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Episode 85: Fueling Fitness

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Dr. Sophie Macleod, ND shares her knowledge around using nutrition and exercise to gain muscle mass in the wake of diet culture.


The content of this podcast has not been evaluated by Health Canada or the FDA. It is educational in nature and should not be taken as medical advice. Always consult a qualified medical professional to see if a diet, lifestyle change, or supplement is right for you. Any supplements mentioned are not intended to diagnose, treat, cure, or prevent any disease. Please note that the opinions of the guests or hosts are their own and may not reflect those of Advanced Orthomolecular Research, Inc.

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Welcome to Supplementing Health, a podcast presented by Advanced Orthomolecular Research. We are all about applying evidence based and effective dietary lifestyle and natural health product strategies for your optimal health. In each episode, we will feature very engaging clinicians and experts from the world of functional and naturopathic medicine to help achieve our mission to empower people to lead their best lives naturally.

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[01:10] Cassy Price: Welcome to Supplementing Health. Today I am joined by Dr Sophie Macleod, Naturopathic Doctor, an outgoing and energetic hardworking individual with an expanse of experience and education in the health and fitness industry. Her passion for health was ignited from a young age when she was only 18 years old when she became a certified personal trainer. She continued to pursue her passion for health by completing her degree in human kinetics and a doctorate in naturopathic medicine. She has become a certified sports nutritionist and she is here to share her expertise in using nutrition and exercise to gain weight and muscle mass particularly for young athletes and menopausal women. Welcome Sophie, thanks for joining me.

[01:49] Dr. Sophie Macleod: Hi. Thanks so much for having me.

[01:51] Cassy Price: Before we dive into the topic, I would love to know what really gave you this passion that you followed throughout your career?

[02:00] Dr. Sophie Macleod: Absolutely. The passion for naturopathic medicine and health and fitness all came intrinsically from within throughout my whole life. It is something that I followed my interests and followed my curiosity. I always wanted to learn more and that eagerness to learn turned into education and that education turned into a career. It really came down to also how I was brought up with my family. My sister is a naturopathic doctor. My father is a clinical pharmacist. I always had those influences in my life that landed me where I am today.

[02:44] Cassy Price: Awesome. We know that obesity has become an epidemic and it is detrimental to long terms good health. Most often when we are talking about weight management it is talking about being synonymous with weight loss however that isn’t always the case. How often do you see clients looking to gain weight or increase muscle mass rather than lose weight?

[03:07] Dr. Sophie Macleod: Absolutely. I am so happy that we are talking about this topic and this discussion today because it really is pushed under the rug because there is such an emphasis on weight loss as supposed to weight gain. It is not something I have ever actually – very seldom people will come to me asking for help gaining weight. It is something that I bring up with my patients. There are certain populations in particular that I emphasise this in our treatment protocols. Age related sarcopenia or muscle loss is huge. We see that, like you mentioned, post-menopausal, we see declines in muscle mass. Those at risk of osteoporosis or have osteopenia. Anyone who is also a cancer patient or going through treatments, we want to maintain their muscle mass and maintain their weight. That is very important as well. Someone that has a history of eating disorders we have to have these discussions around how to maintain weight and do that in a healthy manner. Chronic disease, there is a lot of different factors and a lot of different populations. Athletes, like you said, that could really use help and guidance in this area. It is really hard to find health care providers who can actually support them in that.

[04:37] Cassy Price: When you are working with these different kind of patients do you recommend protocols for them as far as diet and nutrition go, vary depending on which of those motivators or conditions they come to you with?

[04:50] Dr. Sophie Macleod: Absolutely. It is one piece of the big puzzle in terms of what their treatment protocols is, whether we are working on gut health, their hormones, their mental health, right? On the side I would say that we also need to work on helping you to increase your muscle mass, right? We know that we want to do this work preventatively. I don’t want to see someone come into my office that has osteoporosis or has just found out from their doctor that their bone scan came back and their results were not good. I want to have this discussion with patients now, so we are preventing that from happening in the future. A big part of it is education I find. It is education on the importance of maintaining muscle mass, the importance of what the risk factors are when we see muscle mass decline later in life. It comes down to that education piece first before we start implementing the treatment protocols.

[05:56] Cassy Price: I think because of the diet culture that most of us are used to, calories are thought of as the main thing to focus on and so in theory more calories would mean more weight. It is really not that simple when it comes to putting on healthy weight, is it?

