Soccer practice–a whole new experience

Juliana has shed about 22 pounds from her highest weight.  I suspect she will lose 30 more, so she’s still carrying around a lot of excess weight.  Nonetheless, however, she can run faster than she ever has before and has a new level of stamina.  She just started soccer practice for the fall American Youth Soccer Organization (AYSO) season.  She was astonished by how much energy she had.

On a low carb eating plan, she can run hard the whole practice, and not worry about depleting her limited available energy.  Why is this so?

Carbohydrates require insulin to be processed by the body.  But insulin is also the fat storage hormone–it directs the body to store energy as fat.  In Juliana (and other people who can’t tolerate much carbohydrate), eating more than a minimal amount of carbohydrate causes so much insulin release that most of the energy in the food she consumes gets sequestered in fat cells, rather than being available for Juliana to use on physical activity.

This explanation of fat sequestration robbing the individual of usable energy made a lot of sense when I read it in Gary Taubes‘ “Good Calories, Bad Calories.”  (See: Taubes, Gary (2007-09-25). Good Calories, Bad Calories (Kindle Locations 7584-7587). Random House, Inc.. Kindle Edition.

It explained Juliana’s history of not wanting to move–I went to great lengths to keep her physically active.  It wasn’t just that she loves to read (although she does), it was that she had very little energy to move because her body was storing most of it as fat.

This year is her first soccer season ever at a normal energy level.  She is jazzed!

Not getting fat because she’s lazy, but lazy because she’s getting fat

We all associate overweight people with low energy, and there’s a good reason for this.  But it’s not the reason you think.  People don’t get fat because they don’t move much; they don’t move much because they are getting fat.  The energy they could use to be active is being diverted to storage as fat.  The culprit is insulin, which is released mostly in response to eating carbohydrate, much less so in response to eating protein or fat.

When you are a parent, this lethargic behavior is extremely frustrating.  I remember vividly once when Juliana was about 9 and we were on vacation and she didn’t move from the couch all day.  I actually remember wondering what was wrong with her.  She wasn’t sick, but she didn’t look like she felt well.  At 3 in the afternoon I insisted that she go outside and do something, anything.  She didn’t want to.  I had to really push her, and I was trying to hide my anger as I did it.  Eventually she did so, reluctantly.

Now I know that going outside and moving was actually a huge effort for her, because she didn’t have much energy for motion.  It was mostly being stored in fat cells.

Can a child be a low carb vegetarian or vegan?

Can I be a low carb vegan?  Short answer:  No.

How about a low carb lacto-ovo vegetarian?  Possibly, but really difficult.

Most of the low carb eating plans I’ve seen suggest that you can be a vegetarian or even a vegan.  I frankly don’t think this is really realistic even for an adult.  But for a child, a low carb vegetarian eating plan may be setting them up for failure.

There is a dizzying array of high carb food available–most of the food in the supermarket is high carb.  The cereal aisle.  The pasta and rice aisle.  The baking aisle.  The chips and crackers aisle.  The cookie aisle.  The bakery department.  The juice and soda aisle.  When you switch to low carb, your universe of acceptable food shrinks.  That’s the bad news.  The good news is that many of the choices are foods you might have wanted to eat but usually didn’t:  pork bacon, steak, cheeseburgers.  At first, the new eating plan is great.  Bacon, again?  Why Not?  After a while, though, you have to get creative with your meal planning.  No one wants to eat cheeseburgers three meals a day.

Now imagine the only protein and fat sources available to you are eggs, cheese and cream, and some tree nuts.   (In my opinion, substituting highly processed soy products, like tofu and tempeh, for animal-based protein is not a good idea).  Try to come up with 3 meals a day where most of your calories come from those fat and protein sources.  You can eat nut butter, but remember you can’t spread it on bread.  Yes, there are a lot of ways to prepare eggs, but probably not enough to keep your child on the eating plan.

My coach at my gym put it well while giving a nutrition talk.  She said she likes animals, and she doesn’t really want to eat animals, but she needs protein and fat, so she does.

