Beyond Weight Loss

This new approach sounds the death knoll for a noble but failed experiment and holds a promise of health for millions. As you know, our diets are made up of three macronutrients: carbohydrate, protein, and fat. Each of these basic food categories stimulates the secretion of specific hormones in our bodies. This is where the power of what we eat becomes apparent. The action we can take in our daily lives is relatively simple. We can bring a new balance to the percentages of these foods in our meals and snacks. In this way, we direct how the hormones affect us.

In essence, we can change our health for the better by eating less carbohydrate foods (and changing the focus of those we do eat), eating more protein, and continuing to eat healthy fats. The most important aspect of this new eating prescription is the carbohydrate to protein ratio. Recommendations vary from 2:4 to 3:4, applied both loosely and very specifically. Healthy dietary fat intake can remain about 30 percent because, as we learn, our bodies need fat to lose fat.

For the last decade, the people of this country have been on a massive quest for health. In an effort to not only look good but also feel good, we have reduced our fat intake, followed the experts well-intentioned advice to increase our carbohydrate intake, and....gotten fatter. From 1960 to 1980, one in four of us was overweight. Now that figure has jumped to one in three. One-third of us are fat, making us the fattest people in the world. Yikes!!! What happened?

In a recent New York Times article, Dr. Stephen Gullo, director of the Institute for Health and Weight Sciences in Manhattan, commented, "People can get fat on a high fat diet, but people can get fat on a diet high in carbohydrates too." The answer lies in our hormones. When we eat a meal or snack which is high in sweet/starchy carbohydrates and low in fiber and/or fat, our bodies create too much blood sugar too quickly. Our pancreas responds by secreting high levels of insulin to bring blood sugar levels back into balance. Therein lies the problem.

Insulin is a "store and save" hormone. It removes the sugar from the system and stores it as glycogen and fat at the same time making it much more difficult for the body to mobilize either stored fat for muscle energy or glycogen for brain food. As a consequence, shortly after a meal too high in carbohydrate (and too low in protein), we may feel weak and hungry. Of course we have to eat because the brain is calling out, "Feed me."

Diana Schwarzbein, a Santa Barbara endocrinologist interviewed by a local paper, commented that when she asks patients about their typical daily diet, they list a breakfast of non-fat cereal with non-fat milk, a banana or orange juice, and coffee with milk and sugar. She states, "The whole breakfast is sugar. By 10 a.m., they are starving so they have a piece of fruit or a cappuccino or more coffee with sugar and milk....All they eat all day is sugar [in the form of various carbohydrates]. No wonder they complain about fatigue and weight gain."

With the pancreas pumping out insulin day and night, it follows that we never feel satisfied no matter how much we eat, and we are plagued with food cravings. To make matters worse, our muscles can't efficiently access fat, their primary fuel, and oxygen transfer is inhibited, retarding the metabolism of the fat that is accessed. This means that even if we exercise regularly, we aren't getting all the benefits we could...because we are eating too much of the wrong kind of carbohydrate.

As Dr. Dean Ornish, well-known for his work with heart disease patients, has said, "The more insulin your body produces the more likely it is that you will convert dietary calories into body fat." As a result, not only do we get fat, we have all the health problems commensurate with obesity - heart disease, high blood pressure, high triglyceride levels, elevated total cholesterol, and increased incidence of diabetes.

Diabetes is a failure to utilize carbohydrates correctly, and there is more diabetes today than ever before in our history. A decade ago, in every 100 cases of diabetes, 80 were adult onset type and 20 were juvenile diabetes. Today, in every 100 cases, 98 are adult onset and two are juvenile. And no, there are not fewer cases of juvenile diabetes. Other conditions arising from this situation include skin, hair, and nail problems, menstrual irregularities, and depressed immunity. Meanwhile we continue to crave those carbohydrates because we have to feed our brains. We are on a carbohydrate-insulin roller coaster.

So now what? Do we have to stop eating carbohydrates? No. Carbohydrates are essential to life. Plus, not all carbohydrates have the same effect on insulin secretion. The speed at which carbohydrates are broken down by the digestive system and sugar enters the bloodstream determines the rate of insulin secretion. The faster blood sugar levels are increased, the harder the pancreas works producing insulin. 

