Trying To Lose Weight? Are You Doing It Right? (Part 3) – Lt Col (Dr) Mohd Arshil Moideen

Question 1: I am trying to go into serious dieting. How can I do it ?

After 2 weeks of detox, you can start practising strict but healthy diet control. In the process of losing weight, you have to strictly control your diet for 6 days and  should only take 1  day off  per week where you can have your cheat day.  Once you have achieved the target weight loss, you may continue this practice by having 5 days  strict healthy diet  and 2 cheat days to maintain your weight. On your cheat day, you are allowed to take any food  but you should not take any  meals after 9pm. The only exception is processed  foods which are high in trans fat like fast food . NEVER TAKE FOOD CONTAINING TRANS FAT when trying to lose weight or if possible forever. I will discuss what is trans fat and why it is bad.

Question 2: What do you mean by strict but healthy diet control?

The strict but healthy diet control means  eating what is right.  Instead of starving yourself, I am promoting for everyone to EAT !!!. The tips here is to know what  food you should eat to keep you full but at the same time help you to lose weight. Skipping meals is bad for your health and will not help you lose weight. Not only does it lower your Basal Metabolic Rate, it will also lead to over eating on your next meal  as part  of the body’s  response to starvation.  This will in turn make you gain weight rather than losing weight.

Question 3:  I heard some body hormones are responsible for weight control or specifically fat storage. What are the roles of the Body’s Hormones in helping me to lose weight?

One should understand that several HORMONES in our body is responsible to control nearly every aspect of your weight. Understand this and losing weight is just a matter of time. The regulation of fat metabolism is complex and is regulated by multiple mechanisms. The following hormones affect your fat storage and appetite:

Hormone No 1:  Insulin

Every time you eat a high carb meal or sugary drinks, your body responds by releasing Insulin. Insulin’s job is to pull extra glucose from your bloodstream. If you take too much of rice, bread, pasta or  sweet  soda drinks, this excess calories from Glucose will be stored as fat by Insulin. Insulin therefore is your fat storing hormone and the main CULPRIT for your belly fat.  Though in reality, it involves a more complicated biochemistry actions within our body, for the purpose of easy understanding, you can say that by minimizing your Insulin release (while maintaining its efficiency), you will reduce fat storage in your body and subsequently lose weight. The key strategy here is to optimize your body’s INSULIN SENSITIVITY (Smaller amount of Insulin needed to metabolize the same amount of  Glucose).

How Can I Optimize Insulin Sensitivity? You can achieve this by taking low carb diet during the course of your diet or by taking carbs frequently but in smaller amount rather than taking large amount of carbs at one go. Start by eliminating sugar in all your drinks or drink plain water instead in all your meals. You should also limit Carbs intake before 7 pm at night to prevent insulin spike during sleep. If you are hungry after 7 pm, avoid carbs by all means and eat salad or lean meat or nuts instead. An example of healthier option for supper  is lean chicken Tomyam (Taken alone without the rice), salad with grilled lean chicken, omelette, walnuts and almonds. Taking LOW GLYCEMIC INDEX (GI)  carbs regularly  will also help to increase Insulin Sensitivity. A low glycemic index carbs refer to the slow release nature of glucose following the intake of such food. Low GI food will not cause sudden surge in blood sugar as the glucose is released slowly bit by bit into the blood, therefore will limit Insulin release in the body. This will help to improve overall Insulin Sensitivity in body in long run. Know the GI of various carbs available. Bread or anything made of wheat or white flour for example is of High GI ( 2 piece of bread is equivalent in terms of Calories with a bowl of  rice but  with higher GI). A piece of Roti Canai, an all time Malaysian favourite, contain almost double the calorie count as well as higher GI than a bowl of rice. Pasta, even though has lower GI than rice and bread, if taken in large amount, will have the same effect on Insulin release. So, the best option is to limit your Carbs intake by taking a small portion every time with most portion of your meals made up of green vegetables. It is ok to eat more frequently but in small amount than to take large amount of carbs at one go. You can also choose to take healthier options such as the Japanese Soba or Basmathi Parboiled rice or Brown Rice. Japanese Soba, though made of  Buck Wheat, is not the same family with wheat at all. It is a very healthy option of Carb and has low Glycemic Index. The Basmathi Parboiled rice is a special variant of the Basmathi rice with Low GI and qualify under the Whole Grain category. Not all Basmathi rice are low in GI. Look specifically for Parboiled variant. It is sold in Giant, Cold Storage and many other large stores at around RM 46 for 5 KG. NEVER OMIT CARB COMPLETELY! You need carb for energy and to maintain your body function. At least 60% of your body energy comes from Carb.

