Contents 1. Introduction 2. Background 3. The Principles • • • • •
Embrace the power of protein Give fat a chance Glycemic load your carbohydrates Sustainability over intensity Find your framework
4. The Plan 5. Track your progress 6. Appendix 7. Resource Guide 8. Recipes
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1. Introduction So you want to reduce your body fat, feel better about your body and fit into those clothes that are starting to feel a bit tight? Well we want to help you achieve just that and we also want you to never have to repeat this course again. What you will get from this course is 8 weeks of monitoring but also a lifetime of understanding on how to eat right for fat loss and general health. The goal of this guide is to educate you, break down beliefs systems that are just not true and of course help you reduce your body fat.
Course Aims 1. To understand the role of insulin, how it affects fat levels and how to manage it. 2. To choose foods that you enjoy that are high in protein, moderate/high in fat and carbohydrates that have a low glycemic load. 3. To understanding the importance of sating your appetite. 4. To sate your appetite and keep you feeling fuller longer. 5. To get away from calorie counting or calorie restricted concepts. 6. To work for sustainability and be free of the dieting trap.
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2. Background 10 Reasons For Our Approach Trying to make a real change in your body can be hard work, but maybe the problem isn’t you. There are many reasons why people fail in successfully reaching and maintaining a happy weight. Our approach seeks to address the many failings of the many diet programs and the pitfalls that one encounters in successfully maintaining a healthy weight. 1. Deprivation and Restriction. Dieting through restricting or depriving calories has been shown time and time again to end in failure. Not only that they play havoc with your metabolic system. In one study it was shown that after a calorie restricted diet it took up to 6 months for the metabolic rate to return to normal, that is 6 months of normal eating with a slow metabolic rate. 2. Unsustainable Regimes. Most people are yo-yo dieters. There’s a reason for this, diets are not sustainable in the long term. Eating food you don’t like, food that doesn’t satisfy your hunger and not enough calories all lead to weight going up and down. 3. The Need For Instant Results. The minute we make changes to our diet, no matter how large or small, we want to see and fell the difference. Basing a nutrition regime around food you enjoy will lead to fat loss that will be sustainable. 4. Too Much Expectation. The speed that one loses fat must be balanced out with many factors such as age, sex, exercise history, dieting history and genetics to name a few. Many diets underestimate these factors and fail to allow for long term changes to take place. 5. Life Pressures. In Malta, food is a huge part of life. Nearly every place you visit for social purposes has food available or is centered on eating or drinking. It isn’t the availability that is the problem, the problem lies in the type of food available. 6. You Are Human. We all make mistakes. The important thing is to stop looking at an indulgent meal as a mistake against your new approach. You are human and bound to want something sweet or bowl of pasta every now and then. The key to keeping a healthy weight is to enjoy it in moderate quantities and to work in plenty of healthy foods that serve a purpose, such as protein, fat and fiber that keeps you full and your digestive system on track.
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7. All or Nothing Attitude. This is a psychology that many of us use when starting a diet. We’re excited, our fridge is stocked with healthy food and the goal weight is in mind. While it’s great to be enthusiastic, it’s imperative you’re realistic about your weight loss and how fast it will happen. Often when we go in with an all or none attitude, we end up setting ourselves up to fail. It is far smarter to make moderate changes to your diet and adjust to them little by little in order for long term changes to take place. 8. Past Failures. Maybe your last diet failed. Maybe your last 10 diets failed. This can be a deterrent from trying to get fit and on track with a healthy lifestyle. You feel you’ve tried every diet out there, you’ve tried to change your eating habits and you’ve never succeeded or kept the weight off. Psychologically, this can do a lot of damage to your success of building a healthy way of living. Forget the past and move on to working on yourself in a sustainable way that will result in a healthier you. 9. Self-Belief. Whether you’re young or old, making better choices when it comes to what goes in your body will benefit many parts of your health, including your waistline. Do your research and be prepared to make a few mistakes. Remember you’re making changes to your diet not just to lose fat, but also to reduce your chances of heart disease and diabetes. 10. Social Pressure. You might want to change your diet, but are afraid of the people around you constantly asking, “Are you dieting?” Depending on where you live, you may be sized up as “the healthy one,” but it’s a title you want to embrace. Don’t feel the need to lose weight quickly or give dieting tips to others. Focus on yourself, your goals and creating healthy eating habits you can sustain in the long run. More and more people want to get healthy, so you may just inspire family members or colleagues to do the same.
