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Say NO to Fad diets

Introduction  

The world is in the grip of an obesity epidemic; additionally, a “fad diet” industry has arisen. Worldwide obesity has tripled since 1975. It is a chronic and multifactorial disease and one of the most important causes of morbidity and premature mortality worldwide. In my post, Is obesity a disease or risk factor for other conditions? I had discussed the magnitude of obesity and had also highlighted that today most of the major international and national health organisations, including the World Health Organization (WHO), World Obesity Federation, and American Medical Association recognise obesity as a disease. In my post, Childhood obesity: a serious public health challenge and Complications of obesity: the mother of all diseases, I had discussed the health implications of obesity.

The image depicts fronts covers of various diet books with a caption 'Say No to Fad Diets'.
Some popular fad diets.

In my post Diet Plan for Weight Loss – It is going to be a journey, I had discussed in detail, the dietary interventions for the management of obesity. However, in general, our beliefs about food are highly irrational and when we are struggling with weight, we want a magic pill, or in the least, a diet plan for weight loss that’s a functional equivalent of a pill. In my post Diet Plan for Weight Loss, referred to above, I had discussed the issue of weight loss and regain and had highlighted that due to the strong physiological tendency to regain weight, long-term weight loss maintenance remains the main challenge of obesity treatment. Another important aspect that I had discussed in this post was the dramatic disparity between the patient’s expectations from a weight loss regimen and the professional recommendations or reasonable weight loss that can be accomplished and maintained in most cases. The patient’s frustration and anxiety arising as a result of the gulf between the patient’s unrealistic expectations and professional recommendations have been exploited up to the hilt by the dieting industry.

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Keto Diet – Debunking the Myth

Introduction

Obesity continues to be a major worldwide health problem, despite the efforts of the medical community. Intensive lifestyle interventions can achieve weight loss that is sustained over the long-term. Diet is an important component of any lifestyle intervention programme. The dietary plan that restricts energy and fat is the most common strategy and based on it, several other dietary strategies have been proposed. However, the very-low-carbohydrate, high-fat keto diet differs from these approaches. 

In my post Diet Plan for Weight Loss – It’s going to be a journey, I had described various options for the treatment of obesity. As highlighted there, the core principle of any obesity treatment is that it must shift the balance between energy intake and energy expenditure – treating obesity requires creating a state of negative energy balance, therefore a reduction in energy intake is the primary factor that needs to be addressed in a dietary intervention designed to promote weight loss. In the above post, under dietary interventions for the management of obesity, I had briefly discussed the various calorie reduction strategies including reduced-calorie diets, low-calorie diets (LCD), very-low-calorie diets (VLCD) and #keto diets. In the above referred to post, I had discussed reduced-calorie diets in details; in my post, Very-Low-Calorie Diet – All you Need to Know, I had discussed the LCDs and VLCDs. Here, in this post, I shall be discussing the keto diets.

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Very Low Calorie Diet – All You Need to Know!

Introduction

In my post Diet Plan for Weight Loss – It’s going to be a journey, I had described various options for treatment of obesity. As highlighted there, the core principle of any obesity treatment is that it must shift the balance between energy intake and energy expenditure – treating obesity requires creating a state of negative energy balance, therefore a reduction in energy intake is the primary factor that needs to be addressed in a dietary intervention designed to promote weight loss. In the above post, under dietary interventions for the management of obesity, I had discussed various calorie reduction strategies including reduced-calorie diets, low-calorie diets (LCD) and very-low-calorie diets (VLCD). In the above referred to post, I had discussed reduced-calorie diets in details; here, in this post, I shall be discussing the other two diets plans viz. low-calorie diets and very-low-calorie diets. The use of very-low-calorie diets to induce rapid weight loss, in contrast to many other weight loss products in the market, is backed by decades of medical research, and very-low-calorie diets have been in clinical use for almost 40 years. 

