Tuesday, October 30, 2007

The Soy Zone (with recipe!)

101 Delicious and Easy-to-Prepare Recipes


Do you want to live a longer and healthier life? I know I do. Unfortunately, I am also genetically programmed for an early heartattack. For the past two generations most of the males in my family have died of heart attacks by their mid-fifties. I have inherited these same poor genes.

I can't change my genes, but perhaps I can change my genetic destiny by altering the expression of certain genes through the foods I eat. This may sound like scientific fantasy, but it turns out that food is the most potent medicine of all. This is because food can indirectly turn certain genes on and off by altering levels of hormones. I have spent nearly 20 years researching how the foods we eat affect our hormones and how these hormones alter our genetic fate. I hope the scientific odyssey I have embarked upon to prolong the length and quality of my own life can help you do the same.

The basis of the Zone Diet comes from my background in the development of intravenous delivery systems for cancer drugs. I learned that if too little of the drug is administered, the patient dies of cancer. If the patient gets too much, he will die from the drug's toxicity. The goal of the cancer treatment is to maintain that drug within a therapeutic zone: not too high, not too low. I realized that the same philosophy was relevant to maintaining food-generated hormones in similar zones, and our success in reaching that goal depends on the balance of protein, carbohydrate, and fat we eat at every meal.

The Soy Zone represents the next chapter of my ongoing scientific journey, which I have chronicled in all the Zone books I have written in the last five years. This book will explain how following the Zone Diet using primarily soy protein will move you closer to that elusive goal of a longer and better life. It will also bring you vast benefits right now: You'll have more energy and a sharper mental focus to tackle your daily challenges. You'll also shed excess body fat, and keep it off for life. Without a doubt, the Soy Zone Diet is the most powerful version of my Zone technology that I have developed. What's more, the Soy Zone is ideally suited for vegetarians (even vegans) who want to enter the Zone.

The humble soybean is now being hailed as the next magic bullet that will help save us. In many ways that statement is true, because as we replace more of the animal protein in our diet with soy protein, better health is assured. However, if your goal is living longer and better, that can only be achieved by ensuring that your overall diet is hormonally correct, and that means keeping your hormones within a defined zone: not too high, not too low. In other words, you need to combine all the health benefits of soy with a hormonal balancing system like the Zone. When you do, you enter the Soy Zone--which I believe is the healthiest diet in the world.

Baked Golden Tofu Dumplings with Saucy Dip

Servings: 1 Dinner Entree


8 ounces extra-firm tofu
4 teaspoons natural peanut butter
1 1/2 tablespoons tamari sauce
3 scallions, chopped
1 small green or red pepper, chopped
2 medium stalks celery, chopped
8 medium mushrooms, diced
3 water chestnuts, diced
1 medium sprig parsley, minced

3/4 cup apple juice
2 teaspoons maple syrup or brown sugar
1 to 2 teaspoons tamari sauce
1 to 2 teaspoons apple cider vinegar
Optional: 1/2 teaspoon ginger, grated
2 cloves garlic, pressed
1 to 2 teaspoons arrowroot powder dissolved in 1 to 2 teaspoons water
4 medium leaves kale, washed and de-stemmed


1. Preheat oven to 375 F.

2. Mash tofu with fork or potato masher until broken up. Add peanut butter, tamari sauce, scallions, pepper, celery, mushrooms, water chestnuts, and parsley. Mix well.

3. Form the tofu mixture into golf ball-sized dumplings, and place on lightly oiled cookie sheet. Rinse hands in cold water periodically to keep dumplings from clinging.

4. Bake in oven for 30 minutes, or until golden brown.

5. Meanwhile, combine apple juice, maple syrup, tamari sauce, vinegar, ginger, and garlic in small saucepan. Bring to a simmer and cook for 1 to 2 minutes. Add arrowroot water and stir 1 minute more. Remove from heat.

6. Steam kale for 5 to 7 minutes.

7. Serve dumplings on a bed of steamed kale with a small dish of sauce on the side.

The Soy Zone
101 Delicious and Easy-to-Prepare Recipes. Copyright © by Barry Sears. Reprinted by permission of HarperCollins Publishers, Inc. All rights reserved. Available now wherever books are sold.
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Monday, October 29, 2007

First Step to the Zone

Chapter One

Your Grandmother Could Do It. Why Can't You?

Mastering the Zone. Sounds very New Age, like Yoda teaching Luke Skywalker about the Force. But it's not. Instead it's very similar to the advice your grandmother gave you about eating. Eat everything in moderation, eat lots of fruits and vegetables, and have some protein at every meal. Your grandmother didn't know it, but she was teaching you the basic principles for developing a lifelong strategy of hormonal balance. If you can achieve this hormonal balance, you are well on your way to the Zone.

What is the Zone? It is the balance of hormonal responses that occurs every time you eat. A perfect equilibrium: not too high, not too low. Why should you want to get there? Simply said, if you can keep yourself in the Zone, then you will:

* think better, because in the Zone you are maintaining stable blood sugar levels,

* perform better, because being in the Zone allows you to increase oxygen transfer to your muscle cells,

* look better, because in the Zone you are shedding excess body fat at the fastest possible rate, and

* never be hungry between meals, because staying in the Zone means your brain is being constantly supplied with its primary fuel: blood sugar.

All these benefits of being in the Zone will emerge within a one- to two-week period if you follow the instructions in this book. But the best reason to want to stay in the Zone on a lifelong basis is to achieve SuperHealth.

For most people, health is defined as the absence of disease. SuperHealth goes beyond that. In a state of SuperHealth you will reduce the likelihood of developing chronic disease, thetypes of illnesses that represent the bulk of our health care costs. If you have read The Zone, you know that SuperHealth is exactly what you are aiming for. And the only way to obtain SuperHealth is to take control of your diet, and use it to keep yourself in the Zone on a continual basis. The more time you spend in the Zone, the more control you have over the ultimate quality of your life.

When I wrote The Zone in 1995, I tried to show that the age-old inherent common sense about dietary balance is really cutting-edge twenty-first-century hormonal control technology that can be mathematically defined with a precision your grandmother never dreamed of. While your grandmother's diet was prepared intuitively, you can do it scientifically.

This book marks the next step on that quest. It will show you how to make a wide range of food choices, from gourmet meals to fast-food drive-through fare and everything in between, while still staying in the Zone. Although thinking of food hormonally may be revolutionary, eating in the Zone is not. In fact, eating in the Zone is a lot like eating your grandmother's cooking (except for the fast food).

For those of you already in the Zone, this book offers new information on making the Zone part of your lifelong routine, from tips on eating out and shopping, to information about adjusting the Zone Diet to your own body chemistry, to more than a hundred and fifty new Zone meals that will make it easier for you to stay there. For those of you still struggling to reach the Zone, this volume will make your journey much faster and easier.

Once you use these tips, getting into the Zone and staying there becomes second nature because you will be eating the foods you already like to eat and adapting the recipes you currently use everyday into great Zone meals.

Let me help you visualize the Zone on a plate: a moderate serving of low-fat protein (such as fish or chicken) with a significant amount of vegetables covered with slivered almonds, and fruit for dessert. Every time you eat, make sure that your carbohydrates come with a protein chaser and a dash of fat. To be a little more precise, for every cup of vegetables, or half a piece of fruit or 1Ž4 cup of pasta that you plan to eat (these serving sizes will be explained later on), add an ounce of low-fat protein like chicken or fish. Then add a bit of monounsaturated fat, like a little olive oil or a few slivered almonds. Do this at every meal and snack, and, presto, you're pretty close to being in the Zone for the next four to six hours. And during that four- to six-hour period, you will be thinking better, performing better, and losing stored body fat—all without hunger. This book will teach you how.

Once you understand what the Zone is and how it works, you will also understand that virtually every dietary recommendation made by the U.S. government and leading nutritional experts is hormonally dead wrong. What is their recommendation? Eat a high-carbohydrate diet. Unfortunately, these authorities seem to have forgotten that the best way to fatten cattle is to feed them excessive amounts of low-fat grain. The best way to fatten humans is also to feed them excessive amounts of low-fat grain, in the form of pasta and bagels. Another popular dietary slogan these days says, "If no fat touches my lips, then no fat reaches my hips." But that is simply not true. Our war on dietary fat really began in earnest fifteen years ago as fat phobia became the norm. And the results are now clear: Americans have become more obese than anyone on the face of the earth.

Obviously, fat was not the enemy. If fat isn't the enemy, then what is? The answer is insulin. It's excess insulin that makes you fat and keeps you fat. And your body produces excessive amounts of insulin when you eat either (1) too many fat-free carbohydrates, or (2) too many calories at a meal. Therefore, when I talk about the Zone, it is really a zone of insulin. Not too high, not too low: a zone of insulin controlled by your diet.

