Always Counting Calories...
Coconut macaroons from the book Always Delicious by Dr. David Ludwig.
I’ve spent a lifetime reading nutrition labels on the back of packages and deciding whether to eat a food based on the number of calories it contained. After decades of being told that these were the units of energy that mattered most, I’d settled in to a weight, and a habit, that I didn’t love. Faced with a world full of new diets and compelling research, I was finally ready to ditch my calorie-counting routine.
One of the guides behind my newfound freedom was Dr. David Ludwig, a physician and researcher at Harvard Medical School whose work focuses on understanding how fast digesting carbohydrates affect our hormones and metabolism in ways that cause weight gain and increase the risk for chronic diseases like Type 2 diabetes. (I have Type 1.)
When I first spoke to Dr. Ludwig, he shared the example of a child newly diagnosed with Type 1 diabetes. I instantly recalled my own diagnosis at age twelve. I was the thinnest I had ever been. After a week in the hospital, learning to inject an orange and then taking my own insulin, the pounds came tumbling back. The next two decades––through high school, college and into my thirties––I went on diets, went off, exercised, tried to eat right but always struggled with my weight. In my mind, I blamed diabetes for my challenges, and now I knew I was right.
“Insulin has a direct effect on fat cells to promote fat buildup and to inhibit the release of fat from fat cells,” he told me. “Too much insulin for an adult and excessive weight gain will predictably occur.” You’re telling me.
For Dr. Ludwig, the bad guy in the movie is the deluge of fast-digesting carbs available in our markets, schools and workplace that, in return for empty calories, raises our insulin needs. Whether you’re injecting insulin or your body is producing it, eating crappy food drives fat storage. It seems an easy link, but it wasn’t one I truly understood until I was older. As my diet evolved to focus more on whole foods––vegetables, fruit, nuts, and protein––I began to ignore calories.
While I was reading Dr. Ludwig’s books, I wondered how he got into nutrition, an area of medicine that has long been under represented in endocrinology. As a young child he had self-awareness for how food affected his physical and emotional well-being. Then during his endocrine training, “I became involved in basic obesity research––the obesity epidemic was at the time exploding––but found the work too distant from patient care. When I made the leap to clinical nutrition research, my long-term interests in food and a growing appreciation for how food affects hormones converged.”
With that passion for helping patients, and over two decades of real-life experience, Dr. Ludwig packaged up his hands-on experience into two approachable books: “Always Hungry,” which details a three step process of re-learning how to eat: taking out processed carbohydrates, slowly adding back in whole-food grains and focusing on what we eat versus how much we eat and, he launched a Facebook group where people following the program can share wins and as a follow up, he’s published a new book co-written with Dawn Ludwig, his wife and a chef, called “Always Delicious” that continues the conversation and provides recipes, anecdotal stories from the Facebook group and shopping advice. “Always Delicious” isn’t a diet book for people with diabetes, it’s for everyone. So far I’ve made the almond coconut macaroons and the pear cinnamon cashew butter. Next I’m making the pickled vegetables.
Dr. Ludwig’s overarching message is simple: “Beyond the number of calories in a meal—the quality of those calories can help you feel full longer, have more energy, remain calm and focused, think more clearly, feel better and be happier.” The books are easy to read and helpful. I’ve recommended it to my family and friends and I’ve begun lurking in the Facebook group to read everyone’s posts. What can I say: I love food.
Dr. Ludwig meanwhile is still focused on getting the world to change. He’s working on a clinical trialwith results expected in three years and he’s just completed a study comparing diets using a 20% vs 40% vs 60% carbohydrate ratio, which is in the process of being submitted to a journal now. But there is always more to be done. “We have massive 100-million dollar studies run by the government on low fat, but we have yet to get a single high quality low-carb diet study,” he told me.