The Key to Health and Weight Loss
By Diana Schwarzbein, M.D.

"We must reverse the common thinking that a low-fat, 
high-carbohydrate diet is the key to health and weight loss."

Knowing what I know today, it is still hard for me to accept that between 1981 and 1990, while I was in nine years of medical training, my instructors were teaching me and everyone else in medical training that a low-fat diet was the way to prevent obesity, diabetes, and heart attacks. My instructors stressed the -fact- that eating fat not only made you fat but also caused a host of health problems. These professors spoke of hundreds of studies that they said proved that fat was indeed the culprit in creating a national epidemic of obesity, diabetes, and heart disease. 

Countless magazines and newspapers shared the results of these studies with the public. These studies fueled a frenzy outside of medical schools as people got caught up in trying to lose weight and prevent heart disease by reducing or eliminating fat from their diets. And the short-term effects of eating less fat and more carbohydrates seemed to indicate that people could lose weight and decrease their cholesterol by eating this way.

But these studies proved to be wrong. This may come as a surprise to you, but cutting back fat from your diet and filling up on carbohydrates may actually cause you to gain weight in the long run, can increase your cholesterol level, and can set you down a path of what I call -accelerated metabolic aging.- A low-fat diet eaten over a long period of time actually deprives humans of the nutrients they need to regenerate healthy cells, which can lead to disease and early death. The studies referred to by my professors in medical school only took into account the short term. There were-and are-no long-term studies that show a low-fat, high-carbohydrate diet maintains weight over the long run and prevents illness.

Since leaving medical school I have radically changed how I think about nutrition and health. No longer do I believe that fat is evil and carbohydrates are good. From my own clinical research with thousands of patients, I now have a better understanding of what we all need to eat to control our weight and prevent disease. I no longer advocate a low-fat diet, but instead teach all of my patients how to balance their meals. The secret to weight loss and maintenance lies in controlling the amount of the hormone insulin that is released into our bloodstream after a meal. And the secret to preventing disease is to make sure we eat foods that can rebuild our cells and keep them strong.

Over the years I have come to understand how vitally important it is that people stop eating a low-fat, high-carbohydrate diet and start combining their food properly. This understanding started when I took a job at a medical clinic in Santa Barbara, California. I was hired to reestablish a diabetes program there. I would spend a full hour with each diabetic patient, obtaining a detailed history. These were type II diabetics, which accounts for 98 percent of diabetes. With this type of diabetes, the body produces insulin, the hormone responsible for getting sugar into the cells, but the patients’ cells do not respond well to insulin-they are what is called insulin resistant.

As I listened to the patients’ stories, it was clear that they were very upset that instead of getting better after seeking medical help, they were steadily getting worse. They told me that they had started off eating the American Diabetes Association (ADA) diet, which is a low-fat, high-carbohydrate diet. They checked their blood sugars regularly. When they came back to the doctor, the doctor would tell them that they had not been compliant-if they had been, their blood sugars, cholesterol, and weight would be better. Imagine how you’d feel if you’d done precisely what the doctor ordered and not only did you get worse, the doctor as much as called you a liar!

The next therapeutic step was to add in one of the sugar-lowering drugs while continuing to follow the same diet.

During their next follow-up visits they were again told that they must be noncompliant because they were not getting well. A lot of them were then switched from pills to insulin injections. And you guessed it, they still did not get better (remember, these patients are insulin resistant). And if the doctor did believe that they were following their diet, the fact that they were not getting better was attributed to genetic problems and they were still put on insulin injections.

You can see how frustrating this must have been for them. I certainly felt their frustration and anger when I heard these stories. And then I realized I had two choices. I could continue with the same standard treatment regimens that these patients were already on or the patients and I would have to come up with a new treatment plan.

I gave each of these patients a choice. Every one of them wanted to come up with something different, so we started by collecting baseline data. I had them write down everything they put in their mouths. I had them check their blood sugars six times a day, before and after their meals. First thing in the morning I had patients measure their blood sugar. It was always normal. Then they had the breakfast recommended by the ADA, typically a bowl of cereal with nonfat milk, a banana, and a glass of fruit juice. Nondiabetics eating this breakfast would experience only a ten- to twenty-point rise in their blood sugar. But after this high-carbohydrate, low-fat ADA-recommended breakfast, my patients would watch their blood sugar soar—up between 100 and 200 points, ten times the normal blood sugar response.

