3 Weight Loss Truths

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If you haven’t been bombarded with weight loss ads over the past week, you’re probably on a remote island soaking up the sun with the waves gently teasing your feet (bring me next time). There’s something about the start of a New Year that makes people freak out, lose their senses and develop completely unrealistic eating plans they will never follow for more than a few days. Before you get sucked into a crazy diet or juice cleanse, you should know the top three truths about weight loss.


1) No One Eats “Clean” all of the Time

Instagram and Facebook are full of photos of broccoli, brown rice and chicken meals neatly placed in Tupperware and followed by #mealprep #eatclean. The only thing more boring than looking at these meals is eating them day after day. No one eats like this all of the time. No one.
I’ve worked with a number of elite athletes who cut weight before a fight, match or event. They diet down, compete then loosen up their diet a bit before they need to diet down again. They aren’t eating bodybuilding-type meals every day year-round.

2) There is No One Perfect Diet

Jenny Craig, Weight Watchers, juice cleanses, Paleo, Whole30. There is no “perfect” because what’s right for you isn’t necessarily right for me. Figure out what changes you can realistically stick with, combine these with the general principles of healthy eating and start there. Forget what everyone else is doing, how your neighbor dropped 50 lbs. or what the actress on the cover of a magazine did. If you can’t stick with a plan, it won’t work.

Progress, not perfection, is the goal.

Celebrate each “win,” those small changes you’ve made that will add up to a big difference. You won’t necessarily notice a weight loss right away by making a few simple switches in your diet. However, I would rather people focus on the immediate difference – more energy, feeling better, more sleep, than the number on the scale. Feeling better each day will drive you to continue when the scale isn’t moving much.

3) You Must Exercise for Weight Loss

Can you lose weight without exercising? Yes absolutely. However, if you do not exercise you will lose more of your weight as muscle then fat. In addition to burning fewer calories each day when you lose muscle, you will notice a decline in strength and as you get older and everyday activities will become harder to do – lifting groceries, gardening, washing your car.

If you are not an exerciser and typically fall off when you start a new workout program, figure out what you like to do and do it. Forget all of the back-and-forth “noise” about high intensity interval training, the amount of rest in between sets and if you should train until muscle failure (until you cannot possibly lift the weight again). Instead, determine what brings you joy. What do you love to do? Dancing, yoga, hiking? What did you love doing as a kid? Hula hooping, double Dutch jump rope?

Do what makes you happy. Get moving and stay moving.

In addition to following these weight-loss truths, spend time feeling good about your body every single day. I meet so many people that are hyper focused on losing 5 pounds or 50 lbs. As they rattle off the reasons why they want to lose body fat and how this will drastically alter their life and make them happy, my mind often drifts off. I wonder what percentage of their thoughts are consumed by losing weight and dieting and if they are hyper-focused on controlling this aspect of their life because something else isn’t right. A marriage, their job, a friendship, their child’s behavior. If I ask the right questions something else they are ignoring often comes up.

Maintaining weight within a good range is very important for overall health. Obsessing about weight and dieting isn’t. I’ve coached enough people to know that one day you’ll look back years from now and wonder why you wasted so much time hating your body.

You’ll look back and say, “damn, I looked good! I wish I felt better about myself.”

“I wish I wore shorts in the summer.”

“Why didn’t I go to the beach in a bathing suit?”

“I wish I went to that party.”

I promise you, no one is criticizing your body. Every one around you is too busy focused on themselves. So go out and wear shorts, put on a bathing suit, try on that dress.

If you don’t love your body now, you won’t feel your best every day. You won’t enjoy life to the fullest. Work in this first (or in conjunction with healthy eating / a healthy approach to weight loss).

Because it’s a waste of time to spend your days bashing the body that does so much for you.

Ketogenic Diets: Fat-Filled Lies Won’t Make You Slim (or a Better Athlete)

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How do you turn your body into a fat burning machine, run faster than Usain Bolt, recover from exercise immediately and wake up each day bursting with energy? According to some people, the ketogenic diet is your answer (learn the basics of this diet here). This high-fat, moderate protein diet that is practically void of carbohydrates forces your body to use fat for energy. LeBron James supposedly tried it and offensive lineman decided to give it a shot after an ex-NFL center and O-line coach LeCharles Bentley recommended it. However, the offensive lineman and LeBron weren’t actually following a ketogenic diet. Though these athletes didn’t really know what they were following (no worries LeCharles, I’m sure your nutrition advice is on par with me coaching the O-line), people who actually follow it swear by it. Could this be an unconventional path to weight loss and better health? Unfortunately, the ketogenic diet craze has been fattened with misinformation.

Here is what I am covering in this post:

  • Eat Fat, Lose Fat? Does the ketogenic diet make you lose weight?
  • How does this diet impact muscle?
  • The ketogenic diet and athletic performance.
  • The issue with ketogenic research studies.

I am not covering “training low” or low carbohydrate  / non-ketogenic diets in this article.

Eat Fat, Lose Fat?

During the first several days on a ketogenic diet your weight will take a nosedive. Carbohydrate is stored in the form of glycogen in liver and muscle. Each gram of carbohydrate is stored with 3 – 4 grams of water. Decrease your carbohydrate intake, use glycogen and you’ll lose water weight very quickly. Weight loss, even if from water, can motivate people driven by the number on the scale. Given that adherence is the number one predictor of weight loss when on a diet, we can’t discount psychological effect of the number on the scale going down.

What happens if you stay on the diet? A group of NIH researchers admitted seventeen overweight or obese men to a metabolic ward and placed them on a high carbohydrate baseline diet for four weeks followed by four weeks on an isocaloric ketogenic diet (this diet contained the same amount of calories as the high carbohydrate baseline diet). The men lost weight and body fat on both diets. The ketogenic diet did not lead to greater fat loss as compared to the high carbohydrate diet and in fact body fat loss slowed during the ketogenic diet and subjects lost muscle (1). Time to chuck the “carbohydrates make you fat” books in the recycling bin.

