Nutritionist Answers Nutrition Questions From Twitter

I'm Dr. David Katz.

Let's answer some questions from the internet.

This is Nutrition Support.

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@curtismwhitaker, In your opinion,

what is the best diet for health and longevity?

It's a theme.

It's not one specific diet.

Seven words: eat food, not too much, mostly plants.

And that comes to us courtesy of the blue zones,

five populations around the world in Ikaria, Greece,

Sardinia, Italy, Okinawa, Japan, Loma Linda, California,

and the Nicoya Peninsula in Costa Rica,

where people most often live to be 100 years old,

don't get chronic disease or dementia.

They all adhere to that same basic theme,

real food, mostly plants.

Lots of vegetables, fruits, whole grains, beans, lentils,

nuts and seeds, mostly plain water when thirsty.

Aim to love the food that loves you back.

If that's the foundation of your diet,

you can't go too far wrong.

@JayHartmann24 asks, Can you have too much protein?

Yes, you can eat too much protein.

Most Americans get about twice

the recommended amount of protein.

Excess protein is acidic.

Excess protein can't be used by the body,

doesn't turn into big, strong muscles.

The body can store carbohydrate and it can store fat.

It cannot store protein.

Our carbohydrate store is called glycogen,

generally about 1,200 to 1,800 calories worth.

Protein does not get stored,

so what the body does is convert it into something

it can store.

And since glycogen is already capped out,

all surplus protein the body doesn't need

and can't use now it stores as fat.

@xobabydoll9 asks, Where does keto science

and nutrition come from?

How does anyone believe that eating zero carbs

and almost all fat could be good for you?

It doesn't make sense to me.

So where does it come from? Is there a science?

Yes, actually.

So the origins of the ketogenic diet were

it was discovered that if you restricted fuel to the brain

you could sometimes treat seizures

that nothing else would treat, intractable epilepsy.

Their seizures sometimes would stop

if you starved the brain of carbohydrate.

Sometimes, especially in children,

if the typical drugs to treat seizures are not working,

sometimes a ketogenic diet is used.

But that should give everybody else pause.

The calling card of this particular diet

is that it starves the brain of a key nutrient

and quiets brain activity.

Is that really what a healthy person wants their diet to do?

I would say no.

@Outdoctrination asks, What are some of the biggest

nutrition, exercise, health myths you can think of?

So the prevailing view these days

seems to be that carbohydrate is bad.

Everything from lentils to lollipops are carbohydrate.

In fact, all plant foods

along with most processed foods are carbohydrate.

So vegetables, fruits, whole grains, legumes,

all carbohydrate, and all of the best diets for humans

tend to be rich in carbohydrate, but good carbohydrate.

Is there bad carbohydrate?

Refined grains, added sugar, ultra-processed junk food,

yeah, that's bad.

@IdontknOwmyself asks, How do you change your metabolism?

How? Mine is my worst enemy, I hate it.

Good news. You actually can change yours.

Add muscle to your body.

Do resistance training three times a week.

When you add ounces or pounds of muscle to your body,

you're burning more calories 24/7.

So if you kept your current eating the same

and worked out doing resistance training three times a week,

you would start to lose weight

if your current calorie intake was maintaining your weight

because you would need more for those muscles to survive.

@AllisonMcKeany asks,

Are all calories really created equal?

I think what you're really asking is,

does it matter what the source of the calorie is?

And obviously foods are not all created equal.

One of the critical considerations

is that if you eat a wide variety of really wholesome foods,

foods direct from nature, they fill you up on fewer calories

than if you eat ultra-processed foods.

Here is something you may not know.

Non-food components added in with the food.

Now you've got an ultra-processed food.

Those foods are manipulated in all sorts of ways

to extend their shelf life

and to stimulate your appetite center and make you overeat.

So ultra-processing is bad.

@stephanieb789 asks, What is a completely healthy weight?

'Cause BMI is BS and so is the weight number.

Body mass index does not tell you if you're healthy.

It does tell you if, on average,

your weight is what it should be

for somebody who is your height.

Weight is not a measure of health.

One thing that's more reliable than BMI or weight

to get at specific health issues is waist circumference.

More than 35 inches puts a woman at increased risk.

For a man, it's a little higher.

It's about 40 inches.