A women shopping for vegetables in a food store. Consumption of fruits and vegetables are very useful in formulation of very low calorie diets.
Source: UConn Rudd Center for Food Policy & Obesity
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Diet Plan for Weight Loss – It’s going to be a journey.

Introduction

Before I discuss the diet plan for weight loss, the subject matter of this post, it would be worthwhile to discuss certain salient aspects of obesity. Obesity is a multifactorial disease and is the result of a complex interplay of genetic, environmental, metabolic, physiologic, behavioural and social factors; the underlying mechanism is a sustained positive energy imbalance (i.e. the energy intake is more than the expenditure). Therefore, irrespective of the cause(s) of obesity in an individual, the basic concept of weight loss for the management of obesity revolves around energy balance between the number of calories you consume and the number of calories your body uses. To lose weight, it is necessary to create a sustained negative energy imbalance, i.e. reduce energy intake below the energy expenditure and sustain it in the long-term. Though there are many strategies available, however in the present post, my focus will be primarily on formulating a diet plan for weight loss.

Diet plan for weight loss must include healthy foods such as fruits and vegetables.
Source: UConn Rudd Center for Food Policy and Obesity
A woman shopping in the produce department of a grocery store.
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Weight Training Program Design for Optimum Health.

Introduction

For most people, the term ‘exercise’ means aerobic activities like walking, jogging etc. The benefits of weight training (also commonly known as strength training or resistance training; the terms will be used interchangeably) are either overlooked or at best minimized to that of building muscles and improving sports performance. However, we now have a better understanding of the health-related benefits of strength training; the health benefits of enhancing muscular fitness are on par with aerobic fitness, if not more. In my post ‘Health Benefits of Exercise: a grossly underutilised therapy’, I have discussed the health benefits of muscular fitness. Keeping in view the health benefits of muscular fitness, strength training is now a popular form of exercise that is recommended by the World Health Organisation and the US national health organisations such as the American College of Sports Medicine and the American Heart Association, for most populations including adolescents, healthy adults, the elderly, and clinical populations (e.g. those individuals with cardiovascular disease, neuromuscular disease etc.).

People of various categories doing weight training.
Fig: People of various categories doing weight training
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Aerobic Exercise Prescription for Optimum Health Benefits

Introduction

In my post, Health Benefits of Exercise: a grossly underutilised therapy, I have discussed the various health benefits associated with physical activity, as a result of which exercise is now aptly being recognised as ‘medicine’. However, to derive optimal health benefits from exercise, an exercise program needs to follow certain parameters, similar to drug prescription, such as frequency, dose (amount), time (duration) and type (of physical activity). In my post Exercise Prescription for Optimal Health Benefits, I have discussed the FITT-VP principles for exercise prescription. In this post, I shall be discussing ‘prescription for aerobic exercise’ based on the FITT-VP principles. Prescription for strength training as per FITT-VP factors will be discussed in the next post. Aerobic exercise is referred to in the literature, both scientific and lay, by various terms. In the scientific literature, it is referred to as cardiorespiratory endurance or aerobic endurance, while colloquially it is referred to as aerobic exercise or just aerobic, or cardio, or cardio exercises, or cardio workout. In this post, these terms will be used interchangeably.

People engaging in aerobic activities.
People engaging in various aerobic activities.
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Exercise Prescription for Optimum Health Benefits

Introduction

Physical inactivity is now identified as the fourth leading risk factor for death globally, accounting for about 6% of the total deaths worldwide. Physical inactivity levels are rising globally, spanning all economic, educational and age strata. This has major implications for the general health of the people worldwide and for the prevalence of lifestyle diseases such as cardiovascular diseases (coronary heart disease and stroke), diabetes and cancer, and their risk factors such as raised blood pressure, raised blood sugar and overweight. Physical inactivity, i.e. lack of exercise, is estimated as the principal cause for approximately 21-25% of breast and colon cancer burden, 27% of diabetes and approximately 30% of coronary artery diseases (which can ultimately lead to heart attack). As per WHO, of the 56.9 million deaths globally in 2016, 40.5 million or 71% were due to lifestyle diseases. You can read about the total burden of these diseases in my post Chronic Diseases: the Silent Killers.

