Amanda: Hey, this is Amanda, women’s health dietitian.
Emily: And I’m Emily, nutritional therapy practitioner.
Amanda: And this is the Are You Menstrual? podcast where we help you navigate the confusing world of women’s hormones and teach you how to have healthy periods.
Emily: Each week we will be diving into a different topic on women’s health and sharing our perspective using nutrition, female physiology, and metabolic health.
Amanda: Our goal is to help you wade through conflicting health information and empower you on your healing journey.
Emily: We hope you enjoy it.
Amanda: Okay, so welcome to Episode Two. In our last episode, we went through metabolism and kind of broke down what your metabolism is, why it matters for your hormone health. Basically, if you have a slow metabolism, you’re going to have more hormone symptoms. So we kind of promised you, okay, this is what your metabolism is, here’s how it works. This next episode…this is when we are going into…how do we support it? And the biggest thing is with food and with nourishment and with enough food. And so today, we are going to go into what your metabolism needs to properly function and support every other system in the body.
But before we get into everything…we’re covering a lot, we’re jamming a lot into this episode. And we just want to ask you to try to let go of everything you’ve learned in the past about how to eat. And this means, like, how much food you should be eating, what foods you should or should not eat, and when to eat. Because we’re really going to be going into, like, meal frequency, nutrient-dense foods…all that stuff today. And it can be really hard if you’re coming in with, like, all these specific thoughts of this is what you’re supposed to do. So try to let that go, have an open mind. It’s time to rewire your brain and rethink what it looks like to nourish your body—because most likely, it’s not what you expect.
Amanda: So let’s go into the first big area…and this is eating enough food. So if we are under-eating, this is going to put our body in a chronic state of stress. And this is something that we see the most frequently in the women that we work with. And that’s that they’re not eating enough food, so their body’s kind of chronically in that fight or flight state. When that happens, we’re making more cortisol, we’re breaking down more of our own tissues, and using up a lot more nutrients like, important minerals like: magnesium, sodium, and potassium. And so all these things are going to affect our metabolism [and] can affect our hormones, digestion, everything. So how do we know how much to eat? Do you want to go into the total daily energy expenditure a little bit Emily?
Emily: Yes. So that was a question I was just about to ask you, Amanda, is…I don’t feel like a lot of women know if they’re under-eating or, you know, what their calorie breakdown or their macro breakdown or anything like that is which is not necessarily a bad thing. Because I don’t believe in tracking every little thing that you do; I think that can add more stress in a lot of situations. But there is a tool that you can use just for a short time to know if you are getting enough nourishment. And that is the Total Daily Energy Expenditure calculator. So your TDEE is basically how much energy that you burn each day, and this includes everything you do. So it’s all of the vital functions that are going through your body: like, breathing and pumping blood, it’s digestion, it’s cell repair—especially if you’ve had, like, an injury, it’s detox brain power…basically, anything that your body is doing, including exercise, that you do throughout the day is included in this, this total amount, so this TDEE.
And there’s actually a tool that we use for our clients and for our program participants. It’s the TDEE calculator. So we’ll include that in the show notes. It’s not totally perfect, but it is kind of a good estimate of your daily needs based on your activity level and your age and all of that. So it is useful.
Amanda: Yeah, it’s not…it’s, like, we’re not calculators. So it’s…it’s good to remember that, but when it comes to at least having a…some sort of benchmark, I feel like it’s really helpful. And so you can, like, go put your height, weight, age, and activity into the Total Daily Energy Expenditure calculator and then basically you would want to track your food for about like four to five days—you can do it longer if you want—and take an average of that. And then compare that…like is your average intake, you know, for the four to five days, is that close to your total daily energy expenditure? Is it below your total daily energy expenditure or is it above. And again, like not perfect, but at least it gives you a place to start. And it might…I, for a lot of our clients, it gives them permission to eat more, and they’re kind of like, okay, I definitely was under-eating, I didn’t realize I was under-eating by so much.
