Tài liệu Glycemic Load Diet: A POWERFUL NEW PROGRAM FOR LOSING WEIGHT AND REVERSING INSULIN RESISTANCE pdf

Rebalancing Your Metabolism 107 Focusing on What Caused You to Gain Weight 108 Relieving Insulin Resistance: The Rewards 114 vii Contents... Folks who had been unsuccessful at losing wei

A POWERFUL NEW PROGRAM FOR LOSING WEIGHT AND REVERSING INSULIN RESISTANCE

Glycemic

Load Diet

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Professional

Want to learn more?

To Kathy, Maggie, John, and “Nan”

Insulin Resistance: A Hormonal Imbalance,

Not a Character Defect

1 Understanding Why You Gained Weight 3

Sleuthing the Hormonal Culprit: Syndrome X 7Solving the Mystery: Insulin Resistance 8How You Can Reverse Insulin Resistance 13

2 Starch Toxicity: How Our Staples Turned Out

Bread, Potatoes, and Rice: How “Natural” Are They? 18Starch Poisoning: The Price of Civilization 19The Obesity Epidemic: How America Got Fat 22Too Much Starch, Not Enough Exercise, or Both? 26

For more information about this title, click here

3 Understanding What Makes Bad Carbs Bad 29

The Weight-Loss Power of Low-Carb Eating 30Why Some Carbs Are Different from Others 33

Part 2

The Glycemic-Load Diet and Slow-Twitch Muscle

Activation Plan

4 Lightening Your Glycemic Load: The Key to

Why Glycemic Indexes Are Misleading 42

Reducing Your Glycemic Load: A Simple Plan

5 Job One: Purge Starch from Your Diet 49

How I Became a Human Glycemic-Load Meter 50Strategies for Eliminating “Starchy Fillers” 50Cushioning the Glucose Shocks from Starch

6 Eliminate Sugar-Sweetened Beverages 63

Alcohol: Beware of Its Appetite-Stimulating Effects 66Milk: Acceptable for Glycemic-Load Watchers 66Coffee and Tea: Good Beverages in Moderation 67Water Is Great, but Do We Really Need Eight

7 Make Friends with Your Sweet Tooth 69

How Sugar Can Help You Lose Weight 71

8 Activate Your Slow-Twitch Muscles 75

Turning on Your Metabolic “Switch” 80

9 Avoid Diet-Induced Metabolic Shutdown 85

Crash Dieting: A Metabolic Train Wreck 85

Heading Off Metabolic Shutdown Before It Hits 89

Part 3

Strategies to Balance Your Metabolism

and Stay on Track

10 Crafting a Fat-Balancing Strategy 93

The Differences Between “Bad” and “Good” Fats 94Improving the Quantity and Quality of Fats

11 Managing Cholesterol with a

Low-Glycemic-Load Diet 99

Determining if You Have a Cholesterol Problem 103

12 Rebalancing Your Metabolism 107

Focusing on What Caused You to Gain Weight 108

Relieving Insulin Resistance: The Rewards 114

vii

Contents

13 Low-Glycemic-Load Meals and Recipes 117

Appendix A: Glycemic Loads of Common Foods 201 Appendix B: Converting to Metrics 209 Appendix C: References 211 Appendix D: Websites 215

Acknowledgments

I am indebted to my agent, Elizabeth Frost-Knappman, forencouraging me to write this book and shepherding it through itsearly stages Natasha Graf, my editor at McGraw-Hill, wasimmensely helpful, bringing her considerable talents to bear onguiding me through the development and organization of themanuscript

Molly Siple, M.S., R.D., provided exactly the recipe-writing

touch I was seeking Ms Siple is nutrition editor at Natural Health magazine, chef extraordinaire, and author of several acclaimed cookbooks, including Low-Cholesterol Cookbook for Dummies (John Wiley and Sons, 2004), Healing Foods for Dummies (IDG Books, 1999), and Recipes for Change: Nutrition/Cookbook on Foods for Menopause (Dutton, 1996).

She has taught at the Southern California Cordon Bleu School ofCulinary Arts and continues to lecture and write articles oncooking and nutrition

I would like to thank my longtime friend Lean Carroll forcarefully reading and editing the manuscript and patiently shar-ing her thoughts with me I am also indebted to my office staff,Nadine Warner, Lisa Gierlinski, and Charlene Brown, for sooften going beyond the call of duty to make my life enjoyable.Most of all, I would like to thank my wife, Kathy, certainly forher editing skills but especially for her unwavering patience,encouragement, and support

Copyright © 2006 by Robert Thompson Click here for terms of use

Introduction

When I started practicing medicine twenty-five years ago, Ifollowed the party line I recommended calorie counting andlow-fat diets for weight loss and was usually disappointed by theresults People just kept gaining weight Then, in the 1990s,some of my patients started ignoring warnings about fat andcholesterol and going on low-carb diets The results were aston-ishing Folks who had been unsuccessful at losing weight foryears started shedding pounds more easily than they thoughtpossible even as they ate generous amounts of rich food.Remarkably, their blood cholesterol and sugar levels looked bet-ter than ever It was as if they had stopped ingesting a toxin thathad been poisoning them for years I became convinced that thelow-carbohydrate approach had tremendous potential for help-ing people lose weight and regain their health Indeed, as addi-tional research came out, the medical establishment, mired inlow-fat orthodoxy for decades, has come around to thinking thesame way

But just when medical science is focusing more attention oncarbohydrates, the public’s interest in low-carb diets is waning.People rushed to try the Atkins diet—a radical low-carb regi-men popularized in the 1970s—and the South Beach diet, a sort

of second-generation Atkins diet, but the programs didn’t workthe way they hoped People lost weight but usually gained itback Although these diets allowed plenty of rich food, they cre-

Copyright © 2006 by Robert Thompson Click here for terms of use

ated irresistible food cravings People just couldn’t continuethem for long Disillusionment set in, and the low-carb crazebegan to die down.

