Tag Archives: ketogenic mediterranean diet

Long-Term Severe Carbohydrate Restriction Is Possible!

I got an email a few days ago from a blog reader, J.H. (I won’t give his name because I didn’t ask permission to publish his letter):

Dr. Parker — I’m a 65 year old male who has battled insulin resistance and pre-diabetes for many years. About 15 months ago I started pursuing a very low carb (20 grams per day) ketogenic diet, and my health has improved significantly. I’ve lost about 35 lbs (down from 265), and I have not found it difficult at all to stay on this regimen. You mentioned in an article (https://diabeticmediterraneandiet.com/ketogenic-mediterranean-diet/) that you don’t believe people can stay with it for more than 6 months and that most people can only last about two weeks. With all due respect, hogwash! I was fortunate enough to become a patient of Eric Westman at Duke, and he does an excellent job of teaching the ketogenic diet to his patients. Any overweight person should give it great consideration, and it’s just not that hard to follow.

Best regards, J.H.

My response was: “Congrats on a job well done! I wish all my patients had your discipline and commitment.”

I have great respect for Dr. Westman. He’s the c0-author of The New Atkins for a New You. I reviewed it in 2010. No clinical studies have compared the effectiveness of Dr. Westman’s diet to my Ketogenic Mediterranean Diet, which attempts to lasso the health benefits of the time-honored traditional Mediterranean diet while helping folks lose weight. The Ketogenic Mediterranean Diet is a key component of Conquer Diabetes and Prediabetes.

Steve Parker, M.D.

PS: You don’t have to know what ketogenic means to benefit from ketosis.

PPS: I have a non-diabetic version of the Ketogenic Mediterranean Diet for otherwise healthy folks who just need to lose a boatload of weight.

low-carb mediterranean diet

Front cover of book

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Prevent Weight Regain With the Mediterranean Diet

Italian seaside tangentially related to this post

Italian seaside tangentially related to this post

Investigators affiliated with universities in Italy and Greece wondered about the effect on obesity of two ketogenic “Mediterranean” diet spells interspersed with a traditional Mediterranean diet over the course of one year. They found significant weight loss, and perhaps more importantly, no regain of lost weight over the year, on average.

This scientific study is right up my alley. I was excited when I found it. Less excited after I read it.

The Set-Up

This was a retrospective review of medical records of patients of a private nutritional service in three fitness and weight control centers in Italy between 2006 and 2010. It’s unclear whether patients were paying for fitness/weight loss services. 327 patient records were examined. Of these, 89 obese participants met the inclusion and exclusion criteria and started the program; 68 completed it and were the ones analyzed. (That’s not at all a bad drop-out rate for a year-long study.)  The completers were 59 males and 12 females (I know, the numbers don’t add up, but that’s what they reported). Ages were between 25 and 65. Average weight was 101 kg (222 lb), average BMI 35.8, average age 49. All were Caucasian. No diabetics.

Here’s the program:

  1. 20 days of a very-low-carb ketogenic diet, then
  2. 20 days of a low-carbohydrate non-ketogenic diet for stabilization, then
  3. 4 months of a normal caloric Mediterranean diet, then
  4. repeat #1 and #2, then
  5. 6 months of a normal caloric Mediterranean diet

In the ketogenic phases, which the authors referred to as KEMEPHY, participants followed a commercially available protocol called TISANOREICA. KEMEPHY is combination of four herbal extracts that is ill-defined (at least in this article), with the idea of ameliorating weakness and tiredness during ketosis. The investigators called this a ketogenic Mediterranean diet, although I saw little “Mediterranean” about it. They ate “beef & veal, poultry, fish, raw and cooked green vegetables without restriction, cold cuts (dried beef, carpaccio and cured ham), eggs and seasoned cheese (e.g., parmesan).” Coffee and tea were allowed. Items to avoid included alcohol, bread, pasta, rice, milk, and yogurt. “In addition to facilitate the adhesion to the nutritional regime, each subject was given a variety of specialty meals constituted principally of protein and fibers. “These meals (TISANOREICA) that are composed of a protein blend obtained from soya, peas, oats (equivalent to 18 g/portion) and virtually zero carbohydrate (but that mimic their taste) were included in the standard ration.” They took a multivitamin every morning. Prescribed carbohydrate was about 30 grams a day, with macronutrient distribution of 12% carb, 36 or 41% protein, and 51 0r 52% fat. It appears that prescribed daily calories averaged 976 (but how can that be prescribed when some food items are “unrestricted”?).

