Issue 16 October 2023

Bill Campbell's

BODYby SCIENCE
Optimizing Your Physique Within a Maintainable Lifestyle
TABLE of CONTENTS
ABOUT
This Issue of Body by Science . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 03
EXPERT CONTRIBUTORS
Trish Koeslag . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 05
Ted Ryce . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 06

STUDIES
1) The Protein Leverage Hypothesis – How Eating More Can 07
Trigger Eating Less . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Study Strengths & Limitations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Expert Application: Protein Intake Recommendations 17
for Fat Loss. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2) Underreporting of Caloric Intake by More than 1,000 Calories – 22

Are you Serious? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Study Strengths & Limitations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

Expert Application: Recommendations for Improving 31
Calorie Tracking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ABOUT THIS MONTH'S ISSUE
What’s the primary nutritional cause of
obesity? Traditionally, it’s been thought that too
much dietary fat intake is the culprit. This
makes sense since dietary fat has substantially
more calories than carbs and protein (9
calories per gram of dietary fat vs. only 4
calories for carbohydrate and protein).
The argument makes a lot of sense. Since
dietary fat contains a lot of calories, if you eat
too much of it your body will simply store the
excess calories as body fat.
Over the past decade, the debate has shifted
from fat intake to carbohydrate intake. There’s a
vociferous group of people who declare that it’s
high carbohydrate intakes that are the real
culprit for the obesity epidemic that we are
facing. If everyone would simply embrace a
low carbohydrate diet then we wouldn’t have
the problem of obesity that is plaguing our
country.
Then there’s a group of people (including many
evidence-based fitness and nutrition
professionals) who don’t get bogged down in
the details of carbs and fats – their emphasis is
on total caloric intakes (summarized by the
energy balance model). “If you eat more than
you burn, you’ll gain weight. If you eat less
than you burn, you’ll lose weight.” Their
message is simple and backed by the scientific
evidence.
Notice what’s missing from all these
approaches? Protein.
There’s no mention of protein in any of these
historical arguments and theories for the
causation of obesity. Why not? Is it because
there’s no research on the role the dietary
protein may have in weight gain? No!! There’s
plenty of research on this topic.
What about fitness people…they care about
protein, right?
Yes, but fitness enthusiasts are guilty of
categorizing protein as only a muscle building
03
nutrient. There’s good reason for this. You won’t
build ANY MUSCLE WITHOUT dietary protein!!
Protein is key for muscle hypertrophy, and this
also is backed by a lot of scientific evidence.
Some dietitians and nutrition researchers focus
on carbs and fat when trying to solve the
obesity epidemic, and largely ignore the role of
protein. Fitness professionals focus on protein
but limit their attention to its role in the muscle
building process. They largely ignore the role of
protein for obesity, weight management, and
fat loss.
They’re not going to ignore it any longer!!
I’m trying to shed light on the extensive
amount of published research on the role that
protein has for fat loss and the prevention of
weight gain. In this month’s issue I introduce to
you a concept known as the ‘Protein Leverage
Hypothesis’ and a study that underpins why
this hypothesis may be grounded in reality.
------------------------------
Our second study this month has to do with a
common complaint of people who are dieting.
Perhaps you’ve heard this sad statement (or
something similar to it) before:
“I’ve been dieting really hard for several weeks
and just can’t lose any weight.” These claims
present a major problem for many people that
truly want to lose weight, and despite their best
efforts to lose weight, there is repeated failure.
When weight loss does not occur despite the
perception of being in a caloric deficit, there
are three potential reasons:
• The person has an undiagnosed medical
condition (such as hypothyroidism,
Prader-Willi syndrome, etc.)
• Suppressed metabolism (the individual
is not burning many calories and
therefore even if not eating many
calories, it’s still too many to cause
ABOUT THIS MONTH'S ISSUE
weight loss)

• The person is underreporting their

caloric intake (they perceive they are
eating in a caloric deficit, but in reality,
are not)

The first reason is beyond our scope. The

second reason can be initially screened by a
valid resting energy expenditure test. In this
issue I’m reviewing a study that highlights the
potential for underreporting of caloric intake as
the diagnosis for a lack of weight loss success.

04
EXPERT - TRISH KOESLAG:
My health journey began at a very young age with a love for gymnastics, swimming, and
volleyball. I grew up with very active parents that always encouraged me to move my
body. In my early teens I found strength training, and this became my passion. I worked at
a women’s only fitness club helping women discover the benefits of lifting weights. The
turning point for my health journey really came when my father was diagnosed with Type I
diabetes. This ignited a true desire to learn and understand how nutrition impacts
everything from our physical, mental, and emotional well-being.

In 2021 I decided to turn my passion of nutrition and fitness into an online coaching
practice and embarked on my journey of helping women in the 40+ age category. In my
own journey, I had to sift through so much misinformation. I was often left confused. This
inspired me to acquire my CPT and Nutrition certification through ISSA. My goal is to
educate women with evidence-based information and guide them down a path where they
are confident making decisions that are aligned with their health goals.

I continue to further my education and have completed certifications through Dr. Layne
Norton (Nutrition Certifications Level 1, Level 2, and Reverse Dieting); Macro Certification
through scientist, Eve Guzman; Girls Gong Strong Women’s Coaching Specialist through
Molly Galbraith, and Training the Female Athlete through Hattie Boydle and Sebastien
Oreb. I am currently a student enrolled in the Physique Coaching Academy with Dr. Bill
Campbell and Dr. Layne Norton.

As I continue to work with and learn from industry experts, my hope is that my evidence-
based knowledge will teach and inspire women across the globe how to build a strong,
healthy, fueled body.

Instagram: @liftwithtrish

Website: liftwithtrish.com

05
EXPERT - TED RYCE:
Ted Ryce is a body transformation and health optimization coach. He's worked with
hundreds of clients over the past 24 years. His clients include many CEOs of multimillion-
dollar and Fortune 500 companies, busy professionals, and celebrities -- including Sir
Richard Branson, Ricky Martin, and Robert Downey Jr.

He also has a highly-rated podcast on iTunes called "Legendary Life," which focuses on
taking control of your health, transforming your body, and living your best life.

Some places his work has appeared include Washington Post, Inc Magazine, CBS Miami,
Good Men Project, Thrive Global, Medium, national media, The Art Of Charm, and
numerous podcasts.

Ted believes that health & fitness forms the foundation for success.

