Tag Archives: body composition

Why Is Optimizing Protein Intake So Important?

23 May

Why Is Optimizing Protein Intake So Important?

By Tim Skwiat, MEd, CSCS, Pn2

When it comes to improving overall health, performance, body composition, appetite control, and satiety, there is arguably not a single more effective, well-established dietary factor than optimizing one’s protein intake. Research has shown that consuming diets higher in protein are not only safe for otherwise healthy individuals, they may provide a host of benefits. Higher protein diets may:

  • Accelerate fat loss and spare lean body mass while following a reduced-calorie diet.
  • Attenuate weight regain and contribute to long-term weight maintenance.
  • Optimize 24-hour muscle protein synthesis and facilitate the maintenance or building of muscle mass.
  • Boost metabolic rate.
  • Preserve metabolic rate after weight loss.
  • Increase satiety and improve appetite control.
  • Improve carbohydrate metabolism and glycemic regulation.
  • Increase calcium absorption.

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Establishing the ‘New Normal’

While the Institute of Medicine (IOM) has established a recommended dietary allowance (RDA) of protein intake at 0.8 grams of protein per kilogram of body weight per day (or, about 0.36 grams of protein per pound of body weight), research illustrates quite clearly and convincingly that an increase in dietary protein intake to at least TWICE (i.e., ≥ 1.6g/kg or 0.72 g/lb) that of the IOM recommendations may be “metabolically advantageous,” particularly for individuals looking to improve body composition (e.g., lose fat) as well as older adults (who are likely to lose muscle mass as they age) and physically active folks (e.g., athletes, military personnel, recreational exercisers).1

The International Society of Sports Nutrition’s (ISSN) Position Stand on Protein states that “protein intakes of 1.4–2.0 g/kg/day [0.63 – 0.91 grams of protein per pound] for physically active individuals is not only safe, but may improve the training adaptations to exercise training.” Further, the ISSN states, “While it is possible for physically active individuals to obtain their daily protein requirements through a varied, regular diet, supplemental protein in various forms are a practical way of ensuring adequate and quality protein intake for athletes.”2 Further, the American College of Sports Medicine, American Dietetic Association, and Dietitians of Canada support higher protein intakes in this range to optimize body composition and performance.3

According to a study published in the Proceedings of the Nutrition Society, renowned protein researcher Dr. Kevin Tipton from the University of Sterling suggests that a high-protein diet may be defined by as much as 35% of total daily caloric intake.4 What’s more, in a breakthrough study published in the journal Applied Physiology, Nutrition, and Metabolism, researchers revealed the RDA (Recommended Dietary Allowance) for protein has underestimated protein requirements by as much as 30 – 50%. Using a novel, validated scientific method, researchers have established that folks should be consuming as much as 35% of their total daily caloric intake from protein. Along these lines, researchers posit that one can optimize protein intake by eating 1.5 – 2.2 grams of high-quality protein per pound of body weight per day.5

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Show Me the Data

High-protein diets have been shown to accelerate fat loss and spare lean body mass while following a reduced-calorie diet. In one study published in the Journal of Nutrition, researchers from the University of Illinois found that women consuming 0.72 grams of protein per pound of bodyweight (about 125 grams per day or 30% of their total daily caloric intake) for 10 weeks had a 66% better ratio of fat to lean body mass loss compared to the “normal” protein group (who consumed half the amount of protein). This means the high-protein group lost MORE fat and LESS muscle—despite consuming the EXACT same amount of calories.6

Interestingly, when the same group of researchers, led by Dr. Donald Layman, combined exercise (5 days of walking plus 2 days of strength training), the effects of the high-protein diet were amplified. Over the course of 16 weeks, the folks combining a high-protein diet (about 30% of calories per day) with exercise lost 43% more fat than the “normal” protein group, who consumed the same number of calories and followed the same exercise program. Even more, compared to the normal protein group that dieted without exercise, the high-protein plus exercise group lost 75% more fat over the course of the 4-month study.7

In a recent randomized control trial published in The American Journal of Clinical Nutrition, researchers from McMaster University found that men combining a reduced-calorie high-protein diet (about 1 gram per pound of body weight per day) with a strenuous exercise program lost over 10 pounds of fat in 4 weeks—37% more than the low-protein group eating the same number of calories and performing the same exercise routine. What’s more, the high-protein group gained over 2.5 pounds of muscle­—despite heavy calorie restriction—while the low-protein group experienced no change. That’s the holy grail of body composition: Fat loss PLUS muscle gain!8

In a recent randomized control trial, a group of researchers from UCLA, led by Dr. Lorraine Evangelista, found that study participants consuming a high-protein diet for 12 weeks lost 77% more weight and dropped more than TWICE as much body fat than the standard protein group.9 In another recent randomized control trial, a group of German researchers, led by Dr. Marion Flechtner-Mors, found that folks consuming a high-protein diet for 12 months lost over TWICE as much weight as the standard-protein group.10

In yet another randomized control trial conducted at the University of Navarra in Pampalona, Spain, a research team led by Dr. Idoia Labayen found that obese women consuming a high-protein diet (about 30% of daily caloric intake) for 10 weeks lost nearly 10 MORE pounds (or, 92% more weight) and 88% more fat than the standard-protein group—once again, despite both groups eating the exact same number of calories.11

In another recent study, researchers from the University of California-Davis, led by Dr. Sidika Karakas, found that overweight women consuming a high-protein diet lost THREE times more weight and over SIX times more fat than the standard-protein group despite sticking to the same amount of reduced calories.12

One of the most objective analyses of the effects of an intervention (like high-protein diets) is something called a meta-analysis, in which researchers gather all of the studies on a particular topic and perform a highly sophisticated statistical analysis. Along these lines, in a meta-analysis of 24 weight-loss studies published in the American Journal of Clinical Nutrition, researchers from the University of South Australia found that high-protein diets led to significantly greater losses in body weight and body fat and spared losses in lean body mass and reductions in metabolic rate, which are common with standard-protein, reduced-calorie diets.13

The study authors concluded that, compared to standard-protein diets, high-protein diets (between 25 – 35% of total daily caloric intake) provide benefits for weight and fat loss and for mitigating losses in lean body mass and resting metabolic rate.

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No One-Trick Pony

What’s more, high-protein diets help attenuate weight regain and contribute to long-term weight maintenance. That’s right, not only have high-protein diets been shown to lead to greater fat loss and improvements in body composition during dieting trials, researchers have also found that high-protein diets increase compliance and long-term weight management.14 In a study published in the New England Journal of Medicine, researchers found that after dropping over 20 pounds during an 8-week weight loss trial, folks consuming a higher protein diet (25% of daily caloric intake) maintained body weight over the next 12 months whereas individuals consuming a standard-protein diet regained some of the weight lost.15

As mentioned above, high-protein diets also help preserve metabolic rate after weight loss.16 A common concern and consequence of standard-protein, reduced-calorie diets is a significant decline in metabolic rate, which frequently leads to weight regain. However, studies have shown that high-protein diets may conserve metabolic rate, and therefore, prevent weight regain. In one study published in the Journal of the American Medical Association, researchers found that metabolic rate was conserved to a significantly greater extent in folks who consumed a higher protein diet (30% of total calories) compared to individuals who consumed a lower protein diet (20% of total calories).17

One way by which high-protein diets may improve weight-loss outcomes is through increased satiety and improved appetite control. High-protein meals boost satiety, which means that protein-dense foods are much more likely to make you feel full and satisfied.18 What’s more, diets rich in high-quality proteins improve appetite control, as well as reduce daily food intake.19 In a recent study published in the Nutrition Journal, researchers from the University of Missouri found that consuming higher protein, dairy-based snacks (e.g., yogurt) improved satiety, appetite control, and limited subsequent food intake when compared to higher fat and higher carbohydrate-based snacks.20

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Balanced Bites

Many people tend to follow a skewed pattern of protein intake throughout the day. In other words, they might have a carbohydrate-dense breakfast (e.g., oatmeal, cereal, bagel) that contains just a few grams of protein, and at lunch, they may have a salad, sandwich, and/or soup that contain less than 20 grams of protein. Then, at dinner, they tend to have a large meal with their largest portion of protein for the day.

