Pour some sugar on me?. | Coastal Health and Fitness Blog

On second thought, don?t do that. I?m not sure what Def Leppard was singing about with these lyrics, but it probably wasn?t a nutritional statement.

I thought about this song a few days ago as I tried to talk a patient out of his newly started diet. Firstly, I do not like ?diets?. I like people to embrace a manner of eating and live that way forever. Short term changes to one?s eating habits yield short term results. Diets that restrict you to certain foods or prohibit other foods almost always end in failure. Lifestyle modifications, however, are much more likely to succeed because the changes are created with the goal of them lasting a lifetime (duh!).

Back to the patient and his onerous new diet plan. With the goal of losing 20 pounds to become a better cyclist and paddler, he told me that his trainer gave him a plan that included 3-5 protein shakes throughout the day, prohibited all fruits and grains, prohibited alcohol and dairy, prohibited beef and pork and required constant snacking (mostly hard boiled eggs with broccoli, protein shakes and sliced turkey breast with quinoa).

My first question: do you have a personal or family history of kidney disease? Such high protein intake could and would tax the abilities of a compromised kidney to function. He did not, so no big problem there.

Second question: why so much protein? He told me that he was trying to keep his blood sugar low and supply his muscles with the needed material to be big and lean.

Third question: so, is that why you?re not eating fruit? Yes, he replied, the glycemic index of fruits, breads and pastas are too high and are responsible for his extra weight that he had not been able to shed.

With this answer, I realized the need to talk with this patient for several minutes and help him to understand some basic nutritional premises. First, with regards to body weight and unwanted/extra body fat, the old saying holds true: a calorie is a calorie is a calorie. Yes, different food types can have the effect of satiating or increasing hunger. But at the end of the day, to lose weight calories ?in? must be less that calories ?out?. In other words, burn more energy than you consume. This can be accomplished by burning more, consuming less, or both.

Remember the riddle you learned in grade school: what weighs more, a ton of bricks or a ton of feathers? Transfer that riddle over to food: what has more calories, 500 calories of bagels or 500 calories of broccoli? Yes they are both very different foods with different affects on the body, but from a shear caloric standpoint, they are the same.

So, back to my patient. Next question: what is the rationale for eliminating all fruits? His answer: fruits have a high glycemic index which means that they contain a lot of sugars which means that they trigger insulin to store sugar as body fat. This is a pretty easy concept to explain, so I set to work.

There is a nutritional value called the glycemic index. It was established 30+ years ago to help diabetics find foods that would not cause their blood sugar to ?spike? out of control. Originally, it was based upon the blood sugar response to consuming 50g of white bread (now it is based upon pure glucose). All foods are compared as a percentage of that number. So, 50g of glucose yields a score of 100, while 50g of baked potato yields a score of 85 and 50g of peanuts yields a score of 15. A higher score means more grams of simple carbohydrates in that 50g serving and therefore a greater potential to ?spike? blood sugar.

Is he right then to avoid all high glycemic foods? No! There is another food measurement of which he (and most likely his trainer, as well) was unaware: glycemic load. The glycemic load quantifies how much simple carbohydrate comes from a serving of a given food. It is determined by this equation:

(Glycemic index X Number of carbs in the serving of food) / 100

Lets see the glycemic load in action:

Watermelon has a glycemic index of 72 (an index > 70 is considered ?high?). 1 cup of watermelon contains 11g of carbohydrates: (72 x 11) /100 = 8 (less than 10 is ?low?, 11-19 is ?medium? and >20 is ?high?).

Now look at a soda. A typical12 oz. soda has a glycemic index of 59. Note that this number is LOWER than the index value for watermelon. Enter the glycemic load: because a typical soda has 39g of carbohydrates, the load is: (59 x 39) /100 = 23.

If this still isn?t making sense, consider it this way. Imagine 2 rivers, both flowing at the same rate of 3 miles per hour. River A is 6 inches deep and 12 inches wide. River B is 10 feet deep and 50 feet wide. They are both traveling at the same speed, but which is moving more water? The river?s speed is the glycemic index, while the force of the river (its speed combined with its size) is the glycemic load. Which river has greater force?

Once again, back to my patient. At this point I have hopefully convinced him that carrots, pears and bananas are not the evil creation of a malignant being who hopes us all to be obese. I now must convince him of the value of carbohydrates. This part is a little tougher.

Typically, it is recommended that endurance athletes consume 6-10g of carbs per kilo of body weight. This range is pretty broad, covering everything from the 40/30/30 diet to Barry Sear?s Zone diet to Nancy Clark?s endurance athlete diets. While there are several choices for athletes such as my patient, the constant for each of these is the need for carbs. I recommended that he drop the protein shakes entirely, swapping them for snacks consisting of walnuts with apples, sliced turkey with cherries or quinoa with raisins. I further recommended that he allow whole, unprocessed grains into his diet. The bleached, white stuff should be avoided but the whole grains are both good for him and serve as a great source of carbs, his muscle?s primary fuel source.

My hope is that in opening my patient to a simpler world of nutrition, he will be able to create a meal plan that meets his goals and his desires. If he is able to rely upon whole, unprocessed foods, enjoy the ?variety is the spice of life? motto and embrace moderation of all things good and ?bad?, he should do great with his new lifestyle. And if he does not, I?ll give him a choice: go see a registered dietician or I?ll make him listen to Def Leppard!

Source: http://blog.coastalhealthandfitness.com/pour-some-sugar-on-me/

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