Website: LegendaryLifeProgram.com

Instagram: @ted_ryce

Podcast: Legendary Life

06
 STUDY 1:

The Protein Leverage Hypothesis –

How Eating More Can Trigger
Eating Less

Image by senivpetro on Freepik

Study Reviewed:
Testing Protein Leverage in Lean Humans:
A Randomized Controlled Experimental Study
(Gosby, et al., 2011)
07
 STUDY 1:
Background Information
A lot of smart people – doctors, researchers,
fitness professionals, dietitians, etc. have
been trying to figure out what can be done to
help restrain what seemingly is a never-
ending increase in obesity rates.
In searching for answers, the greatest
emphasis has been placed on the relative
roles of fat and carbohydrate in the diet, but
which of these plays the bigger role has been
the subject of a long-running debate with
views alternating at regular intervals over the
past 30 years.
Regardless of what anyone attributes to the
primary cause of obesity (whether it be eating
too many highly refined carbohydrates or too
much dietary fat), everyone agrees that when
too many calories are being consumed weight
gain will result.
A state of obesity cannot occur without
excess calorie consumption. Therefore,
anything that would cause a reduction in
caloric intakes – particularly carbohydrates
and fats – could rightfully be described as an
anti-obesity treatment.
I’m going to present such a ‘treatment’ to you
in this issue.
Is this treatment a pharmaceutical
drug/medication? No
Is this treatment an exercise program? No
The treatment centers on protein intake.
That’s right – protein intake is being inserted
into the obesity epidemic. Historically, the role
of protein in the obesity problem has been
largely ignored. This is for two reasons.
• #1) protein provides the minor part of
total calorie consumption.
08
• #2) protein intake has remained far
more constant over time and across
populations than either fat or
carbohydrate, both as a percentage of
energy in the diet and in terms of
absolute amounts consumed.
While protein does comprise a small
component of the diet, it is tightly regulated
and because of this it could have sufficient
leverage over human ingestive behavior to
explain weight gain and obesity. This concept
of linking protein intake and its control over
carbohydrate and fat intakes (total caloric
intake) is referred to as the ‘Protein Leverage
Hypothesis’.
How does the Protein Leverage Hypothesis
associate protein intake to weight gain and
obesity?
One way to describe the Protein Leverage
Hypothesis is that a reduced protein intake
causes the overconsumption of fats and
carbohydrates (hence total energy). A
reduction in the fraction of protein within the
diet results in increased total food intake and
therefore total caloric intake (this happens
because of the leveraging effects of protein).
You can also think of this theory as the body
prefers and prioritizes protein intake to the
other macronutrients (fat and carbohydrates)
and will have a drive to eat until protein
needs have been met, regardless of the
calorie content of the foods, thus leading to
over-eating and weight gain when the overall
diet is low in protein.
This hypothesis also fits in very well with
what we know about ultra-processed foods.
Since ultra-processed foods contain very little
protein, they do little to satisfy hunger levels
and only lead to more and more food
consumption.
 STUDY 1:
Protein Leverage Hypothesis
Our bodies have a threshold for daily protein
intake. Until this protein intake threshold is
met, we will continue to be hungry and seek
out more food until we reach this daily
protein threshold. Unfortunately, the foods
that many people desire and consume
tend to be highly processed snack-type
foods that are high in carbohydrates and fat.
Consumption of these types of foods
(which are very low in protein) do not get
us closer to the body's threshold for daily
protein intake, and the cycle of hunger-eat /
hunger-eat continues and leads to state
of overconsumption of calories
(primarily from fats and carbohydrates)
and eventual weight gain.
One thing to note about the protein leverage
hypothesis is that it refers to protein as a
percentage of total daily calories. This is
different than how we typically refer to
protein in terms of recommended amounts.
We don’t put an emphasis on the percentage
of protein in the diet, but rather how much
protein someone should ingest relative to
their body weight (such as 0.75 grams of
protein per pound of bodyweight/day or 1.6
grams of protein/kg body weight per day).
Refer to the figure which conceptualizes how
lower protein diets (as a percentage of total
daily intakes) are associated with higher total
calorie intakes.
09
The Protein Leverage Hypothesis links protein
intake to the current obesity epidemic by
citing data where there has been a
progressive dilution of protein in the diet over
recent decades with associated rises in
energy intake and obesity. Stated differently,
over time, people have consumed a smaller
proportion of dietary protein and
subsequently higher proportional intakes of
carbohydrates and fats which have increased
overall calorie consumption which has led to
population-level weight gain and increased
rates of obesity. Prior research on this idea
shows that an estimated decrease in percent
dietary protein from 14% to 12.5% between
1961 and 2000 in the USA was associated
with a 14% increase in non-protein energy
intake (carbohydrates and fat), with absolute
protein intake remaining almost constant.
Who was in the study?
22 lean and healthy males and females
(average age of 25 years ranging from 18 to
51 years old) participated in this study. Body
fat levels were not provided in the study, but
BMI values were reported. Across all subjects,
the average BMI was 22.8. To be eligible, the
subjects had to be healthy, not have followed
or engaged in a weight loss diet for the three
previous months and have no allergies or
strong dislikes for the foods that were going
to be utilized in the study.
What did the researchers do?
The researchers wanted to test the ‘protein
leverage hypothesis’ by disguising the
macronutrient composition of foods offered to
subjects under ad libitum feeding conditions
(meaning the subjects could eat as much or as
little of the food and as often as desired).
More specifically, the researchers
manipulated the protein content of the foods
provided to the subjects to see if a higher
protein diet caused the subjects to eat fewer
 STUDY 1:
total calories.
Each subject was studied over three study
trials (described in more detail below) that
lasted for 4 consecutive days each in an in-
house metabolic kitchen. Each 4-day study
trial was separated by at least one week. This
means that the subjects were confined to the
research facility for a total of 12 days (on three
separate 4-day periods) so the researchers
could provide them with all food and be able
to analyze every aspect of what they chose to
eat and (just as importantly) what they chose
to not eat.
The researchers identified two main
objectives for their study. They wanted to
compare different levels of protein intake on:
• Total Caloric Intake
- This was the most important
variable in this study. If the
lowest protein diet caused the
subjects to eat more food (in the
form of carbohydrates and fat)
this would be evidence in
support of the protein leverage
hypothesis as the increase in
Nutrition Details
During each 4-day study period participants
were provided with ad libitum food
comprising 10%, 15% or 25% protein, so that
by the end of the experiment each group had
undergone 4 continuous days of each of the
10%, 15% and 25% protein menus. As the
10
caloric intakes would lead to
body fat gain over time.
• Feelings of Hunger
- While hunger is a very
important variable for dieters
(and those wanting to prevent
future weight gain), these
subjective variables were
secondary and not as important
as actual caloric intakes in this
study. For example, it’s possible
that the subjects could be more
hungry when they follow one
type of diet over another, but if
this elevated hunger does not
translate to actual increases in
food intake and weight gain, then
it’s not all that meaningful with
respect to weight gain. It’ll be
interesting to see if consuming
higher protein diets for
consecutive days has any impact
on subjective feelings of hunger
and fullness.
Refer to the ‘Study Overview’ figure which
summarizes what the overall study design
looked like.
protein amount changed, so did the
carbohydrate content of the diets. The fat
content of each diet was held constant at 30%
of total calories for all three trials. The
macronutrient composition of each protein
diet was:
• 10% Protein/60% Carbohydrate/30% Fat
 STUDY 1:
• 15% Protein/55% Carbohydrate/30% Fat
• 25% Protein/45% Carbohydrate/30% Fat
The way that the study worked was that the
subjects were given three main meals per day
– breakfast (between 8am and 10am), lunch
(1pm), and dinner (6:30pm) and offered snack
foods that were freely available at all times.
The main meal foods (what the researchers
called meal-time foods) were only available in
one meal sitting), whereas the snack foods
were available to participants anytime once
served (what the researchers called ‘anytime
foods’). Anytime foods were ‘snack’ foods and
foods that were first served at a meal and
could be kept if not eaten or finished at that
meal; these foods were labelled for
identification and kept in a refrigerator to
which participants had free access.
To summarize, using breakfast as an example,
if the subjects were in the 15% protein diet
phase of the study, they were given their
breakfast main meal which contained 15% of
all calories from protein. They could eat as
much or as little of this breakfast meal as they
wanted. They were also given a breakfast
snack item which also contained 15% protein,
and they could eat this with their breakfast,
put it in the refrigerator and eat later, or not
eat the snack at all. This was repeated for
lunch and dinner for four consecutive days.
The same process was also repeated for the
10% and 25% protein diets for four
consecutive days. The foods were made so
well that the subjects could not tell which
foods and study phases had the high,
moderate, and low protein diets (the
researchers did know this, however).
Refer to the table which gives an overview of
the entire menu of foods that were used in
this study. In total, there were 28 different
foods provided to the subjects during each 4-
day study phase. This provided the subjects
with a diet that contained a lot of variability.
11
Notice that the table has some of the food
items that are bolded and other food items
that are not bolded. The meal-time foods are
not bolded while the ‘anytime foods’ (snack
foods) are bolded.
A very important fact about this study was
that the subjects were not able to identify a
difference in protein between the versions.
This was a major hurdle the researchers were
able to overcome in this study. Typically,
whenever food scientists increase the protein
composition of a meal, two things happen:
1) The food doesn’t taste as good (it isn’t
as palatable)
2) The subjects can always identify the
lower protein foods from the higher
protein foods
That’s where this study was truly an epic
study! All of the foods included in this study
were tested in a separate study by a group of
lean, healthy subjects. In that study, the
subjects were presented with the 10%, 15%
and 25% protein versions of each of the food
items simultaneously. Participants sampled
each version and then completed
questionnaires testing for differences in
pleasantness, sensory attributes, and
nutritional perception. To confirm that
palatability was similar between the 10, 15
and 25% protein versions of each food in this
study, food palatability was tested on study
day 4 of each experimental period using a 10
cm visual analogue scale. All foods offered to
 STUDY 1:
participants on study day 4 of each study
period were rated for pleasantness,
sweetness and savoriness and confirmed the
absence of tasted differences from the low,
medium, and high protein foods (replicating
what was reported in the previous separate
study).
Refer to the picture of the 6 meals (this was a
photo that was included in the actual study).
The three photos on the left column are the
10%, 15% and 25% versions (top to bottom) of
each food given to participants at breakfast on
study day 2. In the right-hand column, the
three photos are the 10%, 15% and 25%
versions (top to bottom) of each food given to
participants at dinner on study day 2.
Participants were offered a set amount of each
food that was the same on each study period.
12
This was truly a remarkable study design –
even the plate sizes and appearance were
standardized for each food type during each
study period! The researchers wanted to take
out any aspect of psychology or subjective
bias from the subjects so that the only thing
that would impact the total amount of
calories the subjects would consume was the
amount of protein in the meals.
Participants were given ad libitum access to
study food with no access to other food
sources during each experimental period.
Food intake was measured by recording the
weight of the food before and after serving, to
the nearest gram. Caloric intake was then
calculated using the nutritional information
for each recipe.
Exercise Details
The subjects were taken for a 1-hour
supervised walk each day. This was the only
exercise intervention utilized during this
study.
What physique-related outcome variables
were measured?
The main variable assessed in this study was
the caloric intakes of the subjects. Remember
that the main point of this study was to
determine if eating a low protein diet would
result in eating more total calories. Similarly,
the researchers were also testing if eating a
higher protein diet would result in eating
fewer total calories.
The researchers did not measure body weight
or body composition. That does not concern
me as the study duration was only 4 days. We
wouldn’t expect there to be any changes in
body fat or muscle mass in such a short
period of time, especially when considering
that this was not a dieting study. An
interpretation of this study is that if any of the
protein diets caused the subjects to eat
 STUDY 1:
significantly more calories compared to the
other protein diets, then we would anticipate
and expect there to be weight gain (and body
fat accumulation) over time.
result of eating about 70 fewer calories from
protein (a decrease of 3% total energy) and
330 more calories from carbohydrate and fat
(an increase of 15% total energy).

