey everyone! Thanks for joining us for this week’s Ask the RD podcast. I’m Laura Schoenfeld and on the other end is Kelsey Marksteiner. How are you doing today, Kelsey?
KELSEY: Doing well, Laura, how about you?
LAURA: Good! A little cold…we’re about to enter a cold front for the second time this year.
KELSEY: Oh, yeah. I know, here, I’m in Massachusetts now and we just had a nice, lovely snowstorm that coated all the trees, so the nature is just beautiful.
LAURA: Yeah, well I’m about to head to North Carolina, so I’m excited to escape, hopefully, snow for a long time.
KELSEY: Yeah, lucky you.
LAURA: Yeah. So, okay, I think we’re ready to get started with our first question, and the first one’s for me, right, Kelsey?
KELSEY: It is. All right, so here we go. “My question is regarding Paleo weight gain. I have been Paleo for a few years but don’t do any of the Paleo dessert cheating with nutbreads, muffins, sugar substitutes etc. No grains or sugar including honey or other substitutes. No fruit or nuts, as these make me gain weight. I do include bone broth, cheese, and butter and other good fats. In fact I have increased the fats in my diet significantly—coconut oil, coconut milk, avocado, olive oil, butter. Lots of vegetables and meat – everything is organic and/or grass-fed as this is easy to get in Australia. I do have a couple of coffees every day with coconut oil or MTC oil blended. I eat 3 meals a day with no snacking, as I don’t feel hungry between meals with the increased fats. I walk at a moderate pace for 1 hour a day, do yoga about 3 times a week, and no intense cardio. My problem is that I’m gaining weight. If these foods don’t spike insulin then why am I gaining weight? Because all the low carb podcasts seem to agree that it’s insulin spiking foods that trigger fat storage. My fasting blood sugar averages about 80 mg/dL and goes up to about 90 mg/dL after eating – so it’s not spiking. I’m really confused and starting to think I have to go back to a more conventional calorie counting method, but this would mean cutting out the fats as they are so high.”
LAURA: Okay, so the reason I picked this question is because I think it’s a very common belief, and especially prevalent in the ancestral health community, even though it’s oversimplified and potentially inaccurate from a physiological standpoint. And that belief is that the insulin-spiking foods are the ones that trigger fat storage. I’m going to say something that might be considered controversial, but I do think it’s important for people to understand: A spike in insulin is not necessarily required to store fat. So I’ll say that again. A spike in insulin is not required to store fat. And while chronically high insulin encourages fat storage, the carbohydrate obesity hypothesis takes it a step too far by suggesting that in the absence of insulin fluctuations, that fat cannot be stored. This is the belief that drives low carbohydrate dieting. And I’m not saying that low carb isn’t an effective weight loss strategy. But it’s not simply because it limits insulin release. That belief is part of the reason why people either don’t lose weight or can even gain weight on a low carb diet. And my favorite article dealing with this issue is actually written by Stephan Guyenet. It’s called The Carbohydrate Hypothesis of Obesity: A Critical Examination. And I’ll link to it in the show notes so you can all read it for yourselves, but I will give you the nutshell version as far as the way I understand what he wrote, because he’s a little bit of a high level writer.
In this post, Stephan acknowledges that carbohydrate restriction can be effective as a weight loss strategy, but it’s not a guarantee of weight loss for a couple of different reasons. He argues that rather than insulin signaling, that it’s actually leptin signaling that mostly controls body fat accumulation or loss by its effect on the brain. And that’s because leptin is a hormone that’s made by fat tissue, that acts on the brain to regulate food intake and body weight. It actually helps reduce appetite and decrease body weight if you’re leptin sensitive. So Stephan suggests that insulin’s actual role is to coordinate the shift between various metabolic fuels as they become available through the diet. So if you eat carbohydrates, insulin shifts the body’s metabolism to burning those carbohydrates. But as soon as you run out of the carbs you’ve eaten, the body can shift back to using fat for fuel. So if you’ve eaten low carb but a ton of fat, the body will burn that fat that you’re eating for fuel until that fat runs out, and then it’ll continue burning the fat stored in your body. So insulin can be seen as more a regulator of fuel use rather than solely a storage hormone. And Stephan explains it really well in his article, so I’m just going to read what he says so I don’t mince words here.
He says, “If you eat a meal of 500 calories of carbohydrate, you will burn that carbohydrate under the direction of insulin, which will also make sure that body fat mostly stays inside your fat cells during the process. If you eat a meal of 500 calories of fat, you will burn fat instead of carbohydrate, but since you just ate fat, you aren’t dipping into your body fat stores any more than you were when you ate carbohydrates. So this means that the laws of thermodynamics do apply to humans, and that if you eat more calories than your body burns, you will either store fat, or at a minimum, you will not tap into your fat stores for energy, and thus, weight loss will stall.”