In recent years, billions of dollars have been spent ing human body chemistry Medical science knows much moreabout carbohydrate metabolism now than it did when the low-carb movement began:

research-• Food scientists have developed a way of measuring themetabolic effects of different carbohydrates, called the

glycemic index This concept, only in its infancy when

the low-carb movement began, has evolved into a

power-ful model, the glycemic load This new way of looking at

carbohydrates radically changes the low-carb approach

to losing weight It is the key to a natural promoting eating style that is satisfying and easy enough

weight-loss-to follow for life

• Scientists now know that most overweight people have a

genetically influenced metabolic disorder called insulin resistance that makes them susceptible to weight gain

from eating carbohydrates with high glycemic loads.Researchers have pinpointed the foods and behavior pat-terns that bring out this condition and can now targettreatment toward relieving it

• Recently, physiologists have discovered the metabolicquirk that causes insulin resistance It’s a disorder of the

body’s slow-twitch muscle fibers What’s exciting is that

exercising these muscle fibers creates much less fatiguethan exercising others

These and other new concepts can help you harness theweight-loss power of carbohydrate modification and slow-twitchmuscle activation with a lifestyle that’s much easier to followthan previous weight-loss regimens It really is possible to loseweight without “dieting,” in the usual sense of the word, orengaging in strenuous exercise

Over the years that I’ve worked with people trying to loseweight, I have developed a sense of what people are capable of

I am convinced that willpower is not a prerequisite for successand, in fact, can be a liability When it comes to losing weight,

we all have limited supplies of energy and discipline What’s

crit-ical is finding the right strategy, and the key is knowledge If you

come to understand the physiological disturbances that causedyou to gain weight, you will know exactly what you need to do

to lose it Indeed, once you see the light, I think you’ll find thatshedding pounds and keeping them off for good are much easi-

er than you thought

xiii

Introduction

Part 1

Insulin Resistance:

A Hormonal Imbalance, Not a Character Defect

Copyright © 2006 by Robert Thompson Click here for terms of use

1

Understanding Why You

Gained Weight

It’s enough to drive you crazy You’re constantly battling your

weight while others seem to stay thin effortlessly They don’texercise, they eat anything they want, but they don’t get fat.The perplexing thing about the obesity epidemic—and this hasbeen true of other scourges throughout history—is that somepeople are more vulnerable than others They suffer from theharmful effects of our modern lifestyle, while others seem to beimmune Overeating and lack of exercise are not the whole story.But for years, people thought that being overweight was amatter of choice Just as some folks played golf or did crosswordpuzzles for enjoyment, others got their kicks from eating Doc-tors knew of certain hormonal disturbances that could make peo-ple gain weight, but they thought these were unusual Mostoverweight people just chose to be the way they were

Of course, who in their right mind would choose to be fat?

If it came to a decision between being overweight or getting hit

by a truck, some people would probably opt for the truck Almosteveryone would agree: obesity is unattractive, cumbersome, andunhealthy

Being overweight, then, suggested you were either willed or had some kind of psychological problem However,

weak-Copyright © 2006 by Robert Thompson Click here for terms of use

when psychologists got around to studying overweight peoplesystematically, they came up empty-handed It turns out thatoverweight people are psychologically no different from thinfolks They have some bad habits, but no more than anybodyelse They get a little depressed, but who wouldn’t be? One thing

is certain: they aren’t weak-willed Obese people often showremarkable self-discipline in other aspects of their lives After all,

65 percent of Americans are overweight Do all of these peoplehave some kind of character defect? Of course not

It’s Not a Matter of Willpower

Do you remember when you were a kid and you tried to see howlong you could hold your breath? It was easy at first, but after aminute or so, you developed a different mind-set Lack of oxygentriggered chemical reflexes that told you in no uncertain termsyou needed to breathe Certainly, the need for oxygen is moreurgent than the need for food, but the principle is the same If youreduce your caloric intake, changes in your body chemistry stim-ulate powerful hunger-driving reflexes that overrule lesser con-cerns like how good you look When those instincts say “eat,”unless you have unusual willpower, you eat You can postpone it

for a while—and you have some control over the kinds of foods

you eat—but if you try to defy the urge, you usually come awaythe loser

The reason self-deprivation rarely works for losing weight isthat it defies deeply rooted survival instincts Consider this: Yourbody burns about 1.2 million calories a year If your weightdepended on your consciously regulating the amount you eat,misjudging by 2 percent (that’s about two bites of a potato a day)would add or take off forty-two pounds in ten years Who canfine-tune their eating that much? Your body can’t afford to rely

on your whims It has its own mechanisms for balancing calorieintake with energy output

Just as a lack of willpower didn’t make you gain weight, ply willing yourself to eat less is unlikely to result in lastingweight loss You might think you can dial down your calorie con-sumption at will, and maybe you can for a while But let’s face

sim-it: if you’re like most people, you’ll eventually return to your oldways.