In fact, many people consume as much as 50% of their daily protein intake at a single meal in the evening.21 Contrary to this common pattern (referred to as a “skewed” intake of protein), research shows us that a “balanced” intake of protein throughout the day appears to be optimal to take advantage of the many beneficial attributes of protein.

For instance, in a study published in The Journal of Nutrition, researchers found that balancing protein intake over the course of three meals (about 30 grams of protein per meal) significantly increased muscle protein synthesis (by 25%) when compared to a “skewed” protein intake typical of the American diet.22

Why is this so important? Maximizing protein synthesis is paramount to looking, feeling, and performing your best regardless of your age or goals, and it’s especially important for improving body composition, optimizing metabolism, improving carbohydrate tolerance, avoiding age-related declines in muscle mass and metabolic rate, improving performance, and optimizing physical function.

In a separate study published in the American Journal of Physiology, researchers from McMaster University discovered equally impressive findings when they compared a balanced to a skewed protein intake combined with calorie restriction (i.e., dieting). In general, dieting results in a marked decrease in muscle protein synthesis, which typically leads to muscle loss. In fact, losses in lean mass may account for as much as 25% of the weight lost.23,24

The researchers found that a skewed protein intake combined with calorie restriction led to significantly greater reductions in muscle protein synthesis. In other words, a balanced protein intake “rescued” much of the normal decline seen in protein synthesis with dieting. Even more, they found that combining resistance training with a balanced protein intake completely rescued the decline in protein synthesis seen with energy restriction and skewed protein intake.25

As far as how much protein to eat, the research suggests at least 30 grams per meal (3 – 4 meals per day) as a starting point. More specifically, researchers suggest that about 0.18 grams per pound of bodyweight per meal seems to be optimal.26

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Take-Home Points

  • Optimizing protein intake is a well-established nutrition priority for looking, feeling, and performing your best.
  • Studies show that higher protein intakes accelerate fat loss, preserve lean body mass, promote recovery and performance, increase satiety, improve appetite control, reduce cravings, improve glycemic control, preserve metabolic rate, and attenuate weight regain.
  • The evidence suggests that an optimal protein intake may be between 0.7 – 0.9 grams of protein per pound of bodyweight per day as a starting point.
  • Research also suggests that a balanced intake of protein (versus a skewed intake) throughout the day may be optimal to maximize muscle protein synthesis. Based on the current body of research, an intake of around 0.18 grams of protein per pound of bodyweight per meal may be a good starting point.
  • Combining resistance training with an optimal protein intake appears to be superior (for body composition, health, performance) than a higher protein intake alone.
  • High-quality sources of protein are likely best and include: lean meats, poultry, fish/seafood, and wild game (preferably pasture-raised, wild, organic, etc., when appropriate); eggs (preferably pasture-raised); dairy (e.g., Greek yogurt, cottage cheese; preferably organic); protein supplements. [Note: Many protein studies use milk-based protein supplements (e.g., whey, casein), which are considered superior due to their protein quality (e.g., leucine content) and are often used to establish key baselines.]

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References:

  1. Pasiakos SM. Metabolic Advantages of Higher Protein Diets and Benefits of Dairy Foods on Weight Management, Glycemic Regulation, and Bone: Benefits of higher protein…. J Food Sci. 2015;80(S1):A2-A7. doi:10.1111/1750-3841.12804.
  2. Campbell B, Kreider RB, Ziegenfuss T, et al. International Society of Sports Nutrition position stand: protein and exercise. J Int Soc Sports Nutr. 2007;4(1):8. doi:10.1186/1550-2783-4-8.
  3. Rodriguez NR. Position of the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and Athletic Performance. J Am Diet Assoc. 2009;109(3):509-527. doi:10.1016/j.jada.2009.01.005.
  4. Tipton KD. Efficacy and consequences of very-high-protein diets for athletes and exercisers. Proc Nutr Soc. 2011;70(02):205-214. doi:10.1017/S0029665111000024.
  5. Pencharz PB, Elango R, Wolfe RR. Recent developments in understanding protein needs – How much and what kind should we eat? Appl Physiol Nutr Metab. April 2016:1-4. doi:10.1139/apnm-2015-0549.
  6. Layman DK, Boileau RA, Erickson DJ, et al. A reduced ratio of dietary carbohydrate to protein improves body composition and blood lipid profiles during weight loss in adult women. J Nutr. 2003;133(2):411-417.
  7. Layman DK, Evans E, Baum JI, Seyler J, Erickson DJ, Boileau RA. Dietary protein and exercise have additive effects on body composition during weight loss in adult women. J Nutr. 2005;135(8):1903-1910.
  8. Longland TM, Oikawa SY, Mitchell CJ, Devries MC, Phillips SM. 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(3):738-746. doi:10.3945/ajcn.115.119339.
  9. Evangelista LS, Heber D, Li Z, Bowerman S, Hamilton MA, Fonarow GC. Reduced body weight and adiposity with a high-protein diet improves functional status, lipid profiles, glycemic control, and quality of life in patients with heart failure: a feasibility study. J Cardiovasc Nurs. 2009;24(3):207-215. doi:10.1097/JCN.0b013e31819846b9.
  10. Flechtner-Mors M, Boehm BO, Wittmann R, Thoma U, Ditschuneit HH. Enhanced weight loss with protein-enriched meal replacements in subjects with the metabolic syndrome. Diabetes Metab Res Rev. 2010;26(5):393-405. doi:10.1002/dmrr.1097.
  11. Labayen I, Díez N, González A, Parra D, Martínez JA. Effects of protein vs. carbohydrate-rich diets on fuel utilisation in obese women during weight loss. Forum Nutr. 2003;56:168-170.
  12. Kasim-Karakas SE, Almario RU, Cunningham W. Effects of protein versus simple sugar intake on weight loss in polycystic ovary syndrome (according to the National Institutes of Health criteria). Fertil Steril. 2009;92(1):262-270. doi:10.1016/j.fertnstert.2008.05.065.
  13. Wycherley TP, Moran LJ, Clifton PM, Noakes M, Brinkworth GD. Effects of energy-restricted high-protein, low-fat compared with standard-protein, low-fat diets: a meta-analysis of randomized controlled trials. Am J Clin Nutr. 2012;96(6):1281-1298. doi:10.3945/ajcn.112.044321.
  14. Layman DK, Evans EM, Erickson D, et al. A Moderate-Protein Diet Produces Sustained Weight Loss and Long-Term Changes in Body Composition and Blood Lipids in Obese Adults. J Nutr. 2009;139(3):514-521. doi:10.3945/jn.108.099440.
  15. Larsen TM, Dalskov S-M, van Baak M, et al. Diets with High or Low Protein Content and Glycemic Index for Weight-Loss Maintenance. N Engl J Med. 2010;363(22):2102-2113. doi:10.1056/NEJMoa1007137.
  16. Soenen S, Martens EAP, Hochstenbach-Waelen A, Lemmens SGT, Westerterp-Plantenga MS. Normal protein intake is required for body weight loss and weight maintenance, and elevated protein intake for additional preservation of resting energy expenditure and fat free mass. J Nutr. 2013;143(5):591-596. doi:10.3945/jn.112.167593.
  17. Ebbeling CB, Swain JF, Feldman HA, et al. Effects of dietary composition on energy expenditure during weight-loss maintenance. JAMA. 2012;307(24):2627-2634. doi:10.1001/jama.2012.6607.
  18. Halton TL, Hu FB. The effects of high protein diets on thermogenesis, satiety and weight loss: a critical review. J Am Coll Nutr. 2004;23(5):373-385.
  19. Leidy HJ. Increased dietary protein as a dietary strategy to prevent and/or treat obesity. Mo Med. 2014;111(1):54-58.
  20. Ortinau LC, Hoertel HA, Douglas SM, Leidy HJ. Effects of high-protein vs. high- fat snacks on appetite control, satiety, and eating initiation in healthy women. Nutr J. 2014;13:97. doi:10.1186/1475-2891-13-97.
  21. USDA Agricultural Research Service. Energy Intakes: Percentages of Energy from Protein, Carbohydrate, Fat, and Alcohol, by Gender and Age, What We Eat in America, NHANES 2009–2010.; 2012. http://www.ars.usda.gov/Services/docs.htm?docid=18349.
  22. Mamerow MM, Mettler JA, English KL, et al. Dietary Protein Distribution Positively Influences 24-h Muscle Protein Synthesis in Healthy Adults. J Nutr. 2014;144(6):876-880. doi:10.3945/jn.113.185280.
  23. 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(7):375-388. doi:10.1111/j.1753-4887.2010.00298.x.
  24. Areta JL, Burke LM, Camera DM, et al. Reduced resting skeletal muscle protein synthesis is rescued by resistance exercise and protein ingestion following short-term energy deficit. AJP Endocrinol Metab. 2014;306(8):E989-E997. doi:10.1152/ajpendo.00590.2013.
  25. Murphy CH, Churchward-Venne TA, Mitchell CJ, et al. 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(9):E734-E743. doi:10.1152/ajpendo.00550.2014.
  26. Moore DR, Churchward-Venne TA, Witard O, et al. Protein Ingestion to Stimulate Myofibrillar Protein Synthesis Requires Greater Relative Protein Intakes in Healthy Older Versus Younger Men. J Gerontol A Biol Sci Med Sci. 2015;70(1):57-62. doi:10.1093/gerona/glu103.