To eat in the Zone is to treat food with the same respect you would give a prescription drug. However, this doesn't mean food must taste like a drug. On the contrary, Zone cooking allows for great-tasting food packed with maximum nutrition. Mastering the Zone is a recipe for lifelong hormonal control, a recipe that pretty much lets you forget about counting calories or grams of fat.

Throughout this book, I will refer to my program as the Zone Diet. Most people think of a diet as a limited time they live in a state of deprivation that allows them to return to old eating habits. The Zone Diet is neither deprivation nor short-term. It is not deprivation because while you're in the Zone, you maintain peak mental and physical performance while consuming the foods you like to eat. And being in the Zone is a lifetime habit, not a short-term fad. The hormonal responses generated by food that allow you to reach the Zone haven't changed for the past 100,000 years, and they are not going to change in your lifetime.

Like any lifestyle change, getting into the Zone takes patience and practice. But within two weeks, if not sooner, you will begin to see a dramatic change in your life. Carbohydrate cravings will be gone, mental focus will be increased, physical performance will be enhanced, and you will lose excess body fat at the fastest possible rate. And you will be well on your way to achieving SuperHealth. That's the kind of lifestyle change anyone should be happy to swallow.

This book is divided into three basic parts. The first describes how to determine your unique protein and carbohydrate requirements and how they work together to form your hormonal carburetor. The second part deals with the construction of balanced Zone meals and contains more than one hundred and fifty new Zone recipes. The final part provides helpful hints that will allow you to stay in the Zone for a lifetime.

If SuperHealth is what you want to achieve, then reaching the Zone and staying there is the way to make it happen. Your grandmother knew this intuitively. Treat this book as a personal user's guide and achieve a precision never imagined by your grandmother. And once you're in the Zone, why would you ever want to leave?

Chapter Two

Your Protein Prescription: The First Step to the Zone

You're nearly ready to travel toward the Zone, but just as with any trip, some preparation is necessary before you begin the journey. As I said in the first chapter, reaching the Zone is all about insulin control. If you have read The Zone, you know that the most important step needed to control insulin is fulfilling your body's unique protein requirements.

Why is protein so important? First, your body requires incoming protein on a continual basis to repair and maintain its critical systems. Your muscles, your immune system, and every enzyme in your body are composed of protein. Every day your body loses protein constantly. Without adequate incoming dietary protein, these critical body functions begin to run down.

But more important, protein is so vital because it stimulates the hormone glucagon. Glucagon has the opposite physiological action to insulin. In fact, glucagon acts as the major governor of excessive insulin production. It is excess insulin that makes you fat, makes you hungry, makes you mentally foggy, decreases your physical performance, and increases the likelihood of chronic disease.

If your goal is to enter the Zone and stay there, then you have to control insulin production, and to do that, protein is the key.

Mastering the Zone : The Next Step in Achieving SuperHealth and Permanent Fat Loss
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Sunday, October 28, 2007

Attitude Is Everything

Step 1

Understand the power of "attitude."

The first thing you need to do to turn your attitude into action is to tap into the power of your attitude. This key step is the foundation on which the other nine steps in this book are built. Attitude is everything.

As far back as I can remember, I've heard about the importance of a positive attitude. I heard it from my parents, teachers, coaches, and supervisors over the years. Not only did I hear it, I saw the powerful impact a positive attitude could have. I've seen it countless times in the lives of highly successful people. Some of these success stories make front-page headlines. Those that aren't making the news are certainly making headlines in the lives of those around them. A positive attitude is the foundation of a successful life.

With such compelling evidence to support the theory that a positive attitude pays off, I have made it my lifework to personally embrace a super-fantastic attitude and help others understand that attitude is everything.

Some have questioned my assertion, telling me that attitude isn't everything. That much more is involved in achieving success. Of course, it takes planning and hard work to reach your goals. I believe it is absolutely critical that whatever you do, you should do with all your might. Go for it! Work to the best of your ability.

But your ability may be much higher than you realize. It all comes back to attitude. Attitude is everything because it is involved in everything. It impacts our performance at work and our relationships. Attitude is the cornerstone upon which we build our lives.

If attitude is so important, we'd best understand its meaning. The American Heritage Dictionary defines attitude as a state of mind or feeling with regard to some matter. For me, attitude can be defined in one word: life. The attitude that you carry around makes an incredible difference in your life. It can be a powerful tool for positive action. Or it can be a poison that cripples your ability to fulfill your potential. Your attitude dictates whether you are living life or life is living you. Attitude determines whether you are on the way or in the way.

To develop an attitude that helps you live life to its fullest, as you were designed to do, you must first understand that the heart is the control center for your attitude. Your attitude is nothing but an outward reflection of what resides on the inside. To change your attitude, you must change your heart.

Ear-Gate, Eye-Gate, and Mouth-Gate

The most powerful computer in the world is the human computer. Our programming, then, comes through what we hear, see, and say. We can be programmed for success or failure based on how well we monitor what I call the ear-gate, eye-gate, and mouth-gate. What we see through our eye-gate goes directly into our hearts, frequently having a profound effect on our state of mind, sense of well-being, and, you guessed it -- our attitude. Likewise, what we hear through our ear-gate has the power to lift us up or drag us down. Finally, the mouth-gate speaks to the heart-mouth connection. As the proverb says, "Out of the issues of your heart, your mouth speaks." Our words have a tremendous impact on our attitude and the attitudes of those around us.

These concepts will be more fully developed throughout the book. You will see that regardless of what you have taken to heart throughout your life, it is possible to reprogram your attitude. It's a powerful transformation that can bring you both personal and professional success.

Keith Harrell's Reprogramming

Stories of my own reprogramming began early in life.

I spent most of my young adulthood chasing a dream to become a professional basketball player. In high school, I was an All-American and the Most Valuable Player of our state championship team. I accepted a scholarship to Seattle University, where I was the team captain for three of my four years. I averaged more than sixteen points per game in my senior year. In June of 1979, I expected to be drafted by a National Basketball Association team. It was a dream that I had shared with everyone I knew. My family, friends, teammates, and others who had followed my career had come to expect that it would happen, based on my success as a player in high school and college.

On the day of the NBA draft, I waited and waited and waited ... but the phone did not ring. I was devastated. I had devoted myself to the sport and to my future as an NBA player. It was tough to give up on that dream. I felt cheated when it didn't happen.

In the days and weeks that followed, the bitterness was revived every time someone commented on my failure to be drafted. It didn't help when strangers would note my sixfoot- six-inch height and say, "You must play pro basketball." For a long time I fought the bitterness. Finally I decided to let go of the negative feelings. I found a way to embrace this major change and focus on being positive instead. I realized that to grow inwardly I had to move on with my life.

I developed a new attitude and a new response to questions about my height. Not long ago, a woman seated next to me at a luncheon asked if I played with the NBA.

"Yes, I do," I replied. "I'm a first-round draft choice. I'm the most valuable player. I'm owner of the team, and we win the championship every year!"

"So you do play with the NBA?" she asked.

"Yes, I do. I play with my Natural-Born Abilities, and I'm slam-dunking every day!"

I did recover my positive attitude, but it took a focused effort to reframe my perspective, which is one of the key things I'm going to teach you in this book ...

Attitude is Everything Rev Ed
10 Life-Changing Steps to Turning Attitude into Action. Copyright © by Keith Harrell. Reprinted by permission of HarperCollins Publishers, Inc. All rights reserved. Available now wherever books are sold.
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Saturday, October 27, 2007

Atkins Diabetes Revolution

The Diabetes Crossroads

It's a frustrating fact of life: We don't have much say over whether we fall victim to life-threatening diseases such as cancer, Alzheimer's, or, to a large extent, some types of heart disease. However, there is one, all-too-common killer disease over which we have a great deal of say. Most people do have a choice when it comes to Type 2 diabetes. Astonishing as it sounds, this epidemic disease is almost entirely preventable. Of course, no one consciously chooses to get diabetes. Various factors-some in our control and some not-combine to create the unfortunate scenario. But if we all took proper care of our bodies and kept vigilant rein on the factors that are within our control, there would be no diabetes epidemic. Do you think we're overstating things? No way. In fact, what we hope we have created with this book is a realistic and practical guide to wiping out Type 2 diabetes, one individual atatime.

According to the National Institutes of Health, in 2002, a record number of Americans -- 18.2 million, or 6.3 percent of the population -- were thought to have diabetes. Of these, 13 million were already diagnosed, while 5.2 million probably have diabetes but haven't been diagnosed yet. That means many millions of Americans are blindly chugging down this dangerous road. Sadly, in our experience, many well-meaning health care professionals give their patients the standard information, some of which perpetuates the very disease it's supposed to cure or prevent. That's why Dr. Atkins felt it was crucial to write this book.