The fat that tends to accumulate in the lower extremities,

for example, the legs, the buttocks,

much less metabolically active.

Fat around the middle has a nasty habit

of getting into the liver.

It disrupts normal liver function.

It impairs our ability to manage lipids in our blood

and it tends to make us insulin resistant.

You don't make enough insulin to manage your blood sugar

and you wind up with type 2 diabetes.

We cannot pretend that accumulating

excess body fat doesn't matter.

But you're absolutely right, BMI is not a measure of health.

@paleoplus asks, How legit is the paleo diet?

A true paleo diet is really difficult to achieve

in the modern world.

The paleo diet or paleolithic diet

is about how did humans eat during the Stone Age?

First of all, you can't eat any processed foods.

You can't eat any dairy.

If you eat any meat, it has to be game.

Wild animals exclusively.

The kind of meat our ancestors had access to

was a lot like antelope.

About 7% of the calories in an antelope steak come from fat.

Almost none of that fat is saturated.

Quite a lot of it is omega-3.

Compare that to beef.

35% of the calories come from fat,

most of that fat is saturated, and none of it's omega-3.

Night and day.

Our Stone Age ancestors didn't eat that.

Our Stone Age ancestors got about 100 grams

of fiber every day.

Now the recommendation here in the U.S. for adults

is about 25 grams a day.

But 100 grams a day probably means more time in the bathroom

than your schedule would allow.

@cgwa85 asks, I've come to accept that girl dinner

is the main thing holding me back in life.

Like, why can't I nutrition properly?

I'm relatively new to girl dinner,

but I've done some searching

and I understand it's something like this.

It's basically a quick assembly of foods

that you can easily get your hands on.

The basic concept I think emphasizes convenience.

We've got some processed meat,

but we don't really need that.

We could have an alternative to that,

if you wanted to take out some of the least healthful foods.

But why can't the dip, for example, be a bean dip or hummus?

Crackers as opposed to chips that are made from whole grains

with a very short list of ingredients?

There is cheese.

If you're gonna keep the cheese, grapes go well with cheese.

Some dried fruits go great with cheese.

But when you have milk chocolate

and add in a lot of saturated fat and a lot more calories,

typically more sugar comes along for the ride too.

But if you traded this up to pure dark chocolate,

60% cocoa or higher, it's delicious,

it's rich, it's rewarding.

And because it's bittersweet rather than purely sweet,

it actually fills you up on fewer calories,

and now you're having the indulgence,

but you're also improving overall nutrition.

So I don't think it would be that much work

to overhaul this.

Stick with the girl dinner, trade up the nutrition,

and then girl dinner won't be holding you back.

@fleggpe asks, Explain the major difference

between macro and micronutrients?

Macro is something you can see with the naked eye.

So there are three macronutrients

that make up the bulk of food.

They are abundant enough to be visible,

protein, carbohydrate, and fat.

Micro is something for which you need a microscope.

Micronutrients are vitamins, minerals, antioxidants

that are still very important.

Many of them are essential nutrients,

but they're too small to see.

@JohnPetersonFW asked, I'd really like to know,

from someone that actually knows,

if buying organic food for double the price

is actually worth it/better for you?

A great question.

We really can't say for sure

that it's better for human health,

but we have reason to think so.

Herbicides should not be part of the human diet.

Pesticides should not be part of the human diet.

Antibiotics dosed to animals

should not be part of the human diet.

And if you eat organic, you're avoiding all of those things.

Produce grown organically seems to be on average

as much as 20% more concentrated

in a wide array of micronutrients

than its non-organically grown counterparts.

So that would mean 20% more vitamins, 20% more minerals,

and 20% more antioxidants, for example.

If I look at these foods here,

you think about when would it be more important

to buy organic.

I like it for the lettuces.

We've got radicchio here.

I like it for the carrots.

I really like it for these berries.

So whenever you're not taking a surface off of food

and you're eating it whole,

buying organic tends to matter more.

@CARTIERANG3L asks, Intermittent fasting is BS.

It's literally just skipping breakfast with a fancy name.

It's bit more than that, but you're not entirely wrong.

There have been randomized control trials

putting them head to head,

intermittent fasting to limit your calories

and no time restriction but portion control.

And you wind up with the same number of calories,

the same foods just distributed differently

with intermittent fasting being the difference.

Guess the results.

No discernible difference.

