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Dr. Wolf Funfack, MDInternal Medicine &Nutritional Medicine

What do we really know about what makes us fat?

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The conventional wisdom on the treatment of obesity is very simple!

Obese people have to eat less or exercise more!

The conventional wisdom on the cause of obesity is very simple too!

Obese people consume more than they expend!

Put these two notions together and you find a dissonance because:

These cornerstones of the treatment bring poor and not long lasting results!

What do we really know about what makes us fat?

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Rather than to solve the dissonance by questioning our believeswe blame the obese people for not faithfully follow our advices!

Hundreds of millions have been spent in the last years,to tell people:

Eat less and exercise more!But the people in our countries are getting heavier developing more metabolc diseases every year!

What`s going wrong with that approach?

Treatment of obesity brings poor reults!

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Are we confounding cause and effect?

Are obese people obese because they eat too much?

or

Do obese people eat too much because they are obese?

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Are we confounding cause and effect? e.g. what can we do when it is getting warmer outside?

But is this really the positive proof of global warming?

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1. Burn it as energy!

2. Conserve it in storage, because currentlythere is no need for energy!

3. Dispose of it, because currently there is no need for energy and the stores are full!

There are 3 ways our body can deal with food!

Our body can ...

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Our metabolism is designed for scarcity!

Being able to store more engery translated into a survival advantage!

Fat people often eat LESS than skinny people!

Obesity is NOT a problem with energy balance!

Obesity is a problem of storage!

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1. Change exercise behavior

2. Change eating behavior

What do we really know about treatment of obesity?

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Change exercise behavior

Villareal DT et al. N Engl J Med 2011;364:1218-1229

Wei

gh

t lo

ss

in %

weeks

4 groups:

Control

Exercise

Diet Diät - Exercise

Less than 1%

More than 9%

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Eat less

1. Less calories2. Less Fat

Which tools can provide us?

Change eating behavior

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after 62 weeksafter 10 weeks before starting the diet

N Engl J Med Volume 365(17):1597-1604 October 27, 2011

The Yo-Yo Effect

Time after ingestion

Hu

ng

er

50 obese patientswere set on a dietwith protein shakesfor ten weeks!

30 60 120 180 240 min.

Change eating behavior: 1. less calories

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1 gram of fat results in

1 gram of CH results in

9 Kcal4 Kcal

Solution:We change fats with carbohydrates!

But: Calories and calories are not alike!

Change eating behavior: 2. less fat

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David S. Ludwig, Pediatrics: „High Glycemic Index Foods, Overeating, and Obesity“, 1999; 103;e26

Twelve overweight young adults ate three different breakfasts (randomly applied) over three days. After a 5 hour break they each ate the same meal for lunch.

Effect of calorie intake after different breakfasts

Breakfast 1: Omelette30% fat, 30% protein, 40% carbohydrate

Breakfast 2: Wholegrain muesli20% fat, 16% protein, 64% carbohydrate

Breakfast 3: Cornflakes20% fat, 16% protein, 64% carbohydrate

The three different breakfasts had an identical caloric load

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following omelette

following wholegrain muesli

following cornflakes

2000 kcal

3600 kcal(80% more calories)

3000 kcal(50% more calories)

= low glycemic load

= medium glycemic load

= high glycemic load

Effect of calorie intake after different breakfasts

The three different breakfasts had an identical caloric load

Calories and calories are not alike!

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Low fat dairy products and central obesity

Ris

k f

or

cen

tral

ob

esit

y

high fat

normal fat

Scand. J.of Prim.Health Care, 2013 Holmberg.S. High dairy fat intake related to less central obeesity

1261 svedish men of normal weight (age 40 – 60) were followed up for 12 years.197 (15%) developed “central obesity” (WHR >1)

low fat

Low fat dairy products increase the risk for central obesity by 53%!

Change eating behavior: 2. less fat

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Obesity is NOT a problem with energy balance!

Obesity is a problem of storage!

What do we really know about what makes us fat?

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Blood lipids

Stress-hormones

Storing fat evokes Hunger

Antiaging hormones

Burning fat

Antiinflamatinghormones

The hormone of storage is insulin!

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Blood sugar

Blood Insulin

50

100

150

200

Time [hrs]0

0 1 2 3 4 5

Food intake

Ravenous appetite

How do we produce high insulin levels?

Blo

od

con

cent

ratio

n

by food

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Blood sugar

Blood Insulin

Blo

od

con

cent

ratio

n

50

100

150

200

Time [hrs]

0

0 1 2 3 4 5

Food intake

Feeling of satiety

How can we keep insulin levels low? by food

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Carbohydrates are built up in chaines from thousands of monosacharides

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These long Carbohydrate chaines have to be split up into monosacharides

Only monosacharides are small enoughto pass through the bowel walls into blood

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Food Recommendations

Usual recommendations:

Carbohydrates 55 - 60 %

Fats: 25 - 30 %

Protein: 15 - 20 %

Our recommendations:

Carbohydrates 40 - 45 %

Fats: 30 - 35 %

Protein: 20 - 30 %

5-6 Meals per day 3 Meals per day

How do we produce high/low insulin levels?

high low

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Creation of an individual nutrition plan!

Laboratory Values Individual Meal Plan

PersonalInformation

Nutrient Database

&Proprietary

Method

How do we produce low insulin levels?

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62,5 % of participatns reduced their weight by more than 5% and maintained it at least for one year.

50 % of participants need to reduce their weight by

more than 5% and need to maintain it for more

than one year.

metabolic balance®

International recommendations for long-term success of an efficient weigh management program

Reduction in Body Weight

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Jolly, Kate et al. BMJ, 2011, 343; d6.500 “Comparison of range of commercial or primary care led weight reduction programmes . randomised controlled trial”

met

abo

lic b

alan

ce®

50%

Comparison of weight reduction programs

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The hybernating hedgehog

Please do not

disturb

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So

urce

: http://ww

w.e

volvehea

lth.nl/m

enta

l-coaching

/

Get Dr. Funfack's eBook at Amazon.Com“metabolicmetabolic balance®balance® – Nutrition basics: Introduction to the success program”

Get Dr. Funfack's Book through our Offices„metabolicmetabolic balance®balance® – Your Personalized Nutrition Roadmap“

3. Contact one of our Coaches via www.metabolic-www.metabolic-balance.combalance.com

4. Contact our Canadian or U.S. Offices

Canada:Canada: 1-289-291-3959 USA:USA: 1-727-851-0071

Take the next Step

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Thank you

For

your

! Attention !

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