What the data shows is that, during pregnancy, there are changes to the mother’s gut-associated bacteria between the first and the third trimester. The bacteria during the first trimester are fairly “normal” and contain a high diversity of bacterial species. During the third trimester, several types of bacteria, notably the very inflammatory Proteobacteria become elevated. Interestingly, there are a large number of studies which show that elevated Proteobacteria levels are associated with screwed up metabolism of the host resulting in obesity, diabetes, etc most likely because of excessive inflammation.
What was REALLY cool (at least to a nerd like me) is that when the scientists transferred the bacteria from a third-trimester mom into a germ-free mouse (Think of it as a mouse that lives in a sterile bubble), those animal became fatter and less sensitive to insulin signaling than mice given bacteria from a first-trimester mother.
What this means is that one of the main reason’s why pregnant women gain weight and adiposity during pregnancy is BECAUSE of changes to the bacteria that reside in their gut. The study above went on to show that the bacteria that emerges during pregnancy is better able to extract energy from the diet and transfer that to the mother, and therefore the baby as well. The downside of this is the extra-weight gain and potentially gestational diabetes as a result…
You have to ask yourself, why would you want this to happen during pregnancy? You would think that you’d want Mom to be as healthy as possible and to not have a screwed up metabolism, never mind diabetes, right???? WRONG!
There is a strong hypothesis that during pregnancy, the mothers body is willing to sacrifice its own sensitivity to sugar/gluces so that energy is diverted to the developing baby. Evolutionarily, it makes sense to put that cute little parasite (that you’ll eventually come to love) first.
Its amazing the balance that the host and microbiota have and how they can affect each other. In this scenario basically what we have is the following:
1) Some unknown change in the mother that results in a slow alteration of the microbiota between the first and third trimester.
2) These altered microbiota produce more energy from the consumed food which can be transferred to the host.
3) The third trimester microbiota are also way more inflammatory…
4) The inflammation driven by the altered microbiota has been shown to play a CRITICAL roll in decreasing insulin sensitivity, which in this case is beneficial in diverting energy to the developing baby.
What an absolutely beautiful symbiotic set of events.
I wanted to tell a story of two very different clients of mine and how I’ve approached using nutrition and lifestyle changes to help them get closer to their goals. While we often talk in generalities on how to eat, the reality of the situation is that everyone is unique and needs tweaking to those basic principles to make progress… here are a couple examples.
Clients 1: The crossfitting, butt-kicking, weight losing husband and wife team
The first clients I’m going to talk about are the typical person that approaches me looking to lose weight. Audrey and her husband Mark had been working out at The Fort Crossfit for several years and had been trying to eat with a Paleo style emphasis. This approach worked well for a while with some impressive weight loss numbers, but they eventually hit a plateau as progress stalled. This is when she approached me about working together to help her break through the barrier and improve her health and body composition even further. While they were doing these pretty correctly for the most part, there were definitely some aspects of both nutrition and their lifestyle that needed to be modified.
One of the components of my program is a 28 day meal plan where I detail how I want people to eat for 3 meals plus a snack for every single day of a month. The meals follow some basic principles as it relates to balancing protein, carbs and fat but really the goal is to show people how to eat cleanly for 28 straight days.
While compliance with the program is been a challenge with many clients, Audrey and Mark were committed 110%. They followed the program as closely as any people that I’ve ever worked with and the results were really fantastic. While I generally couldn’t give two shits about the numbers on a scale, the results are worth talking about as Audrey dropped ~16 pounds over two months and Mark dropped about 10 lbs. More importantly, Audrey told me that she was constantly having people tell her that she looked fabulous (she does…) and her coach was thrilled by her progress in the gym. With results like these, they should both be getting compliments for quite a while.
I credit Audrey and Mark’s success to several factors.
1) They actually listened when I told them to get more sleep at night. Most people are unwilling to change their sleep patterns but they did and as a result, reduced stress levels which allowed for improved performance in the gym and more will-power to make the right decisions with nutrition.
2) Audrey and Mark really put a bunch of effort into figuring out how to make the meal plan fit into their lives. When they went to parties, they brought their own snacks and beverages. When it was their anniversary, they picked a place with incredible food that was also healthy. Little choices like this make all the difference in having prolonged success.
3) They stuck with the program for more than just 1 month. Many times people do great when they have someone (like me) holding them accountable, but derail when they are on their own because they have not yet made eating healthy a habit. By sticking with the program for multiple months, Audrey and Mark really did make eating healthy the new “normal.”
