Living Low Carb (45 page)

Rosedale isn’t of the opinion that protein should be unlimited, and I think he may be right on this. He recommends limiting protein to 50 to 75 grams a day. Remember, protein doesn’t have a neutral effect on insulin (the way fat does). “Extra protein can be converted into glucose and burned as sugar, which causes spikes in leptin and insulin levels, which in turn cause sugar cravings,” he points out.

Rosedale’s variation on the low-carb theme is lower in protein than, for example, the Eades program, and—perhaps counterintuitively—concentrates on fat. (Remember, fat is the one macronutrient that has virtually no effect on insulin!)

Rosedale’s take on fat is some of the sharpest and most accurate writing I’ve yet seen, and should be read by everyone. For openers, he distinguishes between “good” and “bad” fat, but he actually knows what he’s talking about. Don’t expect the usual “saturated fat is bad, unsaturated fat is good” platitudes. “Some types of fat are bad for you all the time,” he says, “and some types of fat are bad for you only some of the time. The health effects of fat often depend on what you eat with it.”

Amen.

He warns against too much omega-6 (found in vegetable oils that the conventional establishment thinks are healthful all the time), completely forbids trans-fats, and even points out the fact that saturated fat sometimes has an
advantage
in the diet. But he doesn’t recommend eating a huge amount of saturated fat since, in general, “it is the toughest fat to burn.” “If you are looking to shed pounds, it is best to limit (not eliminate) your intake of saturated fat.”

I have to give Rosedale credit also for being just about the only nutrition doctor I’ve ever read who actually questions the universal mandate that omega-9’s (monounsaturated fat such as that found in olive oil) is great. “I’m not convinced that monounsaturated or omega-9 fat has any special health properties, yet people who eat monounsaturated fats seem to be protected against certain common diseases.” He suggest that the health benefits seen by people consuming the Mediterranean diet (which is famously high in olive oil) get those health benefits more because of the amazing beneficial phenols and antioxidants in olive oil and nuts rather than the omega-9 fat itself. “I believe that the major benefit of monounsaturated fat is what it is
not
,” he says. “It is
not
bad for you and doesn’t have any of the negative effects of other oils.”

Clearly, Rosedale is a guy who thinks for himself.

The Rosedale Diet is divided into two levels: Level 1 and Level 2. “I consider Level 1 to be the healthiest possible diet,” Rosedale says, “and one that will not only help you lose weight quickly, but will give you the best shot at longevity.” On the diet program, you stay on Level 1 for at least three weeks, though you can opt to stay on it forever. “It is basically the diet that I follow most of the time,” Rosedale says. Level 2 contains a wider variety of foods (a few more servings of fruits and starches), but is still a hugely healthful diet.

On the first three weeks of the Rosedale Diet (Level 1), you’ll eat nuts, nut butters, avocados, olives, all kinds of fish, poultry, game, veggie burgers, and even some selected dairy. Protein powders are okay, as is plain tofu, and there’s the usual list of “free” vegetables, from asparagus to zucchini. A few high-fiber starches, limited legumes, tea, and just about any spice you can name round off the list. You don’t count calories, but eat until you’re full, which winds up being less than “usual” because you don’t crave sweets and your body is becoming less leptin-resistant.

After the first three weeks, you can opt to move to Level 2 and begin to add a wider variety of foods, including fruits and legumes, coffee and wine. Off the menu—pretty much permanently—are milk, most full-fat hard cheeses, processed meats, certain legumes (including peanut butter, which I’m not sure I agree with), very starchy vegetables, sugar, commercial fruit juices, soda, and all fried foods. (I have a few minor disagreements with some of the foods on the “banned” list, but for the most part I think he’s nailed it!)

How long can you stay on the diet? The short answer is forever, if you want to. “I consider the Rosedale Diet the optimal diet for life and I urge patients to stay on it forever,” he says. “If you keep your leptin levels down, you will not experience the constant hunger or food cravings that helped make you overweight and sick in the first place, and that makes diets difficult or impossible to maintain.”

The Rosedale Diet as a Lifestyle: Who It Works for, Who Should Look Elsewhere

For those who are metabolically suited to a hunter–gatherer diet of protein, vegetables, and fat (with a few judiciously chosen extras thrown in for good measure), this is a terrific weight-loss plan that you can actually stay on for life.

If you’re okay bucking the conventional-establishment “wisdom” on fat, this is a program definitely worth looking at. The only danger here is the same danger that exists with Atkins—assuming that once you lose the weight, you can continue eating this way plus add back all the junky carbs you used to eat. This program works, but not when you add a bunch of useless carbs to it.

JONNY’S LOWDOWN
  

One thing you can say about the Rosedale Diet that you can say about few other diet books on the market is this: you will actually learn something from it. The information on leptin alone—and its relationship to insulin, stress, and aging—is worth the price of the book. The diet is designed to “turn off your hunger switch,” which certainly makes sticking to a plan a lot easier than gritting your teeth and relying on willpower all the time. Well worth reading, and well worth following.

22. T
HE
6-W
EEK
C
URE FOR THE
M
IDDLE
-A
GED
M
IDDLE

M
ICHAEL
R. E
ADES
, MD
AND
M
ARY
D
AN
E
ADES
, MD

WHAT IT IS IN A NUTSHELL

The authors of Protein Power turn their attention to the problem of visceral abdominal fat (VAT)—also known as the “spare tire.” VAT is an important factor in diabetes, obesity, and “middle-aged spread,” and it’s one that has enormous health consequences. Particularly suitable for those over 40.

