What is metabolic testing ?
The million dollar question on everyone’s mind, “what is metabolic testing ?” Many people have heard the term but have no clue what to expect when they come in to have their metabolism tested. The goal of this blog is to clarify this information and tell you exactly how to prepare for the testing to ensure the best results.
Trust me – there is absolutely nothing remotely scary about having your metabolism tested. Think about it like a walk in the park compared to things like a oral glucose challenge or the fun 18 viles of blood you had pulled for your PCOS panel. In fact – I can almost guarantee you will be skipping out of my office with the new information in hand like a kid on Christmas day.
First things first, metabolism testing does not hurt. I promise! We don’t draw blood. Also there is NO physical exertion involved. In the past, I have had patients show up in their workout gear thinking they were going to participate in something that might resemble a stress test. This is certainly not the case. So no worries you can leave your running shoes at home!
The device we use to measure your metabolism is called the Bodygem. This device measures your metabolism by capturing the air you breath.
Sounds pretty easy? Well it is.
Three things to do to prepare for the metabolism test:
Come fasted with no caffeine in your system for 4 hours prior to your test. You can drink plenty of water though!
Please don’t exercise within 4 hours of the test.
Arrive not having smoked a cigarette within 4 hours of the test.
Caffeine, exercise, and nicotine all can slightly increase your metabolic rate. Therefore, we do our best to minimize these variables so we can deliver you the most accurate results.
Curious about what other factors might influence your metabolism? Check out last week’s informative blog “RMR Testing 101” on this exact topic.
The actual test
Once you arrive we will get you all set up! You will sit peacefully in a chair with a small mouth tube in your mouth and a cute little nose clip on. The goal of the nose clip is to create a vacuum seal so no air escapes.
I promise, I will not post any Facebook pictures with your sexy nose clip on:)
By measuring both the amount of oxygen you exhale and the amount of carbon dioxide you expire we are able to calculate your metabolism. It’s that simple. This method is called indirect calorimetry and is one of the most accurate ways to measure metabolism. The test itself takes about 10 minutes.
Like I mentioned, the test does not hurt. However, some people find it uncomfortable as you need to breathe through your mouth for the duration of the test. However, I am pretty sure you have been through worse.
Once the test is complete we need to talk goals. Generally speaking most patients with PCOS only have one goal – to lose weight. Therefore, the next step will be to weigh you and test your body fat. That way we have a starting point for you to gauge your progress.
Next, we will gather your demographics. Factors such as your age, sex, occupation, type and frequency of exercise, and even your sleep patterns are all important variables in determining an appropriate calorie level for your goals. All this information is then entered into a software program which then generates several important numbers.
The Bodygem tells us the following:
Exactly how many calories you need to take in on the days you workout
Exactly how many calories you need to take in on your non-training (rest) days.
How you compare to other individuals with the same demographics
Once we have this important information I can then specifically tell you where your calories need to be to accomplish your weight loss goals. I can also make suggestions on your macros if that is something you are interested in. If you need help setting up these numbers in a tracking program like MyfitnessPal I am happy to help guide you as well.
If you need additional services like a customized meal planner with specific meal suggestions or guidance on how to incorporate carbohydrate cycling or intermittent fasting these can all be provided at an additional fee.
The entire metabolic test plus the consult should take no longer than 45 minutes. You will leave with a personalized print out with your results and a solid knowledge of what is metabolic testing really entails. No guesswork involved!
On next week’s blog we will dive deeper into the results. We will interpret the results of three actual Bodygem results and discuss how to apply the information. So now when someone asks you the question, ” what is metabolic testing ” you will be able to give them a A+ answer 🙂
P.S. The icing on the cake is if you purchase the metabolism test during the month of July you will be entitled to a 40 % discount for my birthday. Just use coupon code thisis40 when you schedule your metabolism test on www.amyplano.com to receive the discount. However, act fast as this discount will only be around until July 31, 2018.
