by Dr. Joseph Debé
I am a strong advocate of individualizing weight loss programs, as described in “A Holistic Approach to Weight Loss”. However, there are general weight loss principles that apply to most situations. Areas that need to be addressed are behavior modification, diet, exercise, and nutritional supplementation.
First of all, let’s ask a seemingly obvious question: “What is your ultimate goal?” Many people want to achieve a certain bodyweight. This is not the real goal. The goal is actually to achieve a certain appearance and hopefully also to become healthier. Let’s imagine there were no scales on planet earth. Would people still want to look better even if they could not know how much they weighed? Absolutely. A more meaningful goal is to improve one’s body composition, which refers to the amount of lean tissue and the amount of fat comprising one’s body. I routinely measure my patients’ body composition. Most people, especially women, want to lose fat. That’s good. However, many people are not only too fat but they are under-muscled. This is a very critical issue. Toned healthy muscle gives a lean shapely appearance. What’s more, muscle is very metabolically active – it burns calories.
This concept is exemplified by a study that compared two meal replacement products for weight loss. Two groups of women consumed either Ultra Meal or Ultra Slim Fast. The diet and exercise programs they followed were the same. At the end of the 10 week study, the average weight loss in the Ultra Meal group was 11 pounds and in the Ultra Slim Fast group it was 13 pounds. Body composition analysis revealed that all the weight lost in the Ultra Meal group was fat with no loss of muscle mass. By contrast, more than 11 pounds of weight lost in the Ultra Slim Fast group was from muscle. Not surprisingly, the Ultra Slim Fast group was found to experience a slowing of thyroid function. Loss of muscle mass with resultant slowing of metabolism produces greater regain in body fat and then the individual is worth off than before the diet.
One of the most important ways to achieve and maintain an attractive body is to build muscle. Muscle mass tends to decrease with age, and as it does the metabolic rate slows and the body stores more fat. Many women have the false belief that weight training will make them look like men. A study of fourteen women, average age 67 years, found a 16 week strength training program reduced abdominal and thigh fat mass and increased thigh muscle, while increasing strength. To look better (and to be healthier) most people not only need to lose fat but need to build muscle. Weight loss programs that don’t incorporate resistance (weight) training typically result in muscle loss along with fat loss. Aerobic or cardiovascular exercise doesn’t suffice. Supplemental dietary protein, creatine monohydrate and HMB can all aid building of muscle mass.
Why is it that obesity rates have soared in the last twenty years? I believe part of the explanation lies in the government’s advocating of low-fat, high-carbohydrate diets. Excess carbohydrates, especially refined foods, high in simple sugars, result in increased insulin secretion. Insulin excess increases body fat deposition, slows body fat burning and increases appetite. For weight loss, high carbohydrate diets are not desirable. A study published in the International Journal of Obesity Related Metabolic Disorders in 2001, compared a low-fat (20%) diet and a moderate-fat (35%) diet for effects on weight loss. After 18 months, the low-fat diet group averaged a 6.4 pound increase in body weight and a 1 inch increase in waist circumference, while the moderate-fat group lost an average of 9 pounds and 2.7 inches from the waist. The moderate-fat diet was also actually easier for people to stick with.
The type of fat one consumes is very important. Excessive consumption of saturated fat, hydrogenated vegetable oils and omega 6 fatty acids are common attributes of the standard American diet, which produce metabolic changes that interfere with weight loss. Most people need to eat more omega 3 fatty acid-rich foods (and/or take supplements). Omega 3 fatty acids are found in cold water fish like mackerel, sardines, and salmon. Krill, algae, flax seeds and perilla seeds are other good sources. Omega 3 fatty acids reduce appetite, decrease body fat production and storage, increase metabolic rate and fat burning.
The type of carbohydrate one consumes is also very important. The carbohydrate sources that are better for weight loss (and health), as a rule, are unrefined complex carbohydrates as occur in whole fruits, vegetables, lentils, legumes, grains, nuts, and seeds. The sugar molecules in these foods are strung in chains, which require digestion before they can be absorbed. The fiber in these foods also slow absorption of the sugars. The measure of a food’s influence on rise in blood sugar is referred to as glycemic index. The higher the glycemic index, the faster the blood sugar rises after eating that food. Glycemic index also applies to mixed meals. A fast blood sugar rise is unhealthy and stimulates a cascade of hormonal changes that result in increased body fat with loss of muscle mass.
High glycemic index also contributes to excess hunger. The lower the glycemic index and total amount of carbohydrate consumed at one meal, the less food is consumed at the next meal. A study in children had them consume different meals on separate days. The test meals varied in glycemic index. After the test meals, the children were allowed to snack freely. The amount of food they consumed in the 5 hours after the test meals was analyzed. It was found that compared with the period after the low glycemic index meal, the subjects consumed 81% more calories after eating the high glycemic index meal!
An important weight loss principle is to eat meals of low glycemic index. One consideration this involves is choosing carbohydrates with a low glycemic index. Glycemic index tables of foods are available. As a rule, unrefined whole foods, as they are provided by nature, are low in glycemic index. The glycemic index of a meal is also influenced by what is consumed along with the carbohydrate-rich food. It is always a good idea to try to eat a mixture of foods rich in protein and fat at the same time as carbohydrate in order to lower the glycemic index.
