Nutrition Tips for Muscle Gain and Fat Loss: A Guide for Lupus Patients

Q: Nutrition Tips for Muscle Gain and Fat Loss: A Guide for Lupus Patients

Hello： <br>1. <br>Your height is 156 cm and weight is 48 kg, with an ideal weight of 53.5 kg and a BMI of 19.7, which is considered a normal weight. <br>Since body fat percentage was not provided, if a female's body fat exceeds 30%, it is classified as high body fat, and it is re

Muscle Gain and Fat Loss Diet / Post-Workout Nutrition and Sequence / Low-Protein Diet Weight Loss Adjustment

Hello, Dietitian Fan.
Recently, I have noticed an increase in my weight, and it seems that I have gained more fat than before at the same weight, primarily accumulating around my abdomen and spreading to my upper body and chin.
I have lupus erythematosus and am currently taking steroids.
My weight is 48 kg and my height is 156 cm.
I also feel that when I press on my abdomen, I can feel small lumps inside, which I believe to be fat.
I hope to adjust my diet and exercise to build muscle, reduce fat, and restore my weight.
However, I have some dietary questions for you.
1) I have a habit of doing yoga in the morning after waking up (on an empty stomach) for about 30-40 minutes (20 minutes of light sweating exercises followed by about 20 minutes of stretching).
I would like to know if this counts as "exercise." I have read many reports stating that after exercising, one should first replenish carbohydrates and protein, so I want to confirm with you:
1.
After exercising, should I start with protein?
2.
Given my situation, should I eat vegetables first or start with protein for breakfast after my yoga session? (I usually eat vegetables first to avoid a spike in blood sugar after fasting overnight.)
2) After completing a 20-30 minute yoga or dance session that makes me sweat lightly and breathe a bit harder, do I need to consume food? If so, would it be acceptable to have a simple snack of an apple (in an 80% full bowl) and a serving of 200 ml soy milk?
3) Regarding dietary adjustments, last year, due to persistent low albumin levels from lupus erythematosus, I consulted a nutritionist at a major hospital.
My cholesterol levels were also high (recent blood test on July 26 showed Chol 289, L/H 154/93), and I initially had high proteinuria (nephrotic syndrome), but I have recently recovered from that.
My albumin levels have also returned to normal.
After several consultations, the nutritionist arranged a low-protein diet based on my height of 156 cm and initial weight of 46 kg.
The plan included 8 servings of staple foods, 50-55 g of protein, 2 tablespoons of cooking oil, 2 servings of fruit, and 3 servings of vegetables, totaling around 1300 calories.
I was advised to aim for 1600 calories, so if I felt hungry, I could supplement with low-protein starches.
I have followed this dietary plan for the past six months, but I have also indulged in other foods (such as shaved ice with condensed milk, honey aloe, winter melon milk, and cake), leading to a continuous weight increase since the Lunar New Year, and I currently weigh 48.8 kg (height 156 cm), with most of the weight gain around my abdomen.
I would like to reduce my weight back to 46 kg.

I would like to ask how you would recommend adjusting my diet, as I am concerned that reducing my intake too much might lead to insufficient protein, and I am also worried that cutting down on starches too much could hinder muscle synthesis.
How should I calculate the appropriate distribution of different food types in my intake? Additionally, considering my situation, what should my daily caloric intake be if I want to lose weight? (My activity level is low, but I plan to do 30 minutes of yoga or dance daily.) I calculated that if I weigh 48.8 kg, my caloric needs would be 1460 calories (48.8 * 30).
If I follow the common advice to reduce my intake by 500 calories for weight loss, that would leave me with only 964 calories, which is below 1200 calories.
Thank you! Ann

