Sustainable Weight-loss Solutions
A multi-faceted approach can help patients maintain quality weight loss.
According to a 2015 data brief published by the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics, the prevalence of obesity among adults in the United States between 2011 and 2014 was 36.5 percent.
“Diabetes/obesity, otherwise known as ‘diabesity’ is the greatest killer of our world,” said Gabrielle Lyon, an osteopathic physician with The Ash Center in New York. “These two chronic diseases form a continuum that includes insulin resistance and being overweight. Together, they represent the single biggest global health epidemic of our time and are the leading causes of heart disease, dementia and cancer.” According to Dr. Lyon, diabetes and obesity affect more than 1.7 billion people worldwide. In 2015, 2.3 billion people were overweight and 700 million obese. “It is estimated that one in two Americans will be impacted by 2020,” she stated.
The prevalence of obesity, which is almost always found with diabetes, has tripled since the 1980s. In fact, Dr. Lyon shared that in 2010, 27 million Americans were diagnosed with diabetes and 67 million with pre-diabetes. According to the CDC, the number of people affected with diabetes in the U.S. is projected to increase from one in 10 to one in three by 2050.
Conveying to patients that the key to weight loss involves many facets is one way that practitioners can best help patients meet their weight loss goals. According to Adam Killpartrick, DC CNS, chief science officer for Vermont-based DaVinci Labs, addressing the causes of a patient’s weight issues is the most surefire way to impact long-term weight loss.
Dr. Killpartrick, who also maintains a private practice, stated that when he approaches a patient with weight management concerns, he considers a number of factors including food intake, food sensitivities, supporting healthy levels of inflammation, balancing hormones and physical activity.
“I want to ensure that my patient avoids foods that cause an IgG reaction, which some studies have demonstrated has a positive impact on weight management,” he explained. “Balancing stress and metabolic hormones is key to long-term weight management,” he continued. “I consider the stress people are under on a daily basis and look at the elevation of cortisol, which has the capability to impair thyroid hormone from getting into its receptors, possibly block estrogen from its receptors, deplete our progesterone, and can be a contributing factor in insulin resistance, resulting in increased fat stores.”
Lastly, he highlighted the importance of physical activity on weight loss. “Losing weight long term without physical activity is like defying gravity,” he stated. Dr. Killpartrick finds value in two approaches: helping patients find some kind of exercise they love to do but don’t believe they have time for and introducing them to interval training.
Dr. Lyon concurred and stated that building muscle is the best way to high quality weight loss. “Maintaining high quality muscle and losing body fat results in long term weight loss,” she explained.
Natural Remedies for Weight Management
“The best natural remedies for weight loss are those that support the entire digestive and metabolic processes, because if these aren’t working effectively and efficiently, it’s very difficult to reach and maintain an ideal weight,” said Jamie Morea, co-founder of Nevada-based Hyperbiotics.
The latest research in microbial health has demonstrated the importance of a healthy gut in maintaining a healthy weight. “In fact,” explained Morea, “scientists have been able to predict whether a person is at optimal or excess weight far more accurately based on the composition of their gut microbiome than their genes.”
In addition to a balanced diet and smart lifestyle choices including physical activity, Morea believed that recommending probiotic supplements is one way practitioners can help their patients optimize digestion and metabolism to support long-lasting weight loss and maintenance.
According to Dr. Lyon, whey protein and branched chain amino acids (BCAAs) are two of the most important products to help patients achieve high-quality weight loss, especially for patients that practice a vegan or vegetarian lifestyle.
Kelly Heim, PhD, senior director of scientific affairs at Massachusetts-based Pure Encapsulations agreed. “Protein is a foundational essential for any protocol. Individuals on a higher-protein diet (1.6 g/kg body weight) lost 22 percent more fat mass after four months compared with individuals on a moderate-protein diet (0.8 g/kg body weight), according to a clinical study.”
Whey protein has 2.5 grams per serving of leucine, an essential amino acid. According to Dr. Lyon, this dose is vital because it is necessary to reach 2.5 grams of leucine to trigger muscle protein synthesis. “Anything lower than this amount does not trigger the necessary action in the body to take care of the health of the muscle,” she stated.
Dr. Killpartrick pointed to what he considered great natural substances that can help expedite the process of weight loss while helping to maintain a healthy body composition.
