National Geographic Magazine ran an article on sugar in their August 2013 issue. What makes it interesting and worth a read (available for free here) is you learn much of the history and social aspects of sugar production and consumption. For example, did you know sugar was being refined and turned into the white powder we are familiar with today -- back in 500 A.D.?

But what makes this article really interesting to me is it's perspective on sugar's effect on health. This passage is the tastiest morsel, but I encourage you to take the whole course. 

"[Fat] makes up a smaller portion of the American diet than it did 20 years ago. Yet the portion of America that is obese has only grown larger. The primary reason, says [kidney doctor Richard] Johnson, along with other experts, is sugar, and in particular fructose... 

Table sugar (called sucrose) is half glucose and half fructose. Glucose, which is used by nearly every call in the body for energy, also stimulates the production and release of insulin, the hormone that signal our fat cells to become fatter. 

Fructose, on the other hand is the sweeter sugar found in fruits and also processed foods, is metabolized primarily by our liver, which makes blood fats called triglycerides. To quote the NGM article:

"Some of these fats stay in the liver, which over long exposure can turn fatty and dysfunctional. But a lot of the triglycerides are pushed out into the blood too. Over time, blood pressure goes up, and tissues become progressively more resistant to insulin. The pancreas responds by pouring out more insulin, trying to keep things in check. Eventually a condition known as metabolic syndrome kicks in, characterized by obesity, especially around the waist; high blood pressure; and other metabolic changes that, if not checked, can lead to type 2 diabetes, with a heightened danger of heart attack thrown in for good measure. As much as a third of the American adult population could meet the criteria for metabolic syndrome set by the National Institutes of Health."

On this blog, I have focused on the harmful effects of glucose because that is what our experts have studied and understood well. Fructose though has largely been ignored, but at our peril. Luckily experts like Dr. Robert Lustig are shining the light on fructose. 

Bottom line is still the same: sugars are bad for us, and eating too much causes us to become fatter and eventually obese. And thus we should avoid processed foods with easily digestible sugars (as they have little to no natural fibers to slow down sugar digestion, unlike most fruit).

The best infographic that tells us in simple language why foods with lots of easily digestible carbs (white rice, breads from white flour like chappati, potatoes, and fried snacks) are worse than foods with lots of dietary fats. (Courtesy of Massive Health.) Enjoy!

If you want to lose body fat and lose it quickly, the most effective thing you must do it cut down all carbs completely. By carbs, I mean all processed foods, but also all grains and sugars and forms of starches.  

So cut out all white rice and breads from (wheat) flour like naan and chappatti. Cut out all potatoes too as they contain starch. And you must cut it for 1-2 weeks, which is an "induction period".

You must cut down even whole grains. Yes, whole grains. You know, brown rice, whole wheat, and multi-grain products. Cut down on the beans too. Sure, these foods are definitely on the healthy side because they have fiber and nutrients, and they definitely belong in the The Healthy Indian Diet. But they are easily digestible carbs because of the starch inside. So you should cut down on them for a while if you want to lose weight.

Rule #6: Cut All Grains, Sugars and Starches for the First Two Weeks

Where is the evidence that a low-to-no carb diet can help you lose weight. Is there any? Yes, plenty.

The A to Z trial done at Stanford examined the effect of diet on about 310 obese women, where roughly a fourth were on one of four popular diets for a year. Guess which diet let to the greatest weight loss... It was the Atkins Diet. The Atkins Diet is low-carb, high-protein, and high-fat. 

This result surprised the lead researcher Dr. Gardener, and he admits in his lecture seen on YouTube that he was also surprised that the Atkins Diet improved blood fat (cholesterol) levels the most, too. 

An Israeli trial among about 320 moderately obese people examined the effects of three diets: low-fat, low-carb, and Mediterranean diets. Conducted over 2 years, those who adhered to the low-carb diet ate the least amount of carbs and the most amount of protein and fat compared to the others. Who lost the most weight? Right, the people on the low-carb (and high-fat and protein) diets. The same result is seen in a trial on 200 overweight people in Germany, where low-carb dieters lost more weight than low-fat dieters.

These results show that eating very low levels of carbs is the most effective thing for losing weight. They also show that dietary fat does not equal body fat, though related, and that eating a lot of dietary fats do not make us fatter the way that eating a lot of carbs do.

The science behind this counter-intuitive concept is the effect of glucose, a sugar released from carbs during digestion of foods, on the hormone insulin, and insulin's signaling fat tissue to get fatter (using a glycol backbone from carbs and fatty acid chains from dietary fats), which makes us fatter especially in areas deemed unhealthy, namely around our abdominal trunk. (You know, "Beer Gut" or "Wheat Belly"!)

