Macro Basics With Sarah Udell, RD

We break down calories and macronutrients in plain language, then connect the science to real-life habits that make weight loss feel sustainable instead of punishing. We also zoom out to metabolic health, emphasizing small changes, personalization, and protecting mental health while you pursue your goals. 
• Calories as energy and practical ways to estimate needs, including BMR testing and tracking averages 
• Why a small calorie deficit supports sustainability, satiety, and muscle retention 
• Where energy expenditure comes from, including BMR, daily movement, exercise, and the thermic effect of food 
• Tracking tools, food scale accuracy, and non-tracking options like the plate method and mindful eating 
• Protein basics, why it helps during weight loss, and realistic intake ranges for preserving muscle 
• Carbohydrates and fiber, why fiber matters, and common gaps in typical American diets 
• Dietary fat, hydration guidance, and alcohol limits plus strategies to cut back 
• How we prioritize macros based on the person, often by adding food quality rather than restricting 
• Mental health safeguards and why we avoid tracking for people with disordered eating histories 
If you found this information helpful, please share with a friend, family member, or colleague. We need to do all we can to combat the dangerous misinformation that is out there. Please subscribe and write a review. This will help others find the podcast so they may also improve their metabolic health. 

If you want to work with a well educated, effective and caring dietitian, then look no further than Sarah Udell, RD!
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Welcome And Medical Disclaimer

Dr. Lindsay Ogle 0:00

Welcome to the Modern Metabolic Health Podcast with your host, Dr. Lindsay Ogle, Board Certified Family Medicine and Obesity Medicine Physician. Here we learn how we can treat and prevent modern metabolic conditions such as diabetes, PCOS, fatty liver disease, metabolic syndrome, sleep apnea, and more. We focus on optimizing lifestyle while utilizing safe and effective medical treatments. Please remember that while I am a physician, I am not your physician. Everything discussed here is provided as general medical knowledge and not direct medical advice. Please talk to your doctor about what is best for you.

Meet Sarah And The Big Goals

Dr. Lindsay Ogle 0:44

I am here with Sarah Udel. She is a dietitian who is going to be sharing a lot of really helpful information with us. So I will just let her get started.

Speaker 0:55

Hello, everybody. Thanks for joining us. I wanted to come on here today and talk just kind of basically about macronutrients, calories as well, and then their role in sustainable weight loss. So a quote that I like to, you know, I really enjoy when talking about sustainable behavior change is success is the sum of small efforts repeated day in and day out. And that just for me really encompasses what lasting behavior change is all about. It's those tiny things that really add up and make a huge difference in our life. So I'm Sarah Edel, like Dr. Lindsay said. And my I started my private practice last year, and I'm really passionate about helping busy women and moms, especially, but really anybody who wants to stop yo-yo dieting and just finally achieve their nutrition goals, their weight loss goals, and never have to go on another diet again. My background is, like she said, a registered dietitian. I have a both a bachelor's and a master's in nutrition. And I'm also a certified diabetes care and education specialist as of last year, and just recently, last month, became a certified personal trainer. So lots of lifelong learning on my end.

Calories, BMR, And Small Deficits

Speaker 2:06

All right, so to get into it, I think everybody knows what calories are. It's really basically just a unit of energy. It's how we measure the energy that our body needs. And we can estimate this in a number of ways. A lot of dietitians utilize evidence-based equations to get a pretty good estimation of somebody's energy needs. Other options would be BMR testing, which is a little bit more accurate and specific to the individual. And there's actually a couple businesses that have popped up in the last couple of years that I've noticed, especially in Missouri, both around Kansas City and St. Louis area, that offer BMR testing to consumers directly. So the names of those would be Fitness City and DEXAFIT. Those are the two that I'm familiar with. And then also if you don't have one of those local to you and you're interested in doing something like this, check with your local university's sports medicine lab. They might offer some these kinds of tests to the public. Another way to estimate energy needs is just to track intake and really monitor what your weight's doing. I'd say give it like two to three weeks and really look at averages of your energy intake and your weights versus the day-to-day fluctuations and compare those to see if your weights be is if your weight's stable, you can guess that your energy intake is your maintenance amount. And it's really important too, if you're not familiar with a lot of these things, to work with a registered dietitian or you know, health professional that's knowledgeable in this to really get you on the right track. So you're not severely underestimating your energy needs. And then of course, for weight loss, a calorie deficit is required. No way around that. Um, so we do need to consume less calories than our body needs to lose weight over time. And when I work with clients, I really try to keep the calorie deficit as small as possible, but still seeing results. Um, because the more calories we can, you know, keep on board, the less muscle we're gonna lose during weight loss, the happier we're gonna be, it's gonna be more sustainable for us long term. So there's really a lot of positive things that can come out from keeping your calorie intake as high as possible. All right, and just a recap of like where our energy needs are coming from.

