Metabolic Mindset

What happens when eating less, exercising more, and following all the conventional health advice actually makes you feel worse?In this episode of Metabolic Mindset, Shara Perry sits down with Steve Presciutti, orthopedic spine surgeon turned metabolic-health practitioner and founder of BioSpark Health, to discuss the relationship between energy availability, metabolism, and overall health.Drawing from his own health journey and clinical experience, Steve explains why he moved beyond conventional approaches to investigate the underlying physiology driving chronic health issues.We dive into the Minnesota Starvation Experiment, the consequences of chronic underfueling, metabolic adaptation, and why prolonged carbohydrate restriction and fasting may place additional demands on the body's stress-response systems. We also explore cortisol, blood glucose regulation, the Randall cycle, and how simple measurements like waking temperature and pulse can provide additional context when evaluating metabolic health.We wrap things up with a rapid-fire discussion about coffee timing, food-first supplementation, fish oil, and greens powders.In this episode, we cover:Why normal laboratory ranges don't always tell the whole story.The Minnesota Starvation Experiment and what prolonged caloric restriction does to the body.Metabolic adaptation and why the body is more than a calorie-burning machine.How chronic underfueling can affect metabolism, cortisol, and blood glucose.Why cravings may be signals worth paying attention to rather than suppressing.The relationship between carbohydrate availability and stress hormones.How to monitor temperature and pulse as imperfect indicators of metabolic function.Why Steve prioritizes food before supplements.The goal isn't to replace one set of restrictive dietary rules with another. It's to understand physiology, recognize what the body needs, and build a foundation that supports long-term health.Connect with Steve:Website: https://biosparkhealth.comInstagram: @biosparkhealthDisclaimer: This podcast is for educational purposes only and is not intended to provide individualized medical or nutrition advice. The views expressed are those of the host and guest and do not necessarily represent the views of their respective employers or professional organizations.Send us Fan MailSupport the showWork with me at Nourish (covered by insurance, often $0): https://signup.nourish.com/providers/shara-perry?referralSource=Nourish+dietitian&referralName=Shara+Perry&utm_source=Nourish_dietitian&utm_term=Shara_Perry

Can you eat an extremely high-carbohydrate diet and still lose body fat? What happens to insulin, insulin resistance, and fat storage when carbohydrate makes up 75–90% of total calories?In this episode of Metabolic Mindset, we’re examining what clinical research actually tells us about high-carbohydrate versus high-fat diets.We explore Walter Kempner’s famous rice diet, the Ornish and Pritikin approaches, and controlled feeding studies that produced some counterintuitive results. We’ll look at why increasing fat oxidation doesn’t necessarily mean losing more body fat, whether high-carbohydrate diets must worsen insulin resistance, and what happens when carbohydrate intake becomes high enough to drive significant de novo lipogenesis.We also discuss the difference between acute insulin responses and long-term clinical outcomes, why energy balance and the overall dietary pattern matter, and what these findings mean within a pro-metabolic approach to nutrition.In this episode:Can diets providing 75–90% of calories from carbohydrate support substantial weight loss?Does insulin automatically prevent fat loss?What happened when researchers compared fat restriction with carbohydrate restriction under controlled conditions?Can a high-carbohydrate diet reduce spontaneous calorie intake compared with a ketogenic diet?When does carbohydrate conversion into fat become more significant?What can these studies tell us—and what can’t they prove?The goal isn’t to argue that one macronutrient ratio is best for everyone. It’s to understand the physiology, examine the evidence, and question assumptions that are often treated as settled fact.Because we don’t do dogma. We do physiology.Research references1. Kempner et al. (1975)Treatment of massive obesity with rice/reduction diet program: An analysis of 106 patients with at least a 45-kg weight loss. Archives of Internal Medicine.https://doi.org/10.1001/archinte.1975.003301200530082. Ornish et al. (1990)Can lifestyle changes reverse coronary heart disease? The Lifestyle Heart Trial. The Lancet.https://doi.org/10.1016/0140-6736(90)91656-U3. Gerhard et al. (2004)Effects of a low-fat diet compared with those of a high-monounsaturated fat diet on body weight, plasma lipids and lipoproteins, and glycemic control in type 2 diabetes. American Journal of Clinical Nutrition.https://doi.org/10.1093/ajcn/80.3.6684. Hall et al. (2015)Calorie for Calorie, Dietary Fat Restriction Results in More Body Fat Loss than Carbohydrate Restriction in People with Obesity. Cell Metabolism.https://doi.org/10.1016/j.cmet.2015.07.0215. Hall et al. (2021)Effect of a plant-based, low-fat diet versus an animal-based, ketogenic diet on ad libitum energy intake. Nature Medicine.https://doi.org/10.1038/s41591-020-01209-16. Acheson et al. (1988)Glycogen storage capacity and de novo lipogenesis during massive carbohydrate overfeeding in man. American Journal of Clinical Nutrition.https://doi.org/10.1093/ajcn/48.2.2407. Hall (2017)A review of the carbohydrate–insulin model of obesity. European Journal of Clinical Nutrition.https://doi.org/10.1038/ejcn.2016.260This podcast is for educational and informational purposes only. It is not individualized medical or nutrition advice and does not replace guidance from a qualified healthcare professional.Send us Fan MailSupport the showWork with me at Nourish (covered by insurance, often $0): https://signup.nourish.com/providers/shara-perry?referralSource=Nourish+dietitian&referralName=Shara+Perry&utm_source=Nourish_dietitian&utm_term=Shara_Perry

