This section is for everyone. No skipping!
Most of the diets that I have chosen to discuss have three main structures:
1. Restriction in type or amounts of certain foods or both.
2. Carbohydrate counting which is important for metabolic control.
3. Calorie counting which can be important if additional weight loss or gain is needed.
In the metabolic syndrome part I will particularly discuss Dr Annika Dalquhist’s diet and Drs Allen and Lutz “Life without bread” diet. Anna’s is food type restriction diet and Allen and Lutz’s diet is an easy “block” method of carb counting.
In the type two – insulin resistance – diabetes section I will discuss the Atkins diet and the “Eat to meter method.” These both give you suggestions on outcomes and you manipulate your diet to achieve them. More advanced carb counting skills are needed for both methods.
In the type one – insulin dependence- diabetes section I will discuss Dr Richard Bernstein’s diet and Dr Lois Jovanovich’s diet. Both these doctors have type one diabetes themselves. Dr Bernstein is at the strict end of the scale and Dr Jovanovich’s diet is at the more liberal end. By understanding both concepts I hope you can find an eating plan that suits you.
All the dietary plans are suitable for all ranges of glucose metabolism disorders. What will be important is how much you need to control your blood sugars, how much weight you want to lose, how good your carb counting skills are and how much carbohydrate you feel you “must have.”
Carbohydrates are food items that contain sugar and starch.
Dairy products contain fat and variable amounts of carbohydrate and protein.
You may eat full cream milk, yoghurt, feta cheese, cottage cheese, creme fraiche, cream cheese, butter and mayonnaise.
Avoid low fat, lite, or sugar added products.
Meat contains protein with variable amounts of fat.
Eat beef, pork, lamb, chicken, fish and shellfish. You don’t need to remove the fat.
When eating ham, sausage and other processed meats be aware that they often contain sugar and starch as binding and fillers. Choose items that are not more than 5g carbohydrate in 100g of the item.
Eggs are great. High protein and low in fat and carbs.
Herbs, spices, stock, salt, pepper and low carbohydrate sauces will help your food taste pleasant and exciting.
Most vegetables, olives and linseed are good.
Cold pressed oils can be used for dressing and cooking. Olive, rapeseed, linseed, coconut, palmoil and macadamia nut oils are good. Avoid commercial vegetable oils as they contain partially hydrogenated and trans fats.
Unless you eat a lot of fatty fish such as sardines, trout, salmon and herring you may benefit from an omega 3 oil supplement.
Foods to limit or avoid:
Potato and potato products such as chips and crisps.
Rice and rice products.
Corn and corn products eg cornflakes.
Grain based products eg pasta, bread, biscuits, breakfast cereals and porridge.
Sweets, cakes, pastries, non diet fizzy drinks and fruit juice and cordials.
All sugar and sugary products.
Margarines and processed oils contribute to cardiovascular problems, diabetes, weight gain, cancer and allergies.
Oils with a high omega 6 content eg corn oil, sunflower oil, soya oil, peanut oil.
You may be crying when you read this list but I promise you that you can soon get into the way of making much lower carb and healthier versions of many baked goods and desserts.
Many people have been brought up on potatoes and bread and find it particularly hard to let go. Reduce them gradually. Not too gradually!
You may eat a little of these foods:
Beans, lentils, nuts, sunflower seeds.
Chocolate with a high cocoa content such as over 60%.
Avoid dried fruits and fruit juices as there is too much sugar in them.
When you are trying to lose weight the legumes, fruit and chocolate may stall your weight loss. Could you give them up for a while ?
What about alcohol? It also can add to the calories and more importantly can affect your judgement on portion sizes and will power. Beer in particular contains maltose which is a very fast acting carbohydrate. Dry red and white wines are somewhat healthier for you. But only in small quantities.
Yoghurt with 1-2 tablespoons of linseed or sunflower seeds. Add wheat bran if you are prone to constipation.
Eggs, sausage, bacon, ham, black pudding, mushroom, tomato.
Omelettes with meat/fish/vegetables
Low carb baking eg cheesecakes, muffins with double cream and small quantities of fruit as desired.
Coffee or tea with cream or milk.
Lunch and supper options:
Mainly meat/fish/eggs/cheese based dishes with vegetables or salad vegetables such as celery and avocado.
