Fat moms make fat babies; and thin, high-carb eating moms might make fat kids too…

Juliana is the oldest of three kids, and the only one of my three kids who was ever overweight.  Indeed, at the moment, my son Teddy is technically underweight, with a BMI in the 3rd percentile.

When I was pregnant with and nursing Juliana, I ate a vegetarian diet.  When I was pregnant with her sister Molly, I had an overwhelming desire for chicken, and abruptly stopped eating vegetarian after 18 years.  So I got to wondering whether there might be a relationship between what I ate while pregnant and nursing and Juliana’s metabolism and ability to handle carbohydrates versus her siblings.

And there could be.  Fat mothers produce fatter babies; diabetic mothers (whose blood sugar is on average higher than non-diabetic mothers) produce fatter babies.  And the incidence of fat babies is increasingly dramatically, in step with the increase in obese and diabetic adults.

“The probable explanation is that as women of childbearing age get heavier and more of them become diabetic, they pass the metabolic consequences on to their children through what is known technically as the intrauterine environment. The nutrient supply from mother to developing child passes across the placenta in proportion to the nutrient concentration in the mother’s bloodstream. If the mother has high blood sugar, then the developing pancreas in the fetus will respond to this stimulus by overproducing insulin-secreting cells. “The baby is not diabetic,” explains Boyd Metzger, who studies diabetes and pregnancy at Northwestern University, “but the insulin-producing cells in the pancreas are stimulated to function and grow in size and number by the environment they’re in. So they start over functioning. That in turn leads to a baby laying down more fat, which is why the baby of a diabetic mother is typified by being a fat baby.”

Taubes, Gary (2007-09-25). Good Calories, Bad Calories (Kindle Locations 8167-8174). Random House, Inc.. Kindle Edition.

Juliana wasn’t actually a fat baby.  But her intrauterine environment was with me eating a vegetarian diet, which was necessarily higher carb than when I switched to being an omnivore with Molly and Teddy’s pregnancies.  She was also nursed for several years with me eating a vegetarian diet.  I’m not diabetic, but that doesn’t mean Juliana didn’t suffer the consequences of my high-carb eating style:

“There’s no reason to think that the hormonal and metabolic consequences of high blood sugar—from what James Neel in 1982 called the “excessive glucose pulses that result from the refined carbohydrates/ over-alimentation of many civilized diets”—do not pass from mother to child through the intrauterine environment, whether the mother is clinically diabetic or not.”

Taubes, Gary (2007-09-25). Good Calories, Bad Calories (Kindle Locations 8189-8192). Random House, Inc.. Kindle Edition.

I can’t prove that my eating style contributed to Juliana’s carb sensitivity and subsequent overweight–but it’s an interesting association that she is the only one of three kids who experienced my high-carb eating style and she’s the only one with excess weight.

Really, you don’t need carbohydrates

I keep running across comments like this one, from “Ending the Food Fight,” by David Ludwig, MD, PhD: “[Low carb diets] do produce more weight loss than low-fat diets, but only temporarily.  After one year, people following both diets gain back nearly all of the weight they lose.  These approaches ultimately fail because our bodies and our minds rebel against severe restriction of any major nutrient, whether fat or carbohydrate.  (How long do you want to keep eating that bacon double cheeseburger, hold the bun, thank you?)”

First off, I assume Dr. Ludwig is referring to people who stop eating low carb and then gain back their weight, which of course, they will.   Continuing to eat low carb at the level of carbohydrates your body can handle, which might be 20, 50, or 100 grams a day, is one of the most successful ways to maintain weight loss.

Second, why does Dr. Ludwig assume that all macronutrients (fat, protein, carbohydrate) are equal, or equally required?  They’re not.  Carbohydrates in the form of agricultural grains did not even exist in the human diet until several thousand years ago.  People who eat a “Paleo/Primal” or “Caveman” diet eschew all grains, legumes, and dairy.  They eat mostly vegetables and meats, and a small amount of fruit.  (Modern fruit is larger, sweeter, and available for more of the year than ancient fruit).

It’s maybe not surprising then, given that they are so new, that carbohydrate is the only macronutrient your body does NOT require.  It can get along just fine on zero carbohydrate, unlike fat or protein.  ”…animal foods contain all of the essential amino acids (the basic structural building blocks of proteins), and they do so in the ratios that maximize their utility to humans.* 94 They also contain twelve of the thirteen essential vitamins in large quantities…The thirteenth vitamin, vitamin C, ascorbic acid, has long been the point of contention. It is contained in animal foods in such small quantities that nutritionists have considered it insufficient and the question is whether this quantity is indeed sufficient for good health.”

Taubes, Gary (2007-09-25). Good Calories, Bad Calories (Kindle Locations 6551-6557). Random House, Inc.. Kindle Edition.

 It turns out that the tiny quantity of vitamin C in animal foods is sufficient, provided you aren’t eating a diet high in carbohydrate.  In other words, you only need to supplement the vitamin C available from animal foods if you eat a lot of non-animal foods.

Taubes, Gary (2007-09-25). Good Calories, Bad Calories (Kindle Location 6630). Random House, Inc.. Kindle Edition.

Another argument you sometimes hear is that dietary carbohydrates are required to provide glucose for the brain.  But this is not so.  The liver manufactures the fuel it needs from other nutrients if dietary carbohydrate falls below a certain level.

Taubes, Gary (2007-09-25). Good Calories, Bad Calories (Kindle Locations 6492-6498). Random House, Inc.. Kindle Edition.

And what about Dr. Ludwig’s opinion that people can’t live forever without the hamburger bun?  A great effect of a low carb eating plan is that the desire for carbohydrates greatly diminishes, or disappears altogether.  And in sensitive individuals, eating the bun after getting used to the low carb style will probably make you feel sick and tired.  Go ahead and try it once, like Juliana did with a scoop of ice cream, and you won’t be so tempted the next time.