Where Daily Energy Burn Comes From

Speaker 4:29

Um, the biggest part of our energy requirements comes from the BMR or the basal metabolic rate. And then the daily movement is the other kind of larger chunk of our energy needs. And that's all those little things that we're doing, like fidgeting or like I'm doing talking with my hands. Um, if we're walking around a lot, if we, you know, are doing yard work, housework, those are categorized as that daily movement. Um planned exercise is really not a huge part of our energy needs. It's about 10% or so. Um, so I work with a lot of people who tell me, gosh, if I could just exercise more, I lose weight, no problem. And really, I mean, yes, exercise is beneficial, don't get me wrong, but it's not a huge part of our energy needs. And then that last part is the thermic effective food, which is really just the energy that our body requires to uh digest and utilize our nutrients from our

Tracking Options Beyond Calorie Counting

Speaker 5:27

food. All right, so some of the tools that are useful when you're tracking your calories or macronutrients would be some sort of tracking application. Um, there's five that I included here. Uh the three on the left are uh MyFitnessPiles on top, lose it is the one in the middle on the bottom, and then Chronometer is the one on the left on the bottom. And those all have both three free and paid versions, um, if you're interested. And then the two on the right are both paid versions, but they're roughly you know less than $10 a month. And they come with some additional features. Uh both of those, I believe, have a coaching piece to their app. And they actually help you adjust your macronutrient intake based on the data that you're inputting. So whatever your calorie intake is and your weight changes, it will adapt, you know, based on your metabolism, um, you know, according to your goals. So it's a really nice extra benefit for that. Um, other tools that I recommend for individuals who want to track their food, would be a food scale. I really, I really prefer that over the measuring devices, like measuring cups. They're just not as accurate. And I say, hey, if we're gonna track our food and measure it, you know, let's do it right and get it as accurate as possible. So that's something that I do utilize with some of my clients. Um, other approaches, if you're just really not into tracking and that's not something you you want to do, um, there's other approaches. There is visual guides that use household items or, you know, different parts of your hand to estimate portion sizes. The plate method is one I use a lot with people that don't want to track because it's really just basically a template to a balanced meal and helps people, you know, get those portions a little bit uh more in line with their goals. And then another thing that I utilize with a lot of my clients is mindful eating. And that's just really, you know, if you've been dieting for years, if, you know, maybe from your teen years, and um you're really maybe out of tune with your body and you can't necessarily tell when you're hungry or tell when you're full. Mindful eating is a great tool to really get you back in tune with your body and help you be more mindful during mealtimes. And then the last thing, I I really honestly use this with all my clients as well, is tracking those non-scale victories, the non-scale progress, like um how we're feeling, our energy level, uh, how our clothes are fitting, maybe taking progress photos, maybe taking measurements even. Um, so really looking at the bigger picture here. And, you know, most people don't only care about the number on this scale. Um, they really want all the benefits that come from improving their body and or improving their health and making those changes to their lifestyle. So um tracking the non-scale progress is is really helpful there.

