SCIENCE OF An Educational Publication

An Introduction to a Physician’s Guide to Weight Loss

DR. PATRICK M. NEMECHEK, D.O.

Copyright 2010

21173 Elm Way, Verrado, AZ, 85396 • telephone: 913-948-4802 • fax: 866-480-0357 • www.SOH.com ABOUT THE AUTHOR

Dr. Patrick Nemechek is a board-certified Internal Medicine specialist who began his career managing the complexities associated with HIV as an Associate Professor of Medicine at the UCLA School of Medicine. He rapidly became one of the foremost experts in the man- agement of HIV-related weight loss, lecturing across the country and de- veloping one of the largest HIV medical practices in the Midwest.

As the success of HIV treatments progressed, Dr. Nemechek opened his research and treatment center to patients with a wide variety of general medical conditions such as Resistance, Autonomic Dysfunction, Diabetes, Hypertension, Sleep Apnea, Chronic Fatigue Syndrome and many other common aliments such as heart burn, low blood sugar, frequent urination, heart burn, chronic con- stipation and erectile dysfunction.

Dr. Nemechek has since become one of the leading specialists in the treatment of these common medical conditions. His approach consists of a combination of nutritional counseling and short term medical therapies which resolve the underlying dysfunction and often result in com- plete reversal of many of these medical conditions.

Download Dr. Nemechek’s resume by clicking here.

MEDICAL DISCLAIMER

All information contained within this book and on the Hunger of Science website (www.scienceofhunger.com) is intended for informational and educational purposes. The information is not intended nor suited to be a replacement or substitute for professional medical treatment or for profes- sional medical advice relative to a specific medical question or condition.

We urge you to always seek the advice of your physician or medical professional with respect to your medical condition or questions. As a recipient of information from this book, you are not establishing a doctor-patient relationship with a physician. There is no replacement for personal medical treatment and advice from your personal physician.

2 Introduction: Decrease Your Hunger and You’ll Decrease Your Weight

The Science of Hunger: A New Approach to Weight Loss

Most weight loss programs are primarily focused on reducing the consumption of calo- ries. Why is that? You don’t “choose” to eat extra calories every day. You eat extra calories because your brain is commanding you to eat. When you simply try to eat fewer calories your brain begins telling you that you’re hungry and you need to eat.

Constructing a weight loss program without addressing the brain’s excessive of hunger is as illogical as trying to avoid sleeping because you can get more work done in a 24 hour period. Over time with sleep as with hunger, the commands of your brain will ultimately win out.

The Science of Hunger Program focuses on teaching you to de- cease your hunger. You have a “hunger” problem, not an “eat- ing too many calories” problem. Once you’ve learned to decrease your hunger, you will naturally begin less and will start to lose weight.

Why Do We Use the Word Hunger?

Our brain receives countless signals from our body. Some signals strike our brain as pleasant while others make us feel uncomfortable. You may feel some foot because of a small pebble in your shoe, enjoy the pleasing smell of a flower or maybe sense a grumbling sensation in your stomach that you interpret as hunger.

You may think of the stomach grumbling as hunger only because eating makes the grumbling go away. While true hunger is the biological drive for , many other sensations will improve when you eat in spite of the sensations having nothing to do

3 with the need for nutrition. Just think of the times you’ve eaten soup or crackers to set- tle your stomach when you’ve been ill. You weren’t necessarily hungry, you often felt a little nauseated. The food reduced your nausea not because you needed nutrition but because of other biological effects food can have.

You often believe you’re hungry because your brain has learned that if you eat, this uncomfort- able sensation go away. It’s a cause and effect relationship. Feel grumbling... eat food... symptoms go away... therefore it must be hunger. Unfortunately, this string of logic is often wrong.

The grumbling you feel in your stomach often has nothing to do with your need for nu- trition and the reason the grumbling goes away after eating is not because you’ve in- crease some level of nutrient in your body. It goes away because food can have effects on our body’s functioning other than simply raising our blood sugar. The Science of Hunger Program is designed to help you understand the difference between real hun- ger and the symptoms that mimic hunger.

You’re Overweight Because Your Brain Is Too Hungry.

The primary reason you are overweight is not simply because you eat too much. You’re overweight because your brain is telling you to eat food that will make the symptoms you are experiencing go away whether or not you truly need nutrition at that moment.

In other words, you are overweight because your brain is too hungry. You don’t plan on over eating during the day. You over eat because your brain is ordering you to eat to make certain sensations or symptoms go away. Remember, we refer to these symptoms as hunger only because food makes us feel better but its often not true biological hun- ger. Your brain uses food almost like a medicine to make you feel better. Therefore,

4 your weight is really a reflection of your hunger.

Excessive hunger equals excessive eat- ing. Excessive eating equals excessive weight. Learn how to decrease your hunger and you will learn how to fi- nally lose weight.

Isn’t Calorie Reduction Important?

A reduction in calories is very important to the ultimate reduction in weight but making the primary focus is often futile. Although calorie reduction may seem like the logical first step to take, it often fails. Why am I so certain of this? Look at our population that is growing in size every year.

I speak with my patients everyday about the difficulties they have in losing weight. If it were simply a matter of eating less, almost anyone could lose weight by simply choos- ing to eat less yet that is not the case. I believe the conscious effort to reduce calories is an important aspect in weight loss but I believe it is an important refinement step much later in the process. One must first understand what components are driving them to crave in spite of recently having eaten a nutritious .

In other words, you first need to understand that much of the hunger you feel is really a mimic of hunger and learn how to eliminate them. Only after understanding you hun- ger mimics will the conscious effort of calorie reduction be successful journey rather than one filled with inadequacy and failure.

How Will The Science of Hunger Program Help You?

Have you ever eaten lunch only to feel hungry an hour or two later? How about the craving for food a few hours after eating dinner? Why should you feel hungry when you have just recently eaten?

