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Older Bolder Foundations: Is Everything You’ve Been Taught About Macronutrient Partitioning Wrong? Probably. (Part 3)

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Let’s wind up this whirlwind tour of macronutrient partitioning with a look at the role fat plays in your food plan and a key closing thought. Scroll down below (or click) to read Part 1 and Part 2 if you missed them.

Getting to Your Best Macronutrient Partitioning: Fats

Fats, despite growing evidence to the contrary, continue to be broadly demonized by many in the traditional health and nutrition world (see current recommendations from the American Heart Association for example); not only that, we’re constantly implored to utilize the very fats that are in reality shockingly bad for us – namely the highly-oxidized, chemically-modified, PUFA-dominated franken-oils lining most supermarket shelves (again, see the AHA link above).

The good, healthy fats (butter and ghee, coconut oil and coconut products, animal fats, olives and olive oil, and avocados for example) provide a host of benefits and can be enjoyed, within the bounds of common sense, with two primary goals in their consumption: balancing out your daily caloric needs as your primary fuel source (after establishing your carb and protein requirements) and making your food taste good (yep, much of the flavor you savor in your food comes from fat).

[And yes, we’ll being taking a detailed look at what makes ‘good fats’ far better for you in detailed posts down the road. If you’re currently exploring the issue and want to dig deeper (no pun intended), pick up a copy of Dr. Cate Shanahan’s book Deep Nutrition for a dive into the science underlaying the fat recommendations here and across much of the wellness literature today.]

Balancing out daily caloric needs is the key take home point here and points to a critical principle that continues to fly in the face of conventional wisdom – that point being that the human machine (our metabolism) runs optimally on fat as its primary fuel source, not carbohydrates. There’s a plethora of literature espousing this Fat Paradigm (here’s a seminal article from Phinney, 2004), and we’ll be looking at the topic in much more detail a few weeks down the road.

Practically speaking, once you’ve reacquainted your metabolic machinery with the reality of burning fat as a preferred fuel source (which conceptually isn’t that difficult to do), fats become the variable in your food plan allowing you to accomplish all sorts of things. Things like rational, consistent weight loss or fueling high level functional life or athletic activities.

[As an example, I have a client who wants to loose roughly 40 pounds (at a very sustainable rate of 1.5 lb/wk), and we’ve dialed in her comfortable carb intake at about 60 g/day and protein in the neighborhood of 90 g/day. With her calculated BMR (based on LBM and adjusted for activity) 2150 cal/day, it’s a simple calculation to subtract her carb+protein intake derived calories from her BMR, along with the calorie deficit to produce the desired weight loss, to see that she needs about 800 cal/day from good fats, roughly 88 grams. An easy-peasy plan to derive and accomplish.]

For many breaking out of the carb-dependent paradigm can be a challenge, but once you’ve personally experienced the power of changing over to fat as your preferred fuel source, a whole new world of possibility opens up.

Getting to Your Best Macronutrient Partitioning: Seek and You Shall Find

In summary, your best macronutrient partitioning plan isn’t one that comes from the benevolent USDA, the American Heart Association (or just about any other traditional medical “association”), or from the fitness guru (and Instagram celebrity) online who promises a foolproof, customized meal plan for just three easy payments of $39.99.

Your optimal macronutrient partitioning plan…

…is at any point in time unique to you and you alone, though there are useful generalizations available to serve as jumping off points when reshaping your approach to food and nutrition,

…is going to be fluid (flexible), changing as your body composition and metabolic health improves,

…is going to be fluid (flexible), changing as your physical and metabolic demands change over time, perhaps even from day to day,

…is most likely going to built around the concept that the bulk of your daily calories will come from fat (good fats!), less from protein, and minimally from carbohydrates,

…will likely vary seasonally,

…will likely become so intuitive you don’t really even think about it from day to day,

…and will likely benefit from an annual or bi-annual “tune up” or “reset”, as in a period of nutritional ketosis for example.

Your challenge, should you decide to accept it, is to find that optimal macronutrient partitioning plan that fits your life today, and learn the skills to adjust it when life throws you a curve ball, or you just feel the need to push your limits out a little further.

Read. Study. Ask questions. Experiment with your own N=1 clinical trials. Need help along the way? We can help, as can a number of excellent health coaches only an email or call away.