A Matter of Hormones

In recent years, scientists who study body chemistry have covered several hormones that regulate body weight Here are afew examples:

dis-• Your thyroid gland makes a hormone called thyroxin,

which helps regulate how fast your body burns calories

• Your stomach secretes ghrelin to stimulate your appetite

when your stomach is empty

• Your intestines produce peptide YY to curb your appetite

when your intestine has enough food to work on

• Your fat cells secrete leptin to reduce your appetite when

your fat stores have been replenished

Those are only some of the hormones known to control weight,and scientists are still discovering new ones The point is this:powerful chemical reflexes regulate the balance between thecalories you take in and the rate you burn them off Body weight

is not simply a matter of choice.

The hormone systems that regulate body weight evolved overmillions of years during times when hunger was a constantthreat Although these mechanisms helped keep fat accumulation

in check, their main purpose was to prevent starvation Ofcourse, our diet and activity patterns have changed a lot sincethe Stone Age, but our body chemistries work the same Whenour weight-regulating systems sense we’re not getting enough toeat, hunger-stimulating hormones arouse powerful cravings, andenergy-regulating hormones reduce the rate at which our bod-ies burn calories The desire to eat dominates our thoughts, andour bodies do everything they can to replenish fat

So the reason you’re overweight is not that you lackwillpower It’s because something upset the systems that matchyour caloric intake with your energy expenditure Certainly,

choices were involved You influenced the form those calories

5

Understanding Why You Gained Weight

took—whether they were carbohydrates, fats, or protein—butyour body’s weight-regulating mechanisms determined how muchfood you needed to quell your hunger You can’t ignore thoseinstincts Mustering up the discipline to starve yourself is not theanswer You need an approach that doesn’t rely on willpower.But if you have such little control over how much you eat,how can you lose weight? It’s easier than you think, but you justcan’t do it by a frontal assault on deeply rooted survival instincts.There are dozens of ways to lose weight You can cut fats,cut carbs, count calories, fast, go on an exercise kick, or haveyour stomach stapled But if a particular problem—say a hor-monal imbalance, a lifestyle quirk, or a certain kind of food—caused you to gain weight, does it make sense to starve yourselfwithout trying to correct the conditions that caused the problem

in the first place? If you don’t fix what’s wrong, whatever causedyou to gain weight is bound to come back and haunt you

Unlocking the Mystery of Obesity

In recent years, billions of dollars have been spent on ing human metabolism, and indeed, medical science has mademajor breakthroughs in solving the mystery of obesity Althoughthese advances have been obscured by the usual controversy, junkscience, and diet hype that surround the issue of weight loss, oldways of thinking are being turned upside down Scientists nowhave a clearer idea of why people’s weight-regulating mechanismsfall out of kilter and what can be done to put them back in bal-ance Here is the picture that is emerging

research-If you’re like most overweight people, three conditions verged to cause you to accumulate excess fat:

con-1 You inherited a common genetic quirk that affects a type

of muscle fiber in your body called a slow-twitch fiber, making these muscles resistant to the effects of insulin, a

hormone needed to metabolize the sugar glucose

2 Lack of regular activation of your slow-twitch fiberscauses them to spend too much time in a metabolically

dormant state in which they don’t respond normally to

insulin, a condition called insulin resistance.

3 The insensitivity of your muscles to insulin makes you

vulnerable to the harmful effects of dietary starch, the

main ingredient of “white” carbohydrates like bread,potatoes, and rice Starch releases more glucose intoyour bloodstream and does it faster than any other kind

of food

If your muscles are resistant to insulin and you consumequantities of starch typical of our modern diet, your pancreas

gland has to make five or six times the normal amount of insulin

to handle the glucose in your blood And that’s the problem.Insulin is a powerful obesity-promoting hormone—scientists call

it the “feasting hormone.” It triggers overeating and encouragesyour body to store calories as fat Try as you will, you can’t keepthe pounds off

There’s another problem with starch: instead of traversing thefull twenty-two feet of your digestive tract as other foods do, itshort-circuits into your bloodstream in the first foot or two Itnever reaches the last part of your intestine, where certainappetite-suppressing hormones come from Even though starch ischock-full of calories, a few hours after eating it, you’re hungryagain

Sleuthing the Hormonal Culprit:

Syndrome X

Doctors have known for years that certain medical conditionscan throw people’s weight-regulating mechanisms out of kilter

The best known of these conditions is hypothyroidism, an

under-active thyroid gland Many folks wish they had this conditionbecause it’s so easy to correct with pills However, most people’sweight problems are not caused by thyroid trouble

Although doctors have known for years of conditions that

cause obesity in some people, until recently they couldn’t

pin-7

Understanding Why You Gained Weight

point what caused most people’s weight gain Whatever it was,

though, it was apparent that it was extremely common, the ern lifestyle aggravated it, and it got worse with age Then sci-entists got a clue from doctors who took care of heart patients

mod-In the 1980s, clinicians began to notice that patients who hadheart attacks had an unusually high incidence of the followingphysical characteristics and laboratory findings:

• Visceral adiposity, a tendency to accumulate fat in the

abdomen

• High blood levels of a type of fat called triglyceride

• Low blood levels of HDL, a protective kind of

cholesterol particle also called “good cholesterol”

• Mildly elevated blood pressure

• Borderline high blood glucose levels

When several of these findings occurred in the same individual,

it raised the risk of blood vessel blockages even when blood cholesterol levels were normal Not knowing what caused this

phenomenon, doctors called it syndrome X or the metabolic syndrome.

