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Summary

Interested in medical weight loss management and dietary influences on body composition? Join this informative session as we explore the motivations behind weight loss, the definition of healthy weight loss, and delve into the impact of protein-rich diets in regulating body weight and composition, particularly among athletes and the obese population. Discover the intriguing roles and potential dangers of high-protein diets, the advantages of dairy-based proteins, and their correlation with muscle preservation and fat mass reduction. Understand the critical insights and guidelines for protein use in weight loss and enhance your clinical practice or personal fitness goals by applying these useful knowledge points. We conclude with a comprehensive Q&A segment.

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Learning objectives

  1. Understand the multiple motivations for weight loss among different groups, such as obese individuals, regular exercisers, and different categories of athletes.
  2. Develop an understanding of what constitutes healthy weight loss – specifically, loss of fat mass (especially visceral fat) and preservation of muscle mass.
  3. Explore the role of protein, particularly dairy protein and its sub-type whey, in aiding weight loss in obese individuals.
  4. Examine and understand the potential dangers of high protein diets within a critical context.
  5. Acquire knowledge on the guidelines for the use of protein in weight loss strategies, also considering the various benefits posed by a high-protein diet, such as increased total body mass loss, increased fat mass loss, and maintenance of muscle mass.
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Computer generated transcript

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The following transcript was generated automatically from the content and has not been checked or corrected manually.

OK. Um I think I'm gonna make a start now. Um As usual, I'm gonna try and monitor the chat during the presentation in case any questions come up. Um But there will obviously be time for questions at the end as well. Um So welcome to the third part of the teaching series on this time, nutrition for healthy weight loss. Um So today we'll be looking at first just reasons to desire weight loss, what different motivations may they be? Um And then what exactly healthy weight loss is and then we'll dive right into the role of protein drink, weight loss in the obese population. And the role of protein for weight loss in athletes will then cover just a few potential dangers associated with high protein diets. And this will involve another critical analysis and will then end on just guidelines for the use of protein and weight loss. Um I have a bit of a cold going on, so just bear with me. Um I hope it's not too disruptive. Um OK, so why would somebody want to lose weight? Well, firstly, obesity, obese, individuals want to lose weight perhaps for aesthetic purposes, but often the primary factor driving the desire for weight loss in obese individuals is that they want to improve the metabolic health and therefore their standard of living exercisers. Here, we're looking at a cohort that is more interested in losing weight for aesthetic purposes, um to feel better about themselves and yeah, feel better in their own body. And finally, we have athletes and within athletes, there's three kind of broad categories within which weight loss would be desired. One is weight category athletes. So we see this in boxers, wrestlers, jiujitsu. Um these are sports where athletes need to weigh in at a particular weight and if they are heavier than that, they can be disqualified from the competition. Um so that can be one reason for athletes, the other is to increase power to mouth ratio and this is seen particularly in sprinters, road cyclists, swimmers. Um and this is where being a lower body weight gives them a performance advantage um because it increases their power to mass ratio. And finally, we have aesthetic sports like bodybuilding and ballet dancing where the headaches as the name suggests are really important. And so they need to maintain or cut down to a particular weight. Sorry. Um so now that we've covered kind of motivations for weight loss. So what is healthy weight loss? Well, healthy weight loss is the loss of fat mass, particularly visceral fat and the preservation of muscle mass. Now, visceral fat is the fat that surrounds the organs as opposed to subcutaneous fat, which is like under the skin. Um and high visceral fat is associated with higher metabolic disease. And um so that is the fat mass that is that we're interested in losing and then the preservation of muscle mass because muscle mass is the major metabolic organ in the body. So to put this kind of into numbers, this is a study that was done where they followed obese women through a period of hypochloric dieting. And these women lost on average um 8 kg of body mass. But what's interesting is the composition. So what we see on the graph here is in yellow, we have the fat free mass lost and in black, we have the fat mass loss. And what we see is that out of the 8 kg that these women lost on average, actually, only 50% was fat mass. The other 50% that we see in yellow was fat free mass, which is essentially muscle. And this kind of makes sense because an energy deficit impairs muscle protein synthesis. And we want to avoid this at all cost both in the obese population and in athletes because as I said, muscle is the major metabolic organ in the body. It is the most sensitive to glucose uptake. And in obese individuals wishing to reduce their body weight to improve their metabolic health by losing muscle mass. They, they're losing the element that can best help them actually reach metabolic um more healthy metabolic state. And athletes who are looking for performance, muscle is what they use for performance usually in sports. And so, again, losing muscle is not desirable in either of the two chords. So does diet