Does Exercise Make You Lose Weight?

When I was reading Gary Taubes book, Good Calories, Bad Calories: Challenging the Conventional Wisdom on Diet, Weight Control, and Disease, I wasn't all that surprised by his findings about weight loss and exercise.

In fact, much of what he said didn't register on my radar, other than a "yeah that sounds about right" type response as I continued to read on.

My lack of, dare I say, disbelief in his audacity to say exercise doesn't make you lose weight, most likely stemmed from my own experience with weight loss years ago.When I counted calories (a la Weight Watchers) and hit the gym (at first three then five days a week) regularly - including exercise, and then increasing my exercise, it did nothing to make me lose any more weight. Not one who likes to be frustrated, I pretty much quit what wasn't working and quit going to the gym - and then months later, modified my dietary approach to a low carbohydrate diet (a la Atkins). Amazingly, I lost weight and continued to lose steadily without becoming a gym rat again.

So you can see why, as I read Taubes assertions on exercise - specifically that exercise does not make you lose weight or more weight while dieting - it didn't set off any alarm bells in my head. What he was saying meshed with my experience and what I've seen happen with others around me who adopt a carbohydrate restricted diet and don't hit the gym regularly when they start the diet.

Can you or should you exercise?

I'm not convinced Taubes was saying or is saying don't exercise, or that exercise has no benefit - by the end of the book, my impression was that he didn't find any good research to support the idea that exercise will make you lose weight as we're repeatedly told it will as part of the it's all about calories in and calories out; that he found the data doesn't show if you simply eat less and move more and you will lose weight.

Simply put, Taubes contends dieting with exercise doesn't make you lose more weight.

In fact, he reached the contrarian position that exercise does not make you lose weight from a number of studies designed to prove that exercise makes you lose weight - studies that found instead that weight loss is similar between groups who are eating similar calories and one group is exercising and one group is not exercising.

With the release of the book, no one seems to want to actually discuss the studies and data Taubes writes about; instead it seems the intent is to quickly stifle any and all discussion about the matter and maintain the status quo! Heaven forbid anyone learn that they won't lose more weight on the scale if they exercise!

Case in point in the effort to re-direct any discussion on the matter - when Taubes appeared on Larry King Live, among the guests was Jillian Michaels, a former a trainer from the show The Biggest Loser. She was quite visibly upset by the notion that exercise may not help one lose more weight than if they just diet - and stated up front that "exercise is essential to losing weight, just simply because weight is an energy equation."

The following heated exchange then took place:

BEHAR: Gary says exercise makes you hungry and so you eat more.

MICHAELS: Actually, I find that to be untrue in most cases. Exercise releases a series of different hormones, not just insulin.

TAUBES: You ever hear the concept of working up an appetite?

BEHAR: Go, go.

MICHAELS: Gary, if you can show me -- Gary, if you can show me one person you have taken 100 pounds off, then maybe we can apply your theory.

TAUBES: I'm not a diet doctor here. I'm just trying to say ...

MICHAELS: I appreciate that. But here's the thing ...

TAUBES: If you look at the actual evidence when people do clinical trials. Again, she changed a lot of things. She's changed her diet. She changed the way she ate. She exercised. All of those things might have had an effect. But the question is if you're actually doing a clinical trial where you randomize people who exercise versus sedentary lifestyle, you find that you can't show an effect from exercise?

MICHAELS: Wait a second. First of all, exercise actually releases serotonin and endorphins, which have been shown to decrease appetite. They release hormones like your thyroid hormones go up, your estradiol goes up, your testosterone goes up, your HGH goes up.These hormones, not just insuin, are integral to controlling metabolism, body fat and muscle mass. You are a scientist.

You appreciate the fact that science must be applied for a theory to be proven true. Your theory falls short when applied practically because I've applied it.

What's amusing about this particular exchange is how Michaels says Taubes' "theory falls short" when, if she'd actually read the book, she'd know it isn't "Taubes theory" but the conclusion he reached after reviewing the data from a large number of well cited studies.

Note in the exchange - she doesn't wish to discuss the studies; she bases her assertions on her experience with clients who follow her diet and exercise program. From that she believes that without exercise (and without any data to back her up) her clients would not lose the same weight as they do with exercise - afterall, she opened by stating her belief that "exercise is essential to losing weight."

End of discussion. Really! Rather than actually discuss the data or the studies, she instead sums up that Taubes is wrong and says he says what he does because it's "wildly convenient to come up with to sell books."

Okay. Whatever. Who needs data when they have Jillian Michaels?

In a recent New York Magazine article, Taubes wrote (uninterrupted) his analysis of the published data:

This is not to say that there aren’t excellent reasons to be physically active, as these reports invariably point out. We might just enjoy exercise. We may increase our overall fitness; we may live longer, perhaps by reducing our risk of heart disease or diabetes; we’ll probably feel better about ourselves. (Of course, this may be purely a cultural phenomenon. It’s hard to imagine that the French, for instance, would improve their self-esteem by spending more time at the gym.) But there’s no reason to think that we will lose any significant amount of weight, and little reason to think we will prevent ourselves from gaining it.

I point this out because no matter how clear Taubes was in the book, and no matter how many different ways he says it in interviews, somehow something is lost in translation.

Taubes asserts that one will not lose more weight while on a diet if they exercise or that exercise will make you lose weight.

Let's see if I can translate this - two words seem to be lost in the discussions going on about the book - WEIGHT LOSS - with or without exercise is found to be similar when one is dieting to lose weight, even in tightly controlled studies.

Basically, at the end of the day, whether you exercise or don't exercise, the number on the scale is likely to be the same.

For the majority seeing or hearing such words, I think the first thought might just be blasphemy!

And the next might be "burn the heretic!"

That might be because it is so deeply ingrained in our thinking that if you eat less and exercise more you will lose weight. Calories in calories out - if you eat less you consume less calories and if you exercise you burn more calories. Right?

For those of us who have been there, done that and have the XXL t-shirt to prove it didn't work...well we're often confronted by those who insist that it does work if you do it right; with the arguement foisted upon us being that if eating less and exercising more didn't work, then we did something wrong!

Unless of course we want to say we're freaks of nature who defy the laws of thermodynamics!

The funny thing is, Taubes book actually shows how it's possible within the laws of thermodynamics to fully experience little or no weight loss in a calorie deficit with or without exercise.

But, I digress - you'll need to read the book for those details.

Back to the subject at hand - do you lose more weight or not if you exercise?

My friend Adam Campbell, whom I adore, wrote an article on the subject, The Secret To Burning More Fat, on his blog, The Fitness Insider.

Unfortunately, even Adam made a critical mistake in his countering the idea that weight loss isn't all that different in those who exercise compared to those who don't.

He wrote, "There's been some buzz in the news recently about a story that suggests that exercise doesn't help you lose fat. I have plenty of thoughts on the matter, but for now, I'll just provide what I think is a powerful example of why this isn't true." [emphasis mine]

Do you notice the problem right at the start? Fat loss is not the bone of contention - it's weight loss with or without exercise. The issue Taubes talks about, the burning question that it comes down to really is this - at the end of the day, is the number on the scale significantly different in those who exercise when compared to those who don't, when the two groups eat the same calories?

Adam points to a study done by Dr. Jeff Volek as one piece of evidence that one can lose more fat with exercise - not just any exercise, but aerobic exercise and weight training.

But, remember, fat loss is not the bone of contention - it's what is the number on the scale at the end of the day!

After presenting a summary of the study (three groups, same calories; group 1 no exercise, group 2 aerobic exercise, group 3 aerobic exercise + weights) Adam writes, "[e]ach of the groups lost almost the same amount of weight—about 21 pounds...[j]ust because your scale weight may show similar results whether you exercise or not, don't assume that the right kind of exercise isn't providing a signficant benefit."