Have questions on metabolic testing? Please don’t be shy! Ask in the comments section below.
Are you unable to lose weight in spite of vigorous exercise and a disciplined training schedule? Are you looking to maximize your performance yet feel like despite all your efforts you are failing miserably? Have you hit a plateau in your weight loss? Would you like to take the “guesswork” out of determining your calories to achieve your goals? Well if you answered “heck yes” to any of the above questions then you are likely the perfect candidate for RMR testing.
What is Metabolism
First things first, before we talk about RMR testing and why it is so friggin’ important we need to define metabolism. Did you know that even when you’re at rest, your body needs energy for its “silent” functions? These include breathing, circulating blood, adjusting hormone levels, and growing and repairing cells. The number of calories your body uses to carry out these basic functions is known as your basal metabolic rate (BMR) or more often referred to outside of a clinical setting as resting metabolic rate (RMR).
There are many factors which determine our metabolism. Some include:
Your body size and composition.
People who are larger or have more muscle burn more calories. Even at rest these folks tend to have higher RMR’s.
Men usually have less body fat and more muscle than do women of the same age and weight. This means men burn more calories at rest (Boo!). But don’t worry, I will be sharing some tips for how us chicks can optimize our metabolisms.
As we get older (sigh), the amount of muscle we carry tends to decrease. Fat accounts for more of our weight, slowing down calorie burning.
[Truth bomb: If you consistently work out with weights you can help off-set some of this loss 🙂 ]
Two other important factors that determine how many calories your body burns each day:
Food processing (we call this thermogenesis!)
Did you know that digesting, absorbing, transporting and storing the food you consume also expends calories? Score! About 10 percent of the calories you burn each day come from the digestion and absorption of food and nutrients.
Physical activity and exercise accounts for the rest of the calories your body burns up each day. It comes as no surprise that physical activity is by far the most variable of all the factors.
The changes in overall body mass (increase or decrease) ultimately comes down to long-term energy balance which is represented by energy in (via food) and energy out (via metabolic rate). Total energy expenditure is determined by many factors including: body composition, sex, age, thermogenesis and physical activity. Having ‘good’ genetics certainly doesn’t hurt either! So now that you are a master of ‘all terms metabolism’ let’s get down to business.
Here are my top three reasons for why getting your RMR tested is SO important to achieving your body composition and training related goals
1. Takes the guesswork out.
By having your metabolism tested by a professional you never need to ask yourself the annoying questions, “How much or little should I be eating ?!?”
How many times have you entered your height and weight into an online metabolism calculator only to get some crazy number which you have no idea how to interpret?
I cannot tell you how many times patients come into my office following a calorie level that is completely wrong for the goals they are trying to accomplish. This frustrates the heck out of me. It’s not that they are unsuccessful for lack of trying. It’s simply because they have been provided with the wrong information.
By testing your RMR you will now know the exact number of calories your body needs to accomplish your dietary and fitness related goals. There is no more guessing or even second guessing where your calories need to be! Through the use cutting edge technology we can help you determine the exact amount of calories you need to reach your goals. Headache solved!
2. Gives you an accurate baseline.
If you don’t know your baseline calorie needs how do you know if what you are doing is ‘working’?
You have got big goals which I love and admire. However, how can you accomplish your long-term goals if you don’t know where your baseline needs currently are? Testing your metabolism before you make significant changes to your exercise and/or training routine can provide you with a solid foundation in which to make adaptations. Therefore, as things like your body composition, weight and/or performance markers change over time you can adjust your calories relative to your new goals.
Independent of what our specific goals are we all need a caloric starting point. If we don’t have a baseline and we start making changes to our diet how can we tell what specific calorie level is working? Simply put – we can’t.
Therefore, by testing your RMR before making any significant dietary and/ or training changes you are armed with an accurate, reliable calorie level to base your goals on.
