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―F‖ as in Fat Report 2012 Adult obesity rose in 16 states over the past year (2008-2010 data). No decreases. 12 states have obesity rates over 30%. Mississippi highest (34.4%); Colorado lowest (19.8%). Obesity related diseases: diabetes, heart disease, hypertension, cancer still high. 2030? Obesity rates will reach 44%, and in 13 states it will be over 60%!
Evidence Report NIH 1998 In 1995, the NIH convened the first Expert Panel on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults to develop clinical practice guidelines for primary care practitioners. What do they recommend?
Treatment ofOverweight/Obesity ≥ 55% energy from carbohydrates ≤ 30% energy from fat Roughly 15% energy from protein CHO FAT PRO
What are we currently told? CDC: ―you must use up more calories than you take in… since one pound [of fat] equals 3,500 calories reduce 500- 1000 calories per day to lose 1 to 2 pounds per week.‖ Mayo Clinic: ―when it comes to weight loss, it’s calories that count.‖
What are we currently told? NIH Weight-control Information Network: ―to lose weight you need to take in fewer calories than you use.‖ ADA: ―you must eat or drink fewer calories than you body burns off.‖ ―Eat less, exercise more.‖
The issue? Recommendations are for general population. Calories, calories, calories. Eat less, and exercise more! Too general! If it’s that simple why are we continuing to gain weight? Why do people struggle with weight loss? Why are we sick?
What do clinical studies show? Low-Carb, High Fat (LCHF) vs. Low-Fat, high Carb (LFHC) diets. Randomized, controlled—not observational. Challenging conventional wisdom Just because it’s popular belief does not mean it’s true.
Low-carb Diets Yancy et al., 2004: 7-8 months LC (<20% CHO/day) lost 20.7 lb. LF group lost 10.58 lb. LC group: serum Triglycerides, HDL Krauss et al., 2006: in absence of weight loss LC improve antherogenic lipid status. Brehm et al., 2009: 4-6 months eating LC (<20% CHO/day) lost 13.16 lb. LF group lost 7.12 lb.
A to Z study: Weight loss 4 ―fad‖ diets Atkins: low carb + high fat/protein Zone: 40/30/30 Ornish: low fat; at high carbs- as much as you want LEARN: health-professional diet- low-fat
Terms…just so you know Insulin: storage hormone; fat synthesis; insulin resistance; anabolic Glucagon: release stored energy; inhibit fat synthesis; high in fasted state Leptin: decreases appetite; obese are leptin resistant Other shifts in metabolic hormones & substrates based on diet.
Reasons for Low Carb Low insulin response High glucagon Increase satiety (leptin) Lower GI/GL Increase MUFA/PUFA Increase weight loss + fat loss Structuring our body’s energy production around ―fat burning‖ rather than ―sugar burning.‖
Why fat is better? Stores more energy Efficient fuel Preferred fuel in every day situations Quick to mobilize Need machinery to use it
Becoming Keto Adaptive on LowCarb Ketone bodies: byproducts of fat metabolism Keto adaptive vs ketosis vs ketoacidosis What are the benefits? Brain fuel, ROS, insulin sensitivity, protein sparing, better recovery, improve body composition Any side effects? Initial: fatigue, headache, alcohol breathe
Conclusion Short-term (4-8 months): LCHF diets are effective and safe for weight loss. Long-term(>12 months): Effective but weight regain occurs over the long-term. Keto adaptive is beneficial.
Lifestyle Checklist for weightloss Look at 5 things: Nutrition Sleep Exercise Family/work/social Psychology/Emotional Weight loss is a team effort– trainers, family, friends, doctors and therapists, etc. Just find the right ones!
Nutrition: Tips and Tricks Paleo/LCHF 50-100g of carbs/day Learn to cook/make your own meals! Family cooking Eat Whole Foods Bag, box? More than 5 ingredients?
What does a 100g Carb daylook like?Food CHO (g)1 kiwi 5.4½ cup blueberries 10.02 tbsp salsa 2.01 cup broccoli 11.21 cup kale, steamed 7.31 cup apple suace 28½ cup sweet potatoes 18.71 cup green beans 9.8 Total: 92.4 g
Nutrition: Tips and Tricks Shop the perimeter of grocery store
Nutrition: Tips and Tricks Eat every 3-4 hours Intermittent fast (IF) Don’t drink your meals No fruit juices, sports drinks, diet pop, skim milk Fish Oil: at least 2g DHA/EPA per day 7g of standard fish oil or 2-3 g concentrated High-dose: increase weight loss ○ I recommend at least 10 g per day; cycle for 4-6 weeks
Read a Fish Oil LabelFish Oil 1: Good or Bad Fish Oil?
