Contents

1: Diets Are Failing

2: Energy Balance and Why It Matters

3: The Body’s Self Defense System

4: What Really Works?

5: Flexible Dieting

6: Where to Start: How Many Calories?

7: The Macronutrients: What You Need to Know

8: Determining Your Macronutrient Intake

9: Defending Against the Self Defense System

10: You’ve Started… Now What?

11: The Diet AFTER the Diet

12: The Ketogenic Diet

13: Special Considerations

14: Debunking the BS

15: Supplements

1: Diets Are Failing

Currently, some of the more popular diets are the Blood Type diet, Alkaline Diet, Paleo Diet, Carnivore diet, Ornish diet, Atkins Diet, Snake Diet, The Zone diet, South Beach diet, The Ketogenic Diet, The Mediterranean Diet, etc. A lot claim ridiculous reasons for why they work, when the reality is they all tend to address the same concepts (more nutrient dense foods and lower calories). Dieting is seen as controlled starvation, and it activates self-defense systems in the body.

1. Defend – Prevent further weight loss (during the diet aka weight loss plateaus)
2. Restore – Increase the rate of weight regain once sufficient energy is consumed (post-diet)
3. Prevent – Decrease the probability of losing weight in the future.

As the cells start to shrink during an energy deficit, the adipose tissue cells reduce their secretion of leptin. This reduces metabolic rate (calories out), increases hunger (calories in), and tries to drive the body back towards the set point by swinging the body’s caloric balance to a positive direction. During a caloric surplus, fat cells expand and leptin secretion increases, which increases metabolic rate, decreases hunger, and drives calorie balance in a negative direction to bring the body back down towards your body fat set point.

Not only are you storing fat more efficiently during the post-diet, but your hunger increases due to lower levels of leptin, insulin, neuropeptide Y, as well as increased secretion of ghrelin. You can also gain new fat cells if weight gain is too fast.

2: Energy Balance and Why It Matters

Calories are a unit of measurement of heat. If a label says 100 calories it actually means 100 kilocalories and 100,000 calories. One calorie is the amount of energy required to heat up one gram of water by one degree Celsius.

Adipose tissue is made up of adipocytes, which are cells that store massive amounts of fat in the form of triacylglycerides (TAGs). You can also store energy from carbs in the form of glycogen, but this storage is limited at around 300-400g in the liver and 400g in skeletal muscles. At around 4000kcal of stored energy. Carbs contain 4kcal of energy per gram. An average sized male, 80kg and 15% bf would be 12kg bf or 12,000g. That would be 94,000kcal of energy. Gluconeogenesis is the way the body stores glucose from non-carb sources like amino acids, in the liver. 60% of the aminos are gluconeogenic. The carbon backbones can be used to form glucose when the nitrogen is removed. Glucose can also be converted to fat via de novo lipogenesis (DNL), which occurs in the liver and adipose tissue. A small contribution to total bf storage.

The amount of dietary fat you store depends on the amount of carbs you eat. Carbs increase insulin release which impairs lipolysis and fat oxidation. Your body will preferentially oxidize glucose, sparing dietary fats for storage in adipose. If you eat high fat, low carb, you’ll burn lots of fat, because carbs and insulin will be low, which increases the rate of lipolysis and fat oxidation.

• Fat = Fat Storage – Fat Oxidation
• If Storage > Oxidation = Energy Surplus
• If Oxidation > Storage = Energy Deficit
• If Storage = Oxidation = Energy Balance

Calories Out is based on 4 components:

1. Basal Metabolic Rate (BMR)
2. Non Exercise Adaptive Thermogenesis (NEAT) and Non Exercise Physical Activity (NEPA)
3. Exercise Activity (EA)
4. Thermic Effect of Food (TEF)

Total Daily Energy Expenditure (TDEE) = BMR + NEAT + EA + TEF

The dissipation of energy is already accounted for in the calories out side of the equation, since NEAT includes it. The thermal effect of protein is 20-30%, carbs are 5-10%, and fats 0-3%. Protein may have such a high thermal effect due to its role in muscle protein turnover and protein synthesis. This requires ATP to accomplish. Fiber also affects the net calorie of carbs because it is non-metabolizable. Both fiber and protein being satiating too. In saying that, the TEF is only 15% so you can’t eat all the protein you want and expect to lose fat.

3: The Body’s Self Defense System

The end product of macronutrient metabolism is adenosine triphosphate (ATP), water, and carbon dioxide. Thermogenesis refers to the production of heat through dissipation of energy. Most of this occurs in the mitochondria through the activity of uncoupling proteins. These proteins cause “uncoupling” of the mitochondrial membrane, which makes ATP production less efficient, and the wasted energy is given off as heat. Production of ATP is powered by ATP synthase, which is located in the inner membrane and catalyzes the production of ATP from ADP + Phosphate ion. In order to drive this reaction, a hydrogen ion gradient is created by pumping out hydrogen ions from the inner mitochondrial membrane. This gradient then drives ATP synthase. Uncoupling proteins make this inefficient by making the membrane leaky, so that the hydrogen ion gradient is dissipated, less ATP is produced, and the dissipated energy is given off as heat. Thus, increased thermogenesis means more calories are burned.

The more severe an energy deficit the more proportional the body’s defense mechanism to it. A yo-yo dieter will cause a stronger reaction than somebody going on a 2-week diet.

The 3 factors that influence the defense response are:

1. The severity of the energy deficit.
2. How long the deficit is imposed.
3. How frequently the deficits are imposed.

In people who yo-yo diet, their BMR is much lower than it should be. The body overreacts to dieting. The reduction in BMR during dieting is about 15% decline below predicted on average. Usually due to the reduction in lean mass. NEAT is probably the component with the greatest adaptation. Dieting also reduces the amount of energy expended during exercise. When you’re dieting you may be constantly cold. The body adapts by increasing mitochondrial efficiency so that you’re able to produce more energy and less waste from the food you eat. Reduction in uncoupling proteins which usually cause extra energy to be given off as heat (UCP increase seen in BAT during cold exposure).

As fat cells decrease in size, they reduce the amount of leptin released, reducing hunger control. Leptin levels can reduce after dieting even after the diet has ceased. T3 lowers and TSH increases, lowering the BMR. Also, reduced sympathetic nervous system tone. Ghrelin increases, cortisol increases, PYY, CCK, and GLP-1 (anti-hunger hormones) decrease. Neuropeptide-Y and Agouti-related peptides in the brain increase. More energy is desired than required. Insulin levels decline during caloric restriction. As fat cells shrink, they become more insulin sensitive, thus less insulin is released to dispose the glucose and drive fats into adipose. Adipose tissue then becomes really good at sucking up glucose when it is so insulin sensitive.

When you increase food intake after dieting, your body more efficiently stores it as fat compared to lean body mass (LBM). Fat is preferentially stored in the trunk and LBM in the extremities first. LBM in the trunk has a greater effect on metabolic rate compared to LBM in the extremities. Does this mean compound lifts will have an even greater effect?

Adipose tissue can integrate hormonal signals and release hormones, like leptin called “adipokines,” which communicate with other tissues of the body including the brain. Weight loss places a strain on the extracellular matrix of adipocytes, which results in altered metabolic profile that favors weight regain to relieve the stress and strain on it. Massive refeeding after diet results in small fat cells called pre-adipocytes. Which has been shown to increase the total fat cells by 50%. You can turn old cells over but only about 8-10% per year.

Low T3, increased TSH, low leptin, low insulin, decreased SNS tone, and reduced fatty acid oxidation creates an environment that favors pre-adipocyte differentiation into fully formed adipocytes when subjects engaged in rapid weight regain in the post-diet period. T3 and SNS have an inhibitory effect on PreAd diff but they’ve been decreased early on in the diet. Essentially, famine creates desperation and that desperation overrides the adipocytes’ ability to use fat oxidation and glucose clearance and just packs fat and creates new cells. No more wastage. Next time we try to lose weight the body will defend a higher bf set point.

4: What Really Works?

Sustainability and dietary adherence are by far the most important factors in losing weight and keeping it off. Diets must accommodate your social life as sustainability is about physiology, psychology, and sociology. Self-control is fatiguing. People blow their weight loss goals when stress is high. Never leave your results up to pure willpower.

Characteristics of a successful dieter:

1. Cognitive restraint in some form. While it’s important to pick a strategy that requires minimal willpower and sacrifice, every diet requires some level. Decide what you want to sacrifice but don’t make it too difficult.
2. Self-monitoring. Measure your intake and you’ll have better chances of being in control. If you are measuring your weight daily, average it out across the week to avoid neuroticism.
3. Regular exercise. Exercise has been demonstrated to lower the body fat set point. 30min a day, 3x per week of rigorous exercise is enough to provide benefits. It also decreases the expression of lipogenic genes that may be increased from dieting. It also traffics excess nutrients away from energetically efficient storage mechanisms and towards more costly ones., decreasing likelihood of storage. It also seems to provide better satiety signals post diet, reducing caloric intake. Your BMR typically doesn’t return to normal until after pre-LBM lost during diet is back up to normal levels. Based on information from Burn, I’m assuming this result is due to increased LBM increasing total NEAT, rather than caloric expenditure from the exercise.
4. Structured Programs. Successful dieters tended to participate in structured programs more so than those who couldn’t keep the weight off. Adherence may increase due to increased confidence.
5. Ability to focus on the long-term goal. Dieters who lose weight and keep it off don’t focus on quick fixes. They likely have low recency and focus on the long-term goal.
6. Social Support. Compliments and active participation produce favorable outcomes, whereas instruction seems to have a negative impact.

