Ray's Take

Here is a normal day for me

730a

• Wake up
• Coffee (black), 2 cups or so
• no thoughts about food or anything until prob noon or so
• 0 cals, 0 carbs

12p

• BCAA + creatine drink
• this really reduces hunger
• 7g BCAAs, package says 0 cals. Not sure how this is possible but shrug

1p

• Usually do a strength workout, heavy
• note - lifting / exercising takes hunger away too

4p

• Drive to tennis at 4 - on the ride I will drink coffee and have a quest bar (smores)
• 200 cals, 25g protein (i sometimes eat slightly more than 1 so i'll round to 200 cals

430-6p

-Tennis
- Drink propel water (0 cals)

630p

• Get home. No food yet
• drink like a glass of wine or two / beer. Try to keep it to 2 max 3.
• 300 cals if wine only, 400 cals if wine + beer
  

730p

• Dinner - Always protein and veggies with sauce. I eat a lot of veggies
• Veggies, example, cauliflower, broccoli , mushrooms - 300 cals, 20g protein (this is a lot of veggies)
• Salsa, pico (just tomatoes, onions, cilantro) - effectively doesn't matter
• 1/2 avocado for guacamole - 150 cals
• Protein, example, 3 chicken thighs, 600 cals, 80g protein (3/4 of a lb total)
• Olive oil used to cook veggies and chicken - 350 cals
• Total: 1300 cals total, 100g protein

10p

• Protein fluff (1 scoop protein powder, 1/2 cup almond milk unsweetened, 10 frozen strawberries, stevia) - 200 cals, 25g protein
• Protein + lettuce wraps (chicken, turkey, etc) - 200 cals, 30g protein
• Total 400 cals, 55g protein

Grand Total - 2300 cals, 180g protein

Things I would copy / strive for

• no refined carbs
• I get a lot of protein
• I get a lot of fiber

• I eat a lot of water (cauliflower, broccoli, mushrooms are 90% water)
  This is why i'm so full and satisfied

• calories are very reasonable vs my RMR (resting metabolic rate, which is 1600 for just being alive) and EE (I probably burn on average 500 calories moving around). I eat a lot of protein so there is also a decently high amount of thermic energy used ~100 calories (energy required to digest food). This would equate to 2200 cals in, 2200 cals out.

Things you do not need to copy

• timing of eating
• I actually think its NOT ideal to have 1300 cals and 100g protein in one meal as that isn't all accessible to muscles
• exact proteins and vegetables
• quest bar -> feel free to kill and have a normal lunch

Example normal person day

Here is what a day would look like that is for a normal person (and more ideal than my day)

730a

• Wake up
• Coffee (black), 2 cups or so
• quest bar
• 200 cals, 25g protein (i sometimes eat slightly more than 1 so i'll round to 200 cals

1p

• Lunch
• Salad/veg with 2 chicken thigh
• 700 cals, 60g protein

4p

• BCAA + creatine drink
• this really reduces hunger
• 7g BCAAs, package says 0 cals. Not sure how this is possible but shrug

630p

• Dinner - Always protein and veggies with sauce. I eat a lot of veggies
• Veggies, example, cauliflower, broccoli , mushrooms - 150 cals, 10g protein (this is a lot of veggies)
• Salsa, pico (just tomatoes, onions, cilantro) - effectively doesn't matter
• 1/2 avocado for guacamole - 150 cals
• Protein, example, 2 chicken thighs, 600 cals, 80g protein (3/4 of a lb total)
• Olive oil used to cook veggies and chicken - 200 cals
• Total: 1100 cals total, 70g protein

8p

• Protein fluff (1 scoop protein powder, 1/2 cup almond milk unsweetened, 10 frozen strawberries, stevia) - 200 cals, 25g protein
• Total 200 cals, 25g protein

Grand Total - 2300 cals, 180g protein

TLDR: What you need to know

• To get a 6 pack, you have to have low body fat.
  
• To lose fat, you have to lose weight.
• To lose weight, you have to maintain a calorie deficit, sustainably.
• And no, a calorie isn't a calorie, but that doesn't mean you don't need a calorie deficit to lose weight.
• You can maintain the right calorie balance by following 3 simple rules discussed in this article.

Ray's Take

One of my favorite phrases is "Abs are made in the kitchen."

Nothing could be more true - you can only get abs by eating right.

