Busting Fad Diets (Fasting, Carnivore, & More) w/ Dr. Eric Helms (SSOF Ep. 40)

James de Lacey2:31

Nice. And obviously we would class you as an expert in nutrition, even though if you don't think of yourself as an expert, I know many people don't think of themselves as experts. But I'm going to put you there. I learned a ton off you and your philosophies and a lot of other nutrition guys' philosophies around, I guess, athletes into nutrition and kind of learning that new fad diets and stuff aren't the answer to everything.

I still remember asking you back in the day about carb cycling. And I think backloading. I remember backloading.

Dr. Eric Helms3:00

Yeah, that's the one. That's right.

James de Lacey3:00

And I was like, damn, that was so dumb. But obviously that's part and parcel of the learning process. So maybe we start with the idea, I guess, the underlying principles of just sound nutrition for athletes. Obviously it's a very general topic, but it might give us, from there we can segue into other things on various fad diets and things.

Dr. Eric Helms3:28

Absolutely, yeah. I think the big picture principles when it comes to what athletes need to understand about nutrition is one, I think that anytime you're manipulating your nutrition, you're ultimately manipulating your lifestyle, your behavior. And sometimes you'll hear athletes of all different disciplines say things like, "My body's a temple," or "I eat to feed the machine," "I don't live to eat, I eat to live," all those types of tropes that you hear. And that's all well and good, except I know very few athletes who can do that all the time.

And I know very few athletes for whom, at least at certain points and times in the year or certain points in their career, where those two mindsets of being a human and being an athlete actually come into conflict in the form of nutrition-related issues. And I think the analogy, or the example I should say, that I always like to do is you take any nationality or ethnicity and you put the word "grandmother" after it, and that's someone who wants to feed you and who you'll feel bad if you don't eat their food and who you may see on a regular basis, whether that's at holidays or not.

And anytime we take something that's so fundamentally human, it's part of our culture, it's how we celebrate, it's how we connect socially, it is essential for life, it does so many things for us, eating, and we try to purely make it a sports-specific behavior, we run into trouble. And I say that as a competitive bodybuilder who has more extreme nutrition processes than anybody else in the world in terms of which different sport disciplines.

So I think it's just critically important that we acknowledge that first, and that anytime we think about adopting a nutritional strategy, method, or diet, we make sure that we don't necessarily threaten the big picture of being a balanced athlete with a sustainable career that they can stick to. So that's kind of the lens I like to start with. That's like the first principle in my opinion: we have to think about this from an adherence and sustainability perspective.

James de Lacey5:20

Yeah, that's a good place to start too. And I guess if we dive deeper into maybe the specifics surrounding the diet as well for athletes. I know there's so many different things that people will find on YouTube. I mean, I love watching full day eating videos from bodybuilders, grocery shopping videos. Man, those are my jam. And you always hear, man, the amount of protein they're eating. It's like they're looking at, well, over 1 gram per pound. I'm looking like sometimes 2, 3 grams per pound of protein.

I remember talking to you ages ago about that kind of, what cemented my idea of not eating too high protein intakes, because you take away from your carbohydrates and fats what you need for your energy. So maybe you want to dive into the idea of maybe, let's not say optimal split, but good splits of macronutrients, how you should kind of set your diet up if you're looking to count your macros and calories.

And it may be the idea of doing a diet or an eating plan where you're not having to count your calories and macros. How do you go about doing that that's a little more flexible and easy for someone to do?

Dr. Eric Helms6:48

Yeah, fantastic. I love the framing there. Back when I was first getting into nutrition, If It Fits Your Macros, IIFYM, was positioned as a much more flexible approach to the status quo in the fitness space. Because the status quo was eating from a very, very limited list of clean foods and staying away from all the quote-unquote dirty foods. And it basically amounted to a strange and not really well-informed selection of vegetables, complex carbohydrates, and lean proteins.

And depending on who you talk to, those lists would change. And it was a very, very high protein, relatively low fat, moderate carb diet that essentially was applied to everyone that was kind of taken from '80s and '90s bodybuilding. And there's nothing inherently wrong with that approach. Well, that's not true. There are some things inherently wrong with that approach. But there's nothing inherently wrong with the breakdown of the macronutrients that you get to. But it doesn't really educate athletes very well as to understand why you might be doing things, how you integrate them into the way you eat.

And it basically just puts you on these kind of cookie-cutter meal plans in a worst-case scenario. Or in a better-case scenario, maybe you have a coach, maybe you understand the nutritional profiles of these foods, and you can kind of plug and play in a little more customized way. But the considered upgrade of that was what's called If It Fits Your Macros. And it's the idea that, one, which is a good thing, that foods don't have moral qualities. There aren't good or bad foods.

And also realizing that in the vast majority of cases, a single frequency dose eating of a food isn't going to measurably harm you in any way. It's more about the overall diet. There's no such thing as bad foods, there's bad diets. And if you take a good diet and someone has a Snickers bar on a Wednesday, it'll make absolutely no difference except they might be a little happier on that Wednesday. Or in some cases they'll hate themselves because they still believe that they're good and bad foods.

So the idea of If It Fits Your Macros is that, look, we're taking foods and we're going to try to help them fit our macronutrient targets. So you have a target for protein, carbohydrates, and fat. Choose whatever foods you want, which all of a sudden opens people up to eating more regionally specific, more to their personal preferences, more to their budget, and more to what's available, all of which are good things, to fit these target macros. And it also works really well with nutrition

Science and sports nutrition science, because typically the way we study things comes from a reductionist analytical background where we try to make associations between quantitative nutrition values like grams per kilogram of protein, carbohydrates, fat, energy intake, etc., or servings of a different type of food or a certain number of exposures to a given micronutrient, etc., etc., etc., all the studies you can think of, because now you're tracking it in the same way that we might nutrition science. So there's a lot of good things about If It Fits Your Macros and tracking your food.

But there's some things that can be an issue, not necessarily always are. Sometimes you start to think that foods only have value because of the nutrients they contain, rather than the overall food matrix and the other qualities of foods that are more difficult to quantify having a benefit or unique effects. It doesn't take into account for non-quantified nutrients essentially.

