New Podcast Episode Features Professional Low-Carb Diet Proponents

Jimmy Moore posted an interview with Dr. Troy Stapleton and Franziska Spritzler, R.D. They both advocate carbohydrate-restricted diets for management of blood sugars in diabetes. Dr. Stapleton, by the way, has type 1 diabetes; I’ve written about him before. Franziska is available for consultation either by phone, Skype, or in person.

Steve Parker, M.D.

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Is Any Non-Caloric Sweetener Really Natural?

Are noncaloric sweeteners any better than an teaspoon of sugar in your coffee? Is honey better?

Are noncaloric sweeteners any better than an teaspoon of sugar in your coffee? Is honey healthier since it’s “natural”?

Daniel Engber has an article at the online New York Times on the quest for natural no-calorie sweeteners. Some quotes:

As badly as stevia needs the soft-drink companies, the soft-drink companies may need stevia even more. While sweetened carbonated beverages still make up around one-fifth of all the liquids we consume, the volume sold has dropped, per capita, every year since 1998. We’re more afraid of sugar than we’ve ever been. What yesterday were seen as “empty calories” have today been designated “toxic.” Doctors warn that cans of soda put fat into your liver, weaken your response to insulin and increase your risk of heart disease and diabetes. The panic over sugar has grown so pervasive that other dietary boogeymen — salt and fat and gluten — seem like harmless flunkies in comparison. (In 2012, when the market-research firm Mintel asked consumers which ingredients or foods they were trying to avoid, sugar and added sugar topped the list, by a wide margin.)

***

Some consumers also wonder if the natural sweeteners aren’t simply different flavors of the products they’ve been trying to avoid. At the beginning of July, just as PepsiCo got approval for Reb-D and Coca-Cola said it would be working on Reb-X, a 58-year-old woman living in Hawaii filed suit against Big Stevia. In March she bought a box of Truvia at Walmart because she thought it was a natural product. Now she’s convinced it’s no such thing. Her complaint declared that “Reb-A is not the natural crude preparation of stevia,” and that its manufacture is not “similar to making tea,” as Cargill’s packaging suggests. Rather, it’s “a highly chemically processed and purified form of stevia-leaf extract.”

Hers was not the only attack on Cargill’s natural sweetener. In ongoing negotiations to settle a similar suit, Cargill has offered to remove the phrase “similar to making tea” from the packaging and/or add an asterisk to the product’s tagline, “Nature’s Calorie-Free Sweetener,” directing people to a website F.A.Q. That page would explain that Truvia contains very little stevia, by weight, and that its main ingredient — erythritol — comes from yeast that may be fed with genetically modified corn sugar. “As with almost all finished food products,” the F.A.Q. would say, “the journey from field to table involves some processing.”

***

But what’s “natural” mean anyway?

It’s a question that has bedeviled beverage-makers, too. In the fall of 2012, a German food company surveyed 4,000 people in eight European countries, to find out how they understood the “natural” claim. Almost three-quarters said they thought that natural products were more healthful and that they’d pay a premium to get them. More than half argued that natural products have a better taste. But the respondents weren’t sure what degree or form of processing would be enough to strip a product of its natural status. Some drew a line between sea salt (natural) and table salt (artificial). Others did the same for dried pasta and powdered milk, though both are made by dehydration.

 Read the whole enchilada.

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Are We Fat Because We’re Eating Away From Home More?

So easy to over-eat!

So easy to over-eat!

The U.S. trend of increasing overweight and obesity started about 1970. I wonder if eating away from home is related to the trend. I found a USDA report with pertinent data from 1977 to 1995. It also has interesting info on snacking and total calories consumed. Some quotes:

“We define home and away-from-home foods based on where the foods are obtained, not where they are eaten. Food at home consists of foods purchased at a retail store, such as a grocery store, a convenience store, or a supermarket. Food away from home consists of foods obtained at various places other than retail stores (mainly food-service establishments).”

