You Want To Know!
As a member of the LCDA, you should be proud knowing you are taking a proactive lead in healing the prediabetes or diabetes of yourself or a loved one or a patient. And, you have come to the right organization. By learning about The Eight Essentials, and how to bring positive changes to your diet, lifestyle, supplementation, you will learn information that may help you reverse prediabetes and can help you to reverse or control diabetes.
New Expert Interviews!
The low carb diet is the foundation diet for people who have prediabetes or diabetes. The LCDA promotes a nutritional, fun, tasty way to implement the diet.
The Low Carb Ketogenic Diet
I think it is apparent that the LCDA non-profit advocates eating low carb for prevention and treatment of diabetes!
A low carb diet can present itself in four main ways:
- The low carb omnivore diet–whereby people eat in a way that mimics how they normally ate, but remove grains and other high carb foods. Making “fake” grains via nut flours, coconut flour, cauliflower, oopsie bread are common and all proteins that are allowed on a low carb diet are eaten.
- The low carb vegetarian diet–on this diet people limit their protein intake to nuts, soybean, eggs and dairy products.
- The low glycemic vegan diet–on this diet, people only eat soybean and nuts products for protein.
- The low carb ketogenic diet–the lowest in carbohydrates, and the highest in fat, this diet is designed to get people’s body running on ketone bodies. It is also called a low carb high fat (LCHF) diet.
Let’s talk about a ketogenic diet more.
Ketogenic diets were created historically in the 1920s to treat epileptic patients. It is still used for that condition today, especially in children for whom medications are not very effective. Ketogenic diets are also used for chronic migraineurs, and may help patients with brain cancers, dementia or Alzheimer’s, or other central brain diseases, such as Parkinsons.
How do you eat a ketogenic diet?
A ketogenic diet involves a severe restriction of carbohydrates, usually less than 20 grams a day, and substituting in a great deal of (healthy) fats. The diet macronutrient ratios are typically along these lines: Fat intake can be from 60-75% of calories, protein can be 20-35% of calories, depending on how a person chooses to employ the diet, and carbohydrates are 5% of calories. This shifts your body’s metabolism, so that it uses the fat to produce energy. Fat is broken down by the liver and is turned into ketone bodies. The entire body, including the brain, can use ketone bodies for efficient fuel. This allows insulin levels to fall very low, reducing resistance problems, as insulin is not needed for the energy to utilize fat, only for the body to utilize carbohydrates.
When a body is living and working off of ketones it is said to be in ketosis. Fasting is another method of entering into ketosis, but it is impossible to live life and be active while continually fasting! The Ketogenic diet allows for eating while being in the same state.
Ketosis is not the same as ketoacidosis. Ketosis is a healthy way to eat, and ketoacidosis is a complicated scenario where many factors are occurring in a T1DM or insulin dependent T2DM patient: High blood sugar, low insulin levels (which produce ketone bodies) and dehydration are the key problems. Do not confuse the two terms; they are really not related even though ketone bodies are a part of both of them.
There are three main ketone bodies that are produced: acetoacetate, beta-hydroxbutyrate, and acetone. A safe range of ketones in the blood is 0.5-3.0 mmol/l These can be tested via a ketone blood meter, but although a ketone blood meter is not expensive, the test strips are, up to $5 a test strip so this is cost prohibitive for most people. Two Ketone blood meters are NovoMax Plus and Precision Extra.
Another method of measuring ketones is through the urine, but that only measure acetoacetate, not the other ones and the blood is usually higher than the urine. Also, the urine gives a reading that is usually hours away from what is happening at the moment. Positive ketone are a purple color on the urine test strips. Ketostix and Uriscan are two brands.
Foods you can eat on a ketogenic diet:
- Proteins: Grass fed/finished/pasteurized organic meat and poultry (meat and organs); wild-caught fish and seafood; Organic eggs; full-fat dairy (cheese, cream); protein powders; nuts and seeds (generally avoiding cashews, chestnuts, pistachios); organic edamame
- Fats (organic, unrefined): lard, tallow, poultry fat, butter, coconut oils, olive, avocado and macadamia nut oils, red palm oil, peanut oil, walnut oil, flax oil.
