Michael Patterson RD. PG Dip. ( @michaelpattersonrd ) Instagram Profile

michaelpattersonrd

Michael Patterson RD. PG Dip.

💩 Intestinal Failure Dietitian
🎓 Research Fellow/ PhD Student Uni of Hull
📊Nutrition Nerd
🇬🇧🇹🇭Amateur Muay Thai Coach @ministrymuaythai

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Michael Patterson RD. PG Dip. Profile Information

  • Carrying on from my last post, I said I would address each point regarding satiety with its own post so I’ll start with protein and satiety.
🥛
Numerous studies have summarised the literature regarding protein and satiety with Paddon-Jones et al 2008 and Westerterp-Plantenga et al 2012 both good examples to read. The general conclusions from these papers are;
Potential beneficial outcomes associated with protein ingestion include the following:
.
1) Increased satiety—protein usually increases satiety to a greater extent than carbohydrate or fat and may enable a reduction in energy consumption under ad libitum dietary conditions.
.
2) Increased thermogenesis—higher-protein diets are associated with increased thermogenesis, which also influences satiety and augments energy expenditure (in the longer term, increased thermogenesis contributes to the relatively low-energy efficiency of protein).
.
3) Conservation or accretion of fat-free mass—in some individuals, a moderately higher protein diet may provide a stimulatory effect on muscle protein anabolism, favouring the retention of lean muscle mass while improving metabolic profile.
🍳
I want to look at point one in a little more detail, the study that is often used for this is Weigle et al 2015, subjects in this study were put on a weight-maintaining diet (15% protein, 35% fat, and 50% carbohydrate) for 2 weeks, an isocaloric diet (30% protein, 20% fat, and 50% carbohydrate) for 2 weeks, and an ad libitum diet (30% protein, 20% fat, and 50% carbohydrate) for 12 weeks with each participant acting as their own control.
🍗
They found satiety was markedly increased with the isocaloric high-protein diet. Average spontaneous energy intake decreased by ~450 kcal/day, body weight decreased by ~4.9 kg, and fat mass decreased by ~3.7kg with the ad libitum, high-protein diet.
🍠
What is also of note in this study is the carbohydrate content of the diet of 50%, they discuss in the paper which has been discussed in the literature that the effect of protein may help to explain the paradoxical weight loss observed in subjects placed on low-carbohydrate diets.
  • @michaelpattersonrd Profile picture

    @michaelpattersonrd

    Kingston upon Hull

    Carrying on from my last post, I said I would address each point regarding satiety with its own post so I’ll start with protein and satiety.
    🥛
    Numerous studies have summarised the literature regarding protein and satiety with Paddon-Jones et al 2008 and Westerterp-Plantenga et al 2012 both good examples to read. The general conclusions from these papers are;
    Potential beneficial outcomes associated with protein ingestion include the following:
    .
    1) Increased satiety—protein usually increases satiety to a greater extent than carbohydrate or fat and may enable a reduction in energy consumption under ad libitum dietary conditions.
    .
    2) Increased thermogenesis—higher-protein diets are associated with increased thermogenesis, which also influences satiety and augments energy expenditure (in the longer term, increased thermogenesis contributes to the relatively low-energy efficiency of protein).
    .
    3) Conservation or accretion of fat-free mass—in some individuals, a moderately higher protein diet may provide a stimulatory effect on muscle protein anabolism, favouring the retention of lean muscle mass while improving metabolic profile.
    🍳
    I want to look at point one in a little more detail, the study that is often used for this is Weigle et al 2015, subjects in this study were put on a weight-maintaining diet (15% protein, 35% fat, and 50% carbohydrate) for 2 weeks, an isocaloric diet (30% protein, 20% fat, and 50% carbohydrate) for 2 weeks, and an ad libitum diet (30% protein, 20% fat, and 50% carbohydrate) for 12 weeks with each participant acting as their own control.
    🍗
    They found satiety was markedly increased with the isocaloric high-protein diet. Average spontaneous energy intake decreased by ~450 kcal/day, body weight decreased by ~4.9 kg, and fat mass decreased by ~3.7kg with the ad libitum, high-protein diet.
    🍠
    What is also of note in this study is the carbohydrate content of the diet of 50%, they discuss in the paper which has been discussed in the literature that the effect of protein may help to explain the paradoxical weight loss observed in subjects placed on low-carbohydrate diets.

