Nutritional Medicine , Separating Fact from Fiction
Update on the FODMAP Diet and lack of evidence for its use
Update on the FODMAP Diet and lack of evidence for its use
Weight Plateaus are those frightful, bothersome states of metabolic stagnation that occurs smack dab in the middle of a successful weight loss plan. Even if expected, plateaus are cause for discouragement, feelings of failure and a desire to “give up”.
No, no need to give up. Let’s look at some game changers for those plateaus
At the bottom of this physiological storm is that of survival. In a plateau the body is fighting to stay alive, so it lowers its metabolism to match the calories being given it. Yes, it defeats the purpose but the body is just trying to save its own life by this metabolic shift. The question(s) then become the following:
Plateau Interventions, What Should be in Your Toolbox????
Meal Plan Manipulations
Keep the Food/Symptom Diary again if you are not still doing it. Sometimes, as the same old regimen is repeated, boredom slips in. Calories begin to creep back in, portion sizes aren’t watched like they used to be. Go back to the basics: weigh, measure and revisit portion sizes and food choices.
Intermittent-Fasting Routine: For this plateau buster, the weight loss is facilitated by moving calories. For 2-3 days either a very low calorie diet (800 calories) or a fast can be chosen to throw the body’s expectations off. Do this for two days then go back on your meal plan for 3 days and then fast or follow a very low calorie diet on an every- other- day basis. There are various renditions of this manipulation. Now, hunger is still a problem with this type of plan unless your fasting days take you into ketosis. Not appropriate for diabetes.
Fasting is associated with increased ghrelin and decreased obestatin in the blood circulation. Specifically these naughty hormones are ghrelin and obestatin. Both hormones play intricate roles in playing with our regulation of diet induced thermogenesis,
Calorie-Restricted Adequate Nutrition (CRAN): This meal plan, originally developed in life- extension research, was found to be effective at keeping the body lean and mean, but it is not practical to live on such small amounts of food with supplementation for extended periods of time. These human studies continue, but now the rage is to look for CRAN mimetics that make life more livable. However, short term use can blast a hole in a plateau!
Macronutrient Manipulation: Take your meal plan and flip flop it. For example, low carbohydrate high protein for one month may be different. Some meals will be turned from a meat based to a vegetarian based or from a regular carbohydrate diet to a low glycemic carbohydrate, high protein diet. Again, your body is fooled for a bit.
Then, don’t forget the little plateau “busters”: a) drink 8 oz. glass of water or sugar free beverage prior to a meal; b) achieve adequate hydration, but not too much – 1 ml per kcal or 8 glasses per day and consume high water foods such as melons, hot cereals; c) keep your sodium to the recommended level of 2,300 mg. sodium/day or higher if exercise requires it.
Exercise and Lifestyle
Change Your Workout Routine: Keep your metabolism guessing! Here are some guidelines creating new work-outs for your toolbox. Have fun with the following ideas!
Redesign your old work -out program by changing one or more variables – frequency, intensity, duration.
FREQUENCY: Change the number of times you do a work out per week
DURATION: Change the length of time you do a specific workout
INTENSITY: Increase your target heart rate for 20 minutes of the cardio portion of the routine
Add Yoga or Tai Chi to your routine – pay attention to breathing exercises and isometrics
Use Video exercise programs to increase compliance
Try to get fresh air and walk daily!
Remember to adjust your fluid and meal intake to the type of sports you are in – professional athlete vs. weekend warrior.
Get in touch with your hunger signals again and what that feeling is like.
Plan ahead for parties and social events.
Where’s the Pill?
A pill is not our long-term answer. Short-term like in Breaking a Plateau, it is reasonable.
And, our top contenders for Thermogenic Aides are:
Green Tea: This herb has been used medicinally for a very long time. Studies have shown that green tea can help reduce obesity when consumed on a daily basis. I seems to work by increasing metabolism after eating. Green tea may also reduce the appetite, fat absorption and storage. To break a plateau, drink 6 0z of caffeinated green tea 3x per day until weight loss established again.
