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So What’s Low Carb? Chapter 4 – Part 2

The Diabetes Diet
Richard K. Bernstein, MD, FACE, FACN, FACCWS
Part 2 of Chapter 4
So What’s Low Carb?

Meat, Fish, Fowl, Seafood, and Eggs
These foods are usually the major sources of calories in the meal plans of my patients, and they are where you can make most of the adjustments to your own plan so that you feel satisfied. While meat and eggs have until recently been dietary pariahs, my personal observations and recent research implicate carbohydrates rather than dietary fat in the heart disease and abnormal blood lipid profiles of diabetics and even of nondiabetics. If you are frightened of these foods, you can restrict them, but depriving yourself will be unlikely to provide you any health benefit. Egg yolks, by the way, are a major source of the nutrient lutein, which is beneficial to the retina of the eye. Organic eggs contain large amounts of omega-3 fatty acids, which are good for your arteries.
In some of the post-Atkins low-carbohydrate diets, there has been an emphasis on “good” fats. Barry Sears, author of The Zone, is a big proponent of the good-fat theory. I know him, and I’ve tried out his theory with a few of my patients, but I didn’t see it change any part of their lipid profiles.

Tofu, and Soybean Substitutes for Bacon, Sausage,
Hamburger, Fish, Chicken, and Steak

About half the calories in these products come from supposedly benevolent vegetable fats, and the balance from varying amounts of protein and slow-acting carbohydrate. They are easy to cook in a skillet or microwave. Protein and carbohydrate content should be read from the labels and counted in your meal plan (see Chapter 6 for details). The principal value of these foods is for people who are vegetarian or want to avoid red meat. Health food stores stock many of these products, and so do a growing number of supermarkets.
Certain Commercially Prepared
and Homemade Soups
Although most commercial and homemade soups contain large amounts of simple sugars, you can easily learn how to buy or prepare low- or zero-carbohydrate soups. Many but not all packaged bouillon preparations have no added sugar and only small amounts of carbohydrate. Check the labels or use the Clinistix/Diastix test. Plain consommé or broth in some restaurants may (rarely) be prepared without sugar. Again, check with Clinistix/Diastix.
Homemade soups, cooked without vegetables, can be made very tasty if they are concentrated. If you have a no-carbohydrate broth recipe you find appealing, try making it with half the water, or try reducing it considerably to make it richer. Herbs and spices, which have negligible amounts of carbohydrate, are great for adding flavor — and they also have been shown to contain many different kinds of beneficial phytochemicals, or nutrients found in plant foods. (See also “Mustard, Pepper, Salt, Spices, Herbs,” below.) Clam broth (not chowder) is usually very low in carbohydrate. In the United States you can also buy clam juices (not Clamato), which contain only about 2 grams of carbohydrate in 3 fluid ounces. The clam chowder recipe in this book is delicious.
Campbell’s canned beef bouillon and consommé contain only 1 gram carbohydrate per serving. College Inn canned chicken broth contains no carbohydrate. Most bouillon cubes are also low in carbohydrate. Read the labels.

Cheese, Butter, Margarine, and Cream
Most cheeses (other than cottage cheese; see below) contain approximately equal amounts of protein and fat and small amounts of carbohydrate, and you’ll have to figure the carbohydrate and protein into your meal plan. For people who want (unwisely, from a health standpoint) to avoid animal fats, there are some special soybean cheeses, which are not very tasty, and there’s hemp cheese. Cheese is an excellent source of calcium. Generally speaking, every ounce of whole-milk cheese contains approximately 1 gram carbohydrate and 6 grams of protein (which is equivalent to 1 ounce of other protein foods). There are exceptions to this; some Swiss cheese, for example, contains slightly more carbohydrate, and Gruyère contains virtually none. Generally speaking, where dairy products are concerned, the lower the fat, the higher the sugar lactose, with skim-milk cheeses containing the most lactose and the least fat, and butter containing no lactose and the most fat.

Cheese is made from fermented milk, a process in which most or all of the sugar is converted to carbon dioxide and water. Cottage cheese is only partly fermented and so still has a fair amount of lactose, so it should be avoided except in very small amounts, say about 2 tablespoons. Drycurd cottage cheese is sugar-free but may be hard to find. It is also known as farmer’s cheese and baker’s cheese. It has very little flavor.
Neither butter nor margarine will, in my experience, affect blood sugar significantly, and they shouldn’t be a problem as far as weight is concerned if you’re not consuming a lot of carbohydrate along with them. One tablespoon of cream has only 0.5 gram carbohydrate — it would take 8 tablespoons to raise my blood sugar 20 mg/dl.

The cheese puffs I like to make are low in carbohydrate and can be used instead of bread to make sandwiches (see the Cheese Puff Sandwich recipe on page 172).

Yogurt
Although personally I don’t enjoy yogurt, many of my patients feel they cannot survive without it. For our purposes plain whole-milk yogurt, unflavored, unsweetened, and without fruit, is a reasonable food. A full 8-ounce container of plain, Erivan brand, unflavored whole-milk yogurt contains only 11 grams of carbohydrate and 2 ounces of protein. You can even throw in some chopped vegetables and not exceed your 12-gram lunch carbohydrate limit (see the following chapter); some Middle Eastern and Indian dishes combine unsweetened yogurt with cucumbers, for example.

Do not use nonfat yogurt. The carbohydrate goes up to 17 grams in an 8-ounce container of unflavored nonfat yogurt.

Yogurt can be flavored with cinnamon, with Da Vinci brand syrups (see page 88), or with baking flavor extracts such as vanilla liquid. It can be sweetened with stevia liquid or powder, dissolved Equal or Splenda tablets, or liquid saccharin. Erivan brand yogurt is available at health food stores throughout the United States. If you read labels, you may find brands similarly low in carbohydrate in your supermarket; two such brands are Stonyfield Farm and Brown Cow Farm. Be sure to use only the whole-milk versions and
not the low-fat.


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.

Author’s Note:
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.