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00:00:58.350Hey y'all, and welcome back to the Find Your Edge podcast.
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00:01:10.269I am your host, Coach Chris Newport, and I figured this would be an interesting topic, especially if weight loss is on your mind, whether you are an athlete or not.
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00:01:36.909Because I have been seeing so many patients on GLP1s lately that I wanted to get into some of the more nitty-gritty of what I'm seeing on the nutrition care or the nutrition support side of things and how we can optimize nutrition for better outcomes, whether you're on a GLP1 receptor agonist or you're somebody who wants to lose fat and do so the healthy way.
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00:01:45.469So I want to first and foremost mention that this presentation is for informational purposes only and does not constitute medical advice.
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00:01:51.789Be sure to consult your healthcare provider about what is the right path for you.
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00:01:55.390All right, so let's first start off and kind of back up.
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00:02:01.469What is the actual mechanism of this glucagon-like peptide 1 agonist?
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00:02:05.870So how they work is they operate through several key pathways.
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00:02:10.030They enhance insulin secretion in a glucose-dependent manner.
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00:02:14.909So in other words, not as much glucose, not as much insulin, more glucose, more insulin.
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00:02:21.150And they suppress glucagon, which is kind of the opposite of the hormone that's the opposite of insulin.
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00:02:31.229They suppress glucagon secretion under high blood sugar or hyperglycemic or euglycemic normal blood sugar conditions.
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00:02:34.830They also slow gastric emptying.
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00:02:41.870So the contents of your stomach get all mushed up, squished up, and then sent into your small intestines.
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00:02:43.310That's where the magic happens.
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00:02:47.870That's where all the absorption of nutrients happens.
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00:02:52.270So that process goes slower from your stomach into your small intestines.
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00:03:00.270And that prevents an aftermeal or a postprandial glucose spike when your blood sugar rises after a meal.
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00:03:04.109So that process just happens that much slower.
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00:03:09.310Thereby your appetite is decreased.
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00:03:16.989And hopefully the intention is that with less food, then that collectively contributes to weight loss.
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00:03:26.429So I also want to mention that this seems, or at least feels like on my end, a very emotional topic.
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00:03:34.590Anybody who I talk about GLP1 agonized to, the folks who are on it are looking for the information and they want to take care of themselves as best as possible.
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00:03:41.469The folks who are not on it and maybe are somebody who wants to lose weight almost feel like, is this a cheater kind of thing?
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00:04:05.709So, first of all, I want to encourage everybody to remove the shame that could be associated with this drug or really honestly any type of drug, that we're all in this to feel our best and do the best that we possibly can and hopefully have a good relationship with your care team of various healthcare providers so that you can do the best for what is necessary for your health.
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00:04:09.150So I at least just wanted to just kind of lay that out there.
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00:04:17.150I do honestly think that they are a fantastic drug for the right person, in particular at the right time.
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00:04:20.750And I'm here from a nutrition perspective.
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00:04:30.430So I'm helping folks regulate their blood sugar, support their weight management efforts, and reduce the side effects as best as possible so that they can have better outcomes.
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00:04:43.230And in fact, there is substantial research that points to GLP1 alongside nutrition care with a registered dietitian has better outcomes.
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00:04:48.590So if you are a healthcare provider and you're listening to this, or you know a healthcare provider, send it to them.
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00:04:54.829Make sure that everybody who goes on a GLP1 should automatically be referred to a dietitian.
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00:04:57.629You're just gonna have better outcomes when it comes to that.
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00:05:13.470Because, again, better weight management, better blood sugar regulation, and more guidance on just not saying, okay, well, I'm just gonna stop eating, or, you know, because I'm eating less, you know, I'm losing the weight.
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00:05:25.950The concern is, especially for me, especially from a sports dietitian perspective and from a longevity perspective, is how can we lose fat and not just weight?
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00:05:28.830And that's the kind of scarier thing.
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00:05:33.230So if you're watching this on YouTube, got a little slide deck that goes along with this.
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00:05:46.030And of course, I love pretty pictures, and this is a wonderful picture of various protein sources: protein, protein, protein, protein, protein, protein for lean body mass preservation and satiety.
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00:05:48.750So, in other words, feeling full.
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00:06:01.150So, in order to prevent muscle loss, we need essential amino acids, and we need them at a relatively frequent time frame throughout the day.
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00:06:24.990So let's call it an eight-hour evening window, 10-hour, maybe even 12-hour eating window, with which you are able to get in those essential amino acids, which contributes to keeping that lean body mass, that skeletal mass, also contributes to everything from creating antibodies to regulating your pH in your body.
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00:06:38.350Protein has so many different things that it needs to do that if you are prioritizing that, then your body can say, Oh, now I can start to use this stored fat that I have as an energy source.
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00:06:48.510So think of things like fish, poultry, legumes, egg whites, all great high-quality protein with lower amounts of things like saturated fat.
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00:06:55.150And of course, helps with that fullness and preserves that muscle during fat loss, especially on GLP1 therapy.
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00:06:59.870So that is one of the biggest things, especially for folks who really lose quite a bit of their appetite.
