Always Hungry by David Ludwig, MD, PhD

Blogging through “Always Hungry” by Dr. David Ludwig (Part 14: Prep Week Day 1)

This is part 14 in a series summarizing and reviewing “Always Hungry” by David Ludwig, MD, PhD. It may help to start reading these posts in sequence starting with part 1.

***Day 1: Food Prep for Phase 1, Week 1.

As discussed on Day 2, I modified my meal plan (which means I’m really not following Phase 1 at all) to fit my schedule and still be able to try out some of the recipes.

*If you have a chronic disease or are over weight and are looking to reset your body metabolism and get the full benefit from this plan, PLEASE FOLLOW DR. LUDWIG’S INSTRUCTIONS. The closer you adhere to them, the better results you will get. He has been very methodical in helping to provide a balance of macro and micro nutrients to help you transition and actually feel good entering this new phase of healing and wellness. If you do not follow the plan very closely, you will not see the full benefit*

I made

  • Creamy Cauliflower Soup (I like it, especially when you get to add more heavy cream! My boys did not like it. I think the flavors of cauliflower and onions are too strong for them at this point.)
  • Steak Salad and blue cheese dressing (I liked it all! I’ve only eaten cannellini beans cooked in soup before, but they are pretty good in a salad too. I actually made the dressing with feta instead of blue cheese since I have a lot left from a previous recipe I’d made.)
  • Coconut Curry Sauce (for the coconut curry shrimp recipe)

I would have been completely overwhelmed making 10 sauces!!! I guess that’s why Dr. Ludwig suggests making them during the prep day instead of during the week! Another great thing about prepping sauces ahead- the flavors have time to develop. Yum yum! The last reason you should prep your sauces ahead is that for anyone who has “dieted” before they are easy to leave off! Many of the recipes use the sauces as the source of fat, a nutrient most dieters have been forced to avoid. It totally feels wrong to add EXTRA fat to your healthy dishes. Remind yourself that this is part of the plan and the sauces in this plan utilize healthful fats (not over processes vegetable oils or trans fats).

As you move through some of these recipes, don’t feel trapped to do everything from scratch, but be careful which shortcuts you take. For example, I purchased roasted cashews instead of raw to save myself that step. When using a convenience measure like this, try to be sure no extra ingredients were added (for example a vegetable oil or salt). Another acceptable short cut would be to purchase steam in a bag frozen vegetables. Many will say it’s preferable to purchase fresh, and they have a point, but frozen vegetables are flash frozen soon after they are picked which means the veggies are very fresh and already cut, only needing to be cooked. While steam bag vegetables are usually more expensive, the convenience is sometimes worth it, especially when cooking from scratch is so new to a person. That would actually be a great variation edit to this plan!

  • Tier 1 is recommendations and how to do it the best of the best, when money, skill and time are no object.
  • Tier 2 is the same plan phases but with time and budget considerations for the average working person (the current Always Hungry Plan).
  • Tier 3 is the same macro-nutrient profile with considerable modifications for convenience and cost.  What you lose in health benefits you make up for by reducing the barriers to entry in to the plan.

What are you favorite healthy cooking short cuts?

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Always Hungry by David Ludwig, MD, PhD

Blogging through “Always Hungry” by Dr. David Ludwig (Part 13: Prep Week Day 2)

This is part 13 in a series summarizing and reviewing “Always Hungry” by David Ludwig, MD, PhD. It may help to start reading these posts in sequence starting with part 1.

***Day 2- Go Shopping.

Dr. Ludwig’s website http://www.alwayshungrybook.com has the shopping lists you need (non-perishables, prep phase and days 1-3 of recipes) for your biggest shopping trip. Be prepared for the bill- remember you are restocking and many of these items you will use for many weeks. The website also has recommendations for specific products.

I actually had a lot of the items already. I typically follow a restricted eating window (also known as intermittent fasting), which basically means I my first meal is lunch around 11 am. I searched on the always hungry website and facebook page for guidelines on how to follow this plan and IF, but Dr. Ludwig recommends you follow the plan preciesely for phase 1, then in phase 2 and 3 you can begin following a restricted eating window again. Since I’m a rebel and I don’t want to prepare breakfast daily, I did not purchase foods for breakfast meals or the first snack.

