Loosing Weight Part One: Do Calories Matter?

This Post is the Transcript from the Video,

Do Calories Matter? Is a Calorie a Calorie? (Science of Weight Gain).   Here is the link https://www.youtube.com/watch?v=zcMBm-UVdII

Why does Bill Gates have so much money? Because he earned more money than he spent.

Why did Basketball Team X win the big game? They scored more points than Team Y.

Why is Pete fat?”

The typical answer is that more calories went in than out. Calorie counting may induce weight loss, but why would you care about that?

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Losing 10 pounds is great, but wouldn’t you want to know where that 10 lbs. came from?Was it bone, muscle or fat? Then, if it’s fat, which is what most of us want to lose, is it subcutaneous fat or visceral fat?

Pediatric Endocrinologist Robert Lustig points out in his book “Fat Chance” that several studies show that the amount of subcutaneous fat you have, the fat under your skin, correlates with increased longevity; Whereas visceral fat, the fat around your organs that gives you a big belly, promotes inflammation and causes several health detriments meaning the difference between dying early in your fifties or living into your eighties or longer. 

A pound of fat being 3500 calories is usually the piece of data we’re provided with to help us create our weight loss goals. For example if you create a deficit of 500 calories per day, then in a week you will lose a pound of fat. But why would the body choose to discard fat first when you restrict calories?

Decreasing your energy intake is interpreted by your body as you being in a situation where less energy (food) is available. Thus, it will do what it can to keep the stored energy it has and slow down processes that spend energy.

Muscle is a relatively energy expensive tissue while one of fat’s functions is to serve as a place for energy storage. So the body would want to preserve the fat and break down the muscle, to conserve as much energy as it can.And that’s what it does. Through a process called gluconeogenesis, “new glucose making,” muscle is broken down into glucose, which can be used for energy.

So now you have successfully reduced your weight by going into a caloric deficit, but now it’s even harder to maintain a caloric deficit and lose more weight because your resting energy expenditure is now less due to having lost muscle.

Jonathan Bailor points out in his book “The Calorie Myth” that “Studies show that up to 70 percent of the nonwater weight lost when people are eating less comes from burning muscle – not body fat. Only after it’s cannibalized this muscle will our body burn fat.”

So your calorie restrictive diet may actually reduce your weight as you intended, but the weight isn’t necessarily coming off from where you’d like it to, and this whole process becomes an uphill battle.

Restricting calories without modifying the composition of your diet will cause your body to lower energy expenditure and increase hunger to provoke you to get back to your normal energy intake.

“Eat less and exercise,” the typical advice for weight loss, is a strategy fueled mainly by willpower. Hunger and lowered energy expenditure is going to set you up to where the last thing your body wants to do is exercise.

Alright, maybe it’s more simple to look at how people get too fat in the first place. Surely to get fat, one has to eat too much. But what causes that excessive eating?

We have very sensitive receptors in our body that let us know when it is too hot, too cold, when we’re thirsty, et cetera. What would cause someone to eat past the point of satiety so much and so frequently that they become overweight or obese?

Of course small fluctuations in weight throughout the year is not unnatural. But when people get significantly overweight or obese over time through overeating, surely something is significantly wrong with the way their body processes food and the way their hunger and satiety receptors work.

So what “calories in calories out” isn’t explaining is why some people’s bodies will just raise energy expenditure in response to eating too much, keeping them thin while other people get fat. Just because you eat extra calories doesn’t mean they have to be stored, they could just be burned off automatically.

The medical journal QJM reports, “Food in excess of immediate requirements… can easily be disposed of, being burnt up and dissipated as heat. Did this capacity not exist, obesity would be almost universal.”

So why is it that obese people don’t automatically dispose of calories, experience intense lethargy, and have voracious appetites despite having massive amounts of energy available in the form of fat on their body?

What is particularly interesting about this is that the satiety hormone, Leptin, is secreted by your fat cells. So if we are to assume that a calorie is a calorie and the type of food you eat does not have any peripheral effects… like disrupting the hormonal environment of the body, then fat people should have less of an appetite than leaner people.

