We have a problem. 45 million Americans go on a diet each year.
Yet rates of overweight and obesity continue to soar.
60% of Australian adults are overweight or obese. There are more adults that are overweight and obese than those who are not.
This creates a massive threat to the nation's health, as you can see from the infographic below.
So it is clear that something needs to be done about this impending health crisis that threatens most of the western world.
Put (very) simply, obesity is caused by a mis-match between energy intake and energy expenditure.* Now, in order to lose weight, we need to redress this balance between energy intake and expenditure, This can be achieved by either;
1. Reducing energy intake (eat fewer calories), or
2. increasing energy expenditure (by moving more and exercising), or
3. A combination of both.
This article is going to look specifically at the energy intake side of the equation, since this is the most effective way to deal with this imbalance.
So, if weight loss is the goal, a sustainable calorie deficit needs to be created. The most important word in that sentence is sustainable. Below, I want to look at the factors that will enable you to be successful at implementing a diet, and sustainability lies at the heart of this.
But first, some definitions:
“the amount of energy required to raise the temperature of 1 gram of water by 1 degree celcius at the pressure of one atmosphere” - or, put simply, a way of measuring how much energy there is in food.
"The kinds of food that a person, animal, or community habitually eats." (Oxford Dictionary)
I want you to stop thinking about diets as things you 'go on' or 'off'. A diet is simply your habitual eating pattern. It's what you consume day in, day out, week in, week out, year in, year out. It isn't 12 weeks long. It lasts your lifetime.
A state whereby you are expending more energy than you are consuming. A calorie deficit is absolutely essential to successful weight loss. If you are not losing any weight (fat), chances are you are not in a calorie deficit.
“the body will NOT have any need to tap into stored body fat unless the individual is burning more calories than they are taking in” (Lyle McDonald)
The more overweight you are, the more aggressive you can be with your calorie deficit. As you get increasingly lean, it would be better to be more conservative. Here is a very rough guide: -
Obese: Can create a deficit of anywhere up to 50%. That is, if their baseline calorie intake is 2,000 calories, then a 50% reduction can be utilised (at least initially - see Factor 1 below).
Overweight: Use deficits anywhere from 15-30% of baseline calorie intake
Leaner Individuals: Use deficits anywhere from 5-15% of baseline calorie intake
Nutrients your body requires in large amounts. There are 4 to consider here: -
1) Protein - Contains 4 calories per gram, but can be considered the least energy dense of the macronutrients as it takes more energy to break protein down by the body than any other macronutrient.
2) Carbohydrates - Also contains 4 calories per gram.
3) Fat - Contains 9 calories per gram and so is the most energy dense of the macronutrients.
4) Alcohol - Not required by your body, but is considered a macronutrient. Alcohol contains 7 calories per gram
So, how can you create a diet that is actually going to be successful?
Here are the most important factors you must consider.
Factor 1: Rapid Initial Fat Loss (In the overweight and obese)
Yep, we've all been told that 'slow and steady wins the race'. Normally I would agree. That is unless you are talking about overweight or obese individuals seeking to lose weight. In this case, aggressive calorie deficits resulting in more rapid weight loss has been found to be a more successful way of dieting than a more moderate and slow approach.
Nackers et al (2010) divided participants in their study into 3 groups: a fast, moderate and slow weight loss group.
Average weight loss after 6 months was as follows: -
Fast Group: 13.5kg
Moderate Group: 8.9kg
Slow Group: 5.1kg
They then followed up with the groups after 18 months, with the following results: -
Fast group: 10.9kg
Moderate Group: 7.1kg
Slow Group: 3.7kg
The authors of the study conclude:
"Large initial weight losses and the related positive quality of life changes may serve as reinforcers, increasing healthy behaviors and healthy habit learning. This in turn may lead to successful weight loss and maintenance." (Nackers et al, 2010)
Contrary to what is commonly believed, losing weight faster did not result in greater susceptibility to weight re-gain.
So, if you have more weight to lose, it might be beneficial to lose weight at a quicker rate initially, which serves to reinforce these new behaviours and increase motivation.
Factor 2: Individualise Macronutrient Ratios
“Most practitioners are emotionally wedded to a particular diet paradigm, and this includes relative proportions of the macronutrients. Some folks cannot stand the idea of anyone eating high-carb/low-fat, and vice versa. This common proclivity must be ditched in order to program the diet properly” (Alan Aragon)
People like to get dogmatic about macronutrients, especially around the intake of carbohydrate and fat. However, unless you have some kind of performance goals (you play sport to a high level), then the amount of carbohydrate and fat in your diet doesn't matter a great deal (provided you are eating the correct number of calories).
This was recently confirmed by the DIETFITS study conducted by Gardner et al (2018) who assigned a group of 609 people either a healthy low-fat (HLF) or healthy low-carbohydrate diet (HLC). At the end of the 12 months there was no significant difference in weight loss between the two groups despite very different macronutrient intakes.
