Prepare to challenge your understanding of healthy nutrition with my guest, Maria, a registered dietitian and certified diabetes educator. We journey into the world of weight inclusive care and consider how there are metabolically healthy individuals in higher weight bodies. Focusing on the individual as a whole, we discuss how work life, financial situation, and food insecurity issues can shape one's nutritional health.
Ever wondered if there's a healthier and sustainable way to enjoy food without obsessing over diets? We talk about the Mediterranean way of eating, emphasizing the difference between the words 'diet' and 'way of life.' Maria provides enlightening perspective on how the cost of food impacts our eating habits and how to navigate this challenge. We consider the benefits of small, achievable changes, and how these can boost self-efficacy.
https://mariaricupero.ca/
Prepare to challenge your understanding of healthy nutrition with my guest, Maria, a registered dietitian and certified diabetes educator. We journey into the world of weight inclusive care and consider how there are metabolically healthy individuals in higher weight bodies. Focusing on the individual as a whole, we discuss how work life, financial situation, and food insecurity issues can shape one's nutritional health.
Ever wondered if there's a healthier and sustainable way to enjoy food without obsessing over diets? We talk about the Mediterranean way of eating, emphasizing the difference between the words 'diet' and 'way of life.' Maria provides enlightening perspective on how the cost of food impacts our eating habits and how to navigate this challenge. We consider the benefits of small, achievable changes, and how these can boost self-efficacy.
https://mariaricupero.ca/
Welcome to the Mentally Strong Podcast. I'm Colum Sutherland. You can join me on my journey as I explore and discover all there is to know about living well with multiple sclerosis. I'm a normal guy who has recently diagnosed and started treatment. I will share with you my conversations with others who are living with this chronic condition and with professionals who provide resources and advice. My hope is to gain inspiration and ideas to improve your life. Welcome to Episode 4 of the Mentally Strong Podcast.
Speaker 1:Today I'm with a registered dietitian and certified diabetes educated. located in Toronto, canada, she is focused on providing non-diet, weight inclusive care for the prevention and treatment of chronic illness, including heart disease, diabetes, cancer, as well as discovered eating and eating disorders. She offers nutrition counseling and support for individuals and groups who wish to depart from dieting restricting calories or other food rules. She is a master of health science degree in nutrition communication and is trained in motivational interviewing, cognitive behavioral therapy, trauma informed care and group facilitation. She is also a trauma informed certified yoga instructor and has been teaching since 2010. In addition to her private practice, she has taught at two universities and is often invited to speak as a guest speaker nationally and internationally. Maria, welcome to the podcast.
Speaker 2:Thank you, very happy to be here.
Speaker 1:Did I miss anything? No, and how do you have time to be on the podcast with all of that?
Speaker 2:I'm making time. This is an important conversation.
Speaker 1:Thank you. I didn't ask you to say that. I just wanted to highlight one thing in your introduction and it said weight inclusive care. What does that mean?
Speaker 2:Oh, thanks for asking that question. Weight inclusive care is basically there's some other terms that people are also familiar with and that can it can also be referred to, and sometimes is referred to, as weight neutral approach or non diet approach. Essentially, weight inclusive care is not focusing on weight as a marker of success. In other words, your weight is not a reflection of how healthy or how well somebody is, and it also goes beyond that. So weight inclusive is also recognizing that there are other factors that need to be considered when a health professional, health worker, is working with individuals, and that is, you know, not just focusing on the lifestyle and behavior components but also recognizing what are people bringing to the table.
Speaker 2:So what is their work life like? What is their financial situation? Is their food insecurity issues? You know it doesn't make sense to talk about or encourage and promote diet and exercise and changing some of these behaviors. That may not be reasonable or realistic for individuals depending on where they're at at that stage in their life. So I hope that answers the question. But that's what is meant by the inclusive inclusivity part of it. Does that help?
Speaker 1:It does, and it's interesting that you brought up income. In terms of the equation of weight and how that plays into it, i recently listened to a podcast focused on the US, how there's a significantly more obesity problem with lower income.
