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FEATURE
It’s big bucks time for
the weight-loss industry
again, so Alice Ball looks at
whether, when it comes to
trying to watch our weight,
one size can really fit all
s the last of the seasonal
Adecorations are taken down and
those of us in colder countries
settle into the January gloom, some of us
may now be feeling the effect of one mince
pie too many. But before we start scrolling
through social media or lingering over the
lists of best-selling diets, should we take
it for granted that what worked for some
slimmed-down celeb (who’s now pushing
their new diet book/workout) will really
work for us too?
The diet industry has become
increasingly saturated, making the
task of selecting a weight-loss plan
overwhelming to say the least. When
it comes to the basics, however, many
modern commercial diets can be
categorised by different characteristics:
calorie counting; low-carb or low-
glycaemic index (GI) — which is,
essentially, low-carb; and fasting diets.
According to Public Health England’s
Eatwell Guidelines, we should look to
consume approximately 2,000-2,500
calories per day depending on whether
we’re female or male. But Linia Patel,
a registered dietitian from the British
Dietetic Association tells us to remember
that these numbers are guidelines for the
general public and may not be suitable for
everyone.
“The key with weight-loss is that you
create an energy deficit from your daily
caloric intake that results in sustained
weight-loss,” she says. “Science suggests
that creating a calorie deficit of +/- 500
calories per day from your usual intake
will result in a sustainable weight-loss of
0.5 kg per week.”
In scientific terms, your ‘usual intake’
is known as your total daily energy
expenditure (TDEE) — the amount
of calories your body expends in 24
hours, taking into account all physical
activity. According to Patel, your TDEE is
determined by several factors including
age, sex and activity level. “That is why
you can’t just follow any diet plan you
find on the internet or see in a magazine,”
she says.
Louise Robertson, a specialist dietitian
working with inherited metabolic
disorders, also explains how the minimum
amount of energy our body needs to keep
OPTIMUM NUTRITION | WINTER 2018/19
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FEATURE
us alive decreases with age. “Muscle is “As we age, we tend to lose people who eat when they’re stressed —
more metabolically active than fat tissues muscle and increase our fat or some people who don’t; and some who
and requires more energy,” she says. “As have a more sensitive reward element to
we age, we tend to lose muscle mass and mass. If you lose muscle mass, the brain and get a bigger high from food.”
increase our fat mass. If you lose muscle then your body will require less So understanding our own behaviour
mass, then your body will require less and motivation around food is important
energy. Therefore, if you continue to eat energy...” if we want to find solutions to over-
the same amount as you age, you will eating.
gain weight.” Robertson also says that “We first need to understand our
people who are physically active burn friend who is the proverbial dustbin and personal biology and behaviour around
more calories throughout the day, so yet you only have to look at a slice of food before we can select the right
need to eat more to maintain their body bread to feel your waistline expanding. strategy for weight-loss,” says Yeo. This
weight. So it may be some small comfort to could be as simple as identifying the
know that research has revealed that our types of food that we crave most and
Metabolic disorders and lifestyle genetics can play an important role in removing them from our environments.
We might assume that once we’ve how we respond to certain foods. Yeo hopes that in the near future,
calculated our usual intake that we can Dr Giles Yeo, a geneticist at the GPs will be able to carry out gene
plug the numbers into any weight-loss University of Cambridge and a regular tests to create personalised diet plans
strategy. Wrong — this is where lifestyle presenter on the BBC series Trust Me I’m for patients, based on the balance of
factors and even disease factors come in. a Doctor, has spent 20 years studying macronutrients their body responds to
“Some people will find that cutting severe obesity and identifying the role of best.
carbs down is an easy way to help with genetics in controlling food intake.
weight-loss and it may be beneficial for Yeo explains that the brain needs to Traditional approaches
people with or at risk of developing type 2 sense two signals to control what we eat. Yet the concept of individualised eating
diabetes,” says Robertson. “First, it needs to know how much fat has been around for probably longer than
“On the other hand, a low-carb, you have because this determines how we think.
