The good: The concept of separating carbs and fats for weight loss is effective, sustainable, and healthy.
The bad: The Frankensweeteners and stevia recommended as "natural" sugar alternatives can cause serious harm, including miscarriage and infertility.
The ugly: The authors of the book and those running the THM boards on Facebook and elsewhere do not want this information to become public.
Read on below for an in-depth review of the book, the concept behind it, its potential pitfalls, and how to actually make it work AND be healthy doing so.
The good:
Most weight loss plans follow one of the following ideas:
(1) Reduce overall caloric intake. This causes the metabolism to slow down, stalling weight loss. It is also hard to sustain, as the human body is not programmed to run on empty for extended periods of time. People struggling with weight in the first place likely will not have the will power to consume less calories than they are needing for months or even years to reach their goal weight. It's easy to fall off the wagon, and yo-yo dieting ensues.
(2) Cut out fats. Eating healthy fats is CRUCIAL not only for overall health, hormone balance, and brain function, but it is also an integral part of losing weight. People do not get fat from eating healthy fats. In fact, quite the contrary is true. Of course, modern, altered "fats" such as margarine, hydrogenated vegetable oils, and other denatured products are very unhealthy, but they should not be allowed to give fats in general a bad name.
(3) Cut out carbohydrates. While an over-consumption of simple carbs is the main culprit behind excess weight, carbs should not be cut out from the diet entirely. "Give us this day our daily bread" in the Lord's prayer should put that issue to bed for good. Again, as with fats, there is a huge difference between healthy carbs, and those that are, indeed, destructive to good health.
The basic weight loss concept underlying the Trim Healthy Mama book falls into none of the above categories. The authors recognize that healthy, traditional fats play a crucial part in achieving and maintaining healthy weight, and do a good job of explaining this. Likewise, they do not advocate for "low carb" or "paleo/primal" diets, because they know that carbs play an important role in fueling our bodies.
They then go on to explain quite nicely how our bodies respond to both types of primary fuel - carbs and fats - and how the metabolizing of them interferes with one another.
Their conclusion for weight loss, in a nutshell, is this: do not consume fats and carbs in the same meal. To be more specific, a fat-fueled meal (called an "S" meal in the book for "satisfying") should contain no more than 10 g of net carbs, while a carb-fueled meal (called an "E" meal for "energizing") should contain no more than 5 g of fat.
Furthermore, not just any carbs and fats are plan approved. Denatured Frankenfats are out, while butter is promoted (rightfully so). Simple carbs, even in "healthy" forms such as juice, are not "on plan" - only complex carbs that have been properly prepared through soaking and/or sprouting and/or sourdough fermentation are allowed.
Some others have criticized the program, saying it is incompatible with a whole foods lifestyle, but I have to disagree on that point. The plan can be as packed with whole foods as one wants it to be. Remember, the only critical underlying premise is not to mix carbs and fats in the same meal. One could easily make their own sourdough or sprouted bread, make their own almond milk, etc. Likewise, instead of using egg whites from a carton, one could simply separate their own, homegrown eggs, and use the yolks in another meal. There is nothing inherently "denatured" to the program itself, though some of the foods that are recommended or included in the recipes call for weird ingredients, such as "defatted peanut flour" or a highly processed type of whey protein. There is absolutely no need to choose those particular recipes.
For the vast majority of people, even if they decide to use some of the stranger ingredients suggested, the "on plan" foods will still be a great improvement from the standard American diet. In fact, even just cutting out liquid carbs and other simple starches like pasta will do wonders for their waistline.
As far as the recipes in the book go - they are a good starting point for getting ideas, but taste-wise, they are mostly "meh" at best. The
THM Pinterest page, however, is packed with wonderful recipe ideas from all over the web, as are numerous other websites such as
Gwen's Nest.
Should you buy the book? Maybe. If you have never read "Nourishing Traditions," or books such as "Eat Fat, Lose Fat" that debunk modern food myths, Trim Healthy Mama will help teach you about nutrition.
However, please be warned not to jump into the program both feet first until you read the rest of this post.
The bad:
I have already mentioned that some of the ingredient suggestions are a little fad-ish, but whatever - they are not integral to the program at all.