composition influence the outcome of hyperchloric dieting in the obese population? Can we by altering our diet, maximize fat loss was minimizing muscle loss. This study done in obese women again, followed them over 10 weeks of hypocaloric dieting. So they were in an energy deficit, nutritional energy deficit for 10 weeks. And they had two study groups. They had a high protein group and they had a controlled carbohydrate group. In the protein group, the subjects consumed a carb to protein ratio of 1.5. And in the carbohydrate group, a carbon protein ratio of 3.5. And in the graph on the right, we can see kind of the follow up over the weeks, the carbohydrate group are depicted in blue and the protein group in yellow. And what we see is that over the weeks, yes, body mass is lost as with increase in um the height of the columns. But what's interesting about this graph is that it shows that the on the y axis, we have fat loss to fat free mass loss ratio and this is higher in the protein group than in the carbohydrate group. So what they showed is that a high protein hypochloride diet results in greater over o greater overall loss of body mass and particularly a greater loss of fat mass relative to muscle mass. Now, two years later, the same study group did another study with a very similar protocol. But this time they added exercise. So, rather than having just the protein and carbohydrate groups, they now added a protein plus exercise and a carbohydrate plus exercise group. So they had four study groups. The carb protein ratios were same as for the previous study. And they showed again that a high protein diet led to greater reduction in percentage body fat than a a carbohydrate diet. But adding exercise to both the protein and the carbohydrate groups enhanced this more even more. So, adding exercise to carbohydrate diet resulted in a greater reduction in body fat percentage than the protein diet alone. And now adding exercise to the high protein diet, knocks it through the roof. And I mean, we can see this that if we look on the bottom two, cols, we have the protein group leading on average to 2.5% drop in body fat and adding exercise doubles this. I mean, that's, that's incredible over 16 weeks. Um But this study now looked at dairy protein in particular. So we look, we've seen that high protein diets seem to favor body fat loss. What about dairy protein? So this study looked at in white, we have a group with adequate protein and low dairy. In gray, we have adequate protein medium, dairy and in black, we have high protein, high dairy. And what they showed is that the high protein, high dairy group had resulted in a greater change in fat mass, a greater reduction in fat mass over the study period. And particularly in the later weeks, if you look at weeks, 8 to 16, this is where it reaches statistical significance, which is depicted by the little star. And somewhere it makes sense because it's in the later weeks that losing fat is more difficult. At, at the start, the body is avidly breaking down fat is happy about it. But there comes a point where it becomes more difficult to lose weight. And this is where high protein hydrate. Your diet seems to have a particularly strong effect of enhancing the fat mass loss in that period. Now, even more importantly, almost or as importantly, they also showed that the high protein, high dairy group not only preserved muscle mass during this diet phase, but they actually gained muscle mass. So here we see on the right hand side, the change in lean mass. And you can see that consistently, the high protein, high dairy group actually gained muscle mass. Whereas the two other, the adequate protein, low dairy and medium dairy groups lost muscle mass. So it seems like dairy protein really favors the change in body composition that we're looking for, for healthy weight loss. Now, this next study looked more specifically at whey protein. Whey protein is the major milk protein. So it's a big component of dairy protein. And they just took isolated whey protein and they compared it to so soy protein, which is plant protein and carbohydrates, which have negligible protein um amount for our purposes. And not surprisingly, the, if we look at the graph, we can see that the muscle protein, synthetic rates of the carbohydrate groups, regardless of whether it's pre or post study were significantly lower than the protein groups. But what we see is that the whey protein groups pre and post had higher um muscle protein synthetic rates. And um just uh to be clear on the y axis with fractional synthetic rate. And this is a measure of um the rate at which sorry, the rate at which a precursor compound is being incorporated into a product per unit time. And in this case, it's a measure of muscle protein synthesis. So again, if we look just at the green lines before the diet was even started, whey protein seem to significantly enhance muscle protein synthesis after a meal, postprandial after a meal. Um and uh more so than soy and definitely more so than carbohydrates. And this is again, in line with what we covered in um the muscle hypertrophy tutorial where animal protein sources, especially milk protein sources are simply superior in terms of their muscle protein synthetic potential. But what's really interesting here is that after the calorie restricted diet, the muscle protein synthetic rates after a meal were still quite high for the whey protein group. Whereas there was a significant drop seen in the swing carbohydrate groups. So as we said earlier, an energy deficit impairs muscle protein synthesis. So with the protein, we're really trying to just activate the muscle protein synthetic machinery as much as we can to preserve the muscle. And this is because amino acids, particularly leucine is a nutritional signal for muscle protein synthesis. And whey protein is rich in loosen compared to other sources and especially plant sources. And so that can explain why even after the hypochloric diet, we're only seeing a 9% reduction in the post prandial muscle protein synthetic rates with the