Additionally, we do have ways of regulating our energy intake and regulating our food consumption. Instead of planning to eat a certain amount of macronutrients that should put you into a target surplus, deficit, or at maintenance depending on whatever your goal is, most people just eat until they feel a certain level of satiety, also including their hedonic reasons for eating or whatever their quote unquote intuition tells them. And there's issues with that as well. However, there's probably something in between.

So anyway, with that preamble, I'll say that based upon what we know, athletes have the benefit of having a wide variety of macronutrient breakdowns which can effectively support their sport, until they get into pretty extreme sports with very specific sporting demands. So if we're talking about multi-stage endurance athletes, now all of a sudden the default setting is a very high carbohydrate diet, which might get modified if they have GI distress from consuming goo and Gatorade and a very hard high-carb diet and the GI distress impedes performance. Or maybe, for example, if they're not just a multi-stage endurance athlete, but they're actually an ultramarathon runner or ultra-endurance athlete to where they're actually racing for multiple days and I actually want to think about the weight of the food I'm carrying, and it's always in extremely low intensity, I might actually decide to go to a high-fat, low-carbohydrate diet so I'm actually carrying less weight and I can utilize my own adipose tissue stores a little better, just to think about the economy of basically doing adventure hiking competitively over multiple days.

So those are just examples, or a sumo wrestler who is actually trying to get into this massive surplus and needs to think about what are the ways that I can use palatability and the texture of foods and get down a lot of food so I can get to a massive body weight. Or an aesthetic athlete, whether you're a gymnast or whether you're a bodybuilder, where you have to not only think about performance but also making a certain body weight.

So anyway, if we want to kind of bring this to your quote unquote general athlete who has aerobic and anaerobic demands, might need to do bursts of speed and power, you generally want to have something that's reasonably moderate. And the way I like to set up diets from a quantitative perspective is, first we set protein and then we kind of use what's remaining based in the energy budget to get to our target carbohydrate and fat.

So protein, despite the fact that on these like full day of eating videos when you watch an IFBB Pro bodybuilder, they're consuming 2 grams per pound, we have actually some pretty high-quality evidence at this point that, at least in the state of neutral or positive energy balance, where you're trying to put on size or improve performance or get stronger, there seems to be a clustering of findings that suggests we start to see a plateau of the benefits of higher protein intake somewhere around 1.6, 1.5 grams per kilogram, which is right around like .7 grams per pound, with some error around that and some individual differences.

So I think a general rule of thumb, if someone is looking to quote unquote optimize their protein intake for athletic performance, is you want to consume at least about 1.5, 1.6 grams per kilogram of protein per day. Nothing wrong with going higher than that until, you rightly pointed out, it starts to rob Peter to pay Paul, you're actually having to go lower than would be ideal on carbohydrate or fat.

And we've got some pretty good evidence behind this. There was a recent meta-analysis by Nunes and colleagues in 2022 that started, saw the basically the highest positive effect sizes when you're above 1.6, and then staging down as you broke it into categories below that. There's also the meta-analysis 2018 by Morton and colleagues, which I was a part of, where we did a meta-regression with the breakpoint analysis and we saw that kind of roughly things started to be less positive, less clear association with benefits to strength or hypertrophy from being over 1.6.

The only caveat I would add there is it's not like if you're below 1.6, all of a sudden your hamstring falls off. You're still getting benefits even when you're in the range of say 1.2, 1.3, 1.4 grams per kilogram. And it's not until you're getting pretty damn low does it actually impede some of your body composition goals. It's just what's optimal. But I think sometimes people maybe they make it a little too more black and white than it needs to be.

James de Lacey14:52

So after you've set say 1.6 grams per kilogram protein, what are you doing next? Are you setting the fat intake then the carbs take up the rest, or you setting the carb intake first?

Dr. Eric Helms14:52

It actually depends on the athlete. I used to have a pretty formulaic approach to this, and I have papers that recommend that, but I think it's probably more specific to strength athletes or bodybuilders.

But I think ultimately it depends. So if you are a strength athlete, I'd be far more comfortable setting a fat intake and then just letting whatever remains for a carbohydrate. But if you're someone who is actually risking muscle glycogen depletion and training multiple days per week, sometimes back to back or even multiple days per session, and it's not one-off expressions of force, like there are some Olympic weightlifters, as you know, we both used to do Olympic weightlifting, who might train nine or 10 times a week at a high level.

But I mean, the high reps is four or five, right? So how much glycogen depletion is really occurring? Is it an issue? Is it going to impede performance? In most cases it's probably not. You just don't want to be on a carbohydrate-restricted diet unless you're cutting weight.

But I think for someone like say a fighter or a team sport athlete, it might make sense to think about what's the lower end level of carbohydrate and fats that I want to get to. And then after you get to that point, you look at your energy budget and you start to use a little bit of personal preference. And I think you should even experiment. Like, for example, you can play around with a 20% fat diet versus a 40% fat diet with the only difference between those two would not be the protein intake, but then how much higher or lower would your carbohydrate intake be.

And you can look at recovery, you can look at performance, you can look at when do they quote unquote bonk, if they bonk, depending on the sport, and also just personal preference and subjective differences. A lot of the times there won't be a difference, so long as energy intake is in place, because athletes typically have a pretty high budget. But sometimes there are, and it really depends on the individual, and it might change over a career span or a lifespan.

So a decent rule of thumb for minimums, I would say, is you probably don't want to go below 20 or 25% of your calories from fat, assuming that that's a, you have an appropriate calorie budget. If we wanted to give that for grams per kilogram, I'd probably say like 0.5 to 0.7, 0.5 is like the very very very low end while you're dieting, 0.5 grams per kilogram. That's quite low. That's not a target, that's don't go below that.

And admittedly the fat intake is not based on a lot of solid evidence. We really kind of have a general concept of what fat intakes do, how some associations, and then if you look at some studies on medically induced very low calorie diets like a 800-calorie shake, there's some discussion on the peer-reviewed literature of what's the lowest we would go in fat to not result in adverse events in the short term, and it's like 10 to 15 grams of fat, which is again not a recommendation and it's really just medically supervised diets, like risk management rather than what's ideal for performance.

So I think probably in most cases like 25 to 35% of calories for fat is where most people's calories would fall, or fat from calories from fat would fall, and the remaining from carbohydrate.

