Living Low Carb (30 page)

Another premise central to the development of this diet was this: it isn’t only the amount of carbs you eat that matters; it is how
frequently
you eat them. (Therein lies the reason that Rachael felt less hungry when she didn’t eat until dinnertime on those first few days of experimenting.) The Hellers believe that any weight-loss diet that prescribes three or more small meals each day that contain anything more than minor amounts of carbohydrates will ultimately fail with the carbohydrate addict. In the Hellers’ view, hyperinsulinemia (high levels of insulin) is the best explanation for recurring cravings and hunger and the body’s tendency to store fat.

In summary, the following applies to the carbohydrate addict:

•  For the amount of carbs consumed, too much insulin is produced.

•  The constant excess of insulin eventually leads to insulin insensitivity.

•  Serotonin (a feel-good brain chemical) does not rise enough to cause the addict to feel satisfied and to produce the signal to stop eating, so the addict continues to eat carb-rich food.

•  Production of insulin rises with each subsequent carb intake.

•  Greater and greater amounts of carbs may be consumed with no increase in satisfaction.

The Hellers use the addiction model throughout their book. In the patients they have worked with, they identified three levels of addiction, characterized by an escalating need for carbs and sweets as you move up the “ladder.” In level 1, you are simply interested in eating all the time, craving basically wholesome foods but lots of them; in level 2, there is an increased desire for carbs, especially breads and baked goods; and in level 3, there is a much greater reliance on snacks and sandwiches as staples of the diet, with a high contribution from cakes, candies, potato chips, popcorn, cookies, pies, and the like. This is also accompanied by more and more compulsiveness.

Addiction “triggers” can come from emotional events, day-to-day events, or food. Examples of emotional triggers include unexpressed anger, anxiety, depression, a sense of being out of control, excitement, and frustration. Examples of daily-life triggers are stresses of any kind, PMS, illness, or a change in home life. Finally, food triggers are all the things dieters commonly report as deadly and that you would expect to be on a list like this: bread and other grain products, fruit, sweet desserts, snack foods, all kinds of pasta, french fries, and of course sugar.

Carbohydrate addicts have the greatest difficulty controlling their eating when they consume carbohydrates several times a day. According to the Hellers, when the
number
of carb meals (or snacks) is reduced, eating becomes far more controlled and there is a dramatic decrease in cravings. So here’s the program they recommend:

•  Two low-carb meals per day (which they call “complementary” meals)

•  One “reward” meal per day

Complementary meals are defined as high in fiber, low in fat, and low in carbs. They are basically made up of protein and vegetables (with no fat added). The protein can be either 3 to 4 ounces of meat, fish, or fowl or 2 ounces of cheese. You can have 2 cups of vegetables or salad, but you can’t use the vegetables on the “higher-carbohydrate” list. The vegetables on that list have more than 4 grams of carbs per serving, and you
can
eat them, but only at the reward meal. (Some of the vegetables on the Hellers’ list don’t belong there, such as broccoli, which actually has only about 2 grams of effective carbohydrate
^*
per serving, and avocado, which is not even a vegetable and in any case doesn’t contain 4 grams of effective carbohydrate.) Other “high-carb per serving” vegetables not to be eaten during the complementary meals include potatoes and corn.

Reward meals, which happen once a day, usually at dinnertime, are made up of anything you like. Quantities are not limited. There are only three rules.

1.  The meal must be equally balanced, in thirds, among protein, vegetables, and starch (or dessert).

2.  The meal must be consumed within one hour of starting.

3.  You can go back for seconds on this meal, but if you do, you still have to eat equal amounts from all three categories.

There is a one-hour time limit for the reward meal because of the Hellers’ understanding of what is called the biphasic release of insulin (more about this in Jonny’s Lowdown). Insulin is released in two phases (hence the term biphasic). The first phase occurs within minutes of consuming carbs: the pancreas releases a fixed amount of insulin regardless of how much carbohydrate is being consumed at the time. The second phase of insulin release—according to the Hellers but to no one else in the field—takes place about 75 to 90 minutes after eating and is dependent on how much carbohydrate you actually ate at the meal. If the “initial jolt” of insulin release in phase one wasn’t enough to handle the carb load, the second phase shoots out more. Thus, they maintain, you want to consume your entire reward meal within sixty minutes to prevent that “second surge” of insulin production.

Alcohol is not prohibited on this diet, but it needs to be consumed as part of the reward meal. Artificial sweeteners are not permitted, and for a very good theoretical reason: it is hypothesized that insulin release might be subject to conditioned responses, much like salivation was conditioned in Pavlov’s dogs, whose mouths watered when they heard a bell that had been rung every time dinner was served. The Hellers put forth the very interesting hypothesis that artificial sweeteners somehow trick the body into releasing insulin, probably because they taste sweet and because the body becomes used to secreting insulin when the taste buds and the brain notice the sweet stuff coming in. In addition, the sweetness keeps the addictive cycle going and keeps you wanting more.

No snacking is allowed
between meals (except on a variation called Plan A, which allows one “complementary” snack per day). The Hellers explain that “one piece of fruit eaten other than during the reward meal can reverse the whole metabolic process that is emptying your fat cells. That apple or banana or whatever can be the difference between weight loss and weight gain.”

