We check in with the Packard Program

Juliana and I visited with the staff from the Packard Program yesterday.  They are doing great good in the world trying to help obese kids achieve a healthy weight, and they have good success.  Nonetheless, I believe that the calories in/calories out model that underlies the program is wrong.  So why does it work as well it as it does?

The Packard Program teaches kids to substitute lower-calorie yellow or green foods for higher-calorie red foods.  In many cases, those substitutions are from super-high-carb foods to less-high-carb foods.

From a glass of apple juice, for example, to an apple.  8 ounces of apple juice has about 29 grams of carbs; one medium apple has about 16 grams of carbs and it also has 4 grams of fiber, for only 12 grams of “net carbs.”  (When counting carbs, you subtract the fiber grams from the total carbohydrate grams, because fiber does not provoke the same insulin response).

Or from a high-sugar cereal to a low-sugar cereal.   Changing from raisin bran (36 grams of net carbs per cup) to cheerios (19 grams of net carbs per cup) cuts the carb load almost in half.

Both those substitutions are lower calorie changes, but they are also lower-carb changes.  So is it the carbs, or the calories?   I think it’s the carbs.  See chapters 19 and 20 of Gary Taubes‘ “Good Calories, Bad Calories” for a full discussion of this point.

The real power of the realization that carbohydrate restriction is the most important part of the eating plan is that your child will not be constantly hungry on a low carb plan, as they will be on a low calorie “balanced” plan.  At Packard yesterday I really emphasized this point:  Juliana complied perfectly with the program and did lose 6 pounds in 10 weeks.  But she was hungry all the time and I didn’t see how she could possibly keep it up.

A low carb eating plan doesn’t require superhuman restraint to follow.  That makes it a lot easier to coach your child on a low carb eating plan than a low calorie eating plan.

After losing a lot of weight in the beginning, Juliana’s weight loss rate has slowed on the low carb eating plan.  But even if she only loses an average of a 1/2 pound a week, as she did on the Packard Program, she will eventually get to her goal weight WITHOUT suffering constant hunger.  And in the meanwhile, her energy level is high, she has a completely new level of physical stamina, and her mood is consistently good.

Soccer practice–a whole new experience

Juliana has shed about 22 pounds from her highest weight.  I suspect she will lose 30 more, so she’s still carrying around a lot of excess weight.  Nonetheless, however, she can run faster than she ever has before and has a new level of stamina.  She just started soccer practice for the fall American Youth Soccer Organization (AYSO) season.  She was astonished by how much energy she had.

On a low carb eating plan, she can run hard the whole practice, and not worry about depleting her limited available energy.  Why is this so?

Carbohydrates require insulin to be processed by the body.  But insulin is also the fat storage hormone–it directs the body to store energy as fat.  In Juliana (and other people who can’t tolerate much carbohydrate), eating more than a minimal amount of carbohydrate causes so much insulin release that most of the energy in the food she consumes gets sequestered in fat cells, rather than being available for Juliana to use on physical activity.

This explanation of fat sequestration robbing the individual of usable energy made a lot of sense when I read it in Gary Taubes‘ “Good Calories, Bad Calories.”  (See: Taubes, Gary (2007-09-25). Good Calories, Bad Calories (Kindle Locations 7584-7587). Random House, Inc.. Kindle Edition.

It explained Juliana’s history of not wanting to move–I went to great lengths to keep her physically active.  It wasn’t just that she loves to read (although she does), it was that she had very little energy to move because her body was storing most of it as fat.

This year is her first soccer season ever at a normal energy level.  She is jazzed!

Who is Gary Taubes?

Gary Taubes is a science writer who reports and writes about issues of public health, nutrition, and diet.  He wrote two books that completely changed how I thought about Juliana’s overweight, and what we did about it.

Good Calories, Bad Calories is an exhaustively researched and documented history and analysis of obesity research and public policy about nutrition over almost 200 years, that is nonetheless an engaging read.  The book documents that carbohydrates used to be widely recognized as uniquely fattening, and how and why that changed in the years leading up to the push in the 1980s to get Americans to eat high-carb, low-fat diets.

In response to requests from readers for a shorter book they could hand out to family and friends, Taubes wrote “Why We Get Fat and What to Do About it.”  It’s the Cliffs Notes version of “Good Calories, Bad Calories,” and is a great place to start learning about low carb eating.

Visit Taubes’ website.

 

 

 

NOW I see why she’s always tired and hungry

Everything Taubes wrote made sense when I thought about Juliana’s history.  Juliana’s ability, at the age of four, to eat enormous quantities of pasta and be hungry two hours later was explained.  Her obvious preference for simple carbohydrate foods–bread, pasta, baked goods of all kinds–and her difficulty controlling her intake of such foods was not a lack of willpower but a normal response to the hormonal signals her body was sending.  Her frequent lethargy, from a young age.  Her constant hunger on the Packard program made sense.