Weight Loss - A Lifestyle Plan
Improving an individual's metabolic control is an essential component of any diet plan. Preserving muscle mass and losing weight predominantly as body fat is the key to accomplishing this improvement in metabolic control. It is, in fact, muscle mass that dictates metabolism. Very overweight and obese individuals have extremely high body fat relative to muscle mass, which can effectively slow their metabolism as well as promote insulin resistance. A total program, therefore, is one that would incorporate diet and exercise with supplements that will help improve metabolic control. When choosing a weight loss plan, it's important to seek out diets that preserve muscle mass. Crash dieting and fad dieting that induce "quick" weight loss generally promotes muscle and water loss and less fat loss. This results in the "yo-yo" syndrome since when patients gain weight back they gain it as fat-not muscle. The best plan to follow is one that targets the change in body composition and preferentially enhances the lost of body fat rather than muscle mass. In reviewing the scientific data it is clear that a low-glycemic-index (GI) diet appears to promote weight loss more effectively than other types of diets. Those following this type of diet feel full faster, more satisfied with what they have eaten and have better glucose tolerance. Their weight loss occurs predominantly as fat. That's because low-GI diets prevent the metabolic switch from being thrown that increases fat storage rather than fat burning. It is important to realize that this type of diet is not simply a low-carbohydrate diet. Treating all carbohydrates the same still allows dieters to consume high-GI carbohydrates, which will throw the metabolic switch to store more body fat. People who follow a low-GI diet can consume carbohydrates that do not elicit a high-GI response such as fiber, beans, lentils, oats, yams, sweet potatoes as well as a host of other foods. Even most fruits such as apples, oranges and grapefruit, all high in pectin, are low to moderate on the glycemic index, which makes them permissible on this diet plan. Just as simply restricting carbohydrates is not an effective weight loss strategy, simply restricting calories has not resulted in the preferential change in body composition of losing body fat rather than muscle mass. Also, significantly cutting calories in an attempt to lose weight can decrease energy expenditure by 10 percent and during re-feeding by as much as 15 percent. Our bodies don't know we are cutting calories just to lose weight-they are programmed to reduce our metabolism to adjust for food shortages that occurred during our hunter-gatherer existence. Crash dieting leads to further slowing of metabolism since most of the weight is lost as muscle and water and later gained back as body fat. In other words, restriction of calories and/or carbohydrates per se does not ensure that high-GI foods will be eliminated from the diet. High-GI foods can cause a metabolic switch that preferentially stores protein, fat and carbohydrate rather than promoting oxidation of these nutrients. Low-GI diets also improve insulin resistance and other risk factors for coronary artery disease, such as elevated blood lipids. Unlike other diets, a low-GI plan can be followed indefinitely. It is also important to incorporate exercise into the program to significantly improve body composition. Walking, dancing, cycling and using stepper machines are all examples of aerobic exercise. Some extremely overweight and obese people may have pain even when walking, so often water aerobics may be a better place to start. Everyone should start slowly if they are out of shape and start with five to 10 minutes three times each week building up to 30-45 minutes three to five times each week. Strength training can be added later to further preserve body composition. Remember that muscle dictates your metabolism and high body fat slows metabolism. Preserving or even building a little more muscle can have dramatic effects on metabolism. Supplements That Accelerate Weight Loss There are many dietary supplements that can help enhance weight loss when a low-GI diet and exercise plan is followed. Also, these supplements can help improve blood sugar control, metabolism and body composition. They may also help prevent long periods of plateau that can be quite frustrating and can cause dieters to "fall off the wagon." And it is possible that these supplements may also help prevent weight gain with occasional "cheats"-and that means occasional! Green Tea The thermogenic effect of green tea (Camellia sinensis) was originally attributed to its caffeine content. However, green tea stimulates brown fat thermogenesis far greater than a comparable amount of pure caffeine. It appears that the catechin-polyphenols, in particular epigallocatechin gallate (EGCG), and caffeine that naturally occur in green tea work synergistically to stimulate thermogenesis and augment and prolong sympathetic stimulation of thermogenesis. It has been shown to increase 24-hour energy expenditure and fat oxidation (caffeine