Diet right

Physician's book gives three rules for weight loss

Cardiologist Dr. William Gavin sees diet and weight control as two major health factors. He addresses them both in his book, "No White at Night: The Three Rule Diet."

MOLLY GILMORE-BALDWIN FOR THE OLYMPIAN

Monday, August 11, 2003

For 11 years -- since the birth of her youngest son -- Sherrie Duarte struggled in vain to lose weight. Then she discovered the simple plan developed by Dr. Bill Gavin of Olympia.

"I'd tried everything from Atkins to Slim-Fast and had not been able to lose weight," said Duarte, 37, of Lakewood, who works at Providence St. Peter Hospital, where Gavin, a cardiologist, directs The Heart Program.

The simplicity of Gavin's three rules, now featured in a self- published book, finally put Duarte on the road to weight loss.

"They call me Dr. Gavin's poster child," Duarte said. "I've lost 33 pounds since the middle of May. It's really easy. There's no counting."

That's just the kind of success story Gavin likes to hear. He developed his diet plan -- which he's been prescribing to patients for the past three years -- after seeing the difficulty patients had with counting calories and weighing portions of food.

Three Rule Diet

And now he's sharing the diet with everyone, through his book, "No White at Night: The Three Rule Diet" (Eld Inlet Publishing, $19.95). The rules according to Gavin:

- Eat three meals a day, all roughly the same size. A late afternoon snack is OK, too.

- Eat some lean protein at every meal.

- No white at night. "White" translates to starchy carbohydrates, no matter their color -- pasta, rice, potatoes, bread, corn, beans. At breakfast and lunch, one serving of starches, preferably whole grains, is allowed. Gavin also recommends avoiding such fruits as bananas and grapes, which can cause a rapid rise in blood sugar.

Another implication of this rule: "Forget about dessert," he writes. When he's dining at a friend's house and apple pie is on the menu, though, he'll occasionally indulge -- but never at night. Instead, he'll take a slice home and eat it for breakfast.

The reasoning: Starchy foods are easily converted to energy, which the body either uses or stores as fat. He stressed that the effects of limiting these foods at dinner rather than another meal have not been studied, but he thinks it makes sense to be more restrictive late in the day.

"If you eat a big meal and then you have no activity, what's your body going to do other than store it as fat?" he asked.

Activity is the other piece of the plan -- a fourth rule, you might say. "Whatever you do, develop an exercise program," he writes. He recommends a half-hour of walking every day to the patients in his cardiology practice.

Gavin takes these guidelines seriously. He writes them on a prescription blank for patients, and "No White at Night" includes a "prescription" that dieters can post on the fridge as a reminder. "It psychologically elevates it to the same importance as medication," he said.

The prescription blank is apt for another reason, too: Obesity has become a serious health threat. "It may be in the next five years that being obese will be a more common cause of heart disease than, for instance, being a smoker," he said.

"I'm thrilled that he is taking the time to talk about nutrition, because a lot of providers skirt the issue," said Pat Sonnenstuhl of Olympia, a nurse practitioner and nutrition specialist in private practice. "He takes the time to really tell people and give them guidelines, and now he's put it into a format that people can access."

Laurie Schaetzel-Hill of Olympia, a registered dietitian in private practice, also praised Gavin's focus on helping his patients become healthier through better eating and exercise -- and doing so without counting calories.

"Counting calories is time-consuming," she said. "And for a lot of people, it can become an obsession. We don't want people to become so obsessed with their eating that it interferes in their life."

But she worried that Gavin's plan limits healthful carbohydrate foods too much.

"If people are eating tons of potatoes and rice in the evening and this helps them cut back, great. Go for it," she said. "When it comes to the fruits, I don't see a need to eliminate any. Limiting the portions is key, because you can eat a lot of grapes and get a lot of calories and a lot of sugar."

She said foods that tend to raise blood sugar quickly "have less impact in a mixed meal, because proteins and fats in other foods will slow down their absorption."

Gavin's rules aim to guide dieters toward a balance of roughly 40 percent of calories from carbohydrates, 30 percent from protein and 30 percent from fat.

The idea is that such a balance might work better for many dieters than traditional low-fat diets, in which about 80 percent of calories come from carbohydrates, Gavin said. One reason for that: Protein curbs hunger better than any other food group.

The balance of nutrients needed to lose weight successfully varies from person to person, he said -- and it is part of the story.

"For anyone to lose weight on any diet, including the Atkins diet, requires calorie restriction," he said. "You cannot lose weight without restricting calories."

His plan does that by limiting portions of calorie-dense foods. Nonstarchy vegetables, which have few calories, are allowed in unlimited quantities.

The doctor began the process of simplifying when he himself needed to lose weight several years ago. "I followed the Zone diet, but I didn't do the calculations. I understood it well enough that I could kind of wing it."

His patients didn't like doing calculations, either.

"Lots of diets use some sort of calorie-counting mechanism. Weight Watchers uses points, the Zone uses blocks," he said. "Most of my patients didn't want a diet that involved using a scale or a calculator. So I went down to the bookstore and sat in the diet section for about an hour, pulling out book after book to see what I could recommend.

"I couldn't find one that was easy. My favorite was 'Dieting for Dummies.' It was about 350 pages with 100 pages of recipes. It's a great, authoritative book with a lot of facts, but you know what? It's not for dummies."

That's when he developed his plan. "I thought about how I'd changed my eating and what I did differently. I brought it down to these three rules."

One key to keeping the weight off is making permanent changes -- sticking to new eating and exercise habits. That's what Gavin did, and that's what his diet aims to help others do.

That notion of permanent change is a key to evaluating any diet, Schaetzel-Hill said. "For many people, this is a very restrictive diet," she said. "If somebody can't do this long-term, don't do it. If you know you can do this long-term -- and you're getting all of your vitamins and minerals, and you know it -- fine."

Gavin agrees that one diet does not fit all. "There are all kinds of diets out there," he said. "Whatever works for people is great, because everybody's different. Everybody's genetically different; every metabolism is different."

For many of his patients, friends and colleagues -- including Sherrie Duarte -- what works are those three simple rules.

"We were at the nurses station talking about how I wanted to lose 10 pounds to go see 'Jesus Christ Superstar' in Seattle," Duarte said. "I have this great dress, and I knew it would look better if I lost 10 pounds."

Then she tried Gavin's plan.

"I lost 13 pounds by the time I went to the performance, and the dress almost didn't fit," she said.