I found little explanation of period #2 mentioned above, the low-carb non-ketogenic diet. Prescribed macronutrients were 25 or 33% carb, 27 0r 31% protein, 41 or 44% fat, and about 91 g carbohydrate. Prescribed daily calories appear to have averaged 1111.

After the first and second active weight loss ketogenic phases, participants ate what sounds like a traditional Mediterranean diet. Average prescribed macronutrient distribution was 57% carbohydrate, 15 % protein, and 27% fat. Wine was allowed. It looks like 1800 calories a day were recommended.

Food consumption was measured via analysis of 3-day diaries, but you have to guess how often that was done because the authors don’t say. The results of the diary analyses are not reported.

What Did They Find?

Most of the weight loss occurred during the two ketogenic phases. Average weight loss in the first ketogenic period was 7.4 kg (16 lb), and another 5.2 kg (11 lb) in the second ketogenic period. Overall average weight loss for the entire year was 16.1 kg (35 lb).

Average systolic blood pressure over the year dropped a statistically significant 8 units over the year, from 125 to 116 mmHg.

Over the 12 months, they found stable and statistically significant drops in total cholesterol, LDL cholesterol (“bad cholesterol”), triglycerides, and blood sugar levels. No change in HDL cholesterol (“good cholesterol”).

Liver and kidney function tests didn’t change.

The authors didn’t give explanations for the drop-outs.

Although the group on average didn’t regain lost weight, eight participants regained most of it. The investigators write that “…the post dietary analysis showed that they were not compliant with nutritional guidelines given for the Mediterranean diet period. These subjects returned to their previous nutrition habits (“junk” food, high glycaemic index, etc.) with a mean “real” daily intake of 2470 Kcal rather than the prescribed 1800 Kcal.”

Comments

A key take-home point for me is that the traditional Mediterranean diet prevented the weight regain that we see with many, if not most, successful diets.

However, most formulas for calculating steady state caloric requirements would suggest these guys would burn more than the 1800 daily calories recommended to them during the “normal calorie” months. How hard did the dieters work to keep calories around 1800? We can only speculate.

Although the researchers describe the long periods of traditional Mediterranean diet as “normal caloric,” they don’t say how that calorie level was determined  and achieved in the real world. Trust me, you can get fat eating the Mediterranean diet if you eat too much.

I’ll be the first to admit a variety of weight loss diets work, at least short-term. The problem is that people go back to their old ways of eating regain much of the lost weight, typically starting six months after starting the program. It was smart for the investigators to place that second ketogenic phase just before the typical regain would have started!

There are so few women in this study that it would be impossible to generalize results to women. Why so few? Furthermore, weight loss and other results weren’t broken down for each sex.

I suspect the results of this study will be used for marketing KEMEPHY and TISANOREICA. For all I know, that’s why the study was done. We’re trusting the investigators to have done a fair job choosing which patient charts to analyze retrospectively. They could have cherry-picked only the good ones. Some of the funding was from universities, some was from Gianluca Mech SpA (what’s that?).

How much of the success of this protocol is due to the herbal extracts and TISANOREICA? I have no idea.

The authors made no mention of the fact the average fasting glucose at baseline was 103 mg/dl (5.7 mmol/l). That’s elevated into the prediabetic range. So probably half of these folks had prediabetes. After the one-year program, average fasting glucose was normal at 95 mg/dl (5.3 mmol/l).

The improved lipids, blood sugars, and lower blood pressure may have simply reflected successful weight loss and therefore could have been achieved  by a variety of diets.

The authors attribute their success to the weight-losing metabolic effects of the ketogenic diet (particularly the relatively high protein content), combined with the traditional Mediterranean diet preventing weight regain.

The authors write:

The Mediterranean diet is associated with a longer life span, lower rates of coronary heart disease, hypercholesterolemia, hypertension, diabetes and obesity. But it is difficult to isolate the “healthy” constituents of the Mediterranean diet, since it is not a single entity and varies between regions and countries. All things considered there is no “one size fits all” dietary recommendation and for this reason we have tried to merge the benefits of these two approaches: the long term “all-life” Mediterranean diet coupled with brief periods of a metabolism enhancing ketogenic diet.