Speaker 2:There are a lot of associations right between health risks and weight, and I'm not denying or excluding what the evidence shows in terms of that association. We do know that people who are of higher weight are at increased risk for certain health conditions, but it doesn't mean that all people at a higher weight are, in fact, about 30% of people who are in higher weight bodies are metabolically healthy, meaning they don't have high blood sugars, cholesterol, high cholesterol, high blood pressure. And so we make assumptions about people based on their physical appearance. And I can turn that around and present it in another way.
Speaker 2:You can see someone who is in a straight-sized body. So by straight-size I mean these are individuals who can walk into a shopping mall, a store, and not have a problem finding clothes that they fit into. Okay, and there, once again, there are assumptions about folks in straight-size bodies as being healthier or fit. But the reality is we don't know people's stories, we don't know what is happening behind the scenes. And it's not to say that we want to think and make these assumptions that, oh, people are suffering, but the reality is, when we comment on people's body shape, size, weight That is impacting and affecting all of us, regardless of where you fall in terms of Shape size weight.
Speaker 1:I heard an interesting fact. I did not fact check it, but apparently sumo wrestlers, while they're active, are Metabolically healthy in all categories.
Speaker 2:Yeah, and you know again, athletes right, and One time Sylvester Stallone was also when he was doing you know. I don't know how many of your listeners will know.
Speaker 1:Rocky but.
Speaker 2:But you know, back in the day He had very, very low body fat. But the body mass index, which is a horrible indicator of What is still used as a marker of health, which I hope I can see one day.
Speaker 2:You know my lifetime that it's no longer used as a marker of health. He had a very high BMI because of His weight being a higher weight, even though he had very little fat tissue and was all muscle. So you know there. Once again, there There are problems with how we measure health, and a weight-inclusive approach is not just looking at one marker, it's accounting For the, for the whole person and everything that is happening for that person. Not just quantitative measures, but also qualitative.
Speaker 1:Excellent. The background to having Maria on today is when I was diagnosed in starting treatment, the first thing the neurologist said to me was go on the Mediterranean diet, or Strongly encouraged. It didn't tell me I had to, but strongly encouraged it. I came across an article in the Globe of Mail written by Maria. I guess I should have checked the date before I reached out to her, but it's worked out. So that's how Maria and I got we connected. So What is the Mediterranean Mediterranean diet and what are the core principles for it?
Speaker 2:the Mediterranean diet is, and has been, very popular because of the amount of Evidence to support its health benefits. So if we back up to answer your question, what is the Mediterranean diet? I will highlight the core principles that are associated with it. Essentially, it is an emphasis or focus on More plant foods. It's not a vegetarian pattern of eating, but the emphasis is More on plants. So that would include Fruits and vegetables. That oftentimes comes to people's mind, but it's more than that. So an emphasis on more fruits and vegetables, plant proteins. So this is where things like our legumes come in lentils, chickpeas, kidney beans, fava beans the list goes on Nuts and seeds. It's including nuts and seeds on a regular basis, so at least three times a week. It's also about including whole grains, so things like barley oats, quinoa Trying to think of some other example kasha, buckwheat. So these are some examples of Grains or carbohydrate foods that are not heavily or processed right. So that's another key core component or principle to the Mediterranean diet. The Mediterranean diet also encourages greater intake of fish and seafood, and Fish all fish kind of works and counts here, but particularly the fish that tends to be higher in fat. So things like trout, sardines, mackerel, just to give you a few examples. They're higher in omega-3 fats, which have anti inflammatory properties to them, and And so that that is one of the reasons why fish is encouraged at least three times a week, two or three times a week.
Speaker 2:As I mentioned earlier, it's not a vegetarian pattern of eating.
Speaker 2:However, having said that, dairy products, like high-fat dairy products, and meat Right and this is unprocessed meats They're not and, and this would also include poultry, so they're not Excluded from this diet, but they're not the main focus. You know it's typical that in our Western society, if you look at a plate, it's very common for you know a steak to cover perhaps the majority of Of the space on the plate and, if we're lucky, vegetables may make their way on the plate usually, whereas in the Mediterranean pattern of eating that's reversed. So there's a small part, a small section of that plate that will include, if, if, meat is to be included, but then the remainder of it is more of this. Focus on Legumes, as I mentioned earlier, we could put tofu in that as well, even though that's not quite quote-unquote Mediterranean. We've come to make adaptations right to include other cultures in this, in this pattern of eating, and Then the use of olive oil is oftentimes Use. So that's another core principle and that's the extra virgin olive oil.