In 2002 and 2003, the American Diabetes Association redefined and standardized the criteria for blood sugar abnormalities. Unfortunately, none of these changes were implemented in order to find patients earlier in the process. Our interest is in identifying patients with these metabolic problems long before they advance to the "official" blood sugar level defined as diabetes.

If you know what to look for, you can identify the metabolic signposts that signal trouble even earlier in the process -- and intervene immediately. If you are reading this book, you are clearly concerned about your health or perhaps it's someone you love about whom you're concerned. Either way, congratulations to you for picking up this book. Let's not waste another minute.

We will show you how to make relatively simple lifestyle changes that can significantly reduce your risk of ever getting diabetes, even if you already have some of the preliminary symptoms. And if you have already been diagnosed with diabetes, this book can help you mitigate its effects or maybe even stop further progression.

We can be your guides on the road to better health, but it is you who must take control of your destiny by making and implementing the right choices. Imagine that you are standing at a crossroads in the map of your life. Ahead of you lie two paths. One almost inevitably leads to diabetes and its accompanying health problems; the other leads to optimal health. Which will you choose?


Let us tell you about the path that Dr. Atkins recommended to his patients for decades. It differs dramatically from the treatment with drugs most health care practitioners have been taught. Instead, his path identifies risks for diabetes as early as possible, focuses on prevention, and involves permanent lifestyle changes to address the underlying metabolic problems that lead to diabetes. These lifestyle changes can be as simple as changing what you put on your plate -- a better option, we think you'll agree, than swallowing an array of expensive and potentially dangerous drugs. Those of you who have read Dr. Atkins' other books will recognize a point he hammered home for decades: Instead of treating the symptoms, his approach can correct the problem itself.

Finally, for individuals whose blood sugar abnormalities are further advanced or who already have diabetes, this path decreases or eliminates the need for drugs to treat these conditions. (Did you know that some of these drugs actually make it harder to lose weight? Talk about a vicious cycle.) Whether you're just beginning to be concerned about diabetes or you've already been handed the official diagnosis, controlling carbohydrates is the vehicle that will take you off the rutted road of self-destruction and onto the smooth one of recovery and excellent health.

The decision to improve your health is an obvious one, but to follow this "right road" -- and stay on it-you need clear directions and a good map. That's what the Atkins Blood Sugar Control Program (ABSCP) gives you. The ABSCP is a highly individualized approach to weight control and permanent management of the risk factors for diabetes and cardiovascular disease. And it works.

I've witnessed these life-changing improvements in patients such as this 45-year-old woman. Ruth L. weighed 375 pounds, with a body mass index (BMI) of 60.5 and uncontrolled Type 2 diabetes. Although Ruth took three medications daily in an effort to control her blood sugar, her glycated hemoglobin (AlC)was 11 (more than two times the norm, demonstrating very poor blood sugar control). The day she began the program, I had her stop all her blood sugar medications. After two months, her AJC was down to 7.7. After 18 months, she had lost 132 pounds, her lab values were normal, with an A1 C of 5.4, and she remained off blood sugar medications.

The ABSCP builds on the basic controlled-carbohydrate concepts of the famed Atkins Nutritional Approach and individualizes it specifically for people like Ruth who have -- or are at risk for -- blood sugar abnormalities and diabetes.

Once you're heading in the right direction, the program helps you to stay with it and map your progress as you pass milestones along the way. The ABSCP includes controlled-carbohydrate nutrition; supplementation with vitamins, minerals, and other nutrients; and exercise -- all of which are customized to your needs.

To begin, you need to understand more about this insidious disease. Let's start with the basics.

Excrpted from
Atkins Diabetes Revolution
The Groundbreaking Approach to Preventing and Controlling Type 2 Diabetes. Copyright © by Robert Atkins. Reprinted by permission of HarperCollins Publishers, Inc. All rights reserved. Available now wherever books are sold.
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Friday, October 26, 2007

26% of all American children are overweight

I'm very happy to be writing the Foreword to the Feed Your Kids Well: How to Help Your Child Lose Weight and Get Healthy book. For years, I've been treating adults with nutritional medicine with overwhelming success. But why wait until you're an adult to feed yourself well? It makes all the sense in the world to start a healthier way of being in childhood.

Our children are having more problems than ever before. You might find it interesting to revisit your old sixth-grade classroom. Remember how few of your classmates were overweight? Well, look at their successors now. I'll bet you'll note a mini-epidemic of overweight children.

That's just the visible side of the problem. Delve further and you may find that two in every ten schoolchildren have been prescribed the stimulant drug Ritalin because their hyperactivity or inconstant attention spans make the teachers' problems too difficult.

Type II diabetes, something that heretofore required a minimum of three decades to develop, is beginning to be seen in high school students.

The sad news is that all of these problems are obvious consequences of a culture wide series of nutritional mistakes. Yet the leaders of medicine are not only perplexed by the epidemic nature of these and similar problems, they continue to perpetuate the same mistakes that have caused these problems.

Many are the hours that my practice associate, Dr. Fred Pescatore, the Medical Director of the Atkins Center for Complementary Medicine, has talked with me about the vast gulf between the successful results our school- age patients were getting and the lack of success their previous medical management had provided. We agreed that the failure to recognize the harmful consequences of repeated courses of antibiotics or of constantly recycling environmental chemicals created many of their problems, but we were amazed by mainstream medicine's utter failure to recognize the harmful effects on our children's health of junk food containing the refined carbohydrates-sugars and starches. And we wondered when they would realize that their insistence on restricting fats has only led to an increasing intake of junk carbohydrates. That advice has only been part of the problem, not its solution. FOREWORD

Feed Your Kids Well provides that solution. It is based not only on an under- standing of what children must learn to eat and to avoid in order to maintain ideal health, but also on targeting of vitanutrient intake to correct the medical crises our children face.

The information in Feed Your Kids Well is accessible and has been time-tested by the Atkins Center medical staff. You'll find that its suggestions make sense. The most pleasant surprise of all is that the food and nutrition plans Dr. Pescatore suggests will be accepted by most children because the often-immediate improvements they will feel can prove to be self-motivating.

Feed Your Kids Well contains a message that all parents need to learn-junk food and pharmaceuticals both have significant downside risks. If we get our children to avoid both of them, we can allow them to thrive in ideal health.

Dr. Pescatore teaches you, step by step, just how easy and rewarding that can be. Introduction by Fred Pescatore, M.D.

A refrain I hear over and over from the children who come to see me is, "I wanna be healthy." They wanna be healthy but don't know how. And how could they? They arc children, and what they know is what they learn from their parents, teachers, and other children. But they can be healthy. This book is the tool that concerned parents can use to help their overweight and nonoverweight children get healthy.

I am living proof that health is an attainable goal. I was an overweight child. If you've never struggled with a weight problem, it's a condition to which you will never quite be able to relate. Being fat distorts your body perception, gives you a poor self-image, and often leaves you open to ridicule.

That's only what being overweight can do to your child when he or she is young. There are lifelong psychological and physical implications. No matter how slender I might be today, inside there will always be that overweight little boy, longing to be thin and athletic, to fit in. Today, I am exactly the right weight for my size, but I still carry the baggage that will. I'm sure, remain with me for the rest of my life.

I wish my parents had Feed Your Kids Well when they were raising me. Over the years, I have spent a good deal of time undoing the many harmful (albeit well-meaning) eating habits they instilled in me. It's important to understand that habits arc all they are. Proper eating, like proper manners and grooming, must be taught. Too often, parents don't realize this.

I host a weekly radio show. When I interview an author, one of the first questions I ask is how he or she came to write; the answer tells me a good deal about the person, I'd like to share with you some of my background, and how it affected who I am today and why I'm writing this book.

My quest for knowledge has taken me all over the globe to look for the most beneficial ways of treating my patients. I tell my patients that I will do almost anything that will make them well. That is my job, and I take it seriously.

Even as a child I knew I wanted to be a physician. There was never any other consideration for me. I wanted to help other people-and myself. During my medical training in New York City, I was exposed to the latest scientific break- throughs. I was trained in a completely conventional (allopathic) medical way, and I would have been satisfied with that approach-if only the majority of the patients I saw were getting better. That wasn't the case and it concerned me. I began to think there must be something else that could be done; there had to be more to healing than what we were doing in the hospital. I wasn't naïve enough to think everyone should live forever, but I was idealistic enough to believe we could be doing more for our patients.

Fortunately, right after residency training, I stumbled upon complementary medicine, a completely new concept for me. Complementary medicine involves looking for the source of a person's medical complaint, not just attacking symptoms. Complementary medicine challenges the physician to find the answer and the cure. It involves using alternative medical techniques along with those learned in traditional medical schools.