  •  18  0  19 September, 2019
  • Wait a minute before jumping on this. This is the idea is that if weight loss is the aim, people will tend to do better if they’ve bought into a diet concept. This can be something quite general such as low carb or low fat or something on the extreme of the spectrum, such as carnivore or fruitarians. I’ve said this quite a bit but I think diet can be quite religious in that people will swear by an approach even if the evidence doesn’t support is use in every scenario. “But it worked for me”, I’m sorry but the keto and vegan crowd are probably most guilty of this but these are a prime example of a group who have bought into a concept and gone with it.
.
As a standard, the ideal diet for weight loss should be safe, efficacious, healthy and nutritionally sufficient, culturally acceptable and economically affordable. It also needs to allow long-term compliance and maintenance of weight loss. If we think about this, there is never going to be one diet that ticks all of these boxes for every individual.
.
The term healthy in that paragraph is also quite an important notion. When looking at the overall scientific evidence about what constitutes a healthy diet it is quite consistent and straightforward: a healthy diet is a varied diet rich in fruits, vegetables, legumes, nuts, seeds, whole-grain products and high-quality proteins and poor in added sugar, refined grains, and highly-processed foods. The amounts of each are very individual and have to take into account the above points plus an individual’s personal goals and preferences.
.
Long term compliance and maintenance is often the difficulty in any diet with this highlighted in the literature for both low carbohydrate and fat. Behaviour change is very important when it comes to weight loss maintenance with high self‐efficacy for exercise and self‐efficacy for weight management needed. From a dietary perspective James Krieger summarised this well by highlighting that satiety improves adherence with the characteristics of a high satiety diet; • High protein
• High fibre
• Low energy density
• Moderate palatability
• Reduced variety
• Reduced reward
I’ll do separate post on these points...
  • @michaelpattersonrd Profile picture

    @michaelpattersonrd

    Kingston upon Hull

    Wait a minute before jumping on this. This is the idea is that if weight loss is the aim, people will tend to do better if they’ve bought into a diet concept. This can be something quite general such as low carb or low fat or something on the extreme of the spectrum, such as carnivore or fruitarians. I’ve said this quite a bit but I think diet can be quite religious in that people will swear by an approach even if the evidence doesn’t support is use in every scenario. “But it worked for me”, I’m sorry but the keto and vegan crowd are probably most guilty of this but these are a prime example of a group who have bought into a concept and gone with it.
    .
    As a standard, the ideal diet for weight loss should be safe, efficacious, healthy and nutritionally sufficient, culturally acceptable and economically affordable. It also needs to allow long-term compliance and maintenance of weight loss. If we think about this, there is never going to be one diet that ticks all of these boxes for every individual.
    .
    The term healthy in that paragraph is also quite an important notion. When looking at the overall scientific evidence about what constitutes a healthy diet it is quite consistent and straightforward: a healthy diet is a varied diet rich in fruits, vegetables, legumes, nuts, seeds, whole-grain products and high-quality proteins and poor in added sugar, refined grains, and highly-processed foods. The amounts of each are very individual and have to take into account the above points plus an individual’s personal goals and preferences.
    .
    Long term compliance and maintenance is often the difficulty in any diet with this highlighted in the literature for both low carbohydrate and fat. Behaviour change is very important when it comes to weight loss maintenance with high self‐efficacy for exercise and self‐efficacy for weight management needed. From a dietary perspective James Krieger summarised this well by highlighting that satiety improves adherence with the characteristics of a high satiety diet; • High protein
    • High fibre
    • Low energy density
    • Moderate palatability
    • Reduced variety
    • Reduced reward
    I’ll do separate post on these points...

  •  24  0  16 September, 2019
  • Second post regarding home artificial nutrition week, so this post is briefly about parenteral nutrition, my line of work. So these patients are fed intravenously because of intestinal failure (http://www.espen.org/files/PIIS0261561414002349.pdf) this can be short, medium or long term. The paper referenced explains all about it. Home PN patients often have their full nutritional needs met via their PN, including protein, lipids, carbohydrate, vitamin, minerals, electrolyte and fluids needs.
.
What PN does allow is a really good tool to evidence how energy balance works. 
So the patients energy expenditure is estimated taking into account numerous factors including clinical condition, activity, aim for weight gain/loss etc. This is then calculated into macronutrient amounts typically my patients are on around 1.5g/kg of protein. Fat (lipid) at around 0.5-1g/kg/day, capped at around 1g/kg because of the risk of liver damage. The remainder of calories comes from carbohydrate, in the form of dextrose (sugar). So these patients can be on upwards of 3,4,500g of dextrose per day. What’s unique in this situation is that every last gram is absorbed because their is no issues with digestion, it bypasses the normal physiological process of digestion. Also from this side of things there also no thermic effect of the food.
.
If the carbohydrate insulin hypothesis were true then all these patients would be morbidly obese, in fact a large number are quite the opposite. If we are aiming for a patient to gain weight we adjust the overall calorie content of the bags. If we are aiming for a patient to lose weight we also adjust the overall calorie content of the bags. Abracadabra energy balance!
.
I know energy balance has physiological, psychological and social aspects that play a part but broken down simply, energy balance holds true! .
In some ways it could be argued that PN patients are a tightly controlled free living feeding study as there nutritional intake is tightly controlled to the gram.
.
N.B these patients get fed 12 hours overnight (liver protection), maybe they don’t gain weight due to the fasting………
.
.
.
.
.
  • @michaelpattersonrd Profile picture

