Does One Size Fit All?

Does one diet work for everyone? Is there one best way of eating? Is one diet better than all the others? The answer to all these questions is no. There are clear healthy eating habits everyone should follow. This includes avoiding processed foods, eating real/whole foods, avoiding sugar, and avoiding processed oils. The exact composition of a healthy diet can vary depending on one’s age, metabolism, and genetics. Most children are highly sensitive to insulin. This means they can eat carbs all day long and still remain thin. Furthermore, most children have a good metabolism. Unfortunately, as we get older things change. Most people, as they age, become less sensitive to insulin. This means that excess sugar is not burned by the body’s cells, but instead gets stored as fat. Insulin sensitivity varies from person to person. Some people can cut their carbs to 100grams a day and can lose weight and remain thin. Other people need to lower their carbs to under 25grams a day to lose weight. If you are on a low carb diet and not losing weight, you may need to cut your carb intake even more. Remember that everyone’s metabolism is different. Some people can eat a large amount of food and remain thin. Others are not as lucky. As we get older and lose muscle mass our metabolism slows down. We burn less calories at rest compared to when we were younger. A good way to naturally increase your metabolism is to increase muscle mass by lifting weights. More muscle mass leads to a higher metabolism and more calories burned at rest. The take home message is that everyone is different. Do not believe anyone who claims their diet is the best for everyone. What works for others, may not work for you. The key is to experiment and find what does work for you. Again, you can never go wrong avoiding processed food and sugar in your diet. A good rule of thumb that everyone can follow includes a diet of unprocessed, whole foods that your body recognizes as food. For most people, including a good amount of protein in every meal can help with weight loss. As noted above, cutting back on carbs is also important in losing weight. However, the exact amount will vary from person to person. Therefore, experiment a little with your diet if you are not having success. Keep a food diary if needed. Find what works specifically for you. One size does not fit all.

My triglycerides are high. Should I be worried and what can I do to decrease them?

Triglycerides are fats in the blood. They are directly measured in a standard lipid panel that your doctor runs on your annual visit. A healthy triglyceride level is less than 100. Having high triglycerides is very worrisome. High triglyceride levels lead to elevated VLDL levels in the blood, which are direct precursors to small, dense LDL particles. Small dense LDL particles (or type “B” particles) are highly “atherogenic”. This means that they cause blockages to be formed in the arteries, and subsequently heart attacks and strokes. So how do triglyceride levels become elevated? They are formed from excess sugar in the bloodstream. Too much sugar is toxic to the body. The body can only store a small amount of sugar as glycogen in the liver and muscles. To protect the body from toxic excess sugar, the liver turns extra sugar directly into triglycerides. Thus, eating a lot of carbohydrates directly leads to elevated triglycerides. Your body can then store extra triglycerides as fat in your belly. This is how you get fat. The best natural way to lower your triglycerides is to lower your intake of carbohydrates and sugar. Your body is taking all that pasta, rice, potatoes and pretzels you have been eating and turning them directly into triglycerides. This is making you fat and leading to an increased risk of a heart attack or stroke. The good news is that medications are usually not needed to improve the situation. Just decrease your carbohydrate intake and you will see a significant decrease in your triglyceride levels on your next blood draw.

Having difficulty losing weight? Not sure why? Read on.

I have talked with several people in the past few weeks who were frustrated that they were not able to lose any weight. They have been watching what they eat very closely. They have been exercising frequently. But still the scale still has not budged. They were becoming discouraged. I asked each of them to keep a food diary. I wanted to know their daily carb intake. Some used online counters; others found apps on their phones or I pads to help analyze their daily carb intake. They brought in the results for me to review. What we discovered is that each person was consuming a lot more grams of daily carbs than each realized. All were above 100 grams of carbs a day. Some were above 200grams a day and one was above 300grams a day. It was no wonder they could not lose weight. With their elevated daily carb intake levels, their insulin levels were also surely sky-high. Elevated insulin levels make weight loss very difficult if not impossible. We looked at the foods they were consuming including large amounts of whole wheat bread, oatmeal, and brown rice. Most were consuming large amounts of fruit, including daily bananas. We looked at ways to cut their daily intake below 100 grams a day to promote weight loss. Some people may need to cut down their daily carb intake to 50 grams a day. Everyone is different. If you are having trouble losing weight, count your daily carb intake. If you are not losing weight at your current carb intake level, cut down until the weight starts coming off. You need a low enough daily carb intake level to decrease your insulin levels low enough to promote weight loss. Once it does, be patient. Eating healthy is a lifestyle change, not a diet.

How many carbs should I eat a day to lose weight?