In this episode of Metabolic Mindset, I’m joined by Brian Sanders @food.lies for a wide-ranging conversation about metabolism, food quality, satiety, ancestral nutrition, and his new work challenging some of the assumptions underlying conventional nutrition advice.Brian has spent nearly a decade interviewing hundreds of doctors and scientists through Food Lies and Peak Human, trying to answer one deceptively simple question: What should humans actually eat?We dive into his new Nutrient Energy Quotient (NEQ) framework, which looks at the relationship between the nutrients a food provides and the energy it contains. We discuss why all calories may not be physiologically equivalent, how nutrient density and food structure could influence appetite regulation, and why whole foods may allow the body to regulate intake differently than highly processed foods.We also get into:• Why “just eat fewer calories” may be an incomplete approach to fat loss• Brian’s Intake Regulation Model (IRM) and his theory of why processed foods can disrupt appetite regulation• Why protein, vitamins, and minerals may need to be thought about differently from dietary energy• Fiber: essential target or accidental byproduct of eating whole foods?• Whole fruit vs. dried fruit and the role of food structure and water content• GLP-1, satiety, gastric emptying, and the gut-brain connection• Ancestral diets, the Hadza, and what hunter-gatherer populations can—and cannot—teach us• Why “processed” doesn’t necessarily mean unhealthy• Traditional foods like sourdough, fermented foods, cheese, and sausage• Why high-fat + high-carb combinations can make it easier to overconsume energy• Whether we can actually get to a place where our appetite regulates itself without obsessively tracking caloriesAnd, of course, we challenge each other along the way.This is not a conversation about finding the one perfect diet. It’s about stepping outside of nutrition camps, questioning assumptions, and trying to understand the physiology underneath them.Because we don’t do dogma. We do physiology.Follow Brian: @food.liesLearn more about Food Lies: https://www.sapien.org/This podcast is for educational and informational purposes only and is not intended to provide individualized medical or nutrition advice.Send us Fan MailSupport the showWork with me at Nourish (covered by insurance, often $0): https://signup.nourish.com/providers/shara-perry?referralSource=Nourish+dietitian&referralName=Shara+Perry&utm_source=Nourish_dietitian&utm_term=Shara_Perry

Walking is simple. It’s accessible. And because it doesn’t feel particularly hard, it’s easy to underestimate just how much is happening physiologically when you do it.In this episode of Metabolic Mindset, I'm discussing the physiology of walking — from fat oxidation and mitochondrial metabolism to glucose uptake, insulin sensitivity, NEAT, cardiovascular health, appetite, cortisol regulation, and recovery.We’ll talk about why walking after meals can be especially useful for glucose regulation, whether 10,000 steps is actually necessary, how walking can support fat-loss goals without adding excessive recovery demands, and why more intense exercise isn’t always the answer.The goal isn’t to turn walking into another form of calorie compensation or exercise punishment. It’s to understand what walking is actually doing inside your body — and why something as simple as putting one foot in front of the other may be one of the most underrated tools for metabolic health.@dontdodogmaSend us Fan MailSupport the showWork with me at Nourish (covered by insurance, often $0): https://signup.nourish.com/providers/shara-perry?referralSource=Nourish+dietitian&referralName=Shara+Perry&utm_source=Nourish_dietitian&utm_term=Shara_Perry

