When It Feels Like You’re Losing the Weight Loss Game


woman on scale
You know the drill.

You go in for your regular diabetes check and the nurse stands you on the scale. You’ve been avoiding the scale for some time now, and you’ve gained a few pounds. Inside your endocrinologist’s office, you feel – or imagine – her annoyance that you still haven’t taken yourself in hand. As you leave with her familiar instruction to cut the carbs and the number of a nutritionist in hand, you try not to get down.

You know you should lose the weight. If not for the sake of your diabetes, for how you feel. Your fat pants are tight, and you get winded going up the stairs. And then there are the complications from diabetes that you’ve read about online; you certainly don’t want to go there.

So, for the hundredth (or two hundredth time) in your life, you vow to slim down. Sitting behind the wheel of your car in the parking lot, you formulate a plan. Maybe you’ll try Weight Watchers. Or Paleo – a guy at work had good luck with that, losing 25 pounds.

And no matter how many times you’ve made this vow, you swear today will be different. On the back of your parking stub, you figure out how many pounds you can lose by June – 10, 20, maybe the complete 30? You carefully do the math. After all, you’ve been dieting most of your life and you know a lot of numbers – calories, carbs, and fats.

So why can’t you drop the pounds?

Well, you can. You actually lost weight last summer, almost ten pounds, but then you got annoyed. Watching everyone at the Labor Day picnic downing fried chicken didn’t seem fair, so you gave up on picking around the skin and ate the whole leg – skin and everything. It was only one time, and it was a holiday, so it seemed like no big deal. But then there was a birthday in the office, and though you debated for a moment, you allowed yourself a little piece of cake. Later, in the afternoon, you saw all that was left and you let yourself have a second slice -–no sense letting good cake go to waste. And then…

So what’s the answer? Do you give up?

No. But maybe, this time, you do it differently. For the first time, you walk away from diet plans and you figure out not what you need to subtract from your life, but what you need to add. Things that are doable. And enjoyable. That fit in with your twin goals: a lighter you and improved diabetes care.

How about exercise? A walk in the morning and a walk at night? How about vegetables? You know some have more carbs than others, so what kinds? Maybe you try a food tracking app, where you log everything you eat. Sure, you could eat a bag of M&M’s during break, but could you try a bag of baby carrots? If that doesn’t work, could you settle for half the M&M’s rather than an entire bag? How does that impact your sugar? Could you eat half the M&M’s two days a week and the carrots the rest of the time?

The problem with diets is that they often deprive, making you fixate on what you can’t have, which often makes you want that thing more. And when you begin to step outside the rigid rules of the diet, it can be hard to get back on track.

But what if you break down the imposed boundaries of the most popular diets and re-learn what to eat on your own? What if you thought of eating and exercise not as punishment, but a way to understand what you truly need and like and – to paraphrase Marie Kondo – what brings you joy?

Five supplements that claim to speed up weight loss – and what the science says


When you google “weight loss” the challenge to sort fact from fiction begins. These five supplements claim to speed up weight loss, but let’s see what the evidence says.

1. Raspberry ketones

Raspberry ketones, sold as weight loss tablets, are chemicals found in red raspberries responsible for that distinct raspberry flavour and smell. You can also make raspberry ketones in a lab.

A study in obese rats found raspberry ketones reduced their total body fat content. In one study, 70 adults with obesity were put on a weight loss diet and exercise program, and randomised to take a supplement containing either raspberry ketones, or other supplements such as caffeine or garlic, or a placebo.

Only 45 participants completed the study. The 27 who took a supplement lost about 1.9 kilos, compared to 400 grams in the 18 in the placebo group. The drop-out rate was so high that these results need to be interpreted with a lot of caution.

A small pilot study of five adults found no effect on weight when the participants were told to maintain their current eating and exercise patterns and just took supplements of 200mg/day of raspberry ketones.

Concerns have been raised about potential toxic effects of raspberry ketones on the heart and for reproduction.

Verdict: Fiction! Leave the raspberry ketone supplements on the shelf. Spend your money on foods that contain them, including fresh berries, kiwifruit, peaches, grapes, apples and rhubarb.



2. Matcha green tea powder

Matcha is a green tea made from leaves of the Camellia sinensis, or tea plant, but it’s processed into a green powder and can be mixed into liquids or food. Before the leaves are harvested, the tea plant is put in the shade for a few weeks, which increases the content of theanine and caffeine.

No studies have tested the effect of matcha on weight loss. A review of six studies using green tea preparations for weight loss over 12 weeks found a difference based on country. In studies conducted outside of Japan, people consuming green tea did not lose more weight than controls. In the eight studies conducted within Japan, the mean weight loss ranged from 200 grams to 3.5 kilos in favour of green tea preparations.

Verdict: Fiction! There are currently no studies testing whether matcha tea accelerates weight loss.


Read more: Science or Snake Oil: do skinny teas boost weight loss?


Tea has a reputation for weight loss that’s probably not deserved. from http://www.shutterstock.com

3. Garcinia cambogia supplements

Garcinia Cambogia is a tropical fruit that contains a large amount of Hydroxycitric Acid (HCA), claimed to aid weight loss.

In animal studies, HCA interferes with usual production of fatty acids. If this was transferred to humans it could theoretically make it harder to metabolise fat and speed up weight loss. Research studies in humans show this is not the case.

While one 12-week trial in overweight women randomised them to a low kilojoule diet, with or without HCA and found the HCA group lost significantly more weight (3.7 compared to 2.4 kilos for placebo), two other trials found no difference in weight loss.

A 12-week trial in 135 men and women found no difference in weight loss between the HCA group (3.2 kilos) and the placebo group (4.1 kilos). A ten-week trial in 86 men and women who were overweight and randomised to take either Garcinia Cambogia extract or placebo, but were not also put on a weight-loss diet, found minimal weight loss of 650 grams versus 680 grams, with no difference between groups.

Verdict: Fiction! Garcinia cambogia does not accelerate weight loss.



4. Caffeine supplements

Caffeine is claimed to increase your metabolic rate and therefore speed up weight loss. Research studies in volunteers of a healthy weight found an increase in metabolic rate, but it depended on the dose. The more caffeine supplements consumed, the more the metabolic rate went up.