5 The truth is you don’t need additional nutrition. You need to learn to correctly under- stand the sensations you’ve experienced and have incorrectly labeled as “hunger” over your life time. These false hunger sensations are often caused by certain foods we eat such as artificial sweeteners or processed sugars or symptoms of your body not func- tioning in a healthy manner often because of the excessive carbohy- drates you consume.

The Science of Hunger Program will teach you to identify and properly treat the many false sen- sations of hunger you experience throughout the day without eating food. You will experience a significant decline in your hunger level in a few short weeks.

As a result of your declining hunger, you will naturally not eat as often nor as much and will effortlessly begin to lose weight as well as feel healthier than you have in a long time.

Part 1: Stone Age Humans in a Carbohydrate World

Many of us go through life often taking many things for granted and forgetting that many seemingly commonplace aspects of our life are quite new. For example, it was only two decades ago when cell phones were a novelty and now they have become seemingly indispensable to our daily personal and work routines.

The same holds true for the foods we eat. The last 3-4 decades have seen a significant increase in the amount of processed carbohydrates into the average American . Mounting scientific evidence suggests the dramatic increase in carbohydrate consump- tion may be the primary cause behind the and diabetes epidemic in the U.S.

6 How can carbohydrates lead to an increase in obesity? Why now? What other factors might be at play? Understanding how we evolved as a species can shed some light on the present epidemic and help you to better understand the essential elements in the Science of Hunger program.

Stone Age Humans and Carbohydrates

Modern humans evolved from our Stone Age ancestors that lived within a hunter- gatherer society whose main sources of food were animal meat and plants. The animal meat provided a significant source of protein and fat while the plants they ate provided a significant amount of , minerals and fiber.

Scientists estimate that the Stone Age humans’ diet consisted of approximately 60% animal products and 40% plants with a relatively small fraction of simple carbohydrates that came from wild and honey.

Obtaining carbohydrates as part of the diet was difficult for Stone Age humans since carbo- hydrates are not found in abun- dant supply in the wild. It wasn’t until the agricultural revolution (the period when humans began learning how to farm and raise livestock) 5,000 to 10,000 years ago that humans began substantially increasing the amount of carbohydrates in their diet.

Ten thousand years is a relatively short time span considering the millions of years of evolution to produce humans in their present form. To put the time in perspective, if a 100-yard football field represented the entire time span of human evolution, the last 10,000 years would be represented in only the final ¼ inch of the field.

7 Scientifically speaking, a few thousand years is not much time for the human species to evolve and adapt to the increasing car- bohydrate consumption of mod- ern society. Carbohydrate me- tabolism evolution is even less likely considering that many human populations didn’t readily have a continuous sup- ply of carbohydrates in their diet until the last 100-200 years.

Simple table sugar was a precious and often expensive commodity only 100 years ago and often only the wealthy were able to consistently afford it in substantial quantities. Consequently, it was within in the last 1-2 centuries that physicians were beginning to recognize the ill effects these excessive quantities were having on their patients. Many physicians in the late 1800’s and into the 1900’s would often direct their patients to re- strict their intake of bread, sugar, potatoes and wine in effort to reverse their illnesses.

Modern Day Life and Carbohydrate Consumption

So where does this unprecedented increase of dietary carbohydrates leave us in the modern era? By some estimates, modern humans presently consume more carbohy- drates in a single day than Stone Age humans consumed in a year, and 30% more than we did just a few decades ago. A large proportion of this increase has been through the consumption of fructose often referred to as high fructose corn syrup.

Part of the reason for the signifi- cant increase in carbohydrate con- sumption is that carbohydrate-

8 based food products are becoming cheaper to mass-produce and are more convenient for the consumer to obtain and prepare.

An additional significant factor has been the low-fat eating recommendations put forth by U.S. government health agencies and the medical community. Although effective at substantially reducing the per capita consumption of fat, the low fat dietary recommen- dations have lead to a reduction in the frequency of protein consumption as well as an increase in carbohydrate con- sumption of approximately 20-30%.

Remember what the typical breakfast was in the 1940’s or 50’s (if you aren’t old enough to remember, ask your parents or grandparents)? Often it was eggs, with steak or bacon or a cut of ham. If it was oatmeal, it wasn’t the highly processed kind we have today and was often also served with eggs or bacon. Protein was often a major part of breakfast as well as of the other in the day. How much protein do you consistently eat during the day?

Modern Manufacturing and Carbohydrates

Aside from making carbohydrates inexpensive and convenient, modern agricultural and manufacturing techniques are producing a wide range of carbohydrate food prod- ucts that have been so highly processed that they have very little of the food’s natural fiber content. The reduced fiber content causes modern processed carbohydrates to have an even greater unhealthy affect on our metabolism and health.

For example, many forms of instant oatmeal have lost so much of their protective fiber that they increase your blood sugar as rapidly as simple table sugar. Unless you are eat- ing oatmeal which takes 30-40 minutes to prepare, your modern quick-cooking oatmeal

9 is no longer the healthy, warm breakfast food you grew up with and bears little resem- blance to the nutritious breakfast food the manufacturers use in their advertising.

Another measure of how processing has altered the nutritional value of foods is the in- creasing calorie density of food. This can be measured as the number of calories per pound of any given type of food. A shocking example of this is what happens to corn as it goes through modern food processing.

One pound of corn directly off the cob contains approximately 450 calories. Now grind this up a bit and turn it into a modern corn tor- tilla and you have increased the calorie density to an impressive 1000 calories per pound. Let’s take this a step further and convert the corn into commercial tortilla chips. The calorie density of tortilla chips has been condensed to a whopping 2450 calories per pound!