My one, big, huge, main problem with the THM program is with the supposedly healthy and safe sweeteners that are "on plan". While the authors correctly speak out against artificial sweeteners such as Splenda, aspartame, etc., they then go on to allow only two types of sweeteners for the THM plan:
(1) Hydrogenated sugar alcohols, i.e. xylitol and erythritol. These are about as healthy and natural as their names suggest. Their safety (or rather lack thereof) has already been covered in other articles readily available online, such as
Natural News,
Crunchy Betty, and
The Healthy Home Economist. So for the sake of time, I will just point my readers to those resources readily available online.
(2) Stevia. This singular ingredient is really what is giving me a bad taste for the whole program, and why I am reluctant to recommend it to anyone without going into a big speech explaining why the on plan sweeteners are to be avoided, and how to substitute for them.
Before I go off on stevia specifically, I would like to address the problems associated with
any zero-calorie sweetener, no matter how "natural" it claims to be, or even may be. From aspartame to stevia, and everything in between, sweet foods that are not accompanied by actual carbohydrates wreak havoc on human metabolism. Our bodies are programmed to expect carb-based fuels when we taste something sweet. Accordingly, the body prepares for this by releasing insulin, and getting ready to metabolize the incoming fuel. Which may never come, if we are really just downing a diet soda, or coffee sweetened with stevia. Again, this topic has been covered by others extensively, such as on
Empowered Sustenance. It is a well-known fact that sugar-free foods cause weight gain, as evidenced by overweight people everywhere guzzling diet sodas.
But back to stevia. It's an herb, so it's natural, which automatically means it's healthy, right? WRONG. Arsenic is a natural substance, too. As are many other poisons, venoms, and toxins.
Stevia, like a number of other herbs, has traditionally been known to cause infertility in both men and women. So much so, that women in South America (where this plant grows) were known to drink it as tea as a form of birth control.
But unfortunately, it doesn't end there. The reality is, that stevia, like a number of other herbs, can and does act as an abortifacient, or an "implantation preventer." I recently blogged about herbs of this type in my post "
Sarah, the Healthy Home Abortionist." If one believes that life begins at conception (as we do), use of such herbs during the reproductive years of a woman's life should be out of the question.
Will every pregnancy end in miscarriage if you use stevia? No. Will stevia cause all women to become infertile? No. Some women are affected by herbs more than others. In fact, ironically, the healthier you are going into it, the more effectively your body will respond to herbs. Some women are affected more than others specifically by stevia because of the fact that it is in the ragweed family. If you suffer from seasonal allergies, chances are stevia will affect you worse than those who do not suffer from these allergies. Since we cannot know exactly how it affects each of us individually, we should just stay away from it altogether, rather than playing Russian roulette with the lives of our unborn. Just because your cycles are starting on time, does not mean you didn't have a "silent" miscarriage due to the damage done to your hormone levels (an aspect well explained in the
article on Empowered Sustenance), and thus your reproductive system, by stevia.
Another common, negative side effect of stevia stems from the fact that it lowers blood pressure. While this may be great for those suffering from hypertension, people with naturally low blood pressure such as myself may find that stevia lowers their blood pressure to the point where they experience headaches, start seeing black spots, have tunnel vision, or even black out. This in spite of the book's claim that:
(Page 184)
The ugly:
I really was not looking forward to writing this part, but feel it has become necessary because of the growing popularity of the THM program.
Time and again, the question comes up in various THM groups on Facebook of whether or not the plan-approved sweeteners are really safe. These type of discussions are always, without exception, quickly dismissed along the lines of "Yes, they are, and it's all covered in xyz the spot"
The fact of the matter is that the THM book only very briefly touches on the safety concerns regarding stevia, in a total of 2 paragraphs. The only source they point their readers to verify the safety of stevia is the website www.stevia.net - I am certain there is nothing partial on that site, right? By that same token, why not go to www.splenda.com and read all about how healthy and beneficial their artificial sweetener is, complete with "scientific studies" to prove their point.
(page 183 and 184)
I have talked to a number of women who directly blame stevia for their inability to become pregnant, or for a miscarriage - myself being one of them. The authors' above claim to the contrary is either not true, or they are simply shutting these women down before giving them a chance to explain their point.