Eventually, I told Audrey and Mark that it was time to give things a try on their own. I can tell they are continuing to excel all on their own which is exactly my hope for all the people I work with.
Client two: The fit guy that needed to get bigger
I’ve known Kyle for many years now, back from when there was literally a single Crossfit facility in all of New Hampshire. Kyle has always been a skinny guy… seriously, check out this picture from before he really discovered Crossfit.
Kyle’s done a really nice job of improving many aspects of his health and fitness on his own. He’s always given 100% in the gym and his body responded by adding some muscle mass. Unfortunately, being well over 6 feet tall and weight 185 pounds is FAR from ideal when it comes to competing in the sport of fitness, which is Kyle’s personal goal. After working together for several months, it became QUITE clear that Kyle is what we call a “Hard-gainer.” No matter how much clean food he ate, he just could not manage to pack any real muscle mass on. It was time for some drastic measures. Here’s a picture of Kyle before we made some drastic changes… he’s weighing in at about 187 in the picture. Clearly cut, but way too light for a guy his height.
So what did we do to get him where he needed to be.
1) Dropped his workout volume by about 60%. What Kyle needed was not to beat his body senseless 5-6 days a week, but to work out hard and then REST. His body needed extra time to recover and GROW.
2) Spend time under tension. The best way to induce a growth signal is to spend a shitload of time under heavy weight. I had Kyle follow a slightly modified version of Dan John’s program called “Mass Made Simple” which calls for BIG workouts 2 days a week with nothing but rest on the other days. The basis of the program is built around enormous barbell complexes and huge squat sets (think sets of 25-50 reps) with moderate amounts of weight. Supplemented with some technique work on the olympic lifts and some extra unilateral work to correct for imbalances and you have a recipe for success.
3) While eating clean is very important for maximal health, that was not necessarily Kyle’s number one goal. He wanted to get significantly better at Crossfit and was willing to sacrifice some of his long term health to do so. With that in mind, I told Kyle to increase his carbohydrate intake significantly. With a gluten AND dairy sensitivity, this wasn’t easy but we figured a way to increase his carb intake by at least 100 grams a day through white rice… a pretty good fuel source in this case. Luckily this worked well and the mass started to be packed on quickly.
So what were the results? Well, after 8-10 weeks, Kyle was up to 205 lbs. While he lost a little of that leanness at the time, he also put on a ton of muscle mass. He’s since gone back to a regular crossfit style program with a strength emphasis and is down to 199-201 pounds and looks like this.
I think the most striking difference is in his shoulders and in his legs/glutes. He put on a ton of mass in these areas which has definitely come in handy as he’s PR’d his back squat, front squat, clean and jerk, and snatch all after the 8 week mass gain program. Oh, and he can still knockout 15 unbroken muscle ups and a sub 3 minute Fran…
Take home: Most people can make some really great changes to their health, nutrition and body composition by following basic principles around exercise and nutrition. That said, often times an individualized approach is necessary to optimally perform and reach your goals.
Many people come to me looking for help with fine tuning their nutrition to reach their goals, whether it be weight loss or to boost performance. Of course nutrition is important but most people are actually doing a pretty decent job before starting with me. 99 times out of 100 the biggest problem that I actually see is horrible sleep patterns. Unfortunately, no amount of paleo eating, supplement taking, crossfit doing is going to get you to your goals is your sleep sucks. Here’s why…
1) People who sleep less than 6 hours a night have elevated markers of inflammation in their blood stream. If you’ve read some of my other posts, you know that inflammation and increased body fat are closely related.
2) Studies have shown that people on calorie restricted diets lose FAT when they sleep the appropriate amount, but lose muscle mass when they under sleep… Less muscle equals a lower metabolism usually. Also, the same study shows that people who didn’t sleep enough were hungrier throughout the day. Makes sense since the part of the brain that controls sleep also influences metabolism. Question: Do you find you make poorer food choices when you’re overly tired? Thought so…
3) Football, tennis and swimmers were all studied for the effects of sleep on performance. The athletes that slept more (~10 hours) all increased their sprint times compared to the athletes that did not.
4) Some biochemistry and physiology for you: Testosterone and growth hormone are elevated when we sleep and these two hormones are critical to have appropriate recovery from your workouts.
Alright, I think you get the point. Lets look at some things to try to do and things to try and avoid to improve our sleep:
1) A little drink before bed might help you fall asleep but alcohol will disrupt the quality of your sleep as the body as after processing all the alcohol, your brain will switch from deep sleep into REM sleep. REM sleep is MUCH easier to wake from so you’re more likely to wake up in the middle of the night.
2) Try to avoid raising your body temperature too much before going to bed.
