Q. I am on my way to my goal weight…13 pounds down! My problem is I have hypoglycemia and frequently find myself with low blood sugar since starting my diet. Do you have any tips for keeping my blood sugar level up while eating low-fat foods?

A. First of all, congratulations on your success and keep up the good work! I have three suggestions for you.

First of all, watch your sugar intake. Many “low-fat” foods are actually very high in refined carbohydrates, which can send your blood sugar on a roller-coaster ride. This is the dreaded “Snackwell Syndrome.” So, try to choose foods that are low fat but also low in sugar. Use our «nutritiondata.com» to find foods that are both.

Secondly, be sure that you are getting enough fiber, in particular the “soluble” kind of fiber which is found in wheat bran, 100% whole wheat products, apples, oranges, leafy green vegetables, seeds, and nuts. Soluble fiber helps slow down the absorption of sugar from foods, which will keep your blood sugar levels steadier. Aim for a minimun of 30 grams of fiber each day.

Third, try to avoid eating meals and snacks that are all carbohydrates. Including some protein and/or fat with every meal will also help keep your blood sugar levels from bottoming out. So, instead of a piece of fruit, have a piece of fruit and some cheese or nuts. If you are making a meal of pasta and low-fat sauce, add some lean protein, such as a grilled chicken breast.

Let me know if these strategies help!

I attended a very interesting session this morning at the «www.nutritionandhealthconf.org» that I’m attending here in Phoenix, AZ. Dr. Daphne Miller, a professor of medicine at University of California at San Francisco, gave a presentation on her new book, «www.amazon.com»

Over the past ten years, scientists have spent a lot of energy investigating the world’s healthiest and longest-lived populations, trying to figure out what they are doing right. Why do they live so much longer and have vastly lower rates of cancer, heart disease, diabetes, and other diseases than Western countries? We’ve picked apart and analyzed the traditional diets and lifestyles of Okinawans, Cretans, Icelanders, Cameroons, Pima Indians, and so forth, in an attempt to codify, once and for all, the healthiest diet.

The problem, as Dr. Miller discovered when she travelled to all of these places to see for herself, is that health and longevity are about the only things that these cultures have in common. The robust Tarahumara Indians, for example, eat a diet of 80% carbohydrates (mostly in the form of starchy vegetables like corn and potatoes!), while the indestructable Cretans get almost 50% of their calories from fat. Some long-lived cultures eat almost no meat, while the hale and hearty Icelanders eschew vegetables as “animal feed” and eat large quantities of lamb and fish.

I can’t do justice to Dr. Miller’s entire argument in this short post (although I highly recommend checking out her new book), but she concludes that traditional diets work chiefly because they are based on the plants and animals that flourish in the local ecosystem, prepared and consumed in a way that has been fine-tuned by generations of trial and error to provide optimal nutrition for those people.

That’s not to say that only indigenous people will flourish on a particular traditional diet, says Dr. Miller. If you adopt ANY of these diets, she says, you will likely see an improvement in your health. Conversely, all of these incredibly healthy populations suffer from the “migration effect.” When they migrate to Western industrialized nations (or McDonalds inevitably sets up shop in their small village), within a few years, they invariably begin to show the same sorts of degenerative conditions that are routine in Westerners.

Despite the staggering differences between various, apparently “successful” indigenous diets, Dr. Miller has attempted to find the common threads. Among the key concepts she identifies: consumption of native grains, fermented foods, spices, and communal (unhurried) eating. But the differences still seem to loom larger than the commonalities.

A unifying concept that Dr. Miller didn’t mention is that all indigenous diets are composed of a relatively small list of foods. In most cases, about two dozen foods provide 95% of the calories–in some cases, fewer than a dozen! Compare this with the tens of thousands of food products we are confronted with at the grocery store. Hundreds of kinds of produce from every climate inn the world. Dozens of kinds of grains. Scores of protein sources. We think nothing of eating Indian food on Monday, Chinese on Tuesday, sushi on Wednesday, Latin-American on Thursday and Greek on Friday. And this got me thinking: Is a varied diet over-rated?

