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Week 1: Eat Your Medicine: Nutrition Basics

Good nutrition is the foundation of the program. You already have a jump start on this week’s action steps from the preparation phase of the program. Here is what you are going to avoid in the next six weeks. These are the staples of our high-processed, hybridized modern diet and they are killing us. I promise you will discover a whole new world of Mother Nature’s magnificent food pantry, which will delight your senses, stimulate your palate, and leave you feeling clear and healthy, not to mention automatically thinner.

Avoid:

  1. Sugars in any form whatsoever. Examples are agave, maple syrup, stevia, and the “latest, greatest” sweetener of the day. You already started this in the prep week. Keep it up. If you have to ask, “Is this okay?” it isn’t.
  2. All flour products (even gluten-free). These include bagels, breads, rolls, wraps, pastas, etc. They are quickly absorbed and drive insulin sky-high.
  3. All processed food. This includes all trans fats and high-fructose corn syrup. Again, you started this during the prep week.
  4. All gluten and dairy. These are the major inflammatory foods in our diet. You will learn more about eliminating them in this chapter.
  5. If you are on the advanced plan, all grains, starchy vegetables, and fruit. Avoid winter squashes, peas, potatoes, corn, and root vegetables such as rutabagas, parsnips, and turnips, and all fruits, except one-half cup of berries a day, for just six weeks to give yourself a jump start.

After six weeks, I recommend you reintroduce gluten and dairy and see how they affect your weight, blood sugar, and metabolism, and how you feel. You may find they cause weight gain or make you sick. If so, stay off them long term. I explain how to reintroduce these foods later in Chapter 26, “Get Healthy for Life.” If you have been on the advanced plan, slowly add back in whole grains and limited amounts of starchy vegetables and fruit (see below for quantities), and watch how they affect your blood sugar, energy and weight.

FOCUS ON FOOD QUALITY

The most important thing you can do to heal your body is focus on food quality. Americans spend less than 10 percent of their income on food, while Europeans spend about 20 percent. Quality matters. It is more important than quantity when it comes to calories. If you focus on quality, not quantity, you will feel satisfied while naturally avoiding cravings and attraction to food that won’t nourish you. We get the most pleasure from life when we focus on quality—the quality of our relationships, of our work, and of our food. This is not so much about what you can’t have but about all the extraordinary tastes, flavors, textures, and foods you can explore. The side effects are all good.

There is one simple concept you need to learn about nutrition. It is the most important idea in this book, and it will save your life.

Not All Calories Are Created Equal

Five hundred calories of cookies are not the same as 500 calories of broccoli, an idea that even Weight Watchers and the American Diabetic Association are finally recognizing; they are changing their point system and carb exchanges as a result. If you eat the same amount of calories from broccoli rather than cookies, you will lose weight.

Food is information and it controls your gene expression, hormones, and metabolism. The source of the calories (and the information carried along with the calories) makes a gigantic difference in how your genes, hormones, enzymes, and metabolism respond. If you eat food that spikes your insulin level, you will gain weight. If you eat food that reduces your insulin level, you will lose weight. This is true even if it contains exactly the same number of calories or grams of protein, fat, carbohydrate, and fiber.

Portion Size Matters

Portion size does matter. Following are serving sizes for common foods:

Important Portion Sizes

When traveling in Europe, I always notice that everything is smaller, including waist sizes. The sandwiches in airports use a small baguette with one thin slice of natural ham, not a giant loaf stuffed with meats and cheeses and sauces, like our sandwiches. The sodas are 6 ounces, not 20 ounces. A cup of coffee is 4 ounces, not a 20-ounce latte laden with sugar. A pasta serving is only 4 ounces, not a giant mound that spills over the edges of our plates.

MASTERING GLYCEMIC LOAD IS MORE IMPORTANT THAN MASTERING CALORIES

Low-glycemic-load diets are the only diets that have been proven to work— these diets don’t spike blood sugar and insulin.1

In a landmark large-scale study, only one diet showed the capacity for maintaining the most weight loss over time. The study published in the New England Journal of Medicine found that the easiest diet to maintain, and the one that had the biggest impact on preventing weight gain after people had lost weight, was the low-glycemic-load, higher-protein diet.2 After looking at all diet studies, the Cochrane Database, an independent group of scientists who review all available literature, found that low-glycemic-load diets help you lose weight faster and keep it off.

