Getting Started on a Low Carb Diet

Just starting a paleo and/or low-carb diet? Having trouble getting started? I've seen many complaints that the first couple weeks are the hardest. I've gone back and forth from high-carb to low-carb a few times, and talked to friends that have made the journey as well. Here's what I suggest to get yourself started.

First let me say that my diet goal isn't just to eat few carbs; my goal is to eat nutrient-dense food, repair my digestive system, and restore myself to health. I've got symptoms of Metabolic Syndrome, and that's why I'm eating low-carb. A paleo diet isn't strictly low-carb but is compatible with it -- most paleo food is low-carb.

Plan to make small changes. You are changing the way you eat for the rest of your life. Some people can handle big, dramatic changes -- quitting cold turkey. I had trouble with that; I cheated on my diet. Daily. I know what that's like, so if you have the same trouble with going cold turkey, here are some small steps.

Step 1 - More Fat

Eat fatty foods, like cream, bacon, steaks, and cheese. You're going to need to eat more fat in your diet, especially once you start limiting carbs, so get used to eating those foods. Don't eat a ton of fat yet; if you're still eating a good bit of carbs, eating a lot of fat, too, is a great way to gain weight. You just want to start adding these things to your diet. Don't shy away from the fatty steak, for example.

Keep these foods around the house. Bacon and eggs on Sunday morning, a big fatty steak for Friday dinner, berries and cream for a treat now and then. This stuff is yummy, and once you're eating some of them, buying them will be a habit. (More on berries in a bit.)

Step 2 - Cut Sugar

Switch from sugary drinks to their low-calorie versions; whether it's soda, coffee, or tea, either add no sweetener or use the artificial stuff. Eventually you'll want to limit caffeine, but don't worry about that now. Be glad to make progress! Cutting out this sugar is one easy step.

Stay away from sugary treats, too, such as candy bars, sports drinks, deserts (including ice cream), and fruit juice. Yes, fruit juice. That stuff isn't healthy for you. Fruits are seasonal; man isn't built to consume pounds of fruit every day, year round. Modern fruits are "nature's candy bar." Natural, by itself, isn't a good reason to eat food -- there are many toxic plants, for example. Just cuz an orange won't kill you today doesn't mean it's healthy.

Berries are generally better tolerated by our digestive systems than fruits. Fruit juice, especially those big glasses of orange juice that breakfast joints like to serve, is a huge dose of fructose, which has to be processed by the liver, just like alcohol. And causes the same liver disease that alcoholics get, for the same reason -- the liver gets inundated with calories, stores its as oil, and eventually those oily deposits get so big that it ruptures liver cells, causing scars. (I talked about this subject a bit in my Big Meanies post.)

Step 3 - Cut Flour

You'll want to cut corn and wild rice, too, but start with flour. I cut out flour and found myself eating a lot of corn chips (especially with queso when I go out for fajitas). But once I was eating mostly low-carb, removing the corn chips was fairly easy. So just start with the flour. Don't touch pasta (if you're at an italian restaurant, get a sirloin or salad or fish instead), bread, or tortillas. If you go out with friends or coworkers to a sandwich shop, remove the bread. Many burger joints will serve a bunless burger wrapped in lettuce.

Be glad to make progress

Cutting out sugar is a great first step. Maybe you replace it with high-carb foods like bagels, bread, or rice -- but you've removed one bad ingredient from your diet. Focus on where you're going and don't obsess about where you are now. Once you get adjusted to low carb, you'll love it!

Cheating on Your Low Carb Diet

I cheated on Monday.

I have blogged about cheating before, but I had an insight after this episode that I hope will help anyone that's trying to switch to low carb and is having trouble with carb cravings.

I had a burger, fries, and a coke for lunch. Normally I drink tea when I eat out, but for some reason I grabbed a coke. I think I was jonesing for sugar somehow and just gave in.

And then my blood sugar crashed a couple hours later. The afternoon was horrid; I felt those cravings all afternoon. I felt weak and jittery, my concentration was wandering, and I felt hungry. I needed I had to consume something. When I drove home, I grabbed another energy drink -- this time just to settle my blood sugar. I knew what was going on, and figured that was probably the easiest way out of it.