 

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The Skinny on “Skinny Fat” (Normal-Weight Obesity)

16 Nov

Tim Skwiat, MEd, CSCS, Pn2

There’s a common misconception that body weight is a reliable and accurate depiction of health. However, the number on a scale says very little about one’s level of fitness, body fatness, fat storage patterns, and levels of lean body mass.

Typically, an “ideal” or “normal” weight is calculated as a ratio of body weight to height. The most commonly used tool is called the Body Mass Index (BMI), which is a person’s weight (in kilograms) divided by his/her height (in meters) squared (i.e., kg/m2). Using this ratio, the BMI separates folks into the following categories:

  • Underweight (BMI < 18.5)
  • Normal weight (BMI 18.5 – 24.9)
  • Overweight (BMI 25 – 29.9)
  • Obese (BMI > 30)

Hence, the notion of “normal” weight is born, but as mentioned above, there are many limitations associated with the BMI and using this avenue to assess health and fitness. Along those lines, recent research suggests that where folks store body fat—even if they fit into the “normal weight” category—may drastically increase their risk of disease and death.

In a study published in the journal Annals of Internal Medicine, a group of researchers led by Dr. Francisco Lopez-Jimenez, director of preventive cardiology at the Mayo Clinic, examined 14 years worth of data including over 15,000 study participants to determine the potential connection between “normal-weight obesity” and the risk of cardiovascular disease and death. They found that folks who are “normal weight” but store an excessive amount of fat in their mid-sections were more than twice as likely to die from cardiovascular disease compared to “obese” people whose body fat was more equally distributed throughout their bodies.1

It’s not like obese folks have a reduced risk of morbidity and mortality either. In fact, as you might imagine, traditionally defined obesity is a substantial, independent risk factor for cardiovascular disease, and it’s associated with diabetes, high blood pressure, sleep apnea, and a host of metabolic issues.2 This research suggests that “normal-weight obesity” appears to be even worse than that.

To put the increased risk of disease and death into perspective, Dr. Lopez-Jimenez said, “Being normal weight with mid-section obesity is comparable to smoking a half to a full pack of cigarettes daily.”

While the effect of “normal-weight obesity” on mortality has gained a significant amount of attention, it shouldn’t come as a complete shock. Previous research has shown that abdominal obesity is associated with a “constellation of metabolic abnormalities,” including:3,4

  • High triglycerides
  • Low levels of “good” cholesterol (i.e., HDL)
  • High levels of apolipoprotein B (which is considered a better predictor of cardiovascular risk than the more commonly used LDL5)
  • Small, dense LDL and HDL particles (small, dense particles are considered more detrimental than large, fluffy particles6)
  • Unhealthy levels of inflammation
  • Insulin resistance
  • Poor carbohydrate tolerance and metabolism
  • Leptin resistance

A number of important lessons and practical applications can be gleaned from this research and information. For one, it’s possible to be “normal weight” and “metabolically obese,” which Dr. Lopez-Jiminez and colleagues4 have defined as having:

  • Normal BMI
  • High visceral fat
  • High body fat percentage
  • Low muscle mass
  • Reduced insulin sensitivity
  • High blood sugar
  • High triglycerides
  • Reduced HDL cholesterol

Secondly, using a ratio of body weight to height (i.e., BMI) can be a relatively poor indicator of health and fitness. With that in mind, it’s important to use other measurements to determine health risk. While body composition testing (i.e., ratio of fat to lean mass) is arguably the most accurate means to discern health status, using waist circumference and waist-hip ratios may be alternative options.7–9

In general, women who have a waist circumference greater than 35 inches and men whose waist measurement is 40 inches or more are considered to have “central obesity” and be at “substantially increased” risk for cardiovascular disease and metabolic complications. With that said, according to the World Health Organization (WHO), women with a waist circumference greater than 31.5 inches and men with a waist circumference greater than 37 inches are at an “increased” risk for metabolic complications.10

Some research suggests that waist-hip ratio may be an even better predictor of health risk than waist circumference. According to the WHO and other professional health organizations, abdominal obesity is defined as a waist–hip ratio of 0.85 for females and 0.9 or more for men, and folks that fit into these categories are considered to be at “substantially increased” health risk because of their fat distribution.10,11

There appears to be a number of factors that contribute to excessive storage of belly fat. While genetics play a role, there are several modifiable lifestyle and behavioral factors, well within your control, that can be addressed to prevent the accumulation of and/or reduce the amount of existing visceral fat.

Exercise. A sedentary lifestyle, an overall lack of physical activity, and low levels of fitness are associated with abdominal obesity. As mentioned above, it should be noted that “normal-weight obesity” is typically associated with lower levels of muscle mass. This is often described as being “skinny fat.”

Fortunately, a number a studies have examined the impact of exercise on visceral fat, and while the exact amount (i.e., volume) and intensity is still be investigated, a substantial body of evidence suggests that a combination of resistance training and aerobic conditioning (including moderate and intense cardiovascular activity) may be optimal to reduce/attenuate abdominal obesity.12–15 The additional advantage to including resistance training is that it is the primary means by which to increase muscle mass, and it is also very effective at improving carbohydrate tolerance and insulin sensitivity.16,17

According to the American College of Sports Medicine (ACSM), a combination of moderate- to high-intensity exercise performed for a total of at least 250 minutes per week (i.e., 5 – 6 days of 45 – 60 minutes of exercise) is associated with significant weight loss.18

Nutrition. Not surprisingly, nutrition behaviors and food intake appear to have a direct impact on central obesity, and what’s more, studies that combine regular physical activity with diet interventions (i.e., resistance and/or aerobic exercise PLUS a reduced-calorie diet) result in even more significant reductions in visceral fat than either individually.12,19 As cited above, poor insulin sensitivity and carbohydrate tolerance coincide with excessive abdominal obesity, and there’s evidence to suggest that diets rich in refined carbohydrates (e.g., sugar-sweetened beverages) may selectively promote the storage of belly fat.20,21 In addition, excessive consumption of saturated fats also appears to be linked to visceral fat storage.22

Perhaps overtly obvious, long-term energy excess (i.e., overconsumption of calories) also leads to increases in overall body fatness and increases in abdominal obesity, and along those lines, research suggests that reduced-calorie diets (regardless of macronutrient composition) are effective at decreasing abdominal obesity.23,24 With that said, there is evidence that higher-protein (i.e., > 0.5 grams of protein per pound of body weight per day), “controlled carbohydrate” (i.e., <40% of calories from carbohydrate) reduced-calorie diets may be more effective at reducing visceral fat.25–28

