The Low-Carb Diabetes Solution Cookbook (4 page)

Do not let yourself be fooled into thinking that apple juice is better than diet soda, because “it's natural!” Just 1 cup (240 ml) of apple juice contains 29 grams of sugar. Organic sugar from a natural source is still sugar and will still raise your blood glucose and worsen insulin resistance. Don't buy gluten-free bread, figuring that gluten-free also means low carbohydrate. It does not. Agave nectar is not better than sucralose (Splenda) because it's “natural” and “low glycemic” (meaning it raises blood sugar slowly). It is full of fructose (fruit sugar), which worsens insulin resistance.

Remember: 20 grams of total carbs per day. That is your metric, your focus, your goal. If you do this, your blood sugar will drop like pine needles the week after Christmas, we promise.

As first proposed by Michael Eades, M.D., and Mary Dan Eades, M.D., in their book
Protein Power
, the idea was simple: Because fiber is a carbohydrate, but one that the human gut can neither digest nor absorb, dieters could subtract the grams of fiber in a food from the total carb count to get the number of grams of carbohydrate that actually wind up in the bloodstream. This was a way to let their patients eat more vegetables, and maybe a few berries or a little melon.

But you know how it is: Give people an exception to the rule, and they start working out ways to game the system. Pretty soon food processors were subtracting all sorts of things from the total carb count: maltitol, low-glycemic-index sugars, glycerin, resistant starch, you name it. This led to an explosion of foods with “net carb” counts that can best be described as dubious. Many people embraced these products only to find they were not losing weight or getting any of the other benefits of a low-carbohydrate diet.

Also to be considered is that even if, as the Eades intended, you get your carbohydrates from vegetables and low-sugar fruit, you still get more digestible, absorbable carbohydrate than when counting total carbs. Since the Eades were concerned with weight loss, this was not of great concern.

But we are talking about diabetes, end-stage carbohydrate intolerance. We are not talking about looking better at the high school reunion (although you will). We're talking about reversing very serious illness. We're talking about avoiding painful nerve damage, amputated limbs, blindness, heart disease, kidney failure, and early death. We're talking about your life.

It is common for diet plans to make allowances for “cheating.” And the ads on television give testament to all the ways people try to fool themselves into thinking that there is some “healthy” way to continue their addiction, from sugar-loaded “fiber bars” to sugar-loaded “fruit” punch with a few added vitamins. You cannot afford this. Every time your blood sugar goes above 120 mg/dL (6.7 mmol/L) your body sustains irreversible damage, and that damage adds up. Every time you fall for this nonsense, you will move a little closer to disastrous consequences.

This is scary stuff. We have no wiggle room. This is why, at HEAL, we count total carbs, not net carbs. There may come a day when you can afford to loosen up a tiny bit and count net carbs, but until and unless your doctor gives you the green light, that day has not arrived.

Ignore net carb counts. Count total carbs.

However, for those of you who do not have diabetes and are simply restricting carbs for weight loss and health, we've included fiber counts along with total carb counts. Simple subtraction will give you the net carb counts.

Animal products and vegetables are among the most nutrient-dense foods. There is no vitamin or mineral in starchy foods that cannot be found in low-carbohydrate foods.

Brown rice
, long a darling of the health food set, is a great example. One-half cup of cooked brown rice has 109 calories, with 23 grams of carbohydrate. How nutritious is it? It will contain:

0% of the daily value of vitamin A

6% of the daily value of vitamin B
1
(thiamine)

1% of the daily value of vitamin B
2
(riboflavin)

6% of the daily value of vitamin B
3
(niacin)

7% of the daily value of vitamin B
6
(pyridoxine)

0% of the daily value of vitamin B
12

1% of the daily value of folacin

0% of the daily value of vitamin C

1% of the daily value of calcium

3% of the daily value of iron (in a poorly absorbed form)

1% of the daily value of potassium

4% of the daily value of zinc

One cup of
romaine lettuce
has a mere 8 calories, with 1 gram of carbohydrate. Yet it contains:

29% of the daily value of vitamin A

4% of the daily value of vitamin B
1

3% of the daily value of vitamin B
2

1% of the daily value of vitamin B
3

1% of the daily value of vitamin B
6

0% of the daily value of vitamin B
12

19% of the daily value of folacin

22% of the daily value of vitamin C

2% of the daily value of calcium

3% of the daily value of iron

5% of the daily value of potassium

1% of the daily value of zinc

How about
whole-wheat pasta
? Three-quarters of a cup (66 g) of dry whole-wheat pasta—about 1
1
/
2
cups (210 g) cooked—will have 274 calories and 59 grams of carbohydrate. It will provide:

0% of the daily value of vitamin A

26% of the daily value of vitamin B
1

7% of the daily value of vitamin B
2

20% of the daily value of vitamin B
3

9% of the daily value of vitamin B
6

0% of the daily value of vitamin B
12

11% of the daily value of folacin

0% of the daily value of vitamin C

3% of the daily value of calcium

16% of the daily value of iron

5% of the daily value of potassium

12% of the daily value of zinc

Compare this with a 6-ounce (170 g)
salmon fillet
sautéed in a little butter. It will have 299 calories and a mere trace of carbohydrate. With it you will get:

17% of the daily value of vitamin A

23% of the daily value of vitamin B
1

13% of the daily value of vitamin B
2

43% of the daily value of vitamin B
3

17% of the daily value of vitamin B
6

85% of the daily value of vitamin B
12

2% of the daily value of folacin

3% of the daily value of calcium

7% of the daily value of iron

16% of the daily value of potassium

6% of the daily value of zinc

Need a snack? You could have an
apple
, for 81 cal-ories and 21 grams of carbohydrate. It will provide:

1% of the daily value of vitamin A

1% of the daily value of vitamin B
1

1% of the daily value of vitamin B
2

1% of the daily value of vitamin B
3

3% of the daily value of vitamin B
6

0% of the daily value of vitamin B
12

1% of the daily value of folacin

1% of the daily value of calcium

1% of the daily value of iron

5% of the daily value of potassium

0% of the daily value of zinc

Or you could have an “
unsandwich
” of a slice each of ham and cheese, with a little mustard or mayo or both in between. Exclusive of condiments, you'll get 166 calories and 1 gram of carbohydrate, along with:

9% of the daily value of vitamin A

17% of the daily value of vitamin B
1

10% of the daily value of vitamin B
2

8% of the daily value of vitamin B
3

6% of the daily value of vitamin B
6

8% of the daily value of vitamin B
12

2% of the daily value of folacin

21% of the daily value of calcium

3% of the daily value of iron

3% of the daily value of potassium

10% of the daily value of zinc

(I'm going to insert this, because it's such a persistent myth: You don't need to eat bananas— 28 grams of carbohydrate apiece—to get potassium. One banana has 13 percent of your potassium for the day. A 6-ounce [170 g] pork chop will provide 14 percent; 6 ounces [170 g] of sole fillet will provide 18 percent; 6 [170 g] ounces of beef chuck provides 13 percent; half an avocado provides 17 percent. I can only assume that bananas have a good press agent.)

This isn't even considering outright junk—chips, candy, etc. You know that stuff doesn't add to your daily nutrition. In fact, it can dilute it by displacing nutritious foods.

There is no essential vitamin or mineral yet identified that is not available from low-carbohydrate sources—and many grain foods only appear to have a good nutritional profile because they've been enriched at the factory. Enrichment was instituted when it became clear that people whose diets depended on milled grains were developing nutritional deficiency diseases.

It is likely that your nutritional profile will improve. That said, we do recommend taking a well-formulated, iron-free multivitamin daily.

Nonstarchy vegetables are “good carbs” largely because they actually contain very little carbohydrate along with their substantial amounts of vitamins, minerals, and antioxidants.

Perhaps you have heard that carbs are “quick energy.” This is exactly what is wrong with them. Consider an analogy: Gasoline is quick energy, so quick that if you were to check your gas tank by match light, you'd be lucky to live to tell about it. That's why your car has fuel injectors or a carbur-etor—to give it a way to use that explosively quick energy gradually. Without it?
Ka-boom.

Your body doesn't have a carburetor. It has no way to use carbohydrates gradually. When you eat a carb-heavy meal, it is rapidly converted into glucose and rushes into your bloodstream. Your blood sugar shoots up. Your body knows that this is dangerous, so it cranks out lots of insulin to bring your blood sugar down. It converts that sugar to fats known as triglycerides, and stuffs them into your fat cells.

A few things happen: You have some new fat around your waist, and possibly in your liver. Your triglycerides have gone up. And your blood sugar has crashed as quickly as it rose, leaving you tired, cranky, and
hungry.

Your body should be able to use that new fat for fuel. Storage fat should be your steady fuel supply, so that when you burn through the calories in your last meal, you shift over to burning stored fuel with no drop in energy or efficiency. But falling insulin levels are the body's signal to let that stored fat out into the bloodstream, and those carbs you are eating ensure that your insulin is going nowhere but up.

So you eat carbs, and your blood sugar rises sharply. Your body sends out insulin to get your blood sugar back down, shunting most of the fuel you just ate into storage as fat and locking it up. Your blood sugar falls, and you get tired, foggy-headed, irritable, and hungry. You grab a muffin, and the whole process starts over.

As this cycle is endlessly repeated, the insulin receptors—the little “doors” on your cells that the insulin “opens” to usher the sugar out of your bloodstream—start to wear out. You make more and more insulin, and yet it gets harder and harder for your body to get your blood sugar down. Cue the diagnosis of diabetes.

Here's the irony of “energy food”: You're carrying around all the fuel you need to get you through weeks, possibly months, but because of high insulin levels you can't get to it. Yet you still have to lug it around everywhere you go. No wonder you're tired and hungry all the time.

Fat is the real energy food. That 1 teaspoon of sugar in a healthy bloodstream should be the tinder. Fat is the big darned logs that burn for hours and hours. And since you carry a supply of fat around with you, once your insulin levels drop and you get access to the “tank,” you'll have steady, near inexhaustible energy. When you burn through the fat in your last meal, you'll shift smoothly over to burning body fat with no mid-morning slump. That's how the system is supposed to work. With access to all that stored fuel, and no more blood sugar roller coaster, you'll find that you are less hungry. You may be shocked at how much your appetite is reduced.

All you have to do is stop the cycle. Breaking it won't make you tired and hungry. Instead, you will have more energy and less hunger that you ever imagined possible.

This is how your body evolved to work: Store fuel when it's plentiful and then tap into those reserves in between times. How else do you think your hunter-gatherer ancestors tracked a mammoth when they hadn't eaten in a couple of days? It's an elegant system.