First, we’re excited to announce that we just launched our brand new program — The Fat Loss Blueprint! You can check it out HERE.
In this episode, I am speaking with Alex Leaf – who has a master’s degree in nutrition and is on the teaching staff of the University of Western States Human Nutrition and Functional Medicine Program. In this episode, we’ll discuss the science behind fat loss, why fat loss is critical for optimal health, and our new Fat Loss Blueprint program.
If you want to lose fat in and keep it off, the Fat Loss Blueprint is the program for you. It is based on the latest science around fat loss and addresses a broader range of approaches compared to most common weight loss programs.
Table of Contents
In this podcast, Alex and I discuss:
- How obesity affects your immune system
- Are you safe if you are overweight but not obese?
- How carbs can help you reduce weight and diabetes
- The common misconception of insulin resistance (and the actual role it plays in your body)
- The most effective diet for fat loss (It isn’t what you think!)
- Why the calories in – calories out equation don’t work
- The critical role of protein in your diet
- Can you be obese and metabolically healthy?
- Why having muscle mass is critical for optimal health
- How sleep affects your body composition
- The best time of day to eat
Listen or download on iTunes
Listen outside iTunes
Ari: Hey there. This is Ari Whitten and welcome back to the Energy Blueprint Podcast. Today with me again is my good friend and colleague and fellow writer, researcher, [laughs] contributor to the Energy Blueprint. He’s got a master’s degree in nutrition. He’s on the teaching staff of the University of Western States Human Nutrition and Functional Medicine Program and he’s the former senior researcher at examine.com. He’s one of the most brilliant minds for health science and nutrition science that I’ve ever known in my life, and that’s why I hired him to work with me [chuckles] because he’s just phenomenally knowledgeable and wise, and his level of understanding is just very, very nuanced.
He understands how to piece together the science to logically speculate and draw conclusions on what might be true. He understands, “Hey, this research has some caveats and we can’t draw out strong conclusions from that.” He’s just phenomenal at what he does. He’s one of the most brilliant minds that I’ve ever met when it comes to health science. Welcome again, Alex, such a pleasure to have you back on the show.
Alex: Yes, it’s a pleasure to be here.
Ari: I want to recap what we talked about in the last podcast. We talked about obesity or excess body fat, being overweight, having a large amount of excess body fat, and the relationship of that to– In particular, we talked about it and how it links with immune dysfunction which is especially relevant in the context of what we’re all dealing with right now with COVID-19. Just first before we get into some other layers of the story, recap the gist of what you covered in the last podcast.
Alex: Yes. Being obese basically causes your immune system to age prematurely, so that your immune cells are less capable of battling infections, whether they come from bacteria, a virus, or a parasite. Basically, it’s like being immune-compromised. Having a weak immune system and that’s due to the fact that obesity more often than not promotes a state of chronic low-grade inflammation. The state of chronic low-grade inflammation causes your immune system to just be chronically active, and it’s that chronic activity that wears it down and causes it to age prematurely.
This chronic inflammation also makes infectious outcomes worse because a lot of those infectious outcomes involve tissue damage. When the body is in a state of chronic inflammation, it’s not able to implement the anti-inflammatory regulatory processes as easily, which are required to repair any damage that occurs when the body is fighting off infectious diseases. Obesity basically just weakens your immune system. We have data showing that obesity is a major independent risk factor for the flu and other respiratory diseases going all the way back to the H1N1 flu pandemic from 2009.
We have emerging data in the last couple months showing that the same situation exists for COVID-19. Where data from New York, for example, shows that in young adults or and middle-aged adults, anyone under 60, obesity increases the risk of hospitalization by twofold. It increases the risk of being admitted to intensive care by two to fourfold. Then you have research out of France, showing that once you’re in intensive care, it increases your risk of requiring invasive ventilation services by sevenfold. Obesity is extremely relevant to the current pandemic. It’s extremely relevant to past pandemics, and it’s extremely relevant to immune function in general.
The obesity spectrum – why it matters
Ari: Yes, beautifully summarized. One thing that I want to speak to is you’ve used the word obesity. There are some people out there– I’ve made a point of not using that word but using the word large amounts of excess body fat because there are people out there who may not be obese by definition or who may actually be technically obese based on BMI but may not think of themselves as obese. Also, I think this word obese carries a negative emotional feel and stigma to it. What I would like you to speak to is, is it a black and white thing like, “Hey, as are we healthy?” We don’t have to worry about any of these things that you mentioned until we reach that point where we are classified as obese, so we can accumulate lots of excess body fat, but unless we are actually in this category of obesity, we don’t have to worry about any of the things that you said.
Is it more of a spectrum and to the degree that you have excess body fat, you have more and more of the kinds of dysfunction and risk of the consequences you described there in the direction of what obese people have.
Alex: It’s definitely a spectrum. It’s a spectrum with a lot of nuance and complications depending on individual factors. For the most part, when I personally am using the term obesity, I am definitely referring to individuals that carry around an excess amount of body fat as you’ve stated. Yes, there are situations where someone could just have higher amounts of muscle mass, and that could put them into the overweight or obese BMI categories when clearly their body fat isn’t in those general terms. Something for people to keep in mind is that BMI is a scale that was developed for population-level analyses, not for evaluating specific individuals.
There are people that have obesity, but they don’t have low-grade chronic inflammation or insulin resistance or fat cell dysfunction, and these are considered metabolically healthy obesity. There’s also very skinny people that are not obese, they’re at a normal BMI, but they still have–
Ari: Just real quick. You did something there visually that people who are listening, who are not watching the video would not be aware of. You did a little air quote when you said metabolically healthy obesity, can you briefly describe that? I know it’s a bit of a digression, but just succinctly describe why you did air quotes when you said metabolically healthy obesity.
Alex: It’s not really a digression. It actually feeds perfectly into this continuum that we’re talking about. I say metabolically healthy obesity with air quotes because it’s basically a temporary state. Every single person has what’s called a personal fat threshold based on their diet, their genetics, their environment, and lifestyle, circadian rhythms, stress load physical activity level. All of these things impact our metabolism in ways that determine how much fat we can safely store on our body because fat gain is a normal protective mechanism. Once you reach your own individual personal fat threshold, your body can’t safely store fat in your fat cells anymore.
What happens above that point is your fat cells start to become inflammatory, insulin resistant, and dysfunctional. This permeates into the rest of your body. It’s the entire reason why someone with obesity has chronic low-grade inflammation is because their chronically inflamed fat cells secrete inflammatory signaling molecules into the bloodstream so that they can reach every other part of the body. If someone continues to overeat and gain weight, they don’t have ability to store it in their fat tissue anymore. The body undergoes emergency mechanisms, and that includes trying to store the energy that’s you eat, the excess energy into your organs.
That’s how we see the accumulation of visceral fat. That’s how we see fat deposits in the liver, in the pancreas, around the heart and the lungs, which is one reason why infectious outcomes are worse than people with obesity because their lungs and the muscles responsible for breathing simply can’t function as well because of all that fat mass. All of it stems from the fact that they can’t safely store fat anymore and they’ve continued to overheat, and so their body has to put it somewhere because if you leave that energy floating around in your blood, you’ll die very quickly. We see that in people with uncontrolled type 1 diabetes.
We see that in people with uncontrolled type 2 diabetes. They get nerve damage, they go blind, they lose limps, and it’s because they have all of this glucose and fat in their blood stream. Type 2 diabetes is literally the end result of metabolic dysfunction when you surpass your personal fat threshold.
Ari: I want to dig into that more. Do you want to finish your thought before I interrupt you and dig into what you just said there because you–
Alex: Yes, let me just tie it back to the metabolically healthy obesity. The reason I say air quotes is because the wealth of data shows that people with metabolically healthy obesity simply have a higher personal fat threshold than unhealthy obese people. Meaning they can reach these higher levels of body fat and safely store it before metabolic dysfunction occurs. These people have worse health outcomes in the long run than people that are in normal healthy body composition. Mostly because they continue to engage in these lifestyle habits that cause them to gain wait in the first place.
Overtime, as they continue to gain, they do eventually hit their personal fat threshold even though it might require them to become morbidly obese before that happens. Then that’s when everything starts to go downhill. It’s literally a transient state that occurs only because you are able to safely store a lot of fat before hitting your personal fat threshold.
Ari: This is why, to go back to what you talked about in the previous episode, the movement Health at Every Size is misguided. It’s because we have good evidence to show that once you do accumulate a certain degree of excess body fat that surpasses your personal fat threshold there’s a very clear mechanisms of metabolic dysfunction that start to occur that contribute to disease processes.
Alex: Yes, but I do quickly just want to emphasize that the belief that you can have health at any size implying that if you’re obese, then you don’t need to worry, your health is not at risk. That aspect of the Health at Every Size movement is misguided. However, they do promote a lot of other aspects about body positivity, believing in yourself. Things that are really awesome.
Ari: Happiness and self acceptance at every size. It doesn’t mean that you need to blind yourself to the existing data that links high amounts of excess body fat to many different diseases.
Alex: Yes, especially because the way our bodies are designed, the modern environment pretty much takes advantage of it and facilitates gaining weight. What people need to realize is that if you’re overweight or obese, you’re probably more normal in the current modern environment than people that maintain their normal body weight because evolution designed us to have those mechanisms in place because throughout evolutionary history we were always concerned with starvation, not overfeeding.