Older Bolder Foundations: Is Everything You’ve Been Taught About Macronutrient Partitioning Wrong? Probably. (Part 2 of 3)

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If you missed yesterday’s post taking a well-earned jab at the conventional wisdom concerning macronutrients and macronutrient partitioning, scroll down (or click here) to read. Now, let’s get down to some practical nitty-gritty details…

Getting to Your Best Macronutrient Partitioning: First, the Caveats

When trying to dial in optimal macronutrient partitioning for any given individual (most likely you!), a couple of caveats are in order.

One, beware anyone (including the USDA) telling you that their formula / ratio / recommendations work for everyone, particularly if you have to pony up something (likely cash) up front to get the magic data. There’s a simple reason generic, one-size-fits-all partitioning recommendations aren’t worth much…

Two, your optimal macronutrient partitioning needs depend on a host of factors THAT ARE UNIQUE TO YOU; potentially including (a short list, just for example):

  • Your current objective(s): be it weight loss, athletic performance, cognitive improvement, general well being, longevity, etc.
  • Your current body composition: Are you overweight, underweight, lacking appropriate muscle mass?
  • Your overall metabolic health: Are you in full-blown metabolic syndrome with insulin resistance, on the edge, or “fairly healthy”?
  • Your overall level of activity: Are you a cubical-bound couch potato whose idea of a workout is the walk to and from the car in the parking lot, an occasional, casual walker, perhaps working a physically demanding job, or a gym rat?
  • Your overall general health: Do you have conditions that impact your body’s functions in a material way, such as joint problems (degenerative arthritis), heart disease or hypertension, poor sleep, or stress you can’t manage?
  • Your age: For example, protein requirements increase in the elderly, and the elderly’s protein requirements may be more impacted by higher activity levels.
  • Your current progress in your recovery journey: Your best macronutrient partitioning will change over time, pending where you are in your health and wellness journey, and as you purposefully get leaner, more fit, and thoughtful about how you fuel your mind and body.

Optimizing your macros takes paying attention to what your body’s telling you; it’s time to start listening…

Getting to Your Best Macronutrient Partitioning: Carbs

In all the study, reading, and learning I’ve done over the years, from where I sit no one has done a better job illustrating the role that carbs play in your macro intake than Mark Sisson of The Primal Blueprint and Mark’s Daily Apple. In particular his carbohydrate curve packs a boatload of information into one simple yet inspired graphic, reproduced below.

There’s volumes to talk about with regard to carbohydrate intake and we’ll be focusing on the subject extensively here on in months to come. At this point, as the vast majority of folks that I interact with have as a primary objective optimizing lean body mass (for most that means dropping fat and building/preserving muscle), we typically start by targeting 100 g (net) or less of carbs / day.

Getting to Your Best Macronutrient Partitioning: Protein

The current RDA for protein – 0.36 g/lb lean body mass (or 0.8 g protein/kg LBM) – is based on assumptions that don’t apply to many: a sedentary lifestyle, healthy / metabolically sound, with normal lean body mass and not trying to build muscle/increase LBM. For active individuals, for years have recommendations have quickly spun up into the 0.7 to 0.8 g/lb range (or higher).

Interestingly, many in the ancestral health and wellness world have been for some time challenging the RDA dogma above, and suggest that the minimal requirements may indeed be much lower, in the range of 0.5 g/lb LBM.

Intuitively you know that athletes need more, though as science drills down with more and more specific research, the shockingly high amounts of protein recommended (for example in body builders) appear to have quite potentially been simply too much. Suffice it to say that a large portion of the strength training community holds that 1-2 g protein/lb of LBM per day is reasonable.

For those seeking weight loss, and recognizing that goal number one is loss of fat and not lean body mass (muscle being the largest component of LBM), studies have shown that upping protein (basically doubling the RDA above) improves weight loss and better preserves LBM.

The elderly and those recovering from significant illness or injury need more protein (in the ranges of 0.5-0.6 g/lb LBM and 0.7-0.8 g/lb LBM respectively).

We’ll have much more to say about protein in weeks and months to come, but at this point we steer most to target roughly 0.5 to 0.6 g of quality proteins/lb of LBM per day, and adjust within 3-4 weeks based on your body’s response.