Speaker 1:That's a lot.
Speaker 2:It is a lot, and that's because, again, i broke it down. But I'm curious to know, colm, when you say it's a lot like, what makes you say it's a lot like a lot of food or What exactly?
Speaker 1:is listening right now and they're not taking notes. They just forgot some of it, That's all.
Speaker 2:Okay, well, i appreciate that. So let me praise. See that, okay, and and it's what I said right from the outset It's primarily a focus on more plant-based foods, and maybe I'll throw in some fish in there too. So plants and fish more often. It's not about excluding things per se, but it's about you know what is missing from One's pattern of eating that they could actually add to. Another key take home or summary point is The Mediterranean diet. If you were listening at some of the examples even if you can't remember, you're listening and taking in what I was saying It's essentially the inclusion of foods that are less processed, right, higher in fiber. You're getting much more nutritional value, nutritional density. So that's another key component less highly processed foods. Focus on more plant foods and fish. Does that help Get simple?
Speaker 1:Yeah, I've been following the Mediterranean diet for the most part, based on what I've read, since February, maybe beginning of March, and the two pieces that really have changed for me with what you've said. It's like you're watching what I'm saying. It's like you're watching what I'm eating, but Half of my plate is now vegetables, whereas you were looking in January is probably the opposite, and I have increased the fish intake, which, right. I'm gonna ask a follow-up question on that because I have a feeling Someone's thinking this as they're listening to it. Is there a concern about mercury?
Speaker 2:Yeah, and I get this question a lot, so it's a great question, absolutely. You know to a certain degree, sure, there is, and it's not just mercury, it's other heavy metals. So there is a really great website, and I think it's still available So Cchoiceorg, so C, as in the C, s-e-a choiceorg. That is a website that your listeners can refer to and they update it regularly, where they will list the most sustainable choices, those that are lowest or lower in these heavy metals, so anyone who's concerned can take a look and make their choices accordingly. I think the reality here and it depends on what your typical pattern is, but for someone who is a regular consumer of fish and eats that like almost every day, all the time, i'd say that there's more of a concern there, right? So you'd want to change it up. You'd want to be mindful of levels what have you? And, of course, pregnant women, children, right? You'd want to also be mindful of that as well. Generally speaking, my experience in working with people has been that most people don't include fish, but you know, then there's folks like yourself wanting to make a change, hear about the Mediterranean diet, want to include different foods, and you may start to include it more frequently. So, yeah, everything is about a balance And I think this website can help just you know you to make those choices.
Speaker 2:I will say, just to give you an example, something like the larger the fish is, the more likely they are to have a buildup of heavy metals because they've just been around longer. Bottom feeders will tend to have higher mercury levels, right? So some shellfish, for example. So those would be the kinds of things to look out for. Can tuna is very popular, right, it's. It's economical. It's not necessarily economical, but it's convenient, right, and and many people like it The tuna, if it's. You know, yellowfin tuna. You can get albacore tuna, which is a larger fish, but the yellowfin tuna itself is a smaller fish and mercury levels are far lower and generally not a concern.
Speaker 1:So there's tons of fad diets out there. There's tons of different diets that some people may or may not call fad. What do you think differentiates the Mediterranean diet from the rest of the stuff that's out there?
Speaker 2:Yeah, you know some people may think that the Mediterranean diet is is a bit of a fad, right, because it's given this name, this title. I tend to not to look at it that way. Generally speaking, a diet that's referred to like as a fad diet is really oftentimes one that's not sustainable. People can follow it in the short term, maybe they see the results that they want to see, and it's usually pretty difficult to sustain and maintain just because it tends to be highly restrictive in nature, right? So whether it's one major food group that's being eliminated or overall calorie intake, energy intake is being restricted, the bottom line is it's not sustainable long term, whereas the Mediterranean diet is not about restriction, it's not about overconsumption, but it's not about eliminating any one major food, and research shows that it does tend to be a pattern of eating that, for most people, is sustainable in the long term.
