Weight Loss (3 of 3): The role of exercise

In the previous blogs in this series, we discussed how decades of yo-yo dieting, along with our Western, high-carbohydrate diet, produces metabolic problems and weight gain over the years, and what to do when this happens, so that your body can burn fat more easily. In this blog, we’ll look at the role of exercise in all this, as well as how to keep your weight under control once you have lost the excess.

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How Much Exercise Should I Do To Lose Weight?
Active exercise brings a myriad of benefits: the right kind will lower your risk of heart disease and diabetes, and it improves your mortality rate, benefits your immune system, improves your mood, and has even been shown to reduce your chance of developing dementia and certain types of cancers. You can sculpt your muscles and lose inches with it. Exercise works on so many levels, except one. Your weight.

It’s yet another controversial statement to add to the ones we’ve already thrown out there in this series of blogs, and, in fairness, you will lose a little bit of weight when you embark on an exercise program, but it’s in the region of three or four pounds, so that’s not going to cut it for most people. What’s the rationale and evidence, then, to support a statement that flies in the face of current health guidelines?

Indirectly, exercise does have a role in weight loss and weight maintenance. For example, it improves the problem of insulin resistance, which makes us more likely to store our calories as fat than use them for energy, whilst perpetuating continual hunger. And it also promotes the release of a hormone (called ANP, if you’re interested) which helps mobilise fat to produce energy. But a brisk 30 minute walk each day does both these things. So why bother with the treadmill pounding, the expensive gym membership, and the guilt-suffering when we don’t work out for hours? Why are we told we have to be burning it in order to burn it?

It comes down to this out-dated notion that all calories are burnt equally, and that weight loss is simply a matter of creating an energy deficit (of 3500 calories per pound of fat). This idea is perpetuated in part by the fitness industry, who want your expensive membership, but it’s mostly down to the fast-food and junk food giants, who want you to keep eating their unhealthy, obesity-promoting food whilst telling you that a calorie is a calorie regardless of its source, and can therefore be burnt off with exercise if necessary. Note the subliminal message with this: any weight gain is your fault for not burning it off, not theirs, for providing food that will predispose you to gain weight.

How Can I Outrun My Dietary Sins?
The wonderful Dr Aseem Malhotra, one of our leading UK cardiologists, currently trying to educate the public, the government, and health professionals about the root cause of obesity and all the diseases that are associated with it, wrote an article back in 2015 in the British Journal of Sports Nutrition, entitled, “It Is Time to Bust the Myth of Physical Inactivity and Obesity: You Cannot Outrun a Bad Diet”. In this article, he pointed out that, contrary to popular belief, our level of physical activity has actually changed very little in the past 30 years, whilst our obese population has skyrocketed, laying the blame for obesity firmly at the door of what we are eating. And if you think about it, if you could “outrun a bad diet”, jumping on the treadmill every time you needed to atone for a dietary sin, then why are our manual labourers as overweight as the rest of us?

Aseem also points out that, currently, chronic diseases arising from a poor diet currently outstrips those from smoking, alcohol abuse and a sedentary lifestyle combined, a fact completely at odds with current health guidelines that you can eat what you want and just run it off. His co-author in this paper is Tim Noakes, a successful sports elitist who, in his autobiography, Challenging Beliefs, dismantles the notion that running marathons protects you from heart disease. Clearly, we have some catching up to do with our out-of-date ideas on exercise and diet, and its role in disease prevention and weight loss.

So what’s the evidence behind the claims we’re making? Careful and sophisticated exercise studies show that the amount of weight lost through exercise is actually much less than predicted by the “3500 calories expended = one pound of fat lost” calculation, and some of these studies have also shown that it doesn’t even help with keeping the weight off once you’ve done the hard work of losing it, because energy expenditure actually drops by about 30% with more exercise. Brilliant! The body attempts to tune up its energy-burning efficiency by burning even less calories! Trying to lose weight or maintain weight loss by this method starts to feel like swimming against the tide (without the calorie expenditure).

So I Might As Well Be A  Couch Potato?
No! But it’s a fair question: why bother to exercise at all? We’ve mentioned some benefits already, but if we look at what we should be aiming for: sustained health and a level of well-being that simply allows us to enjoy life more fully, then exercise and movement becomes a simple 4-pronged approach that can become part of your lifer, rather than consuming it.

1) General movement. Preferably outside (vitamin D). When you can, in parks and woods, to connect with nature. And the  “move more” idea, the “get off the bus one stop earlier” approach, along with its variants. Why? It will improve insulin sensitivity and stabilise mood.