***

“Over the past two decades, the number of meals consumed has remained fairly stable at 2.6 to 2.7 per day. However, snacking has increased, from less than once a day in 1987–88 to 1.6 times per day in 1995. The increased popularity in dining out is evident as the proportion of meals away from home increased from 16 percent in 1977–78 to 29 percent in 1995, and the proportion of snacks away from home rose from 17 percent in 1977–78 to 22 percent in 1995. Overall, eating occasions (meals and snacks) away from home increased by more than two-thirds over the past two decades, from 16 percent of all eating occasions in 1977–78 to 27 percent in 1995.”

***

“Average caloric intake declined from 1,876 calories per person per day in 1977–78 to 1,807 calories per person per day in 1987–88, then rose steadily to 2,043 calories per person per day in 1995.”

***

“These numbers suggest that, when eating out, people either eat more or eat higher-calorie foods or both.”

Parker here. I’m well aware that these data points don’t prove that increased eating-out, increased snacking,  and increased total calorie consumption have caused our overweight and obesity problem. But they sure make you wonder, don’t they? None of these factors was on a recent list of potential causes of obesity.

If accurate, the increased calories alone could be the cause. Fast-food and other restaurants do all they possibly can to satisfy your cravings and earn your repeat business.

If you struggle with overweight, why not cut down on snacking and eating meals away from home?

Steve Parker, M.D.

Bonus:

Here’s a pie chart I found with more current and detailed information from the U.S. government (h/t Yoni Freedhoff):

feb13_feature_guthrie_fig03

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Spaghetti Squash Recipes

low-carb diet, spaghetti squash, paleobetic diet, diabetic diet

The yellow spaghetti squash is at the top. It’s related to pumpkins and zucchini.

Spaghetti squash is a classic low-carb vegetable. If you’ve never tried it, you should. As vegetables go, it’s one of the largest, heaviest, and most interesting to prepare. Easy, too. The spaghetti squash season is autumn and winter in the northern hemisphere. Purchasing in spring and summer may be iffy.

It’s hard to give up pasta. Many diabetics who don’t notice that their blood sugar levels spike too high when they eat pasta. What’s too high? In general, I’d say over 150 mg/dl (8.33 mmol/l) measured one hour after a meal, or over 130 mg/dl (7.22 mmol/l) two hours after the meal.

Other experts disagree and propose other numbers.

An alternative to spaghetti pasta that shouldn’t raise blood glucose levels as high is the aforementioned spaghetti squash. It’s all about the carbohydrates. A cup of cooked spaghetti squash has 10 g of carb; a cup of cooked spaghetti has 43 g. The fiber grams are about the same. Numbers are from FitDay.com.

In my part of the world, supermarket spaghetti squashes weigh between two and five pounds. We cooked a three-pounder (1.4 kg) that yielded five cups; a five-pounder (2.3 kg) gave us 12 cups. A serving size is one, maybe two cups. What you don’t eat immediately stays fresh in the refrigerator for at least several days. Re-heat by microwaving or stir-frying.

Like pasta and potatoes, the squash by itself is bland. It’s a great substrate for sauces or seasonings.

You can fit spaghetti squash into both the Ketogenic Mediterranean Diet and Low-Carb Mediterranean Diet.

low-carb diet, paleobetic diet, diabetic diet, spaghetti squash

Raw squash cut in half lengthwise

Here’s how we cook it at the Parker Compound. Preheat the oven to 375º F 0r 190º C. Very carefully slice the squash in half lengthwise. Spoon out and discard the guts (seeds and membranes like a pumpkin; it even smells like a pumpkin). Put the halves flat-side down in a pan, then add a half inch (1.3 cm) of water to the pan. Cover with foil and bake until the outer shell (rind) is fairly easily pierced with a paring knife. This will be about 45 minutes for a two-pound squash (0.9 kg); 90 minutes for a four-plus pounder (2.3+ kg). Then turn them over, re-cover with foil, and cook 15 minutes more, until very tender. Remove from the oven and allow them to cool for a few minutes. Then use a fork to pull the strands away from the rind.

