Fat Loss Part 3 22/07/2016. Rates of Weight Loss, Diet Breaks & Metabolic Adaptation AIMS. Rates of Weight Loss. Is slower really better?

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1 Fat Loss Part 3 Rates of Weight Loss, Diet Breaks & Metabolic Adaptation AIMS Rates of weight loss Fast vs Slow Considerations for selecting a rate of weight loss Hormonal, metabolic and physical changes associated with energy restriction and dieting Metabolic adaptation Diet breaks and refeeds When to use a diet break (physiological & psychological considerations) Is slower really better? Rates of Weight Loss 1

2 Bodyweight Bodyweight 22/07/2016 Is there a best rate of weight loss? Time Assumptions of fast rates of weight loss Lower adherence Muscle loss Slowed metabolism More weight regain No behaviour change Time Fast rates actually mean better adherence? Fast = -13.5kg; Moderate = -8.9kg; Slow = -5.1kg No sig. differences between groups were observed in terms of weight regain Subjects maintaining >10% weight loss 1 year after: 16.9% Slow 35.6% MODERATE 50.7% FAST FAST group had more adherence to programme: attended significantly more sessions, completed more food records, consumed fewer calories Nackers et al. (2010) 2

3 Muscle Loss Does it really happen? Is it actually more likely with fast weight loss? Confounding variables Appropriate resistance training when dieting Adequate protein intake (not necessarily high protein intake) Adequate protein to preserve LBM Young, recreationally active males put on a diet (40% energy restriction) and RT programme for 4 weeks Given a lower protein diet (1.2g/kg) or a higher protein diet (2.4g/kg) Low protein diet preserved LBM High protein diet gained LBM Longland et al (2016) What is Adequate Protein? 2 week hypoenergetic diet (40% restriction) Low protein (LP) group 1g/kg High protein group (HP) 2.3g/kg Body comp measured by DXA Weight loss and FFM loss were significantly greater in the low protein group compared to the high protein group (-3kg vs 0.3kg, and -1.6kg vs - 0.3kg respectively) No significant differences in fat mass loss between two groups Mettler et al. (2010) 3

4 Change (%) 22/07/2016 Rates of weight loss and body composition Slow rate 8.5 weeks, fast rate 5.3 weeks Energy intake reduced by: SR 19% ± 2% FR 30% ± 4% BW and FM decreased in both SR & FR SR 5.6% ± 0.8% (BW) and 31% ± 3% (FM) FR 5.5% ± 0.7% (BW) and 21 ± 4% (FM) LBM SR increased by 2.1% ± 0.4% FR unchanged (-0.2% ± 0.7%) Garthe et al. (2011) Performance Measures SR FR Garthe et al. (2011) 4

5 Slows Metabolism? Crash Diet? A 27-year-old male weighing Starting Weight 207 kg Fasted supervised for 382 days Weight post-fast 88kg Patient s weight post fast The amount of weight lost by Mr A.B. was 276 lb, with an average rate of loss of 0.72 lb/day That s kg = 0.33 kg/day Five years after undertaking the fast! 89kg 207kg 89kg 82kg Stewart & Fleming (1973) Fast Rate = Better Results 4 groups 6 month study Control (weight maintenance) Calorie restriction from diet alone (25% restriction) Calorie restriction from diet + exercise (12.5% % restriction; total 25%) Very low calorie diet (43% restriction) ~890kcal/day Fast rate dieted on average 8-11 weeks out of a total of 24 weeks At the end of 6 months, fast rate participants lost significantly more bodyweight vs. slow approaches Heilbronn et al. (2006) Heilbronn et al. (2006) 5

6 Benefits of fast rates of weight loss Early results may increase motivation and buy-in Less time spent in a calorie restrictive state Can return to maintenance calories sooner, thus improving training and recovery Can also use diet breaks often FR + Resistance training + High-protein diet = Minimal /no LBM loss Benefits of slow rates of weight loss Individual dependent Can lead to greater adherence (behaviour change important) More manageable? Can prevent poor food relationships occurring Potentially a better method for the very lean client? Potentially a better method for those with a long history of dieting BUT fast rates interspersed with diet breaks might work well The Metabolic, Hormonal & Physical Effects of Dieting 6

7 The Hormonal Effects Are not necessarily specific to rates of weight loss Studies don t equate time/amount of weight loss Dieting someone using a slower rate of weight loss often simply means they will have to diet for longer to get to their goal 0.5kg vs 1kg/Week Weight Loss 4 weeks, protein at 1.4g/kg, 1100kcal vs 550kcal reduction Serum free & total testosterone concentration decreased significantly in 1kg/week group change was sig. greater in 1kg (30%) than in 0.5kg (3%) SHBG increased significantly in 1kg group Strength decreased significantly in 1kg group Mero et al (2010) Mero et al (2010) 7

8 Energy Availability Research Chronic food intake < 30kcals/kg FFM 70kg with 15% BF = 59.5kg FFM 59.5kg x 30 = 1785kcals Loucks (2004) Loucks (2004) Metabolic Adaptation 8

9 Metabolic adaptation Aka adaptive thermogenesis Can comprise of a number of different variables Decreased satiety, reduced NEAT and increased hunger Improvement in energy efficiency and mitochondrial efficiency Hormonal alterations Leptin Thyroid Ghrelin Reduced BMR Adaptive Thermogenesis It s real, It can turn a legitimate kcal deficit into a maintenance diet 15-20% lower expenditure after hard dieting Does it keep adapting? Nothing to suggest faster dieting is worse 10% vs 20% BW reduction maximal reductions in EE Adaptation in PCOS Suggestion that it could be due to the blunted thermogenesis rather than changes in RMR Segal & Dunaif, (1990) Occurs even if you maintain muscle - Johnannsen et al. (2012) Weight Loss = Reduced Metabolic Rate? Basal/resting metabolic rate is naturally reduced during weight loss However, RMR significantly declined out of proportion with the decrease in body mass (P < 0.01) Johnannsen et al. (2012) 9

10 The Minnesota Study Minnesota semi-starvation study Results: 40% reduction in EE 25% due to weight loss 15% due to metabolic adaptation Adaptive thermogenesis in early weight loss was associated with a fall in insulin secretion and body fluid balance Changes in plasma leptin, ghrelin and T3 resulting from calorie restriction were not related to adaptive thermogenesis Keys (1944) Overcoming Metabolic Adaptation? Diet Breaks Do refeeds have a metabolic benefit? Single day refeeds probably aren t enough Due to low levels of gluconeogenesis from carbohydrate alone you should probably keep fat levels a bit lower Increased carbohydrate intake increases leptin! (Weigle et al, 2003) CHO over-feeding for 3d - Dirlewanger et al. (2000) increases [plasma leptin] by 28%, & 24h EE by 7% However BMR was not changed 10

11 Longer Diet Breaks? Big psychological benefit Metabolic effects/benefits not well studied Anecdotally, increases in NEAT However, how long does this last? Reverse Dieting What is Reverse Dieting? Gradual, incremental reintroduction of calories into the diet following a dieting phase Traditionally, calories (primarily CHO) are increased over a prolonged period ~ 5-10g CHO/week until maintenance levels reached 11

12 Research? Timescales? Some have proposed reversing for as long as you dieted for. However, unified consensus is now Get back to maintenance calories as quickly as possible Post diet binges Avoidance of these is without a doubt the biggest benefit The weight maintenance diet is underappreciated SUMMARY The nuances of dieting are where the magic happens We can only appreciate this magic once we have universal agreement on the laws 12

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