Sunday, October 7, 2012

The Nutrition Debate #69: In Praise of Small Meals

Like many Americans and increasingly people around the world who have eaten a “Westernized” diet, I succumbed to one of the ubiquitous Diseases of Civilization: Metabolic Syndrome. See The Nutrition Debate #9 here for the symptoms. The major signs are obesity, hypertension (high blood pressure) and dyslipidemia (especially high triglycerides and low HDL). It is also nearly synonymous with Type 2 diabetes. I don’t have to tell you: Obesity and T2 diabetes are epidemics of “epic” proportions (pun intended).
Many have already discovered an effective treatment for Metabolic Syndrome – one that can reverse virtually all of the symptoms and avoid further damage to organs and arteries (endothelial dysfunction). Lose weight. And in a way that is without hunger, using the Very Low Carb (VLC) restricted calorie diet advocated in this blog. The benefit of the VLC restricted calorie diet is that it will ameliorate all the symptoms of Metabolic Syndrome: the obesity, the hypertension, the dyslipidemia and dysglycemia (pre-diabetes or even full T2 diabetes).
You can lose weight without hunger. I lost 170 pounds.  Your high triglycerides will plummet and your HDL can soar. For evidence of my own improvement in these areas, see the Nutrition Debate #67, “HDL Cholesterol and the Very Low Carb Diet,” and #68, “Triglycerides, Fish Oil and Sardines.” In addition your blood pressure will likely improve. Mine did. I went from 130/90 (with medications) to 110/70 (with the same medications). Finally, and this is the best news of all: your blood sugars will greatly improve, eliminating or substantially reducing the need to take oral diabetes medications.
In addition, if strictly adhered to, a Very Low Carb diet will put your T2 diabetes in full remission with no clinical signs of disease. Mine is. And once you have reached your goal weight, all of your gains will be retained so long as you continue to eat Very Low Carb. So long as you keep the weight off, and continue to eat VLC, you will have “normal” blood sugars and lower A1c’s, great lipids, especially triglycerides and HDL, and improved blood pressure. But, you can’t go back. You must keep the weight off. And you must continue to eat VLC. Very Low Carb must become your Way of Eating for life (double entendre intended).
 This Way of Eating is very effective for weight loss and weight maintenance because if you aren’t hungry, you should not eat as much. You can eat a small meal and be satisfied. Not sensing hunger, that is, by eliminating the biological imperative your body senses to eat to survive to avoid starvation, you will not want to eat between meals and at every opportunity, and you will not have the desire to scarf down more food than you need when you do sit down to eat.
But hunger is not the only driver of eating. Another force/response that I discuss in the Nutrition Debate #63 here is Impulse Control. Thinking about food, or seeing food, even a visual image on TV, is a stimulus. It induces a hormonal response. Insulin and other hormones start to flow. The stimulus could be one of those Red Lobster TV commercials that depicts an “endless shrimp” dinner. Delicious! Or it could be just the thought of that “half-gallon” of ice cream you know is in the freezer. Resisting this impulse requires self-control: you must deny this biological imperative/response too.
A similar type of behavior modification is involved in proactively understanding that 1) if a small VLC meal satiates your hunger, you should be satisfied and thus learn to eat it and no more. Similarly, if you are not hungry for 5 or 6 hours after a small VLC meal, 2) you should learn that you do not need to eat a between-meal snack. I have learned these two lessons during 10 years of eating VLC and found it easy to apply them. Small meals and no snacks. Let me illustrate:
For 10 years I have been eating a breakfast of 2 fried eggs, 2 strips of bacon and a cup of coffee with half and half and artificial sweetener. It is about 6 grams of carbohydrate (2 eggs = 1, 2 Splenda = 2, and 2oz H&H = 3). It is mostly protein and fat (21g protein; 27g fat). Total calories: about 350. Believe it or not, this small meal is good for 6 or 8 hours!
However, for lunch I have a can of sardines eaten from the can: 13g protein, 24g fat and zero (0) grams of carbohydrate. Calories, including the olive oil in the can: 270. If I have a beverage, it is either a glass of water or diet ice tea. I eat this meal approximately 5 hours after breakfast not because I am hungry (I am not), but because I want to eat some protein (with some fat) at lunchtime to prevent my muscle protein from being used for energy. Because I am not eating carbohydrates for energy, none are stored and dietary protein and fat are needed with each meal as energy sources.
Dinner is likewise mostly protein and fat; however, it is still just a “smallish” serving of protein plus a non-starchy vegetable (carb) tossed in butter or roasted in olive oil (fat). Alternately, I sometimes eat a salad with vinaigrette dressing. Together, the three meals combined are about 1,200 calories, 75g protein, 90g fat and 20g of carbohydrate. This meal plan is about 25% protein, 70% fat and 5% carbohydrate. And all of these meals are small and very satisfying. © Dan Brown 10/7/12


  1. I sure wish I could get my husband to eat like this. I've adopted a LC carb diet for weight control( lost 20lbs since July), need to lose 20 more. I have diabetes T2 on my paternal side so I'm also trying to prevent it. My husband just sees this a another one of my "fad diets", I admit I've been on many, but none have the effect and health benefits of low carb. He just is not interested in the science, he's the outdoorsy non intellectual type and I am the nerdy, bookish, intellectual type (sigh) I'm glad you found the solution to health. I will continue to read your blog .

    1. I've just lost two replies and I am frustrated. Let's see if this one works.

      I started low carbing 10 years ago when my doctor suggested I try Atkins. He had read about it in the NYT Magazine (The Gary Taubes cover story of 7/6/02, I think: "What If Its All Been a Big Fat Lie?"

      We didn't know that it was going to have such a big effect on my diabetes, or blood lipids, and even my blood pressure after I lost 170 pounds.

      I feel much better today than I did 10 years ago.

      Thanks for being a loyal reader.

  2. He has type 2 diabetes as well. Maybe I print one of your posts he might read it. When I hear stories like yours it still gives me hope that he will make the life style changes necessary to control his blood sugar levels, and prevent diabetes related issues.

    1. It's not just the "dreaded complications" of diabetes ("diabetes related issues"), although he is at greater risk of those (blindness, kidney failure and amputations, if he is really out of control for a long period of time. He will likely die (sorry) of one of those, OR OF CARDIOVASCULAR DISEASE (CVD); There is a very strony association with these, atherosclerosis, heart attack, stroke, well. So, there's so much as stake. Is he overweight or worse? About (I forget the actual number) 85% of T2's are.

      If you decide to print out one of my columns, you might want to refer to the Index of Columns. It is between #59 and #60 and can also be easily accessed from the blog. It is linked on the upper right hand corner of the blog under Favorites.

  3. He is slimbwith a pot belly. Maybe just 10lbs overweight? He did weigh more but lost weight when we moved to a rural area and his job got even more physical. So he has been heavier in the past, the heaviest when he was a truck driver, which was just too sedentary for him.

    I'm going to take a look @ the columns and print a few out, next time I go to the library (I access the net with my iPhone mostly)

    1. That's not much overweight. You might want to look at my column #33 titled "Omental Adiposity." It deals with the "pot belly," its causes and risks. Fructose is implicated in omental adiposity, especially fat in and around the liver, including non-alcoholic fatty liver disease (NAFLD). If you husband eats or especially drinks a lot of fructose (in fruit, of course, but also 50% of table sugar, aka sucrose, and 55% of the HFCS used in soft drinks in the US), he could lose some of that beer belly by avoiding most of the fructose. I have written several columns on fructose. Check those out too.