By Maureen Callahan, M.S., R.D.
October 04, 2010

When it first hit the diet scene in 1995, Sugar Busters! rocketed to the number-one spot on the New York Times' best-seller list. Written by a former CEO and three physicians-a cardiovascular surgeon, a gastroenterologist, and an endocrinologist-the book has an "eat like your ancestors" philosophy that caught on quickly: zero refined sugar, whole grains, unprocessed foods. Fast-forward eight years to The New Sugar Busters! Cut Sugar to Trim Fat (Ballantine Books, 2002). The basics (and the authors) are the same, but there's new advice on current issues such as childhood obesity and the growing diabetes epidemic, as well as a whole bunch of new recipes.

Any diet that encourages whole grains and fresh fruits in place of candy and refined flour products is off to a good start. But when otherwise-healthy fruits and vegetables like pineapple, raisins, carrots, and bananas are on the limited or taboo list because they make blood sugar levels rise too quickly, you've gotta wonder if the G.I. strategy is not so perfect as a rating system. Granted, some fruits raise blood sugar just as quickly as table sugar and candy, but shouldn't these get credit for all the nutrients they contain? In fact, it might make more sense to focus on low-calorie, nutrient-dense foods rather than worry about how a single food affects blood sugar.

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Basic principles:

Sugar is the bad guy. Or, more precisely, call it a case of "good carb, bad carb." Dieters avoid simple sugars and refined grains (pasta, white rice) because they promote the storage of body fat. The belief is that these foods cause blood sugar to spike, which in turn triggers a flood of insulin in the body, which leads to fat storage.

How the diet works:

Foods are ranked according to how fast they raise blood sugar and keep it elevated, using a system called the glycemic index (G.I.). In the world of G.I., lower is better. Slowly digested carb-containing foods like lentils and whole-grain pasta have low G.I. rankings because they cause blood sugar to rise slowly. White potatoes, candy, table sugar, and even some fruits (like pineapple) are at the high end of the G.I. scale, so you should avoid them. Simply put, this is a high-fiber, low-G.I.-food diet. Interestingly, the breakdown of nutrients in the original Sugar Busters! is similar to those of many other low-carb plans: 40 percent carbs, 30 percent protein, and 30 percent fat. The New Sugar Busters! mentions that you can increase carbs to 50 percent as long as the choices are low-G.I. foods.

What you can eat:

No crash phases here. This is a basic eating style you take on for the long haul. The focus is on high-fiber carbs, but dieters can round out the plate with lean meats and unsaturated fats. Foods to get rid of: potatoes (red or white); white bread; white rice; white flour; pasta (except the whole-grain kind); corn; beets; and refined sugars and flours, or products that contain them (such as syrups, potato chips, cakes, candy bars, and cookies). Reasonable food portions are important. You fill your plate once at meals, no seconds allowed.

Does the diet take and keep weight off?

Not a stitch of clinical evidence says it does. But the authors offer up a lot of anecdotes of people who have lost weight following the regimen.

Is the diet healthy?

That's not clear. It's a mixed bag of good advice and strange recommendations. A point in the diet's favor: It emphasizes that low-fat processed foods are "usually synonymous with high sugar." The lower levels of carbs and higher levels of protein don't fit with current recommendations, but there's no evidence that they're safe or unsafe over a long period.

What do the experts say?

"I'm leery of a diet that calls sugar toxic," says John Foreyt, PhD, a longtime obesity researcher at Baylor College of Medicine. In fact, out of today's popular diets, he considers Sugar Busters! one of the "least helpful. It's a little too far out." But is there any truth to the assertion that low-G.I. foods, because they are often high in fiber, may help control hunger? "If low-G.I. foods help you to eat less, then this might be a good approach. But from a health point of view, we just don't have the data to support that they [help control hunger]," Gary Foster, PhD, a well-respected weight-loss researcher at the University of Pennsylvania, says this about the Sugar Busters! insulin-G.I. hunger theory: "It seems to make intuitive sense. But this whole idea that high insulin levels are associated with hunger just hasn't been borne out by research. Having said that, the fundamental thing to understand if you want to lose weight is that you have to eat less than you burn. And if cutting carbs helps you do that, if cutting refined sugars helps you do that in a way that is manageable and safe, then that seems reasonable."

Who should consider the diet?

Dieters with a sweet tooth. Sugary foods (all those empty calories!) often sabotage dieting efforts. But if you can satisfy sweet cravings with the natural sugars found in nutrient-dense fresh and dried fruits, then you've taken a big step in a more healthful direction.

Bottom line:

The scientific basis for the diet is far from solid. Still, the advice to limit sugar and seek out high-fiber foods is a good thing. Another good step: Although it's downplayed and mentioned only briefly, take the authors' advice and bump carbs to 50 percent of the plan. People who eat more carbs and a little less protein will actually end up closer to the kind of healthful diet most health experts recommend.
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