The Facts

• Obesity is one of the most common forms of malnutrition in Canada and the US
• Nearly 90% of people surveyed think they weigh too much
• One in three adults in the US is obese
• One out of five children in the US is overweight
• About two-thirds of those who lose weight regain it, and more, within two years
• 90% to 95% regain it within 5 years

Diets: is there an optimum ratio?

• Atkins: 10% (more or less) carbohydrates and higher in fats and/or proteins
• Zone: 40% carbohydrates, 30% proteins, 30% fats
• Pritkin: 75% to 85% carbohydrates, 10% to 15% proteins, 5% to 10% fats

Definitions

• Obesity is an excessive amount of body fat. In terms of body-fat percentage, obesity is defined as a body-fat percentage greater than 30% for women and 25% for men
• Normal Fat Percentages
  • Infant: 12% (highest amount fat than other mammals except whales)
  • 6 month: 25%
  • pre-puberty: 15% to 18%
  • women: need at least 12% to 15% fat by weight to function
  • men: need to be at least 3%
• Lean body mass is your muscle and bone weight only (no fat)
• Body Mass Index (BMI) is your weight in relation to your height (kg/m)
  • Greater than 30 is obese
  • Less than 26 for optimal health
• Diet is a way of life or regimen
• Obesity types is divided into hyperplastic & hypertrophic
  • hyperplastic
    • There is an increased number of fat cells throughout the body
    • Believed to be related to the amount of calories eaten by pregnant mother, thus determined in utero
    • It has no association to diseases
  • Hypertrophic
    • increase in the size of each fat cell
    • can increase 1,000x its original size!
    • two general fat distribution shapes: android (apple-shaped) & gynecoid (pear-shaped) based on a waist/hip ratio
    • the apple-shape obesity associated with diabetes, heart disease, etc., and not the pear-shaped obesity

General causes of obesity

Set-Point Theory

Weight that the body tries to maintain by regulating the amount of food and calories consumed. genetic influence individual fat cells may control this too (insulin insensitivity?)

Altered Thermogenesis

A certain amount of food eaten is converted into heat (thermogenesis). This is how the body wastes calories! In non-obese people, a meal can stimulate up to 40% increase in heat. In obese people, a meal stimulates only 10% or less! For a formerly-obese person to maintain their current weight they must eat 25% less calories than a non-obese person of similar weight.

Causes of Altered Thermogenesis

• Decreased sympathetic activity from the brain
• Body Fats: brown versus white
  • White fats: predominant storage form in the body
  • Brown fats: found 0.5% to 5% in the entire body, but has the ability to burn fats. In fact, 1 ounce (0.1% of body weight) can make the difference between maintaining weight or putting on 10 pounds per year!
• Insulin insensitivity **

Information & Tips on Weight Loss

	Carbohydrates		Water
	Fat		Others
	Protein		Summary
	Fiber

Carbohydrates such as sugars and starches: do we get too much?

Currently more than half of the carbohydrates being eaten today are in the form of sugars that are added to foods as sweetening agents. An average person can only store 300 to 400 grams carbohydrates in muscles and 60 to 90 grams in the liver (equals about 2 cups of pasta, 3 candy bars). The excess carbohydrates are stored as excess fat and cholesterol via the hormone insulin! Even worse, insulin tells the body not to release fat! The refining of our grains (wheat, corn, etc) is also making us fat. White flour behaves like sugar in our bodies while unrefined flour does not. The speed at which dietary sugars enter the blood is called the glycemic index (the role of fibre, sugar structure, fat, vitamins and minerals).

How many carbohydrates do we really need?

Do we really need 60-70% of total calories from carbohydrates?

In one study, two groups consumed either a 40% or 60% carbohydrate diet for 3 weeks. The group eating the high 60% diet experienced increased fat and cholesterol levels (the bad kind) in the blood.

Guess where that fat in the blood is going?

In another study, 15% of the carbohydrates from a high carbohydrate diet (65 to 50%) was lowered and replaced with protein (from 10 to 25% protein). Guess what happened. The fat in the blood went down (the bad cholesterol) and the good cholesterol went up!

Recommendations

• Avoid all refined breads, cereals, muffins, etc.
• Find breads, pastas with fibre in them (like your ancestors did)
• If you eat organic, unprocessed, and unsweetened foods...
• 50% to 60% of total calories from carbohydrates is probably OK
• With standard foods: eat between 30% to 40% (not from cookies, cakes, etc) carbohydrates
• Over 50% of proteins can be converted into sugars, do we really need carbohydrates!?

Fat, the big fat lie?

Is eating fat the same as putting on fat? We know that eating cholesterol does not really increase blood cholesterol. Since low fat diets have been in place, obesity has gone up (not down). Did you know that the brain is the most dense source of fats in body, with 60% fat content? So be careful! The "fat-free diet" is the "no way" diet; it's all marketing. Be aware that there are good fats from plants, vegetables, fish, nuts & seeds, as well as less desireable types of fats (such as saturated and animal fats), and really bad fats (from margarine, hydrogenated vegetable oils, and trans fats).

