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Frequently asked questions about Very Low Calorie Diets (VLCDs)

Questions about VLCD have been continuous and coming from many directions for more than 40 years, because Very Low Calorie Diets really work. They cause safe and substantial weight loss.

Excess weight is a killer and an unnecessary destroyer of the quality of life for too many people.

It is time for a wider understanding of the facts about VLCDs and dieting in general. These facts must be accepted before the medical consequences of excess weight bankrupt the NHS.

In this report we discuss some of the most frequently asked questions about VLCD in an attempt to stop the perpetuation of dieting myths.

1. Are there enough Calories in a VLCD?

2. Is there enough protein in a VLCD?

3. Do VLCDs have enough carbohydrates?

4. Are there enough essential fatty acids in a VLCD?

5. Are there enough nutrients (vitamins, minerals, trace elements) in VLCDs?

6. Is there published evidence on the safety and efficacy of VLCDs?

7. Do VLCDs cause too rapid weight loss? Does the lost weight return rapidly and to a level worse than before the diet?

8. Are there medical benefits from using a VLCD?

1. ARE THERE ENOUGH CALORIES IN A VLCD?

One of the most important features of the human body is the ability to store all but a few of our most essential nutrient needs. Fat is the major storage site for Calories.

In a seriously overweight individual, there are an enormous number of Calories in fat storage. The Calories stored in body fat reach astronomical numbers, about 49,000 Calories per stone.

The purpose of a diet is to reduce the number of stored fat Calories. The stored Calories are there to be used.  Use them. The Calories you ate at lunch may never be used, and are certainly not used immediately.

In a person with large stores of fat Calories, there is really no lower limit to the number of Calories required in the diet, except for the Calories potentially supplied by the essential nutrients.

What do we need to eat?

We choose a variety of plants and animals in order to provide the 50 or so nutrients that are essential to keep us healthy.  Unfortunately, the composition of any of these plants and animals are unique to them, so none of them, on their own, provide for all of our essential requirements. We have to eat a variety of foods in order to get enough of all the vitamins, minerals, trace elements, amino acids, essential fatty acids and even some carbohydrates for us to stay healthy.

The only choice for a single “food” that theoretically has all the nutrients that humans require is another human. Carrots make delicious eating, but they are carrots and not people. Fortunately, the foods we choose to eat are usually not other humans. Most modern societies frown on cannibalism.

When we eat enough variety of food choices we usually get the necessary nutrients. Pick enough of the wrong foods however, and even with a food excess there could still be nutrient deficiencies.

When we diet, it gets harder and harder to get enough of the essential nutrients as the amount of food is reduced. Eventually there comes a limit, when it is impossible to get enough of all essential nutrients, even with the ideal choices of foods. This limit happens to be 1200 Calories per day.  Below 1200 Calories a day there is no combination of conventional foods that can provide enough of all our essential nutrients. Without enough of these nutrients, the body is compromised and, depending on which nutrients become lacking, there can be a wide variety of negative health consequences.

Losing weight is not benign.

An obese person has at least 3 stones of excess stored fat. This amounts to 147,000 Calories, enough to power most active women for at least 10 weeks. A dieter simply requires a complete source of nutrients, not another source of Calories.

Modern Very Low Calorie, nutrient complete diet formulas, provide all the essential nutrients in the necessary amounts to keep people healthy. The only reason the formulas have any Calories at all is because some of the nutrients, the amino acids, the fatty acids and the essential carbs all have caloric values. Of course, these must be provided, since they have other roles beside being a potential source of energy.

VLCDs provide dieters one of the healthiest and most nutritionally complete daily intakes possible.

2. IS THERE ENOUGH PROTEIN IN A VLCD?

The subject of protein relating to storage and skin, the two most important issues for dieters using VLCDs, is complex. Unlike most other nutrients, there is no actual storage site for excess protein and new muscle fibres are not produced after puberty.

Over the years, there have been many demands for increases in the amount of protein provided in VLCDs. Current versions of VLCD formulations may already be less than optimal due to the meddling of various committees, but it would certainly be very unwise to add any more protein.

Protein excess to requirements gets converted to sugar. Extra sugar can be stored either as glycogen or converted to fat, neither being desirable for a dieter. This is especially important for VLCDs since it can interfere with ketosis, causing the rate of weight loss to slow and increase hunger, sometimes enough to lead to dieting failure.