whey protein, but with the soy and carbohydrate groups because that nutritional stimulus to build muscle is not as strong as with whey protein. We see significantly greater reductions in the muscle protein synthetic rates of 28 and 31% respectively. So, what does this mean for the obese individual? Well, in obese and overweight individuals, an increased protein intake during hypocaloric weight loss seems to increase total body mass loss, increase fat mass loss and maintain muscle mass. And in particular, a high protein weight loss diet with a high dairy component because dairy is rich in weight and amongst other reasons may be the most effective for achieving weight loss with a high ratio of fat to muscle mass loss, so, preserving muscle mass and losing more fat mass and some of the reasons why um protein may help. And we did cover a few of these um just now. But one is a thermogenesis. The thermic effect of food is essentially a measure of the amount of energy it takes your body to digest food, mac nutrient and nutrient. And for protein, the thermic effect of food is 20 to 35%. For carbohydrates, it's 5 to 15%. So if you put this into perspective, both protein and carbohydrates have four calories per gram. So if you consume 25 g of protein or 25 g of carbs, both will be 100 calories worth of food. The difference is that with protein out of those 100 calories, 20 to 35 will be used to digest the protein, which means that your body is actually only taking in about 65 to 80 calories with carbohydrates, you're only consuming 5 to 15 calories to digest the carbs. So you're left with 85 to 95 calories still in your body. So for the same amount of calories, actually less protein calories are left in the body after digestion. So that could be one reason why there's more weight loss. The other is satiety protein has a 30% greater satiety on average than carbohydrates, which means that some say eating less or you know, the population, people are eating less they're snacking less. And that also obviously reduces the general chloric intake. But in terms of mechanisms of white protein itself may mechanically um change. The composition is, as we said, it increases protein synthesis. So muscle is a, I mean, sorry, protein and amino acids in the protein in particular are um nutritional signal to activate muscle protein synthesis. And so this allows your body to during the hypochloric dieting be told, keep building muscle. And if it doesn't build muscle, at least that will counteract the body's desire to break down muscle for energy. And because of this, you retain more muscle or gain a little bit of muscle. And this increases the basal metabolic grade because muscle is metabolically active at rest, which means that you're still burning more calories at rest. And perhaps as a result of this high protein diets also allow for increased fat oxidation. And this comes back to the idea that protein is a stimulus for muscle protein synthesis. If your body is in a catabolic state, right, you're not consuming enough calories, it needs to scavenge the calories, the energy from somewhere in the body if you're giving nutritional signals. And in the case of adding exercise, also mechanical signals to build protein, your body when it gets to the protein, to get the energy, it says, well, I'm trying to build protein, I'm not gonna take it away. Now, I'll find somewhere else to get my energy from. And it finds fat and fat fries off of energy. And so it, in a sense can redirect the energy metabolism towards fat because your body doesn't want to break down the muscle. It's working so hard to build. Um, and um, yes, so what about athletes and exercisers? Well, before we look at their requirements, it's important to distinguish the goals between obese individuals and athletes trying to lose weight and the big difference really between the two is the amount of weight to be lost. Athletes, exercisers don't tend to have to lose nearly as much weight as obese individuals for obvious reasons. Um And so a lot of the athlete dieting tends to be more about tweaking and reaching um a particular very specific goal as opposed to overall body lo um body weight loss. And in line with this, it's also about performance, be it performance on the bodybuilding stage, be it performance during a race? They have specific goals and the health parameters are maybe not as like in their primary focus because athletes exercisers tend to be more or less metabolically healthy. And because of this, the considerations of whether to tweak fats or carbohydrates to be able to account for the high protein diet in a weight loss, um phase is different and we'll touch on this again a bit at the end. But in terms of protein intake for body composition, this study was performed on weightlifters who followed a 40% calorie restriction for two weeks. And as before they had a high protein group who consumed 35% protein and a control group who consumed 15% protein. Now, on the surface, if we look at this graph, do you think? Ok. Yeah. The control group lost 2.5 kg. That's almost double what the high protein group lost. Um, high protein diet sucks. But if we look more in detail about, like at the actual composition, we see in blue is the fat mass loss. And in yellow, we have the fat free mass loss or the muscle mass loss. And we can actually see that both the control and high protein diet groups lost about a kilo of fat. So the difference in weight loss and total weight loss between the control and high protein group comes from muscle loss, the control group lost significantly more muscle than the high protein group. And that's what makes up the difference between the weight loss. So if absolute weight loss is the goal, go ahead and follow a control diet, that's fine. But if you're trying to preserve muscle mass whilst losing fat mass, precisely, that's where a high protein diet seems to have an important role. Now, another thing that is important is the rate of um weight loss. This study did, um, looked at two rates of fat loss. They had the slow reduction group sr which