The Dash Diet Weight Loss Solution

CHAPTER 2

The DASH Diet Weight Loss Breakthrough

At the time that the DASH diet was first developed, in the mid-1990s, the prevailing nutrition wisdom was to encourage lots of grains and low-fat eating. But everyone got fatter and less healthy.

Next came the proliferation of low-carb diets. Because it was initially pooh-poohed by the medical establishment, imagine the surprise when research showed no adverse health effects from increased fat intake. With conventional dietary wisdom turned on its head, the DASH researchers designed a new study to evaluate the effects of lower-carb versions of the DASH eating program. In other words, they wanted to do their own side-by-side comparison to see if a DASH diet with some of the starches replaced with either higher levels of protein or more heart-healthy fats would provide the same health benefits as the original (higher-carb) DASH diet. And imagine their surprise when the blood pressure improvements were even better with the low-starch versions of DASH.

This is the first book to use the long-overlooked NIH-sponsored research and present the lower-starch version of the DASH diet. In combination with other research studies that have helped us learn about the weight loss and health benefits of lower-carb eating plans, you will now have the optimized plan in The DASH Diet Weight Loss Solution.

As a dietitian in private practice and at a naval hospital outpatient nutrition clinic, I have successfully implemented this new and improved DASH diet plan with hundreds of people. Many of these were military members who needed to lose weight to maintain fitness levels required by their branch of service. These sailors, soldiers, marines, and airmen needed to stay fit and healthy, and that would not have been possible with an unhealthy quick-fix plan. Yes, the new DASH diet plan sped up weight loss. But we met the weight goal while maintaining the muscle mass required for fitness. The result: improved metabolism, lower body fat, enhanced strength and cardiovascular fitness, and improved health.

The new DASH plan, specifically designed to speed weight loss, also proved effective for the families of military and for military retirees who had diabetes or prediabetes. Lowering blood glucose levels, reducing blood pressure, improving cholesterol and triglycerides, while reaching a healthier weight, became easy for these patients. The lower-carb DASH diet kept hunger under control with filling, low-calorie fruits and veggies, while providing long-lasting satiety with lean protein-rich foods and heart-healthy fats. With an abundance of great food, the lower-carb DASH diet did not feel like a diet at all.

Never before presented to the general public, The DASH Diet Weight Loss Solution is the perfect antidote to America's obesity epidemic. Still rich in the key DASH foods—fruits; vegetables; low-fat and nonfat dairy; lean meats, fish, and poultry; nuts, beans, and seeds; moderate amounts of whole grains; and heart-healthy fats—this DASH program improves the health benefits and provides quicker, more dramatic, sustainable weight loss than the original DASH eating plan, presented in my first book, The DASH Diet Action Plan.

Before going into the full-blown version of this new DASH diet, many people will benefit from going through a "reset" phase, to wipe out their cravings and jump-start their weight loss. So in Chapter 3, we have a surefire way to wake up your fat-burning metabolism and develop a cleaner way of eating that eliminates cravings.

How do you reconcile low-carb and the DASH diet? First, you don't need all the refined starchy foods that most of us overconsume. They are certainly not part of making the DASH diet a healthy plan.

And getting more of the protein-rich foods is important as we get older. Back in the late 1980s and early 1990s, the RDAs for protein were set very low. The target level was that which was needed to prevent muscle wasting during starvation. But it was not high enough to prevent muscle loss on aging. And nutrition professionals, at that time, were taught to make weight loss plans in which calories from all the food groups were lowered proportionally. Today we know that when you help people reduce their calories, you want to keep the protein level high enough to preserve muscle mass. It is primarily the carb calories that you want to reduce.

Certainly, whole grains are healthful. The fiber, lignans, vitamins, and minerals are beneficial. But we do have to be careful not to consume more than we can burn off. And often grains come in foods packed with sugars. From Barbara Rolls's research studies that resulted in the Volumetrics program, we know that foods that contain water are more filling than drier foods. Most of the grain foods, such as breads, pastries, cookies, dry cereals, and even popcorn, are relatively low in moisture. Since they are not filling, we are more likely to overeat these types of foods. A diet that "forgets" these refined grain foods actually makes it easier to curb calories without having to think about it too much.