I have been fortunate to train with one of the founding fathers of complementary medicine. Dr. Robert Atkins. Many of you know him as "the diet doctor," but he's much more than that. He has been treating patients in a complementary fashion for more than thirty years. I was able to draw on his experience and to develop my own ideas on nutrition and vitamin supplementation, allowing me to offer patients more than just one drug after another.

Feed Your Kids Well comes at a time when the medical establishment is finally beginning to realize that alternative treatments exist and are flourishing. In the past year, over one in three Americans visited an alternative medical practitioner, and yet there have not been many doctors discussing the benefits of alternative medical techniques for our children. If you are comfortable exploring alternative techniques for yourself-and you've found success with them- the next logical step would be for your children to share in that success.

Through my years working with Dr. Atkins, I developed my own ideas about health and nutrition, and I have put these ideas to the test with my patients. Some of Dr. Atkins's ideas and mine are similar, while some of them are quite different. His very successful weight-loss diet involves achieving a metabolic state called ketosis, which occurs when the body is actively metabolizing stored fat. Because children are more metabolically active than adults, my nutrition plan, the Next Generation Diet, does not call for your child to achieve this state. I'd like to believe I've taken Dr. Atkins's work to the next level-the next generation.

Feed Your Kids Well includes a nutritional lifestyle program that incorporates the important building blocks-protein, fats, and carbohydrates-combining them in a complete, well-balanced meal plan that is easy to maintain over a life- time. Part One of the book explains the science behind your child's body and metabolism. The diet outlined in Part Two will enable your overweight child to lose weight and to become more healthy. Part Three explores the treatment of some of the most common childhood illnesses in ways your child's pediatrician may not have told you about. It also explores many other diet-related illnesses to which your child may be unknowingly susceptible because of his or her diet

These principles apply to all children-overweight or not. Part Four covers the role of exercise. My program is linked to an exercise plan to ensure success. Exercise has become almost anathema to many of our children; each year, less and less time is spent in the pursuit of physical activity. I will discuss the importance of exercise and many ways you can incorporate this into your and your family's daily routine. In Part Five, I offer sugar-free menu and recipe sections that will enable you to make great meals that have withstood life's toughest critics-children and teenagers. The beauty of The Next Generation Diet is its simplicity. You need not concern yourself with calorie counts or monitor the fat intake. The diet does this for you automatically. Calories don't count, and your child will never go hungry. The only thing you have to monitor is the number of grams of carbohydrates that are present in the foods you feed your child. I'll teach you how to do just that This information is contained on the nutrition label located on the packaging of most foods. To make it easier, I often recommend that my patients buy an inexpensive companion carbohydrate counter they can use to help them plan each meal.

Part of treating a patient in an integrative way involves the use of oral nutritional supplementation-taking vitamins, minerals, and sometimes herbal preparations. I contend that it is possible to treat many common childhood illnesses without the use of harmful drugs. I'll share some of my time-tested favorite supplements with you throughout this book. At the very least, these nutritional supplements may be used in combination with drugs your pediatrician has recommended in order to achieve the optimal health picture for your child. It's important for you to understand that I do not mean for this book to be a replacement for your child's pediatrician, who is very important to the well-being of your child. I simply offer additional advice that has worked in the hundreds of children I've treated.

I believe we are at a health crisis point. Never before have there been so many overweight adults and so many overweight children. What is being over- weight? It's partly based on a scientific ratio that I'll explain to you, and it's partly based on social norms. I'll provide you ways to determine if your own kid is overweight.

According to the National Health and Nutrition Exam Survey, approximately 26 percent, or one in four, of all American children and adolescents are overweight. That is double the rate of thirty years ago. Between 1963 and today, this rate has increased by 54 percent among children aged six to eleven and thirty-nine percent among adolescents aged twelve to eighteen. In the case of a child, obesity, as opposed to simply being overweight, is defined as being greater than 130 percent of the ideal body weight for the child's height. Using these figures, 14 percent of all children and 12 percent of adolescents are obese. When the figures for overweight and obese children are combined, we find that nearly one in three children has a weight problem, while half of all adults arc overweight. You can see that this problem is of epidemic proportions-an epidemic that has occurred despite the years of what I call the "low- fat myth." The low-fat, high-carbohydrate diet was proposed as the ultimate healthy diet because in the athletes who ate this way, cholesterol levels and other health indicators were favorable. However, because most Americans are sedentary and not at all athletic, I feel that advocating this diet has been a great disservice to the American people.

All current indicators show that the health of the American population- adults and children-has gotten worse, not better, since the low-fat diet has become the standard. Even if the low-fat diet is okay for some people, it clearly is not the diet for the majority of the population. Instead of eating meat, people now pile their plates with pasta and think they are eating wisely. In this book I will show you how this is equivalent to piling your plate with sugar. It is my contention that the interaction of sugar and carbohydrates with proteins and fats-not just fat alone or genetics-has led to this obesity epidemic in our children.

As I researched this book, I was amazed to find that there was no similar book that portrays sugar as the "food criminal" for children. This is odd because there have been many diets for adults that view sugar this way. By far the most famous and successful is the phenomenal bestseller Dr. Atkins'New Diet Revolution.

Being overweight is far more than just a cosmetic problem, although it's sometimes treated that way. It can be the cause of a host of health-related problems. Only now, after years of research, are we beginning to realize that the preventable harm we cause our bodies when we are young takes its toll on us as adults. Furthermore, because obesity is affecting a younger and younger segment of the population, diseases-diabetes, heart disease, hypertension, sleep apnea, orthopedic abnormalities, and others-once confined to adults are now becoming increasingly prevalent in our youth. If we don't do something to stop the obesity epidemic, the next generation could suffer these horrible and potentially fatal diseases as regularly as we suffered from chicken pox when we were young.

My original purpose for this book was to provide a weight-loss book for children. However, as I thought about it over the period of several months, it became clearer to me that through a healthy diet many childhood illnesses, including allergies, asthma, and even attention deficit disorder, could be tempered and brought under control without the use of potentially harmful medications, which in fact, might even be a cause of these illnesses.

Don't kid yourself, it's not just baby fat, and it's not just big bones. I can't tell you how many times I've heard those excuses, offered by overprotective parents and grandparents to spare themselves pain. I say this because parents must often make difficult adjustments in their own lives and their own eating habits in order to make successful changes for their children.

No matter how precocious your child may be, it is important to remember that he or she is not merely a pint-sized version of an adult. Some parents for- get this and believe that they can simply place their overweight child on a diet designed for an adult Be forewarned: an adult dietary plan cannot be used for any of your children, overweight or not. Chances are that not only won't the adult diet work, but it could conceivably do damage to healthy growth patterns and the normal maturation of your child.

An adult diet is no more suitable for a child than is a television program or movie that has been designed specifically for mature audiences. Children require different nutritional balances at different stages of their lives. For this reason it is not practical or healthy to put your overweight child-or any child-on any of the numerous adult diets.

Stop to think about it for a moment It would be inconceivable for a parent to feed an infant anything but food especially formulated for them. Yet, once the child is able to speak and eat on his or her own, this same parent wouldn't think twice about giving their toddler or preschooler exactly what they themselves would eat or exactly what the child wants to eat Suddenly, nutrition takes a back scat to everything else.

This book will help you avoid those mistakes by giving you hints on how to handle even the most stress-inducing children in their pursuit of proper eating habits. I discuss children who have terrible eating habits, like those who choose to eat only junk food or those who won't sit at the table with the family.

The earlier in life you start any program, the greater is the chance of a life- time of success, and it is possible to start a diet protocol for any child starting at the age of two. I encourage dietary modifications for the children of my patients this young, but I won't be offering that advice in this book. This is a highly individualized segment of the pediatric population, and I would feel uncomfortable offering advice where I could not personally oversee the results. This book is therefore designed for kids from ages six to eighteen.

Feed Your Kids Well is divided into sections devoted to specific age groups. Please keep in mind that these age groups are only suggestions. For example, a very large five-year-old can certainly be started on the diet A small thirteen- year-old may fit better in the nine to twelve category than in the teenage one. No one knows your child better than you, and common sense in this regard should prevail when deciding in which age group to place your child.

The inspiration for this work comes from my patients, a constant source of enjoyment and encouragement to me. I've successfully treated and helped hundreds of children and thousands of adult patients lose weight and attain health. It is extremely rewarding to me to offer a program that enriches the lives of so many people. It -was at my patients' prompting that I ultimately agreed to share this nutritional plan with the rest of the world. It is my strongest desire that the next generation of children do not have to grow up the way I did.

Many of the success stories you will read are about the children of my adult patients. These parents were so unhappy with the treatment their children were getting from their regular pediatricians (in many cases, it was simply a matter of drug after drug) that they brought them to me, knowing from their own experience that their children would get well and flourish. Each story you will read about in this book is true. The name of each patient has been changed to protect his or her privacy.