The lowest caffeine dose of 100mg, the amount in one instant coffee, increased the average metabolic rate by nine calories per hour, while the 400mg dose, which is roughly equivalent to the caffeine found in two to three cups of barista-made coffee, increased metabolic rate by about 34 calories per hour over three hours.

When adults with obesity were given caffeine supplements at a dose of 8mg per kilo of body weight, there was an increase in metabolic rate of about 16% for up to three hours.

In a study in which adults with obesity were asked to follow a weight-loss diet, then randomised to receive either 200mg caffeine supplements three times a day for 24 weeks or a placebo supplement, there was no difference in weight change between groups. For the first eight weeks, the group taking caffeine supplements experienced side-effects of insomnia, tremor and dizziness.

Verdict: Fiction! While caffeine does speed up the body’s metabolic rate in the short-term, it does not speed up weight loss.


 

5. Alkaline water

Alkalising products are promoted widely. These include alkaline water, alkalising powders and alkaline diets. You’re supposed to measure the acidity of your urine and/or saliva to “assess” body acidity level. Urine usually has a slightly acidic pH (average is about pH6) – vegetables and fruit make it more alkaline, while eating meat makes it less so.

Saliva has a neutral pH of 7. Alkaline diets recommend you modify what you eat based on your urine or saliva pH, claiming a more alkaline pH helps digestion, weight loss and well-being.

But your stomach is highly acidic at a pH less than 3.5, with this acid helping breakdown food. It then moves into the small bowel for digestion and absorption where the pH increases to 4.5-5.0, which is still acidic.

Your body has finely controlled pH balancing mechanisms to make sure your blood pH stays between 7.35-7.45. If it did not, you would die.

On the positive side, alkaline diets encourage healthier eating by promoting plant based foods such as fruit and vegetables. There is some evidence lower intakes of foods of animal origin that contribute to acid load are associated with better long-term health.

Verdict: Fiction! There is no scientific evidence to support alkaline water or powders speeding up weight loss.

Food v exercise: What makes the biggest difference in weight loss?


Searching for the best way to lose weight? Should the emphasis be on diet, or can the solution be found in the gym?

Well, the answer lies somewhere in between.

In the red corner of the weight-loss title fight, sits the dieting contender. On the surface, dieting would appear to have the edge, because no matter what a person’s genetic makeup and metabolism, anyone who stops eating is guaranteed to lose weight.

Starvation, though, is not a dieting option to be recommended or one that is sustainable.

 

 

 

 

 

 

 

 

 

 

 

 

 

So should it be low-fat, low-carbohydrate, high-protein, low-GI, small meals or any one of a myriad other popular dieting approaches?

The scientific jury is now firmly in, with dozens of high-quality, randomised controlled trials showing that no one dieting option is the magic solution for everyone.

Apart from some short-term success for particular approaches – mostly low-carbohydrate diets – all of the popular dieting approaches fare poorly for weight loss and adherence once the six-month milestone has passed.

This was demonstrated in one of the largest and longest-run weight loss studies ever conducted, which investigated how diets with different fat, protein and carbohydrate content influenced weight loss.

Over 800 overweight adults took part in the study which ran for two years. Each person was randomly allocated to one of four different diets which ranged from high-carbohydrate/low-fat to low-carbohydrate/high-fat.

After six months, the average weight loss was 7% of the initial body weight, with negligible differences between the diets. Predictably, much of this lost weight was regained, with only half the respondents maintaining their new weight for two years.

As the study progressed, the differences in the nutrient mix between the diet groups became smaller, as fewer people met their diet goals for fat or carbohydrate intake.

If the participants of this research study found it difficult to stick to a diet, despite expert advice and ongoing follow-up and support, then the chances of success in the “real-world” are even more remote.

The rising rates of obesity in the face of continual best-selling “breakthrough” diet plans attest to that.

The significant number of clinical trials clearly and conclusively show that the fat, protein and carbohydrate composition of the diet matter little for achieving weight loss.

Following a sensible eating plan and sticking to it matters most.

Diets aside, regular exercise increases your chance of long-term weight loss. Kenny Holston

So what about the contender in the blue corner: exercise?

Exercise has a modest, but consistent benefit on body fat reduction. And this benefit is independent of dieting.

But the benefit of exercise in weight loss may not be as great as we may have expected. For people who are already overweight, even 60 minutes of physical activity each day may not be enough to halt weight gain.

One recent high-quality study, which looked at the ability of people to hold onto hard-fought weight loss, found that 12 months after a weight-loss program ended, people who kept up more than 90 minutes of physical activity each day lost the most weight.

If you’re breaking out in a sweat just thinking about that much activity, don’t worry. What it really means is that more attention needs to be paid to the food side of the energy balance equation.

Here’s a simple example of the differences between eating and exercise. A 100g chocolate bar could easily be eaten in under one minute.

You’d need to run for 7km to burn off the energy from one chocolate bar. Flickr/yum me

The amount of energy in that bar – 2200 kJ or 500 Calories – would be enough to fuel the body of a sedentary office worker for around five hours with no other food needed. Or you could try a 7km run or 90 minutes walk to burn off the energy from the chocolate bar.

So making some concerted changes to the “input” side of the energy balance equation can reap large benefits for weight loss.

The weight loss literature, though, is a minefield for diets that result in poor adherence and weight rebound. So instead let’s look at those who have been successful in losing weight and keeping it off.

Long-term successful “weight losers” make a conscious effort to adopt at least one weight-loss strategy from the list following:

  • ↑ fruit and vegetables
  • ↑ exercise
  • ↓ kilojoules
  • ↓ fat
  • ↓ sweets and junk food
  • ↓ portion sizes
  • ↓ overall quantity of food

It’s not surprising that all of these behaviour changes are consistent with current recommendations by nutrition and health professionals for safe and appropriate weight loss.

For most people, dieting is not the way to achieve long-term weight loss. And hitting the gym alone seems to work for only the most dedicated of souls.

Small and realistic lifestyle changes will always be the best recipe for achieving and maintaining a healthy weight.

Vitamin D supplements promote weight loss in weight loss


https://speciality.medicaldialogues.in/vitamin-d-supplements-promote-weight-loss-in-obese-children/

How to Lose Fat and Gain Muscle at the Same Time


Yes, it’s possible.
build-muscle-lose-fat

There are a lot of reasons to work out, including improving health, burning fat, gaining muscle, and just simply feeling better. Many of us have multiple goals at once, and luckily, a lot of these logically go hand-in-hand. Losing fat and gaining muscle, however, seem to be a little conflicting.