high-protein diet could be dangerous for long you’ll last without food in the wild,” Originating in ancient India, Ayurveda is
certain rare metabolic disorders such he says. “Then, it needs to know what a traditional system of medicine that deals
as urea cycle disorder. In people with you have just eaten and what you are with wellness and longevity. It is founded
this disorder, the body cannot get rid of currently eating — these are short-term on the idea that each of us has a unique
ammonia from protein breakdown, so the signals that come from the gut.” combination of three ‘doshas’ — energies
build-up of toxic ammonia can lead to Both your fat and gut do this by that describe everything in and around us.
coma and death.” releasing hormones which your brain Dr Anil Alexander, a qualified Ayurvedic
Likewise, Robertson says that fasting interprets to control your food intake. doctor practising in London, explains that
diets work well for people who are People who are severely obese have our makeup of doshas determines our
motivated to undertake the fast days but genetic mutations in the fat-signalling mind-body type — known as our ‘prakriti’.
aren’t suitable for shift workers or people hormone known as leptin. “Doshas are physical entities
with certain health conditions. “What happens is the brain thinks responsible for the functionalities that
“It wouldn’t be recommended for these people have either no fat at all regulate all physiological, psychological
people that need to keep their calorie or the mutation makes the brain less and spiritual facets of a person,” he says.
intake stable such as people with sensitive to signals from fat and the gut,” “There are three types: vata, pitta and
diabetes on regular insulin, pregnant Yeo explains. “As a result, the brain thinks kapha.”
ladies, or people who have a history of ‘I didn’t eat enough today’, making you According to Alexander, we are at
eating disorders.” eat more and therefore causing you to our best health when our doshas are
gain weight.” in perfect order, and this is affected by
Being balanced But how can research into severe what we eat. “There are four properties
It is equally important that whatever diet obesity help people who are just slightly in every food which determine whether
you follow provides adequate levels of overweight? that food will augment or pacify our
essential nutrients. Low-carb diets often “Rather than being broken, the doshas. These are rasa (taste), virya (hot
limit intake of wholegrains, carbohydrate- pathways in some people are slightly less or cold), vipaka (result of digestion) and
dense fruits and starchy vegetables — all sensitive to signals coming from fat and prabhava (action).” Someone who is
key sources of fibre which is essential the gut,” says Yeo. “If you have someone predominately pitta, for example, would
in maintaining bowel movement and who’s feeling five per cent hungrier all the benefit from consuming cool foods with
digestion. So it is important to ensure time, they’ll end up eating five per cent sweet and bitter tastes, while someone
intake of fibre from vegetables and fruits more all the time and then they’ll gain who is predominately vata will thrive on
such as berries, which are low in sugar. weight.” warm, moist foods that are sour and salty
Diets high in protein have also been The “million-dollar question” according in flavour.
linked to an increased risk of certain to Yeo, is how we can use this research But Ayurveda is not the only medicinal
cancers, including cancer of the breast to change the way we approach weight- system that favours a personalised
and colon; although it is important to bear loss. “There’s never going to be a one size approach to diet. In Japan, blood group is
in mind that overall diet and lifestyle are fits all approach because those of us who considered to be important in determining
also important factors. are overweight or obese have got to this health and even personality; an approach
place for very different reasons,” he says. that was popularised in Eat Right For
It’s in your genes “You could have people who eat more Your Blood Type by Dr Peter D’Adamo, a
Life can seem very unfair if you have a because they’re emotional eaters; some naturopathic physician and director of
WINTER 2018/19 | OPTIMUM NUTRITION
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FEATURE
Physiological differences in
how we approach weight-loss
have also been hypothesised
for many years. The concept
of ‘body type’ was first
introduced in the 1940s by
psychologist William Sheldon
LOW-CARB the Centre of Excellence in Generative with a small frame and little body fat,
Medicine at the University of Bridgeport. who have problems gaining weight and
Because protein and fat break down more “Research dating back to the 1960s muscle no matter what they eat or how
slowly, a low-carb diet can be effective shows that there are fundamental they exercise. The mesomorph tends
for weight-loss because the longer food differences in the way that blood types to have a medium frame and develops
takes to digest, the further down the respond to certain dietary choices,” says muscle easily, while the endomorph is
gut it travels and the fuller you’ll feel. D’Adamo. characterised by higher body fat and less
Carbohydrates are quickest to digest, “All of the recommendations made by muscle — these individuals are thought
followed by fats and lastly by protein. This the blood type diet stem from research to gain weight more easily than other
is why protein and fat should make you on the physiological differences between somatotypes.