We’ll take a hard, detailed look at what constitutes optimal protein sources in a few weeks, and
tomorrow we’ll take a look at fat and some final thoughts on macronutrient partitioning.

Older Bolder Foundations: Is Everything You’ve Been Taught About Macronutrient Partitioning Wrong? Probably. (Part 1 of 3)

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One can’t venture too far down the fitness, weight loss, or wellness roads without encountering some discussion of what makes up the ideal macronutrient partitioning ratio (the amount of carbs, protein, and fats you eat) for the human body. And just about everybody misses a key point about partitioning – we’ll delve more into it in tomorrow’s post – but your critical challenge is finding the right partitioning, at the right time, for you.

[Just so we’re all on the same page in this short discussion, let’s follow accepted convention and think of macronutrients as those nutrients the body needs in large quantities – carbohydrates, proteins, and fats; we’ll designate micronutrients as those needed in smaller amounts – water and fat soluble vitamins and minerals, other esoteric cofactors, and some might even throw water in that mix. (This is a fairly oversimplified approach, though it serves our purpose here).]

Conventional Wisdom on Macronutrient Partitioning

Like many of you, I came of age in the 1970’s, during a time when the earnest folks at the USDA coordinated a number of very diverse interests (including significant representation from food growers/producers) to articulate Dietary Guidelines for us all; the infamous food pyramid arose during those early years.

The USDA continues to this day to offer their increasingly-challenged recommendations; you can read the latest version of their Dietary Guidelines for Americans (2010) here, all mind-numbing 112 pages.

Honing in on their recommendations for macronutrient partitioning, the table below was cut right from the document –

Sadly, despite the explosion of scientific evidence otherwise, these carbohydrate-centric, fat-phobic concepts still pervade much of traditional medical / dietary literature and practice; here’s a quick example from a university website resource (Washington State).

And (perhaps not so) shockingly, despite all of the learned counseling we’ve received, Americans continue to stuff a shocking array foods down our gullets as noted in the Dietary Guidelines (link above); the table below details the top food sources of calories by age groups…

Taking the table above at face value (assuming it’s reasonably representative), it’s no wonder the ‘typical American’ slowly and inexorably gains weight every decade past thirty (many starting much, much earlier). And despite exposure to the Dietary Guidelines over the past 40 years, we’ve become fatter, less healthy, less active, and according to recent news – less intelligent along the way.

There has to be a better path, and there is – Part 2 on macronutrient partitioning tomorrow.

Older Bolder Life Foundations: There is a Far, Far Better Way to Eat

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There is indeed a far, far better way to eat, using a diet format that fits our human physiology better than any other. This food plan is intuitively simple, is accessible to just about anyone and everyone, is packed with nutrients, and probably most importantly – is built for the long-haul as it’s tasty, satisfying, and allows you to be as creative as ever in the kitchen. And for those who want to dig deep into the science behind their own physiology, appears to make the most sense in terms of the science-based evidence in hand today.

I’m talking about a low carbohydrate, moderate protein, high fat approach to nourishment (LC/MP/HF); it’s not a novel approach at this point in mid-2018, but appears to be the optimal one for human physiology (for the vast, vast majority of us on the planet today at least) based on evolving scientific understanding of how the body works, in particular with regard to the cadre of hormones that regulate nutrient transport, metabolism, storage, and your hunger.

Granted, there are plenty who disagree, and on a variety of grounds (many of which are based on preference and not physiology). And there are a host of criticisms of LC/MP/HF that typically mischaracterize the approach in some way; i.e. eating low carb means you never any any carbs at all. That’s fine, after all, we’re all ultimately personally responsible for how our bodies function, and how we relate to the world around us.

If you’re truly serious about living life as fully as possible, optimizing your physical, cognitive, and emotional/spiritual potential, you cannot ignore the body of science and experience detailing the successes of low carbohydrate, moderate protein, high fat food plans. Here are just a few of the reasons the LC/MP/HF approach works.