Why?
- Everyone already has a six pack, we just need to have a low enough % of abdominal fat to actually see them.
- For people that aren't on steroids and not professional athletes, the only way to lose abdominal fat is by losing weight.
- To lose weight, you have to eat less calories than you burn (aka calorie restriction or CR)*.
*Is a calorie a calorie (link)? No, but that doesn't mean the above isn't also true.

Simple enough, but most people never do it.

Why?
Most people never find a system for eating less calories than they burn, over a long enough period of time.

Why?
They try weird gimmick diets that start working, but then become too hard or not satisfying and they give up and revert back to their original diet (does this sound familiar?). After reverting, they start justifying their choice with fake excuses (I just like eating out too much, I felt social pressure, too stressed at work) or real excuses (I was too hungry, family issues, illnesses, some injuries).

So how do we do we solve this?

My personal strategy is pretty simple but before telling it to you, let me explain what I optimize for:
1) I want a 6 pack (see this article on why having a 6 pack usually isn't worth it)
2) I want to eat really delicious food
3) I want to eat a very high volume of food
4) I like ice cream
5) I enjoy drinking alcohol

Sound impossible to optimize for? It's not. I've accomplished 1,2,3,4, and 5 for the last 15 years.

Photo evidence

Thanksgiving in 2015 (31 years old):

Thanksgiving in 2017 (33 years old):

Thanksgiving in 2023 (39years old):

I probably drank too many beers before the photo :)

Ray's eating philosophy

Goal: Eat delicious food to fullness while never missing anything and having a 6 pack.

Rule 1: If you aren't hungry. Don't eat.
This sounds simple, but so many people fail on this. Remember we have to eat less calories than we burn. So if you aren't hungry, don't eat. Seriously. Also, if you are eating, stop when you are full. Save the rest.

Rule 2: Eat as much as you want for foods that are are high volume, low calories.
I have to be top 99.99th% on vegetable intake, specifically lettuce, cauliflower, broccoli, napa cabbage, mushrooms.

Doing this takes more skill than you might think. First, you have to know what foods are high volume, low calorie (this article teaches you in depth) but for now, lets just say its every vegetable. You have to be able to cook vegetables so they taste so delicious that you prefer them over fries, chips, and bread (learn how here). A good trick is to eat them with delicious sauces. My favorite is guacamole.

With these foods, I just eat as much as I want. I can literally eat a whole pound of spaghetti squash or a whole cauliflower every night. When i make salad I can eat 3 heads of lettuce.

Rule 3: Eat delicious higher calorie foods, but don't overeat
Foods in this category would be meat and healthy high fat items such as guacamole, olive oil and nuts (I personally do not eat nuts other than in salads because I cannot follow this rule. I will overeat 100% of the time).

What does not overeating mean? Read rule 1. Just eat until you are satisfied and then stop.

I have never counted calories or macros. It's way too tedious to do correctly as you need to weigh out your food for it to be accurate. We've created many articles on what portion sizes and calories look like for every food type.

Master Rule: Eat and drink whatever you want, but only if its worth it.

This is actually my secret power, and if you keep following, will be yours too.

In my head, I know the rough amount of calories per volume, and can instantly categorize into
- Can eat a lot (low calorie density)
- Eat until I am satisfied (higher calorie density)
- Do not eat (bad, avoid)
See this article on categories of each food.
See this on secrets for being able to eat more, while staying low in calories.

Based on what category the food fits into, I will eat (or not) accordingly.

This system has never failed me. I have never not had a 6 pack in 15 years. And no, I don't just have good genetics. I did not have a 6 pack growing up or in college.

Rather, I learned this philosophy while a business school student in 2011 to get "ripped" for the first time. Today, I stay looking about the same 365 days of the year and never bulk or cut or get into swimsuit shape. I just stay the way I am, looking I'd say pretty good all the time. You can too.

Note on alcohol - I do not recommend that you drink, at all. There are really no health benefits and they are empty calories. However, I enjoy drinking 1-2 glasses of wine or beer per night, and choose to do so because I deem it is worth it for me. There is a real cost to this. If it's not worth it to you, don't drink.

What else?

When you are losing weight, you want to lose fat. Not muscle.

The only way to do this is with resistance training AKA lifting weights and eating enough protein.

Let's be clear though. To get "ripped," your nutrition needs to be on point.

Ray's Rambling

One of the things I sometimes hear from friends is that they can't eat like me because they feel social pressure or judgement to eat the things they know are bad.

This makes ZERO sense to me.

