What is the optimal diet for improved health and body composition?

In the last 5 years there has been lot of noise about different types of diets, with different names and styles. Defining which one works best for the majority of the population with the goal of losing body fat, has become an odyssey for many.

Unfortunately now, losing weight and being healthy seem to be mutual exclusive. Majority of the conversation is based on opinions of people, magazines, books, and not reliant on scientific evidence. Yet changes in body composition have been studied widely to determine which diet is most effective and maintains health. Remember, when you are reading research there are a lot of limitations in studies, and the data need to be analyzed carefully.

We should realize, that there is no universally effective diet; no one-size fits all approach, that promotes sustainable weight reduction. It seems that there is evidence in short-term weight reduction using diets high in protein, low in carbohydrates, and intermittent fasting. However adverse effects are associated with one's long term health if these diets are not adequately controlled. In the long term, the strongest evidence shows that different diets can only work when they create commitment in the person to follow it consistently.

It should not be forgotten that continual weight gain, if maintained over time, will lead to obesity becoming a multifactorial disease, beyond just seeing it as a fat accumulation.  Obesity is a disease that occurs with low-grade inflammation affecting the rest of the systems in the body that can lead to metabolic diseases, such as type 2 diabetes, or coronary heart diseases.

We know that weight gain is undoubtedly the consequence of a positive calorie balance, that is, consuming more calories than we spend through daily activity, movement and exercise. However, what must be acknowledged is the genetic and environmental factors which play a very important role in context of each person.

For successful fat loss, the Academy of Nutrition proposes lifestyle changes, i.e. a diet with reduced processed food, focusing rather on the quality of the food and increasing the energy expenditure (physical activity). This must be in conjunction with focusing on the individual needs of each person. Therefore, it lacks scientific evidence to choose a universal diet for everyone, be it Paleo diet, keto, low carb, high-carb, vegan, vegetarian… because it seems that it does not matter as much what it is, but rather does it creates a negative energy balance in that individual. Therefore, what we believe in is to create a €œnegative energy balance € in the diet with good quality foods that maintain optimal health1.s

As nutritionists, we propose different strategies according to the person's requirements, since an elite athlete is not the same as a recreational athlete, just as the latter will not be the same as a sedentary person. Nor would an obese person be equal to another of better body composition, or even someone with some digestive pathology, such as an irritable bowel syndrome with another who does not have associated digestive pathology. All of these factors must be individualized for a success in the results. Thus, we divide our recommendations into the following categories, according to the objectives of each person:

1) Diet based on macronutrient manipulation. Changing the ratios of proteins, carbohydrates or fats; which can be low-carb, high carb, high protein etc.

2) Diet based on restriction of certain foods according to the person's needs (gluten-free, paleo, dairy-free, vegan, vegetarian).

3) Diet based on time manipulation; like intermittent fasting.

If we have to make a generalized recommendation for weight management from a healthy point of view; we would recommend the Mediterranean diet. Schwingshackl et al. (2019) observed different epidemiological studies regarding diets and concluded that the Mediterranean diet could be the most effective from a health point of view because it was associated with lower cardiovascular risk, lower metabolic risk such as type 2 diabetes, and cancer2. In an analysis conducted by Nita G and colleagues, assessing the evidence and controversy regard diet guidelines for the treatment of Type 2 Diabetes, they also concluded that the Mediterranean diet was the most effective and optimal for these patients3.

What is known of the beneficial effects of the Mediterranean diet?

It relates to the least amount of lipids in the blood circulation, reduction of inflammatory parameters and oxidative stress at the cellular level, improved insulin sensitivity, improved endothelial function (improvement of blood pressure), slows gastric emptying and reduces appetite for longer periods.   All this due to its high content of vegetables, fruits, legumes, nuts, fish and extra virgin olive oil which creates a high adherence to follow this type of diet, maintaining an optimal energy balance and enjoy good longevity.

Conclusion:

There is no evidence that there is any special diet for fat loss that it works for everyone. The most important thing is to create a negative energy balance consuming nutritious good food and adhering to the program for the long-term. To do this, it is important to individualize, in order to accommodate their requirements.

This is only a general recommendation to guide the population, but any treatment or guideline must be individualized according to the needs of each. Our priority is individualization and it is the key to success in the final results. Please free to contact us to discuss what would work for you.

Regards,

Sandra Serrano, Physiotherapist, Msc Clinical & Sport Nutrition, sandra@dubaihtc.com Dubai Herbal and Treatment Center

Eat Well & Keep moving

Nutrition guidelines for maintaining your weight during lock-down situation

asMost of our patients contact us and ask what they could do in order to control their weight during the lock-down situation, when physical activity is restricted, especially those that are working from home and tempted towards the fridge often.

It is worth mentioning that we should not address weight loss through the scale alone, as that is not a good indicator for body composition. Doing an analysis rather for fat loss is more accurate, but we will talk about that later.

It must be observed, €œholiday seasons € are a time when socializing is frequent, and we put aside our good habits. Most of us during lockdown, were not on holiday nor attending our favorite restaurant, however might have said is just a day off €¦. But at the end of lockdown it was more than just one day off.

This is not something new, according to research there is a clear evidence in the increase of weight by more than 500%, when a person goes on holiday.(1)

Reaching to this point, you may just think that this increase of weight (or fat gain) is just temporary and shall be reduced when you go back to your €œnormal life €.

Well then, sorry to say, there is also research highlighting that the fat-mass gained during a period of €œholiday € shall be difficult to shed off, and it is the key point to weight gain in a slow manner over years as people age.

People living in Dubai, during lock-down, have been working from home. We can expect calorie intake to be high along with limited movement or limited activity. Which is very similar to €œHoliday time €. This blog, aims to propose some strategies in order to avoid weight gain during this situation.

