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COVID‐19 patients are prone to develop significant weight loss, malnutrition, and deterioration of body composition which are caused by many different factors. According to research, 81% of patients on the rehab wards post COVID-19 required dietetic input.
The main factors are as follows.
COVID-19 infection can cause major inflammation, particularly pronounced in patients with severe and critical diseases.
Malnutrition is frequently seen in COVID‐19 patients. Disease‐associated reductions in food intake and malnutrition can contribute to tissue wasting.
Immobilization can also significantly contribute to muscle wasting and sarcopenia in COVID‐19. Ultimately, the negative ‘synergy’ of all these factors together can cause significant body wasting in COVID‐19 patients as clinically often observed.
Then how does the body composition change after COVID-19 infection and during the recovery?
Body Composition Change After Infection
Through the actual case of a patient who recovered from COVID-19, we will see how body composition changed after being infected with COVID-19 and in the recovery, and how the InBody results can help COVID-19 patients.
On December 19th of 2020, this person was infected with COVID-19 and hospitalized from the 4th to the 9th of January. This 50-year-old male used to maintain good body composition status (with an InBody score over 80).
Below is his InBody result before & after COVID-19.
If you see the change of his body composition before and after the COVID-19 infection, you can see :
4) Phase Angle decreased, especially the trunk Phase Angle from 9.5 to 5.7.
After the infection, not only the patients’ body composition changes but also their lungs might become inflamed, making it tough for them to breathe. For some people, the infection becomes more serious and the lung tissue itself becomes swollen and filled with fluid and debris from dead cells.
This man had similar symptoms as above. COVID-19 made him difficult to have proper breathing. After the treatment, the function of the lung, immunity system, and breathing ability got slowly well with the effort of doctors and nurses, but he also tried some exercises to accelerate the recovery process and get back to the condition before the infection.
His Efforts for the Recovery
In the beginning, he started doing exercise as usual. He tried running, swimming, and other exercises. However, his heart rate dramatically went up as soon as he tried those exercises. Even when he tried to climb the stairs in his home, his heart rate increased up to 130bpm with SvO2 dropping to 88%. Then it took more than 5 mins to get his breath back. This is because hard/strong exercise for someone who has respiratory diseases makes the condition worse. It is proved by several research studies conducted about how hard exercise negatively affects lung function.
Then how did he manage it? He started to exercise in a controlled condition. Starting with slowly walking between the kitchen and room. Then he tried several exercises with monitoring his SvO2 and HR rate to find the best exercise which does not affect his body condition. He found that indoor cycling at zero effort can maintain his SvO2 between 88-92% and HR between 78-90. He exercised his lung systematically to breathe deeper and deeper. He also monitored blood glucose levels as COVID-19 gave the pancreas beating.
Body Composition Change during the Recovery
As shown above, after the exercise,
His weight increased from 85.5kg to 89.4kg,
His muscle mass, which had been reduced to 37.2kg, increased to 39kg.
Most of the COVID patients suffer from weight loss/muscle loss (about 61% decreases by more than 5% of the total body weight), and it is difficult for them to increase their muscle and weight, but it is very important.
Use of Body Composition for COVID-19 Patient
In order to return to a healthy status same as before the COVID-19, close body composition monitoring is necessary. During the recovery process, if you only focus on the weight gain, important nutritional indicators (ECW ratio, Phase Angle) and fat/muscle management are not able to be achieved. Without management of key factors, the nutritional status may not return to normal.
If we take a look at the results of the 50-year-old man, some of the parameters were recovered, but the ECW Ratio or Phase angle did not return to the previous status, and at the same time he thought that the body condition is not the same as before.
In many cases of COVID-19 patients, they tend to focus on the weight only to monitor the recovery, but in fact, the perfect recovery can be achieved when we monitor and manage the body composition.
• Muscle Loss (Sarcopenia)
1) While the patients are suffering from disease, physical activity decreases. 2) One of the most common post-COVID symptoms is fatigue, which refrains post-COVID patients from physical exercises.
The above two can lead to muscle loss. To prevent sarcopenia, it is important to monitor the muscle mass and have some proper treatments not to lose muscle.
• ECW ratio (Inflammation)
ECW ratio, the ratio of Extracellular Water to Total Body Water is an important indicator to check the balance of body water. Acute systematic inflammation that can occur during the disease can raise the ECW ratio. Moreover, since the ECW ratio sensitively reflects your body condition, it can be used to track the recovery of the patient.
• Phase Angle (Nutrition)
Phase Angle is a clinically important bioimpedance parameter used for nutritional assessment and evaluating the severity of various diseases. Low Phase Angle tends to be consistent in individuals with malnutrition, infection, cancer, and old age.
Phase Angle can be also used to monitor the recovery of the post- COVID patients.
If you want to know more about the body composition analyzer which shows ECW ratio, Phase Angle, please contact us.
Editor’s Note: This post was updated on March 15, 2018, for accuracy and comprehensiveness. It was originally published on October 16, 2015.
Your Basal Metabolic Rate (BMR) is the number of calories you burn at rest.
The safest way to handle a caloric reduction for fat loss is to reduce your intake by something marginal and being consistent.
To optimize your BMR for lean body mass gain, you need to exceed the number of calories you require each day.
When people decide they want to get into shape, the first thing they typically do is sign up for a gym. They start off with great excitement, vowing to hit the treadmill or weight room every day. They keep this up for a couple of weeks, but when the changes don’t come, the enthusiasm wanes. Every day becomes three times a week. Three times a week becomes “I’ll go when I have time.” Before they know it, they’ve given up.
Sound familiar?
The reasons for giving up a fitness program are many, and not seeing results fast enough is one of the most common reasons to quit. However, many people forget one extremely important foundation for their weight loss program: their diet.
Perhaps you’ve heard the expression “six-pack abs are made in the kitchen.” It’s true. You can train as hard as you want in the gym, but you can’t out train a bad diet. Regardless if your goal is to gain muscle or lose fat, if you’re not optimizing your meals to reach those goals, you’re setting yourself up for failure.
So how do you optimize a meal plan? There are many factors that go into meal planning, such as the type of nutrients consumed, the frequency of meals, and the selective use of fasting to name a few. But a great place to start is to determine how many calories you burn a day. And it all starts with your Basal Metabolic Rate or BMR.
How Many Calories Do You Need?
You’re probably familiar with the 2000-calorie diet. This is a range set by the U.S. Food and Drug Administration (FDA) in 1993 for use on nutrition labels for packaged food.
So what are your actual caloric needs? A good way to start is by using a BMR calculator, which will determine the number of calories your body burns each day to perform its basic, life-sustaining functions. This includes all the involuntary processes in your body such as breathing, digesting food, pumping blood, brain activity, and much more. There is no shortage of online resources and apps that will provide you with a BMR calculator. Certain medical/fitness devices also feature BMR as an output during body composition analysis. However, there are a few things you should know about metabolism calculations before diving into the first option you find. Your caloric needs can be calculated in a couple different ways and with a few different equations, including the revised Harris-Benedict equation and the Mifflin-St. Jeor equation. These equations calculate BMR using your weight, with some adjustments for height, age, and gender. However, if you fall outside average assumptions for height, age, and gender (if you’re an athlete, for example), these formulas may not accurately produce your metabolic rate.
For people who do fall outside the assumed ranges for height, age and gender, there is a third option: use the amount of lean body mass you have to determine your metabolic rate. This is what the J.J. Cunningham equation will do. Using this method as a BMR calculator has a couple of benefits:
It won’t give you results that have been influenced by estimations derived from the typical representative member of your age and gender
As you increase lean body mass by developing your skeletal muscle mass, your caloric needs will increase, and the Cunningham equation will account for this.
Once you have your BMR in hand, you’re ready for the next step.
Total Calories and Dieting
Remember, your BMR is just the number of calories your body burns at rest and does not account for the calories you need to walk, talk, exercise, etc. When thinking about your caloric needs for a meal plan, you’ll need to convert your BMR to your Total Daily Energy Expenditure (TDEE). You can do this by multiplying your BMR by a factor that represents your estimated energy level. Those conversions are:
So, let’s take the example of a 171.1-pound male with 133.6 pounds of lean body mass and assume he is moderately active. Using the Cunningham equation, this person would have a BMR of around 1,679 Cal/day. Multiply that by the appropriate conversion, and you get 2,602.45. This is how many calories this person needs to maintain his weight.
When trying to improve your body composition and body fat percentage, you must reduce fat mass and gain lean body mass. That’s why it’s very hard to change your body composition.
This also means that your diet must also match what your current goal is – losing fat mass and/or gaining lean body mass. This is incredibly important. People who don’t do this often end up sabotaging their goals by setting fitness and meal plans that are at odds with each other.
The most classic example is this: “I want to get in shape, so I am going to diet (eat less) and work out more (increase energy use).”
This isn’t a bad plan – if you’re looking to lose fat. If you’re looking to build muscle and get stronger, it’s very unlikely that you will achieve this by eating less than your TDEE while increasing your activity level beyond what you’re is accustomed to.