Stress management. Excessive stress or the inability to cope with stress may also be a contributing factor to central obesity. You may be familiar with the “stress hormone” cortisol, which appears to have a direct connection to fat accumulation, and in particular, abdominal fat. Studies have shown that folks with high waist-hip ratios tend to have poor coping skills and secrete more cortisol when faced with a stressful situation. This suggests a relationship between cortisol and abdominal fat accumulation, and additional studies have identified a similar association between cortisol concentrations, coping skills, chronic stress, and excess belly fat.29,30

There are a number of potential explanations for the stress-cortisol-visceral fat connection. For instance, the enzyme (HSD) that “activates” cortisol from its inactive form (i.e., cortisone) is more prevalent in visceral fat than subcutaneous fat tissue.31 What’s more, visceral fat tissue has greater blood flow and four times as many cortisol receptors (compared to subcutaneous).30

It’s worth noting that there are a number of factors that can contribute to the stress equation—and subsequently, influence the release of cortisol—including psychosocial stressors, food intake, sleep quality and quantity, exercise, and more. Thus, it’s a good idea to examine your overall “stress web” to identify how various domains (e.g., physical, mental, emotional, environmental, financial, spiritual) may contribute to your overall stress levels (i.e., allostatic load).

While stress management can be tricky, yoga, meditation, mindful breathing (i.e., deep belly breathing), healthy levels of physical activity, optimizing sleep, purposeful relaxation, managing finances, and cultivating healthy relationships can all contribute to maintaining healthy stress levels. What’s more, there are certain herbs called adaptogens (e.g., Rhodiola Rosea; Relora®, which is a combination of Magnolia bark extract and Phellodendron bark extract) that may be helpful in reducing cortisol, improving stress levels, and promoting resilience.32,33 Also, phosphatidylserine may blunt cortisol release, reduce stress, and help promote an optimal hormonal status.34

Supplementation. In addition to the suggestions above, there may be additional nutrients that have a beneficial impact on central obesity. Of course, any dietary supplement that can promote a negative energy balance (e.g., increase energy expenditure, reduce calorie intake) has the potential to reduce visceral fat. There is also some evidence that supplementation with conjugated linoleic acids, fatty acids found in small amounts in dairy and meat, may preferentially reduce abdominal fat (i.e., waist circumference) in populations with central obesity.35,36

Take-Home Points

  • Using one’s body weight (and therefore, the scale) as the primary end point for assessing health and fitness may be unreliable and inaccurate.
  • “Skinny fat” (i.e., normal-weight obesity), which is characterized by a relatively high body fat percentage, excess visceral fat, and low levels of muscle mass, may put one at significantly greater health risk than folks who are “fat and fit” (i.e., metabolically healthy but overweight/obese).
  • While using the scale is one way to assess progress, consider using other measurements (e.g., body composition testing, circumference measurements, waist-hip ratios) to paint a more comprehensive picture of levels of body fat, fat storage patterns, and levels of lean body mass.
  • In addition to some factors that may be out of your control (i.e., genetics), there are a number of behavioral factors, well within in your control, that you can modify to reduce visceral fat or attenuate the risk of developing it in the first place.
  • Consider your current physical activity patterns, nutrition behaviors, and stress management tactics and how those areas may be playing a role in your health and fitness. If you could work on just one of those areas, which would it be? More specifically, what’s one thing that you might consider doing more of in one of these domains?

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References:

  1. Sahakyan KR, Somers VK, Rodriguez-Escudero JP, et al. Normal-Weight Central Obesity: Implications for Total and Cardiovascular Mortality. Ann Intern Med. November 2015. doi:10.7326/M14-2525.
  2. Poirier P. Obesity and Cardiovascular Disease: Pathophysiology, Evaluation, and Effect of Weight Loss: An Update of the 1997 American Heart Association Scientific Statement on Obesity and Heart Disease From the Obesity Committee of the Council on Nutrition, Physical Activity, and Metabolism. Circulation. 2006;113(6):898-918. doi:10.1161/CIRCULATIONAHA.106.171016.
  3. Despres J-P. Body Fat Distribution and Risk of Cardiovascular Disease: An Update. Circulation. 2012;126(10):1301-1313. doi:10.1161/CIRCULATIONAHA.111.067264.
  4. Oliveros E, Somers VK, Sochor O, Goel K, Lopez-Jimenez F. The Concept of Normal Weight Obesity. Prog Cardiovasc Dis. 2014;56(4):426-433. doi:10.1016/j.pcad.2013.10.003.
  5. Walldius G, Jungner I. Apolipoprotein B and apolipoprotein A-I: risk indicators of coronary heart disease and targets for lipid-modifying therapy. J Intern Med. 2004;255(2):188-205.
  6. Toft-Petersen AP, Tilsted HH, Aarøe J, et al. Small dense LDL particles – a predictor of coronary artery disease evaluated by invasive and CT-based techniques: a case-control study. Lipids Health Dis. 2011;10(1):21. doi:10.1186/1476-511X-10-21.
  7. Ahima RS, Lazar MA. The Health Risk of Obesity–Better Metrics Imperative. Science. 2013;341(6148):856-858. doi:10.1126/science.1241244.
  8. Janssen I, Katzmarzyk PT, Ross R. Waist circumference and not body mass index explains obesity-related health risk. Am J Clin Nutr. 2004;79(3):379-384.
  9. Welborn TA, Dhaliwal SS, Bennett SA. Waist-hip ratio is the dominant risk factor predicting cardiovascular death in Australia. Med J Aust. 2003;179(11-12):580-585.
  10. World Health Organization. Waist Circumference and Waist-Hip Ratio: Report of a WHO Expert Consultation, Geneva, 8-11 December 2008. Geneva: World Health Organization; 2011.
  11. Ilanne-Parikka P, Eriksson JG, Lindström J, et al. Prevalence of the metabolic syndrome and its components: findings from a Finnish general population sample and the Diabetes Prevention Study cohort. Diabetes Care. 2004;27(9):2135-2140.
  12. Dutheil F, Lac G, Lesourd B, et al. Different modalities of exercise to reduce visceral fat mass and cardiovascular risk in metabolic syndrome: the RESOLVE randomized trial. Int J Cardiol. 2013;168(4):3634-3642. doi:10.1016/j.ijcard.2013.05.012.
  13. Slentz CA, Bateman LA, Willis LH, et al. Effects of aerobic vs. resistance training on visceral and liver fat stores, liver enzymes, and insulin resistance by HOMA in overweight adults from STRRIDE AT/RT. Am J Physiol Endocrinol Metab. 2011;301(5):E1033-E1039. doi:10.1152/ajpendo.00291.2011.
  14. Schmitz KH, Hannan PJ, Stovitz SD, Bryan CJ, Warren M, Jensen MD. Strength training and adiposity in premenopausal women: strong, healthy, and empowered study. Am J Clin Nutr. 2007;86(3):566-572.
  15. Irwin ML, Yasui Y, Ulrich CM, et al. Effect of Exercise on Total and Intra-abdominal Body Fat in Postmenopausal Women: A Randomized Controlled Trial. JAMA. 2003;289(3):323. doi:10.1001/jama.289.3.323.
  16. Moore DR, Tang JE, Burd NA, Rerecich T, Tarnopolsky MA, Phillips SM. Differential stimulation of myofibrillar and sarcoplasmic protein synthesis with protein ingestion at rest and after resistance exercise. J Physiol. 2009;587(Pt 4):897-904. doi:10.1113/jphysiol.2008.164087.
  17. Hansen E, Landstad BJ, Gundersen KT, Torjesen PA, Svebak S. Insulin sensitivity after maximal and endurance resistance training. J Strength Cond Res Natl Strength Cond Assoc. 2012;26(2):327-334. doi:10.1519/JSC.0b013e318220e70f.
  18. Donnelly JE, Blair SN, Jakicic JM, Manore MM, Rankin JW, Smith BK. Appropriate Physical Activity Intervention Strategies for Weight Loss and Prevention of Weight Regain for Adults: Med Sci Sports Exerc. 2009;41(2):459-471. doi:10.1249/MSS.0b013e3181949333.
  19. Idoate F, Ibañez J, Gorostiaga EM, García-Unciti M, Martínez-Labari C, Izquierdo M. Weight-loss diet alone or combined with resistance training induces different regional visceral fat changes in obese women. Int J Obes 2005. 2011;35(5):700-713. doi:10.1038/ijo.2010.190.
  20. Maersk M, Belza A, Stodkilde-Jorgensen H, et al. Sucrose-sweetened beverages increase fat storage in the liver, muscle, and visceral fat depot: a 6-mo randomized intervention study. Am J Clin Nutr. 2012;95(2):283-289. doi:10.3945/ajcn.111.022533.
  21. Stanhope KL, Schwarz JM, Keim NL, et al. Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans. J Clin Invest. 2009;119(5):1322-1334. doi:10.1172/JCI37385.
  22. Rosqvist F, Iggman D, Kullberg J, et al. Overfeeding Polyunsaturated and Saturated Fat Causes Distinct Effects on Liver and Visceral Fat Accumulation in Humans. Diabetes. 2014;63(7):2356-2368. doi:10.2337/db13-1622.
  23. de Souza RJ, Bray GA, Carey VJ, et al. Effects of 4 weight-loss diets differing in fat, protein, and carbohydrate on fat mass, lean mass, visceral adipose tissue, and hepatic fat: results from the POUNDS LOST trial. Am J Clin Nutr. 2012;95(3):614-625. doi:10.3945/ajcn.111.026328.
  24. Bradley U, Spence M, Courtney CH, et al. Low-Fat Versus Low-Carbohydrate Weight Reduction Diets: Effects on Weight Loss, Insulin Resistance, and Cardiovascular Risk: A Randomized Control Trial. Diabetes. 2009;58(12):2741-2748. doi:10.2337/db09-0098.
  25. Miyashita Y, Koide N, Ohtsuka M, et al. Beneficial effect of low carbohydrate in low calorie diets on visceral fat reduction in type 2 diabetic patients with obesity. Diabetes Res Clin Pract. 2004;65(3):235-241. doi:10.1016/j.diabres.2004.01.008.
  26. Skov AR, Toubro S, Rønn B, Holm L, Astrup A. Randomized trial on protein vs carbohydrate in ad libitum fat reduced diet for the treatment of obesity. Int J Obes Relat Metab Disord J Int Assoc Study Obes. 1999;23(5):528-536.
  27. Due A, Toubro S, Skov AR, Astrup A. Effect of normal-fat diets, either medium or high in protein, on body weight in overweight subjects: a randomised 1-year trial. Int J Obes Relat Metab Disord J Int Assoc Study Obes. 2004;28(10):1283-1290. doi:10.1038/sj.ijo.0802767.
  28. Noakes M, Keogh JB, Foster PR, Clifton PM. Effect of an energy-restricted, high-protein, low-fat diet relative to a conventional high-carbohydrate, low-fat diet on weight loss, body composition, nutritional status, and markers of cardiovascular health in obese women. Am J Clin Nutr. 2005;81(6):1298-1306.
  29. Moyer AE, Rodin J, Grilo CM, Cummings N, Larson LM, Rebuffé-Scrive M. Stress-induced cortisol response and fat distribution in women. Obes Res. 1994;2(3):255-262.
  30. Epel ES, McEwen B, Seeman T, et al. Stress and body shape: stress-induced cortisol secretion is consistently greater among women with central fat. Psychosom Med. 2000;62(5):623-632.
  31. Morris KL, Zemel MB. 1,25-dihydroxyvitamin D3 modulation of adipocyte glucocorticoid function. Obes Res. 2005;13(4):670-677. doi:10.1038/oby.2005.75.
  32. Olsson EM, von Schéele B, Panossian AG. A randomised, double-blind, placebo-controlled, parallel-group study of the standardised extract shr-5 of the roots of Rhodiola rosea in the treatment of subjects with stress-related fatigue. Planta Med. 2009;75(2):105-112. doi:10.1055/s-0028-1088346.
  33. Talbott SM, Talbott JA, Pugh M. Effect of Magnolia officinalis and Phellodendron amurense (Relora®) on cortisol and psychological mood state in moderately stressed subjects. J Int Soc Sports Nutr. 2013;10(1):37. doi:10.1186/1550-2783-10-37.
  34. Starks MA, Starks SL, Kingsley M, Purpura M, Jäger R. The effects of phosphatidylserine on endocrine response to moderate intensity exercise. J Int Soc Sports Nutr. 2008;5(1):11. doi:10.1186/1550-2783-5-11.
  35. Risérus U, Berglund L, Vessby B. Conjugated linoleic acid (CLA) reduced abdominal adipose tissue in obese middle-aged men with signs of the metabolic syndrome: a randomised controlled trial. Int J Obes Relat Metab Disord J Int Assoc Study Obes. 2001;25(8):1129-1135. doi:10.1038/sj.ijo.0801659.
  36. Risérus U, Arner P, Brismar K, Vessby B. Treatment with dietary trans10cis12 conjugated linoleic acid causes isomer-specific insulin resistance in obese men with the metabolic syndrome. Diabetes Care. 2002;25(9):1516-1521.

Move More, Eat MORE

7 Oct

By Tim Skwiat, MEd, CSCS, Pn2

When it comes to fat loss, it’s quite common to hear the adage, “Move more, eat less,” which stems from the fundamental principle of physiology, nutrition, and metabolism that states:

In order to lose weight, one must consume fewer calories than s/he burns—on a regular basis, consistently over time.1

Simply put, this is saying that a calorie deficit is necessary (over time) for meaningful fat loss. As simple and straightforward as that is, it’s neither easy nor particularly useful. Just ask anyone who’s attempted to lose weight through a reduced-calorie diet (i.e., eat less). For the overwhelming majority of folks, it’s not sustainable. In fact, researchers estimate that fewer than 25% of folks who lose weight are successfully able to keep it off for at least a year.2

While human physiology complies with the first law of thermodynamics, the “move more, eat less” axiom takes into consideration only a narrow aspect of the weight management equation. That is, there’s more to the story than the “numbers game” (i.e., counting calories) including a variety of environmental and behavioral factors.3

In other words choice to eat food can be sparked by metabolic need, hedonic drive (i.e., the “food reward system”), or a combination of the two. In today’s world, we no longer eat only when we’re “metabolically hungry.” Instead, we are driven to eat even when we’re not truly hungry and despite having vast energy reserves (i.e., body fat).

More and more, obesity researchers are investigating the impact of hedonic drive and other factors, which involves cognitive, reward, and emotional aspects, and may include choosing to eat based on food environment, food addiction, stress relief, boredom, and mood elevation.4

For example, think about a time when you ate (or drank) something because you felt that you “deserved” it, whether that was after a tough workout or a stressful day at the office. You weren’t necessarily hungry, but you made up your mind that you “earned” that reward. Another example of hedonic eating is susceptibility to food environment cues. Think back to a time when you ate something “because it was there.” Ever happen to you?

All of that is meant to create awareness that the “Move more, eat less” approach to fat loss, while “accurate,” may not be all that utilitarian or encompassing. In other words, from a well-educated fitness professional, it’s not very articulate or useful advice. However, there is truth to it, but does it tell the whole story?

Move More, Eat More

It’s no secret that most people could stand to move more. Generally speaking, research suggests that lack of physical activity is a significant determinant of the overall rise in obesity amongst adults and adolescents.5,6 Not surprisingly, people who are “normal weight” typically engage in more moderate and vigorous physical activity compared to overweight and obese folks.7

With little to debate about the energy expenditure portion of the equation, what about eating more? That seems to violate the law of thermodynamics and the age-old proverb about eating less, right?