And if you’re eating more than your total daily energy expenditure and you’re maintaining your current weight, then that would mean that it’s actually higher, the measurement wasn’t perfect for you. And that’s totally fine. But it’s a really good one to kind of understand like, am I under-eating? We get so many women that it’s like, you know, they’re totally daily energy expenditure is like 2400 calories, and they’re eating like 1400. And it doesn’t mean that you immediately start eating 2400 calories, but that could give you the information to say, okay, I’m going to slowly start increasing my food intake and letting my body adjust to that. Most people go, like, too fast too quickly. That’s like my standard, let’s go to an extreme type situation, a lot of women, like, want to jump to that, but you’ll feel, typically, feel better and it’s less stressful if you kind of slowly increase it.
If you are under-eating by that much it might just give you a little bit more information to understand. Okay, so maybe this is why I’m still struggling with my hormones. Or this is why my energy isn’t great, or why I maybe…I don’t recover from workouts as well. Or maybe why, like, you have thyroid issues, you wake up at night a lot, have difficulty sleeping…The total daily energy expenditure really is giving you that piece of information, like, are you eating enough, are you not, then from there you can take the next steps to kind of try to remedy that.
Emily: Right, and as Amanda said, like, our bodies are not calculators. So there are certain things that will increase our needs that you can’t really see on that, you know, tool that we use, that calculator. But basically, if you are going through a period of stress, whether that be emotional, physical, you know, whatever it is…you probably will need some more nourishment and not, you know, [that] includes things like pregnancy [and] breastfeeding. There are a lot of ways, a lot of things in your life that can happen that will basically boost up and increase that need.
So, getting to the next piece of the puzzle…not only eating enough foods, but we definitely want to talk about the foods that you are eating. So eating the most nutrient-dense foods is going to be very helpful in terms of hormone health and overall health. But what [does] that exactly mean? So what foods are the most nutrient-dense? So nutrient-dense just means that they contain a higher level of vitamins, minerals, and amino acids than other foods. You know, when we think nutrient-dense, my mind used to go directly to whole fruits and veggies obviously, like, that’s probably the most minerals and things like that I can eat right? Just a bowl of greens—that’s the best thing.
But I’ve actually learned since, you know, in my own nutrition education and working with Amanda, that it actually takes a lot more fruit and veggies to get the same nutrients in some animal products. So, for example, liver, like beef liver, just one ounce of beef liver has basically the same or even more nutrients of like four pounds of fruit and veggies. So when we’re talking nutrient density, we’re talking those really mineral-rich and amino acid-rich animal foods. And a couple of my favorites are going to be meat. So liver kind of falls under that category, but also just any sort of meat. I prefer red meat, personally, but also things like eggs, seafood—so your fish, your oysters, those kinds of seafoods. And then dairy—which we like grass fed dairy for just more minerals and nutrients in there. And then of course, your fruit and cooked veggies.
So we recommend cooked veggies just because, you know when we’re talking about nutrient density, too, we also want to talk about how our body absorbs those minerals and nutrients, because it doesn’t really matter what you’re eating—If your body can’t break down those foods, it doesn’t really make a difference, right? So we need foods that are bioavailable, the minerals are bioavailable and easily absorbed. And that is going to be your, your animal products.
So for example, when I was in college, I felt like I was on such a good diet, because I was eating a ton of plant foods…lots of salads, that was, like, my basic lunch every day. At night I would have maybe a cooked sweet potato with some legumes and veggies, and this was the way I ate; but, unfortunately, I was constantly bloated, I had a lot of digestive issues, my acne was probably at its worst, and the blood sugar…I was on the blood sugar rollercoaster—I was actually diagnosed pre-diabetic in college and this was around the time where I was eating the most plant foods.
This is not to say that plant foods are bad at all. It was just that I was not balancing my diet out with these really nutrient-rich animal foods. I was not eating dairy at all. I never ate meat, because I didn’t want to cook it. I was kind of lazy, and just the easiest thing to make were salads and things that I could throw together, like smoothies. So it just was not a good situation. And I was constantly confused, because I thought I was so healthy, you know, I was eating so healthy. But this just goes to show that even what we think are the healthiest foods, like fruit and veggies, may not be broken down as well as we think, which is why we need those animal products because of the bioavailability of nutrients.
