Appetite Control: When You're Hungry All the Time

How to turn off the hunger switch.

Fat, Frustration, and the Expert Findings

Vicki Wadlow, a 53-year-old potter, stays busy with chores on the Virginia farm where she and her family live. She has led a vigorous life. She exercises regularly and spends much of the year pursuing outdoor activities. Around the time she turned 45, though, her slim figure gradually began to fill out. "All of a sudden, the pounds started to just creep on," Wadlow says. "It was very frustrating."

As her dress size rose from a six to an eight to a ten, five-foot-three Wadlow tried to lose weight by cutting fat out of her diet. She tried low-fat and even nonfat diets. "That was what all the experts said to do -- cut the fat," says Wadlow. By eliminating most of the fat from her meals, Wadlow lost some weight initially, but she immediately gained it back. And Wadlow thought the missing fat in her diet made her skin sallow. She felt unhealthy and was constantly battling hunger. Sometimes she became so hungry that she would get shaky.

Wadlow decided to try an eating plan that replaced highly refined carbohydrates such as white bread, sugary sweets, and rice cakes with less processed carbohydrates such as whole-grain breads, whole-wheat pasta, beans and lots of nonstarchy fruits and vegetables. The plan also included moderate amounts of protein and heart-healthy unsaturated fats. Much to Wadlow's surprise, she lost 15 pounds. "It didn't take that long, and it was painless," she says. Her craving for sweets disappeared, and she never experienced that shaky, hungry feeling that she'd felt while on other diets. She has kept the weight off for more than four years.

Like many Americans, Wadlow believed that a low-fat diet was the only way to lose weight. She accepted the recommendations of dietary experts to replace fat with carbohydrates. But just as scientists found that there are good and bad fats, they're now discovering there are good and bad carbohydrates. Fiberless, simple sugar carbohydrates -- including classic dieting staples such as low-fat cookies, pretzels, fat-free chips and rice cakes -- may not be much help in shedding pounds. In fact, eating these foods may sharpen your hunger, causing you to gain weight.

When your body digests food, it converts carbohydrates to a sugar called glucose. As blood levels of glucose rise, the pancreas gets the message to release the hormone insulin, which shepherds the sugar into cells. Once there, it's either burned on the spot for energy or converted to fat and other substances for future use.

Over the last two decades, scientists have begun to pay closer attention to glucose and insulin. Measuring how quickly the body absorbs glucose from a food, they've ranked our diets on what's called the glycemic index (GI). A glazed doughnut -- with its high content of the simple carbohydrates white flour and sugar -- is converted rapidly to glucose and scores high; a bowl of slow-cooked oatmeal, which requires more digestive work to be transformed into glucose, ranks much lower. Lower scores can mean less converted fat.

A diet rich in high-GI foods can be hard on your health because it pushes your body to extremes. Say you have a bagel with fat-free cream cheese, which scores higher than the doughnut. Your blood glucose goes through the ceiling, and your pancreas must hustle to meet the insulin demand. Day after day of this can tax your pancreas. Worse, the insulin it releases may become less efficient at corralling sugar.

That adds up to insulin resistance, and people with this condition -- some experts believe there are as many as 50 million Americans -- are at high risk of developing Type 2 diabetes. Some 16 million Americans have Type 2 diabetes, the fifth deadliest disease in the United States.

Diabetes isn't the only worry. High levels of glucose seem to damage blood vessels, and elevated amounts of insulin can raise blood pressure and blood levels of fats, while suppressing levels of "good" cholesterol. The result is increased heart-disease risk.

There's more: David Jenkins, a professor of medicine at the University of Toronto and one of the pioneers of GI research, has recently found links between high-GI diets and ovarian and endometrial cancer. Other studies have tied the diet to increased risk of breast and colon cancer.

Paying attention to the quality of your carbohydrates may be a smart long-term strategy, but the immediate reward is even more compelling: Eating a low-GI diet can suppress hunger.

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