Tuesday, January 16, 2018

Does a Higher Daily Protein Intake Keep You Leaner in the Offseason

 

Picture this…You just ended your 28-week contest prep diet or 16-week vacation dieting phase.

Your daily protein intake is through the roof, you are sick and tired of sucking down protein shakes, your jaw is exhausted from chewing animal protein sources, and you are fed up with the extra money being spent on protein sources.

We all know by now that a higher daily protein intake during a calorie deficit has its benefits, there’s no arguing this (1).

What if we told you it may be worth experimenting with a higher protein diet during the offseason?

In this article, we will look into the protein overfeeding research, see some of the pros and cons to a higher daily protein diet during the offseason, and give you some practical applications that you can implement right after finishing this article.

(Side Note: a good tool to track your daily protein intake is with the IIFYM flexible dieting calculator)

Get your protein shakes ready!

What’s Protein Overfeeding and Why Should You Care?

Jose Antonio and his lab are doing some fascinating research on protein overfeeding and we are almost certain that if you are reading this article, you know that the recommended daily allowance on daily protein intake is 1.76 g/kg/d (0.8 g/lb.) (2,3).

Now what’s cool about what Antonio and his colleagues did was they challenged this RDA of daily protein intake notion and overfed subjects with higher daily protein intakes.

Here’s what they did in their 2015 Protein Overfeeding Study:

  • They took resistance trained subjects
  • Provided a sound resistance training program
  • Had subjects tracked food on My fitness pal
  • Took 2 groups and compared regular protein (0.8g/lb.) vs high protein (1.4g/lb.)
  • They used a Bod Pod to measure body composition

The results showed:

The higher daily protein group lost an average of 1.6 kg (3.5 lbs.) of fat mass versus 0.3 kg (.66 lbs.) and ended up consuming approximately 400 calories more a day.

What’s interesting is there have been speculations over the “disappearance” of extra and higher daily protein intake which includes (4):

  • A higher thermic effect of feeding (body burns more calories during digestion)
  • Increased NEAT (non-exercise activity thermogenesis)
  • Increased TEE (total energy expenditure)
  • Increased fecal energy excretion (poop actually has more calories in it so you haven’t assimilated as much of what you ate)
  • Reduced intake of other macronutrients via increased satiety
  • Suppressed hepatic lipogenesis (suppressed liver fat accumulation)
  • Decreased misreporting of food intake

 

daily protein

 

Moreover, a year later, Antonio and colleagues conducted another overfeeding study and here’s what they concluded:

“In male subjects with several years of experience with resistance training, chronic consumption of a diet high in protein had no harmful effects on any measures of health. Furthermore, there was no change on body weight, fat mass or lean body mass despite eating more total calories and protein. Contrary to popular belief, the consumption of a high protein diet is not mutually exclusive with a diet high in fiber nor does the consumption of cholesterol above the standard recommendations result in any untoward effects on blood lipids. This is the first 1-year longitudinal investigation in resistance trained males that demonstrates the lack of harm caused by a high protein diet.”

After seeing these studies by Antonio and colleagues, it has really put together a piece to a massive puzzle that in a real-world setting, one could have a higher daily protein intake, and overconsume protein, and get great benefits from it.

A Deeper Look at What a Higher Daily Protein Intake in the Offseason Can Really Do

A 2017 study out of the International Journal of Sports Science took 19 male bodybuilders and put them into 2 groups (5):

  • Group 1- Overfeeding subjects (mainly overfeeding with carbohydrates) and 0.8g/lb. of protein per day
  • Group 2- Protein overfeeding subjects (mainly overfeeding with protein) and 1.4g/lb. of protein per day
  • Total calories were matched and training volume was matched

The results showed that the protein overfeeding group led to increased muscle mass, reduced body fat, and improved blood panels.

breastfeeding calories

What’s interesting in this study is it was done in bodybuilders, calories and training volume were matched, and if you do the math in practical terms, just as an example, Group 1- 150-pound male x 0.8 = 120g of daily protein and in Group 2- 150-pound male x 1.4 = 210g of daily protein. Which shows a 90g daily difference of protein intake.

Another interesting study was done by Beals and colleagues, where they took 30 female subjects and divided them into 3 groups (6):

  • Group 1- Overweight subjects
  • Group 2- Obese subjects
  • Group 3- Healthy weight subjects

They gave each group 170g of lean pork which turns into about 36g of high-quality protein post workout and showed the obese and overweight subjects had blunted muscle protein synthesis responses (prohibited your body from being in a muscle growth state) and it was most likely due to the excess body fat they were carrying.

Now, obviously, this study has a lot of limitations and the ones that stand out most are:

  • we need a larger sample size of people
  • this needs to be replicated in athletes or resistance trained subjects
  • there was no resistance training protocol
  • we don’t truly eat protein in isolation
  • more long-term studies need to be conducted

But, this could be a good start to a large puzzle on perhaps having a higher daily protein intake and staying leaner in the offseason to make sure you’re getting a daily response with muscle protein synthesis which over time will keep your body in a muscle growth state and lead to more muscle growth.

A great way to experiment with this is most likely having a higher daily protein intake like the overfeeding studies suggest and really taking advantage of the protein adaptations.

 

daily protein

 

Pros and Cons of a Daily Higher Protein Intake During the Off Season

This area of research really interested us, so we ran our own individual experiments for a full month.

Now, keep in mind we controlled as much as we possibly could, these weren’t actually in lab-controlled experiments, and it was only a month.

We made some interesting observations with a high protein intake during a surplus, along with what the current data says about protein overfeeding, along with the two studies above, and we have compiled some pros and cons to having a higher protein diet during the offseason:

Pros:

  • Leads to less overeating, due to more satiety and protein being the number one most filling macronutrient
  • Increased TEF (Thermic Effect of Food) due to your body working harder to break down protein
  • If you have a personal preference to consume higher protein amounts, then this may work for you
  • There’s something about being more accurate with tracking food when you have a higher protein goal, so this may lead to eating less processed and packaged foods and being more accurate with your macros and calories as research shows misreporting is a big reason why people don’t get results (7)
  • Don’t quote us on this, but a higher protein intake during a surplus combined with a proper high-volume resistance training program may lead to further muscular adaptations. Yet, Roberts and colleagues showed there was no major difference between a high vs moderate protein intake in resistance trained subjects (8). More long-term and replicated studies need to be conducted in this specific area
  • Eating a higher protein intake post diet phase leads to lower weight re-gain due to increased muscle mass, increased REE (Resting Energy Expenditure), increased TEF (Thermic Effect of Food), and Increased satiety (9)

Cons:

  • A higher protein intake may not be a viable option if you don’t have a personal preference for a higher protein intake
  • A higher protein intake in a surplus won’t be feasible if you are vegetarian or vegan
  • A higher protein intake in a surplus could get financially expensive since protein is the most expensive macronutrient
  • The theory of a “Muscle Full Effect” could come into play (10). Some researchers have proposed that muscle protein synthesis tops out at approximately 20-25 grams of protein per serving for young adults. Protein consumed above this dosage is thought to be oxidized for energy rather than used for tissue-building purposes – a phenomenon called the “muscle-full” effect. In what is often cited as the definitive support for this contention, Areta et al investigated the effect of different protein boluses on resistance-trained men (11)
  • All subjects performed a bout of resistance training and were then confined to rest where they consumed 80 grams of protein over a 12-hour recovery period in one of the following three conditions (11):
  • 8 servings of 10 grams of protein every 1.5 hours
  • 4 servings of 20 grams of protein every 3 hours
  • 2 servings of 40 grams of protein every 6 hours
  • Over the course of the recovery period, the greatest effect on stimulation of muscle protein synthesis was seen in the group consuming 4 servings of 20 grams of protein. This would seem to indicate that there was no added benefit to consuming the higher dosage (40 grams) and that the additional amino acids were indeed oxidized for energy (11)
  • Trained individuals may have a lower requirement for protein due to increased efficiency of use of protein. Several studies have shown that resistance trained athletes, consistent with the anabolic stimulus for protein synthesis it provides, actually increases the efficiency of use of protein, which reduces dietary protein requirements (12). If indeed, regular heavy resistance training enhances efficiency, there would be no effect of added protein and body comp alterations

Practical Applications

  • If you are interested in trying a high protein intake during the offseason or having your clients try it, we recommend first setting your daily calorie surplus and then setting protein at 1.4g/lb. Ex) You are consuming 3,000 calories and you weight 175 pounds, multiply 175 x 1.4 = 245g of daily protein and multiply that by 4 (4 calories per 1 gram of protein) = 980 calories. You are then left with 2,020 calories for carbs and fats
  • Then Set fat after that, anywhere from 20-30% of calories
  • Then set the remaining calories as carbs and partition more of them around workouts unless you have a personal preference for other times of the day
  • Experiment with it for a month or so with yourself or your clients, get both objective and subjective data from it and try and control everything as much as possible then re-evaluate everything
  • Don’t expect more muscular adaptations from the higher protein intake, as this will most likely be from the calorie surplus and increased training volume in your resistance training program
  • We highly recommend this for clients or those out of a long contest prep where one lost a significant amount of weight and calories became very low so most likely metabolic adaptations occurred from satiety signals being down, hunger hormones up, and reward system cravings for highly palatable foods were increased (13)
  • We highly recommend experimenting with a higher protein intake for clients or someone that has a tendency to binge or overeat especially those post prep or dieting phase

Wrap Up

Now that you have the secret ninja tips (HIYAAAA) to try a higher protein intake during a surplus, the biggest piece of advice we can give after self-experimenting with this and diving into the research is to have an open mind and just try it out for a month.

See how you respond to it. See how you feel. See what kind of observations you make out of it all. And just have fun with it all as this is what a flexible fitness journey should be about. Taking valid scientific research and implementing it into practice.

There’s only one thing we ask of you after having a higher protein intake during a surplus, don’t come knocking on our door after you see your weekly grocery bill 😉

 

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Wednesday, January 10, 2018

Best Fish Oil Supplement for the Price

 

As someone who believes it’s difficult to put a price tag on good health, I’m still price conscious when shopping for supplements. I don’t buy into the hype and I’m not about to spend money on something that does not have science backing it.

With that being said, IIFYM.com isn’t your source for pushing supplements—in fact, most of the time we try to teach you how to get nutrients from your diet alone. However, there are a few key supplements that we believe are truly beneficial. But, proper nutrition should be at the forefront of your mind at all times.

If you aren’t sure where to even begin with your nutrition, don’t worry. The IIFYM.com website is a wealth of information and even includes calculators to help put you in the driver’s seat when it comes to taking ahold of your health.

In the spirit of helping you maintain and improve your health, I went out in search for the best fish oil supplement for the price. Now mind you, as always, real whole food sources should always come before supplements.

Yet, we know that many of you out there are not fans of eating fish, let alone multiple times each week. So, to give you all the healthy fats and benefits that come along with consuming fish regularly, we found the best fish oil supplement for you to consider adding to your regimen.

Why Should You Consume Omega-3 Fatty Acids?

Healthy fats play a key role in our health since our body cannot manufacture it on its own. Omega-3 fatty acids have the ability to help lower your risk of heart disease and can help lower your levels of triglycerides (blood lipids).

Going along with high triglycerides, you also run the risk of pancreatitis as well, which is inflammation of the pancreas.

This is by far the best fish oil supplement we found that meets our high standards. Each serving is two softgels and gives you 2,100mg of omega-3 fatty acids. Each softgel gives you a 3:1 ratio of EPA and DHA.

When looking for the best fish oil supplement, you need to pay attention to EPA and DHA. EPA is a type of omega-3 that helps reduce inflammation in the body while DHA plays a key role in brain health and function.

Both are extremely important. Your brain needs fats, and with the addition of fish oil, you give it what it’s craving to function optimally.

In addition to finding the best fish oil supplement for your needs, do your homework on if the brand you are looking at is certified and meets the standards so you aren’t tossing your money into a deficient product that won’t make much difference if you used it or not.

 

best fish oil supplement

 

Foods High in Omega-3s

Consuming enough healthy omega-3 fatty acids can be extremely difficult if you don’t like the taste of fish. Our body needs omega-3 fatty acids and is considered essential because our body is not able to produce them on its own.

A simple way to get in enough omega-3’s would be to consume something like salmon and tuna or any other fatty fish twice a week for that matter. You could also get a healthy dose of omega-3 fatty acids from items such as nuts and flaxseeds.

breastfeeding calories

At IIFYM.com, we have many different nutrition plans for you to utilize. In those plans, you can include fatty fish as well as the addition of something like the best fish oil supplement that we will get to shortly.

If the foods mentioned above aren’t your favorite or make your stomach queasy, a supplement is the best way to go and we’ll touch on that next.

The Best Fish Oil Supplement

You came to IIFYM.com because you demand the best content possible, and we don’t want to let you down. Not only do we have some of the best macro-friendly recipes out there to send your taste buds into a frenzy, but we searched high and low to find you the best fish oil supplement for the price.

From the data gathered, we can recommend to you: Nutrigold Triple Strength Fish Oil Omega-3 Gold.

This is by far the best fish oil supplement we found that meets our high standards. Each serving is two softgels and gives you 2,100mg of omega-3 fatty acids. Each softgel gives you a 3:1 ratio of EPA and DHA.

The brand gets its omega-3s from wild-caught whitefish. You are getting yourself some of the most concentrated healthy omega-3s that money can buy. In addition, unlike many other fish oils on the market, the Nutrigold Triple Strength Fish Oil Omega-3 Gold has been known to not give you fish burps or a fishy taste when taking it.

The Nutrigold Triple Strength Fish Oil Omega-3 Gold is certified by IFOS (International Fish Oil Standards Program), ConsumerLab, and Labdoor where it scored a high 77 out of 100. It’s made right here in the United States and is Marine Stewardship Council Certified (MSC).

Not only are you paying for a good quality fish oil supplement, but your money is well spent knowing there has been extensive research completed and certifications given that provide you with peace of mind that the product you are taking is safe.

At IIFYM.com, we don’t want you to waste your hard-earned money on subpar products—that’s why we looked from sea to shining sea to find you the best fish oil supplement. So, if you’re in the market for a fish oil supplement (which you all should be if you aren’t already using one), I’d highly recommend that you give Nutrigold Triple Strength Fish Oil Omega-3 Gold a try.

We hope you found this IIFYM.com article helpful! If you did, please share it with your fellow IIFYM family and friends. Also, don’t forget to check out all of the other great IIFYM.com articles!

 

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Monday, January 8, 2018

The Top 10 IIFYM.com Posts

 

This list doesn’t include just our 2017 posts, these are our top posts from the absolute beginning. That made this quite the task, we have so many personal favorites. Yet, this isn’t about us, this ia about the posts our audience appreciated the most.

We are beyond grateful to all of our readers, followers, and clients. Our aim is to continue putting out more content and resources to help you succeed. The Macro Calculator is a prime example of this, we are always building upon it to help our audience.

Each post below is geared towards creating sustainable lifestyle habits. Without further setup, here’s the list:

 

1. Tracking Alcohol Macros – Can I Drink With IIFYM?

Alcohol consumption is heavily ingrained in our society today. Which make sense that it sits at number one on our blog as the most searched. Even though we don’t condone drinking at IIFYM.com, the people have spoken.

We created this since it’s so common among our population and it would be a tall task to eliminate from everyone’s diet.

We delve into whether you can drink alcohol, how you can track it, and what is the best way to go about it while dieting. As the cliche goes, “everything in moderation”(I’m sure this will get skewed). That pertains to alcohol and dieting quite a bit.

To read the entire article, here’s the full post.

On top of this article, we have a couple of articles that go over low-calorie alcoholic drinks that are easier to track.

 

2. The Perfect Macro Ratio: Is There A Superior Macro Split?

This is a loaded question, which is why we fleshed it out. If you’ve been here for a while then you know the answer to this question. Figuring out what ratio works best for you may take some time and understanding (or a coach to create a plan for you such as our Macro Blueprint).

We go over each facet that needs to be considered to make the right choice. The beauty of this article is that it addresses what each macronutrient brings to the table and what factors are in play.

To see what will lead you to a great macro split, read the entire blog post here.

 

3. Do I Add Back Calories I Burn During Exercise?

I’d be Scrooge McDuck if I had a dollar for every time someone asked me this question. Diving around in gold coins like a maniac, getting in enough exercise solely doing that.

This is a simple answer, but of course, there’s a reason why. This article goes over why macro calculators such as ours include all activity (involuntary and voluntary) within their calculations.

To read the full article, click here.

 

4. IIFYM & Carb Cycling

Whenever someone mentions carb cycling, my first thought is a person eating a sandwich on a bike. If that’s similar to your thinking on the topic, we’re both not far off from what carb cycling is.

With that said, this has to be one of the most common diet approaches. Its scientific backing isn’t there but it still has value. Its benefit stems from helping with diet adherence which is arguably the second most important aspect of being successful in changing your body composition.

There’s a lot of lifestyle scenarios where carb cycling can be applied, but it does have its disadvantages as well.

To read the full post, click here for the insight.

What’s even better is that we added another carb cycling article that fleshes it out even more. Check out that post here.

 

5. The PCOS Playbook: Tracking Macros For Weight Loss

When I began working here PCOS clients were few and far between. Now, “Close to 12% of our female clients have PCOS and need dietary and nutrition changes. This means that over 250 women diagnosed with PCOS come to IIFYM every month…” So, it comes as no surprise that this article comes in at number 5 on the list.

breastfeeding calories

The prevalence of PCOS seems to only be growing (especially in the U.S.). Yet, the positive aspect of this post is that the science of nutrition is trending in a positive direction for women dealing with PCOS.

There’s more available data which can help them decide how to follow a sustainable diet. Here’s the full post which includes the PCOS macro calculator.

(Side note: please consult your preferred physician before following any diet suggestions on our site or any other.)

6. 30 Tips To Maximize Food Volume With Low Macros

This isn’t the exciting part of dieting down, we wish that no one had to get here to reach their body composition goals. Thinking about “poverty macros” makes me sad, but fret not, it should be temporary.

On that note, satiation while not having enough calories is a crucial aspect that we go over. Some of these tips are incredibly simple while others are game changers and make this process sufferable.

Although I don’t wish eating low calorie on my worst enemy, this article doesn’t make it sound so bad.

To read this full post, click here and help yourself to succeed.

 

7. The Benefits and Drawbacks Of The Keto Diet

Oh, the keto craze, it’s not only alive but it’s thriving. Just when you think it’s dwindling, it rears its head out of nowhere. This isn’t to talk down on the diet but to point out that there is so much misinformation associated with it.

It has its own zealots that believe ketogenic dieting is superior and magical (hint: it’s not, it works but it’s not the best. There is no “best diet”.)

Although the above statements make me sound like a hater. We have had plenty of clients who follow a keto diet since it fits their lifestyle. In any case, this article is an incredible analysis of the diet and whether it’s worth your time.

To read the full post, click here!

 

8. Why Does IIFYM Give So Many Calories?

This movement is massive, it’s much larger than us (obviously); even though we are an authority in it. IIFYM is an idea that you can achieve flexibility while dieting. Yet, dieting is synonymous with eating low-calorie and suffering along the way.

For chronic dieters, this means being masochistic. We have been told to hate ourselves while we are working on changing our body composition. The classic diet, a woman should eat 1200-1500 calories, while men should eat between 1800-2000 calories to lose weight.

This general guideline grossly oversimplifies the process. We have been fighting for years to alter that misconception, so far, we are hopeful that this is a dying phenomenon.

With that said, the concern that our coaches or calculator give too many calories is still prevalent. Those same people who ask us, and follow their macros end up reaching their goals. Nothing makes us happier than seeing that.

Without further introduction, here’s the full article to see why we provide the intake we do.

 

9. Tracking Macros While Dining Out: The 3 Best Approaches

Although cooking and prepping your own meals has so many economic and health advantages, going out is great. Trying new places with friends and/or family can be a healthy habit.

Just because your dieting doesn’t mean you have to stop enjoying this part of life. Dieting down often leads to isolating behavior. This is why IIFYM (flexible dieting) is a great approach since it’s not a restrictive diet that has you weeping on a minute-to-minute basis.

Anyway, go out and frolick about while you enjoy losing fat. To find out the best strategies to do so, read the full post.

 

10. How Much Protein Is Needed While Following IIFYM?

Protein is fundamental to your success while dieting for fat loss, and is essential, period. It’s incredibly useful while looking to alter your body composition for the better. Without a sufficient amount, you won’t retain as much fat-free mass (bye, bye beautiful muscles). So, understandably, this question resonates heavily with our audience.

Yet, this post isn’t about fear-mongering you into consuming more, but to help you find your sweet spot while in a calorie deficit. No need to worry, since this can be simplified.

Here’s the full article to help you rest assured you’re consuming enough while on a calorie-restricted program.

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Wednesday, January 3, 2018

Intermittent Fasting for Weight Loss: Fasting Myths Debunked

 

Intermittent fasting (also known as IF) is becoming increasingly popular among people who are looking to lose weight and fat, and even among those who are trying to build muscle and optimize their body composition.

Proponents of this meal timing approach to dieting are convinced that it is superior to other forms of energy restriction, with a number of benefits being attributed to the “fasting” element, including:

  • more weight loss,
  • higher Resting Metabolic Rate (RMR),
  • increased muscle retention, and
  • increased insulin sensitivity.

Is there any truth to the above claims, however, and is there good scientific evidence to support the weight loss benefits attributed to intermittent fasting?
Read on find out!

Intermittent Fasting Defined

Before proceeding any further, let’s quickly look at what exactly intermittent fasting is and what it entails.

In simple terms, intermittent fasting is an eating pattern which involves alternating periods of little or no energy intake (i.e. caloric restriction) with intervening periods of normal food intake, on a recurring basis (1).

Different sub-classes of intermittent fasting include the following:

  • Alternate day fasting (ADF), which involves a 24-hour fasting or very low calorie (~25% of daily energy requirements) period, alternated with a 24-hour ad libitum (i.e. at one’s pleasure) eating period.
  • Whole day fasting (WDF), which usually involves 1-2 days of fasting or very low calorie (~25% of daily energy requirements) periods per week, with the remaining days of the week eating at maintenance.
  • Time-restricted feeding (TRF), which involves a fasting period of 16–20 hours and a feeding period of 4–8 hours daily, and includes Ramadan style fasting as well as the popular Lean Gains approach (2).