Read a Fish Oil LabelFish Oil 2: Good or Bad Fish Oil?
Read a Fish Oil Label Fish Oil 1: One soft gel= 1,000 mg fish oil (or 1g). EPA= 180mg; DHA = 120mg 2g EPA/DHA recommended Let’s look at DHA specifically so use (.120g =120mg) So… 2g/0.120g DHA = 17 soft gels! Fish Oil 2: 4 capsules = 4,000 mg (or 4g). EPA =1600mg; DHA =800mg. So…2g/.800g = 2.5 x 4 = 10 capsules
Nutrition: Tips & Tricks Eat slowly and stop at 80% full Include protein dense foods with each meal Consume 1- 2 vegetables with each meal Eat diary if you tolerate it—if so, go full-fat. Fat: eat it! Avocados, olive oil, nuts (once/day), animal fats, bacon (mmmm), cheese, grass-fed butter, ghee.
Put into Practice Time course: Today: evaluate lifestyle Next 2-3 weeks: ○ Educate yourself: books, blogs, websites ○ See doctor- blood work: fasting insulin, Hba1c, Lipid panel (esp. apoB and small- dense LDL), CRP, kidney & liver, Vitamin D, calcium ○ % body fat + Lean Body Mass- get checked See me! ○ Paleo + LCHF: 4-6 Months
Nutrition: Things to Avoid Do not consume the following: Sugar, brown sugar, sugar cane, HFCS, honey, maple syrup, etc. Anything label ―enriched,‖ ―low-fat‖ or ―reduced.‖ Eating out Artificial Sweeteners: Splenda, Sweet n Low, Equal (Aspartame) Grains: whole grains, cereals breads, muffins, scones, cookies, baked goods, even gluten-free Legumes: beans, peanuts, soy Alcohol: all forms (except wine & 100% agave tequila) Vegetable Oils: canola oil, rapeseed oil.
Fats Extra virgin Coconut oil Palm kernel oil Avocados Extra virgin olive oil Fish oil (EPA/DHA) Flax seeds (ground) Raw, mixed nuts & seeds Hidden fats in fish/meats
Liquids Coffee (black preferred) Tea – no sweetener Water Alcohol - leave it to a minimum
Design the Right Meal Step 1: pick a protein Lean/fatty cut? Fish? Step 2: pick 1-2 vegetables Step 3: pick your fat Avocado? Cooking oil? Step 4: pick your Liquid Step 5: grub!
Lifestyle Checklist for weightloss Look at 5 things: Nutrition Sleep Exercise Family/work/social Psychology
Exercise: Fuel to Perform Idea ―Burn Fat during Exercise‖ – needs to be forgotten (one exception) Fuel to perform—body prefers CHO at high intensities (no oxygen around) ―Anaerobic state‖ Eat CHOs around your workout. Fruits + Vegetables Pre-WOD honey/applesauce
Exercise as a Tool Wellness and weight loss tool. Functional, constantly varied movements. CF + nutrition = (fast) results ―Cherry-picking‖ workouts If you suck at something, continue to do it.
Websites to Visit…Mark’s Daily Apple – Mark SissonLivin’ La Vida Low Carb – Jimmy MooreWellness FxMother Nature Obeyed – Chris MasterjohnPaleo Solution- Robb WolfChris Kresser – Chris KresserWhole 9 Life- Dallas & Mellissa HartwigPaleo Physicians NetworkGround Up Health – Collin Popp
Overall: Weight Loss Keys Evaluate lifestyle Paleo + LCHF Keto adaptive Avoid sugar, grains, legumes, processed crap Exercise as a tool Constantly varied, functional diet! If you eat crap, your body will turn into crap. Don’t turn into crap!
Worksal.CitedYancy et ―A low-carbohydrate, Ketogenic Diet versus a low-fat diet to treat obesity and hyperlipidemia.‖ Ann Inter Med. 2004, 140: 769-777 Krauss et al. ―Separate effects of reduced carbohydrate intake and weight loss on atherogenic dyslipidemia.‖ Am J Clin Nutr 2006, 83(5):1025-1031 Brehm et al. ―A randomized trial comparing a very low carbohydrate diet and a calorie-restricted low fat diet on bdoy weight and cardiovascular risk factors in healthy women.‖ J Clin Endocrinol Metab. 2003;88:1617-1623 Gardner et al. ―Comparison of the Atkins, Zone, Ornish and LEARN diets for change in weight and related risk factors among overweight premenopausal women.‖ JAMA 2007; 297:969-977. Shai et al. ―Weight loss with a low- carbohydrate, mediterranean or low-fat diet.‖ N Engl J Med 2008;359: 229-241.