The second issue is more visible. When people get fat, there are more changes in the body than just putting extra fat into fat cells. A fatter body has more skin. It has more blood. The extra weight puts strain on bones and muscles and there are many metabolic changes.

Can you imagine what would happen if the only change when dieting would be to reduce the amount of fat stored in the fat cells? The most visible effect would be that the extra skin would still be there.  The unpleasant photos in many tabloid publications are true, but not necessary, because current VLCD formulations allow the body to resorb the excess skin. The body uses what it needs. Adding more protein will lead to more people being left with excess skin. Other consequences may not be quite as visible.

3. DO VLCDs HAVE ENOUGH CARBOHYDRATES?

When the Atkins diet, a diet that seriously restricted carbs became very popular, it caused a serious financial problem for the food industry, from bakers to farmers. The backlash against carbohydrate restriction was almost as strong as the previous demand for higher intakes of carbohydrates.

Fortunately, the demands for higher carbohydrates have been muted now that influential people have learned that dietary ketosis is not the same as the disease condition, ketoacidosis, and ketosis has many health benefits.

Ketosis is now being recognized as a valuable treatment for epilepsy (first reported around 500 BC) and accepted by modern medicine in the 1920’s), is increasingly being recognized as a potential cancer treatment and also a potential treatment for a number of neurological diseases from Parkinson’s to Alzheimer’s.

Ketosis is valuable for dieters. The conditions for ketosis are well recognized to be helpful in blunting hunger so that prolonged dieting is possible. Once ketosis is interfered with, even minimally, continued dieting is often very short lived. With ketosis, the dieters can remain comfortable for many weeks.

Ketosis is also very protective during weight loss.

All our cells use sugar as a fuel and the brain has a considerable need for sugar. When sugar is restricted, the brain has a problem. It needs sugar once the body's glycogen reserves are depleted, so the body is quickly forced to convert proteins into sugar. Without ketosis there is a possible reduction in body protein when dieting through this need for conversion of body protein into sugar to fuel the brain. Over a prolonged dieting period this could be harmful.

Ketones, however, can replace sugar as the energy source for the brain. With a VLCD, the time period before ketosis is only a couple of days and the continued ketosis prevents the body protein from being lost.

This is a very important reason for continuous rather than interrupted dieting.

A number of people have been advocating various types of intermittent fasting. What this does is eliminate the metabolic benefits of ketosis and cause a dieter to re-start, with all its problems, very frequently.

Another reason ketones are so valuable is that ketones are produced from the fatty acids that are mobilized from fat as weight is lost. Some of hese fatty acids can be valuable as a source of essential fatty acids, which will be discussed later. Fatty acids, however, are unable to pass through the blood-brain barrier and directly provide energy for the brain. Ketones produced from the breakdown of the fatty acids, are small molecules and water soluble, so they can get into the brain and provide the necessary energy.

A build up of blood fatty acids can also become problematic as they are thought to induce heart arrhythmias. Converting excess fatty acids to ketones with  VLCDs is therefore protective.

Ketogenic, nutrient complete VLCDs are one of the best and safest ways to diet.

 

4.  ARE THERE ENOUGH ESSENTIAL FATTY ACIDS in a VLCD?

Body fat is analogous to a bank savings account. The normal currency supplying the daily energy needs of the body is sugar. Sugar, beyond the amount in the blood at any one time, is stored in a complex form as glycogen, a large molecule made up of lots of molecules of sugar. Glycogen is stored in the body attached to an amount of water that can be as much as 4 times its weight.

As a carbohydrate, every pound of glycogen is worth 1800 Calories, about a day’s supply of energy.

A diet that uses about 250 Calories a day less than the amount of Calories being used, will use up the 1800 glycogen Calories in a week. Using up the pound of glycogen can release its bound 4 pounds of water as well.  A large weight loss with a small calorie deficit, but no fat loss. Permanent weight loss must include fat loss, but losing 5 pounds of fat needs a deficit of 17,500 Calories.

Ketogenic Very Low Calorie diets can actually achieve real fat loss in a reasonable period of time and produce significant fat weight losses. There are many publications attesting to the fact that stored fat is released into the blood, as fatty acids. Current studies demonstrate that there is a selective release of the very fatty acids being considered as possibly being needed as additional ingredients to VLCD.

Since dieters using a VLCD are releasing fat from their fat storage sites into the blood stream, the last thing they need is an additional intake of dietary fat.

