How to Lose Weight Successfully and Sustainably—Here's How!—Part 3

Dear BLOG readers, Dear PEAK customers,

We’ve now reached the third part of my series of posts on weight loss. We’ve already covered a number of general tips and guidelines, particularly regarding important behavioral rules to follow if you plan to lose weight permanently. Today, I’ll get a bit more specific by introducing one of two possible dietary approaches that has already served as a useful tool for many people. Anyone familiar with my HBN (Human-Based Nutrition) dietary concept will notice some parallels with the so-called LCRF approach I’m introducing today. You’ll find out what it’s all about now.
Enjoy!

DIETARY APPROACH – LCRF (Low Carb – Real Food)

What Are “Carbs”?

Carbs (carbohydrates) are one of the three macronutrients, along with protein and fat. Carbohydrates are composed of carbon, water, and oxygen, and, according to current scientific understanding, contribute 4.1 calories per gram to the energy balance. Carbohydrates are primarily divided into starch and sugar. While the former is a long chain of glucose molecules (polysaccharide), sugars consist of one (monosaccharide) or two (disaccharide) molecules. When ingested, carbohydrates travel to the small intestine, where they are broken down into their constituent parts (following the action of salivary amylases in the mouth) before either continuing on to the liver or entering the bloodstream, where they are available to nearly all tissues in the body as a direct source of energy. An exception to this is fructose (fruit sugar), which is metabolized almost exclusively in the liver (84–86). For certain parts of the body, such as the brain or red blood cells, carbohydrates are considered “essential,” but they are not truly so because:
a) in the absence of dietary carbohydrates, the metabolic pathway for ketone body production from fatty acids steps in as a substitute (it can cover 50–70% of the brain’s energy needs) (90–92)
b) the body can produce a certain amount of glucose itself through the process of gluconeogenesis, for example from pyruvate, lactate, or amino acids (87, 89).

Note
: Despite these “survival-ensuring” facts, current scientific evidence nevertheless shows that individuals interested in peak athletic performance do themselves no favors by switching to a so-called ketogenic diet. When it comes to weight loss, carbohydrate content does not appear to be a key factor, at least not in conjunction with strength training (94)—more on this in the following chapter.

Conclusion
: Carbohydrates are primarily a non-essential energy source that we consume in various forms through our diet. The type of carbohydrate determines how it is metabolized in the body.

What Is Low-Carb and What Can It Do?

4 Pillars of Successful Weight Loss

The most important criteria that a truly effective weight-loss diet must meet are:
• Calorie deficit
• High protein intake (64–68)
• Balanced micronutrient intake
• Carbohydrate intake optimized to individual needs

The LOW-xx / HIGH-xy NONSENSE

Even though it is often claimed and seemingly proven in some studies (59–62), according to the latest scientific evidence, the classic low-carb diet does not offer any truly significant advantage over a low-fat approach when it comes to weight loss (63). The picture is somewhat different when it comes to health (69); here, low-carb diets are particularly well-suited for:

• Improving blood lipid levels (triglycerides and HDL) (70–72)
• Lowering blood pressure (73, 74)
• Lowering blood sugar (75–78)
•    Reducing insulin secretion (75–78)
• Improving insulin sensitivity (75–78)
• Reducing liver fat in non-alcoholic fatty liver disease (NAFLD) (79–83)

Distinctions in Low-Carb Diets

Opinions differ on the definition of “low-carb.” A slightly more precise distinction than “low-carb” in the sense of consuming few calories from carbohydrates is the further classification into:
•    VLCD (Very Low-Carb Diet or ketogenic diet) up to 50 g of carbs per day
• LCD (Low-Carb Diet) up to 100 g of carbs per day
• MLCD (Moderate Low-Carb Diet) up to 150 g of carbs per day

The effectiveness of the classic LCD increases with the degree of physical inactivity and decreases with the increase in physical activity and exercise. This is where my nutritional concept, HBN (Human-Based Nutrition), makes a clear distinction and establishes the overarching rule for carbohydrate intake as follows: “Need justifies intake.” For the classic couch potato, an LCD would work, whereas for the physically active person, a slightly modified approach based on the MLCD—or, even more specifically and individually, the HBN—represents the better solution.

