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OBESITY - PART 2
by Eva Urbaniak, N.D.
It seems as though the discussion and debate of obesity goes on and on, meanwhile, the increasingly pervasive problem of obesity in the United States continues. So let's explore a few of the newest diet fads, and hopefully also offer some reasonable suggestions on how to beat obesity, and restore proper equilibrium to the body's metabolic processes.

THE ATKINS DIET, THE SOUTH BEACH DIET, THE ZONE DIET - ARE YOU CONFUSED?

Recently, there has been much press about rapid weight loss with the popular low-carbohydrate Atkins Diet, the South Beach Diet, and the Zone Diet. Americans spend almost 50 billion dollars a year on weight loss products and services. Still, over 50% of Americans are overweight, and the numbers are increasing by 1% per year. As any veteran dieter knows, it can be difficult to lose weight, and even more difficult keeping it off. Although eating too much and not being active enough is the cause of most obesity, the primary focus of losing pounds should be on achieving and maintaining health rather than on simply improving appearance. And in a country that equates being thin with beauty, intelligence and success, additional pressure to be thin can take its toll psychologically.

Successful weight loss and maintenance is about more than just diet. While there are many gimmicks, fads, plans and programs, a common sense approach to weight control offers the best chance at success. Weight that is lost slowly, steadily, the "old fashioned" way with portion control, dietary manipulation, calorie restriction, and especially, daily physical activity, is more apt to stay off than weight lost quickly through fad dieting.

The best and fastest way to lose body fat (and weight) is through steady aerobic exercise lasting longer than 20 minutes. During the early part of exercise, the body uses stored carbohydrate and circulating fatty acids for energy. It is not until after about 20 minutes that it starts to burn fat for energy. The sensible way to exercise is to start slowly and gradually, increasing duration and intensity as tolerated. Bicycling and walking are excellent choices. Other options include swimming, dancing, jogging and other activities.

IS A LOW-CARB DIET HEALTHY? LOW-CARB PROS AND CONS

Carbohydrates are necessary for life, the body's major energy source, providing calories, fiber and naturally occurring sugars. Lowering carbohydrate intake also lowers calories, so it does make sense to control the amount of carbs a person eats. But how many carbs should a person eat per day to lose weight and still be healthy?
A carb is a carb, but what constitutes a bad carb or a good carb? For the purpose of our discussion let's just call them simple and complex carbohydrates.

Simple carbs are those found in refined white sugar, white flour, candies, soda pop, and sugary breakfast cereals. They are absorbed quickly and cause a rapid rise in blood sugar. These ultra-refined, processed simple carbohydrates in the form of bleached white sugar and white flour products ARE the "bad carbs," the ultimate culprits! Those who eat a diet containing too many refined carbs, cannot utilize them all, so they get stored as fat.

Complex carbs are found in vegetables, fruit, whole grains, nuts, and seeds, and do not cause rapid elevation of blood glucose and insulin. Technically, fruit is a source of complex carbohydrates, however because it is sweet, and contains fructose, or fruit sugar, although a more complex sugar than glucose or sucrose (table sugar), it has been unjustly maligned, and many authors are telling us not to eat fruit. Since the preferred fuel of choice for the body's use is glucose, the liver must convert fructose to glucose, an energy-requiring step, so fructose does not cause as rapid a rise in blood sugar as sucrose does. And the fiber in fresh fruit slows down the absorption of the fructose even more. Fresh fruit also contains vitamins, enzymes, and pectin, which provide good nutrition and aid in digestion. Fruit is part of a healthy diet.

FOOD FOR THOUGHT

Before we delve into the complexities of the new "low-carb" world, consider that successful, permanent changes to one's diet include eating foods that satisfy hunger for longer periods of time. Dr. Suzanne Holt, professor of biochemistry at the University of Australia has been doing research on CCK (cholecystokinin), a hormone that sends the signal to the brain for us to stop eating-the "I'm full" hormone. Interestingly enough, what she discovered is that another food item that has been maligned by the low carb proponents, the humble (and yummy) potato, came up as the number one food in releasing CCK in the body, and also bears a satiety value higher than all other foods, at a whopping 323%.