When you’re trying to lose fat, you’re trying to get rid of some of your body’s mass; when you’re gaining muscle, you’re looking to do the opposite and build up your body. So it makes sense to wonder, can you really add muscle mass at the same time? Surprisingly, the answer is yes.

In fact, working on both goals at the same time will maximize your results—many of the same exercises that are good for burning fat are also great for building up muscles. And it’s kind of a domino effect: When you have more muscle mass, your body requires more energy at rest (that is, burns more calories when you’re not even moving).

But nailing fat loss and muscle gains in one fell swoop requires a strategic approach. Here’s why: If you want to lose weight, you need to burn more calories than you consume. But when you restrict your calories, your body has to pull from existing energy stores in your body—fat, carbohydrate, and even protein—in order to function. As a result, you wind up losing fat, but unfortunately, you also lose muscle mass.

In fact, up to a whopping 25 percent of the weight that you lose from a low-calorie diet is in the form of hard-earned muscle, Michaela Devries-Aboud, Ph.D., assistant kinesiology professor at the University of Waterloo, tells SELF.

Yet, multiple studies and experts say that losing fat and gaining muscle simultaneously is totally doable. “It’s difficult, but possible,” Stephen Ball, Ph.D., associate professor of nutritional science and exercise physiology at the University of Missouri, tells SELF.

To achieve both goals at once, you need to focus on two main things: protein and weightlifting.

First, let’s talk about cutting calories. If you’re trying to cut calories to lose weight, there are a few things you need to know to do it safely.

You need to create a calorie deficit to lose weight—that is, you need to consume fewer calories than the energy you burn at rest and during your workout. But that’s only when you want to lose weight. If you’re looking to lose fat and gain muscle, your number on the scale might not budge—or might even go up!—even though your physique is changing dramatically. In fact, you might even notice that you look slimmer or more toned even though you haven’t lost weight. That’s simply because you’re gaining muscle and losing fat.

We’re not suggesting that you should cut calories, but if that’s something you want to do, you’ll need to keep a few things in mind. For one, if you cut too much at once you’ll only sabotage your efforts. Restricting calories too severely leaves you with limited energy to complete a workout, and ultimately slows your metabolism. “Drastic changes in calories make your body compensate metabolically to defend your initial body weight. “Therefore, your body will decrease the amount of energy burned to conserve calories and prevent weight loss,” says Kristen F. Gradney, R.D.N., director of nutrition and metabolic services at Our Lady of the Lake Regional Medical Center and spokesperson for the Academy of Nutrition and Dietetics.

In addition, skimping on calories—protein in particular—can leave next to nothing for your muscles to feed on after your workout. “Resistance exercise is typically considered anabolic, meaning it breaks down muscle,” Gradney tells SELF. “If you’re not consuming adequate calories and protein, muscle may not recover and rebuild appropriately.”

You don’t have to count calories in order to achieve your body composition goals. Many women find that eating mindfully and choosing filling, nutritious foods can keep calories in check without having to track every bite. And if you have a history of eating disorders, always talk with a professional before changing your dietary habits.

If you do want to track your calories, however, here’s some general advice. Keep in mind that these are just general guidelines, and it’s very likely that your particular calorie needs may be lower or higher than what these formulas say. To figure out how many calories you need per day to lose weight safely, you first have to find out how many calories you require just to maintain your current weight. You can do that by finding out your basal metabolic rate (BMR), which is how many calories your body burns at rest. There are some useful formulas to get an approximate estimate, but it’s tough to get a specific, accurate number unless you go get a test done by your doctor (here are a few formulas you can try if you want). The easiest way to get a rough estimate of how many calories you need to maintain your current weight is by using this handy interactive calculator from the United States Department of Agriculture, which takes both your estimated BMR and activity level into consideration.

Once you find your rough daily calorie need, subtract no more than 300 calories, Liz Applegate, Ph.D., senior lecturer in the department of nutrition and director of sports nutrition at the University of California, Davis, tells SELF. “Let’s say you need 2,000 calories,” Applegate says. “If I prescribed 1,700, you can lose fat and build lean mass.”

As this calculation is only an estimate, you may want to log your food for several days (try a free app like MyFitnessPal) to see how much you normally eat and adjust your intake if needed. “It’s important to listen to your body and eat when you feel physical signs of hunger,” Gradney says.

Because you’ll have fewer calories to fuel your body, you’ll want to get the most bang for your buck by opting for whole foods whenever possible. “Whole foods provide calories along with lots of important nutrients, including protein, healthy fats, vitamins, and minerals,” Alissa Rumsey, M.D., R.D., C.S.C.S., owner of Alissa Rumsey Nutrition and Wellness, tells SELF.

And remember: losing fat and gaining muscle does not require cutting calories.

Now let’s talk protein, the macronutrient that’s responsible for building muscle.

According to Devries-Aboud, our bodies are constantly building and breaking down muscle protein, the component of the muscle that’s responsible for changing its size and shape. When you eat a protein-packed meal, the production of muscle protein speeds up. But as time elapses after your meal, the muscle-building process slows down and breakdown speeds up. “Over the course of days, weeks, and months the relative ratio of these two processes will determine whether you gain or lose muscle mass, or if the muscle mass stays the same,” Devries-Aboud says.

To keep your body in muscle protein-building mode while cutting calories, you have to adjust your protein intake. “When you cut calories below your requirement, your need for protein goes up,” Applegate says. This is because a portion of the dietary protein is being used to meet your daily energy needs; consuming a slightly greater amount than what is required to meet your energy needs will ensure you have enough left over to sustain or even build muscle, she adds.

A recent study of 20 young men aimed to find out if increasing the amount of protein consumed in a reduced-calorie diet would have any effect on body composition when paired with intense exercise. Researchers divided subjects into two groups, and assigned one group to follow a higher-protein diet than the other (2.4 grams per kilogram body weight per day versus 1.2). Meanwhile, both groups performed a combination of resistance and high-intensity interval training six days per week. By the end of four weeks, not only did the subjects in the higher-protein group lose more body fat than those in the lower-protein group, but they also managed to gain muscle, despite eating fewer calories than their bodies needed. The results were published in the American Journal of Clinical Nutrition.

