CrossFit and Nutrition – Part 2

Robb Wolf – Split from CrossFit

Eat meat and vegetables, nuts and seeds, some fruit, little starch, and no sugar

–Greg Glassman

I’ve been asked about the CrossFit split from Robb Wolf (Paleo Diet) and how/why CrossFit embraced the Zone Diet. After all they are vastly different approaches to eating. I have opined on the Zone Diet here.

Robb wrote about the split here.

Robb also was in a podcast where he talked about CrossFit:

Here’s another related video where Robb talks about Paleo and training.

 

CrossFit and Nutrition – Part 1

CrossFit used to really get nutrition.  A few caveats about this video:

  • Not sure I completely agree with their body fat percentage goals for older people – or at least making it the priority.
  • Also their initial macro mix has a much higher carb amount (1/3 of calories from carbs) than what Type 2 Diabetics should eat.

Video Points

  1. Eat real food.
  2. Not too much of it.
  3. Mostly plant based.
  • Living = grew out of the ground or had eyes.
  • Stay out of the middle aisles of the supermarket.
  • No man-made food like substances.
  • Don’t use your macros as a way of avoiding eating right.
    • Macros are your mix of Protein/Carbs/Fats within overall calorie limit.

Determine Your Ideal Body Weight

Rather than picking an arbitrary number for vanity there’s a better way.  BMI may be the worse way possible (this Smart BMI page does better). Looking at pictures of other people is probably the second worse possible way. To pick your goal weight you should take these things into account –

  • Gender
  • Lean Body Mass
  • Age
  • Ideal Body Fat

Each of these can be determined fairly easily.

Gender

I’m going to assume that you know your gender although that may not be a safe assumption.

Determining your Lean Body Mass

There are on-line calculators which let you determine your Lean Body mass. Here’s one of them (US Navy Calculator – Body Fat Calculator).  For an example, I put in my current numbers:

That has my Lean Body Mass at 142 lbs and my current Body Fat percentage at 21%.

Ideal Body Fat Percentage by Age

The ideal body fat percentage can be found in various on-line charts such as (Ideal Body Fat Percentage by age) –

I am 55 years old and they have my idea body fat percentage at 20.9%. Pick your own number from above.

Goal Weight

The goal weight is the Lean Body Mass divided by (1 minus the ideal body fat percentage). For me that’s –

142 (Lean Mass from the US Navy calculator above) divided by (1 minus .209 from the Ideal  Body Fat percentage chart at my age) = 179.5 lbs

I am at 180.4 so I am within 1 lb of my ideal weight.

 

Not Losing Weight But Losing Inches

What about people who say that they are not losing weight but they are losing inches? The comment is often something like this:

with the increased protein intake of the keto diet, our bodies produce more muscle mass instead of fat deposits like on a carbohydrate rich diet. Muscle weighs more than fat so that would explain fat disappearing but scale numbers not changing

Maybe… Or maybe not…

Muscle is more dense (lower volume) per pound than fat (article). But gaining muscle mass is very slow. Lyle McDonald say that a young untrained male who begins training can put on as much as two lbs of muscle mass in a month. A woman can put on around half that much. So the rate that people are actually putting on muscle mass is pretty small. And unless someone is exercising pretty hard they won’t put on nearly as much. And older people will put on muscle even slower.

So the if someone is stalled for a couple of days or even weeks it’s not likely that they have put on much muscle mass in that time period. Given months, maybe they have put on some.

But this point can be answered by measuring a person’s body fat percentage.

So, there could be some muscle replacement. Or there could be loss of lean body mass. How do you tell the difference? Take measurements with a tape measure and use a calculator to determine your muscle mass.

And your own body fat percentage goals can be set based on tools like “Visualize Body Fat Percentage“. Make your goal to achieve a body fat percentage not a goal weight. The goal weight can be determined from the goal body fat percentage, etc.

 

Are you Insulin Resistant?

The original mission of this BLOG was to find a cure or at least a way of dealing with my own Insulin Resistance. A typical Type 2 Diabetic has Insulin Resistance.  I knew that was what it was called but what is Insulin Resistance and how can someone tell if they have Insulin Resistance?

This paper lays out one way to determine if you have Insulin Resistance (Ann Intern Med. 2003 Nov 18;139(10):802-9. Use of metabolic markers to identify overweight individuals who are insulin resistant. McLaughlin T1, Abbasi F, Cheal K, Chu J, Lamendola C, Reaven G.) using the numbers that you typically get when you get your blood work done.