only increases metabolism during the time you take it). Drinking several cups of green tea each day also has well documented anti-cancer effects particularly with respect to the prostate, breast, uterus and ovary. Green tea is generally taken as a standardized extract in capsule or tablet form to provide 50 mg of caffeine and 90 mg of epigallocatechin gallate to be taken three times daily before meals. Although green tea contains a small amount of caffeine, it is generally not enough to create any adverse side effects. Drinking several glasses of green tea each day may yield a similar thermogenic effect to the supplement although this has not been studied thus far. Coleus Forskohlii Coleus has a long history of use in Ayurvedic medicine. One of its active compounds is forskolin, which has been studied as a weight loss aid. Animal studies have shown that forskolin has anti-inflammatory and anticancer effects. Human studies have shown that forskolin may be effective for glaucoma (as eye drops) and may have other therapeutic effects. Numerous animal studies have shown that forskolin can raise cyclic AMP (3'5' adenosine monophosphate), a naturally occurring compound in our bodies that releases fatty acids from adipose (fat) tissue storage, which may result in enhanced thermogenesis and loss of body fat, and may increase lean body mass. Coleus appears to be thermogenic and may also decrease body fat and preserve muscle mass. Standardized extracts of Coleus generally provide 10 percent of forskolin. That means that if you are taking 500 mg of standardized Coleus it will provide 50 mg of the active compound forskolin. Citrus Aurantium Citrus aurantium is also known by its Chinese name, Zhi Shi, an herb with a long history in traditional Chinese medicine. It is more commonly known as bitter orange. A standardized extract provides six percent amines and the most studied extract is known as Synephrine, which has thermogenic properties. The amines are similar in action to ephedrine (found in Ma Huang/Ephedra) in terms of thermogenesis, but they do not cause the stimulant side effects associated with ephedrine or large amounts of caffeine such as nervousness, fast heart beat, high blood pressure, dry mouth, insomnia or even more serious side effects recently reported. That's because these active amines work through a different pathway than either caffeine or ephedrine. An effective dose of Citrus aurantium would be 975-1,000 mg and would be standardized to provide six percent of the active amines. Chromium Chromium is an essential mineral that improves glucose tolerance and insulin resistance and lowers elevated blood sugar levels. It may also improve blood levels of cholesterol, triglycerides and HDL cholesterol. Processed foods have most of the chromium removed. Therefore, individuals who regularly consume refined carbohydrates and/or sugar are unable to receive enough of this mineral through food alone. Chromium is effective in improving glucose tolerance and insulin resistance. Human studies using 400-1,000 mcg of chromium have yielded better blood sugar lowering results than when lower doses are used. Chromium does not stimulate metabolism nor is it thermogenic. It is important because it can blunt the rise in blood sugar when a high-GI carbohydrate is consumed, helping to prevent the metabolic switch into fat storage mode. That does not mean that by simply taking chromium you can continue to routinely eat high-GI carbohydrates and achieve weight loss. But it can help if "cheats" are occasional as evidenced in studies with diabetic patients who did not modify their diet, but had improvements in glucose control. What also makes chromium interesting is that it shifts weight loss to favor body fat and preserve muscle mass-the very thing we want to achieve with a total program. Glucosol Glucosol is an herbal extract from the herb Lagerstroemia speciosa. Its active ingredient, corosolic acid, is responsible for its blood sugar lowering and normalizing effect. Numerous animal and human studies have shown that Glucosol improves glucose tolerance, lowers serum blood sugar levels and improves insulin resistance very much like chromium. The most remarkable thing about Glucosol is that it can blunt the rise in blood sugar associated with high-glycemic foods. In some of the studies, a modest weight reduction occurred without the use of a restricted diet. Since Glucosol significantly blunts the blood sugar rise associated with high-GI foods, insulin levels are also blunted. This would prevent the metabolic switching to the storage of body fat associated with elevated glucose and insulin levels. It appears that both Glucosol and chromium may help dieters to better tolerate carbohydrates and help control blood sugar and insulin levels. 