How to Lose Weight – Part 2
Question of the Week: When Weight Loss is “Easy” Today we continue answering the most sought after question – How can someone lose weight? During part 1 – I said that the answer can either be really easy – all about facts and figures or extremely complicated and multifactorial. No one wants to believe that it is going to be a tough and difficult journey for them – most people wish it would happen yesterday already. They wish they would wake up one day and have their most ideal body shape and size and automatically feel super confident in their skin. (Spoiler Alert – you can achieve these things and not lose a single Kg on the scale! – but that’s a discussion for another day…) So today we can discuss the answer that most people wish to hear – How can we lose weight – the easy answer: it’s all about the routine, the variety and the portions of food: Timing of meals: During my lockdown series (found on the blog and on Instagram and Facebook) – I spoke about the importance of having a consistent and regular eating routine. This is the first step to eating healthy and achieving a, long term, healthy weight. There are lots of discussions around intermittent fasting and many people believe in skipping of meals, however this is one of the unhealthiest options for the body, long term and can be very unsustainable. The metabolism (in a nutshell) is the rate at which your organs need and use energy. This energy comes from the food that we eat on a daily basis. So if someone has a consistent meal routine, for a long time, then the organs rely on a consistent input of energy and they can work optimally – people have named this – having a “fast metabolism”. These people feel hungry at regular intervals – and they refuel at regular intervals by eating consistently. When people try various different diets – it distorts this meal routine and the organs habitual reliance on this energy input. Therefore the organs need to find an alternative source of fuel, away from the fuel that we eat, and that comes from internal (bodily) fuel stores. (BUT – Spoiler Alert: this does not mean that the body uses ‘fat reserves’! In a starvation state, the body usually breakdown muscle and fat from the liver – not the abdominal fat that is so widely advertised.) This causes the metabolism to “slow down”, and some people notice that they do not feel hungry nor, feel full. The body was not designed to live off of its internal fuel stores, long term. Therefore by eating regularly i.e. within 1 hour of waking up, and then eating every 2-3 hours afterwards, it will allow the body to notice hunger and fullness cues. Energy intake/ portion size: The metabolism also gives us an ideal of how much fuel/ energy each organ needs in order to function. This is usually expressed as a numerical value in kCal or kJ. If someone has to eat more energy than their organs need – this would result in weight gain. This is because each of the organs can only use a certain amount of fuel and the rest is stored – usually in the form of fat. Out of the fuel/ energy options – Carbohydrates are generally used by organs first, Protein is used secondly and then lastly, Fat is used – therefore any excess energy is stored in the form of (leftover) fat. If someone has to eat too little energy – less than the minimum amount of fuel that the organs need to work optimally – then the organs will break down muscle and store extra body fat, which also results in long term weight gain. This is why many people notice rapid weight loss, however it is not weight loss from fat, but rather weight loss from muscle breakdown. That is why it always results in rapid weight gain. If someone has to eat less energy than the current metabolism, but not less than the minimum amount – it will result in body fat loss while maintaining, or building, muscle mass. This also results in toning up – i.e. losing body fat % and losing centimetres around the midsection/ waist. Food Groups: Carbohydrates are generally used by your organs first and therefore are one of the most important sources of fuel. This means that you need to ensure that your organs receive a certain amount of carbohydrates from the diet. By eliminating carbohydrates from the diet, it will results in increase hunger, carbohydrate cravings and decrease in muscle and increase in stored fat. Therefore it is important to ensure that your main meals, such as breakfast, lunch and supper contain a certain portion size of carbohydrates in the form of fibre filled grains. All food groups provide valuable nutrients and therefore need to be represented in the diet. If you are uncertain of portion sizes, a dietician can provide you with insights into healthy portion sizes to achieve weight goals. Meal plans: Meal plans are guides, given by a dietician, that will allow you to learn about the importance of regular and balanced meals, and give you confidence to make healthy food choices. Healthy Meal Plans: – Provides you with insights into portion sizes and food alternatives – Should be flexible and give you a wide range of options – Always allow you to use your hunger and fullness as cues – Be based on the food items that you are comfortable with i.e. bread – Should be culturally comfortable and financially appropriate Unhealthy Meal plans: – Are restrictive with lists of foods to avoid or cut out – Are too rigid by not giving you options to choose from – Give recommendations of food items that are foreign or called “super” or “superior” e.g. quinoa if you
How To Lose Weight – part 1
Question of the Week: Weight Loss – Part 1 “How do I lose weight?” This is the number one question I get asked either the minute someone finds out my profession or when most of my patients walk through the practice doors. While the bottom line answer to this question is actually relatively easy and straight forward, the way that we achieve it is widely complex and multifactorial. It is the reason why I find this question so difficult to answer on a general platform such as this one. So I shall answer this question over a few posts and articles, and you can decide which answer fits you best – feel free to ask questions if you feel that I am missing something that would relate to you. Part 1: Introduction Weight loss is fundamentally Scientific and Mathematically based. If we had to take someone and place them in a lab and feed them the exact nutritional requirements for their body to thrive, monitor them and control their movements – weight loss would always be achieved, 100% of the time. It is based on numbers