After seeing the popularity of Trim Healthy Mama in the past few years I was curious. I didn’t want to buy the book until I had read it, though, and was skeptical of some of the things they recommend. I wasn’t skeptical that it works and people enjoy it, since that seems apparent from the people I know that do it. But I had heard snippets here and there and wasn’t comfortable with all of it or sure if the science behind it was really accurate, so when I was in Dubai we borrowed it from a friend and my mom (a registered dietitian) and I were able to look at it together. I read it all (skimming most recipes) and bookmarked pages for her to read and for us to talk about.
Since I haven’t actually tried their “plan” then this is just some thoughts on the book itself.
To be honest… I didn’t love it. That’s not to say I’d never try it, just that pretty much everything I was uncomfortable with before I read it I am still uncomfortable with.
The basic idea behind Trim Healthy Mama is that you don’t mix fat and carbs since then your body will burn the carbs and store the fat if you eat them together. Thus you rotate between high-fat meals with minimal carbs and more moderate carb meals that are lower fat, both paired with lots of protein. Even in their carb (called “E” for energizing) meals, carbs are limited, particularly in the kinds of fruit allowed and the amounts of grain. They also say that this is to help prevent insulin spikes which can lead to the body secreting more insulin and thus promoting fat storage.
My mom was reading a Sports Nutrition book (Nancy Clark’s Sports Nutrition Guidebook) and it had a section on insulin so we read through it. It refuted the idea put forth in THM, saying that while insulin can stimulate the appetite, leading to overeating, and can stimulate fat deposition, that more likely lower GI diets lead to weight loss because it means eating fewer refined foods and sugar and more whole grains, vegetables, and fruit. Eating fat and/or protein with carbs will also help to prevent insulin spikes. Also, everyone has a different reaction to insulin depending on fitness level, metabolism, age, etc.
I did some more research on the lower GI thing, and this is what I found:
– A low carb diet automatically lowers your insulin
– This concludes that the low GI diet isn’t really what is effective in losing weight, but can still be beneficial in other ways.
– Takeaway here: again, not a magic bullet, and not necessarily the key to eating healthily, as parsnips have a higher GI than vanilla cake.
– This would support the low-GI, low-carb diet for weight loss.
– Most likely is probably what Mayo Clinic states: “Selecting foods based on a glycemic index or glycemic load value may help you manage your weight because many foods that should be included in a well-balanced, low-fat, healthy diet with minimally processed foods — whole-grain products, fruits, vegetables and low-fat dairy products — have low GI values.”
However, another portion of the sports nutrition book did say that your body does prefer to use carbs and store fat, implying that if you are trying to lose weight keeping them separate might actually help, but I can’t find anything online or anywhere aside from that that would support that theory or say that separating them would be a real game-changer, or what the balance should be, etc., and when they talk about it in THM it seems to be based on their experience more than anything else (unfortunately the basing things on their experience happens a lot). Obviously something in their plan works but I’m just not convinced it’s the separation, especially because it’s not just an issue with carbs. Some quotes from the Sports Nutrition book:
“Any excess protein is burned for energy, or as a last resort, stored as fat or glycogen. Humans do not store excess protein as muscle…”
“[your body] burn proteins (from food and muscles) for energy when carbohydrate and calories are scarce.” (thus just because there aren’t carbs doesn’t mean your body is going to be burning your fat).
Also, without regular carbs, your brain will burn glycogen from muscles, not fat.
So it seems there is little evidence for that really being what causes the weight loss and after reading THM my main question is if people lose weight because they’re separating fuel sources or because they’re on a lower-GI, lower-carb diet that’s cutting refined foods and helping them eat more vegetables leading to lower calorie consumption in general, and the calories that are being eaten are coming from healthy sources.
My guess is that most people have gone onto THM from a more carb-laden diet (even WAPF), and it’s the lower carbs and healthier foods that cause weight loss more than the fat/carb separation. But I don’t know if that’s true or not, though it is what everything I’ve read seems to say. THM isn’t necessarily a full-on low carb diet, but it definitely cuts and limits carbs, even in the energizing meals, to far less than what most Americans eat.
I also didn’t love how it would often require different meals for kids. It seems they make their own lunches separately from the kids every day. Cooking rice on the side for kids and not you isn’t really an issue, but making a full separate meal would be something I wouldn’t do unless there weren’t enough leftovers or something.
If you follow the plan strictly, you will be counting both fat and carb intake at each meal or snack.
So the science might work, but it might not. But my bigger issue was with a lot of the ingredients they put forward. There is debate over this in some cases even in the book as one of the sisters prefers to keep things more “pure” and not use cheat ingredients or items, like laughing cow cheese. But there are things that both of them recommend that I am not ok with in general, nor do I think are really whole-foods.
For example, defatted peanut flour (though I can’t find anything on how it’s made besides this, it just sounds off to me), stevia, truvia, and glucomannan.
Stevia I had done research on and decided not to use some time ago, at the time it was because I had read about the risk of miscarriage and infertility, but those studies have since been debunked. However, most forms of it are highly processed and mixed with other sweeteners, and I have read other things (here), about people having bad experiences, or their qualms about Stevia (though the first post I linked to on Stevia says these aren’t true… however they both quote some science and I haven’t looked into whose studies are more trustworthy). That said, this post is a good reminder that peoples’ bodies react differently to things (but confirmed that during pregnancy and postpartum is probably NOT the time to try new things – I was considering getting some maca for postpartum but have now decided not to). I don’t mind it occasionally, but wouldn’t make it a part of my daily or weekly life.