5-Hydroxytryptophan Several studies have shown that L-tryptophan (currently not available as a dietary supplement) can blunt carbohydrate cravings by increasing brain serotonin levels. Brain serotonin levels have an inhibitory effect on eating behavior and help curb appetite. Since L-tryptophan has been re-moved from the marketplace, 5-hydroxytryptophan (5-HTP) has been made available and appears to have the same benefits. This form of tryptophan is the intermediate metabolite of L-tryptophan in the serotonin pathway. Low serotonin levels in obese patients have been associated with carbohydrate cravings and binge eating behavior. Studies have shown that carbohydrate intake may decrease by as much as 50 percent when 5-HTP is given without dietary restriction and it also has an appetite suppressant effect in very overweight, obese and diabetic patients. Other benefits of 5-HTP administration may include significant improvement in depression, insomnia, fibromyalgia and chronic headaches-many of the conditions associated with being overweight and obese making it difficult for individuals to stick to a program for life. The dosage of 5-HTP is usually 50-300 mg three times daily (30 minutes before meals). Some researchers (including myself) have expressed concern that the level of 5-HTP used in the studies (300 mg three times daily) was very high and may over time cause a neurotransmitter imbalance by increasing serotonin levels well beyond normal. In the published studies those taking 5-HTP were not eating a low-glycemic-index diet. Therefore it is possible that lower levels such as 50-100 mg given one to three times daily may have a similar effect if combined with a low-GI diet and exercise program. Phaseolamin This is also known as Phase 2.® It is a non-stimulant, all-natural nutritional ingredient derived from the white kidney bean. Preliminary research has demonstrated that its action is to neutralize the enzyme alpha amylase before it can digest starch into glucose. It allows some of the starch in foods such as potatoes, breads, pasta, rice, corn and crackers to pass safely through your system without being digested or absorbed. Therefore it can reduce the absorption of some starch calories. This appears to be an exciting new ingredient that can be an excellent adjunct to a low-GI diet and exercise program. Summary A review of the scientific literature reveals that the best diet to follow for life is a low-GI diet. It can be followed indefinitely and helps correct many of the metabolic alterations that overweight and obese people must overcome. Further-more, it appears that dietary supplements such as green tea, Coleus forskohlii, Citrus aurantium, Chromium, Glucosol, 5-HTP and Phaseolamin may assist weight loss goals along with a low-GI diet and exercise plan. Selected References: 1. Samaha FF, Nayyar I, Seshadri P et al. A low-carbohydrate as compared with a low-fat diet in severe obesity. N Engl J Med 2003;348(21):2074-2081. 2. Bell SJ, Goodrick GK. A functional food product for the management of weight. Crit Rev Food Sci Nutr 2002;42(2):163-178. 3. Agnus MSD, Swain, JF, Larson CL et al. Dietary composition and physiologic adaptations to energy restriction. Am J Clin Nutr 2000;71:901-907. 4. Ludwig DS. Dietary glycemic index and obesity. J Nutr 2000;130:280S-283S. 5. Dulloo AG, Giradier L. Adaptive changes in energy expenditure during refeeding following low-calorie intake: evidence for a specific metabolic component favoring fat storage. Am J Clin Nutr 1990;52:415-20. 6. Dulloo AG, Duret C, ,Rohrer D et al. Efficacy of a green tea extract rich in catechin polyphenols and caffeine in increasing 24 hour energy expenditure and fat oxidation in humans. Am J Clin Nutr 1999;70:1040-1045. 7. Chantre P, Lairon D. Recent findings of green tea extract AR25 (Exolise) and its activity for the treatment of obesity. Phytomedicine. 2002 Jan;9(1):3-8. 8. Kao YH, Hiipakka RA, Liao S. Modulation of endocrine systems and food intake by green tea epigallocatechin gallate. Endocrinology. 2000 Mar;141(3):980-7. 9. Lieberman S, Bruning N. Dare To Lose: 4 Simple Steps to a Better Body. Avery/Penguin Putnam, NY, NY 2003. 10. Kaats GR, Blum K, Fisher JA et al. Effects of chromium picolinate supplementation on body composition: a randomized, double-masked, placebo-controlled study. Curr Ther Res 1996;57:747-756. 11. Bahadori B, Schneider H, Wascher TC et al. Effect of chromium yeast and chromium picolinate on body composition of obese, non-diabetic patients during and after a formula diet. Acta Medica Austriaca 1997;24:185-187. 12. Preuss HG, Grojec PL, Lieberman S, Anderson RA. Effects of different chromium compounds on blood pressure and lipid peroxidation of spontaneously hypertensive rats. Clin Nephrol 1998;47(5):325-330. 13. Cangiano C, Ceci F, Cascino A et al. Eating behavior and adherence to dietary prescriptions in obese adult subjects treated with 5-hydroxytryptophan. Am J Clin Nutr 1992;56:863-867. 14. Cangiano C, Ceci F, Cairella M et al. Effect of 5-hydroxytryptophan on eating behavior and adherence to dietary prescriptions in obese adult subjects. Adv Exp Med Biol 1991;294:591-593. 15. Ceci F, Cangiano C, Cairella M et al. The effects of oral 5-hydroxytryptophan administration on feeding behavior in obese adult female subjects. J Neural Transm 1989;76:109-119. 16. 5-Hydroxytryptophan Monograph. Altern Med Rev 1998;3(3):224-226. 17. Resource for information on Phaseolamin: www.phase2info.com.Top of page