James de Lacey17:57

I'm definitely in that camp, but I feel best and perform best on a lower fat, like 25 to 30%, with the rest in carbohydrates, and I typically keep my protein at that 2.2 grams around there. I guess, is there any added benefit for going from that 1.6 to 2.2, or is it just kind of negligible? It's just kind of what you, I mean, it means I can eat more meat, sure.

Dr. Eric Helms18:26

So at the group level, again, when I was talking about meta-analyses, a meta-analysis, while it is the highest quality form of evidence assuming it's done right, it doesn't inform individual differences or choices or preferences. So it tells

Us kind of where's a decent ballpark, but then I think you get to kind of color in your own lines to some degree. In the Morton meta-analysis, it is focused again on strength and hypertrophy. We specifically gave a guideline that's a heuristic, it's not some kind of defensible statistical approach. We took the upper half of the 95% confidence interval. All the confidence interval is, I know that sounds like fancy math stuff, is saying with this degree of confidence, in this case 95%, we think the true mean of that breakpoint, or where we think benefits stop coming from being afterwards, it ranges from here to here.

Our mean was 1.6, but the actual 95% confidence limit was one gram per kg all the way up to 2.2. So there's a lot of variability in these protein trials, is what that tells you. And then the thing we did is we just took the lower half off, so we said you probably want to be somewhere in the range of 1.6 to 2.2 grams per kg.

And that's a decent heuristic that prevents you from getting too high, prevents you from getting too low, and we also know that there's with that kind of intake range, we have no data to suggest there would be a negative effect of going that high. So generally, that's where I like to keep most of my athletes.

There are instances where you could benefit from higher protein intake, but they're mostly theoretical. Like what I did my Masters on was the idea that when you're in a negative energy balance, you're using more protein for energy. There's a greater demand for multiple reasons and there's a greater risk muscle loss. It might not be a bad idea to skew towards the higher end of the protein intake spectrum, but understanding that you're now on a calorie budget, and if you go too far now you have no carbs or fat to eat. That's one instance.

Another instance would be that, at least in the short term, when we look at acute trials or for a temporary period before the person adapts, a very high protein diet seems to blunt hunger. It increases satiety to some degree. You do adapt to it, unfortunately, but we have trials comparing say like 1.8 to like 2.9, 2.8 grams per kg of protein, and some of the markers for acute hunger suppression and increased satiety in the short term, over a brief period of time, are higher in that higher protein group even though both are above that 1.6 mark.

It's not a consistent finding, and again, I wouldn't think if you were to stay on like a 3 grams per kg diet long term that that would result in measurable body composition differences. But let's say you're following a diet, you're trying to drop body fat, and all of a sudden you're having some bad cravings. What you could do is for the next few days just eat a higher protein diet and see if that improves satiety and therefore enhances adherence and then therefore your outcomes. But I wouldn't be like, okay, from now on you're eating an extra 60 grams of protein.

James de Lacey21:34

Gotcha. There's been a couple of camps I've heard recently that when they're tracking their macros, they don't count protein from non-protein sources. They don't count carbohydrates from non-carbohydrate sources. So for example, anyone listening, if you have a potato, obviously there's some protein in potato, and if you track that you would add that to your carbohydrate and protein macro balance. But there are some camps that are taking the potato for example and only adding the carbs and ignoring the protein. What's your thoughts on that, and I guess the rationale behind it?

Dr. Eric Helms22:01

Well, I don't necessarily know the specific rationale behind it, but I can tell you that it would be easier. It is a little more simplistic to think of foods as just their dominant macronutrient. But if anyone is claiming that's like an evidence-informed approach or that's the way they do it in studies, so therefore I'm going to do it that way, would be incorrect. So anytime, like for example, all of the studies in these meta-analyses, they're calculating total protein content and the impact on your body.

So you would have to make some assumptions or just let things go and not worry about the details if you wanted to follow that approach. You would be consuming, let's say you consumed 1.6 grams per kg of protein, but you were only counting protein sources of protein, you'd probably be around 1.8 or 1.9 in reality, which is fine.

Likewise, if you were looking to figure out what your macro targets and what energy was associated with those macros, because that's where we get our energy from, there's four calories per gram of carbohydrate and protein and nine calories per gram of fat. If you were trying to calculate your energy from that type of approach of tracking macros, it would always be a lot less than what your actual energy intake was.

James de Lacey23:25

Because for example, nuts have protein, carbs, and fat in them. And if you just counted them as fat, it wouldn't be an accurate representation of their energy intake. And what do you do with something like cheese or milk?

Dr. Eric Helms23:25

Exactly. Cheese and eggs, for example, are roughly a 50-50 calorie split between protein and fat, depending on the cheese of course. And then exactly, milk, especially if it's like 2% or whole milk, it's got fat, carbs, and protein. So I think it leaves some things to be desired or at least questions that need to be answered if you were to take that approach.

James de Lacey23:52

That's one of the reasons I kind of haven't even tried that myself. I'm like, well, because I love my dairy and I'm like, there's no way in hell I'm going to sit there and get rid of it just for this thing.

But I guess the other question comes as well, the difference between your plant proteins versus your animal proteins. So if you're doing, say you're tracking your macros, obviously you're getting your proteins from things. Maybe you're getting pasta, obviously has a lot of protein for a carbohydrate source, and peas and whatever else. Those would be your plant protein sources. Is there an advantage or disadvantage to maybe getting more protein from those than you would from your meat, et cetera?

Dr. Eric Helms24:15

I think in a well-constructed diet, there's really no... the evidence that we have to date would suggest that when we look at holistic translational outcomes, it probably doesn't make a difference so long as the diet is well-constructed. So there have been a number of studies now that have looked at basically vegan diets with sufficient protein, with a number of sufficient meals, while including resistance training, and they haven't found a benefit to being on an omnivorous diet compared either way. Really, it seems that they are roughly equivalent.

So if you'd asked me this question a few years ago, I would probably tell you it wouldn't be a bad idea to bump your protein intake up a little bit to the higher side because of the idea that maybe you'd have a lower quality, quote unquote, diet from being a vegan. And that's not a statement on the quality necessarily, just related to traditional metrics of the quality of the protein. But more so, from a muscle-building perspective, they tend to, not always, have a poorer essential amino acid profile. So they have a lower content of specific essential amino acids, but that really depends on the protein.