That doesn’t even consider the dip we would scoop up and eat with the chip. With this kind of increase in the calorie density of our foods is it any surprise that the modern carbohydrates many of us eat are contributing to our weight problem?

The result is a confluence of factors leading to a significant increase in highly processed carbohydrate consumption in the U.S. that many believe is the primary cause of the obesity and diabetes epidemic.

There is also an alarming trend in a wide variety of other illnesses being triggered by a metabolic disorder known as Insulin Resistance. Insulin Resistance is responsible for the development of many kinds of cancer, heart burn, diabetes, premature heart disease and stroke, sleep apnea, liver disease, high blood pressure and osteoarthritis. Growing amounts of scientific evidence suggest that Insulin Resistance is caused by the dietary intake of carbohydrates in the American diet.

10 Principles of The Science of Hunger Program

Evolution has given us very sophisticated mechanisms to survive millions of years as a species. Stone Age humans didn’t know what variety of foods were healthy for them nor did they understand how much they needed to eat or drink in order to survive.

Their subconscious brain would trigger cravings for certain kinds of foods for the nutri- ents that they contained. Likewise, Stone Age humans didn’t understand that they needed to drink water to survive but their subconscious brain did and would make them feel the sensation of whenever they required more fluid.

The same is true for the en- ergy (calories) their body needed and the amount of body fat that was advanta- geous for them to survive.

The hunger sensation that is produced by our brain is the driving force determining how much we eat at any particular time. The hungrier we are, the more we eat. The more we eat, the more weight we gain. The opposite is true as well. Decrease your hunger and you will eventually decrease your weight.

The Science of Hunger Program teaches you about how your brain’s sense of hunger can be reduced by harnessing mechanisms we’ve developed through evolution. You will learn how you can lose weight and become healthier by simply choosing foods that maximize these powerful hunger-suppressing signals.

You will also learn that there are certain types of foods that increase your hunger caus- ing you to eat more than your body requires. These foods alter the normal hunger con- trol mechanisms of our brains and force us to feel hungry in spite of already eating enough food. These foods also harm our neurological system and lead to symptoms that mimic hunger.

11 The Science of Hunger Program doesn’t require any fancy menus, vitamins, strange foods or herbs like many other programs do. Most weight loss programs force you to eat a wide variety of foods and recipes that are not a part of your nutritional back- ground or culture. You may lose some weight at first but after a while many people slowly drift away from the program foods or recipes and many of us will go back to eat- ing the foods we prefer and are familiar with. Most typical weight loss programs never teach you how to eat the foods that are part of your nutritional culture in a healthy bal- anced manner.

With the Science of Hunger Program, you will learn how to recognize the difference be- tween protein, carbohydrates and fats and understand how you need to shift the bal- ance of eating predominantly one type of food to another. The secret to losing weight is not in eating different foods but in eating the foods you enjoy in different proportions and at different times of the day.

By simply eating more protein and low carbohydrate vegetables and reducing our in- take of processed carbohydrates, you will decrease you hunger and begin losing weight without “going hungry” or feeling like you are “starving to death.” Again, focusing on decreasing hunger, leads to a decrease in weight.

The secret lies in increasing pro- tein and reducing the amounts of carbohydrates in your diet. This will limit the triggers that artificially increase your hunger beyond your normal biological need for energy and nutrition.

It’s true and it works. One of my diabetic patients was in my office for a follow-up visit recently and didn’t want me to tell him how much he weighed that day. He said he hadn’t been focusing too much on trying to lose weight and thought I’d be disap- pointed in him. To his surprise, he had lost 12 pounds in 3 months! He didn’t under- stand how that could be true.

12 It occurred because he had shifted his food choices enough that his hunger had de- creased from its previous level. Because his hunger was less, he was subsequently eat- ing less and losing weight. He thought he hadn’t done well because he wasn’t strug- gling with the hunger he was familiar with on typical diets.

His previous attempts at weight loss were based on a low fat strategy for weight loss. Unfortunately, this strategy often leads to an in- creased level of hunger due to decreased protein (because a reduction in protein often accompanies a reduction in fat) and increased carbohydrate consumption.

Low fat is the reason people have shifted away from eating eggs and bacon and started eating more cereals, bagels or yogurt for breakfast. The low fat diet idea was why people began eating a baked potato or a salad without protein for lunch instead of having some form of meat. It shifted all the eating choices in the worst possible direc- tion and is one of the main causes of the obesity epidemic.

So get ready to begin to change your health, your weight and your future.

13 Part 2: Protein: Nature’s Suppressant

Stone Age Humans and Protein

As we previously discussed, you were designed through evolution to function as a Stone Age human who ate large amounts of animal tissue (meat and fat) and dark green leafy plants that were high in fiber and low in carbohydrates. It has only been a few thousand years since we have evolved culturally from a hunter-gatherer society to the modern society we live in today. As science continues to better understand our physi- ology nutritional needs in evolutionary terms, we are beginning to better understand the biological mechanisms that naturally control our hunger.

The proportion of protein you eat through the day has a great influence on your level of hunger and is one of the most powerful hunger suppressing components of the Science of Hunger Program. Simple put, you need to eat more protein and less carbohydrates throughout the day than you are accustomed to.

To better understand these evolutionary principles, we need to better understand some basics of nutrition. This chapter will briefly discuss what protein is and how it affects our hunger. We’ll discuss carbohydrates in the next chapter.

What is Protein?

Protein is a large molecule made up of a series of connected building blocks called amino acids. The primary source of protein in our diet comes from animal meat (any living creature that walks, runs, flies, swims or crawls), dairy products or any one of the wide varieties of beans.

When we eat protein, the digestive process breaks up the large protein molecule into individual amino acids that are absorbed by the small intestine. The digestion of pro- tein results in a fairly rapid increase of amino acids circulating within our blood stream that may last for 3-4 hours. Below is a list of some of the common sources of protein in the American diet.

