I started the Trim Healthy Mama plan yesterday and I’ve been S-mealing and E-mealing all over the place! Yesterday was actually an interesting day for me to start because it wasn’t my normal routine at all. My dad had a (minor) surgery so I picked up my grandma and we headed to the surgery center to keep my mom company and help out. This change in schedule was a bit of a test for my first day since I was out and about for much of the day. Here’s a rundown of my first crack at THM:

7:15 am – Breakfast (E meal)

Breakfast time! It was trickier than I expected to come up with a meal, mostly because I do my grocery shopping on Mondays and hadn’t bought food specifically for the plan yet. I started with an E meal of oatmeal with strawberries, cinnamon, and stevia. On the side, I had some plain fat free Greek yogurt with a drop of vanilla and some stevia. I was concerned that this meal wouldn’t have enough protein to make it all the way to lunch, but I was pleasantly surprised that I didn’t get hungry until 11 am. I tossed some oranges in my bag for a snack but never did eat them.

11 am

Dad went in for his surgery and our stomachs were starting to rumble. I volunteered to drop off dad’s prescriptions and grab us some lunch to bring back. Most of the portable options in the vicinity of dad’s pharmacy were fast food. I remembered reading the chapter in the Trim Healthy Mama Plan about eating out. The authors say S meals are the easiest to do while eating out because of the low-carb options at many restaurants. After some quick Googling for ideas on low-carb fast fooding, I discovered that Wendy’s has a lettuce-wrapped burger option, so I dropped off the prescriptions and headed over there.

12 pm – Lunch (S Meal)

When I was ordering, I was a little unsure how much food I would need to be satisfied. Generally, if I get fast food I order a kids’ meal or a cheeseburger with a small serving of french fries. French fries are a no-go on the Trim Healthy Mama plan because they are high in both fat and carbohydrates (not to mention that they are made of white potatoes, which are also discouraged). I’m a sucker for a salty carbohydrate so honestly that was a bit of a bummer. I planned to order a lettuce-wrapped cheeseburger but then wondered if that would be enough when I’m used to also having a bun and some french fries too. I decided to embrace the concept of an S meal and got a double cheeseburger. Now, as a dietitian, I would consider this meal too high in saturated fat and too high in calories (not to mention sodium), but it fits the THM concept. I thought about ordering a side salad also but their online reviews were less than enticing.

The lettuce-wrapped cheeseburger was messy but delicious. I would order one any time! I noticed that eating a low-carb meal didn’t satisfy me as quickly as a balanced meal with carbohydrates does, but after 10-15 minutes the meal’s fat kicked in and I was satisfied for hours.

3 pm 

Time for grocery shopping! For the most part, I was able to buy the usual foods my family eats when planning for THM this week. The exceptions included a handful of specialty foods that are recommended to make the diet easier and more interesting to follow. I bought pressed peanut flour (a low-fat alternative to peanut butter, used mostly as a protein source in E meals), almond flour (for grain-free baking), and coconut oil (recommended by the plan for cooking, along with butter). These products were more expensive than the alternatives I typically buy and upped my grocery bill for the week by about $25. The containers I bought will most likely last for the next 3 weeks and probably beyond, so I imagine the extra costs will average out.

6:30 pm – Dinner (E Meal)

After running around a bit and making sure dad was settled at home, I ended up making a recipe I had planned for last week but never got around to cooking (and just so happened to be a type of burger…déjà vu, anyone?). I was able to use up the ingredients with just a few tweaks for THM. I put my black bean veggie burger (which didn’t hold together well but tasted  good) on a bed of lettuce and a slice of sourdough. I made baked sweet potato fries and a strawberry banana smoothie as sides. It was very satisfying and lasted all the way until bedtime!

Overall, definitely not a bad day. It’s taking a bit of getting used to, thinking carefully about all of the parts of my meal to make sure to balance fuel sources per the THM plan. I have a feeling my husband and boys will particularly love the S meals I have planned for the week!

Disclaimer: This is not a sponsored post and I have no affiliation with the producers or manufacturers of this product; however, as an Amazon Associate, I receive compensation for any purchases of products through the links on this post.