Other cooks simplify the process and just place the squash halves flat-side down on a baking sheet and cook for 30-60 minutes. Some leave the seeds in while cooking and spoon them out just before the stranding step.

Now what?

You got options.

Our first experiment was with l0w-carb spaghetti sauce.

paleobetic diet, low-carb diet, diabetic diet, spaghetti squash

Low-carb spaghetti

Next we took three cups squash (710 ml) and mixed in 2 tbsp (30 ml) extra virgin olive oil, 2.5 tbsp (37 ml) chopped parsley, 1/2 tsp (2.5 ml) minced fresh garlic, 1/2 tsp (2.5 ml) salt, and 1/8 tsp (0.6 ml) black pepper.

low-carb diet, diabetic diet, paleobetic diet

Seasoned with parsley, olive oil, garlic, salt, pepper

Finally, we took a cup (240 ml) of the squash and added minced celery (4 inches or 10 cm of stalk), 3 minced black olives, 5/8 oz (18 g) of minced sweet (bell) pepper, 1/2 clove of minced garlic, salt (a dash), and pepper to taste.

paleobetic diet, diabetic diet, low-carb diet, spaghetti squash

Seasoned with sweet peppers, black olives, garlic, celery, and salt

These last two options I consider side dishes. By the way, they taste good either cold or warm. They would go well with a number of entrees, such as steak or salmon.

I’ve read that this squash is good with pesto, or just with salt and butter.

Nutrition facts from FitDay.com:

One cup of cooked spaghetti squash has 75 calories (I’ve seen 42 elsewhere), 10 g of carbohydrate, 2 g of fiber, 8 g of digestible carb, 4 g of fat (predominantly MUFA), minimal protein, and a fair amount of vitamins A, niacin, B6, and C. Plus 8% of your RDA for manganese.

Steve Parker, M.D.

 

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Low-Carb Spaghetti Sauce

paleobetic diet, low-carb  spaghetti sauce

Spaghetti squash in the background

We eat a lot of spaghetti sauce at the Parker Compound. We make enough for leftovers at subsequent meals. Many folks with diabetes get unacceptable blood sugar spikes when they eat typical wheat-based spaghetti or other pastas. Avoid that with a spaghetti substitute called spaghetti squash (click for the recipe and nutritional analysis).

This recipe uses Truvia, a sweetener that’s a combination of stevia and erythritol. If you don’t have any, don’t fret: you have options.

Stevia is supposedly “natural.” I don’t know where erythritol, a sugar alcohol, comes from. The purpose of a sweetener is to counteract the tartness or bitterness of the tomatoes. Honey would probably serve this purpose, but I’ve never tried it in this recipe. If you use the honey or table sugar option below, it will increase the digestible carb count in each cup by three grams. Whatever your favorite non-caloric sweetener, use the equivalent of two tablespoons of table sugar (sucrose).

Ingredients:

1 lb (454 g) sweet Italian sausage, removed from casing

3/4 lb (340 g kg) lean ground beef (lean = up to 10% fat by weight)

1/2 cup (118 ml) onion, minced

2 cloves garlic, crushed

1 can crushed tomatoes (28 oz or 793 g)

2 cans tomato paste (total of 12 oz or 340 g)

2 cans tomato sauce (total of 16 oz or 454 g)

1/2 cup water (118 ml)

2 tsp (10 ml) Truvia (combo of stevia and erythritol; optional substitutes are table sugar  (2 tbsp or 30 ml) or honey (1.5 tbsp or 22 ml), or leave out sweetener

1.5 tsp (7.4 ml) dried basil leaves

1/2 tsp (2.5 ml) fennel seeds

1 tsp (5 ml) Italian seasoning

1/4 tbsp (3.7 ml) salt

1/4 tsp (1.2 ml) ground black pepper

4 tbsp (60 ml) fresh parsley, chopped

Instructions:

Put the sausage, ground beef, onion, and garlic in a pan and cook over medium heat until well browned. Drain off the excess liquid fat if that’s your preference (not mine). You’ll probably have to transfer that mix to a pot, then add all remaining ingredients and simmer on low heat for two or three hours. You may find the flavor even better tomorrow. If it gets too thick, just add water.