Exactly what Taubes contends - the weight on the scale is no different in those who exercise compared to those that don't.

Adam rightly shows, quite nicely too, that the quality of the weight lost differs - but the total amount of weight lost, what we're told exercise will do for us if we include it when we diet, isn't different.

Let's remember, Taubes' contention isn't about fat loss versus lean body mass loss - it's about weight loss - and the study presented shows exactly that!

The weight on the scale did not differ in those who did not exercise compared to those who did.

So no one misinterprets my intent here - I do think it's important to include activity and/or exercise in your daily routine; just not as a means to lose weight.

As the study Adam presented shows, a difference can be shown between fat loss (good) and lean body mass loss (bad) in those actively losing weight with diet and exercise (or not exercise).

In the above study those who included aerobic exercise and weight training saw a significant increase in fat loss even though they didn't lose more absolute weight, which means they preserved lean body mass - muscle!

Perhaps a better discussion isn't one seeking to discredit what Taubes wrote, but rather an examination of the studies he included so that we can explain to folks who are trying to lose weight that there are health benefits related to exercise that have nothing to do with the scale number at the end of the day.

Maybe if and when we can end the wishful thinking that exercise makes us lose weight, we can then engage in a discussion about how different types of exercise can help preserve lean body mass and lead to greater loss of fat, even if the total weight loss isn't greater with exercise.

What do you think?

Review: Good Calories, Bad Calories Gary Taubes

In the interest of full disclosure, I'll start by saying I received an advance copy of the book Good Calories, Bad Calories: Challenging the Conventional Wisdom on Diet, Weight Control, and Disease, by Gary Taubes, to review; my acceptance of an advance copy came with no strings; I was neither asked to write a review nor was it implied if I chose to, that it be positive.

That said, it's a good thing I received an advance copy - with over 600-pages of content, notes and bibliography, it's a dense reading adventure!

That's not to say it's difficult to read or understand; quite the contrary, I found it to be well-written and a compelling page-turner. Then again, this is the genre of writing I enjoy most - content that is well researched and strongly supported with references, citations and evidence...so you can imagine my excitment as I opened my copy and dug right in!

I was not disappointed.

I've held my review up until today as I was interested in watching how the media was going to play the release of the book. I wondered, would the various shows and articles encourage their viewers and readers to read the book, or would they seek to discredit Taubes to discourage any real discussion about his positions presented and the research he believes supports them?

Save for a couple of appearances and reviews, the silence around the release of the book is deafening. Taubes appeared on Good Morning America last week. The GMA website provides an excerpt from the book to read online and a video clip from the on-air segment (on same page), along with an area to leave comments. Later (same day) Taubes was featured on Nightline. The Nightline website provides a transcript of the show, a video-clip of the segment and an area for comments too.

This week, the Lifestyle: Health & Fitness section on Reuters published its review titled Count your calories.

In the Reuters article we find a glimpse of what is the at the heart of the book, "Good Calories, Bad Calories" examines an alternative hypothesis to the calorie- and fat-centric idea through decades of literature and clinical data on diet and obesity, Taubes says. It's another way to explain observations about diet and weight gain, he says, one for which strong data existed. "If we had taken this other fork in the road," he asks, "what would we have come to believe?"

The book is, in a word, a masterpiece; not because I think Taubes is right with all his conclusion, but because I feel he took the right approach to evaluate the science - he approached the research from the perspective of a skeptic; that despite his own beliefs at the start, he was going to let the data speak for itself and take him where it led from hundreds of studies published over the last century.

Before I continue with the review of the book, let me say that I believe good science requires one be a true skeptic; a good researcher, a scientist, then is not a proponent of any particular point of view, but remains cognizant of the fact that trials finding support for or refuting a hypothesis are both valuable in our quest for understanding; that seeing and believing the data, both in support of or refutation of a hypothesis, is the primary goal in scientific inquiry.

Simply put, letting the data speak for itself and remaining skeptical that your own belief in a hypothesis may in fact be wrong, is an important part of the process in scientific discovery; if one cannot remain open to the idea a hypothesis may be wrong, one cannot reject hypotheses that fail when put through the rigors of testing.

Which brings me back to the book.

Taubes tackles a number of issues in the book, notably the history of how we got where we are today with public health policies and dietary recommendations, and why, even without good science to support our policies as they developed, they were formed and promoted as fact to the population at large.

He then tackles what was two competing hypotheses at the time we hit the crossroad in our search for understanding how diet plays a role in disease: the diet-heart hypothesis and the carbohydrate hypothesis.

He asked, "If we had taken this other fork in the road, what would we have come to believe?"

The only way to begin to answer that question is to set aside what you think you know, set aside preconceived notions and dig into Taubes book.

It's rich with citations for studies lost in the noise and debate; filled with data and findings that for too long collected dust until he brushed them off for a second look; and leaves the door wide open for us to begin to really examine all the data we have.

The full weight of the evidence, Taubes contends, led him to conclusions he did not anticipate himself at the start; conclusions that are controversial but open-ended for more discussion, interpretation, analysis and trial.

Perhaps you too may find yourself in the same predicament at the end of Good Calories, Bad Calories: Challenging the Conventional Wisdom on Diet, Weight Control, and Disease; until you read it though, you just can't know, can you?

I highly recommend the book, for those who firmly hold carbohydrate restriction is scientifically valid and for those who firmly hold limiting dietary fat is scientifically valid.

At the end of the day our quest isn't to prove what is believed right, it's to discover what is rightly to be believed.

Taubes doesn't just argue that what we're told is wrong, he provokes us to examine our beliefs about a healthy diet by providing a wealth of data from hundreds of studies reviewed in his research in writing the book to argue the validity of the scientific process. That is, he presents a compelling arguement that the supportive data used to maintain the status quo of the diet-heart hypothesis and our current dietary guidelines is not as sturdy as we're led to believe, and makes the case that for well over a century there has been, all along throughout the last century, the competing alternate theory, the carbohydrate hypothesis, that has been ignored despite compelling data.

No matter what one currently believes, this book is an eye-opening examination of the science and the history that led us to where we are today; a compelling review of the weight of the evidence from both sides; and a resource rich with citations that allow us to begin examining and questioning the validity of our beliefs in the connections between diet and health.

How Do You Feel on Low-Carb?

An interesting short-term study published in this month's American Journal of Clinical Nutrition, Low- and high-carbohydrate weight-loss diets have similar effects on mood but not cognitive performance, sought to assess differences in mood following a high-carbohydrate diet compared with a low-carbohydrate diet.

In the study, ninety-three subjects were randomized into two groups:

• The high-carbohydrate dieters consuming a calorie restricted diet with 46% carbohydrate, 24% protein and 30% fat. Women consumed approximately 1429-calories each day, or 164g carbohydrate, 48g fat and 86g protein. Men consumed approximately 1667-calories each day, or 192g carbohydrate, 56g fat and 100g protein.
  
• The low-carbohydrate dieters consuming a calorie restricted diet with approximately 4% carbohydrate, 35% protein and 61% fat. Women consume approximately the same calories as above (there was no statistically significant difference for calories consumed in the study), or 15g carbohydrate, 97g fat and 125g protein. Men consumed approximately the same calories as above, or 17g carbohydrate, 113g fat and 146g protein.

Throughout the study, over the course of eight weeks, foods were provided to subjects and every two-weeks weight was taken and mood measured. Compliance by those following the low-carb diet was verified by measuring urinary ketone levels.

Both diets resulted in statistically significant weight loss.