Hormone No 2 : Leptin

Leptin is a hormone produced by Fat Cells. This hormone control your appetite, basically by suppressing it. You need Leptin in your body to send a signal to your brain and suppress your appetite. It is also responsible for Fat Burn. Even though Leptin is produced by Fat Cells, Leptin resistance is common in those with high body fat. It is not clear why this is the case but some researchers are suggesting that excess fat itself produces some chemicals inside the body to block the action of Leptin.

How Can I Optimize Leptin Sensitivity? It can be achieved by exercise and healthy diet. A popular approach to optimize Leptin sensitivity is to drink Power Juice or simply take green vegetables (a cup) first thing in the morning during breakfast. Power Juice is a mixture of some healthy metabolism booster fruits (such as Lemon, Green Apple, Carrot, Tomatoes, Berries) and green vegetables (such as spinach, broccoli, Celery, bak choy etc.). The green vegetables component of this power juice should be more than the fruit component (Ideally 2/3rd). Please note that too much of fruit is also not good and will lead to a skyrocketed blood sugar which in turn will result in more Insulin release and subsequent increase in fat storage. Fruit also contain sugar in the form of naturally occuring fructose. Although naturally occuring Fructose is healthier than Sugar, too much of it is also bad for your body. So, if you think taking 100% all natural fruit juice marketed mostly by food industries as Sugar Free is healthy and will not lead to weight gain, THINK AGAIN!!  The general rule in selecting fruits for the power juice is the more crunchy and the less water the fruit contain, the healthier it is. Banana, although is a good pre exercise snacking (if taken in small amount) may lead to increase in blood sugar if taken regularly.So, i prefer to leave it out of my power juice. This power juice, with a bit of Greek Yogurt, an  all natural muesli  and organic maple syrup is a good meal replacement for breakfast.

Hormone No 3:  Cortisol and Serotonin

Cortisol is a hormone released by Adrenal Gland in response to stress. While it is necessary to have Cortisol in response to acute stress situation like when you are fighting and fleeing, continuously high Cortisol in sustained stress situation will make you hungry and eat more especially high carb or high sugar food. Serotonin on the other hand, has the opposite effect. It calms you down an is a natural appetite suppressant.

How To Balance These 2 Hormones??  To keep Cortisol down, you need to find ways to reduce your stress level. For muslims, reading Quran is one of the ways known to calm you down. Other religions may find peace using their own methods. Yoga is known to relieve stress and help people to relax. To try and elevate Serotonin level, one must first ensure enough good quality night sleep of at least 8 hours a day. the Journal of Neurology Medicine reported in 1 study that level of Cortisol is almost doubled in those working night shift with significant reduction in Serotonin level as compared to those who don’t. For Doctors, have you ever wonder why you are very hungry the next morning after whole night of busy on calls in Hospitals? Taking Natural Yogurt, lentils, asparagus and spinach is also known to help increase Serotonin levels.

Hormone No 4: Catecholamines ( Adrenaline/ Noradrenaline/ Dopamine)

In the world of science, adrenaline is better known as “epinephrine”. Epinephrine is one of several hormones that belong in the larger category known as catecholamines.