- Vegetables: leafy greens, cruciferous vegetables, asparagus, cucumber, summer squash, bamboo shoots, eggplant, bell peppers, onion, leek, garlic, mushrooms, pumpkin, sugar snap peas, water chestnuts, rhubarb
- Fruit: Avocado, berries, coconut, olives
- Beverages: water, coffee, teas; dry red or white wine, straight liquor.
- Condiments: Mayonnaise, mustard, pesto, bone broth, pickles, fermented foods
- All spices and herbs, lemon or lime juice
- Sweeteners: pure stevia, xylitol, Swerve, (no carbs at all).
- Thickeners: arrowroot powder, xanthum gum, cocoa and carob powder
Foods you must avoid on a ketogenic diet:
- All grains
- Poor quality animal products
- Other fruits
- Sweetened alcohol drinks or beer
- Other dairy products
Here is a good Keto Diet Food Pyramid with all credit due to this very helpful keto diet informational website: https://ketodietapp.com/Blog/image.axd?picture=/2015/11/KetogenicFoodPyramid_highres.jpg
A couple of typical days’ ketogenic diet on a might look like this:
Day 1: 2 eggs sauted in 1 TSBP butter, cooked with 1 oz onion, with 4 slices of cooked bacon covered with 2TBSP heavy cream.
Day 2: 3 oz cooked pork breakfast sausage, 1 hard boiled egg, 2 TBSP whipped cream cheese, tea or coffee with heavy cream.
Day 1: 3 or 4 oz of chicken breast on 3 cups of mixed salad greens plus 1 celery stalk; add 2 TBSP olive oil and 2 TSBP ranch dressing.
Day 2: 4 oz baked fish with dill butter sauce, 1 cup of cauliflower sauted in butter, 1 cup of salad greens sprinkled with blue cheese and with 1-2TBSP of full fat dressing.
Day 1: 4-6 oz ribeye steak, 1 cup of raw mushrooms, topped with2 TBSP butter and 2 TBSP heavy cream, 1 cup broccoli.
Day 2: 6 oz salmon, 2 cups shredded cabbage sauted in butter, salad greens with full fat dressing, tea with heavy cream.
There are common themes to the meals: a lot of animal protein, a lot of fat, and some healthy vegetables.
Starting a ketogenic diet is asking your body to switch it’s energy making capacity to a whole new biochemical pathway. It can take weeks to even months in some to get adapted to the new diet, so have some patience. There may be some negative symptoms during that time, such as irritability, headaches, bad breath, poor concentration, and lack of energy.
Once adapted, though, weight loss can occur easily if required; there are numerous studies showing a low carb high fat diet is very efficient at losing weight. Enough weight can be lost that T2DM can be reversed.
Once a person is adapted to the diet, physical energy and endurance can be noticeably enhanced. Of course, this is most pronounced if you are doing endurance activities, such as long hikes or running. The fat is burned steadily and does not run out, as carbohydrates can, so performance can be maximized. In the ketogenic world, though, many discuss the need for electrolytes to boost your capacity to exercise on this strict low carb diet. Adding LoSalt Original (no iodine) to water is a great way to get electrolytes into your body and may really help your performance. Ask your own medical practitioner what to take but it is common to add 1 full teaspoon to two liters of water, such as in a Camelpak. You may need more or less and your medical practitioner can help guide that dosing.
Problems with a ketogenic diet can arise. Adverse reactions are noted in the scientific literature. First, it is a hard diet to commit to for many people, and many will not be able to follow it long-term. In studies people have developed gastrointestinal problems (diarrhea, constipation, reflux disease, nausea and vomiting), increased inflammation, hair loss, kidney stones, muscle cramps and weakness, problems with mood and concentration, nutrient deficiency, negative changes in the intestinal microbiome, bone loss and fracture, acute pancreatitis, heart arrhythmias, menstrual changes and amenorrhea, and, unfortunately, death. Note bene: Death occurred in children on the ketogenic diet usually being treated for epilepsy. This may or may not reflect concerns in T1DM children and the ketogenic diet. Studies showing death occurred can be found in this article here: https://www.thepaleomom.com/adverse-reactions-to-ketogenic-diets-caution-advised/
However, there are many people today doing the ketogenic diet, and doing it well and safely.
