Fat moms make fat babies; and thin, high-carb eating moms might make fat kids too…

Juliana is the oldest of three kids, and the only one of my three kids who was ever overweight.  Indeed, at the moment, my son Teddy is technically underweight, with a BMI in the 3rd percentile.

When I was pregnant with and nursing Juliana, I ate a vegetarian diet.  When I was pregnant with her sister Molly, I had an overwhelming desire for chicken, and abruptly stopped eating vegetarian after 18 years.  So I got to wondering whether there might be a relationship between what I ate while pregnant and nursing and Juliana’s metabolism and ability to handle carbohydrates versus her siblings.

And there could be.  Fat mothers produce fatter babies; diabetic mothers (whose blood sugar is on average higher than non-diabetic mothers) produce fatter babies.  And the incidence of fat babies is increasingly dramatically, in step with the increase in obese and diabetic adults.

“The probable explanation is that as women of childbearing age get heavier and more of them become diabetic, they pass the metabolic consequences on to their children through what is known technically as the intrauterine environment. The nutrient supply from mother to developing child passes across the placenta in proportion to the nutrient concentration in the mother’s bloodstream. If the mother has high blood sugar, then the developing pancreas in the fetus will respond to this stimulus by overproducing insulin-secreting cells. “The baby is not diabetic,” explains Boyd Metzger, who studies diabetes and pregnancy at Northwestern University, “but the insulin-producing cells in the pancreas are stimulated to function and grow in size and number by the environment they’re in. So they start over functioning. That in turn leads to a baby laying down more fat, which is why the baby of a diabetic mother is typified by being a fat baby.”

Taubes, Gary (2007-09-25). Good Calories, Bad Calories (Kindle Locations 8167-8174). Random House, Inc.. Kindle Edition.

Juliana wasn’t actually a fat baby.  But her intrauterine environment was with me eating a vegetarian diet, which was necessarily higher carb than when I switched to being an omnivore with Molly and Teddy’s pregnancies.  She was also nursed for several years with me eating a vegetarian diet.  I’m not diabetic, but that doesn’t mean Juliana didn’t suffer the consequences of my high-carb eating style:

“There’s no reason to think that the hormonal and metabolic consequences of high blood sugar—from what James Neel in 1982 called the “excessive glucose pulses that result from the refined carbohydrates/ over-alimentation of many civilized diets”—do not pass from mother to child through the intrauterine environment, whether the mother is clinically diabetic or not.”

Taubes, Gary (2007-09-25). Good Calories, Bad Calories (Kindle Locations 8189-8192). Random House, Inc.. Kindle Edition.

I can’t prove that my eating style contributed to Juliana’s carb sensitivity and subsequent overweight–but it’s an interesting association that she is the only one of three kids who experienced my high-carb eating style and she’s the only one with excess weight.

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.

Quality of protein matters

What kind of meat and eggs you buy matters in how healthy your eating plan is. The lower quality sources of animal protein can be “Franken-foods,” where the manner in which the animals are raised so alters the nutritional composition of the food that it is not particularly healthy or downright unhealthy.

An organic egg, for instance, is pretty much a perfect food. It has the perfect one-to-one ratio of omega 6 to omega 3 fat, and it’s packed with protein and other nutrients. But a factory-farmed egg contains as much as 19 times more omega-6 than omega-3 fatty acids, making it downright unhealthy.  Remember when eggs were vilified as dangerous for your health?  That was true, but not because of the cholesterol.  It was and is true because of the imbalance of fatty acids, which is brought about by the way in which the chickens are cared for.  (Feed Your Kids Well, p. 84).

Similarly, grass-fed beef and dairy products derived from grass-fed cows are better for you than grain-fed, because cows evolved to eat grass, not grain.  The meat from a grass-fed cow is nutritionally different from the meat from a grain-fed cow.

What about “less carb” instead of “low carb”?

What about a “less carb” eating plan?  Wouldn’t that be a good bet if you still have safety concerns about low carb eating plans?  This page:  about.com low carb for kids provides a nice summary of this viewpoint.  What’s wrong with this logic?  At least three things.