I’ve attempted a similar merger with my Low-Carb Mediterranean Diet. Click here for an outline. Another stab at it was the Spanish Ketogenic Mediterranean Diet. And here’s my version of a Ketogenic Mediterranean Diet.

Steve Parker, M.D.

Reference: Paoli, Antonio, et al. Long Term Successful Weight Loss with a Combination Biphasic Ketogenic Mediterranean Diet and Mediterranean Diet Maintenance Protocol. Nutrients, 5 (2013): 5205-5217. doi: 10.3390/nu5125205

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Recipe: Brussels Sprouts and Bacon Bits

Bacon Bit Brussels Sprouts

Bacon Bit Brussels Sprouts

Brussels sprouts are a classic low-carb vegetable and a good source of vitamin C and fiber. A while back I posted a meal recipe for Bacon Brussels Sprouts to accompany Brian Burgers. To make it a little more convenient, I’ve substituted off-the-shelf real bacon bits instead of frying my own bacon. I traded olive oil for the bacon grease. The two versions taste very similar. You can easily fit Bacon Brussels Sprouts into either the Low-Carb Mediterranean Diet or Ketogenic Mediterranean Diet.

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It’ll take 10 minutes to shred the sprouts

Ingredients:

1 lb (454 g) Brussels sprouts, raw, shredded (slice off and discard the bases first)

4 tbsp (60 ml) extra virgin olive oil

5 tbsp (75 ml or 35 g real bacon bits or crumbles (e.g., by Hormel or Oscar Mayer)

2 garlic cloves, minced (optional)

1/8 (0.6 ml) tsp salt

1/4 tsp (1.2 ml) ground black pepper

3 tbsp (45 ml) water

Instructions:

diabetic diet, paleobetic diet, low-carb diet

Steaming in progress

You’ll be steaming this in a pan with a lid. Put the garlic and olive oil in a pan and cook over medium-high heat for a few minutes to release the flavor of the garlic. Add the water to the pan and let it warm up for a half a minute or so on medium-high heat. Then add the shredded sprouts and cover with the lid. After a minute on this medium-high heat, turn it down to medium. The sprouts will have to cook for only 4–6 minutes. Every minute, shake the pan to keep contents from sticking. You might need to remove the lid and stir with a spoon once, but that lets ourtyour steam and may prolong cooking time. The sprouts are soft when done. Then remove from heat, add the bacon bits, salt, and pepper, then mix thoroughly.

When time allows, I’d like to experiment with this by leaving out the bacon and using various spices instead. Do you know what goes well with Brussels sprouts?

Number of Servings: 3 (1 cup or 240 ml each)

Nutritional Analysis per Serving:

71% fat

19% carbohydrate

10% protein

270 calories

14 g carbohydrate

6 g fiber

8 g digestible carbohydrate

328 mg sodium

646 mg potassium

Prominent feature: High in vitamin C (over 10o% of your RDA)

diabetic diet, low-carb diet, paleobetic diet

Brian burger and bacon Brussels sprouts

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Book Review: The Low Carb Dietitian’s Guide to Health and Beauty

247 pages

247 pages

I just finished reading The Low Carb Dietitian’s Guide to Health and Beauty, written by Franziska Spritzler, RD, CDE, and published in January 2015. CDE, but the way, means Certified Diabetes Educator. Per Amazon’s rating system, I give it five stars (I love it). It’s not written specifically for women with diabetes, but the included recipes are quite consistent with a healthy diabetic diet. Since the author provides the carbohydrate grams with her recipes, you can use them with my Low-Carb Mediterranean Diet and Ketogenic Mediterranean Diet.

*   *   *

This valuable addition to the low-carb literature is unique: No other book covers the beauty and health aspects of low-carb eating specifically in women.

I’m a strong proponent of carbohydrate-restricted eating for weight management and cure or control of certain medical conditions. The great advantages of low-carbing for weight loss are 1) suppression of hunger, and 2) proven greater efficacy compared to other types of dieting. Nevertheless, I wasn’t aware that this way of eating also had potential benefits in terms of beauty maintenance or improvement. The author persuasively makes that case in this ground-breaking book.

Just because she has RD (registered dietitian) behind her name doesn’t mean you just have to take her word for it. Franziska gives us references to the scientific literature if you want to check it out yourself.

The author focuses on health and beauty; the weight loss happens naturally with low-carb eating. That’s a helpful “side effect” since 2/3 of women in the U.S. are overweight or obese.