Yes and no. Again, there’s no discounting the energy balance equation; the current body of scientific research suggests that this is necessary to lose fat. However, eating fewer calories (which can be viewed as “eating less”) doesn’t necessarily have to mean eating less food. In fact, studies show that it’s possible to eat significantly more food and lose substantially more fat.

That is, you don’t necessarily need to rely on the “numbers game” to achieve and maintain your ideal body composition. You see, research suggests that people may not limit what they consume based on calories alone. Specifically, feeling full (i.e., satiety) is a major reason that people stop eating. In other words, rather than the calorie content of food, the volume (i.e., weight, amount) of food that is consumed at a meal is what makes people feel full and stop eating.8

In fact, research strongly suggests that how much you eat daily is regulated by the weight of the food rather than by a certain number of calories. Researchers from Penn State have posited that “energy density is a key determinant of energy intake in that cognitive, behavioral, and sensory cues related to the volume or weight of food consumed can interact with or override physiological cues associated with food intake.”9

Energy density is defined as the relationship of calories to the weight of food (i.e., calories per gram). Foods like oils, bacon, butter, cookies, crackers, junk food, fast food, etc., are generally considered “high-energy-dense” foods (i.e., 4 – 9 calories per gram by weight); on the contrary, nearly all fresh vegetables (and fruits) are considered “low-energy-dense” foods (i.e., 0.0 – 1.5 calories per gram, by weight), as they tend to have a high water content and be a very good source of fiber, two important factors reducing energy density. Fiber itself has a relatively low-energy density, providing only about 1.5 – 2.5 calories per gram.

Along those lines, researchers have found that when folks consume low-energy-dense foods, they feel satisfied earlier and those feelings of fullness persist for relatively longer periods of time—despite reductions in calorie intake. In other words, diets rich in low-energy-dense foods like fruits and vegetables allow folks to eat more total food, which leads to greater feelings of satiety, all while reducing calorie intake.10 By definition, that’s eating more (overall food) and less (calories). Bingo!

In one study published in the American Journal of Clinical Nutrition, researchers from the University of Alabama allowed participants to eat as much food as they wanted (think all-you-can-eat buffet) over the course of 5 days, and their menu options alternated from low-energy-dense to high-energy-dense foods. On the low-energy-density diet, the folks ate only about HALF of the calories (1570) that they consumed before feeling full compared with the high-energy-density diet (3000 calories).11 Satiety (i.e., fullness and satisfaction) and food acceptance ratings were not different across days, meaning that they didn’t stop eating because they didn’t like the food.

In another study published in the American Journal of Clinical Nutrition, researchers from the CDC found that men and women (over 7,000 of them) who consumed a diet rich in low-energy-dense foods consumed between 275 – 425 fewer calories per day than did those folks who opted for more high-energy-dense foods; not only that, the men and women eating more low-energy-dense foods consumed upwards of 14 MORE ounces of food per day (that’s almost a pound).10 Not surprisingly, the folks who ate more low-energy-dense foods like vegetables had healthier body weights (i.e., lowest prevalence of obesity).

A number of other studies have confirmed these findings: Diets rich in low-energy-dense foods like vegetables, fruits, broth-based soups, high-fiber foods, foods with high water content, etc., promote satiety (i.e., feelings of fullness and satisfaction), reduce hunger, and decrease overall calorie intake.

What’s more, long-term studies have shown that low-energy-dense diets also promote weight loss. In fact, studies lasting longer than 6 months demonstrate that folks who eat more low-energy-dense foods experience THREE TIMES greater weight loss than people who simply opt to reduce calories.12

In a study published in the American Journal of Clinical Nutrition, researchers from Penn State University found that overweight women who focused on increasing their intake of low-energy-dense foods (i.e., fruits and vegetables) lost nearly 25% more weight over the course of one year compared to women who were instructed to follow a reduced-calorie diet alone. The women who focused on eating more fruits and vegetables ended up consuming MORE food (despite consuming fewer calories) and experienced greater satiety. The researchers concluded, “Reducing dietary energy density, particularly by increasing fruit and vegetable intakes, is an effective strategy for managing body weight while controlling hunger.”13

With all of that in mind, it should be a bit more clear how you can eat less and more at the same time to support your body composition goals by centering much of your food intake around low-energy-dense foods. This is not only an effective strategy for improving appetite control and reducing caloric intake. You see, what these low-energy-dense foods lack in calories more than make up for in their nutrient density, as they are packed with fiber, essential micronutrients, and important phytochemicals that act as potent antioxidants.

Examples of low-energy-dense foods:

  • Nearly all fresh vegetables and fruits
  • Colorful, starchy vegetables and fruits (e.g., bananas, potatoes, squash, yams)
  • Broth-based soups
  • Beans and lentils
  • Dairy (e.g., Greek yogurt, cottage cheese, milk)
  • Minimally-processed whole grains (e.g., quinoa, maize, amaranth, oats, rice, barley, sprouted grains, spelt, etc.)

Another Hunger Buster

Speaking of satiety, the discussion would not be complete without mentioning dietary protein, which is a nutrition all-star for a number of reasons, including its impact on appetite control.

In general, protein-rich foods result in a greater sense of satisfaction than fat- or carbohydrate-rich foods, and when you eat protein-dense meals, they tend to decrease calorie intake in subsequent feedings. In other words, protein-rich foods and protein-dense meals help you feel fuller, longer.14

Not only that, dietary protein exerts a significantly higher “thermic effect” than fats or carbohydrates, and high-protein meals are associated with increased thermogenesis. Simply put, a higher protein intake increases energy expenditure and boosts the metabolism.15

Even more, high-protein diets help build and maintain lean body mass and preserve metabolic rate, both of which are frequently compromised when dieting for fat loss.16 High-protein diets also tend to lead to significantly greater fat loss, and as a result, markedly better improvements in body composition.

As a matter of fact, when researchers from the University of Illinois compared the effects a high-protein diet to a standard reduced-calorie diet, they found that those folks who consumed more protein experienced a 62% greater ratio of fat loss—even though both groups consumed the same number of calories. 17

The researchers concluded, “This study demonstrates that increasing the proportion of protein to carbohydrate in the diet of adult women has positive effects on body composition, blood lipids, glucose homeostasis and satiety during weight loss.”

Despite the benefits on body composition, metabolism, and appetite, most folks don’t consume enough protein, and eating lean protein at each meal—a key habit of highly effective nutrition plans—along with low-energy dense foods can be tricky. That’s why a high-quality protein supplement tends to be foundational for optimizing overall health, body composition, and performance.

Because protein supplements are typically mixed with water or low-calorie liquid (e.g., unsweetened almond milk), they are inherently low-energy-dense options. For instance, the protein supplement recommended above mixed with 8 ounces of unsweetened almond milk has an energy density of about 0.6 calories per gram.

What’s also neat about a protein supplement is that it provides an opportunity to “sneak” in more low-energy-dense vegetables and fruits. For instance, you can add a couple of handfuls of spinach and some berries to make a great-tasting, nutrient-dense, low-energy dense protein smoothie.

As mentioned above, certain forms (e.g., cottage cheese, Greek yogurt, milk) of dairy are low-energy-dense and protein-dense, and a number of studies have demonstrated that dairy consumption may contribute to increases in lean body mass along with losses in body fat (i.e., improved body composition).18–22

Some folks do take issue with dairy, and in many cases, mild discomfort (whether real or perceived) can be alleviated by gradually increasing consumption and/or through use of digestive enzyme supplementation. While most digestive enzyme supplements in this category tend to only supply the lactase enzyme—which is necessary for the proper breakdown of the sugar lactose found in milk—it’s a better idea to consider a full-spectrum product that also includes proteolytic enzymes to help with the digestion of the proteins (e.g., whey, casein) found in milk, as they may also contribute to digestive discomfort.