Eating Low Carb/Good Carb Tastes Good

One of the keys for success of any long term, healthy eating plan is that is has to taste good. A simple concept, yet so often ignored in the past (I’m remembering one of my yo-yo dieting parents eating cabbage braised in tomato juice twice a day for weeks as child…). For a long term eating plan to succeed there needs to be an vast array of food choices that are satisfying and attractive, and eating nutrient-dense, fresh, healthy carbs (leafy greens with high fat dressing, crispy steamed broccoli dripping with butter, sautéed mushrooms, and more), fits the bill quite nicely.

Eating Low Carb/Good Carb Puts Insulin In Its Place

Insulin plays a number of roles in the body, with one of its principle tasks being to store excess nutrition, and it does so by storing fat. High carb diets chronically keep insulin elevated, keeping fat locked in storage, and the longer you live with elevated levels of insulin, the more risk you become of developing insulin-resistance, which among other devastating things makes it much harder to drop excess body fat.

Eating a low carb/good carb diet lowers insulin levels, one of the first critical steps in getting you back on the healthy track.

Eating Low Carb/Good Carb Increase Fat Intake (And Fat Ain’t the Bad Guy)

Long demonized in the Standard American Diet (SAD), fats are very likely the preferred, optimal fuel for your body to primarily run on, a point we’ll be addressing at length here over time. Among many other things, fat in a meal slows gastric emptying, prolonging a sense of satiety, which means you’re not eating for longer periods, and thus overall lowering calorie intake (which for most of us, is a good and necessary thing!)

Eating Low Carb/Good Carb Emphasizes Quality Protein

Particularly as we age, lean muscle mass diminishes (there are host of reasons for this), and protein intake is critical to combat this natural decline; it’s even more important in the setting of trying to lose excess body fat – you want to the fat to go away, not the muscle!

Quality protein in the diet, particularly in the setting of low carbs, contributes massively to your sensation of satiety, meaning you’re less hungry, sharper longer, and break out of the carb-crash roller coaster pattern the SAD provides.

Eating Low Carb/Good Carb Implies Embracing the Good and Dumping the Bad

There are several foods, ironically centerpieces of the typical American diet, that contribute more to the damaged and deranged health of the population than anything else – sugar, grains, and the highly-oxidized, polyunsaturated, industrially-processed vegetable and seed oils being the worst of all.

Eating a SAD diet, these three categories often make up the preponderance of calories consumed, despite the hard science record that carbs are the principle driver in determining body composition and that excess glucose (yep, we’re looking right at you grains and sugars) is the root culprit fostering the obesity epidemic and the flood of disorders (i.e. T2DM, heart disease) that walk hand in hand with it.

This isn’t a carb-phobic approach – it’s sweeping the crap carbs out of your diet, and replacing them fully with nutrient-dense, fiber-rich, healthy carbs at levels that make sense physiologically.

This is a meaty topic (slight pun intended), and one not well-covered in a few paragraphs; there’ll be much more to come and there’s a plethora of great information at your fingertips today.

Eating Low Carb/Good Carb Works Quickly

Not intentionally referring to the quick loss of water weight that often occurs when transitioning to a LC diet (there’s no question that early success in weight loss efforts often encourages longer-term compliance), but more to the reality that particularly in the obese, dropping carbs to a “low or very low” level (in the setting of appropriate protein and fat intake) often leads to rapid drops in fat stores (maybe even targeting belly fat).

My own experiences speaks to this phenomenon of rapid weight loss; after a 100 lb weight loss and subsequent stall, entering a period of thoughtful nutritional ketosis led to a prolonged run of dropping 2 to 2.5 lb of fat per week, eating to absolute satiety every single day.

Eating Low Carb/Good Carb is Easy, Intuitive, and Simple to Follow

During my years in practice, I advised overweight patients (when treating their bone, muscle, joint, or spine issues), to take a serious run at weight loss; most often I steered them to what I used to call ‘rational’ programs – like Weight Watchers and The Zone. The most common complaints/reasons for failure that I heard over and over was the fact that patients found the regimented programs too restrictive and regimented, difficult to learn, and unsatisfying.

Successful diets and food plans – whether pursuing weight loss, optimizing health, or high level athletic pursuits – are based on simple, easy to understand, almost common-sense principles that allow one to intuitively navigate the sea of food choices laid before us every day. A carefully crafted LC/MP/HF approach, like Primal and Paleo for example, offer just such a framework.

