Women's Bodies, Women's Wisdom (151 page)

This patient underwent a paradigm shift in the way she looked at food. Weight loss was a side effect. She changed her diet to create health—not to lose weight. By changing her diet to create health, she not only lost weight but eventually came to the point where the food she wanted the most was also the food that made her feel the best. She is now in tune with the wisdom of her body, and her former war against herself is over.

Nutritional improvement and regular exercise are powerful ways to create health. Most women are amazed by how much better they feel when they eliminate most refined foods, excess sugar, and excess starch from their diets, following a relatively low-glycemic-index diet instead. The glycemic index is a measure of how much a food raises your blood sugar level. When you eat high-glycemic-index carbohydrates—which in general are starchy and sugary foods such as cookies, candies, soda, alcohol, and white bread, as well as almost all other refined, processed foods—your body quickly metabolizes them into sugar, which causes a spike in insulin levels. But when you eat low-glycemic-index carbohydrates, your body breaks them down slowly, which means your blood sugar and your insulin levels stay relatively steady over a longer period of time.

The link between diet and the health of female organs is impressive. A study in Italy, for example, found a direct association between breast cancer risk and the consumption of sweet foods with a high glycemic index.
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Our trans-fatty-acid-rich, refined-carbohydrate-rich, fiber-poor, nutrient-poor diet and its effects on blood sugar are part of the reason that breast cancer, endometriosis, and uterine fibroids are on the increase, affecting millions of women. (This same refined-carb-heavy diet has been implicated in heart attacks as early as the 1950s, when Benjamin Sandler, M.D., wrote
How to
Prevent Heart Attacks
[Lee Foundation for Nutritional Research, 1958] about his great success in preventing fatal heart attacks in angina patients by prescribing a no-sugar, no-starch food plan that kept blood sugar levels stable.)
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Sixty percent of all cancers of the breast, ovary, and uterus have to do with diet,
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with both benign and malignant conditions of the breast, ovary, and uterus related to diets that cause estrogen levels to be too high.
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Diets that are high in refined carbohydrates are one culprit because they raise blood sugar, and high blood sugar results in increased levels of metabolically active circulating estrogens (because the high triglyceride levels produced by a high-refined-carbohydrate diet displace estrogen from the steroid-binding globulins that render it metabolically inactive). On the other hand, a diet high in a variety of vegetable fibers can lower a woman’s estrogen levels, thereby decreasing her risk of breast cancer, because the vegetable fibers change the metabolism of estrogen in the bowel so that less is available for absorption into the bloodstream and more is excreted.

Women who start their menstrual cycles ear lier and their menopause later are at greater risk for breast cancer because of their longer exposure to high levels of estrogen. Here, too, diet plays a role. Because of their diet, American women typically start menstruating early (at age twelve or thirteen) and enter menopause late.
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But women who follow diets consisting of unrefined natural foods as the rural Chinese and the !Kung, typically start their menstrual periods at age sixteen or seventeen. These women also begin menopause earlier. Their breast cancer rates are very low.
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The same was true for hunter-gatherer societies who had diets rich in meat and fat, no doubt because of their high levels of physical activity, which are also typical of the Chinese and the !Kung. Exercise helps balance hor mones and lower an individual’s percentage of body fat and risk of breast cancer.

Step Three: Understand the Blood Sugar/
Inflammation Connection

To understand how we as a culture got to where we are now in terms of the foods we’re eating and the problems so many are having with them, it helps to go back in time. Our species adapted to a Paleolithic hunter-gatherer diet for more than a hundred thousand years before agriculture was widely adopted. Their diet consisted of lots of wild bitter greens rich in pharmacologically active plant chemicals that have well-documented anti-inflammatory and other properties. They also ate wild fruits and berries in season, as well as meat from game that ate the same wild foods. Archaeological evidence shows that hunter-gatherers also ate a lot of nutrient-rich organ meats such as the brain, the kidneys, the liver, and the heart. Concentrated sweets, other than occasional honey, were simply not available. And though there were a few wild grains in the diet, these bore almost no resemblance to the modern corn, rice, and wheat that are staple foods today. One of the most important things to remember when deciding what is healthy to eat is this: We still have the metabolisms and physiologies of the Paleolithic hunter-gatherers!
¹¹

