CFL NUTRITION SEMINAR: WEIGHT

LOSSPRESENTED BY COLLIN J. POPP

October 4, 2012

What are we recommended to eat?

Time Magazine, September 2011

Nutrition Guidelines

Began in 1980: Food Guide Pyramid

Nutrition Guidelines

MyPyramid 2005

Nutrition Guidelines

MyPlate 2011

Do we see huge changes in nutrition recommendations over

the last 30 years?

What do you think?

Are we a healthy nation?

“F” as in Fat Report 2012 Adult obesity rose in 16 states over the

past year (2008-2010 data). No decreases.

12 states have obesity rates over 30%. Mississippi highest (34.4%); Colorado

lowest (19.8%). Obesity related diseases: diabetes, heart

disease, hypertension, cancer still high. 2030? Obesity rates will reach 44%, and in

13 states it will be over 60%!

Trends in Obesity

Nutrition Science Initiative

Trends in Diabetes

Nutrition Science Initiative

Trends in Childhood Obesity

Nutrition Science Initiative

Side Effects Angina (Chest pain) Inflammation Cancer Hypertension Joint pain Heart Attack/Stroke Amputations Blindness Pre-mature Death Mental Health

Side Effects

But… Obesity and obesity-related diseases

can be prevented and reversed! Best method?

CHANGE IN LIFESTYLE!!!

Are the current recommendations correct?

Evidence Report NIH 1998

In 1995, the NIH convened the first Expert Panel on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults to develop clinical practice guidelines for primary care practitioners.

What do they recommend?

Treatment of Overweight/Obesity ≥ 55% energy from carbohydrates ≤ 30% energy from fat Roughly 15% energy from protein

CHOFATPRO

What are we currently told? CDC: “you must use up more calories

than you take in… since one pound [of fat] equals 3,500 calories reduce 500-1000 calories per day to lose 1 to 2 pounds per week.”

Mayo Clinic: “when it comes to weight loss, it’s calories that count.”

What are we currently told? NIH Weight-control Information Network:

“to lose weight you need to take in fewer calories than you use.”

ADA: “you must eat or drink fewer calories than you body burns off.”

“Eat less, exercise more.”

The issue?

Recommendations are for general population.

Calories, calories, calories. Eat less, and exercise more! Too general! If it’s that simple why are we continuing

to gain weight? Why do people struggle with weight loss? Why are we sick?

What do clinical studies show?

Low-Carb, High Fat (LCHF) vs. Low-Fat, high Carb (LFHC) diets.

Randomized, controlled—not observational.

Challenging conventional wisdom

Just because it’s popular belief does not mean it’s true.

Low-carb Diets

Yancy et al., 2004: 7-8 months LC (<20% CHO/day) lost 20.7 lb. LF group lost 10.58 lb. LC group: serum Triglycerides, HDL

Krauss et al., 2006: in absence of weight loss LC improve antherogenic lipid status.

Brehm et al., 2009: 4-6 months eating LC (<20% CHO/day) lost 13.16 lb. LF group lost 7.12 lb.

A to Z study: Weight loss

4 “fad” diets Atkins: low carb + high fat/protein Zone: 40/30/30 Ornish: low fat; at high carbs- as much

as you want LEARN: health-professional diet- low-fat

A to Z study: findings

Low-Carb, Low-Fat and Mediterrean Diet

Why do low-carbohydrate, high fat diets work?

Terms…just so you know

Insulin: storage hormone; fat synthesis; insulin resistance; anabolic

Glucagon: release stored energy; inhibit fat synthesis; high in fasted state

Leptin: decreases appetite; obese are leptin resistant

Other shifts in metabolic hormones & substrates based on diet.

Reasons for Low Carb

Low insulin response High glucagon Increase satiety (leptin) Lower GI/GL Increase MUFA/PUFA Increase weight loss + fat loss Structuring our body’s energy production

around “fat burning” rather than “sugar burning.”