In addition to the total calorie intakes, on day

4 of each study phase, the researchers had the
participants complete visual analogue scale
questionnaires for the measurement of
palatability of each food as well as the
subjects’ subjective hunger.

What were the results?

As we look at the results of this study, our

primary focus is if one of the protein diets
caused the subjects to eat more calories
compared to the other protein diets. If the An increase from 10% to 15% protein led to a
lowest protein diet (10% of all calories reduction in total caloric intake. However,
coming from protein) caused the subjects to an increase from 15% to 25% protein did not
eat significantly more calories, then this lead to a reduction in energy intake. This
would support the protein leverage would suggest there’s a threshold for which
hypothesis. If there were no differences in protein (as a percentage of total daily calories)
total calories consumed across the three must be consumed to prevent
different protein diets, then this would overconsumption of calories. Until this
challenge the protein leverage hypothesis. threshold is met, one will continue to
consume greater amounts of food and
Total Calorie Intake calories. However, once this threshold is met,
surpassing this threshold does not appear to
All the action for this study centered on the offer greater reductions in caloric intakes
10% protein diet. Participants consumed an (according to this study).
average of 260 more calories each day on a
10% protein diet as compared to the 15% and
25% protein diets (this difference was
statistically significant). The significantly
increased total caloric intake on the lower-
protein diet was evident from the first day of
the trial and continued throughout the
subsequent 3 days. Daily protein and energy
intakes were constant and the cumulative
increase in energy intake on the 10% protein
diet remained significant from day 1 through
day 4 of the trial.

As a percentage, this equated to a 12%

increase in total calories. This increased An interesting finding from this study
caloric intake on the 10% diet was the net surfaced when we look at where the extra

13
 STUDY 1:
calories came from when following the 10%
protein diet. The extra calories came from an
increased consumption of ‘anytime
foods’(snack foods) rather than ‘meal time’
foods. This implies that when a main meal is
lower in protein, people will tend to make up
for this by eating more snack foods between
meals. This lends support to the
recommendation of having a serving of
protein with each of your main meals each
day.
Fiber, salt, and sugar did not correlate with
energy intake suggesting that changes in
these nutrients did not play a significant role
in driving increased energy intakes. There was
no order effect relative to when the three
protein diets were administered (this means
that it didn’t matter what protein diet each
person started with – it had no effect on the
outcome of the study).
throughout the day and how they related to
the breakfast meal. Regardless of how much
protein the subjects consumed for breakfast
(whether it was 10%, 15%, or 25%), it did not
have an impact on the subjects’ hunger
scores in the two hours following breakfast.
However, when looking at hunger scores from
noon onwards we see that hunger scores
were greatly impacted by the protein content
of the breakfast foods. When the subjects
consumed the 10% protein breakfast, they
reported significantly higher hunger scores
compared to the 25% protein breakfast. The
same trend was observed with the 15%
breakfast, but the data did not reach the level
of statistical significance.

