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Sweet 100: Counting Carbs for Weight Loss

Posted May 02 2013 10:08am

by Barbara Berkeley, MD

Since my world view revolves around insulin, I believe that the final common pathway for weight gain and weight loss is carbohydrate consumption.  Carbohydrates trigger the release of insulin and cause fat storage in those who are so pre-disposed.  Eliminating carbohydrates stops any significant insulin release and allows fat to be burned as fuel.   

An insulin-centric world view in no way denies the myriad other contributors to weight gain.  There is no doubt whatsoever that neurotransmitters, food additives, endocrine disruptors, gut micro-organisms and a whole host of other factors are involved in the perfect storm that creates fat.  But I believe that everything has to channel through insulin ultimately.  Control insulin and you control your fat destiny. At least that's how it appears to me as of this writing.  

With this in mind, keeping carbohydrate consumption low is vital to successful weight loss.  Last December I blogged about  dropping carb consumption to 50 grams  to reverse holiday weight gain. Now I want to share the success that one of my patients is achieving by assiduously counting carbohydrate grams and keeping the total below 100. 

Miss B. is a 240 pound woman who has had lots of problems losing weight and whose issues are compounded by the need to take several weight promoting medications.  She was not doing particularly well on our standard diet, which combines meal replacements with a Primarian dinner meal.  Because of issues with insomnia,  Miss B was feeling hungry at night and was often choosing to depart from the diet.  Several months ago, I presented Miss B with the option of going on a full food diet that counted carbohydrates.  We generally get good weight loss with about 100 grams of carbs per day, so that was the figure we picked.  Miss B is facile with the internet and likes tracking things.  She became quite good at figuring out her daily carb count and this enterprise became something of a motivating game for her.  She has done extremely well achieving weight losses of between 2 to 3 pounds per week using this strategy.  In addition, Miss B has encouraged several of her friends to go on the same plan.  All appear to be losing weight. 

While I mostly discourage counting things as a long term weight maintenance strategy, keeping track certainly has its place.  First, there are some people who simply feel more in control when they count.  Second, counting allows the dieter to reach a specific goal each day and this can provide daily motivation.  Third, counting is a learning tool.  Within a short period of time most dieters will have internalized the counts of foods they commonly eat.  At that point, they will know what to do without calculation and this kind of knowledge is necessary for long term success.

If you would like to try the hundred carb count (C100), simply carry a small notebook or scrap of paper with you throughout the day.  Make sure you have access to a counting book (like the one made by Calorie King) or website (My Daily Plate, Calorie King).  Alternatively, you can just google your food by entering something like "number of carbs in one slice of bread".  Look up any food that you are not sure of.  For example, a grande skim latte has 16 ounces of fat free milk, but that adds up to 24 grams of carbohydrate, something that may not be intuitively obvous.

Here are a few additional suggestions:

1. Don't bother counting non starchy vegetables  (DO count the carbs in peas, cooked carrots, corn and potatoes)

2. Make use of foods that are already labeled.  It saves time and makes your count more accurate.  You will already know, for example, that one of the OPTIFAST bars we use in our practice has 20 grams of carbs or that a an Oikos pineapple yogurt has 19 grams.   For diet products, I prefer that you use the total carb count rather than the one labeled "net" carbs.  Err on the side of the larger number.

3. Don't use salt and avoid foods that are salty in restaurants.

4. Don't forget to count carbs in salad dressings and don't use restaurant dressings unless you know the count.

If anyone out there decides to do a couple of weeks (or more) on 100C, please be kind enough to send me some feedback.  I would like to see if this is an effective strategy for weight loss in the general population (in other words, for those who are not seeing a doctor or dietitian or are in an organized diet program).  I would be interested in knowing about ease of use, hunger levels, degree of weight loss and anything else on which you'd like to comment.   Good luck!





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