My ultimate aim is to offer a comprehensive nutritional lifestyle plan that can and will work not only for your child, but for the entire family. You can't isolate one child from siblings, adults in the household, or the outside world. Parents cannot do this important work alone; your children are being minded by many people other than you. Anyone who takes an active caregiver role for your child also needs to read this book. This especially means anyone doing the grocery shopping and meal preparation. This will probably include siblings, grandparents, or household help.

The plan I'm outlining will work not only in the initial phases when every- one is enthusiastic about it, but also in the more difficult maintenance phases when the program needs to be reinforced in order to guarantee a lifetime of healthy eating. Once the honeymoon phase of the diet is over and the real work begins, it is a supportive family that will ensure the longest-lasting effects.

I hope Feed Your Kids Well will help you instill in your children a sense of responsibility for one's own actions, including making the correct decisions about what to eat They need to learn that a healthy diet-and-exercise program will enhance every aspect of their lives.

So do something about your children's weight if they are overweight, and if they are not, do something about their diet in order to prevent them from becoming victims of a diet-related illness. One of my goals is to make you think twice about what you fur entire family, including yourself. If you feed your kids well, you can help ensure a lifetime of good health for your children-the best legacy of all. Chapter 1 - A Personal Story

I GREW UP IN WHAT WE CONSIDERED TO BE A TYPICAL ITALIAN-AMERICAN family. Everyone was obese-my mother, my father, and my two sisters. It wasn't even a topic for conversation because, to us, it was the norm. Italians ate. We ate. And we ate a lot. So what?

The mainstay at each meal was pasta. Pasta and bread, followed by a course of meat. No matter what the main course was, we would start with pasta. And there was no such thing as eating only everything on your plate. In our household, if you didn't ask for seconds, then there had to something wrong with you. If you didn't eat enough, you were probably coming down with something that might require a doctor's attention.

Naturally, because this was my only dining experience, I thought this was the way everybody ate. In fact, when I visited other people's homes and saw that they didn't eat that way, I thought they were odd, that they were the ones who were out of step with the rest of the world. Where was the pasta course? Something was terribly wrong. Didn't they know what a real meal was? I would often come home hungry and my mother would feed me again, only this time what she considered a proper dinner. I was even encouraged not to go out to eat because the food wouldn't be very good and I'd come home hungry.

The Weight Issue

Was weight an issue in our family? Absolutely not. After all, coming from a tight-knit family, we thought everybody lived and ate like we did. There was no standard to compare ourselves to, other than us. Should weight have been an issue for our family? You better believe it! I was overweight, as were my two older sisters. Both my parents were also overweight. The sad thing was, because y parents did not see this as a problem, neither did any of the children. Sure, my sisters attempted to lose weight every so often, but because there was no support from my parents, who were always pushing food in front of us, they were doomed to failure, (And, as a result, they still are overweight. Neither of them has ever been able to maintain weight loss from the numerous diets they've tried over the years.) Perhaps I was more fortunate in my attempt to lose weight because I had the advantage of being the youngest child. I was able to see the way my sisters were constantly sabotaged, and I knew that when I did make the attempt, I had to do it without the prior knowledge and consent of my parents and without listening to their advice and recommendations.

This is not to say that I don't love my parents or value their advice about other issues. It's just that they didn't have the knowledge to handle this problem. They were great parents in every other way and provided me with the means to achieve as much as I have. I just wish they had had this book to hope guide them when I was growing up.

By the time I was fifteen years old, I was five feet ten inches tall an weighed a whopping 240 pounds! My life was a mess. I suffered from asthma and various allergies. I couldn't play sports because I didn't have the stamina. The truth was, I could hardly move. Socially I was an outcast. I was teased unmercifully by my peers which caused me to be deeply ashamed of my obesity and, by extension, myself.

As you can imagine, I was desperately unhappy. I wanted to do what my friends were doing. I wanted to play singles on the tennis team, but I just didn't have the endurance. Finally, I was so miserable that I realized I had to do something. It was Lent, the forty-day period of time when Christians will forgo eating food they like or participating in activities they enjoy in order to commemorate Jesus spending forty days in the desert without food and water. So I made a secret deal with myself that for forty days and forty nights I would give up all solid food.

Without any supervision or guidance whatsoever, I embarked upon a crash starvation diet. I drank diet soda and nothing else. By the end of forty days and forty nights, I had lost sixty pounds. But it was not without paying a steep price. Before beginning the diet, I was a straight A student. By the time it ended, I could hardly pay attention in class and my grades plummeted. My stomach shrank, which was a perfect setup for a lifetime of yo-yo dieting. My body started to break down, and I began to lose muscle tissue. I was sixty pounds lighter, but my body and mind were suffering potentially dire consequences. At this point, as you might well imagine, my mother was beside herself. There were constant fights and attempts at bribery to get me to resume eating "regularly." My parents thought there was something wrong with me and even went so far as to take me to see several physicians and priests. But to no avail. At this pint, I was finally going to take control of my life and see my way to a skinnier me.

Revelation: losing weight means getting healthier

In spite of my poor dietary habits, I had managed to lose an enormous amount of weight and by the time I was finished with my crash diet, I found there was an added bonus: my allergies and asthma had amazingly disappeared. Once I began on my own version of a maintenance diet, which consisted primarily of meats and salads, my stamina returned and my mind cleared. Without realizing it, by losing weight and changing the foods I ate, I had become a healthier person. For the first time in my life, I began to equate what I ate with how I felt. It was only after this experience that it occurred to me that proper eating should be as ingrained in our psyches as is washing our hands before eating and brushing our teeth after meals. I only wish I'd had that knowledge long before I became an obese teenager. It was such a simple lesson to learn: What you place into your body becomes a part of you and can affect how you feel!

If I had grown up with this knowledge as simply another part of the value system my parents had instilled in me, I would never have become obese, and my whole life would not be centered around the struggle with weight as it is today.

I had lost the weight, but as anyone who has a weight problem knows, that's only half the battle. I had to keep the weight off. And, to this day, the maintenance of this weight loss remains a problem.

Since the time of my initial weight loss, I have been on numerous fad diets, many of which I've made up myself. Some of the more humorous ones include the French fry/chocolate pudding diet I was fond of in medical school. Another diet I was partial to in medical school was the egg white/spinach diet I should mention that somehow I managed to lose weight on both these diets, but do either of these sound particularly healthful to you? Of course not. The truth is, because of a young person's metabolism, they will be able to lose weight on most any diet, but the results won't necessarily be healthful.

Even now, twenty years after I lost all that weight, I still think about food pretty much constantly throughout the day. Perhaps this can be somewhat explained by the fact that I practice nutritional medicine, but I think there's more to it than that. At this point, it is relatively easy for me to know what it is I can and cannot cat, but at times I have to be stricter with myself than at other times.

Your children can avoid these troubles. You need only arm them with the necessary nutritional information and then consider it important enough to work with your children to stick to healthful eating. It is my goal that this book help you do just this: Give your child the legacy of good eating habits-and a trim, healthy body.

Feed Your Kids Well: How to Help Your Child Lose Weight and Get Healthy
Buy this book at Barnes & Noble

Thursday, October 25, 2007

The missing link to thinness

Thin For Good provides the missing link to thinness by giving you:

1. a good, healthy low-carbohydrate diet program, and
2. the power to use your mind to control your body.

The way most North Americans are being encouraged to eat today is wrong. There is no scientific evidence to support the claim that by eating a high-carbohydrate, low-fat diet, you will get healthier and thinner. Instead, there is ample evidence to support the fact that a diet too low in fat may eventually lead to adverse health consequences, especially an increase in heart disease-- amazingly, the main problem a diet low in fat was supposed to solve.

This "low-fat myth," as I like to call it, has resulted in people believing that they can eat as many carbohydrates as they wish, as long as they don't contain fat. How many times have you sat down and finished an entire box of cookies or an entire pound of pasta and rationalized it by telling yourself that, after all, the food was fat-free? Fat-free maybe, but what about all the sugar you've just ingested? Yes, there is sugar in those fat-free foods. And yet you still expected to lose weight. Besides, don't you find eating fat-free a little boring? I know I do.

When I decided to write this book, I wanted to keep the good principles of low-carbohydrate eating, leave the bad ones behind, and at the same time change the way people look at food.

Thin For Good teaches you to choose all the delicious and nutritious foods you may eat-- and which foods you should avoid-- while still losing weight. Thin For Good eliminates a treacherous roadblock on the way to thinness: boredom, by not only being much more varied than most other low-carbohydrate diets but by giving you a mind plan that will leave the boredom behind.