I also have a complicating factor of my family- husband, 4 year old boy and 11 month old boy. While I’m glad to include them in this trial, I know they won’t appreciate the strong flavors and varied vegetables in the recipes I will be trying out. So for example, instead of creamy cauliflower soup and the steak salad with blue cheese dressing that I will be eating, they will have steak, green beans, carrots and cannelini beans (no beans for hubs though). My sons don’t like dressing at all and my husband chose store bought ranch.

 

Always Hungry by David Ludwig, MD, PhD

Blogging through “Always Hungry” by Dr. David Ludwig (Part 12: Prep Week)

This is part 12 in a series summarizing and reviewing “Always Hungry” by David Ludwig, MD, PhD. It may help to start reading these posts in sequence starting with part 1.

***Day 3: Gather Your Cooking Tools and Clean Out Your Kitchen

The list of needed kitchen equipment is on page 133. I have all of these items except an immersion blender. I have a food processor and a pitcher style blender, so I will see how much I can get done with these tools instead. I may want to upgrade my paring knife situation. I rely a lot on my chef’s knife and I could see a smaller knife being useful.

Kitchen clean out lists are on pages 135-138. I went through my cupboards, fridge and freezer tossing anything expired, donating items we won’t use and organizing what was left. Note Dr. Ludwig lets you know what items you can keep for phase 2 (that aren’t allowed in phase 1). I also used this time to make a list of what staples I was out of for the Day 2 shopping trip! 🙂

Update on night time ritual and sleep. I have forgotten to keep my daily sheets which means either I’m not used to my current process yet, or I should alter my process to better serve our schedule. To better establish this practice, I will make paper copies of the document and keep at my breastmilk pumping bag, since this is an activity I cannot skip before bed where I would have time to record the day’s events. I will also try to keep my computer there, but I fear my kids may mess with it when they can reach it.

My sleep has been okay, but last night I was stressed about a work commitment (today is my day off for working the weekend). Going through my entire sleep ritual would have been beneficial, but still may not have helped me fall asleep better.

Looking forward to Day 2’s shopping trip!!

Always Hungry by David Ludwig, MD, PhD

Blogging through “Always Hungry” by Dr. David Ludwig (Part 11: Prep Week)

This is part 11 in a series summarizing and reviewing “Always Hungry” by David Ludwig, MD, PhD. It may help to start reading these posts in sequence starting with part 1.

***Day 4: Your “Big Why” and “If-Then” Plans

My Big Why is to avoid the diabetes, hypertension and obesity running in my family. Additionally, as a registered dietitian, I want to have completed a program I can fully endorse as a viable whole life weight loss and wellness solution. This is not measurable though, so my big why will be to reduce my body fat percentage to less than 37% (currently 39.4%, as measured by my home bioelectrical impedance scale which has limited accuracy, but I’ve been tracking myself weekly with this since my 2nd son was born 10 months ago).

My amulet: I keep pictures of my kids near my desk- they will be reminders at work. At home I have an inspirational quote in my bathroom and on my fridge.

If-Then plans:

If-Then plans are planning ahead for probable tricky situations (items in the plan that you don’t normally follow). Just like fire drills, we want to have a pre-made plan so that when the time comes, you don’t have to decide, you just have to act. Think about places you are likely to be “off plan” and answer these questions. example on pg 131. In planning my If-Thens, I found it helpful to reverse the order of #3 and #2. In their current order it feels more like a “guess and check,” to me, but I’m sure either order will yield good results.

  1. Which new habit do you want to establish?
  2. When, where and how will you do it?
  3. What could hinder you from doing it (could be a barrier) and how can you overcome it?

#1

  1. New Habit: making time to have a solid meal every night.
  2. When, where, how: I will prep on the weekend (by Sunday afternoon) and utilize left overs/ making ahead meals. I will create a meal plan for the next week by Thursday night.
  3. Barrier: Feeling rushed on the weekend- complete planning by Thursday night (planning double recipes to take advantage of left overs) and weekly prep by Sunday afternoon.