Hunger and Fullness

The mean hourly hunger levels of participants

across the entire day did not differ between
dietary treatments. At first glance, this may be
surprising because you’d think that since the
low protein diet ate more food (consumed
more calories), that they also would have
been hungrier. However, the likely reason that
they were not any hungrier than the higher
protein diet phases was because they ate
more food! Here's what the authors of the study had to
say about their study's findings:
Do you know what will reduce your hunger?
Eating more food! So, I interpret this outcome “If subjects maintained the level of increased
intake observed on the 10% protein diet in
by concluding that they were more hungry
our study, without an accompanying increase
throughout the day when eating a low protein
in energy expenditure through increased
diet, and to address this they ate more food.
activity or thermogenesis, a 1.0 kg [over
However, when they completed their hunger
2 pounds] weight increase per month
questionnaire, they did not report higher would be expected.”
levels of hunger because their greater food
intake reduced their hunger scores!

Another thing that caught my attention with

this study were the hunger scores recorded

14
 STUDY 1:
Study Strengths & Limitations
Study Strengths
• Macronutrient Composition of Meals
- The researchers did a phenomenal
job of making sure the meals were
matched for energy density and
palatability. In addition, the
researchers disguised the
macronutrient content of the foods
and offered a large variety of foods
to the subjects. The inability of
previous studies to disguise the low
protein from the high protein meals
introduces a big limitation into
those studies as the subjects are
considerably more likely to be
biased or have their thoughts and
feelings about high or low protein
meals and diets to impact their
hunger and eating actions. In this
study, since the subjects were not
able to tell the difference between
the protein diets, the intervention
was superior in comparison to
much of the earlier work on this
topic.
• Study Design – Randomized,
Controlled, Experimental Study
- The study methodology was very
good for this study. First, I loved
that all subjects participated in all
three protein diet trials. This kept the
variability of the dependent
variables lower than it would have
been if they had a different group of
subjects for each protein diet. Also,
the order of the protein diets was
randomized for each participant,
which eliminates any potential time
or order effect.
15
• Length of Study Duration
- A lot of the appetite and caloric
intake research following a previous
meal is very acute in nature.
Specifically, many of these studies
will provide subjects with one meal
and then assess their feelings of
hunger and their food intake at the
next meal only. I’ve been educated
by appetite researchers that this
methodology is not very good and
is not valid or reliable in some
cases. This study was 4 days long
encompassing 28 different meals,
which mitigates many of the validity
and reliability concerns of past
research.
Study Limitations
• Study Duration
- While the researchers did a great
job of measuring the things they
wanted to measure (caloric intake
and feelings of hunger), it would
have been nice if the study duration
was a bit longer and they included
bodyweight and body composition
measures. However, I appreciate
that this would not have been very
practical to do so, as the meal
variety would have likely been
reduced and the cost of housing the
subjects and preparing every gram
of food would have been
substantial!
• Using Carbohydrate as the Dilutant
for Protein
- The researchers used
carbohydrate as the diluent for
protein in the diet, raising the
possibility that the effects observed
were due to carbohydrate rather
 STUDY 1:
than protein. While some people
would ask this, I don’t have any
problem attributing the study’s
findings to the protein composition
of the diet and not associating the
changes in carbohydrate intakes as
being meaningful.

16
 STUDY 1:

Attribution ccPIXs.com

What is your process for recommending

protein in the diets of your clients?

Do you have any strategies to

help people increase their
protein intakes if they struggle
with eating adequate protein?

17
 STUDY 1:
Trish Koeslag Thoughts:
It's no secret that protein is the foundation for all nutritional goals. Whether my clients are
chasing fat loss, looking to build muscle, or living life in the sweet spot of maintenance,
protein will always be the priority.

Because I coach women in the 40+ demographic, I find that many, if not most, come to the
table with an overconsumption of carbohydrates and fats and an underconsumption of
protein. Therefore, before I make any diet recommendations, I ask my clients to track their
food intake. I like to take a deep dive into how much (or how little) she is eating and what
food choices she is making. My approach is that I like to meet them where they are at, help
them understand why protein is paramount, and then lead them through a deliberate
process of increasing protein in-take over time.

It isn't surprising when I see ladies in the 40+ age group eating less than 50g of protein per
day. In fact, it is common. This is where educating comes into play. I aim to enlighten my
clients on the benefits of protein.

Although I highlight all the positives, the 2 that resonate the most are:

1. Protein is key for unlocking all things body recomposition

(fat loss and muscle growth).

2. Protein prevents the loss of muscle and bone mass, which is exceptionally
important for women as we age.

There are many reasons to increase protein consumption, but these two seem to really hit
home.

Once I have food tracking data from my client, I set her protein target based on her current in-
take. Then, we wait a solid 2 weeks so that there is time to acclimate to the plan. I pay
attention to how the body responds through weekly biofeedback check-ins. If my client can
hit her macros and biofeedback is positive, I will adjust with a minimal protein increase of 5g.
I repeat this process of increasing, and acclimating until we achieve the protein target. My
client is my guide; her well-being and comfort are always at the forefront.

When it comes to the protein goal, there are some varying considerations I will make for
vegans, vegetarians as well as clients in the obese category, but for the general population, I
recommend a protein target of 0.8 to 1.0grams/pound of bodyweight (1.8 to 2.2 grams/kg
bodyweight).

Once I've set macros, I create a macro protocol that partitions the macros over the course of
4-6 meals. This encourages my clients to create the habit of eating every few hours. Further,
the visual of smaller protein targets over the course of the day is less daunting for them, and
mentally, it is more manageable.

Hitting 0.8g-1.0g/pound of bodyweight can seem impossible for some women, but with a lot
of education and guidance, it is possible! With just a few tips, most of my clients are hitting
protein targets within the first couple of months.

The first step is planning! If we fail to plan, then we plan to fail. Encouraging my clients to
meal prep a couple of different protein options is usually the top 'trick' for most. If you take
the time to prepare food in advance, you are more likely to hit your protein targets.

18
 STUDY 1:
Trish Koeslag Thoughts: (cont.)
Next, I ask my clients to track their food in an app. This gives them the opportunity to plan out
their food/meals in advance and allows me a sneak peek into how they are doing with their
protein goal. Here, I can offer suggestions and feedback.

When my clients are planning their food in the tracking app, I find that if they input their carb
source first, this helps them see that most carbohydrates have some protein as well. When
the total protein target decreases a bit for that meal, the visual helps the overall protein
target seem less intimidating. Once carbs are tracked, they can add in their protein sources,
and lastly, their fat sources. Visually, I encourage my clients to create a plate that is ¼ protein
source, ½ non-starchy vegetables, ½ complex, starchy or fruit carb, and about a thumb size
for their fat source.