Why fat is better?

Stores more energy Efficient fuel Preferred fuel in every day situations Quick to mobilize Need machinery to use it

Becoming Keto Adaptive on Low Carb Ketone bodies: byproducts of fat

metabolism Keto adaptive vs ketosis vs ketoacidosis What are the benefits?

Brain fuel, ROS, insulin sensitivity, protein sparing, better recovery, improve body composition

Any side effects?Initial: fatigue, headache, alcohol breathe

Conclusion

Short-term (4-8 months): LCHF diets are effective and safe for weight loss.

Long-term(>12 months): Effective but weight regain occurs over the long-term.

Keto adaptive is beneficial.

Now…time for the good stuff!

Steps for change

Step 1: Evaluate Lifestyle Step 2: Strengths + Weaknesses Step 3: Implement change Step 4: Success + Evaluate what works

(and doesn’t work) Step 5: Continue Awesomeness

Lifestyle Checklist for weight loss Look at 5 things:

NutritionSleepExerciseFamily/work/socialPsychology/Emotional

Weight loss is a team effort– trainers, family, friends, doctors and therapists, etc. Just find the right ones!

Nutrition: Tips and Tricks

Paleo/LCHF50-100g of carbs/day

Learn to cook/make your own meals!Family cooking

Eat Whole FoodsBag, box? More than 5

ingredients?

Paleo

What does a 100g Carb day look like?

Food CHO (g)

1 kiwi 5.4

½ cup blueberries 10.0

2 tbsp salsa 2.0

1 cup broccoli 11.2

1 cup kale, steamed 7.3

1 cup apple suace 28

½ cup sweet potatoes 18.7

1 cup green beans 9.8

Total: 92.4 g

Nutrition: Tips and Tricks

Shop the perimeter of grocery store

Nutrition: Tips and Tricks

Eat every 3-4 hours Intermittent fast (IF) Don’t drink your meals

No fruit juices, sports drinks, diet pop, skim milk

Fish Oil: at least 2g DHA/EPA per day7g of standard fish oil or 2-3 g concentratedHigh-dose: increase weight loss

○ I recommend at least 10 g per day; cycle for 4-6 weeks

Read a Fish Oil Label

Fish Oil 1: Good or Bad Fish Oil?

Read a Fish Oil LabelFish Oil 2: Good or Bad Fish Oil?

Read a Fish Oil Label

Fish Oil 1: One soft gel= 1,000 mg fish oil (or 1g). EPA= 180mg; DHA = 120mg2g EPA/DHA recommendedLet’s look at DHA specifically so use (.120g

=120mg)So… 2g/0.120g DHA = 17 soft gels!

Fish Oil 2: 4 capsules = 4,000 mg (or 4g). EPA

=1600mg; DHA =800mg.So…2g/.800g = 2.5 x 4 = 10 capsules

Fish Oil 1: Fish Oil 2:

Nutrition: Tips & Tricks Eat slowly and stop at 80% full Include protein dense foods with each meal Consume 1- 2 vegetables with each meal Eat diary if you tolerate it—if so, go full-fat. Fat: eat it!

Avocados, olive oil, nuts (once/day), animal fats, bacon (mmmm), cheese, grass-fed butter, ghee.

Put into Practice

Time course:Today: evaluate lifestyleNext 2-3 weeks:

○ Educate yourself: books, blogs, websites○ See doctor- blood work: fasting insulin,

Hba1c, Lipid panel (esp. apoB and small-dense LDL), CRP, kidney & liver, Vitamin D, calcium

○ % body fat + Lean Body Mass- get checkedSee me!

○ Paleo + LCHF: 4-6 Months

Nutrition: Things to Avoid Do not consume the following:

Sugar, brown sugar, sugar cane, HFCS, honey, maple syrup, etc.