Speaker 1:Yeah, I prefer to call it the Mediterranean way of eating versus diet. I prefer to go to something that I can do on a regular basis and it's not going to go away. It's nothing about. It's nothing bad about ketogenic diet. Personally, I know I would not be able to do that for the rest of my life If someone came. Great, I know I. I know I can't and won't. So one of the things I have liked about the Mediterranean way is that I know I can continue to do it as long as I want to, except for maybe some Saturday nights.
Speaker 2:Right, and you know it's, it's it is. It is really important to consider that factor And that's oftentimes a question that I will pose to to the folks that I work with. It is important to follow a pattern of eating that you feel you can stick with for the long term. And you know, following a Mediterranean way of eating or pattern of eating for many people is not easy, because there there are a lot of things to consider And I'll just highlight some of them And maybe we can elaborate on them later if you like. But essentially, because there is such a focus and emphasis on more plant foods, not everybody can afford that, right. So the cost of food particular and fish for that matter, right. So the cost of food has really gone up. It's not to say that you can't follow a Mediterranean pattern of eating and be economical about it. There are ways, and it certainly makes it easier if you don't like fish, right, you're not going to be including that more often, but the reality is the cost of food has gone up And people were already feeling it And now they're. They're having even more difficulty with that, and to maintain a behavior change is also challenging.
Speaker 2:I do, if I, if I may. I would like to come back to the word diet because once again this is something that comes up a lot And just for clarification. I'm big on words, right, i did my my masters in communication, so like words matter, and I just wanted to spell a bit of a myth, because the word diet has kind of been morphed into this. You know it's a noun, but it's been morphed into being a verb, right, like I'm dieting. But when we actually look at the root and where, where the word diet is derived from, it comes from the Greek word Deitha, and when you translate that it's actually a way of life. That's the meaning of it And I love that Because and now this is my own take on it Your diet is, you know, your way of eating, right And and again, your way of eating, that you can stick with long term is really important.
Speaker 1:It's an excellent point. I admittedly avoid the word because it's the way society sees it at this point. If you say the word diet, it's a temporary thing. You'll be back to eating your normal way in six weeks. But you're, you're absolutely right. Right, your diet is what you eat. It's not Mediterranean, it's not ketogenic, it's not American. It's what you eat.
Speaker 2:Yeah, and, and you know I maybe I should have like opened up with that, just because I will default to saying diet a lot, but please know that that's where it's coming from.
Speaker 1:It's very safe to use the word. I think people need to hear it and think about in the right context. One of my new favorite sayings I love it And people who listen to this podcast are probably going to get sick of it Is if you want to make a change, pick something you can do. You know you can do and you can do it for the rest of your life. And start doing that tomorrow or start doing it today. But make it small. Make it so that you can do it and be confident in it that you can do that for the rest of your life.
Speaker 2:And that building, that self efficacy.
Speaker 1:Yeah, small steps beautiful, and that will hopefully pull you away from the well, I'm not going to eat bread for six months, or I'm not going to eat this for six months When you know you're not committed to getting rid of it for the rest of your life.
Speaker 2:Yeah, and you know, colm, your comment about like when I was going through the principles of the Mediterranean diet, and your comment about like that's a lot, like I can't remember what you said at the outset. I really do appreciate that Right Note to self. Right, cut it short, but honestly, it's such an important comment because you know, when I, when I work with folks about, and you know, exploring their eating patterns, with them and people wanting to to make a change, i really try to emphasize the point. Well, look at where you're at right now. Like, take a look at what foods you do tend to include most often.
Speaker 2:How can you, knowing these core principles to the Mediterranean diet, how can you, or can you pick one, maybe two, but hey, great, if you can even just start with one. What is one change you can make where you're adding one of these core principles to what you're already doing? And then, so this kind of is in line with what you were saying earlier right, just focus on one thing, small steps, and build, build on it. Because when you see success, right, when you can see, hey, that wasn't so bad, i can do this, that's going to help to build the self efficacy And that's ultimately, what is required to make a change.