It had to be the diet that made their blood sugar levels soar, but why? And then it suddenly hit me—their blood sugar rose dramatically because we were feeding them hidden sugars: hidden sugars in the form of carbohydrates. All carbohydrates are broken down into sugar by the body during digestion, whether they are in the form of grains, starches, dairy, fruits, or sweets. By recommending a high-carbohydrate diet, we were asking diabetics to eat sugar.

After seeing these  patients’ blood sugar levels rise so dramatically after meals, I was convinced that the ADA diet was wrong. Though it was professionally a tough decision for me, I had to turn my back on the ADA-approved diet and conventional learning. The new clinical evidence was too strong. All of my type II diabetic patients reported the same results: the ADA diet made their blood sugar skyrocket.

Now the real process began. If not the ADA diet, what should these patients be eating? I started with the premise that it should be as few carbohydrates as possible, since they were converted to sugar. So that left proteins, fats, and non-starchy vegetables. However, I asked them to keep their fat intake to a minimum because type II diabetics have the highest risk of heart disease of any patient population. Limiting fat seemed wise since I still believed at that time that eating fat caused heart disease.

The most important clinical question was: Could we get the patients’ blood sugars lower while still keeping heart disease at a low level?

One week later the first group of patients returned for an evaluation. I looked at the blood sugar numbers they had recorded. Their progress was astounding. But the ones who had improved the most were the -cheaters.- On their own, with the help of their home sugar-measuring devices, they were seeing that their blood sugar levels were improving when they ate more fat with their meals. Soon they were eating even more mayonnaise, butter, cheese, eggs, and steak. What a delight, after months or years of shredded wheat and nonfat milk!

By cutting down on carbohydrates and eating fats, they were losing weight! For a type II diabetic, losing weight is an almost impossible feat. But these patients were eating fats and losing body fat and it did not end with just losing weight. Everything was improving. They felt satiated and their energy improved. Their cholesterol levels were improving. And because their cholesterol levels were getting better and not worse-believe me, I was monitoring this closely-it encouraged me and my patients to continue this regimen.

My biggest fear-that I would treat their diabetes but increase their risk of heart attacks-proved groundless. Why? Because weight gain around the middle of the body, high blood pressure, high blood sugars, and high cholesterol levels are all risk factors for heart disease and every one of these conditions was improving!

So how did treating diabetics with this diet plan change how I treat all my patients? Because I started to look at our similarities as humans. We all have mouths, stomachs, small intestines, portal veins, and livers. We all digest carbohydrates into sugars by using the same enzymes. We all secrete the same hormones in response to the food that we are eating. Our livers all have the capacity to turn sugars into fat and cholesterol. Our bodies all function the same.

And that is when I started testing my hypothesis on other patients who were not diabetic. It worked for them, too!

I was more astonished with each passing day. Every single patient thrived as he or she adopted this more balanced eating plan-fewer carbohydrates and all the proteins, fats, and non-starchy vegetables they wanted. Those who needed to lose weight did so effortlessly. Those who were already in good shape found themselves with more energy.

While I was watching my patients get healthy while eating fat, it made me realize that I had never met anyone who followed a low-fat diet who was as healthy as my patients were becoming. Well, I thought, maybe it was just that those people I saw came for treatment of some problem. Maybe there were many healthy low-fat dieters out there who never needed a doctor. Or, and this is a frightening thought, were they only healthy temporarily because they hadn’t eaten that way long enough for the damage to their bodies to show up?

This was when I conducted a thorough search of the medical literature and discovered that there was not a single long-term study that proved that a low-fat, high-carbohydrate diet was beneficial to our health. However, I did find thirty years’ worth of basic science studies that proved that high insulin levels were linked to heart disease, high blood pressure, excessive increase in body fat, and many other problems. This is when I concluded that the population studies were not as important in determining how to be healthy as basic science was. Population studies take a segment of the population, follow it for a few years, and try to come up with conclusions. The variability involved in population studies makes this an almost impossible task. On the contrary, basic science is the study of how the body actually works in physiological terms. Basic science does not change greatly. However, every time you turn around the population studies are telling you how to eat differently. If we just stick to science everyone would stay on a balanced eating program consisting of healthy, nutritious foods.

You have seen how we have debunked the myth that eating fat makes you fat by actually looking at basic human physiology, which proves that increased insulin levels cause weight gain. Now let’s go ahead and debunk another myth—that consuming excess calories causes weight gain.

A calorie is simply the amount of energy required to raise one gram of water one degree Celsius. Proteins and carbohydrates each have four calories per gram. Fat has nine calories per gram. Therefore, fat is more than twice as fattening as proteins and carbohydrates, right? Wrong!