She covers all the basics of low-carb eating, including the rationale, potential side effects and how to prevent or deal with them, the science of “good fats,” the importance of plant-derived foods and fiber, info on artificial sweeteners, and management of weight-loss stalls.

Then Franziska does something else unique and very helpful. She offers three different eating plans along with a simple test to help determine which is the best for you. The options are 1) low-carbohydrate diet, 2) high-fiber, moderate saturated fat, low-carb diet, and 3) intermittent fasting low-carb diet with weekly treat meal. You can dig right in with a week’s worth of easy meals made from readily available ingredients.

It was interesting for me to learn that the author ate vegan-style and then pescetarian for awhile. In 2011 she was eating the usual doctor-recommended “healthy” low-fat high-fiber diet when life insurance blood work indicated she had prediabetes. So she cut her daily dietary carbs from 150 grams to 50 or less, with subsequent return of the labs to normal ranges.

I only had a few quibbles with the book. For instance, there’s no index, but that’s mitigated by a very detailed table of contents. The font size is on the small side for my 60-year-old eyes. If either of those issues bother you, get the ebook version. “Net carbs” are mentioned briefly before they are defined, which might confuse folks new to low-carbing.

A particular feature that appealed to me is the vegetarian meal options. Low-carb eating is often criticized as being meat-centric. Franziska shows it doesn’t have to be.

I also appreciate that she provides the net carb grams and calorie counts for her meal plans and recipes. All diabetics and many prediabetics need to know the carb grams. Calorie counts come in handy when analyzing the cause of a weight loss stall. Yes, calories still count in weight management.

I don’t think it’s giving too much away to say that the author’s top low-carb beauty foods are avocados, berries, cinnamon, cocoa/dark chocolate, fatty fish, flaxseed, full-fat dairy, green tea, nuts, olives/olive oil, and non-starchy vegetables. I was skeptical at the start of the beauty foods chapter, but Franziska’s scientific references support her recommendations. I’m already eating most of these foods. Now I’m going to try green tea and ground flaxseed (e.g., her flaxseed bread recipe).

The author will also get you going on exercise. I heartily agree with her that exercise is truly a fountain of youth.

Menopausal? The author has your special challenges covered.

If you’re curious about the paleo diet, note that only about a quarter of these recipes are pure paleo. Dairy products disqualify many of them.

Here are a just a few tidbits I picked up, to help me remember them:

  • a blood test called fructosamine reflects blood sugar levels over the previous three weeks
  • you’ll have less wrinkles if you can reduce the advanced glycation end-products (AGEs) in your skin
  • Japanese women on the highest-fat diets have less wrinkling and better skin elasticity
  • soluble fiber from plants helps to reduce appetite, improves blood sugar control, and helps with weight regulation (see her table of high-fiber plants, including soluble and insoluble fiber)
  • seitan is a meat substitute for vegetarians
  • erythritol (an artificial sweetener) may have less gastrointestinal effects (diarrhea, gas, bloating) than many other artificial sweeteners
  • maltitol (another artificial sweetener in the sugar alcohols class) tends to increase blood sugar more than the other sugar alcohols
  • I’m going to try her “sardines mashed with avocados” recipe (Alton Brown popularized sardine-avocado sandwiches, so it’s not as bizarre as it sounds!)

I wouldn’t be surprised if Franziska’s recommendations help men as well as women keep or regain their youthfulness.

Steve Parker, M.D.

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Recipe: Chicken Avocado Soup

FullSizeRender

Avocados in soup? Yeah, I was skeptical, too. But it works amazingly well. Since I provide the nutritional analysis below, you can easily work this into the Low-Carb Mediterranean Diet, Ketogenic Mediterranean Diet, or Paleobetic Diet.

Ingredients

1.5 lb (680 g) boneless skinless chicken breast

1 tbsp (15 ml) olive oil

1 cup (240 ml) chopped green onions

1/2 jalapeno pepper (or 1 or 2 peppers if you wish), seeded and minced (use the seeds, too, if you want it very spicy hot)

2 roma tomatoes (5 oz or 140 g), seeded and diced

2 garlic cloves, minced

60 oz (1,700 g) low-sodium chicken broth

salt and pepper to taste (nutritional analysis below assumes no salt added)

1/2 tsp (2.5 ml) ground cumin

1/3 cup (80 ml) chopped cilantro

3 tbsp (45 ml) fresh lime juice (2 limes should be enough)