Catecholamines are the “flight or fight” hormones released into the blood from your adrenal glands in response to stress. And good old caffeine from your coffee is another stimulus for increasing catecholamines ( not to be taken too much) . If taken too much, the effect on your Cardiovascular health is bad. Some commercial retails are selling Caffeine containing sachets or capsule to help you lose weight. Skip this, it is not worth it. The amount of caffeine in such products are too high and dangerous. Catecholamines has recently being found to be effectively burn fat and help you to shed your belly fat. High Intensity Interval Training ( HIIT ) is one of the way to maximize the effect of catecholamines on fat burn. I will discuss on this in my part 4 article later .

Hormone No 5:  Chemicals

This is not real hormones per say but rather chemicals found in carbonated drinks, processed foods like fast foods, canned foods or foods which use preservatives in the preparation of it. Even bread is not spared from preservatives these days. These chemicals are known to have blocked the action of Leptin described above and resulted in more fat gain in long run. This fact provide the more reason for you to avoid all the processed foods and go 100% natural.

QUESTION 4: Should I replace my carbs with more protein instead? I heard high protein diet will help me to lose weight, is it true?

One must understand that any nutrients in the body is interconvertible between each other through series of complex biochemical pathways.( i.e Carbs to Fat , protein to Fat, Fat to Carbs etc.) Excess carbs and protein  can be converted into fat storage. If you take high protein diet but you do not exercise, there will be no or little protein uptake by body muscles for repair or anabolism. This excess in Protein will therefore be converted into fat storage, although not as quick as the conversion of  excess carbs into fat. so, if you don’t exercise, taking high protein low carb diet will not help you lose weight.

QUESTION 5: Why can’t I simply follow the Malaysian Food Pyramid guidelines to lose weight?

The Malaysian Food Pyramid above  is a general guidelines aiming at achieving overall general health, not for losing weight. It is not designed to help people to lose weight  or to shed belly fat.  Most people are confused on foods covered under each general term  (i.e grain, fruits  etc) even though the guidelines clearly specify the preference for  healthier option of foods like the Whole Grain. Most people don’t know what is Whole Grain, and resorted to buying processed food marketed as whole grain which is bad for your weight losing effort.  Grain and Whole Grain are not necessarily the same. The white rice, bread and other foods that we eat qualify under the Grain category but is not necessarily Whole Grain. The white rice that we normally take is processed and polished, therefore is not Whole Grain. The fibre components of polished rice is not there, making it an unhealthy option.  Wholegrain is defined as  Whole Grains or foods made from them contain all the essential parts and naturally-occurring nutrients of the entire grain seed in their original proportions. If the grain has been processed (e.g., cracked, crushed, rolled, extruded, and/or cooked), the food product should deliver the same rich balance of nutrients that are found in the original grain seed. An example of this is brown rice, Basmathi rice,  Buckwheat (Japanese Soba) and oats.

If we were to simply  follow the food pyramid by taking  6-12 servings of  grains (rice, bread, pasta etc.) as well as eating more fruits (without taking into account the effect of high fructose in blood on Insulin Sensitivity as explained above),  I can almost guarantee you that you will fail to achieve weight loss despite exercising hard due to the Insulin sensitivity issues explained above. The 2010 Updated Malaysian Food Pyramid suggests more wholegrain should be taken. Even though wholegrain in its natural form is healthy, most of our rice and bread sold in the market are not. While an all natural wholegrain like unpolished rice, natural pasta etc. is healthy, the wholegrain cereals or biscuits marketed by the multi billion food industry players are not. Most often, these cereals contain multiple sources of hidden refined carbohydrates which will not help you to lose weight but rather gain weight. Have a look at the following cereals marketed as wholegrain HEALTHY cereals below:

• Fiber One Raisin Bran Clusters contains 13g of sugar per serving and it contains high fructose corn syrup.
• Raisin Bran Crunch contains a whopping 20g of sugar per serving (and by the way, that’s only one cup and many people put in at least two cups for their cereal amount) and it also contains high fructose corn syrup listed three different times on the label within other ingredients!
• Quaker’s Instant Oatmeal Maple and Brown Sugar Flavor contains 12g of sugar per packet.