Solving the Mystery: Insulin Resistance

Recently, researchers solved the mystery of syndrome X It’s

caused by insulin resistance This discovery was to turn the world

of nutrition upside down and invalidate much of what doctorspreviously believed about diet, obesity, and heart disease It alsoexplained why excessive dietary starch and physical inactivitymake some people gain weight but not others

Insulin resistance isn’t exactly a disease—it’s a variation inthe way people’s bodies process carbohydrates, foods your bodybreaks down to glucose About 22 percent of the American pop-ulation can’t handle the starch and sugar in their diets withoutproducing excessive insulin Although these folks usually have agenetic propensity to insulin resistance, having the tendencydoesn’t necessarily cause the condition People who are heredi-

tarily predisposed can go their entire lives without manifesting it.Something else—something in their activity and eating pat-terns—has to bring it on.

Insulin resistance is basically a muscle problem Your

mus-cles are the main users of glucose, and insulin regulates their sumption Exercise increases your muscles’ responsiveness toinsulin, so they take up more glucose Inactivity decreases theirsensitivity, so they take up less While the lack of physical activ-ity that characterizes the typical modern lifestyle causes somedegree of insulin resistance in everybody, it renders the muscles

con-of genetically prone individuals particularly insensitive to insulin.

Although lack of physical activity brings on insulin resistance,this wouldn’t be such a problem if we ate only meat and raw veg-etation, as our prehistoric ancestors did The body doesn’t needmuch insulin to handle those foods Meat contains virtually noglucose, and the glucose in fresh fruit and vegetables trickles intoour bloodstreams slowly, requiring only small amounts of insulin.The only foods in our diet that call for large amounts of insulinare refined carbohydrates Insulin resistance becomes a problemonly when we consume more starch and sugar than our bodiescan handle

There’s another important factor that brings on insulin tance: being overweight itself It’s a vicious cycle Weight gainworsens insulin resistance, and insulin resistance, in turn, pro-motes more weight gain Even if you weren’t insulin resistant tobegin with, if you’re overweight, you’re more insulin resistant

resis-now than you were before Insulin resistance locks you into being

overweight

The Thrifty-Gene Hypothesis

Why are so many of us genetically prone to such a troublesomecondition as obesity? One benefit of being overweight is that you can withstand starvation better than thinner folks can Inancient times, when humans regularly went long periods with-out food, the ability to store up calories as fat was an advan-tage Because this trait increased the chances of survival during

9

Understanding Why You Gained Weight

famine, more and more humans passed it on to the next ation Biologists call this explanation for why we get fat the

gener-“thrifty-gene hypothesis.”

Did the tendency to store excess fat predispose our ancestors

to diabetes and heart disease? Undoubtedly, it did, but in toric times, people rarely lived long enough to develop such prob-lems In the Stone Age, the average life span was less than thirtyyears Also, people’s diet and activity patterns helped protectthem from these conditions

prehis-How Insulin Resistance Affects Your Health

Excessive demands for insulin, high blood triglyceride levels, andwide fluctuations of blood glucose levels typical of uncheckedinsulin resistance cause myriad health problems, including thefollowing:

• Type 2 diabetes: If insulin production can’t keep up with

demand, glucose levels begin to rise, causing the

condition called type 2 diabetes Uncontrolled diabetes

literally sugarcoats tissues and can eventually lead toeye, kidney, and blood vessel damage

• Islet cell burnout: The islet cells of the pancreas, which

secrete insulin, also make a substance called amylin.

When they secrete excessive amounts of insulin they alsoproduce excessive amylin High concentrations of amylin

turn into an insoluble sludge called amyloid that

damages the very cells that secrete it Biopsies of thepancreases of patients with type 2 diabetes often showreplacement of insulin-secreting cells by amyloid

• Hypoglycemia (low blood sugar): One of the earliest

signs of insulin resistance is what’s commonly called

“low blood sugar.” It might seem strange that a

condition that leads to high blood sugar could cause lowblood sugar, but when insulin-resistant individuals gothree or four hours without eating, they often

experience weakness, poor concentration, and a strongcraving for food, all of which are promptly relieved by

eating Actually, the term “low blood sugar” is a

misnomer When the pancreas has to make large

amounts of insulin, it often overshoots, causing glucoselevels to fall too fast This triggers a surge of another

hormone, adrenaline, which stops glucose from falling.