So for example, pea protein is very popular in vegetarian, vegan circles now because it's a lot higher in leucine, which is one of the branched-chain amino acids that's an essential amino acid, and it's often seen as the most influential essential amino acid for triggering muscle protein synthesis, initiating the process which allows us to build muscle. But pea protein is also kind of low in, I think, methionine, which is one of the essential amino acids, but that's abundant in other vegan sources. So if you have a well-constructed vegetarian or vegan diet, it's pretty much a non-issue and that's been shown.

So there's a study by Java Lorraine back in 2021 where they compared, I think, over 12 weeks, which is pretty long for a study like this, vegan or omnivorous diets where they're consuming at least 1.6 grams per kg per day and looking at hypertrophy and strength gains while they're following a resistance training program. And there were no differences, and quite similar changes, even when you look at it from a non-null hypothesis testing kind of perspective, in terms of leg lean mass, whole muscle cross-sectional area, fiber cross-sectional area, and also strength.

So if you're training, if you're consuming at least say three meals per day, if you're roughly evenly splitting up your protein, if you've got a well-balanced vegan diet and you're consuming a sufficient amount of protein, any differences are going to be pretty negligible. But I think there are plenty of people who follow vegan diets where they struggle to get to 1.6 for one, or they don't necessarily know how to construct them well enough to make sure that they have a lot of complementary protein sources with variety of essential amino acids.

James de Lacey27:08

That's a good call. And before I dive down some more of these diets as well, for someone who doesn't want to track their food, their macros, but still want to eat to perform, what are some guidelines or tips that you have for them to be able to, I guess, put meals together and I guess days of eating together that aren't going to be too variable and maybe lacking in certain areas?

Dr. Eric Helms27:34

Great question, James. So this kind of ties into what you were saying about what about people who just track the main macronutrient of a given food group.

One thing that could work like that that is probably less onerous and would fit for most athletes, assuming they had some basic habits or behaviors in place, is tracking protein and calories. That way you're basically saying, "Hey, I want to make sure I get at least to this protein threshold, and then I want to make sure I have enough energy." And I'm not going to be too fussed about the sources, so long as they're balanced, I'm consuming enough fruit and vegetables, I'm getting enough fiber, and I'm consuming them in a way that supports my training—not too close to training so I can digest, but not too far away so that I'm feeling like I'm hungry and trying to train on an empty tank.

That's one way to do it. But the potential downside, which I planted the seed for, of "if it fits your macros" and basically deciding how much energy and what macronutrients and what foods therefore you consume based upon hitting target numbers is it can lead to a situation where you're less in tune with your hunger and satiety signals.

Which, say what you will about the obesity epidemic, if we look at the States, on average the calculation is that people are in like a double-digit calorie surplus year to year that results in this very, very slow weight gain over time, with a lot of it occurring over the holidays. Which, as you know, living in the States now, is basically all the way from October to January.

James de Lacey29:18

For sure. From Halloween to Thanksgiving to Christmas to New Year's.

Dr. Eric Helms29:18

It is. It's a rough time for people who are looking to control their calorie intake. But even that just results in this slow, gradual weight gain—at least at the population level. Some people are far more or far less susceptible. But we have a very good internal ability to regulate our body mass through regulating energy intake.

And if you talk to any athlete at a high level in most sports, they talk about knowing their body. "I can listen to my body," quote unquote. And I think that's an important skill—is being aware of your signals. What does it feel like to be low on energy, to bonk? Any endurance athlete can tell you what it's like to bonk, which is they're describing muscle glycogen depletion to a certain point and liver glycogen depletion to where they just simply cannot output enough to maintain their race pace and they perform worse.

So there's an equivalent of that, I think, for most things. And an athlete who can tell what's an appropriate level of hunger or fullness for their goal—like right now I'm trying to put on mass, I should be a little uncomfortably full after most meals but not stuffed. Or an athlete who's going through, let's say, a body recomposition phase before they do a weight cut and they're just trying to drop, say, two to three kilos over a month or two of actual body mass or losing body fat—they know they should be maybe just satisfied after meals and maybe a little hungry as they go to bed, but nothing crazy. They shouldn't be white-knuckling a crash diet.

So I think having that awareness is important, and then being able to associate what types of meal construction patterns and having some basic nutritional knowledge to follow that is an important skill. So what it might look like is, "Hey, I have spent a couple weeks or even maybe a month actually tracking my nutrition, but not to hit certain targets." You can use tracking, and you can track your macros without having to hit a specific target, just for monitoring purposes.

So, "Okay, I'm going to monitor my body weight for a month. I'm going to monitor my nutrition for a month. I'm going to read food labels, and I'm going to learn"—here's another upside to that approach you were talking about earlier, where you focus on the dominant macronutrient—"Which foods are high in carbs, which foods are high in fat, which foods are high in protein, which foods do I like, what do I habitually eat?" And then you can kind of do an audit.

You track your nutrition and your macros and your calories and your body weight for a month. Let's see: I was weight stable, I was losing weight, or I was gaining weight. That tells you about your energy requirements. And also, "Okay, I'm only getting in 1.2 grams per kg of protein, so what foods do I eat that I like that are higher in protein, and where do I start to make swaps or modifications to increase those proportions?"

"Okay, I'm pretty high in fat, but I'm pretty low in carbohydrates. And I notice that my performance on those days when I'm lowest in carbohydrates, or the day after, is not my best. So what can I do to increase my carbohydrate content?" And you make those qualitative changes to the food selection, and then you stop tracking and you just try to follow that, and you think about what's an appropriate level of hunger.

So one of the ways I like to do this operationally is I'll give someone hunger scale targets. So if we're trying to slowly gain weight, then I want them on a fullness scale—hungry being one, really, really, really, really hungry, full being five—hanging around a three to a four most of the time. And if the opposite was the goal, if I want to lose weight slowly, it'd be like a two to three.

And then thinking about their meals is kind of like these plates—like the Athlete's Plate. My Plate, I think, is a really good, useful piece of information that's out there. If people aren't aware, you can Google that, Athlete's Plate, and you can see how it breaks down for different goals and energy expenditures. Because that's how people think about foods.