The low-carbohydrate diet resulted in a statistically significant greater weight loss over the eight-week period than the high-carbohydrate diet, with low-carb dieters losing an average of 7.8kg (17.2-pounds) compared to 6.4kg (14.1-pounds) in the intent-to-treat analysis (p=0.04).

Both groups showed improvements in psychological well-being (p=0.01 for time) and there was no significant difference in working memory. The researchers noted "[t]here was some evidence for a smaller improvement in cognitive functioning with the LCHF diet with respect to speed of processing, but further studies are required to determine the replicability of this finding."

Update

I'll be back to my blogging duties on Monday, September 24, 2007!

Sorry about the long delay, things here are a bit hectic!

Dr. Gil Wilshire on PCOS and Infertility

Life here remains hectic and crazy! I do apologize for my scant posts in the last couple of weeks...and hope to catch up with everything this weekend and resume my regular posting schedule Monday.

In the meantime, I'd like to share with my readers today's podcast at Jimmy Moore's site; it's an interview with my husband, Dr. Gil Wilshire, MD FACOG! Jimmy and Gil discuss his practice, PCOS, obesity and infertility. I hope you'll take a few minutes to listen in!


Low-Carb and Fertility: Dr. Gil Wilshire, MD, FACOG

Mid-Missouri Reproductive Medicine & Surgery

Standard Podcast [24:37m]: Hide Player Play in Popup Download

Catching Up!

I've been completely swamped here and the time crunch has impacted my timeliness for posts here. After almost a week of preparing for our big summer party and pulling it off yesterday with more than 50 here, I have quite a bit of clean-up today to prepare for houseguests arriving tomorrow!

So, rather than leave things as they are here, and have nothing new...I'll post some places where others have written about studies or things I've had on my pile to get to, and then, hopefully will be back in full swing before the end of the week!

First up - Dr. Jay Wortman interviewed Gary Taubes about his upcoming book Good Calories Bad Calories, on CKNW. You can hear the broadcast when you register (free) and then head over to the "Audio Vault"...select August 4, 2007 broadcast at 10:00AM.

Jimmy Moore also recently interviewed Gary Taubes about his book, and that interview is here.

Next, Sandy Szwarc at Junkfood Science, wrote an article about Low-Fat is not for Kids; well worth stopping over there for her take on the issue of children and dietary fat.

Dr. Mike Eades wrote about Bantings Letter on Corpulence and then uploaded a free copy of the paper for anyone who wishes to read in its entirety.

Some bloggers are busy folks! Dr. Mary Vernon is one such blogger, and she posts when time allows. She just recently added her take on the New York Times article Looking Past Blood Sugar to Survive with Diabetes last week.

Carol Bardelli (Kudos for Low-Carb) has a great article called Metabolism 101 Part One - Starvation Diets Backfire. Lots of good information and links in that one!

Lastly, Dr. Richard Feinman, PhD from SUNY Downstate Medical Center wrote an article in Diabetes Health to point to the flaws in the article from Hope Warshaw back in May. I wrote about the article here; Dr. Feinman's article is here. The comments following his article are interesting to read too!

I've Been Tagged - Again!

Online Christian over at Low-Carb Lolygagging tagged me last week to post 8 random things about me. Once I've posted that, I'm supposed to tag eight more people to do the same. Here goes:

1. I love to cook, but hate cleaning up afterward....anyone who knows me, knows I can cook up a storm - but leave a kitchen disater in the wake - in preparing one meal, I can use every pot, pan, knife, bowl (you get the idea) available....and cleaning up will take longer than eating the meal did!

2. My newest nickname was born through my nephew; when he was learning to talk he'd babble at me "rah rah"....now, almost six years later I'm "aunt rah-rah" to him and my neice, and "rah-rah" has pretty much stuck with my husband, sister, brother-inlaw, some friends...even my son sometimes calls me "mama rah-rah"

3. Since we moved (just over a year ago) I still haven't figured out what I'd like to do for color in our home - every wall remains platinum white and just begs for color....oh, I have ideas, I just can't seem to commit to any color yet!

4. Four years (plus some) after getting married, my passport remains in my maiden name - it's finally going to expire, so I'll need to renew and change my name on it now...my reason for keeping my maiden name on it was nothing more than not wanting to have to pay to change my name.

5. I can't bring myself to eat scrambled eggs without ketchup; all because when I was a kid (ripe old age of four) I had a stomach bug and did the projectile vomit thing at breakfast one morning and in my kid-think-mind it was the eggs, not a stomach virus, that made me sick. To this day I cannot eat plain scrambled eggs without ketchup on them.

6. I can't sing (doesn't stop me, although now when my son says "mommy noooo" I will stop), can't dance, can't whistle or play an instrument.

7. I like to tinker with HTML and website design. My latest tinkering is with the website for my husband's practice at Mid-Missouri Reproductive Medicine & Surgery - it's not quite finished, but you can see it in the link.

8. I'm still amazed and surprised when I find I'm included in someone's blogroll or mentioned in an article that links back here - I started this blog as, well, a hobby...and am thrilled it's reached the level of readership it has; but the bigger surprise to me is that others link here! So, thanks!

And now I'm tagging:
Dr. Jonny Bowden
Fred Hahn
Cassandra Forsythe
PJ, the Divine Low-Carb
Jimmy Moore
Sweet Tart
Kevin Dill
Mark Sisson

Quick Clicks to Low-Carb Rules Articles

• Handing you the Keys to Success
• Establishing Good Eating Habits: Rule One
• Rule Two: Back to Basics
• Rule Three: Vegetables & Fruits are Heart of Controlled-Carb
• Rule Four: Starches, Sweets: No Longer Staples
• Rule Five: Break Free from Contradictions
• Rule Six: Empower Yourself
• Rule Seven: Use Your Smarts!
• Rule Eight: Keep it Real
• Rules to Drink it Up!
• Rules to Maintain a Balance

Rules to Maintain a Balance

Sometimes when we first start a low-carb diet, our bodies react in ways that might seem off, so the next rule addresses the "potty problems" that some find when they're starting on a new low-carb diet.

Rule 12:

• If you are constipated, mix a tablespoon or more of psyllium husks in a cup or more of water and drink daily. Or mix ground flaxseed into a shake or sprinkle wheat bran on a salad or vegetables.

This rule compliments rule 11 - that is it helps with strategies to avoid and counteract constipation. Water and high-fiber supplements are recommended to help maintain regularity. With any changes to your daily diet your body may experience short-term bouts of constipation and the above rule helps get you through this. It also reinforces for the long-term what works for constipation naturally rather than chemically processed products or sugar-laden fiber mixes that are commercially available.

The secret of this rule is that it is providing you with natural ways to alleviate constipation, not only in beginning, but in the long-term as you look to maintain your goal weight if you still have occasional issues.Important in this rule is to understand what it is to be constipated.

Constipation is not just not having a bowel movement for a couple of days - it is having the urge to have a bowel movement and being unable to go to the bathroom! When you do finally go, the feces are dry and hard. While not going for a day or two may be alarming, if you are not uncomfortable, you are probably not constipated. When you are constipated it is important to be sure you are getting plenty of water and increasing your fiber so that you are able to go without straining. Drinking water as instructed in the previous rule along with this one give you the tools to regulate yourself naturally.

The last rule we'll look at speaks directly to the recommendation to take, at minimum a good multivitamin with minerals. It's pretty much a universal given no matter what type of diet you eat that you should include a vitamin each day, and the same is true for those starting a low-carb diet.

Rule 13:

• At a minimum, take a good daily multivitamin with minerals, including potassium, magnesium and calcium, but without iron.

Many people starting out on a low-carb diet with both feet and take a large number of supplements.