It’s the adrenaline—not low blood glucose—that causesthe shakiness and poor concentration typical of

hypoglycemia Adrenaline highs and lows typically occurseveral times a day, causing quirky eating patterns,frayed nerves, and end-of-the-day fatigue

• Heart and blood vessel disease: When your body gets

more glucose than it can handle, your liver turns theexcess to fat globules, which travel through your

bloodstream to your fat deposits in the form of

triglyceride Although triglyceride doesn’t damage

arteries directly, high concentrations reduce blood levels

of “good cholesterol,” HDL, which raises the risk ofblood vessel disease even when bad cholesterol levels arenormal (I talk about this more in Chapter 11.)

• Menstrual difficulties: In women, insulin resistance

sometimes brings on polycystic ovary syndrome (PCOS),

which causes irregular periods, ovarian cysts, abnormalhair growth, and acne PCOS is the leading cause offemale infertility in the United States, affecting

approximately 6 percent of women It can be treatedwith a low-starch diet, exercise, and insulin-sensitizingmedication

• Sleep apnea: Accumulation of fat in the abdomen and

neck typical of insulin resistance interferes with

breathing during sleep This causes excessive snoring and

aggravates sleep apnea, a form of erratic breathing that

robs sleep of its restfulness

Making the Diagnosis

Although doctors recognized that many of their patients hadinsulin resistance, they had no idea how common it was untilresearchers tested large segments of the population According to

11

Understanding Why You Gained Weight

a recent government study, 22 percent of the American tion has insulin resistance—44 percent of those older than fiftyyears Among overweight individuals, the incidence is 85 percent.The bottom line is this: if you’re overweight, you probably haveinsulin resistance.

popula-Measuring insulin resistance directly is a tedious laboratoryprocedure usually done only in research centers However, doc-tors found they could accurately surmise its presence by lookingfor signs of syndrome X Here are the criteria, defined by theNational Cholesterol Education Program, for diagnosing it Ifyou have any three of the following five characteristics, you prob-ably have insulin resistance:

1 A tendency to accumulate fat in the abdomen: abdominal

girth measured at your navel of thirty-eight inches ormore if you’re a male or thirty-four inches if you’re afemale, or a waist measurement more than 95 percent ofyour hip circumference measured around your buttocks

if you’re a male, 85 percent if you’re a female

2 High blood triglyceride level: a triglyceride level greater

than 150

3 Low blood level of good cholesterol: an HDL level below

40 if you are male or 50 if you are female

4 Borderline or high blood pressure: systolic blood

pressure greater than 130 or diastolic blood pressuregreater than 85

5 Borderline or high blood glucose: fasting blood glucose

level greater than 110

Super X’ers

Viewed from behind, you could hardly tell Henry was overweight

He had narrow hips and little fat on his arms or legs However,

in profile you could see that he had a potbelly His abdomenextended several inches beyond his belt His girth was forty-twoinches His triglyceride level was 280

When Henry reduced his starch intake and started walkingregularly, he lost weight Impressed at how easy it was, he began

testing himself to see how much rich food he could get away witheating He was amazed to find that he could consume generousamounts of fatty foods—even more than he was naturallyinclined to eat—yet continue to lose weight.

I often encounter patients who have especially flagrant signs

of syndrome X—abdominal girth more than forty-two inches formales or thirty-eight inches for females and triglyceride levelsgreater than 225 I call such folks Super X’ers It’s gratifying towork with these individuals because they usually respond dra-matically to measures that relieve insulin resistance

For Super X’ers, eliminating carbohydrates is like taking away

a toxin from people who have been poisoning themselves As long

as they avoid starch, they often seem to be immune to gainingweight from eating fat

How You Can Reverse Insulin Resistance

The good news is that if you have insulin resistance, you don’thave to put up with it Few conditions in medicine are so easy to

treat Of course, you can’t change your genes However, you can

stop the blood glucose surges that trigger excessive insulin

secre-tion, and you can restore your slow-twitch muscles’ sensitivity to

insulin You do it by cutting out a handful of bland and ing foods and engaging in some physical activity that even couchpotatoes don’t mind doing If you do both of those things, yourinsulin levels will drop like a rock, your metabolism will fall backinto balance, and probably, without trying to cut calories orengaging in strenuous exercise, you will steadily lose weight

unexcit-Is this hard to do? Put it this way: there’s no easier way toshed pounds For one thing, starch is essentially tasteless Itreleases a few aromatic chemicals during chewing and a small

fraction breaks down to glucose in your mouth that you can taste.

However, most of it ends up in your stomach without your ing it When you eliminate starch, you’re essentially only remov-ing flavorless paste Most of the satisfying tastes and textures inthe food you eat stay In addition, starch contains no importantvitamins or minerals This is important because deficiencies ofvital nutrients create irresistible food cravings Getting rid of

tast-13

Understanding Why You Gained Weight

refined carbohydrates only makes you healthier No creature everdied for lack of starch.