One of the most important skills you will learn in this book is how to create a meal that has a low glycemic load. The glycemic load of a meal tells us how much of and how quickly a fixed quantity of a specific food will raise your blood sugar and insulin levels. The slower these levels rise, and the lower they are, the better.

Think of it this way. If you added 2 tablespoons of flaxseeds and 2 tablespoons of fish oil to your cola, it would raise your blood sugar much more slowly than straight cola. But please, I am not suggesting this as a way to continue drinking your sodas!

It may take a bit of practice to get the glycemic load of your meals as low as possible. For some, testing your blood sugar one hour after a meal can even be helpful. But at the end of the day, controlling the glycemic load of your meals isn’t very hard. You need to combine protein; fats; and whole-food, fiber-rich, low-starch carbohydrates from vegetables, legumes, nuts, seeds, and a limited amount of whole grains and low-sugar fruit.

Another way to think about it is to never eat carbs alone. Combine carbs with protein and fat at every meal or snack. Have an apple, but eat some nuts with it. Have a little whole grain, but only with a meal containing some fish or chicken, fat, and veggies with fiber.

If you follow the 10 Rules for Eating Safely for Life here and the 10 Tips for Cutting Your Cravings here, you will be automatically eating a low-glycemic-load diet. You will also be eating this way if you follow the meal plan in Part VI. Eventually, this way of eating will become second nature. The key is to have a slow, even burn of food all day to keep your blood sugar and insulin levels stable.

Take Action! Feed Your Body Right

If the quality rather than the quantity of calories you eat determines the state of your health and your ability to keep weight off, then the question is: Which foods will send the right information to your body?

There are four simple principles you can use to choose quality foods that will heal your body and the planet at the same time. At the end of the book, I provide some resources that will help you find these foods. You will also find additional resources online at www.bloodsugarsolution.com.

The Four Principles for a Healthy Planet and a Healthy You

  1. Eat real food. Avoid highly processed, factory-manufactured Frankenfoods. Choose fresh vegetables, fruit, whole grains, beans, nuts, seeds, and lean animal protein such as fish, chicken, and eggs.
  2. Clean up your diet. Look for animal products that are pasture-raised, grass-fed, and antibiotic-, hormone-, and pesticide-free. Go on a low-mercury diet by sticking with small, wild, or sustainably farmed fish.
  3. Go organic. Pesticides and chemical fertilizers poison your metabolism, your thyroid, your sex hormones, and our planet. Buy as much organic food as your budget allows. Refer to the dirty dozen list for the top offenders and the Clean 15 at www.ewg.org.
  4. Stay local. Seasonal, local foods you find at farmers’ markets or community-supported agriculture projects (CSAs) are healthier, taste better, are typically sustainably grown, and help you recognize the intimate relationship between the ecosystem of your body and the broader ecosystem in which we all live. To find a CSA near you, go to www.nal.usda.gov/afsic/pubs/csa/csa.shtml. To find the closest farmers’ market in your area, try www.bloodsugarsolution.com/localharvest. See the face that feeds you.

If you are part of a support group, you might want to buy things in bulk, such as half a grass-fed lamb, or get shares in a local farm. In this way, you can eat higher-quality food for less money. If you can’t make it to farmers’ markets or don’t have a CSA in your area, you should be able to find everything you need in your local supermarket.

It is possible to heal our planet and our health in one step. What you put on the end of your fork has a broad impact on agriculture, energy consumption, the environment, politics, the economy, and your biology.

CARBOHYDRATES: EAT YOUR MEDICINE

You may not realize this, but there are no essential carbohydrates. There are essential fats (omega-3s) and essential proteins (amino acids), but if you never had any carbohydrates again, you would survive.

But there are a few things that hang out almost exclusively with good-quality carbohydrates that come from plant foods (vegetables, beans, whole grains, fruit, nuts, and seeds). So unless you’re going to eat the brains, livers, kidneys, and other organs, and chew the bones of animals like the mostly meat-eating tribes once did, carbohydrates are critical for health. Why? Because they include high levels of vitamins and minerals, fiber, and special plant compounds with healing properties called phytonutrients, or phytochemicals. Phytochemicals are medicinal molecules such as curcumin in turmeric, glucosinolates in broccoli, anthocyanidins in berries and black rice, and so on. (See www.bloodsugarsolution.com for a complete list of the medical properties of different phytochemicals in a plant-rich diet.)