But before you go out and chug protein shakes, keep in mind: Multiple studies (like this one and this one) have shown that a very high protein intake (in one instance, up to 5.5 times the recommended daily allowance) doesn’t lead to better results.

Instead, aim for roughly 20 grams of protein per meal, four times per day, says Applegate. It’s important to distribute it throughout the day instead of cramming it all in at one meal so that your body can use it throughout the day. Research also suggests that this can enhance the muscle-building effects.

On strength training days, Applegate suggests having 20 to 25 grams of protein about 30 minutes after your workout. But if you can’t swing that, don’t worry—what’s most important is getting enough protein throughout the day to fuel muscle building. (How much timing really matters is hotly debated in the nutrition world, but most dietitians suggest aiming for anywhere from 30 minutes to two hours post-workout to be sure you’re refueling properly.)

For the rest of your meals, Darryn Willoughby, Ph.D., director of the exercise and biochemical nutrition laboratory and professor at Baylor University, recommends filling up with lean protein sources like chicken, turkey, and tilapia; fatty fish like salmon and tuna; dairy; and eggs.

As an added bonus, protein provides satiety, leading to feelings of fullness and reduced cravings, says Willoughby. This is especially helpful when your ultimate goal is to lose weight and you have a limited number of calories to work with.

Now, let’s talk about the second piece of the lose-weight/gain-muscle puzzle: strength training. If you want to build muscle on top of burning fat, you need to incorporate resistance exercises into your routine.

When you lift weights, you cause damage to your muscle fibers, which prompts the muscle to call for surrounding satellite cells (the cells involved in growing and repairing skeletal muscle) to help repair or replace those damaged fibers, making your muscles grow. In addition, strength training increases the production of muscle protein for up to 48 hours, according to Devries-Aboud. “As long as the rate of muscle synthesis is greater than the breakdown, you will build muscle,” says Ball.

If you want to see the best fat-burning, muscle-building results from your strength routine, exercise physiologist Michelle Lovitt, M.A., recommends taking advantage of heart rate–based training. You want to bounce between 60 and 85 percent of your maximum heart rate throughout your strength-training session, which will ensure that you burn more fat instead of glycogen, the carbohydrates our bodies store to use as quick energy. (You’ll still burn some glycogen, but the proportion changes so that you’re using more fat than you would with higher intensity exercise.)

Many high-intensity workouts bring you above your anaerobic threshold, which is approximately 85 percent of your maximum heart rate. And when you push past 85 percent, your body starts fueling using mostly carbohydrates. “So you’re burning calories, but those calories aren’t necessarily coming from body fat,” Lovitt says. This spares the fat and often leaves you craving carbs later in the day.

Hit the gym three or four days per week, moving right from a set of a lower-body or multi-joint strength exercises like the squat, which requires greater energy expenditure and jacks up the heart rate (because you’re employing multiple muscle groups at once), into an upper-body or single-joint exercise like a seated row to bring the heart rate back down. Continue alternating between multi-joint and single-joint exercises throughout your workout.

“If you do it properly, you’ll get a cardio workout at the same time,” Lovitt says. The key is to keep your heart rate between 60 and 85 percent of your maximum. (To find your maximum heart rate, subtract your age from 220, then multiply that number by 0.17.)

Keep in mind, these results don’t happen overnight. It takes time—several months, if not more—to significantly change your body, and you need to be consistent with your strength training and diet to get the results you want. Even then, some people will naturally see results faster than others simply because of genetics, lifestyle, or a whole host of other factors. If you’re having trouble reaching your goals, it might be a good idea to work with a nutritionist and a personal trainer to troubleshoot and create a plan that’s customized for you. And always remember: Your happiness and health are more important than what your body looks like. Make sure your goals are realistic for you, and enjoy the process.

Disordered Eating with Diabetes


eating disorder with diabetes

 

“Are you hungry?” my husband asked me after a particularly difficult hike in the Rocky Mountains last summer that lasted over 12 hours, where all we ate during the day was trail mix and some dried fruit. He was starving.

“I’m fine,” I replied. “My blood sugar is 115.”

He looked at me quizzically, and lovingly reminded me that blood sugar and hunger are not the same thing.

As a person with diabetes, I have had to separate my hunger from my need of food. There have been countless instances when at dinner time my blood sugar was over 400, and I had to wait until insulin brought me down to a safe level before digging in. Conversely, there have been many times (too many to count) where I was not hungry at all, but of course had to eat something because my blood sugar was under 60. I am always cognizant of my blood sugar, but not always of the crucial hunger and fullness cues. This is problematic.

People with diabetes have a tricky relationship with food. Diabetes requires one to be diligent when it comes to tracking what and how much they eat. There is also constant monitoring of food intake (carbohydrates in particular), exercise, and insulin. Additionally, people with type 1 diabetes, whose beta cells have been destroyed by the body’s immune system, secrete none of the hormone called amylin at all. Amylin is a peptide hormone that is co-secreted with insulin, and inhibits glucagon secretion, delays gastric emptying, and acts as a satiety agent. This may be why some people with diabetes struggle to feel full after meals. As a result of all of this constant tracking of food, plus the inability to regulate our hunger cues, people with diabetes may be inherently more prone to issues around disordered eating.

According to the National Institutes of Health, adolescents (ages 12-21) with type 1 diabetes experience elevated rates of disordered eating behaviors in 37.9% of females and in 15.9% of males. For adolescents without diabetes, the rates are 3.8% and 1.5%, respectively. The most common type of disordered eating among people with type 1 diabetes is a little known condition called diabulimia, where people intentionally reduce their insulin intake to lose weight. This is a serious condition that leads to diabetic ketoacidosis (DKA) and even death, if not treated.

One in three teenagers (more often than not a girl) will face disordered eating in her lifetime with type 1 diabetes. We’re bombarded with magazines and ads, fad diets and “quick fixes.” We also have to maintain a healthy HbA1c, measure every portion of food we eat, and make sure we get adequate exercise and take our insulin appropriately. It’s stressful. And how “normal” is it that every 12 year old with diabetes knows the carb counts for not only every sandwich they eat, but all of the snacks they eat at sleepovers, as well as their birthday cake?

