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Keeping your weight under control by triggering metabolism by Doctor A.F. Speciani MD www.docsalus.com Keeping your weight under control by triggering metabolism 1. THE NEW FOOD PYRAMID Over the past few years, innovative food pyramids have been proposed with the intention to help losing body fat and preventing obesity. Most of the previous pyramids, now revaluated, were characterised by great excess in carbohydrates, often with no distinction between refined flours and wholemeal grains. Eventually, given the failure of old food pyramids and thanks to new research streams on the importance of metabolism-activating “signals”, recent years have seen every single meal (including breakfast) being proposed with a balanced composition of carbohydrates, proteins, fruits and vegetables. In practice, each of these three types of foods must represent a volume of approximately 1/3 of the plate. Furthermore, after years of disapproval, the value of proteins has been restored, according to the right amount of about 1 gram per kilogram of body weight. Refined carbohydrates, sweet taste and the absence of proteins from meals are among the strongest signals to alter sugar metabolism and facilitate weight gain. 2. LOW-CALORIE DIETS? The history of mankind shows that in populations that eat less (and move more) is uncommon to find obese or diabetic people. This has erroneously led science to believe, in recent years, that low-calorie diets could solve the problem of overweight and obesity, which are affecting the world population more and more. However, reality shows daily that when an overweight person starts eating less, relying on low-calorie diets, they lose weight on the one side (often more muscle mass than fat), but on the other, they get the same (and even more) weight back as soon as the strict food control ceases. More worryingly, many people experience an initial weight loss, yet followed by a gradual, slow and inexorable recovery of the lost kilos despite the continuation of the low-calorie diet (due to the lower metabolism caused by calorie reduction itself). 3. THE LONG-TERM FAILURE OF SIMPLE CALORIE CONTROL Scientific studies have documented that the proportion of people able to maintain the weight loss achieved with a low-calorie diet for at least two years is, at most, 1-2% of the total, while nearly 80% of people “on a diet” have regained (sometimes with interest) their previous weight within one year. This confirms that a prolonged low-calorie diet may not be the solution to the “obesity” problem. It is essential to understand which signals should be sent to the regulatory centres for hunger, metabolism, and even to those for psychological motivation. Some very recent studies indicate that a brief, intense period of calorie reduction (no more than 15-18 hours) can send a strong signal to the body, especially by stimulating fat consumption. In contrast, following a low-calorie diet for a long time sends a signal of nutritional poverty and scarcity to the whole body, in response to which every organism sets in motion defensive instruments against “famine”, which try to accumulate fat even after introducing small quantities of calories. The quality and the wholeness of food, eating times, the way we combine dishes and the control over warning and inflammatory signals are all new factors that everyone should learn in order to regain and maintain well-being. Something, at last, is changing. 4. SIGNAL DIETS The most recent studies on metabolism have explained how our entire body always responds to stimuli and signals that are not just the amount of calories taken in, but many others, such as inflammation, the relationship between different foods on the plate, the time of food ingestion, the emotional state and many more factors. Two similar people, eating the same amount of calories in a day, may show opposite responses towards various received signals. A person, who tends to introduce 1200 calories (as in a classic hypo-caloric diet) only at dinner time, all presented in a unique dish consisting of only carbohydrates, could probably accumulate fat. The same person, eating a breakfast meal of around 1000 calories, well balanced between protein, carbohydrates, whole grains and fruit, and adding another 500 or 600 calories for lunch or dinner (therefore using even more calories than expected), while maintaining a balanced ratio between the nutrients, would conversely receive a signal of metabolic activation, that would lead to fat consumption if they had fat excess, without suffering from hunger. By managing intelligently all the metabolic signals - truly warning factors for the organism - meal times, inflammation and many other “messages”, we can finally gain and maintain our fitness and shape in a more incisive way than just through calories counting. 5. INFLAMMATION, HYPERGLYCAEMIA AND WARNING SIGNALS Food related inflammation, namely the production of inflammatory molecules connected with the intake of certain foods (for some people these are represented by dairy products, for others by yeasts, for others more by gluten and so on), is a common experience often described by people after eating certain foods, when they start feeling discomfort. That is a danger signal for the body directly affecting sugar metabolism and fat accumulation as well as the immune system: among the inflammatory molecules, some (such as BAFF and PAF, measured using the test named BioMarkers, Recaller and FIT) reduce insulin sensitivity and promote a rise in blood glucose and the accumulation of body fat. Inflammation represents an alarm signal for the body, just as a lack of sleep or prolonged stress, which humans have learned to defend themselves from by modifying metabolism and by stockpiling. Being able to control inflammation through diet certainly helps regulate our metabolism and maintain our fitness. 