After a great dinner and then a night sleeping, I felt much better by Tuesday. It was easy to get back on track for Tuesday lunch (soup, some bbq pork), Tuesday dinner (leftover bbq), and through Wednesday (burrito bowl minus the rice and beans, ie meat, cheese, and avocado; steak for dinner) without any of those carb cravings.

An overnight fast is the best time to break out of a carb cycle. I think the blood-sugar low a couple hours after a high-carb meal is the hardest, most challenging part of switching to low-carb. Once you make it past that, it's easier to stay low-carb. I suffered for a few hours on Monday afternoon, but the energy drink five hours after lunch settled me, dinner was relatively low-carb, and then the long fast after that was mostly while I was sleeping. So I went from carbs on Monday back to low-carb by leveraging that overnight fast. My blood sugar was more stable on Tuesday morning; I still felt like my blood sugar was a bit low, but it wasn't as distracting as it was the previous afternoon.

Some people do great quitting cold turkey but that wasn't me. Taking advantage of an overnight fast (ie what you normally do!) might be the start of a pattern for the easiest way to go from the high-carb Standard American Diet to a low-carb diet. Slowly add low-carb meals. Start with breakfast (either skip it or eat low carb) and don't cheat in the mornings. Then add in lunch, keep your afternoons on-diet, then dinner, and then you're set. If you give this a try, let me know in the comments how it goes.

Low Carb and Cravings

A friend of mine here at work is on the South Beach Diet again, this time doing the induction phase to lose a few pounds. When he's not on this Diet, he eats the Standard American Diet of high carbs, processed vegetable oils, and frankenfoods. I talked to him a bit about eating low carb, carb cravings, and the diet.

He first started the diet a few months ago, when his wife wanted to try the diet and he decided to go on it as well to show his support. The first time he went low carb, he says that he had bad carb cravings for a couple weeks; this time, it took about a week for the cravings to subside.

I remember we were going to a party a few months ago (when he wasn't on the diet) and I stopped by his house before we headed out. We were just getting home from work, having not eaten anything since lunch, and he was famished. He downed a couple tortillas and immediately felt better. This is a strange snack, but it makes sense -- he had carb cravings. He knew what his body wanted. I talked to him about this a bit, and his experience matched mine (before I started low carb): you get to know what your body wants. You have a specific feeling when your blood-sugar is low, it's easy to recognize, and you know that eating bread or pasta will make that bad feeling go away.

His cravings never got too severe; mine didn't either. I never felt grossly sick or insane, but then, I always had fairly easy access to carbs. I had a big problem with 'cheating' when I tried going low-carb a couple years ago. My meals were solid, but then I'd drink a soda or eat chips as a snack, when I was feeling the brunt of carb cravings. He never had that snack habit.

I think anyone on a high-carb diet has constant carb cravings. You're used to it; you feel it constantly. You interpret it as a signal to eat, and it's just a part of life. Only when you decide to stop feeding the carb-hungry beast inside do you really separate out those cravings as something abnormal.

We were both addicted to World of Wacraft for a while, and one of the nice things about an addiction like that is, if you're hungry, it's easy enough to just sit and continue playing instead of getting up to eat. One addiction can help suppress another. (So the lesson is, if you're trying to go low carb and having trouble with carb cravings, pick up another addictive habit, like WoW or gambling or meth.)

He's said the pounds of come off quickly, although he's only barely overweight. He's an ectomorph; he doesn't carry body fat on his face and arms etc, just a bit of extra belly fat. A wheat belly, but not the big beer belly that normally comes to mind. (One incentive to try the diet again, he said, was to fit into his pants and not have to buy new clothes.) The general theory in the low carb community is that you drop weight quickly at first when you start eating low carb, and this is mostly water weight, and then the weight loss slows down. This lost water weight comes from burning off glycogen stores; glycogen being a phosphorylated glucose starch that binds water.

We're both programmers, and that's also something that helps deal with carb cravings a bit. At work, I often get caught up in a problem that occupies my mind for hours. I don't have time to sit and be bored, and think about how hungry I am. This lesson is like the addiction lesson above, but less tongue-in-cheek: if you're doing something that keeps your mind occupied, then you'll be able to burn through time. Once you get past the first one or two weeks of eating low carb, the cravings go away. So the trick is just to survive, and if "time flies when you're having fun" (or mentally occupied, whether it's fun or not) then do something that keeps your mind busy and occupied; something without small breaks.

