By Ronald Grisanti D.C., D.A.B.C.O., DACBN, MS, CFMP

There is so much confusion on the best method to lose weight (fat) and at the same time achieve an improved level of health.

I am surprised with the number of people who stand firm on their method of losing weight.

May it be Paleo, Ketogenic, Vegan, Vegetarian, Carnivore, Weight Watchers, Zone, Nutrisystem, Jenny Craig, Atkins, South Beach, Elimination diets and many more you are bound to find those who simply claim that there way of eating is the best.

Most will not budge from their diet camp.

One thing that I want to make perfectly clear and that is ALL DIETS WORK (for some time).

The real issue is sustainability and a diet that has the best science to improve health and fitness.

In addition, I want to emphasize that almost all of above diets will allow you to lose weight however losing weight SHOULD NOT be your only focus. The goal is not only to lose weight and fat but to have a scientifically based program that helps you achieve outstanding positive health outcomes. That would include reversing heart disease, diabetes, auto-immune disease, etc.

I am a research nerd and dig deep into the medical literature to discover the truth from the fluff and spend most of my days reading the literature on a variety of health issues including weight loss (fat).

In addition to my extensive research I also apply this knowledge to real time patient cases and seek to obtain the best and most successful outcomes.

Losing weight while improving health has been high on the list of my research for quite some time.

The one important thing I want to make perfectly clear is I have NO agenda in what I am about to review with you as it relates to the science on losing weight.

Unfortunately there are those who one would call "influencers" who promote their way of losing weight with their special dietary and fitness recommendations as the Holy Grail of weight loss

However there is one overwhelming caveat and that is some have an agenda that puts money in their pockets when they "sell" their way of losing weight. It may include selling supplements, books, courses aligned to promote their program.

Although that may be ok in some cases, the problem arises if indeed the influencer is put in a position finding that there way of losing weight is simply not supported by the literature or downright wrong causing harm to the health of the buyers of their programs.

All diets have some truth to some degree but we must STOP being dogmatic on assuming there is one diet that is the end all be all.

From my research I will say with a high level of confidence that each camp has their strengths and weaknesses.

The key is identifying which one has the most supported science and which program has the optimal blend of all the hardiness of the variety of diets while continuing to strive for improved health and fitness.

All I ask from you is to please STOP being a hard nosed devotee of one diet camp.

With the above comments let's dive into losing weight (fat), keeping it off and at the same time achieving excellent health outcomes. I am referring to reversing heart disease, reversing diabetes, reversing autoimmune diseases, etc.

First and foremost losing weight based on the preponderance of clinical evidence comes down to simply being in a caloric deficit.

Ditch the concept of intuitive dieting. At least when you first get started on your journey to losing weight (fat)

According to the Mayo Clinic Intuitive eating is a simple idea. It means that you make peace with all types of food. Unlike traditional diets that restrict or ban certain foods, intuitive eating requires you to stop looking at food as “good” or “bad.” Instead, you listen to your body and eat what feels right for you.

Again you must accept the fact that you must be in a caloric deficit to lose weight/fat.

You must know your metrics!

The following are the MAJOR PLAYERS in losing weight/fat

Here are the metrics everyone wanting to successfully lose weight need to know

1: What is your current weight and bodyfat?

I recommend using one of the following four methods to determine your bodyfat.

a: DEXA (Dual-energy X-ray Absorptiometry) scan, also known as a body composition scan, can provide a detailed analysis of body fat, lean mass, and bone density. This is the gold standard in accurately measuring your bodyfat but simply not convenient for the majority of people.

b: Bodyfat Calipers- I recommend purchasing Sequoia Fitness Trimcal 4000 Body Fat Calipers. They are inexpensive (Approximately $10.00) but good and can be ordered off Amazon. I recommend the Jackson/Pollock 7 Caliper Method Use the following online calculators to obtain your bodyfat: http://www.linear-software.com/online.html#google_vignette https://www.trainermetrics.com/fitness-assessment-calculations/body-fat-7-site-skinfold-jackson-pollock/

View the following short videos on accurately measuring the 7 sites http://www.linear-software.com/malesites.html

c: Body Smart scale and bodyfat scale by Withings for less than $100.00 https://www.withings.com/us/en/body-smart

I have reviewed fitness authorities claim that the Withings bodyfat scale comes very close to the accuracy of the Dexa Scan.

d: For those who don't want to go through the hassle of the first three, I have made it super simple for you and the following male and female photos will show you different bodyfat percentages. Simply find the photo that best comes close to what you believe is your level of bodyfat.