Takeaway point: Intermittent fasting (IF) is an eating pattern which involves alternating periods of little or no energy intake with intervening periods of normal food intake, and includes alternate day fasting (ADF), whole day fasting (WDF) and time restricted feeding (TRF).

 

intermittent fasting

 

Intermittent Fasting vs Caloric Restriction

As you may have noticed from the definition of intermittent fasting above as well as from the descriptions of its different sub-classes, intermittent fasting tends to go hand in hand with caloric restriction.

In ADF, for example, although subjects are allowed to eat ad libitum (as much as they want) on their feeding days, they usually tend to not eat enough to compensate for the caloric deficit they create on fasting days. This also tends to happen with TRF, where subjects restrict their feeding window to a few hours per day (2).

Similarly, since WDF entails 1-2 days per week of fasting or very low-calorie dieting, with the remaining days of the week eating at maintenance, it also results in weekly caloric restriction and, consequently, in a weekly energy deficit (2).

breastfeeding calories

Many people miss this important point and think about the two (IF and caloric restriction) as being fundamentally different or even antithetical to each other. This means that much of the research that the proponents of IF use, in order to support their claims, doesn’t control for the confounding (and very important) variable of caloric intake.

The above is why the research that is cited in this article controls for caloric intake – so that we can identify the effects of intermittent fasting itself rather than just the effects of the associated caloric restriction.

Takeaway point: Intermittent fasting is, essentially, a form of caloric restriction, with its main difference to “normal” caloric restriction being that the fasting periods are longer in duration and further apart from each other. It is, therefore, important to make sure that the research we read on IF controls for the confounding variable of caloric restriction (or, at least, to take it into account when interpreting research).

Common Weight Loss Effects of IF

With the above said, let’s examine a few common weight loss and body composition benefits that are usually attributed to IF.

Intermittent Fasting and Weight Loss

In recent years, research examining the effects of intermittent fasting on weight loss in humans has been growing steadily. Unfortunately, however, most of the available studies we have to date suffer from the following limitations:

  • They have no control group to compare results to: doing something is, usually, better than doing nothing.
  • The control group doesn’t receive any “treatment” – i.e. they just eat as usual: it makes sense that a group of subjects doing any sort of dieting will lose more weight than the group of subjects who keep eating as usual.
  • The control group receives “treatment” but caloric intake isn’t matched between groups: we can’t attribute weight loss effects to one variable (fasting) when a confounding variable (caloric intake) isn’t controlled for.
  • The control group receives “treatment” and caloric intake is matched between groups, but protein intake is not: since protein is considerably more thermogenic and satiating than carbs and fats (3), the group eating significantly more protein will have higher energy expenditure and will naturally tend to eat fewer calories while often underreporting their food intake.

When excluding studies that suffer from the above limitations, we are left with a relatively small number of studies which compare the effects of intermittent fasting to continuous energy restriction on body weight, and which show that, overall, the two diet types result in identical outcomes in terms of body weight and body fat reduction (4, 5, 6, 7).

Takeaway point: most of the research on intermittent fasting and weight loss suffers from a number of limitations, including a lack of a control group, comparing intermittent fasting to a “no treatment” group, and not controlling for caloric or protein intakes. Research that doesn’t suffer from the above limitations suggests that intermittent fasting and continuous energy restriction result in identical weight and fat loss.

 

intermittent fasting

 

Intermittent Fasting and Metabolic Rate

Metabolic rate also called resting metabolic rate (RMR) and resting energy expenditure (REE), usually makes up around 60-75% of our total daily energy expenditure (8). This means that it can easily determine overall energy balance and, consequently, whether an individual will lose or gain fat.

Metabolic rate is known to be reduced with caloric restriction, mainly because of reductions in:

  • fat mass,
  • fat free mass,
  • circulating leptin and thyroid hormones, and
  • sympathetic nerve activity (9).

It is often argued that intermittent fasting results in a lower reduction in REE relative to continuous caloric restriction when adjusting for decreases in body mass, while some even believe that metabolic rate increases in response to fasting. Is there, however, any truth to this? Well, kind of.

Overall, the available evidence suggests that intermittent fasting results in the same adaptive responses as continuous energy restriction, at least on feeding days.

Some studies, for example, have shown increases in metabolic rate during the first few days of fasting, with the average increase in energy expenditure being around 5.5% (10, 11, 12). Other studies, however, have found both decreased and unaltered REE as measured by indirect calorimetry during fasting (13, 14, 15, 16, 17, 18).

On the whole, studies which have measured REE on feeding days of intermittent fasting have mostly shown reductions in REE similar to those that happen with “normal” dieting in, obese, overweight and normal-weight subjects (6, 19, 20, 21, 22), with one exception being a recent trial where REE decreased with continuous caloric restriction but not with alternate day fasting (23).

Overall, the available evidence suggests that intermittent fasting results in the same adaptive responses as continuous energy restriction, at least on feeding days.

Takeaway point: while some research has found an increase in REE with IF when measured on fasting days, at least in the short term, most research that has measured REE on feeding days has reported reductions in REE similar to those that happen with continuous caloric restriction.

Intermittent Fasting and Muscle Retention

Ideally, weight loss diets should cause the desired rate of weight loss while minimizing fat free mass loss in order to maintain physical function and to prevent reductions in metabolic rate, thereby preventing future weight regain (24).

In general, caloric restriction results in a reduction in both fat mass and fat free mass. However, the percentage of fat free mass lost seems to depend on a number of factors, including:

  • initial body fat levels, with higher body fat levels resulting in lower fat free mass losses,
  • the degree of caloric deficit imposed, with larger deficits generally resulting in bigger fat free mass losses,
  • the extent and type of exercise performed, with resistance training resulting in better fat free mass retention than aerobic exercise and even better retention compared to no exercise at all, and
  • the protein intake of the diet, with higher intakes resulting in better retention of fat free mass (25).

Proponents of intermittent fasting argue that less fat free mass is lost with this type of dieting approach, since the increased levels of growth hormone that are associated with the fasting state cause the body to reduce protein metabolism in favor of fatty acid metabolism.

Although it’s true that fasting causes an increase in growth hormone secretion (26), what does the available scientific evidence show with regards to the effects of intermittent fasting compared with a continuous caloric restriction on fat free mass retention?

breastfeeding calories

Well, when the variables listed above (body fat levels, degree of caloric deficit, exercise, and protein intake) are controlled for, research suggests that there are no significant differences in terms of fat free mass loss between groups.

For example, this study by Harvie et al found no statistically significant differences in terms of fat free mass loss between groups (4). Moreover, this trial by Hill et al (5) as well as this 2013 trial by Harvie et al (27) also reported equal levels of fat free mass loss between an intermittent and a continuous caloric restriction group when caloric and protein intakes were matched between groups.

Takeaway point: the amount of fat free mass that is lost during dieting seems to depend on the subjects initial body fat levels, the degree of energy deficit imposed, the extent and type of exercise performed, and the protein intake of the diet. Studies that control for the above variables generally show no statistically significant differences in fat free mass loss between intermittent fasting and continuous energy restriction.

