There are several foundational concepts behind the Trim Healthy Mama plan that are designed to improve health and help with weight management. As I mentioned in my intro post, for the most part these concepts line up with research and make practical sense. There are some aspects of the plan that don’t, and I’ll explain some of them below. Here’s your chance to get the overview of what research has to say about the basics of the Trim Healthy Mama Plan.

Moderation

Age-old and still good, the advice to eat in moderation is always relevant. By including protein at each meal and limiting carbohydrate portions, the Trim Healthy Mama Plan does a great job of preventing carbohydrate overeating. Overeating carbohydrates leads to storage of extra blood sugar as fat and can also increase inflammation, so regulating blood sugar by moderating carbohydrate intake can be key to weight loss or maintenance.

The weakness I see in this area is with fat moderation. The authors do repeatedly mention the importance of not abusing fat intake, but there is no official limit on fat intake for S meals. This might make it tricky for some to keep fat intake in check (my fat intake was quite high during my first week). Since fat is very calorie dense, it’s possible this could interfere with weight loss or weight maintenance goals. Fortunately fat is filling, so that does help promote natural moderation of fat intake, but keep in mind that the desires of our tastebuds can easily override that moderation if we aren’t careful. Fat is awfully tasty!

Glycemic Index

Besides limiting portions of carbohydrates, the Trim Healthy Mama Plan is designed to manage blood sugar (and thus weight and inflammation) by limiting carbohydrate options to those that raise blood sugar more slowly and gradually. This is quantified using a tool called the glycemic index. Foods with a low glycemic index raise blood sugar slowly, while foods with a high glycemic index raise blood sugar rapidly. For example, barley (allowed on the THM plan) has a glycemic index of 25, while white rice (not allowed on the THM plan) has a glycemic index of 72.¹ This is generally a good way to choose healthful carbohydrates and as a bonus, it typically increases fiber intake since high-fiber carbohydrates tend to have lower glycemic indices.

Researchers have since taken this concept a step further to include not only how rapidly a food raises blood sugar, but also the actual amount of carbohydrates in a standard portion of the food.² This helps differentiate between foods that contain only a few carbohydrates (like watermelon, which has a high glycemic index but contains so few carbohydrates that it barely affects blood sugar), and those that have more carbohydrates and send them in quickly (like sweet potatoes). This new measure is called glycemic load, and it is a more complete representation of how a food actually affects blood sugar.¹ A glycemic load of less than 10 is considered low and a glycemic load of greater than 20 is considered high.

Taking glycemic load into account places some not-on-plan foods like whole wheat bread (which has a glycemic load of 9) and whole wheat tortillas (glycemic load = 8) into a much more favorable position as blood sugar regulators. They fall well below some on-plan foods like sweet potatoes (glycemic load = 22). Utilizing glycemic load rather than glycemic index would allow quite a few more foods and make the THM plan less restrictive while better honoring the spirit of managing and regulating blood sugar. My personal philosophy is always to help clients find the plan that is the least restrictive way to achieve their goals – it makes food more fun!

Fuel Isolation

The authors of THM also encourage that for weight loss or maintenance, you should focus on only one fuel (fat or carbohydrate) per meal. The reason for this is that our bodies prioritize the use of carbohydrate fuels over fat fuels, and will burn blood sugar before using fat. The authors state that by restricting fuels to one at a time, you can ensure that all fuels (including fats) are fully burned before eating the next meal.

This is true as long as the total amount of fuel eaten still matches one’s energy needs in that window. For (an overly simplified) example, if someone ate a meal that contained 450 calories for lunch, and they used 500 calories before they ate again at dinner time, they will have burned all of the 450 calories they ate at lunch (first the energy from carbohydrates, then from fat) and tap into their fat stores to make up the last 50. On the other hand, if they ate a 700-calorie lunch and then only needed 500 calories, they would burn through those 500 (first from carbohydrates, then fat if carbohydrates ran low) then end up storing the extra 200 as body fat. Like I said, this is overly simplified for explanation’s sake and there’s a lot of physiology missing here, but it gives you a rough idea.

To bring this back to the THM concept, restricting fuels to either carbohydrate or fat is one practical way to moderate intakes overall, though it certainly is not the only way and it also doesn’t guarantee that the total amount of energy eaten would match energy needs. The key is whether or not the structure of THM makes it easier for you personally to moderate. For some personalities, the structure of S and E meals makes moderation much more clear and easy to follow. If you prefer or it makes more sense to you, you can balance fuels at each meal with moderated portions of carbohydrates, proteins, and fat as long as the total amount of energy you eat matches the total amount of energy you need (or a little less if you’re trying to lose weight).

The Verdict

Overall, Trim Healthy Mama provides a structure for moderation that is mostly based on valid concepts and is likely to generate weight loss (if desired). It will also direct your eating to healthier pastures, as it eliminates quite a bit of junk food, empty calories, and inflammatory foods. Basically, if this plan works for your personality and lifestyle, go for it! It is more restrictive than is necessary for health and weight management, but keep in mind that your lifestyle is your own – so you can choose parts of the plan that work for you and parts that don’t! In fact, many of the blog articles I have read about THM say that their writers follow “a version of ” THM. Good for them! They made it their own, and finding a plan that works for your life is just as important as finding one that works for your body.

1. https://www.health.harvard.edu/diseases-and-conditions/glycemic-index-and-glycemic-load-for-100-foods
2. https://academic.oup.com/ajcn/article/76/1/5/4689459

So far, we’ve covered carbohydrate counting as the primary method of managing blood sugars. It is by far the most important nutritional factor to pay attention to. There are, however, other lifestyle factors that affect blood sugar and are critical to know.