The LCDA recommends all people on a low carb diet, no matter the type, add in fiber powder, to feed the bacteria making up the intestinal microbiome. These bacteria ferment fiber into short chain fatty acids, which are the food for the colon cells. They are also anti-inflammatory, and may enhance glucose regulation in diabetes, including promoting weight loss.
In summary, the LCDA advocates eating a low carb diet for prevention and treatment of diabetes. However, it does not advocate one particular low carb diet over another. Your integrative medical practitioner should clearly present to you what each of the four main low carb diet entails, and then, help you choose the best and safest diet that will fit your life, your socializing, and your overall medical needs.
Medical Article #2: Alcohol and Diabetes
One of biggest nutritional misunderstandings found by Dr. Morstein with her patients is regarding alcohol intake, blood sugar and diabetes.
It is generally believe by people that drinking alcohol will raise their blood sugar, because alcohol breaks down to glucose. This is, gently, incorrect!
Alcohol biochemically does not metabolize in the body into glucose; instead, in your liver, most ingested alcohol is broken down by the enzyme alcohol dehydrogenase into acetaldehyde. Another enzyme, aldehyde dehydrogenase, then very quickly converts the acetaldehyde into acetate. Acetate is further changed into carbon dioxide and water for excretion. There is no glucose formed anywhere in any of those pathways!
On top of that, alcohol has an inhibitory effect on gluconeogenesis. Gluconeogenesis is the liver’s ability to create glucose from non-carbohydrate substances, such as amino acids (alanine and glutamine), triglycerides, and lactate. In-between meals, the liver maintains a status quo glucose secretion into the bloodstream by means of gluconeogenesis. Alcohol inhibits this pathway.
What does this mean to a diabetic patient? In general, if a diabetic patient has a little alcohol with supper, he or she may indeed wake up with a lower glucose number than if alcohol has not been ingested. This may be a problem for people on a tightly regulated insulin dosing schedule, as a low may occur, but for others it is not a significant drop in glucose, but oftentimes a noticeable one.
So, does this mean that alcohol is a “free for all” for T2DM and T1DM patients? No….Here are some common sense guidelines related to alcohol and diabetes:
- Alcohol can lower glucose levels. Pay attention to that, especially if you are on insulin.
- Alcohol has calories! A 5 oz glass of wine has around 125 calories, a bottle of beer around 150 calories, and a shot of liquor around 100 calories. For a lean T1DM that may not be a problem; however, for a T2DM patient where weight loss is required, a glass of wine five nights a week is 625 extra calories that have to be burned off on top of food eaten. That can add up quickly!
- Alcolism: For woman, drinking more than 1 serving of alcohol a night, or seven a week and for men, drinking more than 2 servings of alcohol a night, or 14 a week, is a clinical definition of alcoholism. If your levels are near or exceeding those, seeking treatment is an immediate need.
- Fatty liver: Around 80% of obese and nearly 100% of morbidly obese people have fatty liver, which means their liver has too much fat stored in it. This is the most common liver condition in the United States, and can cause a great deal of inflammation in the liver cells. Fatty liver can, over time, lead to a type of hepatitis, fibrosis, cirrhosis and liver failure and cancer, negative consequences also of alcoholism and Hepatitis C. Alcohol is completely contra-indicated in a patient with fatty liver, because if the liver has any inflammation, adding alcohol to it can seriously speed up the development of further liver damage.
So, alcohol does not raise glucose, and can be ingested by people with diabetes, unless they are contra-indicated by alcoholism, fatty liver or the need for weight loss. If you wish to drink now and then, discuss alcohol with your comprehensive integrative physician and get individual guidance on doing so.
Acceptable Oral Fixations!
Everyone at some moment wishes to have a little something in their mouth, oftentimes a little sweet something, perhaps when working during the middle of the day, or after supper, or when trying to change a negative habit, like stopping smoking.
What is a good oral fixation for a low carb pre diabetic or diabetic to enjoy? Here are some recommendations:
1. Dr. John’s Kosher Sucking Candies | http://drjohns.com – These candies are made with xylitol and there are different flavors to choose from. The LCDA recommends the Kosher version of candies as they have natural flavors/colors vs. the synthetic ones in the non-kosher varieties. For a good tasting sucking candy (or two) to enjoy this a good company to consider. Try the Sun-Kissed Fruits collection.
