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Calorie Restriction: Why There's More To It Than Simply Weight Loss

Regardless of what you are told, the only way to lose excess body fat is to eat fewer calories.  I have long talked about the benefits of calorie restriction as a way to improve your cardiovascular health thereby improving your healthspan as well. (1-3).  A recent analysis of CALERIE (Comprehensive Assessment of Long term Effects of Reducing Intake of Energy), a study looking at two years of prolonged caloric restriction in healthy individuals, found this to be true in “normal weight” subjects (4).  I say “normal weight” because although their average BMI was 25, their percent body fat was 33 per cent which is considered to be obese (greater than 25 percent for males and greater than 32 per cent for females).  Although they tried to reduce their calorie intake by 25 percent for the two-year study, the best they could achieve was about  12 per cent.  This means the calorie-restricted group was eating about 300 fewer calories per day for two years.

            A couple of surprising things from the study.  First, nearly all the change in weight took place in the first six months with very little change in the next 18 months even with continued calorie restriction.  This is typical of most controlled calorie-restriction programs like the long-term Pounds Lost studies at Harvard (5).  Likewise, it appeared that most of loss of body fat happened in this same time period.  At the 12 month mark, individuals had lost on average 13 pounds of fat, but more than 10 pounds of muscle mass.  The loss of body fat was due to the restriction of calories, but the loss of muscle mass was due to protein restriction. Total protein intake went from an average of 102 grams of protein per day to 89 grams of protein per day.  At 24 months, muscle mass hadn’t been regained, but individuals had gained back about 2 pounds of fat.  Although the calorie-restricted group had lower insulin levels, the change in their fasting glucose levels was virtually the same as the control group.  This is because muscle is the primary site for taking glucose out of the blood, and if you lose muscle mass, then glucose levels in the blood don’t go down even though you are consuming fewer calories.

            Nonetheless, those in the calorie-restricted group did see their blood pressure and blood lipids decreased.  However, all of these changes occurred in the first year with virtually no changes in the second year of the study.  The only parameter that continued to change in the second year compared to the first year was a continued reduction in inflammation as measured by C-reactive protein.  What this means is that most of any weight loss, fat loss, reduction in blood pressure, blood lipids, as well as blood glucose levels are all likely to take place in the first six months of any calorie restriction program. That’s not encouraging news.  But the continued drop in inflammation with calorie restriction is great news because that is the real cause of both a decreased healthspan as well as lifespan.

            This is why Zone Pro-Resolution Nutrition offers an even greater potential for health care in the future.  The Zone Diet is a calorie-restricted diet, but unlike the CALERIE study the Zone Diet contains adequate protein to not only maintain muscle mass, but also to improve satiety.  However, as we have shown clinically, when using the new generation of Zone Protein as a significant source of your total protein, you gain muscle mass instead of losing it (6).  But the real  benefit of following the Zone Diet for a lifetime is the continued reduction of inflammation that can be greatly accelerated by the addition of high-dose omega-3 fatty acids to speed up the resolution of any existing inflammation.  Finally, by adding high-dose polyphenols, you can further active the gene transcription factor AMPK that repairs tissue damaged by inflammation. All of this is detailed in my new book, The Resolution Zone, that will be available shortly (7).

           Increasing your intake of omega-3 fatty acids and polyphenols (along with calorie restriction) can also help you finally reach the Zone. Once you're in the Zone, then you know you have done everything possible to optimize your body’s internal Resolution Response which is  the real key to future of medicine.