What about other studies showing ketogenic diets help athletes lose body fat and maintain performance? These studies were not actually using a ketogenic diet protocol but instead were high fat, high protein, low carbohydrate diets. Also, none of the studies measured if the study subjects were actually in nutritional ketosis (2, 3, 4).  See the section on The Issue with Ketogenic Research Studies for more information on this topic.

Ketogenic diet and weight

Regardless of the studies indicating the ketogenic diet will not lead to greater weight loss as compared to a diet composed of the same amount of calories, some may lose weight because they will end up cutting down on their favorite foods. Fewer food choices often means fewer calories consumed.

Muscle Up with the Ketogenic Diet?

The ketogenic diet isn’t high enough in protein for maximal muscle gains. Using the lower end of fat intake on a classic ketogenic diet (80% of calories), one could consume 15% of calories from protein (112 grams) on a 3,000-calorie diet. Protein requirements are at least 1.2 – 1.8 grams of protein per kilogram bodyweight (or 0.55 – 0.82 grams per lb. bodyweight) per day if training and eating a diet with enough calories to maintain weight. Protein needs go up if you are cutting calories to spare the breakdown of muscle tissue when dieting. On this diet, 112 grams of protein equals just under 1.3 grams of protein per kg bodyweight for a 200 lb. person and even less for anyone who weighs more.

In addition to inadequate protein intake, “the ketogenic diet reduces many of the signaling molecules involved in muscle hypertrophy (growth),” states Dr. Antonio Paoli, M.D., B.Sc., Associate Professor and Vice Dean of the School of Human Movement Sciences, University of Padova. Without getting too technical, even with sufficient calorie intake, the ketogenic diet suppresses the IGF-1 / AKT / mTOR pathway (5). Using ketones for energy slows muscle breakdown. However it doesn’t stop this process (5).

The Ketogenic Diet and Athletic Performance

Once fully adapted to a ketogenic diet, athletes can supposedly rely on a seemingly endless supply of body fat for energy. No need for carbohydrate gels, beans, gummies and sports drinks every 15-30 minutes during long runs, rides or triathlons to sustain energy levels. Fewer calories consumed may make it easier for some people to stay within their total daily calorie needs (though if you are training that much staying within your calorie requirements shouldn’t be difficult).

Trading carbs for fat seems like a huge benefit for athletes, particularly endurance athletes who train and compete for several hours at a time (6). In addition to utilizing body fat, fat actually produces more energy (ATP) (5). However, fat is a slow source of fuel (see graphic below), the human body cannot access it quickly enough to sustain high-intensity exercise and therefore, this diet is really only (potentially) applicable to ultra-runners and triathletes competing at a relatively moderate to slow pace.

In a ketogenic diet study examining athletic endurance, researchers had subjects cycle at a snails pace (equivalent to a heart rate of about 120 beats per minute for anyone 20-30 years old or 115 for a 40 year old) until they became exhausted before and after 4-weeks on a ketogenic diet. There were no differences in the amount of time they were able to cycle before getting tired prior to or after the four-week ketogenic diet (7). In studies examining high fat diets (not ketogenic and ketones weren’t measured) and endurance performance, study subjects relied on more fat as opposed to carbohydrate during low intensity exercise, yet there was no clear performance advantage on the higher fat diet (8). A recently published study examined 20 elite ultra-marathoners and Ironman distance triathletes. Some were habitually consuming a traditional high carbohydrate diet while the other group was following a ketogenic diet (slightly adjusted macronutrient ratios yet they were in ketosis as measured by blood ketone levels). As expected, those following a higher fat diet used a greater percentage of fat for energy while the higher carbohydrate diet group used more carbohydrate for energy during a 180 minute submaximal running test (I’d call that leisure running intensity). There was no difference in calories burned over the course of the run. Both groups had the same level of perceived exertion and there was no test to determine performance differences between groups (9).

If there’s no performance benefit and we know carbohydrates work, why follow this diet? If your primary goal is weight loss, it doesn’t matter if you use more fat than carbohydrate while exercising (SN: can we please stop talking about the fat burning zone) as long as you’re burning more total calories over the course of the day. Plus, in the interest of (if you are not an ultra endurance athlete) jack up the intensity and burn as many calories in a short period of time as possible. Unfortunately, a ketogenic diet won’t help you do that – when relying on fat for fuel, the intensity of your exercise will drop – the body simply can’t access fat (a slow source of energy) quickly enough to sustain high-intensity exercise. Instead, carbohydrates are necessary for high intensity activity.
ketogenic diet and sports

The Issue with Ketogenic Research Studies

Here’s the issue with many ketogenic research studies and media reports based on them: in most cases, the study subjects were not actually following a ketogenic diet – they were following a higher fat, high-protein low carbohydrate diet (10, 11, 12). Each person’s carbohydrate and protein limits needed to stay in ketosis vary and therefore, measuring ketones through blood or urine is the only definitive way to determine if you are in ketosis. Complicating matters more, low carbohydrate diets (including ketogenic diets) lead to a substantial drop in carbohydrate content, and associated water stored with it, in muscle. This change overestimates the drop in lean body mass as measured by DEXA.

ketogenic and low carbohydrate diets

There are no modifications, higher protein intakes or “on again, off again” (where you go on it one day and off it the next) to this diet. You must be in a state of nutritional ketosis or you will need to decrease carbohydrate and protein intake even further to get into nutritional ketosis and rely on ketones for energy.

Is There Any Benefit?

Ketogenic diets help decrease incidence and severity of seizures in epileptic patients (this is what the diet is intended for). Also, ketogenic diets may be beneficial when implemented soon after a traumatic brain injury (including concussion) (13). In addition, scientists are examining if this diet is beneficial for diseases that affect the brain such as Alzheimer’s.

If you want to lose weight, the ketogenic diet is not superior to a reduced calorie diet. Also, unless you are an ultra endurance athlete who just loves dietary fat, hates eating at social occasions and can put up with the potential side effects from this diet it isn’t for you.
Now where is the O-line? I’ve got some coaching to do…

References

1 Hall KD, Chen KY, Guo J, Lam YY, Leibel RL, Mayer LE, Reitman ML, Rosenbaum M, Smith SR, Walsh BT, Ravussin E. Energy expenditure and body composition changes after an isocaloric ketogenic diet in overweight and obese men. Am J Clin Nutr. 2016 Jul 6. [Epub ahead of print]

2 Zajac A, Poprzecki S, Maszczyk A, Czuba M, Michalczyk M, Zydek G. The effects of a ketogenic diet on exercise metabolism and physical performance in off-road cyclists. Nutrients 2014;6(7):2493-508.