If you give someone macronutrient targets, you're assuming a level of education, nutrition knowledge, technological savvy if they're using like MyFitnessPal or what have you, that they may or may not have. So instead, if you speak to them about foods—like what can they do?—you sit down with them and you actually guide them through the process of going through their daily food intake or the different variations on it, and then writing a meal plan for themselves of "How would I modify that with things I like, at times I would eat, that works for me, to get to these targets?" And then you just focus on the foods.

So that type of approach tends to have a higher sustainability, adherence, and I think it's more educational for the athlete than just being simply given a meal plan or these macronutrient targets. I feel like one is limiting, so they learn nothing, and the other is kind of like taking a toddler and just throwing them into the deep end and being like, "Hey, you're going to figure out how to swim. I got to go to the store. See you later."

James de Lacey33:50

That feeling thing, I know that for sure. I mean, when I first started lifting weights back in what I guess they call it high school here, but it's college in New Zealand, when I was about 17, I was like 63 kilos. I'm now 89, what, say, how many years later? Maybe it was 15 or so years later. But I went through phases where I considered myself a hard gainer at through some of those, and I had to bloody stuff my damn face in certain phases to gain weight.

And that feeling of being so full, but then learning when, for example, having to diet down for a competition or whatever, that feeling of knowing what you should feel like after a meal when you need to come down or go up. And those are the things you kind of learn intuitively as well. Even if you're tracking, you still kind of get that, learn those feelings, you should.

Dr. Eric Helms34:42

I think sometimes people will ignore their feelings because it makes it easier just to follow the plan and eat very mechanically. And sometimes that's a necessary approach if you're having to go through a very hard dieting phase and you have to get very lean. That I have—I have to do that sometimes as a bodybuilder. But it's not as useful. That's a cost. That's one of the downsides, it's not a benefit.

Ideally, what you want to do is integrate your body awareness and your habitual kind of understanding of what I do on a day-to-day basis with tracking as an educational tool, rather than as a replacement, and come to something that is inherently customized.

So I like to really use tracking with everybody initially to educate them so they can get basic nutritional competency. And then it also exposes their lack of knowledge. Like, they—you might have an athlete who doesn't know how to cook, who has really lower nutritional knowledge than you might expect. The type of person who goes, "Yeah, like nuts, those are high in protein, right?" You're like, "Well, it's actually like 60% fat."

Or maybe they have been inundated by a lot of one of the information bubbles out there, whether it's carnivore or vegan diets, or paleo, or low carb approaches, that has given them a really unbalanced perspective on nutrition that is not working for them.

And this is a process—having them track, giving them basic tools, mentoring them—just to teach them basic, fundamental concepts of nutrition. They don't need to get a master's degree in nutrition to do this. We're talking three consults with your athlete and sitting down with them, maybe going to the grocery store with them if you can, and just helping them learn these basic skills that can make...

A tremendous difference. And then it's building that kind of body awareness. That's typically the way I go, and then occasionally you can just audit it and go, "All right, let's just track for a week, see what's going on here."

Because I remember the same way when I was young in my bodybuilding career, I struggled to gain weight. And what I realized is that I would eat big on a single day, get stuffed, and then struggle to eat the next day. And I was also trying to eat a little too clean at times. And it wasn't until I started embracing burritos that I was able to put on the mass that I needed, because the average bodybuilding magazines are telling you rice, sweet potato—at the time, obviously, bodybuilding magazines aren't really a thing anymore—broccoli, chicken breasts, and getting in enough calories from that is extremely challenging.

But those are useful foods that have a low energy density, high fiber content, high water content, take a while to eat, they're not hyperpalatable when you're dieting.

So kind of learning these skills that I'm talking about relatively casually are really important aspects if someone does want to use a non-tracking approach. And in my opinion, a tracking approach can lead into these things and it could be used in conjunction with one another. But the goal is to make sure that it's not something that becomes unsustainable if you're the athlete who feels they have to bring a food scale to a restaurant or they never want to go out to eat because they don't know how to track their nutrition when they go out to eat.

Now this tool, if you fit your macros, it's supposed to be more flexible than a rigid meal plan, is actually induced this kind of rigid approach that is not flexible at all and actually can carry with disordered eating patterns. So it's important to make sure that that's not what this is becoming, and instead it becomes an instructional tool.

James de Lacey38:11

Nice. I also wanted to touch on some of these diets. Obviously, you mentioned one of them as carnivore, vegan and stuff. I think one of the, at least around the combat sports world, one of the more popular ones that's still prevailing a lot is the idea of intermittent fasting. And I wanted to get your take on intermittent fasting for athletes.

I know there's been some, a couple of good research papers, showing skipping breakfast, and even if you make up those calories at lunchtime, you still see a potential reduction in afternoon—I think it was cycling performance or time trial performance in that study. But I guess I want to give your take on the idea of intermittent fasting. I guess a lot of people say they do it for the health and longevity reasons, but maybe we'll get your take on the whole idea for athletes.

Dr. Eric Helms38:35

Yeah, it's an interesting space because there's a lot of research now on what is called chrononutrition, which is essentially focusing on the biological clocks—circadian rhythm being one of them—that we have in our body, and not only what we call in the research time-restricted feeding, which we call the colloquial community intermittent fasting, but also when those periods of feeding and fasting occur.

So to give credit where it's due, there's been a lot of people talking about fasting for literally thousands of years. It's embedded in different religious cultures, religions and cultures, excuse me. And there are also, to give credit where it's due, in the last 15, 20 years, there's been a resurgence of this basically as a response to the overly aggressive high meal frequency approach that was inherited from bodybuilding, which I would point out is probably not necessary, and the research doesn't suggest you actually need to eat every two to three hours to either stoke your metabolism or to put on muscle mass.

At best, right now, we say that eating at least three meals per day with roughly evenly spread protein intake should optimize most things, and maybe make sure that one of those meals comes near your training and contains protein. Beyond that, though, you've got a lot of wiggle room, unless of course you're like a multi-stage endurance athlete who's depleting glycogen. Then, yeah, things become a little more complex.

But anywho, the state of the fitness industry, say in the '90s or the mid up to the mid-2000s, was "You need to be eating six meals per day for stoking the metabolic fire, for making sure you keep muscle protein synthesis positive." And having a really, really high meal frequency and a rigid list of good and bad foods, I think, was and it still is a recipe for people getting really, really rigid food patterns, like your partner saying, "Let's go out to eat," or "Let's go out just to have fun or see a movie," and you're like, "How long is the movie?