they had a calorie restriction of 19%. And then a fast reduction group who had a calorie restriction of 30%. And the endpoint of the study was when individuals had lost 5 to 7% of their body mass. And this means that individuals would stay in the study for different durations of time depending on how fast, how big the calorie restriction was. So, the slow reduction group on average followed the diet for 8.3 weeks. The fast reduction group stayed in there for only 5.5 weeks on average. So they clear it was a much faster rate of um weight loss in the fast reduction group. And I just saw the chat. Can we get recordings? Um The tutorials are all recorded and I will upload them at the end of the teaching series on youtube. Um So hopefully there will be a message sent out. Um I'll, I'll make sure you get a link to that once they are uploaded. Um But you do get access to the slides on the metal page as well once you filled out the feedback form. Um Yeah, but uh yeah, sorry. So back back to the study. So, yes, the slow reduction group stayed in the study for 8.3 weeks on average, the fast reduction group for 5.5 weeks on average. And if we look at the graph, obviously, we see the weight same weight loss. Yes, because bab was the endpoint of the study. That was the controlled variable. But now if we look at the proportion of muscle versus fat mass loss in black, this slow reduction group, not only did they lose more fat mass, but they actually gained lean body mass. They gained muscle during the study, whereas the fast reduction group lost less fat and they also lost muscle. So during the study, the the way that both groups actually met, the target weight loss is different. One lost a lot of fat and gained some muscle, which kind of counteract in terms of weight and the other lost fat and muscle. So it seems like the actual rate at which mass is lost, fat is lost. And therefore the extent of restriction is also an important consideration. So in athletes, an increased protein intake during hypochloric dieting seems to reduce the percentage of fat free mass loss and slow weight loss preserves fat free mass. Now, this was shown in the context of athletes, but the rate of weight loss holds true for exercisers and for overweight obese individuals, the rate of fat loss will um the rate of weight, sorry, the rate of weight loss will impact also the body composition. Now, if you have excess fat on your body, as is the case in obese individuals, the rate becomes less important than when you're really playing with a few percentages of body fat like athletes and perhaps some exercises do. So it does become a more important consideration. The leaner you get. But for athletes, whilst a high protein diet is optimal for body composition, there are some negative effects in terms of performance, it increases or it seems to increase in some subjects, the subjective scores of fatigue. So they're more exhausted from training and perhaps performance and also increased mood disturb mood disturbances. And this means that if the total mass lost is the main goal, perhaps protein, high protein is not the most appropriate because per performance may be impacted. But athletes and performance aside, there's a lot of discussion um in the field about the potential dangers of high protein intake and we'll just talk through a few of them now. So the first big one on most people's minds is kidney problems. There's a lot of discussion about high protein diets um being detrimental to kidney function. But really there are no known cases in otherwise healthy individuals that this is the case. Now, if we look at people with underlying kidney damage, yes, high protein diets can definitely make the condition worse. And that's what it becomes an important consideration. Bonos is another consideration. Um The link between high protein diet and bone loss stems primarily from evidence from animal and cell studies, which suggests that high protein diets increase bone loss, but actually meta analysis both from 2009 from studies in humans, so that there's no real association between protein intake and bone problems. And they actually found a slight positive association between protein intake and bone health. Now, more research is warranted in the field, of course. But if you think about the mechanisms somewhere, it makes sense because protein is a big stimulant of I GF. One I GF one is very heavily involved in the protein synthetic machinery, but also in bone formation. So some you know, we can reason through why they might see a positive association. But kidney problems, bone loss, aside, there's one consideration which holds true for everyone following a high protein diet and which can be easily managed. And that is the compromise of the intake of other nutrients such as carbohydrates and fats, a high protein diet, especially when you're following a low calorie diet because you're trying to lose weight means that other nutrients are gonna have to give. And that is where for metabolic health performance, health, all these things, it is really important to consider what nutrient you're gonna compromise on. And that's something to just really be aware of. You can't just be living fully off of protein, but let's look a bit more at kidney disease and with the high protein diets cause kidney disease. So, and subanalysis of the cris study was performed by Vukovich et al in 2023. Now, the cris study was a cross sectional study in the general population of South to rule. So these are otherwise healthy individuals and what they found was that total protein intake and in particular, red and processed meats were associated with higher serum creatinine levels and lower EGF estimated G FR levels. And this is what we see on the graph here, we have on the very top the control of protein intake. And we're on the left hand side of the vertical line, which means that it has essentially a negative effect. It's lowering EGFR levels. And this is particularly true for red processed meats. So, ok, maybe you know, lower eg fr levels. That's not a good indicator of kidney