Note: The majority of lean protein sources (e.g., beef, poultry, seafood, eggs, wild game, etc.) classify as “medium-energy-dense” foods, but they are still exceptional food choices and provide extraordinary nutrient density. As cited above, there are numerous advantages behind consuming protein-rich foods and a high-protein diet beyond the energy density discussion.

Move More, Eat More 2.0

Another interesting application of the “Move more, eat more” concept is what Dr. John Berardi has long advocated and described as G-Flux.23 The concept behind G-Flux, or energy flux, is that there is a multitude of benefits associated with a concomitant increase in both energy expenditure and calorie intake, including:

  • Improvements in body composition
  • Increased metabolic rate
  • Better recovery from and adaptations to exercise
  • Improved health
  • Greater nutrient density and improved micronutrient delivery

In general, when one increases activity (e.g., exercise), s/he burns a certain number of calories. Likewise, any time that you eat, your body expends energy (i.e., thermic effect of feeding) to digest, absorb, and assimilate the nutrients contained in food. With that in mind, there should be a predictable increase in energy expenditure when folks increase both physical activity and food intake.

What’s particularly interesting is that research suggests that these “high energy flux” states result in an unexpected and significant increase in the number of calories burned. In other words, when folks simultaneously increase physical activity and food intake, they tend to show significant increases in resting metabolic rate and burn even more calories than would be expected.24,25 Pretty nifty trick, and even more evidence of the “Move more, eat more” slogan.

What’s also interesting to note is that many folks tend to subconsciously increase non-exercise activity levels when they consume more calories. In other words, researchers have found that some people innately burn off more energy—through fidgeting, maintaining posture, daily activities—in response to overeating in order to preserve leanness and avoid gaining body fat.26 Thus, eating more can actually facilitate moving more, which enhances energy flux and body composition.

Take-Home Points

  • When it comes to fat loss, “Move more, eat less” makes sense, and it’s based on fundamental principles of human physiology. Although many researchers argue that there are other factors in play, an imbalance of calories consumed versus energy expended best describes how body weight changes.27 With that said, this common axiom is overly simplistic, and it doesn’t take into account other important factors (e.g., environment, hedonic compensation) that may influence food intake and eating behaviors.
  • “Move more, eat more” means that you can actually eat a substantially larger volume of food (i.e., low-energy-dense foods), which leads to greater satiety, fewer calories consumed, and greater overall nutrient intake.
  • Especially when starting a fat loss program, begin with the highest possible calorie intake. This leaves the most room for progression along the way. Dramatic reductions in food intake result in significant decreases in energy expenditure (e.g., reduced thermic effect of feeding, decreased cost of physical activity, reduced resting metabolic rate, and metabolic adaptations).28,29
  • Try not to get too caught up in the “numbers game.” While calories in versus calories out may be a rational scientific explanation, it’s virtually impossible to estimate the number of calories that you expend during activity or over the course of the day. Calorie counting can be a futile process, as labels and reporting may lead to estimates with a 30% margin of error. What’s more, without sophisticated equipment, it’s not feasible to accurately assess the number of calories absorbed.
  • When you’re encroaching on a plateau, experiment with the G-Flux concept—simultaneously increase physical activity and food intake. Done progressively, in most cases, folks tend to see rapid improvements in body composition and performance. In the worst cases, they remain at the plateau, and even then, they tend to add some muscle.
  • When you’ve reached your ideal body composition, consider the G-Flux approach as well to help facilitate a higher calorie intake. Once you’re able to maintain a stable weight at the higher energy intake, gradually decrease physical activity.

References:

  1. Hall KD, Heymsfield SB, Kemnitz JW, Klein S, Schoeller DA, Speakman JR. Energy balance and its components: implications for body weight regulation. Am J Clin Nutr. 2012;95(4):989-994. doi:10.3945/ajcn.112.036350.
  2. Wing RR, Hill JO. Successful weight loss maintenance. Annu Rev Nutr. 2001;21:323-341. doi:10.1146/annurev.nutr.21.1.323.
  3. Greenway FL. Physiological adaptations to weight loss and factors favouring weight regain. Int J Obes. 2015;39(8):1188-1196. doi:10.1038/ijo.2015.59.
  4. Berthoud H-R. Metabolic and hedonic drives in the neural control of appetite: who is the boss? Curr Opin Neurobiol. 2011;21(6):888-896. doi:10.1016/j.conb.2011.09.004.
  5. Martínez-González MA, Martínez JA, Hu FB, Gibney MJ, Kearney J. Physical inactivity, sedentary lifestyle and obesity in the European Union. Int J Obes Relat Metab Disord J Int Assoc Study Obes. 1999;23(11):1192-1201.
  6. Pietiläinen KH, Kaprio J, Borg P, et al. Physical inactivity and obesity: a vicious circle. Obes Silver Spring Md. 2008;16(2):409-414. doi:10.1038/oby.2007.72.
  7. Spees CK, Scott JM, Taylor CA. Differences in amounts and types of physical activity by obesity status in US adults. Am J Health Behav. 2012;36(1):56-65.
  8. Holt SH, Miller JC, Petocz P, Farmakalidis E. A satiety index of common foods. Eur J Clin Nutr. 1995;49(9):675-690.
  9. Rolls BJ, Bell EA. Intake of fat and carbohydrate: role of energy density. Eur J Clin Nutr. 1999;53 Suppl 1:S166-S173.
  10. Ledikwe JH, Blanck HM, Kettel Khan L, et al. Dietary energy density is associated with energy intake and weight status in US adults. Am J Clin Nutr. 2006;83(6):1362-1368.
  11. Duncan KH, Bacon JA, Weinsier RL. The effects of high and low energy density diets on satiety, energy intake, and eating time of obese and nonobese subjects. Am J Clin Nutr. 1983;37(5):763-767.
  12. Yao M, Roberts SB. Dietary energy density and weight regulation. Nutr Rev. 2001;59(8 Pt 1):247-258.
  13. Ello-Martin JA, Roe LS, Ledikwe JH, Beach AM, Rolls BJ. Dietary energy density in the treatment of obesity: a year-long trial comparing 2 weight-loss diets. Am J Clin Nutr. 2007;85(6):1465-1477.
  14. Paddon-Jones D, Westman E, Mattes RD, Wolfe RR, Astrup A, Westerterp-Plantenga M. Protein, weight management, and satiety. Am J Clin Nutr. 2008;87(5):1558S – 1561S.
  15. Halton TL, Hu FB. The effects of high protein diets on thermogenesis, satiety and weight loss: a critical review. J Am Coll Nutr. 2004;23(5):373-385.
  16. Soenen S, Martens EAP, Hochstenbach-Waelen A, Lemmens SGT, Westerterp-Plantenga MS. Normal protein intake is required for body weight loss and weight maintenance, and elevated protein intake for additional preservation of resting energy expenditure and fat free mass. J Nutr. 2013;143(5):591-596. doi:10.3945/jn.112.167593.
  17. Layman DK, Boileau RA, Erickson DJ, et al. A reduced ratio of dietary carbohydrate to protein improves body composition and blood lipid profiles during weight loss in adult women. J Nutr. 2003;133(2):411-417.
  18. Josse AR, Atkinson SA, Tarnopolsky MA, Phillips SM. Increased Consumption of Dairy Foods and Protein during Diet- and Exercise-Induced Weight Loss Promotes Fat Mass Loss and Lean Mass Gain in Overweight and Obese Premenopausal Women. J Nutr. 2011;141(9):1626-1634. doi:10.3945/jn.111.141028.
  19. Zemel MB, Richards J, Mathis S, Milstead A, Gebhardt L, Silva E. Dairy augmentation of total and central fat loss in obese subjects. Int J Obes 2005. 2005;29(4):391-397. doi:10.1038/sj.ijo.0802880.
  20. Wilkinson SB, Tarnopolsky MA, Macdonald MJ, Macdonald JR, Armstrong D, Phillips SM. Consumption of fluid skim milk promotes greater muscle protein accretion after resistance exercise than does consumption of an isonitrogenous and isoenergetic soy-protein beverage. Am J Clin Nutr. 2007;85(4):1031-1040.
  21. Hartman JW, Tang JE, Wilkinson SB, et al. Consumption of fat-free fluid milk after resistance exercise promotes greater lean mass accretion than does consumption of soy or carbohydrate in young, novice, male weightlifters. Am J Clin Nutr. 2007;86(2):373-381.
  22. Josse AR, Tang JE, Tarnopolsky MA, Phillips SM. Body composition and strength changes in women with milk and resistance exercise. Med Sci Sports Exerc. 2010;42(6):1122-1130. doi:10.1249/MSS.0b013e3181c854f6.
  23. Andrews R. All About G-Flux. Precis Nutr. http://www.precisionnutrition.com/all-about-g-flux.
  24. Bullough RC, Gillette CA, Harris MA, Melby CL. Interaction of acute changes in exercise energy expenditure and energy intake on resting metabolic rate. Am J Clin Nutr. 1995;61(3):473-481.
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  26. Levine JA. Role of Nonexercise Activity Thermogenesis in Resistance to Fat Gain in Humans. Science. 1999;283(5399):212-214. doi:10.1126/science.283.5399.212.
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Meal Frequency: Does It Matter?