The real cause of insulin resistance
Ari: Absolutely, well said. There’s a lot contained in what you said there, and there’s one important understanding that I really want to emphasize. That is because there’s wide spread misunderstanding and a misconception of insulin resistance in particular but many different diseases. Let’s just take diabetes and insulin resistance as the best example of this. Many people think that insulin resistance is the result of, hey, you just eat carbs or you eat sugar and it therefore causes your body to secrete insulin. If you do that a lot, then it causes insulin resistance and diabetes. Then in the process of that or as a result of the insulin resistance, you get fat. You’re getting fatter as a result of the insulin resistance. A lot of people think about it more through that lens, why is that not accurate and what is really going on?
Alex: If insulin’s job is to pump nutrients into cells and tissues, and insulin resistance means that your cells and tissues are resistant to insulin signal, then just on pure logic it doesn’t make sense that being insulin resistant would facilitate storing fat tissue and gaining weight because it means your cells are literally not responding anymore or to the same extend as they were previously to insulin storage signal. This is one of the biggest problems with having insulin resistance, is that for example, fat tissue is just chronically secreting fatty acids back into the blood stream when you’re fasting, when you eat because they aren’t receiving that signal that says, “Hey, keep this stored away so that we can better metabolize the incoming nutrients.”
Instead they just secrete and they interfere with oxidative metabolism of glucose in muscle tissue which just further permeates insulin resistance in those tissues. The idea that insulin resistance precedes weight gain isn’t supported by logic or in the literature.
Ari: What actually causes insulin resistance then?
Alex: In the way that happens is there’s a twofold hit. I had already talked about surpassing the personal fat threshold. These fat overloaded cells do two things, they become inflammatory and they become insulin resistant themselves once they contain too much energy. It’s not the inflammation that causes the insulin resistance; it’s literally that they contain too much fat already because studies in mice where they removed the ability of the mice to have an inflammatory response at the level of the fat cell, these fat cells still become resistant to insulin signal. We know that literally just storing too much fat causes insulin resistance by itself.
You don’t need any other mechanism. The information just exacerbates that problem. Then you have two problems. You have a fat cell that’s resistant to insulin signal and a fat cell that’s inflammatory. As a result, it secretes inflammatory molecules into circulation and it secretes fatty acids in the circulation because insulin is no longer able to tell it to keep those fats stored. Then what this does is the secretion of inflammatory molecules into circulation causes wide spread information throughout the body. This in turn contributes to insulin resistance in other tissues like muscle tissue. At the same time, the fat leakage into circulation needs to get stored.
The body says, “Oh, we need to get rid of this. We’re going to start inappropriately storing this in the liver, in the pancreas, in the heart, the lungs and even in skeletal muscle.” This inappropriate fat storage also causes insulin resistance. Then you have wide spread systemic insulin resistance stemming from the inflammation and the fat overload of your fat cells to begin with. This widespread insulin resistance then causes metabolic dysfunction like type 2 diabetes. It can all be mechanistically traced back to the fat cell to the extent that we have an emerging pile of evidence that shows that when you take people with type 2 diabetes and you put them on a 600 calorie diet for eight weeks, you can literally reverse their diabetes to the point where they can eat carbohydrates again and not have any problems.
They have restored complete insulin sensitivity, everything, all because you brought them back down below their personal fat threshold and forced the body to use its own body fat as an energy source which helped deplete the fat that was stored in the liver, the pancreas, the skeletal muscle, and throughout the body.
Ari: This is almost a yes or no question because you’ve already explained the mechanisms, but just to emphasis the point, would you say that it’s accurate to say that excess body fat, the accumulation of excess body fat itself is a fundamental primary cause of insulin resistance?
Alex: Yes, definitely. There’s always going to be exceptions, there always is. For example, people with lipodystrophy have a genetic disorder where they literally cannot store body fat. In essence we could think of their personal fat threshold being zero, and they have severe insulin resistance.
Ari: This is just for the sake of clarity. This is assuming maybe less than .1% of the population?
Alex: Yes, extremely rare. They need to eat every hour because they don’t have fat tissue to rely on when they’re fasting as an energy source. There are perfect evidence in favor of the personal fat threshold because for 99.99% of the population, storing too much body fat is the primary cause of insulin resistance.
Ari: Not consuming sugar or eating candy or consuming carbohydrates and boosting insulin, it is not that that drives insulin resistance and diabetes, but it is the process of accumulation of excess body fat.
The role processed foods play in your health
Ari: Now, the tricky part is, of course, that we also know that processed foods and refined foods and hyper-palatable, and hyper rewarding foods which includes refined carbohydrates and refined sugars, and also fats and especially processed foods rich and both sugar or refined carbs and fats together; ice cream, pizza, potato chips, things like that.
In those instances, these kinds of foods tend to override our normal homeostatic eating mechanisms and basically not play well with our adipose stat, our body’s biological system for regulating body fat set point. They tend to override it, shift us more into hedonic eating instead of homeostatic eating, and basically cause us to consume a whole lot more calories than we need over time, and therefore accumulate excess body fat. They are indirectly a contributor to fat gain, which is the primary driver of diabetes.
Alex: Yes, 100%. To give a little shoutout to a friend of both of us. Several years ago, Stephan Guyenet wrote an amazing book called The Hungry Brain that details how the modern food environment completely overrides our evolutionary circuits in the brain and cause inappropriate levels of hunger and reduce satiety that facilitate overeating.
Ari: I’m glad you gave him credit because he was the guy who changed my whole understanding because prior to 2013, 2014. I was teaching carbs or what caused and sugar what caused insulin resistance in diabetes, and everybody has to go on a low-carb diet, and that’s the answer. It was specifically his work that completely blew my mind and changed my whole perception of it because he presented the evidence very systematically that said, “Hey, it’s not carbs and sugar that are the cause of obesity and diabetes, it’s over consumption of calories and accumulation of body fat, largely driven by a hyper-palatable, hyper rewarding processed food environment.” The modern food environment.
Alex: I really like to think about it with an analogy, where if people think about type 2 diabetes, which is we could think of as like the top of the mountain when it comes to insulin resistance, is when you have type 2 diabetes. A lot of people say that you need to eat a low-carb diet to resolve your diabetes because when you remove the carbohydrate, it lowers your fasting blood sugars, it lowers your fasting insulin. It gives the perception that your metabolic health has improved. I like to think of it as like, you never actually got to the root cause of the insulin resistance which is often carrying too much fat mass around. The analogy I like to use is celiac disease.
When you have celiac disease, which is an autoimmune disorder and you stop eating gluten, then you no longer experience the symptoms of celiac disease like intestinal damage, just like when you stop eating carbohydrates when you have type 2 diabetes, you stop experiencing the symptoms, which are elevated blood glucose and insulin levels, but in either case, you’re addressing the cause. With celiac disease to address the cause, you need to somehow stop the autoimmune attack every time you eat gluten. Otherwise, you’re just managing the disease, and it’s the same with diabetes. To actually stop or get rid of diabetes, you need to get rid of the insulin resistance. If you don’t do that, and you just eat a low-carb diet, then you’re just band-aiding the situation. You’re just doing symptom management.
Ari: I know we have a lot more to talk about, but there’s one more aspect of this that I would like to get into. That is, what is the role of carbohydrate and insulin in, let’s say, reversing obesity and helping us lose fat, and helping reverse diabetes. Let’s say someone is listening to this right now, and they’re saying, “I don’t really believe these guys because I heard so and so low-carb advocate say that lowering your carb intake, going keto, keto and low-carb diets is just or zero carb carnivore diet or whatever,” that’s the best way to lose fat, that’s the best way to reverse insulin resistance. What does the research actually say on diets that range in carbohydrate intakes and therefore range in the amount of insulin your body produces? What does it say as far as high-carb versus low-carb in relation to fat loss and reversing insulin resistance?
Alex: Overwhelmingly, you have two types of research. You have one type of research where every variable is tightly controlled, so that you remove any influence of the participants’ outside lifestyle. These experiments usually involve keeping participants in a research center for the duration of the study and providing them with all the food they eat and monitoring their physical activity levels. In these studies, when calories and energy balance are matched between carbohydrate intakes as low as 2% of calories and fat intakes as low as 2% of calories all the way up to 85%, there is no meaningful difference when you aggregate all that data. There is no meaningful difference in energy expenditure or changes in body fat content between the two types of diets.
Which diet is best for fat loss?
Ari: Let me rephrase that in case somebody didn’t quite follow. Two groups of people both on, just for the sake of example, let’s say, 1,200 calorie diets, but one group is on a super low-fat high-carb diet that’s 1,200 calories. The other group is on a super low-carb high-fat diet. That’s the exact same amount of calories. They precisely match the two groups and control for the exact total amount of calories, but radically different amounts of carbohydrate and fat content and therefore different amounts of insulin being produced in response to those meals. Yet, they show the exact same amount of fat loss. Correct?
Alex: Correct and the same effects on energy expenditure. Then to back up these clinical inpatient studies, you have free-living experiments where you just assign people to different diets to see how they play out in the real world where people are in charge of how much food they eat. They’re not having a researcher breathe down their neck and say “Finish it all.” In these experiments, you see that in the very short term, low-carb diets are superior mainly because of losses in water and glycogen content.