14 COMMON SOURCES OF PROTEIN

Beef Pork

Fish Chicken

Eggs Dairy Products

Lamb Wild Game

Beans Shellfish

Our body is constantly breaking down the wide variety of food we eat into the basic components of sugars, simple fat molecules, vitamins, minerals and amino acids. These nutritional components are absorbed and used in a wide variety of cellular and meta- bolic reactions. If these nutrients are not needed at the moment, they can all be stored often for weeks or months for future use by the body. The ex- ception would be amino acids that come from protein.

Many of these amino acids are used for a wide variety of chemical reactions that help to fuel and maintain the cells of our body. Some of the amino acids are used to build or main- tain your muscle while other amino acids are used to help our metabolic machinery function normally. If the amino acids in the blood stream are not used within a few hours after absorption for your metabolic machinery, they will be converted into fatty acids and stored in your fat for future use as energy.

Unfortunately, the only 2 ways your body can obtain amino acids is through the diges- tion of recently eaten protein or to breakdown your own muscle tissues to release the

15 amino acids stored within them. What is the effect of not eating enough protein and what can we do to maximally maintain our muscle mass?

The American Protein Experience

The burning of human muscle between meals to release stored amino acids is a com- mon process that happens to every one of us and is quite normal. The problem with this arises when you don’t eat enough protein through the day, thereby exposing your body to extended periods of muscle breakdown to obtain the amino acids essential for your metabolism.

Most Americans’ daily diet has so little protein that many of us have less muscle than we should. We don’t eat nearly enough protein and what we do eat is not distrib- uted evenly throughout the day.

Commonly, the bulk of your dietary intake of protein occurs during one meal of the day, often dinner. Your body can only process so much protein at any given time. Generally, eating more than 50-60 grams of protein at each meal only results in the excessive protein being converted into fatty acids and stored in the body as fat.

Scientific studies show that eating as much as 20-30 grams of protein per meal, three times daily can significantly suppress your biological hunger and increase the amount of muscle your body carries. This has the benefit of improving your energy, stamina and balance without even exercising. By maintaining a more even distribution of pro- tein intake throughout the day, you minimize unnecessary muscle breakdown, maxi- mize your natural muscle mass and decrease your level of hunger.

16 To put this in perspective, the average person should eat 20-30 grams of protein for breakfast and lunch. This is a significant change from most of our breakfast routines considering an egg is only 6-7 grams of pro- tein. It is equal to the amount of protein in an average-sized chicken breast or medium-sized piece of steak or pork chop.

The and the American Diet

If you need so much more protein than you are getting, why does the food pyramid place protein just below the top most rung where it seems to represent a smaller amount than carbohydrates?

The short story is that the food pyramid was con- structed with the principle of providing the most cost effective amount of protein to meet minimal standards of growth. It was based on the science of animal hus- bandry and is the same principle ranchers use to cost- effectively fatten their cattle without spending excessive money on cattle feed.

The fundamental focus of the first food pyramid was how to adequately feed a large portion of the American population as cost-effectively as possible. Since protein tends to be the most expensive food source, it is recommended sparingly and has been given the smallest share of importance. It was not designed for optimal nutrition of the population and at the time it is was created little was known about optimal protein in- takes.

17 Science is teaching us that the minimal amount of protein recommended by the USDA is just that, the minimum amount required to prevent . The optimal amount of daily protein required by the human body continues to be clarified by scientific stud- ies. At present, we know that many of us are not eating enough or are not getting the most out of the protein we eat because we are often eating too protein much at one sit- ting. Studies are also clarifying the fact that consuming very large quantities of protein is not harmful to your health.

How Protein Affects Our Hunger

Protein is the most effective hunger suppressing food in your diet. The reason behind this is found in studies examining the diets of Stone Age humans.

As we noted earlier, the diet Stone Age humans consumed over millions of years of evo- lution is estimated to consist of ap- proximately 50-60% animal prod- ucts (meat and fat) and 40-50% plants (non-digestible fiber). The plants were predominantly a green leafy variety often referred to as browsing foliage.

Their annual consumption of car- bohydrates was very low and mainly came from the occasional intake of honey or wild . Fruits and grains don’t grow with much frequency in the wild except for some small select areas of the world. When was the last time you ran across a random apple tree in the woods?

This means that as we evolved, the specific evolution of our biological hunger and en- ergy mechanisms were based on a diet that consisted primarily of protein and plant fi- ber. As discussed above, the digestion of protein results in a rapid increase in blood levels of a variety of amino acids. The rise in amino acids results in an effective and sus- tained suppression of our hunger. The fiber in plants triggers the other primary mecha-

18 nism for suppressing our hunger, the fullness we experience with the distention of our stomach. The primitive, Stone Age portion of your brain developed methods to shut off your hunger as amino acids are released in the blood stream and as your stomachs stretch with the addition of fiber.

But what happens when you don’t get a consistent supply of protein throughout the day? Your brain interprets inconsistent protein intake from a Stone Age human per- spective. Your brain thinks there isn’t enough food available in the environment when amino acids aren’t frequently being released into the blood stream.

Stone Age humans might die of if they found themselves in an area with lit- tle protein (or as their brains would experience, small amounts of amino acids being re- leased into the blood stream). Therefore, our inconsistent protein intake triggers an overeating reaction I refer to as the Gorge Reflex.

The Gorge Reflex is a biological response of overeating when protein intake is limited. In other words, you don’t simply eat till your normal amino acids and stomach- stretching signals tells you to stop, you over eat often in order to store an ample excess of food on your bodies so you don’t die of starvation. The Gorge Reflex is felt to be a compensatory survival response for a periodic unstable food supply.