About The 6-Week Cure for the Middle-Aged Middle

Without question, two of the smartest advocates of low-carb dieting in the world are the husband-and-wife team of Mary Dan Eades, MD and Michael R. Eades, MD. (Their best-selling books
Protein Power
and
The Protein Power Lifeplan
are discussed on pages 210–215.) In their latest,
The 6-Week Cure for the Middle-Aged Middle
, they focus their sights specifically on the problem of middle-aged girth.

Though most people aren’t aware of it, fat really comes in two “flavors”—visceral and subcutaneous. The later is more unsightly—it’s the stuff that makes your thighs push against each other in your jeans, the stuff that causes you to ask “Does my butt look big in this?” But the former—visceral fat—is far more dangerous.

“Typically, in middle age, people are afflicted with visceral fat,” explain the Eadeses. While subcutaneous fat is basically contained within a nonrigid, rubbery wall (the skin) and tends to puddle when going from vertical to horizontal, visceral fat is typically contained within the abdominal wall. It’s visceral (abdominal) fat that correlates the most with bad health outcomes and conditions like insulin resistance and diabetes. That’s the reason you’ve heard (correctly) that “apples” (people who store their fat around the middle) are at more risk for health problems than “pears” (people who store it in the thighs and butt). While both can be “unsightly,” it’s the abdominal fat that is a real health concern. Getting rid of visceral fat—or what is properly known as VAT (for visceral adipose tissue)—is the focus of
The 6-Week Cure
.

This program couldn’t have arrived at a more opportune time. Just as I was writing this review, the November 12, 2008 issue of the
New England Journal of Medicine
was published, featuring a widely reported study showing that belly fat was linked to early death. In the study, which followed 360,000 Europeans for over 10 years, those who had the most belly fat had double the risk of dying compared to people with the least amount of belly fat. That’s pretty striking. And that’s on top of previous research showing an association between VAT (belly fat) and a host of other diseases including some cancers, diabetes, and even dementia.

VAT also correlates with something that’s becoming endemic in this country, although at the moment it’s flying under the radar—Non-Alcoholic Fatty Liver Disease (NAFLD). “A recent study on middle-aged people in the Dallas area who had no known health problems showed that 34 percent of this population had liver fat accumulation,” Michael Eades told me. “And a recent autopsy study from San Diego found that 12 percent of adolescents who died from accidents
already
had fat accumulations in their livers. Those who were overweight had much greater accumulation.”

“Clearing fat from the liver is essential to getting rid of VAT,” explain the Eadeses. They give techniques to do this in the book. Surprisingly, consumption of saturated fat helps
rid
the liver of fat, at least in animal studies. Here’s how we know: Researchers give animals alcohol to get them to develop fatty livers quickly. If they add vegetable oil and/or fructose to the mix, the livers fatten more quickly. If they add saturated fat, it’s difficult to get the animals to develop fatty livers, even in the face of continued alcohol consumption. “If you look at the epidemic of NAFLD in this country, it pretty much correlates in time with the advice to reduce saturated fat and replace it with vegetable fat,” says Mike Eades, “not to mention the increase in the consumption of fructose.” While the Eadeses are quick to point out that correlation doesn’t mean causation, it’s certainly easy to make that leap, especially in light of the animal research.

Early in this book, I discussed the work of an old-time GP in New York named Blake Donaldson, MD (see page 13). Donaldson was a mainstream physician who experimented with all-meat diets for his patients, largely as an attempt to treat allergies. The Eadeses discuss Donaldson, as well as another old-timer named Walter L. Voegtlin who, quite independently, experimented with the same all-meat diet as a way of treating ulcerative colitis and Crohn’s disease. Both serendipitously discovered an interesting “side-effect”: all their patients lost weight!

In
The 6-Week Cure for the Middle-Aged Middle
, the Eadeses “deconstruct” the principles behind the all-meat diet and put it back together in the form of a protein shake. You start on three shakes a day plus a protein meal, then move to what is basically an all-meat diet. In the last two weeks of the 6-week diet, you progress to a more typical low-carb diet. “Results have been pretty spectacular in the patients we’ve worked with, many of whose histories are described in the book,” Mike Eades told me.

In virtually every book on low-carb eating, the focus is on the oversecretion of insulin. The mechanism is now familiar to anyone reading this book—blood sugar rises, insulin is secreted, the cells eventually become resistant to its actions, and the body secretes more and more insulin in an (often futile) attempt to get blood sugar back down. But insulin can build up in the bloodstream in two ways, not one. The first is oversecretion; the other is undermetabolism. And undermetabolism is a unique focus of the Eades program.

Here’s how it works. One of the many jobs of the liver is to metabolize proteins (one of which is insulin). But when fat builds up in the liver, the liver slows down and doesn’t work as well. It becomes sluggish, much like a bloated computer loaded down with unwanted programs. Ridding the liver of fat allows it to work better and to more rapidly break down and metabolize circulating insulin. If the insulin that’s hanging around is metabolized more efficiently, by definition there will be less of it hanging around. Less insulin hanging around has the effect of making the cells more sensitive to the insulin that’s left. (This is, after all, one of the major goals of a sugar-and-insulin-lowering low-carb diet.) And more sensitivity to insulin means that we can produce less of it to get the job done.