TLC - DIET

As I mentioned in my last post, TLC stands for therapeutic lifestyle change - things that you can change in your diet, exercise, emotional health, weight, and behaviors like smoking or drinking that are therapeutic (make you more healthy). If you asked a hundred different doctors what they thought was the most important change, you'd likely get a dozen different answers. However, since this is my blog, I get to decide! Actually, despite today's subject, I think the most important thing is to stop smoking. We'll talk about that a different time.

Today, I wanted to talk about diet - what you eat. We had an endocrinologist (a doctor who specializes in things like diabetes) come and talk to our medical practice yesterday. She spent over an hour talking about diabetes without mentioning any medication treatment. Just goes to show you that non-medicine treatments often are the most important part of any treatment plan. She had a great slide that looked something like this:

Treatment of Diabetes

1. Diet
2. Diet
3. Diet
4. Diet
5. Diet
6. Diet
7. Diet
8. Diet
9. Diet and exercise
10. medication


If you are having a difficult time reading that last line, it says "medications". So, whether you have diabetes or not, whether you are overweight or not, diet matters a great deal. If you go to the bookstore, you will see dozens of books on "diet". Many of them have a gimmick: "Eat only fat and protein", "Don't eat any sugar", "Only eat foods that begin with the first letter of your name".

These diets actually do work. Not because the authors have found the magic bullet to achieve weight loss, but because calorie restriction - any type of calorie restriction - will equal weight loss. That's just basic thermodynamics.

However, you don't need to spend any time or money researching the best fad diet. Just eat a healthy diet and practice moderation. What's part of a healthy diet? One great place to get a lot of information is: www.mypyramid.gov

Basic information includes:

1. Brown is good. Brown bread, brown rice, brown pasta. All the "brown" stuff is made from whole wheat or complex carbohydrates. Carbohydrates are just another name for sugar. Simple carbohydrates (like white bread, white rice, or a Twinkie) turn into sugar very quickly in your digestive system. This has a lot of different effects, but to keep it simple, simple carbohydrates can cause weight gain, a burst of energy followed by feeling really fatigued, insulin resistance and even diabetes. Complex carbohydrates break down into sugar more slowly. This is better for your body, a more natural way for your body to absorb sugar, and not associated with the quick up and down sugar levels that you see with simple carbohydrates.

2. Fruits and veggies rock. Do you ever see nutritional supplements or vitamins proclaiming their "anti-oxidant" benefits? Anti-oxidants abound in fruits and vegetables and, while we don't understand exactly how they benefit your health, they help repair damage inside your cells. Over time, this may reduce your risk for heart disease or cancer. Eat as many fruits and vegetables as you can. Every January, I try to eat 8 fruits and vegetables a day. It is hard and I don't have much room left for anything else. So, if you are not a huge fruit and veggie person, just try to gradually increase to a goal of about 5 servings per day.


3. Eat things in their most natural form. This just means to choose an orange instead of orange juice, a baked potato you cook at home rather than one that comes from the frozen food section, or "real" oatmeal instead of an over-flavored packet of instant oatmeal. Now, we all eat "processed" foods because we are no longer part of a society in which people raise their own chickens, grow their own corn, or bake their own bread (unless you are Amish, but then you probably wouldn't be reading a blog). So, just get closer to the food's natural state as much as possible.

4. Do not make anything forbidden. This is likely one of the biggest culprits in diet failure. You ate the forbidden piece of cheesecake, so the whole diet is ruined. Or, you just absolutely must have chocolate and that is not allowed on your "diet". Anything is okay in moderation. "Moderation" means different things for different people. Basically, you can eat whatever you want as long as it does not become a significant source of your daily calories (meaning you only ate 1000 calories today but all of them came from a lemon meringue pie), it is an occasional treat, and you eat a serving at a time (rather than half a cake, a box of twinkies, etc.).

5. No diet sodas. I know this is a touchy subject. And, I have to admit that this is not any organization's "official" recommendation. It is just my personal, albeit educated, opinion. The reason for this particular piece of advice is my belief that diet sodas can contribute to obesity. I'm not sure how this happens, but recent research in lab rats indicates a few possible mechanisms. It may be that when you drink a diet soda and your brain expects to get 250 kilocalories of energy but doesn't, that your ability to accurately detect the caloric content of food is altered. This might make you more prone to overeat. Or it may be that your body thinks it is getting 250 kilocalories of energy, but doesn't and tries to "make up for it" by giving you a craving for more calories in some other way. It also seems that your body processes drinks differently from foods. Whatever the reason, I strongly recommend eliminating diet sodas. This does not mean to substitute with regular sodas (especially if you are diabetic). Instead, choose non-sugary drink options - water, iced tea or coffee.

I hope this is a helpful overview of dietary lifestyle changes.