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A vitally important new book about a widespread condition we’re just beginning to understand
An estimated 20 percent of Americans (55 million people) are insulin resistant—and most of them don't know it! Their high carbohydrate intake is causing their bodies to become immune to their own insulin, and the resulting high blood sugar levels are increasingly linked to diseases and disorders, from Type II diabetes and heart disease to Syndrome X. Medical journalist Miryam Williamson,...
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A vitally important new book about a widespread condition we’re just beginning to understand
An estimated 20 percent of Americans (55 million people) are insulin resistant—and most of them don't know it! Their high carbohydrate intake is causing their bodies to become immune to their own insulin, and the resulting high blood sugar levels are increasingly linked to diseases and disorders, from Type II diabetes and heart disease to Syndrome X. Medical journalist Miryam Williamson, herself afflicted with insulin resistance (IR), draws on the latest medical studies and reports, explains the links between IR and each condition, and offers essential advice on making lifestyle changes that can control or even reverse IR.
Is What You Eat
Making You Sick?
The fact that we shop for food instead of collecting it inthe wild has a lot to do with the situation in which we findourselves today. Archaeologists have pieced together a fairly clearpicture of the health of our ancestors, the early human beingswho date from about 40,000 years ago. Based on their examinationof fossil remains, scientists know that these early peoplewere tall and lean, with well-developed, strong bones. There waslittle or no tooth decay, and barely any evidence of chronic disease.Other indications are that their diet consisted largely ofsmall game animals, birds, reptiles, insects, and eggs. Plantfoods—roots, berries, seeds, and nuts—supplied on average nomore than 25 percent of an individual's caloric intake, or energy.We can conclude from the condition of archaeological remainsthat this diet was good for those who ate it.
Cereal grains—the wheat, rye, barley, oats, corn, rice,sorghum, and millet on which most of the world's people todayrely for nourishment—were not used as food until much later.There is good reason for this. Cud-chewing animals such as cowsand sheep can eat all kinds of vegetation, because they have a secondstomach that contains bacteria capable of fermenting fiber.This enables them to extract the nutrients—proteins, carbohydrates,fats, vitamins, and minerals—in plants, twigs, seeds, andgrains, getting more energy from their food than they use to digestit.
Human beings cannot digest grains in their natural state.Thenutrients in plant foods are enclosed within cells whose walls ourstomachs cannot break down. If we eat whole, unprocessedgrains, they pass right through our digestive system and show upintact in our feces. To get nutritional use out of grain, we have togrind and cook them. Human beings who lived more than10,000 years ago couldn't do this, because the first grindingtools were found in the Middle East about 10,000 years ago.It's probably no coincidence that the agricultural revolution, inwhich people began to domesticate animals and cultivate cerealgrains and legumes (peas and beans), started first in the NearEast about 10,000 years ago and took some 5,000 years tospread to northern Europe. Without the technology for grindingit, there would have been no reason to grow grain.
The fossil record suggests that a variety of environmental pressuresmade it necessary to invent a new way of providing nourishment.Large mammals went extinct all over North America,northern Europe, and Asia at approximately the same time thatagriculture came into existence. By observing the life cycle ofplants in the wild, preagricultural humans may have known howto sow seeds and grow plants long before they started to do so,but as long as game was plentiful and populations were low,there was no motive to engage in farming.
Now, 5,000 or even 10,000 years seems like a long time, butin terms of human evolution it's more like minutes. People whostudy genetics tell us that the human genome (the entire set ofgenetic information present in each cell in the body) has undergonelittle change in the past 40,000 years. In other words, whenour ancestors stopped living as hunter-gatherers and turned toagriculture, their bodies failed to adapt to the lifestyle change.An abundance of scientific papers argue that wherever dietsbased on cereal grains replaced the primarily meat-based diet,there was an increase in infant mortality and a shorter life span.Infectious diseases, dental problems, iron-deficiency anemia, andsoft bones became more common.
It's interesting to contrast what we know about the diet andphysical health of preagricultural hunter-gatherers, who livedmore than 10,000 years ago, with the ancient Egyptians of about5,000 years ago, when agriculture was about 5,000 years old.The Egyptian diet consisted largely of breads, cereals, freshfruits, vegetables, olive oil, goat milk and cheese, some fish andpoultry, and hardly any red meat. The Egyptian diet closely paralleledthe one favored today in the Western world, except for refinedand processed foods. The techniques for refining sugar andremoving the vitamin-rich outer shells of grains did not exist.
