Tag Archives: ketogenic mediterranean diet

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.

Comments Off on Low-Carb Recipe: Turkey Tomato Bowl plus Macadamia Nuts

Filed under Recipes

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

1 Comment

Filed under Recipes

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.

2 Comments

Filed under Uncategorized

Can You Help a Doc Out?

 

"I may not make wine with all of my grapes, but when I do, it's red wine."

“I may not make wine with all of my grapes, but when I do, it’s red wine.”

A major U.S. women’s magazine is considering doing an article on my Low-Carb Mediterranean Diet. The writer would like to be able to interview folks (by phone) who have done the diet and had success with it. The article is about weight  loss, however, not control of diabetes. Before and after pics would be icing on the cake but are not necessary.

If you’ve read Control Diabetes and Prediabetes: The Low-Carb Mediterrean Diet, or The Advanced Mediterranean Diet (2nd edition), or KMD: Ketogenic Mediterranean Diet, then you’ve seen the Low-Carb Mediterranean Diet. Advanced Mediterranean Diet also has a traditional portion/calorie-controlled diet. Control Diabetes and KMD both start with the ketogenic Mediterranean diet (30 carb grams/day) and than add more carbohydrates as tolerated by the individual, resulting in the Low-Carb Mediterranean Diet. Most folks following the Low-Carb Mediterranean Diet will max out carb consumption at 80-100 grams a day.

I’m terrible at marketing myself and my ideas, so I’ve not kept track of individual success stories from the past.

If you’d be willing to share your success story, please email me with a few of the details at steveparkermd AT gmail.com and I will keep your name on file in case the magazine decides to run with the article. I’ll not divulge your information to anyone else. If you share with me, I’ll assume I have your permission to send your story and e-mail address to the writer.

Thanks for your consideration.

Steve Parker, M.D.

Comments Off on Can You Help a Doc Out?

Filed under Shameless Self-Promotion

Wine May Ward Off Depression

…according to an article in The Guardian. This finding is from the PREDIMED study of Spaniards aged 50 to 88. Those who drank between two and seven glasses of wine per week were less prone to develop depression.

She looks happy!

She looks happy!

Wine is allowed on my Advanced Mediterranean Diet, Conquer Diabetes and Prediabetes plan, and the Ketogenic Mediterranean Diet. Of course, some folks should never drink alcohol.

Steve Parker, M.D.

Comments Off on Wine May Ward Off Depression

Filed under Alcohol

E-mail Interview With a Low-Carb Friendly Dietitian

Conquer Diabetes and Prediabetes, Steve Parker MD

Brain food that won’t spike blood sugars

I received an email from a registered dietitian (FS) in May, 2013. She had some reasonable questions for me and I thought you might be interested in my answers. Here’s her email first:

So funny that you happened to comment on my blog post today because I’d already planned to email you. I’m writing an article on low-carbohydrate diets for Diabetes Self Management magazine and was hoping to ask you a few questions about your experience treating your patients with the Diabetic Mediterranean and Ketogenic diets. We could do it via e-mail if you like. What I’d really like to know is how many of your patients were/are successful in sticking to the diet long term and what type of feedback you’ve received from them, along with any other information you feel is pertinent. Also, what carb range to you recommend for your diabetic patients?

My response:

Dear F,

First, let me explain a little about my medical practice. I’m a full-time hospitalist, meaning I treat adult patients only in the hospital setting. Nearly all of my patients come in through the emergency department. I treat a great variety of problems, like pneumonia, heart failure, cellulitis, pancreatitis, urinary tract infections, headaches, strokes, GI tract bleeding, cholecystitis, altered mental status, out of control diabetes, etc. My training is in Internal Medicine.

By the way, I work in Scottsdale, Arizona, which is a fairly sophisticated and affluent community. My two hospitals employ some dietitians who receptive to very-low-carb eating.