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References

  1. Sears B. The Zone.  Regan Books.  New York, NY (1995)
  2. Sears B. The Anti-aging Zone.  Regan Books.  New York, NY (1999)
  3. Sears B. The Anti-Inflammation Zone. Regan Books. New York, NY (2005)
  4. Kraus WE et al. “2 years of calorie restriction and cardiometabolic risk.”  Lancet Diabetes Endocrinol DOI.org:  10.1016S2213-8587(19)30151-2 (2019)
  5. Bray GA et al. “Lessons learned from the POUNDS Lost study: genetic, metabolic, and behavioral factors affecting changes in body weight, body composition, and cardiometabolic risk.”  Curr Obes Rep. 8: 262-283 (2019)
  6. Johnston CS et al. “Use of novel high-protein functional food products as part of a calorie-restricted diet to reduce insulin resistance and increase lean body mass in adults: A Randomized controlled trial.  Nutrients 9: E1182 (2017)  
  7. Sears B. The Resolution Zone:  The Science of the Resolution Response.  Zone Press.  Palm City, FL (2019)

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022724---Weight-Loss-Blog

Dr. Sears Q&A: Weight Loss

With so much interest in weight loss and so much buzz around weight loss drugs, we put together some of the top questions we get in this latest Q&A blog. Here Dr. Sears answers your questions on weight loss, weight loss drugs and what he thinks is the most scientifically backed way to lose weight. See what he has to say.Question: What medical conditions could impede weight loss, and how can they be identified?  Answer:  Any condition associated with insulin resistance will make it difficult to lose weight.  This would include diabetes, heart disease, neurological disease, etc.  Also, any drug that induces insulin resistance will also make it difficult to lose weight.  These include corticosteroids and many neurological drugs. Question: How do hormones affect weight loss, and which imbalances are most detrimental? Answer: High levels of insulin (caused by insulin resistance), high levels of cortisol (caused by stress), and low levels of satiety hormones such as GLP-1 will make weight loss difficult. Question: Is there a connection between sleep quality and weight loss? Answer: Poor quality sleep increases cortisol levels that lead to insulin resistance. The higher your level of insulin resistance, the more difficult it is for any organ to remove glucose from the blood for transport into the cell, where it can be converted to energy. This i Question: Do any weight loss supplements work?  Answer: Not really. You have to restrict calories to activate AMPK which causes your body to effectively burn excess stored body fat.   Question: What medications are FDA approved for weight loss? Answer: There are number of approved older drugs, but the most widely used is still an old drug (Phentermine) that was only recently approved for long-term use. However, the new injectable GLP-1 receptor agonists are more powerful and more popular. The scientific name for the most well-known injectable weight-loss drug is semaglutide, which is marketed under the tradenames Ozempic and Wegovy. In simple terms, these injectable drugs activate the release of the hormone GLP-1 from the gut that goes directly to the brain to tell you to stop eating. These drugs were initially developed to treat type 2 diabetes, but the clinical studies in overweight and obese individuals demonstrated significant weight loss at higher levels. Question: What are the unintended side effects of weight loss medications (i.e. GLP-1s, dual GIP/GLP-1). Answer: One major problem is that the lack of hunger caused by the drug makes you less likely to consume sufficient protein to maintain lean body mass.  Lean body mass is defined as functional tissue such as organs (including the brain) and bone.  Nearly 40 percent of the weight loss in obese patients comes from loss of lean body mass.  Without adequate protein (especially on a diet that is calorie-restricted because of lack of hunger), the replacement of damaged cells is compromised.  The skin and hair are the first site to suffer.  This lack of protein also makes it difficult to maintain mitochondrial function that provides energy for each of your 30 trillion cells. As a result, fatigue (both mental and physical) is often experienced. Question: Would you recommend an injectable weight loss drug? Answer: The answer is no. There is a big difference between weight loss and fat loss. Weight loss is the combined loss of stored body fat and lean body mass (i.e., muscle). You want to lose fat but not muscle. Although the weight loss using weekly semaglutide injections is impressive according to the literature, a deeper look shows that about 40 percent of that weight loss is due to loss of lean body mass. That is not a good sign. It suggests that the injections reduce hunger to the extent that the person has little desire to eat enough protein to maintain muscle mass. In essence, the drug increases the patients' sarcopenia (muscle loss). One of the consequences of sarcopenia is increased frailty. Also once you stop using these weight loss drugs, the weight quickly returns. Question: Does a high protein diet help with weight loss? Answer: Most high protein diets are ketogenic diets that disrupt metabolism in addition to being high fat.  The appropriate diet is protein-adequate (about 30 grams of protein at each meal), carbohydrate-moderate (primarily non-starchy vegetables, low-fat (to reduce calories) and rich in fermentable fiber.  The common name for such a diet is the Zone diet. The ideal amount of protein at each meal for weight loss is about 30 grams. Less than 30 grams of protein at meal will not generate the hormonal signals from the gut to stop hunger. Too much protein at meal, greater than 30 grams, will inhibit AMPK activity which helps cells burn excess stored fat.  

