Gary Taubes

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Tuesday, November 18, 2014

Eating Clean Over the Holidays

In my psychiatry practice many of my patients embrace a diet with low to no refined carbohydrates or processed foods and feel emotionally better within weeks. Some have not felt so mentally and physically well in decades. 

Then the eating holidays (Halloween through New Years) arrive. Unless they are hermits they must confront social pressures to abandon good eating habits (Halloween treats, Grandma's traditional turkey stuffing, the neighbor's Christmas fudge, candy canes, New Years' banquets, holiday ads, less time to prepare healthy meals, etc.)

Most report they feel dreadful with their first high sugar and starch food mistake, but as they continue eating such foods they grow used to not feeling their best. By the time January arrives they have gained weight and slipped back into depression, with the daily mood swings every 2-3 hours that accompany a refined carbohydrate diet (see graph below). 


From They Are What You Feed Them, by Dr. Alex Richardson
[A word on the graph above: When insulin rescues your body from slipping into a coma by taking excess blood sugar away it has to put it somewhere. So insulin helps convert blood sugar to fat and store it in fat cells for future use as fuel. But so long as insulin is high, stored fat cannot be released to use for fuel. Blood sugar drops, and hunger strikes again. People who eat high carbohydrate/low fat diets encounter this roller coaster effect throughout the day, suffering frequent hunger symptoms while gaining weight.--AC]


I start early to address this problem by documenting my patients' moods along with diet reports when they first undertake the low refined carbohydrate program. My notes tell me how well my patients felt when they ate one way v. eating according to unhealthy habits. 

You can do this yourself by starting a dated/timed journal of foods and moods using the ABCs (Date, Time, Antecedents, or what prompted you to eat the food; Behavior, or what you ate, and Consequences, such as how you feel/what your glucometer says/etc. In a separate column record weight gain/loss over time). Journaling helps move eating habits from unconscious to conscious.  It is also a way to get in touch with triggers for eating various types of food, and to solidify reasons to eat clean. Seeing the results of eating on and off target on paper helps make the process tangible for most people. 

It's important to know that starch = sugar, and both sugar and starch promote addiction-like blood sugar curves that increase hunger and food cravings, along with moodiness (see graph above). Once on this roller coaster it's hard to get off. 

One strategy set is to get with like-minded people for moral support over the eating holidays. Make healthy substitutes for your favorite holiday foods. When you go out to eat, don't be shy--ask for what you need. A large piece of lettuce can replace the traditional starchy hamburger bun, for example. 

For my patients considering a reduction in carbohydrates close to the 'eating holidays' I encourage them to go slow, learn as much as they can about the process then embrace their new way of eating fully as a New Year's resolution. 

Bon appetit!

A no-rollercoaster diet plan

Sunday, November 2, 2014

Mood, Anxiety and Diet: Change One Meal, See How You Feel


Mood swings can trigger anxiety and depressive episodes during the day.  If you experience daily mood swings, addressing your diet can help.  If your gallbladder is in good shape (a healthy gallbladder helps you digest animal fats) and your general health is good, try this experiment: Eat a hearty breakfast rich in natural fats (well-sourced saturated fats, such as butter; ghee; heavy whipping cream; uncured bacon) accompanied by about 30 g of complete proteins (in the US, typically meats, fish, shellfish, eggs and/or poultry-- 30g is the equivalent of ~4 oz of meat protein; whey protein may work as well), sans starches and/or sugars (non-starchy vegetables that grow above ground, topped with butter or ghee if cooked, are great; just no toast, orange juice, cereal or etc.).  Pay attention to your mood and hunger in the hours that follow.  How is your mood?  How many hours pass before you are hungry again?  

More on YouTube: Ann M. Childers, MD: Mood Swings and Diet http://buff.ly/1wq5kgV




Friday, October 3, 2014

How Do Low Carb Diets Really Work?

