The Ultimate Fat-Loss Diet

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By Daniel Gwartney, MD and Steve Blechman

Negative physical truths are difficult to deal with, as they are irrefutable and there’s no avoiding the emotional impact. If the checking account is overdrawn or the house is a mess, the facts are undeniable and cause mental anguish until the situation is corrected. This is especially true regarding self-image; a fitness-oriented or image-conscious woman may find excess or unsightly body fat embarrassing, even repulsive. Fortunately, it’s a situation that can be remedied.

A corrective set of actions for fat loss should include lifestyle changes, more rigorous attention to diet and regular exercise. The Ultimate Fat-Loss Diet offers guidelines for reaching the goals of better health, fitness and happiness. Following the suggestions provided should allow one to reduce body fat in a healthy manner; possibly reducing the risk of some of the more serious health concerns facing Americans today, including cardiovascular disease and the metabolic syndrome.

The True Benefits of Fat Loss

Diet is a word that immediately triggers discontented sighs or pained grimaces, but the truth of the matter is sensible diet plans are successful when they’re followed and combined with exercise. Some provide more rapid weight loss, but all diets will result in weight loss as long as they’re hypocaloric – providing fewer calories than are burned each day.1 However, weight loss isn’t necessarily fat loss and though reducing weight produces positive health changes, the true benefits come from fat loss. Additionally, it’s important to realize that the diet has to be sufficient to allow a person to maintain her busy schedule and have energy to exercise. Too often, people choose overly strict diets and find themselves struggling to function throughout the day, let alone make it into the gym. Beyond that, eating is also social – it’s time with friends or family. Gathering around the table to eat a 50-gram protein bar hardly offers the environment to enjoy each other’s company or share in the day’s events. The Ultimate Fat-Loss Diet accommodates these needs in a convenient and practical manner.

The most important factor to consider in any fat-loss diet is total daily calories. Yes, the drudgery of watching calories is part of this plan, but failing to monitor how much is being consumed can lead to failure. This is particularly true when dining out. Though fast-food restaurants will provide a nutrition facts guide describing the calories and other information (grams of fat, protein, sugar, etc.) about their offerings, higher-priced restaurants do not. Hidden calories are present in sauces, dressings and beverages, making it very easy to consume more than intended. It’s even worse at buffets and family-style restaurants, as the settings are designed for overindulging. Thus, to truly succeed with a diet, it’s important that most (actually all, if possible) meals be self-prepared or come in portion-controlled servings to account for all calories being consumed.2

How Many Calories Does It Take?

How many calories should a woman consume when trying to lose weight? There are complex formulas, accounting for various factors such as lean body mass, age, race, etc.3 However, for the purpose of ease-of-use and clarity, the simple calculation of 10 calories per pound of bodyweight per day is a good baseline (daily calories = 10 x bodyweight in pounds). Using this formula, a 140-pound woman would consume 1,400 calories per day (10 x 140 = 1,400). This should create a daily calorie deficit of approximately 500 calories, which theoretically leads to a loss of 1 pound of fat per week. However, as with any “one size fits all” advice, it may need to be adjusted slightly. A woman who exercises and is very active during the day may require more calories to keep up with her schedule, while a sedentary woman who isn’t as vigorous in her training might need to reduce it a bit. However, if the adjustment begins to deviate significantly from this number (more than 15 percent), then other issues may be present that might need to be evaluated by a physician, such as a thyroid condition.

The Importance of Breakfast

It’s very important to be diligent about following The Ultimate Fat-Loss Diet, as it’s been proven that the diet has a much greater impact on weight loss than exercise.4 Though it’s not glamorous or rewarding, cutting calories can reduce weight, even in the absence of exercise. The opposite isn’t necessarily true, as many studies have shown that exercising in the absence of diet management doesn’t promote weight loss.5 The role of exercise shouldn’t be devalued though, as it adds to energy expenditure (calorie burning), aids in controlling appetite and helps maintain and tone muscle.

There is no magical formula for the number of meals the daily calories should be divided into, but facts support two critical points. The first is the importance of breakfast. Breakfast is often viewed as an inconvenience; an unnecessary delay at the start of the day when time and tempers run short. The luxury of 10 extra minutes of sleep frequently overwhelms any intention of rising early enough to make an omelet or even a bowl of cereal. Yet, eating breakfast daily has been recognized as one behavior that defines subjects with long-term success in losing weight.6 The ideal breakfast would include both complex carbohydrates and protein, as the body has been without food for 12 to 14 hours in many cases. While this prolonged fast (sleep) liberates stored fat to provide energy overnight, it also robs muscle of amino acids (the building blocks of protein). A quick, simple and surprisingly tasty breakfast can be made by adding a scoop of low-carb, sugar-free protein powder to oatmeal, flavored with a teaspoon of yogurt and sprinkled with chopped walnuts. As breakfast will follow the morning exercise, it’s vital to include 15 to 25 grams of protein to replenish the amino acids lost during the overnight fast and as a result of exercise-induced breakdown.7

Sample Menu

6:00 a.m.

