May 22, 2006

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Dana Gets Some Time To Read

Sorry this newsletter has been so long in coming. I went out of town to visit family the weekend of the 5th - 7th , and so didn't write that weekend. I came home to the train-wreck that was Insight Broadband's switch-over to a whole new "backbone" - which I believe means that they shifted everything over to new hardware systems - servers and the like. It was an infuriating mess. My email malfunctioned for a few days, followed by five days of no internet service whatsoever. And since we have internet phone service 'round here, we had no phones, either! (Thank God for cell service. They were the only working phones in the house.)

With no internet service, I not only couldn't email, I couldn't do research at the USDA Nutrient Database, or Pubmed, or any of my other usual online haunts. I was out of business for a week, and when my service came back up, I had to get two columns written to make up for my impromptu week off. (If I'm going to have a week off, I'd like a little more warning next time. I could have gone camping or something.)

There was a benefit, though. Without the internet to work with, and more to the point, to distract me, I got a lot of reading done. Indeed, I read my way through three-count-'em-three books on carb-restricted nutrition. I read The Glycemic Load Diet, by Rob Thompson, MD, The No-Grain Diet, by Dr. Joseph Mercola, and Breaking The Vicious Cycle: Intestinal Health Through Diet, by Elaine Gottschall. All three books have things to recommend them, and they all have one important theme in common. I thought I'd give you an over view of each.

Of the three, the one I'd most recommend is The Glycemic Load Diet. I have long believed that the coming great wave of dietary recommendations (assuming that there isn't some huge conspiracy to give us all bad dietary advice, thus maintaining and enlarging the market for pharmaceuticals) will be based on the concept of glycemic load.

For those of you who aren't familiar with it, the glycemic load was devised to make the glycemic index useful in the real world. The glycemic index is the measurement of how rapidly a given carbohydrate food is absorbed, and therefore how fast and hard it spikes blood sugar. In general, a fast, sharp rise in blood sugar triggers a big insulin release (and all the hormonal mischief it causes) and a big blood sugar crash, bringing fatigue, irritability, and cravings for more carbs.

The problem with the glycemic index is that the tests use 50 grams of carbohydrate worth of the food being tested. On a practical level, that means they test a plateful of spaghetti, but a truckload of cucumbers! It doesn't take into account how food is eaten in the real world, and makes foods seem damaging that really aren't.

Take carrots. Carrots have a high glycemic index for a vegetable - around 50. But do you know how many carrots you'd have to eat to get fifty grams of carbohydrate? More than fifty of those little baby carrots! I like carrots, but that's a bit much. Accordingly, I feel free to use a carrot in a soup, or shredded in my coleslaw, or even munch one now and then as a snack.

That's where the concept of the glycemic load comes in. The glycemic load is defined as the glycemic index times the actual number of grams of carbohydrate eaten. Ten or below is a low glycemic load, 11-20 is medium, and anything over 20 is high.

(Let me state here that generally people put a decimal point in front of that glycemic index number. If you don't, then you have to go with 100 or below being a low glycemic load, etc. I point this out because the nice doctor who wrote The Glycemic Load Diet is one of the ones who leaves out the decimal.)

Five baby carrots - about what I'd eat off a relish tray - have 4 grams of carbohydrate. Multiply 4 x .50 and you get a glycemic load of 2 - very low.

But if you look at, say, oatmeal, you'll see something interesting. It has a glycemic index that's about the same as carrots. But a one-cup serving of cooked oatmeal has 25 grams of carbohydrate, for a glycemic load of 12.5. That's a big difference.

The point that Dr. Thompson makes in the The Glycemic Load Diet is that once you understand glycemic load, carbohydrate foods naturally divide themselves into two groups: starches and refined sugars, and everything else. It's the concentration of carbohydrates in the starches, and the artificial concentration of refined sugars, that makes them a problem. (Fruit juice has to be considered a "refined sugar" too, since the fiber is removed.)

Accordingly, Dr. Thompson feels that for most people, simply avoiding the concentrated carbohydrate foods, while eating vegetables, fruits, and the like freely, is sufficient dietary restriction to cause weight loss and improve health. I think that for the vast majority of carb intolerant folks, he's right.

Dr. Thompson also has some interesting things to say about exercise and insulin resistance. He feels that low intensity exercise - ideally walking - is best for improving insulin utilization. He also says that the effect only lasts roughly 48 hours, making a walk at least every other day a necessity.

The Glycemic Load Diet makes huge sense, is simple to understand and implement, and is very reader-friendly. I would recommend it to anyone.

I confess to being a little put out by Dr. Joseph Mercola's book The No-Grain Diet, and for kind of a silly reason: Mercola makes the common error of using the term "simple carbohydrates" to mean "refined carbohydrates," and "complex carbohydrates" to mean "unrefined carbohydrates." With all due respect, he's wrong. Simple carbohydrates are sugars, whether they're found in an apple or a can of Coke. Complex carbohydrates are starches, whether from brown rice or Wonderbread. The misuse of these terms is a pet peeve of mine, and when Dr. Mercola, a man I respect, makes this error, it sets my teeth on edge.

