1. Misconceptions and Correct Practice Jen Day PhD, RD, CPT

2. Defensive Approach to Weight Loss
“CUT CALORIES”
Weight maintenance:
calories in = calories out
Weight loss:
Calories in < calories out
Must be the best way to lose weight, right?
WHY NOT?
Most weight loss programs focus on:
low calorie diets OR
Reduction/elimination of carbs or another major food group

3. Danger of low calorie diets
What is the weight that is being lost?
Fat? Muscle? Water weight?
Usually all three in low calorie diets
Why would it be bad to lose all three?
Is this sustainable?

4. How do low calorie diets alter metabolism?
SLOW IT DOWN
Basal metabolic rate (BMR) or your metabolism is directly tied to how much lean body mass (LBM) an individual has
Big part of this is skeletal muscle
Skeletal muscle is highly metabolically active
Big calorie burner

5. Drop calories too low, lose LBM, slow down metabolism
Can’t rely solely on the weight on the scale
Important to have body composition assessed

6. How do low calorie diets alter metabolism?
Example:
“Jan” starts a low calorie diet with 100 pounds LBM
BMR is 1500 calories
After a low calorie diet , Jan lost 32 pounds really fast!
20 pounds fat and 12 pounds LBM
LBM was 100 pounds, now it is 88 pounds
Looks good on the scale!
Due to muscle loss, BMR dropped to 1200 calories
When go off diet and eat more than 1200 calories the body is going to store it

7. Danger of low carbohydrate diets
People lose weight quickly on these diets
Dropping muscle and water weight
SLOWS metabolism
Easy to gain weight back
Puts you in a state of ketosis
Not sustainable
Really low in grains and fruits
Fiber/antioxidants, vitamins and minerals
Increases acidity in the body
Brain and muscle require glucose -> best from carbohydrate
(shouldn’t be in state of ketosis longer than 4 months)

8. Trending Diets Most popular diets: Low calorie
(<1200 kcals per day)
Low carbohydrate/Keto diet/paleo
Medifast
Whole 30
After discussing the defensive route to weight loss, what would be the pitfalls of these diets?
Medifast ( kcals per day, buy their food)
Whole 30
Reset gut, not for weight loss, taking out allergens, adding things back in slowly to test response
Used too long and past what it was intended for

9. Proactive Approach RAMP UP YOUR METABOLISM
Eat every 2-3 hours
Protein with every snack and meal
Resistance Training
Cardio
Slower weight loss typically via this method
WHY?

10. Eating to Increase Metabolism
Common scenario
“Jan” is trying to drop a few pounds
She skips breakfast and has a salad for lunch
feels like she is being very “healthy” for the day
Trying to limit their calories
Upon returning home after work, Jan is starving and overeats
The body has been in a state of starvation all day
Stores the excess calories as fat to survive the next day of starvation

11. Eating to increase Metabolism
Ate breakfast -> felt more hungry the next few hours?
That is your metabolism WORKING
If you feel yourself getting less hungry throughout the day -> metabolism is SLOWING DOWN
By eating regularly, the body knows it will receive the calories it requires -> doesn’t hang on and store calories to survive the next day
Easier to lose weight

12. Eating to increase metabolism
The more often you eat, the more calories it costs the body to digest the food
Thermic effect of food
Regulates blood sugar
Avoid lows -> cravings
Avoid peaks -> excess blood sugar is stored as fat

13. Eating to increase metabolism
Pair protein with carbohydrates
Shuts down appetite and promotes feeling of fullness
Protein has a higher thermic effect of food
35/45/20

14. Resistance Training to Increase Metabolism
LBM is directly tied to BMR
Increase muscle –> increase metabolism
2 day calorie burn
Slight calorie deficit + 2 day burn and muscle building = increased metabolism and fat lose

15. Cardio Training to Burn Fat
Karvonen Method for target HR zone
60-75% of heart rate reserve
Should be able to carry on a conversation
Aerobic-> fat as fuel
20-30 minutes AT LEAST 3 days a week (minimum)

16. Weight Loss Wrap Up Offensive approach Why avoid defensive approach?
Maintaining or increasing LBM
Slight calorie deficit
Eating every 2-3 hours
Protein paired with carbohydrates
Resistance training
Cardio in HR zone
Why avoid defensive approach?

17. Questions to ask: Can I do this for the rest of my life?
Am I being defensive in my weight loss or offensive?
Is this realistic?
Real food from local grocery store
Workouts that can fit in everyday life
Do I feel better or worse?
Ramp up metabolism or slow it down?

18. Benefits of 5-10
Misconception that a “lot” of weight needs to be lost for health benefits
Deters people from starting a weight loss program
Losing 5-10% can greatly improve overall quality of health

19. Benefits of 5-10% weight loss
Increases “good” HDL cholesterol
Increase by up to 5 points,
lowers the risk of developing heart disease
Lowers Bblood pressure
Decrease triglycerides by 40/50 mg/dl
Substantial drop
Drop even further when paired with exercise
Triglycerides are fat-like particles in the blood that are harmful in elevated amounts -> high triglycerides are at higher risk for heart attacks and strokes

20. Benefits of 5-10% weight loss
Fat cells, especially abdominal fat produce substances that cause inflammation in blood vessels
Lead to clots
10% weight loss -> substantial drop in inflammatory substances circulating

21. Benefits of 5-10% weight loss
Lower A1C
Increases insulin sensitivity
change diabetic diagnosis
Improve sleep apnea
Weaned from CPAP
Figure 1. Adapted from van Kruijsdijk et al, 2009 [6]. In obesity the hypertrophic and hyperactive adipocytes initiate the production of MCP-1, which attract macrophages into the adipose tissue, increasing proinflammatory adipokines production (mainly TNF-α) and decreasing adiponectin production, leading to insulin resistance and inflammation. The weight loss process revert this alterations, improving insulin resistance and inflammation. FFA: fatty free acids; PAI1: Plasminogen activator inhibitor 1; TNFα: tumor necrosis factor-α; MCP1: monocyte chemoattractant protein 1; IL6: interleukin 6.
The link between excess weight and sleep apnea is well established. People who are overweight have extra tissue in the back of their throat, which can fall down over the airway and block the flow of air into the lungs while they sleep.