If sales of whole-grain and low-calorie bread suddenly double, it may be due to a book called The Bread for Life Diet: The High-On-Carbs Weight-Loss Plan. Expanded and updated by Olga Raz-Kessner from her Hebrew bestseller published by Matar four years ago, this 239-page volume targets the well-upholstered half of the American population.
Although the Moscow-born director of the nutrition and dietetic unit at Tel Aviv's Sourasky Medical Center (Ichilov Hospital) went on a 10-city US book tour at the end of September, this is not another attempt to start a fad solely on the basis of personal experience. Raz, 1.65 meters tall and a normal 63 kilos, has successfully treated thousands of zaftig patients at Ichilov over the past two decades, and is currently completing her doctorate on the effects of her bread diet on inflammation. A member of the New York Academy of Science, she is also frequently invited to lecture abroad, and dietitians at Clalit Health Services and elsewhere recommend her weight-loss program to patients.
THE SUBJECT is certainly controversial in the US, where masses of Americans have become obese from a diet of white bread, refined sugar, french fries and non-nutritious snacks, along with fatty hamburgers and hot dogs. In an effort to save themselves, many adopted the Atkins diet, promoted by Dr. Robert Atkins, who in 1972 published Diet Revolution advocating the consumption of saturated fats from protein-rich eggs, red meat and butter, while eschewing carbohydrates. That regimen, he claimed, would help people lose weight painlessly. Atkins has since died, his company has been declared bankrupt, and many experts call his regimen too extreme or even dangerous. The South Beach Diet, a more moderate version of Atkins, has begun to win over some disappointed Atkins' "graduates," although studies have shown that after a year, South Beach is no more successful than calorie-counting regimens such as Weight Watchers.
"Atkins and South Beach are still very popular in the US," says Raz. "I saw endless shelves full of diet books, all advocating high-protein diets. But research shows that high-protein meals lower serotonin levels. That's why people get cranky, nervous, and crave sweets. But hearing someone recommend a lot of 'light' [low-calorie], whole-grain breads, durum-wheat pasta, almost unlimited vegetables and lots of water, and eating them frequently in small portions, shocks Americans," Raz continues.
"It was like an atom bomb for them. At first they didn't know how to digest my idea. Americans eat cheap, simple carbohydrates, mostly in the form of fast food and often not cooked at home. For breakfast, I found that the standard there is eggs and potatoes fried in oil; anything with cottage cheese added can be considered 'dietetic.' But Israel is the ideal place to diet, because we have everything here, vegetables and fruits are relatively cheap, and more people cook at home."
But when Raz, who immigrated to Israel in 1973 after studying biology and worked as an economist before going to study nutrition at The Hebrew University's Agriculture Faculty in Rehovot, explained it in American TV, radio and newspaper interviews, she found "a lot of enthusiasm for my book - and for Israel, by the way - and the concepts in it."
Raz is trying to get the message across, and her new $23 book (www.breadforlifediet.com, published by Stewart, Tabori & Chang and written with her husband, computer expert Amir Kessner) has already garnered hundreds of "hits" on the Internet.
"If thou tastest a crust of bread, thou tastest all the stars and all the heavens," wrote 19th century English poet Robert Browning. The Israeli author would certainly agree. "Good bread is the most fundamentally satisfying of all foods; and good bread with fresh butter, the greatest of feasts," claimed 20th century American chef James Beard; Raz would agree with the first part, but would bar the butter.
She calls her system "the first genuine diet breakthrough in decades" because it regulates the neurotransmitter serotonin, which controls feelings of hunger and satiety. When someone eats complex carbohydrates, whole-grain bread with thin spreads of low-fat cheese, hummus, tehina, avocado and vegetables - every few hours - serotonin levels rise and remain high, so he feels sated. Women can eat as much as 12 slices of "light" bread (or six of regular whole-grain bread) and men 16 (or eight regular whole-grain) a day. "There are no cravings, so you lose weight. The diet can also fix the problems that cause the body to store fat instead of burning it, and corrects the biological imbalances that make weight loss so difficult. You also get to eat a variety of healthful foods such as greens, beans, yogurt, eggs, soups and even high-protein meals," Raz says.
She notes that the "nutritionally balanced program" is well suited to type II diabetics who do not inject insulin, as the regimen "prevents sugar cravings and lowers cholesterol, blood pressure, triglycerides and blood sugar levels" because of the small, frequent meals. It also "alleviates headaches, migraines and sleeping problems, prevents mood and energy slumps caused by diet deprivation, does not require the counting of carbs or calories, is simple to follow and requires no special food preparation."