Focus on low-glycemic-load plant foods. These are the slow carbs, not low carb. When eating slow carbs in a meal or snack, always combine protein, fat, and fiber to lower the glycemic load even more.

Take Action! Eat SLOW Carbs, not LOW Carbs

See the list below for which carbs you can eat in unlimited amounts, which you can have in moderate amounts, and which you should completely avoid. I call these green, yellow, and red, like a traffic light, and forbidden. This does not refer to the color of the carbs, but to how they affect your blood sugar and insulin.

Green Carbs: Eat Freely

Yellow Carbs: Eat in Moderation

Red Carbs: Eat Limited Amounts

You should limit your intake of the following:

Forbidden Carbs: Avoid Completely

Take Action! Boost Phytonutrients

The one thing basically everyone in nutrition agrees on is that eating 5–9 servings of fruits and vegetables a day reduces your risk of chronic illness. One of the reasons these foods are so powerful is because of the phytonutrients they contain.

Different phytonutrients have different properties. Some are natural anti-inflammatories, others are antioxidants, and still others support detoxification. Each is important in its own way, and when eaten together in the right proportion, they can have a dramatic impact on health. Think of the supermarket as your pharmacy, and food as your medicine.

Here are some tips for optimizing your phytonutrient intake and “eating more medicine.”

FAT DOES NOT MAKE YOU FAT

While carbs are not “essential,” fats are. Without enough of the right type of fats, your biology breaks down at the very root. Fats make up your cell walls. If you don’t get enough or you eat too much of the wrong kind, you will not have the building blocks you need for healthy cell membranes, which are needed for optimal insulin function and blood sugar control. Omega-3s are the king among healthy fats. It can take a year to rebuild and remake all your cells and tissues with the right fats, so start right away.

Take Action! Get an Oil Change

Replace the bad fat in your body with good fat:

THE IMPORTANCE OF PROTEIN

Many studies, such as T. Colin Campbell’s China Study,3, 4 point to the risks of too much animal protein, although these studies are mostly based on factory-produced animal protein, not the wild species that comprised the diet of our hunter-gatherer ancestors. The wild elk and deer my patients gave me when I was a small-town doctor in Idaho had very different nutritional properties and fats from those of a feedlot cow.

Some people thrive as vegans; others wither. Some feel great when eating animal protein; others get sick and sluggish. You need to find out what works for your body, and this will take some experimentation. My experience with patients with diabesity is that they typically need more good-quality animal protein (grass- or range-fed animals, eggs, or sustainably farmed or caught low-mercury fish).

Whether you choose vegetarian or animal sources, it is essential that you get protein at each meal and snack. Eating protein turns up your metabolic fire and ability to burn calories while reducing your appetite.

Take Action! Eat High-Quality Protein for Blood Sugar and Insulin Balance and Hunger Control

Choose from these high-quality, safe sources of protein.

Vegetarian Sources of Protein

Healthy Animal Products

HERBS AND SPICES

Many herbs, spices, and seasonings contain healing properties. Make sure to include plenty of your favorites in your cooking. Keep your pantry stocked with them.

Take Action! Include Healthy Condiments and Seasonings

Here are some that I enjoy:

Journaling Exercise: Making Dietary Changes

How do you feel about the dietary changes I have recommended above? Do you feel resistant to them or are you excited about them? Does this sound like deprivation or renovation? Take a few moments to think about what you have just learned and then answer the following questions in your journal:

HOW SHOULD I EAT AND WHEN SHOULD I EAT?

There are two more important nutritional topics I want to address: how to eat and when to eat. It’s not only the quality of your calories that’s important. Focusing on when you eat and the composition of your meals can reprogram your metabolism.

Create the Perfect Plate

Composing the perfect meal (or snack) is an essential life skill. And the government’s new version of the food pyramid called “my plate” will not guide you correctly (though, I admit, it’s an improvement over the food pyramid).

It is most important to avoid eating quickly absorbed carbohydrates alone, as they raise your sugar and insulin levels. And any large meal raises your blood sugar, so smaller meals help keep your blood sugar even.

When you put food on your plate, it should look like this:

If you have advanced diabesity, you should avoid all grains, starchy vegetables, and fruit until your metabolism resets and you become more insulin-sensitive. That may take 6 weeks to 12 months. Just make vegetables three-fourths of your plate and protein one-fourth.