function. I mean, it means the kidney function is maybe not great. So, yeah, maybe high protein diets, you know, do cause kidney problems. And a study in 2021 done on polar bears kind of supports that they showed that in zoo bears fed high protein diets, 37% died from kidney disease and the bears dying from kidney disease were about 10 years younger than ours than those dying of other causes like old age. And another point was that when comparing the serum urea and creatinine levels in the zoo bears with the king disease and that of wild bears, they found that the urea and creatinine levels in the zoo bears was significantly higher than that of bears. So it's kind of, you know, reminiscent of what the cris study showed. And it's z bears are not naturally feeding high protein diets, they usually have a high fat, low protein diet. So this study shows that Ok. Well, if you feed a species who's not supposed to be, you know, by nature evolution, eating high protein diets, a high protein diet, it seems to cause kidney disease. Um, a question in the chat is the secret in eeg G fr similar with intake of creatinine supplements itself. Um, sorry, let me think about that. I'm not sure exactly what you're referring to. Um, I think yes, there's a certain element of animal proteins have crea creatine and that can increase um some of the markers like it can essentially confound some of the markers because it artificially changes them. Um I think you're getting ahead of me. Um that will be discussed in the next slide to a certain extent as well. But um yes, and that's something to watch out for is that there is there can be artificial raising of some of these markers. Um And therefore, it may not really be representative of actual kidney function because the eating the protein and the supplementing with creatine is a um transient increase. It's not a chronic increase due to actual physiological deregulation of the system. Um I hope that's what you were referring to if not um just drop another message. Um But yeah, but so the yes, the polar bear study seems to kind of support the subanalysis of the cris study. But again, there's always a but uh the Narasaki et al um published in 2021 was a retrospective cohort study and what they did is that again, they fed a high protein diet and they showed that, I'm sorry, they looked at um, different cohorts in the US, um, following higher or lower protein diet just based on what they were reporting. And what they showed is that in people with chronic kidney disease, a high daily protein intake DPI stands for daily protein intake was associated with higher mortality. So again, that doesn't really bode well for high protein diets. But in healthy individuals, the opposite was true. In healthy individuals, they found that a low daily protein intake was associated with higher mortality. So why are we seeing these differences? Well, as um Jason suggested in the chat, the study estimated G FR based on fasting serum creatinine. And this means that firstly, there's another estimation of G FR in individuals with a large muscle mass. Um Although to what I said that holds true for this study may be negligible as we're looking at the general population, which I doubt is um full of bodybuilders. But perhaps more interesting in this case is that animal protein may trans the increase exogenous creatinine. And um this means that with exogenous creatinine, this increases serum creatinine and therefore decreases eg fr but this is a transient increase due to an outside source which will we metabolize and will be washed away. So maybe the low eg FR values we're seeing in the high meat consuming population is just a confounding. It's just an effect of their diet. It's not actually reflecting the health of their kidneys now rotted. All these animals who have very different dietary requirements to humans. Yes, polar bears do not follow a high protein diet. They follow a high fat, low protein diet, but humans don't follow a high fat, low protein diet. They follow on average a high carb moderate protein diet, which means that although following a high protein diet for polar bears cause them to have kidney issues. That doesn't mean that humans are also gonna have kidney issues if we follow high protein diet because we have already completely different diet. So the body can react differently to changes in um matrin. And the third point is that the cris study and the neuropsychic study estimated protein intake from food frequency questionnaires or 24 hour recall. And that is obviously prone to recall bias. So to what extent we can really know how much they were eating. Yeah. But one thing that all these three points have in common is that the studies use biomarkers, serum creatinine estimated GFR serum uria are biomarkers for kidney functions. They are not definitive measures of kidney functions. And as we saw in the first point, the cris study and as Jason said with the creatine supplements, they are exogenous factors that can alter these markers and therefore, it is difficult to directly extrapolate. They can be falsely elevated, they can be falsely reduced. Um So we to this day do not have a biomarker that is 100% associated with kidney function. Um Nor do we really have a way of measuring kidney function directly in such a like wide cohort. Um So, you know, they do the best we do our best with the studies. But these are things to keep in mind. Now, back to kind of the guidelines in terms of the guidelines for the use of protein in the clinical setting. So looking at obese and overweight individuals, they should be aiming for gradual weight loss via a moderate decrease in energy intake and with an increase in energy expenditure via probably an exercise program but also increasing just habitual activity. Now, for gradual weight loss and particular interest in the preservation of muscle mass overweight individuals should look to consume about a 3 to 2 ratio of carb protein sorry and an increase in activity with preferably resistance exercise as a major component because as we saw exercise can enhance