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Chiropractic News

March 2004

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3-part plan aims for long-lasting patient weight loss

No carb, low carb. No fat, low fat. Overweight Americans who want a quick-fix for their years of overeating and under-exercising are drawn to fad diets as a way to make themselves healthy and slim.

Obesity has a negative effect on the skeletal system and on health: Obesity promotes insulin resistance and leads to diabetes and heart problems.

But crash diets are not the answer to your patients’ weight problems. The goal of a good weight-loss program is to lose body fat — not muscle, since muscle mass dictates metabolism.

Crash and fad diets reduce energy expenditure by 10 percent and encourage muscle and water loss — not fat loss. Since our bodies are programmed to reduce our metabolism during food shortages, when the diet is over, the increase in calories is turned into stored fat, not muscle.

What’s the answer? Since your goal is to keep your patients healthy for a lifetime, recommend a three-part lifestyle weight-loss plan:
• A low glycemic index (GI) diet;
• Exercise; and
• Supplementation

Glycemic index (GI) refers to how fast a food is likely to raise your blood-sugar level. On a scale of 100, the lower the index number, the better. Foods that break down quickly have a higher GI than those that break down more slowly.

Scientific data indicates that a low GI diet appears to promote weight loss more effectively than other types of diets. People who follow this type of diet feel full faster, are more satisfied with what they have eaten and have a better glucose tolerance. And their weight loss is predominantly fat.

Why? Low GI diets prevent our bodies from throwing a metabolic switch that increases fat storage instead of fat burning. High GI foods, on the other hand, can flip a metabolic switch that causes the body to preferentially store protein, fat and carbohydrates rather than promote the oxidation of these nutrients.

A word of caution: Some patients may believe that a diet of low carbohydrates and high protein is healthy. This is not true:

“Low carbohydrate” does not equate to “low glycemic.” If someone fills up (for example) on 30 grams of low carbohydrates by eating foods with high GI, they throw their “metabolic switch” into fat-storage mode, despite eating restricted calories and even restricted carbs.

The result: They don’t lose weight. And a diet that is high in protein and high in fats promotes insulin resistance, lowers the protective HDL cholesterol and raises C-Reactive Protein — a risk factor for coronary artery disease.

The best diet plan to follow — and which can be followed indefinitely — is one that is based on low-to-moderate GI foods, such as meats and fish, most vegetables and salads and even some fruits, as well as the right carbs, such as beans, lentils and sweet potatoes.

Exercise raises the body’s metabolic rate. The best plan to follow is one that targets the change in body composition and preferentially enhances the loss of body fat rather than muscle mass.

Encourage your patients to incorporate exercise into their lifestyle program to significantly improve body composition. Good aerobic exercises include walking, dancing, cycling and climbing steps (stepper machines). Water aerobics is a good alternative for overweight or obese individuals who experience pain when they walk.

Everyone who begins an exercise program should start slowly, with 5-10 minutes of exercise, three times each week and gradually work up to 30-45 minutes, 3-5 times a week. Strength training — which helps preserve and build more muscle — can be added later to further preserve body composition.

Research has shown that a number of dietary supplements can accelerate weight loss when a low GI diet and exercise plan are followed. These supplements can also help improve blood sugar control, metabolism and body composition. And they may also help prevent long periods of “plateauing,” which can be frustrating to dieters. Here are some supplements you may want to recommend to overweight patients:

•  Green tea. Camellia sinensis has a thermogenic effect that increases 24-hour energy expenditure and fat oxidation. Green tea is generally taken as a standardized extract in capsule or tablet form (taken three times daily

before meals) to provide 50 mg of caffeine and 90 mg of epigallocatechin gallate. The small amount of caffeine in green tea is generally insufficient to create adverse side effects.

• Coleus forskohlii. Coleus appears to be thermogenic and may also decrease body fat and preserve muscle mass. Standardized extracts of Coleus generally provide 10 percent of forskolin. That means that if you are taking 500 mg of standardized coleus it will provide 50 mg of the active compound forskolin, which releases fatty acids from adipose tissue storage.

• Citrus aurantium. This herb, which has a long history in Traditional Chinese Medicine, yields a standardized extract known as Synephrine. Synephrine has thermogenic properties, but does not cause the stimulant side effects associated with ephedrine or large amounts of caffeine. An effective dose of citrus aurantium would be 975-1000 mg, standardized to provide 6 percent of the active amines.

• Chromium. Chromium is an essential mineral for glucose tolerance. It improves glucose tolerance and insulin resistance and lowers elevated blood sugar levels. It may also improve blood levels of cholesterol, triglycerides and HDL cholesterol. Chromium can blunt the rise in blood sugar when a high GI carbohydrate is consumed and help prevent the metabolic switch from going into fat storage mode.

Chromium is available in many forms, including: polynicotinate, dinicotinate, and GTF. Human studies using 400-1000 mcg of chromium have yielded better blood sugar lowering results than when lower doses are used. What also makes chromium interesting is that it shifts weight loss to favor body fat and preserve muscle mass — the very thing we want to achieve with a total program.

• Glucosol. Glucosol is an herbal extract from the herb Lagerstroemia speciosa. The active ingredient, corosolic acid, is responsible for its blood sugar lowering and normalizing effect. Both animal and human studies have shown that Glucosol improves glucose tolerance, lowers serum blood sugar levels and improves insulin resistance, much like chromium. Glucosol can stop the rise in blood sugar and insulin associated with high glycemic index foods. In some of the studies, a modest weight reduction occurred without the use of a restricted diet.

• 5-Hydroxytryptophan. 5-hydroxytryptophan (5-HTP) increases brain serotonin levels, which have an inhibitory effect on eating behavior and help curb appetite. Studies have shown that carbohydrate intake may decrease by as much as 50 percent when 5-HTP is given without dietary restriction and it also has an appetite suppressant effect in very overweight, obese and diabetic patients. Other benefits of 5-HTP administration may include significant improvement in depression, insomnia, fibromyalgia and chronic headaches when taken as 50-300 mg three times daily.

• Phaseolamin. This is a non-stimulant, all-natural nutritional ingredient that is derived from the white kidney bean. Preliminary research has demonstrated that it neutralizes the enzyme alpha amylase before it can digest starch into glucose.

Phaseolamin allows some of the starch in foods such as potatoes, breads, pasta, rice, corn and crackers to pass safely through the body without being digested or absorbed.

A low GI diet can be followed indefinitely and helps correct many of the metabolic alterations that overweight and obese people must overcome. When combined with exercise and specific dietary supplements, you will achieve better results and better patient compliance. That translates into better patient flow and referrals.

Dr. Shari Lieberman earned her PhD in Clinical Nutrition and Exercise Physiology from The Union Institute and her MS degree in nutrition, food science and dietetics from New York University. She is the author of several books on nutrition, including The Real Vitamin & Mineral Book and Dare to Lose: 4 Simple Steps to a Better Body. She can be contacted through her Web site, www.

Editor's note: Weight loss is a well-researched area. If you would like to find out more on this subject, check the selected references Dr. Shari Lieberman used for this article. Go to and click on Bonus Articles.

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