I ran into this video on YouTube (while looking for some music video to watch, go figure…) and found it well done. It is by an M.D. who runs an obesity clinic that also ends up dealing with a lot of diabetes. What she finds is basically what many folks have found: To reduce or eliminate your blood sugar issues, stop or strongly reduce your intake of carbohydrates (and especially ‘fast’ carbs like sugars that hit the blood stream in a fast spike).
Here’s the video, a TED Talk:
I helped my Florida Friend do something very much like this, but slightly modified. He had blood sugar readings in the low 200’s in the hospital (where they were feeding him mashed potatoes… go figure…). After he was out and having more salads, fritatas with vegetable fillings, “lump-o-meat” entrees, steamed vegetables; and only a very small portion of brown rice or potatoes: his blood sugar readings were normal.
For him, being only mildly on the problem side of things, “low not zero” carbs works. For folks who are clinically obese with significant insulin resistance (as described by the Dr. in the video) it is likely they do need to skip all GPS – Grains, Potatoes, Sugar. IMHO the “problems” show up once your carbs intake exceed your daily burn rate. IF you run marathons and bike to work and dig an acre of dirt each weekend gardening, then you can consume a lot more carbs before you have any left over at the end of the day to start that insulin ramp cycle. If, like me, you spend all day sitting in front of a computer / TV and occasionally walking to the kitchen to cook and eat; well, let’s just say my carb burn is likely met by two pieces of toast and a small potato in my evening stew… or the rice on my sushi.
Now realize that’s just my hypothesis, my guess. Based on nothing more than having observed when my own weight changes and how I do on different meal plans. YMMV, especially if you have insulin resistance in spades.
Why mention that at all? Because the good doctor lists as her point 5 to have no GPS – Grains, Potatoes, Sugar. I’m just pointing out that’s for clinically obese patients with strong type 2 diabetes and (as she states at the end talking about herself not needing that diet) it isn’t needed for “normal” folks. So I’m just suggesting that one can modulate the effect of carbs rather than taking a hard Yes/No binary decision.
So that’s my opinion on the one place where I have a trivial issue with the video. I’ve had no problems with small amounts of grains, especially really whole grains, and the occasional potato. I buy grains that are the actual grain in a bag. I don’t buy boxes of “whole grain donuts” or other strange-not-a-grain thing. The one exception is a whole wheat pasta. Yes, it is processed, but not like a mystery-box with 200 ingredients on the list one of which is “whole grain”. A small amount of whole wheat pasta with a cream sauce or pesto ought to be fine for someone with normal blood sugar readings from all the rest of their diet. Especially when it is basically just a side dish to a large dinner salad and pile of steamed vegetables with butter on them.
The fiber in whole grains slows the digestion and absorption of the starches and flattens the whole peak sugar compared to highly refined versions. That flattens the insulin spike and reduces the odds that the sugar digestion runs out while the insulin still has hours to go in the blood stream. That brings it inside the range most folks can handle. BUT, if you are outside that range and it does cause a blood sugar spike in the hour of digestion, then it’s not working out OK and needs to be abandoned. In my opinion, let your blood sugar readings be your guide to what works for you and what doesn’t. Not “some guy’s” opinion.
The Vegetarian POV
In contra-point, we have the vegetarian approach. In this video the Doctor spends a long time working up to the fact that his advocated diet is a vegetarian one. I know the vegetarian approach works due to a family “twin study”. The twin on the vegetarian diet is much thinner than the one eating lots of carbs & meat. But is it the meat, or the carbs? Unclear. IMHO, the vegan diet leads to other health issues (since it is nearly impossible to “do it right” so most folks eventually don’t bother tracking all their omega-3s and B vitamins and amino acid profiles and…)
I’d also complain that his examples showing we must be naturally vegetarians ignores the observation that Chimps also go hunting and eat a low meat diet, not a vegan one. Meat eating did NOT start with the stone age. It started millions of years ago at the Chimp level of advancement. Gorillas are obligate vegans and have a very long large gut to digest all that “roughage”. We have a much shorter gut suited to an omnivore diet. We likely have been scavengers and opportunistic meat eaters for all of human evolution. Do we now eat too much? Quite likely. But that does not mean zero is the answer. It means a nice side salad, some asparagus, and some buttered broccoli ought to dominate the plate with a petite steak; instead of a 2 lb. steak and 1 lb. potato and a quart of red wine…
In the video, the Dr. offers the mechanism that the cells fill up with fat globules and that causes insulin resistance (so far so good…) but then leaps to the conclusion that the answer is to stop eating fat. Not so good. Without the right fatty acid profile, you die. Clearly you MUST have some fat intake. This point is not addressed and I would guess the assumption is just that folks will not actually get to zero fat intake and “it will all work out, somehow”… I’m not fond of that degree of casual inattention.
