Start with smart carbs that keep your blood sugar low and steady. Add good fats that taste good, too—nuts (even peanut butter!) and fish. Put lean, satisfying protein on your plate and have some bone-building, fat-burning milk, yogurt, and cheese. (And don’t forget the chocolate brownies, wine, chips with salsa, and buffalo wings!)
This is the Sugar Solution eating plan—a diet that can help you lose weight now, keep it off forever, and protect you from a wide array of serious health problems, from heart attack and stroke to diabetes, cancer, and memory problems. Our daily menus don’t look like health food or a skimpy low-calorie regimen; they do look (and taste) simply delicious! How about an omelet filled with asparagus and goat cheese for breakfast, a roast beef sandwich for lunch, and cheesy eggplant Parmesan with polenta for dinner—plus a chocolate chip cookie at snack time? Behind these satisfying meals is the latest nutrition and weight-loss research, harnessed to create an everyday eating plan in which virtually every food is a star, proven to help you lose weight and guard—or improve—your health.
Our menus and 60-plus recipes were developed by dietitian Ann Fittante, MS, RD, a certified diabetes educator, nutrition educator, and exercise physiologist at the renowned Joslin Diabetes Center at Swedish Medical Center in Seattle. Her goal? To tickle your tastebuds, turn off between-meal cravings, optimize the way your body burns fat, and nurture your blood sugar control system. In the chapters ahead, you’ll learn how to stock your kitchen to make Sugar Solution meals a snap, stick with the plan when you’re eating in a restaurant, and fit in sweets and other treats, plus you’ll get a month’s worth of clever strategies that will help keep your body and mind on track for weight-loss success and better health.
This chapter outlines the five major components of the plan—we call them the Sugar Solution Food Groups—and shows you the research each one is based on. Let’s get started!
These strategies can lower the overall effect of a meal on your blood sugar.
1. Add beans. Only have time to make instant rice? Just add some beans. Throwing in a low-glycemic-index food brings down the GI rating of the entire meal.
2. Deploy good fat. Bagels for breakfast? Slather with a tablespoon of peanut butter. Fat slows absorption of sugar into the bloodstream.
3. Grab a cheese stick or precooked chicken strips. For less than 100 calories, a stick of string cheese or a few pieces of chicken can transform a potentially blood sugar–raising snack (such as crackers or a piece of toast) into an oasis of satisfaction that will last for hours. Like fat, protein slows digestion and absorption of sugars.
4. Have a salad with vinaigrette. Start lunch or dinner with any vinaigrette-dressed veggie medley—field greens; chilled green beans; even a half cup of steamed, cooled red Bliss potatoes. Arizona State University nutritionists discovered that vinegar prevented blood sugar spikes after eating. They suspect that acetic acid (the compound that makes vinegar so, so sour) interferes with enzymes that break down carbs. Just 2 teaspoons per meal could help tame glucose.
5. Sprinkle on some cinnamon. Just half a teaspoon of cinnamon each day—dust a little on your morning toast, add a bit to your afternoon skim latte or your dinnertime sweet potato—improves your body’s ability to obey insulin and take up glucose, report researchers at the USDA’s Beltsville Human Nutrition Research Center in Maryland. Cinnamon contains a compound called methylhydroxy chalcone polymer that makes cells absorb glucose faster and convert it more easily into energy—so your blood sugar stays lower.
You’ll eat two to four servings of fruit, four to six servings of vegetables, and four to six servings of grains every day, for a total of 50 to 60 percent of your daily calories.
• A rainbow of fresh produce for crunching, including apples, apricots, pears, asparagus, red peppers, salads, sugar snap peas, and fresh soybeans (edamame)—plus dips for raw veggies
• Fruit showcased in berry smoothies, a raspberry tart, strawberries in phyllo dough, and more
• Delicious vegetable dishes such as broccoli with garlic and onions, mashed and baked potatoes, oven fries, and even eggplant Parmesan with melted cheese and an asparagus quiche
• Satisfying and sophisticated grain dishes such as polenta, quinoa (a mild, quick-cooking grain) with peppers, pasta, and barley with spring greens—plus breakfast favorites like waffles, crepes, toast, English muffins, and hearty hot cereals
Low-glycemic-index (GI) carbohydrates—fresh fruits, vegetables, and whole grains—digest more slowly and release glucose to the bloodstream a little bit at a time over the course of hours. The benefit: Blood sugar and insulin (the hormone that tells cells to absorb blood sugar) stay lower. In contrast, high-GI foods like white bread, cake, and doughnuts make blood sugar spike, prompting your body to secrete a flood of insulin.
Recent research has linked lower insulin levels to a lower risk of type 2 diabetes, heart disease, and even memory loss. In one study of 23 young adults from Children’s Hospital Boston—where some of the nation’s most cutting-edge studies on the glycemic index, health, and weight in adults and children are under way—scientists found significant health benefits for volunteers following a low-GI eating plan, compared with those eating a high-GI diet. Specifically, the low-GI group raised their heart-protecting HDL cholesterol further (by 12 points, versus one point for the high-GI group), cut harmful LDL cholesterol by an extra 20 percent, lowered heart-threatening triglycerides twice as much, and raised insulin sensitivity 20 percent more. Low-GI eating can also reduce levels of C-reactive protein, a compound associated with bodywide chronic inflammation, a risk factor for heart disease and diabetes.
“The beauty of the glycemic index for people with diabetes is that it not only helps control blood sugar and insulin but its appetite-suppressing effects help them lose weight. And weight loss alone can reverse type 2,” says Marc Rendell, MD, director of the Creighton Diabetes Center at Creighton University in Omaha, Nebraska, and medical director of the Rose Salter Medical Research Foundation in Baltimore.
Fruits, vegetables, and whole grains are also packed with cholesterol-lowering, digestion-improving fiber and a rainbow of powerful, natural antioxidants that protect your cells from damaging free radicals—rogue oxygen molecules produced naturally in the body that heighten your vulnerability to heart disease and cancer.
Invented in the early 1980s by University of Toronto researchers as a tool for controlling high blood sugar, the glycemic index (GI) ranks carbohydrate foods according to their effect on blood sugar levels. High-GI carbs make blood sugar and insulin levels soar; low-GI carbs are slow-burning fuel that keeps your blood sugar low and steady—and as a result, keeps insulin levels lower. You feel full longer; have fewer food cravings; and reduce your risk for health problems, including type 2 diabetes, heart disease, stroke, cancer, and memory loss.
The GI assigns carbohydrate-containing foods a number based on their impact on your blood sugar. Foods with a GI below 55 cause only a little blip; those in the 55-to-70 range raise blood sugar a little higher; and carbs with GIs over 70 send it soaring.
Why would different carbs have such radically divergent effects on blood sugar? No matter what form the carb initially takes—the lactose in milk, the starch in a bagel, the sucrose in table sugar—eventually, your body breaks it down to glucose. The longer your digestive system has to wrestle with the carb to break it down, the slower the rise in blood sugar and the lower the GI number assigned to the food.
Among the factors that make a carb low-GI: the presence of viscous fiber (such as in oatmeal and beans); the size of starch particles (finely milled flours have a higher GI than coarse flours); how thoroughly a starch is cooked (al dente pasta has a lower GI than soft, overcooked noodles); and the presence of acids (like a vinaigrette dressing) or fat (such as margarine), which slows absorption of blood sugar.
Remember, the glycemic index describes the quality of a carbohydrate but not the quantity that exists within a food. Our plan takes into consideration a food’s glycemic load—its true impact on blood sugar based on the carb’s type and amount. Why does this matter? Some healthy foods that have little effect on blood sugar, such as carrots and watermelon, contain carbs with a high GI. But they actually have very little of it—they’re packed with water and fiber. It would be a mistake to miss out on them.
For a quick start with the glycemic index, try these simple food switches.
| High-GI Favorite | Lower-GI Choice |
| French bread, 95 | 100 percent stone-ground whole wheat bread, 53 |
| Jelly beans, 80 | Dried apricots, 31 |
| Mashed or baked potato, 73 or 85 | Roasted sweet potato, 54 |
| Pretzels, 83 | Popcorn, 55 |
| Side of bread stuffing mix, 74 | Side of canned baked beans, 48 |
| Vanilla wafers, 77 | Oatmeal cookies, 55 |
If you’re insulin resistant—and you probably are, since this condition affects as many as one in two American adults and nearly everyone who’s overweight—your cells “ignore” signals from the hormone insulin to absorb blood sugar. Your body pumps out extra insulin to force sugar into cells. The excess may make weight loss a special challenge for insulin-resistant people. The hormone encourages cells to store more of your extra calories as fat and blocks your body’s attempts to burn stored fat.
The answer? A low-glycemic, reduced-calorie eating plan like the Sugar Solution. In a recent Tufts University–New England Medical Center study of 39 overweight women and men, participants with high insulin levels lost an average of 22 pounds in 6 months on a low-GI plan, compared with 13 pounds on a higher-GI diet. Lower insulin levels seem to “unlock” fat cells so that extra body fat is finally burned off!
Other research suggests that a low-GI diet keeps your metabolism from downshifting dramatically, as happens on most weight-loss diets. Truth is, any low-calorie diet will slow your metabolic rate—the number of calories your body burns each day at rest. But researchers from Children’s Hospital Boston found that adult dieters who ate low-GI foods burned 80 more calories per day than those on a higher-GI, lower-fat diet. They also felt more energetic and had a greater sense of well-being—feelings that can help you stick with a diet and feel more motivated to get up and exercise.
Low-GI diets can also stop food cravings. “GI is not the complete answer to everyone’s weight problem,” says researcher Susan Roberts, PhD, professor of nutrition at Tufts University in Boston. “But aside from the research, I am personally convinced that low-GI diets help people lose weight, myself included. My husband and I were eating a relatively high-GI instant oatmeal for breakfast, but we both kept getting so hungry 2 hours after eating. [They switched to a low-GI Irish oatmeal and felt better.] I keep in mind the GI of what I eat and quite consistently find myself hungrier after very high-GI foods such as bagels and mashed potatoes.”
You don’t really have to consult a glycemic index list before choosing foods. While the science behind this exciting nutrition and weight-loss breakthrough is complex, the basic on-your-plate strategy is simple: All you need to do to get the benefits is choose vegetables, whole fruits, and moderate portions of whole grains in place of a steady diet of white potatoes, fruit juices or sweetened fruit (such as canned in heavy syrup), and refined-grain products.
Foods listed in italic type are high-GI foods that you need not avoid. These foods, such as carrots and watermelon, contain very little carbohydrate (they’re mostly water and fiber), so the actual impact on your blood sugar is small. Foods listed with an asterisk are low-GI foods that are best eaten sparingly. These foods, such as potato chips, are high in fat or calories—and don’t offer much else nutritionally.
You’ll eat some protein at each meal, for a total of 15 to 25 percent of your daily calories.
• Eggs in omelets and frittatas
• Beans in chili, lentil soup, Tuscan bean stew, and even baked beans
• Roll-ups and wrap sandwiches featuring tuna, chicken, turkey, and grilled veggies with melted lower-fat cheese
• Family favorites such as oven-fried chicken, grilled steak, barbecued spareribs, breaded cod with tartar sauce, clam chowder, chicken Parmesan, and shrimp and crab cakes
• Casseroles including eggplant stuffed with beef, Mexican lasagna, and chicken and mushrooms with rigatoni
• Meatless protein in whole wheat pasta, yogurt, whole grain cereal with nuts, snacks featuring nuts, and peanut butter
Bringing their protein levels up to the amount recommended in the Sugar Solution plan (up to 25 percent of daily calories) allowed 25 Danish women and men to shed 10 percent more belly fat—the dangerous intra-abdominal fat that raises risk for diabetes and heart disease—than dieters whose plates held more carbs, say researchers from the Royal Veterinary and Agricultural University in Copenhagen.
No one’s sure why eating more protein would selectively target belly fat. One possible explanation: A higher protein intake may somehow trigger smaller releases of the anxiety hormone cortisol. Cortisol directs the body to store more fat in the abdomen—less cortisol, less belly fat.
Protein switches on that “I’m full” feeling after you eat—and keeps you from feeling so hungry between meals. The effect can be powerful and long lasting. Thirty women who started their day with two eggs and toast felt so full and satisfied that they ate 274 fewer calories the rest of the day than those who had bagels and cream cheese, finds a new study from the Rochester Center for Obesity Research in Michigan. The egg eaters even ate fewer calories the following day. Eggs, note the researchers, are simply more satisfying than breads and bagels.