 

intermittent fasting

 

Intermittent Fasting and Insulin Resistance

Insulin is a peptide hormone produced in the pancreas, the functions of which include:

  • increasing the absorption of glucose into the muscles and fat tissue,
  • inhibiting muscle protein breakdown,
  • increasing the synthesis and absorption of lipids in fat tissue, and
  • reducing the breakdown of lipids and increasing glycogen synthesis in the liver (28).

Insulin resistance is a pathological condition in which cells fail to respond normally to insulin, with overweight and obesity being major risk factors for the development of both peripheral and hepatic insulin resistance (28).

Proponents of intermittent fasting argue that it results in improvements in insulin resistance independent of changes in body weight. What does the research suggest, however? Well, unsurprisingly, studies on both overweight and obese individuals report variable results.

One study by Ash et al, for example, reported similar improvements in glycaemic control in 51 men with type 2 diabetes after 12 weeks of intermittent (four days per week) or continuous energy restriction (6).

A 2011 study by Harvie et al which measured hepatic insulin sensitivity in overweight or obese subjects reported a 25% greater reduction in insulin resistance compared to the daily energy restriction group when measured on the morning after five normal feeding days.

Overall, the limited available research has reported variable effects of intermittent fasting on peripheral and hepatic insulin sensitivity, which may be gender-specific.

It also reported a further 25% reduction in insulin resistance compared with daily energy restriction on the morning after the two energy-restricted days. Importantly, these differences in insulin sensitivity happened despite similar reductions in body fat between the groups (4).

Three other studies that have assessed the effects of 2–3 weeks of whole day fasting and which were designed to ensure that there was no overall energy deficit or weight loss have also reported variable results.

Specifically, the first study by Halberg et al reported improvements in insulin-mediated whole-body glucose uptake and insulin-induced inhibition of adipose tissue lipolysis when measured after two normal feeding days (29), while these results could not be replicated by the Soeters et al study (22).

Interestingly, the third study by Heilbronn et al reported a significant reduction in insulin response and improved glucose uptake and insulin sensitivity in male subjects, whilst female subjects experienced impaired glucose uptake and apparent skeletal muscle insulin resistance (30).

Overall, the limited available research has reported variable effects of intermittent fasting on peripheral and hepatic insulin sensitivity, which may be gender-specific.

Takeaway point: the results of studies which compare energy-matched intermittent fasting to continuous energy restriction or which were designed to ensure that there was no overall energy deficit or weight loss have reported variable results with regards to improvements in insulin sensitivity.

Conclusions

Based on the available well-designed trials, we can draw the following conclusions:

  • Intermittent fasting and continuous energy restriction result in identical weight and fat loss when energy and protein intakes are matched between groups.
  • In most studies, when measured on feeding days, the magnitude of metabolic rate reduction is similar with intermittent fasting and with continuous caloric restriction.
  • When controlling for initial body fat levels, the degree of energy deficit, the extent and type of exercise performed, and the protein intake of the diet, there are no statistically significant differences in fat free mass loss with intermittent fasting or with continuous energy restriction.
  • In studies that compared energy-matched intermittent fasting to continuous energy restriction or which were designed to ensure that there was no overall energy deficit or weight loss, variable results with regards to improvements in insulin sensitivity have been reported.

What is also clearly evident is that there is a need for more high-quality research comparing long-term outcomes of intermittent fasting and continuous energy restriction in order to establish any real benefits of the former with regards to controlling body weight and improving metabolic health in humans.

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Thursday, December 28, 2017

Highly Palatable Food & Weight Management Issues

 

Our society has become pretty comfortable blaming just about anything for their weight management issues. Gluten, dairy, eating too little, even blood types have been suspects over the years. Although a relatively simple concept, admittedly there are a lot of nuances that go into a really successful dieting effort.

Tracking and adjusting your total calorie intake through macronutrient goals with tools like the IIFYM Macro Calculator or an online physique coach is a great place to start. Plenty of bogus excuses float around the Internet any given week.

Through all the bizarre justifications that should just be ignored altogether, one often-underestimated consideration in successful weight management is that of highly palatable foods and how they should fit into the daily intake.

What are Highly Palatable Foods?

By highly palatable foods, I’m referring to foods that you personally really enjoy consuming. Foods like pastries, chips, or comfort foods like pizza. Most often, highly palatable foods are those we not only deeply crave and enjoy but also tend to be very calorically dense. I typically refer to highly palatable foods as “fun” foods with the online clients I work with.

The reason being, it’s not that any one food or food group is “good” or “bad” but simply offer differing proportions of nutrients per calorie that must be taken into account with our current diet and body composition goals.

The IIFYM coaches help their clients understand it. Articles myself and others have written here on IIFYM explain it. And nutritional science continues to teach it. There’s simply no reason to completely restrict any one food for the sake of your physique or health goals (allergies and intolerances aside).

Instead, it is prudent to identify the very highly palatable foods to us personally. Then determine how they should fit into our overall diet goals while allowing us to balance our health & physique goals with pure enjoyment.

Blame Sweet Teeth, not Sweet Treats

 

highly palatable

 

Of all the unfairly blamed culprits for failed weight management, sugar has to be the most widely criticized. One of my most proud works as a fitness author, I have an in-depth article which covers the science behind just why blaming sugar in itself for widespread weight gain is largely-scientifically unfounded.

Checking that article out after this can help explain just why being afraid of sugar isn’t necessary. Along with that, it’s important to identify that these “high sugar” foods apparently causing all the country’s weight gain problems tend to be contributing much more than just added sugar for those who over-consume them on a weekly basis. (“over consume” being the key phrase).

Sugar can not only be part of a balanced diet but also can even serve as a beneficial tool for athletes during prolonged exercises or in need of additional calories to support weight gain goals.

Some of the common culprits contain just as much “non-sugar” carbohydrates and even more notably, calorically dense dietary fat to those consuming them regularly. The big factor is their very low volume in comparison to calorie content. In other words, they don’t take up much space but pack plenty of calories.

Making them very easy to consume in large quantities and easily overshoot intake needs with. It’s not the sugar in them causing you problems, it’s how likely you are to overeat with them, busting up your diet.

 

Food Serving Size Calories Carbs (grams) Fat (grams)
Snickers Bar 44 215 28 11
Glazed Donut 48 190 21 11
Oreos (4) 68 320 50 14

 

If you’re successfully tracking your daily food intake on a regular basis, having some of your daily carbohydrates from sugar in highly palatable foods isn’t going to derail your physique or health progress. What will cause major issues is completely blowing your daily macro goals with highly palatable foods you love but just aren’t able to enjoy in moderation when dieting.

Flexible to a Fault

Let’s explain this in a different way. As my Don’t Blame Sugar for Wide Spread Weight Gain article explains in full, it’s certainly possible to include some sugar-containing foods into your daily macro goals while still achieving health and body composition improvements.

Sugar can not only be part of a balanced diet but also can even serve as a beneficial tool for athletes during prolonged exercises or in need of additional calories to support weight gain goals. In those cases, highly palatable foods can be especially helpful.

breastfeeding calories

When highly palatable foods do become an issue is when we can’t incorporate them into our diet with moderation. Keep a package of Oreos in the cabinet and fit 1-2 into your diet here and there with leftover macros and progress will still keep on rolling along.

That is, as long as total macros and exercise are both adjusted appropriately from week to week. Keep that same Oreo package in your cabinet but plow through an entire sleeve in a sitting- that same innocent treat quickly derails a diet.

Food Selection by Physique Goal

 

hyper palatable

 

This article isn’t to suggest we should completely avoid highly palatable foods and stick with bland meals to prevent overeating. Instead, it’s to suggest we should align our eating habits with our current goals.