We would need to assume that all overweight people have something like a gene defect that screws up their hormones, leading to this dysfunctional situation where the brain is constantly being told to eat more food despite having plenty of stored energy available on the body.

Robert Lustig explains that only 2 percent of morbid obesity is explained by genes.

“Researchers worldwide have scanned the human genome and have identified thirty-two genes that are associated with obesity in the general population. Altogether, these genes explain a total of 9 percent of obesity. And even if one person had every single bad gene variation, it would account for only about 22 pounds –hardly enough to explain our current obesity pandemic.”

So when people get fat, they are of course for some reason or another, taking in much more calories than they need to.  But, their body for some reason chooses to use nearly all these extra calories for body fat accumulation at the expense of muscle.

Dr. Doug McGuff, emergency doctor and exercise expert said: “And I always had it in my head that the morbidly obese were probably pretty well muscled underneath all that because effectively they’re lifting weights all the time. But it’s not the case – their muscles are extraordinarily atrophied. Your external oblique muscle that ought to be you know as thick as a piece of steak, in these people it’s paper thin and stretched to the point of bursting. Because they are having nutrient partitioning that doesn’t allow energy to go anywhere but the body fat. So they are literally starving inside an encasement of blubber.”

A good example for understanding why the body uses calories in different ways is puberty: During puberty, young men and women develop bigger appetites, and that extra energy is put towards developing things like sex organs and making their bodies larger in general. But young men put on a lot of muscle during this phase whereas young women put on more fat. You might attribute this to the fact that young men are more likely to play sports, but the way fat is distributed is very different between the two genders.

Most guys are not gonna find their pants are getting tighter due to butt and hip fat. This is the effect of several hormones, particularly one named insulin. Insulin is an anabolic hormone – it’s known as the energy storage hormone, or sometimes the “fat storage hormone” – one of its jobs is directing how the food you take in will be stored. And, puberty is associated with a higher than normal secretion of insulin.

A very clear illustration of insulin’s fat accumulation abilities is the side effect some diabetes patients experience where they develop a mound of fat at the site where they frequently inject their insulin. This is called lipohypertrophy. So understanding how food affects hormones would be better for weight management than understanding how many calories are going in and out of your body.

Other than insulin, worthwhile hormones to look at are Leptin and Hormone sensitive lipase:

  • Leptin is the satiety hormone – if you have higher leptin levels and your brain has no problem reading these levels, then you feel “full”.
  • And, hormone sensitive lipase breaks down fat so it can be used for energy, this of course is important if you want to lose body fat.

 So the ideal situation is to have high levels of leptin so you are not hungry all the time, and you would want lower levels of insulin so your body doesn’t store too much energy, and you would want hormone sensitive lipase to be activated so it would break down body fat. Losing body fat while not being hungry would be the ideal situation, right?

The problem with calories in calories out is it doesn’t tell you anything about how to achieve this preferred hormonal situation. But, paying attention to how much of and what kinds of proteins, fats, and carbohydrates are in your meals will tell you much more about how your hormones are going to respond.

May you Live Long Healthy.

Yours truly,

Lydia Polstra

Email: lpolstra@bell.net

Facebook: https://www.facebook.com/2healthyhabits/

Blog: https://2healthyhabits.wordpress.com

Disclaimer: The content of this email or Post is not intended for the treatment or prevention of disease, nor as a substitute for medical treatment, nor as an alternative to medical advice. Use of recommendations is at the choice and risk of the reader.

I invite you to Follow my Blog, Facebook or be added to my email distribution list. My focus is to maximize my physical performance and mental clarity, body composition, and most importantly overall health with a wholesome diet and exercise. 

I will bring you compelling articles on Ketogenic and GAPS diets, the Super Slow High-Intensity Exercise Program and supplements.

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Reversing Type 2 Diabetes with Bariatric Surgery, Very Low Calorie Diets, and Carbohydrate Restriction: A Review of the Evidence

Type 2 diabetes (T2D) has long been thought of as a progressive, incurable chronic disease, largely because traditional means of treatment have had limited potential to reverse the disease.