Using BMR to Optimize your Diet for Fat Loss
There is a lot that goes into any meal plan, and it can get complicated quickly. From a dietary standpoint, you can count on one thing: if you want to lose fat, you need to run a caloric deficit. That means you need to take in fewer calories. If you’ve found your BMR and converted it to TDEE, you know what your body requires in a day to stay the same. That’s your starting point. You need to consistently consume less than your TDEE if you want to lose weight.
How many calories do you need to take out of your diet in order to lose weight? Theoretically, any amount that is less than your normal TDEE can cause you to lose weight; it just depends on how quickly you want to see results.
A lot of resources will tell you that you need to subtract 500 calories from your diet each day to lose one pound of fat per week. This is based on the premise that one pound of fat represents 3,500 calories, and that by reducing your caloric intake by 500 over 7 days, you’ll reach a weekly loss of 3,500 calories or a pound of fat. You may have heard this rule before.
However, hard-and-fast “rules” like these are tricky because although they’re usually based on facts (caloric reduction does lead to fat loss), they may not be advisable, recommended, or safe for everyone. Someone with a TDEE of around 2,600 calories might not have many problems dropping to 2,100, but someone whose TDEE is 1,400 will probably have significant difficulties living a normal life and exercising while consuming 900 calories a day for any length of time.
The safest way to handle a caloric reduction is to reduce your intake by something marginal – 200 or 300 calories a day, for example – and be consistent with this for a week or two. After a week, have your body composition analyzed to ensure you aren’t losing lean body mass. If you see your fat mass begin to drop, you can see by how much and adjust your caloric needs accordingly.
How can you cut calories safely? The first thing to do would be to cut any unnecessary snacks and treats in your diet – soda, chips, chocolate, alcohol, etc. Depending on how much of these existed in your diet before, this simple step might be enough to cause you to lose weight without making any other changes!
But what if you were already eating clean? Where do you cut calories on a clean diet? If you’re in this situation, you need to make sure that you are cutting calories from nutrient sources that you can afford to cut from. One nutrient group you should be careful to not cut too much from (if at all) is protein.
Protein helps ensure your weight loss is fat mass and not fat free mass or lean body mass. Find out how much protein should you eat for your body here.
One way to do this from a dietary standpoint is to consume foods that are low in calories but high in protein. Here are a couple of foods to consider:
Tilapia, one fillet: 111 calories/22.75 grams of protein.
Greek yogurt, 170g container: 100 calories/17.32 grams of protein
Boneless skinless chicken breast, 3.5 ounces: 165 calories/31 grams of protein
With proper caloric restriction, nutrition, and exercise, you’ll start to shed off the fat while retaining as much muscle as possible.
Using BMR to Optimize Your Diet for Lean Body Mass Gain
If your goal is to build lean body mass, then your caloric needs and dietary goals are going to be different than if your goal is to reduce body fat. Some aspects of the diet will remain the same. You still need to eat clean and avoid unnecessary calories like in the fat mass diet described above. But you’ll need to exceed your daily caloric needs if you want to gain lean body mass. Additionally, strength training is going to be much more important – it’s not like you can just eat your way to lean body mass gains!
Start with your BMR and convert it to TDEE by multiplying it by the factor that best reflects the amount of physical activity you have in a week. For the sake of consistency, we will use the previous example (1679 Cal/day) and exercise factor (x1.55) to produce a TDEE of 2,602.45. This is the amount of calories that must be exceeded in order to have enough energy to produce the desired results.
How much should you increase your energy intake by in order to gain lean mass? According to research, you need to consume approximately 15% more calories per day than what is required to maintain your body weight (that’s the TDEE). So in this example, this individual should look to increase their caloric intake to about 2992.3 calories which, for convenience’s sake, could be safely rounded off to an even 3,000 calories/day.
How should you be adding these extra calories in your diet? The study cited above suggests that to maximize lean mass gain while minimizing fat mass gain, the increase in calories should be made up of both protein-rich foods and carbohydrates.
However, a word of caution about protein. Before you conclude that you’ll just increase your diet with nothing but protein, consider this: there is a point where eating more protein won’t lead to a measurable increase in lean mass. In a 2006 study of collegiate level athletes, no benefit in muscle or strength gain came from protein consumption that exceeded .9 g of protein per pound of body weight.
While protein is important, caloric intake is arguably more necessary. In the article cited above, the athletes consumed their required protein amount but failed to consume the total amount of calories appropriate for their fitness level, which led the authors to comment:
The low energy intakes observed in this study confirm previous reports that have shown that collegiate athletes generally do not meet their nutritional needs, specifically as it relates to energy intake. Caloric intakes of strength/power athletes should exceed 44 – 50 kcal·kgBM·day-1, however, the caloric intakes reported in this study (33.0 ± 5.5 kcal·kgBM·day-1) were below these recommended levels and likely impacted the ability of these subjects to make significant gains in lean tissue accruement.
Bottom line: you need to exceed the number of calories you require each day if you are trying to gain lean mass.
Final Thoughts
As with any dietary plan, you will expect to see changes over time. All this hard work has to produce results, right? So, how long will it take to see results? Unfortunately, that is going to vary for each individual. A good rule of thumb is to weigh yourself every 1 – 2 weeks. If you are looking for a more precise analysis, you should get your body composition measured as well. Another important factor to consider: your BMR. Since your BMR is closely linked to your lean body mass, any changes will affect the number of calories you burn.
For example, if your plan is to gain lean body mass, and over a period of time you are successful in doing so, your energy needs are going to increase. This is why it is so important to be measuring body composition.
Conversely, if you lose some lean body mass as a result of going on a strict caloric deficit diet, your BMR will decrease. If you lose too much lean mass, but don’t take that change into account, you might take in more calories than you need, which could sabotage your goals.
Finally, a diet is much more than creating a calorie deficit. It’s important to use a BMR calculator or body composition analyzer to understand how much energy your body needs. Without this information, you won’t know how much food you need to add or remove to your diet in order to achieve your goals. With this information, you’ll see quicker results and reach your goals faster.
Editor’s Note: This post was updated on September 14,, 2018, for accuracy and comprehensiveness. It was originally published on January 27, 2016.
Your body is a wonderfully complex machine. Without any conscious direction from you, your body manages to convert food into energy, regulate your body temperature, create new cells, remove waste, and perform thousands of other processes to keep you alive and healthy.
Because your body is such a complex machine, a lot of misconceptions and half-truths exist about how it works, especially when it comes to muscle and fat. This makes it hard to figure out what’s true and what isn’t when it comes to body composition, especially since nowadays there seems to be a supplement for everything and a steady stream of late-night infomercials claiming to have the next greatest invention for fat loss or muscle gain.
To help shed some light on these issues and cut through the clutter, we’ve collected a few key points about muscle and fat for you to take away to help you make the right decisions when you are ready to get healthier and optimize your body composition.
Many people think that muscle gain is only necessary if you’re an athlete. Why would you need to be stronger if you’re not a competitive athlete? Not everyone needs to fight off an opposing defensive back (or wants to muscular), but everyone needs to be able to fight off infection.
What does muscle have to do with infection? Quite a lot actually.
Protein is a important macronutrient that your body needs in order to function properly. Muscle is made up of primarily water and protein content. When your body enters a stressed state (becomes sick), your body’s protein demands suddenly skyrocket, up to four times the amount it normally requires in the event of serious trauma.
If your body does not get the necessary protein it needs from your diet, it will look to your muscles – which your body can treat as large protein reserves – and begin breaking them down. If your muscles aren’t sufficiently developed or underdeveloped, you will have a reduced ability and strength to fight off current infections and may be more susceptible to future ones, especially in serious cases. According to the American Journal of Clinical Nutrition:
If there is a preexisting deficiency of muscle mass before trauma, the acute loss of muscle mass and function may push an individual over a threshold that makes recovery of normal function unlikely to ever occur.
The key takeaway: focusing on muscle gain may pay big dividends down the road with recovery in strength and function.
#2: There’s 2 types of Fat – and one is really dangerous
Most people know that being overweight can lead to health problems over the long term, but not many people know why. Current research is now revealing that your fat mass isn’t just empty weight like a bag of sand, but is in fact metabolically active tissue that acts like an organ inside your body.
But unlike the other organs inside your body that are designed to help keep your body in proper condition, excess visceral fat works to sabotage it.
According to Harvard University, fat mass, and particularly visceral (belly) fat, can have significant negative effects on your health. Visceral fat spreads certain types of chemical called cytokines into the body, and although cytokines aren’t by their nature harmful, the types of cytokines emitted by fat can have serious repercussions on insulin resistance, cholesterol level, and blood pressure.
Over time, visceral fat can lead to developing serious diseases like cardiovascular disease and type 2 diabetes. For skinny fat individuals, they may not be aware their high visceral fat level puts them at risk for these disease because visually they look “healthy” in comparison to obese individuals. In actuality, they share similar health risks. Fortunately, working to reduce fat mass in your body can help reduce some of these harmful effects visceral fat can have.
#3: “Lean Mass” Isn’t the Same as “Muscle”
Lean Mass. Lean Body Mass. Muscle Mass. Skeletal Muscle Mass. It can be really easy to get lost in all these same-sounding terms. Are they all the same?
