Eat Real Food, Mostly Plants  & Not  Much

Why should we care about weight?
 

Obesity is skin deep. More than looking good, achieving and maintaining healthy weight is about feeling good and even more importantly, improving the quality of life in the long run. 

What affects weight management, caloric intake or metabolism?
 

Both. Weight gain  or weight loss depends on a complex interplay between caloric intake and metabolism. A banana is 100 calories for everyone until it is consumed. However, once inside our bodies, our metabolism determines how efficiently we can burn or store these calories. For an effective weight management strategy, it makes sense to work on both ends. That is,

1) manage caloric intake and

2) support metabolism. 

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I am 100 calories before you consume me.

Caloric intake matters

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Successful strategy involves paying attention to both

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Metabolism Matters

Fundamentals of weight management:

No other health topic contains as many diverging views as weight loss does. It is because every human being has experienced weight gain and / or weight loss at some point in life. So everyone knows how it feels and has some idea in terms of what might have contributed to the fluctuation in scale.

Cutting through the details, for to the point facts, following need to be kept in mind;

Think of weight loss strategies as an inverse pyramid. Factors contributing to weight loss/gain reside here in a descending order of weight (no pun intended) or emphasis.

The most important factor where most weight (again, no pun intended) or emphasis needs to be placed is the energy balance or calories in versus calories out. Additional factors play role but with lesser and lesser significance. Below is the list of this descending order.

  1. Energy balance

    1. Calories in 

    2. Exercise out

  2. Metabolic rate

    1. Age (Lower the age, higher the basal metabolism)

    2. Gender (Men have it easier)

    3. Hormones (Thyroid is the key)

  3. Types of food consumed

    1. Caloric density of foods (high fiber, whole foods are low caloric density - yes, your greens)

    2. Diets (no diet works unless caloric balance is controlled and every diet works if calories are reduced)

  4. Fasting / Calorie free times during the day and their length (Provides a window of opportunity to burn fat)

  5. Supplements (Big bucks small gains)

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Energy Balance: 

Calories are energy units that human body can use. Caloric balance is important for weight management. All things being equal, a positive calorie balance results in weight gain and a negative caloric balance results in weight loss.

Managing Caloric Balance:

There are many apps and calculators available to measure daily caloric requirement. Following are two simple ways to quickly measure daily caloric requirement. 

Simple and conservative formula:

Daily Caloric Requirement =

30 x ideal body weight in kg

Don't like math? Use this table

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More accurate formula (preferred for active individuals):

  • Sedentary lifestyle (< 6000 steps /day) :​ Weight (kg) x 30 (maximum 2000 calories /day)

  • Leisurely active lifestyle ( 6000-10000 steps/day): Weight (kg) x 35 (maximum 2500 calories/day)

  • Fit & Active lifestyle (>10000 steps/day including cardio/strength training): Weight (kg) x 40 (maximum 3000 cal/day)

Tip: Don't like counting calories every day? Buy food for a week (equal to daily caloric need x 7) and eat over one week. This allows for extra calories some days and lesser calories other days

Finding it difficult to stay within caloric budget? This is normal because our bodies naturally try to stock up on a bit excess energy reserves than needed. This is due to evolutionary reasons. In order to overcome this default tendency, eat low calorie density foods. Check out Eat this, not that. Also check out Food Labels to learn how to read nutrition labels. 

Metabolic Rate:

​Support Your Metabolism:

Below are ten ways to support your metabolism. 

In addition, visit information on medical interventions for weight loss.

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1. Fasting : 

When we fast, we not only reduce our caloric intake but also boost our metabolism by activating catabolic (fat burning) pathways and improving insulin sensitivity. There are many ways to fast. If you are new to fasting, review or watch Fasting Stress Test.

Three ways to fast

  • 12-24 hours of water down fast - No caloric intake for 12-24 hours. Keep caloric intake in check. 

  • Time restricted feeding - Eat within a window of 4-8 hours in a 24 hour period. Keep caloric intake in check.  

  • Fasting mimicking diet - Commercially available diet plan (prolon) which mimics fasting. A DIY version available on this website. Check out Longevity Focused Diet.