Lastly, one of the most helpful ways to increase overall protein in-take is to supplement with
a high-quality whey protein powder. Although I always encourage my clients to choose more
unprocessed foods, there is plenty of evidence to suggest that whey protein powder is safe
and effective. Whether it is used in a shake, mixed in with some Greek yogurt, or blended in a
nice cup of coffee, this is by far one of the easiest ways to increase protein consumption.

My underlying goal when it comes to protein recommendations for women in this

demographic will always be to educate and enlighten. I want my clients to understand the
why behind my recommendation so that ultimately, she can make the best decisions for
herself.

When we arm ourselves with the most recent, evidence-based information regarding protein,
there is no denying that it is and should be the foundation to any nutrition plan regardless of
demographic or physique goal.

19
 STUDY 1:
Ted Ryce Thoughts:
Protein intake is one of the key principles I teach my clients about. Whether their goal is fat
loss, muscle growth, or long-term health optimization, we teach our clients to “prioritize
protein” and about having a high-protein diet.

For fat loss, I'll typically start an average-sized male at around 200 grams of protein per day
and an average-sized women around 150 grams per day. This is much higher than what is
typically recommended. But I've found it works well as an initial starting point. I have clients
track via MyFitnessPal to hold them accountable. I also combine this with a low-calorie, high-
volume eating plan for the first 2-4 weeks (depending on compliance and how much fat they
have to lose).

After the initial 2-4 weeks, I check their compliance and their weekly protein average via
MyFitnessPal. What's interesting is that I've found that having a higher protein target helps
clients to eat more protein even if they're not hitting the daily target I gave them. For
example, I had a client who thought eating 200 grams of protein per day was too much and
asked if we could lower the target. I agreed and asked for his weekly average in
MyFitnessPal. He was averaging 170 gram per day. When I asked him if he still wanted me to
adjust the daily grams of protein, he changed his mind and said no. His reasoning was that if
we lowered it to 170, he would most likely eat less protein as a result.

This underscores the importance of psychology in approaching setting protein targets as well
as other macro or calorie targets. We must take into account how the numbers affect a client
psychologically. The goal for me is to create a challenge while avoiding creating excessive
stress. I also find fat loss clients struggle more with the psychological side of nutrition versus
clients who are looking to build muscle. And compliance is the number one goal. You can
have the most evidence-based fat loss plan in existence but it's worthless if a client won't
follow it.

The last point is that I find education about the importance of protein to be key in compliance
for the clientele I work with. Just telling them to follow recommendations without proper
context leads to poor adherence. So, I show studies and graphics to back up the idea that
protein leads to more fat loss and increased muscle mass when eaten at the right amount.
This provides extra motivation because the number one goal of every fat loss client is to get
results.

When it comes to maintenance, I recommend to my client to transition to 1.6g/kg/day (0.75

grams/pound). I explain to them why and that if we lower their protein, we can add more
calories from fat and carbs. Ultimately, I give them the choice and let them decide. Again, the
real issue with nutrition approaches is that many clients are given strict rules and they're not
offered a choice. In my experience, empowering a client to make their own choices when
presented with the information to do so leads to the best long-term results.

When it comes to helping clients hit their protein goal, I have a few strategies that have
worked well. I educate my clients about which foods have the highest protein per calorie.
Then I help them understand that although lower fat foods that are high in protein may not
taste as good, they will be able to include more foods that they like while losing fat if they're
willing to make some of their meals based around lean protein.

I also tell my clients to avoid getting fancy with their meal choices. I tell them they can use
primarily protein shakes to meet their protein intake goals if they want. Or they can eat the
same foods at every meal. The goal is to suggest and allow strategies that help the client

20
 STUDY 1:
Ted Ryce Thoughts: (cont.)
achieve their protein intake goals. While some of these strategies may not be optimal from a
nutrient-intake perspective, I've found that by initially encouraging them to keep their meals
simple, they naturally start to find other ways of hitting their protein target once they feel
confident. I've also found that when clients focus on sodium, cholesterol, etc., instead of just
their protein target, they end up getting frustrated and overwhelmed. So, this has been key in
creating adherence and making their diet seem doable.

21
 STUDY 2:

Underreporting of Caloric Intake

by Over 1,000 Calories – Are You Serious?

