Successful Weight Loss

A Seminar by Robert Buist

Copyright © 2012 International Academy of Nutrition

ENTER THE LOW FAT DIETSENTER THE LOW FAT DIETS

1950’s Ancel Keys - recommends low fat diet1977 George McGovern - low fat

dietary goals1984 NIH - fat is a greasy killer

1985 to 2002 Five major studies- fat not linked to heart disease

Profits drive food productionProfits drive food production

We started to eat more starches and refined carbohydrates because these were the cheapest macro nutrients for the food industry to produce with the highest profits

LOW FAT DIETS DIDN’T WORKLOW FAT DIETS DIDN’T WORK

Fat 9 calories /gProtein & Carbs 4 calories /g

Reducing the fat calories didn’t cause weight loss because we ate more carbohydrates (refined grains, flours and corn syrup.

Today we are hungrier than in the 70’s

OBESITY EPIDEMICOBESITY EPIDEMIC

Over 63% Australian men and 47% women are overweight or obese

Aust. Bureau Stats. Nat. Nutr. Survey 1998

Beware low fat foodsBeware low fat foods

Low fat foods contain increased sugar to maintain calories

eg. light beers, yogurts

Failure ofFailure of high carbs / low fathigh carbs / low fat dietsdiets

Lack of phytonutrients High glycaemic response foods Elevated triglycerides The wrong fats Exaggerated insulin response

Importance of insulin controlImportance of insulin control

High GI carbohydrates Í High insulin Í Glucose stored as fat ( Obesity ) Í Insulin resistance ( Syndrome X ) Í Higher insulin levels Easier to store fat Harder to lose weight

VISCERAL OBESITY andVISCERAL OBESITY and SYNDROME X SYNDROME X

Increased waist - hip ratio Abnormal glucose tolerance Insulin resistance Hypertension Hyperlipidaemia Chronic stress / Cushings Syndrome

Insensitivity may be protectiveInsensitivity may be protective

“Insulin resistance may actually be an adaptation to make it harder for the body to store fat as the body becomes more obese”

WHY ARE YOU STILL HUNGRY WHY ARE YOU STILL HUNGRY AFTER A FULL MEAL AFTER A FULL MEAL

High GI carbs cause an insulin spike

Blood glucose drops below pre-meal levels

High insulin prevents fat burning Low blood sugar causes craving

Health ramifications of the GIHealth ramifications of the GI

“The GI concept implies that the primary cause of Syndrome X, Heart Disease, Type 2 diabetes and Obesity is the long term damage caused by repeated surges of insulin that come from eating high GI starches and sugars”

The Glycaemic Index (GI)The Glycaemic Index (GI)

Describes the ability of carbohydrate in food to raise BLOOD GLUCOSE levels.

Glucose GI 100

High GI > 70

Medium GI 56 - 69

Low GI < 55

FACTORS AFFECTING GIFACTORS AFFECTING GI

Starch gelatinisation (heating bursts grains)

Fibrous coat / milling ( starch exposure)

Amylose / amylopectun (enzyme access)

Fibre viscosity (eg. legumes, apples, oats)

Acidity (eg. grapefruit, lemons, salad dressing)

Fat influence (reduces total meal GI)

CHEMICAL STRUCTURE OF STARCHCHEMICAL STRUCTURE OF STARCH

AMYLOSESlower digestion

Legumes,

Basmati rice

AMYLOPECTINRapid digestion,wheat flour,calrose rice

° -° -° -° -° -° -° È È amylose

° Á ° ° Á° ° Á ° °° -° -° -° -° -° -° Á° Ë ° °

° ° Á amylopectin

The Role of FibreThe Role of Fibre

SOLUBLE FIBRE is viscous, slows down digestion and harder for enzymes to attack e.g. apples, oats, legumes

INSOLUBLE FIBRE is not viscous, doesn’t slow digestion but can delay access to enzymes and water to starch unless refined, then it doesn’t work.