If you have diabetes, have a family history of diabetes, or just want to promote health and prevent chronic conditions, check out the list below to learn about the types of things that can affect blood sugar aside from your diet:

• Stress – This one is HUGE. Stress of many kinds raises levels of a hormone called cortisol that raises blood sugar (1). It’s important to keep in mind here that stress is more than mental and emotional stress (bills, relational issues, busy schedules…you get the picture). It also includes physiological stress (think chronic pain, poor sleep quality and/or quantity, infections, illness, etc) that may not come to mind when we think of the word stress. It is important to make a priority of identifying effective methods of managing stress by addressing the roots of these issues.
  • Mental/emotional stress – The “best” methods of stress management vary for each person but good options include yoga, walking, meditation, deep breathing, and enjoyable hobbies. If you struggle with depression, anxiety, or trauma that causes ongoing stress, find a qualified counselor you trust to help you work through these very real and overwhelming conditions.
  • Physiological stress – Pursue the root cause of your physiological stress. If you suffer from chronic pain, discuss pain management options with your doctor (there are many options beyond pain pills!) or talk with a Registered Dietitian who is knowledgeable about methods of eating to reduce inflammation. If you have poor sleep quality, practice good sleep hygiene habits and consider asking your doctor to have a sleep study done (especially if you snore!) to see if you might have a potentially serious condition called sleep apnea.
• Physical inactivity – Our bodies are designed to move and groove. Doing so activates receptors to let more sugar out of the blood and into the cell to make the extra energy we need for all that movement. My favorite part about the benefit of exercise for blood sugar is that just 30 minutes of moderate exercise (brisk walking, dancing, swimming, biking – whatever you like!) can improve blood sugars for 1-2 days afterward (2). Talk about return on your time investment!
• Inflammation – Inflammation is a type of stress, so I could have included it under physiological stressors, but it’s such a big deal I felt it deserved its own bullet point. Type 2 diabetes is an inflammatory disease, and inflammation is one of the causes of the insulin resistance that is a precursor to type 2 diabetes. Reducing inflammation through exercise, anti-inflammatory eating, and achieving a healthful weight can significantly improve blood sugars (3).
• Medications – Certain medications can raise blood sugar significantly in some people. This typically resolves after they stop taking the medications, but not always. For people with diabetes, these meds raise blood sugars even farther. Taking these medications is not always avoidable, but if you’re concerned about your blood sugars, check the side effects on any medications you take and discuss them with your doctor.

1. Aronson, D. (2009) “Cortisol – Its Role in Stress, Inflammation, and Indications for Diet Therapy. Today’s Dietitian, 11(11). Retrieved from http://www.todaysdietitian.com/newarchives/111609p38.shtml
2. Colberg, SR, et al. (2010) “Exercise and Type 2 Diabetes: American College of Sports Medicine and the American Diabetes Association: Joint Position Statement.” Medicine and Science in Sports and Exercise, 42(12). Retrieved from http://europepmc.org/abstract/med/21084931.
3. Shoelson S, Lee J, & Goldfine A. (2006) Inflammation and Insulin Resistance.” The Journal of Clinical Investigation, 116. Retrieved from http://www.jci.org/articles/view/29069?search%5Babstract_text%5D=&search%5Barticle_text%5D=&search%5Bauthors_text%5D=&search%5Bfpage%5D=1793&search%5Bissue%5D=&search%5Btitle_text%5D=&search%5Bvolume%5D=116.

Today ends week 1 on carbohydrate counting and I gotta tell ya, this is my favorite “diet” by far. It doesn’t even really feel like a diet. I mean, check out some of the awesome meals I got to eat!

I think part of the reason it feels easy is that I have taught the principles so many times that I didn’t have much of a learning curve as far as learning how to carb count. I could recite carbohydrate portion sizes in my sleep…as a matter of fact, I probably do. You’d have to ask my husband.

The greatest part about carb counting is that it is not very restrictive IF you are intentional about balancing your plate with non-carbohydrate foods. You can eat pretty much anything, the most important keys are how much and when. There have only been one or two times throughout the week when there was something I wanted more of but I had already run out of carbohydrates. 

Carb counting feels more like a guardrail than a diet – there to guide me in the right direction and keep me from flying off a cliff on a carb binge.

The most difficult part has been boring beverages. Most of the time I would rather spend my carbohydrates on food than on beverages, which leaves me with tea only rather than tea and juice with breakfast and water instead of milk or a glass of wine with dinner. Overall, not that big of a deal but I have to admit I do miss drinking a glass of milk in the evening.

Here are the details for my first week on carb counting:

Though this particular meal plan has been very flexible, I’m looking forward to carb counting on my own and seeing how well I can do flying solo!

Have you ever been following a “diet” and then been faced with that darn thing called life?

Stress, donuts in the break room, or (like for me) date night can throw the best-laid plans out the window and then many people sit, riddled with guilt and feeling like a failure, wondering whether or not to throw their healthy goals out the window simply because they ate something their over-restrictive plan “didn’t allow.” That’s why I am all about focusing on including lots of nutritious choices, being aware of harmful foods and ingredients, and especially having a plan that includes the foods that make your life worth living!

Check out this great article written by a fellow RD about building a healthy relationship with food! I’m in agreement that the mental game of dieting and restriction can be just as destructive as poor eating habits!

“Yes, I’m a registered dietitian and I care deeply about nutritious, wholesome foods and eating. But I also wholeheartedly believe that there’s a time and a place for a treat.”
– RD Paige Smathers, quoted from KSL.com

https://www.youtube.com/watch?v=Uw-SF5C2iHM

Living a healthy lifestyle of any kind – heart healthy or otherwise – can be daunting! It can sometimes feel like you should never eat those foods you love so much or that you’ll never enjoy food again. Not so! Check out this video I made to help you navigate a happy heart-healthy lifestyle.