Holding all of that healthy knowledge inside is overwhelming, especially in a society that values thinness over all else. It is also powerful that every diabetic holds the keys to their health literally in their hands. If they mismanage their diabetes, they will lose weight (losing weight is also a classic symptom of diabetes, so it stands to reason that diabulimia and the mismanagement of the condition leads to weight loss). People with diabetes face many tough battles, and food is a major source of stress for most people with the condition.

Since many people’s relationship to food is warped, it’s important to note the symptoms of diabulimia if your loved ones are showing any of the following signs, and to seek help if you think they have a problem:

According to the National Eating Disorder Association, signs of diabulimia include:

  • Hemoglobin A1c level of 9.0 or higher on a continuous basis
  • Unexplained weight loss
  • Persistent thirst/frequent urination
  • Preoccupation with body image and a fear that insulin will cause weight gain
  • Blood sugar records that do not match hemoglobin A1c results (falsifying sugar logs)
  • Depression
  • Secrecy about blood sugars, shots, and eating
  • Repeated bladder and yeast infections
  • Low sodium/potassium
  • Increased appetite especially in sugary foods
  • Cancelled doctors’ appointments

If you think that you or someone you know is struggling with disordered eating or diabulimia, contact the diabulimia helpline or call their hotline, open 24 hours a day: (425) 985–3635.

Have you seen drastic dietary or behavioral changes in someone you love that has diabetes? Do you recognize any of the aforementioned symptoms in your own life? If so, please seek the help you need. Your diabetes and your life depend on it.

 

Turmeric’s “Weight Loss Secret”: It Turns Bad Fat Good


Turmeric's "Weight Loss Secret": It Turns Bad Fat Good

A groundbreaking new study published in Journal of Nutritional Biochemistry reveals that curcumin, a golden-hued compound in turmeric, may provide a unique solution for overweight individuals by altering the composition of fat cells in their bodies in favor of the calorie-burning type. 

Obesity and overweight are global epidemics today, and are largely due to the now virtually universal Western type diet of highly processed, genetically modified, chemical contaminated, and evolutionarily incompatible foods, and which can have severe if not sometimes lethal adverse health effects.

Diet, however, is not the only contributing factor. Like all conditions, the problem is multi-factorial, with exposure to a host of endocrine disrupters, chronic stress, a dramatically altered and/or depleted microbiome, and a lack of sufficient movement and exercise, all playing key roles. Every year, billions of dollars are spent on weight loss gadgets, bariatric surgeries, and both synthetic and natural pills, and yet the problem only appears to be growing worse.

What if we could strike closer to the root causes of serious weight problems using something as familiar, affordable, and safe as a common spice on our spice rack?

Indeed, turmeric contains a golden-hued compound called curcumin which appears to be capable of changing “bad” fat cells into “good” ones, among a whole host of additional beneficial properties.

Know the Difference Between Brown and White — “Good” and “Bad” — Fat

Fat used to be a really bad word. Today, however, a growing number of consumers and health enthusiasts are embracing the concept of incorporating more “good fats” into the diet, i.e. olive oil, avocado, coconut. That said, many still don’t know that our bodies also contain both “good” (brown) and “bad” fat (white), and depending on our activity levels, environmental conditions, and what we do or do not eat, we’ll have a particular ratio that will significantly affect our level of health as well as risk for an entire gamut of diseases.

Brown fat is colored darkly because of the high density of iron-containing mitochondria it contains. Brown fat cells, unlike white fat cells, are capable of diverting significant quantities of dietary caloric energy into thermal energy or heat. This makes the metabolic role of brown fat cells completely opposite to that of white fat cells whose primary function is to store energy for future use as adipose tissue.  To underscore how radically different brown fat cells are from white, they derive from an entirely different stem cell lineage; the same one that skeletal muscle cells differentiate from.

Since the vast majority of fat found within overweight and obese adults is of the white fat variety (we have the most when we are infants at about 5% by weight), and since abdominal obesity (belly fat) has been found to be a greater risk factor for heart attack than smoking, it behooves us to look at belly fat as a concern relevant to far more than vanity, and to find ways to reduce midsection fat naturally, or at least increase the ratio of brown to white fat in the body.

The discovery of radically differing types of fat in the adult body, and a deficiency or much smaller ratio of brown to white fat in those with weight problems, has lead some researchers to hypothesize that increasing the brown fat cell phenotype could provide a novel intervention for obesity. Indeed, preliminary research on using cold temperatures to increase the brown fat in the mammalian body appear to have significant anti-obesity effects, but there is concern that these temperature changes may have unintended adverse effects for cardiovascular health.[1] Also, exposure to the cold is just plain uncomfortable, making it a less than ideal solution for many. A turmeric-based intervention could provide a much more convenient alternative.

Curcumin Brown Fat

Turmeric Extract (Curcumin) May Be An Ideal Weight Loss Supplement

In the new study titled, “Curcumin induces brown fat-like phenotype in 3T3-L1 and primary white adipocytes,” Korean researchers established for the first time that curcumin is capable of inducing browning of white fat cells (adipocytes) through at least four different mechanisms:

1.     By enhancing the expression of brown fat specific genes. This is a form of nutrigenomic “epigenetic modification,” which means that a nutrient is capable of altering a cell’s patterns of gene expression “from the outside in,” as it were, resulting in significant changes in the structure and function of the cells involved.

2.     By stimulating the production of new mitochondria, as evidenced by increased activity of the electron transport chain and increased fatty acid oxidation. Mitochondrial biogenesis can be stimulated with other natural substances and therapeutic modalities and is an intervention that may be of special benefit in age-associated loss of muscle and brain function, enhancing athletic performance, and in improving mitochondrial disorders. [see our database keyword: “Mitochondrial Biogenesis“]

3.     By increasing protein levels of hormone-sensitive lipase and p-acyl-CoA carboxylase, two markers that play a role in increasing fat-degrading processes (lipolysis) and the suppression of new fat production (lipogenesis).

4.     By increasing the activity AMP-activated protein kinase (AMPK). AMPK activity is something of a cellular metabolic master switch that improves metabolic homeostasis, which is often out of balance in overweight and obese individuals.

In addition to these four mechanisms of action contributing to curcumin’s brown fat supporting properties, the researchers also noted that because curcumin is a well-established anti-inflammatory agent (view 88 studies on the topic here), and because obesity and its various co-morbid states such as diabetes and cardiovascular disease are conditions that involve upregulated and unremitting inflammatory and/or or dysregulated inflammatory response, curcumin’s anti-obesity effects may be in part due to its inflammation-reducing properties.