The most common mistake is when people use the term “lean mass” and when talking about increasing it – “lean gains.” Many people equate muscle mass with lean mass, which is only partially correct.
While it is true that if you develop your muscles you are developing lean mass, that doesn’t mean that your muscle gains are lean gains.Lean Body Mass is different from skeletal muscle in that Lean Body Mass includes the weight attributed to muscle, body water, bone, and everything else that isn’t fat. To illustrate, take a look at the body composition breakdown of this 162-pound male:
Note that this subject has a Lean Body Mass of 128.5 pounds, the majority of which is reflected by Total Body Water. The actual muscle that people try to develop in the gym – skeletal muscle – only accounts for 73.2 pounds of body weight.
While it isn’t likely that the weight of your organs or bones will change significantly, your muscles and water can change in volume and mass depending on a variety of circumstances. Because Lean Body Mass includes body water, increasing your weight by hydrating your cells with sufficient intracellular water is also technically a “lean gain.”
Another way of thinking about it: All muscle gains are lean mass gains, but not all lean mass gains are muscle gains. Get it?
#4: Muscle Doesn’t Become Fat
Admit it– you were pretty sure it didn’t work like this, but you sometimes catch yourself saying that your muscle turned into fat.
Although your body is an amazing machine, there is no process by which your body converts muscle to fat. Many people comment that their muscle has turned into fat after they stop working out regularly, and it really does seem like that’s what’s occurring – you were once lean and muscular, and now you have less muscle and look flabbier. But what’s really going on is a change in body composition – a loss in muscle mass that occurs at the same time fat mass increases.
This can happen for any number of reasons. Many people, especially athletes, can experience muscle loss and fat gain in the off-season when they stop performing entirely and continue to eat like they did when they were playing at a competitive level. That’s because the amount of calories you use in a day – your Total Daily Energy Expenditure – decreases significantly if you change your activity level. So to recap, muscle to fat conversion isn’t real. If you are going to be less active, make sure you adjust your diet accordingly.
When people think of someone with an unhealthy body, they think of someone who is overweight. So, when people think of someone with a healthy body, they naturally think of someone who is skinny.
Not so fast: just because someone looks like a runway model doesn’t mean they are healthy. In fact, it is often the opposite. In some cases, people who strive to be skinny – like runway models for instance – become so excessively skinny that they become severely underweight, lose a significant amount of lean mass, and develop conditions like anorexia. It was for this reason in particular that the French government imposed a ban on hiring runway models with BMIs of less than 18.0 in 2015.
However, not everyone is a runway model, and a much more common condition that some skinny people have that is certainly not healthy is something called sarcopenic obesity, something popularly referred to as being “skinny fat.” Skinny fat people don’t have healthy amounts of muscle mass, so they can actually have a body fat percentage that is similar to someone who is obese, even though they appear to be skinny. They often have body composition profiles resembling this one:
Despite having a normal weight (within 15% of the ideal weight for this person’s height), muscle mass is very underdeveloped while body fat mass is quite high. By dividing fat mass by weight, this person’s body fat percentage would be 36.9%, well over any acceptable range for women – including the ranges set by the American College of Sports Medicine and the American Council on Exercise.
End the Confusion
Lots of these myths and misconceptions occur because many people do not measure their weight accurately.
The only way to properly understand your weight is to have your body composition analyzed. Body composition analysis breaks down your weight into muscle, fat, and body water. Relying on a scale only leaves you in the dark as to why your weight is increasing or decreasing, which can lead you to such thoughts as “my muscle turned into fat” or “is it muscle loss or fat loss”. To learn more about how understanding your body composition can help transform your health, click here.
Ask anyone knowledgeable in nutrition about the benefits of fiber and the positives will trump over the negatives. People claim this type of carbohydrate will help you reduce your risk of certain cancers, lower your type 2 diabetes risk, and help with weight loss as it supposedly reduces appetite and increase satiety. In other words, fiber is magic and should be given the same amount of adoration that we shower antioxidants and the rest of the nutritional superstars with.
Yet when was the last time you fact-checked fiber’s benefits? What if we dig deeper into recent nutrition research to learn more?
In this article, we’ll put fiber in the limelight and sort myths from facts. While mainstream beliefs will tell you that adding lots of fiber to your daily diet is key to good health, let’s figure out if this advice is scientifically sound, especially when it comes to sustainable weight loss and improving your body composition.
Know Thy Fiber
Before we dive into separating myths from established facts and findings, let’s cover the basics.
Dietary fiber, sometimes referred to as roughage, refers to a broad, diverse group of carbohydrates that we, as humans, cannot digest because we are lacking in digestive enzymes to break them down. For this reason, roughage ends up in your colon unchanged.
So why would something that humans can’t digest turn out to be beneficial part of your diet?
Fibers are inherently unique from each other due to their chemical properties. That’s right, the fiber you find brown rice is different than the kind you find in oats. Scientists categorize dietary fibers based on a specific set of characteristics.
To have a better understanding as to how fiber can possibly impact your body composition and overall health, let’s take a closer look at this indigestible carbohydrate through the lens of its popular methods of classification: solubility, viscosity, and fermentability, and a special note on resistant starch.
Soluble and Insoluble Fiber
irst of all, all plant-based foods are generally a mix of both soluble and insoluble fibers. Think of the soluble fiber as the dawdling sibling while the insoluble type is the speedster in the family. How come?
Soluble fiber dissolves in water and morphs into a gel-like substance when it passes through the gut. Foods high in soluble fiber include apples, beans, blueberries, lentils, nuts, and oat products.
Insoluble fiber doesn’t dissolve in water and the term roughage generally refers to this specific type. Unlike its slow solubility sister, roughage does the exact opposite. It speeds up transit time in the digestive system and adds bulk to your stool. This is the basis of the most common health recommendation for eating more roughage: to prevent constipation by helping food move through your system.
Foods high in insoluble fiber include brown rice, carrots, cucumbers, tomatoes, wheat, whole wheat bread, and whole grain couscous.
Contrary to popular belief, solubility does not reliably predict whether or not a certain type of fiber is beneficial to your health. However, the terms soluble and insoluble are still used by many nutrition and healthcare professionals including the US Food and Drug Administration (FDA) in nutritional labels.
Viscous and Nonviscous Fiber
Another way of classifying fiber is through its viscosity. Certain types of soluble fiber are more viscous, or more likely to form firmer, stickier gels when mixed with water than other types. When you digest food with high-viscous fiber in it, it increases the viscosity of the gel-like substance that passes through your gut. As a result, it reduces your appetite because you feel fuller longer.
Viscous fibers include the following:
pectins (abundant in berries and fruits)
β-Glucans (Beta-glucans: abundant in barley and oats)
guar gum (commonly derived from the Indian cluster bean)
psyllium (isolated from psyllium seed husks)
The most frequently cited benefits of fiber (e.g., reduce cholesterol levels, improve glycemic control in type 2 diabetes, improve stool form in both constipation and diarrhea) is directly correlated to its viscosity. Nonviscous food sources tend not to have these beneficial properties. This is incredibly important because the general public tend to lump all types of fiber as one and associate its health benefits to all types too. Until more is known about the beneficial effects of low-viscosity fibers, a good strategy is to learn toward foods higher in viscosity.
Fermentable and Nonfermentable Fiber
If you’re not aware yet, your entire body is host to trillions (yes, trillions!) of beneficial bacteria. The majority live in your intestines and are referred to as your gut microbiome. Also known as the forgotten organ, these little creatures have a say in your body composition and overall health.
The beneficial bacteria in your gut thrive on fermentable fiber. Not to mention that this wonderful alchemy of fermentation in your gut produces short-chain fatty acids such as acetate, propionate, and butyrate that suppress gut inflammation and can possibly reduce your risk of various digestive disorders like irritable bowel syndrome, crohn’s disease and ulcerative colitis.
Majority of fermentable fibers are soluble, but some insoluble fibers are cool with fermentation too. Foods that are rich in fermentable fibers include oats and barley, as well as fruit and vegetables. Cereal fibers that are rich in cellulose (like wheat bran) are nonfermentable.
Special Note on Resistant Starch
Lately, many experts have been encouraging people to add resistant starch to your diet because of its powerful health benefits.
Resistant starch is not exactly a fiber, but another form of carbohydrate (long form of glucose molecules really) that functions like soluble and fermentable fiber. Like fiber, Resistant starch is not fully broken down and absorbed in your small intestine and gut bacteria thrive on it. When fermented, resistant starch produces short-chain fatty acids as well as gases (which in turn can lead to bloating and abdominal discomfort when eaten/taken in excess).
Great food sources of resistant starch to add to your diet include beans, various legumes, green bananas, cashews, raw oats, and cooked (and then cooled) rice/potatoes. The cooling process turns some of the digestible starches into resistant starches through a process called retrogradation.
So why differentiate all the different types of fibers? Because each types will have different effects in the digestive process and having an array of natural food sources (whole wheat, oats, brown rice, starch) in your diet can have a positive overall impact on your health by improving digestion and also feeding bacteria that work so hard to keep you healthy.
Fiber’s Claims to Fame: Legit or Not?
