Macros or Calories?

One of the most common questions I get is whether one should count macros or calories to facilitate weight (fat) loss or muscle gain. The answer? BOTH!!! The reason is because macronutrients (or macros) convert to caloric values! At the end of the day, each of us has a set amount of calories that we require to maintain , lose, or gain weight. So your macro needs will be a reflection of that particular caloric range. Remember, for weight loss, you need to create a consistent caloric deficit that is less than your body’s maintenance caloric needs and muscle gain should incorporate caloric intake that is slightly above weight maintenance calories.

For example, you are trying to lose weight and watch your fat intake at the same time. The general recommendation is typically 40% carbohydrate, 30% protein, and 30% fat – note all these percentages add up to 100%😊. So on a fat “conscious” diet you may want to choose 40% carbohydrate , 35% protein, and 25% fat. You may have noticed that the decreased fat percentage of 5% means that extra five percent of calories needs to be added to protein or carbohydrate percentages so that your percentages always equal 💯 . For this example, the extra 5% went to protein. Here’s where calories come in. Each gram of macro has a caloric equivalent. So if you are also consuming 1600 calories per day to create a deficit below maintenance calories (say your maintenance is 2200), you have to make sure your macro targets are aligned with caloric targets. Here’s the math. 1 gram of protein or carbohydrate yields 4 calories. 1 gram of fat yields 9 calories. Using the 40, 35, 25% target example above for dietary fat limitation goals, the calculation looks like this:

40% carb =

0.40 x 1600 calories = 640 calories ; 640 calories /4 calories per gram of carb = 160 grams of carbs per day

35% protein =

0.35 x 1600 calories = 560 calories; 560 calories/ 4 calories per gram of protein = 140 grams of protein per day

25% fat =

0.25 x 1600 calories = 400 calories; 400 calories / 9 calories per gram of fat = 44.4 grams of fat per day

Now that you know the basic concepts above, you can customize your dietary goals as your needs or goals change!! Note: different starting body weights (fat vs lean mass) and individual energy expenditure will dictate different caloric needs to meet daily goals for calories . You can calculate total energy expenditure (TEE) needs through various tools online. Time to customize your plan for results!!

For personal questions about this concept or other health questions, contact Dr. Kris at:



Will DIM interact with my Birth Control (OCP)?

First of all, the metabolism of estrogen and other hormones in the body varies between individuals for a number of reasons. That said, the evidence is inconclusive as to whether DIM interacts with OCP or YAZ specifically (and other medications that use the same metabolic pathway – there are many) . Current literature suggests dosages of 200-300mg per day to be relatively low risk for interactions and possibly efficacious for various claims for which DIM is marketed. However, lack of evidence does not mean there cannot be an inhibitive effect or competitive absorption. For example,  both DIM and YAZ are metabolized primarily by the liver, but so are cruciferous vegetables like broccoli, cauliflower, cabbage, and Brussel sprouts. The active ingredient in DIM is an extract from a constituent found in cruciferous vegetables. So given the consumption of these vegetables in the population at large, it is not likely a concern. In fact, I cannot think of a medication offhand that warns against potential interactions with broccoli or the likes😊… On the other hand, if avoiding pregnancy is your primary concern, do not take DIM – better safe than sorry and for that matter, it is not likely the end all be all solution to the issue for which you are taking it, so probably not worth the uncertainty in your contraception methods. If you are really wanting to include DIM in your regular supplement regimen, then you may want to consider other options for contraception in the future. None are without risk, but non-hormone secreting IUD is one of the least risky (save for a very low percentage who experience displacement of their IUD. Although the percentage is much lower than risks associated with other major complications and OCP use).

Macro Based Diets During Pregnancy and While Breastfeeding

Pregnancy is a very unique time for a woman and each experience can be very different from a health perspective, let alone what the respective dietary needs may be for each. Many woman want to ensure that they maintain healthy weight gain goals during pregnancy. Counting or tracking dietary macronutrients is a common dietary strategy. On one hand, the current tools and references used in popular diet trends which determine individual macronutrient needs for weight management are not based on expectant or breastfeeding populations. Therefore, the approach may not be appropriate for expectant mothers without some modifications. However, you can count macronutrients provided that you are maintaining an adequate caloric intake to support healthy weight and blood glucose levels for the duration of your pregnancy and that these goals are aligned with your health provider’s recommendations. Weight gain, glucose levels, and several other clinical markers will be monitored frequently throughout pregnancy. Some of these outcomes may be cause for modifications to the recommended diet for a patient at various points throughout their pregnancy. For example, some women may be prescribed a lower protein diet if they present with certain risk factors for a health condition. Additionally, your recommended weight gain is going to vary based on how much weight you are carrying when you become pregnant.