Ex-Kimkins or New to Low Carb?

For those that are switching from a very low calorie diet (or looking into low carb plans for the first time) you'll want to plan to get the most of your diet. Don't just start out cutting carbs and adding fat. You'll want to find a plan and follow it, at least until you know how your body is reacting. If you have been following a very low calorie diet, your body will likely initially react by holding onto fat and water. While this can be distressing, try to ignore it and realize it's temporary!! Take this adjustment time to plan and learn about your diet choice.

Now, I would like to post my own recommendations for anyone coming off Kimkins or just looking into a low carb plan.

1. For the next month or so don't count calories, and don't worry about weight gain or loss. You weight may fluctuate wildly for a while and you need to be prepared so you won't get discouraged. Don't count calories as they will likely regulate themselves and can always be cut back later if necessary. During this time start researching and reading about the different plans.

2. First, cut out all "whites". White flour, rice, sugar, potatoes, etc and all items made with them. So, no white breads, rolls, etc. No potatoes of any kind....and that includes baked as well as fried. No sugar. If you must have sweet, find an acceptable artificial sweetener (AS) and make/buy drinks that contain it. Observe your reactions to the foods you eat, noting especially how soon after eating you get hungry.

3. Start eating 3 regular meals a day with small high protein low carb snacks if needed. Cheese is a great choice for snacks, but many say eating it can lead to a stall. At this point, don’t worry so much about counting things, just eat natural unprocessed foods. If you do used processed foods, choose the one with the best ingredients. You should be eating enough at each meal so you are satisfied, but not overly full. The amount you eat should last until the next meal, although initially you may need snacks to hold you over. If you're used to very low calorie or tight portion control be open to having more than one serving of your protein/fat source. You should never leave the table hungry!

4. Start reading labels. You’ll want to start reading labels on any processed foods you buy or consider buying. Look for the least processed and best ingredients. For example, if you need salsa check out the carb counts and the ingredients. Buy the one that is lower carb especially if it's more natural. Dairy is also a good example. Fat free American cheese contains no fat, but 4 grams carbohydrate per ounce, while full fat cheese contains only 2 grams. Sour cream too....fat free, no fat, but 40 grams of carb per cup while full fat contains only 10 grams per cup. Watch ingredients too. If something says it has no trans-fat, or "0% trans-fat", check the label. Look for “hydrogenated” in the ingredients listing. If that word is there, it's very likely that the food contains at least some trans-fat, but by law can be listed as 0 if it's less than 0.5 grams.

5. Start reading up on low carb plans. There is a ton of information on the web and there are many plans to choose from. Go to your local library or bookstore and read a bit of the plans and see which one you can live with. If, for example, you like to have convenience foods, including frozen meals on hand for quick and easy meals, South Beach might be a better choice than Atkins or Protein Power. Each plan has it's specifics about how much fat, protein, and carb you should eat as well as what kind of foods they come from.

6. Once you decide on a plan, read the book. Front to back, at least once. Take notes or highlight text if you can. But really read the book. Pay attention to the science behind each of the author's points. Does what the author say make sense? Check the claims by searching online and verify facts when you can.

7. When you start on your plan you should follow it as closely as you can. For the first 2 weeks, minimum, do what the plan tells you. If it says to have as much green veggies as you want, then have it. If it tells you to limit something or increase something, then do it. Give yourself a month to decide if this is the right plan for you. Be sure to include exercise in your plan. Resistance training is felt to be more beneficial than cardio by many, but anything that you enjoy is fine.

8. Prepare to record everything you eat as accurately as possible. FitDay.com is an excellent product and is available online for free. If you really want to be accurate, measure and weigh everything you eat or drink. Record any exercise too. Check your weight and measurements and decide on a goal. Write this all down, or record in an online product. (SparkPeople.com is also an excellent free site that has a place to record food, exercise, goals, etc and also features support forums and teams as well as recipes and articles.)

9. Set a start date and de-carb your house. Remove as many of the "unacceptable" foods as you are able to. If you have family that you live with, be sure to get their buy in and agreements to work with you and your plan. At this time, if you haven't already, it would also be a good idea to talk to your doctor and get some baseline blood work done. If you are on any medications you may need your doc's assistance in changing dose as you loose weight. Getting baseline blood work is great to compare to additional work done later.

10. When following your plan, continue to learn more about diet and nutrition. Follow the research, but question anything in the mainstream media. Check out my links to blogs and web sites if you need a place to start!