During my years as the Associate Medical Director of the Atkins Center, I realized that the paradigm needed to change. I do not want people relegated to counting carbohydrates their entire lives-- a new obsession that for some people has replaced the old obsessions about counting calories or fat grams. The problems with the old low-carb diets were especially evident with women, who found that eating all that meat wasn't enabling them to lose the weight they wanted.

Thin For Good offers a new low-carbohydrate way of eating, though not as restrictive as the Atkins diet. I believe it is possible to lose weight without having to be so strict about the carbohydrate content. You won't have to completely ignore carbohydrates that have nutritional value. Just as all fats are not bad, neither are all carbohydrates. I'll show you the differences.

As for fats, you will not be eating an unlimited amount of that food group, either. Fried foods and saturated fats must be limited when trying to devise an eating plan for life. Eating all the bacon and chicken skin you want is not healthy. The Atkins diet rarely took those things into account.

Think about it. How many diets have you been on in your lifetime? If you are an average North American, the number is at least ten. As you read this, one out of three Americans is currently dieting. Some of the diets we go on are pretty loony. And frankly, many of them work-- at least in the short term.

In Thin For Good, I will also show you how the most important component of being a successful dieter was missing from all the other programs you have ever been on. Simply put, you must have the proper mind-body connection if you are ever going to be successful at dieting. No other diet has given you this information, and that's why you haven't been able to stay thin-- up until now.

I have developed a concept called "Mind Over Calories." Mind Over Calories will help you understand the rage and frustration you feel every time you follow a diet perfectly and still fail to lose weight. Food plays an extremely powerful role in the psyche. If you doubt this, I encourage you to take a moment to consider your food cravings and how emotional they may make you get from time to time.

Thin For Good opens the power of your mind to aid your weight loss, something you will not find in other low-carbohydrate eating plans such as Protein Power, Sugar Busters, or The Zone. None of those diets focuses on balancing the mind with the body. If you don't include your mind in the dieting process, you are ultimately doomed to failure. Thin For Good provides the solution to many of dieting's psychological roadblocks-- you won't find it in those other bestsellers.

This book will help you learn how to overcome the overweight mind-set, or at least how to have better coping strategies. Ultimately, it will teach you a new way of life. Your mind holds the key to your success. This is what will make this diet work where others have failed.

For each day of Thin For Good's initiation phase, I will give you an inspirational tip to teach you how to overcome your overweight mindset. I'llgive you an easy one now: Don't call this a diet; call it a nutritional lifestyle program.

For most of us, the word "diet" makes us think of deprivation. As someone who spent most of his childhood and young adulthood as an overweight person, I can tell you that I uttered the phrase, "I can't wait for this diet to be over!" so many times that it practically became my motto. As soon as this diet is over, I can go back to eating the way I like, right? Wrong! You can never be a truly thin person until you stop thinking of a diet as something that has a beginning and an end. Simply put, "diet" must become what you eat.

Thin For Good will provide you with the solution you'll need to master in order to never have to "diet" again. You will see that your mind plays an enormous role in this transformation.

Besides the power of the mind-body connection, there is something else I've learned in my years of practicing nutritional medicine: Women and men eat differently. No other diet book has addressed this cornerstone topic. Thin For Good provides you with another first, namely, one diet for women and another for men. The two diets are similar in that they draw on the same premise of low-carbohydrate eating, but they take into account the fact that there are basic physiological and psychological differences between women and men. After all, how can women and men possibly eat the same way and expect to lose weight? It's not possible, yet other diet books use a "one diet fits all" philosophy. The result is that when we don't lose weight fast enough or we don't lose it at all or-- worse yet-- when we compare ourselves to others we know, we wonder why we're not successful. We then use our lack of success as an excuse to stop dieting.

Over the years, in my role as associate medical director of the Atkins Center for Complementary Medicine in New York City, I worked with thousands of people who were trying to diet. At the center, everyone was placed on the same diet, with few variations. After years of experience, I saw that this was clearly not the way for everyone. There are differences in how a person metabolizes food, and the Atkins diet, as good as it was, did not take that into consideration at all.

Besides the differences between the sexes, there are also eating differences having to do with the stage of life you're in, which doesn't necessarily mean the same thing as your chronological age. Through my years of clinical practice, I have noticed certain stages of life that correspond to different dieting needs. There are four different female stages and three different male stages. So I subdivide Thin For Good into different categories according to your stage of life. One quiz for women and another for men will help you determine exactly in which stage you should start your diet. This is a critical issue, because just as every human being should not be on the same diet, every woman or man should not be on the same diet as women or men in different stages of life.

Another breakthrough is the diet I have devised for vegetarians-- the first low-carbohydrate vegetarian diet available. So, even if you are lacto-ovo or a strict vegan, Thin For Good can help you lose weight the healthy way, too.

Included as part of the diet program are nutritional supplements. These are essential for any dieter. As there are so many to choose from and the array can be confusing, I have laid out a plan that covers the most common needs of any dieter. Individual supplement programs are outlined for both men and women, based on what stage of life you are in. This takes into account the most common health issues, such as menopause for women and prostate problems for men. The information found in this section will take the confusion out of a most difficult task.

With these concepts and tools, I believe that Thin For Good is the solution you need to break the previously inevitable cycle of yo-yo dieting.

When I was young I had no idea that I would be dedicating my life to nutritional medicine. I did know at an early age, however, that I wanted to help people lose weight. The reason was simple: I was an extremely overweight child and, over the years, I have been fortunate enough to learn that it is possible to lose weight forever.

After I initially lost my excess weight, I have never put it back on, yet I know firsthand what a lifelong struggle it can be-- not so much to lose weight, but to keep it off. Many of my patients don't believe I was ever overweight (or simply "heavy," as my parents called it) because of my appearance today. But believe me, it's true.

In the years after medical school, I read every diet book I could find. Two problems all of them shared were 1) the inability to describe a proper maintenance program-- the most essential component of any dietary regime, as far as I am concerned, and 2) the lack of a psychological game plan. After all, how can anyone lose weight without a practical program, with both a nutritional and a mind-body perspective, for how to change improper eating habits and, most importantly, a roadmap for how to learn new habits?

The patients I have treated-- first at the Atkins Center and now at the Centers for Integrative and Complementary Medicine-- have almost always been successful because I am able to modify their diet in order to make it work for them. My secret is to individualize each patient's program by using many of the methods you are about to read. Thin For Good will provide you with many of the tricks I learned to get even the most stubborn body to lose weight.

The emphasis needs to be on teaching you how to lose weight and be successful for a lifetime-- not only for the first few weeks.

With Thin For Good, you will not only enjoy the benefits of low-carbohydrate eating, but you will enjoy something stronger: the power of your mind working with you, not against you. This time, truly make it thin for good.

Let's get started!

Excerpted from Thin For Good



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Tuesday, October 23, 2007


My son is thirsty.

For most parents that sounds rather harmless, one of many
needs that any three-year-old has. At first, Garrett's request seems
particularly innocuous. He has always preferred drinking milk or juice to
eating. His constant running and playing would dehydrate any child, and he
shows no sign of illness. But when he looks up at me and says, "Daddy, I'm
thirsty," repeatedly over several days, I wonder if the damage has already
been done.
Soon Garrett's complaint becomes more urgent, and the water
flows right through his small body, causing frequent trips to the bathroom. I
try to break the cycle, telling him he's had enough to drink and hoping that
his craving will go away. But still he drinks. He is potty trained, and he does
all he can to hold the tidal wave of water coursing through him. On several
occasions, he groans in his sleep to avert wetting his bed. I rush into his
room, hustle him into the bathroom, and yank down his pajamas just in time.
Splash! The urine rushes out like water from a fire hose. A couple of times
the force is too great, and he pees in his bed.
"That's okay, buddy," I tell him. "We just can't drink so much
water at bedtime."
I am hoping for something, anything, whatever it takes to diminish
his longing. But the water has become his lifeline. I watch him hold the glass
in both hands, lift it carefully to his mouth, tilt it, and swallow again and
again. I had once been thirsty like that. It was many years ago, but I
remember it well.