Thanks to the Egyptians' custom, over several centuries, ofpreserving corpses as mummies, scientists have been able to learna great deal about the health and diseases of ancient Egypt. Manymummies have been found to have overlapping folds of skin, indicatingobesity. There is also evidence that dental problems andclogged and scarred arteries were common. Parasites and infectiousdiseases were widespread. Translations of Egyptian texts ofthe day describe many of these medical problems. Apparentlytheir diet did not serve them as well as the high-protein, low-carbohydratediet of the preagricultural human beings, some 5,000years earlier.
Present-day examples of the effect of lifestyle on human healthand appearance are plentiful. The Masai of East Africa are talland slim people who still live the nomadic life, living mainly onmeat and milk from the animals they herd, and picking suchgreens as they can find in the desert. A few generations ago, theaborigines of Australia and the Maori of New Zealand were justas thin and wiry. Then social and economic forces made themmove into the cities and adopt the ways of the dominant society,immigrants from England who displaced them, just as Americanshave displaced the indigenous peoples our ancestors found whenthey came to this continent. Now both the aborigines and Maoriare plagued with the same health problems as those whoselifestyle they have adopted.
Closer to home, the Pima Indians on the Gila River Reservationin central Arizona, a half hour south of Phoenix, are a distressingexample of what happens to a nation that departs fromits ancestral way of life. The Pima Indians have lived in the areafor about 8,000 years. They were nearly wiped out by diseasesbrought to them when the Spaniards came to the desert. Theirtraditional diet consisted of mesquite, cactus buds, prickly pears,and poverty weeds that grow in the desert. They hunted jackrabbit,mule deer, and white-winged dove. They fished in the GilaRiver and grew squash and beans in fields irrigated by river water.The nation endured countless cycles of drought and famine.It was a hard existence, but the people survived. In the early1900s commercial farmers upstream began diverting the GilaRiver for their own use, leaving the Pima with less and less water.By 1945 Pima Indians were almost entirely unable to live off theland. They began to eat a typical American diet.
There is nothing in historical records to suggest the Pima Indiansbefore 1945 were anything but normally healthy people. In1963 a research team from the National Institutes of Health descendedupon the Pima reservation to study rheumatoid arthritisamong the population. They intended to compare this groupwith the Blackfoot Indians of Montana, to see which group hadmore people affected by the disease. What they found was thatobesity was almost universal among adults, many people weighingmore than 400 pounds. The incidence of diabetes was 50 percent.In the general population of the United States it's a bit over6 percent. Blindness, circulatory diseases, and kidney failure—seriouscomplications of diabetes—were common. Scientists continueto study the physical makeup of the Pima Indians, but theanswer to their physical deterioration seems clear: drastic changesin diet and levels of physical activity have spelled disaster.
It's easy to blame a sedentary lifestyle alone for the prevalenceof overweight, but the role of diet shows up in east-central Africaamong the Hutu and Tutsi people of Rwanda and Burundi. Afew years ago war between these two nations caught the attentionof news media the world over. Because they lived so close toeach other, people who heard the news wondered aloud howcombatants could tell on sight who was friend and who was foe.The answer is easy. According to Michael Crawford and DavidMarsh, authors of Nutrition and Evolution, the Tutsi, historically,have been the masters and the Hutu their servants. Whilethe Hutu managed the cattle and tended the gardens, meat andmilk were reserved for the Tutsi. The Hutu lived on plantains,yams, and other starchy crops. They are short and squat; theTutsi are tall, lean, and graceful. There is no report of a differencein activity levels between the two groups, but the differencein diet is striking.
Conventional wisdom blames obesity on the consumption offat, particularly saturated fats found in foods derived from animalsources. But studies of the Inuit nations have shown the opposite.During the long arctic winters they eat nothing but meat,but they remain in good health. It is widely estimated that thetypical Inuit diet derives 85 or 90 percent of its total caloriesfrom fat, a large percentage of it from saturated fats. Yet chronicdiseases are uncommon among the Inuit.