#2

  1. New Habit: not running short on time during the week (for night time ritual AND adequate sleep).
  2. When, where, how: simplify night time ritual, plan ahead so I can leave work no later than 5:30 pm. Be direct in communication when events are unfolding rather than keeping it to myself.
  3. Barrier: Life is unpredictable and no matter how much I plan, things come up. When I can’t make it happen according to plan, I will let it go and forgive myself. Stressing over it would be worse than not sticking exactly to the plan!

#3

  1. New Habit: Utilizing meal prep items and left overs efficiently
  2. When, where, how: label containers in fridge. Trial white board tape and markers to make it easier than masking tape. Develop system of what goes on each shelf (leftovers vs meal prep items).
  3. Barrier: cumbersome to track whats in the containers, remove labels, utilize leftovers in a timely way.
Always Hungry by David Ludwig, MD, PhD

Blogging through “Always Hungry” by Dr. David Ludwig (Part 10: Prep Week)

This is part 10 in a series summarizing and reviewing “Always Hungry” by David Ludwig, MD, PhD. It may help to start reading these posts in sequence starting with part 1.

***Day 5: Movement, Sleep, and Stress Relief Strategies

My joyful movement will be walking. It’s something I can do during work, with the kids or by myself; super flexible. 😉 Since I have no current workout routine, there is nothing to adjust there. 😦 ….But there is no time for guilt, only moving forward! I do think stretching/ yoga will have a place in my program eventually (probably part of a morning session), but right now, I’m focusing on walking.

Safeguarding Your Sleep-  Since my four year old does not like nightlights in his room, but does want some light, we leave the hallway light on for him. This is a problem for my sleep. I know I do not sleep as deeply on nights the light is on all night. Today I purchased my first eyemask at a local retailer. I attempted to buy one on Amazon, but the reviews were so mixed that I couldn’t decide on what style nor could I trust that what was in the picture was what I would receive. Good old bait and switch technique.

Thermostat- I let my husband control the thermostat because I feel like I’d want it to be 72 degrees 24/7. I’m one who sleeps with socks on and a blanket year round. Now that it’s fall, I’m adding more and more blankets to keep myself warm during the night. Otherwise I wake up shivering! I also really enjoy HEAVY blankets. It’s like a constant hug while I sleep! 🙂 I do, however value having my face in the cold; strange, I know.

Screens- My youngest is 10 months old and I’m still pumping breastmilk for him right before I go to bed. This is my all-me-alone time because my whole family is in their beds and most of the house is dark and quiet. I usually watch shows that my family (all boys!) doesn’t like to watch and catch up on facebook (we moved far away from my family and many friends and this tends to be the best way to keep up with their lives). I do use a blue light function on my phone, but the TV is probably a no-go. I’ll research the settings to see if I can change the TV settings. I should just forgo the TV, but being able to watch my shows by myself is the reason the baby is still getting breastmilk (it’s sooooo much work)! I do promise to not watch anything stressful or scary. 😉

Our bedroom does not have extra lights, screens or noises that I am not currently managing (except the hallway light I described earlier).

Pre-sleep ritual- My bedtime is already 9 pm. Because of my boys, I will basically start my ritual when I get home around 6 pm. This is my plan:

6 pm- get home from work, make supper, feed baby, preschooler and myself, do dishes

6:45 or 7 pm go on evening walk with the kids

7 or 7:30 pm baby to bed and begin turning off lights, do prep work for tomorrow’s supper and the boys’ lunches

8 pm preschooler’s bedtime ritual. We will, brush our teeth, read a book together and snuggle, pray and tuck him in his bed

8:30 pm Express breastmilk and do something that makes me happy (facebook, chat with family, catch up on a show). Then 5 minute de-stressing activity (stretching and breathing), take out contacts, put on eye mask and…

9 pm go to bed (this means when I get up at 6 am I will have 9 hours in bed)

***

I’m going to need to do some serious “If-then” strategics…. keeping to this schedule will be a challenge with the unpredictability of the kids.