There is a reason diets don’t work in keeping the fat off in the long term… they simply do not address how the fat got there in the first place.
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3. The Principles 1.Embrace the power of Protein Studies have shown that increased protein levels in women improve fat metabolism during exercise, enhanced body tissue growth (such as muscle), and reduced fat mass and body fat percentages.
2. Give fat a chance The belief that eating fat will make you fat is prevalent in many people’s mind when it comes to weight loss. This is largely due in part to its name, fat, the fact that is contains more calories than either carbohydrates and protein and that excess fat will simple get dumped as fat in our bodies. However, not all fat gets absorbed into the gut and of that fat it does not necessarily mean that fat will get stuck in the fat cells. It also has very little effect on our insulin levels and because it takes longer than any other food group to leave the gut can help us feeling fuller for longer.
3. Glycemic load your carbohydrates Carbohydrates in our diets essentially come in two forms, sugar and starch. While sugar and starch may seem two separate things, they are in essence the same thing; starch is just a chain of glucose molecules stuck together rather than in the simpler form of sugar. As soon as carbohydrates enter our mouths they start to get broken down to a very simple form of sugar, glucose, and ingested in to the blood stream. This means that if we consume sugar or starch or a combination of both, blood sugar levels will start to rise almost straight away. Why do we need to stabilise blood sugar levels for fat loss and health? From a health perspective blood sugar levels that remain high over a long period can lead to health related problems such as strokes, eye and nerve disorders, the need to urinate frequently, and kidney or heart disease. Dangerously high glucose levels are those over 200 mg/dL. From a fat loss prospective we need to understand the role of insulin in the body and what sugar does to it.
Insulin As we eat a carbohydrate the blood sugar levels start to rise, the body via the pancreas triggers off the secretion of a hormone called insulin. Insulin’s major role is to help transport sugar from the blood stream into the cells of the body. Body Works Limited | Triq Wied il-Ghomor, The Gardens, St. Julians, STJ 2043, Malta T + 356 2138 4957 | bookings@bodyworks.com.mt www.bodyworks.com.mt | www.facebook.com/bodyworksmalta
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The major area of concern is the impact that this hormone has on the fat regulation in the body. Instead of viewing excess fat as a consequence of calorie excess, some scientists and doctors are taking the view that it as a disorder of ‘fatty accumulation’ instead. In this sense they are suggesting that the body tends to accumulate and store fat in a way that is, essentially, irrespective of calories. It is important to note that sugar’s passage into the fat cells depends in the first place on insulin as it is secreted in response to eating carbohydrates.
The Science… In the body fat can circulate in the blood stream in the form of what are known as ‘free fatty acids” Free fatty acids have the capacity to float in and out of fat cells. The fatty acids can become fixed in the fat cells, which is not the ideal outcome. The free fatty acids only become fixed when they are converted in to a substance known as a ‘triglyceride’. Take a handful of the excess flesh around your mid riff and most of what you have between your fingers is triglyceride. What causes triglycerides to form in fat cells? Triglycerides are formed not just of free fatty acids but also of another substance called ‘glycerol’. Glycerol is essentially derived from glucose (sugar). Bottom Line – Sugar provides an essential element for the fixing of fat in thedoes fat cells. So the more carbohydrate How blood sugar control work?you eat the more opportunity there is for fat to get stuck in the fat cells and the fatter you become.
The key to understanding blood sugar control is to understand the role played by special cells called Beta-Cells and Alpha cells. These tiny cells are scattered through an organ called the pancreas, which is located just under your stomach. The job of the beta cell is to produce insulin, store it, and release it into the blood stream at appropriate times.
Basal Insulin Release The beta-cells of a healthy person who has not eaten in a while release a small amount of insulin into the blood stream throughout the day and night in the form of very small pulses every few minutes. This is called "basal insulin release." Maintaining this steady supply of insulin is important. It allows the cells of the body to utilize blood sugar even if some time has passed since the last meal.