Ann, 30~39 year old female. Ask Date: 2022/09/18

Dr. Fan Chunmei reply Nutrition

Hello:
1.
Your height is 156 cm and weight is 48 kg, with an ideal weight of 53.5 kg and a BMI of 19.7, which is considered a normal weight.
Since body fat percentage was not provided, if a female's body fat exceeds 30%, it is classified as high body fat, and it is recommended to focus on fat reduction.
The primary approach to fat loss should be controlling total caloric intake, with women not consuming less than 1200 kcal per day.
It is advisable to follow a balanced diet consisting of whole foods, along with moderate exercise such as brisk walking or aerobic exercise for 40-60 minutes.
After aerobic exercise, you can consume one sweet potato and one tea egg, or one rice ball and one unsweetened yogurt drink, or an apple filled to 80% and 200 cc of unsweetened soy milk.
2.
The order of eating should start with vegetables, followed by protein (meat, seafood, or soy products), and finally carbohydrates, while ensuring thorough chewing to help suppress rapid spikes in blood sugar levels.
3.
Given your history of lupus erythematosus and the use of corticosteroids, with regular follow-ups and blood tests at the hospital, it is recommended that if you have any related nutritional concerns, you consult with your nutritionist.
Wishing you safety and well-being!
Sincerely,
Chun-Mei Fan, Director of the Nutrition Department, Taoyuan Hospital, Ministry of Health and Welfare

Reply Date: 2022/09/18

More Info

Dear Ann,
Thank you for reaching out with your concerns regarding nutrition and weight management, especially in the context of your lupus condition. It’s commendable that you are taking proactive steps to adjust your diet and incorporate exercise into your routine. Let’s address your questions systematically.

1. Exercise and Nutrition Timing: Your morning yoga routine, which includes mild sweating and stretching, can indeed be classified as a form of exercise. While it may not be as intense as weight training or cardio, it still contributes to your overall physical activity. After exercising, it is generally recommended to consume a combination of carbohydrates and protein to aid recovery and muscle synthesis. The idea is to replenish glycogen stores and provide amino acids for muscle repair. Therefore, after your yoga session, you might want to start with a small amount of carbohydrates (like a piece of fruit) followed by a source of protein (like yogurt or a protein shake).

2. Post-Exercise Nutrition: After your yoga session, consuming a light meal or snack is beneficial. Your suggestion of having an apple and 200 ml of soy milk is a good option. This combination provides carbohydrates from the apple and protein from the soy milk, which is essential for recovery. Aim to eat within 30 to 60 minutes post-exercise to maximize recovery benefits.

3. Dietary Adjustments for Weight Management: Given your lupus and previous issues with low albumin and proteinuria, it’s crucial to balance your protein intake while managing your caloric intake for weight loss. Since you have been following a low-protein diet, it’s important to ensure you’re still meeting your body’s needs without overloading on protein.
- Caloric Needs: For weight loss, a common approach is to create a caloric deficit. However, your calculations seem to suggest an excessively low caloric intake. Instead of drastically cutting calories, aim for a moderate deficit. A daily intake of around 1200-1500 calories may be more appropriate, depending on your activity level. This allows for gradual weight loss while still providing enough energy and nutrients.

- Macronutrient Distribution: Given your dietary restrictions and goals, consider the following distribution:
- Carbohydrates: 50-60% of total calories. Focus on complex carbohydrates like whole grains, fruits, and vegetables.

- Protein: 15-20% of total calories. Since you have a history of low protein levels, ensure you include adequate protein sources, but choose lower-protein options that are still nutritious, such as legumes, tofu, and fish.

- Fats: 20-30% of total calories. Include healthy fats from sources like olive oil, nuts, and avocados.

4. Monitoring and Adjustments: It’s essential to monitor how your body responds to dietary changes. If you find that you are losing weight too quickly or not at all, you may need to adjust your caloric intake. Additionally, consider consulting with a registered dietitian who can provide personalized guidance based on your health status and dietary needs.

5. Hydration and Overall Health: Don’t forget the importance of hydration, especially if you are active. Drinking enough water can help with digestion and overall well-being.
In summary, focus on a balanced diet that meets your caloric needs while considering your protein intake. Incorporate regular physical activity, and listen to your body’s signals. Gradual changes are often more sustainable and healthier in the long run. If you have further questions or need more specific meal plans, I encourage you to consult with a healthcare professional who specializes in nutrition for chronic conditions.

Wishing you the best on your journey to better health!
Best regards,
Doctor Q&A Teams

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