So Jack was overweight and:
Try as he might, Jack could simply not stick to the diet I urged him to follow. Three days, for instance, of avoiding wheat was promptly interrupted by his wife's tempting him with a nice BLT sandwich. This triggered his appetite, with diet spiraling downward in short order.Presumably the diet he urged was low carb. But just going LC and trying to cut wheat lasted only three days. So the good Dr. Davis told Jack to get a BG meter and strive for 1 hour postprandial glucose levels to be no higher than before eating. So:
If any food or combination of foods increase blood glucose more than the pre-meal value, then eliminate the culprit food or reduce the portion size. For example, if dinner consists of baked salmon, asparagus, and mashed potatoes, and pre-meal blood glucose is 115 mg/dl, post-meal 155 mg/dl, reduce or eliminate the mashed potatoes. If slow-cooked, stone ground oatmeal causes blood glucose to increase from 115 mg/dl to 185 mg/dl (a typical response to oatmeal), then eliminate it.
Now, I've seen the BG levels in like a gazillion studies and even healthy glucose-tolerant individuals will not see their blood glucose return to what it was before eating any meal containing carbs of any significance. A person with any degree of insulin resistance or impaired glucose tolerance would have to eat basically zero carb to attain this goal. Looking at the example dinner, we remove the potatoes and where does that get us? Pretty much biologically zero carb as Dr. A would have called it in 1972.
Ironically, isn't it the postprandial hypoglycemia from the hyperinsulinemia that is supposed to trigger the voracious appetite?? But Davis blames the sugar spike and insulin. But I digress ...
Having immediate feedback on the effects of various foods finally did it for Jack: It identified foods that were triggering excessive blood sugar rises (and thereby insulin) and foods that did not.... Six months later, Jack came back 37 lbs lighter.
OK, I'm all for the immediate feedback thing and I think it is highly instructive to get a BG meter and know how your body reacts to various foods. But really, now. We know what does and doesn't spike BG (except for some of the questionably LC foods like Julian breads IMO. Still, was not the list of issues Jack faced not scary feedback enough to scare him straight? So, if several BG readings/day is going to keep you motivated on the VLC straight and narrow I encourage you to go for it!** Still, I find it hard to believe that someone only lasts 3 days trying to eliminate wheat before a BLT sends him spiraling out of control, but using a BG meter is basically able to cut out all carbs for 6 months. But then Davis really loses me with his closing words of "wisdom":
...What Jack did not do is limit or restrict calories. In fact, I asked him to eat portion sizes that left him comfortable. There was no need to reduce calories, push the plate away, etc. Just don't allow blood sugars to rise. ... And he got there without calorie-counting, without regulating portion sizes, without hunger.
I'm all for ad libitum diets that reduce intake spontaneously, but as my regular readers know well, I can't stand the misrepresentation of such diets as not restricting calories or intake. If Jack lost 37 pounds it had nothing to do with his insulin and blood glucose levels, it was because he was eating a VLC diet known for rather significant reductions in intake w/o deliberate restriction. Gosh folks! This IS the BEAUTY of low carbing! I long for the day that the "gurus" embrace this rather than trying to convince people that they really do lose weight without eating less. There are literally thousands of folks out there diligently following a low carb plan and wondering why they aren't losing weight ... or worse, gaining.
I also have to pipe up a bit about hunger. It's a NATURAL sensation. If you are eating a diet that has your body signalling properly, etc., being hungry should not be an issue that sends you face down into a pile of insert-fave-food-here. Sure, starving yourself so that you get so hungry that you lose control is not the answer, but to expect that your body will be in energy deficit to get you all the way down to an ideal weight without ever experiencing a hunger pang is unrealistic. I'm sure there's someone out there who can claim that to be the case, but let's talk reasonable expectations for the rest of us.
** I can see where monitoring ones blood glucose can get as obsessive as counting calories, carbs, weighing daily or even more often, etc. BG meters just aren't all that accurate down to a few points from what I understand, and although the strips I used were well within expiration date, I noticed distinct differences even for strips within the same lot, and one time a small lot that routinely gave me BG's around 10 pts higher than the other lots. It's also common knowledge that very low carbing can make you more intolerant to a glucose challenge which is why low carbers are encouraged to "carb up" eating 150g/day for several days prior to an oral glucose tolerance test. Something about the term "carb cripple" used by Dr. Michael Dansinger in a recent JM interview struck a chord with me. If you get to a point where your body can't tolerate even 10g carb in a mixed meal this could drive you low omega 6 content nuts!