Now I can't see any three-hour movie because I need to eat," or "Have to smuggle my Tupperware into the building." "What do vacations look like?" All these things. And it creates this kind of hermit-like lifestyle or conflicts with your life, which is I was alluding to at the start of this podcast.

So the pushback against that was primarily from a guy named Martin Berkhan, who started focusing on his brand of, quote unquote, "intermittent fasting," which is essentially time-restricted feeding. And it basically still looks the same these days. That is an eight-hour feeding window that is late-shifted. So you basically skip breakfast. That's the complexity of this approach: skip breakfast. You eat between, like, 1 p.m. to 9 p.m., you go to bed, and you do it again, more or less. And it's slightly modified for certain people—it's instead of a 16-hour fast, it's a 14-hour fast, shift it around or whatever.

But now that we have more and more specific research on it, we see there are independent effects of multiple aspects of this. So one: simply shortening your feeding window from the typical Western approach of that being between 12 to 14 hours a day that you're eating—not eating the whole time, but if you think about, okay, I have dinner at 7 p.m., I have breakfast at 7 a.m., that right there is 12 hours, and then if you have any snack after 7 p.m., which a lot of people do, that can extend that 13, 14, 15 hours, right?

So there's an independent effect of just taking your window and shortening it to a point. And like you said, even when there are potential health benefits, that can come at a cost to performance if there's a large energy deficit, as the data you were pointing out, at least in endurance athletes.

The health benefits are modest, and they do co-vary with other things. So when you restrict yourself to a given feeding window, it tends to result in a restriction of calories. So when you start to match for calorie intake—like if you were to take someone who had a 14-hour feeding window versus an eight-hour feeding window, and both of them were consuming, let's say, a slight energy deficit—these differences still exist, but they're much, much smaller.

And there are also differences at the time that those periods occur. So it's kind of a hierarchical way of looking at it, is that let's say the typical 14-hour feeding window seems to be slightly less good at metabolic health when you control for calories to having an eight-hour or 10 or even 12-hour feeding window, as long as it's a reduction. And then there's a slight, again, difference between if you had an early or late-shifted restricted period based upon what we understand of human circadian rhythm and eating.

We don't do as well metabolically when we're eating at night or when our body would think we should be, quote unquote, "sleeping and digesting." So it's actually skipping dinner that on paper seems to produce slightly better metabolic outcomes. Again, both of them, no matter where that window occurs, if so long as it's a restricted window, seem to outperform the traditional approach. And these differences are small when you match your calories.

But from a strictly "what is better than the other" metabolic health perspective, actually eating breakfast, lunch, and then an early dinner, and then not eating again till the next morning, seems to outperform doing it at night, the traditional intermittent fasting approach.

However, that's just not very compatible with many people's lives. They get off work at 5 p.m., they might have had a quick lunch on the go, they didn't really focus on it, they grabbed a breakfast and went out the door, got in traffic, and then they eat a lot of calories at dinner and then they have a dessert. That's the typical feasting pattern of Americans.

So asking them to eat more and have a more attentive focus on their energy intake when they're busy, when they're at work, and being much more focused on the quality of those meals, is a challenge for people. So I think there are some disconnects in different cultures related to what those fasting windows require of you logistically in life.

But the big picture thing to answer your question for athletes: ultimately we're talking about people who are metabolically healthy, they're highly active, in most cases, not always, and the potential benefits of having a fasting window really aren't compatible with their goals, unless they're currently trying to lose weight or get better metabolic control, which in many cases they aren't.

Like if you have a metabolically unhealthy athlete who needs to lose weight, sure. But if you have a metabolically healthy athlete who's not trying to lose weight, intermittent fasting or time-restricted feeding window probably would do more harm than good in most cases, unless it was part of a specific—like a "sleep low, train high" part, basically a carbohydrate periodization approach where they're trying to train in purposeful times when they're not eating, so they're slightly glycogen-depleted to try to get certain metabolic and muscular adaptations. But that's a whole other can of worms that is a very specific, individualized approach that in many cases isn't necessary.

James de Lacey45:30

Have you

I've heard of people taking it to the further extreme and combining, I guess it has to be an intermittent fasting approach, but having one meal a day. And I sit there and I go, how the hell do you eat two and a half, three thousand calories in one meal? It's impossible, I swear. Well, at least for me, I swear it's impossible.

But I guess what's your take on the idea that, I guess some people might use... I mean, for example, there's a jiu-jitsu player, I can't remember his name, he's on Joe Rogan podcast that eats pizza and pasta or something. I think he eats one meal a day of pizza and pasta or something like that. And I was like, now everyone's going to go do that, that's the new, another new thing on top of everything else. So I guess what's your take on that whole thing?

Dr. Eric Helms46:22

Yeah, I think the one interesting thing that's come out of the time-restricted feeding literature is that if you're able to train in the feeding window of the... Let's say you got an eight-hour feeding window and you eat at the beginning, end, and middle of it and you consume a fair amount of protein, and then you actually train between two of those feedings, at least in the short term, the data we would have suggests that it's not worse for strength and body composition outcomes.

However, there was a study, I want to say it was by Morrow, I may have the author wrong, I'll look it up while I'm summarizing it. But there was a difference between the long-term outcomes. There was actually a study that looked at the same approach for a, I want to say a full year, and it started to find differences that favored the non-time-restricted feeding group.

And I mean, that makes sense when you think about it. It's very difficult to construct a world where we can use anything from the muscle protein synthesis data that suggests, you know, we have all these opportunities to get muscle protein synthesis positive from consuming protein, and then that those additive peaks and area under the curve should have some relationship with muscle gain over time, and to see how is that compatible with spending three-quarters of the day not eating, right, two-thirds of the day not eating.

And I think to some degree that would just be magnified, you'd think, from the one meal a day feeding approaches. We don't have a lot of data on that yet. I'm only aware of one short-term effect of one meal a day, I think it was by Miso and colleagues. And I don't think it was, you know, included resistance training.

But we do have some data on like four-hour feeding windows versus eight-hour feeding windows, and the data is not super clear, but it generally leans in the idea of the longer you restrict or the shorter you make your feeding window, the more likely it's going to have a negative impact on strength, power, hypertrophy, things like that.

