The Diabetes Diet
Richard K. Bernstein, MD, FACE, FACN, FACCWS
Part 5 of Chapter 5
Customizing the Diet
“Fast-acting, concentrated carbohydrate is the ultimate heart-attack food, particularly for those with a sedentary lifestyle.”
CREATING YOUR OWN MEAL PLANS
Most people are creatures of habit and tend to eat the same thing every day for breakfast or lunch. I’ve had patients who have eaten the same toasted bialy for twenty years for breakfast, the same ham and cheese sandwich for lunch. In my experience, most of the variation people have in their diet comes at dinner. But let’s start with breakfast. In my experience, bacon-and-egg people tend to eat bacon and eggs almost every day, maybe varying somewhat on weekends. Cereal people tend to eat cereal every day, even if they happen to change brands or flavors. Same with bagel people.
One of the problems with most of the popular lowcarb diets on the market these days is that they introduce “habits” you would never take up on your own and then, just as you get used to them, move on to a new phase with different foods. So during phase one you might have vegetable juice, a protein food like liquid egg substitute or Canadian bacon, and coffee or tea. But most of the popular diets change to phase two after weight loss has been attained. This usually involves reverting to an approximation of old habits, such as those in the first paragraph. This is certainly not a way to keep blood sugars normal or to prevent recurrence of carbohydrate craving.
Right off the top, you know that I wouldn’t recommend skim milk or vegetable juice, and I would recommend liquid egg substitute only if that was something you liked.
So, what do you like to eat?
There was a time in the American consciousness when fixing a meal was as simple as putting together a serving of protein, one of starch, and one of vegetables, with perhaps a side of salad and a small dessert. That standard menu —a piece of meat next to mashed potatoes, green beans, and tossed salad — made meal planning a simple proposition.
What I’m advocating is really as easy to conceive as the old meat, potatoes, vegetable, salad picture — just leave out the potato.
While the columns of numbers in the typical meal plans that follow may seem a little intimidating at first, in truth, once you become accustomed to the guidelines, putting together a meal — without having to consult a cookbook for every meal — becomes a simple process.
I recommend eating breakfast every day, especially if you’re overweight. In my experience, most obese people have a history of either skipping or eating very little breakfast. They get hungry later in the day and overeat. That’s a habit you should try to change right away. For most of us, any meal can be skipped, but if you’re using blood sugar–lowering medication, you have to take that into account.
A typical breakfast on our meal plan would include up to 6 grams carbohydrate and an amount of protein to be determined by you. The amount of protein you “negotiate” per meal will remain constant from day to day. The best place to start is with what you currently eat, as long as it’s not on the No-No list (see pages 58–61).
Suppose that, like many of my new patients, you’ve been eating a bagel loaded with cream cheese and 2 cups of coffee with skim milk and Sweet’n Low powdered sweet-ener for breakfast (totaling about 40 grams of rapid-acting carbohydrates). As we negotiate, I might propose that you substitute other sweeteners for the Sweet’n Low and 1 ounce WestSoy soymilk (0.5 gram carbohydrate) or cream (1 gram carbohydrate) for the skim milk in each cup of coffee.
Instead of a bagel I’d suggest you try one Bran-a-Crisp cracker (4 grams carbohydrate) with 1 ounce of cream cheese (1 gram carbohydrate plus 1 ounce protein). This adds up to about 6 grams of carbohydrate. Finally, I’d suggest that you add a protein food to your meal to make up for the calories and “filling power” that disappeared with the bagel. This could take almost any form, from lox to ham to a hotdog — or two. (See the lists on page 116.)
If you’re a bacon-and-egg person but have been eating a side order of two slices of toast with jelly, I’d ask what it would take to make you feel satisfied after giving up the toast and jelly. You might add one Bran-a-Crisp cracker or a cheese puff (page 172) instead.
Or you might want to make the Quick Breakfast Omelet (page 164) with three eggs instead of two, which would give you about 4 grams of carbohydrate (to which you could add some scallions or chives or herbs), instead of eating one of the carbohydrate foods mentioned above.
If you’re unnecessarily afraid of the cholesterol in egg yolks, you might use organic eggs or egg whites. If you find egg whites bland, you could add spices, or soy or Tabasco sauce, or some mushrooms or a small amount of onion or cheese, or chili powder, or even cinnamon with stevia, to enhance the taste. One of my current personal favorites for flavoring is a “chili sauce” made from Better Than Bouillon chili base, which is in the Low-Carb Chili recipe on page 218, and which you can get in most supermarkets. This packs a nice chili punch with very little carbohydrate (according to the label, 1 gram of carbohydrate per 2 teaspoons) and works quite well on eggs or other foods, depending on your tastes. (I like to make chili burgers with it — which you could certainly have for breakfast or any other meal.)
We would like to thank the publisher Little Brown and Company and Dr. Richard K. Bernstein, for allowing us to provide excerpts from The Diabetes Diet.
Copyright © 2005 by Richard K. Bernstein, M.D. All rights reserved. No part of this book may be reproduced in any form or by any electronic or mechanical means, including information storage and retrieval systems, without permission in writing from the publisher, except by a reviewer who may quote brief passages in a review.
This book is not intended as a substitute for professional medical care. The reader should regularly consult a physician for all health-related problems and routine care.
For more information on Dr. Bernstein’s and to purchase his books, CD’s or get access to his free monthly webinars, visit his website at DiabetesBook.com.