Eating Low Carb/Good Carb Packs in Nutrients, Not Calories

I’m often stunned at how often a LC skeptic will assert that eating a low carb diet is harmful from the standpoint of missing out on key nutrients. The assertion is almost shamefully easy to counter, as in replacing calorie-dense, carb-dense foods – bread with every meal for example – with a fresh leafy green (or sautéed spinach, broccoli rabe, or green beans, etc.). Doing so ups your micronutrient density significantly, and adds a host of healthy phytochemicals as well.

Sugars are devoid of micronutrients, and grains bring along a lot of unsavory baggage in addition to their unfavorable carbohydrate density – namely lectins (including of course gluten), micronutrient-binding phytates, and the little discussed protein gliadin, binding to opiate-receptors in the brain (more on this little gem later).

More to come.

Older Bolder Life Foundations: Can You Simply Exercise Your Way to the Body You Want? Probably Not.

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One of the most pervasive myths about health and fitness that I personally encountered growing up and later in medical training and practice was that exercise, of all types, was the principle key to attaining a “fit and trim” body composition. To be sure, what one consumed in terms of diet was deemed important, but for example playing high school sports in the mid-70’s, we were taught and trained to be carb-dependent, protein-guzzling machines.

Wait Just a Danged Minute, This Story Doesn’t Add Up

We experienced, yet didn’t really understand, the simple reality that repetitive, glucose-fueled / glucose-burning workouts trained our bodies to prefer or reach for glucose preferentially 24/7.

We burned through glucose in the too-long, too-intense HIIT and chronic cardio-focused training that dominated the day, gorged on carbs and too much protein (leading to gluconeogenesis when glycogen stores refilled quickly) afterward, generating spikes of insulin, with a resultant ‘sugar crash’ leading to even stronger carb cravings.

Some of my very athletic compadres began in high school to pack on a few extra pounds around the middle, a body composition change that became even more prevalent on through college and graduate school years.

Yet the conventional wisdom taught back then (and even in some circles now) was based on the calories-in / calories-out model, and could be ‘fixed’ by simply reducing your total calories per day, usually by restricting fats, and continuing to fuel with carbs as we implored ourselves and patients to just ‘work those calories off in the gym or on the road’.

Yet over the past three decades we (as a Nation) have seen fitness levels plummet as we dutifully pursued the Food Pyramid and chased the current fad diets across the fruited plain, and pounded hours away in the gym hoping to return to the bodies and fitness of our youth.

Body Composition and Exercise: So How Much Does Exercise Truly Matter?

Ironically, looking back on more than twenty-five years in the study and practice of medicine (rehabilitative and musculoskeletally focused), I don’t remember reading or hearing detailed discussion of what we know today to truly drive body composition. Lip service was paid to obtaining “nutritional balance, eating well, and getting lots of exercise”, though nutritional recommendations were seeming directed more by USDA policy than by evidence-based science back in the day.

Sure, medical investigators have long acknowledged that exercise plays a role in body weight and composition (here’s a decent example from the Journal of Obesity back in 2011), though multiple agencies, for example including the American Heart Association, still cling to out-dated and frankly harmful dietary recommendations (see the nitty gritty details here; we’ll have a detailed discussion about these at a later date) and chronic cardio inducing exercise recommendations.

The encouraging reality is this: what you eat will determine 80% of your body composition, with exercise contributing roughly 10%. The other 10% is likely composed of your skills in managing stress (and life can be damned stressful these days) and resting well (sleep matters).

These are of course rough divisions, and will vary in their relative contribution somewhat among individuals pending details such as how far above their ideal body weight they might be, how metabolically impaired they are, how long they’ve been metabolically impaired, if they suffer from other medical issues (comorbidities), how they manage stress, and how they manage sleep – which most of us these day do quite poorly.

Exercise – particularly the right types and in appropriate volumes – is a critical, absolutely necessary, and often fun part of the equation, but what you eat is far, far more important to your overall health, wellness, function, and body composition.

As we progress through our Foundation Series we’ll be digging into each of these areas in much greater detail.

Older Bolder Foundations: Excess Body Fat Isn’t Your Friend

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During the last half of my work as a physician, my practice was focused on the conservative management of spine pain and injuries, though I did treat a number of general muscle, ligament, bone, and joint issues as well.