Speaker 1:Absolutely. I can tell you what mine was for this when I switched over It was making half my plate vegetables. So if half of my plate is vegetables and then there's a healthy protein, whether it's fish or chicken or whatever I think you're pretty much nailing it.
Speaker 2:Yeah, yeah, yeah, that's awesome. And you know, i find too I'm referring, i'm making lots of reference to my own practice, because I feel that these experiences really speak volumes to people listening right. What I'm getting at is, you know, for people who like salads and typically tend to include a salad every now and then So that's not you buying my Call them nodding his head or shaking his head So for those who do like it right, and I'm glad I said that for those who do like salads, being able to, you know, add maybe a handful of chickpeas or kidney beans or some other kind of bean to that salad. That is, i think it's safe to say, not a dramatic or drastic change for someone to implement, so that beans don't necessarily have to be the main event, right, or the main entree, but they can start off by being again added to a rice dish, added to a salad or as a side, and see where that takes you. I'm a big fan of sorry, i'm a big fan of just taking those small steps and building.
Speaker 1:It's funny you say that particular tip or hint because there was a fad diet I was listening to yesterday and one of his hint was adding black beans or chickpeas to breakfast, lunch, dinner, because the fiber will satiate you faster and you'll eat less.
Speaker 2:Well, beans, legumes are quite filling because of the fiber, absolutely, And most people don't even get half of what is recommended on a daily basis. So I think it's fair to say that most of us can probably do better in the fiber department, And just eating fruits and vegetables alone you're not going to, even if you were including them at every meal still not likely to reach the adequate intakes that are recommended.
Speaker 1:We've talked a lot about what we could be eating, what are the potential health benefits, and we'll start with the one that's, i guess, focused towards multiple sclerosis, which would be brain health.
Speaker 2:Yeah, there is some. I mean going in the past. there's some excellent evidence to show that, from a cardiovascular perspective, the Mediterranean diet is great and very beneficial at reducing not just the experiencing what we call a repeat event, meaning if you had a heart attack, preventing another heart attack from happening or preventing stroke from happening, but there's very compelling evidence that shows it can also reduce the risk of mortality. There is emerging and very exciting research focused on brain health And when it comes to MS, we tend to like there are no specific guidelines per se from a diet perspective. we tend to hear well, it's general healthy eating practices. And actually if you take a look at the Mediterranean diet, it's really not that much different from what Health Canada is promoting and suggesting. right, health Canada now has the plate model which you've described, emphasis again more on plant foods, plant proteins. So there's lots of consistencies there And we don't really know. this is the problem with nutrition science. We don't know exactly what is it about food that is bringing about the benefit. So we can speculate, say it's fiber. we can speculate and say is it magnesium, is it calcium? Is it all these nutrients put together that are working synergistically? We don't really know.
Speaker 2:But one thing that is highlighted is the fact and this is what has come up quite a bit with the Mediterranean diet research is that they measured. there was one study that was done where they measured markers of inflammation. So C-reactive protein is an example of that. These are enterolucan 6 and 9, these are other markers of inflammation And what they found is when they measured them at baseline and measured them again after the intervention, when people implemented a Mediterranean diet and compared them to a control group, they found that those markers actually improved.
Speaker 2:So there is evidence that following more plant-based pattern of eating, that doesn't necessarily have to be vegetarian, because that doesn't work for everybody, right, and I'm not dismissing a vegetarian pattern of eating, or even vegan for that matter, but it's not for everybody. So, focusing more on a plant-based diet, we do know that that there is this anti-inflammatory impact or effect And maybe it's that aspect of it that is helping with brain health. There's lots of research focused on Alzheimer's, like prevention of Alzheimer's and dementia very exciting stuff. So you know, another take home here would be just aim to get more color on your plate, because the color primarily in our food does come from plants when you think about it.
Speaker 1:Absolutely. You were talking about brain health. Do you have any thoughts on food versus mental health and how it helps, or does it help?
Speaker 2:Oh, absolutely Absolutely, And yeah, i don't know that most people would make the connection sometimes. So again, thank you for asking the question. We, because we often talk about you, know food, our diet and exercise. Those two go hand in hand And oftentimes they do.
