I'm Starting a Very Low Calorie Diet….Am I mad ?Or am I ?
BY Omar MOULAY, MD
Mar 4, 2022
Let's start with the public general consensus that we were all taught at one point which is a "one-size-fits-all" guide:
“On average, women should have around 2,000 calories a day (8,400 kilojoules) and men should have around 2,500 calories a day (10,500 kilojoules). Most adults consume more calories than they need”.
Hah… What a joke! The sad part about this statement is that this is still common practice. If we have narrow minds and just do as we are told, following this dietary recommendation will likely result in stacking on the pounds.
Remember: This is a very overall statement that does not apply to you necessarily.
The key is...
You need to know your body better!
A- First, how much energy are you spending a day?
1- Basic (basal) Metabolism, or minimal energy spent to keep you alive, warm and functional. This differs between individuals, and can be naturally high or low.
2- Age, gender, psychological and hormonal state at the moment are very important and some can change from day to day and through the day: eg: ovulation and stress elevates basic metabolism, while depression and old age tend to slow basic metabolism…
3- Muscle consumes more oxygen than fat does,
Muscle mass in proportion to body weight varies; ie, a very muscular man would need more energy intake than a man with more fat proportion even if all other parameters are the same
4- Daily activity and spread of intensive activity throughout the day:
higher activity demands more fuel, and intense clustered activity over a short period demands more energy compared to the same amount of activity spread over the day (High intensity interval training HIIT principle)
Checking your sleep has never been more important. Ever so often we have breakthroughs in research with medical diagnostics. What we have observed is that the presence of sleep apnea (lack of breathing or shallow breathing leading to oxygenation issues) directly affect metabolizing hormones such as Ghrelin, Leptin, Growth Hormone and Insulin. The good thing about it is that there are very convenient, easy to use, take home sleep apnea tests that are as accurate as a sleep lab when evaluating for Sleep Apnea. Need an appointment? Capital Home Medical offers Home Sleep Apnea Testing Across the nation.
So your specific needs could range from 1200Cal/d (for a 50yo depressive mildly overweight poorly active 40% of fat to Total Body mass, individual) to more than 3000 Cal/d (for a normal weight constantly active, 21% fat to Total Body Mass young person).
While it seems safe to assume that any diet with less than 1500-1200 Cal/d is a Low Calorie Diet, ingesting 1200 Cal/d can be barely low for some while very low for others.
B- Second, your body reacts differently to food :
1- how much you crave for food
2- how much of ingested food is actually digested
3- how effectively and critically your body would store this food as fat
4- How effectively your body can retrieve energy from these stored reserves
5- How well we metabolize our food based on our physical activity and metabolizing hormones release.
So in the end we need to look at how much of the food is ingested, or lack of food is ingested, that found its way into the body and how effectively the body is able to retrieve energy from your body reserves. Furthermore, if we opt for starvation for weight loss, we need to think about how would your body react and adapt to starvation and would your comorbidities benefit or worsen under starvation? Remember, drastically cutting one element out of your diet is never a good choice. For example, lets look at carbohydrates:
If we have done any research in weight management, there might be a common theme to reduce or cut carbs. When talking in general, we have to be very careful with this strategy as it can easily backfire. First, we need to come to an understanding that the purpose of carbohydrates is for IMMEDIATE energy for the body to use. If it is not used (low physical activity, close to bed time, etc) it stores as fat cells for future use. Eliminating carbs could can induce fast results but comes with the drawback of human starvation of something we love which leads to excessive consumption after the diet. Not only that but Carbs are a "Happy food". Not eating carbs can have you feeling more irritable and less "happy" which has its own consequences. In summary, it is better to have a balanced on-going lifestyle change on how we look at food and where we source energy from.
C- Last, but not least : not all food is energy.
Our body is made of Water, minerals, electrolytes, vitamins, cholesterol and other essential lipids, amino-acids, plus carbs. Believe it or not Vitamins are a major component of it all.
All of these come in very different proportions in our food habitus, but your body needs are very precise, can vary through life, and minimal thresholds need to be respected at all times.
Also, implementing and using those ingredients need energy that relies partially on food intake, since not all energy can be brought effectively and on a timely manner on site
So lowering your daily energy intake could turn out to be counterproductive.
To make it clear, the healthiest and simplest way is to combine a regular physical activity, a healthy stress free mood, with a diverse and wide range eating habit. Then, control your weight and change accordingly.
However, if you need more, if you are struggling with your weight, if you need to lose weight fast, or if you want your food to be ready to serve, then many options are there for you. Just keep in mind, you would better be seeking professional advice before you start anything.
One of the most popular programs and products out there are VLCDs and related products, like Optifast®
Very-low-calorie diets (VLCDs) are typically recommended for individuals with BMI over 30, who have failed to lose weight following an LCD.
VLCDs provide less than 800 kcal per day, over 2 to 16 Weeks, for fast short term results, before switching gradually to LCDs goal of 1200 to 1500 kcal per day over 4 to 6 weeks.
VLCDs require medical supervision because of the increased risk for medical complications, including electrolyte imbalance, dehydration, gallstones, and other abnormalities.
The most common VLCDs consist of medical-grade formulas designed to contain adequate protein, carbohydrate, and fat along with the appropriate micronutrients and meet the recommended dietary allowances of vitamins and minerals.
Supplementation of vitamins and minerals should be reviewed and regularly evaluated by a physician during VLCD administration.
Low-calorie diet is one that restricts your intake to less than the minimal required daily energy intake per your body type, which typically ranges between 1200 to 1500 Cal/d.
For weight loss, most people should consider a low-calorie diet rather than a very low-calorie diet. Less extreme diets are easier to follow, they interrupt normal daily activities less, and are less risky if you're over 50 or have other health problems. In addition, gallstones have been reported in people who go on very low-calorie diets.
Plus, although VLCDs produce greater short-term weight changes ; long-term (1 year of treatment) maintenance of losses was the same as LCDs.
In Canada, Optifast 900 is available, which is a low to very low diet product, that is served, if exclusively, three times a day for a 900 Cal/d, only after medical prescription.
If given less than that, it might be necessary to complete it with other sources of nutrient and energy intake.
This blog is for general education and does not intend to replace your professional advisor
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