Protein—whether from meat, eggs, dairy foods, or nuts—boosts metabolism for up to 3 hours after a meal and to higher levels than carbs or fats do, so you burn more calories.
You’ll eat two servings of dairy products on most days. Dairy calories count toward your daily quota of protein, fat, and even carbs, because milk contains all of these components.
• Yogurt-berry smoothies and snacks that combine the cool, smooth texture of yogurt with the sweetness of fruit
• 1 percent milk
• Cheese. Surprised? You’ll find generous amounts of melted cheese in our recipes for chicken and eggplant Parmesan and on our wrap sandwich with grilled veggies, plus a tasty helping of Parmesan on pasta dishes and a satisfying layer of goat cheese or Jarlsberg on our chicken-pesto pizza.
Dairy foods may protect against metabolic syndrome, a prediabetic condition that raises your risk of heart attack, stroke, high blood pressure, type 2 diabetes, cancer, and memory loss. In one landmark, multicenter study that followed 3,157 young women and men for a decade, insulin resistance risk dropped 21 percent for each daily serving of dairy products. Calcium and other nutrients in dairy foods can also help protect against high blood pressure.
Of course, calcium is also essential for maintaining bone density. That’s why the Sugar Solution plan recommends that you take a daily calcium supplement of at least 500 milligrams, so that your body gets all it needs to protect your bones. Our eating plan provides about 850 milligrams per day, the amount in two regular dairy servings plus small amounts from the other foods you eat. You need 1,000 milligrams per day if you’re between ages 19 and 50 and 1,200 milligrams per day if you’re over 50.
One caveat: Be sure to spread your calcium supplements over the course of the day. Your body can absorb only about 500 milligrams at a time.
On a reduced-calorie diet, the calcium in dairy products (and, to a lesser extent, in supplements) can turbocharge your weight-loss efforts. Despite recent controversies over whether milk can help shed pounds, two research studies from the University of Tennessee’s Nutrition Institute are clear: If you haven’t been getting enough calcium in your diet, adding more (up to safe, normal limits) can help you lose weight more easily. In one of the studies, 32 obese women and men who cut 500 calories a day from their meal plans lost more weight when they added 800 milligrams of supplemental calcium daily, and they shed even more weight and fat when they took supplements containing 1,200 to 1,300 milligrams of calcium. In the other study, 34 obese people on weight-loss diets lost more pounds and more fat if they had three daily servings of yogurt than if they had one.
You’ll get 25 to 30 percent of your daily calories from fat, including daily servings of the good fats your body needs most.
• Omega-3 fatty acids in grilled salmon, ground flaxseed in our multigrain cereal and smoothies, and walnuts for snacking—and in our rich chocolate brownies
• Healthy monounsaturated fat in peanut butter and almond butter on your breakfast toast, olive and canola oils for sautéing and baking, the peanuts in our peanut butter cookies, avocado slices for salads, hummus dip for raw veggies, and cashews (and other nuts) for snacking
• No trans fats and just a smidgen of saturated fat
Early research suggests that getting plenty of omega-3s may cool off chronic inflammation, a risk factor for metabolic syndrome and diabetes. Meanwhile, good fats have a proven track record as protectors against health problems brought on by metabolic syndrome.
Just one weekly serving of fish rich in omega-3s (such as salmon, sardines, or mackerel) can cut the risk of a fatal heart attack by 40 percent. The American Heart Association advises us to eat two servings a week. A 12-year Brigham and Women’s Hospital study of 4,800 people found that those who ate any fish one to four times a week had a 28 percent lower risk of atrial fibrillation (AF) than those who avoided fish. AF disrupts the heart’s rhythm, causing fatigue and shortness of breath.
Northwestern University scientists who had analyzed eight studies involving 200,575 people concluded that eating fatty fish (such as salmon, mackerel, and herring) just once a week cut the risk of ischemic stroke—the most common kind, caused by blood clots—by 13 percent. And a Harvard study of 727 women found that those who ate fatty fish almost every day—compared with those who ate it only three times a month—had 7 to 10 percent lower blood levels of molecules that bind plaque-building cells to artery walls.