And this is really important for people to understand, because I think there’s a prevalent myth out there than when you’re eating low carb, you can just eat as much as you want and you’ll still lose weight. This isn’t true from a physics standpoint. If you’re burning 2200 calories a day and you’re eating 2500—so that’s a surplus of 300 calories per day—you’re likely going to gain weight, and at a minimum, you won’t lose weight. And as I have mentioned before in podcasts and questions that people have asked, your metabolism really does fluctuate a lot, so if I say you’re burning 2200 calories a day, that’s just what your body’s actually burning, and not just an estimate of potentially what you could be burning.
But Stephan also argues that higher insulin release is associated with an increased level of satiety, which means that the more insulin that gets released in a meal, the more satisfied you feel after that meal. Now remember, protein also stimulates insulin release, so a high protein, low carb meal can actually be very satiating. But a high fat, low carb, and somewhat low protein meal will likely not be satiating. In another part of Stephan’s article, he argues that insulin actually reduces fat mass, and that a higher fasting insulin is actually associated with a higher resting energy expenditure. So insulin is there for a metabolic stimulant, and research indicates that insulin constrains food intake and body fatness through its action on the brain. And there are studies that have been done that demonstrate this stuff that Stephan covers in his post.
I know this is a lot of information to take in and I do suggest reading the article, but I think the major takeaway from the article as far as I’m concerned is that low carb diet is not a guaranteed weight loss strategy. And ultimately, you really do need to eat fewer calories than you burn to lose weight. But the reason why this gets complicated is because it’s really difficult to determine what your personal metabolic rate is without using some type of high-tech measurement device, and if you do significantly decrease your caloric intake, your metabolic rate ends up dropping to match your reduction in intake. And this is why, for many people, if they’re following a long-term low-calorie diet, this will lead to a stall in weight loss and potentially a rebound in weight gain, because their metabolism has dropped in its energy expenditure so significantly.
And this also doesn’t take into account the level of stress caused by either long-term severe caloric restriction, and also low carbohydrate diets, because both of these can increase stress hormones, like cortisol, and those hormones stimulate fat storage. So if you’re on a low carb diet long-term and your weight loss stalls, or if you’re starting to gain belly fat, I would say that high cortisol could be an issue here.
And I suppose I do also need to address the issue of weight as a measurement of health. Obviously, if your weight is increasing but your clothes either fit the same or maybe they even become looser, it’s likely that you’re gaining muscle and you shouldn’t really be concerned about the weight gain. But I don’t think this is usually an issue that people would be concerned enough about to ask a question, so I’ll go ahead and assume that the listener is not wearing smaller clothes than they were before.
Okay, so with all that said, here’s what I would suggest to this particular person. First, they should take a detailed 3-day food dairy and do a diet analysis to determine their total caloric intake as well as a macronutrient breakdown. They should compare this to their estimated caloric needs, and I’ll link to two different websites that can be used to determine caloric intake and estimated energy expenditure. And again, like I mentioned before, this is just an estimate. But perhaps this person will see that they’re eating a lot more than they’re burning, and in this case, they’ll need to practice some level of calorie counting to get back into a slight deficit. I think around 300-500 calories below their estimated needs should be enough to stimulate fat loss, and I wouldn’t reduce any more than that. So as an example, if the calorie needs calculator that I’m linking to suggests that you need 2200 calories per day to maintain your current weight, I think aiming for 1800-1900 per day is a good target. And if you want more personalized caloric estimation, you can get something like a calorie tracker, like the Fitbit, or the Nike fuel band, which can help you determine what you’re likely burning in a day. And I say “likely” because again, this is an estimate, and not an exact measurement of caloric expenditure. You really need to be in some kind of bodpod or use a metabolic cart to determine what your actual metabolic rate is.
And if this person’s not overeating, I would recommend replacing some of their fat calories with carbohydrate calories. So if you add 50 grams of carbohydrate to your daily intake, you would need to reduce your fat intake by about 22 grams. Again, this will require some food measurements to start out with, and some calorie counting as well, but I don’t want this person to add carbohydrates without removing an equal amount of fat, because then they’re just increasing their caloric intake, and that will likely not help with their weight loss. And the only reason why you might actually want to increase carbohydrates without reducing fat is if you use those calculators and you determine that you’re significantly undereating—say, by about 500 calories per day below your needs. And in this case, increasing calories could actually help trigger your weight loss. I personally don’t think most women should be eating less than 1500 calories per day, and I don’t think most men should be eating less than 1800 calories per day. And I also think that adding more carbohydrates on days where you’re more active can be helpful. And if you want to do a few days of low carb, save it for days when you’re relatively sedentary, so maybe you’re not doing the long walk that day, or maybe you’re not doing yoga.