"With the large sample size, good retention, substantial weight loss and weight loss variability, and good adherence to and differentiation of diets, the study was well positioned to detect significant interactions by the primary variables of interest if they existed. However, no such effects were observed. Differences in weight loss between the 2 groups were nonsignificant and not clinically meaningful." (Gardner, et al, 2018)
The up-shot of the results from this study are that, provided the correct intake of calories and an adequate intake of protein, the distribution of carbohydrates and fats is more a factor of one's personal preference and what will be more sustainable to the individual in the long-term.
Another point to bear in mind here is that macronutrient distribution doesn't need to remain static across the week. There is no reason why you can't make some days higher in carbohydrates (and subsequently lower in fat) and vice versa. For example, if weekends involve more socialising and eating out, then it might be easier to change the macronutrient distribution on these days.
There is, however, little argument about the importance of protein & how much protein we need to consume if weight loss (and improved body composition is the goal).
Recommendations are for protein intakes of between 1.6g of protein per kg of bodyweight at the lower end, and 2.2g per kg at the higher end. So, for a 70kg individual this would mean a daily protein intake of anywhere from 112g to 154g. Ideally this would be spread relatively evenly across the day.
For the average person this is usually more than they would normally be consuming. Recent data suggests that the average man is consuming 1.1g/kg and women 0.9g/kg.
So, an obvious starting point for most would be to increase the amount of protein you consume on a daily basis. This will have the effect of: -
1) Improving satiety - Protein keeps you feeling fuller for longer. This is absolutely crucial for those in a calorie deficit.
2) Improving Recovery from Training/Exercise: If you include resistance training into your weight loss plan (which I recommend you do), the protein will help your body recovery from the stress training places upon it.
3) Increase the number of calories your body expends - Protein has the highest thermic effect of feeding. In other words, your body uses more energy to break down protein than any of the other macronutrients. Whilst only a small number, this still helps to the overall energy balance equation.
4) Reduce the chance of muscle loss - Creating a calorie deficit can increase the chance of your body using muscle tissue for fuel through the process of gluconeogenesis. This can be avoided to a large extent by eating an adequate amount of protein. Preserving muscle mass should be the goal of anyone seeking to lose weight.
Factor 3: Allow for Variation within a Healthy Framework
Given that sustainability of a diet is absolutely crucial for long term success, it is important that the dieter actually enjoys eating (at least some) of the food they are consuming. A question I always ask clients is if they have any foods they dislike eating. For me, it is crucial to find foods that are enjoyable to eat.
Aragon (2018) divides foods into the following groups and I had provided just some of the foods available in each group: -
Proteins: Chicken, eggs, turkey, beef, lamb, duck, kangaroo, pork, soy, tempeh, whey protein, pea protein, salmon, cod, barramundi, trout, prawns, sardines
Fat: Olive oil, coconut oil, macadamias, almonds, cashews, avocado, sunflower seeds, pumpkin seeds, flaxseed, fatty cuts of meat, fatty fish
Fibrous Veggies: Broccoli, cauliflower, zucchini, green beans, carrots, mange tout, brussels sprouts, asparagus, artichoke, mushrooms, spinach, cabbage, bok choy, peas, kale and the list goes on...
Starch: Potato, sweet potato, pumpkin, bread, pasta, brown rice, oats, rye, barley, quinoa, buckwheat, parsnip, corn
Dairy: Milk, butter, quark, cottage cheese, cheese, yoghurt, casein, cream, creme fraiche, sour cream, whey
Fruit: Apple, orange, plum, blueberries, strawberries, nectarines, banana, apricot, coconut, date, dragonfruit, papaya, pineapple, melon, mango, pear and the list goes on.
So, as you can see, dieting is not just about eating chicken and broccoli every day. Don't like chicken? That's totally fine, select protein sources that you do enjoy eating. Find broccoli detestable? So do most people! Try other vegetables instead.
However, what needs to be underscored here is that we are talking about a variety within a healthy framework of food. Any successful weight loss diet is going to involve the restriction and minimising of foods that I would describe as 'non-optimal'. These foods would have one or more of the following characteristics: -
- Highly refined or processed (the food is a long way from it's natural state)
- Calorie dense
- High in sugar
- Containing trans fats
Examples of the above would include 'junk' foods (pizzas, burgers, donuts, hot dogs, chocolate bars, sweets, cakes etc). What I am not saying is that these foods can never be consumed. What I am saying is that they are going to have to be limited.
Factor 4: Consider Undulating Calorie Intakes as you get leaner
Once you understand how many calories you need to be consuming to elicit the weight loss you desire, it may become beneficial to undulate your calorie intake across the week. For example, one easy way to do this is to have a slightly higher calorie intake on days that you exercise, and a lower intake on days that you don't. So for someone training 4 days per week, a week might look like this:
Monday (Training): 2,400 Calories
Tuesday (Rest): 2,000 Calories
Wednesday (Training): 2,400 Calories
Thursday (Training): 2,400 Calories
Friday: (Rest): 2,000 calories
Saturday (Training): 2,400 Calories
Sunday (Rest): 2,000 Calories
Or, for someone who does a lot of socialising at weekends, they may favour a distribution like the following: -
In both examples, the weekly calorie total is 15,600. The only thing that differs is the distribution of these calories. Don't get caught up in the mindset that calories need to remain the same every day. You can change the daily amount to match your lifestyle. The most important thing to consider is the weekly total.