Always Hungry by David Ludwig, MD, PhD

Blogging through “Always Hungry” by Dr. David Ludwig (Part 9: Prep week)

This is part 9 in a series summarizing and reviewing “Always Hungry” by David Ludwig, MD, PhD. It may help to start reading these posts in sequence starting with part 1.

***

Day 6: Take Your Health Snapshot– and Start Tracking

I took my measurements and added the to the excel tracking sheet from http://www.alwayshungrybook.com > Resources > Book Resources and Downloads > Monthly Tracker. I input height, weight, and waist circumference. I also have my most recent fasting lipid profile, blood pressure and fasting glucose. I do not have fasting insulin, HgA1c, or C-reactive protein. Since I do not yet have chronic disease, I’ve had no occasion to measure these markers and in a quick search of local labs showed they are each at least $100. I’m sure there are cheaper ways to test these markers, but as I said, it’s not valuable to me personally right now.

I also started using the daily tracker sheets today, as recommended. I am actually using the monthly tracker spreadsheet since it has a tab for each day of the month. I plan to keep a few copies of the daily tracker handy in case I don’t have time/ feel like firing up my computer to log before I go to bed.

That was a short post, but that’s the point of this prep week: to be easy steps to prepare for the weeks ahead.

 

Always Hungry by David Ludwig, MD, PhD

Blogging through “Always Hungry” by Dr. David Ludwig (Part 8: Preparing to Change Your Life)

This is part 8 in a series summarizing and reviewing “Always Hungry” by David Ludwig, MD, PhD. It may help to start reading these posts in sequence starting with part 1.

***Summary***

Chapter 5: Preparing to Change Your Life

Dr. Ludwig outlines how to have a successful start with the 7-Day Countdown with activities like collecting baseline metrics, fining your “big why” to help you stay on track, strategies to get sleep, movement and reduce stress, preparing the kitchen, stocking your shelves and some recipe prep work.

Day 7: The Overview

  • Phase 1: Conquer Cravings- 50% fat, 25% carbs, 25% protein for two weeks
  • Phase 2: Retrain Your Fat Cells- 40% fat, 35% carbs, 25% protein for 2-4 weeks or possibly longer if you don’t tolerate carbs well. Some will need to stay on this phase indefinitely.
  • Phase 3: Lose Weight Permanently- 40% fat, 40% carbs, 20% protein with the goal to find out what your body tolerates without triggering cravings or weight gain.

Pages 110- 117 have a chart with each food group and what is allowed during each phase.

Day 6: Take Your Health Snapshot– and Start Tracking

  • Weigh- only weekly, listen to your body instead of numbers of calories or the scale.
  • Waist and height
  • Blood tests (optional)- fasting lipid profile, fasting glucose, C-reactive protein, high sensitivity
  • Blood pressure
  • Daily tracker and Monthly Progress Chart- copies on 310-311 and downloadable at http://www.alwayshungrybook.com. The monthly chart plots your daily carb intake vs subjective ratings of hunger, cravings, satiety, energy level and well-being. It also asks you about your stress reduction, movement, after-meal walk and pre-sleep routine.

Day 5: Movement, Sleep, and Stress Relief Strategies

All of these are interconnected (less stress helps you sleep well, which encourages physical activity ect.)