IMHO, yes, fat build up in the places that burn sugar (like the muscle cells) is the mechanism for causing insulin resistance. BUT, that fat can come directly from dietary fats OR from excess carbs that are turned to fats in the liver et. al. It ought not to matter HOW the fats in the diet are reduced “enough”, only that it eventually happens. Then insulin resistance ought to end.
That “fat in the cell” one mechanism also ignores some minor points like that fats cause you to feel full and stop eating, and that starches and sugars give a big blood sugar spike that causes an insulin surge that causes more sugar-to-fat enzymes and conversion and results in more hunger and cravings. So the “entry” to the vegetarian diet needs to be done in such a way as to avoid sugar and carb spikes anyway.
OK, what’s the good bits? First, that getting total calories down via either reduction of fat intake or reduction of carbs intake leads to lower fat levels inside the cell leads to reversal of insulin resistance. Second, that all those lovely vegetables he shows in his picture are fine on either dietary approach. It is raising the non-starch vegetables that works well on both approaches. The only “argument” is over the meat/fat component vs the carbs component.
Now, once reversed, a lot of that blood sugar spike / insulin spike / fat formation & hunger cycle will be gone in either case. Then, having a vegetarian approach with more fiber loaded fruits and vegetables and not all that much starches and sugars will continue to be OK (especially as vegetarians tend to eat whole grain stuff and lots of fiber slowing the sugar absorption spike anyway). It is also darned near impossible to eat too many calories on a vegan diet (that eliminates all the milk, dairy, eggs allowed on ovo-lacto vegetarian diets). Unless you are drinking seed oils, there’s just too little calorie density in the foods.
Sidebar on Rice: Ever notice that a cup of dry rice makes about 2 quarts cooked, and of that you can eat about 4 ounces? Now think about that. That 4 ounce (volume) serving is about 1/16 of the dry rice cooked.
For those who are fraction-challenged due to a metric immersion and education: 4 cups / quart; so 8 cups in 2 quarts. 4 ounces is 1/2 cup. so 8 cups is 16 half cups. Thus that 4 ounce serving is 1/16 of a dry cup of rice. Or 1/2 ounce. Nearly nothing, really. Now it takes roughly one dry pound to feed a person for a day. Cook a pound of rice, you get somewhere near or over a gallon of cooked rice. Call it 4 liters. Think you can eat a liter of cooked rice 4 x a day? That’s why I don’t worry about folks overeating rice with a meal.
So, OK, eat a meal based on cooked whole grains and non-starchy vegetables without butter or cheese? Yeah, you will loose weight and blood sugar will drop. You also will not be very satisfied and will have some significant metabolic challenges to meet by being VERY careful with exactly what and how much you eat of some “odd” things to assure you do not develop several dietary disease issues. For example: Omega-3 Fatty Acids are essential to life. To get the ones you need on a vegan diet, you MUST include Flax (seed, meal, oil) or a supplement. It is naturally found in grasses, but people don’t eat grasses. Grazing animals do (and sea grasses are the source for fish, though it comes through some other animals first for most fishes). So unless you want to eat a bale of grass every day, you’ve got a problem best met by animals, fish, or animal products. Very few people actually add the flax meal to their diets even though they ought to.
So what’s my point? Damning with faint praise. Yes it will work, but he’s ignoring the other issues of managing a real full on vegan diet. (Vegetarian is ambiguous. It can mean “strict vegetarian” with the synonym vegan. It can mean ovo-lacto vegetarian that allows eggs and dairy. Allowing eggs and dairy makes being a vegetarian a whole lot easier to manage as their are several key vegan nutrient issues that “go away”). This doctor does not state if his use of Vegetarian means ovo-lacto vegetarian or vegan. That’s a warning sign. Similarly, he does not mention that doing vegan and having key nutrient issues to manage is a non-trivial task. You don’t just eat kale and rice and live a long time. So yes, it will work. But also “warning: some assembly required, intelligence needed, and meal planning critical with some background in nutrient biology and biochemistry.” With that said, here’s the other approach: