Losing Weight and Staying Healthy

When it comes to losing weight, many physicians will tell you that the key is to burn more calories than you consume. While there may be some truth to this advice, it is not super helpful. The human body is a complex system with intricate feedback loops that can affect metabolic rate and hunger levels. This means that simply restricting calories is often not enough for sustained weight loss. On the other hand, trying to lose weight by burning more calories through exercise also tends to be ineffective. Exercising alone does not lead to as much weight loss as one might expect, as it can affect factors such as metabolic rate and appetite. Significant weight loss through exercise typically requires more than five hours of exercise per week (video).

Complicating matters further, it becomes increasingly difficult to maintain a healthy weight starting in our 30s due to changes in hormone levels. Let’s consider a 30-year-old man who follows a Standard American Diet (SAD) and starts gaining five pounds per year. By the time he turns 40, he will be 50 pounds overweight. By the time he turns 50, he will be 100 pounds overweight.

For those looking to lose weight or improve their overall health and longevity, I have three pieces of advice:

A) Educate yourself about processed foods and minimize their consumption.
B) Avoid high-fat foods and refined carbs, not complex carbohydrates.
C) Reduce your intake of animal products by at least half and adopt a more plant-forward diet.

I will provide more details on how to implement this advice shortly, but first let us examine how we arrived at this problem.

The history of the obesity epidemic

The prevalence of obesity in the United States has been increasing rapidly since 1980. It reached 15.0% in 1978, 23.3% in 1991, and 30.9% in 2000.^ref

By 2018, 42.4 % of adults (and 19.3% of children) were obese according to the latest data from the National Health and Nutrition Examination Survey (NHANES). 

The obesity epidemic can largely be attributed to the food industry. Through lobbying efforts, technological advancements, and agricultural subsidies, the industry has increased the production of sugary drinks and ultra-processed foods, making them more affordable and convenient.^ref These foods have artificially high amounts of sugar, fat, and salt, making it difficult to avoid overindulging. In fact, the industry carefully engineers food and conducts meticulous experiments to determine the exact amount of salt, sugar, and fat that is most desirable to the average person. As described in Michael Moss’ book, Salt Sugar Fat, the optimal concentration of sugar or “bliss point” for children is approximately double that of adults. Making such sweetened foods available to children further cultivates their cravings for sweeter foods, making them less interested in eating whole foods. Apart from the packaged foods that children ask for, this is apparent in most kid’s menus at restaurants, which offer foods with empty calories like pizza with white flour, quesadillas with white tortillas, fried chicken tenders, and hamburgers with white buns. Plant-based foods should be at the center of these meals as they have higher nutritional densities, containing more nutrients per calorie consumed.

Developing countries have gradually been adopting our bad dietary habits. According to this World Health Organization fact sheet, the rate of adult obesity worldwide has more than doubled since 1990, and adolescent obesity has quadrupled.”

Sadly, being obese draws a great deal of discrimination and stigmatization. At the same time, eating the Standard American Diet has become normalized by society. Fortunately, there is a solution. The World Health Organization’s Acceleration Plan to Stop Obesity notes that “Overweight and obesity are largely preventable. At the individual level, people may be able to reduce their risk by limiting energy intake from total fats and sugars; increasing consumption of fruits and vegetables, as well as legumes, whole grains and nuts; and engaging in regular physical activity.” – WHO Acceleration Plan to Stop Obesity. Of note, the WHO does not recommend a low carbohydrate diet. Instead, it recommends reducing the intake of fat and sugar while increasing consumption of plant-based foods, including whole grains.

A) Ultra-processed foods

Eliminating all processed foods is not feasible for most people so it becomes even more crucial to determine which ones to avoid. The public now recognizes the detrimental effects of ultra-processed foods; however, food labels make it incredibly difficult to identify which products should be considered as such. Packaged foods often display various claims such as “low fat,” “organic,” and “non-GMO.” However, most people are unaware of what to focus on when reading nutrition labels. Therefore, learning to interpret these labels is a critical step toward improving one’s diet. This recorded lecture by nutritionist Jeff Novac, MS, RDN, provides valuable insights on the topic. Here is a summary of Mr. Novac’s recommendations in that lecture:

1. Eat mostly whole foods, avoiding foods that are highly processed.
2. When consuming processed foods, disregard all claims on the front of the box to avoid confusion caused by misleading information.
3. Examine the nutrition label and take note of the number of calories per serving. Calculate 2% of that number (divide by 100 and multiply by 2).
4. The number of grams of fat should not exceed 2% of the total number of calories.
5. The number of grams of added sugars should not exceed 2% of the total number of calories.
6. The number of grams of salt should not surpass the total number of calories.
7. Inspect the list of ingredients and
8. Avoid anything with animal fat, palm/coconut oil or hydrogenated oils in the ingredients because they are high in unhealthy fats.
9. Avoid refined grains (wheat, white, durum, semolina, bleached, unbleached, enriched, ancient, heirloom). Instead, opt for whole grains (whole, rolled, stone ground, cracked, or sprouted wheat). 
10. It is acceptable to occasionally deviate from these guidelines, especially for condiments, which are typically consumed in small quantities. Personally, I also make exceptions for unsweetened oat milk and tortilla chips, both of which have higher fat content than what is recommended above.
11. Be cautious of mayonnaise and sauces, as they can undermine the healthiness of a salad or sandwich.