Olive oil and vinegarOlive oil and vinegar

A side salad with a high GI meal lowers blood glucose and insulin response

30%

HIGH GI FOODSHIGH GI FOODS

White rice (86) Corn flakes ( 77)

Dried dates (103) Rice Bubbles (87)

Glucose (100) Calrose rice(83)

Potato boiled (101) Watermelon (72)

Baked potato (85) Roll-ups - fruit (99)

LOW GI FOODSLOW GI FOODS

Raw cherries (22)Peas - dried (22)Cashews (22)Pearl barley (25)Chick peas (28)Prunes (29)Lentils (29)All Bran (30) Dried apricots (30)Oranges (33)

Snacks between meals...Snacks between meals...

….must have low GI

(because carbohydrates eaten alone

have a stronger effect on blood

sugar)

GI also applies to DiabeticsGI also applies to Diabetics

Sugar doesn’t cause diabetes Sugar is not contraindicated (but also not recommended)

The glycaemic response of the

whole meal is what counts

Glycaemic Load (GL)Glycaemic Load (GL)

GL= (GI x amount carbs/serve) /100 GL(pumpkin) = (75 x 4)/ 100 = 3

Carrots, broccoli, tomatoes, peas, onions, plums, cherries and salad vegetables contain little carbohydrates but plenty of phytonutrients. Eat freely.

LOW GI LUNCHESLOW GI LUNCHES

Fish, lean meats, chicken, eggs (0) Sushi (48), stuffed vine leaves (30) Thai noodles with vegetables (40), Torilla with beans and tomato (39), Ravioli (39), tabbouli (30), lentils &

rice (24), pasta marinara (40), dhal (40), most noodle soups.

GI of MIXED MEALSGI of MIXED MEALS

Adding a low GI food e.g. lentils (dahl) GI 30, to rice GI 80, will lower the glycaemic effect of rice

(50% x 30) + (50% x 80) = 55.

(Protein and fat also delay stomach emptying)

A meal with a very low GIA meal with a very low GI

Example: beans

lamb rice olive oil stringy vegetables

Our Ancestors - Hunters/ GatherersOur Ancestors - Hunters/ Gatherers

Ate more protein - small birds, fish, animals, shellfish, organs

Ate less carbohydrate - fruit & vegetables, herbs, seeds, roots, berries

Fat the same but different composition - more omega-3’s

No cereals until 10,000 years ago

High Fat, High Protein DietsHigh Fat, High Protein Diets

Dr Atkins Diet Revolution (1972)

Insulin was so low that muscles and tissues burned fat for energy, i.e. a ketogenic diet

KETOSIS KETOSIS verses verses KETOACIDOSISKETOACIDOSIS

DIABETIC KETOACIDOSIS:blood glucose high, osmotic diuresis, NO INSULIN, increased respiration, vomiting, dehydration, electrolyte loss and hypotensive shock.

MILD KETOSIS:Blood glucose low, no diuresis, no vomiting, no increased respiration as insulin still present but controlled. Acidosis is usually asymptomatic.

Effect of Ketogenic DietEffect of Ketogenic Diet

Reduces insulin levels Reduces glycogen stores Blocks glucose to fat Burns body fat Decreases addictive cravings

The Role of Glucagon The Role of Glucagon

As insulin and glucose drops, glucagon causes glycogen breakdown…

LIPOLYSIS in adipose tissue Ketogenesis Glycogenolysis

Initial Wt Loss on Ketogenic DietInitial Wt Loss on Ketogenic Diet

Depletion of 500g glycogen (total body

reserves) leads to 2.0 kg water loss 1g carbohydrate binds 4g water (muscle

and liver glycogen)

Ketogenic DietsKetogenic Diets

constipation due to lack of fibre increase oxidized lipids (LDL) due to

lack of phytonutrient antioxidants extra load on kidneys and liver mental judgment impaired on ketones

compared to glucose strenuous exercise difficult without

glycogen stores

Almost universally effective in weight loss but have the following problems:

ATKINS DIET LONG TERMATKINS DIET LONG TERM

Bad breathConstant nauseaHalitosisNervousnessIrritability

ConstipationCancer riskCHD disease riskKidney stonesOsteoporosis

Often the amazing effects of a ketogenic diet are due to ..