[06:14] Dr. Sophie Macleod: Yeah. It is a good question. There is a huge anti-diet movement. There is a huge momentum in the way that we don’t want to think about the diet as just calories, we want to think about what we are actually consuming and the macronutrients and what types of foods we are actually putting into our body which is very important. When we think about putting on weight or adding muscle mass, calories are very important. It is a huge part of the conversation. Now what we are seeing is that the majority of people right now who are trying to lose weight are putting themselves in a pretty significant core deficit. They are decreasing their calories significantly or they are fasting. I have had people come in who have been fasting for very long periods of time. What they have to understand is that when you are fasting, when you are in a negative core balance, you are not doing it properly, you will be a negative nitrogen balance. Essentially, your body will start pulling from the muscle and actually breaking down the muscle to retrieve those essential amino acids that we are not getting from consuming our food because we are not eating enough, okay? That is a huge aspect of the caloric picture. One, how much protein are you getting in that time that you are eating and is it enough?

[07:43] Dr. Sophie Macleod: Back to the calories, when someone is trying to put on weight or someone is struggling to put to put on weight; let’s say a 60-year-old post-menopausal woman with history of fractures who is teetering on that osteopenia/osteoporosis and struggling to get enough food in, just struggling to eat enough. That is a huge obstacle when it comes to increasing our muscle weight and muscle mass because everyone has a lot of fears around food and types of food and what they should be eating. Ultimately, we are trying to put on muscle weight and we are trying to gain weight you have to be eating enough. Usually that looks like 200-400 kilocalorie increase daily to be able to see increases in your weight or muscle mass.

[08:41] Cassy Price: Interesting. How much of that 200-400 calorie increase should be coming from increased protein?

[08:48] Dr. Sophie Macleod: I would look at it less from the 200-400 calorie increase and more look at from the daily picture and we can talk about protein on its own. Those calories would just be any calories essentially just to make sure you are eating enough and then we can talk about that protein. The protein when we look at the requirements they will depend on the entire day and what you are consuming throughout your day.

[09:19] Cassy Price: Okay, then overall is there a specific percentage that you want from protein if you are trying to increase muscle mass, or would that percentage stay the same regardless of what your body composition goals are?

[09:33] Dr. Sophie Macleod: Absolutely. Let’s get into protein because this is one of the biggest factors that we see for someone not being able to put on muscle mass or not being able to increase their weight. When we look at what the protein requirements are our daily protein requirements, we always look above or beyond our RDA. The RDA in Canada is 0.8grams per kilogram and time and time again we see that does not work for the entire population. Definitely not someone who is starting to see decline in their muscle mass or predisposed to any chronic illness, fatigue, athletes. It is just not enough. What I do in my practice, I use a reference range. The number value for the grams per kilogram that I give to a patient will depend on where they are at. It is a lot more individualised. I will take an inventory of their diet. Let’s say this 60-year-old woman that I was talking to you about. Let’s say she weights 120lbs. That weight right there is around 55 kilograms, okay? If I say to her you have to get 1 gram per kilogram of body weight per day, that is 55 grams. To some people that might be okay. Maybe she is already getting more than that. To some people that might be like “oh wow”, they were only getting 30 grams per day depending on how much they are eating. First, we have to look at how much protein they are eating and how we can start increasing that because although we have these numbers and these goals which are great, it is unrealistic to say someone who is only eating 30 grams per day to go to 120, okay? The range will depend on their body weight first. It is grams per kilogram. The range that I always go with is minimum 1.3-2.2 grams per kilogram. That is why I use a large range because it depends on what the baseline of their diet is and what they are actually able to consume throughout the day. It depends on what their goals are. More of an athlete body building, I would be on that higher end of the range verses someone I am just trying to get to consume more calories, I would put them at more of a 1.5 grams per kilogram of protein per day.

[12:08] Cassy Price: Does it make a difference if it comes from vegetarian sources verses animal sources?

[12:15] Dr. Sophie Macleod: Yes. it does. The animal sources are a little bit easier to digest and absorb. Plant proteins can have some difficulty with absorption. Plant proteins you get a lot more fibre, so you get a lot more of those benefits of having more plant fibre and legumes and all of those great things. However, the animal protein has a different amino acid profile, so it has a little bit more of that protein digestibility. A mix is great. If you are vegetarian or vegan, we can chat and I will discuss the importance of losing the amino acid that is most known for stimulating muscle protein synthesis. A variation is great. It is always great to consume more plant proteins in your diet, absolutely. If you are consuming animal products and meats as well, I think that is a great way of supplementing your diet.

