Episode 131 Summary
At Real Life Medicine, we believe in ongoing learning and evaluating what we teach is crucial - We were happy to hear that we were on the right track, during Low Carb Denver, because we place a high priority on staying up-to-date with the latest scientific research in healthcare and maintaining a critical and analytical approach to medicine. We recognize the importance of adapting and evolving our approach as new information becomes available, and we're always striving to be better.
During Low Carb Denver, Dr. Andreas Eenfeldt's presentation on the limitations of the low-carb nutrition approach for some people inspired us - We were moved by his compassionate and scientific approach, and we share his commitment to learning and discovering. As a team, we remain open-minded and inquisitive, continually seeking to learn more and develop new solutions. We know that healthcare is complex and ever-changing, and we strive to approach our work with the mindset of true scientists.
So, how should we eat to lose weight and gain health? - At Real Life Medicine, we believe that modern society has disconnected us from our food and intuition about what to eat. That's why we suggest the "build-a-plate" formula, which starts with a protein source, adds some veggies, and adds some healthy fats if the protein is lean. We also recommend seasoning for flavour.
We understand that tracking your food intake isn't for everyone - We suggest occasional audit days or short-term tracking to help individuals become more aware of their protein intake. Ultimately, we believe in finding a system that works best for each person's personal development journey. If tracking doesn't work for you, that's okay. You're the boss of your own journey. If you love tracking, go for it, but don't forget to pay attention to your body's hunger and satiety signals too.
When it comes to protein, we highly recommend prioritising it in your diet - Protein is essential for overall health and wellbeing, and we suggest a minimum daily intake of 1 gram per kilogram of body weight or 1.6 grams per kilogram of body weight for those at or close to their ideal weight. Many people don't eat this much protein, so it's something to be mindful of.
In terms of intermittent fasting - We suggest having a 5-hour interval between meals within your eating window to allow your gut to rest and insulin levels to decrease between meals. Remember that the eating window isn't a free-for-all for snacking. When you eat enough protein, you should be able to last until your next meal without feeling hungry.
We understand that after-dinner snacking is a common issue that many people face - There are different causes for this, some psychological and some physiological. If you struggle with this, we encourage you to download our after dinner snacking checklist. This tool can help you identify the cause of your snacking and provide practical solutions. Tuning into your body's signals and learning how to change your habits and behaviours can help you achieve the health goals you once thought were unattainable.
Download the checklist:
To learn more about how to overcome night time snacking and download our free night time snacking tool CLICK HERE!
Episode 131 - How do I eat to lose weight?
Dr Mary Barson: (0:11) Hello, my lovely listeners. I'm Dr. Mary Barson.
Dr Lucy Burns: (0:15) And I'm Dr. Lucy Burns. Welcome to this episode of Real Health and Weight Loss
Dr Mary Barson: (0:21) Hello, lovely listeners, Dr. Mary here. And I am joined by the fabulous Dr. Lucy who has just returned from her trip to the United States and not looking at all jetlagged, I would like to add. How are you going, Lovely one?
Dr Lucy Burns: (0:40) I am wonderful Mares, thanks so much for, you know, as usual, a lovely introduction. But whilst I do love a bit of travel, I really, really do love coming home. So I think one of the things that travel, whether it's travel overseas or travel anywhere, holidays, they just allow you that beautiful bit of space to, I guess, re-evaluate and recalibrate and I'm feeling very recalibrated.
Dr Mary Barson: (1:09) Excellent. I'm glad you're feeling recalibrated. I know that you have come back super energised from all of this wonderful stuff that you have learned while you're over there talking to other wonderful doctors and researchers in the field of low carbohydrate medicine and nutrition. And you've shared lots of wonderful insights with me that I am very excited to sort of get my hooks into and to really sort of rip apart and learn, learn more from. And one of these insights you wanted to talk about today, which I think is a fabulous idea.