  • Joyful movement- based on the Italian “passeggiata” it’s an intentional, pleasurable, easy, spandex-free walk. Three 15 minute walks each day have beneficial effect on blood sugar for 24 hours. Add a passeggiata after dinner daily and decrease your current work out regimen (if you have one) by one third during phase 1.
  • Safeguarding Your Sleep- Good sleep helps us deal with stress and decreases risk of developing chronic disease. Bright light suppresses melatonin which helps us fall asleep. Routines help us transition into good quality sleep time!
    1. turn down the thermostat- cool rooms promote deeper sleep
    2. Turn off TV- drama and violence can release stress hormones
    3. Turn off all other screens- starting 2-3 hours before bed, use blue light app such as justgetflux.com and avoid screens as much as possible. No screens in your bedroom.
    4. Keep lights low- Dim lights, block out light from the street with room darkening curtains or eyemask
    5. Block out noise- make bedroom as quiet as possible, consider a fan or white noise machine or ear plugs
    6. Create a pre-sleep ritual- designate a bed time so you get 7-8 hours of sleep (or more if needed), turn off lights early as possible, do stretches, take a shower, 10 minute mineral bath, stress reduction activity, cuddling. Do the same couple activities every night in the same order.
  • Stress relief habit- long term stress means cortisol (stress hormone) can be eroding bone and muscle and building up belly fat. To combat this, intentionally adopt one 5-minutes destressing activity (progressive muscle relaxation, yoga, meditation, prayer, journaling, tai chi or something else) as part of your pre-sleep ritual. In phase 2 you add another session earlier in the day. In phase 3 we build up to 30 minutes per day, but “It’s better to practice 5 minutes every day than 35 minutes once a week.” pg 127

Day 4: Your “Big Why” and “If-Then” Plans

Pick something that centers and the most important goals in your life (family, relationships, future aspirations, avoiding disease progression) and WRITE IT DOWN and add what happens when you achieve your goal and sign it. (ie I will lower my heart disease risk factors by my annual physical. I will see my physician’s happy and surprised face.) Create a “Big Why amulet” (arm band, framed picture, image) and put it somewhere you see it at least daily to remind you/ reconnect with your Big Why. Dig deeper during your meditations and think about what it will sound, smell, feel like when you meet your goal. Who is with you? How do you feel? Imagine you have already achieved your goal.

If-Then plans are planning ahead for probable tricky situations (items in the plan that you don’t normally follow). Just like fire drills, we want to have a pre-made plan so that when the time comes, you don’t have to decide, you just have to act. Think about places you are likely to be “off plan” and answer these questions. example on pg 131.

  1. Which new habit do you want to establish?
  2. When, where and how will you do it?
  3. What could hinder you from doing it (could be a barrier) and how can you overcome it?

Day 3: Gather Your Cooking Tools and Clean Out Your Kitchen

This program contains explanations of how to cook for yourself, what to buy and tips to complete the prep work so you can prepare weekday meals in about 20 minutes. Page 133 is a list of kitchen equipment you will need. Pages 134-138 have charts for each food category. It details which foods to toss vs save for phase 2 vs keep.

Day 2- Go Shopping. Dr. Ludwig’s website http://www.alwayshungrybook.com has the shopping lists you need (non-perishables, prep phase and days 1-3 of recipes) for your biggest shopping trip. Be prepared for the bill- remember you are restocking and many of these items you will use for many weeks. The website also has recommendations for specific products.

Day 1: Food Prep for Phase 1, Week 1. Meal prep on slow days (usually weekends) makes it easier to stay on track on busy days. The prep list on page 142 has 10 sauces and 4 roasted nuts/seeds to be used through the first two weeks and beyond.

Final thoughts: “the main reason people overeat is hunger. Ironically, conventional weight loss plans only make this problem worse by restricting the amount of food you eat….. The Always Hungry Solution turns this approach on its head by encouraging you to eat until fully satisfied and snack whenever hungry. … On this program, calories stay in the bloodstream and nourish the rest of the body longer, leading to long-lasting satiety. You will eventually eat less– and probably burn off more calories, too– but this way with your body’s active cooperation.” pg 143.


My thoughts:

I love the idea of meditating on my Big Why and writing out my if-then statements. My family (like most families) has full days and it’s hard to think about dinner ahead of time. We eat a lot of pasta, frozen chicken and tacos. :-/

In reading page 133, I do not have an immersion blender and do not plan to buy one. I’ll let you know how that goes 🙂

When cleaning out your kitchen, some may say to toss the food out, but with so many hungry people in America, even not-as-healthful foods make a difference. Consider donating to a food pantry or shelter. I was also sad to see Dr. Ludwig didn’t spell out in these lists to get rid of vegetable oils like canola and corn oil. They are very processed and high in Omega-6 fatty acids.