the well preservation and even building of muscle mass because of the mechanical stimulus for muscle protein synthesis. Now, for overweight and obese individuals who are sedentary, they may increase protein at the expensive of carbohydrates. And this is because well, if they are sedentary, they don't need that much direct energy from carbohydrates to be fueling their activities. And because they are not exercising, which removes a huge stimulus for muscle protein synthesis. Through this mechanical pathway, then we say, OK, well, let's at least try and maximize the stimulus from the nutritional side. And that's through protein. Now, for athletes, one important thing to keep in mind is that the recommendations should be individualized based on their training or competition goals. And if the absolute amount of weight loss is the primary goal, a high protein diet may not be the best choice because as we saw earlier, this may impact their performance and their um perceived fatigue um which again impacts negatively their performance. But if it's more important to maintain muscle whilst losing moderate amounts of weight, this is where a high protein diet at the extent of fat is recommended. So as opposed to obese individuals where carbohydrates can be cut out if need be in athletes, carbohydrates are absolutely necessary because as we saw last week, carbohydrates are essential for fueling performance. And um that is why cutting out the fats if need be is the way to go for athletes. And as we saw as well, the rate of weight loss may be important in terms of optimizing body composition. Now, just before, II, do you know I've mentioned this a few times, but today we talked a bit more about nutrition, but I want to underline the importance of strength training and healthy weight loss because whilst nutrition plays a big role, strength training is crucial for healthy weight loss. And for two reasons that we've touched on repeatedly today already. Firstly, lifting weight helps build and preserve muscle mass during the weight loss period. And this is because it is this mechanical stimulus for muscle protein synthesis. And perhaps as a result of this to a certain extent, it enhances the rate of body fat loss. Because as we discussed earlier, by telling your body to build protein, your body is gonna look elsewhere for energy to break down for its use. And that's where it'll turn to its fat stores and that's it. So again, time for questions. Now, if anyone has any, I see another one in the chat, which is so this is the guidance for weight loss essentially to enter a caloric deficit. Yes. The one simple equation, simplified equation for weight loss is your calorie intake needs to be lower than your calorie expenditure or your energy intake needs to be lower than your energy expenditure. That is the only way you can lose muscle because that is the only way your body is gonna be looking for energy within its own energy stores to fuel your living and your activities. If the energy intake is greater than energy expenditure, that is going to be your body assimilating the energy and storing it as fat or muscle. Um So yes, for weight loss, you need to be in a calorie deficit. Um And the primary way to achieve a calorie deficit is through diet because in terms of energy homeostasis diet accounts for about 70% of the weight loss. So just massively increasing your energy expenditure by going on, run upon, run upon run is a gonna wear you down. But, um, it's just not as efficient as simply reducing your calorie intake. And calorie calorie intake can be tweaked so easily by replacing certain foods or by just, you know, eating one less spoonful every meal, you're already eating one less spoonful every meal than you did the past 20 years of your life. And over time that accumulates. And so there are really um a lot of ways to target such a calorie deficit. And the further you get into the diet, obviously, the more difficult it becomes, but at least the initial stages is where it's quite easy to create an energy deficit simply through um simple tweaks in your diet. Um Yeah, gym influencers like to make weight loss confusing. Yes. Um I think the nuance comes in the macronutrient composition and that's where I think, I hope you take away from today that to optimize fat loss, um healthy uh well, to optimize fat loss and thereby healthy weight loss, a high protein diet, hopefully coupled with resistance exercise is really um optimal. Um Then we have another question for strength training. Does high or low rest make any difference as low re focuses more on or no changes. No, as long as you're in the 5 to 30 rep range, which is the repetition range for hypertrophy. Um Below that, you're really just trying to work on power strength and your risk of injury is very high, especially if you're in a calorie deficit and beyond 30 repetitions, you're entering the cardio side of things. Um So repetition range doesn't matter as long as it's something that's sustainable and that you can just keep doing and that you enjoy. Um Yeah. And so yeah. No, in terms of weight loss, it doesn't matter because you're really just looking for the mechanical stimulus for muscle protein synthesis, which is achieved anywhere in the 5 to 30 rep range. Um and just looking at how important is cardio and losing fat. As I said, exercise is only 30% of the equation. So if you're trying to lose weight diet is really the first place I would modify because the, the I'm not saying that you should not do cardio, you should definitely do cardio. There are a lot of health benefits with cardio and it can also help in losing weight and in favoring, you know, the body composition in this weight loss period. But doing excessive amounts of cardio is going to be futile for two. Well, several reasons. Um firstly, the joints will eventually cave. It's physically exhausting your body needs to recover from this. Um and it can lead to excessive fatigue, which you could have avoided essentially by simply slightly tweaking your um intake and by doing moderate amount of exercise, the