I have a whole lot of other cereals on the list but not planning to list everything here. So, to be sure the wholegrain you are taking is healthy, stick to an all natural source rather than packed or processed one.

Question 6 : I love to eat chocolate but i heard eating chocolate will make me fat. Is it true?

This is not entirely  true. In fact, I will ask you to take chocolate to help you to lose weight. The only thing to keep in mind is, the antioxidant and pro metabolic properties of a chocolate depends on the Cocoa content on the chocolate. The more Cocoa you have, the better it is. Therefore, Dark Chocolate is healthy and will help you to lose weight but the normal Milk Chocolate is not. Look for the Cocoa content of at least 70% for maximum effect. Beware of dark chocolate with high sugar content. Some brands may contain more than 50% cocoa but contain lots of sugar in it. DONT TAKE TOO MUCH OF DARK CHOCOLATE AS IT MAY HAVE A LAXATIVE EFFECT.

Question 7:  What is the difference between simple and complex carbohydrates?

Simple carbohydrates are simple sugars with a chemical structure that is composed of one or two sugars. They are refined sugars that have very little nutritional value to the body, and therefore, it’s advisable that their consumption be limited to small quantities. In comparison to complex carbohydrates, simple carbohydrates are digested by the body more quickly, because they have a very simple chemical structure and easily converted into fat. Foods that contain simple carbohydrates include table sugar, products with white flour, honey, milk, yoghurt, candy, chocolate, fruit, fruit juice, cake, jam, biscuits, molasses, soda and packaged cereals. Despite the fact that simple carbohydrates do not contain enough essential nutrients, some foodstuffs such as fruits may still be good for you. As for yogurt, Greek Yogurt is a better option as it contains less carbohydrate and is high in protein and a known metabolism booster. Limit your yogurt intake to once daily especially in the morning.

Complex carbohydrates consist of a chemical structure that is made up of three or more sugars, which are usually linked together to form a chain. These sugars are mostly rich in fiber, vitamins and minerals. Due to their complexity, they take a little longer to digest, and they don’t raise the sugar levels in the blood as quickly as simple carbohydrates. Complex carbohydrates are commonly found in vegetables, whole Grain, and cereals (Natural unprocessed cereals). Examples of foods that contain complex carbohydrates include spinach, yams, sweet potatoes, broccoli, beans, zucchini, lentils, skimmed milk, whole grains and many other plants and vegetables.

Question 8 : What healthier option do I have for sugar replacement?

1. Stevia – The best and healthiest option available is Stevia. It is extracted from the leaves of a plant called Stevia Rebaudiana. This plant has been grown for sweetness and medicinal purposes for centuries in South America. Stevia is a natural, zero calorie sweetener that can lower both blood pressure and blood sugar levels.
2. Erythritol (NON-HALAL) – Erythritol is a sugar alcohol that is very sweet, but low in calories. Studies show that it is very safe to eat, although it can cause digestive problems at high doses.Ethyl alcohol is Haram because of its intoxication quality. But not all alcohol are ethyl alcohol although word alcohol is written with their name. Sugar alcohols do not contain ethyl alcohol but they called sugar alcohol because of their chemical formula. Sugar Alcohols or Polyols are carbohydrate. All the sugar alcohols are Halal except Erythritol(made through alcoholic fermentation) and if Lactittol is made from non Halal whey then it is not Halal. But if Lactitol is made from sucrose then it is halal. (Source: Canadian Halal Authority at http://www.canadianhalalfoods.com/news.html). As I am not authorised to issue local fatwa, please reconfirm this fact with relevant religious authority.
3. Yacon Syrup –  Yacon syrup is very high in fructooligo-saccharides, which is not  digestible by body and help to feed the good bacteria in the intestine. It contain small amount of digestible sugars which are sucrose, fructose and glucose and therefore a healthy replacement for sugar.  It may be helpful against constipation and may help you lose weight.
4. Xylitol – Xylitol is a very popular sweetener. It is another example of sugar alcohol, with about 2.4 calories per gram. It has some dental benefits and may improve bone density and lower the risk of osteoporosis. Please refer to the above explanation for its Halal status.
5. Organic Maple Syrup – This is another healthy substitute to sugar . The Organic version is of Low Glycemic Index (no sugar or Fructose Corn Syrup added) and will help you to control your weight. This is one of my favourite substitute for sugar as it tastes and smells good. A product by Radiant is sold at around RM 34/ bottle in Cold Storage/ Giant.