Protein For Fullness And Muscle

Speaker 8:23

All right, so getting into the macronutrients, protein. I think protein has the best marketing um marketing campaign of any of the macronutrients. Um, everybody you know knows all about it, but um you get about four calories per gram of protein. And of course, some super important roles in the body. Um, tissue growth and maintenance is a really big one, enzyme production, hormone production, and many others as well. Um during weight loss, protein is really beneficial because it does help us feel fuller longer. And especially when we're reducing our calorie intake, hunger is something most of us are wanting to avoid or at least minimize as much as possible. It also actually requires more energy than carbohydrates or fat to digest. It's about 20 to 30 percent of the calories from protein are actually utilized for digestion. And then also just to minimize muscle loss during a calorie deficit, protein is really essential here, um, just to make sure we don't we don't lose more muscle than we want to. All right, so as far as needs go, uh there's a couple different things that we can look at when looking at our protein needs. The minimum required for a sedentary adult is 0.8 grams per kilogram, which that translates to about 0.36 grams per pound of body weight. Um, so really not a lot there to prevent like a deficiency in protein. That doesn't necessarily mean that it's optimal for most people, especially active individuals, people who are strength training and trying to build muscle would really benefit from actually quite a bit more than that. The DRI recommendation for protein is a wide range, 10 to 35% of your total energy needs. So, you know, not super helpful there either, um, as far as pinpointing a specific amount. So the research really is showing us that for weight loss, for preserving muscle tissue and building muscle, 1.2 to 1.6 grams per kilogram of body weight is really kind of that sweet spot there. So that translates to roughly like 0.6 to 0.75 per pound of body weight, um, converting that to pounds there. Um but yeah, just so that's kind of a good range to be in. And then you can always adjust, or um, you know, if you're working with someone, they can help you uh maybe change that around for you, your individual situation. And then for food sources, we really want to focus on kind of those leaner proteins. So like chicken, turkey, lean beef or pork, fish and seafood are excellent protein sources, low-fat dairy, so like Greek yogurt, cottage cheese, uh, eggs and egg whites. And then some of these plant-based sources are also really helpful: beans and lentils, nuts and seeds, and then soy protein as well. Some of the proteins that we want to just minimize in our diet, I don't say cut out because, you know, when we're talking about a um calorie deficit, you know, we really uh we want to still enjoy our food. And, you know, there's room in a healthy diet for some of these occasional high-fat protein options like fried chicken or um maybe full fat dairy or some bacon every now and then. So I'm a big fan of fitting all foods in moderation and not feeling deprived and cutting things out unnecessarily. And then for those that are have that have kidney or liver issues, it's really important to check with your provider before you make any adjustments to your protein, as you would potentially have different recommendations here.

Carbs, Fiber, And Gut Health

Speaker 12:09

All right, and then carbohydrates, kind of the um the macronutrient that gets the bet the worst reputation. But um, I mean, carbs are really essential for energy production. They, you know, help us, uh, they include fiber a lot of times. Uh, fiber is found in primarily carbohydrate-rich foods. So it is important to get adequate carbohydrates for, you know, if you're an athlete or you're just trying to exercise more and you want to have, you know, have an improved performance there, carbohydrates can really be a game changer here. There's different types of carbohydrates: sugar, uh, starches, those are kind of the main two carbohydrates. And then fiber is also included. Our body does not digest fiber. It's primarily a fuel source for our gut bacteria, um, but it does have a really essential role in our overall health. Um, some of the benefits of fiber would be, you know, increased fullness, um, being able to eat a lot more food at your meal without exceeding your calorie goals. Um, that food volume there is really helpful for fiber. And then it does help reduce risk of a lot of chronic health diseases or chronic health issues, heart disease, diabetes, certain types of cancer, uh, fiber has been shown to reduce risk for those. Um, then it also helped keep you regular. So, you know, reducing constipation. Not a bad thing there. Um, so as far as um the recommendation, um, the DRI for carbohydrates, 45 to 65% of your energy needs should come from carbohydrates. And then 25 to 38 grams of fiber per day is what's recommended for adults. And I will say I think about 90% of Americans are not meeting these fiber goals. So definitely something that we can improve on as a whole. Some of the best sources of carbohydrates, which coincidentally all happen to be high in fiber, would be whole grains, beans and lentils, fruits and vegetables. Those are all excellent sources of carbohydrate. Um, the ones that we want to choose a little bit less often would be like refined grains, obviously anything with a lot of added sugar in there, um, candy, sugary beverages. These are things that were typically exceeding our sugar intake for the day. And really, really not just, they're really just not providing us with a lot of nutrients. All right, and the last main macronutrient is dietary fat.

