HOW TO ESTIMATE YOUR REAL FOOD REQUIREMENTS
Richard K. Bernstein, M.D., F.A.C.E., F.A.C.N., C.W.S.
Now suppose you have been following our low-carbohydrate diet, have been conscientiously" pumping iron" every day, and are, in effect, "doing everything right" What else can you do, if you have not lost weight. Well, everyone has some level of caloric intake below which they will lose weight Unfortunately, the "standard" formulas and tables commonly used by nutrition experts set forth caloric guidelines for theoretical individuals of a certain age, height, and sex, but not for real people.
The only way to find out how much food you need in order to maintain, gain, or lose weight is by experiment. Here is an experimental plan that your physician may find useful.
This method usually works, and without counting calories.
Begin by setting an initial target weight and a time frame in which to achieve it. Using standard tables of "ideal body weight" is of little value, simply because they give a very wide target range. This is because some people have more muscle and bone mass for a given height than others. The high end of the ideal weight for a given height on the Metropolitan Life Insurance Company’s table is 30 percent greater than the low end for the same height.
Instead, estimate your target weight by looking in the mirror after weighing yourself. (It pays to do this in the presence of your health care provider, because he/she probably has more experience in estimating appropriate body fat) If you can grab handfuls of fat at the underside of your upper arms, around your thighs, around your waist, or over your belly, it is pretty clear that your body is set for the next famine. Your estimate at this point need not be terribly precise, because as you lose weight your target weight can be re-estimated. Say, for example, that you weigh 200 pounds. You and your physician may agree that a reasonable target would be 150 pounds. By the time you reach 160 pounds, however, you may have lost your visible excess fat — so settle for 160 pounds. Alternately, if you still have fat around your belly when you get down to 150 pounds, it won’t hurt to shoot for 145 or 140 as your next target, before making another visual evaluation. Gradually you zero in on your eventual target, using smaller and smaller steps
Once your initial target weight has been agreed upon, a time frame for losing the weight should be established. Again, this need not be utterly precise. It’s important, however, not to "crash diet". This may cause a "yo-yo" effect by slowing your metabolism and making it difficult to keep off the lost bulk.
Bear in mind that if you starve yourself and lose 10 pounds without adequate dietary protein and an accompanying exercise regimen, you may lose 5 pounds of fat and 5 pounds of muscle. If you gain back the 10 pounds from eating carbohydrate and still are not exercising, it may be 100 percent fat. After crash dieting, once you’ve reached your target, you may go right back to overeating. I like to have my patients follow a gradual weight-reduction diet that matches as closely as possible what they’ll probably be eating after the target has been reached.
In other words, once you reach your target, you stay on the same diet you followed while losing weight. This way you’ve gotten into the habit of eating a certain amount, and you stick to this amount, more or less, for life.
To achieve this, weight loss must be gradual. If you are targeted to lose 25 pounds or less, I suggest a reduction of 1 pound per week. If you’re heavier, you may try for 2 pounds per week. If just cutting the carbohydrate, as suggested in prior chapters, results in a more rapid weight loss, don’t worry — just enjoy your luck.
This has happened to a number of my patients.
Weigh yourself once weekly— stripped, if possible, on the same scale, and before breakfast. Pick a convenient day, and weigh yourself on the same day each week at the same time of day. It’s counterproductive and not very informative to weigh yourself more often. Small, normal variations in body weight occur from day to day and can be frustrating if you misinterpret them. Generally speaking, you won’t lose or gain a pound of body fat in a day. Continue on your low-carbohydrate diet, with enough protein foods to keep you comfortable.
Let’s say that your goal is to lose 1 pound every week. Weigh yourself after one week. If you’ve lost the weight, don’t change anything. If you haven’t lost the pound, reduce the protein at any one meal by one-third. For example, if you’ve been eating 6 ounces of fish or meat at dinner, cut it to 4 ounces. You can pick which meal to cut back. Check your weight one week later. If you have lost a pound, don’t change anything. If you haven’t, cut the protein at another meal by one-third. If you haven’t lost the pound in the subsequent week, cut the protein by one-third in the one remaining meal. Keep doing this, week by week, until you are losing at the target rate. Don’t add back any protein that you have cut out even if you subsequently lose 2 or 3 pounds in a week.
If you’ve managed to lose at least 1 pound weekly for many weeks, but then your weight levels off, this is a good tune for your physician to prescribe the special insulin resistance-lowering agents. Alternately you can just start cutting protein again. Continue this until you reach your initial target or until your visual evaluation of excess body fat tells you that further weight loss isn’t necessary. A 150 pound adult requires at least 9 ounces of high-quality protein daily to prevent protein malnutrition. This can be adjusted to the patients ideal body weight. It is therefore unwise to cut your protein intake below this level. Some authorities recommend double this amount. Once you’ve reached your target weight, do not add back any food.
If you required some of the appetite-reducing medications, do not discontinue them. About six months after you reach your target weight, your physician may want to taper off such medication(s) gradually. If you start eating more than your final meal plan calls for, the medication(s) will have to be tapered up again.
You will probably have to stay on approximately this diet for many years, but you’ll easily become accustomed to it.
The above was abstracted from Dr. Bernstein’s book "Diabetes Solution".
To view other advice from Dr. Bernstein go to
http://www.diabetesincontrol.com/bernsteinarchive.htmFor Information on Dr. Bernstein’s book "Diabetes Solution" go to www.rx4betterhealth.com or visit Dr. Bernstein’s site at http://www.diabetes-normalsugars.com for excerpts.
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