Living Low Carb (60 page)

Whenever a doctor tells me that there is “no good research” on vitamin supplements, I know he has never bothered to do a literature search on PubMed.

—Constantine X.

At the bare minimum, a highquality multivitamin and mineral formula should be part of everyone’s health regimen, even before considering any of the supplements discussed below. People eating grain-based diets can easily suffer from mineral depletions (see “What’s Wrong with Grains” on page 332), and so can people on low-carb diets, especially in the introductory phases. Mineral depletions can decrease activity in the energy-production cycles of the body, effectively slowing down your metabolism.
¹⁶
You want to make sure you’ve covered that base right at the beginning.

The Number One Supplement for Weight Control: It’s Going to Surprise You

It’s not expensive, it’s not exotic, and it’s not sexy, but it works like a charm. It’s plain, old-fashioned fiber. More than a dozen clinical studies have used dietary fiber supplements for weight loss, most with positive outcomes.
¹⁷
When you take the fiber supplement with water before meals, the watersoluble fiber binds to water in the stomach, making you feel full and less likely to overeat. It also suppresses hunger.
¹⁸
Fiber supplements have also been shown to enhance blood-sugar control and insulin effects and even to reduce the number of calories (adding up to about 3 to 18 pounds a year) that the body absorbs.
¹⁹
And a study in the prestigious
New England Journal of Medicine
found that a diet with 50 grams of fiber per day lowered insulin levels in the blood.
²⁰

One of the most impressive studies of all followed 2,900 healthy subjects for 10 years and looked at the relationship between fiber, cardiovascular disease, weight, and insulin. The results were spectacular. Fiber was inversely associated with insulin levels and weight,
and
low fiber intake turned out to be a better predictor of heart disease than saturated-fat consumption! The subjects who consumed the most fiber gained less weight over the course of the ten years than those who consumed the least.
²¹

Guar gum seems to be one of the most effective fiber supplements, but other studies have used glucomannan, which can be taken in pill form. If you choose this form, make sure to buy the capsules rather than the tablets, since you don’t want the fiber coming in contact with water until it gets into your stomach. Another way of adding fiber is with a powdered supplement like psyllium husks, flaxseeds, or even the old standby, sugar-free Metamucil. Some of my personal favorite fiber supplements are Cellulose Fiber by Vital Nutrients, Superseed by Garden of Life, or plain ground flaxseed. In addition, fiber has a ton of other wide-ranging positive effects on the body, like helping to prevent certain kinds of cancer and lowering cholesterol and triglycerides.

Americans currently get a paltry amount of fiber in their diets, estimated at 10 grams a day. Most health organizations like the American Cancer Society recommend about 30 grams, and our caveman ancestors got much more (maybe around 50 or 60 grams). You can—and should—add fiber by eating as many fibrous vegetables and fruits as you can, but it’s doubtful you’ll get enough to have the kind of therapeutic effect I’m talking about. So eat those vegetables, but supplement your intake as well. Incidentally, all the grain foods and cereals that we’ve been taught are a great source of fiber are actually fiber lightweights. Most commercial breads have a couple of grams at best, and most cereals have embarrassingly low amounts. The only two commercial cereals worth talking about when it comes to fiber are All-Bran and Fiber One, both of which have around 10 grams per serving. Nice.

Oh, one more thing. I have a theory that I’ll share with you. In those few studies where a high-carbohydrate, low-fat diet has been shown to help with weight loss or improve blood-lipid profiles, usually in controlled conditions like a clinic or other supervised setting, I believe that what created the benefit was
not
the low-fat diet but the fact that the researchers gave their subjects high-fiber foods. I believe it was the fiber that made the difference, as most of those studies substituted high-fiber carbohydrates for the ones the subjects had usually been eating. One of the reasons the GO-Diet got such a high rating in this book is that it is one of the few programs that truly emphasizes fiber as a constituent of weight loss and health.

A Supplements Overview

The supplements discussed in the following pages are the ones that have the strongest credentials for use in a weight-loss program. In most cases they have a sizable amount of research to back up their use, or they have been used successfully in clinical practice by responsible and thoughtful practitioners for a long enough time to warrant their inclusion in the discussion, or both. (Clinical observation should never be ignored. Remember that there was no good scientific research on aspirin until very recently—for decades, it has been used simply because it has been observed to work.)

There are also a few supplements that I have listed under the category
of possible use
, which will be discussed briefly at the end of the chapter. These supplements have some research behind them, but in my opinion the jury is still out—the research is either not yet strong enough, the clinical evidence not solid enough, or the results have been mixed. These supplements, however, bear watching and may turn out to be very useful.

Supplements of possible use:

•  gymnema sylvestre

•  hydroxycitrate

•  banaba leaf extract (corosolic acid)

The chart on page 295 shows the influence of various supplements on areas of concern to people on low-carb (or other) weight-loss programs.

B Complex

I put the majority of my clients on B vitamins. Energizing for many people, B vitamins are necessary for metabolizing carbohydrates, fats, and proteins, and your need for them increases significantly when you are under stress. A lot of people just plain feel better on them. Certain members of the B vitamin family, like B5, B6, choline, and inositol, have special importance to people on weight-loss programs. Choline is important in the transport and metabolism of fats, while inositol is important for the uptake of fatty acids by the cells. Both have been shown to alleviate, prevent, or improve fatty liver. They are usually included in a B-complex formula; “fat-burning formulas” may have increased amounts.