Question 9. What shouldn’t I use for sugar substitute?

Aspartame – I have explained in my previous article that aspartame may be of zero calorie but because it is chemically produced, it has serious effects on other aspect like stimulating appetite as well as deranging Body’s hormonal function.

Agave Nectar – Agave syrup was previously a very popular sugar substitute marketed as the healthiest natural sweetener available. The truth is, Agave Syrup went through several processes before it can be marketed commercially. The fact that it contain more than 60-70% of simple sugar in the form of Fructose will not help you to lose weight.

Refined Sugar – If  you are given a choice of between refined sugar and raw sugar, take raw sugar instead. It is lower in GI and a healthier option than refined sugar which is refined to make it few times sweeter.

High Fructose Corn Syrup –  AVOID THIS ALTOGETHER.  This is the worst possible source of sugar you could have. High fructose corn syrup is an industrial food product and far from “natural” or a naturally occurring substance . HFCS is produced through genetic modification processes as well refinery process which makes it many times sweeter than sugar. HFCS and cane sugar are NOT biochemically identical or processed the same way by the body, and will make your blood sugar control hair wired.  look for HFCS label or Corn Syrup in the food ingredients and avoid taking this. HINTS : HFCS is widely used in soda drinks.

Question 10. Many food items are marketed as healthy food items. Should I take them all to lose weight??

1. Breakfast Cereals. Most breakfast cereals are loaded with sugars or refined carbs which are some of the most fattening ingredients in existence. Take plain oat or sports muesli instead.
2. Low Fat Yogurt. Most low fat yogurts are flavoured and contain high sugar content. Take plain natural yogurt or Greek Yogurt instead.
3. Grain Fed Beef. Corn are one of the most genetically modified plant in the world. Imagine yourself taking a Corn fed beef. Take grass fed beef instead. It is much more healthier and will help you to lose weight.
4. Wholemeal bread. Some wholemeal bread are not made up of Whole Grain in true sense but rather a marketing gimmick. Be careful of this as most wholemeal breads have Glycemic Index as high as white breads as a result of this marketing ploy. Homemade wholegrain bread is a healthier option.
5. Granola. Granola by itself is healthy. the problem is when the food industry add some sugar and oil in it. this will lead to high Glycemic Index as well as overconsumption.
6. Commercial Salad Dressing. Eating Salad is healthy, but most commercial salad dressings are made of nasty ingredients like soybean and High Fructose Corn Syrup which are bad for your health. Use homemade naturaldressings instead.

Question 11 . May I know what are metabolism booster food?