The question specifically of whether or not stevia causes miscarriage is shut down and deleted from any public discussion almost immediately. Even on threads where members specifically ask, "Is this safe? What are everyone's experiences?" other members are not allowed to weigh in with any advice that contradicts the "stevia is safe" dogma, not even if they accompany it with saying something along the lines of "the plan is great, it works if you use raw honey or maple syrup, but I, too, do not feel that stevia is safe, and think it may be to blame for infertility or miscarriage." One of the administrators, who deleted all my comments on the thread (all of which repeatedly stated that the program itself is great, and effective, but that stevia should be avoided), wrote to tell me that:
I will not allow any other posts like the ones I've
removed to stay up on the board, because it plants unnecessary and
unfounded seeds of fear in the minds of other ladies.
Hm, where have I heard that lingo before... Oh, that's right, it's the same line the pro-GMO companies use. "We can't label foods as containing GMOs, because it will unnecessarily frighten consumers." I guess the THM administrators do not think their readers are smart enough to be presented with both sides of an issue, and come to a conclusion for themselves. If stevia is so safe and harmless, there is nothing to fear. If I told you bananas cause infertility and miscarriage, the National Banana Board would at best get a laugh out of me, but certainly not go on a crusade to shut down all such claims by anyone. If doubts need to be hidden and scrubbed in a concerted effort to silence them, maybe there is a reason they keep "persistently popping up," as the authors themselves put it. Maybe, just maybe, there is truth in it?
The same administrator also told me:
The allegations you're making against the use of stevia are so far as I can tell based simply on anecdotal evidence alone.
Anecdotal - maybe. Sort of like the author declaring stevia as safe because both herself, as well as other ladies she knows, became pregnant while using stevia. People also become pregnant while taking birth control pills, or having IUDs in place, both of which are much stronger and more effective than stevia. All scientific research starts out with anecdotal indications for or against an issue, which is what then motivates a closer examination by way of a study. Seeing as we live in a society that by and large heavily promotes birth control, and does not think that life begins at conception, I do not think that there are any laboratories, universities, or research labs interested in spending time and money to find out just how stevia affects the uterine lining, and what percentage of women will suffer a "silent abortion," in a country where thousands of babies are consciously aborted every single day. This information is hard to come by for birth control pills, whose express purpose is the prevention and interruption of pregnancy - how much more so for an herb that few people care at all about?
The truth of the matter is that there is virtually no research available on how stevia affects fertility and the female reproductive system, either negatively or positively. We are, therefore, forced to come to a decision based on anecdotal evidence, rather than to simply assume it's safe. Shouldn't the burden of proof be on them to show that stevia does NOT negatively impact fertility, and cause miscarriage? There are only two publicly available studies that investigate the effects of stevia on fertility, and both came to the conclusion that it reduces fertility.
To be fair, I would like to mention that there are a number of women who follow the THM plan, lose large amounts of weight, overcome PCOS, and as a result, are able to become pregnant. Clearly, not all women miscarry every pregnancy if consuming any amount of stevia. Like I said, for the majority of women, overcoming their addiction to simple carbs, and adding healthy fats to the diet, will greatly improve their overall health. But this does not negate the fact that stevia is still harmful. It's just the least of a severely overweight person's health problems.
From my own anecdotal evidence, I used stevia very sparingly (every few days in small amounts) for about 4 or 5 weeks, before discontinuing its use because it was making my blood pressure drop dangerously low, to the point where I was on the verge of passing out every time I used stevia. In spite of my very minimal consumption of it, I suffered TWO early miscarriages in two consecutive cycles, once while still using stevia, and the second shortly after discontinuing it. I know miscarriages are common and occur for a number of reasons, but in all our married years (13 and counting), we had only suffered two other miscarriages, and one of those was caused by recently having come off birth control pills. It was not until the second miscarriage that I started to put the puzzle pieces together, mostly due to other people pointing out their "ancedotal" connection of stevia and miscarriage.
I have since talked to many other women who reported being unable to become pregnant while consuming any amount of stevia, no matter how small, and who got pregnant immediately after discontinuing it. The THM group on Facebook for pregnant and nursing moms is replete with stories of moms who report having a miscarriage, many of them habitually. One time, 5 of the 6 posts at the top of the wall were about a mom just having had a miscarriage while "on plan," which presumably involves stevia. While I am not at all claiming that all these are caused by stevia, or that the mothers are to blame, it definitely should give us pause. True, among a group of people who generally embrace fertility and large families, there will inevitably be more miscarriages, simply because there will be more pregnancies - but even accounting for that, the THM boards seem to have an abnormally high rate of miscarriage.This has been pointed out time and again by other people, not just me - but like mine, their comments always get deleted.