[13:12] Cassy Price: if you are in a calorie deficit, does supplementing with protein or BCAAs help to prevent that nitrogen deficiency that you were discussion?

[13:21] Dr. Sophie Macleod: Yes. Anyone can benefit from utilising a protein supplement. Most people aren’t getting or hitting that value about the RDA, the 1.5g-2.2 grams per kilogram that I was discussion. A lot of people don’t know what their average protein intake is throughout the day. Using a protein supplement absolutely is helpful for that. We can go through which protein supplements exactly because the same question you asked before about the animal verses the plant proteins, a whey protein, a casein protein, or a paleo protein. The amino acid profile in those protein is different from a pea or a brown rice or a hemp seed protein. That is the reason why when they have done the research about what protein is best for stimulating muscle protein synthesis, what protein is best for helping someone to increase their muscle size in response to exercise? Whey protein has always beat the other proteins. Way better than soy. Way better than brown rice. Why is that? It is because it has a high leucine content. You do not need to supplement with BCAAs to see an increase in your muscle protein synthesis. People still will buy BCAAs all the time but it is not necessary if you are taking a protein supplement like a whey protein or casein protein. If you are going to use vegetarian or a vegan protein like a brown rice protein, I always look at the amino acid profile. Look at the amino acid profile, take out your protein that you have at home, take it off the shelf, look at the back of it, look at how many grams of Lucene are in it. if it doesn’t have at least 2 grams of Lucene per scoop then you could consider using a BCAA. Then you could consider adding in Lucene on top of that to help stimulate that protein synthesis. Otherwise, all of the research on BCAAs is not very supportive of the use in humans to increase muscle protein synthesis. The results and data is pretty negligible. If you are going to make a choice to what to spend your money on, spend it on the protein.

[15:44] Cassy Price: Okay, that makes sense. Another fad or popular diet right now is going keto especially for weight loss. How do those fads effect weight gain?

[16:02] Dr. Sophie Macleod: It is a little bit of a different topic because that is like rebound weight gain because what happens is when you put your body in such a negative core balance, you lose weight rapidly and you are declining all of that muscle glycogen and you start to lose weight, your basil metabolic rate, BMR, your daily energy expenditure starts to decline in response to that decreased caloric intake. What is going to happen is that rebound weight gain is going to come once you start consuming more calories, your body is going to start putting it into storage. Less about how we can add it in and more for just the responses. I would say that if someone is trying to gain weight I would say avoid any of those types of diets. It really comes down to the macronutrients and protein intake and additional other supplements to help increase that muscle protein synthesis.

[17:08] Cassy Price: What other supplements would you consider for someone who is trying to gain that weight beyond the protein supplement?

[17:16] Dr. Sophie Macleod: Creatine Monohydrate would definitely be my number one. I use it a lot in my practice. It is one of those supplements that unfortunately has been disregarded as just being a supplement for people who are working out six times a week and lifting weights, yes, absolutely they should be taking them. I am talking about using creatine in post-menopausal women, women with osteoporosis anyone with age relates sarcopenia, cancer and those sorts of things. Creatine Monohydrate has so much research and evidence to support its increase in muscle protein synthesis as well as increasing performance. It helps to build muscle and it helps you to feel better. There is research on the cognitive health too. All round it is a great supplement as well as the safety of it. the safety profile is great. They are using it in older populations and the younger populations. The one risk is in extreme kidney failure, so you want to be monitoring kidney function if you are in a population that has kidney disease, otherwise the safety is great. It is pretty inexpensive, and it is easy to take. You take 5 grams per day. You can see really great results with that. I have a lot of post-menopausal women who are not just trying to gain weight but for weight loss protocols because I want them to put on muscle too and not lose muscle if they are trying to lose weight. It goes hand in hand for both of those.

[19:00] Cassy Price: Interesting. Do you use timed nutrition at all with your clients?