16 ounces water, coffee or 100 milligrams of caffeine

6:30 a.m.

Exercise

8:00 a.m.

(End of exercise): Oatmeal and protein powder with nonfat, sugar-free yogurt and walnuts or meal-replacement drink (approximately 200 calories with 20 grams of protein)

10:00 a.m.

One cup of low-fat, sugar-free cottage cheese and a piece of fruit

12:30 p.m.

4-6 ounces of salmon, sautéed spinach or other vegetable and small salad with extra-virgin olive oil dressing

3:00 p.m.

Nonfat, sugar-free yogurt and a handful of almonds

6:00 p.m.

4-6 ounces of chicken, fish, turkey or lean meat, steamed broccoli and cauliflower and a small salad with extra-virgin olive oil dressing and 3 grams of fish oil capsules

8:00 p.m.

Nonfat, sugar-free yogurt, a handful of almonds

During the day, drink at least 2 to 3 liters of water.

The Role of Insulin

Aside from breakfast, the other meals are more flexible. Some people favor having three meals a day, but there’s evidence suggesting that more frequent and smaller meals may be healthier and promote greater fat loss. Barry Sears popularized the idea of a more balanced approach to nutrition with the Zone Diet and its 40-30-30 ratio of carbs to protein to fat, respectively (measured as calories, not grams). Part of the rationale behind his program was the diet’s ability to modify the high levels of insulin associated with weight gain.8 Insulin is a hormone released from the pancreas, a gland located in the abdomen. Insulin can be thought of as a storage hormone, as it shuttles nutrients into tissues to be used for energy production. However, when more calories are consumed than required (especially sugar, the main trigger for insulin release), insulin levels rise and fatty acids are shuttled to the fat cells to be stored rather than being burned for energy. Over time, high insulin levels can and do lead to an increase in total body fat. Even worse, the body appears to become less sensitive to insulin over time, forcing the pancreas to maintain high blood levels of insulin, preventing fat cells from releasing stored fat as efficiently during exercise or overnight. It’s critical to minimize insulin so that stored fat can be broken down and burned. Otherwise, the body will be primed to preserve stored fat and catabolize muscle instead to make up the energy deficit. Remember, the goal is to lose fat, not just weight.

In addition to promoting fat storage, high insulin levels are a central factor in the silent epidemic affecting millions of Americans called the metabolic syndrome.9 Associated with high blood pressure and dangerous blood lipid (fat and cholesterol) levels, people with high insulin levels (including type 2 diabetics) suffer more frequent and severe cardiovascular events, such as heart attacks and strokes. Optimizing insulin sensitivity is essential for long-term health and well-being.

Lowering insulin levels can be accomplished via several mechanisms, but the two primary dietary approaches are decreasing the size of each meal and reducing the sugar/carbohydrate content of each meal. Decreasing meal size is easily accomplished by increasing the number of feedings by adding a small snack mid-morning and mid-afternoon.10 In addition to reducing the stimulus for insulin secretion, it will also help adhere to sensible eating as a ravenous hunger is never allowed to develop. Reducing the sugar/carbohydrate content of each meal can be managed by following a higher protein diet and choosing low-glycemic foods. Low-glycemic refers to how fast the carbohydrates in a food are released as sugar into the bloodstream.11 Processed starches and simple sugars are high-glycemic foods, as they cause a rapid dumping of insulin and often end up causing a state called post-prandial hypoglycemia – the feeling of low energy and sleepiness that follows a massive sugar binge.