The image depicts a doctor advising a patient to exercise regularly.

Global health is being influenced by three trends: globalisation, urbanisation, and population ageing.

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Health Benefits of Exercise: a grossly underutilised therapy

Introduction

Exercise is being increasingly recognised to play an important role not only in the prevention but treatment as well of multiple lifestyle diseases (chronic diseases), health conditions and risk factors associated with these. In view of the above, exercise is now aptly being recognised as medicine. It is the cornerstone of lifestyle modification to achieve Holistic Health. However, like any other medicine, exercise too has some associated risks, though benefits of exercise on health, far outweigh the risks. However, before proceeding with the benefits and risks associated with exercise, it would be pertinent to understand some important related terms. Even though physical activity and exercise are often used interchangeably, they are not synonymous. The definition of these and some closely related terms are given below:

People of different age, gender and categories participating in different physical activities.
People of different age, gender and categories participating in different physical activities.
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Weight Bias: pervasive yet hidden harm of obesity

Introduction

Worldwide prevalence of obesity has been increasing at a menacing pace. As per WHO data, the incidence of obesity worldwide has tripled since 1975. As discussed in my post ‘Is obesity a disease or a risk factor for other conditions?’ in 2016 more than 1.9 billion adults, 18 years and older, were overweight; of these 650 million were obese. It has assumed epidemic proportions in children too. As discussed in my post ‘Childhood obesity: a serious public health challenge’, as per a study led by Imperial College of London and WHO, in a span of just 40 years, the number of school-age children and adolescents (5-19 years of age) with obesity has risen more than 10-fold from 11 million in 1975 to 124 million in 2016. Unfortunately, the obesity epidemic has been accompanied by a parallel epidemic of weight bias.

Rally for end to 'shaming and blaming' people for weight.
Rally for end to ‘shaming and blaming’ people for weight.

In my post ‘Complications of obesity: the mother of all diseases’, I had highlighted that obesity affects almost every aspect of health, from reproductive and respiratory function to memory and mood. Among the various psycho-social complications of obesity, I had discussed weight bias, which negatively affects not only psychological well-being but physical health as well. Although weight bias is pervasive in society and undermines people’s health extensively, awareness about it is very limited. In order to raise awareness about the prevalence, severity and diversity of weight stigma, the World Obesity Federation chose ‘End Weight Stigma’ as the theme for the World Obesity day 2018. To begin with, to help understand the topic better, the term weight bias and other related terms will be explained here briefly.

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Complications of Obesity: the mother of all diseases

Introduction

In my post ‘What is Obesity – is it merely about BMI? I had discussed the definition of obesity, as laid down by the WHO, as “A condition of abnormal or excessive body fat accumulation, to the extent that health may be impaired.” People who are obese are at increased risk for many serious diseases and health conditions, compared to those with a normal or healthy weight. However, in my post “Normal weight obesity – a myth or a reality?” I had discounted a widely prevalent myth amongst the general populace that ‘normal body weight always equals healthy weight’. There I had discussed a subset of individuals, among individuals with normal body weight, who develop and suffer from complications of obesity similar to individuals with a more ‘overt’ obesity.

Obesity affects almost every aspect of health, from reproductive and respiratory function to memory and mood. It decreases both the lifespan and the quality of life and increases costs of health care, both at the individual as well as at the national level. It does this through a variety of pathways; some as straightforward as the mechanical stress of carrying extra weight and some as a result of excessive secretion of certain products by enlarged fat cells and ectopic fat depots. The mechanisms by which obesity gives rise to its various ill-effects on health were discussed in my post “Is obesity a disease or a risk factor for other complications?”

However, the good news is that weight loss can reduce some of the risks associated with obesity. Loss of as little as 5 to 10 per cent of body weight provides substantial health benefits to people, and even if they begin to lose weight later in life.

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