[19:05] Dr. Sophie Macleod: Absolutely. I did a specific podcast on this previously when I was talking about specifically how I use sports nutrition in my practice. Sports nutrition is all about the three Ts which is essentially the type of food you are consuming, the total energy intake or the calories and the timing so when you are consuming those calories as well. When it comes to weight gain and putting on muscle mass the timing is going to be eat as much and as frequently as possible, in the simplest of terms because a lot of people think that if they want to gain muscle they should eat a huge meal right after they do a workout but all of the research now is supporting spreading your protein and energy intake throughout the day. The value that I gain from my daily protein intake was about 1.5 grams per kilograms of body weight – 2.2 grams per kilogram per day just to give patients a target of what they can calculate. I actually always provide a protein target per meal as well. This really helps with the timing and the frequency as well. Usually that value is going to be between 0.2-0.5 grams per kilogram. Once again when we look at a value like that it always depends on the person. It always depends on the goals. We can start low but on average that would equal 20-25grams of protein per meal. If you are exercising after work at 5pm and you are like “okay, I will just have my protein shake after my workout” it actually matters what you had for breakfast and lunch that day. It matters what you had before and after, right? You have to look at that whole picture. That is a huge component of sports nutrition. It is timing out your meals especially for recovery to make sure you are stimulating that muscle growth after you exercise.

[21:15] Cassy Price: Do you think exercise and nutrition are equal when it comes to this weight gain or should be favour diet over exercise?

[21:28] Dr. Sophie Macleod: It is definitely not one or the other. If someone is trying to gain weight the energy intake would win over the expenditure obviously because we would want to get those calories in. The exercise component is really important too. A lot of people totally disregard the fact that we do need to be doing weight bearing activity in order to stimulate muscle growth. In order to build muscle, you need to be doing weight bearing activity. Strength training is a huge component of my protocols and that is from my background of kinesiology as a trainer I can actually prescribe specific exercises based on what we are looking to do whether I have a patient who is prone to falls or at risk of fractures then we have to strengthen their balance and strengthen their glutes and that sort of thing. That is the strength component of it, but you need to have both. I explain this to my patients that you need to have that external and internal influence on that muscle growth. You need to be doing training that is going to help stimulate the muscle but you also need to be eating properly to help build that muscle.

[22:47] Cassy Price: How does sleep and recovery play into this? Obviously, when you are a high-end athlete or any athlete and you are putting a lot of energy expenditure your body naturally needs that time to recover but if it is more around that dietary portion is there still the same need for sleep and recovery as you are trying to lose weight?

[23:09] Dr. Sophie Macleod: Absolutely. There is probably even more of an emphasis on that if someone is trying to build muscle to get enough sleep. How I explain it is that when you are sleeping your body is finally in this anabolic state, it has the opportunity to build as supposed to break down. That is why especially in young athletes, when they are secreting all of the growth hormone, testosterone in our deep sleep, all of those anabolic hormones that help us to build and store and support our body in that way all happens while we sleep. The sleep quality is very important. Additional ways in my practice that I utilise to help increase that anabolic state while we sleep is actually a pre-sleep feed. You can actually do a pre-sleep protein shake. Like a Casein or a slow-release protein, or a whey protein, before you go to bed to help also increase that muscle protein synthesis. It does two things. If someone can’t get enough calories or protein throughout the day we say “okay, you can have a shake before you go to bed.” Research supports that also increases muscle protein synthesis. They have to be sleeping well first before we add anything in. that is definitely just as important in the weight gain verses weight loss.

[24:39] Cassy Price: Do you use any supplementation when you are trying to get patients to have a better sleep hygiene as well?

[24:48] Dr. Sophie Macleod: Yes, we do a magnesium glycinate as a big part of the protocols. It really depends on the person what we would prescribe but absolutely we would add that to the protocol.

[25:02] Cassy Price: Awesome. I really appreciate you taking the time to chat with me. If our listeners are looking to work with you, what would be the best way for them to get in touch?

[25:11] Dr. Sophie Macleod: Absolutely. You can find me at Nutrichem in Ottawa. It is a compound in pharmacy and clinic. My Instagram is @drsophispm. You can always DM on there if you have any further questions or want to book an appointment with me as well.

[25:34] Cassy Price: Fantastic. Well, again, thank you so much for chatting with me again today I really appreciate it.

[25:36] Dr. Sophie Macleod: Thank you so much.

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Thank you for listening to Supplementing Health. For more information about our guests, past shows, and future topics, please visit AOR.ca/podcasts or AOR.us/podcasts. Do you have a topic you want us to cover? We invite you to engage with us on social media to request a future topic or email us at [email protected] We hope you tune in again next week to learn more about supplementing your health.

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