The Glycemic-Load Diet: A powerful new program for losing weight and reversing insulin resistance Paperback – March 23, 2006

While there are now many books out on the so-called glycemic index (GI), most of these pretty much miss the point that the low-GI approach to eating, while better than the usual, is still inadequate. By itself, the glycemic index misses the point of what portions of carbs people "really eat", vs. a merely theoretical level. This is an important weakness. Just looking at the GI level of carrots, for instance, puts them at a higher level than spaghetti noodles. That's why you'll still find some nutrition authors, unaware of the weaknesses of the GI concept alone, advising you to leave out items like carrots. Fortunately, nobody really eats more than a carrot or two at a time, which has a minimal impact on blood sugar; but people easily over-indulge on pasta. Nobody ever got fat eating carrots, but they certainly can eating a lot of pasta...So the real-world portion amounts of carbs people consume is crucial when attempting to do quantitative comparative assessments. Which is why Harvard researchers invented the "load" concept in the first place. Dr. Thompson has done his research homework and explains the scientific rationale for the GL approach to controlling postprandial insulin spikes, and does so probably better than anyone else I've read. That's why readers here are so enthusiastic about the book. They should be; the low-GL approach to (lifelong) eating not only produces good results in terms of blood sugar, it balances some of the blandness of a purely low-carb approach to eating. Although a strict low-carb diet is probably optimal for reducing insulin resistance, many carb-conscious folks might prefer a less-strict diet that allows for more variety of foods which are low on the glycemic-load index, but who are afraid of "carbs" in general. Probably the best part, though, is that if you choose your food choices wisely (and limit the portions of carbs that spike your postprandial blood sugar), you don't need to reduce your overall calorie intake. There's no need to go hungry eating this way. In fact, severe calorie-restricted "diets" don't work long-term anyway; they quickly send the body into a self-protecting starvation-survival mode that makes it almost impossible to lose weight long-term...Eating heartily-but correctly- while still taking the weight off is a novel concept to many but it has been proven in the research.Dr. Rob's low-GL conclusions here echo the work of researchers Mary Gannon PhD and Frank Nuttall MD et al., whose clinical interests have focused on the influence of various type of carbohydrates on blood sugar. When Dr. Rob talks about "starch toxicity" being rampant around the world today, he is not exaggerating. Yes, some cultures where starches are a large part of the diet have fared fairly well until recently, but we need to take into account the traditional work ethic in these countries- putting 16 hours a day in the field farming tends to balance out any excess rice consumption, whereas sitting in front of the TV 6 hours a night won't :-). When Asians, for example, adopt modern sedentary lifestyles while maintaining the same level of starch consumption, they quickly head toward diabetes and cardiovascular problems just as surely as their Western counterparts. Fact is, starch IS toxic, and researchers Gannon and Nuttall tell us why. Their research has shown that it is specifically the glucose content in a carbohydrate that is important in determining postprandial spikes. Starches (wheat, rice, potatos, pasta, breads, cereals, etc.) break down quickly into almost 100% glucose, which is bad for your overall blood sugar control. Dr. Rob terms this phenomenon "starch shock", and how true it is... Fact is, human evolutionary history shows us our paleo ancestors consumed very little of this type of carbohydrate, and our physiology is STILL ill-prepared to take on this task. Humans tend not to do well when they continue to bombard their systems with these "glucose bombs"- witness our current health problems, very heavily tied to the high-starch diets we eat. In fact, this sad state of affairs could well be our theme song of the 20th and 21st centuries :-).Gannon and Nuttall et al have demonstrated that carbs which contain less glucose produce less than half the postprandial spikes than starches do. Why? Simply because one should take into account vastly different postprandial effects of various types of sugars, such as galactose or fructose, when compared to almost pure glucose (excess consumption of fructose has its own problems, however, which I won't get into here...suffice it to say we're not talking about juices and high-fructose corn syrup as wise choices). Alas, the majority of health organizations, much more the nutritionists who follow their advice, are bent on staying in a familiar peer-approval-zone for making generous starch (i.e., "complex carbs") recommendations. This makes a mockery of numerous clinical studies revealing these "high-carb" diets inevitably produce inferior blood-lipid results compared to diets lower in carb totals (especially starches), but health organization "position-statements" always have an eye toward peer approval. And what does current peer consensus think? Sadly, nutrition is still dominated by an outdated paradigm which seems to be this: "Ancel Keys showed us back before 1960 that 'fats are bad' and should therefore be replaced by carbohydrates"... Yes, reader, you are correct- the current mentality of your favorite health organizations is STILL dominated by this terribly outdated (read: flawed) analysis from the 1950s; and indeed, the "high-carb, low-fat" mantra continues to exert a vise-like grip over conventional medical thinking. But how do we know if I am making a fair assessment here? One doesn't have to look far- just ponder why multiple servings of grains are always the predominant recommendation on various "food pyramids" put out by orthodox organizations...or read the constant enthusiastic advice for "complex carbs" and "whole grains" from your typical health-professional author...fact is, starches continue to rank high in the consciousness of the health community, even to this day.The situation is