Ari: Because they’re superior in terms of body weight loss.
Alex: Exactly. When you look at body fat loss, then they are no different in the short term or the long term over years than low-fat diets or really most other diets. The one consistency in research is that the most effective diet is going to be the one that you can stick with over the long term. I think diet fits is a great example of this because this was like $8 million dollar study that involved over 600 obese participants.
Ari: I consider it the best low-carb versus low-fat study that’s ever been done.
Alex: Yes. That’s partially because they had two groups, one low fat. 20 grams of fat per day. One low-carb, 20 grams of carbs per day. They had them eat this diet based around whole foods, not processed foods but both groups were eating whole foods. They had them eat these diets for several weeks and then they said, “Now every week I want you to increase your carb or your fat intake by about 15 grams until it hits a level that you think you can sustain for the duration of the study.”
Ari: Which was a year.
Ari: That’s partly why it’s such a great study. It’s because it’s so rare. A lot of the low-carb, low-fat studies are like 10 days long, 6 weeks long. This was 12 months long with over 600 participants and with actually good nutritional advice. They told people to eat healthy whole foods not just prescribing a junk low-carb or low-fat diet.
Alex: Yes, exactly. What they found, first of all, is that neither group on average could maintain a low-carb or a low-fat diet. They both found them unsustainable. Like low-carb, for example, they started at 20 grams of carbs by the end of the study the average carb take was like 120. Because most people don’t find restricting carbohydrate that low to be sustainable, and it’s the same in the low-fat group. They couldn’t say at 20, they increase to like 60 or 70 grams per day on average. There was basically identical. When you plot the change in weight over the course of a year of each individual in each group, there was an almost basically an identical picture that emerged.
There were in both groups, there were actually people that gained weight, even though they were supposed to be losing weight. There were a bunch of people whose weight didn’t really change, and then there were people who did phenomenally well, losing like 30 to 40 pounds. The study then took all of these changes in body weight and linked them to everyone’s personal insulin response after a glucose challenge and to genetic markers that affect how much insulin they secrete on a daily basis, and there was no association. Meaning that insulin in this study was basically irrelevant to the changes in body composition that these participants experience. The study had a lot of novel findings. Continuing to support the idea that, some people do better on some diets than others, and that eating whole foods doesn’t– As long as you eat whole foods, then it doesn’t really matter whether it’s low-fat or low-carb, you can be successful and insulin isn’t really that relevant.
Ari: Just for the sake of clarity, what was the actual long term finding after 12 months, low-fat versus low-carb in terms of the aggregated weight loss outcomes on both diets?
Alex: About 13 pounds on each diet.
Ari: No significant difference between the two [inaudible] approaches.
Ari: Basically to summarize everything that you just explained there, and you feel free to interject or add to this as you see fit. The carbohydrate theory of obesity that has been espoused for, I think 20 years now by Gary Taubes and a few others, that it is specifically carbohydrates and the insulin response to those carbohydrates as in, insulin is a “fat-storing hormone” and therefore, by consuming carbohydrates which boost the secretion of insulin, you will store more fat as a result of that hormonal milieu, and therefore carbohydrates are the ultimate cause of fat gain and obesity, and the obesity epidemic.
As you’ve just explained, we have many, many layers of evidence from mechanistic studies where they’ve actually used drugs to modulate levels of insulin to see how much that affects, if it affects the process of fat storage to the metabolic ward studies where they precisely match low-carb and low-fat diets for this precise amount of calories and the free-living studies where you actually put people in a real-world environment, low-carb, low-fat studies over the long term, over 12 months. Basically, at every level this research has proven incorrect the carbohydrate theory of obesity. Is that accurate?
Alex: Yes, that’s accurate. Two things all add is that diet fits along with several other studies that have directly tested the carbohydrate-insulin model of obesity were partially funded by the New Science Initiative, which was an organization co-founded by Gary Taubes. His own organization funded research that basically did not support his theories.
Ari: Which pissed him off pretty good.
Alex: Yes. The other part I want to ask too is just I want to encourage people to use a little critical thinking and some high level thought. When you look out in the world, do anyone who is currently skinny and they eat carbohydrates? How do you reconcile that with the idea that carbohydrates should be causing obesity? The Kitavan islanders of Papua New Guinea, they maintain a BMI averaging around 21. Their diet is 70% carbohydrate.
Ari: Just slight correction addition there. The Kitavans are actually on an island called Kitava, but there’s another population called the Tukisenta, people who live in Papua New Guinea who eat an even more extreme diet. They eat basically nothing but root vegetables. It’s like 94%, I think, if I remember correctly. 94% carbohydrate, it’s almost nothing but basically sweet potatoes. They’re pretty much all lean.
Alex: Then finally, just think about all the most delicious foods that you’ve ever eaten. They can be “junk foods” too. Pizza, donuts, ice cream, French fries, any fried food. What’s the one thing these foods really have in common? Is that they are some combination of carbohydrate, fat, salt, and flavorings. It’s not just the carbohydrate, the foods people overeat on are the foods where that carbohydrate is combined with usually fat because it makes it more palatable, and it encourages you to eat more without you even knowing it.
Ari: Yes. I like to think about it this way. What’s more appetizing? Plain broccoli or broccoli with a bunch of butter or cream sauce on it? Like a fatty sauce and maybe some salt. What’s more appetizing, plain bread with nothing on it or bred with maybe some butter or some sugary spread on it? Potato chips, like sliced potatoes by themselves or potato chips that have been covered in oil? There’s something magical that lights up our brains when you start to mix the fats and carbs. At the end of the day, I think we should be clear that this is not trying to hate on low-carb diets or to say that low-carb diets can’t work, or are inferior, or don’t cause as much fat loss, or whatever don’t work, or are bad for you in some way.
They absolutely can work and they work typically according to the research about as well as a healthfully designed lower fat, higher carb diet. That doesn’t mean they’re bad. For some people, they may prefer that a dietary pattern and they may find it more enjoyable and more sustainable and actually get better results on it as a result of just finding that dietary pattern more sustainable and they’re better able to adhere to it. Is that something you’d agree with?
Alex: Exactly, and I’ll even bring it back to type II diabetes and say that, frankly a low carbohydrate approach, if you do have type II diabetes is probably the better approach to take because it lets you manage your symptoms while you actively reduce your calories and lose fat mass to address the underlying causes.
Ari: Absolutely. We’ve covered that. One other thing that I think is maybe worth covering though that’s going to make this podcast long. Do you have time, Alex? Are you good on time?
Alex: Yes, I do.
Is the calories in – calories out paradigm a myth?
Ari: Is just briefly calories and you’ve already spoken to through some of the research you’ve talked about, for example, the metabolic ward studies, but there’s also this other myth that’s actually been promoted in large part with the low-carb movement. It’s calories are nonsense, calories don’t exist, calories aren’t what matter, it’s hormones that matter. There’s even people who have said the calories in, calories out model has been debunked. It’s nonsense, it’s not supported by the science and really it’s about carbs and insulin. We’ve already spoken to the carbs and insulin aspect of that, the studies testing that.
What would you say to somebody who is under the impression that that calories- they’ve been taught to believe that calories don’t matter and that calories in calories out is nonsense and not supported by the evidence?
Alex: I would say that there they are partially correct because the notion of calories in, calories out is an incredibly oversimplified and almost useless way of thinking about energy balance, for numerous reasons. At a very just high level, not every calorie that you eat is going to be absorbed into your body and be available for your metabolism to use. Even just the way you prepare foods can completely alter the calorie counts you would use if you were to like track your food. For example, if you cook a potato and you track that potato, then most of the energy in it is going to be available to your body.
If you simply put that potato in the fridge overnight and let it cool down, it forms a high level of resistant starch that can take off roughly; I think for one serving of potato, it removes 15 to 20% of the available energy from it. If you track potatoes in your food tracker, but you ate cold potatoes, you’d be taking in less energy than you were expecting because not all the energies available to your body due to the formation of what’s called resistance starch. Similarly, we have a lot of data now on nuts showing that how much you chew, the nuts that you eat, determines how much energy you extract from them.
On average, the metabolizable energy content of something like almonds is 20% lower than what appears on the label because no one chooses their almonds until it’s like a paste, there’s always going to be little chunks of almond left that your digestive enzymes can’t break through. You can’t get to the fat that’s inside those little cell walls of the almond, and you can’t use that energy. On the energy expenditure side of the equation, it’s not just about how much calories you expend, because how do you even know. Your body, first of all, can upregulate and downregulate its metabolism on a whim in response to overeating or under eating.
Not to mention that you can become more efficient with exercise when you diet, where you literally burn less calories for a given amount of exercise because your muscles just become better at what they do. Then like the food you eat, if you eat protein, you’re going to burn off more of the energy from that protein as heat than when you eat carbohydrate or fat, so even the foods that you eat affect how much energy you expend. The only scenario I can think of where calories in, calories out is going to be remotely accurate is if you eat like the exact same foods every day, day in and day out.
Because then if you make small changes, it will matter because the accuracy of how many calories you eat or expend is irrelevant as long as you increase or decrease from wherever you’re at, your body composition will change or your body weight will change accordingly. If you take someone eating 2,000 calories of processed foods and you then start feeding them 2,000 calories of whole foods, so all you’re doing is changing out the foods that supply those calories, they’ll probably lose weight because whole foods supply much less available energy than processed foods do because of fiber cell walls, all that stuff.