If you’re in the offseason focused on muscle growth and performance with a higher calorie intake to work with, then enjoying highly palatable foods will likely be easier while still hitting your intake goals more consistently.

Not to mention, these foods that may be less nutrient dense can still be consumed while easily consuming sufficient fruit, vegetables, whole grains and unsaturated fats with the higher macros you’re assigned.

On the other hand, when it comes time to diet and calories decline (and subsequently hunger levels rise), it may be prudent to buy less and less highly palatable foods. That way, triggers you may always struggle with are largely unavailable in your day-to-day routine. Making it easier to focus on eating geared towards your goals and not dreaming of your next oatmeal pie.

Midnight Snacks

As a personal example, I’m a self-proclaimed donut connoisseur. Mini little calorie bombs, you better believe when I’m not dieting, I’m never afraid to enjoy easily the most highly palatable food on earth. Roughly 200 calories for most original doughnuts and around 10g fat and 20-25g carbs, some of the best macros I spend in my week.

Now when it comes time to mini cut or especially begin contest prep, I almost entirely avoid donuts. One reason being, I want to maximize the use of limited macros to continue supporting general health. The other being, they’re quite calorically dense and take up a lot of macros, with little aid in satiety.

If my self-control ever wanes, I could easily knock back a half-dozen without blinking. It’s simply better to limit such a highly palatable food and make it easier on myself to adhere to my dieting macros.

If we’re the culmination of the five friends we surround ourselves with the most, our diets are the culmination of the food types we consume most as well.

By focusing on more nutrient dense, high volume foods and keeping highly palatable foods to a minimum, dieters can stay fuller for longer, ensure health-promoting nutrients are consumed sufficiently and avoid triggers that may make it much harder to adhere to the plan.

If you have an iron will, this may be irrelevant as you’re able to fit small portions of favorite foods into your lower macros without much difficulty. For the many others not quite as mindful with their macros, limiting those highly palatable, fun foods can be hugely beneficial for dieting success.

Not because energy balance is necessarily different from highly palatable foods versus other foods. Instead, simply because for most, adherence greatly improves as triggers are minimized and healthy, productive habits are cultivated.

Not many people wake up in the middle of the night and search for fruit, vegetables or whole grain bread to snack on. Cookies, cakes and other highly palatable, calorically dense treats on the other hand- they’re fair game! Limiting those can make otherwise tempting situation less likely to be an issue.

Addition by Subtraction

 

hyper palatable

 

If we’re the culmination of the five friends we surround ourselves with the most, our diets are the culmination of the food types we consume most as well. I can say from personal experience, along with dozens of conversations I’ve had with other online physique coaches, that dieting phases become much easier once highly palatable, calorie-dense foods are dropped from diets.

By avoiding them, we’re simply able to more easily keep health bases covered, and limit temptation in breaking dietary adherence when the one serving of packaged cookies is looking more appealing as five servings, regardless of remaining macros for the day.

Without pretending to be a psychologist, there’s something to be said about cravings increasing for a food the more often we eat or are around it. Nowadays if I’m in a mini cut or contest prep, I skip pastries nearly completely because the longer I go without them, the less often I am tempted to break my dietary adherence.

Pastries are my culinary kryptonite, so if I want to get through the dieting phase feeling as much like Superman as possible, I’m personally better off sticking to less craving inducing, more filling foods until I’m finished dieting. Then when calories are back up to a good spot I can more easily fit things like doughnuts into my macros.

Let’s Get This Straight

Sugar isn’t the enemy. Highly palatable foods aren’t the enemy. Non-organic foods aren’t the enemy. Our inability to adhere to a consistent diet that allows us to adjust our total daily calorie intake and support our exercise routines with is the enemy.

Continually fine-tuning our nutritional knowledge and areas we can personally tweak in our everyday life makes each phase of our dieting efforts easier to manage. Not to mention less mentally taxing as we continue pursuing the best version of ourselves, inside and out.

 

The post Highly Palatable Food & Weight Management Issues appeared first on IIFYM.



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Wednesday, December 20, 2017

Nutrition in the Prevention and Management of Type-2 Diabetes

 

(Always consult your physician before starting a new diet. This includes using the recommendations from our macro calculator.)

 

In the epidemic of non-communicable diet and lifestyle disease, type-2 diabetes [“diabetes”] has emerged as a particular scourge: the leading cause of death under 60-years of age, and an annual cost of 263-billion dollars in North America in 2013 (1).

The population-based research showing a significant rise in diabetes prevalence over the past 50-years mirrors environmental changes in nutrition habits, food availability, diet composition, and population activity levels (2). The clear environmental determinants of diabetes risk and prevalence in turn point to the potential for diet and lifestyle interventions to be effective in diabetes prevention or remission.

The Relationship Between Bodyweight and Risk for Diabetes

There is a clear association between Body Mass Index [BMI] and risk for diabetes, but the risk is not exclusively linear: BMI varies greatly at time of diagnosis, which indicates that the risk is associated with underlying metabolic complications, including insulin resistance and decreased pancreatic beta-cell [which secrete insulin] function (3).

For example, in metabolically healthy subjects who had the same BMI at baseline, those who progressed to diagnosis 13-years later displayed higher fasting blood glucose [FPG], postprandial glucose tolerance [OGT], and decreased insulin sensitivity at baseline (4).

While this demonstrates that the underlying metabolic dysfunction is a primary issue, the risk is not wholly inseparable from weight, and overweight [BMI ≥25.0 kg/m2] and obesity [BMI ≥30.0 kg/m2] increase risk of diabetes by 3-fold and 7-fold, respectively (5).

In parallel to this risk, weight loss may significantly improve diabetes prevention: a 5-10kg average weight loss is associated with a 50% reduction in risk (6). This is relevant both to extant diabetes prevention, and prevention of progression from “prediabetes” – which refers to 3 states: isolated impaired fasting glucose [IFG], isolated impaired glucose tolerance [IGT], and both IFG and IGT together (7) – to diabetes. It is also relevant to the potential diabetes prevention in already diagnosed subjects.

Weight Loss for Prevention of Prediabetes Progression to Diabetes

 

diabetes prevention

 

There are 4 major trials across different populations showing diet and lifestyle interventions may be successful for diabetes prevention. In the Da Qing Study, prediabetic subjects in diet-only, exercise-only, or diet+exercise groups were successful in diabetes prevention by 22-29% on average (8).

Looking closer at the study, 38% of subjects in the diet-only group achieved diabetes prevention 6-years later compared to 60% in the control group, despite slightly more weight gain in the diet group (8).

In the exercise-only group, 43% of achieved diabetes prevention compared to 72% of controls, despite losing exactly the same amount of weight as controls (8). What this indicates is that diet and exercise influence the underlying metabolic complications – like insulin resistance and glucose tolerance – which may not be reflected by changes in BMI alone.

The preventative effect of diet and lifestyle interventions independent of BMI has been found in other trials. The Indian Diabetes Prevention Programme [IDPP-1] trial found a diet and lifestyle intervention was successful in diabetes prevention over 2.5-years, in a population with a high prevalence of progression to diabetes, despite no change in BMI (9).

This is consistent with the positive impact that diet and physical activity have on the prediabetic state, improving FPG and OGT and reducing risk of progression by increasing glucose tolerance and tissue insulin sensitivity (10).