Conclusion
: When it comes to carbohydrate intake, your needs determine your intake! LCRF distinguishes between three different types of low-carb diets, each allowing for an intake of up to 150 grams per day. For a more personalized approach to determining carbohydrate intake, there are nutritional concepts such as HBN (Human-Based Nutrition), in which several personal factors are taken into account to determine the specific daily carbohydrate intake.

What is “Real Food”?

High-quality? YES—but beware of “nonsense”

Regardless of the specific low-carb approach you choose, the main focus of LCRF is on the use of natural, high-quality foods (similar to the Mediterranean diet). Paleo is often mentioned in the context of a sensible low-carbohydrate diet; however, there are some important factors to consider here (see excerpt)
Excerpt from: “Paleo: A Diet Put to the Test” – www.Body-Coaches.de (64)
After reviewing all the facts surrounding Paleo, it is clear that it is a diet that is no longer relevant today. Modern humans are neither genetically identical to Stone Age humans nor do they live in the same environment or under the same conditions. These facts render some of the Paleo diet’s guidelines and restrictions obsolete, as they not only impose unnecessary limitations on food choices but also carry the risk of certain nutritional deficiencies. Strictly speaking, the Paleo diet needs an update to Version 2.0. Although some of the guidelines certainly yield positive effects compared to a typical Western diet, a clear, unqualified recommendation to switch to the Paleo diet cannot be made at this point. Rather, we should strive for more individualized guidelines and stop emulating what our ancestors may (but only may) have practiced in this form or something similar.

Real Food

“Real Food” is the umbrella term for whole foods consisting of a single ingredient. Terms like “natural” or “processed” are often thrown around in this context but are frequently misinterpreted. If a food with only one ingredient is processed solely by mechanical means—for example, by cutting, grinding, or packaging—it is still considered “natural.” Only chemical processing or the addition of other ingredients turns it into a “processed” food. The advantage of natural foods lies in their higher content of essential nutrients, which help meet daily nutritional needs. The fiber and water content is also often higher in real food, which increases the likelihood of feeling full more quickly and for longer. Certainly, even on a weight-loss diet, it’s not a big deal to reach for a processed food every now and then, as long as a) it fits within your calorie budget and b) your micronutrient needs can still be met by the other foods you eat.

Note
: This is exactly what many people mean by the term IIFYM, aka Flexible Dieting!

The majority of your diet (80–90%) should consist of real food, which you can quickly identify by the following characteristics:

• Ideally, only 1, at most 5 ingredients on the ingredient list
• Natural appearance (not a typical factory-made product)
• Can be produced without chemicals and without large-scale manufacturing facilities

These foods are compatible with LCRF

• Meat
• Fish
• Eggs
• Whole grains
• Vegetables and legumes
• Fatty fruits (olives, avocados)
•    Tubers
• Fruit
• Nuts and seeds
• Full-fat dairy products
• Fats and oils (olive oil, coconut oil, avocado oil, organic butter)

Examples of LCRF-friendly snacks

• A piece of fruit
• A serving of Greek yogurt
• A hard-boiled egg
• Baby carrots
• Nuts
• A serving of cheese
• Berries
• Dark chocolate

These drinks are compatible with LCRF

• Water
• Coffee and tea (without sugar, syrups, etc.)
• Diet drinks (in moderation, as they do not necessarily hinder weight loss) (95)

These foods are not compatible with LCRF

• Sugar-rich foods or drinks
• Foods containing refined carbohydrates (white bread, pasta, french fries, potato chips…)
• “Diet” or “low-fat” products
• Foods containing trans fats (hydrogenated fats)
• Foods high in omega-6 fatty acids and large amounts of vegetable oils

These foods are conditionally suitable for LCRF

• Chocolate with a cocoa content of 70%
or higher • Dry wines with no added sugar
• Bacon
• Protein powder

Conclusion
: “Real food” encompasses a large group of foods that all consist of just one or a few ingredients and end up on supermarket shelves without undergoing extensive processing.

Cheating and LCRF

While “cheating”—in the sense of increasing carbohydrate intake and deviating from the actual LCRF food selection—is only suitable to a very limited extent on a VLCD to avoid falling out of ketosis*, the situation is somewhat less sensitive on an LCD or MLCD.

