Really, you don’t need carbohydrates

I keep running across comments like this one, from “Ending the Food Fight,” by David Ludwig, MD, PhD: “[Low carb diets] do produce more weight loss than low-fat diets, but only temporarily.  After one year, people following both diets gain back nearly all of the weight they lose.  These approaches ultimately fail because our bodies and our minds rebel against severe restriction of any major nutrient, whether fat or carbohydrate.  (How long do you want to keep eating that bacon double cheeseburger, hold the bun, thank you?)”

First off, I assume Dr. Ludwig is referring to people who stop eating low carb and then gain back their weight, which of course, they will.   Continuing to eat low carb at the level of carbohydrates your body can handle, which might be 20, 50, or 100 grams a day, is one of the most successful ways to maintain weight loss.

Second, why does Dr. Ludwig assume that all macronutrients (fat, protein, carbohydrate) are equal, or equally required?  They’re not.  Carbohydrates in the form of agricultural grains did not even exist in the human diet until several thousand years ago.  People who eat a “Paleo/Primal” or “Caveman” diet eschew all grains, legumes, and dairy.  They eat mostly vegetables and meats, and a small amount of fruit.  (Modern fruit is larger, sweeter, and available for more of the year than ancient fruit).

It’s maybe not surprising then, given that they are so new, that carbohydrate is the only macronutrient your body does NOT require.  It can get along just fine on zero carbohydrate, unlike fat or protein.  “…animal foods contain all of the essential amino acids (the basic structural building blocks of proteins), and they do so in the ratios that maximize their utility to humans.* 94 They also contain twelve of the thirteen essential vitamins in large quantities…The thirteenth vitamin, vitamin C, ascorbic acid, has long been the point of contention. It is contained in animal foods in such small quantities that nutritionists have considered it insufficient and the question is whether this quantity is indeed sufficient for good health.”

Taubes, Gary (2007-09-25). Good Calories, Bad Calories (Kindle Locations 6551-6557). Random House, Inc.. Kindle Edition.

 It turns out that the tiny quantity of vitamin C in animal foods is sufficient, provided you aren’t eating a diet high in carbohydrate.  In other words, you only need to supplement the vitamin C available from animal foods if you eat a lot of non-animal foods.

Taubes, Gary (2007-09-25). Good Calories, Bad Calories (Kindle Location 6630). Random House, Inc.. Kindle Edition.

Another argument you sometimes hear is that dietary carbohydrates are required to provide glucose for the brain.  But this is not so.  The liver manufactures the fuel it needs from other nutrients if dietary carbohydrate falls below a certain level.

Taubes, Gary (2007-09-25). Good Calories, Bad Calories (Kindle Locations 6492-6498). Random House, Inc.. Kindle Edition.

And what about Dr. Ludwig’s opinion that people can’t live forever without the hamburger bun?  A great effect of a low carb eating plan is that the desire for carbohydrates greatly diminishes, or disappears altogether.  And in sensitive individuals, eating the bun after getting used to the low carb style will probably make you feel sick and tired.  Go ahead and try it once, like Juliana did with a scoop of ice cream, and you won’t be so tempted the next time.

Dr. Ludwig instead advocates a low-glycemic diet, which I bet works better than a low fat diet for many people.  But in sensitive individuals like Juliana it would not work because it includes more fruit and grains (even if they are whole grains!) than her system can handle.

Juliana’s playing soccer at recess

Among the many transformations in Juliana on the low carb eating plan, one of the most amazing to me is that she is now voluntarily organizing and playing in soccer games at school during recess.  I have been trying to get her to do that for years, because, like most schools these days, she doesn’t have a lot of PE time.  The only way she can get in some movement during the day is to move at recess.

I didn’t push her to start playing soccer during recess.  On the contrary.  A few weeks ago she asked me to buy her a soccer ball to keep in her locker at school so she could play, since the school soccer balls are always getting lost.

As I explain here, she wasn’t getting fat because she was lazy and tired; she was lazy and tired because she was getting fat.  Now that process is reversed.  She’s full of energy because she’s getting thin, and all that stored energy is available to play soccer, every day.

We check in with the Packard Program

Juliana and I visited with the staff from the Packard Program yesterday.  They are doing great good in the world trying to help obese kids achieve a healthy weight, and they have good success.  Nonetheless, I believe that the calories in/calories out model that underlies the program is wrong.  So why does it work as well it as it does?

The Packard Program teaches kids to substitute lower-calorie yellow or green foods for higher-calorie red foods.  In many cases, those substitutions are from super-high-carb foods to less-high-carb foods.

From a glass of apple juice, for example, to an apple.  8 ounces of apple juice has about 29 grams of carbs; one medium apple has about 16 grams of carbs and it also has 4 grams of fiber, for only 12 grams of “net carbs.”  (When counting carbs, you subtract the fiber grams from the total carbohydrate grams, because fiber does not provoke the same insulin response).

Or from a high-sugar cereal to a low-sugar cereal.   Changing from raisin bran (36 grams of net carbs per cup) to cheerios (19 grams of net carbs per cup) cuts the carb load almost in half.

Both those substitutions are lower calorie changes, but they are also lower-carb changes.  So is it the carbs, or the calories?   I think it’s the carbs.  See chapters 19 and 20 of Gary Taubes‘ “Good Calories, Bad Calories” for a full discussion of this point.