The following grid will provide bodyfat goals based on age. Your ultimate goal is to improve your percentage of fat and NOT be exclusively focused on weight. I do want to be clear and encourage you to achieve your ideal weight and your ideal fat percentage.

There are people who one would call Skinny fat.

Skinny fat, also known as thin-fat phenotype, metabolic obesity, or metabolically unhealthy non-obese, is a body type where someone has a normal or underweight weight but a higher percentage of body fat than is healthy. People who are skinny fat may also have lower than ideal lean body mass, which includes muscles, bones, organs, blood, and skin. People with skinny fat may be at an increased risk of developing heart disease and diabetes.

In addition I want to discourage using the BMI as a measure of health and wellness.

The BMI does not take into account people who have a more muscular frame and would be classified as overweight or worse, based on the BMI measurement.

For example, I weigh 195 pounds at a height of 5'9. Based on the BMI measurement I would be considered overweight. However my bodyfat is 17% and according to the bodyfat grid for someone at the age of 67, I am at the athlete status. So again do not use the BMI to measure your level of success in the world of weight/fat loss.

2: Now that you know your weight and bodyfat use the following formula to determine your starting calories, amount of protein, carbohydrates and fat

To determine your optimal calories to be in a deficit use the following calculator https://www.calculator.net/calorie-calculator.html

Be certain to take the extra step when using the above calculator and add your bodyfat for of an accurate number. I recommend using the 1/2 pound to one pound taper week for your daily calories.

Another good option is to simply multiply your ideal weight by 10-12 to find your starting calories to lose weight (fat)

With that in mind use the following grid which provides optimal and realistic ideal weight goals based on your frame.

For example: If you are a man at a height of 5'9 with a large frame your ideal weight is between 155-176 pounds. If we take the ideal weight of 176 and multiply by 10 to 12 you will see that your starting calories may be in the neighborhood of 1760 to 2112 calories.

For example: If you are a woman at a height of 5'4 with a small frame your ideal weight is between 114-127 pounds. If we take the ideal weight of 127 and multiply by 10 to 12 you will see that your starting calories may be in the neighborhood of 1270 to 1524 calories.

You will see that the calculator matches nicely with the above manual option. Either one will work as a good starting point!

If you are looking for a good app to track your calories for a least week or so, consider the FREE MyFitnessPal https://www.myfitnesspal.com/

No need to obtain the app with all the bells and whistles. Simply get the calorie tracker.

4: To calculate your daily protein intake use the following formula: Take your lean body weight and multiply by .7 Take your lean body weight and multiply by 1.3

Example: If you weigh 200 pounds and your bodyfat is 25% you would have a lean muscle mass of 150 pounds and 50 pounds of fat

So you would multiply 150 by .7 and/or 1.3 to get your daily protein consumption of 105 grams or 195 grams per day.

To make all of our lives easier and ensure you're meeting your protein needs, let's get started with 1 gram per pound of lean body weight. Based on the above formula that would be 150 grams of protein per day.

Another simple option is to review the ideal body weight grid based on your frame and use that those numbers to get a close estimate of your daily protein intake.

For example for a 5'11 man with a medium frame he could consider using 154-166 grams of protein per day. For a 5'7 women with a large frame consider using 143-163 grams of protein per day

Let me make an important comment. There are some influencers who recommend consuming 1 gram of protein per bodyweight. This simply does not make sense if you weigh 300 to 350 pounds. That would be 300 to 350 grams of protein a day. Your goal is to fuel the weight that needs to be fueled and that is the LEAN MUSCLE WEIGHT. Why do you want to fuel the FAT associated with the 300-350 pound man or woman?

All of the above calculation metrics will allow you to get very close to your ideal daily protein intake.

5: To calculate your daily fat intake use the following formula You take your "current weight" multiplied by .3 to obtain your daily fat grams

Example: If you weigh 200 pounds you would take 200 pounds and multiply by .3 giving your 60 grams of fat per day

You may be asking why would I go through the time it takes to identify my calorie, protein and fat metrics.