Agriculture was introduced about ten thousand years ago, a mere blip on the screen of evolutionary time. To put this in perspective, for 99.8 percent of our time on earth as
Homo sapiens,
we ate exclusively wild foods.
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Selective breeding practices since that time have increased the starch and sugar content of fruits, vegetables, and grains as well as markedly changed the biochemical composition of the meat we eat. And in the last sixty years, scores of chemical additives and nonfoods such as trans fats and preservatives have been added that our Stone age metabolisms simply weren’t designed to cope with. Soil depletion and the addition of nitrate-based fertilizers after World War II (in response to the need to get rid of the stockpiles of nitrates used for bombs) have further changed the food supply. Excess weight and ele vated blood sugar and blood fats are now the norm as food quantity has far outstripped food quality in most of the developed world. According to Joseph Mercola, D.O., author of
The No-Grain Diet
(Dutton, 2003), the average American is now eating sixty pounds more grain and thirty pounds more sweeteners per year than we did twenty-five years ago.
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(For more information, visit Dr. Mercola’s website at
www.mercola.com
.) Grains, starches, and sugars—and everything made from them (all of which raise blood sugar and lead to addictive eating)—are the real culprits when it comes to excess weight. It’s little wonder that the resources of our health care system are being crushed under the weight of the chronic diseases that are the result of this pro found shift in the human diet. But that doesn’t mean it’s impossible to eat a healthy diet these days. In fact, it’s getting easier and easier. Here’s all you need to know.

Stable Blood Sugar Is the Answer

The most important key to lifelong weight maintenance and vibrant health is knowing how to keep your blood sugar stable. Pure and sim ple. Stable blood sugar throughout the day is also the key to preventing or reversing the diseases that are associated with cellular inflammation. (Note: Most of the vast changes in the hunter-gatherer diet that we evolved with are associated with chronic disrup tions in blood sugar as their final common pathway.) High blood sugar from eating foods that raise blood sugar quickly (high-glycemic-index foods such as candy, soda, white bread, etc.) signals the pancreas to release the hormone insulin. Insulin is a storage hormone that takes sugar out of the blood and stores it in cells until it can be burned as fuel. If this energy is not needed right away, the excess energy gets stored as fat.

Stable blood sugar results from eating the right amount of protein, the right kind of carbohydrates, and the right kinds and amounts of fats at the right time. It has taken me more than forty-five years of research and clinical experience to figure this out. Back in the late 1980s and early 1990s, like many health-conscious people, I was still eating a mostly grain-based, low-fat diet. And I was gaining weight. At about four or five o’clock each afternoon, I would come home from work famished and stand in front of the fridge and begin my evening “grazing,” which didn’t end until I went to bed hours later. I craved sweets and had a difficult time controlling my appetite. My patients complained about the same thing. We also noticed that our waistlines seemed to be disappearing when we hit forty. What had gone wrong with the low-fat, high-complex-carbohydrate, vegetarian diet that so much research said should be keeping us healthy and slim?

At about this time, the popular Zone diet of Barry Sears, Ph.D., came out, followed by the work of family physicians Mary Dan Eades, M.D., and Michael Eades, M.D., authors of
Protein Power
(Bantam Books, 1996) and colleagues of Sears’s. I read the research that their books were based on. It made sense. Too many carbs raise insulin levels, which makes the body store excess calories as fat. Conversely, enough pro tein increases glucagon, which jump-starts the body into burning fat. Moreover, the right kinds of fats in small amounts are necessary building blocks for the cellular hormones that fight inflammation and create optimal cellular metabolism (these hormones are known as eicosanoids, and the inflammatory cytokines and prostaglandins are part of this group; see section on fats, below).

