How much weight, you might ask? Understand first that all of these girls are active athletes. Being part of the crew team means 6 AM daily morning practices before school, with additional practices two nights a week that consist of either strength circuits or working out on the rowing ergometers. And were are not talking about substantial weight loss. My daughter is 5’9” and weighs 132 pounds. She and all of her fellow crewmates need to all be under 130 pounds- the cutoff weight for participation in the event. The largest girl I am told is 133 pounds, so we are not talking about a significant amount of weight loss, just a little trimming.
Now to be sure, I am not going to take the idea of discussing weight loss with a teen age girl lightly. I am well aware of the significant risks of body image dysfunction reflected in the medical conditions bulimia and anorexia. But in this example, we are looking to lose about 4 pounds in an active, healthy girl, which turns out to be about 3% of her body weight. Again, I am stressing that I would never encourage a young woman to look at herself and to consider herself less capable, attractive or successful because of her weight. I would never make any of these recommendations for a young woman in whom I suspected even the slightest tendency towards anorexia or bulimia. I am curious to see if there are 3-4 extra pounds hiding on my daughter’s frame in the form of stored fat that could be metabolized- over the next few weeks- while maintaining her health, strength, and intact body image. Burning off these few pounds might allow her to participate in a race that represents a once in a lifetime opportunity. There are two places where I could possibly intervene to allow her to shave off this weight in the coming three weeks. The first is obviously diet. I am not referring to a diet which counts and restricts calories. I want my child to be eating often, well, and until she feels full. There should be no sense of hunger or deprivation as she proceeds with her “diet”. I am optimistic that she can metabolize off a few extra pounds without having to actually follow or subscribe to a change other than examining the relative intake of the three energy sources: sugar, fat and protein. The second intervention is to utilize some supplementation to direct the metabolic processes that instruct the body on how it is going to utilize its energy and energy stores. As with all metabolic functions in the human body, the breakdown of fats, proteins, or carbohydrates as a fuel source depends in part on the availability of these nutrient classes, the individual’s genetic makeup, and the choreography of the associated vitamins and minerals essential to the process. This can all be influenced by directed supplementation. We’ll explore this in greater depth later in the blog. When carbohydrates (glucose) are consumed, the body releases the hormone insulin. Insulin directs the sugar in the bloodstream to be deposited in the muscle and liver cells in a storage molecule known as glycogen. In the absence of insulin, the carbohydrates consumed are not stored but burned as fuel. Once the dietary carbohydrates have been burned, the body then turns to fats and proteins for energy. The overall premise of this approach is to remind the body that it can easily burn fats and proteins to provide all of the energy required for growth and development. For a body requiring energy, glucose is the ”low hanging fruit”. It is the “preferred” form of nutrition for the brain. So it is no surprise why we so readily reach for foods high in carbohydrates to satisfy our initial urges of hunger. But it is important to recall that the biological process known as gluconeogenesis, the making of glucose from fats and proteins, is more than sufficient. And while a brain preferentially runs on glucose, it is perfectly happy to function on ketone bodies, which come from the breakdown of fats. By limiting carbohydrates and glucose, an individual’s metabolism can be encouraged to utilize the stores of fat for energy. The concept of trimming down body fat to optimize weight while maintaining strength and speed can be achieved not through dieting, but through dietary choices. Dieting alludes to the idea of caloric restriction. Healthy weight loss occurs without restricting any quantities of food, and by identifying and optimizing the correct food type for the body matched with the level of activity. I do not recommend that patients count calories. I believe that substantial, and safe, weight loss can occur without dieting. If my daughter wants to shave off a few pounds before her race in a few weeks, here are my recommendations. For starters, I have suggested that she examine her food selections in regard to fats, proteins and carbohydrates. I believe that she is consuming several hundred calories daily in the form of extra carbohydrates. Recall that in response to carbohydrate intake- less so with the consumption of proteins and fats- insulin rises and instructs the body to store these calories as glycogen and fat. I am suggesting that she try to obtain her calories primarily through proteins and fats. The dietary changes are relatively simple. She needs to cut out almost all excessive carbohydrates from her diet for the next three weeks. Her carbs should not be fully eliminated, but limited. Ideally their consumption should be before a time of mental or physical stress, such as taking a test or doing a workout. I believe that when the morning’s sweet roll, the dessert after lunch, and the bag of corn chips consumed on the couch after school are eliminated, she will begin to lose whatever extra weight is stored in her body as fat. I will encourage her to consume whatever veggies she wants, and in whatever quantities. She should fill up on nuts, avocados, lean proteins, yogurts, beef and turkey jerky, olives and cheeses to her heart’s content. She should eat some fruit, ideally the low carbohydrate choices such as berries, melons and apples and avoid high-carb fruits such as bananas and pineapples. Dried fruits, such as mango and cherries, should be avoided altogether. The challenge is to avoid the “hidden” calories that lurk in foods perceived to be healthy. Granola, energy bars, and organic oatmeal all sound healthy, but all contain high amounts of carbohydrates, and will by definition raise the levels of insulin in response. Are there any supplements that can be used to help accelerate the burning of fat? I think that there are. I would ask her to consider the use of the following: I recommend magnesium to begin with, which is a natural muscle relaxer ( essential for the training athlete), and an important co-factor for the functioning of the insulin receptor. She needs to be taking between 400-600 mg. of elemental magnesium. I like the magnesium citramate from Thorne, which has 135 mg of elemental Magnesium in each capsule. In addition to optimizing the function of the insulin receptor, it helps to relax hard working muscles, and also helps to move the bowels- probably the primary source of a few extra pounds of excess weight. I think that the cellular burning of fat, which is mediated by our cell’s mitochondria, can be stimulated by the use of CoQ10, which is an important component of the final pathway for making energy. Thorne makes a great supplement that I recommend, called Q-best. The daily dose would be about 50 mg a day for a young woman. Another component of cellular energy revolves around actually shuttling the fat molecules into the mitochondria where they are burned. Mitochondria are known as the “powerhouses of the cell”, and biochemists know this as the carnitine shuttle. This requires the molecule carnitine, which is also available in supplement form. For a rapid trimming session, I would use the Thorne powdered L-Carnitine at about 1-3 grams daily. This is typically about one scoop or less. She can mix it in a morning smoothie, or with water. Once the body is beginning to liberate fats for energy, we don’t want to have a pileup at the turn-styles. Carnitine supplementation ensures that the fats can be effectively shuttled into the mitochondria where they will be burned, and that carnitine insufficiency is not a limiting factor in this process. Finally, good current research suggests that carnitine may be mixed with a molecule known as alpha lipoic acid, or ALA, to optimize the mitochondrial function. A couple of good recent papers supporting these choices are referenced below. I would follow the protocol in this study, and use 200 mg of ALA daily to optimize my mitochondrial function for the burning of fat. http://www.ncbi.nlm.nih.gov/pubmed/18026715 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2734271/ To conclude, I do condone and support my daughter’s effort to lose a couple of pounds of excess fat in a healthy and sensible fashion. I think that the process is simple. She need to consume a diet that is practically ketogenic, focusing on fats and proteins and vegetable carbohydrates over conventional carbs. She need to avoid sweets at all costs, including high sugar content fruits, and continue training at the level that has been maintained over the last several months of practices. And finally, she can augment her biological systems with the use of the safe, well-considered dietary supplements of magnesium, CoQ-10, carnitine and alpha lipoic acid.
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