A superpower of mine, might be that I don't care what other people say if I know they are wrong. However, if you are on the opposite end of the spectrum, it is critical you shift your mindset.

I know the science / data of nutrition. I will teach you.

I know what works for me. You will experience for yourself.

If someone tries to tell me something different, I may consider what they think by putting it into my brain, but then i'll make my own decision on what I choose to do based on what I know is best. You should do the same.

FAQ

Do you intermittent fast?
Yes, but that doesn't mean you should

Do you eat sweets?
Yes, I have protein ice cream AKA protein fluff every night

Do you eat fruit?
Mostly frozen berries in protein ice cream

Do you do keto?
Not anymore

Do you do low carb?
Yes

Do I have to do low carb?
No, but I don't really know any good program that doesn't at least eliminate refined carbs and sugar.

Do you eat bread, rice, pasta?
No (unless I'm at a top 1% restaurant)

Do you miss carbs?
No

Do you ever have cheat meals?
I don't understand the concept of cheat meals. I eat if i think its worth it. All the time.

Do you drink?
Yes. I really like red wine and beer

MD's Take

Steak, it's what you want for dinner.

But is it healthy? Can it be part of your health program?

Yes. Steak definitely fits into my health program. And it can fit in yours too.

This is everything you need to know for making steak healthier AND more delicious than any restaurant, at home.

What you'll make will taste way better than any restaurant for 1/4 of the price, and 1/2 the calories.

Who I am

I'm Ray, a doctor that is obsessed with making food tastier than any restaurant, while being 10x healthier.

How to choose steak

Whenever I eat anything, I'm always making a "value" calculation. The value comes from taste and knowing if its healthy.

I'm optimizing for both.

So for steak, I want it to be tender, juicy, and delicious, while not having too much fat or cals. Remember:

• lean protein is basically always good
• lean protein usually comes with fat
• some fat is fine, but should be careful bc too much fat will cause you to get fat.

For steak, I like NY Strip. It's the best combo to me of flavor and "good for me." (See below "nerd" section for full nutrition details).

TLDR is if you cook it with the full fat on (always cook with full fat on), and then don't eat the pure fat parts (I don't like full fat in mouth anyways), you can have 8 oz steak (1/2 lb, raw), and get 50g protein for only ~12g fat and ~300-350 calories.

This is insanely good value (taste and health).

My workflow:

• Buy NY strip steak at Whole Foods. I think this is usually USDA choice (it's unlabeled bc of their animal welfare). I don't get the dry aged. Just the normal one.
  ^^Especially buy if its on sale. You can freeze steak (after sous vide or raw and it'll still be good if you do it right)

• Note - I do go to the store, and choose based on - decent marbling (fat inside meat - you have to have some of this. I wouldn't say the more the better, but if its pure red, it won't be as good), low amount of fat / grizzle on the sides.

• Cook either via sous vide or reverse sear. These are the only two ways to cook steak guys. Don't try any other way. Plan for it to take at least 1.5 hours (you aren't doing anything most of the time).

• Note: Sous vide and reverse sear are the fool proof ways to get perfect medium rare on the inside, with amazing crust on the outside. You do not need to add a ton of butter or any other flavorings. All you need is a good cut of beef and salt. This will taste way better than a restaurant with less than 50% of calories (they use a ton of oil/butter in order to cover up cheaper, worse cut of meat).

• Serve with mashed cauliflower and something green (salad or broccoli usually). The mashed cauliflower is way healthier than mashed potatoes. It's insanely good, low calorie, and makes you feel really really full (there is something about it).

My top option today, is reverse sear. I find that the oven dry heat leads to less juices/blood running out of the meat (though there is a trick below on sous vide to avoid). It's also less set up with sous vide container, device, etc.

Can't go wrong with either.