Eat on Time

We often focus on what to eat, not when we eat it. The best way to gain weight and promote diabesity is to skip breakfast and eat a big meal before bed. I call this the sumo wrestler diet. Other studies show that people who eat small meals frequently throughout the day (3 meals and 2–3 snacks) lose weight compared to people who eat one big meal, even if they eat the exact same number of calories. So eat early and eat often. Keep the fire of your metabolism burning all day, rather than slowing it down during periods of “ministarvation.” Always have breakfast, eat every 3–4 hours, and try to schedule meals at the same time every day. Your metabolism will work faster and more efficiently. You will lose weight, have more energy, and feel better.

FOOD ALLERGIES AND SENSITIVITIES: TREATING AND REVERSING DIABESITY

Earlier we reviewed how food allergies and sensitivities trigger inflammation and diabesity. Some foods for some people have the wrong information.

That is why I recommend you avoid two key groups of foods during the program: gluten and dairy, the two primary food allergens that contribute to insulin imbalances. After the first six weeks, you can reintroduce them into your diet, but I strongly advise that you do this part of the program 100 percent, no exceptions, not even a drop of gluten or dairy. You will likely see dramatic results, not just on your weight and diabesity but also on your overall health and well-being. Stopping gluten and dairy can be life-changing for people with diabesity. This is also true for people with type 1 diabetes, because there is a strong correlation between the casein8 in dairy and the gluten9 in wheat and the development of the disease.

New studies are now pointing to a connection between a leaky gut and type 2 diabetes, triggered by changes in gut bacteria and irritating proteins found in dairy- and gluten-containing grains. Healing a leaky gut by removing allergens and balancing gut bacteria may help with weight loss, reversing diabesity, and overall healing for many.10

Dairy presents a special case because the natural growth hormones in milk stimulate insulin production.11 There are more than 60 anabolic or growth hormones found naturally in milk—it is designed to make young animals grow. Drinking a glass of milk can spike insulin levels 300 percent12 and contribute to obesity and pre-diabetes. This is true despite studies funded by the Dairy Council showing that milk helps with weight loss. The question is, milk compared to what? A diet of bagels and Coke, or a healthy phytonutrient, antioxidant-rich, plant-based diet with lean animal protein?

Eliminating gluten and dairy may seem difficult at first, but after about three days off them, you probably won’t crave them anymore. Don’t shortchange yourself. You can add these back after the six weeks are over and monitor how you feel. Your body will be the best indicator of whether or not you can eat these foods long term.

Take Action! Eat Well for Less

Many people struggle with the cost of good food. Poverty drives obesity and diabetes because subsidized sugar and fat calories are cheap. But I would invite you to keep a careful record of how you spend your food dollars and see if, with some reorganizing of your budget and priorities, you can find more money to spend on real, whole food.

For one week, in your journal track every cent you spend and how you spend every hour of the day. If you understand exactly how you spend your time and money, you can choose what’s really important, rather than make unconscious choices that don’t serve your health or your life goals. What you learn might surprise you.

How much money do you spend on coffee, gum, sodas, convenience foods, or even cigarettes? How much do you spend eating at restaurants or on fast food or takeout?

Think about how you spend your days. Do you waste time reading tabloids, watching television, surfing the Internet, playing video games, or doing too many errands because you don’t plan your time well? Track this in your journal as well.

Then, ask yourself if your time and money are best spent as you are spending them now. Think of money as your life energy. It represents your time in a monetary way. How do you want to spend this life energy? Do you want to spend more of it creating health and vitality? Take some time to write out a response to these questions in your journal.

There is no right or wrong answer. It’s just something to think about. You might discover that you have more time and money than you think to invest in yourself—and in the quality of life and health that you deserve.

Once you’ve thought about your answers to these questions, choose three things to change that can give you more time or money. Write them down in your journal as well. For example, giving up that $2 coffee every day saves you over $700 a year. Or giving up watching just a half hour of television a day gives you an extra 7.6 days a year to plan or cook healthy meals.

We are all overworked, overstressed, and overtaxed. Even so, there are ways of making choices that give us more resources.

Now that I’ve got you thinking, here are a few secrets for eating well on the cheap—and on the fly.

