Battle of the Bread

If I asked 100 random people if bread was "OK' on a diet, or simply as part of a healthy lifestyle, I would surely get mixed answers.  In my early 20s I gave low carb a try and this was about the time the insulin hypothesis was picking up steam.  The insulin hypothesis generally states that since physiologically, surges in insulin not only halt lipolysis (fat breakdown) but encourage lipogenesis (fat storage) that it was the cause of all fat loss woes.  When you eat carbohdrates in any meaningful amount there will be a release of insulin as blood sugar rises so of course, carbohydrates are what's making everyone on the planet obese.

Hopefully you didn't end the blog after the first paragraph because the insulin hypothesis has been debunked and it is a narrow and surface way of viewing our physiological response to eating carbohydrates. If spiking insulin was the culprit you wouldn't want to eat much protein either because many proteins such as  beef, dairy and whey cause a high insulin response.  If becoming insulin resistant was the reasoning for avoiding carbohydrates you wouldn't want to overeat fat because you can induce insulin resistance from overfeeding fat as well.

It's in the details

It's the details that are lost on people who generally fall into the "no bread because carbs because insulin" territory and latching onto  broad but misguided concepts becomes more of a mantra and identity than it really does a diet. Trust me, I have been there with pretty much any food you can imagine and I have experienced an emotional fear or aversion to foods I believed were unhealthy because I embraced a concept I did not fully understand.  

Now this might get your wheels turning and wondering if I am saying that any food at any time can be part of a healthy diet.  In a way, yes.  However, it does not mean that you can overconsume any one food simply because you believe it's healthier than another.  I've seen this slippery slope with things like almonds, dark chocolate, avocado, olive oil, quinoa, granola, nut butter and much more.  What's interesting is that most clients I have worked with who were over-consuming a "healthy" food were very often overconsuming a fat source.  I have a couple theories behind this.  

One is that almonds, olive oil, dark chocolate and avocado are pushed as healthy just like sweet potatoes, fruit, quinoa and beans are.  Most people end up overconsuming the healthy fats rather than the healthy carbohydrates simply because the fats are more calorie dense and take up less volume in the stomach meaning it's easier to overeat them.  For example, two tablespoons of nut butter is about 200 calories but you could consume around 1 to 1 1/2 cups mashed sweet potatoes for the same calories.  Since two tablespoons of nut butter has never mad anyone "full" in the history of the universe, if someone believes it's healthy and therefore cannot be stored as fat, they'll consume until they are full. If they repeated the same approach with sweet potatoes, my guess is that overconsumption would not happn because they'd simply be too full.

Unlimited sweet potatoes

As an example, I had a client once who was easily 300lbs and she had gained and lost large amounts of weight many times.  She was under the assumption that it was probably all of the carbohydrates she was eating but I asked her for a food journal anyway so I could check it out. In looking over it, she certainly consumed a fair amount of carbohydrates but nothing that was extreme. The foods she was certainly overeating were high fat foods like nuts, oil, fatty meat and cheese. In addition, a lot of the desserts and treats she assumed were mostly carbs, like ice cream and cookies, actually derive more calories from fat than they do carbohydrates. My instructions were pretty simple to her and I told her she could eat as many sweet potatoes as she wanted, until she was full.  No limits. Come to find out she almost never consumed more than one medium sweet potato at any one time and was full and satisfied at those meals.  She dropped 30lbs in a very short amount of time. On my end, I knew her calories were under control but on her end, all she experienced was less restrictive eating AND the sensation of being full.

My second theory is that people simply grravitate towards what they really want to do anyway.  If the Mediterannean diet did anything it certainly helped people lose their irrational fear of eating fat. But remember that the Mediterannean diet called for lean proteins, lots of veggies and fibrous carbohydrates along with mono and poly unsaturated fats.  Funny, I never recall anyone over consuming protein or vegetables while advocating for that diet, most individuals end up over consuming fat. If I told you you could eat 5 specific foods in as much quantity as you wanted and still lean out, your ears would perk up. Now, if 4 of those foods were things you didn't really like but 1 of them you loved, guess which one you would preferentially eat!

Lastly, if an individual is overconsuming calories and belives it has to be the carbs, take a closer look at how they consume those carbohydrates.  Very often you'll find them in the presence of a lot of fat.  Sure, pasta is calorie dense but how many people eating plain boiled rigatoni?  It's usually tossed in a calorie dense sauce, drizzled with olive oil, sprinkled with cheese or has a fatty ground meat accompanying it.  How about a bagel?  Who's eating a plain bagel?  Usually we add peanut butter, cream cheese or butter.  

Now, I don't believe that fat is the culprit for fat gain just like I don't believe carbs are either.  I do believe an overconsumption of one, very often in the presence of each other, causes many people to overeat. When you consider that two food sources, a carb and fat, can have the same calorie content but vastly different volumes, it's easy to see why people aren't aware which food they are overconsuming.  By volume, fat makes up a much smaller part of your plate so if you have been eating lots of pasta, you see "carbs" but you don't see the fat as much. You could easily double the calorie content of a bowl of plain pasta by drizzling oil on it but the pasta would still be 95% of the food volume in the bowl.  If you aren't educated on these things, you'll miss that point.