Other characteristics:

• Eat lower-calorie foods
• Consume high protein
• Consume high fiber
• Flexible control of diet versus rigid controls (all or nothing thinking)
• Consume lower GI sources of carbs
• Limit snacking
• Limit stress
• Eat mindfully
• Don’t eat in response to stress or emotions
• Don’t stay up late
• Satisfaction with results
• High emotional intelligence and mindfulness

Strategies and recommendations:

• Track food intake. Write down with a pen and paper, take a picture, Calorie/macro count using an app.
• Make it hard to eat energy dense foods. Eat at home and keep calorie dense foods out. You’ll know what you’re putting in and you’ll know whether you actually want the food items you’re eating. So, you have to walk or drive to get the crap foods. Always keep eggs, rice, tofu, legumes, veggies, chicken, and apples on hand.
• Measure your food.
• Planning and structured flexibility. Regularity of meals. Limiting variety actually reduces cravings. People who have a day off tend to overindulge and ruin their week’s work. You can overcome a binge with planned fasting, eat protein and fiber until the meal, pick out what you want ahead of time.
• Fasting can be useful but protein intake is difficult to accomplish, which impacts muscle mass and limits growth.
• Consistency, habits, and your life. Consistency allows Maslow’s hierarchy of learning to lead from Unconscious incompetence to Unconscious competence. Ensure adequate protein to increase the drive to eat and have the diet tailored to preferences. Maintain satiety.

5: Flexible Dieting

Taking into account your social cultural, religious, and political ideologies.

Allowing you to enjoy the things you like with little restriction.

Prioritizing good food choices.

Not delineating between “clean” or “dirty” foods.

Think of your macros as a budget. If you have a fast metabolism, you have a bigger budget. Eating a chocolate bar is like buying a sports car (256 calories, 4g protein, 33g carbs, 12g fat). A massive waste of money unless the positive effect of joy outweighs the waste and you must be able to afford it. Processed foods are associated with heart disease because they are highly palatable and easy to over consume. So, the negative health effects are mostly because of the overconsumption rather than “chemicals”.

• Eat enough fiber
• Eat enough protein to encourage tissue growth
• Eat enough fat to keep hormones in check
• Eat enough carbs because you like them and provide you with energy
• Or don’t since it’s flexible

Do what you want, just be in a caloric deficit and do something that is sustainable and consistent.

6: Where to Start: How Many Calories?

If you’re going to eat 2200 calories per day to lose weight it makes more sense to get those calories from protein, fiber, or something else with a high TEF.

Fat Mass (FM) = Body weight x body fat percentage

Lean Body Mass (LBM) = Body weight – Fat Mass

• LBM includes bone, organs, hair, fluids, and connective tissues.
• To measure BF use calipers, BIA scales, DXA scans, underwater weighing, Bod Pod, or the Navy BF measurement of age, sex, waist, hip, and neck measurement. Just be consistent.
• Salt, water, diet, hormones, sleep, etc. can affect measurements.
• Weigh every day then average the week.

Revised Harris – Benedict (Roza):

• For men the revised equation is: 88.362 + (13.397 x bodyweight) + (4.799 x height) – (5.677 x age) = BMR

Muller Equation:

• (13.587 x LBM) + (9.613 x FM) + (198 x Sex) – (3.351 x Age (1 for male and 0 for female)) + 674 = BMR

For TDEE your times the BMR by your activity rating:

• 1.2 Sedentary
• 1.375 Light activity (work)
• 1.55 Moderate activity (sedentary job but workout)
• 1.725 Very active (Train hard most days and work on your feet)
• 1.9 Extra active (train hard, work hard)

These equations aren’t gospel. Work it by trial and error.

If you ate 2400 calories per day and lost a kg – 1kg of lipid is 0.87kg of body fat. 1g of fat = 9 calories. So 870g x 9cal = 7830 calories per kg of body fat lost. So, if you lost a kg in 28 days that would be 280 calories per day. Add that 280 cal back to the 2400 and that would be maintenance.

Now for gains:

• If you gained 2.5kg by eating 3600 calories, with 1/4 being LBM.
• 2.5kg x 0.25 = 0.624kg LBM and 2.5 x 0.75 = 1.875kg BF.
• LBM is not 100% protein. About 70% is fluid and 30% lean tissue.
• 0.625kg LBM x 0.3 = 0.1875kg of protein. 0.1875kg x 1000g/kg = 187.5g of protein x 4 calorie/gram of protein = 750 calorie from LBM.
• 1.875kg BF x 0.87 = 1.63125kg of fat/lipid. 1.875kg x 1000g/1kg of fat = 1.631.25g fat x 9 calorie/g of fat = 14681 calories from body fat.
• So, total calorie surplus = 14681 + 750 = 15431. 15431/28 days = 551 calorie/day surplus
• 3600 – 551 = 3049 for the approx. maintenance calorie level.
• Alternatively, you can assume there are approx. 7000 calories in each kg of mass or 3500 per pound.

How Fast Should I Lose Fat?

Many experts recommend a Very Low-Calorie Diet (VLCD) to induce rapid weight loss and increase motivation and adherence. This is short-sighted. Dieting triggers metabolic adaptation to reduce metabolic rate so weight loss will slow and weight gain will increase when the diet is finished. It is better to lose no more than 1% of total body weight per week. The slower the better. However, if too slow it will be demotivating and increase “mental fatigue.” 0.4-0.8% of bw per week is ideal.

Most studies show that 60-70% of weight loss is FM and 30-40% is LBM. Increasing protein intake and exercising (resistance) can shift that towards LBM retention. The higher the original bf % the higher the ratio of fat to LBM. If <11% FM the ratio is about 50/50.

To determine your diet, you will need to work out the following:

1. Fat Mass and LBM

• a) Fat Mass = total body weight x BF%
• b) LBM = total body weight – fat mass (calculated above)

2. How much BF will need to be lost

• a) BF% loss required = Current BF% – target BF%

3. Fat mass loss required

• FM loss required = total body weight x BF% loss required

4. Approx. total body weight loss required

• Total body weight loss = fat mass loss required/approx. % of weight loss from FM

5. Choose rate of loss (0.4-0.8% per week with 1% max)

6. Determine weight loss per week

• Weight loss per week = total body weight x rate of loss % from step 5.

7. Determine required deficit duration

• Deficit duration = total body weight loss (step 3)/weight loss per week (step 6)

A 0.4% loss is the lower end because the calculations are estimates. The metabolism is not a closed system so it is better to go over than be too conservative just in case you lose nothing. There is probably a calorie threshold. The calculations are a starting point.

Determine Starting Daily Calorie Intake

1. Rate of weekly loss: 0.4-0.8% bw per week with a max of 1%

2. Weight loss target (in kg) per week by multiplying total bw by the % in step 1.

3. Average daily calorie deficit by multiplying weekly weight loss target by approx. multiplication factor.

4. Approx. maintenance calories

• a) Using weight and food tracking by hand
• b) Using maintenance calorie calculators listed previously

5. Average daily calories

• Maintenance – average daily deficit

7: The Macronutrients: What You Need to Know

Protein

Protein is made up of amino acids linked together, and proteins mediate countless important processes in the body. Hormones like insulin, growth hormone, IGF-1 are proteins. Same with enzymes and kinases (cellular signaling complexes), transporters, ion channels, etc. Their functions are based on their 3D structures and how they fold – and how they fold is based on their amino acid sequence. It folds into the lowest energy conformation and energetically stable form, which establishes its biological activity. Consuming protein is tissue turnover. 9/20 aminos are essential because we don’t produce them. Ingestion of sufficient dietary protein stimulates muscle protein synthesis, improves recovery, can increase LBM when combined with resistance training, and helps grow strength. The anabolic effect of protein appears to mediated by the amino leucine.

Leucine stimulates a complex in muscle called mTOR (mammalian target of rapamycin), and this initiates a signaling cascade that increases muscle protein synthesis. Leucine is an essential amino acid, not extracted from the gut and liver on first pass metabolism, and has a concentration-dependent, passive diffusion across the cell membrane. So, the amount of it in the cell reflects the quantity in the diet. However, it only increases MPS in the short-term. You need all the essential aminos for it to be sustained.

The thermal effect of protein is 30% more than carbs. Protein turnover is an energy dependent process that requires ATP. It also may activate the “futile cycle” where synthesis and protein degradation both increases, leading to greater dissipation of energy. The act of preserving LBM during diet is important as it slows the drop in metabolism. Better maintenance of metabolic rate. They are also more satiating because they are not very energy dense (voluminous) and it triggers a signaling favorable for satiety in the brain. Whey absorbs faster than casein so has a faster detectable change in amino acid blood concentration. High protein increases anorexic hormones like GLP-1, glucagon, CCK, and PYY.

Carbohydrates

Carbohydrates aren’t essential for survival but they still have benefits. They come in monosaccharides (single-sugar molecules like glucose, fructose, and galactose), disaccharides (two-sugar linked like glucose and fructose), oligosaccharides (short chain saccharides and include disaccharides), and polysaccharides (complex carbs like starches). During digestion they are broken down into their constitutive saccharides and enter circulation as monosaccharides. All carbs except fiber end up as sugar in the body.

Glucose is the most crucial and we need 100-120g per day (liver can make that much without glucose through gluconeogenesis). RBC need it because they can’t use fat or ketones without mitochondria. The brain will exclusively use glucose unless fasting. Glucose can be stored in the liver as glycogen and muscle. It is used for high-intensity anaerobic exercise because ATP can’t be created fast enough from fats and oxidative respiration cannot proceed without sufficient oxygen. When carbs are ingested, insulin is released to shuttle glucose into tissues like muscle, liver, and fat. Glucagon and cortisol can oppose it by liberating glucose from cells or stimulating gluconeogenesis. When blood sugar is too high is can be toxic to blood vessels and endothelial cells. When low, nausea, fainting, coma, etc. Insulin also helps to take in amino acids and lipids, particularly in peripheral tissue. It also inhibits lipolysis and fat oxidation. Carbs actually contribute very little to stored fat. They just inhibit fat oxidation and lipolysis.