In my last post I described the basics of the Trim Healthy Mama Plan, as outlined in the book by the same name. Here, you’ll find my initial impressions of the plan itself from a dietitian’s perspective. I begin test driving the plan myself next week, so I will keep you updated with more firsthand thoughts as I go along. For now, here are the things I like, things I don’t care for, and things I am really curious to try out for myself:

Things I like about the plan

• It is basically structured moderation. It would probably work well for someone who needs a bit of structure (“guardrails” if you will) to feel comfortable with portion control or balance.
• 80% (or so) of the plan is evidence-based and in line with physiology – I’ll go into more detail about that in my research post(s) next week.
• The plan is geared directly toward regulating blood sugar, which prevents fat storage, both of which reduce inflammation, which helps regulate blood sugar, which prevents fat storage…you get the idea. This plan directly addresses the most common “vicious cycle” I see in my clients.
• It is customizable to fit many health-related goals, as discussed in this post.
• It does not entirely eliminate any food groups.
• The authors take a very realistic stance and are careful to emphasize that weight loss will be gradual and health is a long-term journey.

Things I don’t care for

• The tagline on the book is “Keep it simple, keep it sane,” yet even the summarized version of the book is 300 pages long. To get started, you’d probably only need to read the first third of it, but there’s a pretty steep learning curve depending on your starting level of nutrition knowledge. I think (and the authors second) that after a while it would become second nature and not require much thought, but “simple” is not the word I would use to describe the plan out of the gate.
• As you might have deduced from the second bullet above, about 20% of the plan is not evidence-based or wholeheartedly holds on to questionable or controversial stances. Again, more detail is forthcoming in my research post(s).
• In the intro chapters, the book says ALL foods are “in,” but as you read further it says to stay away from certain foods like fruit juice or white potatoes, especially if you’re trying to lose weight. Granted, it never says you can’t have them, but it definitely takes a stance against them. Also, throughout the book they are careful to use the phrase “not on plan” rather than “not allowed,” though technically the feeling you get is that those foods are no-nos. Which leads me to my next point:
• Labeling foods as “bad” or “good” is problematic and can really affect people’s relationships with food in a negative way. This can get really tricky when you’re trying to discuss the nutritional merits of foods and I run into that too. The authors of the book do say that they believe all foods are good to eat; however, some of their language in the book gives the wrong impression (for example, I’m looking at you “Not-so-naughty Noodles recipe! Noodles aren’t “naughty!”).

Things I’m really curious to test out

• The authors claim you can follow this plan very simply, even if you don’t know how to cook.
• Most of the baked goods are grain free, and I haven’t met too many delicious grain-free baked goods in my day. They claim the recipes are tasty, and I hope they’re right!
• I plan to do a mix of S meals, E meals, and crossovers to get the full experience (check out my Trim Healthy 101 post if that sentence made no sense to you).  I sometimes have mild to moderate hypoglycemia which may make it difficult for me to eat S meals, but I’m going to try it to see what happens. The authors state that people with severe hypoglycemia may need to eat crossovers instead to avoid low blood sugar.

I’m looking forward to getting started with this one! Let me know your thoughts, comments, or questions and I’ll make sure to address them.

Disclaimer: This is not a sponsored post and I have no affiliation with the producers or manufacturers of this product; however, as an Amazon Associate, I receive compensation for any purchases of products through the links on this post.

If you’re anything like me, the phrase “Trim Healthy Mama” (aka THM) didn’t really mean much to you – maybe you’d never even heard of it – up until this point. I was vaguely aware of the existence of the plan because several ladies at my church follow it, but as far as details, I couldn’t tell ya much. Or anything, actually.

So last week I got a hold of a copy of the Trim Healthy Mama Plan. This book is the 300ish-page summarized version of the 650ish-page original book Trim Healthy Mama. The writers, sisters Pearl Barrett and Serene Allison, have also released two cookbooks: Trim Healthy Mama Cookbook and Trim Healthy Table.