Ari: I think what you said there is excellent. I want to add one more element, and this is like the one I actually perceive as the biggest factor in the whole calories in, calories out thing. It’s interesting because the metabolic ward studies actually show that calories do matter, and if you starve someone you can very precisely predict how much weight they would lose according to how many calories they’re consuming. We absolutely do have lots of good evidence showing that calories matter, but we simultaneously know that just saying to someone, “Hey, count your calories and restrict your calories.” While it can produce good short term outcomes, it tends not to result in lasting fat loss.
I think the biggest factor for me is if you, let’s say, consume 700 calories from chicken breast and broccoli versus 700 calories of pizza and ice cream, you will create radically different amounts of satiety in that individual. The person who’s consumed 700 calories of chicken and broccoli might get to that point and be like, “Wow, that was a really satiating meal, and I’m done eating now.” The person who consumed 700 calories of pizza and ice cream might feel like they’re just getting started and might consume another 500 calories before they get to the same degree of satiation.
In a free-living environment where you don’t have researchers saying, “Here’s your portion size, this is all the food you’re getting for today.” You actually have the freedom to go to your refrigerator and get some more food or consume a few another extra serving of what’s on the table. You end up consuming hundreds of calories more each day, consuming the hyper-processed food compared to less palatable, less rewarding whole foods.
Alex: Yes, I completely agree. Kevin Hall published a study last year where he locked people in his research institute and gave them identical meals, three meals a day, that were completely identical in terms of calories and macronutrients. They could eat as much as they want. One group ate a very processed diet, and the other ate an unprocessed diet. What you found is that the unprocessed people lost two pounds, whereas the process people gained two pounds. This difference wasn’t due to energy expenditure or anything like that. It was due to the processed group eating an average of 500 more calories per day. Why?
Because the two groups reported having identical levels of hunger and fullness, yet the group eating processed foods ate 500 more calories every day. What it shows is that when you rely on a diet of mostly processed food, you’re going to need to eat more food and calories to achieve the same level of satiety than if you were to eat a whole foods diet.
Ari: I think if we just take this one study and this one finding of the simple fact that you consume several hundred in this case, 500 more calories per day, in this free-living environment to get to the point of satiety on the processed foods without even considering any other factor, this one thing could easily explain the entire obesity epidemic. If you do the math, it’s like 500 calories a day while you get to 3,500 to 4,000 calories in the span of about a week, which means roughly a pound of excess body fat could be stored per week. There’s 52 weeks in a year.
Theoretically, just extending the math in this way. Obviously, it doesn’t work quite like this. Theoretically, you could easily put on 20 to 50 pounds in a year just as a result of this one thing. Then if you add that up over 20 years or 30 years, obviously, just this one thing could easily account for somebody gaining 50 or 80 or 150 pounds of excess body fat.
Alex: I think it’s just a perfect example to help explain why when you take the average westerner and you put them on a whole foods diet, it doesn’t matter whether it’s low-carb, vegan, whatever, they just stop eating all the processed food that they’ve come to rely on for most of their life. They lose weight.
The critical role of protein in health
Ari: Absolutely. At this point I think we’ve talked about calories, we’ve talked about carbs and fats. My position that I’ve been espousing for since I wrote Forever Fat Loss in 2014 has been that the whole story in this battle of low-fat versus low-carb has been massively overblown. The importance of fats and carbs in the diet and the proportion of them as being the most critical factor that dictates your fat loss results has been incredibly misguided and overblown. That food quality, unprocessed versus processed food is a way, way bigger factor than the fat to carb ratio of the diet.
There’s also this other somewhat neglected macronutrient that of the three macronutrients, carbs, fats, and proteins is actually turns out the most important one. It’s the one that’s gotten the least press, and it’s the least talked about in this whole low-carb versus low-fat war that’s been taking place for 30 years now. Talk to me about protein and why it’s so important and why it’s misunderstood.
Alex: Oh, man. Where to begin?
Protein is critically important because at a high-level overview, just consider the fact that 20% of your body mass is protein. 60%, give or take, is water. Protein and water are what make up most of the body. Protein is where our body gets what are called amino acids. These amino acids are building blocks, and they are the building blocks for every tissue in your body. Every cell is built from these amino acids. Your hormones are built from amino acids, for the most part, and your neurotransmitters are built from these amino acids. Basically, protein is critically important for your body and your mental health.
When it comes to dieting, it has two fundamental roles for facilitating fat loss. One of those roles is that it is the only nutrient, carbs and fats can’t do this, only dietary protein can. It’s the only nutrient that can preserve and even build muscle tissue. If you eat a diet devoid of protein, your body still needs amino acids in order for your organs to function, to make hormones and neurotransmitters for your immune system to work. If you don’t get adequate protein, your body is forced to pull those amino acids that needs from somewhere, and the first place it goes is your muscle tissue. When you’re fasting, for example, roughly 80% of your body’s protein requirements come from skeletal muscle, and we see this in starvation studies.
There’s a reason people look very sickly and ill when they’re malnourished. It’s because they don’t have any skeletal muscle on the body because they’re wasting away. It’s the loss of skeletal muscle that is ultimately what kills you during starvation because once you lose about 40% of your skeletal muscle mass, your organs begin to dysfunction and you suffer organ failure, and that’s what kills you when you starve. It’s the skeletal muscle that prolongs your life. It doesn’t matter how much fat you have, because that fat cannot supply the amino acids that your organs need to function. When you diet, you need to eat protein because if you don’t, then you’re just going to lose a bunch of skeletal muscle.
The other important role that protein plays is, there are special receptors in the brain for amino acids that when the amino acids enter into the brain and bind to these receptors, it promotes a very strong satiety signal. It tells your body that, “I am satiated and I no longer need to eat.” There’s been a consistent trend in research that eating higher protein diets reduces appetite and causes a spontaneous, unintentional reduction of food intake in people that are overweight or obese. It’s almost as if eating a higher protein diet can cause weight loss simply by virtue of having you eat less of other food.
Ari: This also, I think, I’m curious if you agree, relates to why some low-carb versus low-fat studies have actually shown when not matched for calories and when not matched for protein intake, it usually shows the low carb diet is superior, usually in the short term measurements 4 weeks, 8 weeks, 12 weeks, 16 weeks. The low carb-diet will cause more fat loss, but almost always without exception, the low carb-diets are also high protein diets and higher protein than the low-fat diets. They end up driving down overall calorie intake to a lower level than the low-fat diets and therefore cause more fat loss as a result of driving down calorie intake as a result of being more satiated from the higher protein intake.
Alex: Yes. That’s exactly right. For people who don’t want to track calories, that’s one of the advantages of a low-carb diet. If you’re not eating carbohydrates, you still have to eat something. Most of the foods where you’re going to get fat and protein, or most of the foods where you get fat are rich in protein. Most carbohydrate-containing foods don’t have a lot of protein. If you base your diet around whole foods and you eliminate carbohydrates, really the only things left for you to eat are dairy, meat, eggs, and fibrous vegetables. Even in fibrous vegetables, half their calories come from protein, and then you have all this highly bioavailable animal-based protein, your protein intake almost always is going to increase.
It’s this increase in these studies of uncontrolled feeding, comparing low-carb to low-fat diets, it’s the increase in protein with low-carb diets that almost unanimously results in the favorable outcomes because it promotes that spontaneous reduction in food intake. It promotes the maintenance of muscle tissue, which means that more of the energy your body needs when you’re dieting is going to come from fat tissue.
Ari: Got it. So many questions. My first question is, there are some people I would say especially the vegan camp and some of the vegan diet authors, and vegan diet experts have promoted a narrative that protein is generally overvalued, that most people are over-consuming protein if anything, and that the RDA of protein is, I think, for the average adult male is something like 30 to 40 grams a day and maybe 30 grams for women a day. It’s like, “All right, we’re already getting adequate amounts of protein easily.” These people who are consuming 80 or 120 grams of protein, they’re getting way more than it’s necessary and it’s not doing anything beneficial, it’s just harming.
What would you say, first of all, to the idea that 30 to 40 grams of protein a day is an adequate amount. Second of all, do you think that the vegan diet camp is misguided on the subject of protein?
Alex: Yes. To tackle that first issue the RDA for protein is 0.8 grams of proteins per kilogram of body weight. Protein requirements have always been based on body weight because protein’s fundamental role in the body is biosynthetic. If you have more body mass, then you are going to need more protein to support that body mass. It’s never based on calories.
The RDA is by definition the absolute minimum requirement necessary to prevent muscle wasting. When I say the absolute minimum, that’s literally what it is. It takes into account the fact that when you eat a low protein diet, your body starts to downregulate a lot of important functions for help but those aren’t required for survival.
The studies used to calculate these RDA were called nitrogen balance studies and they have people eat low protein diets for weeks at a time, which gives the body enough time to adapt to the lower protein intake. By adapt, what it does is it stops synthesizing new muscle tissue so you can’t grow bigger muscles. It downregulates your immune function because it doesn’t want to give as much protein to your immune cells to use to fight off infections. It downregulates hormones like thyroid hormone because it doesn’t want to waste energy building these hormones, and it downregulate transmitters. You start to have imbalances in dopamine and motivation, and serotonin and happiness.