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Insulin levels signal to the liver whether more glucose is needed The regulating of insulin levels has another function other than regulating blood sugar levels. A dropping insulin level signals to the liver that blood sugar is getting low and that it is time to add more glucose. The liver converts the carbohydrate it has stored, (known as glycogen) into glucose, and releases it into the blood stream. This raises the blood sugar back to its normal level. If a person has exhausted their glycogen stores the alpha cells produce a hormone called glucagon, which converts fat and protein into glucose in response to a low level of insulin in the blood. The protein can come from dietary protein or from your body's own muscles, thus making it important to ensure a healthy level of protein is present in ones’ day to day diet. Clearly insulin has a role in fatty accumulation and the above explanation shows that if blood sugar levels drop significantly and the glycogen stores are exhausted then it is glucagons that are utilized to stabilize blood sugar levels and this was the premise for the Atkins diet. While we have seen that insulin plays a role in the accumulation of triglycerides it also has other effects. 1. Activation of an enzyme called c0-A-carboxlase, which in turn stimulates fat production in a process known as lipogenesis 2. Activation of the enzyme called lipase, which also stimulates lipogenesis and therefore fat production. 3. Inhibition of the enzyme lipase, which inhibits the process of fat breakdown lipolysis.
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The Science‌ First Phase Insulin Release -When a healthy person starts to eat a meal, the beta-cells kick into high gear. Their stored insulin is released immediately. Then, if the blood sugar concentration rises over 100 mg/dl, (5.5 mmol/L) the beta-cells start secreting more insulin into the blood stream. This early release of stored insulin after a meal is called "First Phase Insulin Release." In a healthy person it keeps the blood sugar from rising very high because it is available to meet most of the glucose that comes from the digestion of the current meal. The amount of insulin secreted in the first phase response to a meal is usually determined by the amount of glucose encountered in the previous meal. The blood sugar rise caused by the meal peaks about half an hour after you start eating. Second Phase Insulin Release - After completing the first phase insulin release, the beta-cells pause. Then, if blood sugar is still not back under 100 mg/dl (5.5 mmol/L) ten to twenty minutes later, they push out another, smaller second phase insulin response which, in a healthy person, brings the blood sugar back down to its starting level, usually within an hour to an hour and a half after the start of a meal. It is this combination of a robust first phase insulin response followed by a functional second phase insulin response that keeps the blood sugar of a normal person from ever rising over 140 mg/dl(7.8 mmol/L) even after a high carbohydrate meal. When first phase insulin response is completely functional, the blood sugar level at two hours should be back to the normal fasting blood sugar level which is somewhere in the mid 80 mg/dl range (4.5 mmol/L). When first phase release fails, or when second phase insulin response is sluggish, blood sugars start to rise to higher levels after a meal and take longer to return to normal. This condition is called "impaired glucose tolerance." If the blood sugar rises over 200 mg/dl (11 mmol/L) after a meal the same condition is called "Diabetes."
Conclusion A long term raised level of insulin stimulates the accumulation of fat in the fat cells, at the same time it also slows down the body’s ability to break fat down. Carbohydrate is the chief driver of insulin and therefore clearly has fattening potential.
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Glycemic Index The glycemic index (GI) is a numerical system of measuring how rapidly a particular carbohydrate gets broken down into sugar and absorbed into the blood stream. This process causes varying elevations in blood sugar levels. If blood sugar levels rise too rapidly then the master hormone insulin is released. So, a low GI food will cause a small rise, while a high GI food will trigger a dramatic spike. A GI of 70 or more is high, a GI of 56 to 69 inclusive is medium, and a GI of 55 or less is low.
Glycemic Load The glycemic load (GL) is a relatively new way to assess the impact of carbohydrate consumption and uses the glycemic index in its calculation. It gives us a better understanding of the impact of certain carbohydrates than the glycemic index alone. A GI value tells you only how quickly a particular carbohydrate turns into sugar. It doesn't tell you how much of that carbohydrate is in a serving of a particular food. You need to know both things to understand a food's effect on blood sugar. That is where glycemic load comes in. The carbohydrate in watermelon, for example, has a high GI. But there isn't a lot of it, so watermelon's glycemic load is relatively low. A GL of 20 or more is high, a GL of 11 to 19 inclusive is medium, and a GL of 10 or less is low.
