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Melanie Cole: Welcome. This is Christiana Care's Weight Management Podcast Series. I'm Melanie Cole and today we're talking about walking a fine line, eating to support exercise, weight loss, and your metabolism. Our speakers in this podcast series represent Christiana Care Weight Management, a program that uses healthcare experts such as dieticians, exercise, and behavioral specialists to help people lose weight and keep it off. Joining me is Martha Henley. She's a Registered Dietician at Christiana Care Weight Management in the Department of Metabolic Health. Martha, I'm so glad to have you with us today. Let's start with, as people are thinking about weight loss and they always think about starving themselves, but they're also exercising, moving around, doing things they do during the day. Tell us what happens in our bodies when we starve ourselves. What happens when we're in that starvation mode? If we're exercising at rest? What is our body doing?

Martha Henley: Well, our body is trying to optimally survive and function on a daily basis and our body has a lot of different energy needs. The largest is probably to keep the brain going and the heart and the organs. So when we're restricting our food intake and exercising at the same time, if the calories are restricted so much that the brain and the heart and the body is starting to feel shortchanged the body has to adjust a little bit. So it shifts down, it gets a little more efficient and the metabolic rate goes down to conserve the energy for the necessary tasks.

Host: Which is really counterproductive. People think starving themselves is the way to lose weight. Do you have some symptoms of inadequate calorie intake that you can give us, if someone really isn't getting enough calories and maybe they're trying to exercise to lose weight, they're walking outside or their weight training something, are there some symptoms that we might recognize?

Martha Henley: Well, one of the first things people might notice is they might run into a weight stall. Maybe what they were doing was working very well. They were making some dietary changes. They'd started some regular exercise, and now the weight loss is stalled. So sometimes if the weight loss stalls, that's a first symptom. Also that can be accompanied with an increased appetite, including an increased craving for sweets. Maybe even, especially later in the evening. If you are someone who is tracking your exercise progress you might notice that it's more difficult to recover from your exercise or you're feeling more fatigued or sore, legs are a little bit heavier. Something that was easy at one time is now more difficult. People also might notice that they're not able to progress with their exercise routine or push themselves as hard. Other symptoms could be things like, possibly a lower immunity. Maybe you're getting sick more frequently or you just feel burned out and stale with exercise program.

Host: Well, thank you for all of that and so help us to find that sweet spot. How do we know how many calories and our nutrient needs to support exercise and weight loss and our general resting metabolism? How do we find that spot where we know we've heard the 1200 calories to lose weight, 2000, whatever. Is that still the case? Tell us a little bit about that.

Martha Henley: It's very important to recognize that finding that caloric sweet spot is, we'll need to be very individualized. So it really diet has to be customized to the individual, to their health history, medications they're taking as well as the fitness level that they've embarked upon. Just very generally speaking, if someone is taking in under a thousand calories a day, they really should be working with a medical professional. Definitely could end up in that starvation mode if they're at 800 calories a day, that's even without exercise. If they are exercising even a higher level of calories, 1200 or even maybe 13 or up to 15 could put them in that starvation mode if they're exercising at a pretty high or extreme level. So what should you do? Well, if you would like to be on a very low calorie diet, it'd be important to try to work with a medical professional who is involved with weight management and they could definitely give you guidelines, make sure you're getting the macronutrients you need and the vitamins that you need to do it safely. Generally speaking, that sweet spot for calories might be anywhere from about 1200 calories to 1500 calories.

Now at those levels you could do maybe a little more intense exercise, maybe like a cross fit or include some strength training if you're doing less than lower calorie levels in that it's important to keep the exercise very moderate. Maybe just walking, frequency and duration is more important there, several times a week. In terms of macronutrients, so we'd like to see anywhere from 12 to 1500 calories a day, at least if you're tracking your nutrient intake, 150 grams or less of carbohydrates, protein needs to be set at about one gram per kilogram of your goal weight. So for most people that's going to be at least 70 grams a day. And fat can be a wide range. Anywhere from 20 grams a day would be an absolute minimum, but many people might do better with a little higher fat diet, choosing some heart healthy fats. Things like avocados and nuts, that can give them a few extra calories and help with the increased appetite that often comes with the exercise. And also allow them to keep their carbohydrates in check.

Host: Martha, you've mentioned a few types of exercise. Is there one that you would say to somebody who says, I really want to lose weight? Which one should I do? Should I weight train? Should I do yoga? Should I walk on my treadmill or outside? Do you have one that you'd like to recommend that you think is the best for starting a weight loss program?