In order of percentage, a list of other high satiety foods is as follows:

  • Fish 225%
  • Oatmeal 209%
  • Oranges 202%
  • Apples 197%
  • Brown Pasta 188%
  • Beef 176%
  • Baked Beans 168%
  • Grapes 162%
  • Whole Grain Bread 157%

The above foods are often included in healthful weight loss diets, but now that we know how they satisfy our hunger for longer periods of time, it makes even more sense to include them. But with the exception of the fish and beef, a low-carb dieter would avoid them. So it appears that the challenge is to either eat sensibly, a variety of foods that satisfy our hunger, or jump on the fad wagon and eat "low-carb."

WHAT CAN A LOW-CARB DIET DO FOR YOU?

Although current research has shown that test subjects that ate carbohydrate-restricted diets not only lost weight, but dramatically lowered all markers for inflammation, high triglycerides, cholesterol, and diabetes, (in fact, the Zone Diet was developed to help patients with severe inflammation), the conclusion drawn in one study was that that more long-term studies are needed. In another study of very overweight adults, many of whom were diabetic, the low-carb group lost more weight than the low-fat group. But eliminating carbohydrates entirely from the diet is not healthy long-term, because lack of fiber can increase the risk for cancer and other serious diseases. In fact, Dr. Barry Sears, author of the book, Enter the Zone, and innovator of the Zone Diet, the late Dr. Atkins and Dr. Arthur Agatston, author of the South Beach Diet, all concurred that certain carbohydrates must be re-introduced after initial weight loss occurs. But with all these plans, a specially structured diet and menu plan, portion control, and calorie restriction are built in.

AN OVERVIEW OF THE CURRENT POPULAR DIETS

The Atkins Diet eliminates many carbohydrates like fruits and starchy vegetables, and consists of foods such as meat, eggs and cheese, broccoli and salads, but this eating plan can be difficult to stick to for a long period of time, and even Dr. Atkins himself, recommended bringing certain fruits and other carbohydrate containing foods back into the diet once target weight has been achieved. Dr. Atkins stated that sugar was lethal, so sweets and desserts are forbidden. He also acknowledged the fact that no two people (or glucose tolerances) are alike, so one person may be able to eat bananas and lose weight, and another may not. For weight loss on the Atkins Diet, it is recommended to limit carbohydrate intake to 20 grams of carbohydrates per day, and once significant weight loss is achieved, extra carbs can be added one at a time, until weight loss ceases. To continue weight loss, carbs need to be decreased again.

The Zone Diet breaks a meal down into percentages: 40% carbs, 30% protein, and 30% fat. These percentages are broken down into "blocks" and "mini-blocks." A block is made up of three mini-blocks from each macronutrient category of carbs, protein and fat. Up to 11 blocks per day are allowed. Although there is more variety and less deprivation with this diet, the calculations can get complicated. An easier way to incorporate the Zone, especially because an eating plan has to be one that a person can stick to for life, is to divide you plate into thirds; one third should be protein and the other two thirds, low-density carbohydrates, or vegetables, or a salad and a vegetable. Another helpful hint from Dr. Sears is to never eat a protein portion larger than the palm of your hand.

With the Atkins and Zone Diets, an entire new line of food products has been developed; so diet-conscious consumers are buying bars, mixes, and prepared foods at an unprecedented rate.

The South Beach Diet is neither low-carb, nor low-fat, but relies more on healthy protein and the healthier carbs. The South Beach Diet author, Dr. Arthur Agatston takes a frank and serious look at the connection between diet, nutrition and obesity, and addresses the problem of sugar and carbohydrate addiction. A cardiology specialist, he admits that he was overweight, out of shape, and needed to find a plan that would help him get back into shape. He couldn't find such a plan, and was disillusioned with the American Heart Association's low-fat diet, so he invented his own, which became the South Beach Diet. Regarding carbohydrates, he states, "The faster the sugars and starches you eat are processed and absorbed into your bloodstream, the fatter you get." This is why for the first two weeks of his diet plan, no sugar or white flour, breads, pasta, or certain sweet fruits like bananas are allowed.

The evening news continues to faithfully report on obesity and even share some reliable information concerning the problem.
Recently, soda pop was the subject of discussion. The high fructose corn syrup with which it is sweetened was implicated in obesity. Have you ever read the nutrition facts on a can or bottle of pop? One can contains 48 grams of carbohydrate, all from sugar. The equivalent of 12 teaspoons of sugar go into one can of pop.

