Saturday, July 18, 2015

Reader Question: How did I figure out my dietary macros in long term weight maintenance?

Multiple wellness factors for my macros
Great Question from our blogging friend, Ali,
RE: Macros and wellness eating higher dietary fat.

1. How did I determine my weight maintenance macros?

2. How do I maintain with fat in my diet despite mainstream recommending low fat?

Okay. Great questions. Short answers are pretty simple:

1. Short , Simple Answer Macros: I track my food intake and macros very carefully.

Action: If I trend higher on my weight, I reduce my carbohydrates, slightly.

2. Short, Simple Answer: Low level ketosis, sometimes.  Along with good glucose/insulin/ghrelin control. Eating lower carbs lends itself to a diet that has either more protein or more fat, because of the lower carbs.  I started thinking of dietary fat as "energy" and good hormone signals in menopause. Also, the lack of binge urges on a low carb approach has been lifesaving, literally.

The long answers are below: I don't just choose my macros or my dietary fat "willy-nilly"

My theory: If I look at my blood markers and how I feel, then I'll get a warning sign of heart disease, stroke, bone loss, another auto-immune disease. ( I have Hashimotos from 1997).

My Guidelines, both measurements (think blood work, scale, food tracking) and just overall wellness, sleep, and inflammation guidelines (menopause symptoms, acne, migraines) that I use, too.

Blood work guidelines (I'm very mindful of relatively silent blood markers).

1. hs-CRP, low 1 or below
2. fasting glucose, no spiking & return to baseline 1-2 hours post meal ( my average is 86, post meal)
3. HA1c, my average runs 5.2 or 5.3,
4. Triglycerides, I run around 42
5. HDL cholesterol, I run above 70
6. TSH under 2.5 , I feel better in the lower half of the range, always have.
7. Vitamin D, above 30.

 Frequency: For all but fasting glucose, I only measure 1X per year. Fasting glucose is at home via finger stick.

Scale guidelines
1. Total weight
2. Shifts and trends over time
3. Weight distribution: visceral fat vs subcutaneous
4. % body fat

Frequency: Daily weighing and tracking at My Fitness Pal.

Carbohydrates and sometimes calories*
1. Tracking at MFP
2. Looking at my carbohydrate levels over time- Apple Health App. I sync my Fitbit with Apple Health.
3. Calories* Sometimes I'll eat too low in my total intake, so I'll increase what I'm eating if my signals are not working.
4. Calories* Sometimes I'll over eat too high in my total intake due to false hunger signals- this rarely happens anymore, but I do stay mindful over binge urges. Usually, I'm eating too little. Which I also find funny since I used to be the Queen of Binge eating.
Low Carb, Higher Dietary Fat Summer 2015

 Blood pressure
1. Home blood pressure cuff
2. Blood pressure taken by medical professionals.

Frequency: 1-2 X per week with a home pressure cuff. Sometimes my blood pressure runs slightly lower than normal. Sea salt on my food will help raise it. I always find it funny since I had borderline high blood pressure while obese. Typically, I'll feel bad and have a cup of chicken broth, then feel better. No measurements required.

Wellness "I feel good parameters"

1. Good energy between 3 meals. Maybe adding in 4th meal if hiking for hours
2. Correct hunger signals.
3. Natural sleepiness at night, falling asleep quickly, sleeping solidly
4. Calm and cool even under life changing pressure, low anxiety
5. Lack of puffiness and joint pain
6. Body strength, upper body especially arm strength at the gym
7. Good core strength and balance
8. Ability to lift big bags of garden soil, cat litter, and large water cooler bottles, readily and easily.
9. Very few, infrequent menopause symptoms- hot flashes, insomnia.
10. Acne = inflammation. Almost always caused by food
11. No headaches, no migraines (30 years). With a Paleo-ish food template = no migraines, if I'm nut free.
12. No GERD. Gone with the removal of grains. How easy was that? Super simple
13. Working with my regular internist MD to monitor my health and TSH levels.

Other peoples successes

1. Attending the workshop that Sarah Fragoso and Jason Seib taught in 2012. Those attendees ate dietary fat and were quite lean and muscular.  Robb Wolf and Mark Sisson's success stories. Those regular people are just like me!

2. Attending Paleo Fx 2015. So many people had prior health and fat loss goals. They eat dietary fat, and the majority of them were quite lean and muscular, at all ages. Off many medications.

3. Reading the blogs of those who have been obese and are now following NSNG- no sugars, no grains and who also eat dietary fat. Those bloggers previously had type 2, now controlled largely by diet, sleep, low inflammatory exercise.

Okay, hope this helps. I used the scale at the start, but I use my menopause symptoms, blood work, and just overall wellness guidelines. It's very individual, so it pays to experiment yourself. Good luck!

