The Mediterranean Zone (4 page)

As increased cellular inflammation interferes with your body’s ability to signal metabolic disruptions, your organs begin to operate less efficiently. That’s when the physical signs of aging (increased body fat, loss of muscle mass, increased fatigue, development of wrinkles, and so on) begin to appear. Not surprisingly, the practice of “anti-aging” medicine usually depends on increasing certain hormone levels in the body. However, this doesn’t overcome the primary underlying problem, which is the disturbance of hormonal signaling caused by increased cellular inflammation. Solve that problem by following an anti-inflammatory diet, and you will do a lot more to reduce the real rate of aging inside your cells than any amount of hormone supplementation.

Far more ominous to your future is the increasing likelihood of developing dementia, especially in the form of Alzheimer’s disease. It is estimated that, in America, one-third of individuals older than age 65 will die with some form of dementia. Alzheimer’s disease itself is the fifth leading cause of death of individuals older than age 65. By the time a person reaches age 85, approximately 50 percent will have some form of Alzheimer’s. If you have diabetes, you are twice as likely to develop Alzheimer’s.
That’s why many neurologists are beginning to call Alzheimer’s disease type 3 diabetes. What they should be saying is that both diabetes and Alzheimer’s are diseases of inflammation. In diabetes, the pancreas is inflamed. In Alzheimer’s, the brain is inflamed. The earlier you develop type 2 diabetes and the longer its duration, the greater the risk of developing Alzheimer’s. This means we may have a neurological tsunami awaiting us in a very short period of time. The treatment of dementia has already become one of the most costly drains on our health-care system and will only continue to grow as the current generation ages.

Not a very pretty picture for the future of America (as well as the rest of the world). Humans will become fatter, sicker, and demented, primarily due to increased diet-induced inflammation. Fortunately, the next chapter provides a dietary road map to begin to reverse those consequences.

I
f your goal is to lose weight and improve health, then the only way to get there is to reduce diet-induced inflammation. The Mediterranean Zone is your road map.

Reaching the Zone will reduce inflammation by keeping insulin, eicosanoids, and other food-generated hormones within therapeutic ranges twenty-four hours a day, so you are always moving toward optimum health through hormonal balance. Although that may sound intimidating, it really is not. To enter the Zone you need only three things, which you probably have with you wherever you go: a hand, an eye, and a watch. If you have those tools, then a lifetime living in the Zone—perfectly in balance and at dramatically lowered risk for weight gain, diabetes, Alzheimer’s, and other modern scourges—becomes incredibly easy.

Every meal (and that includes breakfast) starts with a plate. Now use your eye to divide the plate into three equal parts. On one-third of the plate, add some low-fat protein such as chicken or fish, or even vegetarian protein-rich products such as extra-firm tofu or soybean imitation-meat substitutes. Just make sure the protein portion on the plate is no larger or thicker than the palm of your hand. This is about 3 ounces of low-fat protein for the average female and about 4 ounces of low-fat protein for the
average male This is the standard recommendation among most registered dieticians. I would agree with them that you should never exceed that amount of protein at a meal.

Next, fill the rest of the plate with colorful, low-glycemic load carbohydrates, such as vegetables and fruits. Bright colors signal that they are rich in polyphenols, which help to control diet-induced inflammation. Non-starchy vegetables (broccoli, peppers, onions, asparagus, and so on) are the best sources of carbohydrates since they have a very low glycemic load. This means they don’t generate a large insulin response when eaten, even though they take up a lot of room on the plate. Fruits have a higher glycemic load, and whole grains have a very high glycemic load. White carbohydrates (bread, pasta, rice, and potatoes) simply have no place on your Zone plate because of their high glycemic load and lack of polyphenols.

Finally, add a little (that means a dash of) fat that is low in both omega-6 and saturated fatty acids. For most people, the best choice is extra-virgin olive oil.

So that covers the eye and the hand. But why do you need the watch? If you created the right balance of protein, carbohydrates, and fat for that particular meal, then for the next five hours you won’t be hungry, and you will maintain peak mental focus and emotional balance because you have stabilized blood glucose levels.

The reasons that this dietary blueprint gets you to the Zone are as follows:

You don’t get to “bank” this hormonal control, as it will last only about five hours. The best thing about the Mediterranean Zone is that a correctly balanced meal will bring you into the Zone and start reducing inflammation immediately, no matter what your nutritional past may have been. But even with a perfectly balanced Zone meal, the hormonal changes will last only five hours. This means you are hormonally only as good as your last meal.

So to optimize your health and weight loss, you have to pay attention to the balance of protein to the glycemic load at every meal. Technically the glycemic load is defined as the total of the individual amounts of each carbohydrate on the plate multiplied by their individual glycemic responses (
the glycemic index). What the glycemic load provides you is an indication of how rapidly your blood glucose levels will rise after a meal. The lower the glycemic load of a meal, the less insulin you produce for the next five hours. If you eat a lot of grains (even whole grains) and starches, blood glucose rises quickly after a meal; so then do your insulin levels, as insulin is secreted to reduce that sudden influx of glucose into the blood. If you replace the grains with fruit (not fruit juices), legumes, and especially non-starchy vegetables, blood glucose levels don’t rise as quickly—and insulin response remains modest.

The more rapid the rise of blood glucose levels, the greater the secretion of insulin to reduce those levels in the blood. The insulin (1) causes the storage of excess glucose either in the liver or muscles (as glycogen), (2) converts excess glucose into fatty acids in the liver that are released into the blood, and (3) helps convert some excess glucose to glycerol and enhances the transport of fatty acids into the fat cells—which then helps transfer excess fatty acids from your blood to your adipose tissue, where fatty acids can be safely stored.