Reverse Sear

1) Line oven sheet with tin foil and place wire rack on top. Spray rack with oil. (If you don't have a wire rack, just put directly on oven sheet with foil).
2) Place steak on top.Can add 1 tsp of salt (or garlic powder and salt mix). Crack of black pepper (optional).
3) Stick in oven thermometer to thickest part, and set alarm at 129 degrees (I have this one}. You can use a regular oven thermometer as well and just check the temp from time to time. Keep in mind, the closer you get to 129, the slower internal temp moves up.
4) Place steak in oven at 200 degrees (if you have 3 hours) 220 degrees (if you have 2 hours). 200 is better imo.
4a optional) Flip the steak after 1.5 hours - I usually don't do this.
5) Take out steak after it hits 129 degrees and place on plate or cutting board. I usually let it rest for 5-15 min.
6) Get pan on high heat - make sure pan is hot
7) Spray avocado oil ~1 tbsp or less
8) Place steak on pan - DO NOT TOUCH IT for at least 1 min
9) Flip - There should be a good crust post-flip. Wait another 1 min without touching
10) You can place each side of the steak on the pan for another 30 sec - 1 min without needing to worry about overcooking.
11) Take steak off and put on cutting board. I'd let it rest there for at least 5 min.
12) Slice. I take off fat sections while preserving max meat
13) Serve with maldon sea salt or any larger crystal salt on plate with mashed cauliflower.

Sous vide

1) Take steak, add 1 tsp salt (or garlic powder/salt mix) , and then put in zip lock - gallon size, freezer bag. Crack of black pepper (optional).
2) Place in sous vide for 2 hours at 131 degrees F (this is for medium rare)
3) Put in ice bath or fridge for at least 15 min (this really helps make the steak less bloody. I don't care what they say online, if you take steak directly from sous vide to pan it will leak out juice when you slice it).
4) Place back in sous vide for a couple min.
5) Dry steak with paper towel (really dry it)
6) Get pan on high heat - make sure pan is hot
7) Spray avocado oil ~1 tbsp or less
8) Place steak on pan - DO NOT TOUCH IT for at least 1 min
9) Flip - There should be a good crust post-flip. Wait another 1 min without touching
10) You can place each side of the steak on the pan for another 30 sec - 1 min without needing to worry about overcooking.
11) Take steak off and put on cutting board. I'd let it rest there for at least 5 min.
12) Slice. I take off fat sections while preserving max meat
13) Serve with maldon sea salt or any larger crystal salt on plate with mashed cauliflower.

Stupid ideas

I only like steak at restaurants
Yea....I never order steak at restaurants...bc I already know I can make it taste better and be healthier at home, for a fraction of the cost. Seriously the quality of the beef is the most important thing, and if you get anything high quality at a restaurant, its gonna be $100+. On top of that, they will serve "wagyu" which is unnecessary fat and honestly doesn't even taste better. I'd rather have more meaty flavor with the right level of fat.

I can't make steak at home
You can. It's actually one of the easist things to not F up bc of sous vide and oven thermometer.

Ribeye is the best
Do you really think so? If you do, then great go for it. But only if you have tried other cuts at home and you still think ribeye is better. Ribeye really does have a ton of excess fat (meaning you are throwing away a lot food or wasting calories eating it). I truly like NY strip, with decent marbling, better. More beefy flavor and healthier.

Nerd knowledge

Here is a breakdown of cuts of beef, ordered by the least fat to the most fat:

Now here is what it looks like if you trim the fat from the steak cuts:

Not bad at all - remember - 100g is almost 1/4 of a lb (0.22 lbs to be exact), and we are never going to trim off ALL of the fat

If we meet full fat and trim in the middle, this means that a full lb of steak (raw, 16 oz, 452g) is ~100g protein and only ~25g fat and ~700 calories.

I can't eat a full lb of steak. 1/2 lb is good for me - thats a lot of delicious bites for only 350 cals.

FAQs

Are you worried about saturated fat?
Not if you have steak 1-2x per week. If you have it every day, just check your apoB. If it goes up, have less. If it doesn't, you're good.

Can I buy steak somewhere else?
Yes of course. Costco is great. Any supermarket is good too.

Do you like choice or prime?
Prime will taste better and have more fat. I'll buy it if it looks good at like costco, but usually just get whole foods which is choice.

Do you like wagyu?
Honestly, no. Maybe one or two bites. I don't like feeling fat gush in my mouth.

Do you buy grass fed or corn?
Grass is "healthier" and def leaner with less fat. I don't like the taste as much. It's def less tender. Prob an acquired taste bc i do believe grass fed cows are treated better, but given the cost, I just get whatever they have at whole foods. Grass fed, corn finish is good.

Do you think its worth buying meat from fancy butchers?
For the taste, no. For the cows and supporting the business, sure (but its up to you).

Is bone in better?
Yes but harder to manage the temp. Do sous vide on this for slightly longer 2.5-3 hours. Reverse sear doable but slightly trickier due to part from bone cooking more slowly than other parts.