Plasma triglyceride concentration, ratio of triglyceride to high-density lipoprotein cholesterol concentrations, and insulin concentration were the most useful metabolic markers in identifying insulin-resistant individuals. The optimal cut-points were 1.47 mmol/L (130 mg/dL) for triglyceride, 1.8 in SI units (3.0 in traditional units) for the triglyceride-high-density lipoprotein cholesterol ratio, and 109 pmol/L for insulin. Respective sensitivity and specificity for these cut-points were 67%, 64%, and 57% and 71%, 68%, and 85%. Their ability to identify insulin-resistant individuals was similar to the ability of the criteria proposed by the Adult Treatment Panel III to diagnose the metabolic syndrome (sensitivity, 52%, and specificity, 85%).

To summarize (in US units):

  • Triglycerides > 130 mg/dL
  • Triglyceride to HDL ratio > 3.0 (using US units)
  • Insulin > 109 pmol/L

I haven’t ever had my Insulin measured so I don’t know what that number would be but I did have the other numbers done in 2015 and here are my numbers:

  • Triglycerides = 460 mg/dL
  • HDL Cholesterol = 36
  • Ratio = 12.7

Those numbers are well over the numbers that trigger the diagnosis of Insulin Resistance (aka Metabolic Syndrome). Check your own numbers to see where you are.

Related content (Abbasi, Fahim et al. High carbohydrate diets, triglyceride-rich lipoproteins, and coronary heart disease risk. American Journal of Cardiology , Volume 85 , Issue 1 , 45 – 48)

High Protein Diets are Good for Type 2 Diabetics

High Protein Diets are good at reducing NAFLD (Non-Alcoholic Fatty Liver Disease). From the study (February 2017, Volume 152, Issue 3, Pages 571–585.e8. Isocaloric Diets High in Animal or Plant Protein Reduce Liver Fat and Inflammation in Individuals With Type 2 Diabetes. Mariya Markova, Etc.):

In a prospective study of patients with type 2 diabetes, we found diets high in protein (either animal or plant) significantly reduced liver fat independently of body weight, and reduced markers of insulin resistance and hepatic necroinflammation. The diets appear to mediate these changes via lipolytic and lipogenic pathways in adipose tissue. Negative effects of BCAA or methionine were not detectable. FGF21 level appears to be a marker of metabolic improvement.

And from the conclusions section:

Postprandial levels of BCAAs and methionine were significantly higher in subjects on the AP vs the PP diet. The AP and PP diets each reduced liver fat by 36%−48% within 6 weeks (for AP diet P = .0002; for PP diet P = .001). These reductions were unrelated to change in body weight, but correlated with down-regulation of lipolysis and lipogenic indices. Serum level of FGF21 decreased by 50% in each group (for AP diet P < .0002; for PP diet P < .0002); decrease in FGF21 correlated with loss of hepatic fat. In gene expression analyses of adipose tissue, expression of the FGF21 receptor cofactor β-klotho was associated with reduced expression of genes encoding lipolytic and lipogenic proteins. In patients on each diet, levels of hepatic enzymes and markers of inflammation decreased, insulin sensitivity increased, and serum level of keratin 18 decreased.

 

Protein Turns into Cupcakes?

Dr Fung makes the following statement on this webpage (Why Low Carb Is High in Fat – Not Protein):

Once again, these amino acids are absorbed into the portal circulation and directed towards the liver where excess amino acids get turned into glucose.

Turns out the process is much more complicated. To be fair Dr Fung may be simplifying the process for his readers, but the process is more like this (which is probably still an oversimplification). From (Amino Acid Metabolism and Synthesis Explained):

Amino acids that are in excess of the body’s needs are converted by liver enzymes into keto acids and urea. Keto acids may be used as sources of energy, converted into glucose, or stored as fat. Urea is excreted from everyone’s body in sweat and urine.

So it is not quite as simple as Dr Fung lays it out. And keto acids are exactly the goal of any Low Carb diet, ie, the production of ketone bodies. We know that the production of glucose from ketones is necessary to feed brain cells (and some other cells) since they don’t get glucose from carbohydrates when we are on a ketogenic diet. In the absence of any dietary carbohydrates we may actually need more Protein to fuel this very path.

Are the Low Protein LCHF folks then making a serious mistake with very low levels of Protein? Are they relying on studies for necessary Protein levels where subject were not in Ketosis? I will bet a donut they are.

What is the basis for “in excess of the body’s needs”? On what timeframe? Is that per day, meal, hour?