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00:07:05.310We really almost have to be very intentional about protein.
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00:07:15.390Healthy fats are also important, albeit protein definitely is up there, but not at the cost of leaving fat out.
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00:07:23.230So things like olive oil, nuts, seeds, things like that are going to help with appropriate cognitive function.
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00:07:29.790That's one of the main things that dietary sources of fat helps with hormone production and nutrient absorption.
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00:07:35.069So we don't want to leave out the fat, but yes, that does help make you fuller faster.
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00:07:36.750So it's all about a balance.
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00:07:52.189So after our good quality sources of protein and making sure we've got that little bit of balance of healthy fat in there, another thing we really need to focus on is your high, lower glycemic, high fiber foods, especially things like soluble fiber.
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00:07:53.790So consider this.
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00:08:09.069If you have, if you started GLP1 and your eating frequency goes down and the amount that you're eating goes down, that means your motility of your gut could potentially slow.
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00:08:13.150It's kind of like what goes in then goes out.
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00:08:22.670So if anybody has experienced a longer time period of fasting, maybe a day or two or even three days of fasting, that does not mean I'm recommending that.
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00:08:24.750But you have likely experienced this.
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00:08:28.110Your bowel movements are going to go down drastically.
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00:08:30.510We need to detox, y'all.
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00:08:35.069We need to get rid of the stuff, if you know what I'm saying.
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00:08:39.389It is no different when you're on an appetite suppressant like a GLP1.
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00:08:45.149So making sure that you are really prioritizing good, high-quality fiber foods.
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00:08:48.029I cannot tell you how many times every day I talk about beans.
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00:08:51.549I freaking love them and I am pushing them on everyone.
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00:08:53.389We need our beans, y'all.
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00:09:00.750And good quality soluble fiber sources like oat bran, which I did a whole podcast that really focused more on oat bran.
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00:09:02.029So go back, listen to that.
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00:09:06.350I'll make sure to link to that below because it is magical.
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00:09:17.069So definitely wanting to make sure that you get all those high fiber foods so that we've got good detoxification, good bowel movements, and regulated blood sugar.
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00:09:22.189So another thing I want to mention is that there might be some side effects.
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00:09:27.470The most common one that I have seen is just feeling a little bit nauseous.
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00:09:35.149So some things that you can do to manage those GI side effects are reducing things like chocolate, mitten, spicy foods.
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00:09:40.349These, of course, are very similar to what you would do if you had something like GERD or reflux.
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00:09:49.069They can reduce the lower esophageal sphincter tone, causing a little bit of mucosal irritation, and they can increase those gastric secretions.
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00:09:57.949So sometimes those foods might be good to sort of back off a little bit if you are having some sort of GERD or nauseous side effects.
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00:10:04.829Consider smaller, maybe more frequent protein-rich snacks because nausea is kind of a catch-22, right?
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00:10:08.909The nausea might be caused by the medication, and then you continue to skip meals.
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00:10:15.870And then, of course, the nausea may be worsened because you've been skipping meals and now your blood sugar is really tinking.
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00:10:23.549So consider smaller, more frequent protein-rich snacks, and especially ensure that you've got adequate hydration.
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00:10:33.549So there have been so many numbers that people come to me with and they're like, oh, I know you're supposed to drink your body weight in ounces, or you're supposed to, I don't know, paired all these crazy things.
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00:10:41.469None of that has any research backing, but we know that at least we need 64 ounces for women and at least 100 ounces for men.
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00:10:42.909You may be a little bit more.
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00:10:50.909Make sure that you are checking your urine color, hopefully uh urinating frequently throughout the day so that you know that you are well hydrated.
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00:10:55.629And then we really have to think about what is your nutrient density?
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00:11:10.589So I want to back up just a little bit because when it comes to nutrient density, I'm thinking overall caloric load and what is the nutrition that you are getting from those calories.
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00:11:17.789So when you reduce your calories so drastically, now we have like no wiggle room.
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00:11:40.589We have to get so much nutrition out of the food that we're eating and potentially even supplement a little bit to ensure that we're getting all the necessary vitamins and minerals that we need to not only just live in life, but hopefully to do some of your sport, to do some of the things that you enjoy with exercise.
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00:12:08.189So I also want to mention that if you were someone who came in to work with me and one of your diagnoses would be excessive caloric consumption, that you are overall eating too many calories for what your activity and needs are, because your appetite is ravenous, and we see a lot of that is genetically related.
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00:12:11.949Some of us have different leptin receptors that make us hungrier.
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00:12:16.429And then there's those folks who literally just forget to eat.
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00:12:24.429This is really great for somebody who is likely overeating and likely has really high appetite genetics.
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00:12:30.990If you are somebody who's not eating light, but you still need to lose weight, we've got other things in the mix.
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00:12:33.389So that needs to be deeper investigated.
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00:12:44.269But I wanted to mention that as it relates to nutrient density, that when we cut our calories quite significantly, it's harder to get all the nutrition that you need through food.
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00:12:49.629And there may need to be some additional considerations for supplements.