2. Spry gum and sucking candies | http://www.xlear.com/spry-dental-defense/xylitol-products/adults/natural-chewing-gum/# – Spry products are advertised as being part of a dental defense plan. This is because xylitol is anti-bacterial against strep mutans, which is the primary bacteria in the mouth associated with causing cavities. Any product with xylitol in it is associated with reduced cavity formation, and reduced incidence of ear infections and sinus infections. If you cannot brush your teeth after eating, using a pick to clean your teeth and sucking on a xylitol candy is a good alternative for teeth protection.
3. Nicks Sticks | http://nicks-sticks.com – For a little extra food that will have little impact on glucose levels, Nicks-sticks jerkies are a great idea. They are omega-3 organic grass fed/finished beef and turkey products with only organic spices added. No soy, no sugar, nothing else. Comes regular or spicy. These very pure meat products are great to travel with, in case you wind up stuck on a plane or in a long layover.
4. Pur Gum | http://thepurecompany.com – Pur gum is a very clean gum that tastes very good, although it doesn’t last exceedingly long. There are eight flavors (and Dr. Morstein recommends the mint pomegranate!). For another time when it would be good to chew some gum, and you want to avoid aspartame, soy lecithin and other problematic aspects of typical gums, Pur is a good way to go.
5. Ice Chips Candy | http://www.icechipscandy.com/buy-ice-chips-candy – Also sweetened with xylitol, Ice Chips are a nice candy that has a fresh taste to it. Like the other candies they are GMO free, and free of gluten, dairy, soy, sugar and corn.
6. Lemonade: A quick recipe of lemonade is a great way to deal with a sweet tooth. Fill a liter bottle up with water, but leave enough space to add in some lemon juice, preferably freshly cut up lemons, but processed lemon juice is also acceptable. Add in your favorite sweetener from pure stevia, monk fruit, inulin (chicory), xylitol, or a combination product like Swerve or Truvia, and you’ve got a refreshing drink that’s healthy. Lemons are great to help flush the liver!
What is better than Coconut Oil For Health? Medium Chain Triglcyerides!
KetoMCT C8 MCT oil is available on Amazon, other buying sites, and at KetoMCT.com for a price of about $39.00 per 32 oz bottle (2 mo supply at 1 tbsp/d), with free shipping on orders over $39.00.
At KetoMCT.com, we offer 10% off on 3-packs and 15% off on 6-packs. Minimum whole sale pricing starts at 30 bottles. Please contact us at https://ketomct.com/pages/contact-us to discuss your volume needs and other requirements. Products are available internationally on eBay.
Ketogenic Diet Books:
- “The Complete Ketogenic Diet for Beginners: Your Essential Guide to Living the Keto Lifestyle” by Amy Ramos
- “30 Keto Meals in Under 30 Minutes: A Ketogenic Cookbook Filled With 40+ Quick and Easy Recipes” by Louise Hendon.
Recipe #1 | Zuccini Lasagna (adapted to full fat foods)
* 1 lb 93% lean ground beef
* 1.5 teaspoons kosher salt
* 1 teaspoon olive oil
* 1/2 large onion, chopped
* 3 cloves garlic, minced
* 1 28 oz can crushed tomatoes
* 2 TBSP chopped fresh basil
* black pepper, to taste
* 3 medium, 8 oz each, zucchini, slices 1/8th thick using mandolini
* 1.5 cups ricotta
* 1/4 cup Parmesan cheese
* 1 large egg
* 16 oz/4 cups shredded full fat mozzarella cheese.
1. In a medium sauce pan, brown meat and season with salt. When cooked drain in colander to remove any fat.
2. Add olive oil to the pan and saute garlic and onions about 2 minutes. Return the meat to the pan, add tomatoes, basil, salt and pepper. Simmer on low for at least 30-40minutes, covered. Do not add extra water, the sauce should be thick.
3. Meanwhile, slice zucchini into 1/8″ thick slices, add lightly salt and set aside or 10 minutes. Zucchini has a lot of water when cooked, salting it takes out a lot of moisture. After 10 minutes, blot excess moisture with a paper towel.