  • I recently read an article featuring a number of misconceptions about how low carbohydrate diets achieve weight loss, and how the body works here: Fitness Truths: do carbs make you fat? - Telegraph http://buff.ly/1xau9fp  My answers do not address processes in depth, but I hope they are clear in conveying general concepts explaining how low carb diets work.  
  • Below you will find statements from the article, followed by my comments.  Article statements are in quotes:
  • "Low carb diets often work because they serve as a simple way to reduce overall calories."
    Yes, low carb diets reduce overall calories, but the mechanism is not simple. When carbohydrates are reduced and adequate proteins and fats are introduced hormonal changes take place such that people are satisfied with their meals and do not tend to overeat.
    "If we take our average male carbohydrate intake of 252g as above and we reduce it to 100g, we have reduced our carb intake by 152g per day. There are four calories (kcal) in a gram of carbohydrate, so we have effectively created a daily overall calorie deficit of 608kcal, which is certainly enough to elicit significant fat loss, especially if we are exercising."
    What is overlooked here is that, in most low carbohydrate diets, carbohydrate calories are not simply reduced but are replaced by dietary fats, and sometimes protein. The reduction of insulin that results from reduction in carbohydrates, with addition of appetite satisfying fats and protein, lead people to eat less food overall.
    Carbohydrates make people and animals hungry. Studies of meat pigs show the less satisfying the meal, the more fat they gain. The ideal commercial mix for meat pigs to promote the greatest fat gain is skim milk mixed with grains. This formula is sadly reminiscent of the American Food Pyramid of 1992 (6-11 servings of grain per day plus non-fat dairy and other low-fat foods).
    "It is worth noting however that we could have just as easily done this (added back calories lost when carbohydrates are removed from the diet--AC) with protein, given that the calorie load per gram is the same for protein as it is for carbohydrates, and that it is not necessarily the cutting of carbs per se that has caused us to lose weight, but rather the reduction of overall calories."
    It's really about insulin. Insulin is a storage hormone. Foods that provoke the production of insulin provokes fat storage. You see, insulin helps convert excess blood sugars to fat to prevent sugar toxicity. When circulating insulin is high, excess carbohydrate energy is locked away as fat and cannot used as energy. With energy continuously locked away, hunger strikes every few hours and people gain weight. We don't get fat because we eat more; we eat more because we're getting fat. In this way a high carbohydrate dietary strategy leads to excess food intake and weight gain. The only way to lose weight on a high carbohydrate diet is to restrict calories. But when calories are restricted on a high carbohydrate diet people most often become exhausted, depressed and irritable, making it nearly impossible to do.
    Starch and sugar, especially refined starch and sugar, provoke insulin to the highest degree. Protein comes in second (protein provokes the production of insulin via gluconeogenesis, the production of the blood sugar glucose from protein). Fat is least able to provoke insulin. Replace carbohydrate calories with fat (making sure high quality protein is about 23% of the diet for an average adult) and you are most likely to lose weight or maintain a more normal weight as a result of reduced appetite. Meal satisfaction is one reason people eat less on a low carbohydrate diet. It is how many obese people eat "all they want" on a low carbohydrate diet and lose weight; the trick is they want to eat less, as much as 1000 Cal less each day because they feel satisfied. Eating excess protein provokes gluconeogenesis, thereby adding carbohydrate back into the system.  In this way excess protein can sabotage a weight loss plan. 
    In America 49% of adults over age 20 are either diabetic or pre-diabetic. Our research team (Feinman, et. al. Nutrition, Elsevier 2014) demonstrates a low carbohydrate diet is an essential first step for treating Type I and Type II diabetes. I would add that those of us who are pre-diabetic or prone to become overweight (carbohydrate sensitive) can also benefit. Partner with your doctor if you will consider this or any diet. Cheers! --Ann

Friday, August 15, 2014

Sugar, Sugar

Sugar Facts:

-CDC reports the lifetime risk of diabetes in America is currently at 40% for an average 20 year old
-American Heart Association reports American adults consume 22 teaspoons added sugars per day, teens 34 teaspoons per day. 
-Sugar promotes tooth decay. The news here is tooth decay and the need to brush/floss teeth is considered a fact of life for most Americans.  In wild animals and healthy hunter gatherers caries are almost unknown, sans dentists/tooth brushes, toothpaste and floss.
-Starch turns to sugar (glucose) in the mouth, and during digestion.   Plain, dry bagels and unsweetened cornflakes may not taste sweet, but they are still "candy" to our bodies.