6. SUGAR AND SWEETENERS THAT PUT ON WEIGHT Sweet taste has represented, for every human being, for hundreds of thousands of years, a powerful message meaning “lots of calories present here” and an incentive to push the body to stockpile, leading to a reactive form of hunger, appearing a few minutes after eating something sweet, whether that is cane sugar, honey, fructose or other types of sugar. Even if sweet taste is triggered by low- or zero-calorie sweeteners, which do not contribute to any calorie in that meal, it will still lead the organism to get what it was due at the next meal, sometimes with interests (making weight gain easier), as recent studies have shown. Since the Palaeolithic Age, this is part of the humankind’s destiny, which is written into chromosomes that are also present today in every person. Those, who want to reduce body weight by reducing fat body mass, can enjoy a healthy, home-made dessert only during a few joyful “exceptional” occasions, first learning how to reduce and then eliminate the use of any sweetener. 7. SWEET TASTE, FAT AND HUNGER Eating or drinking something sweet (drinks included), or full of fat, triggers a mechanism which is present in every man, from the Palaeolithic Age to the present day, leading to look for more sugary and fatty foods by stimulating hunger. The chromosomes of the Palaeolithic man, identical to those of the modern man, lead us to maximize the energy density of these foods by turning the calories ingested into fat and by stimulating a repeated and frequent intake in order to be protected against a possible future food shortage. There are products stimulating a growing hunger for other foods similar to those just eaten (as anyone sitting in front of the TV with a box of biscuits certainly knows). Therefore, in order to lose weight, very fatty and sugary foods should only be enjoyed in good company and by carefully selecting the few occasions to do so. 8. BREAKFAST AND EXERCISE Breakfast in the morning is always one of the fundamental metabolic stimuli, enabling the consumption of unnecessary calories. It should be taken within one hour of waking up and must contain the correct amount of proteins. In the morning, however, the average Italian person usually eats limited amounts of proteins. By combining wholemeal cereals or bread with the right amount of eggs (also prepared as crepes), almonds, hazelnuts, other nuts, yogurt, ham or ricotta cheese, insulin sensitivity is improved, energy decline and late morning hunger are avoided, which all could otherwise lead to the subsequent rise in blood glucose and fat accumulation. Walking briskly, driving a car or using public transport as little as possible, taking the stairs at home and getting off the bus a few stops before are all effective tools useful to reduce physical inactivity and generate health. 9. SOME TRICKS TO LOSE WEIGHT Sleep and rest allow one to lose weight: it is possible to dream of losing weight and waking up really thinner. Lack of sleep is a warning signal that facilitates weight gain, while a good night's sleep rebalances many metabolic mechanisms. Prolonged chewing enables mechanisms that facilitate the consumption of calories accumulated in the form of stored fat, and thus improves well-being. Flatware should be flat, next to the plate, between one bite and another, while the food being eaten is completely chewed in the mouth. When one is hungry, there might also be thirst (the neural centres dealing with hunger and thirst are very close to each other). Before jumping onto food, a large glass of water could be drunk, which in many cases does help to hide thirst and hunger. Only if hunger persists, is it possible to think about food. Carbs and vegetables should always be cooked a little al dente; prolonged cooking converts carbohydrates and makes them much more absorbable, facilitating their rapid transformation into glucose and subsequently into fat. 10. MOVEMENT The key to an effective and lasting weight loss is based on a change in lifestyle focused on the implementation of physical activity by a marked increase in movement. The purpose of such a choice is to succeed in losing all the unnecessary adipose tissue and, at the same time, to increase metabolism. Regular activity (that is, a healthier habit in life) helps consuming fat reserves for energy purposes, while producing new lean body mass (these are all values that can be assessed at the pharmacy by means of a bioelectrical impedance scale). Such is the perfect liaison to obtain a new shape and maintain it with ease. Physical activity also improves and stabilizes mood, helping to improve the relationship with food and with the scale. In general, the appropriate level of movement is achieved by practicing aerobic exercise (swimming, walking, cycling and running) for about 3 hours per week (approximately 30 minutes per day), equivalent to about 10.000 steps per day. Getting used to avoiding the elevator and doing small walks can help improve a sedentary life. This way, you can enable the "hunter signal" sent to the body to stimulate fat consumption. As probably our common Palaeolithic hunting ancestors used to do, by alternating brief periods of intense exercise (20-30 seconds) with short periods of walking (another 30-40 seconds), such behaviour can stimulate fat consumption with only 15-20 minutes of daily physical activity. This represents a possible solution for those with limited time, preventing anyone from finding excuses. 