Fat

Fat comes in forms such as fatty acids, oils, waxes, and steroids. Lipids are essential nutrients because our bodies cannot synthesize essential fatty acids. Fat forms the lipid bilayer of cells, regulate membrane permeability, a source of fat-soluble vitamins, and a storage reservoir for energy. Lipids are unique compared to carbs and protein as they’re absorbed through the lymphatic system as chylomicrons vs the small intestine via pancreatic enzymes and through the intestinal lumen into the liver (carb and protein).

Chylomicrons are lipoproteins, which are what the body uses to package lipids for transport. LDL (low density lipoprotein), HDL (high density lipoproteins), and VDLs (very low-density lipoproteins). All made by your liver for transport. The nomenclature refers to size. LDL large vs HDL small.

Saturated fats are solid at room temp and unsaturated are liquid. These refer to the absence (saturated) or presence (unsaturated) of a double bond in the fatty acid chain. Fatty acids are long chains of carbon and hydrogen (acyl group) attached to a carboxyl group that is acidic. Monounsaturated fats (MUFAs, which have multiple double bonds) and polyunsaturated fats (PUFAs have multiple). These double bonds are called kinks in the fatty acid chain. Trans fats are unsaturated fats with a trans bond instead of cis. To make them you need to pump hydrogen into unsaturated fats. Trans doesn’t create a kink like natural cis bond unsaturated fats do. Don’t touch them. Best bet is PUFAs. Keep fats at an optimal level to maintain a healthy hormonal level. If you lower your fat intake to less than 20% of you daily intake, your test may drop. Although, more fat doesn’t equal more test.

Fiber

Fiber falls under the carb title. It is the portion of carbs that can’t be completely broken down by digestive enzymes. Soluble fiber (fermentable) and insoluble. Soluble includes fructans, pectins, polydextrose, lactulose, xylose, and others. While not completely broken down in the GI tract, soluble fibers can be readily fermented by the colon, producing short-chain fatty acids and gas. This is why veggies make you fart. It also adds bulk to food, causing regular bowel movements and modulating gut transit time. Insoluble includes cellulose, hemicellulose, lignins, xanthan gum, resistant starches, and others. Dietary fiber improves blood glucose and insulin sensitivity, lowers cholesterol, improves blood lipids, weight loss, and satiety. Also, more metabolizable energy than normal carbs. 50-80% of normal. Although, that depends on source and microbiome.

Alcohol is nearly as dense as fat (7kcal/g). Consuming large amounts inhibits protein synthesis and fat oxidation. Also, suppresses testosterone.

8: Determining Your Macronutrient Intake

A study showed 4.4g/per kg of protein preventing fat gain even though 300cal over their daily intake. 2.2g per kg is a good gauge unless you are obese. That is because your overall weight will have a high percentage of body fat which doesn’t require much protein. Adding 1.5% protein every year after 30 helps to reduce sarcopenia. Especially during a caloric deficit.

Once protein calories are taken into account, the fat and carbs are left. If you eat more of one you tend to eat less of the other. Fat is more satiating than carbs per gram but about the same per calorie. Then again carbs have fiber which may give them the edge. Fats don’t need insulin to be stored in adipose. Acyl carrier protein (ACP) can do it with no insulin increase. Fats remain elevated in the bloodstream longer than carbs (from 8-10 hours). A good starting point for carbs to fats is 60/40 after deducting protein calories.

1. Determine total average daily calories
2. Determine protein intake
3. Subtract calories from protein from total daily average calories
4. Distribute remaining calories to carbs and fats as per your preference
5. Divide carb calories by 4 and fat by 9 to determine daily carb and fat gram intakes.

9: Defending Against the Self Defense System

Some people like to eat fewer calories during the week so they can have a larger calorie day. This is fine as long as that day doesn’t exceed double the other days. These are considered refeeds. Refeeds are structured and planned unlike cheat meals.

Another option is a diet break period where you eat maintenance calories. This number will change as your body weight changes so you’ll need to recalculate with the Muller equation. Some people enjoy a 2-week diet with a one-week diet break. It can be customized depending on your goal. There is no reason why you can’t combine it with refeeds either. It’s best not to do more than 4 weeks consistent dieting.

A problem with cheat meals is that it can trigger a disinhibition reflex.

10: You’ve Started… Now What?

Body Weight:

It fluctuates a lot but the weekly average will tell a better story. To minimize variance weigh yourself naked, in the morning, after the bathroom.

Body Fat Measurement:

Also volatile with changes in fluid retention. Just be consistent.

Pictures:

They are good for seeing how far you’ve come.

Circumference Measurements:

Also variable but helpful. Widest part of hips and waist.

Subjective Feedback (1-10):

• Did I adhere to my macro targets, training, and cardio?
• How is my energy?
• How is my strength?
• How are my hunger levels?
• How is my mood?
• How is my stress?
• How am I sleeping?
• Am I on my period?

Typically, weight loss plateaus happen every 2-12 weeks depending on the individual, their metabolic rate, how significant the caloric deficit, how lean they are in the beginning, and how adaptive their metabolism is. Don’t make a change until body weight, BF, pictures, or circumference don’t. If you plateau you decrease calories and/or add in more exercise.

Nutritional Adjustments:

The longer you diet, the more your metabolism adapts, and the lower your TDEE calories become. If you aren’t losing weight or body fat, you aren’t in a deficit.

However, the following situations may cause a “false plateau”:

• Menstrual cycle
• Excessive stress (some people under enormous stress retain a lot of fluid)
• Consistent lack of sleep.
• Illness creating a large immune response that increases total body inflammation and causes greater water retention and increased body weight
• Injury causing an acute increase in inflammation, which may increase water retention and body weight
• Lack of adherence. Most people will not be honest with themselves about their lack of progress. If you don’t follow your fat loss plan consistently, it will not work.

Layne found that reducing the client’s carb and/or fat intake by 5-15% (depending on the plateau) weight loss appears to continue. It’s best to try to only lower the low-calorie days. People who abuse this system and starve themselves on their low days so that they can gorge on their high days tend to struggle. Becoming sluggish, angry, and weak. Only reduce the calories as much as you have to in order to keep weight loss consistent and sustainable.

Exercise Adjustments:

As with calorie adjustments, you can increase your exercise time by about 10%. As long as you aren’t already overdoing it. Find a sustainable method that you enjoy.

Oops, I Screwed Up:

When life throws a curveball, we occasionally mess up. If you have tracked your calories, it makes it easier to subtract the following days to compensate for your overindulgence.

If you’re having frequent emotional binges, you should speak to a counsellor or some other sort of practiced professional.

Consistency trumps perfection.

Summary

Track accurately, make changes when you need to, wait a week before judging results, be consistent with your changes (don’t increase exercise or decrease calories again the following day), be patient.

11: The Diet AFTER the Diet

Ask yourself the following:

• Am I happy with how I’m eating in the context of my lifestyle?
• Can I keep living this way?

If yes, keep eating at your maintenance level. Just keep in mind that your starting maintenance calories will be different from your current maintenance. The rule of thumb is: the more weight you’ve lost and the longer the diet, the more your BMR will have declined. You may gain a bit of weight back but you should be armed with your new knowledge to counter it.

Alternatively, recalculate your new TDEE for your current maintenance. Take the amount of weight you’ve averaged losing over the past four weeks, multiply it by the caloric factor in the table, and that would give you the number of calories you need to add to your current intake to reach your current maintenance calories.

• An example of a guy who got down to 85 kilograms at under 10% body fat and wanted to determine his maintenance. He could use a calculator, but he knows that he’s been losing approximately 0.6 kilograms per week on his current intake of 1770 calories per day. We multiply 0.6 × 834 kcal/d (he’s under 10% body fat, lifts weights, and is on a high-protein diet) = 500.4 calories rounded to 500. He would then add 500 calories to his current deficit calories of 1770 to get 2270 for his current maintenance calories.

Athletic individuals may stall in their weight loss progress, even if they are under-fueling. Too few calories can actually be the problem. The body uses the calories to exercise but fails to supply the other bodily systems (immune system, thyroid, menstruation, reproduction, mental alertness and learning, hair and nail health, emotional regulation). Injuries are common with these individuals.

Reverse Dieting

“A strategy of dieting where calories are increased in a controlled manner over time to increase metabolic rate while minimizing body fat gain.”

The purpose is to increase your metabolic rate so that you can either maintain your current body composition on a higher calorie intake, or lose weight more effectively in the future.

Some people absolutely thrive on reverse dieting. They’re able to increase their calories while maintaining or even dropping weight in some cases. Others gain small amounts of weight, and others gain more weight.

Somehow by adding calories slowly, the energy gap isn’t “sensed” by the body, and the extra calories are favorably dissipated as heat through adaptive thermogenesis and NEAT versus being stored in adipose.

Where to Begin – The Initial Post Diet Phase

If you lost weight for an event, it is recommended to reach your goal weight early so you can spend a few weeks on the maintenance phase. This way you won’t gorge as much and you’ll be able to bring your metabolic rate up a little.

