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February 01.2024
1 Minute Read

Calories or Macros

Calories or Macros

Calories or Macros: A nutritionist explains which works best for weight loss or building muscle

Whether tracking macros or counting calories, you’ll need to get used to recording everything you eat and drink daily.

While reducing calorie intake is a proven way to reduce your weight, there’s no shortage of diets promising the same results but with more flexibility. One such popular diet is “If It Fits Your Macros” (IIFYM), which offers users less restriction in what they eat, while still guaranteeing results.

Rather than counting calories, IIFYM counts the daily macronutrients (fats, carbohydrates, and proteins) found in the foods and drinks we consume. Many people like the diet because it offers flexibility and allows them to consume any food as long as it fits into their daily macronutrient (“macro”) requirements.

However, there’s currently no scientific research that has specifically examined whether counting macros is as effective as other methods in achieving different weight goals.

Past research has looked into the effects of reducing or manipulating individual macros for weight loss, such as comparing the effect of consuming a low-fat versus low-carbohydrate diet or comparing four diets containing different proportions of fat, carbohydrate and protein. Ultimately, researchers found no significant, long-term difference between the diets on how much weight they helped people lose) – and all are difficult to adhere to in the long term.

As such, this makes it difficult to know whether counting calories or macros is more useful when it comes to your different body weight goals.

WEIGHT LOSS

The basic principle to achieving weight loss is eat less energy than your body requires on a daily basis and you will lose weight. Any diet can lead to weight loss as long as this basic principle is applied.

The tricky part is establishing what our energy requirements really are.

The most practical and accurate measure of this, indirect calorimetry (a measurement of the gases that we breathe from which energy expenditure can be estimated), is still not 100% accurate. And the prediction equations commonly used in dietary counselling and by online apps to set calorie intake goals for weight loss are even more inaccurate. This is especially so in those who are overweight or obese due to the equations being based on body weight, and not taking account of fat mass.

But whether you’re counting calories or macros, you still need this starting point to work from to keep within your targets. While our actual energy requirements are uncertain and can vary greatly depending on how active we are, our requirements for macronutrients are more certain, based on government guidelines.

An advantage of counting macros is that it ensures that some essential nutrients are incorporated into your diet, instead of focusing solely on calories.

Counting calories takes no account of nutrients. And while it seems obvious that choosing wholesome nutritious sources of calories is better than processed, high-sugar and saturated fat foods, you could hypothetically eat seven chocolate bars (each worth 228 calories, a total of 1,596 calories) and still lose weight if your total energy expenditure is around 2,000 calories a day.


Macro calculations are estimated based on body weight, height and activity levels and can be adjusted to your weight goal. While fewer restrictions on what to eat may be a bonus for some on IIFYM, for others keeping track of macro intake and hitting those targets can be difficult and time consuming.

Tracking both macros and calories can be time consuming.

Whatever you’re counting you’ll require an affinity for reading food labels and keeping a record of all foods and fluids consumed throughout the day. While there are numerous online nutritional databases and apps that help you track macros and calories, they may not always be accurate either.

Plus there’s the added complication that we may not actually absorb all of the energy or nutrients that food labels list, making it even harder to meet specific targets.

Additionally, neither method will guarantee that you meet all of your other nutrient requirements. For example, as macros only focus on carbs, protein and fats, they may overlook the importance of other vitamins and minerals, such as vitamin A, which are essential for staying healthy and preventing deficiencies. Unless combined with dietary advice about making permanent changes to a healthy balanced diet, neither method is a long-term solution to weight loss or maintenance.

MUSCLE GAIN

On the opposite end of the spectrum are people looking to gain weight to build muscle. Someone looking to gain muscle would need to increase their basic daily protein intake to around 1.2-1.7 grams of protein per kilogram of body weight for muscles to repair any micro-damage that occurs from resistance or strength training which is necessary for muscle growth.