What other cuts of steak do you like?
Porterhouse (strip + filet) is good but more annoying to cook reverse sear bc two sides may not cook at same time. Flank and skirt are good but I cook sliced, lightly marinated, quickly cooked on hot pan (particularly good with asian marinade). Sirloin is ok but only if highly marbled. Ribeye good but too much fat for me.

Should I just buy the leanest cuts?
You can try. Tenderloin can be good sous vide and reverse sear. I generally don't like sirloin as much bc its chewy, even if cooked properly.

Ray's Take

Is low-fat better or low-carb? Is fruit good? What should you actually eat? How much?

Everyone has an opinion on food and nutrition. Researchers and wannabe researchers definitely do. In fact they love arguing pointlessly about it.

My opinion is that the only important thing is that you find a nutrition plan that is sustainable.

Sustainable means you love what you eat, you don't feel like you are sacrificing, and you are making progress towards your objective.

Assuming you have an objective (IE "lose fat," "look hot," "gain strength," "prevent diabetes," "live longer," etc), and want to rethink your nutrition program, let me help.

I will go through what is agreed upon, not agreed upon, and the obvious takeaway to figure out the best program, for you.

1 - Energy balance

Everyone agrees

• Energy cannot be created or destroyed. It can only be transferred. This is the first law of thermodynamics. A fundamental law of physics
• Humans take energy in (calorie in) through food and drink. And use energy (calorie out) through living (basal metabolic rate), moving, and digesting (thermic energy).

People argue

• Why do people eat more calories? (availability of tasty refined carbs, insulin too high, social environment, etc)
• Different calories are metabolized differently, but how does this affect weight gain/loss?

RW OBVIOUS take

• Most people that want to "look better" should lose body fat.
• If you want to lose weight, you have to eat less energy than you burn (caloric deficit).
• If you have a caloric deficit, you must feel fully satisfied in the process (not hungry).
• Once you reach your body fat objective, just maintain with how you got there.

2 - Protein

Everyone agrees

• Protein is required for muscle synthesis. This means you need protein to build muscle.
• Even if you do not want to "build muscle," eating protein will help you keep muscle (very important).
• Protein is broken down into amino acids, of which 9 of them are essential (meaning our body cannot make them). We need these 9 essential amino acids.
• 1g protein contains 4 calories.

People argue

• How much protein exactly should you eat?
• How much is too much?
• Does timing of protein intake actually matter?

RW OBVIOUS take

• Eat more lean protein. Basically, as much as you want. You probably aren't getting enough now.
• I'd aim for 1g protein per lb of body weight. (150g protein per day for a 150 lb person). Studies show there is benefit for building and preserving muscle and strength at levels up to 1g protein per lb of body weight . There is no downside for most people as kidneys can handle way more than this. If you fall short at get 0.75g, that's fine.
• Have protein every meal. 1-2 palm sized pieces at least. No need to time exactly.
• When you eat protein from animal sources, you're usually also getting fat, so you should be aware of this.

3 - Veggies aka fiber and water

Everyone agrees

• Vegetables are mostly water - most are over 90% water! (see chart below).
• Water is 0 calories.
• Besides water, veggies (that grow above ground) are mostly fiber. Fiber are carbs that are hard to digest.
• There are two types of fiber - soluble (can absorb water), and insoluble (stringy). Veggies usually have both.
• Both types of fiber are necessary and have many benefits (link).
• Fiber is low calorie - soluble fiber has 2 calories per gram, and insoluble fiber is 0 calories per gram (estimates).

People argue

• Nothing really. No one argues that eating vegetables is good (other than crazy keto ppl that think there are too many carbs).

RW OBVIOUS take

• Eat maximum veggies. They are just fiber and water. Fiber and water are basically 0 calories, and will make you feel full. There are 5 plausible reasons why but who cares, just think about it, it's obvious. If you eat a lb of veggies, its actually 0.9 lbs of water and the rest fiber your body can't really digest. This will make you feel full and eat less other shit.
• Learn how to make veggies taste delicious, without adding too much fat (some fat is totally fine, keep reading).
• Be careful about potatoes, sweet potatoes, corn, and other starchy vegetables that usually grow below ground. Don't eat max of these.