Quick reference guide
Rule of thumb Foods that have a low GI almost always have a low GL. Foods with an intermediate or high GI may range from very low to very high GL.
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Calculating Glycemic Load You will need the following information 1. Food A’s glycemic index value 2. Carbohydrate content of Food A (on food label under the “Serve Size “ column- minus the fibre from the carbohydrate content) in grams. The calculation is as follows 1/100*2= Take wholemeal bread for example. It has a GI index value of around 69 (depending on brand) and has approx 15 grams of carbohydrate for two slices. 69/100 = .69 * 15 = 10.35, rounded down = 10. Therefore its role in elevating blood sugar levels is relatively low/medium. There are plenty of websites that can help you understand the GI and GL values of foods. In our resource guide we have given you a few.
Integrating the glycemic index and glycemic load in to your daily life 1. For most foods and portion sizes common sense should prevail when considering how a food affects our insulin. 2. The more processed and less refined the carbohydrate content then the more disruptive to our blood sugar levels it is likely to be.
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High sugar content on the food label usually means the opposite of what high fiber content means, which is that you're probably eating a simple carbohydrate, which means very quick digestion and a bad effect on the blood insulin levels. Fiber is one of the few nutrients found on your food label you actually want to be high. Granted, fiber is rarely ever "high," however, a few grams per serving is a good thing as you now know that it most likely means you are eating a complex carbohydrate. Fiber is one of the things that make a complex carbohydrate so good in the first place, as fiber slows the digestion of carbohydrates by our body that in turn improves its effect on our blood insulin levels.
3. Eat first check later. If you are unsure of a certain food eat it and then check it out when you have time. This sustainable eating programme is about knowing what, among the foods you like, are most likely to cause disruptive sugar levels and enjoying them occasionally.
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4. Google glycemic load of the food you want to check. If nothing shows up, Google glycemic index of the food you want to check. You might also want to do this by brand name of the food you are checking. If you cannot find the glycemic load but have found the glycemic index then use the excel sheet we have put together and enter the glycemic index figure and the carbohydrate content minus the fibre and you will get the glycemic load. If in doubt ask your Body Works’ representative, we will find out for you. 5. None of this is an exact science so DO NOT get caught up in trying to make it one, common sense must prevail throughout and if in doubt ask your Body Works’ representative to guide you. It’s a learning process about the foods you like to eat and knowing how it might affect your chances of fat loss if eaten consistently over a long period of time. 6. Food labels are misleading and you can drive yourself mad trying to understand them and also tying to work out what the manufacturer does not want you to know. Use your Body Works’ representative as a reference for anything you do not understand. 7. Always check ingredients list, check what types of sugars are in the food and anything else added to it to make it more palatable. 8. Having fat/oil in your meal will lower the glycemic load. 9. Heat generally increases the glycemic load of food, steamed vegetables will have a lower glycemic load than roasted vegetable. This is not to say you should never roast vegetables but just to highlight how heat can effect the glycemic load of a food. 10. Ask us. We are here to help you understand how you can manage your own eating regime, enjoying the foods you like and lose the fat you want.
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4. Sustainability over intensity Many nutritional approaches fall short in one major area they are just too intense and therefore not sustainable. While the lure of the fast weight drop is attractive it is detrimental to our metabolic systems over the long period, especially if repeated year after year. Working for sustainability is extremely important in ensuring that we maintain a strong metabolic system and consequently our fat burning potential. To successfully reduce body fat mass in a sustainable manner the approach must be one that is manageable and with foods that you enjoy and choose to eat. One failing of many fat loss approaches is that too often they seek to get the person to fit the approach and not the approach to fit the person. They also do not allow for flexibility tending to be rigid in nature and creating negative feelings for the person trying following it. In the case of the calorie restricted nutritional approach (which advocates trying to create a daily calorie deficit between energy going in via food and energy going out via exercise), the restriction of calories leads to the metabolic system being suppressed. More alarming is that the metabolic system can stay suppressed for up to 6 months after the diet has finished and normal eating has resumed. Another flaw in this approach is that exercise does not play a significant role in fat loss. Working at high intensities specifically aimed for fat loss is not only unsustainable but also unnecessary. Working out what your baseline comfort level is for exercise is the key to sustainability, from this point you are able to increase or decrease the level of intensity as your mood fits.