As for activating your slow-twitch muscle fibers, if youascribe to the no-pain, no-gain philosophy of exercise, you mightfind what I’m going to tell you hard to believe, but there are mus-cles in your body that require virtually no effort to exercise Agood example is your diaphragm, the main breathing musclebeneath your rib cage It doesn’t take much effort to breathe,does it? These kinds of muscles are powered by slow-twitchfibers, which, as it turns out, are the ones that determine yourbody’s sensitivity to insulin (I cover this in more detail in Chap-ter 8.) In other words, the muscles you need to activate to relieveinsulin resistance are precisely the ones that require the leasteffort to use Even folks who dislike exercise can do it and actu-ally enjoy it

The combination of removing the starch from your diet and

activating your slow-twitch muscle fibers is also the simplest way

to lose weight Although I have included many delicious starch recipes in this book, there is actually no need for specialfood preparation You can go to the same restaurants as before,eat alongside everybody else, and attract no attention You onlyneed to avoid a handful of foods, which you can quickly learn torecognize

low-You Can Start Today

At your next meal, hold off eating any bread, potatoes, or riceuntil you finish everything else, and then, if you must, have about

a quarter of what you usually eat Do not deprive yourself of food Make up for eating less starch by helping yourself to more

of everything else This is not a calorie-cutting diet It’s a way ofreducing the amount of insulin your body has to make

If in addition to reducing your intake of those “white foods”you walk thirty minutes every other day, after a few days, yourbody chemistry will function much differently than it did before.Your pancreas will make a fraction of the insulin it was produc-ing, your blood sugar will stop fluctuating wildly, and fat glob-

ules will disappear from your blood You will have removed thedriving force behind your weight gain.

You might also notice that you feel better Highs and lows ofblood glucose cause your body to make excessive amounts ofadrenaline, which jars your nerves and leaves you feeling burnedout and exhausted Smoothing out these fluctuations makes youfeel calmer and gives you more energy later in the day

Believing in What You’re Doing

It is possible to lose weight by doing either of those inating foods that cause glucose surges or increasing your mus-cles’ sensitivity to insulin—but the secret is to do both The two

things—elim-approaches potentiate one another—that is, one makes the other

more effective Eliminating blood glucose surges improves yourmuscles’ sensitivity to insulin, and improving your muscles’ sen-sitivity to insulin stabilizes blood glucose levels

Although the changes you need to make to relieve insulinresistance are as small as they can possibly be and still produceweight loss, they are changes nonetheless, and they need to bepermanent This is not a fad diet meant to be started and stoppedwhen you have reached a goal To ingrain new eating habits andactivity patterns, you need to believe in what you’re doing andknow how to do it In the next few chapters, I’m going to showyou the science behind the principles I have outlined here Onceyou understand what made you gain weight, you’ll see clearlywhat you need to do You’ll learn what the easiest, most effectiveway is to stop your body from overproducing insulin If instead

of trying to starve yourself you concentrate on correcting whatcaused you to gain weight, you’ll be astonished at how easy it is

to shed pounds and keep them off for good

15

Understanding Why You Gained Weight

2

Starch Toxicity:

How Our Staples

Turned Out to Be Toxins

One thing is for sure, if your weight has been creeping

up lately, you’re not alone A lot of us have the sameproblem How did so many of us get this way?

To gain weight, you have to take in more calories than youburn off Otherwise, your body would defy the laws of thermo-

dynamics The question is not whether you consumed more ries than you burned off but why you consumed more calories

calo-than you burned off Your body has weight-regulating nisms that are supposed to balance food intake with energyexpenditure What’s throwing those systems out of kilter?You hear a lot these days about toxins in the food chain—things like mercury, PCBs, and iodine The alleged culprit is usu-ally a chemical introduced into the environment by humans andfound to be harmful to laboratory animals in large doses Themedia sound the alarm, people fuss about it for a while, and thenthe hysteria dies down No one seems to get sick from thesethings As a doctor, I’ve personally never seen any illness I couldrelate to mercury, PCB, or iodine toxicity It makes interestingnews, but the amounts of these pollutants in our food are usuallymuch too small to make us sick

mecha-Copyright © 2006 by Robert Thompson Click here for terms of use

However, I do see patients suffering from the effects of

another toxin every day It’s a mixture of two chemicals, amylase and amylopectin, that people introduced into their food only

recently in the span of human existence But unlike the toxinsyou read about in the newspapers, this one exists in our food in,frankly, toxic concentrations Although its effects are subtle,sometimes taking years to do its damage, it often leads to pro-gressive disability, disease, and death Where are we getting thistoxin? We make a point of adding it to nearly every meal we eat.It’s the main ingredient of bread, potatoes, and rice and is more

commonly known as starch.

Bread, Potatoes, and Rice:

How “Natural” Are They?

Starch is, in fact, the same tasteless paste laundries use for ening shirt collars The word starch comes from the Old English

stiff-word sterchen, “to stiffen,” which is what it does to your

arter-ies Most of us don’t think of starch as a toxin because the foodsthat contain it are so familiar to us We’ve been eating bread,potatoes, and rice all our lives, as have our parents and grand-parents Indeed, many people can get away with eating largeamounts of starch without harmful effects because they are genet-ically resistant to its harmful effects or have certain activity pat-terns that protect them However, for those of us who aresusceptible—which includes about 40 percent of the popula-tion—starch toxicity is a menacing reality Consumption ofamounts common in our modern diet can lead to serious prob-lems like diabetes and heart disease—but not before causing years

of unsightly, frustrating obesity

When you’re young, your body can handle a lot of starch.Your pancreas makes plenty of insulin, and your tissues respondvery well to it However, as you age—especially if you have agenetic predisposition to insulin resistance—the way your bodymetabolizes glucose slowly changes Your pancreas continues tomake plenty of insulin, but your body begins losing its respon-siveness to it As a result, your pancreas has to make increasing

amounts of insulin to keep your blood glucose levels down Astime passes, your body’s ability to produce insulin begins to lag.