4 - Fat and carbs (not refined carbs)

Everyone agrees

• Basically nothing

People argue

• Basically everything

RW OBVIOUS take

• There have been 100s of studies and millions of stories about how low carb or low fat is better. Let them argue. We don't care what is best for an overall population. We care about what is best for you. Period.
• Eat a lot of lean protein, and vegetables, and fill the rest with a moderate amount of fat and carbs.
• Most of your protein will come with fat -> eat max chicken breast (very lean) if you want, but if you have pork shoulder (more fatty), just watch your portions.
• You will need to add fat to veggies to make them taste good -> add olive oil for cooking, make guac for dipping, add dressing to salads. Just make sure to consider the portions.
• The best kinds of fat come from fish, olive oil, avocados, and nuts (unsaturated fats). Prioritize these if possible if you want to optimize for heart health/cholesterol.
• If you like carbs, go for unprocessed/whole grain if you can. Also, watch your portions.
• If you can, replace carbs with something higher fiber/water aka cauliflower rice instead of white rice, low-carb tortilla instead of regular tortilla, keto bread instead of regular bread. This works for me but its your choice. If you really want to keep a food, then do so, mindfully.

5 - Fruit

Everyone agrees

• Fruit is better than refined carbs
• Fruit has sugar

People argue

• Is the sugar bad?
• How bad is it?

RW OBVIOUS take

• If you like fruit, then have it.
• Prioritize ones with lower net carbs (berries are the best).
• Be knowledgable of net carbs, portion sizes and just be reasonable.
• Example: Have 1 apple, not 5 apples
• Example 2: Blueberries have more net carbs than other berries, but 1/4 lb is only 75 calories so its totally fine.

6 - Refined carbs and sugar

Everyone agrees

• Refined carbs are carbs that have been processed, so all the fiber is taken out, and often sugar is added - (white flour, chips, crackers, ice cream, candy, etc).
• These are bad. They are "empty calories" meaning no nutritional value and easy to eat a lot of calories.
• These increase insulin, which has negative effects on the body when levels are too high.

People argue

• Nothing (everyone thinks refined carbs are bad).

RW OBVIOUS take

• Just "know" which foods include refined carbs and sugar.
• If its worth it to you, then eat it. If it's not, don't.
• Always be aware of portion sizes.
• Example: I love gelato. I will eat gelato (a lot of it) when I am in Italy. I almost never eat gelato otherwise.
• Example 2: I really like pizza. I will make pizza at home with (00/all purpose flour) once a month or so (with guests), and have a slice or two (~400 calories). I never order dominos, pizza hut, or even fancy pizzas.

Putting it together

RW OBVIOUS take

• Eat the most lean protein and veggies as possible (max foods)
• Have fat, carbs, and fruit in moderation (good foods)
• Make sure eating refined carbs / sugary foods is really worth it ("know" foods) alcohol is a "know" food *- Gain knowledge about nutrition and how foods impact you**

Your goal is to develop a personal program in which you love what you eat, do not feel like you are sacrificing, and are making measurable progress toward your objective.
- If you are not loving what you eat -> learn how to cook better or add more foods you like
- If you are not making progress -> cut down on good and know foods. Increase max foods
- If you really need to eat pizza and ice cream every day -> sorry i can't really help. This is a personal decision.

I would highly recommend learning as much about nutrition as you can. I don't mean the biochemistry of how foods or processed. I certainly don't mean learning about research models. What I mean is learn how to read a nutrition label, understand the caloric density, macros (protein, fat, carbs), so you can decide if you want it and how much. For example, you should be able to look at a container of hummus, and decide if it fits into your plan and which one to buy.

There are so many ways to make max foods taste delicious while having a good foods to make you happy. Every single person's program will be different, but I'm confident you can find your own sustainable program.

Action item

RW OBVIOUS take

• Eat more lean protein and veggies in your next meal
• Eat less of everything else
• Check it in on our app, and write down how you feel

Bonus

• Learn how to cook

FAQs

Should I track my food?
Long term - no its too annoying
Short term - you can if you are the type of person that wants to know. If you do it, I'd buy a kitchen scale and weigh your food. Weighing is the only way to actually know how much you are eating, and tracking correctly. This can be very effective for learning about portion sizes.

Is there an easy way to estimate portion sizes
For veggies - eat as much as you want, it doesn't matter
For protein - a palm size piece is about 1/4 of a lb and ~25g protein
For oil - actually useful to use a measuring spoon. 1 tablespoon of oil is 120 cals and its easy to use 5+ tablespoons

Should I do intermittent fasting
I do. It's up to you. If you aren't hungry in the morning I think its a no brainer to skip that meal. However, not required. Whatever is sustainable.