Plan:

1. Initial caloric intake: Start your post-diet with your current maintenance calories as a minimum. If you’re done losing weight, there’s no reason to keep yourself perpetually in a deficit. But understand that your current maintenance will be much different than your predicted maintenance, because your metabolism has adapted.
2. If you want to avoid gaining body fat, stay at your current maintenance level.
3. If you’re okay with potentially gaining some body fat as a trade-off for having higher calories and feeling less hungry, then try adding an additional 10% to 20% carbohydrate and fat to your maintenance level. If your protein is already sufficient, you don’t need to increase it. In fact, your protein needs are actually lower when you add calories.
4. If protein is sufficient already then you can keep it the same, or decrease it slightly. However, you can keep it the same if you enjoy protein and find that it helps keep you satiated.
5. Remaining calories from carbohydrates and fats can be distributed. Sustainability and adherence are all that matters. However, due to low rates of fat turnover in adipose cells after caloric restriction, there is some evidence that increasing carbs preferentially to fats may help reduce fat gain in the immediate post diet period. That’s because carbohydrates are preferably oxidized, while lipids are preferentially stored in adipose due to significantly reduced rates of fat oxidation. 

High Days/Refeeds During Maintenance or Reverse Dieting

If you want flexibility in your week (like weekend splurges) factor in your calories on said high days. Just make sure the other days will compensate for them. There is no metabolic advantage to caloric cycling, so just do what suits your lifestyle. If you fall off the wagon, account for it. Just don’t go into “fuck it” mode.

Where to Begin – Exercise

You should still exercise with purpose and intensity. If the intensity goes down, increase the volume. Exercise increases your sensitivity to satiety hormones and increases turnover in the fat cell. Just be aware that it is quite difficult to exercise enough to counter a terrible diet. You will hit a limit on how much you can exercise anyway. Sustainability all day long.

Continuing the Reverse

Weekly check ins and monitor the same data.

Unless your average weight increases by more than 0.2-0.5% add reasonable amounts of calories every week. Otherwise err on the side of caution and add conservative numbers of calories.

• Conservative: 2-5%
• Moderate: 5-8%
• Aggressive: >8%

Aggressive is for people who may be feeling exhausted from dieting. Just don’t go over or become chaotic with your changes. You don’t want the yo-yo diet effect. Go by feel.

If your weight goes outside your “acceptable” range over a few weeks, slow or stop your calorie increase. Make better health choices and you should be able to lower the calories too.

Ending the Reverse

Drop the calories by ~5% and stay there for as long as you like.

Focus on the long term. Eat enough so that weight loss is easier in the future. If you’ve been a yo-yo dieter in the past it may take years to push your TDEE up. You just need to be consistent and track to fix it.

Beginning Another Diet: Where to Start?

Many people mistakenly believe that since they reversed very slowly, they should move at the same slow pace to drop calories. But this is a big mistake, because your metabolism will simply adapt in the opposite direction. If raising them slowly causes minimal fat gain, then lowering them slowly will also cause minimal fat loss, because your metabolic rate will drop as you lower calories. You need to make enough of a drop to actually trigger a response from your body.

Drop at least 0.4% body weight per week by adjusting calories to suit.

What If I Already Screwed Up?

When the pain of staying the same becomes greater than the pain of change, that is when we change.

If you’re maintaining your weight on a lower level of calories than you like, but not lower than the specified thresholds, it’s okay to attempt to lose some fat first before you begin a reverse diet. But you should only attempt this weight loss if you acknowledge that it’s simply to help motivate you in the short term, and you will have to do the work to restore your metabolism after you’ve lost whatever you want to lose.

Think long-term and stop panicking about needing to lose weight immediately. That kind of mentality is probably what got you there in the first place. Break the cycle.

Summary

• Have a plan for the diet after the diet
• Do not YOLO (you’re only lean once)
• If you’re happy with your current body fat level and maintenance calories, then stay at your current maintenance indefinitely and enjoy
• If you’re happy with your current body fat levels but not happy with your current maintenance calories, reverse diet
• If you’re unhappy with your current body fat levels and your calories, then you need to decide if dieting or reverse dieting is more appropriate based on the minimum threshold calories described in this chapter
• Reverse until your calories reach a level you’re happy with, and then stay there if you’re happy with your body fat levels
• Reverse until your actual maintenance calories at least match your predicted maintenance calories before attempting another big fat loss phase (preferably 10% to 20% more than predicted calories)

12: The Ketogenic Diet

It has its purposes and can be used to sustainably lose weight. The issues arise when zealots tell everybody that it’s THE way to do it. All that matters is adherence and reduced caloric intake. Exceptions being those who don’t respond favorably to a high fat diet. Genetics and the microbiome may come into play here.

History

Fasting was likely a condition that our ancestors experienced on a relatively regular basis through the greater part of the past 70 thousand years. If they lacked foods highly enriched in carbs, they would be able to rely on their fat stores to survive. 

It wasn’t until the 1900s that fasting ketosis was medically explored in patients suffering from the burden of epilepsy.

Today, the ketogenic diet has been explored as a therapeutic tool against a variety of conditions ranging from rare metabolic disorders to neurodegenerative diseases, diabetes, cancer, and weight loss.

What is the Ketogenic Diet?

The definitive goal of the diet is to enter the metabolic state of ketosis, where the body transitions from burning glucose as the primary fuel to burning fatty acids and ketones. Most people following a “keto diet” for weight loss seldom achieve, much less sustain, a state of ketosis. Ketosis itself is defined by an elevation of blood ketones (beta-hydroxybutyrate; BHB) above 0.5 millimoles per liter; getting to 0.5-3.0 millimoles per liter is optimal.

Variations of the Ketogenic Diet

The classical ketogenic diet equates to roughly 90% of your calories coming from fat, relatively low in protein (6% to 9%), and next-to-no carbohydrates (0% to 4%).

Modified versions of the ketogenic diet can range from:

• Carbohydrates: 0-10% (ideally fibrous veggies)
• Protein: 15-35% (ideally fatty meats and fish)
• Fat: 65-85%

Generally speaking, the daily macronutrient recommendations are:

• Carbohydrates: no more than 50 grams total
• Protein: 1-1.5 g/kg LBM (1.8 g/kg may be more optimal under some conditions)
• Fat: remaining daily calories or to satiety (ideally counting macros, which shouldn’t be surprising at this point)

Understanding How the Body Enters Ketosis

1. Within the first one to 12 hours, you’ll burn through most circulating or previously ingested glycolytic fuel. The length depends on the type and amount of foods ingested.
2. The body will next tap into its stored liver glycogen to sustain blood glucose levels for up to 12 to 24 hours, via glycogenolysis.
3. Upon liver glycogen depletion, gluconeogenesis increases to supply glucose for the brain, primarily from gluconeogenic amino acids in muscle or dietary protein. Gluconeogenesis is typically elevated for a week or more following transition into nutritional ketosis.
4. Gluconeogenesis overlaps with ketogenesis, which is typically elevated after three days (less than 0.5 millimolars). Glucose is progressively spared for the brain by the prevention of glucose utilization in tissues such as muscle and adipose. Reduced insulin and increased glucagon lead to a high glucagon-to-insulin ratio, upregulating the fat oxidation machinery required for the production of ketones in the liver, as well as the liberation of free fatty acids from adipose to the liver. Free fatty acids are then converted to acetoacetate and beta-hydroxybutyrate and exported to peripheral tissues. Liver and muscle can use free fatty acids as fuel directly. The glycerol backbone liberated from triglycerides serves as a gluconeogenic substrate in the liver.
5. As you sustain ketosis, your reliance on glucose for fuel diminishes, ketones are preferentially taken up by the brain (fewer cravings for sugar), muscles will primarily use free fatty acids, and the liver will be poised towards ketone production and gluconeogenesis.

Ketone Bodies

There are two primary ketone bodies produced in the liver: acetoacetate (AcAc) and beta-hydroxybutyrate (BHB). A greater abundance of BHB is favored, accounting for ~78% of total ketones. AcAc is the primary intermediate between the production and utilization of ketones for fuel; BHB is produced from AcAc and converted back to AcAc before being used for energy. Acetone is produced by the spontaneous breakdown of AcAc and is mostly excreted through our urine and breath.

Insulin

• The presence or absence of insulin has the power to dictate whether we use glucose for fuel or fatty acid and ketones, respectively. When carbohydrates are restricted, and as a consequence insulin is suppressed, the doors now open for the transition into ketogenesis.
• Insulin increases: glucose uptake, glycolysis, glycogen synthesis, adipogenesis (with total fat gain or loss dictated by overall calorie intake), and protein synthesis
• Insulin decreases: gluconeogenesis, glycogenolysis, lipolysis, ketogenesis, and protein breakdown.

In the Presence of Insulin

When you consume a carbohydrate-based meal, your body will primarily metabolize glucose as a result of increased insulin levels, which in turn suppresses the hormone glucagon. In the presence of insulin, the liver will take in some of this glucose, and either store it as liver glycogen or metabolize it into acetyl- CoA to be used in the generation of energy. DNL is generally low and contributes very little to overall fat storage, but can be higher with excess fructose consumption. These fatty acids are then used in the production of triglycerides and stored in the liver, or sent for storage in our adipose tissue. Lipolysis, or the breakdown of stored triglycerides in our adipose tissue, is inhibited by insulin. Muscle will also take up glucose in the presence of insulin and use it directly as fuel, or store it as glycogen.

Suppression of Insulin

When you restrict carbohydrates, insulin levels are then suppressed, and it stimulates the release of the hormone glucagon. The ratio of glucagon to insulin is an important contributor to ketogenesis. A higher glucagon-to-insulin ratio is required for the production of ketones. In addition, this ratio alters liver metabolism in a way that ultimately halts glycogen synthesis, and favors the breakdown of liver glycogen and gluconeogenic substrates, which occurs with caloric restriction outside of a ketogenic diet. With that said, muscle glycogen is spared if and when ketones are elevated, based on the transitional use of fatty acids and ketones for fuel. Muscle glycogen is used (and lost) at a much faster rate following a carbohydrate-based diet, especially under conditions of calorie restriction. Thus, being in ketosis has practical implications when it comes to preserving muscle glycogen.