Reducing the amount of carbohydrates in your diet is one of the best ways to lose weight. By reducing the carbohydrates in your diet, especially simple carbs, you will lower your insulin levels. Insulin is the storage (get fat) hormone. Lowering insulin levels keeps your body from storing excess sugar as fat. Furthermore, lowering your insulin levels allows fat to be released from your fat cells to be used as energy. Reduced-carb lifestyles also have benefits that go beyond just weight loss. They naturally lower blood sugar, blood pressure and triglycerides. They raise HDL (the good cholesterol) and improve the pattern of LDL (the bad cholesterol) from type B to type A.

There is no clear definition of exactly what constitutes a low or reduced carb lifestyle. Furthermore, what is low for one person may not be low for another. An individual’s optimal carb intake depends on multiple variables such as age, gender, body composition, activity levels, and current metabolic health. People who are physically active and have more muscle mass can tolerate a lot more carbs than people who are sedentary. Metabolic health is also a very important factor. When people become insulin resistant, obese, or type II diabetic, the rules change. People who fall into this category can’t tolerate the same amount of carbs as those who are healthy. They become “carbohydrate intolerant”. If you are overweight with belly fat, chances are you are carbohydrate intolerant.

For most people, I would recommend starting in the range of 50-100 grams of carbohydrates a day. This range is great if you want to lose weight effortlessly while allowing for a bit of carbs in the diet. It is also a great maintenance range for people who are carb sensitive. This level corresponds to eating lots of vegetables, 2-3 pieces of fruit per day, and minimal if any starchy carbohydrates.

For some though, the 50-100 gram range may not be enough to see benefit. Those who are significantly carbohydrate intolerant, pre-diabetic, insulin resistant, diabetic, or significantly obese may need a lower range to see benefit. If the 50-100 gram range is not working, try the 25-50 gram range. At this level, you can eat plenty of low-carb vegetables, some berries, and minimal carbs from other foods. This range can be difficult for some people to maintain.

Remember, everyone is different. You will need to experiment to see what level works best for you. You may need to start out at a fairly low level, but subsequently you may be able to increase your daily intake as you lose weight and become more carbohydrate sensitive. If you want to try out a reduced carb lifestyle, I recommend initially tracking your food intake for a few weeks to get a feel for the amount of carbs you are eating.

Very important: if you are a diabetic or on diabetes medication, you will need to discuss your diet changes with your primary care physician or endocrinologist first. This is critical. You will need to monitor your blood sugars closely, and most likely reduce your diabetes medication. Your blood sugars will drop fairly quickly and you do not want to become hypoglycemic. Do not try without your personal physician’s guidance.

If you are trying to become healthier and lose weight, give this dietary lifestyle a try. Most people’s metabolisms are just not able to handle the amount of carbohydrates they are ingesting on a daily basis. Lowering your daily carbohydrate intake will make you healthier, naturally, subsequently reducing the need for medications.

Are potatoes making you fat?

While eating a whole potato would seem on the surface to be a reasonably healthy choice compared with processed foods, spuds can be a dud when it comes to their effect on your blood glucose level. Many potatoes fall into the high range on the glycemic index, (GI) which measures the effects of foods on blood sugar. High GI foods, with a score higher than 70, cause your blood sugar to spike quickly. Medium-glycemic foods rank at 55 to 70 on the scale and have a modest effect on your blood sugar. Ideally, the majority of the foods you eat should be low on the glycemic index and have a value less than 55. These low-GI foods raise your blood sugar slightly over a longer period of time. Unfortunately, most potatoes rank higher than table sugar on the glycemic index.

Russet potatoes are some of the worst offenders when it comes to upping your blood sugar. Russets are the most commonly eaten potato in America. A baked russet has an average GI value of 85. If you eat the skin, it falls a bit lower, whereas peeling the skin away makes it as high as 111. Baked white potatoes have a glycemic index of 82. Instant mashed potatoes have a glycemic index of 87. Sweet potatoes have a glycemic index of 70. A better option is yams. Yams have an average GI of 54, meaning they’ll have less effect on blood sugar. Comparatively, table sugar has a glycemic index of 58. Remember, the higher the glycemic index or load, the higher and quicker your blood sugar raises. The higher and quicker your blood sugar rises, the more insulin your body releases to deal with the elevated blood sugar. Finally, high insulin levels lead to obesity.

Remember, potatoes are carbohydrates that are turned quickly into sugar by your digestive tract. This leads to elevated insulin levels and promotes obesity. If you do eat potatoes, also eat the skins, which lower the glycemic index of potatoes. Also remember, the longer potatoes are cooked, the higher the glycemic index. Cooking potatoes breaks down the carbohydrates, which makes the sugars more easily and quickly absorbed. Overall, avoid potatoes if you are trying to lose weight.

Are Cheerios a healthy breakfast?

