Monday, October 31, 2011

Obese No Longer

I lost two pounds this week, but the bigger news is this: now that I weigh 239.8 pounds, my BMI has dropped below the "obese" threshold. I am officially no longer obese; I am now merely "overweight," with a BMI of 29.9. Yes, I am tall (6'3").

Have I ever mentioned that I think the BMI measurement is a bunch of bunk?

Saturday, October 29, 2011

Safe Starch Debate: A Diabetic's Perspective

There is a debate raging in the low carb blogosphere about the concept of "safe starches." Here is the start of the debate; here is Paul Jaminet's initial response, and here is the latest installment, featuring Dr. Ron Rosedale, with an response coming on Tuesday from Paul Jaminet.

One thing all sides have said: We do not necessarily recommend "safe starches" for diabetics. Well, I am a type II diabetic and a Perfect Health Diet follower, so I want to chime in with my experience.

First off, I have lost about 62 pounds, but 55 of that came following the diet described in the back of Gary Taubes' book, Why We Get Fat, which I later learned was the Atkins Induction phase. This helped to stabilize my blood glucose levels in about three weeks time, as well as returning my blood pressure to a normal range. But then I stalled and started reading more broadly about low carb diets. I discovered Gary Taubes didn't have all the answers, and I switched from the Atkins Induction diet to the Perfect Health Diet. I have been eating rice, potatoes, bananas, and other safe starches ever since, as well as fermented dairy products, such as plain, whole milk yogurt. I have also slowly lost another seven pounds. I enthusiastically recommend the book, Perfect Health Diet by Paul and Shou-Ching Jaminet.

Today, my fasting blood glucose reading was 105. Note that since following the Perfect Health Diet, my fasting blood glucose reading has gone down. Previously, I was suffering from the "dawn phenomenon." My blood glucose levels overall were well below 140 one hour after a meal and 120 two hours after a meal. Only my fasting BG reading was out of whack, usually between 120 and 130, first thing in the morning.

For dinner tonight, I had a fatty pork rib, green beans, and a small baked potato with butter and sour cream. For dessert, I had a half cup of vanilla ice cream. One hour after eating, my blood glucose level was 128 and two hours after, it was 112.

So not only am I losing weight on the Perfect Health Diet, my blood glucose levels have actually improved, thanks to the increased carbs counteracting the dawn phenomenon, just as Dr. Kurt Harris (another proponent of safe starches) said it would.

So for me, as a type II diabetic, this "safe starches" exclusion is pointless. I realize that I have greatly helped my diabetes situation by losing a lot of weight prior to switching to the Perfect Health Diet.  And I am taking Metformin Extended Release pills every day. Nevertheless, despite the type II diabetes, I am doing just fine on the Perfect Health Diet, thank you. I reject the diabetic exclusion of safe starches.

Friday, October 28, 2011

Back from Europe

I am back from Europe, where I have been for the past six weeks, with a study abroad group. I had an interesting experience with the Perfect Health Diet while in Europe. First off, it appears I lost 3-4 pounds while I was gone, which is amazing, considering that we ate out almost every day for the past three weeks, often three times per day when we were in deep travel mode.

But following the PHD principles led me to making good choices. Among the items I consumed while abroad: a good deal of cheese made with raw milk; deviled lamb kidneys; pate de foie gras, pheasant pate, goose liver, pastured eggs, grass fed beef (especially in Scotland and Ireland), many truly fresh vegetables, a bit of chicken, fish, shrimp, etc. It was especially easy to eat in France, Belgium, and Luxembourg, as the local culture practically demands quality cuisine. It was more difficult in Switzerland, Germany, England, and Northern Ireland; somewhat less difficult in Wales, Scotland, and Ireland. I spent the most time in Belgium, with a fresh market every weekend and whenever possible, we purchased fresh food and ate in. But when we ate out in Belgium, we ran in to some excellent restaurants, such as Comme Soupe and t'Injaske. Everything is made fresh and the quality is just superb. My wife even bought a Belgian soup cookbook, so we can eat tasty, fresh, and hearty soups in the states.

