Practitioners must consider all factors when developing a protocol to help patients lose weight.
Now that the sun has set on 2015, people look at the New Year as a fresh start. Oftentimes, they set their goals for the year in the form of a New Year’s resolution. In fact, a Nielson survey of the top 10 New Year’s resolutions found that “staying fit and healthy” and “losing weight” were the top two responses for 2015 with 37 and 32 percent of the votes respectively. Unfortunately, a study conducted by the University of Scranton found that just 8 percent of people achieve their New Year’s goals.
While New Year’s resolutions are good starts, the statistics of achieving their weight-loss goals are not often in the favor of most Americans. Being overweight or obese can lead to a number of other health problems such as type 2 diabetes, joint problems, heart disease, among others. According to the National Institutes of Health (NIH), more than two in three adults are considered to be overweight or obese in the U.S., while more than one in three adults are considered to be obese. The problem is also affecting children, with approximately one-third of children and adolescents, ages 2-19, considered to be overweight or obese, and one in six considered to be obese.
“Unfortunately the demographic which is growing most rapidly and at highest risk for obesity related diseases is children. My thoughts are that by the time many kids reach the teen years they have developed either good or bad eating habits, which can be challenging to change,” said Marci Clow, MS, RDN, senior nutritionist for California-based Rainbow Light.
But it isn’t always as simple as eating less and better foods and exercising more. There are often a number of other factors that affect a person’s ability or inability to lose excess weight. According to Beth Baldwin-Lien, ND, director of medical affairs and education for Connecticut-based Vital Nutrients, the main causes of obesity are “excessive caloric intake, high glycemic index diet, sedentary lifestyle, high stress and therefore high cortisol, leading to abdominal obesity and insulin resistance,” she said. “Genetics and endocrine disruption due to environmental toxicity also play a role.”
Michael A. Smith, MD, senior health scientist for Life Extension in Florida added, “Most people ask about losing weight, but knowing why you gained weight in the first place is a better place to start.”
Dr. Smith noted that Life Extension recognizes the following nine mechanisms of weight gain:
1. Insulin resistance
2. Hormonal imbalances
3. Excessive carbohydrate absorption
4. Muscle loss
5. Low brain serotonin
6. Slow resting metabolism
7. Abnormal fat cell signals
According to Sara Gottfried, MD, New York Times bestselling author of The Hormone Reset Diet and The Hormone Cure, while obesity isn’t a simple disease with a single cause, nearly all paths of obesity and weight problems lead back to hormones. “For some people, food addiction is a driver of disordered eating, and it’s unclear if hormones are the cause or effect (or both), i.e., chicken or the egg,” she explained. “For other people, endocrine disruptors act as obesogens and dysregulate insulin, leptin, estrogen, testosterone and/or thyroid hormone.”
“Hormones govern nearly all aspects of fat loss, from where you store fat (and how much) to your cravings, appetite, gut bacteria and even your addictive patterns with food. When misfiring hormones are allowed to spiral downward, you’re left with hormone anarchy and, ultimately, a broken metabolism; and you store fat no matter what,” Dr. Gottfried continued. “If you struggle to get and stay lean, your hormones are to blame. Correcting hormonal misfires with changes to your diet can optimize hormones and reinstate a healthy weight. Calories are important but they’re only part of the problem—hormones control how efficiently a calorie makes you fat.”
Science has yet to discover that “magic bullet” that can fix a person’s weight issues and traditional weight loss avenues that have been promoted in the past may not always be the healthiest. For instance, Adam Killpartrick, DC, Natural Practitioner Advisory Board member and chief science officer for DaVinci Laboratories in Vermont said these days, people are now getting wiser about not relying on things such as microwavable meals. “Microwaving Lean Cuisine or Weight Watcher dinners that are low calorie and even lower in nutrient value in a plastic container used to be the norm,” he said. “I know in my practice that approach was never advocated, however, more and more people are veering away from those types of diets because of the quality (or lack thereof) of the food and even the fact that the food is being heated by microwave while in plastic (which can contain endocrine disruptors and further complicate the process of long term weight loss).”