And even when you do have an eight-hour feeding window, it could be a problem long-term. So yeah, it actually was Morrow. I found the study, and it is "12 Months of Time-Restricted Eating and Resistance Training Improves Inflammatory Markers and Cardiometabolic Risk Factors."

And essentially what it was was this extension of a study. The initial study came out and found that, hey, the 16:8 approach was, roughly summarizing it, just as good for muscle gain and body composition changes for I think an eight-week period. But then they kept it going. They kept as many of the participants who were happy to go for a full year, and you started to see that, yeah, the metabolic benefits were there, but the time-restricted eating approach seems to result in a potential negative effect for muscle gain long-term.

So it makes sense, right? You know, it's probably not an ideal approach if someone is trying to put on as much muscle as possible. But certainly could be a reasonable approach that is, you know, decent for a body composition period. Like, I want a diet for three months, I just find it easier just to have a point in the day where I go, I'm done eating, instead of trying to restrict myself.

There are some personalities and athletes who report they find that easier. And I think so long as you're training in the feeding window and you don't have really, really, really glycogen-depleting and dependent, high energy flux training, then you're probably fine. So there's some athletes I just don't think it'd be a good fit for, like the example you gave of endurance athletes.

James de Lacey49:59

Yeah, it's funny. When I was dieting down for competitions, I was actually using your water cut as well. I would shift my first meal later in the day because I didn't want to go to bed hungry. And there you go.

Yeah, that works. So I would make sure, I think I would have my first meal at 10 a.m. instead of having it when I wake up at seven or eight, and small things like that. So that's, I guess, more of a practical version of putting into practice versus trying just to do intermittent fasting because of some arbitrary potential benefits.

Dr. Eric Helms50:30

Yeah, and that's where the problem is. You'll hear people throw around words like autophagy or, you know, the issues of metabolically breaking the fast when ultimately those metabolic benefits are small. And for athletes, they're not the purpose.

And the benefit, it seems, from having a restricted feeding window for athletes who, assuming they're metabolically healthy, the idea would be to make it easier to hit the target energy without the negative side effects that you experience. So you can break the rules. Like, it doesn't have to be an eight-hour feeding window. It could be nine. You don't... you're allowed to have a protein shake.

Like, let's say, you know, later in the day. It's like, it's not a big deal. Like, if you had an eight-hour feeding window and you looked, I only got 1.3 grams per kilogram of protein, let me have a 30-gram shake at, you know, 9 p.m., even though I was supposed to be done eating at six. Like, you know, so what? Right? It doesn't matter.

So I think that's an important thing to state, because sometimes, if you look at the typical rationale and arguments for following some of these more fad dieting approaches, they often sit in looking at the mechanisms and the rodent data, the petri dish data, not the translational stuff, and kind of make it hyperbolic and sell you on a mechanism. And that can make people feel far more restricted than they need to and feel like it's based on science when it's actually not.

James de Lacey51:45

That was Carb Backloading 101. John Kiefer did a great job of having a fully referenced, inaccurately referenced, but still fully referenced book that seemed very plausible, but sold a lot of pseudo science, unfortunately.

Dr. Eric Helms52:13

Yeah, but he's sitting nice and tight somewhere in the islands with his cocktail now from that little excursion. Haven't heard of him since.

James de Lacey52:13

Yeah, he got in and got out. He didn't even make a career for himself. He just sold some books, didn't show up to some debates, and never heard of him again.

So I guess the other popular diet we've mentioned already is the carnivore diet. And I guess we've talked about vegan, so this is the polar opposite now, going full meat. So what, I guess what are people missing doing something like this? Is this something, I mean, we know that it's probably not sustainable for some people. That might find it sustainable, is this something you can do for like a month and then just go back to normal? Is it something you should do or look to do for a month to go back to normal or try it?

Dr. Eric Helms53:07

I think it's, to me, it's just a comical response to vegan diets. And I predicted we would see a carnivore diet become popular 10 years ago when, when I would say vegan stuff was at its height. It's just a backlash. That's the way humans are. They're contrarians.

And I think the reason why so many people find it compelling when they go on it is it's basically a super elimination diet. You know, if you have issues with FODMAPs, if you have any dietary allergies that aren't of meat, if you have mild intolerances or anything like that, and you stop eating anything except meat, then it's going to correct those issues at the cost of also potentially resulting in long-term health issues and vitamin deficiencies and not getting enough fiber.

And to say that the data is overwhelmingly positive for the benefits of eating plants would be a gross understatement of about, you know, 70 years of nutrition science. So you're kind of signing up for saying... And you will see this, like a lot of the carnivore diet adherents, when they don't have a scientific study to cherry-pick and try to back them up, or something that sounds sciencey, you know, pointing out that, hey, plants have these defense mechanisms so that...

James de Lacey54:10

I was about to say, that's the go-to.

Dr. Eric Helms54:10

That's the go-to. So they'll talk about science and be like, plants are actually killing you. And then we go, like, so what about all the data that suggests people in blue zones who live forever eat a ton of plants? And be like, science is stupid.

So that's the play. Is when science sort of supports your position, then science is great. But anytime it doesn't, then it's, you know, big bad food and the vegan propaganda. So anytime you see that kind of cognitive dissonance and, you know, circular arguing, then you know they have a position or they have a dogmatic belief. So I get it.

I can be persuasive, and if you really like meat it might be fun, and if you have any kind of dietary issues that are diagnosed or undiagnosed you will feel better acutely. But all the data we have would suggest that you're not doing yourself any favors. And if you're an athlete, you've signed up for not only a ketogenic diet but an extremely restrictive ketogenic diet.

So when I sometimes take issue with the high fat, low carb, ketogenic approach, because it essentially cuts out one macronutrient completely and limits your food options at the store. But it's certainly more sustainable than a carnivore diet where it's eliminating not just one whole macronutrient, carbohydrate, but a ton of foods as well that are even also high in protein and high in fat. So it's similarly restrictive to going on a vegan ketogenic diet, going on a carnivore diet.

And yeah, a lot of also adhere to basically the natural fallacy, which is really, really pervasive, naturalistic fallacy. It's really, really pervasive in the fitness industry. "I only eat foods that have less than six ingredients" or "processed foods are going to harm me."