Macronutrients Metabolism and their Respective Hormonal Response

Carbohydrates:

• Carbohydrates are broken down through a series of enzymatic steps until their final conversion to individual glucose molecules in the liver. These glucose molecules are either stored as liver glycogen or enter circulation, providing fuel to the rest of the body. The blood glucose response of carbohydrates depends on dose, and the source of carbohydrate consumed dictates how rapid or delayed the response (e.g. high-fiber foods such as fibrous vegetables can essentially be non-glycemic, although they contain carbohydrates).
• Glucose Response: Dose-dependent and rapid
• Insulin Response: Elevated (depending on fiber content)
• Glucagon Response: Suppressed

Protein:

• Protein can stimulate the release of the hormone glucagon, which triggers the breakdown of liver glycogen to raise blood glucose. Gluconeogenic amino acids can also be converted to glucose in the liver, contributing to an elevation in blood glucose. Protein’s impact on blood glucose levels is very small compared to that of carbohydrates, and the response can be delayed up to 5 hours after consumption, especially in the presence of high fat and fiber.
• Glucose Response: Moderate and delayed
• Insulin Response: Dose-dependent
• Glucagon Response: Elevated

Fat:

• Fats are typically consumed (and stored in adipose) in triglyceride form, which contains a glycerol backbone and three fatty acid chains. The length of the fatty acid chains matter in how they’re metabolized in the body, both in general and in terms of ketogenesis. For example, when long-chain triglycerides (LCT) are ingested, they’re packaged into chylomicrons, which enter our lymphatic system and are delivered to adipose tissue. Whereas medium-chain triglycerides (MCT) bypass this process and are delivered directly to the liver through hepatic portal circulation. MCTs can be rapidly converted to ketone bodies in the liver (under ketogenic conditions), and can be used directly for energy (even by the brain). In terms of glucose response, once liberated from triglycerides, free fatty acids cannot be converted to glucose. The glycerol backbone, however, can be. When keto-adapted, this is the body’s primary source of glucose for cell types that cannot metabolize fat or ketones, but this conversion will have no noticeable effect on insulin.
• Glucose Response: No response
• Insulin Response: No response
• Glucagon Response: Elevated (in response to low insulin)

Glucose, Insulin, and Appetite Control:

If you find that eating carbohydrates causes large fluctuations in your energy, a ketogenic approach might help control this. You could eat a 500-calorie ketogenic meal with little to no elevation of blood glucose, translating to little to no elevation of insulin and perhaps even energy and increased satiety. So, while you’re supplying the body with energy (calories), the body for the most part will be in the “fed” state while the liver will remain in the “semi-fasted” state. This is important for the maintenance of blood glucose. The liver is the master regulator of metabolism, so to sustain ketosis, the liver must maintain this “fasted” state. What’s more important is that after this ketogenic meal, you will remain satiated for two-five+ hours. In addition, fat in combination with moderate protein is very satiating, and for many, a well-formulated ketogenic diet is difficult to overconsume. Can be a good thing or bad thing…

Meal Frequency on the Ketogenic Diet:

• 3-5 protein-containing meals throughout the day are advised for optimizing lean body mass, recommended on the assumption that you’re in a glycolytic state. The ketogenic diet makes room for less frequent feedings due to delayed gastric absorption from consuming high fat. You may find your hunger feels different when you’re in ketosis versus when the body is craving glucose. Instead of eating five times a day, you may find you only want/need to eat two or three times.
• Practicing intermittent fasting or time-restricted feeding (TRF) may become much easier when following a ketogenic diet, and some people find that TRF makes creating and sustaining a calorie deficit easier over time. When you’re in ketosis, you’re no longer a slave to food; one reason being that you’re wearing your food. Even lean athletes can hold ~40,000 calories in stored body fat, and keto-adaptation (over months) makes it easier to access that fat for fuel.
• Leptin and ghrelin are also differentially regulated in a state of ketosis. While the amount of leptin decreases, our sensitivity typically increases, meaning only a small release of leptin will reduce hunger cravings. The suppression of ghrelin has been reported in calorie-restricted subjects who maintained BHB levels above 0.3 millimolars per liter. Additionally, drinking exogenous ketones lowers plasma ghrelin levels compared with isocaloric dextrose, perceived hunger, and desire to eat.
• Dextrose ingestion also lowers ghrelin, just not as much as exogenous ketones. Dextrose has very little satiety value in the short term, so it’s unknown whether exogenous ketones would be better than isocaloric protein or lower-glycemic, carbohydrate-containing fiber. Further, it’s important to note that exogenous ketones have caloric value and thus are not “free calories” but may have some beneficial effects. This effect on ghrelin may help improve satiety in a keto-adapted state.

Signaling Roles of Ketones

Research has found beta-hydroxybutyrate (BHB) to be anti-inflammatory, through the inhibition of the NLRP3 inflammasome. The NLRP3 inflammasome controls the activation of pro-inflammatory molecules, and dampening this pathway can reduce systemic inflammation. Chronic inflammation is also a characteristic of metabolic dysfunction, which is tightly linked to insulin resistance. The ketogenic diet can enhance insulin sensitivity, as well as reduce the inflammation that could be contributing to insulin resistance. If anything, this anti-inflammatory effect may reduce inflammation-associated pain, thereby enhancing performance. What’s less clear, however, is if this anti-inflammatory effect is due to unique properties of ketones, or simply the weight loss associated with caloric restriction.

BHB is a histone deacetylase (HDAC) inhibitor, and generally speaking, HDACs inhibit the gene expression. Through ketone-induced HDAC inhibition, BHB has been shown to induce the expression of genes involved in oxidative stress resistance. This means BHB can enhance our own cellular and physiological protection against oxidative stressors that cause cellular damage. These ketone-induced adaptations may enhance performance resilience, especially under conditions of a calorie deficit and high endurance-training demands.

The Ketogenic Diet and Muscle Maintenance:

Nitrogen excretion slows with keto-adaption, indicating a reduction in protein breakdown since fats and ketones become the primary fuel sources. However, there’s evidence that some LBM is lost during the initial keto-adaptation period until the body reaches keto adaptation. During the transition into ketosis, the brain begins preferentially utilizing ketones for fuel, and therefore relies less on glucose. This decreased reliance on glucose for fuel significantly reduces the breakdown of gluconeogenic amino acids in skeletal muscle, explaining this muscle-sparing effect. Additionally, fatty acids are oxidized as fuel for muscles, sparing ketones for the brain while simultaneously maintaining muscle protein by a reduction in branched chain amino acid oxidation.

It’s important to note that muscles can only use ketones for fuel under aerobic conditions, whereas anaerobic exercise will have obligate glucose usage. Thus, the ketogenic diet may not be optimal for athletes who do high-intensity exercise for muscle sparing. Recently, it was demonstrated that BHB IV infusion in humans has potent anticatabolic effects, preventing muscle-wasting under conditions of induced inflammation.

What to Eat on a Ketogenic Diet

Carbohydrates (0-10%):

• All leafy greens and lettuces
• Cruciferous vegetables (broccoli, cauliflower, Brussel sprouts, cabbage)
• Celery
• Cucumber
• Zucchini
• Bok choy
• Mushrooms

Protein (15-35%):

• Fatty cuts of red meat
• Poultry with skin on
• Fatty fish such as sardines, salmon, mackerel
• Eggs and egg yolks
• Nuts and seeds such as hemp seeds, macadamia nuts, and pecans
• Tempeh

Fat (60-90%):

• Majority from saturated and monounsaturated sources. Emphasis on omega-3s, while minimizing omega-6s.
• Oils: coconut oil, butter, ghee, MCT oil, cacao butter, extra-virgin olive oil, avocado oil, and macadamia nut oil
• Whole foods: avocados, eggs, fatty cuts of meat, poultry with skin on, coconut butter, coconut meat, olives, nuts, and some seeds

Limit:

• Soybean oil
• Corn oil
• Cottonseed oil
• Peanut oil
• Canola oil
• Grapeseed oil
• Safflower oil
• Sunflower oil

How to Test Ketones

• Blood: Most expensive but accurate
• Urine: Accuracy varies
• Breath: Cost effective and non-invasive

Caveats of a Ketogenic Diet:

• A strong argument against the ketogenic diet is that ketones cannot fuel anaerobic activity. However, the ketogenic diet has a glycogen-sparing effect, and thus glycogen should not be depleted (after keto-adaptation) unless anaerobic training volume is high.
• Supplements like creatine may be more beneficial for those on a keto diet, especially during the first few weeks of initiation.
• Another issue people may experience is adherence to the diet based on personal food preferences. If you don’t enjoy ketogenic foods, then this diet isn’t feasible for you.

Summary

• An energy deficit drives fat loss
• While the diet didn’t start as a fad, the language surrounding it now, for the most part, is similar to that of fad diets
• It has clinical applications for neurodegenerative diseases and other ailments
• The original ketogenic diet recommends approximately 90% of your calories come from fat, but some of the modified versions we see today lessen the fat requirement (sometimes as low as 65% of total calories) to allow for more protein. You can attain and sustain nutritional ketosis with both
• Dietary adherence still matters, along with tracking your intake

13: Special Considerations

Menstruation

The uterus sheds its lining along with blood and mucus and discharges from the vagina. Typically, this portion of the cycle lasts as little as two days and as many as eight, barring any complications. The onset of menstruation marks the beginning of one of two phases; this particular phase is called the follicular phase.

The follicular phase lasts until ovulation is marked by the following:

1. Ovarian follicle development
2. Bleeding in the aforementioned time frame
3. Higher estrogen compared to progesterone

In a perfect world, the follicular phase would last 14 days, and then the next phase, the luteal phase, would begin. The luteal phase kicks off with ovulation after the follicle turns into the corpus luteum. The corpus luteum is a structure that releases progesterone, and this helps alter the uterine lining so that a fertilized egg can open up shop there and become a newborn baby at some point.