When we talk about fiber and its impact on one’s health, we are often told about the following benefits:
Lowers down blood sugar levels
Reduces cholesterol levels
Prevents chronic constipation
Reduces the risk of specific cancers such as colon cancer and breast cancer
Help with weight loss and improve weight control
The American Dietetic Association recommends 14g of dietary fiber per 1,000 kcal of food intake or roughly 25g for adult women and 38g for adult men. Food variety in your diet is encouraged to meet one’s daily fiber requirement. Mix it up with whole wheat, nuts, starchy carbs, and vegetables.
Like so much of nutrition, what’s true today may not be true anymore in the next three, five, or ten years. Research findings and conclusions that once seemed valid and well-founded may be revised— or even totally flipped— as new research is completed. The idea that fat doesn’t actually make you fat is a good example.
With that said, let’s figure out the recent science-backed truths of the aforementioned benefits.
Does fiber help in reducing blood sugar and cholesterol levels?
In terms of fiber’s ability to reduce blood sugar and cholesterol levels, a review of studies on the subject published in the Journal of the Academy of Nutrition and Dietetics last February revealed the following:
“…high viscosity fibers (eg, gel-forming fibers such as b-glucan, psyllium, and raw guar gum) exhibit a significant effect on cholesterol lowering and improved glycemic control, whereas non-viscous soluble fibers (eg, inulin, fructooligosaccharides, and wheat dextrin) and insoluble fibers (eg, wheat bran) do not provide these viscosity-dependent health benefits…”
With this information, we can see that not all fibers are created equal. If lowering your serum LDL cholesterol and normalizing blood glucose and insulin levels is your goal, adding soluble, viscous fibers to your diet (mainly from whole food sources) would be beneficial.
Meanwhile, resistant starch can potentially lower down blood sugar levels after meals and improve insulin sensitivity. This means that your body is less likely to store excess glucose as fat. This is good news if you’re currently working to lose fat mass as a priority in improving your body composition.
The takeaway: Not all types of fiber can help control blood sugar and reduce cholesterol levels. To gain fiber’s benefits in terms of regulating blood sugar and lowering cholesterol, opt for high viscous fibers and resistant starches.
Does fiber help with chronic constipation?
How many times have you been told to add more fiber to your diet if you’re having chronic problems in maintaining regularity in your bowel movement?
It turns out that this common advice is not as true as we thought.
In fact, a 2012 study concluded that idiopathic constipation (or constipation of unknown cause) and its associated symptoms can be effectively reduced by stopping or even lowering the intake of dietary fiber.
Furthermore, the same review of studies which examined fiber’s impact on blood sugar and cholesterol recommended that not all types of fiber can help with chronic constipation. The researchers concluded that large/coarse insoluble fibers are more effective as a laxative. Soluble fermentable fibers (e.g. inulin, fructooligosaccharide, and wheat dextrin) do not provide a laxative effect, and some fibers can even be constipating (e.g. wheat dextrin and fine/smooth insoluble wheat bran particles).
The takeaway: Not all types of fiber can help with chronic constipation. Specifically, fruits and vegetables can increase stool bulk and shorten transit time. Meanwhile, fiber supplements that are effective in treating constipation include cellulose and psyllium.
Fruits and vegetables are good sources of cellulose because this type of fiber is mainly found in plant cell walls. On the other hand, psyllium is isolated from the seeds of Plantago ovata, an herb mainly grown in India. Also known as ispaghula husk, it often comes in supplement form such as granules, powder, and capsules. Psyllium is the active ingredient in Metamucil, a popular supplement to reduce constipation.
Some baked goods and fortified cereals contain this type of fiber.
An important note on this is that sufficient fluid intake is also required to maximize the stool-softening effect of increased fiber intake.
Does fiber help reduce my risk of colorectal cancer (as what most people believe)?
The surprising fact is that much of the research does not support this. Recent findings from large prospective cohort studies and clinical intervention trials do not see an association between fiber intake and the risk of colorectal cancer. In fact, a 4-year intervention trial found out that supplementation with 7.5 g/day of wheat bran had no effect on colorectal adenoma recurrence.
As for general disease prevention, it’s worth noting that observational studies that identify associations between high-fiber intakes and reductions in chronic disease risk tend to assess only fiber-rich foods rather than fiber itself. As a result, it is difficult to determine whether observed benefits are actually related to fiber or perhaps, other nutrients or antioxidants found in fiber-rich foods. Another point for eating foods that are naturally high in fiber instead of relying on fiber supplements.
Can I rely on fiber supplements to get the same benefits as fiber from whole sources?
To get the full-benefits of fiber, research reveals that fiber-rich foods trump (as always when it comes to nutrition) supplement sources. A systematic review of studies found out that most supplements do not help at all in reducing body weight.
Okay, Enough With the Science! I Just Want to Lost Weight. Can Fiber Help?
Yes. But you have to understand that fiber for weight loss doesn’t apply to all types of fiber.
As mentioned earlier in this article, some fibers are readily fermented by your gut microbiome, most of which are soluble fibers. Soluble fibers, alongside resistant starch, help promote a thriving and diverse community of gut bacteria. Collectively, they are often referred to as prebiotics (not to be confused with probiotics which are live bacteria). If Popeye thrives on spinach, your gut bacteria thrives on prebiotics!
So what do prebiotics have to do with weight loss and your body composition?
Currently, there is reasonable evidence that increased dietary prebiotic intake decreases inflammation and helps improve insulin sensitivity. It’s worth noting that both inflammation and reduced insulin sensitivity are strong drivers of weight gain and metabolic syndrome.
By feeding your gut’s friendly and health-promoting bacteria with the right type of fiber, you also reduce your risk of obesity or unwanted weight gain. As for fiber’s role in promoting satiety reducing appetite (thus the popular belief that fiber can help with weight loss), research on the subject continues to yield conflicting results.
Conclusion
In summary, fiber’s benefits are wide ranging, but they don’t all come from one food source. In the end, variety is king. Recent findings show viscous fiber types and resistant starch may be the best sources, not just in transforming body composition but also helping you improve in key biometrics like cholesterol and blood sugar levels.
Ultimately, getting more fiber in your diet from whole food sources is always better than relying on supplements. After all, nutrition is not about eating more protein, carbs, or any specific nutrient, but it’s the synergy of these nutrients that truly matters. Besides, berries and apples are more flavorful (and more appetizing!) than chewable tablets, right?
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Kyjean Tomboc is a nurse turned freelance healthcare copywriter and UX researcher. After experimenting with going paleo and vegetarian, she realized that it all boils down to eating real food.
So you started working out and lowered your overall body fat.
First off, congratulations should be in order!
Achieving and maintaining a healthy weight despite life’s occasional curveballs is something that you should be proud of. The positive changes in your body composition is proof that your efforts have finally paid off!
So where do you go from here?
Your next goal may be one of the following:
I want a huge, action star physique.
I want to achieve a leaner, more athletic look.
I want to increase my functional strength and achieve new PR’s in my lifts
Whether your goal is gaining strength or sculpting your body to your desired physique, the approach boils down to same thing — gaining muscle.
Eating for Well-Defined Muscles
As previously discussed in an article published about how much muscle you can gain in a month, the three main pillars of muscle growth are: nutrition, exercise, and hormones.
In this article, we’ll put the spotlight on nutrition and address your most frequently asked questions about what to eat in order to build muscle.
Let’s get started!
People use lean body mass and muscle mass interchangeably. Are they similar or different from each other?
Yes, lean body mass and muscle mass are two different things.
Essentially, all muscle is “lean” meaning it is primarily composed of proteins, which are lean. However, things start to get more confusing when some folks use lean body mass and skeletal muscle mass interchangeably.
Lean body mass (LBM), also known as lean mass, refers to your total weight minus all the weight comprised of fat mass. This includes your organs, your skin, your bones, your body water, and your muscles.
On the other hand, skeletal muscle mass (SMM) is a part of your LBM, but it is the part that is referring to the specific muscles used that are controlled voluntarily to produce movement and maintain posture. When you’re thinking about gaining muscle, you are actually referring more specifically to your SMM. This is what we want to track and here’s why:
Apart from changes in your SMM, a gain in your LBM numbers can also be a result of water gain. Water gain can occur from bloating or eating salty foods but also from swelling from injury or disease. That’s why you cannot attribute a increase to LBM numbers completely to muscle gains.
Now that we cleared that up, let’s dig into the facts and findings about muscle gains through diet and nutrition.
Is the hype about protein justified when it comes to bigger muscle gains?
Yes, to an extent. It’s an established fact that eating high quality protein within close temporal proximity (immediately before and within 24 hours after) of resistance exercise is recommended to increase muscle gains.
The strain of repetition when you perform resistance exercise tears the muscle fibers, and the protein intake (although macronutrients like carbs and fat play a role, too) provides the resources to rebuild the newly torn muscles into something bigger and stronger.
It’s also worth noting that amino acids are the building blocks of protein, and as you most likely already know, your muscle is made up of these macronutrients. As we’ve emphasized in Why Everyone Needs Protein — Think of your muscles as the house itself while the amino acids that make up protein are the bricks.