3 Rhyu HS, Cho SY. The effect of weight loss by ketogenic diet on the body composition, performance-related physical fitness factors and cytokines of Taekwondo athletes. J Exerc Rehabil 2014;10(5):326-31.

4 Paoli A, Grimaldi K, D’Agostino D et al. Ketogenic diet does not affect strength performance in elite artistic gymnasts. JISSN 2012;9:34.

5 Paoli A, Bianco A, Grimaldi KA. The ketogenic diet and sport: a possible marriage? Ex Sports Sci Reviews 2015.

6 Volek J, Noakes T, Phinney SD. Rethinking fat as a fuel for endurance exercise. Eur J Sport Sci 2014;2:1-8.

7 Phinney SD, Bistrian BR, Evans WJ, Gervino E, Blackburn GL. The human metabolic response to chronic ketosis without caloric restriction: preservation of submaximal exercise capability with reduced carbohydrate oxidation. Metabolism 1983;32(8):769-76.

8 Burke LM, Kiens B. “Fat adaptation” for athletic performance: the nail in the coffin? J Appl Physiol 2006;100(1):7-8.

9 Volek J, Freidenreich DJ, Saenz C, Kunces LJ, Creighton BC, Bartley JM, Davitt pm, Munoz CX, Anderson JM, Maresh CM, Lee EC, Schuenke MD, Aerni G, Kraemer WJ, Phinney SD. Metabolic characteristics of keto-adapted ultra-endurance runners. Metab Clin Exp 2016;65(3):100-110.

10 Tinsley GM, Willoughby DS. Fat-Free mass changes during ketogenic diets and the potential role of resistance training. Int J Sport Nutr Exerc Metab. 2015 Aug 12. [Epub ahead of print]2 Rouillier MA, Riel D, Brazeau AS, St. Pierre DH, Karelis AD. Effect of an Acute High Carbohydrate Diet on Body Composition Using DXA in Young Men. Ann Nutr Metab 2015;66:233-236

11  Paoli A. The ketogenic diet and sport: a possible marriage? Ex Sci Sports Sciences Rev 2015;43(3):153-62.

12  Johnstone AM, Horgan GW, Murison SD, Bremner DM, Lobley GE. Effects of a high-protein ketogenic diet on hunger, appetite, and weight loss in obese men feeding ad libitum. Am Society Clin Nutr 2008;87(1):44-55.

13 Nutrition and Traumatic Brain Injury: Improving Acute and Subacute Health Outcomes in Military Personnel (2011). The National Academies Press, Institute of Medicine. Washington DC. 2011 http://www.nap.edu/read/13121/chapter/15

 

The Ketogenic Diet Craze: Fat-Filled Lies, Part 1

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ketogenic diPicture this: a thick, juicy, tender eventeak grilled to perfection with melted butter glazed on top, gently dripping down the sides. Lying next to the steak there’s a side of dark green asparagus sautéed in coconut oil and dusted with a sprinkle of sea salt. Could a diet loaded with fat help you lose diet-resistant body fat that’s been taunting the seams of your dress pants and poking through buttons on your shirt? Will eating fat turn you into an all-star athlete? This is part 1 of a 2 part series on the ketogenic diet.

Here is what I will cover in this blog post:

  • What is the ketogenic diet?
  • Adverse health effects.

Here is what I will cover in tomorrow’s blog on this topic:

  • The issue with ketogenic research studies.
  • Is the ketogenic diet superior for losing fat?
  • How will the ketogenic diet affect muscle?
  • How will the ketogenic diet impact athletic performance?

What is the Ketogenic Diet?

For nearly a century, epileptic patients have used ketogenic diets to control seizures when common medications provide no relief. Scientists aren’t sure why following a ketogenic diet decreases the incidence and severity of seizures but it works.

The ketogenic diet contains – 80-90% of calories from fat, 15% from protein and 5% from carbohydrate (1, 2). Food choices may include heavy cream, bacon, eggs, non-starchy vegetables, mayonnaise and sausage while fruits, starchy vegetables, breads, pasta, cereal and other carbohydrate-rich foods are not allowed.

During the first several days on a ketogenic diet, your body’s limited supply of carbohydrate stored in liver and muscle tissue decreases dramatically. As a result, you will feel like you have mono – exhausted, with headaches and easy exercise will feel like you’re climbing Mount Everest (3). Once your stored carbohydrate has dwindled, ketones, formed from the breakdown of dietary fat, become the primary source of energy for brain and body. Ketogenic means “ketone forming.” It takes at least seven days to reach nutritional ketosis and several weeks to fully adapt to the diet (12). If you aren’t in nutritional ketosis (as measured by blood, urine or breath ketones; ketone levels > 0.5 mmol/L), then you aren’t following a ketogenic diet, you are on a low carbohydrate diet.

Adverse Health Effects from the Ketogenic Diet

Much of the research on adverse effects comes from studies in epileptic children since they have been on the diet for long periods of time. These studies show soon after starting a ketogenic diet, blood cholesterol levels and artery stiffness increase (4, 5). High total and LDL cholesterol are risk factors for cardiovascular disease (diseases of the heart and blood vessels). When arteries are stiff, they cannot expand as well in response to changes in blood pressure. Think of this like a garden hose when you turn up the water pressure, your hose either expands or the water bursts out of the space between the faucet and the hose. When arteries cannot open widely to accommodate increases in blood flow, blood pressure increases leading to microscopic tears on artery walls, development of scar tissue and the perfect surface for plaque buildup (6). Blood cholesterol levels returned to normal in patients who went off the diet and in those who stayed on it, they returned to normal after 6 to 12 months. Artery stiffness returned to normal after 24 months on a ketogenic diet.5 Studies in obese patients suggest ketogenic diets improve blood sugar and blood cholesterol levels over time, either due to the diet, weight loss from the diet, a combination of the two or carbohydrate restriction (7, 8). Lose weight, regardless of what you eat and blood cholesterol, blood pressure, inflammation, blood sugar and many other disease risk factors will improve.

