Happy New Year!!!

The start of the New Year sparks a desire for many to transform some unwanted, unhealthy behaviors into healthy ones. This means that we are currently being bombarded with headlines of  “to do” and “not to do” weight and health tips in the media. The Statistic Brain website’s New Year’s Resolution Statistics page (1) reports that 45% of Americans make a new year’s resolution, with weight loss being the most popular one; however, the overall success rate for those achieving their end goal is only 8%. This means many of these New –Year- resolution- determined -dieters and newbie “health” crusaders will be disappointed in the long-term.

In this blog, I’ll  look at some of the individualizing considerations for those who aren’t getting the results they hope for from generalized dietary and movement changes.

The Missing Factors In Weight Loss Advice

Although the science may be sound in a lot of health experts’ tips, the overall approach by many to weight loss remains the same throughout the years. How can we re-train our body and willpower to burn more calories and fat and optimize exercise results? Sounds good, right? However, it may not be that simple for a few reasons.

1. Most people are focusing on the final result rather than committing to a process which incorporates positive lifestyle changes. As mentioned in the above statistics, diets that only prioritize weight loss tend to fail. However, incorporating healthy lifelong changes in dietary and lifestyle patterns can lead to success long-term due to a shift in priorities. This is in line with studies that suggest that, beyond external and superficial rewards, finding enjoyable ways to achieve health and acquiring knowledge of the risk factors involved in not changing one’s destructive patterns, optimizes outcomes. (2-3)
2. Many are not looking at the individuality of the person. Approaches that take into account the biochemical uniqueness of the individual are often lacking, especially for those who have more complex weight-loss-resistant issues. For some, it may be as simple as changing the diet and exercising optimally. For others, it may not be.

The Missing Factors In Weight Loss & Health Outcomes

In previous blogs, I have discussed various emotional and biological hurdles to health resolutions. These include:

• Inability to modulate stress response in a healthy way
• Hormonal imbalances
• “Leaky gut” or gastrointestinal imbalances related to digestion and assimilation
• Suboptimal microbiome balance
• Chronic and underlying inflammatory reactions, including food allergies and sensitivities
• Neurotransmitter imbalances leading to cravings
• Unmet needs and emotional eating– This factor is important beyond weight loss and dietary choices. (4-5) A 10 year epidemiological study related psychological distress with mortality from several major causes in an English cohort. Although there were some limitations to the study, this effect is profound. (5)
• Lifestyle factors such as eating junk food containing preservatives and other chemicals that confuse our body and trump nutritional needs (food quality), not getting optimal sleep, or changes in timing of sleep
• Differences in ability to detoxify and modulate environmental exposures
• Genetic predispositions to “fat genes” which may change how much epigenomic influence needs to be exerted (6)
• Genetic differences in how the body reacts to exercise (see below)

The Good News

The good news is the old idea of combing cutting calories and exercising like a crazy person (7) as the number one factor for weight loss is getting debunked. (8) More and more, some of the above factors are coming into mainstream. Various experts are speaking out on how the biological and nutritional response to sugar and modified junk foods differs from eating a whole-food-organic diet. (9-11) Furthermore, the topic of “food addiction” is also gaining momentum, leading the way to a more holistic mind-body approach to weight loss.

Furthermore, the role and benefits of high-intensity-interval training (12) and non-exercise movement (staying active through the day) (13) are gaining popularity. This makes the concept of movement and exercise more bearable for those who aren’t fitness gurus or devotees. Another amazing aspect of exercise is that it is one factor that has been shown to modulate how genes express themselves. This not only effects how one burns fat, but also has other important health implications. (14)

Exercise Resistance-More Than One Meaning

I’m not talking about your lack of motivation in this category of willingness to exercise. The fact is, many people may be exercising but still not getting the results they want. Studies have shown that the expected change in mitochondrial function (cellular energy output) aren’t observed in  everyone. One study was done amongst diabetics and another based on a comparison of obese, lean, and diabetic individuals. Below is the excerpt with further explanation from Medscape:

About one in five people with type 2 diabetes do not respond favorably to exercise, a new literature review finds. Taken together, the data suggest that between 15% and 20% of patients with type 2 diabetes will not experience improvements in HbA_1c, insulin sensitivity, percent body fat, or muscle mitochondrial content even with supervised exercise.

Clinically, the findings mean that a patient may be truly attempting to comply with an exercise prescription and simply not responding to it, just as some people don’t respond to weight-loss drugs, the researchers say.

The paper was published online November 20 in the Journal of Clinical Endocrinology and Metabolism by Dr Natalie A Stephens (Translational Research Institute for Metabolism and Diabetes, Florida Hospital, Orlando and Sanford Burnham Medical Research Institute, Orlando) and Dr Lauren M Sparks (Sanford Burnham Medical Research Institute).

…

An Epigenetic Phenomenon

Drs Stephens and Sparks believe that “exercise resistance” in human skeletal muscle is the result of deficiencies within the genes that regulate fatty-acid oxidation, glucose uptake, and overall utilization of glucose and fat.