Another interesting news item was about the "Supersize Me" man, Morgan Spurlock. This man ate at a fast food restaurant for one month, asked for the "supersized" entrées, and proceeded to gain a whopping 26 pounds, almost a pound a day! His blood chemistry also significantly changed for the worse, to the point that his doctor advised him to stop the experiment because he was becoming ill. He has produced a documentary about his experience, which should make good viewing. It should be obvious to anyone that a supersized portion of anything except water is not conducive to weight loss. Imagine how many carbs are in a supersized soda pop-double or triple the amount in a can!

"LOW-CARB" TAKES OVER THE FOOD INDUSTRY AND FOOD MANUFACTURERS -- "NET CARBS"-- HAVE YOUR CAKE AND EAT IT TOO

At last year's NNFA (National Natural Foods Association) convention, I explored all the aisles of food displays, and was amazed how this "low-carb" fad had really overtaken the food industry. To me, "natural foods" mean just that, foods that are as close as possible to the way they come from Nature. But most of the foods displayed, with the exception of some green drinks, yogurts and other milk products, were all highly processed and sweetened with all sorts of newly invented sugar substitutes.
I found a cookie that said it had only 2 net grams of carbohydrate in it, but the label said 28 grams. 26 grams of carbohydrate was from "sugar alcohol," which could be subtracted from the total. This is, however, an estimate that the manufacturer gives for how many carbs your body can be expected to absorb. Dieters are also told that they can deduct any dietary fiber from the total carb count, because fiber slows the absorption of sugars. It makes one wonder though, if a person with impaired sugar metabolism would process such foods the same way as a non-impaired person.
And in fact, what good is "low-carb" if it is still a highly processed food item, not very "natural," not very healthful, and not low-calorie, or low-fat in spite of the "low-carbs." It is one thing to eat a healthful diet lower in carbohydrates, and entirely another to be duped by processed food manufacturers into purchasing "low-carb" food items that are simply processed foods with a "low-carb" label on them.
Since the FDA has no approved definition of "low-carb," food manufacturers can decide how much and what kind of carbs or carb replacements they want to put into a product.

SUGAR SUBSTITUTES, SUGAR ALCOHOLS, and SPLENDA

Aspartame (Nutrasweet or Equal) and Acesulfame potassium are two non-caloric sweeteners that have been around for years and used extensively in diet foods, but the safety of both is still being questioned, and more complaints have been filed with the FDA regarding aspartame than any other substance.

Enter: Polyols and Splenda. What food manufacturers are now telling us is that it "tastes like sugar because it's made from sugar" but it's not really sugar. Hmm. Sucralose or Splenda, or chemically altered table sugar with three of its hydroxyl groups replaced with three chlorine atoms, rendering it a chloro-carbon, is considered safe, but both pre- and post-approval research showed that it causes shrinkage of the thymus gland, enlargement of the cecum, and renal mineralization.

Polyols (sugar alcohols), technical name, polyhydric alcohols; lactitol, maltitol, mannitol, erythritol, sorbitol, xylitol, or sweeteners that are poorly absorbed by the body, are now being used extensively to sweeten "low-carb" foods, snacks, candies, etc. Although these snack foods are called "low-carb," read the labels. They can still be quite high in fat and calories, and remember, a calorie is still a calorie.

Maltitol is made from high maltose corn syrup, sorbitol from glucose, and mannitol from fructose. Because their chemical structure has been altered, resembling alcohol, they are called sugar alcohols. But they are neither sugar nor alcohol.

Although many of these non- and low-calorie sweeteners have been available for years and are considered generally safe, stable, and non-cariogenic (not promoting tooth decay), there are potentially severe side effects associated with the ingestion of the polyol sugar substitutes. Because the body cannot absorb them completely, severe abdominal gas, bloating and diarrhea may result. Foods sweetened with polyols should be eaten with caution, and not in excess. If any adverse effects are experienced, ingestion should be discontinued.

A BETTER NATURAL SWEETENER

A much safer and healthful alternative sweetener is stevia, an herbal extract made from the Stevia rebaundiana plant. It is hundreds of times sweeter than sugar so much less can be used. It also lowers blood sugar, blood pressure, and is non-caloric. It comes in many forms for many uses, powder, liquid, or dissolving tablets for use in hot drinks.