3. It helps you when you are stumped.
Knowing your RMR gives you clarity in those moments when no matter how hard you try – you just cannot seem to tackle your dietary and/or fitness goals.
Knowing your your RMR can be critical when you are stumped. As mentioned previously many people base their goals around a calorie level that is not in tune with their goals. Along with the headache this creates can come a massive amount of frustration. Unfortunately, if you have been there you know exactly what I am talking about 🙁
Trying to gain lean muscle mass but struggling like crazy? It could be that your calories are too low. We all know that in order to build anything we need ‘extra’ resources, right? That extra might be money, resources or time. Same goes for putting on muscle. In this case, the extra needs to be in the form of calories. Therefore, for someone aiming to put on muscle they need to FIRST make sure they are taking in enough calories to do.
On the flip side, do you feel like you are at a weight loss plateau? Are you meticulously counting calories, carbs, protein and everything under the sun and still not losing weight? Is MyFitnessPal definitely not your pal? For most people the simple answer is their calories are not in tune with their weight loss goals. It could be that their calories are too low. Or it could mean that their calories are too high. How the heck will they know unless they actually test their metabolism?
Knowing your unique RMR for the different ‘seasons’ can help optimize your nutrition during both your off-season and peak training periods. During training, you need to make sure you are taking in enough calories to support not only your training but your ideal body composition for your sport. It’s no surprise when an athlete is not taking in enough calories how quickly they feel the side effects. Unintentional weight can lead to fatigue, burnout and injury. All of these can be factors can be minimized if not avoided entirely.
Case in point – I rest my case. Plain and simple – anyone with a performance or body composition related goal should have their metabolism tested. And truth be told I don’t know a whole lot of people who don’t share these goals (especially the later!) By testing your RMR you will no longer be ‘spinning your wheels.’ The precise tools you need to determine the exact calorie level to fit your specific goals is attainable. And just like Jim Rohn’s stated, “When you know what you want and you want it bad enough, you’ll find a way to get it.”
P.S. Did you know we are running a 40 % discount on RMR testing for the month of July? Use the coupon code thisis40 when scheduling your metabolism testing under the ‘appointments’ tab on our website www.amyplano.com
P.P.S. What are you waiting for? This fantastic deal will not be around forever. Cut through all the confusion and get the numbers you need.
P.P.P.S. Does any of this mumbo-jumbo about RMR testing resonate with YOU? If so, in what way? Share your thoughts in the comments below. We ♥ to hear your thoughts. Don’t be shy – we don’t bite.
So it is true … this girl right here turns 40 years old on Friday, June 29th. And what better way to celebrate my 40th then with YOU my loyal readers. So how would you like to receive a present from me? How does a 40 % discount on a metabolism test to celebrate this fabulous occasion sound? I don’t know about you but it sounds pretty dang awesome to me.
Heading into the next decade can be a drag. So rather than have a pity party for myself I decided to give you a pretty sweet present to mark this milestone birthday – 40 % off metabolism testing for the whole month of July. Whoot! Whoot!
For the whole month of July redeem coupon code thisis40 when scheduling your metabolism test to receive 40 % off each individual test. The normal rate for a metabolism test is $150.00. Therefore, by redeeming the code thisis40 you save yourself 60 bucks! If that is not pretty sweet – then I don’t know what is.
Important note: In order to receive the most accurate reading on the metabolic test you should be fasted (no food), with no exercise or caffeine within 4 hours of your test time. You can drink plenty of water – just nothing with caffeine or calories.
Below are the steps to redeem your discounted metabolism test:
- Click HERE and you will be re-directed to the scheduling section of this website.
- Click the link for “Metabolism Testing” under appointments.
- When the prompts ask you “with” who you would like to schedule you can choose either myself or my fabulous RD Audrey. The discount applies to us BOTH.
- Select the time slot you would like to come in for your metabolism test.
- Next put in your name, phone number and email address.