Amanda: Yeah, I think, like, we do mention cooked veggies, because when they’re cooked you can typically absorb a lot of the minerals from them versus when they’re raw they’ve got more of those phytates, the phytic acid, things that bind to minerals. So that’s why we mentioned, like, cooked veggies [are] still very nutrient-dense. Especially if you can get those cooked in, like, a healthy fat, like butter, coconut oil, something like that…then you’re gonna absorb those a lot better. But yeah, I think it’s, it’s, like, it’s confusing when it comes to nutrient density of food.
And something that I totally forgot to say when we were talking about eating enough, but I feel like it really resonates in this section as well is…so many people want to know, like, should I eat this food? Should I eat that food? Should I take this supplement? When in reality, like, their body’s gonna be in a state of stress regardless, because they’re not eating enough, and they’re not balancing their meals. You know, I can’t tell you even now it’s like, I forget that people don’t know that you’re supposed to have, like, protein and carbs at all meals. Fats [are] always gonna be mixed in there somewhere—there’s very few, like, fat free, like proteins and stuff.
So I, like, forget that people still, like, don’t always know that. And they’re kind of, like, oh my energy is crazy, I’m getting anxiety later in the morning. And I’m like, what did you eat for breakfast? And it’s, like, some sort of like cereal or toast or something. Even if they’re like sprouted cereals, like sourdough toast, you know, it’s, it’s not like they’re bad foods. It’s just that I’m, like, what…can you add a protein in there and then we’ll see if you still feel anxious later. You know there’s so many things that we’re kind of looking for and wondering, like, why, why are we not maybe feeling as good as we want to? When it’s, like, it could just be, like, adding in a few of those nutrient-dense foods that helps or balancing out that meal. It doesn’t always necessarily mean we need, like, a supplement or to go on a specific diet.
Emily: Right. And I think a lot of people do focus more on, okay, what can I take out to feel better? When I think what we should be focusing on is, what do I need to add in to feel better? So it’s not about restricting, maybe, foods that aren’t so nutrient-dense, it’s more about adding in the ones that are and just making sure we’re kind of living a more balanced lifestyle with a variety of foods. I think variety is huge when it comes to nutrient density.
Amanda: And if you’re someone like, maybe you relate to Emily’s story. I get so many people that don’t know how to cook meat. So they tend to, like, eat it less or have, like, a slightly more processed version. Or if you are just…you prefer that plant-based type of eating, because that’s what you’re used to. But you’re like…I do have hormone concerns, maybe you have PCOS or irregular cycles, or you feel like you have maybe a lower progesterone [and] higher estrogen, then that’s when you want to start experimenting…like maybe I will just add in some animal foods. And typically, we recommend using some sort of digestive support when you first start doing that, because often when you’re eating mostly plant-based and, like, grains and stuff like that, you don’t make as much stomach acid over time. And so then you go to eat an animal food and you’re like, oh it’s sitting in my stomach, I’m not digesting it. Well, like it really messed with my digestion in general, maybe like your bowel movements…So if you use, like, a little bit of digestive bitters—Urban Moonshine, great brand—or you could just do a, like, one or two teaspoons of apple cider vinegar…great option. And then I would just add them in slowly. Like we get quite a few people that transition from plant-based to, like, including animal foods, and we’re like, drink bone broth, that would be a great first step. Like that’s an animal food—very nutrient-dense, tons of minerals, and there’s protein in it.
And then like gelatin gummies. You know, like, we love those. We’ll talk about those in a little bit. And maybe, like, dairy, eggs, like, seafood. And then once you’ve gotten used to those, then you could try adding in, like, red meat if you feel like that’s a good thing for you. So there’s different ways to do it. Everyone has to experiment and find what works for them. But I encourage you if you are kind of in one camp, like experiment, branch out to the other one and see how you feel.
Emily: For sure.
