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BE YOUR BEST YOU FAT LOSS SEMINARS DR. AMBER MERRICK BSC, ND About me… Licensed ND Former “chubster”, Med School, Digestion, EBV, thyroid nodules Functional Medicine Patient-Centered Care, Integrative Science-based healthcare Approach Integrating BEST medical practices Prescribing rights in Ontario My GOAL “I want to INSPIRE others to take control of their health; so you can FEEL and LOOK your best!” I know the struggle… Outline BMI vs LBM Diet trends Dr. Amber’s 8 Rule Plan Exercise Supplements Obstacles to success! Strength Gain vs. Weight Loss Is skinny the same as being healthy? “Strong is the New Skinny” BMI vs LBM BMI – weight to height ratio Calculated: weight (kg)/height (m2) 19.5-24.5 – “normal” 25-29.5 – “overweight” 30-35 – obese 35+ - morbidly obese BMI vs LBM Lean Body Mass/Body Fat percentage % of fat free mass (muscle, bone, organs, water, etc.) Measured with calipers, BIA, or submersion tank BMI vs LBM Who is healthier? Irrespective of weight, those with a higher lean body mass as a percentage of their weight have decreased risk of chronic illness Weight Loss – not as important, as muscle more dense than fat (by 18%) Muscle will take up less space…a leaner appearance even if weight remains unchanged LBM and Strength – The benefits Long-term, sustained weight loss Increased immune function Improved blood sugar Decreased pain (esp. lower back) Increased bone density (decreased fracture risk) Decreased BP Decreased cancer risk As strength increases, FBG decreases and DMII risk decreases Decreased cholesterol and triglycerides and CHD risk How can I increase my LBM and BURN FAT? Diet HIIT and Resistance Training Supplements (if needed) If you run into difficulties? (cortisol/stress, hormones, sleep, detoxification) How are we eating? Obesity epidemic: 75% Overweight/Obese 35% Obese How are we eating? Bad Fats Trans-fats Increases risk of CHD more than ANY OTHER macronutrient Fast foods, snack foods, fried foods, baked goods How are we eating? Not enough quality protein Grain fed beef = omega-6:omega-3 Hormones and antibiotics Farm raised fish How are we eating? Sugar and Artificial Sweeteners (HFCS) Insulin and Weight Gain Insulin – Hormone released by the pancreas Signals carbs/sugars to be taken up into the cells (GLUT receptors) Insulin and Weight Gain Now what happens? CARBS can be: used as fuel Stored as glycogen Stored as fat If insulin is too high, hormones are inhibited so FAT BURNING decreases What is the BEST diet to LOSE fat Higher protein Higher fat Lots of veggies Low starchy/complex carbs Low simple sugars/fruit Vegetarian Diet GOOD? Low in Saturated fats Low in cholesterol High carbs, fiber, vitamins/minerals/nutrien ts Generally lower BMI, BP, cholesterol, CVD risk Vegetarian Diet Roadblocks to Fat Loss: Limited complete protein options Beans/lentils/quinoa (2:1 carbs:protein) Eat: Tempeh, eggs, dairy, soy protein Low is Saturated Fats Very nutrient dense Eat: Butter, ghee, full fat dairy Mediterranean Diet Mediterranean Diet GOOD? Lots of healthy fats (olive oil) Antioxidants (resveratrol) High fiber (fruits/veggies/grains) Better than a low fat diet for decreasing cholesterol, BP Decreases risk of Dementia and DMII Mediterranean Diet New England Journal of Medicine (2009) 322 Obese patients 2.9kg – Low Fat 4.4kg – Mediterranean Diet 4.7kg – Low Carb Mediterranean Diet Roadblocks to Fat Loss: A lot of carbs – grains, beans, legumes Too much red wine? Omega 6:Omega 3 Paleo Diet GOOD? No processed foods or gluten Grass-fed meats and dairy Nutrient dense; low sodium Omega-3 High fiber, high protein Decrease risk of CVD, diabetes, BP, and auto-immunity Paleo Diet Possible Problems: All or Nothing? Increased Cholesterol? Decreased Carbs can increase cortisol Low Carb/Ketogenic Diet 50-100g carbohydrates/day Decrease appetite Burn Fat; decrease fat storage Improve blood sugar control/insulin sensitivity Increased metabolism British Journal of Nutrition (2013) Reviewed 13 studies; weight loss, BP, TG, HDL-C Low Carb/Ketogenic Diet Ketogenic vs. Mediterranean Diet (Nutrients, 2013) Fat loss better with Low Carb diet, however, after VLCD phases, Mediterranean diet was appropriate for maintaining loss Low Carb/Ketogenic Diet Low Carb and Training Circuits x 3/week Low fat diet vs. high carb vs high protein Carb restricted diet had more fat loss, decreased blood sugar, and leptin We Know The Research