Tag Archives: diet

Detox Diets and Cleanses: Health Boost or Recipe for Disaster?

4 Jan

Detox Diets and Cleanses: Health Boost or Recipe for Disaster?

By Tim Skwiat, MEd, CSCS, Pn2

There’s no doubt about it, the promises of detox diets and cleanses are alluring:

  • “Jump start your weight loss”…
  • ”Eliminate impurities”…
  • ”Drop 21 pounds in 10 days”…
  • ”Expel toxins”…
  • ”Revitalize and re-energize your body”…
  • ”Whisk away polluting nasties”…
  • ”Fast, easy weight loss”…
  • ”Purify the body”…
  • “Lose weight like the celebrities”…
  • ”Flush away toxins”

But do these plans work? Can they provide the health boosts they guarantee? Are they the perfect recipe that the proponents would like you to believe? Or, are they a recipe for disaster and self-sabotage, contributing to a vicious cycle and reinforcing poor eating habits and relationships with food?

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One of the most challenging aspects of assessing the various detox diets and cleanses, which are typically characterized by severe food and energy (i.e., calorie) restriction, is that you’d be hard-pressed to find a specific scientific definition of either, which are typically interchangeable terms.

In the Detox Dossier, an investigation by the Voice of Young Science (VoYS) into 15 different products and special diets that are widely promoted as detoxes, a group of researchers found that no two companies use the same definition for “detox.”1,2 Not only that, the VoYS found that no program or company could name the supposed “toxins” targeted by its detox, and the proponents provided little—and in most cases, no—evidence to back up detox claims.

The VoYS concluded, “No one we contacted was able to provide any evidence for their claims, or give a comprehensive definition of what they meant by ‘detox.’ We concluded that ‘detox’ as used in product marketing is a myth. Many of the claims about how the body works were wrong and some were even dangerous.”

In other words, there’s virtually no agreement on what a detox diet is, and what’s more, not even the creators of these detox diets can verify what toxins they aid in eliminating nor provide any evidence that they actually “work.”

Along those lines, while the detox industry promotes “purification,” “cleansing,” and “elimination,” it’s incredibly important to point that the human body has evolved highly sophisticated mechanisms for eliminating toxins. The liver, kidneys, gastrointestinal system, skin, and lungs all play a role in the excretion of unwanted substances, without chemical intervention. For example, the liver and kidneys both serve as exceptionally effective “detox” organs, converting toxic chemicals into less harmful ones and promoting the excretion of unwanted chemicals.

In its Debunking Detox Leaflet, the VoYS echoes the above: “Your body is capable of removing most potentially harmful chemicals you will encounter in your daily life. The human body has evolved to get rid of unnecessary substances through your liver, kidneys, and colon. It isn’t possible to improve their function without medical assistance.”3

The VoYS is not the only group of health professionals that’s out to set the record straight on the topic of detox diets. The Dietitians Association of Australia have also heavily criticized several popular detoxes, which can result in the loss of healthy gut bacteria and electrolytes.4

Dietitian Melanie McGrice says, “The problem with fad diets is that they’re all about restrictive eating patterns that you can’t stick to over the long haul and may even undermine your health. What you lose on these detox diets is usually fluid, healthy gut bacteria, electrolytes—all the things to keep your body healthy—rather than fat. And you don’t need to go on a severe detox because your body has an inbuilt detox system: the lungs, liver, and kidneys working every minute of the day.”

In a study published in the Journal of Human Nutrition and Dietetics, researchers Professor Hosen Kiat, Head of Cardiology at Macquarie University Hospital and the Australian School of Advanced Medicine, and Dr. Alice Klein from the Cardiac Health Institute conducted a thorough review of the currently available research to assess whether there was any clinical evidence to support the use of detox diets for weight management or toxin elimination. They concluded, “Although the detox industry is booming, there is very little clinical evidence to support the use of these diets. To the best of our knowledge, no randomized controlled trials have been conducted to assess the effectiveness of commercial detox diets in humans.”5

The researchers also identified a number of concerns and potential health risks. For instance, detox diets typically involve severe calorie restriction and nutritional inadequacy. Professor Kiat said, “In assessing one detox diet we found that, based on the average person’s minimum daily energy requirement, it does not meet daily protein requirements for anyone who weighs more than 23 kg [i.e., 50 pounds].”

The take-home point is that there’s no medical evidence indicating that specialized detoxification programs are needed to rid the body of toxins. With that being said, just because the body is equipped with the machinery it needs to “cleanse” and “detoxify” itself and to do so remarkably well, that does not mean that exposure to pollutants, pesticides, food additives, etc., is not a big deal. That point should not be lost; however, it is to say that these approaches do not appear to be effective solutions or quick fixes in that regard.

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As mentioned above, another reason that folks turn to these drastic approaches is to promote weight management. As Professor Kiat and Dr. Klein’s extensive review demonstrated, there’s very little clinical evidence to support this.5 But there’s much more to the story to consider.

