22 March 2016 Weight gain: for many people it’s not as easy as it sounds

“I need to gain weight.”

Now there’s a statement you don’t hear very often these days. But in fact, there are people who need to, or want to gain weight. And believe it or not, for those people weight gain isn’t all that easy.

Who needs to gain weight? In general there are two distinctly different groups of people who need to gain weight:

1. Anyone who experienced unexpected and unwelcome weight loss as a common side effect of one or more disease processes that affect food intake and digestion:

  • Cancer and cancer treatment
  • Malabsorption syndromes
  • Prolonged illnesses
  • Prolonged hospitalizations such as recovery from an accident or surgery
  • Eating disorders
  • Old age, especially combined with dementias

In fact, rapid and unplanned weight loss in an elderly person should raise a red flag for health care providers. Weight loss in these situations is typically due to poor intake and/or malabsorption, with a high likelihood of nutrient deficiencies. And the weight loss isn’t limited to body fat. Older people are prone to losing muscle mass, which impacts strength and mobility, and can have a severe impact on quality of life.

2. People who want to increase muscle mass for sports or bodybuilding. Young teens are especially likely to be in this category. There are key similarities and differences for the weight gain strategies of both these groups.

Protein

More protein = bigger muscles, right? This is a common misconception, promoted by the protein supplement industry. Unfortunately, muscles don’t automatically expand in response to high protein intake. They grow in response to increased use. Working out with weights or with aerobic activity will push muscles to grow. Whether you are a teen athlete or a 70 year old recovering from an illness, physical activity is an essential part of muscle weight gain.

How much protein?

There’s a limit to how much protein muscle can add at one time. In general, sports nutrition experts recommend 1.2 to 2 grams of protein per Kg body weight per day for muscle building. Higher intakes don’t make muscles grow any faster (NOTE: the recommended intake for adults is 0.8 grams/kg).

High protein foods – meat, dairy, eggs, legumes, nuts -- should certainly contribute to total intake. The problem for some people with reduced appetite is that protein can turn off appetite. So overloading on protein may defeat the other key part of weight gain – increased calorie intake.

Eating massive amounts of protein at one meal is not a good plan for building muscle. A giant slab of meat at dinner might cover your entire day’s protein requirement, but excess protein at any one meal will be wasted for muscle building. The best strategy is to spread protein intake as evenly as possible throughout the day, divided between meals and snacks. This optimizes protein utilization. The maximum weight gain protein goal for a teen who weighs 160 lbs would be around 140 grams a day. Eating 30 grams at 3 meals and 15 grams at 3 snacks would meet that goal. A modest 4-5 oz portion of meat contains about 30 grams of protein, so achieving that amount at a meal would not be difficult.

Appetite is an especially important consideration for people trying to gain weight while recovering from illness. Appetite is already compromised by disease or drug treatments, so further reducing appetite with excess protein intake is a bad idea. The best approach would be to stick to modest protein intake goals. For an underweight person, protein intake goals might not be very high to begin with; 65-70 grams of protein per day might be a suitable intake for a person who has lost 30 lbs during the course of an illness, and now weighs 120 lbs. That amount can be achieved by eating 15-20 grams at 3 meals plus a modest 5 grams in 2-3 snacks would meet that goal.

Calories

The human body runs on calories. And energy needs come before muscle building. In cases of severe malnutrition, from disease or starvation, the body uses muscle mass as a calorie source. Under-eating calories from carbs and fat (energy) while loading up on protein to build muscle won’t work. Some of the protein you are eating will be burned to meet energy needs. So the best way to make sure protein goes to muscle building is to consume enough carbs and fat to meet your energy needs.

How many calories is enough? According to a previous MyNetDiary blog post on this topic, users of the calorie tracker should go with an expected Exercise Plan to boost recommended calorie intake. Then customize your nutrient goals to get the right protein level.

The best way to ensure enough calories to promote muscle building is to divide your meals and snacks equally throughout the day. Even then, you might feel like you’re forcing yourself to eat. Olympic medalist Michael Phelps’ had to follow an extremely high calorie diet to support his swim training and competition. Even with that much exercise, he found it difficult to eat that much food every single day. The key is “every single day”. Splurging on an ice cream sundae or double bacon cheeseburger might sound tempting once in awhile, but eating a high calorie diet every day could quickly turn into a chore.

The best strategy is to spread your food intake as evenly as possible throughout the day, with 3 meals and 3 snacks. Divide your calorie requirement by 3. That’s the amount of calories you should consume in the morning, afternoon and evening. For example, if you’re planning to eat 3000 calories a day, roughly 1000 should be eaten before noon. You might have a 700 calorie breakfast at 7:30 a.m. and a 300 calorie snack at 10:30.

Adding calories to meals can be a problem for some people, especially when trying to gain back weight lost during an illness. Instead of trying to consume huge portions, add calories in sneaky invisible ways:

  • Add 1-2 tsp of oil or butter to foods like pasta, rice, hot cereal, vegetables or soups
  • Use extra salad dressing
  • Add croutons, grated cheese or nuts to salads
  • Spread a little extra butter, or a nut butter, on toast or bagels
  • Use whole milk and full fat yogurt, not low fat or skim
  • Sauté your vegetables in oil, rather than steaming or boiling
  • Use sugar or honey for sweetening, not artificial sweeteners
  • Boost portion sizes of palatable foods like potatoes or pasta

Snacks are key

It will be hard to accomplish a high calorie intake by just eating 3 huge meals a day. Add 2-3 snacks a day to increase calories without stuffed. Plan snacks that are 300-500 calories, with protein. Here are some options:

  • A smoothie made with milk or yogurt, fresh fruit and sweetener
  • Chocolate milk and toast with nut butter
  • Granola topped with yogurt
  • A small tuna or egg salad sandwich
  • Cheese and crackers with juice
  • A protein or snack bar with juice

Do you need special protein supplements? Not necessarily. You can get plenty of high quality protein from normal food, so it’s not essential to buy pricey supplements. Loading up on supplemental protein isn’t going to magically bulk up muscles any better than eggs or milk or chicken or legumes. The other problem with protein supplements: they might stifle your appetite, so you end up under-consuming calories at meals, defeating your weight gain goals. However, in some cases, protein supplement drinks can be a convenient snack. The best options are drinks designed to be meal replacements, with vitamins, minerals and carbs, not unbalanced protein-centric products.

The Take Away Message

Weight gain, whether to recover from an illness or build muscle, depends on higher calorie intake and consistent higher protein intake. The best way to accomplish this is to divide your food into 3 meals and 2-3 snacks a day, and be consistent. It can take days for your metabolism to adjust to the higher calorie load, so don’t expect to see weight gain right away.

Donna P. Feldman MS RDN

Nutrition journalist at Radio Nutrition

Co-host: Walk Talk Nutrition podcast.

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Disclaimer: The information provided here does not constitute medical advice. If you are seeking medical advice, please visit your healthcare provider or medical professional.

Tags:

Exercise/Fueling for ExerciseExercise/Weight resistance Weight Gain/Calories & Protein

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