A doctor’s experience with the Slow Carb Diet
by Cyrus Peikari, M.D.
I love recommending this variation of a slow carb diet to my intermediate-level patients. It is an “easy mode” diet that keeps you full and satisfied, allows unlimited desserts one day per week, and works for nearly everyone. “Slow” carbs are those that are absorbed slowly as sugar into your bloodstream. For example, white hamburger buns will spike your blood sugar very high and very quickly, whereas beans won’t. Both are carbs, but the white bread provokes a stronger “insulin response” from your body.
Popularized and refined by author Tim Ferris, this variation of the slow carb diet has simple tenets:
Rule #1: Avoid “white” carbohydrates
We will get into specifics below, but for now, this is the general rule: ry to avoid any carbohydrate that can be considered “white” carbs. That includes rice, potatoes, cereal, bread, pasta, or any breaded fried foods.
There are two exceptions to this rule. First you can have white carbs within 30 minutes of finishing a resistance based workout of at least 20 minutes in length; this includes weight lifting, yoga, etc. Second, you can have fast carbs on your “cheat day”, described below.
Rule #2: Eat the same few meals over and over again
The most successful dieters try to eat roughly the same foods every day, especially at the beginning of the diet. Numerous studies show that the more choices you have to make, the more likely you are to overeat. At the very least, try to keep breakfast the same, so that your mind is not clouded with superfluous decisions early in the day.
Rule #3: Never drink calories
Liquid calories (with the exception of certain kinds of protein shakes) are among the fastest absorbed, and they can give the most severe sugar spikes. Drink as much water as you like, but stay away from sugared beverages. Milk and fruit juice both have a lot of sugar, so strictly avoid them. You can have unsweetened iced tea, tea, coffee (without cream, or other no-calorie beverages).
Rule #4: Take one day off per week
This is the “dieters gone wild” part of the week. On Saturdays I’ll load up on as many chocolate croissants as I want. Anything goes on your cheat day, including sugary cereal with milk, cheesecake, and cupcakes. This is when others will think you’ve lost your mind.
However, spiking your insulin one day per week not only helps with compliance, but also prevents the diet from failing. Why? Because on nearly every diet, the body adapts and down-regulates your metabolism over time, putting the body into “starvation” or survival mode.
You have tried diets in the past, which worked for a few weeks or months, but eventually you gained the fat weight back. That is partly because of your lowered thyroid and leptin levels, two of the hormones that help control your level of metabolism. Worse, you now feel deprived, and you may tend to binge eat: which is all the more dangerous now that your metabolism is lower. The cheat day, then, is programmed to prevent this.
Psychologically, it is also far better to plan your cheat day in advance, rather than “slipping up” and then feeling guilty for blowing your diet.
What foods are allowed?
The following list includes foods which you are allowed to eat as much as you like; at the beginner level, there is no need to count calories or portion sizes:
2) All meat not treated with hormones or antibiotics (fish, poultry, pork and beef)
3) Turkey bacon, organic bacon, organic sausages
4) All fish and seafood
5) All beans (but chickpeas and hummus only in moderation)
6) All vegetables (except yams, potatoes, and sweet potatoes)
7) Hot sauce
8) Salsa (without added sugar)
9) Any oil
11) Spices and herbs
13) Non-creamy, low-sugar dressings
14) Brown rice protein, hemp protein, pea protein
15) Unflavored whey protein isolate
16) Unsweetened cocoa
What foods are NOT allowed on the diet?
The following foods should only be eaten on a cheat day:
2) Milk products including cheese (except cottage cheese)
3) Refined soy products (soy milk, tofu, tempeh, soy protein shake)
4) Fruit, except for tomatoes and up to one medium avocado per day
5) Potatoes (any starchy vegetable, including sweet potatoes, yams, yucca)
6) Bread, rice, grains, quinoa, oatmeal, tortillas
8) Creamy dressings and dressings with sugar
9) Sugar, honey, corn syrup, maple syrup, fructose, agave
10) Deep-fried breaded food
11) Corn, popcorn
12) Alcohol, in any amount or frequency (note: I STRONGLY recommend avoiding this completely, even on cheat days)
The following foods may be eaten in moderation:
4) Avocado (1 medium sized avocado per day)
5) Peanut butter and almond butter (max: 1 or 2 tablespoons per day)
6) Nuts (one small handful per day)
7) Hummus and chickpeas (garbanzo beans)
8) Coffee or tea. You may add up to 2 tablespoons of heavy cream per day.
9) Unsweetened almond milk
Advantages of the Slow Carb Diet
I usually see massive improvement in a patient within days of starting them on this slow carb diet. Over the first few weeks, both high blood sugar and high blood pressure often come down to a normal range. The pasty complexion vanishes from their skin, and a healthy, ruddy glow replaces it. They already look thinner, since water weight is shed first. After several weeks, cholesterol drops as well. Patients who have been on medicines for high cholesterol (statins), diabetes, and high blood pressure may be able to stop their medicines (IMPORTANT: check with your doctor first).