Fortunately, it’s much easier to follow a low-glycemic diet nowadays. For decades, the concept of the low-fat diet was forced onto Americans, through public service announcements, articles and the food pyramid. Dieticians endorsed the practice of replacing fats with lower-calorie (when compared gram to gram), carbohydrate-based food choices. Unfortunately, that advice didn’t seem to work well, as Americans trended to higher rates of obesity.12 Then the high-protein diet revolution turned that advice upside down, with comparative studies showing that high-protein diets actually induced greater weight loss quicker in the short term.1 Over the course of a year or so, the difference is less considerable, as all diets that are hypocaloric will result in significant weight loss eventually.13 Though the high-protein diets remain controversial, it’s clear that they’ve been very successful for many people who failed on low-fat diets. Research has shown that increasing the amount of protein in the diet promotes weight loss/fat loss through a number of healthy and beneficial mechanisms: dietary protein increases the satiety of a meal, making it easier to avoid the temptation to overeat; protein decreases the appetite, so eating between scheduled meals is better controlled; protein increases thermogenesis, which is the process whereby calories are burned to generate heat rather than cellular energy; and lastly, amino acids in protein, particularly leucine, help maintain lean body mass, which often wastes away during hypocaloric dieting.14 Maintaining lean mass is vital as the greatest percentage of calorie burning takes place in lean tissue.

Protein and Fat Sources

Getting protein in the diet is relatively simple and the variety of choices allows for a greater number of options. The primary caveat is to avoid fatty cuts of meats, including fried and breaded foods. Suitable sources are plentiful: fish, poultry, lean cuts of beef, non-fat dairy, legumes, eggs, etc. A large body of evidence suggests that dairy proteins may promote weight loss, possibly due to the high calcium content, but a recent yearlong trial disputes this claim.15,16

Though one looks for protein sources that are not fatty, dietary fat plays a beneficial role in nutrition. We have now learned that balanced diets are better and healthier. Saturated fat has long been the scourge of nutritionists, but recent evaluations of the science suggest saturated fat is not unhealthy in small amounts.17 Ironically, the evil player in the fat cast appears to be trans fats, found in hydrogenated oils and margarines. A clear relationship exists between various types of fat and overall metabolism. In addition to being heart healthy, omega-3 fatty acids (fish oil) appear to have a fat-reducing effect. A small study published in the International Journal of Obesity reported that substituting fish oil for saturated fat (6 grams per day) resulted in the loss of nearly two pounds of body fat, in part by increasing the amount of fat burned for calories.18 Fish is not a staple for many people and aside from tuna can be quite expensive. Fish oil gelcaps offer an alternative for getting more of this nutrient.

Monounsaturated fat (such as oleic acid in olive oil) is another heart-healthy fat associated with weight loss through increased fat-calorie burning. One study suggests that oleic acid is more easily burned following exercise than other types of fat.19 Almonds are another source of monounsaturated fat. A published study suggests that adding almonds to a hypocaloric diet increases weight loss, reduces the waistline and lowers blood pressure compared to a similar diet without the nuts.20 The Ultimate Fat-Loss Diet agrees with the recommendation that 30 percent of calories (approximately 50 grams) come from fat, with very small amounts of saturated fat. Consuming 3 to 6 grams of fish oil daily provides ample omega-3 fats, allowing for a generous serving of monounsaturated fat (such as oleic acid in olive oil). Though this seems tedious, extra-virgin olive oil works well as a dressing on vegetables and salads. Consuming omega-3 fats from fish or fish oil and monounsaturated fats provides the best of all worlds and also aids in improving the body’s response to insulin, keeping the fat storage signal suppressed.

Fish, non-fat, sugar-free yogurt and extra-virgin olive oil are staples in a particular diet that is associated with a lower incidence of many of the diseases that afflict Americans. The Mediterranean diet, so-called because it reflects the traditional fare of the cultures living near the Mediterranean Sea, appears to offer protective benefits to people raised on the diet, as the rates of obesity, heart disease and many cancers are much lower in those regions.21 The Ultimate Fat-Loss Diet differs from the Mediterranean diet in that the protein intake is higher, but this is to accommodate the goal of weight loss/fat loss rather than weight maintenance.

Water and Other Essentials

Red wine is commonly consumed in the Mediterranean cultures as well, possibly accounting for some of the health benefits. A glass of red wine a day may also aid in fat loss, as moderate drinkers appear to have better insulin sensitivity and are less prone to type 2 diabetes.22 Heavy drinking needs to be avoided though, as alcoholic beverages are calorie dense and drinking more than the recommended limits is associated with a greater risk of diabetes.

Water is essential, not only because of the need for proper hydration during the hot, humid months, but also because it replaces calorie-containing beverages and may aid in energy expenditure. Drinking a half-liter of water actually increases the neurotransmitters that signal for fat release from the fat cells.23 Also, drinking ice water forces the body to generate more heat to bring the water up to body temperature, another source of calorie wasting. The general rule of thumb (not counting any excess water loss during exercise) is 64 ounces a day of water. However, most athletes consume double that amount. One source offers a simple, if silly way to measure hydration – you should drink enough water to keep your urine colorless.24 Dark yellow urine is a sure sign of relative dehydration.