In this rule, Dr. Atkins makes it clear that at minimum you need a good multivitamin each day. Also specifically mentioned are minerals, which are important to maintain electrolyte balance, especially when you're starting a low-carb diet and will experience a metabolic shift to burn fat primarily instead of glucose, which releases a lot of water from stored glycogen.

Much like the rule on water (fluid) intake is universally agreed as a "good rule", so too is this rule. While some people will benefit from additional supplements to their daily multi-vitamin, it is not necessary to start with more than a good multi-vitamin with minerals.

In the long-term, maintaining this habit of taking a good multivitamin is also a good idea no matter what diet you follow.

It is important to note with this rule that the multi-vitamin must have potassium, magnesium and calcium - these control and keep in balance your electrolytes (your body salts), so chooing one with a good balance and ratio of these minerals is important. Important too is to use a multi-vitamin not packed with iron (unless you have a medical reason to take additional iron) since your diet will now contain enough iron (if you follow it correctly) each day without additional supplementation of iron. Too much iron is as deterimental to your health as too little. Unless you have a reason to take more iron, find a good multi-vitamin without iron!

The secret within this rule is to learn to keep a balance - insure you're getting all the nutrients you can with real food and have a multivitamin each day to be sure if you missed somewhere along the way, you had it in your vitamin.

This rule and the one before it aren't about extremes - it is about balance.

By taking care of potential "potty problems" and including a good multivitamin each day, you're developing a habit that will enhance your ability to get all of your nutrients each day - even on those days you may not eat "well".

Rules to Drink it Up!

Three rules specify the importance of adequate hydration and choosing beverages wisely.

Rule 9:

• Avoid foods or drinks sweetened with aspartame. Instead, use sucralose or saccharin. Be sure to count each packet of any of these as 1 gram of carbs.

Rule 10:

• Avoid coffee, tea and soft drinks that contain caffeine. Excessive caffeine has been shown to cause low blood sugar, which can make you crave sugar.

Rule 11:

• Drink at least eight 8-ounce glasses of water each day to hydrate your body, avoid constipation and flush out the by-products of burning fat.

Starting with the last one, drinking eight 8-ounce glasses of water, provides direction to make sure we consume enough fluids each day.

It's universally accepted that water is important; with disagreement as to whether fluid intake must be water itself or any beverage that helps provide hydration. I tend toward the belief that all fluids count toward water intake - if someone wants to drink water, great!; if someone wants to consume iced tea with lemon or a diet beverage, great! It's all good as long as we also are mindful of the other rules which have important considerations when choosing what to drink.

Rule nine limits consumption of artificial sweeteners and specifically suggests that we avoid aspartame (NutraSweet, Equal) because evidence suggests it stimulates insulin and may cause lowering of blood sugars. This in turn would trigger hunger and leave one open to eating more than desired. Else where in Atkins book he provides an allowance of three packets of articifical sweetener each day of the two he recommends. This limit isn't to say you can't have something sweet, but rather forces selection and limitation as you're starting a low-carb diet.

That one must count each packet of any artificial sweetener as 1g of carbs - this alone places a limit on how much you can have in a day, without stating it, if you're following rule three and getting the majority of your carbs from vegetables and salads. Long-term, into maintenance, this is an excellent rule - it limits your exposure to chemical sweeteners and lessens the chance you'll use them in excess if you continue to follow this rule for the rest of your life.

The potential of caffeine to affect insulin and blood sugars is also included in the rules. Each time you have caffeine, your body has an insulin response and the potential for cravings to be triggered. In addition to the potential for cravings being induced by caffeine, there is also the risk of feeling more hungry and eating more than you would had you not had the caffeine. While initially caffeine may supress the appetite, later after its effects are waning, you may actually feel more hungry than you would have had you not had the caffeine.

It is especially important in the first two weeks to do all you can to limit your cravings; as you can see from the above rules that are in place, many of them aid in limiting the cravings to keep you on track. It is also important to begin to fully understand "hunger" and how much sates your appetite rather than leaving you stuffed. By avoiding caffeine, limiting artificial sweeteners and keeping yourself hydrated you're accomplishing this goal.

Dehydration when following a low-carb diet, due to ketosis, is to be avoided. It will increase the concentration of ketones in your body and the result is less efficient buring of fat for energy. You'll also run a greater risk of getting constipated, as well as, a greater risk of painful headaches. Proper hydration while you're in ketosis will help to eliminate the ketones from your body in your sweat, urine and respiration - you need the water intake to accomplish this each day.

As an aside, I've found caffeine has little effect on me. Over the years I've noted that it's a "your mileage may vary" type thing and usually recommend an individual see how they feel with and without caffeine in their daily menu.

Rule Eight: Keep it Real

A low-carb dietary approach is easy to maintain almost anywhere you can eat - at home, on the road or in a restaurant. The key is to carefully consider your options available and understand where carbs are most likely to be found in things "allowed" when they're prepared by others. When you're cooking at home, you know what ingredients you're using; on the road or in a restaurant, odds are high that the chef is using ingredients you won't be including in a controlled-carb diet.

Rule 8:

• Eat out as often as you wish but be on guard for hidden carbs in gravies, sauces and dressings. Gravy is often made with flour or cornstarch, and sugar is sometimes an ingredient in salad dressing.

In an effort to keep it real, rule eight establishes that it's perfectly reasonable to eat out, with a caution to be aware of ingredients used in food preparation. As one more rule, it again repeats an underlying theme within all the rules - take responsibility for what you do eat.

Simply put, do not assume anything in a restaurant is acceptable unless you ask or ingredients are clearly stated on the menu! Where ingredients are not disclosed on a menu, learning how to ask and actually taking the time to ask about ingredients and food preparation is something you'll become accustomed to over time - and in the long-term will be an invaluable asset in your tool-box of strategies to insure you're eating controlled-carb for life!

When you eat out, in addition to the food you get, you're paying for a service - to have your food prepared - so be fully prepared to expect to be served acceptable food for your diet. Start by asking that things be prepared in a way that is acceptable for you or ask for guidance as to what else is acceptable if the chef cannot prepare something without particular ingredients. The basic ingredients, at minimum, you must insist are not included in your meal because of carbohydrate content are sugar, corn starch, arrowroot, potato starch and flour. The standard food ingredients to not be included are bread crumbs, breading, rice, pasta and potatoes, sugar based marinades, high carbohydrate salad dressings, etc.

In addition, you also want to be careful to avoid dishes prepared with shortening, margarine and other fats high in trans-fats. This isn't explicit to the rule above, but given our current knowledge, it's something to avoid when eating out.

If a restaurant is having a difficult time accomodating you, choose a simple salad wth oil and vinegar for your dressing, have a basic protein grilled (no marinade) baked or broiled, and some steamed vegetables.

In all the years I've restricted carbohydrate in my diet, I've never been unable to find something on a menu that's acceptable. Sometimes it means being a bit creative, but as long as a restaurant has basic foods, you can find something to eat as a meal while you're there.

Rule Seven: Use Your Smarts!

It's almost impossible to miss the recommendation to read labels on food packages these days. It's good advice no matter what dietary approach you decide to follow, and is front and center in the Rule of Induction (Atkins) too, found in rule number seven.

Rule 7:

• Don't assume any food is low in carbohydrate - instead, read labels. Check the carb count (it's on every package) or use a carbohydrate gram counter.

This rule establishs a lifelong habit that, as you continue along with a controlled-carb diet, will be invaluable to you. You're expected to make it a habit to read labels and take responsibility for your food choices at the start of a low-carb diet and as you continue along and lose weight.

Once firmly rooted as a part of your food selection process, reading labels makes you a smart and savvy shopper - with an ability to quickly identify packaged foods that are not your best bets nutritionally.