What happens in a test tube is not the same as what happens in your body. In your body, a carbohydrate snack must be used for immediate energy or it is stored as fat. But if the snack is protein and fat, the food is used first to replace cells, enzymes, and hormones that are made up of proteins and fats, which leaves fewer leftover calories to be stored around your middle.

After I discovered this, it became clear to me why my patients were able to consume more calories and more fat and still not gain weight. Once again, all signs were pointing to hormone changes in the body as the reason why people lose or gain weight. When insulin levels and their effects are higher, people are more prone to storing fuel as fat.

But I still had more work to do to convince my non-diabetic patients that eating fats was essential. They proved to themselves through experience that eating fat would not make them fat, but they were still worried that consuming more fat and cholesterol would lead to heart disease. So I began telling them how cholesterol and fat are essential to health and life. They are used by the body as building materials, and they need to come from the food you eat. Fat and cholesterol don’t cause heart disease; in fact, you must eat them to avoid heart disease and early death. The more good fats you eat, the healthier you will be.

Look at the good that cholesterol accomplishes in your body:

Essential for brain function 
Forms insulation around nerves to keep electrical impulses moving 
Forms membranes inside cells 
Provides important structures in cell membranes 
Keeps cell membranes permeable 
Helps prevent mood swings 
Maintains a healthy immune system 
Makes important hormones 
Stabilizes neurotransmitters 

I explain to my patients that the body is constantly breaking down cells and building them up again. Dietary fats play a key role in this replenishing process. Like cholesterol deprivation, fat deprivation disrupts all the biochemical processes of your metabolism. It would be impossible to list all the health problems that can occur as a result of depriving your body of fat, but here are a few signs and symptoms:

Brittle nails 
Carbohydrate and stimulant craving 
Constipation 
Dry, limp, thinning hair 
Infertility 
Insomnia 
Loss of lean body mass and fat gain around the middle 
Mood disorders 
Scaly, itchy skin 

The solution to overcoming these conditions and avoiding many more is to eat good dietary fats. Fats found in nature are healthy. Saturated, monounsaturated, and polyunsaturated fats are all natural fats and therefore good for you. Your diet should be rich in fat and cholesterol, which can come from a wide variety of foods, such as avocados, butter, eggs, red meat, chicken, shellfish, fish, olives, tofu, nuts, and seeds.

To summarize, let’s take a quick look at - Conventional Wisdom,   - errors touted by everyone from women’s magazines to the ADA, and compare it to what really happens in your body:

Conventional Wisdom: Eating fat makes your cholesterol rise, and puts you in heart-attack country.

The Truth: The high insulin levels created by a high-carbohydrate, low-fat diet cause plaque to be deposited in your arteries. Build enough plaque and you’ve built a heart attack. Eating fats and cholesterol lowers insulin levels and switches off the body’s production of cholesterol, protecting you from heart attacks.

Conventional Wisdom: Risk of high blood pressure (hypertension) is increased by eating fat.

The Truth: Again, insulin is the real culprit. Without fat, insulin levels rise higher in the blood, which leads to other factors that cause high blood pressure.

Conventional Wisdom: The low-fat, high-carbohydrate diet for diabetics makes patients healthier.

The Truth: Type II diabetics are insulin resistant. Eating a low-fat, high-carbohydrate diet increases their insulin resistance. Patients get better on a balanced plan of protein, fats, nonstarchy vegetables, and limited carbohydrates.

Conventional Wisdom: A low-fat diet prevents cancer. A high-fat diet causes cancer.

The Truth: Cancer cells grow best when insulin levels are high, just the climate created by the low-fat, high-carbohydrate diet. Dietary fat increases a healthy immune system and gives the body key components to fight cancer cells.

You now see why I am on the fat bandwagon. Eating fat isn’t making us fat-it’s the low-fat, high-carbohydrate diet that raises our insulin levels. There are some other factors that raise insulin levels, too, both directly and indirectly. These include dieting, stress, lack of exercise, caffeine, alcohol, aspartame, tobacco, steroids, stimulants and other recreational drugs, excessive and/or unnecessary thyroid replacement therapy, and all over-the-counter and prescription drugs. These insulin-stimulating factors have defined the lifestyle habits that have prevailed over the last twenty years in this country and parallel the rise in the incidence of disease during the same period of time. A more complete exploration of the science as well as the nutritional and lifestyle program I recommend to my patients can be found in The Schwarzbein Principle (Health Communications, Inc., 1999).
 

DIANA SCHWARZBEIN, M.D..

Santa Barbara, California

this article taken from http://www.suzannesomers.com/Somersize/  

for another low-carb article click here: http://thatsrich.com/lowfat.htm 

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