…..THE REMOVAL OF FOOD ALLERGIES

FOOD ADDICTIONSFOOD ADDICTIONS

Allergy addictions to foods can Allergy addictions to foods can be a hidden cause of obesity - be a hidden cause of obesity - especially to wheat and dairy especially to wheat and dairy productsproducts

Dairy products GI 30-50Dairy products GI 30-50

but Insulin index is 3x higher

...possibly because milk proteins are insulinogenic (anabolic) - drives glucose, fatty acids and amino acids into cells for growth

A Safer Ketogenic DietA Safer Ketogenic Diet

Carbo’s low GI and high phytonutrients

Safety depends on phyto-

nutrients, minerals

Protein trimmed of cutaneous fat

Fats mono and omega-3

FAILURE TO DISTINGUISH FAILURE TO DISTINGUISH BETWEEN FATSBETWEEN FATS

Margarine (trans isomers)Polyunsaturated (lowered immune function)

Saturated fats (elevate HDL but contain oxidised cholesterol)

Monounsaturated (more stable, marbled fat, less unsaturation

Omega-3 oils (decreased inflammation, cardiovascular risk

FISH OILS IN WEIGHT LOSSFISH OILS IN WEIGHT LOSS

Omega-3 oils enrich membrane phospholipids with EPA and improve insulin sensitivity and glucose control

FISH PROTECTS KIDNEYSFISH PROTECTS KIDNEYS

109 Dialysis patients consumed fish

107 Dialysis patients consumed NO fish

50% less mortality in fish eaters

over 3 yearsKutner NG et al. Am J Kidney Dis. 39(5) 1018-1024 (2002)

WARNINGWARNING

High fat and high protein have been associated with insulin resistance.

Hence carbohydrate handling ability is decreased.

( blood glucose and insulin)

Urine Ketone TestUrine Ketone Test

Use ketostick test before breakfast and after dinner

SAFE LEVEL trace 0.5 - small 1.5mmol/lUNSAFE LEVEL 4-6mmol/l (acidosis and low

(eat more of electrolytes) low GI carbs)

Drink plenty of water - 8 glasses per day

KETOGENIC DIET TIPSKETOGENIC DIET TIPS Get blood biochemistry prior No caffeine, fruits juices, alcohol,

sugars No high GI foods but high

phyto-nutrients Beware low fat products 150g biologically available protein

daily 25-50g low GI carbohydrates Increase protein up to 25% as

exercise increases

Chronic Stress and ObesityChronic Stress and Obesity

Chronic stress, chronic corticosteroidsChronic stress, chronic corticosteroids

& Cushing Syndrome (hypercortisolism)& Cushing Syndrome (hypercortisolism) is associated withis associated with VISCERAL OBESITYVISCERAL OBESITY INSULIN RESISTANCEINSULIN RESISTANCE HYPERTENSIONHYPERTENSION ELEVATED CHOL & TRIGSELEVATED CHOL & TRIGS SYNDROME X (increased urinary cortisol)SYNDROME X (increased urinary cortisol)

CALORIC RESTRICTIONCALORIC RESTRICTION

Lowers free radical production in Lowers free radical production in mitochondriamitochondria

The key to slowing the aging processThe key to slowing the aging process

Improved SOD, glutathione peroxidase, Improved SOD, glutathione peroxidase, glutathione - transferaseglutathione - transferase

Better kidney, heart, liver and gastric Better kidney, heart, liver and gastric functionfunction

DIETARY RESTRICTION STOPSDIETARY RESTRICTION STOPS DNA DAMAGE (50yr old) DNA DAMAGE (50yr old)