So this brings me back to bread and whether this is a battle worth fighting.  Is consuming bread going to hinder your fat loss? It doesn't have to. Remember that every food is a trade off, if you have 2500 calories to eat daily there is plenty of room to eat things like bread because you hav enough total calories to ensure you are full, whether the food sources are high volume or not.  But what about eating 1600 calories per day?  Now can you afford to eat less filling foods like bread that might eat into your calorie total?  Perhaps you trade off and ditch the bread at that calorie level and consume more veggies, berries and sweet potatoes. I'd even posit that what you put between two slices of bread makes a bigger impact than just the bread itself.  You could slice a chicken, tomato and give the bread a good squeeze of mustard to make a lower calorie but high protein sandwich.  Or you could make a grilled cheese that would probably double the calories but have less than half the protein.  Context!

Bread in the research

The impetus for this blog came from watching a video in the MASS Research Review, it's a monthly review of exercise science and nutrition research, great for nerds like me. In a review of flexible dieting, Eric Helms (a contributor) was discussing a study conducted on bread vs no bread dieting.  Essentially, two groups were given the same diet and calories to follow, except one group was not allowed bread.  The dropout rates for the "no bread" group were much higher and the difficulty for the "no bread" group for those who stayed on remained high. The researchers compared how many times participants slipped up on the diet, or consumed something off plan, and the "no bread" group had more total slipups, with the peak at the 12 week mark.  For many people, overrestricting one food or food group might be doable for the very short term but long term it often does not pan out.  In looking at the numbers, at the 4 week mark, the "no bread" group actually had fewer slipups than the "bread" group but that quickly shifted the other way.

I think this pretty accurately reflects how adherent people are for about a month, no matter the diet, but see adherence quickly drop past that point the more restrictive the protocol.  Part of this is that anyone can not eat "X" food for a month, but what about 3 months, or 6 months?  How long can you cut out a whole food or food group and sustain that?  I also would be concerned about how it affects an individuals relationship with that food.  This also means most people think dieting and leaning out exists in days or weeks.  It doesn't. For true sustainable fat loss that becomes part of your lifestyle, we are looking at months and years. We're never sold a diet or program that operates that way so we struggle to think outside of that box.  The reality is you have people who have been overweight for three decades trying to lose 60lbs and make a complete transformation and lifestyle change in 1-3 months. We ask them to cut out a myriad of foods and make a laundry list of changes and forget how deep-seated so many individual's food issues are. 

Maybe for someone who needs to lose 60lbs they don't need to restrict bread yet, maybe they just need more protein and water.  More vegetables.  More time walking.  Maybe bread is so far down the list you never really have to address it.  If you take all the misconceptions I listed above, multiply it by ten and then extrapolate it over three decades, then you've got your average overweight client. There is so much work to be done on their knowledge and abilities that telling them bread is bad only adds to it.  For someone trying to get sub-10% bodyfat?  Sure, bread might not be the best calorie trade off, but for some it might help with adherence if they get to have an 80 calorie slice of Ezekiel bread alongside their egg whites.  

Cutting out bread is easy.  It's a one-sentence direction that tells a dieter what to do.  However I have experienced (and the research supports) that a diet of inclusion is probably better than a diet of exclusion.  That's because having someone focus on what things to highlight and include also helps them to reduce or exclude any problematic foods without making it an issue.

I don't eat....

The reason I cringe a little when someone says "I don't eat X" food is because at some point, they will eat X food.  The fallout of that can be problematic for a lot of individuals; does eating that food, in this case bread mean you feel like you failed?  Does it start a binge cycle? Does it make you hate yourself and your choices? Understanding that foods have a tradeoff in terms of calorie density, nutrient density and fullness allows you to make choices and include a lot of food items without lumping them into good or bad categories.  If you do choose to exclude a lot of foods because you want to get really lean, do so with the understanding that you are trading off palatability for greater calorie control. And fewer food choices means less decision making when you are diet-fatigued.  It does not mean that any food you didn't eat is automatically bad though.  Many people cling to the approach they used the first time they were successful dieting as "the way". 

If you want to know why any one diet worked for you it's for two reasons. One is that it controlled calories.  Two is that the approach worked for you at that time. 

If you want to lean out, remember that reason number one is an absolute must.  And reason number two follows closely behind but with the caveat that the old approach may not work for you at this time. Age, lifestyle, work, stress, dieting history all factor in for why a diet that controls calories may not work for you a second time around.

In the end, don't battle over bread.  If you end up excluding it because it works better at this time, fine.  But don't fall victim to the idea that cutting out bread was the reason for all of your success. Clinging to what we used to do is what keeps so many people trapped in dieting hell and it's like listening to a middle aged man recounting that one time he made a touchdown in high school football.  "WE GET IT BUT LETS MOVE ON!"