After SAD, Beyond the Zone
Sustainable Dietary Advice, Part I
by James Biddle MD

At our clinic, we use the abbreviation SAD to denote the “Standard American Diet”. Conventional advice to improve upon SAD is to eat less fat and more “complex” carbohydrates. However, the dangers of this simplistic approach have recently been popularized by several best-selling authors, most notably Barry Sears PhD with Mastering the Zone and Michael Eades MD with Protein Power. For example, in “the Zone” each meal has a balance of 40 % carbohydrates, 30 % protein, and 30 % fat. This balance lowers insulin surges and improves metabolism, which is an amazing improvement over SAD for the average person.

Today, I’ll review the reasoning behind why these dietary approaches are indeed generally beneficial. However, next issue I’ll also explain why I do not believe that a “Zone” approach is necessarily ideal for everybody.

Many of our current health challenges arise from the fact that our bodies are not adapted to the very unnatural diet that we consume. Our usual diet consists largely of starches, grains, and refined carbohydrates. These are all absorbed as sugars, causing elevations in blood sugar and therefore overproduction of insulin, which is a hormone released from the pancreas. The purpose of insulin is to promote storage of energy, which it does by turning blood sugar into body fat. Recall that when you “fatten up” animals for slaughter, you feed them grains, not fat. This is why the “low-fat” (i.e. high-carbohydrate) diet has caused a 30% increase in obesity in the U.S. in just 10 years, as well as a whopping 300% increase in diabetes in just 15 years. This is also why the diets currently recommended by the American Diabetes Association and the American Heart Association will actually promote diabetes and heart disease rather than reverse them.

When our bodies are fed the “Standard American Diet”, we repeatedly release insulin and constantly store energy. This not only causes obesity, but also hypoglycemia (low blood sugar) and food cravings. Why? Because after a high-carbohydrate meal, the resulting insulin surge pushes the blood sugar back down too low. In some people, this causes symptoms of hypoglycemia (weakness, sweating, faintness, and lethargy), while in others it simply causes cravings for more sugary snacks to bring the blood sugar back up temporarily. Perhaps you can see why most Americans are on a blood-sugar roller coaster, and also in insulin excess.

Over time, insulin excess creates insulin resistance as we lose sensitivity to the effects of insulin. After floods of insulin, cells become “resistant” to the signal delivered by insulin, resulting in a loss of insulin’s ability to lower blood sugar. The body then needs to release more insulin over time in order to control blood sugar. Eventually, a person develops both high levels of insulin and high levels of blood sugar, leading to overt diabetes.

It is certainly well understood that the high sugar of diabetes causes many illnesses. However, now we also recognize that even without diabetes, excess insulin is a prime cause of many diseases of aging and even of aging itself. Along with widespread deficiencies of vital nutrients and a multitude of unnatural toxins, excess insulin is fundamental in promoting our current epidemic of chronic diseases. This is because excess insulin causes damage, including raising triglycerides and cholesterol, increasing blood pressure and inflammation, and promoting atherosclerosis and heart disease. We are needlessly suffering from the chronic degenerative diseases caused by the excessive insulin generated by our high-carbohydrate eating habits.

Fats are another vastly misunderstood and quite important nutrient. Fats are the foundation of every cell membrane in our bodies. Avoiding fats or eating the wrong fats are common and dangerous errors. Because our bodies cannot produce certain fats, they must be present in our diet, so these are known as essential fatty acids. The current American diet is deficient in one type of essential fat, the omega-3 fatty acids. A deficiency of omega-3 fats causes rigidity, deformity, and dysfunction of cell membranes, contributing to premature aging and disease.

We’ve all been told to avoid cholesterol in our diets, but actually most of the cholesterol in our blood is produced from sugar in our own livers. In fact, excess insulin signals the liver to make excess cholesterol. Most cholesterol-lowering medications (the HMG-CoA reductase inhibitors) simply attempt to block the liver enzyme that makes cholesterol. However, these medications also block the liver’s production of many beneficial substances, including Coenzyme Q-10, a vital nutrient necessary for energy production, especially in the heart. The proper way to regulate cholesterol metabolism is to lower insulin levels by avoiding excess carbohydrates. This includes not only avoiding simple sugars, but also reducing all starchy foods, including potatoes, rice, bread, pasta, and most grains and cereals. All carbohydrates, with the exception of fiber, are absorbed as sugars and therefore cause increases in insulin.