Avoid low fat products. Many stews, soups and gratin dishes are naturally low in carbohydrate. You can adjust most recipies to give a much lower carbohydrate alternative.
Cooked cauliflower especially with cream, cheese and seasoning makes a great substitute for potatoes.
Grated cabbage and carrot with an oil and vinegar dressing makes a good base for a salad.
Quick snacks to tide you over till the next meal are cheese slices, ham, sausage, yoghurt, nuts, olives or boiled eggs.
Crisp breads can be loaded with butter, cheese, ham and other toppings.
At a buffet load up with the high protein and fat items and leave the carbohydrates alone.
Fruit does raise the blood sugar so avoid or take a lot less of the higher sugar tropical types such as bananas and grapes and eat moderate portions of the temperate grown fruits such as apples and pears.
If you do eat a high carbohydrate meal you are likely to feel hungry or get another carb craving after about an hour or two when the high blood sugar starts to drop. Just take a low carb snack at this point. This will help your sugar and insulin levels get on an even keel again.
Low carb diets work because you don’t experience a raise in blood sugar after eating. You avoid the pancreas releasing excess insulin which lowers your blood sugar making you feel hungry again.
Insulin is a major fat storage hormone. It converts the carbohydrate you eat into fat.
Your body can make enough glucose and energy for essential processes all by itself from the protein and fat in your food. Your muscles and brain work just fine with a mixture of ketones and bodily produced glucose. This steady production of sugar in the body is called gluconeogenesis and it can occur in the liver, kidneys and intestinal tract. Reliance on mainly fat and protein for energy mean that you don’t need to load your body with fast sugar releasing carbs that raise and lower your blood sugar and insulin levels causing unhealthy metabolic effects.
This low carbohydrate diet is very suitable for anyone who wishes to lose weight.
If you are on any medication or insulin to lower your blood sugar, for instance if you have type one or two diabetes, you must reduce the carbohydrate in your diet gradually and do more frequent checks on your blood sugar. This diet very effectively reduces your blood sugar and to balance this you will need to have a progressive reduction in your medications and insulin.
This diet is quite similar to the carbohydrate exchange method that was used for many years by diabetics.
The authors, Dr Christian Allen and Dr Wolfgang Lutz have counted out units worth 12g of carb each for most food groups. They suggest that for most people eating six x 12g of carbohydate a day will give around 70g of carb a day which is palatable and helps weight loss, diabetes control and other autoimmune illnesses.
For people over 45 or heart or autoimmune problems they suggest starting at 9 x 12g a day and slowly reducing to 5 or 6 such portions. (60-70g carb a day).
This method gives a bit more flexibility over what foods you can eat compared to Annika’s diet. The basic diet free intake of fish, meat, eggs, cheese, dairy products, non starchy vegetables, moderate intake of nuts and alcohol remains the same.
All carbohydrate containing foods such as grain products and potatoes, sweetened foods, sweet and dried fruits must be accounted for.
For the full list of foods see their book, “Life Without Bread.”
For illustration purposes I will list a typical day that you may have on this diet.
3 egg omlette with onion and peppers
half a grapefruit one unit
Coffee with cream
Cold roast chicken
lettuce, one medium tomato, half an avocado 1.2 units
1/4 cup of rice (before cooking and seasoning) 3 units
Tea with small amount of milk
Peppered steak with cream sauce and mushrooms one unit
Slices of danish blue cheese and brie with celery
Two glasses of wine 0.8 units
The trick is to fill up on a wide variety meat and fats and reserve your carbohydrates to give a bit of variety to your meals. Instead of basing your meals on the same old bread, potatoes, rice and breakfast cereals base them around meats/fish/eggs and cheese and non starchy vegetables.
For a lot of people it is harder to eat low carb away from home and if this true for you allocate more of your allowance to these meals and make the effort to cook delicious low carb meals at home.
For non insulin users alcoholic drinks are just a matter of carbs and calories to worry about. For insulin users however the issue of delayed hypoglycaemia needs to be understood. For diabetics of both types one and two anything more than light or very modest alcohol drinking is not compatible with good control and safety. Many people have no idea what drinks contain and this list aims to give you relevant information on that point.
