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This article is no way a promotion for the Atkin's diet, Protein Power, Sugar Busters, etc. or any other high protein/low carbohydrate diet.  The purpose of this article is for education concerning the physiological effects of sugar and refined carbohydrates on the body.  Consult your physician before beginning any diet program.

Low Carbohydrate: A style of eating.  A way to keep the working population healthy and the medical costs low.  Type 2 diabetes is epidemic and reaching into adolescence.  Low carbohydrate nutrition is a proven way to prevent and treat diabetes.  Low carbohydrate nutrition also prevents a multitude of cardiovascular, ophthalmic and kidney complications as well as preventing hunger, low blood sugar and food cravings.  The key is to break the cycle of eating potatoes or rice, refined (white) bread and sugar.  The present dietary recommendation of eat less fat and more carbohydrates is the cause of the obesity epidemic in America.

Let's look at starches and refined carbohydrates from an industrial point of view.  Calorie for calorie, starches and refined carbohydrates are the cheapest nutrients for the food industry to produce.  They can be sold at the highest profit, it's what we like to eat and it's what poor people can afford to buy.  Since the late 70's annual grain consumption has increased almost 60 lbs. per person.  Caloric sweeteners increased by 30 lbs.  We consume more total calories, now up to 400 more each day, since the government started recommending low fat diets.

Fat is harmless, it is even necessary.  Decreased fat consumption, along with drugs to lower the lipid profile (cholesterol), has paralleled an increase in the suicide rate.  It is the major contributing factor for the deficiencies in essential fatty acids in the US which play a critical role in proper brain and neurological function.

The fact of the matter is carbohydrates such as pasta and bread, rice and potatoes, bagels, and sugar cause obesity and heart disease.  Let's look at some reasons why.

The low-fat-is-good dogma: Reality as we now know it
Hundreds of millions of dollars have been spent to prove the low fat diet's with.  The focus on the adverse effects of fat may have contributed to the obesity epidemic that started in the early 1980's.  Since the early 1980's overweight children have tripled in number and physicians have begun diagnosing Type 2 diabetes in adolescents.  This diet has simply failed the test of time.

In the 1960's, 13-14% of the population was obese.  It went up 8% in the 1980's.  By the end of the 80's nearly 1 in 4 Americans was obese (25%).  The rise in obesity continued through the 90's even though exercise activity remained unchanged, which was an increase from the previous decade.

Type 2 diabetes also rose significantly through this period and heart disease has not declined as had been expected.  In spite of the poor showing of these statistics we "seem" to be doing everything right:  the percentage of ingested fats has been decreasing for two decades, cholesterol levels have been declining and people have been smoking less.

So what isn't working?  Could it be what we now eat?  Fast food consumption c0ontinued to grow steadily through the 70's and 80's, but did not take a sudden leap, as obesity did.  The current low-fat dogma is only about 25 years old.  Until the late 7 -'s it was accepted that fat and protein protected from overeating by making you feel satiated.

Endocrinology 101
Carbohydrates affect insulin and blood sugar.  They also affect fat metabolism and appetite.  Obesity is not due to a lack of willpower and a failure to exercise but because the public health authorities told us to eat those foods that would make us fat -- and it did.  Ask any farmer and he will tell you the way to fatten up pigs and cows is to feed them grain and other carbohydrates.

Let's look at the amazing hormone called insulin.  Insulin regulates blood sugar levels.  After eating carbohydrates they are broken down into component sugar molecules and transported into the blood stream.  The pancreas then secretes insulin, which shunts the blood sugar into muscles and the liver as fuel for the next few hours.

Insulin also regulates metabolism.  We cannot store body fat without insulin.  For a few hours after eating you burn carbohydrates for energy and store excess calories as fat.  During this time insulin levels are high.  When insulin has been depleted, you burn fat as fuel.

This is where insulin becomes a complicated issue.  The fatter you are the more insul8in your pancreas will pump out per meat and the more likely you will develop "insulin resistance" or Syndrome X.  Cells become insensitive to the action of insulin.  You then need greater amounts of insulin to keep your blood sugar in check.  As you gain weight, insulin makes it easier to store fat and harder to lose it.

Remember, when insulin is low you burn fat and when it is high you store fat.  This is why insulin resistance makes it easier to store fat - because of the high insulin levels.  The insulin resistance then prompts the pancreas to produce more insulin and you get stuck in a vicious cycle.

Insulin also affects hunger.  Insulin can indirectly cause hunger by lowering your blood sugar.  It also works in the brain to suppress hunger, so if the brain loses its sensitivity to insulin it will no longer compensate by suppressing appetite.

When diabetics get too much insulin, their blood sugar drops and they get ravenously hungry.  They gain weight because they eat more and the insulin promotes fat deposition or storage.  This happens especially when we eat the carbohydrates of sugar and white flour.