Image by rawpixel.com on Freepik

Study Reviewed:
Discrepancy between Self-Reported and Actual Caloric
Intake and Exercise in Obese Subjects
(Lightman, et al., 1992)
22
 STUDY 2:
Background Information
In the May 2022 issue of ‘Body by Science’, I
reviewed a study about what causes a weight
loss plateau (when you stop losing weight
despite your efforts to remain in a caloric
deficit).
This is a very popular topic – a google search
of “weight loss plateau” yields nearly 30
million records! Clearly, people are
experiencing this phenomenon or at the very
least are interested in the topic.
In that study, the researchers used
mathematical modeling to determine if the
cause of a weight loss plateau was because
of:
• Metabolic Adaptation – the dieter’s
metabolism slows down so much over
time that they are unable to lose
additional body weight at the same
caloric deficit that they had success
with in the first few months of their
diet.
• Adherence – the dieter stopped losing
weight because they stopped following
the prescribed diet after a few months
(not because their metabolism slowed
down).
After running all the mathematical models,
the researchers concluded that the likely
reason why dieters experience weight loss
plateaus after several months of dieting is
because of adherence. Their adherence was
not consistent and this failure to consistently
adhere to a caloric deficit is the likely reason
that a weight loss plateau occurs.
The study I’m reviewing this month is not
about a weight loss plateau, but more about
why someone may not be able to lose body
weight right at the start of a diet. A weight
loss plateau assumes that weight loss has
23
been achieved previously (particularly at the
start of a diet), but the topic we’re looking at
from this study is more foundational to
dieting and weight loss efforts in general.
This issue has to do with why someone may
not be able to lose any weight (even at the
start of a diet). Some will seek medical
support and are assumed to have
hypometabolism (a metabolism that is
suppressed to very low levels) which prevent
or limit the amount of weight loss that can
occur because of this condition.
The subjects enrolled in this study were
individuals with obesity that claim an inability
to lose weight despite reporting their caloric
intake to be less than 1,200 calories per day.
The research study summarized this month
can be considered a ‘landmark study’ due to
its very high-quality study design and the
questions that it answered. (Note: landmark
studies are centrally important because
they've reported an insight or new idea of
great importance within that research topic
area).
What did these researchers do? They studied
whether low total energy expenditure (how
many calories the subjects were burning each
day) or misreporting of food intake
(underreporting) and exercise (overreporting)
accounts for the failure to lose weight in
individuals with obesity who reportedly
restrict their intake to less than 1,200 calories
per day.
It should be noted that this study was
published in 1992 in the New England Journal
of Medicine (one of the top scientific
journals). Why would I review a study that is
over 30 years old? Because this study was
one of the best studies in terms of the tests
and assessments the researchers used to
determine if these individuals with obesity
had some kind of problems with their
 STUDY 2:
metabolism or if they were extremely
inaccurate in their assessment of how many
calories they were consuming and how much
exercise they were performing.
Who was in the study?
Individuals who expressed interest in
participating in a weight loss study were
eligible to participate in this study if they had
a BMI of 27 or greater, were at least 20 years
old, and had no major illness. In total, 90
males and females with obesity participated
in this study.
What did the researchers do?
Once the researchers had their pool of
subjects, they screened them for diet
resistance. Diet resistance was defined as:
• A current intake of less than 1,200
calories per day (as reported on diet
records)
• Weight stability (within a range of 6.5
pounds [3 kgs] for the previous six
months)
• A history of failure to lose weight while
claiming to be in a caloric deficit
If one of the eligible participants met these
three criteria, they were instructed by a
dietitian and shown an educational video
about keeping daily food and physical activity
records. They then went through one more
round of screening to determine if they would
ultimately be placed in the FAILURE group (as
in a failure to lose body weight). A subject
was enrolled in this group if they reported an
average intake of less than 1,200 calories per
day for seven consecutive days without
losing any weight. Ten subjects met all the
criteria to be assigned to the FAILURE group.
The remaining subjects (the others with
obesity that did not report caloric intakes of
24
less than 1,200 calories per day) were
enrolled in the study as CONTROL subjects.
In summary, the researchers divided the 90
subjects into one of these two groups:
• Failure Group (10 subjects; 9 female
and 1 male)
• Control Group (80 subjects; 67 females
and 13 males)
The subjects in the FAILURE group had made
twice as many attempts to diet as the
subjects in the CONTORL group and
attributed their obesity more to genetic and
metabolic factors and less to overeating than
did the subjects in the CONTROL group.
The main thing that the researchers did was
to compare the FAILURE group to the
CONTROL group over a 14-day period on the
following variables:
a Total Energy Expenditure
a Self-reported food intake
a Self-reported physical activity
a Body Composition
Total Daily Energy Expenditure
Total daily energy expenditure was measured
for 14 days with doubly labelled water while
the subjects maintained their usual food
intake. Doubly labelled water is considered
the gold standard of measuring metabolic
rate outside of the lab. This method basically
measures how many calories the subjects
were burning each day (even though they
were not living in the lab).
The researchers measured the total daily
energy expenditures of 16 subjects in the
CONTROL group subjects and then took this
data to create a regression equation that
would predict the total daily energy
expenditure for all subjects in the CONTROL
group. Using this equation, the investigators
 STUDY 2:
then calculated the difference between the
observed and predicted total daily energy
expenditures for the subjects in the FAILURE
group.
The researchers also broke down total daily
energy expenditure into three subdomains:
• Resting Metabolic Rate
- The resting metabolic rate
measured for the CONTROL
group was considered the
‘normal’ value for which the
FAILURE group was compared.
Remember, while the Control
group subjects were obese, they
did not claim to have an inability
to lose body weight, nor did they
report eating less than 1,200
calories per day. A resting
energy expenditure that was
more than 15% lower than the
Control group’s resting energy
expenditure was considered
abnormally low.
• Exercise Energy Expenditure
- Exercise energy expenditure
was measured at three different
workloads on a treadmill. Similar
to the other measures of energy
expenditure, the purpose of this
test was to see if the subjects in
the FAILURE group had a
reduced exercise energy
expenditure compared to the
CONTROL group.
• Thermic Effect of Food
- Thermic effect of food was
measured for a three-hour
period following a standard 710-
calorie liquid meal that both
groups of subjects consumed.
The main goal here was to see if
the subjects in the FAILURE
group had a reduced thermic
25
effect of food response
compared to the CONTROL
group.
Self-Reported Food Intake
All subjects recorded their daily food intake
to the nearest ounce or the number of items
(such as 3 pieces of pizza, two bananas, etc.);
and then this data was converted to calories.
To be clear, the subjects were not responsible
for estimating or counting calories, but only
estimating the volume/amount of food that
they ate each day for 14 days.
Self-Reported Physical Activity
The subjects recorded all their physical
activities during the 14-day study duration.
They reported what kind of exercise they did
as well as how long they did it. From this
information, the researchers estimated the
number of calories expended in physical
activity by multiplying the total time spent
engaged in the category of activity by the
energy cost of that activity.
Body Composition
Body composition was assessed via
hydrodensitometry (underwater weighing).
This test was conducted before and after the
doubly labelled water was implemented, and
the results were used to estimate changes in
bodily energy stores.
What other variables were measured?
The researchers did one more thing in this
study which I think was interesting! Since the
entire study was based on the potential for
underreporting of food intake (since the
subjects claimed to not be able to lose weight
despite eating fewer than 1,200 calories), it
would be good to investigate if the subjects
in the FAILURE group were able to accurately
estimate the portion size of a meal that they
 STUDY 2:
consumed the day prior.
That’s exactly what the researchers did. They
gave a test meal to all 10 subjects in the
FAILURE group and to 10 of the subjects in
the CONTROL group to evaluate the accuracy
of the subjects’ reports of their food intake 24
hours after they ingested the food under
standardized conditions.
The subjects were given a lunch composed of
a variety of foods and instructed to eat until
they felt 80% full, with a time limit of 45
minutes. The next day, a research assistant
contacted each subject by phone and inquired
about the amount of food they had eaten the
day prior. The results of the subjects’ attempt
to recall the test meal were then compared
with the weight of the actual foods eaten.
As we look at the results of this study let's
review the reason for why the study was
conducted in the first place.
Some people think that having a low energy
expenditure (a slow metabolism) is the
reason why they are not able to lose body
weight, even when reportedly consuming a
low-calorie diet.
To test this hypothesis, the researchers
measured total daily energy expenditure (the
total amount of calories burned from all
activities – resting, sleeping, after eating, and
during exercise) to see if subjects who
claimed they couldn't lose weight despite
reporting a low-calorie diet was due to a low
total daily energy expenditure.
A secondary purpose of the study was to
determine if these same subjects were
underreporting their caloric intakes (and
possibly overreporting their physical activity).
How do we know if the subjects were
underreporting caloric intakes? Actual caloric
intake was calculated as the difference
between total energy expenditure (which we
26
know from the doubly labelled water data)
and stored energy (which we know from the
body composition data).
If the subjects were claiming to eat fewer
calories than they were expending and DID
NOT LOSE ANY ENERGY STORES (did not
lose body fat or lean mass), then they were
underreporting their food intakes.
We're confident in our assessment of
underreporting because we know how many
calories the subjects were burning each day
(from the doubly labelled water tests), and
we know if they gained or lost energy stores
(from the body composition assessments). If
any changes in body weight do not match up
with reported energy intakes or energy
expenditure, the only explanation is
underreporting of food consumption.
What were the results of this study?
Total Daily Energy Expenditure
What we’re looking for with total daily energy
expenditure is to see if the FAILURE group
was burning less total daily calories per day
compared to the CONTROL group. If they
were burning less total daily calories, then
there would be evidence that they possessed
a slow metabolism and were at a metabolic
disadvantage compared to the other group of
subjects that did not claim to suffer from
genetic and metabolic factors that make it
more difficult to lose body fat. Remember
that this measure of total daily energy
expenditure was conducted over 14 days in
free-living (during their normal lives)
conditions.
Did the FAILURE group have a lower total
daily energy expenditure?
No!
In fact, on average it was about 4% higher
 STUDY 2:
than that predicted by the regression
equation for the CONTROL groups’ total daily
energy expenditure.
Their total daily energy expenditure was
2,468 calories per day. On a per subject basis,
five of the FAILURE group subjects had total
daily energy expenditures above the
predicted values (28.2%, 21%, 14.7%, 11.2%,
and 4.7% higher) and five of the subjects had
total daily energy expenditures that were
slightly below the predicted values (9.6%,
9.5%, 8.3%, 6%, and 4.4%) of the CONTROL
group.
In my opinion, we could stop here. All the
other energy expenditure tests were just
components of the larger, total daily energy
expenditure value and theoretically (in their
totality) couldn’t produce any result that
would contradict the data reported for total
daily energy expenditure (notwithstanding
non-exercise activity induced thermogenesis).
However, since the researchers measured
three other components, I’ll report on them.
Resting Metabolic Rate
The average resting metabolic rate for the
CONTROL group was about 1,475 calories.
The FAILURE group’s average resting
metabolic rate was about 20 calories per day
higher than this value (about 1.3% higher).
There were no significant differences
27
between the two groups for resting metabolic
rate. The resting metabolic rate figure
displays how each FAILURE group subject
differed from the values for the CONTROL
group on a percentage basis.
Exercise Energy Expenditure
The authors of this study did not give many
details about the exercise energy expenditure
test other than to say that only six subjects in
the FAILURE group performed the exercise
test (one had an injury and three others
became exhausted early in the protocol). The
authors reported that “the energy
expenditure were similar in the subjects in
groups 1 [FAILURE group] and 2 [CONTROL
group].”
Thermic Effect of Food
The thermic effect of food did not differ
significantly between the FAILURE group and
the CONTORL group. Specifically, the
FAILURE group had an 11% increase in
energy expenditure and the CONTROL group
had a 9% increase in energy expenditure in
the 3-hour post-meal assessment period.
What we’ve observed so far is that the
subjects who claimed their inability to lose
weight is attributed to metabolic factors is not
supported by the data. Four different
metabolic tests were conducted (total daily
energy expenditure, resting metabolic rate,
exercise energy expenditure, and a thermic
effect of food test) and in each case there was
 STUDY 2:
no evidence of a suppressed metabolic rate explanation is errors in their reporting of food
or metabolic response in these subjects. intake (also remember that we took away any
argument of having a suppressed
metabolism with the four different metabolic
Conclusions of the Study's Authors tests that were conducted and were found to
be normal metabolic responses).
“...resting metabolic rate, the thermic effect of
food, oxygen consumption in response to
Refer to the ‘Reported vs. Actual Intake’ figure
exercise, and total energy expenditure did
which summarizes this data on a subject-by-
not differ significantly between groups 1
[FAILURE group] and 2 [CONTROL group],
subject basis.
and no subject in [FAILURE group] had a
substantially reduced resting metabolic rate
or total energy expenditure.”