Who is Gary Taubes?

Gary Taubes is a science writer who reports and writes about issues of public health, nutrition, and diet.  He wrote two books that completely changed how I thought about Juliana’s overweight, and what we did about it.

Good Calories, Bad Calories is an exhaustively researched and documented history and analysis of obesity research and public policy about nutrition over almost 200 years, that is nonetheless an engaging read.  The book documents that carbohydrates used to be widely recognized as uniquely fattening, and how and why that changed in the years leading up to the push in the 1980s to get Americans to eat high-carb, low-fat diets.

In response to requests from readers for a shorter book they could hand out to family and friends, Taubes wrote “Why We Get Fat and What to Do About it.”  It’s the Cliffs Notes version of “Good Calories, Bad Calories,” and is a great place to start learning about low carb eating.

Visit Taubes’ website.




Hunter-gatherers don’t burn more calories than we do

Take a look at the brief description of a study of the calorie expenditure in one of the last existing traditional hunter-gatherer societies on earth:  NY Times, Hunter-Gatherer.

The authors conclude decisively that there is no difference in calorie expenditure between the Hazda people in Tanzania and typical adults in the United States and Europe.  They conclude that this finding suggests that “inactivity is not the source of modern obesity.”

Their recommendation to reduce the number of calories we eat is slightly off the mark–although they do particularly recommend eating less sugar, which is tantalizingly close to an endorsement of low carb eating in the very mainstream New York Times.

Times reporting is usually more like this:  A lengthy article by the health writer Tara Parker-Pope in December, 2011 reviewed the steady failure of weight loss diets without ever mentioning low carb plans.  The Fat Trap.  I sent her an email but never heard back.  Gary Taubes sent a rebuttal, but also hasn’t heard back.

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.

The scale is a tool

What about the scale? Throughout her childhood, I had been afraid to put Juliana on a scale. I looked for “innocent” opportunities to check her weight. Doctor’s visits, obviously, but also the scales in the dressing room at the pool–I’d check my weight and ask all my kids if they wanted to check theirs. If I took in one kid to urgent care for an earache or something like that, all 3 of them came with me and we’d kill time by checking our height and weight while waiting for the doctor. But Juliana usually declined.

Since I didn’t check her weight regularly, I am guessing that she gained about 30 pounds in a year from the age of 12 to 13. By not checking her weight regularly, I also missed this steep weight gain as it was happening–more than half a pound a week.

Why was I afraid to put her on a scale? Eating disorders and self-esteem issues. I didn’t want her to tie her self-worth to a number on a scale. I didn’t want to create the impression that food was bad because it was making the number on the scale go up, or that it might be a good idea to starve herself to get to a lower number. When Juliana was 9, her BMI had spiked up again. I asked a family therapist about using a scale with a 9 year old, and she was emphatically against it, for the same sorts of reasons.

For some kids and teens not using a scale might be the right answer. But, the scale is a very valuable tool. Information from the scale allows you, as your child’s coach, to continually tweak what you are doing to help your child achieve a healthy weight. If your eating plan is effective, the numbers on the scale will demonstrate that by going down. If it isn’t, they won’t.

Yes, I know, muscle weighs more than fat and takes up less space. Your child could be adding muscle, staying the same weight, but slimming down. Could be. But unless he or she is on an exercise program that would justify a belief in added muscle, I would be wary of hoping that is happening, simply because the hope delays making tweaks to your eating plan to improve its effectiveness.

What about body composition measurements? We tried a home body fat monitor, but the numbers varied too much day to day to give useful information about the effectiveness of the eating plan. Unlike with a scale, there is far too much variation in the measurements of the body fat monitor from day to day to know if you are losing body fat. Juliana’s measurements bounced up and down between 25% and 35% from day to day.