Anything label “enriched,” “low-fat” or “reduced.”Eating outArtificial Sweeteners: Splenda, Sweet n Low,

Equal (Aspartame)Grains: whole grains, cereals breads, muffins,

scones, cookies, baked goods, even gluten-freeLegumes: beans, peanuts, soyAlcohol: all forms (except wine & 100% agave

tequila)Vegetable Oils: canola oil, rapeseed oil.

What foods should I buy?

Proteins

Grass-Fed red meat Wild Game: bison, elk, deer, bear Salmon (wild) Eggs (cage-free, free-range) Chicken, duck, wild turkey Plain Greek yogurt, cottage cheese (full

fat), coconut milk yogurt

Vegetables

Spinach, Kale (all kinds), mustard greens, collards

Tomatoes, peppers, cucumber Cruciferous vegetables (Broccoli,

cabbage, cauliflower) Brussel Sprouts, mushrooms Tubes/Root Vegetables*: parsnips,

turnips, sweet potatoes, beets, carrots

Fruits

Raspberries Blueberries Blackberries Kiwi Oranges (whole) Cantaloupe

Fats

Extra virgin Coconut oil Palm kernel oil Avocados Extra virgin olive oil Fish oil (EPA/DHA) Flax seeds (ground) Raw, mixed nuts & seeds Hidden fats in fish/meats

Liquids

Coffee (black preferred)

Tea – no sweetener

Water Alcohol - leave it

to a minimum

Design the Right Meal

Step 1: pick a proteinLean/fatty cut? Fish?

Step 2: pick 1-2 vegetables Step 3: pick your fat

Avocado? Cooking oil? Step 4: pick your Liquid Step 5: grub!

Lifestyle Checklist for weight loss Look at 5 things:

NutritionSleepExerciseFamily/work/socialPsychology

Exercise: Fuel to Perform

Idea “Burn Fat during Exercise” – needs to be forgotten (one exception)

Fuel to perform—body prefers CHO at high intensities (no oxygen around)

“Anaerobic state” Eat CHOs around your workout.

Fruits + VegetablesPre-WOD honey/applesauce

Exercise as a Tool

Wellness and weight loss tool. Functional, constantly varied

movements. CF + nutrition = (fast) results “Cherry-picking” workouts

If you suck at something, continue to do it.

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Websites to Visit…

Mark’s Daily Apple – Mark Sisson

Livin’ La Vida Low Carb – Jimmy Moore

Wellness Fx

Mother Nature Obeyed – Chris Masterjohn

Paleo Solution- Robb Wolf

Chris Kresser – Chris Kresser

Whole 9 Life- Dallas & Mellissa Hartwig

Paleo Physicians Network

Ground Up Health – Collin Popp

Overall: Weight Loss Keys Evaluate lifestyle Paleo + LCHF Keto adaptive Avoid sugar, grains, legumes, processed

crap Exercise as a tool Constantly varied, functional diet!

If you eat crap, your body will turn into crap. Don’t turn into crap!

Questions???

Works Cited Yancy et al. “A low-carbohydrate, Ketogenic Diet versus a

low-fat diet to treat obesity and hyperlipidemia.” Ann Inter Med. 2004, 140: 769-777

Krauss et al. “Separate effects of reduced carbohydrate intake and weight loss on atherogenic dyslipidemia.” Am J Clin Nutr 2006, 83(5):1025-1031

Brehm et al. “A randomized trial comparing a very low carbohydrate diet and a calorie-restricted low fat diet on bdoy weight and cardiovascular risk factors in healthy women.” J Clin Endocrinol Metab. 2003;88:1617-1623

Gardner et al. “Comparison of the Atkins, Zone, Ornish and LEARN diets for change in weight and related risk factors among overweight premenopausal women.” JAMA 2007; 297:969-977.

Shai et al. “Weight loss with a low-carbohydrate, mediterranean or low-fat diet.” N Engl J Med 2008;359: 229-241.