Read an Excerpt
Reversing Diabetes Cookbook
By Julian M. Whitaker Peggy Dace
Warner BooksCopyright © 2004 Julian Whitaker, M.D.
All right reserved.
Chapter OneDietary Principles for Reversing Diabetes
Diabetes is a condition marked by elevations in blood sugar. Therefore, a therapeutic diet for people with diabetes is one that helps keep blood sugar levels on an even keel, and that is exactly what the recipes in this book are designed to do. But that's not all. High levels of glucose in the blood overwhelm the kidneys' ability to reabsorb glucose, so it is excreted in the urine-along with substantial amounts of water-soluble nutrients. These nutrient losses are a significant contributor to the complications that plague so many diabetics. The recipes in this cookbook, which use vegetables, fruits, whole grains, beans, salmon, unrefined oils, and other nutrient-dense foods, will go a long way toward improving nutritional status and protecting against diabetic complications.
The foods recommended in this book also help control insulin levels, which are often elevated in people with diabetes. When cells are resistant to the signals of insulin to let glucose in, as they are in most type 2 diabetics, the pancreas responds by producing more and more insulin to clear glucose from the blood. This condition, called insulin resistance, is associated with increased risk of heart attack, hypertension, obesity, and other problems.
Final and equally important considerations in developing these recipes were taste and ease of preparation. No matter how healthy-something might be, if it doesn't taste good, you aren't going to eat it. And although you want to eat right, you probably don't want to spend hours in the kitchen. Therefore, we've included a broad range of foods, cooking methods (most of them quick and easy), and types of cuisines to satisfy every taste. We've tested and retested every one of these recipes, and we hope you like them as much as we and the friends and family members who served as our "taste testers" do.
Before we dive into the recipes, let's review the principles of the diet for reversing diabetes.
Eat the Right Carbohydrates
Carbohydrate has become a dirty word in the past few years. This is nonsense. Of course, some carbohydrate-rich foods, such as breads and other products made with white flour, are bad news. But others, including vegetables, whole grains, beans, and fruits, are a very important part of a therapeutic diabetic diet. It all depends on how a particular carbohydrate is metabolized in the body.
Although all carbs are ultimately broken down into glucose and other simple sugars, the rate at which this happens varies. Some cause a rapid and dramatic rise in blood sugar levels, while others are digested more slowly and their sugars are released into the bloodstream more gradually. Several factors determine where a food falls in this spectrum, including the type of carbohydrate and amount of fiber it contains, how much it has been processed, how long it is cooked, even how acidic it is.
Researchers have devised a means of evaluating this and assigned a set of values to foods called the glycemic index. The higher the glycemic index of a particular food, the faster and more dramatic the rise in blood sugar after eating it. The glycemic index is obviously very useful for people with diabetes. However, because it ignores the amount of carbohydrate in an average serving of a food, it needed a little refining. Enter the glycemic load. The glycemic load of a food takes into account both the glycemic index and the number of carbs per serving, giving us a more reasonable indication of a food's impact on blood sugar.
Watermelon, for example, has a high glycemic index. However, a typical serving, because so much of it is water, contains very little carbohydrate and thus has a low glycemic load. Three-quarters of a cup of watermelon balls has fewer than nine grams of carbohydrate.
In contrast, a bagel, which also has a high glycemic index, has forty-seven grams of carbs and therefore a high glycemic load. (You would have to eat a heck of a lot of watermelon to have the same impact on your blood sugar that a single bagel would have.) This means that watermelon, carrots, and some other high-glycemic index foods that diabetics may previously have shied away from are perfectly acceptable. It can swing the other way as well. Although pasta has a moderately low glycemic index, because it is so carbohydrate-dense, it has a high glycemic load. This doesn't mean that you can't eat pasta, grains, and other dense carbs, but eat them in moderate quantities, as suggested in the recipes in this book. And check your blood sugar levels-some people tolerate more carbs than others. If breads, grains, pasta, beans, and other dense carbohydrates cause problems with blood sugar control, eat them less frequently and in smaller portions. (For more information on the glycemic index/load, visit Rick Mendosa's very informative Web site, mendosa.com.)
Glycemic index and glycemic load, of course, aren't the only considerations when selecting carbohydrate foods. Even though white sugar only has a moderately high glycemic index, it is devoid of nutrients, high in calories, and has no place in a healthy diet. In summary, minimally processed, fiber-rich, nutrient-dense, low-glycemic index vegetables, fruits, beans, and whole grains are your ticket to good blood sugar control, and they should be a foundation of your diet.