It’s interesting to me that Dr. Ludwig makes the same arguments about insulin resistance and utilizing fat cell stores that many ketogenic proponents make. I am wondering if reduction of carbs and eliminating refined sugars will produce the same results as I have seen strict nutritional ketosis do. If so, this may be a much more approachable (and varied) way to achieve health goals and maintain weight loss.

I’m excited to be trying these recipes and this eating plan. My family is ready for some new eating experiences anyway! We have been in quite a rut.

My next 6 blog posts will be quick daily check ins as I complete the prep week activities. “Day 7” was to review the plan, so we’ll call today Day 7.

 

Always Hungry by David Ludwig, MD, PhD

Blogging through “Always Hungry” by Dr. David Ludwig (Part 7)

This is part 7 in a series summarizing and reviewing “Always Hungry” by David Ludwig, MD, PhD. It may help to start reading these posts in sequence starting with part 1.

***Summary***

Chapter 4: The Solution (pg 88-95)

Mini Quiz #7: True or False: Sodium consumption should be reduced as much as possible. Short answer: False. Long answer: “Many processed foods have a tremendous amount of salt that, together with sugar, helps make cheap industrial food products taste good.” (pg 88) Our blood requires a very narrow range of sodium in the blood and our kidneys are the primary way to maintain that balance. “When [sodium] intake falls to below 3 to 4 grams a day, the body compensates by activating powerful hormones, called the renin-angiotensin system (RAS), which helps the kidneys hold on tightly to salt.” Since these receptors are located in multiple places (muscle, pancreas, blood vessels, fat cells and others), when salt intake is consistently out of balance, the system is overactive and “has been shown to cause fat cell dysfunction, insulin resistance, and inflammation.” (pg 89) “In a recent study in the New England Journal of Medicine that followed 100,000 people for an average of four years, the risk of major cardiovascular disease or death was lowest among those with sodium intakes ranging from 3 to 6 grams … compared to either lower or higher amounts.” (pg 90) The bottom line, 1. people without hypertension have no need to restrict sodium below 3 grams per day, 2. processed and fast foods often contain too much sodium.

Mini Quiz #8: How many food additives are FDA approved? Short answer: More than 3,000, not including substances, “Generally Recognized as Safe” Long answer: While the Standard American Diet lacks many things, it also contains many additives to increase shelf life (preservatives), create consistent products (emulsifiers), enhance taste (flavorings), and make foods visually more appealing (colors) as well as inadvertent additions like pesticides, plastics, antibiotics, and heavy metals. “… most artificial additives and pollutants in our food have never been thoroughly tested for long-term health effects. And who knows how these chemicals interact in various combinations inside the body?” (pg 91) Dr. Ludwig’s program focuses on minimally processed, whole foods that are organic and pesticide-free, and filtering your water.

Mini Quiz #9: True or False: Sour Triple Berry Shock Fruit Gushers contain berries. Short answer: False. Long Answer: The have pear and grape juice, but mostly sugars, highly-processed oils, artificial colors and gums.

Mini Quiz #10: Which biological factor best predicts how individuals will respond to diets with varying amounts of carbohydrate? 1. Blood type 2. Eye color 3. Insulin secretion Short answer: Insulin secretion Long answer: A 2008 study in the American Journal of Clinical Nutrition followed weight, diet, and insulin-30 levels in 276 middle-aged adults in Quebec for six years. They found that “a high-carbohydrate diet exacerbates their [those sensitive to carbohydrate] underlying tendency to secrete too much insulin, creating a vicious cycle of high insulin followed by low blood sugar that leads to excessive weight gain.” (pg 93) Another study (mouse models) about high-GI vs low-GI diets showed that Insulin-30 accounted for 85% of variation for weight gain (when known human genetics account for less that 10% of variation in weight in humans). In a 2007 human study, those with low Insulin-30, diet did not affect weight loss, but high Insulin-30 lost 10 pounds more on the low-GI diet compared to a low fat diet. They also found that after 30 days, those on low-GI diets decreased their Insulin-30 without decreasing metabolic rate! (This is part of why there are 3 phases of Dr. Ludwig’s plan.)