* * *

In medical-speak, the word ispolydipsia — abnormal thirst. It's an early
symptom of diabetes: your body, suffering from elevated blood sugar, pees
out the excess glucose and triggers the demand for more water. As the
disease progresses, the body burns its own fat for energy, leading to a
similar cycle of insatiable hunger followed by rapid weight loss. These are
signs of type 1 diabetes, which is usually diagnosed in juveniles and treated
with insulin.
I was diagnosed with type 1 at fifteen, and like every parent with
diabetes, I scrutinize my kids — we also have a six-year-old daughter,
Amanda — every day for symptoms, real or imagined. Hunger. Thirst.
Fatigue. Weight loss. Emergency trips to the bathroom. Cuts that heal
slowly. Crankiness. Unusual cravings. Any aberrant behavior could be a sign,
however tenuous, of disorder in a child's finely tuned metabolic system. As a
diabetic, I learned early on that the price of health is eternal vigilance, but as
a parent, the price of devotion is chronic paranoia.
Garrett, at this stage, displays no other symptoms. He hasn't lost
weight, increased his appetite, or complained of tiredness. On the contrary,
he cannot look any better or behave any more vibrantly, a high-spirited little
boy with tousled sandy hair and limpid brown eyes. His preschool teachers
call him "Smiley" because he's always laughing. He loves sports — running,
tackling, kicking a soccer ball — and is already hitting live pitching in our
driveway. He's strongwilled — a nice way of saying he's stubborn. One night
we heard a loud thump in his room. He had climbed out of his crib and
crashed to the hardwood floor. We figured he had learned his lesson and put
him back in the crib. Minutes later, thump! He had repeated his escape to
the floor. At eighteen months, he was out of the crib. His pediatrician says
that, pound for pound, he's the strongest patient she has.
But all the signs of health are now misleading. A nagging cold has
slowed him down, and despite my coaxing, his desire for water continues to
be strong. Events take an eerie turn one day in September 2004 when I
interview Jeff Hitchcock in Boston for this book. Hitchcock's daughter,
Marissa, was diagnosed with diabetes in 1989. Finding little medical
information, he started a Web site about diabetic children from his home in
Hamilton, Ohio. The site was so wildly successful — 250,000 hits per day
from 149 countries and a raft of advertisers — that Hitchcock quit his
engineering job and now organizes conferences and programs as well. He is
revered by parents who feel neglected by health care professionals and find
his site informative and comforting. When I meet Hitchcock, I understand his
appeal. A lean man with graying hair, glasses, and a soothing demeanor, he
speaks optimistically about the day that improved therapies will eliminate
diabetic complications. But he also directs stinging criticism at the medical
field. This combination of hope and frustration resonates with any diabetic.
Asked what the success of his site reveals about diabetic care in America,
he says, "It stinks." And what should parents do if their child is receiving poor
care? "Fire the doctor," he says. "That doesn't happen nearly enough."
That night, Garrett complains during his bath that his feet and legs
hurt, and he again drinks several cups of water. He goes to bed but wakes up
around midnight, saying he doesn't feel well. He is thirsty, but I tell him he
just had a drink a few hours earlier. He again goes to the bathroom and,
sniffling and achy, climbs into our bed. I look at him in his baseball pajamas,
pale and uncomfortable. Until now, I have not mentioned anything to Sheryl,
my wife, about my fears. She knows about the genetic risks of diabetes, but
when I tell her that I'm going to test Garrett's blood sugar, she's surprised.
The glucose meter measures blood sugar in milligrams per
deciliter. The normal fasting range is less than 100 mg/dl. Between 100 and
125 represents "impaired glucose fasting," so 125 is the magic number —
anything higher is a sign of diabetes. I take my lancet and quickly poke
Garrett's finger for a drop of blood. He is too groggy to complain or even
notice. The blood comes out easily in a thick, gooey drop. The older meters
took thirty seconds or even a minute to read the value, but the newer
meters — mine is a OneTouch Ultra from Lifescan — has a five-second
countdown. I place the drop of blood on the test strip and prepare myself. But
the whole thing is anticlimactic.
I already know the result.
The machine reads HI.
I have never seen such a reading and am momentarily confused.
HI? Why the hell is the machine suddenly greeting me? No, no,
no. Not HI as in HELLO, HI as in HIGH. As in: real HIGH. As in: your entire
life has just changed. I curse Lifescan under my breath. With the millions of
dollars it makes from diabetics, you'd think it could afford to put two more
letters on an elevated glucose reading instead of subjecting us to this
incongruously cheerful, heartbreaking welcome.
"He's high," I tell Sheryl. "I think we'll have to take him to the
She grabs Garrett and hugs him, and will soon dry her tears with
the bloodstained tissue that I used to wipe his finger. I get him a water bottle
and apologize for not letting him drink more. I have tried to deny his body's
downward spiral, to will it back to health by limiting his fluids. But my son is
thirsty. "Here, buddy, drink this," I say.
"Drink as much as you want."
I call my brother, Irl, who's had diabetes since he was a child and
now, as an endocrinologist, runs a large diabetes clinic in Seattle for the
University of Washington. He asks if Garrett has ketones, a fatty acid burned
by the body of an uncontrolled diabetic that spills out in the urine. Almost
1,900 diabetics die each year from ketoacidosis, and a small child, once
ketonic, can become fatally ill. A simple urine or home blood test can
determine the presence of ketones. I tell my brother that I don't know yet, but
I will keep him posted.
Sheryl calls the answering service for Garrett's physician; with no
one on call, the operator bounces us to another practice. A doctor finally gets
on the line and tells us to take Garrett to Children's Hospital Boston, about a
half-hour drive from our house in Needham. I had been across the street from
Children's earlier that day when I spoke with Hitchcock at the Joslin Diabetes
Center. We talked about his Web site, Children with Diabetes. Now I will
return that night with my son in the back seat — a child with diabetes.
Our daughter is sleeping, so Sheryl stays home while I take
Garrett. When he sees her packing his overnight bag, he's excited. "Are
we going to a pajama party?" he asks.
"No, buddy," I say. "We aren't going to a pajama party."
I tell him we're going to the hospital without explaining why. He
has never really been sick and hadn't been in a hospital since he was born.
We load up the Honda Pilot, and Sheryl kisses Garrett and me good-bye.
We briefly hop on the highway, then take Route 9 toward Boston. The road,
normally chaos, is now dark and quiet, with streetlamps splashing islands of
light on the pavement. The city is at peace. Soft music drifts through the car.
Still in his baseball pajamas, Garrett looks calmly out the window, probably
thinking he's going on an adventure, a late-night ride to the hospital —
or "HOTH-ibal," as he calls it, with a slight, endearing lisp — something he
can tell his friends about the next day.
We arrive in the Emergency Room at 2 a.m., Garrett in my arms.
The place is empty. A man at the information desk points me to a
woman in a cubicle who will handle Garrett's admission. We sit down.
"Do you have insurance?" She does not look up.
I guess if you enter a hospital in the dead of night with your son
bleeding from an open wound, choking, or screaming, someone will first ask
if you need medical assistance. Otherwise, reimbursement takes priority.
"Yes, we have insurance."
We are sent to a room where a nurse takes some information and
Garrett is weighed — thirty-three pounds. Then we move to another room.
Garrett sits on my lap, and I assure him that everything is going to be okay.
He doesn't ask any questions as hospital staff members drift in and out with
glucose machines, needles, tubes, and other devices. It appears that we are
the only customers on the floor, and a calm settles in. But that soon ends.
The nurses' first task is extracting Garrett's blood. They initially
use a lancet to get a drop from his finger, which they test in a meter. But now
they need tubes of blood, not just drops, so they have to draw it from his
vein. I hold Garrett on the table while one of the nurses positions the needle
above his arm. As she drives it through the flesh, Garrett lets out a scream
unlike any I have ever heard. Shocked by the attack, he yells, squirms, grits
his teeth, and howls some more. "Daddy, that hurts me! Daddy, that hurts
"I know, buddy, but they're almost done. They're almost done."
But they aren't. The nurse pulls back the plunger but draws no
blood. She tries rotating the needle, increasing the pain and getting more
resistance from Garrett. But she has missed the target, so she removes the
needle and plunges it again into his arm. Garrett tries to escape, but I hold
him down. Tears are rolling down his reddened face as he yells again, "That
hurts me! That hurts me!" The nurse explains that it's often hard to hit a vein
in a young child and says she will try the back of his hand instead — which,
for my money, does not seem particularly promising. I've had blood drawn
well over a hundred times, always from the arm. The puncture stings, but at
least the arm has some cushion, while the hand is as hard and unforgiving as
parched earth.
The needle lunges into Garrett's hand, and this time he closes his
eyes and cries even louder. Still no blood. The nurse again maneuvers the
needle, fruitlessly inflicting more pain until she gives up. I realize I should
have said no to the gouging of his hand; while Garrett has not yet been
officially diagnosed, I have learned a crucial lesson: do not assume health
care providers know what the hell they're doing.
The nurse eventually hits the vein in his left arm, and somewhere
amid the screams and tears and struggles the blood is drawn. I'm certain it
wasn't just the needle that hurt. Garrett is also confused and angry. He has
done nothing wrong, but it feels as though he is being punished. I try to
explain, but how do you convey the enormity of a chronic, life-threatening
disease to a three-year-old? How do you say that he will have to take insulin
for the rest of his life, that he will be denied many foods, that he may pass
out from low blood sugar, and that every organ in his body is now at risk?
"Garrett, I know it hurts, but you have a boo-boo inside your body,
and we have to make it better . . . I'm so sorry, buddy, but we have to make
it better."
I ask a nurse about Garrett's blood sugar. "It was high," she
says, "but we don't have an exact reading." Great. Hospital's got the same
damn meter I have.
I call Sheryl on my cell phone to confirm the diagnosis. Of course
she's awake. "He's doing fine," I tell her. She doesn't need to know how
much her son is hurting.
Garrett's night has just begun. His arm is wrapped with gauze and
taped to a plank of wood, keeping the limb straight to allow an intravenous
tube to be inserted. The tube is attached to a bag of saline, which will help
rehydrate him until — as the doctor later explains — Garrett
becomes "metabolically stable and able to eat on his own." The precaution is
understandable. Most newly diagnosed children have been sick for some
time and require aggressive intervention. Garrett was never so ill that he
couldn't eat or drink, and he may have been fine even without the IV. But now
he can't bend his arm, and he struggles to free it from the plank. The nurses
also places a tube in Garrett's nose, to determine if he is exhaling carbon
dioxide, which occurs during ketoacidosis and would signal the severity of his
condition. The device is one more uncomfortable entanglement.
A nurse returns with information: Garrett is not ketonic, but his
blood sugar is 550. I know how achy and uncomfortable I feel when my blood
sugar spikes to 300. Even though he was almost twice that, he did not ask to
stay home from preschool or curtail any activities. I'm sure he's been running
high for weeks, but with the exception of his thirst, he rarely complained.
Tough kid.
By 4 a.m., exhaustion has worn him down. He still fusses with the
tube in his arm and the intolerable stick of wood, but he finally falls asleep.
At some point, he is given his first injection of insulin.
Garrett had experienced pain before. Shots from the doctor.
Scraped knees. A bumped head. Of course he has cried. But never this. His
short life has mostly been kisses and hugs and cuddles, always very
physical and affectionate, and his outpouring of love and energy was always
reciprocated by those who adored him. Now he's been robbed of his
childhood, I think, and he will never know what life is like without diabetes.
Then again, I was diagnosed at fifteen, and I can barely remember myself.
Friends tell me later that Garrett is fortunate to have a diabetic for
a father, but I'm not sure. Most parents with a newly diagnosed child fear the
unknown. I knew too much.
When the sun comes up, we are in a hospital room, and Garrett is
finally relieved of the tube in his nose and the IV in his arm. He enjoys
pushing the buttons on the retractable bed, and television cartoons bring
some relief. A nurse comes in, and I tell her that we have to be out of here in
a couple of days because Garrett has a soccer game on Saturday. She
pokes his finger for a morning blood sugar.
"It's 279," she reports.
A weird sense of elation suddenly comes over me. This much I
understand: before he got to the hospital, before he received his insulin and
his IV tube and his saline, my son was dying. It wasn't imminent, but he was
dying, his body unable to fulfill its most essential function — converting food
into energy. Eighty-two years ago, before the discovery of insulin, he would
have suffered a swift, miserable death, perhaps fading slowly at first but then
rapidly and inexorably. If he were lucky, he would have been put on a
starvation diet, which would prolong the agony but not change the outcome.
That would have been his fate, his destiny, as it had been for countless
others in the three millennia since diabetes was first recognized.
But the insulin saves him, so for the moment I do not despair over
his burden but feel a surge of happiness. My son is no longer thirsty.

