1. Michael Karing MD
MDVIP Affiliate

2.  What’s the best “diet”
 Major rules of healthy eating
 Macronutrients
 Micronutrients

3.  Can be difficult to ascertain what should my
diet be comprised of or the “type”
 The Mediterranean Diet?
 The DASH(Dietary Approaches to Stop
Hypertension) Diet?
 The Paleo Diet?
 The “I Don’t Give a Poop “ Diet

4.  The information related is a combination of
clinical observations being involved with
weight loss programs, information from all
medical sources put into context, and tying it
into basic biochemistry & physiology.
 Change may be involved with improved
nutrition. If so, there must be a driving purpose
for a desired change.

5.  Never eat after dinner! Finish 3 hours before
going to sleep.
 Eat three meals a day. Never snack!
 Do not eat large meals.
 Eat a breakfast containing protein.
 Reduce the amount of carbohydrates you eat.

6.  What? Never eat after dinner & finish 3 hours
before sleeping! Are you crazy?
 Why?
 Allows the utilization of fat stores after about 9
hours. The potential of 4 hours nightly.
 Eating later disrupts the ability for the body to do
this.
 Higher insulin levels blunt the natural cycle of
hormones such as leptin, melatonin & growth
hormone.

7.  Ok. Five to six hours between meals. No
snacking between meals! Are you crazy?
 Why?
 More frequent eating/snacking stimulates insulin
secretion and therefore higher levels.
 Insulin promotes the storage of energy…fat storage
in adipocytes if glucose already stored in tissues in
the form of glycogen.

8.  With insulin and leptin resistance, it may be
impossible to follow the first 2 rules…to begin
with.
 Two bridges
 Best alternative might be to have more frequent,
smaller meals as metabolic issues improve.
 Also, low calorie, low carbohydrate snacks that have
a lower impact on glucose levels and, thus, insulin
secretion.

9.  Too many calories consumed….they will be
converted to fats and stored in adipocytes.
 Woman daily caloric intake between 1200 to
1500. Translates between 400 to 500/meal.
 Men daily caloric intake between 1800 to 2100.
Translates between 600 to 700/meal.
 Portion sizes, slower eating, fiber, hydration.
 Target high glycemic carbohydrates!!!!!

10.  What are the essential macronutrients?
 Carbs? Proteins? Fats?
 What hormone, secreted near bedtime,
promotes a natural, rhythmic sleep along with
strong anti-oxidant effects and may aid
function of other hormones secreted at
bedtime?
 What hormone is more of a “repair” hormone
during adult life?

11.  Proteins & Omega Fatty Acids. 9 of 20 amino
acids in the body are essential. Omegas are
essential with end products being EPA and
DHA.
 Melatonin promotes sleep and is a strong anti-
oxidant. Levels tend to decline with age.
 Growth Hormone levels peak with melatonin.
Many repair functions overnight. Melatonin
may help secretion of GH.

12.  After a fasting period overnight along with the
metabolic activities of cellular repair and
protein synthesis, the body needs raw building
materials and energy. PROTEIN!
 Totally missing or not getting adequate protein
slows metabolic rate.
 Protein processing thermogenic compared to
other macronutrients. What?
 Adequate? General rule, women 25-30grams &
men 30-35gram.

13.  “Eat like a pyramid, look like a pyramid” from
Mastering Leptin.
 Excessive amounts of carbohydrates lead to
excessive amounts of insulin, which leads to
insulin resistance. Typically, leptin resistance
also.
 Marked reduction of simple sugars in drinks
and food, along with high glycemic complex
carbohydrates.

14.  Sources should be from low glycemic fruits,
vegetables and complex carbohydrates.
 Sources for glycemic index
 www.glycemicindex.com
 www.health.harvard.edu/newsweek/Glycemic_ind
ex_and_glycemic_load_for_100_foods.htm

15.  Never eat after dinner! Finish 3 hours before
going to sleep.
 Eat three meals a day. Never snack!
 Do not eat large meals.
 Eat a breakfast containing protein.
 Reduce the amount of carbohydrates you eat.

16.  Proteins
 Carbohydrates
 Fats

17.  Broken down into amino acids for energy but
primarily building blocks for proteins,
enzymes, and the list goes on. Of the 20 amino
acids in the body, 9 of them are essential. Can
not be made or converted from another source
in the body.
 Not getting adequate amounts? Asking a
machine to perform without even the least
acceptable fuel.

18.  What’s adequate intake?
 A range of about 0.7 to 0.8 grams per pound of Lean
Body Mass. LBM=TBW – Body Fat Mass.
 Most woman, as a general rule, 25 to 30 grams of
protein per meal is good.
 Most men, as a general rule, 30 to 35 grams of
protein per meal is good.
 Body Composition Analysis can give the above
numbers.

19.  Meat
 Poultry
 Seafood
 Eggs
 Low Fat Dairy
 Beans and Peas
 Nuts and Seeds
 Note: Paleo excludes dairy & beans

20.  Meat, poultry and fish share in common that
they provide about 8 grams protein per ounce.
 In general, 4 ounces provides about 30 grams
protein. 4oz filet, 1 chicken breast.
 The size of your palm.
 Grass fed/organic animals have less saturated
fat and higher amounts of omega fatty acids.
 Red meats? Pork, Lamb, Veal are included.

21.  Leaner source of protein than meats. That is,
lower amounts of saturated fats. Excludes the
skin.
 Chicken and Turkey mainly.
 A chicken breast, 4 oz, the size of a palm
provides about 30 grams of protein.