Ketogenic diets are typically low in calcium, vitamin D, potassium, magnesium, folic acid and fiber. There are several potential consequences associated with consistently low intake of each of these micronutrients including softening of the bones, decreased bone density, muscle damage, muscle weakness or spasms, and abnormal heart rhythm. However, with careful planning, a fiber supplement, multivitamin and under the guidance of a physician who may prescribe potassium and sodium supplements (blood sodium could drop to dangerously low levels while on this diet), nutrient needs can be met. Also, to prevent constipation when on a ketogenic diet, a fiber supplement may be necessary along with more water / fluid intake then you are used to.

Here are some other potentially bad side effects from following a high fat diet:

  • Harm to your Brain. Studies in mice show a high fat diet, even when followed for as little as two months leads to chronic inflammation, sedentary immune cells in the brain – these cells typically act like janitors picking up trash and infectious compounds but when they become sedentary they stop doing their job, leading to cognitive impairment (9). Does this happen in humans and resolve over time? We don’t know.
  • Mad Bacteria in Your Gut. A diet with no probiotics (healthy bacteria) and low in prebiotics (certain types of fiber that the healthy bacteria much on for food keeping them happy) will likely change the composition of bacteria in your gut so you have more harmful and less beneficial bacteria.
  • Leaky Gut. High saturated fat meals increase bacterial toxins (endotoxins) in the intestines and intestinal permeability. In other words: leaky gut (10, 11). If you are on this diet, consider opting for foods lower in saturated fat and higher in unsaturated fats (liquid oils, avocado, nuts, seeds, olives).
  • Free radicals in overdrive? If you can’t eat a number of colorful foods including blueberries, beets, corn, oranges, and more, chances are you won’t get a wide array of antioxidant compounds to quench free radicals (compounds that are important for good health but can wreck your body when they aren’t tamed by antioxidants) as well as other plant-based compounds that keep your arteries, muscles and other parts of your body healthy. Will your body adapt? We don’t know at this time.

Are the side effects and potential negative side effects worth it if you can lose weight on this diet? Stay tuned for tomorrow’s post on how the ketogenic diet impacts body fat and athletic performance.

References

1 Freeman JM, Freeman JB, Kelly MT. The ketogenic diet: a treatment for epilepsy. 3rd ed. New York, NY: Demos Health; 2000.

2 Paoli A, Bianco A, Damiani E, Bosco G. Ketogenic Diet in Neuromuscular and Neurodegenerative Diseases. BioMed Research International 2014, Article ID 474296, 10 pages, 2014.

3 White AM, Johnston CS, Swan PD et al. Blood ketones are directly related to fatigue and perceived effort during exercise in overweight adults adhering to low-carbohydrate diets for weight loss: a pilot study. J Am Diet Assoc 2007;107(10):1792-6.

4 Tanakis M, Liuba P, Odermarsky M, Lundgren J, Hallböök T. Effects of ketogenic diet on vascular function. Eur J Paediatr Neurol 2014;18(4):489-94.

5 Coppola G, Natale F, Torino A et al. The impact of the ketogenic diet on arterial morphology and endothelial function in children and young adults with epilepsy: a case-control study. Seizure 2014;23(4):260-5.

6 Cecelja M, Chowienczyk P. Role of arterial stiffness in cardiovascular disease. JRSM Cardiovascular Disease 2012;1(4):1-10.

7 Dashti HM, Mathew TC, Hussein T, Asfar SK, Behbahani A, Khoursheed MA, Al-Sayer HM, Bo-Abbas YY, Al-Zaid NS. Long-term effects of a ketogenic diet in obese patients. Exp Clin Cardiol 2004; 9(3): 200–205.

8 Volek JS, Feinman RD. Carbohydrate restriction improves the features of Metabolic Syndrome. Metabolic Syndrome may be defined by the response to carbohydrate restriction. Nutr Metab (Lond) 2005;2:31.

9 Hao S, Dey A, Yu X, Stranahan AM. Dietary obesity reversibly induces synaptic stripping by microglia and impairs hippocampal plasticity. Brain Behav Immun 2016 Jan;51:230-9.

10 Mani V, Hollis JH, Gabler NK. Dietary oil composition differentially modulates intestinal endotoxin transport and postprandial endotoxemia. Nutr Metab (Lond) 2013; 10: 6.

11 Lam YY, Ha CW, Campbell CR, Mitchell AJ, Dinudom A, Oscarsson J, Cook DI, Hunt NH, Caterson ID, Holmes AJ, Storlien LH. Increased gut permeability and microbiota change associate with mesenteric fat inflammation and metabolic dysfunction in diet-induced obese mice. PLoS One 2012;7(3):e34233.

12 Paoli, A, Grimaldi K, D’Agostino D, Cenci L, Moro T, Bianco A, Palma A. Ketogenic diet does not affect strength performance in elite artistic gymnasts. J Int Soc Sports Nutr 2012;9:34.

Can You Lose Fat and Gain Muscle at the Same Time?

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Eat fewer calories than you burn each day and you’ll lose weight. There’s one major issue with this time-tested approach: you’ll probably strip away more than just body fat. Weight loss, especially fast weight loss, achieved after crash dieting or drastically slashing calorie intake, leads to a decrease in muscle mass and subsequent drop in metabolism. A slower metabolism means your body needs even fewer calories to maintain your new weight (weight loss alone = fewer calories needed to carry around a smaller body, add muscle loss and your calorie needs drop even more). In addition, with less muscle you won’t be able to push yourself as hard during workouts (and therefore burn as many calories). This can put you on the fast track to yo-yo dieting, weight loss and regain. There’s a much better approach and a recently published study highlights how you can lose body fat and gain muscle at the same time.

crash dieting leads to muscle loss

In this article I’ll cover:

  1. How dieting can slow your metabolism;
  2. The latest evidence on losing fat and building muscle at the same time;
  3. Why researchers didn’t use a low carbohydrate diet;
  4. How you can keep the weight off.

