A new clinical perspective: Treating obesity with nutritional coaching versus energy-restricted diets.

Although current guidelines for obesity treatment endorse lifestyle modifications to achieve weight loss, energy-restricted diets are still the most commonly used method for the management of overweight. Diet restriction, however, not only is ineffective in promoting long-term weight loss but also may have more costs than benefits, predisposing the individual to fat regain. Several physiological and psychological mechanisms protect the body against starvation and explain how food restriction can promote paradoxically the opposite of what it is planned to achieve, triggering changes in energy metabolism, endocrine function and, thus, body composition. New approaches that focus on behavioral treatment without diet restriction, such as nutritional coaching, are showing strong growth that arises as an innovative way to create sustainable and effective lifestyle changes.

Técnicas de coaching de bem-estar na mudança do estilo de vida no sistema público de saúde / Lifestyle change coaching techniques in the Public Health System

De acordo com o último relatório da Vigitel 2017 as Doenças Crônicas Não Transmissíveis (DCNT) são responsáveis por 68% de um total de 38 milhões de mortes ocorridas no mundo em 2012. No Brasil, esse cenário não é diferente: em 2011 as DCNT foram responsáveis por 68,3% do total de mortes. Milhares de dólares são gastos hoje com políticas que estimulam hábitos de vida mais saudável, mas essa estratégia, por si só, tem continuamente falhado em produzir resultados consistentes e duradouros. É necessário uma nova abordagem, que promova mudanças no estilo de vida, possibilitando a melhora dos parâmetros de saúde das pessoas. O processo de coaching apoia o desenvolvimento de um relacionamento de ajuda, incentivando o paciente a identificar sua visão, necessidades e objetivos. Além disso, o coaching visa ajudar na organização de rotinas e prioridades, enquanto coloca o paciente no controle de seu destino de saúde.

According to the latest Vigitel 2017 report, non-communicable chronic diseases accounted for 68% of a total of 38 million deaths worldwide in 2012. In Brazil, the scenario is no different; in 2011 the non communicable diseases were responsible for 68.3% of all deaths. Thousands of dollars are spent today on policies that encourage healthier living habits, but this strategy, by itself, has continually failed to produce consistent and long-lasting results. A new approach is needed that promotes lifestyle changes, making it possible to improve people's health parameters. The process of coaching supports the development of a helporiented relationship, encouraging patients to identify their vision, needs and goals. In addition, coaching aims to assist in the organization of routines and priorities, while putting patients in control of their health endgoal.

Improving Nutritional Habits With No Diet Prescription: Details of a Nutritional Coaching Process.

Thousands of dollars are spent today with policies encouraging physical activity and healthy eating, but nutritional consultation per se has continuously failed to yield consistent and lasting results. The aim of this case report is to detail and evaluate nutritional coaching (employing health coaching techniques) in promoting lifestyle changes, enabling improvement of nutritional and body composition associated parameters. The patient in this study had previously engaged in a series of different diet regimens, all of which failed in achieving the proposed aim. After 12 nutritional coaching sessions (one per week) with the strategy presented herein, reductions in body fat mass and in total body weight were attained. Nutritional habits also improved, as the patient showed decreased total energy intake, decreased fat intake, and increased fiber ingestion. Daily physical activity and energy expenditure were enhanced. The coaching program was able to induce immediate health benefits using a strategy with the patient at the core of promoting his own lifestyle changes. In conclusion, the nutritional coaching strategy detailed was effective at helping our patient develop new eating patterns and improve related health parameters.

Body fat regulation: is it a result of a simple energy balance or a high fat intake?

The search for the causes of obesity has involved genetic abnormalities and endocrine and neural lesions. Although evidence suggests that genetics plays an important role in body weight regulation, rapid increases in obesity rates do not seem to be caused by significant genetic changes within populations. Total energy expenditure and total energy intake are not the only factors that regulate body fat. Nitrogen and carbohydrate balances are eased by the capacity of the organism for adjusting amino acids and glucose oxidation rates, respectively. Regarding fat, this mechanism is considerably less precise; a fat intake increase does not stimulate its oxidation on the same basis. In addition, dietary fat is stored very efficiently as body fat. Elevated carbohydrate ingestion enhances glycogen reserves, which usually are much smaller than the maximum capacity of storage and enlargement of these stores, thus stimulating this nutrient's oxidation. These data point to a very well controlled carbohydrate balance in the body. Various studies show lack of efficiency of the hyperlipidic diet in stimulating satiety. Signals arising from the gastrointestinal tract play a fundamental role in regulation of appetite and energy intake, and evidence indicates that the gastrointestinal and hormonal mechanisms involved in the suppression of appetite and in energy intake are compromised in obesity. A high-fat diet is important in its origin. Additional studies are necessary to explain the mechanisms that lead to adipose tissue retention resulting in a fat-rich diet.