Reversing Obesity, Optimizing Weight Loss

While speaking to the ~ 5,000 physicians at the AAFP’s annual scientific meeting this week on obesity and weight loss, I made the point that our national obesity crisis impacts not just our health, but also our national budget, and the bottom line of every company’s medical insurance plan. Wake up America, we are losing the battle of the bulge!

While weight loss medications might provide short term weight loss and rarely cause  heart attacks and strokes, and while very expensive weight loss surgeries have been shown to work long term but have significant side effects, we are not using truly effective lifestyle interventions (diet and exercise) that are shown to really work. See my Weight Loss Plan for details. 

For people who fail appropriate attempts at weight loss through healthy eating and regular exercise, treatments and testing that need much more research and attention are detoxing and genetic testing.

Detox for Weight Loss

When people lose weight, they have the potential to release large quantities of stored pesticides and chemicals from their fat cells into their blood stream that adversely impact their ability to burn calories. This stops further weight loss and promotes rebound weight gain. Detoxing, to remove these chemicals as they are released during weight loss programs, may become the next critical step for successful weight loss. See my discussion on detoxing for details.

Encourage Genetic Testing for Customized Weight Loss Plans

If you aren’t succeeding with weight loss, perhaps you are trying the wrong diet. Results from recent weight loss interventions that included genetic testing show that some patients should follow a Mediterranean Diet, some a low-carb diet, and others a low-fat diet. Everyone is not created equal and it doesn’t make sense that everyone should be following the same eating plan. We have noticed excellent results using customized genetic testing (see www.Pathwayfit.com for details). I’ll discuss NutriGenomic Testing in more detail with a later post.

Of interest, at last week’s scientific assembly of the American Academy of Family Physicians (AAFP), I would estimate that these physicians (and physicians at the twenty 0ther medical meetings I have attended over the last year) have the same problems with weight control as average American men and women, with 1/3 appearing normal weight, 1/3 overweight, and 1/3 obese. Physicians need help with this crisis, too, which is a very clear sign to me that the standard weight loss recommendations that most doctors are using today don’t work.

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Build Muscle Mass

Muscle definition makes you look fantastic, and muscle mass is also essential for long term health. Muscle is made of protein and proteins are made from specific combinations of amino acids, just like words are made from specific combinations of letters. Muscles store amino acids like we store money in the bank. The body uses these amino acids to fight infections, heal and repair tissues, and burn calories, even when resting.  Thus, muscle plays a key role in making you trim and fit. It should not surprise you that your muscle mass is one of the best health predictors of living independently into your 80s and 90s in good health.

Keep in mind that 10% of your muscle mass breaks down and rebuilds every day. To build muscle mass, you need more building than breaking down. After age 30-40, most people lose 1% of their muscle and replace it with 1% more fat every year; in essence they are shifting from free range lean to prime cut fat.

Eating protein also makes you feel full and satisfied, so one strategy to eating less without being hungry means eating more lean protein.

Unlike fat, muscles burn calories even when at rest. Increase your muscle mass by one pound and maintain it for one year, and you burn an extra 40 kcalories every day. At this rate, you burn an extra 14,600 kcalories yearly and if everything else stays the same, you would lose 4.2 pounds of fat—roughly the size of a football.

How to Build Muscles:

  1. Get the right amount and the right type of amino acids.
  2. Stress your muscles to grow, otherwise you convert protein intake into fat.
  3. Limit inflammation, as inflammation breaks down muscle tissue.
  4. Balance your hormones to ensure muscle growth.

Plus there are some finer take home points that I’ll share to optimize your success. Tips that clarify what type of amino acids work best, when to ingest amino acids in relation to exercise, and what type of exercise to do.

How Much Protein Do You Need?

Scientists have studied how much protein muscles can absorb with different forms of activity. Keep in mind 2.2 pounds (lb) = 1 kilogram (kg)

  • The average person who is active for 30 minutes 3-4 days per week, needs 0.8 grams of protein / kg of body weight / day (~0.37 grams of protein per lb of body wt /day)
  • If you exercise 5-10 hrs/wk you need 1.0 gm/kg of body weight/day (0.45 gm protein /lb of body weight /day)
  • Athlete (10-20 hrs/wk intense activity)

– Endurance training athlete (e.g., long distance runner) = 1.2 gm/kg/day

– Strength training athlete (e.g., serious weight lifter) = 1.8 gm/kg/day

– Athlete with 2-3 intense workouts/day (e.g., collegiate football training) = 2.0 gm/kg/day

Here are a couple of examples:

John exercises 8 hours per week and weighs 154 pounds (70 kg). John’s muscles need about 1 gram/kg/day of protein, which is 70 grams.

Jill is a cross country runner, exercising 12 hours per week and she weighs 122 pounds. At 55.5 kg x 1.2 gm of protein/kg/day, she needs 66.5 grams of protein daily.

What Type of Amino Acids Do You Need to Build Muscle?

Muscle needs branched chain amino acids plus glutamine for optimal growth. Both whey and soy protein are rich in branched chain amino acids, making them popular for building muscle mass. Glutamine is more expensive to add, so many supplements don’t provide it.

When to Add Protein with Exercise?

Before a workout, you need a healthy mix of proteins and carbs, plus a little fat. The carbs give you energy for the workout, plus carbs cause insulin levels to rise and an appropriate insulin surge helps to build muscle as well.

The key take home point is that on strength training days (preferably 2-3 days per week) when you stress your muscles to exhaustion, drinking 15-30 grams of protein within 30 minutes of finishing your work out decreases muscle breakdown and accelerates muscle building.