To avoid carbohydrate toxicity—high blood sugar—eat this over spaghetti squash rather than pasta. I’ll have a post on cooking spaghetti squash soon. Small or inactive folks may find a half cup of sauce over one cup of cooked squash is a reasonable serving (about 250 calories). I prefer to double those portions, making it a whole meal.

Sometimes I just eat this sauce straight. But I’m weird. A cup of sauce with some veggies or fruit is a meal for me. If you have other uses for spaghetti sauce other than over spaghetti squash or grain products, please share in the Comments.

Number of Servings: 9 (1-cup each)

Nutritional Analysis: (assumes you retained all fat)

55% fat

23% carbohydrate

22% protein

345 calories

21 g carbohydrate

4 g fiber

17 g digestible carbohydrate

985 mg sodium

1,117 mg potassium

Prominent features: Rich in vitamin B12, iron, copper, niacin, sodium, and selenium

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Dining Out and Obesity: Related?

No need to dine out if you have one of the four "Low-Carbing Among Friends" cookbooks

No need to dine out if you have one of the four “Low-Carbing Among Friends” cookbooks

The U.S. trend of increasing overweight and obesity started about 1970. I wonder if eating away from home is related to the trend. I found a USDA report with pertinent data from 1977 to 1995. It also has interesting info on snacking and total calories consumed. Some quotes:

“We define home and away-from-home foods based on where the foods are obtained, not where they are eaten. Food at home consists of foods purchased at a retail store, such as a grocery store, a convenience store, or a supermarket. Food away from home consists of foods obtained at various places other than retail stores (mainly food-service establishments).”

***

“Over the past two decades, the number of meals consumed has remained fairly stable at 2.6 to 2.7 per day. However, snacking has increased, from less than once a day in 1987-88 to 1.6 times per day in 1995. The increased popularity in dining out is evident as the proportion of meals away from home increased from 16 percent in 1977-78 to 29 percent in 1995, and the proportion of snacks away from home rose from 17 percent in 1977-78 to 22 percent in 1995. Overall, eating occasions (meals and snacks) away from home increased by more than two-thirds over the past two decades, from 16 percent of all eating occasions in 1977-78 to 27 percent in 1995.”

***

“Average caloric intake declined from 1,876 calories per person per day in 1977-78 to 1,807 calories per person per day in 1987-88, then rose steadily to 2,043 calories per person per day in 1995.”

***

“These numbers suggest that, when eating out, people either eat more or eat higher-calorie foods or both.”

Parker here. I’m well aware that these data points don’t prove that increased eating-out, increased snacking,  and increased total calorie consumption have caused our overweight and obesity problem. But they sure make you wonder, don’t they? None of these factors was on a recent list of potential causes of obesity.

If accurate, the increased calories alone could be the cause. Fast-food and other restaurants do all they possibly can to satisfy your cravings and earn your repeat business.

If you struggle with overweight, why not cut down on snacking and eating meals away from home?

Steve Parker, M.D.

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Low-Fat Diet Loses to Mediterranean Diet in Heart Disease Prevention

The American Journal of Medicine has an article entitled “Diets to Prevent Coronary Heart Disease 1957- 2013: What Have We Learned?” The authors conclude:

The Mediterranean-style diet, with a focus on vegetables, fruit, fish, whole grains and olive oil, has proven to reduce cardiovascular events to a degree greater than low fat diets, and equal to or greater than the benefit observed in statin trials.

The only bone I’ll pick with that quote today is that folks with diabetes and prediabetes often have unacceptable blood sugar spikes when they eat whole grains. That’s one reason I designed the Low-Carb Mediterranean Diet.

Steve Parker, M.D.

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