One additional relevant mechanism of action not discussed in this study, but recently identified in a study published earlier this year in the journal Molecular Medicine Reports, is curcumin’s ability to induce programmed cell death (apoptosis) in white fat cells. This may contribute permanently to reducing the overall ability of the body to store unhealthy fat.

The study authors concluded,

“Our findings suggest that curcumin plays a dual modulatory role in inhibition of adipogenesis as well as induction of the brown fat-like phenotype and thus may have potential therapeutic implications for treatment of obesity.”

Curcumin’s Benefits Extend To A Wide Range of Health Issues

Given the research discussed above, curcumin should be considered a pleiotrophic anti-obesity agent, as it is capable of “targeting” and ameliorating a variety of metabolic imbalances in the body simultaneously. In fact, curcumin is so diverse in its therapeutic actions as to boggle the imagination. Our database project alone has characterized over 600 distinct health conditions that curcumin has been studied to prevent, treat, and in some cases reverse – something that puts every pharmaceutical drug on the planet to shame, especially considering that curcumin is immensely safer and has been time-tested for thousands of years in a wide range of different cultures. Add in the fact that curcumin has been studied in human trials to be at least as effective as Prozac for depression, a cardiovascular tonic as significant as exercise, and capable of preventing the progression of prediabetes to diabetes in an astounding 100% of those tested, it would seem unethical not to use it when the choices are either inaction or a pharmaceutical drug. For more information you can view 17 studies we have gathered on turmeric and/or curcumin’s anti-obesity properties here.


References

[1] Dong, Mei; Yang, Xiaoyan; Lim, Sharon; Cao, Ziquan; Honek, Jennifer; Lu, Huixia; Zhang, Cheng; et al. (2 July 2013). “Cold exposure promotes atherosclerotic plaque growth and instability via UCP1-dependent lipolysis” (Short article). Cell Metabolism 18: 118–129.doi:10.1016/j.cmet.2013.06.003.

Obesity Can Actually Scar Your Fat Tissue, Making Weight Loss Even Harder


Our body’s fat-storing mechanisms – called adipose tissues – are very good at the job of taking our excess calories and storing them in the form of high-energy molecules called lipids.

 

But new research suggests their cells can expand to a size that literally suffocates them, triggering inflammation and making the adipose tissues less efficient. Not only is this bad news for losing weight, it also puts other organs at risk of critical damage.

Research led by the University of Exeter in the UK found that levels of an enzyme called lysyl oxidase increase in adipose tissues as an individual’s body mass index goes up, indicating the cells were being scarred as they expanded in size.

Lysyl oxidase – or LOX – crosslinks fibres of collagen, a tough protein that builds structures inside cells and helps connect tissue. Excess LOX can mean there’s too much fibrous structure surrounding cells, making the tissue rigid.

All of this adds up to fat cells that can no longer expand to fit more lipids, and change how fat is distributed around the body.

Scarred adipose tissue can see more fat distributed around organs and less under the skin, giving people an ‘apple’ shape with larger bodies and thinner limbs.

Since this visceral fat is more of a concern for our health than subcutaneous fat, it’s a serious problem that warrants addressing.

“One could have very little fat below the skin and still be at risk of diabetes due to a lot of fat within the abdomen and inner organs,” says physician Katarina Kos from the University of Exeter’s Medical School.

It also means there’s less room for fat to be stored inside the adipose tissue itself.

While you might imagine this to be a good thing, that fat doesn’t disappear – instead, it can be diverted into other tissues such as the liver and the heart, raising the risk of cardiovascular disease.

And if all that isn’t bad enough, stiffer adipose tissues also make it hard for the cells to release their stores of fat.

“Scarring of fat tissue may make weight loss more difficult,” says Kos.

Much of the problem starts with the cells in adipose tissue becoming starved of oxygen.

The researchers compared the levels of messenger RNA expressed for the LOX enzyme in adipose tissues from patients undergoing bariatric surgery, and again in samples collected over nine months later.

They also analysed LOX expression in response to mild inflammation in the fat tissues of healthy male volunteers, and compared levels in diabetic patients.

While having diabetes didn’t affect the levels of LOX, and therefore the scarring of the tissues, low levels of oxygen and inflammation had a significant impact on its expression.

This was taken to suggest that as the cells fill and expand, they’re deprived of the oxygen they need to survive. This triggers and inflammation process, increasing LOX levels and making the cells more fibrous.

Unfortunately weight loss surgery didn’t see the LOX levels decrease, making it unlikely that the tissues would become less scarred even with radical interventions.

The take-home message is to keep our adipose tissue in check before it gets to that stage.

“There is evidence that once fat tissue becomes scarred, despite weight loss, it may not recover fully,” says Kos.

“We need to look after our fat tissue which can cease to cope if it is overworked when being forced to absorb more and more calories.”

Kos’s advice is to exercise or at least take a walk after a meal. Weight loss is hard, and while a few people have the ability to keep at it, others face an uphill battle thanks to a mix of biology and habit.

But if knowing it could only get harder later gives some people that incentive to cut a few calories and walk after a meal, then this is one study to pay close attention to.

Pain Sensitization Declines After Bariatric Tx in Obese Patients


Decreased knee pain linked with central sensitization

Action Points

Weight loss following bariatric surgery was associated with improvements in pain sensitization among obese patients with chronic knee pain, a year-long study found.

One year after bariatric surgery, the pressure pain threshold increased by 38.5% at the patella and by 30.9% at the wrist among patients who had undergone either laparoscopic roux-en-y gastric bypass or sleeve gastrectomy, whereas no changes in the pressure pain threshold were observed among patients who had medical/lifestyle management, according to Joshua J. Stafanik, PhD, MSPT, of Northeastern University in Boston, and colleagues.

 “Improvement in pressure point threshold at the wrist suggests that the pain improvement in the surgical subjects was at least in part mediated through central sensitization,” the researchers wrote online in Arthritis Care & Research.

Obese individuals typically report more musculoskeletal pain than do those of normal weight, particularly at the knees, which has been attributed to mechanical stresses from excess loading at the weight-bearing joints and also to the release of adipokines from adipose tissue and the resulting low-grade joint inflammation.

