The Dash Diet Weight Loss Solution: 2 Weeks to Drop Pounds, Boost Metabolism, and Get Healthy (A DASH Diet Book) (10 page)

While research has shown that vegetable juice can help with successful weight loss on the DASH diet, in general you would like your fruits and vegetables to be whole. You

want the fiber. You want the bulk of whole foods. You want the meal to keep you

feeling full longer than 30 minutes. This is especially important to remember with fruit juices; try to limit them to 4 to 6 ounces per day. It’s better to have whole fruits.

Whole Grains

When we have grains, we want them to be whole grains. Fiber, phytochemicals,

vitamins, and minerals from whole grains are very good. Studies have shown that people who have more whole grains in their diets tend to be less likely to develop diabetes.

For people with sensitivity to gluten, it is absolutely fine to substitute gluten-free (GF) whole grains for wheat products. (For more information on food sensitivities or allergies, see Appendix A.) With the DASH Diet Weight Loss Solution, it actually will be easier to follow a GF plan. Most foods are made without any hidden additives and little flour is used in food preparation, so what you see is what you eat. Cutting out any gluten foods can explain why people often feel so much better during the first two weeks, when no

grains are included in the plan.

When choosing cereals and breads, the only flour used in the food should be whole

grain. The food manufacturers use lots of tricks to confuse us. For example, some cereal producers are putting small amounts of whole grains into their products, and then blazing the words “Whole Grain” across the front of the box. Surprisingly, you can’t always use color to judge if a bread is whole grain. It might have caramel food coloring added to make it appear to be whole grain. When you are choosing cereals, try to get those with no more than 5 grams of sugar, and less than 250 milligrams of sodium.

Fiber

While many of us get too many calories each day, most of us get far too little of the fiber that we need. Recommendations are that we should get 14 grams per every 1,000 calories in our diet. This will not be a problem with the DASH diet, since your foundation will be vegetables, along with sufficient fruit, whole grains, and nuts, seeds, and beans. Just make sure you are getting 6 to 8 glasses of fluid each day. (Fiber without sufficient fluid can be constipating.) If you have trouble digesting the high-fiber foods, consider Beano to help avoid gas.

There are two main types of fiber—soluble and insoluble. Whole grains are especially

rich in insoluble fiber, which is also referred to as roughage and helps to keep your bowel movements regular. Soluble fiber is found in large amounts in beans and fruits, and can help lower cholesterol by reducing the amount of dietary fats you absorb. It can also be beneficial for blood sugar control, since it slows the absorption of glucose during digestion. Regularity is enhanced, since it makes stools softer, bulkier, and easier to move through the intestines.

Research has shown that taking one type of soluble fiber, psyllium, at about 10 to 12

grams per day, can reduce cholesterol by about 3% to 14%. If you decide to add

psyllium to your daily regimen, increase the dosage slowly until you reach the 10-to-12-gram target. (Check the package for serving sizes.) Be sure to drink plenty of fluids.

Not all soluble fiber helps to lower cholesterol. Another term for the ones that do is functional fiber, which helps to differentiate it from the soluble fiber that doesn’t have this special health benefit. Several food manufacturers have introduced new soluble fiber products that have not been shown to have any health benefits, so choose proven

products.

Examples of functional fiber include most of the naturally occurring plant fibers,

including beta-glucan from oats, pectin in many types of fruit, psyllium fiber, and guar gum. For a list of specific foods rich in soluble fiber, see the table
here.

Some Good Sources of Fiber

Soluble fiber, grams

Total fiber, grams

Apple, unpeeled

0.4

3.0

Pear, unpeeled

0.7

4.6

Raspberries, ½ cup

0.3

2.6

Prunes, 5

1.1

3.1

Avocado, ½

1.2

3.1

Sweet potato, ½ cup

0.5

1.9

Broccoli, 2 stalks

0.2

1.8

Carrots, ½ cup

0.4

1.9

Spaghetti sauce, ½ cup

0.6

3.0

Kidney beans, ½ cup

1.0

4.5

All-Bran cereal, cup

0.7

8.1

Oatmeal, cup

1.2

2.7

Sugar Alcohols

Sugar alcohols, such as sorbitol and mannitol, have been long used as low-calorie

sweeteners in foods. Even though they technically have the same calories as other

carbohydrates, they are very difficult for the body to digest, which significantly reduces their caloric contribution to the diet. However, they can have one disturbing side effect if overconsumed. The sugar alcohols are well known to cause diarrhea. This can be

especially noticeable in sugar-free baked goods, where they can be used in high amounts.

And it can be especially problematic for someone who is taking metformin, a common

diabetes medication, which also tends to increase the risk for diarrhea.

One strong benefit of the sugar alcohols is that they are noncariogenic, that is, they do not cause cavities and may prevent them and reduce the risk of periodontal disease. These products have been popular in sugar-free chewing gum for this reason.

Artificial Sweeteners

I was counseling a woman who had just had a heart attack two days prior. She had

poorly controlled type 2 diabetes, which is often associated with increased risk for heart disease. She told me that her daughter wanted her to manage her disease more naturally, saying that artificial sweeteners were poison. Stunned, I explained that for her, with poor glucose control, the starchy foods and sugars were more likely to be poison. (Yes, I

know the dietitians are cringing now, but the relatively young woman had just had a five-way bypass after her heart attack!)

