Data To Live By (Part IV: Nutrition Assessment)
Let’s get one thing out of the way: keeping a food log sucks. I get it. But a comprehensive record of what you’ve consumed over a given 30-day period, at the start of your HWW journey, is really the only way we can assess the nutritional content of your diet, identify any nutritional deficiencies and develop a plan to help you achieve your goals, whatever they may be (to lose weight, to add muscle, to reverse or block progression of disease, to slow the aging process and live with more vigor).
This is why the HWW Nutrition Assessment is the first thing we do. Because nutrition interventions - changing what you eat, how much you eat, when you eat - are the most impactful lifestyle interventions available to us. But we’re not the Food Police. We have no interest in shaming you; the goal is to turn a mirror onto your ingrained dietary habits. We want to make the unconscious conscious, and to empower you to make the right choices to improve your health.
The good news is that it's now easier than ever to log your food intake; there are literally dozens of free nutrition tracking apps that can help you capture your food intake on the go, on your mobile device (I used Nutritionix Track to prepare this blog post). Many of them sync to your fitness tracker apps as well, offering a comprehensive view of your consumption (calories coming in) and activity (calories burned).
I spent most of my life as an unconscious eater. My diet throughout my 20s and into my 30s was atrocious (I’m allowed to shame myself), an example of the typical SAD – Standard American Diet. I didn’t know any better. No one ever told me what I should have been eating and why, and what foods I should have been avoiding and the potential cost, in health capital, of my diet. So I ate what I had always eaten, from childhood. I ate unconsciously.
What did I eat?
A typical breakfast (between 6-7am) was a bagel with cream cheese and a pint of orange juice.
Lunch would be some variation of a sandwich (chicken parm, maybe) and a can of soda.
And dinner (between 7-8pm) was always meat (steak, medium rare) and maybe a few vegetables (a side salad), with a beer (or two) to wash it down. And there was always dessert (crème brulee was my favorite if I was eating out).
A peek under the covers at the macronutrient content of this typical day’s worth of meals is pretty startling:
- Total calories: 3314 (the recommended number of daily calories required by a moderately active 30-year old man to maintain his body weight is 2800; for a similarly active woman of the same age it’s 2200)
- 146g of fat: that’s 25.6% of total calories from fat, or 224% of the recommended daily fat
- 278.4g of carbohydrates: that's 49% of total calories from carbohydrates, or 32% of recommended daily carb intake. This includes 112g of sugar
- 145g of protein: that's 25.4% of calories from protein, or 201.3% of the recommended daily protein for a man of my size and age at the time
- 9.9g of fiber, or 39% of recommended daily fiber intake
And what are the insights to be gleaned from this macronutrient analysis?
3314 calories is too many calories! My BMR (Basal Metabolic Rate) at age 30 would have been approximately 2110 calories (that is, I would have burned 2110 calories during a theoretical 24 hours of rest, without any exercise). This means I would have had to burn at least* an additional 1204 calories just to break even. Chronically over-consuming the wrong kinds of calories compared to what you burn through activity will make you fat**.
Not enough of the right carbohydrates (like vegetables, fruit and whole grains). According to T. Colin Campbell, author of Whole: Rethinking the Science of Nutrition and The China Study, we should aim to get 80% of our calories from carbohydrates, 10% from fat and 10% from protein as part of a balanced, whole-food, plant-based diet. However, over 40% of the carb volume in this typical instance of the SAD diet is from sugars, simple carbs that if not converted to glucose and used immediately will be stored first in the liver and then throughout the body as fat. This imbalance (not enough complex carbs) also results in insufficient fiber consumption, and fiber is important for a healthy gut microbiome, slows the absorption of carbs (preventing a spike in insulin) and protects your liver.
Too much fat, especially the wrong kinds of fat (saturated and trans fats, from meat and dairy). In Fat for Fuel, Dr. Joseph Mercola says that we should be eating mostly plant-based fats (polyunsaturated and monounsaturated fats); these fats burn clean, help heal our mitochondria (the engines of our cells) and can help lower cholesterol and reduce the risk of heart disease (saturated fats also increase risk factors for colon and prostate cancer). Foods like organic, grass-fed butter and ghee, coconut milk, coconut oil, MCT oil, avocados, extra virgin olive oil, nuts, seeds and pastured eggs all provide healthy sources of unsaturated fat.