As well as protein, energy and carbohydrate needs must also be met to ensure the body has enough fuel available to work out. This is where keeping track of macros, instead of counting calories, could be useful to ensure all protein and carbohydrate requirements are met.

Timings of macros are also important for muscle growth. Research shows regular protein intake throughout the day and after exercise, rather than large single doses, is recommended for muscle growth and refueling.

Ultimately, which method you choose for altering body weight and composition depends on your goals and how motivated and tech savvy you are. If you are keen to learn more about the nutrients in the food you are eating then counting macros may be for you. For those who find endless counting and monitoring tedious it may be easier to follow more general guidance for weight loss or maintenance or for bulking up.

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11.04.2025

Nitric Oxide: More About This Important Tiny Molecule With Big Impact on Brain, Heart, Healing, Fitness, and Longevity

Nitric oxide (NO) is a gas your body makes that relaxes blood vessels, supports mitochondrial function, modulates immunity, and helps nerves communicate. Low NO shows up as higher blood pressure, slower recovery, poorer sexual function, and age-related disease risk. NO is built from dietary nitrate (leafy greens, beets) and from arginine/citrulline pathways—and it’s strongly influenced by your oral microbiome and even sunlight. You can restore it with smart nutrition, training, mouth-friendly habits, and targeted supplements where appropriate. PMCWhat Exactly Is Nitric Oxide (NO)?NO is produced by enzymes called nitric oxide synthases (NOS) and by a diet-microbiome pathway that turns nitrate → nitrite → NO. In blood vessels, NO tells smooth muscle to relax, increasing blood flow and lowering vascular resistance—central to healthy endothelial function, the “youth” of your arteries. When endothelial NO is low, vessels get stiff, inflamed, and pro-thrombotic. PMCPubMedWhy NO Matters Across Health Domains1) Cardiovascular health & blood pressureNO is a primary regulator of vascular tone; impaired NO signaling is a hallmark of endothelial dysfunction and a starting point for atherosclerosis and hypertension. Improving NO (through diet, activity, sunlight exposure within safe limits, and—in select cases—supplements) correlates with better blood pressure and vascular function. PMCPubMedAHA Journals2) Brain & cognition (including Alzheimer’s)NO influences cerebral blood flow and neuronal signaling. Recent reviews connect NO dysregulation with Alzheimer’s disease pathology (amyloid, tau, mitochondrial stress). While we don’t have a cure, maintaining NO bioavailability is a plausible target alongside sleep, exercise, and metabolic care. PMCPubMed3) Wound healing & tissue repairTopical and biomaterial strategies that deliver NO can accelerate closure, angiogenesis, and antimicrobial defense—especially relevant in diabetic or “hard-to-heal” wounds. (This is an active research area; therapies are evolving.) PMCPubMed+14) Physical fitness & exercise performanceDietary nitrate (e.g., beetroot) and NO-precursor strategies may lower the oxygen cost of exercise and modestly improve certain performance metrics—effects appear stronger in older adults and in longer, submaximal efforts. Results vary by study and individual. EatingWellNew York PostPubMed5) Sexual function (all genders)Penile and clitoral erection rely on NO-cGMP signaling; endothelial and neuronal NO drive genital blood flow and arousal physiology. Oxidative stress reduces NO bioavailability and contributes to erectile dysfunction (ED); improving endothelial health and NO can help, though severe cases need medical evaluation. PMC+2PMC+26) Age-related chronic diseaseAging, insulin resistance, and oxidative stress reduce NO generation and increase NO “scavenging,” linking low NO to cardiometabolic disease and possibly neurodegeneration. Strategies that restore NO—and reduce oxidative burden—are foundational longevity levers. PMC+1The Oral Microbiome–NO