and physiology i.e. Biochemistry – the place biology (human components) and chemistry (chemical reactions) meet. The reality is we are not lab experiments – we live in the real world with various factors hitting us from all sides. So in reality Weight is impacted by food, portion size, time, biology, genetics, absence or presence of disease, medications, finances, access to food, behaviour, family and friends, personal preferences, access to information, access to support, motivation, emotions, work life, psychological conflicts, internal dialogs, body image, self-esteem and so much more. It is not a one size fits all answer – and it is not simple and easy “fix”– despite what some people might say. So before I could answer this question I would need to find a lot more information from a person. That is why weight loss is not for everyone and should not be generally promoted, because it depends on the person and all those variables discussed above. For some people weight loss can actually be very unhealthy, dangerous and ill-advised; for others it is healthy and relatively easy to achieve; and for a vast group of people it is actually very difficult to maintain and becomes a life-long struggle and pit of despair which leads to depression and anxiety and further health issues. So before we get to the answer everyone wants to know, we need to ask ourselves a few other questions first. I encourage you to read through these and answer them truthfully. What is your current weight? How long have you had this weight for? How do you feel about your current weight? Why do you need to lose weight? What and when was your lowest and highest weights? What have you done previously to lose weight in the past? (if relevant) How long where you able to keep the weight off for? (if relevant) How often to you spend thinking about weight loss, your body shape and size? Would you consider yourself Healthy? What do you think you need to do differently do lose weight? If you would like you are welcome to email me these answers, or you can answer them in your mind, or journal your responses. Either way – this is the first step to answering the question. The truth is that achieving a healthy body and healthy weight depends on how well you know yourself, trust yourself and are willing to learn about yourself. I hope that you are excited about the journey ahead!
Virtual/ Online Consultations
For many people, the idea of Virtual consultations can be uncomfortable, unsettling, impersonal, awkward and foreign. It is not something that many people had engaged in before the lockdown and anything that is new – is often seen as being strange and foreign. As the saying goes – “All new things are difficult, until you start them for the first time. The second time is a lot easier” As the Level 5 Lockdown ended, it is projected that the number of CoVid-19 cases in South Africa will rise. We are committed to everyone’s health and safely and therefore we encourage to continue to practice social distancing as much as possible. Therefore Virtual Consultations is a much safer and wiser option for everyone. But how do they work? Our primary goal is to Encourage, Motivate, give Support and offer Suggestions and Advice as to how to stick to your meal plan during the lockdown period. If you are struggled during this time – it is important to start again, this month so that we can focus on regaining health as soon as possible. Online Consultations focus on: – Check in: How the eating has been over this time period. – Accountability: What to focus on, regarding how to start focusing on eating healthy again. Having someone the check on you plays a big role. – Tips and Suggestions: How to make the eating periods as healthy as possible – Weight Monitoring: if you have a home scale – it will be recorded and checked each follow up. What Online Consultation Options do you have? 1. TeleHealth: If you would prefer a telephone conversation – this can be arranged. You will then schedule your appointment and we shall give you a call within 5 minutes of your appointment starting. Everything will be discussed. Telephone conversation can either be held on WhatsApp Call or Cell Phone Call. 2. Email/ Message Correspondence: If you would prefer not to speak, you are able to engage in an Instant Messaging conversation with your Dietician. This will be scheduled as usual – please be available up to 5 mins into the start of your appointment for the Dietician to contact you. You will have the duration of the appointment to message the Dietician. This can be done via WhatsApp Messaging, Emails, or Google Hangouts – no signup or download required. 3. Virtual Meeting Platforms – not needing Downloaded App: If you would prefer to have video call, this will be done with your dietician. Your appointment will be scheduled as usual. Please be available for the video call and allow for 5 minutes for the dietician to contact you. – If you do not have access to a computer: WhatsApp video call can be used from your cell phone. It is done in the same way as a WhatsApp call. – if you have access to a computer: Google Hangouts is accessed from your browser (Google) and does not need to be downloaded and/or create an account. You will receive an email with a link, please click on the link and you will be directed to the Web Page for your Hangouts Meeting. 4. Virtual Meeting Platforms – Needing to Download an App – if you have access to a computer or Cellphone with PlayStore or AppStore: Zoom is a platform with free Meetings. You need to signin with your email address. You can also download an App that will allow you to access the meeting from your computer, cellphone or Tablet. You will receive an email with a link, please click on the link and you will be directed to the Zoom Meeting Skype is an App, You will need to create an Account with Skype and then send us your Profile details. Alternatively you can Search for myself: Name: Shana Terhart Email: shanaterhart@gmail.com Skype Name: live:shanaterhart Should you wish to contact Andrea, you are welcome to search for: Name: Andrea Jacobs Email: Andrea.j.c@icloud.com Skype Name: live:e37eab0abb95dce1 Once this is set up, your appointment will be start within 5 minutes of the starting time. We realise that these times are difficult and can take a toll on our health and wellbeing. So if you have postponed your appointments from the beginning of Level 5 lockdown, over 1 month ago, we encourage that you do not postpone much further. We will be able to accommodate appointments in a way that best makes sense for you.