Explanations for Blood Sugar Rise with Protein Consumption

Here’s my questions/comments for the KetoGains thread on this subject.

I’ve been trying for a while to wrap my head around this subject. Here’s what I think at the moment. Would welcome any feedback on where I am missing it.

1 – My blood sugar meter shows that my blood sugar goes up 25 points with Protein (50g of whey) for a couple of hours. Not a bad increase since it’s only from 85 to 110 (US units). I have documented this at: http://lowcarbstudies.com/blog/2018/03/29/blood-sugar-response-to-proteins/ .

2 – My blood sugar drops fairly rapidly at the end of the two hours (makes me hungry) which decreases when the blood sugar levels out. As long as I keep that in mind and keep food out of reach in that time frame I am OK. Otherwise, it seems like my body is telling me that it wants is ready to eat more Protein (or just food).
3 – Blood sugar production proceeds at a constant rate which isn’t all that much affected by Protein consumption. I’ve seen enough studies to believe that is probably the case such as (Claire Fromentin, Daniel Tomé, Françoise Nau, Laurent Flet, Catherine Luengo, Dalila Azzout-Marniche, Pascal Sanders, Gilles Fromentin, and Claire Gaudichon. Dietary Proteins Contribute Little to Glucose Production, Even Under Optimal Gluconeogenic Conditions in Healthy Humans. Diabetes 2013 May; 62(5): 1435-1442.). Also, the demand vs supply GNG argument seems strong. This rules out the idea of GNG being increased by the Protein.
4 – In a non-diabetic blood sugar doesn’t rise as much with ingested Protein as it does in a T2 Diabetic. It may not raise at all. I plan on an experiment with a “healthy” friend to confirm this for myself although the studies say it is “minimal”. But is that difference due to broken Insulin Resistance in the T2 Diabetic? As the Insulin goes up to deal with the Protein does that increase the Insulin Resistance of the cells at the same time and block the glucose from being consumed?
5 – The failure for a T2 Diabetic seems to be able to reduce the production of glucose in response to consumption of Protein (or one of the downstream aspects of the consumption). The Glucose (argued above) is getting “backed up” in the process and not being disposed by Insulin since the Insulin is “busy” dealing with the Amino Acids (all in all a very good use of Insulin).

So although arguably Protein doesn’t turn into glucose directly since Protein does lead to a rise in Blood Sugar (in T2 Diabetics) then what difference does it make if it is increased levels of GNG or an inability to reduce the rate of GNG or due to Insulin Resistance? Either way, the result is the same, Blood Sugar goes up (for T2 Diabetics) with protein consumption.

So then the question for me is whether or not Blood Sugar going up by a relatively small amount in a keto dieter who is eating lots of Protein actually a problem? Normally, us diabetics are trained to do things to minimize their blood sugars. This notion is leading a lot of people to eat a lot of fat and less Protein than they probably should.

Put another way, does the advantage of eating more Protein (maintain or growing Lean Body Mass among others) outweigh the disadvantage (marginally higher blood sugars for short periods of time)?

Survey of the Scientific Literature

From an 20 year old article (Diabetes Educ. 1997 Nov-Dec;23(6):643-6, 648, 650-1. Protein: metabolism and effect on blood glucose levels. Franz MJ):

Insulin is required for carbohydrate, fat, and protein to be metabolized. … Protein has a minimal effect on blood glucose levels with adequate insulin. However, with insulin deficiency, gluconeogenesis proceeds rapidly and contributes to an elevated blood glucose level. With adequate insulin, the blood glucose response in persons with diabetes would be expected to be similar to the blood glucose response in persons without diabetes. The reason why protein does not increase blood glucose levels (sic: in a non-diabetic) is unclear. Several possibilities might explain the response: a slow conversion of protein to glucose, less protein being converted to glucose and released than previously thought, glucose from protein being incorporated into hepatic glycogen stores but not increasing the rate of hepatic glucose release, or because the process of gluconeogenesis from protein occurs over a period of hours and glucose can be disposed of if presented for utilization slowly and evenly over a long time period.

Questions raised by this article:

  1. They don’t define “minimum effect” so is a 20 point rise considered to be a “minimum effect”?
  2. Another study indicates that GNG is much more efficient in a Diabetic. Is that because of an Insulin deficiency (the way it is worded above)? Or is that due more to Insulin Resistance?