According to Dr. Killpartrick, addressing the causes is the most surefire way to impact long-term weight loss. He also noted, that when he approaches a patient from a weight management standpoint he considers a number of factors including: food intake, food sensitivities, supporting healthy levels of inflammation, hormones and physical activity.
Texas-based Progressive Laboratories, Inc.’s Kyl Smith, DC, added that there are “three science-based core lifestyle improvements that induce healthy weight loss: 1) Consumption of a low-glycemic, antioxidant rich diet, 2) Daily ‘intense’ exercise (as in ‘interval training’) and 3) Targeted nutrition to promote fat loss and appetite suppression,” Dr. Smith explained. “These three science-based core lifestyle improvements can powerfully and rapidly improve lean muscle, decrease body fat, increase insulin sensitivity all while significantly improving healthy hormone status in both men and women.”
Rainbow Light’s Clow noted that by planning out a week’s worth of healthy meals prior to hitting the grocery store, it will limit impulse purchases and allow people to avoid piling pre-packaged, prepared convenience foods into your basket. Clow said that fresh fruits and vegetables are key and to look for whole grains when purchasing pastas, rice and bread. And for those who aren’t planners, Clow advised that practitioners have patients keep a food diary, which would allow them analyze the kind of and amounts of food patients are consuming.
“Lean sources of protein are another way to maintain satiety and keep cravings at bay, and many consumers like protein shakes for this reason,” she said. “They are easy to whip up when there isn’t time to prepare a healthy meal, and can help prevent binging on sweets and caffeine for energy. One thing to look out for: some protein shakes are loaded with added sugar. It’s a good idea to check labels and make sure there is little or no added sugar in your protein shake of choice, or you’ll be defeating the purpose.”
Rainbow Light’s ThinBerry OptiCurb is a great tasting rice protein powder, which provides an easy-to-digest source of protein and fuel for the body. “This product acts as a perfect vehicle for providing energy, stamina and strong appetite control to support weight management, normalized blood sugar and ultimate well-being,” said Clow. “Each serving provides 15 grams of high quality protein, with a complete amino acid profile. Opticurb is also low-carbohydrate, low fat and provides 4 grams of fiber per serving to contribute to gut health and healthy elimination. Plant-source digestive enzymes including bromelain are added for additional digestive support, ease of assimilation and noticeable energy release.”
In addition to diet and exercise, practitioners often recommend supplementation to fill the nutrition gaps in their patients’ diets. Vital Nutrients’ Dr. Baldwin-Lien explained that there has been success with fish oil, which may help overweight and hypertensive patients improve weight loss, as well as decrease blood glucose, serum cortisol and insulin concentrations. In addition, “people who added whey protein shakes to their regular routine also lost a small amount of weight, body fat, and reduced their waist circumference in a recent study.” According to Dr. Baldwin-Lien, they had significantly lower blood levels of the “hunger” hormone ghrelin than the other groups and unknowingly reduced their carbohydrate intake during the study. And Life Extension’s Dr. Smith noted that because a slow resting metabolism is common for aging adults that green tea, capsasin extract, and 7-Keto DHEA are all great choices for safely boosting metabolic rates.
Vital Nutrients offers a number of supplements that can aid weight loss. In addition to the company’s ProWhey and UltraPure Fish Oil line, the company’s 7-Keto DHEA 100 mg supports healthy resting metabolic rates and burning of fat for energy, even during calorie-restriction. According to Dr. Baldwin-Lien, 7-Keto DHEA is a naturally occurring metabolite of DHEA produced by adrenal glands (3-acetyl-7-keto DHEA). It cannot be converted back to DHEA in the body, or to other sex hormones. 7-Keto declines with age (produce half as much by age 40, as at age 20), and can be supplemented to enhance activity of three thermogenic enzymes in the liver.
The company also sees many practitioners “utilizing Blood Sugar Support formula to address insulin resistance, and Vital Clear protein powder to help manage body burden of environmental toxins with precursors to glutathione, stabilize blood sugar with glucomannan fiber and cinnamon, and decrease inflammation with curcumin,” she explained. “D-Pinitol and Berberine 500 mg have also been studied in the past several years for their effects on body weight and the common complications of PCOS (polycystic ovarian syndrome) and metabolic syndrome.”
