Transcript Successful Weight Loss - International Academy of Nutrition

Successful
Weight
Loss
A Seminar by Robert Buist
Copyright © 2012 International Academy of Nutrition
ENTER THE LOW FAT DIETS
1950’s Ancel Keys - recommends low fat diet
 1977 George McGovern - low fat
dietary goals
 1984 NIH - fat is a greasy killer


1985 to 2002
Five major studies- fat not
linked to heart disease
Profits 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 WORK
 Fat
Protein & Carbs
9 calories /g
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 EPIDEMIC
Over 63% Australian men and
47% women are overweight or
obese
Aust. Bureau Stats. Nat. Nutr. Survey 1998
Beware low fat foods
Low fat foods contain increased
sugar to maintain calories
eg. light beers, yogurts
Failure of
high carbs / low fat diets

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Lack of phytonutrients
High glycaemic response foods
Elevated triglycerides
The wrong fats
Exaggerated insulin response
Importance of insulin control
High GI carbohyd rates

High insulin

Glucose stored as fat ( Obesity )

Insulin resistance ( Syndrome X )

High er insulin levels
Easier to store fat
Harder to lose weight
VISCERAL OBESITY and
SYNDROME X

Increased waist - hip ratio
 Abnormal glucose tolerance
 Insulin resistance
 Hypertension
 Hyperlipidaemia
 Chronic stress / Cushings Syndrome
Insensitivity 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
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 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)
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 GI
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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 STARCH

AMYLOSE
Slower digestion
Legumes,
Basmati rice

AMYLOPECTIN
Rapid digestion,
wheat flour,
calrose rice
------


amylose
 


  
------
 



amylopectin
The 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 vinegar

A side salad
with a high GI
meal lowers
blood glucose
and insulin
response
30%
HIGH 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 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...
….must have low GI
(because carbohydrates eaten alone
have a stronger effect on blood
sugar)
GI 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)
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 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 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 GI
Example:
beans
lamb
rice
olive oil
stringy vegetables
Our 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 Diets
Dr Atkins Diet Revolution (1972)
Insulin was so low that muscles and
tissues burned fat for energy, i.e. a
ketogenic diet
KETOSIS verses KETOACIDOSIS

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 Diet
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Reduces insulin levels
Reduces glycogen stores
Blocks glucose to fat
Burns body fat
Decreases addictive cravings
The Role of Glucagon
As insulin and glucose drops, glucagon
causes glycogen breakdown…

LIPOLYSIS in adipose tissue
 Ketogenesis
 Glycogenolysis
Initial 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 Diets
Almost universally effective in weight loss but
have the following problems:
 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
ATKINS DIET LONG TERM
 Bad breath
 Constant
 Constipation
nausea  Cancer risk
 Halitosis
 CHD disease risk
 Nervousness
 Kidney stones
 Irritability
 Osteoporosis
Often the amazing effects of a
ketogenic diet are due to ..
…..THE REMOVAL OF
FOOD ALLERGIES
FOOD ADDICTIONS
Allergy addictions to foods can
be a hidden cause of obesity especially to wheat and dairy
products
Dairy 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 Diet

Carbo’s low GI and high
phytonutrients

Safety depends on phytonutrients, minerals

Protein trimmed of cutaneous fat

Fats mono and omega-3
FAILURE TO DISTINGUISH
BETWEEN 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 LOSS
Omega-3 oils enrich membrane
phospholipids with EPA and
improve insulin sensitivity and
glucose control
FISH PROTECTS KIDNEYS
109 Dialysis patients consumed fish
107 Dialysis patients consumed NO fish
50% less mortality in fish eaters
over 3 years
Kutner NG et al. Am J Kidney Dis. 39(5) 1018-1024 (2002)
WARNING
High fat and high protein have been
associated with insulin resistance.
Hence carbohydrate handling ability
is decreased.
( blood glucose and insulin)
Urine Ketone Test
Use ketostick test before breakfast and
after dinner
SAFE LEVEL
UNSAFE LEVEL
(eat more
low GI carbs)
trace 0.5 - small 1.5mmol/l
4-6mmol/l (acidosis and low
of electrolytes)
Drink plenty of water - 8 glasses per day
KETOGENIC DIET TIPS
 Get blood biochemistry prior
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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 Obesity
Chronic stress, chronic corticosteroids
& Cushing Syndrome (hypercortisolism)
is associated with
 VISCERAL OBESITY
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INSULIN RESISTANCE
HYPERTENSION
ELEVATED CHOL & TRIGS
SYNDROME X (increased urinary cortisol)
CALORIC RESTRICTION
 Lowers free radical production in
mitochondria
 The key to slowing the aging process
 Improved SOD, glutathione peroxidase,
glutathione - transferase
 Better kidney, heart, liver and gastric
function
DIETARY RESTRICTION STOPS
DNA DAMAGE (50yr old)
Kcals/day
2000
1100
Body wt (lbs)
180
173
Thymidine glycol
(nmol/kg/day)
0.26
0.11
8-hydroxydeoxy
guanosine
(nmol/kg/day)
0.35
0.09
Simic MG et al Mutat Res 250(1-2)17-24(1991)
DIETARY CALORIC RESTRICTION
(for 5 yrs) in RHESUS MONKEYS
Normal Diet
688 cals/day
Reduced Diet
477 cals/day
Body Wt
31 lbs
21 lbs
% Weight from fat
25%
10%
Serum Glucose (mg/dl)
71
56
Serum Insulin (U/ml)
93
29
Serum Triglycerides (mg/dl) 169
67
Weindruch R. Sci Am 274 (1) 32-38 (1996)
AVOID STARVATION DIETS
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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 FAT
As you exercise and look
slimmer you may actually
increase weight due to
increased muscle mass.
MUSCLE CRITICAL FOR Wt LOSS
*(Aerobics and strength building vital)
Fat has low metabolic activity
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Lean muscle mass = energy
Muscle mitochondria = calorie
burning
units
“Your lean body mass is you, your fat is on you”
Biological Value of Protein
Food
Biological Value
Whey protein isolate
Eggs
Milk
Beef
Fish / chicken
Soya
Rice
110 -159
100
91
80
79
74
59
WHEY (High protein powder)
 Whey
(high biological value protein)
(25g serve 2-3 times daily)

Magnesium, calcium, potassium
(electrolytes)

Chromium polynicotinate
(sugar control, decrease fat)

L- or Acetyl Carnitine
(fat burning, performance)
ALPHA LIPOIC ACID (100mg)
 Mitochondrial Fn
Lowers insulin and
glucose levels
 Reduces insulin
resistance
 Improves insulin
sensitivity
 Neutralises free
radicals

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Chromium 1,000 micrograms

Reduces elevated
insulin & glucose

Reduces glycation
Improves insulin
resistance
 Reduce body fat
 Increases muscle
mass

Weight Loss - 2 Diets
Low GI Diet
60% carbs (low GI)
35% protein (low fat)
15% fat (mono/omega-3)
Ketogenic Diet
20% carbs (low GI)
50% protein (low fat)
30% fat (mono/omega 3)
The 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