11. HOW TO USE THE SCALE Knowing your weight is a useful tool to monitor your own health status over time. However, at the same weight, the body can change shape and size in accordance with the different composition in adipose tissue and muscle mass. One kilo of fat occupies more volume than a kilo of muscle, and the same weight formed by more muscle and less fat is healthier and requires a smaller size of trousers and skirts. With the help of the pharmacist, through the use of specific bioelectrical impedance scales, these parameters can be evaluated easily and provide all useful information on our fitness. The principle on which these scales operate is impedance, that is, the ability of the body to conduct electric current. Muscles contain a lot of water (around 70-75%) and are good electric conductors, while the adipose tissue behaves as an insulator and limits the passage of electric current. After stepping on the scale, the body is crossed by an imperceptible electrical signal. Through a particular algorithm, based on the average standard of the population and integrating weight, height, gender, age and levels of physical activity, the physical parameters measured by the scale are translated into lean mass, fat mass and hydration levels. Proper weight loss should result mainly in terms of decreased body fat, by helping muscle mass growth through the right metabolic signals and by keeping inflammation under control. 12. HOW TO USE THE MEASURING TAPE The accumulation of fat excess in “wrong places” is the aesthetic element that disturbs women the most. Moreover, there is a clear correlation between the general health status and the measure of the abdominal circumference. The more the waistline increases, the more the visceral fat is, which is associated with an increased cardiovascular and diabetic risk. With a simple non-elastic measuring tape, such value can be easily monitored, even at home. The tape should be positioned at waist level, following an imaginary horizontal plane parallel to the floor. The waist is the narrowest part of the abdomen and it is usually located above the upper part of the lateral edge of the iliac crest (that is, above the hip). If this area is not evident, the measure should be taken at the level of the navel. This is an indirect but practical method, as well as cost-effective, and provides a discrete level of reliability to follow the progress of a health course. These are reference values, different between men and women, which indicate waist circumference, which should not be exceeded. 13. THE TESTS HELPING TO MAKE THE RIGHT CHOICES Strategies to obtain the right shape and facilitate the loss of fat mass also require clarification of certain blood tests, which help understand if there are warning signals sent by the organism (such as inflammation) or metabolic alterations that drive the body to accumulate fat. With a doctor, the values to be monitored can be chosen, but the most attentive pharmacists can now provide various real-time support services to help to make the right choices. Through the “lipids profile”, for example, it is possible to learn about the most classic features, such as the value of the HDL cholesterol (indicator of physical activity) and the glycaemic- and triglyceride-related levels (often those eating an excess of carbohydrates late in the evening present these values high). General profiling is also linked to the measurement of plasma proteins, which represent a true reflection of a proper protein intake in the diet. At the moment, the levels of inflammation are indicated by BAFF and PAF values, which are cytokines signalling possible food-related reactions, and represent real warning signals to the organism. These are measured through a test called “BioMarkers, Recaller or FIT”, the results of which also indicate how to choose foods in relation to the personal nutritional profile in order to improve insulin sensitivity and increase the efficiency of dietary changes necessary for proper weight loss. 14. WHAT TO DO IN PRACTICE The indications leading to weight loss and to the long-term maintenance of well-being and fitness are those that can help everyone change their lifestyle. The most important signals are those generated from food quality (not refined) and physical movement, from the reduction and then the elimination of daily sweetening, from the control of food-related inflammation and the proper use, in each individual dish, of the right amount of protein. In practice, therefore: Always combine carbohydrates and proteins within the same meal. Choose, when possible, foods with low glycaemic index. Use mainly whole grain carbohydrates, rich in fibre. Reduce and, where possible, eliminate simple sugars and sweetening. Do physical activity on a regular basis to increase insulin sensitivity. Distribute daily meals in such a way that breakfast is richer in nutrients, while lunch and dinner should gradually be reduced in quantity. Taste and chew