The Glycemic Index

When Atkins first published his ''Diet Revolution'' in 1972, he promised that we would lose weight eating steak, eggs and butter, because it was the carbohydrates – the pasta, rice, bagels and sugar – that caused obesity. Fat, he said, was harmless. Atkins allowed his readers to eat luxurious foods without limit – steak with cream sauce, bacon cheeseburgers – but allowed no starches or refined carbohydrates – no sugars, rice, potatoes or anything made from flour, not even fruit juices or brown bread. Long-term however, consuming an unlimited intake of saturated fats and cholesterol-rich food causes heart disease and excessive calcium excretion in urine (increasing the risk for kidney stones and osteoporosis). Not surprisingly, Atkins had to defend his diet in Congress.

Anyone who has stopped eating carbohydrates to lose weight will tell you that doing so, works. But they will also tell you that it is not a happy existence – a life without carbohydrates is no life at all! So we know that in excess quantities (especially the “wrong” kind), carbohydrates can lead to weight gain. But how do you know which is the “wrong kind”? In other words, how can you lose weight without having to give up carbohydrates entirely?

The best way to differentiate between the “right” and the “wrong” carbohydrates is to understand the Glycemic Index. The basic idea is that compared to fats and protein, carbohydrates have the greatest impact on blood sugar because they are converted into glucose by the body. And because the body cannot store more than one day’s worth of glucose in the liver and muscle tissue, excess quantities will be stored as body fat. In other words, the amount of carbohydrates eaten – rather than fats or proteins – will determine how high blood sugar levels will rise – and how much body fat you will accumulate.

The Glycemic Index (GI) is a ranking of food on a scale from 0 to 100 according to the extent to which it raises blood sugar levels after eating.

To determine a food's GI rating, measured portions of the food containing 10 - 50 grams of carbohydrate are fed to 10 healthy people after an overnight fast. Finger-prick blood samples are taken at 15-30 minute intervals over the next two hours. These blood samples are used to construct a blood sugar response curve for the two hour period.

Foods with a high GI (scoring >55 on the GI tables) are those which are rapidly digested and absorbed and result in marked fluctuations in blood sugar levels.

Foods with a low-GI (scoring <55>

*for a complete table, visit: http://www.glycemicindex.com/

With the GI diet, you can lose weight while still eating carbohydrates – you just have to know what kind of carbohydrate is the “right” kind. As a general rule, complex carbohydrates are low-GI foods, and simple carbohydrates are high GI foods. This is because complex carbohydrates are broken down more slowly than simple carbohydrates, keeping you from feeling hungry and providing a more consistent stream of energy. They are also more likely to provide more vitamins and minerals, as well as fiber (helping with digestion). Simple carbohydrates add calories, increase blood glucose levels quickly, and provide little or no other nutrients.

Low-GI foods (complex carbohydrates)	High-GI foods (simple carbohydrates)
Non-starchy vegetables Whole grains: e.g. oats, brown rice, quinoa, wheat, couscous Beans and legumes: e.g. garbanzo, lentils, kidney beans Nuts and seeds: e.g. chia, linaza, walnuts, peanuts Milk Less-sweet fruit: e.g. apples, grapefruit, pears, bananas	Table sugar, sugar cane, honey, and corn syrup and all foods made with these (e.g. cookies, cakes, soda, candy, ice cream) Refined white rice Refined white flour and all foods made with these (e.g. white bread, pasta) Starchy vegetables: e.g. yucca, potatoes, corn Sweet fruit: e.g. pineapple, grapes, kiwi, melon, peaches

Eating according to the Glycemic Index can also help prevent diabetes. This is because high-GI foods cause blood sugar levels to spike, and the body to create excess amounts of insulin (the substance which moves glucose out of the bloodstream and into cells, where it is used for energy). If you’re eating high-GI foods meal after meal, snack after snack, day after day, there is a great deal of stress on the system to produce insulin: eventually, your body may stop producing (diabetes type 1) or stop responding to it (diabetes type 2).

And so, eating a low-GI diet has many advantages. It can lead to lower body weight, because it controls the appetite and delays the sensation of hunger. It can improve your intake of vitamins and minerals, because you are eating whole instead of refined foods (that are stripped of their nutrients). It can improve glucose and lipid levels in people with diabetes (type 1 and type 2). Finally, it can reduce the chances of insulin resistance (type 2 diabetes).

A day eating low-GI food

Breakfast: Blackberry, banana, soy milk, oat smoothie

Lunch: Pumpkin, spinach, lentil and quesillo salad with cumin and paprika vinaigrette

Snack: Unsalted peanuts

Dinner: Lime and curry marinated pork with quinoa salad

Orthorexia

An eating disorder is a condition in which an individual eats, or avoids eating, in a manner which negatively affects both one's physical and mental health. They are thought to be behavioural patterns stemming from emotional conflicts that need to be resolved in order for the sufferer to develop a healthy relationship with food. Last month we learned about compulsive overeating disorder and the movement to recognize alternative eating disorders which do not fall under the two clinically accepted categories, anorexia and bulimia nervosa. This month we will learn about Orthorexia and Selective Eating Disorder. While many doctors believe that these conditions are simply lifestyle choices or “odd” habits, both have the potential to cause a high degree of anxiety and body hatred, restrictive or antisocial behavior, and negative physical symptoms (e.g. excessive thinness, bone deterioration, sleep irregularity, digestion difficulties, etc.). This potential for harm means that they should be recognized and treated accordingly.