My thoughts:

I’ve been looking into the therapeutic properties of ketogenic diets, which are undeniably low-carb and high-fat. My question is, is it important to become a “fat-burner” and be in nutritional ketosis continually. Many people in the keto community, or as Jimmy Moore fondly calls them, ketonians, have been in ketosis for years. I wonder if that strict of control is important or if it is unnecessarily restrictive. We do know that the more restrictive a diet, the less likely someone will give it a chance, especially long term.

I’m excited to continue digging into this protocol. I’ll be following it and letting you know how it’s going.

Always Hungry by David Ludwig, MD, PhD

Blogging through “Always Hungry” by Dr. David Ludwig (Part 6)

This is part 6 in a series summarizing and reviewing “Always Hungry” by David Ludwig, MD, PhD. It may help to start reading these posts in sequence starting with part 1.

***Summary***

Chapter 4: The Solution (pg 81-88)

Mini Quiz #4: Which has the most protein, ounce for ounce? 1. Hard-boiled egg 2. Chicken nuggets 3. Hot dog 4. Tempeh (a soybean product commonly consumed in come Asian countries) Short answer: Tempeh Long answer: factory farmed meats are quite different from home farmed and especially wild animals of our ancestors. There aren’t enough wild animals in the world to feed all of us, so we should also look to vegetarian sources of high quality protein. Dr. Ludwig also notes that replacing carbohydrate with protein forward plant products is associated with 30% lower risk for heart disease over 20 years. Animal proteins stimulate more insulin and less glucagon than plant proteins. Not to mention farmed meats have a less healthful fat profile, excess iron absorption, hormones, preservatives and environmental pollutants. “the scientific evidence provides no reason to banish animal products. However, an emphasis on plants seems sensible, for ourselves and our planet.”

Mini Quiz #5: True or False: The microbes in our intestinal tract outnumber the cells in our body. Short answer: True. Long answer: The bacteria in our gut make up the gut microbiome (100 trillion organisms) which, for most Americans is less diverse due to our hygienic environment, highly processed diet and frequent antibiotic use. Our microbiome helps digest food, support the lining of our gut, ferment short chain fatty acids that nourish the colon and maintain tight gut cells junctions, and help immune cell functions. “However, if the microbiome contains the wrong type or amount of bacteria, the intestinal lining may become damaged and leaky, allowing incompletely digested food and microbial breakdown products to be absorbed directly into the bloodstream.” (p83) This causes an immune response and chronic inflammation leading to chronic diseases. Microbiota that is less diverse is associated with obesity, insulin resistance and chronic inflammation. The solution is prebiotics (food for the bacteria- fiber), probiotics (beneficial bacteria) and polyphenols (chemicals in plants, especially berries and spices, that slow growth of undesirable microbes). The other caution is to avoid emulsifiers (like carboxymethylcellulose, polysorbate-80 and lecithin) that may break down the protective mucus lining of the intestine.

Mini Quiz #6: Is fructose toxic? Short answer: No Long answer: “Unlike glucose, which can be used by all cells in the body, fructose is metabolized almost exclusively in the liver. Too much at one time overwhelms the liver, with the excess being diverted into the production of new molecules of fat.” Eventually leading to fatty liver. It’s more about the rate fructose is absorbed- just like alcohol, one drink is okay, but seven at one time is too much for the liver to deal with. Fructose in fruit is more slowly absorbed, unlike high-fructose corn syrup, table sugar or honey which are brought to the liver quickly. Artificial sweeteners stimulate taste receptors for sweetness hundreds and thousands of times more than sugar which may make natural foods (like fruits and vegetables) less appealing. They also may cause calories to be stored in the cells by stimulating insulin secretion which in turn stimulates hunger again. Some research in mice points to fat cells may possibly have “taste receptors” and react differently to artificial sweeteners. In this plan, Dr. Ludwig initially cuts out sugar, then adds back a moderate amount stressing fresh fruit, then pure maple syrup or honey.