Should I do 7 day fasting
I don't. I don't see how its worth it or sustainable. Be my guest if you want to try.

How do I know if my program is working
Measure the thing you care about. If its weight, then weigh yourself (weekly). Good is 1-2 lbs per week of weight loss. DEXA and body fat % is even better. If its diabetes, measure your hbA1c every 3 months or get a CGM.

Can I snack?
I'd try not to. Definitely do not eat mindlessly. If you are truly hungry then I'd go for a high protein bar (low sugar) or lean protein (turkey, etc.).

Drinks?
Don't drink calories. Water, 0 cal flavored water, coffee, tea are great.

Can I use artificial sugar
It's definitely better than regular sugar. The best are stevia, allulose, and I use the yellow packets (splenda). I think it tastes the best and not using that much so not worried about health dangers.

Ray's take

When most people decide what to eat, it's primarily based on taste (and convenience).

When I decide what to put in my mouth, it's based on value. Value means how it tastes + health benefits (or lack thereof).

If you can decide what to eat based on value, it will make a massive difference for reaching your health objectives.

Who I am

I'm Ray, a doctor that is obsessed with making food tastier than any restaurant, while being 10x healthier.

What value means

Food has to taste amazing. That's a given.

If you want to reach your health objectives, you also need to eat things that help you make positive progress. Remember, nutrition is the bedrock of all health objectives.

Value comes from eating foods that taste amazing, and are healthy.

Can we really have both tasty and healthy?
YES. I've never been so sure about anything.

How?
The first is to shift your thinking for choosing what you eat from purely taste, to taste and healthiness.

Healthiness comes from getting macros that we need (protein and fiber), but those typically happen easily in this system. We'll address this later.

To optimize value, you are maximizing flavor and volume (for satiety), and minimizing calories.

Food value equation:

How much you eat = (How good this tastes) / (How many calories does this have)

Based on this equation:

I don't think its ever worth eating anything that doesn't taste amazing. Thus, within this context, we just need to make food that tastes amazing, that has low or medium calories, and eat those.

Cooking

To eat amazing tasting food with low calories, cooking is a big advantage. Here's why:

• Better Ingredients: You can buy better ingredients than those used at a restaurant. This is a huge advantage.
• Control Over What Goes Into Your Food: Restaurants often add a TON of extra fat and calories. By cooking yourself, you have full control over these aspects. This is huge.
• Portion Control: You can fully define your portions. For me, this means having MORE volume of veggies, which is huge for me.

Is it possible to order out and eat out? Yes

But I'd say most restaurants make good tasting food for med/high calories (and a high price) so its almost never worth it. I only eat at restaurants that I can't reproduce their best tasting stuff, but for way less calories (there are very few of these).

Next Steps

• Learn Low-Calorie Foods: Vegetables, which have a ton of fiber.
• Learn Medium-Calorie Foods: Lean proteins, which usually also include some fat.
• Learn Cooking Techniques: I will show you how, with a moderate use of healthy fats.
• Execute and Eat: Start applying what you've learned.

From here, you will make effortless progress toward your health objectives. I guarantee it.

Examples

Steak dinner

Our version:

• NY Strip Steak with mashed cauliflower and broccoli (Photo shows 1/2 portion)
• 500 cals // 10g fat

Cheesecake Factory version:

• NY strip steak with mashed potatoes and broccoli
• 1710 cals // 97g fat

We can buy a much higher quality steak, cook it perfectly, and pair with mashed cauliflower and an asian style broccoli that is so good. Can also make in batches so its easy to have for a 2nd, 3rd, 4th, 5th meal.

Value: Better taste with less than 1/3 the calories and ~1/10 the fat of cheesecake factory version (or any other steakhouse)

Links:
How to choose and cook steak

Taco night

Our version:

• Spaghetti squash bowl with seasoned ground pork, guacamole, salsa, and pico de gallo. Cauliflower and zucchini optional
• 500 cals // 10g fat

Cheesecake Factory version:

• Factory burrito Grande
• 1950 cals // 105g fat

We will get all the deliciousness we can handle with spaghetti squash as a base for our taco meat (which is so good and so easy to make). We get guac and salsa which are the perfect compliments. If you mix it all together, its so good and you will be so full.