Carbohydrate Basics I

Carbohydrates are a natural part of the human diet, and have been for as long as we've been human, but the easy and cheap access to carbs is the number one cause of disease in Western civilization. Sound extreme? It is. Any consistent position is extreme; a compromise always means subverting a principle in favor of making nice with your enemies. And if the principle you want to follow is good health, then stay away from cheap carbs.

Before I get into the dangers of 'cheap carbs', such as sugar and wheat flour, I want to cover some carb basics -- the types of carbs and carbohydrate digestion.

There are three basic types of carbs: simple sugars, starches, and fiber. You can add alcohols to the list, but they're processed differently by the body and a bit more complicated so I'll leave them out of the discussion today.

The simplest carb is a single sugar molecule, such as glucose or fructose. A molecule containing just one sugar is called a monosaccharide. Some carbs are chains of sugar molecules, one after another bound together. Sucrose (common table sugar) is one molecule of glucose bound to one molecule of fructose. This combination of two sugars (saccharides) is called a disaccharide. Long chains of sugar molecules create starches, of which fiber is one subset. Fiber is differentiated by the fact that it is indigestible, and so does not contribute calories to diet.

Sugar

Sugars are rapidly pulled into the bloodstream from the small intestine. Glucose directly becomes "blood sugar," whereas fructose and galactose are first transported to the liver for conversion. Since these sugars must be converted by the liver, high doses of these sugars tends to produce the same steatic effects as alcohol -- the liver stores excess converted sugars in vacuoles inside liver cells, and eventually these vacuoles grow so large that they rupture their containing cells causing cell death, which leads to tissue scarring (cirrhosis).

Disaccharides can't be absorbed into the bloodstream, so they first have to divided into their two constituent sugars. Disaccharides are broken down into monosaccharides in both the stomach and small intestine. Sucrose (table sugar) is broken down into glucose and fructose; Lactose (milk sugar) breaks down into glucose and galactose; and Maltose (malt sugar) breaks down into two units of glucose. Enzymes speed these reactions, although all will occur in the presence of acid (such as the hydrochloric acid in the stomach).

Starch

Starches, as chains of sugar molecules way longer than just the two sugars in disaccharides, must be broken down even further. Enzymes that promote this breakdown are called amylases. Amylase is found in saliva (which gives starchy foods some of their sweet taste) and is also produced by the pancreas. One genetic mutation in humans is the presence of multiple copies of the amylase gene, which means extra amylase in their saliva. If your ancestors came from the Baltic Sea, then chances are you'll have an easier time digesting starch (especially if you chew your food well).

Fiber

Not all sugar chains can be broken down by our enzymes, though. That depends on how the sugar molecules are joined; there's actually many different ways to do it. Cellulose, which makes up 33% of most plant matter and 50% of wood, is indigestible to humans. Even though it's just chains of glucose molecules, they're joined by beta(1,4) bonds -- whatever that means, the consequence is that we don't have the chemical machinery to break that bond.

There are different types of long sugar chains; some are branched, some are linear, some contain different sugars, some have beta bonds others have alpha bonds, etc etc. Hence, the calorie contribution of long sugar polymers will vary, depending on how much of the sugar molecules are enzymes can break off. Generally, a food is called a "fiber" if it is primarily indigestible, and a "starch" if the amylase our bodies produce can break it down.

Cows can digest cellulose with symbiotic bacteria in their gut -- which is partly why cows have four stomachs. (Other ruminants, such goats, sheep, deer, and llamas have similar systems. They're all ruminants.) To us humans, though, such fibrous plants aren't food. You'll see "fiber" included on the labels in some foods, and the calories there included in the calorie count of the food, but you won't actually get those calories. That's like expecting to survive while eating wood chips. Your body can't do it. (Feel free to blame politicians and bureaucrats for the misleading labeling.)

Next Up

In following posts in this series I want to cover the effect of carbs on metabolism, sugar's effects in disease through glycation, carb-loading before running, high-carb foods, and healthy carb consumption.

Hypertension, Hypothyroidism, and Paleolithic Diets

I went in to the doctor a few weeks ago and my blood pressure was pretty damn high, about 170/100. I was surprised.