Speaker 2:There is a huge connection to our mental health because once again, we're not just our physical bodies right, you think about the World Health Organization definition of health? It's our mental, physical and emotional and spiritual well-being. So it's not just our physical health When we are not nourishing our body, for whatever reason. Sometimes we're on the go, sometimes we didn't get enough sleep, we're feeling groggy, we may not be feeling well, maybe we're purposely restricting our food intake right to get at a desirable weight or so-called quote-unquote healthy weight, which, again, in my opinion, doesn't exist. But I digress.
Speaker 2:You know, when people are not getting or meeting their energy and nutrient requirements, our blood glucose levels start to drop And that is basically our energy level. And food, particularly carbohydrates, all food gives us energy, but our carbohydrate foods so things like your fruit, vegetables, whole grains there's carbohydrate in dairy products, with the exception of cheese and legumes will also contribute to some carbohydrate and glucose in the system. That is the body's primary source of fuel, and the brain, the brain itself, can only function adequately with carbohydrates in the diet, because it's glucose, that's where the brain gets its energy from. So it's extremely important because? well, let me ask you, because we've all been there, myself included. Now I'm putting you on the spot, but you know when, when you've delayed a meal for whatever reason again, sometimes, like life happens right How do you feel when you can't get to having something to eat?
Speaker 1:You just crossed into a whole different conversation, but we'll go with it. We'll go with it Because it's something else that I've done and I'm still doing So. I have switched over for the most part, to the Mediterranean diet way of eating. I have also added to my plan intermittent fasting or time restricted eating. In reading and listening, i've heard a lot about metabolic flexibility And, i'll be honest, i still don't totally understand it. But because of the way I'm eating and because I've gone through, i was doing the 16-8. But I lost way too much weight. I couldn't keep up with it. So I've I've changed it to about 13 hours of fasting, which is basically sleep, and just before bed and just when you wake up. So it's it's not hard to do at all. I don't have an issue if I don't get to food anymore, which I think is a good thing. I don't, i'm rarely hungry and if I have to go six hours without eating, i don't think twice about it.
Speaker 2:So that's interesting And I would say, for most people because I, you know, again, everybody's experience is different The time of the time of day that that is happening, i think, matters. So, for example, if someone is, they wake up in the morning, don't have time for breakfast, don't have time for lunch, They're going a long time without eating, not to mention the overnight fast, right, so that's almost 12 hours without eating. And the reality is that we're designed to eat, right, we need to eat to survive bottom line. So we get to a point where the body's going to send some signals that are going to tell us that we're going to be eating And that are going to tell you that, hey, i need to be nourished. And so what I was hoping that you would say is that, you know, with blood sugar is dropping. I'm kidding, like, i appreciate your answer right, but as blood sugar levels drop, initially too, like, people typically do get a response where sometimes it's hunger. But the more this happens, our bodies adapt to that change, and so low blood sugar is not always synonymous with feeling hungry. Yes, oftentimes it can be, but not always, especially if you know, because you can essentially train your body to adapt and adjust.
Speaker 2:The other thing is that people will report symptoms like it's hard to focus. When I work with university students, they'll often say you know, it's like I'm reading the same paragraph of this article like five times and nothing's registering. I can't focus. It's really hard for me to do my work. Their mood is affected, so they're more irritable. It impacts their relationships.
Speaker 2:So this is the connection between nutrition and mental health, one aspect of it, right, and it impacts again overall wellness and how you feel day to day. Right, just moving, navigating the world. So that's the point that I was just kind of referring to, that. You know, when we talk about this connection between nutrition, food and your mental health, it's very important for us to recognize that and that it's not just fueling the body. Food is so many things to so many people that to reduce the amount of food that's reduced down to just the calories or the fat grams or the sugar amounts that we're consuming is really not doing it justice. We eat for lots of different reasons And, yeah, i think it's important to recognize that because it does contribute to our overall attitudes about food and our relationship with food.
