FAQ

Execution of the Express Diet programme and exercise

VLCD is the most effective way to lose weight. The VLCD programme is included in the current care guidelines as a treatment for obesity. The VLCD programme reduces the risks of several factors detrimental to health, such as type 2 diabetes and cardiovascular diseases.

In the LCD programme, you consume around 800–1,200 kilocalories of energy per day, whereas in the VLCD programme you consume 500–800 kilocalories.

There are no exact guidelines, but after a few weeks you should discuss with your doctor about further continuation of the programme. Your doctor will often check your blood pressure and monitor your condition. Sometimes medication needs to be adjusted. The longest someone has been on the programme is 10–13 continuous weeks. 

A suitable length is 3–6 weeks. If your goal is the reduction of your fasting blood sugar levels, the programme is continued as long as the goal has been achieved or your doctor advises you to quit. 

The length of the programme affects how often you can repeat it. A suggestion could be 1–3 periods per year.

The body consumes a certain amount of energy, and if it cannot get enough from nutrition, it starts consuming its fat reserves.

Yes, but with limits. You should not try to do very vigorous exercise at least during the first week or first couple of weeks on VLCD. Your recovery sets your exercise frequency. If you recover well, you can train more often. Generally during the VLCD programme your glycogen reserves are diminished, so high performance levels may be difficult to achieve. 

Low-intensity exercise is easy to manage, especially from the second week of the diet onwards. Low heart rate exercise burns fats efficiently as an energy source. 

You can manage. You must scale your strength to correspond with your muscles’ glycogen reserves. Your grip strength may be reduced.

Resistance training at the gym helps maintain muscle mass during the VLCD programme.

Possible eating and drinking during the programme

You cannot raise your need of protein high, because your energy intake will become too high. The share of nutrition of your daily need of protein is approximately one third. Two thirds of the total protein circulation comes from your body’s internal protein circulation. As tissue breaks down, it releases proteins that the body breaks down into amino acids and recycles back into proteins in the tissues. 

Proteins contain 4 kilocalories of energy, just as carbohydrates. You cannot consume too much of either, so that the overall energy intake does not exceed 800 kilocalories. The body converts excess protein into blood sugar, which in too high levels disturbs the VLCD programme.

Yes, with a combination of any five Express Diet products.

Water and, if necessary, salt. People who experience constipation may need extra fibre.

You can tweak the soups a little. Spices can be used freely. 

Adding foods that contain energy easily increases the total intake of energy. You can add small amounts of e.g. salt, cream, cheese, chicken or meat to the soups, but primarily just to bring variety. 

Green salad is sometimes used in small portions with oil or an oil dressing. Dieticians recommend consuming half a kilo of vegetables per day in addition to the VLCD products during weight loss programmes. 

You can have green salad and small amounts of meat, chicken, cheese or cream during long weight loss programmes to bring variety to savoury soups.

For nutrients, yes. But you need to secure your intake of salt, for example by using meat/fish/vegetable stock cubes or consuming grains of sea salt with fluid. It is good to make sure that you do not have too much salt. About half a tea spoon per day is enough. 

Yes, especially if you feel weak or dizzy.

Yes, especially spices that do not contain added sugar or carbohydrates in general.

Voi, erityisesti mausteita, joihin ei ole lisätty sokereita tai yleensä hiilihydraatteja.

Yes, if it does not disturb your blood sugar or incite you to drink sugared drinks.

Yes, because the amounts are so minor.

Matters related to the ketogenic diet

A piece of cake at a party will not ruin the VLCD programme, as long as you continue with the programme normally on the next day. The state of ketosis is weakened but it will return the next day as you continue with the programme.

The VLCD programme will not be completely interrupted even by eating a substantial amount of carbohydrates for a couple of days, but this will reduce the formation of ketone bodies. As the programme is resumed, the level of ketone bodies will go back to normal in a couple of days. The only problem with these cheat days is that the craving of sweet things in particular may remain for the next couple of days. This can easily be seen from wanting to eat something throughout the day. If you are unsure of your self-control, avoid these events. The cruise ship is sure to offer some low-carbohydrate alternatives, which can be recommended.

If you eat carbohydrates during a holiday, your state of ketosis may yield, but as you resume the programme, the production of ketone bodies will increase quite quickly, and you probably will not experience the early-stage symptoms. Let us remember, however, that we are individuals and our bodies act differently. 

At parties, you will want to choose low-carbohydrate foods, salads, meat, fish, chicken, cheeses and fermented dairy products. These are often on offer, especially if a meal is catered. With coffee, you can ask for dark chocolate with over 70% of cocoa. 

If you insist, you can have low-carbohydrate drinks in moderation. Red wine is probably the most popular choice on a ketogenic diet. It is good to remember, however, that alcohol may have a much stronger effect during the VLCD programme.  