Another reason why starchy foods tend to provoke hunger is that they break down rather quickly to sugar. More accurately, they break down to glucose. Glucose is the blood sugar that we monitor in diabetics. When there is a surge of glucose into the blood, it triggers the body to pump out insulin to regulate blood sugar. When we are younger and relatively fit, we respond well to the insulin, blood sugar does not go too high, and the glucose moves into our muscle tissue to provide energy for physical activity. However, as we get older, and if we are less fit, the muscles do not respond as well to insulin. The bad news is that our mid-body fat does respond well to insulin, so the sugar gets stored in our belly fat and is then converted into more fat. And it is possible for the insulin to overshoot its target, causing our blood sugar to drop, triggering even more hunger. These up-and-down spikes of blood sugar can lead to more cravings and feeling out of control with your hunger. Meals that are just based on starches and/or sugars will leave us feeling hungry again relatively quickly.

On the other hand, fruits and vegetables also contain carbohydrates. They are rich in fiber, contain naturally occurring sugars, and pack in lots of water, so that they are relatively low in calories for their size. Fruits and vegetables are bulky and filling, which makes these foods wonderful choices for filling your plate. And of course, they are rich in all kinds of vitamins, minerals, antioxidants, and other healthful plant nutrients. Some vegetables contain more starch and are more caloric than others, so we probably want to watch the portion sizes more carefully with these foods, such as potatoes, winter squash, and peas. But with all the rest, an abundance makes it much easier to stay on track.

Protein-rich foods are also more satisfying than foods made from refined grains. Protein takes longer to digest, and it doesn't cause the blood sugar spike of the starchy foods. You are much more likely to feel full longer if you add some protein-rich foods to your meals and snacks. With The DASH Diet Weight Loss Solution, you will learn to mix it up. For example, if you have a snack with fruit and some light cheese or a handful of nuts, you will feel full longer. Include a hard-boiled egg at breakfast. If you are having some pasta, be sure to add a meat sauce or beans to make the meal more satisfying. We need more protein as we get older. Our goal as we age is to keep as much muscle as possible.

Heart-healthy fats are also an important part of the mix in providing satiety. Fats slow down digestion so that energy from your food enters your bloodstream more slowly. Yes, fats have more calories than carbs or protein. However, in moderate quantities they are very beneficial for keeping hunger under control. Often when recipes reduce the amount of fat in the food, they don't reduce the calories. How can this happen? One of the things that fats do in recipes is to help hold in air introduced during mixing. So without the fat, the food is denser, and a serving might have the same calories with or without the fat. Remember the low-fat cookies popular in the early 1990s? They had exactly the same amount of calories as the full-fat cookies they replaced. Life isn't fair. But that does provide another example of where the high-carb, low-fat diets went awry.

What about the health issues around fats, carbs, and protein?

In the 1980s and 1990s, it was generally believed that low-fat, low-protein, high-carb diets were best for heart health. The experts told us that diets higher in fat would cause our cholesterol and triglycerides to soar. Higher protein would cause our kidneys to fail. However, in actuality, the high-carb diets can cause triglycerides to spike, especially if someone is insulin resistant. Elevated triglycerides can be an early sign of impending type 2 diabetes. And high-carb diets tend to stoke the production of bad cholesterol, while depressing the level of good cholesterol.

Research has shown that people who consume heart-healthy fats, especially olive oil, nuts, and seafood rich in DHA and EPA, have lower rates of cardiovascular mortality. Add in their anti-inflammatory properties and these heart-healthy fats are definitely on our must-have list.

It was once thought that high-protein diets would be bad for everyone since excess protein would create extra work for the kidneys. However, we are not recommending excessively high levels of protein. And of course, traditional diets with high levels of salt, sugar, and starch do create extra work for the kidneys, and elevated blood sugar can harm the small blood vessels of the kidneys. Fortunately, the balanced approach of the DASH Diet Weight Loss Solution is consistent with heart health and is less likely to aggravate the kidneys than the traditional American diet. Of course, people with existing kidney disease who have been told to follow certain dietary restrictions by their physician or dietitian should check with their health care professional before adopting any new eating plan.

Another theorized health concern was that high-protein diets might impact bone health. Newer research shows that moderate intake of protein is associated with improved bone health and reduced risk for bone thinning as compared with a lower-protein diet.

Weighty Issues

With this book, you will learn that the most important things that you can do to lose weight are to get on track with healthy eating and become more physically active. Not only will you be healthier, but you will feel better and look better, too.

What Is a Healthy Weight?

There are many definitions of what makes a healthy weight, but the most obvious one is the weight at which you have no health problems. And unfortunately, even individuals whose weight fits the definition of "healthy" can still have habits—such as eating too many processed foods and being inactive—that are causing them to be at increased risk for certain diseases. This is called "metabolic obesity" or "normal weight obesity."