I’ve read most of the way through the book so far, and I’ve gotten the gist of the plan. THM is clearly geared toward women but the authors say their husbands love it and have also lost or maintained weight on the plan. In this post, I’ll lay out a very broad overview. I’ll share my thoughts about it and what the research has to say in future posts.

The plan incorporates the nutritional concepts behind several different “diets” or eating plans. It’s a little bit of glycemic index, a little bit of carbohydrate counting, some low fat, and some low carb, topped with a skosh of mindful eating (you didn’t know that was how skosh was spelled, did you? Me neither…I had to look it up). Pearl and Serene have created their own terminology with which to couch all of these different concepts. Here are a few THM glossary entries you’ll need to know:

S (aka satisfying) meal: a high fat, low carb meal with plenty of protein

E (aka energizing) meal: a moderate carb, low fat meal with plenty of protein

Crossovers: meals that contain both S (high fat) foods and E (high carb) foods

Fuel pull: a type of food that is low enough in both fat and carbs that it doesn’t count toward either group and can be added to either S meals or E meals

Fuel pull meal: low-calorie meal comprised primarily of protein and fuel pull foods

THM is designed so you can customize your own plan based on your needs:

• Weight loss – avoid crossover meals and stick primarily to S or E meals separated by at least 2.5-3 hours, with occasional fuel pull meals sprinkled in
• Weight maintenance – eat a mix of S, E, and crossover meals
• Weight gain – eat primarily crossover meals
• Children, pregnant, nursing – focus on eating mostly crossover meals to support increased nutritional needs

The meals and their organization are based on the premise of selecting fuels intentionally based on your goals. According to the authors, eating multiple fuels at a time is more conducive to weight gain/maintenance, while limiting fuels to one type or the other at a time is more conducive to weight loss. Stay tuned for how this lines up with physiology and research!

There are quite a few nuances and specifics about the foods that comprise each type of meal which I haven’t mentioned here, since this is a broad summary. I start following Trim Healthy Mama on Monday, so keep an eye out for posts with more detail and what it’s like for me while following the plan. Let me know what you think or if you have specific questions in the comments!

Disclaimer: This is not a sponsored post and I have no affiliation with the producers or manufacturers of this product; however, as an Amazon Associate, I receive compensation for any purchases of products through the links on this post.

Thanks for all of your suggestions, everyone! Here are the nominees:

Whole 30

Whole 30 was created by author Melissa Hartwig and is promoted as a “nutritional reset button” in which you eliminate a list of certain foods identified by Whole 30 founders as potential causes of bloating, metabolic upset, and a myriad of other conditions. The Whole 30 website claims that cutting these foods out for 30 days can improve your relationship with food, regulate digestion, and balance your immune system.

28-Day Shrink Your Stomach Challenge

Championed by Dr. Oz, this 28-day challenge focuses on weight loss, reducing bloating, and shrinking your waistline. The plan involves a mild form of intermittent fasting, elimination of dairy, sugar, and alcohol, and includes basic frameworks for each meal and snack. It also includes a daily plank challenge.

Trim Healthy Mama

Trim Healthy Mama is a book written by sisters Pearl Barrett and Serene Allison, promoted as the “easy does it” approach to eating well. The plan focuses on alternating fuel types by avoiding eating carbs and fats in the same meal. It also eliminates added sugar and encourages waiting 3 hours between meals.

Vote for your choice below and let me know how I can help you make informed healthy choices!

This poll is now closed.

I’ve been busy researching, reading, and compiling more information from scientific studies done on intermittent fasting and its potential benefits. This is part two, but you can go here to read about more research on fasting or here if you’re not sure what intermittent fasting is all about.

Can intermittent fasting…

…improve blood sugars and prevent/manage diabetes?