If the pancreas can’t secrete enough insulin to overcome insulinresistance, glucose starts backing up in the bloodstream, the con-

dition we call diabetes.

The tissues that line blood vessels are particularly vulnerable

to high blood glucose levels Diabetes eventually leads to vessel disease, the most common cause of death and disability inthe industrialized world However, diabetes is only the late stage

blood-of starch toxicity Prblood-ofound body chemistry disturbances precedediabetes by decades, causing quirky appetite regulation andimbalances between good and bad cholesterol that promote cho-lesterol buildup in arteries The most frustrating problem,though, is a tendency to accumulate excess body fat

Starch Poisoning: The Price of Civilization

How did the foods we rely on most to prevent hunger—the called staples like wheat, potatoes, and rice—end up causing somuch trouble? For millions of years, humans roamed the earth,hunting game and gathering natural vegetation for food Starchwas not a major part of their diet They consumed it only inminute quantities locked in the protective husks of seeds thatwere not particularly appealing to eat

so-In nature, starch provides a concentrated source of energyfor seeds to sprout The seeds of grasses that are native to regionswith long, hot dry seasons and short, temperate wet seasons areespecially high in starch, which jump-starts these plants so theycan mature quickly during short growing seasons Impermeablehusks protect the seeds from the sun and predators during the dryseason

Around ten thousand years ago—very recently in the span ofhuman existence—people living in the eastern Mediterraneanregion and South Asia, where wheat and rice grew naturally, fig-ured out how to extract the starchy cores of the seeds from theirprotective husks by grinding them between rocks They usedthese kernels to stave off starvation when meat and fresh vege-tation were scarce For the first time, humans discovered a plen-

19

Starch Toxicity: How Our Staples Turned Out to Be Toxins

tiful source of calories for which they didn’t have to compete withother predators and that they could store for months.

Later our ancestors found that by adding water and heatingthese kernels, they could make them more palatable As timepassed, they discovered more ways to make starch taste better.They added fat to flour to make it moist, leavened it with yeast

to lighten it, and added sugar to sweeten it Because high-starchfoods have to be processed or “refined” before they can be eaten,

they have come to be called refined carbohydrates.

The cultivation of wheat in the West, rice in Asia, and corn

in the New World was a boon to humankind These staples vided—and continue to provide—an efficient means of prevent-ing starvation Of all the foods humans eat, refined carbohydratessupply by far the most calories with the least investment of land,labor, and capital

pro-Not only did the domestication of wheat, rice, and cornchange the human diet, but it also transformed civilization Theability to stockpile food supplies freed humans from having toforage constantly This encouraged cooperation, division of labor,and eventually formation of governmental structures Along withgovernment and spare manpower came armies of conquest Even-tually, the eastern Mediterranean and South Asian regions gaverise to the dominant civilizations of the world, and reliance onstarchy staples spread to most societies on earth

A Monumental Change in Body Chemistry

The cultivation of refined carbohydrates represented a majorchange in the human body’s chemical environment Prehistorichumans ate only small amounts of starch entangled in fiber andencapsulated in impervious husks It takes hours for the diges-tive tract to process such foods It was a shock to the humanmetabolism when, instead of the occasional granule of starch,people began consuming cupfuls at every meal in concentrated,rapidly digestible form

Your body handles refined carbohydrates differently fromother kinds of foods As soon as starch hits your stomach, itbreaks down to glucose, which short-circuits directly into your

bloodstream without traveling more than a few inches down yourintestinal tract Within minutes, your blood glucose levels shoot

up to heights never experienced by your prehistoric ancestors

If genetic changes were needed to handle this abrupt change

in digestive physiology, the human race has not had enough time

to evolve them Genetic adaptation requires millions of years, butstarchy staples have been around for only about ten thousand—

a mere tick of the evolutionary clock It isn’t surprising that theshift to refined carbohydrates that has occurred in the last fewthousand years has had a profound effect on human health

The Two Faces of Starch Toxicity

Excessive starch consumption manifests itself in two ways, pending on whether there is sufficient intake of other foods In un-derdeveloped countries where populations rely heavily on starchystaples for survival, refined flour, rice, and potatoes have sup-planted other sources of nutrition, many of which are vital togood health Because starch provides little in the way of vitamins,minerals, or protein, deficiencies of these nutrients are rampant inthese areas In parts of Africa and Asia that rely heavily on starchystaples, as much as 40 percent of the population suffers from iron-poor blood caused by lack of meat and iron-containing vegetables.Iron deficiency is so widespread in some countries that it mea-surably affects their economies Another major health problem

de-in poor countries is kwashiorkor, a disease of protede-in deficiency.

