What Every Practitioner Needs To Know About Current Sports Nutrition Studies And The Implications With Weight Loss Options
My New year’s Resolution – Incorporate Credible Weight Loss In My Practice!
Background
Sports Nutrition recommendations have substantially changed in the past 20 years. Even chiropractors who do not treat or specialize with athletes can benefit from understanding the latest sports nutrition research since this research can substantially impact many patients concerned with weight loss, decreased metabolism, fatigue, stamina, and physical performance. Many sports nutrition studies are well designed and well funded, but it may be difficult to know which studies are credible and it can be challenging to practically incorporate or deliver the specific nutritional recommendations to your clients, whether they are weekend, elite athletes or sedentary couch potatoes.
Surprisingly, many of the credible human performance labs and universities that are conducting the latest sports nutrition exercise studies are not just investigating fat loss, muscle loss, increased metabolic rates, and performance benefits, but also patient compliance, relapse, and complications with quick weight loss. More sports nutrition studies are also investigating the long-term risks for common diseases, such as heart disease, cancer, diabetes, and metabolic syndrome. Nutritional protocols should incorporate realistic guidelines and long-term lifestyle changes while reducing inflammation, insulin resistance, hunger, appetite, satiety, and fatigue, and, ultimately, improve well-being while reducing risks for diseases.
Alternate Day Fasting (ADF) “The Every Other Day Diet”
A patient comes into your office wanting to lose weight and to improve his or her lifestyle and health. The patient reports to you that he or she is not hungry every day, exercises regularly, and often likes to skip meals. The patient is not a diabetic and reports no significant symptoms on days he or she eats very little. Previously, you immediately recommended at least three medium-size meals and at least one to two snacks because most previous studies with athletes show that when normal-weight athletes (sprinters, endurance, weight lifters, etc.) who ate five to six small meals and snacks had increased lean body mass (muscle) as compared to the athletes who just consumed three meals. So what do you recommend?
According to multiple studies conducted by Vardy PhD University of Illinois, the most successful protocol for weight loss and retaining lean body mass and nutritional and exercise compliance was alternating every day from fast day to feast day, so the subjects could look forward to eating ad lib on the day following fasting day. On the fast day, they consumed a 500-calorie meal daily for woman and 600-calorie meal daily for men between noon and 2:00 pm (i.e., chicken veggies, apple, cookie or pizza, apple, cookie or chicken enchilada, apple, cookie). On the feast day, individuals were allowed to consume any type and amount of food they desired. The results of multiple studies show that the “fast day” individuals consumed about 25% of maintenance calories (500 to 600 calories per day). Subjects only consumed 110% of maintenance calories (only 10% over their maintenance needs) on the feast days when researchers expected they might consume up to 175% of calorie needs (or 75% excess calories) to compensate for the deficit of calories the previous day
Astoundingly, after eight weeks of alternate day fasting, 75 to 90% of the weight loss reported was fat; subjects who ate a higher fat meal plan (40% fat compared to 25% fat) lost an average of 17 pounds as compared to those in the low-fat ADF group who lost an average of 13 pounds in eight weeks. Participant dieters lost between 10 to 30 pounds in about eight weeks. Interestingly, the high-fat ADF group had better food compliance, LDL cholesterol was lowered 10 to 25% (particle size increased), and TRIG and BP decreased. Ten percent of study participants dropped out complaining of headaches and most individuals said hunger and cravings subsided after seven to 10 days of following the ADF protocol.
NUTRITION
Interestingly, the high-fat ADF group had better food compliance, LDL cholesterol was lowered 10 to 25% (particle size increased),
and TRIGand BP decreased.
Ketogenic Diets and Implications for Weight loss and Performance (The High Fat Diet)
Eating a diet with at least 65 to 70% of the calories coming from fat sources causes the body to metabolically change to utilizing ketones for energy and is the basis for the ketogenic diet protocol. In a state of ketosis, the mitochondria electron transfer in cells can use fats and ketones to produce more ATP and energy with less oxygen demand, especially during exercise. Surprisingly, using ketones for fuel and being in ketosis has an anti-cancer effect, helps with neurological disorders and seizures, decreases symptoms for hypoglycemia, and has a protein-sparing effect on the body. By keeping the diet approximately 70% fat, 20% protein, and only 5 to 10 % carbohydrate (less than approximately 50 grams of CHO per day), there are significant cognitive and metabolic advantages according to Dr. D’Agostino, an assistant professor at the University of South Florida. However, the body’s transition period into ketosis can take approximately five to seven days, which can be a challenging time for patients. Use of MCT or coconut oil and branched chain amino acids (BCAAS) supplementation can help the body obtain ketosis more easily and allow for the consumption of a few more carbohydrates during ketosis. In some individuals, ketosis happens quickly, but for others it takes longer, which may make the ketogenic diet protocol intolerable and impractical.
Initially, the brain becomes starved of glucose, goes through withdrawal, and mobilizes fats for energy; the liver produces water-soluble ketones, acetoacetate, and beta-hydroxybutyrate; and the brain adapts from using glucose for fuel to ketones as source of energy
The ketogenic diet is a radical shift for most people who are carbohydrate-performing athletes, so clients should give it a minimum of four to six weeks to start to get the benefits with two to three months to completely evaluate enhanced performance.
Fat-adapted athletes can supplement carbohydrates during exercise and the body will use them more efficiently as fuel.
Triathletes, long-distance runners, and power lifters have a definite benefit for ketone adaptations for optimal performance. However, body builders require insulin for hypertrophic muscle growth and may not benefit from this protocol long term. It depends on your sport, if your sport but most importantly the foods you prefer to eat
The Bottom Line – Improved Patient Compliance
In the past 20 years, nutritional philosophies have changed substantially. Patient demographic and clients’ individual and lifestyle vary and need to be addressed on a case-by-case basis. Most seasoned health care practitioners may feel that providing nutritional counseling to patients without having a specific program to address different lifestyle and nutritional needs can be complicated and time consuming. By utilizing nutritional questionnaires with your clients it can help clarify which type of nutritional program a client will be able to better comply with. Using nutritional software, and metabolic analyzers, healthcare practitioners can quickly and efficiently provide clients with custom meal plans based on the clients’ food preferences and the nutritional philosophy of the doctor.
As practitioners, I think we may encourage or limit our patients to unnecessarily follow one specific validated nutritional protocol because of our personal beliefs or lack of understanding of the research. The one-size-fits-all mentality does not work with nutritional counseling and is appropriate for patients with varied lifestyles, food preferences, and medical and personal goals
Christopher Fuzy, MS, RD, LD is the Founder of Lifestyle Nutrition Inc – LIFESTYLENUTRITIONINC.COM, has a Master’s Degree in Clinical & Sports Nutrition, has offices in Ft. Lauderdale and Boca Raton, FL.and In the past 24 years, has trained over 900 physicians nationwide with the Lifestyle Nutrition Counseling Program. For More Information or try your own nutritional program, visit LIFESTYLENUTRITIONINC.COM or call 800-699-8106 For Physicians –LIFESTYLENUTRITIONINC.COM