Live With Dr. Gabrielle Lyon and celebrity trainer Don Saladino
On May 10th, 2022 we hosted another live webinar with trusted experts Dr. Gabrielle Lyon and celebrity trainer Don Saladino. Cronometer users were given the floor and asked all sorts of great questions on women’s health covering everything from the keto diet, menopause considerations and more! Tune in below or read on for some eye opening nutrition and fitness information from the experts!
This webinar is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice. No clinician/patient relationship is formed. The use of information from this webinar or materials linked from this content, is at the user’s own risk. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition and should seek the assistance of their health care professionals for any such conditions.
Do women need any specific considerations while on the keto diet?
Dr. G: The ketogenic diet is 70% or higher fat. It is typically protein is 10% or less and carbohydrates usually breaks down to be about 20 grams. It’s a very high fat, lower protein, which typically people feel that it’s a high protein diet, which it’s not. Number one thing to consider is that it’s a tool. There is no magic fix to nutrition.
I will also say that there are metabolic implications to a ketogenic diet. And what does that simply mean? Meaning some people will respond favourably to it and other people will not. So for example, individuals that have higher cholesterol, those individuals may not be the best people to be trying a ketogenic diet.
I will say, in terms of hormonal regulation, this is purely anecdotal, but a ketogenic diet over the long term may not be as beneficial as a more balanced diet for hormonal health.
Don: I agree with what Dr. G has said here. It depends on what you’re trying to accomplish on the keto diet. There is potential to start dehydrating the muscle of water, then what we think is the keto diet really becomes more about yo-yo dieting and that’s where I would be careful.
What are some negative repercussions of a ketogenic diet?
Dr. G: There’s two reasons why I would prescribe a ketogenic diet. Number one, military operators with head trauma or number two, it was originally discovered for children with seizures. So those are the two medical indications, and then there’s some evidence that it can help with certain types of cancer.
Now, the other side is who would you not recommend? I think that there’s no one answer for that. Again, the ketogenic diet is 70 to 80% fat, five to 10% carbs and then 10 to 20% protein. I wouldn’t recommend this diet if an individual is looking to optimize muscle mass or for older individuals. Also, and I say this hesitantly, since some women do fantastic on a ketogenic diet, but for women trying to get pregnant, it wouldn’t be my first go-to.
So those are some of the reasons why I would not do it, where I would do it is in personal experimentation and those other medical indications.
Is there anything women can do to proactively manage menopause symptoms?
Dr. G: This is a great question. One of the biggest things that we see in women that transition perimenopause to menopause is weight gain, and it’s not because something magical happens and you gain a bunch of weight.
There’s a few things that have the potential to cause the weight gain. Estrogen and overall all hormones decrease and this is the time when women lose the most muscle mass. Make sure going into it, that body composition is optimized and that you are resistance training. Throw in high-intensity interval training.
Monitoring carbohydrate intake at this time is also important. So this is that perimenopausal time where number one, you want to make sure that you’re also not having ebbs and flows of blood sugar.
Sometimes the sweats and irritability can often be due to bayzos motor issues and hormone changes, but also most uncommonly thought of is blood sugar regulation. So when your blood sugar goes too low, you do get counterregulatory hormones, like cortisol and a number of other counterregulatory hormones that can increase irritability.
And then of course to touch on osteoporosis, you have to make sure protein, vitamin D, K and calcium are optimized.
Don: Just want to touch on the importance of muscle. Muscle is our body armour and I think it’s often overlooked in training goals. We all need muscle and we all should be focusing on putting muscle on.
What are the key vitamins for women going through menopause?
Dr. G: setting aside the macronutrients, one of the biggest things is that we see is a change in bone density. So making sure your calcium, vitamin D and K2 are within normal ranges. This is the time where I do recommend calcium supplementation, because it’s so important.
The other thing is. In that pre-menopausal period, not necessarily post-menopausal, but it is something that I see is a decrease in iron. So eventually women stop bleeding, but prior to that, iron is really a big thing.
And then one more thing is fish oil. So fish oil for brain function is really important. Omega-3 fish oil, EPA DHA, all that’s very important for brain function.
Find a blog on women & iron intake here.
What's the best way to improve metabolic flexibility?
Don: I like using a device called Lumen and it’s kind of an educated way of carb cycling. You breathe into it and it’ll let you know whether you’re burning more fats or carbs.
Dr. G: When we think about metabolic flexibility, just for people that maybe aren’t familiar with it, it’s the ability for the body to meet the demands with proper fuel selection. So what does that mean? So basically when you are at rest, you would be burning fatty acids.