Why would the authors want to hide this controversy? In a word, because it's inconvenient. It would fly in the face of their religious belief that life begins at conception, so they would be forced to deal with it if it were true. Not being able to use stevia would make it much more complicated to explain and implement their plan. Just as there is a difference between good fats and bad, there is a world of difference between real, raw honey, and the stuff sold at grocery stores. Furthermore, it would be hard to come up with scrumptious, fat-laden desserts that only use minimal amounts of sweets (carbs). Stevia allows sugar-addicted American palates to "have their cake and eat it, too"
Their highly popular book, that they put so much time and work into, would need to be majorly revised, which may kill it altogether.
Plus, the authors are in the process of releasing their own line of stevia sweeteners.
The healthy alternative: real, whole, low-glycemic sweeteners in moderate amounts
Like I said at the beginning of this post, the basic underlying concept of separating carbs and fats is very effective. I have recommended the program to a number of people, all of which have seen great success with it, whether or not they use only plan-approved sweeteners.
My recommendation is to use raw honey or grade B maple syrup for all E meals, and in moderate amounts (up to 1 tsp per serving) for S meals. This will not interfere with the effectiveness of the program at all, and you will be able to successfully and relatively painlessly lose weight following these basic principles. The biggest challenge are desserts - they need to be S to be tasty and decadent as one would expect a dessert to be, but that means they cannot contain too much honey or the meal will be carb-laden. Making S treats only occasionally (as in, every few days), even if they contain more than the 1 tsp of honey I recommend, will not throw you off plan. Also, your palate will adjust to needing less and less sweetness the more the sugar addiction is broken. Or, switch to E desserts, which are harder to find recipes for, but can be just as tasty.
I myself am currently on the program, not with the goal of losing weight, but maintaining my current weight for the rest of this pregnancy.
When we found out I was expecting twins, I was told to gain 50-70 lbs. I typically gain about 25-30, so this was a shocker, but I
followed the advice because our smaller baby was only getting a fraction
of the food I was eating due to his poor cord insertion. Well, when he
passed away at 20 weeks, I had already gained 40 lbs. There really is no
need for me to gain any more. In fact, I find that when I follow the
program, I end up eating way more calories than when I'm off plan, simply because being on plan makes my metabolism run in high gear, so I
know baby is getting enough even though I am not gaining (as also evidenced by his excellent growth and health based on ultrasound exams). Actually, if I
stay on program all day, every day, I quickly lose weight even while pregnant, and that while using raw honey and grade B maple syrup whenever I like. So every few days, I
have to get off program and consume meals that contain both carbs and fats, even simple carbs, just to stay with my goal of maintaining
rather than losing.
Another tweak that I have made while pregnant is to continue drinking fresh, whole, raw milk, which is always "off plan." Milk contains large amounts of lactose (which is a type of sugar, and therefore a carb), as well as fat. As such, it is by definition not compatible with the THM plan. However, not only does raw milk have a low glycemic index, I think that drinking it is important because I am pregnant, and milk is crucial for growing babies. My own "rule" for using milk and still losing weight is to use 1/2 cup or less for S meals, or count it as an E food if I have more than 1/2 cup. I also do not consume more than 1 cup at a time. Following these guidelines, like I said, has not stood in the way of weight loss for me. When I am not expecting, I do not drink fresh milk, but rather make my own kefir from raw milk. That way, all the benefits of drinking raw milk are preserved, while the lactose has been removed by way of fermentation. For people with digestive issues, drinking soured milk (i.e. kefir) rather than fresh milk is a much better option, anyway.
In conclusion, the plan works. In fact, it works very well, it works fast, and going from being "on plan" to just a regular, whole foods diet (NOT the standard American diet) that contains both fats and carbs in the same meal will not make you regain the lost weight, but rather just maintain your current weight. You will be able to have bacon and eggs for breakfast one day, oatmeal the next, and all sorts of other satisfying foods that will keep you from feeling hungry or deprived. As such, it is the near perfect diet plan - just so long you stay away from the at best questionable "on plan" sweeteners. Your palate may need to adjust to not craving sweets and simple carbs all the time, but eventually, if the weight loss is going to be permanent, this is a necessary component anyway.
Please do weigh in below with your experiences on the program, with the issues surrounding the sweeteners I mentioned, or anything else that would be valuable to this discussion.
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Edited to add: Please see my follow-up post on this topic, "Stevia is safe - OR ELSE!"