The hardest part came when traveling in countries not known for their cuisine (e.g., England, Germany, Switzerland), but my strategy there was to hit the supermarket and buy whatever I could to eat. That usually meant cheeses, chicken, soup, vegetables, and yogurt.

So I am living proof that one can travel, a lot, and eat out, a lot, yet still lose weight when making wise choices. I am especially grateful to the Perfect Health Diet for convincing me to add back foods like rice, potatoes, bananas, and yogurt, which made the task all that much easier. Without spiking my blood sugars, but that is a post for another day (I am a type II diabetic). This "safe starch" concept has really helped make the low carb lifestyle sustainable and healthy.

Saturday, October 22, 2011

How Does Low Carb Work? A Review of Various Theories

In a recent post, I speculated on reasons why people are obese. In many ways, this current post is the opposite: why do low carb diets reduce obese people to slender people? There are a lot of claims on the Internet about why low carb diets work, some of them quite outrageous, and I want to seek wisdom on this topic.

The Carbohydrate Hypothesis. Gary Taubes is the leading proponent of the hypothesis that carbs, especially refined carbs like flour and sugar, are fattening. This is also known as the "carbohydrate hypothesis." According to Taubes, carbs lead to insulin spikes, which leads to fat deposition (accumulation). The "carbohydrate hypothesis" is widely disputed and to date, there is no empirical evidence to back it up, though Taubes is apparently trying to raise money for such an empirical test. Personally, I no longer believe this theory, though at one time, I was a believer. True believers in this hypothesis include Jimmy Moore, Dana Carpender, Gary Taubes (of course), and Tom Naughton, among many others.

Metabolic Advantage. Others suggest that a low carb diet gives you a metabolic advantage (the idea that you burn calories more efficiently while low carbing, and can therefore consume greater quantities of low carb food and still lose weight), though at present there is very little empirical evidence to back up this claim. This idea is also widely disputed, as exemplified by the dust-up between Michael Eades and Anthony Colpo on this very topic. The metabolic advantage theory leads to the idea that calories don't count, that some calories (e.g., "low carb" calories") are better than other calories. Thus, if you eat low carb, you don't have to worry about calories. I am also on record as rejecting this idea.

Satiety. Another theory about why low carb diets work is that protein and fat are more satiating (see this article, too). When you eat a high fat, moderate protein, low carb diet you lose weight because you spontaneously consume fewer calories. There seems to be a lot more evidence for this theory (e.g., here, here, and here). Note, too, that this theory implicitly rejects the theory of metabolic advantage mentioned above. I am on record as saying this is a major reason why low carb works.

Toxins, Infections, and Malnutrition. The Perfect Health Diet maintains that weight loss happens when you eliminate toxins from your diet, as well as malnutrition and infections caused by your diet. The Jaminets have developed a diet based on these three ideas, which is summarized here. The diet is a low carb diet that includes so-called "safe starches," such as potatoes and white rice. A "safe starch" has nothing to do with carb or glucose content. It is a term invented by the Jaminets and "refers to any starchy food which, after normal cooking, lacks toxins, chiefly protein toxins. We do not consider glucose to be a toxin, though it may become toxic in hyperglycemia" (reference). Their definition of a low carb diet is one between 100 to 150 grams of carbs per day, mostly from "safe starches," as a low carb diet for them "means eating less than the body's actual glucose utilization, so that a glucose deficit has to be made up by gluconeogenesis" (reference). But weight loss happens not because carbs are reduced, but because toxins are eliminated, infections are reduced, and malnutrition is aggressively attacked. I am currently following the Perfect Health Diet, so I guess you could say I am a believer in this hypothesis.