However, while diet and exercise may improve FPG and OGT without a change in BMI, one of the issues with progression from prediabetes is continued decline in pancreatic beta-cell function and insulin secretion (11). This may be the crux of diabetes prevention through weight loss. In the Finnish Diabetes Prevention Study, diabetes prevention of 58% at 3-years follow-up in prediabetic overweight subjects corresponded to an average weight loss of 3.5kg compared to 0.8kg in the control group (12; 13).

Diabetes Prevention Program Study

In the Diabetes Prevention Program [DPP], obese subjects with prediabetes were randomly assigned to an intervention of either metformin, diet+exercise, or placebo: diabetes prevention was 58% in the lifestyle group, compared to 31% in the metformin group (14).

This was a significant study, as it showed that diet+lifestyle was superior to frontline pharmacotherapy for diabetes prevention. In analyzing the respective effects of weight loss, diet or exercise separately, the strongest factor associated with diabetes prevention was an average weight loss of 5kg over 3-years (15). Of particular note was that the effect was independent of diet composition: weight loss was the most important factor (15).

…the primary dietary factor in diabetes prevention is energy restriction is confirmed in other lines of research.

The challenge that is clear in the research is that failure to maintain weight loss may negate the ability of the intervention for diabetes prevention. In the DPP, fasting glucose levels returned to their prediabetic baseline after 3.5-years as subjects increased weight from their initial 7% bodyweight reduction to 4% (14).

In another study, an average of 2.6kg weight loss did increase insulin sensitivity but failed to restore beta-cell function (16). In the Da Qing Study long-term follow up 20-years later, 80% in the diet/lifestyle intervention group had progressed to diabetes compared to 93% of controls (17). And in the Finnish DPS, 10-year results showed that relapses in weight corresponded to deteriorations in glucose tolerance (18).

This isn’t intended to be disheartening to diabetes prevention, but it does indicate that, cumulatively, the research suggests that weight loss and maintenance of 5kg or ≥5% bodyweight is required for diabetes prevention from prediabetes (13; 15; 16).

Nutrition in Diabetes Prevention

 

diabetes prevention

 

While bariatric surgery can be an effective intervention for diabetes prevention (19), the fact that it is a surgical intervention and not a nutritional one means this article won’t touch on bariatric surgical procedures for diabetes prevention. Instead, the relevant focus will be on the evidence for nutrition in diabetes prevention.

However, the effects of bariatric surgery provide some clues as to the requirements for diabetes prevention through diet, as significant drops in blood glucose occur within days following surgery prior to any weight loss, in fact, occurring (20). This indicates that the sudden restriction of dietary energy is a primary driver of diabetes remission through surgery (20).

That the primary dietary factor in diabetes prevention is energy restriction is confirmed in other lines of research. Very-low-calorie liquid diets [VLCD] have been a focus of diabetes prevention in clinical settings, and are effective in inducing remission of diabetes.

In a trial in adults with diagnosed diabetes, a 600kcal per day VLCD normalized FPG after 1 week, and by the end of the 8-week intervention both beta-cell insulin secretion and insulin sensitivity had normalized (21).

Why VLCD Isn’t A Long-Term Approach

Part of the critique of VLCD is the ability to sustain long-term clinical effect; in this study subjects gained an average of 3kg in the 12-weeks after the intervention, however, they had lost 15kg during the intervention, and the modest weight regain did not correspond to increases in HbA1c [a marker of long-term blood glucose control] or liver fat (21).

The 15kg weight loss target from VLCD is consistent with the threshold for diabetes prevention observed post-bariatric surgery (22). However, it is clear from the VLCD research that there are responders and non-responders over longer-term maintenance, with one study showing that only 40% maintained remission over 6-months (23).

breastfeeding calories

This is still very clinically significant, however, the caveat of the VLCD research is that it is performed under clinical supervision, and should only be undertaken in medical care.

In the VLCD research, one of the explanations for the return of insulin sensitivity is the decrease in fat in the liver and pancreas, and the effect of reducing circulating fatty acids (21; 23). This is important, as much of the recent focus on low-carb, high-fat [LCHF] diets led to some poor diet advice regarding fat intake circulating the internet [see: Coffee, Butter].

Don’t Dismiss Dietary Fat

However, dietary fats do play a role in the development of diabetes, and nutrition interventions for diabetes prevention need to provide appropriate fat balance. In prediabetic subjects, saturated fats increase FPG and high saturated fat intake may be as deleterious for insulin sensitivity as increasing body fatness (7).

In a controlled feeding trial in both normal glucose tolerant and prediabetic subjects, a high saturated fat intake led to increased whole-body insulin resistance (24).

On the other hand, polyunsaturated fats – in particular, omega-3 fatty acids – have a positive effect on glucose tolerance (24), and research shows replacing saturated fat with polyunsaturated fat reduces diabetes risk (25).

This is an important qualifier when it comes to research looking at diabetes prevention from LCHF diets: the diet setups may be higher in total fat, but they remain lower in saturated fat with emphasis placed on added fats from unsaturated sources (26; 27).

Thus, while there is nothing wrong with a higher total fat diet, the quality and balance of fat subtypes does matter and for optimal metabolic – not just cardiovascular – health, the diet should be lower overall in saturated fat and should emphasize unsaturated fats like olive oil, nuts, fish, and eggs (2).

VLCKD As An Interventions

There are certain proponents of carbohydrate-restricted diets as the primary dietary intervention for diabetes prevention (28). However, a complication with this research area is it is fraught with bias, and one major issue is the lack of any real definition of “low-carb”. So, let’s take a deeper look at the potential for a degree of carbohydrate restriction to be effective in diabetes prevention. The first issue is the degree of restriction: how “low” might one need to go?

Certain research suggests that very-low-carb-ketogenic diets [VLCKD] – with carbohydrate restriction to 20-50g or <10% total energy – are superior to standard very-low-calorie-diets for diabetes prevention (28).

However, the research cited in support of such a proposition didn’t control for calories in the VLCKD diet yet provided a 2,200kcal/d diet as a control diet (29). This is a major limitation, as VLCKD are noted to lead to spontaneous reductions in energy intake, an effect attributable to higher dietary protein intake replacing carbohydrates (30).

Thus, in the absence of the diets being truly controlled for energy intake, the study (29) was not comparing like with like in terms of impacts on glycemic control.

Low, Moderate or High Carb Diet

 

diabetes prevention

 

In a recent long-term trial over 1-year, obese subjects with diabetes were assigned either a low-carb diet of 14% carbohydrate [<50g/d] and 58% fat [with <10% saturated fat] or an isocaloric high-carb diet of 53% carbohydrate and 30% fat [also with <10% saturated fat] (27).

The equating of saturated fat was an important strength of the study, controlling for a nutrient which could impact on insulin resistance (7; 24). In addition, even though the diets differed in carbohydrate content, the study controlled for the glycemic index to minimize the differential effects of simple vs. complex carbohydrates (27).

After 1-year, weight loss was similar in both groups, as were reductions in FPG and HbA1c; the low-carb group did reduce diabetes medications and triglycerides to a greater degree (27).

There are two aspects which emerge from this study: 1) the importance of glycemic index, i.e. carbohydrate quality, and; 2) whether very low carb <50g/d is in fact required for improving glycemic control in diabetes prevention.

In particular, the greater degree of carbohydrate restriction in the short-term over 3–6-months led to greater reductions in HbA1c; over 1-year there was no significant difference between low-moderate or high carb diets (31).

In relation to the former, the research shows that high fiber, low GI diets are associated with diabetes prevention and in extant diabetes, low GI diets lead to greater reductions in HbA1c (2). Thus, relevant to the discussion of the exact amount of carbohydrate in the diet is the stipulation that the type of carbohydrate be complex, unrefined, high fiber, low GI carbohydrates.