What is Orthorexia?

Orthorexia nervosa is a term coined by Dr. Steven Bratman of Colorado University in 1997. It is formed from the Greek word orthos (meaning "correct”) and orexis (meaning "appetite”), modeled on the word anorexia (meaning "without appetite"). Orthorexia is an unhealthy obsession what the sufferer considers to be healthy food: it comes from the drive to become pure, so that a sufferer begins to become obsessed with everything that he or she is consuming. It is believed to be a food-centered manifestation of a person’s obsessive tendencies: many who suffer from Orthorexia also suffer from Obsessive Compulsive Disorder.

Someone who struggles with orthorexia may avoid certain foods, such as those containing fats, preservatives, animal products or other ingredients considered by the subject to be unhealthy. Orthorexics describe preserved products as "dangerous", industrially produced products as "artificial", and biological products as "healthy". They may plan strict meals for breakfast, lunch and dinner for the next day. They are often critical of what others eat, and may isolate themselves from surroundings. If the dietary restrictions are too severe or improperly managed, malnutrition and/or emaciation can reach the extremes seen in anorexia nervosa. In extreme cases death may even result.

What is Selective Eating Disorder?

Selective Eating Disorder (SED) is the categorical refusal to consume certain foods or whole food groups, based on different criteria (nutritional value, ethics, texture, aroma, even color). While pickiness and refusal to eat certain things can be normal (especially throughout childhood) where it is not overcome with age or is accompanied with extreme ridigity, malnutrition and/or psychological distress may result. Like orthorexia, many who suffer from SED also suffer from Obsessive Compulsive Disorder. Those with SED eat a highly limited range of foods and are unlikely to try anything new: certain foods and even specific brands are identified as “safe”, whereas the rest are “dangerous”.

You might suffer from orthorexia or SED if:

1. You care more about the virtue of what you eat than the pleasure you receive from eating it.

2. Your diet socially isolates you.

The raw food diet

Certain health food diets, such as the raw food diet, may lead to orthorexia or SED. This diet is a diet based on unprocessed and uncooked plant foods, such as: fresh fruit and vegetables, sprouts, seeds, nuts, grains, beans, dried fruit and seaweed. It is believe that heating food above 116 degrees is destroys the enzymes in food that assist in the digestion and absorption of food: in other words, cooking is thought to diminish the nutritional value. 75% of the diet must be living or raw. Benefits are claimed to be:

-increased energy

-better skin

-better digestion

-weight loss

-reduced risk of heart disease.

This diet is extremely restrictive and requires an incredibly amount of time and energy. When not administered properly, nutritional deficiencies are more than likely occur: unless one spends all day eating, calcium, iron, B12, protein and calorie intake will most likely be insufficient. Several notable celebrities follow the raw food diet: Gwyneth Paltrow, Demi Moore, Sting and Alicia Silverstone. In 2008, Gwyneth was hospitalized for fainting due to undernourishment.

Recovering

The underlying motivations of orthorexia and SED are different from that of anorexia. An anorexic’s goal is to lose weight, however the orthorexic and someone with SED want to feel pure, healthy and in control. Nevertheless, the outcome may be the same - emotional distress or anxiety, feelings of guilt, inability to participate in social events, physical discomfort when “normal” food is consumed, and/or excessive weight loss. If you think you may be suffering from either of these conditions, consult a professional: you can learn to have a healthy relationship with food without restricting yourself.

Compulsive Eating Disorder

An eating disorder is a condition in which an individual eats, or avoids eating, in a manner which negatively affects both one's physical and mental health. They are thought to be behavioural patterns stemming from emotional conflicts that need to be resolved in order for the sufferer to develop a healthy relationship with food.

Eating disorders can range from mild mental anguish to life-threatening conditions, and can affect every aspect of an individual’s daily life. The most common eating disorders are anorexia nervosa - deliberate and sustained weight loss via conscious abstinence from food - and bulimia nervosa - cyclical and recurring pattern of binge eating followed by guilt, self-recrimination and over-compensatory behavior such as crash dieting, over-exercising and vomiting to compensate for the excessive caloric intake. Together, they affect an estimated 5-7% of females in the United States during their lifetimes.