B5 (Pantothenic Acid)

B5 is “mother’s little helper” for the adrenal glands. It is used in the production of stress hormones, and some studies have shown that supplemental pantothenic acid can help us resist or withstand stress in general.
²²
If you are under stress or your adrenals are in danger of being burned out or exhausted, you most certainly need this supplement. I recommend taking it separately from the B complex, which you should take in addition. A good amount is 250 milligrams, twice a day.

B6

Vitamin B6 is one of the most important supplements you can take, and if you are a woman, it’s
especially
important. It helps convert estradiol, a very active form of estrogen, into estriol, a very benign form. Birth-control pills deplete the body of B6, and supplementing can help relieve the depression that sometimes accompanies use of birth-control pills.
²³
This may be because, for both women and men, B6 is necessary to convert tryptophan into serotonin, as well as for the synthesis of dopamine and norepinephrine, all neurotransmitters that affect weight and appetite. Remember that low serotonin states are almost always associated with carbohydrate cravings.

In addition, in some (but not all) animal studies, vitamin B6–deficient rats that were fed a high-protein (70% protein) diet developed fatty liver. A low intake of B6 can impair glucose tolerance.
²⁴
And in a low-carbohydrate diet, the body makes needed glucose from noncarbohydrate sources (like protein), a process called gluconeogenesis (for a full explanation of this process, see
chapter 2
). During gluconeogenesis, B6 levels are depleted from muscle, another reason for supplementing with B6 while on a low-carb diet.
²⁵
As with B5, I recommend that if you do supplement with B6, you take it at a different time than you take your B-complex vitamin. A good amount is 50 milligrams once a day, as long as you are also taking your B complex.

Vitamin C

Vitamin C basically helps almost everything. When you have high blood sugar, vitamin C can’t travel into the cells.
²⁶
While by itself vitamin C probably does not promote weight loss, it is depleted by stress—understandable, since it is found in very high levels in the adrenals and the brain
²⁷
—and, like vitamin B6, is necessary for making serotonin.
²⁸
If stress or depression contribute to your weight issues, you should definitely be supplementing with vitamin C, 1,000 to 2,000 milligrams per day.

Vitamin E

Vitamin E has a demonstrable effect on insulin resistance.
²⁹
According to diabetes expert Dr. Richard Bernstein, vitamin E in dosages of up to 1,200 IU a day has also been shown to reduce glycosylation, one of the most destructive and aging effects of high blood sugar (see
chapter 2
and “Alpha-Lipoic Acid” below). Bernstein recommends 400 to 1,200 IU a day to many of his patients. Note that the most commonly sold vitamin E is alpha-tocopherol, but this is only one of eight different components in vitamin E, and there’s a lot of evidence that just taking alpha-tocopherol by itself does not give you the maximum benefit. You should look for a combination of alpha-tocopherol and gamma-tocopherol, or even gamma-tocopherol alone. You should also look for a vitamin E supplement that contains tocotrienols, another set of very important heart-healthy compounds in the vitamin E family. Natural vitamin E is unquestionably more effective than any of the synthetic kinds.

The studies that showed benefit for insulin metabolism used 900 IU. Vitamin E is generally sold in 400-IU capsules. If you’re using vitamin E for its general protective effect, add at least 400 IU to your daily regimen, preferably 800. If you’re using it for its therapeutic effects on blood-sugar metabolism, take at least 800 IU.

Omega-3’s

Along with magnesium and alpha-lipoic acid, omega-3’s are the supplements I recommend for just about everybody. The impact of omega-3’s on so many areas of human health are so enormous that it would require a whole book to fully explain them (and several have been published, notably
The Omega Rx Zone
by Dr. Barry Sears and
The Omega-3 Connection
by Dr. Andrew Stoll). For our purposes, let’s talk about blood-sugar regulation and insulin resistance. The evidence that omega-3 fats increase insulin sensitivity and help with blood-sugar regulation is not perfect—some studies show that they have no effect,
³⁰
and a couple show that they do.
³¹
But virtually every clinician, including myself, who uses nutritional supplements with clients recommends omega-3’s—although, because of their numerous overlapping positive effects on the body, it’s difficult to say just what their specific role is in terms of blood sugar and insulin. Nonetheless, the clinical evidence for their use is overwhelmingly positive. Dr. Shari Lieberman, author of
The Real Vitamin and Mineral Book
, says it’s hard to say whether omega-3’s have a specific blood-sugar–lowering effect, though they
probably
do; but she points out that they
definitely
lower C-reactive protein, a measure of inflammation and a risk factor for heart disease that is often elevated in diabetics. “Personally, I think they protect the cells in the pancreas,” she says. Dr. David Leonardi of the Leonardi Medical Institute for Vitality and Longevity in Denver, uses omega-3’s routinely with his diabetic patients precisely for the anti-inflammatory effects. “Diabetes is a disease of inflammation, among other things,” he says. Omega-3’s also reduce triglycerides and increase good cholesterol. Omega-3’s are the first of the fatty acids to be depleted when you lose fat, so the need for supplementation increases even more when you’re on a weight-loss program.