While these popular diets help control energy balance, detox diets typically involve severe energy restriction and nutritional inadequacy, which can lead to protein and vitamin deficiencies, electrolyte imbalances, lactic acidosis, as well as decrements in performance (mental and physical), hormonal imbalances, hair loss, and much, much worse. (Yes, even death.)

Even more, this type of approach lends itself to weight cycling, which may be more commonly recognized as “yo-yo dieting.” Numerous studies have provided evidence that weight cycling increases one’s risk of insulin resistance, type 2 diabetes, and cardiovascular disease.6–8 While very-low-calorie diets (VLCD) like these may lead to significant short-term weight loss, VLCDs do not lead to greater long-term weight loss compared to more moderate reduced-calorie diets.9

For those folks who find themselves resorting to this vicious cycle, it’s important to mention that long-term calorie restriction has been shown to lead to significant reductions in metabolic rate that rival that of life-threatening malnutrition and starvation.10 In other words, chronic dieters—who are often the type to gravitate toward extreme approaches such as detox diets and cleanses—are at risk of a drastically reduced metabolic rate that significantly exceeds what would be predicted by age, sex, and body composition.

It’s also noteworthy to point out that a significant percentage of the short-term weight loss associated with VLCDs is fat-free mass (e.g., muscle mass, glycogen, body water), not body fat. This disproportionate loss in fat-free mass (FFM) is one contributor to a decreased metabolic rate, as FFM comprises the metabolically active tissues of the body, and may also predispose one to weight regain.11,12

When talking about extreme energy restriction, such as the case with the majority of these programs, it’s also important to discuss metabolic adaptation (i.e., adaptive thermogenesis), which refers to the decrease in energy expenditure beyond what can be explained by a loss in FFM.13 In the face of dangerously low energy supplies and stores, this form of energy conservation, which is characterized by reductions in key hormones (e.g., leptin, thyroid hormone, insulin, catecholamines), is a biologically meaningful survival mechanism.10,14,15

However, most people who engage in these restrictive diets generally aren’t trying to get themselves ready for some sort of apocalypse involving a food shortage. Rather, they tend to be using them as a vehicle to optimize body composition, health, and/or performance, and considering that studies show that metabolic adaptation is proportionate to the degree of energy imbalance, this shouldn’t be viewed favorably. Not only are intense energy-restrictive diets tough to maintain, they trigger the body to suppress its resting metabolic rate (RMR) by as much as 20%.9,16

Another fundamental concept to consider is that a crucial component of effective weight management plans and an overall healthy lifestyle is regular physical activity. Rarely do detox diets or cleanses promote exercise, and considering that many of these programs severely restrict caloric intake, not enough calories are being consumed to fuel physical activity. This is important for a number of reasons, one of which is that adding exercise to a weight loss program tends to help spare FFM.17–19

A key objective during weight loss is to reduce body fat while minimizing loss of FFM to promote optimal overall health, metabolic function, cardiovascular health, and physical functioning. This is why an emphasis should be placed on fat loss as opposed to weight loss.

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Some might consider highly-restrictive plans like these (i.e., detox diets, cleanses) as “quick fixes,” but truth be told, they’re not really fixing anything. In fact, as outlined above, they’re quite possibly making things worse. With reductions in RMR (via reduced FFM and adaptive thermogenesis), one is putting him/herself at a greater predisposition for weight regain.

This is particularly true because these plans do little to teach folks how to eat or help them overcome individual limiting factors (e.g., creating a healthy food environment, preparing healthy food choices, cultivating a healthy relationship with food). Not only that, programs like these that heavily restrict both calories and specific foods and food groups make folks more prone to oversconsumption of high-calorie, highly palatable foods via metabolic adaptation and through the activation of hedonic pathways.20 Severe restriction increases appetite (via “hunger hormones”), as well as the activity of hunger and food reward centers. That’s right, “junk food” becomes even tastier, and an even greater amount of it is craved by the body to satisfy its “needs.”

It’s indeed plausible that one could feel better during a detox diet or cleanse. With that in mind, it’s important to point out where some of these plans may go “right.” This most likely is a result of dietary displacement, which simply means replacing less-healthy options with healthier ones. On one hand, if the detox increases one’s consumption of vegetables and fruits, then s/he is going to be bringing in copious amounts of micronutrients, fiber, and phytonutrients, all of which can have a beneficial effect on healthy, body composition, metabolism, feelings of wellbeing, and energy levels.

Conversely, dietary displacement also takes into account you are not eating when following one of these detox diets. If one’s diet resembles anything like that of the typical Western diet, then these types of programs will substantially reduce the overconsumption of energy and processed foods, and that means reductions in calorie intake, sugar, refined grains, and added fats and oils (i.e., industrial vegetable oils).

Research shows that the typical Western diet leads to increased incidence of obesity, metabolic syndrome, oxidative stress, chronic inflammation, cognitive dysfunction, and various chronic diseases and forms of cancer.21–24 Simply by process of elimination, one may look and feel better. That’s not to say that a detox diet is a “good” plan; rather, this highlights how poor typical eating behaviors truly are.