2–4 litres depending on the season. The water lost with sweating must be compensated. You should avoid drinking too much water, as it flushes salts and may strip you of vitality and increase dizziness. If this happens, you should add salt to your soups or have e.g. 1–2 g of grains of sea salt with fluid. 

Yes and no, depending on how your body reacts. If the artificially sweetened drinks increase your craving for sweet drinks or sugared foods in general, you will want to switch to carbonated mineral waters, for example.

Chewing gum always contains some carbohydrates, which is good to remember even if they do not contain sugars. Some pastilles can contain as much as 90% of carbohydrates and still 0 g of sugars. You should read the labelling carefully.
Another problem is the air ingested while chewing, which can accumulate in the stomach and intestines, causing pressure and pain in the intestines. The sugar alcohols, like xylitol, in chewing gum can also ferment in your intestines, which increases the formation of gas and thus bloats the intestines and causes temporary pain.
If you do not experience these problems, you can chew gum, especially because during the VLCD programme you do not chew much food and your jaws ‘require’ something to chew.

Your blood pressure may drop, and it usually will drop by some amount. This may cause dizziness. The problem can often be fixed by increasing your intake of salt. For example, you can have half a teaspoon of sea salt in small portions with water. Sometimes a heavy increase in the intake of salt has been temporarily necessary, especially with endurance athletes. Normally salted meat/fish/vegetable stock cubes contain approximately 5 g of salt. This should be enough to increase blood pressure and alleviate dizziness.
You should be careful with adding salt. When dosing it, you should have small portions, such as a few coarse grains of sea salt at a time with water, and monitor your condition for half an hour. If this helps a little, you can have another portion of sea salt grains with water and monitor your condition for another half an hour.  
The dizziness can be caused by other symptoms as well, so if adding salt does not help and the dizziness continues for several days, you should consult your doctor. 

Poor energy levels may be caused by low blood pressure. You should try the aforementioned remedy. 
A good remedy that often works is walking calmly outdoors in fresh air, for example for half an hour or an hour. This may ease the problem.

Excess intake of salt increases blood pressure. What is the appropriate amount of salt during the VLCD programme? This varies between individuals. You should be careful with adding salt. When dosing it, you should have small portions, such as a few coarse grains of sea salt at a time with water, and monitor your condition for half an hour.

The clammy feeling on the first days may be, and often is, caused by the decrease in your blood sugar level on the first couple of days. As the production of ketone bodies starts on the third or fourth day, you will start feeling much better. If the feeling persists, for example for the first week, you should consult your doctor.

A good remedy that often works is walking calmly outdoors in fresh air, for example for half an hour or an hour. This may ease the problem.

 

You can use painkillers, but only for a day or two. This is often caused by a drop in your blood sugar level and the drastic reduction in your energy intake. If the headache continues longer than a day or two, you should consult your doctor and tell them about the VLCD programme. 
A good remedy that often works is walking calmly outdoors in fresh air, for example for half an hour or an hour. This may ease the problem.

Yes, if it contains very little carbohydrates, or preferably none. 

They may be caused by not getting enough salt. Sometimes adding magnesium as a food supplement may help. During the VLCD programme, the body’s heat production is often reduced, which can be felt as colder limbs. Cold legs may get cramps more often.

Some people on the VLCD programme may have mild cramps on their legs, feet and fingers almost every night during long programmes, but these are rarely severe. Opposite movement often helps. If your calf muscle cramps severely, you will want to press your sole flatly on the floor and bend the knee on that leg heavily towards the floor, i.e. against the cramp. This may provide a quick relief. Another efficient way is setting the toes of the cramping leg on a step of the stairs… 

 

You can try a magnesium supplement for a week, for example. If it helps, you can keep using it for the rest of the programme.

Some may experience this, but it usually only lasts for the first two days. 

It has been suggested that this phenomenon comes from our cave-dwelling ancestors. When food ran out, senses like the sense of smell had to intensify to help with the hunting and gathering of food. 

Some people may start having bad breath during the first week. This varies between individuals and is not very common. Good oral hygiene keeps the smells at bay for the most part. If this is not enough, you should go to the pharmacy and ask about mouthwashes. In customer service, you could think about using some low-carb pastilles or chewing gum. 

The amount of food eaten during the VLCD programme is low, so its accumulation is low as well. For this reason, bowel movements may also be slowed down. It is not uncommon that you do not need to go to the toilet every day, or even every other day. For first aid, you should increase fluid consumption.
But if the situation starts to become a problem, you should get some low-carb fibre supplements from a health food store or the pharmacy, and have them with plenty of water. Psyllium fibre and ispaghula seed or ispaghula seed husk supplements are some examples.

Have more water, increase exercise and get fibre supplements, if necessary. 

In addition to fibres, there are over-the-counter drugs available that are suitable for temporary use. Ask at the pharmacy. 

In principle, if it does not contain a lot of carbohydrates. So, if a portion contains 1–3 g of carbohydrates, you can have a few portions per day. You should monitor the amount of salt you get.

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