When you eat ample amounts of protein (20-30 grams per meal, 3 times per day), your hunger becomes naturally suppressed and you eat less throughout the day. When you eat less protein than this, the Gorge Reflex kicks in, stimulates your hunger and you over eat.

19 One can easily imagine how during times of dangerously unstable food supplies, the Stone Age humans who gorged on available food would out-survive others who didn’t over eat. This is believed to be the evolutionary basis behind the phenomena of over eating in the evening if you haven’t eaten much protein during the day. It is also the underlying concept to include protein in 3 meals per day to avoid becoming over- weight.

20 Part 3 How Processed Carbohydrates Fuel Your Hunger

The Basic Science of Carbohydrates

What are carbohydrates, how do they increase your hunger and how do they cause you to become overweight? Carbohydrate is the term for a wide range of molecules that are often categorized as starch, sugar or fiber. They usually are derived from plant leaves, roots, seeds or fruit. A few exceptions to this rule are honey and the sugar found in animal milk.

Sugar is a small molecule (see molecular structure of glucose to the left) that comes in many forms (glucose, fructose, su- crose, lactose) and all types of sugars can eventually be stored as fat or burned as a source of fuel for our cells.

Starch is a term for a molecule that is a long chain of smaller sugar molecules hooked together to form a single long mole- cule (see below). Starches are digested in our intestinal tract into individual sugar molecules and then absorbed into our blood stream. These long chains of sugar molecules are more slowly digested and released into the blood stream. Because of their slow digestion, they often result in a slower and less intense rise in our insulin levels.

Complex carbohydrates are simply another term often used to describe starches. Think of starches and complex carbohydrates as a time-release form of sugar or energy for the body.

21 Fiber

Fiber is a term given to carbohydrates (commonly starches) that cannot be digested by humans. A simple example of this would be the fiber in common grass. Now we wouldn’t think of eating this for dinner because we do not have the proper digestive enzymes to break this down into simple sugar molecules. But animals such as cattle, deer or goats produce a special enzyme that allows them to digest common grass, con- vert it into sugar, absorb the sugar and burn it as a source of energy.

All the vegetables and grains (wheat, oats, etc) that you eat contain varying amounts of indigestible fiber. The phrase, ‘processed carbohydrates’ refers to starches and sugars that have been manipulated through manufacturing processes that destroys the natural fiber that comes with the natural form of many foods.

NATURAL FORM PROCESSED FORM

Fruit Fruit Juice

Corn Tortilla Chips

Whole Grain Flour Processed Flour Products

Cow’s Milk Yogurt

Steel-Cut Oatmeal Instant Oatmeal

The lower fiber content causes the byproduct of carbohydrate metabolism, sugar, to be more rapidly absorbed through the intestinal tract. The rapid absorption results in higher spikes of blood sugar and insulin. The higher spikes in insulin from these processed carbohydrates lead to a false and unneeded increase in your sense of hunger. The increased hunger drives you to eat more and consequently weigh more.

Stone Age Hunger Control versus Modern Day Carbohydrates

As the modern carbohydrate supply becomes more processed, your body is experienc- ing ever increasing levels of hunger from the intense spikes of sugar and insulin in your blood stream. The elevated forces your body to produce higher and higher levels of insulin to maintain a normal level of blood sugar. The degree to which

22 your body produces insulin to normalize blood sugar levels is represented by a measure known as the Glycemic Index. The Glycemic Index tells us relatively how much insulin certain foods require to return the body’s blood sugar back to normal as compared to other foods.

A high insulin level causes the suppres- sion of another im- portant called . Glucagon’s role in the body is to communicate to the brain about how much body fat you have stored. When you have ample body fat, your glucagon levels are elevated and this suppresses your level of hunger.

The higher your insulin level is raised from processed carbohydrates, the lower your glucagon levels will go. Therefore, when you eat highly processed carbohydrates sev- eral times a day as most other Americans do, your insulin is increased, your glucagon level is suppressed and consequently your hunger increases. The result is you lose the effect of one of the body’s most potent appetite suppressants, glucagon. Scientific stud- ies illustrate this point very nicely.

One such study fed a group of teenage boys a high glycemic breakfast and lunch and compared them with another group of boys fed a low glycemic breakfast and lunch. The boys spent the entire day in a research center where there was a constant supply of food available for them to eat throughout the day. Researchers monitored the amount of calories the boys consumed over a 12-hour period.

The boys who ate the high glycemic meals ate an astounding 83% more calories in 12 hours than did the boys who ate low glycemic meals. This study nicely illustrates how high glycemic, processed carbohydrates ultimately increase your hunger.

23 In the end, it’s the combined effect of the large amount of carbohydrates consumed and the high degree of processing that these carbohydrates have undergone that leads to an increase in your sense of hunger. Just think how this might be affecting you in your daily life.

Good Carbs and Bad Carbs

Now that we’ve learned that the excessive consumption of carbohydrates is dangerous for our health, I want you to understand that are some very healthy forms of carbohy- drates that you can eat without excessively stimulating your hunger (see the list of lower carbohydrate vegetables and fruit in Appendix I and II that I recommend you preferentially incorporate as part of your diet).

A common mistake my patients make is to slip into what is called ‘black and white thinking’ and act as if all carbohydrates are unhealthy. This is absolutely not true. I be- lieve you should do your best to minimize the processed carbohydrates in your diet such as soda, juice drinks, flour, white rice, potatoes and some processed dairy products such as ice cream and many popular forms of yogurt.

You should also work towards increasing the more natural forms of carbohydrates that still contain fiber such as eating an apple instead of drinking apple juice. Did you know that a large glass of orange juice contains the juice of 6-8 oranges! We all know fruit is healthy for you but would you ever eat 8 oranges at one sitting especially when all the protective fiber has been removed? I don’t think so.