Here’s a curve from one paper which shows the body’s Insulin response to Protein vs Carbohydrates which shows that the body has a similar response to Protein as it does to Carbohydrates when it comes to Insulin Levels:

This seems to be a reasonable study (Claire Fromentin1,2, Daniel Tomé1,2, Françoise Nau3, Laurent Flet4, Catherine Luengo1,2, Dalila Azzout-Marniche1,2, Pascal Sanders5, Gilles Fromentin1,2 and Claire Gaudichon1,2. Dietary Proteins Contribute Little to Glucose Production, Even Under Optimal Gluconeogenic Conditions in Healthy Humans. Diabetes 2013 May; 62(5): 1435-1442.) which concludes:

We showed that after a normal intake of protein (20–25 g), the contribution of dietary protein to glucose production was small and did not exceed 10% of the total flux during the 8-h postprandial period, contributing the production of 4 g glucose to 50 g of total glucose production.

While that is true in healthy humans (the subject of this study), is it also true of Diabetic persons?

From one of the comments in this thread

Higher protein intake, which needs insulin response to get it where it needs to be, will increase physiological insulin resistance (adaptive glucose sparing) in order to get the protein into where it needs to go without pushing more glucose into the cells. this will result in seeing a higher fasting blood glucose, and lower circulating ketones, as they replace glucose as a fuel for the tissues that previously used more of it.

Here’s the pieces of the puzzle.

  • Body produces a relatively constant level of blood sugar
  • Non diabetics have little to no rise in Blood Sugar when they eat Protein
  • In a diabetic the down regulation of blood sugar in the presence of Insulin is faulty
    1. Eat Protein
    2. Body begins digesting Protein
    3. Pancreas increases Insulin production to push protein into muscle cells
    4. As Insulin goes up so does Insulin Resistance of the muscle cells to Glucose (difference between a diabetic and a non-diabetic)
    5. Because Glucose is not being disposed by the muscle cells as well, the level of Blood Sugar rises temporarily
    6. After the Protein is processed by the body the Blood Glucose drops

So the theory here is that while the blood sugar rises over the short term it is not being pushed into the cells.

 

mPSMF – Weight Loss Progress – Dec 2017

My modified Protein Sparing Modified Fast is moving along very well. Here’s my weight loss chart (from Cron-o-meter):

I had a nice drop over the past couple of days. Note that I started teh food diary in Cron-o-meter on Oct 24th. That may contribute to the losses due to the increased attention to intake. Before that I was using my own spreadsheet to track diet.  Cron-o-meter may be making me more accurate with measuring food intakes.

Goals Changes?

My newly adjusted weight goal is 170 lbs. That’s 144.4 lbs of Lean Body Mass and 15% body fat. That’s in the middle of the athlete range of body fat and on the low end for an older man like myself.

[Later – Updated goal to 20.9% based on Ideal Body Fat percentage]

Modified Protein Sparing Modified Fast (PSMF)

I am calling what I am doing a Modified Protein Sparing Modified fast (PSMF) since the classical PSMF does not factor in fat oxidation rates.

I think it’s useful to factor in fat oxidation rates since that’s the maximum amount of fat a person can pull from their body per day. See my post, “Hypophagia – How much fat can I lose in a day?” for details.

Lyle McDonald’s Rapid Fat Loss Book

Lyle McDonald’s book “Rapid Fat Loss” (RFL) simply puts people on a particular amount of protein depending upon what stage of the diet a person is on. As the diet goes on and a person loses body fat their protein amount increases on Lyle’s method. So basically, his method is Very Low Carbs (except certain unlimited green veggies).

I think the fault in Lyle’s method isn’t so much that it leads to excessive protein consumption. Some would say that there’s no such thing as too much protein and within limits they could be right.

I think the fault in Lyle’s method is not factoring in the limits of hypophagia. Drop your calorie intake too low (below what the body can provide) and something has to give. If you can’t lose more than a particular amount of fat per day then why would you eat at a lower calorie amount than that?

 

Ideal Body Fat Percentage

The article (Ideal Body Fat Percentage Chart: How Lean Should You Be?) lists two different idea body fat percentage charts:

And:

Note the references to Jackson, A., & Pollock, M. (1978). Generalized equations for predicting body density of menBritish Journal of Nutrition, 40(3), 497-504. doi:10.1079/BJN19780152 (Full Text).

By age (second chart) my ideal body fat percentage is  20.9%. At a LBM of 144.4 lbs, that’s:

144.4 / (1 – .209) = 182 lbs or about 10 lbs to go to that goal.