So finally, my last suggestion would be to add in some weight training to the workout routine. I think yoga’s really great, but I do think one or two days of heavy weightlifting could help increase this person’s metabolic rate and help them build muscle, and that could potentially help with fat loss even if his or her weight stays stable. So of course it’s possible that the yoga this person is doing is fairly rigorous, but if it’s not, then a few days of heavy weight training sessions could help here. And if the person is exercising an hour or two per day but then sitting for the rest of the day, this could actually undo some of the metabolic benefits of exercise. So trying to stand for a couple of hours rather than sitting the whole day would possibly be helpful, too.
And I know some of this sounds like a lot of work, and trust me, I hate calorie counting and measuring my food just as much as the next person, but honestly, I think this person could benefit from having a more clear idea of what his or her caloric needs are, and whether or not they’re surpassing those needs on a regular basis. Because even a couple hundred extra calories per day over what your body is actually using can cause weight gain, and that’s actually really easy to do if you’re eating an unlimited amount of fat. I think fat is great, and I think it’s a very important component of the diet, but I also think it’s easy to overeat if you’re under the impression that you can just eat unlimited fat and not gain weight, which, as I explained, is not true.
So I hope I’ve explained Stephan’s article fairly well, or at least conveyed the overall message of it. I do think that people should read it for themselves if they want more information, but I just don’t think carbohydrate restriction is a magic bullet for weight loss for everyone, and I would hope that making the changes I recommended could be helpful if the person has found themselves gaining weight on a low carb diet.
KELSEY: Yeah, that was great, Laura. And, y’know, I think part of the reason people think about low carb being very helpful for weight loss is because usually when you take out an entire—or at least significantly reduce—an entire macronutrient, people tend to just eat less. So even then, it still comes down to the calories that they’re eating. It’s just because they’re not necessarily thinking about cutting calories; they’re just happening to do it by cutting the carbohydrates. But on the other hand—which is what sounds like is happening in this case—if they take out carbohydrates but then basically double up or triple up on their fat, then yeah, it’s very easy to see how they wouldn’t be losing weight and may even be gaining weight in that case. So I loved your explanation of that, and I think it’s so important for people to understand that even though hormones are absolutely important, it’s not completely, only about the hormones. So it’s not just insulin that comes into play when we’re talking weight loss here.
LAURA: Right. And I think the insulin hormone, just as a singular hormone, is so misunderstood by so many people, because we’ve kind of gotten this message that insulin is just a storage hormone, and all it does is store fat.
LAURA: And it does a lot of other things. Like I mentioned, in Stephan’s article, he explains that insulin actually…the presence of insulin not only reduces your appetite, but it also increases your metabolic rate. So one question that I saw on the forum asked by somebody was that they are eating a very high fat diet and they always feel like they’re still hungry, as far as the physical sensation, and there’s actually some evidence that insulin is an important component of appetite regulation, and if you’re not increasing your insulin enough when you’re eating, that your body is basically still under the impression that you haven’t eaten, and it doesn’t reduce the hormone called ghrelin, which is an appetite stimulating hormone. So I think hormones play a huge role in body fat and a huge role in the way that your body uses the food that you eat, but it also affects your appetite, it affects your metabolic rate, it affects if you’re still hungry once you finish a meal. Say you eat 1000 calories at a meal and you’re still hungry because your insulin didn’t go up. Then you’re not hungry because you need more calories; you’re hungry because the ghrelin hormone hasn’t been tapered off the way it would normally taper off if you had eaten carbohydrates. So, it’s definitely a rabbit hole of some sort—
LAURA: But I hope that people will read this article by Stephan, because it’s really, really good at explaining why the insulin obesity hypothesis is flawed. It’s not 100% inaccurate, it’s just flawed, and people that are using that hypothesis as a weight loss tool might be missing some important components of their diet that can actually help them either lose weight or not gain weight.
KELSEY: Yeah, absolutely. Well, thanks for that, Laura, that was great.
LAURA: Yeah, hopefully I don’t get chewed out on the message board, because I know there’s a lot of people that are dedicated to their low carb diets…
KELSEY: And you know that there’s always new research coming out, and I love to hear people’s opinions that may not be the same as ours. I think that’s fascinating, and as long as everybody’s civil about it, I think we can all learn from each other.
LAURA: Right. And one last thing that I need to point out is that just because I’m saying this low carb diet is not working for this user, that doesn’t mean I don’t think low carb can work for people. I do think people who are insulin resistant can really benefit from a period of low carb dieting. I think people who have possibly 50 to 100 pounds of weight to lose can benefit from low carb. I just don’t think that anyone who needs to lose weight or that they’re trying to keep their weight stable is necessarily going to be doing themselves a favor by completely avoiding carbohydrates. And I’m not saying you have to eat 500g of carbohydrates a day, but it does sound to me from this person’s question that they’re pretty darn strict about avoiding carbs. So if this person was my client, I would definitely try to figure out a meal plan that was a little higher in carbohydrates for him or her. I would assume it’s a her, but I don’t want to make any gross assumptions. So, anyway, I’m happy to chat with people in the comments if they have any questions or further evidence that they’d like to present about the carbohydrate hypothesis.
LAURA: All right, so I think the next question is for you. And this one’s short—the question is, so we’ll see how long your answer is. They ask, “Is there a supplement I can take when eating gas-producing foods? I have trouble with many of my favorite foods such as broccoli, Brussels sprouts, and cabbage. I don’t want to eliminate them from my diet.”
KELSEY: This is a great question. So, to me, it sounds like this person is experiencing something called FODMAP intolerance. And for those of you who aren’t familiar with what FODMAP intolerance is, we’ll go over it right now for you. So FODMAP stands for fermentable, oligo-, di-, monosaccharides, and polyols. So these are short-chain carbohydrates that are poorly absorbed in the small intestine and are easily fermented by bacteria. They also help to bring water into the large intestine. Now, most people can eat these foods without an issue, however, some people become more symptomatic than others when they eat foods that contain FODMAPs. So they’ll experience symptoms such as bloating, gas, and diarrhea. A low FODMAP diet has been studied in the case of IBS and has been shown to be pretty helpful, and I think this is because, at least I would imagine, a higher FODMAP diet would just exacerbate some of those symptoms that they might be experiencing. Because if they’re already having diarrhea and bloating and gas, eating FODMAPs when they’re intolerant to them would just make it infinitely worse.
So there are some underlying factors as to why someone might have a FODMAP intolerance, and I don’t think we have all the answers about this yet, and certainly, research is coming out all the time, and FODMAP is…at least I think it’s a pretty hot topic right now, so I think we’re seeing a lot of stuff about this coming out. And right now, we’re just doing the best we can with the science that’s out there.
So gut health has been shown to be a factor in developing FODMAP intolerance. So things like small intestinal bacterial overgrowth, pathogens, and just general dysbiosis can all play a role in FODMAP intolerance. By testing for and addressing those underlying factors, you may be able to improve your tolerance of FODMAP foods. After you’ve been tested and you know what’s going on, oftentimes a gut-healing diet and supplement protocol can really improve FODMAP intolerance. So what I mean by this is that usually it’s a combination of eradicating any harmful or overgrowing bacteria and adding in probiotics, and just generally balancing the gut flora. This is really something you’d want to work with a practitioner to do. I really wouldn’t recommend trying to do it on your own. But it can be really helpful for someone who wants to improve their FODMAP tolerance, as it sounds like this person definitely wants to do.
However, I’m going to be the bearer of bad news here. You’re likely going to need to be on a low FODMAP diet for some amount of time. You’ll feel better by eliminating these foods that are obviously causing some of these unwanted symptoms for you. Plus, we just don’t want to be overwhelming the GI system with things it candle while we’re trying to fix any underlying issues. So when I work with a patient who’s FODMAP intolerant, we want to know what’s going on their gut and work on improving that balance of the gut flora. But while we’re doing this, this patient is definitely on a low FODMAP diet for the reasons I just stated.
I will say that people vary a lot with their FODMAP intolerance, and this may be the case for this person as well. Some can be on a low FODMAP diet for a long time along with healing any underlying factors and still be pretty sensitive to FODMAPs at the end of it. But I do find that for most people, they’re able to add some small amount of FODMAPs back into their diet after a while, and they do fine with it. And some people, they can eat tons of FODMAPs at the end of this and they’re perfectly fine, so it really just depends on the person.
It sounds like this listener knows which FODMAP foods they’re sensitive to, but for others who just classify themselves as FODMAP intolerant, you may want to start on a stricter low FODMAP diet and then test some of the higher…the foods that contain more FODMAPs, depending on their class. So whether they’re high in fructose, or lactose, or fructans, or anything else, because some people are more sensitive to some of those classes versus others. And in my opinion, it’s good to find out which ones you can handle so that you’re not unnecessarily restricting your diet.
My favorite FODMAP chart to use when I’m doing this with patients is from the Paleo Dietitian’s site, which I’ll link to here. Now, she separates out foods by “safe,” “be careful,” and “avoid” categories. And I will say that I’ve used a lot of other FODMAP lists out there, but I find hers to be the most accurate and my patients do the best with that one versus other ones, when they’re following the safe and avoid categories. So what I usually do is I’ll have people start by only consuming foods on the safe list. And once their symptoms are under control, we’ll try some of the be careful foods, which, when I’m working with patients, I usually find that they either do perfectly fine with a be careful food, or they have a somewhat severe reaction. It really never tends to be an in-between reaction for whatever reason; it’s kind of an either or thing.
Once they’ve done that and they’ve gone through those extra be careful foods and they separate out which ones are working for them and which ones aren’t, then if we think there may be a certain class of foods that they may be able to tolerate…so, for example, if they went through the be careful list and all of the lactose foods they did fine with, we can then try adding some of those foods even from the avoid category that contain lactose and see how they react. And I find that this process tends to work really well and it eliminates some of the unnecessary restriction that people may be doing if they decide to take out all FODMAPs.