1. Oats are rich in fiber, so a serving can help you feel full throughout the day. Just a half cup packs 4.6 grams of Resistant Starch, a healthy carb that boosts metabolism and burns fat.
2. Avocado. There’s no reason to be afraid of eating fats—as long as they’re the right fats.
3. Oleic acid, a compound in avocados’ healthy monounsaturated fats (MUFAs), may trigger your body to actually not feeling hungry. 
4. Blueberries. Best known for their anti-aging effects, blueberries, while tiny, are a powerful fat busting fruit.
5. Brocolli  Cooked or raw, this  veggie is well-known for its cancer-preventing effect, but with a content of filling fiber in less than 30 calories a serving, it’s very useful to prevent weight problems too.
6. Brown Rice   Brown rice is a heartier, fiber-packed alternative to less-than-super white rice. A half-cup serving contains 1.7 grams of Resistant Starch a healthy carb that boosts metabolism and burns fat.
7. Grapefruit.  A compound in this  fruit can lower insulin, a fat-storage hormone, and that can lead to weight loss. It’s also a good source of protein.
8. Nuts. Nuts are another superfood rich in healthy fats that help you slim down.
9. Almonds and walnuts in particular is my favourite choice for breakfast. I mix these nuts with Greek Yogurt and a bit of Organic Maple Syrup. This delicious breakfast can help you shed your belly fat.
10. Green Tea. The antioxidants in green tea will up your fat burn and calorie burn. Look for organic Green tea.
11. Lentils. Lentils are a great source of filling  protein and fiber. A half-cup serving delivers 3.4 grams of Resistant Starch,  a healthy carb that boosts metabolism and burns fat.
12. Eggs. Eggs get a bad rap when it comes to weight loss. But egg is loaded with protein that will curb your appetite, especially when taken during breakfast. Make an omelette with variety of green vegetables and carrots in the egg for a healthier meal.
13. Dark Chocolate. I have explained on this above. take those with at least 70% of cocoa in it.
14. Quinoa. Another diet-friendly whole grain, quinoa is rich in hunger-fighting protein. You’ll stay full longer on fewer calories and avoid overeating at other meals.
15. Spinach. When it comes to weight-loss foods, spinach is a real nutritional powerhouse. A single cup of spinach contains just 7 calories and only 1 gram of carbohydrate, plus it provides you with iron, folate, magnesium, calcium and plenty of antioxidants. Making this filling, low-calorie food a regular part of your meal plan could aid weight loss.
16. Coconut Oil. Organic Cold Pressed coconut oil is the healthiest cooking oil available. Coconut oil is the world’s most weight loss friendly fat. It contains a unique combination of fatty acids with powerful effects on metabolism.Several studies show that just by adding coconut oil to your diet, you can lose fat especially the “dangerous” fat in the abdominal cavity.The only problem is, the commercial organic coconut oil is expensive to be used for cooking but you can gain the benefit by taking 2 tablespoon of organic coconut oil 3 times a day. You can find it in the organic section in most stores.

Question 12 : What are example of  a healthy 1 day diet plan?

Breakfast : Almonds with greek yogurt and organic maple syrup or omelette with green vegetables/ carrots OR plain oats in skimmed milk + almonds/walnuts OR Green Apple mixed with greek yogurt OR Power Juice (healthy fruits like Green Apple, Grapefruit, lemon, carrots + Spinach/ Bak Choy/ other green vegetables + Greek Yogurt + Muesli + Organic Maple Syrup).

Snacking : Almonds OR Walnuts OR Dark Chocolate. Try to take lightly salted/ raw and not honey coated almonds.

Lunch : Salad with lean meat (Chicken or Turkey or Fish or Grass Fed Beef once in a while) OR Basmathi Parboiled Rice/ Brown Rice +  lean grilled chicken/fish + salad/ mildly cooked green vegetables OR Japanese Soba + Salad + Grilled  Lean Meat (Chicken or Fish)

Snacking : Almonds OR  Walnuts OR Dark Chocolate. try to take lightly salted/ raw  and not honey coated almonds.

Dinner :  Try to  eat dinner  early before 7 pm. Same choice as of lunch. No carbs after 9 pm. If you are hungry at night, take salads or lean protein meal or omelette.

 

[This article belongs to The Malaysian Medical Gazette. Any republication (online or offline) without written permission from The Malaysian Medical Gazette is prohibited.]

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