Martha Henley: They say the best exercise is the exercise that you'll do. So it's very important for people to find something that might be interesting or appealing and something that they can do consistently without getting bored and without getting injured. Generally speaking, cardiovascular exercise gives you the best calorie burn for the buck or for the amount of time spent doing the exercise. Probably American College of Sports Medicine guidelines are something like 200 minutes of exercise a week, that comes out to about 30 minutes every day. But if you're just starting out, it certainly would be okay to do more like 50 minutes per week. That comes up to about 10 minutes per day and a home walking program is an excellent starting point. We have some resources here at Christiana where people get started with a couple minutes every day. The goal is frequency and that program can be applied to going in the pool if that's something that's more interesting, the elliptical even doing some dance or some form of exercise like that at home.

Host: Really, so important. This is great information. So as people are looking at their exercise and their caloric intake portion control, the question comes up a lot. So how do you, is that the key to weight loss and healthy eating is portioning food or is it the type of food? I think that's been the million dollar question all these years is should it be smaller amounts of foods that may or may not be as healthy for you or larger amounts of salad and things that may be healthier for you? What about food portioning?

Martha Henley: Well, portioning is going to play a role for, for anybody who is interested in controlling their weight. The bottom line would be choosing what we would call nutrient dense or foods that give you a lot of nutrients per calorie. Portions are important for everybody to pay attention to. I think you can do larger portions of foods that are may even be watery foods. Things like fruits and vegetables that are also nutrient dense. They should work for anybody's weight loss routine portions of more calorie dense foods, even if they're healthier. Things like nuts. People could sometimes get into trouble with nuts. They're very healthy food, but they're also very calorie dense. A small amount half cup can give you about 400 calories, so people do need to be mindful of that portion even when they're choosing healthier foods such as nuts, avocados and things like sunflower seeds or trail mix.

Host: Before we wrap up, give us some strategies that can help us manage our appetite changes. You mentioned it before a little bit and our exercise and metabolism and weight loss, and how all of these things interact and help us on our weight loss journey.

Martha Henley: Well, a lot of people begin an exercise program when they're trying to lose weight. One of the first things they notice is their appetite goes up. And they're probably really is, is some truth to that. We definitely know after people lose given amount of weight, 10, 15 pounds, appetite goes up because your body wants to kind of get back to that comfortable weight or that set point weight. So it is very real when the appetite goes up. What can you do about it? Some of the suggestions that I have is making sure that you get enough fluid in. It's important that people get at least 48 ounces of, that's about six cups of fluid a day. Make sure you're not in turn drinking your calories. They should be, it should be primarily water, at least half of the fluid that you're taking in. Other things could be making sure you're accountable, especially with the exercise. It's helpful to have a buddy could even be a dog or a pet. Working with the trainer could be helpful. Putting exercise on your schedule is an important thing.

How often you should weigh is a controversial subject. Sometimes some, some people say you should weigh every day. Some people say once a week, and I think that depends on the person. If you do weigh every day, you can learn a lot about how different foods impact your weight, how exercise is changing your weight, and then how hydration affects things. And this can be important in staying hydrated, especially as the weather gets warmer. Just back to appetite. Primarily it's just making sure that the food is also satisfying. Making sure that the food tastes good, making sure that you're eating breakfast. These are some other things that can be helpful. Sometimes adding, as I mentioned before, a little more fat. Fat isn't demonized as much as it used to be, but when people are trying to keep calories to a certain level, if they need to go a little higher, they can oftentimes taken a little more fat instead of carbohydrates and feel satisfied getting enough proteins important as well to staying satisfied. So focusing on those two things to keep the hunger at Bay and keep the calories where they need to be to lose weight. When you're trying to balance exercise and your diet with weight loss is the goal. It's a little easier to keep the calories at goal rather than trying to exercise off those extra calories. And people are very good at overeating calories, but not typically found to over-exercise.

Host: Great information, Martha, thank you so much. And that concludes this episode of Christiana Care Weight Management Podcast Series. For more information regarding weight loss programs or to schedule an appointment with the weight management team, please call (302) 623-3475 or you can visit Christianacare.org/weight for more information and to get connected with one of our providers. Please remember to subscribe, rate, and review this podcast and all the other Christiana Care Weight Management Podcasts. I'm Melanie Cole.