feel full for longer, which can help reduce each blood type.” It’s a theory that was investigated
overall caloric intake, resulting in weight- According to D’Adamo, depending on by researchers at the University of
loss — although excess calories from fat your type — A, B, AB or O — the cells in Novi Sad in Serbia, to discover whether
and protein will also lead to weight-gain! your digestive tract will bind and react there were somatotype differences
However, low-carb diets are not suitable to foods differently. He also suggests between metabolically healthy non-
for all. Recently, it was reported that Anna that there are fundamental differences obese and metabolically healthy obese
Boniface, 2017’s London Marathon’s 4
in the quantity of intestinal enzymes and individuals. The team concluded that
fastest amateur female runner, was stomach acid present in each blood type. metabolically healthy non-obese women
diagnosed with a condition called relative “Blood type O and B appear to derive had significantly lower endomorphy
energy deficiency in sport (Red-S) as significant benefit from diets including and higher ectomorphy traits compared
a result of restricting foods such as healthy fats and lean animal proteins to metabolically healthy but obese
carbohydrates to lose weight before because they have much higher levels of women, who had higher values of
races. Red-S can cause a range of health an intestinal enzyme called IAP (intestinal ectomorphy; suggesting that some
problems, including loss of bone density. alkaline phosphatase),” he says. “This is a people are genetically and physiologically
Registered nutritional therapist Kate critical enzyme involved in the digestion predisposed to gaining weight.
Delmar-Morgan says that someone who of proteins and fats.” So back to us; if the best-sellers list
is training for a sporting event may need Evidence to support the concept of doesn’t have the answers to weight-loss,
the additional carbs. She also would not a blood group diet, however, is limited. what does? One approach is to speak to
recommend a low-carb diet for children, Whilst research in the 1960s did a GP, registered nutritional therapist, or
teenagers, anyone who is pregnant or indicate that different blood groups dietitian for advice on losing weight in a
breastfeeding, or who is underweight. were associated with varying amounts safe and sustainable way.
of stomach acid,² a 2014 study from the And as there is no one size fits all way
INTERMITTENT FASTING University of Toronto concluded that to successful dieting, if we do find that
Fasting diets can work by limiting calories the benefits of particular blood group we are struggling with our weight, we
to a shorter time window or reducing eating patterns were independent of an shouldn’t compare ourselves with others
calories on certain days. There have individual’s ABO genotype.³ who appear to maintain theirs without
been claims that fasting can increase Nevertheless, D’Adamo does agree that any effort at all — because what works
metabolism, but current research hasn’t “personalised nutrition is critical” when for their biology may simply not work for
demonstrated that alternate-day fasting it comes to dietary change. “Beyond the yours. And there is no shame in that.
regimens produce superior weight-loss individual foods recommended, even
in comparison to standard, continuous the carbohydrate, protein and fat ratios
calorie restricted plans.¹ along with lifestyle recommendations are References:
Delmar-Morgan does not advise completely different for everyone,” he 1. Patterson R & Sears D (2017). Metabolic effects
fasting for people with adrenal fatigue, says. of intermittent fasting, Ann Rev of Nutr, 37:371-
diabetes or eating disorders, anyone who Physiological differences in how we 393.
is underweight, or for children, teenagers, approach weight-loss have also been 2. Johnson D et al (1964). Gastric ulcers, blood
hypothesised for many years. The concept groups and acid secretion. Gut, 5(5) 402-11.
pregnant or breastfeeding women. She of ‘body type’ was first introduced in the 3. Wang J et al (2014). ABO genotype, ‘blood-
also cautions for anyone with a thyroid type’ diet and cardiometabolic risk factors.
issue. If you are considering a fasting 1940s by psychologist William Sheldon. PloS One, 9(1), e84749. doi:10.1371/journal.
diet and have a medical condition, it is Called somatotypes, these are divided pone.0084749.
into three categories: mesomorphs, 4. Galić et al (2016). Somatotype characteristics
recommended to seek advice from a GP, ectomorphs and endomorphs. of normal-weight and obese women among
registered nutritional therapist or dietitian. Ectomorphs are described as people different metabolic subtypes, Archives of
Endocrin and Metab, 60(1), 60-65.
OPTIMUM NUTRITION | WINTER 2018/19
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