“WellTrim IG (IGOB131) African mango extract supports body weight and waist circumference as well as plasma total cholesterol levels, LDL cholesterol, metabolic function, adiponectin and, perhaps most importantly, C-reactive protein (CRP).” He explained that healthy CRP levels can ultimately support healthy leptin levels.
Additionally, Dr. Killpartrick mentioned green coffee bean for its ability to support healthy levels of glucose-6-phosphate, which is responsible for converting glycogen into glucose and green tea phytosome which supports genetic signaling associated with adiponectin and healthy fat accumulation by supporting lipolysis within adipocytes.
Lastly, he noted that white kidney bean (BeanBlock) is able to target certain enzymatic activity which can lead to the breakdown and absorption of specific marcronutrients such as starch. “Affecting starch absorption can support healthy metabolic processes and satiety,” Dr. Killpartrick said.
The State of the Market
Caroline J. Cederquist, MD, founder and medical director of the Cederquist Medical Wellness Center in Florida, and medical advisor to Pure Encapsulations shared that the weight loss industry in total was estimated to be more than $70 billion, which included everything from diet pills and books to diet soft drinks and health clubs. “According to a study published by McKinsey & Company,” Dr. Cederquist added, “the supplement market is roughly $23 billion in annual sales and is expected to remain strong.”
Dr. Lyon expressed that the current market for weight loss focuses on the problem but doesn’t do much in the way of providing a solution.
“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,” Dr. Killpartrick added.
“The need lies in complete strategies with comprehensive, expanded approaches that address the various aspects that lead to metabolic issues and weight gain,” he continued. “The peaks and valleys for weight management supplements are greater in scale than any other category in the industry. Something gets mentioned on TV and is hot for two months, then it is gone just as quickly as it was here. That type of model can generate a great deal of money in a short period of time, but it doesn’t fulfill the needs of our patients.”
Weight-loss Support Supplements
Gut Health
Better Body from Hyperbiotics contains six targeted probiotic strains that have been clinically shown to optimize digestive and metabolic function. White kidney bean extract reduces the caloric impact of starchy foods by reducing carbohydrate absorption by up to 66 percent, and Orafti P95 Prebiotics provide fuel for the probiotics, so they can set up shop and thrive in the digestive tract. Better Body uses a patented delivery method called BIO-tract that protects the live probiotic organisms from stomach acids in the digestive tract, which according to Hyperbiotics makes the product 15 times more effective than most probiotic supplements.
Hyperbiotics also offers an organic, food-based Prebiotic Powder that helps promote the growth of beneficial bacteria. The prebiotic powder contains a mix of fructooligosaccharides (FOS), inulin, soluble dietary fiber and resistant starch, in a blend that is easy on sensitive stomachs.
Metabolic Support
Adipo-Leptin Benefits from DaVinci Labs offers comprehensive support for weight management. Ingredients include green coffee bean extract, brown seaweed, WellTrim iF (IGOB131) African mango seed extract and GreenSelect Phytosome.
DaVinci Labs also offers Metabolic Arthri Benefits, a product that is positioned as a joint formula for those with metabolic imbalances. Dr. Killpartrick recommended this for patients who need to lose weight, as the primary mechanism of the product is geared toward regulating leptin levels.
The PureLean product line from Pure Encapsulations includes XanthiTrim, which supports resting metabolic rate and Metabolic Xtra, which supports glucose homeostasis. “XanthiTrim is a prudent choice for patients who prefer a simple, research-based product for healthy weight management that only requires two capsules per day,” said Dr. Heim. “Metabolic Xtra is ideal for supporting glucose disposal, which is one of the most important metabolic determinants of success when trying to maintain a healthy weight.”
Protein
Also from Pure Encapsulations’ PureLean line is its PureLean Protein Blend, which provides vegetarian protein in a great-tasting, powdered beverage formulation made from natural flavors.
A new protein-based product from the PureLean line is PureLean Ultra. The formula offers an enhanced blend of vegetarian protein, fiber and metabolic cofactors to help support healthy weight management.
Omega-3 Fatty Acids
Dr. Killpartrick believes that ingesting enough fats is an essential part of weight management. DaVinci’s Omega 3 HP-D provides both EPA and DHA combined with 1,000 IU of vitamin D3. The omega-3 fish oil in this product is from wild-caught anchovies that are molecularly distilled to ensure purity and stability. Omega 3 HP-D supports cholesterol balance, cardiovascular, joint and skin health, as well as immune system function.