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Rather than resorting to an extremist approach that does nothing to promote good nutrition behaviors, teach you how to eat, encourage a healthy relationship with food, or promote a healthy food environment, focus on making changes that support long-term healthy habits. Not only do you not have to suffer and deprive yourself through dramatic restriction, you can enjoy great-tasting whole foods and fully support your health and body composition goals.

In the grand scheme of things, your health, fitness, performance, and body composition are contingent on your entire body of “nutrition work”—not an individual food or special diet. In other words, there’s no “magic bullet.” Instead of viewing foods in isolation as “good” or “bad” or thinking you need to “go on a diet,” think about weight management and “deep health” as the product of practicing healthy eating habits, creating a positive food environment, and choosing high-quality, nutritious foods in appropriate amounts relative to your goals and activity levels regularly and consistently over time. Good nutrition takes practice, and just like getting better and mastering anything in life, it’s about progress—not perfection.

Start where you are and make small changes that you are ready, willing, and able to take on; focus on mastering those new behaviors, one step at a time.

Helpful next steps:

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References:

  1. Voice of Young Scientists. THE DETOX DOSSIER. Sense About Science; 2009. http://www.senseaboutscience.org/data/files/resources/48/Detox-Dossier-Embargoed-until-0001-5th-jan-2009.pdf.
  2. Sense about Science. Debunking detox. Sense Sci. January 2009. http://www.senseaboutscience.org/pages/debunking-detox.html.
  3. Voice of Young Scientists. Debunking detox leaflet. January 2009. http://www.senseaboutscience.org/data/files/resources/49/Detox-leaflet-Final-Embargoed-until-050109remargin.pdf.
  4. NewsMail. Dietitians reveal the three worst diets for your health. January 2014. http://www.news-mail.com.au/news/dietitians-reveal-three-worst-diets-your-health/2132566/.
  5. Klein AV, Kiat H. Detox diets for toxin elimination and weight management: a critical review of the evidence. J Hum Nutr Diet Off J Br Diet Assoc. 2015;28(6):675-686. doi:10.1111/jhn.12286.
  6. Li Z, Hong K, Wong E, Maxwell M, Heber D. Weight cycling in a very low-calorie diet programme has no effect on weight loss velocity, blood pressure and serum lipid profile. Diabetes Obes Metab. 2007;9(3):379-385. doi:10.1111/j.1463-1326.2006.00621.x.
  7. Waring ME, Eaton CB, Lasater TM, Lapane KL. Incident Diabetes in Relation to Weight Patterns During Middle Age. Am J Epidemiol. 2010;171(5):550-556. doi:10.1093/aje/kwp433.
  8. Olson MB, Kelsey SF, Bittner V, et al. Weight cycling and high-density lipoprotein cholesterol in women: evidence of an adverse effect. J Am Coll Cardiol. 2000;36(5):1565-1571. doi:10.1016/S0735-1097(00)00901-3.
  9. Tsai AG, Wadden TA. The evolution of very-low-calorie diets: an update and meta-analysis. Obes Silver Spring Md. 2006;14(8):1283-1293. doi:10.1038/oby.2006.146.
  10. Weyer C, Walford RL, Harper IT, et al. Energy metabolism after 2 y of energy restriction: the biosphere 2 experiment. Am J Clin Nutr. 2000;72(4):946-953.
  11. Müller MJ, Bosy-Westphal A, Kutzner D, Heller M. Metabolically active components of fat-free mass and resting energy expenditure in humans: recent lessons from imaging technologies. Obes Rev Off J Int Assoc Study Obes. 2002;3(2):113-122.
  12. Faria SL, Kelly E, Faria OP. Energy expenditure and weight regain in patients submitted to Roux-en-Y gastric bypass. Obes Surg. 2009;19(7):856-859. doi:10.1007/s11695-009-9842-6.
  13. Camps SGJA, Verhoef SPM, Westerterp KR. Weight loss, weight maintenance, and adaptive thermogenesis. Am J Clin Nutr. 2013;97(5):990-994. doi:10.3945/ajcn.112.050310.
  14. Heilbronn LK, de Jonge L, Frisard MI, et al. Effect of 6-Month Calorie Restriction on Biomarkers of Longevity, Metabolic Adaptation, and Oxidative Stress in Overweight Individuals: A Randomized Controlled Trial. JAMA. 2006;295(13):1539. doi:10.1001/jama.295.13.1539.
  15. Rosenbaum M, Leibel RL. 20 YEARS OF LEPTIN: Role of leptin in energy homeostasis in humans. J Endocrinol. 2014;223(1):T83-T96. doi:10.1530/JOE-14-0358.
  16. Knuth ND, Johannsen DL, Tamboli RA, et al. Metabolic adaptation following massive weight loss is related to the degree of energy imbalance and changes in circulating leptin. Obes Silver Spring Md. 2014;22(12):2563-2569. doi:10.1002/oby.20900.
  17. Garrow JS. Exercise in the treatment of obesity: a marginal contribution. Int J Obes Relat Metab Disord J Int Assoc Study Obes. 1995;19 Suppl 4:S126-S129.
  18. Redman LM, Heilbronn LK, Martin CK, et al. Effect of calorie restriction with or without exercise on body composition and fat distribution. J Clin Endocrinol Metab. 2007;92(3):865-872. doi:10.1210/jc.2006-2184.
  19. 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 Auckl NZ. 2006;36(3):239-262.
  20. 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.
  21. Heinonen I, Rinne P, Ruohonen ST, Ruohonen S, Ahotupa M, Savontaus E. The effects of equal caloric high fat and western diet on metabolic syndrome, oxidative stress and vascular endothelial function in mice. Acta Physiol Oxf Engl. 2014;211(3):515-527. doi:10.1111/apha.12253.
  22. Lutsey PL, Steffen LM, Stevens J. Dietary Intake and the Development of the Metabolic Syndrome: The Atherosclerosis Risk in Communities Study. Circulation. 2008;117(6):754-761. doi:10.1161/CIRCULATIONAHA.107.716159.
  23. Cordain L, Eaton SB, Sebastian A, et al. Origins and evolution of the Western diet: health implications for the 21st century. Am J Clin Nutr. 2005;81(2):341-354.
  24. Kanoski SE, Davidson TL. Western diet consumption and cognitive impairment: Links to hippocampal dysfunction and obesity. Physiol Behav. 2011;103(1):59-68. doi:10.1016/j.physbeh.2010.12.003.
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Habits of Highly Effective Nutrition Plans