The reason is because I have seen way too many patients not knowing their metrics and eating close to two to five times over there optimal caloric weight/fat loss and frustrated why they can't get to ideal healthy weight.

That is synonymous to the person who runs out of money every single month and can not figure out why they are short each and every month. When the same person decides to be accountable for every penny spent for one month they soon discover they are spending $500-$1000 over an above their monthly pay check on STUFF they simply were not thinking about. It could be special coffee latte at Starbucks (Usually between $6 to $8 dollars per day), and just about anything that slips through the cracks.

The great news is you do not have to do the above metrics forever.

After you have locked in your metrics then and only then can you incorporate the concept of intuitive dieting.

6: The rest of your calories would come from carbohydrates. This is the MOST important component of losing weight. You MUST determine your carbohydrate threshold or carb tolerant point to lose weight.

Your protein and fat in grams will stay consistent however your carbohydrates will be the only item you change to continue working on the caloric deficit plan.

7: After two weeks as long as you are losing .5 to 1% of your bodyweight each week you are good. However if you are not losing losing .5 to 1% each week you should reduce your CARBS by 100 to 150 grams per day. If you are still not losing at losing .5 to 1% after another two weeks drop your CARBS by another 100 to 150 grams per day.

I also want to mention if you are losing weight too quickly, increase your CARBS by 100 to 150 grams per day and try again. You do not want to lose weight quickly either, because you will likely be losing muscle and NOT fat.

Many people who lose muscle will soon discover that their weight (fat) loss efforts are halted because the body goes into a metabolic compensation slowing down the metabolism.

The MOTTO is SLOW and STEADY weight (fat) loss is bound for ultimate success.

Now here is another caveat important of mentioning: You MUST remember that your daily calories should be multiplied by 7 days of the weeks to be certain if indeed you go off of your good eating plan on a Friday or Saturday night. Case in Point: If your caloric deficit number is 1700 calories per day that would equal approximately 12,000 calories per week. So if you go out for a splurge dinner on Friday night and your daily calories for that day may be in the neighborhood of 3500 calories your weekly caloric intake would be in the neighborhood of 14,000 calories. That is 2000 calories over and above what you need to be in caloric deficit and likely sabotage your weight (fat) loss goals. Can you imagine if you did the same two days a week? You would almost certainly destroy any hope of accomplishing your weight (fat) loss goals.

Does this make sense? I hope it does because as I have clearly stated throughout this article, YOU MUST BE IN A CALORIC DEFICIT TO LOSE WEIGHT (FAT). PERIOD!

Now you may be asking what foods should I be eating and what eating program has the MOST science to support losing weight (fat) and most certainly improving health and fitness.

The answer is the Mediterranean diet (MedDiet)

This diet, which focuses on quality over specific nutrients or food groups, has been linked to many health benefits in numerous studies. For example, a 2018 study found that women who followed the Mediterranean diet for up to 12 years had a 25% lower risk of developing cardiovascular disease. The diet is also associated with a reduced risk of diabetes, high cholesterol, dementia, memory loss, depression, and breast cancer. It can also help strengthen bones and promote a healthier heart.

Inspired by the traditional eating patterns of southern Italy and Greece, the Mediterranean diet is deemed “the gold standard in preventive medicine,” due to its “harmonic combination” of antioxidants and anti-inflammatory properties, according to a review of studies.

The Mediterranean diet has been ranked the healthiest way to eat by US News & World Report

This is why Harvard, Mayo, Cleveland clinic and most "respected' health authorities endorse the Mediterranean diet.

Moreover, in the era of assessing overall food patterns, no other dietary pattern has undergone such a comprehensive, repeated, and international assessment of its cardiovascular effects. The MedDiet has successfully passed all the needed tests and it approaches the gold standard for cardiovascular health.

As I stated above, the MedDiet has the most supported science and has the optimal blend of all the hardiness of the variety of diets while help many people improve their health and fitness.

In addition to diet, the next important step is appropriate application of exercise.

