Why We Get Fat: And What to Do About It (30 page)

Doctors who understand why we get fat and what to do about it are obviously hard to find; otherwise, this book wouldn’t be necessary. The truly unfortunate fact is that even those doctors who do understand the reality of weight regulation often hesitate to prescribe carbohydrate restriction to their patients—even if this is how they maintain their own weight. Physicians who tell their fat patients to eat less and exercise more, and particularly to eat the kind of low-fat, high-carbohydrate diet that the authorities recommend, will not be sued for malpractice should any of those patients have a heart attack two weeks or even two months later. The doctor who goes against established medical convention and prescribes carbohydrate restriction has no such safeguard.
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There are now innumerable diet books that preach carbohydrate restriction, not to mention cookbooks and websites devoted to low-carbohydrate eating, and even smart-phone apps that can be used for guidance. But it’s vital that doctors understand what I’ve discussed here, that they open their minds to these ideas and, more important, to the hard science that has too often been ignored. This is true of public-health officials, too, not to mention the obesity researchers themselves. As long as these authorities buy into the logic of calories-in/calories-out and dismiss carbohydrate restriction as a fad diet, we will suffer for it. We need their help, which is why this book was written as much for your doctors as for you. Until our doctors truly understand why we get fat, and until our public-health authorities do, the job of losing that fat and remaining healthy will always be far more difficult than it need be.

“No
Sugar, No Starch” Diet: Getting Started

This diet is focused on providing your body with the nutrition it needs, while eliminating foods that your body does not require, namely, nutritionally empty carbohydrates. For most effective weight loss, you will need to keep the total number of carbohydrate grams to
fewer than 20 grams per day
. Your diet is to be made up exclusively of foods and beverages from this handout. If the food is packaged, check the label and make sure that the carbohydrate count is 1 to 2 grams or less for meat and dairy products, 5 grams or less for vegetables. All food may be cooked in a microwave oven, baked, boiled, stir-fried, sautéed, roasted, fried (with no flour, breading, or cornmeal), or grilled.

THE PRIMARY RESTRICTION: CARBOHYDRATES

On this diet, no sugars (simple carbohydrates) and no starches (complex carbohydrates) are eaten. The only carbohydrates encouraged are the nutritionally dense, fiber-rich vegetables listed.

Sugars are simple carbohydrates.
Avoid these kinds of foods:
white sugar, brown sugar, honey, maple syrup, molasses, corn syrup, beer (contains barley malt), milk (contains lactose), flavored yogurts, fruit juice, and fruit.

Starches are complex carbohydrates.
Avoid these kinds of foods:
grains (even “whole” grains), rice, cereals, flour, cornstarch, breads, pastas, muffins, bagels, crackers, and “starchy” vegetables such as slow-cooked beans (pinto, lima, black beans), carrots, parsnips, corn, peas, potatoes, French fries, potato chips.

FATS AND OILS

All fats and oils, even butter, are allowed. Olive oil and peanut oil are especially healthy oils and are encouraged in cooking. Avoid margarine and other hydrogenated oils that contain trans fats.

For salad dressings, the ideal dressing is a homemade oil-and-vinegar dressing, with lemon juice and spices as needed. Blue-cheese, ranch, Caesar, and Italian are also acceptable if the label says 1 to 2 grams of carbohydrate per serving or less. Avoid “lite” dressings, because these commonly have more carbohydrates. Chopped eggs, bacon, and/or grated cheese may also be included in salads.

Fats, in general, are important to include, because they taste good and make you feel full. You are therefore permitted the fat or skin that is served with the meat or poultry that you eat, as long as there is no breading on the skin.
Do not attempt to follow a low-fat diet!

SWEETENERS AND DESSERTS

If you feel the need to eat or drink something sweet, you should select the most sensible alternative sweetener(s) available. Some available alternative sweeteners are: Splenda (sucralose), Nutrasweet (aspartame), Truvia (stevia/erythritol blend), and Sweet ’N Low (saccharin). Avoid food with sugar alcohols (such as sorbitol and maltitol) for now, because they occasionally cause stomach upset, although they may be permitted in limited quantities in the future.

BEVERAGES

Drink as much as you would like of the allowed beverages, but do not force fluids beyond your capacity. The best beverage is water. Essence-flavored seltzers (zero carbs) and bottled spring and mineral waters are also good choices.

Caffeinated beverages: Some patients find that their caffeine intake interferes with their weight loss and blood sugar control. With this in mind, you may have
up to 3 cups of coffee
(black, or with artificial sweetener and/or cream), tea (unsweetened or artificially sweetened), or caffeinated diet soda per day.

ALCOHOL

At first, avoid alcohol consumption on this diet. At a later point in time, as weight loss and dietary patterns become well established, alcohol in moderate quantities, if low in carbohydrates, may be added back into the diet.

QUANTITIES

Eat when you are hungry; stop when you are full
. The diet works best on a “demand feeding” basis—that is, eat whenever you are hungry; try not to eat more than what will satisfy you. Learn to listen to your body. A low-carbohydrate diet has a natural appetite-reduction effect to ease you into the consumption of smaller and smaller quantities comfortably. Therefore, do not eat everything on your plate just because it’s there. On the other hand, don’t go hungry! You are not counting calories. Enjoy losing weight comfortably, without hunger or cravings.

It is recommended that you start your day with a nutritious low-carbohydrate meal. Note that many medications and nutritional supplements need to be taken with food at each meal, or three times per day.

IMPORTANT TIPS AND REMINDERS

The following items are NOT on the diet:
sugar, bread, cereal, flour-containing items, fruits, juices, honey, whole or skimmed milk, yogurt, canned soups, dairy substitutes, ketchup, sweet condiments and relishes.

Avoid these common mistakes:
Beware of “fat-free” or “lite” diet products, and foods containing “hidden” sugars and starches (such as coleslaw or sugar-free cookies and cakes). Check the labels of liquid medications, cough syrups, cough drops, and other over-the-counter medications that may contain sugar. Avoid products that are labeled “Great for Low-Carb Diets!”

LOW-CARB MENU PLANNING

What does a low-carbohydrate menu look like? You can plan your daily menu by using the following as a guide:

A sample day may look like this:

READING A LOW-CARB LABEL

Start by checking the nutrition facts.

• Look at serving size, total carbohydrate, and fiber.
  
• Use total carbohydrate content only.
  
• You may subtract fiber from total carbohydrate to get the “effective or net carb count.” For example,
  if there are 7 grams of carbohydrate and 3 grams of fiber, the difference yields 4 grams of effective carbohydrates
  . That means the effective carbohydrate count is 4 grams per serving.
  
• No need to worry—at this point—about calories or fat.
  
• Effective carbohydrate count of vegetables should be 5 grams or less.
  
• Effective carbohydrate count of meat or condiments should be 1 gram or less.
  
• Also check the ingredient list. Avoid foods that have any form of sugar or starch listed in the first 5 ingredients.