22.  Another great source of lean protein!!
 All types of fish great source of protein.
 Coldwater fish are also a great source of omega
3 fatty acids.
 Wild Salmon, Cod, Halibut, Albacore Tuna,
Anchovies, Sardines, Atlantic Mackerel, Artic
Char. These also have lower mercury levels.
 Again, 4 to 6 ounces provides 28 to 40 grams
protein. Think the size of your palm.

23.  Great, inexpensive source of protein.
 One egg provides about 6 grams of protein.
 The egg white provides the protein, and it is
almost void of fat, cholesterol or carbohydrates.
 The yolk provides cholesterol and fat.
 Tip: I like making scrambled eggs with one
whole egg and two whites.
 4 scrambled egg whites=24 gr protein/96 cal!

25.  Lowfat milk, plain yogurt, plain Greek yogurt,
low fat cheese, low fat cottage cheese, and
whey protein.
 Leanest, lowest carbohydrate sources are Greek
yogurt and whey protein.
 Whey protein is the protein isolate from milk.
Filter off the sugars, the fats and then the liquid
and it’s whey. Whey protein is the ideal mix of
the amino acids needed. Great source of
essential amino acids.

29.  Whey protein. 30 gram=120 calories
 Water, Low Fat Milk about 100 calories,
Unsweetened Almond Milk 30 calories.
 Fruits such as berries, bananas, apples,
mangos, peaches, cherries, pineapples, etc.
 Small amount of Jello pudding can give
additional flavor
 Great “meal” any time. Can be made night
before.

30.  Frequently, over looked as source of protein!!
 Also, great source of fiber and have low
glycemic index due to fiber. Good proteins and
good carbohydrates. Low in fat also.
 16 bean mix available of local stores is great
start.
 Soy? Estrogen like effect? May block
conversion of T4 to T3 those that have thyroid
difficulties.
 Quinoa? Complete source of protein, like whey

31.  Source of protein, but calorie dense due to the
amount of fat in them.
 Would use small amount of raw or roasted nuts for
snack if needed, along with lean proteins. Avoid
carbs as snacks!!
 A serving of almonds has 162 calories, 14 grams of
heart-healthy unsaturated fat, and 6 grams of
protein, and when snacking on almonds, portion
control is key. Count out 23 and see how they fit in
palm.
 Nuts best omega ratios? Walnut, Macadamia &
Pecans

32.  They are not evil, but the availability of simple
sugars added to drinks & foods along with
processing of “complex carbohydrates”
 Processed carbohydrates are carbohydrate
foods that were processed or refined to make
them more consumer-friendly and easier to
transport, but have been stripped of most -- if
not all -- of their nutrients and fiber along the
way.

33.  Avoid drinks that have added sugars. Calories
from drinks? Low fat dairy & occasional
alcoholic beverage.
 Vegetables and fruits are the best sources of
carbohydrates. Usually, associated with fiber
and phytonutrients that have lots of beneficial
biochemical activities.
 Other “complex” carbohydrates should be
whole grain with as little processing as
possible.

35.  Only two fatty acids are known to be essential
for humans: alpha-linoleic acid(an omega-3
fatty acid) and linoleic acid(an omega-6 fatty
acid).
 Alpha-linoleic acid needs to be converted to
usable forms: EPA(eicosapentaenoic acid) and
DHA(docosahexaenoic acid). Humans have
poor ability to convert ingested ALA to active
forms.
 Seafood best overall sources. Meats from organic,
grain feed and eggs raised for higher amounts.

36.  Linoleic Acid much more available and/or
ingested due to sources such as nuts/seeds
and oils from vegetable sources(soy, canola,
safflower).
 Both are essential. However, omega 3’s have
anti-inflammatory effects vs the omega 6’s that
have pro-inflammatory effects. So, encourage
ways to decrease omega 6 intake and increase
omega 3 intake.
 Cooking with extra virgin olive oil lowers 6
intake

37.  Limit fat intake. Remember, what the essential
fats are. All other fats can be made when an
excess of energy is available.
 Transfat? No debate. Avoid it.
 Use of monounsaturated and polyunsaturated
fats? Nuts and seeds and cooking oils biggest
source.
 Limit saturated fat intake? I would.
 Overall? Increase omega 3’s with DHA/EPE
and cook with extra virgin olive oil(low temps).

38.  Essential micronutrients include certain
vitamins and minerals.
 Essential, again, that we can not produce these
substances and must come from diet or
supplementation.
 Phytonutrients, which are complex organic
compounds, are obtained from fruits and
vegetables. Not considered essential but have
significant anti-oxidant and other beneficial
effects.

39.  Studies that show lack of benefit may not be
asking the right questions, designed to answer
the right questions. Consider:
 Magnesium is needed for over 300 metabolic actions.
Estimates of 50% deficiency in hypertensives,
especially on diuretics.
 Vitamin D deficiency very common and has
metabolic effects than are more than just on bones.
 Chromium deficiency maybe quite common in
diabetics. Helps with insulin sensitivity.

40.  Can’t name 1 day this week that you:
1. Know you got enough 24 essential
vitamins and minerals.
2. Ate five to nine servings of fruits
and vegetables, and
3. Ate ocean fish
 Currently on medications that are
associated with deficiencies. Can Google
for lists.

41.  Books: Mastering Leptin. Highly recommended
 Websites: www.glycemicindex.com
 Pintrest great source for meal ideas!!
 Nutrition Action Health Letter. Great source of
ongoing nutritional education and healthy
living. 10 issues per year for less than 30
dollars. Website www.cspinet.org/nah/
 Great YouTube video: Eating to Prevent
Disease MDVIP Louis Malinow MD