After all of these adaptations have taken place in the body, you’re able to survive because your body is trying to conserve, but you’re definitely not living a healthier optimal life. That’s what the RDA is based on. “Hey, this is the amount you need to survive.” It is nowhere near a target for anyone to aim for. It is the floor that you’re standing on because if you go beneath it, you will definitely start to waste away. Overwhelmingly, the research shows that to avoid these metabolic downregulations that occur when you restrict protein, the average adult needs 1.2 grams of protein per kilogram of body weight.
That’s actually what most Americans are eating on average. They aren’t eating too much protein. Even if they are eating one and a half times the RDA, it turns out to be precisely the amount of protein that they need to prevent certain metabolic abnormalities from occurring. This increases depending on your goals and your activity level. We have data showing that in amateur bodybuilders, for example, to prevent this metabolic downregulations from happening they need to eat on average 2.2 grams of protein per kilogram body weight or translated, that’s one gram of protein for every pound that you weigh.
In long-distance endurance athletes they need upwards of almost one and a half grams per pound of body weight. The more active you are, the more breakdown and turnover of your muscle tissue that you have, so the more protein you need to eat to replenish your muscle tissue. As far as concerns go with this higher protein intake levels, there are many different concerns that can be raised against it. The vast majority of them are highly context-dependent. As an example, there is concern over protein’s effects on the kidneys. What’s been shown unequivocally is that in an otherwise healthy adult or even an overweight or obese adult protein intake has no effect on kidney function.
However, there is some evidence suggesting that if you already have a predisposition towards kidney dysfunction like if you have type-2 diabetes, for example, eating excessive amounts of protein can help facilitate the detriment of your kidney function into kidney failure. You also have evidence showing that once you have kidney failure, eating too much protein can just accelerate that process because it makes your kidneys work harder to excrete the byproducts of protein metabolism.
If you’re healthy, and your kidneys are functioning healthy, then there’s no evidence to suggest that eating a high protein diet all the way up to 4.4 grams of protein per kilogram of body weight, or two grams per pound, is detrimental. Another example is acid-base balance.
Ari: Just to put that in actual numbers because some of these studies are pretty crazy. I think Jose Antonio I’ve seen him publish a couple of studies related to this, where they’re literally taking groups of people and putting them on 400 or 450 grams of protein a day and showed no negative effects on kidney function.
Alex: Yes. Exactly. Another one is acid-base balance. People think that, “Hey, if you eat protein there are certain sulfur-containing amino acids that increase the acid load on the kidneys.” When you have an increased acid load in your body, it tries to adapt to this acid load by breaking down bone tissue to release calcium, magnesium, and bicarbonates that can neutralize these acids to maintain the acidity of your blood.
However, in these studies, it’s also shown that protein increases calcium absorption from the diet so that ultimately your calcium balance of the entire body stays stable, and it doesn’t change, but that’s where context comes into play because at the same time, if someone is eating a diet that doesn’t contain a lot of calcium, then there’s nothing more to absorb.
Eating a high protein diet could theoretically impair their bone health over the long-term. We see the same with the microbiome. I’ll use this as my final example. This is probably the most valid concern over a high protein diet is that when protein enters into your large intestine, and it’s putrified by the bacteria in there, it produces numerous carcinogenic and genotoxic compounds that damage not only the beneficial bacteria but also your intestinal lining, and it can contribute to colon cancer.
There is a lot of evidence showing that if you eat a high protein diet, then you need to ensure that you’re eating ample fiber alongside that protein to make sure that you offset the production of these harmful metabolites. That in animal models, if you don’t do that, then the long-term repercussions include intestinal damage, the extinction of beneficial bacteria that produce butyrate, and colorectal cancer. It basically sets you up over the long-term for detriments to occur.
That’s one of my primary concerns with like the carnivore movement because they aren’t eating any fiber and they’re eating a ton of protein. That’s a really good example of where context matters, because if you’re just eating a lot of protein for a long period of time with no fiber, then there is good rationale that you’re doing damage to your body over time, but if you eat it on–
Ari: Maybe also, even in the context of the standard American diet potentially where fiber intakes and vegetable intake and unrefined plant food intake is also very low even though they’re technically not carnivores, they’re, let’s say eating potato chips and french fries and stuff like that alongside meat, which is also not ideal.
Alex: Yes. 100%. This isn’t like I too, I also want to emphasize that this isn’t me just pulling garbage out of my butt. We have loads of evidence supporting the plausibility of this idea, of this relationship between protein intake and gut health. The only things we’re lacking are long-term controlled trials in humans, demonstrating that these high protein low fiber diets cause intestinal disturbances over the long-term. We have those studies in animals; we just don’t have them in humans. That’s understandable because even in theory, how could you conduct a study that would theoretically give a human colon cancer? That’s not ethical. That would never get approved to be conducted.
Ari: One more. Well, just curious if you could speak directly to the vegans who typically– A lot of the big-name vegan diet authors that are out there are generally eating fairly low amounts of protein and often cases, oftentimes, maybe 40 to 60 grams of protein a day, mostly from or entirely from plant foods. Do you think that’s a concern over time? Do you think that they’ve just got this wrong, such that they’re going to suffer health consequences as a result of that level of protein intake?
Alex: Definitely. The level of protein intake is not sufficient to support a healthy level of muscle mass. It’s the loss of muscle mass as we age, which is called sarcopenia that is the leading risk factor for premature death and frailty hospitalizations, low bone mineral density, and poor quality of life in the elderly.
If you’re not giving your body enough protein when you’re younger to build a healthy amount of muscle mass, then you’re just setting yourself up for a shorter lifespan and lower quality of life as you age. You might be able to survive when you’re younger, you probably can, but in the long haul, you’re just going to do yourself damage.
I would go so far to say as there really isn’t any ability to debate this issue. The research showing the importance of protein intake with aging, and how it relates to muscle mass and function is overwhelming. This idea that you should eat around the RDA of protein, which many vegans do, is just completely baffling from the standpoint of what the current evidence base shows, especially considering that this entire issue could be circumvented if people eating a vegan diet would just supplement with vegan protein powders.
Ari: Yes. That’s what I was just going to say. I want to clarify, you’re not advocating, you’re not saying vegan diets are harmful, period. You should not be vegan, all vegans are misguided. You’re saying, if you’re vegan and you’re consuming fairly low levels of protein that is going to result in harm to your health over time.
Alex: Yes, exactly. Look, any diet can be followed in a healthier unhealthy way. Some diets are going to take some more conscious effort than others are; vegan diets are one of them. Vegan diets put you at an increased risk of certain nutritional deficiencies, one of them being protein, but it’s easy to circumvent because that’s one of the beauties of modern society, is that we can circumvent these issues.
There are vegan protein powders that let you completely circumvent the protein problem. Just like when if you’re eating a pure carnivore diet, there are fiber supplements and phytonutrients supplements that let you circumvent the entire issue of not eating plants for whatever reason. Whatever diet you’re following, you can probably do it successfully, you just need to be aware of where you may be falling short and take efforts to fill in those gaps.
Ari: Got it. Specifically, what about these concerns related to protein around mTOR, mammalian target of rapamycin, and IGF-1? These are things that are often brought up especially by people in the vegan camp around basically promoting a narrative that “Hey, high levels of mTOR, high levels of IGF-1, which relate to high levels of protein intake, especially animal-based proteins from their perspective, those things are related to your risk of cancer and disease processes, and you should avoid high levels of IGF-1 and mTOR.” What are your thoughts on that?
Alex: I think it all comes down to balance. We evolved to go through daily cycles of eating and fasting. When we stimulate mTOR and promote growth and reproduction in our body, those are absolutely essential to our health. That’s what helps create new antioxidant enzymes, it helps lay down new muscle tissue. That’s what helps us reproduce and enjoy life. At the same time, we need to have these fasting cycles integrated, because that is what cleans up any of the damage and dysfunction caused by the growth and reproduction that we engage in.
When you think about the relationship of mTOR to inappropriate aging, it almost always actually comes down to people just chronically overeating, being in a caloric surplus and just constantly gaining weight. We already know that being overweight or just carrying around an excess amount of fat tissue is detrimental to health.
We also know that eating around the clock and having chronic stimulation of mTOR and these other growth promoting pathways is detrimental, because it interferes with circadian rhythms and it never gives your body a chance to clean up any accidental dysfunctional proteins that get created in the process.
There’s nothing inherently detrimental about eating an adequate amount of protein to support your activity levels and your body composition. When you are acknowledging the natural way that humans evolve to eat, which is to have an eating window and then a fasting window. Ideally, these would be split or ideally, the fasting window would be a minimum of 12 hours, which isn’t hard for most people, think about it.
You eat dinner at 7:00 PM and then you don’t eat breakfast until 7:00 AM. Most people can go longer than that without issue just based on their normal daily schedules. Depending on your goals, you may want to go longer. If you want to spend a little time in your youth building more muscle, stick to a 12 hour fasting window so that you can get in a couple more meals and a couple of more growth stimulants.
Then if you want to, for example, help resolve diabetes or lose weight or improve your metabolic health, then fast for 16 to 18 hours, but maintain that little window where you can eat adequate protein to supply the growth that your body needs to be healthy.