Aspirin is having a moment. From inflammation and pain to cancer prevention, brain health, metabolism, and even thyroid function, you’ve probably heard some pretty impressive claims about what this little drug can do.But how much of it is actually supported by science?In this episode of Metabolic Mindset, we take a deep dive into Ray Peat’s article “Aspirin, Brain, and Cancer” and unpack the physiology behind his ideas. We’ll explore aspirin’s effects on prostaglandins, inflammation, polyunsaturated fatty acids, mitochondrial function, glucose metabolism, estrogen, cancer biology, the brain, and more.More importantly, we’ll separate interesting mechanisms from actual clinical evidence.What did Peat get right? Where was his reasoning ahead of the research? And where does a plausible physiological mechanism become an unsupported leap?This is not an episode telling you to take aspirin. It’s an exploration of how to critically evaluate physiological theories, understand what the research actually shows, and recognize the difference between a fascinating hypothesis and a clinical recommendation.Because we don’t do dogma—we do physiology.Send us Fan MailSupport the showWork with me at Nourish (covered by insurance, often $0): https://signup.nourish.com/providers/shara-perry?referralSource=Nourish+dietitian&referralName=Shara+Perry&utm_source=Nourish_dietitian&utm_term=Shara_Perry

In this episode, we explore how a dedicated endurance athlete builds a nutrition plan from scratch. We cover calculating calorie and macro requirements, fasting, hydration, and fueling strategies to optimize performance and recovery. In this episode, Shara Perry, RDN and endurance athlete Brance Baca-White discuss optimal nutrition, hydration, and training strategies, emphasizing personalized approaches and scientific insights to improve performance and health.Use these calculations as starting points, then adjust based on body-weight trends, performance, hunger, recovery, sleep, and training quality.1. Estimate BMRMifflin-St JeorMen: BMR = (10 × kg) + (6.25 × cm) − (5 × age) + 5Women: BMR = (10 × kg) + (6.25 × cm) − (5 × age) − 161Conversions: lb ÷ 2.205 = kg inches × 2.54 = cm2. Estimate TDEETDEE = BMR × Activity Factor1.2 = Sedentary 1.375 = Lightly active 1.55 = Moderately active 1.725 = Very active 1.9 = Extremely activeFor high-volume endurance athletes, approximately 1.725–1.9 may be an appropriate starting range.3. Set Protein~1 g protein per lb of desired body weightExample: 185 lb goal = 185 g protein/dayProtein = 4 calories/g4. Set Fat~0.25–0.4 g fat per lb body weightFat = 9 calories/gExample: 196 lb = approximately 49–78 g/day5. Calculate CarbohydratesCarb calories = Total calories − protein calories − fat caloriesCarb grams = Carb calories ÷ 4Example at 3,400 calories:185 g protein = 740 calories 55 g fat = 495 calories Remaining = 2,165 calories Carbohydrate = ~541 g/day6. Pre-Workout FuelFor easy/short sessions, some athletes may tolerate minimal fueling.For long or hard sessions, prioritize carbohydrate.A simple starting point:20–40 g carbohydrate before an early workoutChoose foods that are high-carb, relatively low-fat, relatively low-fiber, and easy to digest.7. During the RunFor sessions lasting more than ~1 hour:30–60 g carbohydrate/hourFor longer marathon-specific sessions:60–90 g/hour may be appropriate for highly trained athletes who have practiced and can tolerate it.8. Post-Workout25–40 g protein + substantial carbohydratePrioritize recovery nutrition after long or demanding sessions, particularly when another hard workout is coming soon.9. Baseline HydrationA practical starting estimate for baseline daily fluid intake is:Body weight (lb) × 0.5–0.67 = ounces of fluid/dayThis is your baseline before accounting for significant exercise losses.10. Calculate Sweat RateRecord:Pre-exercise body weightPost-exercise body weightFluid consumedUrine producedExercise duration Fluid loss = weight loss + fluid consumed − urine producedSweat rate = fluid loss ÷ exercise durationRepeat under different training and environmental conditions for a better estimate.11. Post-Exercise Fluid ReplacementFor more rapid recovery:~16–24 oz fluid per pound of body weight lostThis is particularly useful when another significant workout is coming soon.12. SodiumThere isn't a well-established evidence-based body-weight formula for baseline sodium needs in healthy adults. The National Academies specifically set an adult sodium Adequate Intake at 1,500 mg/day, but they also note that this does not adequately address people with large sweat losses, such as competitive athletes. They could not establish a higher universal requirement for high-intensity athletes.During endurance training:~300–600+ mg sodium/hourIndividual sodium needs vary. Sweat sodium testing can provide a more personalized target.The TakeawayThese calculations are starting points, not magic numbers.Calculate, implement, monitor your response, and adjust based on body weight, performance, hunger, recovery, sleep, and training quality.Send us Fan MailSupport the showWork with me at Nourish (covered by insurance, often $0): https://signup.nourish.com/providers/shara-perry?referralSource=Nourish+dietitian&referralName=Shara+Perry&utm_source=Nourish_dietitian&utm_term=Shara_Perry