What didn't work in the past

1. Moderating all foods and point counting at WW. At no other time did I eat so much junk food, but hey, it did fit my points values.

I hope that other people think twice about moderating grains and sugars if they have lean goals. There are many reasons not to moderate all foods- allergies, intolerance, food addiction, binge urges, disease management.

 Just being near the "Wall of WW Snacks" and watching people line up 10 deep to by highly priced, but very low in points, highly processed foods gave me too many sads. I stopped going to weigh in at WW.  I used to be on those 2 point bars like bees on honey!

Here's my opinion and 2 cents. If you are a stock holder, it is a WIN-WIN. WW makes a ton of revenue selling the packaged snacks to food addicts. That's going to be sustainable in the long run, they will always have customers. Yes, yes, stock holders will benefit.  Sigh. I can only hope the Simply Filling plan where processed foods are discouraged will take a better hold. But hey, profit margins and food addictions. They've cracked the $$ diet profits pretty well.

I was convinced that because WW was US News top diet every year that I was personally defective some how. I felt so much shame and embarrassment that I could not lose weight in my 40's at WW. ( I was successful at WW points in my early 30's, dropping 60 pounds, while binge eating). I blamed myself, wrongly. And, I failed to think for myself. Not WW's problem. Mine. Steep price to pay for not thinking for myself. I still get a case of the sads when thinking about it.  No woulda-coulda-shoulda... moving on...

If you did great on WW, yay you. A pat on the back (be sure to check your blood markers, though)

2. Not reversing my poor blood markers quickly. My hs-CRP got to be very, very high. I'm lucky I did not suffer more symptoms and poor health than I had. I wish everyone would pay more attention to their blood work. Things like walking a half marathon while fueling with Cliff bars and thinking I "earned a muffin or biscotti" had me muffin topped and in a lot of pain and my hs-CRP became 6.8 at the worst. Not smart on my part. Chronic cardio = high risk, for me.

3. Using medications to mask the symptoms of  GERD, acne, joint pain was very expensive, time consuming, painful, and the conditions always returned. NO, you do not have to have these common symptoms as a natural part of aging in many cases. Yes, many times diet can eliminate. It's not "old age", it was inflammatory processes. In my case, reversible.  I know that sometimes obesity related pain is not reversible by losing weight (think knee problems or damaged joints)

4. Moderating processed foods and having lots of hot flashes and frequent insomnia. Think protein bars, Lara Bars, Quest Bars. I know many can tolerate them, but I cannot. It would be easier traveling with them, but whole avocados or a container of coconut manna work just fine for portable travel foods.

5. Not connecting my migraines with common foods- like nuts. Whatever keeps my binge eating urges low also eliminated my migraines. Now if I have a headache, it's dehydration by accident and I can fix it by drinking water and re hydrating.

6. Not looking at my raising glucose levels. I'm a lab professional in real life. No reason other than a walk down the "denial mile" that I didn't do self testing at home. So cheap and easy compared to managing reversible type 2 diabetes. I was close to being diagnosed when I lost weight. I even bought a copy of the book  "Pre-Diabetes for Dummies" thinking I would just manage the disease .  I didn not accept I could prevent it and/or reverse it.  I can laugh at myself now at my thought processes then.

7. Not looking and catching weight gains quickly. If I can measure it, I can manage it. Critical step in long term weight management, IMO.

Hope this helps. I extended my wellness way, way beyond the scale. It's a super simple concept- eat lower carbs from non-starchy veggies, no sugars, no grains. But I do take a multidimensional approach.  The scale is not everything. I do enjoy not eating myself to a slow, progressive end. It is way less physically painful and the freedom from obesity and binge eating is nice.  I feel better!  I urge you to think for yourself, check with your doctor, make changes as needed. Your results and genotype will vary, make your macros work for you for your ages and disease states.

Have you used macros to fine tune your health?

Left, eating low fat, high processed foods May '11, Right, Eating Low Carb, higher dietary fat July '15


  1. Thank you, thank you, thank you! I love this post that you wrote answering all my questions, and I am printing this out at work on Monday! You have no idea how helpful this is--and ow much I love the reasoned, analytical approach you take, and took in writing this.

    I have maintained about a 70 pound weight loss (I am 5'1") and weigh 142 (yes that puts me at a higher BMI), but I have a flat stomach and bjgger hips. I am a size 8, which has been fine for the last year. Recently I gained four pounds because I had a health issue, I stopped exercising and after an initial period of losing weight I started eating my trigger foods--and way too much of them. Well, that stopped this past Thursday. I am back on the eating and exercising track. Because I am perimenopausal (my doctors really believes so, and it looks like I really am), I need to get more weight off now and start to be very careful about my food. I would like to lose about 10-12 pounds to be a size 6. I also realized that by having sweets here and there and a little bread, I was doing myself a disservice so I am really trying to get all grains out of my diet. For now I am keeping in dairy, nuts, and at most two pieces of fruit a day. I am going to experiment with more fat in my diet, and I have been reading a lot of low carb and paleo and primal blogs.