5 Nov

Habits of Highly Effective Nutrition Plans

Tim Skwiat, CSCS, Pn2

While there are quite a few effective nutrition programs out there, there’s not necessarily a single, universal “best” option. In fact, in a recent article published in the prestigious Journal of the American Medical Association, researchers compared various popular diets differing in macronutrient composition, and they found that differences in weight loss and metabolic risk factors were small (i.e., less than a couple of pounds) and inconsistent.1

What they did find, however, was that the single-most important factor influencing weight loss and improvements overall health (i.e., disease-risk outcomes) was adherence, or the ability of folks to stick with a program and consistently meet program goals for diet and physical activity. This led for the researchers to “call for an end to the diet debates.”

In the POUNDS Lost study, published in the New England Journal of Medicine, researchers compared four different diets (with varying amounts of carbohydrates, proteins, and fats), and they found that “reduced-calorie diets result in meaningful weight loss regardless of which macronutrients they emphasize.”2

With all of that being said, there are some common themes—criteria, if you will—amongst the most effective nutrition plans, including:3

  • They raise awareness and attention.
  • They focus on food quality.
  • They help eliminate nutrient deficiencies.
  • They help control appetite and food intake.
  • They promote regular exercise and physical activity.

While there may be no universal “best” diet, there may be a best option for you, and that’s what’s most important. How can you begin to find what works best for you? The following Habits of Highly Effective Nutrition Plans is a great place to start.

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Habit 1: Eat slowly and mindfully. For fat loss, there are two habits that you’ll need to master, and speaking generally—when combined with good food quality and done consistently—these two simple tools are typically enough for almost all clients to lose fat:

  • Eat slowly.
  • Eat until 80% full (i.e., just until satisfied; no longer hungry, but not “full”).

Slow eating provides a host of benefits:

  • Slow eating helps you “check in” and be present, pay attention, and sense into the cues that your body is sending you, why you’re eating, etc.
  • Slow eating allows you to sense into your body’s internal hunger/satiety cues.
  • Slow eating creates awareness of food textures, tastes, and smells.
  • Slow eating enhances digestion.
  • Slow eating doesn’t depend on controlling what you eat. It can be done any time, anywhere, and no matter what’s on your plate or who’s around, you can always eat slowly.
  • Slow eating makes you and your body the boss. You don’t have to rely on eternal cues and control methods (e.g., calorie counting, weighing/measuring food, points, etc.), and relinquishing external control gives you more real control.

Slow eating also ties into another extremely important component of how to eat: Learning appetite awareness. This is key to distinguishing when you feel that want to eat, need to eat, and have eaten enough (or too much). This ties into the concept of eating until 80% full, which you can track using this handy 80% Full Food Journal. Incorporating an Appetite Awareness Tracker along with the aforementioned food journal can be quite helpful in this regard as well.

If you can master the art of eating slowly and mindfully and learn to sense into (and listen to) your physical cues, you will be well on your way to improving your health, body composition, and vitality. You’ll be a nutrition ninja!

Extra Credit ==> Mindful Eating: HOW Do You Eat?