How Dieting Slows Your Metabolism

When you eat fewer calories than you need each day, your body is forced to pull from its backup supply, body fat and muscle, to maintain your energy (calorie) needs. Some people lose a substantial amount of muscle when dieting, 30% or more, of their initial muscle mass. In addition to a decrease in muscle mass and slower metabolism, lower calorie diets decrease the intracellular signaling necessary for the synthesis of new proteins in muscle. Plus, muscle tissue may be less sensitive to protein when you’re dieting. In other words, it’s really tough to build muscle when dieting to lose weight. Based on these physiological changes, there’s an age-old theory suggesting it’s impossible to gain muscle and lose fat at the same time. However, scientists from McMaster University in Canada found it is not only possible but also, doable even when losing a substantial amount of body fat in a relatively short period of time.

Building Muscle While Losing Body Fat

In the McMaster University study, young overweight recreationally active men (prior to the study they exercised 1-2 times per week) were placed on an intense four-week diet and exercise program. Their diet contained 40% fewer calories each day than needed for weight maintenance. All meals were prepared and provided to participants during the study. The men were randomly selected for one of two diet groups:

  Higher Protein Group

 

Lower Protein (Control Group)

 

Total daily calorie intake 15 calories per pound of lean body mass 15 calories per pound of lean body mass
Macronutrients 35% protein, 50% carbohydrate and 15% fat 15% protein, 50% carbohydrates, 35% fat
Total daily protein intake 1.09 grams of protein per lb. body weight (2.4 grams of protein per kg) 0.55 grams of protein per lb. bodyweight (1.2 grams of protein per kg) – 2x the RDA (0.8 g/kg) for protein

 

Per meal protein intake 0.22 grams of protein per lb. of body weight

 

0.10 grams of protein per lb. of body weight

 

Dairy shakes 3- 4 / day including one after exercise (depending on body weight; higher protein, lower carbohydrate shakes compared to the Lower Protein Group)

 

3- 4 / day including one after exercise (depending on body weight; lower protein, higher carbohydrate shakes compared to the Higher Protein Group)

 

Training Program
Supervised workouts consisted of full-body resistance circuit training twice per week and high intensity interval training six days per week. In addition to their structured exercise program, all participants were instructed to get at least 10,000 steps per day as monitored by a pedometer worn on their hip.

Resistance Training Circuit
2 times per week
3 sets of 10 reps at 80% 1 RM with the last set of each exercise to failure
No rest between sets
1-minute rest between each circuit

Sprint Interval Training
1 time per week
Four to eight 30-second bouts on a stationary bike (participants started with four sets and progressed to eight sets)
4 minutes rest between bouts

Modified High Intensity Interval Training
1 time per week
10 bouts of all-out sprint for one minute at 90% VO2max
1-minute rest intervals at 50% VO2max

Time Trial
1 time per week as fast as possible until approximately 250 calories were burned

Plyometric bodyweight circuit
30-second rest between exercises

Results
Both the lower protein and higher protein groups lost weight with no significant difference between groups. Men in the higher protein group gained 2.64 lbs. of muscle and lost 10.56 lbs. of body fat while men in the control group gained little muscle (0.22 lbs.) and lost 7.7 lbs. of fat. Both groups improved all but one measure of strength in addition to aerobic and anaerobic capacity. There were no differences between groups in strength, power, aerobic fitness or performance at the end of the study.

In this study, a higher protein, reduced calorie diet combined with a high intensity circuit-training program including interval training and sprints helped participants build muscle. In addition to their total protein intake, participants in the higher protein group also consumed more protein per meal (approximately 49 grams per meal) than those in the lower protein group (approximately 22 grams per meal).

Why Didn’t They Cut Carbohydrates?

Low carbohydrate diets are not only popular, but they may lead to greater weight loss (in overweight and obese individuals), initially, than higher carbohydrate, low fat diets (some of this is water weight). However, when giving up carbohydrates you also sacrifice something else, intense training. Carbohydrates are the primary source of fuel used during high-intensity exercise because your body can readily access and utilize them for energy. Fat is a slow source of energy and therefore, your body cannot access and use fat quickly enough to sustain high intensity training. In this study, both groups of participants consumed 50% of their calorie intake from carbohydrate. If the study authors cut carbohydrates, the participants wouldn’t make it through their high intensity training program that was specifically designed to take off fat and increase muscle mass.

Keeping the Weight Off

Consider a program like the one used in this study a short-term jumpstart. It isn’t sustainable over a long period of time. The transition to a longer-term approach after weight loss should include a gradual increase in calorie intake while maintaining a higher protein diet (at least 0.55 grams of protein per lb. of body weight to maintain muscle while considerably more, along the lines of 1.09 – 1.41 grams of protein per lb. of body weight may be necessary to continue building muscle during periods of reduced calorie intake). This gradual increase in calorie intake is important because substantial weight loss results in a slower metabolism even if you maintain or build muscle during your jumpstart weight loss program. It isn’t entirely clear why this happens and the drop is greater than scientists can predict based on a decrease in muscle mass. Even if you build some muscle, this won’t rev fire up your metabolism to make up for a drastic decrease in body weight.

One pound of muscle burns a measly 5.9 calories per day at rest while a pound of fat burns 2 calories per day at rest.

Greater weight lost while dieting means an even greater drop in metabolism – something dieters must account for so they can maintain their new weight.

In addition to slowly increasing calorie intake and consuming a higher protein diet, each meal should contain at least 25 – 30 grams of protein. We don’t know the exact amount of protein per meal needed to maximally stimulate muscle building.

Your exercise regimen should continue to include resistance training and you’d be wise to continually vary your training program. Be sure to move each day as well. Research shows many people naturally adjust to greater amounts of aerobic exercise by decreasing their activities of daily living. They exercise intensely at the gym and then sit the rest of the day. Circumvent this by using one of the many devices that counts steps each day. Also, consider doing more work around your house including cleaning, mowing your lawn, gardening, and washing your car. Get moving and stay moving all day long.