So I don’t know what this reader—or, listener, I guess—has done in terms of figuring out which FODMAP foods they’re sensitive to. Obviously he or she has a couple that they’re more concerned about because they’re some of their favorites, but they may just be frustrated because they have to take out so many of these foods, and by doing this kind of FODMAP elimination challenge diet, they can see maybe if there are some they can tolerate either in smaller amounts, or some that they’d be perfectly fine with that they didn’t know about. That might make following this lower FODMAP approach for some time while they’re working on all the underlying factors a little easier for them.
Since this listener asked specifically about supplements to address FODMAP intolerance, I do want to add that when I used to work at a gastroenterology clinic, one of the doctors often recommended Beano to patients with FODMAP intolerance, and for some people it did help. I don’t know if that’s something I would have really guessed would help a lot of people. I mean, I can see it helping if really legumes are the only problem that’s happening for someone, but for most people, I think that if they’re eating a lot of the vegetables and fruits that are causing some issues it may not be particularly helpful. But of course, on a Paleo diet, we’re not really eating legumes anyway. But that did help some people. Now these were people on kind of a standard American-type diet, so I’d be interested to see if it does help anyone who’s FODMAP intolerant on a Paleo diet. So that’s the only thing that I’ve heard of that helps somewhat, and I’m not sure if it would help someone on a Paleo diet to tolerate more FODMAPs. So give it a shot; it certainly can’t hurt, I don’t think, and let us know if that helps you at all.
But other than that, for supplements, really, it’s just supplements that would help the underlying problems going on, like dysbiosis. So probiotics would be helpful, gut-healing supplements, like marshmallow root, DGL, those kinds of things if there’s intestinal permeability, and just basically fixing the gut flora balance can be very, very helpful and eradicating if there’s SIBO or some other kind of pathogen. All of that really, really helps to improve FODMAP tolerance.
So unfortunately, there aren’t supplements out there really that let those of us who are FODMAP intolerant digest FODMAPs much better and not experience symptoms. The best approach is really to just get tested for any gut flora abnormalities and treat those, along with a low FODMAP diet for a while, and then try adding in some of those FODMAP foods to see how they’re tolerated. So it can be somewhat of a long process, but unfortunately, sometimes the hard way is the best way. So I’ll leave it with that.
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LAURA: Yeah, well, something that I was thinking when looking at this question, and this might be a little bit weird or sound a little strange, but I would wonder with this person, when they say “gas,” do they mean abdominal distension, or do they mean a little bit of, y’know, malodorous gas production?
LAURA: Right, exactly. And I think if you’re having discomfort or if it’s really significant gas, then the whole FODMAP thing is definitely something that is worth looking into, but I think another issue could potentially be that this person may think that any gas is unhealthy.
KELSEY: Right, abnormal.
LAURA: Right. And with foods like the broccoli, Brussels sprouts and cabbage, those are very high sulfur containing foods, which is really good as far as health goes, because there’s a lot of benefits to sulfur containing foods that I’m not going to go into now because that could be a whole other podcast, but suffice it to say that sulfur is really healthy for you, but one of the problems with eating a lot of sulfur is that you end up having some sulfur scent to your flatulence, like you said.
LAURA: And I know that this is a little bit…something that could potentially be embarrassing, or not something that you necessarily want to have, but I want to remind all the listeners that it could actually be something that’s just a normal reaction to sulfur containing foods. If you’re having a little bit off-smelling gas from those foods, don’t necessarily jump to conclusions that you have some kind of dysbiosis or something like that, because it really could be just that that’s the smell that comes from that end of your body when you eat the sulfur containing foods.
KELSEY: Right. Very true.
LAURA: In our hyper-hygienic society, it’s like, oh my gosh, gas is so gross and unhealthy, and it’s really a normal process. As gross as it sounds, it’s definitely not something that people should be terrified of. If the person is having, like I said, stomach pain, or if it’s really, really bad smelling gas to the point where you think it smells unhealthy, then that’s one thing.
KELSEY: Right, or just excessive amounts of gas, too. So yeah, it sort of depends on whether it’s really excessive in amount or smell, or you’re having other symptoms along with it, like Laura mentioned. Yeah, I guess I’m answering this question from a standpoint of assuming that it’s excessive, but you’re right, it could absolutely just be a normal reaction to these types of foods. And different people may just experience a little bit of different types of gas with different foods, and that’s probably completely normal.
LAURA: Yeah, so, sorry for taking it down that route, but I feel like…
KELSEY: No, it’s good, it’s good.
LAURA: I just feel like people need to kind of be okay with some bodily functions that are not completely sterile or…it’s not necessarily a sign of gut dysbiosis if you have a little bit of gas here and there.
