Low Carb/High Fibre & Hunger

Carbohydrate restriction resulting in reduced post meal glucose and insulin responses is now an accepted weight loss and diabetes treatment strategy. Even in the context of a high carb diet increased fibre intake has also been associated with weight loss and improvement of T2 diabetes. However, the combination of these approaches has not had much attention. The synergy between low carb and high prebiotic fiber intake is expected to suppress several aspects of appetite regulation:

• Although Low carb diets and low blood glucose and insulin levels result in subsequent reduced hunger and food consumption, high fibre food reduces appetite through several different mechanisms:

• Ketogenic diets do not increase hormones that suppress hunger (GLP1 & PYY) in stark contrast to the marked increase in these satiety hormones with high fibre consumption mainly due to increased production of short chain fatty acids by probiotic gut microbes. Therefore, one would expect a much greater appetite reduction when high fibre is combined with a low carb/ketogenic diet.

• The hunger hormone, ghrelin is lowered for many hours in response to increased short chain fatty acids from prebiotic fermentation.

• Fibre reduces gastric emptying time and the fullness effect alone is satiating.

Calorie restriction is an effective way to lose weight, decrease age related diseases and even extend life expectancy but is unlikely to be sustainable if it is associated with intolerable hunger. High glycemic, rapidly digested carbohydrates, such as sugar, corn syrup, flour, potatoes, rice, corn flour, form over 50% of most people’s diets and attempts at calorie restriction while still consuming these types of addictive foods is associated with agonizing hunger so much so that these foods make it almost impossible to maintain a normal weight over the long term.

Optimal Fiber Intake?

It is difficult to achieve recommended fibre intake with prevailing food choices. Even observational studies that show health benefits of fibre, those subjects eating the most amount of fibre (around 30g/day) were still consuming less than recommended daily amounts. Production of short chain fatty acids particularly butyrate are dose related to fiber fermentation and new evidence regarding the vital roles of butyrate suggests optimal fiber intake needs re-evaluation. A meta-analysis showed a dose response reduction in cardio-vascular disease risk with up to 70g fibre/day whereas hunter gatherer populations customarily consume in excess of 100g/day and experience far fewer metabolic disorders.

For the “Low Carb” treatment of diabetes and obesity there is a problem with obtaining adequate fibre from whole grain wheat flour which is nevertheless a high glycemic/insulinemic food and 40g a day of fibre from whole-wheat flour comes with 250g (1000 kcals) of additional starch. On the other hand it is impractical to consume large volumes of vegetables, for example one would need to eat 1.7 kg of broccoli to get 40g of fibre. Alternatively, our basic baking flour reverses the carb to fibre ratio of whole-wheat flour: (Fiberflour, www.lonjevity-foods.com) where profound macronutrient transformations are achievable substituting FiberFlour for whole-wheat in daily bread, wraps or chapatis for instance.

Suggested Dietary Strategy

• For weight loss and type 2 diabetes.

• Get used to a low carbohydrate diet, high in fiber with modest protein and fat by giving up filler foods like bread, potatoes, rice, pasta, flour and sugar.

• Unlimited amount of daily Fiberflour Bread, chapatis, pizza, flat bread, cookies, pastry, etc.

• Skipping breakfast till midday gives 15 hours of fasting and is surprisingly easy to do if you're not hungry.·

• Gradually extend periods of fasting, one meal a day, or any other intermittent fasting plan e.g. 5 and 2.

• Think about your hunger level and ask the question: am I hungry? Do I need to eat now or am eating out of routine habit?

• If possible, keep a diary of self-assessed hunger on a 1 to 10 scale and food intake.

• After 1 month of following the program there should be significant changes in appetite & spontaneous food consumption, weight, waste line, resting heart rate, blood pressure, mood and subjective wellbeing.

What to Expect When Changing to a Low Carb High Fibre Regime

1. Possible gastro-intestinal side effects such as bloating, colic or diarrhea that may occur with increased fibre consumption expected to lessen with gradual introduction.

2. There will be an increase in stool output and noticeable changes in bowel habit

3. Glycemic response to substitute foods using FiberFlour are expected to be very low.

4. Gradual decrease in HgbA1c over 1 to 2 months.

5. Markers of metabolic syndrome should improve BP, lipid profile, LFT, proteinuria

6. Possible decrease in inflammation related markers and symptoms eg. hsCRP, joint pain and swelling

7. Possible improvement in mood, energy levels, hunger, food intake over time with increasing butyrate levels.

8. Weight loss and waist circumference decrease.