Amanda: So let’s go into the next kind of big area. So we talked about eating enough food, that’s step one, right? And then eating nutrient-dense foods, that is step two. The kind of third area that we want to dig into when you’re building this nourishing nutrition foundation is enjoying your food and reducing stress around your food. I think that this is something that’s not acknowledged enough. Psychology of Eating is an amazing company and program, and they talk a lot about vitamin P, or vitamin pleasure, and how important that is for enjoying in, but enjoying our food, but also, like, digesting and absorbing our food. And they reference a really great study from these researchers in Sweden and Thailand that joined forces to see how cultural preferences for foods affects the absorption of nutrients from those foods. And so they took a group of women from each country, and they were fed, like, a typical Thai meal—which was like rice, veggies, coconut, fish sauce, and hot chili paste, which sounds like…
Amanda: Like, more hot chili paste. So, a very traditional Thai meal. The Thai women enjoy Thai food, and they obviously loved that. They absorbed a good amount of the nutrients, but the Swedish women didn’t. And it was really interesting, because what happened is, there was a metabolic impact of not enjoying the meal. And basically, it showed that even though that meal was like the same nutrient density for both groups, the Swedish women did not absorb as many of the nutrients from that meal. And so it just kind of shows you like, okay, so this matters. They did the same thing or they made a traditional Swedish meal, it was like hamburger, mashed potatoes, and string beans. Same thing, Thai women did not enjoy the meal, they did not absorb as many nutrients from that meal as the Swedish women. And then kind of like the last part was they put them in blenders, they, like, blended up all the food, and then ate it that way—and they both absorbed less, which I thought was super interesting, because it’s already digested a little bit from a blender.
So the whole point of this is to show you that there is a metabolic impact of pleasure when you’re eating, and it can actually help you absorb more nutrients. And I think sometimes we’re eating foods because we feel like we should, which, like, I eat liver that way…I don’t like liver, but I eat it because I’m, like, I know, this is really good for me. And it’s almost like a supplement. But I do think it’s important to also enjoy a lot of your food. That’s something that we see in a lot of the women we work with, especially in the group setting where they kind of go through the first couple steps of the program, and they’re, like, oh my gosh, I’m actually enjoying my food, I actually have energy, you know, and they’re just a lot less stressed out when it comes to eating.
Emily: Right. And, you know, I think something I was thinking about in terms of enjoying your food too, is, that doesn’t necessarily mean you have to put a ton of pressure on yourself each week to be excited about every single meal you’re eating. We obviously know that we live busy lives, and sometimes you’ve just got to get the nourishment where you can. And it’s not going to be the most exciting meal you’re going to eat—and that’s okay. But I think the point of this is just to make sure that as a whole, you are enjoying your, your diet and your foods. And when you sit down to a meal, it’s not something you’re turned off of, and like oh, I really don’t want to eat this, I’m just eating it because I think it’s healthy. So I think that’s the point Amanda is trying to make. And it really does make a difference and how much minerals and nutrients we do absorb. So just something to keep in mind.
And that’s a good segue, I think, into not only what you’re eating and how much you enjoy what you’re eating, but how you eat matters a ton. And so that’s what I’m going to just dive into really quick, because I feel like so many women, when they change this piece of how they eat, that’s when they can start to see a lot of symptoms, especially digestive symptoms, disappear. It all comes back to eating in a relaxed state. So digestion is a north to south process so it actually begins in our brain. What most people don’t realize is that’s where we start, the digestive process is in our brain. So when we smell food, or when we get hungry, start thinking of our meal, our brain tells our digestive system and our stomach and everything that’s a part of our digestive system to start gearing up for food. So we’re about to get food, we need to start that process, right. So that’s going to be, like, things, like, your stomach acid and your enzymes that are produced and everything that goes into breaking down your food…that starts at the very first smell or thought of food.