Low Carb Works by Accident. Kurt Harris, M.D., maintains that low carb diets work by accident.  Specifically, he says:

Low carb plans have helped people lose fat by reducing food reward from white flour and excess sugar and maybe linoleic acid. This is by accident as it happens that most of the "carbs" in our diet are coming in the form of manufactured and processed items that are simply not real food. Low carb does not work for most people via blood sugar or insulin "locking away" fat. Insulin is necessary to store fat, but is not the main hormone regulating fat storage. That would be leptin. (emphasis added).

Food reward is an idea championed by Stephan Guyenet and the basic idea is that highly palatable foods lead to obesity. Lowering food reward, or palatability, by reducing refined sugars, flours, and even salt and other spices to produce more bland eating options leads to losing weight. The idea proposed by Harris and Guyenet is that low carb diets work, not by design, but by accident. By following Atkins, for example, you naturally reduce food reward by eliminating a whole macronutrient category, carbohydrates. As the Harris quote above indicates, he (and Guyenet) both reject Taubes' carbohydrate hypothesis.

This is a curious argument, one that makes a certain amount of sense. Why does Atkins work? If you follow Atkins, you eliminate two major problematic foods: refined sugars and refined flour. This will naturally lead to weight loss. Atkins is not too concerned about seed oils, though, which is why I don't claim to be following Atkins. My version of a low carb diet has eliminated seed oils from a very early stage in my weight loss history. Atkins also produces a lot of junk food, made with wheat gluten, soy, and other products I don't consume. An Atkins low carb diet is not necessarily a low calorie diet, if you eat too much low carb junk food. So I do think there is an element of "accident" in why low carb works.

My Position. I believe low carb works because 1) protein and fat are more satiating than carbs; 2) low carb eating causes me to spontaneously consume fewer calories, since protein and fat are more satiating than carbs; 3) calories count, so be mindful of how much you eat; 4) low carb lowers food reward by eliminating sugar, flour, and seed oils, especially those three in combination; 5) low carb removes toxins, reduces infections, and corrects malnutrition; 6) low carb requires that I eat real foods, the kind that are not processed; and 7) low carb simply offers fewer food choices. It is a lot harder to snack and harder to eat out, at least in the U.S.A. This means I eat real food cooked at home more often than not. Fortunately, my desire to snack is greatly reduced thanks to the satiety of what I eat.

I do not believe in the carbohydrate hypothesis and reject the notion that carbs are inherently fattening (this idea seems to be widely believed and held on the Internet). Rejecting this idea opened my mind to the idea of eating "safe starches," as defined by the Jaminets. I also reject the idea of metabolic advantage and believe that calories count. Thus, I would never substitute a cup of heavy cream for a cup of whole milk, simply because there are fewer carbs in the cream than in the milk, nor would I add 12 tablespoons of fat to two pounds of meat to increase the fat content of my diet That is simply too many calories and a low carb diet is already a high fat, moderate protein, low carb way of eating. You don't need to add a lot of additional fat.

Taken together, the seven reasons cited above are a recipe for low carb success.

Thursday, October 13, 2011

Silence Explained

I take students abroad for my day job and have been in Europe for the past few weeks, working 12-15 hour days. It hasn't left a lot of time for blogging, so I hope that explains my silence. Here are some photos I took from recent travels to Belgium, France, Ireland, Northern Ireland, and Scotland (plus a gratuitous link to my other, neglected study abroad blog).

So a few links: Paul Jaminet responds to various comments about safe starches. The man is a class act and I respect him more now than ever before. Not only has he taught me about how to do low carb safely and correctly, he has taught me how to be a gentleman as well.

I some times despair at finding wisdom in the low carb blogosphere; everyone thinks carbs are fattening and that all we have to do is cut carbs to lose weight. This is not true. But occasionally, I do stumble upon low carb wisdom. Here is one such post. Finding low carb wisdom is the reason I started this blog.

There has been a lot of activity about the book Wheat Belly by Dr. William Davis. I even wrote a review of the book. But Chris Masterjohn, another superb example of a human being, wrote a very decent review of the book that captures the best and the worst aspects of the book. You can tell it is a compelling review by reading Dr. Davis' response to Masterjohn's blog.