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Habit 2: Eat protein-dense foods with each meal. When it comes to improving body composition (e.g., losing fat, building/retaining muscle), optimizing protein intake may be one of the single most important dietary and lifestyle changes that one can make. Protein-dense foods increase satiety (i.e., feeling of fullness) and thermogenesis (i.e., boost the metabolism), and high-protein diets have consistently been proven to be effective at improving body composition (e.g., fat loss), preserving metabolic rate, and improving overall health (e.g., better blood lipids, blood sugar management, insulin concentrations).4–6

Increasing protein intake means moving from “surviving” to “thriving” and from “adequate” to “optimal.” Ideally, you should aim to consume a portion of protein-dense foods with each meal. Generally speaking, one palm-sized portion of protein is equivalent to approximately 20 – 30 grams of protein, and we recommend that:

[If you like to “count,” then a good rule of thumb is probably somewhere around 0.18 grams of protein per pound of bodyweight per feeding.]

Your best protein options include:

  • Lean meats, poultry, fish/seafood, and/or wild game (preferably grass-fed, pasture-raised, organic, etc., when appropriate)
  • Eggs (preferably pasture-raised, which is distinct from free-range and cage-free)
  • Lean dairy, especially Greek yogurt (with live cultures) and cottage cheese (preferably grass-fed, pasture-raised)

As noted above, there are a number of beneficial outcomes associated with a higher protein intake, and most experts tend to agree that folks can optimize protein intake by consuming about 0.7 – 0.9 grams per pound of bodyweight per day. This can be tricky, and this is why a protein supplement like BioTRUST Low Carb is “foundational” for the overwhelming majority of folks.

Bonus recommendation ==> Branched-chain amino acids, which play an intricate role in muscle building and recovery (particularly leucine), reduce muscle breakdown, and help regulate blood sugar levels. BCAAs are particularly useful during exercise, and they may also be especially applicable when protein needs aren’t being met (e.g., fasting, not enough protein at a given meal). What’s more, there’s some evidence to suggest that BCAA supplementation may be especially important (to help maintain muscle and metabolic rate) for older folks, whose protein absorption mechanisms may not be as effective.7

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Habit 3: Eat vegetables with each meal. Mom and grandma were right: Veggies are good for your health and your body composition. Studies show folks who eat more veggies tend to do a better job of losing fat and keeping it off. What’s more, a diet high in vegetables helps balance the body’s pH, which is important for both bone and muscle strength. Vegetables have a high nutrient-density and low energy-density, which means that you can consume a relatively large volume comparative to their calorie content. (See Move More, Eat MORE for more on this.)

While vegetables are also packed with important micronutrients (e.g., vitamins and minerals), they are also loaded with important phytochemicals that are necessary for optimal physiological functioning. These same plant chemicals often serve as anti-oxidants that combat oxidative stress, one of the most important factors mediating the deleterious effects of aging.8–10

Vegetables can essentially be prepared any way that you like (and it’s a good idea to include some healthy fats to maximize absorption of key nutrients),11–13 and while there’s not a limit on the number of non-starchy vegetables that you can include, the following is a good starting point:

Generally speaking, the more color (and the more varieties of colors) means the greatest array of beneficial phythonutrients, and it’s a good idea to consume a variety of vegetables each day. To optimize health, you may consider trying to include at least one serving of each of the primary colors each day:

  • Greens: Various lettuces, spinach, kale, arugula, Brussels sprouts, broccoli, asparagus, zucchini
  • Reds: Tomatoes, red bell peppers, red cabbage
  • Oranges: Carrots, orange bell peppers, various squashes, pumpkin
  • Whites: Onions, garlic, parsnips, cauliflower, yellow squash
  • Purples: Eggplant, purple cabbage, beets

For more examples, please see the World’s Healthiest Foods list.
Bonus recommendation ==> Supplement with a greens powder, which contain vegetables, fruits, grasses, etc., that have been distilled into powder form. While not necessarily a substitute for eating whole vegetables and fruits, greens powders are a good option to add to smoothies, when traveling, and for folks who struggle with adding vegetables to each meal.

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Habit 4: Carbohydrate intake should match activity levels. For fat loss, most people will do better by reducing carbohydrate intake, but it doesn’t mean that a low-carb diet is necessary. Rather, a controlled-carbohydrate diet seems to work best. Generally speaking, most people will do best with some carbs, with appropriate adjustments made for activity level, goals, and body type. In other words, the more active you are, the more smart carbs you’ll need; on the other hand, sedentary folks, especially those who are trying to lose fat and/or have more endomorphic body types, typically need fewer carbohydrates.