While the first couple weeks has an underlying encouragement to limit foods to those which are fresh, it is possible to include a wide variety of prepared and/or packaged foods, thus the potential to derail success if you're not careful with your choices. So, in the first couple of weeks this rule is invaluable anytime you're including packaged processed foods in your menus.

The reality is that most people will include some packaged foods, whether salad dressings or prepared foods, from the start; so making it a habit to read labels reinforces the requirement that one take responsibility for what they eat.

Over time, reading labels helps to develop a keen eye while enabling one to make good choices among the packaged foods they include in their day-to-day menus. As more and more variety is added to a low-carb diet, it is critically important to be in the habit of reading nutrition labels - not only for carbohydrate content, but to understand ingredients used since differing brands of same-type items varying greatly not only in carbohydrate content, but ingredients used in the preparation of the packaged or prepared food.

When Looking Great isn't Good Enough

An interesting look at how what we see in magazines is manipulated into a warped reality is presented today at Jezebel.com as the site looks at how Redbook recently took liberties in doctoring the cover photo of Faith Hill.

This is how the Redbook cover photo appears on magazine covers:





















This is how the original photo of Faith Hill looked before it was touched up:

Rule Six: Empower Yourself

You may recall that in rule one of the Rules of Induction (Atkins), those starting the first phase of the diet are reminded to eat regularly and develop a pattern of eating each day that they're comfortable with, be it three meals a day or four or five. Also within that rule was the caution not to go more than six waking hours without eating something. I bring rule one up again today because it complements rule six, which says:

Rule 6:

• Adjust the quantity you eat to suit your appetite, especially as it decreases. When you're hungry, eat the amount that makes you feel satisfied, but not stuffed. When you're not hungry, eat a small controlled carbohydrate snack to accompany your nutritional supplements.

Where rule one speaks to our need to establish good eating patterns to take with us as we lose weight and then maintain our weight, this rule helps us understand that over time, as our weight declines, our food intake will decline and we still need to be aware that even with a diminished appetite, it's important to nourish our bodies for good health.

So many diets play on our fears - and one of the biggest is our fear that we lack enough willpower to actually stick with a diet long enough to lose the weight; forget about keeping it off!

One of the draws of a low-carb diet is the natural appetite suppression that comes within a few days of carbohydrate restriction. A large number of studies have noted that even when allowed ad libitum access to any and all of the foods allowed on a low-carb diet, those who stick with the allowed foods experience a "spontaneous" reduction on caloric intake while consuming an adequate level of protein and dietary fats to sate appetite and lose weight.

Sometimes the appetite suppression is so good that it's easy to miss a meal or go without eating too long. This rule reminds us that adjusting our food intake as we lose weight is expected, but we do not need to limit our intake to a point where we're potentially doing more harm than good, nor to we have to rely solely on willpower to lose weight or live with hunger pangs as we lose - we need nutrients from food, we need energy from food (even while losing weight) and we need to establish good eating habits.

That means eating for both to nourish the body and to sate appetite; adjust how much you eat to satisfy your appetite, allow yourself - give yourself permission - to eat and feel satisfied. Satisfaction with your meals keeps you motivated as you lose weight.

This rule does have a caution and that is to be aware not to overeat and stuff yourself, not to gorge or binge. For some who are new to low-carb this may be something that could become problematic - eating too little and then binging - so the caution is there to listen to your body, pay attention to your appetite and learn when you're hungry and when you're satisfied. Over time, if you're paying attention to this you'll find your body really does trigger hunger when you're hungry and if you're eating well, establishing an eating pattern happens!

The last part, to include a small carbohydrate controlled snack with your supplements, reminds us that including nutritional supplements is considered a benefit on the diet and eating something small with them can help you with rule one to establish good eating habits!

Over time as you lose weight, your appetite is going to naturally diminish and your energy requirements will adjust too. This is something to be aware of for the long-term - what you eat when you start - whether it's 3000-calories or 2000-calories - is going to slowly decline in time as your body weight is reduced. Someone who weighs 300-pounds needs more calories each day to maintain their weight than someone who weighs 150-pounds. So, in the long term, this rule is establishing this in your mind to remember later, as you reach a lower weight - you won't eat the same as you do at the start of the diet!

Overall this rule fosters a sense of empowerment - the understanding that you can, perhaps for the first time in your life, listen to your body and learn how to eat well over the period of losing weight and then as you maintain your weight!

Keeping Our Eyes on the Ball

Today I'd like to interrupt my series on understanding the short and long-term lessons found within the Rules of Induction (Atkins) and provide space for my husband, Dr. Gil Wilshire, MD to share his thoughts in a guest commentary. So, without further ado:

Keeping Our Eyes on the Ball
Gil Wilshire, MD, FACOG

Back in 2006, Regina and I were interviewed and asked about our thoughts on the future of dietary science and policy. We speculated that carbohydrate restricted diets would be an accepted, main-stream concept by the year 2040. I believe we are well on our way to seeing our goal fulfilled well before this arbitrary temporal milestone.

I try to remain constantly vigilant with regard to new scientific information, and it seems that in every month good, new information is published. Recently, Matt Hayes and colleagues (J. Nutr. 137:1944-50, 2007) drilled deeper into out understanding of carbohydrate restriction, metabolic syndrome, and the biochemistry behind satiety. I am pleased to see that our current shared clinical experience of spontaneous caloric control and rapid reversal of metabolic syndrome is now being bolstered by more clinical data. Although the study in question was rather timid with respect to carbohydrate restriction (it was a South Beach-type protocol) I still found the information valuable.

It is another, peer-reviewed paper to the ever-growing pile of scientific evidence supporting our position.

I would also like to add that my ever-growing clinical experience in my new home of Central Missouri continues to be very gratifying. It seems that not a month goes by where something good happens very quickly after a patient begins their new life style (I dislike the thought of "diets"...this implies a temporary change, instead of a whole new way of being). In my obese, "infertile" patients, it is fairly common for women to become pregnant before instituting hormone therapies. Women who appeared destined for the bariatric surgeon are losing huge amounts of weight...and now are making appointments with the plastic surgeons!

I must say, there are many doctors in the surrounding communities who are truly scratching their heads as our mutual patients make healthy progress eating "high fat" diets. Now, after some period of suspicion, I am actually getting requests to learn more about what we do in my office!

Positive results are very persuasive.

Nothing succeeds like success.

Being married to Regina is never boring, and I am privileged to hear all the latest details occurring within the nutritional community every night when I get home from the office. We are a disparate lot in the "low carb" community, with much independent thinking and talented, innovative thought leaders. I suspect that the field of nutrition and metabolism will never be one of lock-step agreement. However, I would like to take this opportunity to reiterate our common goals and to reinforce our shared understanding:

1) Current dietary recommendations that promote low-fat and low cholesterol diets are unscientific, unproven, and fatally flawed; and,
2) The vast majority of modern humans appear to function best when eating nutritionally dense, whole foods that most closely resemble those foods on which we evolved.

I believe it is these principles that unite us all. There will always be bumps in the road, and we must always be prepared for unexpected turbulence. That's life.

Let's keep our eyes on the ball! Slow, steady progress always wins the race.

Good health to us all!

Gil
Mid-Missouri Reproductive Medicine & Surgery

Rule Five: Break Free from Contradictions

Thus far we've looked at four of the Rules of Induction for the Atkins diet. I've used the Atkins diet rules because no matter which low-carb diet one chooses, these rules have little "gems" that can broadly apply to any controlled-carb diet based on its design, carbohydrate restriction and/or phases.