My thoughts:

I grew up on a hobby farm in rural Minnesota. I spent all day outside in the garden, the woods or with my friend’s farm animals. Now thinking about my sons growing up in the suburbs, I am sad to think about how much they are missing out on! We can travel to farms and orchards and we can spend time outside at our house, but it’s not the same. I realize I need to be more intentional about providing a good home for our microbiomes! Especially since this is an important part of our immune system. I’m also intrigued by the research in leaky gut. While the pathways and mechanisms are not fully understood, it’s still worth investing in the pieces we do have some understanding of (prebiotics, probiotics and polyphenols).

Question #6 regarding sugar consumption is key in my life and in my practice. Refined carbohydrates provide such comfort to us. A busy day at work- grab a pop tart. Challenging evening balancing house work and the kids- have some pasta and ice cream or a handful of chocolate chips. One thing I have started doing to make good choices easier is keeping nuts in my car and buying berries as a treat. These are two foods that are more expensive and smaller portions than “crappy carb-age” I typically buy, but the rewards as functional foods are so much greater and a I feel better in the long run! My next step will be finding a good quick meal at work. Perhaps Dr. Ludwig’s upcoming recipes will give me some good ideas!

I’m excited to continue digging into this protocol. There are a total of 10 questions to get through before Dr. Ludwig lays out the practical solution. — Stay tuned!

Always Hungry by David Ludwig, MD, PhD

Blogging through “Always Hungry” by Dr. David Ludwig (Part 5)

This is part 5 in a series summarizing and reviewing “Always Hungry” by David Ludwig, MD, PhD. It may help to start reading these posts in sequence starting with part 1.

***Summary***

Chapter 4: The Solution (pg 70-81)

Brief recap- traditional low calorie, low fat, extra exercise is creating starvation and actually more long term weight gain and chronic disease.

The solution is retraining your cells to burn fat instead. You do this by eating in a way that creates less insulin response and less inflammation.

Mini Quiz #1: What is the minimum amount of carbohydrate required for long-term survival? Short answer: zero. Long answer: You only need a couple ounces of protein, less than an ounce of fat and zero carb- the rest of the calories you need during the day can come from any one of the macronutrients. Humans have a lot of biological flexibility which is why different cultures can eat so differently and still survive. The question remains- what is the OPTIMAL diet for a human. Page 72 has a very interesting comparison chart of popular weight loss diets with fat % on the x axis and protein % on the Y axis. Dr. Ludwig also notes protein is important in glucagon (the hormone opposite insulin) regulation. Too much protein (more than 40% of calories increases the burden on the liver.

Mini Quiz #2: Which raises blood glucose and insulin the most after consumption, calorie for calorie? 1. White potato (baked) 2. ice cream 3. pure table sugar Short answer: white potato. Long answer: There are significant benefits to restricting carbohydrates- mainly reduced insulin production. Ketogenic diets and ultra-low carb diets are unnecessarily restrictive. The effect carbohydrates on your body is determined by Glycemic Index (affect on blood glucose) and Glycemic Load (amount of carbohydrate). GL of a food reliably predicts within 90% who blood glucose will be effected. High GL foods also help with satiety more than low GI foods.

Mini Quiz #3: Which is less healthy for your heart– white bread or butter? Short answer: white bread. Long answer:  “Despite its negative effects on LDL cholesterol, saturated fat also raises heart-protective HDL cholesterol, leaving their ratio relatively unchanged. In contrast, high-GL carbohydrates lower HDL cholesterol and raise triglycerides, combined effects that appear to be worse for cardiovascular disease than saturated fat.” pg 79. Dr. Ludwig also cites research that note not all fat calories are equally beneficial to the body. Saturated fats may cause chronic inflammation and insulin resistance than unsaturated fats. Also, saturated fat in dairy or coconut are healthier than in red meat. Also, the combination of saturated fats and refined carbohydrates adversely effects blood lipids.


My thoughts:

From these three questions, it’s clear to me processed foods are not beneficial to health. (Though that’s not news to anyone at this point). I’m glad to see there is still room in this diet for high quality carbohydrates, even if the overall carb content is decreased.

I’m excited to continue digging into this protocol. There are a total of 10 questions to get through before Dr. Ludwig lays out the practical solution. — Stay tuned!