Take Action! Have a Plan for Surviving Restaurants

If you eat out, be careful. While I recommend you avoid eating out while on the program, I understand that this is sometimes impossible. Some of you might be obligated to go to business luncheons or social events, for example. In that case, I recommend you follow these guidelines:

  1. Be obnoxious. You have to be very clear about your needs. If you had a peanut allergy and would die if a drop of peanut butter or peanut oil crossed your lips, you would be sure to let your server know. It may be a slow death, but accepting foods that don’t nourish and support you is not being polite. It’s being stupid.
  2. Choose the restaurant when you can. There are many good choices for eating well. Learn the restaurant choices in your area or when you travel. It is worth doing a little homework. Ethnic is always a good choice. Indian, Japanese, Thai, Mediterranean (Italian, Greek, and Spanish), and Middle Eastern are good options. Stay away from fast-food chains. Enjoy slow-food restaurants that celebrate local, fresh, seasonal ingredients. I am an adviser for a new company, LYFE—Love Your Food Everyday—a low-cost, healthy fast-food restaurant using local, seasonal, organic, grass-fed ingredients to make nourishing and delicious meals. They are just starting up but could reach over the whole country soon.
  3. Tell the server you want no bread on the table and no alcoholic drinks. Ask for cut-up raw veggies such as crudités. Skip the dips.
  4. Ask for water. Drink a glass or two before dinner. It will reduce your appetite.
  5. Tell the server you will die if you have any gluten or dairy. (Not a lie, just a slow death.)
  6. Ask for simple food preparation. Ask for grilled fish or chicken and a large plate of vegetables steamed, or sautéed in olive oil with a side of sliced lemons. You may have a salad, but ask for extra virgin olive oil and vinegar or sliced lemons instead of dressing.
  7. Skip the starches. Ask for double vegetables and leave out the potatoes, rice, or noodles.
  8. Stay away from sauces, dressings, and dips. They are often full of sugar, dairy, and gluten.
  9. Follow “hari hachi bu.” The Okinawans are among the longest-lived people on the planet. They have a simple saying: “hari hachi bu,” or 80 percent full. They stop eating when they are gently satisfied. There will always be another meal. Bring leftovers home. Eating too much of the right foods can also spike your insulin.
  10. Ask for berries for dessert. They are gently sweet and nutrient dense, and after a meal their sugar won’t raise your blood sugar or insulin.

Take Action! Create an Emergency Food Pack

If you were insulin-dependent, you wouldn’t leave home without your insulin and needle. If you were asthmatic, you wouldn’t leave home without your inhaler. If you have a body, you need a life pack—a small hand-held cooler that has your daily needs packed away, something quick to assemble but never to forget. It goes in your car, to work, on trips.

Over time you will find your favorite version of the life pack, but here’s an example of what you could include:

Take Action! Be Prepared for Holidays and Special Events

Sometimes you have to eat someplace where you have no control—a party, an event, a friend’s house. You can plan ahead by making special requests, which are happily granted by most. If not, you can do a few things to reduce your stress and preserve your health.

Take Action! Before You Eat, Breathe and Offer Gratitude for the Meal

Mindful eating is the act of becoming aware of what we eat; how that food looks, feels, and tastes in our mouth; and how it makes us feel afterward. It’s the difference between gobbling up junk food or attentively savoring dark chocolate.

When we eat unconsciously, we eat more. Studies allowing people to watch television and eat from bags of chips or popcorn found that the bag always ended up empty, no matter what the size. You taste the first bite of food, but then you drift into mindless eating and don’t feel as if you ate anything. It takes 20 minutes for your brain to register that your stomach is full.

The practice of slow, mindful eating is a powerful way to better enjoy your food, lose weight, and improve your metabolism. Here are some steps that will help you eat more mindfully.

Journaling Exercise: Keeping a Daily Food and Feeling Journal

Every day you are on the program, I recommend you keep track of the foods you eat and how they make you feel. This, in addition to tracking your numbers, will give you the key information you need about how to make healthy food choices in the future. It will help you tune in to the innate wisdom of your body. Does this food make me feel good or bad in my body or mind?

After every meal or snack, do the following:

Go to www.bloodsugarsolution.com for a downloadable printable cheat sheet on Eat Your Medicine: Nutrition Basics for Everyone and online tools for tracking your daily food and feeling journal.