Today, we'll look at rule five. At first glance, it appears to be in a rather harsh tone toward the reader:

Rule 5:

• Eat nothing that isn't on the Acceptable Food List. And that means absolutely nothing. Your "just this one taste won't hurt" rationalization is the kiss of failure during this phase of Atkins.

Simply put, this rule is reinforcing the importance of being able and ready to begin something new and different while letting go of the "diet baggage" we all had/have that will not serve us well throughout weight loss on a low-carb diet, and certainly not when we maintain our weight later. The only way to say it is straight-out and without sugar-coating it - if you start the diet with bad habits and do not address them, they'll be your undoing on this diet (or any diet) you want to utilize as your means to lose weight.

This rule makes clear that everything on the 'acceptable foods list' is allowed, go and enjoy these foods; those not on the list are not allowed right now - not even one bite, not even if you can manage to include them within your carbohydrate allowance for this period. The time frame here is two weeks and you will not die without the foods that are excluded during this period.

You may crave them, want them, think you need them - but what you 'want' is not always what you 'need' and for now, there are plenty of nutrient-dense foods you are allowed to eat, so take this period to eat those and only those foods; more variety will come in time.

Many wonder why this rule is so harsh. In part it is helping to break habits of the past, in part wiping clean years of eating foods that were not the best choices for health and well-being, in part imploring you to ignore many current dietary contradictions, and in part to help you naturally supress cravings for carbohydrate-rich foods.

Did you catch that last item?

It is true for the vast majority of those starting a low-carb diet; if you can simply stick with the 'acceptable foods list' for your first two weeks, you'll find that cravings for carbohydrate-rich foods diminish quickly and by the end of two-weeks, they're supressed so you no longer think much about having bread or pasta or potatoes or sweets.

Now granted, these foods will always be around you; but you will now have a powerful way to make them less tempting in the future if you can avoid them completely for a couple of weeks.

In the process you'll be rewarded for your efforts and discipline too - you'll lose weight in the first two weeks, find you have more energy at the end of the two weeks, and also realize that the foods you used to reach for in times of stress or to celebrate can be replaced by foods that are better for you and your health.

What this two week period is teaching for the long-term is that you ultimately control what you choose to eat. It is a period that is allowing you time to step back from everything you think you know, retreat from all the contradictions we hear from the "experts," step back from all the habits you've developed over the years, and start again - at the basics.

This particular rule goes against everything we hear and read so often; on the one hand we're repeatedly told part of the underlying reasons for obesity is lack of willpower and discipline; on the other hand we hear often this insistence that if you want something eat it, if you're on a diet and craving whatever it's better to eat it than to not because it's not good to deprive yourself of something you want.

How in the world is one supposed to develop this necessary discipline if they're never challenged and expected to discipline themselves?

As I said, this rule sets a standard for you to hold yourself to, that for a short period of time - two weeks - you will avoid any food that is not on the accepted food list so you can prove to yourself some big things:

• What you think you want to eat isn't always what you need to eat
• Food is not the enemy, nor do you lack willpower; given adequate time and nourishment, your body will help you re-learn how to eat well
• You really don't have to punish yourself to lose weight with feelings of hunger, eat what's allowed and you'll be sated
• You really are empowered to make good decisions and eat delicious food while you lose weight
• You'll really get to experiment and play more with your eating later, as you move forward and continue to lose weight

These first two weeks extend to the longer term as you are empowered to listen to what your body is telling you; you'll initially get over the idea you need starchy or sweet foods all the time, and then understand as you continue, when and where these foods will fit into your long-term menus. Once again, you'll also begin to appreciate just how good real food tastes, and take the foods from these first two weeks into your long-term eating, so they serve as your foundation for the future.

Life Gets in the Way

Just a quick post to let readers know that life has gotten a wee-bit hectic here and this week time is short for writing the continuation of the series in progress. I'll be back on Friday morning with the next installement - hope you'll come back then as we continue looking at the rules of induction (Atkins) and how they provide us with insights for long-term success!

Rule Four: Starches, Sweets: No Longer Staples

Rule 4:

• Eat absolutely no fruit, bread, pasta, grains, starchy vegetables or dairy products other than cheese, cream or butter. Do not eat nuts or seeds in the first two weeks. Foods that combine protein and carbohydrates, such as chickpeas, kidney beans and other legumes, are not permitted at this time.

For many the thought of not having a piece of bread, a side of pasta or rice, a bowl of cereal, etc. seems way too restrictive. With the low-carb products on the market, like low-carb bread, low-carb pasta, this rule seems silly - one that can be dismissed as long as they maintain rule 3 and keep carbohydrate at or below 20g net each day.

From this rule, we learn by implication - all carbohydrates are not created equal, and thus are not to be treated in a similar manner as you continue along to the long-term and maintain your weight. In baby steps, you'll be given opportunity to re-introduce many, many carbohydrate-rich foods, but for now, you're at square one and starting to learn how to eat well.

It is in this minimum two weeks period you eat those foods which are nutrient powerhouses - meats, poultry, eggs, fish, non-starchy vegetables, non-traditional fruits, good fats/oils and some dairy.

While critics focus on the limitations imposed on low-carbers - no sweets or starches in the first two weeks - often insinuating this is all one is allowed for the long-term, that's not the case.

This is a two-week period to "eat clean" from a limited selection of foods, designed to break you from the habits of old, establish good eating patterns, get back to basics that provide essential nutrients and lay the foundation of what your base diet will be later, when you are allowed to include more carbohydrate from a wide variety of foods.

By excluding bread, pasta, grains, starchy vegetables, most dairy products, nuts, seeds and legumes, this rule takes the focus off what many people consider highlights of their meals - starch; it resets emphasis on those things - protein, fat, nutrient-dense non-starchy vegetables and low-GL fruits - that in the long-term that will now be the foundation of your meal-planning well into maintenance.

Once you have a firm grip on this basic rule, and are eating in a pattern that no longer requires some sort of bread, potatoes, rice, pasta, etc. as a staple of your meals, you're on your way to understanding how these items may be re-introduced later as a complement in your habitual diet if you choose to include one or more of them.

Where before a meal may have been centered around your big bowl of pasta with maybe a small meatball or sausage, a crusty loaf of italian bread and perhaps croutons on your salad, over the long-term, as you mainatin your weight, your meals - if you learn from the rules of induction - are bulit upong your solid foundation of healthful eating - non-starchy vegeteables, quality protein, good fats and, by then, any additional foods you like and can tolerate well as a complement to your meal instead of the focus of the meal.

This rule fosters breaking the mindset that you need carbohydrate-rich foods to provide the majority of calories in each meal and at the end of each day - you don't - and by following this rule and waiting until the time is right to increase carbohydrate, you will be better able to assess what carbs you can and cannot tolerate in your meals as you progress - you'll better appreciate also how to portion your meals with these items "on your plate" in later in maintenance.

These foods, we often believe are staples will no longer be the main attractions in your meals when you're maintaining, but can still be a part of your diet in the long-term.

Trust the good doctor on this one and just don't eat anything that resembles bread, pasta, grains, etc. - no matter how low-carb they're promoted as.

During the first two weeks (minimum) avoid any and all processed products if you can.

Eat clean.

Keep it simple.

Learn.

Appreciate how good real food tastes.

Take your time.

Plan along the way.

Try new foods that are allowed.

Focus on the delicious food that is allowed.

Enjoy your meals!

Enjoy eating!

It's worth it in the long-term!

Rule Three: Vegetables & Fruits are Heart of Controlled-Carb

We hear much of a healthy diet is from eating fruits and vegetables. Research suggests there is a strong correlation between "good" health and "bad" health over the long-term when comparing the dietary habits of those eating a diet rich with fruits and vegetables to those consuming less than recommended levels.