I would suggest following the above rules at least 90% of the time. Additionally, consider using balsamic vinegar instead of salad dressings and make water your primary beverage. Calorie-free sweeteners, even those labeled as having “natural flavors,” are often highly engineered and can potentially impact metabolism and satiety.

B) Avoid high fat foods, not complex carbohydrates

The high energy density of fat (9 calories per gram) makes it a significant contributor to excess calories consumed. For health reasons, it is especially wise to minimize fat from animal products, which tend to be higher in saturated fat than plant foods (with exceptions mentioned in rule # 7a above). It is best to avoid or limit consumption of ice cream, whole fat milk/yogurt, and fattier meats. While giving up cheese may be challenging, it is worth trying. Either way, it is important to be aware of portion sizes when consuming high-fat and refined carbohydrate foods like pizza and pastries.

Unfortunately, most of the carbohydrates people consume are refined, including white bread, white pasta, and most desserts/pastries.. It’s no surprise that so many people opt to avoid carbohydrates altogether. However, there is a healthier alternative: Avoid refined carbs and eat plenty of complex carbs. In fact, some studies show that it’s easier to lose weight when you eat more complex carbohydrates because it helps you feel full with fewer calories consumed as discussed in this video and this article. In fact, whole grain carbohydrates are even beneficial for diabetics, as explained in this video.

It is important to steer clear of refined carbohydrates due to their lack of nutrients and fiber. Moreover, simple carbs are quickly converted into sugars, resulting in spikes in blood glucose levels (high glycemic index). This process begins in the mouth with the help of the amylase enzyme in our saliva, stimulating pleasure receptors in our brains.

C) A plant-forward diet

To eat a more plant-forward diet, determine the percentage of your daily calories derived from meat and dairy. Aim to reduce that number by at least 50% and replace those calories with whole plant-based foods like fruits, vegetables, legumes, and whole grains. For instance, if your daily calories consist of 1000 from meat and 1000 from plants, aim to eat 500 from meat and 1500 from plants each day. With these new targets, you’ll probably end up consuming fewer than 2000 calories each day because the fiber content in plants helps with satiety, naturally reducing the tendency to overeat.

Consuming a higher proportion of calories from plants aids in weight loss because it reduces the average calorie density of one’s diet. Meat contains only two macronutrients: protein (4 calories per gram) and fat (9 calories per gram). Unlike animal products, plants contain fiber (2 calories per gram), which promotes feelings of fullness (satiety). As a result, plant foods tend to have a lower calorie density than animal products. (See Micro & Macronutrients table). This is why individuals who adopt a 100% whole food plant-based diet often maintain a healthy weight without counting calories. Furthermore, plant foods have a higher nutrient density (more nutrients per calorie) than processed foods and animal products, thanks to the abundance of phytonutrients, vitamins, and minerals found in plants, including whole grains.

The healthiest diets

There is compelling data to support that optimal health from either a traditional Mediterranean diet or a whole food plant-based (WFPB) diet. Between the two, a WFPB diet is more effective for weight loss, as described in this video. If you maintain a vegan diet that is low in processed foods and refined carbohydrates, congratulations! You are eating a whole food plant-based (WFPB) diet. My own diet is about 85% whole food plant-based and can be classified as a traditional Mediterranean diet.

There will never be a double-blinded, randomized controlled trial to definitively prove the benefits of a whole food, plant-based diet. Unlike trials testing medications, it is not possible to provide a “placebo” diet, and human behavior makes it extremely difficult to get people to make drastic and lasting changes to their diets. In lieu of such a trial, we can rely on other types of studies, including prospective cohort studies. The Adventist Health Studies 1 and 2, considered the largest and most comprehensive studies on diet and outcomes, included data on over 90,000 people and have been ongoing since 2001. These studies have demonstrated a multitude of health benefits for individuals who adopt plant-forward diets. The researchers made the following observations about the relationship between diet and BMI:

As noted in the table above, the average BMI of vegans was 24.1, which falls within the normal weight range. In contrast, nonvegetarians in the study had an average BMI of 28.3, categorizing them as overweight (BMI 25 to 30). The disparity in BMI between the two groups was 4.2, equivalent to a weight difference of nearly 30 pounds for individuals of average height.

If you decide to adopt a 100% whole food plant-based diet, there are certain factors to consider, just like with any other type of diet. Adequate protein intake can be achieved through careful planning and incorporating plant-based protein powders can make it even easier. After sampling several on this website, I enjoyed the taste of this one the most.

While the primary focus of this article is on achieving optimal weight, the same principles will benefit overall health in numerous ways. Studies have shown that eating more plants can decrease the risk of developing heart disease, dementia, diabetes, certain types of cancer and other conditions associated with obesity and metabolic syndrome.

Avoiding animal fat provides significant health advantages beyond weight loss, as various diseases are linked to saturated fat. Adhering to a healthy diet may be challenging initially, but over time, your taste preferences will adapt, and cravings for less healthy foods will diminish. With determination and some healthy habits, it is possible for anyone to enjoy a diet that allows them to burn an equal or greater number of calories than they consume.