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Newer research suggests reversal is possible through three methods: bariatric surgery, low calorie diets (LCDs), very low calorie diets (VLCDs) and carbohydrate restriction.

Sarah Hallberg, DO, MS of Virta Health recently published a review of 99 original articles examining the evidence for type 2 diabetes reversal using each of the three reversal methods. We have included the advantages and limitations of each summarized below.

Defining diabetes reversal.      We have defined reversal as maintaining an HbA1c below 6.5% without the use of glycemic control medications. Metformin was excluded from this criteria because it is not specific to diabetes.

Diabetes reversal intervention 1: Bariatric surgery:     The most commonly performed bariatric surgeries in the U.S. include laparoscopic and robotic Roux-en-Y Gastric Bypass (RYGB) or Sleeve Gastrectomy (SG). Anatomically, they both decrease the size of the stomach with RYGB also diverting the small intestine. Bariatric surgery has also been shown to cause alterations in GI hormone releases that may impact eating, hunger, and satiety as well as affect gut microbiota populations.

Advantages of bariatric surgery:

  • Unilateral improvement in glycemia following operation
  • High rates of T2D remission compared to the non-surgical groups
  • Three-year remission rates of up to 68.7% after RYGB
  • Rapid blood glucose improvements (within hours to days), which likely represents the enteroendocrine responses to altered flow of intestinal contents (i.e., bile acid signaling and changes in microbiota and their metabolome).

Disadvantages of bariatric surgery:

  • Surgery of any type can be associated with complications leading to morbidity or mortality. Complication rates have been stated to be as high as 13% and 21% for SG and RYGB, respectively.
  • Significant financial costs of an average of $14,389US.
  • Increased likelihood of long-term adverse events.Major adverse events included medication intolerance, need for reoperation, infection, anastomotic leakage, and venous and thromboembolic events.

Diabetes reversal intervention 2: Low calorie diets (LCDs).      Several studies have reported successful weight loss with decreased insulin resistance and medication use following a LCD or a VLCD.  Total calories per day in studies for VLCDs range from 400-800kcal.  LCDs range from 825-1800 kcal per day and the higher range has been shown to be significantly less effective. Research suggests that LCDs are effective in reversing diabetes in the short term (up to two years), especially in patients with a more recent diabetes diagnosis.

Advantages of LCDs:

  • Quick improvements in glycemic control.A low-calorie diet of 900 kcal, including 115 g of protein, led to significant improvement in glycemic control attributed to improvements in insulin sensitivity.
  • Effective in the short term.A VLCD and gastric bypass surgery were equally effective in achieving weight loss and improving glucose and HbA1c levels in obese patients with T2D in the short term. DiRECT (Diabetes Remission Clinical Trial), a community-based cluster-randomized clinical trial with 306 relatively healthy participants with T2D (given an 825 kcal/day formula for 3-5 months) found that at one year, 46% of patients met the study criteria of diabetes remission (HbA1c <6.5% without antiglycemic medications). This dropped to 36% at two-years.

Disadvantages of LCDs and VLCDs:

  • Overall difficult to sustain.In one study, weight loss persisted in the diet-treated patients only for the first three months, indicating difficulties with long-term maintenance. Other studies also reported similar pattern of early blood glucose normalization without medication use, but the improvements were not sustained long-term. One study showed that while a VLCD normalized glucose levels within a week; however at 12 weeks over a quarter of the patients had an early recurrence of diabetes with an average weight regain of 20%.
  • Requires substantial caloric restriction. A substantial level of calorie restriction is needed to generate enough weight loss to reverse diabetes. Short-term interventions with moderate energy restriction with metformin (which led to modest weight loss) were less effective in reversing diabetes than standard diabetes care.
  • Severe energy restriction may have negative long-term effects.Studies have suggested that the body undergoes physiological and metabolic adaptation in response to caloric restriction, and this may shift one’s energy balance and hormonal regulation of weight toward weight regain after weight loss.