How does this affect weight loss?  Think of how many people keep their calories low by having toast and juice for breakfast.  The body thinks it has run out of fuel (due to the low calorie meal), but the insulin is still high enough to prevent you from burning your own fat (due to the carbohydrates).  The result is a craving for more carbs.

How does fat influence insulin?  Fat and protein make you satiated.  Avoiding carbohydrates and the ensuing swings of blood sugar and insulin, you stay satiated.  The low carbohydrate diet is ketogenic - insulin falls so low that you enter a state called ketosis.  Your muscles and tissues burn body fat for energy as does your brain in the form of molecules produced by the liv called ketones.

This is not to be confused with ketoacidosis, a variant that occurs in untreated diabetics and can be fatal.  Ketosis may be the normal physiologic state of man.  On the evolutionary scale it is not normal to have a McDonald's around every corner - it's normal to starve.  It has been shown that the heart and brain run 25% more efficiently on ketones than on blood sugar.

Mankind did not evolve to eat a diet high in starches or sugars.  We have only been counseled to eat them in high amounts for the past 25 heard even though grain products and concentrated sugars have been around for nearly 10,000 years - a fact absent from the literature on obesity.  As the record shows, eating fat-free carbohydrates makes us hungrier and heavier.

Syndrome X, or insulin resistance, causes a cluster of conditions that can lead to heart disease and Type 2 diabetes.  A low fat, high carbohydrate diet can raise triglyceride levels, lower HDL levels, and accentuate Syndrome X.  A primary cause of Syndrome X,  heart disease, Type 2 diabetes and obesity is the long term damage caused by the repeated surges of insulin that comes from eating starches and refined carbohydrates.  Starches and sugars also raise triglyceride levels - a greater risk for heart disease than cholesterol.

The Glycemic Index
The glycemic index is a rating of how fast a food causes your blood sugar to rise thus causing an increase in insulin.  The faster the rise in blood sugar the higher the glycemic index.  Sugars have a high glycemic index but starches can be absorbed into the blood even faster than sugar.  The longer it takes the carbohydrates to be digested, the lesser the impact on blood sugar and insulin.  Foods with the highest ratings are simple sugars, starches and items made with flour.  Green vegetables, beans, and whole grains cause a much slower rise in blood sugar.  Protein and fat have the same effect.

High glycemic index carbohydrates are absorbed quickly and then cause a spike of blood sugar and a surge of insulin within minutes.  The resulting rush of insulin stores the blood sugar away and a few hours later your blood sugar is lower than it was before you ate.

Reality Check: The low fat message is oversimplified.
The low fat message ignores the fact that unsaturated fats, like olive oil, are good for you.  Saturated ("bad") fats elevate both good and bad cholesterol.  There is no health gain by giving up milk, butter and cheese.  More than 2/3 of the fat in a porterhouse steak will improve cholesterol profile.  The same is true for lard.  But after 20 years of low fat programming, it is hard to look at a breakfast of bacon and eggs without imagining the imminent onset of heart disease.

The National Institute of Health (NIH) spent several hundred million dollars trying to demonstrate a connection between eating fat and getting heart disease.  Despite what we might think, the link was not proven.  However, once the NIH signed off on the low-fat doctrine, societal forces took over.  The food industry began producing thousands of reduced-fat food products but it had to be replaced with something tasty - like some form of sugar.  Then an industry emerged to create fat substitutes.

So what are some good sources of carbohydrates?  A good general rule is to eat foods with a low glycemic index.  The higher the fiber content the lower the glycemic index.  Such foods would include vegetables (especially leafy greens), whole grains and beans or legumes.  Many fruits have a low glycemic index, but due to the natural sugars which they contain, their indexes are higher than vegetables.  These foods also have an anti-inflammatory effect on the body.

The general rules to follow for carbohydrates which should be avoided include anything that states "refined" or "enriched" flour in the ingredients, sugar, white flour and white pasta, and any ingredient which ends in "--ose" -- high fructose corn syrup, dextrose, maltose, etc.  Another thing to remember is that certain vegetables which tend to have high starch contents, such as potatoes and carrots, increase their glycemic index when cooked.  In fact, it has been said that eating a baked potato has the same response on the body as eating a potato skin full of sugar.  While this is certainly  not true nutritionally, it is true for the insulin response that occurs in the body -- they are almost identical.

As a final note, the western mindset of thinking which says, "If a little bit is good, more must be better," is most often not the case.  The most important principle to remember with any health habit is the principle of Balance The body constantly seeks for a perfect state of balance or homeostasis.  The health habits we choose and the way we implement them can either facilitate homeostasis or inhibit it.

For more information concerning your specific health or dietary needs, please feel free to consult Dr. Burrup!