The fault in our carbs: Switching out sugar and starchy carbs for rapid weight loss

by Nicky Pellegrino / 19 October, 2016
Proponents of the blood sugar diet Michael Mosley and Clare Bailey say public health advice needs to catch up to the science. Photo/Joe Sarah

We all know sugar’s not good for us, and it turns out some starchy carbs can be just as villainous. New research is discovering that eating less of these bad guys can have huge health benefits. 

By now we’ve all heard the bad news about sugar. If you’re still spooning it over your breakfast cereal and mainlining chocolate biscuits, you’re flying in the face of revelations that sugar makes you fatter and helps send you down the road to type-2 diabetes.

Research is revealing more about this food villain all the time. Just this week, newly released documents revealed that the sugar industry in the US secretly paid scientists in the 1960s to downplay sugar’s role in heart disease and to shift the blame to saturated fat.

So these days, when UK doctor Clare Bailey sees diabetes patients at her practice in Buckinghamshire, she hardly needs to bother having the sugar conversation. “They’ve already had it drummed into them,” she says.

Bailey is the wife of Michael Mosley, broadcaster and best-selling author of The Fast Diet and The 8-Week Blood Sugar Diet. She’s been pioneering his approach to reversing diabetes in her own medical practice, where about 900 patients have the condition, putting them on a low-calorie, Mediterranean-style diet. “We’re seeing amazing results. A lot of people are able to come off medication or avoid the need for it altogether,” she says.

Photo/Getty Images

As Bailey points out, there’s another villain in the pantry besides sugar: starchy carbohydrates. They create a spike in blood sugar almost as quickly as table sugar, yet haven’t been attracting the same attention. In fact, many official food pyramids and eat-well guides continue to push them as a foundation of a healthy diet.

“They’re still offering the old advice, which is confusing,” says Bailey. “It’s difficult because there’s a standard route people go down to get information. So we have this ridiculous thing where patients go off for official lifestyle advice and are told to eat macaroni cheese and baked potatoes.”

What Bailey used to tell her patients was: eat less, do more exercise and harness some willpower. Now she’s realised how unhelpful that was. “For people who’ve struggled with their weight for years, it was an impossible task.”

For the past year, she’s been advising patients that once they move away from basing their diets on starchy carbs and sugars, they’ll find they no longer feel hungry all the time, and if they stick to the blood sugar diet, they can actually reverse their diabetes. “They see improvements really quickly in their fasting blood-sugar levels,” she says. “It’s a drop-off-the-cliff change.”

Suggesting that patients buy her husband’s book seemed ethically dubious, so Bailey used to hand out an information sheet she’d written. Now she’s collaborated with dietitian and nutritionist Sarah Schenker to produce The 8-Week Blood Sugar Diet Recipe Book, which is filled with meal ideas based on the principles of Mediterranean-style eating.

It’s an approach that involves minimising the white stuff – bread, pasta, potatoes, processed cereals, rice and sugar – and instead eating more vegetables, a small amount of fruit, plenty of high-quality protein, some full-fat dairy and “good” fats such as that in olive oil, nuts, coconut milk and avocado.

Those fats are the secret to the “stickability” of the diet, says Bailey. Not only do they make food taste good but they’re also a source of slow-burn energy, helping you feel full for longer. “People say this is the first diet they can stick to. They don’t feel hungry all the time.”

Healthy swaps

Bailey and Mosley’s personal experience backs up the advice they’re giving. Twenty years ago, health-conscious Mosley followed the standard dietary advice to cut down on fat; subsequently, he gained weight around his middle and was diagnosed with type-2 diabetes. Meanwhile, Bailey was continuing to enjoy full-fat Greek yoghurt and lashings of olive oil.

“We used to be like Jack Sprat and his wife,” she says. “I never embraced low-fat because I wanted curves … which I never got.”

Mosley went on to lose eight kilos on a programme of intermittent fasting that he later branded the 5:2 or Fast diet, and his blood sugar levels normalised. Since then, he’s become interested in the work of Roy Taylor, professor of medicine and metabolism at England’s Newcastle University, who advocates rapid weight loss from a very low-calorie way of eating (just 800 calories a day) to reverse diabetes. Taylor had good results with a small trial that demonstrated that major weight loss can return insulin secretion to normal levels in people who’ve had diabetes for up to 10 years. He’s now doing a much larger study, funded by Diabetes UK.