- Within the information section where it says “Redeem Coupon” put in the discount code thisis40
- Follow the prompts for payment
- Once you have provided payment you will receive an email confirmation with the date and time of your visit.
- Arrive fasted, with no caffeine or exercise within 4 hours of your test.
Our office is located at 500 Boston Post Road, Orange, CT 06477. We are in the same plaza as Hawley Lane Shoes. When you pull into the plaza look for signs for The Plano Program.
Over the next month I will be releasing more information about why having your metabolism tested is SO friggin’ important – so stay tuned for blog updates.
Please fee free to share this birthday gift with anyone who you think might benefit – which I think is pretty much anyone with nutrition related goals. After all who does not want to know their metabolism? Said no one ever ?
Have you ever had your metabolism tested? Did you find it helpful in reaching your nutrition related goals. Please tell us your experience in the comments below.
If you have PCOS , there is a good chance you have heard of the medication metformin. However, what you may not know is why it was prescribed for you in the first place. So much of the advice I give to patients surrounding diet revolves around many of the same reasons and principles why women with PCOS are put on metformin. Therefore, I thought it would be beneficial to discuss the basics of metformin and how it can help with insulin resistance, decreasing your testosterone, improving your chances of ovulation, enhancing fertility and you guessed it – weight loss!
What the heck is metformin?
Metformin is an insulin-sensitizing agent. What this means is metformin makes your body more sensitive to the effects of the hormone insulin. But more about that later!
Metformin comes in tablet form and the dose is gradually increased until the maximum dose required is achieved. Most women with PCOS start at a dose of 500 mg and increase their dose up to 1500 – 2000 mg usually in a 4-6 week span.
Metformin does the following:
- inhibits liver production of glucose
- increases the uptake of glucose by the cells
- decreases oxidation of fatty acids
- decreases the absorption of glucose in the intestines
Note: Metformin is the most commonly prescribed drug for diabetes.
I have PCOS, NOT diabetes? So, why did my GYNO prescribe metformin for ME?!?
Around 70- 80 % of women with PCOS experience what is called Insulin Resistance (IR). If you have IR, your body produces enough insulin, but does not effectively use it. Therefore, your body is not sensitive to the effects of insulin. Your doctor prescribed metformin to help your body respond better to insulin.
Why is insulin SO dang important?
Insulin plays a critical role in metabolism—the way the body uses food for energy. When you eat, the digestive system breaks down carbohydrates—sugars and starches found in many foods—into glucose. Glucose is a form of sugar that enters the bloodstream. With the help of insulin, glucose gets processed into the cells where it is used for energy.
What is Insulin’s Role in Blood Glucose Control?
When blood glucose levels rise after we eat, the pancreas releases insulin into the blood. Insulin and glucose then travel in the blood to the cells throughout the body.
In a healthy person, these actions help regulate blood glucose to keep insulin levels within a normal range.
But I already told you, my doc told me I am NOT healthy! I have PCOS AND Insulin Resistance SO what does that mean?
When someone has insulin resistance their muscle, fat, and liver cells do not respond properly to insulin. Their bodies cannot easily absorb glucose from the bloodstream. As a result, the body needs higher levels of insulin to help glucose enter cells. Basically the cells, despite the presence of insulin in the bloodstream, don’t function properly and don’t allow the glucose in the blood into the cells.
What Role does Insulin Resistance play in PCOS and Weight Loss ?
Insulin is considered a storage hormone. When insulin levels are high (as they are in most women when they are diagnosed with PCOS), the body goes into storage mode. This means the body stores glucose as body fat instead of using it for fuel.
And guess what? What do you think has one of the biggest affects on raising insulin levels? Carbohydrates – especially the refined types! Eating substantial amounts of processed carbohydrates creates large spikes in insulin levels. For women with PCOS – this is like pouring salt on an open wound. No bueno amiga!