The chemicals responsible for green teas effect on weight are primarily from ECGC, catechins and polyphenols
Green Tea should be respected as a known adjunct to reducing the BMI, body weight, body fat, reduction of overall fat cell generation, decrease in fat absorption and in the suppresses of appetite
Hot, Spicy Foods: Incorporate the use of hot chili peppers and turmeric in meals. These spices cause a slight sweating reaction and a greater response to the food thus elevating thermogenesis.
Resveratrol: Resveratrol has been on the market for many years and has been used medicinally for generations. Controversial human trials continue, but studies have shown that 150 mg of trans-resveratrol will cause weight loss in obese but not normal weight humans.
Vitamin D/Calcium: Approximately 90% of our world’s population is deficient in vitamin D. Vitamin D is actually a hormone and recent reports suggest our rise in obesity is related, in part, to our lack of Vitamin D and Calcium
Bitter Orange, p-Synephrine, Caffeine, Kola Nut: These nutrients/foods- all thermogenic teas-can be
used alone or in combination to break the plateau. No adverse side effects have been found.
Vitamin C: Vitamin C is inversely related to body mass. Individuals replete in vitamin C oxidize 30% more fat during moderate exercisers than those who were depleted. Dosage should be 250 mg by food (preferably) or supplement.
Transformation of our Mindset
Accepting and anticipating challenging weight plateaus will either encourage success as each plateau is out-witted or you accept defeat. So, take the challenge and win, out-win that plateau! Once the energy level is restored and the pounds start coming back off again slowly start back on your original (or revised) meal plans and exercise routines.
In taking an Integrative and Functional Medicine Approach, we must look at our tool box holistically. Approaching a problems from many angles means utilizing the most neglected tools to meet our goals at all levels the problem.
Al-salafi R, Irshad M, Abdulghani. Does green tea help to fight against obesity? An overview of the epidemiological reports. Austin Journal of Clinical Medicine. April, 2014. http://www.researchgate.net/profile/Md_Irshad2/publication/262201112_Does_Green_Tea_Help_to_Fight_against_Obesity_An_Overview_of_the_Epidemiological_Reports/links/54367faa0cf2dc341db352c7.pdf. Accessed 5/21/15.
Bradford PG. Curcumin and obesity. Biofactors. 2013; 39 (1):78-87. http://onlinelibrary.wiley.com/enhanced/doi/10.1002/biof.1074 . Accessed 5/22/15.
Johnstone A. Fasting for weight loss: an effective strategy or latest dieting trend? International Journal of Obesity. http://www.nature.com/ijo/journal/v39/n5/full/ijo2014214a.html Accessed 5/21/15.
Lin L, Lee JH, Bongmba OYN . . . The suppression of ghrelin signaling mitigates age-associated thermogenic impairment. 2014. Aging.6 (12):1019 http://www.impactaging.com/papers/v6/n12/pdf/100706.pdf Assessed 5/21/15.
Muceherjee A, Mukherjee S, Biswas J. Phytochemicals in obesity control. International Journal of Current Microbiology and Applied Sciences, 2015 4(4): 558-567 http://www.impactaging.com/papers/v6/n12/pdf/100706.pdf Accessed 5/22/15.
Singh R. Significant improvement in obese, grade three male individual with nutrient dense low calorie, moderate to high protein diet. Advances in Obesity, Weight Management and Control2015. 2(2)
http://medcraveonline.com/AOWMC/AOWMC-02-00013.pdf Accessed 5/22/15.
Stohs SJ, Preuss HG, and Mohd Shara. A review of the human clinical studies involving citrus aurantium (Bitter Orange) Extract and its primary protoalkaloid p-synephrine. International Journal of Medical Sciences 9(7): 527-528. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3444973/ Accessed 5/22/15.
Timmers S, Konings E, Bilet L, . . .Calorie restriction-like effects of 30 days of resveratrol supplementation on energy metabolism and metabolic profile in obese humans. Cell Metabolism. 14:612-622
http://www.sciencedirect.com/science/article/pii/S155041311100386X Accessed 5/21/15.
Wang S, Moustaid-Moussa NM, Chen L. . . Novel insights of dietary polyphenols and obesity. J of Nutr Biochemistry. (25): 1 http://www.sciencedirect.com/science/article/pii/S0955286313001617 Accessed 5/21/15.
Adapted from the Weight-Loss Program, “Synergetics”, by Kathryn J. Shattler, M.S., RDN