A Healthy Indian thus cuts out all rice, all breads -- wheat products like chapati, roti, and naan, and also stuff made of millet, chickpea flour and other such stuff --, all sweets, all fried snacks broadly called "nasta" which is essentially a mix of carbs and burnt oils, and all potato foods, for at least 2 weeks. And honestly, a Healthy Indian barely eats this stuff after the 2-week induction period. 

So then, if you cut all these carbs for 2 weeks, what can you eat? 

Plenty! Foods with proteins and foods with good fats. If you eat meat, it is relatively easy. I advocate healthier stuff like fish and chicken. Eggs are one of the most perfect foods in my opinion. And if a vegetarian, you can easily eat high-protein and high-fat foods such as yogurt and milk, avocado, and all kinds of nuts.

If you must eat beans or whole grains for whatever reason or cravings, keep them to an absolute minimum. As a rule of thumb, eat in half the portion you're accustomed to, such as a single roti instead of two.  Also, eat foods fruits and vegetables, essentially carbs, because they come with fiber and are not starchy, meaning the sugar (glucose) inside will not affect your body as quickly or strongly as sugars coming from starch-dense foods like beans and potatoes. 

So the Healthy Indian, knowing it is difficult but it is also doable, will eat low-to-no carbs for at least 2 weeks to lose body fat and transform him or herself into a healthier person!

Now for the first rule on eating LESS of something, instead of MORE. That something is processed foods, the single category I believe is responsible for people getting fatter more than any other. 

Rule #5: Eliminate Processed Food (or Eat Real Food)

If you've read "The Healthy Indian Diet", you know easily digestible carbohydrates are associated with people becoming fatter. The explanation is straightforward: carbs breakdown into glucose in our intestines, and this glucose is absorbed into our bloodstream and causes levels of the hormone insulin to spike. Insulin then signals our fat cells to get fatter. So the higher our digestible carb intake, the higher our insulin levels are, and the likelier we are to get fat.

Easily digestible carbs -- particularly flour, sugar, and products made from them -- are the bulk of processed foods. By processed foods I mean fried flour products like sev and other dry nasto ("snack food"), chips, cookies, and Indian sweets, and also fast food (like McDonald's burger and fries) and street food (like pav bhaji).

These fried carbs, in addition to fast and bountiful amounts of glucose, give the body free radicals which are created when oils are heated in high temperatures. Free radicals lead to oxidative stress, which has been linked to inflammation generally and specifically to obesity.

But beyond the effects of flour, sugar and other easily digestible carbs on our glucose, insulin, and body fat levels, why are processed foods so bad for your weight and your health? 

Well, according to this insightful editorial in 2011, processed (or "ultraprocessed") foods, made possible thanks to food technologies, have ruined much of our natural food and made us fatter for many other reasons. 

Those reasons are being high in calories, largely thanks to there being so many sweeteners. They are eaten in large portions because we do not get easily satisfied or full. They contain very little fiber, which helps in weight loss. (They also contain too little nutrition.) Also processed foods contain many chemicals, some of which some experts believe cause harmful hormonal effects on our bodies including making us fatter.

In contrast, real food -- unprocessed foods (like vegetables from your garden) or lightly processed foods (think yogurt from the store) -- is lower in calories, have more good fats and good carbs (such as fiber, a non-digestible carb), is more satisfying so we don't eat as much, and does not contain potentially harmful chemicals. So the Healthy Indian gets rid of all processed foods in the home and eats only real food to lose weight!

So far our rules on losing weight have all been about eating MORE. Can eating MORE of some foods actually help you lose weight? The answer is yes (to lose weight you should eat MORE of some foods than you do now). And one of the most important foods to eat MORE of are those that are high in protein.

Rule #4: Eat Protein

Some clinical trials have tested whether high protein diets made any difference in terms of weight loss, and they largely concluded that yes, they do. Look at a study published in 2010 on roughly 500 obese people in Europe who completed being first on a low-calorie diet then on one of 5 different diets based that differed based on content of protein and easily digestible carbohydrate. 

If you have read this blog before, you probably predicted the results: people on the high-protein and low-easily digestible carbs diets lost weight or had less weight regain than those on low-protein or high-easily digestible carb diets. 