Dr. Amber…now what? My RULES for FAT LOSS: #1 – Eat 3 Meals per day Breakfast within 30 minutes of waking NO SNACKING 3 hours post-eating body is only storing glycogen and NO adipose tissue is broken down FAT LOSS RULES #2 – PROTEIN 1-2g/kg per day Men – 2 palms/meal Women – 1-1.5 palms/meal Meat and Fish is best Caution: kidney dysfunction or Parkinson’s FAT LOSS RULES #3 – CARBS 50-100g per day Low GI carbs – sweet potatoes, brown rice, quinoa, root vegetables, rice pasta, legumes Ketogenic – leafy greens and veggies Limit Simple Carbs – breads, sugars and fruit PROTEIN:CARB (1:1 ratio) FAT LOSS RULES Unlimited Veggies (cruciferous and green leafy) Fats – 30-60g/day Men – 2-4 thumbs per meal Women – 1-2 thumbs per meal Saturated – coconut oil, butter, ghee Monounsaturated – Avocado, olive oil PUFA – fish oils, algae Caution – GB issues FAT LOSS RULES FAT LOSS RULES #4 – AVOID WHITE CARBS Chlorine dioxide (bleached grains) + Protein = Alloxan (induces diabetes) FAT LOSS RULES #5 – AVOID artificial sugars/sweeteners: HFCS, saccharine, aspartame Cause greater weight gain than sugar Stimulate appetite Increase carb cravings Stimulate fat storage and weight gain FAT LOSS RULES #6 – Don’t Drink Calories Drink water and herbal teas 6 oz per day of red wine NO soda, juice – liquid sugar super spikes insulin levels which directly leads to FAT GAIN FAT LOSS RULES #7 – Phew…I get a reward Important to REWARD yourself for all of your hard work…keeps your dopamine high, and keeps you motivated Take 1 MEAL OFF per week To avoid hormonal dysregulation from extended “dieting” Satisfy your cravings, makes the rest of the week easier FAT LOSS RULES #8 Exercise!! Exercise Resistance!! Best for sustained fat loss Never too late; can build muscle into your 90’s Weight Training and High Protein Decrease fat mass BP Glucose, insulin, TG, TC, LDL-C Exercise Cardio HIIT Training 4-7 30 second bouts – sprints/bike Improves insulin sensitivity Improves fat oxidation Metabolism (2013) Day 1 – No exercise, 4x30s sprint or extended sprint Day 2 – OGTT; Fat oxidation was increased 63% compared to 38% no exercise EPOC – Heavy resistance and HIIT adds extra 6-15% energy cost of work-out Supplements for Fat Loss Caffeine Thermogenesis SNS Adrenaline Lipolysis Caffeine and exercise Improved mood Decreased fatigue Work/endurance capacity Supplements for Fat Loss Coffee Inversely associated with insulin resistance (>5 cups per day) Decreases risk of DMII (4-6 cups) Filtered, decaf Supplements for Fat Loss Green Tea Increases HR Thermogenesis Small effect of weight loss (BMI, weight) Modest decrease in FBG, HbA1C, Fasting insulin Supplements for Fat Loss Whey Protein ISOLATE Increases LBM better than any other supplement 30g whey isolate and water Caution: dairy sensitivity Supplements for Fat Loss Cinnamon 1g per day Decreases FBG and insulin resistance Decreases HbA1c, TG, LDL-C Supplements for Fat Loss Berberine 200mg tid Decreases insulin HbA1c, FBG As good as metformin Will up-regulate expression of GLUT receptors Also beneficial for GI issues Supplements for Fat Loss Alpha-Lipoic Acid (ALA) 1800mg qd divided doses Fat loss in obese patients FBG, HbA1c Diabetic neuropathy Antioxidant and Anti-inflammatory Team Work! A person is more likely to be obese/healthy if their friends are More of a correlation than parents or siblings Improve your chances, work together! Obstacles to Weight Loss Obstacles to Fat Loss: Gut Health/Inflammation Nutrient Deficiencies Detoxification Hydration Stress/ Cortisol Sleep Thyroid Sex Hormones Gut Health Leaky Gut Gut Health SSx Leaky gut Bloating Constipation and/or diarrhea Nausea Fatigue Systemic concerns – arthritis, HA, skin, etc. Gut Treatment Decrease Sugar Consumption/Processed Foods Identify Food Allergens Elimination Diet IgG Serum Food Sensitivity Test 4 R’s: Replace – Digestive Enzymes Remove – Offending allergens (Hypoallergenic, Detox, Berberine) Restore – gut integrity (Glutamine, Omega-3, Zn) Re-inoculate – healthy probiotics 3 months for full recovery Nutrient Deficiencies Toxin Accumulation Exogenous and Endogenous toxins accumulate in fat As toxins increase, body produces more fat cells to cope Caution when embarking on a fat loss journey (liberates toxins) NHATS in 1982 and 1987 Found between 83 – 100% of fat samples were full of toxins associated with obesity Toxic Burden Food additives, Drugs, Alcohol, Environment Perchlorate Organochlorine pesticides