If the subjects do not have a metabolism

issue, then what’s causing their inability to
lose weight when consuming such low
calories? Let’s keep digging into the results to
find out!

Self-Reported Food Intake

The energy intake reported by the subjects in

the FAILURE group during the 14-day study
period was 1,028 calories (confirming their
claim of believing they were eating less than
1,200 calories per day).
Their actual intake was 2,081 calories per day,
a difference of over 1,000 calories (1,053
calories to be exact).
How do we know the subjects underreported
their food intake? Because we know how
many calories they burned each day (from the
doubly labelled water technique) and if they
lost weight or gained weight (from the body
composition data). We can take this
information and calculate how many calories
the subjects were actually consuming on
average each day. If the number of calories
that they actually consumed (that reconciled
their known body weight changes with the
known number of calories expended each
day) did not match the number of calories
they reported consuming, then the best
Self-Reported Physical Activity
The subjects in the FAILURE group reported
the amount of energy they expended in
physical activities as being about 1,020
calories per day, whereas the actual energy
expended was 770 calories per day, an
overestimation of about 250 calories per day
(which was a significant difference). The
subjects in the CONTROL group also
overestimated their calories, but not as much.
They reported approximately 1,000 calories
expended but the actual number was 875
calories. This was a nonsignificant
overestimation of about 125 calories per day.
Accuracy of Test Meal Calorie Recall
The subjects were asked to recall how many
calories they consumed one day after eating
a test meal (in which they were instructed to
eat until they felt 80% full). The FAILURE
group consumed about 675 calories of this

28
 STUDY 2:
meal but reported eating significantly fewer
calories (~550 kcals), which was
approximately 20% fewer calories than they
actually ate. The subjects in the CONTROL
group consumed about 800 calories of this
meal but reported eating about 900 calories
(which was an overestimation of 12%).
client or person wanting to lose body fat is
reporting their caloric intakes accurately. I
would invest in a process of education that
makes them understand that underreporting
is common, and that it could explain why
they may not be having success with their
diet and exercise program.

I would invest more time and attention to this

Study Authors' Conclusions on clients who are new to fitness and that
have a history of obesity. My level of concern
“...resting metabolic rate, the thermic effect of
and attention to this would be less for
food, oxygen consumption in response to
individuals who are fit and have experience
exercise, and total energy expenditure did
with tracking macros. While my concern and
not differ significantly between groups 1
[FAILURE group] and 2 [CONTROL group],
attention to this would be reduced with this
and no subject in [FAILURE group] had a type of client, I still would have my finger on
substantially reduced resting metabolic rate the pulse of this to some extent!
or total energy expenditure.”

I want to provide some context to this study –

context around the population studied and
how this may or may not relate to the types
of clients that we may work with. This study
was conducted on individuals with obesity
that were likely sedentary and naïve to
tracking food and macronutrients.

What about people who are more fit and that

have experience with tracking macros? Do I
think this type of person may underreport
their food intake? Yes, it’s very possible.
However, it’s likely that the level of
underreporting in this type of person would
be trivial compared to what was reported in
this study. I think we need to consider an
order of magnitude with individuals that are
fit and that have developed the skill of
estimating portion sizes and recording food
intakes. Can they underreport? Yes, but when
they do it’s not likely by over 1,000 calories
per day!

My takeaway with this data is to not make

any assumptions with clients when we
initially start working with them. What I mean
by this is that I would not assume that every

29
 STUDY 2:
Study Strengths & Limitations
Study Limitations
Study Strengths
• Self-Reported Physical Activity
• Robust Testing of Metabolism and Description
Metabolic Responses
- The authors provided very
- The most important metabolism- detailed data on the subjects’
related variable for weight loss is reporting of their energy expended
total daily energy expenditure. The during physical activity. However,
researchers assessed this important their description of the methods of
variable with the best methodology how this was done was lacking.
available for free-living subjects. In There just weren’t many details
addition to this, they also provided that described the
investigated many of the instructions provided to the subjects
components of total daily energy for this study variable.
expenditure – resting metabolic
rate, exercise energy expenditure,
and the thermic effect of food.
Because of their comprehensive
testing, they took away any claim of
a disordered metabolism as an
explanation for a reported lack of
dieting success in this study.

