Saturday, December 10, 2011

The Female Weight-Loss EDC: The Fat Burning, Waist Reducing Synergy of Exercise, Diet and Dark Chocolate

Image 1: Guess how she got in in shape? Right! The EDC Program ;-)
As a loyal reader of this blog you already know that the SuppVersity is the place to go if you want unique information from the world of exercise and nutrition science. It will thusly not surprise you that, instead of the regular weight-loss ABC, I am offering you a female (it will probably work just as well for men, though) weight-loss EDC: A program which takes advantage of the perfect synergy of exercise, diet and chocolate! As confusing as this may initially sound, I promise that after reading this post, you will realize that following the EDC to the T offers a practicable and sustainable solution to reduce your body fat levels, improve your metabolic health before the summer comes. And what's even more important it won't cause permanent metabolic damage and keep you psychologically sane ;-)

The E & D in EDC - or how dieting makes sense only if you "exercise"

Ever since I heard Gary Taubes on Dr. Oz say that exercise would "only make you hungry" and would thusly not help with weight loss, Taubes' otherwise certainly highly recommendable book "Good Calories Bad Calories" has disappeared from the list of potential Christmas presents for friends and family. While I do not doubt that you can lose weight simply by changing your diet, it is yet completely illusory to believe that someone who is leading an otherwise sedentary life-style could ever shed superfluous pounds and build and maintain a decent physique without the fat burning and muscle sparing effects even moderate exercise has to offer. This simple, yet willingly overlooked fact has been substantiated only recently, by a study that is soon going to be published in the Annals of Nutrition and Metabolism (Andreou. 2011).
Image 2: I am not sure about the "C" as in chocolate, as this is a typical "female comfort food", but as far as "E" and "D" are concerned, the protocol will work for men at least as well.
Note: Although the following studies were mostly conducted with female subjects the results should translate to men, as well. This is specifically true for the diet + exercise intervention, as I have mentioned in a previous blogposts on the differential effects of Re-HIIT on body composition that women are at greater "risk" to compensate for an increased energy expenditure during exercise by overeating. Judged by their attenuated orexogenic hormonal response to exercise (cf. Hagobian. 2009), obese / overweight men should thusly benefit even more from the addition of regular exercise to a diet focusing on food quality and a reasonable reduction in total caloric intake (at least for the obese this reduction is mandatory, not facultative - cf. "Stocktaking, Goal Setting, -Tracking & -Resetting to Achieve a Healthy Weight & Shed Excess Body Fat")
In their large scale trial Eleni Andreou, Christiana Philippou and Dimitrios Papandreou, three researchers from the Department of Life and Health Science at the University of Nicosia and the Ministry of Education in Cyprus, evaluated the effects of a long(er) term dietary intervention with and without exercise on body weight, waist circumference (WC), body mass index (BMI), body fat and lean body mass in 206 overweight and obese female subjects from Cyprus. In that, a particular strength of the study was that the scientists accessed the success of their protocol not only at the 18-week mark, i.e. when the supervised study period ended, but also another 18 weeks later. This allows them and us to draw inferences with respect to the sustainability of the weight loss - and I guess that I don't have to tell you that this, i.e. weight maintenance, not -loss, is where most dieters fail.

Exercise exponentiates and modulates the effects of reasonable dietary restriction