When you eat a meal, if you’re eating a glucose meal, then the goal would be then to metabolize glucose. And it’s the ability to switch between fuel utilization. If you were completely considered metabolically inflexible, that would be someone who say is potentially diabetic and they are continuously in a process of gluconeogenesis or making a lot of glucose.
They would likely be less metabolically flexible. So at rest they even have more glucose. So in a short answer, from a perspective of physical health, being lean and being well-trained is going to allow you to really have the metabolic flexibility defined by fuel selection. So it’s really about being lean, healthy and physically active and then eating within a calorie zone that is not overconsumption.
If you're trying to gain muscle and not fat, how would you know if you're being successful?
Dr. G: So from my perspective, you have to track it. This could be a bio impedance machine or a DEXA. DEXA doesn’t look directly at skeletal muscle, but it does look at fat and then it extrapolates the rest. Being consistent and really knowing your starting point is central.
Interestingly to gain muscle, when we’re thinking about muscle hypertrophy, the requirement is metabolic stress, physical tension, ribosomal biogenesis (creation of new proteins), and then the last part would be, which is where I think people go a little bit crazy is they increased calories a bit too much. To gain muscle you could perhaps increase 200-300 calories, nothing crazy. It doesn’t have to be this massive calorie ingestion, but you do have to track. If you then find that you’re putting on body fat, then scale back.
Is mixing fat and carbs a concern? Can you touch on Randall cycle?
Dr. G: Glucose will always dominate your metabolism. And the reason I say this is because glucose will always be the priority to get rid of. It is the only macronutrient that is toxic. Glucose in and of itself remains in a very tightly controlled range in the bloodstream. There is only one mechanism of action to decrease blood glucose by the body. And that is insulin. On the flip side for low levels of blood sugar, there are multiple different mechanisms to raise it.
The question is what about mixing fat and carbohydrates, carbohydrates will always be dominating the metabolism because while glucose is necessary at high levels, it is toxic to the cells. In fact, elevated levels of blood sugar over two hour period is the definition of diabetes.
So all that being said, mixing fat and carbohydrates – not a problem. It is about your total meal intake, depending on if you’re being active or sedentary. I think a better way that is applicable to think about this is how much glucose can the body dispose of at rest. If we know that we want to mitigate blood sugar swings and insulin, you want to keep your carbohydrate intake at a meal threshold, no higher than 50 grams.
What are your thoughts on krill oil vs. omega 3?
Dr. G: They are not the same. I would recommend omega’s over krill if you had to pick one, but krill has anthocyanins, which is a different anti-oxidant component that omega-3 does not have.
Any tips for increasing calcium intake for a post-menopausal woman that is unable to consume dairy?
Dr. G: I would supplement.
What is healthy macro balance for a 63 year old woman who is insulin resistant and normal weight?
Dr. G: For my more mature individuals, I start with 30 grams of protein three times a day at the bare minimum. And the reason is because it helps with metabolic correction. This the concept of even distribution of protein, that is the bare minimum, but it’s a great place to start.
If you are typically a higher carbohydrate eater or even higher fat, or maybe you haven’t planned your meals, this is a solid place to start. Number one, it allows for improving satiation. So you’ll be much less likely to kind of over eat. And number two, it will begin to protect muscle mass. If you control for carbohydrates, you can impact triglycerides, which are really important.
And for you, I wouldn’t go over 40 grams of carbohydrates per meal, and I would focus on high fibers with it because of insulin resistance.
Is it better to weigh food on a scale or use measuring cups?
Eliisa: The most accurate data is always going to be with a weigh scale because you know, people definitely use measuring cups differently.
Dr. Gabrielle Lyon
Dr. Lyon has a doctorate in osteopathic medicine and is board-certified in family medicine. She has studied vitamin and mineral metabolism, chronic disease prevention and management and the physiological effects of diet composition.
She also completed a research/clinical fellowship in Nutritional Science and Geriatrics at Washington University in St. Louis.
She now runs her practice and helps motivated people of any age reach their ideal weight and fullest health potential with the principles of muscle-centric-medicine®.
Don Saladino is a coach and fitness entrepreneur and has been training actors, athletes and musicians for over 20 years. He has owned and operated several brick and mortar gyms and has expanded to a global online fitness business, coaching over a million clients worldwide.
He has developed a reputation for training some of the biggest names in Hollywood for the big screen. Ryan Reynolds, Blake Lively, Jake Gyllenhaal, John Krasinski, Emily Blunt, Liev Schreiber, Sebastian Stan, Anne Hathaway, Zachary Levi, Hugh Jackman, & David Harbour are among his roster of clients.