After clearance from your physician the three exercise patterns recommended include:

1: Zone 2 cardio https://www.functionalmedicineuniversity.com/public/1967.cfm

2: High Intensity Interval Training https://www.functionalmedicineuniversity.com/public/1770.cfm

3: Most important is Resistance Strength Training at least 2-3 times per week Resistance training, also known as strength training or weight training, can help with weight loss by building muscle mass and increasing your metabolism . Muscle burns more calories at rest than other tissues, including fat, and a higher metabolism means your body burns more calories overall. Resistance training can also increase your after-burn, which is the number of calories you burn after exercise

Minor Players in the Weight Loss World Include:

1: Thyroid dysfunction

2: Hormone imbalance

3: Food Sensitivities

4: Stress

5: Medication Side Effects

6: Metabolic Adaptation

It is beyond the scope of this article to provide details on the minor players in achieving weight (fat) loss and improved health metrics.

I suggest consulting with your physician or functional medicine healthcare provider to help you address MINOR PLAYER issues that you may be challenged with. They can help you if the MAJOR PLAYER GUIDE above does not help you accomplish your weight loss/fat loss goal.

I will say however the the MAJOR PLAYER Information listed above will work for the majority of people.

The MAJOR PLAYERS have been carefully outlined above and provide the foundation to accomplish your weight (fat) loss goals

Dr. Grisanti's Comments and Recommendations

There is simply a preponderance of clinical evidence that will consistently work in achieving your ideal weight loss (fat loss) goals by following what has been thoroughly presented in this important article.

I would also like to mention that I have personally followed what I have presented in this article over the last year and at the age of 67 have lost 37 pounds, reduced my waist from 42 inches to 34 inches and achieved a bodyfat of 17% and happily improved my health/labs metrics better than I have done my entire life.

It works again and again for me and thousands of my patients.

** One important point I MUST emphasize includes focusing on your fat consumption on the Mediterranean Diet.

Stay within the guidelines as outlined above. That means to multiply your current weight by .3 to obtain your realistic daily fat consumption in grams.

To help you obtain a great understanding of the Mediterranean Diet, I recommend reviewing this simple overview
https://www.functionalmedicineuniversity.com/mediterranean-diet1.pdf

I recommend watching the following YouTube video on the Mediterranean Diet.

Watch Dr. Gil Carvalho 8 minute video on YouTube on the Mediterranean Diet https://www.youtube.com/watch?v=jAFBqa1WDR4

Gil Carvalho, MD, Ph.D. is a neuroscientist and researcher at the Brain and Creativity Institute, University of Southern California. He obtained his Medical doctorate from the University of Lisbon, and a Ph.D. in Biology from CalTech. Gil was a lead co-investigator with Antonio Damasio in ‘The nature of feelings: evolutionary and neurobiological origins'. Gil is published in academic journals such as Proceedings of the National Academy of Sciences; Nature Reviews and Neuroscience; Trends in Neurosciences; and Current Biology. His work has been cited over a thousand times.

WARNING and DISCLOSURE:

Always check with you primary physician before implementing any of my recommendations on losing weight and exercise. Also I want those who have eating disorders to discuss this article with their counselor or physician.

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9317652/

https://nutritionsource.hsph.harvard.edu/healthy-weight/diet-reviews/mediterranean-diet/

https://www.sciencedirect.com/topics/medicine-and-dentistry/mediterranean-diet

https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/mediterranean-diet/art-20047801

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6723598/

https://www.ahajournals.org/doi/10.1161/CIRCRESAHA.118.313348

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2819335

https://my.clevelandclinic.org/health/articles/16037-mediterranean-diet

** Always consult with a physician or healthcare practitioner with significant integrative or functional medicine training before starting any of the above recommendations.

You can find a qualified and certified functional medicine practitioner by going to: www.FunctionalMedicineDoctors.com

The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Grisanti and his functional medicine community. Dr. Grisanti encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional. Visit www.FunctionalMedicineUniversity.com for more information on our training in functional medicine. Look for practitioners who have successfully completed the Functional Medicine University's Certification Program (CFMP) www.functionalmedicinedoctors.com. This content may be copied in full, with copyright, contact, creation and information intact, without specific permission, when used only in a not-for-profit format. If any other use is desired, permission in writing from Dr. Grisanti is required

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