But before we address the important issue of sustainabilty, let's first take a look at the study design: The Cyprian scientists put all their subjects (age: 34y; weight: 81kg; waist: 93cm; body fat: 40%) on the same "energy restricted" diet (1,500kcal /day; 50% carbs, 30% fat, 20% protein). While half of the subjects just continued on their customary (supposedly sedentary) lifestyle the (un?)lucky other half had to complement their dietary efforts by performing a "moderate exercise" program that consisted of either
  1. 3 or more days a week of vigorous-intensity activity of at least 20 min per day, or
  2. 5 or more days a week of moderate-intensity activity and/or walking of at least 30 min per day, or
  3. 5 or more days a week of any combination of walking, moderate-intensity, or
  4. any desired  vigorous-intensity activities achieving a minimum of at least 600 MET-min/week
The latter is, as you as a physical culturist will probably say, in fact "moderate" - at least compared to the idiotic (over-)training protocols by which many desperate dieters overtax themselves. The flexibility and practicability of the exercise program and the effectively very moderate calorie restriction (their calculated basal metabolic rate is in fact only ~50kcal above their daily allowance) constitute the second major strength of a study, the results of which show that - as long as you are patient and consistent - it really does not take much to induce major changes to the way you look.
Figure 1: Lean body mass, body fat and body water (in kg) at baseline, post intervention (18 weeks) and on post-intervention follow up (36 weeks) (data calculated based on Andreou. 2011)
As you can see in figure 1, the moderate calorie restriction, alone, produced a (for obese subjects) highly desirable loss in body weight. These effects were not simply exaggerated, in the subjects who combined dieting with "exercise training" (option 2, i.e. walking 5x a week for 30min, for example, would rather be "daily activity"), they were potentiated and modulated, so that a simple weight loss intervention turned into an effective tool for body recomposition. This becomes particularly obvious if you look at the lean to fat mass ratio, I plotted in the small graph on the right (cf. figure 1). Contrary to the subjects in the "diet only" arm of the study, the women who "exercised" lost significantly more body fat, while maintaining about the same amount of lean mass.
Figure 2: Weight loss, fat loss, loss of fat-free mass and reduction in BMI after 36 weeks in the "diet only" and the "diet + exercise" arm of the study (data adapted from Andreou. 2011)
The potentiating effect exercise has on the diet-induced loss in body fat, in particular, becomes even more obvious if you take a look at the data in figure 2. As the figures above the bars indicate. The addition of a very moderate exercise regimen to an already moderate caloric restriction resulted in 2x more weight loss, 8x more fat loss and, what is of utmost importance in view of the sustainability of their dietary success, 9x better retention of lean mass (note: the exercise group also lost -15.5% of their waist circumference, my favorite, since easy to measure and reliable marker of obesity, while the "diet only" group lost only 8.4%)

Add the "C" to E & D to keep sane and lean out even faster

So now that we have justified the addition of "E" as in "exercising to lose fat" to the "D" as in "dieting your muscles away", the one thing that is still missing to make this the perfect female weight-loss EDC is the "C" from dark chocolate (60% cacao), of which Cathrine E. Piehowski and her colleagues from the Pennsylvenia State University found that it had, when added as a 90kcal snack two times a day, a beneficial effect on the outcomes of dietary intervention involving 26 overweight and obese (BMI >25 to <43) premenopausal women (Piehowski. 2011).
Figure 3: Reductions in waist circumference, hip circumference, body fat (%) and estimated mean daily calorie intake in women in the chocolate and the non-chocolate snack group (data adapted from Piehowski. 2011)
Not only did the inclusion of a snack (either chocolate or non-chocolate) help the ladies to adhere to 1,500-1,800 (depending on body weight) diets, the ingestion of a chocolate snack led to more pronounced reductions in waist circumference, hip circumference and body fat, despite a significantly smaller reduction in overall calorie intake in the chocolate snack group (cf. figure 3).

So, ladies and, as I explained in the red box, gentlemen, what are you waiting for? The EDC approach to a leaner year 2012 is already there! You better start now, if you want to to have 10% less body fat in the summer month of 2012! To wait for the New Year to make a change, by the way is about as idiotic as Taube's statement that "exercise would just make you more hungry"... with regards to carbohydrates, Taubes is yet totally right. If the diet of the subjects in the Andreou study had been higher in fat and protein and lower in carbs, the results would probably have been even more astonishing. And if you keep following the daily updates on exercise and nutrition science here, at the SuppVersity, and implement all the stuff you learn into your exercise and nutrition regimen, you will have lost the 10% body fat even before the beach season starts ;-)