However, if the egg isn’t fertilized, the corpus luteum, a temporary structure, degrades, and estrogen and progesterone levels drop, and you get your period, thus starting the cycle again. Prior to the beginning of the follicular phase, women sometimes get symptoms that are commonly referred to as premenstrual syndrome (PMS).

Symptoms can include but are not limited to:

• Tender breasts
• Acne
• Bloating
• Lethargy
• Irritability

It might not be a bad idea to go harder right around the time you ovulate, since your testosterone is highest at that point and recovery may be improved. During the early follicular phase, you could focus on doing more work but not going quite as hard on some exercises. Meanwhile, right before menstruation, you could potentially keep your training a bit easier. These aren’t clear cut “rules,” but rather suggestions if you’re someone who finds your energy and strength are severely affected by the different stages of your cycle.

During PMS, many women find that they retain quite a bit of water. Fluctuations of 2% body weight are quite normal for most women, and they can even go up to 4%. Don’t mistake an increase in weight or lack of weight loss during PMS for lack of progress. It’s probably best if you wait until your period passes to determine whether or not progress has truly stalled or if it was simply short-term water retention.

Contraceptives

Polycystic Ovarian Syndrome (PCOS)

PCOS is a hormonal condition that manifests around the age a woman can menstruate. While the exact causes are unknown, symptoms include but aren’t limited to:

• Hirsutism, or excessive amounts of hair where you typically don’t have hair
• Potentially elevated testosterone levels
• Type 2 Diabetes
• Actual cysts on your ovaries

One of the other symptoms of PCOS is menstrual irregularities. For the women with PCOS, there is no uniform irregularity. So, one woman with PCOS might have her period every 14 days. Others might have a prolonged cycle that stretches beyond 28 days, up to 32, 33, 34, or even 35 days. Moreover, bleeding can be heavier than normal on top of some (or all) of the above listed symptoms, or the heavier menstrual bleeding can be the only symptom you experience.

So, for a woman on a diet—provided you’re truly creating a deficit in your calorie intake—PCOS isn’t the worst, especially in terms of keeping LBM and your overall training. Keep in mind, it varies from woman to woman, so you might experience some or even more of the above listed symptoms, but the fact that you do engage in lifestyle management—controlling your diet and exercise—means that you symptoms will likely improve with weight loss. Even if PCOS slows metabolic rate, it doesn’t mean you can’t lose weight; it just may be more difficult, since your calorie intake will have to be lower to cause weight loss.

Celiac Disease and Thyroid Disease

Gluten is a type of storage protein that contains metal ions and some amino acids. It would be correctly called an incomplete protein due to low levels of the essential amino acid lysine.

Celiac disease is basically inflammation of the small intestine lining, and it leads to malabsorption of the nutrients within the food you eat. In people who suffer from celiac, wheat gluten triggers this reaction, and the only effective treatment is a legitimate gluten-free diet.

According to Sun et al.:

• The associations of CD [Celiac Disease] with ulcerative colitis, Crohn’s disease, microscopic colitis, autoimmune liver diseases, and several other immune- and non-immune-based diseases in the digestive system are well recognized. However, many diseases outside the digestive system, such as autoimmune thyroid disease, Sjo¨gren’s syndrome, type 1 diabetes mellitus, and Addison’s disease, are associated with CD, in both its overt and silent forms.

The above meta-analysis looked at euthyroidism. 

In addition to euthyroidism, there’s something called hypothyroidism. Common symptoms include fatigue, trouble concentrating, heavy bleeding in women, and others.

At the opposite end of hypothyroidism, there’s hyperthyroidism. Instead of general lethargy and slowing metabolic processes, hyperthyroidism can cause sudden weight loss, faster heartbeat, and nervousness, among other things.

If you have hypothyroidism and you take your medication (possibly something like levothyroxine or another hormone replacement), then your time in the deficit won’t be nearly as bad as it could be due to having a continually level amount of thyroid hormones. If you have hypothyroidism, the hormone replacement for it could potentially put you into a state of hyperthyroidism. All of this will be monitored by your doctor’s visits, of course, because you’ll let them know if you feel or see any red flags.

For hyperthyroidism, some of the symptoms include, but are not limited to:

• Irregular heartbeat
• Sudden weight loss
• Increased appetite
• Anxiety
• Heat sensitivity

If you have hyperthyroidism, that will likely increase metabolic rate and increase the rate of weight loss. So, if you have hyperthyroidism and you experience sudden weight loss and increased appetite, eating more will help you. And, by virtue of your faster metabolic rate, you can increase your energy intake and still be in a deficit and lose weight. While this likely sounds like a good thing, keep in mind that if you don’t eat more to compensate for the increased caloric output, you could be in danger of losing more lean body mass.

Beta Blockers

These drugs slow down your adrenaline (epinephrine) in an effort to lower your blood pressure. Not only that, they can also regulate your heartbeat as well as mitigate the physical manifestations of anxiety.

In a meta-analysis, Sharma et al. noted that the introduction of beta blockers for the treatment of hypertension yielded a 5% to 10% reduction in TDEE (which was about 100 to 200 calories, according to the authors). That 100 to 200 calories accounted for about 1 kilogram to 3.5 kilograms of weight gain in clinical studies, as well. Moreover, because of metabolic adaptation, the weight gain you observe when taking beta blockers stops after a period of six months to a year, provided you made no change to your diet. The changes may be due to a decrease in NEAT.

Corticosteroids

Hormones like cortisone, cortisol, aldosterone, and their synthetic counterparts fall into the corticosteroid category. Aldosterone regulates your electrolyte balance, but the other two are involved in responses to stress. Cortisone helps to reduce inflammation. If you’ve ever needed a shot of cortisone as an immediate injury treatment, this was the reason why. By way of gluconeogenesis (endogenous production of glucose from various substrates, mainly amino acids), cortisol regulates your blood sugar. In its synthetic form, it’s known as hydrocortisone, and it’s used in asthmatic inhalers and also to treat adrenal insufficiency, among other things.

It seems that the corticosteroids aren’t the direct cause of weight gain, barring exceedingly high doses over a long period of time. Prolonged use coupled with higher doses can result in the redistribution of adipose tissue as well as cushingoid (Cushing’s disease is an illness where cortisol is over-secreted) features.

If you need to use corticosteroids, you may experience an increase in hunger. Thus, it’s a good idea to focus on eating foods that are high fiber and high volume in order to maximize satiety and avoid overeating, which would impair fat loss.

Antidepressants

If you get diagnosed as clinically depressed, you might not eat enough. If you start taking SSRIs or any other antidepressant, you might start eating again. If your activity level is static, then it’s likely you will gain weight.

At the same time, if you’re depressed and use food as a way to “self-medicate,” and you start taking antidepressants to correct your chemical balance, then you actually might notice some weight loss, since you may not resort to that type of behavior anymore.

Except in cases of mirtazapine and amitriptyline, which were the most potent weight gain promoters. Some reduction of body weight can result from treatment with fluoxetine and bupropion, although for fluoxetine the effect may be only transient.

Menopause

During menopause, your estradiol lowers and causes an increase in adipose fat. Not only that, but lower estrogen levels lead to lower bone density. In fact, proper estrogen levels are vital for bone development, and when your levels are lower, exercise will only serve to help maximize your bone mineral density. Aside from that, we talked about the role of protein and its importance for all of your tissues, not just your muscles.

High intake of fruits and vegetables delays the onset of menopause and prolongs the reproductive lifespan because of the presence of antioxidants in fruits and vegetables that counteracts the adverse effects of reactive oxygen species on the number and quality of ovarian follicles.

14: Debunking the BS

With nutrient-dense foods, you can actually eat a larger volume of food or even eat more often without taking a huge caloric toll. On the other hand, if you have a high BMR and you can eat 3500 calories a day, those five doughnut holes won’t be too detrimental, since you can still get your essential micronutrients in as needed. At that caloric intake, you may even have the opposite problem of feeling too full if all you’re eating is nutrient-dense foods. Just keep in mind that even healthy foods can be high in calories (olive oil, coconut, etc.).

Most diets have some validity but zealots take them too seriously and blame variables that are barely researched.

15: Supplements

Whey Protein

Whey protein is an extremely high-quality protein derived from milk protein. It’s high quality because it has a high bioavailability, high PDCAAs (a measure of digestibility and amino acid content), and high leucine content. Leucine, one of the branched chain amino acids, is the amino acid responsible for stimulating the mTOR pathway and triggering protein synthesis in muscle (MPS). In fact, the leucine content of a protein source may be the most important factor in determining that source’s anabolic potency. They found that whey was superior to every other protein source they tested for anabolism based on its leucine content. Most protein sources—virtually all animal sources, rice, soy, pea, and many others—contain approximately 8% leucine, though corn protein seems to be promising with a leucine content similar to whey. Whey has around 11% leucine (can vary between 10% and 13% from source to source).

• WPC is less refined, since it’s formed by centrifuging milk (to separate out the fat content) and then adding acid to separate the insoluble (casein) fraction from the soluble (whey) fraction. Once the soluble fraction is concentrated, you have WPC. WPC naturally has a pleasant taste to it, and it’s rich in bioactive fractions that may have a positive impact on immune function.
• WPI is made from WPC by running the WPC through extra filtration processes that remove a significant amount of byproduct including lactose, extra fat, and carbohydrate. WPI is typically higher in protein concentration (approximately 90% of product weight versus 80% of product weight) and lower in carbohydrate and fat than WPC. WPI is easier for many people to digest due to the reduction in lactose and other byproducts. In fact, many people do not tolerate 100% WPC well, and WPI may be a great option for these people. The downside to WPI is that it’s significantly more expensive than WPC.
• WPH is formed through enzymatic hydrolysis, a process by which added enzymes “chop up” whey protein into shorter, more easily digested peptides. This makes it extremely easy to digest for most people. The downsides to WPH are a significant increase in price over WPC and WPI, a loss of bioactivity of the lactalbumins due to pre-digestion by enzymes, and it typically doesn’t taste nearly as good as WPI or WPC.