I'd be less likely to recommend The No-Grain Diet than The Glycemic Load Diet. The diet has lots of "levels," largely based on how pure and hard-core and restrictive you want to be, and makes everything far more complicated than it needs to be.

Dr. Mercola insists on organic everything, raw-milk cheeses, and grass-fed meat. I think all of these are fine things - I have grass-fed beef, raw-milk cheese, and organic lettuce in my kitchen this moment. But I think the important thing is to get people off of concentrated carbs - that alone will make a huge difference in health, whether you're eating organic or not. Too, I know that many people simply can't afford to buy all organic food, and I'd hate for them to think they can't make great strides with simple carb restriction, because they can.

Dr. Mercola also seems to be anti-pork and anti-shellfish, while I consider both to be excellent foods. Pork, in particular, has gotten a bad rap it doesn't deserve; it's not only a great protein, but one of the best sources of potassium, thiamine, and niacin. Unless you're keeping kosher, I see no reason to rule out these proteins.

(Dr. Mercola and I agree, however, that soy is not the Wonder Health Food of All Existence it's chalked up to be.)

I confess to also being put off a bit by something Dr. Mercola calls EFT, or "Emotional Freedom Technique." EFT consists of tapping yourself on various acupuncture points while repeating affirmations, like "Even though I crave this donut, I deeply and completely accept myself." He claims it will help you program yourself past any cravings or emotional ties to food. I suppose it could be so. I never really needed such a thing; I just needed to know what I had to eat to feel good, and that was enough for me. If you troubled by cravings and emotional ties to food, I suppose EFT couldn't hurt, and might help. I found it off-putting-ly New Age-y.

Those criticisms aside, I'm certain that The No-Grain Diet is a healthy one. I think it would very much appeal to folks approaching the idea of carb restriction from a history of being health-food types, and those who really like to do everything all the way.

Breaking The Vicious Cycle, by Elaine Gottschall, BA, M.Sc., is very different from The No-Grain Diet and The Glycemic Load Diet . It is not about weight loss, and does not recommend overall carbohydrate restriction. Instead, it outlines a program of restriction of specific carbohydrates as a way of treating intestinal disorders such as Crohn's Disease, irritable bowel syndrome, ulcerative colitis, and celiac. The current edition also includes the rather remarkable information that some parents have seen dramatic improvement in the condition of their autistic children by the use of the same diet.

Breaking the Vicious Cycle describes the Specific Carbohydrate Diet. Quite simply, the diet bans any carbohydrate larger than a single sugar molecule - glucose or fructose. These monosaccharides are the very simplest carbohydrates, and need no digestion to be absorbed. The theory is that those with irritable bowel disorders have difficulty digesting and absorbing any carbohydrate more complex than these, and that instead they fuel fermentation and bacterial growth in the gut. (The autism connection is theorized to arise from toxins formed in the gut by the bacterial overgrowth. I was unaware, but apparently a lot of autistic children also have bowel trouble.)

Therefore, the Specific Carbohydrate Diet bans all starches and most dairy. (Some cheeses, and homemade yogurt, incubated long enough to be sure all the lactose is broken down, are allowed.) It also bans the vast majority of processed foods, even those that have very little carbohydrate, because to those with these bowel problems, even a tiny bit of starchy filler can be a setback.

Please note: This means that many foods that are commonly used by low carb dieters would also be banned - low carb breads and tortillas, polyol (sugar alcohol) sweeteners, the inulin (fructooligosaccharides) that is often mixed with stevia extract, all would be off limits. Indeed, Gottschall states that saccharine is the only artificial sweetener allowed, though I'm unsure why. I'm quite certain that Splenda, with its maltodextrin bulking agent, would be a problem.

However, while table sugar is banned, honey - just as high in sugar - is allowed on the Specific Carbohydrate Diet because it is made up of simple sugars, while table sugar is a disaccharide - two sugar molecules linked together. Some fruit juices are allowed as well, so long as you are certain they have no additives.

If you or a family member suffer from inflammatory bowel disease, or you have autism in the family, Breaking the Vicious Cycle is very much worth reading. It's a complex diet, requiring virtually all foods to be made from scratch, but I'm sure that if you suffer from either of these problems it would be worth it and then some. You might get started at

Obviously, the purpose of the Specific Carbohydrate Diet is very different from that of The No-Grain Diet and The Glycemic Load Diet. People with inflammatory bowel conditions have trouble keeping weight on, not taking it off! Still, I find it fascinating that restricting carbohydrate intake has so many different beneficial effects.

I also find it telling that all three diets zero in on the same villain: Grains. More generally, a diet based on starches. We're having whole grains pushed at us from every side, we're being told they're not only beneficial, but essential to good health. I didn't believe it before. These books just reinforced that disbelief.

Posted by HoldTheToast at May 22, 2006 10:36 PM