Without enough insulin being produced by her body, sugar and starch would cause

her blood sugar levels to rise, causing damage to her eyes, kidneys, nerves, and the lining of the veins and arteries. They would also cause her liver to become infiltrated with fat, and pump out excess triglycerides, further aggravating coronary artery disease. They

would lower HDL levels (good cholesterol), which helps to keep arteries clean of

cholesterol plaque buildup.

While it has been popular to denigrate artificial sweeteners, they do have a place in the diet for those people who want to have sweet-flavored foods but who can’t handle the

calories and/or sugar. Artificially sweetened dairy foods can be a great way to get the flavor without adding extra calories. However, artificially sweetened baked goods and pastries are still high in starch and usually have calories equal to the original foods. And for diabetics, since the starch breaks down to glucose during digestion, they are not a better choice than the regular baked goods with sugar. Furthermore, they are usually high in saturated and/or trans fats, which can increase the likelihood of developing type 2

diabetes and heart disease. Most baked goods and pastries are best avoided, unless you are a highly active child who can burn off those extra calories. The bottom line is that, for most of us, artificial sweeteners are a better choice than sugar, especially for people who have or are at risk for heart disease and diabetes.

Another source of extra sugar is energy bars. In general, I am not a big fan of these, other than for people who are engaged in strenuous exercise and need portable energy

sources. Yes, energy bars may have healthy ingredients, such as whole grains or dried fruit. However, for most of us, better choices are the snacks that we show in our menus, with fruits and nuts or cheese, or yogurt and nuts. These choices will fill you up and keep you feeling satisfied longer, without the sugar spike from energy bars.

If you want to avoid the artificial sweeteners, fruit is a great source of natural

sweetness and, of course, is a key part of the DASH plan. You can also try noncaloric natural sweeteners such as stevia. Many other natural sweeteners are based on fructose or sucrose, and thus have the same calories and contribution to blood sugar levels. Some examples are honey, agave, molasses, and maple syrup. With some of these foods, you

can use a little less than with regular table sugar; however, it may not make a significant difference in calories. Again, with baked goods and pastries, less sugar means more

starch, and therefore equal calories and blood glucose. Xylitol is a naturally occurring sugar alcohol that is becoming more common, and has similar benefits and concerns as

other sugar alcohols.

Choosing the Best Carbs

Make a plan to choose great carbs. Think about which high-fiber foods you enjoy and

take a list of them to the grocery store. Stock your pantry and fridge with all the options you love. If you want to avoid foods with artificial sweeteners, choose fruits for

sweetness. It may take some planning, but once you get into your new habits, you won’t even think about the higher-sugar options.

CHAPTER 9

The Skinny on Fats

What are the popular fats today? We hear a lot about omega-3s and monounsaturated

fats. Everyone knows that we want to choose meats that are “lean” (if we eat meat). But it can be confusing to know what to eat, since “expert” nutrition recommendations have

swung back and forth from saying limit your fat intake significantly to stating that fat isn’t a villain; avoid all animal fats, but fish oil is great; butter is bad, but then margarine is worse. And on and on. I will try to help you understand which fats are good for you, and which ones should be avoided, especially for someone who is at risk for diabetes and heart disease.

The Contrarian Viewpoint

Some very popular fats that you will not find here include flaxseed (and its oil) and coconut oil. While much has been written about the health benefits of these fats, I am not convinced. We will choose fats that have been consumed by large groups of people for

long periods of time and have been demonstrated to be associated with lower risk for

heart disease.

Regarding flaxseed, this is not a foodstuff that has been extensively consumed by

humans. The primary fat in flaxseed is alpha-linoleic acid (ALA), which is an omega-3

fatty acid. Some particular omega-3s are considered to be very healthful, specifically EPA and DHA. Flaxseed oil has been promoted as a plant source of omega-3s, which

can be converted in the body to DHA and EPA. However, most evidence indicates that

humans convert very little of the ALA into DHA and EPA. So this becomes less of a

benefit. ALA is an essential fatty acid, but one that is unlikely to be deficient in a diet with a variety of heart-healthy fats. One recent study sought to learn about longer-term effects of flaxseed consumption. They were concerned that there could be problems with the production of red blood cells and kidney function. In the 4-week study, there were no immediate health problems. Flaxseed consumption did not lower blood pressure, did not lower cholesterol, but did raise harmful triglycerides. Some studies are suggesting that increased intake of ALA can raise the risk of prostate cancer. Flax and flaxseed oil are very susceptible to oxidation. And oxidation can be one of the initiators of some kinds of cancer. Proponents will say that the lignans in flax are strong antioxidants and so will counteract the oxidation potential of flaxseed oil. However, I remain concerned, since the lignans and the fats get separated during digestion, and each goes its own way in the body. So that leaves the linoleic acid subject to oxidation. To get a better understanding of this process, think of fats or oils going rancid. Is that a process you want going on in your body? It is, in fact, oxidation that causes fats to go rancid, and the fats that we are avoiding are more susceptible than others.