Patients frequently tell me they eat a healthy breakfast every morning – they eat Cheerios. Cheerios are advertised on TV as “heart healthy”. We are told to eat more cheerios as they “can help lower our cholesterol and may reduce our risk of heart disease”.  So if we eat more cheerios, will we become healthier? Unfortunately, the answer appears to be no. In fact, Cheerios may be making you fat and contributing to your diabetes. How is this possible? The carbohydrates in processed cereals are digested quickly, which increases their glycemic index. As we explained in the prior article, the glycemic index is a way of measuring how much and how quickly a food raises your blood sugar. Cheerios has a glycemic index (GI) rating of 74. For comparison, table sugar has a GI of 65. Remember, the glycemic index lists foods on a scale from zero to 100, with zero being the foods that are digested slowly, resulting in gradual rises in blood sugar levels, and 100 being foods that are rapidly digested, resulting in rapid spikes in blood sugar levels. Foods with a GI of 55 or less are considered low. Conversely, foods with a GI of 70 or more are considered high. By starting your day with a bowl of Cheerios, you are causing a spike in your blood sugar and thus a spike in your insulin levels. Elevated insulin levels are what lead to obesity and makes weight loss so difficult. Therefore, even tough Cheerios have a small amount of fiber, they are likely doing more harm than good. So what would be a good alternative breakfast to keep your insulin levels from spiking? Good low glycemic options include an omelet with vegetables, scrambled eggs, cottage cheese, unsweetened yogurt with berries, nuts, turkey sausage, or even some roasted turkey and cheese.

Use the Glycemic Index and Glycemic Load as natural ways to improve your health.

Obesity is a significant problem in our society. Losing weight and maintaining weight loss is incredibly difficult for most people. A major cause of weight gain in many people is elevated insulin levels. As described in prior articles, insulin is the “get fat and stay fat hormone”. If your insulin levels are high you will gain weight, which tends to be deposited in your belly. This is the dangerous fat, which leads to many diseases. Furthermore, high insulin levels lock in the fat already in your fat cells making weight loss extremely difficult, even with exercise. The glycemic index and glycemic loads are tools you can use to help you decide which foods to eat to help lower your insulin levels. Lower insulin levels will lead to weight loss and help to maintain weight.

 
The glycemic index is a measure of how quickly a food causes our blood sugar levels to rise and how persistent the blood sugar remains elevated. The glycemic index (GI) ranks food on a scale from 0 to 100. Foods with a high GI are quickly digested and absorbed, causing a rapid rise in blood sugar. This leads to a large and persistent increase in insulin secretion. Insulin is the storage hormone that leads to weight gain and prevents weight loss. The foods that rank high on the GI scale tend to be high in processed carbohydrates and sugars. Pretzels, for example, have a GI of 83 and a baked potato without the skin has a GI of 98.
On the other hand, foods with a low GI are digested and absorbed at a slower rate and, subsequently, cause a slower rise in blood sugar levels. This causes low or minimal increase in insulin levels. Low insulin levels lead to weight loss. Low GI foods are typically rich in fiber, protein and/or fat. Examples of these include apples with a glycemic index of 28, unsweetened Greek-style yogurt at 11, and peanuts at 7. Keep in mind that a low GI doesn’t necessarily mean that a food is high in nutrients or healthy. You still need to choose healthy foods high in vitamins, minerals and phytonutrients. Following a low GI diet can make it easier to achieve and maintain a healthy weight, since these foods keep us feeling fuller, longer. Low-GI diets have also been shown to improve insulin resistance, and lower glucose, cholesterol and triglyceride levels in people with type 2 diabetes.

 
One criticism of the glycemic index is that since the scale was created on a standard amount of carbohydrate per food (50 grams), it does not give people information about the amount of food they are actually eating. A common example is carrots. Carrots have a high glycemic index, but to get 50 grams of carbohydrate from carrots, you have to eat 4 cups of chopped carrot. Most people cannot eat this amount of carrots at one sitting. For this reason, the concept of Glycemic load was created, which takes serving size into account. Glycemic load (GL) is a formula that corrects for potentially misleading GI by combining portion size and GI into one number. The carbohydrate content of the actual serving is multiplied by the food’s GI, then that number is divided by 100. So for a cup of beets, the GL would be: 13 times 64 = 832 divided by 100 = a GL of 8.3. As a frame of reference, a GL higher than 20 is considered high, between 11 and 19 is considered moderate, and 10 or less is considered low.

 
If you are trying to lose weight, lower your blood pressure, lower your blood sugar, or lower you triglycerides naturally try to eliminate high glycemic foods from your diet. Many people are “carbohydrate intolerant”, that is their bodies cannot tolerate the large amount of simple carbs they are ingesting on a daily basis. A lower GI diet which eliminates many processed carbs from the diet is a good natural way to improve your health.

 
Click on these links to tables listing foods and their glycemic index/load:

American Journal of Clinical Nutrition

Harvard Medical School