Beer one pint 13g carb 170 calories
Lager 500mls bottle 7.5g carb 146 cals
Stout 275 mls bottle 11g 100 cals
Cider dry one pint 15g 207 cals
Cider sweet one pint 25g 242 cals
Cider vintage strong one pint 42g 580 cals
Dry wine (red or white) 125mls trace carbs 85 cals (some say allow 5-10g)
Sweet sherry 50mls 3.5 carbs 70cals
champagne 125mls 2g 95 cals
Any spirit 25mls trace carbs 60cals
Bacardi Breezer 275mls 20g 170 cals
Soft drink 120mls 14g 50 cals
Tonic water 120mls 12g 45 cals
Gin and Tonic 245mls 16g 170 cals
Diet drinks and water have no carbs and no cals.
Doctors Mike and Mary Dan Eades are the authors of “Protein Power.” This has an excellent section on eating in international restaurants both the dos and the don’ts.
It also gives clear scientific reasons for low carbing and the advantageous effects fo this diet on the metabolic syndrome. There is also a good recipe section.
Here are a selection of what you can eat in restaurants.
Drink a single glass of wine as 5g
Drink mainly diet drinks, water, tea and coffee without sugar.
Dessert can be berries and double unsweetened cream, fresh fruit salad or cheese.
- Grilled meat fish or fowl, green salad, blue cheese or vinaigrette dressing.
- Eat vegetables instead of potatoes, pasta or rice. No bread or crackers.
- Chefs or caesar salad but no croutons.
- Quiche but don’t eat the crust.
- Tomato stuffed with chicken, tuna, crab or cottage cheese.
- Beef, pork, chicken, dry ribs, tossed salad, devilled eggs.
Fast Food Burger Restaurants
- Eat the fillings of grilled chicken, burgers including cheese and bacon. No buns or chips.
- Chicken salad but miss out the croutons.
- Hot and sour soup
- Beef or chicken kebabs
- Beef, chicken, pork, prawn dishes with broccoli or assorted chinese vegetables. No noodles, rice, or pancakes.
- Dry ribs. Avoid sweet sauces.
- Clear soups
- Green salads
- Beef, pork with butter or peppercorn sauce.
- Roast lamb, duck or other poultry.
- Grilled or poached fish.
- Mixed vegetables.
- Avoid sauces thickened with flour.
- Tandoori chicken or lamb.
- Chicken, beef or lamb curry.
- Chicken tikki or chicken masala.
- Tossed green salad, tomato and cucumber salad, spinach, mushrooms.
- Vegetable accomaniments are often good choices. Try cauliflower instead of rice with a meat curry.
- Avoid breads and potato dishes.
- Cured meats and melon
- Chicken or veal, grilled fish, pork. Avoid breaded items.
- Salad and vegetables instead of pasta, risotto or bread.
- Steak Diane.
- Veal in cream sauce.
- Cheese and a few grapes or apple slices for dessert
- Sushi but under eat the rice or order sashimi which has none.
- Miso soup.
- Terriyaki chicken, beef, fish, prawn. No tempura as it is battered.
- Chicken or steak fahitas but miss out the tortilla. You can have the guacamole, sour cream and vegetables.
- Meat and salad.
- Pizza toppings only.
- Buffalo wings with the sour cream rather than bbq sauce.
- No pasta, bread dishes or ice cream.
Atkins for Life: The Complete Controlled Carb Program for Permanent Weight Loss and Good Health. Very good clear book for long term low carbers. Atkins is the standard text on which many other low carb diets are variants. This is the most flexible regarding what fat and what carb you can eat.
Dr. Atkins’ New Diet Revolution, New and Revised Edition. The orange paperback. You can probably borrow someone’s. In every workplace or club someone has done Atkins or knows someone who has.
Atkins Diabetes Revolution: The Groundbreaking Approach to Preventing and Controlling Type 2 Diabetes. More tailored to the type 2 diabetic.
Protein Power: The High-Protein/Low Carbohydrate Way to Lose Weight, Feel Fit, and Boost Your Health-in Just Weeks! by Drs Mike and Mary Eades has been recommended by diabetics.
The Diabetes Diet: Dr. Bernstein’s Low-Carbohydrate Solution. A companion to Dr. Bernstein’s Diabetes Solution.
I find it hard to choose between Atkins for Life and Protein Power as a basic book for people with metabolic syndrome but due to a better cooking section and clearer reasoning of the scientific evidence in Protein Power I recommend the Eades book if you are only going to buy yourself one book on the subject.