If you want to get rid of your love handles while building a six-pack at the same time, combine an effective resistance training and high intensity interval-training program with a reduced calorie, higher protein diet. Your diet and exercise program does not need to be as rigorous as the one in this study. Instead, you can adjust the McMaster University approach to fit your lifestyle, though your results may take more time. Once you reach your goal weight, slowly transition your training program and diet to an approach you can live with.

References
Weinheimer EM, Sands LP, Campbell WW. A systematic review of the separate and combined effects of energy restriction and exercise on fat free mass in middle-aged and older adults: implications for sarcopenic obesity. Nutr Rev 2010;68:375–88.

Stiegler P, Cunliffe A. The role of diet and exercise for the maintenance of fat-free mass and resting metabolic rate during weight loss. Sports Med 2006;36(3):239-62.

Heymsfield SB, Gonzalez MCC, Shen W, Redman L, Thomas D. Weight Loss Composition is One-Fourth Fat-Free Mass: A Critical Review and Critique of This Widely Cited Rule. Obes Rev 2014; 15(4):310–321.

Deurenberg P, Weststrate JA, Hautvast JG. Changes in fat-free mass during weight loss measured by bioelectrical impedance and by densitometry. Am J Clin Nutr 1989;49(1):33-6.

Johannsen DL, Knuth ND, Huizenga R, Rood JC, Ravussin E, Hall KD. Metabolic Slowing with Massive Weight Loss despite Preservation of Fat-Free Mass. J Clin Endocrinol Metab 2012; 97(7): 2489–2496.

Ravussin E, Bogardus C. Review Relationship of genetics, age, and physical fitness to daily energy expenditure and fuel utilization. Am J Clin Nutr 1989; 49(5 Suppl):968-75.

Phillips SM. A Brief Review of Higher Dietary Protein Diets in Weight Loss: A Focus on Athletes. Sports Med 2014; 44(Suppl 2): 149–153.

Longland T, Oikawa SY, Mitchell CJ, Devries MC, Phillips S. Higher compared with lower dietary protein during an energy deficit combined with intense exercise promotes greater lean mass gain and fat mass loss: a randomized trial. Am J Clin Nutr 2016;103:738-46.

Heydari M, Freund J, Boutcher SH. The effect of high-intensity intermittent exercise on body composition of overweight young males. J Obes 2012;2012:480467.

Areta JL, Burke LM, Camera DM, West DW, Crawshay S, Moore DR,Stellingwerff T, Phillips SM, Hawley JA, Coffey VG. Reduced resting skeletal muscle protein synthesis is rescued by resistance exercise and protein ingestion following short-term energy deficit. Am J Physiol Endocrinol Metab 2014;306:E989–97.

Pasiakos SM, Vislocky LM, Carbone JW, Altieri N, Konopelski K, Freake HC, Anderson JM, Ferrando AA, Wolfe RR, Rodriguez NR. Acute energy deprivation affects skeletal muscle protein synthesis and associated intracellular signaling proteins in physically active adults. J Nutr 2010;140:745–51.

Hector AJ, Marcotte GR, Churchward-Venne TA, Murphy CH, Breen, von AM, Baker SK, Phillips SM. Whey protein supplementation preserves postprandial myofibrillar protein synthesis during short-term energy restriction in overweight and obese adults. J Nutr 2015;145:246–52.

Murphy CH, Churchward-Venne TA, Mitchell CJ, Kolar NM, KassisA, Karagounis LG, Burke LM, Hawley JA, Phillips SM. Hypoenergetic diet-induced reductions in myofibrillar protein synthesis are restored with resistance training and balanced daily protein ingestion in older men. Am J Physiol Endocrinol Metab 2015;308:E734–43.

Chaston TB, Dixon JB, O’Brien PE. Changes in fat-free mass during significant weight loss: a systematic review. Int J Obes (Lond) 2007; 31(5):743-50.

Garthe I, Raastad T, Refsnes PE, Koivisto A, Sundgot-Borgen J. Effect of two different weight-loss rates on body composition and strength and power-related performance in elite athletes. Int J Sport Nutr Exerc Metab 2011; 21(2):97-104.

Churchward-Venne TA, Murphy CH, Longland TM, Phillips SM. Role of protein and amino acids in promoting lean mass accretion with resistance exercise and attenuating lean mass loss during energy deficit in humans. Amino Acids 2013; 45(2):231-40.

Helms ER, Zinn C, Rowlands DS, Brown SR. A systematic review of dietary protein during caloric restriction in resistance trained lean athletes: a case for higher intakes. Int J Sport Nutr Exerc Metab 2014; 24(2):127-38.

The Truth about Detox Diets

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Detox Diets and Cleanses

Detox diets promise to clean up the mess left behind from daily life so you feel better, more energetic and lose excess body fat. Consider them the Merry Maids for your body. They come with an army of equipment and compounds to attack years of buildup from environmental toxins, pesticides, allergens, waste, and inflammatory substances. This “sewage sludge” is stuck to your gut, interfering with digestion, leaving you bloated, tired, fat and with joints and muscles that feel like they are on fire.

In theory this sounds great. But there’s one glaring issue. The human body doesn’t need to “detox” because it comes equipped with organs designed to remove waste products. Plus, many detox diets are simply very low calorie plans with added laxatives and diuretics (because instant, yet temporary, weight loss might fool you into believing the outrageous claims on detox and cleansing products). Instead of wasting your money, take the top 3 good points about many of these diets and incorporate them into your overall nutrition plan:

Drink More Water

There are a few studies showing that individuals who are obese can lose weight by drinking 2 glasses of water before each meal. Plus, many people don’t get enough water or total fluids each day anyway and dehydration can make you feel sluggish and grouchy. So, grab it from the tap or if it’s more convenient, fill up your stainless steal water bottles and carry them with you at all times.

Eat More Fruits and Vegetables

The average American is falling short on fruit and vegetable intake. According to the National Cancer Institute, people with diets rich in plant foods, such as fruits and vegetables, have a lower risk of getting some types of cancer as well as diabetes, heart disease and high blood pressure. Produce generally has fewer calories than many other foods making it a great addition to a weight loss diet.

