No Backtracking

No Backtracking principles

This is a plan for life. You will carefully reintroduce certain carbohydrates into your diet — and find the balance that maintains your weight and keeps you feeling trim. This crucial phase will allow you to:

• Establish the carbohydrate levels that you can eat in order to remain slim and supply your energy requirements
• Break totally with bad habits made in the past
• Never return to yo-yo dieting
• Find a healthy attitude to food and a viable eating plan for the rest of your life.

No Backtracking rules

During this phase you need to:

• Increase your daily carb intake by no more than 10g (1/3oz) each week

• Add new foods one at a time

• Eliminate a new food if it provokes weight gain; a return of physical symptoms lost during the Fast-Track Plan; increased appetite, cravings or water retention

• Drop back to the next-lowest level of carbohydrate intake if you gain weight

• Carry on eating adequate amounts of healthy fats and lean protein at every meal to ensure a balanced diet

• Continue to take vitamin and mineral supplements regularly, drink masses of water and, of course, exercise regularly.

Make this diet the one that works

Once you have reached your target weight, you can start on the No Backtracking plan. Increase your intake of carbohydrates by 5-10 grams per day until you reach your optimum level for weight management This will probably be around 40 per cent of your total daily calorific intake, but remember that everybody differs, especially when you consider activity levels.

If you have high insulin resistance, then you may have to Keep on Tracking and be careful about how many carbohydrates you consume on a daily basis. But if you're one of the lucky ones with low insulin resistance, you may be able to eat most vegetables (including starchy vegetables), fruit, pulses andwholegrains such as oats, barley, millet, wild rice, couscous and buckwheat. You can also begin to use recipes containing carbohydrate ingredients such as breadcrumbs; you may even be able to handle an occasional potato. But don't eat all these things in one day. You still have to monitor your carbohydrate intake to stay where you are - healthy and energized. Remember the eating habits that got you here in the first place. You should have successfully gauged your ideal carbohydrate level, and be maintaining a stable weight and energy levels, within 4-12 weeks of following the No Backtracking plan.

Stick to the basic weight management tips and try to be good 80 per cent of the time. We are all allowed the odd slip up - if you want a slab of chocolate cake from time to time, make sure it is the best you find and enjoy it. If you ever see the scales creeping up, cut back, even go back to the Fast Track plan for a few days until your weight is back to normal, and then gradually raise your carbohydrate levels once again.

A template for life

Two portions of higher GI carbohydrates are included per day on the suggested eating plan. Treat this as the template you ought to follow from now on. And try some of these tricks to keep your carbohydrates at a moderate, healthy level:

• Opt for rye bread, oatcakes and rye crackers instead of wheat-based bread. Even if you are not wheat-intolerant, it is worth considering this.

• Eat fruit 20 minutes before eating anything else, not afterwards. Fruit takes less time to digest, but if eaten on top of a heavy meal, can cause bloating.

• If you are going to drink alcohol, choose dry white wine or, even better, red, which contains flavonoids with antioxidant and anti-platelet properties thought to reduce deaths from coronary artery disease. If you have managed to kick the alcohol habit, opt for grape juice, which contains flavonoids similar to those in red wine.

• Mix sweet potato with cauliflower as a mash or purée to go with roast chicken. The aim is to mix a high GI vegetable with a low one, to reduce the total carbohydrate level.

• When making a rice dish such as risotto, reverse your ratio of vegetables to rice: add a little rice to a heap of vegetables. And try grating raw vegetables such as carrots and courgettes into the dish at the last moment - it adds texture and you get the benefit of all those raw phytonutrients.

• Don't give up on those whey-protein smoothies - they are still the most effective way of getting high-value biological protein.

Fast-Track principles

This is a diet, or a way of eating, that will:

• Lower insulin levels and stabilize blood-sugar levels
• Banish food cravings
• Eliminate energy peaks and troughs, and mood swings

Enhance concentration

• Re-educate you into a way of eating that will increase your vitality and improve your overall health
• Help your body to burn fat and normalize your weight.

It is vital that you understand the principles of this diet and follow it responsibly. If you are fundamentally healthy, but insulin-resistant and experiencing any ofthe accompanying symptoms, this plan will help you redress the balance and find a level of carbohydrate intake with which your system can cope. The Fast-Track Plan offers you a kick-start and is aimed at women with a BMI of over 35 and men with a BMI of over 25.