If you are wondering if a certain carbohydrate is processed or not, a good rule of thumb is the more convenient the food is to prepare (frozen dinners or instant meals), the sweeter it is (flavored coffee drinks or yogurts) or the more removed it is from its natu- ral state (corn tortilla chips, white wheat bread or apple juice), the more you should as- sume it contains processed carbohydrates and little fiber. Remember, the more processed the carbohydrate, the more strongly it will increase your hunger.

24 To make matters worse, many prepackaged foods have added sugars that come in many forms with many different names (see the following table for examples of various added sugars). If you are trying to limit your carbohydrate intake, simply read the nu- trition information label. The total of amount of carbohydrates in the food will be listed per serving.

Be certain you determine the number of servings you might be eating; the servings per container is also listed at the top of the nutritional information label as well. You often have to multiply the ‘total carbohydrates per serving’ by 1.5 - 3 times the amount listed to arrive at the total amount of carbohydrates you commonly consume in a single sit- ting.

NAMES OF ADDED SUGARS

Brown Sugar Inverted Sugar

Corn Sweetener Lactose

Corn Syrup Maltose

Dextrose Malt Syrup

Fructose Molasses

Fruit Juice Concentrate Raw Sugar

Glucose High Fructose Corn Syrup

Honey Syrup

Sucrose Sugar

There are many sources of healthy, unprocessed carbohydrates (see Appendix I and II) that provide many important vitamins and minerals. You need natural carbohydrates in your diet because in their natural form, fruits and vegetables are excellent sources of vitamins and minerals.

You just need to be careful you don’t eat too many carbohydrates in your diet because too much of even natural, healthy carbohydrates can result in the associated with insulin resistance.

25 How Many Carbohydrates Are Too Much?

So what should you reduce your total daily carbohydrate intake to? The average American diet now consists of 50-60% of calories from carbohydrates, and many highly processed carbohydrates at that. Scientific studies suggest that you can greatly improve your health if you reduce your carbohydrate intake to approximately 20-25% of your total daily caloric intake. This is equal to about 100 grams of carbohydrates per day for women and 125 grams per day for men.

Start by reducing the larger amounts of carbohydrates from your diet; the frequent serv- ings of potatoes, rice and pasta and eliminating the sugar-containing drinks from your diet. If it seems overwhelming, simply pick one food item at a time. Eliminate sugar contain drinks such as soda, sport drinks, sweetened tea, fruit juice and flavored coffee drinks. Focus on drinking mainly water or unsweetened tea and coffee.

Artificially sweetened drinks have their own health concerns but I’d rather have some- one temporarily switch to artificially sweetened drinks that continue consuming sugary drinks that consistently spike your insulin levels. Natural artificial sweeteners are not believed to be any less risky that unnatural forms.

The Health Benefits of Carbohydrate Reduction

In some people, a condition of abnormal metabolism develops that causes muscle and liver cells to not respond as readily to insulin and the body has to create higher and higher levels of insulin to maintain a normal blood sugar. Doctors refer the metabolic abnormality that causes escalating levels of insulin as Insulin Resistance.

26 Insulin resistance increases the risk of medical conditions such as:

• An increase in intra-abdominal fat • Damage to the autonomic nervous system causing heart burn, fatigue, lighthead- edness and urinary frequency. • Inflammation and narrowing of the blood vessels • Elevated blood sugar leading to Type II Diabetes Mellitus • Low HDL cholesterol levels (the “good” cholesterol) • Elevated Triglycerides • High blood pressure leading to Hypertension • Increase risk of strokes and heart attacks • Sleep Apnea • Acne • Breast, Colon and Prostate Cancers • Polycystic Ovarian Disease • Skin Tags

Reducing your carbohydrate intake to 20% of your total caloric intake provides a dra- matic improvement in the diseases arising from Insulin Resistance. Your triglyceride

27 and HDL cholesterol levels improve, your blood pressure will be greatly reduced and your blood sugar levels will normalize as your body’s response to insulin improves.

This level of carbohydrate reduction has been calculated to be 6-10 times more powerful in reducing your the risk of cardiovascular disease than do the common statin medica- tions that are commonly used to lower a persons LDL cholesterol levels. An extremely large study recently concluded that statin medications are ineffective at preventing heart attacks in individuals who have never had one before.

Why treat these conditions with a growing list of medications when you can prevent and even reverse them with by simply reducing your carbohydrate intake?

Why You Don’t Have to Eat to Keep Your Blood Sugar Up

Our Stone Age ancestors were constantly exposed to the risk of an inconsistent food supply and might go several days or weeks without eating. Because of this evolution- ary need, you have an internal regulatory system that is able to produce all the glucose and energy necessary to maintain your blood sugar and fuel your body without con- tinually eating.

I bring this up because it is a common misperception that your blood sugar may decline if you don’t consistently consume nutrients, especially carbohydrates. Your body can produce all the blood sugar it needs from tissue sources such as the amino acids stored in your muscles or the fatty acids stored in your body fat.

Many patients mistakenly assume they need to continue eating through the day because they will feel shaky, nauseated and weak or have a grumbling stomach if they don’t eat and the symptoms likewise improve with food. These symptoms are often due to a mild underlying medical condition triggered by excessive carbohydrate ingestion that will resolve with a reduction in their carbohydrate intake.

A simple example to prove this point is the fact that all over the world, there are count- less millions of unfortunate individuals who do not have enough to eat on a regular ba- sis. If these individuals needed a constant intake of food to maintain their blood sugar, they would quickly be in severe medical trouble. But in fact, as limited as the nutri-

28 tional resources are for many people of the world, they do not experience symptoms of low blood sugar because of their minimal food intake.

Another example is the wide variety of religions that incorporate a ritual in their services or holidays. The rituals wouldn’t have been maintained over many centuries if humans needed to maintain their food intake to maintain a constant blood sugar level.