Based on this research, I dutifully added more protein to my diet and cut way back on grains and high-glycemic-index foods. (I didn’t want to, though, and it was hard. As a friend once said to me, “I never met a carb I didn’t like!”) Impressed with my newfound energy and a de crease in sugar cravings, I suggested the same to my patients. We felt better, but my cravings were not gone. I simply couldn’t seem to give up my refined carbs, and I was still having a hard time losing weight. So like thousands of others, I decided to carry things a step further. If carbs were bad, why not eliminate them completely for a week or two to see if I’d lose weight? So I went on the Atkins induction program. But that didn’t work, either. Though I ate fewer than 20 grams of carbs per day, my body absolutely refused to go into ketosis, the state in which your body begins to burn fat for energy and ketone bodies are eliminated in the urine. My body was holding on to its fat for dear life, it seemed. And my weight had crept up to an all-time high of 148. (I weighed 150 when I was at the end of my pregnancies!) When I called the late Robert Atkins, M.D., to discuss this with him, he couldn’t explain it except to say, “Well, you’re menopausal.” That explanation didn’t work for me. I also didn’t like eating all that meat and bacon. It had felt infinitely better to eat more fruits, vegetables, and grains.

The Missing Link: Glycemic Stress and Insulin Resistance

Finally I was introduced to the work of Ray Strand, M.D., author of
Healthy for Life: Developing Healthy Lifestyles That Have a Side Effect of
Permanent Fat Loss
(Real Life Press, 2005), a family doctor who, like me, had spent more than twenty-five years seeing the same people and watching them slowly but surely develop expanding waistlines, high cholesterol, high blood pressure, cancer, hypertension, and other illnesses. Dr. Strand’s research documents the fact that conditions known as glycemic stress and excessive insulin secretion begin in childhood and are the result of eating a diet that is far too high in nutrient-poor refined foods that raise blood sugar (and insulin levels) too quickly. This is true even in those who will never get diabetes. Unfortunately, high-glycemic-index foods are the “comfort” foods most people crave, including white bread, cookies, cakes, and bagels. Eating too many high-glycemic-index foods on a daily basis results in glycemic stress/inflammation of the blood ves sels because of the free-radical damage that ensues when blood sugar is too high. Over time, the blood vessel lining thickens, making it more and more difficult for the insulin to get out and into the cells. As Dr. Strand points out, insulin resistance actually begins in the blood vessels of the skeletal muscles, the place where blood sugar is designed to be burned most efficiently. Glycemic stress and inflammation set the stage for hardening of the arteries and also full-blown insulin resistance or metabolic syndrome (also known as syndrome X—see the list on page 690). (For more information, visit Dr. Strand’s website at
www.releasingfat.com
.) Depending upon your ge netics, metabolic syndrome results in either diabetes or heart disease or both.

Just about every cell in our bodies is affected by insulin abuse, which also results in the production of excess inflammatory chemicals—the basis for all chronic disease, including headaches and insomnia. No wonder Kenneth Cooper, M.D., once said, “We die not so much of a particular disease, as from our entire lives.” No kidding. Finally I knew why I had had sweet cravings my entire life, why my HDL cholesterol had been dan gerously low when I was in my thirties, and why I was having so much trouble losing weight at midlife. It was all that high-glycemic-index food. (Many vegetarians eat way too many sweets, pastas, and breads, which results in high blood sugar. I was no exception.) The link between glycemic stress, insulin abuse, and cellular inflammation is why everything from headaches to PMS and high blood pressure often improve when you eat to stabilize your blood sugar.

Over time, as blood sugar levels continue to be too high, the insulin receptors on the cells actually lose their ability to respond to high blood sugar. The wrong kinds of dietary fats also change the insulin receptors on the cell membrane itself, thus contributing to the problem. Micronutrient deficiencies such as too little chromium also contribute to the problem. (See section on micronutrients, pages 725–726.) Over time, the pancreas simply loses its ability to produce insulin and the cells lose their sensitivity to it. Type 2 diabetes is the result. But there’s more. It has recently been discovered that fat cells themselves produce inflammatory chemicals, which is another reason why obesity is a risk factor for cancer. Body fat is loaded with insulin receptors. The fatter you get, the more insulin it takes to get blood sugar into your cells. And because insulin is a stor age hormone, the higher its levels, the harder it is for the body to release fat as fuel. Insulin actually locks fat in place!