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(Part of our January series on S3 Weight Management - Systematic, Stratified and Sustainable) There are multiple lines of evidence to support that getting a good night's sleep is important in order to be able to lose weight. From an evolutionary perspective sleep and energy management are intricately linked. Poor sleep dramatically alters the way the body responds to food.  When you do not get adequate sleep, your hunger hormones send signals to your brain to eat more.
As a result studies have shown that people who have inadequate sleep consume more calories. Compounding this, sleep deprived individuals have been shown to preferentially choose calorie dense foods rich in both fats and carbohydrates. Inadequate sleep also increases the release of the stress hormone cortisol, which in turn signals the brain to increase appetite via the release of another hormone orexin. High levels of cortisol may explain why sleep deprivation appears to lead to loss of muscle mass and increased abdominal (visceral) fat. Independent of its effect on appetite, cortisol also counters the actions of insulin, leading to insulin resistance the result of which can be high levels of insulin. Insulin is a storage hormone promoting the storage of prompt storage of glucose as glycogen and fats within adipose tissue. With high enough levels of insulin, fat will be quickly stored and lipolysis (the breakdown of fat for energy) will be suppressed, resulting in one-way storage in other words "a moment on the lips, forever on the hips" This cortisol induced insulin resistance can be demonstrated in as little as one week of sleep deprivation. Other studies have shown that a lack of sleep can
As a result of these effects it is not surprising that inadequate sleep is associated with weight gain. Large observational studies, like the Nurses Health Study, following 68,000 nurses, demonstrated that short sleep duration increased the likelihood of obesity by 15%. Of course, observational research can show associations it cannot prove causation, however shorter term sleep deprivation studies also show weight gain. The recent PREDIMED Plus study showed that lack of sleep affects weight loss during a trial of the Mediterranean Diet , as overweight people who did not sleep well lost less weight that those without sleep issues. Finally, sleep apnea one of the most devastating sleep disorders is both associated with and worsened by weight gain. This sets up a vicious cycle where poor sleep can lead to weight gain, and potentially sleep apnea and sleep apnea in turn leads to further weight gain. So we can see from this
The resulting vicious cycle can set up a progressive deterioration of sleep with a corresponding weight gain. The key to reversing this cycle is to prioritize sleep:
For more on this, see some of the previous blog posts on sleep
For other posts in our foundational behaviours for weight managemetn series:
On January 29th- we will launch a new group program - fully covered by MSP (for those with a BMI >30 or a BMI between 27 and 30 and a weight related diagnosis). During the month of January - we will be posting about the foundational behaviours for sustainable weight management - stay tuned. If you would like to learn more about the S3 program and whether you are eligible please check out our Sustainable Weight Management program page.
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(Part of our January series on S3 Weight Management - Systematic, Stratified and Sustainable) One of the best ways to improve your overall health is to exercise. Yet from a weight loss perspective, exercise on average yields modest results. The explanation for is captured eloquently by the saying “you can’t outrun a poor diet”. Increasing physical activity increases energy expenditure - the challenge is that it increases appetite. If you have not made changes to your nutrition (eating real food, hydrating without calories, going 12 hours without food and increasing your fibre), then by increasing exercise and your appetite, you run the risk of actually gaining weight as you eat more. Where exercise has it main role in weight management - is helping to prevent you from regaining weight. Once you have lost weight, exercise does a great job of maintaining or increasing your metabolic rate.  Beyond weight management, exercise has numerous health benefits and lack of physical activity has been identified as the fourth leading risk factor for global mortality and has been estimated as being the principal cause for approximately:
It has been estimated that for every hour you exercise you increase your longevity by 7 hours (up to a total benefit of an additional 3 years) and exercise can reduce premature death from all causes by 16% and from cardiovascular disease by about 25%. Simply put, exercise helps you to avoid premature death and live longer. Exercise also has many benefits for the here and now:
Despite these benefits, only 17% of Canadians meet the current guidelines of 150 minutes of “moderate-to-vigorous physical activity” per week. (2019 Canadian Health Measures Survey) This recommendation supported by the WHO reflects the amount of exercise necessary to get most of these benefits. It can be broken down into as little as 10 minute increments. Moderate intensity physical activities will cause adults to sweat a little and to breathe harder - up to the point that you could still have a conversation. Vigorous intensity activities will cause adults to sweat more and be ‘out of breath’. In our Wellness Garage Principles, we recommend:
Some ideas from Participaction: ;
Pick a time. Pick a place. Make a plan and move more. For other posts in this series:
On January 29th- we will launch a new group program - fully covered by MSP (for those with a BMI >30 or a BMI between 27 and 30 and a weight related diagnosis). During the month of January - we will be posting about the foundational behaviours for sustainable weight management - stay tuned. If you would like to learn more about the S3 program and whether you are eligible please check out our Sustainable Weight Management program page. (Part of our January series on S3 Weight Management - Systematic, Stratified and Sustainable) Most often when we think about food, we think energy to fuel us: carbohydrates and fat; or we think about protein to build us up; but one of the most important, and all too often over-looked component of our food is one that we don't even absorb. I'm talking about fibre. OK, sure we think about fibre when we are constipated, but really, fibre does much more than provide regular bowel movements. It is estimated that only 3% of the population eats the recommended fibre intake of 30 g per day - compare this to protein where 97% reach the daily recommendation. Yet we hear so much more about protein. Getting enough fibre is one of the most powerful habits for sustainable weight loss.  Fibre is the fuel of our gut microbiome. The bacteria that live in our gut have been called "the forgotten organ" - they weigh more than a kidney and they may be more metabolically active than our livers.
Healthy bacteria in our guts feed on fibre and in the process create short-chain fatty acids (SCFA's) These fatty acids can be used as fuel: in fact, 10% of our caloric intake comes from SCFA's including 60-70% of the fuel our colons use. In addition to their role as fuel, SCFA's are important messengers and play a key role in hunger, appetite, satiation, fat and glucose metabolism. SCFA's bind to receptors in the colon and fat cells to affect ALL the major hunger hormones
SCFA's have powerful effects on fat metabolism
SCFA's also improve blood glucose regulation by
Simply put, eating more fibre will increase circulating SFCA's resulting in:
Even the inert aspects of fibre are important, eating a meal with significant fibre will:
Bottom line - maintaining adequate fibre in your diet is one of the best ways to lose or maintain weight. Looking at this another way, one of the worst aspects of highly processed foods is the removal of fibre. In 2019, Kevin Hall et al demonstrated that ultra processed foods is not as satiating and resulted in extra food consumption of 500 calories per day! Where is the best place to get fibre?
For other posts in this series:
On January 22nd - we will launch a new group program - fully covered by MSP (for those with a BMI >30 or a BMI between 27 and 30 and a weight related diagnosis). During the month of January - we will be posting about the foundational behaviours for sustainable weight management - stay tuned. If you would like to learn more about the S3 program and whether you are eligible please check out our Sustainable Weight Management program page. (Part of our January series on S3 Weight Management - Systematic, Stratified and Sustainable) In the past year - one of the hottest health trends has been intermittent fasting and one it's most commonly used variants - time restricted eating. A recent New England Journal of Medicine article highlights the physiology of fasting as well as the potential benefits. Two years ago on the Better Blog we wrote on "Why time restricted eating makes sense (and maybe you should try it) which provides much of the scientific evidence for the benefits of fasting. What we want to emphasize here is something a bit different and even simpler:
 Why is this important?