Why Is It So Hard To Cut Back Carbohydrates From Our Diet?

Although modern carbohydrates are produced as pleasant tasting products, you also prefer processed carbohydrates because they have an emotional and even addictive ef- fect that has been shown to be quite strong in some individuals.

Many of the carbohydrates have been blended into very pleasant tasting food products that stimulate the pleasure center in the deep part of our brain known as the hypo- thalamus. These pleasure signals are very powerful and can lead to an emotional and comforting attachment to certain foods.

We often use the phrase “comfort foods” to describe foods that give us that emotional pleasure that goes beyond simply tasting pleasant. So it can feel as if we have lost a friend or part of our emotional supportive network when we are deprived of certain foods. It can be difficult to limit these foods but as I will describe in the Science of Hun- ger program, it is not necessary to completely give up all of your comfort foods. You need to simply decrease how frequently you consume them.

Limiting Carbohydrates as Part of Your Daily Routine

Now take a minute to think about your diet or that of your children. How many times do you mindlessly drink soda, have bread with a meal, eat cereal or a bagel for break- fast, a latte with a few pumps of sugary flavor or a snack in the afternoon? It’s more often than you probably can recall. You developed these habits because society has provided you with highly processed carbohydrates as convenient and inexpensive choices.

29 Whether you feel it or not, these processed carbohydrates only serve to increase your body fat and to increase your level of hunger later in the day. The effect is often very subtle and amounts to only a difference of a few hundred additional calories per day. Although these amounts may not sound like much, these extra calories translate into slow but steady weight gain over time.

Many of us have experienced or heard others complain of the rebound hunger that oc- curs from processed carbohydrates. This is why some people complain that they don’t eat breakfast because it just seems to make them hungry within a few hours. Has that ever happened to you?

Remember, every time you eat processed carbohydrates, you end up confusing your brain into thinking that you’re still hungry and that you need more food. Avoid eating processed carbohydrates by minimizing carbohydrates that come in ready to cook con- venience meals or are served up in restaurants or fast food establishments.

This isn’t necessarily easy at first. You’ve been trained to eat certain foods because they’re inexpensive or convenient and they’ve been prepared to exceptionally good. These very same foods should be viewed with caution as they can distort your normal biological hunger mechanisms and are probably the primary reason you may have trouble controlling your weight.

In addition, many of us have grown up in household a where cooking was neither en- joyable or common. Having to learn to grocery shop and prepare some of your own meals can be quite an intimidating challenge. Just tackle small and simple meals such as scrambled eggs for breakfast or pork chops cooked in a skillet for dinner. You don’t have to cook like a professional chef to enjoy inexpensive, healthy, high protein, low carbohydrate meals.

Tips for Carbohydrate Reduction

How about breakfast? How often do you either skip breakfast or have a grain based item such as cereal, oatmeal or a bagel for breakfast? Simply try to have a high protein

30 item such as eggs and bacon, an omelette, a protein drink or a left over piece of chicken, pork chop or steak from the night before for breakfast more often.

As far as lunch goes, if most of us would avoid having bread, fries, chips or soda and instead eat a sizable portion of protein, we would go a long way towards reducing the amount of processed carbohydrates in our diet. If you eat out often for lunch, this means you’ll be eating just the meat and cheese in your deli sandwich, only the meat patty in your burger or always including salmon or chicken on your salads.

Even if you don’t replace all the processed carbohydrates in your diet with more natural complex carbohydrates, you will experience a marked improvement in your health and reduction in your hunger by simply decreasing your intake of carbohydrates to half of your usual intake. Reserve eating potatoes, rice, pasta, chips or ice cream for special oc- casions rather than allowing them to remain a routine part of your diet.

I find one of the most difficult aspects of decreasing your carbohydrate intake is finding alternative, high protein-based foods that are convenient to purchase or prepare.

You may also need to find another means to reward yourself instead of through food. Invest more time in yourself with an activity that provides you with an increased sense of personal satisfaction.

Many people pour all their energies into their family and work, only to reward their ef- forts with pleasant tasting, high carbohydrate, high caloric foods. This is not a hunger issue, this is an issue of emotional emptiness that needs to be filled with enjoyable ac- tivities other than food.

An additional reason why it is difficult to reduce our carbohydrate intake has to do with a form of chemical addiction. When the human body is chemically addicted to a sub- stance, it will go into what is referred to as a withdrawal state when the substance is discontinued.

The withdrawal state is often associated with a rebound of adrenal that can cause a rapid pulse, increased blood pressure, irritability, nervousness and insomnia.

31 This release of adrenal hormones often last only 1-2 weeks and can be seen with a vari- ety of chemical withdrawal states from substances such as tobacco, alcohol, narcotics and even processed carbohydrates.

The Food We Eat Now, Affects Our Hunger Later

Taking control of your hunger requires making deliberate choices. It requires a con- scious effort to eat a high protein breakfast and lunch, to prepare a healthier balance of foods for dinner and maybe even trying some foods that you have never even consid- ered eating before. As an example, when was the last time you thought about cooking mushrooms, brussel sprouts or eggplant for dinner?

Generally, you can continue eating foods that are part of your own nutritional culture, the foods of your childhood. You can continue to eat these foods but you need to de- crease the quantity and frequency with which you indulge yourself.

There is a couple I’ve been working with from Central America. They are both over- weight, have diabetes and high blood pressure. They were very concerned that they were not going to be able to eat the foods from their native country. They worried that I was going to “take their tortillas away.”

Their weight and medical problems have little to do with eating tortillas or their other cultural foods. Their health problems were due to the large amount of common high carbohydrate American foods in their diet and had little to do with foods from their na- tive country. They ate very little protein at breakfast and lunch and supplemented their diet with convenient, high carbohydrate dinner items. The weight and medical prob- lems had little to do with their native foods and almost everything to do with the un- healthy foods commonly consumed in America.