3) You’ve got to try and deplug from the phone, laptop, etc for 30-60 minutes before going to sleep. The lighting from the screens of these electronics can impact your brains ability to sense its internal clock of when to wake and sleep.
4) Last but not least, you’ve got to avoid caffeine in the afternoon if you’re going to sleep appropriately.
Recently a post on “Precision Nutrition” talked about the dangers of high dose vitamin D supplementation. I wanted to address the post and talk about some of the risk factors that are mentioned. At the bottom of this post, I’ll talk about what my SPECIFIC recommendations are.
Lets look at the arguments made by the precision nutrition author:
1) High dose Vitamin D3 in rodents is a toxin. The problem I have with this argument is that the amount they give the rats is about 10-20x what a person would actually supplement with. Also, there’s no discussion about whether the biologics of rodent vitamin D metabolism mimic humans. Considering that they are nocturnal animals, the biology could certainly be different…
That said, lets say that based upon these results, you shouldn’t be taking extreme levels of vitamin D (above 30000 IU/day).
2) The Vitamin K/Calcium axis. This is actually a really important point that many people overlook. If you have a vitamin K issue, then high dose vitamin D could actually be a big problem. The problem I have is that the author goes on to basically state that if you’re vitamin K deficient you shouldn’t take vitamin D. Personally, if I was deficient in vitamin K, I’d fix my levels of vitamin K and not avoid taking vitamin D completely. This is like saying, well my car is low on oil so I stopped putting gas in the car to prevent it from overheating. Should people low in vitamin K avoid the sun?
I’ve looked and while some blogs like to say that vitamin K deficiency is common, the evidence out there to support this is pretty weak. You cannot just base levels off of food intake because vitamin K2 metabolism is tied to the microbiome. Nevertheless, if you are consuming leafy green vegetables, then you should be fine outside of rare genetic diseases. This leafy green vegetable thing is about to get very repetitive.
3) Magnesium: You’ll notice that in my supplements page, I list a magnesium supplement. Also, the same leafy green veggies I listed above are also really high in magnesium. I think the authors point is a good one, but again, I think the take home message should be to get your other nutrient levels to appropriate levels and NOT to avoid vitamin D if you are showing signs of deficiency.
4) Vitamin A: So vitamin A deficiency is a real problem but mostly in third world countries. In the United States, you’d be shocked at just how many foods are fortified with Vitamin A. As a result, people here are typically not vitamin A deficient. Now, if you eat an all natural organic diet, you aren’t getting any of those FORTIFIED vitamin A fortified foods of course, but the good news is that leafy green vegetables, grass fed beef and many other paleo-type foods which you are likely eating have TONS of vitamin A.
Now, there are in fact some really interesting new observations about vitamin D levels and health. One of these is a study with over 1 million people showing that the lowest mortality from a multitude of causes correlated with vitamin 25D levels between 20 ng/mL and 36 ng/mL. That’s somewhat surprising because the medical community says that the LOWEST your levels should be is about 30 ng/ml and that your better off with levels closer to 50 ng/ml. Interestingly, there are a couple other studies showing just the same thing… that optimal levels are around 30-35 ng/ml.
Now, there are a couple things to remember.
1) This data says that A correlates with B, not that A causes B… very important difference.
2) It does not mean that we should be avoiding vitamin D supplements, just that perhaps we don’t need to be driving levels so high by supplementing like crazy with 10000-50000 IU or more. Doctors are DEFINITELY doing this in some patients for 4-5 weeks. Not sure I’d want that much…
Ultimately, my recommendation is still pretty much the same as before.
1) GET IN THE SUN when possible. The body is (for the most part) capable of limiting its vitamin D levels much better when we use sunlight as our source.
2) If you live in the middle of winter for 6 months, I still think some supplementation is a good idea. 1000 IU/day is probably still pretty safe but I also would advise having your levels checked annually to make sure you’re in that ~ 35 ng/ml range.
3) You’ve GOT to be eating green vegetables for reasons that go way beyond anything to do with vitamin D, but also to mitigate any potential risks with the vitamin D supplementation.
The world we live in has certainly become a confusing place when it comes to figuring out how to make healthy decisions. Every week it seems like there’s a new fitness craze, dietary revolution, etc that completely contradicts what you were told the week before. I’m here to try and help you sort through all the BS thats out there so you can achieve your health and fitness goals.
While no topic will be off-limit, I’ll focus mostly on topics related to gastrointestinal health, systemic inflammation and autoimmune disease, how to eat for health, longevity or athletic performance, and supplements that can help you achieve your goals.