Excerpted from

Cheating Destiny: Living With Diabetes, America's Biggest Epidemic
Copyright © 2006 by James S. Hirsch. Reprinted by permission of Houghton
Mifflin Company. Buy this book at Barnes & Noble



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Friday, October 19, 2007

The Other Diabetes

Although people usually think diabetes is caused by a lack of insulin, the hormone that lowers blood sugar, more often than not the disease is characterized by too much rather than too little insulin. In fact, nine out of ten cases in the United States are type 2 (adult-onset) diabetes, which typically starts out with high insulin levels. But people are more familiar with the less-common type 1 (insulin-requiring) diabetes, because it is an immediate threat to life: If you don't get insulin you die. The other, diabetes is more insidious — half of the people who have type 2 diabetes don't even know it. As expert Dr. James Gavin puts it, type 2 diabetes "takes its victims a little piece at a time."

Too much body fat sets the stage for type 2 diabetes by decreasing the body's ability to use insulin. As we all well know; extra fat is the result of taking in more calories than we burn, which means that too much food and too little exercise are big contributors to type 2 diabetes. But not everyone with a spare tire gets type 2 diabetes, genetics also play a role. And from the current epidemic — an estimated sixteen million cases — it appears that the underlying genetic tendency is not all that rare.

To understand why type 2 diabetes is becoming more common, it helps to step back and take a look at the big picture — where and when the disease occurs. If you have type 2 diabetes, you are not alone. By the year 2000, experts predict that the epidemic we are seeing in the United States will have spread worldwide. How could this be when we are talking about an inherited disorder, not a contagious disease? What is contagious is technology; which creates theenvironment that causes the disease to surface.

Type 2 diabetes is widespread in industrialized nations, such as the United States, the United Kingdom, and Finland, whereas nations with third world economies, as in parts of Asia and Africa, do not have such epidemics. "If you look at the spread of the scurge around the world, type 2 diabetes occurs as a country advances technologically, when people come out of the fields and sit behind desks," say Dr. Irwin Brodsky. Brodsky, a diabetes researcher and clinician who directs the Diabetes Treatment Center at the University of Illinois at Chicago, explains, "It's almost a sign of coming of age; in Saudi Arabia, for example, where oil money started flowing in the late sixties and seventies, we saw a blip in the occurrence of type 2 diabetes about ten years later." Simply said, too much food and too little activity are pushing more and more people with the underlying tendency for type 2 diabetes over the edge.

An industrial economy is a double-edged sword, providing a calorie-rich food supply with little need for physical work to bring home the bacon. Technological advances such as refrigeration, improved agricultural techniques, better transportation, and food processing plants all help make more food readily available to most of the world's population. Initially, these advances have a positive impact on a nation's health by feeding the hungry; but eventually, a richer food supply leads to new health problems.

A Century of Progress

Before the Industrial Revolution, food was often scarce, and what was available did not always provide the balance of nutrients needed to prevent deficiency diseases. In nineteenth-century England, for example, hundreds of thousands of children died of malnutrition. Among the poor, bread, potatoes, and porridge provided the bulk of the calories. Often the only meat was a small bit of bacon cut up with the potatoes; the poorest subsisted on potatoes alone. Those who survived on the poverty-line diet often suffered from scurvy; a deficiency of vitamin C from the lack of fresh fruits and vegetables; rickets, from lack of sunlight and vitamin D; and tuberculosis, a bacterial infection that thrives in a malnourished host. When the great potato famine hit in the 1840s, hundreds of thousands of poor Irish and English immigrants came to America, where there was plenty of land and a promising new agricultural economy.

As homesteaders were given the opportunity to grow their own food on their own land, wave upon wave of immigrants settled farther and farther west. It was a hard life, and the diet of the settlers was one of subsistence based on easily transportable foods that would keep. The typical meal in Laura Ingalls Wilder's memoir Little House on the Prairie consisted of coffee, cornmeal cakes, and salt pork. She described a special meal that her family shared around 1880:

There was stewed jack rabbit with white-flour dumplings and plenty of gravy. There was a steaming-hot, thick cornbread flavored with bacon fat. There was molasses to eat on the cornbread, but because this was company supper, they did not sweeten their coffee with molasses. Ma brought out the little paper sack of pale-brown store sugar.

Don't be fooled by the bit of bacon fat and sugar; the extra calories provided by such meals were still barely enough to sustain a hard-working frontier family. Today a special meal is likely to include several courses; generous servings of meat, drinks, and dessert; and needless to say, many times more calories than meals served in an era when work was physical and type 2 diabetes was unknown.After the Civil War and the Industrial Revolution, the need to provide more food for the expanding population spawned a wave of technological advances. By the 1890s, there were improved canning, flour milling, plant breeding, and refrigeration techniques as well new disease-resistant varieties of wheat and the first gasoline-driven tractors. In the 1920s, Clarence Birdseye introduced a method for freezing produce; by the 1960s, we had high-powered machinery, new fertilizers and pesticides, poultry raised in completely controlled environments, new breeds of heat-resistant cattle, McDonald's burgers and fries, and the heart disease epidemic. In 1983, one in four Americans was overweight; in 1995, it became one in three. From 1958 to 1993, the incidence of type 2 diabetes tripled. All in all, it had taken about a hundred years for over-nutrition to become as big a killer as under-nutrition.

Excerpted from

The Other Diabetes: Living And Eating Well With Type 2 Diabetes
Buy this book at Barnes & Noble

Healthy menus for Diabetes at eDiets.com