The reason the body produces insulin rapidly in response to elevated blood glucose levels is that, in excess, glucose is toxic. It reacts with protein in the blood to form advanced glycosylated end (AGE) products. These “sugar-coated” proteins can bind to specific receptors (called RAGE, or receptors for advanced glycosylated end products) in your cells that initiate inflammatory responses. One of the consequences of increased inflammation is the development of insulin resistance, a condition that results in chronically elevated insulin levels. This is the real reason insulin makes you fat and keeps you fat.

And it’s also the reason reducing the glycemic load of your meals is so important. Protein belongs on your plate to promote satiety and to stimulate the release of hormones that stabilize blood sugar levels. The secret to the success of the Zone Diet is that you are never hungry (because satiety is increased) and never fatigued (because blood glucose levels are stabilized).

The continuing consumption of omega-6 fatty acids (primarily from vegetable oils such as soybean, corn, sunflower, and safflower) combined with
high-glycemic carbohydrates (refined carbohydrates, whole-grain carbohydrates, and white starches such as potatoes and rice) sets the stage for increased levels of diet-induced inflammation by enhancing the synthesis of arachidonic acid (the driver of cellular inflammation). Arachidonic acid (AA) is the driver of cellular inflammation because it is the molecular building block for powerful pro-inflammatory eicosanoids. You might consider AA to be toxic fat, far more dangerous to your health than any trans fat or saturated fat could possibly be. High concentrations of AA can be found in egg yolks and organ meats. However, AA can come from omega-6 fatty acids (primarily in vegetable oils) and a high-glycemic-load diet. The increased secretion of insulin (induced by the rapid entry of glucose into the bloodstream) will accelerate the conversion of omega-6 fatty acids into AA. It is like adding a lighted match to a vat of gasoline. It’s a deadly combination as you get an explosion of cellular inflammation. Why deadly? Cellular inflammation accelerates the development of chronic disease and speeds up the aging process by disrupting hormonal signaling patterns in every cell. This is the real reason you get fatter, become sicker, and age faster.

You have a hot body—about 98.6 degrees Fahrenheit, in fact—and it’s exposed twenty-four hours a day to high levels of oxygen. As you know from storing fruit on the counter in summer, heat plus oxygen leads to spoilage. When the same happens to lipids, you call it rancidity. And that’s exactly what happens to the omega-6 fatty acids you consume—they become rancid inside the body. These oxidized fats not only cause inflammation but also can accelerate heart disease by creating oxidized LDL particles (the
really
bad cholesterol).

This is exactly why the Mediterranean Zone is so effective in fighting disease. Polyphenols—which are powerful antioxidants (far more than vitamin E or vitamin C)—are found in high levels in the colorful carbohydrates (vegetables and fruits) that are the primary carbohydrates of the Mediterranean diet and of the Mediterranean Zone. Of course, it makes even better dietary sense to reduce omega-6 fatty acids and increase polyphenols at the same time.

Unlike omega-6 fatty acids, the long-chain omega-3 fatty acids found in fish and fish oils are anti-inflammatory. Polyphenols in high enough levels are also anti-inflammatory. If you don’t have adequate levels of both in your diet, your ability to turn off inflammation is highly compromised.

Control these separate dietary changes—properly balanced protein and low-glycemic carbohydrates, significantly reduced intake of omega-6 fatty acids, and significantly increased intake of polyphenols and omega-3 fatty acids—and you will always be inside the Zone where the control of cellular inflammation induced by the diet can be maintained for a lifetime. By reducing diet-induced inflammation, you will also lose excess body fat, decrease the likelihood of developing chronic disease, and slow down the aging process. Your body will become more adept at converting food calories to chemical energy. And because you are reducing cellular inflammation, the hormonal signals that tell the brain to stop eating become more effective. As a result, you will not be hungry.

If you aren’t hungry, then you consume fewer calories. Consume fewer calories without hunger and fatigue, and you will lose excess body fat, delay the development of chronic disease, and live longer. That is the secret of the Mediterranean Zone.

If you want to be more technical, these simple rules result in a calorie distribution that is about 40 percent low-glycemic-load carbohydrates (primarily non-starchy vegetables), 30 percent low-fat protein (such as chicken, fish, or tofu and soy imitation-meat products), and 30 percent fat (mostly monounsaturated fat, and low in both omega-6 and saturated fats).

I prefer to keep the total carbohydrate intake at about 40 percent of your calories because the brain is literally a glucose hog. The brain accounts for only 2 percent of the mass of the total body, but it uses 20 percent of the blood glucose. The brain requires about 130 grams of glucose per day, which is why the Mediterranean Zone provides between 100 and 150 grams of carbohydrates per day, split over three meals and one or two snacks. This may sound like a lot, but in fact it’s about a 50 to 67 percent reduction of the total carbohydrates most Americans are currently eating.

But one must be careful to spread those carbohydrates throughout the day. Consuming more than 30 to 40 grams of carbohydrates at any one
meal is going to generate excess insulin. If you are not getting five hours of appetite suppression or you feel you have reached a weight plateau, before you think about lowering the levels of carbohydrates in your diet, first begin to reduce the glycemic load of your meals. Begin by eliminating grains and starches from your diet. If this isn’t sufficient to have the desired result, then start removing fruits and legumes (moderate-glycemic load carbohydrates) from your diet. This will leave non-starchy, low-glycemic load vegetables as your primary carbohydrate source. You will have a very difficult time eating enough non-starchy vegetables to overstimulate insulin, but you will still be maintaining adequate blood glucose for the brain.

A common misconception about the Zone is that it is a high-protein diet. That’s simply not true. Let’s look at the number of grams of macronutrients (carbohydrates, protein, and fat) a normal female or male might be consuming following the Mediterranean Zone.