And to be fair, it's a tough one because there are issues with ultra-processed foods and habitual consumption and how they displace nutrients. And they tend to result in, at the population level, they're associated with a lot of poor health outcomes. But the idea that anything that is natural is inherently good and anything that is not is inherently bad comes with a lot of potentially problematic behaviors in nutrition.

James de Lacey56:29

Yeah, it's funny because I've seen it all over Twitter, people talking about basically anything, "Sugar is bad." I saw one person posting how the oatmeal breakfast that was pushed by whatever the, I don't know, oatmeal is somehow the worst breakfast you could ever have because it's carbs. Like oh my gosh, I can't believe some of those people will say anything now to get a Twitter thread going.

And I guess do you have any advice for people navigating that space in terms of maybe just dietary advice and what to look for that isn't, or something that's going to turn the radar on, be like, "What the hell, whatever they're saying is way off the rails" versus trying to find something that's a bit more sound?

Dr. Eric Helms57:01

I'd be more than happy to give people some BS protection, so how to not get hoodwinked, if you will.

There's a very repeatable pattern. It typically starts with something that is controversial. It'll often get the pitch like this: "Hey, everything we know about nutrition is wrong." And then they give you something that is seemingly logical or seemingly based in evidence or something that makes sense and an extraordinary claim about, "actually what we need to do is this."

So it promotes a little bit of outrage, it gets your attention.

James de Lacey58:03

Doctors hate him.

Dr. Eric Helms58:03

"Hey, the medical establishment has been saying you need to do this." Seed oils, that's the one now.

James de Lacey58:03

Seed oils, yeah.

Dr. Eric Helms58:03

Yeah, and it'll be something next week and next month, and it's always the same: "Conventional wisdom is actually killing us, and that's the silver bullet that has been destroying modern society, and I have the light truth." And probably a product to sell you that will change not only your life but it works the same for everybody.

So anytime someone is giving a universally applicable diet that also asks you to throw out almost a century of nutrition science and basically says, and it uses the fact that we're not doing what society has collectively understood over time through science and knowledge, and any kind of anti-establishment message, run the other way. And I'm not saying you just do whatever a big government agency says you should do or never question anything.

But the idea that because someone is a doctor or a nutrition researcher or that you get a bunch of those people together that therefore their information is poor, I think you just think about that for a second. There's a reason why we're in the phase of the death of the expert. People are actually monetizing and marketing the fact that they're not experts and saying that because "I haven't been propagandized and influenced by the nutrition science or medical establishment, I have the truth. I'm self-taught, I'm a self-taught researcher."

So these messages, whether they're selling vegan, and the anti-establishment there is the dairy and meat industry, whether it's the carnivore which is kind of just anti-science, anti-everything, it's so controversial at this point, or much more traditionally in common for decades now, the low-carb community.

When you hear like, "Oh, the seven countries study" and "if you look at how the dietary guidelines are killing us" and "Ancel Keys, he, this evil conglomeration with the damn food pyramid."

Exactly, "the food industry and that's what's really killing us and they're trying to cover it up." When you get these kind of conspiratorial messaging, and you see it in paleo too, I remember went to a CrossFit gym one time, and I've seen this in multiple CrossFit gyms, they have this poster and they have an image of a nuclear power plant. And it has the words "food inc." on it, like actually the foods that the West makes is made in a nuclear power plant.

And it's like "bad, don't eat processed foods," and then it has a picture of cavemen running around with spears, and "this is how you should eat." It's comical, it literally looks like an episode. It's the silhouette of a nuclear power plant and it's the idea that the food industry is out to kill us all and we just have to eat what paleo man ate.

Of course, paleo is completely uninformed. There's no anthropologists who follow it, it's completely inaccurate as to what was actually eating at that time. But it's probably the least egregious out of all the diets to follow. If you simply eat fruits, vegetables, lean meats, single item food ingredients, and plenty of plants and a relatively high protein diet, you're going to be okay. But it's kind of hard to get enough calories for athletes.

So that one is less harmful, but it's the same messaging every single time: anti-establishment, the experts don't know what they know, there's a conspiracy, there's a vested interest, and therefore "follow the truth and the light, and here's how everyone should eat." And that should tell you something: everyone shouldn't eat the same way, right? That's a problem. It needs to be an individualized approach.

We need to respect the cultural heritage of people from different places, how they eat, what they eat, your personal preferences, what you enjoy. Everything I talked about: how nutrition is a big picture human experience issue, not just numbers or an approach to being better to perform.

And anything that solidifies the multifaceted, extremely complex issue of how nutrition has negatively impacted health in the modernized world to one thing: it's fat, it's sugar, it is plants, it is meat. If it's ever one thing, you know they're wrong. It's at best they've got one piece of a multifaceted puzzle.

Because 40 years of research on the obesity epidemic and public health with people who genuinely care, not just like these evil doctors who for some reason spent their life, "I'm going to go to medical school so I can lie to people." The collective work of scientists all over the world and medical care practitioners to try to figure out, "How do we curtail some of the societal trends that we're seeing?" All of that, they just missed it? It's actually sugar, or it's just processed foods, or it's whatever?

That clearly is wrong. So anytime someone is buying into that, you know that they're not a great critical thinker or they're selling something.

James de Lacey1:02:53

Yeah, that's a perfect rant to end this on. I know you got to shoot in a bit. But if anyone wants to follow you, Eric, see what you're up to, where can they do that? I really appreciated it, great discussion.

Dr. Eric Helms1:03:17

You can follow me at 3dmusclejourney.com. That is the number three, the letter D, then musclejourney.com. From there, there's links to my books, to MASS, which we talked about, anyone who's a strength athlete or bodybuilder. We have coaching which I advise our coaches as our scientific advisor, they do a great job.

And if you want to hear me, where I'm appearing on what podcast that aren't my own, follow me Helms3DMJ on Instagram and you can listen to me rant all you want.

James de Lacey1:03:39

Yeah, I'll link some of those up in the description. You can also just search Eric Helms on YouTube because you host a podcast, Omar Isuf. I think you co-host a billion podcasts as well, so you've got...

Dr. Eric Helms1:03:39

I never shut up, so yeah, if you Google me, you'll find all the good stuff.

James de Lacey1:03:39

Yeah, for sure. Yeah, no, perfect. Well, thanks for coming on Eric, I really appreciate it.

Dr. Eric Helms1:04:05

It's a pleasure, man.