But here is the shocker: far more people sticked to the high-protein and low-easily digestible carb diets. Why? There's probably a few reasons -- maybe the food tasted better, maybe the weight loss results were better thus encouraging continuing on the diet -- but I bet a big reason is satiety. In other words, people on high-protein diets felt fuller because that's how protein makes us feel when we eat a meal with lots of them.

So what foods are high in protein? 

The answers are in the table below (from UHC's larger table). 

The Healthy Indian knows that dals (legumes) are one of the most protein-dense foods there is. Sure there are carbs in them too, but they are not easy to digest (put another way, they are low in glycemic index, which is good). This is why a simple dish of dal and rice is so satisfying.

Also high in protein are tree nuts like pistachios, pecans, and peanuts (though technically not a tree nut), dairy foods like milk and yogurt, meats, poultry, and fish, and eggs (my favorite food). 

These foods being "whole foods" are really good for your body. They will satisfy your hunger for longer, and help take the wind out of your cravings for crap food. And they will help keep your muscles stay in shape as you get into shape (more on this later in the series), which help burn calories and dietary fats. So the Healthy Indian eats protein-rich foods to lose weight!

If you read our book "The Healthy Indian Diet" or this blog before, you know we are all about a low-carb diet guy. Let me clarify what I mean by "low-carb": I mean all carbohydrate-rich foods that are processed or overly fried or cooked. 

So the bad carbs are fried snacks ("nasta"), chips, cookies, sweets, anything with lots of sugar added to it. Cutting this out or down is being "low-carb." 

Also "low-carb" means white rice and refined wheat ("flour"), which are foods that almost every Indian, American, and really anybody on earth eats because these processed staples are in most modern diets. Besides being of little or no nutritional value (because the nutrients are largely removed to make profits better for makers and sellers, with no regard to the people who will eat them), these "bad" carbs" make you fatter because of how quickly glucose affects insulin levels in your body.

What about fruits and vegetables? This is what we call "Plants", and are the "good" carbs. Eat them! Legumes ("dals") too. Now, you may say, 'Hey, fruits contain sugar, and vegetables are carbs too!' This is true, but there is a lot of nutrition in these plants, and they do your body a lot of good. And for weight loss issues, the fiber (soluble and insoluble) found in fruits and vegetables will help you lose body fat and keep your body lean.

Rule #3: Eat Plants

Consider the Harvard study I mentioned in the last post. Among 120,000 people whose diets and weight loss or weight gain were analyzed, those who ate fruits, vegetables, and whole grains (brown rice, whole grain bread) lost between 1/2 and 1/4 lbs (1/10 and 1/4 kg) every 4 years. Doesn't sound like much, especially compared to almost a whole lb (1/2 kg) lost by regular yogurt eaters. But consider that people who ate plants lost weight, while the average person in the same study gained about 3-1/2 lbs (1-1/2 kg) every 4 years. 

And consider the "A to Z Weight Loss Study" from Stanford University. There they compared four diets, including a low-carb high-fat/high-protein diet ("Atkins") and a high-good carb low-fat diet ("Ornish" and "LEARN") by looking at weight loss and blood lipids (i.e., blood fats) in pre-menopausal overweight/obese women without diabetes over 12 months. 

Guess who lost the most weight in this trial? The women who adhered to the low-carb ("Atkins") diet, which includes an induction period of 2-3 months of very low carb and then a relaxing of the low-carb rules for the remainder, lost the most -- 4.7 kg (10-1/2 lbs), while the women on low-fat diets lost 2.2 and 2.6 kg (5 and 6 lbs) over 1 year. 

An important corollary in this series on losing weight is that you should eat more plants while following other advice in this series. As the "A to Z" trial shows, a low-fat diet that is high in good carbs (not bad carbs) is still not as effective for losing weight as a true low-carb diet that is also high in fats and proteins. 

Still, eating lots of plants -- as opposed to processed or overly cooked carbs -- give you lots of fiber, helping you prevent from becoming fat because fiber prevents too much glucose from entering your bloodsteam. Plants also give you nutrients you don't get in crap food. 

After a short induction period where you cut out all bad carbs and many good carbs, which will help accelerate weight loss, the Healthy Indian knows it is important to eat plants, as much as you can, to lose body fat.

Dahi, Doi, Thayir, Perugu, Mosaru, Yoghurt. 

Whatever you call the rich white food from milk when it is fermented by bacteria, a food that even people with lactose intolerance enjoy (because lactose has been broken down into simple sugars and lactic acid), a food that has a "tang" or sourness that makes a nice base for many delicious foods like lassi or yogurt fruit shakes, raita, and many sauces, this food is not only good for your body, it is also good if you want to lose weight. 