11. Tweak your plan, after at least 2 weeks of following your plan exactly. If you don't like a certain aspect of your diet then change it. If you prefer meat over veggies it's not likely to cause you problems as long as the meat you eat is unprocessed and the veggies are good quality and as natural as possible. If you're not loosing enough and feel your carb intake is a bit too high, then lower it a bit. And if there is a food that you really miss see if there is any way to incorporate it or a substitute once in a while.

Following low carb may not be for everyone, but for the majority of us it is beneficial and results in lower blood sugar and insulin levels, lower blood pressure and usually significant weight loss. If you feel you are not loosing fast enough, cut back on carbs, and also rethink your expectations. Rapid weight loss is often not sustained over the long term and can cause several physical reactions.

If you properly follow a low carb plan you must make it a life plan. Sure you can follow the plan until you loose the weight you want to loose then go back to "normal" eating....but if you do you will regain the weight you lost, no question. And, if you are going to make this a life plan, you must find one that works for you!

A friend of mine recently asked me to find a list of foods that she cannot eat. Well, unfortunately it's not that easy!! Some people can eat fruit without a problem, but I'll be plagued by cravings if I am not really careful and have adequate fat and protein along with it. On the other hand, most people experience stalls from eating foods containing sugar alcohols (SA), but they don't seem to influence my weight at all. The foods that you "can't" eat are the foods that induce cravings and early hunger.

Limits should be placed on the total number of carbs per meal and not the food. If you are allowed 15 grams per meal and you want a veggie, you have a lot of choices:
Asparagus, cooked = 2 cups
Broccoli, cooked = 1.6 cups
Cucumber = 5 cups
Romaine Lettuce = 11 cups
Corn = 1/3 cup
Brown rice = 1/2 cup (1/3 cup of white rice)
White potato = 1/2 cup
So...you have a lovely piece of roasted chicken (eat the skin!) and along with it you can have a nice salad of lettuce (2 cups), tomato (1/4 cup), cucumber (1/4 cup), and mushroom (1/4 cup), along with an ounce of shredded cheese and 2 tablespoons of full fat creamy dressing, and some broccoli on the side, all for less than 15 grams of carb...or you can have 1/2 cup of potato. If you don't like salad or you're craving potatoes, maybe eating the 1/2 cup serving will be enough. The other thing to consider, and this is highly individualised, but it's likely that the starch in the potato is going to be rapidly metabolized and you will start to feel hungry sooner than you would if you had the salad. But, it's still your choice!! That's what makes any diet doable!


Here are some of the plans I'm somewhat familiar with:
Dr Atkins New Diet Revolution. Probably the best known and most misunderstood of all the plans. You start out with very low carb, no more than 20 grams per day, then increase them after the first 2 weeks. The increase in carbs is to allow people to figure out what their "critical carb level" (CCL) is. Your CCL is the level at which you no longer loose. Drop your carbs back a bit and you should loose steadily. As you get closer to your goal you increase carbs a bit more to slow your loss and gradually transition into maintenance. With this plan the emphasis is having a high intake of fat and a low intake of carbs. You are encouraged to eat veggies and some fruit. Exercise is a part of the plan, no exceptions.
Protein Power Lifeplan. My personal favorite, although what I do now isn't exactly by the book. For Protein Power plans the emphasis is on getting a minimum of a certain level of protein and keeping carbs below a certain level (30 grams/day to start). The original plan was a bit lower in carbs than the later one, but still the emphasis is on the protein (hence the name! LOL). In the first book there was a formula to figure out your minimum protein intake, but in the later book there's a chart for you to look it up. Fat isn't really addressed except to caution to use natural fresh fats over commercial ones.

And some that I'm less familiar with:
South Beach. Basic low carb for the first 2 weeks, then fairly generous for ongoing weight loss. Emphasis is to NOT remain on the initial phase for longer than 2 weeks. (Dr A and PP plans both "allow" you to stay on the initial level longer) This plan is considered low fat to many low carbers, especially those on Atkins. The emphasis isn't so much on quantity of fat as quality. It cautions against trans-fats (just like the Dr A and PP plans), but also cautions against saturated fat. Dr Agatston is/was a cardiologist, so it makes sense that he would fear saturated fats.

Dr Bernstein's books. I've read one and was impressed, but was already doing well with PP so I've never tried any of his plans. Dr Bernstein is a diabetic, a Type 1, who basically experimented on himself, then went to medical school so he would have more credibility. Unfortunately the general media tends to ignore him. He has a lot of good things to say, and promotes a low carb diet for all diabetics.

Other books about low carb, controlled car, low sugar plans:
Paleo Diet. Basically you eat what was available to our ancestors. So meats and any fruits and veggies that can be eaten as is. No processed foods. Meat, fish, gathered or foraged fruits, leaves, and roots of plants, mushrooms, nuts, eggs, and honey...that's pretty much it.

Sugar Shock. Connie Bennett figured out she was having a reaction to eating sugar and started investigating why. Her book gives and excellent explanation of sugar addiction and reactions in the body. She also has some excellent suggestions for those just looking to kick their sugar addiction.

The Zone diet. This one is about balance. The plan is to keep your carbohydrates, protein and fat in a certain ratio: 40/30/30 to be exact. I've heard that the diet can be confusing....and also that it's fantastic.

Sugar Busters. Basically with Sugar Busters you avoid all processed carbs and carbs that are high GI (Glycemic Index), like potatoes and corn.


Check out MY LINKS to low carb sites, books, and information....and have fun!!

Tonight's Dinner:

Brussels Sprouts with butter
cucumber with Caesar dressing
homemade chunky applesauce
herb rubbed roasted pork loin.

Atkins Editorial Rejected

This is being posted all around. I've copied this from Regina Wilshire's blog, but it's also available on Dr Vernon's, Jimmy Moore, and lots of others.

http://weightoftheevidence.blogspot.com/2007/03/atkins-editorial-rejected.html

Five heathcare professionals - Dr. Stephen D. Phinney, MD; Dr. Mary C. Vernon, MD; Dr. Eric C. Westman, MD; Dr. Jay Wortman, MD; and Jacqueline A. Eberstein, RN - recently penned and submitted an editorial response to the recent media attention concerning the A to Z study published in JAMA. It was rejected by JAMA, Newsweek, Time and others. Here it is, in its entirety:

More Science and Less Zealotry, Please.

The controversy over which diet is best for all has again made headlines with the publication of the Stanford University study in the Journal of the America Medical Association March 7, 2007. Since the results are favorable to the low-carbohydrate atkins diet, the usual criticism can be expected to follow.

Predictably, Dean Ornish has launched a tirade in which he manipulates the study findings to find fault with the low-carb approach and to deflect criticism away from his ultra low-fat diet which did not perform well in the study. Unfortunately, this is an argument based on dogma and not on science. The science speaks for itself.

As scientists and clinicians, we believe that no one dietary approach is going to be ideal for everyone. There is no doubt that, for some, an ultra-low-fat approach may be appropriate. Unlike Dr. Ornish, we recognize that there is no one-size-fits-all approach to the enormously complex problem of obesity and related conditions. Unfortunately, other authoritative sources like the US dietary guidelines also recommend a single lowered fat high-carbohydrate diet approach and have been doing so over the decades that this epidemic has grown.

Gratuitous attacks on the Atkins diet that imply it involves abandonment of wholesome vegetables and fruit for “bacon and brie” are simply wrong. Even in the most restrictive phase it meets the recommended daily guidelines for vegetables and fruits. As one advances through the phases, low-glycemic fruits, more vegetables, legumes and even whole grains are introduced based on an individual’s metabolic tolerance for these foods. One survey found that people who follow the Atkins plan over the long term eat more vegetables than they did before. Another study found that rather than increase the intake of fat and protein to compensate when carbohydrates were reduced, people simply ate less.

The unfortunate reality of today is that too many Americans are eating potato chips and fries and drinking sugar-sweetened beverages. We support the idea that wholesome foods such as meat, fish, cheese and eggs along with vegetables and low glycemic fruits constitute a healthier diet than chips and fries and sodas.

While this study examined four popular dietary approaches, what is clear is that whatever approach one takes to healthy eating, success will depend on how well you can stick to it. In this case, and in many earlier studies, it is clear that the Atkins diet is the one most people can maintain. On the other hand, the extremely low-fat diet advocated by Dr. Ornish is very difficult to follow. In this study, the subjects who were supposed to reduce their fat intake to his recommended intake of 10% could not reach that target.

Another important aspect of this and earlier studies is the beneficial effect that reducing carbohydrates has on metabolic markers. In his criticism, Dr. Ornish states that the LDL-cholesterol level fell in response to his diet, but does not mention that none of the differences in LDL-C in this study were statistically significant. This is therefore not a scientifically valid criticism. On the other hand, it is widely recognized that elevating the HDL-C, the good cholesterol, is an important factor in reducing cardiovascular risk. In this study there was a highly significant 10% rise in HDL-C in the Atkins group but no such change among those who followed the very high-carbohydrate Ornish diet.

In the same vein, the Atkins group demonstrated a significant (both statistically and clinically) greater reduction in systolic and diastolic blood pressure than the other three diets. A difference in mean arterial pressure of 5 mm Hg is about the response we would expect to see with a first-line pharmaceutical in the clinical setting. Any objective observer would acknowledge this as a major beneficial effect of the Atkins diet.

Dr. Ornish suggests that the positive findings of research such as this that supports the Atkins diet will cause problems, and that “many people may go on a diet that harms them based on inaccurate information.” This is a wildly irresponsible statement, given the consistency with which a reduction in important metabolic and cardiovascular risks are achieved by lowering carbohydrate consumption. It is simply preposterous to suggest that an approach that leads to significant risk factor reduction is unhealthy.

The seriousness of the accelerating epidemic compels us to think outside the box to find new solutions where the status quo has failed. The only approach that will be successful is one that people can actually follow. This study adds to the mounting evidence that the Atkins diet is a healthy choice which should be supported as a viable way to lose weight and improve metabolic and cardiovascular risk factors.

The Real Atkins Lifestyle

Before there was research on the Atkins diet it was commonly criticized in the belief that it would elevate cholesterol, ruin one’s kidneys and bones and cause heart disease. None of this has been borne out by the research.

What is clear from this JAMA study, and others like it, is that cardiovascular risk factors actually improve when controlling carbs. The scientific studies of this approach have shown numerous times that a pattern of rising HDL-C and falling triglycerides is the hallmark of carb restriction and that this benefit occurs even in the absence of weight loss.

Research also shows that rising HDL-C (good cholesterol) and falling triglycerides is correlated with larger LDL-C particles which are less likely to cause heart disease. Even the much touted statin drugs do not deliver this kind of improvement in LDL-C particle size. On the other hand, the research shows that eating a high-carb diet and cutting fat intake results in small dense LDL-C particles that are linked to an increased risk of heart disease.

Importance of Fat

There are other problems associated with extremely low fat diets, as well. Cutting fat intake can lead to deficiencies in fat soluble vitamins, depletion of essential fats such as EPA and DHA, and decreases in the absorption of nutrients. Studies also show that people with cholesterol levels that are too low become prone to depression, suicide and cancer and have higher overall death rates than those who have higher cholesterol levels.

When all is said and done, it behooves us to remember that the diet debate is not a horse race where there is only one winner. We know there is a great variability in metabolic and genetic factors that will determine what dietary approach is best for each individual person. Although, in this and many other studies the Atkins diet worked better for more people, it is also evident that other dietary approaches will work for some people as well. The most important thing we have learned from dietary research is that people need to find the approach that will deliver healthy outcomes for them individually. And, just as the proof of the pudding is in the eating, the proof of a diet's effectiveness is whether it can sustain those benefits over the long haul. Hopefully, the weight of the evidence will now allow the Atkins diet to be recognized and supported as a legitimate option for people who want to improve their health through better nutrition.

On a final note, Dr. Ornish’s repugnant attempt to undermine Dr. Atkins’ credibility by perpetuating the myth that he had heart disease is unconscionable. It is unbecoming of any honorable person to make ad hominem attacks on those who are departed. Enough is enough. Dr. Atkins died of a head injury. He is no longer with us, but the line of scientific inquiry that he started continues to vindicate his dietary approach. And no amount of unfounded criticism will alter the fact that this study, and the 60 others before it, clearly demonstrate that what Dr. Atkins had been telling us all along was right.

* Jacqueline A. Eberstein, R.N. Co-author, Atkins diabetes Revolution, President, Controlled Carbohydrate Nutrition
* Stephen D. Phinney, M.D. Ph.D Emeritus Professor, Department of Medicine, UC Davis, Elk Grove, Cal
* Mary C. Vernon, M.D., CMD, Co-author, Atkins Diabetes Revolution, President, American Society of Bariatric Physicians
* Eric C. Westman, M.D. M.H.S, Associate Professor of Medicine, Duke University Medical Center
* Jay Wortman, M.D, Department of Health Care & Epidemiology, Faculty of Medicine, University of British Columbia