True weight loss occurs when the body is forced to draw on its reserve Calories to fuel itself, and also releases these essential fatty acids. Restrict Calories and the body supplies Calories and the essential fatty acids deemed beneficial for health. More dietary fat could increase the blood fatty acid levels which  could be dangerous and also slow weight loss.

Do not do it. The addition of extra Linoleic and Linolenic acids to a VLCD will not only add unnecessary Calories, slowing the rate of weight loss, but alarmingly there is evidence that too high blood fatty acids can lead to arrhythmias.

To make matters even worse there is emerging evidence that Linoleic acid is highly obesogenic and diabetogenic. These are precisely the wrong substances to add to a weight loss programme that already delivers proven safe weight loss.

5. ARE THERE ENOUGH NUTRIENTS (VITAMINS, MINERALS, TRACE ELEMENTS) IN VLCDs?

How much selenium did you eat yesterday?

Selenium is an essential nutrient. You can’t even find out how much you ate by looking at a food composition table. The amount in any food varies from almost none to too much depending on the composition of the soil the plant was grown in or the amount the animal ate from those plants.  Some animals get a disease known as "Blind Staggers" from eating plants thought to be too high in selenium.

There are around 50 substances that are required for human health. To be healthy we must have a number of vitamins, minerals, trace elements, essential amino acids and fatty acids, and some source of carbohydrate. How much time do you spend calculating your intake levels of each of these? My guess is that for most people it is zero. Yet it is extremely important and there is no vitamin supplement that contains all the necessary nutrients.

As the amount of food eaten is reduced, the opportunity to get a wide variety of nutrients goes down.  Many approaches to weight loss, from drugs to behaviour modification, try to suppress appetite so you will eat less.

But eat less of what?  All they appear to care about is Calories.

If you don’t get enough essential nutrients, you will be ill and possibly very ill. The nutrient complete Very Low Calorie Diets have the correct amount of every nutrient you need.

VLCDs are one of the most nutritious foods you could eat, whether or not you are dieting.

6. IS THERE PUBLISHED EVIDENCE ON THE SAFETY AND EFFICACY OF VLCDs?

There is so much published evidence about the safety and efficacy of VLCDs that publishers reject new data on the basis that it is so well known that no one cares.

A proper search of the literature will bring up many hundreds of peer reviewed publications, but these can be made invisible if the correct criteria is not used in the search.

The search criteria often used is to limit the publications to those studied that are placebo controlled and double blind. Since it is not possible to offer study subjects a formula diet without them knowing what they are eating, there are none that turn up in the search.

A partial reference list containing hundreds of papers related to VLCDs is available upon request.

 

7. DO VLCDs CAUSE TOO RAPID WEIGHT LOSS? DOES THE LOST WEIGHT RETURN RAPIDLY AND TO A LEVEL WORSE THAN BEFORE THE DIET?

Most dieters want to lose weight as fast as possible. The problem is that none of the traditional weight loss methods will result in a reasonable rate of weight loss. In defence, traditionalists created the myths that rapid weight loss leads to rapid weight regain and that rapid weight loss causes the loss of muscle.  Both statements are totally false.

One of the best studies of weight maintenance after weight loss was carried out by the Anderson group.

The claim about muscle loss is  ironic in that there is less loss of protein with a ketogenic VLCD than with traditional food diets. Claims about a loss of “lean body mass” were made because some people did not know enough science to understand that the first fuel used up on a diet is sugar and glycogen, as discussed earlier.  Glycogen and it’s attached water is classed in the category of lean body mass since it is not fat. There was absolutely no justification for calling this loss of glycogen and water a loss of protein from muscle. It isn’t.

The paradox comes from the fact that when sugar is depleted, without ketosis, the body has to convert some of its muscle protein into sugar in order to supply the needs of the brain. This is a loss of muscle that does not happen with a ketogenic VLCD.

 

8.  ARE THERE MEDICAL BENEFITS FROM USING A VLCD?

“Being overweight or obese increases your risk of developing high blood pressure. In fact, your blood pressure rises as your body weight increases. Losing even 10 pounds can lower your blood pressure—and losing weight has the biggest effect on those who are overweight and already have hypertension.”