If dietary fat is not the culprit, what is? At least a partial answermay be found in the typical North American diet, which relies soheavily on starchy foods. It wasn't always this way. Until the early1960s, a proper meal was thought to be centered around proteins.But dietary fashions change, along with the length of skirtsand the width of neckties. Gradually in the 1960s and 1970s carbohydrate-richmeals became fashionable. A number of studiesblamed heart attacks and strokes on dietary fat. Since fats are associatedwith proteins more than with vegetables, meat becamesuspect. Furthermore, many were led to give up meat by concernabout Third World poverty, reasoning that more people could befed per agricultural acre if the land was used to grow carbohydrate-richgrain crops rather than graze protein-providing meatanimals.
The low-fat, low-protein, high-carbohydrate trend attractedever more adherents, reaching its pinnacle in August 1992, whenthe U.S. Department of Agriculture's Human Nutrition InformationService, acting on the recommendation of the AmericanDietetic Association, promulgated a new guide to daily food intake(see appendix 1). This guide, depicted as a pyramid withcarbohydrates at its base, specifies that 55 to 60 percent of caloriesshould be derived from carbohydrate sources, and no morethan 30 percent from fats, leaving 20 to 25 percent of caloric intaketo proteins. This was a radical departure from the earlierprotein-dominant diet that the USDA had endorsed for generations.
In response to the new guidelines, health-conscious Americansaltered their diets. Pasta replaced steak as the preferred entreeon dining tables and even at banquets across the country.But the new guidelines did not have the desired effect of improvingAmericans' health. Instead, six years later in October1998 the American Dietetic Association announced the themeof its eighty-first annual meeting: "The Epidemic of Obesity."Calling it "a public health crisis that affects everyone," the association'snews release said, "Obesity contributes to more than300,000 potentially avoidable deaths each year.... Half thepopulation is overweight and a third is obese, according to thelatest federal guidelines. Obesity is a major risk factor for a heartattack. Children are affected, as are the elderly and everyone inbetween."
Still, the American Dietetic Association did not recognize thecorrelation between an increase in dietary carbohydrates andobesity. What seems to have happened is that after years of a dietthat demands large amounts of insulin for energy storage, manypeople had become immune to their own insulin, the hormoneprimarily responsible for turning food into energy. This strain onthe insulin-producing and -metabolizing mechanisms is of littleor no consequence for some people. But for those who are susceptibleto insulin resistance—various estimates set our numberat between 25 percent and 75 percent of the population—the resultsare dangerous, and can be devastating.
When you put food into your mouth, you initiate an extensiveand complex set of chemical reactions designed to provide you—yourbrain first, then the rest of your body—with nourishmentand energy. Digestion is the mechanical and chemical process ofbreaking food down into its individual components so they canbe absorbed. Metabolism is the transformation of those absorbedsubstances into materials for providing energy and buildingnew cells. The word metabolism comes from a Greek wordfor "change."
Nutrition science divides the food we eat into three categories,called macronutrients: proteins, carbohydrates, and fats.Proteins are mainly animal products: meat, fish, poultry, eggs,and cheese. Soy is high in protein and may be placed in this categoryas well. Fats may be saturated, unsaturated, or polyunsaturated(more about this later). Carbohydrate sources includefruits, grains, and vegetables. Some carbohydrates are high instarch, others are not. Fats may be composed entirely of fattysubstances, but few proteins or carbohydrates are purely proteinor carbohydrate. Meat, fish, poultry, eggs, and cheese all containfats to a greater or lesser extent, and even some carbohydrate.Carbohydrates may contain proteins and even fats. Nuts are agood example of a composite food. Some nuts are higher in fatand carbohydrate than others, but all three macronutrients arepresent in all nuts.
Each macronutrient provides some of the many nutrients—vitamins,minerals, amino acids, and fatty acids—necessary to sustainlife. The energy they furnish is measured in calories. In anadult whose metabolism is working properly, the amount of energyconsumed as food is roughly equal to the amount of energyspent. Such a person neither gains nor loses weight under ordinaryconditions. Insulin resistance, as we shall see, is a metabolicmalfunction in which the direct relationship between calories inand calories out is disturbed.