Another factor related to carbohydrate is the amount consumed. More than 50 grams of carbohydrate at a meal will likely result in fat deposition. Different people in different situations need different amounts. One diabetic patient I am working with who weighs well in excess of 350 pounds (that’s as high as my scale goes) had to add another notch to his belt because his pants fell down around his ankles. This was after less than 2 weeks of consuming a diet that included peas, beans, whole grain bread, starchy vegetables and fruit. Some individuals, however, need greater reduction in dietary carbohydrates in order to lose weight.
In addition to the amount and type of food and exercise one gets, the timing is another important factor. Hunger is controlled and metabolic rate is enhanced by a slow, steady supply of nutrients being consumed. The old advice to not snack between meals is wrong. It’s wrong for weight loss. It’s wrong for building muscle. It’s wrong for lowering blood cholesterol levels. A study of obese men, published in the International Journal of Obesity Related Metabolic Disorders in 1999, found that when obese men consumed the same amount of food at one meal, versus spread over 5 meals, they wound up eating 27% more food at the next meal. It is a good idea to eat as many times as possible during the day. I recommend at least 5 times a day. The use of good quality meal replacement shakes or bars make this more convenient.
Another study examined the effects of timing of protein intake in overweight men. Two groups of men did light resistance exercise and consumed the same daily amount of calories and protein. The difference was that one group consumed part of their protein as a supplement immediately after exercise. At the end of twelve weeks, both groups had lost weight and body fat. However, the group consuming the protein supplement had an increase in resting metabolic rate and no change in muscle weight. The other group lost muscle mass. I recommend using a whey protein supplement immediately after exercise. Whey protein appears to be the best protein for muscle building, boosts the immune system, and has been found to reduce cortisol levels and depressive feelings under stress, probably by raising serotonin levels. These are valuable effects for controlling emotional eating. I had a patient who, because of emotional stress, was going to a supermarket every day after work to buy and consume an entire box of cupcakes. Dietary changes and a nutritional supplement plan that included a whey protein product, tamed her appetite. After about eight months she had lost 42 pounds of fat and 9 inches from her waist without losing any muscle. The whey product I usually recommend is Whey Cool from Designs for Health.
You may have heard that it’s not good to eat too much at night. Besides the fact that there is less of an opportunity to burn calories consumed at night, another factor influencing weight gain is the influence of the body’s diurnal rhythm. Levels of the hormone cortisol are normally highest in the morning and fall as the day goes on. A study published in 2001 entitled, “Metabolic effects of short-term elevations of plasma cortisol are more pronounced in the evening than in the morning” found different effects upon glucose and insulin metabolism when cortisol was elevated in the evening compared to in the morning. Elevated evening cortisol levels caused a greater increase in the fat-storing hormone insulin. Obese people have been found to produce more cortisol after eating. So, it does appear to be best to limit food (especially high glycemic index carbohydrate) consumption in the evening. Elevated nighttime cortisol, which is accurately measured from saliva specimens, is also associated with depression. Other factors that raise cortisol are mental-emotional stress and sleep deprivation. These factors can also suppress thyroid function. Therefore, two more weight loss principles, which will help many individuals, are to practice some form of stress reduction and get enough sleep. When cortisol is elevated, I have patients use a supplement called Seriphos, which consistently lowers cortisol levels.
Timing of exercise also may make a difference. Cardiovascular exercise first thing in the morning, on an empty stomach, may be best. In the morning, glycogen stores are lower. Glycogen is the body’s storage form of carbohydrate. When glycogen stores are low, the body more readily burns fat for energy. Strength training on the other hand, should be done when glycogen stores are full (later in the day, after eating). Muscles rely heavily upon glycogen for energy to fuel short, intense activity like lifting weights. Immediately before, during or after weight training are times that high glycemic index carbohydrates can be consumed with less detriment because of the high demand for energy production and replenishment of glycogen stores at these times. Post-weight training carbohydrates are beneficial for building muscle. The amount and timing of high glycemic index carbohydrate intake needs to be individualized. One last point on timing of exercise: another option for cardiovascular exercise is after weight training, prior to simple sugars, when glycogen stores will be lower.
A very important concept that is little known, involves weight loss and toxicity. One large study found that obese individuals who lost weight doubled their risk of dying over the subsequent four years. One possible explanation for this is toxicity. Fat soluble toxins are stored in the body’s fat. Toxins from pesticides, petrochemicals, and solvents permeate our food, water, and air. When a person begins to breakdown and burn body fat, toxins are released into systemic circulation and can again poison the body. Toxins can also contribute to sluggish metabolism. Studies have found blood levels of organochlorines increase during weight loss. This is associated with reductions in T3 (thyroid hormone) levels and resting metabolic rate.
For this reason it is a good idea to begin a weight loss program with several weeks of metabolic detoxification. It is also important to assure adequate nutrition to support detoxication at all times. Metabolic detoxification refers to an approach that lowers the load of toxins entering the body and supports the detoxification enzymes that will eliminate stored toxins from the body. To accomplish this I recommend a specific menu of organic foods, distilled water, and a medical food called Ultra Clear Plus, which has been scientifically designed and proven effective for detoxification. Other therapies such as Swedish massage, guided imagery, and use of saunas can aid detoxification. Continued detoxification during weight loss can be accomplished by way of Advaclear capsules.
These general weight loss principles should help most people. Keep in mind, though, every individual and every situation is unique. The best weight loss results and improvements in health come from a program tailored to the individual by a knowledgeable Board Certified Nutritionist.