For the period of this plan you base your diet on an approximate ratio of 50 per cent high-quality protein/20 per cent low GI carbohydrates/30 per cent healthy fats. You begin the first two weeks of the diet by restricting your carbohydrate intake to 20g (³/4oz), your protein to 150g (5oz) Biological Value and healthy fats to a minimum of 40g (1 1/2oz). On a very simplistic level this means:

• 3 cups low GI vegetables per day.
• 1 portions of protein three times per day and portion twice per day as a
  snack. (A portion of protein is the equivalent to the size of your palm.)
• Around a half to a whole teaspoon of allowable fats at every meal.

Within 48 hours your body will start to burn its own fat as fuel, as your body switches into benign dietary ketosis.

Ketosis

Being in ketosis means that your body burns fat because it isn't taking in sufficient glucose to meet your energy needs. Under everyday conditions the carbohydrates that you eat are converted to glucose, which is the body's primary source of energy. Whenever your carbohydrate intake is limited to a certain range, for a long enough period of time, your body will draw on its fat stores — turning this into a source of fuel called ketones. When you burn a larger amount of fat than is immediately needed for energy, the excess ketones are discarded in the urine.

Dietary ketosis has received a bad press because it is often confused with ketoacidosis, a life-threatening condition most often associated with insulin- deficient, type 1 diabetes.

Benign dietary ketosis, however, is a natural adjustment to the body's reduced intake of carbohydrates, as the body shifts its primary source of energy from carbohydrates to stored fat. The presence of insulin keeps ketone production in check so that a mild beneficial ketosis is achieved. Blood-sugar levels are stabilized within a normal range and there is no breakdown of healthy muscle tissue, as long as sufficient protein is included in the diet.

Measuring ketosis

On a rapid weight-loss diet you will usually start to burn fat instead of sugar within the first 48 hours. To measure the ketone levels in your urine, buy urinary test strips, called lypolisis strips, from any pharmacy, which will show you if your carbohydrate/insulin balance is at optimum levels for fat burning. You should do this twice a day: before breakfast and before your evening meal. Your levels need to be between trace and small (0.5-1.5 mmol-l).

Caution: if your levels rise to above moderate (4 mmol-l), you are not eating enough and should increase your low GI carbohydrates until the ketones are reduced to between trace and small (0.5-1.5 mmol-l). Always drink plenty of water: at least eight large glasses per day.

Becoming a GI Joe

All carbohydrates have a value on what is known as the `glycaemic index' (GI), which indicates how quickly that carbohydrate is metabolized by the body and converted into glucose. The lower a food's GI, the longer it takes to be converted. Foods with the highest GIs are the ones that will have the most profound and immediate effect on your blood-sugar levels. All the carbohydrates on a weight- loss and insulin-balancing regime should come from the lower ranges.

There are two indexes: the glucose standard, which rates glucose as having a GI of 100 and the white bread standard, which is based on white bread being equal to 100. Other carbohydrates are assigned comparative ratios based on these figures. It doesn't really matter which index you adhere to, for they both give a pretty good - and sometimes surprising - insight into the speed with which certain carbohydrates are assimilated into the bloodstream.

Below are a few GI values of common foods, based on the glucose standard. Of course you are not expected to remember each specific food's value, so to make things easier, opposite are two simple tables showing you how to classify fruit and vegetables into those with a low GI value (under 20), those with a medium value (20-60) and those with a high value (over 60).

Density values

Each carbohydrate can also be evaluated by its density value. This is the amount of usable carbohydrate in relation to fibre and water content - the more fibre and water a vegetable or fruit contains, the less usable carbohydrates it will have. The most dense carbohydrate foods are pulses, wholegrains and starchy vegetables, particularly when they are cooked and their fibre is broken down, these will raise your insulin levels, so always be aware of this. The table opposite contains a list of low-density carbohydrates that should form the basis of your carb intake on a low-carb diet.

Not only do many fruits feature highly on the GI scale, but a few should also carry a carbohydrate density warning sign. Bananas, dried fruit and concentrated fruit juices are all a bad idea if you are trying to balance your blood sugar levels. It is best to avoid these totally until your blood sugar and weight have normalized, and then carefully re-introduce them into your diet.