Lifestyle Recommendations
Dr. Lyon explained that weight issues have both genetic and environmental causes. “We are overfed with caloric excess along with a human brain that is hardwired to eat. In addition to excess carbohydrates, our diets are too low in protein. As a result, we are unable to maintain our most metabolically-active tissue which is muscle. Having high body fat and low muscle mass in an environment with too many carbohydrates results in a plethora of weight issues.”
The natural approaches and remedies for weight loss she recommended were:
• Build and maintain muscle
• Have a whey protein shake as the first meal of the day
• Eat 30 grams of protein three times a day (up to 50 grams of protein per meal depending on the patient’s size)
• Supplement with BCAAs if vegan or vegetarian
• Lower carbs to less than 40 grams per meal
Dr. Killpartrick stated that the first and perhaps biggest challenge is getting a patient to shift their mindset away from age-old misunderstandings about what to eat and going on a “diet” versus making lasting lifestyle change. “Once the mindset is shifted even a little, you can start introducing new concepts for someone to adapt and integrate into their daily routine.” This would include making better food choices, increasing physical activity and starting to take nutritional supplements that support metabolism and inflammatory responses and balance hormones.
“Studies have shown that a compromised microbiome can contribute to weight issues,” said Morea. As practitioners become more knowledgeable about the importance of gut health in managing weight, they can better serve their patients by advising them to add a daily probiotic to their routine, she added.
Patient Compliance
According to Dr. Killpartrick, the key to getting any compliance with patients in terms of implementing natural products into a practice is two-fold. First, you have to provide a rationale as to why you are recommending a particular product to a patient. “Make that as solid as you can in terms of understanding,” he said. “The more committed the patient is to the story you tell them, the less likely they’ll be to fall off the program.”
Practitioners should also make ordering products easy for patients by having a dispensary in the office or via virtual dispensary. “Whatever avenue is chosen should be easy for the patient.”
Another concept that he found invaluable was to develop strategic collaborations with other individuals or companies focused on weight management. “Very seldom does one office cover all the bases relative to weight management. 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.” Collaborating with fitness facilities and personal trainers can be very helpful, and it should be easy for patients to take advantage of those partnerships.
Educating patients and setting expectations is also key. “Practitioners should convey to patients that weight loss is a multi-faceted complex of systems and thus need to be approached accordingly,” shared Dr. Killpartrick. “Whenever the picture is painted with a ‘silver bullet’ approach, the practitioner will always lose. When they set the stage that the secret to long-term weight loss could be found by addressing many different things, patients are less likely to lose confidence and get discouraged.” If a patient has a broader understanding of what it takes to lose weight, they’ll be far less likely to throw in the towel if they don’t see immediate changes.
Resources:
1 Bauer J, Biolo G, Cederholm T, Cesari M, Cruz-Jentoft AJ, Morley JE, et al. Evidence-Based Recommendations for Optimal Dietary Protein Intake in Older People: A Position Paper from the PROT-AGE Study Group. J Am Med Dir Assoc. 2013; 14(8):542–59.
2 Greenselect Phytosome for Borderline Metabolic Syndrome. (n.d.). Retrieved from www.hindawi.com/journals/ecam/2013/869061/.
3 Layman DK, Evans EM, Erickson D, et al. A moderate-protein diet produces sustained weight loss and long-term changes in body composition and blood lipids in obese adults. J Nutr. 2009 Mar;139(3):514-21.
4 Noakes M, Keogh JB, Foster PR, Clifton PM. Effect of an energy-restricted, high-protein, low-fat diet relative to a conventional high-carbohydrate, low-fat diet on weight loss, body composition, nutritional status, and markers of cardiovascular health in obese women. Am J Clin Nutr. 2005; 81:1298–1306.
Healthy Take Aways
• Diabetes and obesity affect more than 1.7 billion people worldwide.
• The number of people with diabetes in the U.S. is projected to rise from one in 10 to one in three by 2050.
• Balancing hormones and physical activity are key components to addressing weight-management concerns.
• Having a healthy gut is an important part of maintaining a healthy weight.
• Building and maintaining quality muscle mass is essential for managing weight.
For More Information:
DaVinci Laboratories of Vermont, www.davincilabs.com
Hyperbiotics, Inc., www.hyperbiotics.com
Pure Encapsulations, www.pureencapsulations.com