As it turns out, 30% of my hospitalized patients happen to have diabetes, at least 95% of which is type 2. This is typical for non-pediatric hospitalists. Nearly all of these diabetics have an established diagnosis of diabetes and a relationship with an outpatient doctor who is treating it. I usually ask them, “Are you on any special diet, or do you pretty much eat whatever you want?” Half of them say “nothing special; I eat what I want”! Three out of 10 respond that they “avoid sweets and desserts” or something similar. One or two of every 10 report they make a strong effort to reduce carb consumption below the usual American level (250-300 g/day). No more than five of every 100 has ever heard of Dr. Richard Bernstein’s Diabetes Solution. (I consider Dr. B the founder and leader of the modern carbohydrate-restricted diabetes diet movement.) No more than one of every 100 follows Dr. Bernstein’s or a similar very-low-carb or ketogenic diet.

Once these patients leave the hospital, I cannot follow them in a clinic setting. I wish I could. I see many of them in the hospital only once, which is not much time to develop a trusting relationship. Perhaps surprisingly, I don’t often do a “hard sell” for a low-carb diet, even though that’s what I’d follow if I had diabetes of either type. People have to be ready to make a change in hard-wired eating behavior, like an alcoholic is ready to quit drinking only when he’s hit “rock bottom.” For someone with diabetes, that rock bottom point is typically at the time of initial diagnosis or when a major complication hits (such as neuropathy, kidney impairment, or retinopathy). They’re more receptive to change then. All of my hospitalized diabetics get a business card referring them to my Low-Carb Mediterranean Diet website (Diabetic Mediterranean Diet).

Since I have no outpatient clinic, I have no way of knowing how many of them adopt a low-carb way of eating. I do get unsolicited emails from diabetics who have adopted the Low-Carb Mediterranean Diet or Ketogenic Mediterranean Diet, and they report satisfying results with weight management and glucose control. Problem is, as mentioned, I don’t know the denominator. Not once in two years has anyone ever contacted me to report they were harmed by the diets or that they didn’t help at all with glucose control.

I’m convinced you can get good nutrition eating low-carb and very-low-carb. By “low-carb,” I mean under 130 g/day, and “very-low-carb” is under 50 or so. An added benefit for diabetics is that they may be able to avoid the cost and toxicity of some diabetes drugs. We have no long-term toxicity data on most of our diabetes drugs. (Insulin and metform are safe long-term.)

Whether a diabetic goes with Dr. Bernstein’s, my Low-Carb Mediterranean Diet, or Dr. Atkins’ Diabetes Revolution, I think they’re going to be better off over the long run compared to eating a typical “diabetic” diet that has 200+ grams of net carbs. Of course, I have no hard proof. We may never have it. Of those who choose LCMD, I have no data on how many of them actually follow it long-term. Hey, I finally answered one of your questions!

If one of my diabetics prefers to eat Bernstein or Atkins-style over my program, I have no problem with that at all. (The Atkins program recommends some nutritional supplements that I’m not convinced are necessary or even minimally helpful.)

How many diabetics stick with a carb-restricted diet (e.g., under 130 g/day) long-term, more than 2-3 months? My guesstimate is only two or three out of ten. The problem is that we live in a highly carb-centric culture: temptation abounds, we form firm dietary habits in childhood, carbs are cheap, and, frankly, many taste very good.

Incidentally, I don’t have diabetes but I strive to keep my digestible (or net) carbs in the range of 60 to 80 grams/day. The carb restriction helps me control my weight, and I’m seeing some preliminary evidence that it may help with prevention of dementia and mild cognitive impairment.

The long-term carbohydrate intake range I recommend for diabetics is 60-80 g of net or digestible carb daily. Twenty or 30 g/day (a la Bernstein or my Ketogenic Mediterranean Diet) can help overweight diabetics lose the excess fat a little quicker and easier. But 30 d/day over the long run is extremely difficult for all but the most highly motivated. If I had type 1 diabetes, I’d give 30 g/day a serious try, like Dr. Bernstein. Competitive endurance athletes may need more than 100 g/day. Some mild type 2’s may be able to adequately handle over 80 g/day depending on degree of residual pancreas beta cell function. It bothers me to see a type 2 diabetic taking 4-5 diabetes drugs just so they can control diabetes while eating a high-carb diet (e.g., over 200 g/day). Again, we don’t know the long-term effects of most of these drugs.