As a nutritionist, I myself frequently cite the advantages of a varied diet. First and foremost, you increase the range of nutrients you consume by eating a wide variety of foods, especially whole foods. Secondarily, you limit your exposure to toxins (natural or unnatural) that might be present in certain foods. It’s a cover-all-your-bases and hedge-your-bets sort of approach and one that always made sense to me.

On the other hand, some of these indigenous cultures remain in enviably good health on a diet of two or three vegetables, one source of protein and one or two kinds of grain. It makes you think, doesn’t it? For one thing, it is a fact that we tend to eat more when confronted with a large variety of foods than we do when we eat just one or two things at a meal. (Think of your behavior at buffets.)

I’m hoping to have a chance to catch Dr. Miller later in the conference to get her take on this (and I’ve got to run to the next session now), but in the meantime, what do you think? Could we improve our diets just by making them simpler?

If you had to choose just two dozen foods to make up your entire diet for a week, what would they be?

Editorial introductions.

Editorial introductions Current Opinion in Clinical Nutrition & Metabolic Care. 11(3):ix-xi, May 2008.

Computational modeling of cancer cachexia.

Anabolic and catabolic signals Current Opinion in Clinical Nutrition & Metabolic Care. 11(3):214-221, May 2008.
Hall, Kevin D a; Baracos, Vickie E b

Abstract:
Purpose of review: Measurements of whole-body energy expenditure, body composition, and in-vivo metabolic fluxes are required to quantitatively understand involuntary weight loss in cancer cachexia. Such studies are rare because cancer cachexia occurs near the end of life when invasive metabolic tests may be precluded. Thus, models of cancer-associated weight loss are an important tool for helping to understand this debilitating condition.

Recent findings: A computational model of human macronutrient metabolism was recently developed that simulates the normal metabolic adaptations to semi-starvation and re-feeding. Here, this model was used to integrate data on the metabolic changes in patients with cancer cachexia. The resulting computer simulations show how the known metabolic disturbances synergize with reduced energy intake to result in a progressive loss of body weight, fat mass, and fat-free mass. The model was also used to simulate the effects of nutritional support and investigate inhibition of lipolysis versus proteolysis as potential therapeutic approaches for cancer cachexia.

Summary: Computational modeling is a new tool that can integrate clinical data on the metabolic changes in cancer cachexia and provide a conceptual framework to help understand involuntary weight loss and predict the effects of potential therapies.

(C) 2008 Lippincott Williams & Wilkins, Inc.

Q. I know that I should get about 30 grams of fiber a day. What I don’t know is how much of this fiber should be soluble and how much should be insoluble. What is the exact difference between the two? Is there any difference in how these different fibers are used by the body?

A. There are a dozen or so different types of compounds that fall under the general heading of dietary fiber, including gums, pectins, lignans, beta-glucans, cellulose, etc. Nutritionists tend to categorize different types of fiber as either soluble or insoluble fiber, depending on whether or not the fibers will dissolve in water (soluble) or not (insoluble). The two have very different functions in the body.

Soluble fiber helps slow down digestion (which keeps you from getting hungry as quickly after a meal) and helps regulate blood sugar and cholesterol levels. A diet high in soluble fiber can help reduce your risk of heart disease, diabetes, and may help you lose weight. Good sources of soluble fiber include oranges, apples, carrots, oats and oat bran, psyllium husk, nuts, legumes, and flaxseed.

Insoluble fiber, on the other hand, is the type that helps prevent constipation, colon cancer and other digestive diseases. Good sources of insoluble fiber include wheat bran, corn bran, nuts and seeds, dark leafy vegetables, fruit and vegetable skins (for example, apple and potato skins).

The USDA doesn’t make a specific recommendations for how much of your fiber intake should be soluble or insoluble. I think your best strategy is to eat a wide variety of fiber-rich foods to satisfy your total daily requirements, thereby getting the best of both worlds.