Currently, BMI (Body Mass Index) is the most common measure used to define healthy weight. If BMI is between 19 and 24, it is considered to be healthy. Between 25 and 29 is considered overweight. BMI over 30 is considered to be obese, and in excess of 40 is extreme obesity. These categories aren't just arbitrary distinctions. Health risks go up in each category. For example, women in the overweight category are about 70% more likely to have high blood pressure, compared with normal weight women, and twice as likely if they are obese. The concerns are much more dramatic with diabetes, with women who have a BMI over 35 being 30 times more likely to develop the disease, and even women who are just in the overweight category having about 18 times higher risk for diabetes.

Now, BMI cannot tell you how fit you are, and it is certainly possible for someone to have a BMI in the obese category, but not actually be "overfat." Football players, for example, are normally very muscular and will have weights that appear to be too high by BMI standards. But they are likely to be very fit. A measure of fitness could be percent body fat. This can be evaluated through underwater weighing, DEXA x-ray evaluation, bioelectrical impedance (BIA) done by professional equipment with electrodes, or even home scales that perform BIA to give a percent body fat reading.

Waist size is a very simple measure of whether your weight is healthy. If your waist is over 35 inches (88 cm) for women or over 40 inches (102 cm) for men, there are health concerns that you will want to have evaluated. You may have elevated blood pressure, blood sugar, and/or triglycerides. Even if your BMI is in the healthy zone, with too much belly fat you need to change your eating habits and start to exercise more. Fortunately, the DASH Diet Weight Loss Solution attacks this mid-body fat. At one time, no one believed in being able to "spot reduce." However, since excess belly fat is mostly due to overconsumption of starches and sugars, following this program will help you lose your muffin top.

Your Healthy Weight Goal

Setting targets, and especially short-term targets, can be very motivating and help keep you on track. Your weight target should fall somewhere in the healthy to overweight categories. If you have a lot to lose, setting a more modest goal, say, 5% to 10% of your current weight, would help you feel successful as you meet and exceed your targets, and make you healthier. In the Diabetes Prevention Study, losing as little as 7% of body weight significantly lowered the risk of diabetes.

BMI (Body Mass Index)

We are not going to calculate your target calories. That's right, you will not need to count calories. Instead you will focus on including food groups, and learn to watch portion sizes, especially for the high-calorie foods. This is so much simpler. After all, we eat food, not calories. Focusing on how to include a variety of food groups will teach you habits that you will use for a lifetime.

Further, you want to be sure that you are losing fat, not muscle. A balanced plan with plenty of protein, calcium, and magnesium will help preserve muscle. Adding exercise, especially strength training, will also help with maintaining lean body mass and help keep metabolism as high as possible.

The DASH Diet Weight Loss Solution

With this plan, you will stay full, crave less junk food, and feel like you are eating in a way that is cleaner and lighter. You will want to continue to have this feeling. This makes it much easier to stay on track with your plan.

During the first phase, you will relearn how to make meals. Your focus will be on choosing protein-rich foods that add satiety. You will learn to pair the protein foods with vegetables that provide bulk and happen to be very healthy and very low-calorie. This phase will reset your taste preferences, and turn you on to lighter, healthier eating. It is a two-week transition to reset your entire approach to eating. And it will boost weight loss. The faster, initial weight loss is very motivating, because of the visible changes. You will quickly notice that your clothes fit looser, especially around the waist.

The only key DASH diet component that is missing during phase one is fruit. The good news is that it is missing only during the first phase. We are giving your digestive hormones, liver, and pancreas a break from your typical diet. It is especially important to allow your blood sugar to be calm and stable. By not including starchy and sugary foods, you will ensure that you won't have blood sugar spikes. You will avoid the highs and lows that are typical of most eating patterns. This immediately calms your hunger.

Other side benefits that have been reported during the initial phase include reduction or elimination of gastric reflux, reduced "brain fog," and reduced symptoms of allergies. Because there are no grains, of course, this part of the plan is gluten-free. It does contain dairy since that is a key part of the DASH diet, but you can also choose dairy substitutes if that is a problem for you.

After this initial reset phase, you are ready for Phase Two, which is a lower-carb plan. You will have already learned to make your meals more satisfying with proteins, nonstarchy vegetables, and heart-healthy fats. In Phase Two, you get to add whole grains and fruits. You will continue to lose weight, although slightly more slowly after the initial reset phase. This becomes a plan that you can enjoy for the rest of your life.

CHAPTER 3