Focus on fibrous vegetables that can be eaten raw or steamed - the type that lose a lot of water whilst cooking. This will mean increasing your intake of leafy green vegetables, such as Swiss chard, green cabbage, kale, bok choy, rocket, spinach and endive.

Mix-And-Match Salads

If you fancy creating your own 'superfood' salad, you can use the following guide to pick and mix your own ingredients, either at home or when you are choosing lunch from a deli or salad bar. To get a 10GL meal you can fill your plate with vegetables from the 'Unlimited' box then selectone of the options from both the 'Choose 1 Protein' and 'Choose 1 Carbohydrate' boxes, to provide a balanced meal of protein, carbohydrate and plenty of fibrous vegetables.

For example, you could have spinach, watercress, rocket, cherry tomatoes, artichoke hearts and olives, with chicken slices and butterbeans. Alternatively, try Romaine lettuce, spring onions, celery, roasted red peppers, and smoked mackerel flaked through with quinoa. The serving sizes here are for one person, and include maintenance phase portions when you are allowed more carbohydrate to bring your meal up to 15GL

UNLIMITED

Salad leaves

Lettuce or other leaves, such as spinach, watercress, rocket

Other non-starchy vegetables

Vegetables, such as spring onions or red onion, cherry tomatoes, cucumber, radishes, diced peppers, beansprouts, celery, fresh herbs, vegetable antipasti (such as marinated artichoke hearts, roasted peppers or olives - drain offany excess oil)

CHOOSE 1

Protein

1 chicken breast fillet or equivalent slices or strips of chicken, turkey or lean ham

85g (3oz) (medium fillet) smoked fish, such as smoked salmon, trout or mackerel

85g (3oz) (6 large) cooked prawns ¹/2 x 85g (3oz) can tuna

120g (4¹/4oz) cottage cheese

75g (2³/4oz) cheese, such as feta or goat's cheese

2 hard-boiled eggs (or mash 1 hard-boiled egg into 1 tbsp cottage cheese)

1 tbsp nuts or seeds, such as pine nuts, pecan nuts, walnuts, cashew nuts or pumpkin seeds

200g (7oz) hummus (small pot) 65g (2¹/4oz) quinoa (dry weight) 100g (3¹/2oz) smoked tofu, cubed

CHOOSE 1

Carbohydrate

(grains and starchy vegetables)

1 medium carrot (grated) or

apple (diced)

maintenance phase: 1 large carrot or apple

110g (33/4oz) beetroot maintenance phase: 160g (53/4oz)

¹/2x 410g (14¹/2oz) can (2 tbsp) mixed pulses, butterbeans, lentils or chickpeas (or other pulse) maintenance phase: ²/3 x 410g (14¹/20z) can (3 heaped tbsp)

3 rough oatcakes

maintenance phase: 5 rough oatcakes

³/4 wholemeal pitta bread (or to make life easier, have a whole pitta bread for 10GL but don't have it with a carbohydrate containing filling - so no sun-dried tomatoes or hummus,for example

maintenance phase: 1 pitta

11/2 slices rye bread

maintenance phase: 2 slices rye bread

65g (2¹/4oz) quinoa (dry weight) maintenance phase: 90g (3¹/4oz) (very large serving)

40g (1¹/2oz) brown basmati rice (dry weight) (very small serving) maintenance phase: 60g (2¹/4oz) (small serving)

40g (1¹/2oz) wholemeal pasta (dry weight) (medium serving) maintenance phase: 55g (2oz) (medium-large serving)

3 small baby new potatoes maintenance phase: 4 small baby new potatoes

¹/2 small baked potato/sweet potato maintenance phase: 1 small baked potato/sweet potato

Performance enhancement in perspective

There are countless nutritional products aimed at the sportsperson, which claim to have some performance-enhancing ability. These substances, called `ergogenic aids', theoretically improve performance to a point above that obtainable through a good training programme. Athletes are very susceptible to any claims for even the slightest improvement in performance, as fractions of a second could mean the difference between winning or losing.