5. Find your framework While many weight loss programs are nutritionally sound, they fail to recognise that people find them overwhelming, impractical and rigid. Working out a framework from which you can work under the majority of the time saves you energy and thinking while ensuring that you are adhering to sound nutritional principles that will increase your fat loss potential the majority of the time. Managing your weight or trying to lose weight requires a plan so that you can ensure that a certain amount of thinking is reduced and important energy saved.
TIPS 1. Plan a structure for your daily/weekly eating. The only good defence against chaos or random choices is structure. Before you ever encounter food, plan what you want to eat, how much and when. Your structure needs to be simple enough for your busy life, flexible enough for you deal with the occasional catered meeting or impromptu office party, and yet specific enough to set boundaries. 2. Write a weekly shopping list with the core foods on. Also take into account those days where you come home later than usual or must go back out, have a strategy for meals that require less time and energy to fix. Body Works Limited | Triq Wied il-Ghomor, The Gardens, St. Julians, STJ 2043, Malta T + 356 2138 4957 | bookings@bodyworks.com.mt www.bodyworks.com.mt | www.facebook.com/bodyworksmalta
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3. Eat appropriate serving sizes. You'll need to learn how much you need to eat so that you will be left satisfied for hours after a meal or after a snack. 4. Identify and eat satisfying foods. A lot of diet plans fail because people don't feel satisfied. Protein satisfies the most, fiber bulks up food and fat leaves the stomach more slowly than protein, but it doesn't take up much space. Simple sugars (and simple starches that quickly turn into simple sugars) leave the stomach more than twice as fast. You will be surprised by the types of foods that you may have previously though fattening but actually help us lose fat.
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4. The Plan This plan is not fixed and you will be exploring what works best for you with your Body Works’ representative. What is provided is a framework for you to operate within, again do not worry about quantity just make sure the quality is spot on, in other words your blood sugar levels stay within a normal range and you sate your appetite. The only thing that we strongly advocate is the intake of two daily protein shakes, but again this is optional. Breakfast If you do not have breakfast it is important that you start to. Examples are: 1. Shake mixture – 1 Scoop of protein powder, 1 dessert spoon of oil, 1 dessert spoon of Regucol (you might have to reduce the amount of Regucol you add depending on how sensitive your indigestion system is – remember sustainability is the key). It is important to note that fibre absorbs water so try and drink the shake relatively quickly otherwise you be left with a very thick mixture (again if you do not drink quickly, reduce on the fibre). To this shake you can add either milk, Authentic Full Fat Greek yoghurt, water or any combination. You can also add low GL fruits to help sweeten if you need. I would suggest using the weekends to try and experiment with the shake and to find a taste and texture that suits you (sustainability). 2. Full Fat Greek Yoghurt, nuts and low GL fruits. 3. Natural Yoghurt, nuts and low GL fruits. 4. Eggs based breakfast 5. Ham and Cheese 6. Omelettes Mid Morning 1. Shake 2. Full Fat Greek Yoghurt, nuts and low GL fruits 3. Nuts, oat biscuit and goats cheese Again explore snacks or foods that are high in protein and moderate in fat and low in carbohydrates. Lunch 2. Soups 3. Salads 4. Whole meal Flour Tortillas Wraps Body Works Limited | Triq Wied il-Ghomor, The Gardens, St. Julians, STJ 2043, Malta T + 356 2138 4957 | bookings@bodyworks.com.mt www.bodyworks.com.mt | www.facebook.com/bodyworksmalta
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Mid Afternoon Shake Nuts Fruit Evening Meal Base your meals around these food types. Red Meat, Fish, White Meat, Lentils, Beans, Soups and Egg bases. Again these are suggestions; there are other options you just need to research what you like. Have lots of fresh vegetables and fruit for dessert (though low GL foods). I sometimes use the following system: Monday – Red Meat Night Tues – Fish Night Wed – White Meat Night Thurs – Bean/lentil or soup night This is a framework that reduces some of the thinking, we have just selected food groups within these parameters. With your Body Works’ representative you will explore a personalised framework that suits your taste and lifestyle and start to build your weekly shopping list: See appendix. Understand that this guide does not suggest not eating moderate to high GI/GL foods, that is up to you, but for those of you wanting to lose fat, these principles need to be adhered too for the majority of the week, in other words if you follow this only for 2 days and the rest is unfocused eating you will probably not see any results, you have to work out what is manageable and sustainable for you. We advocate focusing Monday to Friday and then not being so regimental but still mindful over the weekend. For special nutritional considerations your Body Works’ representative will guide you on a framework that will suit you.