1)  A less carb eating plan may not be low carb enough to get the metabolic benefits of low carb–to switch your child’s body over to primarily burning fat, rather than carbohydrates, for fuel.  (Westman, Dr. Eric C.; Phinney, Dr. Stephen D.; Jeff S. Volek (2010-02-17). The New Atkins for a New You (p. 8-). Simon & Schuster, Inc.. Kindle Edition).

2)  A less carb eating plan may not be low carb enough to eliminate carbohydrate cravings, making it much harder for the child to follow.  On a very low carb diet, cravings disappear.  That kid who can’t seem to get enough mac and cheese, muffins, cookies, bread with dinner, potato chips and so forth will disappear.

As you approach your goal weight, you gradually add carbs back in a defined order–but if a given carbohydrate food stops weight loss or causes cravings to return, you eliminate it again.  If you don’t do that, it’s very hard to stay on the eating plan.  (Westman, Dr. Eric C.; Phinney, Dr. Stephen D.; Jeff S. Volek (2010-02-17). The New Atkins for a New You (p. 116-144). Simon & Schuster, Inc.. Kindle Edition.

3) On a less carb eating plan, your child may be hungry even while consuming the same number of calories as on a low carb eating plan that does not result in nagging hunger.  Why?    Carbohydrates stimulate hunger in a way that fat and protein do not.  As Gary Taubes describes in “Good Calories, Bad Calories,” a diet of 1200 calories of fat and protein is satiating.  People find compliance relatively easy, without hunger, and they lose weight.  But a diet of 800 calories of fat and protein and 400 calories of carbohydrate is the classic semi-starvation diet that is successful in perhaps 1 of 100 people.  And a major reason for the low success rate is people can’t tolerate the constant hunger such a diet produces.  (Taubes, Gary (2007-09-25). Good Calories, Bad Calories (Kindle Location 6884-6924). Random House, Inc.. Kindle Edition).

Nor is it necessary to consume only 1200 calories of fat and protein to lose weight on a low carb eating plan.  Taubes summarizes:

“The last decade has witnessed a renewed interest in testing carbohydrate-restricted diets as obesity levels have risen and a new generation of clinicians have come to question the prevailing wisdom on weight loss. Six independent teams of investigators set out to test semi-starvation diets of the kind recommended by the American Heart Association in randomized control trials against “eat as much as you like” Pennington-type diets, now known commonly as the Atkins diet, after Robert Atkins and Dr. Atkins’ Diet Revolution. Five of these trials tested the diet on obese adults, one on adolescents. Together they included considerably more than six hundred obese subjects. In every case, the weight loss after three to six months was two to three times greater on the low-carbohydrate diet—unrestricted in calories—than on the calorie-restricted, low-fat diet.”

Taubes, Gary (2007-09-25). Good Calories, Bad Calories (Kindle Locations 6868-6875). Random House, Inc.. Kindle Edition.

See also:  Westman, Dr. Eric C.; Phinney, Dr. Stephen D.; Jeff S. Volek (2010-02-17). The New Atkins for a New You (p. 49-58). Simon & Schuster, Inc.. Kindle Edition.

Eat like a pyramid, look like a pyramid.

Ok, so fat is good, and low carb eating plans aren’t calorie or nutrient restricted, but they MIGHT still be unsafe, after all, they’re not a “balanced” diet.  What’s the alternative?  We tried the low fat, sensible calorie eating plans, combined with exercise, and my child was still obese.  Being obese is clearly unsafe–it’s a predictor of all sorts of health problems.  Developing those problems–diabetes, high blood pressure, etc. is only a matter of time if you stay obese.

On the low carb eating plan she’s dropping weight–20 pounds so far.  She felt great even before she started to slim down–in less than a week she had much more energy and a better mood.

Most overweight children will become overweight adults. That is a clear and present danger.  The supposed dangers of low carb eating plans are refuted in many reputable books, and by the stories of people who practice low carb eating and have experienced vastly improved health.

