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Better Health Update #49 - Monte Kline, Clinical Nutritionist

Low Carbohydrate Diet

Obesity is one our most common and most frustrating health problems . . . and it's problem that is getting worse all the time. Probably 40 million Americans fit the medical definition of obesity - being 20% over your recommended weight.

The problem is spiraling out of control. Just in the last 10 years, one authority estimates that an additional 20 million Americans have become obese with an average weight gain of 10 pounds for man and woman. For children it's even worse with obesity being virtually epidemic.

FAILED DIETS

America has been on a diet for 50 years and has gained 15 pounds! -Author unknown

Amidst this tremendous increase in obesity, Americans have been surrounded for decades by weight loss diets. Most overweight people have been on many, many diets - diets that either didn't work at all, or diets that in time failed. There's something wrong with this picture. To declare the obvious: Diets generally don't work. Studies have shown that of people who lose weight on a diet, 98% gain back the weight within three years.

Ultimately the reason diets fail is that they don't resolve the root causes of obesity. Let me make one point perfectly clear: Different people have different causes for their obesity. The key is to find out the root causes of your overweight and deal with them accordingly. Possible root causes may include:

Nutrient deficiencies Food Sensitivities
Glandular imbalance Lack of exercise Overeating Emotional stress . . .
And . . . Carbohydrate Addiction

This article is concerned with that last cause, Carbohydrate Addiction. I would estimate that 60% or more of the obese clients in my practice are indeed carbohydrate addicted, yet hardly any of them have approached weight loss from this perspective. If you are a "carbohydrate addict," a low carbohydrate diet is a great idea. But if that isn't particularly your problem, another weight loss approach will make more sense. The following questionnaire, taken from The Carbohydrate Addicts's Diet by Dr. Rachel F. Heller and Dr. Richard F. Heller, will reveal if you suffer from carbohydrate addiction.

CARBOHYDRATE ADDICT QUESTIONNAIRE

1. ____ I get tired and/or hungry in the midafternoon. (4 pts.)
2. ____ An hour or two after eating a full meal that
includes dessert, I want more dessert. (5 pts.)
3. ____ It's harder for me to control my eating for the rest of the day if I have a carbohydrate breakfast, than if I had only coffee or nothing at all. (3 pts.)
4. ____ Not eating for most of the day makes for easier weight loss than eating several small diet meals. (4 pts.)
5. ____ Once I start eating sweets, starches, or snack foods, I often have a difficult time stopping. (3 pts.)
6. ____ I would rather have an ordinary meal that included dessert than a gourmet meal that did not include dessert. (3 pts.)
7. ____ After finishing a full meal, I sometimes feel as if I could go back and eat the whole meal again. (5 pts.)
8. ____ A meal of only meat and vegetables leaves me feeling unsatisfied. (3 pts.)
9. ____ If I'm feeling down, a snack of cake or cookies makes me feel better. (3 pts.)
10. ____ If potatoes, bread, pasta, or dessert are on the table, I will often skip eating vegetables or salad. (3 pts.)
11. ____ I get a sleepy, almost "drugged" feeling after eating a large meal containing bread or pasta or potatoes and dessert, whereas I feel more energetic after a meal of only meat and salad.
(4 pts.)
12. ____ When I am not eating, the sight of other people eating is sometimes irritating to me. (4 pts.)
13. ____ I sometimes have a hard time going to sleep without a bedtime snack. (3 pts.)
14. ____ At times I wake in the middle of the night and can't go back to sleep unless I eat something. (3 pts.)
15. ____ Before going to dinner at a friend's house, I will sometimes eat something in case dinner is delayed. (5 pts.)
16. ____ Now and then I think I am a secret eater. (3 pts.)
17. ____ At a restaurant, I almost always eat too much bread, even before the meal is served. (2 pts.)

Interpretation (total of questions' point value):

21 or less Doubtful Carbohydrate Addiction
22 - 30 Mild Carbohydrate Addiction
31 - 40 Moderate Carbohydrate Addiction
45 - 60 Severe Carbohydrate Addiction

CARBOHYDRATES, INSULIN & FAT

Understanding insulin explains carbohydrate addiction. In the normal person after the consumption of carbohydrates, an appropriate amount of insulin is secreted to control blood sugar. Serotonin levels rise changing the brain chemistry and producing a feeling of satisfaction. Eventually the blood sugar drops, changing the brain chemistry, reducing the feeling of satisfaction, and therefore again producing hunger.