But that doesn't mean intermittent fasting

isn't a valid tactic.

For some people it just works better

than thinking about portion control all the time.

I mean, if you start your day at lunch

and have dinner and then you stop, you're right,

that pretty much involves just skipping breakfast.

And the idea is you're poking a hole

in your daily intake of calories,

so you wind up eating fewer calories,

and that tends to help people

with weight loss and weight control.

@ajrendon96 asks, Ketosis? How does that feel?

The ketogenic diet is trying to avoid overt starvation

but mimic its effects.

When people go into a state of starvation

they have this sense of euphoria.

Some people report mental clarity,

some people report feeling very energetic.

And people who are trying to stay

on a ketogenic diet experience some of what people

in an extended experience of starvation feel,

which is exhaustion, brain fog, constipation,

and a whole host of other ills.

So when we're starving,

we actually start to break down our own tissues.

We use up our glycogen,

and once that's gone we don't have carbohydrates,

so we can't make sugar, so we start burning our body fat.

From my point of view,

the ketogenic diet is not a recommended approach

for long-term.

It restricts many of the most nutritious foods,

the very foods we know are associated

with both longevity and vitality.

@asp1reluna asks, What food/drinks

should I cut out of my diet?

I'm gonna go with soda, source of empty calories,

source of a lot of the excess sugar most Americans eat.

Easily replaceable with much better stuff.

Water would be ideal,

but any kind of seltzer would be a good intermediate step.

We're just gonna cut one thing out of a diet,

let's cut out soda.

@swissbusiness asks, Is going gluten-free

good for everyone?

No, gluten is a component of some really nutritious foods

like whole wheat, whole barley, other grains.

Avoiding gluten is only important

if you're gluten sensitive.

That means you either have celiac disease,

where you actually make antibodies

and you absolutely have to avoid gluten

and then it's very important,

or you just don't feel well

when you eat foods that contain gluten.

In those instances, you should avoid it.

For everybody else, there's no advantage

in avoiding foods that contain gluten.

@ineyeseaohelee asks, Are you plant-based/vegan

and finding it difficult to get the proper nutrition,

protein, minerals, micro, macronutrients?

Now, first of all, I'm primarily vegan.

You get many more vitamins and minerals from plants

than from animal foods.

There are a couple of exceptions like B12,

and so a supplement's not an unreasonable idea.

Protein is not deficient in plant foods.

All plant foods contain all essential amino acids.

And if you find it hard to believe

that you can build big, strong muscles

from eating just plants, take a look at a horse.

Take a look at a gorilla.

Take a look at an ox.

@poeticdweller asks, Is the food pyramid still real?

Like, are you guys actually eating

all these servings every day?

This just feels like a lot.

This is what we're talking about here.

It's not still in use.

It's actually been replaced.

It's been replaced by a plate.

So if your plate is taken up 3/4 by vegetables, fruits,

whole grains on average over the course of the day,

you're gonna be doing pretty well.

@Bull_Spear says, Honestly, I don't know why I bother

reading nutritional labels.

I don't know what the [beep] niacin is

or why one Nutri-Grain bar has 10% DV of it.

Okay, our problem used to be micronutrient deficiencies.

Our problem today is much more about macronutrient excess,

just eating too much of all the wrong foods.

I would say look at an ingredient list

and look for things you recognize as food.

If you're having a Nutri-Grain bar,

you'd really like to make sure

that the first ingredient is a grain

and ideally a whole grain, and that would be a good thing.

If the first ingredient in a grain product

is anything other than a grain, like sugar, for example,

you could do better.

@mintpoid asks, What do I eat pre-workout

versus post-workout macros wise?

In general, you wanna preload for a workout

with carbohydrate that's gonna help you fill

your glycogen stores.

That's the fuel you're going to be running on

during an extended period of exercise,

a long bike ride, a long hike, a long run, a marathon.

Complex carbohydrates, that would be whole grains.

It would be fruit.

For recovery afterwards, you've used your muscle,

you've broken down muscle if you've worked out intensely,

high quality protein.

And the other thing that would be really important

post-workout would be antioxidants.

Antioxidant compounds actually help protect the cells

as they go through that process of breakdown

during exercise recovery after.

So those are all the questions.

I really appreciate the honesty.

Thank you for joining us today on Nutrition Support.