Diets that strategically restrict carbohydrate are often criticized for lack of fruits and vegetables in the dietary approach. Much like the second rule getting lost in translation, from an allowance of a large variety of meats, poultry, fish, shellfish and game to a requirement to eat "fatty steaks, bacon, brie and cheeseburgers," by those unconvinced a low-carb diet is scientifically supported, rule three is often either ignored in the media and/or used to show how unsustainable carbohydrate restriction is in the long-term for someone to do forever.

How about we take a look, and see what the third rule actually says, and what it "pearls" it contains in both the short and long-term, and where vagueness may lead to misinterpretation:

Rule 3:

• Eat no more than 20 grams a day of carbohydrate, most of which must come in the form of salad greens and other vegetables. You can eat approximately three loosely packed cups of salad, or two cups of salad plus one cup of other vegetables.

First, we know from the published books, that the Induction period is a minimum of two weeks; while one can, and many do, stay within the 20g of carbohydrate beyond two weeks, the above rule is in place for at least the first two weeks.

During this time, the person starting the low-carb diet is tasked with two things in this rule:

1. limiting carbohydrate to just 20g a day and
2. ensuring that most of those 20g carbs are from salad greens and other (allowed) vegetables.

As an example, the rule says this is "approximately" three loosely packed cups of "salad" (note not simply salad greens), or two cups of "salad" (again not simply salad greens) plus one cup of other (allowed) vegetables (without mention of raw or cooked state).

We also know that the plan includes a deduction of fiber, so the amount of non-starchy vegetables (and fruits which I'll get to in an upcoming post) - in cups - that one is expected to consume depends highly on which allowed vegetables are selected in a day. Regardless of which are included, a minimum 10g net (deducting fiber) must come from non-starchy vegetables!

We also plainly see that it is not *mandatory* to deduct fiber per the rule above; however, I strongly suggest folks do deduct fiber as it allows a greater intake of non-starchy vegetables, which are not only low in calories, but nutrient powerhouses. When you deduct the fiber, you're able to consume more essential nutrients than if you don't.

I've previously offered examples of how different selections of non-starchy vegetables may look in a day of eating on a plan allowing 20g net in a day. Once again, I am providing examples to emphasize, even at 20g net carbohydrate, where 10g net is the minimum, a low-carb plan - done properly - meets or exceeds intake recommendation of at least five servings per day in the Dietary Recommendations for Americans for fruits and vegetables.

Example 1

• 1-cup green beans (cooked measure)
• 2-cups Shredded Cos/Romaine Lettuce (raw)
• 4-pieces Crimini Mushrooms (raw)
• 1/4-cup Shredded Red Cabbage (raw)
• 4 Cherry Tomatoes (raw)
• 1-cup Spinach (raw)
• Total Carbohydrate = 18g
• Fiber = 8g
• Net Carbohydrate = 10g
• USDA Servings of fruits/vegetables = 5

Example 2

• 1/2 Avocado (raw)
• 3-cups Cos/Romaine Lettuce (raw)
• 4 Cherry Tomatoes (raw)
• 1/4 cup Shredded Red Cabbage (raw)
• 1-cup Spinach (cooked measure)
• 1/2-cup Broccoli Florets (raw)
• 1/2-cup Sliced Cucumber (raw)
• Total Carbohydrate = 24g
• Fiber = 14g
• Net Carbs = 10g
• USDA Servings of fruits/vegetables = 6

Example 3

• 2-cups Shredded Cos/Romaine Lettuce (raw)
• 1/2-cup Cherry Tomatoes (raw)
• 1-cup Spinach (cooked measure)
• 1/2-cup Asparagus (cooked measure)
• 1/2 cup Sweet Green Peppers (cooked measure)
• Total Carbohydrate = 21g
• Fiber = 9g
• Net Carbs = 12g
• USDA Servings of fruits/vegetables = 6

One can see from the examples above, depending on selections made from those fruits and vegetables allowed in the first two weeks, it is not difficult to meet the recommended intake of 5-or-more servings of fruits and vegatables.

The aim to include a minimum of 10g (of the 20g allowed) from non-starchy vegetables is a "must" in the rule above.

It is also clearly stated as a "minimum," and therefore understood that if you would like to include 12g, 15g or more from non-starchy vegetables in lieu of other foods that have carbohydrate, that is also allowed.

So, if one is cognizant of and desiring more than the minimum intake of fruits and vegetables, they are completely allowed to consume more - with the only restriction being not to exceed 20g net (deducting fiber) during the first two weeks.

Must you aim to consume half your allowed carbohydrate from fruits/vegetables? YES

Can you eat more fruits/vegetables (allowed ones), say 12g, 15g, 18g? YES

Can you deduct fiber? YES

Do you have to? NO (but doing so allows a greater intake of fruits/vegetables and associated essential nutrients)

With all that said, and focus on what all the rules mean for the long-term, I contend that one is expected to continue eating this level (as minimum each day) as they progress toward the long-term eating. I believe that this is one more "foundational" part of carbohydrate restricted diets in the long-term and something intended to be continued as one increases carbohydrate and includes a wider selection of foods, including more vegetables, fruits, nuts, seeds, legumes, and if desired, even whole grains.

Many folks say a low/controlled-carb diet is a way of life, yet find it difficult to take what they start with - 20g net (deducting fiber), of which most must be provided by non-starchy vegetables, a 10g minimum each day - and maintain that aspect as one solid foundation to build upon as they continue to lose weight and then maintain their weight.

Old eating habits start to creep back with more carbs; habits such as preferrentially selecting sweeter foods or grains (even if whole grain) with consumption of non-starchy vegetables waning as one re-introduces more carbohydrate.

If one takes this rule, and continues to extend it --- fully --- until they reach 40g net carbohydrate each day (deducting fiber), they will be consuming incredibly healthful levels of fruits and vegetables, and will be able to eat a very wide variety of them too. That is, until 40g carbohydrate is achieved in the diet during weight loss, one must always include half those carbohydrates from fruits and vegetables with each incremental increase in carbohydrate. (Beyond that, it is increasingly difficult to continue adding more non-starchy vegetables and fruits due to their bulk; you can, of course - it's just not as easy to do).

Now that isn't exactly stated explicitly in the rule, but it is from my experience and those I've given assistance, one significant contributor to maintenance of weight in the long-term. That's because if you're aware of and including a lot of fruits and vegetables (specifically non-starchy vegetables and low-glycemic load fruits) it is difficult to consume excess calories each day over the long-term.

It becomes much easier to consume excess calories when you "play" the carb game (like many play the "points" game with Weight Watchers) and make choices to stay within a number, rather than focus on quality of choice.

But if you're committed to making sure that, no matter what intake of carbohydrate you reach (60g, 90, 120g or more), that you always are sure you include at least 10g net minimum at the start and then 20g minimum (net) from non-starchy vegetables/low glycemic-load fruits as you continue along, you'll have a favorable calorie intake that helps maintaining weight easier.

As you add back carbs, this rule must remain in your eating habits, even if you only stick with 10g net as minimum (which I don't suggest you do) as you're learning in the beginning - you cannot add back carbs and eliminate or reduce how many vegetables and salads you eat each day and expect to maintain your weight using grains, nuts, fruits, etc. as your primary source of carbohydrate later....you must always maintain a level of carbs from your vegetables and salad greens - even in maintenace.

This rule, like rule two, is taking you "back to basics" - helping you learn, step-by-step, how to nourish your body with high quality nutrients from real foods; over time you're encouraged to include a wider variety of non-starchy vegetables, low glycemic-load fruits, nuts, seeds, legumes and more, and the starting basics for the diet should be extended out for the long-term; that is, establish now, at the start, that as part of your long-term habitual diet, non-starchy vegetables and low-GL fruits will be a large part of your overall diet - your body will thank you!