Dr Lucy Burns: (1:46) Yeah, I thought what I'd do is share a couple of things. So the first thing that going to a low carbohydrate nutrition conference helped me solidify was that at Real Life Medicine, we are on the right track. So the things that we are teaching in our courses and to our members are really the things that were discussed at this conference. And in particular, around the idea of protein, nutrition, protein, leverage protein, you know, metabolism, but also muscle and muscle mass. And we will talk a little bit about those two things. So I was sort of void because you go with an open mind. And at Real Life Medicine, we certainly are very, you know, we want to follow the science we want to follow, doing what is helpful. And you know, this, I mean, we always talk about it, we are not wedded to an ideology. And I think that some people do have that, and then they get stuck. Because if that's your ideology, it's kind of hard to undo.
Dr Mary Barson: (2:53) Yes.
Dr Lucy Burns: (2:54) Whereas for us, it's really this idea of going, “okay, well, what is the current science suggesting”, but also knowing that the current science, and this was, this was one of the things that I recognised, was that there were robust debates.
Dr Mary Barson: (3:13) Which actually is good.
Dr Lucy Burns: (3:16) And I think, again, this comes back to our philosophy that there is definitely no one size fits all, there is most definitely no one thing that every single person should be doing. And you know, and again, this plays into things like, and we haven't really discussed this in detail, but things like the Eat Lancet study that came out a couple of years ago that suggested the one diet that all humans should eat. I mean, it makes sense that that's just going to be a little bit of rubbish.
Dr Mary Barson: (3:49) It was, scientifically speaking, a bit of a train wreck of a piece of science as well, just put my two cents there. Yeah, absolutely. Consensus isn't science. Ok. Science is not consensus. And if there is consensus, it's not science. And I believe that you and I do a pretty good job of this, you know, not perfectly but a pretty good job of being humble and accepting that human knowledge moves forward, it stretches and changes and that we should not fall into the trap of thinking that we know everything, because there is always more to learn. Ideology has a place, you know, we are nice to each other. We have laws in our society. And much of this is based on our collective ideology, which is not a bad thing. But in the realm of science and human knowledge, ideology is not helpful.
Dr Lucy Burns: (4:48) No, not at all. And one of the interests or one of the speakers was Dr Andreas Eenfeldt from Diet Doctor, which most of you who are listening to us will know.
Dr Mary Barson: (4:58) He’s a lovely guy.
Dr Lucy Burns: (5:00) He is a very humble human. And I thought one of the most interesting things about his talk, he gave a talk on how low carb nutrition works for lots of people, but there is a subset of people for whom something's not working. So as part of what he is trying to do with his business is look at, okay, well for the people for whom it's not working, what is the problem? And he's looking at satiety, which is, you know, your fullness scales and food, we know that some foods are more satiating, or have higher satiety indexes than other foods. So he's trying to develop a system that looks at that as a concept. And again, I just thought, you know what it's so, you know, again, he's got a massive, massive website, massive business, massive buy-in to that particular ideology, that low carb is the cure for everything. And yet, he's still curious enough to go, “Well, actually, it might be really helpful for lots of people, but maybe there's other people for whom a different system is going to be helpful”.
Dr Mary Barson: (6:11) I love it humble, and curious, that is the mind of a scientist.
Dr Lucy Burns: (6:16) Absolutely. So as far as, I guess, what we, you know, have been recommending, and I know that lots of you have heard us talk about our, our build a plate formula. And it's really a way of trying to just give a framework, because, oh and this was one of the other guys, one of the other speakers was a guy called Bill Schindler. I think that's how you pronounce his surname. Anyway, he is an archaeologist by profession, but also a chef. He's written a great book, which I've got, which I bought and he signed, so I was a little chuffed about that. But um, it's currently sitting on my bedside table waiting for me to have enough eyeballs to actually read it. But it was called, you know, ‘What humans eat’. And it was really a fascinating look about human diet over not just, you know, a couple of decades, but over 1000s of years. And the summary is the fact that our current society is completely separated from our food. So that we don't know how our food is made. We don't know how it's produced. We don't know what to eat. We don't know how much to eat. And we've outsourced all of that. And my lovelies, as you all know, particularly if you've ever done dieting, we do, we outsource it to systems, to points, to numbers, to meal deliveries. Yeah. And because we've lost our intuition on what to eat. Now, we do know that for some people with metabolic dysfunction, certainly the hormonal factors that do help our brain recognise satiety. So leptin in particular, you've heard us talk about that. Leptin is a hormone produced by our fat cells that tells our brain we've got enough energy on board. Now, if we have metabolic dysfunction, so we've got high insulin, we are also leptin resistant, which means our brain just doesn't hear that signal.