Adequate Protein Prevents Low Blood Sugar
It is important that everyone gets adequate amounts of protein, for the amino acids into which protein is broken down are used by the body to synthesize proteins for cellular repair and growth, as well as functional proteins like enzymes and hemoglobin. For people with diabetes, it is important for other reasons as well. Unlike carbohydrate, protein doesn't cause an immediate elevation in blood sugar, so replacing fast-burning carbohydrate with protein helps with blood sugar control. However, protein can raise blood sugar several hours after eating, as some amino acids are converted in the liver into glucose.
This is good, for it prevents between-meal hypoglycemia, or low blood sugar, which, if low enough, can be quite serious. Even if it's not life-threatening, hypoglycemia can make you tired, unfocused, irritable, and shaky. It also makes you ravenously hungry, and this is when you reach for chocolate, pretzels, and other high-glycemic carbs that quickly restore blood sugar levels.
We suggest that you eat some protein with every meal and snack, but select your protein sources wisely. Avoid saturated fat laden red meat, eat whole eggs only occasionally, and concentrate on fish, skinless poultry, low-fat dairy products, and protein-rich beans, legumes, soybeans, and tofu. (Note: If you have kidney disease, you'll need to cut back on your protein intake.)
Good Fats, Bad Fats
Dietary fat doesn't affect blood sugar one way or the other, so you may think that it doesn't matter how much fat you eat. Think again. Eating excesses of fat indirectly affects blood sugar control because it interferes with the actions of insulin and makes it less effective in clearing glucose out of the blood.
We're not suggesting that you eat a very low-fat diet-fat is a vital dietary component. But it is important to eat the right types of fats. Excessive intake of saturated fat found in red meat, butter, whole milk, and egg yolks raises levels of harmful LDL cholesterol and increases risk of heart disease and stroke. Occasional intake is fine, but don't make these items a daily habit. Stay completely away from trans fatty acids, which are found extensively in partially hydrogenated fats and in fried and commercially baked foods. These unnatural fats are much worse than saturated fats, for they also lower protective HDL cholesterol.
On the other hand, monounsaturated fats in olive oil, avocados, almonds, and other nuts actually protect against cardiovascular disease. And the polyunsaturated essential fatty acids in fish oils, nuts, and unprocessed vegetable oils have a multitude of health benefits. Enjoy these healthful fats, but don't go overboard, especially if you're trying to lose weight, for they are quite calorie intense.
Do Not Overeat
Not everyone with type 2 diabetes is overweight, but most are. The primary reason people gain weight is because they take in more calories than they expend. And the leading reason for this, lack of exercise notwithstanding, is because we're eating more than ever.
Researchers at New York University recently looked at the average portion sizes served today and compared them to those of several years ago, as well as to the United States Department of Agriculture standards. They found that across the board, serving sizes have ballooned-and they dramatically exceed what the USDA has established as average portions. From hamburgers and French fries to soft drinks and beer, "supersize" is all the rage. And it goes beyond fast food. Today's typical bagel is almost twice as big as the standard serving size set by the USDA, muffins are more than three times larger-and servings of pasta are almost five times heftier.
We urge you to heed the serving sizes in the recipes. If you compare the amounts of food we recommend to what you would get in a restaurant, you may think they are skimpy servings indeed. Yet they meet or exceed recommended portions. If you're still hungry, fuel up on salad, vegetables, and lean protein. Do not increase your portion sizes of starchy carbs such as pasta and bread. Better yet, eat moderately at meals and enjoy between-meal snacks, which encourage better blood sugar control.
Here are some visual size guidelines to help you estimate appropriate serving sizes:
Fish, chicken, or meat: 3 to 4 ounces = a deck of cards
Cheese: 1 ounce = a domino
Cooked pasta, rice, and beans: H cup = half a baseball
Raw vegetables: 1 cup = a baseball
Fruit: medium piece = a tennis ball
Dried fruit: G cup = a golf ball
In Praise of Snacking
If you're like most people, you eat two or three big meals a day, not necessarily when you're hungry but when the clock says it's time to eat. Most of us work, so we're unable to disregard the clock completely.
However, you can return to a more natural, healthier way of eating by partaking moderately at meals and having small snacks between meals.