3 medium California avocados, peeled, seeded, and cubed

Instructions

Heat up the olive oil in a large pot over medium heat, then add the green onions and jalapeño; sauté until tender (1–2 minutes) then add the garlic and cook another 30 seconds or so. Next into the pot goes the chicken broth, cumin, tomatoes, chicken breasts, and optional salt and pepper. If adding salt, I’d wait until just before serving: taste it and then decide if it needs salt. Bring to a boil with high heat, then reduce heat but keep it  boiling, covered with a lid while the chicken cooks through-out. Cooking time depends on thickness of the breasts and may be 15 to 45 minutes. When done, it should be easy to shred with a fork. Reduce heat to low or warm then remove the chicken breasts and allow them to cool for 5–10 minutes. When cool enough, shred the chicken with your fingers and return it to the pot. Add the cilantro. Ladle 1.5 cups (355 ml) into a bowl, add one fifth or sixth of the avocado cubes (half of an avocado) and the juice of 1/4 to 1/2 lime. Enjoy!

IMG_2233

Serving size: 1.5 cup of soup plus 1/2 of an avocado

Servings per Batch: 5

Advanced Mediterranean Diet boxes: 1 veggie, 1 fat, 1 protein

Nutritional Analysis per Serving:

43 % fat

13 % carbohydrate

44 % protein

350 calories

12 g carbohydrate

8 g fiber

4 g digestible carb

638 mg sodium

1,180 mg potassium

Prominent features: Rich in protein, vitamin B6, vitamin C, niacin, pantothenic acid, phosphorus, selenium; plus a fair amount of fiber

PS: You can fancy this up just before serving by adding a couple large triangular corn tortilla chips (broken into a few bits) or half of a 6-inch (15 cm) corn tortilla (first, microwave for 20 seconds, then break into a bits). Both items each add 5 g of digestible carbohydrate; the tortilla chip option adds 60 calories and the corn tortilla adds 25 calories. Shredded cheese might be a nice topper, too.

 

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Recipe: Roasted Asparagus, Beef Stoup, and Blackberries

low-carb diet, paleobetic diet, diabetic diet

Dinner time!

Since I give you the nutritional analysis below, you can fit this meal into the Low-Carb Mediterranean Diet, Ketogenic Mediterranean Diet, or Paleobetic Diet.

The entree is a cross between stew and soup; stoup, if you will.

Ingredients:

2 lb (0.9 kg) stew meat, lean, bite-sized chunks (tenderized by the butcher if able)

1 garlic clove, finely minced

6 sprigs cilantro, de-stemmed, whole leaves

2 oz (58 g) sweet onion, diced (1/2 of a small onion)

1/4 of a medium-size green bell pepper, de-seeded, diced (medium bell pepper weighs about 5.5 oz or 155 g)

8 oz (227 g) canned tomato sauce

2.5 cups (590 ml) water

1.25 tsp (6.2 ml) table salt

freshly ground black pepper to taste (1/4 tsp or 1.2 ml?)

16 oz (454 g) fresh raw asparagus, no larger in diameter than your little finger, with any dry or woody stalk cut off and discarded

1.5 tbsp extra virgin olive oil

7.5 oz (213 g) raw blackberries

Instructions:

Stoup first. In a frying pan or electric skillet, place the stew meat, cilantro, garlic, bell pepper, onion, and cook over medium heat (350º F or 177º C) until the meat is done. Then add the tomato sauce, two cups of the water, one tsp of the salt, and pepper to taste. Simmer for two hours, then add a half cup water to replace evaporation loss.

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Cooking stew meat. NOTE: this is double the amount the recipe calls for.

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Meat is done and the “gravy” has magically appeared

low-carb diet, diabetic diet, paleobetic diet

Appearance after addition of the tomato sauce and 2 cups (480 ml) water

Now the asparagus. Preheat oven to 400º F or 204º C. Place asparagus on a cooking sheet covered with foil, brush the asparagus with the olive oil, then lightly salt (1/4 tsp?) and pepper to taste. (If you don’t mind cleaning up, just use a baking dish without the foil.) Roast in oven for 8–15 minutes; thicker asparagus takes longer. It’s hard to tell when it’s done just by looking; if it’s still hard, it’s not done. Click for another post I wrote on cooking asparagus and brussels sprouts.

