The Magical Trail of Weight Maintenance

1. The Magical Trail of Weight Maintenance By Dr Brian Kelchen

2. Where to start • In all honesty there is no 1 right answer for all people. Everyone digests food differently and what each persons body does with calories is even more complicated • So instead we are going to discuss • Good rules to live by • Exercise • The Good, better, and best options for your family

3. Nutritional Content vs Caloric Content • Some foods offer a lot of bang for your buck and others offer none. Knowing the difference is the key • Fresh Canned Frozen • Lettuce • Protein- different sources, different makes, and models • The media lies…….. But why

4. SUGAR • Yes it is in everything. • There is no such thing as GOOD sugar • Sugar is the most naturally addictive substance in the world. • Carbs, grains, fruit,

5. Worst offenders • Quick salads • “its better than _____ • Soda • Diet vs regular • Alcohol • Better choices • Holidays • Rewards

6. Other myths • 1. Exercise is an extremely effective weight loss tool. • 2. Lots of cardio will make you lose weight. • 3. Fruit juice is healthy. • 4. Eating breakfast is a must. • 5. Whole grains are the most important component of a healthy diet. • 6. “Natural” sugars like honey are ok. • 7. BMI is a good measure of health outcomes. • 8. Total cholesterol is the best indicator of heart attack risk.

7. Myths part 2 • Too much protein is bad for you • You need a lot of complex carbs • All carbs are turned into sugar • You should get all of your nutrients from food and not take any supplements • In an ideal world this would be true; however, most people need assistance getting everything they need

8. Nutritionist Says: “The Best Diet is a Low-Fat Diet, With Carbs at 50-60% of Calories” • Answer: The low-fat diet has been put to the test in several huge randomized controlled trials. It does not cause any weight loss over a period of 7.5 years and it has literally no effect on heart disease or cancer. • The low-fat diet is a huge failure. All the major studies show that it doesn’t work.

9. Nutritionist Says: “Eggs Raise Cholesterol and Lead to Heart Disease” • Answer: The cholesterol in eggs does not raise the “bad” cholesterol in the blood. It raises HDL (the “good”) cholesterol and eggs actually improve the blood lipid profile. • The studies show that egg consumption is not associated with heart disease. Whole eggs are among the most nutritious foods on the planet.

10. Nutritionist Says: “Protein is Bad For Your Kidneys” • Answer: It is often claimed that a high protein intake can cause harm to the kidneys, but this is false. Even though it is important for people with pre-existing kidney disease to reduce protein, the same is not true for people with healthy kidneys. • The studies show that a high protein intake has no detrimental effects of kidney function in healthy people, not even in bodybuilders that eat massive amounts of protein.

11. Nutritionist Says: “Saturated Fat Raises Cholesterol and Causes Heart Disease” • Answer: This is a myth. Saturated fat raises HDL (the “good”) cholesterol and changes the LDL from small, dense to Large LDL, which is benign and doesn’t increase the risk of heart disease. • This has been intensively studied in the past few decades and the studies consistently show that saturated fat is not in any way related to the risk of heart disease.

12. Nutritionist Says: “Low Carb Diets Are Unhealthy” • Answer: This is simply not true. Since the year 2002, low-carb diets have been studied extensively and over 20 randomized controlled trials have been conducted. • They consistently lead to much better health outcomes than the typical low-fat diet. They cause more weight loss and improve all major risk factors for disease, including triglycerides, HDL and blood sugar levels.

13. Nutritionist Says: “Red Meat is Unhealthy and Should Only be Eaten in Moderation” • Answer: It is true that consumption of processed meat is associated with an increased risk of many disease, but the same is not true for unprocessed red meat. • Unprocessed red meat is harmless, although it may form harmful compounds if it is overcooked. The answer is not to avoid red meat, but to make sure not to burn it. • The association between unprocessed red meat and cancer is highly exaggerated, large review studies show that the effect is very weak in men and nonexistent in women.

14. Nutritionist Says: “Protein is Bad For Your Bones and Causes Osteoporosis” • Answer: Although it is true that protein can cause calcium loss from the bones in the short term, this effect does not persist in the long term. • In fact, the studies consistently show that protein actually improves bone health in the long run, NOT the other way around. Therefore, the terrible advice to keep protein low is likely to increase the risk of osteoporosis

15. Nutritionist Says: “People Should Cut Back on Sodium” • Answer: Even though sodium restriction can lower blood pressure, it does not appear to reduce the risk of heart disease or death. • Some studies even show that if you restrict sodium too much, that it can increase some risk factors for disease. • There is no science behind the 1500-2300 mg per day recommendation and people that are healthy can eat “normal” amounts of sodium without any harm.

16. Nutritionist Says: “Polyunsaturated Fats Lower Cholesterol and Reduce Heart Disease Risk” • Answer: There are two types of polyunsaturated fats, Omega-3 and Omega-6. It is true that Omega-3s reduce the risk of heart disease, but the same is not true for the Omega-6s. • Even though the Omega-6s (soybean oil, corn oil, etc.) can lower cholesterol, the studies show that they actually increase the risk of heart disease. • Therefore, the horrible advice to increase polyunsaturated fat, without regards to the type, is probably contributing to heart disease instead of preventing it.

17. Nutritionist Says: “People Should Choose Low-Fat Dairy Products to Reduce Calories and Saturated Fat” • Answer: There is no evidence that people benefit from choosing low-fat instead of full-fat dairy products. Plus low-fat dairy is usually high in sugar, which makes this misguided advice seriously questionable. • Full-fat dairy (especially from grass-fed cows) contains many important nutrients like Vitamin K2 and butyrate, which are very scarce in the diet. • High fat dairy products are actually associated with a lower risk of obesity. In countries where cows are largely grass-fed, people who eat the most high fat dairy products have a drastically reduced risk of heart disease.

18. Nutritionist Says: “Weight Loss is All About Calories in and Calories Out” • Answer: This is completely false, different calorie sources go through different metabolic pathways in the body and have varying effects on hunger, hormones and the brain. • Also, let’s not forget that health is about way more than just weight. Certain calorie sources (added sugar, vegetable oils) can cause harmful effects on metabolism that have nothing to do with their caloric value.

19. Exercise 101 • Goal to increase lean mass • Reason to burn fat while doing nothing • Increases gray area • Increases overall wellness and productivity

20. The real story of exercise • What is the first thing you do when you go • Can’t I just follow this program I saw on Facebook/magazine/ that my friend uses. • Balance is Key • 3-1 ratio back to front is ideal

21. But weights will make me big • No • Weight training will lean your body out • Most people will never build mass without taking a builder • Such as testosterone • Machine vs free weights • Machines require less muscle activation and are easier to cheat on so be careful

22. GOOD better best exercise programs • Worst • Cross fit- high risk of injury and no muscle isolation • Hot yoga- our bodies are not made to perform at high temps. It can cause organ damage • Anything off Facebook- unless it is from a reliable source like Libertyville Wellness Group Good • Boot camp- fun, and can be effective • P90X- at least they attempt to isolate muscle groups and rotate which muscles are being used • Better • Personal Trainer • Check education and experience it varies to an extreme extent • Best • Individualized program • It is important to continually change your work out to make it harder because our bodies will accommodate and we will get lower results

23. Dr Brian’s version • 6 out of 7 days per week • 16-24oz of protein per day • Lean protein • Steak, chicken, pork, fish, hamburger, • Not count • Bacon • Sauges • Unlimited vegetables (not including corn or potatoes they are a carb from now on) • Min= 4 cups • 4 servings of everything else • Carbs- • Pasta, bread, rice • Fats- • Yogurt, cheese, milk • Fruits- • Better- low gycemic index such as blueberries, raspberries, and strawberries • Worst- watermelon, pineapple, cantaloupe

24. 6 out of 7 days • Eating “clean” 6 out of 7 days • Its not how many calories, it s more about what is in each calorie • Frequency matters, Amount matters and Time of day matters on our clean days

25. Other good maintenance plans • Paleo diet • Mediterranean diet • IP plan • King breakfast • Prince lunch • Bum’s supper

26. My least favorite • Juice Diets- lots of sugar and lack of other macro-nutrients • Fasting (non religious reasons)- usually result in a lot of muscle loss • Atkins- does not have enough fruits and does not monitor the type of protein • Vegetarian /vegan- • If done correctly it is great • It is the most difficult and most people do them incorrectly resulting in nutritional deficiencies

27. If you have any questions please ask. I am happy to explain any of my information in more detail

28. References • Howard BV, et al. Low-fat dietary pattern and weight change over 7 years: the Women’s Health Initiative Dietary Modification Trial. Journal of the American Medical Association, 2006. • Howard BV, et al. Low-Fat Dietary Pattern and Risk of Cardiovascular Disease.Journal of the American Medical Association, 2006. • Multiple Risk Factor Intervention Trial: Risk Factor Changes and Mortality Results. Journal of the American Medical Association, 1982. • Stanhope KL, et al. Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans. Journal of Clinical Investigation, 2009. • Stanhope KL, et al. Adverse metabolic effects of dietary fructose: results from the recent epidemiological, clinical, and mechanistic studies. Current Opinion in Lipidology, 2013. • Ludwig DS, et al. Relation between consumption of sugar-sweetened drinks and childhood obesity: a prospective, observational analysis. The Lancet, 2001. • Schulze MB, et al. Sugar-Sweetened Beverages, Weight Gain, and Incidence of Type 2 Diabetes in Young and Middle-Aged Women. Journal of the American Medical Association, 2004. • Bostick RM, et al. Sweetened beverage consumption and risk of coronary heart disease in women. Cancer Causes & Control, 1994. • Fung TT, et al. Sugar, meat, and fat intake, and non-dietary risk factors for colon cancer incidence in Iowa women. The American Journal of Clinical Nutrition, 2009. • Rong Y, et al. Egg consumption and risk of coronary heart disease and stroke: dose-response meta-analysis of prospective cohort studies. British Medical Journal, 2013. • Fernandez ML. Dietary cholesterol provided by eggs and plasma lipoproteins in healthy populations. Current Opinion in Clinical Nutrition & Metabolic Care, 2006. • Blesso CN, et al. Whole egg consumption improves lipoprotein profiles and insulin sensitivity to a greater extent than yolk-free egg substitute in individuals with metabolic syndrome. Metabolism, 2013. • Manninen AH. High-Protein Weight Loss Diets and Purported Adverse Effects: Where is the Evidence? Journal of the International Society of Sports Nutrition, 2004. • Martin WM, et al. Dietary protein intake and renal function. Nutrition & Metabolism, 2005.

29. References 2 • Siri-Tarino PW, et al. Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. The American Journal of Clinical Nutrition, 2010. • Mente A, et al. A systematic review of the evidence supporting a causal link between dietary factors and coronary heart disease. Archives of Internal Medicine, 2009. • Dreon DM, et al. Change in dietary saturated fat intake is correlated with change in mass of large low-density-lipoprotein particles in men. The American Journal of Clinical Nutrition, 1998. • Westman EC, et al. Low-carbohydrate nutrition and metabolism. American Journal of Clinical Nutrition, 2007. • Hession M, et al. Systematic review of randomized controlled trials of low-carbohydrate vs. low-fat/low-calorie diets in the management of obesity and its comorbidities. Obesity Reviews, 2008. • Santos F, et al. Systematic review and meta-analysis of clinical trials of the effects of low carbohydrate diets on cardiovascular risk factors. Obesity Reviews, 2012. • Micha R, et al. Red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes mellitus: a systematic review and meta-analysis. Circulation, 2010. • Rohrmann S, et al. Meat consumption and mortality – results from the European Prospective Investigation into Cancer and Nutrition. BMC Medicine, 2013. • Alexander DD, et al. Meta-analysis of prospective studies of red meat consumption and colorectal cancer. European Journal of Cancer Prevention, 2011. • Alexander DD, et al. Red meat and colorectal cancer: a critical summary of prospective epidemiologic studies. Obesity Reviews, 2011.

30. References 3 • Kerstetter JE, et al. Dietary protein and skeletal health: a review of recent human research. Current Opinion in Lipidology, 2011. • Bonjour JP. Dietary protein: an essential nutrient for bone health. The Journal of the American College of Nutrition, 2005. • Munger RG, et al. Prospective study of dietary protein intake and risk of hip fracture in postmenopausal women. The American Journal of Clinical Nutrition, • Taylor RS, et al. Reduced dietary salt for the prevention of cardiovascular disease. Cochrane Database of Systematic Reviews, 2011. • Jurgens G, et al. Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterols, and triglyceride.Cochrane Database of Systematic Reviews, 2003. • Garg R, et al. Low-salt diet increases insulin resistance in healthy subjects.Metabolism, 2011. • Ramsden CE, et al. Use of dietary linoleic acid for secondary prevention of coronary heart disease and death. British Medical Journal, 2013. • Lands WE, et al. Dietary fat and health: the evidence and the politics of prevention: careful use of dietary fats can improve life and prevent disease.Annals of the New York Academy of Sciences, 2005. • Ramsden CE, et al. n-6 fatty acid-specific and mixed polyunsaturate dietary interventions have different effects on CHD risk: a meta-analysis of randomised controlled trials. British Journal of Nutrition, 2010.

31. References 4 • Kratz M, et al. The relationship between high-fat dairy consumption and obesity, cardiovascular, and metabolic disease. European Journal of Nutrition, 2013. • Bonthius M, et al. Dairy consumption and patterns of mortality of Australian adults. European Journal of Clinical Nutrition, 2010. • Smit, et al. Conjugated linoleic acid in adipose tissue and risk of myocardial infarction. The American Journal of Clinical Nutrition, 2010. • Feinman RD, et al.“A calorie is a calorie” violates the second law of thermodynamics. Nutrition Journal, 2004. • Johnston CS, et al. Postprandial thermogenesis is increased 100% on a high-protein, low-fat diet versus a high-carbohydrate, low-fat diet in healthy, young women. The Journal of the American College of Nutrition, 2002. • Veldhorst MA, et al. Presence or absence of carbohydrates and the proportion of fat in a high-protein diet affect appetite suppression but not energy expenditure in normal-weight human subjects fed in energy balance. British Journal of Nutrition, 2010. • Bellisle F, et al. Meal frequency and energy balance. British Journal of Nutrition, 1997. • Cameron JD, et al. Increased meal frequency does not promote greater weight loss in subjects who were prescribed an 8-week equi-energetic energy-restricted diet. British Journal of Nutrition, 2010. • Brehm BJ, et al. A randomized trial comparing a very low carbohydrate diet and a calorie-restricted low fat diet on body weight and cardiovascular risk factors in healthy women. The Journal of Clinical Endocrinology & Metabolism, 2003. • Yancy WS, et al. A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia: a randomized, controlled trial. Annals of Internal Medicine, 2004. • Westman EC, et al. The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus. Nutrition & Metabolism, 2008.