There are a number of benefits to using this kind of method: -
- Breaks the monotony of eating the same amount of food/calories every day
- Can make the diet work with your lifestyle a bit easier. For example, you could keep calories lower during the week to allow for some socialising at the weekend
- Psychologically makes it seem as if you aren't dieting on higher calorie days
- As you get leaner the high calorie days may actually be a calorie surplus, meaning you don't have to be in a calorie deficit every day
Factor 5: Ditch Binary Thinking
Binary thinking involves seeing things as an either/or. Good or bad. Healthy or unhealthy. I have written about this previously - find the article here.
The problem with binary thinking is that it doesn't work well with nuanced areas in life. Nutrition is one such area. There are no inherently bad foods. Context is always king. For example:
Client: "Chocolate is bad right?"
Me: "Well..... I would be inclined to agree for the most part, but.... What type of chocolate? How much are you eating? What are your goals? How often are you eating it? Do you feel guilty when eating it?"
Client: "1 square of dark chocolate 2 times per week. My goal is to increase muscle mass and the dark chocolate helps keep my cravings for milk chocolate at bay"
As you can see from the scenario given above, eating chocolate is not necessarily a bad thing. It is always context specific.
In order to succeed at dieting you have to try and ditch the binary thought process and understand that it is far more complex than good foods vs bad foods. Thinking in a binary manner will immediately give rise to thoughts of guilt and failure if you eat any food you deem to be 'bad'. However, if you can understand that there are no bad foods per se, and that one meal in the context of your week is not enough to completely un-do all your hard work then you will be less incline to give up.
Factor 6: Take Diet Breaks
The inability to maintain weight loss long-term is the major problem in the treatment of obesity. Maximal weight loss is typically achieved at 6 months, followed by weight regain (Wing & Jeffery, 2012). Utilising diet breaks can help achieve more long-lasting weight loss.
A 'Diet Break' can be considered a period of time when you aren't following a rigid diet and have far greater autonomy and freedom with regard to food choices and eating patterns. Diet breaks can be both planned (i.e. dieting for a set period of time with a diet break planned after a period of time) or unplanned (you have to travel for work for several weeks making the maintenance of your current diet almost impossible).
Typically the diet break would last around 14 days and serves both psychological and physiological needs: -
- Breaks your dieting efforts into smaller, more manageable chunks
- Allow for greater sustainability in the long-term
- Haven't got to be in a calorie deficit all the time
- Help to reverse some of the body's negative adaptations to being in a calorie deficit for extended periods of time. For more on the body's adaptations to dieting, see here.
"Many people won’t even classify what they have been doing as dieting since they are no longer losing weight. They consider the restriction “eating healthy”. The truth is, eating healthy for your body and sanity involves some breaks, indulgences, treats, and balance. Restriction should be restricted (see what I did there?) to brief periods of weight change followed again by periods of balance." (Renaissance Periodisation)
During the diet break, as well as bringing your calorie intake up to maintenance levels, it is also advisable to bring carbohydrate up to a minimum of 100g per day to up-regulate thyroid hormone leptin levels, both of which are crucial to your metabolism (McDonald, 2005).
Breaks should be taken more frequently the leaner you get. As a general rule of thumb: -
Guys Under 10%/Females Under 15% - every 4-6 weeks
Guys 10-15%/Females 20-15% - every 6-8 weeks
Guys 15-20%/Females 25-20% - every 10-12 weeks
"Sometimes the longer road is the road to sustainable results.... Breaks are needed between bouts of hard work and change in almost every instance of life and diet is no exception."
So, To Conclude...
As rates of obesity continue to soar, there is clearly a need for a re-think about how we approach dieting. It is my contention that a diet is for life, not just before a holiday! A diet is not something you start and stop. It relates to your daily nutritional habits and patterns over a lifetime.
Viewed in this context we need to approach dieting with sustainability and adherence at the forefront of our minds, In my view, there are 5 key ways we can become more successful at dieting for weight loss: -
- Be aggressive with weight loss if overweight or obese - early weight loss success will be a reinforcer, increasing healthy behaviours and habit formation, leading to successful weight loss in the long-term (Nackers et al, 2010).
- Individualise Macronutrient Intake to suit your preferences - The DIETFITS study (Gardner et al, 2018) clearly demonstrates both low-fat and low-carb approaches can be equally successful for weight loss.
- Allow for Variation within a healthy framework - Minimise junk food and maximise variety within more optimal food choices
- Undulate Calorie Intake Across the Week - Linear approaches to dieting work in the long run, but as you get leaner you may want to consider changing the distribution of calories across the week to suit your lifestyle
- Ditch Binary Thinking
- Take a Diet Break
So, if you find yourself constantly yo-yoing in weight, or hopping from one overly-restrictive diet to the next, maybe it's time for a re-think on how you approach dieting.
*I know this is a gross over-simplification. To read more on obesity and its many causes, read here.