-Sweetened or not, grain-based cereals are sugar. Period. Spraying vitamins on them does not make them food.
-Fruits are nature's candy.
-Of 60,000 products in grocery stores, 80% contain added sugar (Catie Couric, movie Fed Up)
-The amount of sugar in a product may be misrepresented on the label. In 2014 Whole Foods is sued over yogurt containing 5 times more sugar than the label shows (a discrepancy first reported by Consumer Reports).
-Agave Nectar contains as much as 95% pure fructose.
-Researchers at University of Guelph, Canada, found blood sugar spikes from white bread and sourdough bread pale in comparison to those from whole wheat bread. Whole wheat bread appears to rival some candy bars in this respect yet is thought to be healthy.
-Sugars found in most foods are fermentable carbohydrates. Fermentable carbohydrates promote tooth decay initially, and chronic modern diseases (diabetes, heart disease e.g.) decades later. (P Hujoel: Dietary Carbohydrates and Dental Systemic Diseases)
-Sugar promotes insulin.  Insulin stores excess sugar as fat. Sugar--> Fat
-Alzheimer's is increasingly referred to as Type 3 Diabetes, a disease of carbohydrate (sugar, e.g.) intolerance.
-Eat enough sugar and you may lose the ability to detect small amounts.  Go off for awhile and things you once ate or drank easily may taste too sweet. Broccoli and spring water taste sweeter on a low sugar diet.

-Refined sugars and starches are empty calories that promote fat storage at rapid rates.  
-A high sugar diet promotes mood swings, anxiety and poor concentration.
-Diets high in sugar and starch stiffen arteries.
-Consuming sugars at bedtime can result in frequent awakenings at night, even insomnia. 
-Refined sugars and starches are addictive.  Weaning off is not easy, but is well worth your while if you value your health.

Friday, December 27, 2013

LA asks: What's the best paleo cookbook?

Answer: The best cookbook depends on your needs and desires.  Are you feeding a family?  Is simplicity and speed important to you?  Will you entertain?  Would an on-line resource with photographic illustrations help you in your culinary journey?  A helpful basic cookbook for everyday use is Practical Paleo by Sanfilippo.  A book with artfully flavored dishes and clear prep times is Well Fed by Joulwan.   A book for Paleo entertaining is Gather by Staley.    Nom Nom Paleo has an online site (nomnompaleo.com) and a newly released cookbook.  There are many, many more great paleo books out there, but these should give you an idea of where to start.  Enjoy!

Thursday, December 12, 2013

SC asks: Are there natural remedies for psoriasis?

SC asks: What are the best natural remedies for reducing the irritation of plaque psoriasis caused by Candida overgrowth?

Answer: I cannot tell you the underlying cause of your psoriasis, or if there is one; however, autoimmune conditions are frequently connected to diet and Vitamin D status. You may wish to work with a healthcare provider familiar with common causes of psoriasis. In many cases an elimination diet helps find the culprit. I have patients with autoimmune related skin disorders who tell me their problems improve or clear when they eliminate certain foods, such as gluten and milk dairy. Vitamin D acts as a immune system modifier and your Vitamin D level should be included in your work-up. Candida thrives on dietary sugars and starches. A low carbohydrate, high fat (LCHF) diet can help rid you of Candida, as can some probiotics. I favor large spectrum probiotics containing Saccharomyces boulardii, a probiotic yeast, as it may compete with Candida. Garden of Life Primal Defense Ultra is one such formulation, and there are others. Be sure to check with your doctor before making any diet or supplement changes.

Tuesday, December 3, 2013

JG asks about replacing carbohydrates with protein:

Question:  I've started cutting carbs in my diet and replacing them with more protein. Should you start feeling tired a little as you begin?

Answer: Hello, JG, Yes, you will probably feel tired as you begin.  However, there is one mistake most people make when they start a low carbohydrate diet that makes this transition worse.  You say you are replacing carbohydrates with "more protein."  In reality, assuming you ate adequate protein before you started your new diet plan, you should only replace carbohydrates with fat.  That fat, and especially saturated fat, is a healthy part of a diet is a difficult concept for most Americans to understand, but without adequate dietary fat energy is low and you might not feel as satisfied with your meals.   Full fat meats, fish, eggs and (not skinless) poultry are good sources of natural fats.  The better these animals are raised (pasture finished livestock, low-contamination fish, e.g.) the better they are for your health.  The best diets for healthy weight loss are Low Carbohydrate, High Fat (LCHF) diets; with these diets you will probably end up eating more fat than what you are accustomed to.  Pasture finished butter (or clarified butter/ghee if you are lactose intolerant or want to fry with butter) and coconut oil are great fats to add.  These fats are excellent for cooking and keeping weight normal while enhancing health.  Also consider frying with lard, bacon grease, beef fat and duck fat. So, step up your fat, keep protein intake moderate and carbohydrates low.  Two good resources for low carbohydrate living are: livinlavidalowcarb.com and dietdoctor.com     Good luck, and bon appetit!