Sound Nutrition & Weight Loss: Summary

By: Steve G. Parsons, Ph.D.

The Philosophy of Weight Loss

There are hundreds of health-improving food choices you can make – you just need to find the ones that will work for you. A lifestyle change that is sustainable is far better than a temporary “diet.”

Make sure to also check out the more generic “Sound Nutrition” tab even if your interest is primarily in losing weight.

Ways to Lose Weight:

Calorie deficit (burn more calories than you eat)
a) Burn more calories (but makes you hungry) and/or
b) Eat fewer calories
Change the composition of calories (Keto or low glycemic index)

Understanding the Mechanics

Ketosis-based diets: Ketosis will cause you to burn fat (turning them into ketones). But it is difficult to reach Ketosis (under 50g of carbs, or even under 40g for some people) and it will not be sustainable for many people. You can’t stay in ketosis forever and you will eventually need an exit ramp.
Glycemic Index (GI): Is measured with volunteers who are fasted, then eat a single food. GI is the blood glucose after 2 hrs. It is not perfect since many foods will cause blood glucose spikes in less than 2 hours; however, it is a widely available measure.
- Low GI Foods: Digested more slowly; reduce insulin and blood sugar roller coaster effects; feel full longer.
- GI Reducers: These food components reduce GI: Fiber, fat, protein, and acid.
Average Basal Metabolic Rate: Calories required just to stay alive awake. 20% of these calories fuel your brain; much of the rest is for your internal organs.
Women average: 1400 calories
Men average: 1800 calories
Depends on your weight (and composition)
Varies by person
Rules of Thumb:
- 1 Gram of food = 4 calories (carb or protein), 9 calories (fat), 7 calories (alcohol)
- 3500 calories is a pound of body weight.
- Walking a mile is 60 calories per 100 lb.

Food Categories

Good Foods - High Fiber Foods; Lean Protein; Green, Legumes, Low-Fat Dairy, Nuts and Seeds (small portions).

Bad Foods - Alcohol, Sugar, White Breads & Pasta, White Rice, Potatoes, Corn, Some Fruits, Ice Cream, Candy, Fried Foods.

Good Fats - Each of these has other health benefits beyond those listed.

Omega 3: anti-inflammatory, reduces cholesterol & triglycerides (salmon, seeds, nuts);
Omega 9: increases good (HDL) cholesterol (olive oil, avocados);
Omega 6: reduces LDL (nuts, seeds, ).

Bad Fats -

Trans fats (partially hydrogenated vegetable oils);
Fully saturated fats if more than 10% of calories (AHA suggests less than 6%)?

Good Condiments - Mustard, vinegar, lemon, spices (but watch for extra sugar or salt).

Bad Condiments - Mayo, catsup.

Practical Habits & "Tricks"

Meal Management:

Fluids: Don’t drink calories – but drink a lot of low cal. fluids. You will feel full longer.
Label Reading: Check calories, added sugar, fiber, protein, serving size.
Environment: Keep “bad” foods out of the house; have someone else hide them.
Dining: Eat slowly (give the satiety hormones a chance to kick in); take your plate to the kitchen; brush your teeth shortly after dinner.

Shopping & Planning:

Don’t shop or plan meals when hungry.
Plan leftovers of good food meals.
Find healthier alternatives ahead of time if eating out, especially if eating fast food.
“Plan” to try new foods. This could be genuinely new foods or simply trying new spices or methods of cooking.
Substitute spices for sugar and fat. Most spices are no-cal or low-cal, but read the label for spice mixes

Portion Control:

Measure portions (people do a poor job estimating).
Put “treats” into smaller containers.