thing with cardio as well is that because you so acutely increase your energy expenditure, your body will tell you I've just burned a lot of calories doing this exercise. I now need to refuel. And so, whilst exercising can help manage um hunger signals and satiety signals, doing too much cardio can also work against you in that sense. And then there's also the very simple point of um when are you gonna do all that cardio? Cause I'm assuming, you know, people have lives outside of the diet as well. And that's where diet also is often the most. I don't wanna say easy because it's definitely not easy but simple aspect because you don't need to put any extra time aside for the diet. You just need to know how to eat and what to eat in order to be in a calorie deficit for you. Um Sorry, I hope I answered your question. Um But again, cardio is always important also for cardio respiratory health and it can help kind of potentiate the um weight loss. So that means the cardio doesn't change your maintenance calories that much, right? Um I mean, it does because if you're going on a run, burning from calories, you need to replenish those calories. You've just, if you hadn't got on the run, you would not burn those 400 calories. So it increases your maintenance calories and it creates thereby an extra calorie deficit, which is why it can help with weight loss. What I mean is that doing? Just adding on more and more cardio, there comes a point where it's futile because you're exhausting yourself. And, um, yeah, so cardio definitely helps with weight loss because it means that you can, you can eat more, in theory, you can eat more because if you hadn't gone for the run, you wouldn't have burned those 400 calories and you now need to replenish those 400 calories. So, yes. Um, I just mean, I think in excess amounts, cardio is not good because it wears you down and it can injure you and it can fatigue you. Um, sorry, I hope that wasn't too confusing. Um, so cardio definitely has its place in a weight loss diet. Absolutely. Um, yeah, so sorry, just gonna skip back up. Should exercise be polar in so far as 8020 zone to mitochondrial training versus view. Two mass training with high intensity interval training. Um, in terms of weight loss dieting, I think the most, one of the most important components will be having the strength training because with cardio, you will not have the muscle protein synthetic stimulus to the extent that you get it with strength training. Cardio will come in to increase the calorie deficit to, yeah, allow you to have to perhaps restrict less on the calories to a certain extent. Um, the 8020 zone trainings with, um, mitochondrial training and, um, U two max training that is more in terms of performance and in terms of cardio respiratory adaptations, which is somewhat separate to weight loss. It's all obviously interlinked cause physiology is just one big system. But in terms of zone training, that's more when you're looking at what kind of cardiorespiratory benefits and endurance or power. Um, anaerobic benefits are you looking for? So it's kind of a separate topic. Um, if that makes sense, um, walking versus running for weight loss, whatever you prefer. Um, it's not so much about the form of cardio as just what you enjoy, what your body can handle. I mean, if you're looking at the morbidly obese individuals, you cannot expect them to start running mile up per mile. If you can get them to walk down the block, that's already great. Whatever activity, whatever exercise you can do you enjoy doing, you can keep doing that is what you do. There's a lot of talk about, yeah, walking, lower intensity burns fat. Where's higher intensity burns, um, carbs. So you lose more fat when you're walking. Yes and no, because if you do this consistently with the running, which is yes, higher intensity than, um, walking, running, like running over time leads to muscle adaptations. Um, going back to the previous question about mitochondrial training where your muscles learn to utilize fat as fuel. So you will eventually be able to use the fat as fuel for the running just like you did for the walking. But one important distinction to make here is that it doesn't actually matter what fuel you're utilizing during your exercise. Like whether it's using your fat stores or your um Glycogen stores in terms of weight loss because the calories burn or the calories burn, be it from fat, be it from Lycogen. Those calories need to be replenished and the energy to replenish the source needs to come from somewhere. So, if you're still in an energy deficit, no matter what type of cardio you're doing, whether it's more intense, less intense, the calorie deficit is a calorie deficit and that's what matters essentially. So, do whatever you enjoy most and do some strength training. Um Right. What is the most accurate way of finding out your maintenance calories, trial and error? Um I'm sorry to say, I think we, you have to weigh yourself, weigh yourself regularly. Um Depending obviously, um on what you prefer. Um It's good to have data for once a week. If you're really trying to um follow your body weight closely. And whilst you can weigh yourself just once a week, it's important to keep in mind that there are daily fluctuations in body weight, especially in women with a menstrual cycle. So if you really want to very closely be able to track your body weight, it would be optimal to weigh yourself every day or every other day and then take a weekly average and then compare your weekly averages every, every week. It's important to caution, obviously that obsessive way, things like that are, you know, something that's, um, characteristic of eating disorder. So if that is something that you think you may be prone to do, you know, be careful. But with that being said, yes, you have to weigh yourself. And first just see, like for 23 weeks with what you're eating. Are you gaining weight? Are you losing weight? Are you maintaining your weight and track what you're eating? Right? There are a lot of calorie tracking apps for foods and