Rule #2: Eat yogurt.

Why? Because a lot of evidence points to yogurt helping people lose weight. 

Take research published in 2005 on obese patients who were all eating the same low-calorie diet for 12 weeks, but among whom one group ate yogurt everyday while the other group did not and instead took a calcium supplement. Guess who lost more weight... Right, the people eating yogurt, and by an average of 4.4 kg (or almost 10 lbs) weight loss versus 2.8 kg loss. 

Guess who in that study lost more trunkal fat (this is the baddest fat, the one around your belly that causes diseases like diabetes). Right again, the people eating yogurt, and on average they lose 81% more trunkal fat than those who did not have yogurt. The authors of this study say that dietary calcium has an anti-obesity effect by reducing levels of calcitriol (the form of Vitamin D that behaves as a hormone), which helps increase the "burning" of fat, but something about getting the calcium in the form of yogurt makes the "fat-burning" effect even more powerful.

Take research from Harvard's School of Public Health in 2011 and authored by some of the biggest names in nutrition research (Dariush Mozaffarian, Walter Willett, Frank Hu). In a landmark study looking at what over 120,000 people in the U.S. ate over many years (up to 20 years in one group), these authors found no single food is more associated with weight loss than plain ol' yogurt. 

Their data showed people who ate yogurt regularly lost about 1 pound every 4 years. What, is 1 lb (or 2.2 kg) weight loss every 4 years not a lot? Perhaps. But consider this: the average person in the study gained 3 lbs (6.6 kg) every 4 years. In other words, people who ate yogurt regularly lost a little weight while the average person gained weight. 

Yogurt helps you lose weight because of the effect of calcium, and also because it makes you feel full and less hungry. There may be another cause behind why yogurt seems to work. 

At this point I should mention that you must not eat yogurt sweetened with sugar or corn syrup. That is the majority of yogurt available in the U.S. and other parts of the world too. This will have the opposite effect, because sugars and carbs cause you to become fat more than anything else. 

So if you want to lose weight and still make your yogurt taste sweet, mix fresh fruit with it. Bottom line is this: the Healthy Indian eats yogurt everyday to help the fat go away.

But do we know that eating a healthy breakfast leads to weight loss? Yes! Where is the evidence?

Well, here. According to researchers of the National Weight Control Registry, 4 in every 5 people who lost 30 pounds of weight or more and kept it off for at least half a year reported eating breakfast every single day. Among 10 people who lost this much weight (and 30 pounds is a lot!), 9 of them ate breakfast 5 days a week. 

According to a Duke nutrition researcher, when you don't eat breakfast, you are in a prolonged state of fasting. She says, "When you don't eat breakfast, you're actually fasting for 15 to 20 hours, so you're not producing the enzymes needed to metabolize fat to lose weight." And for some reason, people who eat breakfast tend to exercise more. See this article for more details.

Of course, when you do have breakfast, make sure it is healthy. 

The best choices for breakfast are eggs and yogurt, both excellent sources of proteins. Fruit is a must as it is full of nutrition and also gives your body sugar in a natural form (meaning with fiber), which is much, much better than sugar added to stuff which quickly causes you to become fat.

Whole grain foods like toast and cereal are good. Oats are probably better. Preferably your breakfast will be a combination of lean protein and complex carbohydrates. This low GI (glycemic index) meal will slowly release energy to your body during the morning, rather than all at once, leaving you hungry again. 

Do NOT eat sugary cereals and white flour products like white bread and pancakes because they have a low glycemic index, which is to say that they are easy to digest, cause a big spike in insulin, and will leave you hungry again within hours. And also, there is almost no nutrition in these carbs. 

So in sum, to lose weight, the Healthy Indian eats a healthy breakfast every single day. And a healthy breakfast provides you with protein and other nutrients, and lets you avoid easy-to-digest (bad) carbs. Stay tuned for the next rule to lose weight.

This review titled "The Questionable Link Between Saturated Fat and Heart Disease" in the WSJ is the best one I have read on the subject of the misguided campaign against saturated fats. 

In it the journalist Nina Teicholz clearly explains the faults behind Dr. Ancel Keys research (which formed the basis of the anti-fat crusade), how food companies engineered low-fat foods people would actually eat (by adding sugars, worse than the dietary fats they replaced), and newer findings that show vegetable oils are really bad (as they easily oxidize under high heats, leading to inflammation which is at the root of heart disease and cancers). 

The newest evidence is why I have begun advocating cooking your food in ghee, coconut oil or butter (not margarine or vegetable oils).