When looking for the best diet to treat obesity or overweight, a world of paths and websites offer you different types of food. How to know if the orientation is correct?
- People respond differently to different diets according to their genetics, type of obesity, and cultural background; therefore, a healthy diet must be adapted to their reality, and the nutritionist is the best professional for this.
- When comparing a fractional diet with intermittent fasting or a low-fat diet (low-fat) with a low-carb diet (low-carb), weight loss is very similar; what counts is the number of calories ingested in the day.
- Mealtime is essential, as our grandmother used to say. Recent studies prove that the body handles calories better in the morning than at night. Eat a good breakfast.
- The second factor that most influenced weight loss was how often the patient went to a health professional (endocrinologist, clinician, or nutritionist). External control is necessary because our body tends to deceive us, and even if you think you are eating little, the number of calories ingested tends to increase.
- Dietary treatment must be prolonged. Therefore diets that are very different from your reality tend to have a greater chance of failure.
- The more varied the diet, the less likely you are to get tired of food and the greater the chance of sticking to the diet plan for a long time.
- It is not mandatory to divide meals every 3 hours as was said in the past, although fractionation is a very efficient strategy to reduce hunger.
- As hunger increases with weight treatment and metabolism tends to decrease, adjustments in the number of calories ingested per day should be made periodically.
I’m Gaining Weight By Eating A Little. My Metabolism Is Slow!
A widespread doubt in the office is the ease with which weight is gained over life. Let’s address the various factors that can cause this effect. Weight loss occurs when we run a negative calorie deficit. The amount of calories ingested is less than our caloric expenditure.
Caloric expenditure is determined by multiple factors: age, climate, sex, genetics, amount of muscle mass, hormonal status, and activity of certain neurotransmitters in hypothalamic regions.
Energy expenditure is higher in childhood and decreases over the years. This is why young people can eat more without causing massive weight gain. Men have higher caloric expenditure than women. Living in a cold climate demands a more significant caloric expenditure (in scorching environments, but to a lesser extent). We live in thermo-neutral environments because of the abundance of air conditioners or advances in architecture and clothing.
Without physical resistance exercises (weight training, functional, pilates), we lose muscle mass from 35-40 years of age. The amount of lean mass is the main changeable factor that determines our metabolic activity. This loss of muscle mass can be accentuated by a restricted diet and a sedentary lifestyle. In the endocrinology office, we often see women who are obese despite not eating much. Most have a history of restrictive dieting with little resistance exercise, which has only exacerbated obesity. In these cases, exercise to rebuild muscle mass (lean mass) is more important than the diet for a good result.
Muscle activity helps in caloric expenditure by increasing energy consumption, but also by increasing the energy demand by fat tissue (transformation of white fat into beige fat with a more significant amount of mitochondria and consequently oxygen consumption) and by improving insulin resistance, bringing a better distribution of nutrients throughout the body.
And menopause?
Estrogen deprivation also accentuates the reduction of muscle mass but also affects brain regions that regulate metabolism. This reduction occurs even in men (hypogonadal men who lack estrogen at the hypothalamic level through testosterone conversion to estrogen). Drugs for obesity are being studied that would activate the estrogenic pathway in the hypothalamus and thus increase the body’s energy expenditure. Although several other brain neurotransmitters (dopamine, serotonin, noradrenaline, GABA, cortisol) influence energy expenditure, their clinical application is still limited. However, people who have a good night’s sleep and have a good mood tend to have a more active metabolism by interfering with these neurotransmitters.
And the food?
Although much is said about food increasing energy expenditure, the results are discreet. Some types of fat can boost metabolism, but this increase is less than the number of calories ingested. However, a quality diet rich in vegetables and whole foods and poor in processed foods interferes with the microbiota (number and quality of germs in our digestive tract), and several studies have already associated a good microbiota with increased caloric expenditure through increased metabolism.
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