From a weight management perspective - the simplest answer is that you will eliminate the empty or extra calories of night time snacking...and that might be all that there is to it. But I do think there is more; our bodies follow a diurnal rhythm that very closely follows a 24 hour light dark cycle. During the light part of the cycle, many genes are activated, while others are turned off, preparing our system for what is expected during the day:
During the dark part of the cycle, genes that were activated in the day get turned off, and others get activated, again in the effort of setting our system up for the expected activities
Up to 40% of our genes are affected by the diurnal rhythm - many by light, but some by the presence of absence of food. Putting this more simply, our bodies expect food in the daytime and fasting in the evening - evolution has designed us this way. Other benefits from going 12 hours without food is that it will improve metabolic flexibility - that switch that allows the body to go from utilizing stored carbohydrates to burning fat. If we want to lose weight, we obviously need this flexibility. In our thinking, we don't really think about going 12 hours a day without food as being a form of intermittent fasting - we think it is normal (and optimal) human behaviour. It is most likely what most of our grandparents did and it is certainly what you see in traditional societies. Consistently going 12 hours without food will likely provide many of the demonstrated benefits from intermittent fasting:
If you are interested in intermittent fasting, starting with 12 hours without food is the logical first step. We recommend that before starting IF, you have these foundations in place:
After 4 to 6 weeks extending the fast is something you can explore. The one major caveat to this is really important - if you are taking medications - please check with your doctor and come up with a plan before you start any time of fasting or time-restricted eating. For other posts in this series:
On January 22nd - we will launch a new group program - fully covered by MSP (for those with a BMI >30 or a BMI between 27 and 30 and a weight related diagnosis). During the month of January - we will be posting about the foundational behaviours for sustainable weight management - stay tuned. If you would like to learn more about the S3 program and whether you are eligible please check out our Sustainable Weight Management program page. (Part of our January series on S3 Weight Management - Systematic, Stratified and Sustainable) If you are trying to lose weight - here is a very simple rule - stay hydrated and do not drink your calories.  As Dr. Yoni Freedhof put it recently - "Drink only the calories you love", we might add "Learn to live water!"
Satiate your thirst with clear liquids - water, green tea, black coffee, seltzer. Drink when thirsty and then some. You’ll know your hydration level as the lighter your urine, the more hydrated you are! Liquid calories are always extra - they do not fill you and do not register in your brain’s satiation centre. Most calories in drinks come from either sugar or alcohol - and neither will help you with your goals. As with food, bio-individuality also applies to the amount of water our bodies need to function properly. On average men should ingest about 3.7 liters and women about 2.7 liters of water each day. This may seem like a lot, but this includes water that we get from our food, which accounts for an estimated 20% of water consumed daily. Try these tips and tricks for staying well hydrated!
For other posts in this series:
On January 22nd - we will launch a new group program - fully covered by MSP (for those with a BMI >30 or a BMI between 27 and 30 and a weight related diagnosis). During the month of January - we will be posting about the foundational behaviours for sustainable weight management - stay tuned. If you would like to learn more about the S3 program and whether you are eligible please check out our Sustainable Weight Management program page. (Part of our January series on S3 Weight Management - Systematic, Stratified and Sustainable) The simplest and most profound change you can make for your health is to eat real food or put another way:
Simply put - our bodies were not designed for the processed foods of modern life.  As with most most behaviours there is an evolutionary mismatch between what the environment that we evolved into and our modern world.
From an evolutionary perspective we are omnivores and were hunter/gatherers until about 10,000 years ago. Our bodies are designed for nutrient dense but calorie poor foods with lots of fibre NOT nutrient poor, calorie dense, fibre free processed food. This change in foods hijacks our appetite control and leads to overconsumption. This phenomena was best illustrated by the 2019 Kevin Hall study that showed people over- eat by over 500 calories per day on an ultra processed vs whole food diet. The combination of excess calories, high fat, and high refined carbs (or sugar) sets you up for insulin resistance (IR) - the process underlying Type II DM - where your body produces increasing amounts of insulin to store the same amount of glucose. Insulin is a storage hormone - so high levels lead to increased fat storage and decreased ability to burn fat. In effect with insulin resistance you get one-way fat storage - ‘a moment on your lips, forever on your hips’. So processed foods—-> overconsumption ——> weight gain —-> insulin resistance ——> weight gain - a truly viscous cycle. Fortunately we can stop this cycle by eliminating/reducing the processed foods, refined carbohydrates, added sugars by eating real foods What is processed food? (Food Engineering Definition)
What is processed food? (Nutritional Definition)
Applying the 'better' mindset and decreasing the processed food in your life may be the single biggest thing you can do to take control of your health For other posts in this series: On January 22nd - we will launch a new group program - fully covered by MSP (for those with a BMI >30 or a BMI between 27 and 30 and a weight related diagnosis). During the month of January - we will be posting about the foundational behaviours for sustainable weight management - stay tuned. If you would like to learn more about the S3 program and whether you are eligible please check out our Sustainable Weight Management program page. (Part of our January series on S3 Weight Management - Systematic, Stratified and Sustainable) The first step in transforming your health and gaining control of your weight is knowing your health. Understanding whether your extra weight is caused by a medical condition OR whether your weight is contributing to a medical condition. Or put another way: Are there medical reasons why you have gained weight or why you may be struggling to lose weight?  Fortunately this is not hard - a review of your medical history, current symptoms, and a few lab tests will give you clarity.