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00:13:00.429And that's where labs come in, that's where genetic testing comes in, that's where other things that can help monitor what you actually need rather than just guessing.
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00:13:13.309I'm a test don't guess, kind of gal, and making very informed both food and supplement choices to make sure that you're managing whatever it is that you need managed that align with your goals.
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00:13:19.309All right, so now let's get into some more unique considerations for athletes.
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00:13:23.629So remember how we were talking about that glucagon suppression?
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00:13:32.829So that is key when it comes to athletes, especially when you're going long course, guys.
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00:13:37.309And when I say long course, this is like three or four plus hours.
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00:13:47.789This is where you are probably going to feel, if you are on a GLP1 as an athlete, where you're going to feel the struggle, the potential struggle.
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00:14:02.829So it is really important that you are fueling appropriately pre-during and post-exercise nutrition, both getting your protein, especially for higher intensity workouts or strength training workouts.
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00:14:06.029That's really key to again preserve that lean body mass.
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00:14:30.589But because the body is being regulated in the way it releases your glycogen, breaks down that glycogen for exercise with glucagon and increases or gives you more blood sugar so that you can do work because it's affected on that level, you may feel almost like you're gonna hit the wall sooner.
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00:14:38.189So really being diligent about getting your carbs in during exercise, especially long course exercise, really want to emphasize that.
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00:14:43.309If you're going to the gym for say an hour, 45 minutes, this is likely not going to affect you.
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00:14:57.309But if you are doing marathons, if you're doing Ironman's, if you're doing ultraruns, which you know, probably a smaller percentage of folks who are on GLP1s and doing exercise like that, but these are the things that I've seen.
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00:15:01.549So really being good about monitoring your blood sugar.
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00:15:09.389Huge fan of continuous glucose monitor, if it is used in with the right intentions and with the right support.
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00:15:16.990So somebody like a good dietitian who can understand and can relay that information of, okay, this is what this means.
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00:15:21.949And therefore, we need to add in, say, more carbs or whatever.
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00:15:27.549So definitely get some help from a sports-informed dietitian.
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00:15:43.629Of course, we can help, but if you are not in a place that you want to work with us, just work with a good, knowledgeable, sports-informed dietitian who also knows how GLP1s work and can give you that necessary nutrition monitoring.
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00:15:45.709This is not something a nutrition coach.
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00:15:50.110Nutrition coaches and registered dietitians or licensed dietitians are different.
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00:16:00.189Dieticians have a healthcare background and understand your labs, understand all of those things so that they can put together a better nutrition support plan for where you're at.
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00:16:03.870So at least wanted to give a little bit of background to that.
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00:16:20.269The other thing I want to mention is if I made the rules and if I were able to change the rule books, if you will, and talk to all the physicians out there that are prescribing these, which again, I think is a fantastic tool for the right person at the right time.
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00:16:26.110I think it should be required that they get a referral to a dietitian.
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00:16:31.549If they're an athlete, then they're certainly being referred to a sports dietitian who understands GLP1s.
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00:16:36.509And then on top of that, I would love to see periodic DEXA scans.
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00:16:56.990So dual X-ray absorptiometry is a body composition test, and it should be done in my mind when you start the drug, and then approximately every six to 12 months afterwards, so that we can monitor are they keeping, are you keeping your lean body mass and just losing body fat?
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00:17:04.190And then also having a conversation with your prescribing physician of what is your intended amount of time that you're on this drug.
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00:17:09.150So this shouldn't necessarily be a lifelong drug.
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00:17:27.150Maybe it will be, depending on the situation, but giving yourself the opportunity to learn the tools while you are on the drug of understanding how to navigate social situations, understanding how to meal plan as best as possible.
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00:17:34.269Because yes, one of the things that folks really like about these GLP ones is that it reduces what they like to call food noise.
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00:17:40.430Because your appetite drives you to want food, then you have to start making decisions.
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00:17:42.589And then we get decision fatigue.
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00:17:46.750Y'all, we make over 200 decisions about food every single day.
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00:17:59.470By reducing your overall appetite, you are making fewer decisions because you're overall having to eat a little bit less and you're just generally not thinking about it as much, which for a lot of people is a blessing.
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00:18:04.990Because again, like I was telling you about, those appetite genes are really can be very loud.
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00:18:27.149So in the care of your dietitian, talk through some of those food awareness tools and what is happening in a social situation, what would have happened had you not been on the drug, what is happening when you are on the drug to help you overall reduce your caloric load and ensure that you're getting enough protein.
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00:18:44.029So at least wanted to give you a little taste of what's going on on my side of things, what are the patients I'm seeing, what are their experiences, and what are some of the things that are helping them get through this process of managing their weight, helping themselves get healthier.
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00:18:46.509And if you guys have questions, I want to hear them.
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00:18:47.710Thank you so much for listening.
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00:18:48.829I really appreciate it.
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00:18:52.670And send me ideas when you have new podcast ideas.
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00:18:56.829And again, thanks for listening, and we'll catch you the next time on the Find Your Edge podcast.