Dr Mary Barson: (8:19) Yeah, deaf and dumb to the sense of satiety from fat. Yeah.
Dr Lucy Burns: (8:23) But the good news is that, that signalling, that repairs quite quickly, once you reduce your insulin resistance, and as we all know, again, you can fix your insulin resistance very quickly by changing what you eat. So the summary of all of that was that okay, yes, we definitely need to get back into our food, we definitely need to be more connected with what we're eating. But again, for me, it was like, okay, so what we're teaching the low carb build a plate formula, it's actually the key, it is the key. You just pick a protein. Protein is our most satiating nutrient. If your protein comes with a little bit of fat, that's even better. And then you just add a couple of veggies. Again, whatever you like, above ground is usually more helpful than below ground. Again, if you're not insulin resistant, if you're metabolically flexible, then you can have a higher amount of carbohydrate than if you're metabolically inflexible. So you and me, Mares, who are very genetically prone to insulin resistance.
Dr Mary Barson: (9:29) Yep, we're really good at surviving an Arctic winter in, you know, 10,000 years ago. That's genetically what we’re primed to do. That's it. Yep. Thanks, genetics.
Dr Lucy Burns: (9:39) Yes. And if you're a person who you know, my favourite thing used to be, “All I have to do is look at cake and I put on weight?” Yes, if that's you, then you're probably insulin resistant and or genetically prone to it. So, again, not a bad thing, but it just means that basically, you just need to reduce your carbohydrate and focus on your protein and have a little bit of fat. And it's simple. But yet we make it so complicated, because we've lost the ability to tune into our intuition and tune into our signalling it because of this modern society we live in.
Dr Mary Barson: (10:19) That's right. I love how you don't have to count anything. You can count everything if you want to. You can count your calories and your macros and the minutes you spend fasting. You can measure your blood sugar and your ketones. You can track as much as you want, or not at all. And both ways will work.
Dr Lucy Burns: (10:39) Absolutely. And this is the thing, I think it's really about, as you all know, lovelies I have a billion favourite sayings, but one of my favourites is that you know, weight loss is a personal development journey. It's really about finding a system that works for you. If you love tracking, if that is helpful to you, then do it. If you hate tracking, if the idea of tracking fills you with dread, then don't. Like it doesn't, you know, you get to decide because you're the boss of you. I think sometimes something that is a little helpful is to just do an audit. So maybe one day.
Dr Mary Barson: (11:23) Yeah, I agree with you. I do it every now and again, so that I remember how to do it. But also it can be useful to keep in mind, especially with protein to know how many grams are in protein because that is, I think, the most important macronutrient to key in and to get right, that it can be useful to remind yourself how much protein you're eating, but carbs and fat can be useful, too.
Dr Lucy Burns: (11:47) Yes, absolutely. And in fact, so this was the, you know, one of the take-homes was, again, particularly women, because we have been conditioned in diet culture, not to eat a lot of protein, you know, we were told you have to only eat a palm sized, whatever the size of your hand is. And honestly, that's just not going to be enough. You know, for me, I've spent many, many years eating low fat, low protein, low everything. I don't know what I ate, basically buckets of chemicals that had no calories. So understanding that sometimes tracking is helpful because it helps us unlearn what we learned and what we were conditioned to believe for so long. So the end again, there's lots of protein scales, you know, you can measure protein by measuring your lean mass, well, again, we want to make it easy. So the basic rule of thumb that we suggest is one gram of protein per kilo of body weight. Now, the caveat being that if you're actually at your ideal body weight or close to it, it's actually a bit higher. So it's, it's 1.6 grams per kilo, if you're at your standard body weight, your ideal body weight. So, you know, that's actually quite a lot. Like if you're a 60 kilogram woman, and you're looking at 1.6 grams, then that's close to 100 grams of protein. So the majority of us really don't get that. If we think in particular, the idea that one egg, depending on the size of the egg, is either six or seven grams of protein. So if you're having two boiled eggs for breakfast, it's only 12 grams. It's actually not enough. If you're having a bowl of yoghurt with berries, it's probably only about 10 grams of protein, it's not actually enough. So if you're needing to have 100 grams of protein, and you're only having two meals, you've really got to be really mindful that that's actually a reasonable amount of protein to prioritise first. But again, lots of us have been told to you know, fill up on water before you eat because then you won't eat as much
Dr Mary Barson: (14:01) Some of us have been told to fill up on bread before we eat.
Dr Lucy Burns: (14:05) Yeah, yeah, yeah, absolutely. And in fact, restaurants will do that. I don't know why.
Dr Mary Barson: (14:10) It's cheaper.
Dr Lucy Burns: (14:11) It's cheap. Yeah. And you know, your plate is filled with chips and giant things that fill up, that are cheap and fill you up but actually stop you eating your protein. So one of the things I had at that at Low Carb Denver there were cafes that were selling low carb meals, because you know, they knew that all the patrons going to the conference were clearly not going to be buying bowls of pasta. And they had this great concept called a lox box. So lox is smoked salmon, in Scandinavian countries it will often be referred to as lox. So 100 grams of smoked salmon has quite a lot of protein, about 25 grams give or take. And so they had about 100 grams of smoked salmon, two boiled eggs and a little container of cream cheese, and then a little section that had some fermented veggies in it. So you know, sauerkraut or in this case it was pickled something or other. Anyway, it was so delicious. And honestly, so I counted the protein and it was actually close to 40 grams of protein for that lox box. And seriously, I had it about 11 o'clock, and I was full as full until dinner time.
Dr Mary Barson: (15:27) Yep you would be.
Dr Lucy Burns: (15:28) Yeah. So I think things like that are a really great way to just prioritise that protein and know that it will, it will definitely keep you full.
Dr Mary Barson: (15:40) Yes. And good for your body, good for your brain, good for your mitochondria. Good for every bit of you to ensure that you get enough protein.
Dr Lucy Burns: (15:51) Yeah. Interestingly, one of the other talks that was there was on time restricted eating or fasting, intermittent fasting. It was another great talk, because I know for a lot of people, they're on to the concept of intermittent fasting. But lots of people will think it's 16:8, so you fast for 16 hours, and you've got an eating window of eight hours. And some people will graze the whole time. They'll have a little meal, a bit of a snack, go forth and have something else. And the talk really suggested that, you know it’s one of our golden rules to minimise snacking. That snacking is unhelpful.
Dr Mary Barson: (16:31) Yeah, in time restricted feeding, it doesn't mean that if you have an eight hour when eating window doesn't mean that you eat continuously for eight hours, it means that you you fit your 1, 2 or 3 meals that you choose to eat that day within that eight hour window.
Dr Lucy Burns: (16:45) Yeah, absolutely. And she was suggesting that ideally, you should have five hours between your meals, to just give your gut that time to rest, to reduce, allow your insulin levels to come down. And we know that even low carb eating if you're, particularly if you're prioritising protein, you still get an insulin response. I mean insulin does, it's not just carbohydrates that will cause an insulin response, protein does too. And that's perfectly fine. We need some insulin. Remember, insulin…
Dr Mary Barson: (17:14) You would die without it.
Dr Lucy Burns: (17:16) Yeah, if you don't have any insulin you do, you cark it and that's, that's not really ideal. So we want some insulin. Protein will cause some insulin and that's not a bad thing. But you need time to allow you know, homeostasis and everything just to return, before we eat again.
Dr Mary Barson: (17:35) Spend time in the fed state and in the fasted state, that is naturally what we're designed to do. When we spend all our time metabolically in a fasted state that is when we can get out of balance and it can exacerbate our metabolic dysfunction.