Many ergogenic aids are basically expensive forms of proteins, minerals and vitamins. Their effectiveness is often unproven, based on folklore and reliant on the ignorance of the consumer (for example, substances such as Royal Jelly and wheat germ oil). On the other hand, some performance-enhancing principles are based on reputable scientific evidence that have been shown to improve performance in the laboratory (such as carbohydrate supercompensation - see overleaf).

However, it is interesting that even in cases where the supplement or _special diet has no physical basis, an athlete can sometimes gain purely psychological benefit from consuming something he or she believes in.

Proteins and amino acids

Although certain athletes may need an increased amount of protein, taking excessive amounts in the form of powdered or liquid supplements is unnecessary. Despite the claims of manufacturers, large quantities of protein will have no beneficial effects on muscle growth, strength or on performance. Any excess will simply be used as an energy source or stored as fat. In addition, kidney function may be hampered and dehydration caused as a result of taking in too much protein.

The supplements currently in vogue - especially among body builders and weight lifters - are amino acids, the 'building blocks' of proteins. The theory is that certain amino acids stimulate growth hormones. The increase however is slight and has no practical effect. Amino acids are not 'fat burners' or detoxifiers as has been claimed. Although tablets taken for this purpose are extremely expensive, the amount of amino acids in them is very small. In fact, a single egg contains far more than that found in seven or more amino acid tablets!

Vitamins and minerals

As mentioned earlier in this chapter, supplementing vitamins and minerals has no performance-enhancing properties in an athlete whose normal diet is not deficient. The effects of taking megadoses of certain vitamins may even impair performance.

Manufacturers and quasi-nutritionists have given certain substances vitamin status, although they are not scientifically classified as vitamins. For example, pangamic acid (otherwise known as vitamin B15) supposedly prevents various diseases, slows the ageing process and improves physical performance. None of these claims has been substantiated. Laetrile or vitamin B17 is a source of cyanide and has been banned. Other `pseudovitamins' are orotic acid (vitamin B13), bioflavenoids and vitamin B-T (or carnitine), all of which do not function as vitamins.

Carbohydrate loading

`Carbo-loading' is a phrase which has passed into common use. It has been proved scientifically that carbohydrate loading (otherwise known as carbohydrate supercompensation) is one of the practices which is effective in improving performance. It may be explained in the following way: Exercise which lasts for longer than 60-90 minutes is dependent on the amount of glucose available. Glycogen (glucose) stores in the muscle and liver are small, so enlarging them allows an athlete to continue exercising at a higher intensity for longer. A carbohydrate-loading programme increases the amount of muscle glycogen stored before you need to use it.

The best method of doing this is to gradually reduce the amount of training you do during the six days preceding an event and, during the final three days, eat a diet that is high in carbohydrate (500-600 grams per day). The extra glycogen stored in this way allows the athlete to continue exercising for longer.

Carbohydrates, fluids and sodium during exercise

It has been proved that supplying the body with carbohydrate during endurance-type exercise has a glycogen sparing effect which allows an athlete to exercise for longer. Many studies have been done in attempts to find a solution that will allow the maximum amount of water to be absorbed, while at the same time providing an optimal amount of carbohydrate. So far, it seems that a form of carbohydrate known as 'glucose polymers' has the best absorption rate. These are chains of glucose molecules linked together. A solution containing about 10 per cent carbohydrate in the form of glucose polymers supplies the most glucose to the body during exercise, and at the same time provides sufficient water replacement. (It is important to remember that a carbohydrate solution is only of benefit during prolonged exercise.)

Adding sodium to replacement fluids increases the concentration of the fluid. It was initially thought that this would hamper the absorption of the fluid, but the most recent findings suggest that the addition of a very small amount of salt (1-2 grams per litre) is in fact necessary for absorption.

Alcohol

Not surprisingly, it has been proved that alcohol has no beneficial effect on exercise. In reality alcohol is a depressant that slows reaction time, impairs muscle reflexes and disturbs coordination. In addition, it causes dehydration which interferes with fluid balance and has a negative effect on performance.

Caffeine

Some athletes use caffeine as a stimulant and to increase the amount of free fatty acids in the blood. Theoretically, more fat is then available to be used for energy, resulting in glycogen sparing (see above). However, an excessive amount of caffeine is necessary to produce this effect and, apart from the fact that a very high concentration of it in the urine can disqualify a competitive athlete, there are several other disadvantages to using caffeine in this way. The main one is that it has a diuretic effect, which results in increased fluid losses and a greater risk of dehydration. In addition, overconsumption of caffeine can result in headaches and nausea and it is therefore not advisable to use large doses of this stimulant in an attempt to enhance performance.