Highway (And Why Mouthwash Can Backfire)Leafy greens and beets supply nitrate. Oral bacteria convert nitrate → nitrite, which your body turns into NO—especially when oxygen is low (like during exercise). Antiseptic mouthwashes can blunt this pathway, and several studies associate routine use with higher blood pressure and loss of the nitrate benefit. Older adults may benefit most from dietary nitrate because the oral microbiome and endothelial NO decline with age. PubMed+1EatingWellPractical swapsAvoid daily antiseptic mouthwash unless medically indicated; try gentle rinses and good brushing/flossing instead.Eat nitrate-rich veggies (see list below) and chew them well—the conversion starts in the mouth. PubMed Sunlight & Skin-Stored NOYour skin stores nitrite/nitrate. Non-burning UVA exposure can mobilize NO and acutely lower blood pressure (separate from vitamin D). Be sun-smart—brief, regular exposure appropriate for your skin type; avoid burns. PMCScienceDirectWhat Dr. Nathan Bryan EmphasizesDr. Nathan Bryan—NO biochemist—highlights that modern lifestyles (processed diets, antiseptic oral products, PPIs/antacids, sedentary behavior) erode NO production, while simple habits restore it: nitrate-rich foods, protecting oral bacteria, resistance training, and targeted NO-generating tools. For color and context, see his Diary of a CEO interview and transcript; treat podcasts as commentary, then anchor choices in primary literature. Apple PodcastsThe Singju PostYouTubeHow to Build (and Keep) Your Nitric Oxide1) Eat the NO diet (daily)Prioritize nitrate-rich plants:Beets, beet greens, arugula/rocket, spinach, chard, lettuce, fennel, celery, bok choy, kale.A pattern of these foods consistently supports blood pressure and vascular function; older adults may see the clearest wins. EatingWellNew York Post 2) Train your endotheliumZone 2 cardio (150+ min/week) and resistance training improve endothelial function and NO signaling over time. (Mechanistic vascular literature supports this even when individual supplement trials are mixed.) PMC 3) Protect the oral-nitrate pathwaySkip routine antiseptic mouthwash; maintain gum health with brushing/flossing/pro cleanings. PubMed 4) Smart sunlight (if appropriate)Short, sensible daylight exposure can release NO from skin stores; still use sun safety. PMC5) Consider targeted supplementation (case-by-case)Dietary nitrate (e.g., beet juice shots) may lower BP and aid performance in some—especially older or less fit adults.L-citrulline (often 3–6 g/day) increases arginine and may help blood flow and perceived exertion in some settings; performance results are mixed across meta-analyses and trials.L-arginine can support NO but is more heavily metabolized by the gut/liver; citrulline often raises arginine more reliably.Always screen for interactions (e.g., nitrates + PDE-5 inhibitors), kidney concerns (oxalates in high-dose beet products), and medical conditions. EatingWellPubMedTaylor & Francis Online Where NO Touches Specific ConditionsHypertension & heart disease: Boosting NO via diet and endothelial fitness is foundational; sodium/potassium balance and metabolic health still matter. PMC Alzheimer’s & cognitive decline: Reviews link NO biology to AD mechanisms; lifestyle strategies that preserve NO are low-risk and synergize with brain-healthy habits. PMC Wound care (incl. diabetic wounds): NO-releasing dressings and topicals are promising adjuncts; speak with a clinician for availability. PubMedPMC Sexual function: ED and female sexual arousal disorders are intimately tied to endothelial health; NO signaling is central to genital blood flow. Address cardio-metabolic risk, sleep, stress, and consider medical therapy when indicated. PMCAthletic performance: If you’re over 50, heat-exposed, or doing longer submaximal efforts, nitrate strategies may yield noticeable benefits; test and track. New York Post FAQ (quick, evidence-aware)Is beet juice really effective? 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10.29.2025

Salt, Sodium, and Blood Pressure: Why the Real Story Is More About Insulin and Metabolic Health