Ari: You’ve explained the mechanisms really well, just to play devil’s advocate. Just to speak to any research specifically on protein intake and its relationship to cancer, is there a relationship? Forgetting any theory around mechanisms, but do we have any evidence suggesting that high levels of protein intake increase your likelihood of getting cancer?
Alex: Well, we have conflicting observational research showing that it can, but also that it doesn’t and observational research is really bad for this type of thing because it’s so prone to errors. I think that protein definitely facilitates the growth of cancer cells that are already in the body and in especially cancer cells that have taken a foothold in the body, because protein is necessary for growth of both cancer cells and your own body cells.
I think that there’s a logical reason to restrict protein if you’re currently battling cancer. At the same time, we have to acknowledge that it’s a tricky issue because how long are you going to restrict protein for? Are you going to let your body waste away so that you ultimately die of an infection instead of the actual cancer? What about the role that all these other aspects of your health play? For example, we know that melatonin is a powerful anti-carcinogen and it’s secreted at night, but most people are exposed to artificial light that suppresses its production.
What’s worth worrying about more, protein or ensuring a healthy circadian rhythm? There’s just so many factors at play and with cancer it’s just so complex, because there’s every type of cancer just seems to respond to interventions differently. Some drugs only work on some cancers, some cancers are super responsive to ketogenetic diets. Others thrive in that environment.
I think cancer is a tricky one, because there’s so little that we still know about its relationship to nutrition that it’s very hard to make recommendations outside of; eat whole foods that have a relatively low insulin load.
Ari: Have you seen any convincing research at all that is non-observational research, non-epidemiological research, but it’s actually randomized controlled research that is good quality research that suggested that high protein intakes are strongly linked with increased risk of cancer? Maybe to even phrase this differently, are you personally concerned or would you be concerned if you were giving nutritional advice to your mom, as I’m sure you do. If you were giving nutritional advice to your own mother, would you have any concern whatsoever about her consuming a very high protein intake and that increasing her likelihood of cancer or any other disease?
Alex: When it comes to getting cancer, then no, I am not aware of any evidence whatsoever that eating protein facilitates the development of cancer. However, where in someone that already has a cancer that has established a foothold, there is evidence that suggest that restricting protein intake, at least in the short-term, can help slow the development of the tumor.
In those circumstances– I actually did this with my wife, Briana, when she was diagnosed with stage three melanoma. She spent a month restricting her protein intake down to just bare minimum levels, because we just wanted to help slow the spread of it, assuming that it had spread.
This is pure anecdotal and there’s no way to know if that actually did anything, when she had follow-up scans to see if it metastasized, it didn’t. That was one of the only changes that we made was that, her protein intake dropped down quite low. That’s supported on both some experimental evidence, but definitely overwhelming mechanistic data as well.
When it comes to getting– It’s the same with kidney disease, actually. Eating a high protein diet; it’s not going to give you cancer, it’s not going to give you kidney disease, but if you have cancer or have kidney disease, then a high protein diet can facilitate the worsening of those conditions.
Ari: But outside of those contexts, in a healthy individual, you believe the benefits of higher protein intakes massively outweigh any potential risk?
Alex: 100%. Again, just using aging as an example. The number one killer isn’t cancer. The number one killer is having a low amount of muscle tissue due to eating insufficient protein and that’s causing people to fall down and break their bones. Not be able to experience life, to be refined to a chair in a nursing home. Impair their quality of life, cause depression.
The quality of life benefits of protein vastly outweigh any theoretical risk with cancer. There isn’t even a strong argument to be made for the longevity aspects of restricting protein intake, because there’s no convincing data that supports that. For example, you’ll see studies in mice are a frequent example. We restrict protein in mice, they live longer.
Well, that’s great to point at that single study in that mice, but we also have studies that, for example, have used 41 strains of mice. They feed these 41 different strains of mice the exact same, protein-restricted, calorie-restricted diet that should promote longevity, 60% of those mice actually die sooner than they would have otherwise.
It only extends lifespan in some mice, but not others based on their genetics. Studies in primates. We have two studies now in primates, with one showing no benefit of protein and calorie restriction and the other is showing a benefit of protein and calorie restriction. That second study though, the comparison wasn’t fair, because it was comparing calorie and protein restriction to overfeeding on a Western diet. It doesn’t support–
Ari: On a processed food somewhat similar to a standard American diet?
Alex: Yes. We already knew that having an excess amount of fat mass does increase your risk of dying prematurely and so that’s all that this study showed is that, compared to having an excess amount of fat tissue and being obese, restricting your calories and proteins’ going to be better. If we compare that to being normal weight like we did in the first study where both diets are healthy, it’s just one is lower in protein and calories, it’s not going to extend your lifespan.
Ari: Do you think that– You’ve mentioned a few times that being under muscled is metabolically unhealthy and contributes to disease processes. Do you think that most– a large portion of people in the Western world, maybe the vast majority of whom are actually overweight, do you think that in addition to having excess body fat, they’re under muscled? Do you think that’s a thing?
Alex: Yes, definitely. I think it’s fair to say that if someone is not currently engaged in even just a bare minimum resistance training program, that they are under muscled because– I’m not talking about trying to become a bodybuilder or anything like that, I’m just talking about increasing your strength to a level where you exert yourself a little bit every day. So many people are sedentary or the ones who do exercise spend all of their time doing cardio on an elliptical or going for a jog, but none of them actually just lift heavy things, which is ultimately what’s needed to grow new muscle tissue.
You need to give your body a reason to put down new muscle tissue. I would definitely make the argument that most people are under muscled because most people aren’t engaged in anything that would grow muscle. If you’re not engaged in anything that’s going to tell your body to grow muscle, then all you’re going to do is either sit with what you have or slowly lose it over time.
How sleep affects body composition
Ari: You mentioned circadian rhythm a few minutes ago and the cycles of feeding and fasting and the importance of these rhythms in our metabolic health. What do you think are the key takeaways or the key points that people should understand about how circadian rhythm relates to their body composition into their health?
Alex: I would probably say that the key points are that your circadian rhythm is a set of internal clocks in your body. These clocks are fundamentally regulated by the signal of sunlight coming in through your eyes to signal to your brain its daytime and that permeates down through hormonal and neurochemical signals to the rest of your body that affect its metabolism.
At night, when sunlight disappears, your brain then secretes melatonin that stimulates different processes in your organ tissue. At the same time, you have influences of exercise and the food that you eat. You have these primary external stimuli that set your internal clocks them being light, food, and activity.
We’re meant to eat, be active, and get light during the daytime and we’re meant to sleep, not eat, not be active, and not get light during the nighttime. That’s how we’re wired up. When you take people and you put them on a weight loss diet, and you look at, “Okay, how successful were these people? Now, let’s measure the robustness of their circadian rhythm by doing core body temperature measurements throughout the day. Let’s figure out how the weight loss related to the robustness of their circadian rhythm.” Those who lose more weight have more robust circadian rhythms. Those who lose less weight have less robust circadian rhythms. Light at night disrupts your circadian rhythm and it disrupts your sleep. People that are sleep-restricted are hungrier, they eat more, they weigh more, and they have a lower metabolism.
When you take people that have poor quality sleep and sleep too little, and you force them to sleep for a longer period of time, they spontaneously eat less, have less desires for sweet and savory foods, and they lose weight. When you take people and control all of their food intake, and the only change is that one group is sleep-restricted five and a half hours per night, the other group sleeps just seven hours per night.
It’s only a one and a half-hour difference. You feed them the exact same weight loss diet. You find that the group that was sleep-restricted loses significantly more of their body weight from muscle tissue, and significantly less of it from fat tissue than the group that got adequate sleep. Your circadian rhythms don’t just affect everything that matters in your day to day lives like how hungry you are. It also affects you at a biochemical level that impacts where nutrients are stored and where they come from. The difference between losing fat mass versus losing muscle tissue when you diet. Circadian rhythms are absolutely one of the most important things to pay attention to both for body composition and for health. I think that they’re one of the most under-appreciated concepts in what I would call the “evidence-based crowd” who still likes to just focus on eat your meals whenever it’s most convenient for you, focus on your calories, get your exercise everything will be fine.
Ari: I remember back in 2014 when I wrote Forever Fat Loss and I was basically talking about science around circadian rhythm and how it relates to improved body composition. I would have debates with a lot of the guys in the “evidence-based fitness crowd” online who were like, “Oh, that’s nonsense, all you got to do is count your calories, all this stuff about timing and circadian rhythms.
That’s all, there’s no science to support any of that.” Fast forward to 2020 and it’s like, “Oh, actually it turns out that circadian rhythm is a huge factor in our health, our risk of numerous diseases, our body composition, our results from our diet and exercise routines.” Of course, since this is the energy blueprint our energy levels massively relate to the strength of our circadian rhythm, the robustness of our circadian rhythm.
It’s funny also in 2014 I have to rub it in a little bit but I was one of the first people like Stephan Guyenet and I really give him the credit but I was one of the first people to really talk about the Food Reward Theory of Obesity and why it’s not just as simple as calories in and calories out and why food reward and palatability is a much better model for understanding fat gain and fat loss.