LAURA: Again, like Kelsey said, it’s one of those things that you need to pay attention to if it’s really excessive, but once in a while is not the end of the world.
KELSEY: Right. And if you’re thinking that it might be FODMAP intolerance, you can always look at that list of foods, and if you look at that avoid list and you’re like, check, check, check, all of these cause problems for me, then it’s more likely that that’s probably an issue, whereas if you look at that list and it doesn’t necessarily jump out at you that any of those are particularly problems other than the few that you mentioned, it could just be that’s your reaction to those foods and you can always take them out, but also just thinking about what Laura said is that these things are kind of normal, so it’s not something we need to be overly concerned about as long as there’s no other major issues going along with it.
LAURA: Right. And one issue I’d say people should keep an eye on if they’re concerned is stool consistency.
LAURA: If you’re going number two and it looks normal and it’s a good consistency and you’re not having either constipation or diarrhea, or loose stools, then this gas may not be something that’s pathological. Whereas if you are having stool changes, then I would be more apt to thinking that it is something pathological.
LAURA: Which means disease, or dysbiosis-related.
KELSEY: Great! Well, thanks for that info, Laura. I think that’s really helpful to just…I’m glad you brought that up because you’re right. People tend to just think a lot of times that some of these bodily functions are always abnormal, which is definitely not the case.
LAURA: Right. Unless they’re, y’know, a 22-year-old frat boy, and then they think it’s awesome.
KELSEY: Right, true.
LAURA: All right, well thanks for joining us everyone for this week’s episode of Ask the RD. We hope you’re enjoying the podcast, and if you are, please feel free to leave us a nice comment on iTunes so that other people can find us there. And if you want to ask a question, make sure you submit your question through the link on Chris’s site, and who knows, maybe we’ll answer your question on the next show. Again, thanks for joining us, and we hope you’re enjoying the show. All right, see you next time, Kelsey.
KELSEY: Great, thanks Laura. Take care.
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Please provide link to the FODMAP chart as indicated.
Love the podcast first of all! Great topics and discussions.
I had a similar question to that discussed on this episode. I have be chronically following a 1200-1300 calorie/day diet and my weight loss has stalled despite daily exercise and calorie cutting. I know you said upping calorie intake could trigger weight loss, but I am afraid I will gain weight as my body will hold on to those extra calories as fat. Any thoughts?
Thanks so much!
You advise ” So if you add 50 grams of carbohydrate to your daily intake, you would need to reduce your fat intake by about 22 grams” – I wasn’t clear why the isocaloric substitution would be of benefit.
Is there any evidence that “the presence of insulin not only reduces your appetite, but it also increases your metabolic rate” ? A euglycemic clamp with insulin infusion at varying rates should resolve that one.
For three years I ate a high fat, low carb strict Paleo diet. I initially lost 20 pounds and was able to maintain that loss without any changes. Then, I went into menopause. My estrogen, dhea, and testosterone levels dropped and I gained weight WITHOUT changing diet and excercise. Question: do I need to count calories now? This is just rhetorical. If you are a middle aged woman, all bets are off due to hormones.
this is a good fodmap list… but even the safe foods are portion limited by the Australian doctors in some instances – e.g turnip, zuchini. plus if you have sibo some of the safe foods will still cause issues without tight portion control. the scd/gaps legal list contradicts fodmaps in some places and vice versa. e.g kholrabi i’ve found listed as safe as fodmap, but illegal in scd. Same with rutabaga – portion control and personal tolerance seems key but cross referencing both lists if one has sibo may not be a bad idea.
Oh, man…the calories thing rears its head again. (As if it ever went into hibernation.)
First, let me say that the person from question #1 could probably benefit from consulting a practitioner who’s familiar with different hormones and all the other things that could be hindering weight loss. As Chris’s (and your) fans know, diet is really only part of the equation. Granted, it’s probably the factor with the biggest impact, but there’s also sleep, movement, sunlight, stress, joy — all these things play a role. So if this person’s caloric intake is already in line with where it needs to be, I would suggest working with someone who can identify if an issue with some organ or gland is putting a wrench in the works (thinking specifically liver, adrenals, etc.).
That being said, as someone who “found” low carb and then eventually Paleo after a history of “doing all the right things” (low calorie, lots of exercise) but NOT experiencing any fat loss and remaining chubby all throughout my teens and early 20’s (far chubbier than any of my friends who were sedentary and ate tons of junk), I feel like I need to chime in here.
I do agree that calories matter. Of course they do. You will likely not lose body fat on a low-carb diet if you’re eating 3 sticks of butter a day, regardless of what we know about insulin. It’s not all about carbs and insulin. On that I agree.