As you know, many women who have PCOS are already overweight and carry a substantial amount of body fat in their belly area. Elevated weight and belly fat can further increase IR. Therefore, it no surprise that women who have PCOS have a hard time losing weight – even if their diet and exercise are “spot on.” Insulin resistance and excess weight creates a vicious cycle of weight gain in women with PCOS. And for some – without metformin – this weight is increasingly difficult to take off.
As if that was not bad enough! IR also increases testosterone levels, disrupts menstrual cycles and decreases a women chance of fertility.
How Does Metformin Benefit Women with PCOS?
Metformin is a super hero in my book for women who have PCOS and IR!
Metformin has been used off label in PCOS to prevent diabetes and increase ovulation through weight loss (1). In a recent randomized controlled trial comparing metformin, oral contraceptive pills (OCPs), and the combination of the two in patients with PCOS without T2D, metformin alone or with OCPs decreased weight and BMI. The median decrease in weight with metformin at 12 months was 3 kg (25th and 75th quartiles; -10.3, 0.6). OCP use was associated with increased weight changes of 1.2 kg (25th and 75th quartiles; -0.8, 3.0), and the combination decreased weight by 1.9 kg (25th and 75th quartiles; -4.9, 0.1). One patient in the metformin group dropped out due to nausea; no other side effects or adverse events were reported (2). Therefore, by using metformin by itself or in conjunction with OCPs, women with PCOS experienced a significant decrease in weight over the course of one year.
Metformin is also likely to delay diabetes onset and has a role in PCOS in those at high risk of diabetes. Boom!
While I do not think it is a miracle drug by any means, I personally have seen many of the positive outcomes I described above in my patients. However, with that being said, these same patients are also strongly adhering to my dietary and exercise advice AND are compliant with taking their metformin. You cannot have one – without the other!
Therefore for many women who have PCOS, taking metformin should be a no brainer due its profound impact on metabolic and reproductive function.
- Nieuwenhuis-Ruifrok AE, Kuchenbecker WK, Hoek A, Middleton P, Norman RJ. Insulin sensitizing drugs for weight loss in women of reproductive age who are overweight or obese: systematic review and meta-analysis. Hum Reprod Update. 2009;15:57-68
- Glintborg D, Altinok ML, Mumm H, Hermann AP, Ravn P, Andersen M. Body composition is improved during 12 months’ treatment with metformin alone or combined with oral contraceptives compared with treatment with oral contraceptives in polycystic ovary syndrome. J Clin Endocrinol Metab. 2014;99:2584-2591.
Given the fact I have been successfully helping women with PCOS lose weight for the last decade, it is fair to say I have seen my fair share of diets. However, one thing I can tell is certain Weight Watchers and PCOS don’t mix!
Typically by the time most women find me, they have been struggling for quite some time with their weight. They have tried every diet out there with minimal success. I don’t think there has been one woman who has exited their initial visit with me not having an “ah-ha!” moment. When women leave my office, it’s often with a sigh of relief — like a load has been lifted off their shoulders. What they have been doing for so long has been so wrong — but they have been brainwashed to think that it is SO right. That folks is the true definition of frustration! No bueno!
PCOS and Weight Watchers: Why Weight Watchers is making you fat!
You see, most women with PCOS are SO confused when it comes to diet. And rightfully so! There is so much information out there — low fat, high fat, no gluten, no dairy, no salt, no carbohydrates. I’ve seen every diet out there. But if I were to say there is any one diet I see many PCOSers follow (or followed at some point in their weight loss journey!) is Weight Watchers. If there is anyone diet platform that is just so damn wrong for women with PCOS it is Weight Watchers. Yes, you heard me correcty! If you have PCOS, Weight Watchers is making you fat! Stop the presses — if you are following a Weight Watchers style diet – get the heck off of it now. Weight Watchers and PCOS do not play in the sand box nicely!
Let me tell you why.