The key to carbohydrate selection is the Glycemic Index. (Long time readers will remember that we brought this index to the attention of the lay public over a decade ago when we introduced fructose as a preferred sweetener.) The Glycemic Index standard is white bread at 100 percent. Carbohydrates are then categorized as greater than 100, between 80 and 100 (high insulin inducers), 50 and 80 (moderate inducers), between 30 and 50 (reduced insulin secretion), and those at less than 30 percent. Since we don't have space to include the entire index in these pages, in general the majority of fruits (excepting tropical and dried fruits) and fiber rich vegetables (excepting cooked carrots, beets, and corn) are low glycemic foods. Most grains are on the high end of the index. To give you an idea, puffed cereals, instant rice and potatoes, French bread, and tofu ice "cream" are actually classified as over 100. There are other surprises including fructose at under 30 percent. (See Glycemic Index)

 It is important to note that like fasting and other therapeutic dietary regimens, a temporary high carbohydrate, low fat diet under a physician's direction may be appropriate. Also about 25 percent of us have a blunted insulin response to carbohydrates. These are people who can consume large amounts of carbohydrates without becoming either hungry or fat. On this carbohydrate curve, the middle 50 percent of us will have varying and increasing degrees of difficulty eating a high carbohydrate diet.

At the lower end of the curve are 25 percent of us who are insulin resistant. In this case, even though insulin levels are high, the cellular receptors don't open in response to the insulin. This results in both high insulin and high blood sugar levels, producing a condition which promotes diabetes and encourages the development of heart disease.

With all the emphasis on carbohydrate and low fat, many people who cut back or eliminated red meat and dairy replaced the calories with carbohydrates, not alternative protein sources. Furthermore, the importance of protein has been disregarded in the new food pyramid. So of course it's being disregarded by most of us. Well, guess what? We need to add protein to our diets.

While carbohydrate causes the pancreas to secrete insulin, protein causes it to secrete a different and opposing hormone called glucagon. Glucagon is a mobilization hormone. When blood sugar drops, glucagon acts to release glycogen from the liver to furnish blood sugar to the brain. Glucagon also increases the release of fat from fat cells for use as energy. When insulin and glucagon are in balance, our fuel systems run smoothly, and we aren't bothered by insatiable food cravings.

The important thing to remember here is that this is not a high protein, low carbohydrate diet. It is a balanced diet. (Do you remember those high protein diets of the 60s? The meals consisted of boiled eggs, grapefruit, and broiled skinless chicken.) High protein diets are dangerous. Because of the production of abnormal biochemicals called ketones, the body immediately sloughs them off through increased urination. Although this is weight loss, it is not fat loss. Later because so little carbohydrate is eaten, the body develops a physiological state called ketosis in which muscle begins to be torn down in an attempt to provide blood sugar to the brain. (Consider: the heart is a muscle.) 

Furthermore, when too much protein is eaten, the body secretes insulin and turns it into fat. As if this weren't bad enough, recent research indicates that high-protein, ketogenic diets may cause changes in the fat cells which make them ten times more effective in storing fat than before the diet!

Eat a balance of protein and carbohydrate and keep your hormones working for your best interests and not against them. The figure on the back gives you an idea of this balance.

You have to eat fat to lose fat. This is because essential fatty acids are necessary for the production of some minute hormones called eicosanoids (eye cah' suh noids ). These hormones, and prostaglandins belong to this group, do their work at the cell site. Because of their ubiquitous nature, they have been called "the most powerful" human biological agents known.

 

 

 Although fats can be up to 30 percent of total daily calories, go light on saturated fat (not more than ten percent of fat calories), and consider eliminating organ meats, eggs, and fatty red meats altogether. The latter foods contain arachidonic acid, a fatty acid particularly potent in swinging the eicosanoids out of balance. Also avoid trans-fatty acids, the hydrogenated fats found hidden in so many commercial foods and not hidden at all in margarine and shortening.