Barry Sears PhD of The Zone Diet and Michael Eades MD of Protein Power have done a great service by making millions of Americans aware of the dangers of excess carbohydrates. However, they both make the same basic error of assuming that there is therefore one diet that is appropriate for everyone. In reality, each individual has a unique history and metabolism and therefore a unique ideal diet.

The overall ideal perfect diet is what I call the “Garden of Eden” diet: What would we eat without livestock or grain farming? Of course, today the Garden of Eden diet is only perfect for a body directly from the Garden of Eden, which has never owned a TV or automobile and hasn’t been damaged by decades of improper nutrition and environmental toxins. Therefore, what I’m usually advising for my patients are a variety of “Intervention Diets”: diets designed to help reverse the damage caused by SAD and our modern lifestyle. For many people, this will include reversing insulin dominance by limiting refined and starchy carbohydrates. For everybody, it includes education about the differences between good fats and bad fats, as well as the importance of adequate protein and fiber.

In my next article, I’ll talk more about how to individualize a dietary plan ideal for your own history and metabolism. Meanwhile, if you have challenges with excess weight, diabetes, heart disease, or inflammatory disorders such as arthritis, I encourage you to obtain Mastering the Zone or Protein Power so that you can begin to reap the benefits of lower insulin levels.

Part 2
by James Biddle MD

In the last issue, I discussed SAD (the “Standard American Diet”) and a couple of excellent books you can use to improve your diet, from Barry Sears PhD with Mastering the Zone and Michael Eades MD with Protein Power. These books recommend a balance of proteins, carbohydrates, and fats in order to lower insulin surges, improve metabolism, and burn fat. This is truly an amazing improvement over SAD for the average person. However, today I’ll also explain why I do not believe that a “Zone” approach is necessarily ideal for everybody.

In “The Zone”, one is advised to eat 40% carbohydrates, 30% protein, and 30% fat. This will actually work great for most people, but there are some important caveats to consider.

First, the perfect ratio of carbohydrates to proteins, as well as the total protein requirement per day, is really quite individual. Your daily protein requirement is figured by your lean body mass (in pounds) times a conversion factor based upon your activity level. For most people this will figure out to be between 60 – 100 grams of protein daily. It’s important to realize that this is not a high-protein diet. In fact, the US RDA of protein is 60 grams, so many people barely need to exceed that. What does this look like? Well, one ounce of meat, fish, or cheese has 7 grams of protein, so one pound has about 112 grams of protein. Therefore many people will need less than one pound of a high-protein food distributed through their day.

The real trick is the ratio of carbohydrates to proteins at each meal and snack, because this is the major determinant of whether a person will be creating large insulin surges. You may recall that it is the overproduction of insulin that promotes fat storage, high cholesterol, hypertension, heart disease, and arthritis. Hitting the right ratio of proteins to carbohydrates (CHO) is what really puts you in “The Zone”. However, this is quite different for different individuals.

For example, a young lean athlete may do quite well on a ratio as high as 3:1 of CHO:protein, while an older sedentary diabetic may need to go as low as 1:2 of CHO:protein. What’s amazing to me is that many of the patients I see have long been eating a CHO:protein ratio as high as 10:1, and this is clearly a major contributing factor to their chronic degenerative diseases.

How do you know what your ratio should be? Basically, you need a ratio that prevents insulin surges. At the clinic we measure fasting insulin levels and triglyceride levels for guidance. At home, you can follow blood sugars, weight changes, and symptoms. Have you ever had the experience of a “sugar buzz” followed by a hypoglycemic “crash”? That’s when you know that you’re way outside “The Zone”. In brief, the younger, leaner, and more active you are, the more carbohydrates you can usually get away with.

Here are some things to remember about counting grams of CHO and protein:

• It’s the ratio at each meal and snack that counts. Having all your protein at one meal just doesn’t create the right balance.
  
• It’s the “effective” carbohydrate grams that matter. Fiber is considered a CHO, but it is not absorbed from the gut and turned into sugar, so the “effective” CHOs are the total carbohydrates minus the fiber.
  
• The “glycemic index” counts. The glycemic index is a measure of how fast a particular food raises your blood sugar. Refined and starchy carbohydrates like sugar, fruit juice, potatoes, bread, rice, and pasta have a much higher glycemic index than truly complex “fibrous” foods like broccoli, kale, asparagus, peas, and green beans.
  

1. Adequate protein, adjusted for your lean body mass and activity level.
   
2. Avoid insulin surges by choosing an appropriate CHO:protein ratio at each meal.
   
3. Eat lots of healthy fats and avoid bad fats.
   
4. Eat lots of high-fiber foods, preferably organic.