Fat, Hydration, And Alcohol Reality

Speaker 14:44

And this one comes a little bit more energy dense at nine calories per gram. Fat's definitely important in our body as well. Um, it's an essential nutrient required for absorption of our fat-soluble vitamins. And it can also help slow digestion and keep us fuller longer as well. And the DRI for this nutrient is 20 to 35% of our energy needs. Some of the best food sources would be avocado, nuts and seeds, uh, fatty fish, kind of those whole food fat sources. Um, I suppose plant some plant oils would would fall under that as well. And then things to choose a little bit less often would be, you know, your fatty meats, processed meats, high-fat dairy, and some of the saturated plant oils like coconut or palm oil. All right, and water, I had to include water just because it's so essential for um good health. Obviously, we're about 60% of water, our body is about 60% water. So we we definitely want to get adequate water intake. Um it is important too for a lot of processes, digestion, metabolism, eliminating waste. And the recommendations for water um can vary. Umbout nine cups per day for women, 13 per met for day for men. And really, you know, I think water is more of like an it should be individualized. And some people may need more depending on their activity level, maybe where they live. Um and it's good to just monitor your urine color to really figure out the the best um amount for you to maintain hydration status. And really all fluids provide hydration, and some foods do as well, especially your fruits and vegetables. All right, and the last one here is alcohol. Um, obviously not an essential nutrient, but something that, you know, obviously a lot of Americans are consuming on a fairly regular basis. Um there is, you know, it's recommended that we limit alcohol, especially for um, you know, for women, one drink a day or less, and then for men, two drinks a day or less for men. And then, yeah, obviously we know it's not super great for our health. It's it is a known carcinogen. So finding ways to minimize alcohol in our day, you know, especially if we find that we're turning to it, you know, maybe after a busy work day, stressful day, you know, just want to take a break, you know, kind of figure out, you know, what your relationship with alcohol is. And if you're concerned about it and feel like you have a problem, definitely a good thing to discuss with your provider. Um, but some strategies to help you reduce intake would be finding a good mocktail recipe. Um, luckily, the non-alcoholic movement is pretty strong right now. So there is a lot of non-alcoholic beers and wines and different mixed drinks out there on the market that kind of make it a little bit more exciting to um to drink. So if that's something you'd be interested in, that can be a great way to just reduce your alcohol intake. All right, and that was it. So, kind of a quick rundown of the macronutrients and how they, you know, relate to weight loss and a sustainable approach to weight

Prioritizing Macros The Individual Way

Speaker 18:00

loss. Um, so now I'll take some questions.

Dr. Lindsay Ogle 18:04

Yeah, that was great. Um, I I love how you broke everything down and gave us a lot of information, but it was still um digestible. And you know, I think we all we all learned a lot. Um, I love how you included water. Um, I think that that can get overlooked sometimes. And I agree, I I don't tend to make for my patients a particular um like goal amount or recommendation. I have them look at their urine color and look for uh light yellow or clear color, and then then you know that your body is hydrated because there are so many variables. So totally agree with that. Um, and I was laughing when you were talking about protein having uh the best PR rep out there because I totally agree. Everyone is talking about protein. I've even seen like um at Starbucks, um, I don't know if it's just where I am, but they don't even show the calories anymore, they show the amount of protein in like their food items. So very interesting. Um, but I was curious, do you um for your clients who are focused on um you know their weight management and their health, is is there a particular macronutrient that you tend to focus on first or prioritize? And if so, why?

