Sunday, December 29, 2013

Is this the best diet to promote fat-loss, keep it off, and stay healthy? by Jerry Brainum


Although dieting is never easy, it's nonetheless a truism that it's easier to take weight off, compared to keeping it off.With most dieters, 97 percent of lost weight, especially body fat, quickly returns when the stringent dieting ends. This is particularly true if there is no exercise component, since a rapid weight-loss promotes changes in the body that result in a lowered resting metabolic rate (RMR). The lowered RMR of often ascribed to a loss of lean mass, mainly muscle, that results from a low calorie intake in the absence of exercise. Adding additional protein when calories or carbohydrates are curtailed is absolutely essential for aiding in the retention of lean mass, and is a mistake commonly made by uninformed dieters.
   Keeping lost weight off is difficult because of several factors. First is the aforementioned drop in resting metabolic rate, which means that fewer calories are burned at rest. Thus, if you experience a drop in RME resulting from an extended low calorie intake and low protein intake, combined with lack of resistance exercise, you will quickly regain lost weight when you consume more calories after the diet ends. Dieting also tends to produce changes in some hormones related to appetite control. For example, leptin and insulin resistance,both of which can adversely affect appetite control through an upregulation of  other factors related to appetite,such as a gut hormone called ghrelin, which is the most appetite-boosting substance of all.
     But there may be some hope after all for all those dieters who have lost, but regained body fat. A group of Italian and Greek researchers devised a phased dieting system that takes advantages of two of the best known eating plans: the ketogenic and low carbohydrate diet, and the Mediterranean diet. What they did is manipulate some of the disadvantages of the diets so as to produce maximal compliance with the eating plans. This is a major problem, since most diets fail because people either become bored with them, or are too hungry to continue. The system advocated by these researchers is similar to the type of training suggested by most exercise scientists:periodization, which involves dividing training into phases, where minor changes are made, such as heavier or lighter weights, more sets, less sets, and so on.
    The most effective fat-loss diet for the majority of obese people is the ketogenic diet, which involves a near deletion of carbohydrates from the diet. The popular Dr.Atkins diet also starts with a ketogenic diet, and for good reason. The initial weight loss on such diets consists largely of water, but also includes body fat. However, the loss of water provides an initial psychological boost because of the obvious rapid weight-loss. This phase of the diet also prepares the body for conversion from a largely sugar-burning machine into a fat-burning machine. Very low or ketogenic diets have often been wrongly criticized because of the increase of ketones that occur during the diet. In fact, the rise of ketones during the diet is never dangerous, and isn't comparable to that which occurs during uncontrolled diabetes. Ketones, which are intermediate byproducts of fat metabolism, even provide a number of dieting advantages. They blunt appetite, and can also be used in place of carbohydrates as an energy source. Ketones also provide anti-catabolic effects in muscle, and thus help preserve vital muscle mass under dieting conditions.Ketogenic diets are characterized by a total carbohydrate intake of no more than 50 grams a day. Interestingly, a recent study found that using a ketogenic eating plan immediately following another diet will completely prevent the rise in appetite-stimulating hormones such as ghrelin that normally occurs at the end of a diet, and is chiefly responsible for dieting failures. Dieting success, in contrast, is defined as losing 10 percent of bodyweight, and keeping it off for at least a year after the diet ends.
    The protocol suggested by the scientists consisted of the following:
1) Initial 20 days of very low carb ketogenic diet
2) 20 days of low-carb, but not ketogenic diet
3) Four months of normal caloric intake Mediterranean diet (MD)
4) A second 20-day ketogenic diet phase
5) A second 20-day low carb, not ketogenic diet phase
6) Final 6 months of normal calorie Med diet
     During the ketogenic diet phase, food was limited to beef and veal, poultry, fish, raw and cooked green vegetables (no restriction), dried beef, cured ham, eggs, and some cheese. Drinks permitted were infusion tea, moka coffee, and herbal teas. No alcohol, bread, pasta, rice, milk, yogurt, or other carb sources were permitted during this phase.The subjects were also provided with packaged specialty meals, rich in protein (18 grams per portion) and fiber, but devoid of carbs. To prevent the common side effects that sometimes occur with ketogenic diets, such as fatigue, the subjects also ingested herbal extracts, which are listed below. Thus, the addition of both fiber and the herbal extracts prevented the most common side effects of the ketogenic diet, which encouraged compliance. They also ingested a very weak vitamin and mineral formula, taken once daily.
    With the Mediterranean phase, the subjects consumed a diet composed mainly of whole grains,potatoes, meat, fish, eggs, poultry, vegetables, legumes, fruit, olive oil, whole milk, and red wine.The nutrient intake of this phase was 58% carbs;15% protein, and 27% fat. With the ketogenic phase, the average carb intake was 30 grams a day, with 12% total carb intake;36% protein; and 52% fat. When consuming the low carb phase following the ketogenic phase, the nutrient content was 25% carb;31% protein, and 44% fat. The subjects consisted of 89 male and female obese people, age range of 25 to 65, all healthy but overweight. This diet plan lasted for a year, and at the end, 88.25% of the subjects lost an average of 10% body fat. In the 8 subjects who failed to comply, it was found that they had abandoned the phase protocol and returned to eating high sugar/fat junk foods.Other changes in the dieters who did complete the course included decreases in cholesterol levels, LDL, triglycerides, and glucose levels. No adverse changes occurred in liver or kidney function.  
    Thus, this phase dieting resulted in a high compliance rate,, and a significant improvement in various health measures.By combining the advantages of the proven fat-loss capabilities of the ketogenic and low carb plans with the noted health benefits of the Mediterranean diet, which is the only diet associated with increased longevity, this plan seems to have captured the best of both worlds: rapid and safe fat loss and increased health and vitality.

Paoli, A et al. Long term successful weight loss with a combination biphasic ketogenic Mediterranean diet and Mediterranean diet maintenance protocol.Nutrition 2013;5:5205-5217.



 Plant extracts used in KEMEPHY (ketogenic Mediterranean with phytoextracts) diet
Plant extracts
Week
1-3
Week
4-6
Composition
Extracts A, ml/
day
20 20 Durvillea antarctica, black radish, mint, liquorice, artichoke, horsetail, burdock, dandelion, rhubarb, gentian,
lemon balm, chinaroot, juniper, spear grass, elder, fucus, anise, parsley, bearberry, horehound
Extracts B, ml/
day
20 20 Serenoa, Red clover, Chervil, Bean, Elder, Dandelion, Uncaria, Equisetum, Horehound, Rosemary
Extracts C, ml/
day
50 50 Horsetail, asparagus, birch, cypress, couch grass, corn, dandelion, grape, fennel, elder, rosehip, anise
Extracts D, ml/
day
(only weeks 1
and 2)
40 0 Eleuthero, eurycoma longifolia, ginseng, corn, miura puama, grape, guaranĂ , arabic coffee, ginger

.Main actives ingredients of used phytoextracts, their reported beneficial effects
Extract Main Active ingredients Reported beneficial effects
Refs
A Mint
black radish
burdock
- indigestion
- antioxidant
- choleretic, increases bile secretion helping digestion
[69]
[70]
B Serenoa Repens (saw
palmetto)
hormonal regulating effects
[71]
White bean
alpha-amylase inhibitory properties and has been reported to aid weight loss and glycemic control [72]
[73]
C Equisetum
Antioxidant
diuretic
glycemic control

Dandelion (Taraxacum
officinale
diuretic

D Ginseng
Miura Puama
GuaranĂ 
Ameliorate the commonly reported symptoms of weakness and tiredness during first phase of ketosis (1-2 weeks).


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