Grass-fed beef may be beneficial, since it changes the fatty acid composition of beef (increased omega-3 versus omega-6 fatty acids), but this seems to be irrelevant in whey protein because it has a very low-fat content anyway. While both proteins would likely work just fine, grass-fed whey and goat whey are both more expensive than normal whey and would not likely provide any additional benefit, unless someone was so allergic to whey protein that they could not tolerate any form of it, in which case goat’s whey might be a viable alternative.

Dosing and frequency: 20 to 30 grams of whey protein will increase MPS in most people, and the maximum benefits of whey are probably topped out around 40 grams, depending on the individual’s lean body mass. There’s nothing special about consuming whey protein post-workout other than the fact that you are consuming a high-quality protein source.

Creatine Monohydrate

Creatine seems to work through several mechanisms, but the most prominent is by increasing muscle concentrations of creatine phosphate. Creatine phosphate acts as a high-energy phosphate donor to improve anaerobic exercise performance. Creatine is especially useful for those who are dieting for multiple reasons including increasing lean body mass, improving strength, performing well overall at resistance training, and developing fatigue resistance. Maximizing LBM retention during a diet is crucial to not only losing the weight, but also keeping it off.

Some of the major players that have been purported to be superior to creatine monohydrate include creatine ethyl ester, buffered creatine, and creatine HCl. Thus far, there is no evidence that any of these products are superior to creatine monohydrate. In fact, creatine ethyl ester was actually inferior to monohydrate in head-to-head comparisons. Buffered creatine was also no better than monohydrate in comparisons, and if anything, it was a little worse. Creatine HCl, while promoted as requiring a lower dose than monohydrate, has no empirical evidence to support those claims as of this time. As such, the recommended form to take is the tried-and-true creatine monohydrate.

Approximately 30% of people are considered “non-responders.” In the case of creatine, it has been hypothesized that “non-responders” already have saturated levels of creatine phosphate in their muscle cells, and thus further supplementation doesn’t produce any additional benefit.

Some people may find it counterintuitive to use creatine while dieting, since creatine can increase body weight in the short term. This increase in body weight is from increased water inside the cell as well as increased LBM, not increased fat mass. If you can deal with the fact that you might gain a small amount of weight initially when you start taking creatine, then there’s nothing about it that will hinder your fat loss goals.

Dosing and Frequency: To reap the benefits of creatine, you want to saturate your muscle cells with creatine phosphate. There are a few ways to do that. The first way is to load. You can load for five days at 20 to 25 grams per day followed by a maintenance dose of 3 to 5 grams per day. This will saturate your cells within a week. The downside is that many people experience gastrointestinal (GI) distress due to the increased solute load in the GI. The alternative is to take 3 to 5 grams per day with no loading phase, and within 4 weeks, your cells should be saturated with creatine. The downside is that it takes longer to reach saturation, but the upside is there’s a lower chance of GI distress and bloating.

Caffeine

Caffeine helps with fatigue resistance, improved performance, increased strength, decreased perception of fatigue, and increased power. If you’re someone who doesn’t exercise, then caffeine will probably have little benefit for you since it doesn’t seem to increase fat loss or LBM or affect hunger.

Some people are very sensitive to its effects, and for them it may cause a number of undesirable effects such as anxiety and jitters. Because of this, it’s wise to assess your sensitivity to caffeine and determine if it’s is a good idea for you. Further, caffeine doesn’t work the same forever. It’s well documented that caffeine tolerance builds up over time, making the same dose less effective.

Another potential downside to caffeine is that it may offset the benefits of creatine supplementation. Researchers are unsure of how this occurs, and there only a few studies examining this interaction, so we’ll stop short of saying to not take them together–but the jury is still out.

Most studies demonstrating exercise performance benefits have used 3 to 6 milligrams per kilogram, and of those studies showing an increase in strength, it’s typically on the higher end of that range. Due to the build-up of caffeine tolerance, it may be wise to take week-long caffeine breaks to reset tolerance. It may be helpful to supplement with Rhodiola Rosea since it may help prevent the “crash” during the initial caffeine break.

Caffeine uptake and distribution to tissues is pretty rapid with 99% being absorbed into tissues within 45 minutes of ingestion. Its half-life is 4-6 hours, and thus it really is a great pre-workout supplement as you can take it about an hour before you work out.

Betaine (Trimethylglycine)

Originally popular as a methyl donor and also digestive aid (in the form of Betaine HCl), Betaine supplementation has been demonstrated to improve power output, exercise performance, and recently has been shown to increase lean body mass. Betaine, like creatine, appears to require time to “build up” in order to exert its ergogenic effects. It also seems to be well-tolerated with minimal side effects. People who don’t produce much stomach acid may also benefit from Betaine HCl, but if you suffer from acid reflux, you likely want to refrain from using this form of betaine and instead use betaine anhydrous.

Dosing and Frequency: Most studies have observed the best effects from using 2.5 grams of betaine each day, one time per day.

Carnitine

Carnitine L-Tartrate (LCLT) has been shown to improve workout performance by decreasing fatigue and blood lactate and slightly increasing power output. LCLT may also decrease delayed onset muscle soreness and increase androgen receptor density in muscle cells. More androgen receptors in muscle cells may mean that your current levels of anabolic hormones like testosterone may work more efficiently, and your body can respond more appropriately to these hormones. Androgens like testosterone contribute to muscle growth by stimulating myogenesis, the formulation of muscular tissue. Further, LCLT may also increase blood flow to deliver oxygen and nutrients to hard-working muscles. Interestingly, LCLT may also help improve recovery by decreasing muscle damage and soreness in response to a training session.

There are other forms of carnitine, and Acetyl L-Carnitine (ALCAR) may also have benefits that affect cognition due to its ability to more readily cross the blood-brain barrier. While carnitine was originally postulated to be a fat burner due to its involvement in the transport of fatty acids in the mitochondria, that fervor died off some time ago. 

Dosing and Frequency: For ALCAR, cognition benefits have been seen at 630 milligrams to 2500 milligrams. For LCLT, a dose of 1000 to 4000 milligrams has been used. However, for both, it appears that 2000 milligrams elicit most of the benefits. We would consume it an hour or two pre-workout, and then one other time during the day.

Orlistat

Orlistat works by reducing fat absorption in the GI tract by acting as a pancreatic and gastric lipase inhibitor, inhibiting fat breakdown so that fat is excreted rather than absorbed (decrease in absorption of about 30%). This drug/supplement has the advantage of being non-stimulant in nature and thus doesn’t have side effects that are normally associated with stimulants, like increased blood pressure and heart rate. However, it does have several significant digestive side effects such as diarrhea, leaky stool, and anal leakage. These effects may be exacerbated for those using a high-fat diet. As such, it’s generally not recommended to exceed more than 30% of your calories from fat while using orlistat. It also blocks the absorption of fat-soluble vitamins like A, D, E, and K, so taking it in conjunction with a vitamin supplement is likely advisable. Because of the side effects, orlistat is not recommended unless people have shown an inability to lose weight by conventional means and have failed several attempts.

Dosing and Frequency: If orlistat is being prescribed by your physician, we advise you to follow their recommendations. If you’re taking it over-the-counter, typical dosing is a single 60 milligram capsule (half of the dosage of the prescription Xenical at 120 milligrams) with each meal containing more than 10 grams fat. It’s also recommended not to exceed three capsules in a day. Another way to express this would be to say have it with your three meals that contain the largest amount of fat each day.

Fucoxanthin

Fucoxanthin, a component of brown seaweed, seems to be an effective fat loss agent that doesn’t have many side effects. Fucoxanthin is probably the most effective fat loss supplement available based on the data. There are many compounds that will reduce weight gain during overfeeding, and these are usually present in most fat-loss supplements. Unfortunately, what prevents weight gain is a different question than what causes fat loss. In a study of obese women who took fucoxanthin for 16 weeks but ate at maintenance, the results were extremely impressive. They lost an average of 5 kilograms while eating at maintenance. Not surprisingly, they found that fucoxanthin increased resting energy expenditure, which accounted for the weight loss. What’s impressive is that these people lost weight even though they shouldn’t have been in a deficit. It appears that the increase in metabolic rate from fucoxanthin is likely from its ability to increase the expression of UCP1, an uncoupling protein that increases thermogenesis.

Dosing and Frequency: For effective dosing, we would use 2.4 milligrams of fucoxanthin in combination with 300 milligrams of PSO taken daily with a meal containing fat. You could also just take 8 milligrams of straight fucoxanthin per day, which seems to be effective. PSO seems to increase the bioavailability of fucoxanthin, and since this is what was used in the study where fat loss was demonstrated, that’s what we would recommend.

Synephrine (Bitter orange extract)

Synephrine has been demonstrated to modestly decrease body weight and body fat in humans, which is pretty rare for most supplements. Synephrine’s fat loss mechanism seems to be its ability to increase metabolic rate. It also appears to increase lipolysis (release of fat from adipose cells), and decrease appetite while still being relatively safe. It’s a stimulant, so those who are sensitive may want to avoid it or start at a very low dose. This supplement appears to work at both ends of the energy balance equation by decreasing appetite (calories in) and increasing energy expenditure (calories out), so it may be useful for those looking for a small boost. That said, there’s some evidence that it may slightly increase heart rate and blood pressure and have negative impact sleep quality.