While there is often debate about low-fat versus low-carbohydrate diets and whether or not there are any metabolic advantages (there doesn’t seem to be any given the data at this time), there is some evidence to suggest that an individual’s insulin sensitivity status may influence the outcome of a reduced-calorie diet.14 For instance, in a study published in the journal Diabetes, Obesity and Metabolism, researchers found that folks with poor insulin sensitivity lost less weight on a low-fat, high-carbohydrate diet compared to more insulin sensitive folks (as well as compared to folks who followed a high-fat, low-carbohydrate diet, regardless of insulin sensitivity status).15

Why? Adherence (or lack thereof): Folks with a poor insulin sensitivity status had a much more difficult time sticking to the low-fat, high-carbohydrate diet, and as a result, they were much less likely to lose weight. Why did they have trouble sticking to it? It’s hard to say for certain, but we can speculate that their less-than-stellar carbohydrate metabolism induced a sequence of hormonal and metabolic changes that increases hunger and energy intake (after consuming a low-fat, high-carbohydrate meals).

Overall, when it comes to choosing smart carbs, the emphasis should be placed on whole, minimally-processed foods that are slow-digesting and high in fiber. Some folks find that consuming the majority of these carbs after exercise is best for body composition and recovery. When carbohydrates are added to meals (not necessarily every meal), the following is a good starting point:

Again, carb intake should be proportionate to activity levels, and particularly when the goal is fat loss, a portion may not be included at each feeding. For advanced folks, focusing on including carbs in the hours after exercise may be optimal. When you do choose to add carbs to a meal, the following are the best choices:

  • Colorful, starchy vegetables (e.g., sweet potatoes, purple potatoes, winter squashes)
  • Colorful fruits (e.g., berries)
  • Other sweet/starchy fruits and vegetables (e.g., bananas, plantains, potatoes)
  • Legumes (e.g., lentils and beans)
  • Whole, intact grains (rather than foods made from processed flours), including whole or steel-cut oats; wild, brown, or red rice; quinoa, amaranth, or buckwheat groats; sprouted grains; kamut or spelt grains; maize; millet; and barley
  • Other whole grain products (e.g., sprouted grains)

Bonus recommendation ==> Managing blood sugar and insulin concentrations are key to optimizing body composition, health, and performance. Supplements like IC-5 can help improve carb tolerance, insulin sensitivity, and metabolic flexibility, which are key players in weight management.

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Habit 5: Eat healthy fats daily. Don’t fear the fat! Despite a bad rap, fat does NOT make you fat. In fact, healthy fats from whole foods play important roles in manufacturing and balancing hormones. They also form our cell membranes and brains and nervous systems. They also transport important vitamins and minerals.

Healthy fats are critical for recovery and repair and supporting mental health and feelings of wellbeing. Fats slow gastric emptying and the release of glucose into the bloodstream (i.e., reduce the glycemic response), and furthermore, studies show that consuming fats can reduce the amount of food eaten in subsequent meals.

Generally speaking, the following are good starting points for portion sizes:

The key is to balance fats, and a variety of healthy fats usually does the trick:

  • Raw nuts (e.g., walnuts, almonds, cashews, etc.) and nut butters (e.g., almond butter)
  • Raw seeds (e.g., pumpkin seeds, chia seeds, hemp seeds)
  • Olives and extra-virgin olive oil
  • Avocado
  • Butter (preferably from grass-fed cows, e.g., Kerrygold)
  • Fresh coconut, coconut milk, and extra-virgin coconut oil
  • Cold-pressed, extra-virgin oils (e.g., walnut, macadamia nut, avocado, hemp, pumpkin, flax)
  • Fatty fish (e.g., wild salmon, mackerel)

Bonus recommendation ==> Supplement with omega-3 fatty acids, which, for the overwhelmingly majority of folks, will be “foundational.” For more on why this (i.e., fish oil) is such an important supplement, please refer to the following article:

The Benefits Of Omega-3 Fatty Acid Supplementation

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In sum, for most people who are eating 3 – 4 meals per day, the following is a good starting point:

  • 1 – 2 palm-sized portions of protein
  • 1 – 2 fist-sized portions of vegetables
  • 1 – 2 thumb-sized portions of healthy fats
  • 1 – 2 cupped-handful portions of carbohydrates can be added as needed (i.e., not every meal), depending on activity levels, goals, and body type.

With all of that being said, this is just a starting point. Remember to practice the first Habit, which emphasizes how you eat. Tune into your internal cues (e.g., satiety, appetite) to gauge what works best for you. In other words, find and do what works (for you). Focus on food quality and emphasize building a solid foundation of high-quality nutrition, done consistently.

Depending on where you are in your journey, you might start with something small, like adding a fish oil supplement to help balance your fat intake and reduce inflammation. From there, you might want to make sure that you consume a portion of lean protein at each feeding. Once you’ve nailed that, you might make sure that you’re consuming some colorful vegetables and/or fruits with each feeding.

In other words, take it one step at a time and focus on working on one change or new habit. Direct all of your time and energy into something that you are ready, willing, and able to do. Master that task or habit, and then take that next step. As Robert Collier said, “Success is the sum of small efforts, repeated day in and day out.”

Many find this step-like, habit-based approach to be far more tolerable, and more importantly, successful for long-term behavior change and weight management. However, some folks need or desire to make bigger changes, faster (e.g., athletes making weight, preparing for an event). In these cases, it’s important to understand that you’ll need to tolerate a greater amount of discomfort and disruption to your routine. Worry not, we’re here to support and encourage you every step of the way.