Of course not everyone wants to take such an intensive approach. For these people, Mosley and Bailey advocate switching from the blood sugar diet’s 800 calories a day to a generally low-blood-sugar way of eating that includes keeping an eye on your carbohydrate intake and reducing portion sizes. In The 8-Week Blood Sugar Diet Recipe Book, the Mediterranean diet principles have been extended to incorporate other cuisines – so there are Thai, Chinese and Vietnamese flavours. And there are healthy-swap sugg­estions, such as ways to use cauliflower in place of mashed potatoes and rice. “Even my fussy teenage daughter ate a stir-fry with it and didn’t notice,” says Bailey.

Professor in human nutrition and medicine Jim Mann. Photo/David White

Against the low-fat gospel

It frustrates Bailey that it’s taking so long for public health advice to catch up with the science – even the UK’s National Health Service and Diabetes UK websites promote starchy carbs as healthy choices. She notes that New Zealand’s recommendations for “5+ a day” fruit and vegetables fail to take into account that fruit, while beneficial, is high in sugar and should be limited.

“The well-intended approaches we’ve taken on board often have unintended consequences. I’ve come across diabetics who snack on grapes all day, thinking it’s healthy,” says Bailey who believes a better guideline would be “5 veg + 2 fruit a day”.

After 40 years of the low-fat gospel, it’s inevitably going to take a while to change minds and bodies. “It feels like a juggernaut that was powering ahead and is taking a long time to turn round,” says Bailey. “But a lot of academics are questioning it now and the research is very much backing the Mediterranean diet.”

Recent results from Italy’s Moli-sani Project, a cohort study involving about 25,000 participants from the Molise region, has shown that a Mediterranean-style diet is associated with a significantly reduced risk of death in patients with a history of heart disease. “We found that among those with a higher adherence to the Mediterranean diet, death from any cause was reduced by 37% in comparison to those who poorly adhered to this dietary regime,” says Professor Giovanni de Gaetano of the Neuromed Institute in Pozzilli, Italy.

Dr Clare Bailey. Photo/Joe Sarah

The same plant-rich diet has been associated with lower risks of cognitive decline, Parkinson’s disease and some cancers.

Meanwhile, groundbreaking research from Adelaide found a low-carb diet higher in protein and unsaturated fat was beneficial for type-2 diabetes patients, with twice as many study participants able to reduce their medication compared with those on a traditional low-fat/high-refined-carbohydrate diet.

The problem is the scope for confusion, says Jim Mann, professor in human nutrition and medicine at the University of Otago. He recently wrote a commentary defending dietary guidelines for UK medical journal the Lancet. In it he warned against pitting one macronutrient against another or pitching simplistic messages that fats are good and carbohydrates are bad. “It makes life difficult at a grass-roots level,” he says.

What we should be focusing on instead is the quality of the food in our diet. Mann cites the humble loaf of bread as an example. “It’s hugely confusing. In Nordic countries, it’s a great food, dense and made from proper wholemeal or rye flour.” Quite a different beast to much of the bread in our supermarkets, which he describes as “white bread pretending to be brown bread”.

Mann argues that the current fat-versus-carb debate doesn’t take into account the fact that it’s the nature and the source of these macronutrients that’s most important.

His advice? “Keep sugar to an absolute minimum. You don’t have to cut out all carbs, just concentrate on pulses and dense wholegrain bread – either make it yourself or go to a good baker. And it’s important to have the right kind of fat, but if you’re overweight, you can’t eat as much of it as you like, even if it is unsaturated.”

Want to try the diet?

    • The aim is to wean yourself off sugar, so using artificial sweeteners instead is not advised as it will maintain any sugar cravings. For the occasional sweet treat, Dr Clare Bailey (pictured above) recommends sugar from fruit such as dates, cranberries or raisins.
    • Snacking between meals is best avoided, because at these times the body has a chance to go into fat-burning and repair mode.
    • If you’re sticking to the recommended just 800 calories a day, you should increase your water intake and can also add a bit more salt to your food. Bailey recommends taking a multivitamin every other day, particularly if you’re on the 800-calorie diet for more than a few weeks.
    • Vinegar has been found to improve insulin sensitivity. In one study, researchers found that adding two teaspoons of vinegar to a meal reduced the post-meal blood sugar spike by 20%.

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