The relationship between body weight and blood pressure. - NCBI

https://www.ncbi.nlm.nih.gov/pubmed/3070038

A recent assessment of over 200 people with high blood pressure pre-diet lost more than 5% of their pre-diet weight using a VLCD under the care of pharmacists.  On average, these people lost nearly 2 stones of weight. The weight losses ranged from a half stone to a massive 9 stone. At larger start weights a 5% weight loss equates to a much bigger downward shift in BMI when compared with lower start weights. For example a 5% loss for a 26 stone patient would be 1.3 stone weight loss compared with just over 0.5 stone weight loss for a 12 stone patient achieving 5% weight loss. Patients were excluded on health grounds if their pre-diet BMI was too low to continue weight loss for a minimum of 4 weeks dieting.

These pharmacies have made, and are continuing to make a considerable contribution to the health of their customers.

Possibly an even greater medical benefit from VLCD is the effect on type 2 diabetes.

The media headlines are that “Tackling obesity head on can  REVERSE type 2 diabetes”

Obesity and type 2 diabetes are in the news again. This time it is the revelation that type 2 diabetes can be reversed through weight loss. Although known since the publications of Oxford Professor Arthur Scott Donkin in 1871, and a mass of publications since the introduction of modern VLCD, it is important that this effective treatment for this killer disease is becoming more widely known.  VLCDs could save the NHS the one million pounds an hour that they report spending in treating type 2 diabetes.

The list of medical problems either caused by or made worse by overweight and obesity is long.

Losing significant weight with VLCDs, under the supervision of healthcare professionals, is making an important contribution to the health of the nation.

How do I still diet over Christmas or other holiday period (religious or not)? Lipotrim advice.

Our Best advice is…

DON’T BREAK YOUR LIPOTRIM DIET FOR CHRISTMAS OR ANY OTHER HOLIDAY

It is important to note you are NOT being given permission to break your Lipotrim diet for holidays, even Christmas.

If you choose to break your diet, here are a few of the issues involved:

The Christmas season, as with many other holidays (religious or not) often presents a series of pressures to indulge in food and drink at considerably excessive levels. As a result, the weight regain consequences of a loss of control can be considerable.

Do you really want to prolong your diet on the formula for longer than necessary or even fail to reach your target?

Restarting the Lipotrim diet can be considerably more difficult than when you started for the first time. You have achieved a great deal and are now in danger of forgetting those difficult first few days. Remember it is you that has to be uncomfortable during the restart of the diet. Next time however, because of the success so far, your levels of determination, and possibly desperation, are likely to be much lower. This makes restarting much harder than you may be thinking.

If you plan to break the diet for Christmas, or any holiday, you must refeed appropriately.

Here are a few of the most important points to consider:

1. Maintenance formula foods are designed to help you keep control while eating normal food. Have one or two daily during the tempting days of the holiday period.
2. Try using two Lipotrim maintenance formulas each day plus a normal low fat, high protein meal for two weeks before attempting to restart. This should ease the transition back onto the Lipotrim Total Food Replacement Programme.
3. Restart as soon as you can, making sure you don’t give into the temptation to delay “just another day”. Make sure you keep your regular appointments and never restart Lipotrim as a total replacement without seeking advice, even if you have a few leftover sachets.
4. Alcohol blunts your resolve. Avoid excessive alcohol if at all possible.
5. Keep in mind that the more sugars and high carbohydrate foods you eat, the more glycogen you will store, the more water weight you will regain and the harder the restart will be.
6. It is very important to realise that the more fats and oils you eat, irrespective of the source of fat, the more real body fat you will have to take off after you restart your diet.
7. Turkey and lean ham, for example, are high protein foods and may not make it quite as difficult to restart as high carbohydrate foods will. All foods will remind you what food tastes like and stimulate your desire to eat again, hence our advice to keep to the programme. Try to just eat some of the protein foods and ignore the fats and carbohydrates. Your capacity will not be very large after being on total food replacement for a prolonged period of time. You are likely to become very uncomfortable if you eat a very large meal.
8. Christmas lunch prepared by following very low fat principles will have far fewer calories than the traditional counterpart. This applies to all meals, holidays or not.

Christmas will return again next year as will most holidays that could break your resolve. If you are able to reduce your weight, you stand a much greater chance of celebrating future Christmases and life events.

The choice is yours.  Make sure the choice really is yours.

No-one has the right to force you to eat or drink whether it is Christmas or not. 

Contact Lipotrim today for more help and advice on:

0800 413735   (UK)

01525 5636     (ROI)