“Living the low carb life.” by Jonney Bowden gives lots of reference material throughout his book. One thing that always comes up when you tell your friends that you are going to go on a low carb diet are what I call the “Oh. Buts” Here are some of the commoner myths regarding low carb diets as explained by Jonney Bowden.
Myth One. Low carb diets induce ketosis, a dangerous metabolic state.
Dietary ketosis is not the same as diabetic ketoacidosis. The ketosis of a low carb diet is also not the same as the ketosis of starvation. Many studies have demonstrated the safety of ketogenic diets even for children.
Myth Two. Low carb diets cause calcium loss, bone loss and osteoporosis.
Higher protein intakes do not cause bone loss or osteoporosis especially in the presence of adequate mineral intakes. In fact lower protein diets are associated with more bone loss.
Myth Three. High protein diets cause damage to kidneys.
Higher protein diets do not cause any damage whatsoever to healthy kidneys.
Myth Four. The only reason you lose weight on a low carb diet is because it is low in calories.
Calories count but so do hormones. Many studies show more weight loss on low carb diets than on high carb diets with the same number of calories. Also more of the weight lost on low carb diets comes from fat. Better blood biochemistry occurs too. Lowering fat intake is not the only answer to obesity.
Myth Five: Low carb diets increase the risk of heart disease.
Low carb diets do not increase the risk of heart disease and in fact they improve blood lipid profiles.
Reference: Scientific evidence for the erroneous myths have been gathered and presented in a paper by Anssi H. Manninen. High Protein Weight Loss Diets and Purported Adverse Effects. Where is the Evidence? Sports Nutrition Review Journal. 1 (1): 45-51, 2004. (www.sportsnutritionsociety.org)
Manninen works at the Dept of Physiology, Faculty of Medicine, University of Olulu, Finland.
1. Low carb diets…
a Cause ketosis which is a dangerous metabolic state.
b Lead to calcium loss so causing osteoporosis.
c Increase your risk of heart disease by adverse effects on blood lipids.
d Reduce the risk of heart disease by helpful effects on blood lipids and blood sugar.
2. In a Chinese restaurant the best single choice would be..
a Crispy duck with pancakes.
b Chicken chow mein.
c Prawns cashew nuts and assorted Chinese vegetables.
d Pork in batter with sweet and sour sauce.
3. In a French restaurant you could eat three of these. Which one is off the menu for you?
a Confit de canard.
b Chicken with peppercorn sauce.
c Sole meuniere.
d Crepes flamed with apple brandy.
4. In an Italian restaurant which one of these would you not consider eating?
a Risotto milanese.
b Melon with procuttio.
c Cheese and a few grapes and apple slices.
d Steak Diane.
5. In a Japanese Restaurant you could choose from three of these. Which one would you not eat?
b Miso soup.
c Beef Teryaki
6. A good choice of vegetable to have with your meal could be one of these…
a Fat free pureed carrots.
b Green beans with butter and slivered almonds.
c Mashed potato with cream and butter.
d Baked parsnips.
7. A drink could be chosen from one of these…
a Bacardi breezer.
b Coffee with cream.
c Red wine.
d Gin and slimline tonic.
Have you got it?
1. D is correct. The others are common myths about low carb diets.
2. C is correct. The rest have a lot of starch included and the sweet and sour sauce is also very high in sugar.
3. ABC are good choices. The small amount of breading on the fish is not a concern as long as the vegetable choices are low carb.
4. BCD are good choices. The risotto is mainly rice and picking out a few mushrooms or bits of seafood to eat from these dishes is rarely worth the effort.
5. ABC are good choices. Sushi has a rice base. You would need to eat the fish toppings only to avoid this which makes this a very expensive meal. Sashimi is simply the raw fish without the rice.
6. B is correct. Ther rest are cooked starchy vegetables that will have your blood sugars soaring.
7. BCD are suitable. Mineral waters are also a good choice. Many pre-mixed alcoholic drinks are heavily laden with sugar.
Dr Annika Dalqhist is a Swedish doctor who has had her low carbing blog made into a book. She has enthusiastically approved of my efforts to spread the word about what works with obesity and diabetes and has provided a translation for those of you who don’t understand Swedish. Thank you Annika.
Where to Next?
I reckon many of you are now desperate to head off to your favourite restaurant to try out your new skills in meal choices. But it’s not all about eating on this course!
Whenever you are ready you may all now proceed to the How To: Exercise section.