In terms of conditions causing your weight gain the most common in our experience is insulin resistance. Insulin resistance (IR), as we have written elsewhere on this blog, is a process where, for a variety of reasons, your body requires more insulin to store the same amount of glucose. These reasons include age, genetics, sedentary lifestyle, poor diet (high in CRAP - calorie rich and processed foods), stress and sleep disorders. IR can cause weight gain because high levels of insulin suppress your ability to burn fat. In turn, weight gain worsens IR. This vicious cycle is common, and left unchecked leads to progressive weight gain, metabolic syndrome, pre-diabetes, and diabetes. Fortunately IR is reversible - using the 4 + 2 Strategy - and this reversal generally leads to significant and sustainable weight loss. Other conditions that can lead to weight gain that can be ruled out include inflammation, liver disease, thyroid dysfunction, and abnormal sex hormones. Pairing this medical assessment with a behavioural review to understand how your core behaviours - nutrition, movement, sleep, stress tolerance, relationships and purpose - are affecting your health is the KEY to unlocking the right strategy for weight loss. From a sequence perspective - we start with getting the behaviours right and addressing any medical cause or consequence of weight gain. For most people - this simple alignment of behaviour with their health, combined with the ‘better’ mindset is all that needs to be done. Simple, but not easy. The right behaviours are all very simple - they are unfortunately not all easy to apply consistently, and it is consistency over time that delivers results. Over the next few weeks we will review the foundational behaviours of health and some tips and tricks to apply the ‘better’ mindset to change you habits one small change at a time. For other posts in this series: On January 22nd - we will launch a new group program - fully covered by MSP (for those with a BMI >30 or a BMI between 27 and 30 and a weight related diagnosis). During the month of January - we will be posting about the foundational behaviours for sustainable weight management - stay tuned. If you would like to learn more about the S3 program and whether you are eligible please check out our Sustainable Weight Management program page. Many of you have learned the hard way - diets do not work. Most diets are temporary and highly restrictive programs of eating pursued purely for the purpose of losing weight and are unfortunately damaging exercises in futility. If you are going to lose weight and keep it off - you have to address the root causes of your weight gain. We believe a stratified, systematic approach is the best and most reliable approach to sustainable weight loss.  To start there are two vital questions?