There is a seventeen-item quiz you can take to determine whether this diet is for you. It’s called the Carbohydrate Addict’s Test, and it is also available in a shortened form (a ten-question “Quick Quiz”) on the Web site (
http://www.carbohydrateaddicts.com
). Your score identifies you as having “doubtful addiction,” “mild carbohydrate addiction,” “moderate carbohydrate addiction,” or “severe carbohydrate addiction.” The Hellers claim that they have refined the quiz so that it now identifies 87% of carb addicts and gives a “false positive” (i.e., mislabels a “normal person” as an addict) only 4% of the time. They also point out that their diet was not designed to address the eating patterns or problems of those with “doubtful addiction.”

The Carbohydrate Addict’s Diet as a Lifestyle: Who It Works for, Who Should Look Elsewhere

This program has a huge following and has helped many people. I suspect that those who score highest on the Carbohydrate Addict’s Test are the best candidates for this diet. There are many people for whom the idea of giving up their favorite foods, even if it’s not for the rest of their lives and even if it will result in demonstrably improved health and a great deal of weight loss, is simply too great a sacrifice to contemplate. This program has great appeal to people who feel that way and who find enormous comfort in the fact that they’re never more than 24 hours away from any food they choose to eat. On the other hand, there are many people who are simply too carbsensitive or sugar-addicted to be able to handle trigger foods in any amount, even if it is only once a day. If this is you, you should look for a more carbrestricted plan.

JONNY’S LOW DOWN
  

I have absolutely no doubt that there is such a thing as carbohydrate (and sugar) addiction, but I’m not at all sure that the mechanisms behind it are fully understood. The Hellers are very sincere, very kind people who have helped thousands of people, but the theory behind the program is, depending on where you stand, either really weak or completely false. While it seems pretty clear that there are both insulin and serotonin abnormalities in the obese, it’s not at all clear that high levels of insulin depress levels of serotonin, as the Hellers hypothesize—in fact, the majority of the evidence points to the opposite response
.

Current thinking is that it works like this: insulin not only removes sugar from the bloodstream, but also removes amino acids (protein). Tryptophan, the building block of serotonin, is a little runt of a molecule that is constantly competing with the other amino acids for “elevator space” into the brain, where it can be converted to serotonin. As Kathleen DesMaisons, PhD, author of The Sugar Addict’s Total Recovery Program and an expert on addictive nutrition, colorfully explains, it’s as if a bunch of big bodybuilders and a little runty guy are standing around the gym, waiting for the bench press. All of a sudden, a really great-looking chick walks into the gym and all the bodybuilders gravitate to her, leaving the bench press empty for the runty guy. Insulin functions in the body like the great-looking chick: it temporarily removes the competition, letting tryptophan get up into the brain.
²
Hence, it is thought that more insulin increases serotonin, not lowers it
.

The Hellers predict that the more insulin you have hanging around, the less serotonin in the brain, giving rise to all those terrible cravings. A recent article in the Journal of Clinical Epidemiology
³
suggested exactly the opposite. It found that insulin sensitivity (which would mean lower levels of insulin) was positively related to suicide and accident rates—the authors postulated that accidents and suicide are frequently associated with lowered serotonin. In this model, less insulin goes with less serotonin. The Hellers, remember, postulate the opposite: for them, insulin resistance (higher levels of insulin) equals less serotonin. Calvin Ezrin, MD, author of Your Fat Can Make You Thin, explains the mechanism rather well and shows why high levels of insulin lead to higher levels of serotonin, not lower ones
.
⁴

The two-shot, biphasic theory of insulin release seems to be completely misunderstood by the Hellers. According to Dr. David Leonardi, who lectures worldwide on diabetes and is the medical director of the Leonardi Medical Institute for Vitality and Longevity in Denver, insulin is indeed released in two phases, but there is not a 75-to-90-minute gap between the two
.

“
If you eat a bunch of carbohydrates in fifteen minutes, believe me, you’re not going to have to wait sixty minutes to get that second phase of insulin release,” he says, raising questions shared by many about the theory behind the one-hour time limit on the reward meal
.
⁵

Finally, I’m not comfortable with the short shrift exercise gets in this program. The Hellers are entirely right that exercise alone is not a great weight-loss method, but it’s vital to both maintaining weight and to raising metabolic rate
.

But sometimes a program works well even if it is not for the reasons its designers believe. The Hellers have come up with something that works for a lot of people, even if they’re not 100% correct about why
.

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WHAT IT IS IN A NUTSHELL

A six-step plan to get back on track if you’ve fallen off the low-carb wagon. Alternately, this could be seen as a nonthreatening, step-by-step approach to getting on the Carbohydrate Addict’s Diet
.

About the 7-Day Low-Carb Rescue and Recovery Plan

The dedication in the book that outlines this plan tells you a lot. It reads: “To all of us who have been told to ‘just eat sensibly.’” According to the Hellers, who pioneered their theory in the Carbohydrate Addict’s Diet, carbohydrate addicts are like nearsighted people in a farsighted world—the prescriptions that help others just don’t apply. And the subtitle of the book reveals its intention:
For Every Low-Carb Dieter—On Any Program—Who Needs Real Help Right Now
. That pretty much tells the tale. The 7-Day Low-Carb Rescue and Recovery Plan is about getting back on track.