Other imposters

Royal jelly, wheat germ oil, ginseng, extracts of various herbs and numerous other products have all at one time or another been touted as performance-enhancers. The truth is, however, that the only possible effect most of these substances could have would be a psychological one.

Does sugar make you fat?

Although obesity is not classified as a disease, it is associated with a variety of diseases and since it is a problem - or potential problem - for so many people, the role of sugar in its development and treatment needs to be looked at carefully.

Firstly, overweight, and later obesity, develop as a result of an imbalance between your energy intake (from food) and energy output (the energy used for daily living, including basic body functions and any exercise you do). When you take in more energy than you are using, the body stores the additional energy as body fat. The source of this extra energy is immaterial; it makes no difference where the additional kilojoules come from. In other words, it is not eating one particular food but rather eating too much overall that leads to weight gain. It is possible to put on weight by eating (or drinking) too much of anything.

In practice this would of course be extremely difficult in the case of bulky foods with a high moisture content - such as certain vegetables - simply because it would be difficult to eat enough of these foods to provide kilojoules in excess of your energy needs. By contrast, in the case of concentrated, energy-dense foods such as rich desserts, fried foods or chocolate, it is all too easy to eat enough to lead to an excessive energy intake. Sugar, being a carbohydrate, is not the worst offender in this respect - fat is a far more concentrated source of energy - and it has been said that sugar is often 'guilty by association' because many so-called 'fattening foods' are high in both fat and sugar. For example, in the case of chocolate, sugar contributes approximately 33°k of kilojoules, compared to the fat contribution of over 50%.

Studies have shown that fat people don't eat more sugar than lean people, neither do they have more of a sweet tooth. They do however tend to eat more fat. In the light of recent research this makes sense, since we now know that it is easier to become overweight by eating too much fat than by eating too much carbohydrate.

Fat vs sugar

There are several reasons why fat is a bigger culprit than sugar when it comes to the problem of overweight. To begin with, as mentioned above, fat is far more energy-dense than carbohydrate - a gram of fat provides 38 kilojoules, whereas a gram of carbohydrate provides only 17. Secondly, carbohydrate seems to have a so-called thermogenic' effect, that is, it pushes up the body's metabolic rate so that kilojoules are burnt up faster. Lastly, the process by which the body converts dietary fat into body fat is a very efficient one - only 3% of the kilojoules are lost along the way. By contrast, when the body converts dietary carbohydrate into body fat, 23% of the kilojoules are lost. In other words, when you eat carbohydrate, only 77% of the kilojoules from that food are available as energy for the body.

To prevent weight gain, therefore, the best diet to follow is one that is low in fat and high in carbohydrate. This does not mean a diet high in sugar - the recommended carbohydrates in this case are complex carbohydrates, or starches. You can, however, include a limited amount of simple carbohydrates or sugar in your diet without fear of becoming overweight, as long as the total energy value of the diet is in line with your energy needs. Remember, it is the balance between your energy intake and your energy output that counts, rather than the type of food you eat. People who burn up a lot of energy (through, say, regular exercise or even nervous tension) can therefore eat more of these foods without fear of gaining weight, than can those whose energy requirements are much lower.

Sugar and slimming

When it comes to weight reduction, however, sugar should be looked at more carefully. The basic principle of a slimming diet is to select foods that are high in nutritional value but low in energy, so that although your kilojoule intake is restricted, all your nutritional requirements are met. Sugar provides only energy, so it is the first thing that should be excluded from a slimming diet. Interestingly, though, there is a school of thought which suggests that from a psychological point of view, a small quantity of sugar may be included in a slimming diet to help prevent feelings of deprivation and resultant binges. This obviously depends on the individual - some people crave sweetness and provided they can limit their consumption of sweet foods to one 'treat' a day, it may not be necessary for them to eliminate sugar totally. Of course, if once you've opened a packet of sweets you can't stop until you've eaten the last one - or if you're one of the lucky ones who seldom craves `something sweet' - it would be simpler to cut out sugar completely!