Speaker 1:I'm going to try to tie it together and see what you think of this as your opinion. I'm not trained in nutrition. I've been experimenting on myself. Really, I've been a guinea pig for the last four months on myself. One of the reasons I believe that I'm okay without going to food I don't get. I don't have lows and I don't. I have brain fog once in a while, but I think it's related to other things. I don't think my blood sugar goes super high and drops. So if I'm eating a Mediterranean plate mostly vegetables, lean protein I'm not spiking with a lot of carbs. The other thing is I don't use any additional sugar, if I can help it. I know there's sugar in food, but I'm not adding it. So I think by keeping my blood sugar levels intuitively pretty flat, I'm not having the ups and downs. Does that make sense of why I might have answered it differently than what you thought? Oh, okay, I wasn't sure. We just met folks. We just met.
Speaker 2:No, but quite honestly, you know no, no, and you know the with intermittent fasting. There, as you pointed out, like there are many different protocols right, you alluded to that. There are many different protocols And you know there's one meal a day. There's another protocol is five, seven, where people will find, you know, during the week for five days, will restrict for several hours, and then there are no quote unquote rules to follow on the weekend or whatever days that person chooses, it doesn't have to be the weekend And then there's like three meals a day and not eating after six or seven or again, whatever time the individual chooses, and to me that's not really restriction. Or, you know, for some it would be if they're used to snacking in the evening or eating later in the evening. But you're still most likely, depending on what you're including, able to meet your energy and nutrient requirements right By including three meals. I don't know again, for others it might work out to be two meals, the. I think I was going to say like the problem, and maybe that's not the right word, but when you look at the evidence for intermittent fasting and a lot of this research has been done on people living with diabetes, because that's a hot topic right in terms of improving blood sugar levels and 8-1-C, which is a marker of glucose management control. The problem is number one when we're trying to, there's so many different protocols and it's hard to compare, right. So that's the first problem. The second is that the number of people who are involved in these studies, the sample size, is just too small, so it's not generalizable to the greater public, and these are important things to consider. The other thing is they've only been looked at the follow-up period very short term six months, maybe a year is being the longest. So there's still a lot of questions.
Speaker 2:And I think sometimes when we hear, oh, weight loss, because, face it, that's a society we live in, right, and there's a lot of pressure too coming from the medical community about weight loss and improving health markers. And while I will acknowledge that there is definitely that association, we cannot say for sure that it's caused an effect, because I have seen and this isn't just anecdotal, but there is evidence that also shows that people can improve their blood sugar, cholesterol, blood pressure, all these markers, even if they don't lose weight. And that's not to say that, oh, it just happens on its own. No, there are definitely changes that need to be made. So maybe it's making changes to the way they eat. Exercise building lean tissue tremendously helps to improve insulin resistance, so it's focusing on the behaviors that in my practice, i I it's how I work with folks and not measuring their success by scale, weight or weight size, because the reality is people come in all different shapes and sizes and health does not equal weight.
Speaker 1:A lot of my reading has been focused on longevity and living longer, and you've may have heard of David Sinclair, who sort of seems to lead the way and is a huge fan of intermittent fasting and he's one meal a day. I don't know how he does it, but he does it. That's not a small thing. I'm going to change tomorrow that I can keep doing To the intermittent fasting time restrict to eating Mediterranean diet. Do you think it's fair to say if it's working for someone in some way or modified, and they're feeling good and they're healthy? I know that can be defined in many ways, but for the purpose of the conversation we'll say healthy. Is that not the way they should be eating?
Speaker 2:Yeah, it's a great question. It's a fair question And, honestly, I'm not here to judge what people do bottom line, And you know people can feel quite strongly about food and nutrition. Trust me, right, I know there's very there's often a very strong emotional reaction to food, right? So I'm not here to judge. People will do what they want and what feels right for them. What I, when asked, will share is that what we know from weight science and weight loss trials. People can, for the most part, regardless of what diet plan an individual is falling it could be intermittent fasting, time, restricted eating, it could be keto, it could be Mediterranean diet with a calorie deficit, it could be, etc. Etc. You get my point right. It could be a weight watcher's diet, okay. So anytime energy restriction is involved, it is not uncommon for most people to experience some weight loss.