Living Low Carb (67 page)

That said, a lot of low-carb plans permit some alcohol, particularly red wine (in 4-ounce servings), which contains about 3 grams of net carbohydrate. Do the math and see if it works for you.

What Is the Glycemic Index?

The glycemic index is a numerical way of describing how carbohydrates in foods affect blood-sugar levels (an even more accurate measure is the glycemic
load
; see next question).
²²
The index measures how quickly a 50-gram serving of a particular food converts to sugar. Foods with a high glycemic index cause a dramatic rise in blood sugar (and subsequent demand on insulin levels). That’s why all low-carb diets suggest that you eat
low-glycemic
carbohydrates; these carbs (green vegetables, for example) have a much lower impact on your blood sugar and insulin.

What’s the Difference Between the Glycemic Index and the Glycemic Load?

The glycemic load is a more accurate predictor of what’s going on with blood sugar and insulin than the glycemic index. Here’s why. Suppose I put an empty bucket under a faucet and I want to know how much water is going to wind up in the bucket. You can see immediately that there are two variables I need to know: the water pressure (how high I turn on the faucet), and how
long
I’m going to leave it on. In the same way, if I want to know the impact of a particular food on blood sugar and insulin, I need to know two things: the glycemic index,
and
how
much
of that food I’m going to eat!

The glycemic
index
tells you the impact that a 50-gram serving of a particular food will have on your blood sugar. The glycemic
load
, on the other hand, also takes into account the amount of carbs actually in the food. Remember that all the low-carb plans consider the number of net, or effective, carbohydrates in a serving, because we need to know that information in order to determine the total impact the food is going to have on your blood sugar. Some foods have only a few grams of available carbs; so even if their glycemic index is high, their overall impact will be reduced because there are so few of them. The glycemic load is a measure of that
overall
impact. To find the glycemic load, multiply the glycemic
index
by the number of
net carbohydrates in a standard serving
(find the glycemic index for various foods at
http://www.glycemicindex.com
).

Consider the difference between carrots and pasta. Carrots have a glycemic index of 47, higher than that of whole-wheat spaghetti, which is only 32. If this was the only information you based your decision on, you’d think carrots were much worse, from a blood-sugar point of view. But while there are only 6 net (or effective) grams of carbs in a carrot, there are a whopping 48 grams of net carbs in the pasta! Let’s calculate the glycemic load (index times net carbs): carrots would be 47 times 6, which is 282. But the calculations for the spaghetti would be 32 times 48, which is 1,536—more than 500% higher than carrots!

What’s the Best Type of Protein Drink to Use?

Whey. It seems to be the best all-around source of protein, followed by soy that has been enriched with methionine (an amino acid not found in soy). Whey is absorbed the best and is the most available; it also increases levels of glutathione, perhaps the most powerful antioxidant in the body. There are a lot of people on the anti-soy bandwagon right now, but I think soy protein
in moderation
is fine. Whey, however, is better.

What’s the Difference Between a Protein Drink and a Meal-Replacement Shake?

Protein powders are 100% (or almost 100%) pure protein. You can drink them by themselves or make a “meal-replacement” drink with them by adding a controlled amount of carbohydrates (berries are a good choice) and maybe some fat like nuts or nut butter (women can add flaxseed oil if they don’t mind the taste). Designs for Health makes an excellent protein powder called PaleoMeal that is enriched with omega-3’s and a number of other terrific ingredients (available on my Web site,
http://www.jonnybowden.com
).

Meal-replacement shakes have carbs, protein, and fat in different proportions depending on the philosophy of the company making them. Many are very high in carbs.

What’s Wrong with Grains? Aren’t They Supposed to Be Healthful?

Grains, grain products, starches, and sugars all share some common links: they turn into glucose (sugar) in your body very quickly, they promote addictive eating habits in a large percentage of people, and they trigger insulin release. All of these things result in weight gain and other health problems.
²³
Grains also contain compounds called phytates and pyridoxine glucosides that block absorption of B vitamins, iron, zinc, copper, and calcium and lead to possible mineral deficiencies that can slow metabolism. (For a full discussion of grains, see “The Problem with Grains” on page 207 in “The Paleo Diet.”) In addition, both gluten and certain protein fractions of gluten are a big problem for many people. It used to be thought that celiac disease—a sensitivity to gluten—was rare. We now know that it probably affects one in thirty-three people. That’s a lot. There are an amazing number of toxins used in the processing of wheat and grains, and it is entirely possible that some of the problems that people have with wheat are actually caused by these toxins. (Other problems are definitely caused by the wheat itself.)
²⁴
Clinically, an awful lot of problems seem to just magically “clear up” when you take grains, especially wheat, out of the diet. While whole grains are in theory better than refined grains, they’re not nearly as common as you might think. The making of flour is itself a refining process. And the “wheat breads” in your grocery are no better than white bread. Couple this with the fact that grains usually have a very high glycemic load, and you can see the potential problem. Obviously, not everyone will have a problem with grains, but cutting them out during the initial stages of a low-carb weight-loss program is definitely a good idea.

Is Coffee Okay?

Probably. Those who argue against coffee are concerned with its possible effects on insulin and the adrenal glands. Atkins didn’t like it because he felt it caused unstable blood sugar. There is some research that suggests that caffeine increases insulin resistance
²⁵
and that it raises insulin levels.
²⁶
How much this matters as a practical consideration is debatable—the insulin insensitivity it produces in studies may be an insignificant amount as a practical matter and may be only temporary. There is also research showing that coffee actually
improves
insulin sensitivity
²⁷
and contributes to
reducing
insulin,
²⁸
as well as some research that says it has no effect on insulin at all.
²⁹
And in one study, coffee was actually associated with a much
lower
risk of type 2 diabetes.
³⁰

While coffee is obviously a stimulant, drinking it is also a very pleasant experience for a lot of people, and that has to be factored into the mix. Those who are very concerned about adrenal health (Dr. Diana Schwarzbein) recommend dumping it, but others say it’s fine. From a weight-loss perspective, it’s probably not going to hurt at all; but if you’re looking to go the last mile for ultimate health, you’d be better off without it.