If you have more than 30 grams of protein after a workout (for most people 20 is the maximum they can use), you convert the extra protein into fat. I have searched all over for an excellent quality protein powder. My favorite to date is from Xymogen and is called fitfood LITE whey protein. It tastes great, has 190 calories, comes with 7 grams of healthy fiber, 21 grams of premium New Zealand whey protein, and this includes nearly 4 grams of glutamine and 4 grams of branched chain amino acids.

Strength Training: The Secret to Shaping Up

We all want to feel good in our clothes and look great. Strength training can slim you down and bring back the muscle tone of younger years. But if you eat protein and don’t stress your muscles, you just turn the protein calories into fat.

For details on my Age Busting Fitness Program, refer to Chapter Six in Ten Years Younger. In brief, you need to lift a weight no more than 12-15 times before your muscles are exhausted to add enough stress for them to build (lifting a weight 50 times helps to tone muscles, but doesn’t stress them to the point they are programmed to grow). If you can’t lift a weight at least 8-10 times, then the chance for injury is too high. Somewhere between 8-15 lifts seems ideal with 2-3 sets of those motions. You can use weights, weight machines, elastic bands, or even your furniture. The key is to push your muscles with full, smooth and steady motions.

If you have never done strength training, then likely you would benefit greatly from working with a trainer, even if it is for only 2-4 sessions to get started. Or, for help getting started, set up a coaching session with my Ten Years Younger Coaching Team.

Limit inflammation

When you are inflamed, you tend to lose muscle and grow fat. A simple blood test to measure inflammation levels is a blood test called high sensitivity C Reactive Protein (hs-CRP or cardio-CRP). A good hs-CRP level is <0.5, normal is <1, elevated is 1-3, and > 3 is  considered high risk for a cardiovascular event.

What are steps to lower hs-CRP levels and inflammation?

  • Avoid refined carbs (sugar, sweets, products made from flour, corn syrup), especially important if you have elevated blood sugar levels.
  • Avoid bad fats (saturated fats from fatty meats and all dairy fat, plus trans or hydrogenated fats).
  • Work out 5-6 days per week for 30-60 minutes.
  • Enjoy 1-2 grams of fish oil daily from cold water small mouth fish or a supplement.
  • Eat more fruits and green leafy vegetables.
  • Keep your body fat below 22% (~ BMI under 22) since fat cells release compounds that increase inflammation.

Balance your hormones to ensure muscle growth

Cortisol is a hormone that breaks down muscle, releasing amino acids into your blood stream for repair and fuel. Testosterone is a hormone that helps you build muscle during strength training exercise.

Several factors cause cortisol levels to be high:

Several factors cause testosterone levels to be low:

  • Surgery that removes the ovaries in women (commonly causes a significant abnormal drop in testosterone)
  • Andropause in men
  • Occasionally, menopause in women
  • Obesity (fat cells actually convert testosterone into estrogen, which is one of the reasons men tend to grow breast tissue when they are overweight)

If you suspect either high cortisol or low testosterone levels, then talk to your medical provider about testing.

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Succeed with Weight Loss

Tips to Ensure Your Weight Loss Success. Obesity is an epidemic with expanding waistlines resulting in medical complications that threaten to bankrupt our national budget.

I’ve helped hundreds of patients lose weight, typically 20-30 lbs, but up to 100 lbs of weight loss—no medications or surgeries required!

Here is my outline to successful weight loss:

PLAN A: Most of my patients are able to lose 20-30 pounds following these simple steps

  1. Enjoy real food
  • Choose foods with low calorie density
  • Select foods that provide satiety (they quench your hunger)
  • Stop eating processed food

2.  Burn calories with aerobic exercise

3.  Build muscle mass

4.  Get enough sleep

5.  Meet your nutrient needs

6.  Take supplements that enhance weight loss

If you need help with the details, the I’d strongly encourage you to read Ten Years Younger and/or call for exercise and nutritional support with our coaching program.

PLAN B: Despite the best plan, some people are resistant to weight loss. Either the pounds don’t melt away, or they re-gain the wright they’ve worked so hard to lose. Typically they have one of the following issues holding them back:

  1. Genetically unique dietary needs. The good news is that we now have NutriGenomic (Nutrition-Genetic) testing to help clarify whether people do best with low fat or low carb diets. This same test provides insight into hunger, snacking, satiety, and the tendency to grab food in front of you. Identifying your unique features and designing a plan specifically for you has been shown to markedly improve weight loss success in clinical studies. Contact the Masley Optimal Health Center if you would like to consider NutriGenomic testing (~$400), see www.pathway.com for details.
  2. Low metabolism Some people burn very few calories at rest (they have a low basal metabolic rate, BMR). They have to diet just to maintain their weight. The first step is to test their BMR.  If in fact they do have a low BMR, the trick is diagnosing its cause and fixing it. The first step in answering this question is to measure your body composition with bioelectrical impedance (very accurate & least expensive) or with a DEXA scan.
  3. High levels of unmanaged stress Many people with high levels of unmanaged stress find they can’t lose weight. Ten Years Younger provides detailed information on soothing your stress, so don’t miss Chapter 6 if this applies to you.
  4. Chemical toxins Some people have high levels of toxins. Every time they lose weight, their fat cells release stored toxins into their blood stream slowing metabolism, causing inflammation, and increasing fatigue. The first step should include measuring for heavy metal toxins, and the second would include following a detox program to help remove toxic loads. See Ten Years Younger Detox chapter for details.

PLAN MD:

  1. If you have sincerely tried plans A and B without success and you also have medical problems (not just cosmetic issues) that are worsened by excess body weight, then it is time to talk to a physician about additional weight loss therapies, which might include medications or surgery to ensure you lose weight and keep it off.
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