Speaker 19:29

Yeah, so you know, I think really that depends on the individual. And that's what I love about working with people one-to-one is that there isn't, you know, a blanket recommendation for everyone. There's no best macronutrient split up uh for weight loss. So it is very individualized. Um, I do find that a lot of people that come to me that have been dieting a lot in the past are way under eating, especially fiber, especially carbohydrates in general. So a lot of times we'll kind of assess and see where they're at now and where, you know, we where we want to go and we'll take one to two things at a time. So that's how I, you know, it's how that's how we make behavior change last is taking it in small steps. So we'll, you know, kind of isolate whatever it is that they're struggling with and we'll create some steps to increase that. So for example, if someone is not getting a lot of fiber in their diet, maybe we'll talk about how how can we get some in, you know, what you're doing now. So potentially if they're doing oatmeal for breakfast, we'll see if we can throw in some chia seeds into their oatmeal. Or maybe if they're doing like taco night regularly, can we throw some beans in there with the taco meat to increase the fiber? So just different strategies like that. Um, but I will say it is very individualized. You know, some people are struggling with protein intake. Um, and fiber is another big one. As I mentioned before, you know, 90% of us aren't getting enough fiber. So it's definitely an area for a lot of us to work on.

Dr. Lindsay Ogle 21:07

Yeah, I have um two things to say about that. One is that I I love that you started off with this being an individualized approach. And I think that every single person that I have talked to during this health summit has said the exact same thing. And that makes me know that I chose the right people to have this summit with because I couldn't agree more. I say it's a red flag when you're hearing somebody say there is this one diet or this one supplement or one medication that is going to be the answer for everybody because that is not the case. You want to work with somebody who is going to tailor, you know, their knowledge that they have around health to create a plan that is right for you. So um just wanted to highlight that um because that was. Which is so important. And then second, making the you know, those small changes over time to make it sustainable, I think is is very important as well. Um, and the examples that you gave, um, I don't know if you noticed, but they were ones where you're adding to your diet rather than taking away. And I think that just having that those kind of examples um or those first changes to be additive rather than restrictive and taking things away can help so much from a mental health standpoint um and the relationship with food and with making it um again lasting change. So um yeah, I I think those are great and thank you for sharing.

Speaker 22:47

Yeah, thanks.

Dr. Lindsay Ogle 22:49

Um I guess that and that kind of answers the the next question that I had was about um if there's one dietary approach that you recommend. But uh, do you have any um follow-up comments on that?

Speaker 23:03

Um, you know, I again I think it is very individualized. You know, we know with nutrition, there's no, there's no black and white, there's no one size fits all. Um, so you know, it really just depends on the person. But I generally take a more balanced approach. Um, when people, you know, want to drastically cut out a certain macronutrient or um do things that are, you know, very extreme and not sustainable. That's something that I try to work them away from and try to find more balance in their in their nutrition in general. Um, but yeah, I mean, I think just really I think it's all super individualized. Okay, great.

Mental Health And Who Should Not Track

Dr. Lindsay Ogle 23:42

Um, well, like I said, this was wonderful. I think super helpful. Um, do you have any um closing thoughts or um last things that you'd like to share? Um and also if people want to follow you or ask questions or work with you, how would they do that?

Speaker 24:03

Yeah, yeah. So one thing I wanted to mention earlier in the presentation and it slid my mind is um kind of that relationship with food peace. I take I take mental health very seriously. And if, you know, if we're tracking and where our approach to weight loss is impacting mental health in any way, we pivot. You know, we definitely don't risk our mental health to achieve a weight loss goal. Um, so that's a big thing that I monitor and focus on a lot. And um, I don't recommend tracking for people with a history of disordered eating or an eating disorder. Um, it's definitely, you know, there the risks outweigh the benefits there for a lot of individuals with that history. So um just something I wanted to throw out there that I forgot to mention earlier. Um, but if you want to follow me, I'm on Instagram. It's at Dietician Sarah with two lines underneath. Um, and then my website is www.dieticiansarah.com.

Where To Follow And Final Takeaways

Dr. Lindsay Ogle 25:03

Thank you for listening and learning how you can improve your metabolic health in this modern world. If you found this information helpful, please share with a friend, family member, or colleague. We need to do all we can to combat the dangerous misinformation that is out there. Please subscribe and write a review. This will help others find the podcast so they may also improve their metabolic health. I look forward to our conversation next week.