10 Tips to remain healthy during the Christmas Festive Season
It’s the Festive Season and the end of another long year and so the Cape Dieticians team want to encourage you to continue on your healthy eating journey… 1. Keep meals consistent and routined: Although many are on leave during this period, be cautious against unstructured meal times. Remember to start the day with a healthy breakfast and then add the appropriate snacks and meals during the day, every 3-4 hourly. This includes Christmas day itself – do not starve/ restrict prior to Christmas lunch as this can cause intensify hunger levels that can cause overindulgences when the food is served. 2. Remain active but also balance rest: Being tired after a long year means that rest and recovery is important. But balance is the key – include some exercise and movement days during the festive season to remain focused and motivated to continue on the healthy eating journey. But also be kind to yourself, don’t try to exercise the Christmas indulgences away. Remember not to punish for enjoying food, balance is important. 3. Plan for realistic variety and options, but don’t over-do it: So many times we get to the Christmas table and realise that there isn’t enough space on the plate to get to taste everything. While Christmas lunch may be notorious for plenty, be cautious when planning the menu. Opt for fewer sides and meats so that you can enjoy what is available while not feeling tempted to feast on every option. 4. Remember the plate model: Add healthy vegetable options such as fresh salads and vegetable dishes to make up half of the plate first before dishing up the meat and starch options. And while we are on the topic of vegetables, try to avoid adding sugars – keep it as plain and fresh as possible. 5. Try to keep to healthy portion control: With multicourse menus – it is difficult not to overindulge, remember there is lots of lovely food on its way… try to keep starters as a snack- sized portion, followed by a balanced, healthily portioned main meal and then followed by a snack sized dessert portion. 6. Choose wisely: With so many options, you might need to choose your top few favourite vegetables, starches and meats. But also keep in mind that what you don’t eat for the first meal, you can eat for supper that evening. Be on guard against overeating one large meal and then skipping the next meal later. Try to be aware of choosing lower fat, less added sugars and sauces 7. Who says desserts are ‘bad’? Remember that food is only food – it does not need to be classified as ‘good’ or ‘bad’. So don’t be afraid, or feel guilty for having some dessert. But if ‘health’ is your focus, then why not do some healthier dessert options such as fruit or yoghurt parfaits, using zero custard and sugar-free jelly in trifle, frozen yoghurts instead of ice-cream, chocolate covered strawberries instead of chocolates. Keep dessert as the afternoon snack to make sure that you are not over-eating. 8. Stay hydrated… Increased water during this time is so essential for our hot Christmas climate. If alcoholic beverages are your thing, remember to limit to healthy portions (‘one or two drinks per day’ – not reserving all the weeks drinks for one day). Rather use diet/ sugar free drinks and mixes and alternate a glass of wine/ alcoholic beverage with a glass of water to stay hydrated. 9. Take it slow…… Take your time to get through the days activities. Try mindful moment-by-moment awareness instead of rushing through the eating process and eating hastily. As much as food is a big focus of Christmas day, try to be more focused on the meaning of Christmas and other Christmas traditions such as the family time. Take time to listen to your body and to notice how hungry you are, to select an appropriate portion size to fit your stomach hunger and to stop when you are full… even if you don’t finish everything on the plate. 10. Enjoy! …… Whether you are on work holiday, taking a vacation away, camping, or working throughout – enjoy the Festive time spent with loved ones and appreciate the beauty of the season. This is not the time for diet and restrictions, this is the time for balance, moderation and giving yourself grace when not ‘keeping to the meal plan 100%’. Life is too short for guilt and shame around food, January is around the corner and we can always start fresh and focus on healthy eating in the New Year… So far now, Enjoy the time!
Intermittent Fasting – What’s the real story?