Get Friendly with Bacteria

Many detox plans include unfiltered apple cider vinegar – the kind that has a cloudy appearance – is full of probiotics. Probiotics are friendly (beneficial) bacteria – the kind that live in your gut and have a number of important functions in your body. Improving your gut bacteria may support immune functioning, improve the health of your intestinal tract, increase your body’s absorption of certain nutrients and alleviate constipation. Apple cider vinegar is acidic so I don’t recommend drinking it straight. Instead, dilute it in a big glass of water or another beverage. Other great sources of probiotics include kefir, yogurt (check the container for “live and active cultures”), miso soup, tempeh, sauerkraut, kimchi.

Add 2 glasses of water before each meal, load up on vegetables and fruits and make an effort to consume probiotic-rich food daily and you will reap the rewards of better nutrition without wasting money on detox diets and cleanses.

References:
Parvez J et al. J Appl Microbio 2006;100(6):1171-1185.
Parretti HM et al. Obesity 2015, 23(8):1785-1791.
Dennis EA et al. Obesity 2010;18(2):300-307.

 

How Your Body Image Affects Your Weight & Health

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Today I’m going on a slight rant about something that has been on my mind for a while – body image. And because the majority of my clients (all but 1) are male athletes, I don’t run into the overt self-degrading body comments as often as many of my dietitian colleagues who work with women. However, I’ve run into a number of women lately who either put their bodies down, avoid social situations or the beach / pool / bathing suits because they feel “fat”, obsessively cover up their bodies, obsessively diet or exercise (or both) or engage in other self-depreciating comments and related behaviors stemming from how they feel about their body. And I always walk away thinking “one day she is going to look back and think ‘damn I looked good’ and regret wasting so much time and energy hating a body that helped her cross finish lines, hike mountains, pick up small children, build a beautiful garden and do so much more.”

And though I won’t get into the psychology behind body image and self worth or how to improve your body image (you can read more about that in this article), I do want to talk about how this affects a person’s overall health and sense of well-being. First and foremost, the people around you might not notice the subtle behaviors and words you speak (unless you have dietitian or psychologist friends) but your kids will (children, grandchildren, children you teach or coach). Anyone who has spent 5 minutes with a child knows they pick up everything. Now, let’s say you are that female who won’t wear shorts in the summer because you hate the way your legs look. Your little girl will stop wearing shorts and at some point think her legs look bad too. Or maybe you are the grandma who won’t wear a bathing suit to the beach because you can’t fit into the one you wore last year. Your grandkids will wonder why you aren’t going in the water with them. And finally, if you are a coach of young girls, an entire team will learn about how they should be viewing their bodies from what you think of yours.

In addition to affecting the people around you, I’ve noticed that women who don’t love the bodies they live in spend entirely too much time thinking about food and exercise. And by cutting out certain foods, going on cleanses or popular diets or drastically slashing their food intake, they are cutting out a number of nutrients necessary for good health. And the effects might not be obvious at first, but over time they will catch up to you. Cut calories and it will be difficult to get a number of vitamins, minerals and protein in your diet (And when you fall short on protein you will start losing muscle mass. Over time less muscle means you burn a few less calories each day and you won’t be able to exercise as hard in the gym so you burn fewer calories while working out. Both of these make it challenging to keep weight off over time. Plus less muscle means activities of daily living like gardening, picking up kids, or lifting groceries may be tough). Switch to a vegetarian diet and you better really plan on incorporating protein since you will need more total protein to keep and build muscle. Drop dairy and your bones, teeth and nails will suffer over time (yes you can eat kale, spinach and other leafy greens but you will need at least 10 cups of raw leafy greens a day if this is your only source of calcium). I’ve seen women in their 20s with osteopenia (low bone mass, this often comes before the brittle bone disease osteoporosis). And this is just the tip of the iceberg. But, here’s the most important point: your body image affects what you eat (more than just total calories) and don’t eat. And over time I’m going to make a stretch here and say (from observation) that body image-induced changes in diet affect your intake of vitamins and minerals and over time, consistent vitamin and mineral shortages will affect how your body functions and could impair several aspects of health. So, if you feel like you fall into this category of women or men who loathe your body, make the commitment right now to work on this. I promise you that you are wasting time as well as mental and physical energy. Plus, the changes you are making in an effort to keep weight off may be doing more harm than good.

Effective Strategies for Weight Loss

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Last Friday I spoke at the NSCA’s Personal Trainers meeting in Las, Vegas. They put on one heck of a meeting and I love meeting NSCA members and learning from them as well as the speakers. And one thing I really liked about this meeting was the fact that several speakers challenged commonly held beliefs about nutrition and exercise. Here’s a condensed overview (not all points included) of my talk on Effective Strategies for Weight Loss:

1) Lift Weights or engage in some other type of resistance training, regularly. Muscle tissue doesn’t burn many more calories than fat (despite what people say) – about 4 calories more per day per pound. But, those calories add up over time and more importantly, adults start a gradual slow progression of losing muscle around age 40 (sarcopenia). Less muscle means you can’t exercise as hard which means you won’t burn as many calories while working out (and those activities of daily living like washing your car or lifting groceries will seem tough at some point).

2) Calories Matter. I hate to burst anyone’s bubble who thinks you can eat as much as you want as long as you slash so called “bad calories,” but calories count. If you don’t believe me, check out how nutrition professor Mark Haub lost 27 lbs and significantly improved his blood lipids on a 10-week diet of Twinkies, Doritos, sugary cereals and Hostess cupcakes. Want more evidence published in research journals? Okay, check out the POUNDS LOST trial which found that how much you eat matters more than the proportion of fat, carbohydrate and protein. And, that adherence to a diet determines success (and sticking with extreme diets that cut out food groups sucks so many people don’t last long on them).

3) Calories Matter but Protein is Crucial. Protein preserves muscle during weight loss and the lower your diet is in calories, the more you need protein. How important is protein for preserving muscle? Well, I love the overfeeding study published in JAMA earlier this year in which the study authors overfed participants by 40% more calories than they needed to maintain their weight. The participants were randomized to receive either 5%, 15% or 25% of their calories from protein. Now, 5% may seem low but because of their total daily caloric intake that 5% meant 47 grams per day – that’s 1 gram more than the protein RDA set by our government for women! All groups gained a similar amount of fat and the 15% and 25% group also gained muscle (and therefore more total weight) but, the group consuming 1 gram of protein more than the RDA set for women LOST 0.70 kg lean body mass! Take home points: over consume calories and you’ll gain fat. Make protein a greater proportion of the calories you over consume and you’ll also gain muscle. Follow the RDA and you may lose lean body mass.