actually highly ironic, in that these organizations are supposed to be our health "experts", but remain helpless to counteract the rising health epidemics the country faces - even after decades of funding... And their recommedations on "lifestyle choices" generally are too bland to exert much of a change in somebody's health problems. But it's important to recommend "safe" advice that doesn't raise the hackles of one's peers, isn't it? :-). Reader, do you think I'm exaggerating the problem? Maybe you haven't had a chance to read the weak advice these organizations put out in pamplets and website guidelines for the public.It gets worse. As one on-target cardiologist prominent on the web remarks, whose name I won't give here, if you want to increase your chances of getting diabetes, just follow the generic carb advice still given by the American Diabetes Association; and if you want to increase your chances of getting heart attacks, just follow the current dietary advice of the American Heart Association. Would you like to know, just out of curiosity, what types of foods meet the AHA stamp of approval? Try myriads of items such as Honey Bunches of Oats, Kellogg's Frosted Mini-Wheats, Cocoa Puffs cereal...and numerous other junk foods. And why are products like these getting the AHA heart-check approval? Let's go back to the mentality fostered by Ancel Keys decades ago...ka-chink! That's right - they're "low fat"! Nevermind the damaging sugars and the fact they are mostly pure junk, they're approved by the AHA because they meet the AHA's requirements for low saturated (and total) fat! Gee, isn't that wonderful....talk about a screwed-up way of looking at nutrition... And let's not forget these companies also pay a fee for the AHA's endorsement, so we are looking at a substantial souce of revenue for our beloved AHA...It should be obvious to anyone interested in effective nutrition these drug-company-dominated groups aren't exactly following the Hippocratic Oath very well ("first, do no harm"), but then again, it's hard to give up perks like free fancy hotels, fine dining, and other extravagant perks enjoyed by MDs attending seminars given by the big drug companies... Hence, woe is you if you rely on these organizations for your own unbiased health information.But hey, let's put aside that soapbox for now :-).So the best research has important implications on choosing the least-damaging carbs...and we see starches- yes, even "whole grains"- at the higher end of the glycemic load. Gannon and Nuttall et al. term their dietary approach a "LoBAG" (as in "low-biologically-available-glucose") diet, and it seems to parallel nicely what the glycemic-load index tells us. Want to be healthier? Try knocking off the starches and choose some lower-glucose, low-GL options instead.The low-GL approach to eating (no, not a temporary "diet") is the middle road between extreme low-carb and extreme low-fat advice, and it's a reasonable way for most people to go unless one has a severe insulin-resistance condition. Since adult-onset diabetes and metabolic syndrome are reaching epidemic proportions nowadays, folks need to pay close attention to what they eat. Pretty much everybody has decreased ability to handle dietary sugars as we age throughout life; it's one of the unavoidable physiological negatives of getting older. Hence, the low-GL way of life not only makes sense for the insulin-resistant folks, it makes sense for everyone.A brief note on the exercise chapter in the book. This is really one of the book's strong points, and NOT because it lays out a strenuous program that challenges your will-power. We assume here the book is primarily (but not exclusively) aimed at the beyond-30 crowd, maybe somewhat inactive and who may be interested in a plan that will help them control creeping insulin resistance as they get older. With this group in mind, Dr. Thompson understands the physiology of insulin resistance - at the mitochondrial level- better than most fitness authors. Therefore he recommends an exercise program a bit different than most fitness books. His strength is in recognizing that folks who tend to be insulin-resistant have unique needs for targeting certain muscle fibers, i.e., the "slow-twitch" fibers. These fibers tend to lie "dormant" in folks having trouble processing carbs (which includes a large section of the general population), and so MODERATE exercise, of longer duration, hits these slow-twitch fibers more effectively than high-intensity training. In view of high-intensity protocols like HIIT (i.e., interval training) becoming popular because they promise big results in minimal time, something should be said to balance out the tendency to exclude lower-intensity, longer-duration exercise.I won't say too much here about Dr. Thompson's advice for weight training; his suggestions leave out the important large muscles of the upper body such as the chest and the back, so his advice on resistance training is pretty lame. Resistance training isn't a field documented nearly as well as aerobics in the literature and relying on many of the ridiculous strength training protocols typically found in the exercise literature can be hazardous to one's common sense :-). One would do better to look elsewhere than books like this for a good strength training routine (while still taking the author's suggestions for including moderate-intensity exercise to heart).The only thing I would add here to Dr. Thompson's book is that one can tweak this plan in various ways he doesn't mention much of. Various supplements can be helpful, and some enjoyable items like a glass of red wine daily with lunch or dinner can boost one's insulin sensitivity (alcohol is rather glossed over in the book). Moderate amounts of alcohol are good for the heart, as massive amounts of research shows. It's not necessary to begin drinking, per se, but if one has no issues with it, alcohol in itself (in very moderate doses) seems to be good for relaxing the nervous system and lowering levels of insulin, nevermind the added benefits of polyphenols such as resveratrol and quercetin in wines. I suppose the (slight) benefits may be one reason you see some cardiologists waxing enthusiastic about vino in some of the newer "diet" books. Oh well. Cheers!