    @michaelpattersonrd

    Kingston upon Hull

    Second post regarding home artificial nutrition week, so this post is briefly about parenteral nutrition, my line of work. So these patients are fed intravenously because of intestinal failure (http://www.espen.org/files/PIIS0261561414002349.pdf) this can be short, medium or long term. The paper referenced explains all about it. Home PN patients often have their full nutritional needs met via their PN, including protein, lipids, carbohydrate, vitamin, minerals, electrolyte and fluids needs.
    .
    What PN does allow is a really good tool to evidence how energy balance works.
    So the patients energy expenditure is estimated taking into account numerous factors including clinical condition, activity, aim for weight gain/loss etc. This is then calculated into macronutrient amounts typically my patients are on around 1.5g/kg of protein. Fat (lipid) at around 0.5-1g/kg/day, capped at around 1g/kg because of the risk of liver damage. The remainder of calories comes from carbohydrate, in the form of dextrose (sugar). So these patients can be on upwards of 3,4,500g of dextrose per day. What’s unique in this situation is that every last gram is absorbed because their is no issues with digestion, it bypasses the normal physiological process of digestion. Also from this side of things there also no thermic effect of the food.
    .
    If the carbohydrate insulin hypothesis were true then all these patients would be morbidly obese, in fact a large number are quite the opposite. If we are aiming for a patient to gain weight we adjust the overall calorie content of the bags. If we are aiming for a patient to lose weight we also adjust the overall calorie content of the bags. Abracadabra energy balance!
    .
    I know energy balance has physiological, psychological and social aspects that play a part but broken down simply, energy balance holds true! .
    In some ways it could be argued that PN patients are a tightly controlled free living feeding study as there nutritional intake is tightly controlled to the gram.
    .
    N.B these patients get fed 12 hours overnight (liver protection), maybe they don’t gain weight due to the fasting………
    .
    .
    .
    .
    .

  •  53  0  7 August, 2019
  • So this post is about what I actually do for a living. I set this page up for a bit of fun really, to try and put some good nutritional content out there, try and dispel some of the myths regarding nutrition and also hopefully allow people to reach out to me if they want some advice.
.
So in my day to day practice I work with a lot of people who receive artificial nutrition, both in hospital and at home. For these patients their priorities aren’t ‘have i hit my leucine threshold’, ‘shit I ate carbs after 6 o’clock that means I’ll get fat overnight’. No there priority is will this nutrition keep me alive, will I have some quality of life and without it I will die. .
There are numerous form of artificial nutrition the main method is Enteral Nutrition (EN), tube feeding via various different types of tubes. Feeding tubes can be placed down through the nose into the stomach or bowel, known as Nasoenteric Feeding and includes naso gastric (NG), naso duodenal and naso jejunal (NJ) feeding. Alternative feeding methods are where a tube can be placed directly through the skin into the stomach or bowel, known as Enterostomy Feeding, which includes percutaneous endoscopic gastrostomy (PEG), radiologically inserted percutaneous Gastrostomy (RIG), percutaneous endoscopic jejunostomy (PEJ) and surgical jejunostomy (JEJ) tube. .
The other type of artificial nutrition is Parenteral Nutrition (PN), this is my line of work and also the area I’m studying for my PhD. PN is given via a dedicated catheter (CVC - central venous catheter) which is placed in a main vein or via a PICC line (Peripherally Inserted Central Veneous Catheter). The tip of the catheter sits close to the heart. This is dedicated for patients with intestinal failure which is a broad term that refers to a variety of diseases or injuries to the small intestine which prevent it from absorbing adequate nutrients and water.
.
.
.
.
.
#carbohydrates #diet #nutritionist #fitness #dietitian #clinicalnutrition #medicalnutrition #fit #instafit #keto #pinnt #parenteralnutrition #lowcarb #lchf #intermittentfasting #iifym #flexibledieting #enteralnutrition #eatclean #diet #nutrition #hetf #calorie #calories #food
  • @michaelpattersonrd Profile picture