food for a long time before swallowing; smelling a dish before eating, enjoying it while chewing induces strong signals of satiety. Keep the inflammatory signals under control, such as those coming from food reactions, eating those foods “in rotation”, to regain food tolerance. Always guarantee a significant intake of vegetables in every meal. Drink plenty of water. Eat the right amount of food in each of the three meals, avoiding snacks or hunger stoppers, even if made only of fruit, because these can interrupt the fat-dissolving action triggered by the distance from the last meal. 15. DIVIDE ANY DISH INTO THREE AND INCREASE THE FIBRE CONTENT For many years, the study of metabolism has been focused around the importance of the number of calories that should be introduced into the body. Only a few researchers have revealed how important it is, instead, to choose the right time of the day to eat certain types of food. A study published in the Journal of Nutrition in June 2014 made clear, once and for all, that the best effects in stimulating our metabolism are achieved by distributing the daily protein intake in a balanced and correct way among all three meals of the day. Signal diets suggest the use of well-combined quantities of proteins, carbohydrates, fruit and vegetables in each of the three meals. In our recommendations, such a ratio is linked to an amount of about one third for each of the groups mentioned. By altering these values, insulin resistance may be triggered, which provokes weight gain, diabetes, obesity and other metabolic or cardiovascular conditions. A relative excess of carbohydrates represents a “warning signal”, similar to that triggered by food-related inflammation, stimulating the accumulation of fat in a similar way. The World Health Organisation (WHO) recommends between 0.8 and 1.0 g of protein per kilogram of weight as the daily amount of protein required by a normal person. Therefore, a person weighing 70 kg should eat about 70 grams of protein in a day, and it is useful that such a quantity is symmetrically distributed, i.e. 25 g in the morning, 25 g in the afternoon and 20-25 g in the evening (combining every dish with similar volumes of complex carbohydrates and vegetables). 16. HOW MUCH PROTEIN ON YOUR PLATE? A healthy 70 kg person, wanting to lose body fat, needs to eat 65-70 g of protein during the whole day. A piece of fish (or of turkey) weighing about 100 grams contains around 18-20 g of protein. That person should eat about 3 slices of fish to reach the amount required, or 200 g of Parmesan cheese (33 g per 100 g), 400 grams of soft cheese (18 grams per 100 g) or three beef steaks of 100 g each (22 g per 100 g). These are quantities that cannot and should not be taken in at only a single meal (like most Italians do at dinner), but instead should be distributed throughout the day, possibly integrating other protein-rich foods such as wholegrain cereals, eggs and oily seeds from the beginning of the day, using the correct quantities and also choosing vegetable proteins. 17. GLYCAEMIC INDEX AND SIGNALS There are foods with low glycaemic index, such as wholegrain cereals, some types of fruit, almost all vegetables, wholemeal bread and pasta and especially legumes, which are very good in preventing the blood glucose levels from skyrocketing. Sometimes, you just need to replace high glycaemic index foods, such as white bread, sugar, commercial or packaged desserts and refined grains with the correspondent whole foods, in order to boost metabolism, to control glycaemic rises and activate a greater fat consumption. Generally, fruit does not trigger blood glucose changes, although some people, because of individual reactivity, should eat it more cautiously. Therefore, our body responds to simple signals that can be activated and maintained through the right choices of food, in order to balance sugar fluctuations. 18. SUPPLEMENTS AND SIGNALS No supplement or drug can produce the same results as a change in lifestyle. It is possible to lose weight through correct exercise and certain food choices as we have outlined in these pages. However, many supplements can help control inflammatory warning signals and put the organism in a position to make best use of its resources and make the most of the dietary changes introduced. For example, various cooking spices can be used such as ancient ones, used for centuries for their ability to normalize glycaemia, for example cinnamon or turmeric root. It is possible to choose to accompany a specific diet with food supplements like chromium, zinc, magnesium and Omega-3 (Perilla oil, blackcurrant oil, fish oils), which are known for their action in improving insulin sensitivity and the inflammatory reduction effect. Other supplements, containing inositol (which also improves insulin sensitivity), act as a second messenger in the fine regulation of metabolism. The pharmacist should always discuss with his client the most useful and effective choices available. ABOUT THE AUTHOR In his practice, Dr Attilio Speciani uses the latest immunological scientific research in combination with an innovative nutritional approach in treating a variety of inflammatory, metabolic and autoimmune diseases. In addition he has carried out his own extensive research into the relationship between food and inflammation and is a prolific writer on the subject. Through his published work, he has become very well known in Italy. www.docsalus.com