The good news is that your body can manufacture a huge chunk of these amino acids. The not-so-good news is that some of them, also known as essential amino acids (EAA), can’t be made by the body. You have to get your EAAs from food sources.
In short, you need to follow a high protein meal plan that contains mixed amounts of these EAAs to help ensure increase muscle protein synthesis (MPS)
How do I know if I have enough protein intake to promote MPS?
As of June 2017, the International Society of Sports Nutrition (ISSN) recommends an overall daily protein intake in the range of 1.4–2.0 g protein/kg body weight/day (g/kg/d) for building and maintaining muscle mass. Remember, your specific dietary needs depend on the amount of muscle mass you have as well as the type and intensity of your physical activity
With these figures in mind, let’s say you weigh 125 pounds (57 kilos), and you’re working to increase your LBM. You would need 57 x 1.4- 2.0, or 79.8 – 114 grams of protein a day.
This may sound like a lot but it’s not. A cup (140 grams) of chicken contains 43 grams of protein. Meanwhile, a can of tuna can contain as much as 49 grams. Eating a cup of chicken and a can of tuna, you’d almost entirely meet your protein needs. If you add in a glass of 2% milk (another 9-10 grams of protein), you’ve already hit your goal.
Below is a rough dietary guideline based on activity level:
0.8-1.2 g/kg for regular activity
1.2-1.5 g/kg for endurance athletes
1.5-1.8 g/kg for strength/power athletes
If counting grams of protein for the day is not your thing, researchers have recommend an intake of about 20-40 grams of whey protein following a heavy bout of whole body resistance exercise to promote greater muscle recovery. The results stressed that the traditional 20 grams of whey supplement after working out did not promote as much MPS as the 40 grams of protein.
Can I build more muscle from eating too much protein?
Not really.
Researchers found that eating five times the recommended daily allowance of protein has no effect on body composition in resistance-trained individuals who otherwise maintain the same training regimen. That means that doubling or tripling your protein intake doesn’t translate to greater muscle gain after exercise.
It’s also worth noting that this is one of the first interventional study to demonstrate that eating a high protein meals does not result in an increase in fat mass.
Will too much protein hurt my kidneys?
While protein restriction may be appropriate for treatment of existing kidney disease, some research has shown high protein intake in healthy individuals to not be harmful to kidney function. Unlike extra stores of fat that the body is so keen about in holding on, the amino acids in protein are more likely to be excreted via the urine when not in use.
With that in mind, there are certainly risks associated with consuming too much protein so it’s wise to keep your intake in check.
So what our conclusion here? Eating more protein makes you feel fuller longer, can help curb overeating, and is essential for recovery and growth but don’t forget equally important nutrients like carbohydrates and fats for proteins when hitting your daily caloric goals (we’ll address this issue later).
Meat is often considered an excellent source of protein. So should I eat more meat to gain muscle? What if I’m on a plant-based diet?
Good question!
Sure, meat provides complete sources of proteins that are rich in essential amino acids so it truly is an excellent source of protein.
In a small study comparing the effects of resistance training-induced changes in body composition and skeletal muscle among two groups — older men with an omnivorous (meat-containing) diet and those with lacto-ovo vegetarian (meat-free) diet, the researchers found that the omnivorous diet resulted to greater gains in fat-free mass and skeletal muscle mass when combined with resistance training than the vegetarian-diet group.
Another study of 74 men and women who had type 2 diabetes — one half on a vegetarian diet and the other half on a conventional diabetic diet — were assessed at three and six months to measure how much weight they had lost. The study concluded that the vegetarian diet was almost twice as effective at reducing weight compared with the conventional diet.
But here’s the caveat — The greater weight loss seen in people on the vegetarian diet was also accompanied by greater muscle loss, particularly when maintaining their normal exercise routine. This might be an unwanted outcome and a disadvantage when compared with the omnivorous diet.
Finally, another research study examining the relationship between the type of protein intake and the level of muscle mass in healthy omnivorous and vegetarian Caucasian women found:
“A vegetarian diet is associated with a lower muscle mass index than is an omnivorous diet at the same protein intake. A good indicator of muscle mass index in women seems to be animal protein intake.”
Take note, however, that these findings do not automatically mean that animal protein is necessary to develop muscle mass.
As we mentioned in this in-depth article on whether or not you need to eat meat to gain muscle, the findings indicate that vegetarians might have a harder time getting adequate protein intake. As a result, they may not be receiving the same quality of amino acid variety to support muscle maintenance/growth as meat-eaters. This issue can be addressed by adding more variety in your diet or through supplementation.
So what about my intake of carbs and fat?
If you want to build muscle, increasing your dietary protein intake makes sense. However, this doesn’t mean that you should disregard carbs and fats.
For one, carbohydrates help replace glycogen and aids in enhancing the role of insulin when it comes to transporting nutrients into the cells, including your muscles. Combining protein and carbs also has the added advantage of limiting post- exercise breakdown and promoting growth.
In a nutshell, a diet balanced in protein, carbs, fats, and fiber is the most effective way to build muscle.
How about the ketogenic diet? Can it help me gain more muscle mass?
Most likely. The main premise of a ketogenic diet is to opt for high fat, moderate protein, and a very low carb diet.
In an 11-week study of men who performed resistance training three times a week, the researchers found that lean body mass increased significantly in subjects who consumed a very low carb, ketogenic diet (VLCKD). Significant fat loss was also observed amongst the VLCKD subjects.
Does “when I eat” if I want to build muscle?
For decades, the idea of nutrient timing (eating certain macronutrients at specific times like before, during, or after exercise) and meal scheduling has sparked a lot of interest, excitement, and confusion.
A good example of nutrient timing is the idea of the anabolic window, also known as a period of time after exercise, where our body is supposedly primed for nutrients to help recovery and growth.
However, a review of related literature revealed that while protein intake after workout helps muscle growth, it may persist long after training.
If you’re going to ask the ISSN, meeting the total daily intake of protein, preferably with evenly spaced protein feedings (approximately every 3 h during the day), should be given more emphasis for exercising individuals.
They also state that ingesting a 20–40 g protein dose (0.25–0.40 g/kg body mass/dose) of a high-quality source every 3 to 4 hours appears to favorably affect MPS rates over other dietary patterns, which allows for improved body composition and performance outcomes.
In short, it’s more important to focus on the total amount of protein and carbohydrate you eat over the course of the day than worry about nutrient timing strategies.
The Takeaway
In summary, here’s what you need to remember when it comes to eating in order to gain muscle:
Muscle gains are hard to come by if you don’t complement your exercise training with the right nutrition. Besides acting as fuel for physical activity, eating right helps in muscle recovery and development of new muscle tissue.
Pay special attention to your protein intake in order to build muscle. Helpful figures to remember are 1.4–2.0 g protein/kg body weight/day (g/kg/d) depending on your body composition, activity type, and activity intensity.
There’s been a lot of talk about a specific amino acids and anabolic (muscle-building) superpowers. However, it’s still important to consume different sources of protein when you can and not just focus on a single protein source. Plus, remember that your body needs carbs and fat too.
Do not worry about when is the best time to eat your steak. Eating a portion of lean protein with some fiber-rich carbs and fat every meal is a good way to help your body repair and rebuild muscle after resistance exercise. As much as possible, increase make sure to complement your exercise with the appropriate nutrients to promote muscle recovery and growth.
If you’re on a plant-based diet, make sure you’re incorporating a wide variety of protein-rich plants to ensure that you’re getting the full range of amino acids. You may have to consider plant-based protein powder supplementation.
Remember, people have different goals when it comes to working out and gaining muscle — from aesthetics to improved sports performance to feeling better about yourself. That means there is no “one-size-fits-all” approach.
Whatever your goal, it all begins with one small step at a time. What changes are you going to make today?
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Kyjean Tomboc is a nurse turned freelance healthcare copywriter and UX researcher. After experimenting with going paleo and vegetarian, she realized that it all boils down to eating real food.
There’s an oft-used saying that “abs are made in the kitchen.”
The underlying theory, for those who haven’t heard this before, is that what you eat is more important than how much you exercise if you want to see defined abdominal muscles.
How much truth is there to this mantra? Are Instagram perfect abs really made simply by watching what you eat? Or can you just do a thousand crunches a day and reveal your six-pack that way?
In this article, we’ll 1) break down the science of nutrition vs. exercise and how each impacts body composition, 2) look at a few different types of diet plans and their effects on the body, 3) decide whether the saying “abs are made in the kitchen” is fact or fiction.
Let’s jump right in.
Background
The notion of “abs are made in the kitchen” is based on the fact that it is so much easier to gain calories than it is to burn it off through exercise.
This makes sense when you attach some numbers to it.
For example, let’s say your preferred exercise routine is swimming a few days a week. On average, you can expect to burn 400-700 calories in an hour.
But if you go home and scarf down a couple pieces of pizza, you can quickly take in the same amount of calories in a matter of minutes.
So from a time/practicality standpoint, it’s much easier to reduce your caloric intake by 400 – 600 calories a day and create the same calorie deficit as swimming/running for an hour.