• Inclusion of a Standardized Test Meal

to Assess Accuracy of Estimating Food
Portion

- While clearly not the most

important assessment conducted in
this study, the inclusion of this
supported the other main findings
of the study. The primary finding of
the study was that the subjects
claiming a genetic or metabolic
cause for their lack of dieting
success was due to underreporting
of food intake. The recall of the test
meal caloric intake complimented
the findings of the study as it
showed an inability to accurately
estimate and report a true caloric
intake value.

30
 STUDY 2:

Attribution ccPIXs.com

How do you help clients that may

be struggling with accurately
tracking macros/calories?

What strategies do you use to

increase your confidence that the
nutrition data your clients
submit to you is accurate?

31
 STUDY 2:
Trish Koeslag Thoughts:
This study fascinated me! I see first-hand how food consumption and energy output are under
and over reported, respectively, but this study really emphasized how much.

When I meet with a potential client there are a series of questions I will go through, the first
one being “what is your primary goal?

Whether she says fat loss, maintenance, building muscle, or simply creating better health
habits, my answer will always be that I can help her achieve her goal, but the one caveat is that
she must track her food intake. To me, tracking food is the gold standard in food consumption
accuracy. For many women, this is unchartered territory and can seem very overwhelming.
The best way to minimize this fear is through education. Once I share why tracking food is so
important for progress and offer some simple and effective tips, this usually eases any
apprehension she might be feeling.

Before a client starts her journey with me, I ask her to start logging her food intake on the food
tracking app that I use with all my clients. She will track for 4 weeks before she onboards! This
might seem like a long time, but this ensures that she has plenty of time to get through the
learning curve of tracking, all while having my eyes to help. We can follow one another on the
app, which allows me to guide her as she builds confidence in her tracking skills. During this
phase, I share with her that I just want her to track whatever she eats, and not to change a
thing.

And the most important thing is that all food must be tracked in grams. Often, this comes with
a bit of a dispute, but it's nothing that a little education can't handle! When we measure our
food in volume, for example, cups or tablespoons, the accuracy of the measurement becomes
very subjective. For example, my tablespoon of peanut butter (15g) may be a lot bigger than
someone else's tablespoon. But if we weigh the serving in grams, there is no denying that my
15g on a food scale will be the same 15g on someone else's food scale. All of these 'little'
differences can add up, faster than we think!

Once my client is fully immersed in my program, I review her food logs every day. It is my goal
to ensure that all my clients are progressing well. If I see that things are a bit too challenging or
overwhelming, I will adjust to meet her where she is at. Sometimes, this means asking her to
only track protein and overall calories, letting carbohydrates and fats fall where they may. Once
things seem more manageable, I will reintroduce the tracking of carbs and fats.

In the beginning stage of the journey, I will often do a 'deep dive' into food logs with my
clients, making recommendations on how to adjust food quantities, suggesting different food
options, and ensuring that all items were tracked. It isn't uncommon for new trackers to forget
about oils, condiments, and alcohol. It's important to remind clients that anything with a
calorie needs to be tracked!

One of the most common struggles that I see with clients is not knowing what to eat. The best
'tip' I like to share (and one of the reasons I love tracking macros and not meal plans), is to
continue eating the foods you are already eating. If fat loss is the goal, then you eat a little
less; if muscle gain is the goal, you eat a little more. I truly feel that we can enjoy all the foods
we love in moderation, we just need to track them!

If a client is trying to work on better health habits, and to improve her food choices, I often
suggest keeping food simple, 3-4 ingredients at the most. A meal like grilled chicken breast,
roasted potatoes, and some sauteed green beans, is easy to track. Unlike recipes which can be
complicated to track and cause a lot of unnecessary frustration!

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 STUDY 2:
Trish Koeslag Thoughts: (cont.)
Another reason I like suggesting simple meals is because it gives a good visual as to what an
ideal portion size should look like. This helps build confidence when clients are out enjoying
social meals, where tracking food might not be possible. Although tracking is best for accuracy,
mindful eating is a great skill we should all aim to achieve. Tracking is a tool that can help to
accomplish this.

For those that think tracking is time consuming, my favorite way to combat this is to become a
creature of habit. Having the same meals (that you enjoy) on repeat can take the guess work
out of tracking and lessen the burden that some might feel when new to logging food. And,
once you find meals that you enjoy, it becomes a plug and play type of scenario which saves a
lot of time.

These tips are just a few ways to help make food tracking a painless experience. Not only do
they offer some guidance in ensuring consistency and accuracy for my client, but they also
ensure that as a coach, I am receiving the most accurate data from my clients.

Nutrition data is key. It is one of the main ways, as a coach, to determine next steps in a
client's nutrition plan. And, it provides an open book into why progress is, or isn't being made!

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 STUDY 2:
Ted Ryce Thoughts:
The goal with all my coaching clients is to get them tracking their calories. So, I have several
strategies I use to help my clients do it in a way that 1) gets them to lose fat and 2) doesn't cause
excessive psychological stress.

The first strategy is mindset. The fact is that my clients are already busy, and most are usually
dealing with high amounts of stress. I explain that they will experience some challenge with
tracking. But I also explain why I believe it to be the best approach. Most of my clients have tried
strict diets and gave up on them when the strictness of their nutrition approach caused too much
stress. Tracking allows us to lose fat while having the flexibility to include foods that we love –
provided they stay within our weekly calorie limit. Understanding the “why” of tracking gives
them the motivation to push themselves to do it accurately.

I also explain how learning to track is a skill that will give them the missing knowledge that they
currently lack. In other words, tracking calories is a strategy that they can do for a year to learn
about the caloric “costs” of their food choices. But once they know enough to make nutrition
choices to maintain their weight, they can stop tracking.

The second strategy is to put constraints on how much time they take to track meals. I tell them
not to take more than 15 minutes per day to track. Some clients have the tendency to spend too
much time tracking. Or they get “paralysis by analysis” from all the potential choices to track. By
putting a 15-minute limit on tracking, they're forced to do their best then move on. Then we focus
on improving their skill and accuracy with tracking.

The third strategy is to ask my clients questions every week about what their biggest lesson was
from tracking as well as their biggest challenge. Going over the biggest lessons helps them to
realize that tracking is helping them make better choices. And identifying their biggest challenges
helps to pinpoint how to help them improve their tracking.

Another important thing I have my clients focus on is total calories and protein. I explain that we
set the carbs and fat because MyFitnessPal doesn't allow for a “track calories and protein only”
option. But that it's really total calories and daily protein intake that lead to results with fat loss.

An additional strategy we use is to tell clients to weigh and measure their food at home. But to
“guestimate” when they eat out. And we also have our clients overestimate their calories at
restaurants instead of trying to be accurate.

The last thing I'll mention is that we coach our clients on energy balance and how there is no
exception to this rule. So, if a client isn't losing weight we challenge them to operate within the
idea of energy balance – even if they don't believe in it 100%. We ask them to prove it wrong by
tracking accurately and only eating at home for a week. We teach and coach through experience
versus trying to argue or use theory.

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