    So I want to thank you again because your eating and exercise program really gives me a lot to think about. I know it takes time to write posts like these so consider me very grateful! And of course, you already know that I always read your instagram feed for food ideas (grass fed bison, lettuce, onions, red peppers, guacamole, and salsa has become a staple dinner of mine after I saw it on your instagram post).

    Have a great weekend and thanks so, so much!!!!

    1. Ali, Great that you are looking at your diet in pre-menopause. I think that geneotype/phenotype really determines how much natural sugar you can have, IMO. Also, if it kicks up any cravings or binge urges, fasting glucose, or glucose spikes that's a red flag right there. Some folks can eat all the fruit. I stick with berries, in season.Some citrus here and there or a sliver of peaches or stone fruit.

      I think it's also smart to work with your doctor- because of the health history and updated screening recommendations. I never go into my doctor and say, well, I've doubled my fat intake, what do you think? I just let her do the exam, I ask questions about bone health, disease risk in menopause, family history, screening frequencies, etc, then listen. She's seen me yo-yo diet for more than 15 years. I can see the look on her face when she didn't believe I'd keep the weight off this time. Never heard of Medifast or Paleo. Both worked like a charm for me.

      I'd keep dairy and nuts in my diet too, if I could. They were the last to go- only because of allergies and migraines- maybe binge eating on the nuts. Glad you noticed the effects with sweets and breads.

      So many post menopausal women all say the same thing- zero or low symptoms on a low processed foods diet. If people only knew that post weight loss, one does not have to starve. Sigh. That's why I do my IG account for my food template.

      Let me know how it's going. Mmmmmm bison bowl. So yummy.

    2. PS I am going to have my primary care physician order a full work up for me when I see her in September and talk to her about the above markers you reference, as well as do my own research. For me, the hot flashes are sporadic and come and go for no rhyme or reason. My blood pressure has been trending higher lately the last few times I have been to the doctor in the past six weeks. For a while I was high and was put on bp medication (it is genetic and at the time I was n prednisone). Then I got to a good place with my blood pressure, but I think exercise really affects mine--and I stopped exercising for about eight weeks. I am back on track and hope to see a change soon, and I find that lifting weights really helps my blood pressure.

      I also was thinking that what you do to keep healthy is sustainable when you have a job and want a life. I read several blogs where the women exercise to crazy extents and then preach moderation. Well, that's well and good but I would prefer to have a life and while I believe exercise is necessary, I also don't have time to spend all day doing it.

  2. I would love to have a list of those Type 2 folks blogs that are eating this way. I have always been interested in reversing diabetes with diet. I am not diabetic but care so much about this topic. Thanks Karen!

    1. Hi KCalla.

      Check the right hand side bar of these sites, not all of Jimmy Moore's blog links are for type 2, but some are. I do think there's a big diet component in type 2. Low Carb or a real foods template may not be a "cure", but I do think that management and blood markers can be vastly improved.

      Readers, if you have favorite type 2 diabetes management, feel free to comment

  3. Thanks! I'm familiar with the last 2 but not the first! Off to read! :)

  4. I'm jealous of your D level-mine is at a 21 and I've been deficient for years, even with taking a higher dose D3 sigh....
    As for macros-I started playing around with them after I transitioned into maintenance, and for me nothing magical has happened when I follow a certain macros ratio :) So I don't worry about them too much!

    1. Sara, I'm glad my doc and my wellness panel started ordering Vitamin D. I'd love to be higher, but it seems like even with supplementing, the most of my vitamin D comes in via my skin on walks in So.Cal. I've decided to live someplace sunny just because of it.

      I also noticed on a Paleo food template, I tan rather than burn for regular sun exposures. If I'm out for a long time, I do use sunscreen on a limited bases. Otherwise, 30-45 mins, I soak in the sun.

      Be glad you don't have to mess with your macros. It can be tricky sometimes. I didn't have to mind my macros as much until I hit menopause.That requires a lot of testing n=1 in my case.

  5. is "Apple Health" the official name of that app? My husband gave me a fitbit for my birthday, so on your mention of it, i searched in the Apple store, and as usual nothing of that exact name came up.... Thanks!

    1. Hi Tess, apple the heart symbol on the iphone 6. Comes preloaded. I can sync different parameters to the apple health app from the Fitbit and the charting gives me a different graph options. I like it a lot.

  6. Thanks so much for taking the time to write this post !! I have printed it out to reread frequently xoxox