Notice and name what you do well and where you need help. Are there certain challenges that you face? The more awareness (here’s that mindfulness thing again) that you have of your habits, behaviors, and triggers, the more proactive that you can be in your approach to good nutrition. Remember, good nutrition (and being healthy) is not about perfection; it’s about improvement. It’s about the process—the journey. It’s about making the best, wise choices, as often as possible. It’s about living with purpose and getting up each day being your “best self,” with integrity. It’s about chasing health and wellness.

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Bonus resources:

Additional references used for this article: 16,17

References:

  1. Pagoto SL, Appelhans BM. A Call for an End to the Diet Debates. JAMA. 2013;310(7):687. doi:10.1001/jama.2013.8601.
  2. Sacks FM, Bray GA, Carey VJ, et al. Comparison of Weight-Loss Diets with Different Compositions of Fat, Protein, and Carbohydrates. N Engl J Med. 2009;360(9):859-873. doi:10.1056/NEJMoa0804748.
  3. Berardi J. Paleo, vegan, intermittent fasting…Here’s how to choose the best diet for you. Precis Nutr. http://www.precisionnutrition.com/best-diet.
  4. 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.
  5. 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.
  6. Westerterp-Plantenga MS, Nieuwenhuizen A, Tomé D, Soenen S, Westerterp KR. Dietary protein, weight loss, and weight maintenance. Annu Rev Nutr. 2009;29:21-41. doi:10.1146/annurev-nutr-080508-141056.
  7. Casperson SL, Sheffield-Moore M, Hewlings SJ, Paddon-Jones D. Leucine supplementation chronically improves muscle protein synthesis in older adults consuming the RDA for protein. Clin Nutr Edinb Scotl. 2012;31(4):512-519. doi:10.1016/j.clnu.2012.01.005.
  8. Floyd RA. Antioxidants, oxidative stress, and degenerative neurological disorders. Proc Soc Exp Biol Med Soc Exp Biol Med N Y N. 1999;222(3):236-245.
  9. Betteridge DJ. What is oxidative stress? Metabolism. 2000;49(2 Suppl 1):3-8.
  10. Fernández-Sánchez A, Madrigal-Santillán E, Bautista M, et al. Inflammation, Oxidative Stress, and Obesity. Int J Mol Sci. 2011;12(12):3117-3132. doi:10.3390/ijms12053117.
  11. Unlu NZ, Bohn T, Clinton SK, Schwartz SJ. Carotenoid absorption from salad and salsa by humans is enhanced by the addition of avocado or avocado oil. J Nutr. 2005;135(3):431-436.
  12. Brown MJ, Ferruzzi MG, Nguyen ML, et al. Carotenoid bioavailability is higher from salads ingested with full-fat than with fat-reduced salad dressings as measured with electrochemical detection. Am J Clin Nutr. 2004;80(2):396-403.
  13. Goltz SR, Campbell WW, Chitchumroonchokchai C, Failla ML, Ferruzzi MG. Meal triacylglycerol profile modulates postprandial absorption of carotenoids in humans. Mol Nutr Food Res. 2012;56(6):866-877. doi:10.1002/mnfr.201100687.
  14. Pittas AG, Roberts SB. Dietary Composition and Weight Loss: Can We Individualize Dietary Prescriptions According to Insulin Sensitivity or Secretion Status? Nutr Rev. 2006;64(10):435-448. doi:10.1111/j.1753-4887.2006.tb00174.x.
  15. McClain AD, Otten JJ, Hekler EB, Gardner CD. Adherence to a low-fat vs. low-carbohydrate diet differs by insulin resistance status: Research Letter. Diabetes Obes Metab. 2013;15(1):87-90. doi:10.1111/j.1463-1326.2012.01668.x.
  16. Berardi, J, Andrews R. The Essentials of Sport and Exercise Nutrition. Second Edition. Precision Nutrition; 2013. http://www.precisionnutrition.com/cmd.php?Clk=5266221.
  17. Berardi J, Scott-Dixon K. Precision Nutrition Level 2 Certification: Master Class. Precision Nutrition; 2014. http://www.precisionnutrition.com/pn-level-2-vip.

Exercise ALONE Doesn’t Work

19 Jun

Exercise ALONE Doesn’t Work
By Tim Skwiat, MEd., CSCS, Pn1

As a personal trainer, you are emblazoned with the opportunity to help people improve their health and fitness, overcome aches and pains, improve their performance, and much, much more. With this opportunity comes great responsibility. You see, you are not just a trainer, you are a coach, and you are charged with the opportunity and responsibility to get your clients from where they are to where they want to be.

The vast majority of your clients are coming to you to help them improve their body composition — to lose body fat, to add calorie-burning lean muscle mass, or some combination of the two. As a great trainer, you understand the importance of a progressive, personalized training program to help these folks achieve their goals.