So if we are constantly eating on the go, let’s say you’re not even stopping…you’re, you’re going through work, you’re going through the drive-thru, you know, you’re on your way to something stressful…your brain is not going to send off those signals. And so digestion is already going to kind of take a backseat right to everything else going on in our head, in our lives. So we really need to try to be in a relaxed state—this is called the parasympathetic state—instead of a sympathetic state, which is a more kind of go, go, go stressed state. Because when we are in that state of stress, when we’re eating, we aren’t going to release those stomach acids and those enzymes, and that’s when you’re going to start experiencing a lot of digestive issues like: bloating, the acid reflux, ultimately dysbiosis. So it’s just really important to kind of be mindful of how you’re eating your food as well. And I think a lot of people take this for granted. I used to be one of them. Sometimes I still am depending on what I have going on during the day, but I definitely notice a difference when I prioritize my meals and stop what I’m doing, sit down, take a breath, say grace, whatever it is, that kind of gets me into a better and more mindful headspace, before I start eating my food. And not only is this going to have health benefits, but it’s also just a better…you’re going to enjoy your food more, right? You’re going to enjoy that break rather than kind of being in this fight or flight mode. So definitely something to think about.
And you know, when we talk about nutrient density, like I said before, you could eat the best foods in the world, you could have the best diet ever, the most…very nutrient-dense diet—but if you’re not breaking down those foods, it doesn’t really matter and it’s not going to do you any good. Just a recommendation to actually take a lunch break, sit down, take a few deep breaths, and relax when you’re eating.
Amanda: I think too, like, if you’re someone that struggles with digestion, like, if you deal with a lot of bloating or indigestion or reflux…this is one of those things where it’s, like, it’s free to do this, like, it doesn’t cost you any money. Usually, yes, it takes some intention, I definitely think, but it can actually become a very enjoyable part of your day. Like I really started to not do things at my meals, like I used to work through breakfast, through lunch…dinner was really the only one that I was relaxing at, because I felt like I didn’t have time. And when I started to prioritize, even like 15-20 minutes for those meals to, like, sit there and, like, not do anything else…it makes a really big difference in my, like, mental health space, and just relaxing and not constantly being on the go. But I’ve also seen in so many clients that they’re like, oh, I’m already less bloated. And it’s the only thing they changed! They didn’t even, like, changing the food that they were eating. So I think this is one that’s, like, very under-utilized. Because we’re always like scrolling on our phones or something while we’re eating, or eating, like, during a meeting. And sometimes you have to do that otherwise you’re not going to eat. But I think if you assess your day-to-day and think about, like, am I constantly doing things when I’m eating my meals? Or is it kind of like half and half. And just thinking about, I’m going to pick one meal where I’m gonna eat without distractions…that’s the best place to start. Because then you can slowly build on that. And when you start doing it, you notice a difference. Like now if I have to eat and do other things, I’m like, oh this is not enjoyable. I can feel it more, whereas if you’re used to that…it’s your norm. So it can be hard to change.
Emily: And if you think about it’s kind of common sense. Like my husband, he is not in the health space at all, but every time I sit down at my computer with my lunch, he’s like, “What are you doing? Sit at the table, get off your computer.” So he’s like my accountability partner, and he doesn’t even know how that affects digestion. But it is just more of a cultural, common sense thing that I think we’ve kind of lost.
Amanda: Yeah, it’s like it’s normal to work through lunch, you know? But think about that, see, like, where do you stand in all this and look at your day to day. I think kind of the last really big area that we want to talk about is meal frequency. So we’ve talked about eating enough nutrient-dense foods, enjoying your food through pleasure, and then making sure that you’re not distracted at your meals. The last kind of piece of the puzzle for looking at your nourishing nutrition foundation is how often are you eating. And I know that this is a controversial one. I know that it can be very confusing, because you’ve got one camp that’s like intermittent fasting—only eat when you’re hungry, and if you’re not hungry, don’t eat—we’ll get into that. And then you’ve got like the other camp where it’s like, you need to eat meals every few hours. Some people are kind of in the middle, and they’re like you want to give your body at least like four hours between meals. Is it Whole30 that they tell you to wait like four or five hours…?