Important note: it’s not just the caffeine that’s a problem (there’s caffeine in green tea too, and that doesn’t seem to hurt anyone): it’s the enormous amount of toxins in the coffee plant. You can go a long way toward reducing any negative health impact of coffee by purchasing organically grown beans.

Are Diet Sodas Acceptable on My Low-Carb Diet?

You’d be
much
better off without them. If you can’t give them up right away, put it on your goal list and at least start cutting back. Most of them use aspartame, which should definitely be eliminated (see next question); in addition, diet soda can stall weight loss in some people (up to 40% to 50%, by some estimations), possibly due to the citric acid they contain.

Many people do drink soda addictively (I had one client who routinely consumed sixteen cans a day), and the amounts consumed by people like this have never been tested for safety in long-term studies. Through a classical conditioning mechanism, like the one used to teach Pavlov’s dogs to salivate at the sound of a bell, drinking diet soda may well trigger insulin production (as may the consumption of other artificial sweeteners). And the chemicals, food colorings, flavorings, and other stuff in diet soda make it no picnic for the liver, either.

What about Aspartame?

Aspartame, the most common of the artificial sweeteners and the one used in most diet sodas, is a real problem. Even though it has been declared “safe,” the FDA has received numerous reports of seizures and other problems that have been linked to it.
³¹
There’s also good reason to believe that aspartame may be neurotoxic.
³²
In a report to the Senate Labor and Human Resources Committee, Dr. Richard Wurtman, professor of neuroendocrine regulation at the Massachusetts Institute of Technology, stated that the most common side effects linked to aspartame include dizziness, visual impairment, disorientation, ear buzzing, a high level of SGOT (a liver enzyme), loss of equilibrium, severe muscle aches, episodes of high blood pressure, and other not-so-lovely stuff.
³³
Other reports claim that in susceptible people, aspartame can produce symptoms ranging from sleep disturbances to headaches to fuzzy thinking to mood disturbances, and one recent article in the
Townsend Newsletter for Doctors and Patients
suggested that in susceptible people (called aspartame responders), the substance could be somewhat addictive. Kathleen DesMaisons, PhD, an expert in addictive nutrition, believes that the taste of any sweetener, for sugar-sensitive people, evokes a beta-endorphin response in the body which will create cravings.
³⁴

No integrative or holistic practitioner I interviewed had anything good to say about aspartame. The consensus: stay away.

What about Artificial Sweeteners in General?

You basically have seven choices.

•
Aspartame
(Equal), is probably the most commonly used artificial sweetener these days, but it’s also one that I
cannot
recommend (see previous question).

•
Saccharin
(Sweet’n Low) has been around for about a hundred years, and at one time it had a reputation as a cancer-causing agent because of studies in which rats got bladder tumors when they were fed incredibly high amounts (equivalent to what a human would get drinking eight hundred cans of diet soda a day). Recently, saccharin was declared safe, and probably is—in reasonable amounts. Next to sucralose and stevia, it’s probably the best choice.

•
Cyclamate
(Sugar Twin, Sucaryl) also continues to have a cloud of smoke around it concerning cancer in rats, but it too has been added to food and beverages since the 1950s and is probably safe in small amounts.

•
Acesulfame-K
(Sunette) is in the same family as saccharin but isn’t widely available in the States.

•
Sucralose
(Splenda) was once the most promising of all, but recent investigations have raised serious concerns about its composition. Until the jury is in, I no longer recommend Splenda. It is basically a slightly chemically altered version of sucrose (sugar) and is 600 times sweeter. The chemical alteration prevents the digestive system from “recognizing” it and absorbing it, so it doesn’t cause the rise in blood sugar and insulin associated with sucrose, unless of course it turns out to cause an insulin rise through a conditioned response mechanism. The problem with Splenda—and it is theoretical but disturbing—is that the chemical “alteration” involves adding chlorine molecules. As of this writing, there is a growing movement among “natural health” people to ban Splenda, due to enormous concerns about that chlorine molecule. The situation is evolving, so it bears keeping an eye on.

•
Erythritol
is, in my opinion, one of the most promising “artificial” sweeteners currently available. It’s a natural sugar alcohol, has virtually no glycemic impact, and tastes great. And you can use it in beverages. Several companies are coming to market with erythritol in individual serving packets. Keep an eye out for them.

•
Stevia
is an herb sold as a food additive, which has basically no downside except a somewhat weird aftertaste that some people don’t mind at all. You can get it at any health-food store.

Note that the only ones you can cook with are Sweet’n Low, Sugar Twin, Sunette, and Splenda.

Is Fructose Okay?

No. Fructose doesn’t raise blood sugar a lot, so it used to be thought of as the perfect sweetener for diabetics. Bad idea. Even though it doesn’t raise blood sugar very fast, it induces insulin resistance in both animals
³⁵
and humans.
³⁶
Fructose is turned to fat in the liver, so it raises your triglycerides. High-fructose corn syrup is the worst offender of all. When you consume fructose, make sure it comes in its natural container—fruit—surrounded by fiber. Never use it as a sweetener, and don’t make a habit of eating foods that are sweetened with it.