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Human data followed, leading to generalized anti-sodium recommendations.Salt sensitivity actually applies to a subset of people—estimated at 25–50%; many individuals exhibit minimal blood pressure changes regardless of sodium intake (salt-resistant) .Large observational studies like PURE (Prospective Urban Rural Epidemiology) found a J-shaped curve: very high sodium was harmful, but so was very low sodium intake. Cardiovascular risk was lowest in moderate intake ranges .Individual variability matters—kidney function, age, insulin resistance, and genetics significantly modify how sodium affects you.So, the blanket statement “salt causes hypertension” is outdated and overly simplistic.Insulin Resistance: The Hidden Driver of Sodium RetentionInsulin controls how your kidneys handle sodium. In hyperinsulinemia states, the kidneys retain more sodium, increasing blood volume and pressure .Additionally, insulin may activate the sympathetic nervous system, tightening blood vessels and further raising blood pressure .This implies many with hypertension are “insulin-sensitive” rather than “salt-sensitive.” Addressing insulin sensitivity—with diet, movement, sleep, and stress reduction—can impact blood pressure independently of sodium intake.Sodium + Potassium: The Balancing ActPotassium counters sodium. It helps the kidneys excrete excess sodium and relaxes blood vessels. Diets low in potassium, which are common in the Western diet, worsen sodium’s effects on blood pressure .Traditional diets rich in fruits, vegetables, beans, and tubers naturally provide this balance.The DASH diet (Dietary Approaches to Stop Hypertension) lowers blood pressure in part by emphasizing potassium-rich foods—even without extreme sodium restriction.How Much Sodium Do We Really Need?General Guidelines (Non-Training Days)The AHA recommends up to 2,300 mg/day (≈1 tsp salt), aiming toward 1,500 mg/day for those with hypertension .The PURE study suggests lowest cardiovascular risk with 3,000–5,000 mg/day, depending on potassium and metabolic health .Training Days / AthletesSweat can lose 500–2,000 mg sodium per liter. Endurance athletes, especially in heat, may need 3,500–5,500 mg/day or more.Guidance:90 min intense/hot: ~500–1,000 mg sodium/hour.Signs You’re Getting It WrongToo little sodium (relative to need):Dizziness, headaches, muscle crampsBrain fog, fatigue, nauseaFrequent urination with very clear urineIn extreme cases: hyponatremia—an emergencyToo much sodium (chronically):Elevated blood pressure in salt-sensitive individualsBloating, swelling (hands, ankles)Constant thirstThe Type of Salt Matters (But Not As Much As You Think)Your body cares about sodium, not crystal color—but the form of salt has context:Iodized table salt: Adds iodine (essential for thyroid health).Sea salt / Himalayan pink salt: Trace minerals present but negligible nutrition-wise; sodium per gram nearly identical to table salt.Kosher salt: Larger crystals, great for cooking; often lacks iodine.Electrolyte salts: Blend sodium with potassium and magnesium—useful for athletes and hot training days.Specialty salts may taste or look different, but they don’t alter sodium’s effect on blood pressure or physiology.Smarter Sodium StrategiesSalt whole foods—not processed ones. 70–80% of dietary sodium comes from packaged and restaurant foods, not your shaker.Boost potassium. Incorporate avocado, beans, leafy greens, yogurt, and squash.Control insulin. Prioritize exercise, protein-forward whole foods, sleep, and stress management for better sodium handling.Use the right salt for your iodine needs. If seafood isn’t in your diet, iodized salt is important.Personalize intake. Monitor blood pressure at home over 2–4 weeks as you adjust sodium and lifestyle.Sample Day FrameworksBalanced Rest DaySodium Targets & Strategy ~2,000 mg sodium totalBreakfastGreek yogurt + salted pumpkin seeds (~250 mg)LunchChicken salad with olives, feta, vinaigrette (~600 mg)SnackCottage cheese with cucumber (~400 mg)DinnerSalmon, roasted potatoes, green beans, pinch of sea salt (~750 mg)Hot Training Day~3,500 mg sodium totalPre-WorkoutWater + pinch of salt + half a banana (~200 mg)During TrainingElectrolyte drink (~1,000 mg sodium total)Post-Workout MealRice bowl with steak, salsa, avocado (~900 mg)DinnerSoupy stew with chicken and vegetables (~1,000 mg)SnacksPickles/olives if craving salt (~400 mg)FAQsQ: Does salt cause high blood pressure in everyone? No. Only 25–50% are salt-sensitive; insulin resistance, age, and low potassium often play larger roles .Q: Should I avoid all processed foods? Not necessarily—but since most sodium comes from processed sources, cooking at home gives you control.Q: Is Himalayan salt healthier? Not for sodium content. Its trace minerals are negligible. If iodized salt isn’t used, ensure iodine from seafood or dairy .The TakeawaySodium is essential, not evil.Insulin resistance and low potassium drive hypertension more than salt alone.Most people do well with 2,000–3,500 mg/day, though athletes and hot-weather exercisers may need more.Personalization beats one-size-fits-all.Prioritize whole foods, metabolic health, and mindful sodium intake.ReferencesSalt sensitivity estimates and individual variation in blood pressure responsePURE study findings on J-shaped sodium-risk curveInsulin’s effect on renal sodium retentionInsulin, sympathetic activation, and blood pressurePotassium’s sodium-excretion effect and guidelinesAHA sodium intake recommendationsNIH iodine guidelines for iodized saltSodium sources — processed vs home-cooked (widely reported estimates) …and based on prior evidence and dietary surveys.

10.16.2025

Understanding SIBO: How It Starts and How to Reverse Its Effects

Small Intestinal Bacterial Overgrowth (SIBO) is a condition where bacteria from the colon overpopulate the small intestine, leading to bloating, gas, malnutrition, and a host of frustrating symptoms.1. What is SIBO—and How Does It Begin?The small intestine typically has very few bacteria, thanks to protective mechanisms like stomach acid, bile, digestive enzymes, and intestinal motility. But when these systems break down, bacteria can thrive where they shouldn’t.Protective barriers include gastric acid, bile, digestive enzymes, the migrating motor complex (MMC), intact ileocecal valve, and immune defenses (e.g., secretory IgA) PMC+15NCBI+15Dr Stavy Nikitopoulou+15.When they fail—due to low stomach acid, enzyme insufficiency, anatomical changes, autoimmune conditions, hypothyroidism, diabetes, scleroderma, IBS, or post-infectious gut damage—SIBO can take hold NCBI.Other common triggers include prior food poisoning, medication use (like PPIs or painkillers), and structural issues like surgeries or fistulas Health.2. Common Symptoms & Diagnostic ChallengesPatients with SIBO often experience:Bloating, abdominal pain, diarrhea or constipation, and nutrient malabsorption IFN Academy+15PubMed+15stevegranthealth.com+15Health.Nutrient deficiencies—particularly in iron, B12, folate, fat-soluble vitamins A, D, and E—due to impaired absorption EatingWell+1.Extraintestinal symptoms like fatigue, brain fog, and skin conditions (e.g., rosacea) EatingWell.Diagnosing SIBO is not straightforward. While the jejunal aspirate culture is the gold standard (detecting >10^5 bacteria/mL), it’s invasive and often impractical PMC+12Wikipedia+12Health+12. Instead, breath tests measuring hydrogen and methane are commonly used, though they come with false positives and variability Verywell Health+2Wikipedia+2.3. Reversing SIBO—A Functional Medicine BlueprintRoot-Cause HealingThe functional medicine approach looks beyond symptoms to heal underlying causes:Evaluate triggers like digestive motility issues, immune dysfunction, enzyme insufficiency, dysbiosis, or structural dysfunctions functional-medicine.associates+7PubMed+7thechi.ca+7stevegranthealth.com+1.Treating the underlying cause—not just the symptoms—is essential for long-term resolution PMCPubMed.Clinical & Therapeutic StrategiesEradicate OvergrowthAntibiotics: Rifaximin is often preferred; neomycin may be used for methane-predominant cases PMC+1.Herbal antimicrobials: Emerging evidence indicates they can be as effective as rifaximin The Institute for Functional Medicine+1.Dietary InterventionsLow-FODMAP diet can reduce fermentation and symptoms—but isn’t meant for long-term use due to potential negative effects on gut microbiome diversity WikipediaVerywell Health.Elemental diet (a pre-digested liquid formula) can starve bacteria while nourishing the body—shown to normalize breath tests in up to ~85% of cases over 14–21 days Wikipedia.Supportive TherapiesProkinetics to restore MMC function and prevent recurrence Wikipedia+1.Targeted supplementation for underlying deficiencies (like B12, iron, or fat-soluble vitamins) Health+1.Probiotics: Can be effective when timed appropriately—e.g., Lactobacillus strains post-antibiotic therapy PMC+3Wikipedia+3Health+3.Functional Medicine Clinical ModelIdentify the root cause (motility, acid/enzyme function, immune, structural).Eradicate the microbial overgrowth using herbal or pharmaceutical interventions.Rebuild and rebalance gut health with nutrition, prokinetics, nutrients, and microbiome support.Monitor and prevent recurrence with periodic re-evaluation and maintenance strategies Wikipedia+10NCBI+10Rupa Health+10PMC+4PubMed+4EatingWell+4.4. Why Functional Medicine Delivers ResultsUnlike single-solution strategies, this approach:Addresses multiple layers—digestion, motility, immune function, gut microbiota, and structural health.Seeks long-term remission by fixing root causes, not just suppressing overgrowths.Uses rotation of therapies (diet, elemental, antimicrobials, prokinetics) to minimize recurrence risk EatingWell+5NCBI+5Wikipedia+5. Supplements for SIBO Recovery1. Antimicrobial Phase (Eradicating Overgrowth)(Typically 4–8 weeks, guided by a practitioner)Herbal antimicrobials (shown in studies to be as effective as rifaximin):Oregano oil (enteric-coated) – broad spectrum antimicrobial【PubMed: PMID 24891990】Berberine (from goldenseal/barberry) – antibacterial, antifungal, anti-inflammatory【PubMed: PMID 33274096】Neem – supports bacterial balance, especially methane SIBOGarlic extract (allicin) – targeted against methane-producing archaea【PubMed: PMID 16842559】Caution: These are potent — best rotated or combined under guidance to prevent resistance and minimize die-off symptoms (Herxheimer reaction).2. Motility & Prevention (Keeping the Gut Moving)(Supports the Migrating Motor Complex, MMC — prevents relapse)Prokinetics (usually at night, after antimicrobial phase):Ginger extract (1–2 g/day) — stimulates gastric emptying5-HTP or low-dose melatonin — modulates serotonin, improves motilityIberogast (herbal blend) — clinically shown to support MMC function【PubMed: PMID 15836424】Optional: prescription prokinetics (prucalopride, low-dose erythromycin) if natural support isn’t enough.3. Gut Lining Repair (Reduce Inflammation, Support Absorption)(Rebuilds the intestinal barrier after bacterial damage)L-Glutamine (5–10 g/day) — primary fuel for enterocytes, reduces permeability【PubMed: PMID 26447961】Zinc carnosine — promotes mucosal healing【PubMed: PMID 23028914】Collagen peptides or bone broth — provide glycine and proline for gut repairAloe vera extract or slippery elm/marshmallow root — soothing botanicals for irritated mucosa4. Rebalancing the Microbiome(Usually added after antimicrobials, otherwise may worsen symptoms)ProbioticsSoil-based strains (Bacillus species) are better tolerated early onLactobacillus & Bifidobacterium blends can be reintroduced laterSome studies show probiotics may improve breath test results and symptoms post-treatment【PubMed: PMID 28708949Prebiotics: Introduce slowly (e.g., partially hydrolyzed guar gum, PHGG) to support long-term microbiome diversity once stable5. Nutrient Repletion (Fixing Deficiencies Caused by SIBO)Because SIBO often leads to malabsorption:B12 (methylcobalamin or injections if deficient)Iron (if ferritin

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