2. Exercise:

A cardio or HIIT (high intensity interval training) exercise not only helps burn calories but also can rev up metabolism for the next 24-48 hours. 

3. Sleep:

Lack of sleep or interrupted sleep increases insulin resistance which can slow our weight loss efforts. A good quality (combination of Non-REM deep sleep and REM sleep) are critical to healthy metabolism.

4. Functional Foods:

Although this effect is marginal, these functional foods boost our metabolism. 

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5. Avoid Junk Foods:

These are sugars, refined carbs, and processed foods. Processed foods are the foods which go in the pantry and can be eaten readily or go in the freezer and you can't recognize the ingredients. 

Clean your pantry and freezer from 

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6. Avoid Certain Medications:

Some medications can slow our metabolism by increasing insulin resistance, or activating metabolic pathways which help burn fat. Under the guidance of your health care practitioner, consider switching these medications to alternate options. 

  • Birth control pills

  • Other hormonal contraceptives

  • Insulin

  • Steroids

  • Antidepressants

  • Antipsychotics

  • Sleep aids

  • Neuroleptic

  • Some blood pressure meds

  • Long term antibiotics (through altering gut microbiome)

7. Prescription Medications to Help:

A handful of prescription medications (such as phentermine, liraglutide, semaglutide, plenity) help suppress appetite and stimulate metabolism. However, these should be used cautiously under the supervision of a healthcare practitioner and only after weighing benefits versus risk. 

8. Balance Hormones:

Hormone imbalance can pose a challenge when it comes to weight loss efforts. Therefore, women after menopause (overall low hormone levels), men after andropause (low testosterone levels) and several people under stress (high cortisol levels) find it hard losing weight and despite not overeating, tend to gain weight. Check out hormone evaluation and consider intervention. 

9. Balance Microbiome:

Gut microbes alter the way our metabolism works. A decline in furmicutes and bacteroids ratio has been associated with weight gain. Consider testing and intervention with probiotics if out of balance. More importantly, eat a fiber rich and healthy diet to stimulate the growth of hhealthy microbiome. 

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10. Avoid toxins:

Avoid environmental toxins and processed foods which accumulate toxins. Toxic burden can give rise to insulin resistance and jeopardize our weight loss efforts. 

In addition to above, visit information on medical interventions for weight loss

Additional fixed factors that affect metabolism:

Age:

Because bas al metabolic rate slows as we age, it is easier to lose weight at young age versus older age. One way to increase basal metabolic rate at older age is to improve mitochondrial health. Mitochondria are energy producing organelles in cells. Their function declines as we age. Following help improve mitochondrial function;

  1. Exercise – 30 – 40 minutes high intensity interval exercise which leads to sweating

  2. Avoidance of toxic substances such as processed foods and environmental pollutants

  3. Supplements such as ATP support. There are several available by manufacturers. Make sure to look for a pharmaceutical grade supplement and the ingredients such as NAD, nicotinamide, CoQ10 etc.

 

Gender:

Basal metabolic rate is slower in women versus men mostly due to lower muscles mass and lower testosterone levels. Women can use testosterone supplements with caution and under medical supervision to improve metabolic rate.

Hormones:

Additional hormones which support metabolism are thyroid and cortisol and are discussed at length under 10 ways to support your metabolism.

Types of Foods:

Caloric Density of Foods:

                This is one of the most important factors and perhaps one of the easiest methods to start losing weight. We all feel hungry when we are in caloric deficit state. Natural tendency is to eat till we are full or somewhat full. After we start eating food, stretch receptors in the stomach, various hormones released by the stomach and chemical released in brain give us a signal that it is time to stop. If we had been easting high calorie density foods such as chocolate, ice cream, fried foods, by the time stretch receptors and other signals take effect, our body has already consumed a large amount of calories and it throws us into a positive energy balance causing weight gain. But if we consume low calorie density foods, we start feeling full with the large volume of food that had relatively low calories and don’t feel hungry. These foods are mostly fiber containing foods such as vegetables, some fruits and other natural whole plant based foods.

A successful strategy is to make low calorie density foods 70-80% of your diet. There is no hard and fast rule but more you rely on low energy density foods, higher the rewards n terms of weight loss.