• Animals that ate intermittently exhibited resistance to diabetes and improved blood glucose and insulin sensitivity, even if they did not achieve caloric restriction (Anson et al 2003; Duan et al 2003)
• Animals on daily caloric restriction have lower fasting blood glucose, fasting insulin, reduced inflammatory markers, and improved insulin sensitivity (Lane, Ingram, Roth 1999; Imai 2010; Hursting et al 2003; Lane et al 1995; Wang et al 2007; Bonkowski et al 2006; Okauchi et al 1995; Walford et al 1999; Walford et al 2002; Wang et al 2007; Kalani et al 2006)
• Human results on intermittent fasting are mixed:
  • One study found no change in glucose but lower fasting insulin after 22 days of intermittent fasting (Hielbronn et al Jan 2005).
  • One study found that, while fasting, subjects with diabetes had higher blood sugar levels (Saada et al 2010).
  • Another found that after 22 days of intermittent fasting, women’s bodies showed more difficulty clearing blood glucose but that there was no difference in men. Men also had a decreased insulin response, but women didn’t. (Hielbronn et al Mar 2005).
  • Another study found no change in glucose or insulin in men after 14 days of intermittent fasting (Halberg et al 2005).
  • Two studies found that in humans, insulin sensitivity is more improved with fasting than with caloric restriction (Varady & Hellerstein 2007; Harvie et al 2010)
• Humans on caloric restriction showed lower fasting insulin levels, improved insulin sensitivity, and lower blood glucose. (Hielbronn et al 2006; Weiss et al 2006; Fontana et al 2004).
• The boiled-down verdict: Animals show improvements in blood glucose, insulin sensitivity, and resistance to diabetes with both intermittent fasting (without caloric restriction) as well as caloric restriction (without intermittent fasting). In humans, research on intermittent fasting and blood sugars delivers mixed messages, which probably means there are other factors involved that we don’t understand yet. There might be a gender difference in the blood glucose response to intermittent fasting. Several studies showed that daily caloric restriction can improve fasting insulin levels, insulin sensitivity, and blood glucose in humans.

…treat asthma?

• In one study, intermittent fasting reduced airway resistance, reduced inflammation, and improved the medicinal effects of albuterol in patients with asthma. (Johnson et al 2007)
• The boiled-down verdict: We need more research, but intermittent fasting may have some promising benefits for those with asthma.

…decrease risk of heart disease?

• In animals, caloric restriction has led to lower triglycerides, better cholesterol panels, and reduced inflammatory markers (Edwards et al 1998; Wang et al 2007; Kalani et al 2006; Lane, Ingram, Roth 1999).
• Animals on intermittent fasting and caloric restriction have lower blood pressures and heart rates (Tikoo et al 2007; Wan et al 2003; Lane, Ingram, Roth 1999; Wang et al 2007; Fontana et al 2004; Mager et al 2004).
• In humans, similar improvement is seen in cholesterol, inflammatory markers, and blood pressure with caloric restriction via intermittent fasting (Harvie et al 2011, Varady et al 2009; Walford et al 1999, Walford et al 2002).
• The boiled-down verdict: It seems you can protect your heart with lowered cholesterol, inflammation, and blood pressure by reducing calories, either by eating a little less every day or by intermittent fasting.

…slow cancer?

• Animals that eat intermittently exhibit slowed tumor growth, improved the effectiveness of chemotherapy, and reduced side effects of chemotherapy (Berrigan et al 2002;Lee at al 2012).
• In mice, intermittent fasting without caloric restriction reduced the occurrence and growth of lymphoma (Descamps et al 2005).
• Several studies show that animals with tumors had slower tumor growth and lived longer when calorically restricted with adequate protein, vitamin, and mineral intakes (Weindruch et al 1986; Pashko & Shwartz 1996; Pugh et al 1999; Imai 2010; Hursting et al 2003); however, one study showed mice had no slowing of tumor growth when on caloric restriction (Keenan et al 1997).
• Reviews of animal research conclude that the cancer prevention/slowing benefits are similar between intermittent fasting and calorie restriction (Varady & Hellerstein 2007).
• The boiled-down verdict: Research on the benefits of caloric restriction for cancer is mixed. Intermittent fasting may slow tumor growth and improve the effects of cancer treatment in animals. We need more research to know how these effects may transfer over to humans.