Knowing what and how much to eat is only part of the lesson. In order to maximize the benefits of the The Ultimate Fat-Loss Diet, it’s important to time the diet to best advantage.

Dietary Caveats to Training

Early morning exercise takes place to maximize the burning of calories derived from fat. In order to facilitate this, it’s important not to sabotage the unique metabolic environment present after a night’s sleep. Overnight fasting primes the fat-burning process. When fasting, fat cells are stimulated by hormones that signal a need for the stored calories to be released, including growth hormone and glucagon, among others. The fat-release signal is stopped by insulin which is released when a meal is consumed, particularly a carbohydrate-containing meal.25 Insulin also reduces the secretion of a hormone produced by the stomach called ghrelin, which stimulates growth hormone release.26 In fact, just the taste of something sweet may release enough insulin to shut down the fat releasing process.27 Then the energy has to come from stored sugar (glycogen) or through the break down of lean mass protein. So it’s vital, for the purposes of this program, that no carbohydrates be consumed prior to training. Even though no carbohydrates are being consumed, hydration is vital at this time for the same reason; no water has been drunk for hours typically.

Drinking a half-liter of refrigerated water, along with a source of caffeine (coffee or a 100-milligram tablet) optimizes the metabolic environment. Caffeine enhances lipolysis and fat loss. It also increases alertness, elevates mood, heightens the ability to concentrate and wards off fatigue. A study found that one to three cups of coffee (a rich source of dietary antioxidants) daily can lower inflammation and protect against cardiovascular disease and other inflammatory diseases.30 A few people are particularly sensitive to caffeine, so it’s important to watch for signs of caffeine excess (jitteriness, tremors, headaches, blurred vision, etc). Decrease the caffeine to a tolerable dose if these symptoms do arise. People with heart disease or under the care of a physician should inquire about caffeine prior to its use.

Immediately after exercise is the time to eat breakfast or a meal replacement shake. Exercise enhances insulin sensitivity so the body is primed for nutrient absorption and carbs and proteins are effectively shuttled into the active muscle rather than fat.14 Waiting will not provide the same benefit, as the exercise effect wanes quickly and is gone within three hours.28

During the day, The Ultimate Fat-Loss Diet becomes easier to manage. By consuming breakfast, you allow for four or five more “meals.” Since eating is social as much as functional, it helps to plan larger meals at lunch and supper. These meals can be whole food, comprised of fish, chicken, turkey, or lean meat, vegetables and a small salad. Add a little extra-virgin olive oil dressing on the salad and a complete meal is prepared. Smaller servings will keep these two meals at about 400 calories each.

Thus far, approximately 1,000 calories have been consumed. The meals are small, but this allows for two or three “snacks” to be consumed throughout the day. The Ultimate Fat-Loss Diet focuses on healthy choices. A piece of fresh fruit and low-fat, sugar-free cottage cheese, or sugar-free, nonfat yogurt and almonds are excellent choices. The summer is wonderful because of the fruit selection available everywhere. Vitamins, fiber and phytonutrients are important to attaining a balanced diet.

Getting in Better Shape

In addition to the demands of family, work and other obligations, adhering to a rigorous workout schedule and cutting calories can be stressful. Getting a full night’s sleep needs to be a priority during this time, not only so you can stay alert and function well, but also because it may help promote fat loss. A lack of sleep is being associated with obesity in adults and children, even more strongly than activity habits in studies.29

Many people equate weight loss with getting in better shape, but for the athletic and health-conscious, it goes beyond that. Losing fat is the primary goal of The Ultimate Fat-Loss Diet, but doing so in a manner that supports an active lifestyle and reduces the risk of ill-health conditions are also vital considerations. Using the backbone of low-glycemic food choices, including traditional Mediterranean fare, this diet should improve fitness, appearance and well-being. The flexibility and variety of choices allows one to adopt the diet without sacrificing or feeling like a cafeteria outcast. As the inches come off and self-esteem increases, don’t be surprised to see your friends and co-workers suddenly eating the same ways, as you become their role model.

References:

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3. Vander Weg MW, Watson JM, et al. Development and cross-validation of a prediction equation for estimating resting energy expenditure in healthy African-American and European-American women. Eur J Clin Nutr, 2004;58:474-80.

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6. Wyatt HR Grunwald GK, et al. Long-term weight loss and breakfast in subjects in the National Weight Control Registry. Obes Res, 2002;10(2):78-82.