Dosing and Frequency: A wide dosing range appears safe (10 to 80 milligrams per day), but most of the studies demonstrating benefits typically used around 50 milligrams of synephrine per day. We recommend breaking this up into two doses: one in the morning and one in the early afternoon. We don’t recommend consuming close to bed. If you train, we recommend consuming it approximately 45 to 90 minutes pre-training. If you’re very sensitive to stimulants or have heart issues, don’t use this product, or speak with a physician first. 

Hydroxycitric Acid (HCA)

Isolated from Garcinia Cambogia, it appears that HCA has a small but significant impact on weight loss, though it’s probably less than synephrine. It appears to increase energy expenditure and act as an appetite suppressant similar to synephrine, but probably not quite as strong. It also appears to be relatively safe for usage even up to high doses, with the most frequent side effect being GI distress.

Dosing and Frequency: Dosages from 1 to 2.8 grams per day have demonstrated benefits, but currently the “optimal” dosage is unknown. We recommend dosing similar to synephrine, since the mechanisms appear similar. That would be 0.5 to 1.4 grams two times per day, once in the morning and once in the early afternoon. Begin at a low dose to assess tolerance before moving to a higher dose.

Fish Oil Omega 3s (EPA and DHA)

EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) are both omega-3 fatty acids found in fish oil that seem to provide a myriad of benefits. Both of them are anti-inflammatory, which can be a good thing but also can be a bad thing. It appears there’s an “optimal range” of inflammation for anabolism. For example, in healthy young adults, using anti-inflammatories can reduce muscle building. However, in older adults with higher basal levels of inflammation, anti-inflammatories enhanced muscle growth. These omega 3s seem to have a myriad of health benefits, but for our purposes, they may be useful for dieting due to their anti-catabolic and anabolic effects. EPA in particular seems to be an inhibitor of muscle protein breakdown. Further, they also may enhance the anabolic effects of a meal when co-ingested. Further, fish oil may also decrease soreness and improve recovery.

Dosing and Frequency: The studies showing increased anabolism from fish oil used a dosage of about 465 milligrams EPA and 375 milligrams DHA per gram of capsule. The study used 4 grams for a total dosage of 1860 milligrams EPA and 1500 milligrams DHA. Keep in mind that most fish oils contain around 180 milligrams EPA and 120 milligrams DHA per gram of capsule. Unless you want to consume 10 to 11 fish oil capsules per day, it may be beneficial to find a more concentrated fish oil supplement than standard supplements.

Branched Chain Amino Acids (BCAAs)

Some studies have demonstrated an increase in LBM with BCAA supplementation, while others have not. Another study demonstrated that BCAAs helped maintain LBM while in caloric restriction compared to placebo. BCAAs have been demonstrated to increase MPS after exercise, specifically because of the leucine. BCAAs also seem to reliably decrease muscle soreness and improve time to recovery post-exercise (although consuming the BCAAs before exercise may have a superior effect on soreness). BCAAs also improve strength recovery post-training, meaning they can help you recover so you can train again harder and hopefully sooner. It has also been proposed that BCAAs may improve exercise performance by decreasing fatigue via competing with tryptophan for entry through the blood-brain barrier, therefore decreasing serotonin production. Serotonin production may increase fatigue during exercise, but the effect of BCAA doesn’t seem strong enough to produce notable increases in performance.

After consuming a meal that stimulates MPS, an observed “refractory period” occurs where MPS declines even in the face of elevated anabolic signaling and amino acids. By providing BCAAs in between meals, approximately two to three hours post-meal and two to three hours before another meal, we observed that this refractory period could be overcome, and MPS extended. This is likely due to providing a source of ATP to the muscle cells, since increases in MPS actually cause depletion of ATP in muscle cells. Since BCAAs can be metabolized in muscle cells to form ATP, BCAAs provide a method of preventing this decline in ATP. Ingesting carbohydrates between meals produces a similar effect, since it provides ATP for muscle and overcomes the refractory effect. Thus, either five to 10 grams of BCAAs or 30 to 40 grams of carbohydrate between meals may help overcome the refractory phenomenon and extend MPS after a meal. So, why spend money on BCAA if carbohydrate will do the same thing? It appears BCAA can produce the same effect at a lower dose and thus less calories, which is greater “anabolic bang” for your “caloric buck.” This can be an advantage during a diet when calories are limited.

Dosing and Frequency: To reduce soreness, consume 10 to 20 grams of BCAAs pre-workout. If you wish to be more “experimental” and attempt to attenuate the anti-anabolic effects of the “refractory period” post-meal, consume 0.03 to 0.05 grams of BCAA per kilogram of lean body mass in between meals (1.5 to 3 hours post meal, 1.5 to 3 hours before the following meal).

Melatonin

Numerous studies have demonstrated that supplementing with melatonin can assist with sleep. This could be extremely useful during dieting, since previous research has demonstrated that sleep is disrupted during dieting. While it’s not surprising that melatonin can assist with sleep, what is surprising is that supplementing with it appears to have small but statistically positive effects on fat loss and body composition. It also appears to modestly increase leptin, which may assist with reducing hunger levels. Furthermore, leptin appears to attenuate markers of muscle damage, which may further assist with compromised recovery during dieting. It’s very possible that many of these beneficial effects of melatonin are secondary to people simply getting better sleep while taking melatonin. Either way, it does appear that melatonin has a very consistent beneficial effect in the research studies.

Dosing and Frequency: One to 10 milligrams taken 30 to 60 minutes before bed will help improve sleep. It appears that melatonin only requires a small dose to improve sleep, and more does not seem to enhance the effect further. However, high doses of 100 milligrams per day have also been studied and do not seem to cause side effects. However, one to 10 milligrams are what most of the studies have utilized previously. Based on the research and our personal experience with melatonin, we think three to five milligrams per evening is just fine.

Rhodiola Rosea

Among the most striking benefits are a decrease in the perception of fatigue, improved endurance exercise performance, improved cognition, and feelings of well-being. It also may improve exercise recovery by decreasing muscle damage, although this effect is somewhat contradictory between studies. Regardless, it does seem like rhodiola rosea reliably improves mood and cognition, both of which deteriorate during dieting.

Dosing and Frequency: It appears both a low dose taken over a long time and a large dose taken acutely can have benefits. Chronic doses of 50 milligrams per day can have benefits, but large doses of 300 to 600 milligrams (standardized for 3% rosavins and 1% salidroside) can have an immediate beneficial effect. We recommend not exceeding 600 milligrams, because it seems that high doses may negate the benefits of rhodiola rosea. In this way, it appears to work on a bell-curve dose response.

Essential Amino Acids (EAAs)

The downside is that they’re less anabolic per gram due to lower leucine content. The upside is that since they contain the full spectrum of EAAs, they provide the substrates necessary for forming new complete proteins, and not just the stimulus for muscle protein synthesis. This may be especially useful for people who train fasted and do fasted cardio. While we don’t advise fasted training or cardio, some people choose to do them because it fits their lifestyle better. Consuming EAAs first thing in the morning before cardio or training can provide a source of anabolic amino acids to overcome catabolism from an overnight fast. It can also be consumed rapidly, so that it doesn’t disrupt someone’s lifestyle, or their enjoyment of training fasted. If you don’t train fasted, we would simply utilize BCAA instead of EAA, because there will be ample substrate available for synthesis of new proteins if you’re consuming a high-protein diet overall.

Dosing and Frequency: 15 grams of EAA consumed in the morning before training or cardio. You can also consume this at any time if you suffer from IBS symptoms and are struggling with digesting complete sources of protein.

HMB (β-Hydroxy β-Methylbutyrate)

HMB is a metabolite of the amino acid leucine. HMB does not appear to be a muscle builder, but rather an anti-catabolic agent. It appears to significantly decrease rates of muscle protein breakdown. It also appears to work well as an anti-catabolic agent during conditions in which rates of muscle protein breakdown are elevated. These include cancer, sepsis, and novice trainers where extensive muscle damage occurs. It also increases rates of muscle protein synthesis, though the effect is not as powerful as that seen with leucine. It appears that HMB has limited to no benefit in experienced trainers who don’t have elevated rates of muscle protein degradation. However, it does appear to have a small but notable effect on increasing lean body mass and strength in novice trainers. So, it’s possible that HMB supplementation may provide a small but significant benefit to advanced trainers during dieting when caloric restriction decreases protein balance. This is completely theoretical, but at minimum, HMB may assist in recovery from exercise and reduce delayed onset muscle soreness.

Dosing and Frequency: It appears that a dose of 3 grams of either calcium HMB or HMB free acid is effective at decreasing muscle protein breakdown and muscle soreness when taken one time daily, with pre-training likely being the best.

Vitamin D

Low vitamin D is associated with reduced testosterone and energy. Supplementing with it at ~3000 IU per day has been demonstrated to restore testosterone. If you have normal vitamin D levels, however, it’s unlikely that supplementing with super high levels of vitamin D will also supraphysiologically increase testosterone. Vitamin D supplementation was also shown to have a small effect on improving weight loss in people who are deficient. Further, vitamin D appears to have protective effects on heart disease and cancer.

Dosing and Frequency: 1000 to 3000 IUs per day should get you into the “optimal” range for vitamin D. We wouldn’t recommend going much higher than this, since vitamin D is fat soluble, and super high doses could cause toxicity issues since it’s not readily excreted. However, in the majority of studies, it appears to be quite safe.

Multivitamin

We will say not to waste your money on multivitamins that have super high doses of the B-vitamins (expensive urine) but don’t have the full RDA of things like iron and vitamin D. We would also say focus on a product that uses the more absorbable forms of vitamins and minerals like natural vitamin E (d-alpha tocopherol) versus synthetic (a racemic mixture of vitamins D and l that is less absorbable); vitamin D3; and heme-iron instead of non-heme iron.