*Ketosis
: A term describing the body’s “fat-adapted” or “keto-adapted” state, in which ketone bodies are produced and consumed in increased amounts as an alternative energy source to carbohydrates.

In general, regarding refeeds (the planned form of “cheating”), it’s worth noting that they are all the more justified the more leptin levels have been lowered as a result of dieting. We can intentionally influence leptin levels through:

• Sleep
patterns • Physical activity
• Calorie deficit
• Carbohydrate deficit
• Body fat percentage

Leptin not only has a lasting effect on metabolism (24-hour REM, lipolysis) and hormone balance (insulin, cortisol, thyroid hormone), but is also considered the strongest signaling molecule in the orexic network that controls hunger and satiety (96). From this perspective, it may therefore make sense—depending on the individual—to incorporate planned refeed days starting at a certain point. On the other hand, the psychological aspect of “treating yourself” should not be overlooked. In many cases, even a single so-called “cheat meal” per week is enough to restore a positive mindset. To ensure that cheating or refeeding doesn’t get out of hand, it’s important to follow these rules:

1. Keep
an eye on your hunger/satiety scale 2. Eat mindfully and savor
your food 3. Don’t panic if your body weight increases temporarily—it’s just water!

Conclusion
: Refeeding is justified starting at a certain phase of the diet, depending on leptin status. Planned refeeds involve consuming larger amounts of carbohydrates along with moderate amounts of protein and little fat, whereas a “cheat meal” has no specific guidelines and serves more to satisfy the psychological rather than the metabolic/hormonal aspect of a dietary regimen.

Physical Activity and LCRF

The extent to which physical activity is beneficial—or indeed necessary—for achieving sustainable, healthy weight loss is not really up for debate. A wealth of studies demonstrates the immense benefits of regular exercise for metabolic health and for reducing the risk of numerous chronic diseases prevalent in modern society (97–100). Nevertheless, misinterpretations occur time and again, as seen in King et al. (101), particularly when quantitative weight loss is either confused with the loss of body fat or prioritized over it. When the scale reading is prioritized over the results of a BIA, DXA, or caliper measurement, this very often comes at the expense of preserving muscle mass, which has been shown to help maintain RER (resting energy expenditure) during a weight-loss diet (102–105). If, with exercise (especially strength training), the scale’s needle does not move to the left as quickly as it would without exercise, it can be concluded that, in addition to a loss of body fat, muscle mass can be preserved and, in the best-case scenario, even built up for a certain period of time (110). Recent studies confirm this possibility—even for a limited period—in normal-weight, trained subjects as part of an optimized competition preparation plan (106). In fact, more in-depth studies on physical activity do indeed demonstrate more effective reduction of body fat—and in particular of visceral fat, which is located between the organs in the abdominal cavity and is considered a critical health concern (107,108).
Anyone interested in counteracting a loss of muscle mass or a diet-induced reduction in metabolism (111, 112) would be well advised to include strength training in their workout plan. Those aiming to maximize weight loss success would be well advised to combine strength and endurance training (109).

Note
: As mentioned above, it can be beneficial to slightly increase carbohydrate intake in line with the level of physical activity. Targeted intake not only promotes recovery but also helps maintain performance levels or ensures they decline at a slower rate. This approach of needs-based carbohydrate intake is refined in my nutritional concept, HBN (Human-Based Nutrition).

Conclusion
: A weight-loss program that promises permanent weight loss without any physical effort isn’t even worth the paper it’s printed on. The modern world is “so overweight and unhealthy” because people don’t get enough exercise! The smart approach is to combine a diet that suits your individual needs with a combination of strength and endurance training to achieve the best possible weight-loss results.