However, this doesn’t necessarily mean that creating a calorie deficit through diet has the same effects on body composition as exercise.
First, we’ll look at some studies that weigh in (pun intended) on exercise.
How Exercise Impacts Body Composition
In a 2011 study published in the International Journal of Obesity, 320 post-menopausal women ranging in weight from normal to obese were split into two groups. The first were asked to do 45 minutes worth of moderate-to-vigorous aerobic exercise, 5 times a week for a full year (they actually ended up averaging about 3.6 days per week). The second group did not exercise. And neither group was asked to improve nutrition or try portion control.
After one year, the exercise group lost an average of 5.3 pounds of body fat.
That’s a lot of work to lose 5 pounds of fat.
HIIT, or high-intensity interval training, may be a more efficient approach to improving your body composition, especially in the abdominal region. One study compared two groups who exercised at different intensities: one that did three days a week of high-intensity exercise and another that did five days a week of low-intensity exercise. After 16 weeks, the high-intensity exercise group lost both more abdominal visceral and subcutaneous fat than the steady-state exercise one.
So it appears exercise, specifically high-intensity exercise, can produce faster results if you want to see those abs.
Next, let’s see what type of impact diet has.
How Diet Affects Body Composition
There are many different diet plans for those hoping to lose fat and/or increase lean body mass. We’ll look at some of the most popular and review which are effective for changing body composition and which need to be studied more.
Paleo Diet
The Paleo diet (or “Paleo” for short), consists of eating foods that are assumed to have been available to humans prior to the establishment of modern agriculture. If the caveman didn’t eat it, it’s out. This includes eating things like lean meat, fish, vegetables, fruits, eggs, and nuts. It excludes foods like grains, legumes, dairy, sugar, and processed oils.
Paleo is relatively new (in terms of nutrition research) and therefore doesn’t have a whole lot of credible evidence on its impact on body composition specifically. One meta-analysis published in the American Journal of Clinical Nutrition compared the Paleo to 4 control diets based on U.S. nutrition guidelines.
The researchers found that the Paleo led to greater short-term improvements in waist circumference, triglyceride levels, and blood pressure.
It’ll interesting to see if Paleo proves to be more effective than other diet plans on improving body composition as more studies become available.
Ketogenic Diet
The ketogenic diet (or “Keto” ) consists of eating high fat, moderate protein, and very low carb foods. It’s similar to Paleo but carbs are restricted to 25-50 grams per day.
A 2013 meta-analysis that compared Keto to a low-fat nutritional plan suggests that keto is more effective for weight loss as well as improvement of cardiometabolic health.
Another study that compared the ketogenic diet to a low-fat diet found that Keto was effective in short-term body weight and fat loss. On top of that, it appears that Keto may support preferential fat loss in the trunk area, although this requires further validation.
Finally, a study in which men performed resistance training three times a week and compared body composition effects of keto vs. the traditional Western diet found that the ketogenic group experienced significant fat mass loss, as well as lean body mass gains, compared to the Western diet group.
Mediterranean Diet
The Mediterranean diet is based on typical foods and recipes of Mediterranean-style cooking (native to Italy, Greece, Spain, etc.).
This includes large quantities of fresh fruits and veggies, nuts, fish and olive oil. The Mediterranean diet is one of the most studied diets and for good reason: It has been shown to help reduce the risk of heart disease, certain cancers, diabetes, Parkinson’s and Alzheimer’s diseases.
Let’s see what type of impact, if any, it has on body composition though.
One study on 248 healthy women published in the European Journal of Clinical Nutrition found that the Mediterranean diet could help reduce body fat levels.
Another study in subjects with coronary artery disease showed that adherence to the Mediterranean diet significantly reduced body fat mass and percent body fat.
A meta-analysis published in the journal Metabolic Syndrome and Related Disorders concluded that the Mediterranean diet “may be a useful tool to reduce body weight, especially when the Mediterranean diet is energy-restricted, associated with physical activity, and more than 6 months in length.”
Finally, when researchers looked at the Mediterranean diet’s effects on weight loss and cardiovascular risk factor levels in overweight or obese individuals trying to lose weight and compared them to low-fat diets, they found that the Mediterranean diet produced greater weight loss.
Diets: The Bottom Line
Science shows there’s no one-size-fits-all approach to dieting. A meta-analysis published in the Journal of the American Medical Association, reviewed 59 studies with various nutritional recommendations (low-fat, low-carb, etc).
Researchers found that weight loss differences between individual diets were small. Participants were able to change their body composition (lose weight) with both low carb and low-fat diets.
However, getting the right amount of protein seems to be one of the most important things you can do to improve your body composition.
In another meta-analysis of 87 studies published in the American Journal of Clinical Nutrition, researchers found that low-carbohydrate, high-protein diets favorably affect body mass and composition.
So it seems the consensus is that eating more protein can also help you preserve lean body mass when dieting.
Now, let’s look at the most effective approach for getting a six pack: combining a high protein/low carb diet with different types of exercise like cardio and strength training. This is where things get interesting.
How Exercise Combined with Diet Impacts Body Composition
According to another study published in the journal Obesity that compared the effect of dieting and exercising (alone or combined) on weight and body composition in overweight-to-obese post-menopausal women, the diet-only group achieved more weight loss than the exercise-only group. However, the greatest effects were seen in the combined diet/exercise group, “where 60% of participants achieved ≥10% weight loss at 1 year.”
Other studies show similar results: a combination of dieting and exercising works best if you want to lose fat (which is how you will see your abdominal muscles).
The question is, are certain types of exercise (resistance training, long duration cardio, etc) more effective than others for improving your body composition?
Exercise in combination with diet led to the most significant changes in body composition.
The combination of resistance training and diet was more effective than endurance training or a combination of endurance and resistance training at altering body composition measures (reduction of body mass and fat mass).
Conclusion
Making adjustments to how you eat can lead to more fat loss in less time compared to exercise alone.
So, the verdict? Abs are made in the kitchen and the gym.
Like anything worth achieving in life, getting a six-pack takes both work and knowledge. Doing 1000 crunches and 1 hour of cardio a day won’t help you see your abdominal muscles any faster if you don’t make the right changes to your diet.
“Spot reduction” is also another myth. You can target your abs and core with resistance training that help with the muscles in that area, but you also need to lose overall body fat to see the definition in those abdominal muscles– and that requires a combination of diet and exercise.
So where do you go from here?
First, determine your body composition goals. If your goal is to lose fat and gain more definition, then you’re going to have to eat at a calorie deficit. If your goal is to increase lean body mass and lose fat, then your diet and exercise regimen may look different.
At the end of the day, the best exercise/nutritional plan is the one you can stick with. Once you find the right approach for you, you can make it a lifelong habit. That’s what will give you your six-pack.
When it comes to malnutrition, most the focus—and rightly so—is on severe malnutrition in developing countries wherelack of access to food has tragic consequences.
This condition can have debilitating effects on body composition, quality of life, and independent living. But malnutrition among older adults in developed countries is more widespread than most people realize. How can malnutrition coexist in countries that have an obesity epidemic?
Technically, malnutrition is an umbrella term including overnutrition (i.e. obesity) and undernutrition. Just as important as fighting increasing obesity, it’s important to understand how various aspects of aging can make it difficult to consume all the essential nutrients the body needs.
The good news is that malnutrition is easily diagnosed, managed and even reversed. As we continue we will be discussing treatment and prevention, but first let’s raise awareness about the issue itself.
The What, Who, and Why of Malnutrition and Aging
With so many different people experiencing different effects and severities of malnutrition, it can be complicated to break down. Since there are several primary types of malnutrition, we’ll focus on how malnutrition impacts body composition and why this is so important for your long-term health.
WHAT IS MALNUTRITION?
The World Health Organization defines malnutrition as “deficiencies, excesses or imbalances in a person’s intake of energy and/or nutrients”. Protein-energy deficiency is one of the most common forms of malnutrition and this health condition has an immediate and negative impact on body composition. This deficiency wreaks havoc on skeletal muscle mass in particular, as the body eventually goes into starvation mode and breaks down its own protein (stored in muscle) for fuel.
Micronutrient deficiency is a lack of nutrients, like minerals and vitamins, that support important bodily processes like cells regeneration, your immune system, and even eyesight. Some common examples are iron or calcium deficiencies. Micronutrient deficiency has the greatest impact on normal physiological functions/processes and can actually occur in conjunction with protein-energy deficiency since most micronutrients are obtained from food.
Although nutritional deficiencies of certain micronutrients can impact processes such as building and repairing muscle, protein-energy deficiency has a more pronounced effect on body composition due to the fact that lowered protein intake can lead to more drastic losses in muscle mass. The American Society for Parenteral and Enteral Nutrition (ASPEN) defines several features of malnutrition and nutritional deficiencies in adults:
Insufficient energy intake
Unintended weight loss
Diminished physical function (including hand grip strength, and physical performance testing)
Serious medical conditions (such as edema resulting from fluid accumulation)
WHO IS AFFECTED, AND WHY?
You would assume that adults spending time in rehabilitation centers or hospitals should be well nourished since they have a range of staff taking care of them, right?
In theory, yes. But in reality, things are more complicated.