paleobetic diet, low-carb diet, diabetic diet

Asparagus roasted at 400 degrees F for 12 minutes

Enjoy the berries for desert.

low-carb diet, diabetic diet, paleobetic diet

2.5 oz or 1/2 cup of blackberries

Servings: 3 [one serving is 1.5 cups (355 ml) of soup, a third of the asparagus (5 oz (140 g), and 2.5 oz (70 g) berries]

Nutritional Analysis:

40 % fat

12 % carbohydrate

48 % protein

590 calories

19 g carbohydrate

8.5 g fiber

10.5 g digestible carb

1,557 mg sodium

1,778 mg potassium

Prominent features: Rich in protein, B6, B12, copper, iron, niacin, phosphorus, selenium, and zinc

low-carb diet, paleobetic diet, diabetic diet

The fresh cilantro is a nice touch

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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 Recipe: Turkey Tomato Bowl plus Macadamia Nuts

paleobetic diet, low-carb

Not enough tomatoes here to spike your blood sugar

With the high price of hamburger and steak, we’re eating more turkey at the Parker Compound. This is what I did with some of our leftover Thanksgiving turkey last year. If you don’t have leftover turkey, I bet leftover chicken or steak would be  fine substitutes. I’m tempted to try it with salmon or canned tuna or chicken. In addition to the flavor, what I like about this meal is that it’s crazy quick. You can easily work this meal into the Low-Carb Mediterranean Diet or Ketogenic Mediterranean Diet.

Ingredients:

6 oz (170 g) cooked turkey chunks, light meat (or 8 oz (225 g) if you’re starting raw and planning to cook it)

5 oz (140 g) raw tomato (2 small roma tomatoes, for example), cut into chunks

2 tbsp (30 ml) balsamic vinaigrette

black pepper to taste

1 oz (30 g) roasted macadamia nuts

paleobetic diet, low-carb, diabetes, diabetic diet, paleo diet

These roma tomatoes were amazingly flavorful for late Fall in the northern hemisphere. Before cooking, my wife injected the bird with olive oil, massaged periodically over 30 minutes, then popped it in the oven.

Instructions:

Toss the turkey and tomato chunks in a bowl, splash on the vinaigrette, then microwave for 60-80 seconds. Pepper as desired. Drink the leftover juice right out of the bowl. Enjoy with macadamia nuts for dessert and you’ve got a full meal.

Discussion:

paleobetic diet, low-carb, diabetes, diabetic diet

Grok wouldn’t have access to this

I was lazy when I made this so I just used a commercial salad dressing rather than making my own vinaigrette. I like the flavor of Wish-Bone Balsamic Vinaigrette Dressing “with extra virgin olive oil.” Here are the top ingredients, in order: water, balsamic vinegar, soybean oil and extra virgin olive oil (sic), sugar, salt, spices, etc. So the oil could have been soybean oil with one drop of EVOO for all I know. Olive oil is a rich source of monounsaturated fatty acid, so you might be able to calculate how much EVOO was in the dressing if I tell you there were five grams of fat per two tbsp (30 ml) serving, of which 1.5 grams were monounsaturated. That serving also has three grams of carbohydrate (all sugar) and only 60 calories. Right there on the bottle is says” gluten-free” and “no high fructose corn syrup.” I bet it had HFCS in it three years ago and there would be no mention of the trendy “gluten-free.”

I don’t know any home cooks who add water to vinaigrettes. They are essentially oil and vinegar (in a ratio of 3:1) and spices. The ones I make have quite a bit more than 60 calories per two tbsp (30 ml); more like 220 cals. All of the oils you would use have about 120 calories per tbsp, all from fat. If you make this recipe with home-made vinaigrette, add 150 calories to the nutritional analysis below. It won’t affect the carb count.

Note that of the common vinegars, balsamic has the most carbohydrates—some vinegars have zero. If you use typical amounts of balsamic vinaigrette, you shouldn’t need to worry about the carbohydrates unless perhaps you’re on a strict ketogenic diet and limited to 20-30 grams of carb daily.

Servings: 1

Nutritional Analysis:

58% fat

7% carbohydrate

35% protein

620 calories

11.5 g carbohydrate

3.7 g fiber

8 g digestible carbohydrate

743 mg sodium

877 mg potassium

Prominent features: High in protein, vitamin B6, iron, manganese, niacin, phosphorus, selenium, and zinc.

paleobetic diet, low-carb, diabetic diet, paleo diet

Bonus pic! A horse at the Parker Compound, an old-style Morgan. I call him Java but his formal name’s Espresso.