We evolved as grazers, nibbling our way through the day. The natural time to eat is when you're hungry-and only enough to leave you satiated. This is particularly important for people who have diabetes. Eating smaller, more frequent meals promotes better blood sugar control, and this is especially true if those meals and snacks consist of reasonable amounts of low-glycemic carbohydrates, protein, and healthful fats. These foods fill you up and tide you over. You will feel more satiated throughout the day and have fewer blood sugar swings.
In addition to your regular meals, you should eat a small snack mid-morning, mid-afternoon, and before bedtime. Recent research suggests that a protein snack at bedtime helps maintain adequate blood sugar levels through the night. The ideal snack should be similar to the ideal meal, only smaller. Don't forget, healthy snacking also means eating less at meals. Eating snacks on top of high-calorie meals is a ticket for weight gain.
Leftovers are perfect snacks. A small serving of most any of the main dishes or soups in this cookbook makes an ideal snack. Other recipes are worth making just to have on hand for snacks.
Oatmeal Breakfast Cake: Cakelike squares of sweetened oatmeal that you can eat at room temperature or heat for a few seconds in a microwave.
Apricot-Oat Granola Bars: Cookielike and chewy, easy to tuck into a bag or lunch box.
Blueberry, Applesauce, and Oat Bran-Apricot Muffins: These recipes make twelve; reheat leftovers for a snack.
Catalina Crab Dip: Eat with raw vegetables.
Chicken and Wild Rice Salad and Chicken-Grape Salad: Pull out a small serving of these cold chicken salads between meals.
Texas Caviar: Down-home black-eyed pea salad.
Falafel Sandwiches with Garlic Sauce: Have falafel patties without the bread.
Crispy Cookie Bars: Sesame seeds and oatmeal keep these cookies healthy.
THINGS YOU CAN QUICKLY THROW TOGETHER IN THE KITCHEN
Cheese "Danish": The combination of cottage cheese, fruit and sprouted-grain bread makes this a complete snack.
Cinnamon-Applesauce Toast: Heated under the broiler until bubbly and warm.
Tutti-Frutti, Purple Haze, and Peach Smoothies: Protein powder raises these fruit drinks a notch.
Nutty Breakfast Ambrosia: A delicious combo of fruit, nuts, and yogurt.
Creamy Smoked Salmon: Great on a slice of toasted rye bread.
Brandon's Bean Dip: Beans, salsa, and cheese-wrap some in a tortilla.
Spicy Hummus: Eat this garbanzo bean spread on pita bread.
Zesty Cottage Cheese: A yummy combination of cottage cheese, radishes, onions, and green chiles.
HALF OF ANY ONE OF THESE QUICK AND EASY SANDWICHES
Smoked Salmon Sandwiches Chicken-Chile Quesadillas Smart Hot Dogs Gourmet PB&Js Southwest Wraps Crunchy Tuna Sandwiches Chicken Caesar Salad Wraps
OTHER SNACK IDEAS
Nuts and seeds: 2 tablespoons of raw almonds, sunflower seeds, pumpkin seeds, and other nuts and seeds
Apples and nut butter: A small sliced apple with a tablespoon of almond butter
Cottage cheese: Nonfat or low-fat, 1.2 to 3.4 cup
Yogurt: Nonfat plain yogurt, 3.4 cup, with a little stevia-or xylitol-sweetened fruit
Turkey on rye: A slice of turkey or chicken on a RyKrisp cracker
Fruit and nuts: A small piece, plus 1 tablespoon of nuts Edamame: 1.2 cup of boiled soybeans in their pods
Whitaker Wellness Health & Nutrition Bar: See "Resources" for details on this healthy, low-glycemic snack bar
A One-Week Menu Plan
Sitting down once a week and planning what you're going to eat during that week saves a lot of bother, frustration, and time. No more gazing into the open fridge or freezer, hoping for an inspiration for the night's dinner. No more starting to cook a recipe, only to realize that you don't have all the ingredients. No more multiple trips to the store to purchase forgotten items.
Planning your lunches, snacks, and other meals eaten away from home is particularly important, or you'll catch yourself eating out more often than not and grabbing whatever snack you can get your hands on. Leftovers and the sandwich and soup recipes make particularly good lunches, but if they aren't available to reheat or fix in a hurry, you're not going to bother. It seems as if we're always in a rush in the morning, so we've found that preparing the next day's lunch the evening before is the best way to go.
Excerpted from Reversing Diabetes Cookbook by Julian M. Whitaker Peggy Dace Copyright © 2004 by Julian Whitaker, M.D.. Excerpted by permission.
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