Diets:

Types of diet play important role but only to a very modest degree. As an example, popular ketogenic diet / very low carb diet help lose weight fast. This is because  body goes into an energy deficit state relatively quickly when carbohydrates are restricted. However, ultimately weight loss really depends on energy balance. If ketogenic diet or any low carb diet is adopted but caloric intake is still higher than energy needs, weight loss will not occur or will occur for very short periods of time. So follow a diet only if it is convenient and easier to commit to, not because it will lead to weight loss. Most people can achieve sustainable weight loss without following a particular diet.

Fasting or calorie free times during the day:

                Fasting is a powerful tool and is discussed in detail under support your metabolism. Learn more about fasting here. 

 

Supplements:

                Supplements have a small role to play and these do help support metabolism. But benefits are very modest to minimal. These are discussed in detail under support your metabolism.

Additional Tips Based Upon FAQs:

Why is it that I hit a plateau every time I try to lose weight?
 

This is because of the same phenomenon as described above. Losing more and more weight is like fighting an uphill battle. It is relatively easy to lose a few pounds in the beginning. Then, the body goes up in arms against our weight loss efforts because body tries to "conserve" itself. In other words, it goes in the survival mode. Now we have less body mass to feed than before so the caloric needs drop. The metabolism slows down. And fat burning hormones such as "leptin" levels drop. As a results, it becomes harder to lose weight as we lose weight. 

Should I eat frequently to keep my metabolism going? 
 

Although eating or a fed state brings us out of the starvation mode, it does not necessarily increase basal metabolic rate. The reasons for this are because as soon as we start eating, we raise our insulin levels. Insulin is an anabolic (building) hormone and dampens any pathways which intake of food might have induced to speed the metabolism. 

 

Why is it that I lost weight with good diet and exercise and am keeping up with a healthy diet but the weight have slowly started to creep up? I am not overeating, eating bad or even eating as much as I used to?
 

Body likes routine and consistency. It always tries to go back to its balance where it finds familiarity. If we have been over weight, it will try to go back to the weight it has been familiar with if we do not take proactive steps to train the body the "new normal". If we do nothing to gain and/or loose weight and just eat right, make conscious efforts to not overeat, small (even negligible) amount of weight will continue to accumulate over time. This is due to evolutionary reasons. At subconscious levels, human body is designed to always keep store a little extra for the rainy day. In other words, if our caloric need is 1600 calories a day. We will not feel very full even if we eat 1700 calories every day. A 1700 calorie diet will not make us feel full, nor will it show any difference on the scale on a day to day basis. At times, it may even feel that we are starving our selves. This is because although at a conscious level, we are eating just fine, at a subconscious level, our body is asking to bring in a little extra to conserve small amount of energy reserve for that rainy day. We never even feel that we overate because the satiety hormones don't get released and a year later, we step on the scale to find out that we are 10 pounds heavier. 

It can't just be subconscious overeating. Is it possible that there are other factors?
 

Yes, absolutely. When it comes to weight management, aging, fitness or almost anything related to the biological science, time is not on our side. With the passage of time (aka aging), metabolism slows down, hormones fluctuate and the energy balance shifts to where it becomes increasingly difficult to stimulate thermogenic or weight loss pathways. 

If it is all about energy balance, should I not follow a diet which keeps me full, suppresses my insulin levels and helps me fast? (aka ketogenic diet)
 

Any diet that works for us in the short run (emphasis is on "the short run") is a reasonable diet to follow in the short run. However, long term adaptation of such diets is not advisable. As an example, ketogenic diet contains high fat content and inevitably results in an imbalance in the macronutrients. Meta-analysis studies show that such diets result in high cholesterol, higher coronary artery disease and up to 30% increase in all cause mortality (overall death rate).

Should I follow a diet based upon genetic testing?
 

Genetic testing gives you some information about your metabolism but it does not change the basic equation of weight loss. Most genes which contribute to polygenic obesity (so called FTO genes) have only marginal effect and their effect can be overridden with the help of healthy lifestyle. Stronger genes which lead to monogenic obesity (MC4R, LEPR, POMC genes) are deterministic and cannot be overridden. But such genes are quite rare.