But it has not been established whether additional pain relief at sites beyond the knee is provided by changes in central and peripheral pain sensitization, defined as “increased responsiveness of the peripheral and central nervous systems to nociceptive input,” according to the authors. So they sought to examine this possibility among individuals seen at the Nutrition and Weight Management Center at Boston Medical Center.

They recruited 87 participants who met the eligibility criteria for bariatric surgery, which were a BMI of 35 plus a weight-associated comorbidity, or a BMI >40. They all had knee pain on most days of the previous month.

Those receiving medical management were prescribed a low-fat diet of 1,200 to 1,800 calories per day plus medications such as phentermine, lorcaserin, and bupropion/naltrexone. Exercise, including walking 30 minutes daily, also was encouraged.

Knee pain was evaluated according to the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and pressure pain thresholds were assessed with a hand-held algometer applied at a rate of 0.5 kg/sec to the radioulnar joint and index patella.

The radioulnar joint of the right wrist was considered a control site, as it is not usually affected by osteoarthritis. The researchers also recorded the number of joints other than the knees with frequent pain in the past month.

A lower pressure pain threshold reflects higher sensitivity to pain.

A total of 45 patients in the surgery group and 22 in the medical group completed the 1-year follow-up.

Among the surgery group, mean age was 43.8, 97.8% were women, and baseline BMI was 42.1. Their WOMAC pain score was 9.5 out of 20, and the average number of painful joints was 7.1. The pressure pain thresholds were 346.5 kilopascals at the patella and 335.6 at the wrist.

 In the medical management group, mean age was 48.1, 86.4% were women, and BMI was 40.7. WOMAC pain score was 11.5, mean number of painful joints was 6.3, and pressure pain thresholds were 450.7 and 387.7 at the patella and wrist, respectively.

At 1 year, the mean weight loss in the surgery group was 32.7 kg (about 72 lbs) compared with 4.6 kg in the medical management group.

Mean change in WOMAC pain score from baseline in the surgery group was -4.9, which was statistically significant (P<0.0001), while the -1.5 change in the medical management group was not significant. The change from baseline in number of painful joints was -2.3 in the surgery group (P=0.002), but +0.9 in the medical management group.

At 1 year, the change in pressure point threshold was +133.3 at the patella and +103.8 at the wrist, compared with changes of -56.4 and +44.4 in the medical group.

Changes in weight correlated with differences in WOMAC pain (r=0.50, P<0.0001) and in pressure point threshold at the patella (r=-0.33, P=0.006), although not with changes in pressure point threshold at the wrist (r=-0.04, P=0.77). There also was a moderate inverse correlation between WOMAC pain changes and changes in pressure point thresholds at both patella (r=-0.4, P=0.007) and wrist (r=-0.4, P=0.002).

 The improved pressure point thresholds at the wrist and decrease in number of painful joints support the possibility that central pain sensitization is a mediator of pain reduction in the patients who had bariatric surgery, the authors noted.

“In the presence of sensitization, nociceptors respond to stimuli that they would normally not respond to. However, due to neuroplasticity, removal of the stimuli that contribute to sensitization may normalize nociceptor functioning,” they explained.

They also pointed out that other factors also may contribute to changes in pain after weight loss surgery, such as increased physical activity and improvements in mood and quality of sleep. In addition, further research will be needed to account for the potential influence of inflammatory markers such as C-reactive protein and metabolic factors on pain following bariatric surgery.

The 5 Necessities of an Effective Weight Loss Diet for People With Diabetes


weight loss for people with diabetes

This is not just another general “eat salad and completely avoid carbs” article. I’m tired of seeing generalized diet information that, to be brutally honest, is pointless and inapplicable to most people’s lives. This article is aimed to help the diabetic community focus on and prioritize what works.

Weight loss is science, not magic or voodoo or luck. There is a specific set of requirements needed to lose weight efficiently as a person with diabetes (type 1 or type 2). Yes, you may have heard of your friend’s cousin’s mother doing a no carb detox cleansing bath scrub to lose belly fat who lost 10 pounds, but I highly encourage you to check in with that person who does every fad diet possible in a few weeks or months. Chances are they gained the weight back and then some.

That’s because while some diets cause people to lose weight initially, they don’t employ the basic principles of continued effective weight loss. Whether it’s water weight loss, weight loss from severe calorie deficit, or avoidance of food, a lot of diets promise and sometimes produce acute results — that is temporary or short term results.

From helping hundreds of diabetics lose weight on social media, I was nicknamed the “T1D Fat Loss Coach” and now help people with all kinds of diabetes and chronic illnesses get on effective diets.

I have a 3 “E” rule for an effective diet before you continue on in this article. A diet must be all three of the following for you for it to be effective:

  1. Easy to adhere to long term
  2. Enjoyable or at least not miserable and affecting quality of life (socially or mood related)
  3. Effective in producing results long term (any diet change can produce short term results)

So, in deciding on a diet, make sure you have these rules in mind. These next five components of a diet will determine your success.

Optimal Weight Loss Blood Sugar

Blood sugar management is more important than exercise and diet combined for weight loss. Why? Because chasing blood sugars involves ruining your diet and training effectiveness.

You can’t optimally lose fat, build lean muscle, or get a healthier physique while mismanaging your blood sugars.

When your sugars are low, you are likely to (or at least more at risk to):

  • Overeat to correct lows
  • Overcompensate the overeating with medication that could lead to another low
  • Experience another low in the next 24-48 hours (“lows beget lows”)
  • Reduce intensity of exercise
  • Experience increased hunger and cravings which can be hard to fight

When your blood sugars are high, you are likely to (or at least more at risk to):

  • Overtreat with insulin which could lead to another low
  • Reduce nutrient absorption necessary to increase or preserve lean muscle mass
  • Decrease effectiveness of a workout
  • Experience a false sense of scale weight loss when in reality, you could be losing lean tissue which means reducing your metabolic rate and storing more body fat

In order to improve your metabolic rate and your body’s fat burning capability/processes, blood sugar management has to be a priority. In order to reduce cravings and hypo and hyperglycemic events that negatively affect diet and training, blood sugar management must be a main priority that isn’t overlooked.