The latter question is, however, the divisive one: is “very-low” required, or can more moderate carb diets achieve diabetes prevention?

A recent meta-analysis provides the fairest representation of the state of the evidence overall in specific relation to diabetes prevention, and compared diets with 45-60% carbohydrate [high-carb] with diets <45% carbohydrate [low-to-moderate carb] from randomized controlled trials – average intake in the low-moderate trials was 30% (31). A strong feature of this meta-analysis was the inclusion of studies which quantified carbohydrate intake by percentage, with 4 studies reporting on actual intake in grams (31).

Long-Term Study Results

The results indicate that low-moderate carb diets led to greater reductions in HbA1c over 1-year than high-carb diets (31). In particular, the greater degree of carbohydrate restriction in the short-term over 3–6-months led to greater reductions in HbA1c; over 1-year there was no significant difference between low-moderate or high carb diets (31). This meta-analysis also confirmed that there was a greater reduction in medication over 3–6-months in low-moderate carb diets (31), an effect observed in other trials (27).

One of the salient features of this meta-analysis – which is a consistent observation in the literature – is that whatever the percentage of initial carbohydrate restriction, carbohydrate intake amongst subjects incrementally increases when analyzed over the longer term (>12-24m).

This should be considered in light of the greater drop-out rates in low-carb diet groups in the included studies (31). This suggests that practically for diabetes prevention, the degree of restriction of CHO <20-30% of calories in neither necessary for treatment effect over the long term, nor achievable in free-living settings.

Ultimately, the contentions of marked superiority to very low-carb diets are simply not borne out in high quality randomized controlled trials – improvements in glycemic control occur with a reduction in energy <45% (31).

In a recent trial, prediabetic obese adults were randomized to a diet of either 30% protein, 30% fat and 40% carbohydrate vs. a control diet of 15% protein, 30% fat and 55% carbohydrate: after 6-months, the higher protein/lower carb group had achieved 100% remission to normal glucose tolerance compared to only 33% of subjects in the standard diet (26).

The overall weight of the literature certainly supports reducing carbohydrate intake from >50% to <45%; it does not support any real need to go <20% for therapeutic effect, and <30% appears to be practically unsustainable in free-living conditions.

Conclusions

 

diabetes prevention

 

Let’s recap the foregoing paragraphs with a synopsis of the research:

Nutrition interventions can be successful in diabetes prevention;

Weight loss is a fundamental, overarching goal in both pre-diabetic and diabetic states;

In “prediabetes” – impaired fasting blood glucose, impaired glucose tolerance, or both FPG + IGT, the primary goal is weight loss and maintenance of 5-10kg or 5-10% baseline weight;

In extant diabetes, very-low-calorie liquid meal replacement diets may be employed to induce remission, but only under clinical supervision;

Very-low-carb-ketogenic diets do not appear to be necessary, but may certainly be strategically employed in the short-term (3-months) to achieve greater glycemic control;

Low-moderate carb diets, defined as energy intake from carbs 20-45%, may be the appropriate intervention generally going over 3–6-months. Lower intake does not appear to be necessary over the long-term;

The carbohydrate type should be unrefined, whole grain, complex [i.e. low GI] carbohydrates;

Protein is favored as the ideal replacement nutrient for carbs;

Fat composition should emphasize added unsaturated fats from plant sources and oily fish.

It is generally acknowledged that diabetes prevention can be achieved through diet and lifestyle change. However, the interventions in research often involve intensive in-person counseling, diet guidance, supervision, and in some cases prepared meals.

If you’re dealing with prediabetes or extant diabetes, make sure to work with a Registered Dietician or regulated nutritionist legally entitled to give medical nutrition advice, in conjunction with your medical supervisors.

 

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Friday, December 15, 2017

10 Low-Calorie Starbucks Drinks Worth Your Macros

 

1. Dark Chocolate Light Frappuccino

One of the most popular Starbucks drinks ever, we had to give you a way of enjoying this rich, smooth, chocolatey dream the low calorie way!!!

Ordering:

Grande, Dark Mocha Light Frappuccino, no whip

Macros:

F: 1 C: 34 P: 5

Calories: 160

2. Grande Toasted White Chocolate Mocha

Recipe by @TheMacrosBarista on Instagram

Just in time for the holidays, when you want to grab a low calorie Starbucks drinks, add hot toasted white mocha to your list after you hit the iron!

Ordering

Grande Toasted White Mocha with 2 pumps toasted white mocha syrup, 2 pumps sugar-free vanilla (or Splenda) and Half water, Half coconut Water.

Macros

F: 3 C:29 P: 1

Calories: 150

3. Grande Cappuccino

For the foam lovers of the world, it’s easy to hit your macros with cappuccinos. Soft, velvety foam and of course, caffeine, without going over on your numbers!

Ordering

Grande 2% Cappuccino

Macros

F: 4 C: 12 P: 8

Calories: 120

4. Skinny Non-Fat Mocha

What kind of list would this be WITHOUT a classic mocha made into a low calorie Starbucks drinks addition??? Chocolate and coffee were made to go together, so you should be able to enjoy them while reaching your goals!

Ordering

Grande, 1% milk, Mocha

Macros

F: 1.5 C: 24 P: 14

Calories: 160

5. Vanilla Chai Tea Latte

Recipe by @TheMacroBarista on Instagram

One of the most requested low calorie recipes of all time, grab you a vanilla chai for only 110 calories!

Ordering

Grande (Hot or iced), Coconut milk, 2 pumps chai, 2 pumps sugar free vanilla.

breastfeeding calories

Macros

F: 4.5 C: 18 P: 8

Calories: 110

6. Skinny Peppermint Hot Chocolate

Is it really even the holidays without hot chocolate? Cozy up with one of these for your low calorie Starbucks drinks.

Ordering

Grande Skinny Peppermint Hot Chocolate

Macros

F: 1.5 C: 23 P: 13

Calories: 160

7. Iced Pumpkin Spice Macchiato

Recipe by @TheMacroBarista on Instagram

If you’re into pumpkin foodstuffs as much as nearly everyone, this drink is perfection in a cup. Sweet, spicy, and PRETTY, this low calorie version of Pumpkin Spice is ingenious!

Ordering

Grande Latte macchiato, 2 pumps pumpkin sauce, half coconut milk, half water, extra pumpkin spice topping.

Macros

F: 2.5 C: 26 P: >1

Calories: 125

8. Gingerbread Latte

There is something extremely comforting about Gingerbread in a cup. These low calorie Starbucks drinks offer up the caffeine and gingerbread- a combo that is definitely what’s up.

Ordering

Tall, 1%, Gingerbread Latte, no whip

Macros

F: 0 C: 39 P: 12

Calorie: 200

9. Java Chip Frappuccino

While dieters are cringing on daily wheatgrass shots, it’s okay, you can feel a little smug that you can make this low calorie frappuccino fit your macros.

Ordering

Tall, Java Chip Light Frappuccino, No Whip

Macros

F: 3 C: 29 P: 4

10. Tazo Zen Tea

When you’re wanting to go on a low calorie Starbucks drinks binge, this is your beverage of choice. It’s subtle and perfect for sipping and studying without worrying at all if it fits. Grab it hot or cold, whatever’s your cup of tea.

Ordering

Venti Zen Hot Tea

Macros

F: 0 C: 0 P: 0

Calories: 0

 

*All of the links to the original recipes or the recipes these stemmed from, are located in the reference box below.

 

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