PCB’s PDBE’s (97% of US residents) BPA Heavy Metals Signals that your body needs a detox: Unexplained fatigue, listlessness, depression or lethargy accompanied by poor digestion, PMS, headaches and other menstrual difficulties; bags under the eyes Allergic reactions Unexplained weight gain and the appearance of cellulite, even if you are thin A distended stomach even if the rest of your body is thin Poor hair texture and slow hair growth Mental confusion, “brain fog” Skin itching and irritation Anemia and large bruise patches indicate severe liver exhaustion Sluggish elimination, general constipation alternating to diarrhea Food and chemical sensitivities, usually A yellowish tint to the skin and/or liver spots on the skin Detoxification LIVER Vitamin C Alpha-Lipoic Acid B-vitamins Selenium Magnesium Whey Protein Milk thistle, Curcumin NAC GUT Heal Leaky Gut Fibre – toxin absorbers Skin – SWEAT!!!! Hydration 2-3 L water per day To support metabolic reactions Carries nutrients and hormones to cells Removes waste Adrenals Signs/Symptoms Adrenal Fatigue Anxiety/Nervousness Trouble sleeping Inability to cope with Nausea or flushing stress Impatience Irritability Light-headedness, dizziness Shaky, trembling Racing or pounding heart during stress Decreased blood sugar Sweating Salt or sweet craving Causes of Adrenal Fatigue Being on T4 ONLY; Adrenals NEED T3 Years of undiagnosed hypothyroidism Chronic stress – biological, environmental (Fl, Cl, heavy metals, etc.), emotional or physical Eating high carb diet with low fat Adrenal Fatigue: How do you know for sure? Blood Serum Cortisol: 8am, noon, 4pm 24 Hour Salivary Cortisol: 8am, noon, 4pm, 11pm Cortisol and Weight Loss Increases cravings (esp. sugar) Break-down muscle tissue for energy (decreases metabolism) More fat storage (esp. abdomen as 30% more cortisol receptors than elsewhere in body) In a normal metabolic state: 40% of incoming calories are directed to the muscle, liver and blood 60% should be stored as fat In a stressed metabolic state: 10-20% of incoming calories are stored in the muscle, liver and blood 80 -90% is stored as fat Cortisol and Weight Loss A 2-year study with 2800 working adults showed wellness programs that targeted stress management/reduction in the workplace reduced weight more so than dietary changes (Fernandez et al, 2010). Treating Your Adrenals Laugh and enjoy life Meditation, Yoga, Breathing Sleep and Rest 3 Meals per day Avoid over-stimulating exercise Treating Your Adrenals Care for your healthy adrenals: Vitamin C B vitamins (esp. B5 &B6) Vit. E, Calcium, Magnesium, trace minerals Herbs: Licorice Root*, Ashwagandha, Ginseng, RHODIOLA ROSEA Adrenal Glandulars (Cortex ONLY) If Cortisol too high: Relora, PS *not with high blood pressure Sleep Sleeping one hour less per night reduces melatonin and stimulates cortisol production Low melatonin (sleep hormone) inhibits leptin, serotonin, GH and increases ghrelin (an appetitestimulating hormone produced by the stomach) Supplementing with melatonin - greater weight loss with NO change in calorie consumption Chronic restricted sleep caused weight gain - 2 pounds per week versus those who slept 8 hours per night 7 hrs versus 6 hours sleep/night in teens improved insulin resistance by 9% Sleep High night time cortisol/Sleep Melatonin 1-3mg Phosphatidylserine (PS) Zinc (with Cu) Holy Basil Relora GABA/L-Theanine The Thyroid Gland Thyroid Thyroid Treatment Synthetic T4 or T3 Armour/Porcine Thyroid (combo T4, T3) Selenomethionine Zinc D3 Iodine/Iron if needed (Urinary Iodine and ferritin levels) Tyrosine Avoid Goitrogens (Soy, Bromides, Heavy metals, GLUTEN, etc.) Sex Hormones Sex Hormones Normal hormone production peaks at age 25 Gradually declines from age 25-50 Each hormone declines independently creating imbalances Lifestyle Choices also contribute to imbalances: Plastics, diet, habits, exposure to toxins Age-related Hormonal Decline Sex Hormones Hormones are anabolic E2, P4, Testosterone, GH, DHEA They are natural anti-inflammatories Diseases of inflammation: Heart disease, Diabetes, HBP, Alzheimer’s, CA Other ways to decrease inflammation: Weight management Low Carb diet, High Veg/Fruit Intake Exercise Natural bio-identical hormone therapies when appropriate (talk to your licensed ND) Questions? Integrated Health Care 577 Ontario Street St. Catharines, ON 905-988-9160 www.integratedhealthcare.ca Follow me on Facebook Amber Merrick ND www.doctoramber.com