Within a few months, most patients have lost inches from their waist. Note that the scale may not change, but rather your body composition has changed from fat to muscle.
A problem to consider: you may need to go shopping for smaller clothes!
One of the real drawbacks to this diet is psychological: a day or two after your cheat day, the scale temporarily will rise by a few pounds due to water retention from the spike in carbs on the prior cheat day. This water weight will come off over the next few days, but if you don’t have faith in the process, it can be psychologically devastating. Most of us, particularly women, have been brainwashed to be slaves to the scale; even if we are losing inches and looking great, we start to panic if the scale weight doesn’t go down. For example, I helped one of my patients (a high school girl who had struggled with PCOS and weight gain for years) drop from 214 down to an athletic 175 with this diet. Unfortunately, her mom made her stop the diet because she felt it made her daughter “bloated”. In other words, her mother had forgotten about the 39 pounds of fat loss, and was obsessed only by the 2-3 pounds of temporary water weight after a cheat day.
Other issues can occur in women with PCOS, or polycystic ovarian syndrome. Many women have PCOS, or a partially expressed (“subclinical”) form of PCOS, characterized by various symptoms including irregular periods, excessive weight gain, increased body and facial hair, decreased fertility, and a tendency towards diabetes. To be clear, the slow carb diet is amazing for women with PCOS: it works really well for fat loss. It may even improve insulin resistance (thus staving off diabetes) and can improve fertility. However, with PCOS, ANY diet that causes fat loss can result in a flare of acne. That’s partly because estrogen is produced by fat cells; as you lose body fat, your estrogen dominance is reduced. Less estrogen means a higher relative concentration of male hormones, causing acne. Luckily, there are ways to address the acne if it occurs.
For vegans, this can be a tough diet. Eliminating fast carbs for 6 days per week means that you will have to get creative in your food choices. Without rice, bread, chips, and potatoes, your carbs must come from other sources such as beans.
Expert Tips for the Cheat Day
There are various ways to limit the damage that you do on your cheat day. The most important trick is to break your fast with a large serving of protein, 30 grams or more. If you charge right into breakfast with sugary cereal and donuts, you are likely to get dizzy and stay that way all day. In fact, I prefer to have servings of protein before each meal or large snack throughout the entire cheat day. That way, I end up eating fewer chocolate croissants, and thanks to the protein buffer I don’t feel as bloated or dizzy.
Another method is to start the cheat day later, or end it earlier. For example, you can wait until after lunch to start your cheat day, and then continue it until dinnertime.
After several weeks or months, you actually may start to dread the cheat day, because you’ll miss the mental sharpness that you’ve developed on your slow carb days. In this case, you may want to do the cheat day only ever second or third week.
Do I Need to See a Doctor?
It is standard to always recommend seeing a doctor before starting any new diet. Practically speaking, there are some cases where it is a big advantage to get supervision from a provider familiar with nutrition. These cases include, but are not limited to, the following examples:
If you are over the age of 50, or taking meds for high cholesterol, high blood pressure, or diabetes, then you definitely want to involve your healthcare provider in your plans. Diabetics can get into trouble on this diet, since your blood sugar levels can drop back to the normal range within days of starting it. In this case, diabetes meds can drop the blood sugar too low, causing hypoglycemia. For example, passing out when you are driving can be deadly for you and others.
If you have symptoms of low thyroid, you may need to have that treated; otherwise, weight loss can stall. Symptoms of low thyroid include fatigue, difficulty losing weight, hair loss, constipation, irritability, memory loss, decreased libido, or sensitivity to heat or cold temperatures. There are many well established forms of thyroid replacement, including synthetic thyroid, and the more traditional “dessicated thyroid”.
If you suffer from chronically low testosterone, it can be very difficult to lose body fat without treatment. It would be like trying to swim upstream. Both men and women can have low testosterone, particularly after the age of 50. Symptoms of low testosterone include trouble sleeping, reduced sex drive, fatigue, hot flashes, loss of muscle, depression, mood swings, and a pot belly.
Scared That it Won’t Work?
Of all the diets I’ve used with patients over the years, this slow carb diet seems to have the highest success rate long term. You’ll stay full and satisfied every day. And you still get to eat all the desserts and foods that you love, as much as you want, on your cheat day every week. Please take a second to leave your comment below!
DISCLAIMER: The information provided is intended for your general knowledge only and is not a substitute for professional medical advice or treatment for specific medical conditions. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your own healthcare provider with any questions or concerns you may have regarding your condition. The safest and only proven way to lose weight is through regular moderate exercise and appropriate diet, as prescribed by your own healthcare provider. RESULTS NOT TYPICAL.