However, I’m here to share some sobering research with you to highlight the fact that exercise, in the absence of nutritional intervention, is shamefully lacking when it comes to producing the desired fat loss that your clients seek.

When asked what the best exercise is for developing six-pack abs, renowned strength coach Mike Boyle will tell you, with a straight face and without hesitation, “Table push-aways.” The fact of the matter is that you can’t out-train a crappy diet.

As a matter of fact, a recent study demonstrated shockingly embarrassing results after 16 weeks of a solid training program. In the study, researchers assigned overweight folks to either a control group — where they didn’t exercise at all — or an exercise group.

The participants assigned to the exercise group trained for five total hours per week: three hours performing strength-training exercises with an Olympic weightlifting coach and two hours performing circuit training with a group exercise instructor. Throughout the course of the study, the scientists gathered data on body composition, as well as various other measures.

While the exercisers did get better results than the non-exercisers, the results were nothing short of embarrassing…

The control group gained 1 pound of lean mass, lost a ½ pound of body fat, and lost 0.5% body fat.

The exercise group gained 3 pounds of lean mass, lost 2 pounds of body fat, and lost 1.5% body fat.

While the control group sat on their rear ends, the exercise group trained intensely for 80 hours and lost only a few measly pounds to show for their effort! Ouch.

fatty-exercising

We could look at a couple other studies that show the same exact, pathetic results of exercise without nutritional intervention:

• In a study conducted at the University of Oklahoma, researchers again had the exercising group perform five hours of training each week and compared the results with a non-exercising control group. In this study, the exercisers performed three hours of aerobic exercise and two hours of resistance training. At the end of 10 weeks, the exercising group had dropped a measly 1 ½ pounds of fat.

• Researchers in Australia looked at the effects of an aerobic exercise program on the body composition of 58 obese men and women. The subjects exercised at 70% maximum heart rate five times per week (each session totaling 500 calories burned) for 12 weeks. At the end of the study, the subjects measured disappointing, “less-than-expected” average weight loss of less than 2 pounds.

• This seems so strong, in fact, that the American College of Sports Medicine (ACSM) Position Stand, “Appropriate intervention strategies for weight loss and prevention of weight regain for adults”, states there is little evidence to suggest that exercise-alone is as effective as energy restriction for promoting weight loss.

While there are handfuls more to show, let’s offer some research that demonstrates the promising perspective of what happens when we add nutritional intervention to an exercise program:

• In a meta-analysis analyzing data from 25 years of research, scientists found that 15 weeks of combined dietary and exercise intervention produced a staggering 22-pound average weight loss that was also maintained by the subjects after one year.

• In a 9-month study at the University of Pennsylvania, researchers separated subjects into one of three groups: 1. diet (D) intervention; 2. exercise (E) intervention; or 3. diet + exercise (DE) intervention. You guessed it: the DE group demonstrated a significantly greater weight loss than either the D or E groups. Notably, the D group also lost significantly more weight than the E group.

• Researchers in Seattle performed a similar study to the one above but added a control (C) group and carried out the research for 12 months. In this study, the E group did lose slightly more weight than the C group, but the DE group blew those results out of the water: DE resulted in 3 ½ times greater weight loss than E alone.

The point of this is most certainly not to deter, frustrate, or upset you. You already know that a properly structured exercise program is part of the equation, and a significant one at that. The point, on the other hand, is to make it very clear that to optimize your clients’ efforts, their nutrition is going to play a huge role in their success — and yours. As your resource for honest nutrition and health information, it is a privilege to help you learn the tools of the trade that you can implement effectively and efficiently to best assist your clients. That will be the aim of this column moving forward, and I look forward to it!

References:

Caudwell P et al. Exercise alone is not enough: weight loss also needs a healthy (Mediterranean) diet? Public Health Nutr. 2009 Sep;12(9A):1663-6.

Foster-Schubert KE et al. Effect of diet and exercise, alone or combined, on weight and body composition in overweight-to-obese postmenopausal women. Obesity (Silver Spring). 2012 Aug;20(8):1628-38.

Jakicic JM et al. American College of Sports Medicine position stand. Appropriate intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc. 2001 Dec;33(12):2145-56.

King NA et al. Beneficial effects of exercise: shifting the focus from body weight to other markers of health. Br J Sports Med. 2009 Dec;43(12):924-7.

Lockwood CM et al. Minimal nutrition intervention with high-protein/low-carbohydrate and low-fat, nutrient-dense food supplement improves body composition and exercise benefits in overweight adults: A randomized controlled trial. Nutr Metab (Lond). 2008; 5: 11.

Miller WC et al. A meta-analysis of the past 25 years of weight loss research using diet, exercise or diet plus exercise intervention. Int J Obes Relat Metab Disord. 1997 Oct;21(10):941-7.

Volpe SL et al. Effect of diet and exercise on body composition, energy intake and leptin levels in overweight women and men. J Am Coll Nutr. 2008 Apr;27(2):195-208.