When general movement was swapped for dedicated “exercise” back in the 1970s, the idea was that sitting at a desk all day was ok if you were working out and hitting that calorie expenditure target. Unfortunately, we now know that is just not true, something that Donal O’Neill explains more fully in The Pioppi Diet,  co-authored with Aseem. But the good news is that it takes just two to three minutes of movement every forty-five minutes to counteract the negative impact of sitting at a desk all day, because within two minutes of standing up, your body responds positively. Setting a timer to do this will benefit you enormously.

2) This one is a bit of a buzz word (or rather, acronym) in the fitness industry at the moment: HIIT, or high intensity interval training, often referred to as “hit workouts”, which is simply the most effective anti-ageing and cardiovascular exercise you can do. Not only that, but it only needs to take a few minutes, something that you probably wouldn’t be aware of if you listen to many gym personnel, who obviously have to turn it into a substantial “class” to make it seem worthwhile. By definition, the longer the workout, the less intense it will have to be, otherwise you either won’t get through it or you’ll die, which kind of defeats the object. HIIT is simply a short, sharp burst (20 seconds is enough) of exercise at your maximum intensity, followed by a short rest, and then repeated several times. The exercise can be anything that puffs you out, and that you are comfortable with: sprints, squats, punching the air… It’s the “maximum intensity” bit that is key.

3) and 4) Pretty much self-explanatory and non controversial: weight-bearing exercise (using free weights, machine weights, or your own body weight) in order to maintain muscle mass and bone density, which becomes increasingly important as we age and start to lose both; and stretching, to keep the joints and body flexible and supple. Both of these ensure that we can continue to move effortless and painlessly as we age.

Obviously, these exercise modalities can overlap. Pilates, for example, incorporates both weight bearing and stretching exercises, whilst movement would be naturally interspersed with bursts of HIIT if you were digging the garden borders or chasing the dog. And hopefully it goes without saying that the more enjoyable or rewarding the form of exercise for you, the better it will be: you are more likely to keep at it, it will counteract the effects of stress, and you will release feel-good hormones (endorphins).

If You Can’t Outrun A Bad Diet, It’s Going To Come Down To Diet!
Exactly! If exercise doesn’t work for weight loss or maintenance, what does? Diet.

Diet is the single-most important factor that determines your weight, your likelihood of gaining weight, your ability and ease of losing weight, and the likelihood of you maintaining your weight loss, and, as we have said in the previous blog, it is not so much how much you eat, but what you eat, and that goes for weight-loss maintenance as well as losing it in the first place. Exactly how you approach weight-loss maintenance is likely to depend on how you got the weight off in the first place, but essentially it’s going to mean relaxing the rules a little and monitoring your personal response. Suddenly going all hell for leather on those foods you didn’t have for a few months will take you straight back to where you started within about 3 months. The key to how much you can relax the rules is to monitor your progress and reign it back in as soon as possible if you start gaining weight or if cravings reappear. There is no one-size-fits-all method here, so monitoring your own response is pivotal to success. And remember that weight loss and weight maintenance is only part of the picture. Improved health, physical and mental well-being, and avoidance of crippling disease comes along for the ride.

If you took a very low carbohydrate, high fat, moderate protein (ketogenic) approach, you may want to start adding in some starchy tubers, some fruit, occasional grains (most people are better off without wheat, but it’s up to you), beans and legumes, and dairy. Choose one of these groups per week and monitor the results. How you feel is as important as what the scales tell you.

If you’ve lost weight by doing a form of modified fast that we discussed in the last blog, you may want to see how you get on relaxing the rules. For example, turn the 5:2 into a 6:1, or increase your feeding window if you’ve done restricted feeding. Again, though, reverting completely to old habits means that you will revert to your old body in a few months.

Food For Thought….
So, having dissected the facts from the fiction, and thrown out some controversial statements in the process, the take-home message from this series of blogs simply comes down to this: diet is the single-most important factor in determining weight gain, weight loss and weight maintenance and avoidance of disease. But that doesn’t diminish the importance of exercise when it comes to inch loss, and its contribution, along with diet, to health, well-being and longevity.

Springwell Clinic specialises in body contouring, inch-loss treatments to augment any exercise program, and provides free-of-charge dietary advice based on the recommendations from these blogs.

References:
Fat Chance by Dr Robert Lustig
Always Hungry? by Dr David Ludwig
Wired To Eat by Robb Wolf
The Pioppi Diet by Dr Aseem Malhotra & Donal O’Neill

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Weight Loss (2 of 3): How to get out of a big fat mess