Truvia – erythritol. While of all the sugar alcohols erythritol seems to have the least amount of problems, I don’t think I would use it, especially not as one of my 2 main sweeteners (and if you follow the recipes from the THM book, it’s A LOT for both stevia and truvia).
First, sugar alcohols in general: most of them, while being low carb, low GI, and low calorie, aren’t digested well if at all, which puts up red flags for me, even moreso since they aren’t allowed on GAPS (not that GAPS is the standard for those of us with a healthy gut, but still). Chris Kresser gives them a cautious ok, but Kitchen Stewardship, while generally ok-ing them reminds that it doesn’t help sugar cravings at all to just use a better sweetener.
I do use xylitol in our toothpaste, but we’re not swallowing it and I always make sure what I order is non-GMO.
Glucomannan powder is used in the book as a thickener, but what they don’t mention is that glucomannan is actually often used as a weight loss supplement. This doesn’t mean it’s bad, per se, but I do find it odd that they’re not upfront about that and that it’s their thickener of choice when it has 15 grams of carbs per tablespoon but arrowroot has 7 and gelatin has 0 (though I can’t find a clear answer on how much is needed relatively speaking. It seems about 1 tsp glucommannan to thicken 1.5 c water compared to 1 tbsp gelatin to gel 2 c water and 1.5 tsp arrowroot to thicken 1 c water, but “thicken” is a rather imprecise term).
I am on the fence about protein powders, especially as I struggle to get enough protein while pregnant and they really help me. But something that is more “whole food” like gelatin is probably better anyway. This is an interesting post about protein powders, even the real, whole-food ones.
Two smaller things: they have you only use egg whites for E meals, and also recommend low-fat dairy products a lot so you can eat them with E meals. Again, not wrong per-se, but something I don’t see as being all that “whole food” friendly.
Over at Kitchen Stewardship you can read more about these ingredients (and unlike some upset commenters, I have read the whole book and wholeheartedly agree with the review).
You can do THM without these things, but it would be much harder, not so much in everyday food but it would be harder to stay “on plan” since their treats almost always use some of these ingredients, and I think the ability to recreate most foods is what makes it so effective as people can stay on plan.
I really don’t love their style of writing, both how informal it is as well as some of the things they talk about and they way they talk about it. The most off-putting thing was that the way they talk about avoiding the “unhealthy” foods or mixing fat and carbs is something that I don’t think would encourage a healthy relationship with food. “It’s fattening.” “It will go right to your hips,” etc. Often it made me wonder “is this about my health or my wasitline?” It also seemed like you would always be having to keep track of what kind of meal you last ate and when you ate to avoid mixing fuel sources, and always be having to measure.
There’s also a lot of “you won’t miss anything” and hype that there won’t be any foods you can’t eat as long as you keep the carbs and fat separate. But they basically say you should never eat white potatoes or corn, and rarely eat bananas.
I also don’t agree with all of their theology (especially as it seems inconsistent, as they talk about using all the food groups and all the foods ok’d in the Bible, yet say “no honey!”), nor with their implications that THM is the ONLY and BEST way to lose weight.
However, I read the 2012 edition, so the newer one may be better in that regard.
I agree that our diets should be much lower in grain than the standard American diet is (ie, cereal for breakfast, sandwich for lunch, pasta for dinner). THM is getting people to eat more veggies and less processed, sugar-laden food, which is great!
They also rightly say that rapid weight loss isn’t good and it’s better to have slower, sustainable weight loss and lifestyle than to lose it quickly. Also that it’s not about counting calories (though they do laud calorie-free foods as long as they’re made with the ingredients allowed).
They talk about tailoring the plan for YOUR needs, which as a pregnant and nursing mother I really appreciated as so many other things are hard to do in those circumstances, if you can do them at all (full GAPS), or as in my experience grain-free, left me with no energy but also not knowing how to boost it without re-introducing grain (and maybe that’s just exactly what I needed anyway!). But this is especially important with a low GI diet as everyone has a different response to insulin and different weight loss needs (and THM isn’t just a plan for weight loss, but weight maintenance as well).
The exercise portion was in line with a lot of what I’ve read lately about high intensity interval workouts being most effective as well as fighting a sedentary lifestyle.
I only skimmed the skincare portion, but it seemed good. The section on hormones also made sense, but I haven’t done any research into that so can’t say if it’s really accurate or not.
A number of friends love the plan and find it sustainable, effective, and freeing, which is great! It can be done without ingredients that might make you uncomfortable, and while the science behind it may not be fully accurate, it does seem to work.
Would I ever do it? Possibly, but I would probably try just a plain low-carb diet first, as it’s easier and seems to be more supported by science, and if I ever did go onto full THM I would do it without the ingredients I mentioned above, on a traditional-foods diet.
(Another review can be found at Nourishing Gourmet).
Some updated comments:
I joined some of the Facebook groups but was never able to get more of the science behind the fat/carb separation despite asking others who have done it and researched it some more, so I’m still skeptical of that. Also after being in the Facebook groups it feels even more diet and fad-like than it did it in the book.
I did find myself thinking about it a lot over the next while and that it really wouldn’t be that tough to implement, especially if you ate fewer grains and more veggies.
Some other good things: apple cider vinegar is a well-known weight loss aid, and it’s a main ingredient in some of their drinks. Also not eating as much fruit, especially dried fruit – I realized dried fruit was a go-to snack for me but it’s so high in sugar and calories so I’m trying to find better snacks!
Some confusion: bananas and milk ARE low GI. Bananas are high carb so I guess that’s why they write it off, but milk is 15 carbs/cup, so not sure why it’s labelled as bad, especially as if it was your only carb source you could have a cup of full fat milk with an S meal, or more lower fat in a E meal (full fat has 8g fat/cup, the max in an E meal is 5).