THE IDEA of using "the staff of life" as the basis for a lifelong diet came to her when she was participating in clinical research at Sourasky. "We set out to establish the connection between food and serotonin. Different types of meals were given to healthy volunteers. We found that when people ate a high-protein meal, the serotonin level dropped sharply, and when they ate bread, the serotonin level increased. It is an amazing revelation when you consider that high levels of serotonin provide a feeling of satiety, while low levels can cause cravings.
"The results made me realize that bread, which people fear eating most when dieting, is in fact the most satisfying, the most comforting, and the best satiety-providing food of all. In addition, bread, especially light bread, is relatively low in calories, given its satiety value. A slice of regular bread, feared and missed by so many dieters, has approximately 80 calories - about the same as a container of plain yogurt - but is so much more satisfying. A slice of 'light' bread, which I believe has about half as many calories because it's more airy and has more gluten, is almost as satisfying."
She advised overweight patients to eat a lot of whole-grained bread together with other foods to make the diet healthful and balanced, and - to their great surprise - many lost weight, kept it off and enjoyed steadier moods. She and colleagues developed weight-loss and maintenance group sessions called "It's All in Your Head," which have been running since the early 1990s.
"People always seem to react the same way when I tell them they have to eat 10 slices or more of light bread a day. "They ask, 'You mean 10 slices a week?' They're very surprised to learn that 10 slices or more is the daily portion. Then they discover how painlessly and efficiently they drop weight while actually eating all that bread."
Statistics show that with most diets, only 5% of people maintain their weight loss after two years; with the Bread for Life Diet, Raz maintains, the rate approaches 15%.
She advocates choosing foods according to their glycemic index - the concept popularized by Barbara Schipper (also an Israeli) in her book and referring to the relative rise in blood glucose levels. Barley, bran cereal, durum wheat spaghetti, rye and pumpernickel bread and brown or basmati rice, for example, have low glycemic indexes and are recommended, while cornflakes, corn chips, rice cakes, white potatoes, dates and rice pasta have high indexes and thus should be avoided.
Raz's diet has two stages: During the first two week or so, one eats mostly slices of whole-grained light bread with thin spreads (not butter or chocolate), plus unlimited amounts of vegetables (except for potatoes and corn). Small meals should be eaten every two or three hours. Then, after losing weight quickly, the stage-two maintenance diet, which she says can continue for an unlimited time, allows more food choices and includes suitable substitutes for some bread slices (such as durum pasta and brown rice), plus fish, olive or canola oil, soups, low-fat chicken, eggs or meat three meals a week), a moderate amount of fruit and plenty of vegetables. People are also encouraged to drink a lot of water and make exercise a daily part of their routine.
AMONG THE tips in the book is the suggestion to persuade yourself that if you "cheat" with ice cream or cake, tell yourself that the first bite tastes like all the rest, so one should suffice. Meals must not be missed, and one should not go to bed hungry. The diet is adaptable to vegetarians and vegans as well as to children, "who should be given more protein, including milk products, to ensure their growth."
Raz also advocates eating before going to a restaurant or social event or going food shopping, so you don't go there starving and buy things you shouldn't eat. Find ways to socialize without eating, and keep cookies or pastries out of the house completely instead of "saving them for the kids." The book, which comes with the caveat that anyone with a medical condition and pregnant women should consult with their doctor before adopting the diet, concludes with a large variety of (kosher) recipes.
"I ate 12 slices of bread and other delicious food every day and lost 30 pounds. I learned that in order to lose weight, you have to eat well," said Israeli lawyer Ethan Brosh in his testimonial. "I got rid of 22 unnecessary and harmful kilos. My blood sugar and cholesterol levels are now normal. Thanks to the special composition of the diet, I am allowed to feel full and enjoy the real taste of bread," commented writer David Markish. "After seven years of trying each and every new diet, I came to Olga Raz in despair and bereft of hope. I lost 24 kilos and have continued to eat according to the diet, not because I have to, but out of free choice," said an Israeli physician, Dr. Leah Koren. "Her diet really changed my life. It changed me from being overweight into a thin and much happier person."
ASKED TO comment about the Bread for Life Diet's claims about being ideal for non-insulin-dependent diabetics, Hadassah University Medical Center diabetes expert Prof. Itamar Raz said: "The most important thing for diabetics is to lose weight. If this diet does it for them, it can be recommended. But diabetics react differently; some who eat carbohydrates see their blood sugar go up, while in others it goes down. It is an individual matter, and diabetics should consult with their doctor."
Prof. Elliot Berry, dean of Jerusalem's Hebrew University-Hadassah Braun School of Public Health and Community Medicine, who is also a metabolism expert, said "people who have low serotonin levels could give it a try. The most important thing is to follow a diet that people enjoy, so there is high compliance. We have found there is no magic bullet, no diet suited to everyone. But I want to stress the importance of regular exercise - walking 10,000 steps a day - for losing weight, keeping it off and improving your health.
"Changing behavior and habits is much more difficult than changing what you eat."