based on that, based on seeing how your weight progresses over three weeks whilst tracking your calories, you can say, right? I haven't gained any weight. I haven't lost any weight. This is my maintenance calories. Oh, I've gained a bit of weight. Ok. Let me try and eat a little bit less. And then see, and then that's how you say, oh, I've lost a bit of weight. Oh, I was already in a calorie deficit. Cool. Um That's really the way to go weighing yourself and tracking your food. Um Yeah, when you say high protein diet, how many grams per kilogram of body weight do you mean um we're looking at 1.2 to 2 g per kilogram. Um It's similar guidelines as that um advice for muscle hypertrophy because in essence, that is what we're targeting, we're targeting a muscle hypertrophy stimulus during a fat loss phase and even if it doesn't lead to muscle gain, at least it'll help us preserve the muscle. Um, so that's what we're looking at. It depends obviously on how much you can tolerate high protein diets, as I said, are very satiating. Um, it depends on your energy levels. If you're just completely sluggish because of the thermic effect of food, all the blood's going to your stomach to digest the protein, maybe cut it down a little. Um But yes, looking at 1.2 to 2 g per kilogram of body weight predict and spread over regular meals to have the regular peaks in muscle protein synthesis rather than having one big peak and then just it's going off. And then one more question, I was meaning zone two to enhance mitochondrial function and this better fat oxidation rather than glycolysis. Ok, I see what you mean. Um So again, whilst zone two training can so low, moderate intensity, longer duration training can over time enhance the body's capacity to use fat as fuel for muscle contraction. Um It's again, not directly relevant to body composition because here we're looking at intramuscular fat as opposed to visceral fat. Um So really exercise is going to be looking at the calorie deficit you're creating with um cardio and then the muscle protein synthetic stimulus you're creating with um resistance training. So I hope that answers your question in terms of zone two, training. Zone three training. It really is what you enjoy the most because in terms of cardio for weight loss, it's about the calorie deficit you're creating and not the actual substrates you're using for energy. Um Right. Another question does taking creatine supplements have a similar effect to high protein diet as it seems like they both end up as creatinine or something like that anyways. Um No. So creatine supplementation in terms of muscle has two key effects. Firstly, it attracts water into the muscle cell causing the muscle cell to swell up and look bigger. Essentially, it, it makes the muscle looks fuller. And therefore, it um allows you to uh like you would actually gain weight when you take creatine, but it's the muscle cells swelling up. So you just look more b um which, you know, I think most people like that side, that effect of creatine. Um And the second effect is that it's, it um increases the phosphocreatine stores in the muscle, which acts as an immediate source of AP, which means that when you're exercising, you have this anaerobic. So you don't need oxygen, immediate source of ATP of energy that can allow you to have a high power output very quickly, very rapidly. And um that is how it can enhance muscle hypertrophy because it allows you to train harder essentially um to train harder repeatedly. Um But sorry, it doesn't have a um I mean, it also sorry, it also acts on IGF one which as I mentioned, previously is a stimulus for muscle protein synthesis. One of the main signaling molecules for muscle protein synthesis. And it also seems to inhibit fox oh and myostatin, which are two negative regulator of muscle protein synthesis. So they inhibit muscle protein synthesis. So it really acts in all possible domains in terms of maximizing um muscle hypertrophy. But it's not, I mean, you still need the substrates, you still like you can have all the machinery, all the signaling in place. If you don't have the actual amino acids from the protein in your diet to build the protein, you're not building anything. And it's like having all the workers at a construction site, but none of the materials, it's great. The crew is there but they can't do anything. And it's kind of the same and it's also not nearly as strong of a muscle protein, synthetic stimulus as protein is or as exercise is, it's just like it boosts it a little bit. But um it's, yeah, it's, it's not um the same as a high protein diet. Um Right. I didn't see any difference when we started taking creatine and it all didn't bother much about protein. Um Yes, there are obviously um bigger responder, uh like stronger responders, less, stronger responders. So some people take creatine and they have no effect from it. They don't, um their muscles will swell up. They don't have like increased PCR sos they just are nonresponders. Others are hyper responders. So it's all again along the bell curve. Um But yeah, um right, there's another one I missed the most I recession. Is there any way I can get the slides for that, please? Thank you. Um As I said, all the tutorials um are recorded and I will upload the recordings at the end of the teaching series, which will be in three weeks time. Um So I hope, um I hope that's ok. Um I will obviously send, um make sure that everyone is contacted. I will also drop a message at the end of the last teaching series um to let you all know that that will be uploaded. I hope that's um I hope that's fine. But yeah, um I think that's all the questions answered. Um Is there any more questions feel free to ask now? Um But otherwise, thank you for joining me. And um as usual, a feedback survey will be sent out after this, which if you complete it, you'll get access to the slides and it does really help me out a lot to have your feedback. And it also helps me structure the future tutorials based on what you enjoy, what you didn't enjoy so much. Um So, yeah, thank you.