7. Tipton KD, Rasmussen BB, et al. Timing of amino acid-carbohydrate ingestion alters anabolic response of muscle to resistance exercise. Am J Physiol Endocrinol Metab, 2001;281:E197-206.

8. Fontani G, Corradeschi F, et al. Blood profiles, body fat and mood state in healthy subjects on different diets supplemented with Omega-3 polyunsaturated fatty acids. Eur J Clin Invest, 2005;35(8):499-507.

9. Rutter MK, Meigs JB, et al. Insulin Resistance, the Metabolic Syndrome, and Incident Cardiovascular Events in the Framingham Offspring Study. Diabetes, 2005;54(11):3252-3257.

10. Vilsboll T, Krarup T, et al. Incretin secretion in relation to meal size and body weight in healthy subjects and people with type 1 and type 2 diabetes mellitus. J Clin Endocrinol Metab, 2003;88(6):2706-13.

11. Granfeldt Y, Wu X, et al. Determination of glycaemic index; some methodological aspects related to the analysis of carbohydrate load and characteristics of the previous evening meal. Eur J Clin Nutr, 2006;60(1):104-12.

12. Caban AJ, Lee DJ, et al. Obesity in US workers: The National Health Interview Survey, 1986 to 2002. Am J Public Health, 2005;95(9):1614-22.

13. Dansinger ML, Gleason JA, et al. Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: a randomized trial. JAMA, 2005;293(1):43-53.

14. Koopman R, Wagenmakers AJ, et al. Combined ingestion of protein and free leucine with carbohydrate increases postexercise muscle protein synthesis in vivo in male subjects. Am J Physiol Endocrinol Metab, 2005;288:E645-53.

15. Zemel MB. The role of dairy foods in weight management. J Am Coll Nutr, 2005;24(6 Suppl):537S-46S.

16. Gunther CW, Legowski PA, et al. Dairy products do not lead to alterations in body weight or fat mass in young women in a 1-y intervention. Am J Clin Nutr, 2005;81(4):751-6.

17. Volek JS, Forsythe CE. The case for not restricting saturated fat on a low carbohydrate diet. Nutrition & Metabolism, 2005;2:21.

18. Couet C, Delarue J, et al. Effect of dietary fish oil on body fat mass and basal fat oxidation in healthy adults. Int J Obes, 1997;21:637-43.

19. Votruba SB, Atkinson RL, et al. Sustained increase in dietary oleic acid oxidation following morning exercise. Int J Obes, 2005;29:100-7.

20. Wien MA, Sabaté JM, et al. Almonds vs complex carbohydrates in a weight reduction program. Int J Obes Relat Metab Disord, 2003;27:1365-72.

21. Serra-Majem L, Roman B, et al. Scientific evidence of interventions using the Mediterranean diet: a systematic review. Nutr Rev, 2006;64(2 Pt 2):S27-47.

22. Beulens JWJ, Grobbee DE, et al. Alcohol consumption and risk of type 2 diabetes among older women. Diabetes Care, 2005;28:2933-8.

23. Boschmann M, Steiniger J, et al. Water-induced thermogenesis. J Clin Endocrinol Metab, 2003;88:6015-9.

24. Wakefield B, Mentes J, et al. Monitoring hydration status in elderly veterans. West J Nurs Res, 2002;24:132-42.

25. Dimitriadis G, Mitrou P, et al. Glucose and lipid fluxes in the adipose tissue after meal ingestion in hyperthyroidism. J Clin Endocrinol Metab, 2006;91:1112-8.

26. Giuseppe Murdolo, Paola Lucidi, et al. Insulin is required for prandial ghrelin suppression in humans. Diabetes, 52(12):2923-2927, 2003.

27. L Abdallah, M Chabert, et al. Cephalic phase responses to sweet taste. Am J Clin Nutr, 1997;65:737-43.

28. Esmarck BJL, Anderson S, et al. Timing of postexercise protein intake is important for muscle hypertrophy with resistance training in elderly humans. J Physiol, 2001;535:301-11.

29. Hasler G, Buysse DJ, et al. The association between short sleep duration and obesity in young adults: a 13-year prospective study. Sleep, 2004;27:661-6.

30. Anderson, LF, Jacobs DR, Carlsen, MH, Blomhoff, R. Consumption of coffee is associated with reduced risk of death attributed to inflammatory and cardiovascular disease in the Iowa Women’s Health Study. Am J Clin Nutr, 2006; 83:1039-46.

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