The "good guys" help weight loss!

• Essential fats: the body can not make them (vegetables, nuts, seeds, fish) so we need to get them from the diet
• Omega-3 fats (fish, flaxseed, walnuts) are the key to weight-loss and optimal health
• Did you know that essential fats shrink the size of fat cells in animal research?
• Omega-3 oils have be shown to lower blood fats ( also known as triglycerides)
• Omega-3 oils from fish oil (called EPA & DHA) prevented insulin resistance in rats. That means less insulin, which means less fat storage!
• EPA & DHA omega-3 fats stimulates the good brown fats in your body
• Omega-3 oils have also been shown to stimulate the thyroid gland and feed your mood too

Recommendations

• Eliminate or minimize hydrogenated and trans fats (i.e. margarine)
• Eat foods higher in omega-3 oils (flax seed, hemp seed, pumpkin seed, canola, soybeans, walnut, wheat germ, variable green leafy vegetables, walnuts)
• Eat fish, which are also high in omega-3 oils (salmon, herring, trout, sardines, caviar, mackerel, anchovies, albacore, and tuna)
• Consider supplementing 1 to 2 tablespoons of flaxseed oil per day or 1 to 2 teaspoons of salmon oil or cod liver oil per day

Protein

• Obesity is rare in hunter-gatherer societies that eat only meat and uncultivated vegetables, fruits, and nuts
• Those who eat very low calorie diets have double the protein requirement
• Not eating enough protein while dieting causes muscle tissue loss
• Protein has 30% to 40% more vagus nerve stimulating ability than carbohydrates or glucose. This results in satiety. This is also why it is easier to overeat starches and sugars than protein.
• Protein stabilizes sugar levels and curbs insulin levels
• Protein increases brain chemicals like serotonin which both calms depression, hunger, and makes you feel good
• Protein from animals is a good source of carnitine (the fat burner)
• Protein has shown to increase good cholesterol and protect the heart

Recommendations

• Use formula to calculate daily protein requirement
• Eat at each meal
• Stress, exercise, and dieting all increase the need for protein
• Remember to eat a small protein meal before bed to stabilize blood sugar levels while sleeping
• Increase your B-vitamins when taking in extra protein

Fiber

• Some examples that you may be aware of: chitosan, chitozyme, "the fat trapper"
• Effects in relation to weight loss: satiety, slows carbohydrate and fat absorption, slows gastric emptying, reduce calorie intake, decreases insulin spikes

Types of fiber

• Fibre types: soluble (psyllium husks) and insoluble (bran)
• Soluble types: pectin, gum mucilage, algal
• Insoluble types: cellulose, hemicellulose, lignin
• Soluble fibre linked with decreasing cholesterol, TAG, fat binding, lower blood pressure
• Insoluble fibre linked with fecal bulking and transit times
• Study: Guar gum most related to stabilizing sugar levels and weight loss. In one study 9 women lost an average of 9 pounds over an 8 week period taking 10 grams immediately before lunch and dinner
• Most studies with fiber on 1,200 to 1,600 Calorie diet with supplemented 7 grams of fibre
• Constipation: your body needs to clear toxins and move daily! Ideal weight-loss can't be treated unless constipation is treated first

Recommendations

• An absolute must for dieting and long term health
• Dietary recommendations 50 grams per day or greater!
• Fiber must be given for every meal, best source being from the diet
• Can supplement 1 tablespoon soluble fibre (flaxseed meal, psyllium husks) mixed in water and drink before every major meal followed by insoluble fibre after each meal to increase fecal bulking

Note: can cause gas and bloating so begin slowly taking 1 gram per meal and slowly increase to a level of comfort.

Water

• There exists a vital connection between drinking water and fat loss
• Food provides about 70% water, so you need to increase water if you plan cutting calories
• Remember that most fluid by body weight is found inside your cells where the burning of fats take place
• Water is you ally which can satisfy hunger and burn calories due to warming
• Water helps to wash out stored toxins and by products from the body
• Helps prevent constipation, maintain temperature control & normal blood pressure, and prevent sagging skin during fat loss
• An over weight person needs more water than a thin person due to having larger metabolic loads
• Most people are dehydrated: you need to lose about a half to one litre of fluid before you experience thirst

Recommendations

• Drink water 30 minutes before meals to decrease appetite
• Dose per day formula: your weight in pounds/ three, equals your daily water intake in ounces
• For every cup of coffee, pop, etc. drink double the amount of water to counter the effects of these beverages
• According to Dr. Batmanghelidj MD, your urine should always be: clear and light yellow in color

Exercise

• You need to move!
• Find your Biological Age
• Increased longevity occur after spending more than 2,000 Cal per week on exercise
• Walking uses about 300 cal/hour; high intensity exercises burn about 600 cal/h
• It has been calculated that you can lose 15 pounds per year by performing 30 minutes of aerobic exercise three times per week
• Studies show that exercise maintains long-term weight-loss!

The aspartame controversy

In a one-year follow-up of 78,000 women (aged 50 to 69) aspartame users were more likely to gain weight than in non-users. These results could not be explained by differences in food consumption patterns.

Source: Stellman SD et al. Artificial sweetener use and one-year weight change among women. Prev Med 1986;15:195-202.

Food Allergies and Obesity

If an allergic food is eaten several times daily, a masked or chronic allergic reaction may develop. This reaction is characterized by an improvement in chronic symptoms occurring immediately after food is eaten, followed by a progressive increase in symptoms after about 2 hours. Patients with masked allergies learn to avoid these reactions by eating at frequent intervals the foods to which they are allergic. Withdrawal symptoms may include a gnawing hunger sensation, nasal stuffiness, inability to concentrate, fatigue, sleepiness and nervousness. The foods these patients eat most frequently between meals are those which there is the highest incidence of sensitivity; namely, corn, wheat, and milk. As these foods are all high in calories, patients with food allergies may have great difficulty losing weight. However, avoidance of masked allergens is often followed by diuresis (excess urination), disappearance of swelling, decreased appetite, and sudden weight loss.

Source: Randolph TG. Masked food allergy as a factor in the development and persistence of obesity. J Lab Clin Med 1947; 32:1547.

Hormones and Metabolism

• Thyroid
• Growth hormone
• Testosterone
• DHEA

*A deficiency of any of these hormones will make weight loss more difficult. It is important to be appropriately assessed through standard blood tests & physical examination.

Sleep

• Hormones such as growth hormone, testosterone, erythropoietin are released mainly during deep sleep (stage 3,4)
• This hormones stimulate the body to heal and grow, and even lose weight!

Medications Which Cause Weight Gain

• psychotropic drugs: phenothiazines, antidepressants, tranquilizers
• hormones: estrogen (birth control pill, premarin), prednisone
• anti-arthritic medications (NSAIDs)

Summary

• Lower your intake of refined foods, especially carbohydrates with a high glycemic index (the strong insulin reducers). Remember that excess carbohydrates and starches turns into fat and cholesterol.
• Try to eat foods which are organic
• Incorporate protein into every meal: protein feeds the brain and stabilizes blood sugar
• Eat quality fats (from fish, nuts, seeds): people crave fats because they are missing the omega-3 fats their body needs. Remember that good fats stimulate metabolism (thyroid) and brown fats which makes you lose weight
• Do not eat a "fat-free" diet: the brain is the most dense source of fats in the whole body, so please don't deprive it. Remember, there is no culture in the world that has eaten a "fat-free" diet
• Focus on green leafy vegetables, tomatoes, celery, for every meal to ensure dietary fiber & minerals. Consider supplements (guar gum, chitosan) if necessary
• Drink water: remember your urine should be clear to light yellow in color
• Sleep: that's when fat burning hormones are released (growth hormone)
• Minimize aspartame: use stevia, erythritol, instead. If you are going to binge on sugar use honey/brown/cane sugar instead of white sugar!
• Minimize aspartame: use stevia, erythritol, instead. If you are going to binge on sugar use honey/brown/cane sugar instead of white sugar!
• You need to move (exercise): determine your biological age. Pick something you like. Anything is better than nothing: walking to the corner store for the paper instead of driving is a great start.
• Watch for food allergies and weight gain: foods that people are sensitive too are usually eaten most frequently, and have the highest calories
• Make sure your hormones are in check: thyroid, growth hormone, DHEA
• Remember that if these hormones are low, weight-loss is difficult
• Everybody take your multivitamin, B-complex , and chromium daily! It protects you from the biochemical hazards associated with dieting and also lowers insulin levels
• Check your medications or ask your doctor or pharmacist on which cause weight-gain
• Take the necessary vitamin/minerals to help combat the side-effects
• Don't rely on bathroom-type scales for monitoring weight-loss. Use fat, lean body mass measurements instead. Invest in a bioelectrical impedance scale (also known as a body-fat scale).
• Don't be in a hurry to lose weight. Effective weight loss is typically 0.5 to 1 pound per week. Quick weight loss can be stressful physically, emotionally, and mentally for most people. Stress ages you, and actually makes weight loss more difficult. Take your time.
• Eat a diet that is suited to your unique needs. Activity level, ancestry, stress level, present nutrient levels in your body and your biochemical individuality.
• Listen to your body, it will guide you the right way!

Eating Patterns to Optimize Weight Loss

• Chew your food slowly and thoroughly to ensure proper digestion (remember it also burns calories)
• Break from eating 3 major meals per day and increase to 5 or greater. Remember that eating frequently throughout the day stimulates brown fat production and also decreases insulin levels (no fat storage!).
• Eat in a relaxed atmosphere. Excess noise, stress, and emotional reactivity can significantly suppress digestion.
• Eat less concentrated foods first such as salads first, followed by more concentrated foods, such as cooked vegetables and grains
• Eat for the right reason - hunger. When upset, angry, bored, etc., do not try to use food to regulate your emotional response. Don't use food for emotional nourishment.
• Do not bring "junk" home. You will not eat it if it is not around you.
• Center your entertainment around activities other than food and eating. Exercise more, especially outdoors.
• Cultivate friendships with people who live healthfully. Supportive friends really help.