See, for instance, “The Art and Science of Low Carbohydrate Living,” by Jeff Volek, PhD, RD and Stephen Phinney, MD, PhD; “Good Calories, Bad Calories,” by Gary Taubes; and “Why We Get Fat and What to do About it,” also by Gary Taubes.  Take a look at Jimmy Moore’s livinlavidalowcarb blog, and the many low carb sites to which he links.

But aren’t low carb diets high in fat?

Low carb diets are high in fat–can that be safe?  When you eliminate carbohydrates, some of the food may be replaced by protein, but most of it should be replaced by fat. (It is not wise to try to eat a low carb, low fat diet, because you will end up on a high protein diet, which is not a good idea).

Fat is bad, right?  You are what you eat?  No, “you are what your body chooses to store from what you eat.”  (Westman, Dr. Eric C.; Phinney, Dr. Stephen D.; Jeff S. Volek (2010-02-17). The New Atkins for a New You (p. 49). Simon & Schuster, Inc.. Kindle Edition).  On a low carbohydrate eating plan, your body doesn’t choose to store fat as fat, rather it uses fat as fuel, and fat is your friend.  On a relatively high carbohydrate eating plan, your body will choose to store fat as fat (and also carbohydrate as fat), and fat is not your friend.  (Read all of chapter 4 of “The New Atkins for a New You” for a good discussion of this essential point about low carb eating plans).

This fact is one of the harder things to wrap your mind around when thinking about what foods to offer your children.  In our case, Juliana was so habituated to NOT eating fat, that she trims all the fat off of pork chops or steak or chicken because she doesn’t like the taste.  We have to add fat back to her meal, by pouring olive oil on broccoli, for instance.

They probably won’t “grow into it.”

If you buy into the idea that your overweight child may grow into his or her weight, you have to wait until adolescence–possibly until the age of 16 or so for boys–to see if the slimming growth spurt appears before taking action. Your child will go through middle school and high school overweight or obese. They may experience teasing, social isolation, and will certainly find it harder to participate in sports because of their weight.

So what does the research science actually show?   It shows clearly that overweight and obesity among children is more and more common, and that most overweight children will become overweight adults. Time article. CDC Page. About.com.  So the odds are that even if some kids will grow into their weight, yours won’t.

And if they don’t, then they are at risk for all the chronic diseases associated with overweight and obesity.

Don’t let the small possibility that growth will outpace weight gain for your child prevent you from taking action now.

Low carb eating plans are not calorie- or nutrient-restricted

Mainstream advice generally is against children or teenagers going on diets. The worry seems to be that calorie or nutrient restriction can interfere with healthy development.  You will frequently see the advice to try to stabilize weight first, because it is assumed that doing so will require less calorie restriction than actually trying to lose weight.  By preventing more weight gain, children can “grow into their weight.”  This recommendation makes no sense on its face for children who already weigh more than a healthy adult weight, of which there are many, including Juliana when she started her low carb eating plan.

The unspoken assumption is that a weight-reducing diet must be calorie restricted and therefore nutrient restricted. But a low carb diet is neither. Children can and should eat until they are satisfied. It is better to call it a low carb eating plan, since diet seems to be synonymous with calorie restriction in most people’s minds.

Our eating plan consists of high quality meats, organic eggs, a little cheese, tree nuts, and vegetables. It is not calorie-restricted. It is not nutrient-restricted. There are no essential nutrients available in grains that are not available from other sources.  See Epilogue of : Taubes, Gary (2007-09-25). Good Calories, Bad Calories (Kindle Locations 9085-9089). Random House, Inc.. Kindle Edition, for a review of the evidence demonstrating that 1) the brain does not need ingested carbohydrate for fuel, but can manufacture what it needs from ingested fat and protein and 2) there are no essential vitamins and minerals in carbohydrate that are not available from meat and fat.

Moreover, we usually eat more than the recommended 5-9 servings of vegetables (not fruit) per day, unlike the vast majority of Americans.