According to a study of over 4,000 individuals, approximately 40-50% of patients in rehabilitation centers and hospitals are malnourished, compared to 14% in nursing homes and just 6% in independently dwelling adults. These are staggering differences, but the numbers should be put in context.
There are two overarching reasons malnutrition strikes older adults.
Insufficient food intake. This often results from factors inherent to aging, including loss of taste or smell, dentition (poor muscle function or loss of teeth), or cognitive decline.
Disease-related malnutrition. Decreased food intake or absorption due to a wide range of diseases from cancer to inflammatory bowel disease or from cases such as hospitalization including surgery or emergency medical interventions (stroke, trauma, etc.)
Since individuals suffering from disease-related malnutrition are more likely to require hospitalization (to treat their disease), this could contribute to the high rates of malnutrition in hospitals and rehabilitation facilities. But a host of other factors in hospitals make it no wonder that longer hospital stays are related to rates of malnutrition.
WHY YOU SHOULD CARE, EVEN IF YOU ARE NOT DIRECTLY AFFECTED
Malnutrition really is an important issue in that it takes a high toll on people afflicted; on top of that is the associated economic cost that extends the burden beyond the malnourished individual. Massive medical bills strain individuals and their families and consume significant amounts of healthcare resources.
In a study of almost 2000 older adults, health care costs for malnourished adults were more than double those for non-malnourished adults. More visits to general practitioners and hospitals equals higher cost.
However it is worth noting that although treatment for malnutrition can add up in cost, the sooner the treatment, the better. Intervening with treatment called oral nutritional supplementation (ONS) does add to healthcare costs, but according to an economic model analysis, the cost of ONS treatment is more than offset by the long-term reduction in hospital admissions as a result of treatment.
In other words, treating this condition sooner not only makes sense for health reasons, it makes sense economically.
How Body Composition Changes During Malnutrition
Now that we have covered the “What”, “Who”, and “Why”, let’s discuss the “How” malnutrition affects body composition.
Most adults experience a natural shift in body composition as they age, partly thanks to a decrease in physical activity. What might accelerate and worsen that shift?
That’s right: malnutrition.
While Fat Free Mass starts to decline in the middle of adulthood, it drops at a concerning rate by the time adults reach their 80’s. Coupled with a decrease in functional health, it’s clear that unfavorable changes are happening.
Adding protein-energy deficiency into that mix makes the situation even more concerning. Researchers comparing elderly and middle-aged malnourished adults found that the elderly group was more prone to losing Fat Free Mass than fat mass and this may come down to not taking in enough nutrients to support and maintain muscles and their function.
In other words, undernutrition exacerbates the issue of muscle loss and those that are malnourished are more likely to tap into their muscle protein for fuel rather than those pesky fat stores (which are designed to be our energy-stores).
That matters because malnourished older adults are already at an increased risk of mortality. On top of that, losing muscle makes it difficult to perform those normal activities of daily living. As you burn through muscle protein, functional capacity declines, and loss of independence and malnutrition ensues
Recognize and Take Action
In light of the fact that malnutrition is more prevalent than most would think,what are the warning signs you should you look out for? It’s a tough problem to assess, and catching it before significant changes in body composition or muscle mass occur is best. However, watching out for these risk factors can be helpful in determining your likelihood of malnutrition or the severity of muscle loss.
ADDRESSING THE RISKS
Just because malnutrition can be difficult to spot early on, doesn’t mean all is lost. There are a variety of risk factors and health problems to be aware of and recognize. Here is a list of a few.
The first step to addressing the undernutrition problem is to make people aware of the problem. Research shows that among cancer patients (a nutritionally at-risk group) at home, nearly 25% do not receive nutritional support or counseling despite receiving other health care.
If you don’t recognize a problem, you can’t do anything about it.
Before getting into actual treatment, here are a couple strategies to address malnutrition risk factors head on.
Spice up your food. A few dashes of flavored powders like beef bouillon or lemon butter help increased body weight and prevent a decline in energy intake by making foods more appealing.
Take care of your teeth. Missing a substantial number of teeth is associated with lower energy and protein intake. Wearing dentures can lower your risk of malnutrition by about 20%, but only if you wear them consistently.
Make meals something to look forward to. Rather than eat each meal alone, have meals with other people in your community or schedule regular dinners with family and friends.
Get your body composition tested. Regularly get your body composition tested either bi-monthly or monthly to make sure that your muscle and fat levels are where you want them to be.
FOOD-FORWARD SOLUTIONS
If you do find yourself, or a patient, facing malnutrition, oral nutritional supplementation (ONS) is one of the most promising treatments you can use.
Most nutritional supplements you are familiar with probably come in pill form, like Vitamin A or Vitamin D, but ONS is in liquid form. Boost and Ensure (though not necessarily brands we are recommending- please do your research on fitting the ingredients to your specific needs) are some common brand names, and there are dozens of more options out there in a variety of flavors and formulas.
The science behind ONS is substantial. It counteracts malnutrition and related comorbidities in adults ranging from hospitalized hip fracture patients to frail community-dwelling elderly adults.
An analysis of 36 studies on high-protein ONS found that it increases calorie intake by more than 300 calories per day and protein by over 20g per day, slightly increases body weight, and improves muscle size and strength. That’s all from drinking just a daily 8 oz. shake.
Of course, getting your nutritional needs in by consuming real food is better than relying on supplements. However, when it comes to malnutrition it’s critical to get enough protein, vitamins, minerals, and calories, making supplements often necessary to round out the diet.
Getting enough real food is tough if it’s difficult to swallow or your sense of taste and smell start to go (or down). That’s why researchers experiment with ‘densification’ of real foods.
Densification involves adding calorie and protein content without changing the types and quantities of food. The idea is to get patients to consume more nutrients without feeling overburdened by large meals, and it works.
Elderly adults who prefer smaller meals consume more calories across breakfast and lunch when foods are ‘densified’. This strategy can even be implemented at home. To add calories and protein to the foods, researchers simply replace water in recipes with extra fats and dairy.
Whether ONS, food densification, or just adding more food to the diet, increasing calories and the range of vitamins and minerals will certainly offset malnutrition and its associated effects.
WHERE DOES EXERCISE FIT INTO ALL THIS?
In some ways, ONS to a malnourished older adult is like protein powder to a bodybuilder. It’s not the only way to build muscle and work towards body composition goals, but it sure does help.
Malnourished older adults and bodybuilders also have this in common: their bodies require a nutritional and exercise jumpstart in order to build muscle.
Researchers recently gave older adults with sarcopenia, or a significant loss of muscle mass, a whey protein shake along with a progressive strength training program. By the end of the study, almost 70% of the participants reversed many of their symptoms.
Part of their success was probably thanks to a dedicated team of researchers keeping them on track with the study. Social support is important for frail older adults who want to use nutrition and exercise therapy to regain a healthy body composition. It can be as simple as asking a family member or friend to come by a couple times per week to help keep you on track..
So while bodybuilders may be more intrinsically motivated to increase their diet and exercise to improve the muscle mass and physique, older adults may need some social support to improve their diet and exercise in order to offset or prevent these symptoms from occurring in the first place.
Wrap-Up: Your Next Steps
By the time someone becomes clinically malnourished or frail, their eating and exercise habits have likely been insufficient for a long time. With some exceptions in disease-related malnutrition, this is not something that happens overnight.
So what can we do to increase awareness, maintain our well-being, and prevent these conditions associated with malnutrition? Keeping a healthy, well-rounded, and calorically full diet with regular exercise is the best method of prevention.
Ignoring nutrition will gradually work against your body composition, just as your smell and taste can eventually decline and various other factors we’ve discussed set in to increase the risk for malnutrition. But forming a few key dietary habits before the effects of aging truly appear can help you prevent poor outcomes later in life.
Establish a strength training routine. Although some muscle mass loss can be stopped later in life with exercise, it’s better to start out with muscle mass than try to play catch-up.
Eat sufficient protein throughout the day. It is often best to space out your protein across meals rather than consuming it all at once to ensure you’re getting a good amount on a daily basis.
Monitor your body composition regularly. You should make sure you minimize muscle mass loss and fat mass gain as you age.
By avoiding or treating malnutrition and maintaining your body composition, you can continue on to age gracefully… who wouldn’t want that?
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Max Gaitán,MEd is an exercise physiologist and a USA Triathlon Certified Coach. When he’s not coaching, studying, or writing, Max spends most of his time outdoors training for triathlons.
At dinner last night, one slice of chocolate cake somehow turned into half a cake…
Today, you stuffed yourself with five buttery rolls at the office potluck. That wouldn’t have been so bad if you didn’t eat three plates of food.
We’ve all been there, and we all know how those post-binge episodes go — from guilt to frustration to promising yourself that it’s going to be the last time you stuff yourself with unhealthy food! (Not to mention the dreaded food coma…)
You thought you’ve overcome overeating for good, yet it turns out that you’re back to square one when it comes to getting your cravings under control.
Why is it so hard to break out of this cycle?
Is there a way to kick this ceaseless habit for good?
Does it have to do with self-control and having an endless supply of willpower?