My wife and I bought this book a little over a month ago and started a week later after reading it thoroughly. This book explains the basic truth about why so many of us are overweight. In a word - starches! If we each take the time to inspect our cupboards and refrigerators we'll see that our diets are flooded with white and over-processed starches. Because of this we are paying the hard dues of obesity and other related illnesses and injuries.Being completely honest, my wife and I have tried many diets (Atkins, Six-Week Body Makeover, South Beach, Vegetarian, etc...). All provided some weight loss, but ultimately failed in the end because the level of deprivation was too steep for any human being to maintain an honest commitment. More importantly, too many diets ask you to sacrifice salts, sugars, and fats. In other words, those diets ask you to sacrifice flavor. When you give up flavor it is inevitable that your dieting efforts will fail.My wife and I have both lost approximately six pounds in the first month and we have done nothing more than cut out potatoes, rice and wheat products while increasing our intake of meats and vegetables. Have we been 100% perfect - never straying from the path? No. But I can honesty say that we have never missed a meal, never felt hungry, and never felt deprived of flavor. Our stomachs don't even make that all too familiar growl that comes with other dietary approaches. Before we started this approach I will admit that I often struggled to push myself away from the table when I was eating starch heavy meals. I just couldn't get that feeling of fullness or I was hungry all over agin shortly after my meals. Now I am satisfied after one single serving and I no longer feel the need to go back to the refrigerator for more. As for exercise, the only form I get is the mile walk to work and again in the evening when I walk back to my car. My job is a sedentary one, as I spend the majority of my day in a cubicle with a computer.This is not a gimmick diet nor is it difficult. You'll enjoy tasty food and will no longer need to count calories or figure out exchange points or any other form of nonsense. You simply eat your meats and vegetables and do your best to avoid starches (potatoes, rice, and bread) and other high-sugar foods like soda pop. Notice that I said avoid and not eradicate. The whole point of the book is that some starches can be consumed, but you should do your best to ensure that the starches that you eat are better low-glycemic load foods. Glycemic loading information is similar to the glycemic index (GI), but it goes one step further and factors in serving size - which the GI does'nt.Don't worry, My wife and I still enjoy small pieces of dark chocolate candy or a glass of almond or coconut milk after dinner just to satisfy our sweet tooth. And yet we still lose weight. Does it come off quickly? No. Is it supposed to? Once again, no. This is a lifestyle change and you need to think of it in that manner. Some weeks I have lost two pounds and others I have lost only a fraction of a pound, but I have always lost weight. Do not get hung up how much you're losing. If you're honest you will admit that it took you years of abuse to get overweight and you should be prepared to spend some time in losing the weight.The book is well written and divided into two basic groups. The first half makes the case for the approach and the second half of the book is glycemic load data and other appendices with related information. This book is an easy read and should take you no longer than a few days to read. The author presents the information in a friendly manner and share's his own experiences with weight loss. The fact that Mr. Thompson is also a doctor adds credibility to his assessment of the American diet since 1970. This book will open your eyes and expose a lot of the half-truths and misconceptions that are floating around in the dietary literature.I have since given this book to my mother and I am hopeful that she too will enjoy some of the many benefits that both my wife and I have enjoyed. Imagine this: never feeling bloated anymore, never felling hungry anymore, never turning down food because it has fat or other supposedly bad ingredients.Good Luck with Your Weight Loss Goals.