This condition weakens the immune system and causes children

to die of otherwise minor illnesses like measles and chicken pox

In addition, many children in these regions suffer from rickets, a

disease of calcium deficiency that causes weakening and bending

of bones These conditions are practically unheard of in areaswith adequate supplies of meat and dairy products

Excessive consumption of refined carbohydrates causes a ferent set of problems in developed countries In these parts of theworld, people can choose from a wide variety of foods, and vit-amin, mineral, and protein deficiencies are rare But while mostinhabitants of industrialized nations aren’t dependent on starchfor survival, they still eat large amounts of it The problem in

dif-21

Starch Toxicity: How Our Staples Turned Out to Be Toxins

these countries is not the crowding out of other foods by starchbut rather the toxic effects of starch itself Excessive amounts ofrefined carbohydrates have caused epidemics of obesity anddiabetes.

Why Do We Eat So Much Starch?

Economics drive our dependence on starch Bread, potatoes, andrice are cheap People can eat their fill without spending a lot ofmoney Not only is starch economical for consumers, it’s cheapfor food producers, and sometimes they can obtain patents ontheir processing techniques so other firms can’t compete withthem This allows manufacturers to sell their products at highprofit margins The potential for large profits encourages pro-ducers to think up ever more imaginative ways to prepare andmarket starch, and large price markups over production costsallow revenue for advertising Consequently, firms that manufac-ture brand-name processed foods, like crackers, chips, and break-fast cereals, advertise heavily In contrast, producers of foods intheir natural state can’t obtain patents on their products With-out the ability to exclude competition, suppliers of fresh fruit,vegetables, meat, and dairy products have to maintain competi-tive prices The only way they can make a profit is by keepingtheir overhead down Consequently, they don’t advertise much.You rarely see television ads for fresh produce

As a rule, when others are paying for the ingredients of thefood you eat, their economic incentive is to feed you starch.That’s why restaurants are happy to see you fill up on bread,potatoes, and rice The profit margin on a McDonald’s ham-burger is razor thin Fast-food restaurants make most of theirmoney selling french fries and soft drinks

The Obesity Epidemic:

How America Got Fat

In 1962, 13 percent of the American population was obese(defined as being thirty pounds overweight or more), and that

percentage had remained stable for decades Then, around 1970,the numbers suddenly started rising By 1998, the proportion ofobese Americans more than doubled to 31 percent, and the inci-dence of diabetes, which is often brought on by excessive weightgain, rose sixfold What caused the obesity rate to suddenly shoot

up like this?

You’ll hear many explanations for why so many people areoverweight these days Proponents of various theories usually citesome evidence to support their opinions, but the data are oftenflawed It’s hard to study people’s diets You can’t put humans inpens, the way you can with laboratory animals, and control whatthey eat In a sense, though, we all live in a sort of pen—the onedefined by our national borders The U.S Department of Agri-culture keeps close tabs on the types of foods Americans eat, andthe National Health and Nutrition Examination Survey carefullytracks people’s height and weight If you combine these twosources of data, you can gain some compelling insights as to why

we are gaining weight

In the 1950s and 1960s, Americans reveled in their ability toeat fresh farm food, including eggs, meat, and dairy products.For the first time in history, mass agricultural production, refrig-eration, and rapid transportation made these goods available andaffordable for most citizens Americans remembered harder timesduring the Great Depression, when people suffered from iron-deficiency anemia and rickets caused by lack of adequate nutri-tion To be able to enjoy fresh produce, which prevented suchconditions, was a privilege

Then, around 1970, something came along that chilled ica’s ardor for eggs, meat, and dairy products Government agen-cies and medical organizations, concerned about the risingincidence of heart disease, started recommending low-fat, low-cholesterol diets—not just for people prone to artery disease butfor everybody The theory was that reducing the cholesterol infood would reduce cholesterol in people’s blood and prevent heartattacks This public health effort coincided with a rise in popu-larity of vegetarianism and a period of rampant inflation of meatand dairy product prices The result was an abrupt shift in eat-ing patterns away from eggs, red meat, and dairy food Table 2.1

Amer-23

Starch Toxicity: How Our Staples Turned Out to Be Toxins

shows how consumption of these foods has changed since 1970.Clearly, Americans did exactly what government agencies anddoctors told them to do: they cut down on fat- and cholesterol-containing foods We are now eating 16 percent less red meat, 23percent fewer eggs, and 52 percent less milk fat per person than

we did thirty years ago

If you eat less of one kind of food, you’re bound to eat more

of another Indeed, Americans are now eating more drates—plant-based foods The biggest change in the American

carbohy-diet in the last thirty years has been a dramatic increase in

con-sumption of refined carbohydrates: flour, rice, and potatoes As

you can see from Table 2.2, we are eating 48 percent more flour,

Table 2.1 Annual Consumption of Red Meat, Eggs, and Milk,

1970 Versus 1997

Consumption per Person

Change,

Milk fat (equivalent in whole milk) 114 qt 55 qt Down 52%

Source: U.S Department of Agriculture National Nutrient Database

Table 2.2 Annual Consumption of Flour, Rice, and Potatoes, 1970 Versus 1997

Consumption per Person

Change,

Frozen potato products (mainly french fries) 13 lb 30 lb Up 131%

Source: U.S Department of Agriculture National Nutrient Database