Though I didn’t keep a formal record, thinking back and estimating conservatively, I’d venture that at least 75-80% of the individuals I interviewed in exam rooms and later examined were above their ideal body weight. (Clearly there’s a bit of selection bias at play in that number, as people above their ideal body weight tend to suffer more musculoskeletal injuries and degenerative problems.)

By far and away, the most common response from patients when queried about their body weight history ran something like this….

I know I’m overweight, Doc, but I’m in a lot better shape than I look…

Many of these folks were amateur athletes, weekend warriors, hikers, hunters, gym rats, and many were employed in physically demanding work environments as well; yet some arguing how fit they were easily met the criteria to be labeled as obese.

[Along those same lines, I’ve just watched a series of video interviews featuring Dr. Phil Maffetone, who noted several times how shocked he was to see how many amateur runners competing in half and full marathons he’d attended recently were clearly overweight.]

Then, as now, it’s brutally clear that excess body fat isn’t anyone’s friend.

The list of problems induced by, frankly caused by, or worsened by excess body fat is long and daunting:

  • Premature and severe joint degeneration and arthritis
  • Heart disease
  • T2DM
  • Hypertension
  • Various lipid disorders
  • Cerebrovascular disease (stroke)
  • Liver and Gallbladder diseases such as Fatty Liver Disease
  • Metabolic Syndrome
  • Sleep Apnea and other respiratory issues
  • Menstrual abnormalities
  • Infertility
  • PCOS (polycystic ovarian syndrome)
  • Erectile Dysfunction
  • Some types of Cancer (endometrial, breast, colon, renal, gallbladder, hepatic)
  • Lymphedema
  • Higher All-Cause Mortality
  • Pyschosocial issues
  • Overall lower functional life quality

The list is easily made longer (if you want to split a few hairs and nitpick specific diagnoses), but again the point is clear – excess body fat isn’t your friend, and will eventually contribute to issues that severely impact your ability to function, which is what life is all about.

Take heart, no matter what your health status now, there are ways to eat and exercise your way to a fuller, more productive life.

Older Bolder Foundations: Optimizing Lean Body Mass, Not Weight Loss, Is Goal One

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Many of us are drawn to efforts to improve our personal health (or the health of a loved one) by the lure of weight loss; given the fact that roughly a third of Americans are obese by typical measurement standards, weight loss is an appropriate and worthy goal.

What we should be more focused upon, though, is optimizing our lean body mass, given the almost astounding benefits optimal lean body mass provides.

Granted, weight loss and optimizing lean body mass are kissing cousins and very closely intertwined, though there are subtle (and some not so subtle) differences in approach and practice between the two.

Why bother with the distinction? The answer is easy – there are some extreme approaches to weight loss (and long term food plan choices) that compromise, some significantly, lean body mass and therefore general health and well-being over the long haul. Getting and staying optimally healthy and functional is of course the objective, and the road to get there is in reality pretty conceptually simple to navigate.

It’s worth thinking a bit more about lean body mass and its benefits…

What is Lean Body Mass?

Lean body mass is term used quite frequently these days by folks from all across the health and wellness spectrum. The simplest definition for Lean Body Mass (LBM) is the weight (mass) of everything in your body minus/without the various types of body fat stored on your frame.

LBM is sometimes (incorrectly) used interchangeably with muscle mass, and while they’re correlated strongly, of course LBM includes the weight of all “the other stuff” in our bodies beside muscle tissue – our skeletal structure, skin, internal organs, nervous system, the various fluids circulating through the system. There are a number of tools that are able to more accurately measure body composition and sort out with much greater precision your muscle mass, such as DEXA scans (duel-energy X-ray absorptiometry and BIA (bioelectrical impedance analysis).

Higher Lean Body Mass Implies Enhanced Function (and Function is the Ultimate Goal)

Life is about function – engaging fully and productively with your environment – and to do so optimally implies an intact and fully functional lean body mass. In particular, engaging fully functionally with our environment implies consistent, high-level function of our musculoskeletal system (muscles and joints aren’t necessarily designed to wear to failure in our sixties), and all the organ mass that supports their mobility-centric activities (heart, gut, liver, brain and neural tissue, etc.)