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Recipe: Steak, Avocado, Olives, and Tomato

Paleobetic diet

I ate mine for breakfast. Who needs bagels, cereal, and donuts?

This meal has only 8 grams of digestible carbohydrate so it works in both the Ketogenic Mediterranean Diet and Low-Carb Mediterranean Diet. It was super-easy to put together because I used leftover steak. But I’ll assume you’re cooking your steak fresh. We bought ours as thinly sliced round steak, about a 1/4-inch thick (0.6 cm). Some places refer to this as a “minute steak” because it cooks so quickly. Minute steak also refers to a piece of beef, usually the round, that’s been pounded flat, about a 1/4-inch thick. Even if you start with raw meat, you can prepare today’s recipe in 10 minutes.

Paleobetic diet

It tastes as good as it looks

Ingredients:

4 oz (113 g) cooked thin round steak (start with 5 oz raw)

1 California (Hass) avocado, standard size (4.5 oz or 127 g), peeled, pitted, and chunked

14 black olives, pitted, medium size (Purist alert: probably highly processed)

1 tomato, medium-size (medium size or 2.5-inch diameter (6,4 cm), or a large roma tomato), cut into wedges

Salt and pepper to taste, or use commercial steak seasoning such as Montreal Steak Seasoning by McCormick (a favorite at the Parker Compound)

Instructions:

Sprinkle your steak with seasoning then cook over medium or medium-high heat in a skillet, about a minute on each side. Or heat your leftover steak in the microwave. If you overcook, it will be tough.

Place all ingredients artfully on a plate and enjoy.

Servings: 1

Nutritional Analysis (via Fitday):

60% fat

12% carbohydrate

28% protein

600 calories

20 g carbohydrate

12 g fiber

8 g digestible carbohydrate

587 mg sodium

1530 mg potassium

Prominent features: Lots of protein, vitamin B6, vitamin B12, copper, iron, niacin, pantothenic acid, phosphorus, selenium, and zinc

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Recipe: Eggs, Bacon, and Honeydew Melon

 

Bacon, eggs, black coffee, and Cholula hot sauce. A caveman wouldn't recognized any of this except for eggs.
Bacon, eggs, black coffee, and Cholula hot sauce

If you follow nutrition science literature, you’ll see periodic references to “processed meats” like bacon contributing to increased risk of cardiovascular disease, cancer, or premature death. I think the associations are pretty weak. Health-conscious cautious people aren’t going to go hog-wild on processed meats. I don’t. We may never have a definitive science-based resolution of the issue.

If you want to control the degree of processing in your bacon, make your own. The recipe at the link includes pink salt (sodium nitrite), maple syrup, and dark brown sugar. Many other recipes are available. My understanding is that sodium nitrite is a preservative and gives bacon meat that pink color. (Does it contribute to flavor?) If you’re not storing your bacon for a long time, you may not need the pink salt.

In any case, I thoroughly enjoyed three strips of bacon with my eggs recently. Mine was the Kirkland brand from Costco was $3.80/pound (USD). Two slices provide 80 calories (uncooked) and zero grams of carb although, if I recall correctly, it was honey-cured bacon.

Ingredients:

3 large eggs

3 strips of bacon, standard thin slices

Salt and pepper to taste

1/2 cup raw honeydew melon, cubed

Instructions:

Fry the bacon over medium or medium-high heat. If there’s too much grease leftover in the pan after cooking, poor out what you don’t want, for later use or drizzle over your dog’s dry kibble food. Leave a little grease in the pan so your eggs don’t stick. Then fry your eggs over medium heat. Enjoy with raw honeydew, which will cleanse your palate after eating bacon.

You can pay a lot more than $3.80 a pound for bacon
You can pay a lot more than $3.80 a pound for bacon

Servings: One

Nutritional Analysis per Serving: (from FitDay.com)

63 % fat

10 % carbohydrate

26 % protein

319 calories

9 carb grams

1 fiber grams

8 digestible carb grams

845 mg sodium

423 mg potassium

Prominent features: high in B12, riboflavin, selenium, protein, pantothenic acid, and phosphorus. Although this is low in calories, it’s adequately satiating because of the rich protein and fat content. The calorie count will be higher by 50 if you eat all the bacon grease.

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