HOWEVER…and I’m saying this with all due respect to Stephan Guyenet, because obviously he’s dedicated his advanced education and his career to studying this stuff and his research is helping to elucidate a lot of things in this community. But it’s all well and good for him to sit in the ivory tower and talk about calories in and out, but tell that to the chubby 16-year-old girl who’s eating a grilled chicken salad at the mall food court (and who went for a 5-mile run earlier that day), while her much thinner friends are scarfing down nachos/burgers and fries/horrendous examples of “food,” but will go on to the next store and happily slink into size 4 jeans while the salad girl is over in the section with the 14s.
I’m not saying that having been lean all his life disqualifies Stephan from contributing to the conversation. Of course it doesn’t. (After all, then there would be no male OB/GYNs, no oncologists who’d never had cancer themselves, etc.) I’m just trying to make the point that sometimes the equations and formulas that look great on paper just fall to complete pieces when applied to living, breathing, human beings not sequestered in metabolic wards.
Regarding the way insulin determines fuel usage, I can see that. It sounds good. But to use the example you cited in the podcast, let’s say an overweight, insulin resistant person eats a meal of 500 calories of carbohydrate. It should be that insulin tells the body to use those 500 carb calories first, but once those are gone, the body should switch to using fat instead. But if someone is overweight and insulin resistant, it’s reasonable to assume that their insulin levels are *always* a little elevated, even when they *haven’t* just eaten a truckload of carbs. Because of being IR, their insulin levels are *higher* after a high-carb meal than the average person’s, and they likely remain at that elevated level for a longer period of time. So their insulin levels almost never come back to a nice, low baseline (except maybe first thing in the morning).
So if insulin levels are still a little elevated from the glut of carbs, when those 500 calories run out, their bodies *aren’t* able to switch right over to fat burning. The insulin is still in the way. This is what we mean when we say that, at least on a cellular level, obese people are actually *starving.* They have tons of great fuel stored all over their body (in the form of adipose tissue), but they can’t *access* any of it because of the chronically high insulin. So a couple hours after eating that high-carb meal, rather than tapping into those fat stores, they get hungry again — specifically, they tend to get hungry for *more carbs.* Talk about a vicious cycle…
Again, I am absolutely not discounting what Stephan’s research and interpretations tell us. All of these parts and pieces are useful to our ever-evolving understanding of this.
But on a personal level, I just feel like bringing this back to calories in/calories out makes it too easy to revert to a “blame the victim” perspective: Overweight people are just lazy. If they just ate less, or exercised more…if they weren’t so greedy…
In our society, unfortunately, being overweight is still seen as a character flaw or some kind of moral failure, rather than what it really is: an imbalance at a cellular level. (Caused, ironically, in part, by many of the foods we’ve been told are so good for us!) How is it that some people can gain body fat by *looking* at a cupcake, and others can eat everything in sight and remain lean?
And when we talk about “calories out,” or energy expenditure, we tend to think automatically of working out. Of dedicated exercise: running, biking, lifting, walking. We don’t put enough emphasis on energy expenditure at the cellular level. Everything we do requires ATP — sitting upright, breathing, blinking, holding a pencil to write something…we “burn calories” *constantly* throughout the day (and night!), even when we’re not on a treadmill or doing squats. So what determines the rate at which some of us burn fat versus glucose during all these *other* processes and activities our bodies do? *This* is the underlying stuff that can mean the difference between, say, eating less and *still* gaining more, or eating more yet losing body fat.
This is all so complex, but we do overweight people a disservice by downplaying all the factors involved in fat storage and mobilization and reverting back to calories. (And again, I know that’s not what Laura and Kelsey are doing here. Most people in this community know better, and are aware that calories are important, but they’re just one of a host of things at work.)
My apologies for the extra-long comment. As a former “fat girl,” I just feel compelled to advocate for another side of things. (And no, that other side doesn’t include 600-calorie cups of coffee with butter & MCT oil.)
P.S. Something that irks me a little about weight loss questions is that we often don’t know *how much* weight a person is trying to lose. Your answer might have been different if we knew whether this person has 90 pounds to lose or 10. (And let’s not forget how many people in this community–women, especially, but men too–are *already* at a healthy weight, but *think* they need to lose 10 more…)
Thanks for your input, Amy! My main point was that there is a common misconception that it is “impossible” to gain weight on a low carb diet because of the lack of insulin release in response to eating. Obviously weight loss is a hugely complex topic and varies between individuals immensely. I just wanted to address the belief that low-carb is a magic bullet for weight loss for everyone.
Totally, Laura. I understand that completely — and I agree. Low-carb can be quite literally a lifesaver for some, but it’s isn’t the perfect fix (or an automatic one) for everyone.
It comes down to calories. Period. (Well explained, Laura.)
For those who are trying to achieve lower levels of body fat, I have to put in a plug for Leangains (intermittent fasting + carb/fat cycling). If one’s goal is single-digit body fat percentages, it is worth your time to look into Martin Berkhan’s work. Richard Nikoley (freetheanimal.com) has a few posts about his personal journey with Berkhan.