Worldwide however, there is a movement to recognize alternative eating disorders, which do not fall under these two clinically accepted categories (neither anorexia nor bulimia nervosa). This stems from the fact that 9 in 10 women in the United States claim they are unhappy with their body, and while not all of these women are anorexic or bulimic, they all display unhealthy or conflictive relationships with eating and food in general. Examples of alternative disorders are orthorexia (unhealthy obsession with healthy food and/or purity), selective eating (categorical exclusion of certain foods or food groups), and compulsive overeating (eating excessively to feed emotions). While many doctors believe that these conditions are simply lifestyle choices, “odd” or “bad” habits, all three have the potential to cause a high degree of anxiety and body hatred, restrictive or antisocial behavior, and negative physical symptoms (e.g. obesity, excessive thinness, bone deterioration, diabetes, sleep irregularity, digestion difficulties, etc.). Here, we will discuss compulsive overeating (also known as emotional, or binge eating).

What is compulsive overeating?

Compulsive eating is using food for reasons other than hunger or social events, and feeling unable to stop the behaviour. It is a response to a certain emotion (boredom, stress, anger, sadness, etc.). Someone with compulsive overeating disorder is addicted to eating food in large amounts, but unlike with bulimia, they do not purge. In short, food is used to feed feelings instead of a hungry stomach. Symptoms include:

• Eating excessive quantities of foods perceived as “forbidden”, when not physically hungry
• Eating until stuffed and uncomfortable, or grazing and never really finishing a meal
• Eating much more rapidly than normal
• Eating excessively one or various days, then healthily the next few days
• Feeling very self-conscious eating in front of others
• Eating alone due to shame and embarrassment of the quantities of food consumed (e.g. in the middle of the night)
• Secretly planning or fantasizing about eating alone
• Feeling ashamed, depressed or guilty after bingeing
• Being secretive about what was eaten
• 24-hour preoccupation with body weight
• Depression or mood swings
• Awareness that eating patterns are abnormal
• History of weight fluctuations
• Withdrawal from activities because of embarrassment about weight
• Eating little in public, but maintaining a high body weight
• Being unable to purge or compensate for the food eaten.

Side effects can include: difficulty sleeping at night, joint pain, muscle pains, menstrual problems, headaches, suicidal thoughts, struggle digesting, and a high level of stress. Left untreated, compulsive overeating can lead to serious medical conditions including cholesterol, diabetes, heart disease, hypertension, sleep apnea, and major depression. Emotional eaters can be overweight, “normal”, and even underweight, however all are significantly uncomfortable existing in their body.

Because compulsive eating is not yet clinically accepted, people suffering from the disorder often blame their weight on their binges and do not consider that there might be a psychological reason behind their binge eating. A very common misconception is that people who have the disorder do not know anything about healthy eating habits: however, one can be informed about nutrition and health, but still display the behavior.

It is estimated that 2 percent of all adults in the United States struggle with this disorder, and it is seen most in young adults. Many individuals fail to seek or receive appropriate intervention until middle age, remaining in the darkness of shame and secrecy.

How does eating distract from emotions?

· Eating produces a sense of fullness and increases blood sugar levels. Both reduce the physical agitation that comes with feelings of anger, distress, and anxiety and produces an experience of numbness in which all emotions, including depression and loneliness, are minimized.

· Eating to the point of physical discomfort distracts from emotional pain.

· Continuous eating also distracts from disturbing thoughts.

· Consuming foods that are enjoyable or that are associated with positive experiences brings pleasure, temporarily relieving depression.

· Certain foods raise endorphin levels (the “feel-good” brain chemical).

· High carbohydrate food facilitates the release of serotonin. Serotonin is the calming brain chemical. When the brain is using it, feelings of stress and tension are erased. This is why foods eaten out of emotion rather than hunger are frequently high carbohydrate (e.g. pasta, pizza, bread, pastries), since such foods increase serotonin.

The emotional relief from food is short-lived and is repeatedly followed by an extreme sense of guilt and disgust with one’s self. The more emotions build, the more likely the individual is to engage in the very same behavior that resulted in feelings of guilt. The person becomes addicted to the “ups” and “downs”.

Recovering from compulsive overeating

Approximately 80% of sufferers who seek professional help recover completely. Treatment programs that address only the depression will not be successful in breaking the cycle of compulsive overeating: treatment for both the clinical symptoms of depression, and the behavior of compulsive eating, is needed to successfully end this vicious cycle. The most effective weight loss programs combine diet, lifestyle change, nutritional education, exercise, and antidepressants (where appropriate).

Overeaters Anonymous, the global support group for those suffering from compulsive overeating disorder, has the saying: "when you are addicted to drugs you put the tiger in the cage to recover; when you are addicted to food you put the tiger in the cage, but take it out three times a day for a walk." If you think you may be suffering from compulsive overeating disorder, contact a professional immediately: you can learn to love food, and your body, without abusing either of them.

4 basic rules of “normal eating”:

1. Eating only when you are hungry or to facilitate social events.

2. Choose foods that satisfy you and don’t leave you “hanging”.

3. Eating with awareness and enjoyment.

4. Stop when full or satisfied.