Or is there some otherworldly, mystical force that you need to tap on in order to break free from binge-eating episodes?
To help us figure out if it’s sorcery or science, this article is divided into two parts.
First, you’ll learn about the possible reasons why it’s so tempting to finish a large box of pizza all by yourself. Second, you’ll discover how to put an end to compulsive overeating and finally take your body composition goals seriously.
With obesity affecting more than one-third of the U.S. adult population, getting out of the binge-diet cycle remains a puzzle to many.
To have a greater understanding as to how overeating happens, it makes sense to initially get a grasp of how our appetite, or the desire to eat, works.
Understanding Overeating
How Appetite Works
It’s worth noting that appetite is a tad different from hunger. Think of hunger as a need to eat while appetite is more like a desire to snack mindlessly even after you had lunch.
At a fundamental level, hunger and appetite are both influenced by a network of pathways involving the neuroendocrine system. Appetite regulation, satiety, and energy balance involve the following:
The smart folks over at ASAPscience simplified the science of hunger and cravings in a two-minute video below. It talks about the body’s hunger-regulation system and why we’re tempted to go for second helpings.
In essence, high-calorie foods rich in fat and sugar were extremely desirable to our hunter-gatherer ancestors for survival because they were scarce. However, this instinct for fatty and sugary meals still remain even though these types of food are now available 24/7.
Eventually, the continual intake of high-calorie fat and sugar-laden food overrides the human body’s natural hunger regulation system, leading to habitual overeating.
Another way of understanding appetite is to look at it from the perspective of eating for two main reasons— as a response to hunger (homeostatic) and for pleasure (hedonic).
In a review of studies differentiating the two, the researchers described that homeostatic hunger is the result of the prolonged absence of energy intake or the food itself, while hedonic hunger is strongly influenced by the availability and palatability of food in your environment. Furthermore, a 2016 study found out that intense feelings of pleasure derived from palatable foods (hedonic hunger) predicts the likelihood of losing control when eating among female college freshmen.
Why You Really Overeat and Binge
At first thought, it seems like putting an end to overeating is simply a matter of telling your brain to stop consuming food. Yet we all know that it’s not that easy, right?
Your brain may be the main driving force behind your cravings, but it’s not acting alone.
The frequency and the amount of food you finish is also influenced by a complex interaction of the following factors:
1. Genetic Influences
Your gut, hormones, and brain may be working together to control appetite, but your genetic makeup also has a say as if you’re the type to overindulge.
For instance, a London study on children revealed that genetic influences on weight and abdominal fat accumulation are high in children who are born since the onset of the childhood obesity epidemic. Furthermore, there is evidence indicating that specific genes can possibly impact your likelihood of frequent LOC (loss of control) eating episodes.
2. Environmental Influences
Environmental factors also contribute to the rise of food cravings. These factors include the atmosphere of the room and the presence/absence of distractions during meals. This also applies to social and cultural cues. Remember a time when you overindulged because everyone seems to be in the mood for feasting?
Finally, child feeding practices by parents during the first years of childhood tend to impact one’s eating behavior later in life. A review of studies on the parental influence on eating behavior revealed the following interesting findings:
Restrictive feeding practices by caregivers are associated with overeating and poorer self-regulation of food intake among preschool-age children.
Restricting access to palatable snacks and desserts like cookies in children may be counterproductive because it will eventually promote their intake.
Higher levels of parental control and pressure to eat healthily were associated with lower fruit and vegetable intakes and higher intake of dietary fat among young girls.
3. Psychological Influences
Did you know that not sleeping enough or getting stressed over finals week could lead to you reaching out for the cookie jar 5x a day when we’re not actually hungry?
It turns out that your appetite and hunger regulation is also influenced by these behavioral factors.
In fact, evidence from longitudinal studies suggests that chronic life stress may be linked to weight gain, with a greater effect seen in men. Furthermore, your work schedule can also impact how much you eat. A study revealed that shift workers may be particularly vulnerable to the tendency to eat the largest meals in the evening as they remain awake longer during the times when you naturally feel hungry for high calorie sweet, salty, and starchy foods.
Your Action Plan to Curb Overeating (Without Depriving Yourself)
Whether it’s stress or social pressure that’s driving you to overeat, we all know how frustrating it is to realize that you gave in to your cravings (again!). The good news is you can do something the next time you’re about to open your third bag of chips.
For a start, consider the following easy yet sustainable solutions to put an end to overeating, minus the horrible feeling of self-deprivation.
1. Learn to recognize the difference between homeostatic and hedonistic hunger.
As mentioned earlier, you can eat because you’re hungry but you can also eat for pleasure.
It can be a struggle to figure out the difference between the two because it requires you to be more mindful and listen to your body. As a result, misinterpreting these signals can lead to overeating.
While these cues will differ from one person to another (as well as depend on the time of day), you can learn to recognize your motivation for eating and adjust your eating habits by asking the following question:
Am I eating as a response to a physical cue (e.g. growling stomach, headache) or am I eating because I am feeling stressed, anxious, or overjoyed?
Whether you’re stressed about deadlines or bummed about your annual employee performance review, talking to a friend or journaling may be more helpful than emotional eating.
2. Be mindful of your “food environment”.
Your “food environment” may be divided into two parts:
Your social interaction and the overall atmosphere of your environment
How your food is served
To help promote a positive food environment, consider the following best practices:
Keep an eye on your portions.
Before eating two bagels in one sitting, savor one piece instead. Furthermore, you might also want to use smaller plates and bowls to avoid taking in too much when you’re in a buffet. Research reveals that larger plates can make a serving of food appear smaller, and smaller plates can lead people to misjudge the same serving size of food as being significantly larger.
Press pause (whether on your TV or phone) until you’re done with lunch or dinner.
When you’re distracted, you tend to eat mindlessly. As a result, you’ll be less sensitive to satiety cues because your brain is paying more attention to other things.
Be like the Okinawans in Japan by only eating until your 80 percent full.
Known for having one of the longest life expectancies in the world, Okinawans call this practice as “Hara Hachi Bu”, and this can be a useful guideline to help stop overeating.
Eat slowly.
A Greek study found that eating at a slower pace tended to increased fullness and reduce hungry feelings in overweight and obese participants.
Surround yourself with people who are taking steps to eat more mindfully.
Whether it’s your co-worker who’s into calorie counting or your brother who’s a geek when it comes to meal planning, being around others who eat mindfully will help reinforce your own good habits and perhaps teach you some new tips and tricks as well.
3. Make tiny adjustments to your daily habits that may impact your eating behavior.
Curbing overeating is not about making massive changes in your life but rather making tiny adjustments to your daily habits.
Going on a “healthy” detox diet or juice cleanse right after binging may help your weight loss temporarily, but it’s not sustainable in the long run. Instead, you’ll likely end up going through the same cycle of overeating, feeling guilty, restricting yourself, and giving in again to cravings. That’s why making smaller healthy changes is more effective for changing your lifestyle permanently.
These are three examples of tiny adjustments you can make to your daily habits.
There may be some exceptions (like when you’re doing intermittent fasting), but skipping your morning meal usually leads to overeating because you end up feeling famished throughout the day. On the other hand, a healthy high protein breakfast has been shown to stabilize blood sugar levels, increased satiety, and reduced hunger cues.
Do whole food swaps instead of cutting out certain foods entirely or adopting crazy diets.
Remember how high-calorie food that’s loaded with salt and sugar tends to encourage overeating? That why food choices are important. By opting for whole food alternatives, you will eventually reduce your cravings for unhealthy sweets and salty treats.
Don’t just adopt the latest trending diet and toss all the junk food residing in your fridge right away. A good rule of thumb is to have at least 80 percent of your daily meals from whole food sources and devote the rest to the not-so-healthy food items. And when the craving hits reach for a healthy snack like fruit or nuts. By doing so, you won’t feel deprived, which in turn can lead to another binging episode.
Special Note on Food Addiction
A lot of people can relate to overeating (because it happens to the best of us too!) but food addiction is a different story. If you feel that your binging episodes has turned into more than just a bad habit that you can change, seek professional help.
The Takeaway: Mindful Eating Can Go a Long Way for Your Body Composition
If you’ve noticed, the majority of the points discussed in the action plan has something to do with mindfulness.
Recognizing if you’re truly hungry or simply eating as a response to stress or other environmental factors requires constant practice and a heightened sense of self-awareness.
The idea of mindfulness may sound like a meditation fad or just another self-help woo-woo. However, mindfulness-based interventions in addressing compulsive overeating and other obesity-related eating behaviors have gained popularity recently. In fact, a systematic review of related studies on the topic supports its efficacy.
Overall, beating overeating and taking your body composition seriously begins with this single step—uncover the reason behind your binging habit. Keep in mind that you need to know the “why” first before diving into the “how” of putting an end to your tendency to overeat. Once you figure out your “why” the benefits are tremendous: a healthier relationship with food, weight loss, and a better sense of control. Good luck and here’s to a happier more mindful life.
***
Kyjean Tomboc is a nurse turned freelance healthcare copywriter and UX researcher. After experimenting with going paleo and vegetarian, she realized that it all boils down to eating real food.
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