And just like that, 3 weeks of intermittent fasting is over. In the last week, I changed the structure of my intermittent fasting a little bit. I followed a pre-made intermittent fasting plan that had a 12 pm – 8 pm eating window and planned meals and workouts. The workouts were more targeted for fat loss and not for muscle building (which were my goals with my previous workouts). Changing the workouts allowed me to aim for slightly lower calorie goals since losing fat requires fewer calories than gaining muscle.

Let’s review the entire three weeks, shall we?

How it Went:

Unfortunately, I did not enjoy the experience of intermittent fasting. I’m a lifelong breakfast eater – can’t even remember ever skipping one – so not eating until 10 am or noon (depending on my window) was pretty miserable. I was super hungry, weak, and tired in the mornings, and I noticed that I was more tired as the three weeks went on. I’m not sure if this was related to the eating schedule itself or not, because I also realized that throughout the three weeks I ate fewer vegetables than normal. This was sort of an interesting “side effect” of the eating schedule. Because I was trying to fit all my macros in a small window (and was full throughout most of that window), I ate vegetables less often because I didn’t have space for them! For the most part, vegetables have very few macronutrients (carbs, protein, or fat) and a lot of micronutrients (vitamins and minerals). I often recommend clients increase vegetable intake to help with fullness without adding a lot of calories or macronutrients – the opposite happened here! I was so full throughout the eating window that I strayed away from veggies and towards things that were going to help me meet my macro goals. As a result, my vitamin and mineral intake was much lower than normal, and could definitely have caused my tiredness.

One positive change I noticed is that I liked not eating later in the evening. There are reasons to avoid eating close to bedtime, and having a set time that my eating window “closed” prevented me from going to bed on a stomach full of energy I didn’t need, as well as habitual (not hunger-driven) nighttime snacking and desserts. I usually felt pretty good in the evenings.

As a side note, I love to cook and eat food in general, but I tended not to look forward as much to eating because I was either hungry and waiting to eat or full and had to eat anyway. Eating this way was much less enjoyable and satisfying for me than intuitive eating on a schedule that works well for my body.

What I Learned:

While reviewing the research on intermittent fasting this week, I discovered that researchers have almost exclusively studied alternate day or 5:2 fasting protocols rather than the 16:8 protocol that I followed. If you’re confused about what those protocols mean, check out this post. I wish I would have read through more research before I started, because I might have followed those protocols instead just to match the research.

From a dietitian’s perspective, I learned that there are certain people with certain goals who are good candidates for intermittent fasting and for whom it might work wonderfully. In fact, throughout my time on this diet I met several people (or found out about people I already knew) who use intermittent fasting to regulate their intakes and benefit their health. I plan to summarize characteristics of those folks in an upcoming post! The research is clear that intermittent fasting is one way to achieve quite a few health goals (though there are other ways!). In my practice, I will keep intermittent fasting as another option in my dietitian “tool belt” to help create plans that best match each client’s personality, lifestyle, and goals.

How I did and What Changed:

Overall in 3 weeks, I lost 3.6 lbs, 1.75″ from my waist, 1″ from my thighs and 1.6% body fat. Not too shabby!

The third week is on its own because when I changed my workouts, my calorie and macro needs changed. The meal plan I used that week must have been built on different macro targets than I had set, because I ended up higher on fat and lower on carbs and protein in general. I did the best at hitting my macro goals in the second half of week two, when I broke my needs down into a schedule with macro goals at each meal. It’s important to note here, though, that in the research studies, they often did not track macros or make sure that subjects were meeting their calculated macro needs. In fact, in many of the human studies, the subjects often did not end up meeting their calculated calorie needs.

There are a lot of health claims around the benefits of intermittent fasting. As there is so much to say about this topic, I had to split the research into two parts. I am sure this is nowhere near a comprehensive compilation, but I have done my best to boil down the results of a variety of research studies on the potential benefits of intermittent fasting.