Excessive fat (adipose) mass is an unwelcome traveler along for the ride, a lumpy mass of nutrient storage far, far beyond rational possible needs, dampening the actions of homeostasis-seeking hormones (i.e. insulin resistance, decreased leptin signaling), overloading joints, driving inflammation, invoking frustration, shame, and anguish, and much more.

Lean Body Mass Promotes Insulin Sensitivity

The plague of insulin resistance carries with it a host of metabolic consequences, though it’s been a well-documented and long-accepted fact that a higher lean body mass is associated with lower rates of what many term prediabetes and insulin resistance. It’s well established that increasing insulin sensitivity is good, and insulin resistance is bad; we’ll delve more into insulin resistance later.

Try a quick search engine query of “lean body mass and insulin resistance” and you’ll find a flood of studies completed over the past several decades; we’ll look in detail at several in a later post.

Higher Lean Body Mass Increases Longevity

Observational studies such as this one have demonstrated conclusively that higher muscle mass (a strong correlate of LBM) in older adults is associated with lower all-cause mortality. Lower skeletal muscle mass and abdominal obesity (implying low lean body mass) has been shown to correlate strongly with higher all-cause mortality and cardiovascular mortality.

Lean Body Mass Strengthens Bones

Osteoporosis, in lay terms often referred to as thinning of the bones in the body, is a bone disease that occurs when the body makes too little bone, loses too much bone, or a combination of the two. (The word osteoporosis actually means “porous bone”.) Osteoporosis in it’s worst forms leads to a plethora of fractures (femur, wrist, and spine among the more common and serious), requiring at times aggressive intervention, and inducing impressive losses in the functional realm.

Bones in our bodies constantly remodel and change in response to a variety of factors, one of the more critical being mechanical stress – the kind of stress that is delivered by weight-bearing movement and stress in particular, movement and stress that is driven by our lean body mass/muscle tissue.

Lean body mass has been shown to be much more effective in preventing bone density loss than fat mass.

Lean Body Mass Serves as a Reserve in Times of Illness and Injury Stress

Many of us, during our lifetimes, will encounter on one level or another an event or catastrophe in the form of illness or injury that serves as a serious, maybe even life-threatening stressor.

I spent the first years of my medical career caring for individuals who had suffered some of the most catastrophic, survivable insults to health imaginable – spinal cord injuries, multi-system and/or widespread orthopaedic trauma, severe burns, traumatic brain injuries, progressive neuromuscular diseases, and strokes. Despite a careful, intensive, multidisciplinary approach to care, more often than not, during these times of severe stress, some degree of lean body mass loss was noted as bodies reached for every available resource at their disposal to recover.

Breaking down muscle mass, among other healthy tissues, to support recovery in these situations isn’t optimal, but can be life saving in a crisis. And lean body mass can be rebuilt too.

Lean Body Mass Increases Metabolic Efficiency

Having a higher LBM clearly improves metabolic efficiency, though I should clarify what I mean here by metabolic efficiency (which implies a host of meanings pending context and author).

Perhaps the best example is that of a carb-dependent (CD) versus a fat-adapted (FA) marathoner. Our CD runner will burn through liver and muscle glycogen stores fairly early in their race, necessitating loading the gut with more carbs (a potentially problematic issue in and of itself), followed by an insulin spike to combat the flood of carbohydrate into the bloodstream, with the body then utilizing the glucose to generate energy, though that process is metabolically “dirty”, producing a host of oxidation by-products.

Our fat-adapted runner, hydrating with water or electrolytes, has built the much more efficient metabolic machinery to burn fats, and without any exogenous fuels, even the thinnest, fittest runners carry thousands of calories in storage with them wherever they run, pulling fats out of storage and utilizing more efficient cellular machinery (FA folks have happier and more functional mitochondria) to keep the fires stoked throughout a race event. The FA athlete, by utilizing fats which offer more than twice the calories of energy produced than glucose – roughly 9 Cal/gram in fats vs. 4 Cal/gram in glucose – has a distinct advantage.

Lean body mass can be “trained” to burn fats (and ketones) very efficiently; fat mass doesn’t.

Tomorrow’s Foundation Post will look at how excess body fat isn’t your friend.