Diabetes reversal intervention 3: Carbohydrate restriction:    Before insulin was discovered in 1921, low carbohydrate (LC) diets were the standard of care for diabetes. With the emergence of exogenous insulin, the goal became to maintain blood sugar control through the use of medications instead of preventing elevations in blood glucose by restricting carbohydrates in the diet. In response to recent studies, the idea of preventing blood sugar elevations with carbohydrate restriction has found its way back into the mainstream standard of care.

A low carbohydrate diet typically restricts carbs to less than 130 grams per day, and a ketogenic diet to 20-50 grams per day.

Advantages of carbohydrate restriction:

  • Highly effective.In our published trial providing significant support through the use of a continuous care intervention (CCI), we examined using a low carbohydrate diet in patients with T2D, compared with usual care T2D patients. At one year, the HbA1c decreased by 1.3% in the CCI, with 60% of completers achieving a HbA1c below 6.5% without hypoglycemic medication (excluding metformin). Insulin was reduced or eliminated in 94% of users. Most cardiovascular risk factors showed significant improvement. Improvements were not observed in the usual care patients. Another 34-week trial found that a ketogenic diet intervention (20–50 g net carbs per day) resulted in HbA1c below the threshold for diabetes in 55% of the patients, compared to 0% of patients in the low-fat group.
  • Does not require calorie restriction.Patients are instructed to carefully restrict dietary carbohydrates, eat protein in moderation, and consume dietary fats to satiety.
  • Sustainable with support. The one-year retention rate in our continuous care intervention was 83%, indicating that a non-calorie-restricted, low carbohydrate intervention can be sustained.
  • More cost-effective than bariatric surgery.
  • More effective than restricting overall calories.A study comparing a non-calorie restricted, very low carbohydrate (<20g total) diet to an energy-restricted low-glycemic diet in patients with T2D found a greater reduction in HbA1c, weight, and insulin levels in the low carbohydrate group. 95% of participants in the low carbohydrate group reduced or eliminated glycemic control medications, compared to 62% in the low glycemic index group at 24 weeks.A small (34 participants) one-year study of an eat to satiety on a very low carbohydrate diet compared to a calorie-restricted moderate carbohydrate diet found a significant reduction in HbA1c between groups, favoring the low carbohydrate group.

Disadvantages of carbohydrate restriction:

  • Often requires support. Many of these trials included an educational component, and determining the appropriate method of support may be key to the overall success with disease reversal.
  • Results are promising, but longer-term follow-up studies are needed. Follow up studies have shown sustainability at two years, so longer-term studies are needed to determine the sustainability beyond that.

This Post has been condensed from Reversing Type 2 Diabetes with Bariatric Surgery, Very Low Calorie Diets, and Carbohydrate Restriction: A Review of the Evidence

Sarah Hallberg, DO, MS on April 8, 2019. Please copy and paste this link into your search bar  https://blog.virtahealth.com/reversing-type-2-diabetes-bariatric-surgery-low-calorie-diets-carbohydrate-restriction/

I invite you to Follow my Blog, Facebook or be added to my email distribution list. My focus is to maximize my physical performance and mental clarity, body composition, and most importantly overall health with a wholesome diet and exercise.

 I will bring you compelling articles on Ketogenic and GAPS diets, the Super Slow High-Intensity Exercise Program and supplements.

To follow my Blog, please click the Follow button to receive an email when the next posting is available. Hint: You may have to click the Accept and Close button before follow is available.

I thrive on feedback. Please let me know you are interested in the content by clicking Like, Commenting or sending me a message or email about the Post.

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May you Live Long Healthy.

Yours truly,

Lydia Polstra

Email: lpolstra@bell.net

Facebook: https://www.facebook.com/2healthyhabits/

Blog: https://2healthyhabits.wordpress.com

Disclaimer: The content of this email or Post is not intended for the treatment or prevention of disease, nor as a substitute for medical treatment, nor as an alternative to medical advice. Use of recommendations is at the choice and risk of the reader.