Eating fish once a week could lower your risk of developing Alzheimer’s disease, according to a study at Rush Presbyterian–St. Luke’s Medical Center in Chicago. Researchers collected dietary information from 815 people ages 65 to 94 who were free from Alzheimer’s at the start of the study. After an average follow-up of about 4 years, 131 of the participants developed Alzheimer’s. Compared with those who rarely or never ate fish, those who ate it once a week had a 60 percent risk reduction.
Plant-based omega-3s are heart-healthy, too. Vigorous arteries pump fluid through smooth, untarnished “pipes.” Eating walnuts may help them stay that way, suggest Spanish researchers. They gave two groups of people heart-healthy diets that differed in just one respect: One diet included eight to 13 walnuts a day. After 4 weeks, the walnut eaters had 64 percent stronger artery-pumping action and 20 percent less gunk-sticky molecules that initiate atherosclerotic plaque. Among nuts, walnuts alone are high in heart-healthy omega-3 fatty acids.
Meanwhile, almonds—a rich source of fiber, monounsaturated fats, and the antioxidant vitamin E—can cut heart disease risk 12.5 percent. After tracking more than 83,000 women with no history of diabetes, cardiovascular disease, or cancer for 16 years, Harvard researchers found that those who ate nuts at least five times per week reduced their risk of type 2 diabetes by almost 30 percent, compared with those who rarely or never noshed on these tasty nuggets. Those who ate peanut butter at least five times a week reduced their risk for type 2 diabetes by almost 20 percent, compared with women who rarely ate peanut butter.
When 65 overweight women and men followed a 1,000-calorie-a-day diet for 24 weeks, those who ate almonds at snack time lost 18 percent of their body weight, while those whose treats were carbohydrate-based (such as crackers, baked potatoes, and popcorn) lost just 11 percent. The nut eaters whittled their waists 14 percent; the carb snackers, 9 percent. Researchers from the City of Hope National Medical Center in Duarte, California, suspect that the protein, fat, and fiber in almonds keep you feeling full longer—and that not all the calories in almonds are absorbed, thanks to the tough cell walls of these nuts.
You’ll enjoy at least one treat every day.
• Wine—some menus include a glass of red or white wine—plus, advice on how to swap calories to fit in a drink on other days
• Real desserts that are fun to bake and guilt-free to eat, including chocolate chip cookies, raspberry tart, brownies, zucchini–chocolate chip bread, and rice pudding
• Tortilla chips at snack time, dips for veggies, a nacho plate for lunch, appetizers like shrimp in mustard-horseradish sauce and buffalo wings
• Easy treats like low-fat ice cream or sorbet, string cheese, and air-popped popcorn
Often, we’ve paired sweeter treats with fats, fiber, and proteins—a strategy that blunts the effect of sweets on your blood sugar—and trimmed the calories so these goodies won’t add inches to your waistline (a risk factor for insulin resistance). We’ve also taken advantage of an underappreciated fact about sugar (yes, nearly all of our desserts use the real thing): Gram for gram, the carbs in table sugar have less effect on your blood sugar than do the starchy carbs in foods like white bread, some pastas and noodles, and many breakfast cereals. A moderately sized homemade treat or a sprinkle of sugar on oatmeal or strawberries won’t make you fat. (Portions count, though; overdoing it will increase calories.)
We do urge you to avoid drinks sweetened with high fructose corn syrup. These high-calorie drinks seem to trigger a desire to drink even more—raising your risk for overweight and problems like diabetes.
We firmly believe that regular treats will help you stay on track with your weight-loss plans. And to keep the luscious desserts in this book within your fat and calorie budget, we’ve made strategic and sparing use of low-fat baking ingredients (such as reduced-fat cream cheese) and, occasionally, the artificial sweetener Splenda. This allows us to keep in delicious, authentic ingredients such as real chocolate chips, butter, and sugar (in moderate quantities) so that Sugar Solution desserts taste like the real thing. You’ll feel pampered—and satisfied. We used the same strategy in developing appetizer recipes that are delicious enough to serve company but won’t throw you off your weight-loss plan.