Dr. Ludwig instead advocates a low-glycemic diet, which I bet works better than a low fat diet for many people.  But in sensitive individuals like Juliana it would not work because it includes more fruit and grains (even if they are whole grains!) than her system can handle.

Not getting fat because she’s lazy, but lazy because she’s getting fat

We all associate overweight people with low energy, and there’s a good reason for this.  But it’s not the reason you think.  People don’t get fat because they don’t move much; they don’t move much because they are getting fat.  The energy they could use to be active is being diverted to storage as fat.  The culprit is insulin, which is released mostly in response to eating carbohydrate, much less so in response to eating protein or fat.

When you are a parent, this lethargic behavior is extremely frustrating.  I remember vividly once when Juliana was about 9 and we were on vacation and she didn’t move from the couch all day.  I actually remember wondering what was wrong with her.  She wasn’t sick, but she didn’t look like she felt well.  At 3 in the afternoon I insisted that she go outside and do something, anything.  She didn’t want to.  I had to really push her, and I was trying to hide my anger as I did it.  Eventually she did so, reluctantly.

Now I know that going outside and moving was actually a huge effort for her, because she didn’t have much energy for motion.  It was mostly being stored in fat cells.

What can water do for you?

water: courtesy of FreeDigitalPhotos.netYou hear it all the time–drink at least 8 glasses of water a day.  What does water do for you–and lack of water do–when you are eating low carb to lose or maintain your weight?  Three things.

1)   It’s the job of your liver to metabolize fat.  If your kidneys don’t have enough water to do their job, however, they send some of their work over to the liver.  Then the liver has less bandwidth to metabolize fat.

2)  On a low carb eating plan, you literally urinate out portions of fat molecules called ketones.  You are not only “burning” fat–you are also excreting fat in your urine. See page 170 of No More Fat Kids. Without enough water, this process slows down.

3)  If you don’t drink enough water, your body tries to conserve water, meaning you will weigh more.  If the body has plenty of water coming in, it won’t retain water.  So, paradoxically, drink more water to get rid of water bloat.

Drinking A LOT of water has been critical to Juliana’s progress.  When she came home from six weeks of traveling, in August, 2012, we found that Juliana had maintained her weight while growing half an inch.

She resumed a very low carb eating plan to give herself another weight loss jump start after a summer of less control over her food. But after five days, she had gained a pound. On the one hand, a pound could be normal variation. On the other hand, the more experience I get the more I feel that she is likely very sensitive to carbohydrate, and it is not easy for her to lose weight even on a low carb eating plan.

Unlike an adult who finds after the age of 40 that they can’t maintain their weight on a high carb diet after a lifetime of high carb eating–she was sensitive to carbohydrate already at a young age–she became obese over one year from 3.5 to 4.5. And she isn’t one of the many people you read about, if you poke around in the low carb community, who dropped 5 dress sizes in as many months eating low carb. So to me, a gain of a pound when we were trying to jump start her weight loss, when she hadn’t been doing a lot of strength training or the like that might argue she had added muscle, was significant.

We reviewed many tips and tricks. I zeroed in on water. Juliana has never felt much thirst, or drunk much water. I’ve encouraged her to drink more water for years.

We set a goal of a gallon per day. She has a 32 ounce water bottle she fills and empties four times. As her coach, I check in with her during the day to see how many water bottles she has finished. I frequently find the water bottle in the house, fill it with ice water, and bring it over to her.

After 3 days of drinking a gallon of water per day, she had dropped a pound and a half, and is now at her lowest weight ever since we started the low carb eating plan.

Eating Out

How do you eat low carb while you are traveling or eating out? A lot more easily than you eat low calorie.

It’s an ordeal to order a low-calorie meal from a commercial kitchen. I spent years trying to order plain, steamed broccoli (which was never on the menu) for my kids in restaurants so they could fill up on something besides chicken fingers. Until I learned to emphasize “plain, no butter, no oil” it would come to the table coated in fat. The only place I can think of that is familiar with providing low fat, low calorie meals is at a residential weight loss clinic. Any other commercial kitchen and you are fighting against the tide.

On a low carb plan, on the other hand, eating out is pretty easy. Order a protein (meat, fish or eggs), veggies if they have them (sure, the butter or oil is fine!), or a salad with full fat (no sugar, hopefully) dressing if you like that, or else plain. Skip the low calorie dressings that are high carb. No vegetables or salad? No problem. Try again at your next meal. Meanwhile you’ll be full and satisfied from your hunk of protein, which will naturally also contain a good amount of fat, not hungry two hours later from the potatoes you ate.

If your children are older and able to travel independently, the low carb eating plan is easier for them to manage than a low fat, high carb plan. Juliana took a ski trip with her school while on the standard American “healthy” diet followed by the Packard program and had no choice but to eat a lot of “red” foods. Then she took a teen service trip to Costa Rica on the low carb plan. It took some planning and reminding–I wrote her eating plan on her medical form and had to nudge her to talk to the trip leader when I discovered she had eaten low carb bars she brought along for snacks as meals when there wasn’t something else she could eat. Then she found a kosher counselor who also had to eat different food sometimes–neither of them could eat the meat/cheese lasagne they had for dinner one night–and from there on out it went smoothly.

Low carb is easy to explain: green vegetables, salad, meat, chicken, eggs. Butter and oil ok. The eating plan includes ingredients that any commercial kitchen will have on hand, and their usual methods of preparation are fine. They don’t have to try to cook without oil, for instance. They just have to serve the carbs separately from the rest of the food so your child can avoid them.