Furthermore, the article indicates exercise resistance is not just for type 2 diabetics:

While exercise resistance is probably not limited to people with type 2 diabetes, they may be more prone to it. The data suggest that they are more likely to have impaired exercise capacity and perceive a greater effort during aerobic exercise than do nondiabetic patients, even after adjustment for relative work intensity, the doctors write.

In an unpublished study they conducted, significantly varying responses in muscle mitochondrial content and fatty-acid oxidation rates were seen among 42 men and women with type 2 diabetes following 9 months of aerobic, resistance, or combination exercise training. Glucose homeostasis and/or muscle-substrate metabolism did not improve in 20%, despite the intensive, supervised exercise regimen.

Meanwhile, another published study found overlap in resting ATP-synthesis rates after training among lean and obese individuals and those with type 2 diabetes. Resting in vivo mitochondrial function did not improve after a 3-week aerobic exercise training intervention in some individuals, whereas others achieved resting in vivo mitochondrial function comparable to that of lean, healthy individuals (J Clin Endocrinol Metab. 2011;96: 1160-1168). (15)

This article describes the evidence that, although exercise can modulate gene expression; it’s not the whole picture. Specifically, exercise can affect how genes express themselves, but differing exercises and the genetic predispositions of an individual, such as those with MTHFR variants, and other factors listed above, all combine to affect outcomes. This means you could be exercising optimally but other factors, such as hormonal imbalances or chronic inflammation, may be thwarting your results.

The Generalizations- What You Can Control

Happily, most people will see results when the general health foundations are in place. Furthermore, one can partner with a knowledgeable practitioner to overcome some of the individual barriers to optimizing weight. Click here to read on how to set yourself up for a healthier lifestyle in general and see what to do if this isn’t enough.

References

(1) Statistic Brain. http://www.statisticbrain.com/new-years-resolution-statistics/. Accessed December 30, 2014. (statistics verified by the University of Scranton. Journal of Clinical Psychology on 1/1/14)

(2) Crane MM, Tate DF, Finkelstein EA, Linnan LA. Motivation for Participating in a Weight Loss Program and Financial Incentives: An Analysis from a Randomized Trial. Journal of Obesity. 2012;2012:290589. doi:10.1155/2012/290589.

(3) Wee CC, Davis RB, Phillips RS. Stage of Readiness to Control Weight and Adopt Weight Control Behaviors in Primary Care. Journal of General Internal Medicine. 2005;20(5):410-415. doi:10.1111/j.1525-1497.2005.0074.x.

(4) How can you improve your mental health and well-being in 2015? December 24, 2014. http://www.medicalnewstoday.com/articles/286428.php

(5) Association between psychological distress and mortality: individual participant pooled analysis of 10 prospective cohort studies. BMJ. 2012; 345. doi: http://dx.doi.org/10.1136/bmj.e4933

(6) Owens, B. New contender for ‘fat gene’ found. Nature. March 12, 2014. http://www.nature.com/news/new-contender-for-fat-gene-found-1.14863

(7) Body fat content influences the body composition response to nutrition and exercise. Ann N Y Acad Sci. 2000 May;904:359-65.

(8) Sean C Lucan and James J DiNicolantonio. How calorie-focused thinking about obesity and related diseases may mislead and harm public health. An alternative. Public Health Nutrition, available on CJO2014. doi:10.1017/S1368980014002559.

(9) Fung, B. Organic Food Isn’t More Nutritious, but That Isn’t the Point. 9/4/12. The Atlantic. http://www.theatlantic.com/health/archive/2012/09/organic-food-isnt-more-nutritious-but-that-isnt-the-point/261929/

(10) Gillam, C. GMO battles over ‘settled’ science spur new study of crops. Reuter’s. November 11, 2014. http://www.reuters.com/article/2014/11/11/us-gmo-science-idUSKCN0IV24C20141111

(11) Organic Consumers Association. Reference list for GMO studies and open letter to EU: http://www.organicconsumers.org/articles/article_31420.cfm

(12) Boutcher SH. High-Intensity Intermittent Exercise and Fat Loss. Journal of Obesity. 2011:868305. doi:10.1155/2011/868305.

(13) Owen N, Healy GN, Matthews CE, Dunstan DW. Too Much Sitting: The Population-Health Science of Sedentary Behavior. Exercise and Sport Sciences Reviews 2010;38(3):105-113. doi:10.109(14) Voisin, S., Eynon, N., Yan, X. and Bishop, D. J. (2015), Exercise training and DNA methylation in humans. Acta Physiologica. 213: 39–59. doi: 10.1111/apha.12414

(14) Voisin, S., Eynon, N., Yan, X. and Bishop, D. J. (2015), Exercise training and DNA methylation in humans. Acta Physiologica. 213: 39–59. doi: 10.1111/apha.12414

(15) Tucker, M. One in Five With Type 2 Diabetes Nonresponsive to Exercise. Medscape Medical News. November 20, 2014. http://www.medscape.com/viewarticle/835225?src=wnl_edit_medn_wir&uac=146852BY&spon=34

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