Mindset & Success

Goal Setting: Have short-run and long-run goals that are (SMART) Specific, Measurable, Achievable, Realistic, and Time-bound. Revisit your goals
Motivation: Make a list of reasons you want to lose weight – then revisit that list.
Mindfulness: I want everyone to have a positive relationship with food. Eat slowly and enjoy food. This allows satiety hormones to kick in. Even if you made a bad nutritional choice - enjoy the food; perhaps eating slowly will help you save part of that food for later - rather than wolfing it down since you feel guilty.
- Avoid these locations when eating - you are more likely to engage in mindless eating:
  - In your car.
  - At your desk.
  - At the TV
Persistence: If you fall off the wagon (it happens) – get back on. Find a “food friend” to stay positive. Even better if you can find an organization such as TOPS (Take off Pounds Sensibly) to have many food friends to help you.
Triggers: Identify the circumstances (triggers) that cause you to make poor nutritional choices. Try to find the best coping mechanisms for each trigger.
Visualization: Visualize how you cope with certain trigger circumstances. For example, say to the waiter with the desert tray - “no thank you but I will take a cup of decalf coffee instead.” Visualize, write it down, speak it out loud.
YOU CAN DO IT

There are hundreds of health-improving food choices you can make – the key is to find the ones that work for you.

‍Appendix: Obesity and Health Issues‍ ‍

Obesity Measures.

If I had my way, “obesity” would be a word I would not use. The problem is that there is mountain of scientific research that uses the concept and measurement of obesity.

Body Mass Index (BMI) is by far the most common measure of obesity: (Weight in Kilos)/(Height in Meters)2. On the internet you can find BMI calculators using pounds and inches. Here is the current BMI categorization:

18.5 or less = underweight.
18.5 to 25 = normal weight.
25-30 = overweight.
30-35 = Class 1 obesity.
35-40 = Class 2 obesity.
40+ = Class 3 (severe) obesity.

My preference is to think about being overweight as a continuum, the higher the BMI the greater the potential for health issues. Also, BMI is certainly not perfect, most body builders are obese but will less than 20% body fat. Conversely someone who is “skinny fat” will have relatively high percentage of body fat, low percentage of muscle mass but normal BMI.

One concern is visceral fat (inside your body cavity and often on or around your internal organs). A higher proportion of visceral fat is associated with cardio-vascular disease, dementia, insulin resistance and type 2 diabetes. A rule of thumb is visceral fat is likely a problem if your waist is greater than 35” (women) and 40” (men). Similarly, a waist/hip ratio of greater than .85 (women) and .90 (men) indicates a visceral fat problem. The Mayo clinic adds waist size to BMI with a warning at high waist size (Tool: BMI and waist circumference calculator - Mayo Clinic) Harvard What is considered a healthy body fat percentage as you age? - Harvard Health) also suggests a waist/height ratio, with 0.4 to 0.49 the healthy range.

While many people believe that percentage of body fat would be a better measure than BMI there is no widespread agreement on how to interpret the values. In addition, many people may not have access to body composition tests.

Current and Past US Obesity Trends‍ ‍

Percentage of Adults Obese

1900 – 2.6%
1950s – 10%
1999 – 30%
2021 – 40%
2025 – 37% (GLP-1 Drugs)

Percentage of Children Obese (2025)

Ages 2-5: 12.7%
Ages 6-11: 20.7%
In 2023 the American Academy for Pediatrics changed its clinical practice guide for when to consider:
- Medication = age 12, Surgery = age 13.

There have been dozens of genes linked to the propensity to gain weight. The genetics of the US population has hardly changed over the last 150 years. However, the table above suggests that the genes associated with weight gain were largely irrelevant 130 years ago. That is, these genes could only meaningfully express themselves in the modern environment with cultural differences, highly processed foods, greater food availability, higher incomes and sedentary lifestyles. ‍ ‍

Medical Problems Associated with Obesity‍ ‍

Medical problems associated with obesity are well established. These include:

Type II Diabetes
Heart disease & stroke
Increased risk of some cancers
Sleep disorders
Endocrine & reproductive problems
Infections - increased mortality rates ‍ ‍

References: ‍ ‍