Among the macronutrients, proteins break down mainly intoamino acids, carbohydrates into sugars, and fats into fatty acidsand glycerol. Amino acids assemble themselves to replenish thebody's tissues. The average person requires about 300 calories'worth of protein each day—some 70 to 100 grams—to supplythe amino acids that the body can't make on its own, and about75 calories (a bit less than 9 grams) of linoleic acid, the only fattyacid that the body can't make by itself. These are the bare minimumrequirements. More calories are needed to provide energyfor metabolism and physical activity. It is generally accepted thata person of average size needs about 900 calories a day to sustainlife. Proteins and fats contribute to the making of hormones, thechemical messengers responsible for much of what goes on inour bodies. Carbohydrates provide energy, but so do proteinsand fats. In fact, carbohydrates perform no function that is notduplicated by proteins and fats. In other words, carbohydratesare not essential to human life.
It is true that carbohydrates turn into glucose, the simplesugar that provides energy to the cells. Glucose is created inplants by a chemical process called photosynthesis that requiressunlight. Plants then convert glucose into a variety of carbohydrates.Animals (human beings included) eat plants to satisfytheir need for glucose-derived energy. Human beings requireglucose to fuel the brain and red blood cells. Without it we develophypoglycemia (low blood sugar), an uncomfortable andsometimes dangerous condition (see chapter 4). Glucose is alsoused in a broad variety of structures in the body, including cellmembranes and DNA, the material of heredity. While we musthave glucose, we don't need to get it from plant foods. If there'snot enough glucose coming from carbohydrates, proteins willmake up the deficiency. Even stored fat can provide energy, althoughnot as glucose. The process by which fat becomes energyis known as ketosis. To sum up, while we can live without carbohydrates,we cannot live without proteins and fats.
Excerpted from Blood Sugar Blues by Miryam Ehrlich Williamson. Copyright © 2001 by Miryam Ehrlich Williamson. Excerpted by permission. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
|Part I.||Nutrition and Metabolism|
|1.||Is What You Eat Making You Sick?||7|
|Part II.||Diseases and Disorders Related to Insulin Resistance|
|3.||Heart Disease, High Blood Pressure, and High Blood Fats||35|
|4.||Glucose Intolerance and Hypoglycemia||48|
|Type 2 Diabetes||64|
|6.||Polycystic Ovarian Syndrome||69|
|Heartburn and GERD||78|
|Celiac Disease (Nontropical Sprue) and Irritable Bowel||80|
|Inflammatory Bowel Diseases||82|
|Part III.||Lifestyle Changes that Combat Insulin Resistance|
|12.||Getting Started with Low-Carb Eating and Exercise||117|
|What to Expect||121|
|Easing Your Way into the Low-Carb Lifestyle||128|
|The Glycemic Index of Foods||130|
|Substitutes for Sugar||136|
|Promoting Insulin Sensitivity through Exercise||139|
|Carbohydrates You Can Eat||142|
|13.||Ketosis, and Other Myths about Low-Carbohydrate Eating||145|
|Gout, Kidney Stones, and Kidney Damage||149|
|Depression, Chronic Anger, and other Mood Disorders||154|
|14.||Hidden Triggers of Insulin Resistance||156|
|Medications and Supplements||160|
|15.||Choosing a Low-Carbohydrate Eating Plan||166|
|Dr. Atkins' New Diet Revolution||169|
|The Carbohydrate Addict's Diet||172|
|Life without Bread||185|
|Which Plan Is Best for You?||189|
|16.||Miryam's Sample Menus and Recipes||192|
|Appendix 1.||How to Read a Nutrition Facts Label||203|
|Appendix 2.||Aids to Record Keeping||204|
|Daily Weigh-In Chart||204|
|The Food Diary||205|
|Diets and Diet Books||210|
|General Information Web Sites||210|
|Internet Mailing Lists and Archives||213|
|Internet News Groups||215|
Posted April 17, 2004
Miryam Williamson's book is well researched, well written and couldn't have come at a better time in my life. I've been suffering for years with unexplained body pain, headaches, blood sugar crashes, IBS ... the list goes on ad infinitum. Not until I read Blood Sugar Blues (in late February 2004) did I finally find answers to the mysteries of my health issues and can discuss this information with my health care professionals. Her comprehensive book details symptoms of insulin resistance (which I had never heard of) and clearly differentiates between Fibromyalgia and Chronic Fatigue Syndrome. I'm now adhering to a well-balanced, low carb diet and am feeling so much better. Shortly after changing my diet and living a far less driven life, I lost 14 pounds, am sleeping far better and the fatigue and body pain are barely noticeable. I'm convinced that I'm on the right track and will continue to improve.Was this review helpful? Yes NoThank you for your feedback. Report this reviewThank you, this review has been flagged.