This process is all messed up in the carbohydrate addict, following this progression:

1. Too much insulin is produced for the amount of carbohydrate consumed.
2. The excess insulin decreases the number of insulin
receptors, decreasing the removal of insulin and sugar from the blood.
3. Serotonin levels in the brain do not rise enough to produce a feeling of satisfaction. You continue eating carbohydrates.
4. More insulin is secreted with each carbohydrate intake.
5. More and more carbohydrates are consumed without any feeling of satisfaction being produced.

Glucose, with the aid of insulin, is converted to glycogen and triglycerides via the liver. Insulin stimulates fat synthesis. Studies have shown that overweight people have higher insulin levels in the blood than normal individuals. Other studies have found that animals given insulin injections become obese. Thus the key to solving the weight problem of the carbohydrate addict, is reducing carbohydrate intake and the subsequent secretion of insulin. When you reduce insulin, your body burns stored fat.

DIET GUIDELINES

There are two possible approaches for implementing a low carbohydrate diet. One approach, advocated by Dr. Robert Atkins, M.D. in Dr. Atkins' New Diet Revolution, uses the diet for all three meals. The amount of allowable carbohydrates are increased as one moves into maintenance. The other, as advocated by Dr. and Dr. Heller in The Carbohydrate Addict's Diet, allows one "reward meal" per day during which carbohydrates may be eaten.

While either approach can work, I lean more toward the complete avoidance of carbohydrates, at least initially. Both of these low carbohydrate books have some problems from an overall health point-of-view, particularly the Atkins' Diet, which sees no problem with bacon, other fried foods, shellfish - foods that just can't be considered healthy. Superimposing good natural food eating guidelines over these low carbohydrate diets makes a lot more sense.
In my view these diet books tend to be complicated and confusing. Let me try to make it really simple with what's okay, what isn't, and meal examples:

FOODS TO EAT (Low Carbohydrate)

Chicken Turkey Beef Yogurt Lamb Fish Cheese Eggs Tofu Non-Starchy Vegetables

FOODS TO AVOID (High Carbohydrate)

Breads Cereals Pastas Potatoes Carrots Beets Avocados Garbanzo Artichokes Parsnip Winter Squash beans Corn Peas Kidney beans Lima beans
Fruits Fruit juices Alcohol Sugar Dextrose Fructose Corn syrup Maltodextrin Dried fruit

GENERAL RULES

1. Do not eat anything in between meals.
2. Drink plenty of distilled water daily (body weight in pounds divided by two equals number of ounces of water to consume daily)
3. If using the "Reward Meal" concept, maximum time limit for this meal is 60 minutes.
4. You may wish to use a Protein Supplement (in water preferably) as a breakfast substitute.
5. You may also want to use a psyllium husk fiber supplement to maintain good bowel regularity.

SAMPLE MEALS

Possible Breakfasts

Protein Drink (in water or diluted fruit juice)
Omelets
Scrambled Eggs
Yogurt (plain, perhaps with some frozen berries)
Cottage Cheese
Soy sausage

Possible Lunches

Green Salad with cubes of cheese
Baked or broiled fish
Tuna salad
Chicken salad
Sliced turkey
Beef dishes
Steamed vegetables

Possible Dinners

(1) Same possibilities as lunch if following diet for all three meals.
(2) If using dinner as the "Reward Meal" any foods, including high carbohyrate foods, on our general Suggested Diet may be used. However, all foods must be consumed within 60 minutes.

EXPECTATIONS & COMMITMENT

This, or any other healthy weight loss program requires patience. One to two pounds per week is a good weight loss. Temporary plateaus are common and normal. If you are a carbohydrate addict and you keep the carbohydrates low, it should be relatively easy to keep the weight off.
Now my most important admonition: If you are not absolutely committed to doing this, don't bother! Most people who are overweight are not really committed to losing it - they have preferences but not convictions. But if you've had enough and you commit yourself to this and just do it, I'll be amazed if it doesn't work for you. Health change requires lifestyle change.

DISCLAIMER: The information contained in this publication is for educational purposes only. It is not intended to diagnose illness nor prescribe treatment. Rather, this material is designed to be used in cooperation with your nutritionally-oriented health professional to deal with your personal health problems. Should you use this information on your own, you are prescribing for yourself, which is your constitutional right, but neither the author nor publisher assume responsibility.