32 Part 4 The 8 Basic Triggers of Hunger

Hunger: Biological, Mimicked and Stimulated

As I’ve previously stated, not all sensations relieved by food constitute hunger. Don’t get me wrong, we do have true biological hunger cravings but these are mainly driven by the amount of protein we eat and amount of body fat we have stored on our body.

For those of us struggling to lose weight, many of the sensations we attribute to hunger throughout the day are symptoms of abnormal metabolic and physical symptoms that improve with the ingestion of food. These are the symptoms that I refer to as the Mim- ics of Hunger.

Another cause of increased hunger is when you increase your frequency and intensity of exercise in an attempt to burn off more calories. Many patients are surprised to learn that most scientific studies indicate that increasing your level of exercise during a weight loss program only serves to slow down your rate of weight loss.

Fortunately, understanding the source of each of our sensations of hunger is the key to losing weight. It is quite simple to isolate and eliminate many of these nonbiological hunger symptoms. Reducing your hunger will result in a reduction in your weight, it’s that simple.

The 8 Triggers of Hunger

This is the essence of the Science of Hunger program. I believe there are 8 essential triggers of hunger. Some represent a true biological drive for nutrition while most falsely lead us to believe we are hungry simply because the symptoms resolve with the ingestion of food.

The 8 most common triggers of hunger are as follows:

1. Stomach Acid Accumulation

33 2. Decreased Blood Flow To The Brain

3. Inadequate Protein Intake

4. Excessive Carbohydrate Consumption

5. Artificial Sweeteners

6. Excessive Exercise

7. and Behavioral Patterns

8. Visual Exposure To Food

The 1st trigger is the most common trigger of false hunger. The 2nd through 6th are also common mimics of hunger. The 7th and 8th riggers represent the more compli- cated psychological impact that food has in our lives. In the complete version of the Science of Hunger weight loss guide, I examine each of these triggers in greater detail, help you to recognize what hunger triggers your are experiencing and help you develop a strategy to reduce your false triggers of hunger.

Conclusion

The Science of Hunger Program

The Science of Hunger Program offers a scientifically established method of reducing an individual’s hunger based upon increasing or decreasing certain types of foods (protein or carbohydrates) as well as identifying the several medical and psychological mecha- nisms that mimic hunger.

Once your Science of Hunger of Program is underway, you will be able to reduce your carbohydrate consumption, resolve the medical conditions that mimic hunger and be- gin losing weight without counting calories. Once your hunger levels decline, you will naturally eat less food and begin to lose weight.

34 Share This Book with Your Friends

If you enjoyed the content of this book at all, please do me a favor in return and send it to at least 2 of your friends or family members who you think might enjoy reading it. I am passionate about teaching people to learn to improve their health and weight with- out the use of potentially toxic herbs, high dose vitamins, surgery or medications. If you have any additional suggestions or questions you can e-mail me at [email protected] and I’d be more than happy to help.

Want to Learn More About The Science of Hunger Program?

Go to www.ScienceOfHunger.com to buy the extended version of this book and learn about how to individualize your own hunger reducing weight loss program.

Aren’t you tired of feeling tired, being overweight, occasionally lightheaded, having to urinate frequently, bloated and dealing with erectile dysfunction or constipation? Now is your chance to take control of your life and improve your life by simply restructuring how you eat so your hunger drops leading to a decrease in carbohydrate intake as well as a drop in your body weight.

Appendix #1 Listing of Vegetable Carbohydrate Contents

This list is roughly arranged from lowest to highest carbohydrate counts, but all are non-starchy and generally low in carbohydrates. The exact carbohydrate count depends on serving size.

Low-Carbohydrate Vegetable List

* Sprouts (bean, alfalfa, etc.) * Greens – lettuces, spinach, chard, etc. * Hearty Greens * Radicchio and Endive count as greens * Herbs * Bok Choy * Celery * Radishes

35 * Sea Vegetables (Nori, etc) * Broccoli * Cauliflower * Cabbage (or sauerkraut) * Mushrooms * Jicama * Avocado * Cucumber (or pickles) * Peppers o Green Bell Peppers o Red Bell Peppers o Jalapeno Peppers * Summer Squash (including Zucchini) * Scallions or green onions * Asparagus * Bamboo Shoots * Leeks * Brussels Sprouts * Snow Peas (pods) * Green Beans and Wax Beans * Tomatoes * Eggplant * Artichoke Hearts * Fennel * Onions * Okra * Spaghetti Squash * Celery Root (Celeriac) * Carrots * Turnip * Water Chestnuts * Pumpkin

Starchy (High Carbohydrate) Vegetables

The main vegetables to be minimized when reducing carbohydrates are the starchier vegetables: * Beets * Carrots (depends on diet) * Corn * Parsnips * Peas * Plantains

36 * Potatoes in all forms * Winter Squashes (particularly acorn and butternut)

37 Index #2 Listing of Fruit Carbohydrate Contents

Favorable Fruits

Fruits Lowest in Sugar * Small Amounts of Lemon or Lime * Rhubarb * Raspberries * Blackberries * Cranberries

Fruits Low to Medium in Sugar * Strawberries * Casaba Melon * Papaya * Watermelon * Peaches * Nectarines * Blueberries * Cantaloupes * Honeydew Melons * Apples * Guavas * Apricots * Grapefruit

Minimize the Consumption of Fruits Below When Reducing Carbohydrates

Fruits Fairly High in Sugar * Plums * Oranges * Kiwifruit * Pears * Pineapple

Fruits Very High in Sugar * Tangerines * Cherries * Grapes * Pomegranates

38 * Mangos * Figs * Bananas * , such as o Dates o Raisins o Dried Apricots o Prunes

39