4) Change your Environment for Success. Eat off smaller plates and bowls, choose smaller packages, get the food you don’t want to eat out of your house (if it is there, you will eat it at some point). Put healthy food within your line of vision. Avoid constant refills (chip basket at restaurants, bread basket, that never ending tub of beer bottles). And, surround yourself with people who encourage your success vs. those who will get in the way.

5) Keep your stress levels down. For more information on how stress impacts weight, click here.

6) Figure out WHY you are eating. You can have all the nutrition knowledge in the world and weight loss strategies but if you don’t delve into what is making you eat vs. using other coping mechanisms, long term success will elude you.

Now, you are probably wondering “well what about Forks Over Knives, the documentary that covered the supposed evils of animal protein?” I promise I’ll give my uncensored opinion (slashing) of that documentary in my next post in addition to more about protein 🙂

For a hilarious and insightful overview of this conference, check out fitness and nutrition expert Alan Aragon’s post. And, here’s a post from another one of my favorite writers, renowned fitness expert Brad Schoenfeld.

Why Calorie Reduction & Exercise Doesn’t Always Lead to Weight Loss

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For years people have bought into the notion that 3,500 calories added or subtracted from one’s diet means you will gain or lose one pound, respectively. It’s an easy concept to grasp and helps people feel in control of their weight. And, if you’ve followed the man who went on the Twinkie diet, this formula does seem to work, at least in the short term (meaning it’s the total calories that matter, not the type of calories). But, in reality, few aspects of nutrition are that clear-cut, especially weight control.

Why doesn’t this simple formula of subtracting 3,500 calories through a combination of food and exercise expenditure work? For one thing it doesn’t take into account the type of weight you are losing (muscle, bone, fat) and how your metabolism changes over time based on the type of weight you lose and your overall daily calorie needs (which change as your weight and body composition changes). But, a new tool, from the National Institutes of Health, uses a mathematical model to predict weight change based on changes in diet and physical activity. This new formula helps account for changes in metabolism as you lose weight. So for instance, if you start at 215 lbs and then get down to 180, you’ll have to drop your calorie intake further or exercise more to continue losing weight.

Despite the fact that this model is for reseach purposes and not an individual prescription for weight loss, it is indeed, pretty cool and hopefully will contribute to additional research on weight loss.

Take a look at this Body Weight Simulator by clicking here.

The team that developed this Body Weight Simulator found that people adapt slowly to changes in dietary intake (this is one reason many people quit and think “changing what I eat doesn’t work!” And, they also found that initially, heavy people can quickly lose weight. The neat thing about this new model is that it can show how long it will take to achieve a specific weight loss goal if one aspect of nutrition or exercise is altered (consistently altered that is).

Keep in mind that the most effective way to lose weight is an individual approach that takes into account your medical history, medications, exercise program, types of food you consume and your daily life (this is why following a specific diet book may work for your friend but not for you). And, as you make diet and lifestyle changes, remember that it may take time to see the results on the scale or in your clothes.

Lose Weight with Whey

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If you know me you know I love helping pack muscle weight on already big guys. But, I also use a variety of simple solutions to help people shed extra fat weight. And, in both scenarios, I often turn to whey protein.

Whey protein is one of the two proteins found in milk. It is the liquid byproduct that results from cheese production. And, years ago, this liquid was washed right down the drain. Now however, liquid whey goes through a series of steps before it becomes what we know of as whey protein powder.

How does whey help you lose weight? First, it is one of the highest quality proteins available (it contains the amino acids your muscle tissue needs). Why care about muscle? If you are losing weight you lose a combination of muscle and fat (and sometimes a tiny bit of bone tissue depending on your initial weight). In order to preserve your muscle tissue as you lose weight, it is imperative that you eat enough high quality protein to prevent or minimize muscle tissue loss (your metabolically active tissue as it burns more calories at rest than fat).

In addition to preserving muscle, protein is the most filling macronutrient (the 3 macronutrients are protein, fat and carbohydrate). And, studies show that whey protein increases the release of hormones that send those “I’m full” signals to your brain telling you to stop eating.

Where can you find whey? Dairy products! Milk, cheese and yogurt have varying amounts of whey protein. You can also choose a whey protein supplement in the form of a powder, liquid or nutrition bar (or other solid food). Luckily, according to a recently published study, it doesn’t matter if you consume whey in a food or beverage form – both are equally filling.

If weight loss is your goal, dairy and/or whey protein products will help you along the way!

Control Your Appetite with this Weight-loss Elixir

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Hundreds of thousands of dollars are spent on weight loss every year. And while some people win the battle of the bulge, many end up frustrated with a burning desire to throw their deluxe scale down the several flights of stairs they walk up everyday (with their pedometer on of course).

But, I’m going to tell you a secret. Weight loss doesn’t have to be that hard. Especially if you don’t measure yourself by pounds and ounces on a daily basis. There are many things you can do that add up over time and are guaranteed to work. And one of them is a magic potion that will you shed pounds, look and feel better. According to a study presented at the 240th National Meeting of the American Chemical Society, two ounces of this potent potion, when taken before meals, will help you lose weight.

And folks, this drink is free. In fact, it comes right out of the faucets throughout your house. Yep, I’m talking about plain old water. Brenda Davy, PhD, RD and her team conducted the first randomized controlled intervention trial examining water consumption and weight loss. They found that those who drank water before each meal 3 times per day lost more weight than those who didn’t.

In the quest for a fab figure, don’t overlook the obvious. And, keep in mind that relying solely on weight loss pills or gimicky programs may make you forget the things you could be doing every day to lose weight. If you don’t like plain water, try a zero calorie beverage or bottled water (many of these taste better than tap water, especially if the tap water where you live isn’t that good).