If there are significant medical or behavioural reasons for your weight gain - correcting these comes first. Embracing a flexible, “better mindset”, where you seek small incremental changes in behaviour works better than a rigid, “perfect” mindset. Sustainable, lifestyle change happens one healthy habit at a time. Over time, you find that you are eating real whole food, exercising regularly, sleeping well, coping with stress, and happy and fulfilled in relationships and purpose. For many people these changes are sufficient to unlock their ability to lose weight. For others we need to go deeper. In the end, all weight loss requires becoming efficient at burning fat for fuel. Unfortunately, some people, despite good nutrition are unable to effectively burn fat: they lack metabolic flexibility. Physiological testing provides the answer to whether you are metabolically flexible and able to burn fat. If the answer is no, pursuing specific strategies to unlock your ability to burn fat comes next. If at this stage you are metabolically flexible, have healthy behaviors, and have dealt with any contributing medical issues, the next thing to examine is your resting metabolic rate as determined by physiologic testing and compare it to your actual caloric intake, ensuring that there is a sufficient deficit to ensure weight loss. Our experience along with medical evidence has shown that this type of structured, behavioral program stratified on the basis of your personal data will lead to improved health and sustainable weight loss. On January 22nd - we will launch a new group program - fully covered by MSP (for those with a BMI >30 or a BMI between 27 and 30 and a weight related diagnosis). During the month of January - we will be posting about the foundational behaviours for sustainable weight management: If you would like to learn more about the S3 program and whether you are eligible please check out our Sustainable Weight Management program page. If there was one thing that I could wave a magic wand and provide to anyone looking to transform their health it would be the ‘better mindset’. Forget perfect - it does not exist. Think ‘better’ - better in terms of you, better in terms of yesterday, better in terms of what could have been.  At Wellness Garage, we have seen hundreds of people improve and in some cases truly transform their health (diabetes reversal, etc) and while each person’s journey is truly unique a common thread appears: 'small changes, done consistently, lead to massive results over time' In other words, people that really get better start by doing better in small ways.
When the world conspires against you and you cannot fit in the workout, or eat well, or get your 8 hours of sleep, the better mindset helps you find something you can do that is better than what could have been. When things don’t go well, the better mindset has you reflect and learn from the situation so that you can plan better next time. When you fall off track, the better mindset reminds you that tomorrow is another day to be better. Above all the better mindset, is about taking small steps to improve and feel good about yourself. So forget perfect - it is too unforgiving, and it’s self talk can be loathing - forget perfect and embrace ‘better’. Learn more about our free Diabetes Reversal Program
Learn more about our free Weight Management Program - 'When You are Done with Dieting' Find out if a Precision Health Tune Up is what you need to take control of your health. Check out our Health Tips and Resources Type II Diabetes is a disease of insulin resistance eventually leading to decreased insulin secretion. Insulin resistance happens for a variety of reasons including age, genetics, obesity, especially visceral obesity, sedentary behavior, stress, poor sleep and of course poor nutrition.  Regardless of the cause, the effect is the same - initially the pancreas has to release more and more insulin to maintain blood sugars.
At some point, the pancreas can no longer keep up, insulin levels plateau and then decrease. When this happens, blood sugars begin to rise. When blood sugars become mildly abnormal we call this pre-diabetes (5.5 mmol/l to 6.9 mmol/L). At this point, insulin levels are 2-3 times normal and 50% of pancreatic beta cells are dysfunctional. With further progression of pancreatic dysfunction, insulin levels begin to fall and blood sugars rise. Once fasting blood sugars reach 7.0 mmol/L we call this Type II Diabetes and an estimated 80% of pancreatic beta cells are no longer secreting insulin. Insulin resistance takes place in multiple organ systems: muscle, fat, liver and pancreas. The sequence and degree of progression in these organs determines the pattern of disease in each person. The key to reversing Type II Diabetes lies in understanding how each of these 4 organ systems become insulin resistant and what simple actions you can take to reverse the conditions that lead to insulin resistance. With insulin resistance the effect of stress and the importance of stress cannot be underestimated. Both result in increased levels of the stress hormone cortisol and both increase appetite. Anything that chronically increases cortisol will worsen insulin resistance. The Wellness Garage 4+2 Diabetes Reversal Strategy is an evidence-based approach that identifies the key behaviours that can reverse the underlying, tissue specific insulin resistance process. In combination, changing these behaviours has been shown to improve insulin resistance and decrease or normalize blood sugars while decreasing weight and improving overall health. If you are on diabetic medications, your dosing may need to be adjusted as you implement these strategies, and in some cases reduced before you start. For anyone on medications, we recommend consultation and close collaboration with a physician to ensure that you do not have any dangerous low blood sugar events. Download the Wellness Garage 4+2 Diabetes Reversal Strategy |
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