It is true, we need to build Self-Control and Motivation to monitor our weight consistently, as we often have less control in what we eat. Most of the patients we encounter are emotional eaters.

So if we put together all these facts together, our actual environment doesn't really help us to maintain or improve our body weight!

What can we do in order to improve our Body Composition during this lock-down?

First, we would like to clarify a myth about body composition:

  • Traditionally, healthy weight was defined as one where there is no risk for the person's health. To determine this, we would use the Body Mass Index (BMI) as a fast and simple way to calculate if a person has a normal, low or high weight in relation to their height. One of the drawbacks is that BMI does not calculate what are the percentages of fat mass, muscle mass, bone mass, fluid or residual tissue.

However today, we can find measuring devices that allow us to know our weight, BMI and our Body Composition, such as bio impedance, or scales as Inbody, Omron, Tanita, etc. In general we can say, that in optimum health conditions:

  • Muscle mass should represent 40% of our weight
  • Bone mass 14%
  • Fat mass 20% (it could be higher in women).

Therefore, in obese cases, fat mass is very high, while muscle mass is low, and it could reach a point of sarcopenia (lack of strength and muscular tissue degeneration). On the other side, a person with malnutrition can have both a reduction in fat and muscle mass.

Obesity, malnutrition and under nutrition are all health-risk conditions. It must be stated strongly that a person's nutritional and energy requirements depend on their body composition, and not just weight, size, age, sex and physical activity.

Here is our advice to improve your Body Composition:(2)

  1. Eat real food and avoid processed food.
  2. Half of your plate should be carbohydrates, such as vegetables, fruits and pasta, rice, potatoes specially on days when you are more physically active.
  3. Protein is a very important macro nutrient and should be about 30 to 35% of your plate. Meats, eggs, white fish and vegetable options (green peas, legumes) will satisfy one's appetite and make you feel full. If you pursue regular weight training, protein consumption per day should be around 2g/kg of your weight. In these circumstances, protein supplements (such as protein shakes, oat porridge with yogurt) is advisable if one cannot reach their daily requirements.
  4. Healthy fats should constitute around 15% of your plate. Good examples are extra virgin olive oil, salmon, avocado.
  5. In addition to that, training should not be forgotten. None of the above will work to improve Body Composition if a training routine is not included. It is preferable to prioritizing strength exercises. If one is unaware, YouTube has many quality channels with exercise routines using own body weight, without additional materials require. This shall help until gyms and personal trainers return. Otherwise contact us and we will set up an exercise program for you.
  6. We should not forget about Stress. There are innumerable strategies on apps, to control stress via meditation, breathing techniques, along with good rest and quality sleep which is essential.

Please note that all of this is general recommendation for the population as a guide, but all treatments and guidelines must be individualized according to one's personal needs. Our priority is individualization being the key for successful results.

Regards,

Elena Naranjo, Physiotherapist & Nutrition Coach at DHTC

Summertime Nutrition Tips

All that abundant sunshine in the summer can cause dry skin and hair, eye damage, and other ailments. Find out which vitamins and minerals can counteract sun damage.Summertime, and the living is easy €" that is, until you notice the havoc all that fun in the sun has wrought on your body. Fortunately, summer also brings an abundance of tasty and nutritious foods, including berries (loaded with  antioxidants), tomatoes, bell peppers (good  vitamin C  source), and protein-filled grilled fish. And by simply choosing the right ones to add to your daily diet, you can help prevent or alleviate the following common hot-weather woes:

Dry or Damaged Skin

What causes it:  You sweat more in the summer, so  skin  is less supple; plus, saltwater and chlorine have a drying effect. Sunburns and  bug bites  are also saboteurs of  healthy skin.

What to eat:Help heal weathered skin with foods like raspberries, blueberries, and strawberries, which are rich in antioxidants and vitamin C. Protein, in the form of lean meats, beans, nuts, and seeds, is also key. Keep dryness at bay by drinking lots of water. Women drink 8-10 cups of water in the summer and men up to 15 cups to prevent  dehydration.

Parched Hair

What causes it: Overexposure to sun, saltwater, and chlorine.

What to eat: Make a three-bean salad or other protein-rich meal because  hair  consists of protein fibers called keratin. Eating foods rich in vitamin B-5 (found in yogurt and California avocadoes), vitamin B-8 (in  liver  and cooked eggs),  folic acid  (in fortified cereals and beans),  calcium  (in yogurt), and zinc (in meat and fish) can reduce  hair loss  and replace dull  hair  with shiny hair. Theses  nutrients  also play a role in maintaining healthy skin.

Muscle Cramps

What causes them: Muscle cramps  result from overexertion and  dehydration. When you don't have enough fluid in your system, it leads to an electrolyte imbalance that causes your muscles to cramp up. Sodium,  calcium, and  potassium  are the main  electrolytes  lost through  sweating  during  exercise.

What to eat:  Drink water. Potassium-rich foods include, raisins, potatoes, and spinach.

Eye Damage

What causes it: Age-related  macular degeneration  is the most common cause of  vision loss  and blindness in people over the age of 55. This occurs when the central part of the retina (macula) becomes damaged.

What to eat: The retina is actually made up of  vitamin A. Thus, foods rich in this vitamin €" along with beta-carotene, zinc, and  Vitamins  C and E €" are beneficial to the  eyes. Good sources are dark green vegetables like kale, chard, and mustard greens, plus bell peppers, carrots, and blueberries.

Cold Sores

What causes them: Sun exposure can trigger  cold sores  in people who are prone to them.

What to eat: The amino acid L-lysine has been shown in some small studies to help, but larger studies are needed to confirm these findings. Deficiency in B  vitamins  and riboflavin can make you susceptible to  cold sores. Taking a B-complex vitamin can help prevent  cold sores.