Talk to your endocrinologist and diabetes management team as you decide on what the best approach is in conjunction with your changing diet and exercise habits. Then, you can get into specifics on calories and the makeup of those calories for fat loss optimization.

Specifying Calorie Intake

In order for you to lose weight, you have to be in a calorie deficit — that means burning more calories than you take in. You can do this by eating less, burning more calories through activity, or, ideally, a combination of both.

But first, you have to determine what is the appropriate number of calories you should be intaking based on your personal stats and goals. But can’t I just eat “healthy” and lose weight? You can and leave it to chance but even if you eat healthy foods in the wrong quantities, you will gain weight.

There is no universal fix to an individual problem.

That means what works for me doesn’t optimally work for your mom or for you. Specificity is optimal. To figure out how many calories you need to consume, you can find any TDEE calculator online like this one. This determines your Total Daily Energy Expenditure, or the calories you need to eat to maintain your current weight.

 IIFYM TDEE calculator

Now if you want to lose weight, you need to be in a caloric deficit which means you need to eat less than what you expend daily. My personal, general rule of thumb is:

  • If you want to lose 5 lbs/2 kg or less, subtract 250 calories from your TDEE
  • If you want to lose 5-15 lbs/2-7 kg, subtract 500 calories from your TDEE
  • If you want to lose over 20 lbs/10 kg, subtract up to 750 calories from your TDEE

This is a general rule that has helped hundreds of my type 1 and type 2 online weight loss clients lose between 5-60 lbs/2-25 kg but always be sure to consult your doctor before starting a new diet and training program.

Once you have your daily caloric limits, you can be more specific and determine your macronutrient goals.

Identifying Your Ideal Macro Balance

Calories determine weight change, but macronutrient balance determines the kind of weight change. Macronutrients are your proteins, carbohydrates, and fats.

  • Protein has 4 calories per gram
  • Carbs have 4 calories per gram
  • Fat has 9 calories per gram

Why is macronutrient balance important? Take two people eating a 1500 calorie diet based on the advice above. Person A is eating 90% fat, 5% carbs, and 5% protein while person B is eating a balanced macronutrient diet of 35% protein, 30% carbs, and 35% fat. Who will get better results?

Person A is eating far too little protein and far too much fat. Higher protein diets are effective in helping people lose body fat, reduce hunger and cravings, and manage blood sugars. That little protein intake would increase risk of lean muscle loss which is the exact opposite goal. High protein diets are also proven to not be dangerous or harmful to the kidneys as long as there is no pre existing kidney damage.

That high of fat intake might make person A more hungry too as fat is more calorie dense meaning less total food intake. More hunger = more of a chance to fall off the diet when faced with opportunity to cheat.

The goal is to preserve or even build lean muscle while losing body fat. Losing muscle decreases your metabolic rate and lowers your body’s ability to burn fat. Keeping your protein around 30-40% of your total caloric intake is key for long term fat loss.

What about carbs?

Given that protein is 30-40%, carbs I leave up to my clients’ personal preference. Some people choose a moderate carb intake, some choose a lower carb intake, and some even choose to follow a ketogenic approach.

I personally don’t care as long as you are managing your sugars, eating the right protein amount, and hitting around your decided macronutrient intakes.

In terms of pure weight loss science, hundreds of studies have compared low-carb, high-fat diets to high-carb, low-fat diets and found no significant difference in weight loss when calories and protein are equated.

There may be some instances where clients with insulin resistance or hormonal issues (Type 2, PCOS, Hashimotos, post menopause, etc.) might be encouraged to be on the lower side of carb intake but, for the most part, it is a personal choice.

Carbs and fats usually have an inverse relationship — if one is higher the other is lower. If your protein intake is at 30% and you decide you want to do a moderate carb approach at 30% carbs, then you know your fat intake will be 40% (the remainder).

Some of my preferred macro percentages with my clients are:

  • Low-carb: 40% protein/20% carbs/40% fat
  • Moderate carb: 35% protein/30% carbs/35% fat
  • Moderate carb, high activity level: 40% protein/30% carbs/30% fat

These are just a few of the many possibilities and strategies to elicit fat loss. Simply download a calorie counting app like My Fitness Pal to track these numbers discussed above.

Navigating My Way Through a Food Heavy Culture

Food Choices

It is not necessarily the choices of food that affect us as much as the quantities of food in terms of weight gain and weight loss, directly speaking. Indirectly, food choice can be a major indicator of adherence to a diet.

Eating processed foods is shown to decrease satiety (feeling of fullness), increase cravings, and increase guilt. These repercussions of not eating healthy can slow or even reverse progress. I like to take an 80/20 approach with my diabetic clientele and myself.

80% of the food eaten should be whole foods. 20% can be your personal indulgent. That means if you are alloted 1500 calories a day, 20%, or 300 calories, can come from your craving foods. I believe this helps people cheat within the diet so they stay on track for longer and get far better results than being extremely strict.

An interesting note, a Kansas state nutrition professor ate twinkies and protein shakes for 10 weeks and lost 27lbs/12kg and improved his metabolic profile in the process. He wanted to show that quantity of food is extremely important when it comes to weight loss. Obviously, I don’t recommend doing this and neither does he, so please don’t replicate his experiment.

Meal Timing & Frequency

One of the biggest myths in the dieting world is having to eat every two hours to “stoke the metabolic fire.” There is no metabolic fire or fire inside of your body — I promise. Daily macronutrient & caloric totals matter most not meal timing or frequency. When you add diabetes to the mix, that’s when these variables become more relevant.

Meal timing prior to cardio or exercise can determine if you are going to have a great workout or diabetic emergency. Both hypo- & hyperglycemia can ruin a workout so timing meals according to your activity level can greatly improve blood sugar management, which indirectly improves your ability to adhere to your diet and training.

Meal frequency is a personal preference but some people with diabetes find it easier to minimize glucose variability with smaller, more frequent meals. Ultimately, that is your decision. Whatever fits into your lifestyle best is what you should do.

Effective Weight Loss With Diabetes

Blood sugar management, proper caloric intake, and macronutrient balance will help you lose body fat long term, the right way. There are tons of advanced strategies I’ve used to help people with diabetes transform their bodies but all progress stems from these basic principles. Yes, it takes some work. Yes, you have to type some stuff and do some math. Yes, it takes conscious, daily effort just like diabetes management. But, in doing so, your body will thank you.

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