One major thing to note as you read through this is that there are a lot of documented health benefits to eating less than we usually do, or in scientific terms, caloric restriction. Most studies on intermittent fasting restricted intakes to 0-50% of the participants’ calorie needs for 2-4 days per week. On the rest of the days, they could eat as much as they wanted. Some studies on intermittent reported subjects overall caloric intake, others didn’t, so it can be tough to make that distinction. In general, when animals are on an intermittent fasting regimen, they eat enough on feeding days to compensate and usually do not end up restricting calories (Anson et al 2003; Descamps et al 2005). Humans, however, usually do not eat enough to compensate and end up restricting calories via intermittent fasting (Harvie et al 2011; Heilbronn et al 2005; Catennaci et al 2016). In other words, the results in many of the human studies could be based on the fact that calories were restricted by fasting, not by anything special about fasting itself. We need more research to distinguish between the two!

Can intermittent fasting…

…cause fat loss?

• Animals on both intermittent fasting and caloric restriction lose fat (Anson et al 2003; Lane, Ingram, Roth 1999; Pashko & Shwartz 1996; Duan et al 2003). One study on mice showed that even though the mice on intermittent fasting averaged the same amount of calories as the normally-fed mice, they did weigh a little less (Anson et al 2003).
• Humans lose fat with intermittent fasting too, though most humans who followed intermittent fasting ended up eating fewer calories overall, also achieving caloric restriction (Harvie et al 2011; Heilbronn et al 2005; Catennaci et al 2016). It is relevant to note here that in studies that asked subjects about their hunger levels, subjects were more hungry on an intermittent fasting diet.
• In one study, women who restricted calories via intermittent fasting lost more body weight than women on daily caloric restriction (Harvie et al 2013). In both cases, their calories were restricted.
• One study found no difference in metabolism (measured by resting metabolic rate (RMR)) between those who had intermittently fasted and those who did not (Heilbronn et al 2005).
• Studies on caloric restriction show that subjects tend to lose muscle mass while losing fat, but can prevent this by eating a high-protein diet while restricting calories (Piatti et al 1994). Two studies have shown that while intermittent fasting, subjects lost fat and were able to maintain muscle mass while eating a lower protein diet (Bhutani et al 2010; Catennaci et al 2016).
• The boiled-down verdict: Fat loss can be achieved by eating less overall, either through eating a little bit less each day or fasting (eating ~25% of your daily needs) every other day or a couple of days per week. Based on limited research, it seems you can maintain muscle while losing fat, either by restricting calories and eating plenty of protein, or by restricting calories using intermittent fasting. It’s possible that weight loss could be faster when calories are restricted via intermittent fasting, but more research is needed to confirm that.

…preserve brain function?

• Animals that eat intermittently experienced slower progression of age-related memory loss and  neurodegenerative diseases (Parkinson’s, Hungtington’s, and Alzheimer’s) (Anson et al 2003; Halagappa et al 2007; Duan et al 2003). This is also seen with caloric restriction in both animals and humans (Imai 2010;Hursting et al 2003; Pitsikas et al 1990; Halagappa et al 2007; Yu and Mattson, 1999).
• Mice on calorie restriction via intermittent fasting had less brain damage during and after a stroke than mice who ate all they wanted (Arumugam et al 2009).
• The boiled-down verdict: In mice, it’s possible to prevent and slow brain aging, damage, or diseases by eating less overall, either through eating a little bit less each day or fasting every other day. We need more research to know how this applies to humans.

…help you live longer?

• Animals that eat intermittently (every other day) can live more than 30% longer than those who eat daily (Goodrick et al. 1983; Anson et al 2003,  Duan et al 2003).
• Mice lived 35-60% longer when on caloric restriction but meeting protein, vitamin, and mineral needs (Weindruch et al 1986; Imai 2010; Hursting et al 2003; Canto & Auwerx 2009; Keenan et al 1997, Pugh et al 1999)
• The boiled-down verdict: As long as macronutrient, vitamin, and mineral needs are met, both intermittent fasting and caloric restriction can promote longevity in animals. Human research on longevity is really tricky (and expensive), so that’s lacking.

Check out this post to learn about the research on intermittent fasting and diabetes, cancer, asthma, and more!