At that time, all the people in the evidence-based fitness crowd pooh-poohed all that stuff as well and were totally unaware of it, “All that’s nonsense, just counting your calories.” Fast forward a few years and now all of them have widely accepted all of these things to be true.
Alex: Yes I think what people, I guess, need to appreciate is that look. You can restrict your sleep, you can completely ignore your circadian rhythms and you can drastically cut the amount of calories that you put in your mouth and you’re going to lose weight, you’re going to lose fat. You’re also going to be extremely more hungry than if you respected your circadian rhythm.
The entire process is going to be miserable and your body composition is going to change in a much different way with a lot more muscle loss and a lot less fat loss. Yes, you can lose weight just not eating. No one’s denying that but why not make the process as effective and enjoyable as possible?
Ari: You mentioned before we’re meant to get light, eat and move our bodies during the daytime hours and to do the opposite during the nighttime hours. Where do most people in the modern world, especially the Western world, where do we get that simple formula wrong?
Alex: Well, everywhere. [chuckles] Well, first of all, most people are sedentary so I mean they’re just not moving anytime. They’re eating chronically throughout the day and well into the night. People talk about, “Yes, I eat three square meals,” but when the USDA actually surveyed Americans and asked them how many meals they eat, the lower end of the range of responses they received was 3.3 meals per day.
Literally, no one’s eating three meals per day. They eat three meals plus snacks and so on. They eat them spread throughout the day usually across a 12 to 15-hour window and well into the night. People eat dinner at 7:00 PM but then have a snack at 8:00 PM or 9:00 PM. Some people will stay up until 1:00 in the morning, they’ll be eating at midnight because why not? They’re watching a movie and then they have all this artificial lighting that is telling their body, “Hey, it’s daytime,” when actually it’s supposed to be nighttime. They aren’t– All of their signals going through their body, the signals that are produced by the liver from eating, the signals produced from the muscles from exercise, or the lack of, and the signals that change from the brain, depending on whether you have light going in your eyes or no light at all, all of those signals get screwed up and mismatch. It’s a complete storm of circadian dysfunction in the modern world.
Ari: That was a really good explanation. Let’s map out some of the consequences of getting these simple things wrong. There’s a whole bunch of mechanisms. Literally, dozens of mechanisms we could talk about, but related to body composition, related to energy levels, related to disease risk and all give maybe a very brief overview, and then you can dig in more but let’s just look at like hormonal consequences.
We know there’s blood sugar dysregulation as a result of circadian rhythm and sleep disruption increases in insulin resistance, abnormal levels of cortisol, insulin resistance. We know that autophagy, a process of cellular cleanup that happens every night while we sleep gets disrupted when circadian rhythm and sleep are not optimal.
We know that melatonin levels– To mention something you mentioned before about appetite, we know that appetite hormones, things like leptin and ghrelin as well as the endocannabinoid system, which impact on our appetite regulation get disrupted with circadian rhythm and sleep disruption such that we end up as you said, consuming hundreds of calories more as a result of those things being disrupted.
Then melatonin, which I know this is something that you’re very passionate about, you know a ton about is– Everybody knows it’s powerful for optimizing sleep. The part of the story that most people don’t know is that it’s also probably the single most critical compound for protecting your mitochondria. It is a powerful mitochondrial antioxidant.
It also has a role in preventing numerous diseases, including especially cancer, as you mentioned previously. Then you consider artificial light at night, lowers melatonin levels, this hormone that our brain produces every night by upwards of 50% or 70% every night. It’s again this powerful protector of your mitochondria, your cellular energy generators, powerful hormone that helps you sleep better, a powerful hormone that protects you from cancer.
Do you think that it matters if every night for year after year for decades, you’re producing less than 50% of the amount of melatonin that you should be? Do you think that might increase your likelihood of poor sleep, insomnia, fatigue, and increase you’re likely to have cancer? Heck, yes, it does. Anyway, that’s my brief mapping out of some of the consequences of getting these things wrong but you do want to add anything to that?
Alex: Actually, I would love to just circle that back to something you and I were mentioning when you had brought up the Health at Every Size movement. It’s the same way for if you acknowledge that your health is not where you want it to be. I think your explanation even with just melatonin alone, is how long were you raised as a child through your developmental periods where your parents let you stay up late and watch TV they had lights on with all of these circadian disrupting things were being done to you without your knowledge or control and even in your young adulthood and probably even in the middle age.
How long did you go about doing these things without even knowing simply because they were a natural part of the modern environment? If your health isn’t where you want it to be right now, what’s important to understand is that there are so many factors at play that you had no knowledge or control over. It is for all the people that say, “Oh, it’s your fault that you’re carrying around too much fat. It’s your fault.” No, not really. It’s not.
Once you’re aware, then you need to take the next step. Once you know, “Hey, I shouldn’t have these lights on at night because they disrupt my melatonin secretion.” Then you can start to actively make changes to regain that health to regain your energy levels and that’s what really matters is knowing when we’re talking about fat loss and all these factors, it’s not about passing blame because ultimately the cause doesn’t really matter. What matters is acknowledging what needs to change to facilitate the future that you want.
Ari: Yes, very well said. Quick shameless plug here, I want to mention as I mentioned in the last episode and hopefully, you guys see Alex’s brilliance and the reason that I hired him to be on the team and cope co-write books with me and co-create programs with me. The guy is just, he’s a stud, he’s brilliant.
I love talking to him, I want to talk to him for five hours every day and just geek out on all the science, but we’ve created an advanced fat loss program. To be quite blunt with you guys, this is not BS. This is not typical, “Hey, lose 20 pounds in 15 days with our special magic trick diet. This is no BS, no dogma, just straight science of advanced fat loss.”
We’re assuming you know the basics of good nutrition and healthy eating and healthy lifestyle habits that you’re already doing at least some basic exercise regimen and that you maybe have still excess body fat that you’d like to lose and you want to know how to break through that plateau and get to the next level. Again, no BS, no gimmicks, no pseudo-science, no magic pill nonsense, but just the real science of fat loss. This is the program we’ve put together.
Alex, we’re going along time at this point. I would love to carry on for another hour with you and I’m sure everybody listening is loving this material, but to translate some of the things that we’ve talked about protein intake in particular and circadian rhythm into a few practical steps. If you could summarize your top three or four practical strategies that people could implement as a result of understanding this information that you’ve gone over today around protein and circadian rhythm, what would those top three or four strategies be?
Alex: For protein, regardless of whether you’re eating a vegan diet or an omnivorous diet if you are overweight or obese, then try to aim for eating about one and a half grams of protein per kilogram of your current body weight. That’s an important distinction because many people go based on your ideal body weight or your lean body weight.
The majority of research actually just uses your current body weight because that’s a lot easier to measure in research studies. It’s a lot less invasive, they just have the participants up on the scale. One and a half grams of protein per kilogram of your current body weight just aim for that every day divided across however many meals you find most convenient. I don’t want to get more complicated than that. If you can just aim to hit that one number before focusing on anything else, you will probably see some vast improvements.
Ari: I’ll mention that this one thing blows a lot of people’s minds when they actually calculate how much protein they’re consuming and they realize how far off of those recommendations they are. Just a warning to everybody listening, don’t be shocked when you discover that you’re probably eating like half of the amount that Alex just recommended.
Alex: Yes, and if you’re sitting there saying, this is too much, I can’t get it all in, then I’m going to say back to you, “Good because that means that you’re not going to have room to eat anything else.” That’s going to facilitate your fat loss and you’re going to be full and you’re going to have a more enjoyable experience. That’s what we want. As for–
Ari: Just to add to that, we want that because it means you’re losing fat while not suffering and starving, you’re losing fat while you’re satiated.
Alex: Yes, exactly.
Ari: The fat loss that you get, yes, you can starve yourself into temporary fat loss, but if you’re hungry all the time and you’re fatigued all the time and if you feel like crap you’re not going to sustain it. As you mentioned before, adherence to the diet and adherence to the lifestyle that leads to fat loss is the critical factor in long-term results. Anybody can starve themselves for a few weeks and lose a whole bunch of weight. The problem is you regain it a few months later and so the key to lasting permanent fat loss is you have to adopt fat habits that drive fat loss that are sustainable and that do not feel like suffering.
Alex: Yes, and part of that is going to be eating a diet that doesn’t give you a ton of calories but does give you a lot of satiety and protein is a central component of that. Then you can just eat however much you want and you can enjoy your meals without worrying that you’re going to be overeating. As far as circadian rhythms go, there are a lot of things that impact circadian rhythms as we talked about. I would argue that probably the number one place for most people to start would be to just after you eat dinner, don’t touch food and either turn out the lights or get some blue and green blocking glasses.
I know that all you have in article up on your web site where you give recommendations for blue-green blocking glasses that are excellent. The goal here is to; first of all, just stop snacking at night because that tells your body, “Oh, its day time, I’m eating.” But also to block out the light that’s coming from your laptop, your TV, your cell phone that is telling your brain it’s daytime now when you should be in a period of rest and you should have higher levels of melatonin being secreted.
Ari: Absolutely. Do you have any thoughts on light? You mentioned artificial light at night; do you have any thoughts on the melatonin aspect and daytime light exposure?
Alex: Yes, but this one is definitely difficult for some people just based on geography. There is definitely a body of evidence showing that when you expose people to sunlight during the day that their melatonin secretion at night increases even when you keep everything else constant. It’s like the sunlight during the day primes your body to secrete even more melatonin at night, if you keep all those constant.