    @michaelpattersonrd

    Kingston upon Hull

    So this post is about what I actually do for a living. I set this page up for a bit of fun really, to try and put some good nutritional content out there, try and dispel some of the myths regarding nutrition and also hopefully allow people to reach out to me if they want some advice.
    .
    So in my day to day practice I work with a lot of people who receive artificial nutrition, both in hospital and at home. For these patients their priorities aren’t ‘have i hit my leucine threshold’, ‘shit I ate carbs after 6 o’clock that means I’ll get fat overnight’. No there priority is will this nutrition keep me alive, will I have some quality of life and without it I will die. .
    There are numerous form of artificial nutrition the main method is Enteral Nutrition (EN), tube feeding via various different types of tubes. Feeding tubes can be placed down through the nose into the stomach or bowel, known as Nasoenteric Feeding and includes naso gastric (NG), naso duodenal and naso jejunal (NJ) feeding. Alternative feeding methods are where a tube can be placed directly through the skin into the stomach or bowel, known as Enterostomy Feeding, which includes percutaneous endoscopic gastrostomy (PEG), radiologically inserted percutaneous Gastrostomy (RIG), percutaneous endoscopic jejunostomy (PEJ) and surgical jejunostomy (JEJ) tube. .
    The other type of artificial nutrition is Parenteral Nutrition (PN), this is my line of work and also the area I’m studying for my PhD. PN is given via a dedicated catheter (CVC - central venous catheter) which is placed in a main vein or via a PICC line (Peripherally Inserted Central Veneous Catheter). The tip of the catheter sits close to the heart. This is dedicated for patients with intestinal failure which is a broad term that refers to a variety of diseases or injuries to the small intestine which prevent it from absorbing adequate nutrients and water.
    .
    .
    .
    .
    .
    #carbohydrates #diet #nutritionist #fitness #dietitian #clinicalnutrition #medicalnutrition #fit #instafit #keto #pinnt #parenteralnutrition #lowcarb #lchf #intermittentfasting #iifym #flexibledieting #enteralnutrition #eatclean #diet #nutrition #hetf #calorie #calories #food

  •  20  0  5 August, 2019
  • 💊New study examining the safety of creatine supplementation and renal function. To keep it brief; “The findings indicate that creatine supplementation does not induce renal damage in the studied amounts and durations”. Looks like another tick in the box of creatine safety. 💊
.
🏋🏻‍♂️The International Society of Sports Nutrition concluded amongst other things; ‘Creatine monohydrate is the most effective ergogenic nutritional supplement currently available to athletes with the intent of increasing high-intensity exercise capacity and lean body mass during training.”🏋🏻‍♂️
.
🏥It also has been reported to have a number of therapeutic benefits in healthy and diseased populations ranging from;🏥
.
✅Post exercise recovery
✅Injury prevention
✅Thermoregulation
✅Concussion
✅Spinal cord protection
✅Short term memory
✅Intelligence/reasoning ✅Muscular dystrophy ✅Parkinson’s
✅Huntington’s
✅Diabetes
✅Fibromyalgia
✅Aging
✅Brain and heart ischemia
.
.
.
.
#carbohydrates #diet #workout #fitness #dietitian #fasting #performance #fit #instafit #keto #weightloss #insulin #lowcarb #lchf #intermittentfasting #iifym #flexibledieting #cleaneating #eatclean #diet #nutrition #caloriedeficit #calorie #calories #food
  • @michaelpattersonrd Profile picture

    @michaelpattersonrd

    Kingston upon Hull

    💊New study examining the safety of creatine supplementation and renal function. To keep it brief; “The findings indicate that creatine supplementation does not induce renal damage in the studied amounts and durations”. Looks like another tick in the box of creatine safety. 💊
    .
    🏋🏻‍♂️The International Society of Sports Nutrition concluded amongst other things; ‘Creatine monohydrate is the most effective ergogenic nutritional supplement currently available to athletes with the intent of increasing high-intensity exercise capacity and lean body mass during training.”🏋🏻‍♂️
    .
    🏥It also has been reported to have a number of therapeutic benefits in healthy and diseased populations ranging from;🏥
    .
    ✅Post exercise recovery
    ✅Injury prevention
    ✅Thermoregulation
    ✅Concussion
    ✅Spinal cord protection
    ✅Short term memory
    ✅Intelligence/reasoning ✅Muscular dystrophy ✅Parkinson’s
    ✅Huntington’s
    ✅Diabetes
    ✅Fibromyalgia
    ✅Aging
    ✅Brain and heart ischemia
    .
    .
    .
    .
    #carbohydrates #diet #workout #fitness #dietitian #fasting #performance #fit #instafit #keto #weightloss #insulin #lowcarb #lchf #intermittentfasting #iifym #flexibledieting #cleaneating #eatclean #diet #nutrition #caloriedeficit #calorie #calories #food

  •  19  0  4 August, 2019