Part of the reason I went into the doctor was that I felt 'weird', and wanted to get a new prescription for my thyroid medication. Hypertension is one common effect of untreated hypothyroidism ("patients with hypothyroidism have triple the risk of developing hypertension" from one source, or this paper listed in PubMed, or a study that looked specifically at the two), so I knew that not being on meds could be a problem. My first goal was to get back on thyroid meds, continue workout out, and continue losing weight. Not being on the medication was itself a gross mistake, one that I really only made because of the hassle of dealing with medical insurance. Moving on -- I'm back on thyroid medication.

Strength training has sometimes been associated with higher blood pressure, but most of what I've seen in that regard says that it is while lifting weights that one's blood pressure goes up. Nearly every source I've checked says that athletes (and children) have low blood pressure, so I'm not sure that building muscle tissue should cause hypertension. That seems weird. So I'm not going to stop strength training yet, especially since I'm working on other avenues. Normally when one says "athletes" I think what comes to mind is runners, sports players, cyclists, and the like -- people engaged in long-term cardiovascular exercise, who can exert themselves for hours at a sport or exercise. So running should help lower my blood pressure, although I expect that benefit to be slow and gradual as I step up my running.

Blood pressure is also correlated with weight loss. But I'm losing weight (on the paleo diet), so that should also be a continuing benefit, again slow and gradual as the weight comes off.

Of course, the doctor wants to give me pills for the hypertension and then pretend the problem is solved. She didn't know of any pill that I could take once that would cure the problem, so the "only option" is lifetime medication. Blech! I didn't want that solution. I want to be healthy, not just have "healthy numbers."

Thyroid function is harder to restore, I know, as Hashimoto's is an autoimmune disease. I expect to continue to be on thyroid medication for a long time. Some people have been able to reverse autoimmune diseases after fixing their gut (by removing lectins such as WGA and other stessors from their diet) and eating nutrient-dense food, but all the anecdotes I've read about it says that it takes a year or more for your body to restore itself to health. Some relief can be found immediately depending on the disease, but hypothyroidism doesn't cause pain or other severe effects like some of the other autoimmune diseases. I would like to restore my thryoid to normal functioning; I don't want to be on that medication for life. But that depends on how damaged my thyroid is, and if removing antagonists will eventually convince my immune system to leave my thyroid alone.

My blood pressure numbers have been coming down; I'm back into pre-hypertension range. I've got a BP cuff at home now, and I'm using that to track my BP a few times a day. My diet hasn't changed (still paleo), although the high BP reading was enough to convince me to be more consistent in my workouts (running every other day, strength training every four). It's also convinced me to keep to the diet.

I've been consistently paleo for three months and have lost 20 pounds. I figure strength training has helped me put on some lean mass, but I haven't been tracking body fat % so I can't really judge that. At some point I'll post my weight and BP readings, probably in one big chunk, for those that would like to see hard numbers.

Weighing Yourself for Motivation

I weigh myself every morning. I've read a bunch of posts, by many different authors, recommending against this practice. The main argument against it is that your weight fluctuates so much day-to-day that a daily measurement isn't accurate; that if you try to figure out why your weight goes up or down you'll just frustrate yourself.

The thing is, you have to accept that argument. Acknowledge it. I weight myself every morning and don't pretend to know why my weight goes up or down. Instead, I use it to reinforce habits.

Did my weight go up? There's a lot of reasons that could happen, but if I ate some potatoes the day before I'll blame it on the potatoes. Or not workout out enough, or not running farther. Did my weight go down? I use that to cheer myself on, to remind myself to stick to eating good foods and exercising.

The key is to make an emotional association between what you see on the scale and a behavior. Losing a pound is a great feeling, that's what I want -- and I try to transfer some of that feel-good to habits that I want to reinforce. It's important to not pretend that I know something, that "obviously I gained weight because I ate some berries with dinner", or whatever. I keep records so that I know where my weight is going, but I could do that just by weighing myself once a week.

There's another benefit to frequent measurements, and that's to get an idea of where my weight really is. If I just weigh once a week, then I have a very rough picture of where my weight is. Each weekly reading would be within a pound or two of my 'true' weight, but with weight loss going on as it is, I wouldn't know whether that week's reading was high or low. By measuring myself every day, I have a bunch more data points and so a clearer picture of what my weight is actually doing.

I will continue to weigh myself every day. Daily measurements are a great tool for motivating myself, to reinforce good habits and to break bad habits.