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020524-Winter-E-Newsletter-Blog-4

Aging: Can You Slow It Down?

The first few weeks of the New Year are often focused on the resolve to lose weight, when in actuality people should focus their goals on slowing down aging, no matter the time of year. The only regimen that clinically achieves results in slowing the aging process is calorie restriction without malnutrition. Why? It’s not simply losing weight but orchestrating the complex interplay of reducing senescent cells, reprograming your metabolism, and changing gene expression, leading to a longer and better life.   A Timeline of Calorie Restriction   The first recorded human experiments with calorie restriction began with the written books of Luigi Cornaro in the 16th century, as I outlined in my book The Anti-Aging Zone, published in 1999. However, the molecular mechanisms of why calorie restriction is so effective required more recent breakthroughs in metabolism and epigenetics that were confirmed with the CALERIE study that carefully controlled the diets of 225 participants over two years and then ongoing testing of their retained blood samples.     The results of the CALERIE study have been impressive. However, the one clear take-home lesson was that reduction of insulin resistance was the most predictive blood marker correlated with the genetic changes and the decrease in senescent cells that ultimately accelerate aging.   The Zone on Calorie Restriction   The Zone diet is a calorie-restricted diet that was patented to reduce insulin resistance. It requires balancing macronutrients at each meal to generate the rapid hormonal changes that give rise to satiety. Only then can you follow calorie restriction for a lifetime without hunger and fatigue. It starts with having enough protein at each meal to create satiety in the brain's appetite control center. You need about 30 grams of protein (no more, but no less) at each meal to generate the same hormonal responses induced by the recent injectable weight loss drugs. However, you also must balance that protein with an adequate level of low-glycemic carbohydrates (about 40 grams) to stabilize blood glucose levels, and then add a dash of monounsaturated fat (about 15 grams). Over the years, it has been demonstrated by more than 40 research publications that the Zone diet is superior to ketogenic diets and the Mediterranean diet under controlled clinical research.    A New Technology to Slow Down Aging  Unfortunately, many people think the Zone diet requires too much thinking.  That’s why I developed Zone Foods to overcome that problem. The first generation of Zone Foods demonstrated dramatic reductions in insulin resistance compared to a control group, getting an equal number of calories (1). The second generation of Zone Foods offers greater variety and even more appetite suppression without thinking. This second generation will include new and improved versions of the Zone Pasta and Zone Bars, with new additions of Zone Muffins, Zone Oatmeal, Zone Granola, Zone Soups, and Zone Cookies (coming soon!). Each Zone Food contains 15 grams of protein, balanced with the appropriate level of low-glycemic carbohydrates, so any combination of two Zone Foods will provide the critical 30 grams of protein at a meal to stop hunger and maintain peak mental awareness for the next five hours. The growing variety of Zone Foods makes following the Zone diet incredibly easy. If you are never hungry, that indicates that you are reducing insulin resistance. The long-term benefit to you is slowing aging, which is only possible with lifelong use of Metabolic Engineering that starts with the Zone diet as its foundation. You May Also Like: Reaching the Zone Using Metabolic Engineering

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