Amanda: …between meals. It’s like, there’s different….there’s so many, there’s a spectrum of meal frequency. And we personally fall on the part of the spectrum where it really depends on how stressed the person is and what your current health looks like. So it’s…meal frequency is going to look different for everyone, and especially depending on where you’re at now. But we recommend, like the biggest place we like to start for people is eating breakfast within an hour of waking. And the main reason for this is because at nighttime, we’re sleeping so we’re all fasting, right? Technically, we’re all intermittent fasters. We’re fasting at night for the duration of when we’re sleeping. What we’re doing during that time is using up the glucose that’s stored in our liver. And we have about seven to nine hours of glucose stored in the liver. And so we’re using that to keep our blood sugar stable while we’re sleeping. And so when you wake up, you should be hungry, because you’ve used up a lot of your liver glucose and you should eat. And that’s, like, what is the best way to get your cortisol to come down. Because when we’re not eating at night, and if we don’t have enough glucose stored in our liver, we are going to release cortisol to get glucose from our tissues so that our blood sugar stays stable. Like, our body’s main goal is to keep us alive. It might not be great for you to not sleep well, to wake up throughout the night, but it’s just your body trying to protect you.
And so if we think about, okay, so if I’m waking at night frequently, or if I have a hard time falling asleep, it’s probably a blood sugar imbalance. And this means that you want to look at how are you eating all day? How are you living all day? That’s going to impact how you sleep at night. So by starting your day with breakfast within an hour, you’re taking yourself out of that stress state and nourishing your body. Which is what we want, because then the rest of the day you’re so much more likely to have balanced blood sugar, to feel good, and have good energy. Versus when we don’t eat in the morning and we’re fasting, then that’s typically going to lead to a crash later.
Emily: Okay, Amanda, I have a question now, because a lot of people will argue, “Well, I wake up, and I’m not hungry, and I…just the act of eating just kind of nauseates me. I really don’t want to eat.” What would you suggest for those types of people?
Amanda:It’s usually because you’re running on cortisol. So you’re running out of stress hormones, so you want to keep that in mind. And I, I think if you are listening to this podcast, you probably have a hormone health concern. And so this is where we have to kind of shift our thinking into, “Okay, so I’m not hungry. So that’s not a good thing.” Like our clients, when they wake up hungry, they’re excited. They’re like, “Yes, I’m hungry. That means I’m using the right fuel and my metabolism is working. And I’m not like, you know, running on stress hormones.” So we want to think about, okay, so if I’m not hungry, I know I need to eat something…what is something even just really small that you can have first thing in the morning?
This is where we really like the gummies that we make, they’re gelatin gummies. I have those first thing every morning. I do eat a regular breakfast after that, but it’s like I have to get up, take my dogs out, feed them. And otherwise, I wouldn’t be eating for like, at least, like, 30 minutes in the morning so I have the gummies first thing. A lot of our clients start with the gummies, and so they’re at least having something and then you build on that. So you don’t have to, like, force feed yourself a full breakfast, but even just having something small when you wake up is going to allow your adrenals to take a break and get you out of that fight or flight state.
Emily: And I will say, the gummies are delicious. So if you haven’t tried Amanda’s recipe, it’s on Instagram and it’s really good. But we’ll also link to that in the show notes.
So okay, so you say to eat breakfast within about an hour of waking. What about the rest of the day? Like, what…what sort of frequency do you think is the best for metabolic and hormonal health for most women?
Amanda: So I would say, like, ideally eating every three to four hours. Do some women need to eat more frequently? Yes, believe it or not, they do. It really depends on, like, the state that you’re coming in. So when we get women started with our group program, or one-on-one, we are really trying to meet them where they’re at. And so this is when you want to assess, like, “Okay, what am I currently doing?” Maybe you’re not eating until like 10 or 11am. And so you decide to add gummies in first thing. That’s an easy one, typically you…that helps turn on your hunger cues. Right? So it’s instead of, like, not feeling hunger or…and having difficulty feeling fullness, because that’s usually what happens for those people, then you eventually start to notice, like, “Oh, I am hungry a few hours later.” So then you would want to eat something.
By starting to eat then eating every like three to four hours, depending on the person, but I would really look at, like, do you eat all your food at night? We get a lot of people that tend to, like, not eat until later in the day, and then they eat a ton and they feel awful, and they don’t sleep well, their digestion is not great. So you want to start slow. So I would just say, like, eat first thing and then try to eat a couple meals during the day. And ideally, you’