15 Jul

By Tim Skwiat, MEd, CSCS, Pn1

You’re ready. Whether it’s doctor’s orders, an upcoming high school reunion, a New Year’s resolution, a significant other (or, potential significant other), or that pair of skinny jeans staring at you in the closet, you now have the motivation that you need to get started on your weight loss journey. You’re going to sign up for a personal trainer at your gym. You’ve got all of your BioTrust supplements. You’re ready to take on the dreaded d-word: The Diet.

One of the first questions that’s bound to come up: When it comes to body composition and fat loss, does meal frequency matter?

Sorry if this hits you like a ton of bricks, but the conditional answer is that meal frequency probably doesn’t matter. It’s conditional because it does hinge on the much more important factors of food choices and portion control. That is, when calories and macronutrients are controlled, meal frequency doesn’t matter. Better said, if you eat the right types of food (i.e., food choices) in the right amounts (i.e., portion control), meal frequency becomes a matter of personal preference.

Thus, if you do a better job of eating more metabolism-boosting protein and health-promoting vegetables over the course of six meals, then that may be the best strategy for you. However, if you do better with a few larger meals, then go for it.

There are some downsides to each approach. Starting with smaller, more frequent feedings, it just doesn’t bode well for many people for some of the following reasons:

  • It typically requires significant meal planning and preparation.
  • Many people “watch the clock” either waiting for the next meal or making sure they don’t miss one.
  • You spend a lot of time eating.
  • Many folks tend to schedule their days around their meals.
  • This population tends to be more apt to get HANGRY.

Likewise, there may be some pitfalls to less frequent feedings:

  • Some folks have a much harder time with portion control.
  • Likewise, some people will find it more challenging to include as much nutrient-dense food in a shorter period of time and/or fewer feedings.

That sounds convincing, but is there any research that actually compares meal frequency?

Yes, as a matter of fact, there is quite a bit of research on the topic. Researchers from Purdue recently performed a meal frequency experiment where they divided overweight men into multiple groups. One group of men consumed six meals per day, evenly spread out every two hours. Another group of men consumed precisely the same total number of calories in three feedings, which were separated by five hours. Both groups were following a calorie-restricted diet, but the scientists noted no significant differences in weight loss as a result of meal frequency.

Interestingly, the authors of the study did find that those subjects who ate fewer, larger meals experienced greater late-night fullness, which could potentially reduce the chances of snacking. Furthermore, the researchers noted that there were more compliance issues with the group assigned to eating six meals per day. On top of the meal frequency portion of the study, the scientists found that, compared to a normal-protein diet (i.e., 14% of calories), a high-protein diet (i.e., 25% of calories) collectively led to improved appetite and satiety and lower late-night urges to eat as well as reduced preoccupation with food.

In another study that appeared in the British Journal of Nutrition, scientists again separated subjects into high meal frequency (i.e., 6 meals per day) and low meal frequency (i.e., 3 meals per day) groups. Both groups of subjects followed a reduced-calorie diet, and at the end of eight weeks, the researchers found no significant difference in body weight, fat mass, lean body mass, or body mass index. The authors concluded that increased meal frequency “does not promote greater body weight loss.”

In a study funded by the National Institute on Aging and the US Department of Agriculture, researchers questioned the notion that, despite its commonality, “three squares” (i.e.,three meals per day) is optimal for health. The scientists separated subjects into two groups. One group group consumed three meals per day while the other group consumed only one. The groups both consumed an equal number of calories daily, which were assigned at maintenance level (i.e., not a calorie-restricted study). After eight weeks, the researchers found that reduced meal frequency (i.e. one meal per day), without a reduction in calories, led to a significant modification in body composition including reductions in body fat, as well as a significant decrease in cortisol.

Perhaps most important, the renowned International Society of Sports Nutrition, one of the world’s top authorities on sports nutrition, recently released their position stand on meal frequency. It should be noted that, when an organization of this magnitude issues a position statement on any given topic, it’s typically regarded as solid evidence—the closest to the truth as we know from science. In said statement, the organization concluded that increasing meal frequency does not appear to favorably change body composition.

What about the idea of “stoking” the metabolism with smaller, more frequent meals?

As you’ll see in our Critical Elements of Fat Loss Training article, there are several components that make up one’s metabolic rate (i.e., energy expenditure). This particular argument rests on the notion that eating more frequently will increase the element of metabolism known as the Thermic Effect of Feeding (TEF), which refers to the amount of energy that the body uses to digest, absorb, and assimilate all of the nutrients we consume (from food).

Sure, it makes sense. If you eat more frequently, there will be more increases (i.e., pulses) in metabolic rate due to the TEF associated with each meal. However, do more pulses mean a greater overall response? Nope. As a matter of fact, the most extensive review of studies performed on TEF and various meal frequencies, ranging between 1 – 17 meals, concluded:

“Studies using whole-body calorimetry and doubly-labelled water to assess total 24 h energy expenditure find no difference between nibbling and gorging.” [NOTE: This is NOT an excuse to gorge oneself; rather, it is to make a point regarding TEF. This is a completely other issue in and of itself.]

Furthermore, the researchers also negated the notion that meal frequency has an effect on weight loss and concluded that “any effects of meal pattern on the regulation of body weight are likely to be mediated through effects on the food intake side of the energy balance equation.” Hmmm…that sounds a lot like food choices and portion control.

Surely, if you miss a meal, the body will go into starvation mode, right?

Not so much. Efficient adaptation to famine was no doubt a significant metabolic consequence during evolution (See: Understanding leptin). A decrease in metabolic rate during times of starvation was actually a good thing, as it increased the likelihood of living until one perhaps found some sustenance. However, it’s important to delineate starvation from missing a meal or even fasting for 24 hours. The idea that skipping a meal or implementing a short fast or intermittent fasting (IF) results in a reduced metabolic rate is not substantiated by science.

As a matter of fact, the earliest that scientific research has noted a decrease in metabolic rate in response to fasting is after 60 hours, which resulted in an 8% drop. Other research has shown that a dip in metabolic rate does not occur until 72 – 90 hours of fasting. Even with more pronounced IF protocols that implement daily fasts, the longest time without food is typically about 36 hours, which may actually have the opposite-than-expected effect on metabolic rate.

Ironically, there is frequently a short-term boost in metabolism with fasting. Studies have shown an increase of 4 – 10% in metabolic rate with fasting up to 36 – 48 hours. This likely is the result of increased catecholamines (i.e., epinephrine and norepinephrine), which serve to provide more energy and sharpen focus. This can be seen as desirable as the body is now in somewhat of a “fight” mode to find food. At some point—as mentioned above—this would be counter-productive, and the body would have to decrease metabolic rate in order to simply survive.

With all that being said, the best approach, in terms of meal frequency, may be the one that best works for you. That is, as long as you choose the right types of foods and eat them in the appropriate amounts, then meal frequency doesn’t matter.