I’m sorry for being so long-winded! I hope this helps. Email me soon if you have more questions and I’ll respond w/in 24h. Or call me at xxx-xxx-xxxx. Please keep up the good work. In turn, I’ll keep doing my little part to turn around this carb-centric culture. At least until the science dictates otherwise.

Sincerely,

-Steve

9 Comments

Filed under Carbohydrate, ketogenic diet, Mediterranean Diet, Prediabetes

Potential Problems With Major Carbohydrate Restriction

Caprese salad, naturally low-carb

Caprese salad, naturally low-carb

Ketogenic Diets

First, let’s define ketogenic diets.  For most folks, that means eating under 50 grams of digestible carbohydrate daily.

Your body gets nearly all its energy either from fats, or from carbohydrates like glucose and glycogen. In people eating “normally,” 60% of their energy at rest comes from fats. In a ketogenic diet, the carbohydrate content of the diet is so low that the body has to break down even more of its fat to supply energy needed by most tissues. Fat breakdown generates ketone bodies in the bloodstream. Hence, “ketogenic diet.” Also called “very-low-carb diets,” ketogenic diets have been around for over a hundred years.

What Could Go Wrong?

Long-term effects of a very-low-carb or ketogenic diet in most people are unclear—they may have better or worse overall health—we just don’t know for sure yet. Perhaps some people gain a clear benefit, while others—with different metabolisms and genetic make-up—are worse off.

If the diet results in major weight loss that lasts, we may see longer lifespan, less type 2 diabetes, less cancer, less heart disease, less high blood pressure, and fewer of the other obesity-related medical conditions.

Ketogenic diets are generally higher in protein, total fat, saturated fat, and cholesterol than some other diets. Some authorities are concerned this may increase the risk of coronary heart disease and stroke; the latest evidence indicates otherwise.

Some authorities worry that ketogenic diets have the potential to cause kidney stones, osteoporosis (thin, brittle bones), gout, and may worsen existing kidney disease. Others disagree.

Soon after adoption of very-low-carb eating, dieters may have headaches, bad breath, easy bruising, nausea, fatigue, aching, muscle cramps, constipation, and dizziness, among other symptoms. “Induction flu” may occur around days two through five, consisting of achiness, easy fatigue, and low energy. It clears up after a few days.

Very-low-carb ketogenic diets may have the potential to cause  low blood pressure, high uric acid in the blood, excessive loss of sodium and potassium in the urine, worsening of kidney disease, deficiency of calcium and vitamins A, B, C, and D, among other adverse effects.

Athletic individuals who perform vigorous exercise should expect a deterioration in performance levels during the first three to four weeks of any ketogenic very-low-carb diet. The body needs that time to adjust to burning mostly fat for fuel rather than carbohydrate.

Competitive weight-lifters or other anaerobic athletes (e.g., sprinters) will be hampered by the low muscle glycogen stores that accompany ketogenic diets. They need more carbohydrates.

What About Adherence to the Diet?

It’s clear that for many folks, compliance with very-low-carb diets is difficult to maintain for six to 12 months.  Some can’t do it for more than a couple weeks. Potential long-term effects, therefore, haven’t come into play for most users. When used for weight loss, regain of lost weight is a problem—but regain is a major issue with all weight-loss programs. I anticipate that the majority of non-diabetics who try a ketogenic diet will stay on it for only one to six months. After that, more carbohydrates can be added to gain the potential long-term benefits of additional fruits and vegetables, legumes, and whole grains.

Or not.

People with type 2 diabetes or prediabetes may be so pleased with the metabolic effects of the ketogenic diet that they’ll stay on it long-term.

The most famous ketogenic diet is Dr. Atkins New Diet Revolution.  I’ve put together one call the Ketogenic Mediterranean Diet.

Steve Parker, M.D.

1 Comment

Filed under Carbohydrate, ketogenic diet