According to Dr. Gottfried, berberine is able to activate an enzyme called Adenosine Monophosphate-Activated Protein Kinase (AMPK) while inhibiting Protein-Tyrosine Phosphatase 1B (PTP1B). Activating AMPK is important to health, and appears to play a key role in reversing insulin resistance, promoting glycolysis, and reducing oxidative stress. One result of activating AMPK is suppression of hepatic glucose output, so that insulin and IGF-1 levels are lower.
“Berberine reduces blood glucose in people with diabetes by several mechanisms, including reducing production in the liver,” she explained. “Berberine lowers fasting glucose, fasting insulin, post-prandial glucose, and HbA1c by growing new insulin receptors. Berberine boosts insulin receptor expression four-fold.”
Dr. Gottfried noted that the best general dose of berberine is 500 mg, three times per day, and it shouldn’t be taken for longer than eight weeks.
Studies show that Garcinia cambogia can be beneficial for weight loss and even help make it easier for the body to use glucose. Progressive Laboratories’ Super CitriMax Garcinia cambogia fruit extract is the only Garcinia cambogia studied by Dr. Harry Preuss at Georgetown University Medical Center and has five published peer-reviewed studies, Dr. Smith said. “Super CitriMax providing HCA is an exciting botanical ingredient clinically shown to support natural weight management without stimulating the central nervous system. This unique and natural fruit extract positively influences appetite and energy levels while inhibiting fatty acid biosynthesis.”
And while supplementation can be beneficial, Dr. Killpartrick does warn that supplement companies should vet the ingredients that they use—and not be swayed by the new “hot ingredient.”
“The market does not need any other single isolated compounds that become a flash in the pan and further disintegrate the public’s trust in supplement companies because they were promised the world with one product,” he said. “The need lies in complete strategies with comprehensive, expanded approaches that address the various aspects that lead to metabolic issues and weight gain.”
“The peaks and valleys for weight management supplements are greater in scale than any other category in the industry,” Dr. Killpartrick continued. “Something gets mentioned on TV and it’s hot for two months, then its gone just as quickly as it was here. That type of model can generate a great deal of money in that short period of time, but doesn’t fulfill the needs of our patients.”
Practitioners have only the best intentions when it comes to helping their patients, but they can’t be with them at all times to make sure that they are following protocol. Patients need to do their part to allow their practitioners to assist them. To aid their patients in being compliant, practitioners can use a number of tools.
For instance, to support practitioners in making sure that their patients stay on track and hold themselves accountable, Clow recommends utilizing technology. “I think the most buzz worthy concept, which could have a great impact on the weight management health category is the abundance of tech tools, apps and even online resources that help people track progress and stay motived.”
Dr. Killpartrick also suggests that practitioners collaborate with others to help patients reach their goals. “Very seldom does one office cover all the bases relative to weight management,” he concluded. “As a chiropractor and nutritionist, I can provide dietary guidelines, supplement recommendations and keep them well adjusted for mobility and energy levels, but my office is not set up as a personal training facility. That is exactly why I have collaborated with the CrossFit facilities and personal trainers in my area. And again, I’ve made it easy for my patients to take advantage of these relationships.”
Healthy Take Aways:
■ A Nielson survey of the top 10 New Year’s resolutions found that “staying fit and healthy” and “losing weight” were the top two responses for 2015.
■ According to NIH, more than two in three adults are considered to be overweight or obese in the U.S., while more than one in three adults are considered to be obese.
■ According to Dr. Sara Gottfried, hormones govern nearly all aspects of fat loss, from where you store fat (and how much) to your cravings, appetite, gut bacteria, and even your addictive patterns with food.
For More Information:
■ Life Extension, (954) 202-7660, www.lifeextension.com
■ Progressive Laboratories, Inc., (800) 527-9512, www.progressivelabs.com
■ Rainbow Light, (800) 635-1233, www.rainbowlight.com
■ Vital Nutrients, (888) 328-9992, www.vitalnutrients.net