Kcals/day 2000 1100Kcals/day 2000 1100

Body wt (lbs) 180 173Body wt (lbs) 180 173

Thymidine glycol 0.26 0.11Thymidine glycol 0.26 0.11(nmol/kg/day)(nmol/kg/day)

8-hydroxydeoxy 0.35 0.098-hydroxydeoxy 0.35 0.09guanosineguanosine(nmol/kg/day)(nmol/kg/day)

Simic MG et al Mutat Res 250(1-2)17-24(1991)Simic MG et al Mutat Res 250(1-2)17-24(1991)

DIETARY CALORIC RESTRICTION DIETARY CALORIC RESTRICTION (for 5 yrs) in RHESUS MONKEYS (for 5 yrs) in RHESUS MONKEYS

Normal Diet Reduced DietNormal Diet Reduced Diet 688 cals/day 477 cals/day688 cals/day 477 cals/day

Body Wt 31 lbs 21 lbsBody Wt 31 lbs 21 lbs

% Weight from fat 25% 10%% Weight from fat 25% 10%

Serum Glucose (mg/dl) 71 56Serum Glucose (mg/dl) 71 56

Serum Insulin (Serum Insulin (U/ml) 93 29U/ml) 93 29

Serum Triglycerides (mg/dl) 169 67Serum Triglycerides (mg/dl) 169 67

Weindruch R. Sci Am 274 (1) 32-38 (1996)Weindruch R. Sci Am 274 (1) 32-38 (1996)

AVOID STARVATION DIETSAVOID STARVATION DIETS

Lower metabolic rate Induce fat storage Muscle is lost Mitochondria number decrease Low energy levels

(Don’t skip meals -

metabolism slows down)

MUSCLE IS HEAVIER THAN FATMUSCLE IS HEAVIER THAN FAT

As you exercise and look slimmer you may actually increase weight due to increased muscle mass.

MUSCLE CRITICAL FOR Wt LOSSMUSCLE CRITICAL FOR Wt LOSS

*(Aerobics and strength building vital)

Fat has low metabolic activityFat has low metabolic activity

Lean muscle mass = energy Muscle mitochondria = calorie

burning units “Your lean body mass is you, your fat is on you”

Biological Value of ProteinBiological Value of Protein

Food Biological Value Whey protein isolate 110 -159 Eggs 100 Milk 91 Beef 80 Fish / chicken 79 Soya 74 Rice 59

WHEY (WHEY (High protein powderHigh protein powder))

Whey (high biological value protein)Whey (high biological value protein) (25g serve 2-3 times daily)

Magnesium, calcium, potassiumMagnesium, calcium, potassium (electrolytes) Chromium polynicotinateChromium polynicotinate

(sugar control, decrease fat) L- or Acetyl Carnitine L- or Acetyl Carnitine (fat burning, performance)

ALPHA LIPOIC ACID (100mg)ALPHA LIPOIC ACID (100mg)

Mitochondrial FnLowers insulin and

glucose levelsReduces insulin

resistanceImproves insulin

sensitivityNeutralises free

radicals

Chromium 1,000 microgramsChromium 1,000 microgramsReduces elevated

insulin & glucose

Reduces glycationImproves insulin

resistanceReduce body fat Increases muscle

mass

Weight Loss - 2 DietsWeight Loss - 2 Diets

Low GI DietLow GI Diet60% carbs (low GI)

35% protein (low fat)

15% fat (mono/omega-3)

Ketogenic DietKetogenic Diet 20% carbs (low GI)

50% protein (low fat)

30% fat (mono/omega 3)

The Whey Diet PlanThe Whey Diet Plan

Breakfast: A Whey Smoothie or boiled egg, omelette,

bacon&tomatoes, grated apple Lunch: Mediterranean Salad or chicken waldorf, salmon salad,

bean & chicken, lentil soup Dinner: Stir-Fry or lamb fillet, chicken & almonds, pork & cabbage, poached salmon