4. Preheat a gas grill to medium high, and grill 2 to 3 minutes per side, until slightly browned. Place on paper towels to soak any excess moisture.5. 5. Preheat oven to 375°.
6. In a medium bowl mix ricotta cheese, parmesan cheese and egg. Stir well.
7. In a 9×12 casserole spread 1/2 cup of sauce on the bottom and layer the zucchini to cover. Spread 1/2 cup of the ricotta cheese mixture, then top with 1 cup of the mozzarella cheese and repeat the process until all your ingredients are used up. The last layer top with remaining zucchini and sauce, cover with foil and bake 30 minutes.
8. Uncover the foil and bake 20
1. minutes (to dry up the sauce) then place the remaining 1 cup mozzarella and bake until melted, 10 minutes.
2. 9. Let stand about 5 – 10 minutes before serving.
Yield: 8 servings, Serving Size: 1/8
* Amount Per Serving:
* Smart Points: 9
* Points +: 9
* Calories: 275
* Total Fat: 13g
* Saturated Fat: 7g
* Cholesterol: 84mg
* Sodium: 648mg
* Carbohydrates: 13g
* Fiber: 2.5g
* Sugar: 5g
* Protein: 26g
Recipe #2 | Oopsie Bread Lasagna
For the noodles
* 2 large eggs
* 4 oz cream cheese, softened
* 1/4 cup parmesan cheese, grated
* 1 1/4 cup mozzarella cheese, shredded
* 1/4 tsp Italian seasoning
* 1/4 garlic powder
* 1/4 onion powder
For the Filling
* 1 lb ground beef
* 1.5 cups three cheese marinara sauce (see below for recipe)
* 3/4 cup mozzarella cheese, shredded
* 6 TSBP ricotta cheese
* 1 TBSP minced onion flakes
* 1 tsp dried oregano
* 1 tsp dried basil
* 1 tsp Italian seasoning
Three cheese Marinara Sauce:
* 28 oz can crushed tomatoes
* 6 oz can tomato paste
* 1.5 tsp dried basil
* 1 tsp dried parsley
* 1/2 tsp garlic powder, onion powder, and sea salt
* 1/4 tsp crushed red pepper flakes
* 1/4 cup each of parmesan cheese, romano cheese and mozzarella cheese, shredded
1. In a large sauce pan, over low heat, combine crushed tomatoes, tomato paste, garlic, basil, onion powder, sea salt, and crushed red pepper flakes. Simmer for 15 minutes, stirring frequently.
2. Stir in the three cheeses, and continue stirring until they are melted and well incorporated.
For the “Noodles”
1. This part will take the longest, so feel free to make the “noodles” the night before and just leave them in the fridge until you are ready for them.
2. Preheat oven to 375° Line a 9×13 baking dish with parchment paper.
3. In a large mixing bowl, using a hand mixer, cream together cream cheese and eggs.
4. Next, add Parmesan cheese, Italian seasoning, garlic powder, and onion powder. Mix until all ingredients are well combined.
5. Using a rubber spatula, fold in mozzarella cheese and mix until well incorporated.
6. Spread the mixture into the baking dish, forming a nice even layer.
7. Bake on the middle rack for 20-25 minutes. 8. When the “noodles” are done baking, cool in the fridge for about 20 minutes and then cut into thirds. This makes three perfectly sized “noodle” layers for an 8.5 X 4.5 X 2.5 loaf pan.
For The filling:
1. In a large skillet over medium-high heat, combine ground beef, minced onion, oregano, garlic powder, dried basil and a pinch of salt. Cook until the meat is browned.
2. Drain excess fat from pan and add ¾ cup marinara sauce to meat. Reduce heat to low and simmer for 10 minutes.
Putting it all together:
1. Pour ¼ cup marinara sauce into bottom of loaf pan. Top with the first “noodle” layer
2. Layer a third of the ground beef mixture. Top with ¼ cup mozzarella cheese and 3 tbsp ricotta cheese, and cover with another “noodle” layer. Repeat these steps.
3. Cover the top “noodle” layer with remaining ground beef, and mozzarella cheese. Sprinkle Italian seasoning over top. Bake for 20 minutes.
Calories: 486 kcal
Fat: 34 grams
Protein: 57 grams
Carbs: 9.5 grams