Why Weight Watchers doesn’t work for women with PCOS
You see, Weight Watchers is a very high carbohydrate, moderate protein, low fat diet. Most of the programs created by Weight Watchers provide at least 60 % of the total daily calories from carbohydrates. For Pete’s sake — I don’t even feed my professional athletes that many carbohydrates! Most women with PCOS effectively lose weight when their diet is just around 30 – 40 % total calories coming from carbohydrates. For someone following a 1300 calorie diet, 40 % of your calories coming from carbohydrates would be < 140 grams per day. If you were following the same level calories (I know you don’t count calories on Weight Watchers – you count points – but bare with me sister’!) on a Weight Watchers plan would you would be taking in about 200 grams per day. As small as it sounds — these 60 grams of extra carbohydrates ARE NOT working for your waist line – not to mention how it is impacting your fertility and overall health.
Every time we consume carbohydrates of any kind (it doesn’t matter if it is fruit, oatmeal or a sweet potato!) our bodies break down the carbohydrates into glucose. In response to glucose your angry body dumps out the hormone insulin. Insulin is what we consider a storage hormone. This means when insulin is circulating in our blood system – our bodies do not break down body fat for fuel – but instead it goes into fat storage mode.
As many as 70 % of women with PCOS are insulin resistant. This means their bodies’ are resistant to the effects of insulin. Insulin resistance makes it very difficult for their bodies to process carbohydrates. That is why many women with PCOS take the medication Metformin. This miracle drug for women with PCOS makes their cells more sensitive to the effects of insulin. Therefore, Metformin allows them to break down carbohydrates more effectively. I say more effectively because even on a therapeutic dose of Metformin, say around 1500 mg/day, women with PCOS still tend to not thrive on a diet higher than 40 % total calories coming from carbohydrates. I think of PCOS like having a carbohydrate handicap – that even when medicated on Metformin — this handicap does not go away 🙁
Stop the carbohydrate madness – just say heck ‘no’ to Weight Watchers and PCOS
Weight Watchers is the wrong weight loss program for women with PCOS
So back to Weight Watchers and why it could be responsible for making you fat if you have PCOS. On a typical Weight Watchers program you are eating carbohydrates all day. Breakfast — Special K Cereal (Carb) with Skim Milk (Carb) and fruit (Carb) Lunch – Turkey Sandwich (Carb) with pretzels (Carbs) and a yogurt (Carb) Dinner — Chicken, Sweet Potato (Carb) and broccoli. Snacks – Flavored Greek Yogurt (Carb), Apple (Carb), Skinny Cow (Carb). As you can see there is no shortage of carbohydrates. You mine as well be fueling for a marathon!
I want to make it clear – I have nothing against any of these foods. But for women with PCOS this style of eating creates an insulin disaster! All day long your body is getting flooded with carbohydrates that drives your insulin through the roof. Therefore, on a program like Weight Watchers you become a fat-storing machine – completely the opposite of what you want!
I think Weight Watchers is fantastic for many things – one being accountability. Also for many people it clearly works – and I cannot deny that! But I lie to you not – Weight Watchers is NOT the appropriate program for someone with PCOS trying to lose weight. I work with MANY women who actually gain weight while on a Weight Watchers program. If this is you — do not blame yourself. I bet you are spot-on with your points — it is just not the right program for you.
The right weight loss diet for women with PCOS
Women with PCOS need to follow a modest, lower carbohydrate diet to promote and sustain weight loss. That isn’t the same thing as a no-carbohydrate diet or a low-carbohydrate diet (< 20 grams per day). No need to be so drastic. So please don’t get these terms confused. Most women do well when their carbohydrates are between 90 – 140 grams per day.
In future blog posts, I’ll discuss what a typical day looks like at these carbohydrate levels. But in the meantime if you are hanging with the ladies at Weight Watchers and you have PCOS, please promise me you will cut your ties?
I’m only saying this for your own good – I promise.
Got questions on why Weight Watchers could be making you fat if you struggle with PCOS? Please post them in the comments below. I would love to hear your thoughts.