Thanks for mentioning my FODMAP list! 🙂 I also have a lot more info about digestive health in my book “Digestive Health with REAL Food” if people really want to get rid of their bloating, gas and other digestive issues: http://www.eat-real-food-paleodietitian.com/digestive-health-with-REAL-food-the-book.html. 🙂
What about food sensitivities? I put on 3 pounds if I eat lettuce!
Will you have a written transcript for this?
We hope to! Stay tuned.
Quite disappointed! Too much info here for such a simple question….is there an enzyme that would help to digest the foods in question?
Beano is designed for this purpose.
I think Kelsey’s point was that it’s better to figure out why the gas is happening rather than mask the symptoms.
From what I’ve read Beano contains gluten so those of us with Celiac or gluten intolerance can’t use this.
Laura, thank you for your well-researched and thoughtful response. I’m in the same boat as the person who wrote question 1 and your feedback made a lot of sense. It was exactly the lesson I needed and I’m going to make modifications based on your suggestions.
Great podcast and info addressing weight gain on Paleo/lower carb & high fat diets.
Do you have some general daily ratios on Fat, carbs, protein, etc?
It would really help to have these when controlling my caloric intake.
Example: I am 5’9”, 172 lbs, w/20% body fat and would like to get down only 10-12% body fat (could care less about my overall weight).
I would think 1800 calories per day would work fine, but what kind of ratios, i.e. carbs: 50 grams, protein 50-60 grams, fats: 70 grams…
Thanks for your info!
Chris talks all about those ratios in his book, Your Personal Paleo Code.
Have you read it yet? It may help you determine your ideal diet.
Yep, about half way through I’ll look it up. Thx!
Check out Chapter 18 for specific guidance.
I have been keeping off an 80 pound weight loss for over twenty five years. I love Gary Taubes, but, at least for me, the diet does not work without self-monitoring of protein, fats and any caloric vegetables one might have. I’d love to eat more coconut oil, but will gain if I eat more. Even after all these years, my weight fluctuates a bit up and down. I’m not skinny, and even though I’d love to be, it is not to be. Calories count.
But, this kind of diet makes me feel well; I have plenty of energy for the first time in years, and have decided it’s time to accept myself at a normal weight, and be happy and grateful as well.
For question 1, doesn’t her response mostly contradict what Chris Kresser preaches?
To me, he doesn’t sound like a calories in/calories out advocate for weight loss. He mostly describes nutrient density, lower carb, anti-gluten, and gut flora optimization for losing weight. I just don’t recall him talking much at all about counting calories and staying away from fat because of the additional calories per gram.
Well, it seems like this person who asked the question is using “nutrient density, lower carb, anti-gluten” and finding that she’s gaining weight. You can still overeat on a low-carb diet. I don’t recommend calorie counting for the general public but for this particular person, I think it would be helpful for her to be more “calorie aware” until she gets her weight gain under control.
Also, I didn’t say to “stay away from fat” – I simply said this person should reduce fat and increase carbohydrates, as well as determine if she’s overeating calories, if she wants to try to reverse her weight gain.
I believe Chris would agree that overeating on any type of diet (even low carb, gluten-free) can lead to weight gain. Do you disagree?
I agree. Thanks!
What constitutes overeating is very individualistic. I don’t know how many calories I consume to maintain my weight, but it’s nowhere near 1,500. I mean it’s a lot less. And I’m not skinny. But, clearly I have a “slow” metabolism, and have to just live with that. Those of us with a history of obesity may have to live with a somewhat higher maintenance weight along with a lower calorie diet, especially if we’re older. Unfair, but what isn’t?
I guess when I embarked on the paleo approach to eating, I hoped that overheating wouldn’t really occur (as compared to a SAD diet) because the increased ratios of fat and protein would be more satiating and therefore I would be less inclined to over eat. Unfortunately, I didn’t find this to be the case for me. At the very least, I didn’t find it all as easy as many others seem to have.
I’m so confused, is this podcast not available on ITUNES anymore? Can we only listen to it via the website?
It should be on iTunes! https://itunes.apple.com/us/podcast/ask-the-rd/id730993514
Some time ago, it was discovered that carbohydrates triggered the absorption of foods. So, like farmers all the day’s heaviest exercise/work was finished in the early morning hours and ONLY AFTER THIS was any food or liquid drunk (aside from water). The daily amount of calories in their food was 2X or 3X (or more) than the typical 1900 cal/day but still no fat was gained.
The use of a mild ketogenic diet from time to time (eg. the winter season) should keep the weight down + set several metabolic processes right, so that diabetes type ll, and obesity can be eliminated as potentials…. “Lights Out” by TS Wiley. [Circadian rhythm interruption by artificial light is a major problem. Bright lights (at night) = cortisol(production) and fat gain
Drinking oil in your coffee and slathering added fats (i.e. caloric density) on all your meals, and gaining weight? SHOCKER.