One thing I notice, as a health professional, is that that there are a lot of different opinions about what it means to be healthy. These change over time according to old wives’ tales, favorite magazines, even a little inspiration from Google. Currently, a big diet trend that I see being advertised and spoken about a lot is Intermittent fasting (IF)… But what is it really and does it actually work to help improve health and aid in weight loss? So, what is IF? IF is defined as eating according to a specific schedule or pattern that alternates between periods of normal eating and periods of severe caloric restriction (also known as fasting). The main idea behind this calorie restriction is, like all diets, to reduce the calorie intake on those specific fasting days; in order to lose weight. However, unlike most diets, this way of eating only focuses on when to eat and does not look at what to eat. The fasting is also not specifically defined; some IF diets refer to no food intakes at all, while others specify only liquid foods, and a few refer to eating only 500 kCal per day. Now, let’s talk about the types of IF: There are a few variations of the IF diet: 1. 12 Hour fasting. This diet pattern, and arguably the more common one, allows food to be eaten over a period of 12 hours, while someone is awake; and then moves to a 12 hour fasting pattern, mainly before and during sleep. 2. Meal skipping. This fasting pattern allows occasional skipping of either the breakfast or a dinner meal. 3. Modified fasting regimens: a. 5:2 – This diet pattern refers to eating “normally” over 5 days and then restricting food intake to only 500 kCal on the other 2 days of the week. b. The Alternate Day fasting – Fasting every alternate day c. Eat Stop Eat Diet – Fasting for 24 hours – 1 or 2 days during a week d. Time Restricted Eating (16:8) – Fast for 16 hours and only eating during an 8 hour window, usually between 12:00 and 20:00. e. The Warrior diet – arguably the most extreme version of the IF pattern. It includes eating very small amounts of food during a 20 hour fasting period and then only one large meal at night. Okay… So, why would people want to do this? The main reason why most people attempt such restrictive eating routines is the proposed weight loss benefit. The other claims are that it allows for increased fat breakdown, improves brain function, decreases blood sugar and reduces inflammation – to name a few. But are these claims even true or are there just words being used to generate a buzz? Now, let’s see what the Science has to say about IF: There aren’t many published and validated research studies available on the IF diet, however, there are a few that are available (skip past this next bit if your just looking for the summary 🙂 – Animal studies – the animal studies available seem to support the hypothesis that restrictive feeding cycles improves the metabolism, decreases obesity risk and improves health conditions in rodents. – The studies available on humans are limited to a few observational studies around religious fasting – e.g. the Ramadan fast and intervention (trial based) studies with small sample sizes and short trial periods: Study Summaries Health effect Pros Cons Effect on weight “Significant” weight loss – but according to 1 or 2 day fasting periods and small sample sizes 1 Showed weight regain 2 weeks post fast 1 Effect on Cholesterol Decrease in LDL cholesterol (part of the unhealthy cholesterol)2 AND One study showed improved triglycerides (unhealthy cholesterol) and improved HDL (healthy cholesterol) BUT also increased LDL (unhealthy cholesterol) 2,4 Mixed results in cholesterol profiles 2,4 Effect on Blood Glucose/Sugar Decrease in blood sugar on fasting day2 Detrimental effect on blood sugar and insulin the day after fasting 4 Effect on hunger/ mood and food intakeA study showed the potential in eating more frequently, decreasing evening snacking and fasting for longer nightly intervals which may decrease inflammation 3,4Participants complained of distraction, poorer moods and lower perceived work performance 6 The general conclusions: – Weight loss was similar for people in the IF diet group and people in the regular (non fasting) calorie restricted eating group 5 – Intermittent energy restriction (IF diet) resulted in short term weight loss and changes in body composition which were seen to be more effective than no intervention at all/ not dietiting at all 1 – No differences in blood pressure, fasting blood sugar, fasting insulin, insulin resistance The conclusion: weight loss was not superior compared to daily healthy, balanced, regular eating and more studies are needed to verify any of the claims made by IF studies So, in other words…? Fasting decreases the number of hours available to eat and therefore reduces overall food intake; which is how people could lose some weight. However, the studies show that the overall weight loss benefit was not greater than that resulting from a healthy and balanced meal plan. While this type of dieting is not generally harmful, it is also not necessarily safe for everyone; as studies have commented that participants with certain medical conditions showed less favourable health outcomes. And so, it is for this reason that IF is not recommended for those who have diabetes, insulin resistance, high cholesterol or cardiovascular disease and other medical conditions; including those who are pregnant or breastfeeding. What are my thoughts on IF? I think the 12 hour eating pattern, followed by a 12 hour fasting over the night routine could potentially be a healthy way of following this diet trend. However, more studies, done over a longer duration and that follow reliable protocols, are needed in order to advocate for any long term health benefits/ pitfalls or complications of the IF diet. For now, if one is considering this diet