Is intuitive eating compatible with intentional nutrition, metabolic health, and even weight loss goals?In this episode of Metabolic Mindset, we take a nuanced look at intuitive eating—what it actually means, where it gets things right, and where additional context may be helpful.Joined by fellow Registered Dietitian Kelsie Kropp Chabala, we walk through all 10 principles of intuitive eating and discuss how they can fit alongside structured nutrition, adequate fueling, protein intake, exercise, metabolic restoration, and intentional health goals.Intuitive eating isn't simply "eat whatever you want," but it also doesn't mean abandoning nutrition science. So can you improve your relationship with food while still being intentional about your health?Let's get into it.Send us Fan MailSupport the showWork with me at Nourish (covered by insurance, often $0): https://signup.nourish.com/providers/shara-perry?referralSource=Nourish+dietitian&referralName=Shara+Perry&utm_source=Nourish_dietitian&utm_term=Shara_Perry

In this episode, Brance Baca-White (@bbacawhite) shares his journey from casual runner to competitive marathoner, discussing training strategies, biohacking, and the importance of community in achieving athletic goals. Perfect for endurance athletes and fitness enthusiasts looking to optimize performance and health.Key TopicsBrance's running journey and motivationImportance of proper footwear and training balanceBiohacking techniques for athletic performanceSetting SMART goals for running successCommunity's role in motivation and growthNutrition and recovery strategies for runnersThe mental aspect of endurance sportsTools and devices for biohacking and tracking progressResourcesNick Bare - The Pillars of Distance Running - https://www.youtube.com/watch?v=hcHYG9ZpYugLMNT Electrolytes - https://drinklmnt.com/Garmin Running Devices - https://garmin.comThe Circles Project - Austin Trail Run Club - https://instagram.com/thecirclesprojectSend us Fan MailSupport the showWork with me at Nourish (covered by insurance, often $0): https://signup.nourish.com/providers/shara-perry?referralSource=Nourish+dietitian&referralName=Shara+Perry&utm_source=Nourish_dietitian&utm_term=Shara_Perry

In this episode of Metabolic Mindset, I break down exactly how I determine calorie, protein, carbohydrate, fat, hydration, and sodium targets using a pro-metabolic framework. We cover the physiology behind energy needs, why I use the Mifflin-St Jeor equation as a starting point, how adaptive thermogenesis influences nutrition planning, and why biofeedback matters just as much as the numbers. You'll also learn how I decide when to adjust calories or macros, why sodium recommendations differ for active individuals, and how to recognize signs that your metabolism is moving in the right direction.Send us Fan MailSupport the showWork with me at Nourish (covered by insurance, often $0): https://signup.nourish.com/providers/shara-perry?referralSource=Nourish+dietitian&referralName=Shara+Perry&utm_source=Nourish_dietitian&utm_term=Shara_Perry

Many people believe metabolism is simply a matter of calories in versus calories out. But if that's true, why can two people eat the same amount of food, weigh the same, and exercise the same amount, yet experience completely different levels of energy, recovery, hunger, hormone health, and body composition?In this episode, we're diving into one of the most overlooked concepts in nutrition and metabolism: energy availability. You'll learn why your body doesn't just track calories—it continuously evaluates whether enough energy is available to support essential functions like hormone production, thyroid health, recovery, immune function, and daily activity. We'll discuss: What energy availability actually means  Why calories alone don't tell the whole story  The role of ATP, glycogen, and stored energy  How the brain gathers information about your energy status  Why chronic dieting can lead to fatigue, stalled progress, and metabolic adaptation  The connection between carbohydrate intake, recovery, and energy expenditure  What NEAT (non-exercise activity thermogenesis) is and why it matters  Why some people feel and perform better when they start eating more If you've ever wondered why your body seems to resist your efforts despite eating less and exercising more, this episode will help you understand the metabolic signals happening behind the scenes.This is Part 1 of a two-part series on energy availability and metabolism.Send us Fan MailSupport the showWork with me at Nourish (covered by insurance, often $0): https://signup.nourish.com/providers/shara-perry?referralSource=Nourish+dietitian&referralName=Shara+Perry&utm_source=Nourish_dietitian&utm_term=Shara_Perry