Nutrition (and diet) 201

For part 1, start here.

I’m self diagnosed as somewhat hypoglycemic. This is basically the opposite of being diabetic. In diabetes, the body does not produce enough insulin (the hormone that helps glucose [sugar] in the blood stream move into the cells for storage). With hypoglycemia, the body overproduces insulin in response to a sugary meal, causing too much circulating blood sugar to be removed.

I’m one of those people who gets crabby and shaky if I haven’t had something to eat in a while. (And once food is available, you had better not get between me and the meal if you want to walk out with all of your body parts intact). I once ate a butterfinger candy bar on an empty stomach while driving somewhere, and had to pull over and let my passenger take the wheel, I had become so shaky and light-headed from the blood sugar crash.

Strangely, this has actually served me well. I have learned to not eat sugar on an empty stomach if I want to be functional. No doughnuts for breakfast, no matter how good they look on the break room table or how hungry I am. No eating the whole box of cookies in one sitting because they are there. There is nothing like the correlation of feeling lousy and having a headache after eating something to make you not want to repeat the experiment.

So generally, I have pretty good control around sweets. A small piece after a meal and I’m good to go. (I’d probably weigh 150 lbs if this were not so). But bread…that’s a different matter. Give me a good loaf of crusty chewy bread and a bit of butter or oil to put on it, and I’ll keep eating it until it is gone, often even after the meal itself is done.

When I found my weight creeping up in my 30’s, I started researching what I could do about it. I’m not one to weigh out all of my food to the last teaspoon and count every calorie. I know this works for some people (in fact, it is often a necessity to help them learn portion control), but I wanted to lose 5 lbs, not 50, and counting calories was just too persnickity for me. While reading Prevention magazine, I kept seeing references to the South Beach Diet, which they were promoting heavily at the time. The diet was designed by cardiologist Arthur Agatson for his heart patients, as an alternative to the low fat Ornish and Pritikin diets advocated by the American Heart Association in the 1980′. It was the fact that it was designed by a cardiologist (science, people) that caught my interest. And it did not require you to count calories. I ordered the book and dove in.

The main thing I learned? Glycemic index, baby. Glycemic index is a measure of the effects of carbohydrates (i.e. sugars) in a food on blood sugar once eaten (and was originally designed for diabetes patients). Lower glycemic index foods are digested at a slower rate, release their sugars into the blood stream at a slower rate, and thus even out the spike/drop blood sugar pattern typical when one eats an easily digested/high glycemic index meal.

To test a food’s glycemic index, food must be eaten by real human subjects. Pure glucose is given a baseline value of 100. Subjects are given an amount of food to eat where the carbohydrate content equals 50 grams (so the amount of food eaten varies depending on what else is in it. A 16 oz coca cola has about 50 grams of carbohydrate. You’d have to eat three apples or four cups of raw carrots to reach the same 50 g of carbohydrate) and then their blood sugar is monitored for 2 hours. Many fruits and vegetables (but not potatoes) contain very little carbohydrate per serving, and the average person is not likely to eat 50 g of carbohydrate from these foods in one sitting. Therefore, fruits and vegetables tend to have a low glycemic index.

Low glycemic foods are < 55. Medium = 55-70. High > 70. High foods tend to be white and high in starch. White bread, white flour tortillas, white rice, potatoes. And of course, foods high in sugar (white or otherwise) because they sugar is a simple molecule that is easy to break down.

Because in order for a food to have an index, it needs to have been tested on human subjects, not every product you encounter will be on a list somewhere. The answer? Eat whole recognizable minimally processed foods, remember that calories in > calories out = weight gain and listen to your body. Yes, peanut M&M’s might have a low glycemic index, but they are also high in fat from the peanuts, and pretty low in nutrition, so you shouldn’t be substituting them for carrot sticks for your afternoon snack every day.

The other big part of the South Beach Diet is the idea that this constant blood sugar spike/drop pattern makes you constantly crave more food. They distinguish between real hunger (the feeling you get when you experience a normal and gradual drop in blood sugar about four or five hours after a meal) and a craving (caused by exaggerated spikes and dips in blood sugar that occur after eating highly processed carbohydrates like white bread, cake, and white rice. It’s this drop in blood sugar levels that causes a craving, not real hunger). But to break the cycle, you have to “detox” for a few weeks, fighting through the cravings until your body evens out and gets used to healthy eating.

Does it work? For me it does. When I have really mastered my cravings, I am no longer sitting on the couch at 8:00 pm thinking about the chocolate in the cupboard or the ice cream in the freezer. I truly don’t want it. And no more mid afternoon slump where all I want to do is take a nap under my desk. Are there other routes to this same end besides South Beach. Absolutely. South Beach just happened to be the gateway I found into what worked for my own body.

Fats, fiber, acids and protein will also slow down the digestive process somewhat. Faced with a big bowl of potato salad at a pot luck? If you only eat a small portion, you’ll have less of a blood sugar spike (because of the fat and acid in the mayonnaise and pickles) than you would if it was just a bowl of mashed potatoes. Have some pulled pork with that (skip the bun), add some baked beans, and you’ve added protein and fiber and some additional fat, which should also help you stay on an even keel. Is this better than a nice green salad with a small amount of vinaigrette and a lean grilled piece of chicken? No. You’re more likely to gain weight with the typical BBQ meal, but at least you’ll have the energy to go for a walk later to burn off the extra calories.

Do I follow the South Beach Diet to the letter? No. In the first version, it was recommended that diary be avoided in “phase 1”. I saw no reason for this, as plain low-fat yogurt has a low glycemic index and ricotta cheese was allowed. I tried out different things to see what worked for me. I listened to my own body. I used common sense. I ate yogurt and berries during phase 1. I did not find excuses to eat poorly (this flourless chocolate cake has a low glycemic index because it is mostly butter – so I’m going to have a piece).

But it did change the way I ate, and cooked (for a while I stopped baking with all-purpose flour all together) and shopped (packaged food = bad, shopping the perimeter of the grocery store = good). Do I fall off the wagon and eat a big hunk of ciabatta bread once in a while? Oh hell yeah. If I do this too much do I notice I’m searching for the cookies in the back of the cupboard at 10:00 pm? Yes. But this diet gives me a tool to bring things back into balance.

Next up: Control and Justification