Month 3

Month 3: Eliminate processed junk food and replace it with lots of nuts.

Processed, high calorie junk food is everywhere these days.  Most of us think about chips, cookies and fast food when the words “junk food” are mentioned, however, there are many other foods that are equally processed and fattening.  If we label all refined or processed food as junk, we should include most granola bars, breakfast cereals, yogurts, frozen meals (even the low calorie ones), white breads and rolls and most pastas.  When we use this more strict definition of junk food, most Americans derive around 80% of their daily calories from junk food.

Junk foods consist primarily of processed carbohydrates that are rapidly absorbed by your intestine shortly after you eat them.  These contrast to the carbohydrates that exist in beans, vegetables, whole grains and nuts which are slowly absorbed.  The rate at which carbohydrates are absorbed determines how likely they are to be converted to fat and stored.  You may have heard the term “glycemic index” used as an explanation of whether or not a food was fattening.  The glycemic index is measured by checking people’s blood sugars after eating certain foods.  Those foods with a low glycemic index result in modest increases in your blood sugar, while high glycemic index foods cause a rapid increase in your blood sugar.  

The graphic above shows the cyclic changes in blood sugar that can occur after eating junk food that is high in refined carbohydrates.  Shortly after eating the junk, your blood sugar goes up rapidly until you reach point A.  When your blood sugar is a little high, you typically feel full and satisfied.  However, your metabolism responds to a high blood sugar by releasing Insulin, a hormone that works to bring your blood sugar back to its normal value.  Rapid rises in blood sugar result in the release of lots of insulin.  Insulin works to lower blood sugar by driving the sugar into the liver and fat cells for storage, resulting in excess body fat.  However, a rapid release of  insulin often overshoots its target resulting in a low blood sugar an hour or so after eating (point B).  Low blood sugar causes hunger and irritability triggering you to, of course, eat more junk food.  This cycle often occurs many times each day and leaves the patient wondering why they feel so hungry all day long.

The solution to this roller coaster is not willpower, it’s to not eat the junk in the first place.  During month 3, I challenge my patients to eliminate all junk food.  Giving up these foods is usually not difficult for most of my patients, until they find themselves short of time and starving.  Junk food is not particularly good tasting, it’s just extremely convenient.  Grab a buck, walk down the hall to the vending machine and, voila, a granola bar is delivered.  You go back to your busy life, and without a conscious thought, you devour the granola bar.  Often, the only thing that reminds you that you just ate it is the empty wrapper in the garbage can.

Thankfully, there is a healthy food that is widely available (even in most vending machines) that is completely healthy, delicious, affordable and will not cause weight gain.  While nuts and seeds are often vilified as high in fat and calories, there is an abundance of literature that demonstrates that increasing your daily consumption of nuts often leads to weight loss, not weight gain as most would think.  

There is lots of discussion about which type of nut or seed is the healthiest, however, there are very few differences.  Even peanuts, which are technically legumes, not nuts make an excellent snack.  The important factor in the healthfulness of nuts and seeds is the preparation.  Preparations can be categorized into four different groups.

Raw (also known as natural) – This is the healthiest preparation, however the nuts and seeds lack the crunch that is often necessary to replace junk food.  They are not heated and nothing is added to them.  These rarely come salted, however, if you like, add a little salt and toast them without fear of health consequences.  

Dry Roasted – These are nuts or seeds that are essentially toasted, but do not have anything added to them during the cooking process.  They come in salted & unsalted varieties.  Again, feel free to select the salted version without guilt.  Eliminating junk food will result in such a significant decrease in your daily sodium intake, a little salted, dry roasted nuts or seeds will still ensure that you are consuming much less sodium than before.

Roasted – Roasted nuts are coated in oil and then heated.  Roasted nuts can easily be differentiated from dry roasted preparations by looking at the list of ingredients.  Dry Roasted nuts will list only nuts and salt in the ingredient list, while roasted nuts or seeds will also list oil.  Often the oil comes from the same nut or seed.  For instance, peanuts are often roasted in peanut oil and sunflower seeds are roasted in sunflower oil.  Nut oils in particular are very heat sensitive.  When nut oils are heated, they often transform into trans-fats.  Trans-fat cause heart disease and weight gain and there is even legislation that prevents them from being used in foods.  However, this legislation only factors in the original ingredient, not the byproducts of the cooking process.  Because of the added oil and potential for exposure to trans-fats, roasted nuts should be avoided if possible.

Roasted and sweetened – This preparation contains roasted nuts or seeds with a flavoring that contains sugar or other sweeteners.  Honey, Barbecue and Spicy preparations often have sugar added, making these oiled and sweetened nuts or seeds as dangerous as the junk food you are trying to replace.

Month 3 marks another big step in cleaning up your diet.  By the end of the third month, you will be eating a pound or more of vegetables, minimal refined sugar or artificial sweeteners, lots of fruit, nuts and seeds and very little junk food.  You will be well on the road to the healthy diet that will ensure that your weight loss surgery results in a life free of obesity.

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