Too much protein. We should be consuming between .31 and .36g of protein per pound of body weight, according to Dr. Valter Longer, the author of The Longevity Diet. This is low relative to accepted mainstream dietary guidelines (and especially gimmicky dietary fads like the Atkins or Paleo diets), but research suggests that too much protein, especially animal protein from red and white meat and dairy, promotes inflammation and free radical production, both of which are responsible for tissue damage. Protein should come from high quality (e.g., organic) sources like nuts, seeds, legumes and fish (but only certain kinds, like wild-caught salmon and sardines, to avoid mercury and other toxins, and only limited to 2-3 times per week).
You can increase protein intake on strength training days or after intense exercise to support recovery and muscle regeneration.
Way too much sugar! 112g is equal to 28 teaspoons of sugar; the recommended daily sugar intake (from the World Health Organization) is 6 teaspoons. My sugar consumption on this theoretical SAD day was over 4 and a half times the daily recommended allowance. Prolonged over-consumption of sugar creates insulin resistance (and, eventually, Type 2 diabetes), activates aging-related genes, causes inflammation and makes you fat. According to the WHO, the incidence of diabetes has quadrupled worldwide in the past 35 years, and the Journal of the American Medical Association (JAMA) estimates that over 45% of US adults are either obese or morbidly obese. Over-consumption of sugar contributes to both.
Not enough phytonutrients from fruits and vegetables. This is the big disadvantage of any nutrition program that is not primarily whole-food and plant-based: you’re filling up on calories that are simply not as nutritious as the calories that come from fruits, vegetables and whole grains. If you’re not eating lots of fruits and vegetables then you’re missing out on the important antioxidant and anti-inflammatory phytochemicals (and fiber!) which contribute to good health.
Continuous access to food. I was literally eating from the time I woke up in the morning to just before bed. This kind of continuous eating has many awful side effects for our health: it prevents blood sugar and insulin levels from stabilizing; the gut is constantly digesting and doesn’t get a chance to rest; the immune system becomes overtaxed from fighting chronic inflammation; and metabolism decreases as fat storage increases. Introducing even short periods of intermittent fasting (fasting has been called the oldest dietary intervention known to man) can help revitalize these important biological functions and more.
How much exercise would it have taken to work off the more than 3300 calories consumed during this typical day, you might be wondering?
I would have had to walk for 14.8 hours.
Or I would have had to cycle for 7.6 hours.
Or I would have had to run for 5.2 hours.
In other words, I would have had to be training like a marathon runner or triathlete to justify this level of calorie consumption. But I wasn’t a marathon runner or a triathlete. I was a rapidly aging, increasingly sedentary knowledge worker and weekend warrior. I played basketball and jogged and lifted weights but in no way could my level of activity undo the unseen damage that my diet was causing.
I looked like I was in shape – I was reasonably fit and strong – but what I didn’t realize was that my diet was killing me slowly, from the inside-out. Unbeknownst to me, my diet was compromising my internal terrain, making it more and more hospitable to the growth of prostate cancer.
My diagnosis, and the decision to forgo surgery in favor of dramatic lifestyle interventions to try and mange the progression of my disease, forced me to reckon with the damage that my diet had wrought. I had to look at my food choices; I had to make the unconscious conscious. Only then was I able to use nutrition as therapy.
This is the purpose of the HWW Nutrition Assessment. To provide the information to make different food choices, proactively, before there's a health crisis. Then, once you've established healthy, conscious nutrition habits, you'll no longer have to track your food intake. You'll be an expert, a Health Warrior. Then you'll be able to help someone else, maybe someone you love, through their own food struggles. They'll thank you for it.
* My hypothetical food log doesn’t include the hypothetical cookie I would have picked up on the table in the pantry at the office or the hypothetical bag of chips I would have eaten with my lunch or the hypothetical ice cream I would have had an hour before bed or the hypothetical Halloween candy I would have pilfered from my kids’ stash.
** Between the ages of 25-40 people accumulate, on average, an extra 14 pounds of fat, or roughly a pound of fat per year. This is a result of excessive calorie consumption, a slowing metabolism and an increasingly sedentary lifestyle, all things that are within our control.