PERSONALIZED PROGRAMS YIELD BETTER SUCCESS

Since obesity is being studied now more than ever before, we are learning more about it every day. Weight loss is often individualized. There are many ways to lose weight and excess body fat. What works for one person, may not work for another. It is not enough to eat healthful foods and exercise for a few weeks or months. One must change the behaviors that caused overweight or obesity in the first place.

Lifestyle changes involve looking at eating habits and daily routine. Even though regularly scheduled aerobic exercise is best for losing fat and weight, with 30 minutes 3 times a week a good starting minimum, working up to 4 to 5 times a week, any extra physical activity helps burn calories.

Setting realistic goals is also important. Physical activity can be fun and entertaining. Reaching goal weight may take some time. Working out a strategy to gradually change the habits and attitudes that might have sabotaged previous efforts is also important. But most of all, being healthy and fit, in body and mind is ultimately more important than numbers on a scale.

HERBS USEFUL FOR WEIGHT LOSS-GREEN TEA AND GYMNEMA

There are many good reasons to supplement a weight loss program with herbs. Herbs contain nutrients, minerals, and can act as catalysts for powerful reactions in the body. Using the appropriate herbs for their specific actions can spell success for those wanting to shed pounds.

Two herbs that can be of great benefit in the "battle of the bulge" are Green tea and Gymnema.

Green tea (Camellia sinensis) is a sensible adjunct to a weight loss program because it suppresses the appetite, increases metabolic rate and fat utilization. Green tea contains about half the caffeine as a cup of black tea. The polyphenols in green tea such as epigallocatechin (EGC) and epigallocatechin gallate (EGCG) are potent anti-oxidants associated not only with weight loss, but diabetes prevention, anti-aging, and lowering cholesterol levels and risk of cancer.

There are so many different brands of green tea on the market that it is hard to know if one is getting the maximum active constituents per cup or per capsule. Standardization and full disclosure of the polyphenol content can help one decide on a supplement. It makes sense to supplement with Green tea for weight loss.

Gymnema (Gymnema sylvestre) is an Ayurvedic, saponin-containing herb which has some quite remarkable attributes that can be helpful in weight loss. It reduces glucose absorption, craving for sweets, and balances blood glucose, therefore making it an ideal supplement for the pre-diabetic, diabetic or obese individual.

Especially if a person has a "sweet tooth," Gymnema can have a strong impact on the taste of sweet foods, a kinder type of aversion therapy. Although the herb works very well taken in capsule form, the contents of a capsule can also be emptied into a small amount of water and swished and swallowed, or placed directly onto the tongue, and this will alter the taste buds to sweet tasting foods for approximately 3 hours. Sweet foods will either taste somewhat salty or tasteless, thereby deterring the dieter even more from wanting sweets. Let Gymnema help with a weight loss plan by keeping blood sugar levels healthy and reducing cravings for sweets.

References:
A Satiety Index of Common Foods. Holt, SH; Miller JC; PetoczP; et al Eur J Clin Nutr (England0 Sep 1995 49(9) p 675-90
Agatston, Arthur, M.D. The South Beach Diet Rodale Press 2003
American Dietetic Association. www.eatright.org
Atkins Nutritionals. The Science Behind the Diet. Accessed May 2004
CalorieControl.org Questions and Answers About Polyols Accessed May 2004
Cholecystokinin octapeptide decreases intake of solid food in man. Stacher G; Steinringer H; Schmierer G; Schneider C; Winklehner S. Peptides, 1982 March 3:2, 133-6
Fructose Sweetener Linked to Obesity Rise Hartsoe, Steve. Associated Press March 25, 2004
Mayo Clinic Health Oasis. www.mayohealth.org
Mills, Simon; Bone, Kerry. Principles and Practice of Phytotherapy. Churchill Livingstone 2000
Murray, Michael, N.D., Pizzorno, Joseph, N.D. Encyclopedia of Natural Healing. Prima Publishing 1990
Sears, Barry Ph.D.; Lawren, William Enter The Zone HarperCollins Publishers New York, N.Y. 1995
Shape Up America www.shapeup.org
Tilgner, Sharol, N.D. Herbal Medicines From the Heart of the Earth. Wise Acres Press 1999
Weight-control Information Network, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health. www.niddk.nih.gov/health/nutrit/win.htm

 

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