Dr Lucy Burns: (17:50) Absolutely. So one of the things that we found Mares and I know that you've spoken to your patients in when you're in practice, and certainly to many of our members, is that lots of people struggle with after dinner eating. So they have the supposed last meal. And then, and then there's not. There's the second last meal.
Dr Mary Barson: (18:14) Yes.
Dr Lucy Burns: (18:15) And the third last meal. And you know, there's many, many reasons why people have after dinner, find after dinner snacking to be a problem.
Dr Mary Barson: (18:24) A large part of the after dinner snacking comes down to habits and stories in our head. Often, especially if we have eaten a meal, for which we prioritise that delicious protein, and maybe a bit of fat and our delicious veggies. We're not physiologically hungry. And yet there can be this strong need to continue eating to the detriment of your health goals.
Dr Lucy Burns: (18:51) Absolutely, absolutely. But you know, interestingly, I think, like everything that we talk about, there's both the physiology and the psychology. So for some people that do the after dinner eating comes down to the fact that they haven't physiologically given their body what it needs. And then for other people, there's the psychology of why they're not actually able to do what it is that they want to do, or what they plan to do in the morning. And you know, we often talk about this idea that everyone wakes up all enthusiastic, and they're ready and then by lunchtime, they're a bit wobbly, and then by dinner, they're even more, and then after dinner, they completely cave. So we've got a little checklist for people to be able to go through and find out what do they think is the reason that they're doing their after dinner snacking. So if that's you, if you're an after dinner snacker, and you'd like not to be, which is what we recommend, then you can download our checklist and that will point you in the direction of what may be the problem, what might be the cause. So all you need to do is go to our rlmedicine.com/snacking and you will get that checklist and then you'll be able to determine what is the cause of your after dinner snacking and then address that. Because for most of us, we don't know where to start. And we just, the only tool that we have is to hope that tomorrow will do better.
Dr Mary Barson: (20:21) I'd like to share a little anecdote with my daughter about after dinner eating. She had dinner at a friend's last night. And she came home and it was sort of like it was time for bed. It was like eight o'clock at night and I'm trying to get her into bed and she's procrastinating. She's arcing up a little bit and I’m like, “What's going on for you? Why don't you want to go to bed?” And she just puts her hands up in the air, she goes, “I'm hungry. I didn't eat enough protein at dinner.” So even though it was bedtime, I was like, “Okay.” I felt very proud that she had recognised this. I was like “Okay you can have some after dinner protein because you need to have more protein with your dinner.”
Dr Lucy Burns: (21:01) Yeah.
Dr Mary Barson: (21:02) Yep. She's cued in. .
Dr Lucy Burns: (21:05) Absolutely, absolutely. And I love that because that's it. She's, so she is really tuning into her signals. And you know, you've taught her to be able to recognise what actually is her body trying to tell her? Most of us have no idea. No idea and no tools. We feel that our only tool is, “Do better. I'll do better tomorrow.” And that's our tool. We just give ourselves sometimes a very, very stern talking to which again, as we all know, not always helpful.
Dr Mary Barson: (21:33) Yes, yeah. And tools are essential because so many of us want to change. So many of us can be ready to change and know why we want to change but without the actual tools without knowing how it is very difficult. But it is entirely possible to learn how. It's a skill set that you can learn like any other.
Dr Lucy Burns: (21:56) Absolutely, absolutely. Everything is learnable. I love it. Everything is learnable. So gorgeous ones if you want to identify why you might be eating after dinner, just download our checklist on rlmedicine.com/snacking The link will be in the show notes and we will see you all again next week. Take care, gorgeous ones. See ya. So my lovely listeners that ends this episode of Real Health and Weight Loss. I'm Dr. Lucy Burns,
Dr Mary Barson: (22:33) and I'm Dr. Mary Barson. We’re from Real Life Medicine. To contact us, please visit https://www.rlmedicine.com.
Dr Lucy Burns: (22:43) And until next time, thanks for listening. The information shared on the Real Health and Weight Loss podcast, including show notes and links provides general information only. It is not a substitute, nor is it intended to provide individualised medical advice, diagnosis or treatment, nor can it be construed as such. Please consult your doctor for any medical concerns.