Maintaining Weight Loss

Losing weight quickly is one thing, but what happens after 3 months, 6 months, or even several years? A study involving participants from the weight-loss TV show “The Biggest Loser” clearly demonstrates how improper “dieting” has a lasting negative impact on metabolism (even over 6 years!) and, as a result, causes a large proportion of those trying to lose weight to regain at least the weight they lost in the years that follow (113). Another interesting study on this topic (114) compared weight trends over two years resulting from three different dietary approaches:
• Calorie-restricted low-fat diet
• Calorie-restricted Mediterranean diet
• Non-calorie-restricted low-carb diet  
As the figure shows, participants in the low-carb group lost the most weight and were still ahead in terms of weight loss 3 to 6 months after the weight-loss phase. Within two years, however, this lead had narrowed to a negligible margin compared to the results from the Mediterranean diet. The researchers suspect that a gradual return to old eating habits is the reason. Another study by Ochner et al. (115) identifies the gradual return to old eating habits as a general cause of recurrent weight gain—a phenomenon not limited to low-carb diets alone. So it is important to have the right strategy in place even AFTER the actual weight-loss phase. These tips can help:
• Continue
to use the hunger/satiety scale even after the diet • Continue to weigh
yourself regularly even after the diet • Do not return to old eating habits
• Educate yourself on all aspects of healthy eating and exercise
•    Choose restaurants that offer
suitable dishes • Consciously “treat yourself” only as an exception
• Keep healthy, appropriate snacks on hand (see above)

Conclusion
: Losing weight isn’t rocket science. Those who have truly mastered their situation are the ones who, even months and years after the weight-loss phase, can still say they’ve “lost weight”!

Dealing with Side Effects

The higher your calorie and carbohydrate intake was beforehand, and the more drastically you now restrict these two factors upon starting LCRF, the more—or less—pronounced transition symptoms you may experience, depending on the individual.
In particular, those who opt for a VLCD (very low-calorie diet) of up to 50 grams of carbohydrates per day should expect to experience something in the first few days that is often referred to as the “low-carb flu.” This term refers to symptoms associated with a reduction in carbohydrate intake. Until the entire metabolism has adjusted to the alternative energy supply, the following symptoms may occur for about 3–4 days:

• Headache
• Fatigue
• Difficulty
concentrating • Bad breath
• Hunger
• Poor sleep
• Nausea
• Constipation
• Reduced physical performance
• Cravings for carbohydrates

After some time, however, you’ll reach the point of full adaptation. From there on, things will start looking up again. To better cope with the so-called “low-carb flu,” try these tips:

• Drink
plenty of fluids • Consume salt intentionally (sodium is excreted at a higher rate during this phase)
• Increase your intake of other minerals
• Avoid intense physical activity (switch to light workouts for a short time)
•    Before completely cutting out carbs, first get
used to a low-carb diet such as LCD or MLCD • High fiber intake (from vegetables, nuts, and seeds)
• Use
sugar-free gum or mints to combat bad breath • Use psyllium husks to relieve constipation

Conclusion
: Noticeable, unpleasant adjustment difficulties with a low-carb diet are only to be expected with VLCD, since our body must switch its energy supply to ketone bodies in this case.

What else is worth noting?
• Pregnant women and children should not follow a VLCD regimen but should opt
for at least an MLCD • Even with a VLCD, 20g is recommended
as the minimum carbohydrate intake •    The more unbalanced the diet and the lower the calorie intake, the higher the likelihood that targeted use of dietary supplements will be necessary to ensure a certain balance of micronutrients, dietary fiber, or other essential nutrients (e.g., omega-3 fatty acids)
•    The use of Bulletproof Coffee is not recommended, as it provides too few essential nutrients relative to its calorie content. Its effect on cholesterol levels also remains unclear to date

Summary
: LCRF involves far more than simply limiting carbohydrate intake and sticking to certain foods. When properly implemented, the approach takes into account all the factors necessary for sustainable weight loss, starting with a calorie deficit, continuing with an adequate supply of protein and micronutrients, and extending to determining the appropriate amount of carbohydrates for each individual. My nutritional concept, HBN (Human-Based Nutrition), represents what you might call the “pro version” of LCRF. It covers all the fundamental pillars of a weight-loss diet and determines carbohydrate needs on an individual basis. The key to long-term success in weight loss is finding an approach that fits seamlessly into your daily life and can become a habit. For many people, LCRF provides this solution.
In Part 4 below, I’d like to introduce you to another alternative to LCRF that explores the approach of intermittent fasting—and, more specifically, alternate-day fasting (ADF). This is also a very interesting option for certain individuals, so you should definitely keep reading.

Best regards
, Holger Gugg
www.body-coaches.de