Value: Better taste with ~1/4 the calories and less than 1/10 the fat of cheesecake factory version (or any other burrito place, though cheesecake factory seems particularly bad)

Links:
How to cook spaghetti squash

Stupid Ideas

Stupid: I don't want to learn how to cook
RW response: Did you read this article? Even more reasons why you should learn how to cook.

Stupid: I don't know how to cook
RW response: You can learn. I will teach you.

Stupid: I don't have time to cook
RW response: You can cook in batches so prep time will be faster than ordering takeout and way faster than going to a restaurant.

Stupid: What I cook won't taste good
RW response: Yes. It will. I'll show you how to make foods that are really hard to mess up. I guarantee I've taught people less proficient in the kitchen than you, how to make delicious, high value foods.

TLDR: What you need to know

• CRP (C-reactive protein) is a general indicator of inflammation in your body, and can be measured with a blood test you can ask your doctor for. We also include it in the Ray Wu MD program
• High CRP levels are associated with higher risk of heart disease, stroke, and other inflammatory conditions.
• A high CRP level is not a specific marker for any one condition but is a general signal that inflammation is present in the body. Being sick can also temporarily increase CRP.
• Lifestyle modifications, such as improving nutrition, exercise, and stress management, can lower CRP. -CRP can be a useful marker for monitoring if our lifestyle changes are effective.

Ray's Take

I think monitoring hs-CRP (hs stands for high sensitivity. Same thing as CRP) levels are interesting. The reason I say interesting, is because it is a non-specific measure of inflammation in your body.

Research dating back to the 2000s (linked below) has shown that high CRP increases your relative risk for heart attack and stroke. However, its also been shown through genetic studies that high CRP itself is not likely to be causal for heart disease. This means that CRP itself isn't the culprit. Rather, something else is going on, that is causing CRP to increase, which also increases your risk for disease.

So why test CRP? It's a simple test we can get with other metrics, and if your levels high, there are things we can do to try to decrease it. CRP can be decreased with nutrition, exercise, and other lifestyle factors such as managing stress.

What to do if you have a high CRP level

While high CRP may mean something related to cardiovascular disease, there are two more common causes.

First - you were sick or extremely stressed when you took the test. This can cause temporarily high levels. The only action item here is to wait until you are not sick, and then retest.

Second - you might have a reaction to a type of food you are eating, with the two most common cultprits being dairy and wheat. We recommend eliminating dairy or wheat for 2 months, and then retesting.

Besides the above, having a solid nutrition plan beyond just eliminating dairy/wheat is helpful, as is exercise and getting good sleep.

If everything has been tried, then we recommend adding some additional tests including fibrinogen, another non-specific marker for inflammation which is related to clotting.

Cool Knowledge for Normal People

This image from an article in "Hypertension" shows how CRP is produced by the liver and adipocytes (fat cells) in response to inflammation.

The presence of CRP in your blood indicates that your body is in a state of inflammation, which can be due to various reasons ranging from infections to chronic diseases.

While it seems that CRP itself doesn't cause diseases, high levels are often found in patients with conditions that involve inflammation, such as heart disease and autoimmune disorder and higher CRP levels predict heart attack/myocardial infarction (MI), stroke, peripheral arterial disease, sudden cardiac death, and all-cause mortality in healthy individuals with no history of cardiovascular disease.

Elevated CRP levels may not pinpoint the exact cause of inflammation but serve as a crucial indicator that something in the body needs attention.

Understanding your CRP levels can be a significant first step in taking charge of your health and preventing potential health issues related to chronic inflammation.

Optional Info for Nerding Out

From the New England Journal of Medicine:
C-Reactive Protein and the Prediction of Cardiovascular Events Among Those at Intermediate Risk
This study discusses the role of CRP in predicting cardiovascular events, providing insights into its value as a biomarker in clinical settings.

From the British Medical Journal (BMJ):
Association Between C Reactive Protein and Coronary Heart Disease: Mendelian Randomization Analysis
This research explores the genetic associations between CRP levels and coronary heart disease. It concludes that CRP is not causal for coronary artery disease

From Circulation:

Adjusted relative risks of future myocardial infarction associated with increasing quintiles of HSCRP (hs-CRP) among apparently healthy middle-aged men (left) and women (right). Risk estimates are adjusted for age, smoking status, body mass index (kg/m2), diabetes, history of hyperlipidemia, history of hypertension, exercise level, and family history of coronary disease.
High-Sensitivity C-Reactive Protein: Potential Adjunct for Global Risk Assessment in the Primary Prevention of Cardiovascular Disease