The real power of the realization that carbohydrate restriction is the most important part of the eating plan is that your child will not be constantly hungry on a low carb plan, as they will be on a low calorie “balanced” plan.  At Packard yesterday I really emphasized this point:  Juliana complied perfectly with the program and did lose 6 pounds in 10 weeks.  But she was hungry all the time and I didn’t see how she could possibly keep it up.

A low carb eating plan doesn’t require superhuman restraint to follow.  That makes it a lot easier to coach your child on a low carb eating plan than a low calorie eating plan.

After losing a lot of weight in the beginning, Juliana’s weight loss rate has slowed on the low carb eating plan.  But even if she only loses an average of a 1/2 pound a week, as she did on the Packard Program, she will eventually get to her goal weight WITHOUT suffering constant hunger.  And in the meanwhile, her energy level is high, she has a completely new level of physical stamina, and her mood is consistently good.

Juliana’s “low” moods disappear

From a young age, Juliana was prone to dips in her mood.  Mood disorders run in my family so I assumed she had just inherited this trait from me.  We noticed that if she didn’t exercise, she was much more likely to suffer a low mood, so we taught her that she needed to move every day to help keep her on an even keel.  And that helped her.

Then we tried low carb eating, and her mood problems have disappeared.  I also feel an elevated mood eating low carb.  Both of us still exercise, but neither of us feels as dependent on doing so to regulate how we feel.

 

Juliana ditches the baggy t-shirts

For as long as I can remember, Juliana has been uninterested in clothes.  She hated shopping.  She hated trying on clothes that I ordered on the internet.  Her grandmother loves to shop–and Juliana refused to go with her–she wanted the same boots she had last time, just in a bigger size.  She also wanted nothing clingy.  I like close-cut t-shirts from the Gap, she hated them.  She wanted baggy “Life is Good” t-shirts.

Then she started eating low-carb.  She discovered that she liked the shirts they have at REI.  I bought her some, she loves them, and she wanted to buy some more.  She chose shirts that were not tight, but they were form fitting–a far cry from baggy.  I explained that since she was steadily losing weight we should wait to buy her more clothes–I thought she would probably go down a size in not too much time.  She said, no, the smaller shirts won’t fit on my shoulders.  I explained that even though she might not realize it, she was losing weight all over.  It’s obvious when your pants are too small or too big, you have to change sizes.  It’s not as obvious on top–you can wear a too-small or too-big shirt.  I could see the wheels spinning in her head as she took in this information.

The next day, she brought me a stack of shirts and announced:  “These are too big.  They are like jackets.”   (She has never cleaned out her drawers before now of clothes that didn’t fit–I always did that).  She’s very thrifty, so she is glad that I can wear her too big shirts.  I am also thrifty, but I’m happy to spend money buying her new, smaller, cuter clothes that she clearly feels great wearing.

Ice cream–a blessing in disguise

The Google ice cream was the ultimate blessing in disguise. I was initially upset that she had deviated from the low carb plan–I thought she didn’t understand the fact that a scoop of ice cream would temporarily negate all the benefits of becoming a “fat burner,” and it would take several days to get back to the same place.  On Atkins type eating plans, people can choose to start in an initial very low carbohydrate phase (called “Induction” by Atkins) that accelerates the process of changing over from burning primarily carbohydrate for energy to burning primarily fat for energy.  If you consume a lot of carbohydrate in this phase, you quickly reverse the process and go back to burning carbohydrate.

But the effect of the ice cream was so dramatic and so negative, she now finds it pretty easy to adhere to the low carb eating plan. She knows she will feel badly if she eats a high-carbohydrate food. She feels GREAT eating low carb. Her energy is high all day, a big improvement and a big change.

A lesson from ice cream

We live in the heart of Silicon Valley. Seven days after starting the low carb eating, Juliana took a field trip with her class to the Google campus in Mountain View.

Google has what they call the 150/15 rule.  The 150 is the number of feet you are from food anywhere on the Google campus, and the 15 is the number of pounds you gain your first year working there.    So, naturally, the field trip to Google included ice cream.

Juliana ate a scoop, came home, and lay on the couch the rest of the day.  She felt slightly nauseous. She had to cancel a homework appointment with a classmate. At first she thought she was tired because they had walked around Google so much. I didn’t think so.

The zap of sugar to her system caused a spike of insulin which in turn caused her body to store all the ice cream energy in fat cells, leaving none for Juliana to use.  After only 7 days of low carb eating, her system couldn’t handle a scoop of ice cream.  Then I knew we were really onto something.

We try a Low Carb eating plan

Lots of disparate information was clicking into place in my head and pointing to a low carb eating plan. Juliana’s reaction to my research was precious.  She commented to her dad, mama’s been reading books again…  I do have a tendency to research.  Nonetheless, she was game.  We embarked on a low carb eating plan.  After 5 days, at her next weekly weight check at the Packard program, she was down 3.5 pounds.  (The first thing that happens on a low carb diet is that you dump retained water.  Many people find that they feel and look less puffy and bloated eating low carb).

The Packard people were a little startled.  They immediately ascribed the weight loss to Juliana exercising more, since her total of red foods was the same.  The most Juliana had lost in one week up to that point was 1.5 pounds.  By the calories in/calories out logic, she would have had to have burned an additional 7000 calories to explain the additional two pounds of weight loss, which she hadn’t come close to doing.  7000 calories is 10 hours of running at 10 minutes a mile.  She was exercising more, but not an extra hour and a half of running every single day. I knew exercise couldn’t explain the sudden drop in weight, and had high hopes for the controlled carbohydrate eating plan.