Nutritional science & weight loss. - Fat Flush Plan - book review

Townsend Letter for Doctors and Patients, May, 2002 by Jonny Bowden

The Fat Flush Plan

by Ann Louise Gittleman

McGraw-Hill, January 2002, 288 pp, hardcover, ISBN 0-07-138383-2

$21.95 -- order through Barnes & Noble, www.amazon.com or by calling 800-888-4353

Let's not mince words: Ann Louise Gittleman's new book The Fat Flush Plan is a superb book. It belongs in the company of the half dozen best how-to books on diet written in the past decade. Diet books are always a paradox -- if the public loves it the academics will rarely take it seriously. Ann Louise has written a book that should satisfy both camps -- it should have huge appeal for a mass audience while at the same time contains enough solid info and documentation to warrant a spot on many professionals short list of "must haves."

To paraphrase Barry Sears in the intro to this book, few things have the power to generate visceral responses like nutrition and politics. And like politics, nutrition has both "left wing" and "right wing" factions and is almost never politically neutral. On the one side is the American Dietetic Association and their apologists. The other side -- (full disclosure: the side on which my feet are firmly planted) -- includes Gittleman, Barry Sears, Jesse Hanley, Diana Schwarzbein, Jeffrey Bland, Robert Crayhon, Sidney Baker, Sandra Cabot and a few other notables who are working valiantly to bring a comprehensive, functional medicine outlook to the field of nutrition and weight loss and take it beyond the calorie counting, supplement-bashing fundamentalism of the dietitians. In the land of the fundamentalists, calories are all that matter and people gain weight simply because they eat too much food. End of story. Any diet other than the food pyramid is "high protein" and "faddist" and a priori dangerous. (In nutri tion, like religion, true believers refuse to let a little thing like lack of evidence get in the way of their beliefs). While there is more than a grain of truth to the idea that people get fat because they eat too much food, it is so far from being the whole story that it virtually constitutes philosophical malpractice.

Anyone claiming to completely understand the whole story about weight gain, appetite, fat loss and diet right now is standing on a slippery slope -- there is just too much still unknown about how and why people lose weight successfully. There are, however, some factors we can say with a fair degree of certainty are big players on the field. Chief among them are intake of the right kinds of fats, the role of stress, the role of insulin and blood sugar destabilization and, perhaps most important, liver health. This book addresses them all.

Gittleman first introduced the idea of using fats such as GLA (gamma linolenic acid) to stimulate fat loss in an earlier work, Beyond Pritikin, a book in which she first defected from the "fat free" dogma of Nathan Pritikin and his followers. GLA may assist in fat loss in two ways -- one by stimulating BAT (Brown adipose tissue), a special kind of metabolically active fat, and two, by being the raw material for eicosanoids, which control the sodium-potassium pump and rev up the metabolic rate. The use of both GLA and flaxseed figure prominently in The Fat Flush Plan.

Another key concept in the book is the role of liver health in the fat loss process and indeed the bulk of the first section of The Fat Flush Plan is about detoxification. The thinking runs like this: bile breaks down fats, and the liver can't do its job if it's lacking in certain nutrients that make up bile salts, or if it's congested or thickened with chemicals, toxins, excess hormones, drugs or heavy metals. So first and foremost among Gittleman's recommendations is the avoidance of anything that will add to the burden of an already overtaxed liver (processed foods, caffeine and trans-fats are forbidden, and she's understandably not a fan of birth control pills). Next is a diet rich in all the nutrients that will help the liver do its job better. Lemon juice and water is used daily for its benefits to bile formation and its promotion of peristalsis. Eggs are strongly recommended for their lecithin (fat emulsifier) content as well as for their taurine, cysteine and methionine (all sulfur-containing amino ac ids) and because they are a superb source of phosphatidylcholine, one of the best nutrients for liver health on the planet. She also gives a passing nod to liver-friendly supplements like milk thistle, tumeric and dandelion. (I would have liked to see more emphasis on alpha lipoic acid here but I'm quibbling). She also recommends the use of a daily cocktail of unsweetened cranberry juice, water and psyllium husks (to which she gives the catchy name "Long Life Cocktail"). This potent source of phytonutrients such as anthocyanins, provide nutritional support for both the cytochrome P450 Phase 1 and Phase 2 detoxification pathways. The fiber from the psyllium husks blocks absorption of fat and helps to bind toxins.

Among the other factors discussed in the book is stress fat, and there is a wonderful discussion of the concept of "false fat," first pioneered by Dr. Elson Hans. The idea here is that when you eat "reactive foods" -- i.e. foods to which you may have a sub-clinical allergy or hypersensitivity--the IgG antibodies kick off a reaction which turns on histamine and releases a flood of excess fluid resulting in water retention and abdominal bloating that can add up to 10 or more pounds of unwanted and uncomfortable water weight. This immune system reaction also causes the release of endorphins ultimately producing the well-known cycle of allergy and addiction. In addition, serotonin levels drop causing a cycle of cravings which are in turn satisfied by foods which destabilize insulin and blood sugar and ultimately cause additional weight gain. In other words, a metabolic mess. Needless to say The Fat Flush Plan eliminates or severely reduces the "usual suspects" in this unpleasant roller coaster, wheat, dairy and s ugar being prime among them.