If you live somewhere where you have access to regular sun exposure like especially if you live around the equator then definitely make an effort to get up and get in the sun not just in the morning but take some walks throughout the day. If you live somewhere into north to where there isn’t much sunlight as many people do, unfortunately, like in many parts of Europe and Canada or the upper parts of the US especially during the winter. Invest in a lightbox that can hit you with 10,000 lux of light in the morning for 30 to 60 minutes. It’s nowhere near as good as sunlight but it is better than nothing at all.
Ari: In the energy blueprint program I have as you know about 30 different strategies for optimizing circadian rhythm and sleep. We’re going to cover two here or three.
Alex: [crosstalk] there is a lot that affects it all.
Ari: Yes, but you mentioned the feeding and fasting cycles, the feeding and fasting windows as being a critical component. What are your thoughts on the optimal windows of time for feeding and fasting each day?
Alex: I definitely prioritize more of your food towards the morning and the early afternoon, if possible. This, unfortunately, while we continue to have growing body of literature looking at how altering the window of eating affects health. Where that window is placed whether in the daytime or the nighttime has almost no research trying to compare that but what we do have suggests that eating your food earlier in the day is better for metabolic health and potentially body composition as well than eating later in the day.
We also need to be realistic. Being realistic means that you should probably not like overhaul your entire schedule if it’s too inconvenient and you shouldn’t stress yourself out. Especially in this fat loss program that we’re coming out with, there are so many ways that you can make small changes to your lifestyle that will facilitate fat loss and lifelong fat loss maintenance that if eating most of your food earlier in the day just doesn’t work with your current schedule for whatever reason, focus your efforts somewhere else until you have an opportunity to focus it on that.
The Fat Loss Blueprint Program
Ari: Well said. To that point, there’s something that I think we want to emphasize about this program. This is not just another diet, this is not just another exercise program, it’s not just diet and exercise but part of advanced fat loss strategies is recognizing that there are a whole bunch of other layers to the story of body composition that go beyond, just diet and exercise. Yes, nutrition and exercise are very, very important, and they’re covered in the program but there’s also a whole bunch of layers to the story of how people who are already eating a good diet, already on a good exercise program can take things to the next level and start to see fat loss, maybe even if they haven’t seen fat loss in several years. Alex, do you want to speak to that point at all?
Alex: Yes. Well, the program is basically 18 lessons and we only spend two or maybe three of those lessons actually talking about diet and exercise, because we’re coming from the standpoint that you have those things dialed in. The rest of it deals with optimizing your meal timing and windows, optimizing your circadian rhythm, optimizing your leisure time activity, finding out ways to engage your body in hormetic stressors that can stimulate positive outcomes like heat stress, cold stress, stress that you can induce by certain things you eat in your diet.
We have whole sections on stress management, on resetting your hedonism when you eat and you’re food reward circuitry. We even have an entire section dedicated specifically to women, that talks about the tips and tricks that women can use to take advantage of their monthly cycle or take advantage of being postmenopausal to make the dieting process easier. Then we talk about fat burning supplements for anyone who wants some extra help.
Again, very little of it’s actually spent on diet or exercise because most people know what they need to eat and know that they need to be regularly active. Instead, we want to address all the other areas where you could unintentionally be sabotaging your efforts.
Ari: Absolutely. One thing I want to say, I started out in the in the fat loss space and this has been something that’s been my area from the beginning of when I started getting into fitness and nutrition when I was 13 or 14 years old. I started reading textbooks on nutrition and physiology and biomechanics and weight training and things like that. I was all about fat loss and muscle gain.
That was my entire world for 15 years and before I started the Energy Blueprint and really shifted my focus to my obsession. I became obsessed with the science of energy and got out of the whole fat loss realm. Part of the reason I got out of it is because, to be honest with you, I was really disgusted with what is going on right now in the internet world, related to fat loss, of just everybody trying to sell you on the magic diet and they’ve got these diet secrets and the magic supplement.
There’s just so much just an unbelievable amount of nonsense and pseudoscience and gimmicks and BS, just utter BS and charlatans. People who are not actual experts on the science who are literally just making up a diet and then claiming it’s the best fat loss diet in the world and you can lose 20 pounds in 10 days. I just became, just disgusted.
It just felt gross to me to even be a part of that and have to compete with people who are so slimy and making claims like that. I was actually resistant to doing another Fat Loss Program at this point and getting back into that space at all, but I said, “If we’re going to do this, I want to do it the right way, I want to do it in an ethical and an honest way, not in a misleading way.”
I don’t want to compete with the charlatans and the gimmicks and the BS and try to one up them on their nonsense claims of saying, “Hey, you can lose 20 pounds on your magical diet in 15 days and what we’re going to say, you can lose 28 pounds in 20 days.” I don’t want to play that game of marketing and salesy sliminess.
The reality is, this is going to be the best Fat Loss Program in existence. This is just the most comprehensive compilation of the actual science and evidence and research around how to optimize your body composition and it covers, as Alex said, the whole gamut, it’s not just a diet. It’s not just an exercise program; this is a complete examination of the research around how to optimize your body composition. No BS. No gimmicky claims. No pseudoscience. No magical diets. This is just the science of fat loss. If you’re listening to this, and that sounds like what you want. If you’re sick of being duped by these gimmicky BS charlatans who are selling you on magical diets and diet pills and so on, and you want to just actually see the real science of how to optimize your body composition and lose fat permanently in a sustainable way that is not suffering, this is the program for you.
I hope you all will get it. If you have excess body fat, I hope you see now that this is increasing your risk of disease. Also, it’s as Alex said, increasing chronic inflammation. It’s decreasing immune function increasing your risk of having severe symptoms and dying from COVID-19. Again, obesity, diabetes, high blood pressure, metabolic syndrome, cardiovascular disease which are all directly related to excess body fat are major, major risk factors for severe symptoms and death from COVID-19 and upper respiratory tract infections. Respiratory tract infections in general.
This is not just about looking good. This is about optimizing your health and preventing disease and increasing your lifespan and increasing your energy levels and your quality of life. I hope you guys will get this advanced fat loss programs even if you have only five pounds you want to lose, check out the science. It’ll help you bust you through that plateau and lose those last five pounds.
If you got 50 or 80 pounds to lose, it’ll help you lose those in a sustainable permanent way that does not involve starvation and suffering. I hope you guys will get it. It will be at theenergyblueprint.com/fatloss. So theenergyblueprint.com/fatloss, you can get that program. Alex, this has been phenomenal. Always a pleasure talking to you. This is why I hired the guy. He’s a stud as you guys have heard.
He’s brilliant, and he’s helped me put together this advanced Fat Loss Program and it’s really just a phenomenal program. I hope you guys enjoyed listening to this. Alex, thank you so much. Do you have any final words for people listening?
Alex: Yes, actually, I do. I just want to let everyone know that with this program, our goal, honestly, the goal when Ari and I were working on it was not to think about, “Okay, how can we make you lose as much fat as possible?” The goal was to think, what are all the things that impact body composition that could be sabotaging you, and how can we help you build the self-efficacy that you need to take the power back into your hands?
To be able to understand why certain lifestyle habits are leading to certain outcomes when it comes to your health and body composition and how can you then make changes that lead to the changes in your body composition and health that you want to see. We basically want to teach you so that you can’t be misled by any of as Ari said, the charlatans out there saying, “Hey, lose 21 pounds in three days.”
We want you to have literally all the information you would ever need at your fingertips, so that if you hit a weight loss plateau, you can go back and you can say, “Okay, what’s going on in my life right now that could be causing this?” We want to help you be able to identify these things in your life so that you can have complete control over your health and body composition.
Ari: Yes, well said. I should also mention on that note if you join the program, you’re going to get access to a Face book group with Alex and I in the group there to guide you, to answer your questions, and coach you to success. We really want you to be successful in this process. This is not something we’re just like, “Hey, buy the program, you’re on your own.” It’s like, “No, buy the program, get in our group, come online with us, ask us questions, let us help you and coach you to success and we’re going to be there for you every step of the way.”
I hope you guys enjoyed this. Lots more podcasts to come with Alex. He is a wealth of knowledge. There’s a million other topics that we could talk about for hours. Thank you so much for coming on the show my friend. Always a pleasure, and I look forward to the next one.
Alex: Yes, thank you for having me. I’m looking forward to it too.
Ari: Yes, and to everybody listening, whether you’ve got five pounds or 100 pounds to lose, go get this program. Having excess body fat is not just an aesthetic issue. This is an issue of your energy levels, your longevity, your risk of disease, your risk of severe symptoms from respiratory tract infections, immune health. So many things about your quality of life and your health directly relate to your body composition so get this area of your life handled. There is no better time to do it than right now. I hope you enjoyed this podcast. Go to theenergyblueprint.com/fatloss and check out the program. I hope to see you inside.
The obesity spectrum – why it matters (04:27)
The real cause of insulin resistance (13:00)
The role processed foods play in your health (20:10)
Which diet is best for fat loss? (26:12)
Is the calories in – calories out paradigm a myth? (37:37)
The critical role of protein in health (47:10)
How sleep affects body composition (1:21:20)
The Fat Loss Blueprint Program (1:35:15)