We started with weekly weigh-ins, which was the procedure on the Packard pediatric weight control program. But now we weigh in daily, because we don’t want to waste time on a losing strategy. She feels great eating low carb, and she’ll eat this way the rest of her life, and yes, eventually she’ll reach her goal weight one way or the other; but she still wants to slim down without wasting time. I think everyone does. So if you can use the scale as a tool, and not obsess over the number, you should.  Juliana is doing well with the information from a daily weigh-in.  You have to judge for yourself whether using the scale is going to do more harm than good for your child.

Common medications can stop weight loss

We are learning that there are many things that can interfere with weight loss or cause weight gain, most of which aren’t commonly known, perhaps because of the dominance of the mainstream calories in/calories out model.

After about 4 weeks of eating very low carb, we added in some cheese and nuts. The Atkins approach is to add carbohydrate foods back to your eating plan in a specific order–called the carb ladder–until you find the number of grams of carbs you can eat per day and continue to lose or to maintain weight (whichever your goal is at the time). Juliana gained about 3.5 pounds over a few weeks.

We went back to very low carb, with most of her daily carb intake coming from green vegetables. The weight came off but more slowly than before. I kept reading and googling. I found that allergy medications (both over the counter and prescription) that she had started because of a seasonal allergy attack were believed by some people to cause weight gain, or to interfere with weight loss. She had started the medications on almost the same day she began eating cheese and nuts, and they, not the cheese and nuts, might explain the weight she had regained and the fact that she was now losing much more slowly. Later I was reading a book called “Mastering Leptin.” It includes a possible explanation for why antihistamines have this effect: histamines in the brain depress appetite (see Chapter 24, section “Histamine and Neuropeptide Y”).

She stopped the medications just as she was leaving for a 3 week teen service trip overseas. After 2 weeks, she reported that the pants she had brought with her were way too big. The trip posted pictures of the kids online. Juliana’s face looked noticeably slimmer.

What can water do for you?

water: courtesy of FreeDigitalPhotos.netYou hear it all the time–drink at least 8 glasses of water a day.  What does water do for you–and lack of water do–when you are eating low carb to lose or maintain your weight?  Three things.

1)   It’s the job of your liver to metabolize fat.  If your kidneys don’t have enough water to do their job, however, they send some of their work over to the liver.  Then the liver has less bandwidth to metabolize fat.

2)  On a low carb eating plan, you literally urinate out portions of fat molecules called ketones.  You are not only “burning” fat–you are also excreting fat in your urine. See page 170 of No More Fat Kids. Without enough water, this process slows down.

3)  If you don’t drink enough water, your body tries to conserve water, meaning you will weigh more.  If the body has plenty of water coming in, it won’t retain water.  So, paradoxically, drink more water to get rid of water bloat.

Drinking A LOT of water has been critical to Juliana’s progress.  When she came home from six weeks of traveling, in August, 2012, we found that Juliana had maintained her weight while growing half an inch.

She resumed a very low carb eating plan to give herself another weight loss jump start after a summer of less control over her food. But after five days, she had gained a pound. On the one hand, a pound could be normal variation. On the other hand, the more experience I get the more I feel that she is likely very sensitive to carbohydrate, and it is not easy for her to lose weight even on a low carb eating plan.

Unlike an adult who finds after the age of 40 that they can’t maintain their weight on a high carb diet after a lifetime of high carb eating–she was sensitive to carbohydrate already at a young age–she became obese over one year from 3.5 to 4.5. And she isn’t one of the many people you read about, if you poke around in the low carb community, who dropped 5 dress sizes in as many months eating low carb. So to me, a gain of a pound when we were trying to jump start her weight loss, when she hadn’t been doing a lot of strength training or the like that might argue she had added muscle, was significant.

We reviewed many tips and tricks. I zeroed in on water. Juliana has never felt much thirst, or drunk much water. I’ve encouraged her to drink more water for years.

We set a goal of a gallon per day. She has a 32 ounce water bottle she fills and empties four times. As her coach, I check in with her during the day to see how many water bottles she has finished. I frequently find the water bottle in the house, fill it with ice water, and bring it over to her.

After 3 days of drinking a gallon of water per day, she had dropped a pound and a half, and is now at her lowest weight ever since we started the low carb eating plan.

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.