Rule Two: Back to Basics

Over the last few decades, the population at large, has slowly been indoctrinated to fear dietary fat; to limit intake of dietary cholesterol; and to limit consumption of foods rich with saturated fat like meat, whole dairy, butter and eggs. This happened despite little evidence that such an approach to eating provided a long-term health benefit, or ability to maintain weight. But, with decades of reinforcement in the popular thinking, it's understandable how the second rule in the Rules of Induction is the most misunderstood and maligned of them all.

Let's take a look:

Rule 2:

• Eat liberally of combinations of fat and protein in the form of poultry, fish, shellfish, eggs and red meat, as well as pure, natural fat in the form of butter, mayonnaise, olive oil, safflower, sunflower and other vegetable oils (preferably expeller-pressed or cold-pressed).

Is it any wonder that, when a diet comes along and allows these foods, in complete contradiction to decades of fat phobia propoganda, it is vehemently opposed by the leading health organizations and government agencies? That we're innundated with dire warnings of consequence to health, heaped upon us in a concerted effort to discredit and dismiss anyone who says differently; despite scientific evidence and data supporting not only the inclusion of these foods in the human diet, but their inportant contributions to the human diet!

Ignore the man behind the curtain Dorothy....ignore that in the noble attempts to improve the health of our population, researchers and clinicians were lead astray by what we now know was half-truth data, published in the fifties and sixties.

They know it, we know it, but still it's difficult to come to grips with that fact and reverse direction after decades of building the foundation of a "truth" only to find it terribly flawed. It's often easier to continue on in the lie than face the fact you're wrong; moreso when the entire group and community you exist within endorses the continuation of the established dogma, despite the evidence to the contrary.

It's easier to "kill the messenger" than kill the flawed paradigm that hold these foods are to be limited, heck, even avoided at all cost.

To admit such is akin to killing thyself and the core set of beliefs one holds to be true.

Dramatic license here?

Sure, but it does speak of something critically important one must do for their long-term health when they begin to, perhaps for the first time in their life, establish good eating habits for the rest of their life.

Simply put, the second rule of induction grants us permission to dismiss everything we've been told and taught to hold as truth about eating, macronutrients (carbohydrate, protein, fat) and a "balanced, healthy" diet; allows us to re-learn what it means to be human and eat food; and encourages us to enjoy the experience of truly eating a healthy diet while losing weight and then continue to do so along the way to finally, once and for all, maintain that weight well into the future.

I'm quite the optimist aren't I?

Seriously, don't studies tell us again and again that dieting to lose weight fails, that all we really ever do is get good at losing weight, but we're never quite able to master maintaining our weight in the long-term?

Let's start by examining the very base reason most folks even begin a diet to lose weight - they're overweight or obese and have decided it's time to do something about it.

So they begin, they are off to a good start, they're motivated and continue to be motivated with each incremental decline they see on the scale.

Problem?

Absolutely - the focus is on the scale; the number on the scale matters most and damn the torpedos, no matter how inconvenient, stressful or annoying it is to weigh, measure and count every calorie, the individual is in a battle against their bathroom scale to reach a desired number in the shortest period of time possible.

Millions have mastered this task, only to have to repeat it again and again throughout their life. I apolgize now if this sounds crass, but anyone can lose weight with even just a small level of effort; it doesn't take an Einstein to eat less for weeks or months to reach a number on the scale; most will put up with high levels of discomfort to reach that goal - hunger, moodiness, irritability, stress and counting, measuring and weighing anything they consider putting in their mouth.

In the short-term, such measures do work; in the long-term they fail because the person has been mistakenly led to believe "if only..." they do this, measure that, control this and avoid that over the short-term, somehow that alone will enable them to maintain their new lower weight without much more than keeping on keeping on; except the keeping on part is next to impossible!

That's because the very dogmatic recommendations we're repeatedly told are balanced and healthy to lose weight are scaring people away from the very foods that we need to eat to thrive as humans; this forces an unnatural eating patten across the population due to a deeply flawed fear of dietary fat and cholesterol and leads to failure in the long-term because it is not only unsustainable, it's incompatible with true health in the longer term.

The heart and soul of our metabolism is the endocrine system - when it dysfunctions, a cascade of health problems follow - insulin resistance, high blood pressure, dyslipidemia, diabetes, and other chronic and debhilitating diseases.

Why then are we specifically told to avoid the very foods that fuel the proper function of this system?

The current recommendations not only scare us from healthy food, they make simply eating way too stressful for an average person - measure this, weigh that, watch this, avoid that, don't eat this, that's better, blah, blah, blah - who wants to deal with that much stress each day? Sure, a motivated person, desiring weight loss will submit to such stress to reach a goal - but then what happens? They do what is natural and human - they do what they need to do to relieve the stress and relax, are then an easy target to point to as someone lacking willpower, someone just not commited to sticking with it; someone who simply doesn't care and is lazy!

Anyone who has attempted to lose weight only to regain it can relate - no matter how hard you try to stick with a diet that is, for lack of a better phrase, "high maintenance" to follow each day for the rest of your life - sooner or later you find the "benefit" (weight on scale) isn't worth the time and "stress" (weighing, measuring, going hungry, chastising yourself for wanting to eat, etc.).

As I said in my last post, what if the problem isn't you or your "willpower," but a deep flaw within the recommendations that lead not to success, but failure in the long-term?

Here's the rule again:

Rule 2:

• Eat liberally of combinations of fat and protein in the form of poultry, fish, shellfish, eggs and red meat, as well as pure, natural fat in the form of butter, mayonnaise, olive oil, safflower, sunflower and other vegetable oils (preferably expeller-pressed or cold-pressed).

The short and long-term secrets within this rule include:

1. Eating "liberally" is not the same as eating until you are stuffed and goes hand-in-hand with rule 6, which we'll look at later this week. This rule is also a natural extention to rule 1 to eat regular sized portions.

2. You're allowed to eat animal foods such as meats, poultry, fish and eggs provides you with combinations of both fats and protein - necessary for health, losing and maintaining weight on a carbohydrate restricted diet.

Note that in the rule, no one is told they must eat "fatty meats" or must consume "bacon, brie and oodles of t-bone steaks." No, instead they're to eat foods that provide both fat and protein; they can choose whatever cuts they like, whatever combinations suit their tastes; whatever they prefer.

Want boneless skinless chicken breast? Allowed.

Want a filet mignon? Allowed.

Want some eggs? Allowed.

Want some dark turkey meat? Allowed

Want some salmon? Allowed.

This "allowance" of all things that provide a good fat-protein combination reinforces our mindfullness not to fear food, food is not the enemy!

Adding to this is that using fats and/or oils as part of your meals is allowed - from sources of natural, good fats and oils; with those natual oils being preferentially from expeller-pressed or cold-pressed sources.

Why are the animal products with combinations of fat and protein and the use of natural fats & oils so important?

By integrating both into your meals you are also beginning the process of balancing your essential fatty acid ratios in your eating from the fats found in these sources, and perhaps for the first time, consuming adequate protein, thus adequate essential amino acids.

Important too is to choose quality, eat well and enjoy your food and meals. Don't worry each day about how much fat is in a particular food or meal at this stage, over time you'll be able to "tweak" as you go and learn better how to nourish your body and eat what really is a well-balanced, healthy diet.

With fat and protein providing the vast majority of "essential" nutrients, this liberal approach at the start of your weight loss diet takes you "back to basics" and with time, provides you the opportunity to not only learn how to eat well for the long-term, but to actually enjoy your meals again - without fear that you're killing yourself with every bite!