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5. Track Your Progress Take Your Measurements This is the preferred way of tracking progress because it doesn't require any fancy equipment and anyone can do it. Taking your measurements at certain areas can give you an idea of where you're losing fat, which is important since we all lose fat in different areas and in a different order. Taking your measurements can help reassure you that things are happening--even if you're not losing fat exactly where you want just yet. Start by wearing tight fitting clothing (or no clothing) and make a note of what you're wearing so you know to wear the same clothes the next time you measure.
How to Measure Waist - Measure your waist without holding the tape too tightly (or too loosely). As a rough guide, your waist is the narrowest part of your trunk, or approximately 1 inch above your belly button. Hips - Measure the hips around the fullest part of your buttocks with your heels together. Triceps - This is hard to measure on your own. Measure from the point from where your collarbone and shoulder blade meet to the elbow, divide this in two and measure the circumference of your arm. Record new measurements every 2 weeks. Try to avoid measuring or weighing every day as small changes typically don't show up on the scale or the measuring tape. Your body is changing even if you can't see it yet! Tip: It may seem obvious, but don't overlook one of the simplest ways to track progress--how you look and how your clothes fit. You may want to take a picture of yourself wearing a bathing suit and keep it in your weight loss journal. Each month, take a new picture...you'll be surprised at how many changes you notice in a picture as opposed to just seeing yourself in the mirror. You can also use your clothes to keep track of your progress. Choose pants, shorts and a shirt and try them on every week or month to see how they fit.
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6. Appendix Plan Guide This is to be filled in with your Body Works’ representative.
Mon
Tues
Wed
Thurs
Fri
Sat
Sun
Morning Mid Am Lunch Avo Supper
Core weekly shopping List
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5. Appendix Track your progress Date:
__________________
Circumference Measurements Waist: __________________ Hips: __________________ Arms: __________________
Date:
__________________
Circumference Measurements Waist: __________________ Hips: __________________ Arms: __________________
Date:
__________________
Circumference Measurements Waist: __________________ Hips: __________________ Arms: __________________
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Date:
__________________
Circumference Measurements Waist: __________________ Hips: __________________ Arms: __________________
Date:
__________________
Circumference Measurements Waist: __________________ Hips: __________________ Arms: __________________
Date:
__________________
Weight:
________________
Circumference Measurements Waist: __________________ Hips: __________________ Arms: __________________
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7. Resource Guide • General drbriffa.com - A general site on all aspects of health and an incredible depth of information and guidance.
• Using Google for meal ideas If you use Google to help you then these are some of the key words you should be using. Make sure you bookmark the ones you like the most for easy reference. 1. 2. 3. 4. 5. 6. 7. 8.
High protein, low carb meals or recipes Low glycemic index meals or recipes Low GI diet Low glycemic load meals or recipes South Beach Diet meals or recipes High protein snacks Atkins meals or recipes The Zone meals or recipes
• Glycemic Index and Glycemic Load Information http://www.glycemicindex.com/ http://www.the-gi-diet.org/glycemicindexchart/ http://nutritiondata.self.com/topics/glycemic-index http://www.glycemicedge.com/ http://www.mendosa.com
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